Corticosteroides vs dosis bajas de adrenocorticotropina en el tratamiento de espasmos infantiles. Revisión sistemática de la literatura

Antecedentes: El tratamiento de los espasmos infantiles generalmente se realiza con ACTH a pesar de perfil de efectos secundarios y el alto costo financiero. Se ha propuesto el uso de los corticoides como primera línea de tratamiento para la enfermedad, no obstante no existe certeza sobre la eficacia de este esquema. Objetivos: Evaluar la eficacia del uso de los corticoides comparados con la ACTH como primera línea de tratamiento en el manejo de pacientes con espasmos infantiles. Metodología: Se realizó una revisión sistemática de la literatura. La búsqueda se efectuó en las bases de datos Pubmed, Embase, Ovid, LiLaCs y en el registro de ensayos clínicos de Estados Unidos. Se incluyeron estudios en portugués, ingles y español, no se fijo límite de tiempo para la publicación. Se realizó un análisis de riesgo de sesgo y de calidad de la evidencia utilizando el programa GRADEPRO. Se estimaron OR y sus respectivos intervalos de confianza al 95%. Resultados: Se incluyeron 4 estudios, un ensayo clínico y tres estudios de cohorte retrospectiva. Dos estudios aportaron evidencia de calidad moderada y alta. No se encontraron diferencias en la eficacia a corto plazo entre el uso de los corticoides y la ACTH sobre desenlaces clínicos o electroencefalográficos. No se encontraron estudios de seguridad a largo plazo. La seguridad a corto plazo no mostró diferencias. Conclusiones: Es muy probable que el uso de los corticoides como primera línea de tratamiento puedan reemplazar el uso de la ACTH, se requiere estudios de seguridad a largo plazo. La decisión de su uso rutinario debería estar basada en un análisis de costo efectividad y bajo la mirada del balance riesgo/beneficio.

Análisis desde el ordenamiento territorial de los patrones de distribución y cobertura de los equipamientos colectivos de educación, cultura y, recreación y deporte. Caso de estudio:UPZ el Rincón

El interés de este estudio de caso es avaluar la situación de los patrones de distribución y cobertura de los equipamientos de educación, cultura, recreación y deporte, de la UPZ El Rincón de la ciudad de Bogotá. Se describe y analiza con ayuda de un sistema de información geográfica la localización y accesibilidad a los equipamientos desde el sistema de transporte y las diferentes manzanas que componen la UPZ, bajo la mirada de la importancia de los equipamientos colectivos para el ordenamiento territorial de las ciudades. Siguiendo finalmente los estándares urbanísticos se establece el déficit de la UPZ en cuanto a estos equipamientos y una posible propuesta para intentar cubrirlo de manera óptima.

What you see is what you want to see: motivationally relevant stimuli can interrupt current resource allocation

Arousing stimuli, either threat-related or pleasant, may be selected for priority at different stages within the processing stream. Here we examine the pattern of processing for non-task-relevant threatening (spiders: arousing to some) and pleasant stimuli (babies or chocolate: arousing to all) by recording the gaze of a spider Fearful and Non-fearful group while they performed a simple “follow the cross” task. There was no difference in first saccade latencies. Saccade trajectories showed a general hypervigilance for all stimuli in the Fearful group. Saccade landing positions corresponded to what each group would find arousing, such that the Fearful group deviated towards both types of images whereas the Non-fearful group deviated towards pleasant images. Secondary corrective saccade latencies away from threat-related stimuli were longer for the Fearful group (difficulty in disengaging) compared with the Non-fearful group. These results suggest that attentional biases towards arousing stimuli may occur at different processing stages.

Followers are not followed: observed group interactions modulate subsequent social attention

We asked whether previous observations of group interactions modulate subsequent social attention episodes. Participants first completed a learning phase with two conditions. In the ‘leader’ condition one of three identities turned her gaze first, followed by the two other faces. In the ‘follower’ condition, one of the identities turned her gaze after the two other faces had first shifted their gaze. Thus, participants observed that some individuals were consistently ‘leaders’ and others ‘followers’ of others’ attention. In the test phase, the faces of ‘leaders’ and ‘followers’ were presented in a gaze cueing paradigm. Remarkably, the ‘followers’ did not elicit gaze cueing. Our data demonstrate that individuals who do not guide group attention in exploring the environment are ineffective social attention directors in later encounters. Thus, the role played in previous group social attention interactions modulates the relative weight assigned to others’ gaze: we ignore the gaze of group followers.

