Main Doubts Research Articles

A1-Mart (The e-Commerce Web Application)

Online Shopping play a great importance in the modern business environment. A1-Mart (The e-Commerce Web Application) has opened the door of opportunity and advantage to the firms. This paper analyzed the different issue of online shopping. The research aims to provide theoretical contribution in understanding the present status of online shopping. The Study Discuss the consumers’ online shopping behaviors. Papers also identify the problems face by the consumers when they want to accept internet shopping. Present paper is an expressive study based on the detailed review of earlier pertinent studies related to the various concepts of online shopping to discover the concept of online shopping. Solitude and safety risk emerge regularly as a reason for being cautious about internet shopping. Shopping convenience, information seeking, social contact, and diversity affects the consumer attitude towards online shopping. The impossibility of product testing, problems with complaints, product return and missus of personal data are the main doubts regarding on-line shopping.

Utilizing a family sciences approach to inform integrated care research, practice, and policy.

This interactive workshop describes and makes a case for using a family sciences approach to inform integrated care research, practice, and policy improvements, particularly when integrated care for adult populations is the aim. 
 Adults in need of healthcare are part of unique family systems, and these family systems interact with integrated care systems. For example, when older adults experience declines in health, family members are intricately involved in making care decisions and providing many types of support that interact with care systems. When integrated care is challenged by disconnection or the lack of communication and/or coordination between providers and patients and their families, a family sciences approach to research, practice, and policy improvements can create new knowledge and useful family-based interventions to improve integrated care outcomes for adult populations. This workshop will engage researchers, care providers, and policy makers in understanding the role of family sciences in integrated care research, practice, and policy. 
 This workshop will consist of the following: 
 1)An introduction to family sciences will set the stage by teaching about the principles of family sciences and highlighting the main theories used by family scientists when considering improvements to integrated care for adult populations. 
 2)A family sciences approach will be applied to integrated care research and practice. 
 a)We will consider how, when, and why family sciences could be applied to integrated care research focused on adult populations. We will use examples of family-based methods for research that are appropriate for studying adult populations and intergenerational families (e.g., genograms, ecomaps, dyadic interviewing); the benefits and potential pitfalls of these methods will be discussed. An interactive activity will be used when small groups closely examine a selection of family-based methods. A discussion about the applicability of these research methods in group members’ fields of study will be included. 
 b)We will consider the application of family sciences to integrated care practice and policy. We will examine how, when, and why a family sciences lens could be used to improve integrated care practice and policy. Examples of family focused interventions will be presented, and the benefits and potential pitfalls of these interventions will be discussed. An interactive jigsaw activity will have small groups each examine a unique family-based intervention and discuss the benefits/challenges to implementation, including how the intervention might interact with policy. Groups will summarize the intervention and present their findings to each other so the whole workshop groups is exposed to each family-based intervention. 
 3)We will conclude by considering the future of combining family sciences and integrated care. Participants will list their three main doubts in combining family science approaches and integrated care. They will also list one concrete action they could take in their own research, practice, or policy-setting role that aligns a family sciences approach to integrated care.

Mitigating Function in Verb Forms Conveying Doubt in the Chilean PRESEEA Semi-Structured Interviews Corpus

This article analyzes the attenuating function of verbal forms expressing doubt in semi-structured interviews found in the PRESEEA corpus of Santiago de Chile. 36 interviews, collected in 2009, were analized taking into account the participants image, speech acts, and discursive positions. Verb sociolinguistic variation —as determined by sex, age, and education level— was also examined. The main doubt expressions with an attenuating function found include doxastic verbs such as creer (“believe”) and suponer (“suppose”), the modal verbs deber (“must” or “should”) and poder (“could”, “might”), and the verb expressing lack of knowledge no saber (“to not know”). These expressions occur when speakers express their true point of view as a doubt, or when they report a state of affairs. The result is a speaker directed towards the “other”, who does not want to expose their image to their interlocutor, when the speaker expresses opinions about controversial topics or when they report facts that they prefer not to express openly. Sociolinguistic variation is scarce and is mostly related to age.

