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Abstract With a national prevalence of 0.9%, Burundi is close to achieving UNAIDS’ 2025 targets. Despite this, different types of crises periodically disrupt its HIV health services. The community-based program EPIC measured the impact of the COVID-19 health crisis on people living with HIV (PLHIV) in Burundi in 2021. Specifically, it assessed ART interruption and associated factors since the beginning of the pandemic. The study questionnaire was administered to PLHIV in three cities between October and November 2021. Participants were recruited using convenience sampling. Logistic regression models helped identify factors associated with ART interruption. Of the 317 respondents, 37 (11.7%) reported interruption. The majority (79.2%) self-identified as belonging to key populations. Interruption was significantly associated with: fewer HIV medical follow-up visits (adjusted Odds Ratio, aOR = 7.80, p = 0.001) and forced HIV status disclosure (aOR = 4.10, p = 0.004). It was inversely associated with multi-month ART dispensing (aOR = 0.36, p = 0.017) since the beginning of the pandemic and the perception of not having been sufficiently informed by the HIV medical team about the risk of COVID-19 infection (aOR = 0.11, p

Little is known about the adaption of community-based organizations (CBOs) during the COVID-19 crisis. This study aimed to study how HIV CBOs and their community health workers (CHWs) faced the COVID-19 outbreak. Semi-structured interviews (n = 53) were conducted among CHWs in Burundi, Mauritania, and Lebanon in 2021. A thematic content analysis was performed. Results showed that CBOs had succeeded in maintaining HIV services and integrated COVID-19 prevention and awareness in their activities. COVID-19 led to innovation in terms of HIV services (eg, telemedicine and online psychosocial support) and to opportunities to try new modalities of antiretroviral therapy dispensation. Field workers (a specific group among CHWs) were negatively impacted by the COVID-19 crisis and showed resilience in their adaptation to ensure the continuity of their activities. Considering the essential role of field workers during the crisis, their status and the sustainability of their activities should be clearly supported by health policies and programs.

Disturbances in T-cells, specifically the Th17/Treg balance, have been implicated in adverse pregnancy outcomes. We investigated these two T-cell populations following pre-pregnancy and pregnancy SARS-CoV-2 infection and COVID-19 vaccination in 351 participants from a pregnancy cohort in New York City (Generation C; 2020-2022). SARS-CoV-2 infection status was determined via laboratory or medical diagnosis and COVID-19 vaccination status via survey and electronic medical records data. Peripheral blood mononuclear cells (PBMCs) were collected at routine prenatal visits throughout gestation (median 108 days; IQR 67-191 days) with repeated measures for 104 participants (29.6%). T-cell populations CD4+/CD3+, Th17/CD4+, Treg/CD4+ and the Th17/Treg ratio were quantified using flow cytometry. Results showed that inter-individual differences are a main influencing factor in Th17 and Treg variance, however total variance explained remained small (R2 = 15-39%). Overall, Th17 and Treg populations were not significantly affected by SARS-CoV-2 infection during pregnancy in adjusted linear mixed models (p>0.05), however comparison of repeated measures among SARS-CoV-2 infected participants and non-infected controls suggests a relative increase of the Th17/Treg ratio following infection. In addition, the Th17/Treg ratio was significantly higher after SARS-CoV-2 infection prior to pregnancy (10-138 weeks) compared to controls (β=0.48, p=0.003). COVID-19 vaccination was not associated with Th17 and Treg cells. Our findings suggest an impact of SARS-CoV-2 infection on the Th17/Treg ratio, likely depending on severity of infection, yet the observed trends and their potential consequences for pregnancy outcomes require further investigation. Our study contributes to growing evidence that COVID-19 vaccination during pregnancy does not lead to an exacerbated immune response.

BackgroundInformation concerning the impact of the COVID-19 health crisis on populations most affected by HIV and hepatitis C virus (HCV; or key populations [KP]), and those working with these populations in community settings, is limited. Community-based organizations working in the field of HIV and viral hepatitis are well placed to identify and meet the new needs of KP owing to the health crisis. ObjectiveThis study aims to describe the development and implementation of an exploratory and descriptive multicountry, community-based research program, EPIC (Enquêtes Pour évaluer l’Impact de la crise sanitaire covid en milieu Communautaire), within an international network of community-based organizations involved in the response to HIV and viral hepatitis. The EPIC program aimed to study the impact of the COVID-19 health crisis on KP or people living with HIV or HCV and people working with these populations at the community level (community health workers [CHWs]) and to identify the key innovations and adaptations in HIV and HCV services. MethodsA general protocol and study documents were developed and shared within the Coalition PLUS network. The protocol had a built-in flexibility that allowed participating organizations to adapt the study to local needs in terms of the target population and specific themes of interest. Data were collected using surveys or interviews. ResultsFrom July 2020 to May 2022, a total of 79 organizations participated in the EPIC program. Across 32 countries, 118 studies were conducted: 66 quantitative (n=12,060 among KP or people living with HIV or people living with HCV and n=811 among CHWs) and 52 qualitative (n=766 among KP or people living with HIV or people living with HCV and n=136 among CHWs). ConclusionsThe results of the EPIC program will provide data to describe the impact of the health crisis on KP and CHWs and identify their emerging needs. Documentation of innovative solutions that were put into place in this context may help improve the provision of services after COVID-19 and for future health crises. International Registered Report Identifier (IRRID)DERR1-10.2196/45204

