Guides or guidelines for interacting and playing with medical complex children: a qualitative documentary research.

OBJECTIVES: to identify content on play and interaction with children with special health care needs recommended in clinical guidelines; analyze play and interaction activities applicable to children with special health care needs and complex care requirements. METHOD: qualitative documentary research based on guides, protocols, or guidelines on playing and interacting with children with special and living with complex care. Search terms in English (guidelines, playing OR play, complex needs, OR chronic disease) and in Portuguese ( guia, brincar ou brincadeiras, condições crônicas ) on the first ten pages of_Google Search ® . Thematic analysis was applied to the information extracted from the documents. RESULTS: a total of nine documents with similar content were grouped into units of analysis, keeping only the interacting and playing activities applicable to children with special health care needs and living with complex care requirements, namely stimulation of potential, stimulation of adult-child interaction, and stimulation of the senses (touch, sight, and hearing), to be carried out by health professionals and family caregivers in the different care contexts. CONCLUSION: interaction and play are potential promoters of adult-child interaction, with application in the stimulating and life-delivering complex care for children.

Self-care deficits reported by school children with cystic fibrosis.

BACKGROUND: Self-care refers to the ability that an individual has or develops to regulate the functioning of the body. Health status and age are factors associated with dependency on, and the need for, someone else to take over self-care. In the present case, there was a self-care deficit. Cystic fibrosis is a chronic disease that occurs in one in 10,000 live births in Brazil, and the affected population in the country is predominantly pediatric (approximately 73%). Support from nursing teams is necessary to improve patients' skills until they can take full responsibility for their self-care. PURPOSE: This study aimed to identify self-care deficits based on reports from schoolchildren with cystic fibrosis. DESIGN AND METHOD: A qualitative study was conducted with eight Brazilian schoolchildren with cystic fibrosis, using an art-based technique during interviews. Minayo's thematic analysis was used for data analysis and interpretation. RESULTS: These results emerged from Orem's theory of self-care deficits and needs. A main theme labeled as universal self-care requisites was identified, and three subthemes were derived-maintenance of an adequate air supply; maintenance of a balance between activity and rest; and avoiding risks to life, bodily functions, and well-being. CONCLUSION: Schoolchildren living with cystic fibrosis have a negative attitude toward their disease, which makes it difficult for them to acquire the ability to care for themselves with greater autonomy. This leads to deficits in the self-care delivered by providers. IMPLICATIONS TO PRACTICE: It is necessary to recognize the deficits in self-care and the extent to which children living with cystic fibrosis depend on self-care providers. Families must be aware of these self-care deficits to develop holistic self-care abilities.

Antibacterial Activity of Epigallocatechin-3-gallate (EGCG) Loaded Lipid-chitosan Hybrid Nanoparticle against Planktonic Microorganisms.

Epigallocatechin-3-gallate (EGCG), a polyphenol derived from Green Tea, is one of the sources of natural bioactive compounds which are currently being developed as medicinal ingredients. Besides other biological activities, this natural compound exhibits anti-cariogenic effects. However, EGCG has low physical-chemical stability and poor bioavailability. Thus, the purpose of this study was to develop and characterize lipid-chitosan hybrid nanoparticle with EGCG and to evaluate its in vitro activity against cariogenic planktonic microorganisms. Lipid-chitosan hybrid nanoparticle (LCHNP-EGCG) were prepared by emulsion and sonication method in one step and characterized according to diameter, polydispersity index (PdI), zeta potential (ZP), encapsulation efficiency (EE), mucoadhesion capacity and morphology. Strains of Streptococcus mutans, Streptococcus sobrinus and Lactobacillus casei were treated with LCHNP- EGCG, and minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) were evaluated. LCHNP-EGCG exhibited a size of 217.3 ± 5.1 nm with a low polydispersity index (0.17) and positive zeta potential indicating the presence of chitosan on the lipid nanoparticle surface (+33.7 mV). The LCHNP-EGCG showed a spherical morphology, high stability and a mucoadhesive property due to the presence of chitosan coating. In addition, the EGCG encapsulation efficiency was 96%. A reduction of almost 15-fold in the MIC and MBC against the strains was observed when EGCG was encapsulated in LCHNP, indicating the potential of EGCG encapsulation in lipid-polymer hybrid nanoparticles. Taking the results together, the LCHNP-EGCG could be an interesting system to use in dental care due to their nanometric size, mucoadhesive properties high antibacterial activity against relevant planktonic microorganisms.

Contribution of Wireless Wi-Fi Intraoral Cameras to the Assessment of Swallowing Safety and Efficiency.

BACKGROUND: Clinical evaluation of swallowing provides important clinical information but is limited in detecting penetration, aspiration, and pharyngeal residue in patients with suspected dysphagia. Although this is an old problem, there remains limited access to low-cost methods to evaluate swallowing safety and efficiency. PURPOSE: The purpose of this technical report is to describe the experience of a single center that recently began using a wireless Wi-Fi intraoral camera for transoral endoscopic procedures as an adjunct to clinical swallowing evaluation. We describe the theoretical structure of this new clinical evaluation proposal. We present descriptive findings on its diagnostic performance in relation to videofluoroscopic swallowing study as the gold standard in a cohort of seven patients with dysphagia following head and neck cancer. We provide quantitative data on intra- and interrater reliability. Furthermore, this report discusses how this technology can be applied in the clinical practice of professionals who treat patients with dysphagia and provides directions for future research. CONCLUSIONS: This preliminary retrospective study suggests that intraoral cameras can reveal the accumulated oropharyngeal secretions and postswallow pharyngolaryngeal residue in patients with suspected dysphagia. Future large-scale studies focusing on validating and exploring this contemporary low-cost technology as part of a clinical swallowing evaluation are warranted.

