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Objectives: to evaluate the relative risk of smoking cessation treatment dropout during its intensive phase., Methods: a retrospective and quantitative cohort study was developed from the electronic medical records of individuals who started smoking cessation treatment between 2015 and 2019 at a specialty clinic in a city in the interior of São Paulo, Brazil. The relative risk of dropping out of treatment was calculated using the Poisson regression model., Results: it was observed that out of the 396 (100.0%) individuals who started the treatment, 109 (27.5%) abandoned it before the end of the intensive phase. For each one-year increase in age, the risk of dropping out of smoking cessation treatment decreased by an average of 2%., Conclusions: the risk of dropping out of smoking cessation treatment is higher among younger individuals. It is necessary to rethink the care offered to younger adults to promote the continuity of treatment.

Background: Hansen's disease is a chronic, infectious and transmissible disease that is considered a public health problem in Brazil. Hansen's disease is marked by stigma and prejudice, because it carries with it a strong negative social image, reinforced by policies of social isolation in the community., Methods: A qualitative study was conducted in Ribeirão Preto, an inland city of the state of São Paulo, Brazil. Eleven patients under treatment for the disease were interviewed. The interviews were audio recorded and transcribed in full, then were analyzed through the stages of transcription, transposition and reconstitution, as informed by concepts proposed by Goffman., Results: The results showed that the marks of stigma are still present in the twenty-first century and were presented in two axes: 'Stigma and work for the person affected by Hansen's disease' and 'The experience of stigma in the family'. The participants refer to fears of losing their jobs and of being ridiculed, which stops them talking about the disease. Regarding their families, the participants reported episodes of discrimination, the creation of family secrets and fear of relatives' reactions., Conclusions: All these aspects interfere in the follow-up and treatment of patients and need to be considered and welcomed by health professionals. It is recommended that these aspects are addressed in the initial training and continuing education of health professionals., Contexte: La maladie de Hansen est une maladie chronique, infectieuse et transmissible, considérée comme un problème de santé publique au Brésil. La maladie de Hansen est marquée par la stigmatisation et les préjugés, car elle véhicule une image sociale fortement négative, renforcée par des politiques d'isolement social au sein de la communauté., Méthodes: Étude qualitative menée à Ribeirão Preto, une ville intérieure de l'État de São Paulo, au Brésil. Onze patients traités pour la maladie ont été interrogés. Les entretiens ont été enregistrés et transcrits intégralement, et ont été analysés en suivant les étapes de transcription, de transposition et de reconstitution, selon les concepts proposés par Goffman., Résultats: Les résultats montrent que les marques de la stigmatisation sont toujours présentes au 21ème siècle et ont été présentées selon deux axes : 'La stigmatisation et le travail pour la personne affectée par la maladie de Hansen' et 'L'expérience de la stigmatisation dans la famille'. Les participants évoquent la peur de perdre leur emploi, la peur d'être ridiculisés, ce qui les pousse à ne pas parler de la maladie. En ce qui concerne les familles, les participants ont rapporté des épisodes de discrimination, la création de secrets de famille et la peur des réactions des proches., Conclusions: Tous ces aspects interfèrent dans le suivi et le traitement des patients et doivent être pris en compte et accueillis par les professionnels de la santé. Il est recommandé que ces aspects soient abordés dans la formation initiale et la formation continue des professionnels de la santé., Antecedentes: La enfermedad de Hansen es una enfermedad crónica, infecciosa y transmisible, considerada un problema de salud pública en Brasil. La enfermedad de Hansen está marcada por el estigma y el prejuicio, ya que conlleva una fuerte imagen social negativa, reforzada por políticas de aislamiento social en la comunidad., Métodos: Estudio cualitativo realizado en Ribeirão Preto, una ciudad del interior del estado de São Paulo, Brasil. Se entrevistaron a once pacientes en tratamiento para la enfermedad. Las entrevistas fueron grabadas en audio, transcritas en su totalidad y analizadas a través de etapas de transcripción, transposición y reconstitución, según los conceptos propuestos por Goffman., Resultados: Los resultados muestran que las marcas del estigma siguen presentes en el siglo XXI y se presentaron en dos ejes: 'Estigma y trabajo para la persona afectada por la enfermedad de Hansen' y 'La experiencia del estigma en la familia'. Los participantes mencionan el miedo a perder sus trabajos, el temor a ser ridiculizados, lo que les impide comentar sobre la enfermedad. En cuanto a las familias, los participantes reportaron episodios de discriminación, la creación de secretos familiares y el miedo a las reacciones de los familiares., Conclusiones: Todos estos aspectos interfieren en el seguimiento y tratamiento de los pacientes y deben ser considerados y acogidos por los profesionales sanitarios. Se recomienda abordar estos aspectos en la formación inicial y la educación continua de los profesionales sanitarios., (© The Author(s) 2024. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.)

