Clinical Profile, Predictors of Mortality, and Treatment of Patients after Myocardial Infarction, in an Academic Medical Center Hospital

OBJECTIVE: To evaluate clinical profiles, predictors of 30-day mortality, and the adherence to international recommendations for the treatment of myocardial infarction in an academic medical center hospital. METHODS: We retrospectively studied 172 patients with acute myocardial infarction, admitted in the intensive care unit from January 1992 to December 1997. RESULTS: Most patients were male (68%), white (97%), and over 60 years old (59%). The main risk factor for coronary atherosclerotic disease was systemic blood hypertension (63%). Among all the variables studied, reperfusion therapy, smoking, hypertension, cardiogenic shock, and age were the predictors of 30-day mortality. Most commonly used medications were: acetylsalicylic acid (71%), nitrates (61%), diuretics (51%), angiotensin-converting enzyme inhibitors (46%), thrombolytic therapy (39%), and beta-blockers (35%). CONCLUSION: The absence of reperfusion therapy, smoking status, hypertension, cardiogenic shock, and advanced age are predictors of 30-day mortality in patients with acute myocardial infarction. In addition, some medications that are undoubtedly beneficial have been under-used after acute myocardial infarction.

Predicting academic success of engineering students in technical drawing from working memory

Tests on spatial aptitude, in particular Visualization, have been shown to be efficient predictors of the academic performance of Technical Drawing stu-dents. It has recently been found that Spatial Working Memory (a construct defined as the ability to perform tasks with a figurative content that require si-multaneous storage and transformation of information) is strongly associated with Visualization. In the present study we analyze the predictive efficiency of a bat-tery of tests that included tests on Visualization, SpatialWorking Memory, Spatial Short-term Memory and Executive Function on a sample of first year engineering students. The results show that Spatial Working Memory (SWM) is the most important predictor of academic success in Technical Drawing. In our view, SWM tests can be useful for detecting as early as possible those students who will require more attention and support in the teaching-learning process.

Six-year follow-up of maxillary anterior rehabilitation with forced orthodontic extrusion: Achieving esthetic excellence with a multidisciplinary approach

Orthodontic extrusion with multidisciplinary treatment can provide predictable outcomes in selected situations, reducing the costs and the adaptation times of gingival tissues after implant integration. Forced orthodontic extrusion is strongly related to interactions of teeth with their supportive periodontal tissues. This article reports a case of orthodontic extrusion of the maxillary incisors for later implant rehabilitation in a patient with periodontal disease. Slow forces were applied for 14 months. After this time, the teeth were extracted, and the implants were placed on the same day. Also in the same session, the provisional crown was fabricated for restoration of the anterior maxillary interdental papillae loss and for gingival contouring. Clinical and radiographic examinations at the 6-year follow-up showed successful tooth replacement and an improved esthetic appearance achieved by this multidisciplinary treatment. The decision to perform orthodontic extrusion for implant placement in adult patients should be multidisciplinary. Copyright © 2013 by the American Association of Orthodontists.

Construção de um sistema de informações georeferenciais sobre geoturismo na Bacia hidrográfica do Rio Corumbataí - SP

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Prevalence of burnout syndrome in clinical nurses at a hospital of excellence

Background: Burnout syndrome can be defined as long-term work stress resulting from the interaction between constant emotional pressure associated with intense interpersonal involvement for long periods of time and personal characteristics. We investigated the prevalence/propensity of Burnout syndrome in clinical nurses, and the factors related to Burnout syndrome-associated such as socio-demographic characteristics, work load, social and family life, leisure activities, extra work activities, physical activities, and work-related health problems. Method: We conducted a cross-sectional, quantitative, prospective epidemiological study with 188 surgical clinic nurses. We used the Maslach Burnout Inventory (MBI), which is a socio-demographic questionnaire and the most widely used instrument to assess Burnout syndrome (three basic dimensions: emotional exhaustion, despersonalization and professional underachievement). The socio-demographic profile questionnaire wascomposed of questions regarding identification, training, time at work, work characteristics and personal circumstances. Results: The prevalence of Burnout syndrome was higher (10.1%) and 55, 4% of subjects had a propensity to develop this syndrome. The analysis of the socio-demographic profile of the nurse sample studied showed that most nurses were childless married women, over 35 years of age, working the day shift for 36 hours weekly on average, with 2-6 years of post-graduation experience, and without extra employments. Factors such as marital status, work load, emotion and work related stress aggravated the onset of the syndrome. Conclusion: The prevalence and propensity of Burnout syndrome were high. Some factors identified can be useful for the adoption of preventive actions in order to decrease the prevalence of the clinical nurses Burnout syndrome.