Acesso de familiares aos conhecimentos para cuidar em casa de criança com gastrostomia: Estudo qualitativo / Family caregivers' access to pediatric gastrostomy home care education: A qualitative study / Acceso de los cuidadores familiares a los conocimientos sobre cómo cuidar en casa a un niño con gastrostomía: Estudio cualitativo

Resumo Enquadramento: Conhecimento de familiares cuidadores sobre a gestãodo cuidado de crianças com gastrostomia no processo de cuidar. Objetivo: Analisar o acesso de familiares cuidadores a conhecimentos sobre como cuidar de crianças com gastrostomia em casa. Metodologia: Aplicado a dinâmica corpo-saber do método criativo sensível, com10 familiares de lactentes e pré-escolares, em internamento. Estudo realizado entre junho e dezembro de 2019, em um hospital público do Rio de Janeiro, Brasil. Utilizou-se a análise lexical, do software Iramuteq®. Resultados: Cuidadores acederam a duas fontes de conhecimentos na preparação para a alta do internamento. A primeira, treino com orientações e demonstração de procedimentos do campo da ciência de enfermagem. A segunda, observação livre dos cuidados prestados pelos profissionais de saúde. Houve cuidadores que não receberam instruções, demonstrando limitação na preparação para a alta. Conclusão: Viver com gastrostomia mobiliza a família para cuidados seguros, dependentes de conhecimentos de enfermagem. Os enfermeiros precisam atentar para às necessidades dos familiares, na continuidade do cuidar em casa.

Abstract Background: Family caregivers' information on caring for a child's gastrostomy at home. Objective: To analyze family caregivers' access to pediatric gastrostomy home care education. Methodology: This study used an arts-based creative research method (Dinâmica Corpo-Saber do Método Criativo Sensível) with ten family members of hospitalized infants and preschool-aged children. The study was conducted between June and December 2019 in a public hospital in Rio de Janeiro, Brazil. Lexical analysis was performed using the IRAMUTEQ® software. Results: Family caregivers had access to two sources of information to prepare for their children's hospital discharge. The first was the education received through nurses' guidance and demonstration of procedures. The second was the caregivers' observation of health professionals' care delivery to their children. Some family caregivers received no guidance, showing limitations in discharge preparation. Conclusion: Families of children fed via gastrotomy tube must be mobilized to deliver safe care based on nursing knowledge. Nurses must consider family members' needs regarding the continuity of care at home.

Resumen Marco contextual: Conocimiento de los cuidadores familiares sobre la gestión de los cuidados de los niños con gastrostomía en el proceso de asistencia. Objetivo: Analizar el acceso de los cuidadores familiares a los conocimientos sobre cómo cuidar a los niños con gastrostomía en casa. Metodología: Aplicada la dinámica cuerpo-conocimiento del método creativo sensible, con 10 familiares de lactantes y preescolares hospitalizados. Estudio realizado entre junio y diciembre de 2019 en un hospital público de Río de Janeiro, Brasil. Se utilizó el análisis léxico, del software Iramuteq®. Resultados: Los cuidadores accedieron a dos fuentes de conocimiento en la preparación del alta hospitalaria. La primera, la formación con directrices y demostración de procedimientos en el campo de la ciencia enfermera. La segunda, la observación libre de los cuidados prestados por los profesionales sanitarios. Hubo cuidadores que no recibieron instrucciones y mostraron limitaciones en la preparación para el alta. Conclusión: Vivir con una gastrostomía moviliza a la familia para conseguir unos cuidados seguros, basados en los conocimientos de enfermería. Los enfermeros deben prestar atención a las necesidades de los familiares dentro de la continuidad de los cuidados en el domicilio.

Development and validation of a video on first aid for choking incidents in the school environment.

OBJECTIVE: To develop and validate an educational video on first aid for choking incidents in children in the school environment. METHOD: Methodological study, conducted between 2021 and 2022, in six stages: search for themes through interviews with 13 teachers and staff members who work in early childhood education in Niterói; theoretical study; development of the video; validation with 17 expert judges; video adaptation and validation with 17 teachers and staff. The interviews were analyzed using the Iramuteq software and the validation through the concordance index, with a desirable value of 70%. RESULTS: The animated video, lasting 4 minutes and 10 seconds, addressed the identification and management of the child experiencing choking and was validated with a concordance index of 97% among the judges and 96% with target audience. CONCLUSION: The video is a validated technology that can be used to develop educational practices with professionals in the school environment.

