Clinical Cases in Obstetrics, Gynaecology and Women's Health

An updated edition for our popular Clinical Cases collection, this book is aimed medical students following the core curriculum in Australia and New Zealand; and the United Kingdom, junior doctors at resident or house officer level, and general practitioners. This handy, lab coat pocket-sized book broadly covers the whole syllabus for the medical student, and the whole range of obstetric and gynaecological problems likely to come into the path of the busy junior hospital doctor or general practitioner, but it is not a textbook providing simply a list of differential diagnoses and treatments. The approach has been developed from the experienced authors teaching of problem-based learning scenarios (PBLs) to clinical students. PBLs introduce students to typical clinical situations and then encourage those students to think about how they would take appropriate histories, examine, investigate and finally treat their patients. In this book, by using case histories that are more developed and complex, we aim to show readers in greater detail how women may present with particular conditions, and demonstrate what should take place in the way of consultation, investigations and treatment. However, by questioning our readers as we go along we also hope to encourage them to think about why they would choose a certain clinical course of action and to base their decisions firmly on current scientific evidence. In addition to the purely clinical aspects of the cases, the emotional, social and psychological aspects of the care of each woman is described. Each of the 50 case histories commences with a straightforward description following a woman through the clinical presentation of a particular condition. Along the way, important points in clinical examination and diagnosis, complications, investigations and management are incorporated into the text as a conversation with the reader, and essential points are highlighted in boxes. Being an Australian author team, tips are included for those junior doctors faced with obstetric or gynaecological problems in a smaller metropolitan or rural setting - facilities for care and the advice of senior practitioners may be more limited in such surroundings and different care paths may be more appropriate, especially in remote parts of Australia

Saúde Mental de Profissionais de Saúde no Contexto da Pandemia COVID-19: Revisão Integrativa da Literatura

Trabalho de conclusão de Residência Multiprofissional em Saúde da Família - Universidade Federal da Integração Latino-Americana. Foz do Iguaçu, 2022.A pandemia de COVID-19 representa uma emergência de saúde física e mental. Além dos estressores vivenciados neste momento, os profissionais de saúde precisam atuar neste contexto, estando expostos a condições de trabalho novas e inesperadas no cuidado aos pacientes. Diante desta complexidade, o presente estudo objetivou realizar uma revisão integrativa da produção científica nacional sobre a saúde mental dos profissionais de saúde na pandemia COVID-19. Foi realizada uma busca por artigos publicados entre março de 2020 a março de 2021, nas bases de dados Scielo, Pubmed, PsycInfo (APA) e Lilacs. Foram selecionados seis artigos para o estudo. Os resultados evidenciaram que a proximidade do trabalho e prestação de cuidado geram exposição ao risco de contaminação e sentimentos como medo e culpa, principalmente devido aos dilemas éticos vivenciados e o constante envolvimento nos processos de viver e morrer. As dificuldades encontradas estavam relacionadas aos longos plantões, falta de equipamento de proteção individual e sobrecarga dos cuidados oferecidos aos pacientes. Os resultados apontaram a existência de desgaste psicológico, ansiedade, medo e desesperança que afetam e são afetados pelos processos de trabalho dos profissionais na pandemia. Como prevenção e promoção de saúde mental citam- se disponibilização de informações confiáveis, mapeamento de profissionais emocionalmente fragilizados, recomendações de autocuidado e organização de suporte psicológico, com ações de saúde que possibilitem acolhimento e atendimento aos sinais e sintomas. Conclui-se que a prevenção e a promoção de saúde devem perpassar, principalmente pelos processos de trabalho, levando em consideração todos os fatores envolvidos e suas repercussões para a saúde mental dos profissionais

Fetal membrane bacterial load is increased in histologically confirmed inflammatory chorioamnionitis: A retrospective cohort study