Objective: To analyze the influences of the institutions in the operation of the Local Health councils., Design: qualitative, descriptive and exploratory study., Study Setting: 02 Primary Health Care services of a municipality in the inland of the state of São Paulo, Brazil., Participants: twenty-four members of the Local Health Councils and 4 key informants., Methods: Supported by the theoretical methodological framework of Institutional Analysis. Data were produced through 28 semi-structured interviews, observation and participation in the activities of the councils and recording in the research diary. Data were organized and analyzed by the process of transcription, transposition and reconstitution., Results: The institutions act in the territories represented by social actors who occupy positions and functions within the Primary Health Care services, evidencing the perpetuation of hierarchization with valorization of the speeches of professionals and managers to the detriment of patients and predominance of bureaucratized meetings. The social actors reproduce the ideals of the collective to which they belong in these spaces., Conclusions: The health management teams do not recognize the different forces that act in the health territory, however, these forces interfere in the activities performed and in health care. The groups act both in formal spaces through official representatives who meet and discuss issues in collegiate meetings and in informal spaces, and constitute forces in dispute in the health territory., (Copyright © 2023 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.)

Violence demands considerable attention due to its complexity and social consequences. The objective of this study was to analyze violence in the nursing professional workplace in the context of primary health care in Brazil. It is a qualitative study with theoretical and methodological reference to institutional analysis. It was carried out in basic health units in Brazil. Nursing professionals (N = 11) participated in semi-structured interviews and discussion groups, in addition to a research diary and participant observation. Data collection took place from October to December 2021. The results are presented in five categories: types of violence and aggressors from the perspective of nursing professionals; the causes of violence reported by professionals; strategies for the management of violence; professionals' proposals for preventing violence in health contexts; the consequences of violence in the workplace. Nursing professionals make up a large part of the workforce and have reported verbal, physical, moral, and psychological violence. The main causes are associated with user access to services. For the prevention of violence, professionals do not see themselves as protagonists of change. The consequences are the loss of quality of work and the health of professionals who requested sick leave and transfers. The study's findings can help in the development of public policies and educational and management actions.

Fish Aggregating Devices (FADs) are anchored floating structures often made with cheap scrapped materials and used to aggregate pelagic fish species under their artificial shadows. Globally, the dangerous impact of FADs is well known. They pose a severe threat as a source of bycatch, as a danger to navigation, and with their high potential to become marine litter. Unintended entanglement and consequent mortality in FADs of vulnerable (e.g., sharks, sea turtles, and cetaceans) and commercial species is a serious concern for several international inter-governmental bodies (e.g., EU, GFCM, and IWC). This work describes the first case of a cetacean, a striped dolphin ( Stenella coeruleoalba ), entangled in a FAD in the Mediterranean Sea. A young male of striped dolphins was found dead along the coast of Lazio (central Tyrrhenian Sea) with its peduncle entangled in typical debris from illegal/artisanal FADs (i.e., a nylon rope, teared gardening plastic sheets, bush branches, and scrapped empty plastic bottles). Although this is the first confirmed case of a cetacean entangled in a FAD in Mediterranean waters, given the extent of the deployment of anchored FADs, the scale of this type of interaction with protected species might be seriously underestimated. Therefore, actions and monitoring need to be implemented urgently to effectively protect and conserve marine biodiversity.

As climate-related impacts threaten marine biodiversity globally, it is important to adjust conservation efforts to mitigate the effects of climate change. Translating scientific knowledge into practical management, however, is often complicated due to resource, economic and policy constraints, generating a knowledge-action gap. To develop potential solutions for marine turtle conservation, we explored the perceptions of key actors across 18 countries in the Mediterranean. These actors evaluated their perceived relative importance of 19 adaptation and mitigation measures that could safeguard marine turtles from climate change. Of importance, despite differences in expertise, experience and focal country, the perceptions of researchers and management practitioners largely converged with respect to prioritizing adaptation and mitigation measures. Climate change was considered to have the greatest impacts on offspring sex ratios and suitable nesting sites. The most viable adaptation/mitigation measures were considered to be reducing other pressures that act in parallel to climate change. Ecological effectiveness represented a key determinant for implementing proposed measures, followed by practical applicability, financial cost, and societal cost. This convergence in opinions across actors likely reflects long-standing initiatives in the Mediterranean region towards supporting knowledge exchange in marine turtle conservation. Our results provide important guidance on how to prioritize measures that incorporate climate change in decision-making processes related to the current and future management and protection of marine turtles at the ocean-basin scale, and could be used to guide decisions in other regions globally. Importantly, this study demonstrates a successful example of how interactive processes can be used to fill the knowledge-action gap between research and management., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

The literature in the field of health management mentions a concept called new public management (NPM), introduced in Brazil and France at the end of the 20th century. The objective of the study was to analyze the repercussions of the work of nurses in primary health care in Brazil and France under the influence of NPM. This is an excerpt of a double-titled thesis, which is a research intervention with nurses from two Brazilian states and five French departments. Data were produced between February 2019 and July 2021. The public policy Health on the Hour acted as an institutional transducer, provoking a reduction in access and producing effects on professional practices. In both countries, NPM amplified the predominance of technical and quantifiable acts, the focus on individual care, and the loss of autonomy. Nurses reported insurmountable situations, using the metaphor "Sophie's choice". The results showed that making dilemmatic decisions has been the daily routine of nurses, which has not resulted in debureaucratization and higher quality of care.

