Consciousness and education: contributions by Piaget, Vygotsky and Steiner

The objective of this study is to gain an understanding of the development of consciousness and its relationship with education based on different theoretical models-namely those by Piaget, Vygotsky and Steiner. All three of them focus on different subcomponents of the educational process and there is hence a need for integrative discussion. Piaget and Vygotsky are fundamental references in the understanding of developmental and learning processes. Steiner was a pioneer in proposing a pedagogy that progresses by integrating feeling and wanting alongside thinking in the educational process. Their theories have important similarities but also differences and these will be essential for broadening the understanding of the construction of consciousness and its relationships with education.

Maternal mental health, marital adjustment, and family support in the grieving process after a pregnancy loss

Pregnancy loss can have a profound impact on a woman's psychological and emotional health often leading to a grieving process. Furthermore, the loss of a child is a risk factor for Prolonged Grief Disorder (PGD) according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition-Text Revision (DSM-5-TR). This cross-sectional study investigated the associations between mental health, marital adjustment, family support, gestational age, and prolonged grief. We recruited 93 women who had lost a pregnancy and had a living child born after the loss. Maternal mental health and gestational age at the time of loss were the variables most correlated with prolonged grief symptoms. A network model further confirmed the results and highlighted the importance of adopting a systemic and interactive approach to these and the other variables of interest related to pregnancy loss. Raising awareness regarding mental healthcare and support networks for mothers after pregnancy loss is essential.

Parenting styles and dental caries in Brazilian children and adolescents in foster care

PURPOSE

This study aimed to analyse parenting styles as a possible factor associated with caries in foster children and adolescents who had been victims of domestic violence.

METHODS

The study was carried out in nine foster shelters in Recife, Northeast Brazil, with a sample of 88 participants aged 8 to 17 years old. Data were collected through intraoral examinations to verify deft/DMFT indices, applying the Demandingness and Responsiveness Scales to determine parenting styles. In turn, sociodemographic data were retrieved from records filed at the institutions. Descriptive analysis was performed, with the Mann-Whitney and Kruskal-Wallis tests being used to compare the categories of numerical variables.

RESULTS

The mean deft/DMFT was of 3.78 in children (8 and 9 years old) and 1.93 in adolescents (10 years old and older). Overall, the index was of 2.31. Neglect was the main reason for the children's admission to foster care, while neglectful was the most prevalent parenting style.

CONCLUSION

Children of indulgent parents had higher caries indices in both deciduous and permanent teeth, while children of authoritative (permanent teeth) and authoritarian parents (deciduous teeth) had the lowest caries indices. However, no significant associations were found between caries and parenting styles.

Trend in mortality from mental and behavioral disorders due to alcohol use in Brazil, 2010-2021

OBJECTIVE

To analyze the trend in mortality from mental and behavioral disorders due to alcohol use in Brazil, 2010-2021.

METHODS

This was an time series study using Mortality Information System data. Annual percentage change (APC) and 95% confidence intervals (95% CI) were calculated using Prais-Winsten linear regression.

RESULTS

Mortality showed a stationary trend for Brazil as a whole (APC = 0.6; 95%CI -4.2;3.0), a falling trend in individuals aged 20-29 years in the South (APC = -7.4; 95%CI -10.0;-4.3) and Northeast (APC = -3.4; 95%CI -6.4;-0.4) regions, in people aged 30-39 in the Midwest region (APC = -3,8; 95%CI -7.4;-0.1) and 40-49 in the South (APC = -2.1; 95%CI -3.8;-0.4), North (APC = -3.1; 95%CI -5.7;-0.5) and Midwest (APC = -2.9; 95%CI -5.5;-0.3) regions.

CONCLUSION

Mortality from mental and behavioral disorders due to alcohol use showed a stationary trend nationally and a falling trend in some age groups regionally.

Emotion regulation skills as a mediator of STEM teachers' stress, well-being, and burnout

The teaching profession highly stressful, and teachers are often faced with challenging situations. This is particularly the case in STEM (science, technology, engineering, and math) education, which is a uniquely demanding and challenging field. This study examined the role of emotional regulation (ER) skills in STEM teachers' stress, well-being, and burnout. The sample included 165 STEM teachers in middle and high schools who completed standard online questionnaires on ER, stress, well-being, and burnout. They were also asked to comment on three videos depicting authentic mathematical and pedagogical situations. The results indicated that contrary to popular belief, seniority was not linked with levels of stress, difficulties in ER, lower levels of well-being, or higher levels of burnout. A structural equation model and bootstrapping analysis showed teachers' levels of stress predicted their well-being, and this link between stress and well-being was mediated by teachers' level of difficulty in ER. The study highlights the importance of STEM teachers' well-being and suggests the need to reduce stress and burnout by providing tools for teachers to regulate their emotions in the classroom.

[The mediating role of social media addiction and sleep quality in the association between social media usage and depressive symptoms in university students]

Increase in time spent on social media and its association with depressive symptoms, especially among young adults, has generated the need to understand how this association occurs in order to support the development of policies to reduce harm and complications. In view of this fact, this study aimed to assess the mediating effect of social media addiction and sleep quality on the association between time spent on social media and depressive symptoms in Brazilian university students. This is a cross-sectional study conducted with 2,823 university students, who provided information regarding time spent on social media, social media addiction, depressive symptoms and sleep quality. The mediation analysis, adjusted for confounding factors, was performed using the PROCESS macro for SPSS to obtain the total (c), direct (c'), and indirect effects (EI1, EI2, and EI3). The results identified an association between time spent on social media and depressive symptoms, mediated by social media addiction (EI1 = 20%) and sleep quality (EI1 = 40%). These findings help expand knowledge about the mechanisms that mutually influence the relationship between time spent on social media and depressive symptoms, supporting the adoption of strategies to reduce harm resulting from excessive social media use.

Breast cancer cultural representations: a scoping review

This article aims to map the global scientific production on social or cultural representations and breast cancer in Public Health and discuss how it is presented in the literature. We conducted a scoping review guided by the question: "How are cultural or social representations in the context of breast cancer described in the global scientific Public Health production?". We searched for works in five scientific literature sources and included 45 studies. The analytical process followed the content analysis technique in the thematic modality. The analyzed collection can be thematized into the following categories: (1) Compromised body image and interactions, (2) Spirituality, (3) Loss of control over life, (4) Going on with life, and (5) Association with ethnic-racial issues. Despite advances in biomedicine, we observed that representations of breast cancer still have metaphors associated with cancer in the last century. We conclude that, among other aspects, care for women with breast cancer cannot be guided only by biomedical and epidemiological approaches since this disease is traversed by knowledge that competes with these approaches.

Survival analysis of Chagas disease patients, beneficiaries of social security and social assistance in Brazil, 1942-2016

OBJECTIVE

To analyze the survival of patients with Chagas disease, beneficiaries of social security and social assistance, in Brazil, from 1942 to 2016.

METHODS

This is a retrospective cohort study with data from the Brazilian Ministry of Social Security. The event of interest was death, and the survival functions were estimated by the Kaplan-Meier and Cox regression methods.

RESULTS

In the period "onset of the disease until death", women (HR=0.54; 95%CI 0.43-0.53) and receiving social security benefits (HR=0.13; 95%CI 0.11-0.23) were associated with longer survival. Lower survival was associated with the cardiac form of the disease (HR=2.64; 95%CI 2.23-3.12), living in a rural area (HR=1.23; 95%CI 1.14-1.21), and manifestation of the disease between the years 2000 and 2016 (HR=5.32; 95%CI 4.74-5.93). Likewise, in the period "work disability until death", women (HR=0.51; 95%CI 0.41-0.52) and receiving social security benefits (HR=0.24; 95%CI 0,14-0.45) were associated with longer survival, as well as the cardiac form of the disease (HR=1.95; 95%CI 1.83-2.13), living in a rural area (HR=1.31; 95%CI 1.21-1.54), and manifestation of the disease between 2000 and 2016 (HR=1.53; 95%CI 1.33-1.71) were associated with lower survival.

