Política nacional de atuação oncológica: dificuldades e desafios / National policy of oncological action: difficulties and challenges

Objetivo: compreender a percepção dos pacientes oncológicos assistidos em um centro oncológico de uma cidade do município do Cariri – CE, a cerca e atuação da Política Nacional Oncológica e seus desafios e dificuldades. Método: pesquisa descritiva e exploratória, com abordagem qualitativa, desenvolvida com dezesseis pacientes oncológico, de ambos os sexos. Os dados foram coletados por meio de entrevistas individuais semiestruturadas, no período de janeiro a abril de 2019. Na interpretação dos dados, utilizou-se a análise de conteúdo de Bardin. Resultados: emergiram em quatro categorias: “perfil dos participantes”, “percepção sobre o câncer”, “processo de descoberta” e “dificuldades e desafios”. No estudo foi perceptível o pouco conhecimento dos participantes acerca da existência de uma política que os contempla. Obtemos relatos sobre as vivencias da realidade de pacientes oncológicos frente aos serviços públicos de saúde, encontrando as principais dificuldades em todo processo itinerário terapêutico, como a demora dos resultados de exames, transporte, benefícios auxilio-doença, e suporte psicossocial. Conclusão: Contudo, observamos na realidade a importância de monitorar a assistência que é feita, a gestão e a organização dos serviços e investir em ações por meios de políticas públicas em saúde, visando ter melhorias na assistência fornecida ao paciente e na qualidade de vida do mesmo

Optimal plant density and nitrogen rates for improving off-season corn yields in Brazil

Integrating plant density and nitrogen (N) management is a strategy for improving corn yields, especially for off-season corn production in the tropics. This study tested the hypothesis that increasing plant densities and N rates promotes yield gains for off-season corn production in high-yielding environments. The aim of the study was to investigate the yield performances of two hybrid versions (DKB PRO and DKB PRO3) submitted to three plant densities (55,000; 65,000 and 75,000 plants ha−1) and four N rates (control, 60, 120 and 180 kg ha−1 N). Field trials were undertaken at Uberlândia-MG (site1 and 2) and Pedro Afonso-TO (site 3), Brazil from which data on corn yield parameters were collected and analyzed. Multivariate analysis separated the three trial areas into two groups, presenting high (sites 1 and 2) and low yields (site 3), which were related to weather conditions. There was no influence of a hybrid version or plant densities on crop yields at site 1 or 2. In contrast, there was a positive response to increasing plant densities and the use of DKB PRO3 at site 3. A significant response to N was observed at sites 2 and 3, following a plateau model. Our results suggest that N application rates and plant densities do have the potential to increase off-season corn yields in low yielding environments

Vibration Measurement Using Laser Triangulation for Applications in Wind Turbine Blades

The blades in a wind turbine are currently manufactured with flexible and light materials, which make them more susceptible to the effects of vibrations when the wind speed is high enough, causing fatigue damage, affecting the functionality of its structure and aerodynamic efficiency. This work presents a comparison of the modal vibration parameters, applied to a cantilever beam, determined with two experimental methods—the use of accelerometers and a proposed optical non-contact method—based on the principle of laser triangulation and photogrammetry techniques. This technique uses the geometric symmetry of the equidistant displacements along the z axis of the beam to obtain the amplitude data. Parameters such as natural frequency and modal form are obtained by fitting the data to a nonlinear equation with a solution which is an exponential/harmonic equation. Also, analytically, these parameters are determined, and a comparison is made between the experimental methods. The result shows that the relative error of the first-order natural vibration frequency is below 1%. The proposed method is simple, efficient, reliable, and it is also a method that has not been applied to the test of wind turbine blades, so its implementation as this type of wind turbine component is an area of opportunity for the validation of modal vibration parameters in the wind industry. An analysis of results is presented showing benefits of the proposed method and its limitations

The use of social networking sites as an innovative tool at university: Facebook as a collaborative learning tool in Immunology

