How does the ascending aorta geometry change when it dissects?

OBJECTIVES The purpose of this study is to delineate changes in aortic geometry and diameter due to dissection. BACKGROUND Aortic diameter is the major criterion for elective ascending aortic replacement for dilated ascending aortas to prevent aortic dissection. However, recommendations are made on the basis of clinical experience and observation of diameters of previously dissected aortas. METHODS Six tertiary centers on 2 continents reviewed their acute aortic dissection type A databases, which contained 1,821 patients. Included were all non-Marfan patients with nonbicuspid aortic valves who had undergone computed tomography angiography <2 years before and within 12 h after aortic dissection onset. Aortic geometry before and after dissection onset were compared. RESULTS Altogether, 63 patients were included (27 spontaneous and 36 retrograde dissections, median age 68 [57; 77] years; 54% were men). In all but 1 patient, maximum ascending aortic diameter was <55 mm before aortic dissection onset. The largest increase in diameter and volume induced by the dissection were observed in the ascending aorta (40.1 [36.6; 45.3] mm vs. 52.9 [46.1; 58.6] mm, +12.8 mm; p < 0.001; 124.0 [90.8; 162.5] cm(3) vs. 171.0 [147.0; 197.0] cm(3), +47 cm(3); p < 0.001). Mean aortic arch diameter increased from 39.8 (30.5; 42.6) mm to 46.4 (42.0; 51.6) mm (+6.6 mm; p < 0.001) and descending thoracic aorta diameter from 31.2 (27.0; 33.3) mm to 34.9 (30.9; 39.5) mm (+3.7 mm; p < 0.001). Changes in thoracic aorta geometry were similar for spontaneous and retrograde etiology. CONCLUSIONS Geometry of the thoracic aorta is affected by aortic dissection, leading to an increase in diameter that is most pronounced in the ascending aorta. Both spontaneous and retrograde dissection result in similar aortic geometry changes.

How quota-based procedures affect the self-ascribed fit and motivation of European women and men striving for leadership positions

The consequences of quota-based hiring policies on women’s and men’s self-ascribed fit and motivation to apply for leadership positions were investigated in the European context. 389 management students (195 women, 194 men) from Switzerland, Germany, and Austria received job advertisements varying in their gender policies. Interestingly, women’s and men’s self-ascribed fit and motivation to apply did not differ when no policy was included. Instead, participant’s agency was the relevant predictor leading to higher perceived fit, resulting in higher inclination to apply. When women were either explicitly invited to apply or preferentially treated when equally qualified, they reported higher fit and inclination to apply compared to both the control condition and men. In contrast, when a quota of 40% women should be established, neither women’s fit nor motivation to apply were increased beyond the levels of the control or men’s. Men were not affected by the different policies.

Retrievability of implant-supported crowns when using three different cements: a controlled clinical trial

PURPOSE The purpose of this study was to analyze the removal of implant-supported crowns retained by three different cements using an air-accelerated crown remover and to evaluate the patients' response to the procedure. MATERIALS AND METHODS This controlled clinical trial was conducted with 21 patients (10 women, 11 men; mean age: 51 ± 10.2 years) who had received a total of 74 implants (all placed in the posterior zone of the mandible). Four months after implant surgery, the crowns were cemented on standard titanium abutments of different heights. Three different cements (two temporary: Harvard TEMP and Improv; and one definitive: Durelon) were used and randomly assigned to the patients. Eight months later, one blinded investigator removed all crowns. The number of activations of the instrument (CORONAflex, KaVo) required for crown removal was recorded. The patients completed a questionnaire retrospectively to determine the impact of the procedure and to gauge their subjective perception. A linear regression model and descriptive statistics were used for data analysis. RESULTS All crowns could be retrieved without any technical complications or damage. Both abutment height (P = .019) and cement type (P = .004) had a significant effect on the number of activations, but the type of cement was more important. An increased total number of activations had no or only a weak correlation to the patients' perception of concussion, noise, pain, and unwillingness to use the device. CONCLUSIONS Cemented implant crowns can be removed, and the application of an air-accelerated device is a practicable method. A type of cement with appropriate retention force has to be selected. The impact on the patients' subjective perception should be taken into account.

