Evolving trends in immunosuppression use and cytomegalovirus infection risk over the past decade in kidney transplantation.

BACKGROUND: The goal was to determine trends in immunosuppression use and its impact on cytomegalovirus (CMV) outcomes over the past 10 years. METHODS: This was a single-center longitudinal cohort study of adult kidney recipients transplanted between Jan 2012 and June 2021. Baseline and follow-up data were gathered via chart abstraction and analyzed using univariate and multivariate analyses. RESULTS: Of 2392 kidney transplants conducted, 131 patients did not meet inclusion criteria. The mean age was 52 years, 41% were female, 57% were black, and 19% were CMV high-risk. The use of rabbit anti-thymocyte globulin (RATG) induction (odds ratio [OR] 1.6, 1.3-2.1), tacrolimus (FK) level >8 ng/mL (OR 1.1, 1.09-1.11), CMV D+/R- rates (OR 1.06, 1.02-1.10), white blood cell count <3000 (OR 1.22, 1.18-1.26) and valganciclovir prophylaxis (OR 1.7, 1.6-1.9) have significantly increased over the past 10 years.  Rejection rates (OR 0.86, 0.82-0.91) and BK viremia >2000 (OR 0.91, 0.91-0.98) have decreased. RATG induction (adjusted hazard ratio [aHR] 1.35, 1.2-1.5), FK >8 ng/mL (aHR 3.5, 3.2-3.9), Belatacept conversion (aHR 2.5, 2.1-3.1), and rejection (aHR 1.8, 1.6-2.0) were significant risk factors for developing CMV infection, while mycophenolate mofetil <1500 mg (aHR 0.52, 0.47-0.59), mammalian target of rapamycin inhibitor (mTORi) conversion (0.77, 0.56-0.89), cyclosporine-A conversion (aHR 0.68, 0.56-0.84) were associated with lower risk of CMV infection. CONCLUSION: Increasing use of potent immunosuppression coupled with higher CMV D+/R- F rates may be driving higher rates of CMV infection. Cyclosporine and mTORi conversion appears to be protective against CMV.  A more individualized immunosuppression regimen based on infection risk merits consideration.

Devaluation of response-produced safety signals reveals circuits for goal-directed versus habitual avoidance in dorsal striatum.

Active avoidance responses (ARs) are instrumental behaviors that prevent harm. Adaptive ARs may contribute to active coping, whereas maladaptive avoidance habits are implicated in anxiety and obsessive-compulsive disorders. The AR learning mechanism has remained elusive, as successful avoidance trials produce no obvious reinforcer. We used a novel outcome-devaluation procedure in rats to show that ARs are positively reinforced by response-produced feedback (FB) cues that develop into safety signals during training. Males were sensitive to FB-devaluation after moderate training, but not overtraining, consistent with a transition from goal-directed to habitual avoidance. Using chemogenetics and FB-devaluation, we also show that goal-directed vs. habitual ARs depend on dorsomedial vs. dorsolateral striatum, suggesting a significant overlap between the mechanisms of avoidance and rewarded instrumental behavior. Females were insensitive to FB-devaluation due to a remarkable context-dependence of counterconditioning. However, degrading the AR-FB contingency suggests that both sexes rely on safety signals to perform goal-directed ARs.

Impact of obesity on the conversion of immediate-release tacrolimus to extended-release tacrolimus in kidney transplant recipients.

Outcomes analyzing conversion from IR-tacrolimus (IR) to LCP-tacrolimus (LCP) in obesity are limited. This was a retrospective longitudinal cohort study of patients converted from IR to LCP from June 2019 to October 2020. Primary outcomes were conversion ratios for weight-based dose at a steady-state therapeutic level and identification of appropriate dosing weight. Other outcomes included tacrolimus coefficient of variation (CV), time in therapeutic range (TITR), adverse events, infections, donor specific antibodies (DSAs), and acute rejection. A total of 292 patients were included; 156 and 136 patients with a BMI < 30 and BMI ≥ 30 kg/m2 , respectively. Baseline characteristics were similar, except for pancreas transplant, diabetes, and HLA mismatch. IR to LCP conversion ratio ranged from .73 to .79. Mean LCP dose was similar (.08 vs. .07 mg/kg/day for BMI < 30 and BMI ≥ 30 kg/m2 , respectively); there was a significant difference in IR and LCP mg/kg dosing at steady state with TBW (.11 mg/kg vs.09 mg/kg and .08 mg/kg vs. .06 mg/kg, respectively). The most appropriate dosing weight was adjusted body weight (AdjBW), consistent across IR and LCP steady-state doses, and might yield more accurate steady-state dosing requirements. In multivariable modeling, BMI was a significant predictor of steady state mg/kg dosing at therapeutic goal for total body weight (TBW), but not ideal body weight (IBW) or AdjBW.

Local Infiltration of Tranexamic Acid in Breast Reduction for Symptomatic Macromastia.

