O conhecimento dos Acadêmicos de Enfermagem sobre Saúde Mental e o mercado generalista emergente

The aim of this study was to identify and evaluate the knowledge of nursing students on Mental Health, answering the question: "Do nursing students feel prepared for the emerging market in Mental Health, aiming at psychosocial care, in practice?". It was a descriptive study, with a qualitative approach, conducted at a private university located in the State of Rio de Janeiro, with 17 academics from the last nursing periods. The data collected in the interviews were analyzed using Bardin's Content Analysis method, which made it possible to emerge three thematic categories: The clinical case, the paradigm of medicating, containing, and monitoring and social stigmas. The students found it difficult to rationalize the clinical case of a routine nature in general hospitals; with speeches full of stigmas and prejudices and difficulties in implementing the new model of assistance in Mental Health, proposed in graduation. On the other hand, curricular changes obtained so far have not been able to guarantee comprehensive care in the area, claiming to resolve gaps and uncertainties that will guarantee a more complete academic education, while the emerging generalist market demands professionals more and more apt in this issue of Health Public.Objetivou-se com o presente trabalho identificar e avaliar o conhecimento dos discentes de enfermagem sobre Saúde Mental, respondendo à questão: “Os acadêmicos de Enfermagem se sentem preparados para o mercado emergente em Saúde Mental, visando o cuidado psicossocial, na prática?”. Foi um estudo descritivo, com abordagem qualitativa, realizado em uma universidade privada localizada no Estado do Rio de Janeiro, com 17 acadêmicos dos últimos períodos de enfermagem. Os dados coletados nas entrevistas foram analisados pelo método de Análise de Conteúdo de Bardin, o que tornou possível a emersão de três categorias temáticas: O caso clínico, o paradigma do medicar, conter e vigiar e estigmas sociais. Os discentes encontraram dificuldade em racionalizar o caso clínico de caráter rotineiro em hospitais gerais; com falas repletas de estigmas e preconceitos e dificuldades em implementar o novo modelo de assistência em Saúde Mental, proposto na graduação. Por outro lado, alterações curriculares obtidas até então não têm dado conta de garantir um cuidado integral na área, clamando por resolver lacunas e incertezas que garantirão uma formação acadêmica mais completa, enquanto o mercado generalista emergente demanda profissionais cada vez mais aptos nessa questão de Saúde Pública

Skills in Reading and Mathematics: Perceptions of Teachers about the Possible Impacts of Remote Teaching on Students of the Elementary School, from a Neuropsychopedagogical Perspective

This study analyzed impacts caused by the emergency implementation of distance education, during the COVID 19 Pandemic, through the perceptions of 6th grade teachers in public schools located in Baixada Fluminense, State of Rio de Janeiro. Teachers participated, among the subjects of Portuguese Language and Mathematics, through Google Forms, which made it possible to collect data from those who are on the front line, working directly with our students. Our data proved that the pedagogical losses that occurred during the implementation period of remote teaching are significant. Therefore, we point out paths that are already yielding excellent results through evidence shown in schools, in loco, with the inclusion of Neuropsychopedagogy protocols, the science of learning. The notes and study shown here about the impacts of remote teaching on the learning of our students in basic skills in the curricular components of reading and Mathematics, suggest a great need to intensify studies on the subject and propose a dialogue with the theoretical and methodological contributions of Neuropsychopedagogy

Plantas alimentícias não convencionais (PANC) nos levantamentos etnobotânicos do Brasil

