Abstract Introduction: Organizational management models influence supervisory activity in nursing. Collaborative practice between students and health professionals in the provision of person- and family-centred care allows them to evolve in the process of autonomy and knowledge transfer. However, this does not guarantee the acquisition of supervisory practices and inter-organisational interaction between the hospital and the academy, which are necessary for carrying out safe and qualified clinical procedures. However, this does not guarantee efficient acquisition of supervisory practices and inter-organizational interaction between hospital and academia, which are necessary to provide safe and effective clinical procedures. Objectives: The aim is to understand the possible dimensions of inter-organisational collaborative practice (academic and hospital), identifying its possible processes and results capable of guaranteeing the safety and quality of clinical procedures. Methods: This study emerges from a first mixed research intervention with N=50 nurse supervisors, non-randomized, using the snowball technique. We will, nevertheless, focus on its qualitative, exploratory, and descriptive approach, using the Focus Group technique in which seven nurse supervisors took part. By using Bardin's assumptions, we conducted the content analysis of the participants' speech. Results: The content analysis allowed us to recognise the Processes of Inter-Collaborative Supervision in Nursing as the main dimension of analysis. The results identify, on the one hand, potential threats, highlighted by the time dedicated to supervision and access to information in the hospital context and, on the other hand, opportunities for articulation, highlighted by the importance of involving the various actors in each context, both in planning training programmes and in using supervisory strategies. Conclusion: This study explores the collaborative processes of nursing supervision between academia and hospitals, highlighting common elements of care and education. It reveals the influence of both bureaucratic and anarchic models in shaping these relationships. The findings underscore the importance of inter-organizational coordination, which plays a critical role in effective health promotion practices.

RESUMEN Introducción: la salud mental es crucial para el bienestar y el rendimiento académico de los estudiantes universitarios. Los estudiantes de Kinesiología y Fisioterapia enfrentan desafíos únicos que pueden afectar su salud mental. Objetivo: determinar la frecuencia de trastornos mentales comunes en estudiantes de kinesiología y fisioterapia de la Universidad Nacional de Asunción. Metodología: se trata de un estudio observacional, descriptivo y transversal. La muestra no probabilística estuvo compuesta por 150 estudiantes de Kinesiología y Fisioterapia de la Universidad Nacional de Asunción. Se recogieron datos sociodemográficos, académicos, ocupacionales, de estilo de vida y psicopatológicos mediante la Escala de Depresión, Ansiedad y Estrés - 21 (DASS-21). El análisis se realizó mediante Jamovi con regresión logística binomial multivariada. Resultados: la frecuencia de depresión, ansiedad y estrés fue del 61,3 %, 72 % y 54,7 %, respectivamente. Los factores importantes para la depresión incluyeron ser un estudiante irregular, trabajar y no realizar actividad física. Para la ansiedad, fueron significativos ser estudiante irregular y ser mujer. Respecto al estrés, se encontraron relevantes ser estudiante irregular, trabajar y no realizar actividad física. Los modelos resultantes tuvieron clasificaciones correctas del 90,2 %, 88 % y 72 % para depresión, ansiedad y estrés, respectivamente. Conclusión: Este estudio reveló una alta frecuencia de depresión, ansiedad y estrés entre estudiantes de kinesiología y fisioterapia, lo que se asoció significativamente con irregularidad académica, empleo y falta de actividad física. Estos hallazgos subrayan la necesidad de implementar estrategias de intervención y programas de apoyo que aborden estos factores de riesgo para promover la salud mental y el bienestar de los futuros profesionales de la salud.

ABSTRACT Introduction: mental health is crucial for university students’ well-being and academic performance. Kinesiology and Physical Therapy students face unique challenges that can affect their mental health. Objective: to determine the frequency of common mental disorders in kinesiology and physical therapy students at the Universidad Nacional de Asunción. Methodology: this was an observational and descriptive cross-sectional study. The nonprobabilistic sample included 150 Kinesiology and Physiotherapy students from the Universidad Nacional de Asunción. Sociodemographic, academic, occupational, lifestyle, and psychopathological data were collected using the Depression, Anxiety and Stress Scale - 21 (DASS-21). The analysis was performed using Jamovi with multivariate binomial logistic regression. Results: the frequency of depression, anxiety, and stress was 61.3 %, 72 %, and 54.7 %, respectively. The significant factors for depression included being an irregular student, working, and not engaging in physical activity. For anxiety, being an irregular student and being a woman were significant. Regarding stress, being an irregular student, working, and not engaging in physical activity were found to be relevant. The resulting models had correct classifications of 90.2 %, 88 %, and 72 % for depression, anxiety, and stress, respectively. Conclusion: this study revealed a high frequency of depression, anxiety, and stress among kinesiology and physical therapy students, which was significantly associated with academic irregularity, employment, and a lack of physical activity. These findings underscore the need to implement intervention strategies and support programs that address these risk factors in order to promote the mental health and well-being of future health professionals.

School-related Gender-based Violence (SRGBV) is a sub-set of gender-based violence (GBV) that occurs in primary and secondary school settings. SRGBV is a daunting reality, a crime against humanity, and therefore a human rights issue. Responsive SRGBV programmes need to be dynamic, and determined by the needs of communities and learners. If the Department of Basic Education (DBE) wants to remain relevant in supporting communities into becoming safe spaces for all, it needs to promote safe community models with adequate flexibility. Although school-based occupational therapists are a human resource of the DBE, traditionally occupational therapists have not been involved in addressing SRGBV in school settings in South Africa. IMPLICATIONS FOR PRACTICE: This opinion paper elaborates on the context within which school-based occupational therapists can reframe SRGBV as an occupational injustice, and develop life skills interventions that address SRGBV. Recommendations for action are made using existing frameworks such as the Participatory Occupational Justice Framework, and the INSPIRE framework of the United Nations. It encourages school-based occupational therapists to become activists that promote occupational justice, and are leaders in the prevention of and intervention for SRGBV.

