Capacitação para o controle da hanseníase: avaliação e contribuições para a gestão / Training process for leprosy control: evaluation and contributions to management

RESUMO Este estudo tem o objetivo de apresentar a avaliação de um projeto de capacitação em serviço para profissionais de saúde nas ações de prevenção e controle da hanseníase, problematizando o modelo de avaliação adotado, com foco na utilização para a gestão em saúde. Foi realizada uma avaliação ex-post em 18 municípios prioritários brasileiros participantes das capacitações. Empregou-se a estratégia Rapid Evaluation Methods (REM), priorizando: a) abordagem colaborativa; b) técnicas qualitativas; e c) enfoque conceitual da translação do conhecimento. Foram realizadas 24 entrevistas grupais, envolvendo 278 participantes. A abordagem de ensino em serviço foi importante para revalorização das ações de prevenção e controle da hanseníase e para conferir um lugar privilegiado de discussão técnica, de reflexão e de mudanças na atenção primária e em sua relação com a especializada. Conclui-se que o modelo de avaliação possibilitou que as controvérsias e convergências surgissem, assim como as recomendações para ajustes da intervenção junto à gestão em tempo oportuno.

ABSTRACT This study aims to present the evaluation of an in-service training project for health professionals in leprosy prevention and control actions, questioning the adopted evaluation model, focusing on its use for health management. An ex-post evaluation was carried out in 18 priority Brazilian municipalities participating in the training project. Rapid Evaluation Methods (REM) strategy was employed, prioritizing: a) a collaborative approach; b) qualitative techniques; and c) a conceptual approach to knowledge translation. Twenty-four group interviews were carried out, involving 278 participants. The in-service teaching approach was important for revaluing leprosy prevention and control actions and to provide a privileged place for technical discussion, reflection and changes in primary health care and in its relationship with specialized care. It can be concluded that the evaluation model enabled controversies and convergences to emerge, as well as recommendations for managers to adjust the intervention timely.

Planejamento e gestão do processo de trabalho em saúde: avanços e limites no Subsistema de Atenção à Saúde Indígena do SUS / Planning and management of the health work process: advances and limits in the SUS-Indigenous Health Care Subsystem

Resumo O Subsistema de Atenção à Saúde Indígena (SasiSUS), como parte do Sistema Único de Saúde (SUS), é responsável pela atenção à saúde dos povos indígenas do Brasil. Em âmbito local, são os Distritos Sanitários Especiais Indígenas (DSEI) os responsáveis pela gestão, planejamento e organização do processo de trabalho das equipes multidisciplinares de saúde indígena (EMSI), que realizam a atenção primária à saúde para essa população. O objetivo do estudo foi analisar como ocorrem o planejamento e a gestão do processo de trabalho das EMSI. Foi realizado um estudo de casos múltiplos holístico, considerando sete DSEI como unidades de análise. A principal fonte de dados utilizada foi a entrevista e, de forma complementar, a observação direta. Os resultados indicaram que, de forma geral, o planejamento está presente na organização do processo de trabalho das equipes, com variações entre os DSEI. A efetivação das ações planejadas foi relacionada à disponibilidade de diferentes recursos: funcionamento adequado do sistema de informação e a articulação intra e intersetorial do SasiSUS. Como conclusão, apontou-se a necessidade de radicalização da participação no planejamento e na gestão, necessária a uma ação coordenada para garantia da atenção diferenciada e dos princípios do SUS.

Abstract The Indigenous Health Care Subsystem (SasiSUS), as part of the Brazilian National Health System (SUS), is responsible for health care for indigenous peoples in Brazil. At the local level, the Special Indigenous Health Districts (DSEI) are responsible for managing, planning, and organizing the work process of the multidisciplinary indigenous health teams (EMSI), which provide primary health care for this population. The objective of the study was to analyze how the planning and the management of the EMSI work process occurs. A holistic multiple-case study was carried out, considering seven DSEI as units of analysis. The main source of data used were interviews and, in a complementary way, direct observation. The results indicated that, in general, planning is present in the organization of the teams' work process, with variations between the DSEI. Carrying out the planned actions was related to the availability of different resources: adequate functioning of the information system and the intra and intersectoral articulation of SasiSUS. As a conclusion, the need to radicalize participation in planning and management, necessary for a coordinated action to guarantee differentiated care and the principles of SUS, was pointed out.

Factors Correlated with Body Image Dissatisfaction in Children and Adolescents Diagnosed with HIV: A Cross-Sectional Study.

(1) Background: The adverse effects of continuous use of antiretroviral therapy can generate dissatisfaction with body image in children and adolescents diagnosed with Human Immunodeficiency Virus infection (HIV) infection. The aim of this study was to verify the prevalence and factors associated with body image dissatisfaction (BI) in children and adolescents diagnosed with HIV infection; (2) This is a cross-sectional study with 60 children and adolescents (32 females; 28 males) aged 8-15 years diagnosed with HIV, carried out in Florianópolis, Brazil. Information on BI was collected through a silhouette scale, as well as sociodemographic information, biological maturation, lifestyle, self-esteem, adherence to antiretroviral treatment and aspects of HIV infection; (3) Results: The results indicated that 53.13% of female patients and 53.57% of male patients were dissatisfied with their BI. Lower subscapular skinfold and higher calf skinfold values were associated with BI dissatisfaction in females. Pre-pubertal maturation stage, higher economic level, lower concentrations of CD4+ lymphocytes, lower viral load, lower level of physical activity and longer time in front of the computer and/or video game were associated with BI dissatisfaction in males; (4) Conclusions: BI dissatisfaction was observed in more than half of patients and morphological, economic, behavioral and HIV infection aspects were associated with BI dissatisfaction.

Essential Oils as a Source of Ecofriendly Insecticides for Drosophila suzukii (Diptera: Drosophilidae) and Their Potential Non-Target Effects.