O termo PANC – Plantas Alimentícias Não Convencionais – refere-se às plantas alimentícias que possuem uma ou mais partes comestíveis, apresentando grande potencial econômico e biológico. O objetivo deste trabalho é realizar levantamentos sobre Plantas Alimentícias Não Convencionais (PANC) nos estudos etnobotânicos do Brasil e propor uma releitura dos conceitos e subcategorizações de espécies. Foram identificadas 618 PANC nos estudos, subcategorizadas 542 como PANC comum, 64 como PANC em transição, 9 como PANC por parte consumida e 3 como PANC por forma de consumo. Esse novo olhar convida a uma reflexão sobre a mutabilidade do conhecimento e o desenvolvimento de ideias, aliado a necessidade de sobrevivência e manutenção da biodiversidade através do reconhecimento de muitas espécies em potencial. Essas estratégias favorecem a disseminação da informação e despertam possibilidades de consumo mais saudável, rentável e de caráter predominantemente sustentável para a população e o mundo, o que traduz uma das mais urgentes necessidades atuais

Association between respiratory capacity, quality of life and cognitive function in elderly individuals

OBJECTIVE: To investigate associations between respiratory capacity, quality of life and cognitive function in elderly individuals. METHODS: The sample included 386 elderly individuals (232 women). Respiratory capacity assessment was based on maximal expiratory pressure measured at peak expiratory flow. Subjects were classified according to peak expiratory flow values adjusted for sex, age and height of individuals with normal (peak expiratory flow curve 60%) or reduced (peak expiratory flow curve < 60%) respiratory capacity. The World Health Organization Quality of Life Questionnaire and the Mini-Mental State Examination were used to assess quality of life and cognitive function, respectively. RESULTS: Elderly women with reduced respiratory capacity scored lower on the Mini-Mental State Examination (p=0.048) and quality of life questionnaire (p=0.040) compared to those with normal respiratory capacity. These differences were not observed in men (p>0.05). CONCLUSION: Reduced respiratory capacity was associated with poorer quality of life and cognitive function in elderly women. These associations were not observed in elderly men

Transcriptomic landscape of skin lesions in cutaneous leishmaniasis reveals a strong CD8(+) T cell immunosenescence signature linked to immunopathology

The severity of lesions that develop in patients infected by Leishmania braziliensis is mainly associated with a highly cytotoxic and inflammatory cutaneous environment. Recently, we demonstrated that senescent T and NK cells play a role in the establishment and maintenance of this tissue inflammation. Here, we extended those findings using transcriptomic analyses that demonstrate a strong co-induction of senescence and pro-inflammatory gene signatures in cutaneous leishmaniasis (CL) lesions. The senescence-associated signature was characterized by marked expression of key genes such as ATM, Sestrin 2, p16, p21 and p38. The cell type identification from deconvolution of bulk sequencing data showed that the senescence signature was linked with CD8+ effector memory and TEMRA subsets and also senescent NK cells. A key observation was that the senescence markers in the skin lesions are age-independent of patients and were correlated with lesion size. Moreover, a striking expression of the senescence-associated secretory phenotype (SASP), pro-inflammatory cytokine and chemokines genes was found within lesions that were most strongly associated with the senescent CD8 TEMRA subset. Collectively, our results confirm that there is a senescence transcriptomic signature in CL lesions and supports the hypothesis that lesional senescent cells have a major role in mediating immunopathology of the disease

poder profissional ameaçado?

