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Objetivo: Apresentar reflexões sobre a consecução de uma pesquisa com a temática da mobilidade urbana cotidiana, realizada a partir dos pressupostos teórico-metodológicos do materialismo histórico-dialético em terapia ocupacional social. Síntese dos elementos do estudo: Contextualiza-se a pesquisa e seus referenciais teóricos, sua metodologia de construção e análise dos dados. Finaliza-se refletindo sobre o processo da pesquisa, suas implicações e o materialismo-histórico na terapia ocupacional social. Conclusão: O destaque à abordagem dialética materialista-histórica em pesquisas pode contribuir para o fortalecimento do arcabouço teórico da terapia ocupacional, informando práticas profissionais técnicas, éticas e políticas, para que oferte respostas efetivas às demandas contemporâneasPalavras-chave: Terapia Ocupacional Social. Materialismo-histórico. Direito à Cidade. Mobilidade Urbana Cotidiana. Pesquisa Abstract Objective: To present reflections achieved in research about everyday urban mobility carried out from the theoretical-methodological background of historical-dialectical materialism, emphasizing social occupational therapy. Synthesis of the study's elements: The research and its theoretical references, its methodology of construction and data analysis are contextualized. It ends by reflecting on the research process, its implications and historical materialism in social occupational therapy. Conclusion: The dialectical historical materialism in research contributes to consolidate the theoretical framework of occupational therapy, informing technical, ethical, and political professional practices, so that it can effectively respond to contemporary demands.Keywords: Social Occupational Therapy. Historical Materialism. Right to the City. Daily Urban Mobility. ResearchResumenObjetivo: Presentar reflexiones sobre la realización de una investigación sobre el tema de la movilidad urbana cotidiana realizada a partir de los presupuestos teórico-metodológicos del materialismo histórico-dialéctico en terapia social ocupacional. Síntesis de los elementos del estudio: Se contextualiza la investigación y sus referentes teóricos, su metodología de construcción y análisis de datos. Finaliza reflexionando sobre el proceso de investigación, sus implicaciones e histórico-materialismo en la terapia ocupacional social. Conclusión: Enfatizar el enfoque dialéctico materialista-histórico en la investigación puede contribuir a fortalecer el marco teórico de la terapia ocupacional, informando prácticas profesionales técnicas, éticas y políticas, para que ofrezca respuestas efectivas a las demandas contemporáneas.Palabras clave: Terapia Social Ocupacional. Materialismo Histórico. Derecho a la Ciudad. Movilidad Urbana Diaria. Investigación

Neurodegenerative diseases are often caused by uncontrolled amyloid aggregation. Hence, many drug discovery processes are oriented to evaluate new compounds that are able to modulate self-recognition mechanisms. Herein, two related glycoconjugate pentacoordinate Pt(II) complexes were analyzed in their capacity to affect the self-aggregation processes of two amyloidogenic fragments, Aβ21-40 and Aβ25-35, of the C-terminal region of the β-amyloid (Aβ) peptide, the major component of Alzheimerʼs disease (AD) neuronal plaques. The most water-soluble complex, 1Ptdep, is able to bind both fragments and to deeply influence the morphology of peptide aggregates. Thioflavin T (ThT) binding assays, electrospray ionization mass spectrometry (ESI-MS), and ultraviolet-visible (UV-vis) absorption spectroscopy indicated that 1Ptdep shows different kinetics and mechanisms of inhibition toward the two sequences and demonstrated that the peptide aggregation inhibition is associated with a direct coordinative bond of the compound metal center to the peptides. These data support the in vitro ability of pentacoordinate Pt(II) complexes to inhibit the formation of amyloid aggregates and pave the way for the application of this class of compounds as potential neurotherapeutics.

A matéria orgânica do solo (MOS) exerce papel fundamental para a sustentabilidade de ecossistemas florestais. O estudo das frações da MOS possibilita avaliar a qualidade do solo sob florestas nativas ou plantadas. O objetivo dessa pesquisa foi comparar o carbono orgânico sob mata nativa e florestas plantadas, em longo prazo. Foram avaliados os estoques de carbono orgânico total (COT), as frações leve (COL) e pesada (COP) e o índice de manejo do carbono (IMC) da camada superficial de Latossolo Vermelho distroférrico, sob plantios de quatro espécies de eucaliptos australianos - Eucalyptus grandis, E. pilularis, E. cloeziana e Corymbia maculata - e Pinus caribaea var. hondurensis, com 40 anos de idade, e sob Floresta Estacional Semidecidual. C. maculata manteve estoques de COT, COP e de COL e o IMC em níveis similares aos encontrados sob a mata nativa, sendo considerada a espécie mais eficiente na ciclagem e estocagem de carbono no solo, seguida por E. cloeziana. E. pilularis e o pinus apresentaram os menores estoques de carbono e IMC.

Lobar atelectasis may be a complication of pulmonary exacerbations in cystic fibrosis (CF). There are no established guidelines on the management of this condition in patients with CF. Therapeutic bronchoscopy with recombinant human deoxyribonuclease (rhDNase) instillation has been described to be successful in patients not responding to conservative measures. We describe a case of a young man with CF, with previously mild impaired lung function, presenting with cough, desaturation, and worsening dyspnea, persisting for over 6 weeks, despite conservative therapy. Thoracic imaging showed right lower lobe atelectasis, which was successfully treated with bronchoscopy and instillation of rhDNase. Long-term resolution of the atelectasis was confirmed with chest magnetic resonance imaging follow-up.

No methods exist to rapidly and accurately quantify the immune insult created by burn injuries. The development of a rapid, noninvasive clinical biomarker assay that evaluates a burn patient's underlying immune dysfunction and predicts clinical outcomes could transform burn care. We aimed to determine a set of peripheral biomarkers that correlates with clinical outcomes of burn patients.This prospective observational study enrolled two patient cohorts within a single burn center into an institutionally approved institutional review board study. Blood draws were performed48 hours after injury. Initial unbiased immune gene expression analysis compared 23 burn patients and 6 healthy controls using multiplex immune gene expression analysis of RNA from peripheral blood mononuclear cells. We then performed confirmatory outcomes analysis in 109 burn patients and 19 healthy controls using a targeted rapid quantitative polymerase chain reaction. Findings were validated and modeled associations with clinical outcomes using a regression model.A total of 149 genes with a significant difference in expression from burn patients compared with controls were identified. Pathway analysis identified pathways related to interleukin (IL)-10 and inducible nitric oxide synthase signaling to have significant z scores. quantitative polymerase chain reaction analysis of IL-10, IL-12, arginase 1 (ARG1), and inducible nitric oxide synthase demonstrated that burn injury was associated with increased expression of ARG1 and IL-10, and decreased expression of nitric oxide synthase 2 (NOS2) and IL-12. Burn severity, acute lung injury, development of infection, failure of skin autograft, and mortality significantly correlated with expression of one or more of these genes. Ratios of IL-10/IL-12, ARG1/NOS2, and (ARG1-IL-10)/(NOS2-IL-12) transcript levels further improved the correlation with outcomes. Using a multivariate regression model, adjusting for patient confounders demonstrated that (ARG1-IL-10)/(NOS2-IL-12) significantly correlated with burn severity and development of acute lung injury.We present a means to predict patient outcomes early after burn injury using peripheral blood, allowing early identification of underlying immune dysfunction.Prognostic/Epidemiological; Level II.

Background: Manouguian aortic root enlargement (ARE) has been a standard root enlargement procedure to assist in patients with a small annular size. We describe a modification to the Manouguian ARE similar to Yang et al. This approach could serve as an alternate technique for performing ARE; to date only case reports have defined this approach and no studies have evaluated its efficacy or safety. Methods: A retrospective case series was performed on patients who underwent ARE for surgical aortic valve replacement via the modified Manouguian procedure at a single institution. Thirteen patients were identified between 2015-2021, and all surgeries were performed by a single operator. Data were collected via the Society of Thoracic Surgeons database and chart review. The primary outcome was difference in valve size after the procedure. Results: The most common indication for surgery was aortic stenosis (12, 92%), with the most common etiology being degenerative calcification (7, 54%). Congenital bicuspid or uni-cuspid valves were identified in 5 (38%) patients. The majority (10, 77%) of patients received a mechanical valve. This procedure was successfully performed in all 13 of the patients. Additionally, 13 of the 13 patients (100%) were upsized to a satisfactory valve size based on pre-operative echocardiography sizing. Conclusions: The modified Manouguian aortic enlargement technique can be safely and effectively used as an aortic enlargement procedure in a broad sample of patients.

