Abstract In some areas of Oaxaca, Mexico, it is necessary to implement plantations that use seeds of genetic quality, to increase productivity and phenotypic quality. The objective was to select outstanding phenotypes of Pinus chiapensis (Martínez) Andresen and P. douglasiana Martínez, evaluating quantitative and qualitative characteristics. In 2021, 15 superior phenotypes per species were selected to evaluate inventory variables (height, diameter), density (trees ha-1), age and chip increments, recording climate and site data. Crown area (m2), basal area (m2) and total volume with bark (VTcc, m3) were determined for each tree; site index (SI) was determined based on anamorphic curves, density guides and average VTcc. Data were analyzed with Student's t tests, Pearson's correlation (( = 0.05), cluster analysis, and principal component analysis. The species showed significant differences (p ≤ 0.01) in dasometric characteristics. Using the average volume as a selection criterion, six P. chiapensis trees presented volumes above average (≥ 9.76 m3) and seven P. douglasiana trees presented volume above average (> 4.14 m3) and clear stem height (18.7 m), in places with high precipitation; while comparing morphological, of site and climatic characteristics, 10 individuals of P. chiapensis and six of P. douglasiana with excellent quality IS were selected. The selected trees have outstanding characteristics of wood quality and volume, so it is convenient to use them to collect seeds in the study area.

Resumen En algunas zonas de Oaxaca, México se requiere implementar plantaciones que usen semillas de calidad genética, para aumentar productividad y calidad fenotípica. El objetivo fue seleccionar fenotipos sobresalientes de Pinus chiapensis (Martínez) Andresen y P. douglasiana Martínez, a través de sus características cuantitativas y cualitativas. En 2021 se seleccionaron 15 fenotipos superiores por especie, para evaluar variables dasométricas (altura, diámetro), densidad (árboles ha-1), edad e incrementos en virutas, registro de datos climáticos y de sitio. En cada árbol se determinó área de copa (m2), área basal (m2) y volumen total con corteza (VTcc, m3); se determinó índice de sitio (IS) con base a curvas anamórficas, guías de densidad y promedio de VTcc. Los datos se analizaron con pruebas t-Student, correlación de Pearson (( = 0.05), análisis clúster y análisis de componentes principales. Las especies mostraron diferencias significativas (p ≤ 0.01) en características dasométricas. Al utilizar el volumen promedio como criterio de selección seis árboles de P. chiapensis presentaron volúmenes superiores al promedio (≥ 9.76 m3) y siete árboles de P. douglasiana obtuvieron mayor volumen al promedio (> 4.14 m3) y altura de fuste limpio (18.7 m), en sitios con alta precipitación; mientras que, comparando características morfológicas, de sitio y climáticas, se seleccionaron 10 individuos de P. chiapensis y seis de P. douglasiana con IS de excelente calidad. Los árboles seleccionados tienen características sobresalientes de calidad de madera y volumen, por lo que conviene usarlos para colectar semilla en la zona de estudio.

ABSTRACT Objective: To systematically review the effect of the prone position on endotracheal intubation and mortality in nonintubated COVID-19 patients with acute respiratory distress syndrome. Methods: We registered the protocol (CRD42021286711) and searched for four databases and gray literature from inception to December 31, 2022. We included observational studies and clinical trials. There was no limit by date or the language of publication. We excluded case reports, case series, studies not available in full text, and those studies that included children < 18-years-old. Results: We included ten observational studies, eight clinical trials, 3,969 patients, 1,120 endotracheal intubation events, and 843 deaths. All of the studies had a low risk of bias (Newcastle-Ottawa Scale and Risk of Bias 2 tools). We found that the conscious prone position decreased the odds of endotracheal intubation by 44% (OR 0.56; 95%CI 0.40 - 0.78) and mortality by 43% (OR 0.57; 95%CI 0.39 - 0.84) in nonintubated COVID-19 patients with acute respiratory distress syndrome. This protective effect on endotracheal intubation and mortality was more robust in those who spent > 8 hours/day in the conscious prone position (OR 0.43; 95%CI 0.26 - 0.72 and OR 0.38; 95%CI 0.24 - 0.60, respectively). The certainty of the evidence according to the GRADE criteria was moderate. Conclusion: The conscious prone position decreased the odds of endotracheal intubation and mortality, especially when patients spent over 8 hours/day in the conscious prone position and treatment in the intensive care unit. However, our results should be cautiously interpreted due to limitations in evaluating randomized clinical trials, nonrandomized clinical trials and observational studies. However, despite systematic reviews with meta-analyses of randomized clinical trials, we must keep in mind that these studies remain heterogeneous from a clinical and methodological point of view. Objective COVID19 COVID 19 COVID-1 syndrome Methods CRD42021286711 CRD (CRD42021286711 31 2022 publication reports series text 18yearsold. 18yearsold yearsold 18 years old. old 18-years-old Results 3969 3 969 3,96 1120 1 120 1,12 events 84 deaths NewcastleOttawa Newcastle Ottawa tools. tools . tools) 44 0.56 056 0 56 95CI CI 95 040 40 0.4 0.78 078 78 43 0.57 057 57 039 39 0.3 0.84 084 hoursday hours day 0.43 043 026 26 0.2 072 72 0.7 0.38 038 38 024 24 060 60 0.60 respectively. respectively respectively) moderate Conclusion unit However metaanalyses meta analyses view COVID1 COVID- CRD4202128671 (CRD4202128671 202 396 96 3,9 112 12 1,1 4 0.5 05 5 9 04 0. 07 7 03 0.8 08 02 06 6 0.6 CRD420212867 (CRD420212867 20 3, 11 1, CRD42021286 (CRD42021286 CRD4202128 (CRD4202128 CRD420212 (CRD420212 CRD42021 (CRD42021 CRD4202 (CRD4202 CRD420 (CRD420 CRD42 (CRD42 CRD4 (CRD4 (CRD

