Perspectives and Experiences of Individuals Undergoing Predictive Testing for Hereditary Breast and Ovarian Cancer (HBOC) Syndrome in the Western Cape, South Africa.

Breast cancer is the most common malignancy affecting females globally. Hereditary breast and ovarian cancer (HBOC) syndrome is caused by pathogenic variants in BRCA1 and BRCA2 and is seen in approximately 50% of families with a strong history of breast and ovarian cancers. Predictive testing (PT) is offered to unaffected individuals with a positive family history of HBOC, with an already identified BRCA1 or BRCA2 mutation in an affected family member. There is an overwhelming amount of research that has focused on the after-effects of diagnostic genetic testing for HBOC but there has been little investigation into how individuals experience the actual PT process. The present study therefore aimed to investigate individuals’ decisions for undergoing and their experiences of PT for HBOC in a local context, by focusing on at-risk South African individuals residing in the Western Cape Province. Sixteen participants were recruited retrospectively from the breast cancer and/or clinical genetics clinics at Groote Schuur Hospital, Tygerberg Hospital and private genetic counselling practices in Cape Town. Semi structured interviews were conducted, and the interview transcripts were analysed using the framework approach for qualitative data analysis. Using this approach, five themes were identified relating to the perspectives and experiences of individuals undergoing PT for HBOC, in selected settings in the Western Cape. While some participants felt that their decision to pursue PT was influenced by their family history of cancer and the associated cancer-related distress, others felt that their decision was made out of a sense of duty to their families or in solidarity with those that were affected or received a positive test result. Overall, the participants felt that the pre-test counselling was beneficial in allowing for an improved understanding of HBOC, however not all participants felt that the pre-test counselling prepared them for receiving their results. Receiving a negative test result was often accompanied by feelings of guilt and did not exempt participants from the fear of developing cancer. Some of the concerns raised by participants that received a positive test result were centred around prophylactic intervention and its effect on body image. Overall, participants felt empowered by their mutation status and felt that they were better able to manage their risk. The need for additional support, both practical and emotional support, was particularly evident amongst mutation-carriers. The findings of this study provide valuable insight into the perspectives and experiences of this population, which could potentially impact the services that are provided to individuals undergoing PT for HBOC in similar settings

Culpa con representación o dolo eventual en la actividad médica

A lo largo de toda la historia de la humanidad ha existido gran preocupación por el ejercicio licito y diligente de la actividad médica; una profesión sin duda nunca exenta de riesgos. Aunque la mayor parte del ejercicio medico se desarrolla bajo la rigurosidad y la disciplina de la lex artis, existe unos infortunados eventos en donde la trasgresión del riesgo permitido, da al traste con la vulneración de bienes jurídicos tutelados como la vida y la integridad personal de los pacientes, lo que facilita su accionar en el sistema jurídico penal; razón por la cual, el profesional sanitario se ve abocado a responder por la comisión de delitos en modalidad culposa o dolosa. Importa señalar que, en la mayor parte de los casos, el facultativo responde por ilícitos culposos, sin embargo, existe una franja minoritaria de eventos en donde la infracción penal puede ser señalada bajo la modalidad de dolo eventual, lo que de suyo comporta una mayor punibilidad respecto a la atenuada que admite el delito culposo. El presente trabajo, persigue establecer los elementos diferenciadores entre la culpa con representación y el dolo eventual, en el ejercicio de actividades sanitarias, en procura de una correcta caracterización del ilícito.Throughout the entire history of humanity there has been great concern about the lawful and diligent exercise of medical activity; a profession without a doubt never without risks. Although most of the medical practice is carried out under the rigor and discipline of the lex artis, there are some unfortunate events where the transgression of the permitted risk destroys the violation of protected legal assets such as the life and personal integrity of patients, which facilitates their actions in the criminal legal system; reason why, the health professional is forced to answer for the commission of crimes in guilty or intentional modality. It is important to point out that, in the majority of cases, the doctor is liable for wrongful acts, however, there is a minority strip of events where the criminal offense can be indicated under the modality of possible intent, which in itself entails a greater punishability with respect to the attenuated that admits the guilty crime. The present work seeks to establish the differentiating elements between guilt with representation and possible fraud, in the exercise of sanitary activities, in search of a correct characterization of the crime.Magíster en Derecho MédicoMaestrí

An Exploratory Case Study of the Influences Personal Abilities and Self-Efficacy have on Performance for Remote Workers.

