A comunidade da suspens��o de cirurgias pedi��tricas: motivos e sentimentos envolvidos no processo

P��s-gradua����o em Enfermagem (mestrado profissional) - FMB

Checklist de cirurgias da OMS: an��lise da seguran��a e comunica����o da equipe cir��rgica de um hospital escola

WHO has launched the ���Safe Surgery Saves Lives��� program with the purpose to reduce damage to surgical patients and define safety standards specifically in order to reduce such patients��� morbi-mortality by providing surgery teams and hospital managers with orientation about the standards of safe surgery and a uniform service evaluation instrument for national and international surveillance. Hence, this study aimed at applying the WHO safe-surgery checklist to the surgical specialties of a university hospital and evaluating the team���s opinion about the influence of its application on the safety of surgical process and on the team���s interpersonal communication. It was a descriptive, analytical, qualitative field study conducted in the surgery facilities of a university hospital in a public establishment in S��o Paulo state. The checklist was applied to eight surgical specialties, resulting in a total number of 30 surgeries. Its application was conducted by the researcher in three phases: Sign in, Time out, Sign Out. Next, one member of the surgery team was invited to voluntarily participate in the study by signing an informed consent form and answering guiding questions. Thirty members of the surgery team participated in the study. Bardin���s Content Analysis Method was used to organize and analyze the data. As regards the safety provided by the checklist, the following thematic categories emerged: ���It reduces risk and possible complications���; ���It standardizes conducts and reviews safety steps���; ���It allows for better understanding of the process���; and ���It provides safety to the team as a whole���. The category ���It is not included in the institution���s routine��� emerged from the subjects��� statements when they understood that, in this form, the checklist does not provide safety to surgical procedures. As regards communication, two thematic categories emerged: ...(Complete abstract click electronic access below)

