ELEMENTOS QUE INFLUENCIAM NA OPÇÃO PELA VIA DE PARTO

Introduction: The time of delivery is essential for the maternal-fetal binomial, and the process of choosing the way of delivery is influenced by numerous external factors, biopsychosocial components, and the maternal imaginary. Discussion: Based on the articles, different elements that influence in this decision were identified, and despite the fact that it is the pregnant woman's right to choose the way of delivery, according to the risks and benefits informed by the obstetrician, it was found that the principle of autonomy often is not respected, making women restrained, despite their initial desire. In this scenario, Brazil is experiencing an epidemic of surgical deliveries, especially in the supplementary health network, the so called cesarean culture. Considerations: The intense unnecessary interventionism and the often disrespect for the autonomy of pregnant woman in the decision process, culminated in the emergence of movements in support of humanized childbirth and criticism of medical interference, revealing the need for changes in the current obstetrics attention model.  Introdución: El momento del nacimiento es fundamental para el binomio materno-fetal, y el proceso de elección de la vía del parto está regido por numerosos factores externos, componentes biopsicosociales y la imaginación materna. Discusión: A partir de los estudios se identificaron diferentes elementos que influyen en esta decisión, y a pesar de ser derecho de la gestante elegir el método de parto, de acuerdo a los riesgos y beneficios informados por el médico, se encontró que el principio de autonomía muchas veces no se respeta, lo que hace que las mujeres lo rehuyan, a pesar de su deseo inicial. En este escenario, Brasil vive una verdadera epidemia de partos quirúrgicos, especialmente en la red complementaria de salud, la llamada cultura de la cesárea. Consideraciones: El intenso intervencionismo innecesario y el frecuente irrespeto a la autonomía de la gestante en el proceso de toma de decisiones, culminaron en el surgimiento de movimientos de apoyo al parto humanizado y críticas a la injerencia médica, revelando la necesidad de una nueva perspectiva de cambio en atención obstétrica hacia un modelo centrado en la mujer embarazada.  Introdução: O momento do parto figura-se como essencial para o binômio materno-fetal, e o processo de escolha da via de parto é regido por inúmeros fatores externos, componentes biopsicossociais e do imaginário materno. Discussão: Com base nos estudos, foram identificados diferentes elementos que influenciam nesta decisão, e à despeito de ser um direito da gestante optar pela via de parto, conforme os riscos e benefícios informados pelo médico, constatou-se que o princípio da autonomia muitas vezes não é respeitado, tornando as mulheres coibidas, apesar de sua vontade inicial. Neste cenário, o Brasil vive uma verdadeira epidemia de partos cirúrgicos, em especial na rede suplementar de saúde, a então denominada cultura da cesárea. Considerações: O intenso intervencionismo desnecessário e o não raro desrespeito à autonomia da gestante no processo de decisão, culminaram no surgimento de movimentos em apoio ao parto humanizado e crítica à interferência médica, revelando a necessidade de um novo olhar de mudança sob a assistência obstétrica atual para um modelo centrado na gestante.  Introdução: O momento do parto figura-se como essencial para o binômio materno-fetal, e o processo de escolha da via de parto é regido por inúmeros fatores externos, componentes biopsicossociais e do imaginário materno. Discussão: Com base nos estudos, foram identificados diferentes elementos que influenciam nesta decisão, e à despeito de ser um direito da gestante optar pela via de parto, conforme os riscos e benefícios informados pelo médico, constatou-se que o princípio da autonomia muitas vezes não é respeitado, tornando as mulheres coibidas, apesar de sua vontade inicial. Neste cenário, o Brasil vive uma verdadeira epidemia de partos cirúrgicos, em especial na rede suplementar de saúde, a então denominada cultura da cesárea. Considerações: O intenso intervencionismo desnecessário e o não raro desrespeito à autonomia da gestante no processo de decisão, culminaram no surgimento de movimentos em apoio ao parto humanizado e crítica à interferência médica, revelando a necessidade de um novo olhar de mudança sob a assistência obstétrica atual para um modelo centrado na gestante.