CONCLUSION

The main predictors of mortality and survival of patients with Chagas disease who receive social security and assistance benefits in Brazil were presented. These findings can guide the definition of priorities for follow-up actions by Primary Health Care, currently recommended for the longitudinal management of the disease.

Women with disabilities and their motherhood: scoping review

This review aims to disclose the gaps and needs for acknowledging the rights to experience motherhood of women with disabilities. To do so, we map how much is known about these women's experience with motherhood, shedding light on their sexual and reproductive rights. The present work followed the scoping review by the Joanna Briggs Institute (JBI). This research is structured by elaborating the question, identifying the relevant studies, selecting the studies, extracting the data, sorting, summarizing, and creating reports based on the results. Results: we found 1050 articles, of which 53 were selected for the analysis. considering the different themes, we generated three axes: (1) infantilization, dehumanization, and discredit in the experience of motherhood; (2) obstetric ableism - an expression of violence in obstetrics; (3) reproductive justice - politicize motherhood and care. The study showed the urgent need to regard women with disabilities as people having the right to make sexual and reproductive health choices. Health professionals need permanent education to acknowledge and guarantee such a need as interweaving relationships to reach decision-making and autonomy.

Reading processes of public and private middle school and high school students

INTRODUCTION

Reading has been widely discussed, mainly due to the published results of international performance tests of schoolchildren. The gaps generated in literacy hinder the development of basic skills necessary for reading, which will have a negative impact on the teaching-learning process from elementary school to high school. This study aimed to compare the reading performance of the students in public and private schools through tests of the Brazilian reading processes-PROLEC-SE-R.

METHODS

Cross-sectional study. The Brazilian adaptation of the PROLEC-SE-R was administered to 436 students: 221 from the state school (G1 6th year, n = 30; G2 7th year, n = 33; G3 8th year, n = 35; G4 9th year, n = 31; G5 1st year, n = 32; G6 2nd year, n = 30; G7 3rd year, n = 30) e 215 private schools (G8 6th year, n = 31; G9 7th year, n = 31; G10 8th year, n = 30; G11 9th year, n = 31; G12 1st year, n = 30; G13 2nd year, n = 31; G14 3rd year, n = 31). Tools of descriptive and bivariate analysis were used.

RESULTS

Superior performance of the private school students on spelling tests helps their reading as evidenced by their scores for syntactic and semantic processes. When the knowledge of the use of the word in text, extraction of meaning and its understanding was needed, the difficulty of access to the mental lexicon of the studied population became evident.

CONCLUSION

The PROLEC-SE-R, in addition to establishing the reading profile of elementary and high school students, shows that the gaps in teaching and learning, which exist between public and private education in the literacy period, accompany students throughout the basic education cycle. Knowing the reading profile and in which process there is a disruption is important so that the teaching of specific strategies can be promoted throughout the entire schooling process, especially in primary and secondary education.

Meanings and perceptions of parenthood among transgender men who became pregnant before gender transition

This qualitative study, with five participating interlocutors, sought to understand the senses and meanings of parenting among trans men who became pregnant before gender transition. Analysis was conducted in light of social theories of gender. The results demonstrated an experience of parenthood subject to a field of tensions and negotiations, as well as subjective production that oscillated between transgression and accommodation of the cultural perspective of their own experience. The forms of violence found to be practiced reiterated social vulnerabilities, exposed healthcare service weaknesses and produced harmful effects on transgender men who become pregnant before gender transition.

Skin donation for transplantation: Social representations of family members who (do not) give consent for collection

Despite the advantages of using deceased donor skin in the treatment of burns, it is not easy to obtain these grafts due to low tissue donation rates. In order to discover the social representations of family members of organ donors regarding skin donation and to analyze the convergences and divergences of these representations between family members who consented and those who refused to allow skin to be donated for transplantation, we conducted interviews with 20 family members of organ donors in a situation of brain death. Data were obtained through interviews and submitted to the Collective Subject Discourse Analysis Technique. This study shows that in the opinion of family members who consented and those who did not authorize skin donation, the consideration contains both positive and negative representations, which can have different weights and influence decision-making. This study also highlights, in an unprecedented way, the representation of the animalization of the donor, which can be a reason for the refusal to allow skin to be donated.

Gender-Based Differences in Psychological, Nutritional, Physical Activity, and Oral Health Factors Associated with Stress in Teachers

The aim of this study was to analyze gender differences in stress-related factors among active teachers. A cross-sectional study was conducted to examine gender disparities in psychological, nutritional, physical activity, and oral health factors and how these habits correlate with stress and burnout in their work environment. The sample comprised 1037 teachers from Spain, Colombia, and Chile, consisting of 40.1% men and 59.9% women, with an average age of 41 years and teaching experience of 11.8 ± 9.2 and 12.2 ± 8.7 years, respectively. They were evaluated using a compilation of questionnaires with the objective of analyzing gender differences in habits that are associated with stress levels in teachers. The findings revealed that men had significantly higher levels of depersonalization and personal accomplishment, whereas women exhibited higher levels of perceived stress and conscientiousness. Regarding nutritional habits, results were more positive for women, and men exhibited healthier functional habits by engaging in more weekly sports. Regarding oral health habits, women had better oral hygiene practices, brushing their teeth more frequently. However, women showed a higher tendency to smoke than their male counterparts. We conclude that there are notable gender differences that can provide insights for developing strategies to enhance the overall well-being of teachers.

Exploring the prevalence of anabolic steroid use among men and women resistance training practitioners after the COVID-19 pandemic

BACKGROUND

The COVID-19 pandemic has had a significant impact on individual health and fitness routines globally. Resistance training, in particular, has become increasingly popular among men and women looking to maintain or improve their physical fitness during the pandemic. However, using Anabolic Steroids (AS) for performance enhancement in resistance training has known adverse effects. Thus, this study aimed to explore the prevalence of AS use among men and women resistance training practitioners after the COVID-19 pandemic.

METHODS

A cross-sectional survey was conducted among 3,603 resistance training practitioners (1,855 men and 1,748 women) in various geographical locations impacted by COVID-19. The participants were asked to complete self-administered questionnaires, which included questions regarding demographic information, training habits, and current or prior usage of AS. The data were analyzed using SPSS statistical software and the chi-square method, with a significance level of (P < 0.05).

RESULTS

A total of 3603 men and women resistance training practitioners completed the survey. In the study, 53.05% of men and 41.99% of women used anabolic and androgenic steroids. Of those men who used steroids, 29.47% used Testosterone, while 31.20% of women used Winstrol. Additionally, 50.30% of men used steroids via injection, while 49.05% of women used them orally. According to the study, 49.99% of the participants had 6 to 12 months of experience with resistance training, and 64.25% of them underwent three training sessions per week. The analysis using the χ2 test did not reveal any significant difference between men and women in terms of duration of bodybuilding, frequency per week, and engagement in other activities.

CONCLUSION

This study shows that a significant proportion of men and women resistance training practitioners used AS, particularly among young adults with limited training experience. Thus, there is a need for targeted education and awareness campaigns to address the hazards of AS use and promote healthy training habits during the COVID-19 pandemic.