Modelling the impact of deferring HCV treatment on liver-related complications in HIV coinfected men who have sex with men

BACKGROUND AND AIMS Hepatitis C (HCV) is a leading cause of morbidity and mortality in people who live with HIV. In many countries, access to direct acting antiviral agents to treat HCV is restricted to individuals with advanced liver disease (METAVIR stage F3 or F4). Our goal was to estimate the long term impact of deferring HCV treatment for men who have sex with men (MSM) who are coinfected with HIV and often have multiple risk factors for liver disease progression. METHODS We developed an individual-based model of liver disease progression in HIV/HCV coinfected men who have sex with men. We estimated liver-related morbidity and mortality as well as the median time spent with replicating HCV infection when individuals were treated in liver fibrosis stages F0, F1, F2, F3 or F4 on the METAVIR scale. RESULTS The percentage of individuals who died of liver-related complications was 2% if treatment was initiated in F0 or F1. It increased to 3% if treatment was deferred until F2, 7% if it was deferred until F3 and 22% if deferred until F4. The median time individuals spent with replicating HCV increased from 5 years if treatment was initiated in F2 to almost 15 years if it was deferred until F4. CONCLUSIONS Deferring HCV therapy until advanced liver fibrosis is established could increase liver-related morbidity and mortality in HIV/HCV coinfected individuals, and substantially prolong the time individuals spend with replicating HCV infection.

Maximal exercise hemodynamics and risk of mortality in apparently healthy men and women

The use of exercise electrocardiography (ECG) to detect latent coronary heart disease (CHD) is discouraged in apparently healthy populations because of low sensitivity. These recommendations however, are based on the efficacy of evaluation of ischemia (ST segment changes) with little regard for other measures of cardiac function that are available during exertion. The purpose of this investigation was to determine the association of maximal exercise hemodynamic responses with risk of mortality due to all-causes, cardiovascular disease (CVD), and coronary heart disease (CHD) in apparently healthy individuals. Study participants were 20,387 men (mean age = 42.2 years) and 6,234 women (mean age = 41.9 years) patients of a preventive medicine center in Dallas, TX examined between 1971 and 1989. During an average of 8.1 years of follow-up, there were 348 deaths in men and 66 deaths in women. In men, age-adjusted all-cause death rates (per 10,000 person years) across quartiles of maximal systolic blood pressure (SBP) (low to high) were: 18.2, 16.2, 23.8, and 24.6 (p for trend $<$0.001). Corresponding rates for maximal heart rate were: 28.9, 15.9, 18.4, and 15.1 (p trend $<$0.001). After adjustment for confounding variables including age, resting systolic pressure, serum cholesterol and glucose, body mass index, smoking status, physical fitness and family history of CVD, risks (and 95% confidence interval (CI)) of all-cause mortality for quartiles of maximal SBP, relative to the lowest quartile, were: 0.96 (0.70-1.33), 1.36 (1.01-1.85), and 1.37 (0.98-1.92) for quartiles 2-4 respectively. Similar risks for maximal heart rate were: 0.61 (0.44-0.85), 0.69 (0.51-0.93), and 0.60 (0.41-0.87). No associations were noted between maximal exercise rate-pressure product mortality. Similar results were seen for risk of CVD and CHD death. In women, similar trends in age-adjusted all-cause and CVD death rates across maximal SBP and heart rate categories were observed. Sensitivity of the exercise test in predicting mortality was enhanced when ECG results were evaluated together with maximal exercise SBP or heart rate with a concomitant decrease in specificity. Positive predictive values were not improved. The efficacy of the exercise test in predicting mortality in apparently healthy men and women was not enhanced by using maximal exercise hemodynamic responses. These results suggest that an exaggerated systolic blood pressure or an attenuated heart rate response to maximal exercise are risk factors for mortality in apparently healthy individuals. ^

