Concordancia del diagnostico radiológico vs biopsia en patología pulmonar

En Colombia, la patología pulmonar es una de las causas mas frecuentes de consulta y morbilidad de servicios de medicina general y de medicina interna. Algunas de las patologías que se presentan a nivel neumológico requieren de un diagnostico exacto para su adecuado tratamiento, ya sean estas de índole infeccioso, tumoral u ocupacional. El Hospital Santa Clara (ESE) es una institución pública de referencia en enfermedades neumológicas en Bogotá y durante muchos años en el país. El servicio de anatomía patológica cuenta con un archivo sistematizado desde 1997 en el cual se identificó cada paciente con los diagnósticos emitidos por estudio de lavado broncoalveolar (BAL), biopsia transbronquial y biopsia abierta. Con los datos de este archivo y teniendo acceso a las historias clínicas de los pacientes fue revisado el diagnostico radiológico previo a las pruebas de patología para evaluar el grado de correlación entre los mismos. Se encontró registro de 268 pacientes en la base de datos ya mencionada, sobre los cuales se realizo el análisis por variables encontrando que la mayoría de procedimientos se realizo en hombres, con una edad promedio de 51 anos y diagnóstico más frecuente con el estudio anatomopatológico son las neoplasias primarias y el menos frecuente como es de esperarse por el fácil diagnostico de la misma con estudios no invasivos es la TBC. Para el estudio de concordancia diagnostica solo se tubo acceso a la información completa de 58 pacientes sobre los cuales se hizo el análisis encontrando un grado de concordancia débil (Kappa de 0.3236). El bajo grado de concordancia diagnostica encontrado podría estar influenciado por los problemas metodológicos propios de un estudio en el cual la información es tomada de historias clínicas, teniendo en cuenta que no se pudo hacer control de sesgos tan importantes como el grado de entrenamiento y experiencia de los diferentes radiólogos que realizaron la lectura, lo cual tiene también gran influencia en los resultados. Es necesario realizar estudios futuros donde se tenga en cuenta las dificultades técnicas que se tuvieron durante el desarrollo de este trabajo por la metodología utilizada y la influencia que pueden tener en los resultados para mejorarlos.

Bioética y universidad: el hospital universitario, ¿público o privado?

Para el aprendizaje de la medicina, la práctica directa con el paciente es fundamental, con el fin de poder aplicar de manera adecuada los conocimientos teóricos. De hecho, sin esta práctica, el aprendizaje de la medicina no se consolida. Por lo tanto, el hospital se convierte en el aula docente más importante durante el entrenamiento del médico. Ancestralmente han sido los hospitales públicos, antaño de caridad, los que acogían a las facultades de medicina, concepto inherente al modelo paternalista de la medicina. Sin embargo, con el cambio de paradigma hacia una medicina respetuosa de la justicia y la autonomía, es indispensable replantearse si esta educación en sitios donde se atienden primordialmente pacientes del régimen contributivo o subsidiado es ético. Esta discriminación atenta contra la justicia, la dignidad de las personas y su autonomía. No existen criterios reales que permitan discriminar de esta manera la educación, y ésta debe desarrollarse en todos los ámbitos: públicos y privados.

La educación secundaria y sus dos dimensiones, efectos del barrio y del colegio sobre los resultados saber 11.

Resumen: Este trabajo estudia los resultados en matemáticas y lenguaje de 32000 estudiantes en la prueba saber 11 del 2008, de la ciudad de Bogotá. Este análisis reconoce que los individuos se encuentran contenidos en barrios y colegios, pero no todos los individuos del mismo barrio asisten a la misma escuela y viceversa. Con el fin de modelar esta estructura de datos se utilizan varios modelos econométricos, incluyendo una regresión jerárquica multinivel de efectos cruzados. Nuestro objetivo central es identificar en qué medida y que condiciones del barrio y del colegio se correlacionan con los resultados educacionales de la población objetivo y cuáles características de los barrios y de los colegios están más asociadas al resultado en las pruebas. Usamos datos de la prueba saber 11, del censo de colegios c600, del censo poblacional del 2005 y de la policía metropolitana de Bogotá. Nuestras estimaciones muestran que tanto el barrio como el colegio están correlacionados con los resultados en las pruebas; pero el efecto del colegio parece ser mucho más fuerte que el del barrio. Las características del colegio que están más asociadas con el resultado en las pruebas son la educación de los profesores, la jornada, el valor de la pensión, y el contexto socio económico del colegio. Las características de los barrios más asociadas con el resultado en las pruebas son, la presencia de universitarios en la UPZ, un clúster de altos niveles de educación y nivel de crimen en el barrio que se correlaciona negativamente. Los resultados anteriores fueron hallados teniendo en cuenta controles familiares y personales.

