615 resultados para elective surgey


Relevância:

10.00% 10.00%

Publicador:

Resumo:

O fenômeno religioso neopentecostal tem crescido consideravelmente nos últimos anos no Brasil, com isso aumenta o interesse de pesquisadores em compreender a sua lógica de funcionamento. O foco desse trabalho não é o estudo isolado de um caso, mas sim a analise do contexto social que permite o florescimento dessa vertente do cristianismo. Assim, estudo a relação entre religião e o mundo do trabalho, partindo do pressuposto de que existe certa afinidade eletiva entre o neopentecostalismo e o toyotismo. O recorte do objeto de estudo está focado no Brasil, a partir dos anos de 1990. Essa escolha ocorre pelas mudanças políticas e econômicas pelas quais o país passou e passa com o neoliberalismo. O mundo do trabalho, na contemporaneidade, caracteriza-se por nova reestruturação produtiva, na transformação do fordismo ao toyotismo, considero que essa mudança é substancial para as recentes formas de trabalho. Constatei que o discurso neopentecostal está em afinidade eletiva com essas metamorfoses, dando sentidos axiológicos aos atuais aspectos do trabalho. O primeiro capítulo aborda o toyotismo no Brasil a partir da década de 1990, ressaltando a transformação do fordismo para o trabalho flexível. O capítulo dois ressalta o fenômeno neopentecostal em seu crescimento contemporâneo e define os conceitos sobre religião que nortearam a pesquisa. Por fim, o capítulo três, mostra a relação entre essas duas áreas, da forma que a ética neopentecostal está em afinidades eletivas com o toyotismo.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

OBJECTIVE: To estimate the prevalence and severity of postcesarean pelvic dysfunction. STUDY DESIGN: Using biopsychosocial interviewing at home, 184 postcesarean primiparas were compared to 100 vaginally delivered women regarding symptoms of stress incontinence, anal incontinence and dyspareunia. Delivery details were confirmed from medical records. RESULTS: Comparison of postcesarean vs. vaginally delivered women revealed stress incontinence in 33% vs. 54% and dyspareunia in 27% vs. 46%, both differences reaching statistical significance, unlike anal incontinence, which was manifest in 51% vs. 44%. When compared to emergency cesarean the relative risk of stress incontinence following an elective cesarean was 0.99 (0.71, 1.39), of dyspareunia 1.02 and of anal incontinence 1.05, indicating no statistically significant difference. Thirty (22%) stress incontinent and 4 (3%) fecally incontinent mothers used pads continuously, suggesting severe physical morbidity. Severe dysphoria (depression) was expressed by 41 (35%) stress incontinent mothers, 38 (30%) with dyspareunia and 34 (26%) with anal incontinence; the association of severe dysphoria with dyspareunia was statistically significant (OR = 2.504 [1.362, 4.602]). Few women came forward to seek help. CONCLUSION: Pelvic dysfunction was similar after elective or emergency cesarean. Compared to vaginal delivery, postcesarean stress incontinence and dyspareunia were less frequent but biopsychosocial morbidity could be severe.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

In this textbook, Kathy Daniels writes about Employee Relations from an organisational context perspective. It is an ideal book for students studying Employee Relations modules on HR and business degree programmes at undergraduate level. It is also suitable for the CIPD elective, covering all the CIPD standards in this area, and provides a strong legal background to the topic. Online resource centre - PowerPoint slides - Lecturer's guide The success or failure of organisations is, in part, dependent on the success or failure of its employees and the relationship that they have with each other. Looking at Employee Relations from an organisational context perspective, this text is designed specifically to cater for the CIPD Employee Relations PDS module and for Employee Relations modules on HR and business degree programmes at both undergraduate and postgraduate levels.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