The joy and pain of being a harm reduction worker: a qualitative study of the meanings about harm reduction in Brazil

BACKGROUND

Although harm reduction is highlighted as an effective intervention for alcohol and drug use, a funding gap for harm reduction interventions has been identified, mainly in low- and middle-income countries. In these countries, tensions between abstinence and harm reduction models have impaired the shift from punitive practices to evidence-based interventions committed to guaranteeing the human rights of people who use drugs. Since 2015, the Brazilian government has adopted a more punitive and abstinence-focused drug policy that jeopardizes the care of people who use alcohol and other drugs and the comprehension of the harm reduction workers' perspective in relation to their practice. Therefore, this study aimed to comprehend the meanings constructed by Brazilian harm reduction workers regarding their practices with vulnerable populations amidst a context of political tension.

METHODS

We conducted 15 in-depth semi-structured qualitative interviews with harm reduction workers employed in public health services for at least 6 months. Data were analyzed using thematic analysis.

RESULTS

The thematic axis "The joy and pain of being a harm reduction worker in Brazil" was constructed and divided into four major themes: (1) Invisibility of harm reduction work; (2) Black, poor, and people who use drugs: identification with the service users; (3) Between advocacy and profession: harm reduction as a political act; (4) Small achievements matter. Despite the perceived invisibility of harm reduction workers in the public health and alcohol and drug fields, valuing small achievements and advocacy were important resources to deal with political tension and punitive strategies in Brazil. The findings also highlight the important role of harm reduction workers due to their personal characteristics and understanding of drug use behavior, which bring the target audience closer to actions within the public health system.

CONCLUSION

There is an urgent need to acknowledge harm reduction based on peer support as a professional category that deserves adequate financial support and workplace benefits. Additionally, expanding evidence-based harm reduction interventions and community-based voluntary drug use treatment centers should be prioritized by public policies to address the human rights violations experienced by people who use drugs.

Compliance and initiative: A discussion on the relationship between standards and activities in radiopharmaceutical production

This study investigated how a standard could become reality-based in a workplace where certain types of deviations are not permitted, such as a radiopharmaceutical production unit. Compliance with standards is necessary to ensure the safety of individuals who manufacture such substances as well as the security of patients receiving treatment. In this qualitative case study, an ergonomic analysis of work (also known as activity analysis) was performed, with noncompliance recorded in internal audits as a starting point: the lack of double-checking in radiopharmaceutical synthesis cassette assembly. Field observations and self-confrontation interviews with workers from a production unit were conducted to analyze the activities. Although a double-check did not occur, the radiopharmaceutical synthesis operator apparently developed another risk control strategy, focusing his attention to the equipment assembly details, which necessitated continuous control and verification actions to ensure that there were no problems at this stage of production. A multilevel approach was used to demonstrate how the safety and quality of production processes based on standard compliance only become effective and adherent to the activity after resolving various conflicts at work, including control systems (external and internal audits), work collectives, the contradiction of the activity itself, and the discussion of singular situations arising daily. This study contributes to the discussion on workplace safety considering standardization and advances the discussion on changing perspectives regarding rule compliance.

Psychological well-being of hospice staff: systematic review

BACKGROUND

Poor psychological well-being among healthcare staff has implications for staff sickness and absence rates, and impacts on the quality, cost and safety of patient care. Although numerous studies have explored the well-being of hospice staff, study findings vary and the evidence has not yet been reviewed and synthesised. Using job demands-resources (JD-R) theory, this review aimed to investigate what factors are associated with the well-being of hospice staff.

METHODS

We searched MEDLINE, CINAHL and PsycINFO for peer-reviewed quantitative, qualitative or mixed-methods studies focused on understanding what contributes to the well-being of hospice staff who provide care to patients (adults and children). The date of the last search was 11 March 2022. Studies were published from 2000 onwards in the English language and conducted in Organisation for Economic Co-operation and Development countries. Study quality was assessed using the Mixed Methods Appraisal Tool. Data synthesis was conducted using a result-based convergent design, which involved an iterative, thematic approach of collating data into distinct factors and mapping these to the JD-R theory.

RESULTS

A total of 4016 unique records were screened by title and abstract, 115 full-text articles were retrieved and reviewed and 27 articles describing 23 studies were included in the review. The majority of the evidence came from studies of staff working with adult patients. Twenty-seven individual factors were identified in the included studies. There is a strong and moderate evidence that 21 of the 27 identified factors can influence hospice staff well-being. These 21 factors can be grouped into three categories: (1) those that are specific to the hospice environment and role, such as the complexity and diversity of the hospice role; (2) those that have been found to be associated with well-being in other similar settings, such as relationships with patients and their families; and (3) those that affect workers regardless of their role and work environment, that is, that are not unique to working in a healthcare role, such as workload and working relationships. There was strong evidence that neither staff demographic characteristics nor education level can influence well-being.

DISCUSSION

The factors identified in this review highlight the importance of assessing both positive and negative domains of experience to determine coping interventions. Hospice organisations should aim to offer a wide range of interventions to ensure their staff have access to something that works for them. These should involve continuing or commencing initiatives to protect the factors that make hospices good environments in which to work, as well as recognising that hospice staff are also subject to many of the same factors that affect psychological well-being in all work environments. Only two studies included in the review were set in children's hospices, suggesting that more research is needed in these settings.

PROSPERO REGISTRATION NUMBER

CRD42019136721 (Deviations from the protocol are noted in Table 8, Supplementary material).

Paper-based analytical device for sensitive colorimetric determination of sulfonamides in pharmaceutical samples

Sulfa drugs are frequently used to treat infections, particularly in antibiotic resistant people. There are several techniques available to determine sulfa drugs, however, they are laborious operation, reagent consumption, expensive, and need specialized types of equipment. Here, a new, very simple and inexpensive paper-based analytical device described for the determination of five sulfa drugs: sulfacetamide, sulfadiazine, sulfamerazine, sulfamethoxazole, and sulfathiazole in pharmaceutical preparations. The method is a one-step reaction, based on the colorimetric reaction between acid-hydrolyzed sulfa drugs and 4-dimethylaminobenzaldehyde. Using a smartphone, the RGB value of color intensity was used as an analytical signal. The paper-based device displayed linear ranges of 0.10-5.00 µg mL-1, linear correlations ranging from 0.9903 to 0.9972, limits of detection 0.0030 to 0.0082 µg mL-1, and RSD of ≤0.258 under optimal conditions. The suggested approach was applied for determining five sulfa drugs in pharmaceutical formulations. This approach is appropriate for pharmaceutical applications since it is inexpensive, simple to utilize, sensitive, and selective.

Social skills training with a tabletop role-playing game, before and during the pandemic of 2020: in-person and online group sessions

Background

The area of social skills is broad, in theory and in practice. For social skills training, various clinical practices have been applied in group sessions, as have motivational resources such as role-playing games (RPGs). In recent years, the need arose to assess the clinical impact of the pandemic. The objective of this study was to determine the impact that the pandemic has had on in-person and online social skills training.

Methods

We evaluated six subjects with autism spectrum disorder, with or without another, similar disorder, each of whom attended a total of 12 two-hour RPG sessions over a 12-month period. The original (Portuguese-language) version of the Social Skills Inventory for Adolescents was applied at three different time points (pre-, mid-, and post-intervention).

Results

After six in-person tabletop RPG sessions, there was an increase in the mean frequency scores and a decrease in the mean difficulty scores. However, during the pandemic, the remaining six sessions were conducted online and the effect was the opposite.

Conclusion

Our data indicate that there is a need for further studies assessing social skills training in online contexts.

Women's body representations across the life course: A comparative study in Southern Brazil

The aim of this study is to observe how women of different ages represent their bodies and the changes they undergo across their life course. The research is based on the theory of social representations, idealized by Serge Moscovici. A total of 201 women between 25 and 88 years old from southern Brazil participated in the research. The methodological instrument consists of a questionnaire containing free associations, sentence completion and selection of images. The processing and classification of the data were done by the software Evoc (2000) and content analysis. The results showed differences between the age groups. Younger women represented the body according to aesthetic references and manifested the desire to monitor the body. Older women related the body more frequently with notions of health, social relationships, and leisure. The memories of a younger body and anticipations of an older one reflected the conventions about ageing. The study also shows that concerns about bodily limitations and age-related diseases were frequent in all age groups and may guide behaviour and attitudes towards the body. The study can inform policymakers on the needs and expectations of a growing ageing sector of the population in Brazil and worldwide.