Variation in peach fruit susceptibility to Monilinia laxa and gene expression

Brown rot caused by Monilinia laxa and Monilinia fructigena is considered one of the most important diseases affecting Prunus species. Although some losses can result from the rotten fruits in the orchard, most of the damage is caused to fruits during the post-harvest phase. Several studies reported that brown rot incidence during fruit development highly varies; it was found that at a period corresponding to the the pit hardening stage, fruit susceptibility drastically decreases, to be quickly restored afterwards. However the molecular basis of this phenomenon is still not well understood. Furthermore, no difference in the rot incidence was found between wound and un-wound fruits, suggesting that resistance associated more to a specifc biochemical response of the fruit, rather than to a higher mechanical resistance. So far, the interaction Monilinia-peach was analyzed through chemical approaches. In this study, a bio-molecular approach was undertaken in order to reveal alteration in gene expression associated to the variation of susceptibility. In this thesis three different methods for gene expression analysis were used to analyze the alterations in gene expression occurring in peach fruits during the pit hardening stage, in a period encompassing the temporary change in Monilinia susceptibility: real time PCR, microarray and cDNA AFLP techniques. In 2005, peach fruits (cv.K2) were weekly harvested during a 19-week long-period, starting from the fourth week after full bloom, until full maturity. At each sampling time, three replicates of 5 fruits each were dipped in the M.laxa conidial suspension or in distilled water, as negative control. The fruits were maintained at room temperature for 3 hours; afterwards, they were peeled with a scalpel; the peel was immediately frozen in liquid nitrogen and transferred to -80 ��C until use. The degree of susceptibility of peach fruit to the pathogen was determined on 3 replicates of 20 fruits each, as percentage of infected fruits, after one week at 20 ��C. Real time PCR analysis was performed to study the variation in expression of those genes encoding for the enzymes of the phenylpropanoid pathway (phenylalanine ammonia lyase (PAL), chalcone synthase (CHS), cinnamate 4-hydroxylase (C4H), leucoanthocyanidine reductase (LAR), hydroxycinnamoyl CoA quinate hydroxycinnamoyl transferase (HQT) and of the jasmonate pathway, such as lipoxygenase (LOX), both involved in the production of important defense compounds. Alteration in gene expression was monitored on fruit samples of a period encompassing the pit hardening stage and the corresponding temporary resistance to M.laxa infections, weekly, from the 6thto the 12th week after full bloom (AFB) inoculated with M. laxa or mock-inoculated. The data suggest a critical change in the expression level of the phenylpropanoid pathway from the 7th to the 8th week AFB; such change could be directly physiologically associated to the peach growth and it could indirectly determine the decrease of susceptibility of peach fruit to Monilinia rot during the subsequent weeks. To investigate on the transcriptome variation underneath the temporary loss of susceptibility of peach fruits to Monilinia rot, the microarray and the cDNA AFLP techniques were used. The samples harvested on the 8th week AFB (named S, for susceptible ones) and on the 12th week AFB (named R, for resistant ones) were compared, both inoculated or mock-inoculated. The microarray experiments were carried out at the University of Padua (Dept. of Environmental Agronomy and Crop Science), using the ��PEACH1.0 microarray together with the suited protocols. The analysis showed that 30 genes (corresponding to the 0.6% of the total sequences (4806) contained in the ��Peach1.0 microarray) were found up-regulated and 31 ( 0.6%) down regulated in RH vs. SH fruits. On the other hand, 20 genes (0.4%) were shown to be up-regulated and 13 (0.3%) down-regulated in the RI vs. SI fruit. No genes were found differentially expressed in the mock-inoculated resistant fruits (RH) vs. the inoculated resistant ones (RI). Among the up-regulated genes an ATP sulfurylase, an heat shock protein 70, the major allergen Pru P1, an harpin inducing protein and S-adenosylmethionine decarboxylase were found, conversely among the down-regulated ones, cinnamyl alcohol dehydrogenase, an histidine- containing phosphotransfer protein and the ferritin were found. The microarray experimental results and the data indirectly derived, were tested by Real Time PCR analysis. cDNA AFLP analysis was also performed on the same samples. 339 transcript derived fragments considered significant for Monilinia resistance, were selected, sequenced and classified. Genes potentially involved in cell rescue and defence were well represented (8%); several genes (12.1%) involved in the protein folding, post-transductional modification and genes (9.2%) involved in cellular transport were also found. A further 10.3% of genes were classified as involved in the metabolism of aminoacid, carbohydrate and fatty acid. On the other hand, genes involved in the protein synthesis (5.7%) and in signal transduction and communication (5.7%) were found. Among the most interesting genes found differentially expressed between susceptible and resistant fruits, genes encoding for pathogenesis related (PR) proteins were found. To investigate on the association of Monilinia resistance and PR biological function, the major allergen Pru P1 (GenBank accession AM493970) and its isoform (here named Pru P2), were expressed in heterologous system and in vitro assayed for their anti-microbial activity. The ribonuclease activity of the recombinant Pru P1 and Pru P2 proteins was assayed against peach total RNA. As the other PR10 proteins, they showed a ribonucleolytic activity, that could be important to contrast pathogen penetration. Moreover Pru P1 and Pru P2 recombinant proteins were checked for direct antimicrobial activity. No inhibitory effect of Pru P1 or Pru P2 was detected against the selected fungi.

The Technocrat - v. 35, no. 2

In this issue...2014 Elections, native fish restoration, Ryan Zinke, John Lewis, Academic Center for Excellence, climate change, interpersonal communication, student opinion

Intelligent Virtual Patients for Training Clinical Skills

The article presents the design process of intelligent virtual human patients that are used for the enhancement of clinical skills. The description covers the development from conceptualization and character creation to technical components and the application in clinical research and training. The aim is to create believable social interactions with virtual agents that help the clinician to develop skills in symptom and ability assessment, diagnosis, interview techniques and interpersonal communication. The virtual patient fulfills the requirements of a standardized patient producing consistent, reliable and valid interactions in portraying symptoms and behaviour related to a specific clinical condition.

