La muerte y el morir según representaciones de estudiantes de enfermería

This is a qualitative study whose objective was to know the representations of the Federal University of São Paulo's undergraduate Nursing students on the questions that involve death and dying. The subjects were 40 students, males and females, in the 2nd, 3rd and 4th year of the undergraduate course in Nursing. As a methodology were used the assumptions of the Social Representations, using the technique of an interview with two nonstructured guiding questions. The results of this study were organized and placed on a maximum tree having as the represen tation's central nucleus the event death and as the most important peripheral representations concepts, fear of death and relationship pupil-patient.Se trata de un estudio cualitativo, cuyo objetivo fue conocer las representaciones de los estudiantes del curso de graduación en Enfermería de la Universidad Federal de São Paulo, sobre las cuestiones que envuelven la muerte y el morir. Los sujetos fueron 40 estudiantes del sexo masculino y femenino que frecuentaban la 2ª, 3ª y 4ª series del curso de graduación en Enfermería. Como metodología usamos las premisas de las Representaciones Sociales, utilizando la técnica de entrevista con dos cuestiones dirigidas no estructuradas. Los resultados de este estudio fueron organizados y dispuestos en un árbol máximo, teniendo como núcleo céntrico de la representación el evento muerte y como representaciones periféricas más importantes: conceptos, miedo a la muerte y relación alumno-paciente.Trata-se de um estudo qualitativo, cujo objetivo foi conhecer as representações das estudantes do curso de graduação em Enfermagem da Universidade Federal de São Paulo (UNIFESP), sobre as questões que envolvem a morte e o morrer. Os sujeitos foram 40 estudantes do sexo masculino e feminino que freqüentavam a 2.ª, 3.ª e 4.ª séries do curso de graduação em Enfermagem. Como metodologia, foram utilizadas as premissas das Representações Sociais, usando a técnica de entrevista com duas questões norteadoras não estruturadas. Os resultados deste estudo foram organizados e dispostos em uma árvore máxima, tendo como núcleo central da representação o evento morte e como representações periféricas mais importantes: conceitos, medo da morte e relacionamento aluno-paciente.Universidade Federal de São Paulo (UNIFESP)UNIFESPSciEL

HIV-1 tropism determination using a phenotypic Env recombinant viral assay highlights overestimation of CXCR4-usage by genotypic prediction algorithms for CRRF01_AE and CRF02_AG

Background: Human Immunodeficiency virus type-1 (HIV) entry into target cells involves binding of the viral envelope (Env) to CD4 and a coreceptor, mainly CCR5 or CXCR4. The only currently licensed HIV entry inhibitor, maraviroc, targets CCR5, and the presence of CXCX4-using strains must be excluded prior to treatment. Co-receptor usage can be assessed by phenotypic assays or through genotypic prediction. Here we compared the performance of a phenotypic Env-Recombinant Viral Assay (RVA) to the two most widely used genotypic prediction algorithms, Geno2Pheno([coreceptor]) and webPSSM. Methods: Co-receptor tropism of samples from 73 subtype B and 219 non-B infections was measured phenotypically using a luciferase-tagged, NL4-3-based, RVA targeting Env. In parallel, tropism was inferred genotypically from the corresponding V3-loop sequences using Geno2Pheno([coreceptor]) (5-20% FPR) and webPSSM-R5X4. For discordant samples, phenotypic outcome was retested using co-receptor antagonists or the validated Trofile (R) Enhanced-Sensitivity-Tropism-Assay. Results: The lower detection limit of the RVA was 2.5% and 5% for X4 and R5 minority variants respectively. A phenotype/genotype result was obtained for 210 samples. Overall, concordance of phenotypic results with Geno2Pheno([coreceptor]) was 85.2% and concordance with webPSSM was 79.5%. For subtype B, concordance with Geno2pheno([coreceptor]) was 94.4% and concordance with webPSSM was 79.6%. High concordance of genotypic tools with phenotypic outcome was seen for subtype C (90% for both tools). Main discordances involved CRF01_AE and CRF02_AG for both algorithms (CRF01_AE: 35.9% discordances with Geno2Pheno([coreceptor]) and 28.2% with webPSSM; CRF02_AG: 20.7% for both algorithms). Genotypic prediction overestimated CXCR4-usage for both CRFs. For webPSSM, 40% discordance was observed for subtype A. Conclusions: Phenotypic assays remain the most accurate for most non-B subtypes and new subtype-specific rules should be developed for non-B subtypes, as research studies more and more draw conclusions from genotypically-inferred tropism, and to avoid unnecessarily precluding patients with limited treatment options from receiving maraviroc or other entry inhibitors

