Comparison of adverse events following immunization with pandemic influenza A (H1N1)pdm09 vaccine with or without adjuvant among health professionals in Rio de Janeiro, Brazil

A vaccination campaign against pandemic influenza A (H1N1)pdm09 was held in Brazil in March 2010, using two types of monovalent split virus vaccines: an AS03-adjuvanted vaccine and a non-adjuvanted vaccine. We compared the reactogenicity of the vaccines in health professionals from a Clinical Research Institute in Rio de Janeiro, Brazil and there were no serious adverse events following immunization (AEFI) among the 494 subjects evaluated. The prevalence of any AEFI was higher in the AS03-adjuvanted vaccine at 2 h and 24 h post-vaccination [preva-lence ratio (PR): 2.05, confidence interval (CI) 95%: 1.55-2.71, PR: 3.42, CI 95%: 2.62-4.48, respectively]; however, there was no difference between the vaccines in the assessments conducted at seven and 21 days post-vaccination. The group receiving the AS03 post-adjuvanted vaccine had a higher frequency of local reactions at 2 h (PR: 3.01, CI 95%: 2.12-4.29), 24 h (PR: 4.57, CI 95%: 3.29-6.37) and seven days (PR: 6.05, CI 95%: 2.98-12.28) post-vaccination. We concluded that the two types of vaccines caused no serious AEFI in the studied population and the adjuvanted vaccine was more reactogenic, particularly in the 24 h following vaccination. This behaviour must be confirmed and better characterised by longitudinal studies in the general population.

Expectations, experiences and attitudes of patients and primary care health professionals regarding online psychotherapeutic interventions for depression: protocol for a qualitative study.

BACKGROUND In the year 2020, depression will cause the second highest amount of disability worldwide. One quarter of the population will suffer from depression symptoms at some point in their lives. Mental health services in Western countries are overburdened. Therefore, cost-effective interventions that do not involve mental health services, such as online psychotherapy programs, have been proposed. These programs demonstrate satisfactory outcomes, but the completion rate for patients is low. Health professionals' attitudes towards this type of psychotherapy are more negative than the attitudes of depressed patients themselves. The aim of this study is to describe the profile of depressed patients who would benefit most from online psychotherapy and to identify expectations, experiences, and attitudes about online psychotherapy among both patients and health professionals that can facilitate or hinder its effects. METHODS A parallel qualitative design will be used in a randomised controlled trial on the efficiency of online psychotherapeutic treatment for depression. Through interviews and focus groups, the experiences of treated patients, their reasons for abandoning the program, the expectations of untreated patients, and the attitudes of health professionals will be examined. Questions will be asked about training in new technologies, opinions of online psychotherapy, adjustment to therapy within the daily routine, the virtual and anonymous relationship with the therapist, the process of online communication, information necessary to make progress in therapy, process of working with the program, motivations and attitudes about treatment, expected consequences, normalisation of this type of therapy in primary care, changes in the physician-patient relationship, and resources and risks. A thematic content analysis from the grounded theory for interviews and an analysis of the discursive positions of participants based on the sociological model for focus groups will be performed. DISCUSSION Knowledge of the expectations, experiences, and attitudes of both patients and medical personnel regarding online interventions for depression can facilitate the implementation of this new psychotherapeutic tool. This qualitative investigation will provide thorough knowledge of the perceptions, beliefs, and values of patients and clinicians, which will be very useful for understanding how to implement this intervention method for depression.

Valoració de l'UCI oberta vs tancada dels professionals que han desenvolupat la seva tasca assistencial en els dos règims de visites: factors contribuients

Es pretén conèixer la valoració que fan els professionals de la Salut que treballen en un sistema de visites obert, dins una Unitat de Cures Intensives Polivalent d’Adults, en comparació a l’experiència d’haver treballat en un sistema de visites tancat. Malgrat ser ben valorat per pacients, familiars i professionals; el sistema obert provoca inconvenients que afecten directament a la tasca assistencial dels professionals. Cal trobar estratègies que permetin millorar les relacions interprofessionals amb les famílies i disminuir les interferències a l’hora de fer les cures, a la vegada, que es puguin mantenir els beneficis d’un sistema de visites obert.

The encouragement of the open access movement: an essential realm for health information professionals in the 21st century

According to the Bethesda Statement on Open Access Policy for libraries and the recommendations of the BOAI10, libraries and librarians have an important role to fulfil in the encouragement of open access. Taking into account the Competencies for Information Professionals of the 21st Century, elaborated by the Special Libraries Association, and the Librarians’ Competencies Profile for Scholarly Publishing and Open Access, we shall identify the competencies and new areas of knowledge and expertise that have been involved in the process of the development and upkeep of our institutional repository (Repositorio SSPA).

