ABSTRACT Objective: To assess the impact of different vertical positions on lung aeration in patients receiving invasive mechanical ventilation. Methods: An open-label randomized crossover clinical trial was conducted between January and July 2020. Adults receiving invasive mechanical ventilation for > 24 hours and < 7 days with hemodynamic, respiratory and neurological stability were randomly assigned at a 1:1 ratio to the sitting position followed by passive orthostasis condition or the passive orthostasis followed by the sitting position condition. The primary outcome was lung aeration assessed using the lung ultrasound score (score ranges from 0 [better] to 36 [worse]). Results: A total of 186 subjects were screened; of these subjects, 19 were enrolled (57.8% male; mean age, 73.2 years). All participants were assigned to receive at least one verticalization protocol. Passive orthostasis resulted in mean lung ultrasound scores that did not differ significantly from the sitting position (11.0 versus 13.7; mean difference, -2.7; [95%CI -6.1 to 0.71; p = 0.11). Adverse events occurred in three subjects in the passive orthostasis group and in one in the sitting position group (p = 0.99). Conclusion: This analysis did not find significant differences in lung aeration between the sitting and passive orthostasis groups. A randomized crossover clinical trial assessing the impact of vertical positioning on lung aeration in patients receiving invasive mechanical ventilation is feasible. Unfortunately, the study was interrupted due to the need to treat COVID-19 patients. ClinicalTrials.gov registry: NCT04176445

RESUMO Objetivo: Avaliar o impacto de diferentes posicionamentos verticais na aeração pulmonar em pacientes em ventilação mecânica invasiva. Métodos: Trata-se de ensaio clínico aberto, randomizado e transversal, realizado entre janeiro e julho de 2020. Adultos em ventilação mecânica invasiva por mais de 24 horas e menos de 7 dias com estabilidade hemodinâmica, respiratória e neurológica foram distribuídos aleatoriamente em uma proporção de 1:1 à postura sentada seguida da condição de ortostatismo passivo ou o ortostatismo passivo seguido de postura sentada. O desfecho primário foi a aeração pulmonar avaliada pelo lung ultrasound score. O escore varia de zero (melhor) a 36 (pior). Resultados: Foram selecionados 186 indivíduos; destes, 19 foram incluídos (57,8% do sexo masculino; média idade de 73,2 anos). Todos os participantes foram selecionados para receber pelo menos um protocolo de verticalização. O ortostatismo passivo resultou em escores médios de aeração pulmonar por ultrassonografia que não diferiram significativamente da postura sentada (11,0 versus 13,7; diferença média, -2,7; IC95% -6,1 a 0,71; p = 0,11). Ocorreram eventos adversos em três indivíduos no grupo ortostatismo passivo e em um no grupo postura sentada (p = 0,99). Conclusão: Esta análise não encontrou diferenças significativas na aeração pulmonar entre os grupos ortostatismo passivo e postura sentada. É factível conduzir um estudo clínico transversal randomizado para avaliar o impacto do posicionamento vertical na aeração pulmonar em pacientes em ventilação mecânica invasiva. Infelizmente, o estudo foi interrompido devido à necessidade de tratar pacientes com COVID-19. Registro ClinicalTrials.gov: NCT04176445

This article explores the transformations of social demands in popular territories that inform the emerging challenges and the consequent forms of collective action of social movements in the Metropolitan Region of Belo Horizonte (RMBH). From the meetings of researchers and social activists in a training course, we analyze the articulation between the updated agendas and the ideas of Urban Reform and the Right to the City. The meetings promote discussions from the perspective of social movements on urban reform and the right to the city, in addition to disseminating practices that these actors build in their daily activities. The debates held during the course indicate a plurality of agendas and a hybridization of struggles for urban reform and the right to the city. Although historically guided by the housing issue, today there is a broad panorama of interests and needs that are articulated in the practices of social movements. Urban agroecology, for example, is linked to health, food security, the environment, and job and income generation. The scope of action of social movements has expanded towards the integration of agendas. This work contributes to advancing the analysis of the agents, interests and collective actions of social movements in the RMBH.

