O cuidado ao agressor familiar persistente na percepção de estudantes de enfermagem

Objective: to analyze the perception of nursing students about the care given to the persistent family aggressor. Method: a descriptive study, with a qualitative approach. Madeleine Leininger’s Theory of Diversity and Universality of Care was used as a theoretical reference. The data collection took place with 37 in the last year of at a public university in Southeast Brazil. We used the technique of Projective Design with a Topic and semi-structured interview. The data were analyzed with the content analysis. Results: the examination of the narratives underpinned the construction of four categories: The care of the aggressor with the family, Recognition of family values and culture, The search for knowledge to care for the aggressor and family, Multidisciplinary and intersectoral care to confront violence. Conclusion: there is an acknowledgment that the care for the aggressor should not only be individual but should involve all those affected. For this, multidisciplinary work is important, and the search for knowledge on the subject is essential for culturally significant care.Objetivo: analisar a percepção de estudantes de enfermagem sobre o cuidado dispensado ao agressor familiar persistente. Método: estudo descritivo, de abordagem qualitativa. Usou-se da Teoria da Diversidade e Universalidade do Cuidado de Madeleine Leininger como referencial teórico. A coleta foi realizada com 37 concluintes de enfermagem de uma universidade pública da região Sudeste do Brasil. Utilizou-se da técnica do Desenho Projetivo com tema e entrevista semiestruturada. Os dados foram analisados com a análise de conteúdo. Resultados: o exame das narrativas embasou a construção de quatro categorias: “O cuidado do agressor junto à família”, “Reconhecimento dos valores e cultura da família”, “A busca de conhecimento para cuidar do agressor e família”, “O cuidado multidisciplinar e intersetorial para o enfrentamento da violência”. Conclusão: há o reconhecimento de que o cuidado do agressor não deve ser individual apenas, mas envolver todos os afetados. Para isto, o trabalho multidisciplinar mostra-se importante, e a busca de conhecimento sobre o tema é algo essencial para o cuidado culturalmente significativo.Objetivo: analizar la perspectiva de los estudiantes de enfermería sobre el cuidado que se dispensa al agresor familiar persistente. Método: estudio descriptivo, de enfoque cualitativo. Como marco teórico, se utilizó la Teoría de la Diversidad y de la Universalidad del Cuidado de Madeleine Leinninger. La recolección de datos se realizó con 37 estudiantes del último año de la carrera de enfermería de una universidad pública del Sudeste de Brasil. Se utilizó la técnica de Diseño Proyectivo con Tema y Entrevista Semiestructurada. Los datos se analizaron a partir del análisis de contenido. Resultados: el examen de los discursos permitió la construcción de 4 categorías: “El cuidado del agresor junto a su familia”, “Reconocimiento de los valores y de la cultura familiar”, “La búsqueda de conocimiento para cuidar al agresor y a su familia”, “El cuidado multidisciplinario e intersectorial para el enfrentamiento de la violencia”. Conclusión: se reconoce que el cuidado del agresor no debe ser individual, sino que debe involucrar a todos los afectados. A tal efecto, el trabajo multidisciplinario se mostró importante, y la búsqueda de conocimiento sobre el tema es esencial para el un cuidado culturalmente significativo

The Indiscriminate use of Ritalin by Universities in the Health Area at the University of Gurupi – UNIRG

MPH methylphenidate, popularly known as Ritalin, was synthesized in 1954 in Switzerland and marketed in Brazil in 1998, belonging to the class of amphetamines. It acts in the CNS crossing the blood-brain barrier very easily. Used for cognitive improvement by college students. Its excessive consumption leads to dependence and possible side effects. The objective of this study was to analyze 91 university students who answered questionnaires on the theme. The collected data analyzed the incidence of Ritalin use among health academics at the University of Gurupi-UNIRG. After conducting the surveys, it was intended to understand the real reason that leads the student to the indiscriminate use of the drug and its possible consequences, to subsequently conduct guidance regarding the use without a prescription for academic purposes

Diretriz da Sociedade Brasileira de Cardiologia sobre Diagnóstico e Tratamento de Pacientes com Cardiomiopatia da Doença de Chagas

