937 resultados para P-Closed Space


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

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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

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BackgroundThe success of epidural anaesthesia depends on correct identification of the epidural space. For several decades, the decision of whether to use air or physiological saline during the loss of resistance technique for identification of the epidural space has been governed by the personal experience of the anaesthesiologist. Epidural block remains one of the main regional anaesthesia techniques. It is used for surgical anaesthesia, obstetrical analgesia, postoperative analgesia and treatment of chronic pain and as a complement to general anaesthesia. The sensation felt by the anaesthesiologist from the syringe plunger with loss of resistance is different when air is compared with saline (fluid). Frequently fluid allows a rapid change from resistance to non-resistance and increased movement of the plunger. However, the ideal technique for identification of the epidural space remains unclear.ObjectivesTo evaluate the efficacy and safety of both air and saline in the loss of resistance technique for identification of the epidural space.To evaluate complications related to the air or saline injected.Search methodsWe searched the Cochrane Central Register of Controlled Trials (CENTRAL) (2013, Issue 9), MEDLINE, EMBASE and the Latin American and Caribbean Health Science Information Database (LILACS) (from inception to September 2013). We applied no language restrictions. The date of the most recent search was 7 September 2013.Selection criteriaWe included randomized controlled trials (RCTs) and quasi-randomized controlled trials (quasi-RCTs) on air and saline in the loss of resistance technique for identification of the epidural space.Data collection and analysisTwo review authors independently assessed trial quality and extracted data.Main resultsWe included in the review seven studies with a total of 852 participants. The methodological quality of the included studies was generally ranked as showing low risk of bias inmost domains, with the exception of one study, which did not mask participants. We were able to include data from 838 participants in the meta-analysis. We found no statistically significant differences between participants receiving air and those given saline in any of the outcomes evaluated: inability to locate the epidural space (three trials, 619 participants) (risk ratio (RR) 0.88, 95% confidence interval (CI) 0.33 to 2.31, low-quality evidence); accidental intravascular catheter placement (two trials, 223 participants) (RR 0.90, 95% CI 0.33 to 2.45, low-quality evidence); accidental subarachnoid catheter placement (four trials, 682 participants) (RR 2.95, 95% CI 0.12 to 71.90, low-quality evidence); combined spinal epidural failure (two trials, 400 participants) (RR 0.98, 95% CI 0.44 to 2.18, low-quality evidence); unblocked segments (five studies, 423 participants) (RR 1.66, 95% CI 0.72 to 3.85); and pain measured by VAS (two studies, 395 participants) (mean difference (MD) -0.09, 95% CI -0.37 to 0.18). With regard to adverse effects, we found no statistically significant differences between participants receiving air and those given saline in the occurrence of paraesthesias (three trials, 572 participants) (RR 0.89, 95% CI 0.69 to 1.15); difficulty in advancing the catheter (two trials, 227 participants) (RR 0.91, 95% CI 0.32 to 2.56); catheter replacement (two trials, 501 participants) (RR 0.69, 95% CI 0.26 to 1.83); and postdural puncture headache (one trial, 110 participants) (RR 0.83, 95% CI 0.12 to 5.71).Authors' conclusionsLow-quality evidence shows that results do not differ between air and saline in terms of the loss of resistance technique for identification of the epidural space and reduction of complications. Applicability might be compromised, as most of the results described in this review were obtained from parturient patients. This review underlines the need to conduct well-designed trials in this field.

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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

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

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New real estate launch products and closed residential spaces, occurs with increasing frequency in Brazilian cities and are based on the assumption that there is a general increase in violence, as we address urban insecurity, which involves individual coping, and privatizing adept practices of exacerbated control mechanisms. We researched deployment and appropriation of residential spaces in middle cities of Sao Paulo (Brazil). We identify social representations of the others, blamed for insecurity growing, and analyzed from everyday life perspective. We hypothesized that new forms of production of urban space with a tendency to social and spatial fragmentation, generate new practices.

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This article proposes a reflection on the “continuities of the process” in narratives, defined by the closure of the space and by the waiting in time (chronopoiesis), as well as on the “halts of the process” in narratives, defined by the opening of the space and by the repose in time (chronotrophy). In Claude Zilberberg?s proposal about the missive making (le faire missif ), it means, the profound making that governs the becoming of the narratives, temporality and spatiality are related to the categories of closure and opening. The terms chronopoiesis and chronotrophy, established by Zilberberg from the Greek stems, have etymologically in common the stem “krónos”, the time. The first term is added to “poiesis”, “creation”; the second comes together with “trophê”, the “feeding”, the “development”. The remissive making, that carries the “continuities of the process”, is chronopoietic (the expectant temporality, which creates the waiting time), and spatially closed. On the other hand, the emissive making, which carries the “halts of the process”, is chronotrophic (the “originating” temporality, because it is “fed”, creating the passing time) and spatially open. Our reflection on chronopoiesis and chronotrophy aims at verifying if these temporal operations of the missivity necessarily correspond to spatial closures and openings, respectively, as the Zilberberg’s model proposes, in verbo-visual narratives, specifically in comics.

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The curriculum is an important instrument, through which are outlined the main aspects to be achieved in the educational context . It can be real, occurs in the classroom as a result of the education program, and be hidden normally be transmitted without being mentioned by teachers. Sexuality although it is not integrated with the components of the formal curriculum, and is present in said prohibited school , the way you act, speak and articulate the school community , expressing itself through the hidden curriculum. Considering this, the present study based on qualitative and quantitative aimed to analyze the curriculum of a course in pedagogy of a State University located in the State of São Paulo, as well as giving voice to students of that course in order to analyze if sexuality is to clearly present the formal curriculum. Therefore , a study of the documents in that course , but precisely its curriculum process n º 342/89 , their volumes I to IX , the period extending from 1959 to 200, as well as the curriculum in force until the year 2007. In addition, we used a closed questionnaire containing 20 questions which included the participation of 70 students Pedagogy daytime and night of that educational institution. Since its initial curriculum to the latest nonexistent space for disciplines sexuality, and the ' progress ' that can be noted is the introduction of the limited elective courses that no longer exist in the current course. In the words of most students sexuality is not a matter encompassed in that course. These data show that both the real and the hidden curriculum does not give due importance to this issue. Therefore, it is imperative that this course, as well as the different undergraduate courses, should adhere to sexuality need to be part of the actual curriculum, in order to allow students access to this knowledge.

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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