Qualificação de profissionais da saúde para testagem rápida de Infecções Sexualmente Transmissíveis: experiência da Escola de Saúde Pública de Minas Gerais

Resumo: O objetivo do presente artigo é relatar experiência desenvolvida pela Escola de Saúde Pública do Estado de Minas Gerais, de qualificação de profissionais da Atenção Primária em Saúde para realização da testagem rápida de Infecções Sexualmente Transmissíveis, mais especificamente HIV/Aids; Sífilis e Hepatites Virais. Em atendimento a demanda apresentada pela Secretaria de Saúde do Estado de Minas Gerais, a Escola desenvolveu metodologia de formação para qualificar profissionais para a realização de todas as etapas da testagem rápida, incluindo treinamento prático e preparo para realização de Acolhimento e Aconselhamento pré, durante e pós teste. O curso foi ofertado de forma descentralizada, durante o período de junho de 2019 a março de 2020 em sete regionais de saúde do estado. Foram qualificados ao total 704 profissionais atuantes na Atenção Primária em Saúde em MG. A avaliação positiva do curso, na percepção dos profissionais qualificados evidencia o sucesso da iniciativa. Por sua vez, os dados recentes sobre a notificação desses agravos reforçam a necessidade de se continuar a investir na qualificação dos profissionais de forma a se avançar na implementação da testagem rápida no estado.

In-hospital and Post-discharge Status in COVID-19 Patients With Acute Respiratory Failure Supported With Extracorporeal Membrane Oxygenation.

Few data from Latin American centers on clinical outcomes in coronavirus disease 2019 (COVID-19) patients with acute respiratory distress syndrome who required extracorporeal membrane oxygenation (ECMO) are published. Moreover, clinical and functional status after hospital discharge remains poorly explored in these patients. We evaluated in-hospital outcomes of severe COVID-19 patients who received ECMO support in two Brazilian hospitals. In one-third of the survivors, post-acute COVID-19 syndrome (PACS), quality of life, anxiety, depression, and return to work were evaluated. Eighty-five patients were included and in-hospital mortality was 47%. Age >65 years (HR: 4.8; 95% confidence interval [CI]: 1.4-16.4), diabetes (HR: 6.0; 95% CI: 1.8-19.6), ECMO support duration (HR: 1.08; 95% CI: 1.05-1.12) and dialysis initiated after ECMO (HR: 3.4; 95% CI: 1.1-10.8) were independently associated with higher in-hospital mortality and mechanical ventilation (MV) duration before ECMO was not (HR: 1.18; 95% CI: 0.71-2.09). PACS-related symptoms were reported by two-thirds and half of patients at 30- and 90-days post-discharge, respectively. The median EQ-5D score was 0.85 (0.70-1.00) and 0.77 (0.66-1.00) at 30 and 90 days. Of the 15 responders, all previously working patients, except one, have returned to work at 90 days. In conclusion, in-hospital mortality in a large Latin American cohort was comparable to the Global extracorporeal life support organization registry.

The use of toys by nursing as a therapeutic resource in the care of hospitalized children.

OBJECTIVES: to describe the use of toys by nursing during the care of children in the inpatient unit; to analyze the factors that influence the use of therapeutic toys by nursing in the care of hospitalized children. METHODS: qualitative research, conducted in a pediatric hospital in Rio de Janeiro between July and August 2019. Semi-structured interview and thematic analysis were used as methodological procedure. RESULTS: the 12 nurses and 7 nursing technicians revealed minimizing fear, relieving tension, and creating a bond between the child and the professional as the main benefits; they use as resources: children's toys, hospital materials, cartoons, and children's videos. The high demand for work, deficit of human resources, and appropriate ludic materials are factors that interfere with the use of toys as a therapeutic resource. FINAL CONSIDERATIONS: although the participants recognize the importance of the toy as a therapeutic resource, there is no systematization of its use in pediatric practice.

Research and Diagnostic Algorithmic Rules (RADAR) for mood disorders, recurrence of illness, suicidal behaviours, and the patient's lifetime trajectory.

The top-down Diagnostic and Statistical Manual/International Statistical Classification of Diseases categories of mood disorders are inaccurate, and their dogmatic nature precludes both deductive (as indisputable) and inductive (as top-down) remodelling of case definitions. In trials, psychiatric rating scale scores employed as outcome variables are invalid and rely on folk psychology-like narratives. Using machine learning techniques, we developed a new precision nomothetic model of mood disorders with a recurrence of illness (ROI) index, a new endophenotype class, namely Major Dysmood Disorder (MDMD), characterised by increased ROI, a more severe phenome, and more disabilities. Nonetheless, our previous studies did not compute Research and Diagnostic Algorithmic Rules (RADAR) to diagnose MDMD and score ROI, lifetime (LT), and current suicidal behaviours, as well as the phenome of mood disorders. Here, we provide rules to compute bottom-up RADAR scores for MDMD, ROI, LT and current suicidal ideation and attempts, the phenome of mood disorders, and the lifetime trajectory of mood disorder patients from a family history of mood disorders and substance abuse to adverse childhood experiences, ROI, and the phenome. We also demonstrate how to plot the 12 major scores in a single RADAR graph, which displays all features in a two-dimensional plot. These graphs allow the characteristics of a patient to be displayed as an idiomatic fingerprint, allowing one to estimate the key traits and severity of the illness at a glance. Consequently, biomarker research into mood disorders should use our RADAR scores to examine pan-omics data, which should be used to enlarge our precision models and RADAR graph.