BACKGROUND: With a surge of tranexamic acid (TXA) use in the plastic surgery community and a constant demand for breast reduction for symptomatic macromastia, questions about the benefits and risks emerge. The aims of this study are to evaluate and compare outcomes of patients undergoing breast reduction while receiving local TXA as opposed to standard procedure without TXA and to assess intraoperative bleeding and operative time. METHODS: A retrospective review of breast reductions at a single institution from June 2020 to December 2021 was performed. The breast was infiltrated with tumescent solution at the time of surgery, with or without TXA. The population was divided into 2 groups: the TXA receiving group and tumescent only group. Demographics, intraoperative bleeding, operative time, complications, and drain duration were compared between groups. T test and χ 2 test analyses were performed on IBM SPSS.TM. RESULTS: A total of 81 patients and 162 breasts were included. Mean age among patients was 30 ± 13.44 years. Mean SN-N distance was 32.80 ± 3.62 cm. Average resected breast specimen weight was 903.21 ± 336.50 g. Mean operating room time was 159 minutes. Intraoperative blood loss and operative time were not statistically different between groups ( P = 0.583 and P = 0.549, respectively). T-junction dehiscence was lower in the TXA group ( P = 0.016). Incidence of suture granulomas was lower in the TXA group ( P = 0.05). Drain duration was statistically significantly higher in the TXA group ( P = 0.033). CONCLUSIONS: No decreases in intraoperative blood loss, operative time, or hematoma were seen after local administration of TXA during breast reduction. The rate of overall complications was not increased by using TXA, and incidence of T-junction dehiscence was lower in the TXA group lending to TXA's relatively safe profile. More research is necessary to further elucidate the TXA-related benefits in standard breast reductions.

Impact of converting adult kidney transplant recipients with high tacrolimus variability from twice daily immediate release tacrolimus to once daily LCP-Tacrolimus.

BACKGROUND: The influence of converting to once daily, extended-release LCP-Tacrolimus (Tac) for those with high tacrolimus variability in kidney transplant recipients (KTRs) is not well-studied. METHODS: Single-center, retrospective cohort study of adult KTRs converted from Tac immediate release to LCP-Tac 1-2 years post-transplant. Primary measures were Tac variability, using the coefficient of variation (CV) and time in therapeutic range (TTR), as well as clinical outcomes (rejection, infections, graft loss, death). RESULTS: A total of 193 KTRs included with a follow-up of 3.2 ± .7 years and 1.3 ± .3 years since LCP-Tac conversion. Mean age was 52 ± 13 years; 70% were African American, 39% were female, 16% living donor and 12% donor after cardiac death (DCD). In the overall cohort, tac CV was 29.5% before conversion, which increased to 33.4% after LCP-Tac (p = .008). In those with Tac CV >30% (n = 86), conversion to LCP-Tac reduced variability (40.6% vs. 35.5%; p = .019) and for those with Tac CV >30% and nonadherence or med errors (n = 16), LCP-Tac conversion substantially reduced Tac CV (43.4% vs. 29.9%; p = .026). TTR significantly improved for those with Tac CV >30% with (52.4% vs. 82.8%; p = .027) or without nonadherence or med errors (64.8% vs. 73.2%; p = .005). CMV, BK, and overall infections were significantly higher prior to LCP-Tac conversion. In the overall cohort, 3% had rejection before conversion and 2% after (p = NS). At end of follow-up, graft and patient survival were 94% and 96%, respectively. CONCLUSIONS: In those with high Tac CV, conversion to LCP-Tac is associated with a significant reduction in variability and improvement in TTR, particularly in those with nonadherence or medication errors.

Diabetes is a significant and independent predictor for tacrolimus immediate release and LCP-tacrolimus conversion ratios.

Diabetes (DM) is a common comorbidity in transplant patients with known effects on gastrointestinal (GI) motility and absorption; however, DM's impact on immediate release (IR) tacrolimus to LCP-tacrolimus (LCP) conversion ratios has not been studied. This multivariable analysis of a retrospective longitudinal cohort study included kidney transplant recipients converted from IR to LCP between 2019 and 2020. The primary outcome was IR to LCP conversion ratio based on DM status. Other outcomes included tacrolimus variability, rejection, graft loss, and death. Of the 292 patients included, 172 patients had DM and 120 did not. The IR:LCP conversion ratio was significantly higher with DM (67.5% ± 21.1% no DM vs. 79.8% ± 28.7% in DM; P < .001). In multivariable modeling, DM was the only variable significantly and independently associated with IR:LCP conversion ratios. No difference was observed in rejection rates. Graft (97.5% no DM vs. 92.4% in DM; P = .062) and patient survival (100% no DM vs. 94.8% in DM; P = .011) were lower with DM. The presence of DM significantly increased the IR:LCP conversion ratio by 13%-14%, compared to patients without DM. On multivariable analysis, DM was the only significant predictor of conversion ratios, potentially related to GI motility or absorption differences.

Inspiratory muscle training in addition to whole body vibration for functional and physical outcomes in pre-frail older women: a randomized controlled trial.

BACKGROUND: to investigate the efficacy of addition of inspiratory muscle training (IMT) to the whole body vibration (WBV) on functional outcomes, physical performance, muscle strength and metabolism in pre-frail older women. METHODS: this study was a randomized double-blind trial. Forty-two older women aged 60-80 years who meet the Cardiovascular Health Study frailty criteria for pre-frailty were randomly allocated to IMT + WBV, IMTsham + WBV or Sham groups. IMT + WBV group received 12 weeks of both trainings, whereas IMTsham + WVB received 12 weeks of WBV alone. Sham group received 12 weeks of IMT with a low fixed load and were positioned at the vibratory platform without therapeutic effect. Participants were evaluated before and after the intervention for the following outcomes: 6-min walk test distance (6MWD), balance using Tinetti test, functional mobility using timed up and go test (TUG), handgrip strength (HGS) and peripheral muscle metabolism (glucose and lactate levels). RESULTS: after the training, both groups IMT + WBV and IMTsham + WBV improved 6MWD [mean percentage changes = 20.31 (SD = 14.62) and 13.02 (SD = 12.14), respectively] compared with Sham [0.27 (SD = 6.51)], P <0.01. There was also a significant decrease of mean percentage changes on time of the TUG for IMT + WBV [-21.87 (SD = 7.87)] and IMTsham + WBV [-11.15 (SD = 13.64)] compared with Sham [-4.25 (SD = 13.25)], P <0.01. IMT + WBV group improved balance when compared with IMTsham + WBV and Sham groups (P <0.05 and < 0.01, respectively). HGS and levels of lactate and glucose were similar between groups. CONCLUSIONS: the addition of IMT to the WBV was effective to improve functionality, balance and physical performance in pre-frail older women.

