991 resultados para Tipos de úlceras


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Venous ulcers (VU), recurrent chronic wounds resulting from Chronic Venous Insufficiency (CVI), affect different age groups and would severely affect ambulation of patients. The lesions require treatment lasting and complex and are responsible for significant morbidity and mortality. Thus, this study aims to identify the important aspects covered in the scientific literature protocol for assisting patients with venous ulcers, identifying the issues to be proposed by the judges of the study (nurses, doctors and physiotherapists) to the protocol of care provided to patients venous ulcers and present the structure of protocol proposed by the judges of the study to assist patients with venous ulcers treated at a referral hospital of Rio Grande do Norte. This is a descriptive study using a quantitative approach, carried out at the dressings, located in the outpatient surgical clinic of the Hospital University Onofre Lopes (HUOL), located in East Sanitary District, Natal-RN. The sample consisted of 39 professionals, 30 nurses, seven doctors and two physical therapists, team members HUOL surgical clinic and other public and private institutions of Rio Grande do Norte and Jequié/Bahia. These professionals were the judges responsible for selecting the guidelines already proposed in the literature on VU protocols. Approved by the Ethics in Research HUOL (Report n.o 081/07), began the first stage of the study which consisted of reviewing the scientific literature about the relevant aspects to be included in a protocol for assisting patients with VU. These aspects were organized into a proposed questionnaire to the judges of the study. Following examination, held on the content validation with application of the Kappa (K), accepting a score higher than 0.80 and the Likert Scale, whereas rates from 4.0 to 5.0. The data collected were organized in Microsoft Excel and exported into Statistical Package for Social Sciences (SPSS) 15.0. The literature review included national and international scientific articles, thesis, dissertation and institutional protocols. Regarding the characterization of professional nurses predominated (76.1%), between 34 and 45 years (41.0%), female (79.5%), married/consensual union (46.2%), with specialization in VU care (61.5%), working in the hospital network (46.1%), with up to 5 years experience in VU (69.2%) and claiming to feel prepared to care for these injuries (92.3 %). With regard to aspects that had very good agreement (K ≥ 0.81), remained the items found in the literature with some modifications. In the analysis of the proposed evaluation items had very important, ranging from 4.1 (drug treatment) to 4.9 (patient assessment and care of the injury and the injured and perilesional skin). The proposition of the protocol is arranged in eleven items: A) Evaluation of patient and lesion, B) Registration and documentation, C) the wound and perilesional skin, D) an indication of coverage, E) Use of antibiotic and pain treatment, F) Surgical treatment of CVI, G) Drug treatment, H) Improving venous return and prevetion of recurrence, I) Referral of patients, J) Training and K) Reference and counter reference

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Venous ulcers are lesions resulting from chronic venous insufficiency, venous valvular abnormalities and venous thrombosis. Its occurrence has been growing with the increase in life expectancy of the world population. Considered as fundamental aspects in the approach to the person with venous ulcer care with the interdisciplinary approach, adoption of protocol-specific knowledge, technical skill, coordination between levels of care complexity of the Health System and active participation of patients and their families, a holistic perspective. The construction of a clinical protocol for people with venous ulcers can help professionals of high complexity services in patient assessment and the establishment of quality care in a systematic way and focused on the factors that interfere with wound healing. Thus, this study aimed to analyze the evidence of validation of a clinical protocol for people with venous ulcers treated at high-complexity services. This is a methodological study with a quantitative approach, developed in three stages: literature review, evidence of content validity and evidence of validation in the clinical context. Approved by the Federal University of Rio Grande do Norte Research Ethics Committee (Opinion: 147.452 and CAAE: 07556312.0.0000.5537). The literature review was conducted in August and September 2012, becoming the basis for the construction of the protocol. Then the evidence of content validity, which included 53 judges (experts) selected by the Lattes platform to evaluate the protocol items was performed. The judges were contacted by e-mail and rated the protocol via Google Docs . After analyzing the ratios obtained in this step, which reported kappa between 0.75 and 0.96 and between 0.80 and 0.98 IVC, and the suggestions of the judges, the protocol was adjusted and subjected to empirical evidence to validate the clinical setting at the University Hospital Onofre Lopes in Natal / RN. Evidence of validation in the clinical setting involved 4 judges who acted in pairs (paired) evaluated 32 patients with venous ulcers in the clinical context of high complexity. In both stages, we used the Kappa Index and Content Validity Index to analyze the responses of the judges. The parameters set as acceptable for these indices were: Kappa ≥ 0.61 and Content Validity Index > 0.80. Any evidence of content validity, as evidence of validation in the clinical context, the protocol items that have not reached Kappa and Content Validity Index established indices were excluded and some items were modified or added after suggestions. The process of content validation evidence and evidence of validation in the clinical setting allowed the improvement of the protocol for the care of people with venous ulcers initially proposed. The initial version of the protocol, built from the literature, contained 15 categories and 108 items; after evidence of content validity, remained the reduction to 15 categories with 91 items; the final version, clinically validated, is composed of the same 15 categories, 76 items. The protocol was validated in its content and in the clinical aspect, so we accepted the alternative hypothesis in the study. This protocol may contribute to the care system, allowing tailor behaviors and promote greater resolution in the treatment of people with venous ulcers in health services of high complexity

