Perceived Pain in People Living with Amyotrophic Lateral Sclerosis-A Scoping Review.

(1) Background: Pain is a common symptom in patients with Amyotrophic Lateral Sclerosis (ALS). There are no evidence-based pharmacological treatments for pain in ALS; recommendations are based on guidelines for chronic non-oncological pain and clinical experience. The aim is to map the literature on how people with ALS experience pain, and how this affects their daily activities and social relationships. (2) Methods: This scoping review included studies concerning patients with spinal/bulbar ALS aged ≥ 18 years who experience pain, focusing on perception, characteristics, treatment, and impact on quality of life. Temporal and linguistic criteria were applied when searching the MEDLINE, CINAHL, and SCOPUS databases. (3) Results: The management of pain in these patients is complex and involves the use of anti-inflammatory drugs, analgesics, and opioids. Pain is associated with other conditions such as depression and anxiety, which contribute to a deterioration in the quality of life. Moreover, pain may also negatively influence patient compliance with prescribed treatment regimens and the quality of care they perceive themselves to be receiving. (4) Conclusions: It is of the most importance to identify effective ways to assess and treat this issue, with health care professionals taking an active role in this process.

Role of emotions in the clinical decision-making process of the hospital nurse: A multicentre qualitative study.

While for a long-time emotional reaction and moral distress, have been primarily investigated for the possible outcomes of the nursing decision-making process rather than in terms of their role as antecedents of the final decision taken. The primary study's aim is to explore how inpatient nurses' decision-making takes place in different care settings, with a special focus on the role played by emotions during decision-making. The secondary aim is to explore the subjective experience of hospital nurses in relation to successful and unsuccessful decision-making situations. Multicentre qualitative study, consisting of three phases with different designs: participatory study, grounded theory study, and phenomenological study. Participants will be nurses and may be doctors with various levels of professional experience working in hospital, outpatient, or ward settings. Participants will be recruited through different sampling (purposive and convenience). Data will be collected through focus groups and in-depth interviews with nurses working in different hospital care settings. The researchers expect to find themes that will contribute to a better understanding of the role of emotions in decision-making. The results of this study have the potential of providing important implications to support nurses in the recognition and management of their emotions during the decision-making process.

Gamification as an Educational Approach for Oncological Patients: A Systematic Scoping Review.

BACKGROUND: Education plays a pivotal role in the care of oncological patients, reducing health costs, hospital readmission, and disease relapses. Education can be supportive in achieving multiple outcomes, improving symptom control and quality of life. A new approach is emerging in patient education: gamification. Gamification was defined as the "use of game elements in non-game contexts", including the application of games in serious contexts. The aim of this review is to explore the use of gamification in the oncology setting. METHODS: A systematic scoping review was conducted in the MEDLINE, CINAHL, PsychINFO, Embase, Scopus, and Cochrane Library databases using the JBI guidelines. RESULTS: The 13 included reports were critically appraised by two reviewers independently. It seems that gamification could be effective both in prevention and cancer treatments. Gamification also seems to improve chemotherapy-induced nausea and vomiting management, quality of life, and reduced anxiety levels in different cancer groups. Moreover, gamification seems effective in improving self-care in cancer patients, regardless of gender, age, and ethnicity. CONCLUSIONS: Gamification improves patient engagement and biopsychosocial outcomes and could represent a valid approach to cancer patient education; however, it is not a substitute for healthcare professionals, who remain the leaders in the education process.

Rationale and design of the CV-PREVITAL study: an Italian multiple cohort randomised controlled trial investigating innovative digital strategies in primary cardiovascular prevention.

INTRODUCTION: Prevention of cardiovascular disease (CVD) is of key importance in reducing morbidity, disability and mortality worldwide. Observational studies suggest that digital health interventions can be an effective strategy to reduce cardiovascular (CV) risk. However, evidence from large randomised clinical trials is lacking. METHODS AND ANALYSIS: The CV-PREVITAL study is a multicentre, prospective, randomised, controlled, open-label interventional trial designed to compare the effectiveness of an educational and motivational mobile health (mHealth) intervention versus usual care in reducing CV risk. The intervention aims at improving diet, physical activity, sleep quality, psycho-behavioural aspects, as well as promoting smoking cessation and adherence to pharmacological treatment for CV risk factors. The trial aims to enrol approximately 80 000 subjects without overt CVDs referring to general practitioners' offices, community pharmacies or clinics of Scientific Institute for Research, Hospitalization and Health Care (Italian acronym IRCCS) affiliated with the Italian Cardiology Network. All participants are evaluated at baseline and after 12 months to assess the effectiveness of the intervention on short-term endpoints, namely improvement in CV risk score and reduction of major CV risk factors. Beyond the funded life of the study, a long-term (7 years) follow-up is also planned to assess the effectiveness of the intervention on the incidence of major adverse CV events. A series of ancillary studies designed to evaluate the effect of the mHealth intervention on additional risk biomarkers are also performed. ETHICS AND DISSEMINATION: This study received ethics approval from the ethics committee of the coordinating centre (Monzino Cardiology Center; R1256/20-CCM 1319) and from all other relevant IRBs and ethics committees. Findings are disseminated through scientific meetings and peer-reviewed journals and via social media. Partners are informed about the study's course and findings through regular meetings. TRIAL REGISTRATION NUMBER: NCT05339841.