Uma intervenção educativa para profissionais de saúde na prevenção de pneumonia associada à ventilação mecânica

Quasi-experimental study, prospective with quantitative approach, performed at the Hospital do Coração in Natal, aimed at verified the existence of difference between the care given by health professionals to the patients under mechanical ventilation (MV) in the Intensive Care Unit, before and after an educative intervention. The population was of 31 professionals, with data collected between november 05 of 2007 to march 27 of 2008. The results show a yong population, female gender, middle level of education, nursing technique, working between 05 and 09 years on nursing profession, and 01 to 04 years on Intensive Care Unit; almost all, never had an kind of training over prevent pneumonia associated to mechanical ventilation; from those that had training, occur on the work place with duration from 12 to 24 hours. About endotracheal intubation, the cuff was tested with a sterilized syringe had a positive change after a educative intervention, increased from 75,0% to 100,0%; the sterile guide was used on 75,0% before and 100,0% after an educative intervention. Regarding endotracheal suction procedure, was not informed to the patient on 72,7% before, however was informed on 56,7% after; the hands was not previously washed 68,5% before, however was 63,3% after the procedure; mask was used on 74,2 % opportunities before and 76,7% after; the aspiration catheter had adequated size on 98,9% observation before and 100,0% after; the gaze was sterilized on 95,7% before and 100,0% after; the ventilator was connected to the patient during the aspiration intervals on 94,4% observation before and 100,0% after; the ambu bag was clean and protected on 76,1% before and 85,7% after; the aspiration catheter was discarded after be used on 98,9% before and 100,0% after; FIO2 was turned to the begging value on 32,9% observation before and 12,0% after; before the procedure 71,9% professions washed their hands and 73,3% after; before, notes of aspiration results were performed on 70,8% observation and 86,7% after. Regarding devices used on respiratory tract, aspirator flasks were not swapped on 84,6% observations before and 71,0% after; daily látex extention change was not performed on 93,6% observation before and 87,1% after; the ambu bag change was not performed on 50,0% observation before even if was duty or unprotected and on 75,8% opportunities was changed, after; nebulization was not prepared with sterile fluids or manipulated aseptically on 65,2% observation before, perhaps was on 71,7% after; before nebulizers were not changed on 65,2% observations, perhaps were on 60,9% after. Concerning ventilator breathing circuits, condense fluids cumulated on circuits were removed on 55,0% opportunities before, and 64,0% after; moisturizer was not filled with sterile water when already had small amount of liquid inside on 78,4% observations before, and 90,2% after; MV circuits were changed on 97,0% observations on presence of visible duty or when presents some kind of failure, before and 98,4% after. About body position, on 51,3% observations the decubitus position change were done before and 78,2% after; fowler position was maitened on 95,5% observations before and 98,2% after; Regarding respiratory physiotherapy, enteral diet was not interrupted before respiratory physiotherapy on 94,9% before and 90,0% after; respiratory physiotherapy devices were not disinfected or sterile on 69,6% observations before but they re on 60,0% after; before the cateter was not tested before introduction enteral diet or medications on 100,0% but after was done on 15,2%. About enteral feeding, intestine motility and measure of stomach contents were not done on 100,0% observations before, but was 15,2% after. We conclude that 05 of 07 valuated procedures in relation to MV, had a significant improvement on quality of care given after educative intervention, when compared before intervention

Modelos de realizações discursivas nos benditos populares e nas novenas

With the purpose of contribute to the understanding of oral texts constituent processes, we seek, with this work, verify how formulaicity processes in the benditos and novenas , religious intangible heritage, are established. For this, we made an overview on the performance of repetitions which are established in the corpus collected for the study, considering the presence of Discourse Traditions in the analyzed texts. It is noteworthy that the corpus consists of benditos and novenas collected in the municipality of Lajes, Rio Grande do Norte. This material is part of the differential corpus of the Project for the History of Brazilian Portuguese (PHPB-RN). Regarding the theoretical framework used to guide the research, we based our analysis on Discourse Traditions (DTs) theoretical assumptions, with the ideas defended by Johannes Kabatek, besides taking into consideration the assumptions of Paul Zumthor about orality in popular religious texts, among other authors cited throughout the work. In the context of popular cultures, the existence of oral texts serves to various interactive objects and this is not different in popular benditos and novenas (cf. Sá Júnior, 2009). In this sense, focusing the gaze through Discourse Traditions (DTs), we can verify that the texts/discourses present discursive regularities or textual forms already produced by society, in earlier times, which remain or are modified throughout its existence, as shows Johannes Kabatek (2001, 2003, 2005 and 2006). Also in this sense, Paul Zumthor (1993) presents us the idea that talk about using "word" in memory, in its real sense, implies admitting it as something which has an immeasurable power, which is able to decide directions in world, and from that is established the "wealth of oral traditions"

Compreendendo a experiência de pessoas portadoras de transtorno mental: histórias de vidas severinas repletas de possibilidades

