Sociologia e História

Não é fácil estabelecer relações entre dois campos de saber tão vastos quanto a Sociologia e a História, as quais, malgrado a unidade de escopo que se observa em cada um de per si, se espraiam por áreas variadas da realidade humana.

EFFECTIVENESS OF CLINICAL RISK MANAGEMENT IN INTENSIVE CARE

Objetivou-se mensurar a taxa de efetividade do gerenciamento de riscos clínicos na terapia intensiva. Trata-se de um estudo transversal, com uma abordagem quantitativa, realizado em um hospital filantrópico do município de Caxias do Sul. A amostra foi composta pelos pacientes internados na terapia intensiva inclusos no formulário de gerenciamento de riscos no período de janeiro de 2013 a dezembro de 2014. Os riscos que foram analisados nesta pesquisa foram: queda; lesão de pele; extubação acidental; perda acidental de sonda nasoentérica e sonda nasogástrica; e perda acidental de cateter venoso central. O total da amostra foi de 51220 pacientes-dia. Os resultados encontrados evidenciaram que a taxa de efetividade nos riscos pesquisados, em sua maioria, permaneceu acima de 99%. Conclui-se que a enfermagem tem papel fundamental no gerenciamento de riscos, atividade essa que exige do enfermeiro aperfeiçoamento constante, com foco na qualidade e segurança da assistência.The present study aimed to measure the effectiveness of clinical risk management in intensive care. Cross-sectional study with quantitative approach conducted in a philanthropic hospital in the city of Caxias do Sul. The sample was composed of patients admitted to the intensive care unit included in the risk management assessment form in the period of January 2013 to December 2014. The risks analyzed in this study were fall; skin lesion; unplanned extubation; accidental removal of nasoenteral feeding tube and nasogastric tube and accidental catheter removal for central venous catheter. The sample was composed of 51,220 patients-day. According to the results obtained, the effectiveness of the management of the risks investigated in this study was above 99%. It is concluded that nursing plays a key role in risk management, an activity that requires continuing training of nurses, with focus on care quality and safety.Fue la finalidad de este estudio mensurar la taja de efectividad de la gestión de riesgos clínicos en la terapia intensiva. Trasversal y con abordaje cuantitativo, el estudio fue realizado en un hospital filantrópico del municipio de Caxias do Sul. La muestra fue compuesta por los pacientes internados en la terapia intensiva inclusos en el formulario de gestión de riesgos en el periodo de enero de 2013 a diciembre de 2014. Los riesgos analizados en esta investigación fueron caída; lesión de piel; extubación accidental; pérdida accidental de sonda nasoentérica y sonda nasogástrica; y pérdida accidental de catéter venoso central. El total de la muestra fue de 51220 pacientes al día. Los resultados evidenciaron que la taja de efectividad de la mayoría de los riesgos investigados resultó en más de 99%. La conclusión es que la enfermería tiene papel fundamental en la gestión de riesgos, la cual es una actividad que exige al enfermero constante perfeccionamiento, con énfasis en la cualidad y seguridad de la asistencia

Dental and maxillomandibular incidental findings in panoramic radiography among individuals with mucopolysaccharidosis: a cross-sectional study

Mucopolysaccharidosis (MPS) is a group of rare and inherited metabolic disorders caused by the accumulation of macromolecule glycosaminoglycans inside lysosomes. Affected individuals may have dental and craniofacial tissue alterations, facilitating the development of several oral diseases. Objectives: To assess, with panoramic radiographic images, the frequency of dental and maxillomandibular incidental findings among MPS individuals and compare them with non-MPS individuals. Methodology: A cross-sectional study evaluating a sample of 14 MPS individuals and 28 non-MPS individuals aged from 5 to 26 years was carried out. They were matched for sex and age on a 2:1 proportion. Panoramic radiographs were assessed for the presence/absence of the following dental and maxillomandibular alterations: dental anomalies of number (hypodontia/dental agenesis, supernumerary teeth); anomalies of form (microdontia, macrodontia, conoid teeth, taurodontism, and root dilaceration); anomalies of position (impacted tooth, inverted tooth, tooth migration, partially bony teeth, complete bony teeth); periapical alterations (furcation lesion, circumscribed bone rarefaction); other alterations (radiolucent bone lesions, radiopaque bone lesions, radiopacity in the maxillary sinus, condylar hypoplasia). Differences between groups were tested by the Fisher’s exact test and chi-square test (p<0.05). Results: For intrarater agreement, Kappa values were 0.76 to 0.85. The presence of supernumerary teeth (p=0.003); conoid teeth (p=0.009); taurodontism (p<0.001); impacted teeth (p<0.001); partial bony teeth (p=0.040); complete bony teeth (p=0.013); and root dilaceration (p=0.047) were statistically more frequent in MPS individuals compared to non-MPS individuals. Bone rarefaction/furcation lesions (p=0.032), condylar hypoplasia (p<0.001), radiolucent bone lesions (p=0.001), and dentigerous cysts (p=0.002) were also more frequent in MPS individuals. Conclusion: The presence of specific oral manifestations is more common in MPS individuals than non-MPS individuals

