PERCEPÇÃO DA MÃE QUANTO ÀS CONSEQUÊNCIAS QUE O CÂNCER DO FILHO TRAZ AO RELACIONAMENTO CONJUGAL

O câncer quando acomete um indivíduo afeta também toda a sua família. Talvez, uma das maiores dificuldades experimentadas pelos pais que acompanham o tratamento oncológico de um filho seja visualizar o futuro, encontrando sentido para suas próprias vidas e para a vida conjugal. O objetivo desta pesquisa foi conhecer a percepção da mãe quanto às consequências que o diagnóstico de câncer do filho trouxe ao relacionamento conjugal. Nesse sentido, investigaram-se através de estudo de campo, qualitativo e exploratório onze mães que acompanham seus filhos em tratamento oncológico e que são assistidas em uma fundação de amparo à criança com câncer no Norte de Minas. As idades das participantes variaram entre 23 e 55 anos; 91% das famílias possuem renda de um salário mínimo, sendo este um dos motivos de serem assistidas na fundação. Quanto ao tempo de tratamento, todas iniciaram assim que receberam o diagnóstico. A descoberta mais recente foi há seis meses e a mais antiga, há 15 anos.  Conclui-se que houve afastamento físico (55%), porém, 73% das mães relataram que não houve afastamento emocional. Apesar da hipótese inicial de que haveria o afastamento emocional, os resultados dessa investigação indicaram que essas famílias desenvolveram estratégias de enfrentamento que reduziram a frequência do fenômeno

Avaliação da atenção no contexto do trânsito: uma amostra da Bahia – Brasil

No Brasil, um teste psicológico, para ser considerado em condições de uso, deve ser aprovado pelo Conselho Federal de Psicologia, que regulamenta a matéria por meio da Resolução 002/2003. Tal resolução dispõe sobre elaboração, comercialização e uso dos testes psicológicos. Para isto devem ser apresentados estudos atualizados relativos aos parâmetros psicométricos do teste, particularmente os que evidenciem sua validade e precisão, pelos profissionais que fazem uso dos mesmos. Em decorrência desta regulamentação existe um grande número de instrumentos que são estudados com o objetivo de atualizar e aperfeiçoar as avaliações já realizadas, dada à importância dos testes psicológicos no processo de avaliação psicológica. A validade de um instrumento de avaliação deve ser apoiada por uma análise complexa, relacionada com fatores como objetivos, contexto, variáveis a serem examinadas, sujeito ou população e, consequentemente, os resultados e propósitos do processo avaliativo. O objetivo deste trabalho foi buscar evidência de validade para os testes de Atenção Dividida e Alternada, que avaliam dois tipos de atenção. O Teste de Atenção Dividida (TEADI) traz uma medida sobre a capacidade do indivíduo para dividir a atenção, de buscar mais de dois estímulos simultaneamente. Já o Teste de Atenção Alternada (TEALT) avalia a capacidade que o sujeito tem para focar a atenção de modo alternado em distintos estímulos. Nos dois testes, ao buscar os estímulos alvejados, o indivíduo deve desconsiderar os estímulos que dificultem esta ação. Os dois instrumentos podem ser aplicados individual ou coletivamente. Os testes foram aplicados de forma coletiva em 311 pessoas que passaram pelo processo de avaliação psicológica para obtenção da Carteira Nacional de Habilitação - CNH e motoristas que buscavam a renovação ou mudança de categoria da CNH no estado da Bahia - Brasil. A idade da amostra variou de 18 a 68 anos, sendo 165 solteiros, 137 casados ou em convivência estável e 09 separados, divorciados ou viúvos. A escolaridade variou do ensino fundamental a pós-graduação. Foi calculada a correlação de Pearson entre os totais de pontos. Os principais resultados apontam que ocorreu correlação moderada, positiva e significativa entre as pontuações dos testes TEADI e TEALT. Os dados disponíveis até o momento permitem concluir que, nesta amostra, existem evidências de validade dos referidos testes

A reflexão sobre a eficiência dos pressupostos realistas na contemporaneidade através da invasão do Iraque em 2003

