Mortalidade prematura por Doenças Crônicas Não Transmissíveis, em Santa Catarina: uma análise temporal 2006 - 2015

TCC (graduação) - Universidade Federal de Santa Catarina. Centro de Ciências da Saúde. Enfermagem.Objetivo: investigar a variação da taxa de mortalidade prematura (de 30 a 69 anos) pelas quatro principais Doenças Crônicas Não Transmissíveis em Santa Catarina, no período de 2006 a 2015. Método: Estudo ecológico, com dados disponibilizados pelo Ministério da Saúde, com população de 30 a 69 anos, residentes em Santa Catarina. O motivo da morte dos estudados foram as quatro principais DCNT, de acordo com as categorias da Classificação Internacional de Doenças e Problemas Relacionados à Saúde, relacionadas a doenças cardiovasculares, neoplasias, respiratórias e diabetes. A análise foi feita pelo método de estimativa de modelos de regressão, no programa de estatística Joinpoint, versão 4.5.0.1. Resultados: Ocorrem 2.692.416 óbitos prematuros por DCNT no Brasil, 91.046 em Santa Catarina, 54.155 eram homens e 36.891 mulheres. Houve redução na taxa de mortalidade prematura de 1,2% ao ano no grupo geral, 1,6% ao ano para homens e 0,7% ao ano para as mulheres. A maior diminuição na taxa de mortalidade prematura ocorreu no grupo geral de 50 a 59 anos, com 3,5% ao ano. No sexo masculino, a redução foi de 3,5%. Enquanto o sexo feminino, apresentou duas variações de redução, sendo de 2006 à 2007, 7,4% e de 2008 a 2015, 1,4% ao ano. Conclusão: Foi possível observar que no grupo geral (de 30 a 69 anos), o Estado de Santa Catarina não atingiu a redução de 2% ao ano da mortalidade prematura pelas quatro principais DCNT. No entanto, por faixa etária e por sexo, é possível observar que no grupo de 50 a 59 anos, tanto para as mulheres quanto para os homens foi superada a expectativa do Plano de ações estratégicas para o enfrentamento das doenças crônicas não transmissíveis no Brasil, revelando que as políticas e programas criados para diminuição da mortalidade prematura estão surtindo efeito em determinados grupos etários

Comprometimento organizacional : um estudo no 17º Regimento de Cavalaria Mecanizado

Monografia (graduação)—Universidade de Brasília, Faculdade de Economia, Administração e Contabilidade, Departamento de Administração, 2016.O estudo buscou apresentar o relacionamento do comprometimento organizacional, apresentado pelos autores Meyer e Allen, na carreira militar. O campo para a realização da pesquisa foi no 17º Regimento de Cavalaria de Mecanizado, situado em Amambaí - MS. A população pesquisada foi de 696 militares da ativa, sendo a amostra composta de 170 militares. O trabalho apresentou primeiramente um levantamento teórico sobre o comprometimento organizacional. Os dados foram coletados através de um questionário, dividido em duas partes. A primeira buscou informações sobre o perfil do participante, e a segunda coletou as informações necessárias para que fosse possível verificar as dimensões de comprometimento, sendo elas: afetiva, normativa e instrumental. A escala utilizada foi validada em nosso país por Medeiros e Enders, (1997), Ricco (1998) e Bandeira et al (1999). Os resultados apresentou que a grande maioria dos militares são comprometidos com a instituição, evidenciando a predominância da dimensão afetiva, que reflete o vínculo do militar baseado na identificação com a instituição e vínculo emocional

Le patrimoine industriel comme vecteur de requalification urbain à Rio de Janeiro: le cas de la Gare Leopoldina et ses alentours