Impactos psicossociais do rompimento da barragem da Samarco, Vale e BH Billiton em Mariana/MG / Psychosocial impacts of the Samarco, Vale and BH Billiton dam rupture in Mariana / MG / Impactos psicosociales de la ruptura de las presas Samarco, Vale y BH Billiton en Mariana/ MG

Este artigo apresenta parte dos resultados de uma pesquisa de doutorado em psicologia social que investigou os impactos do rompimento da barragem de rejeitos de minério de ferro das empresas Samarco, Vale e BHP Billiton sobre a população atingida em Mariana/MG. Para levantamento dos dados em campo foi realizada observação de reuniões entre atingidos e atingidas com representantes das empresas e órgãos públicos, bem como, levantamento documental de atas e decisões judiciais, matérias de jornais e foi realizada entrevistas com pessoas atingidas, tendo como orientação teórica e metodológica a psicologia social e comunitária e a pesquisa participante. Ao longo das análises constatou-se o profundo imbricamento entre capitalismo, mineração e violência psicossocial, nexos de uma mesma cadeia de exploração.(AU)

This article presents part of the results of a doctoral research in social psychology that investigated the impacts of the collapse of the iron ore tailings dam of the companies Samarco, Vale and BHP Billiton on the affected population in Mariana/MG. To collect data in the field, observation of meetings between those affected with representatives of companies and public bodies was carried out, as well as a documental survey of minutes and judicial decisions, newspaper articles and interviews were carried out with affected people, having as theoretical and methodological approach, social and community psychology and participatory research. Over the course of the analysis, a deep intertwining between capitalism, mining and psychosocial violence was found, nexuses of the same chain of exploitation.(AU)

Este artículo presenta parte de los resultados de una investigación de doctorado en psicología social que investigó los impactos del colapso de la presa de relaves de minería de hierro de las empresas Samarco, Vale y BHP Billiton en la población afectada en Mariana/MG. Para la recogida de datos en campo se realizó la observación de reuniones entre afectados con representantes de empresas y organismos públicos, así como un levantamiento documental de actas y decisiones judiciales, artículos de prensa y entrevistas a afectados, teniendo como enfoque teórico y metodológico, la psicología social y comunitaria y la investigación participativa. En el transcurso del análisis se encontró un profundo entrelazamiento entre capitalismo, minería y violencia psicosocial, nexos de una misma cadena de explotación.(AU)

Nurse's bedside screening of dysphagia: an umbrella review.

INTRODUCTION: Dysphagia often results in serious, poor health outcomes. Nurses have an important role in assessing dysphagia. Therefore, they need reliable and effective screening tools to detect dysphagia. The purpose of this umbrella review is to locate the most valid, reliable, and usable bedside screening tools that allow nurses to identify dysphagia in institutionalized patients. METHODS: Umbrella Review as suggested by the Joanna Briggs Institute. Inclusion criteria were: systematic reviews of randomized controlled trials or cross-sectional studies. We excluded: pediatric and psychiatric patients. We searched on PubMed, CINAHL, Scopus, Cochrane Library, the Joanna Briggs Institute Database of Systematic Reviews and Implementation Reports, and the Joanna Briggs Institute Evidence-Based Practice Database. RESULTS: Six reviews were included. Four tools were reported in all the reviews: 3 oz swallowing water test, Mann Assessment of Swallowing Ability, Toronto Bedside Swallowing Screening Test, Gugging Swallowing Screen. They have shown fair to good sensitivity and specificity. The reviews analysed did not allow for a comparative analysis between instruments, which may be hindering the selection of the optimal instrument for clinical practice. CONCLUSIONS: Almost all reviews have considered stroke patients. The next steps will be to determine if there is a tool applicable in multiple settings with different patients and if this intervention is cost-effective.

Efficacy and safety of osteopathic manipulative treatment: an overview of systematic reviews.

