COVID-19 and zoonoses in Brazil: Environmental scan of one health preparedness and response.

The emergence of the COVID-19 pandemic reinforced the central role of the One Health (OH) approach, as a multisectoral and multidisciplinary perspective, to tackle health threats at the human-animal-environment interface. This study assessed Brazilian preparedness and response to COVID-19 and zoonoses with a focus on the OH approach and equity dimensions. We conducted an environmental scan using a protocol developed as part of a multi-country study. The article selection process resulted in 45 documents: 79 files and 112 references on OH; 41 files and 81 references on equity. The OH and equity aspects are poorly represented in the official documents regarding the COVID-19 response, either at the federal and state levels. Brazil has a governance infrastructure that allows for the response to infectious diseases, including zoonoses, as well as the fight against antimicrobial resistance through the OH approach. However, the response to the pandemic did not fully utilize the resources of the Brazilian state, due to the lack of central coordination and articulation among the sectors involved. Brazil is considered an area of high risk for emergence of zoonoses mainly due to climate change, large-scale deforestation and urbanization, high wildlife biodiversity, wide dry frontier, and poor control of wild animals' traffic. Therefore, encouraging existing mechanisms for collaboration across sectors and disciplines, with the inclusion of vulnerable populations, is required for making a multisectoral OH approach successful in the country.

A real-life analysis on the indications and prognostic relevance of perioperative chemotherapy in locally advanced resectable gastric adenocarcinoma.

BACKGROUND AND PURPOSE: Perioperative chemotherapy (periCTX) based on the "MAGIC" scheme has become a standard treatment in Europe for locally advanced oesophagogastric cancer. We assessed implementation and long-term oncological outcomes of MAGIC periCTX for locally advanced gastric cancer. METHODS: Population-based cohort study of all patients with locally advanced gastric cancer undergoing surgical resection with curative intent in Catalonia and Navarra (the first two autonomous communities included in the EURECCA Upper GI Spanish Working Group) between January 2011 and December 2013. The main variable was the percentage of patients treated with MAGIC periCTX. Kaplan-Meier analysis and Cox proportional hazards model were used to assess the survival benefit of periCTX. RESULTS: Among 814 patients, 217 (26.6%) received periCTX (especially patients more likely to receive it: aged < 70 years, with proximal tumors, low anesthetic risk, and cT3-4/cN+ clinical stage). 35% did not complete perioperative chemotherapy, with no relationship with age. PeriCTX showed no effect on postoperative morbimortality. Histological tumor regression was more often absent or poor (38.2%) than total or almost total (27.8%), although clinico-pathological lymph-node downstaging was higher than expected by staging inaccuracy (38.7% vs. 24.2%). PeriCTX was associated with a better survival only in cT3-4 and cN+ patients, showing less prognostic relevance than optimal oncological surgery with D2 lymphadenectomy. CONCLUSIONS: Only 26.6% of locally advanced resectable gastric cancer patients received PeriCTX. Pathological response was poor, although some degree of nodal downstaging was observed. Survival benefit of periCTX was limited to cT3-4 and cN+ patients, being less relevant than D2 lymphadenectomy.

VNTR confirms the heterogeneity of Madurella mycetomatis and is a promising typing tool for this mycetoma causing agent.

The neglected tropical disease mycetoma is a chronic granulomatous inflammatory and infectious disease affecting various body parts. The most common causative agent is the fungus Madurella mycetomatis. In order to study the genetic diversity of this fungus and to monitor any potential outbreaks, a good typing method that can be used in endemic settings is needed. Previous typing methods developed were not discriminative and not easy to perform in resource-limited laboratories. Variable-Number-Tandem-Repeat (VNTR) typing overcomes these difficulties and further enables interlaboratory data comparison. Therefore, in this study we developed a VNTR method for typing M. mycetomatis. Six tandem-repeats were identified in the genome of M. mycetomatis isolate MM55 using an online tandem repeats software. The variation in these repeats was determined by PCR and gel-electrophoresis on DNA obtained from 81 M. mycetomatis isolates obtained from patients. These patients originated from Sudan, Mali, Peru, and India. The 81 isolates were divided into 14 genotypes which separated into two main clusters with seven and five subdivisions, respectively. VNTR typing confirms the heterogeneity of M. mycetomatis strains and can be used to study the epidemiology of M. mycetomatis. The results presented in this article are made fully available to the scientific community on request from the Eumycetoma Working Group. We hope that this open resource approach will bridge scientific community working with mycetoma from all around the world and lead to a deeper understanding of M. mycetomatis.