This dissertation explores the personal abilities and self-efficacy variables that have an influence on performance in the context of remote work, advances in technology and the global spread of COVID-19. The recent pandemic has forced many companies to increase employees’ physical proximity from their place of work and, in order to maintain service levels, precipitated a vast expansion in remote working. The research aims of this study were developed to investigate which tools remote workers have available to overcome obstacles in a virtual environment and the challenges faced while performing their jobs. To represent these objectives and provide structure to the research, the following research questions were proposed: 1. What is the importance of self-efficacy for employees in performing their tasks when working remotely? 2. What are the challenges remote workers face when performing their job? The study has an extensive literature review of the pertinent subjects relevant for remote work which allowed for the development of a conceptual framework and informed the approach for primary research. This dissertation takes the form of an exploratory qualitative case study methodology and semi-structured interviews as a data-gathering tool, this approach was selected after considering the research questions and the context of this dissertation. This research contributes to the existing literature by proposing that organisations address certain core issues when adopting remote work as a business strategy, and the role of personal abilities and self-efficacy during the evaluation of the performance of remote workers

Impact of sex on hyperalgesia induced by sleep loss

This study evaluated the impact of sex on the short term consequences of different periods of sleep deprivation and the effect of the respective sleep recovery periods on nociceptive responses. Male and female C57BL/6J mice were assigned to the following groups: paradoxical sleep deprived (PSD) for 72 h, sleep restricted (SR) for 15 days, exposed to respective recovery periods for 24 h, or untreated home-cage controls (CTRL). Mice were submitted to a noxious thermal stimulus to evaluate their nociceptive response after PSD, SR, or recovery periods. Blood was collected for hormonal analysis. the nociceptive response was significantly lower in PSD and SR mice compared to CTRL animals, regardless of the sex. However, SR females had a lower paw withdrawal threshold than males. Sleep recovery was able to restore normal nociceptive sensitivity after PSD in both sexes. the hyperalgesia induced by SR was not reversed by sleep rebound. in females, low concentrations of estradiol were found after SR, and these concentrations continued to decrease after 24 hours of sleep recovery. the PSD male mice exhibited higher concentrations of corticosterone than the CTRL and SR male mice. Corticosterone levels were not affected by SR. Our study revealed that PSD and SR induce hyperalgesia in mice. the SR groups showed marked changes in the nociceptive response, and the females were more sensitive to these alterations. This finding indicates that, although different periods of sleep deprivation change the nociceptive sensitivity in male and female mice, sex could influence hyperalgesia induced by chronic sleep loss. (C) 2010 Elsevier Inc. All rights reserved.Associacao Fundo de Incentivo a Psicofarmacologia (AFIP)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Universidade Federal de São Paulo, Dept Psicobiol, BR-04024002 São Paulo, BrazilUniv Fed Goias, Dept Ciencias Fisiol, Goiania, Go, BrazilUniversidade Federal de São Paulo, Dept Psicobiol, BR-04024002 São Paulo, BrazilFAPESP: 98/14303-3FAPESP: 10/50130-0Web of Scienc

Formulación del plan institucional de gestión ambiental (PIGA) para la institución educativa Jorge Eliecer Gaitán, periodo 2016-2020, en el municipio de orito, departamento del Putumayo

La formulación del Plan Institucional de Gestión Ambiental para la institución Educativa Jorge Eliecer Gaitán del Municipio de Orito Putumayo; se desarrolló a partir de la realización de una evaluación ambiental inicial para evaluar el desempeño ambiental de la institución, de esta forma se recolecto la información necesaria a través del recorrido por las instalaciones del plantel educativo, reconociendo las diferentes condiciones de desempeño ambiental.The formulation of the Institutional Environmental Management Plan for Educational institution Jorge Eliecer Gaitan Orito Putumayo Township; It was developed from conducting an initial environmental assessment to assess the environmental performance of the institution, thus the necessary information was collected through the tour of the facilities of the campus, recognizing the different conditions of environmental performance

The Academy of Legal Sciences and the seizure of St.Franci’s Convent in the City of Sao Paulo

In 1827, São Paulo had its first Law School, the Academia de Sciencias Juridicas de São Paulo, currently Faculdade de Direito da Universidade de São Paulo. However, despite all efforts, there was no building to house the Academy. In order to fix this problem, the Imperial Government and the São Paulo Provincial Governor negotiated the cession of Saint Francis’ Convent to host the first Brazilian Law School. Nevertheless, based on extensive original documentation, we will argue, in this paper, that the negotiations were not totally friendly and the Franciscans resisted delivering their building. In this sense, the manuscripts analysed here reveal a hostile takeover rather than a friendly grant.Neste texto, apresentamos um grupo de manuscritos que revela detalhes da negociação que levou à cessão do edifício do Convento dos Franciscanos, no ano de 1828, à Academia de Sciencias Juridicas de São Paulo, atual Faculdade de Direito da Universidade de São Paulo. Os manuscritos, datados de 1827 e 1828, documentam o processo de escolha do edifício, a comunicação entre o então diretor da Academia (José Arouche de Toledo Rendon), a Secretaria dos Negócios do Império e os representantes franciscanos, bem como os conflitos dessa relação. Pretendemos mostrar, através da análise dos manuscritos, que a entrega do Convento dos Franciscanos ao Curso Jurídico em 1828 constituiu-se mais em uma tomada do edifício do que uma simples cessão voluntária

Nanocrystalline Anatase Tio2/reduced Graphene Oxide Composite Films As Photoanodes For Photoelectrochemical Water Splitting Studies: The Role Of Reduced Graphene Oxide.