RESUMO Objetivo: Revisar sistematicamente o efeito da posição prona na intubação endotraqueal e na mortalidade em pacientes com COVID-19 não intubados com síndrome do desconforto respiratório agudo. Métodos: Registramos o protocolo (CRD42021286711) e pesquisamos quatro bancos de dados e literatura cinzenta desde o início até 31 de dezembro de 2022. Incluímos estudos observacionais e ensaios clínicos. Não houve limite de data ou idioma de publicação. Excluímos relatos de casos, séries de casos, estudos não disponíveis em texto completo e estudos que incluíram pacientes < 18 anos de idade. Resultados: Incluímos 10 estudos observacionais, 8 ensaios clínicos, 3.969 pacientes, 1.120 eventos de intubação endotraqueal e 843 mortes. Todos os estudos tinham baixo risco de viés (ferramentas Newcastle-Ottawa Scale e Risk of Bias 2). Observamos que a pronação consciente reduziu as chances de intubação endotraqueal em 44% (RC 0,56; IC95% 0,40 - 0,78) e a mortalidade em 43% (RC 0,57; IC95% 0,39 - 0,84) em pacientes com COVID-19 não intubados com síndrome do desconforto respiratório agudo. Esse efeito protetor sobre a intubação endotraqueal e a mortalidade foi mais robusto naqueles que passaram > 8 horas por dia na pronação consciente (RC 0,43; IC95% 0,26 - 0,72 e OR 0,38; IC95% 0,24 - 0,60, respectivamente). A certeza da evidência, de acordo com os critérios GRADE, foi moderada. Conclusão: A pronação consciente diminuiu as chances de intubação endotraqueal e mortalidade, especialmente quando os pacientes passaram > 8 horas por dia na pronação consciente e tratamento na unidade de terapia intensiva. Contudo, nossos resultados devem ser interpretados com cautela devido às limitações na avaliação de ensaios clínicos randomizados, ensaios clínicos não randomizados e estudos observacionais. Não obstante, apesar das revisões sistemáticas com metanálises de ensaios clínicos randomizados, devemos ter em mente que esses estudos permanecem heterogêneos do ponto de vista clínico e metodológico. Objetivo COVID19 COVID 19 COVID-1 agudo Métodos CRD42021286711 CRD (CRD42021286711 3 2022 publicação casos 1 idade Resultados 3969 969 3.96 1120 120 1.12 84 mortes ferramentas NewcastleOttawa Newcastle Ottawa 2. 2 . 2) 44 RC 0,56 056 0 56 IC95 IC 040 40 0,4 0,78 078 78 43 0,57 057 57 039 39 0,3 0,84 084 0,43 043 026 26 0,2 072 72 0,7 0,38 038 38 024 24 060 60 0,60 respectivamente. respectivamente respectivamente) evidência GRADE moderada Conclusão intensiva Contudo obstante metodológico COVID1 COVID- CRD4202128671 (CRD4202128671 202 396 96 3.9 112 12 1.1 4 0,5 05 5 IC9 04 0, 07 7 03 0,8 08 02 06 6 0,6 CRD420212867 (CRD420212867 20 9 3. 11 1. CRD42021286 (CRD42021286 CRD4202128 (CRD4202128 CRD420212 (CRD420212 CRD42021 (CRD42021 CRD4202 (CRD4202 CRD420 (CRD420 CRD42 (CRD42 CRD4 (CRD4 (CRD

Abstract There is growing interest in using cannabinoids across various clinical scenarios, including pain medicine, leading to the disregard of regulatory protocols in some countries. Legislation has been implemented in Brazil, specifically in the state of São Paulo, permitting the distribution of cannabinoid products by health authorities for clinical purposes, free of charge for patients, upon professional prescription. Thus, it is imperative to assess the existing evidence regarding the efficacy and safety of these products in pain management. In light of this, the São Paulo State Society of Anesthesiology (SAESP) established a task force to conduct a narrative review on the topic using the Delphi method, requiring a minimum agreement of 60% among panelists. The study concluded that cannabinoid products could potentially serve as adjuncts in pain management but stressed the importance of judicious prescription. Nevertheless, this review advises against their use for acute pain and cancer-related pain. In other clinical scenarios, established treatments should take precedence, particularly when clinical protocols are available, such as in neuropathic pain. Only patients exhibiting poor therapeutic responses to established protocols or demonstrating intolerance to recommended management may be considered as potential candidates for cannabinoids, which should be prescribed by physicians experienced in handling these substances. Special attention should be given to individual patient characteristics and the likelihood of drug interactions. scenarios medicine countries Brazil purposes prescription Thus SAESP (SAESP method 60 panelists Nevertheless cancerrelated cancer related precedence available substances interactions 6

