La experiencia de los receptores en el trasplante de órganos y tejidos

El trasplante de órganos y/o tejidos es considerado como una opción terapéutica viable para el tratamiento tanto de enfermedades crónicas o en estadios terminales, como de afectaciones no vitales, pero que generen una disminución en la calidad de vida percibida por el paciente. Este procedimiento, de carácter multidimensional, está compuesto por 3 actores principales: el donante, el órgano/tejido, y el receptor. Si bien un porcentaje significativo de investigaciones y planes de intervención han girado en torno a la dimensión biológica del trasplante, y a la promoción de la donación; el interés por la experiencia psicosocial y la calidad de vida de los receptores en este proceso ha aumentado durante la última década. En relación con esto, la presente monografía se plantea como objetivo general la exploración de la experiencia y los significados construidos por los pacientes trasplantados, a través de una revisión sistemática de la literatura sobre esta temática. Para ello, se plantearon unos objetivos específicos derivados del general, se seleccionaron términos o palabras claves por cada uno de estos, y se realizó una búsqueda en 5 bases de datos para revistas indexadas: Ebsco Host (Academic Search; y Psychology and Behavioral Sciences Collection); Proquest; Pubmed; y Science Direct. A partir de los resultados, se establece que si bien la vivencia de los receptores ha comenzado a ser investigada, aún es necesaria una mayor exploración sobre la experiencia de estos pacientes; exploración que carecería de objetivo si no se hiciera a través de las narrativas o testimonios de los mismos receptores

Análisis de las variables que inciden en la eficiencia de la gestión clínica en el área de consulta externa

La eficiencia en la gestión clínica de los médicos generales es un pilar fundamental en el control de los recursos en salud y puede generar un impacto positivo en la reducción de gastos innecesarios en el sistema. Se realiza un estudio analítico en donde se diseña una encuesta transversal para identificar las principales variables que puedan influir en la toma de decisiones de los médicos generales en una IPS de Bogotá, y se aplicó a 20 médicos. Los resultados encontrados fueron contrastados con la literatura actual. Se agruparon los resultados con variables como: relación profesional de la salud, organización y costo médico; pertinencia en la remisión a especialistas y formulación de medicamentos y paraclínicos, formación en pregrado de administración en salud, número de trabajos, cansancio físico, y finalmente, se analiza la influencia de la edad con otras variables descritas. Los resultados evidenciaron falta de conciencia por parte de los médicos con relación al control de los recursos que se relacionan con la mala derivación de los pacientes a los especialistas y la formulación de exámenes paraclínicos sin pertinencia adecuada. Sobre los factores descritos influyen características como la edad del médico, la adherencia a las guías de manejo, el cansancio físico y las características del paciente. Por otro lado hay una clara división con relación a la dirección y los médicos, no hay seguimiento a su desempeño, tampoco incentivos que promuevan la prestación del servicio con calidad, capacitación permanente, ni una remuneración adecuada. Finalmente, identificados dichos factores se plantean estrategias de intervención, y con esto generar un impacto adecuado en la optimización del recurso y mejoría de las condiciones laborales.

Sobrevida y factores relacionados con reintervención en pacientes tratados con valvuloplastia aórtica con balón en la Fundación Cardioinfantil