Trends in Brazilian academic production in the History of Mathematics Education: directions from EBRAPEM

The number of papers on History of Mathematics Education presented at EBRAPEM (Brazilian Meeting of Graduate Students in Mathematics Education) has increased significantly between 2003 and 2008. This article presents a study with the aim of identifying themes, periods in focus, and sources and theoretical and methodological references used by the authors of the papers on History of Mathematics Education published in the proceedings of VII, VIII, IX, X, XI and XII EBRAPEM. The study indicates that the approach of ongoing research in History of Mathematics Education in Brazil has been similar to the approach of research in History of Education in general. However, the institutional separation between these two areas of investigation is noted as a factor rendering communication between both groups of researchers difficult.

Construction of the dispositions of institutional habitus in the academic field

This paper describes the main phases of development of an Institute of Chemistry in relation with national policy from the academic field. Its history begins with a proposal to meet the demand for chemistry teacher education and goes on to become a major center for research, education and extension. Throughout its 50 years of history, the Institution has faced numerous challenges by adopting strategies that have established and revealed its institutional habitus. To this end, we use some of René Kaës’s concepts about the development of groups and institutions, highlighting mainly the origins, expectations and covenants that underpinned its foundation, and the entire process of its expansion and institutionalization. Our main focus, also interpreted based on the theory of Pierre Bourdieu and followers, is the establishment of its institutional habitus, i.e., how it interprets and organizes its institutional teaching, research and extension activities within the context of the academic field. The peculiarity of the process has been the mismatch between internal and external pressures. Even though presenting the results of a case study, in general, our methodology can improve the understanding of institution’s development in relation with educational policy.

Student's academic efficacy or Inefficacy? an example on how to evaluate the psychometric properties of a measuring instrument and evaluate the effects of item wording

This study evaluated the effect of item inversion on the construct validity and reliability of psychometric scales and proposed a theoretical framework for the evaluation of the psychometric properties of data gathered with psychometric instruments. To this propose, we used the Maslach Burnout Inventory, which is the most used psychometric inventory to measure burnout in different professional context (Students, Teachers, Police, Doctors, Nurses, etc…). The version of the MBI used was the MBI-Student Survey (MBI-SS). This inventory is composed of three key dimensions: Exhaustion, Cynicism and Professional Efficacy. The two first dimensions—which have positive formulated items—are moderate to strong positive correlated, and show moderate to strong negative correlations with the 3rd dimension—which has negative formulated items. We tested the hypothesis that, in college students, formulating the 3rd dimension of burnout as Inefficacy (reverting the negatively worded items in the Efficacy dimension) improves the correlation of the 3rd dimension with the other two dimensions, improves its internal consistency, and the overall MBI-SS’ construct validity and reliability. Confirmatory factor analysis results, estimated by Maximum Likelihood, revealed adequate factorial fit for both forms of the MBI-SS (with Efficacy) vs. the MBI-SSi (with Inefficacy). Also both forms showed adequate convergent and discriminant related validity. However, reliability and convergent validity were higher for the MBI-SSi. There were also stronger (positive) correlations between the 3 factors in MBI-SSi than the ones observed in MBI-SS. Results show that positively rewording of the 3rd dimension of the MBI-SS improves its validity and reliability. We therefore propose that the 3rd dimension of the MBI-SS should be named Professional Inefficacy and its items should be positively worded.

Profile of the production engineer student at a school of engineering in Brazil: academic and professional trajectories and tendencies

The objective of this paper is to introduce a study on the academic trajectory and professional profile of production engineers who graduated in a traditional and renowned Brazilian University (School of Engineering at Bauru – FEB). The study was conducted with the first three classes of undergraduates in the production engineering program at FEB/UNESP. A 50% response rate was obtained and with the data collected it was possible to characterize the professional profile of the students and outline their academic trajectory. According to the sample, the main result is that the curricular grid is the main criterion of similarity in student education, thus, the focus on program improvements should focus on the curricular grid. Tendencies are also pointed out to guide the search for improvements in the academic trajectory of production engineering students.