Access to Information, and Concerns, Myths and Truths about Food Safety during the COVID-19 Pandemic: An Overview of the Portuguese Population.

The COVID-19 pandemic raised questions and concerns about the possibility of the virus being transmitted through food, as the virus was found in sewage, shrimps and packages of frozen food. During the first wave of COVID-19, concerns about the transmission of SARS-CoV-2 through food arose. As the number of cases began to increase rapidly, so did the availability of information regarding the virus and ways to prevent infection. A significant portion of this information was disseminated by the media and the general public. Identifying and understanding the main doubts and concerns about food hygiene and safety raised by the Portuguese population during the first wave of COVID-19 is important in order to understand whether these issues have influenced their practices and what lessons can be learnt for food safety and hygiene education. The aims of this work were (1) to understand the doubts and concerns of the Portuguese population regarding food safety and hygiene during the first wave of COVID-19, and how these issues were clarified, (2) to analyze the population's opinion on food/hygiene myths and truths related to the transmission and prevention of the infection, and (3) to understand how the first wave of COVID-19 may have influenced the population's practices linked to food handling and consumption. The main doubts of the respondents were related to food handling (41.6%) and the possibility of transmission of COVID-19 through food (17%). Television was the main source of information used to clarify these doubts (32.9%), followed by a guideline issued by the Directorate-General of Health (30.7%). However, most respondents (50.9%) said that they had only found answers to some of their questions. Most respondents reported washing and disinfecting hands before (85% and 63.4%, respectively) and after (73.8% and 57.3%, respectively) the handling and organization of food purchases. Most respondents did not believe the myths about COVID-19 and food safety, but this depended on their level of education. Some practices may have changed as a result of the pandemic, particularly with regard to washing and disinfecting hands and food, as well as kitchen hygiene.

Access to Information, Concerns, Myths and Truths on Food Safety During COVID-19: An Overview of Portuguese Population

PurposeThe COVID-19 pandemic raised questions and concerns about the possibility of transmission of SARS-CoV-2 via foods. While cases of COVID were rapidly rising, information related to the virus and ways of prevention was also increasing, with much of this information being provided by the media and the general population. In this context, this study had two main objectives: 1) To understand the doubts and concerns of the Portuguese population related to food safety during the first wave of COVID-19 and how they clarified these issues and 2) to analyze the population's opinion on myths and truths related to the transmission of the infection.Methods & MaterialsA survey including questions about a) concerns and information on food safety during the first wave of COVID-19 pandemic; b) myths and truths about COVID-1 and c) respondents’ profile. The survey was released online between June and October of 2020.ResultsThe main doubt of the respondents was related to the manipulation of food (40,7%) followed by the possibility of transmission of COVID-19 through food (12,6%) and which foods should be avoided due to the pandemic (12,6%). 33,3% of the participants stated that television was the main mean of information accessed to clarify these doubts, followed by a Guideline launched by the Directorate-General of Health (31,8%). However, 50,3% said that they had only found answers to some of their questions. 50% of the respondents with higher level of education and 30% of the respondents with lower level of education had doubts about the possibility of the transmission of COVID-19 through food. Also, most of the survey participants disagreed with the affirmations regarding popular ways of disinfecting food to prevent infection.ConclusionCOVID-19 pandemic raised several doubts, however when related to food safety, the main doubt was about the manipulation of food due to the concern of SARS-CoV-2 transmission. Most respondents do not believe myths about COVID-19 and food safety, but this was dependent on the level of education.