Background. A growing body of occupational therapy knowledge and practice focuses not on health but on social transformation, and couples occupational therapy with community development. A tension in both these fields is the disconnect between what practitioners espouse and what they do, limiting the potential of practice. To address this, practitioners are encouraged to engage in praxis—the critical synthesis of theory and practice. Purpose. To explore whether and how Australian occupational therapy-community development practitioners engage in critical praxis. Method. A critical dialogical method was employed to complete multiple in-depth interviews with four occupational therapy-community development practitioners. Interviews were transcribed and analyzed using thematic analysis. Findings. Practitioners appeared capable of praxis but were not consistently employing it. Findings were grouped into themes: disjointed praxis, authentic praxis, supporting praxis, and praxis challenges and solutions. Implications. Occupational therapists need to be supported to develop, use, and maintain skills in critical praxis.

Bee pollen, a natural resource collected by bees, is rich in many nutrients, therefore it may represent a useful dietary supplement. Different uses of bee pollen are proposed due to its beneficial health properties, which includes the capacity to improve animal performance and promote immunostimulation. Animal nutrition can directly affect adults and their offspring, and larval stage is a critical moment for fish due to high mortality related to immune challenges. Thus, the present study attempted to evaluate the effects of adding bee pollen to a zebrafish diet, specifically, analyzing the effects on reproduction and immunity transference to descendants. Zebrafish adults received control diets based on commercial flakes and live food Artemia sp. nauplii or bee pollen-supplemented diets, administered three times a day, at the same time. The animals received the diets over 60 d, and throughout this period, they were tested for: egg production per female, total number of eggs, embryo viability rate, larval survival rate after exposure to spring viremia of carp virus and to Salmonella enterica serovar Typhimurium, and larval neutrophil recruitment after tail wounding. Bee pollen supplementation failed to improve egg production and embryo viability, and was unable to substitute flakes in zebrafish breeders. Instead, the offspring of breeders fed with bee pollen supplemented diets showed longer survival upon virus exposure and higher neutrophil migration to wounds. These results indicate that bee pollen can influence vertical immunity through important mechanisms related to offspring immunity in the early stages, when larval immune system is not fully developed.

PURPOSE Despite advances in palliative care in Uganda, there has been relatively little recent patient-centered research investigating end-of-life outcomes in this region. We assessed the quality of dying and death of patients with cancer in hospice care in Uganda. METHODS Bereaved caregivers of patients who received hospice care in Uganda and died 2-12 months earlier (N = 201) completed the Quality of Dying and Death Questionnaire, which includes 31 items and single-item ratings of overall quality of dying and moment of death, and the FAMCARE measure of family satisfaction with cancer care. RESULTS Caregivers reported low-intermediate overall quality of dying (mean [M] standard deviation [SD], 3.25 [2.98]) and overall quality of moment of death (M [SD], 3.59 [3.51]), with 47.0% of the ratings of these two outcomes in the poor range, but the mean family satisfaction with care was high (M [SD], 77.75 [10.26]). Most Quality of Dying and Death Questionnaire items (74.2%) were rated within the intermediate range. Items rated within the good range were religious-spiritual, interpersonal, and personal facets; two items within the poor range reflected physical functioning. Overall quality of dying was most strongly correlated with pain control (Spearman's rho [rs] = 0.45, P < .001), and overall quality of moment of death with state of consciousness before death and being unafraid of dying (rs = 0.42, P < .001). The FAMCARE score was not correlated with overall quality of dying or moment of death ( P = .576-.813). Only one FAMCARE item, information on managing patient's pain, was correlated with overall quality of moment of death (rs = –0.19, P = .008). CONCLUSION End-of-life care in hospices in Uganda requires further improvement, particularly with regard to symptom control. Patient-centered data could bolster advocacy efforts to support quality improvement of palliative care in this and other countries.

Considering that occupational therapy practices act in spaces of daily life where there is a plurality of existences, it is imperative to build heterogeneous practices from the historical-social contexts that produce them. In South America, debates have emerged that challenge the prevailing north-Eurocentric and Anglocentric discourse due to its claim to universality, objectivity, and neutrality, bringing with its positivist scientific reasoning and dualistic logic. This article aims to present seven debates identified in some of the written productions of Brazil, Argentina, Colombia, and Chile between 2010-2018, both in older occupational therapy journals in the region and in books of collective authorships that discuss occupational therapy. A mapping of controversies is carried out through a documentary review and analysis of 133 journal articles and 53 book chapters. The issues they discuss are related to occupational therapy practices around the social; communities and territories; human rights; knowledge and knowledge production; the critical; gender and feminisms; and Latin America and the global south. It is possible to conclude that each debate condenses different historical moments, from which plural and unfinished forms of occupational therapy are produced that make visible controversial issues that have given them richness and heterogeneity, allowing to stress the asymmetries of power and give political relevance to the practices that are produced from South America for the local-global context.

ObjectivesDeath anxiety (DA), a condition characterized by fear, angst, or panic related to the awareness of one’s own death, is commonly observed in advanced cancer patients. The aim of this study was to examine the psychometric properties of the Italian version of the Death and Dying Distress Scale (DADDS-IT) in a sample of patients with advanced cancer.MethodsThe sample included 200 Italian advanced cancer patients meeting eligibility criteria to access palliative care. Patients’ levels of DA were assessed by using the DADDS-IT, while the levels of depression, anxiety, demoralization, spiritual well-being, and symptom burden were assessed using the Patient Health Questionnaire-9, the Generalized Anxiety Disorder-7, the Demoralization Scale, the Functional Assessment of Chronic Illness Therapy–Spiritual Well-Being Scale, and the Edmonton Symptom Assessment System, respectively; Karnofsky Performance Status was used to measure functional impairment. Confirmatory factor analyses (CFA) of previous structures and exploratory factor analyses (EFA) were conducted.ResultsCFA revealed that none of the previous structures adequately fitted data from our sample. EFA revealed a 4-factor model comprising Finitude (α = 0.91), Regret (α = 0.86), Dying (α = 0.88), and Relational Burden (α = 0.73), accounting for the 77.1% of the variance. Dying subscore was higher in hospice patients than in those recruited in medical wards.Significance of resultsThe present study provides further evidence that DA is a condition that deserves attention and that DADDS-IT shows good psychometric properties to support its use in research and clinical settings.

IntroductionThe diagnosis, progression or recurrence of cancer is often highly traumatic for family caregivers (FCs), but systematic assessments of distress and approaches for its prevention and treatment are lacking. Acute leukaemia (AL) is a life-threatening cancer of the blood, which most often presents acutely, requires intensive treatment and is associated with severe physical symptoms. Consequently, traumatic stress may be common in the FCs of patients with AL. We aim to determine the prevalence, severity, longitudinal course and predictors of traumatic stress symptoms in FCs of patients with AL in the first year after diagnosis, and to understand their lived experience of traumatic stress and perceived support needs.Methods and analysisThis two-site longitudinal, observational, mixed methods study will recruit 223 adult FCs of paediatric or adult patients newly diagnosed with AL from two tertiary care centres. Quantitative data will be collected from self-report questionnaires at enrolment, and 1, 3, 6, 9 and 12 months after admission to hospital for initial treatment. Quantitative data will be analysed using descriptive and machine learning approaches and a multilevel modelling (MLM) approach will be used to confirm machine learning findings. Semi-structured qualitative interviews will be conducted at 3, 6 and 12 months and analysed using a grounded theory approach.Ethics and disseminationThis study is funded by the Canadian Institutes of Health Research (CIHR number PJT 173255) and has received ethical approval from the Ontario Cancer Research Ethics Board (CTO Project ID: 2104). The data generated have the potential to inform the development of targeted psychosocial interventions for traumatic stress, which is a public health priority for high-risk populations such as FCs of patients with haematological malignancies. An integrated and end-of-study knowledge translation strategy that involves FCs and other stakeholders will be used to interpret and disseminate study results.

The role exerted by the nucleus in the regulation of proteostasis in both health and disease is recognized of outmost importance, even though not fully understood. Many recent investigations are focused on its ability to modulate and coordinate protein quality control machineries in mammalian cells. Nucleophosmin 1 (NPM1) is one of the most abundant nucleolar proteins and its gene is mutated in ~30% of Acute Myeloid Leukemia (AML) patients. Mutations are localized in the C-terminal domain of the protein and cause cytoplasmatically delocalized and possibly aggregated forms of NPM1 (NPM1c+). Therapeutic interventions targeted on NPM1c+ are in demand and, to this end, deeper knowledge of NPM1c+ behavior in the blasts' cytosol is required. Here by means of complementary biophysical techniques we compared the conformational and aggregative behavior of the entire C-terminal domains of NPM1wt and type A NPM1c+ (bearing the most common mutation). Overall data show that only Cterm_mutA is able to form amyloid-like assemblies with fibrillar morphology and that the oligomers are toxic in human neuroblastoma SHSY cells. This study adds a novel piece of knowledge to the comprehension of the molecular roles exerted by cytoplasmatic NPM1c+ and suggests the exploitation of the amyloidogenic propensity of NPM1c+ as a new strategy for targeting AML with NPM1 mutations.

