Teaching-learning process from service teaching of mental health nursing: experience report

Objective: Describe the conceptions of resident nurses about the nurse's role in mental health services. Method: Descriptive/reflexive study of the experience-report type, carried out from experiences of nurses from the Multiprofessional Residency Program in Mental Health, guided by the theoretical presuppositions of the Brazilian Psychiatric Reform and structured from the Arch of Charles Maguerez. Results: In-service teaching provided reflections on the residents' conceptions of nurses' performance in mental health services. The key posts were the insertion in the specific nursing care, the construction of the multiprofessional work process, the recognition of their professional identity. Therapeutic relationship and communication, receptiveness, co-responsibility of care and the construction of links with clients, family and work colleagues for the solution of the problems.  Conclusions: The Arch of Charles Maguerez facilitated the teaching process in service. In addition, it provided the perception of the action-reflection-action movement as essential to understand fundamentals of care practices in nursing and to collaborate to the insertion of the nurse and the process of changes, from the daily services of mental health

As Representações do Corpo Feminino na Literatura e Nas Artes Visuais Judaicas da América Latina

O objetivo dessa dissertação foi analisar as representações corporais presentes nas obras literárias das escritoras Ana Vásquez e Cintia Moscovich e nas artísticas de Clara Pechansky, Liza Schnaiderman, Lucía Waiser e Raquel Partnoy cotejando-as e comparando-as situando-as no contexto econômico, político e social da América Latina.A princípio foram dados conceitos e definições sobre a história da imigração judaica para a América Latina, sobre o corpo e os temas mais relevantes sobre ele. Em seguida, foram analisados os dois romances, Duas Iguais (2004) e Mi amiga, Chantal (1991). Depois fez-se uma análise das obras de pintoras e escultoras e a visão do corpo da mulher com suas (de)formidades. Por fim, analisa-se o folheto da exposição A Lição de pintura (2003) o qual resume em si o diálogo entre as artes visuais e a literatura, já que, no referido folheto, os quadros da artista Pechansky são apresentados pelos textos da escritora Moscovich.Com esta pesquisa, conclui-se que as representações corporais presentes na literatura e nas artes visuais dessas artistas, questionam o processo repressivo ao qual está submetida a mulher desde os tempos bíblicos. Essas obras propõem novas formas identitárias (de)formadas resultantes de questionamentos, descobertas e inquietações surgidas ao longo da história

Clinical manifestations of intermediate allele carriers in Huntington disease

Objective: There is controversy about the clinical consequences of intermediate alleles (IAs) in Huntington disease (HD). The main objective of this study was to establish the clinical manifestations of IA carriers for a prospective, international, European HD registry. Methods: We assessed a cohort of participants at risk with <36 CAG repeats of the huntingtin (HTT) gene. Outcome measures were the Unified Huntington's Disease Rating Scale (UHDRS) motor, cognitive, and behavior domains, Total Functional Capacity (TFC), and quality of life (Short Form-36 [SF-36]). This cohort was subdivided into IA carriers (27-35 CAG) and controls (<27 CAG) and younger vs older participants. IA carriers and controls were compared for sociodemographic, environmental, and outcome measures. We used regression analysis to estimate the association of age and CAG repeats on the UHDRS scores. Results: Of 12,190 participants, 657 (5.38%) with <36 CAG repeats were identified: 76 IA carriers (11.56%) and 581 controls (88.44%). After correcting for multiple comparisons, at baseline, we found no significant differences between IA carriers and controls for total UHDRS motor, SF-36, behavioral, cognitive, or TFC scores. However, older participants with IAs had higher chorea scores compared to controls (p 0.001). Linear regression analysis showed that aging was the most contributing factor to increased UHDRS motor scores (p 0.002). On the other hand, 1-year follow-up data analysis showed IA carriers had greater cognitive decline compared to controls (p 0.002). Conclusions: Although aging worsened the UHDRS scores independently of the genetic status, IAs might confer a late-onset abnormal motor and cognitive phenotype. These results might have important implications for genetic counseling. ClinicalTrials.gov identifier: NCT01590589

Reduced Cancer Incidence in Huntington's Disease: Analysis in the Registry Study

Background: People with Huntington's disease (HD) have been observed to have lower rates of cancers. Objective: To investigate the relationship between age of onset of HD, CAG repeat length, and cancer diagnosis. Methods: Data were obtained from the European Huntington's disease network REGISTRY study for 6540 subjects. Population cancer incidence was ascertained from the GLOBOCAN database to obtain standardised incidence ratios of cancers in the REGISTRY subjects. Results: 173/6528 HD REGISTRY subjects had had a cancer diagnosis. The age-standardised incidence rate of all cancers in the REGISTRY HD population was 0.26 (CI 0.22-0.30). Individual cancers showed a lower age-standardised incidence rate compared with the control population with prostate and colorectal cancers showing the lowest rates. There was no effect of CAG length on the likelihood of cancer, but a cancer diagnosis within the last year was associated with a greatly increased rate of HD onset (Hazard Ratio 18.94, p < 0.001). Conclusions: Cancer is less common than expected in the HD population, confirming previous reports. However, this does not appear to be related to CAG length in HTT. A recent diagnosis of cancer increases the risk of HD onset at any age, likely due to increased investigation following a cancer diagnosis

Clinical and genetic characteristics of late-onset Huntington's disease

Background: The frequency of late-onset Huntington's disease (&gt;59 years) is assumed to be low and the clinical course milder. However, previous literature on late-onset disease is scarce and inconclusive. Objective: Our aim is to study clinical characteristics of late-onset compared to common-onset HD patients in a large cohort of HD patients from the Registry database. Methods: Participants with late- and common-onset (30–50 years)were compared for first clinical symptoms, disease progression, CAG repeat size and family history. Participants with a missing CAG repeat size, a repeat size of ≤35 or a UHDRS motor score of ≤5 were excluded. Results: Of 6007 eligible participants, 687 had late-onset (11.4%) and 3216 (53.5%) common-onset HD. Late-onset (n = 577) had significantly more gait and balance problems as first symptom compared to common-onset (n = 2408) (P &lt;.001). Overall motor and cognitive performance (P &lt;.001) were worse, however only disease motor progression was slower (coefficient, −0.58; SE 0.16; P &lt;.001) compared to the common-onset group. Repeat size was significantly lower in the late-onset (n = 40.8; SD 1.6) compared to common-onset (n = 44.4; SD 2.8) (P &lt;.001). Fewer late-onset patients (n = 451) had a positive family history compared to common-onset (n = 2940) (P &lt;.001). Conclusions: Late-onset patients present more frequently with gait and balance problems as first symptom, and disease progression is not milder compared to common-onset HD patients apart from motor progression. The family history is likely to be negative, which might make diagnosing HD more difficult in this population. However, the balance and gait problems might be helpful in diagnosing HD in elderly patients