Introduction It is widely debated whether fetal membranes possess a genuine microbiome, and if bacterial presence and load is linked to inflammation. Chorioamnionitis is an inflammation of the fetal membranes. This research focussed on inflammatory diagnosed histological chorioamnionitis (HCA) and aimed to determine whether the bacterial load in fetal membranes correlates to inflammatory response, including histological staging and inflammatory markers in HCA. Methods Fetal membrane samples were collected from patients with preterm spontaneous labour and histologically phenotyped chorioamnionitis (HCA; n = 12), or preterm (n = 6) and term labour without HCA (n = 6). The bacterial profile of fetal membranes was analysed by sequencing the V4 region of the 16S rRNA gene. Bacterial load was determined using qPCR copy number/mg of tissue. The association between bacterial load and bacterial profile composition was assessed using correlation analysis. Results Bacterial load was significantly greater within HCA amnion (p = 0.002) and chorion (p = 0.042), compared to preterm birth without HCA. Increased bacterial load was positively correlated with increased histological staging (p = 0.001) and the expression of five inflammatory markers; IL8, TLR1, TLR2, LY96 and IRAK2 (p=<0.050). Bacterial profiles were significantly different between membranes with and without HCA in amnion (p = 0.012) and chorion (p = 0.001), but no differences between specific genera were detected. Discussion Inflammatory HCA is associated with infection and increased bacterial load in a dose response relationship. Bacterial load is positively correlated with HCA severity and the TLR signalling pathway. Further research should investigate the bacterial load threshold required to generate an inflammatory response in HCA

Corporate brand rehab: Diagnosing trust repair mechanisms in the service sectors

Purpose and objectives In recent times, a number of spectacular organizational transgressions have damaged consumers trust towards corporate brands. To survive, these damaged brands must ‘spend some time in the trust rehabilitation clinic’ to repair and regain trust. Trust repair is a complex brand-specific rehabilitation process. According to Bachmann, Gillespie and Priem (2015), a combination of multiple approaches is required for trust rehabilitation across levels. In 2017 Bozic has called for new studies to adopt an interpretivist perspective to empirically explore consumer trust repair process. In this paper, we respond to Bozic’s call and our research purpose is to evaluate consumer responses to trust repair mechanisms adopted by corporate brands. We address the research purpose by exploring the following research objectives: (1) to evaluate consumer understanding of trust; (2) to evaluate trust damage; (3) to identify the mechanisms which contribute to consumer trust repair. Originality The present study examines an important gap in the literature. On the one hand, there is an established body of theoretical work around trust repair mechanisms within the organizational context (Bachmann et al., 2015). On the other hand there is a paucity of empirical research addressing how consumers respond to trust repair strategies adopted by corporate brands. Our research addressed the latter gap by integrating theoretical ideas of Bachmann et al. (2015) to evaluate consumer responses to trust repair mechanisms adopted by corporate brands. Research methodology This study opts for an interpretivist approach to address three research objectives. We employed the focus group discussion method. This decision was driven by two rationales: the cases under investigation are high profile (misspelling of Payment Protection Insurance (PPI) policies, HR issues in Sports Direct and safety issues in Alton Towers) and have had wide coverage across varied mass and social media. This study comprised a total of six focus groups, with two focus groups per case. In total, 48 participants, with roughly equal gender distribution with ages ranging from 18 years to over 75 years agreed to participate in this study. Analysis of the focus group data employed the template analysis approach and procedure. Focus group transcriptions were imported into the NVivo interface. Findings and discussion Discussion of the findings is organised around the three objectives of the research. Firstly, in line with existing research (Schoorman, Mayer & Davis, 2007; Dietz & Gillespie 2012) when defining consumer trust, participants in this study have mostly discussed the trustworthiness of corporate brands and what shapes the trustworthiness. Participants across all groups primarily defined consumer trust in terms of competence and integrity. We also know that trust is context specific (Bozic, 2017). Our results, however, suggest that the trust dimensions may change as a result of trust damage, whereby those dimensions that most closely match the cause of the trust damage shape consumers’ trusting behaviour. Secondly, the transgressions appear to have caused the greatest impact on cognitive trust. Consumers tend to continue relationships with corporate brands where trust erosion impacted others (i.e. employees) or where consumer choice is limited due to an unconditional trust in competences of financial brands (i.e. PPI case) or due to market-based manipulations of service elements (i.e. low price in the Sports Direct case). So far, it has been theoretically discussed in the context of healthcare services only (Fotaki, 2014). Thirdly, we found that despite severity of trust damage, our research illustrates that corporate brands can recover. However, in line with existing research (Bozic 2017; Bachmann et al. 2015), our findings suggest that not all trust repair mechanisms are equally applicable to all service contexts. Hence, context specific nature of trust affects choice of trust repair mechanisms. We also found that corporate brands in the service sectors should focus on sense-making, relational approaches and transparency. Conclusion Evaluation of consumer responses to trust repair mechanisms adopted by corporate brands in the service sectors confirms previous theoretical work in that consumer trust varies by context. Transgressions may however change consumers’ perception of trust as they reflect on the incident. To our knowledge, no studies suggest that corporate brand rehabilitation of consumer trust requires careful examination of what trustworthiness components consumers expressed before and after the trust erosion incident. In doing so, effective diagnosis of trust repair mechanisms against trust damage is most likely to guarantee a successful rehabilitation. Our results also suggest that trust erosion mainly impacts cognitive consumer trust. Theoretical and practical implications We have illustrated that it is important to reconsider conceptual models of trust repair process and integrate post-transgression consumer research that investigates general trustworthiness components in a particular corporate brand situation. With our empirical research we also evidenced that there is a complex relationship between consumer choice and consumer trust: it also raises quite important theoretical question on whether consumer choice can replace consumer trust. Research limitations Although this study provides a better understanding of consumer responses to trust repair mechanisms adopted by corporate brands, findings need to be interpreted with caution. Our findings are limited and applicable to specific service sector cases we examined. Brand crisis and trust damage, as a result of it, is not restricted to the service sector as the Samsung phone incident and labor violation of Apple’s suppliers in developing countries have demonstrated. There is therefore scope to extend our work into other industry sectors