The Aston Centre for Human Resources (ACHR) was created at Aston Business School, Aston University, in February 2006. The mission of the Centre is both to inform and influence practice through conducting high quality, challenging research in order to extend the existing theoretical frameworks and to develop new and relevant conceptual models to represent and guide the changing realities facing businesses and the people they employ in the 21st century. * Students studying an Employment Law module on a HR or general business degree, whether undergraduate or postgraduate. * Students taking the Employment Law elective on the CIPD's Professional Development Scheme (PDS). * Students studying Employee Relations or Diversity. This new edition has been thoroughly updated, and includes expanded coverage of the impact of EU Law, and Discrimination Law including ageism, sexual orientation, religious belief, harassment and disability. The text is ideal text for those business students on undergraduate and postgraduate courses who are taking a first module in Employment Law. It covers a comprehensive range of topics enabling students to gain a solid understanding of the key principles of the subject. The engaging, authoritative writing style and range of learning features make this a refreshingly accessible and student-friendly read. Each chapter includes summaries of topical and relevant cases, direction to key sources of legal information and suggestions for further reading whilst covering the CIPD’s standards for the Employment Law elective on the Professional Development Scheme (PDS). This text includes a range of case studies, tasks and examples to consolidate learning and includes a brand new section on Employment Law study skills to help students get to grips with how to access and read law reports, understand the sources of the law, find and use up-to-date legal information (particularly websites) and how to prepare for exams and written assignments.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

This text is designed specifically for the increasing number of students taking modules in Equality andDiversity, including those taking the CIPD specialist elective Managing Diversity and Equal Opportunities module. The authors’ combined experience is used to offer a mixture of a strong practical focus and a clear academic approach to create a balance of theory and practice. This text is the only accessible, up-to-date and student-focused text in the market that specifically features this subject area. his text is designed specifically for the increasing number of students taking a module in Equality and Diversity. The text contains a range of features to aid student learning, including: - Learning objectives - at the beginning of each chapter summarising the content of the chapter - Tasks - interactive tasks to encourage students to research around the subject - Case studies - thought-provoking examples of practice - Legal cases - examples of legal practice - Key Points - at the end of each chapter, a summary of key issues raised in the chapter - Examples to work through - at the end of each chapter, mini case examples with questions to check students' understanding.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

The aim was to define post-caesarean dyspareunia as a sexual and pelvic-perineal symptom. Post-caesarean (80 elective, 104 emergency) and 100 vaginally delivered primiparae had domiciliary interviews at 10 months postpartum. A total of 50 (28% and 27%) post-caesarean and 46 (46%) vaginally delivered, reported dyspareunia. Severely impaired general sexual health occurred in 82 (24% elective, 25% emergency, 35% vaginally delivered) as category 3 (dyspareunia with sexual symptoms) and 27 (10% elective, 7% emergency, 12% vaginally delivered) as category 4 (reduced frequency <6). The risk of dyspareunia (RR 1.14, CI 0.73, 1.77) or impaired general sexual health (RR 0.93, CI 0.32, 2.74) was similar among those with or without perineal trauma. Both caesarean and perineal scars were associated with sexual malfunction. Primiparae with new incontinence had a lower risk of dyspareunia than impaired general sexual health. Awareness of the associations of post-caesarean dyspareunia and impaired general sexual health with incontinence would facilitate appropriate obstetric decision-making. Further research is indicated. © 2011 Informa UK, Ltd.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