The spotted wing drosophila (Drosophila suzukii) is one of the main invasive pests of small fruits in the world. Thus, 19 essential oils (EOs) were selected to analyze the effects through toxicity and repellency on oviposition and D. suzukii adults. In addition, their lethal and sublethal effects on the pupal endoparasitoid Trichopria anastrephae were evaluated. The EOs of C. flexuosus and Mentha spp. had the highest toxicity observed in the topical application bioassay for D. suzukii. In contrast, the EOs of C. verum, C. citratus QT citratus, and C. winterianus showed the highest toxicity in the ingestion bioassay for D. suzukii. The dry residues of C. verum and C. citratus QT citratus reduced the oviposition of D. suzukii. In the repellency bioassays, the 19 EOs analyzed repelled ≅ 90% of the D. suzukii females. All EOs evaluated using the LC90 values of the products provided mortality of less than 20% of T. anastrephae adults and did not cause a reduction in the parasitism of surviving T. anastrephae females. We conclude that the EOs evaluated have the potential to be used in the management of D. suzukii. They can also serve as selective active ingredients for the formulation and synthesis of new biopesticides.

Application of Hot Water Extraction Techniques and the Principal Component Analysis to Study the Influence of Cultivation of Commercial Yerba Mate Samples on Their Mineral Profiles.

Consumption of organic food has grown much around the world in the last 20 years. Change in the profile of consumers who have increasingly sought a healthy diet is the major contributor to this phenomenon. In scientific literature, some studies have already shown the nutritional superiority of organic food in the individual evaluation of metabolites. However, few studies have assessed interaction among metabolites, especially the one between minerals and the food matrix. This information may have great relevance in determining the extractability of minerals, especially in food consumed through infusion, such as yerba mate, since this interaction can directly influence their solubility. Thus, this study aimed to use hot water extraction techniques (infusion and decoction) and the principal component analysis (PCA) to evaluate the differences between organic and conventional cultivation systems in absorption and availability of Ca, Mg, Fe, Mn, and Zn in yerba mate leaves and stems. The PCA showed that cultivation influences total mineral contents found in both leaves and stems. Results of extractability only showed differences in conventional leaf samples, from which all minerals under study were better extracted. Results point out a different interaction between minerals and the matrix, depending on the cultivation, and to the stronger interaction between the matrix and minerals in organic samples, a fact which leads to low availability of minerals for consumption.

[Study of the evaluability of the Information System on Indigenous Health: potentialities and challenges for supporting local health administration]. / Estudo de avaliabilidade do Sistema de Informação da Atenção à Saúde Indígena: potencialidades e desafios para apoiar a gestão em saúde no nível local.

The article's objective is to present the results of the study on the evaluability of the Information System on Indigenous Health (SIASI) and its implications for local health administration. The study was performed with the following stages: description of the intervention, description of potential users, and context analysis (internal and external). The following data collection techniques were adopted: document analysis, interviews with key informants, and a workshop. Modeling of the SIASI in the Special Indigenous Health District Upper Solimões River (Amazonas State) and Special Indigenous Health District Eastern Roraima (Roraima State) allowed a schematic view of the system's mode of functioning, considering the peculiarities of the decentralized and centralized information flow. Context analysis pointed to acknowledgment of the SIASI as a tool for organization of the work process in the multidisciplinary indigenous health team (EMSI) and for follow-up of the health situation, despite low utilization of the information in the territories. Persistent challenges include infrastructure problems and fragmentation of information, causing an increase in rework in feeding the data. One key feature is the creation of the Local SIASI Panel, generating dynamic and interactive reports on the health situation. In conclusion, the capacity for use of the SIASI as a tool to support local management can be enhanced by expanding the decentralization of the information flow.

O objetivo do artigo é apresentar os resultados do estudo de avaliabilidade do Sistema de Informação da Atenção à Saúde Indígena (SIASI) e suas implicações para a gestão em saúde no nível local. O estudo foi desenvolvido com base nas seguintes etapas: descrição da intervenção, descrição dos usuários potenciais e análise de contexto (interno e externo). Para tanto, adotaram-se as seguintes técnicas de coleta de dados: análise documental, entrevistas com informantes-chave e oficina de trabalho. A modelização do SIASI no Distrito Sanitário Especial Indígena (DSEI) Alto Rio Solimões (Amazonas) e no DSEI Leste Roraima (Roraima) possibilitou a visualização esquemática do modo de funcionamento do sistema, considerando-se as peculiaridades do fluxo de informação descentralizado e centralizado. A análise de contexto aponta para o reconhecimento do SIASI como ferramenta para a organização do processo de trabalho das equipes multidisciplinares de saúde indígena (EMSI) e o acompanhamento da situação de saúde, ainda que ocorra baixa utilização das informações nos territórios. Entre os desafios, persistem os problemas de infraestrutura e a fragmentação das informações, provocando aumento do retrabalho na alimentação dos dados. Como potencialidade, destaca-se a criação do Painel SIASI Local, que gera relatórios dinâmicos e interativos sobre a situação de saúde. Conclui-se que a capacidade de utilização do SIASI como ferramenta de apoio à gestão pelo nível local pode ser potencializada com a ampliação do processo de descentralização do fluxo de informações.