Este artigo explora as transformações das demandas sociais em territórios populares que informam os desafios emergentes e as consequentes formas de ação coletiva de movimentos sociais na Região Metropolitana de Belo Horizonte (RMBH). A partir dos encontros de pesquisadores e ativistas sociais em um curso de formação, analisamos a articulação entre as pautas atualizadas e o ideário da Reforma Urbana e do Direito à Cidade. Os encontros promovem discussões a partir da perspectiva dos movimentos sociais sobre a reforma urbana e o direito à cidade, além de difundir práticas que esses atores empregam em suas atividades cotidianas. Os debates realizados no curso indicam uma pluralidade de pautas e uma hibridização das lutas pela reforma urbana e pelo direito à cidade. Apesar de historicamente guiadas pela questão habitacional, hoje nota-se um amplo panorama de interesses e necessidades que são articuladas nas práticas dos movimentos sociais. À agroecologia urbana, por exemplo, vinculam-se saúde, segurança alimentar, meio ambiente e geração de emprego e renda. O escopo de ação dos movimentos sociais tem se ampliado na direção da integração das pautas. O presente trabalho contribui para avançar na análise sobre os agentes, interesses e ações coletivas de movimentos sociais da RMBH.&nbsp;&nbsp;

Abstract This study sought to assess factors associated with spiritual well-being and religiosity in people living with HIV/AIDS. This is a cross-sectional study with a quantitative approach, carried out in Specialized Assistance Services that are reference in the treatment of HIV/AIDS, from June to November 2016. Data were collected using sociodemographic and clinical questionnaire and the scales Duke Index of Religiosity and Spiritual Well-Being. Survey participants (n=356) had above-average Religious Well-Being (56.04±7.89) and Total Well-Being (104.36±14.60) scores. Existential Well-Being was considered below average (48.34±9.33). The Organizational (4.16±1.72), Non-Organizational (4.84±1.24) and Intrinsic (13.12±2.60) Religiousness indexes were high. It is concluded that high levels of religiosity and Spiritual Well-Being can have positive repercussions on coping with and living with a chronic illness. In addition to providing good support in existential crises and other conflicts capable of compromising levels of well-being. It is important for the health team to consider spiritual care when assisting these patients.

Resumo Este estudo buscou avaliar os fatores associados ao bem-estar espiritual e religiosidade em pessoas vivendo com HIV/Aids. Trata-se de um estudo transversal com abordagem quantitativa, realizado em Serviços de Assistência Especializada de referência no tratamento de HIV/Aids, no período de junho a novembro de 2016. Os dados foram coletados utilizando-se um questionário sociodemográfico e clínico e as escalas de Índice de Religiosidade de Duke e Bem-estar Espiritual. Os participantes da pesquisa (n=356) apresentaram escores de Bem-Estar Religioso (56,04 ± 7,89) e Bem-Estar Total (104,36±14,60) acima da média. O Bem-Estar Existencial foi considerado abaixo da média (48,34±9,33). Os índices de Religiosidade Organizacional (4,16±1,72), Não Organizacional (4,84±1,24) e Intrínseca (13,12±2,60) foram elevados. Conclui-se que os níveis elevados de religiosidade e Bem-Estar Espiritual podem ter repercussões positivas no enfrentamento e convívio com uma doença crônica. Além de fornecer um bom suporte nas crises existenciais e outros conflitos capazes de comprometer os níveis de bem-estar. É importante que a equipe de saúde considere o cuidado espiritual na assistência a esses pacientes.

Abstract The Human Immunodeficiency Virus, a contagious and treatable infectious disease, has shown advances in its control, however the centralization of care threatens comprehensive care. Objective To identify the potentials and weaknesses of decentralization in the care of people living with HIV in Primary Health Care. This is an integrative literature review, whose data search took place between the months of August and September 2019 in the LILACS, BDENF, MEDLINE/PUBMED databases. Scientific articles available in full, in Portuguese, English and Spanish and published in the years 2014 to 2019 were selected. The search resulted in 2,794 articles, with 14 articles included in the final sample. The data showed potentials and weaknesses in changing the model of care for people living with HIV. Advances in the decentralization process are identified, such as the expansion of care for primary care, however the existing barriers are still challenges for the consolidation of the process and reorganization of health services.