Reflexiones de los estudiantes de enfermería sobre la muerte y el morir

This article refers to the first phase of a survey on nursing students' representations on death and dying. The research has an exploratory character and was carried out with first year students of the undergraduate course in Nursing of the Federal University of São Paulo. Its objectives were to know the impressions of the students concerning the theme death and dying and to give subsidies for the second phase of the survey. It was carried through a dynamic with a guiding question, as part of the curricular program of the discipline Psychology Applied to Health. For the interpretation of the data the method of the Analysis of Content was used, and the following categories were obtained: fear of death; concepts; attitude in the face of death and dying; belief as an intervening element.Se trata de la presentación de la primera fase de una investigación sobre las representaciones de estudiantes de enfermería respecto a la muerte y al morir. La misma tiene carácter exploratorio y fue realizada con estudiantes del primer año del pregrado en Enfermería de la Universidad Federal de São Paulo. Tuvo por objetivos conocer las impresiones de los estudiantes acerca del asunto muerte y morir y subsidiar la segunda fase de la investigación. Fue realizada por medio de una dinámica con una pregunta orientadora, en la disciplina curricular Psicología Aplicada a la Salud. Para la interpretación de los datos fue utilizado el método del Análisis de Contenido, obteniendo las siguientes categorías: miedo a la muerte; conceptos; actitud frente a la muerte y el morir; creencia en cuanto elemento de intervención.Trata-se da apresentação da primeira fase de uma pesquisa sobre as representações de estudantes de enfermagem sobre a morte e o morrer. A mesma tem caráter exploratório e foi realizada junto a estudantes do primeiro ano do curso de graduação em Enfermagem da Universidade Federal de São Paulo (UNIFESP). Teve por objetivos conhecer as impressões dos estudantes acerca do assunto morte e o morrer e subsidiar a segunda fase da pesquisa. Foi realizada por meio de uma dinâmica com uma questão norteadora, junto ao programa da disciplina curricular Psicologia Aplicada à Saúde. Para interpretação dos dados foi utilizado o método da Análise de Conteúdo, obtendo as seguintes categorias: medo da morte; conceitos; atitude diante da morte e o morrer; crença enquanto elemento interveniente.Universidade Federal de São Paulo (UNIFESP) Departamento de EnfermagemUniversidade Federal de São Paulo (UNIFESP)UNIFESP, Depto. de EnfermagemUNIFESPSciEL

Lean Supply Chain Management: Insights from bibliometric analysis and literature review

The covid-19 pandemic has impacted many countries and with it arose a growing concern of organizations about the vulnerability and low resilience of global supply chains. The incorporation of lean manufacturing in the supply chains enables the systematic reduction of activities that do not add value in an organization and within a chain could improve business performance, which can be widely extended between areas. Thus, this paper aims to investigate the advancement of knowledge about the lean supply chain through bibliometric indicators of scientific production and literature review. Among the research results, the number of publications increased over the years (1996-2021), and the countries that published the most on the topic are Brazil (46 documents), Malaysia (42), and the United States of America (40). The most applied tool was the Value Stream Mapping (VSM). As for future research, there is a need to propose more applied and comprehensive research; study the impact of lean on the supply chain; evaluate the Lean Supply Chain implementation process, and study the relationship between sustainability and Lean Supply Chain Management

A morte e o morrer segundo representações de estudantes de enfermagem

Trata-se de um estudo qualitativo, cujo objetivo foi conhecer as representações das estudantes do curso de graduação em Enfermagem da Universidade Federal de São Paulo, sobre as questões que envolvem a morte e o morrer. Os sujeitos foram 40 estudantes do sexo masculino e feminino que freqüentavam a 2.ª, 3.ª e 4.ª séries do curso de graduação em Enfermagem. Como metodologia, foram utilizadas as premissas das Representações Sociais, usando a técnica de entrevista com duas questões norteadoras não estruturadas. Os resultados deste estudo foram organizados e dispostos em uma árvore máxima, tendo como núcleo central da representação o evento morte e como representações periféricas mais importantes: conceitos, medo da morte e relacionamento aluno-paciente.Se trata de un estudio cualitativo, cuyo objetivo fue conocer las representaciones de los estudiantes del curso de graduación en Enfermería de la Universidad Federal de São Paulo, sobre las cuestiones que envuelven la muerte y el morir. Los sujetos fueron 40 estudiantes del sexo masculino y femenino que frecuentaban la 2ª, 3ª y 4ª series del curso de graduación en Enfermería. Como metodología usamos las premisas de las Representaciones Sociales, utilizando la técnica de entrevista con dos cuestiones dirigidas no estructuradas. Los resultados de este estudio fueron organizados y dispuestos en un árbol máximo, teniendo como núcleo céntrico de la representación el evento muerte y como representaciones periféricas más importantes: conceptos, miedo a la muerte y relación alumno-paciente.This is a qualitative study whose objective was to know the representations of the Federal University of São Paulo's undergraduate Nursing students on the questions that involve death and dying. The subjects were 40 students, males and females, in the 2nd, 3rd and 4th year of the undergraduate course in Nursing. As a methodology were used the assumptions of the Social Representations, using the technique of an interview with two nonstructured guiding questions. The results of this study were organized and placed on a maximum tree having as the represen tation's central nucleus the event death and as the most important peripheral representations concepts, fear of death and relationship pupil-patient

