Valorización de la Iglesia San Francisco de Asís de Asunción a través de la interpretación de la Simbología e Iconografía

El propósito de este trabajo es ofrecer una visión sobre la presencia Franciscana en Paraguay hasta nuestros días, la incidencia en nuestra sociedad y su trascendencia. Relacionar la espiritualidad franciscana aplicada a las obras y la arquitectura en las que se resaltan los mismos valores franciscanos, en las cuales la sencillez se aprecia en la belleza a través de la proporción, en particular la aplicación de las características franciscanas en la Iglesia San Francisco de Asís de Asunción, desde un análisis de la simbología y la iconografía. En este sentido, se investigó sobre la existencia del módulo de proporción que genera el proyecto mismo de la iglesia y que permite definir la regla por la cual se organizan y distribuyen los espacios y sus relaciones. Se interpretan los símbolos y signos presentes en la planta, fachada y altar, hasta demostrar que a través de la expresión artística, se aprecian los símbolos y mensajes que marcan un impacto en la sociedad, identifican un estilo y que pueden ser leídos principalmente por los que los conocen. Con la identificación y preservación de estos símbolos es posible establecer criterios de valoración patrimonial

Matrix support: a study on the perspective of mental health professionals

Matrix support is part of the new organizational arrangements and methodology for management of healthcare work that aim to integrate the dialogue between different specialties and levels of care. This paper analyses matrix support from the perspective of professionals working in different mental health clinics in the municipality of Campinas, state of São Paulo, Brazil. It is a descriptive qualitative study that involved interviews with professionals from different specialties. The data obtained were processed based on discourse analysis methodology. The results showed that the proposition of matrix support was not clearly incorporated by all the professionals, but that it enabled exchange of knowledge, interdisciplinary work, construction of intervention strategies and co-responsibility within the clinical field. Success in relation to these new organizational arrangements requires joint and collective effort by all players who seek comprehensive care.O apoio matricial constitui parte dos novos arranjos organizacionais e metodologia para a gestão do trabalho em saúde, objetivando a integração dialógica entre distintas especialidades e níveis de atenção. Este trabalho analisa o apoio matricial sob a ótica de profissionais que atuam na saúde mental em diferentes serviços do município de Campinas, SP, Brasil. Trata-se de estudo qualitativo, envolvendo entrevistas junto a profissionais de diferentes especialidades. Os dados obtidos foram tratados com base na metodologia da análise do discurso. Os resultados evidenciam que a proposição do apoio matricial não foi incorporada com clareza por todos os profissionais, mas viabilizou: a troca de conhecimentos, interdisciplinaridade, construção de estratégias de intervenção e corresponsabilização no campo da clínica. O êxito desses novos arranjos organizacionais exige articulação e trabalho coletivo de todos os atores que buscam a integralidade da atenção.El apoyo matricial es parte de un nuevo régimen de organización y metodología para la gestión del trabajo en salud que pretende integrar el diálogo entre las diferentes especialidades y diferentes niveles de atención. Este trabajo hace análisis del apoyo matricial desde la perspectiva de los profesionales que trabajan en diferentes servicios de salud mental en Campinas, SP, Brasil. Es un estudio cualitativo, con entrevistas con profesionales de diferentes especialidades. Los datos fueron procesados con base en la metodología del análisis del discurso. Los resultados apuntan que el apoyo matricial no fue incorporado con claridad por todos los profesionales, pero permitió el intercambio de conocimientos, la interdisciplinariedad y co-responsabilidad en el campo de la clínica. El éxito de estos arreglos de organización requiere un esfuerzo conjunto y colectivo de todos los actores que buscan una atención de salud integral.76777

