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Abstract: The short story “High Rise” was published in 2021 by Brazilian-American author Frances de Pontes Peebles. The story reflects the socio-political tensions surrounding the death of a five-year-old boy who fell from the ninth floor of a luxurious high-rise in Recife, Brazil, during the Covid-19 pandemic. It explores how neglect and violence shape the lives of Brazil’s marginalized groups, highlighting the ways social hierarchies are maintained even amid global crises like the pandemic. The translation into Portuguese is introduced by a discussion of the story within Brazil’s social, historical, and political framework. It also examines the challenges and nuances of translating such a culturally specific narrative for a Brazilian readership. Keywords: Northeastern Brazil, Covid-19 Literature, Black Lives Matter, Literary Translation, Brazilian Contemporary Literature, Recife, Frances de Pontes Peebles. Resumo: O conto “High Rise” foi publicado em 2021 pela autora brasileiro-americana Frances de Pontes Peebles. A narrativa reflete as tensões sociopolíticas que vêm à tona quando um menino de cinco anos cai do nono andar de um edifício de alto padrão no Recife durante a pandemia de Covid-19. O texto explora como a negligência e a violência determinam a vida de grupos marginalizados no Brasil, evidenciando também como as hierarquias sociais são mantidas mesmo durante uma crise global como a pandemia. A tradução para o português é precedida por uma discussão sobre o texto e o entorno social, histórico e político do Brasil e examina decisões e desafios de traduzir uma narrativa localizada no Nordeste para o público brasileiro. Palavras-chave: Nordeste Brasileiro, Literatura da Covid-19, Vidas Negras Importam, Tradução Literária, Literatura Brasileira Contemporânea, Recife, Frances de Pontes Peebles.

Background Despite maximal treatment, heart failure (HF) remains a major clinical challenge. Besides neurohormonal overactivation, myocardial energy homoeostasis is also impaired in HF. Trimetazidine has the potential to restore myocardial energy status by inhibiting fatty acid oxidation, concomitantly enhancing glucose oxidation. Trimetazidine is an interesting adjunct treatment, for it is safe, easy to use and comes at a low cost.Objective We conducted a systematic review to evaluate all available clinical evidence on trimetazidine in HF. We searched Medline/PubMed, Embase, Cochrane CENTRAL and ClinicalTrials.gov to identify relevant studies.Methods Out of 213 records, we included 28 studies in the meta-analysis (containing 2552 unique patients), which almost exclusively randomised patients with HF with reduced ejection fraction (HFrEF). The studies were relatively small (median study size: N=58) and of short duration (mean follow-up: 6 months), with the majority (68%) being open label.Results Trimetazidine in HFrEF was found to significantly reduce cardiovascular mortality (OR 0.33, 95% CI 0.21 to 0.53) and HF hospitalisations (OR 0.42, 95% CI 0.29 to 0.60). In addition, trimetazidine improved (New York Heart Association) functional class (mean difference: −0.44 (95% CI −0.49 to −0.39), 6 min walk distance (mean difference: +109 m (95% CI 105 to 114 m) and quality of life (standardised mean difference: +0.52 (95% CI 0.32 to 0.71). A similar pattern of effects was observed for both ischaemic and non-ischaemic cardiomyopathy.Conclusions Current evidence supports the potential role of trimetazidine in HFrEF, but this is based on multiple smaller trials of varying quality in study design. We recommend a large pragmatic randomised clinical trial to establish the definitive role of trimetazidine in the management of HFrEF.

Abstract Background Contact tracing is one of the main public health tools in the control of coronavirus disease 2019 (COVID-19). A centralized contact tracing system was developed in Belgium in 2020. We aim to evaluate the performance and describe the results, between January 01, 2021, and September 30, 2021. The characteristics of COVID-19 cases and the impact of COVID-19 vaccination on testing and tracing are also described. Methods We combined laboratory diagnostic test data (molecular and antigen test), vaccination data, and contact tracing data. A descriptive analysis was done to evaluate the performance of contact tracing and describe insights into the epidemiology of COVID-19 by contact tracing. Results Between January and September 2021, 555.181 COVID-19 cases were reported to the central contact center and 91% were contacted. The average delay between symptom onset and contact tracing initiation was around 5 days, of which 4 days corresponded to pre-testing delay. High-Risk Contacts (HRC) were reported by 49% of the contacted index cases. The mean number of reported HRC was 2.7. In total, 666.869 HRC were reported of which 91% were successfully contacted and 89% of these were tested at least once following the interview. The estimated average secondary attack rate (SAR) among the contacts of the COVID-19 cases who reported at least one contact, was 27% and was significantly higher among household HRC. The proportion of COVID-19 cases who were previously identified as HRC within the central system was 24%. Conclusions The contact-tracing system contacted more than 90% of the reported COVID-19 cases and their HRC. This proportion remained stable between January 1 2021 and September 30 2021 despite an increase in cases in March–April 2021. We report high SAR, indicating that through contact tracing a large number of infections were prospectively detected. The system can be further improved by (1) reducing the delay between onset of illness and medical consultation (2) having more exhaustive reporting of HRC by the COVID-19 case.

