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ABSTRACT Objective: To understand the bioethical issues involved in the care management of nurses working in the Family Health Strategy. Method: A qualitative study was conducted through five focus groups with 36 nurses selected in the sample. Thematic content analysis was performed based on the bioethical framework, and the synthesis was presented in a conceptual map. Results: Bioethical issues were identified in the nursing care practice, related to both specific bioethical themes and the peculiarities of the work. Additionally, challenges and facilitators that interfere with addressing these issues were identified. Final considerations: Understanding the bioethical issues involved in the care management of nurses was possible with the theoretical support of different bioethical perspectives. The identified issues relate to persistent and current themes in the field of bioethics. However, some aspects intrinsic to daily practice are still imperceptible to professionals, contributing to the difficulty of discussing bioethics in this care model.

The United States Pharmacopeial Convention (USP) is a nonprofit, scientific, standard-setting organization, and world leader in establishing quality, purity, and testing standards for medicines, foods, and dietary supplements. USP quality standards are used in more than 140 countries and are legally recognized by more than 40 countries. Currently, there is renewed interest in herbal medicines globally, and health policies are being implemented worldwide for the use of complementary and traditional medicine. In response, USP has developed a robust body of monographs that can be used to guide industry and regulators in ensuring the quality and safety of botanical ingredients used in dietary supplements and herbal medicines. Throughout the Pan American regions, there is a strong tradition of using botanicals as herbal medicines and, as in other regions, a growing desire for botanical dietary supplements. This underscores the need for public quality standards to ensure quality, reduce the flow of substandard and adulterated products, and ensure public health and safety. In April 2022, USP launched the Pan America Botanical Dietary Supplements and Herbal Medicines Expert Panel, with experts representing 12 different countries. The Expert Panel’s work focuses on developing quality control standards for the most important botanical ingredients used in the respective countries, ingredients that are also of global importance. This article provides an overview of the state of botanical dietary supplements and herbal medicines in different Pan American regions with a focus on the regulatory status of herbal products, the development of national quality and research initiatives, and policies related to agriculture conservation and sustainability, among other topics.

Basiliximab (BAS) is an interleukin-2 monoclonal antibody initially used as induction therapy after liver and kidney transplantation. BAS use after lung transplantation (LTx) has supplanted antithymocyte globulin (ATG) as the main induction immunosuppression over the years, but few studies have compared them. In this study, we aimed to compare the efficacy and safety between BAS and ATG in LTx. We performed a retrospective analysis of all LTx done in Portugal between January 2016 and December 2019. Three groups were made according to the initial induction status: BAS, ATG or no induction (NI). The occurrences of cytomegalovirus (CMV) infection, pneumonia, side effects, primary graft dysfunction (PGD), acute rejection, chronic allograft disfunction (CLAD) and death episodes were assessed during two years after LTx. A total of 124 patients were divided in 3 groups: 61 (49.2%) BAS; 43 (34.7%) ATG; 20 (16.1%) NI. The incidences of pneumonia and CMV were similar between induction groups. Additionally, there was no difference between the induction groups in PGD, acute rejection, CLAD, deaths and two-year survival. Side effects were reported only in ATG group (n = 20; 46.5%). In our study, BAS had a better safety profile than ATG in LTx with a similar efficacy.

There is only a very short reaction time for people to find the best way out of a building in a fire outbreak. Software applications can be used to assist the rapid evacuation of people from the building; however, this is an arduous task, which requires an understanding of advanced technologies. Since well-known pathway algorithms (such as, Dijkstra, Bellman–Ford, and A*) can lead to serious performance problems, when it comes to multi-objective problems, we decided to make use of deep reinforcement learning techniques. A wide range of strategies including a random initialization of replay buffer and transfer learning were assessed in three projects involving schools of different sizes. The results showed the proposal was viable and that in most cases the performance of transfer learning was superior, enabling the learning agent to be trained in times shorter than 1 min, with 100% accuracy in the routes. In addition, the study raised challenges that had to be faced in the future.

RESUMO Os objetivos do estudo foram mapear e analisar a oferta das Práticas Integrativas e Complementares (Pics) na atenção primária pela enfermagem no município de São Paulo e a interferência da pandemia da Covid-19 na oferta dessas práticas. Estudo descritivo de série temporal, realizado com dados secundá- rios a partir do banco de dados oficiais do Departamento de Informática do Sistema Único de Saúde no período entre 2018 e 2020. Os resultados demonstram que as Pics ofertadas pela enfermagem totalizaram 10.933 procedimentos em 2018, 24.684 em 2019 e 12.651 em 2020. Entre os anos de 2018 e 2019, houve um aumento de 120% na oferta, tendência interrompida em 2020 em decorrência da pandemia da Covid-19. A oferta dessas práticas pela enfermagem é uma forma de atendimento com vistas ao cuidado integral e apreensão ampliada do processo saúde-doença. Contudo, apesar do grande potencial para adoção dessa abordagem no cuidado, a categoria tem demonstrado percentuais pouco representativos do total ofertado no município analisado.

Maize is a crop of significant economic importance. In the northeast region of Brazil, it serves as the foundation of family support for the majority of farmers. However, achieving high levels of productivity requires an adequate water supply throughout its growth cycle. The northeast semi-arid region experiences low rainfall and high potential evapotranspiration, directly affecting maize development and leading to severe declines in productivity. In this study, genetic selection and proteomic analysis are proposed as a strategy to identify the tolerance of maize cultivars against water stress. The experiments were conducted under two water regimes using randomized block designs with three replicates. Development and productivity traits were evaluated, and genetic parameters were estimated using mixed linear models. Selection for water stress tolerance was based on the harmonic mean of the relative performance of genotypic values. Total protein extraction from maize leaves followed the protocol established by the phenol method, and peptides were analyzed through mass spectrometry. The AG8677P cultivar demonstrated remarkable productivity under drought stress conditions, and proteins related to various fundamentally important biological processes for the tolerance mechanism were identified. The combination of genetic selection with proteomic analysis proves to be an efficient strategy, even in the face of limited resources and a small number of treatments.

Introdução: A pandemia da COVID-19 tem feito inúmeras vítimas fatais em todo o mundo. Ela não apenas ameaça a esfera física do indivíduo, como também pode gerar importante adoecimento psicológico na população, principalmente por conta do medo de contrair a doença. Objetivo: Avaliar a relação do medo da COVID-19 com sintomas ansiosos e depressivos dos residentes de Medicina de Família e Comunidade da região metropolitana de Fortaleza. Métodos: Realizou-se um estudo quantitativo analítico, correlacional e transversal, no qual os participantes responderam a um formulário eletrônico que continha um questionário elaborado pelos autores e os instrumentos Escala Hospitalar de Ansiedade e Depressão (HADS) e Escala de Medo do COVID-19 (EMC-19). Resultados: A pesquisa contou com 50 participantes. Verificou-se que 52% dos residentes apresentavam sintomas de ansiedade, 36% sintomas depressivos e 22% possuíam medo da doença de moderado a intenso. As maiores médias de medo foram dos residentes que já tratavam ansiedade ou depressão e dos residentes que iniciaram tratamento durante a pandemia. Conclusões: O estudo demonstrou que uma porcentagem relevante dos pesquisados apresentou sintomas de ansiedade e depressão, além de mostrar associação direta entre esses sintomas e o medo da COVID-19. Conclui-se enfatizando que o contexto pandêmico exige maior atenção às circunstâncias da saúde mental dos residentes de Medicina de Família para propor medidas de enfrentamento mais resolutivas à problemática.