This study presents a reflective analysis of the implementation of interprofessional education in undergraduate nursing courses, considering as an example the curricula of undergraduate nursing careers in Brazil. Despite investments to advance interprofessional education, its practice is not institutionalized in the curricula of undergraduate courses. These findings represent a limitation for the implementation of interprofessional education in nursing courses, and the case of Brazil allows to learn lessons for the education of nursing professionals in other countries of the Region of the Americas. Recommendations are provided for training, management and intersectoral articulation of health and education services, with emphasis on primary health care and the Sustainable Development Goals, aimed at educational institutions wishing to implement interprofessional education.

Introduction: Elements mark the reality of reading the female body in symbolic constructions and social symbols in the exercise of their reproductive health. The study aims to identify elements that characterize the female condition while analyzing the reproductive health of Brazilian and French women., Materials and Methods: A qualitative, multicenter, international study was conducted in Brazil and in France between 2016 and 2019. Data were produced through the use of semi-structured scripts. Focus group discussions and individual interviews were conducted with women who gave birth, hetero-female couples who lived the experience of gestation and birth of a baby, and professionals of maternal and childcare services or members of the associations concerned with the health of mothers and babies. It was guided by the theoretical-methodological framework of institutional analysis in line with the French Institutional Socioclinics., Results: Sexual and reproductive health in the realities researched in Brazil and France are sometimes close and sometimes far apart. In what involves the Brazilian health system, abortion is criminalized and often performed illegally. Furthermore, pregnancy, childbirth, and the postpartum period are highly medicalized. In addition, childbirth is not assured as an experience for a woman and her family. This aspect is confirmed by high numbers of cesarean sections performed or by maternal and infant mortality indicators. The French health system prioritizes vaginal deliveries and seems to assure more autonomy to women, but at the same time, it is worn out by the logic of profit, the efficiency of actions, and the rationalization of practices. In association with these, there are other intrinsic elements in the functioning of the institution that delineates the format of each country: notion of women's rights, violence against women, and discussion regarding the oppression markers of race, gender, sexuality, and social class., Conclusions: Both countries reveal aspects related to the social role of women's bodies. The established logic reflects in the decision to have children, motherhood, women's autonomy over their own bodies, and in the core values linked to the termination of pregnancy and the professional practices developed in prenatal care, childbirth, and postpartum., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Silva, Fortuna, Monceau, Soulière and Pilotti.)

Fisheries bycatch is recognised as a global threat to vulnerable marine megafauna and historical data can contribute to quantify the magnitude of the impact. Here, we present a collection of three datasets generated between 2006 and 2019 by a monitoring programme on marine megafauna bycatch in one of the main Italian fisheries, the northern central Adriatic midwater pair trawl fishery. The three datasets consist of: (i) monitored fishing effort; (ii) bycatch and biological data of dolphins, sea turtles and elasmobranchs; (iii) and dolphin sightings. Some information included in these datasets has already proved to provide a unique opportunity to estimate total incidental capture of species of conservation concern and trends of their relative abundance over time in the northern - central Adriatic Sea. These datasets are expected to be considered by different end users to improve the conservation of species and fishery management approaches to assess the impact of a fishery on species of conservation concern., (© 2022. The Author(s).)

Objective: to analyze how the social, historical, economic and professional elements influence the institutionalization process of cesarean childbirth in Brazil and France., Method: a qualitative study grounded on the theoretical framework of the institutional socioclinic. The data were produced through focus groups and individual interviews, supported by semi-structured scripts, with health professionals, mothers and fathers and a research diary. The study had 83 participants. The analysis was based on the theoretical framework and thematic analysis. Cross analysis was developed between the different types of data, services and groups, as well as between countries., Results: the participants were characterized in terms of schooling, employment, level of training and workplace. The countries researched have their own peculiar health and educational structure and are marked by a social-historical-economic construction outlined by patriarchy. The New Public Management influences both contexts and makes health care precarious. The technical and organizational dimensions reinforce an intellectual and social division of work and knowledge in health., Conclusion: the institutionalization process of childbirth in the countries is marked by social, economic and professional aspects. Practices and speeches of the professionals in their work process influence the occurrence, or not, of cesarean sections.

Objective: to know the interferences of leprosy in women's lives and how they reinvent themselves in coping with the disease., Method: a descriptive study with a qualitative approach. The theoretical-methodological framework adopts an approximation to the cartographic method and some concepts of schizoanalysis, which were used to analyze the data. The tools used to produce the data were the interview and the logbook. The interviews were conducted from July to November 2019, at the participants' homes., Results: the group consisted of nine women. To display the data, we were inspired by Deleuze's ideas about difference and repetition. The results were organized in three thematic axes that address the lives of these women affected by leprosy, which accompany concerns, anxieties and worries about the effects of the disease. The transformations in the female body, the financial maintenance itself due to the comorbidities caused by leprosy and its difficulties in guaranteeing rights are elements strongly pointed out by women., Conclusion: there is overlap and interference of the female condition in a patriarchal society that still accompanies it. We bet on the strength of becoming-a-woman and the need to consider them in their singularities and in their context for producing care permeated by meetings of the affirmation of the power of life.