Abstract Objective: Ovarian torsion (OT) represents a severe gynecological emergency in female pediatric patients, necessitating immediate surgical intervention to prevent ovarian ischemia and preserve fertility. Prompt diagnosis is, therefore, paramount. This retrospective study set out to assess the utility of combined clinical, ultrasound, and laboratory features in diagnosing OT. Methods: The authors included 326 female pediatric patients aged under 14 years who underwent surgical confirmation of OT over a five-year period. Logistic regression analysis was employed to pinpoint factors linked with OT, and the authors compared clinical presentation, laboratory results, and ultrasound characteristics between patients with OT (OT group) and without OT (N-OT group). The authors conducted receiver operating characteristic (ROC) curve analysis to gauge the predictive capacity of the combined features. Results: Among 326, OTwas confirmed in 24.23 % (79 cases) of the patients. The OT group had a higher incidence of prenatal ovarian masses than the N-OT (22 cases versus 7 cases) (p < 0.0001). Similarly, the authors observed significant differences in the presence of lower abdominal pain, suspected torsion on transabdominal ultrasound, and a high neutrophil-lymphocyte ratio (NLR > 3) between the OTand non-OT groups (p < 0.05). Furthermore, when these parameters were combined, the resulting area under the curve (AUC) was 0.868, demonstrating their potential utility in OT diagnosis. Conclusion: This study demonstrates a prediction model integrating clinical, laboratory, and ultrasound findings that can support the preoperative diagnosis of ovarian torsion, thereby enhancing diagnostic precision and improving patient management. Future prospective studies should concentrate on developing clinical predictive models for OTin pediatric patients. Objective fertility is therefore paramount Methods 32 1 fiveyear five year period presentation results NOT N group. . ROC (ROC Results 2423 24 23 24.2 79 (7 22 (2 p 0.0001. 00001 0.0001 0 0001 0.0001) Similarly pain neutrophillymphocyte neutrophil lymphocyte NLR 3 nonOT non 0.05. 005 0.05 05 0.05) Furthermore AUC (AUC 0868 868 0.868 Conclusion management 242 2 24. ( 0000 0.000 000 00 0.0 086 86 0.86 0.00 0. 08 8 0.8

Resumen Introducción: la profilaxis preexposición al VIH (PrEP) ha demostrado disminuir la incidencia del VIH, pero su adopción en Colombia es aún incipiente. Para avanzar en la implementación de la PrEP como intervención de salud pública es necesario conocer el interés de las poblaciones en riesgo de VIH y los factores que facilitarían su uso. Objetivo: identificar los factores relacionados con el interés e intención de tomar PrEP en hombres gay/bisexuales. Metodología: estudio transversal analítico en una muestra no probabilística en ciudades principales de Colombia. Se exploraron las características sociodemográficas, conocimiento, motivaciones, habilidades conductuales y factores psicosociales, se utilizaron modelos logísticos para estimar la relación de estos factores con el interés y la intención de usar la PrEP. Resultados y conclusiones: participaron 552 hombres gay/bisexuales, 301 (54 %) reclutados en línea y 251 en persona. Solo el 40 % de la muestra sabía de la existencia de PrEP. 57.4 % (IC95%:54.9%-62.4%) reportaron interés e 52.9 % (IC95%: 48.5%-57.3%) intención de usar PrEP. El interés y la intención de usar la PrEP se relacionaron con actitudes y normas positivas hacia PrEP, así como con mayores habilidades relacionadas con servicios de PrEP. El estigma hacia la PrEP y los síntomas depresivos se relacionaron con menor interés e intención. Los resultados sugieren la necesidad de fomentar la información sobre PrEP, especialmente en poblaciones con más desventajas sociales y que experimentan más estigma, al igual que desarrollar intervenciones comunitarias que apoyen las motivaciones y las habilidades para usar la PrEP.

Abstract Introduction: HIV pre-exposure prophylaxis (PrEP) has been shown to reduce the incidence of HIV, but its adoption in Colombia is still beginning. To advance the implementation of PrEP as a public health intervention, it is necessary to know the interest of populations at risk of HIV and the factors that would facilitate its use. Objective: Identify factors related to interest and intention to take PrEP in gay/bisexual men. Methodology: Analytical cross-sectional study in a non-probabilistic sample in main cities of Colombia. Sociodemographic characteristics, knowledge, motivations, behavioral skills, and psychosocial factors were explored; logistic models were used to estimate the relationship of these factors with interest and intention to use PrEP. Results and conclusions: 552 gay/bisexual men participated, 301 (54%) recruited online and 251 in person. Only 40% of the sample knew of the existence of PrEP. 57.4% (95% CI: 54.9%-62.4%) reported interest and 52.9% (95% CI: 48.5%-57.3%) intention to use PrEP. Interest and intention to use PrEP were related to positive attitudes and norms toward PrEP, as well as greater skills related to PrEP services. Stigma toward PrEP and depressive symptoms were related to lower interest and intention. Our results suggest the need to promote information about PrEP, especially in populations with more social disadvantages and who experience more stigma, as well as to develop community interventions that support motivations and skills to use PrEP.

