Socio-cultural beliefs and perceptions influencing diagnosis and treatment of breast cancer among women in Ghana: a systematic review.

BACKGROUND: Breast cancer is currently the most commonly diagnosed cancer in Ghana and the leading cause of cancer mortality among women. Few published empirical evidence exist on cultural beliefs and perceptions about breast cancer diagnosis and treatment in Ghana. This systematic review sought to map evidence on the socio-cultural beliefs and perceptions influencing the diagnosis and treatment of breast cancer among Ghanaian women. METHODS: This review was conducted following the methodological guideline of Joanna Briggs Institute and reported in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses. The literature search was conducted in PubMed, CINAHL via EBSCOhost, PsycINFO, Web of Science, and Embase. Studies that were conducted on cultural, religious, and spiritual beliefs were included. The included studies were screened by title, abstract, and full text by three reviewers. Data were charted and results were presented in a narrative synthesis form. RESULTS: After the title, abstract, and full-text screening, 15 studies were included. Three categories were identified after the synthesis of the charted data. The categories included: cultural, religious and spiritual beliefs and misconceptions about breast cancer. The cultural beliefs included ancestral punishment and curses from the gods for wrongdoing leading to breast cancer. Spiritual beliefs about breast cancer were attributed to spiritual or supernatural forces. People had the religious belief that breast cancer is a test from God and they resorted to prayers for healing. Some women perceived that breast cancer is caused by spider bites, heredity, extreme stress, trauma, infections, diet, or lifestyle. CONCLUSION: This study adduces evidence of the socio-cultural beliefs that impact on the diagnosis and treatment of breast cancer among women in Ghana. Taking into consideration the diverse cultural and traditional beliefs about breast cancer diagnosis and treatment, there is a compelling need to intensify nationwide public education on breast cancer to clarify the myths and misconceptions about the disease. We recommend the need to incorporate socio-cultural factors influencing breast cancer diagnosis and treatment into breast cancer awareness programs, education, and interventions in Ghana.

"Until death do us part". A multidisciplinary study on human- Animal co- burials from the Late Iron Age necropolis of Seminario Vescovile in Verona (Northern Italy, 3rd-1st c. BCE).

Animal remains are a common find in prehistoric and protohistoric funerary contexts. While taphonomic and osteological data provide insights about the proximate (depositional) factors responsible for these findings, the ultimate cultural causes leading to this observed mortuary behavior are obscured by the opacity of the archaeological record and the lack of written sources. Here, we apply an interdisciplinary suite of analytical approaches (zooarchaeological, anthropological, archaeological, paleogenetic, and isotopic) to explore the funerary deposition of animal remains and the nature of joint human-animal burials at Seminario Vescovile (Verona, Northern Italy 3rd-1st c. BCE). This context, culturally attributed to the Cenomane culture, features 161 inhumations, of which only 16 included animal remains in the form of full skeletons, isolated skeletal parts, or food offerings. Of these, four are of particular interest as they contain either horses (Equus caballus) or dogs (Canis lupus familiaris)-animals that did not play a dietary role. Analyses show no demographic, dietary, funerary similarities, or genetic relatedness between individuals buried with animals. Isotopic data from two analyzed dogs suggest differing management strategies for these animals, possibly linked to economic and/or ritual factors. Overall, our results point to the unsuitability of simple, straightforward explanations for the observed funerary variability. At the same time, they connect the evidence from Seminario Vescovile with documented Transalpine cultural traditions possibly influenced by local and Roman customs.

Designing Efficient Single Metal Atom Biocatalysts at the Atomic Structure Level.

Various nanomaterials as biocatalysts could be custom-designed and modified to precisely match the specific microenvironment of diseases, showing a promise in achieving effective therapy outcomes. Compared to conventional biocatalysts, single metal atom catalysts (SMACs) with maximized atom utilization through well-defined structures offer enhanced catalytic activity and selectivity. Currently, there is still a gap in a comprehensive overview of the connection between structures and biocatalytic mechanisms of SMACs. Therefore, it is crucial to deeply investigate the role of SMACs in biocatalysis from the atomic structure level and to elucidate their potential mechanisms in biocatalytic processes. In this minireview, we summarize catalysis regulation methods of SMACs at the atomic structure level, focusing on the optimization of catalytic active sites, coordination environment, and active site-support interactions, and briefly discuss biocatalytic mechanisms for biomedical applications.

Raising Cultural Awareness and Addressing Barriers to Breast Imaging Care for Black Women.