OBJECTIVE: To summarise the available clinical evidence on the efficacy and safety of osteopathic manipulative treatment (OMT) for different conditions. DESIGN: Overview of systematic reviews (SRs) and meta-analyses (MAs). PROSPERO CRD42020170983. DATA SOURCES: An electronic search was performed using seven databases: PubMed, EMBASE, CINAHL, Scopus, JBI, Prospero and Cochrane Library, from their inception until November 2021. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: SRs and MAs of randomised controlled trials evaluating the efficacy and safety of OMT for any condition were included. DATA EXTRACTION AND SYNTHESIS: The data were independently extracted by two authors. The AMSTAR-2 tool was used to assess the methodological quality of the SRs and MAs. The overview was conducted and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. RESULTS: The literature search revealed nine SRs or MAs conducted between 2013 and 2020 with 55 primary trials involving 3740 participants. The SRs reported a wide range of conditions including acute and chronic non-specific low back pain (NSLBP, four SRs), chronic non-specific neck pain (CNSNP, one SR), chronic non-cancer pain (CNCP, one SR), paediatric (one SR), neurological (primary headache, one SR) and irritable bowel syndrome (IBS, one SR). Although with a different effect size and quality of evidence, MAs reported that OMT is more effective than comparators in reducing pain and improving functional status in acute/chronic NSLBP, CNSNP and CNCP. Due to small sample size, presence of conflicting results and high heterogeneity, questionable evidence existed on OMT efficacy for paediatric conditions, primary headache and IBS.No adverse events were reported in most SRs. According to AMSTAR-2, the methodological quality of the included SRs was rated low or critically low. CONCLUSION: Based on the currently available SRs and MAs, promising evidence suggests the possible effectiveness of OMT for musculoskeletal disorders. Limited and inconclusive evidence occurs for paediatric conditions, primary headache and IBS. Further well-conducted SRs and MAs are needed to confirm and extend the efficacy and safety of OMT.

Lived experience of patients in ICU after cardiac surgery: A phenomenological study.

BACKGROUND: Cardiac surgery (CS) patients spend a significant amount of time in the intensive care unit (ICU). This event can be very overwhelming, with an intense emotional impact, causing vulnerability and a sense of helplessness in patients. Currently, the in-depth description of the ICU stay experience from a patient's own perspective is little studied, especially in the CS setting and using a qualitative approach in Italy. AIMS: This study aimed to describe CS patients' lived experiences. METHODS: A qualitative phenomenological study was conducted between October 2018 and December 2019 using the interpretative phenomenological analysis approach. RESULTS: Eleven patients were interviewed during the months after discharge from the ICU. Four main themes emerged from the analysis of the interviews: (a) will not wake up anymore; (b) endless time in ICU; (c) something keeps me from breathing; and (d) "anchor in the storm." Results confirm the negative experience of patients in the ICU, mainly because of the extubating procedure. Nurses were found to play a key role in decisions, supporting and protecting patients from the psychological stress related to the ICU stay. CONCLUSION: This is the first study capturing ICU patients' lived experiences after a CS intervention with the use of interpretative phenomenology in Italy. Further investigations are warranted to systematically identify which approaches or strategies are essential to support these patients in the Italian context. RELEVANCE TO CLINICAL PRACTICE: Our study's results could be useful for tailored care delivery to meet the real needs of Italian patients in the ICU after CS and, consequently, improve the quality of nursing care and patients' outcomes.

Saúde mental na Atenção Primária: (des)encontros entre enfermeiros e pacientes com diagnóstico de esquizofrenia / Mental health in Primary Health Care: (dis)encounters between nurses and patients diagnosed with schizophrenia / Salud mental en Atención Primaria: (des)encuentros entre enfermeros y pacientes con diagnóstico de esquizofrenia

OBJETIVO: compreender o imaginário coletivo sobre pacientes com diagnóstico de esquizofrenia por parte de enfermeiros inseridos na Atenção Primária, com foco em suas possíveis reverberações no tocante à atenção em saúde mental. MÉTODO: pesquisa qualitativa, orientada pelo método investigativo psicanalítico, desenvolvida junto a 15 enfermeiros. O instrumento utilizado foi o Procedimento de Desenho-Estória com Tema, e os dados coletados foram interpretados psicanaliticamente visando à captação dos campos de sentido. RESULTADOS: no imaginário coletivo da maioria dos participantes, ocupa lugar central a crença de que o acompanhamento de pacientes com diagnóstico de esquizofrenia é responsabilidade exclusiva de profissionais e/ou serviços de saúde "especializados", o que aparentemente atravessa, de modo marcante, os (des)encontros que se estabelecem entre os enfermeiros e os referidos pacientes. CONCLUSÃO: essa crença é incompatível com os preceitos da Reforma Psiquiátrica Brasileira e com o papel a ser desempenhado, na Atenção Primária, pelos enfermeiros.