Geriatric oncology in Spain: survey results and analysis of the current situation.

INTRODUCTION: Geriatric oncology (GO) is a discipline that focuses on the management of elderly patients with cancer. The Spanish Society of Medical Oncology (SEOM) created a Working group dedicated to geriatric oncology in February 2016. OBJECTIVES: The main goal of this study was to describe the current situation in Spain regarding the management of elderly cancer patients through an online survey of medical oncologists. METHODS: A descriptive survey was sent to several hospitals by means of the SEOM website. A personal e-mail was also sent to SEOM members. RESULTS: Between March 2016 and April 2017, 154 answers were collected. Only 74 centers (48%) had a geriatrics department and a mere 21 (14%) medical oncology departments had a person dedicated to GO. The vast majority (n = 135; 88%) had the perception that the number of elderly patients with cancer seen in clinical practice had increased. Eighteen (12%) oncologists had specific protocols and geriatric scales were used at 55 (31%) centers. Almost all (92%) claimed to apply special management practices using specific tools. There was agreement that GO afforded certain potential advantages. Finally, 99% of the oncologists surveyed believed it and that training in GO had to be improved. CONCLUSIONS: From the nationwide survey promoted by the Spanish Geriatric Oncology Working Group on behalf of SEOM, we conclude that there is currently no defined care structure for elderly cancer patients. There is an increasing perception of the need for training in GO. This survey reflects a reality in which specific needs are perceived.

Grupos: o vértice psicanalítico / Groups: a psychoanalytic vertex / Grupos: el vértice psicoanalítico

Este texto, sob a forma de verbete, feito sob gentil solicitação dos editores deste periódico, enfoca agrupamentos de pessoas observadas segundo o vértice psicanalítico, que pode ser visto como integração transdisciplinar entre, pelo menos, dois âmbitos de observação. Para finalidades de comunicação, esses âmbitos são definíveis por "níveis" ou "dimensões": macro e micro. Mais especificamente, trata-se do estudo das experiências emocionais que podem ocorrer no inter-relacionamento de pessoas que compõem um determinado grupo e também, conjuntamente, das características conscientes e inconscientes que podem agir. O estudo ressalta alguns antecedentes históricos e consequências em termos de comportamento; tanto o comportamento concreto, aparente, expresso (fenomenologicamente observável), como o comportamento implícito, imaterial, sempre atuante (denominado por Bion como "ultra" e "infra" sensorial, que não pode ser totalmente apreendido pelo aparato sensorial humano). Este estudo sobre grupos de pessoas identifica duas fantasias inconscientes, de natureza onisciente e onipotente, que compartilham da mesma aparência - a de postulados autoritários. Essas fantasias, compondo ideologias (ou Weltanschauungen), postulam duas tendências no pensar, segundo um vértice da história das ideias (ou, mais precisamente, duas tendências em que ocorre ausência do pensar). Para fins didáticos e operacionais, denominaram-se essas tendências de "quantitativa" e "qualitativa"; a partir daí, sempre sob o vértice psicanalítico, descreve-se o conceito de grupos de trabalho, e especificam-se métodos de estudo para grupos de pessoas; o estudo se finaliza com um breve elenco de experiências práticas em clínica que embasam este texto...

Organized under the form of an entry of a dictionary, this paper was written in response to the kind invitation from the editors of this journal. It focuses on groupings of people, observed under the psychoanalytic vertex. This vertex can be seen as a transdisciplinary integration between, at least, two fields of observation. Roughly speaking, just for communicative purposes, one may define those fields according to their "levels" and/or "dimensions": macro and micro (levels). Being more specific, this is a study of emotional experiences, which may happen in certain human group, and of conscious and unconscious features that may act on interrelationships among individuals who are parts of a group. The study emphasizes some historical antecedents as well as some effects, in terms of group behavior - both the concrete, evident, express behavior (phenomenally observable), and the implicit, immaterial and ever present behavior (which Bion named "ultrasensuous" and "infrasensuous", and cannot be fully apprehended by human sense apparatus). This study about groups of people identifies two omnipotent and omniscient phantasies that share the same appearance - the appearance of an authoritarian postulate. Composing ideologies (or Weltanshauungen), those phantasies propose two tendencies of thinking, according to a vertex of the history of ideas (or, more precisely, two tendencies in which mindlessness - or lack of real thinking - does prevail). For didactic, operational purposes, the author names these tendencies "quantitative" and "qualitative". From this point, always under the psychoanalytic vertex, he describes the concept of working group and specifies few methods for the study of groups. The author finishes this study with a brief list of experiences in clinical practice (cases) that support his theory...