Health care disparities, which are differences in the attainment of full health potential among population groups, have been documented across medical conditions, clinical settings, and diagnostic and treatment modalities. Deeply rooted health care disparities due to many factors have affected how Black women (BW) view medical care including screening mammography. This article explores health care disparities around breast cancer in BW and how patient distrust, provider biases, race, and social determinants of health continue to have negative effects on breast cancer outcomes in BW, despite medical advances in breast cancer detection and management. In addition, this article addresses the importance of culturally competent care for BW around breast cancer awareness, screening, and treatment, and offers strategies to address disparities and rebuild trust.

How Culture Impacts Health: The Hispanic Narrative.

The Hispanic population is the largest and fastest-growing minority group in the United States, and is disproportionately impacted by health problems, including heart disease, stroke, diabetes, obesity, cancer, and unintentional injuries. Factors contributing to these disparities include cultural practices, lack of access to health care, language barriers, and a lack of cultural competence by health-care providers. Family, religion, and gender roles play an essential part in the cultural heritage of Hispanic people, which heavily impacts health outcomes in this population. Nurses must be knowledgeable about the impact of culture on health to dismantle racial/ethnic health disparities and deliver equitable and high-quality care to individuals, families, and communities. This narrative aims to introduce some fundamental cultural factors and beliefs in the Hispanic culture that impact health. It also seeks to provide insights into culturally sensitive practices, to promote quality nursing care and address health disparities within this population.

Photothermal effects of terahertz-band and optical electromagnetic radiation on human tissues.

The field of wireless communication has witnessed tremendous advancements in the past few decades, leading to more pervasive and ubiquitous networks. Human bodies are continually exposed to electromagnetic radiation, but typically this does not impact the body as the radiation is non-ionizing and the waves carry low power. However, with progress in the sixth generation (6G) of wireless networks and the adoption of the spectrum above 100 GHz in the next few years, higher power radiation is needed to cover larger areas, exposing humans to stronger and more prolonged radiation. Also, water has a high absorption coefficient at these frequencies and could lead to thermal effects on the skin. Hence, there is a need to study the radiation effects on human tissues, specifically the photothermal effects. In this paper, we present a custom-built, multi-physics model to investigate electromagnetic wave propagation in human tissue and study its subsequent photothermal effects. The proposed finite-element model consists of two segments-the first one estimates the intensity distribution along the beam path, while the second calculates the increase in temperature due to the wave distribution inside the tissue. We determine the intensity variation in the tissue using the radiative transfer equation and compare the results with Monte Carlo analysis and existing analytical models. The intensity information is then utilized to predict the rise in temperature with a bio-heat transfer module, powered by Pennes' bioheat equation. The model is parametric, and we perform a systematic photothermal analysis to recognize the crucial variables responsible for the temperature growth inside the tissue, particularly for terahertz and near-infrared optical frequencies. Our numerical model can serve as a benchmark for studying the high-frequency radiation effects on complex heterogeneous media such as human tissue.

Artificial intelligence and Italian culture: an understanding of how artificial intelligence can transform the radiation therapy landscape.

The aim is to support the perception of artificial intelligence in the radiation therapy landscape.

Infrared spectroscopic laser scanning confocal microscopy for whole-slide chemical imaging.

Chemical imaging, especially mid-infrared spectroscopic microscopy, enables label-free biomedical analyses while achieving expansive molecular sensitivity. However, its slow speed and poor image quality impede widespread adoption. We present a microscope that provides high-throughput recording, low noise, and high spatial resolution where the bottom-up design of its optical train facilitates dual-axis galvo laser scanning of a diffraction-limited focal point over large areas using custom, compound, infinity-corrected refractive objectives. We demonstrate whole-slide, speckle-free imaging in ~3 min per discrete wavelength at 10× magnification (2 µm/pixel) and high-resolution capability with its 20× counterpart (1 µm/pixel), both offering spatial quality at theoretical limits while maintaining high signal-to-noise ratios (>100:1). The data quality enables applications of modern machine learning and capabilities not previously feasible - 3D reconstructions using serial sections, comprehensive assessments of whole model organisms, and histological assessments of disease in time comparable to clinical workflows. Distinct from conventional approaches that focus on morphological investigations or immunostaining techniques, this development makes label-free imaging of minimally processed tissue practical.

P-CSEM: An Attention Module for Improved Laparoscopic Surgical Tool Detection.