Objective: to analyze the safety attitudes of health and support areas professionals working in Surgical Center. Method: sequential explanatory mixed methods study. The quantitative stage covered 172 health and support professionals in eight Surgical Centers of a hospital complex. The Safety Attitudes Questionnaire/Surgical Center was applied. In the subsequent qualitative stage, 16 professionals participated in the Focus Group. Photographic methods were used from the perspective of ecological and restorative thinking, and data analysis occurred in an integrated manner, through connection. Results: the general score, by group of Surgical Centers, based on the domains of the Safety Attitudes Questionnaire/Surgical Center, reveals a favorable perception of the safety climate, with emphasis on the domains Stress Perception, Communication in the Surgical Environment, Safety Climate and Perception of Professional Performance. The overall analysis of the domain Communication and Collaboration between Teams appears positive and is corroborated by data from the qualitative stage, which highlights the importance of interaction and communication between healthcare teams as fundamental for daily work. Conclusion: the perception of safety attitudes among health and support professionals was positive. The perception of the nursing team stands out as closer or more favorable to attitudes consistent with the safety culture. Objective Method study 17 complex QuestionnaireSurgical Questionnaire applied 1 Group thinking manner connection Results score climate Environment Performance work Conclusion culture

Objetivo: analizar las actitudes de seguridad de los profesionales de la salud y de áreas de apoyo que trabajan en el Centro Quirúrgico. Método: estudio explicativo secuencial de métodos mixtos. La etapa cuantitativa abarcó a 172 profesionales de la salud y de apoyo en ocho Centros Quirúrgicos de un complejo hospitalario. Se aplicó el Cuestionario de Actitudes de Seguridad/Centro Quirúrgico. En la etapa cualitativa posterior, participaron del Grupo Focal 16 profesionales. Se utilizaron métodos fotográficos desde la perspectiva del pensamiento ecológico y restaurativo, y el análisis de datos se produjo de manera integrada, por medio de conexión. Resultados: el puntaje general, por grupo de Centros Quirúrgicos, con base en los dominios del Cuestionario de Actitudes de Seguridad/Centro Quirúrgico, revela una percepción favorable del clima de seguridad, con énfasis en los dominios Percepción del Estrés, Comunicación en el Ambiente Quirúrgico, Clima de Seguridad y Percepción del Desempeño Profesional. El análisis global del dominio Comunicación y Colaboración entre Equipos parece positivo y está corroborado por datos de la etapa cualitativa, que resalta la importancia de la interacción y de la comunicación entre los equipos de salud como fundamentales para el trabajo diario. Conclusión: la percepción de las actitudes de seguridad entre los profesionales de la salud y de apoyo fue positiva. Se destaca la percepción del equipo de enfermería como más cercana o favorable a actitudes coherentes con la cultura de seguridad. Objetivo Quirúrgico Método mixtos 17 hospitalario SeguridadCentro posterior 1 restaurativo integrada conexión Resultados general Estrés Profesional diario Conclusión positiva

Objetivo: analisar as atitudes de segurança de profissionais da saúde e de áreas de apoio atuantes em Centro Cirúrgico. Método: estudo explanatório sequencial de métodos mistos. A etapa quantitativa abrangeu 172 profissionais da saúde e de apoio em oito Centros Cirúrgicos de um complexo hospitalar. Aplicou-se o Questionário de Atitudes de Segurança/Centro Cirúrgico . Na etapa qualitativa subsequente, 16 profissionais participaram do Grupo Focal. Utilizaram-se métodos fotográficos na perspectiva do pensamento ecológico e restaurativo, e a análise dos dados ocorreu de maneira integrada, por conexão. Resultados: o escore geral, por agrupamento de Centros Cirúrgicos, com base nos domínios do Questionário de Atitudes de Segurança/Centro Cirúrgico, revela percepção favorável do clima de segurança, com destaque para os domínios Percepção do Estresse, Comunicação no Ambiente Cirúrgico, Clima de Segurança e Percepção do Desempenho Profissional. A análise global do domínio Comunicação e Colaboração entre as Equipes mostra-se positiva e é corroborada pelos dados da etapa qualitativa, na qual destaca-se a importância da interação e da comunicação entre as equipes de saúde como fundamentais para o trabalho diário. Conclusão: a percepção das atitudes de segurança entre os profissionais da saúde e de apoio foi positiva. A percepção da equipe de enfermagem se destaca como mais próxima ou favorável a atitudes condizentes com a cultura de segurança. Objetivo Método mistos 17 hospitalar Aplicouse Aplicou SegurançaCentro subsequente 1 Focal Utilizaramse Utilizaram restaurativo integrada conexão Resultados geral Estresse Profissional mostrase mostra destacase diário Conclusão