Endodontic treatment during pregnancy: case series and literature review

ABSTRACT The aim of this paper is to provide a scientific basis for conducting safe root canal treatment in pregnant women, illustrating with case reports treated in the extension project Maternal-Child Dental Care at the Federal University of Pelotas. The scientific bases address the main doubts of professionals when performing prenatal dental care: use of radiographic examination, local anesthetics, prescription of medications, among other essential factors in the care of pregnant women. The assisted pregnant women sought care with dental pain. In two cases symptomatic irreversible pulpitis was diagnosed, while a third was experiencing acute apical periodontitis. Endodontic procedures were performed under controlled and standardized conditions. The root canals were prepared in a single session, using mechanical instrumentation with reciprocating kinematics (Wave One® Gold Primary - Dentsply Sirona), and the root canal length was determined by an electronic apex locator FinePex (Schuster). Root canal filling was performed by the single cone technique with Wave One® gutta-percha points. After endodontic treatment, coronal sealing was performed with composite resin A2 Z350 XT (3M ESPE). The care related to the gestational condition is highlighted, and the patients remain under monitoring. It is concluded that the use of apical locators and mechanical instrumentation, using reciprocating files associated with the single cone obturation technique with a standardized cone for each system, represents advances for the accomplishment of endodontic treatment in pregnant patients due to the shorter clinical time and greater comfort of the procedure.

PESQUISA COM ADOLESCENTES E JOVENS SOBRE GESTÃO FINANCEIRA PESSOAL

The present work has as its theme the personal financial management, where the main objective is to identify the financial literacy level of adolescents and young people between 15 and 21 years old and how they behave in relation to their income, consumption, and expenses. The choice of this theme arose from the need to understand the main doubts of adolescents and young adults at the beginning of their financial lives, who have income. The aim of this initiative is to make the subject a more natural and present subject, in the family nucleus, as well as approach the subject in a technological way in relation to the target audience through the adopted research tools. Therefore, this article intends to disseminate the results of the research. identify the level of financial literacy and list the main doubts of adolescents in the context of personal financial management. We made the research available through an online questionnaire with the Google Forms tool and the project was presented to the target audience through partner institutions such as the Presidente Prudente Mirim Guard and through the researcher's social networks. After applying the questionnaires, the answers were divided into two groups for better analysis, and it was concluded that both young people and adolescents already have debts.

Dental avulsion management by emergency professionals and efficacy of education

This intervention study evaluated knowledge of first responders regarding the emergency clinical protocol in cases of dental avulsions and impact of an informative campaign. A questionnaire was applied to evaluate effect of provided information on knowledge among emergency service professionals regarding the management of avulsion of teeth: before campaign (T0) and after campaign (T1). Participants were invited to attend the dental trauma awareness campaign that was carried out by the researchers. The campaign addressed main doubts and difficulties regarding emergency dental trauma care. Data were statistically analyzed (p <0.05). There was significant increasing in the knowledge of professionals regarding the possibility (from 74% to 88%) and ability (5% to 32%) of first responders perform tooth replantation; about the ideal time to perform the replantation (from 30% to 59%); about the correct handling (from 52% to 85%) and the need for cleaning (from 60% to 79%) of an avulsed tooth for replantation. It can be concluded there is a lack of knowledge of emergency service professionals about tooth avulsion management. The strong message is the importance not only of identifying the lack of knowledge of the professionals about tooth injuries, but also perform the education that can significantly improve the professional knowledge.

Atividade lúdica e educativa para higienização das mãos em tempos de pandemia: relato de experiência

Objective: to describe the experience of a playful activity to reflect on the hand hygiene technique among nursing professionals regarding the care of patients with Coronavirus. Method: this is a study of a professional experience report about an educational activity carried out with 25 professionals who are on the front line of COVID-19. Result: the participants realized the flaws during the hand hygiene procedure and were clarified about the main doubts about the correct technique, friction time, amount of soap to be used, causing their practices to be put to the test. Conclusion: the permanent education is essential to encourage and carry out appropriate techniques, mainly those related to the barriers of exposure to the virus. The increasing in quality of hand hygiene requires investment in continuing education for health professionals and changes in the aspects related to the beliefs and culture of these professionals.