En la actualidad los docentes universitarios tienen el reto de enseñar a la conocida como “generación Y”, alumnos nacidos entre los años 1980 y 2000, los cuales no han conocido el mundo sin internet o teléfono móvil. Esto por supuesto implica que el acercamiento al conocimiento, y por tanto los modos de aprendizaje, son completamente diferentes a los de generaciones anteriores. Esto unido a la implementación de las nuevas titulaciones acordes con el proceso de convergencia europea y el sistema de créditos ECTS, y siguiendo los desafíos de la enseñanza contemplados en el Espacio Europeo de Educación Superior (EEES), hace inevitable la implementación de nuevas formas de comunicación entre los alumnos y los profesores en el ámbito Universitario. Aunque en este aspecto la mayoría de las Universidades cuentan ya con diferentes herramientas de e-Learning, su uso e implementación en algunas ocasiones puede resultar insuficiente. En este escenario, por el contrario, son muchas las posibilidades que ofrecen las redes sociales y su extenso uso entre el alumnado, quien accede generalmente con mucha frecuencia a sus perfiles y grupos, proporcionando una comunicación rápida, fácil y flexible. En el presente proyecto de innovación docente hemos combinado el uso de un grupo de Facebook con los recursos tradicionales en la docencia relativa a la asignatura de Inmunología, usando esta red social como herramienta de apoyo para compartir materiales e información. Todo ello buscando un nuevo ambiente de comunicación más directo entre alumnos y profesorado, sin por supuesto tener que sustituir las vías de comunicación formales como el correo electrónico y Moodle. Esto nos ha permitido evaluar su uso, participación y satisfacción entre el alumnado que ha participado en el proyecto.Nowadays, University teachers face the challenge of teaching the so-called “Y generation”, students born between 1980 and 2000, who haven't experienced their lives without the Internet or the mobile phone. This has a direct consequence on their approach to knowledge and, therefore, to the learning styles, which are completely different to those of former generations. This fact, together with the implementation of new degrees more in line with the European convergence process and the ECTS credit system, and following the educative challenges included in the new European Space of Higher Education (EEES), makes it necessary to implement new forms of communication between pupils and teachers in the university context. Although most universities already make use of different e-Learning tools, their use and implementation can sometimes be insufficient. In this scenery, on the contrary, the social networking sites and their extended use by students, who check their profiles and groups very often, offer a lot of possibilities, as they allow a fast, easy and flexible communication. In the present project of teaching innovation, we have combined the use of a Facebook group with the traditional resources used in Immunology, so that this social networking site becomes a support tool to share materials and information. In the same sense, we look for a new atmosphere where a more direct communication between students and teachers is possible, without avoiding the more formal forms of communication such as the email or Moodle. This has allowed us to evaluate its use, participation and satisfaction, both between the students and the teachers taking part in the project

Hemodiálise e seus impactos psicossociais em mulheres em idade fértil / Hemodiálism and its psychosocial impacts in women at fertility