Introducción: La valvuloplastía aórtica con balón (VAB) es el procedimiento de elección para el manejo de La estenosis valvular aórtica en pediatría. La mortalidad y la supervivencia libre de reintervenciones no han sido evaluadas en Colombia. Objetivo: Determinar la sobrevida global y los factores asociados de reintervención valvular aórtica (RVA) en los pacientes tratados con VAB en la Fundación Cardio infantil – Instituto de Cardiología entre febrero del 2005 y marzo del 2013. Métodos: estudio estudio analítico de cohorte Resultados: Se evaluaron 69 VAB. La edad promedio de realización fue de 74,89 meses. La relación hombre: mujer de 4:1. Un 30,5% de los pacientes tenían malformaciones cardiacas asociadas. Se presentaron complicaciones en 13% de las VAB. La presión sistólica del ventrículo izquierdo presento una reducción promedio de un 63,6%. Se siguieron el 81,2% de las VAB, encontrando a los 9 años de seguimiento, supervivencia de 89,2% y necesidad de RVA en 14,2% de las VAB, siendo más frecuentes en VAB con gradiente post-VAB mayor de 35 mmhg (p= 0.005), con un RR de 6.6. Los otros factores no mostraron relaciones estadísticamente significativas (edad, morfología valvular, malformaciones asociadas, insuficiencia aórtica post-VAB). Conclusiones: La VAB es eficaz en el manejo de la EVA congénita, con una mortalidad y supervivencia libre de RVA similares a las encontradas en estudios previamente publicados. El gradiente post VAB mayor de 35 mm hg fue el único factor de riesgo que se correlacionó con la supervivencia libre de RVA.

On approximate electromagnetic cloaking by transformation media

We give a comprehensive study on regularized approximate electromagnetic cloaking in the spherical geometry via the transformation optics approach. The following aspects are investigated: (i) near-invisibility cloaking of passive media as well as active/radiating sources; (ii) the existence of cloak-busting inclusions without lossy medium lining; (iii) overcoming the cloaking-busts by employing a lossy layer outside the cloaked region; and (iv) the frequency dependence of the cloaking performances. We address these issues and connect the obtained asymptotic results to singular ideal cloaking. Numerical verifications and demonstrations are provided to show the sharpness of our analytical study.

An introduction to television studies. 3rd edition.

This is a comprehensive textbook for students of Television Studies, now updated for its third edition. The book provides students with a framework for understanding the key concepts and main approaches to Television Studies, including audience research, television history and broadcasting policy, and the analytical study of individual programmes. The book includes a glossary of key terms used in the television industry and in the academic study of television, there are suggestions for further reading at the end of each chapter, and chapters include suggested activities for use in class or as assignments. The case studies in the book include analysis of advertisements, approaches to news reporting, television scheduling, and challenges to television in new contexts of viewing on computers and mobile devices. The topics of individual chapters are: studying television, television histories, television cultures, television texts and narratives, television genres and formats, television production, television quality and value, television realities and representation, television censorship and regulation, television audiences, and the likely future for television.

Cooperação, capital social e desempenho econômico: um estudo analítico

O objetivo deste artigo é definir capital social como infra-estrutura social e procurar incluir tal variável num modelo de crescimento econômico. O capital social, visto de tal forma, teria impacto sobre a produtividade dos fatores de produção. Em primeiro lugar, discutirei como as variáveis institucionais podem afetar o crescimento. Em segundo lugar, analisando várias definições de capital social, mostrarei quais são as virtudes e problemas de cada uma e definirei, para a introdução de tal variável num modelo de crescimento, capital social como infra-estrutura social. Por fim, tentarei abrir espaço para estudos empíricos posteriores, tanto no campo da mensuração de estoque de capital social, como em estudos entre economias no sentido de captar o impacto do capital social sobre o crescimento econômico.

A metodologia do ensino superior e a sua significação para a formação do professor de ensino superior feita nos cursos de mestrado em educação