Clinical applications of neurofeedback based on sensorimotor rhythm: a systematic review and meta-analysis

Background

Among the brain-machine interfaces, neurofeedback is a non-invasive technique that uses sensorimotor rhythm (SMR) as a clinical intervention protocol. This study aimed to investigate the clinical applications of SMR neurofeedback to understand its clinical effectiveness in different pathologies or symptoms.

Methods

A systematic review study with meta-analysis of the clinical applications of EEG-based SMR neurofeedback performed using pre-selected publication databases. A qualitative analysis of these studies was performed using the Consensus tool on the Reporting and Experimental Design of Neurofeedback studies (CRED-nf). The Meta-analysis of clinical efficacy was carried out using Review Manager software, version 5.4.1 (RevMan 5; Cochrane Collaboration, Oxford, UK).

Results

The qualitative analysis includes 44 studies, of which only 27 studies had some kind of control condition, five studies were double-blinded, and only three reported a blind follow-up throughout the intervention. The meta-analysis included a total sample of 203 individuals between stroke and fibromyalgia. Studies on multiple sclerosis, insomnia, quadriplegia, paraplegia, and mild cognitive impairment were excluded due to the absence of a control group or results based only on post-intervention scales. Statistical analysis indicated that stroke patients did not benefit from neurofeedback interventions when compared to other therapies (Std. mean. dif. 0.31, 95% CI 0.03-0.60, p = 0.03), and there was no significant heterogeneity among stroke studies, classified as moderate I2 = 46% p-value = 0.06. Patients diagnosed with fibromyalgia showed, by means of quantitative analysis, a better benefit for the group that used neurofeedback (Std. mean. dif. -0.73, 95% CI -1.22 to -0.24, p = 0.001). Thus, on performing the pooled analysis between conditions, no significant differences were observed between the neurofeedback intervention and standard therapy (0.05, CI 95%, -0.20 to -0.30, p = 0.69), with the presence of substantial heterogeneity I2 = 92.2%, p-value < 0.001.

Conclusion

We conclude that although neurofeedback based on electrophysiological patterns of SMR contemplates the interest of numerous researchers and the existence of research that presents promising results, it is currently not possible to point out the clinical benefits of the technique as a form of clinical intervention. Therefore, it is necessary to develop more robust studies with a greater sample of a more rigorous methodology to understand the benefits that the technique can provide to the population.

Neuropsychological evaluation of children and adolescents with fetal alcohol spectrum disorders in the Brazilian population

Fetal Alcohol Spectrum Disorder (FASD) is a collective name for lifelong physical and neurodevelopmental problems caused by the gestational consumption of alcohol affecting fetal development. In Brazil, the lack of awareness among healthcare professionals, and the scarcity of suitable diagnostic tools and trained clinicians, can contribute to the underestimation of FASD prevalence and severity. The present review aims to map and analyze studies conducted in Brazil on children and adolescents with FASD or a history of prenatal alcohol exposure (PAE). Additionally, it intends to report the psychometric properties of the neurodevelopmental assessment tools applied in the selected articles. Searches were carried out in the databases Scielo, LILACS, PePSIC, EMBASE, PsycINFO, Web of Science, selecting original clinical studies that have investigated the neurodevelopment of this population. From a total of 175 studies, ten articles fit the inclusion criteria in which 18 instruments were identified. The most reported deficits were related to language, general intelligence quotient (IQ), adaptive behavior, attention, and visual perception. Our results point to the need for more clinical research on FASD in Brazil, as well as for the standardization and validation of neurodevelopmental assessment tools for the accurate diagnosis of FASD in Brazil.

Adaptation at the Family Level in Families of Individuals With Down Syndrome: A Scoping Review

Down syndrome (DS) is a chromosomal disorder associated with intellectual and physical disabilities and has historically been viewed by health care providers through a negative lens when considering the effect the condition has on the individual, family, and community. The purpose of this scoping review was to provide an overview of recent research concerning adaptation in families of individuals with DS with a focus on family adaptation rather than individual or dyadic adaptation. Three literature indexes were searched from 2017 to 2022, with 41 articles included. Foci of the studies included strength/resilience, stress/coping, and negative/challenge. Thirteen studies reported using a family framework. Multiple methodological approaches and family measures were used in the studies and are outlined. Findings from this review show there has been a shift in focus when researching families of individuals with DS from a negative and challenging experience to one of strength and resilience.

Acceptability and Feasibility of Online Support Groups for Mental Health Promotion in Brazilian Graduate Students During the COVID-19 Pandemic: Longitudinal Observational Study

BACKGROUND

The outbreak of the COVID-19 pandemic in 2020 aggravated already existing difficulties and added new challenges for students. Owing to the gap between needed and available psychological services, group interventions may offer a helpful strategy for student mental health promotion.

OBJECTIVE

This study aimed to investigate the acceptability and feasibility of a 4-week online support group program designed for mental health promotion tailored to graduate students at a Brazilian public university in the context of the COVID-19 pandemic (May 2022 to June 2022).

METHODS

Participants in the program took part in online support groups based on a pilot group facilitated by a trained clinical psychologist. Self-administered, standardized web-based questionnaires were assessed at the baseline (T0; before the intervention), postintervention (T2), and follow-up (T3; after 4-6 weeks) time points. We measured sociodemographic variables, treatment credibility and expectancy (Credibility and Expectancy Questionnaire), satisfaction (Client Satisfaction Questionnaire), negative effects of the intervention (Negative Effects Questionnaire), depressive symptoms (Patient Health Questionnaire-9 [PHQ-9]), and participants' quality of life (abbreviated World Health Organization Quality of Life assessment). A 9-answer option questionnaire and open-ended questions also assessed the group's perceived positive and negative outcomes.

RESULTS

The total sample comprised 32 participants. Most (23/32, 72%) were doctoral students. Credibility and expectancy scores were high. Participants' satisfaction (Client Satisfaction Questionnaire) with the program was high at the postintervention (T2) and follow-up (T3) evaluations (T2: mean 28.66, SD 3.02; T3: mean 27.91, SD 3.02). Most participants reported that they could learn from other participants' experiences (T2: 29/32, 91%; T3: 27/32, 84%) and felt encouraged to take better care of themselves (T2: 22/32, 69%; T3: 24/32, 75%). None of the participants reported that they had no benefits from the program. The PHQ-9 scores showed mild to moderate depressive symptoms (mean 9.59, SD 6.34), whereas the answers of 9% (3/32) of the participants to the PHQ-9 item 9 indicated suicidality at baseline (T0). Finally, the 4 domains of quality of life (physical: P=.01; psychological: P=.004; social: P=.02; and environmental: P<.001) showed a slight and statistically significant improvement at the postintervention evaluation (T0: mean 57.03, SD 15.39 to 59.64, SD 17.21; T2: mean 64.32, SD 11.97 to 68.75, SD 8.87).

CONCLUSIONS

Online support groups for the mental health promotion of graduate students are feasible and can be especially useful for universities with students allocated to different cities. They are also satisfactory and may positively influence participants' quality of life. Therefore, they can be considered a helpful mental health promotion strategy in the educational context. Further studies could evaluate these (or similar) programs under nonpandemic circumstances.