OBJECTIVE: understand the collective imaginary about patients diagnosed with schizophrenia by nurses in Primary Health Care, focusing on their possible reverberations regarding mental health care. METHOD: qualitative research oriented by the psychoanalytical investigative method, developed with 15 nurses. The instrument used was the Drawing-Story with Theme Procedure, and the data collected were interpreted psychoanalytically to capture fields of meaning. RESULTS: in the collective imaginary of most participants, is central the belief that the continuity of mental health care of patients diagnosed with schizophrenia is an exclusive responsibility of "specialized" health professionals and/or services, and it seems to significantly affect the (dis)encounters established between the nurses and those patients. CONCLUSION: this belief is incompatible with the precepts of the Brazilian Psychiatric Reform and with the role of nurses in Primary Health Care.

OBJETIVO: comprender el imaginario colectivo sobre pacientes con diagnóstico de esquizofrenia por parte de enfermeros de la Atención Primaria, enfocándose en sus posibles reverberaciones con respecto a la atención en salud mental. MÉTODO: investigación cualitativa, orientada por el método investigativo psicoanalítico, desarrollada con 15 enfermeros. El instrumento utilizado fue el Procedimiento de Dibujo-Cuentos con Tema, y los datos fueron interpretados psicoanalíticamente para capturar campos de sentido. RESULTADOS: en el imaginario colectivo de la mayoría de los participantes, es central la creencia de que la continuidad de la asistencia a pacientes con diagnóstico de esquizofrenia es responsabilidad exclusiva de profesionales y/o servicios de salud "especializados", lo que aparentemente afecta de manera significativa los (des)encuentros que se establecen entre los enfermeros y esos pacientes. CONCLUSIÓN: esta creencia es incompatible con los preceptos de la Reforma Psiquiátrica Brasileña y con el papel que deben desempeñar los enfermeros en la Atención Primaria.

Sistema Único de Saúde na representação dos jovens / Sistema Único de Salud en la representación de los jóvenes / Social representations of young people about Unified Health System

Objetivo: analisar as representações de jovens sobre o Sistema Único de Saúde e a assistência em saúde para esse grupo populacional. Método: pesquisa qualitativa e descritiva desenvolvida com 86 jovens de 15 a 24 anos de cursos profissionalizantes de uma instituição de ensino de Santa Catarina. Utilizou-se questionário e a Técnica de Associação Livre de Palavras. Os dados passaram por Análise Temática, com auxílio do software Atlas.ti. Resultados: os achados revelam que os jovens possuem um conjunto de saberes sobre o tema, vinculado este à possibilidade de acesso à saúde, às fragilidades da gestão, ao atendimento e ao desconhecimento do sistema, com críticas à gestão em saúde e à qualidade do atendimento. Conclusão: há lacunas significativas na compreensão do tema pelos jovens, as quais são sustentadas predominantemente em uma concepção de críticas vinculadas à gestão e assistência em saúde.(AU)

Objective: to analyze the representations of young people about the Unified Health System and health care for this population group. Method: qualitative and descriptive research carried out with 86 young people aged 15 to 24 years on vocational courses at an educational institution in Santa Catarina. A questionnaire and the Free Word Association Technique were used. The data went through Thematic Analysis, with the aid of the ATLAS.ti® software. Results: the findings reveal that young people have a set of knowledge about theme, linked to the possibility of access to health, management weaknesses, care and ignorance of the system, with criticisms of health management, quality of care. Conclusion: there are significant gaps in the understanding of theme by young people, which are sustained predominantly in a conception of criticisms linked to health management and assistance.(AU)

Objetivo: analizar las representaciones de los jóvenes sobre el Sistema Único de Salud y la atención de salud para este grupo de población. Método: investigación cualitativa y descriptiva realizada con 86 jóvenes de 15 a 24 años de cursos de formación profesional en una institución educativa de Santa Catarina. Se utilizó un cuestionario y la Técnica de Libre Asociación de Palabras. Los datos pasaron por Análisis Temático, con la ayuda del software ATLAS.ti®. Resultados: los hallazgos revelan que los jóvenes tienen un conjunto de conocimientos sobre el tema, vinculado a la posibilidad de acceso a la salud, debilidades de gestión, atención y desconocimiento del sistema, con críticas a la gestión en salud, calidad de la atención. Conclusión: existen importantes lagunas en la comprensión del tema por parte de los jóvenes, que se sustentan predominantemente en una concepción de las críticas vinculadas a la gestión y asistencia en salud.(AU)