1. Ribeiro CDS, Alencar CSM, Feitosa MCD, Mesquita MASB. Percepção do portador de doença renal crônica sobre o tratamento hemodialitico. R. Interd. v.6, n. 3, p. 36-44, jul.ago.set. 2013.2. Maniva SJCF, Freitas CHA. O paciente em hemodiálise: autocuidado com a fístula arteriovenosa. Rev. Rene. Fortaleza, v. 11, n. 1, p. 152-160, jan./mar.2010.3. Farias MS, Maia ICG, Ferreira GMS, Pinto JR, Ferreira FIS. Sentimentos de pessoas em hemodiálise que esperam por um transplante renal. Revista Brasileira de Ciências da Saúde. v.24, n.4, p.357-362, 2018.4. Sociedade Brasileira de Nefrologia. Doença Renal Crônica. Associação Médica Brasileira, fundada em 1960. São Paulo, 23 de janeiro de 2012.5. Guedes KD, Guedes HM. Qualidade de vida do paciente portador de insuficiência. Revista Ciência & Saúde, Porto Alegre, v. 5, n. 1, p. 48-53, jan./jun. 2012.6. Silva KAL, Cargnin MCS, Ventura J, Paula SF, Groos JV. Qualidade de vida de pacientes com insuficiência renal em tratamento hemodialitico. Rev enferm UFPE on line, Recife, 11(Supl. 11):4663-70, nov, 2017.7. Silva RAR, Souza VL, Oliveira GJN, Silva BCO, Rocha CCT, Holanda JRR. Estratégias de enfrentamento utilizadas por pacientes renais crônicos em tratamento hemodialitico. Escola Anna Nery 20(1) Jan-Mar 2016.8. Ribas CCC, Fonseca RCV. Manual de metodologia opet. P.6, Curitiba, 2008.9. Gil AC. Métodos e técnicas de pesquisa social / Antonio Carlos Gil. - 6. ed. - São Paulo: Atlas, 2008.10. Prodanov CC, Freitas EC. Metodologia do trabalho cientifico: Métodos e Técnicas da Pesquisa e do Trabalho Acadêmico. 2.ed, p.70. Novo Hamburgo- Rio Grande do Sul, 2013.11. Bardin L. Análise de conteúdo. 4ed. Lisboa:Edições70, 2010.12. Pereira ER, Ribeiro IML, Ruas EFG, Silva PLN, Gonçalves RPF, Diamantino NAM. Análise das principais complicações durante a terapia hemodialítica em pacientes com insuficiência renal crônica. R. Enferm. Cent. O. Min. 2014 maio/ago; 4(2):1123-1134.13. Fioravante FA, Souza WC, Coelho NMD, Côelho JCA. Doenças renais: a enfermagem na terapia de substituição renal. Rev. Conexão Eletrônica – Três Lagoas, MS - Volume 15 – Número 1 – Ano 2018.14. Marques FRB, Botelho MR, Marcon SS, Pupulim JSL. Estratégias de coping utilizadas por familiares de indivíduos em tratamento hemodialitico. Texto Contexto Enferm, Florianópolis, 2014 Out-Dez; 23(4): 915-24.15. Gomes NDB, Leal NPR, Pimenta CJL, Martins KP, Ferreira GRS, Costa KNFM. Qualidade de vida de homens e mulheres em hemodiálise. Rev baiana enferm (2018); 32:e24935.16. Horta HHL, Lopes ML. Complicações decorrentes do tratamento dialítico: contribuição do enfermeiro no cuidado e educação ao paciente. Revista Enfermagem Contemporânea. 2017 Outubrol;6(2):221-227.17. Freitas RLS, Mendonça AEO. Cuidados de enfermagem ao paciente renal crônico em hemodiálise. Carpe Diem: Revista Cultural e Científica do UNIFACEX. v. 14, n. 2, 2016.18. Nogueira FLL, Freitas LR, Cavalcante NS, Pennafort VPS. Percepção do paciente renal crônico acerca dos cuidados com acessos para hemodiálise. Cogitare Enferm. 2016 Jul/set; 21(3): 01-08.19. Freitas EA, Freitas EA, Santos MF, Félis KC, Moraes-Filho IM, Ramos LSA. Assistência de enfermagem visando a qualidade de vida dos pacientes renais crônicos na hemodiálise. Rev Inic Cient e Ext. 2018 Jul-Dez;1(2):114-21

Approach to Endoscopic Procedures: A Routine Protocol from a Quaternary University Referral Center Exclusively for Coronavirus Disease 2019 Patients

OBJECTIVES: The present coronavirus disease (COVID-19) pandemic has ushered in an unprecedented era of quality control that has necessitated advanced safety precautions and the need to ensure the adequate protection of healthcare professionals (HCPs). Endoscopy units, endoscopists, and other HCP may be at a significant risk for transmission of the virus. Given the immense burden on the healthcare system and surge in the number of patients with COVID-19, well-designed protocols and recommendations are needed. We aimed to systematically characterize our approach to endoscopic procedures in a quaternary university hospital setting and provide summary protocol recommendations. METHOD: This descriptive study details a COVID-19-specific protocol designed to minimize infection risks to patients and healthcare workers in the endoscopy unit. RESULTS: Our institution, located in Sa˜o Paulo, Brazil, includes a 900-bed hospital, with a 200-bed-specific intensive care unit exclusively designed for patients with moderate and severe COVID-19. We highlighted recommendations for infection prevention and control during endoscopic procedures, including appropriate triage and screening, outpatient management and procedural recommendations, role and usage of personal protective equipment (PPE), and role and procedural logistics involving COVID-19-positive patients. We also detailed hospital protocols for reprocessing endoscopes and cleaning rooms and also provided recommendations to minimize severe acute respiratory syndrome coronavirus 2 transmission. CONCLUSION: This COVID-19-specific administrative and clinical protocol can be replicated or adapted in multiple institutions and endoscopy units worldwide. Furthermore, the recommendations and summary protocol may improve patient and HCP safety in these trying times