O presente trabalho é uma revisão integrativa da literatura sobre o conceito de topofilia, entendendo que a percepção ambiental é um fator influenciador da vida humana através do comportamento, da sociabilidade e do bem-estar. O estudo teve o objetivo de compreender como o conceito tem sido abordado nos estudos de paisagem cultural, natural e urbana. Foram selecionados 30 artigos que investigam a relação humana com o ambiente ou com a paisagem, que discutem o senso de lugar, apego ou a conexão com o lugar. Como resultado foram identificadas diferentes abordagens que puderam ser agregadas em três grupos de análise: o indivíduo, a coletividade e o ambiente. Além disso, foram avaliados quantitativamente dados que apontam direções para um futuro aprofundamento do estudo acerca do tema.

Objetiva o presente artigo compor análise do alcance da responsabilidade penal do psicopata considerando as ramificações da culpabilidade enquanto ser imputável, semi-imputável ou inimputável. Para tanto, a pesquisa se deu em duas mãos, a primeira com a análise das características psicológicas do indivíduo identificado como psicopata, bem como a realização do incidente de insanidade mental e medidas de segurança a serem aplicadas em eventual condenação, enfatizando a importância do exame pericial. E, a segunda, deu-se com a análise das leis e jurisprudências brasileiras acerca da responsabilidade penal do psicopata. Desta feita, concluiu-se que, o estudo do tema “psicopatia” é extremamente exíguo no campo doutrinário e na construção legislativa, fator que, sem dúvidas, resulta na impossibilidade da devida aplicação da responsabilidade penal àqueles diagnosticados com este transtorno de personalidade. Isso porque, o que se observa é que sequer magistrados deliberam de forma uníssona em julgamentos que tratam de casos afetos a psicopatas. A metodologia da pesquisa foi baseada na pesquisa descritiva, procedimentos bibliográficos, método hipotético-dedutivo e abordagem qualitativa.

Abstract Background Obesity and its consequences are worldwide epidemic problem; therefore, studies with strategies and mechanisms that favor weight loss to improve outcomes in health are necessary. Effects of mushrooms on body weight are uncertain. The aim of this systematic review is to determine the efficacy of mushrooms in weight loss in animal preclinical models. Method This is a systematic review of preclinical studies of animal models of obesity (any type of non-aquatic mammal), which were exposed to edible and medicinal mushrooms orally in comparison with the control. The following databases will be used: MEDLINE (PubMed), Web of Science, BIOSIS, SCOPUS, and gray literature. There will be no restriction of language, date, or publication status. The primary outcome will be body weight loss. And the secondary outcomes include the total amount of food consumed by the animals, analysis of metabolic parameters, inflammatory mediators, mortality for any causes, and any adverse effect reported. A team of reviewers will select, in pairs and independently, the titles and abstracts, extract data from qualifying studies, and assess bias risk (using SYstematic Review Centre for Laboratory animal Experimentation SYRCLE’s risk of bias tool and the Collaborative Approach to Meta-Analysis and Review of Animal Data from Experimental Studies (CAMARADES) checklist). The standardized mean difference (SMD) will be calculated to measure treatment effect, with 95% confidence intervals (95% CI). The heterogeneity between-study will be calculated by I 2 inconsistency values and Cochran’s Q statistical test, where I 2 > 50% and/or p < 0.10 suggest high heterogeneity meta-analyses of random effects will be conducted as possible. Discussion Although many experimental studies about the effects of mushrooms on obesity have already been published, there is still no consensus in the literature. This study will provide evidences of preclinical research on mushrooms and their relation to body weight loss in animal models of obesity, being non-aquatic mammals. Also, this systematic review will show the limitations and strengths of the studies available in the literature, as well as it will to encourage the financing of new studies by public health managers and governmental entities. Systematic review registration PROSPERO (CRD42019125299).