Minimal invasive surgery, more specifically laparoscopic surgery, is an active topic in the field of research. The collaboration between surgeons and new technologies aims to improve operation procedures as well as to ensure the safety of patients. An integral part of operating rooms modernization is the real-time communication between the surgeon and the data gathered using the numerous devices during surgery. A fundamental tool that can aid surgeons during laparoscopic surgery is the recognition of the different phases during an operation. Current research has shown a correlation between the surgical tools utilized and the present phase of surgery. To this end, a robust surgical tool classifier is desired for optimal performance. In this paper, a deep learning framework embedded with a custom attention module, the P-CSEM, has been proposed to refine the spatial features for surgical tool classification in laparoscopic surgery videos. This approach utilizes convolutional neural networks (CNNs) integrated with P-CSEM attention modules at different levels of the architecture for improved feature refinement. The model was trained and tested on the popular, publicly available Cholec80 database. Results showed that the attention integrated model achieved a mean average precision of 93.14%, and visualizations revealed the ability of the model to adhere more towards features of tool relevance. The proposed approach displays the benefits of integrating attention modules into surgical tool classification models for a more robust and precise detection.

Using DUCK-Net for polyp image segmentation.

This paper presents a novel supervised convolutional neural network architecture, "DUCK-Net", capable of effectively learning and generalizing from small amounts of medical images to perform accurate segmentation tasks. Our model utilizes an encoder-decoder structure with a residual downsampling mechanism and a custom convolutional block to capture and process image information at multiple resolutions in the encoder segment. We employ data augmentation techniques to enrich the training set, thus increasing our model's performance. While our architecture is versatile and applicable to various segmentation tasks, in this study, we demonstrate its capabilities specifically for polyp segmentation in colonoscopy images. We evaluate the performance of our method on several popular benchmark datasets for polyp segmentation, Kvasir-SEG, CVC-ClinicDB, CVC-ColonDB, and ETIS-LARIBPOLYPDB showing that it achieves state-of-the-art results in terms of mean Dice coefficient, Jaccard index, Precision, Recall, and Accuracy. Our approach demonstrates strong generalization capabilities, achieving excellent performance even with limited training data.

A Japanese Family Experience in America.

Even though my uncle was not in the health professions, much less surgery, I share his memorial as the story of one family that had one of its offspring become integrated into the professional mainstream through the opportunity of medical education.

Onde Vivem os Monstros? Enlaces entre Cinema, Adolescência e Horror / Where do the Monsters Live? Links Between Cinema, Adolescence and Horror / ¿Dónde Viven Los Monstruos? Vínculos Entre Cine, Adolescencia y Horror

Partindo da ideia de Stephen King de que as produções de horror servem como um barômetro muito preciso que aponta aquilo que aterroriza uma sociedade, este artigo tem como objetivo propor uma reflexão acerca dos enlaces entre adolescência, cinema e horror, no momento em que a adolescência como categoria social se consolida, isto é, nos anos 1950. Para isso, realizamos uma revisão bibliográfica sobre a relação entre horror, monstruosidade e cultura, assim como sobre o desenvolvimento dos gêneros cinematográficos horror e teen movies. Também realizamos sucintas análises fílmicas de algumas obras importantes na história desses gêneros cinematográficos. Observamos que, se, por um lado, com o surgimento dos teen movies, as telas do cinema passam a ser habitadas por monstros adolescentes, por outro, os discursos com pretensão de cientificidade nos falam sobre uma adolescência monstruosa. A partir disso, concluímos que talvez haja uma intrigante equivalência cultural entre adolescência e monstruosidade: tanto monstros quanto adolescentes trazem à luz algumas questões fundamentais para o ser humano, encarnam aquilo para o que não temos resposta, apontam os limites do saber.

Based upon Stephen King's idea that the horror productions act as a barometer, pointing out what terrifies some societies, this article aims to propose some thoughts about the possible links among adolescence, cinema, and horror, around the time adolescence emerges as a consolidated social category (in the 1950s). In order to achieve that, we researched the relations between horror, monstrosity, culture, and the development of the horror and teen movies cinematographic genres. We also made a brief film analysis of some important works in the history of these cinematographic genres. We notice that two events occurred in parallel: the emergence of teenage monsters in teen movies on the cinema screens and the allegedly scientific discourses about a monstrous adolescence. We have concluded that perhaps there is a cultural equivalence between adolescence and monstrosity: monsters and teenagers bring to light some fundamental questions for the human being; they incorporate things to which we do not have an answer and point out the limits of our knowledge.

Partiendo de la idea de Stephen King de que las producciones de terror sirven como un barómetro muy preciso que señala lo que aterroriza a una sociedad, este artículo pretende proponer una reflexión sobre los vínculos entre la adolescencia, el cine y el terror, en el momento en el que la adolescencia se consolida como una categoría social, es decir, en la década de 1950. Para ello, realizamos un repaso sobre la relación entre horror, monstruosidad y cultura, así como sobre el desarrollo de los géneros cinematográficos horror y teen movies. También hicimos un breve análisis fílmico de algunas películas importantes en la historia de estos géneros cinematográficos. Observamos que, por un lado, con la aparición de los teen movies, las pantallas de cine ahora están habitadas por monstruos adolescentes, por otro, los discursos con pretensión de cientificidad nos hablan de una adolescencia monstruosa. De esto, concluimos que puede haber una equivalencia cultural intrigante entre la adolescencia y la monstruosidad: tanto los monstruos como los adolescentes sacan a la luz algunas preguntas fundamentales para los seres humanos, encarnan aquello para lo que no tenemos respuesta, señalan los límites del saber.