Depression and Associated Factors among Family Caregivers of Children with Disabilities: Analysis of Intergenerational Differences

Family caregivers of children with disabilities might face high risks of depression, whereas the existing literature focused more on parents neglecting grandparents. This study investigated 380 parents and 108 grandparents of children with disabilities to identify depression and associated factors. Descriptive statistics, Chi-square test, Mann-Whitney U test, and multivariable logistic regression were performed to describe the participants' characteristics and risks of depression and identify significant factors. Results showed that parents (35.5%) had higher risks of depression than grandparents (32.4%), but statistical differences were not found. Children's sleep problems (AOR = 1.751, 95%CI = 1.019, 3.008), harmonious family relationships (AOR = 0.694, 95%CI = 0.569, 0.846), and better barrier-free construction (AOR = 0.742, 95%CI = 0.568, 0.970) were significantly associated with depression among parents. As for grandparents, higher education (AOR = 4.108, 95%CI = 1.526, 11.057) and caring for children who experience frequent mood swings (AOR = 2.242, 95%CI = 1.161, 4.329) were associated with higher risks of depression. Further, house ownership (AOR = 0.167, 95%CI = 0.031, 0.887), higher family cohesion (AOR = 0.545, 95%CI = 0.297, 1.000), and better barrier-free construction (AOR = 0.401, 95%CI = 0.185, 0.869) were associated with lower odds of depression. Therefore, both parents and grandparents of children with disabilities had high risks of depression and thus required urgent attention. Healthcare providers and policymakers should develop and implement interventions considering intergenerational differences to reach optimal efficiency.

School Memories about Homophobic Bullying: A Study Based on Cultural-Historical Psychology

The expression of homophobic violence in schools reveals the urgency of an analytical approach to debate the impact of this phenomenon on students' mental health. This article seeks to debate and better comprehend school memories from young gays, lesbians, and bisexuals, as well as to discuss how homophobic bullying affected their school trajectories. This study is based on cultural-historical psychology in intersection with gender and sexuality studies. In-depth online interviews were conducted with three young subjects who identified themselves as non-heterosexual. The interviews were recorded, transcribed, and analyzed through the analytical discourse tool defined as Nuclei of Meanings. The results were organized in two topics of discussion: (a) the problems associated with non-heterosexual identity in schools; (b) the search for other ways of experiencing sexual identity in school. Throughout the article, reflections were held about the challenges participants had to deal with in order to regularly attend school and be educated, as well as the obstacles they faced in building their own ways of recognizing their sexual identity. The unique ways in which these young subjects took a stand in the face of homophobic situations show new methods to create educational interventions in order to include sexual diversity and openness to different possibilities of being and acting.

Architectural accessibility and perception of falls of elderly people in the peridomicile: mixed method

OBJECTIVE

To describe contents, structure and origin of social representations about falls by elderly people, the peridomiciliary structural conditions that predispose to falls, and to relate the implications of these empirical evidence on the routine of the elderly in the architectural context.

METHOD

Convergent mixed method by triangulation. Qualitative approaches(structural, n=195 and procedural, n=40of the Theory of Social Representations) and quantitative (descriptive sectional, n=183) were used. Elderly people enrolled in primary care were interviewed at home in 2018. Analysis techniques: categorical-thematic, prototypical, statistical, and deductive according to Leininger.

RESULTS

Categories of analysis: 1) Peridomicile: fall scenario and 2) Aging and vulnerability: risk of falls in peridomicile. The following environmental characteristics were precursors to falls: uneven floors, holes, unevenness and objects in the pathway. Feelings and behaviors allocated in the possible central core are associated, justifying falls, and determining their causes.

CONCLUSION

There was an association between the peridomiciliary architectural environment and the predictive characteristics of the risk of falls.

Activities and participation of children with language disorders in outpatient care according to the ICF

PURPOSE

To identify the main categories of the Activities and Participation component of the International Classification of Functioning, Disability, and Health and to verify the association with age, gender, education, and speech therapy diagnosis in children who are assisted by an oral language clinic.

METHODS

This is an analytical and cross-sectional observational study, carried out with secondary data from 32 medical records of children with the majority male, mean age of 41.03 months, in early childhood education and language disorder associated with other conditions. The main speech-language pathology manifestations were coded according to the pre-selected categories of the Activities and Participation component, and descriptive and bivariate statistical analyzes were performed, and the Fisher's Exact test was used with a significance level of 5%.

RESULTS

The descriptive analysis of the pre-selected categories allowed us to verify a high number of "Not informed" answers, with a higher percentage in vocal expression without speech (d331) performance (93.8%), making decisions (d177) ability (90.6%), problem solving (d175) performance (65.6%) and capacity (87.5%), reception of oral messages (d310) performance (65.6%) and eating (d550) capacity (65.6%). Among the 24 categories selected, 12 jointly contemplated the Qualifiers of Performance and Capacity. There was a statistically significant association between the three categories with sociodemographic data and speech therapy diagnoses.

CONCLUSION

Difficulties were identified in several categories of the Activities and Participation component and statistically significant associations between them and sociodemographic data and speech therapy diagnoses, showing the impacts of oral language disorders on the activities and participation of children assisted in an outpatient speech therapy service.

Socioemotional Factors and Cardiovascular Risk: What Is the Relationship in Brazilian Older Adults?

Background and Objectives

Cardiovascular risk is composed of several modifiable factors that cannot be explained only at the individual level. The aim of this study was to investigate the association between socioemotional factors and cardiovascular risk in older adults.

Research Design and Methods

A cross-sectional study with data from The Brazilian Longitudinal Study of Aging (Estudo Longitudinal de Saúde dos Idosos Brasileiros, ELSI-Brazil), population based with data collected between 2015 and 2016. Cardiovascular risk-the study outcome-was assessed using the WHO/ISH Cardiovascular Risk Prediction Charts. The exposure variables were perceived social support from those who would receive help in situations and productive and leisurely social participation carried out in the last 12 months. We used crude and adjusted logistic regression for socioeconomic conditions, health conditions, and lifestyle habits to estimate odds ratio (OR) and 95% confidence intervals (CIs) for the occurrence of the outcome.

Results

There were 6,005 participants between 50 and 74 years old with complete data. Of these, 18.7% (95% CI: 16.9-20.6) had high cardiovascular risk. Being in the highest tertile of greater social participation is associated with a lower prevalence of high cardiovascular risk (OR: 0.69; 95% CI: 0.50-0.95), adjusted for all variables, when compared to the lowest tertile. Furthermore, the absence of perceived social support is associated with a higher prevalence in different models. Perceived social support from close family members (son/daughter, son-in-law, and daughter-in-law) for material issues is associated with a higher prevalence, whereas having support from friends for affective resources is associated with a lower prevalence of high cardiovascular risk.

Discussion and Implications

Socioemotional factors such as lack of perceived social support and social participation were significantly associated with cardiovascular risk. This suggested that the development of strategies aimed at reducing cardiovascular risk during aging needs to consider socioemotional factors and social relationships.

School and language performance in children born with low birth weight

OBJECTIVES

To identify the impact of birth weight on the development of metalinguistic skills and performance in reading, writing, and arithmetic in students aged 6 to 10 years, enrolled from the 1st to the 4th grade of Elementary School in public schools of the metropolitan region of São Paulo.

METHODS

The concurrent cohort included 315 students. Birth weight was the exposure variable, and the outcomes were performance in receptive and expressive language, oral metalinguistic skills, and performance in writing, arithmetic, and reading. The tools employed were the Test of Language Competence (TLC) and the School Performance Test (SPT). Students were grouped into quartiles by birth weight for data analysis (P1: < 2170 g, P2: from 2171 g to 2450 g, P3: from 2451 g to 3150 g, and P4: > 3150 g).

RESULTS

The authors observed a tendency for the lower performance of the two groups with lower birth weights in listening comprehension and oral expression. The lower-weight group tended to perform poorly compared to the other groups vis-à-vis reading. In the global result of the SPT, worse performance was observed in the students in the first quartile compared to the others (p = 0.019). The multivariate analysis revealed no association between birth weight and results in the tests applied after adjusting for maternal schooling.