Inspiratory Muscle Training in the Severity of Obstructive Sleep Apnea, Sleep Quality and Excessive Daytime Sleepiness: A Placebo-Controlled, Randomized Trial.

PURPOSE: Exercise programs have been considered as an adjuvant treatment in obstructive sleep apnea (OSA). However, few studies have focused on the effects of the inspiratory muscle training (IMT) in reducing the severity and the symptoms of OSA. PATIENTS AND METHODS: A randomized controlled trial was conducted and approved by the local Ethics Committee. All subjects signed the informed consent form and were randomized into 2 groups: a) IMT group (n = 8), 8 weeks of IMT with 75% of maximal inspiratory pressure (MIP) and b) placebo group (n = 8): subjects performed IMT without load. RESULTS: IMT group showed reduction in the apnea-hypopnea index (AHI) (p = 0.01), in the Berlin questionnaire score (p = 0.001) and an increase in inspiratory muscle strength (p = 0.018). IMT group demonstrated a reduction in the AHI (31.7 ± 15.9 events/h vs 29.9 ± 15.8 events/h; p <0.001), in the Berlin questionnaire scores (2.6 ± 0.5 vs 1.2 ± 0.5; p = 0.016), Pittsburgh Sleep Quality Index (PSQI) score (7.2 ± 3.6 vs 3.7 ± 1.3; p = 0.008), in the Epworth Sleepiness Scale (ESS) (12.5 ± 4.0 vs 7.7 ± 3.0; p = 0.008) and increase in MIP (83.6 ± 26.5 cmH2O and 127.9 ± 32.5 cmH2O; p = 0.010). CONCLUSION: The IMT promotes discrete changes in the AHI and improves sleep quality and excessive daytime sleepiness in OSA. Moreover, IMT is a cheap, useful and simple home-based training program and can be considered as an adjunct therapy for OSA patients.

Short Version of Self-Assessment Scale of Job Performance / Versión reducida de la Escala de Autoevaluación del Desempeño en el Trabajo

This paper aims to reduce the job performance self-assessment scale as well as control the response Bias and acquiescence bias using vignettes anchors and inverted items. The original scale database was composed of 20 items divided into two factors: task and context. For the reduction, the ten items with higher factor loads and thresholds were chosen. The reduced scale was estimated by a general factor and two specific dimensions: task and context, representing a bifactor model, with adequate adjustment indicators (RMSEA = .05; TLI = .98). To control response bias and acquiescence, a second study was carried out, in which the responses were recoded and factor analyses were performed in order to make a comparison of the results with and without the use of the vignettes and inverted items. The results indicated that the vignettes improved the factorial loads; however, the reversed items did not perform better than the vignettes

Este artículo tiene como objetivo reducir la Escala de autoevaluación de Desempeño en el trabajo, como también controlar el direccionamiento de respuesta y aprobación, utilizando la técnica de viñetas y elementos invertidos. Para la reducción de la escala, se utilizó el banco de datos de la escala original, compuesta por 20 elementos divididos en dos factores: tarea y contexto. Para la reducción, fueron elegidos los 10 elementos con mayores cargas factoriales y thresholds. La escala reducida fue estimada por un factor general y dos dimensiones específicas: Tarea y contexto, representando un modelo bifactor, con indicadores de ajustes adecuados (RMSEA = 0,05; TLI = 0,98). Para controlar el direccionamiento de respuesta y aprobación, fue realizada una colecta de datos, en la cual las respuestas fueron recodificadas y realizados análisis factoriales con la finalidad de realizar una comparación de los resultados con y sin la utilización de viñetas y elementos invertidos. Los resultados apuntaron a que las viñetas mejoraron las cargas factoriales de los análisis, y que los elementos invertidos no tuvieron mejores resultados además de las viñetas

Suporte à aprendizagem e desempenho no trabalho: modelo de mediação moderada / Learning support and job performance: model of moderate mediation / Apoyo al aprendizaje y desempeño en el trabajo: modelo de mediación moderada

Essa pesquisa propõe analisar um modelo de compreensão do desempenho no trabalho por meio da inteligência, suporte à aprendizagem, job crafting e complexidade subjetiva da tarefa. Participaram 250 funcionários de empresas públicas e privadas (71% do sexo masculino, idade média de 23,7 anos, DP = 4,8). A relação entre a inteligência e o desempenho não foi estatisticamente significativa. O job crafting mediou a relação entre o suporte à aprendizagem e o desempenho. Ademais, essa mediação foi moderada negativamente pela complexidade da tarefa. Assim, o suporte à aprendizagem oferece ao trabalhador a possibilidade de redesenhar o seu trabalho, que, por sua vez respalda o desempenho. Ademais, a complexidade da tarefa diminui a dependência do suporte à aprendizagem para que esse redesenho ocorra.