Entre Silêncios e Formas: Censura e Pós-Censura na Arte Brasileira Contemporânea / Between Silences and Forms: Censorship and Post-Censorship in Contemporary Brazilian Art / Entre los Silencios y Las Formas: Censura y Poscensura en el Arte Brasileño Contemporáneo

O artigo trata da censura na arte brasileira contemporânea que, desde 2016, com o encerramento da exposição Queermuseu, marcou o retorno de um tipo de ato censório (pós-censura) que difere da censura praticada desde a redemocratização. Para tal, apresentamos um retorno até as formas da censura institucionalizada na Ditadura Militar (censura clássica) e sua dissolução na cultura. Com apoio em trechos de algumas entrevistas que realizamos em nosso campo empírico, a articulação teórica é feita entre os campos da estética, da política e da psicanálise, com apoio principal nas teorias de Michel Foucault, Jacques Rancière e Sigmund Freud. Argumentamos que a censura expõe de forma inequívoca o fato de que a criação responde às transformações no campo político que, por sua vez, geram novas formas artísticas. Conclui-se que a prinicipal marca da pós-censura é a imprecisão da figura do censor e que, tanto num como noutro contexto, a censura impede o exercício da função social da arte, questão que deve ser observada na psicanálise para além da subjetividade individual do artista.

The article deals with censorship in contemporary Brazilian art which, since 2016, with the closing of the Queermuseu exhibition, marked the return of a type of censorship act (post-censorship) that differs from the censorship practiced since redemocratization. To this end, we present a return to the forms of institutionalized censorship in the Military Dictatorship (classical censorship) and its dissolution in culture. Supported by excerpts from some interviews that we carried out in our empirical field, the theoretical articulation is made between the fields of aesthetics, politics and psychoanalysis, with main support in the theories of Michel Foucault, Jacques Rancière and Sigmund Freud. We argue that censorship unequivocally exposes the fact that creation responds to transformations in the political field which, in turn, generate new artistic forms. It is concluded that the main mark of post-censorship is the imprecision of the figure of the censor and that, both in one context and in another, censorship prevents the exercise of the social function of art, an issue that must be observed in psychoanalysis beyond individual subjectivity of the artist.

El artículo trata de la censura en el arte brasileño contemporáneo que, desde 2016, con la clausura de la exposición Queermuseu, marcó el retorno de un tipo de acto de censura (poscensura) que difiere de la censura practicada desde la redemocratización. Para ello, presentamos un retorno a las formas de censura institucionalizadas en la Dictadura Militar (censura clásica) y su disolución en la cultura. Apoyada en extractos de algunas entrevistas que realizamos en nuestro campo empírico, se realiza la articulación teórica entre los campos de la estética, la política y el psicoanálisis, con apoyo principal en Michel Foucault, Jacques Rancière y Sigmund Freud. Argumentamos que la censura expone de manera inequívoca que la creación responde a transformaciones en el campo político que, a su vez, generan nuevas formas artísticas. Se concluye que la principal marca de la poscensura es la imprecisión de la figura del censor y que, tanto en un contexto como en otro, la censura impide el ejercicio de la función social del arte, cuestión que debe observarse en el psicoanálisis más allá de la subjetividad individual del artista.

Salient Beliefs in the Intention for Self-Care Behaviors when Facing Hypertensive Disorders in Pregnant Women / Creencias salientes en la intención de comportamientos de autocuidado ante los trastornos hipertensivos en mujeres embarazadas / Crenças relevantes na intenção de comportamentos de autocuidado para síndromes hipertensivas gestacionais