Resumo Introdução: Foi demonstrado que a profilaxia pré-exposição ao VIH (PrEP) reduz a incidência do VIH, mas a sua adopção na Colômbia está apenas a começar. Para avançar na implementação da PrEP como intervenção de saúde pública, é necessário conhecer o interesse das populações em risco de VIH e os fatores que facilitariam a sua utilização. Objetivo: Identificar fatores relacionados ao interesse e intenção de tomar PrEP em homens gays/bissexuais. Metodologia: Estudo analítico transversal em amostra não probabilística nas principais cidades da Colômbia. Foram exploradas características sociodemográficas, conhecimentos, motivações, habilidades comportamentais e fatores psicossociais; modelos logísticos foram utilizados para estimar a relação desses fatores com o interesse e intenção de uso da PrEP. Resultados e conclusões: Participaram 552 homens gays/bissexuais, 301 (54%) recrutados online e 251 pessoalmente. Apenas 40% da amostra sabia da existência da PrEP. 57,4% (IC 95%: 54,9%-62,4%) relataram interesse e 52,9% (IC 95%: 48,5%-57,3%) intenção de usar a PrEP. O interesse e a intenção de usar a PrEP estavam relacionados com atitudes e normas positivas em relação à PrEP, bem como com maiores competências relacionadas com os serviços de PrEP. O estigma em relação à PrEP e os sintomas depressivos foram relacionados com menor interesse e intenção. Os nossos resultados sugerem a necessidade de promover informação sobre a PrEP, especialmente em populações com mais desvantagens sociais e que sofrem mais estigma, bem como desenvolver intervenções comunitárias que apoiem motivações e competências para usar a PrEP.

Resumen El objetivo de este texto es sistematizar los motivos de circunspección en relación con determinados usos de la noción de "subjetividad", en particular en el análisis de la relación con la actividad de trabajo. Esta noción, originaria de la filosofía, aunque notoriamente ambigua, ha ganado protagonismo en los últimos años, reavivando diversas polémicas. Se analizan las producciones científicas que la utilizan, especialmente cuando esta noción permite esbozar un "panorama conceptualizado". También se presentan modelos de intervención basados en este marco con el fin de aclarar algunos debates. En segundo lugar, se discuten modelos teórico-metodológicos y de intervención que se inscriben en una comunidad epistémica fundada en la convicción, emancipada de la noción de subjetividad, de que los avances en las disciplinas científicas cuyo objeto de estudio es la actividad de trabajo resultan de su encuentro con el conocimiento experiencial. El texto también destaca el carácter heurístico de los análisis comparativos y llama a la vigilancia el uso, a veces indiscriminado, de la noción de subjetividad.

Résumé On propose de systématiser les raisons d'une circonspection à l'égard de certains usages, particulièrement dans l'analyse de la relation avec l'activité de travail, de la notion de "subjectivité". Cette notion, issue de la philosophie, bien que notoirement ambiguë, s'est imposée ces dernières années, réactivant certaines controverses. Des productions scientifiques qui y ont recours sont analysées, notamment lorsque cette notion permet d'énoncer un "panorama conceptualisé". Des modèles d'intervention qui s’en sont inspirés sont également repris, permettant d'éclaircir certains débats. Dans un deuxième temps, on évoque des modèles théorico-méthodologiques et d’intervention qui s'inscrivent au sein d'une communauté épistémique fondée sur la conviction, émancipée de la notion de subjectivité, que les avancées des disciplines scientifiques définissant l’activité de travail comme leur objet d’étude, émergent de leur rencontre avec des savoirs d'expérience. Le texte insiste sur le caractère heuristique des analyses comparatives. C’est aussi un appel à la vigilance face à l'usage souvent indiscriminé de la notion de subjectivité.

Resumo O propósito do texto é de sistematizar as razões de circunspeção em relação a certos usos da noção de "subjetividade", nomeadamente na análise da relação com a atividade de trabalho. Esta noção, originária da filosofia, embora notoriamente ambígua, tem vindo a ganhar destaque nos últimos anos, reavivando polémicas variadas. São analisadas produções científicas que a utilizam, especialmente quando esta noção permite delinear um "panorama conceptualizado". São também apresentados modelos de intervenção assentes nesse quadro com o objetivo de clarificar alguns debates. Em segundo lugar, são discutidos modelos teórico-metodológicos e de intervenção que fazem parte de uma comunidade epistémica fundada na convicção, emancipada da noção de subjetividade, de que os avanços das disciplinas científicas que têm como objeto de estudo a atividade laboral resultam do seu encontro com os saberes experienciais. O texto sublinha ainda o carácter heurístico das análises comparativas e apela também à vigilância nas utilizações, por vezes indiscriminadas, da noção de subjetividade.

Abstract We propose to systematize the reasons for our circumspection with regard to certain uses of the notion of "subjectivity", particularly in the analysis of the relationship with work activity. Although notoriously ambiguous, this notion, stemming from philosophy, has come to the fore in recent years, reactivating certain controversies. We analyze scientific productions that make use of this notion, particularly when it allows us to set out a "conceptualized panorama". Intervention models inspired by this approach are also reviewed, helping to clarify certain debates. Secondly, we discuss theoretical-methodological and intervention models that are part of an epistemic community founded on the conviction, emancipated from the notion of subjectivity, that advances in scientific disciplines defining work activity as their object of study, emerge from their encounter with experiential knowledge. The text insists on the heuristic character of comparative analyses. It also calls for vigilance in the face of the often-indiscriminate use of the notion of subjectivity.

