Apoio Matricial Como Articulador Das Relações Interprofissionais Entre Serviços Especializados E Atenção Primária à Saúde

This paper sought to carry out an integrative review of the national production on Matrix Support methodology, whilst encompassing empirical studies on effectiveness and theoretical-methodological review papers on Matrix Support. The used material is comprised of papers that are indexed in the PubMed database, the NLM and the BVS (Virtual Library of Health), between 1999 and 2013, in Portuguese, English and Spanish. We included 28 articles, and its analysis allowed the identification of three categories: 1) foundation goods and consolidation of the concept of matrix support; 2) Review articles on the matrix support; 3) Items arising from empirical research involving the concept of matrix support. The publications showed that the matrix support brings an innovative proposal and powerful to transform the health care model. However, to achieve their goals is necessary to overcome some impasses, several interconnected directly with the implementation of their directives and to overcoming structural problems of the National Health System (SUS). © 2016, Institute de Medicina Social da UERJ. All rights reserved.26245548

Apoio Matricial No Sus Campinas: Análise Da Consolidação De Uma Prática Interprofissional Na Rede De Saúde

This study aims to characterize the teams and the inter-professional work process of Matrix Support developed and practiced in primary healthcare provided by the Brazilian Unified Health System (SUS) in Campinas, São Paulo State, Brazil. This is an exploratory descriptive study involving a questionnaire that was applied to 232 professionals who practice Matrix Support for primary healthcare. For analysis, the data were grouped into four categories: Identification of the professional; Work links to the Campinas SUS; Organization of the Matrix Support work; and the Support practice. The study indicates that the methodology of support for inter-professional work has achieved an important degree of consolidation in the municipality, in spite of the restricted investment. The reduced working time dedicated to support, and the large number of teams supported by each Matrix Support team were identified as the principal points of fragility in the work process. In turn, strong points that emerged were the multiplicity of tools used, the possibility of shared construction of work guidelines, and the flexibility in the composition of the support teams. Both the fragilities and the potentialities found can offer inputs for reflection and full creation of Matrix Support in other contexts. © 2016, Associacao Brasileira de Pos - Graduacao em Saude Coletiva. All rights reserved.2151625163

Survival-extinction phase transition in a bit-string population with mutation

A bit-string model for the evolution of a population of haploid organisms, subject to competition, reproduction with mutation and selection is studied, using mean field theory and Monte Carlo simulations. We show that, depending on environmental flexibility and genetic variability, the model exhibits a phase transtion between extinction and survival. The mean-field theory describes the infinite-size limit, while simulations are used to study quasi-stationary properties.Comment: 11 pages, 5 figure

Fluctuations of an evaporating black hole from back reaction of its Hawking radiation: Questioning a premise in earlier work

This paper delineates the first steps in a systematic quantitative study of the spacetime fluctuations induced by quantum fields in an evaporating black hole. We explain how the stochastic gravity formalism can be a useful tool for that purpose within a low-energy effective field theory approach to quantum gravity. As an explicit example we apply it to the study of the spherically-symmetric sector of metric perturbations around an evaporating black hole background geometry. For macroscopic black holes we find that those fluctuations grow and eventually become important when considering sufficiently long periods of time (of the order of the evaporation time), but well before the Planckian regime is reached. In addition, the assumption of a simple correlation between the fluctuations of the energy flux crossing the horizon and far from it, which was made in earlier work on spherically-symmetric induced fluctuations, is carefully analyzed and found to be invalid. Our analysis suggests the existence of an infinite amplitude for the fluctuations of the horizon as a three-dimensional hypersurface. We emphasize the need for understanding and designing operational ways of probing quantum metric fluctuations near the horizon and extracting physically meaningful information.Comment: 10 pages, REVTeX; minor changes, a few references added and a brief discussion of their relevance included. To appear in the proceedings of the 10th Peyresq meeting. Dedicated to Rafael Sorkin on the occasion of his 60th birthda

Determining the virulence properties of Escherichia coli ST131 containing bacteriocin-encoding plasmids using short-and long-read sequencing and comparing them with those of other E. Coli lineages