Principais dificuldades vivenciadas por primíparas no cuidado ao recém-nascido

Objetivo: Identificar as principais dúvidas e dificuldades vividas pelas puérperas primíparas em relação ao recém-nascido. Métodos: Trata-se de uma pesquisa de campo, descritiva e exploratória de abordagem quanti-qualitativa, realizada no domicílio de 22 primíparas atendidas pelas Estratégia de Saúde da Família (ESF) de um município do interior do estado do Piauí, sendo executada durante o mês de julho de 2016. Resultados: Durante as entrevistas, as participantes foram questionadas quanto às suas dúvidas ou dificuldades enfrentadas para a realização do cuidado ao recém-nascido. A análise das falas obtidas demonstrou que a dificuldade prevalente foi a amamentação, seguida de engasgo e regurgitação; banho e higiene; choro; vacinas e suas reações adversas. Conclusão: As puérperas, embora tenham sido informadas e orientadas quanto aos cuidados com o recém-nascido, apresentaram dúvidas e dificuldades para realizarem tal prática por diversos motivos, sendo a primiparidade o principal deles e revelando aos profissionais de saúde as necessidades no enfrentamento da maternidade.

Orthognathic surgery: doubts from patients with orofacial fissures regarding the immediate postoperative period.

to identify the main doubts regarding the immediate postoperative care of patients with orofacial clefts undergoing orthognathic surgery. cross-sectional, quantitative study, developed in a public and tertiary hospital, between November 2017 and May 2018. Data collection occurred through interviews during the preoperative nursing consultation. An instrument was used to describe doubts, which later were grouped according to the subject. 48 patients participated. The doubts referred to sun exposure (56%), food/mastication (48%), the relationship between intermaxillary block-breathing-vomiting (48%), oral hygiene (31%), physical activity restriction (27%), nasopharyngeal cannula, removal of surgical stitches, hospitalization time and speech/communication (23%), bleeding, cryotherapy, facial massage, aesthetic and functional results, healing, edema/ecchymosis, postoperative pain, and changes in facial sensitivity (21%). the doubts were related to food, the period of convalescence, care for the surgical wound, postoperative complications, and medications.

Energy cluster – an attempt in characterisation and definition

Clusters are an organisational and economic phenomenon. This paper attempts to answer what an energy cluster actually is and whether it meets the requirements of a cluster in the classical approach of economic sciences. The Act of 20 February 2015 on renewable energy sources (Ustawa OZE 2015) introduced the concept of an ‘energy cluster’. It was aimed at, among others, increasing energy security and environmental protection through an efficient use of renewable energy sources. In the literature on the subject, there is no single universally applicable definition of a cluster, it can only be considered in its various aspects. The concept of a cluster has so many applications, associations and meanings that in many respects it has become a ‘chaotic idea’ due to flattening and equalising different types, processes and spatial scales of economic location within one universal concept. However, the main doubt concerns the very definition of a cluster. The paper considers the organisational attributes of clusters, based on the analysis of the following aspects: a) Cluster in historical terms. Overview of cluster and network definitions: i. Overview of cluster definitions ii. Overview of network structure definitions b) Energy cluster. Forms of interorganisational relations and the typology of energy clusters i. Forms of interorganisational relations in an energy cluster ii. Energy cluster against in relation to organisational network typology iii. Energy cluster as a form of company network – common features and differences c) An attempt in characterisation and definition of an energy cluster.

Enforcement of Investment Arbitration Awards

The enforceability of decisions is a central pillar of any dispute resolution mechanism, whether of internal or international nature. This chapter aims to explain the rules for enforcement under the two main enforcement systems that are currently in force in the realm of investment arbitration: the 1958 New York Convention on the Recognition and Enforcement of Foreign Arbitral Awards, and the 1965 Washington Convention (the “ICSID Convention”). In particular, Section 2 analyses the scheme for enforcement under the New York Convention, and assesses the obligations of the states parties; Section 3 examines the scheme for enforcement under the ICSID Convention along with the related obligations of states parties. In both cases, we will shortly introduce a linkage to the threat that sovereign immunity for execution of awards poses to the function of the investor-state arbitration regime. Some conclusions on the relationship between the two Conventions will be attempted. In such a context we will finally propose some reflections on an issue related to the enforcement and recognition of arbitral awards which could assume particular relevance in the very near future: the proposed investment court system (ICS) and multilateral investment court (MIC). We thus briefly address the main doubts that have been raised concerning the enforcement and recognition of decisions by the ICS/MIC.

