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Resumo Enquadramento: A pandemia por COVID-19 trouxe inúmeros desafios às mães de crianças e jovens até aos 18 anos de idade, pela gestão de responsabilidades a que o seu papel social se encontra inerente. Objetivo: Compreender quais são os significados e os contextos das vivências de mães portuguesas de crianças e jovens adolescentes até aos 18 anos de idade, no período de situação pandémica por COVID-19; Metodologia: Estudo qualitativo, descritivo e retrospetivo recorrendo à análise de conteúdo de Bardin. Participaram no estudo 16 mulheres, mães de crianças e jovens adolescentes até aos 18 anos de idade. Resultados: Emergiram um total de nove categorias, sendo elas - Sentimentos; Perceção de saúde; Alterações no estado de saúde; experiências marcantes; Significado das experiências; Dificuldades sentidas durante o período de situação pandémica; dificuldades sentidas na educação; dificuldades sentidas enquanto mãe e mulher e impactos na educação dos filhos. Conclusão: A maioria das mães entrevistadas considerou o período pandémico por COVID-19 como uma fase impactante nas suas vidas, originando ambivalência de sentimentos e contextos vivenciais distintos.

Abstract Background: The COVID-19 pandemic has posed many challenges for mothers of children and adolescents up to 18 years of age in managing the responsibilities associated with their social roles. Objective: To understand the meanings and contexts of the experiences of Portuguese mothers of children and adolescents up to 18 years of age during the COVID-19 pandemic. Methodology: Qualitative, descriptive, and retrospective study using Bardin's content analysis. The sample consisted of 16 mothers of children and adolescents up to 18 years of age. Results: Nine categories emerged - Feelings; Perception of health; Changes in health status; Significant experiences; Meaning of experiences; Difficulties felt during the pandemic; Difficulties felt in education; Difficulties felt as a mother and wife; and Impact on children's education. Conclusion: Most of the interviewed mothers considered the COVID-19 pandemic a significant period in their lives, giving rise to ambivalent feelings and distinct life contexts.

Resumen Marco contextual: La pandemia de SARS- CoV-2 ha planteado numerosos retos a las madres de niños y jóvenes de hasta 18 años, debido a la gestión de las responsabilidades inherentes a su papel social. Objetivo: Comprender los significados y contextos de las experiencias de las madres portuguesas de niños y jóvenes adolescentes de hasta 18 años, durante la situación de pandemia de COVID-19. Metodología: Estudio cualitativo, descriptivo y retrospectivo mediante el análisis de contenido de Bardin. Participaron en el estudio 16 mujeres, madres de niños y jóvenes adolescentes de hasta 18 años. Resultados: Surgieron un total de nueve categorías - Sentimientos; Percepción de la salud; Cambios en el estado de salud; Experiencias notables; Significado de las experiencias; Dificultades sentidas durante la situación de pandemia; Dificultades sentidas en la educación; Dificultades sentidas como madre y esposa, e Impactos en la educación de los hijos. Conclusión: La mayoría de las madres entrevistadas consideraron que el periodo de la pandemia de COVID-19 fue una fase impactante en sus vidas, lo que dio lugar a una ambivalencia de sentimientos y diferentes contextos experienciales.

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Patient safety is a priority for health systems and is especially relevant for critically ill patients. Despite its relevance in recent years, many patients suffer adverse events with harm and negative repercussions for professionals and institutions. Numerous safe practices have been promoted and strategies have been developed that have been incorporated into institutional policies and thereby improving the safety culture. But there are still underdeveloped strategies, such as incorporating the participation of patients and family members in their safety. Until recently, the patient and family have been considered as a passive part in the reception of health services, not as an active part, much less as a possible opportunity to improve safety against errors that occur during care. The critically ill patient and/or family members must be informed and, ideally, trained to facilitate active participation in their safety. It is not about transferring responsibility, but about facilitating and promoting their participation by reinforcing their safety. And professionals must be committed to their safety and facilitate the conditions to encourage their participation. We provide tools and reflections to help professionals implement the participation of patients and family members in safety as they pass through intensive medicine services.

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La pandemia de COVID-19 representó un gran desafío para los profesionales de la salud de Perú, debido al riesgo elevado de contagio, la sobrecarga laboral y afectación de la salud mental. Objetivo: describir las experiencias laborales y percepciones del personal sanitario de este país durante la pandemia de COVID-19. Materiales y Métodos: se llevó a cabo un estudio cualitativo fenomenológico, en el que se realizaron ocho entrevistas semiestructuradas a profesionales de la salud pública en Perú entre mayo y diciembre del año 2020. Las mismas fueron grabadas y transcritas para la recolección de la información, las cuales se analizaron en categorías. Resultados: en las entrevistas realizadas se destacaron los desafíos organizativos y de recursos, como la escasez de equipos de protección personal y gestión burocrática. Se resaltó el impacto humano y social en términos de comunicación, empatía y reevaluación de valores personales. Se observó adaptaciones significativas en la práctica médica, con énfasis en el manejo de pacientes y la capacitación. Conclusiones: las experiencias clínicas y emocionales reflejaron los retos y motivaciones del personal sanitario durante la pandemia; en el que se demostró la necesidad de una mayor adaptabilidad y preparación, así como la importancia del bienestar emocional y social.

