O contributo da intervenção psicomotora em meio aquático no comportamento adaptativo e nas competências em meio aquático de adolescentes e adultos com dificuldades intelectuais e desenvolvimentais

Artigo 1: O comportamento adaptativo (CA), como desempenho típico individual perante as exigências socioculturais, tem assumido um papel integrante na compreensão e definição da Dificuldade Intelectual e Desenvolvimental (DID), destacando-se o impacto do contexto ecológico. A introdução do CA exige uma mudança nas intervenções, com pessoas com DID, enfatizando a relação entre as capacidades intelectuais e adaptativas e o tipo de apoio para o funcionamento independente e participação social. A intervenção psicomotora parte do movimento e do corpo mediador como fatores basilares para a adaptação individual ao contexto, assumindose como um dos apoios prestados às pessoas com DID e que se pode operacionalizar em diferentes meios (e.g.: o aquático). A utilização da água para fins terapêuticos, é perspetivada como uma prática vantajosa, permitindo explorações psicomotoras, para um novo reportório corporal. Neste sentido, este artigo faz um enquadramento teórico do contributo que a intervenção psicomotora em meio aquático poderá assumir ao nível do comportamento adaptativo e nas competências em meio aquático, de adolescentes e adultos com dificuldades intelectuais e desenvolvimentais.Artigo 2: Apesar da intervenção psicomotora se assumir como um dos apoios prestados a pessoas com Dificuldades Intelectuais e Desenvolvimentais (DID) em contexto institucional, continua a fazer-se sentir a necessidade da sua compreensão e aplicação, sentindo-se a necessidade de monitorizar a sua efetividade. O meio aquático possibilita diversas experiências, sensações e aprendizagens que contribuem para o desenvolvimento individual. Este estudo analisa o contributo da intervenção psicomotora em meio aquático no comportamento adaptativo e nas competências em meio aquático de 4 adolescentes, entre os 14 e 17 anos (15.25±1.26) e 4 adultos entre os 24 e 45 anos (34.50±9.33), 6 do género masculino, com DID e institucionalizados. Todos os participantes foram avaliados em três momentos (baseline, pós-intervenção e um mês após a intervenção) através da Escala de Comportamento Adaptativo - versão Portuguesa e Checklist de Avaliação do Meio Aquático. Baseados nos resultados da avaliação baseline, foi planeado e implementado um programa de intervenção psicomotora em meio aquático durante 6 meses, com uma a duas sessões de 45 min por semana. Apesar dos resultados não traduzirem diferenças significativas, observaram-se melhorias qualitativas nas atividades de vida diária e em algumas competências em meio aquático. As principais conclusões e recomendações serão apresentadas.Article 1: Adaptive Behavior, focused on the quality of daily interaction between person and environment has become increasingly important in the newest definitions and comprehensive approach of intellectual and developmental disability (IDD), highlighting an ecological framework. Ensuring a better understanding of IDD as well as a multidimensional approach to human functioning, the introduction of the adaptive behavior construct and its assessment is demanding new and more adjusted interventions, emphasizing the relationship between intellectual and adaptive skills as well as the type of supports needed, for a more independent functioning and social participation. Psychomotor Therapy uses movement as a therapeutic tool and body as the mediating variable, through a wide range of movement activities for personal adaptation to community settings. Psychomotor Therapy is one of the services and supports provided, to people with IDD, in institutions and it can be applied within several environments such as water, due to its properties which allow different and new adjusted psychomotor experiences. This article aims to contribute for an theoretical framework on the contribution of psychomotor intervention in an aquatic environment in both adaptive behavior and aquatic skills of adolescents and adults with intellectual and developmental difficulties.Article 2: Nowadays, Psychomotor Therapy is one of the supports most provided to people with intellectual and developmental disabilities (IDD) in institutional contexts. Nevertheless, the need for its effectiveness assessment is still needed, due to scarce scientific evidences on the field. The aquatic environment provides varied experiences, feelings and learnings that contribute to personal development. Therefore, this study aims to analyze the contribution of a psychomotor therapy program in water, on the adaptive behavior and aquatic skills of 4 adolescents between 14 and 17 years (15:25 ± 1:26) and 4 adults between 24 and 45 years (34.50 ± 9:33), 6 male, with IDD, all institutionalized. All participants were evaluated in three different moments (baseline, post-intervention and one month after the intervention) through the Portuguese version of Adaptive Behavior Scale - and Aquatic Environment Checklist. Based on the baseline evaluation results, a 6-month aquatic psychomotor intervention program was planned and implemented, with one to two sessions of 45 min per week. Although results did not show significant differences, qualitative improvements were observed in daily life activities and in some aquatic skills. Main conclusions and recommendations to research and practice will be presented