Abstract With the upsurge of community uptake in popula tion-based early screening for autism, the main obstacle to increasing access to early treatment and intervention services is the extremely limited access to high quality diagnosis, specifically the shortage of expert clinicians. Diagnostic evaluation models deployed by academic cen ters of excellence, which typically require the investment of 6-10 hours by specialized multidisciplinary teams, is not a viable solution to the vast needs of communities, resulting in parents’ “diagnostic odysseys” and delays, often of several years, for treatment, interventions and supports. Biomarker-based objective procedures for early diagnosis and assessment of autism are now available, clinically validated, and cleared for broad implementa tion by the US Food and Drug Administration (FDA). They are intended to increase access while maintaining high quality. Such solutions, however, will require change in entrenched models of diagnostic care, and aggressive prioritization of the needs of the community at large. If these innovations are successful, the number of children diagnosed in the first three years of life will double or triple. This will, in turn, require much greater inves tments in resources for treatment, including massive workforce training of providers capable of delivering community-viable caregiver-mediated interventions, and of early educators capable of serving autistic children in therapeutic inclusive preschool settings.

Resumen Con el aumento de la aceptación comunitaria de la detección temprana del autismo basada en la pobla ción, el principal obstáculo para aumentar el acceso al tratamiento temprano y a los servicios de intervención es el acceso extremadamente limitado a un diagnóstico de alta calidad, específicamente la escasez de médicos expertos. Los modelos de evaluación diagnóstica imple mentados por centros académicos de excelencia, que normalmente requieren la inversión de 6 a 10 horas por parte de equipos multidisciplinarios especializados, no son una solución viable para las vastas necesidades de las comunidades, lo que resulta en “odiseas diagnósti cas” y retrasos, a menudo de gran importancia, para los padres varios años, para tratamiento, intervenciones y apoyos. Los procedimientos objetivos basados en bio marcadores para el diagnóstico temprano y la evaluación del autismo ya están disponibles, clínicamente validados y aprobados para su amplia implementación por la Ad ministración de Alimentos y Medicamentos de EE. UU. (FDA). Su objetivo es aumentar el acceso manteniendo una alta calidad. Sin embargo, tales soluciones requeri rán cambios en los modelos arraigados de atención de diagnóstico y una priorización agresiva de las necesida des de la comunidad en general. Si estas innovaciones tienen éxito, el número de niños diagnosticados en los primeros tres años de vida se duplicará o triplicará. 51 Esto, a su vez, requerirá inversiones mucho mayores en recursos para el tratamiento, incluida la capacitación masiva de la fuerza laboral de proveedores capaces de brindar intervenciones comunitarias viables mediadas por cuidadores, y de educadores tempranos capaces de atender a niños autistas en entornos preescolares terapéuticos inclusivos.

RESUMEN Introducción: el acceso a los servicios de salud en Paraguay, está determinado por varios tipos de barreras. Por ello, es preciso describir el impacto que tienen las políticas públicas y sus implicancias en la mitigación de las mismas. Objetivo: describir el acompañamiento diferenciado y su contribución al apoyo socio emocional, adhesión al tratamiento y acceso a servicios de salud en el área de atención a personas varones que viven con el VIH. Metodología: estudio de carácter cualitativo, descriptivo, con entrevistas semi estructuradas y muestra no probabilística, dirigida e intencional; Resultados: este estudio cualitativo exploró las experiencias de personas viviendo con VIH que recibieron acompañamiento psicosocial diferenciado en un servicio de atención integral. Los participantes destacaron la importancia del acompañamiento para afrontar la crisis posterior al diagnóstico. La orientación presencial, escucha empática y seguimiento facilitaron la vinculación y adherencia al servicio de salud y al tratamiento antirretroviral. El apoyo psicosocial fue clave para desmitificar ideas erróneas sobre el VIH/SIDA, empoderarse sobre su estado serológico y mejorar la calidad de vida. Se enfatizó el rol de los grupos de pares para brindar contención. Algunos participantes reportaron experiencias previas de revelación no consentida y vulneración de confidencialidad. El acompañamiento psicosocial diferenciado resultó fundamental para facilitar la inserción y permanencia de las personas con VIH en los servicios de atención integral (adhesión al tratamiento). Conclusiones: el acompañamiento psicosocial diferenciado resultó clave para facilitar la vinculación y adherencia en personas con VIH. La atención integral requiere identificar situaciones particulares, establecer relaciones de confianza y comunicación efectiva. El apoyo inicial es fundamental brindando contención ante el impacto emocional del diagnóstico. El seguimiento continuo es esencial dada la doble discriminación. La confidencialidad y capacidad de generar vínculos empáticos son elementos centrales. Los factores mencionados favorecen la adhesión al tratamiento. Los resultados sugieren que estas prácticas psicosociales pueden optimizar modelos de atención integral a personas con VIH.