The COVID-19 pandemic represented a great challenge for health professionals in Peru, due to the high risk of contagion, work overload, and impact on mental health. Objective: describe the work experiences and perceptions of health personnel in this country during the COVID-19 pandemic. Materials and Methods: a qualitative phenomenological study was carried out, in which eight semi-structured interviews were carried out with public health professionals in Peru between May and December 2020. They were recorded and transcribed for the collection of information, which were analyzed in categories. Results: organizational and resource challenges were highlighted in the interviews conducted, such as the shortage of personal protective equipment and bureaucratic management. The human and social impact was highlighted in terms of communication, empathy and reevaluation of personal values. Significant adaptations were observed in medical practice, with emphasis on patient management and training. Conclusions: the clinical and emotional experiences reflected the challenges and motivations of healthcare personnel during the pandemic; in which the need for greater adaptability and preparation was demonstrated, as well as the importance of emotional and social well-being

A pandemia da COVID-19 representou um grande desafio para os profissionais de saúde no Peru, devido ao alto risco de contágio, sobrecarga de trabalho e impacto na saúde mental. Objetivo: descrever as experiências de trabalho e percepções do pessoal de saúde neste país durante a pandemia da COVID-19. Materiais e Métodos: Foi realizado um estudo fenomenológico qualitativo, no qual foram realizadas oito entrevistas semiestruturadas com profissionais de saúde pública no Peru entre maio e dezembro de 2020. Elas foram gravadas e transcritas para a coleta de informações. Resultados: os desafios organizacionais e de recursos foram destacados nas entrevistas realizadas, como a escassez de equipamentos de proteção individual e a gestão burocrática. O impacto humano e social foi destacado em termos de comunicação, empatia e reavaliação de valores pessoais. Adaptações significativas foram observadas na prática médica, com ênfase no manejo e treinamento dos pacientes. Conclusões: as experiências clínicas e emocionais refletiram os desafios e motivações dos profissionais de saúde durante a pandemia; em que foi demonstrada a necessidade de maior adaptabilidade e preparação, bem como a importância do bem-estar emocional e social

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La pandemia de COVID-19 representó un gran desafío para los profesionales de la salud de Perú, debido al riesgo elevado de contagio, la sobrecarga laboral y afectación de la salud mental. Objetivo: Describir las experiencias laborales y percepciones del personal sanitario de este país durante la pandemia de COVID-19. Materiales y Métodos: Se llevó a cabo un estudio cualitativo fenomenológico, en el que se realizaron ocho entrevistas semiestructuradas a profesionales de la salud pública en Perú entre mayo y diciembre del año 2020. Las mismas fueron grabadas y transcritas para la recolección de la información, las cuales se analizaron en categorías. Resultados: En las entrevistas realizadas se destacaron los desafíos organizativos y de recursos, como la escasez de equipos de protección personal y gestión burocrática. Se resaltó el impacto humano y social en términos de comunicación, empatía y reevaluación de valores personales. Se observó adaptaciones significativas en la práctica médica, con énfasis en el manejo de pacientes y la capacitación. Conclusiones: Las experiencias clínicas y emocionales reflejaron los retos y motivaciones del personal sanitario durante la pandemia; en el que se demostró la necesidad de una mayor adaptabilidad y preparación, así como la importancia del bienestar emocional y social.

The COVID-19 pandemic represented a great challenge for health professionals in Peru, due to the high risk of contagion, work overload, and impact on mental health. Objective: Describe the work experiences and perceptions of health personnel in this country during the COVID-19 pandemic. Materials and Methods: A qualitative phenomenological study was carried out, in which eight semi-structured interviews were carried out with public health professionals in Peru between May and December 2020. They were recorded and transcribed for the collection of information, which were analyzed in categories. Results: Organizational and resource challenges were highlighted in the interviews conducted, such as the shortage of personal protective equipment and bureaucratic management. The human and social impact was highlighted in terms of communication, empathy and reevaluation of personal values. Significant adaptations were observed in medical practice, with emphasis on patient management and training. Conclusions: The clinical and emotional experiences reflected the challenges and motivations of healthcare personnel during the pandemic; in which the need for greater adaptability and preparation was demonstrated, as well as the importance of emotional and social well-being.

A pandemia da COVID-19 representou um grande desafio para os profissionais de saúde no Peru, devido ao alto risco de contágio, sobrecarga de trabalho e impacto na saúde mental. Objetivo: Descrever as experiências de trabalho e percepções do pessoal de saúde neste país durante a pandemia da COVID-19. Materiais e Métodos: Foi realizado um estudo fenomenológico qualitativo, no qual foram realizadas oito entrevistas semiestruturadas com profissionais de saúde pública no Peru entre maio e dezembro de 2020. Elas foram gravadas e transcritas para a coleta de informações. Resultados: Os desafios organizacionais e de recursos foram destacados nas entrevistas realizadas, como a escassez de equipamentos de proteção individual e a gestão burocrática. O impacto humano e social foi destacado em termos de comunicação, empatia e reavaliação de valores pessoais. Adaptações significativas foram observadas na prática médica, com ênfase no manejo e treinamento dos pacientes. Conclusões: As experiências clínicas e emocionais refletiram os desafios e motivações dos profissionais de saúde durante a pandemia; em que foi demonstrada a necessidade de maior adaptabilidade e preparação, bem como a importância do bem-estar emocional e social.

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El parto humanizado es un modelo de atención que considera el respeto a las opiniones y necesidades de las mujeres y sus familias, e incluye la atención durante el embarazo, parto, puerperio y, por supuesto, la atención del recién nacido. En Venezuela, existe legislación suficiente que respalda la atención del parto humanizado o respetado, sin embargo, la misma no es conocida por gran parte del personal de salud involucrado en la atención obstétrica. Es necesario que tal legislación se conozca ampliamente y se aplique. La presente revisión se realizó con la intención de revisar los fundamentos legales que respaldan la atención del parto respetado(AU)

Humanized childbirth is a model of care that considers respect for the opinions and needs of women and their families, and includes care during pregnancy, childbirth, puerperium and, of course, newborn care. In Venezuela, there is sufficient legislation that supports humanized or respected childbirth care, however, it is not known by a large part of the health personnel involved in obstetric care. Such legislation needs to be widely known and implemented. This review was conducted with the intention of reviewing the legal foundations that support respected childbirth care(AU)

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BACKGROUND: Patient-reported outcome measures (PROMs) and patient-reported experiences measures (PREMs) are crucial for understanding the impact of GD on quality of life and patient's perceptions on care, but also to guide decision-making processes. Nevertheless, no specific PREMs in GD have been published, neither PROMs for Spanish GD patients have been developed. METHODS: Two project coordinators selected key-points to be included in a PROMs/PREMs questionnaire, and the scientific committee and a group of expert patients contributed to the initial draft. Then, 9 meetings with experts were held to discuss controversial points. After, a questionnaire with 103 items regarding symptomatology, aspects of daily life and care experience was developed. Finally, it was conducted a Delphi survey among a multidisciplinary group of experts in GD. RESULTS: Consensus was reached on 85 out of the 103 items. Recommendations on PROMs and PREMs regarding symptomatology, aspects of daily life and care experience were obtained. Consensus was reached on the importance of considering fatigue, concentration problems, and communication issues in GD patients using 5-step analog scales. Panelists recommended asking GD patients about the impact on social functioning and work/school performance. Finally, consensus was reached on considering care experiences, such as treatment satisfaction, treatment interruptions or transitions and healthcare professionals involved in patient's management to perceive patient's perceptions. CONCLUSION: This expert consensus may help developing GD-specific PROMs/PREMs for improving GD management. Properly developed and validated PROMs/PREMs may help decision-making, establishing patient-tailored therapeutic and follow-up goals.