Abstract The purpose of this reflection is to include ethical principles in the discussion on resource allocation in times of covid-19. This study presents recent news and documents on the use of resources in the pandemic and principles such as justice, autonomy and beneficence. The comprehension that all human beings are worthy of respect, solidarity and protection can help pave the way for accelerating pandemic control for all.

Every day there is criticism about lack of evidence on traditional, complementary, and integrative medicine (TCIM). But is this narrative evidence-based? Are we really missing research about TCIM? Or are we just not looking correctly at the evidence? Evidence maps are a useful method with the dual function of synthesizing available evidence on a specific topic and identifying knowledge gaps. This article presents a six-step evidence map methodology along with recently published TCIM evidence maps, including one related to COVID-19. TCIM evidence maps are useful instruments to inform decision-making for policymakers, health practitioners, and patients.

ABSTRACT OBJECTIVE: To identify the possible repercussions of the COVID-19 pandemic on the workers’ health, the care strategies used, and the provision of Integrative and Complementary Practices in health services in the context of COVID-19. METHOD: Descriptive study, with a qualitative approach, which used a focus group for data collection and content analysis according to Bardin. RESULTS: Eleven health professionals from the city of Registro (SP) participated and, based on the information analysis, four categories emerged: (1) Changes in work routine caused by the pandemic and the feelings they generate in health professionals; (2) Integrative and Complementary Practices as a self-care strategy in the pandemic; (3) Provision of Integrative and Complementary Practices during the pandemic; and (4) Occupational health as the focus and strategy motivator to resume the provision of Integrative and Complementary Practices in the municipality. CONCLUSION: This study allowed the identification of the impact of the pandemic, especially on workers’ mental health, which influenced the search for care strategies that included the Integrative and Complementary Practices. Professionals with this training began to offer the Integrative and Complementary Practices in the service to other workers, given the interruption of their provision to the population due to the COVID-19 pandemic.

Abstract Caffeine is a highly-consumed substance around the world and can be found in various food sources and certain medications. The present systematic review aimed to evaluate the effect of caffeine on bone metabolism in rats. A systematic review was conducted in the PubMed, Medline, Scopus, Cocharane, Embase, and Clinical Trials.gov databases, and the Guidelines for Preferential Reporting for Systematic Reviews and Meta-Analyzes (PRISMA) were followed. In vivo experimental studies that presented caffeine as the study object were included, and studies which did not evaluate the bone metabolism and/or evaluated the caffeine in association with other substances were excluded. The quality evaluation of the selected studies was carried out following the guidelines of the Systematic Review Center for Laboratory Animal Experimentation (SYRCLE) and the Animal Research Reporting In Vivo Experiment (ARRIVE). Nine of the 472 initially identified articles met the inclusion criteria and were selected for qualitative evaluation. There was a variation between the included studies regarding the administered caffeine doses in each experimental group, as well as their frequency and duration of ingestion. Most studies show that caffeine can interfere with bone metabolism, be it in a negative way by accelerating bone loss and delaying bone repair, or in a beneficial way by activating osteogenesis and bone neoformation. There is a need for further studies to better understand the real effect of caffeine on bone metabolism.

Os anti-inflamatório são usados para amenizar ou impedir reação de inflamação, além disso possuem duas classes, sendo elas os esteroides e os não esteroides (AINEs). Os AINEs agem inibindo a ciclo-oxigenase (COX) e são um dos fármacos mais prescritos no mundo para controle da dor. Entretanto, o uso prolongado ou em altas doses pode ter efeitos deletérios, impedindo funções não relacionado à inflamação, como a citoproteção da isoenzima, que previne gastropatias. Ademais, é usado frequentemente em associação com outros fármacos, caracterizando polifarmácia, principalmente em idosos, que se apresentam efeitos adversos potencializados. Logo o presente estudo tem como objetivo analisar e descrever os efeitos do uso indiscriminado dos anti-inflamatórios não esteroidais, sua associação com a polifarmácia e as consequências gastropáticas relacionadas a isso. O trabalho é uma revisão integrativa, realizada de forma descritiva de informações compiladas de bases de dados, para a seleção dos artigos foram usados os descritores “gastrointestinal diseases” AND “drug effects” e as palavras chaves “anti-inflamatório” e “polifarmácia”, entre os anos de 2010 a 2019. Tais fármacos são percursores ao causar deficiência de prostaglandinas pela inibição da COX, não deixando ocorrer a cicatrização, o que pode causar hemorragia gastrointestinal oculta ou evidente nas fezes, desconforto gástrico, dispepsia, diarreia e doenças inflamatórias, dentre outros sintomas. Além disso os AINEs estão intimamente ligados ao risco de desenvolver doença de Crohn, aumentando, também, em 2x, a chance para desenvolver colite. Os estudos demostraram que existe relação desses medicamentos com complicações gastrointestinais, principalmente em polifarmácia, presente em especial na população idosa. Assim, definiu-se que indivíduos do sexo masculino, maiores de 75 anos e usuários de AINEs são pacientes com características para a alta suscetibilidade do desenvolvimento de patologias gástricas. Desse modo, o estudo fomenta uma maior atenção dos profissionais de saúde a fim de evitar a potencialização do risco dessas complicações gastrointestinais.

Study Basis: This evidence map presents a summary of studies that addressed the effects of meditation on various clinical and health conditions. Meditation is a contemplative practice that has been used for the promotion of health, and the treatment of different conditions.Method: The study is based on the search of four electronic databases for the period 1994-November 2019 and includes systematic reviews, meta-analyses, meta-syntheses, and integrative reviews. 3iE evidence gap map was the methodology of choice, and AMSTAR 2 was used for the analyses. Tableau was used to graphically display the confidence level, number of reviews, health outcomes, and intervention effects.Results: This map encompasses 191 studies, with Mindfulness being the key word that retrieved the highest number of results. Several meditation techniques were evaluated in different contexts, and the confidence levels of 22 studies were high, 84 were moderate, and 82 were low. Two 2 meta-syntheses and 1 integrative review were also included. Most of the studies reported positive effects and a beneficial potential of the practice of meditation. Health outcomes were divided into five groups out of which mental health and vitality, and well-being and quality of life stood out with the largest number of studies.Conclusions: Meditation has been applied in different areas. This Evidence Map intends to be an easy visual tool to access valuable evidence-based information on this complementary therapy for patients, health professionals, and managers.

Background: The mind-body therapies of traditional Chinese medicine include several intervention types and combine physical poses with conscious relaxation and breathing techniques. The purpose of this Evidence Map is to describe these different interventions and report related health outcomes.Methods: This evidence map is based on the 3iE Evidence Gap Map methodology. We searched seven electronic databases (BVS, PUBMED, EMBASE, PEDro, ScienceDirect, Web of Sciences, and PschyInfo) from inception to November 2019 and included systematic reviews only. Systematic reviews were analyzed based on AMSTAR 2. We used Tableau to graphically display quality assessment, the number of reviews, outcomes, and effects.Results: The map is based on 116 systematic reviews and 44 meta-analyses. Most of the reviews were published in the last 5 years. The most researched interventions were Tai Chi and Qi Gong. The reviews presented the following quality assessment: 80 high, 43 moderate, 23 low, and 14 critically low. Every 680 distinct outcome effect was classified: 421 as potential positive; 237 as positive; 21 as inconclusive/mixed; one potential negative and none no effect. Positive effects were related to chronic diseases; mental indicators and disorders; vitality, well-being, and quality of life. Potential positive effects were related to balance, mobility, Parkinson's disease, hypertension, joint pain, cognitive performance, and sleep quality. Inconclusive/mixed-effects justify further research, especially in the following areas: Acupressure as Shiatsu and Tuiná for nausea and vomiting; Tai Chi and Qi Gong for acute diseases, prevention of stroke, stroke risk factors, and schizophrenia.Conclusions: The mind-body therapies from traditional Chinese medicine have been applied in different areas and this Evidence Map provides a visualization of valuable information for patients, professionals, and policymakers, to promote evidence-based complementary therapies.