O paciente em crise psiquiátrica no imaginário coletivo de profissionais de um serviço comunitário / The patient in psychiatric crisis in the collective imaginary of professionals from a community service / El paciente en crisis psiquiátrica en el imaginario colectivo de profesionales de un servicio comunitario

A crise psiquiátrica constitui um importante desafio ao cuidado psicossocial, mas tem sido tematizada em poucas pesquisas empíricas nacionais. O presente estudo teve como objetivo compreender o imaginário coletivo de um grupo de profissionais de um CAPS acerca do paciente com transtorno mental em crise psiquiátrica. Trata-se de um estudo qualitativo, do qual participaram 10 profissionais lotados em um CAPS. A coleta de dados foi realizada individualmente mediante o emprego do Procedimento de Desenho-Estória com Tema. O corpus foi constituído pela transcrição das verbalizações dos participantes e, secundariamente, por seus desenhos. A análise de dados visou à formulação de interpretações voltadas à demarcação de campos de sentido. Em linhas gerais, observou-se que, de acordo com o imaginário coletivo dos participantes, o paciente em crise psiquiátrica é alguém que atravessa um estado de perturbação, bem como perturba sua própria família, a vizinhança e os profissionais de saúde.

The psychiatric crisis is an important challenge to psychosocial care, but it has been thematized in few Brazilian empirical researches. The present study aimed to understand the collective imaginary of professionals from a CAPS unit about patients with mental disorders in psychiatric crisis. This is a qualitative study, in which 10 professionals from a CAPS unit participated. Data collection was performed individually using the Drawing-Story with Theme Procedure. The corpus was constituted by the transcription of the participants' verbalizations and, secondarily, by their drawings. Data analysis looked for the formulation of interpretations to demarcate meaning fields. In general, it was observed that, according to the collective imaginary of the participants, the patient in psychiatric crisis is someone who is in a state of disturbance, as well as disturbing his own family, the neighborhood and health professionals.

La crisis psiquiátrica constituye un desafío importante para el cuidado psicosocial, pero ha sido tematizada en pocas investigaciones empíricas brasileñas. El presente estudio tuvo como objetivo comprender el imaginario colectivo de un grupo de profesionales de un CAPS sobre pacientes con trastornos mentales en crisis psiquiátrica. Este es un estudio cualitativo, del que participaron 10 profesionales de un CAPS. La recolección de datos se realizó individualmente utilizando el Procedimiento de Dibujo-Cuento con Tema. El corpus fue constituido por la transcripción de las verbalizaciones de los participantes y, secundariamente, por sus dibujos. El análisis de datos buscó la formulación de interpretaciones destinadas a demarcar campos de significado. En general, se observó que, de acuerdo con el imaginario colectivo de los participantes, el paciente en crisis psiquiátrica es alguien que atraviesa un estado de perturbación, además de molestar a su propia familia, al vecindario y a los profesionales de la salud.

"Paciente-problema": imaginário coletivo de enfermeiros acerca do usuário com diagnóstico de esquizofrenia / "Problem-patient": collective imaginary of nurses about the user diagnosed with schizophrenia

Resumo O estudo teve por objetivo compreender crenças e emoções acerca do usuário com diagnóstico de esquizofrenia vigentes no imaginário coletivo de enfermeiros inseridos na Atenção Primária à Saúde. Trata-se de estudo de abordagem qualitativa pautado pelo método investigativo psicanalítico. Os participantes foram 15 enfermeiros que atuavam no referido nível de atenção em saúde de uma cidade de médio porte. A coleta de dados foi realizada com o emprego do Procedimento de Desenho-Estória com Tema (PDE-T) e a análise de dados buscou captar campos de sentido mediante a execução dos movimentos técnicos preconizados para a operacionalização do método investigativo psicanalítico. Verificou-se que, de modo não-consciente, o usuário com diagnóstico de esquizofrenia é representado negativamente no imaginário coletivo dos participantes, pois é visto como alguém inconveniente, que cria alvoroço e desperta medo, sobretudo devido à sua "agitação" supostamente típica. Assim, deparar-se com tal usuário corresponde, para os participantes, a uma situação a ser "resolvida" com rapidez. Este estudo, portanto, demarca dificuldades no tocante à atenção em saúde mental oferecida ao usuário com diagnóstico de esquizofrenia, as quais estão relacionadas a elementos não-conscientes da subjetividade grupal que, ao mesmo tempo, possuem caráter social e individual.

