ABSTRACT
Issue Female genital mutilation (FGM) comprises all procedures that injury female genital organs for non-medical reasons, with several health impacts. Due to global migration, FGM has been increasingly recognised as a healthcare issue in Europe, affecting nearly 1 million women. In Portugal it is estimated that 5483 migrant women have undergone FGM in the Lisbon region. Intervention is required to tackle this issue. Description Portugal launched the “Healthy Practices: End of FGM”, a multiagency project targeting Lisbon and Tagus Valley region. Project implementation started in Nov 2018 at 5 local public health units (PHU) and was scaled-up to 5 more in Feb 2020. Project comprises 3 main axes: 1) inclusion in public policy instruments;2) professionals’ education and awareness;and 3) community intervention. We describe inclusion of FGM in public policy, professionals training and changes in FGM recording before and after intervention. Results Between 2018-2022, inclusion of FGM in municipalities’ migration policies doubled. Between 2019-2021, 110 training sessions (n = 1722 professionals) were promoted. During pandemic years, only 344 (2020) and 202 (2021) were trained. Raising awareness and empowerment to risk communities happened mainly through local/online open sessions, workshops, flyer distribution, video projections. These occurred in all 10 PHU, mostly through partnerships with Non-Governmental Organizations and municipalities. According to the Portuguese Health Records, until 2018 there were only 300 women registered with FGM. Between 2019-2021, 363 more were added. Lessons The multisectoral approach allowed PHU professionals to collaborate directly with external organizations from different society sectors. COVID-19 pandemic posed a challenge to implementation, especially in the community intervention axis. Notification numbers increased after interventions, though causality could not be established and impact evaluation is yet to be performed. Key messages • Multisectoral projects for FGM intervention have specific implementation challenges, including how to justify and evaluate them, that must be considered in each setting. • Training health professionals might increase identification and notification of FGM, but the impact in preventing FGM in the Portuguese reality is still largely unknown.
ABSTRACT
This patient was a 73-year-old man who initially came to our service with acute respiratory failure secondary to COVID-19. Soon after hospitalization, he was submitted to orotracheal intubation and placed in the prone position to improve hypoxia, due to severe acute respiratory syndrome (SARS). On the third day of hospitalization, he developed acute oliguric kidney injury and volume overload. The nephrology service was activated to obtain deep venous access for renal replacement therapy (RRT). The patient could not be placed in the supine position due to significant hypoxemia. A 50-cm Permcath (MAHURKARTM, Covidien, Massachusetts, USA) was inserted through the left popliteal vein. This case report describes a possible challenging scenario that the interventional nephrologist may encounter when dealing with patients with COVID-19 with respiratory impairment in the prone position.
ABSTRACT
This article aims to identify the possibilities of the diaconal action of the Evangelical Church of Lutheran Confession in Brazil-IECLB in face of the crisis caused by COVID-19, which is taking place and which will bring relevant consequences for the socio-political context in the Country. At the beginning of the article, there is a report of the diaconal experience of the Sinodo Nordeste Gaucho and its way of acting in the 2020 pandemic situation. Based on a reflection on the relationship between crisis and transforming diakonia, the article returns to the origins and facts of the diaconal history of the IECLB, demonstrating how the church and it's Diakonia has acted in these difficult times that have already occurred.
ABSTRACT
The COVID-19 pandemic has quickly and radically transformed health systems worldwide. The challenges are imposed by the need for social distance, remote management of less severe cases, and the constant need for updating health care professionals and the population with reliable information. We aim to describe the experiences and developments of a Brazilian telehealth public service during the pandemic. Numerous tools have been developed and made available, to be used in an integrated manner, by both health professionals and the general public. Those included a chatbot for guidance, a teleconsultation platform combined with a telemonitoring system, a teleconsulting service, and a tele-education program. The TNMG services appear to be efficient and robust during the health crisis of COVID-19, through different tools and methodologies focused on both professionals and users of the health systems. © 2021 The authors and IOS Press.