George Oliveira Silva

Background: Secretory immunoglobulin A (IgA) is the predominant immunoglobulin in human milk and a key component of neonatal mucosal immunity. While its biological functions are well established, the impact of maternal psycho‑emotional factors on its concentration remains largely unknown. No previous review has systematically mapped this intersection. Objectives: To synthesize evidence on relationships between maternal psycho-emotional factors—depression, anxiety, stress, fatigue, and sleep disturbance—and IgA concentrations in human milk. Methods: Following the JBI framework and PRISMA-ScR guidelines, a comprehensive search was conducted across MEDLINE, Embase, Cochrane, CINAHL, PsycINFO, Scopus, and Web of Science without date restrictions. Fourteen studies met eligibility criteria. Data were extracted using a standardized form and synthesized narratively. Results: Findings were heterogeneous, with positive, negative, and null associations across psychological domains. Occasionally, anxiety was associated with lower milk IgA in early postpartum cohorts, whereas associations with depressive symptoms varied by lactation stage. Postpartum-specific stress showed the clearest inverse relationship with milk IgA, although evidence remained limited. Only one study assessed maternal fatigue, and none examined sleep disturbance. Differences in lactation stage, milk sampling timing, and laboratory methods appeared to contribute substantially to variability across studies. Conclusion: Maternal psycho-emotional factors do not exert a uniform influence on milk IgA. Instead, evidence suggests context-dependent patterns shaped by lactation stage, biological processes, and methodological factors. This review highlights an understudied area and underscores the need for standardized longitudinal studies to clarify how maternal mental health interfaces with lactational immunity.

RESUMO A formação de profissionais da Atenção Primária à Saúde para o manejo de Doenças Crônicas Não Transmissíveis é fundamental no contexto do Sistema Único de Saúde. Apesar de sua relevância, ainda há carência de avaliações robustas sobre os impactos de tal formação. Este estudo avaliou os efeitos do Programa QualiDCNT na capacitação supracitada. Foi realizado um estudo transversal e analítico, utilizando um questionário estruturado sociodemográfico, laboral e três escalas: Reação aos Procedimentos Instrucionais, Suporte Psicossocial e Material à Transferência de Treinamento e Autoavaliação de Impacto. Os dados foram coletados ao final do Programa e 30 dias após, e analisados por estatística descritiva e inferencial. A amostra foi composta por 64 participantes na primeira etapa e 71 na segunda, recrutados por conveniência. Os escores de satisfação registraram maiores médias para Reação aos Procedimentos Instrucionais, a Autoavaliação de Impacto apresentou médias moderadas e os escores do Suporte Psicossocial e Material à Transferência de Treinamento foram os mais baixos. Os resultados destacam que o Programa contribuiu positivamente para a satisfação e a percepção de impacto dos participantes, mas apontou desafios relacionados ao entendimento de que o suporte organizacional seja indissociável do sucesso das ações formativas para o Sistema Único de Saúde.

The training of Primary Health Care professionals in the management of Chronic Non-Communicable Diseases is essential within the context of the Brazilian Unified Health System. Despite its relevance, there is still a lack of robust evaluations on the impacts of such training. This study evaluated the effects of the QualiDCNT Program on the aforementioned training. A cross-sectional and analytical study was conducted using a structured questionnaire that included sociodemographic and work-related data, along with three validated scales: Reaction to Instructional Procedures, Psychosocial and Material Support for Training Transfer, and Self-Assessment of Impact. Data were collected at the end of the program and 30 days later, and analyzed using descriptive and inferential statistics. The sample consisted of 64 participants in the first stage and 71 in the second, recruited by convenience. Satisfaction scores showed higher averages for Reaction to Instructional Procedures, Self-Assessment of Impact presented moderate averages, and the scores for Psychosocial and Material Support for Training Transfer were the lowest. The results indicate that the Program contributed positively to participant satisfaction and perceived impact, but also highlighted challenges related to the understanding that organizational support is inseparable from the success of training initiatives for the Unified Health System.

Objective: To describe the actions performed by nurses and understand their perceptions of autonomy in primary health care (PHC). Method: A qualitative, exploratory, multiple-case study was conducted with seven nurses from Basic Health Units, both with and without the Family Health Strategy, in Goiânia, Brazil. Online interviews were conducted between January and June 2021, transcribed, and analyzed by four researchers using content analysis. Results: A total of 55 actions performed by nurses were mapped and grouped into three categories: individual care, collective activities, and management actions. Two analytical categories reflected professional autonomy: “Working Conditions of Nurses in PHC” and “Professional Practice of Nurses in PHC.” Conclusion: Nurses’ autonomy is shaped by the organization of work processes and the availability of human, material, physical, and informational resources. The scope of practice, clarity of roles, and institutional boundaries determine the realization of professional practice.

Objetivo: Relatar a experiência de professores e uma enfermeira sobre a importância do Programa Saúde na Escola (PSE) como campo para ensino de saúde da criança na graduação em enfermagem. Método: Relato de experiência das atividades práticas da disciplina de saúde da criança realizadas por meio da parceria entre Universidade, uma unidade da Estratégia Saúde da Família e uma escola filantrópica conveniada à rede municipal de educação, para realização de ações do Programa Saúde na Escola. Resultados: 40 estudantes de enfermagem, divididos em seis grupos de 6 a 8 estudantes desempenharam ações vinculadas a dois eixos do programa: 1. monitoramento e acompanhamento das condições de saúde das crianças matriculadas na escola, como antropometria, aferição da pressão arterial e avaliação da acuidade visual pelos estudantes de enfermagem; e 2. ações de educação em saúde para as crianças, lideradas pelos estudantes de enfermagem desde o planejamento à execução, com temas voltados para alimentação saudável e prevenção de acidentes domésticos. Conclusão: O PSE é uma excelente oportunidade para o ensino de saúde da criança, aplicando na prática as políticas de saúde e programa a elas relacionado, com possibilidade de articulação de saberes teóricos e práticos, desenvolvimento de competências necessárias à atuação profissional.

This study aimed to identify the determinants of academic adaptation and quality of life in university students. Through a cross-sectional design, 90 university students participated in the research, responding to a questionnaire focused on sociodemographic, academic, and health-related variables. The Academic Life-Experiences Questionnaire and the Medical Outcomes Study 36-Item Short-Form Health Survey were used to evaluate academic adaptation and quality of life, respectively. Multiple linear regressions were performed to identify positive and negative predictors of these outcomes. The results showed that high scores in the physical and mental components of quality of life, living in the same city as the university, and receiving some types of scholarship were positive predictors of academic adaptation, while not performing physical activities was a negative predictor. The positive predictors of the physical component were income of more than two minimum wages, having no comorbidities, and being students of Black race. In contrast, the negative predictors were stressful factors such as the teaching method, evaluation method, and experiences during the internship. The mental component had only positive predictors, such as having no intention of dropping out and having no minor mental disorders. Academic adaptation was positively correlated with physical and mental components of quality of life. The findings of this study showed that university students’ academic trajectories have diverse influencing factors related to sociodemographic, academic, and health-related determinants.