Resumo O Vírus da Imunodeficiência Humana, doença infectocontagiosa e tratável, tem apresentado avanços em seu controle, entretanto a centralização do atendimento ameaça o cuidado integral da assistência. O objetivo desse artigo é identificar as potencialidades e fragilidades da descentralização no atendimento às pessoas que vivem com HIV na Atenção Primária à Saúde. Trata-se de uma revisão integrativa da literatura, cuja busca dos dados ocorreu entre os meses de agosto e setembro de 2019 nas bases de dados LILACS, BDENF, MEDLINE/PUBMED. Foram selecionados artigos científicos, disponíveis na íntegra, nos idiomas português, inglês e espanhol, publicados nos anos de 2014 a 2019. A busca resultou em 2.794 artigos, sendo incluídos na amostra final 14 artigos. Os dados encontrados mostraram potencialidades e fragilidades na mudança do modelo de atenção às pessoas vivendo com HIV. Identificam-se avanços no processo de descentralização, tais como a ampliação do atendimento para atenção primária, contudo as barreiras existentes ainda são desafios para a consolidação do processo e reorganização dos serviços de saúde.

Abstract Leadership theories developed since the beginning of the last century primarily represent positivist premises, strongly marked by the separation between subject and object, dichotomization, objectivism, quantification, reproduction, and validation. Based on this, we argue that the field needs epistemological approaches that challenge the mainstream of leadership studies. To this end, phenomenology can ground the possibility of understanding leadership as a world phenomenon. In theoretical terms, phenomenology is a return to the acts through which we gain knowledge of objects, thus the proposal to return to the things themselves. This article analyzes the contributions of phenomenology to leadership studies. In order to interact with such identified gaps in leadership studies, we explore the rescue of the lifeworld in the face of objectivism, the reconciliation between subject and object, the attribution of meanings, the epoché, and the change of positioning.

Resumen Las teorías del liderazgo que se han desarrollado desde principios del siglo pasado representan, en su mayoría, premisas positivistas, fuertemente marcadas por la separación entre sujeto y objeto, dicotomización, objetivismo, cuantificación, reproducción y validación. A partir de esto, argumentamos que el campo carece de enfoques epistemológicos que desafíen la corriente principal de los estudios de liderazgo. Para ello, la fenomenología puede sustentar la posibilidad de entender el liderazgo como un fenómeno en el mundo. En términos teóricos, la fenomenología es una vuelta a los actos a través de los cuales se conocen los objetos, de ahí la propuesta de volver a las cosas mismas. Así, el objetivo de este artículo es analizar las contribuciones de la fenomenología a los estudios de liderazgo. Por tanto, para interactuar con tales vacíos identificados en el campo de los estudios de liderazgo, exploramos el rescate del mundo de la vida frente al objetivismo; la reconciliación entre sujeto y objeto, atribución de significados; la epoché y el cambio de posición.

Resumo As teorias de liderança que vêm sendo desenvolvidas desde o início do século passado representam, em sua maioria, premissas positivistas, fortemente marcadas pela separação entre sujeito e objeto, dicotomização, objetivismo, quantificação, reprodução, validação. Com base nisso, argumentamos que o campo carece de abordagens epistemológicas que desafiem o mainstream dos estudos de liderança. Nesse intuito, a fenomenologia pode fundamentar a possibilidade para o entendimento da liderança enquanto um fenômeno no mundo. Em termos teóricos, a fenomenologia é um retorno aos atos por meio dos quais se tem conhecimento dos objetos: por isso a proposta de se voltar às coisas mesmas. Desse modo, o objetivo deste artigo é analisar as contribuições da fenomenologia para os estudos em liderança. Para tanto, de modo a interagir com tais lacunas identificadas no campo de estudos de liderança, exploramos o resgate do mundo-da-vida frente ao objetivismo; à reconciliação entre sujeito e objeto; à atribuição de sentidos; à epoché e à mudança de posicionamento.

