Counsellee’s experience of cancer genetic counselling with pedigrees that automatically incorporate genealogical and cancer database information

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked Files. This article is open access.While pedigree drawing software is often utilised in genetic services, the use of genealogical databases in genetic counselling is unusual. This is mainly because of the unavailability of such databases in most countries. Electronically generated pedigrees used for cancer genetic counselling in Iceland create pedigrees that automatically incorporate information from a large, comprehensive genealogy database and nation-wide cancer registry. The aim of this descriptive qualitative study was to explore counsellees' experiences of genetic services, including family history taking, using these electronically generated pedigrees. Four online focus groups with 19 participants were formed, using an asynchronous posting method. Participants were encouraged to discuss their responses to questions posted on the website by the researcher. The main themes arising were motivation, information and trust, impact of testing and emotional responses. Most of the participants expressed trust in the method of using electronically generated pedigrees, although some voiced worries about information safety. Many experienced worry and anxiety while waiting for results of genetic testing, but limited survival guilt was noted. Family communication was either unchanged or improved following genetic counselling. The use of electronically generated pedigrees was well received by participants, and they trusted the information obtained via the databases. Age did not seem to influence responses. These results may be indicative of the particular culture in Iceland, where genealogical information is well known and freely shared. Further studies are needed to determine whether use of similar approaches to genealogical information gathering may be acceptable elsewhere

Access to water in the Lisbon region in 1900

Abstract: Access to water has always been of strategic importance for urban areas, agricultural purposes and other economic activities. Rapid population growth and urbanization and the subsequent increase in the demand for water have made access to water an important environmental and social issue. This paper examines how water was accessed in the Lisbon region in the nineteen hundreds, a period of time when a specific technological model, commonly referred to as traditional, was in force. Currently, when water management is mostly dependent on technological models based on energy consumption, financial resources, and competition for private management, it would seem that the analysis of how former water systems were organized is a central issue. Through historical evidence from cartographic sources and surveys on water quality and water availability, this article demonstrates: (1) the complexity of the identified traditional water system; (2) the diversity of the water elements that contributed to the functioning of the identified water system; (3) the reliability of such water system; and (4) the value of integrating historical and scientific data to enhance our understanding of the nexus between the human and physical world, within specific temporal and spatial settings. A number of traditional water elements, which existed in the Lisbon region in 1900, are identified and geo-referenced for the first time. These offer important details which will enrich our knowledge of the history of water and possibly allow us to tackle future sustainability issues.info:eu-repo/semantics/publishedVersio

Produção científica sobre eliminações urinárias em periódicos de enfermagem brasileiros Producción científica sobre eliminaciones urinarias en periódicos de enfermería brasileños Scientific literature on urinary elimination in Brazilian nursing journals