El objetivo del artículo es presentar los resultados del estudio de evaluabilidad del Sistema de Información de Atención en Salud al Indígena (SIASI) y sus implicaciones para la gestión sanitaria en el nivel local. El estudio se desarrolló en base a las siguientes etapas: descripción de la intervención, descripción de los usuarios potenciales y análisis de contexto (interno y externo). Para tal fin se adoptaron las siguientes técnicas de recogida de datos: análisis documental, entrevistas con informantes-clave y taller de trabajo. La modelización del SIASI en el Distrito Sanitário Especial Indígena (DSEI) Alto Rio Solimões (Amazonas) y en el DSEI Leste Roraima (Roraima) posibilitó la visualización esquemática del modo de funcionamiento del sistema, considerándose las peculiaridades del flujo de información descentralizado y centralizado. El análisis de contexto apunta al reconocimiento del SIASI como herramienta para la organización del proceso de trabajo de los equipos multidisciplinares de salud indígena (EMSI) y el seguimiento de la situación de salud, aunque exista una baja utilización de la información en los territorios. Entre los desafíos persisten los problemas de infraestructura y fragmentación de la información, provocando un aumento del retrabajo en la alimentación de datos. Como potencialidad se destaca la creación del Panel SIASI Local que genera informes dinámicos e interactivos sobre la situación de salud. Se concluye que la capacidad de utilización del SIASI como herramienta de apoyo a la gestión por parte del nivel local puede potenciarse con la ampliación del proceso de descentralización del flujo de información.

Population Dynamics of Heliothrips haemorrhoidalis (Thysanoptera: Thripidae) in Strawberry Cultivars in Southern Brazil.

Heliothrips haemorrhoidalis is a polyphagous thrips species that has been reported as a potential pest in strawberry cultivation in Brazil. Since it has only recently emerged as a pest species in production areas, understanding seasonal trends in the species' activity is particularly important for designing management strategies. Therefore, this study aims to investigate the influence of climate factors (temperature and relative humidity) and six strawberry cultivars ('Albion', 'Aromas', 'Camino Real', 'Monterey', 'Portola', and 'San Andreas') on the population dynamics of H. haemorrhoidalis during the 2018-2019 and 2019-2020 growing seasons in southern Brazil. The greatest peak in thrips populations in the cultivars assessed occurred between January and March (summer) in both growing seasons. The relationship between the incidence of H. haemorrhoidalis and temperature was observed to be negative during the autumn, spring, and summer months but positive during winter. Relative humidity levels above 70% had a negative influence on the abundance of insects. Populations of H. haemorrhoidalis varied between the cultivars as follows: 'Aromas' > 'Monterey' > 'San Andreas' > 'Albion' > 'Camino Real' > 'Portola'. Cross-sections of strawberry leaves showed that 'Monterey' had the highest density of nonglandular trichomes/mm2 (7.26), while 'Portola' cultivar, the greatest predominance of glandular trichomes/mm2 (12.67), which may have contributed to the incidence of H. haemorrhoidalis. The demographic information presented on H. haemorrhoidalis in strawberry cultivars provides a starting point to better understand the insect's population dynamics. These results also indicate that climatic conditions are a limiting factor for the development of H. haemorrhoidalis.

Effect of fruits and vegetables in the anaerobic digestion of food waste from university restaurant.

The aim of this study was to evaluate the theoretical potential of methane production of the food waste generated by a university restaurant, as well as to verify the influence of the fruit and vegetable waste in the feeding composition of an anaerobic bioreactor treating this type of waste. Four feeding compositions combining three fractions of the food waste (fruit and vegetable fraction, soy protein and beans fraction, and rice fraction) at different concentrations were tested in anaerobic processes lasting 10 and 30 days. Additionally, a study of the theoretical potential of methane production from each fraction that composes the food waste was carried out, as well as the evaluation of the specific methanogenic activity of the anaerobic sludge. Despite its low theoretical potential of methane production (0.037 LCH4/g), the presence of the fruit and vegetable mixture in three of the feeding compositions led to greater organic matter degradation (above 69%) and CH4 yields (above 0.20 LCH4/gVS) in both periods tested, in comparison with the achieved by the feeding composition lacking this fraction. The results suggest that the presence of the fruit and vegetable mixture contributed with the supplementation of micro- and macroelements to the anaerobic sludge during the digestion of food waste.

Streptomyces spp. Isolated from Marine and Caatinga Biomes in Brazil for the Biological Control of Duponchelia fovealis.

Actinobacteria have been drawing attention due to their potential for the development of new pest control products. We hereby assess the effects of Streptomyces isolated from marine and caatinga biomes against Duponchelia fovealis Zeller (Lepidoptera: Crambidae), a pest associated with the strawberry culture at a global scale. To this end, eggs deposited by adults were immersed for 5 s in a bacterial suspension, and the larvae were fed on leaflets placed in glass tubes containing bacterial suspensions. In both treatments, the control was a saline solution. The bioassays demonstrated that the Streptomyces strains were able to cause the death of D. fovealis eggs (≈ 40%) and larvae (≈ 65%) compared to untreated eggs (1.4%) and larvae (2.0%). The crude extract of strain T49 and the chitinase extract of strain T26 affected larval growth when applied directly to the thorax of first-instar larvae (larval-adult lifespan of 65.3 ± 0.5 days and 67.5 ± 0.7 days, respectively; survival of 61.2 ± 1.2%) in relation to the control treatment (larval-adult lifespan of 41.75 ± 0.2 days and survival of 83.7 ± 2.6%). The Streptomyces spp. strains T41, T49, and T50 caused antifeeding activity. Apart from larval mortality, the adults that emerged from the larvae exposed to the extracts presented morphological abnormalities, and the moths' chitin spectra showed clear alterations to the pupa and wings. Our studies show, for the very first time, that Streptomyces isolated from the marine environment and the Caatinga biome are effective at provoking the mortality of D. fovealis and are promising agents for developing new products with biological control properties.

Essential Oil of Rosmarinus officinalis Ecotypes and Their Major Compounds: Insecticidal and Histological Assessment Against Drosophila suzukii and Their Impact on a Nontarget Parasitoid.

