RESUMO
Caribbean small island developing states are becoming increasingly vulnerable to compounding disasters, prominently featuring climate-related hazards and pandemic diseases, which exacerbate existing barriers to cancer control in the region. We describe the complexities of cancer prevention and control efforts throughout the Caribbean small island developing states, including the unique challenges of people diagnosed with cancer in the region. We highlight potential solutions and strategies that concurrently address disaster adaptation and cancer control. Because Caribbean small island developing states are affected first and worst by the hazards of compounding disasters, the innovative solutions developed in the region are relevant for climate mitigation, disaster adaptation, and cancer control efforts globally. In the age of complex and cascading disaster scenarios, developing strategies to mitigate their effect on the cancer control continuum, and protecting the health and safety of people diagnosed with cancer from extreme events become increasingly urgent. The equitable development of such strategies relies on collaborative efforts among professionals whose diverse expertise from complementary fields infuses the local community perspective while focusing on implementing solutions.
Assuntos
Neoplasias , Humanos , Neoplasias/epidemiologia , Neoplasias/diagnóstico , Neoplasias/prevenção & controle , Região do Caribe/epidemiologia , Desastres , Planejamento em Desastres/organização & administraçãoRESUMO
Objetivo: identificar, pelas evidências científicas na consulta do enfermeiro em cuidado avançado, o emprego das terminologias padronizadas nas etapas do processo de enfermagem em contextos de cuidado. Método: revisão integrativa realizada em seis etapas. Resultados: foram selecionados 14 artigos. As terminologias padronizadas mais utilizadas pelo enfermeiro durante as consultas de enfermagem foram a CIPE® (65%), seguida da NNN NANDA-I, NOC e NIC (21%); NOC (7%); CIPE®, NNN e Omaha System (7%). 43% utilizam a linguagem padronizada nas etapas de diagnóstico, resultado e intervenção. A respeito do contexto de cuidado, o uso de terminologias padronizadas de enfermagem era empregado 36% em ambiente hospitalar, 14% em Home Care, 14% em Atenção Primária à Saúde, 7% em clínica privada e 29% não foram informados. Conclusão: a terminologia padronizada mais utilizada foi a CIPE® (65%), nas etapas de diagnóstico, resultado e intervenção (43%) no ambiente hospitalar (36%).
Objective: to identify, through scientific evidence in the consultation of nurses in advanced care, the use of standardized terminologies in the stages of the nursing process in care contexts. Methodology: integrative review carried out in six stages. Results: 14 articles were selected. The standardized terminologies most used by nurses during nursing consultations were ICNP® (65%), followed by NNN-NANDA-I, NOC and NIC (21%); NOC (7%); ICNP®, NNN and Omaha System (7%). 43% use standardized language in the stages of diagnosis, outcome and intervention. Regarding the care context, the use of standardized nursing terminologies was used by 36% in a hospital environment, 14% in Home Care, 14% in Primary Health Care, 7% in a private clinic and 29% were not informed. Conclusion: the most used standardized terminology was ICNP® (65%), in the stages of diagnosis, outcome and intervention (43%) in the hospital environment (36%).
Objetivo: identificar, por medio de las evidencias científicas en la consulta del enfermero en cuidado avanzado, el empleo de las terminologías estandarizadas en las etapas del proceso de enfermería en contextos de cuidado. Metodología: revisión integradora realizada en seis etapas. Resultados: se seleccionaron 14 artículos. Las terminologías estandarizadas más utilizadas por las enfermeras durante las consultas de enfermería fueron CIPE® (65%), seguida de NNN NANDA-I, NOC y NIC (21%); NOC (7%); CIPE®, NNN y Omaha System (7%). El 43% utilizó el lenguaje estandarizado en las etapas de diagnóstico, resultado e intervención. En lo que respecta al contexto de la atención, el uso de las terminologías denominadas de enfermería se empleó en un 36% en el entorno hospitalario, en un 14% en la atención domiciliaria, en un 14% en la atención primaria a la salud, en un 7% en clínica privada y un 29% no fueron informados. Conclusión: la terminología estandarizada más utilizada fue la CIPE® (65%), en las etapas de diagnóstico, resultado e intervención (43%) en el ámbito hospitalario (36%).