At the turn of the nineteenth and twentieth centuries, when Rudolph Kjellén created the geopolitics term, political realism was recognized as a dominant explanatory theory for understanding power relations globally. After the two World Wars, the interdependence of nations seemed a final goal, even during the Cold War period, the opposition between ideologies could put political limitations on integration which already was possible due to advances of transport and communication. In the 1970s, Realism has found in academia, within the International Relations, a rival theory that have a great explanatory power for rearrangement of the future order: liberalism, understood as a theory pointing the international institutions and the interdependence of trade as powerful forces to explain the power relations globally. Through the 2003 invasion of Iraq, this work intends point to two different ways to interpret the same event in the light of Realism and Liberalism, aiming at finding their limitations on a world still in transition with regard to consolidation or extinction of its analytical assumptions. To do so, it focuses on the characteristics of the contemporary world coming jeopardizing some realistic assumptions.Na virada dos séculos XIX e XX, quando Rudolph Kjéllen cunhava o termo geopolítica, o realismo político consagrava-se como uma teoria explicativa dominante para o entendimento das relações de poder em âmbito global. Passadas as duas Grandes Guerras Mundiais, a interdependência das nações pareceu um caminho sem volta, ainda que, durante o período da Guerra Fria, as oposições ideológicas pudessem colocar limitações políticas à integração que já era possível devido aos avanços dos transportes e comunicações. Na década de 1970, o Realismo encontrou na academia, no seio das Relações Internacionais, uma teoria rival com grande poder explicativo para o rearranjo da ordem futura: o Liberalismo, entendido como uma teoria que aponta as instituições internacionais e a interdependência do comércio como forças poderosas no que tange à explicação das relações de poder em âmbito global. Este trabalho pretende apontar, através da invasão do Iraque de 2003, duas maneiras distintas de interpretar o mesmo evento à luz do Realismo e do Liberalismo, objetivando verificar suas limitações em um mundo ainda em transição no que tange à consolidação ou à caducidade de seus pressupostos analíticos. Para tanto, centra-se nas características do mundo contemporâneo que vem colocando em xeque alguns dos pressupostos realistas.

Establishing a global quality of care benchmark report.

BACKGROUND: The Movember funded TrueNTH Global Registry (TNGR) aims to improve care by collecting and analysing a consistent dataset to identify variation in disease management, benchmark care delivery in accordance with best practice guidelines and provide this information to those in a position to enact change. We discuss considerations of designing and implementing a quality of care report for TNGR. METHODS: Eleven working group sessions were held prior to and as reports were being built with representation from clinicians, data managers and investigators contributing to TNGR. The aim of the meetings was to understand current data display approaches, share literature review findings and ideas for innovative approaches. Preferred displays were evaluated with two surveys (survey 1: 5 clinicians and 5 non-clinicians, 83% response rate; survey 2: 17 clinicians and 18 non-clinicians, 93% response rate). RESULTS: Consensus on dashboard design and three data-display preferences were achieved. The dashboard comprised two performance summary charts; one summarising site's relative quality indicator (QI) performance and another to summarise data quality. Binary outcome QIs were presented as funnel plots. Patient-reported outcome measures of function score and the extent to which men were bothered by their symptoms were presented in bubble plots. Time series graphs were seen as providing important information to supplement funnel and bubble plots. R Markdown was selected as the software program principally because of its excellent analytic and graph display capacity, open source licensing model and the large global community sharing program code enhancements. CONCLUSIONS: International collaboration in creating and maintaining clinical quality registries has allowed benchmarking of process and outcome measures on a large scale. A registry report system was developed with stakeholder engagement to produce dynamic reports that provide user-specific feedback to 132 participating sites across 13 countries

Planck Intermediate Results II: Comparison of Sunyaev-Zeldovich measurements from Planck and from the Arcminute Microkelvin Imager for 11 galaxy clusters

A comparison is presented of Sunyaev-Zeldovich measurements for 11 galaxy clusters as obtained by Planck and by the ground-based interferometer, the Arcminute Microkelvin Imager. Assuming a universal spherically-symmetric Generalised Navarro, Frenk & White (GNFW) model for the cluster gas pressure profile, we jointly constrain the integrated Compton-Y parameter (Y_500) and the scale radius (theta_500) of each cluster. Our resulting constraints in the Y_500-theta_500 2D parameter space derived from the two instruments overlap significantly for eight of the clusters, although, overall, there is a tendency for AMI to find the Sunyaev-Zeldovich signal to be smaller in angular size and fainter than Planck. Significant discrepancies exist for the three remaining clusters in the sample, namely A1413, A1914, and the newly-discovered Planck cluster PLCKESZ G139.59+24.18. The robustness of the analysis of both the Planck and AMI data is demonstrated through the use of detailed simulations, which also discount confusion from residual point (radio) sources and from diffuse astrophysical foregrounds as possible explanations for the discrepancies found. For a subset of our cluster sample, we have investigated the dependence of our results on the assumed pressure profile by repeating the analysis adopting the best-fitting GNFW profile shape which best matches X-ray observations. Adopting the best-fitting profile shape from the X-ray data does not, in general, resolve the discrepancies found in this subset of five clusters. Though based on a small sample, our results suggest that the adopted GNFW model may not be sufficiently flexible to describe clusters universally.Comment: update to metadata author list onl

Planck Intermediate Results. IV. The XMM-Newton validation programme for new Planck galaxy clusters