Objective: Vomiting in pregnancy is a common condition affecting 80% of pregnant women. Hyperemesis is at one end of the spectrum, seen in 0.5–2% of the pregnant population. Known factors such as nulliparity, younger age and high body mass indexare associated with an increased risk of this condition in the first trimester. Late pregnancy complications attributable to hyperemesis, the pathogenesis of which is poorly understood, have not been studied in large population-based studies in the United Kingdom. The objective of this study was to determine a plausible association between hyperemesis and pregnancy complications,such as pregnancy-related hypertension, gestational diabetes and liver problems in pregnancy, and the rates of elective (ElCS) and emergency caesarean section (EmCS). Methods: Using a database based on ICD-10 classification, anonymised data of admissions to a large multi-ethnic hospital in Manchester, UK between 2000 and 2012 were examined.Notwithstanding the obvious limitations with hospital database-based research, this large volume of datasets allows powerful studies of disease trends and complications.Results Between 2000 and 2012, 156 507 women aged 45 or under were admitted to hospital. Of these, 1111 women were coded for hyperemesis (0.4%). A greater proportion of women with hyperemesis than without hyperemesis were coded forhypertensive disorders in pregnancy such as pregnancy-induced hypertension, pre-eclampsia and eclampsia (2.7% vs 1.5%;P=0.001). The proportion of gestational diabetes and liver disorders in pregnancy was similar for both groups (diabetes:0.5% vs. 0.4%; P=0.945, liver disorders: 0.2% vs. 0.1%;P=0.662). Hyperemesis patients had a higher proportion of elective and emergency caesarean sections compared with the non-hyperemesis group (ElCS: 3.3% vs. 2%; P=0.002, EmCS: 5% vs.3%; P=0.00). Conclusions: There was a higher rate of emergency and elective caesarean section in women with hyperemesis, which could reflect the higher prevalence of pregnancy-related hypertensive disorders(but not diabetes or liver disorders) in this group. The factors contributing to the higher prevalence of hypertensive disorders arenot known, but these findings lead us to question whether there is a similar pathogenesis in the development of both the conditions and hence whether further study in this area is warranted.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

Increasingly, neuroscientists are taking the opportunity to use live human tissue obtained from elective neurosurgical procedures for electrophysiological studies in vitro. Access to this valuable resource permits unique studies into the network dynamics that contribute to the generation of pathological electrical activity in the human epileptic brain. Whilst this approach has provided insights into the mechanistic features of electrophysiological patterns associated with human epilepsy, it is not without technical and methodological challenges. This review outlines the main difficulties associated with working with epileptic human brain slices from the point of collection, through the stages of preparation, storage and recording. Moreover, it outlines the limitations, in terms of the nature of epileptic activity that can be observed in such tissue, in particular, the rarity of spontaneous ictal discharges, we discuss manipulations that can be utilised to induce such activity. In addition to discussing conventional electrophysiological techniques that are routinely employed in epileptic human brain slices, we review how imaging and multielectrode array recordings could provide novel insights into the network dynamics of human epileptogenesis. Acute studies in human brain slices are ultimately limited by the lifetime of the tissue so overcoming this issue provides increased opportunity for information gain. We review the literature with respect to organotypic culture techniques that may hold the key to prolonging the viability of this material. A combination of long-term culture techniques, viral transduction approaches and electrophysiology in human brain slices promotes the possibility of large scale monitoring and manipulation of neuronal activity in epileptic microcircuits.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

With the establishment of The New University Code in 1994, Taiwan's colleges and universities were mandated to shift physical education from a required course to an elective. The four-year colleges and universities are now responsible for either developing new physical education programs or removing existing programs from their curriculum. Planned change and curriculum leadership are considered in light of policy changes regarding required physical education programs enacted by the Ministry of Education. ^ This study compared the organizational structure and the curriculum of physical education at accredited colleges and universities in Taiwan. Chairpersons of physical education departments from 60 four-year colleges and universities were surveyed using a modified version of the Hensley's Basic Instruction Program (BIP) Questionnaire. Results were analyzed using analysis of variance (ANOVA) and crosstabs. The findings confirmed that physical education programs were effected by declining enrollment and administrative decisions to eliminate them. However, at the same time, chairpersons expressed strong support for the maintenance of the traditional physical education curriculum. ^

Relevância:

10.00% 10.00%

Publicador:

Resumo:

The implementation of term limits on state legislators has provided a wealth of data for study. Florida, the second largest state in the Union with term limits, has not been comprehensively studied. This research examines the effects of term limits on electoral competition, member composition, legislator career paths, legislative leadership, and intra- and inter-governmental influences on Florida's legislature. This study looks at the Florida legislature from 1992 when term limits were enacted through 2004, three electoral cycles in which term limits have been in effect. This study uses both quantitative and qualitative data where appropriate. Electoral data is used to assess electoral and demographic effects, as well as member career trajectories. Interview data with current and former legislators, lobbyists, and executive branch officials is used to analyze both changes in legislative organization and intra- and inter-governmental influences on the legislative process. Term limits has only created greater competition when a legislative seat opens and has actually created a greater advantage for incumbents. Women and minorities have only made minimal gains in winning seats post-term limits. Newly elected legislators are not political novices with a vast majority having previous elective experience. Leadership is more centralized under term limits and the Senate has gained an advantage over the more inexperienced House. Lastly, the influence of staff, lobbyists, and most importantly, the governor has greatly increased under term limits. This research finds that term limits have not produced the consequences that proponents had envisioned.^