Introduction: Hypertensive disorders of pregnancy represent a maternal and perinatal health problem. Therefore, it is important to identify the beliefs preceding the determinants of health behaviors during pregnancy. Objective: To identify the salient beliefs in the intention for self-care behaviors when facing hypertensive disorders in pregnant women. Materials and Methods: A descriptive study with a quantitative approach guided by the Theory of Planned Behavior. Each questionnaire was designed and its semantic validity was assessed. The sample was convenience one and included 114 pregnant women enrolled in prenatal control at a health institution from Piedecuesta, Santander, who answered the questionnaire via telephone calls between January and February of 2022. Data analysis was descriptive, resorting to absolute and relative frequencies. Results: The positive behavioral beliefs were focused on the mother's proper nutrition, the baby's healthy growth and development, disease prevention and control during pregnancy, the mother's relaxation and peace of mind, and blood pressure control and monitoring. Regarding normative beliefs, health personnel, mothers, husbands, and family members exert positive influences on each behavior. The following were acknowledged among the control beliefs: visiting family members promotes the practice of physical exercises; at the nutritional level, there is a habit of preferring low-salt preparations; both family and social support and habit and preference favor the consumption of fruit, vegetables, legumes and meats; lack of habit avoids the consumption of fats, flours, sugars, caffeine, alcohol, and cigarettes; purchase power favors calcium intake; taking a previous shower promotes rest and sleep, and going to pharmacies allows controlling blood pressure. Conclusions: Identifying the salient beliefs allowed determining those that need to be reinforced, negotiated, or restructured in achieving self-care behaviors when facing hypertensive disorders in pregnancy.

Introducción: los trastornos hipertensivos del embarazo representan un problema en la salud materna y perinatal. Por lo tanto, es importante identificar las creencias que preceden a los determinantes de los comportamientos en salud durante el embarazo. Objetivo: identificar las creencias salientes en la intención de comportamientos de autocuidado ante los trastornos hipertensivos por parte de la mujer embarazada. Materiales y métodos: estudio descriptivo de enfoque cuantitativo guiado por la teoría del comportamiento planificado. Se diseñó y evaluó la validez semántica de cada cuestionario. La muestra por conveniencia fue de 114 embarazadas inscritas en el control prenatal de una institución de salud de Piedecuesta, Santander, las cuales respondieron el cuestionario a través de entrevista telefónica, entre enero y febrero de 2022. El análisis de los datos fue descriptivo, utilizando frecuencias absolutas y relativas. Resultados: las creencias conductuales positivas se enfocaron en la adecuada nutrición de la madre; en el sano crecimiento y desarrollo del bebé; la prevención y control de enfermedades durante el embarazo; la relajación y la tranquilidad de la madre; y el control y seguimiento de la presión arterial. En las creencias normativas, el personal de salud, la madre, el esposo y familiares influyen positivamente en cada comportamiento. Entre las creencias de control, se admite que: visitar familiares promueve la práctica del ejercicio; a nivel nutricional existe el hábito por preparaciones bajas en sal; tanto el apoyo familiar y social como el hábito y el gusto favorecen el consumo de frutas, verduras, legumbres y carnes; la falta de hábito evita el consumo de grasas, harinas, azúcares, cafeína, alcohol o cigarrillo; la capacidad económica favorece la ingesta del calcio; tomar una ducha previa promueve el sueño y descanso; y asistir a farmacias permite el control de la presión arterial. Conclusiones: la identificación de las creencias salientes permitió demostrar aquellas que necesitan ser reforzadas, negociadas o reestructuradas en el logro de comportamientos de autocuidado ante los trastornos hipertensivos del embarazo.

Introdução: as síndromes hipertensivas gestacionais representam um problema na saúde materna e perinatal. Portanto, é importante identificar as crenças que precedem os determinantes dos comportamentos de saúde durante a gravidez. Objetivo: identificar as crenças relevantes na intenção de comportamentos de autocuidado diante de distúrbios hipertensivos por parte das gestantes. Materiais e método: estudo descritivo com abordagem quantitativa orientada pela teoria do comportamento planejado. A validade semântica de cada questionário foi elaborada e avaliada. A amostra de conveniência foi composta de 114 gestantes inscritas no pré-natal de uma instituição de saúde em Piedecuesta, Santander (Colômbia), que responderam ao questionário por meio de entrevista telefônica entre janeiro e fevereiro de 2022. A análise dos dados foi descritiva, usando frequências absolutas e relativas. Resultados: as crenças comportamentais positivas se concentraram em nutrição adequada para a mãe; crescimento e desenvolvimento saudáveis do bebê; prevenção e controle de doenças durante a gravidez; relaxamento e tranquilidade para a mãe; e controle e monitoramento da pressão arterial. Nas crenças normativas, a equipe de saúde, a mãe, o companheiro e os membros da família influenciam positivamente cada comportamento. Entre as crenças de controle, admite-se que visitar parentes promove a prática de exercícios; no nível nutricional, há o hábito de preparações com pouco sal; tanto o apoio familiar e social quanto o hábito e o gosto favorecem o consumo de frutas, verduras, legumes e carnes; a falta de hábito evita o consumo de gorduras, farinhas, açúcares, cafeína, álcool ou cigarros; a capacidade econômica favorece a ingestão de cálcio; tomar banho antes da gravidez promove o sono e o descanso; e ir a farmácias permite o controle da pressão arterial. Conclusões: a identificação das crenças relevantes nos permitiu demonstrar aquelas que precisam ser reforçadas, negociadas ou reestruturadas na obtenção de comportamentos de autocuidado diante de síndromes hipertensivas gestacionais.