Planeación, gobernanza y sustentabilidad Retos y desafíos desde el enfoque territorial

Frente a la compleja realidad actual, resulta ineludible el desarrollo de la investigación científica de los fenómenos y procesos urbanos, territoriales y ambientales, que contribuya a su comprensión y la construcción de alternativas de solución a los retos y desafíos vigentes. En este contexto, el abordaje de las ciudades y regiones metropolitanas, el ordenamiento del territorio y la ocupación del espacio, así como la relación sociedad-naturaleza y la complejidad ambiental, precisa la generación de metodologías y procesos de investigación multi e inter disciplinarios que contribuyan a la comprensión de los procesos socioterritoriales, el mejoramiento de las condiciones de vida y la conservación ambiental.Programa de Fortalecimiento de la Calidad Educativa PFCE-2016 proyecto K0313101

Predictive Power of the "Trigger Tool" for the detection of adverse events in general surgery: a multicenter observational validation study

Background In spite of the global implementation of standardized surgical safety checklists and evidence-based practices, general surgery remains associated with a high residual risk of preventable perioperative complications and adverse events. This study was designed to validate the hypothesis that a new “Trigger Tool” represents a sensitive predictor of adverse events in general surgery. Methods An observational multicenter validation study was performed among 31 hospitals in Spain. The previously described “Trigger Tool” based on 40 specific triggers was applied to validate the predictive power of predicting adverse events in the perioperative care of surgical patients. A prediction model was used by means of a binary logistic regression analysis. Results The prevalence of adverse events among a total of 1,132 surgical cases included in this study was 31.53%. The “Trigger Tool” had a sensitivity and specificity of 86.27% and 79.55% respectively for predicting these adverse events. A total of 12 selected triggers of overall 40 triggers were identified for optimizing the predictive power of the “Trigger Tool”. Conclusions The “Trigger Tool” has a high predictive capacity for predicting adverse events in surgical procedures. We recommend a revision of the original 40 triggers to 12 selected triggers to optimize the predictive power of this tool, which will have to be validated in future studies

Avanços da cirurgia robotica no tratamento do Câncer

A cirurgia robótica tem sido almejada por profissionais cirurgiões, visto que, é um procedimento considerado de alta eficácia, assim como, apresenta reduzidos níveis de riscos ao paciente, o que configura significativamente a qualidade elevada do procedimento médico. Logo, tem sido utilizada no tratamento cirúrgico de diversos tipos de câncer, o qual tem demonstrado melhores resultados quando comparados com procedimentos mais invasivas ou tradicionais O principal objetivo do é discutir por meio de uma revisão sistematizada da literatura acerca dos avanços da cirurgia robótica no tratamento dos demais tipos de cânceres. O presente estudo trata-se de uma revisão sistemática da literatura, de modo que, realizou-se buscas de na Scielo, Periódico Capes e na Biblioteca Virtual em Saúde (BVS), através de termos específicos do Decs, o qual resultou-se em: “Neoplasias” AND “Procedimentos Cirúrgicos Robóticos” AND “Terapêutica”. Foram elegíveis um total de 8 estudos na presente revisão sistemática. Este procedimento é devidamente realizado com menores danos de incisão possível no paciente, de modo que, possibilitou a diminuição de dores pós-operatórios, além da redução de sangramentos, traumas, respostas inflamatórias, tempo de internação e até mesmo melhores resultados estéticos nos pacientes, quando comparados com os métodos mais tradicionais e invasivos

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio