Clinical and Microbiologic Evaluation of Chronic Leg Ulcers: A Cross-sectional Study

OBJECTIVE: This study aimed at evaluating the flora and bacterial load of chronic leg ulcers (CLUs) according to the clinical judgment of colonization or infection.DESIGN: This was an analytical and cross-sectional study.SETTING: This study was conducted in an outpatient wound care unit in the Dermatology Department of the Botucatu School of Medicine-UNESP, Brazil.PARTICIPANTS: The participants were patients with CLUs who did not use systemic antibiotics.METHODS: The ulcers were clinically divided into 3 groups: ulcers with good granulation tissue (GGT), critical colonization (CC), and infection. Secretion was collected from a 1-cm(2) area using a swab and seeded by the semiquantitative method.OUTCOME MEASURES: The main outcome measures were genus and species of the bacteria found in the cultures and result of the semiquantitative culture correlating with the clinical diagnosis of GGT, CC, and infection.MAIN RESULTS: Seventy-seven ulcers were evaluated: 27 with GGT, 29 with CC, and 21 with infection. Gram-negative bacteria were most often found in all groups (81%): Pseudomonas aeruginosa, in granulation and colonized ulcers, and Proteus mirabilis, in infected ulcers. Ulcers from the infected group showed higher bacterial load.CONCLUSIONS: The flora of CLUs was predominantly constituted by gram-negative bacteria, and P aeruginosa was the most prevalent. The bacterial load of infected ulcers was higher as compared with the others, although some ulcers with GGT also presented a high load. The interpretation of microbiologic tests based on the swab techniques and even on semiquantitative analysis requires close clinical correlation.

Exaggerating, mislabeling or simulating obsessive-compulsive symptoms: Case reports of patients claiming to have obsessive-compulsive disorder

Background: There are no reported cases of factitious or simulated obsessive compulsive disorder (OCD). However, over the last years, our clinic has come across a number of individuals that seem to exaggerate, mislabel or even intentionally produce obsessive and/or compulsive symptoms in order to be diagnosed with OCD.Methods: In this study, experienced clinicians working on a university-based OCD clinic were requested to provide clinical vignettes of patients who, despite having a formal diagnosis of OCD, were felt to display non-genuine forms of this condition.Results: Ten non-consecutive patients with a self-proclaimed diagnosis of OCD were identified and described. Although patients were diagnosed with OCD according to various structured interviews, they exhibited diverse combinations of the following features: (i) overly technical and/or doctrinaire description of their symptoms, (ii) mounting irritability, as the interviewer attempts to unveil the underlying nature of these descriptions; (iii) marked shifts in symptom patterns and disease course; (iv) an affirmative yes pattern of response to interview questions; (v) multiple Axis I psychiatric disorders; (vi) cluster B features; (vii) an erratic pattern of treatment response; and (viii) excessive or contradictory drug-related side effects.Conclusions: In sum, reliance on overly structured assessments conducted by insufficiently trained or naive personnel may result in invalid OCD diagnoses, particularly those that leave no room for clinical judgment. (C) 2014 Elsevier Inc. All rights reserved.

O jogo simbólico livre e dirigido e as manifestações do juízo moral em crianças da educação infantil

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Modelos de recuperação de informação e web semântica: a questão da relevância

Introduction: In the Web environment, there is a need for greater care with regard to the processing of descriptive and thematic information. The concern with the recovery of information in computer systems precedes the development of the first personal computers. Models of information retrieval have been and are today widely used in databases specific to a field whose scope is known. Objectives: Verify how the issue of relevance is treated in the main computer models of information retrieval and, especially, as the issue is addressed in the future of the Web, the called Semantic Web. Methodology: Bibliographical research. Results: In the classical models studied here, it was realized that the main concern is retrieving documents whose description is closest to the search expression used by the user, which does not necessarily imply that this really needs. In semantic retrieval is the use of ontologies, feature that extends the user's search for a wider range of possible relevant options. Conclusions: The relevance is a subjective judgment and inherent to the user, it will depend on the interaction with the system and especially the fact that he expects to recover in your search. Systems that are based on a model of relevance are not popular, because it requires greater interaction and depend on the user's disposal. The Semantic Web is so far the initiative more efficient in the case of information retrieval in the digital environment.

Relaciones entre tendencias de juicio moral, estilos de resolución de conflictos y percepción de la manifestación de la agresividad en niños y adolescentes

The moral judgment was approached upon a constructivist perspective which focuses on its evolution according to the different types of social relations. The several forms of resolution of conflicts are also considered in this reference, since they are related to situations of interaction, as well as the aggressiveness. The research was carried out with sixty children and teenagers from a socio-educational institution. It aimed to identify the variations according to age, and relate the trends in moral judgment, the styles of resolution of conflicts, and the perception of the educators regarding to the manifestation of aggressive behaviors. The instruments for collecting data were the Scale of Perception from Teachers for children that manifested Aggressive Behaviors in School, a Clinical Interview about moral judgment and the adaptation of the Children\'s Action Tendency Scale - CATS. The results showed that variations in relation to age were significant regarding to moral judgment. The younger children showed more heteronomous judgments and the older children more autonomous. Furthermore, the data evidenced a positive relationship between semiautonomia and aggressiveness, which raises the possibility of this being regarded as one of the unique strategies to take a position within an authoritarian and coercive environment.

