Estudo multicêntrico de avaliação perioperatória para operações não cardíacas (EMAPO)

INTRODUCTION: The accuracy of perioperative evaluation methods available is better than chance, but their performance is not ideal. OBJECTIVES: To compare a new evaluation method (EMAPO) to the American College of Physicians method for determining the risk of cardiovascular complications in noncardiac surgeries and to look for new influencing variables. METHODS: Evaluations through EMAPO and the American College of Physicians method were employed for 700 patients. Cardiac events and deaths were recorded, the risk variables related to the occurrence of complications were verified, and the models were compared by analyzing the areas under the receiver operating characteristic curves. RESULTS: Mortality rate was 3.4%, and the incidence of cardiovascular complications was 5.3%. Renal failure (P = 0.01), major surgery (P = 0.004), and emergency surgery (P = 0.003) were independently related to the occurrence of cardiovascular complications. The two methods produced similar results. CONCLUSION: EMAPO is as good as the American College of Physicians method in determining the risk of cardiovascular complications in noncardiac surgeries. New variables related to surgical risk were identified.INTRODUÇÃO: A precisão dos métodos de avaliação perioperatória disponíveis é melhor que o acaso, porém está longe do ideal. OBJETIVOS: Comparar um novo método de avaliação perioperatória (EMAPO) ao método do American College of Physicians para determinar o risco cardíaco em cirurgias não cardíacas e buscar novas variáveis envolvidas na determinação deste risco. MÉTODOS: O EMAPO e o método do American College of Physicians foram aplicados em 700 pacientes. A ocorrência de eventos cardíacos e de mortes foi documentada, a relação entre as variáveis de risco e as complicações foi estabelecida e os métodos foram comparados analisando as áreas sob a curva ROC. RESULTADOS: A mortalidade foi 3.4% e a incidência de complicações cardiovasculares 5.3%. A presença de insuficiência renal (p=0.01), cirurgia de grande porte (p=0.004) e cirurgia de emergência (p=0.003) se correlacionaram com a ocorrência de complicações cardiovasculares na análise multivariada. Não houve diferença entre os dois métodos. CONCLUSÕES: O EMAPO é tão eficaz quanto o método do American College of Physicians para determinar o risco de complicações cardiovasculares em cirurgias não cardíacas. Novas variáveis relacionadas com o risco perioperatório foram encontradas

Contribution to the qualitative study of work in the area of nursing

Identiticação dos fatores causadores de sofrimento ou prazer no trabalho da enfermagem. Possibilidades de mudanças. com repercussões positivas. nas vidas dos enfermeiros e nas vidas daqueles com quem interagem. Dimensão da experiência que expressa o sujeito na interseção de sua particularidade com o mundo sociocultural e histórico.The attendance of the diary work of the people \\ho work at the nursing. their fulfilments and suffcring moments set up as mobilizing elements to a close present study. The relevance of our study takes place in search of identifying factors which make up motive of suffcring ar pleasure on the wark of nursing workers. Such factors can mean changing of possibilities. with positive repercussion on their lives and on the lives of the people they interact with. The dimension of the experience that expresses the subject on intersection of his/her specialities with the social-cultural and historical world

Análise do trabalho prisional : um estudo exploratório

O estudo, baseado em pesquisa de natureza exploratório-descritiva, busca identificar fatores do atual modelo de trabalho prisional do Rio Grande do Sul que dificultam a promoção da ressocialização de apenados. Concomitantemente, propõe mudanças na sua concepção como estratégia, para o atingimento de índices mais expressivos de ressocialização. Os dados foram coletados por meio de consultas aos prontuários penais e de entrevistas semi-estruturadas com vinte apenados do sistema penitenciário gaúcho. Para a análise dos dados coletados, utilizou-se a metodologia da análise de conteúdo, na modalidade de análise temática. Os resultados são apresentados em cinco categorias finais: o trabalho prisional, a identidade no sistema prisional, a ressocialização idealizada, o trabalho prisional no desenvolvimento pessoal e as condições do trabalho prisional. Detectou-se o desconhecimento por parte da Administração Penitenciária da importância da relação entre prazer, sofrimento e motivação mais ampla no trabalho, para uma construção positiva da identidade dos apenados.In this exploratory-descriptive research, the author looks into the identification of the factors concerning the present work model in Rio Grande do Sul State prisions, Brazil. This criticized model is responsible for the difficulties in promoting a reasonable resocialization of the prisoners. Simultaneously the author suggests important changes in the conquest of a more expressive achievement toward the expected resocialization. Data were collected in examining penal hanbook and references and chiefly by means of semi-structured interviews with twenty prisioners. Collected data were analyzed according to content methodology; results are presented in five final categories: (1) prisonal work; (2) prison system identity; (3) ideological resocialization; (4) prisional work influence on personal growth; (5) prisional work conditions. It was noticed that Penitentiary Administration ignores the importance of a better relation among psychological motivation, suffering and a legitimate pleasure in accomplishing prisonal imposed work, in overcoming huge problems and challenges and in reaching the intended prisioners' resocialization

