A Política Nacional de Atenção Integral à Saúde do Homem não se mostra capaz de atender às necessidades específicas dos homens trans, especialmente em saúde reprodutiva e parentalidade. Assim, este estudo qualitativo, discute as limitações da política atual, problematizando gênero, masculinidade e paternidade. Como resultado, foram destacados três eixos baseados nas falas dos participantes: Gênero, sexo e sexualidade – fusões que contornam a construção parental, Construção da paternidade e do reconhecimento parental e Estigmatização e exclusão. Conclui-se que há necessidade urgente de educação contínua em saúde e sensibilização nas políticas de parentalidade, na Política Nacional de Atenção Integral à Saúde do Homem e nos profissionais de saúde, sendo crucial reconhecer e apoiar diversas estruturas familiares e experiências parentais, incluindo as de pais trans.

La Política Nacional de Atención Integral a la Salud del Hombre no se muestra capaz de atender las necesidades específicas de los hombres trans, especialmente en salud reproductiva y parentalidad. Por lo tanto, este estudio cualitativo discute las limitaciones de la política actual, problematizando género, masculinidad y paternidad. Como resultado, se destacan tres ejes con base en las declaraciones de los participantes: Género, sexo y sexualidad –fusiones que contornan la construcción parental–; Construcción de la paternidad y del reconocimiento parental y Estigmatización y exclusión. Se concluye que existe la necesidad urgente de educación continua en salud y sensibilización en las políticas de parentalidad, en la Política Nacional de Atención integral a la Salud del Hombre y en los profesionales de salud, siendo crucial el reconocimiento y el apoyo de diversas estructuras familiares y experiencias parentales, incluyendo las de padres trans.

The National Policy for Comprehensive Men's Health Care has shown itself to be incapable of meeting the specific needs of trans men, especially when it comes to reproductive health and parenting. This qualitative study investigated the limitations of the current policy, problematizing gender, masculinity and parenting. We highlight three core themes based on the participants’ comments and observations: Gender, sex and sexuality – fusions that circumvent the parenting construct; Constructing parenting and parental recognition; and Stigmatization and exclusion. It is concluded that there is an urgent need for continuous health education and awareness raising regarding parenting policies and the National Policy for Comprehensive Men's Health Care, and among health professionals. It is crucial to recognize and support a variety of family structures and parenting experiences, including those of trans parents.

Resumo Este artigo trata dos resultados de um estudo etnográfico sobre as experiências de violência de gênero de migrantes aimarás bolivianas empregadas na agricultura ou no comércio agrícola na periferia dos territórios chilenos da Tríplice Fronteira Andina. Nosso objetivo é analisar as agressões sofridas pelas mulheres em seu ambiente familiar. Analisaremos as narrativas de 30 mulheres para descrever as agressões perpetradas pelas figuras masculinas de suas famílias de origem (pais, irmãos, padrastos), e também pelas suas mães. Observaremos como esses abusos se repetem nas relações que estas migrantes constroem com seus próprios parceiros e com seus filhos. Veremos que há uma diferença potencial da violência nos territórios chilenos e bolivianos da fronteira e que o reconhecimento dessa diferença motiva a mobilidade transfronteiriça feminina. O texto busca contribuir aos debates sobre a violência de gênero em contextos de fronteira. Andina familiar 3 pais, pais (pais irmãos padrastos, padrastos , padrastos) mães filhos feminina

Résumé Cet article aborde les résultats d’une étude ethnographique sur les expériences de violence de genre vécues par les migrantes aymaras boliviennes employées dans l’agriculture ou le commerce agricole en périphérie des territoires chiliens de la Triple-frontière Andine. Notre objectif est d’analyser les agressions subies par les femmes dans leur cadre familial. Nous utiliserons les récits de 30 femmes pour décrire les agressions perpétrées par les figures masculines de leurs familles d’origine (pères, frères, beaux-pères), mais aussi par leurs mères. De plus, nous observerons comment ces abus se répètent dans les relations qu’elles construisent avec leurs propres partenaires et leurs enfants. Nous verrons qu’il existe une différence potentielle dans la violence du côté chilien et bolivien de la frontière, et que la reconnaissance de cette différence motive la mobilité transfrontalière féminine. Le texte vise à contribuer et à discuter des débats sur la violence de genre dans les contextes frontaliers. dune d lagriculture l agriculture Triplefrontière Triple frontière Andine danalyser analyser familial 3 dorigine origine pères, pères (pères frères beauxpères, beauxpères beaux , beaux-pères) mères plus quelles qu elles enfants quil il féminine frontaliers beaux-pères

Resumen Este artículo aborda los resultados de un estudio etnográfico sobre las experiencias de violencia de género de migrantes aymara bolivianas empleadas en la agricultura o en el comercio agrícola en la periferia de los territorios chilenos de la Triple-Frontera Andina. Nuestro objetivo es analizar las agresiones que sufren las mujeres en su ámbito familiar. Retomaremos las narrativas de 30 mujeres para describir las agresiones perpetradas por las figuras masculinas de sus familias de origen (padres, hermanos, padrastros), pero también por sus madres. Además, observaremos cómo estos abusos se repiten en las relaciones que construyen con sus propias parejas y con sus hijos. Veremos que existe una diferencia potencial en la violencia del lado chileno y boliviano de la frontera y que el reconocimiento de esta diferencia motiva la movilidad transfronteriza femenina. El texto busca aportar y discutir en torno a los debates sobre violencia de género en contextos fronterizos. TripleFrontera Triple Frontera Andina familiar 3 padres, padres (padres hermanos padrastros, padrastros , padrastros) madres Además hijos femenina fronterizos

Abstract This article presents the results of an ethnographic study on the experiences of gender-based violence of Aymara Bolivian women employed in agriculture or agricultural trade in the outskirts of Chilean territories of the Andean tri-border region. Our objective is to analyze the aggressions that women suffer in their family circles. We will analyze the narratives of 30 women to describe the aggressions perpetrated by the male figures in their families of origin (fathers, brothers, stepfathers), and their mothers. In addition, we will observe how these abuses are repeated in the relationships that they build with their partners and children. We will see a potential difference in violence between the Chilean and Bolivian border territories, and recognizing this difference motivates female cross-border mobility. The text seeks to contribute to the discussions on gender-based violence in border contexts. genderbased gender based triborder tri region circles 3 fathers, fathers (fathers brothers stepfathers, stepfathers , stepfathers) mothers addition children crossborder cross mobility contexts