Use of cell phones in the transmission of preventive messages about COVID-19 to pregnant women in Yucatan, Mexico. Preliminary data

Objective. Present a strategy to rescue pregnant women from the pandemic through the use of mobile technology, to explore their health status and provide preventive information to limit damage. Methodology. Descriptive, cross-sectional study. Pregnant women from two municipalities of Yucatan participated. Based on national guidelines and direct questions to a sample of pregnant women, infographics were prepared on the main warning signs and most common questions about COVID-19, respectively. The infographics were sent to each pregnant woman's cell phone. Descriptive statistics were used and tables, graphs and figures were prepared to present the results. Contribution. 330 pregnant women were identified, of which 50 (15.1%) have already received infographics. The main doubts of a sample of 13 (3.9%) pregnant women about COVID-19 were: if something can happen to their baby if they get COVID-19, 13 (100%); if you can give COVID-19 to your baby in the hospital, 12 (92.3%); what measures to take and how to prevent COVID19, 12 (92.3%); risks in childbirth if you get COVID-19, 7 (53.8%). It is important to continue with preventive information through digital means to improve the knowledge of pregnant women and prevent the risk of contagion. This study contributes to reduce the maternal mortality.

Opinión de los profesionales de la salud sobre un documento de registro de directivas de adecuación de esfuerzo terapéutico en pediatría

Introduction: during the medical care of children with life-threatening or life-limiting conditions (EALV), sometimes is necessary to adequate the therapeutic effort (ATE). The pediatric palliative care unit of the Pereira Rossell Hospital Center (PPCU- PRHC) implemented a decision-making procedure on ATE and its registration in the clinical history.Objective: to know: the opinion of health care professionals regarding the utility of the ATE registration document, the main difficulties found, and the interest in training activities.Material and method: descriptive, cross-sectional study, by means of a survey of physicians and nurses working in the PRHC, between 23 / 10-12 / 11/2018. It was endorsed by the Ethics Committee.Results: 75.4% (181/240) of the respondents had attended children with ATE documents, occasionally: 73.5%, frequently: 21.5%. They considered it useful to have ATE records: 30% and very useful: 58%. They expressed to find ethical, clinical and / or legal doubts, occasionally: 51.4%, frequently: 27.6%; the main doubts: responsibility when fulfilling the directives and the lack of signature of the parents. The main difficulties referred to were: that the parents do not have the document at the consultation, and that they are distressed and ask to “do everything”. Most professionals expressed that it would be useful or very useful to receive more information and/ or training on ATE.Conclusions: most of the professionals surveyed had participated in the care of children with ATE registration. They considered it useful or very useful to have these records, but they expressed occasional clinical, ethical and/ or legal doubts.

SUN-095 Understanding and Communication Around DSD According to the Mothers and Patients’ Perspectives

Communication around DSD is complex. It involves diagnosis and treatment aspects and is influenced by the psychological status of the individuals and the cultural context. An adequate understanding by patients and relatives is essential for approach of DSD. Objetive: To evaluate the DSD care setting in three Brazilian tertiary centers in order to identify the barriers to an adequate understanding and an optimal communication. Methods: A guide with 69 questions, assessing the level of knowledge, the main doubts and difficulties around DSD was developed and guided individual interviews with 100 mothers and 53 adult patients with DSD. The main doubts were clarified and a self-assessment was requested to them before and after the interview on a scale from 0 to 10. Results: Mothers and patients mean age were, respectevily, 35.2 and 36.5 years. Both of them had a satisfactory educational level. Although 48% (p<0.01) of mothers and 68% (p:0.02) of patients were satisfied/very satisfied about their knowledge related to the DSD, 78% and 58%, respectively, of them still had doubts. The doubts were related to diagnosis, karyotype, medications, appearance of genitalia, surgery, sexual activity, fertility, genetic counseling, consequences of the condition and treatment on general health and condition influence on the child’s behavior and personality The unsatisfied mothers cited as barriers to an optimal understanding the complexity of the conditions, the difficult terms and the psychological stress at diagnosis. Patients also cited as barriers the absence of dialogue about the condition at home and some of them chose not to know. About 55% of mothers and 62% of patients didn’t even know the name of the condition; but positively 88% of them knew the necessary treatment. Regarding communication, 68% of mothers and 89% of patients didn’t feel comfortable talking to people about the DSD condition and around 68% of them underwent negative comments. Although 73% of patients would prefer to be first informed about their condition at childhood, 29% of mothers think that childhood is the best age for it. Among mothers and patients, the most and least appropriate term to name the DSD condition is, respectively, genital malformation and disease (p<0.01). Both of them have the stigma as the main concern. Conclusion: Even in a tertiary center with a multidisciplinary team, the mothers and patient’s knowledge about DSD conditions is scarce. The proper choice of the term to refer to DSD conditions should consider the families and patients perspectives. Communication about DSD is prejudiced by the lack of knowledge and the stigma suffered by these patients and families. Thus, due to complexity of this topic, continued educational action must be instituted as a strategy to modify this scenario.

