Onde há fumaça há fogo. Tabagismo entre escolares de Volta Redonda, um problema de enfermagem

A indústria do tabaco tem concentrado suas estratégias de marketing sobre crianças e adolescentes. Estudos do Cebrid/Unifesp apontam a relação entre diminuição na experimentação com o aumento de informação, maior inclusão e crescente envolvimento das escolas. O Programa Saber Saúde, do Ministério da Saúde, propõe educação para a saúde objetivando, entre outros, a formação de cidadãos capazes de decidir sobre a adoção de estilos de vidas saudáveis. Neste trabalho avaliamos os fatores condicionantes ao uso do tabaco e a importância da educação na prevenção/conscientização sobre o uso, entre os estudantes de escolas públicas (entre 10 e 19 anos) do município de Volta Redonda. Através da aplicação de questionários e com a abrangência de 23 bairros do município, observamos que a idade média de experimentação para o grupo estudado foi de 11,7 ± 2,8 anos, sendo maior a frequência dentro do grupo masculino (33,3%) do que no grupo feminino (16%). Os fumantes de maior influência entre os entrevistados foram: “amigo ou namorado (a)”, “parentes (primos, tios, avós, etc)” e “irmão” com respectivamente; 75; 12,5 e 12,5%. Analisando os dados de convívio, o grupo que experimentou o cigarro apresentava valores superiores no percentual de familiares e amigos fumantes, quando comparados ao grupo que não o experimentou; 6,5 e 2 vezes maior respectivamente. Sessenta e um por cento dos entrevistados não obtiveram informação sobre tabaco na escola. O enfermeiro é um profissional apto e competente para organizar atividades que visem o empoderamento social sobre a saúde por meio da educação. A abordagem sobre tabaco no âmbito escolar otimiza os resultados desta atividade, sendo a prevenção primária não exercida somente na Unidade Básica ou Programa Saúde da Família, que não sempre consegue lançar atrativos para a participação dos adolescentes em ações de educação em saúde. A educação é a única forma de apagar o fogo alimentado pela indústria tabagista que encanta os adolescentes e lhes priva da verdade que há por traz da fumaça

Clinical inertia is the enemy of therapeutic success in the management of diabetes and its complications: A narrative literature review

Diabetes mellitus is a chronic disease characterized by high social, economic and health burden, mostly due to the high incidence and morbidity of diabetes complications. Numerous studies have shown that optimizing metabolic control may reduce the risk of micro and macrovascular complications related to the disease, and the algorithms suggest that an appropriate and timely step of care intensification should be proposed after 3 months from the failure to achieve metabolic goals. Nonetheless, many population studies show that glycemic control in diabetic patients is often inadequate. The phenomenon of clinical inertia in diabetology, defined as the failure to start a therapy or its intensification/de-intensification when appropriate, has been studied for almost 20 years, and it is not limited to diabetes care, but also affects other specialties. In the present manuscript, we have documented the issue of inertia in its complexity, assessing its dimensions, its epidemiological weight, and its burden over the effectiveness of care. Our main goal is the identification of the causes of clinical inertia in diabetology, and the quantification of its social and health-related consequences through the adoption of appropriate indicators, in an effort to advance possible solutions and proposals to fight and possibly overcome clinical inertia, thus improving health outcomes and quality of care

An Algebraic q-Deformed Form for Shape-Invariant Systems

A quantum deformed theory applicable to all shape-invariant bound-state systems is introduced by defining q-deformed ladder operators. We show these new ladder operators satisfy new q-deformed commutation relations. In this context we construct an alternative q-deformed model that preserve the shape-invariance property presented by primary system. q-deformed generalizations of Morse, Scarf, and Coulomb potentials are given as examples

Perfectly Translating Lattices on a Cylinder

We perform molecular dynamics simulations on an interacting electron gas confined to a cylindrical surface and subject to a radial magnetic field and the field of the positive background. In order to study the system at lowest energy states that still carry a current, initial configurations are obtained by a special quenching procedure. We observe the formation of a steady state in which the entire electron-lattice cycles with a common uniform velocity. Certain runs show an intermediate instability leading to lattice rearrangements. A Hall resistance can be defined and depends linearly on the magnetic field with an anomalous coefficient reflecting the manybody contributions peculiar to two dimensions.Comment: 13 pages, 5 figure

An integrated care pathway for cancer patients with diabetes: A proposal from the Italian experience

Diabetes and cancer frequently coexist in the same subject, often with relevant clinical effects on the management and prognosis of the comorbid patient. The existing guidelines, however, do not appropriately address many clinical issues in this setting. Although collaboration between diabetologists and oncologists should play an important role in achieving appropriate levels of care, close coordination or agreement between these specialists is seldom offered. There is an urgent need for greater interdisciplinary integration between all specialists involved in this setting, for a shared approach ensuring that organisational silos are overcome. To this end, the Italian Associations of Medical Diabetologists (AMD) and the Italian Association of Medical Oncology (AIOM) recently established a dedicated Working Group on 'Diabetes and Cancer'. The working group outlined a diagnostic and therapeutic clinical pathway dedicated to hospitalised patients with diabetes and cancer. In this article, we describe the Italian proposal including some suggested measures to assess, monitor and improve blood glucose control in the hospital setting, to integrate different specialists from both areas, as well as to ensure discharge planning and continuity of care from the hospital to the territory

Remote sensing applied to grassland ecosystems in regions with climatic vulnerability.

Abstract: The aim of this review is to present the concepts and current research on the use of remote sensing in studies of pastoral ecosystems. The management of pasture plays an important role in the balance between biomass production and its regrowth so that the determination of biomass production is fundamental information to perform the adjustment of the number of animals. There are direct and indirect methods to obtain forage biomass in pastures. Generally the most used are direct methods, where there is the cutting of all forage present in a known area frame, and this requires the help of a variety of tools, requiring infrastructure, labor with long-term fieldwork. Remote sensing is an indirect way to determine biomass in pastures, which has a significant potential to monitor vegetation dynamics, besides predicting events such as the beginning or peak of vegetation growth. One of the ways to monitor the vegetation is through the use of vegetation indexes. There are several vegetation indexes, but soil adjusted vegetation index (SAVI) and normalized difference vegetation index (NDVI) are the most used in studies on pastoral ecosystems. Remote sensing used for pasture evaluation can contribute with relevant and complementary information on forage production, as well as the growth behavior of the forage plant, allowing to obtain information on large scales

Uso do fogo em pastagens naturais.

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Charting service quality gaps

Some of the most influential models in the service management literature (Parasuraman et al., 1985; Grönroos, 1990) focus on the concept of service quality gap (SQG). Parasuraman et al. (1985) define a pioneering model with five SQGs, the concepts of which are amplified in Brogowicz et al.’s (1990) model. The latter has five types of encompassing gaps: information and feedback-related gaps; design-related gaps; implementation-related gaps; communication-related gaps; and customers’ perceptions and expectations related gaps. Additionally to this model amplification, other authors (e.g., Brown & Swartz, 1989) have pointed to relevant SQGs that have not been considered previously. This paper integrates current models and a group of SQGs dispersed through the literature in a new comprehensive model. It draws a link between the model and the stages of a strategy process, emphasising the SQGs’ impact on the process and raising relevant research questions.FCT, FEUALG, UALG