Effectiveness of a pediatric palliative home care team as experienced by parents and health care professionals.

OBJECTIVES: Little data are available on palliative home care for children. The objective of this study was to evaluate the effectiveness of a specialized pediatric palliative home care team (PPHCT) as experienced by parents and health care professionals (HCPs). METHODS: Parents and HCPs involved in the care of terminally ill children who died and whom the PPHCT was in charge of were surveyed with questionnaires focusing on satisfaction with the PPHCT, satisfaction with the course of the dying phase, and the development of anxiety, depression, and prolonged grief disorder. RESULTS: Forty-three parent dyads participated (return rate, 88%). Satisfaction with the PPHCT scored a median of 10 (numeric rating scale, 0-10). The child's death was predominantly experienced as very peaceful (median, 9); 71% died at home. According to parents, involvement of the PPHCT led to highly significant (p<0.001) improvements in the children's symptoms and quality of life, as well as in aspects of communication and administrative barrier reduction. Anxiety was detected in 25% of parents, depression in 19%, and prolonged grief disorder in 13%. HCPs (return rate, 83%) evaluated all investigated care domains (particularly cooperation/communication/family support) as being significantly improved (p<0.001). Thirty-five percent of HCPs felt uncertain concerning pediatric palliative care; 79% would welcome specific training opportunities. CONCLUSIONS: Involvement of a PPHCT is experienced as a substantial improvement of care by parents and HCPs. Coordination of palliative care during the last phase of life appears to be an important quality factor for the home care of dying children and their families.

Anàlisi de les competències transversals dels professionals de les TIC en l'àmbit empresarial

Aquest estudi es centra en l'anàlisi del concepte de competències transversals (CT) i en la valoració d'aquestes per part del sector empresarial lligat als professionals de les TIC.

'Doctor, what would you do in my position?' Health professionals and the decision-making process in pregnancy monitoring.

OBJECTIVE: Routine prenatal screening for Down syndrome challenges professional non-directiveness and patient autonomy in daily clinical practices. This paper aims to describe how professionals negotiate their role when a pregnant woman asks them to become involved in the decision-making process implied by screening. METHODS: Forty-one semi-structured interviews were conducted with gynaecologists-obstetricians (n=26) and midwives (n=15) in a large Swiss city. RESULTS: Three professional profiles were constructed along a continuum that defines the relative distance or proximity towards patients' demands for professional involvement in the decision-making process. The first profile insists on enforcing patient responsibility, wherein the healthcare provider avoids any form of professional participation. A second profile defends the idea of a shared decision making between patients and professionals. The third highlights the intervening factors that justify professionals' involvement in decisions. CONCLUSIONS: These results illustrate various applications of the principle of autonomy and highlight the complexity of the doctor-patient relationship amidst medical decisions today.

Medical and legal professionals' attitudes towards confidentiality and disclosure of clinical information in forensic settings: a survey using case vignettes.

OBJECTIVE: When potentially dangerous patients reveal criminal fantasies to their therapists, the latter must decide whether this information has to be transmitted to a third person in order to protect potential victims. We were interested in how medical and legal professionals handle such situations in the context of prison medicine and forensic evaluations. We aimed to explore the motives behind their actions and to compare these professional groups. METHOD: A mail survey was conducted among medical and legal professionals using five fictitious case vignettes. For each vignette, participants were asked to answer questions exploring what the professional should do in the situation and to explain their justification for the chosen response. RESULTS: A total of 147 questionnaires were analysed. Agreement between participants varied from one scenario to another. Overall, legal professionals tended to disclose information to a third party more easily than medical professionals, the latter tending to privilege confidentiality and patient autonomy over security. Perception of potential danger in a given situation was not consistently associated with actions. CONCLUSION: Professionals' opinions and attitudes regarding the confidentiality of potentially dangerous patients differ widely and appear to be subjectively determined. Shared discussions about clinical situations could enhance knowledge and competencies and reduce differences between professional groups.

Knowledge as a factor in vulnerability to tuberculosis among nursing students and professionals

The objective of this study was to identify vulnerability to tuberculosis (TB) related to knowledge about the disease among 76 nursing students and professionals. A quantitative descriptive study was conducted using a closed questionnaire for the collection of data regarding transmission, preventive and biosafety measures, diagnosis, and prejudice regarding the disease. The SAS software version 9.1.3 was used for data analysis, with the level of significance set at 5% (p < 0.05). Nursing students and professionals showed a vulnerability to TB related to knowledge about transmission, preventive and biosafety measures, and diagnosis of the disease. With respect to transmission, vulnerability was higher among nursing professionals. The results indicate the need for investment by healthcare institutions surrounding this topic in view of the important role of nursing in the establishment of strategies for prevention and control of the disease.

