The legal aspects involving repetitive strain injuries (RSI)

In order to have a good patient-physician relationship, besides practicing a fair and updated technical medicine, the physician is obligated to have knowledge of and follow the laws, rules and regulations, which grant specific rights to some and delegate obligations to others. The physician is responsible for writing legal statements based on information from medical records. These declarations will serve as important documents, upon which public or private entities will base their decision on granting rights or delegating obligations. This article stresses the importance of adequate physician decision making capacity when it comes to access the patient's needs within the working environment. It also emphasizes the seriousness of reaching an optimal treatment plan, in order to prevent expected complications. Our objective is to promote the practice of medicine within the current law, giving directions to the reader on where to obtain this information. Physicians have to keep themselves updated not only regarding the technical aspects of the profession. The current knowledge of local, state and national laws, rules, and regulations is also of paramount importance.No relacionamento entre médico e paciente, além da boa prática da medicina, o médico está obrigado a conhecer e cumprir as leis, normas e convenções que podem garantir direitos a uns e gerar obrigações a outros, com base nas informações criadas e perenizadas em prontuários, atestados e pareceres, que servirão de referência às decisões de entidades públicas ou privadas na concessão ou na recusa de direitos e deveres legais. Apontamos como os médicos devem se comportar em relação aos pacientes e aos aspectos legais dentro desse cenário ocupacional, no sentido de adequar a conduta e prevenir eventuais dissabores, aos quais estamos expostos. Nossa ideia é chamar a atenção para a necessidade da prática médica dentro das normas legais, orientando onde buscar a respectiva informação. O médico não pode estar alheio à evolução da medicina, nem às atualizações permanentes das leis, normas e convenções da região em que atua.INSSCRM-PRJustiça Federal da 3ª Região/SPUniversidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina (EPM)UNIFESP, EPMSciEL

The Effects of Transformational Leadership on Sales Performance in a Multilevel Marketing Organization

Despite the rapid growth of multilevel marketing (MLM), there is little research that examines distributor performance in this unique organizational setting. The present study focused on the relationships between individual distributors and the people who recruited them into the organization (i.e., their sponsors). Given the unique structure of MLM organizations and the importance of sponsor-recruit relationships, it has previously been proposed that sponsors should employ a transformational leadership style. This study investigated transformational leadership as a predictor of performance, which was defined using both objective and subjective measures. Participants were 479 distributors at an MLM organization who were instructed to assess the degree to which their sponsors demonstrated key transformational leader behaviors. While transformational leadership positively predicted the subjective performance outcomes, it was unable to predict the objective performance outcomes. However, experimental design limitations threaten the interpretation of these results. These limitations, along with suggestions for future research, are discussed

Incidencia del control interno en la gestión administrativa del Mercado Central de Huaraz, 2015

La presente investigación tuvo como objetivo determinar la influencia del Control Interno en la gestión administrativa del Mercado Central de Huaraz, periodo 2015, el estudio de la investigación Por su finalidad fue de tipo básica en razón que tuvo como propósito conocer cómo se relacionó el Control Interno en la Gestión Administrativa del Mercado Central de Huaraz así mismo debido a la naturaleza de la materia de investigación, el presente trabajo respondió a una investigación por objetivos, la población en estudio estuvo conformada por 732 socios, 18 pertenecientes a la Junta Administrativa del Mercado Central de Huaraz . Se utilizó la Encuesta la cual nos permitió el conocimiento de las motivaciones, las actitudes y las opiniones de los individuos con relación a su objeto de investigación y de igual manera por medio de la recolección de datos se utilizó un cuestionario tipo encuesta, dirigido a los socios que cuenta con educación superior. Finalmente se concluyó que: El Control Interno ha influido en la gestión administrativa del Mercado Central de Huaraz tal es así que las políticas utilizadas son coherentes, observándose las normas y procedimientos en todas las áreas influyendo favorablemente en el trabajo que se realizó, sin embargo se amerita un manual para su ejecución y en cuanto a la gestión administrativa se determinó que la organización cuenta con un proceso de toma de decisiones centralizado por los directores no aplicándose así la administración estratégica y por ende no contando así con el personal calificado para las diversas áreas.Tesi

