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BACKGROUND: The diagnosis of a life-limiting condition of a child in the perinatal or neonatal period is a threat to parental hopes. Hope is an interactional and multidimensional construct, and in palliative care, it is a determinant of quality of life, survival, acceptance and peaceful death. OBJECTIVE: To map scientific evidence on parents' hope in perinatal and neonatal palliative care contexts. METHOD: a scoping review theoretically grounded on Dufault and Martocchio's Framework, following the Joanna Briggs Institute methodological recommendations. Searches were performed until May 2023 in the MEDLINE, CINAHL and PsycINFO databases. The searches returned 1341 studies. RESULTS: Eligible papers included 27 studies, most of which were carried out in the United States under a phenomenological or literature review approach. The centrality of women's perspectives in the context of pregnancy and perinatal palliative care was identified. The parental hope experience is articulated in dealing with the uncertainty of information and diagnosis, an approach to which interaction with health professionals is a determinant and potentially distressful element. Hope was identified as one of the determinants of coping and, consequently, linked to autonomy and parenthood. Cognitive and affiliative dimensions were the hope dimensions that predominated in the results, which corresponded to the parents' ability to formulate realistic goals and meaningful interpersonal relationships, respectively. CONCLUSION: Hope is a force capable of guiding parents along the path of uncertainties experienced through the diagnosis of a condition that compromises their child's life. Health professionals can manage the family's hope by establishing sensitive therapeutic relationships that focus on the dimension of hope. The need for advanced research and intervention in parental and family hope are some of the points made in this study. PROTOCOL REGISTRATION: https://osf.io/u9xr5/ .

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OBJECTIVES: to present a theoretical model for the interactional context of health professionals and families of children and adolescents under palliative care. METHODS: qualitative study based on the theoretical frameworks of Grounded Theory and Symbolic Interactionism. Ten palliative care professionals took part in this study through semi-structured interviews employing snowball technique from 2020 to 2021. RESULTS: the comparative data analysis resulted in the theoretical model "Searching for human connection to transcend symbolisms in pediatric palliative care". It reveals symbolic elements that substantiate the construction of a collaborative context integrating two phenomena: "Overcoming boundaries and intertwining paths" and "Embracing suffering to weave meaningful experiences". Symbolisms in palliative care guide the behavior of families and professionals, which makes them the key factor to be managed. FINAL CONSIDERATIONS: symbolisms and suffering continually integrate the interactional experience of professionals. Empathy and compassion are fundamental elements to enable their connection with families.

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ABSTRACT Objectives: to present a theoretical model for the interactional context of health professionals and families of children and adolescents under palliative care. Methods: qualitative study based on the theoretical frameworks of Grounded Theory and Symbolic Interactionism. Ten palliative care professionals took part in this study through semi-structured interviews employing snowball technique from 2020 to 2021. Results: the comparative data analysis resulted in the theoretical model "Searching for human connection to transcend symbolisms in pediatric palliative care". It reveals symbolic elements that substantiate the construction of a collaborative context integrating two phenomena: "Overcoming boundaries and intertwining paths" and "Embracing suffering to weave meaningful experiences". Symbolisms in palliative care guide the behavior of families and professionals, which makes them the key factor to be managed. Final Considerations: symbolisms and suffering continually integrate the interactional experience of professionals. Empathy and compassion are fundamental elements to enable their connection with families.

RESUMEN Objetivos: presentar un modelo teórico sobre el contexto interaccional entre los profesionales de la salud y las familias de niños y adolescentes en cuidados paliativos. Métodos: estudio cualitativo bajo la Teoría Fundamentada en los Datos y el Interaccionismo Simbólico. Participaron diez profesionales activos en cuidados paliativos, a través de entrevistas semiestructuradas, con base en la técnica de "bola de nieve", entre los años 2020 y 2021. Resultados: el análisis comparativo de los datos resultó en el modelo teórico 'Buscando la conexión humana para trascender simbolismos de los cuidados paliativos pediátricos'. Evidencia los elementos simbólicos que apoyan la construcción del contexto colaborativo integrando dos fenómenos: 'Rompiendo fronteras y entrelazando caminos' y 'Acogiendo el sufrimiento para tejer experiencias de vida significativas'. Los simbolismos de los cuidados paliativos guían los comportamientos de las familias y los profesionales, constituyendo el principal factor a ser manejado. Consideraciones Finales: el simbolismo y el sufrimiento son continuamente parte de la experiencia de interacción del profesional. La empatía y la compasión son elementos fundamentales para su conexión con las familias.