Abstract The aim of the UPHILL study (a nutrition and lifestyle intervention in patients with pulmonary arterial hypertension [PAH]: effect on quality of life [QoL]), was to determine the effect of innovative nutritional interventions on adjustments in nutritional intake and QoL. In this study a group of prevalent PAH patients at a single center in Amsterdam (the Netherlands) was informed about healthy nutrition using a newly designed video e‐learning. They were subsequently instructed to follow a healthy diet during dietary intervention. Nutritional intake was assessed using a food frequency questionnaire (HELIUS) and QoL by the short‐form (SF)‐36 questionnaire. Nutritional parameters were determined in blood samples. Seventeen patients stable under treatment, who had been diagnosed with PAH 7.0 [3.0−14.0] years before, started and completed the intervention (2 males, 15 females; 45.35 ± 13.57 years). Since all patients in the intervention group made behavioral changes in nutritional intake, during study and follow‐up, nutritional and lifestyle adaptations persisted. Despite the fact that patients had already high mean scores at baseline for both mental (74.10 [60.51−84.25]) and physical QoL (66.46 [50.21−73.84]), scores improved further during e‐learning. Furthermore, patients who realized most nutritional adaptations, had the best improvement in QoL. This pilot study showed that e‐learning modules on nutrition provide an unique opportunity to change nutritional intake in PAH patients and by that improve QoL.

We examine how recent increases in air temperature and precipitation, together with reductions in sea ice extent, may have affected the regional δD–δ18O composition of precipitation. In spring 2014, 80 snow samples were collected from six glaciers and ice caps across the Queen Elizabeth Islands, and in 2009 and 2014, two shallow ice cores were collected from Agassiz Ice Cap and White Glacier, respectively. The snow samples showed average δ18O values from 2013 to 2014 to be approximately 2‰–3‰ higher than those recorded in 1973–1974 in nearby locations, with the ice cores showing similar trends in δ18O values. A zonal average water isotope model was used to help understand the causes of the increased δ18O values, using inputs calibrated for observed changes in temperature, vapour flux, and sea ice extent. Model results indicate that atmospheric temperature changes account for

There have been rapid recent reductions in sea ice age and extent in the Canadian Arctic, but little previous analysis of how this has impacted the navigability of Arctic shipping. In this study we analyze how navigability changed over the period 1972–2016 by converting Canadian Ice Service ice charts to shipping navigability charts for different hull strength classifications based on the Arctic Ice Regime Shipping System. Analysis focuses on the southern route of the Northwest Passage, and the Arctic Bridge route across Hudson Bay, for changes in early-season (∼25 June), mid-season (∼3 September), and late-season (∼15 October) conditions. Results reveal that there has been a marked easing in shipping navigability for all vessels over the past decade, driven by reductions in the area and age of sea ice, particularly across the southern route of the Northwest Passage. Both medium (Type B) and little (Type E) ice strengthened vessels were able to transit the full length of this route in the middle part of the shipping season in 2012–2016, but not in 1972–1976 or 1992–1996.