This research aims to test a model to explain the job performance by intelligence, learning support, job crafting, and subjective task complexity. Participants were 250 employees from different public and private companies (71% were male; age average was 23.7 years old, SD = 4.8). The relationship between intelligence and job performance was not statistically significant. The relationship between learning support and job performance was mediated by job crafting, and this mediation was moderated (negatively) by the task complexity. Therefore, the learning support by the company give to the employee the possibility of work redesign, which supports the job performance enhancement. Furthermore, the task complexity reduces the liability on the learning support to redesign the work.

Esta investigación propone analizar un modelo de comprensión del desempeño en el trabajo a través de la inteligencia, el apoyo al aprendizaje, el trabajo y la complejidad subjetiva de la tarea. Participaron 250 funcionarios de empresas públicas y privadas (71% del sexo masculino, edad media de 23,7 años, DP = 4,8). La relación entre la inteligencia y el desempeño no fue estadísticamente significativa. El rediseño en el trabajo medió la relación entre el soporte al aprendizaje y el rendimiento. Además, esa mediación fue moderada negativamente por la complejidad de la tarea. Así, el soporte al aprendizaje ofrece al trabajador la posibilidad de rediseñar su trabajo, que a su vez respalda el desempeño. Además, la complejidad de la tarea disminuye la dependencia del soporte al aprendizaje para que ese rediseño ocurra.

Percepção da equipe de enfermagem sobre a função do gerente de enfermagem hospitalar / Perception of the nursing team about the role of hospital nursing manager / Percepción del equipo de enfermería sobre el papel gestor de enfermería en el hospital

Objetivo: analisar a percepção da equipe de enfermagem sobre a função do gerente de enfermagem hospitalar, e como essa interfere na qualidade da assistência prestada pela equipe. Método: pesquisa descritiva e exploratória, de abordagem qualitativa dos dados, realizado com 20 profissionais de Enfermagem. Para análise dos resultados, utilizou-se o método do Discurso do Sujeito Coletivo. Resultados: o pensamento coletivo foi agrupado em 04 classes: A função burocrática associada a gerência e as relações gerente-equipe de enfermagem; Competências percebidas pela equipe de enfermagem para o trabalho do gerente de Enfermagem; Desafios na função do gerente de enfermagem percebidos pela equipe de enfermagem; A influência do gerente de enfermagem na qualidade e na assistência prestada ao cliente. Conclusão: a atividade do gerente de enfermagem é extremamente burocrática, e vista pela equipe de Enfermagem como hierarquizada, contribuindo para distanciar o gerente do convívio com a equipe

Objective: to analyze the perception of the nursing team about the role of the hospital nursing manager, and how this interferes with the quality of care provided by the team. Methods: descriptive and exploratory research, qualitative approach of the data, performed with 20 Nursing professionals. For the analysis of the results, the Collective Subject Discourse method was used. Results: collective thinking was grouped in 04 classes: The bureaucratic function associated with management and the manager-nursing team relations; Skills perceived by the nursing team for the work of the Nursing manager; Challenges in the nursing manager's role perceived by the nursing team; The influence of the nursing manager on the quality and the assistance provided to the client. Conclusion: the activity of the nursing manager is extremely bureaucratic, and seen by the Nursing team as hierarchical, contributing to distance the manager from the conviviality with the team. Descriptors: Nursing; Nursing team; Hospital administration

Objetivo: analizar la percepción del equipo de enfermería sobre el papel de gestor de enfermería en el hospital, y cómo esto afecta a la calidad de la atención prestada por el personal. Métodos: estudio descriptivo y exploratorio de abordaje cualitativo, realizado con 20 profesionales de enfermería. Para el análisis de los datos, se utilizó el método del Discurso del Sujeto Colectivo. Resultados: el pensamiento de grupo se agrupan en 04 clases: la función burocrática asociada con la administración y gestión de relaciones con el personal de enfermería; Habilidades percibidas por el equipo de enfermería para el trabajo del administrador de enfermería; Desafíos en la función del gestor de enfermería percibida por el personal de enfermería; La influencia del gerente de enfermería en la calidad y servicio prestado al cliente. Conclusión: la actividad del administrador de enfermería es muy burocrático y visto por el personal de enfermería como jerárquica, ayudando a distanciar al gestor de interacción con el personal. Descriptores: Enfermería; Grupo de enfermería; Administración hospitalaria

Is transcutaneous electrical muscle stimulation an alternative for preventing acquired muscle weakness in the pediatric intensive care unit? A scoping review.

BACKGROUND: Transcutaneous electrical muscle stimulation (TEMS) has been progressively used as add-on therapy to reduce muscle atrophy in adults unable to carry out active mobilization in the intensive care unit (ICU). There are no studies addressing TEMS in the pediatric ICU. Therefore, we decided to develop a scoping review, a type of knowledge synthesis, which unlike systematic review, identify gaps in the literature to aid the planning and commissioning of future research. OBJECTIVE: To provide current perspectives on the application of TEMS for combating pediatric intensive care unit acquired weakness (PICUAW). METHODS: Online databases were used to identify papers published 2006-2016, from which we selected those used musculoskeletal and cardiorespiratory performance as a primary or secondary outcome variable in participants under 18 years. RESULTS: The publications reported six clinical trials from 218 outpatients with 9.5 ± 8 years old. There were differences in current modulation and duration of TEMS sessions, with a predominance of high intensity and short duration in which a muscle contraction is triggered. The main use of TEMS was in pediatric neurological disorders. TEMS was more effective when compared with SHAM on spasticity, bone mineral density, disability, and gait. One study regarding spine injury showed improvement in VO2 (P = 0.035) when combined cycling with TEMS. CONCLUSION: TEMS was an effective and safe treatment for musculoskeletal impairments and cardiorespiratory performance in children with neurological disorders. Although the physiopathology is different in outpatients, an individualized protocol with TEMS might be promising for preventing PICUAW. Its effectiveness, however, deserves further investigation.

