35 research outputs found
Busca dos fatores associados Ă evasĂŁo
Em razĂŁo do baixo nĂșmero de brasileiros com ensino superior e isso estar relacionado com o menor desenvolvimento do paĂs, a evasĂŁo escolar se torna o epicentro de grandes problemas: retenção do crescimento tecnolĂłgico nacional, continuidade dos problemas sociais e desperdĂcio econĂŽmico. SĂŁo muitos os modelos explicativos para a evasĂŁo, no entanto cada localidade tem suas prĂłprias peculiaridades quanto as reais causas desse evento, e por isso tais estudos, no Ăąmbito local, sĂŁo essenciais para criação de polĂticas pĂșblicas de enfrentamento. Diante disso, realizou-se uma pesquisa com 63 estudantes evadidos do campus CrateĂșs da Universidade Federal do CearĂĄ (UFC) no intuito de analisar as causas da evasĂŁo por meio de uma anĂĄlise fatorial exploratĂłria e de uma confirmatĂłria. ApĂłs a anĂĄlise Ă© possĂvel confirmar os principais motivos desse evento, como a frustração pelo desempenho acadĂȘmico, alteração da saĂșde mental, a falta de vontade de cursar a graduação escolhida, a falta de apoio familiar, a falta de comprometimento com a graduação etc. Portanto, Ă© urgente a necessidade de uniĂŁo entre diversas instituiçÔes pĂșblicas, como instituiçÔes de ensino, de saĂșde e de segurança, visando enfrentar as raĂzes da evasĂŁo
GERENCIAMENTO PERIOPERATĂRIO DE PACIENTES COM OBESIDADE MĂRBIDA SUBMETIDOS Ă CIRURGIA BARIĂTRICA
This study addresses the perioperative management of morbid obesity in patients undergoing bariatric surgery, aiming to understand current approaches, challenges, and future perspectives. Through an integrative review, studies published between 2014 and 2023 in selected databases were analyzed, highlighting the importance of a multidisciplinary approach, treatment personalization, and awareness of morbid obesity. The results evidenced advances in surgical techniques, novel pharmacological and therapeutic strategies, as well as the need for continuous care and equitable access to treatments. It is concluded that collaboration among healthcare professionals, patient education, and investment in research are crucial to improving long-term outcomes and the quality of life of patients with morbid obesity undergoing bariatric surgery.Este estudo aborda o gerenciamento perioperatĂłrio da obesidade mĂłrbida em pacientes submetidos Ă cirurgia bariĂĄtrica, visando compreender as abordagens atuais, desafios e perspectivas futuras. Utilizando uma revisĂŁo integrativa, foram analisados estudos publicados entre 2014 e 2023 em bases de dados selecionadas, destacando-se a importĂąncia da abordagem multidisciplinar, a personalização do tratamento e a conscientização sobre a obesidade mĂłrbida. Os resultados evidenciaram avanços nas tĂ©cnicas cirĂșrgicas, novas estratĂ©gias farmacolĂłgicas e terapĂȘuticas, bem como a necessidade de cuidados contĂnuos e acesso equitativo aos tratamentos. Conclui-se que a colaboração entre profissionais de saĂșde, a educação do paciente e o investimento em pesquisa sĂŁo cruciais para melhorar os resultados a longo prazo e a qualidade de vida dos pacientes com obesidade mĂłrbida submetidos Ă cirurgia bariĂĄtrica
A História da Alimentação: balizas historiogråficas
Os M. pretenderam traçar um quadro da HistĂłria da Alimentação, nĂŁo como um novo ramo epistemolĂłgico da disciplina, mas como um campo em desenvolvimento de prĂĄticas e atividades especializadas, incluindo pesquisa, formação, publicaçÔes, associaçÔes, encontros acadĂȘmicos, etc. Um breve relato das condiçÔes em que tal campo se assentou faz-se preceder de um panorama dos estudos de alimentação e temas correia tos, em geral, segundo cinco abardagens Ia biolĂłgica, a econĂŽmica, a social, a cultural e a filosĂłfica!, assim como da identificação das contribuiçÔes mais relevantes da Antropologia, Arqueologia, Sociologia e Geografia. A fim de comentar a multiforme e volumosa bibliografia histĂłrica, foi ela organizada segundo critĂ©rios morfolĂłgicos. A seguir, alguns tĂłpicos importantes mereceram tratamento Ă parte: a fome, o alimento e o domĂnio religioso, as descobertas europĂ©ias e a difusĂŁo mundial de alimentos, gosto e gastronomia. O artigo se encerra com um rĂĄpido balanço crĂtico da historiografia brasileira sobre o tema
Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study
Summary
Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally.
Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies
have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of
the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income
countries globally, and identified factors associated with mortality.
Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to
hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis,
exomphalos, anorectal malformation, and Hirschsprungâs disease. Recruitment was of consecutive patients for a
minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical
status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary
intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause,
in-hospital mortality for all conditions combined and each condition individually, stratified by country income status.
We did a complete case analysis.
Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital
diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal
malformation, and 517 with Hirschsprungâs disease) from 264 hospitals (89 in high-income countries, 166 in middleincome
countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male.
Median gestational age at birth was 38 weeks (IQR 36â39) and median bodyweight at presentation was 2·8 kg (2·3â3·3).
Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income
countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups).
Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome
countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries;
pâ€0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients
combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88â4·11],
p<0·0001; middle-income vs high-income countries, 2·11 [1·59â2·79], p<0·0001), sepsis at presentation (1·20
[1·04â1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention
(ASA 4â5 vs ASA 1â2, 1·82 [1·40â2·35], p<0·0001; ASA 3 vs ASA 1â2, 1·58, [1·30â1·92], p<0·0001]), surgical safety
checklist not used (1·39 [1·02â1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed
(ventilation 1·96, [1·41â2·71], p=0·0001; parenteral nutrition 1·35, [1·05â1·74], p=0·018). Administration of
parenteral nutrition (0·61, [0·47â0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65
[0·50â0·86], p=0·0024) or percutaneous central line (0·69 [0·48â1·00], p=0·049) were associated with lower mortality.
Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome,
middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will
be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger
than 5 years by 2030
Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries
Abstract
Background
Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres.
Methods
This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and lowâmiddle-income countries.
Results
In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of âsingle-useâ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for lowâmiddle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia.
Conclusion
This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both highâ and lowâmiddleâincome countries
GestĂŁo pĂșblica II: relatos, pesquisas, experiĂȘncias e visĂŁo de trabalho.
ColetĂąnea de trabalhos publicados e premiados no II SeminĂĄrio de GestĂŁo PĂșblica da UFRA e na 1ÂȘ edição do PrĂȘmio Novos Ventos de GestĂŁo PĂșblica, sob a responsabilidade da PrĂł-Reitoria de GestĂŁo de Pessoas (PROGEP).UNIVERSIDADE FEDERAL RURAL DA AMAZĂNIAEste livro, na forma de coletĂąnea, se constituiu em um processo mais amplo de reflexĂŁo sobre a gestĂŁo pĂșblica dentro da Universidade. Aqui, partimos para uma importante reflexĂŁo, a partir do processo de sistematizar experiĂȘncias, relatos de experiĂȘncia, e pesquisas, sobre a Universidade PĂșblica e sua relação com as pessoas e as ciĂȘncias.
Em especial, o capĂtulo 1, a partir da coletĂąnea dos trabalhos apresentados no II SeminĂĄrio de GestĂŁo PĂșblica, diferencia-se dos trabalhos submetidos para a primeira edição. As experiĂȘncias destacadas para este livro reforçam a identidade e missĂŁo da UFRA, como os resultados dos trabalhos âOS CAMINHOS DA MERENDA ESCOLAR: anĂĄlise da logĂstica na cadeia de suprimentos do municĂpio de TomĂ©-Açuâ e âANĂLISE
QVT NA GESTĂO DE UMA EMPRESA PRODUTORA DE DENDĂ EM TOMĂ-AĂU/PAâ, e que tambĂ©m agregam valor a gestores e equipes de trabalho quando promovem a discussĂŁo de temas relacionados ao dia-a-dia do trabalho, tais como: QUALIDADE DE VIDA NO TRABALHO e GESTĂO ESTRATĂGICA DE PESSOAS NO SETOR PĂBLICO.
Nesse sentido, servidores e pesquisadores cumprem a função de embasar inĂșmeras discussĂ”es que vĂȘm sendo travadas pelas InstituiçÔes PĂșblicas sobre qualidade de vida, inclusĂŁo, garantia de direitos, melhoria de procedimentos, dentre outros.
O capĂtulo II, enquanto coletĂąnea das experiĂȘncias de trabalho indicada para premiação, Ă© um momento riquĂssimo de se perceber a quantidade e a qualidade de açÔes planejadas, organizadas e realizadas por servidores pĂșblicos. Em tempos que algumas prĂĄticas do serviço pĂșblico nĂŁo sĂŁo bem vistas, reforça-se aqui que alguns dos relatos foram concebidos em meio a falta de recursos financeiros e estruturais, mas que nĂŁo impediram os proponentes de seguir em frente. Mais do que isso, o reconhecimento dos beneficiĂĄrios e usuĂĄrios faz com que reforcemos a necessidade de fortalecer açÔes que agregam inĂșmeros valores a vida
laboral dos servidores pĂșblicos e a prĂłpria Universidade PĂșblica.This book, in the form of a collection, constituted a broader process of reflection on public management within the University. Here, we start an important reflection, based on the process of systematizing experiences, experience reports, and research, about the Public University and its relationship with people and the sciences.
In particular, chapter 1, from the collection of works presented at the II Seminar on Public Management, differs from the works submitted for the first edition. The experiences highlighted for this book reinforce UFRA's identity and mission, such as the results of the work âTHE PATHS OF SCHOOL BREAKFAST: analysis of logistics in the supply chain in the municipality of TomĂ©-Açuâ and âQVT ANALYSIS IN THE MANAGEMENT OF A PRODUCING COMPANY OF DENDĂ IN TOMĂ-AĂU / PA â, and which also add value to managers and work teams when promoting the discussion of topics related to day-to-day work, such as: QUALITY OF LIFE AT WORK and STRATEGIC PEOPLE MANAGEMENT IN THE PUBLIC SECTOR.
In this sense, civil servants and researchers fulfill the function of supporting numerous discussions that have been held by Public Institutions on quality of life, inclusion, guarantee of rights, improvement of procedures, among others.
Chapter II, as a collection of work experiences indicated for awards, is a very rich moment to realize the quantity and quality of actions planned, organized and carried out by public servants. In times when some public service practices are not well regarded, it is reinforced here that some of the reports were conceived amid a lack of financial and structural resources, but that did not prevent proponents from moving forward. More than that, the recognition of beneficiaries and users makes us reinforce the need to strengthen actions that add innumerable values ââto the working life of public servants and the Public University itself