This was a reflective theoretical essay that was based on the national and international literature. The goal was to analyze the interfaces and historical-conceptual distinctions between permanent education in health and interprofessional education in health. In the international context, there have been educational movements aimed at health workers with an emphasis on the incentives of the Pan-American Health Organization. In Brazil, both proposals highlight a commitment to the quality of practice in the Unified Health System, focused on health needs, with approaches that have a lot in common. Permanent education in health is geared toward on-the-job training to transform work processes, with the objective of delivering comprehensive care. Interprofessional education in health involves shared interactive learning of collaborative skills for effective teamwork, guided by interprofessional collaboration. The purpose of both is to qualify health practices through the education of workers in groups; however it is essential to distinguish the theoretical, conceptual, and methodological frameworks that support them.

Objective: To analyze matrix support for Family Health Strategy teams in relation to Mental Health in Children and Adolescents., Method: This is a research-intervention with a qualitative approach, based on the Institutional Analysis framework, Socio-clinic, carried out with eighteen health workers from two Family Health Strategy and Psychosocial Care Center teams of a small municipality in the countryside of the state of São Paulo, through eleven reflection meetings., Results: The following themes emerged: The dynamics of relations in the FHS territory; Matrix Support as a technological device: unveiling established practices. Subsequently, the results were discussed based on the principles of Institutional Socio-clinic., Conclusion: Matrix support in children's mental health, based on Institutional Socio-clinic, favored the deterritorialization of professionals, revealing how mental health care is provided for children and adolescents, and the crossings that occur in the production of this care as well as possible paths to be followed to improve health actions.

Objectives: to analyze the ways in which neoliberalism has consolidated itself in the public university and in university teaching in nursing; and what interferences it has produced in the pedagogical conceptions and practices of nurse educators., Methods: this is a qualitative research based on Institutional Analysis and conducted in a public university., Results: the data produced with the nursing teachers revealed the consolidation of the New Public Management in the university teaching of the professor-nurse, which is in contradiction with the formative assumptions for the Unified Health System., Final Considerations: it is noticeable how the university and the university teaching in nursing are already impregnated by neoliberal logic. This will possibly have repercussions on the training of professionals for the Unified Health System.

Objectives: to analyze the understanding of homeless people living in a city in the countryside of São Paulo about what health is and about their experiences in health services., Methods: a qualitative exploratory study developed through interviews with homeless people and a field diary. The data were organized by themes and the findings were compared to a collective health framework., Results: the explored themes were: "Being healthy for the homeless population", "The search for health services" and "Being a user of health services from the perspective of homeless people". We present the interviewees' understanding of health and their experiences in healthcare services. Along this path, we outline aspects that show the network's weaknesses, permeated by prejudices and discrimination., Final Considerations: this population has conceptions about health and needs that need to be singularly taken into consideration to facilitate access and care.

Objectives: to identify and analyze possibilities for recognizing health needs in the nurses' work at Family Health Strategy., Methods: a qualitative study with interviews and observation of the nurses' work in the countryside of São Paulo. The empirical material was subjected to thematic content analysis and interpreted in the light of the health work process., Results: two themes emerged: Possibilities utilized and Possibilities neglected to recognize health needs. Careful observation, welcoming, attention, listening, bonding and dialogue developed by nurses, in live work in action with users, touched on the possibilities, which, taken advantage of, were evidenced in care in spontaneous demand, scheduled consultation, examination gynecological and group activities., Final Considerations: nurses are able to recognize health needs, which can expand their clinical practice and interprofessionality in Family Health.

Objective: to map the available evidence on the main topics investigated in palliative care in primary health care., Method: scoping review type study carried out in five databases, including original articles, based on the descriptors palliative care, palliative care at the end of life, terminal care, terminal state, primary health care and their respective acronyms and synonyms, totaling 18 publications. The extraction of data from primary studies was performed using an instrument produced by the authors and which allowed the construction of the categories presented., Results: 18 publications were included in this review. Among the most studied themes are the difficulties of the teams regarding the continuity of care in the health network; the importance of in-service education by the multidisciplinary team; professional unpreparedness; bioethics; the validation and application of scales for prognosis and care for some pathologies such as cancer and diabetes; among others., Conclusion: it became evident that palliative care in primary health care has been gradually developed, but it is necessary to consider the organization of primary health care and the social policies that support or weaken it, being considered a complex challenge.

Objective: To analyze the use of the Institutional Analysis theoretical-methodological framework and of the central concept of institution in its three moments - instituted, instituting and institutionalizing in health studies., Method: Integrative review conducted in databases of PubMed/Medline, LILACS, Scopus, and CINAHL including original research articles published between 2012 and 2017., Results: Analysis of 26 publications. A plurality of study objects was found, and the most common were related to collective health, namely: mental health, violence, family-team relationship, family health, primary care, health of women, children and adolescents, oral health, continuing education, micropolitics of health work, health surveillance, HIV, law, pedagogical practices, school education and Autism. Nursing and psychology were the areas that most opted for Institutional Analysis. The polysemy of the institution concept was confirmed in the findings, indicating the richness of modes and uses of the concepts., Conclusion: Institutional Analysis presents tool-concepts to perform analyzes of health practices consistent with the Unified Health System.