Background: This evidence map describes Pediatrics Massage intervention research reporting health outcomes. Massage is a complementary therapy and can be defined as any form of systematic tactile stimulation by human hands, the type of massage typically used in pediatrics care is a gentle, slow stroking of each part of the body in turn. Methods: The evidence map is based on the 3iE evidence gap map methodology. We searched four electronic databases from inception to November 2019 and included systematic reviews and non-systematic reviews. Systematic reviews were analyzed based on AMSTAR 2. We used tableau to graphically display confidence level, number of reviews, outcomes and a broad estimate of effectiveness. Results: The map is based on 38 reviews. Most of the reviews were published in the last ten years. The Pediatrics Massage was the most researched intervention. Massage was evaluated as an intervention in several health outcomes, resulting in the following confidence levels: 11 high, 13 moderate and 14 low. Every outcome effect was classified: 6 as no effect; 1 mixed and 28 as positive. The outcomes were divided into four major groups: physical and metabolic effects; vitality, well-being and quality of life, mental health; and management. High quality studies presented no effect and positive effects, highlighting outcomes related to neuro-motor development (Badr et al., 2015; Bennett et al., 2013; Vickers et al., 2015), growth (Badr et al., 2015; Bennett et al., 2013; Vickers et al., 2015) and stress disorders (Bennett et al., 2013; Vickers et al., 2015). Conclusions: Pediatrics massage has been applied in different areas and these Evidence Gap Map provides an easy visualization of valuable information for patients, health practitioners and managers, in order to promote evidence-based complementary therapies.

Background: Pain is a disagreeable and distressing feeling that affects human beings in multi-dimensional ways. A number of non-pharmacological interventions have had varying degrees of success in treating cancer-related pain, such as breathing and relaxation techniques, and music therapy, which have been identified as beneficial therapies for alleviating pain and anxiety. Objective: Identify the therapeutic effects of music interventions in psychological and physiological terms and on the quality of life of children undergoing cancer treatment. Method: Systematic review of effectiveness based on the methodology of the Joanna Briggs Institute. Results: Eleven articles were included with a total of 429 children, whose ages ranged from 0 to 18 years. The mean duration of the music intervention was 30.6 (±SD 9.8) min. In a combined estimate of five studies for pain and anxiety outcomes, there were benefits to using music when compared with the control group (SMD −1.05; CI 95 % −1.70 – 0.40 N = 453 I2 = 90 %). A combined analysis of five studies to assess quality of life showed that the use of music was favorable when compared with the control (SMD -0.80; CI 95 % −1.17−0.43 N = 457= I2 = 71 %). Conclusion: After completing this review, it was determined that there is evidence to support the use of music to reduce pain and anxiety and improve the quality of life of children undergoing cancer treatment.

Resumo Objetivo Conhecer os benefícios das práticas de enfermagem aos pacientes com dor acompanhados na clinica de dor. Métodos Revisão integrativa de literatura, sendo utilizado o portal eletrônico SCIELO, e base de dados CINAHL e PubMed Central, com recorte temporal de 2008 a 2018 e período de coleta de dados entre junho e julho de 2018. Como descritores em saúde (DeCs): Pacientes, Dor crônica, Cuidados de Enfermagem, Clínicas de dor; e, o Medical Subject Heading (MeSH): Patients, Chronic pain, Nurse Care, Pain clinic. Resultados Evidenciou-se que a produção analisada é, majoritariamente, sobre práticas de enfermagem não farmacológica a pacientes com dor crônica, com publicações reduzidas no Brasil e tendem a se concentrar nos últimos cinco anos. O paciente com este tipo de agravo, vivencia condições multifatoriais que influenciam diretamente na condição de saúde, e necessitando de acompanhamento integral por equipe interprofissional, com inclusão da rede cuidadora, através intervenções qualificadas e resolutivas, visando adaptação e ou melhora da sua condição de saúde. Conclusão Os estudos indicam benefícios gerados pelas práticas sistematizadas implementadas por enfermeiros, por meio de instrumentos e ferramentas para detecção, intervenção e avaliação, além de apoio clínico.

Abstract: Introduction: The presence of chronic stress, caused by the activities and demands of the medical course, can lead to what is called ‘burnout’, a syndrome characterized by three dimensions: emotional exhaustion, dehumanization (or depersonalization) and reduced professional achievement. Considering the increased incidence of burnout syndrome, anxiety and depression symptoms, suicide attempts and suicide rates among medical students, as a consequence of increasing demands for professional and financial success at the expense of physical and mental health, one understands the importance of studying the subject and proposing measures of prevention and control. The aim of this study was to evaluate and describe the levels of burnout and well-being of medical students at a Brazilian public university. Method: The stress and well-being levels of students from the first to the sixth year for the Medical Course at Universidade Federal de São Paulo were evaluated using MBI-SS and WHOQOL-BREF questionnaires, applied online on the REDCAP platform. Results: A total of 302 students completed the questionnaires. Regarding the MBI-SS, students showed a low value in the emotional exhaustion factor and high levels of professional disbelief and effectiveness, indicating a burnout that ranged from low to moderate. It was also observed that female students showed a greater tendency toward emotional exhaustion when compared to male ones, as well as the fact that students from the 1st and 2nd years showed higher values of professional effectiveness when compared with 3rd and 4th years, with no difference between genders. Based on the answers from WHOQUOL-BREF questionnaire, the students thought they had a good quality of life. Discussion: These results reinforce possible factors that might interfere with the students’ quality of life: excessive workload, teaching model based on extensive lectures, lack of stimulation, recognition for their efforts. Conclusion: The medical students evaluated in this study have a good quality of life and show low or moderate burnout levels.

Background: Due to the pandemic, there is a significant interest in the therapeutic resources linked to TCIM to support potentially therapeutic research and intervention in the management of Coronavirus - 19 (COVID-19). At the date of this evidence map´s publication, there is no evidence of specific treatments for COVID-19. This map organizes information about symptoms management (especially on dimensions related to mental health and mild viral respiratory infections, as well as immune system strengthening and antiviral activity). Method: This evidence map applies methodology developed by Latin American and Caribbean Center on Health Sciences Information based on the 3iE evidence gap map. A search was performed in the Traditional, Complementary and Integrative Medicine Virtual Health Library and PubMed, using the MeSH and DeCS terms for respiratory viral diseases associated with epidemics, COVID-19 symptoms, relevant mental health topics, pharmacological and non-pharmacological interventions related to TCIM. Results: For the map, 126 systematic reviews and controlled clinical studies were characterized, distributed in a matrix with 62 interventions (18 phytotherapy, 9 mind-body therapies, 11 traditional Chinese medicine, 7 homeopathic and anthroposophic dynamized medicines and 17 supplements), and 67 outcomes (14 immunological response, 23 mental health, 25 complementary clinical management of the infection and 5 other). Conclusion: The map presents an overview of possible TCIM contributions to various dimensions of the COVID-19 pandemic, especially in the field of mental health, and it is directed to researchers and health professionals specialized in TCIM. Most of the antiviral activity outcomes described in this map refers to respiratory viruses in general, and not specifically to SARS-CoV-2 (Severe Acute Respiratory Syndrome CoronaVirus 2). This information may be useful to guide new research, but not necessarily to support a therapeutic recommendation. Finally, any suspicion of COVID-19 infection should follow the protocols recommended by the health authorities of each country/region.