Aim The aim of the present study is to assess the perception of undergraduate students on the impact of the COVID-19 pandemic on Brazilian dental education. Methods This cross-sectional study was conducted using an online questionnaire hosted in Google Forms platform and publicized on Instagram® and Facebook®. The questionnaire was available between July 8-27, 2020. Absolute and relative frequencies were obtained for variables of interest using Pearson’s chi-squared and considering 95% confidence intervals. Prevalence of learning resource variables according to self-reported skin color, educational institution, and Brazilian region were presented using equiplots. Results A total of 1,050 undergraduate dental students answered the questionnaire. Most students reported being in full-distance learning mode. Among the undergraduate students, 65.4% reported perceiving a very high impact in dental education, and 16.6% of students reported not being able to follow distance learning. In addition, 14% reported not having a personal laptop or desktop to study with, with this condition being more prevalent among non-white than white individuals. Conclusion We conclude that Brazilian dental students perceived a high impact of COVID-19 on dental education, as well as one-sixth of the students reported not having adequate resources to continue with distance learning. It is important that different policies are developed at the institutional and governmental levels to reduce the impact of the pandemic on dental education.

ABSTRACT Objective: To develop and validate an instrument to evaluate the decentralization process of care for People Living with HIV in Primary Health Care. Method: Methodological study, developed in four stages: elaboration of the logical model based on the triad Structure-Process-Outcomes; development of the instrument; content validation by expert judges and technical reviewers; and semantic validation. Online questionnaires were used, and the Kappa index was used for analysis. Results: The instrument with 68 items and 8 factors was submitted to validation by expert judges who recommended the exclusion of 3 items and the alteration of 2 factors. In the validation by technical reviewers, 2 items were excluded and 6 factors were highlighted; the agreement index was ≥0.75. In the semantic validation, 87.3% of the judges answered “totally agree” for the items presented. Conclusion: The instrument is validated for its content, has 63 items and has the potential to assess the care provided for people living with HIV in Primary Health Care.

RESUMEN Objetivo: Construir y validar un instrumento para la evaluación del proceso de descentralización de la atención a personas conviviendo con VIH en la Atención Primaria de Salud. Métodos: Es un estudio metodológico desarrollado en cuatro etapas: elaboración del modelo lógico basado en la tríada Estructura-Proceso-Resultados; construcción del instrumento; validación del contenido por jueces especialistas y revisores técnicos; y validación semántica. Se utilizaron cuestionarios en línea y el índice de Kappa para el análisis. Resultados: El instrumento con 68 ítems y 8 factores fue sometido a validación por jueces expertos que recomendaron la exclusión de 3 ítems y el cambio de 2 factores. En la validación por parte de los revisores técnicos, se excluyeron 2 ítems y se puntuaron 6 factores; el índice de acuerdo fue ≥0,75. En la validación semántica, el 87,3% respondió “totalmente de acuerdo” a los ítems presentados. Conclusiones: El instrumento se encuentra validado cuanto al contenido, posee 63 ítems y potencial para la evaluación de la atención de personas conviviendo con VIH en la Atención Primaria de Salud.

RESUMO Objetivo: construir e validar um instrumento de avaliação do processo de descentralização do atendimento às pessoas vivendo com HIV para Atenção Primária à Saúde. Métodos: estudo metodológico, desenvolvido em quatro etapas: elaboração do modelo lógico baseado na tríade Estrutura-Processo-Resultados; construção do instrumento; validação de conteúdo por juízes especialistas e revisores técnicos; e validação semântica. Utilizaram-se questionários on-line e, para análise, o índice de Kappa. Resultados: o instrumento, com 68 itens e 8 fatores, foi submetido à validação por juízes especialistas que recomendaram a exclusão de 3 itens e mudança de 2 fatores. Na validação por revisores técnicos, foram excluídos 2 itens e pontou-se 6 fatores, o índice de concordância foi ≥0,75. Na validação semântica 87,3% responderam “concordo totalmente” para os itens apresentados. Conclusões: O instrumento encontra-se validado quanto ao conteúdo, possui 63 itens e potencial para avaliação do atendimento às pessoas vivendo com HIV na Atenção Primária à Saúde.

