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Background Cysteinyl leukotrienes (CysLT) are potent inflammation-promoting mediators, but remain scarcely explored in COVID-19. We evaluated urinary CysLT (U-CysLT) relationship with disease severity and their usefulness for prognostication in hospitalized COVID-19 patients. The impact on U-CysLT of veno-venous extracorporeal membrane oxygenation (VV-ECMO) and of comorbidities such as hypertension and obesity was also assessed. Methods Blood and spot urine were collected in “severe” (n = 26), “critically ill” (n = 17) and “critically ill on VV-ECMO” (n = 17) patients with COVID-19 at days 1–2 (admission), 3–4, 5–8 and weekly thereafter, and in controls (n = 23) at a single time point. U-CysLT were measured by ELISA. Routine markers, prognostic scores and outcomes were also evaluated. Results U-CysLT did not differ between groups at admission, but significantly increased along hospitalization only in critical groups, being markedly higher in VV-ECMO patients, especially in hypertensives. U-CysLT values during the first week were positively associated with ICU and total hospital length of stay in critical groups and showed acceptable area under curve (AUC) for prediction of 30-day mortality (AUC: 0.734, p = 0.001) among all patients. Conclusions U-CysLT increase during hospitalization in critical COVID-19 patients, especially in hypertensives on VV-ECMO. U-CysLT association with severe outcomes suggests their usefulness for prognostication and as therapeutic targets.

O objetivo principal deste estudo é investigar a influência dos valores organizacionais no processo de transferência de tecnologia nas empresas brasileiras. O presente estudo é de natureza teórica e busca compreender os valores organizacionais e as fontes de transferência de tecnologia nas organizações brasileiras. A metodologia foi a pesquisa exploratória, com delineamento levantamento utilizando a abordagem quantitativa, através de dois instrumentos de pesquisas desenvolvidos por Pinto (2006). As conclusões são baseadas em uma pesquisa com quatro empresas que ganharam o Prêmio Brasil de Inovação em 2017 e pertecem a diferentes setores. Em primeiro lugar os resultados mostram a ausência de variações significativas nos dados fornecidos pela pequena amostra e no sentido da coesão dos valores organizacionais e suas preferências pelas fontes de transferência de tecnologia. Em segundo lugar, a pesquisa enfatiza a influência dos valores culturais nas práticas corporativas e no processo de tomada de decisão nessas organizações.

Background: Healthcare professionals are increasingly making end-of-life decisions (ELDs), which have become an integrated dimension of contemporary palliative and end-of-life care. ELDs are medical decisions made at the end of life that may have a potentially life-shortening effect. These situations are very often moments of high vulnerability with a profound impact on patients' ability to exercise their autonomy. Healthcare professionals perceive end-of-life decision-making as complex, difficult, and stressful. Evidence shows that making ELDs is frequently associated with burnout and moral distress. Strategies need to be implemented to enhance ethical decision-making at the end-of-life. Aim: To explore and discuss strategies on how to promote team empowerment within interdisciplinary teams to support and enhance ethical decision-making processes surrounded by uncertainty, risk, and asymmetry of information. Methods: This presentation is based on the work developed within project DELiCare: Decisions, Decision-making, and End-of-Life Care: Ethical Framework and Reasoning. The knowledge, experiences, and evidence from different fields will be mobilized and integrated to build theoretical and empirical frameworks. The structure and processes that can enhance ethico-clinical decision-making processes and their effectiveness in palliative and end-of-life care will be explored. Results: The need to make ELDs requires healthcare professionals and teams, as well as patients and family members, to embrace ethico-clinical decision-making processes under uncertainty, risk, and asymmetry of information. Shared decision-making is a cooperative process among healthcare professionals, patients, and families that enables a way of decision-making combining both the professionals’ expertise and the patient’s values, preferences, and goals. Shared decision-making processes should integrate information exchange, a deliberation period and making a decision. Communication among all stakeholders is paramount. Conclusions: Shared decision-making processes helps teams to bring together information and views, anticipate scenarios, and prepare a joint and common approach to the decision that needs to be made. This team empowering strategy fosters the sense of both individual and teamwork meaning, a core dimension of empowerment. By fostering shared decision-making processes, professionals and teams feel more empowered and are more effective in meeting patients’ values, wishes and preferences.