ABSTRACT BACKGROUND AND OBJECTIVES: The mechanisms underlying nociplastic pain, such as fibromyalgia (FM), are not fully understood, however, it is believed that altered sensory processing and pain modulation play prominent roles in the maintenance of nociplastic pain. The hypothesis is that changes in the primary somesthetic cortex (S1) contribute to the generalized pain character of FM. The objective of this study was to evaluate the involvement of the primary somesthetic cortex in humans with fibromyalgia, as well as to investigate possible associations between S1 changes and clinical signs and symptoms of FM. CONTENTS: For this integrative review, the following databases were used: Pubmed and Web of Science, including observational studies carried out in humans with FM. In total, 541 studies were identified and four were included. The majority of studies are case-control studies, published between 2016 and 2022. In total, data from 161 individuals were included in this review. It was identified that there are morphological changes, hyperactivation and increased functional connectivity between S1 and periaqueductal gray matter and between S1 and anterior cingulate cortex. CONCLUSION: Patients with FM present morphological changes and hyperactivation in S1, as well as increased functional connectivity between S1 and periaqueductal gray matter and S1 and limbic system. Furthermore, different bilateral somatotropic subregions (legs, chest, fingers, hands, face and back) showed reduced functional connectivity in patients with FM. These regions are often presented as “tender points” in FM. OBJECTIVES FM, , (FM) understood however S (S1 CONTENTS review used Science total 54 casecontrol case control 201 2022 16 CONCLUSION system Furthermore legs, legs (legs chest fingers hands back tender points (FM (S 5 20 202 1 2

RESUMO JUSTIFICATIVA E OBJETIVOS: Os mecanismos subjacentes à dor nociplástica, como a fibromialgia (FM), não são totalmente compreendidos, contudo acredita-se que o processamento sensorial e a modulação da dor alterados desempenham papéis proeminentes para a manutenção da dor nociplástica. Com a hipótese de que alterações no córtex somestésico primário (S1) contribuam para o caráter de dor generalizada da FM, o objetivo deste estudo foi avaliar o envolvimento do córtex somestésico primário em humanos com FM, bem como investigar possíveis associações entre alterações de S1 com sinais e sintomas clínicos da FM. CONTEÚDO: Para esta revisão integrativa, foram utilizadas as seguintes bases de dados: Pubmed e Web of Science, incluindo estudos observacionais realizados em humanos com FM. No total, 541 estudos foram identificados e quatro foram incluídos. A maioria dos estudos são do tipo caso-controle, publicados entre 2016 e 2022. Ao todo, dados de 161 indivíduos foram incluídos. Foi identificado que há alterações morfológicas, hiperativação e aumento da conectividade funcional entre S1 e substância cinzenta periaquedutal e entre S1 e córtex cingulado anterior. CONCLUSÃO: Pacientes com FM apresentam alterações morfológicas e hiperativação em S1, bem como aumento da conectividade funcional entre S1 e substância cinzenta periaquedutal e S1 e sistema límbico. Ademais, diferentes sub-regiões somatotrópicas bilaterais (pernas, tórax, dedos, mãos, face e costas) apresentaram redução da conectividade funcional em pacientes com FM. Essas regiões são frequentemente apresentadas como “tender points” na FM. OBJETIVOS nociplástica , (FM) compreendidos acreditase acredita se S (S1 CONTEÚDO integrativa Science total 54 incluídos casocontrole, casocontrole caso controle, controle caso-controle 201 2022 todo 16 anterior CONCLUSÃO límbico Ademais subregiões sub pernas, pernas (pernas tórax dedos mãos costas tender points (FM (S 5 20 202 1 2

Abstract Objective To develop a mobile application with a standardized routine, to be used by general otolaryngologists for evaluating patients with chronic rhinosinusitis. Methods A systematic review was made to identify outcomes, recommendations and what tests that would be used in the routine evaluation of patients with chronic rhinosinusitis; establish an expert consensus on items to be included in this routine evaluation of patients with chronic rhinosinusitis using the Delphi method; development of an application for use on a mobile device, with the routine evaluation of patients with chronic rhinosinusitis. Results Based on the systematic review, the outcomes used in studies about chronic rhinosinusitis were identified, as well as guidelines recommendations, which showed discrepancies between them. These recommendations and outcomes were presented to specialists in chronic rhinosinusitis, until a consensus was reached. As a result of the Delphi method, the flowchart of the routine evaluation of patients with chronic rhinosinusitis was defined, and then was used for the development of the mobile application. Conclusion The creation of the mobile application for evaluating patients with chronic rhinosinusitis followed an adequate methodology of elaboration made by specialists in the field of chronic rhinosinusitis, standardizing the investigation of these patients. Level of evidence: Level 5. method device identified them reached defined evidence 5