Nanocrystalline TiO2 and reduced graphene oxide (TiO2/RGO) composite films were prepared by combining a sol-gel method with hydrothermal treatment, employing titanium isopropoxide (Ti(O(i)Pr)4) and graphene oxide (GO) as starting materials. Although several reports in the literature have explored the benefits of RGO addition in titania films for photocatalysis and water splitting reactions, the role of RGO in the composite is always described as that of a material that is able to act as an electron acceptor and transport electrons more efficiently. However, in most of these reports, no clear evidence for this role is presented, and the main focus is deviated to the improved efficiency and not to the reasons for said efficiency. In this study, we employed several techniques to definitively present our understanding of the role of RGO in titania composite films. The TiO2/RGO composite films were characterized by X ray diffraction, Raman spectroscopy, microscopy and electrochemical techniques. In photoelectrochemical water splitting studies, the TiO2/RGO(0.1%) photoelectrodes showed the highest photocurrent density values (0.20 mA cm(-2) at 1.23 VRHE) compared to other electrodes, with an increase of 78% in relation to pristine TiO2 film (0.11 mA cm(-2) at 1.23 VRHE). The transient absorption spectroscopy (TAS) results indicated increases in the lifetime and yield of both the photogenerated holes and electrons. Interestingly, the TiO2/RGO(0.1%) film exhibited the best charge generation upon excitation, corroborating the photoelectrochemical data. We proposed that in films with lower concentrations (<0.1 wt%), the RGO sheets are electron acceptors, and a decrease in the charge recombination processes is the immediate consequence. Thus, both holes and electrons live longer and contribute more effectively to the photocurrent density.182608-261

Effectiveness Of A Physical Exercise Intervention Program In Improving Functional Mobility In Older Adults After Hip Fracture In Later Stage Rehabilitation: Protocol Of A Randomized Clinical Trial (reative Study)

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Hip fractures resulting from falls increase substantially with advancing age and less than half of older hip fracture survivors regain their former levels of mobility. There is increasing evidence that rehabilitation interventions with exercises that goes beyond the sub-acute phase or even in a later stage of care have a positive impact on various functional abilities. The purpose of this study is to determine if exercise program training for people who have suffered a fall-related hip fracture will improve functional mobility when compared with usual care. Methods: A randomized controlled trial with blinded assessors and intention-to-treat analysis will be undertaken. We will recruit 82 older adults, 60 years or over who have suffered a hip fracture due to a fall in the previous 6 to 24 months. Participants randomized to the Intervention Group (IG) will undertake a physical exercise program involving progressive and challenging balance training and neuromuscular and functional training of the lower limbs, conducted at home by physiotherapists, once a week, lasting about one hour, in the first, second and third month after randomization and will be taught to perform exercises at home, twice a week, using a booklet. Visits to monitor and progress the home exercise program will be conducted once a month, from the fourth to the sixth month and each 2 months until the end of the follow up at the 12th month, i.e., a total of 18 sessions. Participants will receive monthly phone calls to encourage exercise adherence. The control group will receive usual care. The primary outcome will be mobility-related disability and participants will be assessed at baseline, and at 3 months, 6 and 12 months. Participants will receive monthly phone calls to ask about falls and exercise adherence. Adverse effects will be monitored. Discussion: This study proposes a home-based exercise program, which may in part overcome some barriers for rehabilitation, such as difficulties with public transportation and lack of a caregiver to accompany older patients to sessions. If a positive effect is observed this program has the potential to be incorporated into the public health system and contribute to building a pathway of care for older people with hip fracture.16Sao Paulo Research Foundation - FAPESP [2013/25149-7]Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Fourth International Conference on Sustainable Tourism Planet, People, Peace (P3)

El texto relata los principales puntos de discusión presentados en la IV Conferencia Internacional de Turismo Sostenible Planeta, Personas, Paz; con énfasis en los desafíos que presenta el desarrollo del turismo desde una perspectiva de sostenibilidad. Se presenta también la estructura y concepto del evento.El texto relata los principales puntos de discusión presentados en la IV Conferencia Internacional de Turismo Sostenible Planeta, Personas, Paz; con énfasis en los desafíos que presenta el desarrollo del turismo desde una perspectiva de sostenibilidad. Se presenta también la estructura y concepto del evento.The following text recounts the main discussions presented in the IV International Conference on Sustainable Tourism Planet, People, Peace; emphasizing in the challenges of tourism development from a sustainability perspective. It also provides the structure and concept of the event