Assuntos
Humanos , Masculino , Feminino , Prática Avançada de Enfermagem/tendências , Enfermagem Baseada em EvidênciasRESUMO
Objetivo: identificar as características profissionais e de formação dos enfermeiros da atenção primária e a operacionalização da consulta de enfermagem como contribuição para as Práticas Avançadas de Enfermagem. Método: estudo transversal e descritivo, incluindo 10 enfermeiros da Atenção Primária no sul de Minas Gerais, Brasil. Os dados foram coletados entre fevereiro e março/2022, após aprovação do Comitê de Ética e Pesquisa sob CAAE 53210021.6.0000.5099 e Parecer nº5.136.913. Resultados: 90% eram mulheres, com 17,33 anos de formação, especialistas (80%), sendo 70% em Saúde da Família; 70% atuavam somente na atenção primária; 100% compreendiam sobre as Práticas Avançadas de Enfermagem e consideravam um nível de compreensão alto (60%). 100% realizavam a consulta de enfermagem, 70% utilizavam a Classificação Internacional de Atenção Primária. Conclusão: os enfermeiros eram especialistas, tinham conhecimento sobre Práticas Avançadas de Enfermagem, realizavam a consulta de enfermagem e utilizavam a Classificação Internacional de Atenção Primária como linguagem padronizada
Objective: identify the professional and training characteristics of primary care nurses and the operationalization of the nursing consultation as a contribution to Advanced Nursing Practices. Method: cross-sectional and descriptive study, including ten primary care nurses in southern Minas Gerais, Brazil. Data were collected between February and March/2022 after approval by the Ethics and Research Committee under CAAE 53210021.6.0000.5099 and Opinion nº5.136.913. Results: 90% of the nurses were women, with 17.33 years of education, specialists (80%), 60% in Family Health; 70% worked only in primary care; 100% understood Advanced Nursing Practice and considered a high level of understanding (60%). 100% performed the nursing consultation, and 70% used the International Classification of Primary Care. Conclusion: the nurses were specialists, had knowledge about Advanced Nursing Practices, performed the nursing consultation, and used the International Classification of Primary Care as a standardized language
Objetivo: identificar las características profesionales y formativas de los enfermeros de atención primaria y la operacionalización de la consulta de enfermería como contribución a las Prácticas Avanzadas de Enfermería. Método: estudio transversal y descriptivo, incluyendo 10 enfermeros de atención primaria en el sur de Minas Gerais, Brasil. Los datos fueron recogidos entre febrero y marzo/2022, tras la aprobación del Comité de Ética e Investigación bajo el CAAE 53210021.6.0000.5099 y el Dictamen nº 5.136.913. Resultados: el 90% eran mujeres, con 17,33 años de formación, especialistas (80%), siendo el 60% en Salud de la Familia; el 70% trabajaba sólo en atención primaria; el 100% entendía sobre las Prácticas Avanzadas de Enfermería y consideraba un nivel alto de comprensión (60%). El 100% realizó la consulta de enfermería, el 70% utilizó la Clasificación Internacional de la Atención Primaria. Conclusión: los enfermeros eran especialistas, tenían conocimientos sobre las Prácticas Avanzadas de Enfermería, realizaban la consulta de enfermería y utilizaban el Clasificación Internacional de la Atención Primaria como lenguaje estandarizado
Assuntos
Humanos , Masculino , Feminino , Atenção Primária à Saúde , Classificação Internacional de Atenção Primária , Processo de EnfermagemRESUMO