This guideline aimed to update the concepts and formulate the standards of conduct and scientific evidence that support them, regarding the diagnosis and treatment of the Cardiomyopathy of Chagas disease, with special emphasis on the rationality base that supported it.  Chagas disease in the 21st century maintains an epidemiological pattern of endemicity in 21 Latin American countries. Researchers and managers from endemic and non-endemic countries point to the need to adopt comprehensive public health policies to effectively control the interhuman transmission of T. cruzi infection, and to obtain an optimized level of care for already infected individuals, focusing on diagnostic and therapeutic opportunistic opportunities.   Pathogenic and pathophysiological mechanisms of the Cardiomyopathy of Chagas disease were revisited after in-depth updating and the notion that necrosis and fibrosis are stimulated by tissue parasitic persistence and adverse immune reaction, as fundamental mechanisms, assisted by autonomic and microvascular disorders, was well established. Some of them have recently formed potential targets of therapies.  The natural history of the acute and chronic phases was reviewed, with enhancement for oral transmission, indeterminate form and chronic syndromes. Recent meta-analyses of observational studies have estimated the risk of evolution from acute and indeterminate forms and mortality after chronic cardiomyopathy. Therapeutic approaches applicable to individuals with Indeterminate form of Chagas disease were specifically addressed. All methods to detect structural and/or functional alterations with various cardiac imaging techniques were also reviewed, with recommendations for use in various clinical scenarios. Mortality risk stratification based on the Rassi score, with recent studies of its application, was complemented by methods that detect myocardial fibrosis.  The current methodology for etiological diagnosis and the consequent implications of trypanonomic treatment deserved a comprehensive and in-depth approach. Also the treatment of patients at risk or with heart failure, arrhythmias and thromboembolic events, based on pharmacological and complementary resources, received special attention. Additional chapters supported the conducts applicable to several special contexts, including t. cruzi/HIV co-infection, risk during surgeries, in pregnant women, in the reactivation of infection after heart transplantation, and others.     Finally, two chapters of great social significance, addressing the structuring of specialized services to care for individuals with the Cardiomyopathy of Chagas disease, and reviewing the concepts of severe heart disease and its medical-labor implications completed this guideline.Esta diretriz teve como objetivo principal atualizar os conceitos e formular as normas de conduta e evidências científicas que as suportam, quanto ao diagnóstico e tratamento da CDC, com especial ênfase na base de racionalidade que a embasou. A DC no século XXI mantém padrão epidemiológico de endemicidade em 21 países da América Latina. Investigadores e gestores de países endêmicos e não endêmicos indigitam a necessidade de se adotarem políticas abrangentes, de saúde pública, para controle eficaz da transmissão inter-humanos da infecção pelo T. cruzi, e obter-se nível otimizado de atendimento aos indivíduos já infectados, com foco em oportunização diagnóstica e terapêutica. Mecanismos patogênicos e fisiopatológicos da CDC foram revisitados após atualização aprofundada e ficou bem consolidada a noção de que necrose e fibrose sejam estimuladas pela persistência parasitária tissular e reação imune adversa, como mecanismos fundamentais, coadjuvados por distúrbios autonômicos e microvasculares. Alguns deles recentemente constituíram alvos potenciais de terapêuticas. A história natural das fases aguda e crônica foi revista, com realce para a transmissão oral, a forma indeterminada e as síndromes crônicas. Metanálises recentes de estudos observacionais estimaram o risco de evolução a partir das formas aguda e indeterminada e de mortalidade após instalação da cardiomiopatia crônica. Condutas terapêuticas aplicáveis aos indivíduos com a FIDC foram abordadas especificamente. Todos os métodos para detectar alterações estruturais e/ou funcionais com variadas técnicas de imageamento cardíaco também foram revisados, com recomendações de uso nos vários cenários clínicos. Estratificação de risco de mortalidade fundamentada no escore de Rassi, com estudos recentes de sua aplicação, foi complementada por métodos que detectam fibrose miocárdica. A metodologia atual para diagnóstico etiológico e as consequentes implicações do tratamento tripanossomicida mereceram enfoque abrangente e aprofundado. Também o tratamento de pacientes em risco ou com insuficiência cardíaca, arritmias e eventos tromboembólicos, baseado em recursos farmacológicos e complementares, recebeu especial atenção. Capítulos suplementares subsidiaram as condutas aplicáveis a diversos contextos especiais, entre eles o da co-infecção por T. cruzi/HIV, risco durante cirurgias, em grávidas, na reativação da infecção após transplante cardíacos, e outros.    Por fim, dois capítulos de grande significado social, abordando a estruturação de serviços especializados para atendimento aos indivíduos com a CDC, e revisando os conceitos de cardiopatia grave e suas implicações médico-trabalhistas completaram esta diretriz.&nbsp