Objetivo: Descrever os aspectos epidemiológicos, as complicações e as hospitalizações relacionadas à estomia. Métodos: Trata-se de um estudo transversal, descritivo e quantitativo das variáveis: sexo, idade, faixa etária, raça/cor, tempo de estomia, tipo de estomia, etiologia, complicações e internações hospitalares associadas à colostomia de 123 pacientes atendidos no ambulatório de enfermagem para pacientes estomizados de um hospital escola em Goiânia, Goiás, Brasil. Após a disposição dos dados em tabelas, utilizou-se o software Epi Info 7 para a descrição dos resultados, a análise de prevalências e a associação de variáveis. Resultados: 51,2% (n=63) dos pacientes eram do sexo masculino e houve predominância do tipo de colostomia terminal (n=68;57,6%), enquanto 24,5% (n=29) era do tipo em alça e 17% (n=20) do tipo dupla boca. Quanto à etiologia da estomia, 40,5% (n=49) ocorreu por neoplasia, 17,3% (n=21) por doença inflamatória intestinal e 9% (n=11) por trauma. O desenvolvimento de complicações esteve presente em 38 (30,89%) pacientes, sendo a dermatite periestomal a principal delas, e 9 (7%) pacientes necessitaram de internação hospitalar relacionada à estomia. Conclusão: Observa-se que os pacientes investigados apresentam predominância do sexo masculino, média de idade de 61,5 anos, raça/cor parda, de colostomia terminal e etiologia neoplásica, sendo a maioria dos pacientes portadores de colostomia há cerca de 5 anos.

Abstract Background Mindfulness has been applied in the United States and Europe to improve physical and psychological health; however, little is known about its feasibility and efficacy in a Brazilian population. Mindfulness may also be relevant in tackling obesity and eating disorders by decreasing binge eating episodes—partly responsible for weight regain for a large number of people—and increasing awareness of emotional and other triggers for overeating. The aim of the present study protocol is to evaluate and compare the feasibility and efficacy of two mindfulness-based interventions (MBIs) addressing overweight and obesity in primary care patients: a general programme called Mindfulness-Based Health Promotion and a targeted mindful eating protocol called Mindfulness-Based Eating Awareness Training. Methods/design A randomised controlled trial will be conducted to compare treatment as usual separately in primary care with both programmes (health promotion and mindful eating) added to treatment as usual. Two hundred forty adult women with overweight and obesity will be enrolled. The primary outcome will be an assessment of improvement in eating behaviour. Secondary outcomes will be (1) biochemical control; (2) anthropometric parameters, body composition, dietary intake and basal metabolism; and (3) levels of mindfulness, stress, depression, self-compassion and anxiety. At the end of each intervention, a focus group will be held to assess the programme’s impact on the participants’ lives, diet and health. A feasibility study on access to benefits from and importance of MBIs at primary care facilities will be conducted among primary care health care professionals and participants. Monthly maintenance sessions lasting at least 1 hour will be offered, according to each protocol, during the 3-month follow-up periods. Discussion This clinical trial will result in more effective mindfulness-based interventions as a complementary treatment in primary care for people with overweight and obesity. If the findings of this study confirm the effectiveness of mindfulness programmes in this population, it will be possible to improve quality of life and health while optimising public resources and reaching a greater number of people. In addition, on the basis of the evaluation of the feasibility of implementing this intervention in primary care facilities, we expect to be able to suggest the intervention for incorporation into public policy. Trial registration ClinicalTrials.gov, NCT02893150. Registered retrospectively on 30 March 2017.

RESUMO Objetivo Compartilhar a experiência da dupla titulação em enfermagem promovida entre a Escola de Enfermagem da Universidade de São Paulo e o Instituto de Ciências da Saúde da Universidade Católica Portuguesa, fazendo uma reflexão sobre as potencialidades e os desafios dessa oportunidade para o estudante de pós-graduação. Método Trata-se de um relato de experiência apresentado em ordem cronológica e de natureza descritiva. A dupla titulação em enfermagem foi realizada no período de 6 meses, em instituição diferente da de origem. Resultados Dentre as atividades desenvolvidas durante a dupla titulação destacam-se: participação em bancas de defesa, congressos, seminário, cursos, encontros, palestras, colóquios, aulas, grupos de pesquisa e visita técnica aos serviços de saúde. Um quadro apresenta e descreve os principais benefícios da experiência vivenciada pelas autoras. Conclusão A dupla titulação, quando bem planejada e desenvolvida, pode promover o desenvolvimento pessoal, cultural e profissional do estudante, favorecendo a internacionalização e contribuindo para a qualificação dos programas de pós-graduação.

Atualmente, os destinos turísticos exigem uma oferta adaptada às exigências dos novos e diferentes mercados, tendo em vista a competitividade dos territórios. O turismo criativo, impulsionado pela co-criação de experiências, surge como uma forma de conferir um caráter único a estes espaços, proporcionando contextos de aprendizagem e envolvimento entre turistas e comunidades locais. No entanto, esta interação tem sido vedada à população com incapacidade, sendo crucial eliminar determinados constrangimentos (internos, interativos e externos). É neste contexto que o presente artigo visa realçar a pertinência em se apostar na educação e sensibilização dos stakeholders dos destinos para a promoção da interatividade, dinamismo e total envolvimento dos intervenientes na experiência turística. O Modelo Educacional de Turismo Criativo para Todos sugerido evidencia a importância da educação na co-criação de produtos turísticos inovadores e inclusivos, tendo em vista a plena participação de qualquer interveniente, bem como a competitividade e desenvolvimento dos destinos turísticos.

Objective To identify the understanding of the healthcare professionals in relation to the role of complementary therapies in primary health care. Method Systematic review by way of the following information sources: PubMed, CINAHL, PeriEnf, AMED, EMBASE, Web of Science, Psicoinfo and Psicodoc, using the keyword Primary Health Care alone, and associated with the following keywords: Medicinal Plants, Herbal Medicine, Homeopathy, Traditional Chinese Medicine, Acupuncture, Anthroposophical Medicine. Results Twenty-two studies from 1986 to 2011 were included. We identified three styles of practice: conventional medicine, complementary therapies and integrative medicine. Positioning professional practices within these three styles may facilitate discussion of concepts of health care, enhancing the health care provided as a result. Conclusion The work process in primary care presents difficulties for conducting integrative and holistic health care, but this practice has been introduced over time by professionals who integrate conventional medicine and complementary therapies, concerned with the care and well-being of patients.

Pesquisa qualitativa, do tipo descritiva, exploratório-analítica, em base documental. O objetivo foi caracterizar e analisar as tendências pedagógicas encontradas na produção de artigos científicos relacionados à temática Educação em Enfermagem, capturadas a partir da publicação dos pesquisadores dos Grupos de Pesquisa em Educação em Enfermagem do Estado de São Paulo de 2004 a 2010. Foram identificadas as seguintes tendências pedagógicas: Tradicional, Renovada, Tecnicista, Libertadora e a Crítico-Social dos Conteúdos. Foram analisados 131 estudos, sendo que 46,56% estão pautados em tendências centralmente marcadas por preocupações políticas e sociais. Percebeu-se um movimento intenso em busca de transformação da Educação em Enfermagem dentro dos Grupos de Pesquisa. A grande concentração de estudos embasados em tendências libertadoras ou com a ambição de adotar tais posturas, revela um fator positivo dos Grupos de Pesquisa em Educação em Enfermagem.