Resumo O artigo trata da experiência do Grupo de Trabalho (GT) Corpo e Finitude. O GT, multidisciplinar e interinstitucional, é sediado na Clínica da Dor do Instituto Nacional de Câncer (Inca) e ocorre no âmbito do convênio desta instituição com o Programa de Pós-Graduação em Teoria Psicanalítica da Universidade Federal do Rio de Janeiro (UFRJ), e o Instituto Nacional Nacional de Traumatologia e Ortopedia (Into). Apresentando a experiência do GT, localiza seus objetivos, sua metodologia e os procedimentos usados para desenvolvê-la, e discute os efeitos observados até o momento, com vistas a examinar as condições para sua continuidade. O método do trabalho é dado pelo referencial teórico-clínico da psicanálise. Trata-se de um procedimento que recorre aos textos para delimitar e elaborar os conceitos que servirão de guia para intervenções na prática hospitalar cotidiana. Esta prática é submetida à discussão em grupos semanais que apontam em que o conceito precisa ser ainda mais elaborado, para orientar a clínica desenvolvida nas várias pontas do trabalho. Num procedimento de vaivém da clínica à teoria e desta à prática, vão se estabelecendo rotinas que evitam simples aplicações automáticas de protocolos, dando condições a cada profissional de examinar e fazer uma reflexão crítica sobre sua prática e sua conduta no trabalho hospitalar. Conclui que a experiência tem incidência sobre o próprio ou a própria profissional e sobre os pacientes e colegas de equipe. Dentre os importantes efeitos, encontra-se a possibilidade de dar voz ao sujeito e seu desejo, retirando-o da função de mero distribuidor de serviços.

Bacteria belonging to Staphylococcus genus, in particular methicillin-resistant Staphylococcus aureus and multidrug-resistant Staphylococcus epidermidis, together with Cutibacterium acnes are the main strains involved in skin disease. The increase in multidrug-resistant bacteria has revived attention on natural compounds as alternative agents for the treatment management. Among these, hop extract, a hydroalcoholic solution obtained from experimental crops of Humulus lupulus L. variety cascade (hop), displays diverse biological properties including an antimicrobial one. The aim of this study was to evaluate the antimicrobial activity and the capacity to inhibit the biofilm formation of a characterized hop extract against S. aureus and S. epidermidis multidrug-resistant strains and against a C. acnes strain. The hop extract was characterized by (i) phytochemical analysis through a reversed-phase high-performance liquid chromatography (HPLC)–fluorimetric method, (ii) biocompatibility test with Artemia salina L., (iii) cytotoxicity against two cell lines, (iv) docking analysis, and (v) antimicrobial and antibiofilm activities by detection of zones inhibition, minimal inhibitory concentrations (MICs), biomass quantification, and cell viability. The hop extract was biocompatible and non-cytotoxic at all tested concentrations. HPLC analysis revealed significant levels of gallic acid, resveratrol, and rutin. This last compound was the most representative displaying a high affinity against PBP2a and KAS III (Ki values in the submicromolar range). The characterized hop extract showed a good antimicrobial action with MICs ranging from 1 to 16 μg/mL and was able to inhibit the biofilm formation of all tested strains, except for two S. aureus strains. The biofilm formed in presence of the hop extract was significantly reduced in most cases, even when present at a concentration of 1/4 MIC. The live/dead images showed a remarkable inhibition in the biofilm formation by hop extract with a weak killing action. Overall, the tested hop extract is a good candidate to further explore for its use in the prevention of infection particularly, by multidrug-resistant Gram-positive pathogens.

Este texto visa indicar as bases teóricas do trabalho com História de Vida, tendo como base a abordagem da Psicossociologia Clínica. Os conceitos História de Vida, Abordagem Clínica e Historicidade foram apresentados e podem embasar tanto a pesquisa acadêmica, quanto a intervenção de profissionais. A compreensão proposta evita que se culpabilize os indivíduos por suas escolhas, além de permitir que se reconheça a influência exercidas pelos sujeitos no meio coletivo.

ContextMetabolic syndrome (MetS) is a complex condition comprising a 'clustering' of components representing cardiometabolic risk factors for heart disease and diabetes; its prevalence rate is high and consequences serious. Evidence suggests that light exposure patterns and misalignment of circadian rhythms might contribute to MetS etiology by impacting energy metabolism and glucose regulation.ObjectiveWe hypothesised that individuals with MetS would show disrupted circadian and sleep parameters alongside differences in light exposure profiles. We investigated this using data from a cohort study in Brazil.MethodsData from 103 individuals from the Baependi Heart Cohort Study aged between 50 and 70 were analysed. Motor activity and light exposure were measured using wrist-worn actigraphy devices. Cardiometabolic data were used to calculate the number of MetS components present in each participant, and participants grouped as MetS/non-MetS according to standard guidelines. Between-group comparisons were made for the actigraphy measures; additionally, correlation analyses were conducted.ResultsMotor activity and circadian profiles showed no differences between groups. However, the MetS group presented lower light exposure during the day and higher light exposure at night. Correlation analyses, including all participants, showed that greater daytime light exposure and greater light exposure difference between day and night were associated with reduced MetS risk (a lower number of MetS components). Also, the light exposure difference between day and night correlated with body mass index across all participants.ConclusionsThe observed results suggest a direct association between light exposure and MetS which appears to not be attributable to disruptions in circadian activity rhythm nor to sleep parameters. This link between light exposure patterns and MetS risk could inform possible prevention strategies.