Dear Colleagues, dear Friends; It is a pleasure to welcome you to the 18th World Congress of the European Association for Palliative Care in Rotterdam. This 2023 congress is the first face-to-face congress organized by the EAPC since 2019. Like other EAPC congresses, this congress is the result of two years of planning, organisation, meetings, reflection, and decision-making. Finally, here we are! It has been my honour to co-chair the Scientific Committee of this congress together with my colleague Agnes Csikos. For the first time, as far as I remember, the Scientific Committee, composed of a dedicated group of colleagues (thank you Alberto Alonso, Augusto Caraceni, Fin Craig, Jeroen Hasselaar, Martin Loucka, Wendy Oldenmenger, Christoph Ostgathe, Danai Papadatou, Nancy Preston, Audrey Roulston, and Rainer Simader), was co-chaired by two women who have the particularity of living in the South and Eastern parts of Europe. Under the theme “Equity and Diversity in Palliative Care”, the EAPC 2023 congress focuses on understanding health inequities and diversity in palliative care. Through a rich and diversified program, this congress draws attention to the utmost need and goal of creating equity of fair access, opportunity, and advancement in palliative care for all people in need of this care, within a context of diversity. We will have the opportunity to reflect on ways to better understand why and how inequities in palliative care occur, develop strategies aimed at reducing those inequities, and identify which challenges and policies could help to improve equity in palliative care. That is why, determining the prominent factors in the production of inequities in palliative care and deciding which ones are most amenable to change is paramount. As an operational definition of equity in palliative care, we adapted the definition proposed by the International Society for Equity in Health. Equity in palliative care is the absence of systematic and potentially remediable differences in one or more aspects of palliative care outcomes across socially, demographically, or geographically defined population groups. There is no basis for expecting a single characteristic or set of characteristics to be most influential in causing inequities in palliative care. Evidence suggests otherwise. To complement the understanding of health inequities in palliative care, we need to take diversity in palliative care into account. The definition of diversity encompasses variety and the condition of being different or having differences. Rarely are diverse influences simultaneously explored in the literature to better understand and tackle plausible explanations for inequities in palliative care. Sometimes, diversity is used as a euphemism for “outside the majority” or “different from the dominant group”. Yet, as human beings, diversity is part of who we are. We are inherently diverse, and evidence shows that when reflecting on and discussing palliative care, there is no “one size fits all”. Are we promoting equity in palliative care? If not, why are we failing on equity in palliative care? Do we spend inadequately or inappropriately on palliative care provision? Why in a world now much more aware of the impact of the social determinants of health are the world’s most vulnerable persons still missing out? Why are we still failing in providing increased or augmented palliative care services for socially, demographically, or geographically defined population groups with greater palliative care needs? How can diversity help to understand and tackle inequities in palliative care? These are just a few examples of questions that will certainly become “food for thought” during our days together in Rotterdam. And, we are so grateful to all and each one of you for your contributions to the scientific programme. The 18th World Congress of the European Association for Palliative Care gives us the opportunity to reconnect and share all the exiting work that is being developed within our worldwide palliative care community. These days together offer us the amazing chance to meet colleagues and friends, to be inspired and inspire others, and to re-energise ourselves to face the future challenges for palliative care.Promoting equity and taking diversity into account is not only the theme of the 18th World Congress of the EAPC. They should also be at the heart of palliative care practice, organisation, research, education, advocacy, and policy. I wish you a wonderful and exciting congress and look forward to meeting you in Rotterdam.

The ability to deliver oxygen to the skeletal muscles and use it to generate energy to support muscle activity is known as cardiorespiratory fitness (CRF). Because of its importance to health, young people’s declining CRF is a cause of concern. Therefore, promoting CRF through physical activity (PA) participation is needed. Among young people, the school setting has been proposed as a privileged context to promote PA and CRF, and school-based PA interventions are known to improve PA and CRF. Nevertheless, school-based PA interventions are not universal and may not be sustainable over long periods if the mobilized resources are not sustained. There is a need to promote sustainable health promotion actions to maintain their benefits beyond the initial stage of implementation and deliver within the limits of the available resources. One way of doing so is through physical education (PE). PE is part of the curriculum in most countries, allows children and adolescents to engage in PA, and is supervised by trained PE teachers. The school is a privileged context for health promotion actions through its regular implementation across most education years. This chapter advocates PE as a privileged setting for promoting PA and CRF.