BackgroundThymic epithelial tumors (TETs) are frequently accompanied by Good Syndrome (GS), a rare immunodeficiency, characterized by hypogammaglobulinemia and peripheral B cell lymphopenia. TETs can be also associated to other immunological disorders, both immunodeficiency and autoimmunity.MethodsIn this study, we enrolled TET patients with GS to address differences between patients with or without associated autoimmune diseases (AD). We analyzed the immunophenotype from peripheral blood of these patients focusing on selected immune cell subsets (CD4+T cells, CD8+T cells, T regulatory cells, NK cells, B-cells, monocytes, eosinophils, basophils, neutrophils) and serum levels of cytokines, chemokines and growth factors.ResultsWe observed higher number of leucocytes, in particular lymphocytes, B lymphopenia and lower number of T regulatory cells in TET patients with associated AD compared to TET patients without AD. In the group of TET patients with AD, we also observed increased serum levels of IL-15, VEGF, IP-10, GM-CSF, IL-6, and MIP-1α. Thus, we identified considerable differences in the lymphocyte profiles of TET patients with and without ADs, in particular a reduction in the numbers of B lymphocytes and T-regulatory cells in the former, as well as differences in the serum levels of various immune modulators.ConclusionsAlthough the pathogenic mechanisms are still unclear, our results add new knowledge to better understand the disease, suggesting the need of surveilling the immunophenotype of TET patients to ameliorate their clinical management.

BACKGROUND Wandering spleen (WS) is a rare medical condition in which the spleen migrates from its usual position commonly to the pelvis or lower abdomen assuming an ever-wandering state. The incidence of ectopic spleen is 0.2%, with variable clinical manifestations from asymptomatic to abdominal emergency. Symptoms are most attributed to complications related to torsion, so that a nonoperative management of a WS is not advised. According to the literature, 69.5% of patients with WS need splenectomy and 78.6% need laparotomy. CASE REPORT The patient exhibited vague intermittent lower abdominal pain for 6 months due to progressive torsion of the spleen, which resulted in venous congestion. Abdominal investigation revealed a mobile intra-abdominal mass and parenchymatous consistency in the pelvis. Diagnosis by computed tomography outlined abdominal splenomegaly with abnormal position both of pancreas and stomach. Laparoscopy established a giant spleen, with a lengthened pelvic and twisty vascular pedicle. In its ectopic location, the spleen had dragged the pancreas with it, which had taken a vertical position. The classic splenic ligaments were not recognizable. Spleen was removed with median laparotomic incision. Splenectomy was performed to prevent any traumatic fractures of the spleen, a complete twist of the splenic hilum, and the onset of recurrent acute pancreatitis. CONCLUSIONS Wandering spleen is rare in patients presenting with acute abdominal pain. An approach supported by clinical findings and investigation, even considering splenectomy over splenopexy, and laparoscopy over open surgery, may solve and prevent complications and health risks.

In a protein, point mutations associated with diseases can alter the native structure and provide loss or alteration of functional levels, and an internal structural network defines the connectivity among domains, as well as aggregate/soluble states’ equilibria. Nucleophosmin (NPM)1 is an abundant nucleolar protein, which becomes mutated in acute myeloid leukemia (AML) patients. NPM1-dependent leukemogenesis, which leads to its aggregation in the cytoplasm (NPMc+), is still obscure, but the investigations have outlined a direct link between AML mutations and amyloid aggregation. Protein aggregation can be due to the cooperation among several hot spots located within the aggregation-prone regions (APR), often predictable with bioinformatic tools. In the present study, we investigated potential APRs in the entire NPM1 not yet investigated. On the basis of bioinformatic predictions and experimental structures, we designed several protein fragments and analyzed them through typical aggrsegation experiments, such as Thioflavin T (ThT), fluorescence and scanning electron microscopy (SEM) experiments, carried out at different times; in addition, their biocompatibility in SHSY5 cells was also evaluated. The presented data clearly demonstrate the existence of hot spots of aggregation located in different regions, mostly in the N-terminal domain (NTD) of the entire NPM1 protein, and provide a more comprehensive view of the molecular details potentially at the basis of NPMc+-dependent AML.

This invited commentary responds to ‘A Pledge to Mobilize Against Racism’ (Stanley et al., 2020), a position statement published by the Editorial Board of the Journal of Occupational Science (JOS) ...

Com base em uma perspectiva compreensiva da realidade, este estudo teve como objetivo analisar as representacoes que jovens moradores de uma favela brasileira tem sobre aquele local, com foco nos i...

G-quadruplexes (G4s) are nucleic secondary structures characterized by G-tetrads. G4 motif stabilization induces DNA damage and cancer cell death; therefore, G4-targeting small molecules are the focus of clinical investigation. DNA destabilization induced by G4 ligands might potentiate the anticancer activity of agents targeting DNA or inhibiting its repair such as oncolytic viruses. This study represents the first approach combining G4 ligands, BRACO-19 (B19), pyridostatin (PDS), and the adenovirus

The "Acute Myeloid Leukemia with gene mutations'' group includes mutations in Nucleophosmin 1(NPM1) that is an abundant multifunctional protein with chaperon functions. This protein also takes part to rRNA maturation in ribosome biogenesis, tumor suppression and nucleolar stress response. Mutations of NPM1 associated to AML present in its C-terminal domain (CTD) unable its correct folding and confer it an aberrant cytoplasmatic localization (NPMc+). AML cells with NPM1 mutations retain a certain amount of wt NPM1 in the nucleolus and since NPM1 acts as a hub protein, the nucleolus of AML cells are more vulnerable with respect to cells expressing only wt NPM1. Thus, interfering with the levels or the oligomerization status of NPM1 may influence its capability to properly build up the nucleolus in AML cells. Our biophysical recent results demonstrated that AML-CTDs contain regions prone to amyloid aggregation and, herein, we present results oriented to exploit this amylodogenesis in a potential therapeutic way. We evaluated the different ability of two small molecules to enhance amyloid aggregation through complementary biophysical approaches as fluorescence and Circular Dichroism spectroscopies, Scanning Electron Microscopy and cell-viability assays, to evaluate the cytoxicity of these molecules in AML cells lines. These findings could pave the way into molecular mechanisms of NPM1c and in novel therapeutic routes toward AML progression.

A body in the city A large exclusive city Phobic, racist, separatist, elitist city But Rio de Janeiro is still beautiful, isn’t it? It is not beautiful at all It is not normal (Matheusa Passarelli....

The termsTo understand the formation of the concepts ofA conceptual review of the specific literature in journals, databases and books published in Latin America between 1990 and July 2020. The two most frequently recurring authors of publications in each country were interviewed.74 publications were selected. The first definitions of these concepts date from the late 1990s. Dialogue with other areas of knowledge began in 2002.Although the terms are conceptually little developed, their use in occupational therapy in Latin America evidences the understanding that the singularity of people and groups is inseparable from their social history.Occupational therapy in Latin America has appropriated notions of

La pandemia causada por el SARS-CoV-2 ha demandado a todas las profesiones repensar y restructurar sus roles para lidiar con la COVID-19, asegurando y reafirmando la importancia de sus contribuciones frente a la complejidad de las exigencias del momento que vivimos. La Terapia Ocupacional ha venido participando de este proceso a través de diferentes iniciativas, centrando la atención en el cotidiano de las personas, quienes, en sus diferentes modos de vida, tienen en común la necesidad del distanciamiento social impuesto por la transmisión acelerada del virus y por las debilidades e imposibilidades de los sistemas de vigilancia sanitaria y epidemiológica de muchos países. No obstante, consideramos que nuestro rol es fundamental en el ámbito de la seguridad social, en consonancia con las políticas sociales y, especialmente, abordando importantes situaciones relacionadas con las inequidades sociales que impactan la vida de las personas, los grupos y las comunidades con quienes trabajamos, especialmente en Brasil.