Análise da dicotomia sofrimento e prazer na função gerencial feminina

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MicroRNA-dependent control of sensory neuron function regulates posture behavior in Drosophila

All what we see, touch, hear, taste, or smell must first be detected by the sensory elements of our nervous system. Sensory neurons, therefore, represent a critical component in all neural circuits and their correct function is essential for the generation of behavior and adaptation to the environment. Here, we report that the evolutionarily-conserved microRNA (miRNA) miR-263b plays a key behavioral role in Drosophila melanogaster through effects on the function of larval sensory neurons. Several independent experiments (in 50:50 male:female populations) support this finding: First, miRNA expression analysis, via reporter expression and fluorescent-activated cell sorting (FACS)-quantitative PCR (qPCR) analysis, demonstrate miR- 263b expression in larval sensory neurons. Second, behavioral tests in miR-263b null mutants show defects in self-righting, an innate and evolutionarily conserved posture-control behavior that allows larvae to rectify their position if turned upsidedown. Third, competitive inhibition of miR-263b in sensory neurons using a miR-263b "sponge"leads to self-righting defects. Fourth, systematic analysis of sensory neurons in miR-263b mutants shows no detectable morphologic defects in their stereotypic pattern, while genetically-encoded calcium sensors expressed in the sensory domain reveal a reduction in neural activity in miR-263b mutants. Fifth, miR-263b null mutants show reduced "touch-response"behavior and a compromised response to sound, both characteristic of larval sensory deficits. Furthermore, bioinformatic miRNA target analysis, gene expression assays, and behavioral phenocopy experiments suggest that miR-263b might exert its effects, at least in part, through repression of the basic helix-loop-helix (bHLH) transcription factor Atonal. Altogether, our study suggests a model in which miRNA-dependent control of transcription factor expression affects sensory function and behavior

Mental Illness Sexual Stigma: Implications for Health and Recovery

The majority of people in psychiatric care worldwide are sexually active, and studies have revealed sharply elevated rates of HIV infection in that group compared with the general population. Recovery-oriented treatment does not routinely address sexuality. We examined the relationship between gender, severe mental illness diagnosis, and stigma experiences related to sexuality among people in psychiatric outpatient care. Method: Sexually active adults attending 8 public outpatient psychiatric clinics in Rio de Janeiro (N = 641) were interviewed for psychiatric diagnosis and stigma experiences. Stigma mechanisms well-established in the literature but not previously examined in relation to sexuality were measured with the Mental Illness Sex Stigma Questionnaire, a 27-item interview about stigma in sexual situations and activities. Results: Experiences of stigma were reported by a majority of participants for 48% of questionnaire items. Most people reported supportive attitudes toward their sexuality from providers and family members. Those with severe mental illness diagnoses showed greater stigma on individual discrimination and structural stigma mechanisms than did those with nonsevere mental illness diagnoses, whereas there was no difference on the social psychological processes (internalized stigma) mechanism. Regardless of diagnosis or gender, a majority of participants devalued themselves as sexual partners. Conclusions and Implications for Practice: Adults in psychiatric outpatient care frequently reported stigma experiences related to aspects of their sexual lives. From the perspectives of both HIV prevention and recovery from mental illness, examinations of the consequences of stigma in the sexual lives of people in psychiatric care and improving their measurement would have wide applicability

Surface crystallization of ionic liquid crystals

The evidence for surface crystallization in ionic liquids is scarce. The existing reports seem to be contradictory as for its driving forces, since in the two compounds investigated in the literature, the contribution of coloumbic and van der Waals forces is very different. In this work 1-dodecyl-3- methylimidazolium tetrafluoroborate was studied and its surface crystallization characterized by surface tension, ellipsometry and optical microscopy. The results obtained seem to reconcile previous observations, and it was further shown, using the same techniques, that this phenomenon is prevalent in other ionic liquids. MD simulation results illustrate the different possibilities of organization, providing reasonable models to rationalize the experimental observations.This work was developed with the scope of the project CICECO – Aveiro Institute of Materials, UID/CTM/50011/2019, Associate Laboratory LSRE-LCM, UID/EQU/50020/2019, and of Instituto de Telecomunicaço˜es/IT (UID/EEA/50008/2013) – funded by national funds through FCT/MCTES (PIDDAC). M. A. R. M. acknowledges financial support from NORTE-01-0145-FEDER- 000006 – funded by NORTE2020 through PT2020 and ERDF, and P. J. C. acknowledges the FCT for the contract IF/00758/2015. A. R. Bastos from UA is acknowledged for help in the ellipsometry measurements. M. C. C. aknowledges FAPESP (2012/05027-1) and CNPq (310272/2017) for financial support.info:eu-repo/semantics/publishedVersio