Parcerias pela saúde: projeto hipertensão - articulação entre poder público e universidade

Hipertensão Arterial(HA) é uma doença multifatorial e assintomática, que atinge 20-30% dos brasileiros. É um dos mais importantes fatores de risco para doenças cardiovasculares, aumentando a morbimortalidade mundial. São hipertensos aqueles que apresentam Pressão Arterial acima de 140 e 90mmHg. As cardiopatias necessitam de atenção devido ao seu impacto social. O Projeto Hipertensão é resultado de uma parceria entre a Secretaria de Saúde, Prefeitura municipal de Bauru e Depto. Ed. Física, Unesp Bauru, e está em andamento há 2 anos, com 25 alunos. O projeto encontra-se na fase de estudo piloto por desenvolver um modelo de intervenção em população carente, cuja fase subseqüente prevê sua implantação junto às Unidades Básicas de Saúde(UB) do município, conforme definido com a Secretaria de Saúde. fetuar um modelo de intervenção através da prática regular de exercício físico com o intuito de reduzir ou estabilizar os níveis pressóricos de hipertensos oriundos de classes sociais C, D e E. a UB Otávio Rasi são efetuadas as triagens, as avaliações médicas, exames laboratoriais e prescrição de tratamento medicamentoso. Os pacientes, hipertensos leves ou moderados, são encaminhados para o Laboratório de Avaliação e Prescrição de Exercícios(LAPE), onde são avaliados e recebem prescrição individualizada de acordo com o diagnóstico da condição física. A cada 4 meses, cada paciente passa por reavaliação médica e física e os procedimentos de intervenção são reajustados. As aulas ocorrem nas dependências do Depto Ed. Física da UNESP-Bauru, com 3 sessões semanais. partir da casuística do projeto, várias comunicações em Congressos e Eventos Científicos já ocorreram, bem como, submissão de artigos para publicação em periódicos indexados e publicações de divulgação acadêmica como Jornal da Unesp e da Fapesp. Desse modo, a seguir serão apresentados alguns dados de pesquisas efetuadas a partir da intervenção realizada. Observou-se que:i) após 1 ano de exercícios físicos regulares, comparando com igual período sem intervenção, os pacientes apresentaram redução dos custos com tratamento ambulatorial de R$ 28.886,68/100 pacientes-ano (35,9%). As consultas médicas diminuíram 28%, os gastos com exames 45% e com medicamentos anti-hipertensivos e outras patologias 24,8%,ii) Outra pesquisa revelou que ocorreu redução significativa dos níveis pressóricos de PAS (-5mmHg) e PAD (-4 mmHg). Em síntese, os dados amealhados no período sinalizam para a necessidade de se promover maior aproximação entre Universidade e Poder Público, na direção de obter respostas eficientes aos graves problemas que acometem as comunidades menos favorecidas, resultando em impacto positivo tanto para a saúde quanto para a qualidade de vida da população

Projeto qualidade de vida: a universidade (Unesp) proporcionando saúde aos trabalhadores da saúde

A obesidade é um importante problema de saúde pública e vem se tornando uma epidemia global. Considera-se obeso indivíduos com índice de massa corporal acima de 30 kg/m2 e % de gordura corporal maior que 25 e 35% para homens e mulheres. A hipertensão arterial (HA) e suas complicações responde por alta freqüência de internações no Brasil, e tem contribuído para aumentar a morbimortalidade mundial. HA é definida por pressão arterial acima de 140x90 mmHg. Dislipidemias são alterações da conteúdo de lipídeos no sangue levando a um processo de aterosclerose, um dos principais fatores de risco de doença arterial coronariana (DAC). Normalmente, pessoas que trabalham em ritmo intenso e estressante apresentam estas patologias e, preocupados com esta situação, surgiu a parceria entre a Divisão Regional de Saúde de Bauru (DIR-X) e o Depto de Ed. Fís. da Unesp/Bauru, no sentido de diagnosticar estas patologias e promover a implementação do projeto A Saúde do Trabalhador da Saúde: efeitos de um programa de exercício físico supervisionado - PQV O Projeto PQV, tem como finalidade proporcionar um programa de exercício físico supervisionado, com objetivo de prevenção e reabilitação aos os trabalhadores da DIR-X. pós consentimento médico e exames bioquímicos, os indivíduos são encaminhados para o Laboratório de Avaliação e Prescrição de Exercícios para as avaliações físicas. As prescrições são individualizadas, de acordo com a condição física. As aulas ocorrem nas dependências do Depto. Ed. Fís., Unesp/Bauru, com 3 sessões semanais. Já na 1a avaliação, determinou-se o perfil dos funcionários, apresentado em Congressos Científicos e em publicações de divulgação acadêmica (Jornal da Unesp e Revista Fapesp). Dos 95 avaliados, apenas 35% possuíam superior completo e 41% colegial completo. A %Gordura e a flexibilidade estava anormal em 71% e 79% dos casos, respectivamente. A capacidade cardiorrespiratória estava ruim em 20% dos avaliados, 52% possuíam sobrepeso e 20% eram fumantes. A classe social predominante foi a B, com 53% dos casos. Dentre os avaliados, 20-80% apresentavam algum problemas relacionado à dislipidemia e 63% eram sedentários. HA ou mesmo pré-hipertensão estava presente em 47% dos avaliados. O risco coronariano médio a elevado foi identificado em 87% dos trabalhadores, de acordo com classificação do American Heart Association . Estes resultados apontam que os indivíduos que tratam da saúde de terceiros não são devidamente assistidos. O elevado grau de sedentarismo, associado a fatores de risco de doenças coronarianas, indica a necessidade de se empreender políticas setoriais e parcerias entre Universidade e Poder Público voltadas para a melhoria da qualidade de vida dessa população