Essential oils (EOs) produced by plants in the Lamiaceae family may provide new insecticidal molecules. Novel control compounds are needed to control Drosophila suzukii (Matsumura), a severe economic invasive pest of thin-skinned fruit crops. Thus, we characterized the main compounds of EOs from three rosemary Rosmarinus officinalis ecotypes (ECOs) and evaluated their toxicity to D. suzukii adults, deterrence of oviposition behavior, and histological alterations in larvae. Additionally, we analyzed the lethal and sublethal effect on the pupal parasitoid Trichopria anastrephae. The main compounds identified in the R. officinalis ECOs were α-pinene, camphor and 1,8-cineole. In bioassays via topical application or ingestion, ECOs and their major compounds showed high toxicity on D. suzukii adults and a lower concentration could kill 50% and 90% of flies compared to spinetoram. The dry residues of a-pinene, 1,8-cineole, and camphor provided a repellent effect by reducing D. suzukii oviposition by ~47% compared to untreated fruit. Histological sections of 3rd instar larval D. suzukii posttreatment revealed damage to the fat body, Malpighian tubules, brain, salivary gland, and midgut, which contributed to high larval and pupal mortality. Survival and parasitism by adult T. anastrephae were not affected. Thus, R. officinalis EO and their compounds have potential for developing novel insecticides to manage D. suzukii.

Chemoselective Synthesis of Mannich Adducts from 1,4-Naphthoquinones and Profile as Autophagic Inducers in Oral Squamous Cell Carcinoma.

Oral squamous cell carcinoma (OSCC) is a worldwide public health problem, accounting for approximately 90% of all oral cancers, and is the eighth most common cancer in men. Cisplatin and carboplatin are the main chemotherapy drugs used in the clinic. However, in addition to their serious side effects, such as damage to the nervous system and kidneys, there is also drug resistance. Thus, the development of new drugs becomes of great importance. Naphthoquinones have been described with antitumor activity. Some of them are found in nature, but semi synthesis has been used as strategy to find new chemical entities for the treatment of cancer. In the present study, we promote a multiple component reaction (MCR) among lawsone, arylaldehydes, and benzylamine to produce sixteen chemoselectively derivated Mannich adducts of 1,4-naphthoquinones in good yield (up to 97%). The antitumor activities and molecular mechanisms of action of these compounds were investigated in OSCC models and the compound 6a induced cytotoxicity in three different tumor cell lines (OSCC4, OSCC9, and OSCC25) and was more selective (IS > 2) for tumor cells than the chemotropic drug carboplatin and the controls lapachol and shikonin, which are chemically similar compounds with cytotoxic effects. The 6a selectively and significantly reduced the amount of cell colony growth, was not hemolytic, and tolerable in mice with no serious side effects at a concentration of 100 mg/kg with a LD50 of 150 mg/kg. The new compound is biologically stable with a profile similar to carboplatin. Morphologically, 6a does not induce cell retraction or membrane blebs, but it does induce intense vesicle formation and late emergence of membrane bubbles. Exploring the mechanism of cell death induction, compound 6a does not induce ROS formation, and cell viability was not affected by inhibitors of apoptosis (ZVAD) and necroptosis (necrostatin 1). Autophagy followed by a late apoptosis process appears to be the death-inducing pathway of 6a, as observed by increased viability by the autophagy inhibitor (3-MA) and by the appearance of autophagosomes, later triggering a process of late apoptosis with the presence of caspase 3/7 and DNA fragmentation. Molecular modeling suggests the ability of the compound to bind to topoisomerase I and II and with greater affinity to hPKM2 enzyme than controls, which could explain the mechanism of cell death by autophagy. Finally, the in-silico prediction of drug-relevant properties showed that compound 6a has a good pharmacokinetic profile when compared to carboplatin and doxorubicin. Among the sixteen naphthoquinones tested, compound 6a was the most effective and is highly selective and well tolerated in animals. The induction of cell death in OSCC through autophagy followed by late apoptosis possibly via inhibition of the PKM2 enzyme points to a promising potential of 6a as a new preclinical anticancer candidate.

Estudo de avaliabilidade do Sistema de Informação da Atenção à Saúde Indígena: potencialidades e desafios para apoiar a gestão em saúde no nível local / Study of the evaluability of the Information System on Indigenous Health: potentialities and challenges for supporting local health administration / Estudio de evaluabilidad del Sistema de Información de Atención en Salud al Indígena: potencialidades y desafíos para apoyar la gestión en salud en el nivel local

O objetivo do artigo é apresentar os resultados do estudo de avaliabilidade do Sistema de Informação da Atenção à Saúde Indígena (SIASI) e suas implicações para a gestão em saúde no nível local. O estudo foi desenvolvido com base nas seguintes etapas: descrição da intervenção, descrição dos usuários potenciais e análise de contexto (interno e externo). Para tanto, adotaram-se as seguintes técnicas de coleta de dados: análise documental, entrevistas com informantes-chave e oficina de trabalho. A modelização do SIASI no Distrito Sanitário Especial Indígena (DSEI) Alto Rio Solimões (Amazonas) e no DSEI Leste Roraima (Roraima) possibilitou a visualização esquemática do modo de funcionamento do sistema, considerando-se as peculiaridades do fluxo de informação descentralizado e centralizado. A análise de contexto aponta para o reconhecimento do SIASI como ferramenta para a organização do processo de trabalho das equipes multidisciplinares de saúde indígena (EMSI) e o acompanhamento da situação de saúde, ainda que ocorra baixa utilização das informações nos territórios. Entre os desafios, persistem os problemas de infraestrutura e a fragmentação das informações, provocando aumento do retrabalho na alimentação dos dados. Como potencialidade, destaca-se a criação do Painel SIASI Local, que gera relatórios dinâmicos e interativos sobre a situação de saúde. Conclui-se que a capacidade de utilização do SIASI como ferramenta de apoio à gestão pelo nível local pode ser potencializada com a ampliação do processo de descentralização do fluxo de informações.