Reflexões de estudantes de enfermagem sobre morte e o morrer

Trata-se da apresentação da primeira fase de uma pesquisa sobre as representações de estudantes de enfermagem sobre a morte e o morrer. A mesma tem caráter exploratório e foi realizada junto a estudantes do primeiro ano do curso de graduação em Enfermagem da Universidade Federal de São Paulo. Teve por objetivos conhecer as impressões dos estudantes acerca do assunto "morte e o morrer" e subsidiar a segunda fase da pesquisa. Foi realizada por meio de uma dinâmica com uma questão norteadora, junto ao programa da disciplina curricular Psicologia Aplicada à Saúde. Para interpretação dos dados foi utilizado o método da Análise de Conteúdo, obtendo as seguintes categorias: medo da morte; conceitos; atitude diante da morte e o morrer; crença enquanto elemento interveniente.Se trata de la presentación de la primera fase de una investigación sobre las representaciones de estudiantes de enfermería respecto a la muerte y al morir. La misma tiene carácter exploratorio y fue realizada con estudiantes del primer año del pregrado en Enfermería de la Universidad Federal de São Paulo. Tuvo por objetivos conocer las impresiones de los estudiantes acerca del asunto "muerte y morir" y subsidiar la segunda fase de la investigación. Fue realizada por medio de una dinámica con una pregunta orientadora, en la disciplina curricular Psicología Aplicada a la Salud. Para la interpretación de los datos fue utilizado el método del Análisis de Contenido, obteniendo las siguientes categorías: miedo a la muerte; conceptos; actitud frente a la muerte y el morir; creencia en cuanto elemento de intervención.This article refers to the first phase of a survey on nursing students' representations on death and dying. The research has an exploratory character and was carried out with first year students of the undergraduate course in Nursing of the Federal University of São Paulo. Its objectives were to know the impressions of the students concerning the theme "death and dying" and to give subsidies for the second phase of the survey. It was carried through a dynamic with a guiding question, as part of the curricular program of the discipline Psychology Applied to Health. For the interpretation of the data the method of the Analysis of Content was used, and the following categories were obtained: fear of death; concepts; attitude in the face of death and dying; belief as an intervening element

Determinação do tropismo viral por ensaios genotípicos e fenotípicos em pacientes brasileiros infectados por HIV-1

The clinical application of CCR5 antagonists involves first determining the coreceptor usage by the infecting viral strain. Bioinformatics programs that predict coreceptor usage could provide an alternative method to screen candidates for treatment with CCR5 antagonists, particularly in countries with limited financial resources. Thus, the present study aims to identify the best approach using bioinformatics tools for determining HIV-1 coreceptor usage in clinical practice. Proviral DNA sequences and Trofile results from 99 HIV-1-infected subjects under clinical monitoring were analyzed in this study. Based on the Trofile results, the viral variants present were 81.1% R5, 21.4% R5X4 and 1.8% X4. Determination of tropism using a Geno2pheno[coreceptor] analysis with a false positive rate of 10% gave the most suitable performance in this sampling: the R5 and X4 strains were found at frequencies of 78.5% and 28.4%, respectively, and there was 78.6% concordance between the phenotypic and genotypic results. Further studies are needed to clarify how genetic diversity amongst virus strains affects bioinformatics-driven approaches for determining tropism. Although this strategy could be useful for screening patients in developing countries, some limitations remain that restrict the wider application of coreceptor usage tests in clinical practice.A aplicação clínica dos antagonistas de CCR5 envolve em primeiro lugar determinar o uso de co-receptor pela cepa viral infectante. Programas de bioinformática que prevêem o uso co-receptor poderiam fornecer um método alternativo para selecionar candidatos para o tratamento com os antagonistas do CCR5, particularmente em países com poucos recursos financeiros. Assim, o presente estudo teve por objetivo identificar a melhor abordagem utilizando ferramentas de bioinformática para determinar qual o tipo de co-receptor do HIV-1 que poderia ser usado na prática clínica. Sequências de DNA proviral e Trofile resultados a partir de 99 pacientes infectados pelo HIV-1 sob monitorização clínica foram avaliadas. Com base nos resultados do Teste Trofile, as variantes virais presentes eram R5 (81,1%), R5X4 (21,4%) e X4 (1,8%). Determinação do tropismo pela análise do Geno2pheno, com taxa de falso positivos de 10% apresentou desempenho mais adequado para esta amostragem: as cepas R5 e X4 foram encontradas em frequências de 78,5% e 28,4%, respectivamente, e foi de 78,6% a concordância entre os resultados fenotípicos e genotípicos. Mais estudos são necessários para esclarecer como a diversidade genética entre as cepas do vírus afeta abordagens baseadas na determinação do tropismo pelas ferramentas de bioinformática. Embora esta estratégia possa ser útil para o rastreio de pacientes em países em desenvolvimento, permanecem algumas limitações que restringem a aplicação mais ampla para utilização de testes de co-receptor na prática clínica