A formação dos docentes para o magistério superior é uma das funções dos Cursos de Mestrado. Na pesquisa das condições em que se desenvolve a formação do professor de Ensino Superior nos Cursos de Mestrado em Educação, identificam-se. entre outras disciplinas básicas, algumas especificamente didáticas: a Metodologia do Ensino Superior no IESAE/cMEd, a Didática do Ensino Superior na UFRJ/CMEd e a Metodologia Didática na PUC/CMEd. Verifica-se não serem obrigatórias essas disciplinas para todos os mestrandos, fato que leva a supor serem suas funções insuficientemente definidas na estrutura curricular desses Cursos, no tocante ã formação do docente. Julgando-se desempenharem essas disciplinas uma mesma função na formação do professor, precisamente daquele que se destina ao magistério superior, supõe-se que a falta de definição do papel por ela desempenhado no currículo dos mestrandos em Educação resulta da imprecisão dos termos Metodologia do Ensino Superior, Didática do Ensino Superior e Metodologia Didática. Esta imprecisão é constatada ao examinar-se a literatura especializada e ao analisar-se as respostas dos mestrandos que cursaram estas disciplinas e que as lecionaram. Os resultados das reflexões dos professores feitas conduziram a opção da Metodologia do Ensino Superior como disciplina eminentemente formativa do docente para este nível de ensino, por considerá-la mais abrangente do que as demais. Pelo mesmo motivo, defende-se sua obrigatoriedade de no currículo de todos os mestrandos em Educação. Caracteriza-se a MES pela interdisciplinar idade, definindo-a como método de trabalho reflexivo, tico e elaborativo que possibilita ao professor de Ensino Superior conduzir adequadamente o processo ensino-aprendizagem. o trabalho consta de duas etapas: a fundamentação teórica e a pesquisa de campo. Na primeira foram feitas: a revisão da literatura, a definição da função da Metodologia do Ensino Superior na formação dos professores e o estudo analítico dos programas das disciplinas Metodologia do Ensino Superior, Didática do Ensino Superior e Metodologia Didática. A pesquisa de campo consiste em aplicação de questionários e entrevistas. o universo da pesquisa compõe-se de todos os mestrandos que cursaram as disciplinas Metodologia de Ensino Superior, Didática do Ensino Superior e Metodologia Didática, dos professores destas disciplinas e dos Coordenadores dos Cursos de Mestrado em Educação do IESAE, da UFRJ e da PUC, respectivamente(1976). Os pressupostos e questionamentos que orientam a pesquisa referem-se à imprecisão conceitual da Metodologia do Ensino Superior e a seu papel indefinido na formação do professor de Ensino Superior.

Relação entre ambiente familiar e capacidade funcional de idosos residentes no município de Jequié-BA

(Objective) Assess the functional capacity and determine the difference between the means of functional capacity (basic and instrumental activities of daily living) and the age groups of elderly residents in an outlying area in the hinterland of Bahia/Northeast of Brazil. (Methods) Analytical study with cross-sectional design and a sample of 150 elderly individuals enrolled in four Health Units in the municipality of Jequié, Bahia, Brazil. The instrument consisted of sociodemographic and health data, the Barthel Index and the Lawton scale. (Results) In all, 78.00% of the elderly were classified as dependent in the basic activities and 65.33% in the instrumental activities of daily living. Using the Kruskal- Wallis test, we found a statistically significant difference between the means of instrumental activities and the age groups (p= 0.011). (Conclusion) An elevated number of elderly were classified as dependent in terms of functional capacity and increased age is related to greater impairment in the execution of instrumental activities of daily living

Uma visita ao universo matemático de Lewis Carrol e o (re)encontro com sua lógica do nonsense

Notable mathematics teacher, Lewis Carroll, pseudonym of Charles Lutwidge Dodgson (1832-1898), made the mixture of mathematics with literature a ludic environment for learning that discipline. Author of Alice s Adventures In Wonderland and its sequel Alice Through The Looking Glass, he eventually created a real and complex universe which uses what we call the logic of the nonsense as an element to motivate the development of mathematical thinking of the reader, taking it as well, learn by establishing a link between the concrete (mathematics) and the imaginary (their universe). In order to investigate and discuss the educational potential of their works and state some elements that can contribute to a decentralized math education from the traditional method of following the models and decorate formulas, we visited his works based on the studies of archeology of knowledge (FOUCAULT, 2007), the rational thought and symbolic thinking (VERGANI, 2003) and about the importance of stories and narratives to the development of human cognition (FARIAS, 2006). Through a descriptive, analytical study, we used the literary construction and presented part of our study in form of a mathematical novel, to give the mathematical school a particular charm, without depriving it of its basics properties as discipline and content. Our study showed how the works of Carroll have a strong didactic element that can deploy in various activities of study and teaching for mathematics classes