Transcriptomic Analysis of Acetaminophen Biodegradation by Penicillium chrysogenum var. halophenolicum and Insights into Energy and Stress Response Pathways

Publisher Copyright: © 2023 by the authors. This research received no external funding(1) Background: Acetaminophen (APAP), an active component of many analgesic and antipyretic drugs, is one of the most concerning trace contaminants in the environment and is considered as an emergent pollutant of marine and aquatic ecosystems. Despite its biodegradability, APAP has become a recalcitrant compound due to the growth of the global population, the ease of availability, and the inefficient wastewater treatment applied. (2) Methods: In this study, we used a transcriptomic approach to obtain functional and metabolic insights about the metabolization of APAP by a phenol-degrading fungal strain, Penicillium chrysogenum var. halophenolicum. (3) Results: We determined that the transcriptomic profile exhibited by the fungal strain during APAP degradation was very dynamic, being characterized by an abundance of dysregulated transcripts which were proportional to the drug metabolization. Using a systems biology approach, we also inferred the protein functional interaction networks that could be related to APAP degradation. We proposed the involvement of intracellular and extracellular enzymes, such as amidases, cytochrome P450, laccases, and extradiol-dioxygenases, among others. (4) Conclusions: Our data suggested that the fungus could metabolize APAP via a complex metabolic pathway, generating nontoxic metabolites, which demonstrated its potential in the bioremediation of this drug.publishersversionpublishe

DNA damage induced by hydroquinone can be prevented by fungal detoxification

© 2014 The Authors. Published by Elsevier Ireland Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/3.0/).Hydroquinone is a benzene metabolite with a wide range of industrial applications, which has potential for widespread human exposure; however, the toxicity of hydroquinone on human cells remains unclear. The aims of this study are to investigate the cytotoxicity and genotoxicity of hydroquinone in human primary fibroblasts and human colon cancer cells (HCT116). Low doses of hydroquinone (227-454 μM) reduce the viability of fibroblasts and HCT116 cells, determined by resazurin conversion, and induce genotoxic damage (DNA strand breaks), as assessed by alkaline comet assays. Bioremediation may provide an excellent alternative to promote the degradation of hydroquinone, however few microorganisms are known that efficiently degrade it. Here we also investigate the capacity of a halotolerant fungus, Penicillium chrysogenum var. halophenolicum, to remove hydroquinone toxicity under hypersaline condition. The fungus is able to tolerate high concentrations of hydroquinone and can reverse these noxious effects via degradation of hydroquinone to completion, even when the initial concentration of this compound is as high as 7265 μM. Our findings reveal that P. chrysogenum var. halophenolicum efficiently degrade hydroquinone under hypersaline conditions, placing this fungus among the best candidates for the detoxification of habitats contaminated with this aromatic compound.This work was partially supported by a Gulbenkian Foundation research grant (#96526/2009) awarded to JF, and PD received support from Fundação para a Ciência e Tecnologia/FCT-Portugal (SFRH/BD/45502/2008).info:eu-repo/semantics/publishedVersio

