Functioning in victims of non-fatal traffic accident / Funcionalidade em vítimas não fatais de acidente de trânsito

Abstract Introduction Traffic accidents are a problem for the health system and society, evidenced by the high rates of deaths, hospitalizations and care in health services due to serious injuries and disabilities, affecting the functioning and quality of life of individuals. Objective To identify outcome measures in studies on victims of non-fatal traffic accidents, to fulfill the first step in the development of a Core Set of the International Classification of Functioning, Disability and Health (ICF) for victims of non-fatal traffic accidents. Methods A systematic review of published articles was carried out in the electronic databases PubMed/MEDLINE and SciELO, between 2011 and 2022, using terms in English. The search strategy combined terms about the consequences of traffic accidents in adults. The selection of articles was carried out by two independent reviewers, applying the eligibility criteria. Results A total of 626 studies were located in the databases, and 91 articles were included in the review. The consequences observed in the studies were injuries, fractures and trauma. When extracting outcome measures, 780 concepts were identified, linked to a total of 124 ICF categories, in the components: body function (30 categories); body structure (72 categories); activity and participation (20 categories); and environmental factors (two categories). Conclusion This systematic review revealed that the main consequences of non-fatal traffic accidents for victims are in the body structures related to the movement, mobility and stability of joints.

Resumo Introdução Os acidentes de trânsito são um problema para o sistema de saúde e para a sociedade, evidenciado pelas altas taxas de óbito, internações e atendimento nos serviços de saúde em função das lesões graves e incapacidades, repercutindo na funcionalidade e qualidade de vida dos indivíduos. Objetivo Identificar medidas de desfecho nos estudos sobre vítimas não fatais de acidentes de trânsito, para cumprir a primeira das etapas no desenvolvimento de um core set da Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF) para vítimas não fatais de acidentes de trânsito. Métodos Trata-se de uma revisão sistemática cuja busca foi feita nas bases de dados PubMed/MEDLINE e SciELO, entre 2011 e 2022, utilizando termos em inglês. A estratégia de busca combinou termos sobre as consequências dos acidentes de trânsito em adultos. A seleção dos artigos deu-se por dois revisores independentes, aplicando os critérios de elegibilidade. Resultados Foram localizados 626 estudos nas bases de dados e incluídos, na revisão, 91 artigos. As consequências observadas nos estudos foram lesões, fraturas e traumas. Na extração das medidas de desfecho, 780 conceitos foram identificados, vinculados a um total de 124 categorias da CIF nos componentes: função do corpo (30 categorias); estrutura do corpo (72 categorias); atividade e participação (20 categorias); e fatores ambientais (duas categorias). Conclusão Esta revisão sistemática revelou que as principais consequências dos acidentes de trânsito para as vítimas não fatais estão nas estruturas do corpo relacionadas ao movimento e à mobilidade e estabilidade das articulações.

Precision medicine in Thoracic Oncology: understanding disparities to tackle inequities in access.

INTRODUCTION: Precision medicine is defined as personalized interventions fitted to patients' or tumors' characteristics. Patients diagnosed with different neoplasms have benefited from a personalized therapeutic approach in terms of response and survival. However, several challenges must be addressed for precision oncology to become a global reality. Access to genomic testing that allows biomarker identification is a main issue. AREAS COVERED: A nonsystematic literature review about inequities in access to molecular genetic testing, focusing on lung cancer as the prominent example, was performed by a group of expert clinical oncologists. EXPERT OPINION: Access to molecular tests and their matched treatments differ between regions of the world and even among diverse populations in the same country. Socioeconomic characteristics are often strongly correlated with this disparity. Furthermore, although the cost is a determinant factor for inequality, other issues have been recognized. Advances in the education of healthcare professionals, patient advocacy initiatives, building local laboratory workstreams, and promoting favorable regulatory environment are vital factors in promoting equal access.

Peri-operative multimodal monitoring: a real need or a luxury?