Background: Primary care nurses play a pivotal role in the response to disasters and pandemics. The coronavirus diseases 2019 (COVID-19) pandemic required preventative, diagnostic, and curative measures for persons presenting with symptoms of COVID-19 by healthcare providers, whilst continuing other essential services. We aimed to investigate the reorganisation of primary care services during COVID-19 from the perspectives of primary care nurses in the Western Cape province of South Africa. Methods: We administered an online survey with closed and open-ended questions to professional nurses enrolled for a Postgraduate Diploma in Primary Care Nursing at Stellenbosch University (2020) and alumni (2017–2019) working in the Western Cape. Eighty-three participants completed the questionnaire. Results: The majority of the participants (74.4%) reported that they were reorganising services using a multitude of initiatives in response to the diverse infrastructure, logistics and services of the various healthcare facilities. Despite this, 48.2% of the participants expressed concerns, which mainly related to possible non-adherence of patients with chronic conditions, the lack of promotive and preventative services, challenges with facility infrastructure, and staff time devoted to triage and screening. More than half of the participants (57.8%) indicated that other services were affected by COVID-19, whilst 44.6% indicated that these services were worse than before. Conclusion: Our findings suggest that the very necessary reorganisation of services that took place at the start of the COVID-19 pandemic in South Africa enabled effective management of patients infected with COVID-19. However, the reorganisation of services may have longer-term consequences for primary care services in terms of lack of care for patients with other conditions, as well as preventive and promotive care.

Introduction: The novel coronavirus 2019 or COVID-19 pandemic has brought about a global public health crisis. Primary care (PC) nurses render first line care, or refer for more specialised services. Aim: To investigate the preparedness of PC nurses for COVID-19 in the Western Cape. Setting: The Western Cape province of South Africa. Methods: We administered an online survey, with closed and open-ended questions, to 83 Stellenbosch University postgraduate PC nursing students and alumni working in the Western Cape, between 03 July and 01 September 2020. Results: The results indicated that 43.3% of participants were confident about the infection, prevention, and control (IPC) training they received and 56.7% felt prepared to provide direct care to suspected cases of COVID-19. Primary care nurses were more comfortable to triage (78.3%) than to manage persons with COVID-19 (42.2%), indicating that they may not be functioning to the full capacity of their education and training. Adequate infrastructure was reported by less than a third of the participants (30.1%) and 59.1% reported that personal protective equipment (PPE) was always available. Primary care nurses needed support in coping with stress (57.8%) although few (14.5%) reported access to mental health services. Conclusion: Primary care nurses were not prepared optimally for the COVID-19 pandemic. Challenges included adequate training, infrastructure, the availability of personal protective equipment, COVID-19 testing of health care workers and management support. Primary care nurses need comprehensive support to manage stress and anxiety.

Background: First Nations (FN) women have a higher risk of diabetes than non-FN women in Canada. Prenatal education and breastfeeding may reduce the risk of diabetes in mothers and offspring. The rates of breastfeeding initiation and participation in the prenatal program are low in FN communities. Methods: A prenatal educational website, social media-assisted prenatal chat groups and community support teams were developed in three rural or remote FN communities in Manitoba. The rates of participation of pregnant women in prenatal programs and breastfeeding initiation were compared before and after the start of the remote prenatal education program within 2014-2017. Findings: The participation rate of FN pregnant women in rural or remote communities in the prenatal program and breastfeeding initiation during 1-year after the start of the community-based remote prenatal education program were significantly increased compared to that during 1-year before the start of the program (54% versus 36% for the participation rate, 50% versus 34% for breastfeeding initiation, p

Orientation: Talent management is one of the most important and key strategic issues facing managers in the South African (SA) higher education sector. Research purpose: The study aimed to establish talent management challenges at one selected SA public higher education institution (HEI) which offers contact tuition in the Western Cape. Motivation for the study: Emerging trends show talent management has since presented unique sets of challenges in the SA higher education sector. SA needs to attract and retain academic talent to reach target levels of education and skills development and also ensure tertiary institutions accomplish their visions and missions. Research approach/design and method: We conducted the study using the interpretivist research paradigm. Semi-structured interviews were applied to a purposive sample of 7 human resource (HR) professionals from one selected HEI in the Western Cape. Content analysis was used for data analysis. Main findings: We established that workforce planning, compensation and rewards, training and development, succession planning, recruitment, selection, and performance management were negatively affecting the talent management practices of the selected HEI. Practical/managerial implications: HR professionals can use the study findings as a basis for understanding talent management challenges in a selected HEI and what causes these challenges. Contribution/value-add: The study establishes an insight into the talent management challenges of a selected HEI and provides reasons for what causes them. It also made several recommendations to the institution in order to solve the talent management challenges.

Objectives The purpose of this study was to assess (1) the overall mental health of Members of Parliament (MPs) and (2) awareness among MPs of the mental health support services available to them in Parliament.Design An anonymous self-completed online cross-sectional survey was conducted in December 2016.Setting 56th UK House of Commons.Participants All 650 members of the 56th UK House of Commons were invited to participate; 146 MPs (23%) completed the survey.Outcomes The General Health Questionnaire-12 was used to assess age- and sex-standardised prevalence of probable common mental disorders (CMD). Results were compared with a nationally representative survey, the Health Survey for England (HSE) 2014. Core demographic questions, MPs’ awareness of available mental health services, their willingness to discuss mental health issues with party Whips and fellow MPs and the effects of employment outside Parliament were assessed.Results Comparison of MP respondents with HSE comparator groups found that MPs have higher rates of mental health problems (age- and sex-standardised prevalence of probable CMD in 49 surveyed MPs 34% (95% CI 27% to 42%) versus 17% (95% CI 13% to 21%) in the high-income comparison group). Survey respondents were younger, more likely to be female and more educated compared with all MPs. 77% of MPs (n=112) did not know how to access in-house mental health support. 52% (n=76) would not discuss their mental health with party Whips or other MPs (48%; n=70).Conclusions MPs in the study sample had higher rates of mental health problems than rates seen in the whole English population or comparable occupational groups. Most surveyed MPs are unaware of mental health support services or how to access them. Our findings represent a relatively small sample of MPs. There is a need for MPs to have better awareness of, and access to, mental health support.

The 2018 European Respiratory Society (ERS) International Congress in Paris, France, highlighted the subject of pulmonary vascular disease (PVD). 2018 was an exciting year for the PVD community as it was the first ERS International Congress since the formation of Assembly 13, which is dedicated to PVD, pulmonary embolism and the right ventricle. This article aims to summarise the high-quality studies presented at the 2018 Congress into four subject areas: the use of risk stratification in pulmonary arterial hypertension, the molecular mechanisms and treatment of pulmonary hypertension (PH), understanding and improving the right ventricle in PH, and finally, advances in the field of acute pulmonary embolus.

Student-staff partnerships can be used to support the development of contextualised digital learning and teaching practices. This can be done by shifting the focus from IT skills to addressing a priority in learning and teaching using a digital approach that is appropriate for that discipline. The development of a formal ‘Digital Innovation Partnership’ (DIP) scheme at the University of Leicester brings students’ digital confidence, perspectives and motivation to enhance learning and teaching. It also recognises the valuable contribution and expertise of student and staff participants. This draws on the academic literacies work of Lea and Street (1998; 2006) and digital literacies work of Sharpe and Beetham (2010) to appreciate that staff and students are developing social practices that are situated within a discipline and intertwined with social, cultural and political factors, power and identity. The reasons for the success of the scheme are explored here, with recommendations for how the model can be applied more generally to educational design to support students’ academic literacies development.

Background: Main pulmonary artery (MPA) dilation is a radiological sign of pulmonary hypertension (PH) and is an independent risk factor of sudden death (Żyłkowska et al, Chest 2012). Extreme MPA dilation is a rare consequence of PH. We hypothesize that the main pulmonary artery compliance is larger and contributes more to total arterial compliance in PH patients with an extremely dilated MPA when compared to patients with a less dilated MPA. Methods: Cardiac magnetic imaging (CMR) scans of idiopathic and hereditary pulmonary arterial hypertension (PAH) patients were retrospectively analyzed. Six PAH patients with extremely dilated MPAs (≥45 mm diameter on transverse plain CMR images of the MPA) and six PAH patients with MPA diameter

Objectives: This study aimed to assess patient satisfaction with behavioral health consultation in a primary and specialty care setting and to gauge patient interest in other behavioral health services. Methods: We surveyed patients with type 2 diabetes mellitus (N = 65), following a brief behavioral health consultation about their satisfaction with the experience and their interest in various behavioral health services. Doctoral students with master’s degrees in clinical psychology provided the consultations. Results: Patients were highly satisfied with behavioral health consultations and expressed moderate to high interest in various potential behavioral health services. Patients with more diabetes-related concerns were less satisfied with brief behavioral health consultations but reported greater interest in other behavioral health services. Conclusions: Results were used to build stakeholder support and guide expansion of integrated behavioral health services. Examining patient experience can help identify patients who need more extensive services and ensure that services are patient centered.