SUMMARY BACKGROUND: Chemotherapy with doxorubicin may lead to left ventricular dysfunction. There is a controversial recommendation that biomarkers can predict ventricular dysfunction, which is one of the most feared manifestations of anthracycline cardiotoxicity. OBJECTIVE: The aim of this study was to evaluate the behavior of biomarkers such as Troponin I, type B natriuretic peptide, creatine phosphokinase fraction MB, and myoglobin in predicting cardiotoxicity in a cohort of women with breast cancer undergoing chemotherapy with anthracycline. METHODS: This is an observational, prospective, longitudinal, unicentric study, which included 40 women with breast cancer, whose therapeutic proposal included treatment with doxorubicin. The protocol had a clinical follow-up of 12 months. Biomarkers such as Troponin I, type B natriuretic peptide, creatine phosphokinase fraction MB, and myoglobin were measured pre-chemotherapy and after the first, third, fourth, and sixth cycles of chemotherapy. RESULTS: There was a progressive increase in type B natriuretic peptide and myoglobin values in all chemotherapy cycles. Although creatine phosphokinase fraction MB showed a sustained increase, this increase was not statistically significant. Troponin, type B natriuretic peptide, myoglobin, and creatine phosphokinase fraction MB were the cardiotoxicity markers with the earliest changes, with a significant increase after the first chemotherapy session. However, they were not able to predict cardiotoxicity. CONCLUSION: Troponin I, type B natriuretic peptide, myoglobin, and creatine phosphokinase fraction MB are elevated during chemotherapy with doxorubicin, but they were not able to predict cardiotoxicity according to established clinical and echocardiographic criteria. The incidence of subclinical cardiotoxicity resulting from the administration of doxorubicin was 12.5%. BACKGROUND dysfunction OBJECTIVE I METHODS observational prospective longitudinal 4 followup follow up 1 months prechemotherapy pre third fourth RESULTS changes session However CONCLUSION criteria 125 5 12.5% 12.5 12.

Abstract This study aimed to evaluate the phenophases of Cenostigma pyramidale (Tul.) Gagnon & G.P.Lewis in an area of Caatinga in the semi-arid region of Paraíba, Brazil. Field research was carried out in the municipality of Sumé, in the Experimental Space reserved for Studies on Ecology and Dynamics of the Caatinga - Area I of the Laboratory of Ecology and Botany - LAEB/CDSA/UFCG (7°39'38.8'' S and 36°53'42.4'' W; 538 m altitude). A total of 96 plots of 10 x 10 m were arranged in the study area, seeking to identify one specimen of C. pyramidale per plot. Monitoring was performed monthly from March 2019 to February 2020, recording budding, senescence, flower bud, flowering, and fruiting data. The Fournier intensity percentage and the activity index were analyzed. The highest budding intensity index was observed when there was a gradual increase in precipitation. Senescence had the highest peaks of intensity in the months with the absence or reduced levels of precipitation. Flower bud and flowering were practically equal throughout the monitoring period. The highest fruiting intensity occurred in the month with the highest precipitation. Regarding the budding activity index, all specimens expressed this phenophase as soon as the precipitation levels increased. In the dry period, all specimens showed senescence. Flower bud and flowering phenophases occurred synchronously. Fruiting had a higher activity index in periods of higher precipitation. Thus, it was observed that precipitation has a great influence on phenological events. Tul. Tul (Tul. GPLewis G P Lewis semiarid semi arid Paraíba Brazil Sumé LAEBCDSAUFCG LAEB CDSA UFCG 7°3938.8 739388 7°39 38.8 7 39 38 8 (7°39'38.8' 36°5342.4 3653424 36°53 42.4 36 53 42 4 36°53'42.4' W altitude. altitude . altitude) 9 1 C plot 201 2020 senescence data analyzed period increased synchronously Thus events (Tul 3938 7°3938. 73938 739 7°3 388 38. 3 (7°39'38.8 5342 36°5342. 365342 3653 36°5 424 42. 5 36°53'42.4 20 202 393 7°3938 7393 73 7° (7°39'38. 534 36°5342 36534 365 36° 36°53'42. 2 7°393 (7°39'38 36°534 36°53'42 (7°39'3 36°53'4 (7°39' 36°53' (7°39 (7°3 (7° (7 (

Resumo O presente artigo consiste em uma revisão bibliográfica que tem como objetivo descrever os diferentes fatores que influenciam o desenvolvimento da sexualidade infantil para compreendê-la a partir da terapia ocupacional. A problemática levantada aborda a invisibilidade dos componentes naturais e normativos da sexualidade na primeira e segunda infâncias e como o terapeuta ocupacional aborda esses fatores em sua intervenção. Para realizar esta busca bibliográfica, foram utilizadas diversas bases de dados e periódicos da área de terapia ocupacional, a fim de encontrar textos que estivessem relacionados ao objetivo e problemática propostos, os quais foram filtrados segundo critérios de exclusão e inclusão. Dos resultados obtém-se que há escassa informação acadêmica a respeito de como os componentes da sexualidade infantil estão diretamente relacionados às áreas de atuação do terapeuta ocupacional. Portanto, conclui-se que a disciplina está incorporando recentemente a abordagem dessa temática e se levanta a urgente necessidade de reconstruir a conceituação da sexualidade infantil, a partir de uma base de direitos da criança e afastando-se da hegemonia de uma cultura heteronormativa adultocêntrica. São considerados os diferentes fatores que influenciam o desenvolvimento da sexualidade infantil, entendendo-a não apenas como uma ocupação, mas também como parte fundamental da identidade ocupacional, cujos componentes são autonomia corporal, desenvolvimento socioafetivo, prazer e gozo, gênero e escolhas ocupacionais, os quais orientariam a abordagem da terapia ocupacional. compreendêla compreendê la intervenção propostos inclusão obtémse obtém Portanto concluise conclui afastandose afastando adultocêntrica entendendoa entendendo ocupação corporal socioafetivo gozo ocupacionais