The present case of a patient with several co-morbidities undergoing complex vitrectomy under peribulbar block and sedation with Target Controlled Infusion (TCI of propofol and dexmedetomidine with EEG and Analgesia Nociception Index (ANI) monitoring illustrates the benefits of multimodal monitoring to differentiate the effect of hypnotic and antinociceptive drugs.It is highlighted the delta-alpha electroencephalographic pattern showing adequate sedation, the beta arousal pattern in the EEG concommitant to decrease in the ANI translating insufficient anti-nociception.

Barriers in precision medicine implementation among Advanced Nonsquamous Cell Lung Cancer-patients: A Real-World Evidence Scenario.

Background: Precision oncology has a prominent role in nonsquamous non-small cell lung cancer (nsNSCLC) treatment progress; however, its access in a real-world scenario might be limited. Objective: To investigate the time spent in nsNSCLC molecular profile evaluation and its influence on clinical decisions. Methods: nsNSCLC patients who underwent molecular testing in a private referral Brazilian center between November 2015 and February 2020 were identified. The interval from nsNSCLC diagnosis to the characterization of the molecular profile was determined. Other outcomes, focusing on the biomarker tissue journey, were also assessed. Results: In this cohort (n = 78), the median time between the advanced nsNSCLC diagnosis and biomarker characterization was 40.5 days (range, 29.5-68.5). The median interval between the diagnosis and the test request was longer than the interval between the request and the results (respectively 29.0 versus 12.0 days; p < 0.001). At the treatment initiation, 51% (36/71) of the patients who received any systemic therapy did not have their driver mutations panel results available. But on these, 42% (15/36) had a targetable alteration identified later on. Among patients harboring a targetable alteration, only 46% (n = 13/28) received a tyrosine kinase inhibitor (TKI) as first-line therapy. The median time to the TKI initiation was even longer than the median time to all treatment initiation (92.0 versus 40.0 days). Conclusions: Our data show a long median time from advanced nsNSCLC diagnosis and the availability of the biomarker testing in medical practice, which impacted the choice of a non-personalized therapy as the first-line.

Short report: Introduction of chikungunya virus ECSA genotype into the Brazilian Midwest and its dispersion through the Americas.

Since introduction into Brazil in 2014, chikungunya virus (CHIKV) has presented sustained transmission, although much is unknown about its circulation in the midwestern states. Here, we analyze 24 novel partial and near complete CHIKV genomes from Cuiaba, an urban metropolis located in the Brazilian midwestern state of Mato Grosso (MT). Nanopore technology was used for sequencing CHIKV complete genomes. Phylogenetic and epidemiological approaches were used to explore the recent spatio-temporal evolution and spread of the CHIKV-ECSA genotype in Midwest Brazil as well as in the Americas. Epidemiological data revealed a reduction in the number of reported cases over 2018-2020, likely as a consequence of a gradual accumulation of herd-immunity. Phylogeographic reconstructions revealed that at least two independent introductions of the ECSA lineage occurred in MT from a dispersion event originating in the northeastern region and suggest that the midwestern Brazilian region appears to have acted as a source of virus transmission towards Paraguay, a bordering South American country. Our results show a complex dynamic of transmission between epidemic seasons and suggest a possible role of Brazil as a source for international dispersion of the CHIKV-ECSA genotype to other countries in the Americas.

Successful treatment with alectinib after crizotinib-induced hepatitis in ALK-rearranged advanced lung cancer patient: a case report.

BACKGROUND: Besides the clinical benefit of crizotinib in ALK-rearranged metastatic non-small cell lung cancer (NSCLC), concerns about its hepatotoxicity have arisen. It is not clear whether this is a drug class side effect or if the use of other selective ALKs inhibitors is safe after this serious adverse event. While evidence from clinical trials is scarce, reports of treatment after crizotinib-induces hepatitis may add to clinical decision. CASE PRESENTATION: Herein, we report a case of acute hepatitis induced by crizotinib in a 32-years-old female diagnosed with metastatic NSCLC, harboring the ALK-rearrangement. After 60 days of crizotinib therapy, the patient presented with acute hepatitis, diagnosed after investigation of non-specific symptoms, such as nausea and fatigue. Serum aspartate aminotransferase and alanine aminotransferase levels had increased from baseline to 3010 IU/L and 9145 IU/L, respectively. Total bilirubin increased up to 7.91 mg/dL, but she did not develop liver failure. After crizotinib discontinuation, a gradual hepatic function recovery occurred. Unfortunately, during the period without specific oncology treatment, her disease showed an unequivocal progression. Therefore, she started on alectinib with great response, and no liver function alteration recurred. CONCLUSIONS: This case suggests that alectinib, even belonging to the same drug class, could be used as an alternative agent when crizotinib is the etiology of liver damage, but more robust evidence has awaited.