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The problem facing the incidence of pressure ulcers (UP) in the hospital environment especially in the intensive care unit (ICU), although it is an old and frequent event in our professional practice, it is not notified in the researches as much as it should be. We observed a tendency to invest in therapeutical and in studies about the production of sophisticated new bandages. Few, however, are the investments in research on preventive measures in order to prevent or at least slow down the development of lesions. In this sense, the study aimed to analyze the correlation between nursing care and the risk of developing UP measured by the Braden scale in ICU patients. This is a descriptive study of longitudinal quantitative approach. The project obtained a favourable opinion from the Ethics Committee of HUOL (no 486/10). Data collection was carried out in the Hospital of Unimed in Natal during six months in 2011. The sample was of 32 patients hospitalized in ICU for over four days. The results were processed in SPSS 15.0 for descriptive statistics and inferential statistics. We identified that, only 9.4% of our sample developed UP, being predominantly male, elderly people aged above 60 years, Caucasian, with diagnostic hypothesis at the time of hospitalization of sepsis, were clinical patients, who presented hemodynamic instability, using orotracheal tube (TOT), enteral probe (SNE), vesical probe delay (SVD) and had values of albumin and hemoglobin levels below normal. In addition, these patients had a longer hospital stay, longer usage of TOT, SNE, SVD, increased use of sedation and drain than those who did not develop UP and were all at risk for developing these injuries second Braden scores. 66.7% of the lesions developed were located in the sacral region, limiting the degree I and all patients that developed were considered serious, 100.0% of them have evolved since the death. Small were the differences between the averages of Braden scores between patients with and without UP, 11,9+2,4 against 12,4+2,6 with p = 0.627. The clinical aspects of the patients in the study were instrumental in the development of UP, once, these findings were statistically significant through the Mann-Whitney test, and appropriateness of nursing conduct was decisive for the prevention of pressure ulcers in critical patients, since many were those classified as at risk (28) and few who have developed lesions (03)

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The venous ulcer is an epidemiological problem of high prevalence, causing disability and dependence. Assess the tissue impairment level of patients with venous lesions, within a nursing referential, is relevant for the implementation of a directed assistance to specific clientele. Thus, this work aims to characterize the health status regarding the integrity the lower limbs skin of patients with venous ulcers, according to the of tissue integrity outcome indicators from the Nursing Outcomes Classification. A cross-sectional study conducted in a university hospital in Natal - Rio Grande do Norte. The sample consisted of 50 participants, selected through consecutive sampling. Data collection occurred through a interview and physical examination form and a operational definitions tool for indicators of the nursing Tissue Integrity outcome directed to patients with venous ulcer, applied from February to June 2012. Data analysis was done by descriptive statistics and nonparametric tests (Spearman, Kruskal-Wallis and Mann-Whitney tests). The project was approved by the Research Ethics Committee with protocol 608/11 and Presentation Certificate to Ethical Consideration No. 0038.0.294.000-11. The results were presented using three scientific articles derivatives of research. It was found that the indicators show moderate impairment, light and not impaired, as the median. The respondents had an average of 59.72 years, 66% female, 50% were retired, 60% with a partner, 44% had arterial hypertension, 26% allergies, 20% diabetes mellitus, 96% were sedentary, 14% drank alcohol and 6% were smokers. There was a statistically significant correlation of low intensity between age and hydration (p=0.032; rs=-0.304) and skin desquamation (p=0.026; rs=-0.316), family income and necrosis (p=0.012; rs=-0.353); Ankle Brachial Index and tissue perfusion (p=0,044; rs=-0,329); Diabetes Mellitus and texture (p=0.015) and tissue perfusion (p=0.026); allergy and texture (p=0.034), physical activity and hydration (p=0.034), smoking and thickness (p=0.018), and alcohol consumption and exudate (p=0.045). We conclude that the patients had light to moderate impairment, indicating a good state of health on the integrity of the skin of the lower limbs, according to the indicators of the outcome of tissue integrity Classification Nursing Outcomes valued in the present study. It is believed that the evaluation of impairment tissue using a self-nursing system and its relation with socioeconomic, clinical and risk factors are unique tools in the care planning and in the wound healing