Organizational factors associated with adherence to low tidal volume ventilation: a secondary analysis of the CHECKLIST-ICU database

Background: Survival benefit from low tidal volume (VT) ventilation (LTVV) has been demonstrated for patients with acute respiratory distress syndrome (ARDS), and patients not having ARDS could also benefit from this strategy. Organizational factors may play a role on adherence to LTVV. The present study aimed to identify organizational factors with an independent association with adherence to LTVV. Methods: Secondary analysis of the database of a multicenter two-phase study (prospective cohort followed by a cluster-randomized trial) performed in 118 Brazilian intensive care units. Patients under mechanical ventilation at day 2 were included. LTVV was defined as a VT ≤ 8 ml/kg PBW on the second day of ventilation. Data on the type and number of beds of the hospital, teaching status, nursing, respiratory therapists and physician staffing, use of structured checklist, and presence of protocols were tested. A multivariable mixed-effect model was used to assess the association between organizational factors and adherence to LTVV. Results: The study included 5719 patients; 3340 (58%) patients received LTVV. A greater number of hospital beds (absolute difference 7.43% [95% confidence interval 0.61–14.24%]; p = 0.038), use of structured checklist during multidisciplinary rounds (5.10% [0.55–9.81%]; p = 0.030), and presence of at least one nurse per 10 patients during all shifts (17.24% [0.85–33.60%]; p = 0.045) were the only three factors that had an independent association with adherence to LTVV. Conclusions: Number of hospital beds, use of a structured checklist during multidisciplinary rounds, and nurse staffing are organizational factors associated with adherence to LTVV. These findings shed light on organizational factors that may improve ventilation in critically ill patients

Development of the CMS detector for the CERN LHC Run 3

International audienceSince the initial data taking of the CERN LHC, the CMS experiment has undergone substantial upgrades and improvements. This paper discusses the CMS detector as it is configured for the third data-taking period of the CERN LHC, Run 3, which started in 2022. The entire silicon pixel tracking detector was replaced. A new powering system for the superconducting solenoid was installed. The electronics of the hadron calorimeter was upgraded. All the muon electronic systems were upgraded, and new muon detector stations were added, including a gas electron multiplier detector. The precision proton spectrometer was upgraded. The dedicated luminosity detectors and the beam loss monitor were refurbished. Substantial improvements to the trigger, data acquisition, software, and computing systems were also implemented, including a new hybrid CPU/GPU farm for the high-level trigger

Development of the CMS detector for the CERN LHC Run 3

International audienceSince the initial data taking of the CERN LHC, the CMS experiment has undergone substantial upgrades and improvements. This paper discusses the CMS detector as it is configured for the third data-taking period of the CERN LHC, Run 3, which started in 2022. The entire silicon pixel tracking detector was replaced. A new powering system for the superconducting solenoid was installed. The electronics of the hadron calorimeter was upgraded. All the muon electronic systems were upgraded, and new muon detector stations were added, including a gas electron multiplier detector. The precision proton spectrometer was upgraded. The dedicated luminosity detectors and the beam loss monitor were refurbished. Substantial improvements to the trigger, data acquisition, software, and computing systems were also implemented, including a new hybrid CPU/GPU farm for the high-level trigger

