EMATER / RS - ASCAR: Case study on the social assistant in ATER policy

A assistência técnica e extensão rural (ATER) esta pautada na construção coletiva do conhecimento e na valorização do saber para a redução das desigualdades, preocupando-se com as condições e qualidade de vida da população rural e o pleno exercício da cidadania. No Rio Grande do Sul a Associação Rio-Grandense de Empreendimentos de Assistência Técnica e Extensão Rural (EMATER/RS – ASCAR) é responsável pelo desenvolvimento de ações de ATER. Para tanto, conta com uma equipe multidisciplinar, da qual faz parte o assistente social. Com base no exposto, objetivou-se compreender a dinâmica de trabalho dos assistentes sociais lotados na EMATER/RS e como a instituição está organizada no tocante ao trabalho com a questão social e suas expressões. Desta maneira, delimitou-se o campo de pesquisa aos profissionais assistentes sociais lotados na EMATER/RS, sendo os dados coletados a partir de um estudo qualitativo, através de entrevista estruturada – composta por perguntas abertas – e pesquisa bibliográfica. Os resultados demonstraram que o número de assistentes sociais vinculadas à EMATER/RS é de apenas duas profissionais, sendo este número insuficiente para atender as demandas de todo o estado. Todavia, esses resultados também apontaram que o assistente social tem sido cada vez mais reconhecido pelo público atendido e demais agentes de ATER.Technical assistance and rural extension (ATER) is based on the collective construction of knowledge and the valorisation of knowledge for the reduction of inequalities, being concerned with the conditions and quality of life of the rural population and the full exercise of citizenship. In Rio Grande do Sul, the Rio-Grandense Association of Enterprises for Technical Assistance and Rural Extension (EMATER / RS - ASCAR) is responsible for the development of ATER actions. For such, it counts on a multidisciplinary team, of which the social worker is part. Based on the above, the objective was to understand the work dynamics of the social workers crowded in EMATER / RS and how the institution is organized in relation to work with the social question and its expressions. In this way, the field of research was delimited to the social assistants crowded at EMATER / RS, and the data were collected from a qualitative study, through a structured interview - composed of open questions - and bibliographic research. number of social workers linked to EMATER / RS is only two professionals, and this number is insufficient to meet the demands of the entire state. However, these results also pointed out that the social worker has been increasingly recognized by the attending public and other ATER agents.Facultad de Ciencias Agrarias y Forestale

Epidemiology, practice of ventilation and outcome for patients at increased risk of postoperative pulmonary complications: LAS VEGAS - An observational study in 29 countries

BACKGROUND Limited information exists about the epidemiology and outcome of surgical patients at increased risk of postoperative pulmonary complications (PPCs), and how intraoperative ventilation was managed in these patients. OBJECTIVES To determine the incidence of surgical patients at increased risk of PPCs, and to compare the intraoperative ventilation management and postoperative outcomes with patients at low risk of PPCs. DESIGN This was a prospective international 1-week observational study using the ‘Assess Respiratory Risk in Surgical Patients in Catalonia risk score’ (ARISCAT score) for PPC for risk stratification. PATIENTS AND SETTING Adult patients requiring intraoperative ventilation during general anaesthesia for surgery in 146 hospitals across 29 countries. MAIN OUTCOME MEASURES The primary outcome was the incidence of patients at increased risk of PPCs based on the ARISCAT score. Secondary outcomes included intraoperative ventilatory management and clinical outcomes. RESULTS A total of 9864 patients fulfilled the inclusion criteria. The incidence of patients at increased risk was 28.4%. The most frequently chosen tidal volume (V T) size was 500 ml, or 7 to 9 ml kg−1 predicted body weight, slightly lower in patients at increased risk of PPCs. Levels of positive end-expiratory pressure (PEEP) were slightly higher in patients at increased risk of PPCs, with 14.3% receiving more than 5 cmH2O PEEP compared with 7.6% in patients at low risk of PPCs (P ˂ 0.001). Patients with a predicted preoperative increased risk of PPCs developed PPCs more frequently: 19 versus 7%, relative risk (RR) 3.16 (95% confidence interval 2.76 to 3.61), P ˂ 0.001) and had longer hospital stays. The only ventilatory factor associated with the occurrence of PPCs was the peak pressure. CONCLUSION The incidence of patients with a predicted increased risk of PPCs is high. A large proportion of patients receive high V T and low PEEP levels. PPCs occur frequently in patients at increased risk, with worse clinical outcome.</p