BackgroundDue to the multiple health benefits of breastfeeding, it is essential to identify factors that may negatively interfere with this healthy practice. Among such factors are postpartum depression (PPD) and maternal satisfaction with breastfeeding. The objective of this study was to evaluate the association between maternal satisfaction with breastfeeding and symptoms of PPD in the first month after childbirth.MethodsThis cross-sectional study nested in a cohort study was conducted in Porto Alegre, Brazil, with 287 puerperal women selected at two maternity hospitals, one public and one private. Women were interviewed at their homes the week after the infant completed 30 days of life. A structured questionnaire was applied, as well as instruments to evaluate maternal satisfaction with breastfeeding (Maternal Breastfeeding Evaluation Scale) and to screen for PPD (Edinburgh Postnatal Depression Scale). The association between higher satisfaction with breastfeeding (outcome) and negative PPD screening test was assessed using Poisson regression with robust variance, adjusting for specific covariables. Adjusted prevalence ratios (aPR) and respective 95% confidence intervals (95%CI) were estimated.ResultsThe prevalence of increased satisfaction with breastfeeding (defined as women with scores above the median) was 47% higher among women who screened negative for PPD when compared to those with a positive result (aPR 1.47; 95%CI 1.01-2.16). This result was adjusted for maternal age and skin color, cohabitation with the infant's father, planned pregnancy, type of delivery, exclusive breastfeeding, and occurrence of breastfeeding problems.ConclusionsThe findings of this study showed an association between higher maternal satisfaction with breastfeeding and absence of PPD symptoms, reinforcing the importance of caring for the mental health of pregnant and puerperal women and paying attention to their satisfaction with breastfeeding.

Objetivo Descrever as caraterísticas familiares associadas à exposição a tempo de ecrã (TE) nas crianças com idades entre 0 e 18 meses. Tipo de estudo Estudo observacional transversal analítico. Local USF Além D’Ouro, USF Camélias, USF Novos Rumos, USF Terras de Santa Maria, USF Vale do Vouga e UCSP de Crestuma. População Crianças com idade entre 0 e 18 meses, inscritas nas unidades referidas. Métodos Foi desenvolvido pelos autores um questionário sobre o TE das crianças e uma breve caraterização da família, de resposta voluntária e confidencial. O tratamento estatístico dos dados foi realizado através do programa Statistical Package for the Social Sciences - SPSS®. Considerou-se existir significância estatística para valores de p< 0,05. Resultados Foram devolvidos 142 questionários preenchidos (taxa de resposta de 42,5%) e incluídos 137. A mediana de idades foi 12 meses e 50,4% eram do género masculino. A média de idades do pai foi 34 anos e da mãe 33. Cerca de 83% das crianças pertencia a famílias nucleares e 31,4% ficava ao cuidado dos avós ou no infantário. Das 137 crianças analisadas, 81% teve exposição e, destas, mais de metade teve o primeiro contacto até aos 6 meses de vida. Não se verificou diferença na duração de TE à semana e ao fim-de-semana (71,2% e 73% das crianças com exposição, respetivamente). Verificou-se uma correlação estatisticamente significativa entre o TE e as variáveis “idade da criança” e “idade da mãe”, sendo que crianças de mães com idade igual ou superior a 39 anos foram expostas a TE mais tardiamente. Conclusão Este estudo demonstrou hábitos de TE inadequados face às recomendações atuais para a idade, resultados concordantes com estudos nacionais e internacionais. A elaboração de estratégias de intervenção generalizadas, nomeadamente a capacitação dos cuidadores acerca do TE adequado à idade da criança, deve ser incentivada.

Objective We aimed to develop and validate a new instrument called Questionnaire for the assessment of the knowledge, management and reporting ADR in Paediatrics by Healthcare teams (QUESA-P).Design This is a cross-sectional study.Settings and participants Teams of healthcare professionals (HCP) that lead with pharmacological therapy in Paediatrician’s sector (Paediatric-HCP) in seven public hospitals in Brazil.Outcome An assessment of the knowledge and current management of ADR in Paediatric-HCP.Methods We developed and validated QUESA-P, using a standardised procedure which included item development and psychometric prevalidation using Cronbach’s Alpha, item-total correlation and test–retest validity for internal consistency and reliability. External criterion was used as criterion validation (the instrument was applied to the focus group expert vs focus group team of Paediatric-HCP in hospitals). The focus group of experts who participated in psychometrics was asked to respond to the QUESA-P twice in order to assess test-retest reliability. The content validity of the initial questionnaire was assessed by the Delphi method and pilot test. Subsequently, we made minor revisions and finalized the QUESA-PResults Selection of domains and facets were based on literature review made in duplicate by authors. Content validity was done by trial of different examiners (panellists, n=16), conducting analysis through Delphi method (three rounds). The QUESA-P was constructed with three domains. The intraclass correlations (0.80) and the Cronbach’s alpha coefficient (0.82), indicated adequate test–retest reliability and internal consistency for each domain. The application of the QUESA to 61 Paediatric-HCP in hospital resulted in lower mean score of 42.1 ± 3.4 in all domains when compared with expert teams (n= 46) 48.2 ± 3.7 (p

