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Introdução: a colaboração entre os diversos profissionais da saúde é essencial para garantir um pré-natal seguro e de qualidade, bem como desfechos favoráveis no parto. Objetivo: descrever estratégias interprofissionais de gestão e atenção pré-natais no contexto da atenção primária à saúde. Materiais e método: pesquisa qualitativa realizada entre agosto e dezembro de 2022. Os dados foram coletados a partir de um instrumento de análise do conteúdo de infográficos produzidos por 26 profissionais que atuam na atenção primária à saúde, no sul do Brasil, como atividade avaliativa de um curso de qualificação. O conteúdo dos infográficos foi analisado com base no processo de codificação proposto por Minayo. Resultados: os dados analisados possibilitaram a delimitação de três categorias temáticas: “A necessária articulação intersetorial e interprofissional”; “Responsabilidades construídas e compartilhadas entre gestantes e profissionais”; “Planejamento e qualificação dos fluxos e dos processos de trabalho”. Conclusões: as estratégias interprofissionais de gestão e atenção pré-natais no contexto da atenção primária à saúde estão associadas à superação de abordagens fragmentadas e dicotômicas, bem como à prospecção de processos de gestão e atenção pré-natais mais participativos, dialógicos e interativos, com a inclusão dos diversos atores da saúde.

Institutional investors control a sizable portion of all votes in major public corporations. In contrast to their traditional deference to management, some institutional investors have begun to lobby portfolio companies for reductions in greenhouse gas ("GHG") emissions because even broadly diversified portfolios are vulnerable to the systemic risks associated with climate change. In theory, this logic could align the interests of diversified investors and those of society at large, resulting in welfare-enhancing climate activism. However, because of the chasm between the portfolio-level goal of GHG reduction and the company-level goal of value maximization, climate activism by institutional investors is bound to trigger conflicting fiduciary duties on several levels. This paper analyzes how these economic and legal limitations make it unlikely that the enormous financial power wielded by institutional investors will ultimately translate into similarly massive decarbonization effects. [ABSTRACT FROM AUTHOR]

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Background: Patients with inflammatory bowel disease (IBD) are at an increased risk of developing Clostridioides difficile infection (CDI). Treatment of CDI in patients with IBD is challenging due to higher failure rates and concomitant IBD activity. Objectives: We performed a multicentre cohort study in patients with IBD who received fecal microbiota transplantation (FMT) for recurrent CDI (rCDI), to further investigate factors that influence the clinical outcome and course of both rCDI and IBD. Design: This is a multicentre cohort study conducted in five European FMT centres. Methods: Adult IBD patients treated with FMT for rCDI were studied. Cure was defined as clinical resolution of diarrhoea or diarrhoea with a negative C. difficile test. The definition of an IBD flare was record based. Long-term follow-up data were collected including new episodes of CDI, IBD flares, infections, hospital admissions, and death. Results: In total, 113 IBD patients underwent FMT because of rCDI. Mean age of the patients was 48 years; 64% had ulcerative colitis. Concomitant rCDI was associated with an IBD flare in 54%, of whom 63% had received IBD remission-induction therapy prior to FMT. All FMT procedures were preceded by vancomycin treatment, 40% of patients received FMT via colonoscopy. CDI cure rate was 71%. Long-term follow-up data were available in 90 patients with a median follow-up of 784 days (402–1251). IBD activity decreased in 39% of patients who had active IBD at baseline, whereas an IBD flare occurred in only 5%. During follow-up of up to 2 years, 27% of the patients had infections, 39% were hospitalized, 5% underwent colectomy, and 10% died (median age of these latter patients: 72 years). Conclusion: FMT for rCDI in IBD patients is safe and effective, and IBD exacerbation after FMT is infrequent. Further studies should investigate the effects on IBD course following FMT.