Saúde Mental e enfermagem: em busca da integralidade na ESF

The present work shows an inquiry about the conceptions and practical work of the nursing professionals on the accompaniment of mental sick patients in the Family s Health Strategy, under the approach of the completeness in health. The justification of this research is given by bringing an special attention concerning the subjet to these professionals of health: the gradual abandonment of the traditional manicomial model leads to the insertion of mental patients in the community . The nursing professionals must be prepared to receive these patients in the basic net of health and contribute to help their adaptation and insertion in the social environment as citizen. In this context, considering the entire attention to the mental health, it is important to detach that the assistance to the patient must search his reinsertion in the community by providing programs that develops his sociability. This analytical study was developed using a qualitative approach and a thematic verbal history. Ten nurses of Nova Natal s Health of the Family Unit, of Felipe Camarão Mista s Unit and of Cidade da Esperança s Health Unit contributed for its development . The information was acquired through an instrument research that made possible the accomplishment of the interviews. These ones were set previously and counted on the assent of the participants. The interviews were recorded and analyzed in accordance with the pertinent literature concerning the subject. The aggregation of the information was then discussed. At this moment three thematic axles were defined dividing the categories of analysis. According to the results of the interviews, the practical procedure given to the patients with mental upheaval is resumed by the prescription of psicotroprics medicaments. It doesn t provide an accompaniment by the professionals of health, specifically, nurses, to the patients and their families. The lack of qualification and a multi-professional team emerged as one of the challenges for the implementation of practical procedures towards the patients with mental upheaval. Therefore, the results of this research show the necessity of transformations in the current scene of the mental health in the Family s Health Strategy. These changes can be reached by politics investments on the mental health area, not only financially but by providing human resources that should allow the professionals to exert the completeness procedures

Custo-efetividade da terapia compressiva no processo de cicatrização de úlceras venosas

Analytical study of therapeutic nonrandomized intervention type, intra-group controlled, with the aim of analyzing the cost-effectiveness of compression therapy with manipulated Unna boot in relation to conventional therapy in the healing of venous ulcers (VU) of patients treated in ambulatory clinic. The study population was composed by patients with VU treated by angiologists in Surgical Clinic Ambulatory of the Onofre Lopes University Hospital (HUOL) with a sample of 18 patients. It obtained the assent of the HUOL Ethics in Research Committee (Protocol 276/09). Data collection was performed over a period of four months by the own master's student and 34 nursing students, through the application of the research instrument in the admission of patients to the study and in the ten subsequent evaluations, performed at the time of changing Unna boot, weekly, for a maximum period of 10 weeks. The data were analyzed with SPSS 15.0 software, using descriptive and inferential statistics, and presented as tables, charts and graphs. Among those surveyed, prevailed: females, mean age 57.6 years, low education and income levels, most retired, unemployed or off work, with the standing position more than six hours per day and up to eight hours daily of domestic or occupational activities. In health status profile of respondents there were predominantly sleep, rest and inadequate elevation of the lower limbs, no smoking and/or alcohol use, presence of hypertension and no use of drugs. Most presented the first VU for over 10 years, recurrences, present VU for more than five years, involvement of left leg, in malleolar and / or distal leg region, mild edema, hyperpigmentation, lipodermatosclerosis, telangiectasies, reticular and varicose veins, mild pain, serous exudate in moderate quantity, small lesions (up to 50cm2), with predominance of granulation tissue and / or epithelialization and demarcated, elevated and irregular borders, with crusts and macerated. Most patients reported that in the 10 weeks prior to admission, made bandages at home and / or Basic Health Unit and / or ambulatory, with nursing aides or technicians, daily, and on weekends or holidays, performed by patients themselves, using healing ointment on the lesion, being observed granulation / epithelialization and increase in VU prevalent in the 10 weeks of traditional treatment. After follow up with manipulated Unna boot, was observed a decrease of lesions in all study patients, with complete healing in 27.8% of those between 1 and 5 weeks of treatment, with satisfactory evolution of the lesions, pain and ankle and calf circumferences, and unsatisfactory development of the borders of ulcers, edema, sleep, rest and elevation of the lower limbs, especially in more chronic patients. Furthermore, patients who achieved total healing and exhibited the greatest percentage reduction of lesions had a higher number of wound healing factors (ρ = 0.01 and ρ = 0.027, respectively). The manipulated Unna boot showed better results in those patients with shorter duration of injury, leading them to a satisfactory outcome within a short period of treatment. After the cost-effectiveness analysis, we conclude that the manipulated Unna boot is more effective than conventional therapy in the healing process of VU and is more cost-effective in patients with shorter lesions (ρ = 0.001), shorter treatment (ρ = 0.000) and greater number of wound healing factors (ρ = 0.005).