Considerando que sujeitos e sentidos se constituem mutuamente e que a linguagem não é transparente, este estudo, ancorado nos pressupostos da Análise de Discurso, se propõe a analisar os processos discursivos em funcionamento em um guia de prevenção da violência sexual para crianças a partir dos 4 anos. Em função do caráter social da educação e da articulação entre ensino, conhecimento e sociedade, pareceu-nos significativo refletir sobre o modo como o Estado, através das instituições e dos discursos que nelas circulam, administra o complexo processo de significação sobre a violência sexual na infância, produzindo identificações e efeitos de verdade.

The Kleine–Levin Syndrome is a differential diagnosis for patients with diurnal excessive sleepiness and a suspicion of narcolepsy. It is characterized by paroxysmal attacks of diurnal excessive sleepiness, associated with one or more symptoms of hyperphagia, hypersexuality, coprolalia and copropraxia. During crisis intervals, there are no symptoms. This pathology predominantly manifests itself in teenagers, being more frequent among males. The course of this disease is unpredictable, with variable duration and frequency. The most accepted physiopathology is that of a hypothalamic dysfunction, although and recently, there has appeared a hypothesis of a post-infectious autoimmune disorder. These patients show an elevated body mass index, which can predispose to association with comorbidities such as the sleep obstructive apnea syndrome. Treatment involves medications with different effects, but there is no specific and effective therapy. Our article shows a classic case of Kleine–Levin Syndrome associated with sleep obstructive apnea syndrome, a rare association in the literature.

Este trabalho é resultado de uma pesquisa teórica que teve como objetivo analisar a contribuição de Herbert Marcuse, autor da teoria crítica da sociedade, para pensar a relação entre arte, sujeito e formação para a resistência à sociedade unidimensional. Foram estudados os seguintes textos escritos entre 1941 e 1977: Razão e revolução (1941/1978), Eros e civilização (1955/1969), Ideologia da sociedade industrial: o homem unidimensional (1964/1973), Ideias sobre uma teoria crítica da sociedade (1969/1981) e A dimensão estética (1977/1999). Para Marcuse, a arte é política, apresenta universalidade, alteridade, transcendência, forma estética e negação e confirmação da realidade. A arte é objetivação e não trabalho alienado, ela realiza a sublimação e provoca sensibilidade, diferenciando-se da mercadoria que se apropria da cultura, fazendo-a esvaziar-se em seu sentido. Ao analisar a arte, esse autor contribuiu para uma psicologia social crítica que revela a arte como mediação psicossocial para um sujeito não adaptado.

Moebius syndrome (MS) is a congenital syndrome characterized by unilateral or bilateral aplasia of the VI and VII cranial nerves, with consequent convergent strabismus and bilateral peripheral facial paralysis. This syndrome might be associated with diurnal excessive sleepiness and muscular hypotony, mimetizing in this manner, narcolepsy. The diagnostic criteria for narcolepsy depend on the presence of REM sleep during the day. As with patients with MS we do not have ocular movements due to the VI nerve paralysis, the absence of horizontal ocular movements might make it difficult to confirm narcolepsy in these patients. The common clinical characteristics of these patients are due to a possible impairment of the same structures that are affected in the central nervous system. However, the mechanism by which it occurs remains to be fully understood. Further electrophysiological researches are necessary to better clarify the association of these two diseases. The objective of this dissertation is to describe and discuss a case of Moebius syndrome with diurnal excessive sleepiness as a differential diagnosis for narcolepsy.

Narcolepsy is a chronic neurological disease characterized by diurnal excessive sleepiness and catapleaxy. It affects 1 in every 2000 to 4000 individuals with personal, social and familiar significant repercussions. The treatment of narcolepsy is mainly based on the use of stimulants for the control of the diurnal excessive sleepiness, in conjunction with behavioral measures and sleep hygiene. Among the stimulants, modafinil has presently been the drug of choice for the treatment of the diurnal excessive sleepiness in patients with narcolepsy. In the worldwide experience, its use is better tolerated and the majority of its side effects is considered light or moderate. However, the clinical use in Brazil was initiated at the end of 2008, with little experience on the narcolepsy population of this country. In this context, the objective of this study was the evaluation of the use of modafinil, verifying the indication of use, causes for discontinuation, daily dosage, efficiency of the treatment in a patient sample of narcoleptics consulted in a specialized center in Brazil. In this study, modafinil was effective for the control of the symptoms related do narcolepsy in 66% of the studied patients. The side effects such as headache, parestesias and diarrhea were the main reasons for the discontinuation of treatment with modafinil. It is important to clinically follow up the patients for a long period to evaluate symptomatology, control of use, tolerability and re-evaluation of the more effective therapeutic dosage able to control narcolepsy. Due to its high cost and clinical benefits, this drug should be on the government׳s list of free drugs for the treatment of these patients.