Entre grifos, esboços e rasuras: as representações sociais de psicólogo para estudantes de psicologia / Between underlines, drafts and erasures: social representations of the psychologist for psychology students / Entre grifos, esbozos y rastros: las representaciones sociales del psicólogo para estudiantes de psicología

Objetiva-se discutir os resultados de um estudo que enfocou as representações sociais de psicólogo para os estudantes de Psicologia da Universidade Federal de Alagoas/Unidade Educacional de Palmeira dos Índios. Com fundamento teórico-metodológico na Teoria das Representações Sociais, realizou-se uma pesquisa qualitativa, com a reunião de procedimentos metodológicos diversos: a análise documental, Técnica de Associação Livre de Palavras ­ TALP ­ e grupo focal. Devido ao recorte proposto, o presente trabalho discute os dados provenientes da TALP, da qual participaram 169 estudantes de Psicologia do referido curso e que foi realizada com a associação ao termo "psicólogo". Com a técnica de análise do conteúdo, chegou-se a cinco categorias, que compõem o campo semântico de psicólogo: perfil, função, trabalho, ciência e processo formativo. Os resultados sinalizam que o desenho do psicólogo aproxima-se do modelo tradicional de atuação, entretanto, tal desenho encontra-se em movimento, com a inserção de outros traços que apontam práticas que visam romper com tal modelo. Diante disso, para possibilitar a reconfiguração desse modelo, o processo formativo deve abrir espaço para o diálogo entre diferentes saberes, objetivando a reflexão sobre a Psicologia e suas práticas subjacentes.

This paper aims to discuss the results of a study focused on the social representations of the psychologist for psychology students at the Federal University of Alagoas / Palmeira dos Índios Educational Unit. Theoretically and methodologically based on the Theory of Social Representations, a qualitative research was conducted with the combination of several methodological procedures: document analysis, free evocation of words technique ­ FEWT - and focus group. The data from FEWT, attended by 169 Psychology students from Palmeira dos Índios, which was held with the evocation to the word "psycho- logist" is analyzed. With the content analysis technique, five categories were reached that cover the psychologist semantic field: profile, function, work, science and educational process. The results indicate that the psychologist drawing approaches the traditional model of work, however, such a design is in constantly changing with the inclusion of other traits that link practices intended to break away from such a model. Therefore, in order to enable the reconfiguration of this model, the educational process should open space for the dialogue between different knowledges, aiming to reflect on psychology and its underlying practices.

Se pretende discutir los resultados de un estudio que enfocó en las representaciones sociales del psicólogo para los estudiantes de Psicología de la Universidad Federal de Alagoas/Unidad educacional de Palmeira dos Indios. Con fundamento teórico-metodológico en la teoría de las representaciones sociales, fue realizada una investigación cualitativa, con la reunión de diversos procedimientos metodológicos: el análisis documental, técnica de asociación libre de palabras-TALP- y grupo focal. Debido al objetivo propuesto, el presente trabajo discute los datos provenientes de la TALP, en la cual participaron 169 estudiantes de psicología del curso referido y que fue realizada con la asociación al termino "psicólogo". Con la técnica de análisis de contenido, se establecieron cinco categorías, que componen el campo semántico de psicólogo: perfil, función, trabajo, ciencia y proceso formativo. Los resultados señalizaron que el diseño del psicólogo se aproxima al modelo tradicional de actuación, Entre grifos, esboços e rasuras 145 sin embargo, tal diseño se encuentra en movimiento, con la inserción de otros trazos que apuntan prácticas que visan quebrar con tal modelo. Frente a eso, para posibilitar la reconfiguración dese modelo, el proceso formativo debe abrir espacio para el diálogo entre diferentes saberes, objetivando la reflexión sobre la psicología y sus prácticas subyacentes.

ARPP-16 Is a Striatal-Enriched Inhibitor of Protein Phosphatase 2A Regulated by Microtubule-Associated Serine/Threonine Kinase 3 (Mast 3 Kinase).