Natural History of MYH7-Related Dilated Cardiomyopathy

BACKGROUND Variants in myosin heavy chain 7 (MYH7) are responsible for disease in 1% to 5% of patients with dilated cardiomyopathy (DCM); however, the clinical characteristics and natural history of MYH7-related DCM are poorly described. OBJECTIVES We sought to determine the phenotype and prognosis of MYH7-related DCM. We also evaluated the influence of variant location on phenotypic expression. METHODS We studied clinical data from 147 individuals with DCM-causing MYH7 variants (47.6% female; 35.6 +/- 19.2 years) recruited from 29 international centers. RESULTS At initial evaluation, 106 (72.1%) patients had DCM (left ventricular ejection fraction: 34.5% +/- 11.7%). Median follow-up was 4.5 years (IQR: 1.7-8.0 years), and 23.7% of carriers who were initially phenotype-negative developed DCM. Phenotypic expression by 40 and 60 years was 46% and 88%, respectively, with 18 patients (16%) first diagnosed at <18 years of age. Thirty-six percent of patients with DCM met imaging criteria for LV noncompaction. During follow-up, 28% showed left ventricular reverse remodeling. Incidence of adverse cardiac events among patients with DCM at 5 years was 11.6%, with 5 (4.6%) deaths caused by end-stage heart failure (ESHF) and 5 patients (4.6%) requiring heart transplantation. The major ventricular arrhythmia rate was low (1.0% and 2.1% at 5 years in patients with DCM and in those with LVEF of <= 35%, respectively). ESHF and major ventricular arrhythmia were significantly lower compared with LMNA-related DCM and similar to DCM caused by TTN truncating variants. CONCLUSIONS MYH7-related DCM is characterized by early age of onset, high phenotypic expression, low left ventricular reverse remodeling, and frequent progression to ESHF. Heart failure complications predominate over ventricular arrhythmias, which are rare. (C) 2022 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation

Spatiotemporal Characteristics of the Largest HIV-1 CRF02_AG Outbreak in Spain: Evidence for Onward Transmissions

Background and Aim: The circulating recombinant form 02_AG (CRF02_AG) is the predominant clade among the human immunodeficiency virus type-1 (HIV-1) non-Bs with a prevalence of 5.97% (95% Confidence Interval-CI: 5.41–6.57%) across Spain. Our aim was to estimate the levels of regional clustering for CRF02_AG and the spatiotemporal characteristics of the largest CRF02_AG subepidemic in Spain.Methods: We studied 396 CRF02_AG sequences obtained from HIV-1 diagnosed patients during 2000–2014 from 10 autonomous communities of Spain. Phylogenetic analysis was performed on the 391 CRF02_AG sequences along with all globally sampled CRF02_AG sequences (N = 3,302) as references. Phylodynamic and phylogeographic analysis was performed to the largest CRF02_AG monophyletic cluster by a Bayesian method in BEAST v1.8.0 and by reconstructing ancestral states using the criterion of parsimony in Mesquite v3.4, respectively.Results: The HIV-1 CRF02_AG prevalence differed across Spanish autonomous communities we sampled from (p &lt; 0.001). Phylogenetic analysis revealed that 52.7% of the CRF02_AG sequences formed 56 monophyletic clusters, with a range of 2–79 sequences. The CRF02_AG regional dispersal differed across Spain (p = 0.003), as suggested by monophyletic clustering. For the largest monophyletic cluster (subepidemic) (N = 79), 49.4% of the clustered sequences originated from Madrid, while most sequences (51.9%) had been obtained from men having sex with men (MSM). Molecular clock analysis suggested that the origin (tMRCA) of the CRF02_AG subepidemic was in 2002 (median estimate; 95% Highest Posterior Density-HPD interval: 1999–2004). Additionally, we found significant clustering within the CRF02_AG subepidemic according to the ethnic origin.Conclusion: CRF02_AG has been introduced as a result of multiple introductions in Spain, following regional dispersal in several cases. We showed that CRF02_AG transmissions were mostly due to regional dispersal in Spain. The hot-spot for the largest CRF02_AG regional subepidemic in Spain was in Madrid associated with MSM transmission risk group. The existence of subepidemics suggest that several spillovers occurred from Madrid to other areas. CRF02_AG sequences from Hispanics were clustered in a separate subclade suggesting no linkage between the local and Hispanic subepidemics