Abstract This study aimed to understand beliefs and emotions about the user diagnosed with schizophrenia current in the collective imaginary of nurses working in Primary Health Care. It is a qualitative study based on the psychoanalytic investigative method. The participants were 15 nurses who worked at the referred level of health care in a medium-sized city. Data collection was performed using the Drawing-Story with Theme Procedure (PDE-T) and data analysis sought to capture fields of meaning through the execution of the technical movements recommended for the operationalization of the psychoanalytic investigative method. It was found that, in a non-conscious way, the user diagnosed with schizophrenia is negatively represented in the collective imaginary of the participants, because he is seen as an inconvenient person, who creates uproar and arouses fear, mainly due to his supposedly typical "agitation". Thus, facing such a user means, for the participants, a situation to be quickly "solved". Therefore, this study highlights difficulties concerning mental health care offered to users diagnosed with schizophrenia, which are related to non-conscious elements of group subjectivity that, at the same time, have a social and individual character.

Factors Affecting the Retention Efficiency and Physicochemical Properties of Spray Dried Lipid Nanoparticles Loaded with Lippia sidoides Essential Oil.

Essential oils (EOs) are widely used in various industrial sectors but can present several instability problems when exposed to environmental factors. Encapsulation technologies are effective solutions to improve EOs properties and stability. Currently, the encapsulation in lipid nanoparticles has received significant attention, due to the several recognized advantages over conventional systems. The study aimed to investigate the influence of the lipid matrix composition and spray-drying process on the physicochemical properties of the lipid-based nanoparticles loaded with Lippia sidoides EO and their retention efficiency for the oil. The obtained spray-dried products were characterized by determination of flow properties (Carr Index: from 25.0% to 47.93%, and Hausner ratio: from 1.25 to 1.38), moisture (from 3.78% to 5.20%), water activity (<0.5), and powder morphology. Zeta potential, mean particle size and polydispersity index, of the redispersed dried product, fell between -25.9 mV and -30.9 mV, 525.3 nm and 1143 nm, and 0.425 and 0.652, respectively; showing slight differences with the results obtained prior to spray-drying (from -16.4 mV to -31.6 mV; 147 nm to 1531 nm; and 0.459 to 0.729). Thymol retention in the dried products was significantly lower than the values determined for the liquid formulations and was affected by the drying of nanoparticles.

Comunidades sujas de lama: da destruição à ressignificação e a resistência em mariana/mg / Comunidades sucias de barro: de la destrucción a la resignificación y la resistencia en mariana/mg / Mud-dirty communities: from destruction to resignification and resistance in mariana/mg, brazil

Resumo No dia 5 de novembro de 2015, o rompimento da barragem de rejeitos de Fundão em Mariana-MG (Brasil) de propriedade das mineradoras Samarco, Vale e BHP Billiton destruiu comunidades e contaminou o Rio Doce, sendo reconhecido como o maior desastre/crime sócio ambiental do Brasil. Nosso objetivo neste artigo é compreender os sentidos de comunidade construídos e acessados pelos atingidos dessas localidades anteriormente ao desastre e após o mesmo. Para tal, recorreremos a dados coletados durante diferentes contatos com o campo realizados pelas três autoras e que incluíram a realização de visitas aos territórios, entrevistas com atingidos e atingidas, observação participante (eventos, reuniões, outros), registro em diário de campo. Os resultados apontam que há uma constante busca por tentar recriar o sentimento de comunidade que se mostra principalmente na manutenção do vínculo com o espaço físico devastado e na tentativa de recriar o mesmo no espaço onde será feito o reassentamento.

Resumen El 5 de noviembre de 2015, la ruptura de la presa de relaves Fundão en Mariana-MG (Brasil), propiedad de las compañías mineras Samarco, Vale y BHP Billiton, destruyó comunidades y contaminó el Río Doce, siendo reconocido como el mayor desastre/crimen socioambiental en Brasil. Nuestro objetivo en este artículo es comprender los significados de la comunidad construida y accedida por los afectados en estos lugares antes y después del desastre. Con este fin, utilizaremos los datos recopilados durante los diferentes contactos con el campo llevados a cabo por las tres autoras, que incluyeron visitas a los territorios, entrevistas con los afectados y afectadas, observación participante (eventos, reuniones, otros) y registro en un diario de campo. Los resultados muestran que existe una búsqueda constante para tratar de recrear el sentimiento de comunidad que se muestra principalmente en el mantenimiento del vínculo con el espacio físico devastado y en el intento de recrearlo en el espacio donde se realizará el reasentamiento.