Safety culture among operating room healthcare workers: still a long way to go. An analytical cross-sectional study from Turkey

Introduction: safety culture attitudes of health workers are still not at the desired level. Although the creation of patient safety culture is important for all health care environments, it is more vital for critical units. Objective: to determine the patient safety culture levels of those working in the operating room environment and compare them with the 2008 results of the same hospitals. Materials and Methods: an analytical cross-sectional study was conducted in 2017-2018. The Turkish version of the Hospital Survey on Patient Safety Culture was administered to nurses, anesthesia technicians, assistant physicians, and specialist physicians working in the Operating Rooms (n=258) of two university hospitals in Konya, a large city in Anatolian region of Turkey. Results: average percent positive response to the 42 items was low (41%, n=258). While there was no change in one dimension of the questionnaire compared to 2008; there was a positive change in 8 dimensions and a negative change in 3 dimensions. All 12 dimensions were lower than the Agency for Healthcare Research and Quality score. Discussion: Despite many studies, policy developments and interventions on patient safety, the improvement of a patient safety culture is very slowly in Turkey as in other countries. Conclusion: non-reporting of errors and a punitive approach in case of errors are still considered the most important problems.

Introducción: las actitudes del personal de salud frente a la cultura de la seguridad siguen sin alcanzar su nivel deseado. Aunque la creación de una cultura de seguridad del paciente es importante en todos los entornos de cuidado, es vital en las unidades de cuidado crítico. Objetivo: determinar los niveles de cultura de seguridad del paciente de quienes trabajan en quirófanos y compararlos con los 2008 resultados de los mismos hospitales. Materiales y métodos: se realizó un estudio transversal analítico entre 2017 y 2018. La versión en turco de la Encuesta Hospitalaria sobre Cultura de Seguridad del Paciente se administró a profesionales de enfermería, anestesistas, médicos auxiliares y médicos especialistas que trabajaban en los quirófanos (n=258) de dos hospitales universitarios de Konya, una ciudad de la región de Anatolia en Turquía. Resultados: El porcentaje medio de respuestas positivas a los 42 ítems fue bajo (41%, n=258). Si bien no hubo cambios en una dimensión del cuestionario en comparación con los 2008 resultados, hubo un cambio positivo en 8 dimensiones y un cambio negativo en 3 dimensiones. Las 12 dimensiones presentaron una puntuación inferior a la de la Agencia para la Investigación y la Calidad del Cuidado de la Salud. Discusión: A pesar de los numerosos estudios, desarrollos en política e intervenciones en materia de seguridad del paciente, la mejora de la cultura de seguridad del paciente es muy lenta en Turquía, al igual que en otros países. Conclusión: No notificar errores y un enfoque punitivo en caso de error siguen considerándose los problemas más importantes.

Introdução: as atitudes de cultura de segurança dos profissionais de saúde ainda não estão no nível desejado. Embora a criação da cultura de segurança do paciente seja importante para todos os ambientes de assistência médica, ela é mais vital para as unidades críticas. Objetivo: determinar os níveis de cultura de segurança do paciente daqueles que trabalham no ambiente da sala de cirurgia e compará-los com os resultados de 2008 dos mesmos hospitais. Materiais e Métodos: um estudo analítico de corte transversal foi realizado em 2017-2018. A versão turca da Pesquisa Hospitalar sobre Cultura de Segurança do Paciente foi aplicada a enfermeiros, técnicos de anestesia, médicos assistentes e médicos especialistas que trabalham nas salas de cirurgia (n=258) de dois hospitais universitários em Konya, uma grande cidade na região da Anatólia, Turquia. Resultados: a porcentagem média de respostas positivas aos 42 itens foi baixa (41%, n=258). Embora não tenha havido alteração em uma dimensão do questionário em comparação com 2008, houve uma alteração positiva em 8 dimensões e uma alteração negativa em 3 dimensões. Todas as 12 dimensões foram inferiores à pontuação da Agency for Healthcare Research and Quality. Discussão: Apesar de muitos estudos, desenvolvimentos de políticas e intervenções sobre a segurança do paciente, o aprimoramento de uma cultura de segurança do paciente é muito lento na Turquia, assim como em outros países. Conclusão: a não notificação de erros e uma abordagem punitiva em caso de erros ainda são considerados os problemas mais importantes.

The effect of Chinese culture-adapted dignity therapy on advanced cancer patients receiving chemotherapy in the day oncology unit: A quasi-experimental study.