Frequency of and predictors for withholding patient safety concerns among oncology staff: a survey study.

Speaking up about patient safety is vital to avoid errors reaching the patient and to improve a culture of safety. This study investigated the prevalence of non-speaking up despite concerns for safety and aimed to identify predictors for withholding voice among healthcare professionals (HCPs) in oncology. A self-administered questionnaire assessed safety concerns, speaking up beliefs and behaviours among nurses and doctors from nine oncology departments. Multiple regression analysis was used to identify predictors for withholding safety concerns. A total of 1013 HCPs returned the completed survey (response rate 65%). Safety concerns were common among responders. Fifty-four per cent reported to recognise their colleagues making potentially harmful errors at least sometimes. A majority of responders reported at least some episodes of withholding concerns about patient safety. Thirty-seven per cent said they remained silent at least once when they had information that might have helped prevent an incident. Respondents believed that a high level of interpersonal, communication and coping skills are necessary to speak up about patient safety issues at their workplace. Higher levels of perceived advocacy for patient safety and psychological safety significantly decreased the frequency of withholding voice. Remaining silent about safety concerns is a common phenomenon in oncology. Improved strategies are needed to support staff in effective communication and make cancer care safer.

Nonverbal synchrony in social interactions of patients with schizophrenia indicates socio-communicative deficits

Background Disordered interpersonal communication can be a serious problem in schizophrenia. Recent advances in computer-based measures allow reliable and objective quantification of nonverbal behavior. Research using these novel measures has shown that objective amounts of body and head movement in patients with schizophrenia during social interactions are closely related to the symptom profiles of these patients. In addition to and above mere amounts of movement, the degree of synchrony, or imitation, between patients and normal interactants may be indicative of core deficits underlying various problems in domains related to interpersonal communication, such as symptoms, social competence, and social functioning. Methods Nonverbal synchrony was assessed objectively using Motion Energy Analysis (MEA) in 378 brief, videotaped role-play scenes involving 27 stabilized outpatients diagnosed with paranoid-type schizophrenia. Results Low nonverbal synchrony was indicative of symptoms, low social competence, impaired social functioning, and low self-evaluation of competence. These relationships remained largely significant when correcting for the amounts of patients��� movement. When patients showed reduced imitation of their interactants��� movements, negative symptoms were likely to be prominent. Conversely, positive symptoms were more prominent in patients when their interaction partners��� imitation of their movements was reduced. Conclusions Nonverbal synchrony can be an objective and sensitive indicator of the severity of patients��� problems. Furthermore, quantitative analysis of nonverbal synchrony may provide novel insights into specific relationships between symptoms, cognition, and core communicative problems in schizophrenia.

CATCH across Texas: Building a model for the diffusion of effective school-based health promotion programs

The impact of health promotion programs is related to both program effectiveness and the extent to which the program is implemented among the target population. The purpose of this dissertation was to describe the development and evaluation of a school-based program diffusion intervention designed to increase the rate of dissemination and adoption of the Child and Adolescent Trial for Cardiovascular Health, or CATCH program (recently renamed the Coordinated Approach to Child Health). ^ The first study described the process by which schools across the state of Texas spontaneously began to adopt the CATCH program after it was tested and proven effective in a multi-site randomized efficacy trial. A survey of teachers and administrator representatives of all schools on record that purchased the CATCH program, but were not involved in the efficacy trial, was used to find out who brought CATCH into the schools, how they garnered support for its adoption, why they decided to adopt the program, and what was involved in deciding to adopt. ^ The second study described how the Intervention Mapping framework guided the planning, development and implementation of a program for the diffusion of CATCH. An iterative process was used to integrate theory, literature, the experience of project staff and data from the target population into a meaningful set of program determinants and performance objectives. Proximal program objectives were specified and translated into both media and interpersonal communication strategies for program diffusion. ^ The third study assessed the effectiveness of the diffusion program in a case-comparison design. Three of the twenty Education Service Center regions in Texas were chosen, selected based on similar demographic criteria, and were followed for adoption of the CATCH curriculum. One of these regions received the full media and interpersonal channel intervention; a second received a reduced media-only intervention, and a third received no intervention. Results suggested the use of the interpersonal channels with media follow-up is an effective means to facilitate program dissemination and adoption. The media-alone condition was not effective in facilitating program adoption. ^