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BACKGROUND: We assessed pain, acceptability, patient preference, and tolerability of patients with psoriasis and psoriatic arthritis after switching guselkumab from a prefilled syringe to One-Press autoinjector pen. METHODS: Patients with psoriasis and psoriatic arthritis treated for at least 6 months with guselkumab syringe were recruited from Jan 2019 to Dec 2022. Gender, age, diagnosis, self-administration, and pain perception of guselkumab prefilled syringe were recorded. At the first visit, patients completed a post-auto-injection syringe questionnaire before starting auto-injection pen administration. After 2 and 6 months of guselkumab self-injection using the One-Press autoinjector pen, patient experience, adherence, preference, pain, and safety of each administration were assessed using post-guselkumab by One-Press autoinjector pen questionnaire. RESULTS: 40 patients [psoriasis n=34, psoriatic arthritis n=6] were included. All patients self-administered guselkumab by One-Press autoinjector pen. Pain at the injection site was significantly reduced with the use of the One-Press autoinjector pen. All patients considered that using One-Press autoinjector pen was easier than the syringe, 98% chose the pen as their preferred delivery system. CONCLUSION: The One-Press autoinjector pen for guselkumab administration is presented as a preferred option, with a high satisfaction and less painful compared to the administration of guselkumab in a prefilled syringe.

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Por que admiramos e subimos montanhas? Para discutir essa questão, iniciamos esclarecendo as diferenças conceituais entre natureza e paisagem e como se dá a experiência estética paisagística, subjetiva e objetiva ao mesmo tempo, com o apoio da Filosofia da Paisagem. Na sequência, com base na historiografia da paisagem e na literatura da arte, narramos a invenção cultural da montanha no imaginário universal, no qual afirmou-se como uma realidade compósita, natureza e paisagem. Essa condição a faz admirada e visitada tanto pelos seus atributos naturais quanto pelos imateriais e afetivos. Dá-lhe também um valor estratégico: subir montanhas é uma experiência física e estética que nos incita a pensar, enriquece os nossos sentidos e imaginação, fundamentais para a nossa consciência de mundo. Do seu alto alcançamos tanto belezas quanto destruição e isso nos conduz a posicionamentos éticos. A decisão, em paisagem, é topológica.

Why do we admire and climb mountains? To discuss this topic, we begin by explaining the conceptual differences between nature and landscape and how the aesthetic experience of landscape occurs, with the support of the Philosophy of Landscape. Based on the historiography of the landscape and the literature of art, we continue to narrate the historical path of cultural invention of the mountain within the universal imaginary, in which it asserted itself as a double reality, nature and landscape. This condition made it admired and experienced by both their natural attributes and their immaterial and affective values. It also gives to it a strategic value: climbing mountains is both aesthetic and physical experience that incites us to think, enriches our senses and imagination, fundamental to our awareness of the world. Over the mountain, we can see beauty or destruction, and this leads us into ethical positions. The decision, in landscape, is topological.

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Background: Narrative exposure therapy (NET) is a recommended intervention for people with multiple trauma histories; however, research is lacking into its use with people experiencing psychosis, many of whom report multiple trauma histories.Objective: This study aimed to explore experiences of NET in early intervention in psychosis (EIP) services.Method: Eight clinicians and four experts with lived experience (experts by experience) of psychosis and multiple trauma were interviewed on a single occasion using two versions (clinician and expert by experience) of a semi-structured interview schedule. Data was analysed using thematic analysis.Results: Five overarching themes were generated, relating to fear and avoidance of memories, importance of trust, organizing memories and making new meaning, reconnecting with emotions, and considerations when delivering NET in EIP.Conclusions: Directly addressing the impact of multiple trauma in people experiencing first episode psychosis is frightening and emotive, but helps to address painful memories and organize them into a personal narrative. Increases in distress and anomalous experiences were carefully considered by clinicians, but typically outweighed by the benefits of NET. Challenges were comparable to those described in non-psychosis research. Implications for clinical practice and future research are outlined.

Many people experiencing psychosis report multiple trauma histories. Narrative exposure therapy (NET) is a recommended intervention for people with multiple trauma histories, but research into its use with people experiencing psychosis is limited.This qualitative study found that clinicians and experts by experience in early intervention in psychosis services valued NET for its effect on organizing memories, reducing their emotional impact, and making new meaning around experiences, and that challenges of NET were similar to those described in non-psychosis research.Some participants described experiencing distress and dysregulation during NET, including an increase in anomalous experiences. Although this was typically temporary and outweighed by NET's benefits, careful assessment before and flexibility during the intervention are considered important for building engagement and trust.