PURPOSE: To examine the effects of Chinese culture-adapted dignity therapy on dignity-related and psychological, spiritual distress and family function for advanced cancer patients receiving chemotherapy in the day oncology unit. METHOD: This is a quasi-experimental study. Patients were recruited from a day oncology unit at a tertiary cancer hospital in Northern China. A total of 39 patients agreeing to participate were assigned to receive Chinese culture-adapted dignity therapy (intervention group, n = 21) or supportive interview (control group, n = 18) according to their admission time. Patients' dignity-related, psychological, spiritual distress, and family function were assessed at baseline (T0) and after completing the intervention (T1) and the scores were compared between and within the groups. Besides, the interviews were conducted with patients at T1 to obtain their feedback, which were analyzed and integrated with the quantitative results. RESULTS: There was no statistical significance in all outcomes at T1 between the two groups, as well as in most outcomes between T0 and T1 in the intervention groups except for the relieved dignity-related distress (P = 0.017), especially the physical distress (P = 0.026), and the improved family function (P = 0.005), especially the family adaptability (P = 0.006). The synthesized quantitative and qualitative results showed that the intervention could relieve physical and psychological distress, enhance the sense of dignity, and improve the spiritual well-being and family function of patients. CONCLUSIONS: The Chinese culture-adapted dignity therapy showed positive effects on the life experiences of patients receiving chemotherapy in the day oncology unit and their family, and it might be a suitable, indirect communication prompt for Chinese families.

Federated Learning with Research Prototypes: Application to Multi-Center MRI-based Detection of Prostate Cancer with Diverse Histopathology.

RATIONALE AND OBJECTIVES: Early prostate cancer detection and staging from MRI is extremely challenging for both radiologists and deep learning algorithms, but the potential to learn from large and diverse datasets remains a promising avenue to increase their performance within and across institutions. To enable this for prototype-stage algorithms, where the majority of existing research remains, we introduce a flexible federated learning framework for cross-site training, validation, and evaluation of custom deep learning prostate cancer detection algorithms. MATERIALS AND METHODS: We introduce an abstraction of prostate cancer groundtruth that represents diverse annotation and histopathology data. We maximize use of this groundtruth if and when they are available using UCNet, a custom 3D UNet that enables simultaneous supervision of pixel-wise, region-wise, and gland-wise classification. We leverage these modules to perform cross-site federated training using 1400+ heterogeneous multi-parameteric prostate MRI exams from two University hospitals. RESULTS: We observe a positive result, with significant improvements in cross-site generalization performance with negligible intra-site performance degradation for both lesion segmentation and per-lesion binary classification of clinically-significant prostate cancer. Cross-site lesion segmentation performance intersection-over-union (IoU) improved by 100%, while cross-site lesion classification performance overall accuracy improved by 9.5-14.8%, depending on the optimal checkpoint selected by each site. CONCLUSION: Federated learning can improve the generalization performance of prostate cancer detection models across institutions while protecting patient health information and institution-specific code and data. However, even more data and participating institutions are likely required to improve the absolute performance of prostate cancer classification models. To enable adoption of federated learning with limited re-engineering of federated components, we open-source our FLtools system at https://federated.ucsf.edu, including examples that can be easily adapted to other medical imaging deep learning projects.

O pensamento complexo da comunicação organizacional: sobre identidade, imagem-conceito e gestão de imagem da ciência e do SUS / The complex thinking of organizational communication: on identity, concept-image and image management of science and of SUS / El pensamiento complejo de la comunicación organizacional: sobre identidad, imagen-concepto e gestión de la imagen de la ciencia y del SUS

A vivência num caminho de empregado de 'chão de fábrica' de grande empresa a gestor de uma pequena empresa, junto às teorias de comunicação, contribuíram para as reflexões acadêmicas no campo da comunicação organizacional do cientista e professor Rudimar Baldissera. Em entrevista à Reciis, o professor mobiliza termos frequentemente associados à comunicação e às organizações, tais como imagem-conceito, identidade e públicos, e problematiza o prisma das decisões e dos objetivos da gestão em perspectiva da comunicação para a partilha, o diálogo, a ação/retroação e as perturbações geradas pelos diversos públicos que são constitutivos das organizações. Por meio de reflexões a partir do paradigma da complexidade, Baldissera discorre sobre o 'tecer' e 'retecer'da imagem das instituições de saúde, da ciência, das universidades públicas e do SUS, no contexto contemporâneo marcado pela emergência sanitária da covid-19. Destaca a comunicação organizacional como um campo consolidado na construção da crítica e do conhecimento na área da comunicação e informação. Rudimar Baldissera é professor associado do Departamento de Comunicação ­ Faculdade de Biblioteconomia e Comunicação (Fabico), e professor e pesquisador do PPGCOM/UFRGS