Adult weight gain and risk of colon cancer in men

Previous research supports the hypothesis that a "rich" diet (i.e., high in fat and low in fiber) increases the risk of colon cancer. Previous research also supports the hypothesis that physical inactivity increases the risk of colon cancer, perhaps because physical inactivity decreases gut motility, thereby increasing tee time that carcinogens are in contact with the intestinal mucosa. Habitual physical inactivity, combined with rich diet, ordinarily results in chronic energy imbalance and gain in weight, except when energy balance is modified by disease or factors such as cigarette smoking. Cigarette smokers typically stay lean because of effects of smoking on the resting metabolic rate as well as on efficiency of caloric intake and storage. Therefore, if physical inactivity and rich diet do increase the risk of colon cancer, then weight gain during young adulthood should be positively associated with incidence of colon cancer during later life, especially in nonsmokers.^ This hypothesis was investigated in a cohort of 2,059 randomly selected middle-aged men who were employed at the Western Electric Company in Chicago and were free of clinically diagnosed cancer at initial examination in 1958. Body mass index (BMI) in middle age was calculated from measured height and weight at the initial examination. BMI at age 20 was estimated from weight at age 20 as recalled at the initial examination and height as measured at the initial examination. Change in BMI between age 20 and middle age was estimated by subtracting the BMI at 20 from the BMI in middle age. Forty-nine incident cases of colon cancer were detected during 25 years (43,326 person-years) at risk. When stratified by level of change in BMI from age 20 to middle age ($\le$1.9, 2.0-3.9, 4.0-5.9, $\ge$6.0 kg/m$\sp2$), age-adjusted relative hazards of colon cancer in never-smokers were 1.00, 1.22, 2.31, and 5.01, respectively (p for trend = 0.008); corresponding values in ever-smokers were 1.00, 0.95, 0.77, and 0.87, These associations did not change appreciably after further adjustment for BMI at age 20, subscapular-triceps skinfold ratio, cigarette smoking, consumption of alcohol, energy, fat, and calcium.^ We also investigated the hypothesis that the risk of colon cancer was higher in men who were lean at age 20 and became fat by middle age (lean-to-fat) than in men who were fat at age 20 and stayed fat in middle-age (fat-to-fat). "Lean" was defined as BMI $<$24 kg/m$\sp2$ at age 20 and as BMI $<$27.0 kg/m$\sp2$ in middle age. Among never-smokers, in comparison to men who were lean at age 20 and in middle age (lean-to-lean), the age-adjusted relative hazard of colon cancer was 1.43 in the fat-to-fat group (95% confidence interval (CI) 0.37-5.52) and 3.36 in the lean-to-fat group (95% CI 1.21-9.37). This investigation provides new results on the magnitude of risk of colon cancer associated with weight gain during adulthood (from age 20 to middle age). This relation was obscured or underestimated in previous studies due to effect-modification by cigarette smoking. Finally, the result supports the idea that a life-style characterized by chronic energy imbalance during young adulthood increases risk of colon cancer. ^

Compañeros de ruta, reencuentro de ex presos políticos cordobeses

El propósito de este trabajo es investigar los motivos, anhelos, sueños, deseos que llevan a un grupo de entre 20 y 25 ex presos políticos a reunirse semanalmente en el local del sindicato Luz y Fuerza, Córdoba. Optamos por entrevistar a quienes daban la sensación de ser más participativos o más explícitos, en la elección procuramos que hubiesen casi por igual miembros de las dos organizaciones mayoritarias en el pasado: Montoneros y Partido Revolucionario de los Trabajadores. El celo a la hora de elegir se entronca con las subculturas que emergieron de las organizaciones. Otro aspecto observado es la cuestión de género, mujeres y hombres, equitativamente incorporados, se constituyeron en narradores.2 En la ciudad mediterránea hubo alrededor de dos mil detenidos por causas políticas a partir de la dictadura que iniciara Jorge Rafael Videla. La curiosidad social es acicateada por el número exiguo de ex-represaliados que constituyen la comisión de presos políticos, que entre otras tareas peticiona ante las autoridades solicitando reivindicaciones a raíz de su condición de ex detenidos, organizan eventos sociales y políticos, gestionan los ex centros de detención convertidos en "museos de la memoria", impulsan los juicios contra los ex represores, editan publicaciones. Concurrimos a las reuniones semanales, a asados, "locreadas"; empleamos en las investigaciones la observación participante. La participación se dio en eventos, en compartir ruedas de mate en la casa de los entrevistados, íntimas ruedas de café, por un fenómeno de indexicalidad en relación con el discurso ideológico pudimos avanzar en la profundidad de la conversación. Además, de las entrevistas en profundidad, analizamos material periodístico y material escrito por los detenidos; cuando la emoción del entrevistado dificultaba la conversación, en algunos casos nos remitieron a elaboraciones suyas sobre la situación planteada.. Nos favoreció, en el trabajo, el hecho de haber participado en la vida política, y el tener familiares que lucharon junto a los ex-represaliados. A pesar de ello no fue fácil llegar a subjetividades que hacía largo tiempo se hallaban abroqueladas. Mead e Erving Goffman nos acompañaron en el camino de reconocimiento de los selfs en la dramaturgia montada en el local de Luz y Fuerza