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Relatar a experiência vivenciada por enfermeiras mestrandas e docente de disciplina eletiva de universidade pública do interior de Minas Gerais. Método: estudo descritivo, do tipo relato de experiência, a fim de relatar reflexões críticas acerca da Política Nacional de Humanização (PNH) realizadas em disciplina de Programa de Pós-graduação stricto sensu ministrada entre agosto e novembro de 2023. Resultados: participaram sete enfermeiras, todas do sexo feminino, com vivências em instituições de saúde públicas e privadas. Foi possível compreender sobre diversos aspectos, e duas categorias foram elaboradas: Repercussões e entraves referentes à implantação plena da PNH; Humanização e ensino teórico-prático nas instituições formadoras. Também foi produzido um mapa mental sobre a temática. Conclusão: destaca-se a importância de discutir sobre humanização nas instituições de ensino para o aprofundamento do tema e disseminação do conhecimento associado ao olhar prático humanizado.(AU)

To report on the experience of master's degree nurses and a lecturer in an elective course at a public university in the interior of Minas Gerais. Method: this is a descriptive, experience-report type study, aimed at reporting critical reflections on the National Humanization Policy (NHP) carried out in a stricto sensu postgraduate program course taught between August and November 2023. Results: Seven nurses took part, all female, with experience in public and private healthcare institutions. It was possible to understand various aspects, and two categories were created: Repercussions and obstacles regarding the full implementation of the PNH; Humanization and theoretical-practical teaching in training institutions. A mind map on the subject was also produced. Conclusion: The importance of discussing humanization in educational institutions is highlighted in order to deepen the subject and disseminate knowledge associated with a practical humanized approach.(AU)

Relatar la experiencia de enfermeros de maestría y de un profesor en un curso electivo de una universidad pública del interior de Minas Gerais. Método: se trata de un estudio descriptivo, de tipo experiencia-informe, con el objetivo de relatar reflexiones críticas sobre la Política Nacional de Humanización (PNH) realizadas en una asignatura del programa de posgrado stricto sensu impartida entre agosto y noviembre de 2023. Resultados: Participaron siete enfermeras, todas del sexo femenino, con experiencia en instituciones de salud públicas y privadas. Se pudieron conocer diversos aspectos y se desarrollaron dos categorías: repercusiones y obstáculos en la plena implantación de la PNH; humanización y enseñanza teórico-práctica en las instituciones de formación. También se elaboró un mapa mental sobre el tema. Conclusión: Se destaca la importancia de discutir la humanización en las instituciones de enseñanza para profundizar el tema y difundir el conocimiento asociado a un abordaje humanizado práctico.(AU)

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OBJECTIVE: To describe the aspects with the greatest impact on the satisfaction of patients treated in a multidisciplinary unit specialising in immune-mediated inflammatory diseases (IMIDs) and to identify areas for improvement in the care model. METHODS: Cross-sectional descriptive study using a satisfaction survey structured in three blocks: sociodemographic variables, functional aspects of the unit and satisfaction with the professionals. Immediate satisfaction was measured on aspects related to the care received, the physical structure and the likelihood of recommending the unit. RESULTS: A total of 168 patients completed the surveys, the mean score of overall satisfaction with the unit was 4.75 (SD:0.4). The regression model showed the relationship between overall satisfaction and unit signage (OR:3.558, p=0.045, 95% CI: 1.027-12.33), coordination between professionals (OR:9.043, p=0.000, 95% CI: 2.79-29.28) and participation in decision making (OR: 44.836, p=0.000, 95% CI: 5.49-365.97). In terms of immediate satisfaction, the overall Net Promoter Score (NPS) was 87 (excellent). The mean score for coordination with Primary Care was 4.54 (SD:0.8) and they scored waiting time to be seen with 4.49 (SD:0.8), so they have been considered an area for improvement The mean score for coordination with Primary Care was 4.54 (SD:0.8) and they scored waiting time to be seen with 4.49 (SD:0.8), so both were considered areas for improvement. CONCLUSIONS: Coordination between intra-centre professionals and patient participation in decision-making explain the excellent level of patient satisfaction. The monitoring of satisfaction has made it possible to implement immediate improvement actions.

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Human behavior is a key driver of the biodiversity crisis, and addressing it requires changing individual choices and actions. Yet, the same processes that imperil biodiversity (e.g., urbanization) also alienate people from the experience of nature, eroding care for the natural world. Although averting this extinction of experience is increasingly recognized as a major contemporary conservation challenge, understanding of what constitutes nature experience remains elusive and few empirical studies have explored it directly. Most researchers have used nature interactions as a stand-in for experience, even though experience extends beyond interactions. We aimed to determine what constitutes the experience of nature and to propose a holistic, empirically derived framework that incorporates the multiple dimensions and components of the experience of nature. Using a mixed-method approach across 3 countries (the United States, Switzerland, and Israel), we conducted a multistage, conceptual content, cognitive mapping (3CM) exercise with 106 participants. This methodology included developing a prompt to capture participants' perceptions of nature experiences and subsequently refining and organizing their input into distinct components and underlying dimensions through an iterative engagement process. Beyond multisensory interactions with nature, experience of nature consisted of 2 dimensions: the circumstances in which interactions occur and the internal responses that encompass various cognitive, affective, and restorative benefits associated with nature interactions. These 3 dimensions had 33 components that occurred consistently across participants in the 3 countries. Frequently mentioned components included seeing animals, landscapes, or scenery; lack of human influence; weather conditions; relaxing, recharging; feeling good; and awe for nature. Fear and nature experienced at home were the least mentioned components. Together, our results showed that nature experience is a combination of nature interactions, circumstances, and internal responses. The emphasized components underscore the significance of offering access to extensive, less human-influenced natural spaces. This in turn can foster a profound nature experience, cultivating feelings of connectedness and care for nature.