Este texto en forma de nota fue elaborado para atender una gentil invitación de los editores del Jornal de Psicoanálisis y versa sobre agrupamientos de personas observados desde el vértice psicoanalítico. Puede ser visto como una integración transdisciplinaria entre, por lo menos, dos ambientes de observación definibles como "niveles" o "dimensiones": macro y micro. Más específicamente, se trata de un estudio de las experiencias emocionales que pueden suceder y de las características conscientes e inconscientes que pueden actuar en la interrelación de personas que componen un determinado grupo. El estudio resalta algunos antecedentes históricos y consecuencias comportamentales, tanto el comportamiento concreto, aparente, manifiesto (fenomenológicamente observable) cuanto el comportamiento implícito, inmaterial, siempre actuante (denominado por Bion "ultra" e "infra" sensorial, que no puede ser totalmente aprehendido por el aparato sensitivo humano). Este estudio sobre Grupos de Personas identifica dos fantasías inconscientes de naturaleza omnisciente y omnipotente, que comparten la misma apariencia de postulados autoritarios. Estas fantasías componiendo ideologías determinan dos tendencias en el pensar, según un vértice de la historia de las ideas o, más precisamente, dos tendencias cuando ocurre la ausencia del pensar, que se denominaron, didáctica y operacionalmente, "cuantitativa" y "cualitativa". Luego, se describe el concepto de Grupo de Trabajo y se especifican los métodos para estudiar Grupos de Personas. Finalmente, es citada una serie de experiencias clínicas que le dan embasamiento a este texto...

Grupos: o vértice psicanalítico / Groups: a psychoanalytic vertex / Grupos: el vértice psicoanalítico

Este texto, sob a forma de verbete, feito sob gentil solicitação dos editores deste periódico, enfoca agrupamentos de pessoas observadas segundo o vértice psicanalítico, que pode ser visto como integração transdisciplinar entre, pelo menos, dois âmbitos de observação. Para finalidades de comunicação, esses âmbitos são definíveis por "níveis" ou "dimensões": macro e micro. Mais especificamente, trata-se do estudo das experiências emocionais que podem ocorrer no inter-relacionamento de pessoas que compõem um determinado grupo e também, conjuntamente, das características conscientes e inconscientes que podem agir. O estudo ressalta alguns antecedentes históricos e consequências em termos de comportamento; tanto o comportamento concreto, aparente, expresso (fenomenologicamente observável), como o comportamento implícito, imaterial, sempre atuante (denominado por Bion como "ultra" e "infra" sensorial, que não pode ser totalmente apreendido pelo aparato sensorial humano). Este estudo sobre grupos de pessoas identifica duas fantasias inconscientes, de natureza onisciente e onipotente, que compartilham da mesma aparência - a de postulados autoritários. Essas fantasias, compondo ideologias (ou Weltanschauungen), postulam duas tendências no pensar, segundo um vértice da história das ideias (ou, mais precisamente, duas tendências em que ocorre ausência do pensar). Para fins didáticos e operacionais, denominaram-se essas tendências de "quantitativa" e "qualitativa"; a partir daí, sempre sob o vértice psicanalítico, descreve-se o conceito de grupos de trabalho, e especificam-se métodos de estudo para grupos de pessoas; o estudo se finaliza com um breve elenco de experiências práticas em clínica que embasam este texto.(AU)

Organized under the form of an entry of a dictionary, this paper was written in response to the kind invitation from the editors of this journal. It focuses on groupings of people, observed under the psychoanalytic vertex. This vertex can be seen as a transdisciplinary integration between, at least, two fields of observation. Roughly speaking, just for communicative purposes, one may define those fields according to their "levels" and/or "dimensions": macro and micro (levels). Being more specific, this is a study of emotional experiences, which may happen in certain human group, and of conscious and unconscious features that may act on interrelationships among individuals who are parts of a group. The study emphasizes some historical antecedents as well as some effects, in terms of group behavior - both the concrete, evident, express behavior (phenomenally observable), and the implicit, immaterial and ever present behavior (which Bion named "ultrasensuous" and "infrasensuous", and cannot be fully apprehended by human sense apparatus). This study about groups of people identifies two omnipotent and omniscient phantasies that share the same appearance - the appearance of an authoritarian postulate. Composing ideologies (or Weltanshauungen), those phantasies propose two tendencies of thinking, according to a vertex of the history of ideas (or, more precisely, two tendencies in which mindlessness - or lack of real thinking - does prevail). For didactic, operational purposes, the author names these tendencies "quantitative" and "qualitative". From this point, always under the psychoanalytic vertex, he describes the concept of working group and specifies few methods for the study of groups. The author finishes this study with a brief list of experiences in clinical practice (cases) that support his theory.(AU)