Objective: to analyze a process of Permanent Education in Health about mental health with Family Health teams., Method: research-intervention performed with 20 workers from two teams of the Family Health Strategies. Semi-structured interviews and 12 reflection meetings were carried out with each team. The principles of Institutional Socio-clinic were used to guide the meetings and the analysis of the data., Results: seven beaconing tips were identified for the Process of Permanent Education in Health: effects produced from the choices of inclusion of the management in the planning of the meetings, revealing established ways of working; attention to non-control in training movements; use of restitution at meetings, reducing stiffness and tensions; attention to the institutions that cross us; analysis of the facilitator's involvement in the training, redirecting behaviors and attitudes; problematization about the object, instrument and purpose, which favored the reflection about the mental health care and to learn to facilitate and experience the Permanent Education in Health in the act of making., Conclusions: socio-clinic assisted the experience of facilitating in-service training, pointing out tips for the collective construction of contextualized, reflexive and problematizing knowledge.

Objective: analyze professional implication with the support of humanization and articulators of permanent education in health as a tool of Permanent Education in Health., Method: this is an interventional study of qualitative approach, based on the theoretical reference of Institutional Analysis. Thirty-five humanization supporters and/or permanent education articulators participated in this study. Semi-structured interviews, monthly meetings, restitution meetings and a daily logbook were used as tools for data production. The material was analyzed according to the principles of the study reference and the results were presented according to the ideological, organizational and libidinal dimensions of professional implication., Results: this study identified a contradiction when finding a professional profile for the development of support and articulation; feelings of discouragement, pessimism and optimism in the development of these roles; influences of the nursing profession on the development of support and articulation; length of professional service; and the absence/presence of desire in such development., Conclusion: the analysis of professional implication consisted of a powerful tool generating training processes. It allowed learning and reflection of the practice through analysis of the actions performed by the professionals, generating changes in the conception of work in health.

Objective: To analyze conflict situations in the basic care team as possible catalysts of democratic relations at work, favoring team performance., Method: A qualitative study with a family health team from a municipality in the interior of São Paulo State. The data collected included systematic observation and interviews with workers who were organized and analyzed from the confrontation with the theoretical reference of the health work process. Thematic content analysis was used., Results: 16 workers participated. The data are organized into two thematic categories: the reception of unity as a place where conflicts become more explicit, and the conflict as an opening for building democratic relationships in teamwork., Conclusion: Receiving users at the reception and who will or will not work in this space reveals different values and conceptions about the care each professional provides, and constitutes a situation that generates conflict. However, opposing ideas in the conflict are fruitful because they are able to complement each other and provide a qualitative leap in team relations, with a tendency to influence a reduction in the vulnerabilities of the relations between the subjects. This is a pressing and current need in the discussion involving the reorganization of health practices.

Objective: To discuss and reflect on collective health nursing practices, presenting the work-related experience of nurses., Method: This was a reflection paper based on the labor process theory., Results: Studies conducted in research groups, discussions at scientific events, and professional experiences point to the importance of recognizing the intentionality of health work. Furthermore, it is essential t understand the health-illness-care process adopted and advocated by health professionals, and the role of social determinants and the entire historical, political, economic and social context of professional training, healthcare service organization and society., Conclusion: Collective health nursing practices play an important role in the health care provided to the population. Nurses are reference professionals in health care in all stages of life; however, further reflection is required on professional training, politicization, and the concepts of health and illness that guide professional practices.

Heterogeneous data collection in the marine environment has led to large gaps in our knowledge of marine species distributions. To fill these gaps, models calibrated on existing data may be used to predict species distributions in unsampled areas, given that available data are sufficiently representative. Our objective was to evaluate the feasibility of mapping cetacean densities across the entire Mediterranean Sea using models calibrated on available survey data and various environmental covariates. We aggregated 302,481 km of line transect survey effort conducted in the Mediterranean Sea within the past 20 years by many organisations. Survey coverage was highly heterogeneous geographically and seasonally: large data gaps were present in the eastern and southern Mediterranean and in non-summer months. We mapped the extent of interpolation versus extrapolation and the proportion of data nearby in environmental space when models calibrated on existing survey data were used for prediction across the entire Mediterranean Sea. Using model predictions to map cetacean densities in the eastern and southern Mediterranean, characterised by warmer, less productive waters, and more intense eddy activity, would lead to potentially unreliable extrapolations. We stress the need for systematic surveys of cetaceans in these environmentally unique Mediterranean waters, particularly in non-summer months.

Elasmobranchs are among the most threatened long-lived marine species worldwide, and incidental capture is a major source of mortality. The northern central Adriatic Sea, though one of the most overfished basins of the Mediterranean Sea, supports a very valuable marine biodiversity, including elasmobranchs. This study assesses the impact of the northern central Adriatic pelagic trawl fishery on common smooth-hound (Mustelus mustelus), spiny dogfish (Squalus acanthias), common eagle ray (Myliobatis aquila), and pelagic stingray (Pteroplatytrygon violacea) by examining incidental catches recorded between 2006 and 2015. The distribution of bycatch events was evaluated using geo-referenced data. Generalized Linear Models were computed to standardize the catch of the four species and to predict the relative abundance of bycatch events. Data analysis shows that most bycatch events involving all four species occurred in the northern Adriatic Sea. The models predicted significant, distinct temporal patterns of standardized catches in line with previous investigations. Water depth, season, and fishing region were the best predictors to explain bycatch events. The present data suggest that the northern Adriatic may be an important nursery area for several elasmobranchs. They also highlight the urgent need for a better understanding of the interactions between elasmobranchs and fisheries to develop and apply suitable, ad hoc management measures.