Atividades profissionais da enfermagem no contexto hospitalar: influências nas relações de trabalho

The present study is based on an analysis of professional work relationships in the nursing team from the task/skills of its members as a contribution to understanding the work process in nursing. It is aimed to identify the skills of the nursing team members through the vision of nurses, technicians and nursing assistants, thus it attempts to find strategies to improve the health assistance to patients. It is a descriptive and analytical study with a qualitative approach grounded in theoretical and methodological framework of Symbolic Interactionism. The research was carried out in the participant work place, a Public Hospital of Reference for the SUS, located in the eastern health district of Natal/RN. Nineteen nursing professionals participated in the study, which seven was nurse and twelve nursing technician. As procedure to collect data we used an unstructured interview accompanied by a standard topic guide which was recorded and later transcribed. The content analysis was chosen as the main methodology to analyze the discussion, which gave rise to thematic categories that were considered relevant based on the theoretical framework of this study, and the interactionist theory. This study was in accordance with the ethical principles of the Resolution nº. 196/96, it has obtained an appropriate consent of the UFRN Research Ethics Committee. The results indicate that the professionals seen the nursing as a profession strongly attached to the health care process and as a profession that acquired a scientific status very recently. Regarding to the nursing functions in the work process in nursing, the professionals they identified the manage/administer category as the main activities developed by these professionals, thus the education and complex care in nursing categories. Concerning to the technicians and nursing assistants functions, it was figured out in the professional s opinion that there is not distinction among the attribution of these categories. The interviewed were unanimous in report that these professionals are more involved in direct patient health care through performance of basic duties in nursing care. Finally, with regard to the work relationship among nursing team members, the majority of those interviewed see this relationship as disharmony and quarrelsome and in general, there is not bond between categories that comprise the process of work in nursing. On the basis of our results we consider the importance of knowing the meaning of nursing given by these professionals; also their skills could be useful as basis to identify problems, which source could be detected in the power relationship, deviations of functions, gap between design (knowledge) and performance (doing) work, besides the loss of the global activities view in the process of nursing work

O trabalho do enfermeiro de um hospital pediátrico de ensino e o SUS: desafios a enfrentar

This study analyzes the point of view of nurses working at a pediatric teaching hospital on their work process within the scope of the Brazilian unified healthcare system SUS, in order to identify factors that interfere with its development and find out how work relations are taking place between nurses, other nursing professionals and the multidisciplinary staff. It is a descriptive and analytical study, qualitative in nature, which starts with a consideration of a nurse s current practices and moves on to reflect on a perspective of transformation aiming at rethinking their work process pursuant to the principles of SUS. In order to attain these objectives, we decided on using the focal group as a data-collecting technique, which took place from November to December 2005, by using as instruments a questionnaire for the characterization of the persons being researched and a discussion outline. Theoretical support has approached transformations in the world of work, placing it in the context of healthcare and nursing and has tried, specifically, to understand the work process of a nurse engaged in the production of health services. Therefore, the discourse analysis of participants, in the light of theoretical support, has evinced an ambiguity inasmuch as though identified as such in their work process, nurses are also fulfilling multiple functions in health services. Through this study it has also been possible to identify several factors that interfere with the work of these professionals, including poor working conditions and excessive hiring of high school graduate interns as an attempt to make up for a meager nursing workforce, as well as reveal the possibilities brought about by the SUS in retargeting its professional practice to interdisciplinarity and integrality