Development and validation of a video on first aid for choking incidents in the school environment / Elaboración y validación de vídeo sobre primeros auxilios en caso de atragantamiento en el ámbito escolar / Elaboração e validação de vídeo sobre primeiros socorros em situação de engasgo no ambiente escolar

ABSTRACT Objective: To develop and validate an educational video on first aid for choking incidents in children in the school environment. Method: Methodological study, conducted between 2021 and 2022, in six stages: search for themes through interviews with 13 teachers and staff members who work in early childhood education in Niterói; theoretical study; development of the video; validation with 17 expert judges; video adaptation and validation with 17 teachers and staff. The interviews were analyzed using the Iramuteq software and the validation through the concordance index, with a desirable value of 70%. Results: The animated video, lasting 4 minutes and 10 seconds, addressed the identification and management of the child experiencing choking and was validated with a concordance index of 97% among the judges and 96% with target audience. Conclusion: The video is a validated technology that can be used to develop educational practices with professionals in the school environment.

RESUMEN Objetivo: Desarrollar y validar un video educativo sobre primeros auxilios para niños en situaciones de atragantamiento en el ámbito escolar. Método: Estudio metodológico, realizado entre 2021 y 2022, en 6 etapas: búsqueda de temas en entrevistas con 13 profesores y empleados que trabajan en la educación infantil en Niterói; estudio teórico; desarrollo del vídeo; validación con 17 jueces expertos; adaptación y validación del vídeo con 17 profesores y empleados. Las entrevistas se analizaron con ayuda del programa informático Iramuteq y la validación mediante el índice de concordancia, valor deseable 70%. Resultados: El vídeo animado, de 4 minutos y 10 segundos de duración, abordaba la identificación y el manejo del niño en situación de atragantamiento y fue validado con índice de concordancia del 97% entre los jueces y del 96% con público objetivo. Conclusión: El vídeo es una tecnología validada que puede utilizarse para desarrollar prácticas educativas con profesionales en el ámbito escolar.

RESUMO Objetivo: Elaborar e validar um vídeo educativo sobre primeiros socorros à criança em situação de engasgo no ambiente escolar. Método: Estudo metodológico, realizado de 2021 a 2022, em seis etapas: busca de temas por meio de entrevistas com 13 professores e funcionários que atuam na educação infantil, em Niterói; estudo teórico; elaboração do vídeo; validação com 17 juízes especialistas; adequação do vídeo e validação com 17 professores e funcionários. As entrevistas foram analisadas com auxílio do software Iramuteq e a validação por meio do índice de concordância, valor desejável 70%. Resultados: O vídeo animado, com duração de 4 minutos e 10 segundos, abordou a identificação e manejo da criança em situação de engasgo e foi validado com índice de concordância de 97% entre os juízes e 99% com público-alvo. Conclusão: O vídeo elaborado é uma tecnologia validada que pode ser utilizada para desenvolver práticas educativas junto aos profissionais no ambiente escolar.

Therapeutic play toy for children with totally implanted central venous catheters: nurses' perception / Juguete terapéutico para niños con catéteres venosos centrales totalmente implantados: la percepción de los enfermeros / Brinquedo terapêutico para crianças com cateter venoso central totalmente implantado: percepção dos enfermeiros

ABSTRACT Objective: to describe nurses' perception about an Instructional Therapeutic Play toy for children with totally implanted central venous catheters. Method: a qualitative, descriptive and exploratory study carried out in a public hospital from Rio de Janeiro with 12 nurses who work in the care of children with totally implanted central venous catheters. The data were collected through semi-structured interviews from March to May 2019 and subjected to thematic analysis. Results: two thematic units that dealt with the necessary adaptations in the Therapeutic Play toy regarding materials, gender, race, age and catheter implantation site in the body emerged. Conclusion: it was possible to understand the aspects that permeate the Therapeutic Play toy scenario and the possibilities and limitations that interfere with its use in children's care. In this way, the adaptations enhance the Advanced Pediatric Nursing Practice, as playing is a children's need.

RESUMEN Objetivo: describir la percepción de los enfermeros sobre un juguete terapéutico instructivo para niños con catéteres venosos centrales totalmente implantados. Método: estudio cualitativo, descriptivo y exploratorio realizado en un hospital público de Rio de Janeiro con 12 enfermeros que trabajan en la asistencia provista a niños con catéteres venosos centrales totalmente implantados. Los datos se recolectaron por medio de entrevistas semiestructurada entre marzo y mayo de 2019 y fueron sometidos a análisis temático. Resultados: surgieron dos unidades temáticas que tratan sobre las adaptaciones necesarias en el juguete terapéutico en relación con los materiales, el sexo, la raza, la edad y el sitio en el que se implanta el catéter en el cuerpo. Conclusión: fue posible comprender los diversos aspectos intrínsecos al escenario de los juguetes terapéuticos y las posibilidades y limitaciones que interfieren en su utilización al atender a los niños. De esta manera, las adaptaciones potencian la práctica avanzada de Enfermería Pediátrica, ya que jugar es una necesidad inherente de los niños.

RESUMO Objetivo: descrever a percepção dos enfermeiros sobre um brinquedo terapêutico instrucional para crianças com cateter venoso central totalmente implantado. Método: estudo qualitativo, descritivo, exploratório, realizado em um hospital público do Rio de Janeiro com 12 enfermeiros que trabalham na assistência à criança em uso de cateter venoso central totalmente implantado. Os dados foram coletados por meio de uma entrevista semiestruturada, nos meses de março e maio de 2019, e submetidos à análise temática. Resultados: emergiram duas unidades temáticas que versaram sobre as adaptações necessárias no brinquedo terapêutico quanto aos materiais, gênero, raça, idade e o local de implantação do cateter no corpo. Conclusão: pôde-se compreender as vertentes que permeiam o cenário do brinquedo terapêutico e as possibilidades e limitações que interferem em sua utilização na assistência à criança. Dessa forma, as adaptações potencializam a prática avançada de enfermagem pediátrica, uma vez que o brincar é uma necessidade da criança.