O modo de trabalhar das equipes de Saúde da Família pode favorecer o compartilhamento entre diferentes campos de saberes e o desenvolvimento de práticas colaborativas interprofissionais. Objetivou-se compreender como se dá a construção de práticas colaborativas interprofissionais no processo de trabalho em unidades de Saúde da Família (USF). Investigação exploratória, descritiva, com abordagens quantitativa e qualitativa, realizada com equipes de Saúde da Família de 26 municípios do interior paulista, utilizando dados secundários e entrevistas semiestruturadas. Da análise, emergiram duas categorias temáticas: o desenvolvimento do trabalho interprofissional e aspectos relacionados com a equipe. A construção das práticas colaborativas interprofissionais perpassa os espaços coletivos em momentos de integração dos profissionais. Porém, existem fragilidades decorrentes da fragmentação das práticas profissionais e da não centralidade no usuário. Objetivouse Objetivou USF. USF . (USF) exploratória descritiva qualitativa 2 paulista semiestruturadas análise temáticas equipe Porém usuário (USF

El modo de trabajar de los equipos de Salud de la Familia puede favorecer la compartición entre diferentes campos de saberes y el desarrollo de prácticas colaborativas interprofesionales. El objetivo fue comprender cómo se realiza la construcción de prácticas colaborativas interprofesionales en el proceso de trabajo en unidades de Salud de la Familia. Una investigación exploratoria, descriptiva, con abordajes cuantitativo y cualitativo, realizada con equipos de Salud de la Familia de 26 municipios del interior del Estado de São Paulo, utilizando datos secundarios y entrevistas semiestructuradas. Del análisis surgieron dos categorías temáticas: el desarrollo del trabajo interprofesional y aspectos relacionados con el equipo. La construcción de las prácticas colaborativas interprofesionales atraviesa los espacios colectivos, en momentos de integración de los profesionales. No obstante, hay fragilidades provenientes de la fragmentación de las prácticas profesionales y de la no centralidad en el usuario. exploratoria descriptiva cualitativo 2 Paulo semiestructuradas temáticas equipo colectivos obstante usuario

The way Family Health teams work can encourage sharing between different fields of knowledge and the development of interprofessional collaborative practices. The objective was to understand how interprofessional collaborative practices are built in the work process in Family Health units. Exploratory, descriptive research, with quantitative and qualitative approaches, carried out with Family Health teams from 26 municipalities in the countryside of the state of São Paulo, using secondary data and semi-structured interviews. From the analysis, two thematic categories emerged: the development of interprofessional work and aspects related to the team. The construction of interprofessional collaborative practices permeates collective spaces in moments of professional integration. However, there are weaknesses arising from the fragmentation of professional practices and the lack of user-centeredness. units Exploratory research approaches 2 Paulo semistructured semi structured interviews analysis emerged team integration However usercenteredness. usercenteredness user centeredness. centeredness user-centeredness

Resumo A demência é um problema de Saúde Pública emergente, consequente ao envelhecimento populacional e à transição epidemiológica. Assim sendo, a pesquisa teve como objetivo analisar as redes vivas tecidas por um usuário com demência e sua família no percurso em busca de Atenção à Saúde e cuidado, por meio das conexões existenciais que vão estabelecendo em sua trajetória sob a ótica de uma equipe-guia. Para tal, aplicou-se a metodologia qualitativa de abordagem cartográfica com base nas técnicas de grupo focal, no fluxograma analisador e no diário de campo. A análise dos resultados possibilitou identificar a visita domiciliar como instrumento de tecnologia leve no movimento de redes vivas, e a necessidade de Educação Permanente para garantir a integralidade do cuidado dos usuários com síndromes demenciais. Conclui-se que há necessidade de melhor articular tecnologias do cuidado para tornar as ações mais efetivas. emergente epidemiológica sendo equipeguia. equipeguia equipe guia. guia equipe-guia tal aplicouse aplicou se focal campo demenciais Concluise Conclui efetivas

Resumen La demencia es un problema de salud pública emergente, consecuencia del envejecimiento poblacional y de la transición epidemiológica. Por esa razón, la investigación tuvo el objetivo de analizar las redes vivas tejidas por un usuario con demencia y su familia, en la jornada de la búsqueda de atención de la salud y el cuidado, desde el punto de vista de un equipo guía. Para ello, se aplicó la metodología cualitativa de abordaje cartográfico, a partir de las técnicas de grupo focal, diagrama de flujo analizador y diario de campo. El análisis de los resultados posibilitó la identificación de la visita a domicilio como instrumento de tecnología leve en el movimiento de redes vivas y la necesidad de educación permanente para asegurar la integralidad del cuidado de los usuarios con síndromes demenciales. Se concluyó que existe la necesidad de articular mejor las tecnologías del cuidado para que las acciones sean más efectivas. emergente epidemiológica razón familia guía ello cartográfico focal campo demenciales efectivas

ABSTRACT Dementia is an emerging public health issue resulting from population aging and epidemiological transition. Therefore, this research aimed to analyze the living networks woven by a user with dementia and her family in the path of seeking health care and support, through the existential connections established in their journey, from the perspective of a guiding team. To achieve this, a qualitative cartographic approach was applied using techniques such as focus groups, analyzer flowchart, and field diary. The analysis of the results allowed identifying home visits as a tool of soft technology in the movement of living networks and the need for ongoing education to ensure the comprehensive care of users with dementia syndromes. It is concluded that there is a need to better articulate care technologies in order to make actions more effective. transition Therefore support journey team groups flowchart diary syndromes effective