ARPP-16 (cAMP-regulated phospho-protein of molecular weight 16 kDa) is one of several small acid-soluble proteins highly expressed in medium spiny neurons of striatum that are phosphorylated in response to dopamine acting via D1 receptor/protein kinase A (PKA) signaling. We show here that ARPP-16 is also phosphorylated in vitro and in vivo by microtubule-associated serine/threonine kinase 3 (MAST3 kinase), an enzyme of previously unknown function that is enriched in striatum. We find that ARPP-16 interacts directly with the scaffolding A subunit of the serine/threonine protein phosphatase, PP2A, and that phosphorylation of ARPP-16 at Ser46 by MAST3 kinase converts the protein into a selective inhibitor of B55α- and B56δ-containing heterotrimeric forms of PP2A. Ser46 of ARPP-16 is phosphorylated to a high basal stoichiometry in striatum, suggestive of basal inhibition of PP2A in striatal neurons. In support of this hypothesis, conditional knock-out of ARPP-16 in CaMKIIα::cre/floxed ARPP-16/19 mice results in dephosphorylation of a subset of PP2A substrates including phospho-Thr75-DARPP-32, phospho-T308-Akt, and phospho-T202/Y204-ERK. Conditional knock-out of ARPP-16/19 is associated with increased motivation measured on a progressive ratio schedule of food reinforcement, yet an attenuated locomotor response to acute cocaine. Our previous studies have shown that ARPP-16 is phosphorylated at Ser88 by PKA. Activation of PKA in striatal slices leads to phosphorylation of Ser88, and this is accompanied by marked dephosphorylation of Ser46. Together, these studies suggest that phospho-Ser46-ARPP-16 acts to basally control PP2A in striatal medium spiny neurons but that dopamine acting via PKA inactivates ARPP-16 leading to selective potentiation of PP2A signaling.SIGNIFICANCE STATEMENT We describe a novel mechanism of signal transduction enriched in medium spiny neurons of striatum that likely mediates effects of the neurotransmitter dopamine acting on these cells. We find that the protein ARPP-16, which is highly expressed in striatal medium spiny neurons, acts as a selective inhibitor of certain forms of the serine/threonine protein phosphatase, PP2A, when phosphorylated by the kinase, MAST3. Under basal conditions, ARPP-16 is phosphorylated by MAST3 to a very high stoichiometry. However, the actions of MAST3 are antagonized by dopamine and cAMP-regulated signaling leading to disinhibition of ARPP-16 and increased PP2A action.

Pesquisa com grupo focal: contribuições ao estudo das representações sociais / Investigación con grupo focal: contribuciones al estudio de las representaciones sociales / Research with focal group: contributions to the study on social representation

RESUMO Este artigo é uma reflexão teórica, que objetiva discutir sobre o grupo focal enquanto aporte metodológico válido para pesquisas com a Teoria das Representações Sociais - TRS. Tem como argumento central a afirmação de que o grupo focal é uma técnica de produção de dados profícua em estudos que enfoquem o contexto grupal e os movimentos de constituição das representações sociais, uma vez que pode evidenciar tal processo e sua sociogênese. Para tanto, discute-se a TRS, enfatizando seu caráter psicossocial e sua base sociogenética e, em seguida, aborda-se a estratégia do grupo focal em pesquisas com a TRS. Conclui-se que o cenário de comunicações e interações proporcionado pelo grupo focal cria oportunidades de acesso às representações sociais e aos elementos e processos grupais que as constituem, favorecendo em especial investigações sobre suas características sociogenéticas.

RESUMEN Este artículo es una reflexión teórica, que tiene como objetivo discutir el grupo focal como un método válido para investigaciones sobre la Teoría de las Representaciones Sociales - TRS. Su argumento central es la afirmación de que el grupo focal es una técnica de producción de datos fecunda en los estudios que se centran en el contexto del grupo y en el movimiento de constitución de las representaciones sociales, ya que demuestra este proceso y su socio génesis. Con tal objeto, se discute la TRS, su carácter psicosocial y su base socio genética y, después, se aborda la estrategia del grupo focal en la investigación con la TRS. Nuestras conclusiones describen que el escenario de las comunicaciones e interacciones proporcionadas por el grupo focal crea oportunidades de acceso a las representaciones y a los elementos y procesos grupales que las constituyen, favoreciendo particularmente las investigaciones sobre su característica socio genética.

ABSTRACT This paper is a theoretical reflection, which aims to discuss the focus group as a valid methodological approach to research on the Theory of Social Representations - TSR. Its central argument is that the focus group is a profitable technique of data producing in studies that observe the group context and the movements of the constitution of social representations, because it can evidence this process and its socio genesis. For this purpose, we discuss the TRS, emphasizing its psychosocial character and its socio genetic basis and then, we discuss the strategy of the focus group in researches with TSR. We conclude that the scenario of communications and interactions provided by the focus group creates opportunities for access to social representations and to its elements and group processes that constitute them, which favors researches about their socio genetic characteristics, in particular.

Perspectiva dos discentes de enfermagem sobre o estágio curricular / Perspective of nursing students on curricular training

Objetivo: Caracterizar o estágio curricular desenvolvido no Curso de Enfermagem de uma instituição pública de ensino. Metodologia: Estudo exploratório descritivo, cuja população constituiu-se de 61 alunos do curso de enfermagem do 8º e 9º período matriculados no estágio curricular. A amostra foi de 44 alunos que concordaram em responder um formulário com questões abertas e fechadas. Os resultados foram digitados no Excel versão 2010 e organizados em tabelas e gráficos. Resultados: A maioria dos alunos era do sexo feminino, com faixa etária entre 21 a 26 anos. A realização do estágio foi predominantemente, em instituições hospitalares.Ao serem questionados sobre a infraestrutura física das instituições em que estagiaram os alunos referiram (43,2%) como adequadas e (43,2%) parcialmente adequadas. As relações interpessoais entre alunos, professores, equipe de saúde e pacientes foram relatadas como adequadas. Em relação à segurança no desenvolvimento das práticas no estágio (55%)dos alunos relataram que desenvolveram as práticas com segurança, (43%) com segurança parcial e (2%) com insegurança. A maioria referiu que no estágio os conteúdos teóricos ministrados foram parcialmente aplicados. Conclusão: O estágio curricular apresentou aspectos que favorecem a aprendizagem dos alunos, todavia verificou-se uma centralidade do hospital como campo de prática do estágio.