Relevância:

10.00% 10.00%

Publicador:

Resumo:

The practices developed in the everyday life of obstetric services are sometimes out of step with the recommendations of the public health policies. Accordingly, this research had the objective of assessing the quality of the care provided to women and children during cases of natural childbirth in municipal public maternity wards of the city of Natal/RN, Brazilian Northeast. We developed a cross-sectional and quantitative study in two maternity wards that provide care actions to pregnant women at regular risk (maternity wards A and B). The participants were 314 puerperal women who were treated during the period between April and July 2014, whose children were born alive, through transpelvic way, with spontaneous or induced beginning of labor and that showed physical and emotional conditions to respond to the proposed questions. The data collection instrument was constructed on the basis of the recommendations of the World Health Organization focused on the care of normal childbirth and validated by skilled judges, and the final version has obtained optimum agreement (k = 0,96; IVC = 0,99). Associated with these recommendations, we used three indicators: percentage of women with induced labor or subjected to elective cesarean section (Indicator A); percentage of women served by a qualified health professional during labor and childbirth (Indicator B); and Bologna Index (Indicator C). The research obtained a favorable opinion of the Research Ethics Committee from the Federal University of Rio Grande do Norte, under the nº 562.313 and Certificate of Presentation for Ethics Appreciation: 25958513.0.0000.5537. The analysis of categories related to the recommendations of the World Health Organization was conducted by means of absolute and relative frequency and the Chi-square Pearson’s and Fisher’s exact tests made the comparison of the differences observed between the two maternity wards. Furthermore, we calculated the percentage of the indicators A and B and with the results of the Indicator C, the quality was assessed as follows: the closer to 5, the better will be the quality, and the closer to 0, the worst will be the quality, and the Mann-Whitney U test was used to compare the differences of the obtained averages. The significance level of 5% was considered in all statistical tests. The differences between the maternity wards were identified with regard to the provision of liquids orally (p=0,018), stimulus for non-supine positions (p=0,002), existence of partograph (p=0,001), support or welcoming by health professionals (p= 0,047), intravenous infusion (p<0,001), supine position (p<0,001), use of oxytocin (p<0,001), food and liquid restriction (p= 0,002) and, lastly, the fact of the touch is performed by more than 1 examiner (p=0,011). The indicators A and B showed percentages of 13,09% and 100%, respectively. The overall average of the Indicator C was equal to 2,07 (± 0,74). There was a statistically significant difference between the averages of the maternity wards (p<0,001). The care actions provided during the process of labor and childbirth is inappropriate, especially in the maternity ward B. It is necessary to implement improvements and redesign the obstetric model in force

Relevância:

10.00% 10.00%

Publicador:

Resumo:

This paper analyzed the relation between participation and school autonomy, observing Director actions and School Council actions and if school has pedagogic, administrative and financial autonomy. This is a descriptive search, with quantitative approach, realized in 47 state schools in Rio Grande do Norte, and composed by 292 participants, divided in 3 groups (Direction, Coordination and School Council). The instrument to catch data was a questionnaire and the data treatment realized by way descriptive statistic and inferences using X 2 test. The results show that school administration is composed in great part by women with specialization grade. All schools have School Council and Financial Council, but have not Parents and Masters Association and just one of them has Student Guild. The direction choose process is, in 83% of the schools, by elective way. The indicators show that the relation involving family, society and school stays weak, but Directors, Coordinators and School Council members develop their functions with coherence. About autonomy, it is limited and presents correlation with participation, but the educational system stays rigid and centralizer

Relevância:

10.00% 10.00%

Publicador:

Resumo:

This study aimed to characterize in a clinical and epidemiological way the patients who are on a waiting list for transplantation and the patients transplanted with corneal tissue in a corneal transplants reference service in the state of Rio Grande do Norte. It is an epidemiological study of a quantitative approach, with cross-sectional, descriptive and analytical cut including all patients on the waiting list for transplantation (population A) and the patients already transplanted with a corneal tissue (population B) in a reference service. In population A, there was a census conducted of patients on the waiting list for corneal transplantation (n=62 patients). In population B, the sample was non-probabilistic and corresponded to all corneal transplants performed in the service in the period from 2010 to 2014 (n=258). This study is approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte, in Opinion 876 177 and CAAE 37533014.8.0000.5537. Data were collected in full in the period from January to April 2015, by two instruments built to systematize the necessary data collection. After being coded and tabulated, data were analyzed using the Statistical Package for Social Sciences software, version 20.0. The definition of variables and their distribution patterns were presented as frequencies and measures of central tendency while, for multivariate analysis, the effect of magnitude measures were applied (prevalence ratio) and measures of association (chi-square test or Fisher's exact test) for a 0.05 significance level. The results are shown in two scientific articles coming from the field survey data. It was found that the epidemiological profile of patients on the waiting list (n=62) showed a prevalence of individuals aged over 50 years old, female (54.84%) and residents of the middle region of East Rio Grande do Norte (66.13%). The clinical profile of patients with corneal transplantation (n=258) was characterized by being male (51.16%) with an average age of 49.33 years old and 57.75% were coming from East Rio Grande do Norte. The average time on the waiting list was 172.63 days in elective transplants and 9.03 days in urgent transplants. Keratoconus was the main indicator condition to perform the transplant. For patients on the waiting list, the variable “type of disorder of the cornea” showed statistically significant association with gender and age. For patients with corneal transplants, the variable "type of disorder of the cornea" was associated with the variables gender, age, previous surgery, failure of previous graft, classification of the eye and glaucoma. By characterizing the clinical and epidemiological profile of corneal transplants, it is possible to question the reality, pointing about the care that should be offered and develop targeted interventions to collective and individual needs intrinsic to patients who need this surgery as a treatment option.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

© 2016 American Heart Association, Inc.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

Copyright © 2014 International Anesthesia Research Society.BACKGROUND: Goal-directed fluid therapy (GDFT) is associated with improved outcomes after surgery. The esophageal Doppler monitor (EDM) is widely used, but has several limitations. The NICOM, a completely noninvasive cardiac output monitor (Cheetah Medical), may be appropriate for guiding GDFT. No prospective studies have compared the NICOM and the EDM. We hypothesized that the NICOM is not significantly different from the EDM for monitoring during GDFT. METHODS: One hundred adult patients undergoing elective colorectal surgery participated in this study. Patients in phase I (n = 50) had intraoperative GDFT guided by the EDM while the NICOM was connected, and patients in phase II (n = 50) had intraoperative GDFT guided by the NICOM while the EDM was connected. Each patient's stroke volume was optimized using 250- mL colloid boluses. Agreement between the monitors was assessed, and patient outcomes (postoperative pain, nausea, and return of bowel function), complications (renal, pulmonary, infectious, and wound complications), and length of hospital stay (LOS) were compared. RESULTS: Using a 10% increase in stroke volume after fluid challenge, agreement between monitors was 60% at 5 minutes, 61% at 10 minutes, and 66% at 15 minutes, with no significant systematic disagreement (McNemar P > 0.05) at any time point. The EDM had significantly more missing data than the NICOM. No clinically significant differences were found in total LOS or other outcomes. The mean LOS was 6.56 ± 4.32 days in phase I and 6.07 ± 2.85 days in phase II, and 95% confidence limits for the difference were -0.96 to +1.95 days (P = 0.5016). CONCLUSIONS: The NICOM performs similarly to the EDM in guiding GDFT, with no clinically significant differences in outcomes, and offers increased ease of use as well as fewer missing data points. The NICOM may be a viable alternative monitor to guide GDFT.