PERLINDUNGAN TERHADAP KAUM MINORITAS DALAM PENERAPAN NILAI KEADILAN MENURUT KAJIAN FILSAFAT HUKUM

Tujuan penelitian ini adalah untuk memberikan pengetahuan baru tentang diskriminasi antara kelompok minoritas atau komunitas-komunitas, khususnya pada kelompok yang berbeda keyakinan berdasarkan dari filsafat hukum dalam menerapkan keadilan. Penulis dalam makalah ini fokus untuk menganalisa diskriminasi antara kelompok atau komunitas minoritas, khususnya pada kelompok yang berbeda keyakinan. Metode penelitian yang digunakan dalam memecahkan permasalahan ini adalah metode normatif yuridis yang menggunakan data sekunder sebagai sumber datanya, seperti teori-teori hukum, jurnal, buku-buku, laporan, dan peraturan-peraturan. Dalam filsafat, keadilan adalah sebuah hal yang sangat mendasar dalam menjaga masyarakat politik yang stabil. Berkenaan dengan masalah minoritas, hal ini berhubungan dengan pembentukan keadilan, karena hal itu adalah bagian yang tidak terpisahkan dalam tujuan hukum

Lineamientos básicos para la estructura de un sistema penal

Publicación a texto completo no autorizada por el autorEl documento digital no refiere asesorPretende sentar los lineamientos básicos para la estructuración y funcionamiento de un sistema penal, dotándole de una conceptualización, estructura, contenido y funcionalidad, y sobre todo, definiendo su finalidad en un medio social; para ello se toma como referencia la Teoría de Sistemas bajo la óptica del sociólogo alemán Niklas Luhmann. Se plantea legitimar el sistema penal peruano, a partir de una unificación y coordinación de los elementos que lo componen (normativos, cognitivos, organizacionales y funcionales), definiendo su apertura o inicio, así como su clausura, pasando por la dinámica de su funcionalidad, y su conexión con los elementos de su entorno y del extra sistema; relevando no sólo el ámbito de la comisión del delito, sino también el de la prevención del delito; y enfatizando como protagonistas del mismo, tanto al infractor penal como a la víctima o agraviado. Todo ello con la finalidad de otorgarle legitimidad en la sociedad, basado en el mantenimiento o restauración de la pacífica convivencia de los miembros de una sociedad.Tesi

Ultrasonography for the diagnosis of tendinitis and electromyography for the diagnosis of peripheral neuropathy and upper limb radiculopathy: rheumatologists' perspectives

OBJECTIVE: To ascertain the value ascribed by Brazilian rheumatologists to ultrasonography (US) for diagnosing tendinitis and to electromyography (EMG) for diagnosing peripheral neuropathy and upper limb radiculopathy. MATERIAL AND METHODS: In total, 165 rheumatologists answered an anonymous survey (sent via the internet) concerning the two exams, with respect to the following characteristics: reliability, diagnostic accuracy, the importance and necessity of these tests for diagnostic RESULTS: The study revealed that most of the rheumatologists recognised that these exams are operator-dependent, that clinicians do not rely entirely on the results, that these exams are not mandatory for the diagnoses listed, and that professionals who perform these exams should be better trained to provide reliable results. CONCLUSIONS: The Brazilian rheumatologists believe the following: the results of these exams should be interpreted with caution and are not definitive for diagnosis; musculoskeletal US and EMG should be performed by trained professionals; and there must be better preparation of the professionals who perform these exams.OBJETIVO: Averiguar o valor que os reumatologistas brasileiros conferem ao exame de ultrassonografia para o diagnóstico de tendinite e ao exame de eletroneuromiografia para o diagnóstico da neuropatia periférica e da radiculopatia dos membros superiores. MATERIAL E MÉTODOS: No total, 165 reumatologistas responderam a uma pesquisa de opinião anônima (enviada pela internet), sobre diversas situações relativas aos dois exames, no que diz respeito aos seguintes questionamentos: confiabilidade, precisão no diagnóstico, importância e necessidade desses exames para confirmação diagnóstica e credibilidade e treinamento dos profissionais que executam os exames. RESULTADOS: O estudo revelou que a maioria dos reumatologistas reconhece que esses exames são operador-dependentes, que não confia integralmente nos resultados observados, que tais exames não são imperativos para os diagnósticos elencados, e que os profissionais que executam esses exames deveriam ser mais bem treinados para fornecer resultados mais confiantes. CONCLUSÃO: Para os reumatologistas brasileiros, os resultados desses exames devem ser interpretados com cautela e não são definitivos para o diagnóstico; a ultrassonografia musculoesquelética e a eletroneuromiografia devem ser realizadas por profissionais capacitados; deve haver melhor preparo dos executores desses exames em nosso meio.Universidade Federal de São Paulo (UNIFESP)Hospital de Base do Distrito Federal Serviço de ReumatologiaUniversidade de BrasíliaJustiça Federal Seção Judiciária de São PauloJustiça Federal do Paraná Seção Judiciária do ParanáUNIFESPSciEL