Os efeitos do financiamento do BNDES sobre o lucro e o crescimento das empresas

A presente dissertação tem por objetivo articular os conceitos de estratégia e políticas públicas, orientadas para o papel do BNDES no contexto brasileiro. A expressividade da atuação do BNDES, a origem de seus recursos e a relevância de seus desembolsos ratificam a importância dos financiamentos da instituição para a economia doméstica.

Geometrizando no segundo ciclo :relato de uma intervenção pedagógica voltada à construção de conceitos geométricos no ensino fundamental

This work has proposed to relate the experience product of a pedagogical intervention, performed in a public institution of teaching situated in this capital. It had as objective to validade the applying of a teaching module of geometry, more specifically about the conceptions of perimeter and área in the second cycle of fundamental teaching. This dissertation has presented the problematic which involves the teaching of geometry in different contexts. It has adopted the broach of the radical constructivism while methodological theoretical referencial through which it has tried to explain the phenomena that involves the teaching and the apprenticeship. It appropriates Jean s Piaget contributions related to the development stages, while referencial that will dialogue in the search by sense and comprehension of the geometric apprenticeship process and it runs over Richard s Skemp (1980) theory in order to explicit the student s apprenticeship according to the levels of instrumental comprehesion and relacional comprehension . The research has presented datum related to initial diagnosis evaluantion, the pedagogical intervention and analysis of the activities and students perfomance displaying still the results of the final evaluation. According to the results got, we could check the students group growth front to the acquisition of the concepts of perimeter and área in comparison with the previous knowledges presented in the initial diagnosis evoluation of the students participants of the research. We have concluded evaluating the objectives of the research, connecting the strategies and reasoning employed by the students in order to resolve the questions and then to reach the objectives proposed by the teaching module. We have presented still the main obstacles to the apprenticeship of such concepts

Proposta Curricular para Educação infantil: (re) significando saberes docentes

The theory contemporary in the field of early children education, as well the legal discourse and official texts valid in our country point to the need for systematization of proposals pedagogic / curriculum in institutions, built and carried out by subjects that act as factor of assurance care quality. Quest us about what knowledge are required to teachers in developing a proposed curriculum for children education. Defined as an object of study, the knowledge teachers necessary for the development of a proposed curriculum for children education. As goals, assume: investigate teachers knowledge necessary for the development of a proposed curriculum in a Public Institution for children education and contribute to the (new) meaning on the part of teachers, knowledge needed to build a proposed curriculum for children education. Assuming the principles of the paradigm of qualitative research, we have developed a research institution of a children education Network Public Hall of Ceará-Mirim-RN, which serves children of four and five years old (preschool) with the participation of 17 teachers and two supervisory (teachers) that institution - subject of our research. Therefore, we have adopted the principles of action research, according to which the knowledge gained through research should build so shared / dialogue in the relationship between researcher and participants, what is the implementation of an effective action formative. As the search procedures developed observations no-teaching participants in the meetings and activities of the classroom; semi-structured interviews (individual and collective) with teachers and supervisors; analysis of school documents and participant observation in the seminars of studies reflective. The latter is implemented as key moments of speech and thought, and finally to (new) meaning of knowledge, the subject of the research-action. For these knowledge, the systematization of the register built was developed based on the principles of analysis of Content that guided us to the definition of two categories 1) knowledge teachers concerning conceptions of curriculum / proposed curriculum and 2) knowledge teachers concerning specifics of children education. From these were built subs representing thematings more specific and significant, among the many that emerged in the analysis: 1.1) Definitions of curriculum and curriculum proposal; 1.2) The subjects makers / implementing a curriculum / proposed curriculum; 1.3) elements constituting a curriculum / proposed curriculum for children education and 2.1) Functions of children education and conception of child; 2.2) The space of the play in the organization of routine. Under the intervention could significant advances with regard to (new) meaning of such knowledge from the subjects, with major disruptions to their original designs. These are presented and reflected in this work. In front of this movement, transformation, made the need for a permanent work in the context of the institution of in-service training, or mediated by pedagogical coordinator or other to assume this role with teachers, in order to provide the development and effectiveness of proposed curriculum consistent and contextualized in practice effective with the children concrete envisage the service to their specificities and a quality education