Abstract On November 5, 2015, the Fundão dam owned by the mining companies Samarco, Vale and BHP Billiton broke in Mariana/MG (Brazil), destroying communities and contaminating the Rio Doce, being recognized as the biggest socio-environmental catastrophe/crime in Brazil. Our goal in this article is to understand the senses of community built and accessed by those affected before and after the disaster. To this end, we used data collected during different field contacts made by the three authors, which included visits to the affected territories, interviews with those affected, participant observation (events, meetings and others), and recording in a field diary. The results indicate that there is a constant search to try to recreate the feeling of community, which is shown mainly in the maintenance of the bond with the devastated physical space and in the attempt to recreate it in the space where the resettlement will be done.

O conceito de imaginário coletivo em sua acepção psicanalítica: uma revisão integrativa / The concept of collective imaginary in its psychoanalytic sense: an integrative review / El concepto de imaginario colectivo en su acepción psicoanalítica: una revisión integrativa

Este estudo teve como objetivo, por meio de uma revisão da literatura, mapear e analisar criticamente a produção científica brasileira, veiculada no formato de artigos, sobre o imaginário coletivo em sua acepção psicanalítica. Trata-se de uma revisão integrativa empreendida mediante consultas às bases de dados PEPsic e SciELO-Brasil, sem limite de tempo. As referências localizadas foram selecionadas e então examinadas independentemente por dois avaliadores, de acordo com um conjunto de dimensões analíticas. O corpus foi constituído por 17 referências, as quais contemplaram o imaginário coletivo de populações diversas, em relação a diferentes fenômenos, com certas variações em termos das estratégias de coleta e análise de dados. Verificou-se ainda que as referências lançaram luz sobre uma gama de produções imaginativas não conscientes que ensejam atuações no mundo externo ou delas representam um momento inicial. Logo, este estudo realça a plasticidade do conceito de imaginário coletivo em sua acepção psicanalítica para captar uma diversidade de processos psicológicos que são, ao mesmo tempo, individuais e sociais.

The objective in this study was, through a review of literature, to map and critically analyse the Brazilian scientific production, published in the form of articles, about the collective imaginary in its psychoanalytical sense. An integrative review was undertaken by consulting the databases PEPsic and SciELO-Brazil, without time limit. The identified references were selected, and two reviewers evaluated them independently, according to a set of analytic dimensions. The corpus consisted of 17 references, which discussed the collective imaginary of several populations, concerning different phenomena with some variations in terms of data collection and analysis strategies. In addition, the references have shed light on a range of unconscious imaginative productions that give rise to or represent the onset of actions in the external world. Hence, this study highlights the plasticity of the collective imaginary concept in its psychoanalytical sense to capture a range of psychological processes which are, at the same time, individual and social.

La finalidad de este estudio fue, por medio de una revisión de literatura, mapear y analizar críticamente la producción científica brasileña, vehiculada en el formato de artículos, sobre el imaginario colectivo en su acepción psicoanalítica. Se trata de una revisión integrativa emprendida mediante consultas a las bases de datos PEPsic y SciELO-Brasil, sin límite de tiempo. Las referencias encontradas se seleccionaron con evaluación independiente por dos evaluadores, según un conjunto de dimensiones analíticas. El corpus abarcó 17 referencias, que contemplaron el imaginario colectivo de poblaciones diversas, con relación a diferentes fenómenos, con ciertas variaciones en las estrategias de recolecta y análisis de datos. Se verificó además que las referencias han arrojado luz sobre una gama de producciones imaginativas no conscientes que brindan actuaciones en el mundo externo o de ellas representan un momento inicial. Así, este estudio destaca la plasticidad del concepto de imaginario colectivo en su acepción psicoanalítica para captar una diversidad de procesos psicológicos que son, al mismo tiempo, individuales y sociales.

Bedside nursing handover and organisational will to achieve personalisation within an Italian Cardiac SurgeryUnit: the nurses' viewpoint through a qualitative study.

INTRODUCTION: Bedside nursing handover may be an efficient way to achieve quality nursing outcomes, supporting the personalization of care. Recent literature attests to how bedside nursing handover is perceived by cardiac patents, but the experience of nurses participating in these handovers is largely unknown. The aim of this study is to explore nurses' experiences after the implementation of bedside nursing handover in an Italian cardiac surgical ward. METHOD: A qualitative descriptive research approach was used to respond to the study aim, and the data was collected using two focus groups. RESULTS: The main themes that were identified revolved around improving nursing care, greater professionalism, effective relationships, consequences for the patient, and obstacles to change. Moreover, we found that nurses perceive bedside nursing handover to be effective in promoting patient-centred care. The nurses in our study also felt that any difficulties with the implementation of a bedside nursing handover protocol (e.g. confidentiality) should be addressed through continued nursing education. CONCLUSIONS: This study provides a valuable insight into nurses' perceptions of bedside nursing handover in a single cardiac surgery setting in Italy and is the first qualitative investigation from this perspective. Further research may help to elucidate the impact of bedside nursing handover on clinical and organisational outcomes.