T. Escherichia coli ST131 is a clinical challenge due to its multidrug resistant profile and successful global spread. They are often associated with complicated infections, particularly urinary tract infections (UTIs). Bacteriocins play an important role to outcompete other microorganisms present in the human gut. Here, we characterized bacteriocin-encoding plasmids found in ST131 isolates of patients suffering from a UTI using both short-and long-read sequencing. Colicins Ia, Ib and E1, and microcin V, were identified among plasmids that also contained resistance and virulence genes. To investigate if the potential transmission range of the colicin E1 plasmid is influenced by the presence of a resistance gene, we constructed a strain containing a plasmid which had both the colicin E1 and blaCMY-2 genes. No difference in transmission range was found between transformant and wild-type strains. However, a statistically significantly difference was found in adhesion and invasion ability. Bacteriocin-producing isolates from both ST131 and non-ST131 lineages were able to inhibit the growth of other E. coli isolates, including other ST131. In summary, plasmids harboring bacteriocins give additional advantages for highly virulent and resistant ST131 isolates, improving the ability of these isolates to compete with other microbiota for a niche and thereby increasing the risk of infection

Vaccinia Virus Infection in Monkeys, Brazilian Amazon

To detect orthopoxvirus in the Brazilian Amazon, we conducted a serosurvey of 344 wild animals. Neutralizing antibodies against orthopoxvirus were detected by plaque-reduction neutralizing tests in 84 serum samples. Amplicons from 6 monkey samples were sequenced. These amplicons identified vaccinia virus genetically similar to strains from bovine vaccinia outbreaks in Brazil

THE AFTERCARE SURVEY:Assessment and intervention practices after brain tumour surgery in Europe

Introduction People with gliomas need specialized neurosurgical, neuro-oncological, psycho-oncological, and neuropsychological care. The role of language and cognitive recovery and rehabilitation in patients’ well-being and resumption of work is crucial, but there are no clear guidelines for the ideal timing and character of assessments and interventions. The goal of the present work was to describe representative (neuro)psychological practices implemented after brain surgery in Europe. Methods An online survey was addressed to professionals working with individuals after brain surgery. We inquired about the assessments and interventions and the involvement of caregivers. Additionally, we asked about recommendations for an ideal assessment and intervention plan. Results Thirty-eight European centres completed the survey. Thirty of them offered at least one post-surgical (neuro)psychological assessment, mainly for language and cognition, especially during the early recovery stage and at long-term. Twenty-eight of the participating centres offered post-surgical therapies. Patients who stand the highest chances of being included in evaluation and therapy post-surgically are those who underwent awake brain surgery, harboured a low-grade glioma, or showed poor recovery. Nearly half of the respondents offer support programs to caregivers, and all teams recommend them. Treatments differed between these offered to individuals with low-grade glioma versus those with high-grade glioma. The figure of caregiver is not yet fully recognized in the recovery phase. Conclusion We stress the need for more complete rehabilitation plans, including the emotional and health-related aspects of recovery. In respondents´ opinions, assessment and rehabilitation plans should also be individually tailored and goal-directed (e.g., professional reinsertion)

An Integrated TCGA Pan-Cancer Clinical Data Resource to Drive High-Quality Survival Outcome Analytics

For a decade, The Cancer Genome Atlas (TCGA) program collected clinicopathologic annotation data along with multi-platform molecular profiles of more than 11,000 human tumors across 33 different cancer types. TCGA clinical data contain key features representing the democratized nature of the data collection process. To ensure proper use of this large clinical dataset associated with genomic features, we developed a standardized dataset named the TCGA Pan-Cancer Clinical Data Resource (TCGA-CDR), which includes four major clinical outcome endpoints. In addition to detailing major challenges and statistical limitations encountered during the effort of integrating the acquired clinical data, we present a summary that includes endpoint usage recommendations for each cancer type. These TCGA-CDR findings appear to be consistent with cancer genomics studies independent of the TCGA effort and provide opportunities for investigating cancer biology using clinical correlates at an unprecedented scale. Analysis of clinicopathologic annotations for over 11,000 cancer patients in the TCGA program leads to the generation of TCGA Clinical Data Resource, which provides recommendations of clinical outcome endpoint usage for 33 cancer types