CONCLUSIONS

Birth weight can interfere with oral and written language development. However, the determination of these processes occurs in the face of complex interaction that includes sociodemographic factors, especially family support and maternal schooling.

Inclusion of men in health services and educational activities: the fathers' perceptions

OBJECTIVE

To learn about the perception of fathers regarding their inclusion in health services and/or educational activities.

METHOD

Qualitative, exploratory, and descriptive study addressing 22 fathers participating in a group of pregnant women in Rio Grande, RS, Brazil. Data were collected through semi-structured interviews and analyzed using the content analysis technique.

RESULTS

The following categories emerged from the participants' reports: fathers' perceptions regarding their presence in health services and fathers' perceptions regarding their participation in the group of pregnant women. Additionally, they provided contributions and suggestions regarding their experiences with the group's meetings.

CONCLUSION

The participants felt excluded from the services, which shows that health intervention strategies need to be (re)constructed to implement actions that include fathers as active participants in care, so they recognize the importance of their role in healthy human development.

Managing emotions in panic disorder: A systematic review of studies related to emotional intelligence, alexithymia, emotion regulation, and coping

BACKGROUND AND OBJECTIVES

Panic disorder is defined by recurring and unexpected panic attacks, accompanied by anticipatory anxiety about future attacks and their consequences. This generally involves avoiding situations and behaviors that can produce panic attacks (American Psychiatric Association [APA], 2013). Among anxiety disorders, panic disorder is associated with some of the greatest burdens in terms of personal suffering, occupational disability, and societal cost. The objective of this article is to systematically identify and review the empirical literature on emotional management processes and strategies associated with panic disorder, with the aim of evaluating their role in the development and maintenance of panic disorder, in order to better understand the pathogenesis of the disorder and guide clinicians to improve their current treatments.

METHODS

Four databases were searched for studies which were based on self-reported questionnaires or a methodology based on an experimental procedure.

RESULTS

Of the 1719 articles identified, 61 referred to different aspects of emotional management. People living with PD are characterized by low emotional intelligence levels, excessive use of suppression, impaired cognitive reappraisal, high levels of alexithymia and maladaptive coping strategies.

LIMITATIONS

Most of the reviewed studies used measures of emotional management in cross-sectional models and were based on self-assessment reports.

CONCLUSIONS

Improving emotional intelligence levels is key to increasing emotion regulation flexibility for people living with PD. Automatic cognitive reappraisal impairment in these people indicates low importance of cognitive restructuring in psychotherapeutic treatment.

Is There an Association between Food Consumption According to the Degree of Processing and Body Image (Dis)satisfaction in Adolescents?

(1) Background: Adolescence is characterized by changes in eating habits, with increased consumption of ultra-processed foods and reduced intake of unprocessed or minimally processed foods, which can affect body image satisfaction. Thus, this study aims to verify the association of food consumption according to the degree of processing with body image (dis)satisfaction in adolescents from the 1997/1998 birth cohort of São Luís, Maranhão. (2) Methods: A cross-sectional study was conducted with 2515 adolescents aged between 18 and 19. Food consumption was stratified based on the NOVA classification in culinary preparations, processed foods, and ultra-processed foods, categorized into tertiles. Body image (dis)satisfaction was evaluated based on the Stunkard Body Scale and was classified as satisfaction, dissatisfaction with thinness, and dissatisfaction with excess weight. Multinomial logistic regression was used for associations. (3) Results: Among the adolescents, 77% considered themselves dissatisfied with their body image, with 42.8% dissatisfied with being thin and 34.2% dissatisfied with excess weight. However, food consumption, according to the degree of processing, was not associated with body image (dis)satisfaction. (4) Conclusion: This work highlighted the prevalence of body image dissatisfaction among adolescents but found no association between body (dis)satisfaction and food consumption according to the degree of processing.

Validation of the Opening Minds Scale for Health Care Providers (OMS-HC): Factor Structure and Psychometric Properties of the Brazilian Version

Stigma towards people with mental illness is also present among health professionals. The study validated and estimated the reliability, dimensionality and structure of the Opening Minds Stigma Scale for Health Care Providers (OMS-HC) scale in Brazil. In this methodological study, health professionals (n = 199) from Family Health Units in Brazil were recruited by convenience sampling. The EFA conducted with 16 items resulted in four factors. The Cronbach's Alpha for the OMS scale was 0.74, which is considered to reflect reasonable reliability. The data presented contribute to the use of the scale in studies that investigate the level of stigma among health professionals towards people with mental illness, as well as in the development of anti-stigma interventions in this context.

A qualitative analysis of denture wearing experience affecting the quality of life of older adults

OBJECTIVE

To explore how denture-related experiences affect older adults' quality of life using a qualitative assessment of the Oral Health Impact Profile for Edentulous individuals (OHIP-Edent).

MATERIALS AND METHODS

Twenty elderly individuals were interviewed before and 3 months after delivering new complete dentures, using an open-ended interview guide based on the OHIP-Edent. Interviews were audio-recorded and transcribed. Data were open coded and thematically analyzed following a Grounded Theory approach. Findings were integrated and constantly compared to understand the interviewees' difficulties, beliefs, and perceptions.

RESULTS

Three interconnected themes were developed: functional and psychosocial impairments, and coping strategies. Even when posed as an open-ended format, the wording of some OHIP-Edent items was confusing while others were not relevant to the respondents. New categories related to speaking, smiling, swallowing, emotional and functional coping emerged from the interviews. Interviewees adapted to chewing and swallowing difficulties through food avoidance, modification of food choice and preparation techniques, and changes in dietary behaviors.

CONCLUSIONS

Denture wearing is a daily challenging experience that encompasses various functional and psychosocial aspects and sheds light on the need for addressing the coping strategies employed by patients, as the current OHIP-Edent items may not fully represent other deemed important aspects of the quality of life of individuals who wear dentures.

CLINICAL RELEVANCE

Dentists must not solely rely on structured questionnaires to explore the impact of denture wearing and treatment outcomes. Clinicians can use a more holistic approach to comprehend older adults' experiences with dentures including advice about coping mechanisms, food preparation techniques, and meal planning.

Factors associated with sleep quality in university students

To investigate factors associated with poor sleep quality. A cross-sectional study was conducted in 2019 with random sampling. Information on sleep was obtained using the Mini Sleep Questionnaire (MSQ). Independent variables included sociodemographic, behavioural, academic and psychological health characteristics. Adjusted analyzes were performed using Poisson regression. A total of 996 undergraduate students participated in the study. The poor sleep quality affected 23.1% of the sample (95%CI 20.5-25.9), ranging from 13.4% for those with little concern about violence in the neighbourhood to 36.5% for those with less social support. In the adjusted analysis, female sex [PR] 1.81; (95%CI 1.33-2.45), concern about violence in the neighbourhood [PR] 2.21; (95%CI 1.48-3.28), discrimination at university [PR] 1.42; (95%CI 1.08-1.86) and food insecurity [PR] 1.45; (95%CI 1.11-1.89) were associated with the presence of poor sleep quality, as well as having less social support and income and suffering psychological distress. The results highlight socioeconomic and mental health factors that affect sleep quality and demonstrate the need for reflection and interventions capable of minimizing this problem.