Un marco de trabajo para entender la experiencia humana de la naturaleza a través del mapeo cognitivo Resumen El comportamiento humano es un factor clave en la crisis de la biodiversidad, por lo que abordarlo requiere cambios en las acciones y elecciones individuales. Aun así, los mismos procesos que ponen en peligro la biodiversidad (p. ej.: la urbanización) también alejan a las personas de experimentar la naturaleza, lo que disminuye el cuidado por la naturaleza. Aunque cada vez se reconoce más que evitar la extinción de las experiencias es un reto importante para la conservación, todavía no está claro qué constituye una experiencia de la naturaleza y pocos estudios empíricos lo han estudiado directamente. La mayoría de los investigadores ha usado las interacciones con la naturaleza como un sustituto para las experiencias, aunque éstas van más allá de las interacciones. Buscamos determinar qué constituye a las experiencias de la naturaleza y proponer un marco holístico y empírico que incorpore las múltiples dimensiones y componentes de la experiencia de la naturaleza. Usamos una estrategia de método mixto en tres países (EUA, Suiza e Israel) para realizar un ejercicio de un mapeo cognitivo de contenido conceptual en varias fases (3CM) con 106 participantes. Esta metodología incluyó el desarrollo de una entrada para capturar la percepción de los participantes con respecto a las experiencias de la naturaleza y con ello refinar y organizar sus contribuciones en diferentes componentes y dimensiones subyacentes por medio de un proceso iterativo de participación. Más allá de las interacciones multisensoriales con la naturaleza, las vivencias de la naturaleza consistieron en dos dimensiones: las circunstancias en las que ocurren las interacciones y las respuestas internas que engloban varios beneficios cognitivos, afectivos y restauradores asociados con las interacciones con la naturaleza. Estas dos dimensiones contaron con 33 componentes que aparecieron constantemente entre los participantes de los tres países. Con frecuencia mencionaron componentes que incluían avistamiento de animales o paisajes; la ausencia de influencia humana; las condiciones del clima; relajarse, recargarse; sentirse bien; y asombro por la naturaleza. El miedo y la naturaleza vivida en casa fueron los componentes menos mencionados. En conjunto, nuestros resultados mostraron que las vivencias de la naturaleza son una combinación de interacciones con la naturaleza, circunstancias y respuestas internas. Los componentes enfatizados resaltan la importancia de ofrecer acceso a los espacios naturales extensos con menos influencia humana. Esto a la vez puede promover una experiencia profunda de la naturaleza, lo que genera sentimientos de conexión y cuidado de la naturaleza.

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A presença das bicicletas em Fortaleza, uma capital brasileira que tem ampliado a oferta de rotas cicláveis, ciclovias e ciclofaixas, é notada em diversas regiões da cidade e pode ser percebida como elemento fundamental na paisagem e tem forte influência nas alterações do tecido urbano de Fortaleza, desde a intensa manifestação cidadã em sua defesa como meio de transporte ou através da arte urbana. O estudo baseia-se em pesquisa exploratória, bibliográfica e documental, com observação participante e realização de grupo focal; traz reflexões sobre a bicicleta como bem simbólico, como elemento comunicativo, indutor do direito à cidade e instrumento de desenvolvimento urbano sustentável. Dialogando com Armando Silva (2014), Jane Jacobs (2011), Michel Maffesoli (2014), Fernanda Sánchez (2010), Jean-Mar Besse (2014), arguimos a importância do artefato bicicleta como elemento dinâmico na composição da paisagem cultural de Fortaleza.

The presence of bicycles in Fortaleza, a Brazilian capital that has expanded the offer of cycling routes, cycle paths and cycle lanes, is noted in several regions of the city and can be perceived as a fundamental element in the landscape and has a strong influence on changes to the urban fabric of Fortaleza, from the intense citizen demonstration in defense of it as a means of transport or through urban art. The study is based on exploratory, bibliographic and documentary research, with participant observation and focus groups; brings reflections on the bicycle as a symbolic asset, as a communicative element, an inducer of the right to the city and an instrument of sustainable urban development. Dialoguing with Armando Silva (2014), Jane Jacobs (2011), Michel Maffesoli (2014), Fernanda Sánchez (2010), Jean-Mar Besse (2014), we argue the importance of the bicycle artifact as a dynamic element in the composition of the cultural landscape of Fortaleza.

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Introduction The Colonoscopy Satisfaction and Safety Questionnaire based on Patient experience (CSSQP) was recently developed and validated within a Bowel Cancer Screening Program. We aimed to identify factor related to patient experience through the CSSQP, including all indications for colonoscopy. Indicators of satisfaction and perceived safety with colonoscopy were also assessed to compare the different centers. Methods Multicenter study in nine Spanish hospitals. Consecutive patients who had undergone a colonoscopy completed the CSSQP adding a novel item on bowel preparation. Factors related to patient experiences and data from non-respondents were analyzed. Results Of 2200 patients, 1753 filled out the questionnaire (response rate 79.7%, sample error 2%). Patients whose colonoscopy indication was a primary colorectal cancer screening (OR: 1.68, 95% CI: 1.15–2.44, p=0.007) or due to a +FIT (OR: 1.73, 95% CI: 1.18–2.53) reported higher satisfaction than patients with gastrointestinal symptoms. In addition, college-educated patients (OR: 2.11, 95% CI: 1.25–3.56) were more likely to report better overall satisfaction than patients with lower education level. Significant differences were observed in the majority of the CSSQP items between centers. Safety incidents were reported by 35 (2%) patients, and 176 (10%) patients reported that they received insufficient information. Conclusion The CSSQP identifies several significant factors on satisfaction and perceived safety in patients referred for colonoscopy for any reason. The CSSQP also allows comparison of patient-identified colonoscopy quality indicators between centers (AU)

Introducción El Cuestionario de Satisfacción y Seguridad de la Colonoscopia basado en la experiencia del Paciente (CSSQP) ha sido desarrollado y validado recientemente en pacientes del Programa de cribado de cáncer colorrectal (CCR). El objetivo del estudio fue identificar los factores relacionados con la experiencia de los pacientes a través del CSSQP, incluyendo todas las indicaciones de la colonoscopia. Además, se evaluaron los factores relacionados con la satisfacción y la seguridad del paciente con el fin de comparar diferentes departamentos. Métodos Estudio multicéntrico de nueve hospitales españoles en el que se incluyeron pacientes consecutivos que completaron el CSSQP incorporando un nuevo ítem sobre la preparación intestinal. Se analizaron los factores relacionados con la experiencia de los pacientes y los datos de los no respondedores. Resultados De 2.200 pacientes, 1.753 completaron el cuestionario (tasa de respuesta del 79,7%, error muestral del 2%). Los pacientes en los que la indicación era por cribado de CCR (OR: 1,68; IC 95%: 1,15-2,44; p=0,007) o por FIT positivo (OR: 1,73; IC 95%: 1,18-2,53) informaron mayor satisfacción que en aquellos que se solicitó la colonoscopia por síntomas gastrointestinales. Además, los pacientes con estudios universitarios (OR: 2,11; IC 95%: 1,25-3,56) informaron mayor satisfacción que aquellos con menor nivel de estudios. Se observaron diferencias significativas en la mayoría de los ítems del CSSQP entre los centros participantes. Treinta y cinco (2%) pacientes reportaron incidentes de seguridad y 176 (10%) reconocieron haber recibido información insuficiente. Conclusiones El CSSQP identifica los factores determinantes que influyen en la satisfacción y la seguridad de los pacientes a los que se les realiza colonoscopia por cualquier indicación. Además, permite comparar los indicadores de calidad de la colonoscopia desde la perspectiva del paciente entre los distintos centros (AU)