OBJECTIVE: to identify values which structure and guide nursing as social practice. METHOD: qualitative meta-synthesis. RESULTS: three concepts were identified: The tension between technique, organization and ethics in the nurse's practice; Historical carry-overs of the values which run through nursing practice; Attention to ethics, to reform of the health system, and to the humanization of care. These led to the synthesis of the principal variables 'planning' and 'care', which represent, respectively, guiding values of the technical-operative and ethical-moral elements of the social practice of nursing. CONCLUSION: these values are articulated through the prism of ordering so as to care well. Their recognition contributed to a better understanding of the process of health care and nursing care. OBJETIVO: identificar valores que estructuran y orientan la enfermería como una práctica social. MÉTODO: metasíntesis cualitativa. RESULTADOS: fueron identificados tres conceptos: la tensión entre técnica, organización y ética en la práctica de la enfermera; el lastre histórico de los valores transversales de la práctica de la enfermería; y, la atención a la ética, a la reforma del sistema de salud y a la humanización de la asistencia. Estos llevaron a la síntesis de las variables principales: ordenamiento y cuidado, las que representan, respectivamente, valores que señalan los elementos técnico-operativo y ético-moral de la práctica social de la enfermería. CONCLUSÍON: estos valores se articulan bajo el prisma de ordenar para bien cuidar. Reconocerlos contribuye para una mejor comprensión del proceso de atención a la salud y de los cuidados de enfermería. OBJETIVO: identificar valores que estruturam e orientam a enfermagem enquanto prática social. MÉTODO: metassíntese qualitativa RESULTADOS: foram identificados três conceitos: a tensão entre técnica, organização e ética na prática da enfermeira; lastros históricos dos valores transversais à prática da enfermagem; atenção à ética, à reforma do sistema de saúde e à humanização da assistência. Esses levaram à síntese das variáveis principais "ordenamento" e "cuidado" que representam, respectivamente, valores balizadores dos elementos técnico-operativo e eticomoral da prática social da enfermagem. CONCLUSÃO: esses valores articulam-se sob o prisma de ordenar para bem cuidar. Reconhecê-los contribui para melhor compreensão do processo de atenção à saúde e dos cuidados de enfermagem.

Este estudo objetivou identificar os Estilos de Pensamento dos Grupos de Pesquisa em Educação em Enfermagem de três regiões do Brasil. MÉTODO: Pesquisa do tipo descritiva, exploratório-analítica, em base documental, de natureza qualitativa. RESULTADOS: A Região Norte demonstrou um Estilo Libertador, caracterizado por uma postura pedagógica libertadora e dialógica. A Região Centro-Oeste apresentou um Estilo Tecnicista-Libertador, caracterizado por uma postura pedagógica intermediária, que mostra exceções à postura pedagógica tecnicista e a crescente valorização da postura pedagógica crítica. Na Região Nordeste, apareceu o Estilo Tecnicista-Libertador-Efetivo, caracterizado por discutir a implantação das Diretrizes Curriculares Nacionais para o curso de Enfermagem nos Projetos Políticos Pedagógicos das Instituições de Ensino. CONCLUSÃO: Os Estilos identificados estão em constante movimento, porém, nesse momento, identificar a pedagogia libertadora e a sua efetivação a partir das Diretrizes Curriculares é essencial para o desenvolvimento da Educação em Enfermagem e o seu reconhecimento.Este estudio objetivó identificar los Estilos de Pensamiento de los Grupos de Investigación en Educación en Enfermería en tres regiones de Brasil. MÉTODO: investigación descriptiva y exploratoria, en base documental, de naturaleza cualitativa. RESULTADOS: la Región Norte mostró un Estilo Libertador caracterizado por una actitud pedagógica libertadora y dialógica. La Región Centro-Oeste tuvo un Estilo Tecnicista-Libertador, caracterizado por una postura pedagógica intermedia que evidencia excepciones a los aspectos técnicos de enseñanza y un aprecio cada vez mayor de la propuesta pedagógica crítica. En el Nordeste apareció el Estilo Tecnicista-Libertador-Eficaz, que se caracteriza por discutir la implementación de las Directrices Curriculares Nacionales para el Curso de Enfermería en los Proyectos Políticos Pedagógicos de las Instituciones de Educación Superior. CONCLUSIÓN: los estilos identificados están en constante movimiento, pero identificar la pedagogía liberadora y su eficacia desde la implementación de las Directrices Curriculares es esencial para el desarrollo de la Educación en Enfermería.This study aimed to identify the Thought Styles of Research Groups in Nursing Education in three regions of Brazil. METHOD: Qualitative research, exploratory and descriptive. RESULTS: Northern Region showed a Style named Liberating, characterized by a pedagogical stance based in dialogue. Midwest Region had a Style named Technicist-Liberating, characterized by an intermediate pedagogical stance that shows exceptions to technicist education and at the same time growing appreciation of critical pedagogical approach. In the Northeast appeared a Style named Technicist-Liberating-Effective, characterized by discussing the deployment of the National Directions for Nurse Courses in the Political Pedagogical Projects in the Institutions of Higher Education. CONCLUSION: The Styles identified are in a constant movement, but it is relevant this time to identify liberating education and its effectiveness by the application of National Directions as essential for the development of Nursing Education and its recognition.

Este estudio tuvo como objetivo identificar el término más utilizado por los estudiantes de enfermería: usuario, cliente o paciente, y también saber acerca de la comprensión colectiva de cada término. Estudio prospectivo, cuanti-cualitativo, elaborado en la Escuela de Enfermería, Universidad de São Paulo, con los estudiantes de los cuatro años del curso de Licenciatura en Enfermería. En total 215 estudiantes fueron abordados, 162 respondieron y de estos 60% utilizaran el término usuario. Independiente de cual término es empleado en la práctica de la atención es importante señalar que los conceptos comunes de autonomía y atención de salud como un derecho deben ser respetados, de la misma manera que la relación inhumana y la pasividad deben ser dejados de fuera en la relación dialógica que debe establecerse entre los profesionales y el usuario-cliente-paciente.

O estudo objetivou compreender a deliberação ética de enfermeiros e médicos diante de pacientes difíceis na Atenção Primária à Saúde (APS). Utilizou-se uma abordagem compreensiva, ancorada no referencial teórico metodológico da bioética deliberativa. Analisaram-se as entrevistas semiestruturadas, tomando a prudência como categoria analítica. Entre 2002-2010, entrevistaram-se setenta profissionais da APS do município de São Paulo. Os resultados evidenciam que os cursos de ação intermediários dos profissionais tendem à conciliação dos valores cuidado e ordenamento. Nos cursos de ação extremos, as enfermeiras tendem para o cuidado, e os médicos, para o ordenamento. Conclui-se que os pacientes difíceis são comuns na APS e os profissionais tendem a apresentar cursos de ação para atendê-los, sem perturbar a rotina da unidade, os demais profissionais e usuários.