Enfrentamento da pandemia de COVID-19 retratado nas Universidades Públicas Federais do Brasil / Enfrentamiento de la pandemia de COVID-19 reflejado en las universidades públicas nacionales de Brasil / Coping with the COVID-19 pandemic addressed in Brazilian federal public universities

Resumo Objetivo O presente estudo teve como objetivo identificar as medidas sanitárias adotadas pelas universidades públicas federais no contexto da pandemia da COVID-19. Métodos Trata-se de uma pesquisa quali-quantitativa, exploratória e descritiva feita por meio da análise documental dos protocolos, diretrizes, portarias e cartilhas confeccionadas no âmbito universitário federal do Brasil. Quanto aos critérios de inclusão foram o documento estar disponível no site de cada universidade federal no período da coleta e a livre consulta do acervo pela internet. O período de coleta foi de março de 2020 a novembro de 2021. Resultados Foram encontrados 51 documentos. As universidades do Nordeste e Sudeste foram responsáveis por 46,4% das publicações totais das universidades federais do Brasil. Conclusão Diante das medidas adotadas pelas Instituições Federais de Ensino Superior, foi perceptível a congruência em tentar estabelecer rotinas e procedimentos padronizados que fossem capazes de controlar e minimizar a disseminação da COVID-19 dentro da universidade.

Resumen Objetivo El presente estudio tuvo como objetivo identificar las medidas sanitarias adoptadas por las universidades públicas nacionales en el contexto de la pandemia de COVID-19. Métodos Se trata de un estudio cuali-cuantitativo, exploratorio y descriptivo, realizado mediante el análisis documental de los protocolos, directrices, resoluciones y cartillas confeccionadas en el contexto universitario nacional de Brasil. Los criterios de inclusión fueron la disponibilidad del documento en el sitio web de cada universidad nacional en el período de la recopilación y la libre consulta del acervo por internet. El período de recopilación fue de marzo de 2020 a noviembre de 2021. Resultados Se encontraron 51 documentos. Las universidades del nordeste y del sudeste fueron responsables por el 46,4 % de las publicaciones totales de las universidades nacionales de Brasil. Conclusión Ante las medidas adoptadas por las instituciones nacionales de educación superior, se percibió congruencia para intentar establecer rutinas y procedimientos estandarizados que fueran capaces de controlar y minimizar la diseminación de COVID-19 dentro de la universidad.

Abstract Objective The present study aimed to identify the health measures adopted by federal public universities in the context of the COVID-19 pandemic. Methods This is a qualitative-quantitative, exploratory and descriptive research carried out through documental analysis of protocols, guidelines, ordinances and booklets made in the federal university scope of Brazil. As for the inclusion criteria, documents must be available on the website of each federal university during the collection period and free consultation of the collection on the internet. The collection period was from March 2020 to November 2021. Results We found 51 documents. Northeastern and southeastern universities were responsible for 46.4% of the total publications of federal universities in Brazil. Conclusion Considering the measures adopted by Higher Education Federal Institutions, the congruence in trying to establish standardized routines and procedures that were able to manage and minimize the spread of COVID-19 within the university was noticeable.

The use of toys by nursing as a therapeutic resource in the care of hospitalized children / El uso del juguete por la enfermería como recurso terapéutico en la atención al niño hospitalizado / O uso do brinquedo pela enfermagem como recurso terapêutico na assistência à criança hospitalizada

ABSTRACT Objectives: to describe the use of toys by nursing during the care of children in the inpatient unit; to analyze the factors that influence the use of therapeutic toys by nursing in the care of hospitalized children. Methods: qualitative research, conducted in a pediatric hospital in Rio de Janeiro between July and August 2019. Semi-structured interview and thematic analysis were used as methodological procedure. Results: the 12 nurses and 7 nursing technicians revealed minimizing fear, relieving tension, and creating a bond between the child and the professional as the main benefits; they use as resources: children's toys, hospital materials, cartoons, and children's videos. The high demand for work, deficit of human resources, and appropriate ludic materials are factors that interfere with the use of toys as a therapeutic resource. Final Considerations: although the participants recognize the importance of the toy as a therapeutic resource, there is no systematization of its use in pediatric practice.

RESUMEN Objetivos: describir uso del juguete por la enfermería durante la atención al niño en unidad de internación; analizar los factores que influencian la utilización del juguete terapéutico por la enfermería en la atención al niño hospitalizado. Métodos: investigación cualitativa, realizada en un hospital pediátrico de Rio de Janeiro entre julio y agosto de 2019. Procedimiento metodológico fue la entrevista semiestructurada y análisis temático. Resultados: los 12 enfermeros y 7 técnicos de enfermería revelan como principales beneficios minimizar miedo, aliviar tensión y construir vínculo entre niño y profesional; utilizan como recursos: juguetes del niño, materiales hospitalarios, dibujos animados y videos infantiles. La alta demanda de trabajo y el déficit de recursos humanos y materiales lúdicos apropiados son factores que interferen en el uso del juguete como recurso terapéutico. Consideraciones Finales: aunque los participantes reconozcan la importancia del juguete mientras recurso terapéutico, no hay sistematización de su utilización en la práctica pediátrica.