This work developed an effective and eco-friendly analytical method to support quality control for Brazilian Bill proposal No. 5332/2009. The bill advocates the creation of the “Brazilian bread” by mandating the incorporation of cassava byproducts into wheat flour, with the aim of reducing Brazil’s external dependency on wheat imports and promoting domestic cassava family farming. For this, a handheld near-infrared (NIR) spectrophotometer was utilized for on-site determination of cassava starch in commercial wheat flour. The quantitative analysis, which utilized NIR spectra pre-processed with offset correction (OFF) combined with linear baseline correction (LBC), alongside the successive projections algorithm for interval selection in partial least squares (iSPA-PLS), exhibited superior predictive capability, achieving a relative error of prediction below 8%. Furthermore, the classification process, which involved NIR spectra pre-processed with LBC and iSPA-PLS for discriminant analysis (iSPA-PLS-DA), yielded an impressive 94% overall accuracy, with only 3 misclassifications in the test set. ecofriendly eco friendly No 53322009 5332 2009 5332/2009 bread flour Brazils Brazil s farming this nearinfrared near infrared (NIR onsite site preprocessed pre processed OFF (OFF LBC, , (LBC) iSPAPLS, iSPAPLS iSPA PLS (iSPA-PLS) capability 8 8% Furthermore process iSPAPLSDA, iSPAPLSDA DA (iSPA-PLS-DA) 94 accuracy set 5332200 533 200 5332/200 (LBC (iSPA-PLS (iSPA-PLS-DA 9 533220 53 20 5332/20 53322 5 2 5332/2 5332/

RESUMO Objetivo: Reconhecer e abordar a síndrome de Patau, apesar de sua raridade e da baixa expectativa de vida associada, por meio da apresentação de um estudo de caso de uma paciente de dois anos que recebe cuidados em casa por intermédio de serviços de home care. Descrição do caso: Apresentamos uma paciente do sexo feminino que desafiou as probabilidades, com sobrevivência prolongada devida, possivelmente, ao home care. Ela nasceu por cesariana, com 31 semanas + 4 dias, em razão da restrição do crescimento uterino. A mãe, de 36 anos, recebeu cuidados pré-natais adequados e gozava de boa saúde. O diagnóstico da síndrome de Patau foi confirmado por meio de cariótipo após o nascimento. Apesar da gravidade clínica do caso, a paciente, hoje com dois anos, recebe atendimento domiciliar especializado, apoiado por traqueostomia e gastrostomia. Um técnico de enfermagem dedicado 24 horas garante acompanhamento contínuo, e a paciente beneficia-se de check-ups médicos regulares, fisioterapia cinco vezes por semana, sessões semanais de fonoaudiologia, consultas mensais com nutricionista e apoio psicológico contínuo aos familiares. Comentários: Esta abordagem multidisciplinar resultou em melhora motora discreta, destacando o impacto positivo do cuidado integral no seu bem-estar geral. A existência de uma rede robusta de apoio às famílias que enfrentam desafios semelhantes é crucial, e um cuidado multidisciplinar pode prevenir eficazmente as complicações associadas a esta impactante síndrome. Objetivo associada care probabilidades devida possivelmente cesariana 3 dias uterino mãe prénatais pré natais saúde nascimento especializado gastrostomia 2 beneficiase beneficia se checkups check ups regulares semana fonoaudiologia familiares Comentários discreta bemestar bem estar geral crucial

ABSTRACT Objective: To recognize and address Patau’s syndrome, despite its rarity and associated low life expectancy, through the presentation of a case study of a 2-year-old patient receiving Home Care services. Case description: We present a female patient who defied the odds with a prolonged survival, possible due to Home Care. She was delivered via cesarean section at 31 weeks + 4 days due to restricted uterine growth. The mother, aged 36, had received proper prenatal care and was in good health. The diagnosis of Patau’s syndrome was confirmed through karyotyping after birth. Despite the severe clinical nature of the case, the patient, now with two years old, receives specialized home-based care, supported by a tracheostomy and gastrostomy. A dedicated 24-hour nursing technician ensures continuous monitoring, and the patient benefits from regular medical check-ups, physiotherapy five times a week, weekly speech therapy sessions, monthly consultations with a nutritionist, and ongoing psychological support for her family members. Comments: This multidisciplinary approach has resulted in a slight motor response, highlighting the positive impact of comprehensive care on her overall well-being. The existence of a robust support network for families facing similar challenges is crucial, and a multidisciplinary care can effectively prevent complications associated with this impactful syndrome. Objective Pataus Patau s expectancy 2yearold yearold 2 year old services description survival 3 growth mother 36 health birth homebased home based gastrostomy 24hour hour 24 monitoring checkups, checkups check ups, ups check-ups week sessions nutritionist members Comments response wellbeing. wellbeing well being. being well-being crucial