OBJETIVO: Verificar a produção científica sobre eliminações urinárias divulgada em periódicos de enfermagem brasileiros. MÉTODOS: Estudo realizado por meio de revisão integrativa da literatura, contemplando as bases de dados MEDLINE, LILACS e Web of Science, utilizando 30 descritores para busca de artigos publicados entre 1999 a 2009; assim, foram selecionados 18 artigos, disponíveis na integra, produzidos por enfermeiros. Os manuscritos foram analisados tendo por base um instrumento de coleta de dados discriminando-se nome do periódico, ano de publicação, tipo do estudo, assunto abordado e nível de evidências. RESULTADOS: Os 18 estudos foram classificados com nível de evidência IV e a incontinência urinária foi o tema mais freqüente nos artigos analisados. CONCLUSÃO: Embora as alterações nas eliminações urinárias integrem a prática clínica do enfermeiro, nos artigos selecionados, o tema foi limitado a um âmbito restrito de assuntos, com baixo nível de delineamento, oriundos da produção de reduzido número de autores, indicando a importância de maior investimento em pesquisas nessa área<br>OBJETIVO: Verificar la producción científica sobre eliminaciones urinarias difundidas en periódicos de enfermería brasileños. MÉTODOS: Estudio realizado por medio de revisión integrativa de la literatura, contemplando las bases de datos MEDLINE, LILACS y Web of Science, utilizando 30 descriptores para búsqueda de artículos publicados entre 1999 al 2009; así, fueron seleccionados 18 artículos, disponibles íntegramente, producidos por enfermeros. Los manuscritos fueron analizados teniendo como base un instrumento de recolección de datos discriminándose el nombre del periódico, año de publicación, tipo del estudio, asunto abordado y nivel de evidencias. RESULTADOS: Los 18 estudios fueron clasificados con nivel de evidencia IV y la incontinencia urinaria fue el tema más frecuente en los artículos analizados. CONCLUSIÓN: A pesar que las alteraciones en las eliminaciones urinarias integren la práctica clínica del enfermero, en los artículos seleccionados, el tema fue limitado a un ámbito restringido de asuntos, con bajo nivel de delineamiento, procedentes de la producción de un reducido número de autores, indicando la importancia de una mayor inversión en investigaciones en esa área<br>OBJECTIVE: To assess the scientific literature on urinary elimination in nursing journals published in Brazil. METHODS: An integrative literature review was used to review the databases MEDLINE, LILACS and Web of Science. The authors used 30 descriptors to search for articles published between the years 1999 to 2009, resulting in a total of 18 articles that met criteria and which were published by nurses. The papers were analyzed using a data collection instrument to identify journal name, year of publication, type of study, subject matter, and level of evidence. RESULTS: Eighteen studies were classified as Level of Evidence IV; urinary incontinence was the most frequent theme in the articles analyzed. CONCLUSION: While the clinical practice of nurses was integrated into articles addressing changes in urinary elimination, we found that this topic was narrowly defined, studies used lower level research designs, and it was noted that few authors published on the topic. All of these findings indicate the importance of greater investment in nursing research in this area of nursing knowledge and practic

Consensos sobre o papel do gestor estadual na regionalização da assistência à saúde no Sistema Único de Saúde (SUS) Consensus regarding the role of the State manager in the regionalization of health care in Brazilian National Health System (SUS)

OBJETIVOS: identificar os consensos acerca do papel do gestor estadual na regionalização da assistência à saúde no SUS. MÉTODOS: foram elaborados um modelo teórico-lógico e uma matriz de avaliação acerca das atribuições do gestor estadual na condução da regionalização. Essa matriz foi submetida à apreciação de especialistas que julgaram a importância dos indicadores de análise definidos, estabelecendo-se o consenso ou o dissenso a partir de pontos de corte previamente definidos, utilizando-se como técnica a Conferência de Consenso. RESULTADOS: a matriz de avaliação resultante do consenso apresenta três níveis de análise (governo, gestão e assistência), que estão desmembrados em seis dimensões compostas de 14 critérios e 82 indicadores de avaliação que exploram as responsabilidades do gestor estadual do SUS frente à regionalização da saúde. Do total de indicadores, apenas quatro não apresentaram consenso, o que indica que a matriz se mostra um instrumento eficiente para avaliação da regionalização da assistência no SUS, abordando as diferentes dimensões dessa intervenção em saúde. CONCLUSÕES: apesar de provisório, o consenso ora estabelecido pode constituir um referencial de elevada utilidade para a realização de pesquisas, podendo servir de base para a realização de investigações avaliativas sobre a implantação dos processos de regionalização, de forma a permitir maior comparabilidade entre os estudos.<br>OBJECTIVES: to identify points of agreement regarding the role of the State manager in the regionalization of health care in Brazilian National Health System (SUS). METHODS: a theoretical framework and evaluation grid were drawn up to evaluate the role of the State manager in regionalization. These were ratified by specialists, who confirmed the importance of the indicators chosen to establish the existence of consensus or the lack of it, on the basis of previously established cut-off points, using the Consensus Conference technique. RESULTS: the evaluation grid resulting from the consensus achieved involves three levels of analysis (government, management and care), which are broken down into six categories comprising 14 criteria and 82 indicators exploring the responsibility of the State manager of the SUS vis-à-vis the regionalization of health care. There was not a consensus regarding only four of these indicators, suggesting that the grid adopted is an efficient instrument for the evaluation of the regionalization of health care in SUS care and covers the various levels of this healt care intervention. CONCLUSIONS: the consensus now established, however provisional, may be taken as an extremely useful point of reference for further research and could serve as the basis for future evaluations of the implementation of regionalization, in such a way as to allow for comparative studies to be carried out