‘I know I'm not invincible’: An interpretative phenomenological analysis of thyroid cancer in young people

Objective. Thyroid cancer is one of the most common cancers affecting young people and carries an excellent prognosis. Little is known about the psychosocial issues that face young people diagnosed with a treatable cancer. This study explored how young people experienced diagnosis, treatment, and how they made sense of an experience which challenged their views on what it means to have cancer. Method. Semi-structured interviews were conducted with eight young people diagnosed with either papillary or follicular thyroid cancer, and analysed with interpre- tative phenomenological analysis (IPA). Results. Two inter-related aspects of their experience are discussed: (1) the range of feelings and emotions experienced including feeling disregarded, vulnerability, shock and isolation; (2) how they made sense of and ascribed meaning to their experience in the light of the unique nature of their cancer. A thread running throughout the findings highlights that this was a disruptive biographical experience. Conclusions. Young people experienced a loss of youthful immunity which contrasted with a sense of growth and shift in life perspective. Having a highly treatable cancer was helpful in aiding them to reframe their situation positively but at the same time left them feeling dismissed over a lack of recognition that they had cancer. The young peoples’ experiences point to a need for increased understanding of this rare cancer, more effective communication from health care professionals and a greater understanding of the experiential impact of this disease on young people. Suggestions to improve the service provision to this patient group are provided

Trabalho de crianças e adolescentes: os desafios da intersetorialidade e o papel do Sistema Único de Saúde Adolescent and child labor: the challenges of inter-sector work and the role of the Unified National Health System

Este artigo apresenta uma reflexão sobre o papel do setor saúde (do Sistema Único de Saúde) e sobre os desafios da prática de intersetorialidade na prevenção e erradicação do trabalho de crianças e adolescentes, a partir da experiência do Centro de Estudos da Saúde do Trabalhador, junto ao Programa de Prevenção e Erradicação do Trabalho Infantil do Estado da Bahia, de 1997 a 2001. Discute aspectos importantes como a invisibilidade do trabalho infantil para o setor saúde, as práticas fragmentadas de atenção e vigilância em saúde, a inserção e a adesão diferenciada dos setores no Programa, e a importância das organizações e representações da sociedade civil no processo de gestão e acompanhamento das políticas públicas. Conclui pela necessidade de construção do trabalho infantil como objeto da saúde coletiva e de qualificação das práticas de planejamento intersetorial que se constituam em um espaço de poder compartilhado e de articulação de interesses, saberes e práticas das diversas organizações.<br>This paper presents the role of the public health sector and the intersectorial action in the issue of the child labor, considering the experience of the Worker’s Health Study Center of the State Department of Health in the Bahia State Program for the Child Labour Prevention and Eradication, period 1997 to 2001. Some aspects are pointed out, as the child labour invisibility to health services, the fragmentation between surveillance and health care, the different compliance and participation of the institutions in the program, the relevance of the role of communitary and non-governamental organizations on the management and supervising public policies. It is concluded that is necessary to build the concept of child labour as an object of public health, and to improve intersectorial planning practices by means of creating empowering and sharing spaces and joining interests, learnings and practices from the various organizations

A Systematic Review and Meta-Analysis of Fecal Contamination and Inadequate Treatment of Packaged Water

<div><p>Background</p><p>Packaged water products provide an increasingly important source of water for consumption. However, recent studies raise concerns over their safety.</p><p>Objectives</p><p>To assess the microbial safety of packaged water, examine differences between regions, country incomes, packaged water types, and compare packaged water with other water sources.</p><p>Methods</p><p>We performed a systematic review and meta-analysis. Articles published in English, French, Portuguese, Spanish and Turkish, with no date restrictions were identified from online databases and two previous reviews. Studies published before April 2014 that assessed packaged water for the presence of <i>Escherichia coli</i>, thermotolerant or total coliforms were included provided they tested at least ten samples or brands.</p><p>Results</p><p>A total of 170 studies were included in the review. The majority of studies did not detect fecal indicator bacteria in packaged water (78/141). Compared to packaged water from upper-middle and high-income countries, packaged water from low and lower-middle-income countries was 4.6 (95% CI: 2.6–8.1) and 13.6 (95% CI: 6.9–26.7) times more likely to contain fecal indicator bacteria and total coliforms, respectively. Compared to all other packaged water types, water from small bottles was less likely to be contaminated with fecal indicator bacteria (OR = 0.32, 95%CI: 0.17–0.58) and total coliforms (OR = 0.10, 95%CI: 0.05, 0.22). Packaged water was less likely to contain fecal indicator bacteria (OR = 0.35, 95%CI: 0.20, 0.62) compared to other water sources used for consumption.</p><p>Conclusions</p><p>Policymakers and regulators should recognize the potential benefits of packaged water in providing safer water for consumption at and away from home, especially for those who are otherwise unlikely to gain access to a reliable, safe water supply in the near future. To improve the quality of packaged water products they should be integrated into regulatory and monitoring frameworks.</p></div