RESUMO Objetivo: Investigar os fatores contextuais associados à qualidade de vida (QV) de crianças brasileiras de zero a 12 anos, em momento de ápice de distanciamento social. Métodos: Estudo observacional, transversal, online, de julho a setembro de 2020, com questionário sobre fatores do contexto familiar associados à QV e Inventário Pediátrico sobre QV — PedsQL™. A análise dos dados foi feita por de regressão logística multinomial. Resultados: A amostra foi de 849 crianças, na maioria da Região Sul (75%), brancas (83%), com desenvolvimento típico (79%), sedentárias (68%), com uso de telas (85%) em tempo >3h/dia (44%). As mães eram as cuidadoras principais (90%). Foram significativamente associadas a escores mais elevados de QV: a condição de saúde típica (odds ratio — OR 2,38; intervalo de confiança de 95% — IC95% 1,60–3,55), o tempo de tela ≤2h/dia (OR 1,62; IC95% 1,17–2,24), o distanciamento social considerado “fácil” (OR 1,67; IC95% 1,20–2,32) e a família afirmar estimular a criança (OR 1,93; IC95% 1,08–3,45). Conclusões: Este estudo mostra que o contexto familiar pode influenciar a QV de crianças, especialmente no período de pandemia e de reorganização do ambiente domiciliar. Objetivo (QV 1 anos Métodos observacional transversal online 2020 PedsQL PedsQL™ multinomial Resultados 84 75%, 75 75% , (75%) 83%, 83 83% (83%) 79%, 79 79% (79%) 68%, 68 68% (68%) 85% 85 (85% 3hdia hdia 3h dia h 44%. 44 44% . (44%) 90%. 90 90% (90%) odds 2,38 238 2 38 95 IC95 IC 1,60–3,55, 160355 1,60–3,55 60 3 55 1,60–3,55) 2hdia 2h 1,62 162 62 1,17–2,24, 117224 1,17–2,24 17 24 1,17–2,24) fácil “fácil 1,67 167 67 1,20–2,32 120232 20 32 1,93 193 93 1,08–3,45. 108345 1,08–3,45 08 45 1,08–3,45) Conclusões domiciliar 202 8 7 (75% (83% (79% 6 (68% (85 4 (44% 9 (90% 2,3 23 IC9 16035 1,60–3,5 5 1,6 16 11722 1,17–2,2 1,20–2,3 12023 1,9 19 10834 1,08–3,4 0 (75 (83 (79 (68 (8 (44 (90 2, 1603 1,60–3, 1, 1172 1,17–2, 1,20–2, 1202 1083 1,08–3, (7 (6 ( (4 (9 160 1,60–3 117 1,17–2 1,20–2 120 108 1,08–3 1,60– 11 1,17– 1,20– 10 1,08– 1,60 1,17 1,20 1,08 1,1 1,2 1,0

ABSTRACT Objective: The aim of this study was to investigate the contextual factors associated with the quality of life (QOL) of Brazilian children aged 0–12 years during the strict period of social isolation. Methods: This observational cross-sectional study was conducted between July and September 2020 using an online questionnaire on QOL-related family factors and the Pediatric Quality of Life Inventory (PedsQL™). Results were analyzed by multinomial logistic regression analysis. Results: The sample had 849 children, mostly from the South Region of Brazil (75%), white (83%), with typical development (79%), sedentary (68%), using screen (85%) for >3 h/day (44%). Their mothers were their main caregivers (90%). The following variables were significantly associated with high scores of QOL: typical health status (OR 2.38; 95%CI 1.60–3.55; screen time ≤2 h/day (OR 1.62; 95%CI 1.17–2.24); social distancing considered as “easy” (OR 1.67; 95%CI 1.20–2.32), and stimulation of the child by the family (OR 1.93; 95%CI 1.08–3.45). Conclusions: This study indicates that the family context can influence children’s QOL, especially during the COVID-19 pandemic and home environment reorganization. Objective QOL (QOL 012 0 12 0–1 isolation Methods crosssectional cross sectional 202 QOLrelated related PedsQL™. PedsQL PedsQL™ . (PedsQL™) analysis 84 75%, 75 75% , (75%) 83%, 83 83% (83%) 79%, 79 79% (79%) 68%, 68 68% (68%) 85% 85 (85% 3 > hday h day 44%. 44 44% (44%) 90%. 90 90% (90%) OR 2.38 238 2 38 95CI CI 95 1.60–3.55 160355 1 60 55 ≤ 1.62 162 62 1.17–2.24 117224 17 24 1.17–2.24) easy “easy 1.67 167 67 1.20–2.32, 120232 1.20–2.32 20 32 1.20–2.32) 1.93 193 93 1.08–3.45. 108345 1.08–3.45 08 45 1.08–3.45) Conclusions childrens s COVID19 COVID 19 COVID-1 reorganization 01 0– (PedsQL™ 8 7 (75% (83% (79% 6 (68% (85 4 (44% 9 (90% 2.3 23 1.60–3.5 16035 5 1.6 16 1.17–2.2 11722 12023 1.20–2.3 1.9 10834 1.08–3.4 COVID1 COVID- (PedsQL (75 (83 (79 (68 (8 (44 (90 2. 1.60–3. 1603 1. 1.17–2. 1172 1202 1.20–2. 1083 1.08–3. (7 (6 ( (4 (9 1.60–3 160 1.17–2 117 120 1.20–2 108 1.08–3 1.60– 1.17– 11 1.20– 10 1.08– 1.60 1.17 1.20 1.08 1.1 1.2 1.0

RESUMO: A migração de crianças adultas rurais suscitou preocupações crescentes sobre a fragilidade do apoio intergeracional das crianças aos seus pais que ficaram para trás. Com base nos dados dos China Family Panel Studies, este artigo analisa sistematicamente o impacto da migração de crianças adultas rurais no apoio intergeracional aos seus pais de meia-idade e idosos que ficaram para trás e explora ainda mais o efeito moderador da cultura do clã sobre ela. Constatou-se que a migração de crianças adultas rurais não enfraquece o apoio intergeracional aos seus pais em todos os domínios, mas afeta as formas de apoio intergeracional; ou seja, muda de “servir ao lado” para “focar no material”, e de conforto emocional “face a face” para comunicação “em rede”. A cultura tradicional do clã não facilitou a mudança nas formas de apoio intergeracional das crianças, mas reforçou o apoio financeiro. Estes resultados são relevantes para uma conceção eficiente de políticas de cuidados para pais que ficaram para trás em todo o mundo. RESUMO Studies meiaidade meia idade ela Constatouse Constatou se domínios seja servir lado focar material, material , material” face rede. rede . rede” financeiro mundo

ABSTRACT: Rural adult children’s migration has raised growing concerns about the weakness in children’s intergenerational support to their left-behind parents. Based on the data from the China Family Panel Studies, this paper systematically analyzed the impact of rural adult children’s migration on intergenerational support to their middle-aged and elderly left-behind parents and further explores the moderating effect of clan culture on it. It has found that the migration of rural adult children does not weaken intergenerational support for their parents across the board, but affects the forms of intergenerational support; that is, it changes from “serving on the side” to “focusing on material”, and from “face-to-face” emotion comfort to “network” communication. The traditional clan culture has not eased the shift in the forms of children’s intergenerational support but strengthened the financial support. These findings are relevant for an efficient policy design of care for left-behind parents worldwide. ABSTRACT childrens s leftbehind left behind Studies middleaged middle aged board is serving side focusing material, material , material” facetoface face “face-to-face network “network communication worldwide