RESUMO Objetivos: descrever o uso do brinquedo pela enfermagem durante a assistência à criança na unidade de internação; analisar os fatores que influenciam a utilização do brinquedo terapêutico pela enfermagem no cuidado da criança hospitalizada. Métodos: pesquisa qualitativa, realizada em um hospital pediátrico do Rio de Janeiro entre julho e agosto de 2019. O procedimento metodológico foi a entrevista semiestruturada e análise temática. Resultados: os 12 enfermeiros e 7 técnicos de enfermagem revelam como principais benefícios minimizar o medo, aliviar a tensão e criar vínculo entre criança e profissional e; utilizam como recursos: brinquedos da criança, materiais hospitalares, desenhos animados e vídeos infantis. A alta demanda de trabalho e o déficit de recursos humanos e materiais lúdicos apropriados são fatores que interferem no uso do brinquedo como recurso terapêutico. Considerações Finais: embora os participantes reconheçam a importância do brinquedo enquanto recurso terapêutico, não há sistematização de sua utilização na prática pediátrica.

The use of toys by nursing as a therapeutic resource in the care of hospitalized children / El uso del juguete por la enfermería como recurso terapéutico en la atención al niño hospitalizado / O uso do brinquedo pela enfermagem como recurso terapêutico na assistência à criança hospitalizada

ABSTRACT Objectives: to describe the use of toys by nursing during the care of children in the inpatient unit; to analyze the factors that influence the use of therapeutic toys by nursing in the care of hospitalized children. Methods: qualitative research, conducted in a pediatric hospital in Rio de Janeiro between July and August 2019. Semi-structured interview and thematic analysis were used as methodological procedure. Results: the 12 nurses and 7 nursing technicians revealed minimizing fear, relieving tension, and creating a bond between the child and the professional as the main benefits; they use as resources: children's toys, hospital materials, cartoons, and children's videos. The high demand for work, deficit of human resources, and appropriate ludic materials are factors that interfere with the use of toys as a therapeutic resource. Final Considerations: although the participants recognize the importance of the toy as a therapeutic resource, there is no systematization of its use in pediatric practice.

RESUMEN Objetivos: describir uso del juguete por la enfermería durante la atención al niño en unidad de internación; analizar los factores que influencian la utilización del juguete terapéutico por la enfermería en la atención al niño hospitalizado. Métodos: investigación cualitativa, realizada en un hospital pediátrico de Rio de Janeiro entre julio y agosto de 2019. Procedimiento metodológico fue la entrevista semiestructurada y análisis temático. Resultados: los 12 enfermeros y 7 técnicos de enfermería revelan como principales beneficios minimizar miedo, aliviar tensión y construir vínculo entre niño y profesional; utilizan como recursos: juguetes del niño, materiales hospitalarios, dibujos animados y videos infantiles. La alta demanda de trabajo y el déficit de recursos humanos y materiales lúdicos apropiados son factores que interferen en el uso del juguete como recurso terapéutico. Consideraciones Finales: aunque los participantes reconozcan la importancia del juguete mientras recurso terapéutico, no hay sistematización de su utilización en la práctica pediátrica.

RESUMO Objetivos: descrever o uso do brinquedo pela enfermagem durante a assistência à criança na unidade de internação; analisar os fatores que influenciam a utilização do brinquedo terapêutico pela enfermagem no cuidado da criança hospitalizada. Métodos: pesquisa qualitativa, realizada em um hospital pediátrico do Rio de Janeiro entre julho e agosto de 2019. O procedimento metodológico foi a entrevista semiestruturada e análise temática. Resultados: os 12 enfermeiros e 7 técnicos de enfermagem revelam como principais benefícios minimizar o medo, aliviar a tensão e criar vínculo entre criança e profissional e; utilizam como recursos: brinquedos da criança, materiais hospitalares, desenhos animados e vídeos infantis. A alta demanda de trabalho e o déficit de recursos humanos e materiais lúdicos apropriados são fatores que interferem no uso do brinquedo como recurso terapêutico. Considerações Finais: embora os participantes reconheçam a importância do brinquedo enquanto recurso terapêutico, não há sistematização de sua utilização na prática pediátrica.

Sobrecarga de Cuidadores Primários de Crianças com Cardiopatia Congênita / Burden of primary caregivers of children with congenital heart disease / Sobrecarga de los Cuidadores Primarios de niños con cardiopatías congénitas

Objetivo: identificar o nível de sobrecarga nos cuidadores primários de crianças com cardiopatia congênita. Método: estudo transversal descritivo de abordagem quantitativa. A coleta de dados foi realizada em ambiente virtual nos meses de junho de 2021 até fevereiro de 2022, após aprovação pelo Comitê de Ética em Pesquisa. Utilizou-se um formulário para caracterização da amostra e a escala Zarit Burden. Os dados foram analisados através do programa SPSS versão 24 utilizando a estatística descritiva e análise de variância de p≤0,05. Protocolo de pesquisa aprovado pelo Comitê de Ética em Pesquisa. Resultados: participaram 100 mães com média de idade entre 34,08 anos, a maioria casada (57%), residentes do estado de São Paulo (25%), com ensino médio completo (51%) Observou-se que 56,0% evidenciaram sobrecarga moderada. Conclusão: a sobrecarga é uma realidade em cuidadores primários de crianças com cardiopatias congênitas e o compartilhamento de cuidado e apoio familiar são identificados como fatores de proteção.