Burden of Tuberculosis Hospitalizations in Portugal From 2000 to 2015 / Hospitalizaciones por tuberculosis en Portugal entre 2000 y 2015

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Behavior and illusions: a model to study superstition in a participant replacement experiment.

The notion of superstitious behavior can provide a basic background for understanding such notions as illusions and beliefs. The present study investigated the social mechanism of the transmission of superstitious behavior in an experiment that utilized participant replacement. The sample was composed of a total of 38 participants. Participants performed a task on a computer: they could click a colored rectangle using the mouse. When the rectangle was in a particular color, the participants received points independently of their behavior (variable time schedule). When the color of the rectangle was changed, no points were presented (extinction). Under an Individual Exposure condition, ten participants worked alone on the task. Other participants were exposed to the same experimental task under a Social Exposure condition, in which each participant first learned by observation and then worked on the task in a participant replacement (chain) procedure. The first participant in each chain in the Social Exposure condition was a confederate who worked on the task "superstitiously," clicking the rectangle when points were presented. Superstitious responding was transmitted because of the behavior of the confederate. This also influenced estimates of personal control. These findings suggest that social learning can facilitate the acquisition and maintenance of superstitious behavior and the illusion of control. Our data also suggest that superstitious behavior and the illusion of control may involve similar learning principles.

Behavior and illusions: a model to study superstition in a participant replacement experiment

Abstract The notion of superstitious behavior can provide a basic background for understanding such notions as illusions and beliefs. The present study investigated the social mechanism of the transmission of superstitious behavior in an experiment that utilized participant replacement. The sample was composed of a total of 38 participants. Participants performed a task on a computer: they could click a colored rectangle using the mouse. When the rectangle was in a particular color, the participants received points independently of their behavior (variable time schedule). When the color of the rectangle was changed, no points were presented (extinction). Under an Individual Exposure condition, ten participants worked alone on the task. Other participants were exposed to the same experimental task under a Social Exposure condition, in which each participant first learned by observation and then worked on the task in a participant replacement (chain) procedure. The first participant in each chain in the Social Exposure condition was a confederate who worked on the task "superstitiously," clicking the rectangle when points were presented. Superstitious responding was transmitted because of the behavior of the confederate. This also influenced estimates of personal control. These findings suggest that social learning can facilitate the acquisition and maintenance of superstitious behavior and the illusion of control. Our data also suggest that superstitious behavior and the illusion of control may involve similar learning principles.

Efeitos do comportamento do outro sobre desempenho em esquema múltiplo VT EXT em um procedimento de transmissão cultural / Effects of other person's behavior on performance in multiple schedule VT EX in a an cultural transmission design

Responder mantido por relação acidental com reforço, comportamento supersticioso, pode ser facilitado por variáveis sociais como a modelação. O presente estudo investigou o comportamento supersticioso em um procedimento com ou sem substituição de participantes. No procedimento com substituição, um participante trabalhava em uma tarefa no computador enquanto outro o observava. Quando terminava a tarefa, o participante observador passava a realizar a tarefa e outro participante era chamado para observá-lo. A tarefa básica envolveu a programação de um esquema múltiplo com componentes de VT e EXT. Os participantes podiam emitir respostas, por meio da manipulação de um mouse, em um retângulo colorido apresentado na tela do computador. Dois grupos de oito participantes foram constituídos para avaliar a transmissão do padrão desenvolvido em VT EXT, designados Cultura A e Cultura B. Cada uma dessas duas culturas começava com um experimentador confederado, que respondia no componente VT e não respondia no componente EXT. As cores do retângulo que sinalizavam os componentes VT e EXT eram alteradas a cada troca de participante, de modo a favorecer o responder em ambas as contingências a cada vez que o novo participante era colocado na tarefa. Em um Grupo de Exposição Individual, cada participante foi exposto a três sessões experimentais seguidas, sem acesso a modelo. Ao final de cada sessão, os participantes eram solicitados a estimar o controle que tinham sobre a tarefa. Resultados mostraram que houve mais respostas em VT e em EXT para os participantes com o procedimento com troca de participantes do que para os do Grupo de Exposição Individual, indicando o efeito do comportamento do outro sobre o desempenho em esquema múltiplo.(AU)