Burnout em Profissionais de Terapia Intensiva: Um Olhar Pré e Pós-pandemia

Introduction: Feeling of exhaustion, cynicism or negative feelings related to work and reduced professional efficacy are the characterizations of burnout syndrome, which has a high prevalence among health professionals, being even more susceptible to professionals who have a more exhausting work routine in an ICU environment. Discussion: Burnout in the medical class is shown in ascendancy, and studies indicate that the risk and clinical presentations of the syndrome vary according to the specialty and conditions to which the professional is exposed, such as workload, emotional aspects of the patient and family, mortality rates, among others. Therefore, intensive care medicine received special prominence in the presence of emotional and physical exhaustion, a fact that was greatly aggravated at the time of the COVID-19 pandemic. Several characteristics were influenced in mental exhaustion, psychological imbalance and professional frustration in relation to the intensive physician, including female professionals, with a higher prevalence than males. It was found that there are numerous repercussions both for the quality of life of the professional, as emotional lability and susceptibility to other diseases, as well as damage to medical care, a consequence of the professional's exhaustion. Conclusion: Taking into account all the negative repercussions of Burnout, it is highlighted that prolonged stress that culminates in exhaustion is a process that can be avoided, from the dissemination and knowledge of the syndrome.Introducción: Sensación de agotamiento, cinismo o sentimientos negativos relacionados con el trabajo y la reducida eficacia profesional son las caracterizaciones del síndrome de burnout, que tiene una alta prevalencia entre los profesionales de la salud, siendo aún más susceptibles a los profesionales que tienen una rutina laboral más agotadora en un entorno de UCI. Discusión: El burnout en la clase médica se muestra en ascenso, y los estudios indican que el riesgo y las presentaciones clínicas del síndrome varían según la especialidad y las condiciones a las que está expuesto el profesional, como la carga de trabajo, los aspectos emocionales del paciente y la familia, las tasas de mortalidad, entre otros. Por lo tanto, la medicina de cuidados intensivos recibió especial protagonismo en presencia de agotamiento emocional y físico, un hecho que se agravó enormemente en el momento de la pandemia de COVID-19. Varias características fueron influenciadas en el agotamiento mental, el desequilibrio psicológico y la frustración profesional en relación con el médico intensivo, incluidas las mujeres profesionales, con una mayor prevalencia que los hombres. Se comprobó que existen numerosas repercusiones tanto para la calidad de vida del profesional, como la labilidad emocional y susceptibilidad a otras enfermedades, así como daños en la atención médica, consecuencia del agotamiento del profesional. Conclusión: Teniendo en cuenta todas las repercusiones negativas del Burnout, se destaca que el estrés prolongado que culmina en el agotamiento es un proceso que se puede evitar, desde la diseminación y el conocimiento del síndrome.Introdução: Sensação de esgotamento, cinismo ou sentimentos negativos relacionados ao trabalho e eficácia profissional reduzida são os caracterizadores da síndrome de Burnout, que possui alta prevalência dentre os profissionais de saúde, estando ainda mais suscetíveis os profissionais que possuem rotina de trabalho mais desgastante, em ambiente de UTI. Discussão: O Burnout na classe médica mostra-se em ascendência, e os estudos apontam que o risco e as apresentações clínicas da síndrome variam conforme a especialidade e as condições às quais o profissional é exposto, como carga de trabalho, aspectos emocionais do paciente e família, índices de mortalidade, dentre outras. Assim sendo, a medicina intensiva recebeu especial destaque na presença de desgaste emocional e físico, fato este que muito se agravou no momento da pandemia da COVID-19. Diversas características mostraram-se influenciadores no esgotamento mental, desequilíbrio psicológico e frustração profissional em relação ao médico intensivista, incluindo profissional do sexo feminino, com prevalência superior ao sexo masculino. Constatou-se que há inúmeras repercussões tanto para a qualidade de vida do profissional, como labilidade emocional e susceptibilidade a outras doenças, quanto prejuízos para a assistência médica, consequência do esgotamento do profissional. Conclusão: Levando em consideração todas as repercussões negativas do Burnout, destaca-se que o estresse prolongado que culmina em esgotamento é um processo que pode ser evitado, a partir da divulgação e conhecimento da síndrome

