A formação do professor em face das violências das/nas escolas

O desvelamento das violências das/nas escolas levou ao desenvolvimento de numerosas pesquisas sobre a formação inicial e continuada de professores. Parte destas analisa a socialização profissional do magistério e encontra questões como as novas faces do "choque de realidade" dos docentes. Assim, efetuou-se uma investigação sobre as percepções dos licenciandos a respeito das violências e de seu próprio preparo. Os resultados, obtidos por meio de grupos focais realizados com licenciandos, confirmam a sensação de despreparo para a imersão, ainda que gradual, na prática. Entre as propostas dos participantes, destacam-se a construção de um gradiente teoria-prática mais adequado, o caráter mais aplicado das disciplinas e o desenvolvimento da capacidade de encontrar soluções, sem receituários.

Accuracy of prehospital triage of trauma patients by emergency physicians: a retrospective study in western Switzerland.

OBJECTIVE: Accurate identification of major trauma patients in the prehospital setting positively affects survival and resource utilization. Triage algorithms using predictive criteria of injury severity have been identified in paramedic-based prehospital systems. Our rescue system is based on prehospital paramedics and emergency physicians. The aim of this study was to evaluate the accuracy of the prehospital triage performed by physicians and to identify the predictive factors leading to errors of triage.METHODS: Retrospective study of trauma patients triaged by physicians. Prehospital triage was analyzed using criteria defining major trauma victims (MTVs, Injury Severity Score >15, admission to ICU, need for immediate surgery and death within 48 h). Adequate triage was defined as MTVs oriented to the trauma centre or non-MTV (NMTV) oriented to regional hospitals.RESULTS: One thousand six hundred and eighti-five patients (blunt trauma 96%) were included (558 MTV and 1127 NMTV). Triage was adequate in 1455 patients (86.4%). Overtriage occurred in 171 cases (10.1%) and undertriage in 59 cases (3.5%). Sensitivity and specificity was 90 and 85%, respectively, whereas positive predictive value and negative predictive value were 75 and 94%, respectively. Using logistic regression analysis, significant (P<0.05) predictors of undertriage were head or thorax injuries (odds ratio >2.5). Predictors of overtriage were paediatric age group, pedestrian or 2 wheel-vehicle road traffic accidents (odds ratio >2.0).CONCLUSION: Physicians using clinical judgement provide effective prehospital triage of trauma patients. Only a few factors predicting errors in triage process were identified in this study.

Pan-dôra - omnium munus. Philosophes et apologistes face au mythe de Pandore

Recueil de soixante études dont certains concernent la pensée de L. Couloubaritsis dans les domaines qui ont été au centre de ces recherches : philosophie antique, médiévale et contemporain ; mythe et religion ; métaphysique, et plus spécialement l'hénologie et la complexité.

Trauma and disorganized attachment in refugee children : integrating theories and exploring treatment options

Refugee families incur many different types of stressors in the course of the phases prior to flight, those of flight, and resettlement. Multiple and varied negative life events and traumas, such as those experienced by refugee families, may give rise to negative changes in attachment between children and their parents. However, such negative changes in attachment may be countered through the use of culturally appropriate counselling theories and their respective interventions. The integration of attachment theory with family systems, trauma systems, and cognitive behavioural theories and the use of cognitive behavioural caregiver support, filial therapy training, and play therapy interventions are discussed as a treamtent framework for promoting more positive and secure attachments between refugee children and their caregivers.

[Voyage en Italie : 1824-1830]. , Charpente de la grande salle du vieux palais ; charpente du nouveau theâtre de Prato : [élévations d'une ferme et sous-face d'un entrait pour chacune des deux charpentes] : [dessin] / h. L. [Henri Labrouste]

Référence bibliographique : Weigert, 147

[Voyage en Italie : 1824-1830]. , Pont d'Auguste à Rimini : [élévations partielles du pont (travée centrale et deux demi-travées) et de la face intérieure du parapet, coupe sur une arche, trois profils] : [dessin] / h. L. [Henri Labrouste]

Référence bibliographique : Weigert, 485

[Voyage en Italie : 1824-1830]. , [Un chapiteau] près la Basilique : [vues de face et de biais] : [dessin] / h. L. [Henri Labrouste]

Référence bibliographique : Weigert, 421

[Voyage en Italie : 1824-1830]. , [Préparatifs pour la fête des SS. Pierre et Paul ?] St Pierre de Rome, 28 juin : [face et deux profils d'une femme voilée, vue perspective d'une porte intérieure de la basilique ornée de guirlandes] : [dessin] / h. L. [Henri Labrouste]

Référence bibliographique : Weigert, 539

Monitoring the clinical introduction of a glutamine and antioxidant solution in critically ill trauma and burn patients

OBJECTIVE: Enteral glutamine supplementation and antioxidants have been shown to be beneficial in some categories of critically ill patients. This study investigated the impact on organ function and clinical outcome of an enteral solution enriched with glutamine and antioxidant micronutrients in patients with trauma and with burns. METHODS: This was a prospective study of a historical control group including critically ill, burned and major trauma patients (n = 86, 40 patients with burns and 46 with trauma, 43 in each group) on admission to an intensive care unit in a university hospital (matching for severity, age, and sex). The intervention aimed to deliver a 500-mL enteral solution containing 30 g of glutamine per day, selenium, zinc, and vitamin E (Gln-AOX) for a maximum of 10 d, in addition to control treatment consisting of enteral nutrition in all patients and intravenous trace elements in all burn patients. RESULTS: Patients were comparable at baseline, except for more inhalation injuries in the burn-Gln-AOX group (P = 0.10) and greater neurologic impairment in the trauma-Gln-AOX group (P = 0.022). Intestinal tolerance was good. The full 500-mL dose was rarely delivered, resulting in a low mean glutamine daily dose (22 g for burn patients and 16 g for trauma patients). In burn patients intravenous trace element delivery was superior to the enteral dose. The evolution of the Sequential Organ Failure Assessment score and other outcome variables did not differ significantly between groups. C-reactive protein decreased faster in the Gln-AOX group. CONCLUSION: The Gln-AOX supplement was well tolerated in critically ill, injured patients, but did not improve outcome significantly. The delivery of glutamine below the 0.5-g/kg recommended dose in association with high intravenous trace element substitution doses in burn patients are likely to have blunted the impact by not reaching an efficient treatment dose. Further trials testing higher doses of Gln are required.