Wyłączenie pracownika na podstawie art. 24 § 1 pkt 5 Kodeksu postępowania administracyjnego oraz art. 130 § 1 pkt 6 Ordynacji podatkowej

Przedmiot badań: Autorka uczyniła przedmiotem badań instytucję wyłączenia pracownika w postępowaniu jurysdykcyjnym (ogólnym i podatkowym) w sytuacji, gdy pracownik organu brał wcześniej udział w wydaniu zaskarżonej decyzji. Przesłankę wyłączenia pracownika w ta­kich przypadkach formułuje art. 24 § 1 pkt 5 Kpa oraz art. 130 § 1 pkt 6 Op. Spośród wszystkich podstaw wyłączenia pracownika analizowana przesłanka wywołuje najwięcej wątpliwości oraz sporów w judykaturze i piśmiennictwie.&#x0D; Cel badawczy: Zasadnicza wątpliwość, na którą autorka poszukuje odpowiedzi, sprowadza się do pytania: czy w świetle art. 24 § 1 pkt 5 Kpa oraz art. 130 § 1 pkt 6 Op. pracownik organu administracji publicznej I instancji podlega wyłączeniu od udziału w postępowaniu w sprawie, w której organ II instancji uchylił zaskarżoną decyzję i przekazał sprawę do ponownego rozpa­trzenia organowi I instancji, bądź też czy podlega on wyłączeniu po uchyleniu decyzji przez WSA i przekazaniu przez sąd sprawy do ponownego rozpoznania organowi administracji? Analizowa­ny problem ma istotne znaczenie z punktu widzenia praktyki stosowania prawa. Konsekwencje prawne wydania decyzji administracyjnej przez pracownika podlegającego wyłączeniu są daleko idące. Prowadzą one do uchylenia decyzji w postępowaniu sądowoadministracyjnym przez WSA bądź wzruszenia decyzji w trybie nadzwyczajnym wznowienia postępowania.&#x0D; Metoda badawcza: W pracy zastosowano metodę dogmatyczną oraz (posiłkowo) komparaty­styczną, a także historyczną oraz socjologiczną.1&#x0D; Wnioski: Przeprowadzone w pracy rozważania prowadzą do konkluzji, że wyłączenie pracowni­ka na podstawie art. 24 § 1 pkt 5 Kodeksu postępowania administracyjnego oraz art. 130 § 1 pkt 6 Ordynacji podatkowej powinno mieć miejsce w każdym przypadku, gdy sprawa ponownie trafia do danego organu po uchyleniu jego decyzji przez organ odwoławczy bądź sąd administracyjny.