ABSTRACT Objective: To estimate the frequency of preschool children who attended a dental visit and identify associated factors. Material and Methods: A cross-sectional study was conducted with children aged 2-5 years enrolled in preschools (n=200) in southern Brazil. Parents/guardians completed a questionnaire, and oral exams were performed using the CAST instrument. The outcome was whether the children had consulted a dentist in their lifetime. Andersen's behavioral model was applied to assess associated factors, including predisposing factors (sex, age, maternal education), enabling factors (family income), need factors (dental caries severity, dental pain, oral health-related quality of life (OHRQoL), and oral hygiene habits), and psychosocial factors (dental fear). Associations were tested using Poisson's regression, obtaining the prevalence ratio (PR) and 95% confidence interval (CI). Results: The majority of the children had never visited a dentist (71%; n=141), while 15% (30) had done so for prevention and 14% (29) for oral health problems. Need factors associated with having consulted a dentist included severe dental caries (PR=3.11; 95%CI=1.85-5.20), dental pain (PR=2.04; 95%CI=1.32-2.17), toothbrushing performed by parents (PR=1.99; 95%CI=1.05-3.77), and presence of an impact on OHRQoL (PR=1.87; 95%CI=1.21-2.89). The psychosocial factor of the absence of dental fear (PR=2.28; 95%CI=1.45-3.59) was also associated with the outcome. Conclusion: Most preschool children have never visited a dentist. Using a dental service was associated with both need and psychosocial factors. Objective Methods crosssectional cross sectional 25 2 5 2- n=200 n200 n 200 (n=200 Brazil Parentsguardians Parents guardians questionnaire instrument lifetime Andersens Andersen s sex, sex (sex age education, education , education) family income, income income) severity healthrelated related OHRQoL, (OHRQoL) habits, habits habits) fear. . fear) Poissons Poisson regression PR (PR 95 CI. CI (CI) Results 71% 71 (71% n=141, n141 n=141 141 n=141) 15 30 (30 14 29 (29 problems PR=3.11 PR311 3 11 (PR=3.11 95%CI=1.855.20, 95CI185520 95%CI=1.85 5.20 1 85 20 95%CI=1.85-5.20) PR=2.04 PR204 04 (PR=2.04 95%CI=1.322.17, 95CI132217 95%CI=1.32 2.17 32 17 95%CI=1.32-2.17) PR=1.99 PR199 99 (PR=1.99 95%CI=1.053.77, 95CI105377 95%CI=1.05 3.77 05 77 95%CI=1.05-3.77) PR=1.87 PR187 87 (PR=1.87 95%CI=1.212.89. 95CI121289 95%CI=1.21 2.89 21 89 95%CI=1.21-2.89) PR=2.28 PR228 28 (PR=2.28 95%CI=1.453.59 95CI145359 95%CI=1.45 3.59 45 59 95%CI=1.45-3.59 Conclusion n=20 n20 (n=20 (OHRQoL 9 (CI 7 (71 n14 n=14 (3 (2 PR=3.1 PR31 (PR=3.1 855 95%CI=1.855.20 95CI18552 95CI185 95%CI=1.8 520 5.2 8 95%CI=1.85-5.20 PR=2.0 PR20 0 (PR=2.0 322 95%CI=1.322.17 95CI13221 95CI132 95%CI=1.3 217 2.1 95%CI=1.32-2.17 PR=1.9 PR19 (PR=1.9 053 95%CI=1.053.77 95CI10537 95CI105 95%CI=1.0 377 3.7 95%CI=1.05-3.77 PR=1.8 PR18 (PR=1.8 212 95%CI=1.212.89 95CI12128 95CI121 95%CI=1.2 289 2.8 95%CI=1.21-2.89 PR=2.2 PR22 (PR=2.2 453 95%CI=1.453.5 95CI14535 95CI145 95%CI=1.4 359 3.5 4 95%CI=1.45-3.5 n=2 n2 (n=2 (7 n1 n=1 ( PR=3. PR3 (PR=3. 95%CI=1.855.2 95CI1855 95CI18 95%CI=1. 52 5. 95%CI=1.85-5.2 PR=2. PR2 (PR=2. 95%CI=1.322.1 95CI1322 95CI13 2. 95%CI=1.32-2.1 PR=1. PR1 (PR=1. 95%CI=1.053.7 95CI1053 95CI10 37 3. 95%CI=1.05-3.7 95%CI=1.212.8 95CI1212 95CI12 95%CI=1.21-2.8 95%CI=1.453. 95CI1453 95CI14 35 95%CI=1.45-3. n= (n= PR=3 (PR=3 95%CI=1.855. 95CI1 95%CI=1 95%CI=1.85-5. PR=2 (PR=2 95%CI=1.322. 95%CI=1.32-2. PR=1 (PR=1 95%CI=1.053. 95%CI=1.05-3. 95%CI=1.212. 95%CI=1.21-2. 95%CI=1.453 95%CI=1.45-3 (n PR= (PR= 95%CI=1.855 95CI 95%CI= 95%CI=1.85-5 95%CI=1.322 95%CI=1.32-2 95%CI=1.053 95%CI=1.05-3 95%CI=1.212 95%CI=1.21-2 95%CI=1.45- 95%CI 95%CI=1.85- 95%CI=1.32- 95%CI=1.05- 95%CI=1.21-