Genetic parameters of iron and zinc concentrations in Andean common bean seeds

ABSTRACT. The genetic parameter estimates of the iron and zinc concentrations in Andean common bean seeds were obtained using the IAC Boreal × Light Red Kidney and Ouro Branco × Light Red Kidney crosses. The parents and the F1, F1 reciprocal, F2, F2 reciprocal, and backcross BC11 and BC12 generations were evaluated in a field experiment that was carried out in the state of Rio Grande do Sul, Brazil. The iron concentration in Andean common bean seeds ranged from 24.70 to 102.40 mg kg-1 dry matter (DM), the zinc concentration ranged from 10.73 to 37.50 mg kg-1 DM, and no significant maternal effect was observed. The narrow-sense heritability ranged from low (h2n= 19.04%) to high (h2n= 63.60%) for the concentrations of iron and zinc, respectively. Hybrid vigor and transgressive segregation were observed for the iron and zinc concentrations in Andean common bean seeds. In the hybrid combination IAC Boreal × Light Red Kidney, it was possible to select recombinants for the iron and zinc biofortification program. From the tested hybrid combinations, recombinants with low iron and zinc concentrations in seeds could be selected to use when the diet needs to be restricted in those minerals

Genetic parameters of iron and zinc concentrations in Andean common bean seeds

The genetic parameter estimates of the iron and zinc concentrations in Andean common bean seeds were obtained using the IAC Boreal × Light Red Kidney and Ouro Branco × Light Red Kidney crosses. The parents and the F1, F1 reciprocal, F2, F2 reciprocal, and backcross BC11 and BC12 generations were evaluated in a field experiment that was carried out in the state of Rio Grande do Sul, Brazil. The iron concentration in Andean common bean seeds ranged from 24.70 to 102.40 mg kg-1 dry matter (DM), the zinc concentration ranged from 10.73 to 37.50 mg kg-1 DM, and no significant maternal effect was observed. The narrow-sense heritability ranged from low (h2n= 19.04%) to high (h2n= 63.60%) for the concentrations of iron and zinc, respectively. Hybrid vigor and transgressive segregation were observed for the iron and zinc concentrations in Andean common bean seeds. In the hybrid combination IAC Boreal × Light Red Kidney, it was possible to select recombinants for the iron and zinc biofortification program. From the tested hybrid combinations, recombinants with low iron and zinc concentrations in seeds could be selected to use when the diet needs to be restricted in those minerals.

Numerical Analysis of Reinforced Concrete Corbels Using Concrete Damage Plasticity: Sensitivity to Material Parameters and Comparison with Analytical Models

The Concrete Damage Plasticity (CDP) model is a widely used constitutive model to represent the non-linear behavior of concrete in numerical analysis. However, a limited number of studies compared the level of accuracy of numerical models with the main code provisions from the literature. In addition, the influence of CDP material parameters on the structural behavior of corbels was scarcely studied. This study proposes to evaluate the ability of numerical models using CDP to represent the structural behavior of corbels regarding the ultimate load, reinforcement deformation and failure mechanism. In addition, we compared the predictions of the numerical models with the ones from design code expressions regarding the ultimate capacity. For this, three test results of corbels from the literature were evaluated with numerical models using the CDP, as well as with analytical models from different code provisions. A sensitivity analysis—by changing the dilation angle (ψ) and shape factor (Kc)—was performed. The comparison between tested and predicted resistances with the proposed numerical modeling choices was equal to 1.04 with a coefficient of variation of 11%. On the other hand, the analytical models evaluated overestimated the corbel capacity by more than 62%, on average. Therefore, the proposed modeling choices provide better predictions of ultimate capacity than the evaluated analytical models and can be used to assess the corbel design under more complex boundary conditions