Service brand rehab: Diagnosing trust repair mechanisms

This paper aims to understand consumers’ response to the trust repair mechanisms adopted by corporate brands in a service sector context following prominent trust damaging organizational transgressions. Adopting a qualitative approach, six focus group discussions are employed to investigate three high profile consumer trust erosion cases within the service sector. Consumer trust varies by context. Despite the severity of trust damage, corporate brands can recover trust towards their brands amongst consumers not directly affected by transgressions. Not all trust repair mechanisms are equally applicable to all service contexts and re-branding could be used as a trust repair mechanism. Corporate brands in the service sector should focus on sense-making, relational approaches and transparency. Orchestration of trust repair mechanisms needs to be integrated within the trust rehabilitation processes. This study illustrates it is important to reconsider trust repair processes to accommodate context and integrate post-transgression consumer research. Successful corporate brand rehabilitation of consumer trust requires examination of the trustworthiness dimensions consumers express before and after the transgression to select the most appropriate trust repair mechanisms. Findings suggest organizations also have preventative trust repair management programs. This research is the first to empirically apply the conceptual framework of Bachmann et al. (2015) to explore consumer responses to the trust repair mechanisms adopted by corporate brands by context

Passado em disputa: desafios e possibilidades para o ensino de História

The growing information war and the amplification of revisionist and/or denialist narratives about sensitive topics have brought new challenges and possibilities for the teaching of History in the Present Time. Understanding the classroom as a place for the construction of historical knowledge, the approach to disputes over the past with the so-called Digital Information and Communication Technologies (TDIC) can bring students and teachers together, instigate research, and enable teaching of History more significant for all those involved, uniting historical and technological knowledge.A crescente guerra de informações e a amplificação de narrativas revisionistas e/ou negacionistas acerca de temas sensíveis trouxeram novos desafios e possibilidades para o ensino de História no Tempo Presente. Entendendo a sala de aula como lugar de construção do conhecimento histórico, a abordagem das disputas pelo passado com as chamadas Tecnologias Digitais da Informação e da Comunicação (TDIC) pode aproximar alunos/as e professores/as, instigar a pesquisa, e possibilitar um ensino de História mais significativo para todos/as os/as envolvidos/as, unindo conhecimentos históricos e tecnológicos.&nbsp

