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ASSESSMENT OF DISABILITY, SOCIAL DETERMINANTS OF HEALTH, AND INSTRUMENTALITY OF SOCIAL WORK: CRITICAL MEDIATIONS BASED ON THE MODIFIED BRAZILIAN FUNCTIONALITY INDEX
This theoretical-analytical chapter addresses the assessment of disability through the articulation between the social determinants of health, the Modified Brazilian Functioning Index (IFBrM), and the instrumentality of Social Work within the scope of Brazilian public policies. It begins with a critique of the traditional biomedical model, which understands disability as an individual limitation, highlighting the transition to social and biopsychosocial approaches that recognize the interaction between physical impairments and social barriers. Based on a theoretical and documentary review, it discusses how the perspective of the social determinants of health contributes to understanding disability as a socially produced phenomenon, influenced by living conditions, work, income, education, and access to public policies. In this context, the IFBrM is analyzed as a technical instrument aligned with the International Classification of Functioning and Disability (ICF) and Brazilian legislation on the rights of people with disabilities, highlighting its role in operationalizing biopsychosocial assessment in accessing social rights. It is argued that the use of this instrument requires critical mediation from Social Work, whose professional instrumentality allows for the articulation of social analysis, theoretical foundations, and ethical-political commitment in the construction of socially referenced assessments. It is concluded that disability assessment, when guided by a critical perspective, can contribute to the strengthening of inclusive public policies and to the realization of the rights of people with disabilities.
Biopsychosocial Assessment of Disability
Copyright (c) 2026 https://creativecommons.org/licenses/by-nc/4.0
CHALLENGES OF HEALTHCARE WASTE MANAGEMENT IN TIMES OF HEALTH CRISIS: AN ANALYSIS IN PUBLIC HOSPITALS
This study analyzes the implementation of the Healthcare Waste Management Plan (PGRSS) in two public hospitals in Teresina (PI), Brazil, during the COVID-19 pandemic, focusing on general service professionals. The research uses interviews, questionnaires, and technical visits to evaluate the organizational structure, the procedures adopted, and the workers' knowledge of the subject. The results indicate that, although both hospitals have formalized PGRSS plans, there are significant differences in practical implementation, especially regarding the training of professionals and the monitoring of waste generation. The state hospital presents greater organization and control, while the municipal hospital faces structural and operational limitations. The pandemic intensifies the challenges, increasing the volume of waste and requiring rapid adaptations. It is concluded that effective waste management depends on the articulation between planning, continuous training, and the appreciation of the professionals involved.
EPIDEMIOLOGICAL OVERVIEW OF ACUTE CHAGAS DISEASE CASES IN BRAZIL (2013–2023)
The chapter presents an epidemiological analysis of confirmed cases of acute Chagas disease reported in Brazil between 2013 and 2023, based on secondary data from SINAN/DATASUS. During this period, 3,389 cases were recorded, with a marked concentration in the Northern Region, which accounted for 95.4% of notifications, highlighting the persistence of this area as the main focus of the acute phase of the disease in the country. The study showed a predominance of cases among males (53.8%), especially in the 20–39 age group, followed by 40–59 years, indicating a higher occurrence among individuals of working age. The main route of transmission identified was oral, responsible for 84.4% of cases, reinforcing its relevance in the recent epidemiology of the disease, particularly in outbreaks associated with the consumption of contaminated food and beverages. The authors conclude that acute Chagas disease remains an important public health problem in Brazil, emphasizing the need to strengthen surveillance, prevention, and control actions, especially in areas of higher endemicity.
B-MODE AND COLOR DOPPLER ULTRASONOGRAPHY OF MAMMARY TUMORS AND LOCOREGIONAL LYMPH NODES FOR CLINICAL STAGING OF MAMMARY NEOPLASMS IN BITCHES
Mammary neoplasms in bitches are highly prevalent, present elevated malignancy rates, and require accurate clinical staging, particularly regarding lymph node involvement. This study aimed to evaluate the applicability of B-mode and color Doppler ultrasonography in differentiating benign and malignant mammary tumors, as well as in detecting metastasis and reactivity in locoregional lymph nodes of bitches. Thirty bitches with mammary tumors were included and allocated into three groups according to tumor size. Ultrasonographic evaluation of mammary tumors and axillary and inguinal lymph nodes was performed, followed by mastectomy and lymphadenectomy with histopathological confirmation. Clinical and ultrasonographic tumor characteristics were not able to predict malignancy (p = 0.99). Likewise, ultrasonographic variables assessed in axillary and inguinal lymph nodes were ineffective in predicting metastasis or reactivity (p > 0.5). Ultrasonography showed high sensitivity and negative predictive value for non-metastatic lymph nodes; however, specificity (14%) and positive predictive value (2%) were low, limiting its reliability for confirming nodal metastasis. Under the conditions of this study, B-mode and color Doppler ultrasonography alone were not reliable tools for predicting tumor malignancy or lymph node involvement, emphasizing the importance of histopathological evaluation for accurate clinical staging of canine mammary neoplasms.