ABSTRACT Introduction: access to healthcare services in Paraguay is influenced by various barriers. Thus, it is essential to describe the impact of public policies and their implications in mitigating these barriers. Objective: to describe the differentiated support and its contribution to socio-emotional support, therapeutic adherence, and access to healthcare services in the area of care for males living with HIV. Methodology: a qualitative, descriptive study with semi-structured interviews and a non-probabilistic, directed, and intentional sample. Results: this qualitative study explored the experiences of individuals living with HIV who received differentiated psychosocial support in an integrated care service. Participants emphasized the importance of support in coping with the post-diagnosis crisis. In-person guidance, empathetic listening, and follow-up facilitated engagement and adherence to healthcare services and antiretroviral treatment. Psychosocial support played a critical role in debunking misconceptions about HIV/AIDS, empowering individuals regarding their serostatus, and improving their quality of life. The role of peer groups in providing emotional support was emphasized. Some participants reported previous experiences of non-consensual disclosure and confidentiality breaches. Differentiated psychosocial support was essential in promoting the integration and retention of people with HIV in integrated care services (therapeutic adherence). Conclusions: differentiated psychosocial support was crucial in facilitating the engagement and adherence of individuals with HIV. Comprehensive care necessitates identifying specific situations, establishing trust-based relationships, and effective communication. Initial support is vital for providing emotional support in the face of the diagnostic impact. Ongoing follow-up is essential due to the dual discrimination faced. Confidentiality and the ability to build empathetic relationships are central elements. The aforementioned factors favor adherence to treatment. The results suggest that these psychosocial practices can enhance models of comprehensive care for people with HIV.

Resumo O aumento de infecções sexualmente transmissíveis (IST) na Europa e nos EUA, especialmente entre homens que fazem sexo com homens (HSH) e mulheres transexuais (TW), levantou preocupações e levou à exploração da profilaxia com doxiciclina como uma intervenção potencial. A profilaxia com doxiciclina pode ser administrada em dose diária de 100 mg (DoxyPrEP) ou em dose única de 200 mg pós-atividade sexual (DoxyPEP). Ensaios clínicos recentes, centrados principalmente em grupos de maior risco, mostraram reduções de aproximadamente 70% nas infecções por sífilis e clamídia e resultados conflituantes em relação à infecção por gonorreia (até 50%). Apesar destes avanços, a eficácia da profilaxia com doxiciclina entre as mulheres não foi demonstrada e esta estratégia levanta preocupações sobre a aceitabilidade da comunidade, eventos adversos, segurança, resistência antimicrobiana, perturbação do microbioma e relação custo-eficácia. Os ensaios clínicos em curso e os modelos baseados em agentes visam abordar estas incertezas para prever o impacto a nível populacional e em grupos específicos. Esta revisão tem como objetivo avaliar os dados existentes sobre a profilaxia de IST com doxiciclina, identificar lacunas de conhecimento e sintetizar a literatura e as diretrizes existentes sobre as recomendações atuais.

Abstract The increase in sexually transmitted infections (STIs) in Europe and the USA, especially among men who have sex with men (MSM) and transgender women (TW), has raised concerns and prompted the exploration of doxycycline prophylaxis as a potential intervention. Doxycycline prophylaxis can be administered either as a daily 100 mg dose (DoxyPrEP) or a single 200 mg dose post-sexual activity (DoxyPEP). Recent clinical trials, primarily focusing on higher-risk groups, have shown reductions of approximately 70% in syphilis and chlamydia infections and conflicting results regarding gonorrhea infection (up to 50%). Despite these advancements, the effectiveness of doxycycline prophylaxis among women has not been established and this strategy raises concerns about community acceptability, adverse events, safety, antimicrobial resistance, microbiome disruption, and cost-effectiveness. Ongoing clinical trials and agent-based models aim to address these uncertainties to predict the impact on a population level and on specific groups. This review aims to assess the existing data of doxycycline STI prophylaxis, identify knowledge gaps, and synthesize existing literature and guidelines about the current recommendations.

Objective: To test the efficacy of a dissonance-based (DB) intervention in targeting risk factors for eating disorders (EDs) and predisposing factors for muscle dysmorphia (MD) symptoms in body-dissatisfied Brazilian men over 1 year of follow-up and evaluate whether reductions in body-ideal internalization would mediate the intervention’s impact on ED and MD symptoms. Methods: Participants were randomized to a two-session DB intervention (n=89) or assessment-only control (AOC) (n=91), and completed validated measures assessing body-ideal internalization, body dissatisfaction, ED, and MD symptoms at baseline, post-intervention, 1-month, 6-month, and 1-year follow-ups. Results: The DB condition showed significantly greater reductions in MD symptoms and body dissatisfaction compared with the AOC group over a 1-year follow-up, while significant differences were not observed for body-ideal internalization and ED symptoms. Changes in body-ideal internalization from baseline to 1-month follow-up completely mediated the relationship between condition and the changes observed in both ED and MD symptoms. Conclusion: These results provide further evidence of the efficacy of the tested intervention through 1-year follow-up in reducing body dissatisfaction and MD symptoms, but no such result was observed for body-ideal internalization and EDs. Our findings provide support for theoretical models of eating pathology and MD symptoms in Brazilian men. Clinical Trial Registration: Brazilian Registry of Clinical Trials (ReBEC): RBR-27dc264. Objective dissonancebased dissonance based (DB EDs (EDs (MD bodydissatisfied dissatisfied followup follow up bodyideal ideal interventions s Methods twosession two session n=89 n89 n 89 (n=89 assessmentonly assessment only (AOC n=91, n91 n=91 , 91 (n=91) postintervention, postintervention post intervention, post-intervention 1month, 1month month month, 6month, 6month 6 6-month 1year followups. followups ups. ups follow-ups Results followup, up, Conclusion Registration ReBEC (ReBEC) RBR27dc264. RBR27dc264 RBRdc RBR 27dc264. 27dc264 dc RBR-27dc264 n=8 n8 8 (n=8 n9 n=9 9 (n=91 (ReBEC RBR27dc26 27dc26 RBR-27dc26 n= (n= (n=9 RBR27dc2 27dc2 RBR-27dc2 (n RBR27dc 27dc RBR-27dc