O Kanban é um arranjo tecnológico de organização do cuidado hospitalar orientado para a gestão de leitos e da clínica, que visa à qualidade e integralidade da assistência, maior rotatividade dos leitos, com consequente redução do tempo de internação e custos hospitalares. O constante e atualizado acompanhamento do paciente, compartilhado pela equipe profissional em reuniões sistemáticas é seu elemento mais marcante e inovador. O objetivo foi caracterizar os prováveis impactos da adoção de tal arranjo no poder profissional (autonomia e autoridade) dos médicos. Estudo qualitativo em hospital de urgência-emergência municipal com uso das seguintes técnicas de produção de dados: etnografia do cotidiano do hospital, com observação e registro em diários de campo, e realização de seminários compartilhados entre pesquisadores e equipes. Os médicos valorizam o trabalho multiprofissional como um qualificador de sua prática, em uma linha auxiliar e complementar. Acresce que o Kanban tende a ser controlado por “híbridos” (médicos que acumulam funções gerenciais e clínicas) que traduzem sinergias entre “gestão clínica” e “gestão de leitos”. Assim, interferências no trabalho dos médicos não são exercidas de fora, e as suas decisões clínicas continuam a condicionar o trabalho dos demais grupos profissionais. Os médicos não percebem sua autoridade e autonomia ameaçadas pelo Kanban, dada a articulação entre a autoridade administrativa e a autoridade profissional. Contudo, aspectos relacionados à hibridização e estratificação interna da profissão médica precisam ser mais convocados para o debate do poder profissional em saúde. Kanban is a technical arrangement for the organization of hospital care focused on the management of beds and clinical care, aimed at the quality and comprehensiveness of care and greater hospital bed turnover, and thus a reduction in length-ofstay and hospital costs. The system's most striking and innovative feature is constant, updated patient follow-up, shared by the professional team in systematic meetings. Characterize the probable impacts from the arrangement's adoption on physicians' professional power (autonomy and authority). Qualitative study in a municipal urgency- emergency hospital using the following data production techniques: ethnography of the hospital's routine, with observation and records in field diaries, and shared seminars with researchers and teams. Physicians value multi-professional work for qualifying their practice, as an ancillary and complementary line. Kanban tends to be controlled by "hybrids" (physicians who accumulate management and clinical functions) that express synergies between "clinical management" and "hospital bed management". Thus, in this arrangement interferences in physicians' work are not exercised from outside, and physicians' clinical decisions still condition the work of the other professional groups. Physicians do not see their authority and autonomy threatened by Kanban, given the linkage between management authority and professional authority. Still, aspects related to hybridization and internal stratification of the medical profession need to be better addressed in the debate on health professionals' power. El Kanban es una solución tecnológica para la organización del cuidado hospitalario, orientada a la gestión de camas y apartado clínico, que tiene como meta la calidad e integralidad de la asistencia, una mayor rotatividad de las camas, con la consecuente reducción del tiempo de internamiento y costes hospitalarios. El seguimiento constante y actualizado del paciente, compartido por un equipo profesional en reuniones sistemáticas, es su característica más destacable e innovadora. Caracterizar los probables impactos en la adopción de tal solución tecnológica, respecto al poder profesional (autonomía y autoridad) de los médicos. Estudio cualitativo en un hospital de urgencias municipal, mediante el uso de las siguientes técnicas de producción de datos: etnografía del día a día del hospital, con observación y registro en diarios de campo, así como la realización de seminarios compartidos entre investigadores y equipos. Los médicos valoran el trabajo multiprofesional como un elemento que cualifica en su práctica, dentro de una línea auxiliar y complementaria. Añade que el Kanban tiende a estar controlado por “híbridos” (médicos que acumulan funciones de gerencia y clínicas) que se traducen en sinergias entre “gestión clínica” y “gestión de camas”. De esta forma, las interferencias en el trabajo de los médicos no se ejercen a partir de fuera y sus decisiones clínicas continúan condicionando el trabajo de los demás grupos profesionales. Los médicos no perciben que su autoridad y autonomía estén amenazadas por el Kanban, dada la coordinación entre la autoridad administrativa y la autoridad profesional. No obstante, los aspectos relacionados con la hibridización y estratificación interna de la profesión médica necesitan ser estudiados más para los debates sobre el poder profesional en salud.publishersversionpublishe

Utilization of the excimer laser and a moving piezoelectric mirror to accomplish the customized contact lens ablation to correct high-order aberrations