Compañeros de ruta, reencuentro de ex presos políticos cordobeses

El propósito de este trabajo es investigar los motivos, anhelos, sueños, deseos que llevan a un grupo de entre 20 y 25 ex presos políticos a reunirse semanalmente en el local del sindicato Luz y Fuerza, Córdoba. Optamos por entrevistar a quienes daban la sensación de ser más participativos o más explícitos, en la elección procuramos que hubiesen casi por igual miembros de las dos organizaciones mayoritarias en el pasado: Montoneros y Partido Revolucionario de los Trabajadores. El celo a la hora de elegir se entronca con las subculturas que emergieron de las organizaciones. Otro aspecto observado es la cuestión de género, mujeres y hombres, equitativamente incorporados, se constituyeron en narradores.2 En la ciudad mediterránea hubo alrededor de dos mil detenidos por causas políticas a partir de la dictadura que iniciara Jorge Rafael Videla. La curiosidad social es acicateada por el número exiguo de ex-represaliados que constituyen la comisión de presos políticos, que entre otras tareas peticiona ante las autoridades solicitando reivindicaciones a raíz de su condición de ex detenidos, organizan eventos sociales y políticos, gestionan los ex centros de detención convertidos en "museos de la memoria", impulsan los juicios contra los ex represores, editan publicaciones. Concurrimos a las reuniones semanales, a asados, "locreadas"; empleamos en las investigaciones la observación participante. La participación se dio en eventos, en compartir ruedas de mate en la casa de los entrevistados, íntimas ruedas de café, por un fenómeno de indexicalidad en relación con el discurso ideológico pudimos avanzar en la profundidad de la conversación. Además, de las entrevistas en profundidad, analizamos material periodístico y material escrito por los detenidos; cuando la emoción del entrevistado dificultaba la conversación, en algunos casos nos remitieron a elaboraciones suyas sobre la situación planteada.. Nos favoreció, en el trabajo, el hecho de haber participado en la vida política, y el tener familiares que lucharon junto a los ex-represaliados. A pesar de ello no fue fácil llegar a subjetividades que hacía largo tiempo se hallaban abroqueladas. Mead e Erving Goffman nos acompañaron en el camino de reconocimiento de los selfs en la dramaturgia montada en el local de Luz y Fuerza

Ball possession effectiveness in men's and women's elite basketball according to situational variables in different game periods

The aim of the present study was to identify the importance of floorball tactical variables to predict ball possession effectiveness, when controlling quality of opposition and game periods. The sample was composed by 1500 ball possessions, corresponding to 14 games randomly selected from the International Championships played during 2008 and 2010 (World Championship, Four nations tournament and classificatory phases for World Championship) by teams from different competition levels (HIGH, INTERMEDIATE and LOW). The effects of the predictor variables on successful ball possessions according to the three game contexts (HIGH vs. HIGH; HIGH vs. LOW; LOW vs. LOW games) were analyzed using Binomial Logistic Regressions. The results showed no interaction with the game period. In HIGH vs. HIGH games, quality of opposition showed an association with ball possession effectiveness with ending zone, offensive system, possession duration, height of shooting and defensive pressures previous to the shot. In HIGH vs. LOW games the important factors were the starting zone, possession duration, defensive pressure previous to the last pass and to the shot, technique of shooting and the number players involved in each ball possession. Finally, in LOW vs. LOW games, the results emphasized the importance of starting and ending zones, the number of passes used and the technique of shooting. In conclusion, elite floorball performance is mainly affected by quality of opposition showing different game patterns in each context that should be considered by coaches when preparing practices and competitions.