Superstitious behavior as response maintained by accidental relation with reinforcement can be facilitated by social variables such as modelling. Present study examined superstitious behavior in a procedure involving participants replacement or not. In replacement procedure one of the participants worked on a task on the computer while the other watched. When finished the task, the participant who was observing passed to perform the task and another participant was asked to observe. Programmed task involved basically a multiple schedule with VT and EXT components. Participants could emit responses by mouse clicking in a colored rectangle presented on computer screen. Two groups of eight subjects called "Culture A" and "Culture B" were made to evaluate developed EXT VT transmission. Each of these two cultures began with an experimenter confederate, who answered VT component but not EXT component. Rectangles color signaled VT and EXT components were changed when participant changed in order to favor responding in both contingencies with each new participant. In Individual Exhibition Group, each participant was exposed to three consecutive experimental sessions with no access. At the end of each session, participants were asked to estimate the control they had over the task. Results showed there were more responses in VT and EXT on replacing participants procedure than Individual Exhibition Group, indicating other's behavior effect on multiple schedule performance

Alimentação fora do domicílio deuniversitários de alguns cursos da área dasaúde de uma instituição privada / Away-from-home food consumption of students from somecourses in the health area of a private university

Este estudo objetivou caracterizar a alimentação fora do domicílio de universitários da área da saúde de uma instituiçãoprivada de Goiânia-GO, Brasil. Trata-se de um estudo transversal e descritivo, com 101 universitários dos cursos deenfermagem, nutrição e fisioterapia de uma instituição de ensino superior do Estado de Goiás. Foram coletados dadossociodemográficos, hábitos de consumo de alimentos fora do domicílio e realizada análise descritiva dos dados. A maioriaera do sexo feminino (85,1%) e se encontrava na faixa etária de 18 a 21 anos (68,3%). Destes, 84,2% afirmaram quecostumam se alimentar fora de casa, 70,3% já adoeceram após ingerirem alimentos na rua e 63,4% relataram que suaaparência física influencia em suas escolhas alimentares. As refeições de maior consumo fora do domicílio foram: almoço(32,7%), lanche da tarde (24,8%) e colação (20,8%) e os alimentos mais consumidos foram: leite / derivados (43,2%),frutas (35,8%), doces (26,3%), salgados (25,3%) e biscoitos (20,0%). Os acadêmicos de nutrição procuram alimentos maissaudáveis para se alimentar fora do domicílio, enquanto que os de enfermagem e de fisioterapia apresentam um consumoelevado de alimentos reconhecidos como “não saudáveis”, sendo o almoço a refeição mais consumida e o restaurante aquilo o estabelecimento mais procurado.

This study aimed to characterize the food eaten away from home by students from the health area at a private universityin Goiania, Goiás. This was a cross-sectional and descriptive study with 101 nursing, nutrition and physiotherapy studentsin an undergraduate institution in the State of Goiás. Socio-demographic data and data about away-from-home food consumptionhabits were collected and a descriptive analysis was carried out. Most subjects were female (85.1%) and wereaged between 18 and 21 (68.3%). From these, 84.2% stated that they tended to eat outside their home, 70.3% had alreadygotten sick after eating street food and 63.4% reported that their physical appearance influenced their food choices. Themeals with a higher frequency of consumption outside home were: lunch (32.7%), afternoon snacks (24.8%) and lightmeals (20.8%) and the most consumed foods were: dairy products (43.2%), fruits (35.8%), sweets (26.3%), savory snacks(25.3%) and cookies (20.0%). Nutrition students look for healthy food to eat when away from home, while nursing andphysical therapy students had a high intake of recognized unhealthy food. Lunch is the meal with a higher frequency ofconsumption outside home and “by-the-kilo” restaurants were the most frequented type.

