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Negative feedback loops represent a regulatory mechanism that guarantees that signaling thresholds are compatible with a physiological response. Previously, we established that Lrig1 acts through this mechanism to inhibit Ret activity. However, it is unclear whether other Lrig family members play similar roles. Here, we show that Lrig1 and Lrig3 are co-expressed in Ret-positive mouse dorsal root ganglion (DRG) neurons. Lrig3, like Lrig1, interacts with Ret and inhibits GDNF/Ret signaling. Treatment of DRG neurons with GDNF ligands induces a significant increase in the expression of Lrig1 and Lrig3. Our findings show that, whereas a single deletion of either Lrig1 or Lrig3 fails to promote Ret-mediated axonal growth, haploinsufficiency of Lrig1 in Lrig3 mutants significantly potentiates Ret signaling and axonal growth of DRG neurons in response to GDNF ligands. We observe that Lrig1 and Lrig3 act redundantly to ensure proper cutaneous innervation of nonpeptidergic axons and behavioral sensitivity to cold, which correlates with a significant increase in the expression of the cold-responsive channel TrpA1. Together, our findings provide insights into the in vivo functions through which Lrig genes control morphology, connectivity and function in sensory neurons.
Assuntos
Axônios/metabolismo , Epiderme/metabolismo , Glicoproteínas de Membrana/metabolismo , Proteínas de Membrana/metabolismo , Proteínas do Tecido Nervoso/metabolismo , Proteínas Proto-Oncogênicas c-ret/metabolismo , Células Receptoras Sensoriais/metabolismo , Transdução de Sinais/genética , Animais , Animais Recém-Nascidos , Linhagem Celular Transformada , Gânglios Espinais/metabolismo , Fator Neurotrófico Derivado de Linhagem de Célula Glial/metabolismo , Fator Neurotrófico Derivado de Linhagem de Célula Glial/farmacologia , Células HEK293 , Humanos , Ligantes , Masculino , Glicoproteínas de Membrana/genética , Proteínas de Membrana/genética , Camundongos , Camundongos Knockout , Neurônios Motores/metabolismo , Proteínas do Tecido Nervoso/genética , Crescimento Neuronal/genética , Ratos , Ratos Wistar , Transdução de Sinais/efeitos dos fármacos , TransfecçãoRESUMO
O suicídio é um grave problema de saúde pública e envolve uma associação de fatores biológicos, psicológicos, sociais e culturais. Por se tratar de uma morte violenta, causada pelo próprio indivíduo, gera impactos emocionais e sociais significativos na dinâmica familiar. Por essa razão, os familiares enlutados apresentam dificuldades em desenvolver estratégias de enfrentamento para lidar com o sofrimento psíquico derivado do suicídio de um de seus membros. O enfrentamento ou coping são os esforços cognitivos ou comportamentais que um indivíduo utiliza para administrar situações consideradas estressoras. É classificado em: coping focalizado na emoção e coping focalizado no problema. O presente artigo visa levantar as estratégias de enfrentamento mais utilizadas pelos familiares no processo de luto por suicídio. Trata-se de uma revisão integrativa da literatura realizada nas bases de dados on-line: SCIELO, MEDLINE e PUBMED, nas quais foram selecionadas 10 publicações, artigos nos idiomas inglês e português, no período de 2011 a 2020. Foram incluídos artigos disponíveis na íntegra acerca da temática aqui proposta, excluindo dissertações de mestrado, teses de doutorado e monografias. Os resultados demonstraram que as estratégias de enfrentamento mais adotadas pelos familiares enlutados por suicídio foram: evitamento, isolamento, afastamento, auto culpa, reavaliação positiva, religiosidade, resolução planejada, apoio e suporte social, adaptação à perda e autocontrole. Concluiu-se que é necessária a realização de novas pesquisas acerca dessa temática, visando expandir a discussão e ampliar as estratégias de cuidado aos familiares enlutados por suicídio.
Suicide is a serious public health problem and involves the association of biological, psychological, social, and cultural factors. Since it is a violent death, caused by the individual, it generates significant emotional and social impacts on the family dynamics. Thus, bereaved family members have difficulties in developing coping strategies to deal with the psychological suffering that result from the suicide of one of their members. Coping is related to cognitive or behavioral efforts that an individual uses to manage situations considered stressful. They are classified into emotion-focused coping and problem-focused coping. This article aims to raise the coping strategies most used by family members in the process of bereavement by suicide. This is an integrative literature review carried out on the online databases: SCIELO, MEDLINE and PUBMED, in articles in English and Portuguese. Ten publications, from 2011 to 2020, were selected. Master's dissertations, doctoral theses, and final papers were excluded. The results showed that the coping strategies most adopted by family members bereaved by suicide were avoidance, isolation, withdrawal, self-blame, positive reappraisal, religiosity, planned resolution, support and social support, adaptation to loss, and self-control. It was possible to conclude that it is necessary to carry out further research on this topic, aiming to expand the discussion and expand care strategies for family members bereaved by suicide.