Objective: to identify the burden level on primary caregivers of children with congenital heart disease. Method: descriptive cross-sectional study with a quantitative approach. Data collection was carried out in a virtual environment from June 2021 to February 2022, after approval by the Research Ethics Committee. A form was used to characterize the sample and the Zarit Burden scale. Data were analyzed using the SPSS version 24 program using descriptive statistics and analysis of variance of p≤0.05. Research protocol approved by the Research Ethics Committee. Results: 100 mothers participated with a mean age of 34.08 years, most of them married (57%), residents of the state of São Paulo (25%), with complete secondary education (51%) It was observed that 56.0% showed moderate overload. Conclusion: burden is a reality in primary caregivers of children with congenital heart disease and sharing care and family support are identified as protective factors.

Objetivo: identificar el nivel de sobrecarga de los cuidadores principales de niños con cardiopatías congénitas. Método: estudio descriptivo transversal con enfoque cuantitativo. La recolección de datos se realizó en ambiente virtual de junio de 2021 a febrero de 2022, previa aprobación del Comité de Ética en Investigación. Se utilizó un formulario para caracterizar la muestra y la escala de Zarit. Los datos se analizaron con el programa SPSS versión 24 mediante estadística descriptiva y análisis de desviación de p≤0,05. El Comité de Ética en Investigación aprobó el Protocolo de investigación. Resultados: Participaron 100 madres con media de edad de 34,08 años, la mayoría casadas (57%), residentes en el estado de São Paulo (25%), con educación secundaria completa (51%). Se observó que el 56,0% mostró moderada sobrecarga. Conclusión: la sobrecarga es una realidad en los cuidadores primarios de niños con cardiopatías congénitas; el cuidado compartido y el apoyo familiar se identifican como factores de protección.

Promoção da saúde no âmbito do ensino superior / Health promotion within higher education

Resumo: O presente estudo buscou analisar a percepção dos gestores universitários acerca das ações de promoção da saúde desenvolvidas no âmbito de uma instituição pública de ensino superior da região Sul do Brasil. Trata-se de uma pesquisa qualitativa, do tipo descritiva e exploratória. A coleta de dados foi através de entrevistas individuais, que ocorreram no período de junho a agosto de 2022, e teve como participantes seis gestores que exercem funções de coordenações de cursos de graduação, serviços de saúde e gestores administrativos. O questionário utilizado nas entrevistas foi elaborado com base nos critérios de Boas Práticas em Saúde do American College Health Association, contemplando as seguintes dimensões: Integração com a missão do ensino superior; Prática de abordagem socioecológica; Colaboração; Prática inclusiva; Prática baseada na teoria; Prática informada por evidência; Desenvolvimento profissional contínuo; e Serviço para o campo. As falas foram tratadas com o apoio do software WebQDA, e analisadas pelo referencial de Análise de Conteúdo, assim os resultados foram organizados em três categorias: "perfil do gestor universitário e seus desafios"; "ensino superior no campo da saúde"; e "responsabilidade social e desafios da promoção da saúde como resultado da pandemia e suas implicações para as universidades". O perfil dos gestores aponta predominância feminina, fato que pode estar relacionado às mudanças evidentes no cenário de trabalho, antes dominado pelo sexo masculino, com ampliação do reconhecimento e valorização da mulher, assim como a enfermagem ser considerada uma das principais responsáveis pelo cuidado em saúde. Identifica-se que os gestores universitários compreendem os fatores social, cultural, de sustentabilidade e econômico como essenciais e correlacionados para que seja promovida a saúde da comunidade acadêmica, porém, em sua maioria, são relatadas fragilidades em instituir ações efetivas nestes eixos, enfatizando os cortes financeiros e contingenciamentos sofridos pela universidade. Os resultados do estudo apontam que a implementação de práticas de promoção da saúde no âmbito da Instituição Ensino Superior ainda se constitui um desafio para os pesquisadores e entusiastas da área. Todavia, apesar de a instituição de ensino pesquisada não pertencer à Rede de Universidades Promotoras da Saúde, foram notados o desenvolvimento e a busca por melhores condições e cuidados em saúde da comunidade acadêmica. Vale ressaltar que um ambiente saudável é um estímulo para que os sujeitos desenvolvam condutas positivas de saúde, tendo em vista que apenas mudanças físicas não constroem uma Universidade Promotora de Saúde, sendo necessárias políticas e estruturas curriculares, lideradas por gestores universitários comprometidos com o desenvolvimento de estilos de vidas saudáveis. Assim, refletir sobre a promoção da saúde no setor do ensino superior é uma forma de divulgar o conhecimento sobre esse conceito de saúde e as Políticas Públicas voltadas a ele.