Morphology and geographical distribution of the poorly known snake Umbrivaga pygmaea (Serpentes: Dipsadidae) in Brazil

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Linguagem da química na educação química

Neste ensaio, pretendemos abordar a linguagem da Química a partir de duas perspectivas: a epistemológica e a hermenêutica. Partimos do pressuposto de que a linguagem constitui os seres humanos e que, a partir dela, torna-se possível a comunicação e a interação, ou seja, os seres humanos se constituem pela e na linguagem e dela são dependentes. Sua importância se reflete no campo educacional, pois ao considerarmos que a escola é um lugar de aprender a viver em sociedade, a interpretação, a compreensão e o diálogo sobre o conhecimento se dão na linguagem. No ensino de Ciências, é possível destacar a presença de duas perspectivas de linguagem. Portanto, este trabalho trata da linguagem da Química a partir destas duas perspectivas: i. a linguagem fundamentada pela epistemologia e; ii. a linguagem fundamentada pela hermenêutica. Por conta da importância das duas perspectivas na compreensão do conhecimento historicamente produzido e ao compromisso da escola em sua transmissão às gerações mais jovens, este ensaio propõe um estudo da linguagem da Química fundamentado a partir dessas duas perspectivas, entendendo-as de forma complementar. Através da ideia de complementaridade, a epistemologia trataria da racionalidade técnica, com seus direcionamentos lógicos e instrumentais e a hermenêutica trataria da racionalidade do compreender por meio da historicidade e da tradição

Linguagem da química na educação química: entre caminhos epistemológicos e hermenêuticos

In this essay, we intend to approach the language of Chemistry from two perspectives: epistemological and hermeneutic. We assume that language constitutes human beings and that, based on it, communication and interaction become possible, that is, human beings are constituted by and in language and are dependent on it. Its importance is reflected in the educational field, because when we consider that the school is a place to learn to live in society, interpretation, understanding and dialogue about knowledge take place in language. In Science Education, it is possible to highlight the presence of two language perspectives. Therefore, this work deals with the language of Chemistry from these two perspectives: i. the language based on epistemology and; ii. the language founded by hermeneutics. Due to the importance of the two perspectives in understanding historically produced knowledge and the school's commitment to transmitting it to younger generations, this essay proposes a study of the language of Chemistry based on these two perspectives, understanding them in a complementary way. Through the idea of complementarity, epistemology would deal with technical rationality, with its logical and instrumental directions, and hermeneutics would deal with the rationality of understanding through historicity and tradition.Neste ensaio, pretendemos abordar a linguagem da Química a partir de duas perspectivas: a epistemológica e a hermenêutica. Partimos do pressuposto de que a linguagem constitui os seres humanos e que, a partir dela, torna-se possível a comunicação e a interação, ou seja, os seres humanos se constituem pela e na linguagem e dela são dependentes. Sua importância se reflete no campo educacional, pois ao considerarmos que a escola é um lugar de aprender a viver em sociedade, a interpretação, a compreensão e o diálogo sobre o conhecimento se dão na linguagem. No ensino de Ciências, é possível destacar a presença de duas perspectivas de linguagem. Portanto, este trabalho trata da linguagem da Química a partir destas duas perspectivas: i. a linguagem fundamentada pela epistemologia e; ii. a linguagem fundamentada pela hermenêutica. Por conta da importância das duas perspectivas na compreensão do conhecimento historicamente produzido e ao compromisso da escola em sua transmissão às gerações mais jovens, este ensaio propõe um estudo da linguagem da Química fundamentado a partir dessas duas perspectivas, entendendo-as de forma complementar. Através da ideia de complementaridade, a epistemologia trataria da racionalidade técnica, com seus direcionamentos lógicos e instrumentais e a hermenêutica trataria da racionalidade do compreender por meio da historicidade e da tradição