Objectives to identify nursing challenges for universal health coverage, based on the findings of a systematic review focused on the health workforce' understanding of the role of humanization practices in Primary Health Care. Method systematic review and meta-synthesis, from the following information sources: PubMed, CINAHL, Scielo, Web of Science, PsycInfo, SCOPUS, DEDALUS and Proquest, using the keyword Primary Health Care associated, separately, with the following keywords: humanization of assistance, holistic care/health, patient centred care, user embracement, personal autonomy, holism, attitude of health personnel. Results thirty studies between 1999-2011. Primary Health Care work processes are complex and present difficulties for conducting integrative care, especially for nursing, but humanizing practices have showed an important role towards the development of positive work environments, quality of care and people-centered care by promoting access and universal health coverage. Conclusions nursing challenges for universal health coverage are related to education and training, to better working conditions and clear definition of nursing role in primary health care. It is necessary to overcome difficulties such as fragmented concepts of health and care and invest in multidisciplinary teamwork, community empowerment, professional-patient bond, user embracement, soft technologies, to promote quality of life, holistic care and universal health coverage.

O Mercosul, instituído com vistas à integração econômica, política, social e cultural entre os países membros, atualmente destaca-se pelas estratégias integrativas de âmbito educacional. Este artigo aborda os movimentos acerca da formação acadêmica dos cursos de Enfermagem e o trajeto histórico de integração educacional, apresentando o Sistema de Acreditação dos Cursos Universitários do Mercosul, o ARCU-SUL, além dos setores responsáveis por esse processo e as perspectivas para a Enfermagem nos países do Mercosul. Entendemos que para o desenvolvimento de profissionais críticos, reflexivos e com compromisso político-social, é fundamental investir na formação e na qualidade dos centros de ensino em Enfermagem.El Mercosur, establecido con miras a la integración económica, el intercambio político, social y cultural entre los países miembros, actualmente se destaca por las estrategias del marco educativo. Este artículo aborda el movimiento en la formación académica de la carrera de Enfermería y el récord del campo de la integración educativa, al presentar el sistema de acreditación de carreras universitarias del Mercosur, el Arcu-Sur, y los sectores responsables de este proceso y las perspectivas para la Enfermería en el Mercosur. Creemos que para el desarrollo de profesionales críticos, reflexivos y con el compromiso social-político es esencial invertir en la formación y en la calidad de los centros de educación en enfermería.The Mercosul, established with the objective of integrate economics, political, social and cultural differences among member countries, currently is highlighted by its strategies of educational framework. This article discusses the movement on the academic background of the Nursing career and the history of educational integration, presenting the accreditation system for university courses of Mercosul, the Arcu-Sul, and also the sectors responsible for this process and the prospects for Nursing in Mercosul. We believe that for the development of a critic, reflective and social-political committed professional is essential to invest in training and in the quality of education centers in Nursing.

This qualitative research aimed to identify the attitudes of undergraduate Nursing students regarding transmissible diseases and the people who have them, and to recognize how the Nursing with Transmissible Diseases course in the University of São Paulo’s undergraduate nursing course influences this process. Hypothetical situations were presented before (2006) and after (2010) the course for the students to reflect on. The students recorded their perceptions in writing, resulting in 69 records for each point (2006 and 2010). On analysis of the data, the following categories were identified: fear, prejudice, anger, sadness, shame, worry, insecurity, care, curiosity, hope and calm. The knowledge conveyed in the transmissible diseases course was important in mobilizing the students’ behaviors regarding prejudice and stigma. Further, the theoretical-practical content was able to instrumentalize the students to understand these illnesses as harm which may be treated and monitored by the nursing team.

Este estudo objetivou identificar as temáticas das linhas de pesquisa (LP) e da produção científica publicada pelos Grupos de Pesquisa em Educação em Enfermagem (GPEE) das regiões Norte, Nordeste e Centro-Oeste do Brasil. Pesquisa documental, descritiva e exploratória. Identificaram-se 12 GPEE, 45 linhas de pesquisa e 448 artigos científicos, 60% dos quais foram publicados em revistas A, B1 e B2. Nesses GPEE, 36% das LP foram sobre educação, porém somente 25% das publicações abordaram este assunto, enquanto 34% das LP enfocaram o tema cuidado, que foi objeto de 44% das publicações. Há necessidade de repensar a organização dos GPEE a partir de linhas e projetos de pesquisa para favorecer a consolidação da temática da Educação em Enfermagem na produção de conhecimentos da área.

This transversal and exploratory study aimed to characterize the socioeconomic, demographic and work profile of the community healthcare assistants in the city of Florianópolis in the state of Santa Catarina. 470 staff participated in the study, their details being collected by a structured, self-applied questionnaire. It was ascertained that the majority of the subjects had the following characteristics: female, Caucasian, young adult, married, Roman Catholic, educated to senior high school level, with previous work experience in commerce, both resident and born in the city, mother of one or two children, with an average per capita family income of three minimum salaries, and with five years’ experience in the same healthcare team. It is concluded that it is possible to see the strengths and weaknesses of this group of workers, such that their potential may be maximized and the work processes improved, so as to continuously improve the standards of care given by the Brazilian National Health Service (Sistema Único de Saúde)

O estudo tem por objetivo caracterizar as produções científicas dos Grupos de Pesquisa em Educação em Enfermagem (GPEE) dos Estados do Rio de Janeiro e Minas Gerais do Brasil. Pesquisa documental, quantitativa, descritiva retrospectiva, conduzida pela busca dos Currículos Lattes de todos os pesquisadores que integravam os GPEE dos Estados supracitados, seguida pela busca, organização e qualificação da produção científica dos respectivos pesquisadores, em acordo ao Qualis/CAPES. O período investigado foi 1995-2009 (cinco últimos triênios da CAPES) e incluiu na análise: artigos científicos, livros, capítulos de livros e trabalhos completos em anais de eventos. Os resultados indicaram que o Rio de Janeiro apresenta maior número de produção de artigos científicos em Educação em Enfermagem, com destaque à qualificação dos pesquisadores em nível de doutorado. Os dois Estados apresentam fatores históricos e sócio-econômicos favoráveis ao desenvolvimento científico.El objetivo del estudio fue caracterizar la producción científica de los Grupos de Investigación en Enfermería (GPEE) de las Provincias de Rio de Janeiro y Minas Gerais de Brasil. Investigación documental, retrospectivo cuantitativo, descriptivo, impulsada por la búsqueda de los Curriculos Lattes de todos los investigadores que participan de los Grupos de Investigación de las Provincias ya citadas, seguido de la búsqueda, clasificación y organización de la producción científica de los investigadores de acuerdo con los criterios de evaluación del Qualis/CAPES. El período investigado fue de 1995-2009 (los cinco últimos trienios de la CAPES) y se incluyeron en el análisis los artículos científicos, libros, capítulos de libros y ponencias en actas de congresos. Los resultados indican que el Rio de Janeiro presenta un número mayor de artículos científicos en Educación en Enfermería y se destaca la cualificación de los investigadores en nivel de doctorado. Las dos Provincias tienen factores históricos y socio-económico favorables al desarrollo científico.This study aims to characterize the scientific groups of research in Nursing Education (GPEE) of the states of Rio de Janeiro and Minas Gerais in Brazil. This is a documentary research, quantitative, descriptive retrospective, conducted by the curricular search of Lattes of all researchers who are part of the GPEE of all the above states, by searching the organization and production qualification of its scientific researchers according to Qualis/CAPES, the production of their scientific researchers. The period studied was between1995-2009 (the last five training of CAPES) included for analyzing scientific articles, books, book chapters, and full paper of conference proceedings. The results indicated that the Rio de Janeiro has highest number of production scientific article in Nursing Education, and with highlights of researchers with qualification of doctorate level. These states present historic factors and socio-economic environment to scientific development.