The Impact of Nursing Homes Staff Education on End-of-Life Care in Residents With Advanced Dementia: A Quality Improvement Study.

CONTEXT: End-of-life care in nursing homes (NHs) needs improvement. We carried out a study in 29 NHs in the Lombardy Region (Italy). OBJECTIVES: The objective of this study was to compare end-of-life care in NH residents with advanced dementia before and after an educational intervention aimed to improving palliative care. METHODS: The intervention consisted of a seven-hour lecture, followed by two 3-hour meetings consisting of case discussions. The intervention was held in each NH and well attended by NH staff. This multicenter, comparative, observational study included up to 20 residents with advanced dementia from each NH: the last 10 who died before the intervention (preintervention group, 245 residents) and the first 10 who died at least three months after the intervention (postintervention group, 237 residents). Data for these residents were collected from records for 60 days and seven days before death. RESULTS: The use of "comfort hydration" (<1000 mL/day subcutaneously) tended to increase from 16.9% to 26.8% in the postintervention group. The number of residents receiving a palliative approach for nutrition and hydration increased, though not significantly, from 24% preintervention to 31.5% postintervention. On the other hand, the proportion of tube-fed residents and residents receiving intravenous hydration decreased from 15.5% to 10.5%, and from 52% to 42%, respectively. Cardiopulmonary resuscitations decreased also from 52/245 (21%) to 18/237 (7.6%) cases (P = 0.002). CONCLUSION: The short educational intervention modified some practices relevant to the quality of end-of-life care of advanced dementia patients in NHs, possibly raising and reinforcing beliefs and attitudes already largely present.

Caffeine levels as a predictor of Human mastadenovirus presence in surface waters-a case study in the Sinos River basin-Brazil.

The presence of caffeine in environmental water samples is almost entirely human-related, given that there are virtually no industrial or agricultural releases. Caffeine has already been proposed as an anthropogenic marker for wastewater contamination of surface waters. The aim of this study was to evaluate if caffeine concentrations in water can be a predictor of virological and bacteriological contamination. Water samples were taken at three sampling sites from urban water streams from the hydrographic basin of the Sinos River (Brazil) monthly in the period of May 9th, 2016 to April 11th, 2017 (n = 36). Concentrations of Human mastadenovirus (HAdV-F and HAdV-C), fecal coliforms, and caffeine were measured in all collected samples. Concentrations of caffeine in water were strongly correlated with HAdV-F (rs = 0.704, p = 0.000). This study, for the first time, characterized caffeine concentrations in water as predictors of virus presence, with cut-off values presenting 92.9% specificity and 95.5% sensitivity for HAdV-F and 66.7% specificity and 80% sensitivity for HAdV-C. Considering its marked chemical stability and ease of quantification, caffeine concentrations can be used as a comprehensive marker of human contamination of water resources, also being predictive of bacteriological and virological concentrations.

Pegylated liposomal doxorubicin in combination with low-dose metronomic cyclophosphamide as preoperative treatment for patients with locally advanced breast cancer.

AIM: To evaluate the role of pegylated liposomal doxorubicin with low-dose metronomic cyclophosphamide as primary systemic treatment in locally advanced breast cancer. PATIENTS AND METHODS: The activity and safety of intravenous pegylated liposomal doxorubicin 20 mg sqm(-1) biweekly for eight courses in combination with metronomic cyclophosphamide 50 mg day(-1) orally were evaluated in 29 patients with locally advanced breast cancer who were not suitable to receive a standard chemotherapy due to age or co-morbidities or who asked for a regimen with low incidence of toxic effects irrespective of age. RESULTS: The rate of breast-conserving surgery was 44.8%. Eighteen patients (62.1%) achieved a partial response (including one pathological complete response), 10 (34.5%) a stable disease and one patient experienced a progressive disease. Treatment was well tolerated, with no grade 4 toxicities, and with grade 3 skin toxicity in three patients and hand-foot syndrome in four patients. CONCLUSION: The regimen was well tolerated but with limited activity in the preoperative setting. Other options (e.g., endocrine therapy in estrogen receptor -positive disease) should be considered in locally advanced breast cancer patients who are not suitable to receive a standard chemotherapy.