Abstract This article consists of a bibliographical review that aims to describe the different factors that influence the development of child sexuality to understand it from Occupational Therapy (OT). The problem raised addresses the invisibility of the natural and normative components of sexuality in early and second childhood and how OT approaches these factors in its intervention. To carry out this bibliographic search, various databases and journals of Occupational Therapy were used, in order to find texts that were related to the objective and proposed problem, which were filtered according to exclusion and inclusion criteria. From the results it is obtained that there is limited academic information regarding how the components of child sexuality are directly related to the areas of work of the OT. From the foregoing, it is concluded that the discipline is recently incorporating the approach to this issue and the urgent need to reconstruct the conceptualization of child sexuality is raised, from a base of children's rights, moving away from the hegemony of a heteronormative culture, and adult centric. The different factors that influence the development of child sexuality are considered, understanding it not only as an occupation but also as a fundamental part of occupational identity, whose components are bodily autonomy, socio-affective development, pleasure and enjoyment, gender and occupational choices, which would guide the occupational therapy approach. . (OT) intervention search used criteria foregoing childrens children s rights culture centric considered identity autonomy socioaffective socio affective enjoyment choices (OT

Resumen El presente artículo consta de una revisión bibliográfica que tiene por objetivo describir los distintos factores que influyen en el desarrollo de la sexualidad infantil para comprenderla desde la terapia ocupacional. La problemática planteada aborda la invisibilidad de los componentes naturales y normativos de la sexualidad en la primera y segunda infancia y cómo la terapia ocupacional se aproxima a estos factores en su intervención. Para llevar a cabo esta búsqueda bibliográfica, se utilizaron variadas bases de datos y revistas de terapia ocupacional, con el fin de encontrar textos que tuvieran relación con el objetivo y problemática propuesta, los cuales fueron filtrados de acuerdo a criterios de exclusión e inclusión. De los resultados se obtiene que existe escasa información académica respecto a cómo se relacionan directamente los componentes de la sexualidad infantil con las áreas de trabajo de la terapia ocupacional. Por lo anterior se concluye que la disciplina está recientemente en la incorporación del abordaje de esta temática y se plantea la necesidad urgente de reconstruir la conceptualización de la sexualidad infantil, desde una base de derechos de la niñez y alejándose de la hegemonía de una cultura heteronormada y adultocéntrica. Se consideran los distintos factores que influyen al desarrollo de la sexualidad infantil y entendiéndola no solo como ocupación sino como parte fundamental de la identidad ocupacional, que tiene como componentes la autonomía corporal, el desarrollo socio afectivo, el placer y el disfrute, el género y las elecciones ocupacionales, los cuales guiarían el abordaje de terapia ocupacional. intervención propuesta inclusión adultocéntrica corporal afectivo disfrute ocupacionales

Abstract Objective In the midst of assimilationist onslaughts, the Xavante determined the migration of children to Ribeirão Preto/SP, where they would grow and observe the white people. One of the recent protagonists of this migration experienced intense psychic suffering, diagnosed and treated by western medicine. He showed significant improvements; however, only when he finally returned to the village of origin he got completely rehabilitated. The objective of this work was to go beyond the canonical biomedical narrative, showing how the consideration of multiple forms of “translation” allows us to glimpse an indigenous phenomenon in its complexity. Method For this purpose, ten unstructured interviews conducted with this young indigenous individual and some of his main interlocutors in the urban environment (host family, schoolmates, religious space) were reviewed. Results Plural narratives have emerged that focus on what is experienced but it is suppressed by the universalizing biomedical discourse. Conclusion The youth experienced a process of negotiation between universes of meaning, whose synthesis culminated in enhancing the Xavante peoples self-assertion and appropriating their own voice, among others. onslaughts PretoSP Preto SP Preto/SP people suffering medicine improvements however rehabilitated narrative translation “translation complexity purpose host family schoolmates space reviewed discourse meaning selfassertion self assertion voice others