ABSTRACT Objective: To evaluate the factors associated with the fear of dental students infecting their relatives with COVID-19 as a result of clinical practice. Material and Methods: Online questionnaires were sent by e-mail and social media to dental students from a Brazilian School of Dentistry. The outcome was "fear of infecting the family." The independent variables were sociodemographic data, personal protective equipment use, adoption of infection control measures, and knowledge and feelings about the pandemic and the future of Dentistry. Data analysis used Pearson's Chi-square and Fisher's exact tests (p≤0.05). Results: With 65 participants, the prevalence of fear was 61.5%. Measures to prevent COVID-19, such as frequent hand cleansing (p=0.028) and avoiding the use of aerosol-generating instruments (p=0.027), not having or not knowing if they have been infected by the disease (p=0.038), and feelings of more significant anxiety during the pandemic period (p=0.047), and that Dentistry will undergo major post-pandemic changes (p=0.020) were associated with fear. Conclusion: Changes in behavior about biosafety and feelings of anxiety and uncertainty about the disease were associated with the dental students' fear of infecting their relatives with COVID-19 as a result of clinical practice. Objective COVID19 COVID 19 COVID-1 practice Methods email e mail family. family data measures Pearsons Pearson s Chisquare Chi square Fishers Fisher p≤0.05. p005 p p≤0.05 . 0 05 (p≤0.05) Results 6 participants 615 61 5 61.5% COVID19, 19, p=0.028 p0028 028 (p=0.028 aerosolgenerating aerosol generating p=0.027, p0027 p=0.027 , 027 (p=0.027) p=0.038, p0038 p=0.038 038 (p=0.038) p=0.047, p0047 p=0.047 047 (p=0.047) postpandemic post p=0.020 p0020 020 (p=0.020 Conclusion COVID1 1 COVID- p00 p≤0.0 (p≤0.05 61.5 p=0.02 p002 02 (p=0.02 (p=0.027 p003 p=0.03 03 (p=0.038 p004 p=0.04 04 (p=0.047 p0 p≤0. (p≤0.0 61. p=0.0 (p=0.0 (p=0.03 (p=0.04 p≤0 (p≤0. p=0. (p=0. p≤ (p≤0 p=0 (p=0 (p≤ p= (p= (p

A Política Nacional de Atenção Integral à Saúde do Homem não se mostra capaz de atender às necessidades específicas dos homens trans, especialmente em saúde reprodutiva e parentalidade. Assim, este estudo qualitativo, discute as limitações da política atual, problematizando gênero, masculinidade e paternidade. Como resultado, foram destacados três eixos baseados nas falas dos participantes: Gênero, sexo e sexualidade – fusões que contornam a construção parental, Construção da paternidade e do reconhecimento parental e Estigmatização e exclusão. Conclui-se que há necessidade urgente de educação contínua em saúde e sensibilização nas políticas de parentalidade, na Política Nacional de Atenção Integral à Saúde do Homem e nos profissionais de saúde, sendo crucial reconhecer e apoiar diversas estruturas familiares e experiências parentais, incluindo as de pais trans. trans parentalidade Assim qualitativo atual gênero resultado participantes Gênero exclusão Concluise Conclui parentais

La Política Nacional de Atención Integral a la Salud del Hombre no se muestra capaz de atender las necesidades específicas de los hombres trans, especialmente en salud reproductiva y parentalidad. Por lo tanto, este estudio cualitativo discute las limitaciones de la política actual, problematizando género, masculinidad y paternidad. Como resultado, se destacan tres ejes con base en las declaraciones de los participantes: Género, sexo y sexualidad –fusiones que contornan la construcción parental–; Construcción de la paternidad y del reconocimiento parental y Estigmatización y exclusión. Se concluye que existe la necesidad urgente de educación continua en salud y sensibilización en las políticas de parentalidad, en la Política Nacional de Atención integral a la Salud del Hombre y en los profesionales de salud, siendo crucial el reconocimiento y el apoyo de diversas estructuras familiares y experiencias parentales, incluyendo las de padres trans. trans parentalidad tanto actual género resultado participantes Género fusiones parental– exclusión parentales

The National Policy for Comprehensive Men's Health Care has shown itself to be incapable of meeting the specific needs of trans men, especially when it comes to reproductive health and parenting. This qualitative study investigated the limitations of the current policy, problematizing gender, masculinity and parenting. We highlight three core themes based on the participants’ comments and observations: Gender, sex and sexuality – fusions that circumvent the parenting construct; Constructing parenting and parental recognition; and Stigmatization and exclusion. It is concluded that there is an urgent need for continuous health education and awareness raising regarding parenting policies and the National Policy for Comprehensive Men's Health Care, and among health professionals. It is crucial to recognize and support a variety of family structures and parenting experiences, including those of trans parents. Mens Men s men policy gender participants observations Gender construct recognition exclusion professionals experiences parents

ABSTRACT Purpose: To describe the epidemiological and clinical profile of hospitalized patients with retinoblastoma in Brazil. Methods: Using data from the Hospital Cancer Registry of the Instituto Nacional de Câncer, patients with the morphological codes of retinoblastoma who were diagnosed between 2000 to 2018, aged 0–19 years, and followed up in registered hospitals (analytical cases) were selected. The relative and absolute frequencies of demographic, clinical, diagnostic, therapeutic, and outcome variables were described. Hospital performance indicators were calculated and compared between hospitals qualified and not qualified to treat pediatric oncology cases and between hospitals with different case volumes (<20, 20-75, >75 cases). Results: Of the 2,269 identified analytical cases from 86 institutions, 48% were from the Southeast, 54% were male, and 66% were aged <4 years. The proportion of missing data (NA) was too high for several variables. Approximately 84% of the patients were from the public health system, 40% had a positive family history, and 88% had unilateral involvement. The first treatment included surgery in 58.3% of the patients (NA=2), Approximately 36.6% of these patients achieved complete remission, 10.8% achieved partial remission, and 12.7% died (NA=59%). Hospital performance indicators were within the target in >90% of the patients. The median time between the first appointment and diagnosis (6 days, interquartile range [IQR] 1–14) was significantly lower and the median time to death was longer (343 days, IQR, 212-539) in high-volume hospitals (>75 cases) than in medium- and low-volume hospitals. Conclusions: Despite the high proportion of missing data, we found that the delay in diagnosis is due to prehospital factors. Additionally, there is a need for educational programs for healthcare professionals and families that emphasize early identification and referral to specialized centers. Future studies should focus on the impact of Hospital Cancer Registry data completeness on outcomes, causes of delay in diagnosis, regional inequalities, and barriers to accessing specialized services. Purpose Brazil Methods Câncer 200 2018 019 0 19 0–1 years selected demographic diagnostic therapeutic described <20, 20 (<20 2075, 2075 75, 75 20-75 >7 cases. . Results 2269 2 269 2,26 8 institutions 48 Southeast 54 male 66 4 < NA (NA 84 system 40 history 88 involvement 583 58 3 58.3 NA=2, NA2 NA=2 , (NA=2) 366 36 6 36.6 remission 108 10 10.8 127 12 7 12.7 NA=59%. NA59 NA=59% 59 (NA=59%) 90 >90 ( days IQR [IQR 1–14 114 1 14 343 (34 212539 212 539 212-539 highvolume volume (>7 medium lowvolume low Conclusions factors Additionally centers outcomes inequalities services 201 01 0– <20 (<2 207 20-7 > 226 26 2,2 5 58. NA= (NA=2 36. 10. 12. NA5 NA=59 (NA=59% 9 >9 1–1 11 34 (3 21253 21 53 212-53 (> <2 (< 20- 22 2, (NA= NA=5 (NA=59 1– 2125 212-5 (NA=5 212-

