Os sentidos do trabalho para enfermeiros da Atenção Primária à Saúde em áreas rurais

This study aims to analyze the senses nurses attribute to their work in Primary Health Care in rural areas. Exploratory, descriptive, qualitative research, carried out with nurses from rural Family Health Strategy teams in the city of Campina Grande, Paraíba. For data analysis, Bardin's Content Analysis technique was chosen. From the analysis of the interviews, eight empirical categories emerged that were grouped into three dimensions. Professionals who work in the rural context have skills that depend on individual, organizational and social dimensions to carry out their routine activities. From this study, it was possible to verify the influence of these dimensions in the attribution of senses to the work performed by nurses in primary health care in rural areas. Furthermore, it is noteworthy that in the educational institutions there is little articulation of teaching, research and extension with the rural health services of the municipalities. This study can contribute to the guidance of nursing research in health systems and services, in order to bring Education closer to the Health sector, especially in the most vulnerable areas, such as rural and remote areas.Este estudo tem como objetivo analisar os sentidos atribuídos pelos enfermeiros ao seu trabalho na Atenção Primária à Saúde em áreas rurais. A relevância desta pesquisa está no fato de existirem lacunas em relação ao trabalho dos profissionais da Atenção Primária à Saúde rural, tendo em vista que o Brasil ainda não tem uma política de Atenção Primária à Saúde específica para áreas rurais que direcione o trabalho dos profissionais. Pesquisa qualitativa, descritiva-exploratória, com enfermeiros de equipes da Estratégia de Saúde da Família rurais do município de Campina Grande, Paraíba. Utilizaram-se entrevistas semiestruturadas, com análise a partir da técnica de Análise de Conteúdo. Constatou-se que o sentido do trabalho dos enfermeiros está na satisfação pessoal, contribuição social, na identificação com o trabalho em áreas rurais e na existência de vínculo com a população rural e equipe; e como perda de sentido para o trabalho, as condições de trabalho precárias, além da ordenação dos serviços, e a distância do ponto de vista físico e relacional entre a gestão municipal e os profissionais de áreas rurais, que não oferece suporte para o desenvolvimento eficaz das ações. A partir desta pesquisa, pôde-se constatar a influência dessas dimensões na atribuição de sentido ao trabalho exercido pelos enfermeiros de Atenção Primária à Saúde de áreas rurais. Este estudo pode contribuir na orientação de pesquisas de enfermagem em sistemas e serviços de saúde, em se tratando de áreas mais vulneráveis, como as rurais e remotas

SARS-CoV-2 introductions and early dynamics of the epidemic in Portugal

Genomic surveillance of SARS-CoV-2 in Portugal was rapidly implemented by the National Institute of Health in the early stages of the COVID-19 epidemic, in collaboration with more than 50 laboratories distributed nationwide. Methods By applying recent phylodynamic models that allow integration of individual-based travel history, we reconstructed and characterized the spatio-temporal dynamics of SARSCoV-2 introductions and early dissemination in Portugal. Results We detected at least 277 independent SARS-CoV-2 introductions, mostly from European countries (namely the United Kingdom, Spain, France, Italy, and Switzerland), which were consistent with the countries with the highest connectivity with Portugal. Although most introductions were estimated to have occurred during early March 2020, it is likely that SARS-CoV-2 was silently circulating in Portugal throughout February, before the first cases were confirmed. Conclusions Here we conclude that the earlier implementation of measures could have minimized the number of introductions and subsequent virus expansion in Portugal. This study lays the foundation for genomic epidemiology of SARS-CoV-2 in Portugal, and highlights the need for systematic and geographically-representative genomic surveillance.We gratefully acknowledge to Sara Hill and Nuno Faria (University of Oxford) and Joshua Quick and Nick Loman (University of Birmingham) for kindly providing us with the initial sets of Artic Network primers for NGS; Rafael Mamede (MRamirez team, IMM, Lisbon) for developing and sharing a bioinformatics script for sequence curation (https://github.com/rfm-targa/BioinfUtils); Philippe Lemey (KU Leuven) for providing guidance on the implementation of the phylodynamic models; Joshua L. Cherry (National Center for Biotechnology Information, National Library of Medicine, National Institutes of Health) for providing guidance with the subsampling strategies; and all authors, originating and submitting laboratories who have contributed genome data on GISAID (https://www.gisaid.org/) on which part of this research is based. The opinions expressed in this article are those of the authors and do not reflect the view of the National Institutes of Health, the Department of Health and Human Services, or the United States government. This study is co-funded by Fundação para a Ciência e Tecnologia and Agência de Investigação Clínica e Inovação Biomédica (234_596874175) on behalf of the Research 4 COVID-19 call. Some infrastructural resources used in this study come from the GenomePT project (POCI-01-0145-FEDER-022184), supported by COMPETE 2020 - Operational Programme for Competitiveness and Internationalisation (POCI), Lisboa Portugal Regional Operational Programme (Lisboa2020), Algarve Portugal Regional Operational Programme (CRESC Algarve2020), under the PORTUGAL 2020 Partnership Agreement, through the European Regional Development Fund (ERDF), and by Fundação para a Ciência e a Tecnologia (FCT).info:eu-repo/semantics/publishedVersio

BARRIERS TO THE PRACTICE OF PALLIATIVE CARE IN ONCOLOGY: A SCOPING REVIEW PROTOCOL

A scoping review will be conducted according to the framework of the Joanna Briggs Institute (JBI), to answer the question: What barriers do health professionals face when providing palliative care to cancer patients? To identify the studies, multidisciplinary electronic databases in the health sciences and repositories of dissertations and theses will be used. The identification and analysis of the evidence available through the studies highlighted significant aspects related to palliative care in oncology, its impacts and the challenges faced by health professionals. It is hoped that the scoping review will contribute to a critical analysis of the barriers faced by healthcare professionals, involving practical, emotional and systemic issues that can impact on the provision of palliative care to cancer patients. This will enable the creation of more effective strategies to overcome these barriers, thus improving the quality of palliative care provided to cancer patients