Objective: To characterize the curricular training in the Nursing Course of a public educational institution. Methods: descriptive exploratory study, whose the population was of 61 students who attended the 8th and 9th period and were enrolled in the curricular training. The sample consisted of 44 students, whoagreed in answer a form with open and closed questions. Data were typed in Excel version 2010 and organizedin tables and graphs. Results: Majority of students were females, with age between 21 and 26 years. The traineeship was conducted predominantly in hospitals. When asked about the physical infrastructure of the institutions in which they performed the stage (43.18%) reported that they were appropriate and (43.18%)reported partially adequate. Interpersonal relationships between students, teachers, health staff and patients were considered adequate. Regarding the safety of students in the development of practical activities onstage (55%) reported that developed the practices with safety, (43%) with partial security, and (2%) within security. The majority reported that taught theoretical contents were partially applied onstage. Conclusion: The curricular training presented aspects that promote student learning, however there was a centrality of the hospital as a field of practice of curricular training.

O discurso de John Dewey sobre natureza humana e conduta: contribuições à psicologia e à educação / John Dewey's speech about human nature and conduct: contributions to psychology and education

O ponto de partida da presente pesquisa foi a constatação de que o tema natureza humana constitui uma das bases fundamentais do pensamento do filósofo e educador John Dewey (EUA, 18591952), abrangendo suas elaborações no campo estrito da filosofia, bem como nos terrenos da psicologia, da política e da educação. Para o autor, é imprescindível dar tratamento científico à noção de natureza humana, mediante uma perspectiva que considere o homem um ser coletivo. Nessa formulação, surge como problema a necessidade de uma ciência social formada por saberes diretamente voltados ao entendimento da experiência humana no âmbito da cultura; destaca-se também a relevância das investigações desenvolvidas na área da psicologia, uma vez que tal ciência, para Dewey, é essencial para o pensar filosófico, pois se ocupa das manifestações particulares que permitem compreender o homem em sua totalidade. A pesquisa realizada teve por objetivo compreender a noção deweyana de natureza humana, analisando, para isso, a obra Human nature and conduct: an introduction to Social Psychology, de 1922. A metodologia de análise deste trabalho seguiu os estudos desenvolvidos pelo Grupo de Pesquisa Retórica e Argumentação na Pedagogia, que focaliza as teorias da argumentação elaboradas por autores como Perelman e Toulmin. Tal método qualitativo de análise permitiu o exame do discurso de Dewey sobre a natureza humana e a conduta, possibilitando, conseqüentemente, reflexões sobre as manifestações do filósofo acerca do psiquismo, do trabalho inteligente da mente e da comunicação associada como meio de formar e educar o homem. Vimos que o discurso deweyano identifica-se com a filosofia prática, pois se destina a elaborar propostas de ação, culminando com a proposição de uma ciência para estudar e transformar o homem. Os resultados da pesquisa realizada permitiram, também, obter uma compreensão das interlocuções de John Dewey com a comunidade de...(AU)

The starting point of the present research was the verification that the theme 'human nature' constitutes one of the fundamental bases of the thought of the philosopher and educator John Dewey (USA, 1859-1952), including his elaborations in the strict field of philosophy, as well as in the lands of psychology, politics and education. To the author it is indispensable to give a scientific treatment to the notion of human nature, through a perspective that considers the man a collective being. In this formulation, it appears as a problem the need of a social science formed by knowings directly inclined to the understanding of human experience in cultures extent; it also stands out the relevance of the investigations developed in psychological area, once for Dewey, psychology as a science is essential for the philosophical thinking because it studies those private manifestations that allow us to understand the man in his totality. The accomplished research aimed to understand the Deweyan notion of human nature analyzing, for that, the book Human nature and conduct: an introduction Social to Psychology, 1922. The methodology of analysis of this work followed the studies developed in the Research Group 'Rhetoric and Argumentation in Pedagogy', which focuses its attention to the argumentations theories elaborated by authors as Perelman and Toulmin. Such a qualitative method of analysis allowed us to exam Deweys speech about human nature and conduct, making possible, consequently, reflections about his manifestations concerning the psyche, the intelligent work of the mind and associated communication as a way to form and educate the man. We saw that deweyan speech identifies itself with practical philosophy, as it is destined to elaborate proposals of action culminating with the proposition of a science to study and transform the man. The results of the accomplished research also allowed us to obtain an...(AU)

Práticas avaliativas no ensino fundamental e cultura escolar / Practicas de evaluación en la enseñanza y cultura escolar / Assessment practices in elementary education and school culture

A Lei de Diretrizes e Bases da Educação Nacional 9394/96, ao propor a organização do ensino em ciclos e o regime de progressão continuada, introduz importantes modificações na organização escolar e nas práticas de avaliação adotadas nas escolas brasileiras. Nessa perspectiva, os objetivos desta pesquisa foram: investigar as práticas avaliativas que configuram a cultura e o ethos escolares e como esses valores fundamentam e orientam o trabalho pedagógico. Considerando os objetivos propostos, foi adotado referencial teórico-metodológico da pesquisa qualitativa. O estudo foi realizado em três escolas de ensino fundamental da rede estadual paulista junto a professores, equipe pedagógica e direção. Os resultados permitem concluir que há predominância de práticas fundadas no sistema de ensino seriado. Foram observados valores associados à função seletiva da escola e movimentos de resistência e ajustamento às novas medidas, como: remanejamentos informais de alunos, precariedade na formalização das avaliações.(AU)