Development of the CMS detector for the CERN LHC Run 3

International audienceSince the initial data taking of the CERN LHC, the CMS experiment has undergone substantial upgrades and improvements. This paper discusses the CMS detector as it is configured for the third data-taking period of the CERN LHC, Run 3, which started in 2022. The entire silicon pixel tracking detector was replaced. A new powering system for the superconducting solenoid was installed. The electronics of the hadron calorimeter was upgraded. All the muon electronic systems were upgraded, and new muon detector stations were added, including a gas electron multiplier detector. The precision proton spectrometer was upgraded. The dedicated luminosity detectors and the beam loss monitor were refurbished. Substantial improvements to the trigger, data acquisition, software, and computing systems were also implemented, including a new hybrid CPU/GPU farm for the high-level trigger

Development of the CMS detector for the CERN LHC Run 3

Since the initial data taking of the CERN LHC, the CMS experiment has undergone substantial upgrades and improvements. This paper discusses the CMS detector as it is configured for the third data-taking period of the CERN LHC, Run 3, which started in 2022. The entire silicon pixel tracking detector was replaced. A new powering system for the superconducting solenoid was installed. The electronics of the hadron calorimeter was upgraded. All the muon electronic systems were upgraded, and new muon detector stations were added, including a gas electron multiplier detector. The precision proton spectrometer was upgraded. The dedicated luminosity detectors and the beam loss monitor were refurbished. Substantial improvements to the trigger, data acquisition, software, and computing systems were also implemented, including a new hybrid CPU/GPU farm for the high-level trigger.Since the initial data taking of the CERN LHC, the CMS experiment has undergone substantial upgrades and improvements. This paper discusses the CMS detector as it is configured for the third data-taking period of the CERN LHC, Run 3, which started in 2022. The entire silicon pixel tracking detector was replaced. A new powering system for the superconducting solenoid was installed. The electronics of the hadron calorimeter was upgraded. All the muon electronic systems were upgraded, and new muon detector stations were added, including a gas electron multiplier detector. The precision proton spectrometer was upgraded. The dedicated luminosity detectors and the beam loss monitor were refurbished. Substantial improvements to the trigger, data acquisition, software, and computing systems were also implemented, including a new hybrid CPU/GPU farm for the high-level trigger

Development of the CMS detector for the CERN LHC Run 3

International audienceSince the initial data taking of the CERN LHC, the CMS experiment has undergone substantial upgrades and improvements. This paper discusses the CMS detector as it is configured for the third data-taking period of the CERN LHC, Run 3, which started in 2022. The entire silicon pixel tracking detector was replaced. A new powering system for the superconducting solenoid was installed. The electronics of the hadron calorimeter was upgraded. All the muon electronic systems were upgraded, and new muon detector stations were added, including a gas electron multiplier detector. The precision proton spectrometer was upgraded. The dedicated luminosity detectors and the beam loss monitor were refurbished. Substantial improvements to the trigger, data acquisition, software, and computing systems were also implemented, including a new hybrid CPU/GPU farm for the high-level trigger

Development of the CMS detector for the CERN LHC Run 3

Since the initial data taking of the CERN LHC, the CMS experiment has undergone substantial upgrades and improvements. This paper discusses the CMS detector as it is configured for the third data-taking period of the CERN LHC, Run 3, which started in 2022. The entire silicon pixel tracking detector was replaced. A new powering system for the superconducting solenoid was installed. The electronics of the hadron calorimeter was upgraded. All the muon electronic systems were upgraded, and new muon detector stations were added, including a gas electron multiplier detector. The precision proton spectrometer was upgraded. The dedicated luminosity detectors and the beam loss monitor were refurbished. Substantial improvements to the trigger, data acquisition, software, and computing systems were also implemented, including a new hybrid CPU/GPU farm for the high-level trigger

Measurement of the double-differential inclusive jet cross section in proton-proton collisions at s\sqrt{s} = 5.02 TeV

International audienceThe inclusive jet cross section is measured as a function of jet transverse momentum $p_\mathrm{T}$ and rapidity $y$. The measurement is performed using proton-proton collision data at $\sqrt{s}$ = 5.02 TeV, recorded by the CMS experiment at the LHC, corresponding to an integrated luminosity of 27.4 pb$^{-1}$. The jets are reconstructed with the anti-$k_\mathrm{T}$ algorithm using a distance parameter of $R$ = 0.4, within the rapidity interval $\lvert y\rvert$$\lt$ 2, and across the kinematic range 0.06 $\lt$$p_\mathrm{T}$$\lt$ 1 TeV. The jet cross section is unfolded from detector to particle level using the determined jet response and resolution. The results are compared to predictions of perturbative quantum chromodynamics, calculated at both next-to-leading order and next-to-next-to-leading order. The predictions are corrected for nonperturbative effects, and presented for a variety of parton distribution functions and choices of the renormalization/factorization scales and the strong coupling $\alpha_\mathrm{S}$