The article's objective is to present the results of the study on the evaluability of the Information System on Indigenous Health (SIASI) and its implications for local health administration. The study was performed with the following stages: description of the intervention, description of potential users, and context analysis (internal and external). The following data collection techniques were adopted: document analysis, interviews with key informants, and a workshop. Modeling of the SIASI in the Special Indigenous Health District Upper Solimões River (Amazonas State) and Special Indigenous Health District Eastern Roraima (Roraima State) allowed a schematic view of the system's mode of functioning, considering the peculiarities of the decentralized and centralized information flow. Context analysis pointed to acknowledgment of the SIASI as a tool for organization of the work process in the multidisciplinary indigenous health team (EMSI) and for follow-up of the health situation, despite low utilization of the information in the territories. Persistent challenges include infrastructure problems and fragmentation of information, causing an increase in rework in feeding the data. One key feature is the creation of the Local SIASI Panel, generating dynamic and interactive reports on the health situation. In conclusion, the capacity for use of the SIASI as a tool to support local management can be enhanced by expanding the decentralization of the information flow.

El objetivo del artículo es presentar los resultados del estudio de evaluabilidad del Sistema de Información de Atención en Salud al Indígena (SIASI) y sus implicaciones para la gestión sanitaria en el nivel local. El estudio se desarrolló en base a las siguientes etapas: descripción de la intervención, descripción de los usuarios potenciales y análisis de contexto (interno y externo). Para tal fin se adoptaron las siguientes técnicas de recogida de datos: análisis documental, entrevistas con informantes-clave y taller de trabajo. La modelización del SIASI en el Distrito Sanitário Especial Indígena (DSEI) Alto Rio Solimões (Amazonas) y en el DSEI Leste Roraima (Roraima) posibilitó la visualización esquemática del modo de funcionamiento del sistema, considerándose las peculiaridades del flujo de información descentralizado y centralizado. El análisis de contexto apunta al reconocimiento del SIASI como herramienta para la organización del proceso de trabajo de los equipos multidisciplinares de salud indígena (EMSI) y el seguimiento de la situación de salud, aunque exista una baja utilización de la información en los territorios. Entre los desafíos persisten los problemas de infraestructura y fragmentación de la información, provocando un aumento del retrabajo en la alimentación de datos. Como potencialidad se destaca la creación del Panel SIASI Local que genera informes dinámicos e interactivos sobre la situación de salud. Se concluye que la capacidad de utilización del SIASI como herramienta de apoyo a la gestión por parte del nivel local puede potenciarse con la ampliación del proceso de descentralización del flujo de información.

Curso em saúde mental no contexto da Covid-19 com povos indígenas por meio de ensino remoto / Course in mental health in the context of COVID-19 with indigenous poeples through remote learning / Curso sobre salud mental en el contexto del Covid-19 con pueblos indígenas a través del aprendizaje a distancia

Resumo O enfrentamento à Covid-19 suscitou a necessidade da formação em Saúde Mental para profissionais da saúde, educação, proteção social e lideranças comunitárias que atuam junto aos povos indígenas. Em seus cotidianos, essas comunidades já convivem com questões que impactam a saúde mental e a espiritual, mas o sofrimento psíquico ficou ainda mais evidenciado no contexto pandêmico. O curso 'Bem viver: Saúde Mental Indígena', voltado para mitigar o impacto psicossocial da Covid-19 nas populações indígenas da Amazônia brasileira, exigiu estratégias inovadoras ante o desafio de ensino remoto nesse contexto de conectividade limitada e isolamento territorial. Os desenhos pedagógico e operacional do curso priorizaram o diálogo intercultural na elaboração dos conteúdos com uso de diversas ferramentas de ensino para superar barreiras de conectividade e de entendimento da língua portuguesa no formato escrito. Apesar do desafio da produção coletiva e intercultural, dada a diversidade étnica, o curso foi um espaço de produção e trocas entre profissionais de diferentes áreas e lideranças comunitárias, sempre buscando um olhar ampliado sobre as práticas de cuidado, apoio psicossocial e valorizando as formas de atenção à saúde utilizadas pelas comunidades.

Abstract The confrontation with COVID-19 raised the need for training in Mental Health for health, education, social protection and community leaders who work with indigenous peoples. In their daily lives, these communities already live with issues that impact mental and spiritual health, but psychological distress was even more evident in the pandemic context. The 'Well Living: Indigenous Mental Health' course, aimed at mitigating the psychosocial impact of COVID-19 on indigenous populations in the Brazilian Amazon, required innovative strategies in the face of the challenge of remote learning in this context of limited connectivity and territorial isolation. The pedagogical and operational design of the course prioritized intercultural dialogue in the development of content using various teaching tools to overcome barriers to connectivity and understanding of the Portuguese language in written format. Despite the challenge of collective and intercultural production, given the ethnic diversity, the course was a space for production and exchanges between professionals from different areas and community leaders, always seeking a broader look at care practices, psychosocial support and valuing ways of health care used by communities.

Resumen La lucha contra el Covid-19 planteó la necesidad de promover la capacitación en Salud Mental para los profesionales de salud, educación, protección social y líderes comunitarios que trabajan con pueblos indígenas. En su vida diaria, estas comunidades ya conviven con problemas que impactan la salud mental y espiritual, pero el sufrimiento psíquico fue aún más evidente en el contexto de la pandemia. El curso 'Bien Vivir: Salud Mental Indígena', dirigido a mitigar el impacto psicosocial del Covid-19 en las poblaciones indígenas de la Amazonía brasileña, requirió estrategias innovadoras ante el desafío del aprendizaje remoto en un contexto de conectividad limitada y aislamiento territorial. El diseño pedagógico y operacional del curso priorizó el diálogo intercultural en el desarrollo de contenidos, utilizando diversas herramientas didácticas para superar las barreras a la conectividad y comprensión del idioma portugués en formato escrito. A pesar del desafío de la producción colectiva e intercultural, dada la diversidad étnica, el curso fue un espacio de producción e intercambio entre profesionales de diferentes áreas y líderes comunitarios, buscando siempre una mirada más amplia a las prácticas asistenciales, al apoyo psicosocial y de valoración de las formas de atención a la salud utilizadas por las comunidades.

Desigualdade social e vulnerabilidade dos povos indígenas no enfrentamento da Covid-19: um olhar dos atores nas lives / Social inequality and vulnerability of Indigenous peoples facing COVID-19: a perspective by stakeholders in the lives

RESUMO A pandemia da Covid-19 tem evidenciado as profundas desigualdades da sociedade brasileira para o enfrentamento adequado dessa catástrofe sanitária. Este estudo buscou compreender as repercussões da Covid-19 nos povos indígenas brasileiros e a sua forma de organização no contexto de desigualdade social e vulnerabilidade. Realizou-se uma pesquisa qualitativa a partir da análise de lives. A busca foi feita via plataforma YouTube usando como descritores "coronavírus e indígena" e "covid e população indígena", totalizando 56 lives - que permitiram analisar diversos olhares para o enfrentamento da pandemia, sendo evidente que o ponto de partida para prevenção, vigilância, atenção em saúde e comunicação da Covid-19 entre os povos indígenas é totalmente diferente do resto da população. O protagonismo da sociedade civil indígena está sendo extremamente relevante para o enfrentamento da pandemia. A profunda desigualdade social e as múltiplas vulnerabilidades dos povos indígenas são realidades que devem ser entendidas para superar os enormes desafios produzidos, não somente pela Covid-19, mas fundamentalmente pelo atual contexto de invisibilização, desconhecimento e ataque às sociedades indígenas brasileiras. O controle social ficou muito fragilizado, e urge seu fortalecimento para criar um modelo de saúde diferenciado que realmente contemple os interesses e modos de vida desses povos.

ABSTRACT The COVID-19 pandemic has highlighted the deep inequalities of Brazilian society to address this health-related catastrophe. This study aimed to understand the repercussions of COVID-19 on Brazilian Indigenous peoples and how they organize in the context of social inequalities and vulnerabilities. Qualitative research was conducted based on the analysis of 'lives'. The search was performed on YouTube using descriptors "coronavirus and Indigenous" and "COVID and Indigenous population", totaling 56 live events, which allowed us to analyze different perspectives on the fight against the pandemic showing that the starting point for COVID-19 prevention, surveillance, health care, and communication among Indigenous peoples is different from the rest of the population. The leading role of the Indigenous civil society is highly relevant to the fight against the pandemic. The profound inequality and the multiple vulnerabilities of Indigenous peoples are realities that must be understood to overcome the enormous challenges produced not only by COVID-19 and, fundamentally, the current context of invisibility, ignorance, and attack on Brazilian Indigenous societies. Social control has been weakened, and its strengthening is urgent to create a differentiated health model that considers these people's interests and ways of life.

Insecticidal and oviposition deterrent effects of essential oils of Baccharis spp. and histological assessment against Drosophila suzukii (Diptera: Drosophilidae).

The diverse flora of the Atlantic Forest is fertile ground for discovering new chemical structures with insecticidal activity. The presence of species belonging to the genus Baccharis is of particular interest, as these species have shown promise in pest management applications. The objective of this study is to chemically identify the constituents expressed in the leaves of seven species of Baccharis (B. anomala DC., B. calvescens DC., B. mesoneura DC., B. milleflora DC., B. oblongifolia Pers., B. trimera (Less) DC. and B. uncinella DC.) and to evaluate the toxicological and morphological effects caused by essential oils (EOs) on the larvae and adults of Drosophila suzukii (Diptera: Drosophilidae). Chemical analysis using gas chromatography-mass spectrometry (GC-MS) indicated that limonene was the main common constituent in all Baccharis species. This constituent in isolation, as well as the EOs of B. calvescens, B. mesoneura, and B. oblongifolia, caused mortality in over 80% of adults of D. suzukii at a discriminatory concentration of 80 mg L-1 in bioassays of ingestion and topical application. These results are similar to the effect of spinosyn-based synthetic insecticides (spinetoram 75 mg L-1) 120 h after exposure. Limonene and EOs from all species had the lowest LC50 and LC90 values relative to spinosyn and azadirachtin (12 g L-1) in both bioassays. However, they showed the same time toxicity over time as spinetoram when applied to adults of D. suzukii (LT50 ranging from 4.6 to 8.7 h) in a topical application bioassay. In olfactometry tests, 92% of D. suzukii females showed repellent behavior when exposed to the EOs and limonene. Likewise, the EOs of B. calvescens, B. mesoneura, and B. oblongifolia significantly reduced the number of eggs in artificial fruits (≅ 7.6 eggs fruit-1), differing from the control treatment with water (17.2 eggs fruit-1) and acetone (17.6 eggs fruit-1). According to histological analyses, the L3 larvae of D. suzukii had morphological and physiological alterations and deformations after exposure to treatments containing EOs and limonene, which resulted in high larval, pupal, and adult mortality. In view of the results, Baccharis EOs and their isolated constituent, limonene, proved to be promising alternatives for developing bioinsecticides to manage of D. suzukii.

Comparative Performance of Citrate, Borohydride, Hydroxylamine and ß-Cyclodextrin Silver Sols for Detecting Ibuprofen and Caffeine Pollutants by Means of Surface-Enhanced Raman Spectroscopy.

The detection of emerging contaminants in the aquatic environment, such as ibuprofen and caffeine, was studied by means of surface-enhanced Raman spectroscopy (SERS) using Ag nanoparticles (AgNPs) synthesized with ß-cyclodextrin (ßCD) as a reducing agent. The effect on the SERS signal of different molar ratios of Ag+/ßCD in the synthesis route and the aging process of AgNPs were investigated by using trans-cinnamic as a test molecule. The SERS effectiveness of these ß-cyclodextrin colloids (Ag@ßCD) was also checked and compared with that of other silver sols usually employed in SERS synthesized by using other reducing agents such as citrate, borohydride and hydroxylamine. All the synthesized SERS substrates were characterized by different techniques. The experimental results indicate that Ag@ßCD with the more diluted Ag+/ßCD molar ratio showed the best SERS signal, enabling detection at trace concentrations of 0.5 µM in the case of trans-cinnamic acid. The Ag@ßCD sols also showed the best sensitivity for detecting ibuprofen and caffeine, reaching the lowest limit of detection (0.1 mM). The proposed synthetic route for Ag@ßCD sols provides an improved SERS substrate for detecting organic pollutants with better performance than other standard silver sols.