Family connections in the treatment of relatives of people with eating disorders and personality disorders: study protocol of a randomized control trial

BACKGROUND

Eating disorders (EDs) are serious disorders that significantly affect not only the lives of patients, but also those of their family members who often experience high levels of burden, suffering and helplessness. If, in addition to ED, the patient has a personality disorder (PD), the psychological distress experienced by family members can be devastating. However, few treatments have been developed for family members of people with ED and PD. Family Connections (FC) is a programme that has been shown to be effective for family members of people with borderline personality disorder. The overall aims of this work are: (a) to adapt FC for application to family members of patients with BPD-PD (FC: ED-PD); (b) to analyse, in a randomised controlled clinical trial, the efficacy of this programme in a Spanish population, compared to a control condition consisting of treatment as usual optimised treatment (TAU-O); (c) to analyse the feasibility of the intervention protocol; (d) to analyse whether the changes that may occur in relatives are related to improvements in the family climate and/or improvements observed in patients; and (e) to analyse the perceptions and opinions of relatives and patients about the two intervention protocols.

METHODS

The study uses a two-arm randomised controlled clinical trial with two experimental conditions: adaptation of FC programme (FC: ED-PD) or Treatment as usual optimised (TAU-O). Participants will be family members of patients who meet DSM-5 criteria for ED and PD or dysfunctional personality traits. Participants will be assessed before and after treatment and at one-year follow-up. The intention-to-treat principle will be used when analysing the data.

DISCUSSION

The results obtained are expected to confirm the effectiveness of the programme and its good acceptance by family members. Trial registration ClinicalTrials.gov Identifier: NCT05404035. Accepted: May 2022.

Análise do Processo de Interconsulta Psicológica com Idosos em um Hospital Universitário

Objetivou-se estudar o instrumento de interconsulta de pacientes idosos hospitalizados na clínica médica de um hospital universitário, bem como identificar os principais motivos de solicitação de interconsulta psicológica e verificar as respostas dadas pelo psicólogo hospitalar. Utilizou-se metodologia qualitativa com análise documental. Os resultados indicaram que a pneumologia e a propedêutica foram as especialidades médicas que mais solicitaram interconsulta psicológica. Como motivos de encaminhamento, verificou-se a predominância do humor deprimido. Quanto às condutas terapêuticas realizadas pelos psicólogos, identificou-se a realização de intervenções psicoterápicas de apoio, escuta ativa, atendimentos de acompanhamento, orientações, sugestões, psicoeducação, contato com equipe e entrevista psicológica. Em suma, os dados deste estudo reforçam a complexidade da interconsulta, que se mostra um instrumento de comunicação interdisciplinar e de compreensão da demanda do paciente.

Avaliação dos Centros de Atenção Psicossocial: Uma Revisão Integrativa

Introdução: O Centro de Atenção Psicossocial (CAPS) é um serviço orientado pelos princípios de reforma psiquiátrica, o qual oferece atendimento às pessoas com transtornos mentais ou problemas relacionados ao uso de álcool/drogas e necessita de constante avaliação. Objetivou-se analisar a produção científica acerca das condições de trabalho e da qualidade do serviço prestado nos CAPS. Método: Realizou-se uma revisão integrativa da literatura, selecionando artigos publicados no SciELO, BVS-Saúde e PubMed, por meio de critérios predefinidos. Resultados: Analisaram-se 34 artigos. Prevaleceram estudos publicados em revistas de saúde coletiva, retratando pesquisas qualitativas. Sinalizam a qualidade do serviço do CAPS, seu potencial de inclusão social dos usuários, deficits na operacionalização de algumas práticas da reforma psiquiátrica (ações de território, redução de danos, apoio matricial), problemas interpessoais entre profissionais e gestores, falta de recursos materiais e fragilidade de vínculo empregatício dos profissionais. Discussão: Apesar da longa luta antimanicomial, existem problemas orçamentários, estruturais e na formação e comunicação entre profissionais que comprometem a assistência em saúde mental. Conclusão: O CAPS é um serviço essencial aos usuários, porém possui problemas operacionais, especialmente no atendimento, condições de trabalho e vínculo entre redes assistenciais, exigindo reorganização do serviço e capacitação profissional.

Autopercepção Negativa de Saúde em Adolescentes durante a Pandemia de Covid-19 e Fatores Associados

O objetivo deste estudo foi analisar a prevalência da autopercepção negativa de saúde de adolescentes durante a pandemia de covid-19 e fatores associados. Trata-se de um estudo descritivo de corte transversal, realizado com 287 adolescentes. Foram avaliadas questões referentes à autopercepção de saúde, ao perfil sociodemográfico e aos fatores comportamentais. As razões de prevalência (RP) e os intervalos com 95% de confiança (IC95%) foram estimados por meio de modelos múltiplos de regressão de Poisson. A prevalência de autopercepção negativa de saúde foi observada em 31,0% dos adolescentes. Observou-se que a imagem corporal (RP = 1,14; IC95%:1,05-1,23), a prática de atividade física (RP = 1,12; IC95%:1,03-1,21), a qualidade do sono (RP = 1,17; IC95%:1,08-1,28) e o consumo de frutas (RP = 1,18; IC95%:1,07-1,30) mostraram-se associados à autopercepção negativa de saúde dos adolescentes. Conclui-se que, durante a pandemia de covid-19, foi observada alta prevalência de autopercepção negativa da saúde. Ademais, a insatisfação com a imagem corporal, a prática de atividade física insuficiente, a qualidade do sono ruim e o consumo de frutas afetaram a autopercepção de saúde dos adolescentes.

La importancia de la comunicación médico-paciente: un estudio en Argentina

Objetivo: Analizar la importancia de la comunicación en la relación médico-paciente y recopilar información sobre la percepción durante su práctica. Método: Se realiza una revisión bibliográfica y una encuesta (participaron 105 médicos en Argentina). Resultados: Los resultados muestran que la mayoría de los profesionales refiere dificultades en la comunicación y que estas dificultan la atención. Los médicos manifestaron dificultades para comunicar malas noticias, mayormente en las áreas clínicas, y que la habilidad de ponerse en el lugar del paciente es fundamental para la comunicación de dichas noticias. Los jóvenes consideran de manera significativa que la comunicación de malas noticias depende de la práctica. Conclusiones: Las habilidades comunicativas son indispensables. Existe evidencia para sugerir que es necesario profundizar en la adquisición de competencias comunicativas y valores éticos.

How parents share and limit their child’s access to information about COVID-19: A mixed methods online survey study

This study aimed to understand the role that parents play in sharing or limiting their child's access to information about coronavirus disease 2019 (COVID-19). A subset of data from an international mixed methods online survey study was analysed to elucidate the findings from Brazil. An online survey, conducted between April and June 2020, gathered closed and open text views from parents of children aged 7-12 years old. Quantitative data were analysed using descriptive statistics. Qualitative open text data were analysed using the three stages of the Bardin content analysis framework: pre-analysis (data organisation and initial full-content reading); exploration of the material (thematic coding to identify major motifs and develop thematic categories) and interpretation (treating the data as significant and valid). The sample consisted of 112 (89%) mothers and 14 (11%) fathers. The analysis of the parents open text resulted in two categories: 'How parents share information with their children about COVID-19' and 'How parents limit information to their children about COVID-19'. Some parents reported adopting an honest and open approach on how they shared information with their children, whilst some parents chose to minimise their child's access to information about the pandemic over concerns of the mortality related to COVID-19.

Virological failure and adherence to antiretroviral therapy in adolescents and young adults living with human immunodeficiency virus

OBJECTIVE

HIV (human immunodeficiency virus) infection remains a major public health challenge. Infected young people at any age are less likely to adhere to care in a timely manner and to maintain a suppressed VL. This review aims to identify factors associated with virologic failure and adherence to drug therapy in adolescents and young adults (10-24 years) living with HIV.

METHODS

Systematic review using the PubMed and Virtual Health Library databases and including articles published between 2009 and 2021. Data were analysed in six categories: individual factors, pharmacological/therapy-related aspects, factors related to HIV/acquired immunodeficiency syndrome (AIDS) infection, HIV/AIDS stigma, social support and health system/services. The study's protocol was registered on the PROSPERO platform (CRD42020167581).