ADVERSE EFFECTS OF IODINATED CONTRAST USED IN IMAGING EXAMS: CHALLENGES FOR RADIOLOGIC TECHNOLOGISTS
Iodinated contrast media are widely used in imaging examinations, contributing to improved image quality and increased diagnostic accuracy. However, their administration may be associated with adverse reactions of varying severity, ranging from mild manifestations such as nausea and pruritus to severe events such as anaphylaxis and contrast-induced nephropathy. This study aimed to review aspects related to the use of these agents, with emphasis on risk factors, types of adverse reactions, and prevention strategies. This is a literature review based on scientific publications and national and international guidelines. The main preventive measures include detailed medical history assessment, appropriate selection of the contrast agent, intravenous hydration in at-risk patients, and prophylactic premedication when indicated, aiming to reduce complications and improve the safety of radiological procedures.
PSYCHOMETRIC VALIDATION OF THE BRAZILIAN VERSION OF THE ATTITUDES TO PATIENT SAFETY QUESTIONNAIRE (APSQ-III) AMONG HEALTH STUDENTS
This chapter details the cross-cultural adaptation and psychometric validation of the Attitudes to Patient Safety Questionnaire III (APSQ-III) for Brazilian Portuguese, aiming to assess the attitudes of health area students regarding patient safety. Driven by the growing importance of patient safety in education, the study sought to provide a reliable tool to identify training gaps and support pedagogical interventions. The methodology employed a quantitative, descriptive, and cross-sectional study involving 292 first-year Medicine, Nursing, and Psychology students from a Brazilian public university. The cross-cultural adaptation process followed rigorous guidelines, including multiple translations, back-translations, and evaluation by an expert committee, which resulted in high semantic, idiomatic, experiential, and cultural equivalence of the Brazilian version. A pre-test with 50 students allowed for minor adjustments to improve item clarity. In the validity analysis, a final model of 26 items and 9 factors of the APSQ-III showed a satisfactory fit to the data through confirmatory factor analysis (CFA). Factor loadings were mostly high, confirming the structure. However, the factors "Inevitability of error" (F4) and "Importance of patient safety in the curriculum" (F9) demonstrated low reliability, suggesting the need for future revisions of these constructs. Correlations between factors revealed significant associations, such as the strong link between team functioning and the valuing of safety in the curriculum, and the relationship between training and confidence in reporting errors. Comparison by sex indicated a statistically significant difference only in the "Confidence in reporting error" (F2) factor, with men showing slightly more confidence than women, albeit with a small effect size. In conclusion, the Brazilian version of the APSQ-III is a valid and reliable tool for most of its dimensions, useful for identifying strengths and weaknesses in training and for monitoring safety culture. Limitations include the convenience sample and the low reliability of two factors. Future research is recommended to diversify samples, revise less robust factors, and conduct longitudinal studies to monitor the evoluton of students' attitudes.
Attitudes to Patient Safety Questionnaire
Stela Regina Pedroso Vilela Torres de Carvalho
Ana Maria Rita Pedroso Vilela Torres de Carvalho
THE TRAJECTORY OF SELF-EFFICACY IN MEDICAL EDUCATION: CHALLENGES AND PROSPECTS
This longitudinal study investigated the trajectory of perceived self-efficacy among medical students over a four-year undergraduate program, grounded in Albert Bandura's Social Cognitive Theory. Self-efficacy, understood as the belief in one's capacity to succeed in specific situations, is essential for academic performance, persistence, and adaptation. The research followed students from the basic science cycle through clinical internship, utilizing the Perceived Self-Efficacy Scale in Higher Education (EAPES), which assesses five dimensions: academic competence, learning regulation, social interaction, proactive actions, and academic management. The findings revealed a significant decline in overall self-efficacy from the beginning of the course through the mid-clinical cycle, followed by partial recovery during the internship year, though not returning to initial levels. The proactive actions dimension exhibited the most pronounced decline and least recovery, suggesting that students' confidence in taking initiative and acting independently is particularly vulnerable during medical training. Individual trajectories varied considerably, underscoring the influence of personal and contextual factors. These findings have substantial implications for medical education, indicating the necessity for targeted pedagogical interventions, particularly during critical transition periods between cycles. The study contributes to understanding how the escalating demands of medical training impact students' perceived competence.