Religião e espiritualidade de idosos internados em uma enfermaria geriátrica / Religion and spirituality of elderly living in a geriatrics ward

Esta pesquisa avaliou a influência da religião e espiritualidade no enfrentamento da hospitalização em pacientes idosos. A amostra foi composta por 30 idosos hospitalizados numa enfermaria geriátrica. Os instrumentos utilizados foram um questionário sociodemográfico e a Escala de Religiosidade DUREL - Duke Religious Index. Religião e espiritualidade são recursos relevantes aos quais idosos recorrem no enfrentamento da hospitalização. Reconhecer o bem-estar que estes aspectos proporcionam aos idosos é prestar atendimento humanizado. Sugere-se o desenvolvimento de mais pesquisas e instrumentos de avaliação acerca do tema, bem como a inclusão de disciplinas que abordam religião e espiritualidade na formação dos profissionais de saúde, dada a importância que a população idosa atribui às suas crenças religiosas e espirituais em momentos de dificuldades.(AU)

This study evaluated the influence of religion and spirituality on the way in which elderly patients cope with their hospitalization. A total of 30 elderly living in a geriatrics ward participated in the study. The instruments used were: a socio-demographic questionnaire and the DUREL Religious Scale (Duke Religious Index). Results indicate that the elderly attach much importance to their spiritual and religious beliefs to cope with their hospitalization. Recognizing the well-being that these aspects provide for the elderly is to provide humanized care. In order to do that, the development of further research and evaluation tools on the theme is suggested, as well as the inclusion of disciplines of religion and spirituality in the training of health professionals.(AU)

Religião e espiritualidade de idosos internados em uma enfermaria geriátrica / Religion and spirituality of elderly living in a geriatrics ward

Esta pesquisa avaliou a influência da religião e espiritualidade no enfrentamento da hospitalização em pacientes idosos. A amostra foi composta por 30 idosos hospitalizados numa enfermaria geriátrica. Os instrumentos utilizados foram um questionário sociodemográfico e a Escala de Religiosidade DUREL - Duke Religious Index. Religião e espiritualidade são recursos relevantes aos quais idosos recorrem no enfrentamento da hospitalização. Reconhecer o bem-estar que estes aspectos proporcionam aos idosos é prestar atendimento humanizado. Sugere-se o desenvolvimento de mais pesquisas e instrumentos de avaliação acerca do tema, bem como a inclusão de disciplinas que abordam religião e espiritualidade na formação dos profissionais de saúde, dada a importância que a população idosa atribui às suas crenças religiosas e espirituais em momentos de dificuldades.

This study evaluated the influence of religion and spirituality on the way in which elderly patients cope with their hospitalization. A total of 30 elderly living in a geriatrics ward participated in the study. The instruments used were: a socio-demographic questionnaire and the DUREL Religious Scale (Duke Religious Index). Results indicate that the elderly attach much importance to their spiritual and religious beliefs to cope with their hospitalization. Recognizing the well-being that these aspects provide for the elderly is to provide humanized care. In order to do that, the development of further research and evaluation tools on the theme is suggested, as well as the inclusion of disciplines of religion and spirituality in the training of health professionals.

Adolescente: internauta ou astronauta? / Adolescents: are they internet users or astronauts?

Este trabalho trata de um tema bastante atual, que provoca inquietações e questionamentos em todos aqueles, profissionais ou leigos, pais ou educadores, que percebem as influências das novas formas de comunicação virtual sobre os jovens. Ao pesquisar na literatura psicanalítica referências teóricas que pudessem embasar esta reflexão, pouco encontramos de específico. No entanto, deparamo-nos com inquietações indênticas por parte de autores comtemporâneos que se dedicaram ao tema e ofereceram valiosas contribuições para a elaboração deste escrito. Assim, examinamos alguns aspectos psicodinâmicos da adolescência na atualidade e suas intersecções com as formas de comunicação virtual. O comportamento do adolescente frente às vicissitudes da vida pós-moderna e sau relação com a virtualidade são questões que o presente artigo se propõe a discutir