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The "health emergency" forced analysts to seek new ways of continuing with analysis. The article focuses, in particular, on the changes brought about in the setting by the presence of the sanitary mask, following a line that begins with the theme of the "mask" in the collective uses of human cultures, and develops through the Jungian concept of persona, as opposed to the "face" that may convey an authentic image of oneself. A clinical vignette illustrates the issues that the mask raises in the setting by obstructing the communication of emotions. When there is no transformative processing of concrete data, "unmasking" can also lead to an uncanny encounter and to moments of darkness and confusion in analysis, when the analyst experiences the kind of "unconscious identity" between therapist and patient that Jung defined as nigredo. The article is intended as a contribution to the analytic community's current reflections on the new and unforeseen challenges encountered in analysis at the time of the Coronavirus. It is possible to learn from these experiences with a view to integrating new elements and thus modify one's own internal setting, the compass with which each analyst orientates himself.

'L'urgence sanitaire' a forcé les analystes à rechercher de nouvelles manières de poursuivre le travail analytique. Cet article met l'accent en particulier sur les changements survenus dans le cadre du fait du port du masque sanitaire; l'article suit un fil conducteur qui commence avec le thème du 'masque' dans les usages collectifs des cultures humaines et se poursuit avec le concept Jungien de persona, en opposition avec le 'visage' qui peut communiquer une image authentique de soi. Une vignette clinique illustre les problèmes que le masque soulève dans la situation analytique en entravant la communication d'émotions. Quand il n'y a pas de processus de transformation des données concrètes, 'démasquer' peut également mener à une rencontre étrange et à des moments de ténèbres et de confusion dans l'analyse, quand l'analyste fait l'expérience du type 'd'identité inconsciente' entre le thérapeute et le patient que Jung a défini comme nigredo. Cet article a pour but de contribuer aux réflexions actuelles de la communauté analytique en ce qui concerne les défis nouveaux et inattendus rencontrés dans l'analyse dans la période du Coronavirus. Il est possible de tirer des leçons de ces expériences afin d'intégrer de nouveaux éléments et ainsi de modifier notre propre cadre interne, la boussole avec laquelle chaque analyste s'oriente.

La "emergencia sanitaria" obligó a los analistas a buscar nuevas formas de continuar con el análisis. El artículo se centra, en particular, en los cambios provocados en el encuadre analítico por la presencia de la mascarilla sanitaria. Presenta un desarrollo a partir del tema de la "máscara" en los usos colectivos de las culturas humanas, y continúa a través del concepto junguiano de persona, en contraposición al de "rostro", el cual puede transmitir una imagen auténtica de uno mismo. Una viñeta clínica ilustra los problemas que plantea la máscara en el entorno al obstruir la comunicación de las emociones. Cuando no hay un procesamiento transformador de los datos concretos, el "desenmascaramiento" también puede conducir a un encuentro misterioso y a momentos de oscuridad y confusión en el análisis, cuando el analista experimenta una forma de "identidad inconsciente" entre terapeuta y paciente que Jung definió como nigredo. El artículo pretende ser una contribución a las reflexiones actuales de la comunidad analítica sobre los nuevos e imprevistos desafíos encontrados en el análisis en la época del Coronavirus. Es posible aprender de estas experiencias con vistas a integrar nuevos elementos y así modificar la propia configuración interna, la brújula con la que cada analista se orienta.

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INTRODUCTION: The Colonoscopy Satisfaction and Safety Questionnaire based on Patient experience (CSSQP) was recently developed and validated within a Bowel Cancer Screening Program. We aimed to identify factor related to patient experience through the CSSQP, including all indications for colonoscopy. Indicators of satisfaction and perceived safety with colonoscopy were also assessed to compare the different centers. METHODS: Multicenter study in nine Spanish hospitals. Consecutive patients who had undergone a colonoscopy completed the CSSQP adding a novel item on bowel preparation. Factors related to patient experiences and data from non-respondents were analyzed. RESULTS: Of 2200 patients, 1753 filled out the questionnaire (response rate 79.7%, sample error 2%). Patients whose colonoscopy indication was a primary colorectal cancer screening (OR: 1.68, 95% CI: 1.15-2.44, p=0.007) or due to a +FIT (OR: 1.73, 95% CI: 1.18-2.53) reported higher satisfaction than patients with gastrointestinal symptoms. In addition, college-educated patients (OR: 2.11, 95% CI: 1.25-3.56) were more likely to report better overall satisfaction than patients with lower education level. Significant differences were observed in the majority of the CSSQP items between centers. Safety incidents were reported by 35 (2%) patients, and 176 (10%) patients reported that they received insufficient information. CONCLUSION: The CSSQP identifies several significant factors on satisfaction and perceived safety in patients referred for colonoscopy for any reason. The CSSQP also allows comparison of patient-identified colonoscopy quality indicators between centers.