A formação ética do educador: competência e juízo moral de graduandos de pedagogia

Traditionally, undergraduate education emphasizes theory and technique. The ethical education of the professional who will act in society is placed at most in a discipline related to professional´s deontology. Ethical discussions are developed in a bored way and the mission of educating students is considered fulfilled. Based on this analysis, the principal purpose of this study was to verify if the training provided by university has some influence on the development of students’ moral judgment and moral competence. The participants were 540 undergraduate students from the first and the last year of education from Pedagogy course from two universities of São Paulo state, one of them was public and the other private. The instruments were Defining Issues Test (DIT-2) and Moral Judgment Test (MJT-xt). The results indicated that the training received did not lead to significant improvement of their capacity to reflect about moral issues.

Informação orgânica como insumo estratégico para a tomada de decisão em ambientes competitivos: estudo nas empresas do setor varejista situadas na cidade de Marília/SP

The focus of this research is centered on organic information production, sharingand use on the enterprise decision making process. The information on the present economy becomes value source for organizations. The organic information is produced on the organization s internal environment been a product of the activities made by execution its functions. Knowing the elements that involve this process gives a great help to managers once the decision making process is permeated by conflicts and different perceptions. Therefore, the organic information can reduce these conflicts on organizational contexts, because it reduces the uncertainness, propitiates more security and more trustworthiness to the decision making process, besides it gives dynamism to people s time involved on the process. The investigated universe was composed by the companies affiliated to Construnova Net, from construction material segment, located at Marilia Region s cities, Sao Paulo State, because it is an important segment which influences the local and regional economy. The methodological proceedings used are based on the qualitative approach which method is related to descriptive and exploratory research. As data collecting instruments were elaborated a structured questionnaire with closed questions and an interview s syllabus which contents are related to the research s aims. As analysis proceedings for the collected data and also to consider the qualitative approach it was chosen the Contents Analysis method from Bardin and more specifically the Categorical Analysis . Consequently, we conclude that it is deficient in production of organic information, or to produce documents that prove and control the activities that are developed within the organization is not satisfactory. The decision usually is not subsidized by organic information. Accordingly the study points out the deficiency of the perception of the importance of the organic type information as an aid to decision making and al

Processos de gestão da informação: tratamento, recuperação e uso da informação no mercado de capitais

In the capital market the information are used as subsidies for the decision making of investors, among the main highlights are the economic, political, accounting and relating nature to the financial results of companies which have stocks traded at Stock Exchanges. In this perspective, it is essential that the agents involved especially brokerage companies establish management processes that contain a set of criteria for the organization and treatment of information collected in newspapers, news agencies and the companies that trade in stocks. Thus, it is essential to establish rigor in relation to recovery mechanisms of such information, which requires more than technology, because actions are necessary that will propitiate the informational content are made available with consistency, clarity and trustworthiness, so as that users can retrieve them in a timely manner. Furthermore, those processes should provide the efficient use of the information retrieved by users, so that they can use them aiming to subsidize the decisions of sale or purchase shares. Considering that the information systems are responsible for the information dissemination in the framework of capital market, it is necessary to present requisites that contemplate the set organization, treatment, retrieval and use of information. That way, we sought to evidence in this paper these issues, utilizing as a premise the elements proposed by Guimarães (2003) from the perspective of the information environment of a values brokerage companies reflecting through the model used, how these companies realize their work considering the dimensions of the documentary analysis, informational treatment, and the instruments for retrieval and use of information.

Meninices de uma poetisa: um estudo de O menino poeta, de Henriqueta Lisboa

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

Different approaches on seed germination to look into global warming effects on Araucaria angustifolia

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Triple-aspect monism: Physiological, mental unconscious and conscious aspects of brain activity

Brain activity contains three fundamental aspects: (a) The physiological aspect, covering all kinds of processes that involve matter and/or energy; (b) the mental unconscious aspect, consisting of dynamical patterns (i.e., frequency, amplitude and phase-modulated waves) embodied in neural activity. These patterns are variously operated (transmitted, stored, combined, matched, amplified, erased, etc), forming cognitive and emotional unconscious processes and (c) the mental conscious aspect, consisting of feelings experienced in the first-person perspective and cognitive functions grounded in feelings, as memory formation, selection of the focus of attention, voluntary behavior, aesthetical appraisal and ethical judgment. Triple-aspect monism (TAM) is a philosophical theory that provides a model of the relation of the three aspects. Spatially distributed neuronal dendritic potentials generate amplitude-modulated waveforms transmitted to the extracellular medium and adjacent astrocytes, prompting the formation of large waves in the astrocyte network, which are claimed to both integrate distributed information and instantiate feelings. According to the valence of the feeling, the large wave feeds back on neuronal synapses, modulating (reinforcing or depressing) cognitive and behavioral functions.