Resumo Objetivo Analisar os resultados da aplicação de telessaúde na assistência ao paciente por enfermeiros de prática avançada. Métodos Revisão sistemática de estudos de intervenção, conforme recomendações do Joanna Briggs Institute I e do Preferred Reporting Items for Systematic Reviews and Meta-Analyses. A busca foi conduzida em 23 de agosto de 2023, utilizando os descritores “telemedicine”, “nurse practitioner”, “patient care” e as palavras-chaves correlatas. Foram acessadas sete bases de dados: Lilacs, PubMed®, Cinahl, Embase, Scopus, Cochrane Database of Systematic Reviews e Web of Science Core Collection. Foram incluídos ensaios clínicos, randomizados ou não; estudos pré-pós testes ou tipo antes e depois, sem restrição de data de publicação ou idioma, que responderam à questão/PICO “Qual o resultado da aplicação da telessaúde realizada por enfermeiros de prática avançada na assistência ao paciente?” Foi realizada a análise da qualidade metodológica, tendo sido incluídos apenas os estudos de moderada e de alta qualidade metodológica; não foi possível realizar metanálise. Resultados Foram selecionados 15 artigos, com população de pacientes adultos, idosos e familiares de crianças com doenças crônicas. As intervenções envolveram telefonemas, combinações de diferentes dispositivos ou programas para educação, monitoramento ou aconselhamentos. Foram identificados, em 12 estudos, efeitos positivos para os desfechos primários: custos; autogestão do cuidado, satisfação do cuidador com gestão da saúde; qualidade de vida, conforto, adaptação ao tratamento, recuperação funcional, indicadores clínicos e sinais vitais. Conclusão Os efeitos positivos do emprego da telessaúde para obtenção de dados clínicos e gestão do cuidado e seu uso seguro, evidenciados no presente estudo, permitem recomendá-la. intervenção MetaAnalyses. MetaAnalyses Meta Analyses. Analyses Meta-Analyses 2 2023 telemedicine, telemedicine , “telemedicine” nurse practitioner, practitioner practitioner” patient care palavraschaves palavras chaves correlatas Lilacs PubMed PubMed® Cinahl Embase Scopus Collection prépós pré pós depois idioma questãoPICO questão PICO Qual paciente? metodológica metanálise 1 artigos adultos crônicas telefonemas educação aconselhamentos identificados primários custos saúde vida conforto tratamento funcional vitais seguro estudo recomendála. recomendála recomendá la. la recomendá-la 202 “telemedicine 20

Resumen Objetivo Analizar los resultados de la aplicación de la salud digital en la atención a pacientes por enfermeros de práctica avanzada. Métodos Revisión sistemática de estudios de intervención, de acuerdo con las recomendaciones del Joanna Briggs Institute I y del Preferred Reporting Items for Systematic Reviews and Meta-Analyses. La búsqueda se llevó a cabo el 23 de agosto de 2023, utilizando los descriptores “telemedicine”, “nurse practitioner”, “patient care” y palabras clave relacionadas. Se consultaron siete bases de datos: Lilacs, PubMed®, Cinahl, Embase, Scopus, Cochrane Database of Systematic Reviews y Web of Science Core Collection. Se incluyeron ensayos clínicos, aleatorizados o no aleatorizados, estudios prepruebas y pospruebas o del tipo antes y después, sin restricción de fecha de publicación ni idioma, que respondieran la pregunta/PICO “Cuál es el resultado de la aplicación de salud digital realizada por enfermeros de práctica avanzada en la atención a pacientes?” Se realizó el análisis de la calidad metodológica y se incluyeron solo los estudios de calidad metodológica moderada y alta; no fue posible realizar metanálisis. Resultados Se seleccionaron 15 artículos, con población de pacientes adultos, adultos mayores y familiares de niños y niñas con enfermedades crónicas. Las intervenciones incluyeron llamadas telefónicas, combinaciones de diferentes dispositivos o programas para educación, monitoreo o asesoramiento. En 12 estudios, se identificaron efectos positivos en los resultados primarios: costos, autogestión del cuidado, satisfacción del cuidador con manejo de la salud, calidad de vida, bienestar, adaptación al tratamiento, recuperación funcional, indicadores clínicos y signos vitales. Conclusión Es posible recomendar la aplicación de la salud digital gracias a los efectos positivos de obtención de datos clínicos y manejo del cuidado y su uso seguro, observados en el presente estudio. PROSPERO Register: CRD42023465566 intervención MetaAnalyses. MetaAnalyses Meta Analyses. Analyses Meta-Analyses 2 2023 telemedicine, telemedicine , “telemedicine” nurse practitioner, practitioner practitioner” patient care relacionadas Lilacs PubMed PubMed® Cinahl Embase Scopus Collection después idioma preguntaPICO pregunta PICO Cuál pacientes? alta metanálisis 1 artículos crónicas telefónicas educación asesoramiento primarios costos vida bienestar tratamiento funcional vitales seguro estudio Register CRD CRD4202346556 202 “telemedicine CRD420234655 20 CRD42023465 CRD4202346 CRD420234 CRD42023 CRD4202 CRD420 CRD42 CRD4