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ABSTRACT Objective: This study aimed to assess the frequency with which orthodontic patients decided to shift to another type of orthodontic appliance, among conventional metal brackets, ceramic brackets, lingual brackets and clear aligner, based on their personal experiences of pain, ulcers, bad breath, hygiene issues and social difficulties. Material and Methods: This study comprises of patients seeking orthodontic treatment. The sample (n = 500; age group = 19-25 years) was divided equally into four groups based on the treatment modality: conventional metal brackets, ceramic brackets, lingual brackets and clear aligner. Patients rated the questionnaire using a visual analogue scale, to assess variables (such as pain, ulcer etc) that impact various treatment modalities. Subsequently, patients from all groups provided feedback regarding their treatment experiences, and expressed their preference for an alternative modality. Intergroup comparison among the four groups was done using one-way analysis of variance with Tukey's HSD post-hoc test (p ≤ 0.05). Results: Patients who received lingual brackets reported higher levels of pain and ulceration, as compared to those who received clear aligners. All four groups showed statistically significant differences for ulcers during treatment (p ≤ 0.05). Of the 125 patients who received conventional metal brackets, 28% expressed a preference for clear aligner therapy, while 20% preferred ceramic brackets. In the lingual group, 56% of 125 patients preferred clear aligner therapy, and 8% preferred ceramic brackets to complete their treatment. In the ceramic group, 83% did not want to switch, whereas 17% desired to switch to clear aligner, while in aligner group no patient desired to switch. Conclusions: A higher percentage of patients from lingual brackets group chose to shift to clear aligners, followed by conventional metal brackets group and by ceramic brackets group, in this descending order. The clear aligner group demonstrated fewer issues than the other treatment modalities.

RESUMO Objetivo: Este estudo teve como objetivo avaliar a frequência com que pacientes ortodônticos decidiram mudar para outro tipo de aparelho ortodôntico, entre braquetes convencionais de metal, braquetes cerâmicos, braquetes linguais e alinhadores transparentes, com base em suas experiências pessoais de dor, aftas, mau hálito, problemas de higiene e dificuldades sociais. Material e Métodos: Esse estudo foi composto por pacientes que procuram tratamento ortodôntico. A amostra (n = 500; faixa etária = 19-25 anos) foi dividida igualmente em quatro grupos, com base na modalidade de tratamento: braquetes metálicos convencionais, braquetes cerâmicos, braquetes linguais e alinhadores transparentes. Os pacientes responderam a um questionário, usando uma escala visual analógica, para avaliar variáveis como dor e aftas, que impactam diferentes modalidades de tratamento. Posteriormente, os pacientes de todos os grupos forneceram feedback sobre suas experiências de tratamento e expressaram sua preferência por uma modalidade alternativa. A comparação intergrupos entre os quatro grupos foi feita usando análise de variância unidirecional com teste post-hoc HSD de Tukey (p ≤ 0,05). Resultados: Os pacientes que usaram braquetes linguais relataram níveis mais elevados de dor e aftas, em comparação com aqueles que usaram alinhadores transparentes. Todos os quatro grupos apresentaram diferenças estatisticamente significativas para aftas durante o tratamento (p ≤ 0,05). Dos 125 pacientes que usaram braquetes metálicos convencionais, 28% expressaram preferência pelo tratamento com alinhadores transparentes, enquanto 20% preferiram braquetes cerâmicos. No grupo com braquetes linguais, 56% dos 125 pacientes preferiram o tratamento com alinhadores transparentes e 8% preferiram braquetes cerâmicos para completar o tratamento. No grupo com braquetes cerâmicos, 83% não queriam trocar de tratamento, enquanto 17% desejavam mudar para os alinhadores transparentes; enquanto no grupo de alinhadores nenhum paciente desejou mudar. Conclusões: Uma porcentagem maior de pacientes do grupo com braquetes linguais optou pela mudança para alinhadores transparentes, seguido pelo grupo com braquetes metálicos convencionais e pelo grupo com braquetes cerâmicos, em ordem decrescente. O grupo de alinhadores transparentes demonstrou menos problemas do que as outras modalidades de tratamento.

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Partindo de uma articulação entre a psicanálise e a fenomenologia de Merleau-Ponty, o objetivo deste artigo é traçar um caminho na psicanálise para uma noção de experiência. A experiência, seja pensada a partir de problemáticas levantadas pela psicanálise contemporânea, mais especificamente no que concerne aos estados limites, seja a partir da fenomenologia, não pertence a um sujeito, mas comporta uma abertura para o mundo. Com base em certas noções e interpretações de diferentes autores na psicanálise, buscam-se caminhos que permitam alcançar um deslocamento de uma posição idealista ou objetivista. Seguindo as indicações de Winnicott, três eixos são destacados como hipóteses centrais para definir a experiência: a corporeidade, o tempo e o sentido. Por fim, propõe-se um questionamento sobre a possibilidade de conceber a experiência como um conceito para a psicanálise contemporânea

By articulating psychoanalysis and Merleau-Ponty's phenomenology, this article traces a possible path towards a notion of experience. Experience, whether based on the problems raised by contemporary psychoanalysis (limit states) or on phenomenology, does not belong to a subject; rather, it includes an opening to the world. Based on certain notions and interpretations by different authors in psychoanalysis, we sought paths that allow a shift from an idealistic or objectivist position. Following Winnicott's propositions, we highlight three axes as central hypotheses to define experience: corporeality, time, and sense. Finally, we question whether experience can be conceived as a concept for contemporary psychoanalysis

En articulant la psychanalyse et la phénoménologie de Merleau-Ponty, cet article trace un chemin en psychanalyse vers une notion d'expérience. L'expérience, qu'elle soit fondée sur les problèmes soulevés par la psychanalyse contemporaine (états limites) ou sur la phénoménologie, n'appartient pas à un sujet, mais comporte une ouverture au monde. Basé sur certaines notions et interprétations de différents auteurs en psychanalyse, on cherche des voies permettant le passage d'une position idéaliste ou objectiviste. Suivant les propositions de Winnicott, trois axes sont mis en évidence comme hypothèses centrales pour définir l'expérience: la corporéité, le temps et le sens. Enfin, on discute de la possibilité de concevoir l'expérience comme un concept pour la psychanalyse contemporaine