COMUNICAÇÃO PROXÊMICA ENTRE MÃE E RECÉM-NASCIDO DE RISCO NA UNIDADE NEONATAL

Estudio descriptivo y exploratorio con el objetivo de analizar la conducta espacial del binomio madre y recién nacido (RN) internados en uma Unidad de Terapia Intensiva Neonatal – UTIN en Fortaleza-Ceará, de octubre/ noviembre/2006. 20 madres y 20 RN compusieron la amuestra. Se utilizó seis factores de la Teoria Proxémica de Hall. Los resultados señalaron tres ángulos de interacción entre madre y RN: dieciocho madres friente a friente, una lateral, una de espaldas. Factor proxémica y factores cinésicos, quince madres adoptaron una distancia íntima, cuatro distancia personal, una distancia social. Mientras a las expresiones faciales de las madres se observó con mayor frecuencia la sonrisa (9), tranquilidad (7); entre los RN’s, lloro (13) y tranquilidad (7). En el comportamiento de contacto, la mayoría de las madres acariciaron (16), palparon (14), tenieron en las manos demoradamente (15). En el código de vista, diecinueve madres miraron sus hijos. En el volumen de la voz, hablaron bajo (14), normal (2). Se concluye que los comportamientos señalados por los factores permitieron evaluar el comportamiento espacial del binomio madre e recién nacido

Reasons for non-compliance of mothers to immunization schedule of children exposed to HIV

We aimed to describe the knowledge of HIV seropositive mother on the children immunization schedule and know the reasons for their non-compliance to the children immunization schedule. This is a descriptive study with qualitative approach carried out in the outpatient clinic of a public institution, in Fortaleza-CE, Brazil. The subjects were 16 mothers or caregivers of children up to two years of age exposed to HIV/AIDS. Data collection happened through semi-structured interviews conducted from January to March 2012. Two categories emerged from the analysis: Lack of knowledge of mother about special immunization schedule for children with HIV and Reasons for non-compliance to special immunization schedule. Mothers presented poor knowledge, fear and disinterest in the information on the disease and preventive measures, as well as the difficulties faced. Health professionals should promote strategies with these mothers seeking integration, commitment and comprehension of the importance of immunization in children

MOTIVOS DA NÃO ADESÃO DE MÃES AO ESQUEMA VACINAL DE FILHOS EXPOSTOS AO HIV

El objetivo fue describir el conocimiento de madre seropositiva al VIH sobre el calendario de vacunación del hijo y conocer las razones de no adhesión al esquema de vacunas del hijo. Estudio descriptivo, cualitativo, llevado a cabo en ambulatorio de institución pública de Fortaleza-CE, Brasil. Participaron 16 madres/cuidadoras de niños con hasta dos años expuestos al VIH/SIDA. Los datos fueron recolectados a través de entrevista semiestructurada, de enero a marzo/2012. Del análisis, emergieron dos categorías: desconocimiento de la madre acerca de las vacunas especiales en niños con VIH y razones de la no adherencia al programa de vacunación especial. Las madres presentaron deficiencia de conocimiento, señalaron miedo y desinterés por informaciones sobre la enfermedad y las medidas preventivas, además de dificultades enfrentadas. Los profesionales de salud deben promover acciones con estas madres para integración, responsabilidad y atención acerca de la importancia de las vacunas a la salud del hijo