Engolo and Capoeira. From Ethnic to Diasporic Combat Games in the Southern Atlantic

This article provides a re-examination of the main Afrocentric narrative of capoeira origins, the engolo or ‘Zebra Dance’, in light of historical primary sources and new ethnographic evidence gathered during fieldwork in south-west Angola. By examining engolo’s bodily techniques, its socio-historical context and cultural meanings, the piece emphasises its insertion into a pastoral lifestyle and highlights the relatively narrow ethnic character of the practice in Angola. This analysis and the comparison with capoeira helps us to develop certain hypotheses about the formation, migration, and re-invention of diasporic combat games between southern Angola and coastal Brazil, and more broadly, to increase our understanding of how African cultures spread across the southern Atlantic

Familial hypercholesterolaemia in children and adolescents from 48 countries: a cross-sectional study

Background: Approximately 450 000 children are born with familial hypercholesterolaemia worldwide every year, yet only 2·1% of adults with familial hypercholesterolaemia were diagnosed before age 18 years via current diagnostic approaches, which are derived from observations in adults. We aimed to characterise children and adolescents with heterozygous familial hypercholesterolaemia (HeFH) and understand current approaches to the identification and management of familial hypercholesterolaemia to inform future public health strategies. Methods: For this cross-sectional study, we assessed children and adolescents younger than 18 years with a clinical or genetic diagnosis of HeFH at the time of entry into the Familial Hypercholesterolaemia Studies Collaboration (FHSC) registry between Oct 1, 2015, and Jan 31, 2021. Data in the registry were collected from 55 regional or national registries in 48 countries. Diagnoses relying on self-reported history of familial hypercholesterolaemia and suspected secondary hypercholesterolaemia were excluded from the registry; people with untreated LDL cholesterol (LDL-C) of at least 13·0 mmol/L were excluded from this study. Data were assessed overall and by WHO region, World Bank country income status, age, diagnostic criteria, and index-case status. The main outcome of this study was to assess current identification and management of children and adolescents with familial hypercholesterolaemia. Findings: Of 63 093 individuals in the FHSC registry, 11 848 (18·8%) were children or adolescents younger than 18 years with HeFH and were included in this study; 5756 (50·2%) of 11 476 included individuals were female and 5720 (49·8%) were male. Sex data were missing for 372 (3·1%) of 11 848 individuals. Median age at registry entry was 9·6 years (IQR 5·8-13·2). 10 099 (89·9%) of 11 235 included individuals had a final genetically confirmed diagnosis of familial hypercholesterolaemia and 1136 (10·1%) had a clinical diagnosis. Genetically confirmed diagnosis data or clinical diagnosis data were missing for 613 (5·2%) of 11 848 individuals. Genetic diagnosis was more common in children and adolescents from high-income countries (9427 [92·4%] of 10 202) than in children and adolescents from non-high-income countries (199 [48·0%] of 415). 3414 (31·6%) of 10 804 children or adolescents were index cases. Familial-hypercholesterolaemia-related physical signs, cardiovascular risk factors, and cardiovascular disease were uncommon, but were more common in non-high-income countries. 7557 (72·4%) of 10 428 included children or adolescents were not taking lipid-lowering medication (LLM) and had a median LDL-C of 5·00 mmol/L (IQR 4·05-6·08). Compared with genetic diagnosis, the use of unadapted clinical criteria intended for use in adults and reliant on more extreme phenotypes could result in 50-75% of children and adolescents with familial hypercholesterolaemia not being identified. Interpretation: Clinical characteristics observed in adults with familial hypercholesterolaemia are uncommon in children and adolescents with familial hypercholesterolaemia, hence detection in this age group relies on measurement of LDL-C and genetic confirmation. Where genetic testing is unavailable, increased availability and use of LDL-C measurements in the first few years of life could help reduce the current gap between prevalence and detection, enabling increased use of combination LLM to reach recommended LDL-C targets early in life