Physicochemical Characteristics and Superficial Damage Modulate Persimmon Infestation by Drosophila suzukii (Diptera: Drosophilidae) and Zaprionus indianus.

Drosophila suzukii (Matsumura) (Diptera: Drosophilidae) and Zaprionus indianus Gupta (Diptera: Drosophilidae) were recently observed co-infesting persimmons in Brazil. We evaluate the infestation susceptibility of persimmons at different ripening stages (unripe, UN; early ripe, ER; orange ripe, OR, and overripe, OV) by D. suzukii and Z. indianus in the field and laboratory conditions. Additionally, we determined the influence of physicochemical characteristics (e.g., resistance to penetration force, fruit skin color, acidity (pH), TSS concentration, total titratable acidity [TTA]) and the type of damage that facilitates infestation by D. suzukii or Z. indianus. In the field, the natural infestation capacity and biological development of D. suzukii and Z. indianus were verified in whole fruits at the ripening stages ER, OR, and OV. The natural infestation was directly related to the physicochemical characteristics of the fruits (resistance to penetration force, pH, and total soluble solids). In the no-choice bioassay, the oviposition rate of D. suzukii did not differ between the ripening stages of the fruit. However, in the choice bioassay, there was a higher preference for oviposition in OV fruits. Regarding Z. indianus, the highest preference for oviposition was observed in OR and OV fruits in both bioassays. The presence of mechanical damage did not increase the susceptibility of the fruits to D. suzukii. However, it favored the oviposition of Z. indianus in OR and OV fruits. The damage caused by D. suzukii or mechanical damage favored the infestation by Z. indianus. This is the first report of the capacity of D. suzukii to infest whole persimmons in Brazil.

National Emergency Training in Mental Health and Psychosocial Care at COVID-19: an experience report / Capacitação nacional emergencial em saúde mental e atenção psicossocial na COVID-19: um relato de experiência

In March 2020, the World Health Organization declared a pandemic, due to the rapid spread of the SARS-Cov-2 virus, triggering the global alert about the need for rapid expansion of the capacity for surveillance, prevention and implementation of assistance structures for the countries' health systems. In the day after the statement by the Brazilian Ministry of Health, that recognized community transmission in Brazil, a group of researchers was invited to gather scientific evidence and best practices for mental health and psychosocial care at COVID-19. 1,563 articles were selected that referred to mental health and / or psychosocial care in contexts of health emergencies. Researchers, teachers and volunteers from 25 institutions, recognized for their notorious knowledge, participated, totaling 117 volunteer professionals. It was decided to set up an online national course. Altogether 60,780 professionals joined the course in the first 30 days of enrollment. The online modeling, synchronous and asynchronous, enabled training during a period of social distance, and also allowed professionals from different states in the national territory to have access to updated information based on national and international research, seeking to guarantee the strengthening of actions within the scope health policies, and based on international protocols.

Em março/2020, a Organização Mundial da Saúde emitiu a declaração de pandemia, em decorrência da disseminação do vírus SARS-Cov-2, disparando o alerta mundial sobre a necessidade de rápida expansão da capacidade de vigilância, prevenção e implementação das estruturas de assistência dos sistemas de saúde dos países. No dia seguinte a declaração do Ministério da Saúde que reconheceu a transmissão comunitária no Brasil, um grupo de pesquisadores foi convidado a reunir evidências científicas e melhores práticas de SMAPS na COVID-19. Foram selecionados 1.563 artigos que se referiam à saúde mental e/ou atenção psicossocial em contextos de emergências sanitárias. Participaram pesquisadores, docentes e voluntários de 25 instituições reconhecidas pelo notório saber, totalizando um montante de 117 profissionais voluntários. Optou-se por conformar um curso nacional na modalidade de Educação a distância. Ao todo 60.780 profissionais ingressaram no curso nos primeiros 30 dias de inscrição. A modelagem online, síncrona e assíncrona, possibilitou a formação durante período de distanciamento social, e também permitiu que profissionais de todos os estados, e do Distrito Federal, pudessem ter acesso a informações atualizadas e baseadas em pesquisas nacionais e internacionais, buscando garantir o fortalecimento das ações no âmbito das políticas de saúde, e com base nos protocolos internacionais.

The experience with volunteer and collaborative work in mental health and psychosocial care during the COVID-19 pandemic. / A experiência do trabalho voluntário e colaborativo em saúde mental e atenção psicossocial na COVID-19.

Brazil is the country of the world with the second most COVID-19 cases and deaths, and the pandemic's impacts pose multiple challenges for mental health. This paper reports on experience with the emergency organization of the volunteer and collaborative Working Group (GT, in Portuguese) on mental health and psychosocial care aimed at producing rapid responses for health services in the context of COVID-19. The study involved the identification and systematization of current evidence in the scientific literature on mental health and psychosocial care in public health emergencies and pandemics, with the establishment of a network involving 117 researchers and 25 institutions, and the organization of themes for the elaboration of materials, referenced on the response phases in public health emergencies and pandemics. In less than 60 days, 18 technical documents were produced, ranging from services organization and management for different vulnerable groups. The materials became references in health institutions and services. A national course on mental health and psychosocial care in COVID-19 was also organized, with more than 60,000 people registered. The experience provides food for thought and a contribution for future experiences involving knowledge translation in the current pandemic and in future public health emergencies and pandemics, with the following: (1) combination of volunteer and collaborative work involving professionals with experience in the organization of services and care in past events; (2) reliance on institutional support and resources; (3) speed and credibility of work involving the establishment of networks of professionals and institutions; and (4) responses to the urgent needs with the capacity to shape paths for care in mental health and psychosocial care.

