La Imagen y la Narrativa Como Herramientas Para el Abordaje Psicosocial en Escenarios de Violencia. Departamento de la Guajira Distrito Especial, Turístico y Cultural de Riohacha

Las etapas de los diferentes escenarios de violencia son variables, dependen del contexto en el cual fue vivida como observados, escuchados o narrados. Por medio de este informe final se tiene como propósito el análisis y comprensión desde nuestros conocimientos aprendidos como futuras psicólogas, planteándonos varios escenarios de violencia por medio de relatos vividos por parte de personas víctimas del conflicto armado. Por medio de un relato seleccionado se busca realizar un abordaje psicosocial en conjunto, con el fin de analizar los escenarios vividos por esta comunidad en general realizando un proceso de acompañamiento, con el propósito de generar un cambio en la vida de estas personas desde una mirada donde favorezca la empatía, el empoderamiento y la resiliencia; para generar una mirada hacia el futuro con fe y esperanza de una nueva vida buscando superar los hechos vividos y el sufrimiento de ser víctima del conflicto armado. Se realiza también el análisis del caso Pandurí en donde se busca generar reflexiones sobre su respectivo abordaje y cuáles deben ser las estrategias de acompañamiento psicosocial, desde una mirada analítica y comprensiva, para generar un cambio e impacto en esta población con el fin de mejorar su estilo de vida; siendo abordados desde todos los ámbitos como psicológico, mental, humano, físico, cultural, espiritual, familiar, comunitario y social para contribuir a reparar los impactos generados por dicha violencia. Por medio de las tres estrategias planteadas se busca realizar un abordaje completo dirigido a brindar las herramientas necesarias para la superación del daño generado en todos los ámbitos a estas personas, respetando sus derechos individuales y colectivos para permitir una adecuada confianza y empatía entre la persona, comunidad o familia abordada y la psicóloga encargada del abordaje para que sea más significativo el desarrollo del mismo.The stages of the different scenarios of violence are variable, depending on the context in which it was experienced as observed, heard or narrated. The purpose of this final report is to analyze and understand from our knowledge learned as future psychologists, posing various scenarios of violence through stories lived by people victims of the armed conflict. By means of a selected story, we seek to carry out a psychosocial approach together, in order to analyze the scenarios experienced by this community in general, carrying out a process of accompaniment, with the purpose of generating a change in the lives of these people from a perspective where it fosters empathy, empowerment and resilience; to generate a look towards the future with faith and hope for a new life, seeking to overcome the facts lived and the suffering of being a victim of the armed conflict. The analysis of the Pandurí case is also carried out, where it seeks to generate reflections on its respective approach and what the psychosocial support strategies should be, from an analytical and comprehensive perspective, to generate a change and impact in this population in order to improve their Lifestyle; being approached from all areas such as psychological, mental, human, physical, cultural, spiritual, family, community and social to help repair the impacts generated by said violence. Through the three strategies proposed, we seek to carry out a comprehensive approach aimed at providing the necessary tools to overcome the damage generated in all areas to these people, respecting their individual and collective rights to allow adequate trust and empathy between the person, community or family approached and the psychologist in charge of the approach so that its development is more significant

Adaptación cultural y propiedades psicométricas iniciales del instrumento DISABKIDS ® – Cystic Fibrosis Module – versión brasileña