Lo p��blico en lo privado : la calle elevada como catalizador del encuentro colectivo

En la actualidad, el individualismo social originado por las nuevas sociedades de la informaci��n, la crisis econ��mica, y, a��n m��s acusado por aquella arquitectura que busca la m��xima rentabilidad, ha provocado una creciente incomunicaci��n entre las personas que comparten los mismos espacios residenciales. La presente tesis doctoral aborda el estudio del espacio com��n dentro del proyecto de vivienda colectiva, desde la noci��n de espacio intermedio, entendido como frontera espacial ���entre el espacio p��blico de la ciudad y la atmosfera ��ntima de la vivienda��� donde tienen lugar los encuentros sociales entre residentes. El principal objetivo de la investigaci��n es rescatar y poner en valor principios b��sicos del dise��o arquitect��nico ���muchos de ellos en desuso��� que mejoran la calidad del espacio colectivo y favorecen la aparici��n de una atm��sfera agradable para el encuentro interpersonal, as�� como un intento de codificaci��n de estos aspectos, atendiendo a criterios conceptuales que definen el espacio p��blico contempor��neo. La hip��tesis de partida se basa en la consideraci��n del proyecto de viviendas como modelo an��logo al proyecto urbano de la ciudad ���con el que guarda sugerentes similitudes���, y los espacios intermedios como espacio de referencia que pone en valor aquello que liga ��� integrado en el propio proyecto���. Este supuesto b��sico ha permitido a diferentes autores poner en relaci��n fecunda el dise��o de la casa, el edificio y la ciudad, con el individuo, la comunidad y la sociedad; y ha posibilitado plantear la trasposici��n de conceptos arquitect��nicos fruct��feros, en relaci��n con el espacio p��blico ���usando como representante la idea de calle elevada���, que ahora pueden enriquecer el entorno privado del edificio. Sirvi��ndose de instrumentos espec��ficos de la disciplina arquitect��nica, la tesis trata de explicar la devaluaci��n a nivel social de los espacios colectivos, derivada de la construcci��n en altura y del uso excesivo de la estandarizaci��n en el proyecto de viviendas a partir del per��odo de postguerra, e intensificada en el postmodernismo por la revoluci��n de las comunicaciones. Se puede as�� reorientar el dise��o de los proyectos de vivienda colectiva no como una simple agrupaci��n de viviendas que favorecen la incomunicaci��n, sino tratando de impulsar unas edificaciones que potencien la comunicaci��n interpersonal. La reuni��n y reagrupaci��n de un vocabulario arquitect��nico espec��fico, acorde con la complejidad social intr��nseca en los espacios colectivos, amplia el alcance de los conceptos tratados. Dicha terminolog��a se basa principalmente en mecanismos de cualificaci��n espacial y permite evaluar la dimensi��n colectiva de la esfera semip��blica en el edificio de viviendas. ABSTRACT Currently, the social individualism caused by the new societies of information, the economic crisis and even more by architecture, which looks for maximum profitability, has led to a rising lack of communication between people that share the same living space. This doctoral thesis deals with the study of common space, which is based on the notion of in-between space, within the collective housing project. It is considered as a spatial frontier ���between the public space of the city and the intimate atmosphere of the housing��� where social contact between residents takes place. The main purpose of this research is to collect basic principles of architectural design ���many of them no longer in use��� that improve the quality of collective space. Following conceptual criteria that define the contemporary public space, they encourage the emergence of a pleasant atmosphere for interpersonal meeting as well as an attempt to codify these aspects. The initial hypothesis is based on the consideration of the housing project as a model analogous to the urban project of the city, with which it bears some similarities. Furthermore, it is based on the in-between spaces as space of reference that valuates what binds ��� integrated in the project-. That basic supposition has served various authors to connect the design of the house, the building and the city with the individual, the community and the society. In addition ���regarding public space and using the idea of the street in the sky as representative���, it has enabled to bring up the transposition of productive architectural concepts, which can now enrich the private environment of the building. Using specific architectural instruments, this thesis deals with explaining the social devaluation of collective spaces. It has resulted from the high rise building construction as well as from the excessive standardization in the housing project since the postwar period and is intensified by the communications revolution in postmodernism. Thus, it is possible to change the design of collective housing projects not as a mere cluster of dwellings that enhance isolation, but by trying to promote buildings that improve interpersonal communication. The collection and regrouping of a specific architectural vocabulary, in accordance with the social complexity inherent in collective spaces, expands the scope of the discussed concepts. Such terminology is mainly based on qualifying spatial strategies and allows to assess the collective dimension of the semi-public sphere in dwelling.