Ana Maria Rita Pedroso Vilela Torres de Carvalho Engel
LANGUAGE, DISCOURSE AND TOTALITARIANISM: FROM THE REDUCTION OF THE OTHER TO THE DEMOCRATIC PATHS OF DIALOGUE
This article aims to analyze the relationship between the constitution of language and the central role of discourse in the individual’s participation within the social sphere, based on the hypothesis that the predominance of monolithic discourses fosters the emergence of totalitarian regimes. Such regimes systematically seek cultural and social homogenization, transforming all forms of alterity into threats to be eliminated, thereby contributing to the construction of exclusionary logics and potential social and political conflicts. The study adopts a hypothetical-deductive method, grounded in bibliographic research, and draws on the contributions of Michel Foucault and Ludwig Wittgenstein in the field of philosophy of language, particularly regarding the formation and functioning of language. With respect to totalitarianism and the construction of authoritarian discourse, the analysis is supported by the theoretical frameworks of Hannah Arendt and Claude Lefort. Finally, the article emphasizes the importance of the inclusion of the other and the role of dialogue, from a Habermasian perspective, as fundamental elements for the preservation of democratic societies and for resisting the consolidation of totalitarian structures.
EXPENDITURES ON SCIENCE AND TECHNOLOGY (S&T) AND RESEARCH AND DEVELOPMENT (R&D) APPLIED TO THE MINISTRY OF HEALTH: CORRELATION WITH HUMAN RESOURCES TRAINING AND PUBLIC POLICIES FOR THE PERIOD 2014 – 2023
This study analyzes public expenditures on Science and Technology (S&T) and Research and Development (R&D) within the Ministry of Health (MS), correlating them with human resources training provided by the Ministry of Education (MEC/CAPES) between 2014 and 2023. The timeframe covers the period from the 2015 fiscal crisis to the 2023 budgetary restoration, including the critical impact of the COVID-19 pandemic. The research investigates how structural investment in the scientific base and personnel qualification within the National Graduate System support the Health Economic-Industrial Complex (CEIS). Adopting a transversal approach, it examines the role of regulatory frameworks, such as the New Legal Framework for S,T&I, in reducing external dependence and promoting health sovereignty. The results indicate that the resilience of health policies depends on the integration between the MS technological induction and the academic capacity fostered by the MEC.
HANNAH ARENDT: FREEDOM, POLITICS, AND LAW
This study investigates the concept of freedom in Hannah Arendt, which transcends individual autonomy to manifest itself as a political commitment. The central question addresses how political freedom is only achieved in moderate regimes that respect plurality and citizen participation. The theoretical-analytical research is based on works such as On Revolution, Truth and Politics, and Denktagebuch, as well as analyses by Christian Volk and Jeremy Waldron. The results indicate that political freedom depends on the de-hierarchization between Law and Politics, the recognition of others, and an enlarged mentality that allows for the consideration of multiple perspectives. Active participation in public assemblies and the stabilizing role of Law are fundamental to ensuring political order. It is concluded that political freedom is a distinct way of guiding action among different communities, experienced through concerted action in a pluralistic environment.
SOCIAL REPRESENTATIONS OF INDIGENOUS LANDS AND THE LEGITIMATION OF THE BRAZILIAN SUPREME FEDERAL COURT’S DECISION ON THE “TEMPORAL FRAMEWORK” (MARCO TEMPORAL) IN LIGHT OF MAX WEBER’S INTERPRETIVE SOCIOLOGY
For the present paper examines the decision of the Brazilian Supreme Federal Court (Supremo Tribunal Federal – STF) in RE 1.017.365/SC, which struck down the so-called “time frame” thesis for the demarcation of indigenous lands, in the light of Max Weber’s comprehensive sociology, with particular emphasis on the notion of social representation. Drawing on the concept of social action and on the centrality of the “subjectively represented meaning” in social relations, the paper seeks to identify the different value ideas that shape the representations of indigenous land in the Court’s reasoning: at times as an economic asset and an object of legal certainty for private property, at others as an original territory and a constitutive dimension of indigenous cultural identity. It is argued that culture, understood as an arena of disputes among competing representations, offers the key to understanding the Court’s decision not merely as a technical-legal application of constitutional rules, but as a moment of selection and consecration of particular value ideas in the Brazilian constitutional order. Finally, the article discusses to what extent the decision contributes to the legitimation of legal-rational domination and to the reshaping of social representations of indigenous peoples and their territories.
NATIONAL PUBLIC POLICIES FOR MICRO AND SMALL ENTERPRISES: MARKET ACCESS AND THE PROMOTION OF INTEGRATIVE POLICIES BETWEEN THE STATE AND CITIZENS
Micro and small enterprises (MSEs) represent 99% of formal businesses in Brazil and play a central role in economic and social development. However, access to markets, especially public markets, remains a structural challenge. This study investigates the association between the formalization of MSEs and their participation in public service procurement processes conducted within the Banrisul System during the first quarter of 2025, the first full cycle under Law No. 14,133/2021. The research adopts a mixed-methods approach, including documentary analysis of bidding notices and contracts, collection of secondary data (CNPJ and tax registries), and the application of questionnaires and interviews with entrepreneurs and managers. The methodological design is descriptive-correlational, with no intention of inferring causality. It is expected that the prospect of supplying to the State acts as an incentive for formalization, particularly in the service sector, which is characterized by high levels of informality. Preliminary results suggest a concentration of newly established firms close to the dates of bidding processes, indicating a relevant correlation between public procurement and entry into the formal market. It is concluded that the effectiveness of the policy depends not only on the legal framework but also on the institutional capacity of subnational entities and the mediating role of SEBRAE.