This study aimed to perform the cultural adaptation and describe the initial psychometric properties of the DISABKIDS®−Cystic Fibrosis Module instrument to measure health-related quality of life for children and adolescents and their parents/caregivers. Methodological study of sequential development, including 126 participants in four Brazilian states. Involved translation and back translation of items, semantic and conceptual equivalence, face validity and description of the initial psychometric properties related to the construct and reliability. For semantic equivalence of the adapted version, there were adjustments in the phrasing of an item. The instrument showed satisfactory internal consistency with Cronbach’s alpha values between 0.70 and 0.85, convergent validity with correlation values above 0.40 in 85% of the items and divergent validity with scale fit higher than 75%. The Brazilian version of DISABKIDS® – CFM will certainly constitute a valid and reliable instrument for measuring the quality of life of Brazilian children and adolescents with cystic fibrosis.Este estudio tuvo como objetivo adaptar culturalmente y describir las propiedades psicométricas iniciales del instrumento de medida de la calidad de vida relacionada a la salud, DISABKIDS® – Cystic Fibrosis Module para niños/adolescentes y sus padres/cuidadores. Estudio metodológico de desarrollo secuencial, incluyendo 126 participantes en cuatro estados brasileños. Envolvió la traducción y retro-traducción de los ítems, la equivalencia conceptual y semántica, la validez externa y la descripción de las propiedades psicométricas iniciales con relación al constructo y la confiabilidad. Para la equivalencia semántica de la versión adaptada hubo ajustes en la redacción de un ítem. El instrumento presentó consistencia interna satisfactoria con valores de alfa de Cronbach entre 0,70 y 0,85, validez convergente con valores de correlación superiores a 0,40 en 85% de los ítems y validez divergente con valores de ajuste superiores a 75%. La versión brasileña del DISABKIDS® - CFM ciertamente será un instrumento válido y confiable para medir la Calidad de Vida de niños y adolescentes con fibrosis quística.Este estudo objetivou adaptar culturalmente e descrever as propriedades psicométricas iniciais do instrumento de mensuração de qualidade de vida relacionada à saúde DISABKIDS® − Cystic Fibrosis Module para crianças e adolescentes e seus pais/cuidadores. Estudo metodológico de desenvolvimento sequencial, incluindo 126 participantes em quatro estados brasileiros. Envolveu tradução e retrotradução dos itens, equivalência conceitual e semântica, validade de face e descrição das propriedades psicométricas iniciais relacionadas ao construto e fidedignidade . Para equivalência semântica da versão adaptada houve ajustes na redação de um item. O instrumento apresentou consistência interna satisfatória com valores de alfa de Cronbach entre 0,70 e 0,85, validade convergente com valores de correlação acima 0,40 em 85% dos itens e validade divergente com valores de ajuste superiores a 75%. A versão brasileira do DISABKIDS® - CFM certamente se constituirá em um instrumento válido e confiável para a mensuração da qualidade de vida de crianças e adolescentes brasileiros com fibrose cística.Universidade de São Paulo Escola de Enfermagem de Ribeirao PretoUniversidade Federal de São Paulo (UNIFESP)Universidade Federal do Rio Grande do Sul Departamento de Odontologia Preventiva e SocialHospital das Clinicas Hospital das ClinicasFaculdade de Medicina Faculdade de MedicinaUniversidade de São PauloUniversitatsklinikim Hambug-EppendorfUNIFESPSciEL

Adaptação cultural e propriedades psicométricas iniciais do instrumento DISABKIDS ® – Cystic Fibrosis Module – versão brasileira

This study aimed to perform the cultural adaptation and describe the initial psychometric properties of the DISABKIDS®−Cystic Fibrosis Module instrument to measure health-related quality of life for children and adolescents and their parents/caregivers. Methodological study of sequential development, including 126 participants in four Brazilian states. Involved translation and back translation of items, semantic and conceptual equivalence, face validity and description of the initial psychometric properties related to the construct and reliability. For semantic equivalence of the adapted version, there were adjustments in the phrasing of an item. The instrument showed satisfactory internal consistency with Cronbach’s alpha values between 0.70 and 0.85, convergent validity with correlation values above 0.40 in 85% of the items and divergent validity with scale fit higher than 75%. The Brazilian version of DISABKIDS® – CFM will certainly constitute a valid and reliable instrument for measuring the quality of life of Brazilian children and adolescents with cystic fibrosis.Este estudio tuvo como objetivo adaptar culturalmente y describir las propiedades psicométricas iniciales del instrumento de medida de la calidad de vida relacionada a la salud, DISABKIDS® – Cystic Fibrosis Module para niños/adolescentes y sus padres/cuidadores. Estudio metodológico de desarrollo secuencial, incluyendo 126 participantes en cuatro estados brasileños. Envolvió la traducción y retro-traducción de los ítems, la equivalencia conceptual y semántica, la validez externa y la descripción de las propiedades psicométricas iniciales con relación al constructo y la confiabilidad. Para la equivalencia semántica de la versión adaptada hubo ajustes en la redacción de un ítem. El instrumento presentó consistencia interna satisfactoria con valores de alfa de Cronbach entre 0,70 y 0,85, validez convergente con valores de correlación superiores a 0,40 en 85% de los ítems y validez divergente con valores de ajuste superiores a 75%. La versión brasileña del DISABKIDS® - CFM ciertamente será un instrumento válido y confiable para medir la Calidad de Vida de niños y adolescentes con fibrosis quística.Este estudo objetivou adaptar culturalmente e descrever as propriedades psicométricas iniciais do instrumento de mensuração de qualidade de vida relacionada à saúde DISABKIDS® − Cystic Fibrosis Module para crianças e adolescentes e seus pais/cuidadores. Estudo metodológico de desenvolvimento sequencial, incluindo 126 participantes em quatro estados brasileiros. Envolveu tradução e retrotradução dos itens, equivalência conceitual e semântica, validade de face e descrição das propriedades psicométricas iniciais relacionadas ao construto e fidedignidade . Para equivalência semântica da versão adaptada houve ajustes na redação de um item. O instrumento apresentou consistência interna satisfatória com valores de alfa de Cronbach entre 0,70 e 0,85, validade convergente com valores de correlação acima 0,40 em 85% dos itens e validade divergente com valores de ajuste superiores a 75%. A versão brasileira do DISABKIDS® - CFM certamente se constituirá em um instrumento válido e confiável para a mensuração da qualidade de vida de crianças e adolescentes brasileiros com fibrose cística