Effects of Dialogic Reading in the Improvement of Reading Comprehension in Students of Primary Education

Reading is an essential factor for success at school that requires certain skills and strategies of great complexity rarely taught in schools. Verbalization of comprehension strategies can be considered an effective measure in learning to read. The purpose of this study was to analyze the effect of a program of teaching reading strategies implemented through interactive dialogic reading groups in the learning of reading comprehension. A quasi-experimental comparison with pretest and posttest design between groups was used. A sample of 355 participants aged between 8 and 9 years aged was used. The results weigh the potential value of the program and support the development of teaching models that integrate dialogic reading practices as they facilitate learning of reading comprehension.

Equal Partners in Dialogue? Participation Equality in a Transnational Deliberative Poll (Europolis)

By gathering a representative sample of citizens from all 27 EU Member States, the deliberative poll Europolis created the opportunity for the inclusion of a wide variety of European voices. Taking up claims of difference democrats who argue that informal hurdles to participation can endure even after individuals gain formal access to the floor, this article argues for an extended approach to evaluate equality in deliberative minipublics. Specifically, it assesses whether participants contributed in roughly equal measures to the discussion and whether their discussion partners considered their contributions on equal merits. In doing so, the article adds to the small but growing literature on deliberation that expresses reservations about taking the willingness to engage with others' claims for granted. In order to account for the intrinsically relational aspect of interpersonal communication, measures of social network analysis are introduced as possible tools to evaluate participation equality in deliberative encounters.

Family style and environmental interaction /

Mode of access: Internet.

An examination of the effects of print media exposure and contact on subjective social reality and acculturation attitudes

This study draws upon cultivation theory, acculturation theory, and works on intergroup relations to examine the effects of print media exposure and contact on subjective social reality and acculturation attitudes of Chinese immigrants in Australia. Data was gathered via a survey administered to 265 respondents with Chinese origin. Results indicate that exposure to mainstream newspapers is only positively related to one indicator of subjective reality, namely, outgroup perception whereas exposure to ethnic newspapers was not significantly related to any of the indicators of subjective reality. Acculturation attitudes, on the other hand, are more closely related to group perception and contact but not closely associated with exposure to print media. These findings have again challenged the direct effect assumption of cultivation theory, paved the ground for combining mediated communication variables with interpersonal communication variables in acculturation research and suggested policy implications for interethnic coexistence. (c) 2005 Elsevier Ltd. All rights reserved.