Measurement of the W±ZW^{\pm}Z boson pair-production cross section in pppp collisions at s=13\sqrt{s}=13 TeV with the ATLAS Detector

The production of $W^{\pm}Z$ events in proton--proton collisions at a centre-of-mass energy of 13 TeV is measured with the ATLAS detector at the LHC. The collected data correspond to an integrated luminosity of 3.2 fb$^{-1}$. The $W^{\pm}Z$ candidates are reconstructed using leptonic decays of the gauge bosons into electrons or muons. The measured inclusive cross section in the detector fiducial region for leptonic decay modes is $\sigma_{W^\pm Z \rightarrow \ell^{'} \nu \ell \ell}^{\textrm{fid.}} = 63.2 \pm 3.2$ (stat.) $\pm 2.6$ (sys.) $\pm 1.5$ (lumi.) fb. In comparison, the next-to-leading-order Standard Model prediction is $53.4^{+3.6}_{-2.8}$ fb. The extrapolation of the measurement from the fiducial to the total phase space yields $\sigma_{W^{\pm}Z}^{\textrm{tot.}} = 50.6 \pm 2.6$ (stat.) $\pm 2.0$ (sys.) $\pm 0.9$ (th.) $\pm 1.2$ (lumi.) pb, in agreement with a recent next-to-next-to-leading-order calculation of $48.2^{+1.1}_{-1.0}$ pb. The cross section as a function of jet multiplicity is also measured, together with the charge-dependent $W^+Z$ and $W^-Z$ cross sections and their ratio

Measurements of the Total and Differential Higgs Boson Production Cross Sections Combining the H??????? and H???ZZ*???4??? Decay Channels at s\sqrt{s}=8??????TeV with the ATLAS Detector

Measurements of the total and differential cross sections of Higgs boson production are performed using 20.3~fb$^{-1}$ of $pp$ collisions produced by the Large Hadron Collider at a center-of-mass energy of $\sqrt{s} = 8$ TeV and recorded by the ATLAS detector. Cross sections are obtained from measured $H \rightarrow \gamma \gamma$ and $H \rightarrow ZZ ^{*}\rightarrow 4\ell$ event yields, which are combined accounting for detector efficiencies, fiducial acceptances and branching fractions. Differential cross sections are reported as a function of Higgs boson transverse momentum, Higgs boson rapidity, number of jets in the event, and transverse momentum of the leading jet. The total production cross section is determined to be $\sigma_{pp \to H} = 33.0 \pm 5.3 \, ({\rm stat}) \pm 1.6 \, ({\rm sys}) \mathrm{pb}$. The measurements are compared to state-of-the-art predictions.Measurements of the total and differential cross sections of Higgs boson production are performed using 20.3  fb-1 of pp collisions produced by the Large Hadron Collider at a center-of-mass energy of s=8  TeV and recorded by the ATLAS detector. Cross sections are obtained from measured H→γγ and H→ZZ*→4ℓ event yields, which are combined accounting for detector efficiencies, fiducial acceptances, and branching fractions. Differential cross sections are reported as a function of Higgs boson transverse momentum, Higgs boson rapidity, number of jets in the event, and transverse momentum of the leading jet. The total production cross section is determined to be σpp→H=33.0±5.3 (stat)±1.6 (syst)  pb. The measurements are compared to state-of-the-art predictions.Measurements of the total and differential cross sections of Higgs boson production are performed using 20.3 fb$^{-1}$ of $pp$ collisions produced by the Large Hadron Collider at a center-of-mass energy of $\sqrt{s} = 8$ TeV and recorded by the ATLAS detector. Cross sections are obtained from measured $H \rightarrow \gamma \gamma$ and $H \rightarrow ZZ ^{*}\rightarrow 4\ell$ event yields, which are combined accounting for detector efficiencies, fiducial acceptances and branching fractions. Differential cross sections are reported as a function of Higgs boson transverse momentum, Higgs boson rapidity, number of jets in the event, and transverse momentum of the leading jet. The total production cross section is determined to be $\sigma_{pp \to H} = 33.0 \pm 5.3 \, ({\rm stat}) \pm 1.6 \, ({\rm sys}) \mathrm{pb}$. The measurements are compared to state-of-the-art predictions