O derramamento do Espírito : fortalecimento dos enfraquecidos

Esta tese se insere dentro da leitura bíblica latino-americana trazendo, nessa ótica, a riqueza e o desafio do que significa ler a Bíblia a partir de um contexto de opressão como é o nosso continente. Nos servimos do roteiro das ciências bíblicas e dos métodos exegéticos modernos. É uma pesquisa bibliográfica onde, eventualmente, consideramos o nível experiêncial, por exemplo quando trabalhamos o tema do derramamento do Espírito nos pentecostais chilenos. Esse capítulo, IV, segue o roteiro da hipótese central de nossa tese na medida que firmamos o princípio de que os pentecostais fazem parte do amplo e diverso grupo dos enfraquecidos como produto de um sistema excludente, baseado na exploração social. Numa situação de crise, o anúncio do derramamento do Espírito é um sinal de salvação, de perspectivas futuras, de conservação e prolongação da vida. Esta tese relê o tema do derramamento do Espírito, a partir de Jl 3,1-5. O tema é analisado num contexto social concreto, onde os enfraquecidos recebem o Espírito do Senhor. O eixo que nos permite fazer esta leitura encontra sua referencial nas pessoas setores sociais - mencionadas como beneficiadas diretas da ação do Espírito. São pessoas que representam setores diferentes; jovens, escravos e escravas, formam o grupo que sustenta e faz funcionar o sistema imperial persa grego - baseado na exploração e mão de obra barata. Eles, juntamente com os idosos que não produzem mais, são a base de sustentação da pirâmide social. Como demostraremos no decorrer da tese, nossa hipótese somente é possível se duas conjunturas se cruzam. Para isso, em num primeiro momento, localizamos e demostramos que o livro de Joel deve ser situado no contexto da literatura apocalíptica (nascimento). Em seguida, demonstramos que o livro de Joel, como produto literário final, deve ser localizado no contexto histórico do pós-exílio, isto é, no tempo dos impérios persa e grego. A confirmação destes dois aspectos desenvolvidos nos capítulos I e II, nos permitem, na análise literária, capítulo III, aprofundar, mediante a análise exegética, e confirmar a nossa hipótese central. Com estes três capítulos demostramos que o derramamento do Espírito do Senhor tem como destinatários preferenciais, senão exclusivos, os setores enfraquecidos pela política social, econômica e religiosa dos impérios persa e grego. Com estes três capítulos desenvolvidos, no quarto capítulo analisamos uma experiência concreta, de um setor majoritariamente pobre que tem se apropriado do texto de Jl 3,1-5, e encontrado nele uma alternativa social, política e religiosa para se manter fiel ao Senhor e por quase um século recria e revive a experiência do derramamento do Espírito. Os velhos, os jovens, os escravos e as escravas, formam o setor dos enfraquecidos. É o setor que nada espera, e que nada terá da parte dos impérios e que, como os pentecostais, pela sua situação de enfraquecimento, acredita que somente uma intervenção externa pode mudar o seu futuro, pode trazer de volta a esperança. Essa intervenção externa começa a ser possível pelo derramamento do Espírito e se concretiza na chegada do dia de Javé, que será grande e terrível, onde o sol e a lua se unem para indicar o monte de Sião e a cidade de Jerusalém como lugar de adoração, refúgio e salvação. Esta perspectiva da ação do Espírito é possível somente no período do pós-exílio. Nesse tempo o Espírito adquire uma dimensão ampla e inclusiva agindo sobre diversos setores sociais, independe de serem ou não judeus.(AU)

INTELIGÊNCIAS EMOCIONAIS E ENSINO SUPERIOR: uma leitura a partir da percepção de professores de um curso de administração.

