Territorialização como instrumento diagnóstico em saúde em uma região vulnerável em um município maranhense / Territorialization as a health diagnostic instrument in a vulnerable region in a maranhense municipality

O objetivo desse estudo é registrar e apresentar os dados obtidos no processo de territorialização de uma área vulnerável no município de Timon-MA, denominada “Linha do Trem”, identificando suas necessidades e demandas nos campos sociais e da saúde. Estudo de natureza observacional, descritivo, transversal e qualiquantitativo. A coleta de dados foi realizada entre abril e maio de 2017. Foram realizadas visitas pelos pesquisadores no território vizinho à “Linha do Trem” e em seguida a área supracitada foi percorrida e as informações foram obtidas por meio de entrevistas onde foram coletados dados acerca de caracterizações sociodemográficas, sociosanitárias e de saúde, além da realização de entrevistas com os moradores adscritos na área pesquisada e registros fotográficos. Com a realização da territorialização foi possível observar que a população que reside na Linha do Trem apresenta um baixo nível de condições educacionais, sociosanitárias e acesso limitado aos serviços de saúde

A síndrome de burnout em profissionais docentes: uma revisão integrativa da literatura / Burnout syndrome in teaching professionals: an integrative review of the literature

RESUMO Objetivo: verificar as evidências científicas sobre Síndrome de Burnout (SB) nos profissionais docentes, no período de 2014 a 2018. Método: Trata-se de uma pesquisa descritiva com abordagem qualitativa, através de uma Revisão Integrativa da Literatura (RIL). Nas bases de dados LILALCS e MEDLINE, incluindo artigos originais e de revisão, na língua portuguesa, publicados entre 2014 e 2018. Utilizou-se o protocolo de Ursi para a organização dos dados, e para a análise dos dados a análise de conteúdo de Bardin. Resultados: Buscou-se em 8 artigos, elencou-se duas categorias temáticas: A prevalência da SB em Docentes; Fatores associados ao desenvolvimento da SB nos docentes. Conclusão: A SB se apresenta em alta prevalência nos docentes, em especial os do ensino fundamental. Evidenciou-se fatores associados para o desenvolvimento da SB como: carga horária extensa de trabalho, falta de tempo para lazer e família, trabalhar sob pressão e ambiente hostil. 

Protocol Proposal For The Care Of The Person With Venous Ulcer

Objective: To propose a care protocol for the care of the person with a venous ulcer in highly complex services. Methods and results: This is a methodological study, in three stages: literature review, validation of content and validation in the clinical context. The literature review was carried out from June to August/2011, being the basis for the construction of the Protocol for Venous Ulcers. The content validation included 53 judges (44 nurses, 8 physicians and 1 physiotherapist) selected through the Lattes platform to evaluate the items of the protocol. Validation in the clinical context occurred at the University Hospital Onofre Lopes, in Natal/RN with four judges (nurses), who worked in pairs, evaluating 32 patients with venous ulcers. The protocol was validated with 15 categories: sociodemographic data; anamnesis; examinations; ulcer characteristics; care with the lesion and perilesional area; medicines used to treat the lesion; evaluation and treatment of pain; surgical treatment of chronic venous disease; recurrence prevention (clinical and educational strategies); reference; counter-reference; and quality of life. Conclusion: The validated protocol regarding content and clinical context was applicable. Its implementation is a viable measure that assists in the reorientation of the team in high complexity services, aiming at wound healing and restoration of the patient´s integral health. Keywords: Varicose ulcer; Tertiary Health Care; Protocols; Validation studies

Forward-central two-particle correlations in p-Pb collisions at root s(NN)=5.02 TeV

Two-particle angular correlations between trigger particles in the forward pseudorapidity range (2.5 2GeV/c. (C) 2015 CERN for the benefit of the ALICE Collaboration. Published by Elsevier B. V.Peer reviewe

Event-shape engineering for inclusive spectra and elliptic flow in Pb-Pb collisions at root(NN)-N-S=2.76 TeV

Peer reviewe

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Elliptic flow of muons from heavy-flavour hadron decays at forward rapidity in Pb-Pb collisions at root s(NN)=2.76TeV

The elliptic flow, v(2), of muons from heavy-flavour hadron decays at forward rapidity (2.5 <y <4) is measured in Pb-Pb collisions at root s(NN)= 2.76TeVwith the ALICE detector at the LHC. The scalar product, two- and four-particle Q cumulants and Lee-Yang zeros methods are used. The dependence of the v(2) of muons from heavy-flavour hadron decays on the collision centrality, in the range 0-40%, and on transverse momentum, p(T), is studied in the interval 3 <p(T)<10 GeV/c. A positive v(2) is observed with the scalar product and two-particle Q cumulants in semi-central collisions (10-20% and 20-40% centrality classes) for the p(T) interval from 3 to about 5GeV/c with a significance larger than 3 sigma, based on the combination of statistical and systematic uncertainties. The v(2) magnitude tends to decrease towards more central collisions and with increasing pT. It becomes compatible with zero in the interval 6 <p(T)<10 GeV/c. The results are compared to models describing the interaction of heavy quarks and open heavy-flavour hadrons with the high-density medium formed in high-energy heavy-ion collisions. (C) 2015 CERN for the benefit of the ALICE Collaboration. Published by Elsevier B.V.Peer reviewe