Assuntos
Ajustamento Emocional , Suicídio , Luto , Adaptação PsicológicaRESUMO
No Brasil, crianças com deficiência têm comumente seus direitos à educação violados. Ao serem impedidas de frequentar a escola regular, lhes é negada a participação em espaços formativos no âmbito pessoal, cognitivo, relacional e político, o que reforça, inclusive para a própria criança, uma lógica segregacionista. Aqui apresentam-se resultados parciais de uma pesquisa qualitativa exploratória analítica, que teve por campo uma escola regular do Município de São Paulo. Teve como objetivo compreender quais os impactos da entrada na escola regular de crianças com deficiência sobre o cotidiano destas crianças e sua família, detectando os sentidos do processo de escolarização. Os dados foram coletados utilizando-se: 1) entrevistas semiestruturadas com pais e educadores de duas crianças com deficiência escolhidos intencionalmente; 2) genogramas e ecomapas das crianças para compreender sua rede de relações. A análise dos dados ocorreu segundo método abordagem da estrutura. Apesar de existirem entraves à efetivação da inclusão escolar, como preconceitos e vivências de uma inclusão perversa, estar na escola regular trouxe ganhos relacionais às crianças com deficiência, organizou seus cotidianos, e possibilitou novos horizontes para as crianças e suas famílias
In Brazil the educational rights of children with disabilities still have been denied. By being prevented from attending regular school, they are denied participation in formative spaces in the personal, cognitive, relational and political spheres, which reinforces, even for the children themselves, a segregationist logic. Here we present partial results of an exploratory analytical qualitative research, which was conducted in a regular school in the city of São Paulo. The objective was to understand the impacts of the entry of children with disabilities into regular school on the daily lives of these children and their families, detecting the meanings of the schooling process. Data were collected using: 1) semi-structured interviews with parents and educators of two children with disabilities chosen intentionally; 2) genograms and ecomaps of the children to understand their network of relationships. The Data analysis took place according to the structure approach method. Although there are obstacles to the effectiveness of school inclusion, such as prejudices, stereotypes and the experience of a perverse inclusion, being in a regular school brought relational gains to children with disabilities, organizing their daily lives, and allowing new horizons for children and their families.KEYWORDS: Inclusion in education; School inclusion; School; People with disabilities; Family members; Occupational therapy.
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RESUMEN Fundamento: develar las representaciones sociales del cáncer mamario puede acercar a profesionales de las ciencias psicológicas a comprender actitudes, conductas y las influencias que ejercen en pacientes, familiares y especialistas. Objetivo: determinar la estructura de las representaciones sociales (actitud, información, campo representacional) del cáncer mamario en los sujetos del estudio. Métodos: estudio exploratorio, transversal, de metodología mixta, en el período comprendido entre mayo 2014 a diciembre de 2015. Se aplicaron como técnicas: formulario datos sociodemográficos y clínicos, entrevista semiestructurada, composición, asociación libre. Las variables analizadas fueron: direccionabilidad de la actitud hacia el diagnóstico del cáncer mamario, direccionabilidad de la actitud hacia los tratamientos, en la dimensión información: conocimientos sobre conceptualización de la enfermedad, conocimientos de los síntomas, conocimientos sobre tratamientos, creencias sobre factores de riesgo, opiniones sobre las consecuencias del cáncer mamario, opiniones sobre necesidad de brindar conocimientos de la enfermedad a pacientes, familiares. Se efectuó análisis estadístico descriptivo de frecuencias. Se procesó la información de las variables en la base de datos del paquete estadístico SPSS 15.0 para Windows. Los resultados se expresaron en frecuencias absolutas y relativas. Resultados: pacientes, familiares mostraron direccionabilidad de la actitud negativa hacia el diagnóstico y tratamientos. Prevalencia de respuestas ajustadas en las áreas exploradas de la dimensión información, aunque con nivel de profundidad homogéneo los familiares. El campo representacional del cáncer mamario dio cuenta de modelos mayoritariamente de desafío a la enfermedad en los sujetos del estudio. Conclusiones: cómo se comportaron el conocimiento de la estructura de las representaciones sociales del cáncer mamario en los sujetos del estudio, contribuye al análisis del marco de referencia de la actuación sanitaria, desde un abordaje integral, holístico, por coexistir sentido común y ciencia.
ABSTRACT Background: unveiling the social representations of breast cancer can bring professionals in the psychological sciences to understand attitudes, behaviors and the influences they exert on patients, family members and specialists. Objective: to determine the structure of the social representations (attitude, information, representational field) of breast cancer in the study subjects. Methods: exploratory, cross-sectional study, of mixed methodology, in the period from May 2014 to December 2015. Applied as techniques: sociodemographic and clinical data form, semi-structured interview, composition, free association. The variables analyzed were: addressability of the attitude towards the diagnosis of breast cancer, addressability of the attitude towards treatments, in the information dimension: knowledge about disease conceptualization, knowledge of symptoms, knowledge about treatments, beliefs about risk factors , opinions on the consequences of breast cancer, opinions on the need to provide knowledge of the disease to patients, relatives. Descriptive statistical analysis of frequencies was performed. The information of the variables in the database of the statistical package SPSS 15.0 for Windows was processed. The results were expressed in absolute and relative frequencies. Results: patients, relatives showed addressability of the negative attitude towards diagnosis and treatment. There was a prevalence of adjusted responses in the explored areas of the information dimension, although with a homogeneous level of depth, in family members. The representative field of breast cancer accounted for mostly models of disease challenge in the study subjects. Conclusions: the subjects of the study in relation to breast cancer showed a negative attitude, there was a predominance of adjusted answers about the pathology information and mostly models of disease challenges.
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One of the key features of good practice in medicine is the doctor-patient communication. Radiation protection standards for radiosynovectomy (RS) is limited. Yttrium-90 is a beta-emitting radioisotope used in RS to treat joint pain from haemophilic arthritis. ICRP 94 states that if a patient is treated with up to 200 MBq, there is no need for further precautions when it comes to public exposure, however, activities can go up to 370 MBq in RS for the knee. This study analysed 119 family members' safety (16.7% pregnant women). The ambient dose equivalent rate was measured within four distances. A survey was carried analysing risk groups and time spent next to patients. Results showed that family members should be advised to remain at 1.0 m from the patient to decrease accumulated dose by 97.6%. The dose per activity factors estimated in this study is also a useful tool during the risk assessment and doctor/patient communication. Pamphlets were distributed with radiation protection recommendations. Ambient dose equivalent was low enough to show that RS is a safe procedure for family members, which is essential to promote adherence to RS in countries where it is needed but not performed due to lack of information on radiation safety.