Este estudio tiene como objetivo identificar y caracterizar la producción científica de los grupos de investigación en educación en enfermería de las regiones Norte, Nordeste y Centro-Oeste de Brasil. Estudio documental, descriptivo y exploratorio, cuantitativo. El Norte, Nordeste y Centro-Oeste tienen 98 grupos de investigación en enfermería, el 26% del total nacional, y doce en educación en enfermería. Hay 140 investigadores, 120 estudiantes y 22 técnicos. Entre los años 1995-2008, estos grupos han producido 275 trabajos de investigación en las actas de congresos, 383 capítulos de libros, 135 libros y 455 artículos científicos. Construir y mantener grupos de investigación en la educación en enfermería en los diferentes escenarios necesita disciplina y la promoción de diversas organizaciones, de educación y salud, para reducir desigualdades y promover la producción del conocimiento. Además, la producción científica puede ser una forma de socializar y discutir Educación en Enfermería en los niveles regional y nacional

Gracilaria tenuistipitata, a species of commercial interest, is becoming a model organism for studies on red algal physiology and molecular biology as it can be grown easily in vitro under a broad range of conditions. Most of the experiments carried out around the world have been based on a tetrasporophytic clone isolated in our laboratory from a specimen collected in China. Here we describe the life history of this species, give anatomic details of the reproductive structures, illustrate the morphological variability of tetraspore progeny and compare the growth rate of gametophytic and sporophytic thalli. Tetrasporophytic branches showed higher growth rates than gametophytic branches.

A educação é um processo político, no qual a sociedade opera de forma constante sobre o desenvolvimento da pessoa, com intuito de integrá-la ao modo de ser vivente. O estudo representa uma reflexão-teórica a partir de um paralelo entre as diretrizes da Política Nacional de Educação Permanente em Saúde e os princípios norteadores da Administração Complexa. A partir de um breve resgate bibliográfico, buscou-se contextualizar a Política, bem como essa nova forma de administração baseada na autonomia, cooperação, agregação e auto-organização. Defende-se que esta aproximação entre educação permanente e administração complexa poderá facilitar a realização do cuidado em enfermagem e saúde, bem como as atividades gerenciais, impulsionar a autonomia, além do crescimento pessoal, profissional e organizacional.La educación es un proceso político, en el cual la sociedad opera de forma constante sobre el desarrollo de la persona, con objetivo de integrarla al modo de ser viviente. El estudio representa una reflexión-teórica a partir de un paralelo entre las directrices de la Política Nacional de Educación Permanente en Salud y los principios norteadores de la Administración Compleja. A partir de uno breve rescate bibliográfico, se buscó contextualizar la Política, bien como esa nueva forma de administración basada en la autonomía, cooperación, agregación y auto-organización. Se defiende que esta relación entre educación permanente y administración compleja podrá facilitar la aproximación del cuidado en enfermería y salud, bien como las actividades gerenciales, impulsar la autonomía, además del crecimiento personal, profesional y organizacional.Education is a political process, in which the society operates consistently on the development of the individual, aiming to integrate it into the way of living being. The present work represents a theoretical reflection, from a parallel between the guidelines of the National Politic in Continuing Education in Health and the principles of the Complex Administration. From a brief review of the literature, it is attempted to contextualize the policy, and this new form of administration based on freedom, cooperation, aggregation and self-organization. Results of the study suggest that the relation between continuing education and complex administration could facilitate the implementation of nursing care and health, as well as management's activities by promoting autonomy, and personal, professional and organizational growth.

FUNDAMENTO: A hipertensão arterial (HA) é uma doença de massa, com conseqüências para o aparelho cardiocirculatório, pois suas complicações elevam as taxas de morbi-mortalidade. Controlar a pressão arterial (PA) diminui complicações e pode preservar a qualidade de vida (QV) dos pacientes. Estudos mostram os efeitos positivos da música como coadjuvante no tratamento de diversas patologias. OBJETIVO: Avaliar o efeito da musicoterapia na QV e no controle da PA de pacientes hipertensos. MÉTODOS: Realizou-se um ensaio clínico controlado que avaliou pacientes de ambos os sexos, maiores que 50 anos, HA estágio 1, em uso de medicação, matriculados em serviço multiprofissional para tratamento da HA. Divididos em grupos experimental (GE) e controle (GC). O GE, além do tratamento convencional, participou de sessões musicoterápicas semanais por doze semanas. O GC permaneceu sob tratamento padrão do serviço. Antes e após a intervenção foi aplicado nos dois grupos o questionário SF-36 e verificada a PA. A voz, importante elemento da comunicação, reflexo do estado físico, psíquico e emocional, foi o principal recurso utilizado. Estatística: testes t-Student e Wilcoxon (significantes pFUNDAMENTO: La hipertensión arterial (HA) es una enfermedad de masa, con consecuencias para el aparato circulatorio, pues sus complicaciones elevan las tasas de morbilidad y mortalidad. Controlar la presión arterial (PA) disminuye complicaciones y puede preservar la calidad de vida (CV) de los pacientes. Estudios muestran los efectos positivos de la música como coadyuvante en el tratamiento de diversas patologías. OBJETIVO: Evaluar el efecto de la musicoterapia en la CV y en el control de la PA de pacientes hipertensos. MÉTODOS: Se realizó un ensayo clínico controlado que evaluó pacientes de ambos sexos, mayores de 50 años, HA estado 1, en uso de medicación, matriculados en servicio multiprofesional para tratamiento de la HA. Se dividieron en grupos experimental (GE) y control (GC). El GE, además del tratamiento convencional, participó en sesiones musicoterápicas semanales por doce semanas. El GC permaneció bajo tratamiento estándar del servicio. Antes y después de la intervención se aplicó en los dos grupos el cuestionario SF-36 y se verificó la PA. La voz, importante elemento de comunicación, reflejo del estado físico, psíquico y emocional, fue el principal recurso utilizado. Estadística: tests t-Student y Wilcoxon (significantes pBACKGROUND: Arterial Hypertension (AH) is a mass disease, with consequences for the cardiocirculatory system, since its complications raise the rates of morbidity and mortality. Controlling blood pressure (BP) reduces complications and may preserve the quality of life (QOL) of patients. Studies show positive effects of music therapy as an adjuvant in the treatment of several diseases. OBJECTIVE: to evaluate the effect of music therapy on the QOL and BP control of hypertensive patients. METHODS: This was a controlled clinical study that evaluated patients of both genders, aged over 50 years, with stage 1 hypertension, in use of medication and enrolled in multidisciplinary service for treatment of hypertension. They were divided into an experimental group (EG) and a control group (CG). The EG, in addition to the conventional treatment, participated in weekly music therapy sessions for twelve weeks. The CG received the standard treatment of the service. Before and after the intervention, the SF-36 questionnaire was applied in both groups, and the BP of each patient was measured. The voice, an important element of communication, reflecting the patient's physical, mental and emotional state, was the main resource used. Statistics: Student T-test and Wilcoxon test were considered significant at p