RESUMO Objetivos: apresentar um modelo teórico sobre o contexto interacional entre profissionais de saúde e famílias de crianças e adolescentes em cuidados paliativos. Métodos: estudo qualitativo sob os referenciais da Teoria Fundamentada nos Dados e Interacionismo Simbólico. Participaram dez profissionais atuantes em cuidado paliativo, por meio de entrevista semiestruturada, a partir da técnica "bola de neve", entre os anos 2020 e 2021. Resultados: a análise comparativa dos dados resultou no modelo teórico 'Buscando por conexão humana para transcender simbolismos do cuidado paliativo pediátrico'. Evidencia elementos simbólicos que sustentam a construção do contexto colaborativo integrando dois fenômenos: 'Rompendo fronteiras e entrelaçando caminhos' e 'Acolhendo o sofrimento para tecer experiências de vida significativas'. Simbolismos dos cuidados paliativos orientam comportamentos das famílias e profissionais, constituindo-se no principal interveniente a ser manejado. Considerações Finais: simbolismos e sofrimento integram continuamente a experiência interacional do profissional. Empatia e compaixão são elementos fundamentais para sua conexão com as famílias.

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In the current study, the occupational and dietary exposures of feed handling workers (N = 28) to aflatoxins (AFs), fumonisins (FBs), ochratoxin A (OTA), deoxynivalenol (DON), zearalenone (ZEN), toxins T-2 and HT-2 were assessed for the first time in animal-producing farms and feed factories from São Paulo, Brazil. Mycotoxins in food (n = 244) and airborne dust (n = 27), as well as biomarkers in urine (n = 97) samples were determined by liquid chromatography coupled with tandem mass spectrometry. FBs were detected in all airborne dust samples, with concentrations ranging from 7.85 to 16,839 ng/m3. The mean probable daily intake (PDI) based on food data were 0.005, 0.769, 0.673 and 0.012 µg/kg of body weight (bw)/day for AFs, FBs, DON and ZEN, respectively. Mean PDI values obtained through urinary biomarkers were 0.29, 0.10, 0.50, 9.72 and 0.10 µg/kg body weight/day for AFB1, DON, OTA, FB1 and ZEN, respectively. The analyses based on urinary biomarkers revealed a potential health concern for OTA and FBs, although no potential health concern was observed with PDI calculated through food data. Results of this trial stress the need for preventive measures to avoid health risks of workers in Brazilian animal-producing farms and feed industries.

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In this study, the occurrence of aflatoxins (AFs), fumonisins (FBs), ochratoxin A (OTA), deoxynivalenol (DON), zearalenone (ZEN) and some of their metabolites were assessed in breast milk and urine of lactating women (N = 74) from Pirassununga, São Paulo, Brazil. Exposure estimations through urinary mycotoxin biomarkers was also performed. Samples were collected in four sampling times (May and August 2018, February and July 2019) and analyzed by liquid chromatography coupled to tandem mass spectrometry. Aflatoxin M1 (AFM1) was not detected in breast milk. However, two samples (3%) presented FB1 at 2200 and 3400 ng/L, while 4 samples (5%) had OTA at the median level of 360 ng/L. In urine, AFM1 and aflatoxin P1 (AFP1) were found in 51 and 11% of samples, respectively (median levels: 0.16 and 0.07 ng/mg creatinine, respectively). Urinary DON (median level: 38.59 ng/mg creatinine), OTA (median level: 2.38 ng/mg creatinine) and ZEN (median level: 0.02 ng/mg of creatinine) were quantified in 18, 8 and 10% of the samples, respectively. Mean probable daily intake (PDI) values based on urinary biomarkers were 1.58, 1.09, 5.07, and 0.05 µg/kg body weight/day for AFM1, DON, OTA, and ZEN, respectively. Although a low mycotoxin occurrence was detected in breast milk, the PDI for the genotoxic AFs was much higher than those reported previously in Brazil, while PDI values obtained for OTA and DON were higher than recommended tolerable daily intakes. These outcomes warrant concern on the exposure of lactating women to these mycotoxins in the studied area.