SUN-241 Understanding and Communication of DSD in Patients' Perspectives

Communication in DSD is complex: it involves diagnosis and treatment aspects, psychological status of the pantients and cultural context. An adequate understanding by patients is essential for approach and communication in DSD. Objective: Evaluating the DSD care setting in two tertiary centers in order to identify the barriers to the adequate understanding and optimal communication. Methods: Specific questionnaire (69 questions), assessing the knowledge level, the main doubts and difficulties in DSD communication was developed and applied to DSD patients. The main doubts were clarified and a self assessment was requested for the patients before and after the interview. Results: 40 patients were interviewed. Mean patients age was 36,2y (SD: 13,7) and 54% finished at least hight school. When asked about their condition understanding, although 55% (p: 0,073) of them was satisfied, 62% doesn’t know the condition name, 53% doesn’t know the main condition characteristics and why they’re were affected and 57% still had any doubt. Doubts were related to diagnosis, drugs, surgery, appearance of the genitália, karyotype and fertility. Positevely, 77% (p < 0,01) knows the necessary treatment. The mais barriers to full understandig reported were: scientific terms used in the approach, the complexity of the conditions, the absence of dialogue about the condition at home and patient's choice not to want to know. When asked about how they were informed, 26% of them were informed in infancy, 58% in adolescence and 16% in adulthood (mean age: 14,7y SD: 7,3). 68% of them were informed by doctors. 35,5% (p: 0,01) was insatisfied with the first approach and 79% (p < 0,01) of them would prefer to know early in childhood for better adaptation. They suggested as an ideal approach to avoid omission and difficult terms, to explain gradually, clearly, using visual aids and with psychological support. Concerning communication about DSD in society, 86,5% (p < 0,01) doens’t feel conforttable talking to people about their condition and 58% suffered negative comments in family, school, work and social environment. Only 24% (p:0,064) of them doens’t bother with the judgment of other people. For better communication, among the terms (disease, clinical condition, genitalia malformation, ambiguous genitalia and disorders of sex development), 35% considered genitália malformation as the best for clarity and objectivity, and for 40% of them. disease was the worst for stigma. Their self assessment 1 to 10) improved from 6 before to 9 after the interview (t(38): 7,8, d: 1,52, IC 95%: 2,2-3,69; p< 0,01), with a positive impact on the patients knowledge. Conclsuion: Communication iabout DSD is prejudiced by the stigma and lack of knowledge. The choice of the term to refer to DSD conditions should consider the patient perspectives. Thus continued educational actions must be instituted to modify this scenario.

Disforia de Gênero em crianças: revisão integrativa da literatura e recomendações para o manejo na Atenção Primária à Saúde

Introdução: Disforia de Gênero em crianças é um tema pouco abordado no treinamento clínico, apesar do aumento do interesse das famílias sobre as questões de gênero. Objetivos: Realizar revisão integrativa de pesquisas sobre Disforia de Gênero em crianças e identificar recomendações para o manejo na Atenção Primária à Saúde. Métodos: Revisão integrativa da literatura utilizando termos MeSH nas bases de dados Pubmed, Medline, Lilacs e Scielo para artigos publicados entre 2008 e 2018 que utilizaram crianças transgêneras em suas análises. Resultados: Dos 2.488 artigos identificados pela chave de busca, 12 artigos foram selecionados para estudo. A maioria de centros especializados no atendimento a crianças transgêneras em quatro países. O profissional de saúde deve realizar anamnese direcionada às questões de comportamento da criança em casa e na escola, dinâmica familiar, contexto cultural, história familiar de não conformidade de gênero, vida social da criança e segurança infantil. Deve-se atentar para a avaliação psicossocial adequada para a idade da criança. Cabe à equipe de Atenção Primária à Saúde esclarecer as principais dúvidas das famílias, realizar a suspeita diagnóstica e encaminhar ao centro especializado no atendimento a crianças transgêneras do seu estado. Conclusão: Cabe à equipe de Atenção Primária à Saúde providenciar um ambiente acolhedor e sem discriminação para que estas famílias sejam avaliadas e conduzidas de forma adequada.

The Evolution and the Advantages of MicroED.

MicroED is a method which combines cryo-EM sample preparation and instrumentation, with electron and X-ray crystallography data analysis, and it has been employed to solve many protein crystal structures at high resolution. Initially, the main doubts of this method for structure determination were the dynamic scattering of electrons, which would cause severe inaccuracies in the measured intensities. In this paper, we will review the evolution of MicroED data collection and processing, the major differences of multiple scattering effects in protein crystals and inorganic material, and the advantages of continuous rotation data collection. Additionally, because of the periodic nature of the crystalline sample, radiation doses can be kept significantly lower than those used in single particle data collection. We review the work where this was used to assess the radiation damage of a high-energy electron beam on the protein molecules at much lower dose ranges compared to imaging.