Câncer ginecológico e suas políticas públicas sob a perspectiva de Peplau

When paralleling the Interpersonal Theory with public health policies in Brazil and the assistance to women in health promotion, prevention or treatment of gynecological cancer, it is reflected that gynecological cancer in women is seen by the woman herself as a part of your self, is your femininity, your identity; concepts which are deeply crushed by the news of a cancer diagnosis. In view of the exchange of experiences at the time of assistance, Peplau states that the assistance and the relationship of those involved are influenced by the external environment (environment), internal environment (personality, lived experiences, religion, culture) and the professional's posture. In this scenario of a fragile and frightened woman, often without due privacy or attention due to the lack of inputs, structure and high demand from the public health service in Brazil, her assistance can be compromised, precisely because she does not have interpersonal skills, either in promotion health, prevention or treatment. It can be said that information is a precious asset when it comes to health care. In addition to the correct information, the nursing professional and the others who form the multidisciplinary team need to have an empathetic, humanized, welcoming attitude, based on science, ethics and respect for the woman's life, in order to pass the correct information in the correct way for greater adherence. Given “golden assistance”, it is only possible based on public training policies for its employees, which certainly not only update and train professionals, they save lives.Ao realizar um paralelo da Teoria Interpessoal com as políticas públicas de saúde do Brasil e a assistência à mulher na promoção da saúde, prevenção ou tratamento de câncer ginecológico, reflete-se que o câncer ginecológico em mulheres é visto pela própria mulher como uma parte do seu eu, é a sua feminilidade, sua identidade; conceitos os quais são profundamente esmagados com a notícia de um diagnóstico de câncer. Tendo em vista a troca de experiências na hora da assistência, Peplau afirma que a assistência e o relacionamento dos envolvidos são influenciados pelo meio externo (ambiente), meio interno (personalidade, experiências vividas, religião, cultura) e pela postura do profissional. Neste cenário de uma mulher fragilidade e amedrontada, muitas vezes sem a devida privacidade ou atenção pela falta de insumos, estrutura e alta demanda do serviço público de saúde do Brasil, sua assistência pode ser comprometida, justamente por não ter a interpessoalidade, seja na promoção da saúde, prevenção ou tratamento. Pode-se dizer que a informação é um bem precioso quando se trata de assistência à saúde. Além da informação correta, o profissional de enfermagem e os demais que formam a equipe multidisciplinar precisam ter uma postura empática, humanizada, de acolhimento, fundamentadas na ciência, ética e respeito à vida da mulher, a fim de passar a informação correta da forma correta para a maior adesão. Dada “assistência de ouro” só é possível a partir de políticas públicas de capacitação de seus colaboradores que, certamente, não apenas atualizam e capacitam o profissional, salvam vidas

Long-Acting Injectable Cabotegravir for HIV Preexposure Prophylaxis Among Sexual and Gender Minorities: Protocol for an Implementation Study