Promoção de saúde da mulher : desafios e tendências

A enfermagem de saúde materna e obstétrica focada na saúde sexual e reprodutiva apresenta-se como eixo central nesta edição didática, de cariz metodológico. São apresentados oito artigos de revisão, seis utilizam o método de revisão integrativa da literatura e dois artigos utilizam a Scoping Review, com vista à identificação ou mapeamento da síntese do conhecimento produzido. As temáticas apresentadas são as seguintes: literacia em sexualidade e a adoção de comportamentos de risco em estudantes do ensino superior: uma revisão integrativa da literatura; conhecimentos dos enfermeiros sobre métodos modernos de planeamento familiar natural para evitar uma gravidez: uma scoping review; adesão dos casais aos programas de preparação para o nascimento com o enfermeiro especialista de saúde materna e obstétrica: uma revisão integrativa da literatura; intervenções do enfermeiro especialista durante o trabalho de parto consideradas como cuidados centrados na mulher/casal: uma revisão integrativa da literatura; o efeito da massagem no alívio da dor de trabalho de parto: uma scoping review; complicações maternas e fetais decorrentes da utilização da manobra de kristeller durante o período expulsivo: uma revisão integrativa da literatura; distócia de ombros, manobras a implementar: uma revisão integrativa da literatura; Disfunções do pavimento pélvico durante o primeiro ano após o parto: uma revisão integrativa da literatura.Maternal and obstetric health nursing focused on sexual and reproductive health is the central axis of this didactic and methodological edition. Eight review articles are presented, six use the integrative literature review method and two articles use the Scoping Review, with a view to identifying or mapping the synthesis of the knowledge produced. The themes presented are the following: Sexual literacy and the adoption of risk behaviors in higher education students; Nurses’ knowledge of modern natural family planning methods to avoid pregnancy: a scoping review; Couples' adherence to birth preparation programs with a maternal and obstetric health nurse specialist: an integrative literature review; Interventions of the midwife nurse during delivery considered as women / couple centered care: an integrative literature review; The effect of massage on labor pain relief: an scoping review; Second stage of labour complications for mother and child due to the use os kristeller maneuver; Shoulder dystocia: maneuvers to implement; Pelvic Floor Disorders in the first year after childbirth: an integrative literature review.La enfermería materno-obstétrica centrada en la salud sexual y reproductiva es el eje central de esta edición didáctica y metodológica. Se presentan ocho artículos de revisión, seis utilizan el método de revisión bibliográfica integradora y dos artículos utilizan la revisión de alcance, con el fin de identificar o mapear la síntesis del conocimiento producido. Los temas presentados son los siguientes: Alfabetización en sexualidad y adopción de comportamientos de riesgo en estudiantes de educación superior; Conocimientos de los enfermeros sobre métodos modernos de planejamento familiar natural para evitar un embarazo: una scoping review; Adhesión de las parejas a los programas de preparación al parto con una enfermera especialista en salud materna y obstétrica: una revisión integradora de la literatura; Intervenciones de la enfermera especialista durante el trabajo del parto considerado cuidado centrado en la mujer / pareja: una revisión integradora de la literatura; El efecto del masaje sobre el alivio del dolor del proceso de parto: a scoping review; Complicaciones maternas y fetales derivadas del uso de la maniobra de kristeller durante el período de expulsión; Distocia de hombros: maiobras para implementar; Los transtornos del suelo pélvico en el primer año después del parto: una revisión integradora de la literatureinfo:eu-repo/semantics/publishedVersio