As Inteligências Emocionais (IEs) têm sido objeto de estudo e discussão nos últimos quinze anos. Todavia, escassos são os estudos científicos, sobremaneira no campo da educação, voltados para o entendimento dos desafios e possibilidades das IEs no cenário do ensino superior. O modelo newtoniano-cartesiano, assumido por setores dominantes de nossa cultura de forma racionalista e reducionista, vem se estabelecendo desde tempos remotos, mais especificamente a partir do século XVI, avançando até os tempos atuais e trazendo muitas marcas para os diferentes campos da cultura ocidental, inclusive para a educação. Como características deste modelo, passíveis de crítica, estão a fragmentação do conhecimento, o foco na especialização e, a instituição de uma relação pedagógica dominadora e não dialogal que negligencia as múltiplas inteligências desenvolvidas e presentes nos indivíduos. Essas características contribuíram para o estabelecimento de uma sociedade de conhecimentos parcelares, para a disjunção entre sujeito e objeto, o descuido nas relações do homem para consigo mesmo, dele para com os demais homens e, dele para com os demais seres vivos que cohabitam o planeta, culminando numa intensa crise planetária. Urge discutir e rever o paradigma newtoniano-cartesiano, dado ao fato de que os resultados colhidos nestes últimos quinhentos anos, se por um lado nos beneficiaram do ponto de vista científico e tecnológico, não mais respondem aos problemas e necessidades com os quais nos deparamos, de modo especial na educação. Delimito esta pesquisa no âmbito do Ensino Superior e, no interior deste, no campo dos estudos de graduação em Administração. As perguntas que motivam o meu trabalho são: 1. Os professores do Curso de Administração consideram as dimensões emocionais em seu trabalho docente? 2. Eles sabem o que são IEs? 3. Que dificuldades eles vêem para desenvolver um trabalho com as dimensões emocionais? 4. Eles vêem possibilidades positivas no trabalho com as IEs? 5. Que pistas as respostas às perguntas acima sugerem à formação continuada de professores no campo da Administração? 6. Ao planejar e organizar suas aulas o professor tem vista o trabalho com a dimensão afetiva? Para fazer a crítica da educação construída na perspectiva newtoniano-cartesiana assumi como referências principais Morin (1995, 2000), Santos (1988) e Moraes (1997). Para estudar a construção do conhecimento considerando as IEs tomei como referências para esta pesquisa Gardner (1995), Izquierdo (2002) e Valle (2003). Foi realizada uma pesquisa de campo com seis (6) professores de um Curso de Administração, mediante um questionário estruturado. O objetivo desta pesquisa foi identificar as principais dificuldades dos docentes quando se pensa num trabalho pedagógico sensível às inteligências emocionais e, estudando estas dificuldades à luz dos teóricos por mim trazidos, construírem possíveis pistas para uma ação formativa, na perspectiva da formação continuada, que considere também o determinante das inteligências emocionais.(AU)

INTELIGÊNCIAS EMOCIONAIS E ENSINO SUPERIOR: uma leitura a partir da percepção de professores de um curso de administração.