Este texto en forma de nota fue elaborado para atender una gentil invitación de los editores del Jornal de Psicoanálisis y versa sobre agrupamientos de personas observados desde el vértice psicoanalítico. Puede ser visto como una integración transdisciplinaria entre, por lo menos, dos ambientes de observación definibles como "niveles" o "dimensiones": macro y micro. Más específicamente, se trata de un estudio de las experiencias emocionales que pueden suceder y de las características conscientes e inconscientes que pueden actuar en la interrelación de personas que componen un determinado grupo. El estudio resalta algunos antecedentes históricos y consecuencias comportamentales, tanto el comportamiento concreto, aparente, manifiesto (fenomenológicamente observable) cuanto el comportamiento implícito, inmaterial, siempre actuante (denominado por Bion "ultra" e "infra" sensorial, que no puede ser totalmente aprehendido por el aparato sensitivo humano). Este estudio sobre Grupos de Personas identifica dos fantasías inconscientes de naturaleza omnisciente y omnipotente, que comparten la misma apariencia de postulados autoritarios. Estas fantasías componiendo ideologías determinan dos tendencias en el pensar, según un vértice de la historia de las ideas o, más precisamente, dos tendencias cuando ocurre la ausencia del pensar, que se denominaron, didáctica y operacionalmente, "cuantitativa" y "cualitativa". Luego, se describe el concepto de Grupo de Trabajo y se especifican los métodos para estudiar Grupos de Personas. Finalmente, es citada una serie de experiencias clínicas que le dan embasamiento a este texto.(AU)

Intervenção sociodramática breve operacionalizada (ISBO) / Brief operationalised sociodramatic intervention (BOSI)

A ISBO - Intervenção Sociodramática Breve Operacionalizada fundamenta-se em estudo psicodramático, conjugado ao método psicanalítico aplicado no campo socioeducacional. Considera que o clima afetivo grupal de "suposições básicas" de dependência, ataque-fuga e acasalamento (Bion) é induzido pelas respostas contratransferenciais do líder (sujeito que ajuda um grupo a se tornar mais eficaz, criando e conquistando objetivos comuns, por meio da participação). Parte do pressuposto que o procedimento sociodramático possibilita a emergência da significação funcional da repetição/atuação contida nas respostas contratransferenciais de líderes, podendo assim contribuir para melhor produtividade grupal, em diferentes contextos sociais. A qualidade da relação entre o líder e os participantes de seu grupo de referência é analisada a partir das "suposições básicas", presentificadas nas cenas coconstruídas, em subgrupos referentes aos quatro setores da adaptação: afetivo-relacional, produtividade, orgânico e sociocultural (Simon). Em seguida, por meio do teatro espontâneo, propicia-se o encaminhamento de respostas novas e mais adequadas, para constituir um grupo de trabalho, centrado na tarefa. A técnica de inversão de papéis é indicada como um instrumento que permite a resolução de conflitos interculturais, na medida em que os membros de um subgrupo podem experimentar, no "como se", os papéis existentes em outros subgrupos. O bom resultado dessa proposta é garantido pelos personagens projetados na cena protagônica, que refletem e resolvem os conflitos grupais sem expor os participantes da ISBO. Desse modo, a identidade, a identificação subjetiva e o papel de líder estão interligados. Neste artigo, descrevo o procedimento utilizado como intervenção diagnóstica inicial em grupos de líderes. Após o diagnóstico, é construído o planejamento de ações aplicado entre quatro e oito encontros sociodramáticos tematizados. Assim, esse procedimento favorece o desenvolvimento ...(AU)