Na,K-ATPase alpha isoforms at the blood-cerebrospinal fluid-trigeminal nerve and blood-retina interfaces in the rat

Background: Cerebrospinal fluid (CSF) sodium concentration increases during migraine attacks, and both CSF and vitreous humor sodium increase in the rat migraine model. The Na,K-ATPase is a probable source of these sodium fluxes. Since Na,K-ATPase isoforms have different locations and physiological roles, our objective was to establish which alpha isoforms are present at sites where sodium homeostasis is disrupted. Methods: Specific Na,K-ATPase alpha isoforms were identified in rat tissues by immunohistochemistry at the blood-CSF barrier at the choroid plexus, at the blood-CSF-trigeminal barrier at the meninges, at the blood-retina barrier, and at the blood-aqueous barrier at the ciliary body. Calcitonin gene-related peptide (CGRP), occludin, or von Willibrand factor (vWF) were co-localized with Na,K-ATPase to identify trigeminal nociceptor fibers, tight junctions, and capillary endothelial cells respectively. Results: The Na,K-ATPase alpha-2 isoform is located on capillaries and intensely at nociceptive trigeminal nerve fibers at the meningeal blood-CSF-trigeminal barrier. Alpha-1 and −3 are lightly expressed on the trigeminal nerve fibers but not at capillaries. Alpha-2 is expressed at the blood-retina barriers and, with alpha-1, at the ciliary body blood aqueous barrier. Intense apical membrane alpha-1 was associated with moderate cytoplasmic alpha-2 expression at the choroid plexus blood-CSF barrier. Conclusion: Na,K-ATPase alpha isoforms are present at the meningeal, choroid plexus, and retinal barriers. Alpha-2 predominates at the capillary endothelial cells in the meninges and retinal ganglion cell layer

Propuesta didáctica para el desarrollo de las competencias matemáticas en estudiantes de cinco años del nivel inicial en una institución educativa pública de Nuevo Progreso, Datem del Marañón, Loreto

El presente trabajo tiene como objetivo formular una propuesta didáctica para desarrollar las competencias matemáticas en estudiantes de cinco años del nivel inicial en una institución educativa pública de Nuevo Progreso, Datem del Marañón, Loreto. En el primer capítulo se describe el marco situacional. En el segundo capítulo se presenta a los tres autores del Paradigma Socio cognitivo Humanista quienes aportan los principios pedagógicos tales como: Jean Piaget, Lev Vygotsky y David Ausubel. En el tercer capítulo se elabora la programación curricular y los respectivos instrumentos de evaluación. Este trabajo culmina con las conclusiones, recomendaciones y referencias.The purpose of this paper is to formulate a didactic proposal to develop mathematical competencies in five-year old students at the early to develop mathematical competencies in five-year-old students of the initial level in a public educational public educational institution of Nuevo Progreso, Datem del Marañón, Loreto. In the first first chapter describes the situational framework. The second chapter presents the three authors of the three authors of the Socio-cognitive Humanist Paradigm who provide the pedagogical principles such as: Jean Piñón pedagogical principles such as: Jean Piaget, Lev Vygotsky and David Ausubel. In the third chapter elaborates the curricular programming and the respective evaluation instruments. evaluation instruments. This work ends with conclusions, recommendations and references.Trabajo de suficiencia profesiona

Nonlinear Control of a Novel Two-Link Pendulum

This paper describes nonlinear control of a two degree of freedom mechanical system which models a bird perched on a branch or cable. The primary contribution is the implementation, in a controlled laboratory experiment, of the recently developed C\ adaptive control approach. This technique, which allows fast adaptation with guaranteed stability margins, has been proposed for use in a variety of more sophisticated applications. Experimental results for this simple mechanical control system provide further motivation to pursue those applications. The system being considered is a variation of Spong's "Acrobot", a classic example of an underactuated mechanical control system. In addition to the ℒ_1 controller, a swing-up controller based on Spong's original work on collocated partial feedback linearization is implemented with switching logic