La LDB 9.394/96, Lei de Diretrizes e Bases da Educação Nacional (Ley de Directrices y Bases de la Educación Nacional), al proponer la organización de la enseñanza en ciclos y el régimen de progresión continua, introduce importantes cambios en la organización escolar y en las prácticas de evaluación adoptadas por escuelas brasileñas. En ese contexto, los objetivos de la investigación fueron investigar las prácticas de evaluación que configuran la cultura y el ethos escolares y como esos valores fundamentan y orientan el trabajo pedagógico. De acuerdo con los objetivos propuestos, se ha adoptado el referencial teórico-metodológico de la pesquisa cualitativa. El estudio se ha realizado en tres escuelas de enseñanza fundamental del estado de São Paulo con profesores, personal de coordinación pedagógica y dirección. Los resultados permiten concluir que hay predominancia de prácticas fundadas en el sistema de enseñanza serial. Se han observado valores asociados a la función selectiva de la escuela y movimientos de resistencia y de acomodación a las nuevas medidas, como: reacomodaciones informales de alumnos y precariedad en la formalización de las evaluaciones.(AU)

The LDB 9.394/96, Lei de Diretrizes e Bases da Educação Nacional (Directives and Basis for the National Education), introduced important modifications in the organization and assessment practices adopted in Brazilian schools. In this context, the purpose of this study was to investigate the assessment practices that shape school culture and its ethos and also how these values give basis to and guide the pedagogical work. Considering the aims proposed, the qualitative investigation was used as a methodological support. The study was conducted in three state public elementary schools involving teachers, pedagogical coordinators and direction. The results indicate that there is a predominance of practices grounded on a sequencial system instead of a progressive one. Values associated to a selective school function and movements of resistance and of adjustment to the new purposes were noticed as follows: informal handling of student class transfers, precarious ordination of the assessments and the establishment.(AU)

Práticas avaliativas no ensino fundamental e cultura escolar / Practicas de evaluación en la enseñanza y cultura escolar / Assessment practices in elementary education and school culture

A Lei de Diretrizes e Bases da Educação Nacional 9394/96, ao propor a organização do ensino em ciclos e o regime de progressão continuada, introduz importantes modificações na organização escolar e nas práticas de avaliação adotadas nas escolas brasileiras. Nessa perspectiva, os objetivos desta pesquisa foram: investigar as práticas avaliativas que configuram a cultura e o ethos escolares e como esses valores fundamentam e orientam o trabalho pedagógico. Considerando os objetivos propostos, foi adotado referencial teórico-metodológico da pesquisa qualitativa. O estudo foi realizado em três escolas de ensino fundamental da rede estadual paulista junto a professores, equipe pedagógica e direção. Os resultados permitem concluir que há predominância de práticas fundadas no sistema de ensino seriado. Foram observados valores associados à função seletiva da escola e movimentos de resistência e ajustamento às novas medidas, como: remanejamentos informais de alunos, precariedade na formalização das avaliações.

The LDB 9.394/96, Lei de Diretrizes e Bases da Educação Nacional (Directives and Basis for the National Education), introduced important modifications in the organization and assessment practices adopted in Brazilian schools. In this context, the purpose of this study was to investigate the assessment practices that shape school culture and its ethos and also how these values give basis to and guide the pedagogical work. Considering the aims proposed, the qualitative investigation was used as a methodological support. The study was conducted in three state public elementary schools involving teachers, pedagogical coordinators and direction. The results indicate that there is a predominance of practices grounded on a sequencial system instead of a progressive one. Values associated to a selective school function and movements of resistance and of adjustment to the new purposes were noticed as follows: informal handling of student class transfers, precarious ordination of the assessments and the establishment.

La LDB 9.394/96, Lei de Diretrizes e Bases da Educação Nacional (Ley de Directrices y Bases de la Educación Nacional), al proponer la organización de la enseñanza en ciclos y el régimen de progresión continua, introduce importantes cambios en la organización escolar y en las prácticas de evaluación adoptadas por escuelas brasileñas. En ese contexto, los objetivos de la investigación fueron investigar las prácticas de evaluación que configuran la cultura y el ethos escolares y como esos valores fundamentan y orientan el trabajo pedagógico. De acuerdo con los objetivos propuestos, se ha adoptado el referencial teórico-metodológico de la pesquisa cualitativa. El estudio se ha realizado en tres escuelas de enseñanza fundamental del estado de São Paulo con profesores, personal de coordinación pedagógica y dirección. Los resultados permiten concluir que hay predominancia de prácticas fundadas en el sistema de enseñanza serial. Se han observado valores asociados a la función selectiva de la escuela y movimientos de resistencia y de acomodación a las nuevas medidas, como: reacomodaciones informales de alumnos y precariedad en la formalización de las evaluaciones.

Recent advances in neuroproteomics.

The last few years have seen a rapid growth in the use of proteomic methods to study normal brain function. In addition, such methods have been used to analyze changes in protein expression associated with the onset and progression of neuronal disease. The field of neuroproteomics faces special challenges given the complex cellular and sub-cellular architecture of the central nervous system. This article presents a review of recent progress in studies of neuroproteomics, and highlights the strengths and limitations of current proteomic profiling technologies used in studies of neuronal protein expression.