SHEAR STRENGTH OF ONE-WAY RIBBED SLABS WITH STEEL FIBER CONCRETE
The ribbed slabs are used both in small and large constructions, and its use is growing due to the advantages that this constructive system provides. However, considering the demeanor of these slabs without transverse reinforcements (stirrups), few studies were made in Brazil. This study brings an experimental analysis of 8 unidirectional ribbed slabs of reinforced concrete subjected to loads perpendicularly distributed to the ribs. 4 (four) reference slabs and 4 (four) reinforced slabs with steel fibers with a length of 1,700 mm and width ranging from 650 to 950 mm were tested, all with table thickness of 40 mm and ribs with cross section of (100 x 100) mm². The compressive strength of concrete was approximately of 30 MPa. The results were compared to those estimated by the design codes ACI 318 [1], EHE 08 [2], NBR 6118 [3] and MC10 [4]. It was verified that the increase in shear and bending strength of the reinforced slabs with fibers was substantial, what makes those slabs technically feasible.
A SOCIO-LEGAL ANALYSIS OF PARENTAL AUTHORITY FROM THE PERSPECTIVE OF BRAZILIAN PRIVATE LAW
This work aims to analyze the institutions of parental authority, guardianship, and curatorship in the Brazilian legal system. Parental authority, understood as the set of attributions, rights, and duties concerning the holders of the family entity, enshrined in the 1988 Federal Constitution as the basis of society, enjoys special protection from the State. Regardless of the family arrangement established by the spouses, that is, stable union or marriage, the protection of minor children is imperative. The research problem consists of the difficulty in exercising parental authority in the current societal model, since family models have changed over the years and high divorce rates have led to difficulties regarding the interests of guardians and curators. The results obtained demonstrate an understanding of the institution of parental authority, particularly guardianship, enabling minors under guardianship to reach full legal capacity in adulthood. This is because reaching the age of majority fully authorizes individuals to perform legal acts. In exceptional cases, when the expression of will is impossible, the figure of the guardian or curator emerges to consent to those acts on behalf of the ward or person under guardianship, thus enabling acts in the civic sphere. In this context, the research methodology of this work was qualitative, that is, through bibliographic and documentary research, it seeks to analyze, understand, and propose solutions to the problem of parental authority in the current family context.
ADVANCES AND PERSPECTIVES IN PHOTOTHERAPY FOR PSORIASIS
Psoriasis is a chronic and inflammatory dermatological pathology affecting approximately 2% of the world population, characterized by a complex pathophysiology involving a cycle of keratinocyte hyperproliferation and immune dysfunction primarily mediated by the IL-23/IL-17 axis. Phototherapy has established itself as an effective therapeutic modality by interrupting this cycle through the controlled interaction of ultraviolet radiation (UVR) with the skin molecular components. Its efficacy is based on multiple mechanisms, including the induction of apoptosis in keratinocytes and T lymphocytes, the reduction of pro-inflammatory cytokines such as IL-12 and IL-23, and the promotion of local immunosuppression. Historically, the treatment evolved from the Goeckerman regimen and the Ingram method to the technological milestone of narrowband UVB (NB-UVB) radiation. This specific radiation has become the modern gold standard due to its superior efficacy and safety compared to broadband UVB. In clinical practice, photochemotherapy (PUVA) combines psoralens with UVA radiation and remains a vital option for severe and resistant cases. The 2024 Brazilian Psoriasis Consensus elevated phototherapy to the same level of importance as methotrexate for the initiation of systemic therapy, targeting ambitious goals such as a 90% reduction in the Psoriasis Area and Severity Index 90. Modern equipment, ranging from professional booths to portable panels and localized units, ensures precise radiation delivery and patient comfort. While biological agents often show higher response rates, phototherapy remains essential due to its high cost-effectiveness, proven safety for pregnant and lactating women, and potential for use in combination therapies to enhance results. Regarding long-term safety, the risk of carcinogenesis is dose-dependent in PUVA, whereas NB-UVB radiation demonstrates a highly favorable safety profile, particularly in individuals with higher phototypes. Thus, phototherapy represents a potent, biologically viable, and accessible solution, with future perspectives pointing toward the integration of controlled home units and targeted lasers to maintain its indispensable role in the therapeutic arsenal against psoriasis.
WHAT IS THE IMPORTANCE OF PHYSICAL EDUCATION CLASSES IN THE SCHOOL CONTEXT FOR COMBATING CHILDHOOD OBESITY?