O Patrimônio industrial como vetor de requalificação urbana no Rio de Janeiro: o caso da estação Leopoldina e de seu entorno Resumo: Este projecto coloca em causa os desafios para a reabertura da estação Leopoldina através da análise das suas fragilidades e potencialidades, afim que ela possa servir como vector para a requalificação do seu entorno e como modelo para a recuperação dos exemplares do património edificado industrial do porto do Rio de Janeiro. Também conhecida como estação Barão de Mauá, o edifício está localizado no bairro do Santo Cristo, que faz parte da região portuária do Rio de Janeiro, na região sudeste do Brasil. Construída em 1926, a estação Leopoldina foi escolhida como objecto de investigação devido ao seu valor histórico, arquitectónico e por ter sido um edifício de grande importância para a conexão do território, mas que sofreu tardiamente os efeitos da tentativa de extinção do sistema ferroviário brasileiro; Le patrimoine industriel comme vecteur de réqualification urbain à Rio de Janeiro: le cas de la gare Leopoldina et ses alentours Résumé: Ce présent projet s’interroge à propos des défis pour la réouverture de la gare Leopoldina à traves de l'analyse des faiblesses et des potentiels, pour qu’elle puisse servir de vecteur à la requalification de ses environs et comme modèle pour la récupération d’autres patrimoines industrielles bâti du port de Rio de Janeiro. Aussi connu comme gare Barão de Mauá, elle est située au quartier de Santo Cristo, qui fait partie de la région portuaire de Rio de Janeiro, une ville dans la région sud-est du Brésil. Bâti en 1926, la Gare Leopoldina a été choisie comme objet de recherche en raison de sa valeur historique, architectural et pour avoir été un bâtiment d’une grande importance pour la connexion du territoire, qui a souffert tardivement des effets de la tentative d'extinction du système ferroviaire brésilien; Industrial heritage as a vector for urban requalification in Rio de Janeiro: the case of the Leopoldina station and its surroundings Abstract: This present project examines the challenges for the reopening of the Leopoldina railway station through the analysis of its weaknesses and potentials, so that it can serve as a vector for the requalification of its surroundings and as a model for the recovery of other industrial built heritage by the port of Rio de Janeiro. Also known as Barão de Mauá railway station, it is located in the Santo Cristo district, which is part of the port region of Rio de Janeiro, a city in the southeast region of Brazil. Built in 1926, the Leopoldina railway station was chosen as an object of research because of its historical and architectural value and for having been a building of great importance for the connection of the territory, which belatedly suffered the effects of the attempted extinction of the Brazilian railway system

Survival of Shigella flexneri in swimming pool water

Shigellosis is a disease caused by the pathogenic bacterium Shigella flexneri. The bacterium causes bloody diarrheadiarrhea, fever and abdominal pain. Infections can be and may cause fatal. . The disease may also cause bloody diarrhea and intense intestinal crampings. In the United States, there have been many outbreaks of shigellosis have been traced back to associated with inadequately disinfectedchlorinated public swimming pools and wading pools. These outbreaks of sShigellosis are most commonly seen among small children who play in these pools. . My goal is to determine how well Shigella survives in freshly chlorinated pool water and in pool water that has been stored outside in Las Vegas weather for fixed periods. It is well documented that water dechlorinates and loses its bacterial killing power with exposure to high temperatures and UV. In my experiment, pool water will be distributed into flasks and inoculated with two different strains of Shigella, 2457T (wild type) and BS103 (cured of its virulence plasmid). The pool water will not be chlorinated once the experiment has begun. Chlorine levels will be monitored over time and samples of water will be removed to determine the number of viable Shigella cells. I hypothesize that both strains of Shigella will not survive in pool water that is treated properly. However, once the levels of chlorine have dropped, the survival rate of wild type Shigella will increase

Comparative Analysis of 3D Expression Patterns of Transcription Factor Genes and Digit Fate Maps in the Developing Chick Wing