Este estudo apresenta reflexões sobre o trabalho interdisciplinar com idosos, a partir da visão da equipe de profissionais de Psicologia e Assistência Social de uma Instituição de Longa Permanência para Idosos (ILPI). Foi abordada a contribuição da atuação interprofissional, considerando-se os aspectos biopsicossociais do envelhecimento, a promoção de saúde e a institucionalização. Os resultados mostram o benefício de ações nessa perspectiva e a importância da compreensão do acolhido e do processo de acolhimento em seus múltiplos aspectos.

This study aims to analyze working conditions according to Brazilian and Chinese labor laws. A systematic literature review was made through the Methodi Ordinatio method, researching papers in Emerald, PubMed, SciELO, Science Direct, Scopus and Web of Science databases in terms of the corporate code of conduct, labor legislation, working conditions, labor laws, Brazil and China descriptors, considering 94 papers for the final analysis, within which 42 are related to Brazilian working conditions and 52 to Chinese ones. Regarding Brazil, the studies highlight job insecurity and, consequently, point the flexibilization of labor laws. The informal employment is one of the concerns in the studies related to Chinese working conditions. In both countries there are gaps when it comes to working conditions and future researches can investigate the cohesion lack between the formal law and the applied one.

To analyse whether pre-exercise CHO + PRO vs. CHO intake distinctly influences running performance and metabolic biomarkers along a various of exercise intensities.In a randomised, double blind, counterbalanced, crossover and placebo control design, 10 middle distance runners were tested in 3 occasions. After 10 h of fasting, participants ingested isovolumic beverages (0.75 + 0.25g·BW-1 of CHO + PRO, 1.0g·BW-1 of CHO and placebo control) 30 min before a treadmill running incremental protocol of 4 min steps until exhaustion. Venous blood was collected at fasting, 30 min after beverage ingestion and after the 3rd and 7th running steps. Oxygen uptake-related variables, including respiratory exchange ratio, heart rate, plasma glucose, insulin, glucagon, free fatty acids, blood lactate concentrations, gastrointestinal discomfort and rate of perceived exertion were measured.The addition of PRO to CHO had no influence on the measured variables, which did not differ between conditions along all incremental protocol intensities. The intake of CHO + PRO (compared to CHO) tended to decrease glycaemia (106.5 ± 21.3 vs. 113.6 ± 26.5) and to increase insulinaemia (14.4 ± 15.1 vs. 12.7 ± 10.8) at intensities close to maximum oxygen uptake.The addition of PRO to a pre-exercise CHO beverage had no impact on running performance and related metabolic variables at a wide spectrum of exercise intensities.

O presente artigo tem por objetivo analisar como a capacidade absortiva pode gerar inovação dentro de um Arranjo Produtivo Local (APL) de móveis na cidade de Marco, no interior do Ceará. Tal estudo se deu em cinco empresas inseridas no polo moveleiro do Marco, Cidade do Estado do Ceará que, configura-se como 8º arranjo produtivo local do país, e com o presidente da associação local. Caracteriza-se como um estudo qualitativo, utilizando-se como instrumento para coleta de dados um roteiro de entrevista semiestruturado, pesquisa documental e a técnica de observação, como forma de complementar a coleta de dados. O estudo mostra como uma nova relação entre empresas se manifesta dentro de um ambiente dinâmico ainda considerado incipiente se comparado a outros locais ou países. Baseado na análise dos dados salienta-se que a capacidade absortiva se caracteriza por meio de mecanismos desenvolvidos pelas próprias empresas em níveis diferentes, o que traz inovação em algumas áreas, como produtos, processos ou serviços desenvolvidos. O Arranjo Produtivo Local do Marco torna-se referência numa região onde a capacidade produtiva e as competências se tornam diferencial para o pleno desenvolvimento da região.