La presente investigación tuvo como objetivo describir las pautas, creencias y prácticas de crianza relacionadas con el castigo y su transmisión generacional en cuatro familias de nivel socioeconómico bajo de la ciudad de Bogotá. Utilizamos entrevistas semiestructuradas, historias de vida, observaciones de campo, y el Software Atlas.ti para analizar los resultados. Encontramos que las pautas de crianza relacionadas con el castigo están enmarcadas en el rol del abuelo o de la abuela como cuidador o cuidadora entre semana, en el del padre o madre como cuidador o cuidadora de fin de semana, y en el del niño o niña como el sujeto travieso. Las creencias se establecen en torno al niño o niña como fuerte y frágil, y al castigo como formador, ambivalente, maltratante y temido.

La presente investigación tuvo como objetivo describir las pautas, creencias y prácticas de crianza relacionadas con el castigo y su transmisión generacional en cuatro familias de nivel socioeconómico bajo de la ciudad de Bogotá. Utilizamos entrevistas semiestructuradas, historias de vida, observaciones de campo, y el Software Atlas.ti para analizar los resultados. Encontramos que las pautas de crianza relacionadas con el castigo están enmarcadas en el rol del abuelo o de la abuela como cuidador o cuidadora entre semana, en el del padre o madre como cuidador o cuidadora de fin de semana, y en el del niño o niña como el sujeto travieso. Las creencias se establecen en torno al niño o niña como fuerte y frágil, y al castigo como formador, ambivalente, maltratante y temido.

El presente trabajo aborda un tema que ha ido ganando importancia en el mundo actual: las Multilatinas. Estas empresas han surgido de las economías en desarrollo de América Latina y durante las últimas décadas han crecido exponencialmente tanto en el ámbito nacional como internacional.A través de este trabajo se estudia la importancia de las Multilatinas en la región, sus características comunes y sus procesos de internacionalización con el fin de identificar si existe un patrón común en sus movimientos internacionales. De hecho, la apertura económica que vivió América Latina en los años 90 dejó dos opciones para las empresas: modernizarse o desaparecer. Por lo tanto, las Multilatinas son las sobrevivientes de este fenómeno que se desarrolló en condiciones adversas a través de un proceso de “Aprender-haciendo”.The following paper addresses an issue that has been gaining importance in today’s world: Multilatinas. Those are companies that have emerged from Latin American developing economies and that during the last decades have been growing really fast in the national and the international field. Through this paper we studied the importance of Multilatinas in the region, their common characteristics and their internationalization processes in order to identify if there is a common pattern in their international moves. Actually, the economic openness of Latin America in the 90s left two options for enterprises: to modernize or to disappear. Therefore, Multilatinas represent the survivors from this phenomenon that flourished in adverse conditions through a process of “learning-by-doing”.

O Programa RECAJ UFMG, originado em 2007, consiste em grupo de estudos, pesquisa e extensão acerca das formas de resolução de conflitos e do acesso à justiça. Orientado pela Professora Adjunta da Faculdade de Direito da Universidade Federal de Minas Gerais, Dra. Adriana Goulart de Sena Orsini, o RECAJ UFMG, composto por alunos e ex?alunos de graduação e pós? graduação, dedica suas atividades ao estudo e à difusão social dos diferentes métodos de solução de controvérsias, com destaque para as formas alternativas e pacíficas de resolução de conflitos. Ao longo de sua existência, o Programa já promoveu, dentre outros, seminários, pesquisas e uma cartilha didática em parceria com o Ministério da Educação intitulada “Formas de resolução de conflitos e acesso à justiça”.Boaventura de Souza Santos (2004) considera ser inerente à universidade pública a função de estabelecer uma relação dialógica e mutuamente benéfica entre o meio acadêmico e comunidade em geral . Por meio da extensão universitária, o Programa RECAJ criou em 2011 o Projeto “RECAJ nas Escolas”, compreendendo ser possível e necessária a realização de parcerias autênticas entre as diferentes instituições de ensino ? públicas e privadas – nas quais se enseje relações dialógicas entre o ensino fundamental, médio e superior. O enfoque pluralista, interdisciplinar e construtivista do referido projeto, encontrou, nas obras pedagógico?educacionais de Paulo Freire, um importante norte teórico para o desenvolvimento dos trabalhos junto às crianças e aos adolescentes.

The present study was carried out to investigate the effects of Rudgea viburnoides infusion on the body biometry and testicular morphometry and stereology of adult Wistar rats. Two groups received the infusion daily at the concentration of 3 or 6 mg/mL for 40 days. The control group received only water. Neither the biometrical parameters nor the tubular diameter and the height of the seminiferous epithelium showed any significant alterations in the treated animals. Leydig cells stereology did not show any significant alterations in the treated animals. These results indicated that R. viburnoides did not cause alterations in body biometry and testicular morphometry.