The coffee crop hosts pests such as mites, mealybugs, and aphids which serve as food for the predator Chrysoperla externa (Hagen) (Neuroptera: Chrysopidae). The preservation of this chrysopid in coffee agroecosystem is very important to achieve sustainability of this agricultural sector, and can be obtained by applying low toxicity insecticides. The present study aimed to evaluate the susceptibility of C. externa to azadiracthin, chlorpyrifos, ethiprole and teflubenzuron. Predator eggs, third instar larvae, pupae and adults were exposed to insecticides by Potter tower spraying. When evaluating exposure of C. externa eggs we observed that chlorpyrifos, ethiprole and teflubenzuron reduced larvae hatching, while azadiracthin prolonged first instar duration. Meanwhile, the exposure of third instar larvae to chlorpyrifos and ethiprole caused mortality of all insects after 72 h, while azadiracthin prolonged the larval development time; we also observed that no compound allowed the formation of adults. After pupae were exposed to chlorpyrifos and teflubenzuron, it was observed a reduction on the emergence of adults, while the longevity of adults from these pupae and the evaluated reproductive parameters were reduced by all insecticides. For the bioassay with adults, chlorpyrifos, ethiprole and teflubenzuron reduced the longevity of insects, while the reproductive parameters evaluated were negatively affected after exposure to azadiracthin and teflubenzuron. It was concluded that all insecticides negatively affected at least one biological characteristic of the predator in at least one of the insect's developmental stages, requiring further research in semi-field and field conditions to prove its toxicity.

Based on a comprehensive perspective of reality, this study aimed to analyze the representations that young dwellers of a Brazilian favela have about that place, focusing on the impacts on urban mo...

1,8-naphthyridine-3-carboxamide structures were previously identified as a promising scaffold from which to obtain CB2R agonists with anticancer and anti-inflammatory activity. This work describes the synthesis and functional characterization of new 1,8-naphthyridin-2(1H)-one-3-carboxamides with high affinity and selectivity for CB2R. The new compounds were able to pharmacologically modulate the cAMP response without modulating CB2R-dependent β-arrestin2 recruitment. These structures were also evaluated for their anti-cancer activity against SH-SY5Y and SK-N-BE cells. They were able to reduce the cell viability of both neuroblastoma cancer cell lines with micromolar potency (IC50 of FG158a = 11.8 μM and FG160a = 13.2 μM in SH-SY5Y cells) by a CB2R-mediated mechanism. Finally, in SH-SY5Y cells one of the newly synthesized compounds, FG158a, was able to modulate ERK1/2 expression by a CB2R-mediated effect, thus suggesting that this signaling pathway might be involved in its potential anti-cancer effect.

We report the case of a patient with cystic fibrosis (CF) presenting with a full-blown cytokine storm syndrome probably triggered by infection. This condition is rare and the diagnosis can be particularly difficult in patients with a complex chronic disease such as CF. However, timely recognition and appropriate treatment in the early stages are key to avoiding a potentially fatal course.

Resumo A formação de redes como estratégia de ação técnica tem se caracterizado como uma temática amplamente defendida no bojo das políticas sociais, as quais são historicamente organizadas em setores e precisam ter suas atuações reorganizadas em vista das cada vez mais complexas demandas sociais. O trabalho em rede é compreendido como um recurso de enfrentamento à questão social e suas consequências, e como ferramenta para efetivação de propostas de intervenção junto à população assistida. A terapia ocupacional pode utilizar da criação e/ou fortalecimento das redes sociais como processos que buscam garantir maior autonomia e inserção social a pessoas ou grupos que vivenciam processos de ruptura em suas vidas. Objetivou-se investigar a estratégia de articulação intersetorial entre os serviços que compõem as políticas sociais em Campinas - SP como possível ferramenta de suporte, enfocando a atuação de terapeutas ocupacionais. Como método, 13 coordenadores distritais das áreas de assistência social, educação e saúde foram entrevistadas e 17 das 36 terapeutas ocupacionais (47%) que atuam na rede municipal responderam a um questionário. Além disso, observou-se duas redes institucionais por quatro meses. Por fim, nove terapeutas ocupacionais participaram de um encontro presencial para discutir sua experiência e papel nas redes. Aqui analisam-se os dados dos questionários e grupo com as profissionais. Conclui-se que, considerando a centralidade da (re)inserção social como objetivo da terapia ocupacional, somada a características como disponibilidade e flexibilidade, o fomento de redes intersetoriais é integrado ao seu trabalho; contudo, essa não pode ser considerada uma ação profissional específica ou exclusiva. Abstract The formation of networks as a strategy for professional action is a broadly advocated theme within the framework of social policies, which have been historically organized in sectors and need to have their actions reorganized in view of the increasingly complex social demands. Networking is understood as a resource to confront the social question and its consequences, and as a tool for effecting proposals for professional intervention. Occupational therapy can use the creation and/or strengthening of social networks as processes that seek to ensure greater autonomy and social insertion to individuals or groups who are experiencing processes of rupture in their lives. This study aimed to investigate the strategy of forming intersectoral networks between the services that comprise social policies in the municipality of Campinas, state of São Paulo, Brazil, as a possible support tool focusing on the work of occupational therapists. As a method, 13 district coordinators from the social assistance, education and health areas were interviewed and a questionnaire was applied to 17 of the 36 occupational therapists (47%) working in the municipal network. In addition, two institutional networks were observed for four months. Finally, nine occupational therapists participated in a face-to-face meeting to discuss their experience and role in networks. Here, the data from the questionnaires and the group with the professionals are analyzed. In conclusion, considering the centrality of social (re)insertion as an objective of the occupational therapists, in addition to characteristics such as availability and flexibility, the promotion of intersectoral networks is a part of this work; however, this cannot be considered a specific or exclusive professional action.

The formation of networks as a strategy for professional action is a broadly advocated theme within the framework of social policies, which have been historically organized in sectors and need to have their actions reorganized in view of the increasingly complex social demands. Networking is understood as a resource to confront the social question and its consequences, and as a tool for effecting proposals for professional intervention. Occupational therapy can use the creation and/or strengthening of social networks as processes that seek to ensure greater autonomy and social insertion to individuals or groups who are experiencing processes of rupture in their lives. This study aimed to investigate the strategy of forming intersectoral networks between the services that comprise social policies in the municipality of Campinas, state of São Paulo, Brazil, as a possible support tool focusing on the work of occupational therapists. As a method, 13 district coordinators from the social assistance, education and health areas were interviewed and a questionnaire was applied to 17 of the 36 occupational therapists (47%) working in the municipal network. In addition, two institutional networks were observed for four months. Finally, nine occupational therapists participated in a face-to-face meeting to discuss their experience and role in networks. Here, the data from the questionnaires and the group with the professionals are analyzed. In conclusion, considering the centrality of social (re)insertion as an objective of the occupational therapists, in addition to characteristics such as availability and flexibility, the promotion of intersectoral networks is a part of this work; however, this cannot be considered a specific or exclusive professional action. A formação de redes como estratégia de ação técnica tem se caracterizado como uma temática amplamente defendida no bojo das políticas sociais, as quais são historicamente organizadas em setores e precisam ter suas atuações reorganizadas em vista das cada vez mais complexas demandas sociais. O trabalho em rede é compreendido como um recurso de enfrentamento à questão social e suas consequências, e como ferramenta para efetivação de propostas de intervenção junto à população assistida. A terapia ocupacional pode utilizar da criação e/ou fortalecimento das redes sociais como processos que buscam garantir maior autonomia e inserção social a pessoas ou grupos que vivenciam processos de ruptura em suas vidas. Objetivou-se investigar a estratégia de articulação intersetorial entre os serviços que compõem as políticas sociais em Campinas - SP como possível ferramenta de suporte, enfocando a atuação de terapeutas ocupacionais. Como método, 13 coordenadores distritais das áreas de assistência social, educação e saúde foram entrevistadas e 17 das 36 terapeutas ocupacionais (47%) que atuam na rede municipal responderam a um questionário. Além disso, observou-se duas redes institucionais por quatro meses. Por fim, nove terapeutas ocupacionais participaram de um encontro presencial para discutir sua experiência e papel nas redes. Aqui analisam-se os dados dos questionários e grupo com as profissionais. Conclui-se que, considerando a centralidade da (re)inserção social como objetivo da terapia ocupacional, somada a características como disponibilidade e flexibilidade, o fomento de redes intersetoriais é integrado ao seu trabalho; contudo, essa não pode ser considerada uma ação profissional específica ou exclusiva.