Abstract Modern non-destructive investigation techniques and computational tools for nonlinear analysis allow understanding the structural behavior and damage of existing buildings, aiming at the least possible extent of intervention. Careful and minimal intervention is essential to preserve the authenticity of the built cultural heritage. An investigation with a historical, experimental, and numerical approach was carried out in the Theatro Municipal do Rio de Janeiro, in Brazil, a building with an eclectic architecture from the beginning of the twentieth century. Its masonry domes and vault have paintings by renowned artists on their intrados and were strengthened in the 1970s. The adopted methodology was based on anamnesis, characterization and observation of the structure employing non-destructive tests, and on the assessment of its vulnerability by nonlinear analyses of calibrated numerical models. Several hypotheses of differential settlement under gravitational actions were investigated, seeking to reproduce the cracking pattern and to identify the causes of damage to the masonry domes and vault before the strengthening. The nonlinear analysis of the structure allowed to evaluate the causes of the observed damage, assess the level of safety, identify the most vulnerable parts, and characterize the collapse mechanisms, in addition to demonstrating the efficiency of the intervention measures adopted in the past. nondestructive non destructive buildings heritage historical experimental Janeiro Brazil century 1970s s anamnesis tests models investigated strengthening safety parts mechanisms past

Resumo Técnicas modernas de investigação não destrutiva e ferramentas computacionais para análise não linear permitem compreender o comportamento estrutural e danos em edifícios existentes, visando a menor intervenção possível. A intervenção cuidadosa e mínima é essencial para preservar a autenticidade do patrimônio cultural construído. Uma investigação de abordagem histórica, experimental e numérica foi realizada no Theatro Municipal do Rio de Janeiro, no Brasil, edifício de arquitetura eclética do início do século XX. Suas cúpulas e abóbada em alvenaria possuem pinturas de renomados artistas no intradorso e foram reforçadas na década de 1970. A metodologia adotada baseou-se na anamnese, caracterização e observação da estrutura por meio de ensaios não destrutivos e na avaliação de sua vulnerabilidade por análises não lineares de modelos numéricos calibrados. Diversas hipóteses de recalque diferencial sob ações gravitacionais foram investigadas, buscando reproduzir o padrão de fissuração e identificar as causas dos danos nas alvenarias antes do reforço. A análise não linear da estrutura permitiu avaliar as causas dos danos observados, estimar o nível de segurança, identificar as partes mais vulneráveis e caracterizar os mecanismos de colapso, além de demonstrar a eficácia das medidas de intervenção adotadas no passado. existentes possível construído histórica Janeiro Brasil XX 1970 baseouse baseou se anamnese calibrados investigadas reforço observados segurança colapso passado 197 19 1

Abstract Background Women, in comparison to men, experience worse outcomes after acute coronary syndrome (ACS). However, whether the female sex per se is an independent predictor of such adverse events remains unclear. Objective This study aims to assess the association between the female sex and in-hospital mortality after ST-elevation myocardial infarction (STEMI). Methods We conducted a retrospective cohort study by enrolling consecutive STEMI patients admitted to a tertiary hospital from January 2018 to February 2019. All patients were treated per current guideline recommendations. Multivariable logistic regression models were applied to evaluate in-hospital mortality using GRACE variables. Model accuracy was evaluated using c-index. A p-value < 0.05 was statistically significant. Results Out of the 1678 ACS patients, 709 presented with STEMI. The population consisted of 36% women, and the median age was 61 years. Women were older (63.13 years vs. 60.53 years, p = 0.011); more often presented with hypertension (75.1% vs. 62.4%, p = 0.001), diabetes (42.2% vs. 27.8%, p < 0.001), and hyperlipidemia (34.1% vs. 23.9%, p = 0.004); and were less likely to undergo percutaneous coronary intervention (PCI) via radial access (23.7% vs. 46.1%, p < 0.001). In-hospital mortality rate was significantly higher in women (13.2% vs. 5.6%, p = 0.001), and the female sex remained at higher risk for in-hospital mortality (OR 2.79, 95% CI 1.15–6.76, p = 0.023). A multivariate model including age, sex, systolic blood pressure, cardiac arrest, and Killip class was 94.1% accurate in predicting in-hospital mortality, and the c-index was 0.85 (95% CI 0.77–0.93). Conclusion After adjusting for the risk factors in the GRACE prediction model, women remain at higher risk for in-hospital mortality. men ACS. . (ACS) However unclear inhospital STelevation ST elevation (STEMI) 201 2019 recommendations variables cindex. cindex c index. index pvalue value 005 0 05 0.0 significant 167 70 36 6 63.13 6313 63 13 (63.1 vs 6053 60 53 60.5 0.011 0011 011 0.011) 75.1% 751 75 1 (75.1 624 62 4 62.4% 0.001, 0001 0.001 , 001 0.001) 42.2% 422 42 2 (42.2 278 27 8 27.8% 34.1% 341 34 (34.1 239 23 9 23.9% 0.004 0004 004 0.004) PCI (PCI 23.7% 237 7 (23.7 461 46 46.1% 0.001. Inhospital In 13.2% 132 (13.2 56 5 5.6% OR 279 79 2.79 95 115676 15 76 1.15–6.76 0.023. 0023 0.023 023 0.023) pressure arrest 941 94 94.1 085 85 0.8 (95 0.77–0.93. 077093 0.77–0.93 77 93 0.77–0.93) (ACS (STEMI 20 00 0. 16 3 63.1 631 (63. 605 60. 0.01 01 75.1 (75. 62.4 000 0.00 42.2 (42. 27.8 34.1 (34. 23.9 23.7 (23. 46.1 13.2 (13. 5.6 2.7 11567 1.15–6.7 002 0.02 02 94. 08 (9 07709 0.77–0.9 63. (63 75. (75 62. 42. (42 27. 34. (34 23. (23 46. 13. (13 5. 2. 1156 1.15–6. ( 0770 0.77–0. (6 (7 (4 (3 (2 (1 115 1.15–6 077 0.77–0 11 1.15– 07 0.77– 1.15 0.77 1.1 0.7 1.