Fugindo da banalidade: o uso do orkut como extensão da sala de aula

This dissertation investigated the insert and use of the education technologies in the on-line social net Orkut, as an extension of the classroom, especially for debates. With that experience accomplished in a discipline of a Brazilian public institution of higher education, it was tried to go beyond the use of the atmosphere for entertainment and to look Orkut as a tool of assistance to the process of teaching and learning. The research was based in the Paulo Freire´s communication concept and in the Célestin Freinet´s school cooperation concept. In this dissertation, in methodological terms, was adopted the category of the qualitative research. The adopted method was a combination of case´s study with research-action. The technique was the application of questionnaires, the collect of data was personal and the types of data were primary. Finally, introduces, then, prognostics about the future of the on-line social nets and finally suggest the formation of academicals on-line social networks

O desenvolvimento profissional docente e a participação colegiado no Atheneu Norte-Riograndense

To investigate the relationship that exists among the educational participation of the school board and the teacher's professional development, starting from the analysis teachers of a public institution who teaches daily in the city of Natal. We focused the possible relationships between the teacher's action and their professional development, which includes the participation of the School board, considered by us as a collective space. To accomplish this research we used Interviews (KAUFMANN, 1996; SILVA, 2002) to analyze the nine participants, who are teachers' of the school board, and their oral speeches, considered as main references of our study. While trying to understand the reasons that led the teachers to choose her/his educational profession, we noticed the difficulty of recognition of the job of lecturing as a profession. This fact comes as an obstacle to the perspective of the teachers' professional development. In what he/she refers to the forms of the teachers' participation in the board and their meanings, we noticed in first place that the feeling of it belongs one of the decisive factors it can be considered actively for the teacher to announce of the actions colegiadas. This for them to want and they believe that that is the best road for if they develop better while professionals and consequently to improve the situation of the school. In second place we noticed that the school board represents, a place of articulation of the equality among all the ones that form the school community. So, we tried to understand how they happened to the collective actions in the school, how the teachers presented them in spite of what they know, how a collective action should be presented in the elements of fragility of that process that inhibit the development of the overall action. Finally, we questioned the elements that would contribute to the educational professional development; we noticed that the teachers present the competence, the ethics and professional valorization, as factors that contributed at the present time to their educational professional development

A banalização da injustiça social no cotidiano de trabalho : a propósito da violência no trabalho e ameaça à saúde do trabalhador

Analyzes the factors that unleash violence by banalization of the problems and health questions of workers in a federal public institution, in Natal/RN. It analyzes transformations in the world of the work, with its politic, social and economic determinatives and its relation to the worker health. Boarding the violence in the work enviroment and its implications to the worker health, focusing on the banalization of problems faced by the workers as a kind of violence in and with the work. It was chosen an analitic methodology with qualitative approach, through the collection tecnic and information analyzes according to the thematic oral history, with recorders of authorized personal narratives, through individual interview with a semi-structured guide. In the analyzis of results it were made empiric cathegories: the daily work enviroment and its influence to the worker profession and life; the violence presents in the work enviroment and its consequences to the worker life and health; the banalization of the social injustice, due to violence against the worker that broked their dreams concerned to the nursing contribution. The results revealed the ordinary work of these workers showing enviromental and organizational unhealthy conditions, caracterized by physical and tecnical insecurity; absence and disqualification of instrumental and human supplies; overload and complexity service; bad distribution of the duties and pressure to the deadline and productivity, producing tension, conflict and anxiety related to the users, colleagues, superiors and to the duties. In the work enviroment, it were identified a external violence, caracterized by physical and verbal aggresion, psychic suffering, worker depreciation; and internal, caracterized by: moral and psychological molestations and accupational structural violence. These kinds of violence bring consequences to the life, that is, professional, economic and moral order of factors and to the health by biological, mental and emocional factors. The banalization of social injustice during the daily work was discussed in the aspects of banalization of problems and work conditions, the health, qualification banalizations and professional valorization. The workers expectatives pointed out to the necessity of: secure conditions of work; trainning and tecnical assistance; politics of attention to the physical, mental and social health to the workers and their family. We conclude the enviromental and organizational conditions of the workers interviewed do not offer physical and tecnical security that they need to the execution of their activities, neither offer comfort or physical and psychological satisfactions. The politic the instituition has used points out to the depreciation and inhumanization of them producing feelings as unsatisfaction, frustation and indignation related to the institution and the work, bringing suffering and physical and mental sicking. We noticed the most terrible violence found in the work enviroment is the banalization of social injustice related do the problems and health of these workers, producing a slowly debility and simbolic death of their lifes. Therefore, it is necessary the implementation of a politic that promotes assurance, health and integral education, valorization and humanization of these workers