BOSI - Brief Operational Sociodramatic Intervention is based in psychodramatic study, combined with the psychoanalytic method applied to the socio-educational field. It considers that the affective group climate of "basic assumptions" of dependency, attack-run and mating (Bion) is induced by the leader's countertransferential responses (person who help a group to become more effective, creating and achieving common goals, by stimulating participation). It assumes that the socio-dramatic procedure allows the emergence of the functional significance of repetition/practice contained in the countertransferential responses of leaders, what can contribute to better group productivity, in different social contexts. The quality of the relationship between the leader and the participants of their reference group is analyzed from the "basic assumptions" made present in the co-constructed scenes, in sub-groups related to four areas of adaptation: emotional-relational, productivity, organic and socio-cultural. Then, by means of spontaneous theater, the routing of new and more appropriate responses is provided, in the sense of becoming a working group focused on the task. The technique of role reversal is indicated as a tool for resolving inter-cultural conflicts, once the members of a sub-group can experience roles that exist in other subgroups. The good result of this proposal is guaranteed by the characters projected in the protagonic scene, who reflect and resolve conflicts in the group without exposing participants of the BOSI. Thus, the identity, subjective identification and the role of leader are linked. In this article, the author describes the procedure used as initial diagnostic intervention in groups of leaders. After diagnosis, the plan of activities is composed and applied in four to eight thematized socio-dramatic meetings. Thus, this procedure favors the development of the critical capacity of reflecting on own thinking and actions ...(AU)

Em direção a uma demografia ambiental? Avaliação e tendências dos estudos de população e ambiente no Brasil / Towards an environmental Demography? Evaluation and tendencies of population and environment studies in Brazil

As Ciências Sociais foram as últimas a aceitar e incorporar a temática ambiental em seus respectivos temas de pesquisa. Entre elas, a Demografia talvez tenha sido a última a fazer esta conversão, incluindo aos poucos questões referentes à relação população/ambiente. O debate tem convergido para a crescente incorporação da dimensão espacial, sempre presente, mesmo não sendo o eixo central nos estudos demográficos, mas que na discussão ambiental se mostra preponderante. O desenvolvimento do campo, embora rápido e promissor, tem encontrado dificuldades inerentes a áreas de estudo que tendem à interdisciplinaridade, localizando-se na periferia de uma ciência em interface com outras. No Brasil, tais estudos também têm evoluído nas últimas duas décadas, sendo importante para seu delineamento a produção do Grupo de Trabalho "População e Meio Ambiente", da Associação Brasileira de Estudos Populacionais, privilegiado foco difusor destas preocupações no país. Em vista disso, este artigo procura refletir sobre a produção do grupo, na expectativa de trazer à tona alguns elementos acerca dos métodos, temas e problemáticas abordadas ao longo dos anos, no sentido de localizar em que ponto deste desenvolvimento se encontra a temática hoje, e quais as perspectivas e os desafios que se abrem para o futuro.

The social sciences were latecomers in the acceptance and incorporation of the environment into their respective research programs. Among them, Demography was perhaps the last to make this change, gradually incorporating population-environment questions. The debate has converged toward the growing incorporation of the spatial dimension, long present but not a defining issue of demographic studies, but which is central in the environmental discussion. The development of the field, though rapid and promising, has encountered difficulties inherent to interdisciplinary fields, occupying a place on the periphery of one science, at the interface with others. In Brazil, where these studies have also evolved over the last two decades, the work of the Working Group on Population and Environment of the Brazilian Association of Population Studies has been a key factor in disseminating this concern. In view of this, we seek to reflect on the production of this group to identify elements concerning the methods, themes and problematics treated over the years, in order to assess where this field is today, and what are its future perspectives and challenges.

Las Ciencias Sociales fueron las últimas en aceptar e incorporar la temática ambiental en sus respectivos temas de investigación. Entre ellas, la Demografía tal vez haya sido la última en hacer esta conversión, incluyendo poco a poco aspectos referentes a la relación población-ambiente. El debate ha convergido hacia la creciente incorporación de la dimensión espacial, siempre presente, aun no siendo el eje central en los estudios demográficos, pero que en la discusión ambiental se muestra preponderante. El desarrollo del campo, aunque rápido y promisorio, ha encontrado dificultades inherentes a áreas de estudio que tienden a la interdisciplinaridad, localizándose en la periferia de una ciencia en interfase con otras. En Brasil estos estudios también han evolucionado en las últimas dos décadas, siendo importante para su delineación el trabajo del Grupo de Trabajo "Población y Medio Ambiente", de la Asociación Brasileña de Estudios Poblacionales, privilegiado foco difusor de estas preocupaciones en el país. En vista de esto, este artículo pretende reflexionar sobre el trabajo del grupo, con la expectativa de traer a la superficie algunos elementos acerca de los métodos, temas y problemáticas abordadas a lo largo de los años, en el sentido de localizar en que punto de este desarrollo se encuentra hoy la temática, y cuales son las perspectivas y los desafíos que se abren para el futuro.