Hoxd13, Tbx2, Tbx3, Sall1 and Sall3 genes are candidates for encoding antero-posterior positional values in the developing chick wing and specifying digit identity. In order to build up a detailed profile of gene expression patterns in cell lineages that give rise to each of the digits over time, we compared 3 dimensional (3D) expression patterns of these genes during wing development and related them to digit fate maps. 3D gene expression data at stages 21, 24 and 27 spanning early bud to digital plate formation, captured from in situ hybridisation whole mounts using Optical Projection Tomography (OPT) were mapped to reference wing bud models. Grafts of wing bud tissue from GFP chicken embryos were used to fate map regions of the wing bud giving rise to each digit; 3D images of the grafts were captured using OPT and mapped on to the same models. Computational analysis of the combined computerised data revealed that Tbx2 and Tbx3 are expressed in digit 3 and 4 progenitors at all stages, consistent with encoding stable antero-posterior positional values established in the early bud; Hoxd13 and Sall1 expression is more dynamic, being associated with posterior digit 3 and 4 progenitors in the early bud but later becoming associated with anterior digit 2 progenitors in the digital plate. Sox9 expression in digit condensations lies within domains of digit progenitors defined by fate mapping; digit 3 condensations express Hoxd13 and Sall1, digit 4 condensations Hoxd13, Tbx3 and to a lesser extent Tbx2. Sall3 is only transiently expressed in digit 3 progenitors at stage 24 together with Sall1 and Hoxd13; then becomes excluded from the digital plate. These dynamic patterns of expression suggest that these genes may play different roles in digit identity either together or in combination at different stages including the digit condensation stage

Management of amiodarone-induced thyrotoxicosis at a cardiac transplantation centre

Background: Amiodarone-induced thyrotoxicosis (AIT) is associated with significant morbidity and mortality, particularly in patients with cardiac failure. The aim of the study was to evaluate the management of AIT at a tertiary hospital specialising in cardiac failure and transplantation. Methods: Retrospective audit of 66 patients treated for AIT by Endocrinology (2007–2016), classified as type 1 (T1) or type 2 (T2) based on radiological criteria. Main outcome measurements were response rate to initial treatment, time to euthyroidism, and frequency/safety of thyroidectomy. Results: Mean age was 60 ± 2 years; 80% were male. Sixty-four patients commenced medical treatment: thionamides (THIO) in 23, glucocorticoids (GC) in 17 and combination (COMB) in 24. Median thyroxine (fT4) was 35.1 (31.2–46.7) in THIO, 43.1 (30.4 –60.7) in GC, and 60.0 (39.0 –\u3e99.9) pmol/L in COMB (p = 0.01). Initial therapy induced euthyroidism in 52%: 70% THIO, 53% GC, and 33% COMB (p = 0.045) by 100 (49–167), 47 (35–61), and 53 (45–99) days, respectively (p = 0.02). A further 11% became euthyroid after transitioning from monotherapy to COMB. Thyroidectomy was undertaken in 33%. Patients who underwent thyroidectomy were younger (54 ± 3 vs. 63 ± 2 years; p = 0.03), with higher prevalence of severely impaired left ventricular function prior to diagnosis of AIT (38 vs. 18%; p = 0.08). Despite median American Society of Anaesthesiologists classification 4, no thyroidectomy patient experienced cardiorespiratory complications/death. Conclusions: Patients with AIT had limited response to medical treatment. The poorest response was observed in COMB group, likely related to greater hyperthyroidism severity. Thyroidectomy is safe in patients with severe cardiac failure if performed in a centre with cardiac anaesthetic expertise. There should be low threshold for proceeding to thyroidectomy in patients with severe AIT and/or cardiac failure

Why patients in palliative care in-patient settings are at high risk of falls and falls-related harm: A realist synthesis