O Gênero requerimento na perspectiva sociorretórica: análise da produção de graduandos no ambiente acadêmico-administrativo da UFRN

In administrative settings of public institutions, many activities are conducted through writing practices. Concerning this, writing is always connected to an activity we intend to perform. Among those practices, the genre request consists of an instrument through which the requirer addresses to an institution in order to request something under the support of legislation. Considering our work experience in a public institution of higher education, we elected - as object of our research - the genre request produced by undergraduates within the administrative domain of the Federal University of Rio Grande do Norte (UFRN) due to its importance in this context. For this, the theoretical framework adopted refers to the socio-rethorical conception of genre studies, which understands the genre as forms as rhetorically typified action (MILLER, 2009a; SWALES, 1990; BAZERMAN, 2009). Regarding methodology, it is a research associated to a qualitative approach (BODGAN; BIKLEN, 1994; CHIZZOTTI, 2010) whose discussion inserts into the field of Applied Linguistics. The data were generated from samples of requests and their users replies in questionnaires, interviews and verbal protocols of writing. The data analysis is based on the ethnographic methods of genre analysis postulated by Devitt, Reiff and Bawarshi (apud JOHNS et al., 2006). These analyses indicated that the requests are not always fully accomplished due to a lack of comprehension about the genre and its rhetorical situation on the part of the producers. It must probably happen - among other reasons - because these students may not have understood that several factors, such as: context, audience and purpose, affect the text production. We believe that one possibility to make the practice of this genre more efficient is to develop a more simple and practical way of elaborating requests, taking the needs imposed by the rhetorical situation as a basis

Avaliação e monitoramento de políticas públicas: criação de um modelo sistêmico aplicado ao Instituto de Assistência Técnica e Extensão Rural do Rio Grande do Norte (EMATER-RN)

The nature of this thesis is interventionist and aims to create an alternative on how to control and evaluate the public policies implementation developed at the Institute for Technical Assistance and Rural Extension of Rio Grande do Norte State. The cenarium takes place in a public institution , classified as a municipality that belongs to the Rio Grande do Norte government and adopts the design science research methodology , where it generates a set of artifacts that guide the development of a computerized information system . To ensure the decisions, the literature was reviewed aiming to bring and highlight concepts that will be used as base to build the intervention. The use of an effective methodology called Iconix systems analysis , provides a software development process in a short time . As a result of many artifacts created by the methodology there is a software computer able of running on the Internet environment with G2C behavior, it is suggested as a management tool for monitoring artifacts generated by the various methods. Moreover, it reveals barriers faced in the public companies environment such as lack of infrastructure , the strength of the workforce and the executives behavior

O trabalho docente em psicólogo e o enfrentamento da violência contra crianças e adolescentes: uma experiência teresinense

In this thesis I discuss the role of the psychologist as a university professor and as intellectual from a specific context and also from a specific query. The context is the city of Teresina, capital city of Piauí state, which is peripheral in Brazil s northeast region. The defiance here is to build a critical psychological tradition that will deal with the challenges imposed by the reality of poverty and socio-economic backwardness of the region. The greatest difficulty is the lack of a public institution of learning that carries out instruction, research and extension with commitment to social transformation, and with the production of a psychological knowledge that is able to understand local reality. I take it that the undergraduate course in Psychology at UESPI [State University of Piauí] is the only one in Teresina that can take over such mission. The query is confronting violence against children and adolescents that defies us to ethically and politically commit to solidarity toward fragile human beings in need of adult involvement in order to survive this daily inhumanity. The involvement of psychologists from Teresina in this must result from a social commitment and a technical competence to deal with prevention and therapeutic consideration toward the victims. This dissertation is divided into three parts: the first is a study on the curriculum and the performance of psychologists, which revises the academic output in Brazil and envisages new queries to the theme, such as the role of teaching inside the curriculum, and presents social security (including Medicare) as the privileged field in which Brazilian psychologists perform. The second part contains a study on the concepts of childhood, adolescence and violence, which presents a consideration on the strategies to confront violence against children and adolescents. In the last part I discuss the role of the psychologist as teacher and intellectual in the context undergraduate course in Psychology at UESPI [State University of Piauí] from the commitment to the protection of children and adolescents