RESULTS

A total of 19,819 articles were found in the initial search and 31 studies were included in this systematic review. Most studies were carried out on the African continent. Male sex, alcohol use, low education, adverse effects of medication, lack of social support, stigma related to HIV/AIDS, need for transportation to access the health service and forgetfulness were linked to poor adherence to therapy. Good adherence was achieved with sufficient nutrition, good social support, greater confidence in the use of therapy and fewer ART side effects. Low levels of CD4, alcohol use, substance abuse, low education, non-adherence to medication and forgetfulness were linked to virological failure.

CONCLUSION

Individual, social and structural factors constitute barriers to adherence to ART among adolescent and young adults. It is necessary to know the difficulties related to the use of therapy to work out specific strategies that create conditions to improve medication adherence and viral suppression, reducing the levels of virological failure in this population.

Relationship of Age at Menarche, Coitarche and First Gestation: A Retrospective Cohort Analysis

Introduction

Teenage pregnancy is defined as a pregnancy occurring between ages 10 and 19 (Loredo-Abdlá et al., 2017; Belitzky, 1985; Kaplanoglu et al., 2015), and is associated with increased morbidity and mortality for both mother and child. Several factors have been identified with increased risk of a teenage pregnancy, including incomplete sexual education awareness and increased exposure at a young age. In addition, an earlier onset of sexual intercourse, or coitarche, has been linked to a higher risk of teenage pregnancy. Early menarche, defined as first menstruation before the age of 12 has been previously identified as a risk factor for an earlier coitarche, possibly linking an early menarche with a higher incidence of teenage pregnancy. This study aims to compare and determine the relationship between the incidence of teenage pregnancy with early menarche and coitarche in a low income setting.

Design Setting Participants Interventions Main Outcome Measures

A cross sectional review of electronic records of women admitted for delivery in a second level center in northeastern Mexico, being a low-income setting, where 814 teenage and 1474 adult mothers were included.

Results

Primigravid teenagers had earlier menarche and coitarche than adult counterparts and opted for postpartum contraception more frequently. Linear regression analysis revealed significant unadjusted beta coefficients between age at first pregnancy and coitarche (0.839) and menarche (0.362). Menarche and coitarche had a significant linear regression association of 0.395.

Conclusion

We found amongst primigravid patients that teenagers had earlier menarche and coitarche than adults, which in turn correlated to their age at their first pregnancy.

Anti-Black attitudes predict decreased concern about COVID-19 among Whites in the U.S. and Brazil

RATIONALE

From the earliest days of the COVID-19 pandemic, public health officials and news organizations reported pervasive racial disparities in the infection, morbidity, and mortality of the virus. In both the U.S. and Brazil, Black, Native, and mixed-race individuals were more negatively impacted by COVID-19 than White people. Simultaneously, significant social factions downplayed the threat and insisted on living "normally". We examined how these two factors coexisted.

OBJECTIVE

We sought to establish whether Whites' anti-Black attitudes predicted their concern about the pandemic and tendency to behave in ways that exacerbated the pandemic.

METHODS

and Results: In five studies, conducted in two countries (total N = 3425), we found that anti-Black attitudes (above and beyond political orientation, White racial identification, and perceptions of racial disparities) were associated with less concern about COVID-19, lower adoption of health and social distancing behaviors, and greater interest in returning to normalcy.

DISCUSSION

We discuss how efforts to combat anti-Blackness may improve the health of the general population.

Learning from within: Therapists' actions in daily clinical practice

The integration of theories and techniques is part of family therapists' daily practice, raising the need to understand which resources are used in this professional's clinical actions. Our aim is to reflect on the use of theoretical and technical resources by family therapists in their daily practice. We developed an inquiry process inspired by collaborative action research and social constructionism. Couple and family therapy sessions were conducted by two family therapists, and we developed subsequent dialogs with them focused on describing theoretical and technical inspirations for their actions. Next, we named four categories of actions in this process: exploratory actions, actions for the construction of relational visions, actions for the construction of communication, and actions for family orientation. The therapists-participants referred to many theoretical and technical resources that inspired their practice. For them, the choice of using one or another resource was based on the demands of the interactive moment, which involves their relational and embodied responses to what was experienced in the sessions. We argue that epistemological coherence is not something that guides the therapist's practice a priori, but something that can be achieved by talking about and reflecting on their actions. This article can contribute to clinical practice and training in family therapy by presenting an interesting reflexive process that can be useful to enhance practice in couple and family therapy (FAPESP, Process n. 2015/21316-1).

Transtornos Mentais Comuns em Motoristas de Transporte Coletivo de Passageiros

Este estudo teve como objetivo a identificação dos fatores associados aos transtornos mentais comuns (TMC) em motoristas de transporte coletivo de passageiros, em uma amostra de 258 motoristas pertencentes ao quadro funcional de duas empresas de transporte coletivo. Para a coleta de dados, foram utilizados o Questionário de Dados Sociodemográficos, Laborais e Estressores Ocupacionais e o Self-Reporting Questionnaire (SRQ-20). Realizaram-se análises bivariadas (qui-quadrado de Pearson) entre todas as variáveis independentes. Para a análise dos TMC e relação com as variáveis independentes, foi utilizada análise de regressão logística bivariada e a odds ratio (OR), que consiste na razão de chances de aquisição do agravo entre expostos e não expostos. Os resultados identificaram como preditoras dos transtornos mentais comuns as variáveis pouco tempo de intervalo; falta de suporte social; falta de autonomia; e escala de trabalho.

“Não Tenho Filhos e Não Quero”: Questões Subjetivas Implicadas na Opção pela Não Maternidade

A não maternidade tem se tornado uma opção crescente no Brasil, onde atualmente 37% das mulheres encontram-se nesse grupo. Este artigo teve como objetivo levantar quais aspectos subjetivos estão envolvidos nessa opção. Tratou-se de pesquisa qualitativa, na qual foram realizadas entrevistas semiestruturadas com dez mulheres, convocadas a partir da técnica “Bola de Neve” (Snowball Sample), sendo cinco brancas e cinco negras, de diversas orientações sexuais e classes sociais, sem problemas de fertilidade e que escolheram não ter filhos. As entrevistas foram submetidas à Análise de Conteúdo (Bardin, 1977) e foram elencadas quatro categorias. Os resultados apontam que essas mulheres percebem a maternidade como um lugar de grande exigência social e forte renúncia dos projetos pessoais, para além de projetos profissionais. O não desejo de maternidade é ainda estigmatizado socialmente, e as maiores cobranças pela maternidade são feitas a mulheres heterossexuais. Novos estudos a partir da perspectiva de gênero são recomendados.  

Psicologia e Políticas Públicas no Sudeste Paranaense: Potencialidades e Desafios

A atuação da Psicologia nas políticas públicas se expandiu no Brasil. O objetivo deste estudo foi mapear a inserção de psicólogas(os) no Sistema Único de Saúde (SUS) e no Sistema Único de Assistência Social (SUAS) em uma Regional no Estado do Paraná, Brasil. Foi realizada uma pesquisa descritiva, por meio da consulta aos Cadastros Nacionais e cruzamento com consulta às gestões dos nove municípios da Regional. Foi identificada a inserção de 20 psicólogas no SUS e 28 no SUAS. Na assistência social, predomina a atuação na proteção social básica e o vínculo estatutário, enquanto na saúde predomina a atuação no nível especializado, com contratos via pessoa jurídica. A discussão ressalta três aspectos: a defasagem dos cadastros em relação aos serviços; as particularidades da inserção da psicologia nas políticas públicas; os vínculos e a precarização do trabalho. Diante do cenário de consolidação da inserção da Psicologia nas políticas públicas, indicam-se desafios à atuação e formação profissional.