O Brasil é um dos países com maior número de casos e óbitos na pandemia por COVID-19, e seus impactos representam múltiplos desafios para a saúde mental. Esta comunicação relata a experiência de conformação emergencial do Grupo de Trabalho (GT) voluntário e colaborativo em saúde mental e atenção psicossocial, com objetivo de fornecer respostas rápidas aos serviços de saúde no contexto da COVID-19. O trabalho envolveu a identificação e sistematização de evidências atualizadas da literatura científica sobre saúde mental e atenção psicossocial em situações de emergências em saúde pública e pandemias, a constituição de uma rede envolvendo 117 pesquisadores e 25 instituições, além da organização de temas para elaboração de materiais, tendo como referência as fases de resposta em emergências em saúde pública e pandemias. Em menos de 60 dias foram publicados 18 documentos técnicos norteadores, englobando desde a organização e gestão dos serviços voltados aos diferentes grupos vulneráveis, ações que se tornaram referência em instituições e serviços de saúde, tendo sido também lançado um curso nacional sobre saúde mental e atenção psicossocial na COVID-19, com mais de 60 mil inscritos. Da experiência, são destacados tópicos para reflexão e contribuição para futuras ações, envolvendo translação do conhecimento nesta e em próximas emergências em saúde pública e pandemias: (1) combinar o trabalho voluntário e colaborativo com o envolvimento de profissionais experientes na organização de serviços e atenção em eventos passados; (2) contar com o suporte e recursos institucionais; (3) envolver a constituição de redes de profissionais e instituições para atingir rapidez e credibilidade no trabalho; (4) para as respostas às necessidades urgentes, deve-se envolver também a capacidade de moldar caminhos para a atenção e os cuidados em saúde mental e atenção psicossocial.

Brasil es uno de los países con mayor número de casos y óbitos en la pandemia por COVID-19 y sus impactos representan múltiples desafíos para la salud mental. Esta comunicación relata la experiencia de conformación de emergencia del Grupo de Trabajo (GT) voluntario y colaborativo en salud mental y atención psicosocial, con el objetivo de proporcionar respuestas rápidas a los servicios de salud en el contexto de la COVID-19. El trabajo implicó la identificación y sistematización de evidencias actualizadas de la literatura científica sobre salud mental y atención psicosocial en situaciones de emergencias en salud pública y pandemias, la constitución de una red implicando a 117 investigadores y 25 instituciones, la organización de temas para la elaboración de materiales, teniendo como referencia las fases de respuesta en emergencias en salud pública y pandemias. En menos de 60 días se publicaron 18 documentos técnicos orientativos, desde la organización de los servicios y gestión de los servicios a los diferentes grupos vulnerables, que se convirtieron en referencia en instituciones y servicios de salud, así como el lanzamiento de un curso nacional sobre salud mental y atención psicosocial en la COVID-19, con más de 60 mil inscritos. De la experiencia se destacan temas para reflexión y contribución para futuras experiencias, implicando translación del conocimiento en esta y en futuras emergencias en salud pública y pandemias: (1) combinar el trabajo voluntario y colaborativo con la implicación profesionales con experiencia en la organización de servicios y atención en eventos pasados; (2) contar con el apoyo y recursos institucionales; (3) la rapidez y la credibilidad del trabajo implica la constitución de redes de profesionales e instituciones; (4) las respuestas a las necesidades urgentes deben implicar también la capacidad de moldear caminos para la atención y los cuidados en salud mental y atención psicosocial.

Molecular mechanism of action of new 1,4-naphthoquinones tethered to 1,2,3-1H-triazoles with cytotoxic and selective effect against oral squamous cell carcinoma.

The oral squamous cell carcinoma (OSCC) stands out as a public health problem due to its high incidence and low survival rate, despite advances in diagnosis and treatment. Moreover, the most commonly chemotherapeutic agents for OSCC, such as carboplatin and cisplatin, generate important side effects, evidencing the urgency in developing new drugs. Naphthoquinones are an important class of natural products or synthetic compounds with cytotoxic effect demonstrated on different cancer types. In the present study, thirty-five 1,4-naphthoquinones tethered to 1,2,3-1H-triazoles were synthesized and the antitumor activity and molecular mechanisms were evaluated in several assays including in vitro and in vivo models of OSCC and normal oral human cells. Compounds 16a, 16b and 16 g were able to induce cytotoxicity in three different tumor cell lines of human OSCC (SCC4, SCC9 and SCC25) and were more toxic and selective to tumor cells (Selective Index, SI > 2) than classical and chemically similar controls (Carboplatin and Lapachol). Compound 16 g showed the higher SI value. Besides, compounds 16a, 16b and 16 g significantly reduced colony formation of SCC9 cells in the tested concentrations. Hemolytic assay using compounds 16a, 16b and 16 g at high concentrations showed no compound exhibited hemolysis higher than 5%, similar to controls. In vivo acute toxicity study showed that 16 g was the only one, among the three compounds, with no apparent limiting toxic effects on mice in the tested concentrations. Thus, the investigation of cell death mechanisms was conducted with this compound. 16 g does not trigger ROS production nor binds to DNA. On the other hand, compound 16 g induced microtubule disorganization, and molecular modeling studies suggests a potential mechanism of action related to inhibition of topoisomerases and/or hPKM2 activities. Cell morphology, pyknotic nuclei presence, cleaved caspase-3 staining and viability assays using caspase-3 inhibitors demonstrate compound 16 g induced cell death through apoptosis. Among the 35 synthesized triazole naphthoquinones, compound 16 g was the most effective compound against OSCC cells, presenting high cytotoxicity (~35 µM), selectivity (SI ~ 6) and low acute toxicity on animals, and therefore might be considered for future cancer therapy.