Resumo Objetivo Em meio a investidas assimilacionistas, os Xavante determinaram a migração de crianças para Ribeirão Preto/SP, no intuito de estudarem os brancos. Um dos protagonistas recentes desse intercâmbio experienciou intenso sofrimento psíquico, diagnosticado e tratado pela medicina branca. Apresentou melhoras expressivas, contudo, somente quando retornou em definitivo à aldeia de origem. Objetivou-se, nesse contexto, ultrapassar a narrativa biomédica canônica, evidenciando como a consideração de múltiplas formas de “tradução” permite vislumbrar um fenômeno indígena em sua complexidade. Método Para esse efeito, foram analisadas dez entrevistas não estruturadas realizadas com o jovem e alguns de seus principais interlocutores no meio urbano (família de acolhimento, colegas de escola, espaço religioso). Resultados Emergiram narrativas plurais que incidem sobre o vivenciado, suprimidas pela discursividade universalizante biomédica. Conclusão O jovem experienciou um processo de negociação entre universos de significação, cuja síntese culminou no fortalecimento da autoafirmação Xavante e na apropriação de uma voz própria, de permeio às demais. assimilacionistas PretoSP Preto SP Preto/SP brancos psíquico branca expressivas contudo origem Objetivouse, Objetivouse Objetivou se, se Objetivou-se contexto canônica tradução “tradução complexidade efeito família acolhimento escola religioso. religioso . religioso) vivenciado significação própria demais

Resumen: Se trata de una investigación documental, exploratoria, descriptiva, parte de un estudio multicéntrico, internacional entre Brasil, España, Italia y Portugal sobre los Sistemas Nacionales de Salud con un modelo de atención basado en la atención primaria de salud y financiado por el Consejo Nacional de Desarrollo Científico y Tecnológico (CNPq) de Brasil. Tiene como objetivo identificar la legislación de base de la salud, el derecho a la salud y los principios doctrinales y organizativos de cada país seleccionado con énfasis en el impacto de los determinantes sociales de la salud sobre los sistemas nacionales de salud. Los resultados revelaron países con legislaciones y principios doctrinales similares, con derecho a salud constitucional, anclados en la atención primaria de salud y con un modelo asistencial de acceso del tipo salud de la familia. Los desafíos encontrados fueron la baja tasa de natalidad y la alta esperanza de vida al nacer en países europeos y criterios para el acceso a medicamentos y financiación asistencial. Con base en nuestros hallazgos, los países que tuvieron mayor inversión en base estructural, asegurando condiciones socioeconómicas y sanitarias más dignas, sólidas y vigilantes, garantizan una diferenciación importante en la capacidad de respuesta y sostenibilidad del sistema nacional de salud y en el impacto directo en la calidad de vida de las personas. Resumen documental exploratoria descriptiva multicéntrico Brasil España CNPq (CNPq similares constitucional familia hallazgos estructural dignas vigilantes personas

Resumo: Trata-se de uma pesquisa documental, exploratória, descritiva, partindo de um estudo multicêntrico e internacional entre Brasil, Espanha, Itália e Portugal sobre sistemas nacionais de saúde com modelo de atenção baseado na atenção primária à saúde e financiado pelo Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) do Brasil. Tem como objetivo identificar as legislações de base da saúde, o direito à saúde e os princípios doutrinários e organizativos de cada país selecionado com ênfase no impacto dos determinantes sociais de saúde sobre os sistemas nacionais de saúde. Os resultados revelaram países com legislações e princípios doutrinários semelhantes, com direito à saúde constitucional, ancorados na atenção primária à saúde, e com modelo assistencial de acesso do tipo saúde da família. Os desafios encontrados foram a baixa natalidade e elevada expectativa de vida ao nascer em países europeus e critérios para acesso a medicamentos e financiamento assistencial. Com base nos nossos achados, os países que tiveram maior investimento em base estrutural, perpassando por assegurar condições socioeconômicas e sanitárias mais dignas, sólidas e vigilantes, garantiram importante diferenciação na capacidade de resposta e sustentabilidade do sistema nacional de saúde e no impacto direto na qualidade de vida das pessoas. Resumo Tratase Trata se documental exploratória descritiva Brasil Espanha CNPq (CNPq semelhantes constitucional família achados estrutural dignas vigilantes pessoas

Abstract: This is a documentary, exploratory, descriptive study, which is part of a multicenter international study assessing the national health systems with a care model based on primary health care of Brazil, Spain, Italy, and Portugal, funded by the Brazilian National Research Council (CNPq, acronym in Portuguese). It aims to identify the basic health legislation, the right to health, and the doctrinal and organizational principles of each country with a focus on the impact of social determinants of health on the national health systems. The results showed these countries have similar legislation and doctrinal principles, with a constitutional right to health, based on primary health care, and with a care model of the family health type. The challenges identified were low birth rate and high life expectancy at birth in European countries and criteria for access to medication and care financing. Based on our findings, the countries with higher investment in a structural basis, ensuring more dignified, solid, and vigilant socioeconomic and sanitary conditions, provide an important differentiation in responsiveness and sustainability of the national health system and direct impact on the quality of life. Abstract documentary exploratory Brazil Spain Italy Portugal CNPq, CNPq (CNPq Portuguese. Portuguese . Portuguese) type financing findings basis dignified solid conditions