Resumo Fundamento As mulheres, em comparação aos homens, apresentam piores resultados após a síndrome coronariana aguda (SCA). No entanto, ainda não está claro se o sexo feminino em si é um preditor independente de tais eventos adversos. Objetivo Este estudo tem como objetivo avaliar a associação entre o sexo feminino e a mortalidade hospitalar após infarto do miocárdio com supradesnivelamento do segmento ST (IAMCSST). Métodos Conduzimos um estudo de coorte retrospectivo, recrutando pacientes consecutivos com IAMCSST, internados em um hospital terciário de janeiro de 2018 a fevereiro de 2019. Todos os pacientes foram tratados de acordo com as recomendações das diretrizes atuais. Modelos de regressão logística multivariada foram aplicados para avaliar a mortalidade hospitalar utilizando variáveis de GRACE. A precisão do modelo foi avaliada usando o índice c. Um valor de p < 0,05 foi estatisticamente significativo. Resultados Dos 1.678 pacientes com SCA, 709 apresentaram IAMCSST. A população era composta por 36% de mulheres e a idade média era de 61 anos. As mulheres tinham maior idade (63,13 anos vs. 60,53 anos, p = 0,011); apresentavam hipertensão (75,1% vs. 62,4%, p = 0,001), diabetes (42,2% vs. 27,8%, p < 0,001) e hiperlipidemia (34,1% vs. 23,9%, p = 0,004) mais frequentemente; e apresentaram menor probabilidade de serem submetidas a intervenção coronária percutânea (ICP) por acesso radial (23,7% vs. 46,1%, p < 0,001). A taxa de mortalidade hospitalar foi significativamente maior em mulheres (13,2% vs. 5,6%, p = 0,001), e o sexo feminino permaneceu em maior risco de mortalidade hospitalar (OR 2,79, IC de 95% 1,15–6,76, p = 0,023). Um modelo multivariado incluindo idade, sexo, pressão arterial sistólica, parada cardíaca e classe de Killip atingiu 94,1% de precisão na previsão de mortalidade hospitalar, e o índice c foi de 0,85 (IC de 95% 0,77–0,93). Conclusão Após ajuste para os fatores de risco no modelo de previsão do GRACE, as mulheres continuam em maior risco de mortalidade hospitalar. homens SCA. SCA . (SCA) entanto adversos IAMCSST (IAMCSST) retrospectivo 201 2019 atuais GRACE 005 0 05 0,0 significativo 1678 1 678 1.67 70 36 6 63,13 6313 63 13 (63,1 vs 6053 60 53 60,5 0,011 0011 011 0,011) 75,1% 751 75 (75,1 624 62 4 62,4% 0,001, 0001 0,001 , 001 42,2% 422 42 2 (42,2 278 27 8 27,8% 34,1% 341 34 (34,1 239 23 9 23,9% 0,004 0004 004 frequentemente ICP (ICP 23,7% 237 7 (23,7 461 46 46,1% 0,001. 13,2% 132 (13,2 56 5 5,6% OR 279 79 2,79 95 115676 15 76 1,15–6,76 0,023. 0023 0,023 023 0,023) sistólica 941 94 94,1 085 85 0,8 0,77–0,93. 077093 0,77–0,93 77 93 0,77–0,93) (SCA (IAMCSST 20 00 0, 167 67 1.6 3 63,1 631 (63, 605 60, 0,01 01 75,1 (75, 62,4 000 0,00 42,2 (42, 27,8 34,1 (34, 23,9 23,7 (23, 46,1 13,2 (13, 5,6 2,7 11567 1,15–6,7 002 0,02 02 94, 08 07709 0,77–0,9 16 1. 63, (63 75, (75 62, 42, (42 27, 34, (34 23, (23 46, 13, (13 5, 2, 1156 1,15–6, 0770 0,77–0, (6 (7 (4 (3 (2 (1 115 1,15–6 077 0,77–0 ( 11 1,15– 07 0,77– 1,15 0,77 1,1 0,7 1,

Abstract In this paper, we use a Bayesian method to estimate the effective reproduction number ( R ( t )), in the context of monitoring the time evolution of the COVID-19 pandemic in Brazil at different geographic levels. The focus of this study is to investigate the similarities between the trends in the evolution of such indicators at different subnational levels with the trends observed nationally. The underlying question addressed is whether national surveillance of such variables is enough to provide a picture of the epidemic evolution in the country or if it may hide important localized trends. This is particularly relevant in the scenario where health authorities use information obtained from such indicators in the design of non-pharmaceutical intervention policies to control the epidemic. A comparison between R ( t ) estimates and the moving average (MA) of daily reported infections is also presented, which is another commonly monitored variable. The analysis carried out in this paper is based on the data of confirmed infected cases provided by a public repository. The correlations between the time series of R ( t ) and MA in different geographic levels are assessed. Comparing national with subnational trends, higher degrees of correlation are found for the time series of R ( t ) estimates, compared to the MA time series. Nevertheless, differences between national and subnational trends are observed for both indicators, suggesting that local epidemiological surveillance would be more suitable as an input to the design of non-pharmaceutical intervention policies in Brazil, particularly for the least populated states. , )) COVID19 COVID 19 COVID-1 nationally nonpharmaceutical non pharmaceutical (MA presented variable repository assessed Nevertheless states COVID1 1 COVID-