Partiendo de una articulación entre el psicoanálisis y la fenomenología de Merleau-Ponty, el objetivo del artículo es trazar un posible camino en el psicoanálisis hacia una noción de experiencia. La experiencia, ya sea basada en los problemas planteados por el psicoanálisis contemporáneo, más específicamente con respecto a los estados límite, o basada en la fenomenología, no pertenece a un sujeto, sino que incluye una apertura al mundo. A partir de ciertas nociones e interpretaciones de diferentes autores en el psicoanálisis, buscamos formas que permitan lograr un cambio desde una posición idealista u objetivista. Siguiendo las indicaciones de Winnicott, se destacan tres ejes como hipótesis centrales para definir la experiencia: corporalidad, tiempo y sentido. Finalmente, se hace una pregunta sobre la posibilidad de concebir la experiencia como un concepto para el psicoanálisis contemporáneo

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Introducción: La Organización Panamericana de la Salud refiere que a nivel mundial pocos son los países que aplican el contacto piel con piel cuando lo realizan es por un tiempo inadecuado a pesar de los múltiples beneficios para la madre y el recién nacido. Objetivo: Describir la aplicación del contacto piel con piel desde la experiencia del equipo de salud en un centro materno infantil del sector público en Perú. Métodos: Investigación cualitativa con diseño descriptivo, de tipo estudio de caso, en una muestra no probabilística de 10 integrantes del equipo de salud, elegidos por conveniencia y determinado por saturación y redundancia. Los datos se recolectaron a través de la entrevista semiestructurada en línea. La información se procesó de manera manual, mediante el análisis de contenido temático. Resultados: Se obtuvieron tres categorías: a) aplicación del contacto piel con piel en la atención inmediata del recién nacido, b) estrategias implementadas para la aplicación del contacto piel con piel y c) barreras afrontadas por el equipo de salud para aplicar el contacto piel con piel. Conclusiones: Desde la experiencia del personal de salud, es posible aplicar el contacto pial a piel previa capacitación y sensibilización al equipo de salud, y acondicionamiento del ambiente, a fin de implementarlo como política del establecimiento de salud(AU)

Introduction: The Pan American Health Organization reports that few countries worldwide apply skin-to-skin contact and when they use it is during an inadequate amount of time despite the multiple benefits for the mother and the newborn. Objective: To describe the application of skin-to-skin contact from the experience of the health team in a public maternal and child center in Peru. Methods: A qualitative research with a descriptive design, case study, was carried out in a non-probabilistic sample of 10 members of the health team, chosen by convenience and determined by saturation and redundancy. Data were collected through semi-structured online interviews. The information was processed manually, through thematic content analysis. Results: Three categories were obtained: a) application of skin-to-skin contact in the immediate care of the newborn, b) strategies implemented for the application of skin-to-skin contact, and c) barriers faced by the health team to apply skin-to-skin contact. Conclusions: From the experience of health personnel, it is possible to apply skin-to-skin contact after training and sensitization to the health team and conditioning of the environment, in order to implement it as a policy of the health facility(AU)

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Este texto traz um relato de experiência advindo das atividades de uma orientadora social realizado no Serviço de Convivência e Fortalecimento de Vínculos (SCFV) de um Centro de Referência de Assistência Social (Cras) situado na Grande Florianópolis (SC). O serviço integrou 20 jovens com idade entre 12 e 18 anos no espaço de uma instituição de formação policial. Este trabalho analisará: (1) um acontecimento ocorrido na instituição policial; (2) quais foram os seus desdobramentos; e (3) como a orientadora social atuou na mediação do grupo. A análise da do relato de experiência e a mediação da orientadora social foram embasadas no conceito de acontecimento de Gilles Deleuze. No decorrer dos encontros, a instituição parceira do projeto adotou medidas disciplinares que desqualificavam a cultura proveniente dos cotidiano dos(as) jovens participantes, o que levou o grupo a constituir uma identidade coletiva a partir da resistência à violência simbólica. Assim, diante da situação-problema, tornou-se possível uma experiência de fortalecimentos de laços comunitários

This paper discusses a situation that occurred in a public youth service for young people living in vulnerable city areas. The service worked with 20 young people aged between 12 and 18 years and the meetings took place at a police training institution. Inspired by Gilles Deleuze's theory, this text analyzes 1) an event that occurred at the police institution, 2) their consequences and 3) how the professional responsible dealt with the event in a group context. At some point in the meetings, the police training institution adopted disciplinary measures that disqualified the participants' culture, leading the group to create a collective identity to resist symbolic violence. Thus, a community gathering experience emerged in the face of the conflicted situation

Le texte discute une situation survenue dans une fonction publique désignée pour accueillir des jeunes vivant dans des quartiers vulnérables. Le service comprenait 20 jeunes de 12 à 18 ans et les réunions se sont déroulées dans un établissement de formation policière. Inspirées par la théorie de Gilles Deleuze, ce texte analyse 1) un événement survenu dans l'institution policière, 2) qu'elles en ont été ses conséquences et 3) comment le professionnel responsable a agi pour faire face à l'événement dans un contexte de groupe. À un moment donné au cours des réunions, l'institution de formation a adopté des mesures disciplinaires qui disqualifiaient la culture des jeunes participants, ce qui a conduit le groupe à se forger une identité collective basée sur la résistance à la violence symbolique. Par conséquent, une expérience de rassemblement communautaire a émergé face à la situation conflictuelle

El texto se refiere a una situación ocurrida en un servicio público designado para trabajar con jóvenes que viven en zonas vulnerables de la ciudad. El servicio incluyó a 20 jóvenes de entre 12 y 18 años y las reuniones se ubicaron en una institución de capacitación policial. Este texto analiza 1) un suceso que ocurrió en la institución policial, 2) cuáles fueron sus consecuencias y 3) cómo actuó el profesional responsable del servicio para enfrentar el suceso en un contexto grupal. El análisis de esta situación y la referencia teórica que apoyó los actos profesionales se inspiraron en la teoría de Gilles Deleuze. En algún momento de los encuentros, la institución de capacitación policial adoptó medidas disciplinarias que descalificaron la cultura de los jóvenes participantes, lo que llevó al grupo a constituir una identidad colectiva basada en la resistencia contra la violencia simbólica. Por lo tanto, ante la situación conflictiva, fue posible una experiencia de reunión comunitaria

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