Metodologias ativas de ensino em saúde e ambientes reais de prática: uma revisão

Introduction: In view of the demand for the elaboration of teaching strategies adapted to the current reality, knowledge about active teaching-learning methodologies has great value for medical education. There are several types of active methodologies and those based on problem cases have been implemented in medical graduation earlier; despite being an integral and necessary part of the curriculum of medical education institutions, there is no consensus on its form of guidance, applicability and evaluation. We propose a review of the literature on teaching-learning methodologies in real environments, knowing their benefits and applications. Materials and Methods: The present study is a narrative review of the literature which included 23 articles and 1 book chapter between 1992 and 2018, in Portuguese and English, and the PubMed, SciELO, Lilacs and CAPES Periodicals. Discussion: The methods proposed for guidance, evaluation and feedback are varied, adaptable and constantly changing. “Preceptor in a minute”, “The moment in five minutes” and “SNAPPS method” are different ways of discussing these scenarios in order to facilitate the student-patient-preceptor interaction process. Learning strategies in real environments present benefits in relation to the learning of strict theoretical contents, as it places the student in a real working environment and stimulates the elaboration of systematic diagnostic reasoning, which requires the recovery of previous knowledge. It is believed that the professional who is trained with these active methodologies will have a profile of autonomy, self-education and a proactive and scientifically based professional attitude. Conclusion: There are no rules for inserting active methodologies in the university curriculum, their use must be adapted to the reality and profile of each institution. It is noteworthy that the teacher / preceptor must reflect on his teaching methods, seeking to understand his methodology and reframing his performance, encouraging the search for more active and efficient tasks.Introdução: Diante da demanda para a elaboração de estratégias de ensino adaptadas para realidade atual, o conhecimento sobre metodologias ativas de ensino-aprendizagem tem grande valor, para a educação médica. Há diversos tipos de metodologias ativas e aquelas baseadas em casos-problema tem sido implementadas na graduação médica de forma mais precoce; apesar de ser parte integrante e necessária do currículo das instituições de ensino médico, não há consenso sobre sua forma de orientação, aplicabilidade e avaliação. Propõe-se revisar a literatura sobre as metodologias de ensino-aprendizagem em ambientes reais, conhecendo seus benefícios e a aplicações. Materiais e Métodos: O presente estudo trata-se de uma revisão integrativa da literatura na qual foram incluídos 23 artigos e 1 capítulo de livro entre os anos 1992 e 2018, em língua portuguesa e inglesa, sendo exploradas as bases de dados PubMed, SciELO, Lilacs e Periódicos CAPES. Discussão: Os métodos propostos para orientação, avaliação e feedback são variados, adaptáveis e estão em constante modificação. “Preceptor em um minuto”, “O momento em cinco minutos” e “Método SNAPPS” são diferentes maneiras de discussão nesses cenários a fim de facilitar o processo de interação estudante-paciente-preceptor. Estratégias de aprendizagem em ambientes reais apresentam benefícios em relação ao aprendizado de conteúdos teóricos estritos, pois coloca o aluno em ambiente de atuação verídico e estimula a elaboração de raciocínio diagnóstico sistematizado, que exige a recuperação de conhecimentos prévios. Acredita-se que o profissional que seja formado com essas metodologias ativas terá um perfil de autonomia, autodidatismo e atitude profissional proativa e com base científica. Conclusão: Não há “regra prática” para inserção das metodologias ativas no currículo das universidades, seu uso deve ser adaptado à realidade e ao perfil de cada instituição. Ressalta-se que o professor/preceptor deve refletir sobre seus métodos de ensino, buscando entender sua metodologia e ressignificar a sua atuação, estimulando a busca de tarefas mais ativas e eficientes

Portuguese recommendations for the use of methotrexate in the treatment of rheumatoid arthritis

Objectives:To develop Portuguese evidence-based recommendations for the use of methotrexate (MTX) in daily clinical practice in rheumatic disorders. Methods:The Portuguese project was integrated in the multinational 3E Initiative (Evidence, Expertise, Exchange) 2007-2008 where a total of 751 rheumatologists from 17 countries have participated. Ten clinical questions concerning the use of MTX in rheumatic diseases were formulated and the Portuguese group added three more questions. A systematic literature search in Medline, Embase, Cochrane Library and 2005-2007 ACR/EULAR meeting abstracts was conducted. Selected articles were systematically reviewed and the evidence was appraised according to the Oxford Levels of Evidence. In Portugal, a national meeting was held in Obidos on February 15 th and 16 th, 2008, involving 50 rheumatologists who discussed and voted by Dephi method the recommendations. Finally, the agreement among the rheumatologists and the potential impact on their clinical practice was assessed. Results: Thirteen national key recommendations on the use of MTX were formulated: work-up before starting MTX, optimal dosage and route of administration, use of folic acid, monitoring, management of hepatotoxicity, long-term safety, mono versus combination therapy, management in the perioperative period, during infections, before/during pregnancy and after clinical remission, screening and treatment of tuberculosis and the role of MTX as a steroid-sparing agent in rheumatic diseases. Discussion: The Portuguese recommendations for the use of MTX in daily clinical practice were developed, which are evidence-based and supported by a panel of 50 rheumatologists, enhancing their validity and practical use. This project was integrated in a multinational initiative that led to the recent publication of ten multinational recommendations which differ from ours in some specific aspects.publishersversionpublishe