Studies have pointed out that approximately 50–60% of narcolepsy patients may demonstrate higher prevalence of periodical leg movements. However, we highlight that the prevalence studies and the effects of periodical leg movements in patients with narcolepsy are limited and with conflicting results. The objective of this study was that of describing and discussing the prevalence of periodical leg movements in patients with narcolepsy in the outpatient facility of diurnal excessive sleepiness of the Federal University of São Paulo, Brazil. We revised 59 files of patients with the clinical and electrophysiological diagnosis of narcolepsy according to the American Academy of Sleep Medicine. Of these 59 cases of patients with narcolepsy, 12 (20.3%) demonstrated periodical leg movements. Thirty five patients (59.3%) had history of cataplexy and 38 patients (64.4%) had the presence of the allele HLA-DQB1⁎0602. There was a higher prevalence of periodical leg movements in patients with cataplexy (p

This is a series of cases describing the use of citalopram for the treatment of cataplexy in patients with narcolepsy. Cataplexy is the most specific symptom of narcolepsy, being characterized by a sudden and temporary loss of muscle tonus, triggered by episodes of emotion during vigil. Some antidepressants, besides gamma-hydroxybutyrate, are used for the control of cataplexy. As gamma-hydroxybutyrate is not available in Brazil, local treatment is usually done by the use of antidepressants. Citalopram is a selective inhibitor of serotonin reuptake, with reasonable price and with fewer side effects when compared with other drugs of the same type. In this study, we report a series of cases with patients with narcolepsy and cataplexy, treated with citalopram for the control of cataplexy.

Narcolepsy is a disease in which there is diurnal excessive sleepiness with sleep attacks and a prevalence in the general population of 1/4000 individuals. Classically, it is characterized by cataplexy, sleep paralysis, hypnagogic hallucinations and fragmented sleep. The use of modafinil in the treatment of narcolepsy is the first option of treatment for diurnal excessive sleepiness. Although considered a safe drug for use in patients with narcolepsy, being utilized for more than 20 years, modafinil possesses a series of side effects, some of them still not fully researched or described. Side effects such as headache, nausea, anxiety, insomnia, lumbago, diarrhea, dyspepsia, rhinitis and vertigo are the most frequent. However, the clinical follow-up of patients under treatment with modafinil must be intensive and the side effects ought to be noted and evaluated. The under-response to treatment or the unexpected side effects must always be directed to differential diagnostics. The objective of this article is to describe an unexpected side effect of the use of modafinil in a patient with incorrect diagnosis of narcolepsy.

Rudgea viburnoides leaves are widely used in popular Brazilian medicine as a diuretic, antirheumatic, hypotensive and blood depurative tea. The present study was carried out to investigate the effects of this infusion on the liver and on the plasma biochemical parameters of Wistar rats. Two groups received the R. viburnoides leaf infusion at a daily dose of 10 or 20g dry-leaves/L water, during 40 days. The histopathological analysis did not show degenerated areas or infiltration of leucocytes. Hepatic morphometry showed accumulation of fat in the hepatocytes of the treated groups. There was no significant change in the plasma levels of urea, creatinin, uric acid, direct bilirubin, cholesterol, total proteins, albumin, gamma glutamyl tranferase (gamma-GT), alanine transaminase (ALT), aspartate transaminase (AST), chlorine, phosphate and calcium. A significant reduction in the plasma levels of triacylglycerol (TAG) occurred in the group that received the higher dose.As folhas de Rudgea viburnoides Benth. são utilizadas na medicina popular como diuréticas, hipotensoras, anti-reumáticas, depurativas do sangue e em regimes de emagrecimento. O presente estudo foi delineado para avaliar o efeito da infusão das folhas de R. viburnoides nos parâmetros bioquímicos plasmáticos e na morfologia e morfometria hepática de ratos Wistar adultos. Dois grupos receberam a infusão das folhas, diariamente, nas dosagens de 10 e 20 g de folhas secas/L de água, durante 40 dias. O grupo controle recebeu a mesma quantidade de água. As análises histopatológicas não mostraram áreas degeneradas e infiltrados inflamatórios. A morfometria hepática mostrou acúmulo significativo de gordura nos hepatócitos dos animais tratados, principalmente no grupo que recebeu a maior dose da infusão (8,75% de gotículas lipídicas), comparado com 0,25% delas encontradas nos animais controles. Não foram observadas alterações nos níveis plasmáticos de uréia, creatinina, ácido úrico, bilirrubina direta, colesterol, proteínas totais, albumina, gama-glutamil transferase (GGT), alanina transaminase (ALT), aspartato transaminase (AST), cloro, fósforo e cálcio. Foi observada redução significativa de 20,6% nos níveis plasmáticos de triacilglicerol no grupo que recebeu a infusão mais concentrada, comparada aos animais controle.