Objective: To analyze the interference of leprosy in women's life regarding work and daily life activities., Method: Exploratory qualitative study developed from semi-structured interviews and with the use of field diaries. The strategy of the organization of data was a thematic analysis of content and referential of the work process in health and gender., Results: The themes presented are: "The leprosy pains", "Changes with the disease and adaptation at work and activities" and "Being a woman with leprosy". On them, we present the aspects that changed in women's life from the leprosy, especially regarding work and daily activities. Beyond physical limitation, there are impacts on social relations and above all on formal work, there may even be dismission., Final Considerations: In women affected by leprosy, work and daily activities are directly affected; this deepens the social difficulties and requires attention of health professionals.

Objective: To identify evidences in scientific Brazilian literature on nursing care to aged people with HIV., Method: Integrative review of literature from databases: Latin American and Caribbean Literature on Health Sciences (LILACS), Scientific Eletronic Library Online (SciELO), Cochrane and the Nursing Database (BDENF). The applied inclusion criteria were publications that were fully available from 2001 to 2015 and answered to the guiding question of this study., Results: We included 13 studies; and the categories that allowed a better presentation of the scientific evidence on nursing care to aged people with HIV carrier were: Epidemiological profile, perceptions and experiences of aged people with HIV and nursing care to aged people with HIV., Conclusion: The studies address nursing care from a clinic that follows NANDA diagnoses of strong individualizing approach and low consideration of social aspects.

OBJECTIVE Analyzing the relationships among professionals and between professionals with managers and users based on the user embracement analyzer. METHOD A qualitative study incorporating the theoretical-methodological reference of institutional analysis. The data were produced through focus groups and organized from transcription, transposition and reconstitution. Seventeen (17) focus group sessions were conducted involving six municipalities and health professionals from various backgrounds. RESULTS 137 professionals participated in this study. User embracement has been carried out with the aim to organize spontaneous demand. Doctors have not been directly involved, although they have the final say. Intermediate nursing deals with the users and nurses perform important negotiation work among the network sectors. The receptionists and the community agents develop the first approach to the users, forwarding them to nursing to negotiate the service. Managers hope to avoid complaints by attending everyone. Users take advantage of party politics and of the media for services when there is no access. CONCLUSION User embracement is an analyzer, since it produces visibility and readability of the relations being produced in health services, and when analyzed can lead to denaturalizing these actions.

This qualitative study is based on institutional analysis as the methodological theoretical reference with the objective of analyzing researchers' implication during a research-intervention and the interferences caused by this analysis. The study involved researchers from courses in medicine, nursing, and dentistry at two universities and workers from a Regional Health Department in follow-up on the implementation of the Stork Network in São Paulo State, Brazil. The researchers worked together in the intervention and in analysis workshops, supported by an external institutional analysis. Two institutions stood out in the analysis: the research, established mainly with characteristics of neutrality, and management, with Taylorist characteristics. Differences between researchers and difficulties in identifying actions proper to network management and research were some of the interferences that were identified. The study concludes that implication analysis is a powerful tool for such studies.

Objective:: to analyze the aspects that potentialize groups in Primary Health Care according to their coordinators and participants., Method:: This is a descriptive study with a qualitative approach, conducted with a health promotion group affiliated with a Family Health Unit. The data were collected by means of focus groups with participants and community workers who were submitted to thematic content analysis., Results:: the analysis gave rise to three thematic categories: The group is our medicine; Healthy living and learning; and Priceless leadership., Conclusion:: the leads identified during the study were as follows: group organization involves investment in motivation and leadership by the coordinators; production of grouping and cohesion is a result of participants and coordinators meeting together, interspersed with dialog, things said and left unsaid that the subjects expressed in the group dynamic; the sense of belonging guarantees their placement in the group based on the recognition of their knowledge and affective, social and health needs.

Objective: to analyze patient satisfaction in a Family Health Unit (FHU) of a municipality in the interior of São Paulo, Brazil, from the perspective of responsiveness., Method: this was a qualitative study with 41 patients of families who used the FHU at least once in the last six months. A semi-structured interview was used for data collection, performed from November of 2010 to January of 2011, focusing on the dimensions of responsiveness: dignity, autonomy, facilities and physical environment, immediate attention, choice, confidentiality, and communication. A thematic analysis was conducted., Results: four themes emerged from the analysis: the health unit environment; access and components of accessibility - favoring the responsiveness?; possibilities of developing a patient - health service staff relationship; and the FHU team - processing care and welcoming., Conclusion: responsiveness allows for the tracking and monitoring of non-medical aspects of care of the patients; it contributes to achieving universal coverage, emphasizing the quality of care.

A 3-years sea ambient-noise (SAN) monitoring was carried out in the Cres-Lošinj Archipelago (Croatia), where a bottlenose dolphin population is threatened by unregulated nautical tourism. A total of 540 5-min SAN samples were collected and analyzed in an Indicator 11.2.1 (Marine Strategy Framework Directive) perspective. The 1/3-octave band center frequencies of 63 and 125 Hz (re 1 μPa.rms) proved to be predictive of local predominant ship type over time. However, the noisiest band level was centered on 200 Hz. We therefore suggest measuring a wider frequency band than those requested in Indicator 11.2.1.