Abstract Objectives: this study aimed to explore a set of factors associated with lower maternal-fetal attachment (MFA) in pregnant women. Methods: this is a cross-sectional study corresponding to the second wave of a cohort study with a population-based sample of pregnant women in the South of Brazil. The maternal-fetal attachment scale (MFAS) was used to measure MFA. Bivariate analysis was performed using the t-test and ANOVA. The variables that presented p<0.20 were taken for multivariate analysis, through linear regression, in order to control possible confounding factors. Results: a total of 840 pregnant women were included. Pregnant women who had lower MFA means were those who did not live with a partner (B=-3.8 [CI95%=-6.0; -1.7]), those between the first and second trimester of pregnancy (B=-4.3 [CI95%=-5.9; -2.6]), those who did not have support from their mother during pregnancy (B=-2.4 [CI95%=-4.6; -0.2]), and those with depressive symptoms (B=-4.9 [CI95%=-7.4; -2.5]). Conclusions: the results showed that a higher MFA it is associated with an adequate support network during pregnancy, better maternal mental health, and with an advanced pregnancy. Early evaluation of MFA and effort to promote an adequate prenatal bond, focusing on maternal psychological and emotional aspects are strongly suggested.

Resumo Objetivos: explorar um conjunto de fatores associados ao menor apego materno-fetal (AMF) em gestantes. Métodos: trata-se de um estudo transversal, correspondente à segunda fase de um estudo de coorte com uma amostra de base populacional de gestantes no sul do Brasil. Foi utilizada a Escala de Apego Materno-Fetal (EAMF) para medir o AMF. A análise bivariada foi realizada através do teste t e ANOVA. As variáveis que apresentaram p<0,20 foram levadas para análise multivariada, por meio de regressão linear, a fim de controlar possíveis fatores de confusão. Resultados: foram incluídas 840 gestantes. As gestantes que apresentaram menores médias de AMF foram aquelas que não moravam com um companheiro (B=-3,8 [IC95%=-6,0; -1,7]), que estavam entre o primeiro e o segundo trimestre de gestação (B=-4,3 [IC95%=-5,9; -2,6]), que não tiveram o apoio da mãe durante a gestação (B=-2,4 [IC95%=-4,6; -0,2]) e que apresentaram sintomas depressivos (B=-4,9 [IC95%=-7,4; -2,5]). Conclusões: os resultados mostraram que um maior AMF está associado a presença de uma rede de apoio adequada na gravidez, melhor saúde mental materna e a uma gestação avançada. A avaliação precoce do AMF e a promoção de um vínculo pré-natal adequado, com foco nos aspectos psicológicos e emocionais maternos são fortemente sugeridos.

ABSTRACT Introduction: Obesity and overweight have been increasing in Brazil and in the world, in an expressive way, as well as the demand for bariatric surgeries. As a result, post-bariatric plastic surgery has also grown, especially abdominal dermolipectomy. The objective is to describe the frequency of post-bariatric plastic surgeries performed by the Unified Health System (SUS - Sistema Único em Saúde, in portuguese) from January 1, 2015 to October 21, 2020. Methods: Ecological study, where individuals who underwent post-bariatric surgeries were selected. bariatric tests by SUS obtained by the Hospital Information System of Department of Informatics of the Unified Health System (DATASUS - Departamento de Informática do Sistema Único de Saúde, in portuguese). Data from the 27 states of the national territory were analyzed and the following variables were used: gender, age group, procedure performed, level of education. Results: The southeastern region of the country had the highest number of post-bariatric surgeries. White individuals, on the other hand, had higher numbers than other races (60.9%), abdominal dermolipectomy was the most frequent (53.7%) followed by mammoplasty (22.3%). Conclusion: Plastic surgeries have increased significantly in the last five years, and are more frequent among white women, aged between 35 and 44 years, living in the southeastern region of the country.

