Topographic and Morphometric Study of the Foramen Spinosum of the Skull and Its Clinical Correlation

Background and Objectives: The spinous foramen (FS) of the skull is an opening located in the greater wing of the sphenoid bone at the base of the skull, and it includes the middle meningeal vessels and the meningeal branch of the mandibular trigeminal nerve. The FS is commonly used as an anatomical landmark in neurosurgical procedures and neuroimaging of the middle cranial fossa because of its relationship with other cranial foramina and surrounding vascular and nervous structures. Thus, specific knowledge of its topography and possible anatomical variations is important regarding some surgical interventions and skull imaging. The aim of this study was to provide further details on the morphology of the FS of the skull by evaluating its topographic and morphometric relationships and correlating the findings with clinical practice. Materials and Methods: Thirty dried skulls of human skeletons from body donors from the collection of the Laboratory of Anatomical Microdissection at a medical school were used. The metric dimensions and variations of the FS and its relationship with adjacent bone structures were analyzed with an interface digital microscope. Results: The results showed the bilateral presence of the FS in all skulls; however, differences were observed in the shape, diameter, and topography in relation to the foramen ovale and the spine of the sphenoid. The FS was present in the greater wing of the sphenoid bone; however, in one skull, it was located in the lateral lamina of the pterygoid process. The FS was smaller than the foramen ovale. A round and oval FS shape was the most common (42.1% and 32.8% of the samples, respectively), followed by drop-shaped (12.5%) and irregular-shaped (12.5%) foramina. Conclusions: In conclusion, FS variations among individuals are common and must be considered by surgeons during skull base interventions in order to avoid accidents and postoperative complications

A formação clínica e a produção do cuidado em saúde e na enfermagem Clinical training and the production care in health and nursing

Este ensaio propõe uma discussão sobre a clínica na prática e na formação acadêmica da enfermagem com base em referenciais teórico-conceituais situados no campo da filosofia, tendo como pistas as relações de poder, saber e subjetividade presentes no encontro entre os sujeitos implicados com a produção do cuidado em saúde e com a formação acadêmica. A clínica na enfermagem foi impregnada pelo referencial biomédico, o que lhe conferiu alguns atributos que condicionaram sua prática: a pretensa neutralidade nas relações entre quem cuida e quem é cuidado, bem como a objetificação dos sujeitos, dos problemas e das necessidades de saúde que limita o olhar e as possíveis intervenções elaboradas no sentido de atendê-las. Nesta perspectiva, estas se pautam na compreensão da doença apenas em sua dimensão orgânica. Encontramos na filosofia espinosista a clínica como um encontro potencializador dos sujeitos, espaço de recriação e ressignificação da vida. Em Epicuro, esse encontro produz também desvios, movimentos aversos a estaticidade e apatia. Partindo dessas concepções, entendemos que a reconstrução da prática clínica no trabalho do enfermeiro passa necessariamente pela reconstrução das relações entre os sujeitos envolvidos na formação e pela produção de dispositivos mobilizadores de subjetividades<br>This essay proposes a discussion on the practice and academic training in nursing based on theoretical and conceptual references in the field of philosophy, taking as cues the relationships of power, knowledge, and subjectivity in the meeting between the subjects involved with the production of health care and academic education. The nursing practice was impregnated by biomedical references, which conferred it a few attributes that have imposed limitations on it: the supposed neutrality in the relationships between those who provide care and those who are cared for, the problems and needs in health that limit the analysis and possible interventions developed in order to meet them. From this perspective, they are guided in seeking to understand disease only in its organic dimension. In Spinoza's philosophy, the clinical practice is a place that potentializes the subjects, a space to recreate and give new meaning to life. In Epicurus, this place also produces deviations, movements that are averse to changelessness and apathy. Based on these conceptions, we argue that the reconstruction of the clinical practice in nursing work should observe the reconstruction of the relationships among the individuals involved in the training and the production of devices that set subjectivities into motio

A autoavaliação institucional no processo de tomada de decisão em IES: estudo de caso das Faculdades SENAC/SC Institutional self-evaluation in the decision-making process at HEIs: a case study of SENAC/SC higher education school

O presente artigo pretende demonstrar em seu contexto a relação existente entre o sistema de autoavaliação institucional e o processo de tomada de decisão, especificamente nas Faculdades de Tecnologia pertencentes à Administração Regional do SENAC-SC. Utilizando uma amostra intencional deste universo, o estudo, realizado em 2010, é caracterizado como descritivo-exploratório, do tipo quali-quantitativo, mediante a aplicação de uma pesquisa bibliográfico-documental, configurada como um estudo multicaso. Nas seis unidades investigadas, foram entrevistados: o diretor da unidade e os coordenadores de áreas (Núcleo Relações com o Mercado, Núcleo Administrativo Financeiro e Núcleos Educacional Básico e do Ensino Superior), aplicando-se um questionário estruturado com questões abertas e fechadas, permitindo a avaliação de aspectos objetivos e quantificáveis e subjetivo-discursivos. Os resultados apontam para a autoavaliação institucional como facilitadora do processo decisório, provendo informações que permitem avaliar determinada situação. Adicionalmente, identificam os pontos fortes e fracos da IES e que melhoram a qualidade das decisões estratégicas, o que confirma a existência da relação pressuposta acima, bem como a importância do processo de autoavaliação institucional. Mostram, ainda, a necessidade de revisão da estrutura, visando aprimorar a apropriação dos dados levantados pela autoavaliação e aplicados como suporte no processo de tomada de decisão das instituições do universo analisado. Por fim, a hipótese de pesquisa, em base a esses resultados, acabou sendo validada, ratificando tal relação.<br>This article presents, briefly, the master thesis that gave rise and that analyzes the institutional self-evaluation and the decision-making process at SENAC-SC and the relationship between them. By using an intentional sample of six technology universities belonging to the regional administration of SENAC-SC, this research, carried out in June and July 2010 (cross-sectional basis, i.e., during the current year), had the main purpose of analyzing the institutional self-evaluation and its influence over the decision-making process, supplemented by its specific purposes that were: describe these two processes; identify the appropriation of the results from the institutional self-evaluation in the SENAC-SC universities; and list and discuss those elements that either make it easier or difficult to appropriate such results in the decision-making process within the institution. The study was characterized as a qualitative/quantitative-type descriptive-exploratory study upon the application of a bibliographic-documentary research configured as a multi-case study. Interviews were carried out at each investigated university with: The director of the unit and the area coordinators (market relationship core, administrative/financial core and basic and superior education core), who are understood as the managers of these institutions. A structured questionnaire was applied, containing open and closed-type questions, in the mentioned period, in order to evaluate not only objective and aspects, but also subjective-discursive aspects. The main results have confirmed the existence of the above-assumed relationship, including the importance of the institutional self-evaluation process. In addition and in attention to the specific goals, they indicate that notwithstanding such importance, its structure needs to be revised in order to improve such relationship and improve the appropriation of the surveyed data by the self-evaluation and apply them as an auxiliary means for the decision-making process of the universities in the analyzed universe. The research hypothesis, which was predicting that the institutional self-evaluation, when established in an institution, influences with the provision of subsidies, the decision-making process, was validated by the results