Parental education and the risk of cerebral palsy for children:an evaluation of causality

Aim To explore whether increasing parental education has a causal effect on risk of cerebral palsy (CP) in the child, or whether unobserved confounding is a more likely explanation. Method We used data from Norwegian registries on approximately 1.5 million children born between 1967 and 2011. We compared results from a traditional cohort design with results from a family‐based matched case–control design, in which children with CP were matched to their first cousins without CP. In addition, we performed a simulation study to assess the role of unobserved confounding. Results In the cohort design, the odds of CP were reduced in children of mothers and fathers with higher education (adjusted odds ratio [OR] 0.67, 95% confidence interval [CI] 0.60–0.75 for maternal education, and adjusted OR 0.75, 95% CI 0.67–0.85 for paternal education). In the family‐based case–control design, only an association for maternal education remained (adjusted OR 0.80, 95% CI 0.64–0.99). Results from a simulation study suggested that this association could be explained by unobserved confounding. Interpretation A causal effect of obtaining higher education on risk of CP in the child is unlikely. Results stress the importance of continued research on the role of genetic and environmental risk factors that vary by parents’ educational level.publishedVersio

Attitudes and perceptions of Australian pharmacy students towards Complementary and Alternative Medicine – a pilot study

<p>Abstract</p> <p>Background</p> <p>With the increased usage of CAM worldwide comes the demand for its integration into health professional education. However, the incorporation of CAM into health professional curricula is handled quite differently by different institutions and countries. Furthermore, the evaluation of CAM curricula is complicated because students' ability to learn about CAM may be influenced by factors such as student's prior knowledge and motivation, together with the perceptions and attitudes of clinical preceptors.</p> <p>The study aimed to describe the attitudes, perceptions and beliefs of second, third and fourth year pharmacy students towards complementary and alternative medicine (CAM) and to explore factors that might affect attitudes such as learning, preceptors and placements.</p> <p>Methods</p> <p>Pharmacy students from a University in South East Queensland, Australia participated in the study. The study consisted of a cross-sectional survey (n = 110) and semi-structured interviews (n = 9).</p> <p>Results</p> <p>The overall response rate for the survey was 75%, namely 50% (36/72) for second year, 77.3% (34/44) for third year and 97.6% (40/41) for fourth year students. Overall, 95.5% of pharmacy students believe that pharmacists should be able to advise patients about CAM and most (93.7%) have used CAM prior to course enrolment. Students' attitudes to CAM are influenced by the use of CAM by family, friends and self, CAM training, lecturers and to a lesser degree by preceptors. The majority of pharmacy students (89.2%) perceive education about CAM as a core and integral part of their professional degree and favour it over an additional postgraduate degree. However, they see a greater need for education in complementary medicines (such as herbal medicines, vitamins and minerals) than for education in complementary therapies (such as acupuncture, meditation and bio-magnetism). Knowledge and educational input rationalised rather than marginalised students' attitudes towards CAM.</p> <p>Conclusion</p> <p>Pharmacy students perceive education about CAM as a core and integral part of their professional degree. Students' attitudes towards CAM can be influenced by learning, lecturers, preceptors and practice experience. The content and focus of CAM education has to be further investigated and tailored to meet the professional needs of our future health professionals.</p