Objetivo: explorar as percepções dos enfermeiros da Atenção Primária sobre a importância de avaliar o Letramento em Saúde, durante a consulta de enfermagem aos doentes crônicos. Método: abordagem qualitativa, descritivo, desenvolvido com dez enfermeiros das Estratégias de Saúde da Família de um município sul Mineiro. A coleta de dados ocorreu por meio da técnica de grupo focal, sob a análise de conteúdo Bardin. Resultados: através da análise do discurso dos participantes, pode-se observar as percepções e estratégias decorrentes do Letramento em Saúde na consulta de enfermagem aos doentes crônicos. Conclusão: os participantes demonstraram conhecimento sobre o Letramento em Saúde, conseguindo identificar fatores influenciadores, impacto gerado pelo nível de Letramento em Saúde, assim como os facilitadores e barreiras que afetam no desenvolvimento de atividades de enfermagem que visam melhorar o nível de Letramento em Saúde dos pacientes
Objectives: to explore the perceptions of Primary Care nurses about the importance of assessing Health Literacy during the nursing consultation with the chronically ill. Method: qualitative, descriptive approach, developed with ten nurses from the Family Health Strategies of a city in the south of Minas Gerais. Data collection occurred through the focus group technique, under Bardin content analysis. Results: through the analysis of the participants' discourse, the perceptions and strategies arising from Health Literacy in the nursing consultation with the chronically ill can be observed. Conclusion: the participants demonstrated knowledge about Health Literacy, being able to identify influencing factors, impact generated by the level of Health Literacy, as well as facilitators and barriers that affect the development of nursing activities aimed at improving the level of Health Literacy of patients
Objetivos: explorar las percepciones de enfermeros de Atención Primaria sobre la importancia de evaluar la Alfabetización en Salud durante la consulta de enfermería con enfermos crónicos. Método: abordaje cualitativo, descriptivo, desarrollado con diez enfermeros de las Estrategias de Salud de la Familia de un municipio del sur de Minas Gerais. La recolección de datos ocurrió a través de la técnica de grupo focal, bajo análisis de contenido Bardin. Resultados: a través del análisis del discurso de los participantes, se pueden observar las percepciones y estrategias decentes del Letramento en Salud en la consulta de enfermería a los pacientes crónicos. Conclusión: los participantes demostraron conocimientos sobre Letramento en Salud, siendo capaces de identificar factores influyentes, impacto generado por el nivel de Letramento en Salud, así como facilitadores y barreras que afectan al desarrollo de actividades de enfermería dirigidas a mejorar el nivel de Letramento en Salud de los pacientes
Assuntos
Humanos , Masculino , Feminino , Atenção Primária à Saúde , Doença Crônica , Letramento em Saúde , PacientesRESUMO
Cloning systems like Gateway and Golden Gate/Braid are known because of their efficiency and accuracy. While the main drawback of Gateway is the expensive cost of the enzymes used in its two-step (LR and BP) reaction, Golden Gate requires non-reusable components due to their specific restriction sites. We present the Brick into the Gateway (BiG) protocol as a new cloning strategy, faster and more economic method that combines (i) reusable modules or bricks assembled by the GoldenBraid approach, and (ii) Gateway LR reactions [recombination of attachment sites: attL (L from left) and attR (R from right)] avoiding the BP reaction [recombination of attachment sites: attP (P from phage) and attB (B from bacteria)] usually necessary in the Gateway cloning. The starting point is to perform a PCR reaction to add type IIS restriction sites into DNA fragments generating specific fusion sites. Then, this PCR product is used to design GoldenBraid bricks, including the attL Gateway recombination sites. Using the Golden Gate method, these bricks are assembled to produce an attL1 -gene of interest- attL2 fragment, which is integrated into a compatible vector producing a Gateway entry vector. Finally, the fragment containing the target gene is recombined by LR reaction into the Gateway destination vector. This protocol was validated in: Plasmid (2022), DOI: 10.1016/j.plasmid.2022.102630 Graphical abstract.