Assuntos
Artrite/complicações , Artrite/radioterapia , Família , Hemofilia A/complicações , Pacientes Ambulatoriais , Doses de Radiação , Sinovectomia/efeitos adversos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Gravidez , Radiocirurgia/efeitos adversos , Segurança , Radioisótopos de Ítrio/uso terapêuticoRESUMO
Este trabalho buscou identificar as concepções de familiares de usuários de um Centro de Atenção Psicossocial sobre o atendimento prestado. Participaram deste estudo 15 familiares, com idade média de 53 anos, sendo 11 mulheres e quatro homens. Foi utilizado um roteiro de entrevista semiestruturado que investigou a trajetória do usuário por serviços psiquiátricos, a avaliação do familiar sobre as atividades oferecidas no Caps, pontos positivos e barreiras na provisão de cuidado pela equipe. Foi realizada análise de conteúdo das entrevistas e as categorias emergentes foram: diferença entre Caps e demais serviços, participação da família no Caps, melhora do usuário após tratamento no Caps, sobrecarga familiar e sugestões para o aprimoramento do serviço. Os entrevistados, em grande maioria mulheres, destacaram o papel da equipe como promotora da melhora do usuário, sem deixar de compreender que há barreiras a serem vencidas, como o espaço físico e a inexistência de leitos de retaguarda.
This study aimed to identify the evaluation of relatives of users of a Psychosocial Care Center for the care provided. The study included 15 families with an average age of 53 years, 11 women and four men. A Semi-Structured Interview Guide was used to investigate the user's path by psychiatric services, the family's assessment of the activities offered at Caps, strengths and barriers in the provision of care by the staff. Was conducted content analysis of the interviews and the emerging categories were: difference between Caps and other services, family participation in Caps, user improvement after treatment in Caps, family burden and suggestions for improving the service. Respondents, mainly women, highlighted the role of the team as promoting the improvement of the user, while understanding that there are barriers to overcome, such as the physical space and the lack of spare beds.
Este estudio tuvo como objetivo identificar la evaluación de los familiares de usuarios de un Centro de Atención Psicosocial de la atención recibida. El estudio incluyó a 15 familias con una edad promedio de 53 años, 11 mujeres y cuatro hombres. Una entrevista semiestructurada Guía se utilizó para investigar la ruta del usuario por los servicios psiquiátricos, la evaluación de las actividades que se ofrecen en Caps, fortalezas y barreras en la prestación de atención por parte del personal de la familia. Se llevó a cabo el análisis de contenido de las entrevistas y las categorías emergentes fueron: diferencia entre mayúsculas y otros servicios, la participación familiar en el Caps, la mejora de usuario después del tratamiento en el Caps, la carga familiar y sugerencias para mejorar el servicio. Los entrevistados eran principalmente mujeres e destacaron el papel del equipo como la promoción de la mejora del usuario, mientras que la comprensión de que hay barreras que superar, como el espacio físico y la falta de camas de repuesto.
Assuntos
Saúde Mental , Serviços de Saúde Mental , Estresse Psicológico , Família , Atenção à Saúde , Sistemas de Apoio PsicossocialRESUMO
Objetivo: Analisar a prevalência de Transtornos Mentais Comuns (TMC) e sua associação com a sobrecarga em cuidadores familiares de idosos. Métodos: Estudo epidemiológico descritivo de caráter transversal, com amostra de conveniência, no qual foram analisados 73 cuidadores familiares de idosos atendidos no ambulatório de Geriatria de um hospital público da Rede Estadual de Saúde de Pernambuco. Os dados foram coletados por meio de um questionário sociodemográfico, elaborado para a presente pesquisa e do Self-Reporting Questionnaire (SRQ-20), instrumento desenvolvido para a identificação de TMC, já validado para a realidade brasileira. O último instrumento utilizado foi a escala Zarit Burden Interview, validada no Brasil para avaliar a sobrecarga do cuidador. Resultados: Dos 73 cuidadores familiares de idosos, 26 foram classificados com TMC, o que corresponde a uma prevalência de 35,6%. Quanto ao nível de sobrecarga desses cuidadores, 43,8% tinham sobrecarga de leve a moderada, 41,1% não apresentaram sobrecarga, enquanto que 13,7% foram classificados com sobrecarga de moderada à severa e apenas um cuidador (1,4%) apresentava nível de sobrecarga severa. Conclusão: A associação entre TMC do cuidador familiar e a sobrecarga no cuidado do idoso foi estatisticamente significante (p = 0,000), observando-se que a frequência de TMC entre os cuidadores sem sobrecarga foi de 13,3%, enquanto que a frequência de TMC entre aqueles que tinham um nível de leve a moderado de sobrecarga foi de 37,5% e, entre os cuidadores com nível de sobrecarga moderada à severa, quase a totalidade (90,9%) tinha TMC.
Objective: This study aims to analyze the prevalence of Common Mental Disorders (CMD) associated with the burden placed on family caregivers of elderly. Methods: Descriptive epidemiologic study from transverse nature, with convenience sample, in which were analyzed 73 family caregivers of elderly treated at Geriatric ambulatory from public hospital in Pernambuco healthy state network. The data were collected through sociodemographic questionnaire, drawn up for this research and Self-Reporting Questionnaire (SRQ-20), instrument developed to the identification of CMD, validated to Brazilian reality. And the last instrument used was Zarit Burden Interview scale, validated on Brazil to evaluated overload of caregivers. Results: At 73 family caregivers of elderly, 26 were classifieds with CMD, which correspond to a prevalence of 35.6%. About the level of overload, 43.8% had mild to moderated overload, 41.1% did not report overload, while 13.7% were classified with overload moderated to heavy; and just one caregiver (1.4%) present heavy level of overload. Conclusion: The association between caregivers CMD and the overload on elderly cares were statically significant (p = 0,000), observing that the frequency of CMD between those had a mild to moderated overload level were 37.5% and between the caregivers with moderated to heavy level of overload, almost the total (90.9%) had CMD.