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OBJECTIVES: to know the meaning attributed by family members to the health safety of pediatric patients, with attention to the possibilities of their collaboration. METHODS: this qualitative study was conducted with eighteen family members of children hospitalized in a pediatric unit, from January to July 2018. Symbolic Interactionism was used as a theoretical framework, and Inductive Content Analysis as method. RESULTS: child hospitalization poses risks to possible incidents and adverse events. Participants and professionals are responsible for patient safety. Thus, their actions focus on error prevention. Therefore, they seek information and observe in a vigil way professional care in classic aspects of safety. They conceive essential and favoring safety the approach centered on children and family members. Final Considerations: family members recognized the chances of errors and care damage, identified themselves as support in minimizing damage and were in partnership with the professional, increasing chances of effecting safety.

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The proteasome is the key player in the cellular protein degradation machinery and is pivotal for protein homeostasis and Schistosoma mansoni (S. mansoni) survival. Our group study provides insights into proteasome inhibitors and reveals that selective schistosomiasis agents represent an interesting branch of proteasome research linked to the development of new drugs for this neglected disease. Here, we explored the phenotypic response of S. mansoni to b-AP15, a bis-benzylidine piperidone that inhibits 26S proteasome deubiquitinases (DUBs), ubiquitin-specific protease 14 (USP14), and ubiquitin carboxyl-terminal hydrolase 5 (UCHL5). b-AP15 induces a modest decrease in egg production in vitro and reduces viability, leading to the death of parasite couples. This inhibitor also induces a twofold increase in the accumulation of polyubiquitinated proteins in S. mansoni adult worms and causes tegument changes such as disintegration, wrinkling, and bubble formation, both throughout the length of the parasite and in the oral sucker. b-AP15 alters the cell organelles of adult S. mansoni worms, and we specifically observed mitochondrial alterations, which are suggestive of proteotoxic stress leading to autophagy. Taken together, these results indicate that the deubiquitinase function of the proteasome is essential for the parasite and support the hypothesis that the proteasome constitutes an interesting drug target for the treatment of schistosomiasis.

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ABSTRACT Objectives: to know the meaning attributed by family members to the health safety of pediatric patients, with attention to the possibilities of their collaboration. Methods: this qualitative study was conducted with eighteen family members of children hospitalized in a pediatric unit, from January to July 2018. Symbolic Interactionism was used as a theoretical framework, and Inductive Content Analysis as method. Results: child hospitalization poses risks to possible incidents and adverse events. Participants and professionals are responsible for patient safety. Thus, their actions focus on error prevention. Therefore, they seek information and observe in a vigil way professional care in classic aspects of safety. They conceive essential and favoring safety the approach centered on children and family members. Final Considerations: family members recognized the chances of errors and care damage, identified themselves as support in minimizing damage and were in partnership with the professional, increasing chances of effecting safety.

RESUMEN Objetivos: conocer el significado atribuido por los familiares a la seguridad de los pacientes pediátricos, con atención a las posibilidades de su colaboración. Métodos: estudio cualitativo, realizado con dieciocho amiliares de niños hospitalizados en una unidad pediátrica, de enero a julio de 2018. El interaccionismo simbólico se utilizó como marco teórico y el análisis de contenido inductivo como método. Resultados: la hospitalización infantil impone riesgos a posibles incidentes y eventos adversos. Los participantes se identifican como corresponsables de la seguridad del paciente junto con los profesionales. Por lo tanto, sus acciones están dirigidas a prevenir errores y, para eso, buscan información y observan la atención de los profesionales en los aspectos clásicos de la seguridad de manera vigilante. El enfoque centrado en la persona del niño y la familia se considera esencial y promueve la seguridad. Consideraciones Finales: los miembros de la familia reconocieron las posibilidades de errores y daños a la atención, se identificaron como apoyo para minimizarlos y vieron en la asociación con profesionales mayores posibilidades de hacer efectiva la seguridad.