RESUMO
Mammals show immune up-regulation and increased plasma and local (gastrointestinal tract) concentrations of some immunoregulatory hormones, such as corticosterone and melatonin, after feeding. However, little is known about the endocrine and immune modulation in the postprandial period of ectothermic animals. This study investigated the effects of feeding on endocrine and immune responses in the bullfrog (Lithobates catesbeianus). Frogs were fasted for 10â days and divided into two groups: fasted and fed with fish feed (5% of body mass). Blood and gastrointestinal tract tissues (stomach and intestine) were collected at 6, 24, 48, 96 and 168â h to measure neutrophil/lymphocyte ratio, plasma bacterial killing ability, phagocytosis of blood leukocytes, plasma corticosterone and melatonin, and stomach and intestine melatonin. Feeding increased plasma corticosterone at 24â h and decreased it at 168â h, and increased neutrophil/lymphocyte ratio at 6, 24 and 96â h. We also observed decreased bacterial killing ability 48â h after feeding. Stomach melatonin increased after 17 days of fasting. We show that feeding activates the hypothalamic-pituitary-interrenal axis and promotes transient immunosuppression, without stimulating an inflammatory response. Increased corticosterone may mobilize energy to support digestive processes and melatonin may protect the stomach during fasting. We conclude that feeding modulates secretion of immunoregulatory hormones, initially increasing plasma corticosterone levels, followed by a decrease at the end of meal digestion, and causes systemic immune cell redistribution, increasing neutrophil/lymphocyte ratio for almost the entire period of meal digestion in bullfrogs. Also, fasting modulates secretion of melatonin in the stomach.
Assuntos
Melatonina , Período Pós-Prandial , Animais , Corticosterona , Linfócitos , Rana catesbeianaRESUMO
This work was aimed at identifying the effectiveness of two interventions applied to a group of eight kennelled police dogs. Interventions consisted of access to a lawn area (350 m2) and "toy" (a 30 cm jute rag roll, hanging from the kennel ceiling), both available for 15 min a day, for four days in a row. We collected behavioural data and faecal samples for cortisol metabolites evaluation before, during and after interventions. Faecal cortisol metabolites levels were significantly reduced (Friedman, X2(3) = 12.450; p = 0.006) during the second round of intervention, regardless of the type of intervention, indicating that the interventions can have a beneficial cumulative effect. Regarding the frequency of stereotyped behaviour, cluster analysis identified two groups of individuals: (1) high-stereotyping individuals (n = 3) that had a tendency to reduce stereotyping behaviours in the lawn intervention when compared to toy intervention (Friedman, X2(3) = 2.530; p = 0.068), and (2) low-stereotyping animals (n = 5) that did not present significant behavioural changes during the experiment. The variety of behavioural and endocrine parameters evaluated highlights the need to account for the individual in behaviour and welfare research. Overall, our results suggest that even simple environmental enrichment can be an effective method to mitigate behaviour and physiological signs of stress.
RESUMO
Oral diseases such as periodontitis can have a more negative influence on the quality of life of obese than in normal-weight patients. The objective of the present study was to assess the impact of one-stage full-mouth disinfection (OSFMD) therapy on the oral health-related quality of life (OHRQL) of obese and non-obese individuals with periodontitis. Fifty-five obese and thirty-nine non-obese patients were evaluated. The questionnaires oral impacts on daily performance (OIDP) and oral health and quality of life (OHQoL) were given to all patients at baseline and 6 months after periodontal treatment by the OSFMD protocol. For statistical analysis, Chi-square, the two-factor repeated-measures ANOVA, and correlation tests were used. At baseline, mean global OHQoL and OIDP scores were similar for both groups (p > 0.05). At 6 months, OSFMD resulted in OHQoL and OIDP global scores improvements in both groups (p < 0.05), with no significant difference between groups. The most impaired activity at baseline was eating and cleaning teeth for both groups. Periodontal parameters were associated with worse values in the OHQoL and OIDP questionnaires only in obese patients. In conclusion, OSFMD yielded similar improvements in overall OHRQL in both obese and non-obese individuals. Periodontal parameters were associated with a worse quality of life in obese patients. Periodontal treatment can be an important component to improve the OHRQL of obese individuals, and clinicians should expect similar results as those obtained with non-obese patients.