Childhood obesity is a complex and multifactorial disease, and its control and prevention remain a challenge. Physical exercise is a well-known non-pharmacological tool in the literature. This study aimed to describe the benefits of physical education classes within the school context for children and adolescents. This study is characterized as a descriptive literature review of the last 5 years, from 2020 to 2025. The inclusion criteria were: male and female students enrolled in public and private schools who participate in school physical education classes at least once a week, aged between 3 and 18 years. The authors found 197 articles using the PubMed database, but none met the inclusion criteria. Therefore, the authors concluded that more studies are needed to truly verify the impacts that physical education classes can provide. For the discussion, the authors presented studies that showed the minimum recommended amount of physical exercise to achieve a significant impact on BMI. The ACSM, WHO, and 24-hour Movement guidelines presented in the study justify the increased teaching hours mandated by legislation. However, the authors concluded that the current teaching hours are insufficient to significantly benefit students. They suggested that teachers could encourage students to engage in physical activity outside of school to reduce medication costs and improve their quality of life.
THE USE OF DRAWINGS AS A LEARNING STRATEGY IN HEMATOLOGY CLASSES: THE CONSTRUCTION OF KNOWLEDGE BY THE STUDENT
The study of hematology is multifaceted, requiring students to have both theoretical knowledge and prior ability to visualize complex microscopic structures. This work evaluated the impact of a methodology, using drawings of leukocyte morphology along with their morphofunctional description, with students from the Pharmacy course. This is a descriptive study, with a qualitative and quantitative approach, developed with 40 students enrolled in the Basic Hematology course of the Pharmacy program. Initially, the teacher gave a theoretical-practical presentation on the main characteristics of leukocytes, using microscopic slides to introduce and contextualize the content. Then, the students were instructed to draw the visualized cells and describe them in terms of morphology and function. Subsequently, a microscopic quiz was conducted to identify cell types before and after the activity, allowing for a comparative analysis. Finally, a Google Forms evaluation questionnaire was applied. As a result, a significant level of participation in the proposed activity was observed, with 35 students (87.5%) taking part. Regarding the assessment of self-perception of knowledge, a substantial modification was observed in the parameters presented by the students after the strategy, with the consolidation of learning. Regarding the activity's contribution to academic life, 85.7% of participants stated that the methodology helped elucidate robust concepts associated with cells, and 59.5% reported that the proposal facilitated microscopic visualization. It was concluded that the leukocyte drawing activity was effective in strengthening learning and connecting the practical and theoretical aspects of the Basic Hematology discipline.
RACIAL LITERACY: THE BEAUTY OF DIVERSITIES – LEARNING TO BE AND TO COEXIST MUNICIPALITY OF BENEVIDES – PARÁ
In a context where differences are often met with strangeness and prejudice, educating for ethnic-racial and cultural diversity becomes an extremely important topic for forming citizens capable of respecting and engaging in dialogue with people and the world. Learning to be and learning to coexist are two fundamental pillars of education; therefore, helping children recognize the beauty of their own identity allows them to expand their perspective beyond themselves and discover that others also have unique beauties. Considering the roots of racism and its sociocultural persistence is a way to seek paths that give new meaning to our history, where we can embrace and value the richness of knowledge and practices that have color and ancestry, thereby contributing to a more socially just and humane world. The project’s general objective was to provide children with awareness of the beauty of diversities, considering the importance of each child in discovering their own identity, and, through self-recognition, expanding their perspective toward respectful coexistence with various racial diversities. The project was carried out in five stages. The process of strengthening each child’s identity was developed through dialogue, listening, and support, and culminated in Afro-Brazilian music and dance, theater with storytelling, and a photo exhibition—a celebration with the participation of the school community, including education staff and the children’s families.
SOCIOECONOMIC DETERMINANTS OF ESSAY WRITING PERFORMANCE: A DESCRIPTIVE STUDY BASED ON MICRODATA FROM THE 2022 ENEM EXAM
This study conducts a descriptive and interpretative statistical analysis of the 2022 ENEM microdata from a sociological perspective to investigate how structural disparities influence proficiency in the essay exam. Based on a sample of 3,517 participants, the research examines categorical variables such as family income, school type, and household technological resources. The results reveal profound educational stratification, where access to computers and the internet at home correlates with progressive and significant increases in mean and median scores. This highlights what authors such as Rubim, Mantovani, and Alavarse (2025) classify as the expressive impact of combining devices and connectivity on proficiency. The analysis of family income demonstrates that academic performance is strongly determined by socioeconomic background, showing a trend toward higher scores as income increases, which stabilizes only at higher income levels. Furthermore, the study discusses geoFigureical and school inequalities, pointing out the underrepresentation of rural students and the superiority of scores in private and federal public institutions compared to state and municipal networks, as corroborated by Correia and Pintos-Payeras (2025). Under the lens of Jessé Souza (2017), the text reflects on the roots of Brazilian backwardness and the perpetuation of inequalities in access to higher education. It concludes that ENEM has established itself as a fundamental tool for university access, becoming even more effective through the implementation of public policies for digital inclusion and the strengthening of basic education. Such actions are essential to increase equity in the examination and ensure that admission to higher education is an accessible reality for all students.