BackgroundLong-acting injectable cabotegravir (CAB-LA) for preexposure prophylaxis (PrEP) has proven efficacious in randomized controlled trials. Further research is critical to evaluate its effectiveness in real-world settings and identify effective implementation approaches, especially among young sexual and gender minorities (SGMs). ObjectiveImPrEP CAB Brasil is an implementation study aiming to generate critical evidence on the feasibility, acceptability, and effectiveness of incorporating CAB-LA into the existing public health oral PrEP services in 6 Brazilian cities. It will also evaluate a mobile health (mHealth) education and decision support tool, digital injection appointment reminders, and the facilitators of and barriers to integrating CAB-LA into the existing services. MethodsThis type-2 hybrid implementation-effectiveness study includes formative work, qualitative assessments, and clinical steps 1 to 4. For formative work, we will use participatory design methods to develop an initial CAB-LA implementation package and process mapping at each site to facilitate optimal client flow. SGMs aged 18 to 30 years arriving at a study clinic interested in PrEP (naive) will be invited for step 1. Individuals who tested HIV negative will receive mHealth intervention and standard of care (SOC) counseling or SOC for PrEP choice (oral or CAB-LA). Participants interested in CAB-LA will be invited for step 2, and those with undetectable HIV viral load will receive same-day CAB-LA injection and will be randomized to receive digital appointment reminders or SOC. Clinical appointments and CAB-LA injection are scheduled after 1 month and every 2 months thereafter (25-month follow-up). Participants will be invited to a 1-year follow-up to step 3 if they decide to change to oral PrEP or discontinue CAB-LA and to step 4 if diagnosed with HIV during the study. Outcomes of interest include PrEP acceptability, choice, effectiveness, implementation, and feasibility. HIV incidence in the CAB-LA cohort (n=1200) will be compared with that in a similar oral PrEP cohort from the public health system. The effectiveness of the mHealth and digital interventions will be assessed using interrupted time series analysis and logistic mixed models, respectively. ResultsDuring the third and fourth quarters of 2022, we obtained regulatory approvals; programmed data entry and management systems; trained sites; and performed community consultancy and formative work. Study enrollment is programmed for the second quarter of 2023. ConclusionsImPrEP CAB Brasil is the first study to evaluate CAB-LA PrEP implementation in Latin America, one of the regions where PrEP scale-up is most needed. This study will be fundamental to designing programmatic strategies for implementing and scaling up feasible, equitable, cost-effective, sustainable, and comprehensive alternatives for PrEP programs. It will also contribute to maximizing the impact of a public health approach to reducing HIV incidence among SGMs in Brazil and other countries in the Global South. Trial RegistrationClinicaltrials.gov NCT05515770; https://clinicaltrials.gov/ct2/show/NCT05515770 International Registered Report Identifier (IRRID)PRR1-10.2196/4496

PET/CT Imaging as a Diagnostic Tool in Distinguishing Well-Differentiated versus Dedifferentiated Liposarcoma

Distinguishing well-differentiated liposarcoma (WDLPS) from dedifferentiated liposarcoma (DDLPS) is essential given distinct treatment paradigms and chemosensitivity. Percutaneous biopsy has a low sensitivity for detecting DDLPS. We sought to identify the diagnostic utility of positron emission tomography/computed tomography (PET/CT) in identifying WDLPS versus DDLPS. An independent radiologist reviewed PET/CT images to identify target lesions and determine the maximum standardized uptake value (SUVmax). An independent pathologist review confirmed WDLPS or DDLPS histology. A binary cutoff point of SUVmax was identified using a classification and regression trees (CART) algorithm. We identified 20 patients with WDLPS or DDLPS with 26 PET/CTs performed for separate recurrences that were followed by surgical sampling. Of the 26 records, 12 were DDLPS (46%) and 14 were WDLPS (54%). Patients with DDLPS had significantly higher SUVmax than those with WDLPS (p value = 0.0035). A SUVmax of 4 was identified as the cutoff point. Using this cutoff, the sensitivity of SUVmax identifying a case as DDLPS was 83.3% (95% CI: 51.6%, 97.9%) and the specificity was 85.7% (95% CI: 57.2%, 98.2%). PET/CT is a sensitive and specific diagnostic tool to identify the presence of dedifferentiation within the tumor