Objetivo: descrever como as crianças percebem o tratamento quimioterápico e sua internação neste período. Método: estudo descritivo exploratório, de abordagem qualitativa, realizado com seis crianças em tratamento quimioterápico internadas em unidade hemato-oncológica de um hospital-ensino, localizado na região central do Rio Grande do Sul. Realizaram-se entrevistas individualizadas, gravadas em mídia digital e transcritas na íntegra. As entrevistas foram submetidas à análise temática. Resultados: identificaram-se três categorias temáticas: percepções da criança quanto ao tratamento quimioterápico; principais desafios apontados durante a internação pela criança em tratamento quimioterápico; ludicidade como aliada no enfrentamento da internação para quimioterapia em crianças. Conclusão: considera-se que a criança internada em tratamento quimioterápico tem conhecimento da importância da terapêutica para a cura da doença. A importância da ludicidade e do brincar nas hospitalizações também foram ratificadas no estudo, visto que estas apresentam-se como estratégias de enfrentamento do processo de adoecimento por parte da criança internada em tratamento oncológico.

Objetivo: analisar os sentimentos e dificuldades de mães no retorno da licença-maternidade e a percepção do acolhimento institucional. Método: estudo quali-quantitativo com 40 mães trabalhadoras de uma instituição de ensino pública de ensino médio, técnico e superior que retornaram ao trabalho após o período de licença. Foi aplicado um questionário on-line, com análise quantitativa descritiva e qualitativa de conteúdo. Resultados: das participantes, 42,5% relataram sentimentos difíceis (tristeza, depressão e desamparo), 50% dificuldade nas rotinas, 17,5% problemas para amamentar pela distância e 35% pontos positivos quanto à amamentação exclusiva no trabalho remoto. Cinco categorias foram encontradas: sentimentos no retorno ao trabalho; dificuldades do retorno e amamentação; pandemia e trabalho remoto; fragilidades percebidas e sugestões de melhorias; reflexões quanto à sua saúde mental. Conclusão: os sentimentos negativos e as dificuldades prevaleceram na percepção das mães, demandando atenção institucional para acolhimento no retorno da licença-maternidade.

Abstract Objectives: to characterize the teaching-learning process of children in early childhood taught by their parents and/or caregivers in remote educational mode, in different social contexts, during the COVID-19 pandemic. Methods: a bibliographic study was carried out through a qualitative research in three VHL, Lilacs and Scielo databases. The descriptors Children, Pandemic, Caregivers, Distance education and Mental health were used. The sample was composed of 35 materials. Results: it was observed that countries presented problems in its educational system and that their situation also aggravated, such as in Brazil. Schools should try to mitigate the impact of the confinement, based on the recommendations that aim to consolidate what has been learned and interrupt the teaching of new content, eliminating the pressure on parents and guardians who assist students at this time. It is known that there is a lack of preparation of these caregivers, since the vast majority do not have materials or available time, because of home office, making remote learning difficult. The psychological impacts of remote learning - stress, fear, decreased performance and frustration are noticeable in everyone who is involved. Thus, the coping strategy focused on the problem can prevent the worsening of symptoms in mental health. Conclusion: it is expected to promote future reflections according to the theme through Psychology.

A growing body of research indicates that urban landscapes can support biodiversity and provide multiple ecosystem services. However, we still have limited knowledge about how specific design and management choices impact environmental benefits within highly modified landscapes. Furthermore, we know relatively little about the potential tradeoffs and synergies encountered when managing for multiple ecosystem services within urban landscapes. In this study, we address knowledge gaps in both research and practice by leveraging a ‘designed experiment’ approach that included a diverse team of researchers and practitioners to evaluate the impacts of designed landscapes on several focal environmental outcomes essential for urban sustainability. Specifically, we evaluated small-scale designed-landscape research plots that varied in plant richness, origin of vegetation, and drought tolerance, and we simultaneously quantified impacts on water conservation, pollinators, and maintenance-related impacts, as well as their intersection with aesthetic appeal for residents. Our results indicate that key landscape choices such as the selection of drought-tolerant plants and a diverse native plant palette can simultaneously enhance water conservation, increase resources for pollinators, and reduce maintenance impacts. Importantly, the designs that rated more highly in terms of visual quality were also those that supported higher pollinator biodiversity and required relatively little water for irrigation, indicating that synergy across multiple benefits is achievable in designed landscapes. In urban landscapes, aesthetic appeal is often a top priority, and our results indicate that visual quality does not need to be sacrificed in order to design landscapes that additionally support water conservation and provide resources for pollinators.