Competência de juízo moral dos estudantes de medicina: um estudo piloto

The authors conducted a cross-sectional short-term study using Lind's Moral Judgment Test (MJT) to compare the moral judgment competence (C-score) among students in the first and eighth semesters from a medical school in the Northeast region of Brazil. This study also evaluated the influence of such factors as age and gender on moral competence. A difference equal to or greater than 5.0 points (absolute effect-size) on the C-score was considered significant. A regression of moral judgment competence among the students in their eighth semester in relation to the students in the first semester (C-score: 20.5 and 26.2 points, respectively) was observed. In the analysis of the students' performances in terms of MJT dilemmas, the phenomenon of moral segmentation was observed in both semesters, and the students performed better on the worker's dilemma than on the doctor's dilemma. Among students in the same semester of study, older students had lower C-scores. When comparing performance by gender, there was no significant difference between men's and women's C-scores. The finding of regression or stagnation in moral competence among the medical students demands deep reflection by those who work with the political-pedagogical projects of medical schools and by the entire faculty, in order to seek strategies to reverse this condition.

A produção científica sobre diagnóstico de enfermagem NANDA no Brasil: revisão integrativa da literatura-UNESP – Botucatu

Concern about the identity of nursing professionals has existed since Florence Nightingale. The exercise of the nursing profession must be based on scientific principles so that the actual health problems of a given community can be assessed and actions targeted at improving the population’s quality of life can be designed from such assessments. This problem assessment is referred to as Nursing Diagnosis. NANDA defines diagnosis as “a clinical judgment about individual, family or community responses to actual or potential health problems/life processes. Nursing diagnosis provides the basis for selection of nursing interventions to achieve outcomes for which nurses are accountable”. The present study aimed at investigating the scientific production on Nursing Diagnosis (NANDA). This is an literature review. For data collection, an instrument that addressed the following items was used: identification of original articles and evaluation of their objectives, methodological characteristics, results and conclusion. In the present review, 15 articles that met the inclusion criteria were analyzed. They were all authored by nurses. Four articles addressed obstetrics, puerperium and neonatology, and the diagnosis of an unsatisfactory breastfeeding process was observed in 100% of cases. As regards chronic diseases, four articles were found, and two exclusively addressed diabetes, with a main diagnosis of an ineffective control of the therapeutic regimen. Three articles addressed the elderly, and the main diagnosis found was hindered mobility in more than 90% of cases. As regards, sexually transmitted diseases, one article was found with three diagnoses with 100% for disturbed sleep patterns, infection risk and ineffective protection. As to patients with sequelae, two articles were identified, and the diagnoses found were hindered physical mobility, with 100%; self-care deficit for... (Complete abstract click electronic access below)

RPG e mídia: uma análise do caso Ouro Preto

This paper is intended to perform an analysis of the news published by the Website Ouropreto.com.br and the portals and Uai e Terra in news about the murder of the student Aline Silveira Soares and about its judgment. According with the news, the student's body was found in the cemetery of the church Nossa Senhora das Mercês e Misericórdia on 14th October 2001 in the city of Ouro Preto in Minas Gerais. The police and the media reverberated the hypothesis that Aline would had been killed during a Satanic ritual related to the RPG game(Role Playing Game) which is a game where players assume characters within a story. Our proposal is to analyze the coverage of vehicles of different ranges (local, regional and national) and evaluate how the case was shown focusing on its supposed relationship with the RPG game

Percepção dos portadores de hanseníase acerca do auto cuidado

This study aimed at evaluating the perception of leprosy patients, the disease, with regard to its concept and self-care practice, as well as their knowledge concerning drug therapy. Fifteen patients participated in the study, of whom 11 were classified as multibacillary and 04 as paucibacillary. Semi-structure interviews containing six guiding questions were used for data collection, and the Collective Subject Discourse (CSD) was utilized as a theoretical framework. Analysis was performed based on the Theory of Complexity. It showed that patients suffer pain, a fact that is reflected on the need to change habits and prevent disability. It also showed that patients have doubts and feel insecure about treatment and prognosis, and that they are also the target of social prejudice even thought the term leprosy has been replaced by Hansen‟s disease. As regards self-care, the subjects showed lack of autonomy, limitations and subjection to instructions from health care professionals, who, according to the discourse that emerged, are mostly responsible for transmitting the knowledge concerning self-care practice. This fact can be explained by evidence of self-knowledge deficit by the the subjects. Concerning polychemotherapy treatment, which is recommended by the Ministry of Health, it was observed that the knowledge concerning its action and adverse effects is precarious. This information is provided during consultation; however, CSD showed that the subjects do not apprehend it. Therefore, health care professionals must instruct their clients not only as regards conventional treatment practices, but they must also help them to know themselves and to improve their critical judgment so that they can choose the best form of living after being diagnosed with the disease, thus guiding self-care by taking such choice into account