The aim of this paper is to propose a reflection about the care in Brazilian nursing considering some theorists. For doing so, we have started with a discussion about the anglo saxon concept of care and possible translations into Portuguese language. After this, some authors who have theoretically subsidized some scientific productions in healthcare and specifically in Brazilian nursing are introduced. Within this analysis, the presence of different ways of thinking nursing care were identified, but in relation to the concept of care, as it has been proposed in France, there are not too many studies and scientific research. However, despite the limitation of academic research about care in health area, particularly in Brazilian nursing, it is possible to observe that its conceptual assumptions tangent certain bets made in some health policies such as the National Humanization Policy and the Health Continuing Education Policy, as well as in the organization of the Unified Health System, that focus on the integrality of patient care.

Objective: Analysing the concepts of Continuous Health Education - CHE (EPS - in Portuguese), operated by municipal managers and translated into official documents., Method: Qualitative research with the use of official documents and semi-structured interviews with the Municipal Health Secretaries or Coordinators of Primary Health Care in the Northeast Region of São Paulo State, and thematic analysis of empirical material., Results: Results indicate difficulties in the municipalities problematizing their management practices, services and health care; EPS tools presented are insufficient and unsatisfactory for amending the array of problems raised and are still far from the routine of Primary Care services., Conclusion: Despite efforts to implement EPS actions for the strengthening of primary care, the process appears to be incipient.

Objective: to analyze the meanings of leprosy for people treated during the sulfonic and multidrug therapy periods., Method: qualitative nature study based on the Vigotski's historical-cultural approach, which guided the production and analysis of data. It included eight respondents who have had leprosy and were submitted to sulfonic and multidrug therapy treatments. The participants are also members of the Movement for Reintegration of People Affected by Leprosy., Results: the meanings were organized into three meaning cores: spots on the body: something is out of order; leprosy or hanseniasis? and leprosy from the inclusion in the Movement for Reintegration of People Affected by Leprosy., Conclusion: the meanings of leprosy for people submitted to both regimens point to a complex construction thereof, indicating differences and similarities in both treatments. Health professionals may contribute to the change of the meanings, since these are socially constructed and the changes are continuous.

The occurrence of larval Anisakidae and Raphidascarididae in anchovies and sardines from the North Adriatic Sea has been estimated. Anisakis pegreffii and Hysterothylacium aduncum were reported, with low prevalence values. In brief, a total amount of 7650 fish specimens collected between September 2011 and 2012 were analysed using three different inspection analyses: a visual inspection of the coelomic cavity, an examination of the viscera exploiting the positive hydro-tropism of the larvae (modified Baermann technique) and enzymatic digestion of muscular tissue pools. Low level of infestation was reported for Anisakis sp. in both in anchovies and sardines, while higher values were reported for Hysterothylacium sp. Subsamples of nematodes collected were characterized at species level using the molecular diagnostic key based on ITS nuclear ribosomal region, and A. pegreffii and H. aduncum were identified. The low prevalence of Anisakis sp. in sardines and anchovies from the North Adriatic Sea could be related to the peculiar distribution of cetaceans and carnivorous zooplankton in the investigated region and could be used as a potential tag to define oily fishes from this specific fishing area as at low-risk for anisakiasis., (Copyright © 2015 Elsevier B.V. All rights reserved.)

The ways of forming the nursing professional are linked to the history and to the socio-political and economic context. The article discusses the academic training for nurses in Brazil in three different public universities : University of São Paulo, Ribeirão Preto ; Federal University of Goiás, Catalão and Federal University of Minas Gerais, Belo Horizonte. It notes the challenges and their differences and similarities. The networks of health services, the universities and university training for nurses are too much different in Brazilian territory. A national law that regulates the training of nurses but the universities has some autonomy to apply these programs. How this structure the nurses formation in this three different universities that we'll compared ? Even with the resources and different histories, the programs of formation have the objectives the management of integral quality care in all health and social services in the country. The achievement of this project is conditioned in each university to the reality and the situation of the health care system and universities as well the work of the professor and nurses.

This paper maps the experience of a family health team (FHT) in the creation of a knowledge and responsibility field to practice Oral Health (OH). Institutional analysis was used to establish the theoretical and methodological framework, supported by the concept analyzers, implication analysis, territorialization and deterritorialization. Cartography was used to monitor the procedures and the order of events and to facilitate understanding. The subjects were members of an FHT in a training context. Data production took place during the FHT meetings on administrative and family discussion matters. The case study presented here was one of the research analyzers. As results, the process of building the case study was identified, which revealed how the FHT took the family into care; the movements broadening the perspective of care, finding ways for disciplinary interactions in order to construct a collective OH approach, which emerged from the day-to-day tensions of the FHT work process. The conclusion reached is that this case study revealed the stresses involved in the process of deconstruction of dental assistance and the movement towards the interaction of several fields of knowledge and practices for the production of care from the perspective of OH attention.