This study aims to understand the experience of people suffering from mental disorder. The patients are enrolled in a mental health ambulatory clinic in the city of Natal (RN). Mental disorders are growing rapidly in the contemporary world and are a source of intense mental suffering. Besides patients being strongly marked by a history of isolation and prejudice, they have been the target of real atrocities committed in the name of preservation of a supposed normality. The understanding and treatment of this disorder is influenced by cultural and historical inferences, depending on the period in which it is experienced. Semi-directed Interviews were conducted with a group of users, with the emphasis on giving voice to their uniqueness and individuality, highlighting how each one perceives his or her own experience. These were recorded and later transcribed by identifying the core of meanings. The results were analyzed under the gaze of the Humanist Phenomenology Existential perspective, which aims to unravel the phenomenon, without truths from volatility, highlighting the existence of the mental disorder as a way of living, being permeated by suffering mental and influenced by social problems, assuming contours very particular to each individual. Some progress has been perceived, even by users, with respect to the change of paradigm in the way of care, but still there is a consistent emphasis on medical and drug use. The changes point to the need for offering services to replace the asylum hospital model, and in addition to accept the bearer of mental disorder as a citizen, a bearer of rights who should be accepted and respected by society. Despite the pain expressed and its close liaison with suicide, their reports are full of perspectives and attitudes of confrontation facing life, pointing to new possibilities to be, recreating itself

Sistema não-Intrusivo para Estimação da Direção do olhar utilizando redes neurais artificiais

The fundamental senses of the human body are: vision, hearing, touch, taste and smell. These senses are the functions that provide our relationship with the environment. The vision serves as a sensory receptor responsible for obtaining information from the outside world that will be sent to the brain. The gaze reflects its attention, intention and interest. Therefore, the estimation of gaze direction, using computer tools, provides a promising alternative to improve the capacity of human-computer interaction, mainly with respect to those people who suffer from motor deficiencies. Thus, the objective of this work is to present a non-intrusive system that basically uses a personal computer and a low cost webcam, combined with the use of digital image processing techniques, Wavelets transforms and pattern recognition, such as artificial neural network models, resulting in a complete system that performs since the image acquisition (including face detection and eye tracking) to the estimation of gaze direction. The obtained results show the feasibility of the proposed system, as well as several feature advantages.

Características dos enunciados dispersos de uma criança com diagnóstico fonoaudiológico de distúrbio de linguagem

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Os desafios contemporâneos do estágio supervisionado em Serviço Social na formação acadêmica

Pós-graduação em Serviço Social - FCHS

O tempo e as imagens de mídia: capas de revistas como signos de um olhar contemporâneo

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Hilda Hilst e o seu pendulear em Fluxo-floema

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Relações na escola da infância: perspectivas teóricas e didático-pedagógicas

This article portrays pathways and studies, arising from research already completed on relationships that constitute the process of appropriation-objectification of the world of human culture by the child at the School for Children, under the gaze of Historical-Cultural Approach. The studies had been configured in accord with a theoretical look that understands the relations as propeller of the humanization process and the child as capable to learn since very small. Initially, there is deepening of theoretical issues concerning the regularities of human development between three and six years old, based on the propositions of the Historical-Cultural Approach. Subsequently, it presents results of the routes methodological that integrated observation sessions of educational practice in schools in early childhood education, involving the relationship between children, adults and objects, as well as sessions of designs and semi-structured interviews with the children. These results show the resulting analysis of the pedagogical implications of the propositions of the HistoricalCultural Approach about the humanization process, mediation and activity.

Direitos humanos e demandas escolares: problematizando a aproximação entre psicologia e conselho tutelar

This paper presents the main achievements in the field of children and youngsters social rights and provides some data on Brazilian education that show the discrepancy between the legal guidelines and the educational situation of children and youngsters within public schools. It presents a critical approach to the ways production and attendance of school problems have been interpreted and shows the dimension in which social facilities established to provide protection to children and adolescents have not been able to ensure a good quality schooling. It highlights the Guardian Council as addressee of school demands and stands out the urgency of debating the violation of fundamental rights such as the lack of quality in education, the repeated situations of failure, and dropping out experienced by a significant number of poor students. The analyzes developed point to the fragility of the relationship between school and Guardian Council revealing an institutional dynamic that individualize social issues. The analyzes developed also suggest the possibility of including Psychology mediation to school, family and Guardian Council. These aim to break the hegemony of the gaze individualizing approach that blame individual and / or family for school failures. This all present to professionals the urgenct for a critical attitude, based on theoretical and practical approaches able to research and propose critical interventions in order to overcome the production of educational exclusion.

Análise dos ciclos operacionais para especificação de motores de indução trifásicos

This paper addresses the three-phase induction motor by a thermal analysis of its operation, under the gaze of the standards of the Brazilian Association of Technical Standards that deal with working arrangements (operating cycles) defined by appropriate tests and for each use of the motor basis of this study, emphasizing especially the fact of the first three cycles are the cycles with greater possibilities of use for scaling a three-phase induction motor for the main industrial processes, will also be made an analysis of the reasons why the three-phase induction motors have a loss of power at altitudes above 1000 m above sea level and some methods of how to define how a three phase induction motor can be used in one of the first three working arrangements