Peptide hydrogels, deriving from natural protein fragments, present unique advantages as compatibility and low cost of production that allow their wide application in different fields as wound healing, cell delivery and tissue regeneration. To engineer new biomaterials, the change of the chirality of single amino acids demonstrated a powerful approach to modulate the self-assembly mechanism. Recently we unveiled that a small stretch spanning residues 268–273 in the C-terminal domain (CTD) of Nucleophosmin 1 (NPM1) is an amyloid sequence. Herein, we performed a systematic D-scan of this sequence and analyzed the structural properties of obtained peptides. The conformational and kinetic features of self-aggregates and the morphologies of derived microstructures were investigated by means of different biophysical techniques, as well as the compatibility of hydrogels was evaluated in HeLa cells. All the investigated hexapeptides formed hydrogels even if they exhibited different conformational intermediates during aggregation, and they structural featured are finely tuned by introduced chiralities.

ObjectivesThe Clinical Evaluation Questionnaire (CEQ) is a patient-reported experience measure (PREM) that assesses the perceived benefit of therapeutic interactions of patients with advanced cancer with their healthcare providers concerning issues relevant to their illness. It was developed for a randomised controlled trial of Managing Cancer and Living Meaningfully (CALM), a brief supportive-expressive therapy for patients with advanced cancer. The present study evaluates the preliminary psychometric properties of the CEQ.MethodPatients in the CALM and usual care groups completed the CEQ 3 (n=195) and 6 (n=186) months after randomisation. The CEQ’s internal consistency, factor structure and concurrent validity were evaluated, and CEQ scores in the treatment groups were compared.ResultsThe CEQ demonstrated high internal consistency for both treatment arms (Cronbach’s α=0.94 to 0.95), and a single factor was consistently found in exploratory factor analyses. CEQ scores correlated significantly with satisfaction with the relationship with healthcare providers (r=0.23 to 0.61, p≤0.02) and life completion (r=0.24 to 0.37, p≤0.02) in both groups and with spiritual well-being in the CALM group (meaning: r=0.23 to 0.24, p=0.01 to 0.02; faith: r=0.24 to 0.34, p=0.001 to 0.02). The CALM group showed higher CEQ total scores than usual care at 6 months (CALM: 18.19±6.59; usual care: 14.36±7.67, pConclusionsThe CEQ is a reliable and valid PREM of the benefit perceived by patients with advanced cancer from their interactions with healthcare providers. Further study is needed to establish its value as a measure of perceived intervention benefit across different clinical and research settings.

Issue/problem People with disabilities are disproportionately exposed to the risks of COVID-19, due to underlying health conditions, as well as on account of mechanisms introduced as a response to COVID-19. This study examines the disability inclusiveness of government measures to COVID-19 in Brazil and Chile. With more than one billion people with disabilities worldwide, it is important to examine the inclusiveness of official government responses, in order to protect and mitigate the impacts of the pandemic for this population. Description of the problem Government responses have a direct impact on the capacity of people with disabilities to protect themselves against health-related, economic, and social consequences of the pandemic. In order to examine official measures, we conducted documentary research, using framework analysis, and studied official documents published from February 1st, 2020 until June 30th, 2021. The aim was to explore the inclusiveness of government responses in areas such as access to healthcare, and social welfare. Results We analysed 41 documents in total. The findings highlight that while both countries took steps to ensure access to healthcare, and relevant information, as well as financial support, they also implemented policies - or did not undertake any at all - that often resulted in an amplification of existing inequalities. Neither country included people with disabilities and their organisations in decision-making processes. Lessons This study illustrates how oficial government responses taken by Brazil and Chile - while positive, in several aspects - do not fully address the needs of people with disabilities. In order to ensure response to COVID-19 is disability-inclusive, it is necessary to translate recommendations into practice, consider people with disabilities both in mainstream policy and in disability-specific measures, and focus on the long-term reconstruction phase. Key messages People with disabilities are particularly exposed to the risks of and responses to COVID-19. Inclusive measures have been adopted but the needs of this population have not been fully addressed.

Orientadores: Newton Antonio Paciulli Bryan, Roseli Esquerdo Lopes Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Educação Resumo: O presente trabalho dedica-se à investigação da implementação de dois programas sociais em uma região empobrecida da cidade de São Paulo (região do Brás e Belém), caracterizada pela presença de cortiços, ex-cortiços, e pela atuação do movimento social de luta por moradia urbana. Pretende-se conhecer e apreender a política de saúde firmada pela Prefeitura de São Paulo, através do Programa de Saúde da Família (PSF), para o qual são previstas ações de Agentes Comunitários de Saúde ACS), pessoas da própria comunidade que integram a equipe do PSF. Tem-se, na região, a atuação de cinco ACS, sendo três deles membros do movimento de moradia. Investiga-se o processo de educação popular envolvido no trabalho dos Agentes Comunitários, a sua compreensão sobre o programa pelo qual são responsáveis pela execução nas comunidades, e como lidam com problemáticas para além do campo da saúde. Articuladamente, estuda-se o Projeto Casarão ¿ Centro de Cultura e Convivência Celso Garcia, que se caracterizou como uma parceria entre a comunidade e a Universidade, para a atenção a infância e juventude. O projeto foi desenvolvido entre os de 1999 e 2002. Como procedimentos metodológicos realizou-se entrevistas com atores envolvidos nos dois programas e utilizou-se da observação participante. No Projeto Casarão trabalhou-se, também, com a pesquisa participante. Objetivou-se apreender se a implantação de políticas públicas e projetos sociais em comunidades organizadas possibilita a produção de formas de consolidação e/ou ampliação das redes sociais de suporte para a população em situação de vulnerabilidade social e/ou desfiliação (dupla fragilização social). Dentre as análises realizadas, a partir do acompanhamento do movimento de luta por moradia urbana do Casarão, observou-se o processo de educação popular vincula-se à participação no movimento social, porém, ao se buscar a continuidade das lutas após a conquista da casa, não há uma assunção da comunidade local por outras demandas. O PSF, por sua vez, embute potencialidades na intervenção dos ACS, porém precisa expandir seu escopo de atuação para além das demandas já reconhecidas na saúde. Quando as lideranças locais lidam com tais demandas, isto se dá mais por um investimento pessoal do que por uma diretriz governamental. Contudo, pode-se dizer que, a criação e/ou ampliação das redes sociais de suporte pelas políticas e projetos atuais, dá-se de maneira individualizada, particular, sem estruturação para a construção de macro ações nas redes sociais de suporte de comunidades em situação de vulnerabilidade social. As políticas sociais atuarão nas redes sociais de suporte dos indivíduos se ampliarem seus horizontes de intervenção e buscarem o campo intersetorial. As políticas públicas devem atuar de forma integrada com o movimento popular Abstract:This work researched about the implementation of two social programs in a poor region of Sao Paulo (Bras and Belem regions), characterized by the presence of slums, ex-slums and social movements for housing. We wish to know and learn about 'Prefeitura Municipal de São Paulo¿ (Sao Paulo Town Hall) Health Policy ('Programa de Saúde da Família¿ - 'PSF¿ (Family's Health Program), according to which are performed actions by Health Community Agents, who are members from the community which compose the staff of 'PSF¿. In this region, there are five community agents and three of them are members of social movements for housing. It was researched about the popular educational process involved in the community agent work, their understanding of the program whose execution they are responsible for in the communities, and how they deal with problems not usually faced by health services. Articulately, the 'Projeto Casarão ¿ Centro de Cultura e Convivência da Celso Garcia¿ was studied, which is a partnership between the community and the University, relating the attention for children and adolescents. This project has been developed from 1999 to 2002. As methodological procedures, interviews with actors of both programs and participative observation were applied. In the 'Projeto Casarão¿ participative research was also applied. The goal was to apprehend if the implementation of public policies and social projects in vulnerable communities contribute for the consolidation, the creation and/or the increase of the supporting social nets for population in vulnerability and/or desfiliation (double social fragility). In the analysis performed through the follow up of the social movements for housing in 'Casarão¿, it was observed that the educational popular process is tied with participation in the social movement, but, when trying to keep on fighting for something more after the house conquest, there is not an appropriation of other demands. The 'PSF¿, in the other hand, supposes potentiality in the community agents intervention, but it needs to increase the field of actuation with other demands beyond the recognized ones in the health field. When the community local leaders deal with these demands it comes much more from a personal investment than a governmental directive. Although, it can be stated that, the creation and/or the increase of the supporting social nets by the policies and projects, nowadays, they happen in individual and particular ways, without a structure for the construction of macro actions in the social nets for socially vulnerable population. The social policies will act in the social nets of people if their view of intervention is increased and they go for the intersection field. The public policies must act with the social movement in an integrated way Mestrado Politicas de Educação e Sistemas Educativos Mestre em Educação

BACKGROUND: Esophagectomies and repair of esophageal perforations are operations used for a variety of clinical indications. Anastomotic leaks are a major post-operative complication after these procedures. At our institution, we routinely use grape juice to detect esophageal leaks in the post-operative setting in addition to other standard imaging modalities. We hypothesize that grape juice can provide similar diagnostic sensitivity and specificity to other modalities for leak detection. METHODS: A retrospective review of all patients who underwent an esophagectomy or repair of esophageal perforations from 2013–2019 by the thoracic surgery service at our institution was performed. All patients underwent a barium swallow study, CT imaging or upper endoscopy, as well as ingesting purple grape juice on post-operative day 5 or greater. Purple grape juice observed in the tube thoracostomy drainage system was identified as a positive esophageal leak. RESULTS: Sixty-four patients were included in the study period (25% female, 88% white, median age 62 years old). Sixty-three patients had both a barium swallow study and grape juice test, while one patient underwent CT imaging and grape juice study. Grape juice test sensitivity and specificity were found to be 80% and 98.3%, respectively. CONCLUSIONS: This pilot study demonstrates the effectiveness of using grape juice in detecting esophageal leaks after esophageal operations in patients with tube thoracostomies. Grape juice may be cheaper and potentially less morbid than other studies performed to detect esophageal leaks. Further research is needed to justify the increased use of grape juice in patients who undergo esophageal operations.

Wheat production is dependent on costly insecticides that generate social and environmental issues. The growing demand for a rate reduction of spray applications and increased spray efficiency make essential the research for more adequate crop management. Therefore, this study aimed to evaluate technologies of imidacloprid application on wheat aphid, Schizaphis graminum and its natural enemies, Chrysoperla externa and Orius insidiosus. A set of experiments were performed to evaluate the effectiveness of S. graminum control and the toxicity to natural enemies using imidacloprid plus adjuvants sprayed with different nozzles and application rates. Improved S. graminum control was observed in the association between the adjuvant lauryl ether sodium sulfate and the hollow cone nozzle for both application rates (75 and 150 L ha-1), and the adjuvant copolymer of polyester + silicone + d-limonene with the asymmetric twin flat-fan nozzle at a low rate (75 L ha-1), since these treatments eliminate the wheat aphid after the fifth day of treatment application. The reduction of spray volume to wheat aphid control is possible with no loss of insecticide effectiveness. Imidacloprid associated with any one of the adjuvants tested is harmful to C. externa and O. insidiosus, even at the fifth day after application the insecticide continues being harmful to the natural enemies, regardless of the technology used. Key words: Triticum aestivum, Schizaphis graminum, ecological disturbance, insecticide impacts, natural control, neonicotinoid.

Over the past decades, the profession of occupational therapy has increased its focus on the wellbeing of society as a whole in response to growing inequality. In addition, guidelines for occupational therapy student education have also been revised to ensure that occupational therapists graduate with an appreciation of and ability to work with diverse populations of people in multiple contexts, beyond a biomedical focus on health and impairment. As a result, occupational therapy educators have been challenged to create curricula that meet the profession’s social responsibility by preparing students to practice with communities and populations in a contextualised way. To contribute to this discussion and foster dialogue about what this may look like in occupational therapy programs, we present examples of curricula from three courses in two undergraduate occupational therapy programs in Australia and Brazil: “Understanding the Context of Occupation” and “Occupation, Health and Participation - Communities and Populations”, at Griffith University, Australia; and the course “Social Occupational Therapy”, at the Federal University of Sao Carlos, Brazil. The courses include topics such as: working in micro to macro contexts, working with communities and populations, collective occupation, politics and advocacy, social justice, occupational justice, social security and others. With differences across the programs, based on their geographical and institutional contexts, as well as their socio-historical and cultural contexts, the examples provide some ideas for educators about preparing students to work in a contextualised way with communities and populations. Resumo Nas últimas décadas, a área de terapia ocupacional ampliou seu enfoque em dimensões sociais em resposta ao crescente patamar de desigualdade. Além disso, as diretrizes para a formação de terapeutas ocupacionais também foram revisadas para garantir que os profissionais se graduem com uma sensibilidade e capacidade de trabalhar com populações diversas e em múltiplos contextos, para além de um foco biomédico em saúde e deficiência. Como resultado, os educadores em terapia ocupacional têm sido desafiados a criar currículos que abordem a responsabilidade social, preparando os alunos para atuarem com comunidades e populações de forma contextualizada. Para contribuir com essa discussão e dialogar sobre como poderiam ser programas em terapia ocupacional, apresentamos exemplos de currículos de três cursos em dois programas de terapia ocupacional, um na Austrália e um no Brasil, são eles: “Entendendo o contexto da ocupação” e “Ocupação, saúde e participação - comunidades e populações”, na Griffith University, Austrália; e o curso “Terapia Ocupacional Social”, da Universidade Federal de São Carlos, Brasil. Os cursos incluem tópicos como: trabalhar do micro ao macro contextos, trabalhar com comunidades e populações, ocupação coletiva, política e defesa de direitos, justiça social, justiça ocupacional, seguridade social e outros. Com diferenças entre o programas, com base em seus contextos geográficos e institucionais, bem como em seus contextos sócio-históricos e culturais, os exemplos fornecem algumas ideias para educadores sobre como preparar os alunos para trabalhar de maneira contextualizada com comunidades e populações.