RESUMO Introdução: A obesidade e o sobrepeso vêm aumentando no Brasil e no mundo, de uma forma expressiva, assim como a procura por cirurgias bariátricas. Em consequência, a cirurgia plástica pós-bariátrica também cresceu, com destaque para a dermolipectomia abdominal. O objetivo é descrever a frequência das cirurgias plásticas pós-bariátricas feitas pelo Sistema Único de Saúde (SUS) no período de 1 de janeiro de 2015 a 21 de outubro de 2020. Método: Estudo ecológico, no qual foram selecionados indivíduos que realizaram cirurgias pós-bariátricas pelo SUS obtidos pelo Sistema de Informações Hospitalares do Departamento de Informática do Sistema Único de Saúde (DATASUS). Foram analisados dados dos 27 estados do território nacional e utilizaram-se as variáveis: sexo, faixa etária, procedimento realizado, grau de instrução. Resultados: A Região Sudeste do país apresentou maiores números de cirurgias pós-bariátricas. Já indivíduos da cor branca apresentaram números maiores do que outras raças (60,9%); a dermolipectomia abdominal foi a mais frequente (53,7%), em seguida, a mamoplastia (22,3%). Conclusão: As cirurgias plásticas tiveram aumento expressivo nos últimos cinco anos e são mais frequentes entre mulheres, brancas, com faixa etária de 35 a 44 anos, residentes na Região Sudeste do país.

BACKGROUND In 2022, an outbreak of mpox that started in European countries spread worldwide through human-to-human transmission. Cases have been mostly mild, but severe clinical presentations have been reported. In these cases, tecovirimat has been the drug of choice to treat patients with aggravated disease. OBJECTIVES Here we investigated the tecovirimat susceptibility of 18 clinical isolates of monkeypox virus (MPXV) obtained from different regions of Brazil. METHODS Different concentrations of tecovirimat were added to cell monolayers infected with each MPXV isolate. After 72 hours, cells were fixed and stained for plaque visualization, counting, and measurement. The ortholog of F13L gene from each MPXV isolate was polymerase chain reaction (PCR)-amplified, sequenced, and the predicted protein sequences were analyzed. FINDINGS The eighteen MPXV isolates generated plaques of different sizes. Although all isolates were highly sensitive to the drug, two showed different response curves and IC50 values. However, the target protein of tecovirimat, F13 (VP37), was 100% conserved in all MPXV isolates and therefore does not explain the difference in sensitivity. MAIN CONCLUSIONS Our results support screening different MPXV isolates for tecovirimat susceptibility as an important tool to better use of the restricted number of tecovirimat doses available in low-income countries to treat patients with mpox.

Abstract Limited experiential contact to natural environment can affect the knowledge of the local flora and, consequently, the intentions to conserve it. Therefore, this study aims to analyze whether high school students from Teresina (PI-Brazil) can identify more species of native than exotic plants and the factors that can affect this ability. 333 students from state public schools were interviewed through semi-structured questionnaires and with printed images of 20 species of plants found in the region. The data were analyzed using univariate non-parametric statistics. The results show that living in the countryside positively influenced the identification of local flora, but there was no significant difference in the number of identified plants between students who attended botany classes and those who did not. Two native plants (cashew-96.7% and pitomba-91.9%) and three exotic plants (mango-90.7%, guava-94.9% and acerola-82.0%) stood out among the most identified plant species. It was also found that, for two species of native plants very important for the State of Piauí, the caneleiro (0.6%) and the carnauba (26.7%), the identification rates were scarce. Thus, it is necessary to use Environmental Education and the teaching of Botany to prioritize native plant species, valuing local ecology and ensuring their protection.

Abstract BACKGROUND: The worldwide prevalences of anxiety and depressive disorders are 3.6% and 4.4%, respectively. Among medical students, many studies have indicated that the prevalences of these mental disorders vary between 19.7% and 47.1%, but there is a lack of information on psychotropic drug usage in this group of students. OBJECTIVE: To evaluate the prevalence of psychotropic drug use, adherence to therapy and main clinical and diagnostic indications relating to psychotropic drug use among medical students. DESIGN AND SETTING: Cross-sectional study at a Brazilian private university in the city of Sorocaba, state of São Paulo. METHODS: Observational analytical cross-sectional study, conducted during the second semester of 2019, through a semi-structured online questionnaire, answered by first to sixth-year medical students. RESULTS: Among the 263 participants (41.7% of the 630 enrolled students), the current prevalence of psychotropic drug usage was 30.4%. This prevalence increased over the course and 90.7% of the drugs were prescribed at regular medical consultations (85.5% by psychiatrists). The main indications for psychotropic drug usage were anxiety (30.0%), depression (22.8%), insomnia (7.2%), panic (5.3%) and attention deficit hyperactivity disorder (3.8%). Women were more likely to present diagnoses of depression and panic. Most of the participants used antidepressants and had good adherence to medications. Adequate sleep and regular physical activity were identified as protective factors against mental disorders. CONCLUSION: The prevalence of mental disorders among medical students is high, which justifies the use of psychotropic drugs. This study provides valuable information and recommendations for institutional educational actions to improve students’ mental health.