Objetivo: Analizar la prevalencia de los Trastornos Mentales Comunes (TMC) asociados con la sobrecarga de cuidadores familiares de ancianos. Métodos: Estudio epidemiológico descriptivo de la transversal, con muestra de conveniencia, que analizó 73 cuidadores familiares de ancianos asistidas en geriatría clínica de un hospital público de Pernambuco de la Red de Salud del Estado. Los datos fueron recolectados a través de un cuestionario sociodemográfico desarrollado para este estudio y auto-Reporting Questionnaire (SRQ-20), un instrumento desarrollado para la identificación de los CMD, ya validados para la realidad brasileña. Y el último instrumento utilizado fue la escala de Zarit Burden Interview, validado en Brasil para evaluar la sobrecarga del cuidador. Resultados: De los 73 cuidadores familiares de ancianos, 26 se clasificaron como TMC, que corresponde a una prevalencia del 35,6%. En cuanto al nivel de la sobrecarga de estos cuidadores, un 43,8% tenían de leve a moderada sobrecarga, 41,1% no mostró ninguna sobrecarga, mientras que el 13,7% fue clasificado con moderada a severa sobrecarga y solo un cuidador (1,4%) tenían nivel de sobrecarga severa. Conclusión: La asociación entre TMC del cuidador familiar y la sobrecarga para el cuidado de ancianos fue estadísticamente significativa (p = 0,000), y señaló que la frecuencia TMC entre los cuidadores sin sobrecarga fue del 13,3%, mientras que la frecuencia de TMC entre los que tenían un nivel de leve a moderada sobrecarga fue del 37,5% y entre los cuidadores con nivel moderado de los gastos generales a grave, casi todos (90,9%) tenían TMC.
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[{"text": "Introdução: O Tailored Activity Program (TAP) é um programa de intervenção em terapia ocupacional\r\npara indivíduos com demência e seus cuidadores, desenvolvido em oito sessões domiciliares por um período de três a quatro meses. Não há disponível no Brasil nenhuma metodologia sistematizada de ação em terapia ocupacional para o tratamento de idosos com demência, o que justifica a adaptação transcultural do TAP à cultura brasileira. Objetivo: Adaptar à cultura brasileira os materiais de referência do TAP: Manual de Intervenção e o Manual Educativo para os Cuidadores. Método: A metodologia utilizada propõe a tradução, a retrotradução, a avaliação das equivalências semântica, idiomática, conceitual e cultural, seguida do pré-teste dos materiais para produção das versões em português. Resultados: Na fase de tradução, 17 itens foram adaptados culturalmente. Na fase de retrotradução, não foram identificadas distorções. Na avaliação das equivalências semânticas e idiomáticas do Manual de Intervenção, dos 374 itens avaliados, 74 apresentaram discordância; já na avaliação do Manual Educativo para os Cuidadores, dos 2.051 itens, 96 apresentaram discordância. Nas equivalências conceituais e culturais do Manual de Intervenção, 62 dos 374 itens apresentaram discordância, enquanto no Manual Educativo para os Cuidadores, 57 dos 2.051 itens. Os itens discordantes foram modificados a partir das sugestões dos juízes. Após a avaliação dos juízes, foi realizado o pré-teste das versões produzidas, e dois itens foram adaptados. Conclusão: O TAP foi adaptado à cultura brasileira, passando a se chamar Programa Personalizado de Atividades (TAP-BR), e manteve a proposta de intervenção original com oito sessões por período de três a quatro meses.", "_i": "pt"}, {"text": "Introduction: The Tailored Activity Program (TAP) is an intervention program in Occupational Therapy\r\nfor individuals with dementia and their caregivers. It is based on 8 home-based sessions, during 3 or 4 months. Brazil lacks an Occupational Therapy methodology of action, which justifies the cross-cultural adaptation of the TAP. Objective: To adapt the TAP reference materials "Intervention Manual" and the "Caregiver Notebook" to the Brazilian culture. Method: The methodology used proposes the translation, back translation, evaluation of semantic, idiomatic, conceptual and cultural equivalences and the pre-test of materials for production in Portuguese. Results: The translation phase adapted 17 items; the back-translation process identified distortions. In the evaluation of the semantic and idiomatic equivalence of the Manual Intervention, 74 items of 374 items evaluated were discordant; and in the Caregivers Notebook 96 items of 2051 items evaluated were discordant. Regarding to conceptual and cultural equivalence, in the Manual Intervention, 62 of 374 items evaluated were discordant and in the Caregivers\r\nNotebook, 57 of 2051 items. The discordant items were modified from suggestions given by the reviewers. After the evaluation of the committee of reviewers, we conducted a pre-test of the Portuguese versions and two items were adapted. Conclusion: The TAP has been adapted to the Brazilian culture and kept the original proposal for intervention with 8 sessions during a period of 3 to 4 months.", "_i": "en"}]
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As in many other health disorders, people who misuse substances tend to be assisted by female caregivers. Despite this, little is known about the characteristics of women affected by a substance misusing relative (SMR). Data from 2541 Brazilian female affected family members (AFM) were analyzed. The majority of participants were mothers, age 45 or above, in a relationship, responsible for the substance use treatment of the SMR, and were related to a male SMR. High levels of physical and psychological symptoms were associated with socioeconomic status, mothers, responsibility for the SMR's treatment, cocaine and crack-cocaine as substance of the preference of the SMR, and financial contraints as reasons for the delay to seeking help. Findings demonstrate the complex social systems associated with female AFMs and the need of gender sensitive approaches to address the AFM's coping responses to the substance misuse problem in the family.