Abstract Objective To analyze the results of application of telehealth in patient care by advanced practice nurses. Methos This is a systematic review of intervention studies, in accordance with recommendations from the JBI and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The search was conducted on August 23, 2023, using the descriptors “telemedicine”, “nurse practitioner”, “patient care” and related keywords. Seven databases were accessed, such as LILACS, PubMed®, CINAHL, Embase, Scopus, Cochrane Database of Systematic Reviews and Web of Science Core Collection. Clinical trials, randomized or not, pre-post testing or before and after studies, without restrictions on publication date or language, that answered the question/PICO “What is the result of the application of telehealth carried out by advanced practice nurses in patient care?”, were included. An analysis of methodological quality was carried out, only studies of moderate and high methodological quality were included, and it was not possible to perform a meta-analysis. Results A total of 15 articles were selected, with a population of adult patients, older adults and family members of children with chronic diseases. Interventions involved phone calls, combinations of different devices or programs for education, monitoring or counseling. In 12 studies, positive effects were identified for the primary outcomes: costs; self-management of care, caregiver satisfaction with health management; quality of life, comfort, adaptation to treatment, functional recovery, clinical indicators and vital signs. Conclusion The positive effects of using telehealth to obtain clinical data and care management and its safe use, evidenced in the present study, allow us to recommend it. PROSPERO Register: CRD42023465566 MetaAnalyses. MetaAnalyses Meta Analyses. Analyses Meta-Analyses 23 2023 telemedicine, telemedicine , “telemedicine” nurse practitioner, practitioner practitioner” keywords accessed LILACS PubMed PubMed® CINAHL Embase Scopus Collection trials prepost pre post language questionPICO question PICO What care?” included metaanalysis. metaanalysis meta analysis. meta-analysis 1 selected patients diseases calls education counseling outcomes costs selfmanagement self life comfort treatment recovery signs use study Register CRD CRD4202346556 2 202 “telemedicine care? CRD420234655 20 CRD42023465 CRD4202346 CRD420234 CRD42023 CRD4202 CRD420 CRD42 CRD4

ABSTRACT Purpose: To evaluate the presence of congenital hypertrophy of the retinal pigment epithelium in a large family affected by familial adenomatous polyposis and identify the causative mutation in the adenomatous polyposis coli gene. Thus, we aimed to determine the significance of congenital hypertrophy of the retinal pigment epithelium as a phenotypic marker of the disease. Methods: A family consisting of 95 individuals was evaluated. Among these, 45 individuals were randomly selected by convenience sampling method to undergo ophthalmological evaluation. A funduscopic exam, including slit lamp and indirect ophthalmoscopy, were performed in the selected patients. In those with retinal lesions, a retinography was obtained. The adenomatous polyposis coli gene was sequenced in one affected family member to identify the pathogenic mutation. Once the variant was identified, six undiagnosed family members were tested for the mutation via capillary electrophoresis sequencing. Results: Congenital hypertrophy of the retinal pigment epithelium was observed in 13 (28.9%) of the 45 individuals evaluated. Of these, nine patients were confirmed to have familial adenomatous polyposis (via colonoscopy or molecular testing). However, four patients had not been investigated. Of the 32 (71.1%) family members without the lesion, 14 did not have familial adenomatous polyposis and 18 were yet to be evaluated. The lesions were bilaterally present and exhibited a peculiar fish-tail shape in all the evaluated individuals. Adenomatous polyposis coli gene sequencing revealed a pathogenic variant c.4031del. (Ser1344*), in heterozygosity (49.27%), in exon 16. Conclusions: The study findings confirmed the significance of congenital hypertrophy of the retinal pigment epithelium as a phenotypic marker for familial adenomatous polyposis. Furthermore, it is an effective first-line screening method for at risk family members of such patients. The novel mutation identified in our study participants, which is yet to be described in the literature, causes an aggressive form of the disease. Purpose Thus disease Methods 9 these 4 evaluation exam ophthalmoscopy obtained Results 1 28.9% 289 28 (28.9% testing. testing . testing) However investigated 3 71.1% 711 71 (71.1% lesion fishtail fish tail c4031del cdel c 4031del del c.4031del Ser1344*, Ser1344 Ser Ser1344* , (Ser1344*) 49.27%, 4927 49.27% 49 27 (49.27%) 16 Conclusions Furthermore firstline first line participants literature 28.9 2 (28.9 71.1 7 (71.1 Ser134 (Ser1344* 492 49.27 (49.27% 28. (28. 71. (71. Ser13 (Ser1344 49.2 (49.27 (28 (71 Ser1 (Ser134 49. (49.2 (2 (7 (Ser13 (49. ( (Ser1 (49 (Ser (4

ABSTRACT Proper waste management is a major worldwide concern; waste is disposed of directly into the environment, affecting water, soil and air quality. The development and production of green energy sources is strongly encouraged in modern society. The aim of this study, in accordance with Sustainable Development Goals (SDGs) 1, 2 and 7 of the 2030 Agenda of the UN, is to combine the correct disposal of animal waste with the generation of energy to mitigate the energy insecurity of families in an extremely vulnerable semi-arid region in the north-east of the country using biodigesters. To this end, a conceptual proposal was drawn up for a low-cost, easy-to-maintain and easy-to-use biodigester. A small-scale prototype was used to assess its operation by evaluating the main factors that affect biogas production (pH, temperature and the biomass properties: total solids, fixed solids, volatile solids, concentration of volatile fatty acids and C/N ratio). Evaluation of the test prototype gave satisfactory results that corroborate other studies and make it possible to propose an economically viable and efficient full-scale biodigester for biogas production. concern environment water quality society study SDGs (SDGs 1 203 UN semiarid semi arid northeast north east biodigesters end lowcost, lowcost low cost, cost low-cost easytomaintain easy maintain easytouse use smallscale small scale pH, pH (pH properties solids CN C N ratio. ratio . ratio) fullscale full 20