RESUMO JUSTIFICATIVA E OBJETIVOS A mamografia é um exame de imagens das mamas, obtidas por meio de radiografia com realização da compressão do tecido mamário. A dor é um fator constantemente relatado pelas pacientes submetidas ao procedimento e, por esse motivo, evidencia-se a necessidade de estabelecer estratégias alternativas não farmacológicas que reduzam a sensação dolorosa. O objetivo deste estudo foi realizar uma revisão integrativa sobre os métodos não farmacológicos utilizados para o alívio da dor durante o exame mamográfico. CONTEÚDO A busca foi realizada no mês de abril de 2021 em quatro bases de dados (Pubmed, Medline, Scopus e CINAHL) utilizando os descritores “dor”, “manejo da dor”, “mamografia”, “musicoterapia” e “terapias complementares”. Após a leitura e análise final, quatro artigos atenderam aos critérios preestabelecidos, abordando o manejo não farmacológico da dor durante a mamografia. Os estudos evidenciaram diferentes métodos para redução da dor, como a utilização de almofada e a alteração no protocolo de compressão, bem como a intervenção com música. CONCLUSÃO Evidências sobre o manejo não farmacológico da dor relacionada à mamografia ainda são escassas. Entre as estratégias encontradas, o protocolo personalizado de compressão e o uso de almofadas compressíveis apresentaram eficácia analgésica, enquanto o uso da música não resultou em redução significativa da dor procedimental. No entanto, por se tratar de uma revisão integrativa, destaca-se a necessidade da realização de sínteses de evidências com maior rigor metodológico para estimar o tamanho do efeito analgésico dessas intervenções.

ABSTRACT BACKGROUND AND OBJECTIVES Mammography is an examination of images of the breasts, obtained through radiography with compression of the breast tissue. Pain is a factor constantly reported by patients undergoing the procedure and, for this reason, there is a need to establish alternative non-pharmacological strategies that reduce the sensation of pain. The aim of this study was to carry out an integrative review on non-pharmacological methods used for pain relief during mammography examination. CONTENTS The search was carried out in April 2021 in four databases (Pubmed, Medline, Scopus and CINAHL) using the descriptors “pain”, “pain management”, “mammography”, “music therapy” and “complementary therapies “. After reading and final analysis, four articles met the pre-established criteria, addressing the non-pharmacological management of pain during mammography. The studies showed different methods to reduce pain, such as the use of pads and changes in the compression protocol, as well as the intervention with music. CONCLUSION Evidence on the non-pharmacological management of mammography-related pain is still scarce. Among the strategies found, the customized compression protocol and the use of compressible pads showed analgesic efficacy, while the use of music did not result in a significant reduction in procedural pain. However, as this is an integrative review, there is a need to carry out evidence syntheses with greater methodological rigor to estimate the size of the analgesic effect of these interventions.

Objective: To test the hypothesis that genetic variations of cannabinoid receptors contribute to the pathophysiology of cognitive deficits in schizophrenia. Methods: In this genetic association case-control study, cannabinoid receptor polymorphisms CNR1 rs12720071 and CNR2 rs2229579 were tested for association with neurocognitive performance in 69 patients with schizophrenia and 45 healthy controls. Neurocognition was assessed by the Brief Assessment of Cognition in Schizophrenia (BACS). Results: We found a consistent association between CNR1 rs12720071 polymorphism and the cognitive performance of patients in several cognitive domains. Patients with C/C polymorphism presented significantly worse performance in motor speed, verbal fluency, attention/processing speed and reasoning/problem solving. Conclusion: Although limited, our data support the hypothesis that CNR1 variations may be associated with the pathogenesis of cognitive deficits of schizophrenia.