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Descriptive research aimed at evaluating the assistance offered to patients with venous ulcers, on lower limbs, attended by the Family Health Program (FHP) team, from the municipality of Natal/RN. The target population was composed of 74 patients with venous ulcers (VU), attended by the FHP teams in the 31 FHUs. The study was approved by the Ethics Committee of the Federal University of Rio Grande do Norte (protocol n.55/05). The data collection was performed in patients homes and in the FHUs, through structured interviews and physical examinations of patients with VU and non-participant observation during the changing of wound dressings in these Units and in users homes. The data was organized into an Excel electronic table and transported into the SPSS 14.0 program, for descriptive analysis on 2x2 contingency tables and inferential (Qui-Square χ2, Spearman Correlation, Binomial Proportion Test and p-value <0.05). The prevalence of VU (0.36/1000) in the target population (over 20 years of age) was greater than in the population registered in FHP (0.25/1000). We detected a greater prevalence in the age area of over 60 years (2.22/1000), with 2.98/1000 for females and 1.3/1000 for males (p-value=0.008). The sociodemographical and health characteristics of patients with VU revealed predominance of females (74.5%), elders over 60 years of age (67.6%), with fundamental education (74.3%), family earnings of up to 2 minimum wages (68.9%), retired (90.5%), ortostatic position (23.0%), inadequate sleep (59,9%), presence of CVI (100.0%), hypertension (44.6%) and diabetes (25.7%). As for the time of existence of the VU, 64.9% had over 1 year, and 35.1% less than 1 year), with predominance of one wound (67.6%). The changing of wound dressings is performed mostly at home, in and inadequate way, especially with incorrect cleaning techniques, likewise incorrect use of products and substances, and reduced participation of the FHP team on the evaluation and application of the dressing and choosing of products and substances. The compressive therapy is not part of therapeutic conducts for treatment in the FHUs. As for the evaluation of assistance to patients with VU, 90.5% were inadequate and only 9.5% adequate. The main inadequacy factors were the absence of: diagnosis (47.3%), consultation with and angiologist (63.5%), compressive treatment (100.0%), adequate optical therapy (98.62%), adequate dressing kit (70.3%), training for the changing of dressings (67.6%), following by the FHP team (51.4%) and performed exams (55.4%). We ve concluded that patients with VU mostly present now socioeconomical level and associated chronic diseases. Considering that assistance offered by FHP is non-systematic, fragmented, with no diagnosis planning, continual evaluation and evolution, we qualify the assistance as inadequate and with low level of solution, directly interfering on the maintenance of the VUs chronic state

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To characterize patients according to gender, age category, internment time, diagnostical hypothesis and location of the pressure ulcer; to identify the susceptibility conditions, intrinsical and extrinsical factors present on ICU patients and to verify on the existence of association between the susceptibility conditions and the intrinsecal and extrinsecal factors on the occurrence of PU. Methods: It is a descriptive study, of longitudinal design of the panel type, with quantitative approach, performed on two ICU s of a private hospital located in Natal/RN, with 40 patients interned at these units. The data collection was performed on all three shifts through a structured observation and physical exam of the patients' skin form seeking to identify the presence of PU. Results: The greatest occurence of PU was on individuals of the male gender (70%) when compared to the female gender (30%), that difference being statistically significant (p=0,0267), with the male gender presenting 4,3 times greater chance of developing PU than the female; the predominant age category was from 60 years of age on (85%), 60,0% presented 1 to 2 PU s after 7 (seven) days of permanence in the ICU s, the predominant diagnostical hypothesis on the patients with PU were the respiratory diseases (42,3%) and the most frequent locations of PU were the sacral region (40,0%) and heels (36,0%). 25 PU s of stage I were diagnosed on 50,0% of the followed patients, with general incidence of 50,0% on both ICUs. from the 88 variables researched, 75 were identified on the patients from the study, being the predominant conditions (anemia, hypotension, leukocytosis, other diseases hypertension blood pressure, cardiac insuffience, pneumonia - and ansiolythic), the intrinsecal factors (diminished muscular strenght and/or mass, discrete edema, totally compromised mobile coordination and total inability for movement on the bed) and the extrinsecal factors (inadequate mattress type, permanence on a single position for >2 hours, shearing/friction force, bed clothes with folds that leave marks on the body, pressure force) predominated on patients with PU. The male gender variables (p=0,0267,OR=4,3), sedation (p=0,0006,OR=4,1), psychomotive agitation (p=0,0375,OR=5,8) and leukocytosis (p=0,0285,OR=5,0) presented a significant statistical diference when analyzed independently. We verified an association of 17,3%, statistically significant (p=0,0384), between the susceptibility conditions (anemia, leukocytosis and hypotension), the intrinsecal factors (age equal or above 60 years, diminished/absent pain sensibility and smooth, fine or delicate skin) and the extrinsecal factors (inadequate mattress, pressure forces, shearing/friction force, permanence on a single position for more than 2 hours, elevation between 30 to 45 degrees and inadequate bed clothes' conditions), with a chance ratio of 4,6 times the risk of occurrence of PU on the patients that presented the referred association. Conclusion: The incidence of PU detected on the ICU-interned patients was high and we made evident the existence of association between the susceptibility conditions, the intrinsecal and extrinsecal factors on the occurrence of PU s on the ICUinterned patients, and thus we accept the alternative hypothesis proposed on the study

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Este trabalho teve por objetivo a avaliação da vida útil potencial de carambolas cv. Golden Star, minimamente processadas, armazenadas em diferentes tipos de embalagens plásticas, para a concepção da atmosfera modificada. Os frutos colhidos fisiologicamente maturos apresentaram coloração verde-amarelada, sólidos solúveis (SS) médios de 6,8 ºBrix e massa média de 185 g. Antes da aplicação dos tratamentos, os frutos foram selecionados, higienizados em solução de hipoclorito de sódio (NaOCl) a 100 mg. L-1, resfriados por 12 horas a 15 ± 0,5 &deg;C, seccionados transversalmente, sendo então novamente higienizados em solução de NaOCl a 10 mg.L-1, por 3 minutos. em seguida, os pedaços em forma de estrelas foram acondicionados em bandejas rígidas de poliestireno, com capacidade para 250 g, e revestidas com os seguintes materiais: T1: filme plástico perfurado de polietileno de baixa densidade (PEBD), de 0,006 mm; T2: filme plástico poliolefínico com antiembassamento da Dupont® (AGF), de 0,015 mm; T3: filme plástico poliolefínico da Dupont® (HF), de 0,015 mm; T4: filme plástico de PEBD, de 60 µm; T5: filme plástico de PEBD, de 80 µm; T6: filme plástico de polipropileno (PP), de 22 µm, e T7: bandeja rígida de polietileno tereftalato (PET), com capacidade para 500 mL, com tampa do mesmo material. As embalagens foram então armazenadas em câmara frigorífica a 12 ± 0,5 &deg;C e 90 ± 3% de U.R, por 18 dias. Observou-se que não houve diferença significativa quanto aos sólidos solúveis (SS) e acidez titulável (AT). O maior número de microrganismos e valor de pH foram observados nos frutos embalados nos filmes plásticos de PEBD de 0,006 mm, AGF e HF de 0,015 mm da Dupont®. Entretanto, os frutos acondicionados nas embalagens PET apresentaram o maior teor de ácido ascórbico. da mesma forma, somente nas embalagens PET é que se conseguiu modificação atmosférica eficiente do ponto de vista da manutenção dos atributos de qualidade durante o AR. Assim, esse tratamento proporcionou adequado controle microbiológico e manutenção das características de qualidade por 18 dias para as carambolas minimamente processadas.

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O presente estudo teve como objetivo avaliar parâmetros operacionais de um conjunto mecanizado envolvendo trator e semeadora, assim como o rendimento da cultura do milho semeada nas diferentes configurações das máquinas e combinações com o ambiente de produção. Os tratamentos consistiram de tipos de sulcadores (discos duplos e hastes), os quais foram avaliados em experimentos em que a operação de semeadura direta do milho foi efetuada transversalmente ao declive (em nível) e em aclive e declive. A semeadura contra o declive e o uso de haste sulcadora implicaram maior demanda de esforço de tração, patinagem do trator e consumo de combustível por área trabalhada e não influenciaram o volume de solo mobilizado, a população de plantas e a produtividade de grãos do milho, em relação à operação realizada em declive e uso de sulcador de discos duplos, respectivamente. A utilização de sulcador do tipo haste resultou em menor número de plantas acamadas e quebradas, em relação ao uso de discos duplos, independentemente do sentido da operação. A principal diferença entre semear em nível ou em declive é a formação de sulcos orientados no sentido do terreno, pela ação de sulcadores do tipo haste e elevada patinagem dos rodados do trator, já que o consumo de combustível por área trabalhada e capacidade operacional não foram afetados por aquelas variáveis.

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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A propagação vegetativa é considerada importante ferramenta para o melhoramento de espécies lenhosas e herbáceas e vem sendo amplamente utilizada, visando melhorar e manter variedades de importância econômica e medicinal. Neste contexto utilizou-se estacas de alfavaca-cravo de 15 cm para apicais e 25 cm para as medianas, sendo estas com e sem folhas. As estacas foram plantadas em bandejas de isopor de 72 células, utilizando-se 10 substratos. Após 35 dias, as estacas foram retiradas com cuidado, sendo as partes aéreas e radiculares separadas e acondicionadas em saco de papel e mantidas em estufa a 70ºC por 48 h para posterior avaliação da matéria seca. Analisou-se a percentagem de enraizamento, número de folhas na estaca, peso de matéria seca de folha e de raiz. Não houve interação significativa entre os diferentes tipos de substrato e estaca para percentagem de enraizamento, sendo que os substratos de modo geral diferiram pouco entre si. Entre os tipos de estaca destacaram-se para esta variável a mediana sem folha e a apical com folha. Para as demais variáveis houve interação significativa entre o tipo de estaca e o substrato. A melhor estaca foi a mediana sem folhas plantadas em substrato arisco + esterco + húmus e vermiculita nas seguintes proporções: 20%:40%:40%; 40%:20%:40% e 40%:40%.

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Avaliaram-se a composição química da madeira e da casca de sete espécies (E. saligna E. grandis, E. urophylla, E. camaldulensis, E. citriodora, E. paniculata e E. pellita) e três clones de eucalipto (híbridos de E. grandis x E. urophylla), antes e durante o cultivo das linhagens LE-95/01 e LE-96/18 de shiitake (Lentinula edodes), em toras. Cada linhagem de shiitake foi inoculada em nove toras de cada tipo de eucalipto com 1 m de comprimento e 9 a 14 cm de diâmetro. Assim, o delineamento experimental foi inteiramente casualizado, com 20 tratamentos e nove repetições, sendo cada repetição correspondente a uma tora. As toras foram mantidas em estufa climatizada, com temperatura de 25 ºC ± 5 e umidade relativa do ar entre 60-80%, durante 12 meses. Para a determinação da composição química da madeira, analisaram-se cunhas de discos e cascas de eucalipto recém-cortadas (sem inoculação das linhagens de L. edodes) e cunhas de discos e cascas retirados de toras já inoculadas com as linhagens de L. edodes após oito meses de incubação. Os resultados mostraram diferenças nos teores de holocelulose, lignina e extrativos totais na madeira e casca após o corte e depois de oito meses de incubação nas espécies e clones de eucalipto; o maior índice de decomposição da holocelulose na madeira, ao longo do tempo, ocorreu no E. saligna (5,5%), indicando, assim, ser o mais favorável para o desenvolvimento micelial do L. edodes. Já na casca aconteceu no clone 24 (22,2%). O E. camaldulensis apresentou o maior índice de decomposição da lignina na madeira (6,8%), ao longo do tempo. Já na casca, entre os eucaliptos testados, o E. grandis sofreu a maior decomposição de lignina (21,9%); o L. edodes degradou muito mais a holocelulose e lignina da casca que da madeira, tornando evidente a importância da casca; a casca da maioria dos tipos de eucaliptos apresentou menor teor de holocelulose, maior teor de extrativos totais e teores de lignina semelhantes ou superiores quando comparados com a madeira. O fator tipo de eucalipto (espécies e clones) teve maior efeito que o fator linhagem de L. edodes na degradação da holocelulose e lignina.

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Avaliou-se o efeito de três doses de composto orgânico de três composições distintas, aplicados em dois solos [Latossolo Vermelho Escuro, textura arenosa (LE) e Areia Quartzoza (AQ)], na produção e absorção de nutrientes pela planta de alface. Conduziu-se de 02/07 a 27/08/1997 um experimento dentro de túnel plástico, pertencente à UNESP, em Botucatu, em vaso plástico, contendo quatro quilos de solo. Os solos foram corrigidos para atingirem saturação por base de 80% e todos os vasos receberam adubação fosfatada (150 mg de P kg-1 de solo), potássica (100 mg de K kg-1 de solo) e micronutrientes. Os compostos foram misturados aos solos nas quantidades de 60; 120 e 240 g de composto por vaso. Os três compostos foram originados a partir de casca de eucalipto, serragem de madeira e palhada de feijão, misturados com esterco de aves. O experimento foi realizado em delineamento inteiramente casualizado, em três repetições, com vinte tratamentos em esquema fatorial (3 doses x 3 compostos x 2 solos) mais um tratamento testemunha para cada solo (ausência de composto orgânico). O composto de palhada de feijão aumentou a biomassa fresca da parte aérea e a quantidade de N, K, Ca, Mg, B, Cu, Fe e Zn nas plantas de alface. Para o P e Mn o composto de palhada de feijão diferiu significativamente apenas em relação ao composto de casca de eucalipto. em todas as características avaliadas no LE houve melhores respostas da cultura em relação ao AQ. Quanto às dosagens utilizadas, as diferenças foram observadas somente nos tratamentos com palhada de feijão, onde as maiores dosagens propiciaram o aumento de biomassa fresca e seca da parte aérea, e nas quantidades de macro e micronutrientes.

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The rocket is a leafy herbaceous annual, features small size, rapid vegetative growth and short life cycle. Silicon is considered a beneficial element, and despite not having his definition of essential mineral nutrition of plants has been widely used in research. The objective was to assess the effect of foliar fertilization with silicon levels in soils in the cultivation of the rocket. The experiment was conducted in a greenhouse in the DRN / Soil Science, UNESP / FCA, Botucatu-SP, from April 15 to May 20, 2008. The experimental design was randomized blocks in factorial 2x5 (two solos and five doses of silicon). At the end of the experiment, evaluated at the point of harvest to plant height (cm), leaf area (LA), total fresh mass (TFM), total dry matter (TDM), leaf area ratio (LAR), specific weight Leaf (PEF), amount of water in the shoot (AWS) and content and accumulation of silicon in the leaves. It was concluded that silicon had no influence on the agronomic characteristics of the rocket and changes were only to soil type.

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O objetivo deste artigo foi analisar, nas interações realizadas por escrito dentro de um chat educacional, os tipos de operacionalização para o processo da correção - enquanto procedimento de reformulação, de acordo com a Perspectiva Textual-Interativa. O corpus, constituído por 31 sessões e por 17 participantes (1 professor e 16 alunos), mostrou a presença de quatro tipos de operacionalização da correção: autocorreção autoiniciada, autocorreção heteroiniciada, heterocorreção autoiniciada e heterocorreção heteroiniciada. O maior número de ocorrências foi o da autocorreção autoiniciada. Esse resultado sugere que: i) os participantes, nesse contexto, parecem se preocupar em preservar a auto-imagem, já que a correção não era essencial à compreensão do texto; ii) os escreventes conhecem as regras e, por isso, se monitoram; iii) a própria ferramenta chat contribui para a autocorreção autoiniciada; e iv) a preferência pela autocorreção autoiniciada parece evitar que o professor assuma o papel de corretor do curso de língua. Foram identificados, ainda, padrões de reformulação com e sem marcadores inscritos na materialidade do texto.

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Discutem-se os tipos de Violência Sexual (VS) sofridos na infância e/ou adolescência e suas vicissitudes, nas trajetórias sexuais de 236 adolescentes, de ambos os sexos, cursando o Ensino Médio no interior do Oeste Paulista que declararam ter sofrido um ou mais tipos de violência sexual. Dentre esses tipos, destacamos a Violência Doméstica Sexual (VDS), aqui definida como intrafamiliar. Nesse caso, observamos que, dentre os 236 adolescentes com histórico de VDS, 94 (39.8%) declararam ter pensado em suicídio e 39 (16.5%) disseram ter tentado, sendo que 35 (89.7%) deles se declararam heterossexuais (27 [77.1%] do sexo feminino) e 4 não-heterossexuais (3 bissexuais e 1 outro, sendo todos do sexo feminino). A maioria das vítimas finda por relatar o ocorrido aos amigos e responsáveis, mas pouco ou nada é feito, em termos de medidas protetivas a elas.