As Inteligências Emocionais (IEs) têm sido objeto de estudo e discussão nos últimos quinze anos. Todavia, escassos são os estudos científicos, sobremaneira no campo da educação, voltados para o entendimento dos desafios e possibilidades das IEs no cenário do ensino superior. O modelo newtoniano-cartesiano, assumido por setores dominantes de nossa cultura de forma racionalista e reducionista, vem se estabelecendo desde tempos remotos, mais especificamente a partir do século XVI, avançando até os tempos atuais e trazendo muitas marcas para os diferentes campos da cultura ocidental, inclusive para a educação. Como características deste modelo, passíveis de crítica, estão a fragmentação do conhecimento, o foco na especialização e, a instituição de uma relação pedagógica dominadora e não dialogal que negligencia as múltiplas inteligências desenvolvidas e presentes nos indivíduos. Essas características contribuíram para o estabelecimento de uma sociedade de conhecimentos parcelares, para a disjunção entre sujeito e objeto, o descuido nas relações do homem para consigo mesmo, dele para com os demais homens e, dele para com os demais seres vivos que cohabitam o planeta, culminando numa intensa crise planetária. Urge discutir e rever o paradigma newtoniano-cartesiano, dado ao fato de que os resultados colhidos nestes últimos quinhentos anos, se por um lado nos beneficiaram do ponto de vista científico e tecnológico, não mais respondem aos problemas e necessidades com os quais nos deparamos, de modo especial na educação. Delimito esta pesquisa no âmbito do Ensino Superior e, no interior deste, no campo dos estudos de graduação em Administração. As perguntas que motivam o meu trabalho são: 1. Os professores do Curso de Administração consideram as dimensões emocionais em seu trabalho docente? 2. Eles sabem o que são IEs? 3. Que dificuldades eles vêem para desenvolver um trabalho com as dimensões emocionais? 4. Eles vêem possibilidades positivas no trabalho com as IEs? 5. Que pistas as respostas às perguntas acima sugerem à formação continuada de professores no campo da Administração? 6. Ao planejar e organizar suas aulas o professor tem vista o trabalho com a dimensão afetiva? Para fazer a crítica da educação construída na perspectiva newtoniano-cartesiana assumi como referências principais Morin (1995, 2000), Santos (1988) e Moraes (1997). Para estudar a construção do conhecimento considerando as IEs tomei como referências para esta pesquisa Gardner (1995), Izquierdo (2002) e Valle (2003). Foi realizada uma pesquisa de campo com seis (6) professores de um Curso de Administração, mediante um questionário estruturado. O objetivo desta pesquisa foi identificar as principais dificuldades dos docentes quando se pensa num trabalho pedagógico sensível às inteligências emocionais e, estudando estas dificuldades à luz dos teóricos por mim trazidos, construírem possíveis pistas para uma ação formativa, na perspectiva da formação continuada, que considere também o determinante das inteligências emocionais.(AU)

Clinical Implications for Working with Gay Men A Self Psychological Treatment Approach.

Specific training for conducting psychotherapy with gay men is limited for psychologists, particularly when using a Self Psychology theoretical orientation (Robertson, 1996). In fact, psychologists often are faced with conflicting and contradictory points of view that mirror society's condemnation of homosexuality (Robertson, 1996). This paper is written from a self-psychological perspective to address the lack of a constructive body of literature that explains the unique treatment needs which impact gay men. Estimates of the prevalence of male homosexuality have generated considerable debate. A common assumption is that there are homosexual and non-homosexual men. However, scientists have long been aware that sexual responsiveness to others of the same sex, like most human traits, is continuously distributed in the population (Michaels, 1996). Still the presumption exists that such traits are stable within each man over time (Michaels, 1996). Conflating same-sex sexual experiences with a categorization of the man as homosexual is problematic, in that defining sexuality solely on the basis of experience excludes people who fantasize about sex with others of the same sex but never have sexual contact. Thus, most modern conceptions of sexual orientation consider personal identification, sexual behavior, and sexual fantasy (McWhirter, Sanders & Reinisch, 1990). Gay men's mental health can only be understood in the context of homosexuality throughout history, since religious and moral objections to sexual attraction between men have existed for centuries. Men who desired other men were regarded as sinful and depraved if not ill or abnormal, and same sex contacts were not distinguished from lewd behaviors (Weeks, 1989). Although most people, regardless of sexual orientation, have experienced some feelings of personal rejection, rarely do heterosexuals become targets for disapproval based on the nature of their attractions and behaviors relative to the same and to the other sex. For lesbians, bisexuals, and gay men, however, homosexuality becomes the focus of aspects of themselves that make them feel hated and hateful (Isay, 1989). While gay men and lesbians are often considered together because of the same-sex nature of their relationships and the similar issues that they may experience in their treatment within society, there are many issues where they might be best studied separately. Issues involving with health, parenthood, sexuality and perceived roles and status in society, for example, are often related more to gender than to any shared concept of a 'gay and lesbian community'. Many issues surrounding lesbians and lesbian culture will have more to do with women's issues, and some issues involving with gay men will have more to do with the gay male subculture and with masculinity. The author of this paper has limited experience in working with lesbian and bisexual individuals, and although it is likely that some of the concepts articulated in this paper could translate to working with lesbian and bisexual individuals, further research is indicated to examine the beneficence of utilizing a Self Psychological orientation in psychotherapy with lesbian women and bisexual individuals. This paper presents an overview of the literature including historical treatments of homosexuality, the history of Self Psychology, key principles in Self Psychology, research on Self Psychology, identity development models for gay men, and Self Psychological perspectives on identity development related to gay men. The literature review is followed by a section on treatment implications for psychologists seeking to treat gay men, including case vignettes based on work from my own practice. I have preserved the anonymity of clients by changing demographics, and rearranging and combining presenting issues and historical backgrounds among the case examples.