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The abuse of older adults is a serious public health issue that can be difficult to identify at the first level of care. Medical and nursing personnel are sometimes unable to identify older adults who suffer family mistreatment. This can occur when victims feel shame or as a result of cultural factors. In the light of this, healthcare personnel require a screening tool that can be used to identify signs of mistreatment. The aim of this study was to develop and validate a screening tool for detecting the familial mistreatment of older adults in primary care settings. A mixed method cross-sectional study was carried out in three phases between 2009 and 2012 in Mexico. The formative phase involved using a qualitative methodology to identify terms that older adults use to identify practices defined as forms of mistreatment. On this basis, the second phase involved the design of a screening tool through the formation of items in collaboration with a panel of experts. These items were tested on older adults to ensure their intelligibility. Finally, validity and reliability levels were evaluated through the application of the screening tool to a sample of older adults at a primary care facility and at a legal centre. These findings were discussed with gerontologists, and the data were analysed through an exploratory factor analysis with orthogonal rotation and Cronbach's alpha using STATA v13. From the results, we generated a screening tool that is culturally and socially tailored to older adults in Mexico. The tool has a Cronbach's alpha of 0.89, a sensitivity value of 86% (p < .05) and a specificity value of 90% (p < .05) for positive answers to the tool's 15 items. Applying this tool at the first level of care could limit damage to older adults' health and could lower the frequency of emergency room use in hospitals.
Assuntos
Abuso de Idosos/diagnóstico , Avaliação Geriátrica/estatística & dados numéricos , Programas de Rastreamento/normas , Inquéritos e Questionários/normas , Idoso , Estudos Transversais , Feminino , Humanos , Masculino , México , Atenção Primária à Saúde/normas , Psicometria/estatística & dados numéricos , Reprodutibilidade dos Testes , Medição de RiscoRESUMO
Maple Syrup Urine Disease (MSUD) is an inborn error of metabolism caused by a deficiency of the branched-chain α-keto acid dehydrogenase complex activity. This blockage leads to accumulation of the branched-chain amino acids leucine, isoleucine and valine, as well as their corresponding α-keto acids and α-hydroxy acids. The affected patients present severe neurological symptoms, such as coma and seizures, as well as edema and cerebral atrophy. Considering that the mechanisms of the neurological symptoms presented by MSUD patients are still poorly understood, in this study, protein levels of apoptotic factors are measured, such as Bcl-2, Bcl-xL, Bax, caspase-3 and -8 in hippocampus and cerebral cortex of rats submitted to acute administration of branched-chain amino acids during their development. The results in this study demonstrated that BCAA acute exposure during the early postnatal period did not significantly change Bcl-2, Bcl-xL, Bax and caspase-8 protein levels. However, the Bax/Bcl-2 ratio and procaspase-3 protein levels were decreased in hippocampus. On the other hand, acute administration of BCAA in 30-day-old rats increase in Bax/Bcl-2 ratio followed by an increased caspase-3 activity in cerebral cortex, whereas BCAA induces apoptosis in hippocampus through activation and cleavage of caspase-3 and -8 without changing the Bax/Bcl-2 ratio. In conclusion, the results suggest that apoptosis could be of pivotal importance in the developmental neurotoxic effects of BCAA. In addition, the current studies also suggest that multiple mechanisms may be involved in BCAA-induced apoptosis in the cerebral cortex and hippocampus.
Assuntos
Aminoácidos de Cadeia Ramificada/farmacologia , Apoptose/efeitos dos fármacos , Hipocampo/efeitos dos fármacos , Doença da Urina de Xarope de Bordo/metabolismo , Transdução de Sinais/efeitos dos fármacos , Animais , Caspase 3/metabolismo , Caspase 8/metabolismo , Córtex Cerebral/efeitos dos fármacos , Córtex Cerebral/metabolismo , Modelos Animais de Doenças , Hipocampo/metabolismo , Masculino , Proteínas Proto-Oncogênicas c-bcl-2/metabolismo , Ratos , Ratos Wistar , Proteína X Associada a bcl-2/metabolismo , Proteína bcl-X/metabolismoRESUMO
A sexualidade é um fenômeno presente na vida do ser humano desde o seu nascimento, mas é na adolescência que ela se evidencia a partir das mudanças que ocorrem no indivíduo e que envolvem aspectos bio-psico-sociais. Essas mudanças geram muitas vezes insegurança e modificações no contexto familiar, principalmente quando envolve o manejo das questões da sexualidade. Objeto de Estudo: A sexualidade na adolescência no contexto da família. Os objetivos foram: Compreender os modos de construção dos saberes dos familiares dos adolescentes sobre a temática sobre a sexualidade; Desvelar os sentidos que os familiares têm sobre a temática da sexualidade e como esta é abordada por eles junto aos adolescentes; Analisar, a partir dos discursos dos familiares os modos de reprodução deste tema na orientação sexual dos seus filhos adolescentes. Metodologia: Estudo de abordagem qualitativa, desenvolvido através do grupo focal, com 13 familiares/cuidadores dos adolescentes atendidos em uma Unidade Pré-Hospitalar, localizada na cidade de Duque de Caxias. O estudo foi realizado no período de julho de 2015 a maio de 2016. Os dados foram analisados a partir da análise de discurso e interpretados à luz do pensamento de Foucault. Resultados: A prática discursiva dos familiares/cuidadores revelou que a formação dos saberes sobre a sexualidade ocorreu basicamente a partir da adolescência. Entretanto, a falta de informação no interior da família, fez com que as participantes aprendessem sobre essas questões com as experiências de vida; a partir de conversas com pessoas mais velhas, profissionais de saúde e professores. Isto foi um fator determinante na decisão das mães participantes desse estudo em abordar essas questões com seus filhos nesse momento de sua adolescência. Evitando que os mesmos vivenciem a falta de esclarecimento sobre esse assunto, como aconteceu com elas no passado. Entretanto, o processo de transferência desses saberes se dá de forma restritiva, prescritiva e controladora. Dentre os temas mais abordados pelas familiares/cuidadoras junto aos seus filhos estão: as mudanças fisiológicas ocorridas na puberdade, as DSTs, os métodos contraceptivos, a gravidez e o ato sexual. Nesse sentido, a abordagem se dá no campo dos aspectos reprodutivos ou patológicos, em detrimento dos aspectos psíquicos, emocionais e sociais que envolvem essa temática. Conclui-se que os familiares/cuidadores precisam oportunizar espaços de diálogos junto a seus adolescentes, tornando as discussões sobre a temática da sexualidade como parte natural de uma conversa, numa relação dialógica, de reflexão-ação sobre essas questões. Implicações para a enfermagem: salienta-se a importância do enfermeiro em abordar essas questões junto aos familiares de adolescentes de modo a suprir as dificuldades encontradas por eles para abordar essa temática no interior de sua família.