All-cause mortality in the cohorts of the Spanish AIDS Research Network (RIS) compared with the general population: 1997Ł2010

Abstract Background: Combination antiretroviral therapy (cART) has produced significant changes in mortality of HIVinfected persons. Our objective was to estimate mortality rates, standardized mortality ratios and excess mortality rates of cohorts of the AIDS Research Network (RIS) (CoRIS-MD and CoRIS) compared to the general population. Methods: We analysed data of CoRIS-MD and CoRIS cohorts from 1997 to 2010. We calculated: (i) all-cause mortality rates, (ii) standardized mortality ratio (SMR) and (iii) excess mortality rates for both cohort for 100 personyears (py) of follow-up, comparing all-cause mortality with that of the general population of similar age and gender. Results: Between 1997 and 2010, 8,214 HIV positive subjects were included, 2,453 (29.9%) in CoRIS-MD and 5,761 (70.1%) in CoRIS and 294 deaths were registered. All-cause mortality rate was 1.02 (95% CI 0.91-1.15) per 100 py, SMR was 6.8 (95% CI 5.9-7.9) and excess mortality rate was 0.8 (95% CI 0.7-0.9) per 100 py. Mortality was higher in patients with AIDS, hepatitis C virus (HCV) co-infection, and those from CoRIS-MD cohort (1997. Conclusion: Mortality among HIV-positive persons remains higher than that of the general population of similar age and sex, with significant differences depending on the history of AIDS or HCV coinfection

Valorización de la Iglesia San Francisco de Asís de Asunción a través de la interpretación de la Simbología e Iconografía

El propósito de este trabajo es ofrecer una visión sobre la presencia Franciscana en Paraguay hasta nuestros días, la incidencia en nuestra sociedad y su trascendencia. Relacionar la espiritualidad franciscana aplicada a las obras y la arquitectura en las que se resaltan los mismos valores franciscanos, en las cuales la sencillez se aprecia en la belleza a través de la proporción, en particular la aplicación de las características franciscanas en la Iglesia San Francisco de Asís de Asunción, desde un análisis de la simbología y la iconografía. En este sentido, se investigó sobre la existencia del módulo de proporción que genera el proyecto mismo de la iglesia y que permite definir la regla por la cual se organizan y distribuyen los espacios y sus relaciones. Se interpretan los símbolos y signos presentes en la planta, fachada y altar, hasta demostrar que a través de la expresión artística, se aprecian los símbolos y mensajes que marcan un impacto en la sociedad, identifican un estilo y que pueden ser leídos principalmente por los que los conocen. Con la identificación y preservación de estos símbolos es posible establecer criterios de valoración patrimonial

Apoio matricial: um estudo sobre a perspectiva de profissionais da saúde mental

O apoio matricial constitui parte dos novos arranjos organizacionais e metodologia para a gestão do trabalho em saúde, objetivando a integração dialógica entre distintas especialidades e níveis de atenção. Este trabalho analisa o apoio matricial sob a ótica de profissionais que atuam na saúde mental em diferentes serviços do município de Campinas, SP, Brasil. Trata-se de estudo qualitativo, envolvendo entrevistas junto a profissionais de diferentes especialidades. Os dados obtidos foram tratados com base na metodologia da análise do discurso. Os resultados evidenciam que a proposição do apoio matricial não foi incorporada com clareza por todos os profissionais, mas viabilizou: a troca de conhecimentos, interdisciplinaridade, construção de estratégias de intervenção e corresponsabilização no campo da clínica. O êxito desses novos arranjos organizacionais exige articulação e trabalho coletivo de todos os atores que buscam a integralidade da atenção