Health-Sector Responses to Intimate Partner Violence Fitting the Response Into the Biomedical Health System or Adapting the System to Meet the Response?

This study aims to analyze how middle-level health systems’ managers understand the integration of a health care response to intimate partner violence (IPV) within the Spanish health system. Data were obtained through 26 individual interviews with professionals in charge of coordinating the health care response to IPV within the 17 regional health systems in Spain. The transcripts were analyzed following grounded theory in accordance with the constructivist approach described by Charmaz. Three categories emerged, showing the efforts and challenges to integrate a health care response to IPV within the Spanish health system: “IPV is a complex issue that generates activism and/or resistance,” “The mandate to integrate a health sector response to IPV: a priority not always prioritized,” and “The Spanish health system: respectful with professionals’ autonomy and firmly biomedical.” The core category, “Developing diverse responses to IPV integration,” crosscut the three categories and encompassed the range of different responses that emerge when a strong mandate to integrate a health care response to IPV is enacted. Such responses ranged from refraining to deal with the issue to offering a women-centered response. Attempting to integrate a response to nonbiomedical health problems as IPV into health systems that remain strongly biomedicalized is challenging and strongly dependent both on the motivation of professionals and on organizational factors. Implementing and sustaining changes in the structure and culture of the health care system are needed if a health care response to IPV that fulfills the World Health Organization guidelines is to be ensured.

Avaliação do comportamento mecânico de blindagens balísticas

Desde os primórdios da história, o ser humano tem procurado criar e aperfeiçoar mecanismos que o protejam das agressões do inimigo. Neste sentido, o desenvolvimento técnico e científico em torno das blindagens tem procurado contrariar o constante aperfeiçoamento dos projécteis e do seu poder de penetração. De facto, as blindagens são muitas vezes desenvolvidas para fins específicos de forma a aumentar o seu desempenho na protecção de pessoas e equipamentos. Para cumprir este objectivo, é muitas vezes necessário recorrer a soluções inovadoras, tanto em termos dos materiais e da respectiva qualidade/quantidade utilizada no fabrico, como ao nível do formato da própria blindagem. A avaliação do desempenho das blindagens é extremamente importante para garantir a segurança do utilizador nas mais diversas actividades, tanto militares, como civis. No entanto, esta informação é considerada muitas vezes sigilosa pelo risco que representa para a sociedade militar e civil, e/ou por fortes interesses económicos por parte das empresas que comercializam estes equipamentos de protecção. Quando realizada, esta avaliação restringe-se geralmente a aspectos meramente qualitativos, tais como a verificação do dano produzido pelo projéctil. No entanto, não é usual avaliar o valor da energia remanescente de impacto que, não sendo absorvida pela blindagem, é transmitida ao utilizador ou equipamento. Por outras palavras, será a não penetrabilidade da blindagem uma condição suficiente para garantir a segurança? A presente investigação incidiu no desenvolvimento de uma metodologia experimental inovadora que permita quantificar a energia remanescente de impacto, transmitida através da blindagem ao utilizador, a quando da interacção com o projéctil. Para permitir realizar os ensaios balísticos em condições laboratoriais controladas foi desenvolvido um sistema de impulsão electromagnética que possibilita a ausência de ruído, de fumos ou clarões, consentindo o disparo de diferentes tipos de projécteis com ajuste contínuo da energia de impacto. Para testar a metodologia desenvolvida foram utilizadas blindagens representativas das actividades do Exército Português. De facto, o contributo do presente trabalho permite preencher uma lacuna na avaliação de blindagens, apresentando-se como uma mais-valia, na medida que poderá ser utilizado futuramente pelo Exército Português para uma avaliação independente de blindagens.