Sexuality is a phenomenon present in human life since birth, but it is in adolescence that it is evidenced from the changes that occur in the individual and that involve bio-psycho- social aspects. These changes often generate insecurity and changes in the family context, especially when they involve the handling of sexuality issues. Object of study: The approach of sexuality by family members with adolescents. The objectives were: To understand the ways of building knowledge by the relatives of adolescents on the theme of sexuality; To unveil the senses that family members have about sexuality and how they approach them with the adolescents; and To analyze, from the discourses of the relatives about the theme of sexuality, the ways of reproducing the subject in the sexual orientation to their adolescent children. Methodology: A qualitative study, developed through focus group, with 13 adolescents's family members attending a Pre-Hospital Unit located in the city of Duque de Caxias/RJ. Data were collected from November 2015 to March 2016, analyzed through the discourse analysis and interpreted in the light of Foucault's thinking. Results: The discursive practice of family members revealed that the formation of knowledge about sexuality occurred basically from the time of adolescence. However, the lack of information within the family made the participants learn about these issues from life experiences; from conversations with older people; health professionals and teachers. This was a determining factor in the decision of the mothers participating in this study to address these issues with their children at this point in their adolescence, preventing them from experiencing the lack of clarification on this subject as they have in the past. However, the process of transferring this knowledge takes place in a restrictive, prescriptive and controlling way. Among the topics most approached by family members with their children are: the physiological changes occurring at puberty, sexually transmitted infections (STIs), contraceptive methods, pregnancy and sexual intercourse. In this sense, the approach is in the field of reproductive or pathological aspects, to the detriment of the psychic, emotional and social aspects that involve this theme. It is concluded that family members need to provide dialogue spaces with their adolescents, making the discussions on sexuality a natural part of a conversation, in a dialogical relationship of reflection-action on these issues. Implications for nursing: the importance of the nurse in addressing these issues with the relatives of adolescents is highlighted in order to overcome the difficulties they encounter in addressing this issue within their families.
Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Adolescente , Relações Familiares , Cuidados de Enfermagem , Sexualidade , Saúde do Adolescente , Brasil , Comportamento SexualRESUMO
Este artigo é um desdobramento de tese de doutorado defendida pela Universidade Federal do Espírito Santo. Pretende-se analisar a elucidação de necessidades, a elaboração de demanda e oferta, no processo de produção de cuidado, na relação entre profissionais de saúde mental e familiares de pessoas com sofrimento psíquico. A perspectiva qualitativa de investigação configurou-se como método para alcançar os objetivos propostos. Foram realizadas entrevistas semi estruturadas com profissionais de saúde mental de dois centros de atenção psicossocial (CAPS) do município de Vitória ES e com familiares de usuários destas instituições. Após análise temática do conteúdo, foram evidenciados sentidos, significados e valores atribuídos às necessidades, demandas e ofertas, presentes nessa relação. É evidenciada a disparidade entre demanda e oferta, a desvalorização, o desconhecimento das necessidades dos familiares e as demandas dos familiares relacionadas à lógica manicomial. Tendo como referência a ética na filosofia de Espinosa, são discutidas as consequências do encontro entre profissionais de saúde mental e familiares de pessoas com sofrimento psíquico e a micropolítica da produção de cuidado no contexto desses atores.
This paper is a development of a doctoral thesis presented at the Federal University of Espírito Santo. It seeks to analyze the elucidation of needs, development of supply and demand in the provision of care and the relationship between mental health professionals and family members of people with mental disorders. A qualitative research approach was used as the method of choice to achieve the proposed objectives. Semi-structured interviews were conducted with mental health professionals from two psychosocial care centers (CAPS) in the city of Vitória, Espírito Santo, and with family members of frequenters of these institutions. After thematic analysis of content, senses, meanings and values assigned to the needs, supplies and demands present in this relationship were revealed. It highlighted the disparity between supply and demand and the lack of awareness of the needs of family members and their demands related to the routines of mental institutions. Using ethics in the philosophy of Spinoza as a benchmark, the ramifications of this process are discussed in the meetings between mental health professionals and family members of people with mental disorders and the micropolitics of the provision of care in the context of these actors.
Assuntos
Humanos , Relações Profissional-Família , Família , Pessoal de Saúde , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Transtornos Mentais/terapia , Serviços de Saúde Mental/provisão & distribuiçãoRESUMO
BACKGROUND: This study proposes to describe family members in the city of Sao Paulo who are seeking support in mutual self-help groups to deal with a substance misusing relative. METHOD: Five hundred participants (one participant per family) completed a structured questionnaire collecting socio-demographic information, length of time taken to seek help, and where they sought help. Participants were recruited from the mutual self-help group 'Amor Exigente' in the city of Sao Paulo, Brazil. RESULTS: Parents of substance misusers counted as the largest group of family members. It took an average time of 3.7 years for the family members to discover their relatives' substance misuse. 42% had then sought help immediately; it took an average of 2.6 years for the remaining 58% of the sample to seek some form of support. A belief that the substance misuse of their relatives was just a transient problem or that they could cope with the situation by themselves were among the most indicated reasons for delay in seeking help. DISCUSSION: Findings stress the importance of implementing services that take into account the difficulties families have in finding help to deal with the substance misusing relative.