Maria Valbene da Paixão Cunha de Lima Arruda
CHALLENGES IN THE DEVELOPMENT OF HUMAN CAPITAL IN ANGOLA
This study aimed to analyze the challenges and prospects of human capital in Angola, considering its relationship with education, the labor market, and public policies. It was a descriptive-exploratory research with a mixed-methods approach, combining quantitative and qualitative analyses. Data were collected through a structured digital questionnaire administered to a sample of 264 participants. The results revealed a highly educated profile but one marked by difficulties in labor insertion and career progression, associated with the absence of effective employment policies, nepotism, and job scarcity. Furthermore, a low organizational appreciation of human capital was observed. Despite the predominantly critical perception, respondents identified priority areas such as quality basic education, technical and vocational training, and technological innovation. Accordingly, six practical and strategic recommendations were developed to strengthen human capital. The study concludes that reinforcing human capital in Angola requires consistent public policies, closer education–labor market integration, and professional valorization strategies, which are essential for sustainable development.
TECHNICAL MANUAL FOR FOLIAR DNA EXTRACTION OF CARYOCAR BRASILIENSE (CARYOCARACEAE). STANDARDIZED PROTOCOL FOR OBTAINING HIGH-QUALITY GENOMIC DNA IN CERRADO SPECIES
The pequi tree (Caryocar brasiliense Cambess.) is a native species of the Brazilian Cerrado with significant ecological, economic, and sociocultural importance. Despite its relevance, molecular studies involving this species often face challenges related to obtaining high-quality DNA, mainly due to the high concentration of phenolic compounds and other secondary metabolites present in plant tissues. This technical manual presents a standardized and optimized protocol for genomic DNA extraction from C. brasiliense leaves, based on the classical method proposed by Doyle and Doyle (1987) and adapted to the specific characteristics of the species. The procedure includes steps for appropriate collection and preservation of plant material, tissue maceration using liquid nitrogen, CTAB-based extraction, purification with chloroform:isoamyl alcohol, and alcoholic DNA precipitation. Guidelines for DNA quantification and quality assessment using spectrophotometry and agarose gel electrophoresis are also provided. Additionally, the use of bovine serum albumin (BSA) in PCR reactions is discussed as a strategy to reduce the inhibitory effects of secondary metabolites and improve amplification efficiency. The proposed protocol demonstrates good reproducibility and yield, producing high-integrity and high-purity DNA suitable for several molecular analyses, including ISSR and SSR markers. Therefore, this manual represents an important methodological resource for studies in conservation genetics, population structure, biotechnology, and sustainable management of C. brasiliense.
THERAPEUTIC APPROACHES TO MEDULLOBLASTOMA
Medulloblastoma is the most prevalent malignant brain neoplasm in the pediatric population, characterized by marked clinical and biological heterogeneity and stratified into four main molecular subgroups: WNT, SHH, Group 3, and Group 4. Although traditional management with surgical resection, craniospinal radiotherapy, and chemotherapy has improved cure rates, survivors frequently develop severe neurocognitive and endocrine deficits due to the toxicity of conventional treatment. This narrative literature review, based on PubMed articles published between 2021 and 2025, sought to synthesize advances in therapeutic approaches to medulloblastoma. The results highlight the emergence of targeted therapies, such as DHODH enzyme inhibition for Group 3 medulloblastoma (frequently associated with MYC oncogene amplification) and the identification of new cell survival mechanisms. In monitoring, cerebrospinal fluid (CSF) liquid biopsy has become established for the assessment of measurable residual disease (MRD). Furthermore, new immunotherapy strategies focused on NK cells and checkpoint blockade are being explored to overcome immune evasion. It is concluded that the future of medulloblastoma management lies in combining dynamic monitoring via liquid biopsy with polytherapies that simultaneously target oncogenic signaling and aberrant cellular metabolism, seeking to balance tumor control with the preservation of neurological functions and child development.
HEALTH EDUCATION TOOL: THE USE OF WHO GROWTH CURVES
Monitoring child growth, based on the World Health Organization (WHO) growth charts, is an essential tool for health surveillance and education, allowing for the early identification of nutritional deficiencies and pathologies through the serial analysis of parameters such as weight, height, and head circumference. Developed through a narrative literature review, based on data obtained from PubMed using the descriptor "Growth Curves," this study showed that the practical application of these charts should begin in the prenatal period and extend to postnatal follow-up, highlighting that choosing the appropriate tool is crucial for the pertinent classification of fetal and child development. The results indicate that, although the WHO charts are the global standard, specific populations, such as premature newborns and children with genetic conditions like achondroplasia, require the use of customized third-generation charts to avoid misdiagnoses and reduce parental anxiety. In the discussion, it is emphasized that the objective of these tools is to transform biometric data into visual representations that are understandable for family members, although the professional must consider international growth charts, as well as the biological and environmental factors of each case, avoiding the use of isolated cut-off points as absolute truths. It is concluded that growth charts are cornerstones of modern pediatrics, facilitating clinical-family communication, but their interpretation requires caution and an individualized clinical approach that considers the unique developmental trajectory of each child in their specific context.