A COMUNICA����O INTERPESSOAL COMO REGULADORA DA PERCEP����O DA QUALIDADE DOS SERVI��OS DE SA��DE

Quem utiliza, hoje, os servi��os de uma organiza����o especializada na ��rea da sa��de, encontra pela frente profissionais que desenvolvem atividades assistenciais, cujo exerc��cio est�� a exigir bem mais do que apenas compet��ncia t��cnica. S��o m��dicos, enfermeiros, psic��logos, fisioterapeutas, nutricionistas, terapeutas ocupacionais, assistentes sociais, entre outros, que, al��m das a����es e procedimentos relacionados ��s suas ��reas espec��ficas de conhecimento, t��m de estabelecer sempre, com as pessoas que atende, rela����es de car��ter interpessoal. Existe literatura suficiente indicando haver consider��vel al��vio por parte dos pacientes (clientes) e melhoria das condi����es do trabalho assistencial quando o profissional de sa��de est�� apto a conhecer mais de perto os motivos para muitos dos comportamentos dos seus pacientes. Nessa perspectiva, uma intera����o para melhor compreender suas necessidades, ang��stias, raivas e expectativas �� de fundamental import��ncia. �� tamb��m conhecido o fato de que muitas das reclama����es e insatisfa����es dos servi��os prestados nessas institui����es poderiam ser evitados ou atenuados quando os pacientes se sentem compreendidos e respeitados pelos profissionais envolvidos no seu atendimento. A falta de acolhimento das demandas da clientela e a observa����o, por parte desta, de que os aspectos emocionais na rela����o com quem o assiste est�� sendo negligenciada pode conduzir este paciente, enquanto cliente, �� conclus��o de que o servi��o prestado �� de m�� qualidade. Este estudo ter�� por objetivo conhecer, dentro do fen��meno da comunica����o interpessoal, as modalidades de intera����es sociais constitu��das atrav��s dela �� forma����o das exig��ncias, expectativas e percep����es desses atores sociais, al��m do entendimento de como se d�� a rela����o entre paciente e atendente. Para isso, estudaremos os principais conceitos de servi��os, qualidade e os fundamentos te��ricos do modelo conceitual formulado por PARASURAMAN, ZEITHAML & BERRY e seus posteriores refinamentos , que resultaram na escala Servqual, cuja concep����o determina que a qualidade dos servi��os de qualquer natureza detectada por uma clientela, resulta do hiato entre as expectativas iniciais e a performance percebida do servi��o. A escala Servqual se constituir�� assim, no principal instrumento te��rico a ser utilizado neste trabalho. Entendendo a sociedade de hoje como uma rede sist��mica, estudaremos, por fim, as lacunas entre as expectativas e percep����es de uma clientela espec��fica dos servi��os oferecidos por uma empresa hospitalar especializada na ��rea de maternidade. �� uma pesquisa na qual se procurar�� determinar em que dimens��es da qualidade a comunica����o interpessoal apresenta maior influ��ncia, funcionando como um mecanismo regulador da percep����o dos servi��os prestados sob uma ��tica qualitativa.

A COMUNICA����O PARA A SA��DE NA RESSOCIALIZA����O E AUTONOMIA DO CIDAD��O IDOSO

O presente trabalho trata da import��ncia da intersec����o entre a comunica����o para a sa��de e a atividade f��sica como fatores de ressocializa����o, de melhoria da qualidade de vida e da autonomia do segmento carente da terceira idade. Objetivo �� verificar se a realiza����o de atividades f��sicas em grupo, se a comunica����o interpessoal advindas destas atividades e as trocas de informa����o sobre qualidade de vida, doen��a e sa��de podem ser consideradas como fatores relevantes para a sociabilidade e a melhoria da sa��de dos idosos carentes que participam dessas oportunidades de intera����o. Trata-se de uma pesquisa explorat��ria realizada por meio de aplica����o de question��rio, cujas entrevistas, foram realizadas pessoalmente, al��m de pesquisa bibliogr��fica. A principal conclus��o �� que embora idosos mere��am ter acesso a uma rede de apoio em sa��de interdisciplinar, �� necess��ria ainda, ressaltar a urg��ncia em organiza����o de servi��os de atendimento a essa popula����o e uma maior ��nfase na comunica����o voltada para os idosos.(AU)