Atividade do professor na educação a distância: interações com o gênero profissional docente

This research aimed to analyze the dynamics established between the activity of the teacher in Distance Education (DE) and professional gender of teaching, in terms of impact of DE in teacher s usual professional activity. Previous studies showed that one of the central discussions concerning DE refers to the role that the teacher is called to perform. The present research, based on theoretical and methodological assumptions issued from Clinic of Activity, analyzed the impact referred above. This central aim was operationally executed along three main stages: 1) survey study for description of socio-professional profile of teachers working in DE in two universities from Natal (RN-Brazil), 2) clinical analysis of professional activity of teachers working in DE, taking into account four simultaneous levels of psychological constitution and development of human activity: personal, interpersonal, transpersonal and impersonal; 3) analytical focus on transpersonal context in order to understand the influence of pedagogical practice in DE on professional gender of teaching. Documental research, audio recorded voice data and a multiple choice Likert scale questionnaire concerning socio-professional information were used as procedural tools. The qualitative-clinical procedural tool of instruction to the double , firstly proposed by Clinic of Activity research group, was used in order to obtain oral productions concerning professional activity. Data issued from stage 1 (n=70, 28 men and 41 women) was submitted to descriptive and inferential statistical analyzes. 65.7% of the sample worked in a public institution, 30% in a private institution, and 4.3% in public and private institutions. 31.4% of the sample of participants was formed by teachers having a master degree, 28.6% were doctors and 26.3% had degrees of specialists. 54.3% of participants acted as remote tutor, and 44.3% were regents teachers. After descriptive multidimensional cluster analysis, two groups emerged (remote tutors and regents teachers), the most important variables in terms of contributions to this distinction being: professional function, level of graduate formation, level of income, activities and forms of entry in DE. Clinical analysis of data produced by two participant-teachers of each group, issued from instruction to the double technique, was performed. This analysis indicated the existence of different models of distance education. A general concern referring to the need of both taking into account information technology and pedagogical attitudes was detected. On the other hand, participant-teachers considered that participation in DE activities could bring relevant contributions to general professional gender of teaching. . Finally, teachers warned against certain formats of organization of teachers professional activity, as found in the domain of DE, since these activities could promote the intensification and individualization of teachers` work activity, and even the worsening of relations, rather than exchanges and shares through collective bargaining. This process could compromise the renew of the professional gender, by losing its historical roots and diminishing activity possibilities of teachers in their labor context

O trabalho docente em psicólogo e o enfrentamento da violência contra crianças e adolescentes: uma experiência teresinense

In this thesis I discuss the role of the psychologist as a university professor and as intellectual from a specific context and also from a specific query. The context is the city of Teresina, capital city of Piauí state, which is peripheral in Brazil s northeast region. The defiance here is to build a critical psychological tradition that will deal with the challenges imposed by the reality of poverty and socio-economic backwardness of the region. The greatest difficulty is the lack of a public institution of learning that carries out instruction, research and extension with commitment to social transformation, and with the production of a psychological knowledge that is able to understand local reality. I take it that the undergraduate course in Psychology at UESPI [State University of Piauí] is the only one in Teresina that can take over such mission. The query is confronting violence against children and adolescents that defies us to ethically and politically commit to solidarity toward fragile human beings in need of adult involvement in order to survive this daily inhumanity. The involvement of psychologists from Teresina in this must result from a social commitment and a technical competence to deal with prevention and therapeutic consideration toward the victims. This dissertation is divided into three parts: the first is a study on the curriculum and the performance of psychologists, which revises the academic output in Brazil and envisages new queries to the theme, such as the role of teaching inside the curriculum, and presents social security (including Medicare) as the privileged field in which Brazilian psychologists perform. The second part contains a study on the concepts of childhood, adolescence and violence, which presents a consideration on the strategies to confront violence against children and adolescents. In the last part I discuss the role of the psychologist as teacher and intellectual in the context undergraduate course in Psychology at UESPI [State University of Piauí] from the commitment to the protection of children and adolescents