Assuntos
Periodontite , Qualidade de Vida , Humanos , Obesidade/complicações , Saúde Bucal , Periodontite/terapia , Inquéritos e QuestionáriosRESUMO
X-linked myopathy with excessive autophagy (XMEA) is a genetic disease associated with weakness of the proximal muscles. It is caused by mutations in the VMA21 gene, coding for a chaperone that functions in the vacuolar ATPase (v-ATPase) assembly. Mutations associated with lower content of assembled v-ATPases lead to an increase in lysosomal pH, culminating in partial blockage of macroautophagy, with accumulation of vacuoles of undigested content. Here, we studied a 5-year-old boy affected by XMEA, caused by a small indel in the VMA21 gene. Detection of sarcoplasmic Lc3 (also known as MAP1LC3B)-positive vacuoles in his muscle biopsy confirmed an autophagy defect. To understand how autophagy is regulated in XMEA myogenesis, we used patient-derived muscle cells to evaluate autophagy during in vitro muscle differentiation. An increase in lysosomal pH was observed in the patient's cells, compatible with predicted functional defect of his mutation. Additionally, there was an increase in autophagic flux in XMEA myotubes. Interestingly, we observed that differentiation of XMEA myoblasts was altered, with increased myotube formation observed through a higher fusion index, which was not dependent on lysosomal acidification. Moreover, no variation in the expression of myogenic factors nor the presence of regenerating fibers in the patient's muscle were observed. Myoblast fusion is a tightly regulated process; therefore, the uncontrolled fusion of XMEA myoblasts might generate cells that are not as functional as normal muscle cells. Our data provide new evidence on the reason for predominant muscle involvement in the context of the XMEA phenotype.This article has an associated First Person interview with the first author of the paper.
Assuntos
Diferenciação Celular , Doenças Genéticas Ligadas ao Cromossomo X/patologia , Músculo Esquelético/patologia , Doenças Musculares/patologia , Autofagia , Sequência de Bases , Biópsia , Brasil , Proliferação de Células , Pré-Escolar , Feminino , Regulação da Expressão Gênica , Doenças Genéticas Ligadas ao Cromossomo X/genética , Humanos , Recém-Nascido , Lisossomos/metabolismo , Masculino , Fusão de Membrana , Desenvolvimento Muscular/genética , Fibras Musculares Esqueléticas/metabolismo , Fibras Musculares Esqueléticas/patologia , Doenças Musculares/genética , Mioblastos/metabolismo , Mioblastos/patologia , Linhagem , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , ATPases Vacuolares Próton-Translocadoras/genética , ATPases Vacuolares Próton-Translocadoras/metabolismo , Vacúolos/patologia , Vacúolos/ultraestruturaRESUMO
Central Core Disease (CCD) is an inherited neuromuscular disorder characterized by the presence of cores in muscle biopsy. CCD is caused by mutations in the RYR1 gene. This gene encodes the ryanodine receptor 1, which is an intracellular calcium release channel from the sarcoplasmic reticulum to the cytosol in response to depolarization of the plasma membrane. Mutations in this gene are also associated with susceptibility to Malignant Hyperthermia (MHS). In this study, we evaluated 20 families with clinical and histological characteristics of CCD to identify primary mutations in patients, for diagnosis and genetic counseling of the families. We identified variants in the RYR1 gene in 19/20 families. The molecular pathogenicity was confirmed in 16 of them. Most of these variants (22/23) are missense and unique in the families. Two variants were recurrent in two different families. We identified six families with biallelic mutations, five compound heterozygotes with no consanguinity, and one homozygous, with consanguineous parents, resulting in 30% of cases with possible autosomal recessive inheritance. We identified seven novel variants, four of them classified as pathogenic. In one family, we identified two mutations in exon 102, segregating in cis, suggesting an additive effect of two mutations in the same allele. This work highlights the importance of using Next-Generation Sequencing technology for the molecular diagnosis of genetic diseases when a very large gene is involved, associated to a broad distribution of the mutations along it. These data also influence the prevention through adequate genetic counseling for the families and cautions against malignant hyperthermia susceptibility.