A pandemia causada pelo SARS-CoV-2 tem implicado o esforco de todas categorias profissionais se posicionarem frente aos seus papeis no lidar com a CoVID-19, reafirmando e mesmo recolocando a potencia de suas contribuicoes diante da complexidade das exigencias postas pelo momento que vivemos. Nesta direcao, a area de terapia ocupacional tem participado de tal processo com diferentes manifestacoes, visando a atencao ao cotidiano dos sujeitos, que, em seus diferentes modos de viver, tem em comum a necessidade de distanciamento social imposto pela transmissao acelerada do virus e pelas debilidades e impossibilidades dos sistemas de vigilância sanitaria e epidemiologica em muitos paises. Nao obstante, consideramos relevante pontuar nossa funcao no âmbito da seguridade social , em consonância as politicas sociais e, especialmente, abordando situacoes sociais que envolvem as importantes diferencas e desigualdades que a maioria das pessoas, grupos e comunidades com quem atuamos vivencia, especialmente no Brasil. A Federacao Mundial de Terapeutas Ocupacionais ( World Federation of Occupational Therapists ) lancou um posicionamento publico sobre a resposta de terapeutas ocupacionais a pandemia de CoVID-19, assinalando o profundo impacto nas vidas, saude e bem-estar dos sujeitos, familias e comunidades ao redor do mundo. Enfatiza o papel dos terapeutas ocupacionais nas atividades diarias dos sujeitos, seus significados e propositos para a vida. Desta forma, ressalta a relevância da producao de estrategias para facilitar o desenvolvimento das “ocupacoes”, em sua linguagem original, com destaque para as adaptacoes para a realizacao das “ocupacoes”, para aspectos do sofrimento psiquico e da saude mental que envolvem essa pandemia, para a divulgacao de tecnologias assistivas e para a viabilizacao de teleatendimentos como um novo formato de trabalho (World Federation of Occupational Therapists, 2020). Tambem nesse sentido, o Conselho Federal de Fisioterapia e Terapia Ocupacional (COFFITO) regulamentou a teleconsulta, o telemonitoramento e a teleconsultoria por meio da Resolucao no 516, de 20 de marco de 2020, como modalidades possiveis de trabalho, a fim de permitir a continuidade de acoes para alguns grupos populacionais assistidos por terapeutas ocupacionais e fisioterapeutas (Conselho Federal de Fisioterapia e Terapia Ocupacional, 2020a). Novas modalidades de cuidado (Malfitano & Sakellariou, 2019) tem sido criadas para buscar garantir que nao haja interrupcao do atendimento a grupos especificos. A Associacao Brasileira de Terapeutas Ocupacionais (ABRATO) manifestou sua preocupacao com a defesa de condicoes para a atuacao profissional nesse cenario, bem como assinalando suas contribuicoes e declarando a presenca de terapeutas ocupacionais na linha de frente do combate a pandemia seja no Sistema Unico de Saude (SUS), no sistema privado de saude, no Sistema Unico de Assistencia Social (SUAS), em instituicoes do terceiro setor, em projetos sociossanitarios e, ainda, em projetos culturais e humanitarios (Associacao Brasileira de Terapeutas Ocupacionais, 2020). Com foco especificamente no cotidiano dos sujeitos, a Associacao Australiana de Terapeutas Ocupacionais publicou um guia denominado “Vida normal tem sido interrompida: manejando rupturas causadas pela COVID-19” (Occupational Therapy Australia, 2020), traduzido para o portugues pela Associacao Cultural dos Terapeutas Ocupacionais do Estado do Parana (ACTOEP), sob o titulo “Orientacoes praticas para rotinas saudaveis: aprendendo a lidar com as mudancas de rotina devido ao COVID-19” (Associacao Cultural de Terapeutas Ocupacionais do Estado do Parana, 2020), sistematizando informacoes importantes para a organizacao da vida diaria em termos de produtividade, autocuidado, lazer, ambiente, rotina e o exercicio pessoal de diferentes papeis. O guia indica recomendacoes praticas para a realizacao das atividades diarias no isolamento domestico, juntamente com orientacoes e sugestoes para a manutencao da saude fisica e mental. Considerando o locus prioritario das acoes em terapia ocupacional, ou seja, os cotidianos, as atividades, os fazeres ou as ocupacoes dos sujeitos, alguns materiais direcionados a populacoes especificas tem igualmente sido produzidos, sem o foco na terapia ocupacional, mas com a participacao e/ou colaboracao destes profissionais em sua autoria, voltados a grupos e/ou tematicas com as quais trabalhamos, tais como: saude mental (Universidade Federal de Sao Carlos, 2020a), autismo (Universidade Federal de Sao Carlos, 2020b), ergonomia (Conselho Federal de Fisioterapia e Terapia Ocupacional, 2020b), dentre outros. Assim, demarcando a relevância de todas essas iniciativas e contribuicoes, igualmente pontuamos a necessidade de terapeutas ocupacionais lidarem com a dimensao da desigualdade social, com o alastramento do virus e da doenca em comunidades empobrecidas nas periferias das cidades, por exemplo nas favelas, trazendo grandes desafios para o exercicio do distanciamento social, em si, bem como para a manutencao material da sobrevivencia, ali onde “ha naturalizacao do risco de vida” (Associacao Brasileira de Saude Coletiva, 2020), com a atencao a grupos como pessoas em situacao de rua, migrantes, albergados, detentos e prisioneiros, com alguns efeitos deste processo, como o triste aumento da violencia domestica (Vieira et al., 2020), entre outras inumeras situacoes. E neste contexto que defendemos uma atuacao de terapeutas ocupacionais e de outros profissionais que se paute pela nocao e defesa da seguridade social . A seguridade social e prevista na Constituicao Brasileira, no seu Artigo 194, envolvendo um conjunto integrado de iniciativas para assegurar os direitos relativos a saude, a previdencia e a assistencia social (Brasil, 1988). A relevância deste principio legislativo nacional esta em determinar que apenas por meio da integracao de tais direitos sociais e que se pode contempla-los para a vida social de todos, ou seja, a “Saude” requer acoes da “Previdencia”, garantindo meios para a sobrevivencia, ao menos, dos trabalhadores, independentemente de sua condicao de doenca e/ou velhice, e, igualmente, acoes de “Assistencia Social”, visando a seguranca do acesso aos bens sociais basicos a todos cidadaos. A seguridade social so se realiza por meio de politicas e programas sociais que esses tres setores de acoes e servicos devem garantir o acesso e/ou disponibilizar aos cidadaos. Ainda, e importante destacar a conexao com a “Educacao”, regulamentada por meio do Artigo 205 da Constituicao, que simultaneamente se conecta aos demais direitos e setores, se fazendo possivel nesta integracao, assim como os possibilitando. Portanto, precisamos tambem abordar o papel dos profissionais no SUAS, no Instituto Nacional de Previdencia Social (INSS), no Sistema Prisional ou Sociojuridico, nas escolas, nos diferentes setores de acao territorial e comunitaria, em organizacoes nao governamentais de interesse publico. Mais do que nunca e preciso que usemos nossos espacos, nossas acoes e nossas vozes para problematizar o que vem ocorrendo para o acesso aos beneficios sociais essenciais para a manutencao das vidas de tantos sujeitos e, consequentemente, para a viabilizacao de seus cotidianos. O desafio e fazer valer a centralidade da seguridade social, tambem em seus aspectos da assistencia social como direito da cidadania e dever do Estado e da sociedade, para o que a compreensao sobre as dimensoes sociais em torno do isolamento/distanciamento social (Bezerra et al., 2020) e o engajamento em campanhas/acoes fundadas na solidariedade entre os sujeitos sao requisitos. Tal defesa coaduna-se com o pressuposto de que e por meio dos direitos sociais, pela seguridade social, que poderemos abordar os cotidianos, as atividades, os fazeres, as ocupacoes dos diferentes sujeitos, grupos e comunidades. Assim e que a defesa das politicas publicas sociais, notadamente da saude publica, da previdencia e da assistencia social, compoe os tempos de pandemia que atravessamos e nos lanca para alem da adaptacao e organizacao da vida diaria de todos nos, desafiando terapeutas ocupacionais a tecer relacoes entre contextos, politicas e vidas. Finalizamos na afirmativa que o trabalho em terapia ocupacional, nos cotidianos dos sujeitos, so se concretiza na luta pela vida possivel para todos, em todas as potencias e diferencas que lhes dao significado e fazem diminuir as desigualdades, o que, necessariamente, envolve a defesa da seguridade social e nosso papel profissional nela.

Este texto decorre de um esforco de reflexao em torno dos aspectos teoricos que vem parametrizando a terapia ocupacional social no Brasil e aqueles sob os quais se fundamentam os “marcadores sociais da diferenca”, visando a formulacoes que viabilizem a proposicao de metodologias e acoes terapeutico-ocupacionais que considerem os cotidianos que constituem a vida de diferentes sujeitos. Tais reflexoes surgem com base nas demandas contemporâneas de diversos segmentos sociais e de preocupacoes quanto a uma melhor conformacao do aporte teorico e metodologico que subsidia as praticas da terapia ocupacional social. Para tanto, retoma-se o processo historico de constituicao do social como um campo de acao da terapia ocupacional, apresenta-se a perspectiva dos marcadores sociais da diferenca e, nesse entrelacamento, o dialogo acerca das possibilidades e aproximacoes da e com a terapia ocupacional social. Pontua-se que os “marcadores sociais da diferenca” podem se constituir como uma importante lente conceitual para informar a pratica da terapia ocupacional social, a medida que inclui em seu arcabouco a constituicao das diferencas – genero, raca, etnia, classe, sexualidade, geracao, entre outras – como ponto de partida para a compreensao das desigualdades sociais.

Introduction In the burned patient, clinical outcomes are inextricably linked with immune function. Patients are subject to an early pro-inflammatory response and a subsequent compensatory anti-inflammatory response syndrome. This dysregulation can lead to infection, multiple organ dysfunction syndrome, and death. Despite continuing efforts, a profile of immune gene expression from burn patients that can be transformed into an “immune suppression index”, which accurately reflects the underlying degree of immune insult and significantly correlates with the degree compromise, has yet to be developed. The development of such an approach that can predict graft failure, susceptibility to infection, length-of-stay in the hospital, and/or that can inform a provider on how to better manage the timing of surgical interventions would be transformative. Objective To determine a set of peripheral biomarkers that correlates with clinical outcomes of burn patients. Methods This observational study enrolled two participant cohorts within a single burn center. Initial unbiased analysis compared 23 burn patients and 6 healthy controls. Confirmatory outcomes analysis was performed in 109 burn patients and 19 healthy controls. We employed multiplex gene expression analysis to identify differential peripheral blood mononuclear cells (PBMC) immune gene expression. qPCR was used to validate these findings, identify, and model associations with outcomes. Results We identified 149 genes with a significant difference in expression within PBMCs from burn patients compared to controls (Figure 1a). Pathway analysis identified pathways related to IL-10 and inducible nitric oxide synthase (iNOS) signaling (Figure 1b). qPCR analysis of IL-10, IL-12, arginase-1 (ARG1), and iNOS demonstrated that burn injury was associated with increased expression of ARG1 and IL-10, and decreased expression of NOS2 and IL-12. Burn severity, acute lung injury (ALI), development of infection, failure of skin autograft, and mortality significantly correlated with expression of one or more of these genes. Ratios of IL-10/IL-12, ARG1/NOS2 and (ARG1+IL-10)/(NOS2+IL-12) transcript levels further improved the correlation with outcomes. A multivariate regression model, adjusting for confounders, demonstrated that (ARG1+IL-10)/(NOS2+IL-12) significantly correlated with burn severity and development of ALI (Table 1). Conclusions We present a robust model to predict patient outcomes early after burn injury using non-invasive methods, allowing early identification of underlying immune dysfunction.