Proposta d’un mètode de deliberació sobre problemàtiques ètiques per a professionals del camp del treball social

Aquest treball es proposa analitzar els diferents mètodes existents en el camp assistencial per resoldre problemàtiques ètiques, per després proposar un mètode (nou o existent) de deliberació de problemàtiques ètiques, adreçat a professionals del camp del treball social. En el primer apartat de l’estudi s’exposa la definició del concepte de problema ètic en el camp del treball social. Seguidament es presenta una reflexió sobre la presència de problemes ètics en la professió de treball social. Posteriorment es realitza una justificació de la necessitat d’un mètode de resolució de problemes ètics per a professionals del treball social i d’una nova proposta, per exposar tot seguit els objectius del treball, amb les hipòtesis corresponents. En el segon apartat es realitza un repàs de les condicions necessàries per a la deliberació, entenent aquest concepte com a base per a aplicar qualsevol mètode d’anàlisi i/o resolució de problemes ètics. En el tercer apartat s’exposen i analitzen els mètodes de deliberació ètica més rellevants en medicina i treball social, després de dissenyar i aplicar ítems de valoració dels mateixos. En el quart apartat es proposa un mètode de deliberació sobre problemàtiques ètiques per a professionals del camp del treball social i es planteja una segona fase de l’estudi per implementar el mètode i aplicar-lo a casos pràctics. Per últim es presenten les conclusions del treball, i a continuació la bibliografia

A qui li dic? : la detecció de l’abús sexual infantil i el traspàs d’informació entre professionals

Aquest treball s'estructura en una primera part de fonamentació teòrica. El procediment que s'ha seguit ha estat la recerca bibliogràfica. Es basa en els aspectes tècnics a tenir en compte per la detecció de l' Abusos Sexuals Infantils (ASI), la ubicació dels Serveis Bàsics d'Atenció Social (SBAS) dins el sistema català de serveis socials, el marc jurídic dels drets i de la protecció a la infància i l'adolescència així com de qüestions relatives al tractament de dades, de la confidencialitat de les informacions de què disposem els/les professionals, l'obligació de secret, complementat amb la deontologia professional, que ens pot orientar a l'hora de prendre les decisions més adequades a la nostra praxi. La segona part del treball és empírica. El procediment ha estat portar a terme un grup de reflexió ètica amb professionals del Consorci de Benestar Social del Pla de l'Estany-Banyoles. Partint de casos pràctics de sospita d'ASI, les persones participants han concretat els principals problemes (alguns dels quals relacionats amb l'ètica aplicada) davant els quals s'han trobat a la fase de detecció/intervenció. Les aportacions extretes de les diferents sessions en les quals es van treballar part dels objectius d'aquesta recerca ens permeten concretar la realitat i una primera deliberació sobre quina podria ser la bona pràctica general. La tercera part utilitza la fonamentació teòrica i els material del treball de camp per presentar la reflexió final que pretén donar resposta als objectius plantejats en aquesta recerca

Improvement courses about violence prevention: the impact on health sector professionals

Uncontrolled intervention study that compared the effectiveness of two elective courses on Prevention and Assistance to violence victims for students and professionals of the Health Sector. The participants answered multiple-choice questions on the topic before and after the course. Statistical analyzes were performed by comparison of two proportions on STATA/IC. Regarding the overall index of correct answers,before and after, it was 54.8 and 58.4% in the 10h Course and the 69.6 and 79.2% in the 30h Course. The most effective course was the 30h Course, with strategies of case discussions and visits to assistance services to violence victims. There is a great necessity to include the discipline in the curriculum of healthcare courses permanently.



Intervening factors in attention flow of professionals injured by biological material

Objective: To describe the barriers and facilitator factors to follow the attention flow of professionals injured by biological material in the worker perspective. Method: Qualitative descriptive study with data collected through individual interviews with 18 injured workers, assisted in reference public units in the city of Goiânia. The content analysis was carried out with assistance of the ATLAS.ti 6.2 software, under the work organization and subjective perspectives. Results: From the interviews regarding the barriers and facilitator factors emerged the categories: organizational structure, Support from close people, and Knowledge influence. Conclusion: The organized services have enabled more qualified consultations and the workers follow-up, which caused a satisfaction feeling in relation to the working environment.