Search for Higgs and ZZ Boson Decays to J/ψγJ/\psi\gamma and Υ(nS)γ\Upsilon(nS)\gamma with the ATLAS Detector

A search for the decays of the Higgs and $Z$ bosons to $J/\psi\gamma$ and $\Upsilon(nS)\gamma$ ($n=1,2,3$) is performed with $pp$ collision data samples corresponding to integrated luminosities of up to $20.3\mathrm{fb}^{-1}$ collected at $\sqrt{s}=8\mathrm{TeV}$ with the ATLAS detector at the CERN Large Hadron Collider. No significant excess of events is observed above expected backgrounds and 95% CL upper limits are placed on the branching fractions. In the $J/\psi\gamma$ final state the limits are $1.5\times10^{-3}$ and $2.6\times10^{-6}$ for the Higgs and $Z$ bosons, respectively, while in the $\Upsilon(1S,2S,3S)\,\gamma$ final states the limits are $(1.3,1.9,1.3)\times10^{-3}$ and $(3.4,6.5,5.4)\times10^{-6}$, respectively

Search for Scalar-Charm pair production in pp collisions at s=8\sqrt{s}=8 TeV with the ATLAS detector

The results of a dedicated search for pair production of scalar partners of charm quarks are reported. The search is based on an integrated luminosity of 20.3 fb$^{-1}$ of pp collisions at $\sqrt{s}=8$ TeV recorded with the ATLAS detector at the LHC. The search is performed using events with large missing transverse momentum and at least two jets, where the two leading jets are each tagged as originating from c-quarks. Events containing isolated electrons or muons are vetoed. In an R-parity-conserving minimal supersymmetric scenario in which a single scalar-charm state is kinematically accessible, and where it decays exclusively into a charm quark and a neutralino, 95% confidence-level upper limits are obtained in the scalar-charm-neutralino mass plane such that, for neutralino masses below 200 GeV, scalar-charm masses up to 490 GeV are excluded

Search for Higgs and Z Boson Decays to J/ψγJ/\psi\gamma and Υ(nS)γ\Upsilon(nS)\gamma with the ATLAS Detector

A search for the decays of the Higgs and Z bosons to J/ψγ and ϒ(nS)γ (n=1,2,3) is performed with pp collision data samples corresponding to integrated luminosities of up to 20.3 fb-1 collected at s=8 TeV with the ATLAS detector at the CERN Large Hadron Collider. No significant excess of events is observed above expected backgrounds and 95% C.L. upper limits are placed on the branching fractions. In the J/ψγ final state the limits are 1.5×10-3 and 2.6×10-6 for the Higgs and Z boson decays, respectively, while in the ϒ(1S,2S,3S)γ final states the limits are (1.3,1.9,1.3)×10-3 and (3.4,6.5,5.4)×10-6, respectively

Search for Scalar Diphoton Resonances in the Mass Range 65−60065-600 GeV with the ATLAS Detector in pppp Collision Data at s\sqrt{s} = 8 TeVTeV

A search for scalar particles decaying via narrow resonances into two photons in the mass range 65–600 GeV is performed using $20.3\text{}\text{}{\mathrm{fb}}^{-1}$ of $\sqrt{s}=8\text{}\text{}\mathrm{TeV}$ $pp$ collision data collected with the ATLAS detector at the Large Hadron Collider. The recently discovered Higgs boson is treated as a background. No significant evidence for an additional signal is observed. The results are presented as limits at the 95% confidence level on the production cross section of a scalar boson times branching ratio into two photons, in a fiducial volume where the reconstruction efficiency is approximately independent of the event topology. The upper limits set extend over a considerably wider mass range than previous searches