Along with communication theories, the experience acquired during the path from 'factory floor' employee to manager of a small business contributed to the academic reflections done by scientist and professor Rudimar Baldissera in the organizational communication field. In an interview to Reciis, the professor mobilizes terms frequently associated with communication and organizations, such as concept-image, identity and audience, and problematizes the prism of decisions and objectives of management in perspective of communication for sharing, dialogue, action/feedback and disturbances generated by the different publics that are constitutive of organizations. Through reflections from the paradigm of complexity, Baldissera discusses the 'weaving' and 'reweaving' of the image of health institutions, science, public universities and SUS, in the contemporary context marked by the health emergency of covid-19. He highlights organizational communication as a consolidated field in the construction of criticism and knowledge in communication and information field. Rudimar Baldissera is an associate professor at the Department of Communication ­ Faculty of Library Science and Communication (Fabico), and professor and researcher at PPGCOM/UFRGS

La experiencia en un camino de empleado en el 'piso de fábrica' de una gran empresa a gerente de una pequeña, junto con las teorías de la comunicación, contribuyó a las reflexiones académicas en el campo de la comunicación organizacional del científico y profesor Rudimar Baldissera. En entrevista con Reciis, el profesor moviliza términos frecuentemente asociados con la comunicación y las organizaciones, como ima-gen-concepto, identidad y públicos, y problematiza el prisma de las decisiones y objetivos de la gestión en la perspectiva de la comunicación para compartir, el diálogo, la acción/retroalimentación y las perturbaciones generadas por los diversos públicos que son constitutivos de las organizaciones. A través de reflexiones desde el paradigma de la complejidad, Baldissera discute el 'tejer' y 'retejer' de la imagen de las institucio-nes de salud, la ciencia, las universidades públicas y el SUS, en el contexto contemporáneo marcado por la emergencia sanitaria de la covid-19. Destaca la comunicación organizacional como un campo consolidado en la construcción de la crítica y el conocimiento en el campo de la comunicación y información. Rudimar Baldissera es profesor asociado del Departamento de Comunicación de la Facultad de Biblioteconomía y Comunicación (Fabico) y docente e investigador del PPGCOM/UFRGS

Early cervical cancer screening: The influence of culture and religion.

BACKGROUND: Screening for cervical cancer at an early stage is essential for providing women with a better chance of receiving effective treatment for both precancers and cancer. Delaying screening until cancer has advanced can be detrimental, resulting in late presentation of cervical cancer and, as a result, cancer metastasis. AIM: The purpose of this study was to assess the extent to which culture and religion influence early cervical cancer screening in women. SETTING: The research was conducted in one of the rural districts in Manicaland Province of Zimbabwe. METHODS: A qualitative exploratory and contextual design was utilised, and data were gathered by means of semistructured interviews. At 17 semistructured interviews, data saturation was reached and further data collection terminated. Data were thematically analysed. RESULTS: Five themes that described participants' perceptions on culture and religion as barriers to early cervical cancer screening emerged from the data. These included a lack of knowledge, stigmatisation, cultural beliefs and values, religion and a lack of resources. These all negatively affected participants' motivation to seek early screening services. CONCLUSION: According to the study findings, culture and religion constitute impediments to early cervical cancer screening for rural women. Interventions that encourage screening, such as targeted health education and health promotion materials, must consider cultural and religious views if behaviour change in diverse groups is to be accomplished.Contribution: The study has the potential to inform Zimbabwean health policy and contribute to prospective interventions or health education that encourage women to attend early cancer screening.

Magnetoelastic Monitoring System for Tracking Growth of Human Mesenchymal Stromal Cells.

Magnetoelastic sensors, which undergo mechanical resonance when interrogated with magnetic fields, can be functionalized to measure various physical quantities and chemical/biological analytes by tracking their resonance behaviors. The unique wireless and functionalizable nature of these sensors makes them good candidates for biological sensing applications, from the detection of specific bacteria to tracking force loading inside the human body. In this study, we evaluate the viability of magnetoelastic sensors based on a commercially available magnetoelastic material (Metglas 2826 MB) for wirelessly monitoring the attachment and growth of human mesenchymal stromal cells (hMSCs) in 2D in vitro cell culture. The results indicate that the changes in sensor resonance are linearly correlated with cell quantity. Experiments using a custom-built monitoring system also demonstrated the ability of this technology to collect temporal profiles of cell growth, which could elucidate key stages of cell proliferation based on acute features in the profile. Additionally, there was no observed change in the morphology of cells after they were subjected to magnetic and mechanical stimuli from the monitoring system, indicating that this method for tracking cell growth may have minimal impact on cell quality and potency.