This study was carried out to evaluate the effects of Arctium lappa L. (burdock) on the liver of adult male Wistar rats as measured by light microscopy and biochemical parameters. The rats received the extract in water bottles at doses of 10 or 20 g/L daily for 40 days. There were no significant changes in the plasma levels of albumin, aspartate transaminase (AST), alanine transaminase (ALT), gamma glutamyl transferase (GGT), total protein, total cholesterol, urea, uric acid, triacylglycerol, calcium, phosphorus, chlorine and direct bilirubin. The morphological analysis did not reveal histopathological alterations in liver tissue. Both biochemical and morphological data did not indicate A. lappa toxicity.A bardana (Arctium lappa L) é uma planta trazida do Japão e aclimatada no Brasil, e é extensamente utilizada na medicina popular em todo mundo. Este estudo foi realizado para avaliar os possíveis efeitos da A. lappa no fígado e nos parâmetros bioquímicos plasmáticos em ratos Wistar adultos. Estes receberam a infusão de bardana nas doses de 10 ou 20 g de folhas secas /L de água, por 40 dias. Não houve alteração significativa nos níveis plasmáticos de albumina, aspartato transaminase (AST), alanina transaminase (ALT), gamma glutamil transferase (GGT), proteínas totais, colesterol total, uréia, ácido úrico, triglicérides, cálcio, fósforo, bilirrubina direta e cloro. A análise morfológica não revelou alterações histopatológicas no fígado. Os dados bioquímicos e morfológicos não indicaram a toxicidade da bardana.

This paper provides descriptive conceptual evidence and a theoretical interpretation of the international processes followed by leading Latin American multinationals (multilatinas) in the food industry (JBS-Friboi, Bimbo, Mar- frig, Gruma, and Brasil Foods). Using a multiple-case study methodology, this paper presents evidence for building and testing in internationalization theory. We found that Latin American multinationals in this specific sector have assumed unremitting creative adaptation processes to overcome the liabilities of foreignness and emerging-ness while demonstrating speedily reactions to market opportunities and institutional adversities. Even though there are distinc- tive case-by-case features, this paper confirms that theoretical frameworks do exist that are sufficiently able to pro- vide an understanding of these emerging-market multinationals’ internationalization processes.

The epidermis of Ostariophysi fish is composed of 4 main cell types: epidermal cells (or filament containing cells), mucous cells, granular cells and club cells. The morphological analysis of the epidermis of the catfish Pimelodella lateristriga revealed the presence of only two types of cells: epidermal and club cells. The latter were evident in the middle layer of the epidermis, being the largest cells within the epithelium. Few organelles were located in the perinuclear region, while the rest of the cytoplasm was filled with a non-vesicular fibrillar substance. Club cells contained two irregular nuclei with evident nucleoli and high compacted peripheral chromatin. Histochemical analysis detected prevalence of protein within the cytoplasm other than carbohydrates, which were absent. These characteristics are similar to those described to most Ostariophysi studied so far. On the other hand, the epidermal cells differ from what is found in the literature. The present study described three distinct types, as follows: superficial, abundant and dense cells. Differences among them were restricted to their cytoplasm and nucleus morphology. Mucous cells were found in all Ostariophysi studied so far, although they were absent in P. lateristriga, along with granular cells, also typical of other catfish epidermis. The preset study corroborates the observations on club cells' morphology in Siluriformes specimens, and shows important differences in epidermis composition and cell structure of P. lateristriga regarding the literature data.

Abstract Objective To explore 1) if perfectionism, perceived distress/coping, and cognitive emotion regulation (CER) are associated with and predictive of negative/positive affect (NA/PA); and 2) if CER and perceived distress/coping are associated with perfectionism and if they mediate the perfectionism-NA/PA associations. There is a distinction between maladaptive and adaptive perfectionism in its association with NA/PA. CER and perceived distress/coping may mediate the maladaptive/adaptive perfectionism and NA/PA associations. Methods 344 students (68.4% girls) completed the Hewitt & Flett and the Frost Multidimensional Perfectionism Scales, the Composite Multidimensional Perfectionism Scale, the Profile of Mood States, the Perceived Stress Scale, and the Cognitive Emotion Regulation Questionnaire. Results NA predictors were maladaptive/adaptive perfectionism, maladaptive CER and perceived distress (positively), positive reappraisal and planning, and perceived coping (negatively). PA predictors were maladaptive/adaptive perfectionism and perceived distress (negatively), positive reappraisal and planning, positive refocusing and perceived coping (positively). The association between maladaptive perfectionism and NA was mediated by maladaptive CER/low adaptive CER, perceived distress/low coping. Maladaptive perfectionism and low PA association was mediated by perceived distress. High PA was determined by low maladaptive perfectionism and this association was mediated by adaptive REC and coping. Adaptive perfectionism and NA association was mediated by maladaptive CER and perceived distress. Conclusion CER and perceived distress/coping are associated and mediate the perfectionism-NA/PA associations.