Sob a espada de Dâmocles: a prática de Psicólogas em Oncologia Pediátrica em Recife-Pe

A prática de psicólogos em oncologia pediátrica envolve demandas ligadas ao processo de adoecimento e suas implicações psicossociais, e, não raro, iminência de morte e/ou até chances de cura. Assim, tal pesquisa objetivou compreender a prática desses profissionais no Município de Recife- PE. A metodologia foi qualitativa de inspiração fenomenológica, ancorada na ontologia heideggeriana. Os instrumentos utilizados foram: entrevistas, grupo focal e diálogos com nove participantes, além das anotações de campo. As narrativas foram transcritas na íntegra, literalizadas (Schmidt, 1990) e interpretadas mediante a analítica do sentido (Critelli, 2007). A prática caracterizou-se pela coexistência dos seguintes aspectos: longo período de convivência de pacientes e familiares, envolvimento afetivo e proximidade entre profissionais de saúde, familiares e crianças, além da intensidade no que diz respeito aos vínculos estabelecidos. Tais dimensões repercutem nos modos-de-ser e de estar-no-mundo das participantes, fazendo a prática transitar por entre as dimensões ôntica e ontológica do cuidado. Com o tempo, a prática tende a ancorar-se nas experiências de coexistência. Exercício ético de acolhimento à alteridade, impossibilidade de controle dos acontecimentos, além da iminência de morte, perpassam tal prática, levando os profissionais a romper ações isoladas, a redimensionar o saber-fazer e a reinventar modos interventivos por meio da experimentação cotidiana

Atuação de doulas no serviço público de saúde

Objective: to analyze the performance of doulas in the public health service, based on their vision and management at a local maternity hospital. Method: qualitative, descriptive study, anchored in Martin Heidegger's existential phenomenological perspective, involving four doulas and three managers. In the data analysis, Discourse Analysis was used. Results: the fields of action of the doulas that emerged were primary care and hospital, and the main difficulty of action was the resistance of the medical team to accept this caregiver in the delivery scenario. The acquisition of information by professionals was presented by doulas as a possibility to mitigate the difficulties experienced in the hospital environment. The managers recognize the importance of the doula in the process of delivery and birth. Conclusion: The study provided an expanded view of the possibilities of doulas' performance in the public health service.Objetivo: analisar a atuação das doulas no serviço público de saúde, a partir da visão destas e da gestão em uma maternidade local. Método: estudo qualitativo, descritivo, ancorado na perspectiva fenomenológica existencial de Martin Heidegger, envolvendo quatro doulas e três gestoras. Na análise dos dados foi utilizado a Análise de Discurso. Resultados: os campos de atuação das doulas que emergiram foram atenção primária e hospital, e como principal dificuldade de atuação foi a resistência da equipe médica em aceitar essa cuidadora no cenário do parto. A aquisição de informações pelos profissionais foi apresentada pelas doulas como uma possibilidade de atenuar as dificuldades vivenciadas no ambiente hospitalar. As gestoras reconhecem a importância da doula no processo de parto e nascimento. Conclusão: O estudo possibilitou uma visão ampliada acerca das possibilidades de atuação das doulas no serviço público de saúde

Five years of Stent for Life in Portugal

Objective: To analyze changes in performance indicators five years after Portugal joined the Stent for Life (SFL) initiative. Methods: National surveys were carried out annually over one-month periods designated as study Time Points between 2011 (Time Zero) and 2016 (Time Five). In this study, 1340 consecutive patients with suspected ST-elevation myocardial infarction (STEMI) who underwent coronary angiography, admitted to 18 24/7 primary percutaneous coronary intervention (PCI) centers, were enrolled. Results: There was a significant reduction in the proportion of patients who attended primary healthcare centers (20.3% vs. 4.8%, p<0.001) and non-PCI-capable centers (54.5% vs. 42.5%, p=0.013). The proportions of patients who called 112, the national emergency medical services (EMS) number (35.2% vs. 46.6%, p=0.022) and of those transported via the EMS to a PCI-capable center (13.1% vs. 30.5%, p<0.001) increased. The main improvement observed in timings for revascularization was a trend toward a reduction in patient delay (114 min in 2011 vs. 100 min in 2016, p=0.050). System delay and door-to-balloon time remained constant, at a median of 134 and 57 min in 2016, respectively. Conclusion: During the lifetime of the SFL initiative in Portugal, there was a positive change in patient delay indicators, especially the lower proportion of patients who attended non-PCI centers, along with an increase in those who called 112. System delay did not change significantly over this period. These results should be taken into consideration in the current Stent - Save a Life initiative.info:eu-repo/semantics/publishedVersio

Unraveling the genetic background of individuals with a clinical familial hypercholesterolemia phenotype

Familial hypercholesterolemia (FH) is a common genetic disorder of lipid metabolism caused by pathogenic/likely pathogenic variants in LDLR, APOB, and PCSK9 genes. Variants in FH-phenocopy genes (LDLRAP1, APOE, LIPA, ABCG5, and ABCG8), polygenic hypercholesterolemia, and hyperlipoprotein (a) [Lp(a)] can also mimic a clinical FH phenotype. We aim to present a new diagnostic tool to unravel the genetic background of clinical FH phenotype. Biochemical and genetic study was performed in 1,005 individuals with clinical diagnosis of FH, referred to the Portuguese FH Study. A next-generation sequencing panel, covering eight genes and eight SNPs to determine LDL-C polygenic risk score and LPA genetic score, was validated, and used in this study. FH was genetically confirmed in 417 index cases: 408 heterozygotes and 9 homozygotes. Cascade screening increased the identification to 1,000 FH individuals, including 11 homozygotes. FH-negative individuals (phenotype positive and genotype negative) have Lp(a) >50 mg/dl (30%), high polygenic risk score (16%), other monogenic lipid metabolism disorders (1%), and heterozygous pathogenic variants in FH-phenocopy genes (2%). Heterozygous variants of uncertain significance were identified in primary genes (12%) and phenocopy genes (7%). Overall, 42% of our cohort was genetically confirmed with FH. In the remaining individuals, other causes for high LDL-C were identified in 68%. Hyper-Lp(a) or polygenic hypercholesterolemia may be the cause of the clinical FH phenotype in almost half of FH-negative individuals. A small part has pathogenic variants in ABCG5/ABCG8 in heterozygosity that can cause hypercholesterolemia and should be further investigated. This extended next-generation sequencing panel identifies individuals with FH and FH-phenocopies, allowing to personalize each person’s treatment according to the affected pathway

Characterisation of microbial attack on archaeological bone

As part of an EU funded project to investigate the factors influencing bone preservation in the archaeological record, more than 250 bones from 41 archaeological sites in five countries spanning four climatic regions were studied for diagenetic alteration. Sites were selected to cover a range of environmental conditions and archaeological contexts. Microscopic and physical (mercury intrusion porosimetry) analyses of these bones revealed that the majority (68%) had suffered microbial attack. Furthermore, significant differences were found between animal and human bone in both the state of preservation and the type of microbial attack present. These differences in preservation might result from differences in early taphonomy of the bones. © 2003 Elsevier Science Ltd. All rights reserved