Problem, research strategy, and findings: Although theory and practice contend that local knowledge improves climate adaptation planning, little research has documented the kinds of information shared by residents. Planners can use this information to assist in the creation of planning processes and tools, as well as investigate how local knowledge contributes—or does not contribute—to planning outcomes. We developed a provisional typology of how local knowledge has been used for adaptation planning and used a case study to ask: When compared with existing research, what information do residents share? How might this knowledge be useful for climate adaptation? In interviews, residents identified new ideas about local knowledge and climate adaptation planning: cascading harms and repeated trauma from—and mental health implications related to—climate events, lack of trust in municipalities, and how community capacity increases climate adaptation. Although these themes support existing research, to our knowledge, these findings are the first empirical data from studies focused on local knowledge in which frontline residents themselves identified the need for increased attention to mental health, community capacity, and trust building. Our findings contribute to larger conversations about climate adaptation planning as well as help inform the development of an adaptation tool in Austin (TX). Takeaway for practice: We identified three takeaways for climate adaptation planning: increase acknowledgment of and attention to mental health effects, integrate local knowledge about community capacity, and consider incorporating local knowledge to build trust. [ABSTRACT FROM AUTHOR]

Realizou-se um estudo qualitativo, com objetivo de descrever as sessões de intervenção de um grupo de orientação de pais para cuidadores de adolescentes. A intervenção se deu em dez sessões, de uma hora semanal, previamente estruturadas. Participaram cinco cuidadoras. Os instrumentos utilizados foram diário de campo produzidos pelas pesquisadoras que realizaram as intervenções no grupo e entrevistas semiestruturadas com as participantes, aplicada um encontro antes do primeira sessão da intervenção. Os resultados foram analisados quanto ao seu conteúdo, de onde se originaram três categorias: comunicação efetiva, parentalidade e uso de telas exemplificados em cada uma das dez sessões. Percebe-se a importância da intervenção em grupo para orientação parental através das mudanças cotidianas na organização familiar, incremento na comunicação das cuidadoras com seus filhos, seguimento de rotina por parte do adolescente, sob orientação parental e promoção de escuta ativa, clara e aberta das cuidadoras com os adolescentes.

Bacteriophage therapy holds promise in addressing the antibiotic-resistance crisis, globally and in Germany. Here, we provide an overview of the current situation (2023) of applied phage therapy and supporting research in Germany. The authors, an interdisciplinary group working on patient-focused bacteriophage research, addressed phage production, phage banks, susceptibility testing, clinical application, ongoing translational research, the regulatory situation, and the network structure in Germany. They identified critical shortcomings including the lack of clinical trials, a paucity of appropriate regulation and a shortage of phages for clinical use. Phage therapy is currently being applied to a limited number of patients as individual treatment trials. There is presently only one site in Germany for large-scale good-manufacturing-practice (GMP) phage production, and one clinic carrying out permission-free production of medicinal products. Several phage banks exist, but due to varying institutional policies, exchange among them is limited. The number of phage research projects has remarkably increased in recent years, some of which are part of structured networks. There is a demand for the expansion of production capacities with defined quality standards, a structured registry of all treated patients and clear therapeutic guidelines. Furthermore, the medical field is still poorly informed about phage therapy. The current status of non-approval, however, may also be regarded as advantageous, as insufficiently restricted use of phage therapy without adequate scientific evidence for effectiveness and safety must be prevented. In close coordination with the regulatory authorities, it seems sensible to first allow some centers to treat patients following the Belgian model. There is an urgent need for targeted networking and funding, particularly of translational research, to help advance the clinical application of phages.