Autoestima e qualidade de vida de pessoas com úlcera venosa atendidas na atenção primária

Venous ulcers (VU) is a chronic injury of the lower extremities and because of its high incidence and recurrence implies long and complex treatments, damaging the quality of life (QOL) and self-esteem (SE) of the people. This study aimed to analyze the association between self-esteem with the quality of life of people with venous ulcers treated in primary care. Cross sectional analytical study with a quantitative approach conducted with 44 people met with VU at 13 primary care units 2 and Mixed units in Natal/RN. The study was approved by the Ethics Committee in Research of the Federal University of Rio Grande do Norte (UFRN), CAAE: 07556312.0.0000.5537. Held data collection from February to April 2014 and used three instruments: a structured form covering sociodemographic, health care and clinical variables, the Rosenberg Self-Esteem Scale and the SF-36. The collected data were entered into a database and processed on computerized software for descriptive and inferential analyzes. The results showed a predominance of people with UV females (65,9%), with more than 60 years (59,1%), married or in a stable relationship (52,3%), low education (86,4%) without occupation (68,2%) and less than one minimum wage income (81,8%). Regarding assistance characteristics was observed that most patients performed the dressing with appropriate material (72,7%), professional or trained caregiver (61,4%) did not use compression therapy (81,8%), treating the injury for more than 6 months (77,3%), lack of guidelines for the use of compression therapy, elevation of legs, and regular exercise (77,3%) and consulting the angiologist last year (52,3% ). Regarding clinical features of the lesion was found that most of the recurrent lesions are (77,3%), over one year of current lesion (52,3%) medium to large lesions (54,8%), without signs of infection (61,3%) and pain (79,5%). The mean SE of respondents was 9,3 (± 5,1). The relations between the SE and the sociodemographic variables, health care and clinics showed that individuals without a partner (a) (p = 0,01), who did not wear compression therapy (p = 0,04), with more 6 months of treatment (p = 0,01) and larger lesions (p = 0,01) had a lower SE. The mean domain and the dimensions of the SF-36 were lower emphasizing the functional capacity 36.5 (± 27,6) and the physical aspects of 15.3 (± 30,6). There were significant correlations between AE people with VU and the domains and dimensions of the SF-36: physical functioning (r = -0,432), general health (r = -0,415), vitality (r = -0,573), aspects social (r = -0,517), mental health (r = -0,612) and mental health dimensions (r = -0,612) and physical health (r = -0,473). Based on these results it is concluded by rejecting the null hypothesis and accept the alternative proposed in the study in which it was found that there is a negative correlation between the SE and the QOL of people with venous ulcers

Desenvolvimento de monopolos quase-espirais para aplicações em sistemas UWB

This work is the analysis of a structure of the microstrip antenna designed for application in ultra wide band systems (Ultra Wideband - UWB). This is a prospective analytical study where they tested the changes in the geometry of the antenna, observing their suitability to the proposed objectives. It is known that the UWB antenna must operate in a range of at least 500 MHz, and answer a fractional bandwidth greater than or equal to 25%. It is also desirable that the antenna meets the specifications of track determined by FCC - Federal Communication Commission, which regulates the system in 2002 designating the UWB bandwidth of 7.5 GHz, a range that varies from 3.1 GHz to 10, 6 GHz. by setting the maximum power spectral density of operation in -41.3 dB / MHz, and defining the fractional bandwidth by 20%. The study starts of a structure of geometry in the form of stylized @, which evolves through changes in its form, in simulated commercial software CST MICROWAVE STUDIO, version 5.3.1, and then tested using the ANSOFT HFSS, version 9. These variations, based on observations of publications available from literature referring to the microstrip monopole planar antennas. As a result it is proposed an antenna, called Monopole Antenna Planar Spiral Almost Rectangular for applications in UWB systems - AMQEUWB, which presents simulated and measured results satisfactory, consistent with the objectives of the study. Some proposals for future work are mentioned