Background: Falls are the third highest reported safety incident in Specialist Palliative Care in-patient settings and yet specific risk factors connected with falling and associated outcomes in this setting are poorly understood.Aim: To understand the key individualised risk factors leading to falls in specialist in-patient palliative care settings and understand the implications and outcomes for the patients who fall.Design: A realist synthesis of the literature, reported following the Realist And Meta-narrative Evidence Syntheses: Evolving Standards (RAMESES) standards. Data Sources: An iterative literature search was conducted across three recognised health collections as well as grey literature from policy, practice and other relevant areas.Results: Falls taking place within in-patient specialist palliative care settings can cause significant harm to patients. The risk factors for these patients are multifaceted and often interlinked with underpinning complex realist mechanisms including a history of falls, the age of the person, impact of complex medications, improving functional status and the presence of delirium.Conclusion: In-patients in specialist palliative care settings are at risk of falling and this is multifactorial with complex reasoning mechanisms underpinning the identified risks. There is a significant impact of a fall in this cohort of patients with many sustaining serious harm, delayed discharge, and both physical and psychological impacts

Direct Genetics Referral Pathway for High-Grade Serous Ovarian Cancer Patients: The opt-Out Process

Purpose. In order to meet a clinical need for better pathways to access genetic testing for ovarian cancer patients, we implemented and reviewed an opt-out referral process for genetic consultation whereby a referral is automatically sent to genetics following a pathological diagnosis of HGSC. Methods. Following implementation of the opt-out referral process, each month a list of new cases of HGSC was generated from the synoptic pathology report and forwarded directly to the Cancer Genetics clinic. Using an advanced directive, patients were automatically referred for genetic counselling two months after surgery. If the patient declined genetic counselling (opted-out) after discussion with their surgeon within the two months after surgery, the Genetic Counsellor was informed and the patient was removed from the referral process. Results. Between January 1, 2015, and December 31, 2017, 168 women were diagnosed with HGSC, of whom 167 received a referral for genetic consultation. In only one case the referral was cancelled by the surgeon, resulting in a referral rate of 99.4%. By the end of the study period, 133 women attended a genetics consultation appointment and 125 (94%) agreed to proceed with genetic testing. Among those who completed genetic testing, 15% tested positive for a BRCA1 or BRCA2 gene mutation. Of the women who tested positive for a BRCA1/2 mutation, 56% had no family history of breast or ovarian cancer. Conclusions. The opt-out referral process described in this study is s a feasible, effective, and patient-centred approach to increase access to BRCA1/2 testing for patients with ovarian cancer

International trauma-informed practice principles for schools (ITIPPS): Expert consensus of best-practice principles

Recognition that schools should be responsive to children who are impacted by adversity and trauma is burgeoning internationally. However, consensus regarding the necessary components of a trauma-informed school is lacking. This research developed expert-informed and internationally relevant best-practice trauma-informed principles for schools. A four-phase methodology included (i) identification of school-relevant trauma-informed practice programs, (ii) inductive thematic analysis of the main concepts underlying programs, (iii) phrasing of draft Principles and (iv) Principle revision and finalisation via a two-round Delphi survey with international experts. Excellent agreement by experts on the importance of all Principles was achieved (round 1 ≥ 86.4%, 2 ≥ 92.3%). The final ‘International Trauma-Informed Practice Principles for Schools’ (ITIPPS) include four Overarching (A–D) and 10 Practice Principles (1–10). Summarised, these include that the school: (A) is student focussed; (B) models compassion and generosity; (C) is understanding and responsive; (D) incorporates recognition of their First Nations peoples in the school’s ethos: (1) prioritises safety and wellbeing; (2) models positive relationships; (3) provides a positive culture and connects; (4) consults and collaborates; (5) supports vulnerable students; (6) teaches social and emotional learning; (7) provides trauma-informed practice training; (8) is predictable yet flexible; (9) identifies and nurtures strengths and (10) reflects, changes and grows. The ITIPPS provide clear guidance for education sectors, schools and other settings about appropriate learning environments for children and young people impacted by trauma. Research is now underway in Western Australian schools to pilot test the feasibility and impact of using the ITIPPS within a framework (thoughtfulschools.org.au) to establish trauma-informed schools