Assuntos
Família/psicologia , Acessibilidade aos Serviços de Saúde , Apoio Social , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adaptação Psicológica , Adulto , Brasil , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Grupos de Autoajuda , Fatores de TempoRESUMO
Introdução: As sequelas físicas e cognitivas provocadas pelo AVE comprometem a capacidade funcional, a independência e a autonomia da pessoa acometida e acarreta alterações na dinâmica de vida não só do indivíduo acometido, mas também da família, sobretudo na do cuidador principal. Objetivos: Avaliar a qualidade de vida relacionada à saúde de cuidadores familiares de pacientes com sequelas com AVE. Metodologia: A pesquisa foi do tipo descritivo, transversal, com abordagem quantitativa, realizada no domicílio dos pacientes com sequela de AVE, no município de João Pessoa PB, no período de fevereiro a abril de 2013. A população do estudo foi composta por 136 cuidadores familiares de pacientes acometidos por acidente vascular. Para a coleta dos dados, foi utilizado um instrumento estruturado, contemplando questões fechadas relativas às variáveis do estudo e às medidas específicas para avaliar, respectivamente, a capacidade física dos indivíduos com sequela de AVE, a sobrecarga e a qualidade de vida relacionada à saúde entre os cuidadores: índice Barthel, Burden Interview Scale e o Short-Form-36. A análise foi realizada através de três técnicas: estatísticas: Análise Descritiva e Exploratória de Dados e Análise de Associação por meio do Teste de qui-quadrado e o Teste T e F para comparações das médias. O projeto foi encaminhado ao comitê de ética do Centro de Ciências da Saúde da Universidade Federal da Paraíba e aprovado sob o protocolo n 0279/13 e CAAE: 13778313.3.0000.5188 Resultados: Foi evidenciado comprometimento em quase todos os domínios da qualidade de vida dos cuidadores familiares. Entre eles, os que se apresentaram com menor média foram: Dor (40,16), Saúde mental (53,62) e Aspectos sociais (54,12).
Introduction: The physical and cognitive sequelae caused by CVA compromise the functional capacity, and the independence and autonomy of the person affected by the CVA, causing changes in the dynamics of life not only of the individual affected, but also the family, especially for the main caregiver. Objectives: evaluating the health-related quality of life of family caregivers of patients with sequelae with CVA. Methods: the research was descriptive, transversal type, with a quantitative approach, held at the domicile of patients with sequelae by AVE, in the city of João Pessoa-Paraíba, in the period between the months of February and April 2013. The population of the study consisted of 136 family caregivers of patients affected by stroke. For data collection, there was used a structured instrument, contemplating closed issues relating to variables of the study and the specific measures to assess, respectively, the physical capacity of individuals with sequel by CVA, the overload and health-related quality of life among caregivers: Barthel index, Burden Interview Scale and Short Form-36. The analysis was performed using three techniques: statistical descriptive analysis and exploratory data analysis and Association through the Chi-square test and the T-test and F for comparisons of the averages. The project was submitted to the ethics committee of the Centre for Health Sciences, Federal University of Paraíba Health and approved under protocol number 0279/13 and CAAE: 13778313.3.0000.5188. Results: commitment was evidenced in almost all domains of quality of life of family caregivers, among them, those who were presented with lower average were: Pain (40.16), Mental Health (53.62) and Social Aspects (54.12).
Assuntos
Humanos , Acidente Vascular Cerebral , Cuidadores , Qualidade de VidaRESUMO
Los factores de riesgo cardiovascular pueden favorecer la presencia de enfermedades cardiovasculares en la adultez o contribuir a la aparición de eventos cardiovasculares durante la práctica deportiva. Los objetivos de este estudio fueron: 1) estimar la distribución de factores de riesgo cardiovascular personales; 2) vincular la presencia de factores de riesgo cardiovascular en los padres o abuelos a la condición clínica de los niños. Se realizó un estudio retrospectivo para evaluar el sobrepeso, la obesidad y la hipertensión en 1021 niños deportistas. Se estudiaron los antecedentes familiares de obesidad, diabetes tipo 2, cardiopatía isquémica y accidente cerebrovascular. El 22,1% (n= 226) de los niños eran obesos y 2,1% (n= 21) eran hipertensos. La obesidad fue el factor familiar más frecuente (30%).(AU)
Cardiovascular risk factors can predispose to cardiovascular disease in adults or lead to cardiovascular events while practicing sports. The objectives of this study were: 1) to estimate the distribution of individual cardiovascular risk factors; 2) to establish a relationship between cardiovascular risk factors in parents or grandparents and the childrens clinical condition. This was a retrospective study to assess overweight, obesity and hypertension in 1021 child athletes. The family history of obesity, type 2 diabetes, ischemic heart disease, and stroke was studied. Out of the studied children, 22.1% (n= 226) were obese and 2.1% (n= 21) had hypertension. Obesity was the most common family risk factor (30%).(AU)
RESUMO
Los factores de riesgo cardiovascular pueden favorecer la presencia de enfermedades cardiovasculares en la adultez o contribuir a la aparición de eventos cardiovasculares durante la práctica deportiva. Los objetivos de este estudio fueron: 1) estimar la distribución de factores de riesgo cardiovascular personales; 2) vincular la presencia de factores de riesgo cardiovascular en los padres o abuelos a la condición clínica de los niños. Se realizó un estudio retrospectivo para evaluar el sobrepeso, la obesidad y la hipertensión en 1021 niños deportistas. Se estudiaron los antecedentes familiares de obesidad, diabetes tipo 2, cardiopatía isquémica y accidente cerebrovascular. El 22,1% (n= 226) de los niños eran obesos y 2,1% (n= 21) eran hipertensos. La obesidad fue el factor familiar más frecuente (30%).
Cardiovascular risk factors can predispose to cardiovascular disease in adults or lead to cardiovascular events while practicing sports. The objectives of this study were: 1) to estimate the distribution of individual cardiovascular risk factors; 2) to establish a relationship between cardiovascular risk factors in parents or grandparents and the children's clinical condition. This was a retrospective study to assess overweight, obesity and hypertension in 1021 child athletes. The family history of obesity, type 2 diabetes, ischemic heart disease, and stroke was studied. Out of the studied children, 22.1% (n= 226) were obese and 2.1% (n= 21) had hypertension. Obesity was the most common family risk factor (30%).
Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Doenças Cardiovasculares , Saúde da Família , Hipertensão , Obesidade , Sobrepeso , Pais , Estudos Retrospectivos , Fatores de RiscoRESUMO
OBJECTIVES: Family members of patients in a vegetative state have relatively high rates of anxiety and distress. It is important to recognize the problems faced by this population and apply psychological interventions to help them. This exploratory study describes the psychological stress experienced by family members of patients in a vegetative state. We discuss the effectiveness of a psychological crisis intervention directed at this population and offer suggestions for future clinical work. METHODS: A total of 107 family members of patients in a vegetative state were included in the study. The intervention included four steps: acquisition of facts about each family, sharing their first thoughts concerning the event, assessment of their emotional reactions and developing their coping abilities. The Symptom Check List-90 was used to evaluate the psychological distress of the participants at baseline and one month after the psychological intervention. Differences between the Symptom Check List-90 scores at the baseline and follow-up evaluations were analyzed. RESULTS: All participants in the study had significantly higher Symptom Check List-90 factor scores than the national norms at baseline. There were no significant differences between the intervention group and the control group at baseline. Most of the Symptom Check List-90 factor scores at the one-month follow-up evaluation were significantly lower than those at baseline for both groups; however, the intervention group improved significantly more than the control group on most subscales, including somatization, obsessive-compulsive behavior, depression, and anxiety. CONCLUSION: The results of this study indicate that the four-step intervention method effectively improves the mental health of the family members who received this treatment and lessens the psychological symptoms of somatization, obsessive-compulsive behavior, depression and anxiety.
Assuntos
Adulto , Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Intervenção em Crise , Família/psicologia , Estado Vegetativo Persistente/psicologia , Estresse Psicológico/terapia , China , Escolaridade , Seguimentos , Estado CivilRESUMO
Apoptosis deregulation might have a role in the pathophysiology of polycythemia vera (PV). This study evaluated Bcl-2 molecule expression in CD34+ cells and leukocytes in 12 PV patients. Gene expression was investigated by real time PCR using SybrGreen Quantitect kit and protein expression was evaluated by western-blotting. JAK2 V617F mutation was detected according to Baxter et al (2005). CD34+ cells from PV patients presented higher levels of A1 and Mcl-1 expression (median: 22.6 and 5.2, respectively) in comparison with controls (0.9 and 0.5, p=0.004 and p=0.020); while Bcl-2 and Bcl-xL expression decreased in PV patients (0.18 and 1.19) compared with controls (1.39 and 2.01, p=0.006 and p=0.020). CD34+ cells in PV patients showed an elevated Bid expression (14.4) in comparison with healthy subjects (1.0; p=0.002). Patients' leukocytes showed an A1 augmentation (7.41, p=0.001) and a reduced expression of Bax (0.19; p=0.040) and Bad (0.2; p=0.030). There was no correlation between JAK2 V617F allele burden and molecular expression. PV patients showed alterations in Bcl-2 members' expression, which may interfere with control of apoptotic machinery and contribute to disease pathogenesis.
A desregulação da apoptose parece participar da fisiopatologia da policitemia vera (PV). Este estudo avaliou a expressão das moléculas da família Bcl-2 em células hematopoéticas CD34 + e leucócitos de 12 pacientes com PV. Foram realizados: a quantificação da expressão gênica por PCR em tempo real utilizando kit Sybrgreen Quantitect, avaliação da expressão de proteínas por western-blot e detecção da mutação JAK2 V617F segundo Baxter et al. (2005). Células CD34 + dos pacientes com PV apresentaram maior expressão de A1 e Mcl-1 (mediana: 22,6 e 5,2, respectivamente) em comparação com controles (0,9 e 0,5, p = 0,004 e p = 0,020) e expressão de Bcl-2 e Bcl-xL diminuída nestes pacientes (0,18 e 1,19) em relação aos controles (1,39 e 2,01, p = 0,006 e p = 0,020). Células CD34 + dos pacientes com PV mostraram expressão elevada de bid (14,4) em comparação aos controles (1,0; p = 0,002). Leucócitos dos pacientes mostraram aumento de A1 (7,41, p = 0,001) e expressão reduzida do Bax (0,19; p = 0,04) e Bad (0,2; p = 0,030). Não houve correlação entre percentagem de alelos JAK2 V617F mutados e expressão molecular. Pacientes com PV apresentaram alterações na expressão de moléculas Bcl-2 que podem interferir no controle da apoptose e contribuir para a patogênese da doença.
Assuntos
Humanos , Policitemia Vera/classificação , Apoptose/fisiologia , Genes bcl-2 , MutaçãoRESUMO
O objetivo desse artigo foi identificar os fatores terapêuticos em um grupo de apoio psicológico para familiares de pessoas com anorexia nervosa e bulimia nervosa. Os fatores encontrados em maior frequência foram: aprendizagem através da ação interpessoal, instilação de esperança, altruísmo, autorrevelação e aceitação; enquanto o fator orientação obteve o menor índice. Os participantes oferecem ajuda, trocam experiências em uma postura mais ativa. Manteve-se no grupo a oportunidade de os participantes falarem de suas experiências e vivências relacionadas à doença e à própria vida.(AU)
The aim of this study was to identify the therapeutic factors in a support group for family members of people diagnosed with anorexia nervosa and bulimia nervosa. The most predominant factors were learning through interpersonal action; hope promotion; altruism; self-revelation and acceptance. The least predominant factor was orientation. The participants offered help, exchanged experiences in an active way. The family members could talk about their experiences concerning the disease and their own lives.(AU)
El objetivo de este artículo fue identificar los factores terapéuticos en un grupo de apoyo psicológico a los familiares de las personas con anorexia nerviosa y bulimia nerviosa. Los factores más frecuentes fueron: el aprendizaje mediante la acción interpersonal, la instilación de esperanza, el altruismo, la auto-revelación y aceptación, mientras que el factor de orientación tuvo el menor índice. Los participantes ofrecen ayuda, comparten experiencias en una posición más activa. Permaneció en el grupo la oportunidad que los participante hablen sobre sus experiencias relacionadas a la enfermedad y la vida misma.(AU)