TREATMENT OF ACUTE RESPIRATORY DISTRESS SYNDROME
Acute Respiratory Distress Syndrome (ARDS) remains a significant cause of severe respiratory failure in intensive care units, associated with high mortality and marked clinical, pathophysiological, and biological heterogeneity. This chapter aimed to review the most recent scientific evidence on the treatment of ARDS, with an emphasis on protective ventilatory strategies and individualized therapeutic approaches. This is a narrative literature review, conducted in the PubMed database, including articles published in the last five years directly related to the management of the syndrome. The analyzed evidence demonstrates that invasive mechanical ventilation with low tidal volumes, plateau pressure limitation, careful PEEP titration, prolonged prone positioning, and selective use of neuromuscular blocking agents remain the cornerstones of treatment. In addition, rescue therapies, such as ECMO, and non-invasive strategies can be employed in specific situations. Recent literature also highlights the relevance of phenotypic stratification, multimodal monitoring, and advanced imaging tools, such as electrical impedance tomography, for individualizing ventilatory support and reducing ventilator-induced lung injury. It is concluded that contemporary ARDS management should integrate established protocols with personalized approaches, guided by biological phenotypes, functional monitoring, and early rehabilitation, aiming to optimize clinical outcomes and functional recovery of patients.
MANAGEMENT OF THE DELIVERY ROUTE IN PREMATURE PLACENTAL ABRUPTION
Introduction: Premature Placental Abruption (PPA) is considered an obstetric emergency. This is because it involves the partial or total separation of the placenta, a temporary organ that arises during pregnancy to nourish and oxygenate the fetus. PPA usually occurs after the 20th week of pregnancy and can be caused by multiple factors: high blood pressure, abdominal trauma, use of chemical substances, premature rupture of membranes, among others. It is one of the most critical conditions in obstetrics, as it is associated with high rates of perinatal mortality. Method: This research constitutes a narrative literature review. Data retrieval was performed in the PubMed database using the descriptor "Premature Placental Abruption," integrated according to the Medical Subject Headings (MeSH) terminology. The selection included studies published between 2021 and 2025, with full text available in English or Portuguese, addressing the clinical and surgical management of PPA. Results and Discussion: Early identification of the signs and symptoms of this condition is extremely important for choosing the delivery method. It is necessary to assess the health status of both mother and baby before intervening. However, emergency cesarean section is generally the gold standard due to the rapid deterioration of the maternal and fetal clinical condition. It is worth noting, however, that the decision must be made with great caution and safety, because although cesarean section increases the chances of saving lives, it also poses risks like any surgical procedure: hemorrhage, infection, and organ perforation. As for vaginal delivery, this is only indicated when the pregnancy is at term or periterm, there are no signs of complications, or placental abruption is in its early stages. Another possibility is when fetal death has already occurred due to severe placental abruption. In these situations, labor is induced. Conclusion: Early attention to risk factors allows the pregnant woman to be monitored more closely or even undergo high-risk prenatal care. Ultrasound examination is fundamental for identifying uterine abnormalities, fibroids, twin pregnancies, and subchorionic hematomas—aspects that raise concerns about placental abruption. Therefore, healthcare professionals attending to pregnant women, whether in primary care or hospital settings, should frequently monitor the gestational trajectory in order to intervene when the pregnancy no longer offers benefits.
Postoperative delirium (POD) is one of the most frequent and serious complications in elderly patients undergoing surgical procedures, characterized by acute and fluctuating disturbances of attention, consciousness, and cognition. Its occurrence is associated with significant adverse outcomes, including increased morbidity and mortality, prolonged hospital stay, functional and cognitive decline, institutionalization, and increased healthcare costs. The pathophysiology of POD is complex and multifactorial, involving the interaction between underlying brain vulnerability (predisposing factors) and acute perioperative stressors (precipitating factors). Predisposing factors include advanced age, frailty, malnutrition, multimorbidity, previous cognitive impairment, and depression. Precipitating factors include major surgeries, systemic inflammatory response, intraoperative hypotension, poorly controlled pain, and the use of medications such as benzodiazepines. Prevention of postoperative delirium (POD) is based on multicomponent non-pharmacological interventions, such as those proposed by the Hospital Elder Life Program (HELP), which have demonstrated effectiveness in reducing the incidence of the condition. Comprehensive Geriatric Assessment (CGA) in the preoperative period allows for the systematic optimization of modifiable risk factors. Evidence for pharmacological prophylaxis is limited, with dexmedetomidine standing out as a promising option in selected populations, while benzodiazepines should be avoided. Machine learning-based prediction models have demonstrated superior accuracy to traditional logistic regression in identifying high-risk patients, incorporating biomarkers such as brain natriuretic peptide (BNP), troponin T, and C-reactive protein. The relationship between delirium and dementia is intimate and bidirectional, with delirium frequently underdiagnosed in patients with pre-existing dementia. The clinical approach should prioritize the identification and management of triggering factors in all confused elderly individuals, regardless of suspicion of underlying dementia.