RESUMO Objetivos: conhecer o significado atribuído pelos familiares à segurança do paciente pediátrico, com atenção às possibilidades de sua colaboração. Métodos: estudo qualitativo, realizado com dezoito familiares de crianças internadas em unidade pediátrica, de janeiro a julho de 2018. Utilizou-se o Interacionismo Simbólico como referencial teórico, e a Análise de Conteúdo Indutiva como método. Resultados: a hospitalização infantil impõe riscos a possíveis incidentes e eventos adversos. Os participantes se significam enquanto corresponsáveis pela segurança do paciente juntamente aos profissionais. Assim, suas ações voltam-se à prevenção de erros e, para isso, buscam informações e observam de forma vigil o cuidado dos profissionais em aspectos clássicos da segurança. Abordagem centrada na criança e na família é considerada essencial e favorecedora de segurança. Considerações Finais: os familiares reconheceram chances de erros e danos assistenciais, identificam-se como apoio na minimização destes e veêm na parceria com profisisonais chances ampliadas de efetivar a segurança.

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This study aimed to assess the exposure of Brazilian residents (N = 86) from rural areas to multiple mycotoxins and characterize the associated risk in two sampling periods (SP) (April-May and December/2016). Mycotoxins in food and urine samples were determined by liquid chromatography coupled to tandem mass spectrometry. Mean probable daily intake (PDI) values based on occurrence data in foods in both SP varied from 0.007 to 0.013, 0.069 to 1.002, 0.119 to 0.321 and 0.013-0.156 µg kg-1 body weight (bw) day-1 for aflatoxins (AFs), deoxynivalenol (DON), fumonisins (FBs) and zearalenone (ZEN), respectively. Mean PDI values based on urinary biomarkers were 0.001, 84.914, 0.031, 0.377 and 0.002 µg kg-1 bw day-1 for AFB1, DON, ochratoxin A (OTA), FB1 and ZEN, respectively. Hazard quotient (HQ) calculated using food data revealed a potential health concern for ZEN in 2nd SP. HQ > 1 based on urinary biomarkers were observed for DON in the two SP. Although OTA was not detected in any food sample, the HQ based on urinary OTA levels was >1 in the 1st SP. Margin of exposure values for AF from food and urine data in the 1st SP were below 10,000, indicating potential health risks.

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The aim of the present study was to assess the occurrence of aflatoxins (AFs) and fumonisins (FBs) in feed ingredients (corn and soybean meal) and finishing feed in a broiler operation system, as well was to evaluate their effect on the productivity of 20 batches of broilers produced and the histology status of broilers liver after slaughter. Corn samples presented the highest frequencies of AFs and FBs, at mean levels of 29.1 and 2,100µg/kg, respectively. Soybean samples presented mean levels of 1.5 and 70µg/kg for AFs and FBs, respectively. Batches of broilers receiving feed containing FB levels higher than 1,000µg/kg had lower weight gain and higher mortality rates, while those fed rations with AFs equal or above the limit of quantification (LOQ) of the analytical method presented higher scores of histological changes in the liver. A dilution effect was observed for AFs and FBs from ingredients, especially corn, to feed during manufacture, whilst not enough to prevent losses in productivity. Results of this trial highlighted the need for strict control of mycotoxins in corn intended for broilers.(AU)

O objetivo do presente trabalho foi verificar a ocorrência de aflatoxinas (AFs) e fumonisinas (FBs) em ingredientes (milho e farelo de soja) e na ração de abate sobre a produtividade de uma empresa integradora de frangos de corte, bem como avaliar seus efeitos sobre produtividade de 20 lotes de frangos produzidos pela empresa e a histologia dos fígados dos frangos após o abate. As amostras de milho apresentaram as maiores frequências de AFs e FBs, em concentrações médias de 29,1 e 2.100µg/kg, respectivamente. As amostras de farelo de soja apresentaram níveis médios de 1,5 e 70µg/kg para AFs e FBs, respectivamente. Os lotes de aves que receberam ração contendo níveis de FBs maiores que 1,000µg/kg apresentaram menor ganho de peso e maior percentual de mortalidade, enquanto que as que receberam ração com AFs iguais ou superiores ao limite de quantificação (LQ) do método analítico apresentaram maior grau de alteração histopatológica no fígado. Houve efeito de diluição de AFs e FBs dos ingredientes, especialmente o milho, à ração no processo de fabricação, porém não suficiente para evitar perdas na produtividade. Os resultados do estudo reforçam a necessidade do controle estrito de micotoxinas no milho destinado à alimentação de frangos de corte.(AU)

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