Abstract Background Systemic sclerosis (SSc) is a rare chronic autoimmune disease with heterogeneous manifestations. In the last decade, several clinical trials have been conducted to evaluate new treatment options for SSc. The purpose of this work is to update the recommendations of the Brazilian Society of Rheumatology in light of the new evidence available for the pharmacological management of SSc. Methods A systematic review including randomized clinical trials (RCTs) for predefined questions that were elaborated according to the Patient/Population, Intervention, Comparison, and Outcomes (PICO) strategy was conducted. The rating of the available evidence was performed according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. To become a recommendation, at least 75% agreement of the voting panel was needed. Results Six recommendations were elaborated regarding the pharmacological treatment of Raynaud’s phenomenon, the treatment (healing) and prevention of digital ulcers, skin involvement, interstitial lung disease (ILD) and gastrointestinal involvement in SSc patients based on results available from RCTs. New drugs, such as rituximab, were included as therapeutic options for skin involvement, and rituximab, tocilizumab and nintedanib were included as therapeutic options for ILD. Recommendations for the pharmacological treatment of scleroderma renal crisis and musculoskeletal involvement were elaborated based on the expert opinion of the voting panel, as no placebo-controlled RCTs were found. Conclusion These guidelines updated and incorporated new treatment options for the management of SSc based on evidence from the literature and expert opinion regarding SSc, providing support for decision-making in clinical practice. (SSc manifestations decade (RCTs PatientPopulation Patient Population Patient/Population Intervention Comparison PICO (PICO Assessment GRADE (GRADE methodology recommendation 75 needed Raynauds Raynaud s phenomenon healing (healing ulcers ILD (ILD drugs rituximab placebocontrolled placebo controlled found decisionmaking decision making practice 7

Abstract: This is a documentary, exploratory, descriptive study, which is part of a multicenter international study assessing the national health systems with a care model based on primary health care of Brazil, Spain, Italy, and Portugal, funded by the Brazilian National Research Council (CNPq, acronym in Portuguese). It aims to identify the basic health legislation, the right to health, and the doctrinal and organizational principles of each country with a focus on the impact of social determinants of health on the national health systems. The results showed these countries have similar legislation and doctrinal principles, with a constitutional right to health, based on primary health care, and with a care model of the family health type. The challenges identified were low birth rate and high life expectancy at birth in European countries and criteria for access to medication and care financing. Based on our findings, the countries with higher investment in a structural basis, ensuring more dignified, solid, and vigilant socioeconomic and sanitary conditions, provide an important differentiation in responsiveness and sustainability of the national health system and direct impact on the quality of life.

Resumen: Se trata de una investigación documental, exploratoria, descriptiva, parte de un estudio multicéntrico, internacional entre Brasil, España, Italia y Portugal sobre los Sistemas Nacionales de Salud con un modelo de atención basado en la atención primaria de salud y financiado por el Consejo Nacional de Desarrollo Científico y Tecnológico (CNPq) de Brasil. Tiene como objetivo identificar la legislación de base de la salud, el derecho a la salud y los principios doctrinales y organizativos de cada país seleccionado con énfasis en el impacto de los determinantes sociales de la salud sobre los sistemas nacionales de salud. Los resultados revelaron países con legislaciones y principios doctrinales similares, con derecho a salud constitucional, anclados en la atención primaria de salud y con un modelo asistencial de acceso del tipo salud de la familia. Los desafíos encontrados fueron la baja tasa de natalidad y la alta esperanza de vida al nacer en países europeos y criterios para el acceso a medicamentos y financiación asistencial. Con base en nuestros hallazgos, los países que tuvieron mayor inversión en base estructural, asegurando condiciones socioeconómicas y sanitarias más dignas, sólidas y vigilantes, garantizan una diferenciación importante en la capacidad de respuesta y sostenibilidad del sistema nacional de salud y en el impacto directo en la calidad de vida de las personas.

Resumo: Trata-se de uma pesquisa documental, exploratória, descritiva, partindo de um estudo multicêntrico e internacional entre Brasil, Espanha, Itália e Portugal sobre sistemas nacionais de saúde com modelo de atenção baseado na atenção primária à saúde e financiado pelo Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) do Brasil. Tem como objetivo identificar as legislações de base da saúde, o direito à saúde e os princípios doutrinários e organizativos de cada país selecionado com ênfase no impacto dos determinantes sociais de saúde sobre os sistemas nacionais de saúde. Os resultados revelaram países com legislações e princípios doutrinários semelhantes, com direito à saúde constitucional, ancorados na atenção primária à saúde, e com modelo assistencial de acesso do tipo saúde da família. Os desafios encontrados foram a baixa natalidade e elevada expectativa de vida ao nascer em países europeus e critérios para acesso a medicamentos e financiamento assistencial. Com base nos nossos achados, os países que tiveram maior investimento em base estrutural, perpassando por assegurar condições socioeconômicas e sanitárias mais dignas, sólidas e vigilantes, garantiram importante diferenciação na capacidade de resposta e sustentabilidade do sistema nacional de saúde e no impacto direto na qualidade de vida das pessoas.