Apresenta-se o relato e a análise de uma experiência de extensão universitária realizada numa escola pública da periferia de Fortaleza (CE), durante quatro anos, por estudantes e docentes da área de terapia ocupacional. Direcionado a crianças, jovens, familiares, professores e gestores, o trabalho estruturou-se em cinco eixos em torno da temática das violências. Foram utilizadas atividades grupais participativas, tomando-se como diretriz a participação dialógica dos diferentes sujeitos, para a reflexão e construção de propostas de enfrentamento às violências e para a promoção de projetos de vidas ali tecidas. Verificou-se que, ao criar oportunidades de discussão e reflexão na escola, a comunidade as utiliza, reconfigurando os lugares dos sujeitos para a “conversa”. Ocorreram diálogos que definiram responsabilidades a serem partilhadas, além da análise de estratégias de trabalho coletivo e participativo, ressignificando a escola pública como um equipamento social que precisa e pode integrar uma rede intersetorial de proteção e suporte social.

We designed a novel, manualized intervention called Emotion And Symptom-focused Engagement (EASE) for acute leukemia (AL) and report here on a phase II randomized controlled trial (RCT) to assess its feasibility and preliminary efficacy. Patients were recruited within 1 month of hospital admission and randomized to EASE plus usual care (UC) or UC alone. EASE includes (1) EASE-psy, a tailored psychotherapy delivered over 8 weeks, and (2) EASE-phys, weekly physical symptom screening over 8 weeks to trigger early palliative care. The primary outcome was traumatic stress symptoms; secondary outcomes included physical symptom burden and quality of life. Assessments were conducted at baseline and at 4, 8, and 12 weeks. Between-group differences were evaluated using multilevel modeling. Forty-two patients were randomized to EASE (n = 22) or UC (n = 20), with 76% retention at 12 weeks. Predefined feasibility outcomes were met: 86% (19/22) of EASE participants completed ≥ 50% of EASE-psy sessions (goal ≥ 64%); 100% received Edmonton Symptom Assessment System (ESAS, modified for AL) screenings, 64% (14/22) of whom completed ≥ 50% of planned screenings (goal ≥50%); and 100% with scores ≥ 4/10 on any physical ESAS-AL item had ≥ 1 meeting with the EASE-phys team (goal 100%). Significant treatment-group differences favoring EASE were observed in traumatic stress symptoms at 4 and 12 weeks, and pain intensity and interference at 12 weeks (all p

Com foco nas iniciativas de países da América Latina no enfrentamento à vulnerabilidade social da população idosa, realizou-se um estudo de revisão, no acervo on-line da Comissão Econômica para a América Latina e o Caribe – CEPAL. Reuniram-se 27 publicações, entre 2007-2017, discutidas quanto a sistemas de pensão, redes de apoio, políticas e programas sociais. As iniciativas são heterogêneas e decorrem, sobretudo, do grau de envelhecimento e do perfil socioeconômico de cada país.

Background: G-quadruplex (G4) are nucleic secondary structures characterized by G-tetrads. G4 motif stabilization induces DNA damage and cancer cell death; therefore, G4-targeting small molecules are the focus of clinical investigation. DNA destabilization induced by G4 ligands might potentiate the anticancer activity of agents targeting DNA or inhibiting its repair like oncolytic viruses. This study represents the first approach combining G4 ligands and the adenovirus dl922-947 in MDA-MB-231 and MCF-7 cell lines.Methods: We used G4 binders, BRACO-19 (B19), pyridostatin (PDS) and dl922-947 or their combination in cytotoxicity assays. G4 motif formation and distribution, cell cycle and viral entry were evaluated using agents alone or in combination by flow cytometry. Viral replication was evaluated by RT-PCR. Cell senescence was assessed by microscope observation and count of blue SA-b-Gal blue-stained cells. Phagocytosis of THP-1 cells was evaluated by flow cytometry.Results: G4 binders and dl922-947 induce cytotoxicity in MDA-MB-231 and MCF-7 cells. G4 binders induce G4 motifs mainly distributed in the S and G2/M phases of the cell cycle in MCF-7 cells. The combination G4 binders/dl922-947 increased viral entry, replication and cell cytotoxicity. The combinatory treatments increased the subG0/G1 phase of the cell cycle, whereas the agents used singularly or in combination similarly enhanced cell senescence. Noteworthy, dl922-947 induces G4 motifs and its combination with PDS potentiates this effect. The conditioned media of MCF-7 cells increased phagocytosis whereas the combination dl922-947/PDS restored it to the control values and did not affect monocyte proliferation.Conclusions: We present the first evidence of a new mechanism of oncolytic viruses able to induce senescence and G4 structures in breast cancer cells. We suggest a novel strategy based on the use of G4 binders/virotherapy combination to enhance anti-cancer activity. Indeed, oncolytic viruses and G4 ligands are already singularly employed in clinical settings, thus their combination may be envisioned for translational studies.

Introduction: A growing number of occupational therapists are re-engaging in work with communities and populations to advance a social justice agenda. To assist in this endeavour, many are coupling occupational therapy and community development theory, as reflected in the social occupational therapy field. Social occupational therapy practitioners work with groups of people who do not necessarily have a health diagnosis or illness but who nonetheless experience occupational issues due to structural barriers within society. Practitioners work across micro- and macro-levels to not only alleviate symptoms of these issues but also to transform their root causes. Although community development is a logical partner to assist such practice, there are inherent tensions in the coupling of these disciplines. This study aimed to explore what theory occupational therapists were using from occupational therapy and community development to guide them in their social occupational therapy practice. Methods: This study employed a collaborative and participatory qualitative research method. Four occupational therapy community development practitioners each participated in two one-on-one dialogical interviews with the first author. These were transcribed and analysed using Braun and Clarke's method of thematic analysis. Findings: Findings were grouped into two themes: (a) Occupational therapy and community development – synergies and tensions, and (b) Of the profession but not in it. Findings highlighted the theoretical shortcomings of occupational therapy for community development practice, theoretical tensions between the two disciplines, and the ‘underground’ nature of occupational therapy community development practice. Conclusion: Practitioners should be supported by the occupational therapy profession to be effective community development practitioners, capable of advancing the profession's vision of social justice. Future research should explore methods to support practitioners to navigate tensions between occupational therapy and community development, and bring this practice ‘above ground’.

TPS7072 Background: Acute leukemia (AL) is characterized by rapid symptom onset requiring urgent hospitalization and initiation of intensive treatment with high mortality. Despite this, there is scant research on its psychological and physical impacts and even less on interventions to alleviate them [Bryant 2016]. We conducted a longitudinal study showing substantial physical and psychological distress in these patients [Rodin 2013; Zimmermann 2013; Nissim 2013; Nissim 2014; Gheihman 2016; Rodin 2018a; Shaulov 2019]. Despite this distress, we observed a lack of referrals for specialized psychosocial and palliative care. Based on these findings, we developed an integrated psychosocial and early palliative care (symptom control) intervention, Emotion And Symptom-focused Engagement (EASE), for AL [Rodin 2015]. In a subsequent randomized phase II trial of EASE in patients newly diagnosed with AL, we demonstrated its feasibility and found preliminary evidence that it reduces physical and psychological distress compared to usual care [Rodin 2020]. EASE includes: i) an 8-week manualized psychotherapy intervention tailored to AL to prevent and treat psychological symptoms through: supportive counselling and trauma-focused cognitive-behavioural therapy; and emotional assessment and affect modulation; ii) 4-week systematic screening of physical symptoms with automatic referrals to palliative care for the management of moderate to severe symptoms. Methods: We are conducting a multi-centre randomized controlled phase III trial of 266 AL patients comparing EASE to usual care in collaboration with the Canadian Cancer Trials Group at Princess Margaret Cancer Centre, Sunnybrook Health Sciences, Kingston Health Sciences and the Ottawa Hospital in Ontario, Canada. Patients are newly diagnosed with acute myeloid leukemia or acute lymphoblastic leukemia and randomized within two weeks of hospital admission for induction chemotherapy with curative intent. Patients randomized to EASE will receive psychological support from a trained mental health clinician for 8 weeks and will be assessed for physical symptoms twice weekly until discharged from hospital. Moderate to severe physical symptoms will trigger a referral to a symptom-control team for symptom management. The symptom-control team consists of a physician and nurse with expertise in symptom control and other professionals as needed. All participants will be assessed for physical symptom severity, psychological distress, quality of life and satisfaction with care at baseline, 4, 8, 12 weeks, 6 and 12 months. Hypotheses will be tested using multilevel modeling (MLM) with maximum likelihood estimation, conducted as intention-to-treat analyses. The DMC last reviewed the trial in April 2021 and suggested that the trial continue as planned. Clinical trial information: NCT04224974.