We present the final results from the XMM-Newton validation follow-up of new Planck galaxy cluster candidates. We observed 15 new candidates, detected with signal-to-noise ratios between 4.0 and 6.1 in the 15.5-month nominal Planck survey. The candidates were selected using ancillary data flags derived from the ROSAT All Sky Survey (RASS) and Digitized Sky Survey all-sky maps, with the aim of pushing into the low SZ flux, high-z regime and testing RASS flags as indicators of candidate reliability. 14 new clusters were detected by XMM, including 2 double systems. Redshifts lie in the range 0.2 to 0.9, with 6 clusters at z>0.5. Estimated M500 range from 2.5 10^14 to 8 10^14 Msun. We discuss our results in the context of the full XMM validation programme, in which 51 new clusters have been detected. This includes 4 double and 2 triple systems, some of which are chance projections on the sky of clusters at different z. We find that association with a RASS-BSC source is a robust indicator of the reliability of a candidate, whereas association with a FSC source does not guarantee that the SZ candidate is a bona fide cluster. Nevertheless, most Planck clusters appear in RASS maps, with a significance greater than 2 sigma being a good indication that the candidate is a real cluster. The full sample gives a Planck sensitivity threshold of Y500 ~ 4 10^-4 arcmin^2, with indication for Malmquist bias in the YX-Y500 relation below this level. The corresponding mass threshold depends on z. Systems with M500 > 5 10^14 Msun at z > 0.5 are easily detectable with Planck. The newly-detected clusters follow the YX-Y500 relation derived from X-ray selected samples. Compared to X-ray selected clusters, the new SZ clusters have a lower X-ray luminosity on average for their mass. There is no indication of departure from standard self-similar evolution in the X-ray versus SZ scaling properties. (abridged)Comment: accepted by A&

Protons in near earth orbit

The proton spectrum in the kinetic energy range 0.1 to 200 GeV was measured by the Alpha Magnetic Spectrometer (AMS) during space shuttle flight STS-91 at an altitude of 380 km. Above the geomagnetic cutoff the observed spectrum is parameterized by a power law. Below the geomagnetic cutoff a substantial second spectrum was observed concentrated at equatorial latitudes with a flux ~ 70 m^-2 sec^-1 sr^-1. Most of these second spectrum protons follow a complicated trajectory and originate from a restricted geographic region.Comment: 19 pages, Latex, 7 .eps figure

Effects of different doses of erythropoietin in patients with myelodysplastic syndromes: A propensity score-matched analysis

Erythropoiesis-stimulating agents effectively improve the hemoglobin levels in a fraction of anemic patients with myelodysplastic syndromes (MDS). Higher doses (HD) of recombinant human erythropoietin (rhEPO) have been proposed to overcome suboptimal response rates observed in MDS patients treated with lower "standard doses" (SD) of rhEPO. However, a direct comparison between the different doses of rhEPO is lacking

Planck intermediate results. III. The relation between galaxy cluster mass and Sunyaev-Zeldovich signal

We examine the relation between the galaxy cluster mass M and Sunyaev-Zeldovich (SZ) effect signal D_A^2 Y for a sample of 19 objects for which weak lensing (WL) mass measurements obtained from Subaru Telescope data are available in the literature. Hydrostatic X-ray masses are derived from XMM-Newton archive data and the SZ effect signal is measured from Planck all-sky survey data. We find an M_WL-D_A^2 Y relation that is consistent in slope and normalisation with previous determinations using weak lensing masses; however, there is a normalisation offset with respect to previous measures based on hydrostatic X-ray mass-proxy relations. We verify that our SZ effect measurements are in excellent agreement with previous determinations from Planck data. For the present sample, the hydrostatic X-ray masses at R_500 are on average ~ 20 per cent larger than the corresponding weak lensing masses, at odds with expectations. We show that the mass discrepancy is driven by a difference in mass concentration as measured by the two methods, and, for the present sample, the mass discrepancy and difference in mass concentration is especially large for disturbed systems. The mass discrepancy is also linked to the offset in centres used by the X-ray and weak lensing analyses, which again is most important in disturbed systems. We outline several approaches that are needed to help achieve convergence in cluster mass measurement with X-ray and weak lensing observations.Comment: 19 pages, 9 figures, matches accepted versio

Planck intermediate results. VIII. Filaments between interacting clusters

About half of the baryons of the Universe are expected to be in the form of filaments of hot and low density intergalactic medium. Most of these baryons remain undetected even by the most advanced X-ray observatories which are limited in sensitivity to the diffuse low density medium. The Planck satellite has provided hundreds of detections of the hot gas in clusters of galaxies via the thermal Sunyaev-Zel'dovich (tSZ) effect and is an ideal instrument for studying extended low density media through the tSZ effect. In this paper we use the Planck data to search for signatures of a fraction of these missing baryons between pairs of galaxy clusters. Cluster pairs are good candidates for searching for the hotter and denser phase of the intergalactic medium (which is more easily observed through the SZ effect). Using an X-ray catalogue of clusters and the Planck data, we select physical pairs of clusters as candidates. Using the Planck data we construct a local map of the tSZ effect centered on each pair of galaxy clusters. ROSAT data is used to construct X-ray maps of these pairs. After having modelled and subtracted the tSZ effect and X-ray emission for each cluster in the pair we study the residuals on both the SZ and X-ray maps. For the merging cluster pair A399-A401 we observe a significant tSZ effect signal in the intercluster region beyond the virial radii of the clusters. A joint X-ray SZ analysis allows us to constrain the temperature and density of this intercluster medium. We obtain a temperature of kT = 7.1 +- 0.9, keV (consistent with previous estimates) and a baryon density of (3.7 +- 0.2)x10^-4, cm^-3. The Planck satellite mission has provided the first SZ detection of the hot and diffuse intercluster gas.Comment: Accepted by A&