A atuação do serviço público na produção da paz

This article has as the objective to present the results of the research that searched to outline thevarious concepts of peace, as well as to check in which way these concepts present themselves inrelation to the responsible people for the municipal secretaries of a city of medium tonnage. Themethods utilized were the systematic revision and the semi-structured interview with theresponsible people for the secretaries. We have found as a result, that the workers manage to get todescribe various concepts of peace and how they are worked in the practice of the service aspublic actors. It was found that peace is used as a contemplation of a place in construction and thatthe production is not concerned to its Secretary, generating the inexistence of actions and itsdelegation outward of its work.Este artigo tem como objetivo apresentar os resultados de pesquisa em que se buscou delinear osvários conceitos de paz, bem como verificar de que modo esses conceitos se apresentam em facedos responsáveis pelas secretarias municipais de uma cidade de médio porte. Os métodosutilizados foram a revisão sistemática de literatura e uma entrevista semiestruturada com osresponsáveis pelas secretarias. Como resultado, concluiu-se que os trabalhadores conseguemdescrever diversos conceitos de paz e investigou-se como esses conceitos são trabalhados por elesna prática do serviço enquanto atores públicos. Verificou-se, ainda, que a paz é utilizada comocontemplação de um lugar em construção e compreendeu-se que sua produção não diz respeito àsecretaria em que o trabalhador atua, gerando a inexistência de ações e a sua delegação para forada alçada do servidor

Epidemiologia dos transtornos do desenvolvimento psicológico em adolescentes: uso de álcool e outras drogas

identificar las características personales y clínicas de adolescentes con Trastornos del Desarrollo Psicológico, usuarios de alcohol y otras drogas. Método: estudio retrospectivo que analizó la atención en un Centro de Atención Psicosocial III. Resultados: de 415 adolescentes tratados, 52,3% eran mujeres; 89,9% con 12 a 14 años; 51,6% asistidos por orden judicial; 28,2% tenían “Trastorno del Desarrollo Psicológico no Especificado”; 32,3% utilizaban múltiples drogas. Tener entre 12 y 14 años presentó, respectivamente, riesgos 2,5 y 1,5 veces mayores de Trastorno de Desarrollo Psicológico. Consumidores de cocaína/grieta presentaron más probabilidad (4,27 veces) de recibir el diagnóstico “Uso de Sustancias Psicoactivas”. Conclusión: los adolescentes son tratados según la Ley, que requiere tratamiento debido a las inadecuaciones al convivio común, en alto uso de cannabinoides, y la dificultad de profesionales en la atención de los Trastornos del Desarrollo Psicológico

Epidemiology of psychological development disorders in adolescents: use of alcohol and other drugs

\ud Objective: to identify the personal and clinical characteristics of adolescents alcohol and other drugs’ users with Psychological Development Disorders. Methods: this retrospective study analyzes the care of the Psychosocial Care III Center. Results: from the 415 adolescents treated, 52.3% were female; 89.9% were between 12 to 14 years old, 51.6% attended by court order, 28.2% had “Unspecified Disorder of Psychological Development”; 32.3% used multiple drugs. Being between 12 and 14 years of age meant 2.5 and 1.5 times more risk of having Psychological Development Disorders, respectively. Cocaine/crack users were more likely (4.27 times) to receive the diagnosis of “Psychoactive Substance Use.” Conclusion: adolescents are treated in accordance with the law, which requires treatment for social living inadequacies due to high use of cannabinoids, and there is a difficulty of professionals in treating Psychological Development Disorders

Mídia e política no Brasil: textos e agenda de pesquisa Midia and politics in Brazil: texts and research agenda

Um especialista em estudos de comunicação e um cientista político apresentam conjuntamente um panorama da pesquisa sobre as relações entre os meios de comunicação e os processos políticos no Brasil. Uma agenda de pesquisa é proposta e um elenco de textos nessa área é apresentado.<br>A specialist in communication studies and a political scientist present together a panorama of research on the relations between communication midia and political processes in Brazil A research agenda is proposed and a list of texts in this area is presented

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research