Objective: Analyzing the conceptions of supervision of nurses in the Family Health Strategy (ESF - Estratégia Saúde da Família) in relation to community health workers (ACS - Agente Comunitário de Saúde), taking for reference the work process and the power relations., Method: A qualitative study, in which 18 interviews were carried out with nurses from the ESF in the countryside of the state of Goiás. Following transcription, the data were subjected to thematic content analysis and the following categories were identified: Supervision with that sees it all and Supervision is participating and working together., Results: Among the findings, it is clear the character of control and monitoring that is carried out primarily through printed instruments and home visits, which constitute vertical and impositive relations, and suffer influence of the local health management. Another finding is the supervision as acting together and with the educational perspective., Conclusion: The supervision carried out does not provide the changes intended by the ESF.

Levels of 24 organochlorine compounds, including toxic mono-ortho PCB congeners, were determined in the organs and tissues (blubber, kidney, lung, muscle, liver, heart) of 13 common bottlenose dolphins (Tursiops truncatus) stranded between 2000 and 2005 in the northern part of the Croatian territorial waters of the Adriatic Sea. Polychlorinated biphenyls (PCBs) were found at higher concentrations in comparison with organochlorine pesticides (OCPs) in all of the analyzed tissues. Sums of six indicator congeners (Σ6PCB) constituted around 50% of the total PCB amount, while PCB-153 and PCB-138 were found to have the highest concentrations. Among the seven investigated OCPs, p,p'-DDE was found at the highest concentrations. In blubber, mean values of 22,048 and 11,310ngg(-1) wet weight were determined for ΣPCB and ΣDDT, respectively. Much lower concentrations were found in muscle samples, followed by similar concentrations in kidneys, liver and heart, while the lowest levels of organochlorine contaminants were found in lungs. The results indicate that p,p'-DDT is still being introduced in the Mediterranean region. PCB concentrations are among the highest found in this region and toxicological assessments indicate that the health of this specie is at high risk., (Copyright © 2014 Elsevier B.V. All rights reserved.)

The aim of this study was to identify therapeutic factors presented in a group of health promotion for the elderly. This is a descriptive, exploratory study with a qualitative approach. Data were collected between December 2010 and April 2011 in focal groups that included participants and their coordinators. Results were submitted to content analysis and thematic approach. Findings showed convergence of answers among participants, who indicated resonance and complementarity in identification of the following therapeutic factors: cohesion, introduction of hope, socialization, information sharing, existential factors, altruism, interpersonal relationships, and universal learning. The identification of these factors indicates the therapeutic potential of focal groups, especially for attending to the needs of elderly people, keeping these patients healthy, and strengthening their feelings of love and life, and being part of a social group.

Objective: to analyze the experience of the family health team in resignifying the way to develop educational groups., Method: groups of discussion, with twenty-six biweekly group meetings conducted, with an average of fifteen professionals from the family health team, during the year 2009. The empirical material consisted of the transcription of the groups, on which thematic analysis was performed., Results: two themes were developed and explored from the collective discussions with the team: "The experience and coordination of the groups" and "The work process and educational groups in a service-school"., Conclusions: continuing Education in Health developed with the team, not only permitted learning about the educational groups that comprised the population, but also contributed to the team's analysis of its own relationships and its work process that is traversed by institutions. This study contributed to the advancement of scientific knowledge about the process of continuing health education as well as educational groups with the population. Also noteworthy is the research design used, providing reflexivity and critical analysis on the part of the team about the group process experienced in the meetings, appropriating knowledge in a meaningful and transformative manner.

This qualitative research aimed to analyze the view of the workers at a basic health unit on the presence of nursing students at the service. Eighteen workers participated in semi-structured interviews, analyzed after transcription. In the content analysis, we identified two themes: The slowing and quickening of service and The (un) preparedness to learn and teach. The results point to a process of teaching-service partnership still under construction, in which workers feel as though they are learning, but also feel devalued. The presence of the students changes the work dynamics, slowing it. At the same time, the presence of the students questions the hegemonic ways of rapid assistance. An expectation of collaboration in actions is evidenced, there being a preference for students in the last years of undergraduate courses, who perform procedures and do not require constant accompanying. We conclude that the approach between university and primary healthcare services exposes tensions which, collectively analyzed, can engender new ways of caring, teaching and learning.

The waters of the Cres-Lošinj archipelago are subject to intense boat traffic related to the high number of leisure boats frequenting this area during the summer tourist season. Boat noise dominates the acoustic environment of the local bottlenose dolphin (Tursiops truncatus) population. This study investigates the spatial and temporal change in the underwater noise levels due to intense boating, and its effect on the distribution of the bottlenose dolphins. In the period 2007-2009 sea ambient noise (SAN) was sampled across ten acoustic stations. During data collection the presence of leisure boats was recorded if they were within 2 km of the sampling station. Bottlenose dolphin spatial distribution was monitored in the same period. Results showed a strong positive correlation between high SAN levels and boat presence, particularly in the tourist season. Dolphin distribution indicated significant seasonal displacements from noisy areas characterized by the intense leisure boating., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

Nurses who hold a doctorate in sciences do not have any defined function in France. Indeed, while there exists no specific doctoral programme in nursing sciences, the place and status of nurses with doctoral degrees are not recognised.To teach as a permanent trainer, a healthcare manager diploma issued by a healthcare manager training institute is required. Innovation in this respect therefore appears essential, for example by reconciling as from today, the demands of nursing practice, research and training.