Abstract: The present study sought to analyze the perception of university managers about the health promotion actions developed within a public institution of higher education in the South of Brazil. This is a qualitative, descriptive and exploratory research. The data collection was through individual interviews, which occurred in the period from June to August 2022, and had as participants six managers who exercise functions in undergraduate course coordinations, health services, and administrative managers. The questionnaire used in the interviews was based on the American College Health Association's Good Health Practice criteria, covering the following dimensions: integration with the mission of higher education; practice with a social-ecological approach; collaboration; inclusive practice; theory-based practice; evidence-informed practice; continuous professional development; and, service to the field. The speeches were processed with the support of WebQDA software and analyzed using Content Analysis, so the results were organized into three categories: "profile of the university manager and his challenges"; "higher education in the health field", and; "social responsibility, and challenges of health promotion as a result of the pandemic and its implications for universities". This fact may be related to the evident changes in the work scenario, previously dominated by men, with increased recognition and appreciation of women, as well as nursing being considered one of the main agents responsible for health care. It was identified that university managers understand the social, cultural, sustainability and economic factors as essential and correlated to promote the health of the academic community, however, most of them report that there are weaknesses in instituting effective actions in these axes, emphasizing the financial cuts and contingencies suffered by the university. The results of the study indicate that the implementation of health promotion practices in the scope of the Higher Education Institution still constitutes a challenge for researchers and enthusiasts in the area. However, despite the fact that the researched educational institution does not belong to the Health Promoting Universities Network, the development and search for better conditions and health care for the community that attends it was noticed. It is worth mentioning that a healthy environment is a stimulus for the subjects to develop positive health behaviors, however, only physical changes do not build a Health Promoting University, it is necessary curricular policies and structures, led by university managers committed to the development of healthy lifestyles. Thus, reflecting on health promotion in the sphere of higher education is a way to spread knowledge about this concept of health and the Public Policies aimed at it.

Karyotype variability in six Amazonian species of the family Curimatidae (Characiformes) revealed by repetitive sequence mapping.

Fishes of the Curimatidae family represent one of the most important freshwater ichthyofauna groups of Central and South America, with 117 recognized species distributed in eight genera. In this study, six species - Curimata inornata, Curimatella dorsalis, and Psectrogaster falcata collected from the Lower Araguaia River, Pará, Brazil; Curimata vittata, Curimatella meyeri, and Psectrogaster rutiloides collected from the Catalão Lake, Amazonas, Brazil - were cytogenetically analyzed, investigate the occurrence and distribution of repetitive DNA classes in the karyotypes. All species had 2n=54 metacentric/submetacentric chromosomes. Despite the conservative diploid number, we observed variations in the karyotypic structure among species. Ribosomal DNA (rDNA) 18S and 5S were found in single or multiple sites, with the first report of synteny in Curimatella dorsalis, and the occurrence of several interstitial telomeric sequences (ITSs) in species of the genera Curimatella and Psectrogaster. Interspecific karyotypic diversity both concerning structure and location/position of the nucleolar organizer regions (NOR) and ribosomal DNA, suggesting the occurrence of several non-Robertsonian rearrangements driving the evolution of this family.

Official COVID-19 coping strategies in educational institutions.

OBJECTIVE: To analyze normative acts on coping with COVID-19 in the teaching environment, sanctioned by the state and federal governments of Brazil. METHODS: Documentary research, with a qualitative approach to documents published by federal and state education and health bodies between March/2020 and March/2021, analyzed according to Bardin's Document Analysis framework. RESULTS: From 61 documents, four categories resulted: Acts and strategies to protect against COVID19 adopted by the federal government; Normative acts of state governments on suspension of classes; Strategies to protect against COVID-19 in the teaching environment common among Brazilian states; Strategies to protect against COVID-19 in the teaching environment specific to Brazilian states. FINAL CONSIDERATIONS: The normative acts analyzed present weaknesses regarding the clarification on how to establish the systematization of COVID-19 surveillance actions in the teaching environment, as well as there is a lack of reflections on the importance of such actions.

Methyl-CpG binding proteins (MBD) family evolution and conservation in plants.

DNA methylation is an epigenetic mechanism that acts on cytosine residues. The methyl-CpG-binding domain proteins (MBD) are involved in the recognition of methyl-cytosines by activating a signaling cascade that induces the formation of heterochromatin or euchromatin, thereby regulating gene expression. In this study, we analyzed the evolution and conservation of MBD proteins in plants. First, we performed a genome-wide identification and analysis of the MBD family in common bean and soybean, since they have experienced one and two whole-genome duplication events, respectively. We found one pair of MBD paralogs in soybean (GmMBD2) has subfunctionalized after their recent divergence, which was corroborated with their expression profile. Phylogenetic analysis revealed that classes of MBD proteins clustered with human MBD. Interestingly, the MBD9 may have emerged after the hexaploidization event in eudicots. We found that plants and humans share a great similarity in MBDs' binding affinity in the mCpG context. MBD2 and MBD4 from different plant species have the conserved four amino acid residues -Arg (R), Asp (D), Tyr (Y) and Arg (R)- reported to be responsible for MBD-binding in the mCpG. However, MBD8, MBD9, MBD10, and MBD11 underwent substitutions in these residues, suggesting the non-interaction in the mCpG context, but a heterochromatin association as MBD5 and MBD6 from human. This study represents the first genome-wide analysis of the MBD gene family in eurosids I - soybean and common bean. The data presented here contribute towards understanding the evolution of MBDs proteins in plants and their specific binding affinity on mCpG site.