FOLIC ACID SUPPLEMENTATION AND REPRODUCTIVE HEALTH, TRANSCENDING THE PREVENTION OF NEURAL TUBE DEFECTS
Introduction: Folic acid is a vitamin that is traditionally prescribed to pregnant women in order to reduce the risk of neural tube abnormalities in the embryo, however, this practice should be reevaluated under the observation that many of the pregnancies are detected after the neural tube has formed and what would be the advantages or disadvantages after 28 days of gestation. Development: Scientific evidence supports that folic acid supplementation is relevant from gametogenesis to the day of delivery, because it contributes to sperm meiosis, oocyte maturation, embryonic tissue formation and the growth of fetal organs and structures. At present, studies on folic acid toxicity do not show conclusive results and further research is needed to elucidate this issue. Conclusion: Adequate folic acid supplementation is important for reproductive health, directly influencing the proper development of gametes, the embryo/fetus, and the health of the pregnant woman.
CHILDHOOD AND OLD AGE: SIMILARITIES AND DIFFERENCES AT THE EXTREMES OF THE LIFE COURSE AND THEIR IMPLICATIONS FOR HEALTHCARE
Childhood and old age represent extremes of the life cycle and are often associated with vulnerability, dependence, and an increased need for care. This approximation, present both in the social imagination and in clinical practice, may encourage more empathetic attitudes, but it may also produce relevant distortions, especially in the care of older adults. This study aims to critically analyze the similarities and differences between childhood and old age, exploring biological, cognitive, functional, and social dimensions, as well as their implications for healthcare practice. This is a qualitative and interpretative narrative review based on indexed scientific literature and institutional documents. Although both groups share greater physiological vulnerability and need for support, they differ substantially in terms of autonomy, identity, accumulated experience, and social role. The risk of infantilization of older adults is highlighted as a practice still present in healthcare settings. It is concluded that recognizing such similarities must be accompanied by a critical understanding of their differences, making it essential to adopt person-centered, ethically oriented care that is sensitive to the singularities of each stage of life.
THE EVOLUTION OF HEALTH JUDICIALIZATION IN BRAZIL: FROM ATOMIZED LITIGATION TO BINDING PRECEDENTS
This article analyzes the evolution of the judicialization of the fundamental right to health in Brazil, highlighting the paradigm shift from an atomized litigation model to a rationalization structured by binding precedents. Initially, the study examines the institutional expansion of the Judiciary and its intervention in public policies as a response to state inertia. Subsequently, it investigates judicial activism regarding healthcare, analyzing the case law of the Superior Courts, with an emphasis on the integration between STJ Theme 106 and STF Themes 6, 793, and 1.234. It demonstrates that this new legal framework, by redefining competencies and centralizing the funding of medications not included in official lists, imposes evidence-based medicine criteria and administrative deference, consolidating budgetary pragmatism in health management. The article concludes that this arrangement aims to ensure the sustainability of the Unified Health System (SUS) and the Brazilian federal order, promoting a hermeneutic reconfiguration of the “existential minimum” within the boundaries of the “reserve of the possible”.
Aline Cristina de Oliveira Amaral Barbosa
SAFE MEDICATION ADMINISTRATION: ASSESSMENT OF NURSING STUDENTS' COMPETENCE AT A PUBLIC UNIVERSITY IN THE AMAZON
This study examined the pharmacological skills of 123 nursing students at the University of the State of Amazonas (UEA). The descriptive, cross-sectional study focused on students enrolled between the 4th and 10th semesters, mostly female, with a mean age of 23 years. Data collection was performed using a structured questionnaire, with descriptive analysis of the results. A high level of theoretical knowledge was observed among participants regarding indications, contraindications, and drug interactions, with superior performance demonstrated by students in more advanced semesters. However, the study revealed significant gaps in the management of adverse reactions and essential practical skills, such as preparation, dose calculation, and safe administration of medications. This discrepancy highlights a mismatch between conceptual mastery and proficiency in clinical application. In view of this, the study concludes that, despite the theoretical advances acquired throughout the training, the consolidation of practical skills still requires a focused curricular improvement. Strengthening active methodologies and clinical simulations is recommended as a priority strategy to ensure patient safety and promote safer and more effective pharmacological practice.