Objectives: To review and synthetize the evidence on end-of-life in burn intensive care units about (i) the characteristics of end-of-life in burn intensive care units, (ii) the symptom control provided to burned patients facing dying and death in this context, and (iii) the concept, models and designs of the care provided. Methods: Systematically conducted scoping review, following Arksey and O'Malley's framework. Preferred Reporting Items for Systemic Reviews extension for Scoping Reviews was used as a reporting guideline. Searches were performed in three databases, with no time restriction and up to September 2021. Results: 16,287 documents identified; thirteen (13) selected for analysis and synthesis. Three key themes emerged: (i) characteristics of the end-of-life in burn intensive care units, including end-of-life decisions, decision-making processes, causes and trajectories of death; (ii) symptom control at the end-of-life in burn intensive care units focusing on patients’ comfort; and (iii) concepts, models, and designs of the care provided to burned patients at the end-of-life, mainly care approaches, provision of care and palliative care.Significance of Results: End-of-life care is a major step in the care provided to critically ill burned patients. Dying and death in burn intensive care units are often preceded by end-of-life decisions, namely forgoing treatment, and do-not-attempt to resuscitate. Different dying trajectories were described, suggesting the possibility to develop further studies to identify triggers for palliative care referral. Symptom control was not described in detail. Palliative care was rarely involved in end-of-life care for these patients. This review highlights the need for early and high-quality palliative and end-of-life care in the trajectories of critically ill burned patients, leading to an improved perception of end-of-life in burn intensive care units. Further research is needed to study the best way to provide optimal end-of-life care and foster integrated palliative care in burn intensive care units.

Objectives The aim of this article is to review and synthesize the evidence on end-of-life in burn intensive care units. Methods Systematic scoping review: Preferred Reporting Items for Systemic Reviews extension for Scoping Reviews was used as a reporting guideline. Searches were performed in 3 databases, with no time restriction and up to September 2021. Results A total of 16,287 documents were identified; 18 were selected for analysis and synthesis. Three key themes emerged: (i) characteristics of the end-of-life in burn intensive care units, including end-of-life decisions, decision-making processes, causes, and trajectories of death; (ii) symptom control at the end-of-life in burn intensive care units focusing on patients’ comfort; and (iii) concepts, models, and designs of the care provided to burned patients at the end-of-life, mainly care approaches, provision of care, and palliative care. Significance of results End-of-life care is a major step in the care provided to critically ill burned patients. Dying and death in burn intensive care units are often preceded by end-of-life decisions, namely forgoing treatment and do-not-attempt to resuscitate. Different dying trajectories were described, suggesting the possibility to develop further studies to identify triggers for palliative care referral. Symptom control was not described in detail. Palliative care was rarely involved in end-of-life care for these patients. This review highlights the need for early and high-quality palliative and end-of-life care in the trajectories of critically ill burned patients, leading to an improved perception of end-of-life in burn intensive care units. Further research is needed to study the best way to provide optimal end-of-life care and foster integrated palliative care in burn intensive care units.

Este artigo foi elaborado a partir de pesquisa de campo desenvolvida no Museu Nacional da Colômbia em 2011 durante realização do doutorado no Programa de Pós-graduação Integração da América Latina – PROLAM/USP. Dessa forma, contém informações e dados compilados no período da investigação, bem como relatos de entrevistas obtidas e efetuadas durante o trabalho de campo no Museu. O texto tem como objetivo refletir sobre estratégias e ações educativas, desenvolvidas que buscam estimular a participação e a experiência nos museus por meio das interações ali promovidas. O foco principal é a exposição “Velórios Vivos”, realizada em 2010 pelo Museu Nacional da Colômbia e que apresenta práticas fúnebres de comunidades raizales e palenqueras colombianas1. A escolha desta mostra para compor o artigo se deve a suas aspectos inovadores indo ao encontro das perspectivas adotadas pela museologia social e por ser permeada pelo que hoje vem sendo denominado de pensamento decolonial ou decolonialidade2. Trata-se de um texto que visa contribuir para o debate sobre as práticas museais que tem por finalidade promover identidades e diversidades culturais, fomentar a participação e os diálogos e ampliar as relações com o ambiente sociocultural.