Objective: To ascertain whether sociodemographic and health-related characteristics known from previous research to have a substantive impact on recovery from depression modified the effect of a digital intervention designed to improve depressive symptoms (CONEMO). Methods: The CONEMO study consisted of two randomized controlled trials, one conducted in Lima, Peru, and one in São Paulo, Brazil. As a secondary trial plan analysis, mixed logistic regression was used to explore interactions between the treatment arm and subgroups of interest defined by characteristics measured before randomization – suicidal ideation, race/color, age, gender, income, type of mobile phone, alcohol misuse, tobacco use, and diabetes/hypertension – in both trials. We estimated interaction effects between the treatment group and these subgroup factors for the secondary outcomes using linear mixed regression models. Results: Increased effects of the CONEMO intervention on the primary outcome (reduction of at least 50% in depressive symptom scores at 3-month follow-up) were observed among older and wealthier participants in the Lima trial (p = 0.030 and p = 0.001, respectively). Conclusion: There was no evidence of such differential effects in São Paulo, and no evidence of impact of any other secondary outcomes in either trial. Clinical trial registration: NCT02846662 (São Paulo, Brazil – SP), NCT03026426 (Lima, Peru – LI). Funded by the U.S. National Institute of Mental Health (grant U19MH098780). Objective healthrelated health related CONEMO. . (CONEMO) Methods trials Paulo analysis ideation racecolor race color race/color age gender income phone misuse use diabeteshypertension diabetes hypertension models Results reduction 50 3month month 3 followup follow up follow-up 0030 0 030 0.03 0001 001 0.001 respectively. respectively respectively) Conclusion registration NCT NCT0284666 SP, SP , SP) NCT0302642 (Lima LI. LI LI) US U S U.S grant U19MH098780. U19MH098780 UMH MH U19MH098780) (CONEMO 5 003 03 0.0 000 00 0.00 NCT028466 NCT030264 U19MH09878 0. NCT02846 NCT03026 U19MH0987 NCT0284 NCT0302 U19MH098 NCT028 NCT030 U19MH09 NCT02 NCT03 U19MH0 NCT0 U19MH

ABSTRACT There is a growing need for intervention in existing structures to recover or increase strength capacity. The use of composite materials, such as carbon fiber, has been efficient, but cost is an obstacle. The application of steel bars as a strengthening element is an alternative and technically viable material, but there are few studies in the literature. This work carried out an experimental series with three reinforced concrete beams without transverse reinforcement, and strengthened in shear with steel bars using the near-surface mounted (NSM) technique. The load, displacement and cracking pattern were monitored in the experiment. The results demonstrated the efficiency of the strengthening with an increase of 69% in the ultimate load and 63% in the load for the appearance of the first cracks compared to the reference beam. The strengthening also increased the ductility of the beams before sudden shear failure. Numerical models via the finite element method (FEM) were carried out in the ABAQUS software using different elements and meshes. The numerical results were validated with the experimental results, and it was observed that the use of quadratic elements compared to linear elements can better represent the cracking pattern and the load capacity of the beams. The mean ratio of numerical/experimental results for maximum load of strengthening beams was 0.94. materials fiber efficient obstacle material literature reinforcement nearsurface near surface NSM (NSM technique experiment 69 63 beam failure FEM (FEM meshes numericalexperimental 094 0 94 0.94 6 09 9 0.9 0.

RESUMO Há uma necessidade crescente de intervenção nas estruturas de concreto armado existentes para recuperar ou aumentar a sua capacidade resistente. O uso de materiais compósitos, como a fibra de carbono, tem sido eficiente, mas o custo ainda é um entrave. A aplicação de barras de aço como elemento de reforço apresenta-se como material alternativo e tecnicamente viável, porém existem poucos trabalhos na literatura. Desse modo, este trabalho realizou uma série experimental com três vigas de concreto armado sem armadura transversal, e reforçadas ao cisalhamento com barras de aço utilizando a técnica near-surface mounted (NSM). Foram monitorados no experimento a carga, o deslocamento e o padrão de fissuração. Os resultados demonstraram a eficiência do reforço com aumento de 69% da carga última e 63% da carga para surgimento das primeiras fissuras comparados a viga de referência. O reforço também aumentou a ductibilidade das vigas antes da ruptura brusca por cisalhamento. Modelos numéricos via método dos elementos finitos (MEF) foram realizados no software ABAQUS utilizando diferentes tipos de elementos e malhas. Os resultados numéricos foram validados com os resultados experimentais e foi observado que o uso de elementos quadráticos comparados a elementos lineares consegue representar melhor o padrão de fissuração e a capacidade de carga das vigas. A relação média dos resultados numérico/experimental para carga máxima das vigas reforçadas foi de 0,94. resistente compósitos carbono eficiente entrave apresentase apresenta se viável literatura modo transversal nearsurface near surface NSM. NSM . (NSM) 69 63 referência MEF (MEF malhas numéricoexperimental numérico 094 0 94 0,94 (NSM 6 09 9 0,9 0,