The use of the Hartman-Shack sensor in ophthalmology allowed the identification of higher-order aberrations, which make possible the search for methods to correct them. Customized refractive surgery is one of the most successful methods, although there are patients which cannot be submitted to this surgery due to a variety of abnormal limiting factors such as cornea thickness and quantity of higher-order aberrations. Being this an irreversible process, the alternative is to develop a non-surgical method. This work proposes a method to obtain personalized contact lenses to correct high-order aberrations via the development of a customized ablation system using an excimer laser and a moving piezoelectric mirror. The process to produce such lenses consists of four steps. 1) The map of total aberrations of the patient’s eye is measured by using an aberrometer with a Hartman-Shack sensor. 2) The measured aberration map is used to determine the maps for correction and related distribution of laser pulses for the ablation process with the excimer laser. 3) The lens production is performed following the same principle as customized refractive surgery. 4) The quality control of the lens is evaluated by two tests. 4.1) The lens is measured by a non-commercial lensometer, which is assembled specially for this measurement, as the ones commercially available are not capable of measuring asymmetric and irregular surfaces. 4.2) The evaluation of the lens-eye system is made using the aberrometer of the first step in order to verify the residual aberrations. Here, the lenses are ablated with a customized refractive surgery system.FAPESP (07/54195-6

RELAÇÃO DA AUTOPERCEPÇÃO DE SAÚDE, CAPACIDADE FUNCIONAL E CONDIÇÕES DE SAÚDE DE IDOSOS LONGEVOS RESIDENTES EM DOMICÍLIO EM JEQUIÉ - BA

A maior prevalência de doenças crônicas degenerativas e o declínio da capacidade funcional podem desencadear sentimentos negativos, acarretando numa qualidade de vida má ou péssima, sendo confirmada pela autopercepção de saúde. O objetivo desse estudo foi verificar a relação das condições de saúde e da capacidade funcional com a autopercepção de saúde de idosos longevos residentes em domicílio no município de Jequié-BA. Trata-se de uma pesquisa do tipo analítica com delineamento transversal, com uma amostra de 63 idosos longevos, residentes em domicílio em Jequié-BA. O instrumento utilizado é constituído de: avaliação cognitiva, informações sociodemográficas, estado de saúde e avaliação da capacidade funcional. A análise estatística dos dados foi descritiva por meio do Programa estatístico SPSS versão 20.0. Verificou-se uma maior frequência de idosos com presença de doenças (86,3%), com autopercepção de saúde referente positiva (63,3%), com presença de dor (62,4%) e que realiza tratamento (82,9%). Constatou-se no presente estudo que não houve relação entre as condições de saúde, capacidade funcional e autopercepção de saúde

Intranasal immunization with chitosan microparticles enhances LACK-DNA vaccine protection and induces specific long-lasting immunity against visceral leishmaniasis

Development of a protective vaccine against Leishmania depends on antigen formulation and adjuvants that induce specific immunity and long-lasting immune responses. We previously demonstrated that BALB/c mice intranasally vaccinated with a plasmid DNA encoding the p36/LACK leishmanial antigen (LACK-DNA) develop a protective immunity for up to 3 months after vaccination, which was linked with the systemic expression of vaccine mRNA in peripheral organs. In this study, LACK-DNA vaccine was associated with biocompatible chitosan microparticles cross-linked with glyceraldehyde (CMC) to boost the long-lasting immunity against the late Leishmania infantum challenge. Infection at 7 days, 3 or 6 months after vaccination resulted in significantly lower parasite loads when compared with non-vaccinated controls. Besides, LACK-DNA-chitosan vaccinated mice showed long-time protection observed after the late time point challenge. The achieved protection was correlated with an enhanced spleen cell responsiveness to parasite antigens, marked by increased proliferation and IFN-γ as well as decreased IL-10 production. Moreover, we found diminished systemic levels of TNF-α that was compatible with the better health condition observed in LACK-DNA/CMC vaccinated-infected mice. Together, our data indicate the feasibility of chitosan microparticles as a delivery system tool to extend the protective immunity conferred by LACK-DNA vaccine, which may be explored in vaccine formulations against Leishmania parasite infections