FUNDAMENTO: O baixo peso ao nascimento (BPN) está associado com aumento da pressão arterial (PA) e de doenças cardiovasculares no adulto. OBJETIVO: Avaliar as possíveis alterações na monitorização ambulatorial da pressão arterial (MAPA) em crianças com BPN. MÉTODOS: Avaliou-se o peso ao nascimento (PN) de 1.049 crianças, entre 8 e 11 anos, em escolas de Goiânia. Aquelas com BPN (PN < 2,5 kg) foram comparadas com crianças com peso ao nascimento normal - PNN (PN > 3,0 kg). O PN foi obtido no cartão da criança. Avaliaram-se PA casual e MAPA. Após a obtenção do peso e da estatura para cálculo do índice de massa corpórea (IMC), realizou-se avaliação da maturação sexual segundo os critérios de Tanner (excluídos Tanner >2). RESULTADOS: Obtiveram-se 34 crianças com BPN e 34 com PNN. Os grupos foram semelhantes quanto a idade, sexo, raça, peso, estatura, IMC e história familiar de hipertensão. As crianças com BPN apresentaram maior pressão sistólica (PS) casual (p = 0,007). Na MAPA, apresentaram maior pressão diastólica (PD) nas 24 horas (p = 0,009), maior PD de vigília (p = 0,002), maiores PS e PD no sono (p = 0,005 e p = 0,001) e menor descenso noturno da PS e PD (p = 0,001) do que as com PNN. Observou-se uma correlação positiva do PN com o descenso noturno da PS (p = 0,022) e negativa com a PS no sono (p = 0,032). CONCLUSÃO: As crianças com BPN apresentaram PA mais elevada e alteração do ritmo circadiano da pressão arterial, com atenuação do descenso noturno. Esses achados podem representar um risco aumentado para a hipertensão arterial e doença cardiovascular no adulto.FUNDAMENTO: El bajo peso al nacer (BPN) está asociado al aumento de la presión arterial (PA) y de enfermedades cardiovasculares en el adulto. OBJETIVO: Evaluar las posibles alteraciones en el monitoreo ambulatorio de la presión arterial (MAPA) en niños con BPN. MÉTODOS: Se evaluó el peso al nacer (PN) de 1.049 niños, entre 8 y 11 años, en escuelas de la ciudad de Goiânia. Aquellos con BPN (PN < 2,5 kg) se compararon con niños con peso normal al nacer - PNN (PN > 3,0 kg). El PN se obtuvo en la tarjeta del niño. Se evaluaron la PA casual y el MAPA. Tras la medición del peso y de la estatura para cálculo del índice de masa corpórea (IMC), se evaluó la maduración sexual según los criterios de Tanner (excluidos Tanner >2). RESULTADOS: Se obtuvo un total de 34 niños con BPN y 34 con PNN. Los grupos fueron semejantes relación a la edad, sexo, raza, peso, estatura, IMC e historia familiar de hipertensión. Los niños con BPN presentaron mayor presión sistólica (PS) casual (p = 0,007). En el MAPA, presentaron mayor presión diastólica (PD) en las 24 horas (p = 0,009), mayor PD de vigilia (p = 0,002), mayores PS y PD en el sueño (p = 0,005 y p = 0,001) y menor descenso nocturno de la PS y PD (p = 0,001) que las con PNN. Se observó una correlación positiva del PN con el descenso nocturno de la PS (p = 0,022) y negativa con la PS en el sueño (p = 0,032). CONCLUSIÓN: Los niños con BPN presentaron PA más elevada y cambio del ritmo circadiano de la presión arterial, con atenuación del descenso nocturno. Esos hallazgos pueden representar un riesgo aumentado para la hipertensión arterial y enfermedad cardiovascular en el adulto.BACKGROUND: Low birth weight (LBW) is associated with increased incidence of high blood pressure (BP) and cardiovascular diseases in adulthood. OBJECTIVE: To evaluate possible changes in Ambulatory Blood Pressure Monitoring (ABPM) in LBW children. METHODS: The birth weight (BW) of 1049 school children (ages 8 to 11) living in Goiânia was assessed. Children with low birth weight (BW < 2.5 Kg) were compared with those of normal birth weight (BW > 3.0 Kg). Information on birth weight was obtained from each child's health card. Casual BP and ABPM were measured. Height and weight measurements were obtained to calculate the body mass index (BMI), and sexual maturity was assessed according to Tanner's criteria (those at Tanner stage > 2 were excluded). RESULTS: Thirty-four children had low birth weight (LBW) and 34 had normal birth weight (NBW). Both groups were similar regarding age, gender, race, body weight, height, BMI, and family history of hypertension. Low-birth-weight children had higher casual systolic blood pressure (SBP) (p = 0.007). ABPM recordings showed that these children had higher 24-hour diastolic blood pressure (DBP) (p = 0.009), daytime DBP (p = 0.002), night-time DBP and SBP (p = 0.005 and p = 0.001), and reduced nocturnal dip in SBP and DBP (p = 0.001) than those born with normal weight. Birth weight was positively correlated with nocturnal dip in SBP (p = 0.022) and negatively correlated with sleep SBP (p = 0.032). CONCLUSION: Low-birth-weight children have higher BP and changes in circadian rhythm of blood pressure, with reduced nocturnal dipping. These findings may reflect increased risk of adult hypertension and cardiovascular diseases.

Investigación Convergente Asistencial bajo el punto de vista teórico de Paulo Freire, cuyo objetivo fue desvelar críticamente la Carta de los Derechos de los Usuarios de la Salud y crear estrategias de poderío de la comunidad mediante la realización de talleres educativos. Participaron 470 Agentes Comunitarios de Salud de Florianópolis/SC, organizados en pequeños grupos de dialogo, que elaboraron cinco estrategias para lograr el cumplimiento de los derechos y obligaciones de los usuarios, a saber: divulgar la importancia del Consejo Local de Salud en las visitas a domicilio; El plan de orientación a los usuarios acerca de los medicamentos; Fijar carteles en la Unidad Local de Salud sobre el primer principio de la Carta; Divulgar otros servicios de apoyo a la salud; y, Divulgación y poderío de la comunidad sobre sus derechos y deberes. Las intervenciones señaladas inspiran el fortalecimiento de las acciones en educación y salud, con miras a la instrumentalización del equipo de salud, sin exigir del Estado demandas en la estructura socio-económica.

Esta pesquisa objetivou identificar como a incorporação de práticas integrativas e complementares na Atenção Primária em Saúde tem auxiliado a promover a humanização do cuidado. Foi realizada uma Revisão Sistemática de Literatura que utilizou os descritores ‘Atenção Primária em Saúde’ (Primary Health Care) e ‘Práticas Integrativas e Complementares’ (Complementary Therapies), por meio do conector AND, nas seguintes bases de dados: PubMed e EMBASE, para buscar artigos publicados até 2011. Foram encontradas 1434 referências; dessas, 680 foram selecionadas pelo título e 15, pelo resumo. O ideal para incluir as PIC na APS é pensar dentro da lógica de cuidado humanizado e, para tal, deve-se considerar: fomentar pesquisas sobre PIC, inserir PIC nos cursos de graduação e em treinamentos de profissionais de saúde, promover a colaboração internacional, aproximar curadores tradicionais e profissionais da APS e organizar lista de fitoterápicos e plantas medicinais recomendadas pelos sistemas de saúde

Relato de experiência de oficina realizada por acadêmicos do 5o semestre do curso de graduação em Enfermagem da Universidade de São Paulo. Esta atividade teve o objetivo de desenvolver a promoção de saúde no trabalho por meio da autovalorização e a motivação dos trabalhadores que compõem a equipe amarela da Estratégia Saúde da Família da Unidade Básica de Saúde Paulo VI, localizada no Distrito de Raposo Tavares, na cidade de São Paulo. As dinâmicas empregadas na oficina foram a “Massagem coletiva”, “Eu sou” e “Encher o balão”. Como resultado, foi montado o “Coração de Qualidades” durante a oficina, que posteriormente foi levado pela equipe para o seu ambiente de trabalho. Todos os participantes se manifestaram de maneira espontânea e interagiram nas atividades sugeridas de forma descontraída. A atividade foi avaliada de maneira positiva tanto pelos profissionais quanto pelos graduandos como ferramenta capaz de fomentar a cidadania e o bem-estar da equipe.