Avaliação do ensino da obstretícia e da assistência ao parto sob a percepção dos graduandos em medicina e enfermagem na Universidade Federal do Rio Grande do Norte

OBJETIVE: To evaluate the perception of Medical and Nursing students of Medicine and Nursing graduation courses at the Federal University of Rio Grande do Norte (UFRN), on obstetrics teaching and labor assistance in the context of the maternal care provided by the Maternity Hospital Januário Cicco (MEJC) and contribute to curricular updating planning of teaching obstetrics, in accordance with the principles of humanization. METHODS: It was conducted a study of cross-cutting approach and qualitative and quantitative descriptive method, with students in medicine and nursing of UFRN, who were attending or had been attended the midwifery disciplines medicine; and women's health in nursing. The data were collected through a questionnaire with objective and subjective questions, and stored in a database, spreadsheet software Excel / Office 2010 with all the variables. RESULTS: We interviewed 169 students, 118 of medical school and 51 from the nursing program, of which 46.75% were male and 53.25% female. The largest number of medical respondents is the 11th period (40.67%), and nursing, on 10, (43.15%). These students witnessed 1,073 births, and (61.8%) vaginal deliveries. The obstetricians were the most performed vaginal deliveries (40%). Nurses performed only (8.13%). The assistance provided to women during the process of labor and delivery, was configured as suitable for 87.58% of respondents and these glimpsed humane conduct. Students who performed deliveries, 76.27% were medical and 11.76% were nursing. All had guidance while doing them. A total of 19.50% medical students reported that there is a prejudice against vaginal delivery, particularly for the humanized birth, unlike all nursing students (100%) who reported that there is this prejudice. Most students (73%) showed preference for vaginal delivery, especially nursing students. On the knowledge of myths in relation to vaginal delivery, 60.35% answered that they know some. CONCLUSION: This study presents itself as a highly relevant, since the results may contribute to curricular changing and updating related to obstetrics teaching, but also serve as a resource for analysis of humanization practices that should be developed in educational institutions and which are recommended by the Ministry of Health.

The influence of interhemispheric connections on ongoing and evoked orientation preference maps and spiking activity in the cat primary visual cortex

In the primary visual cortex, neurons with similar physiological features are clustered together in columns extending through all six cortical layers. These columns form modular orientation preference maps. Long-range lateral fibers are associated to the structure of orientation maps since they do not connect columns randomly; they rather cluster in regular intervals and interconnect predominantly columns of neurons responding to similar stimulus features. Single orientation preference maps – the joint activation of domains preferring the same orientation - were observed to emerge spontaneously and it was speculated whether this structured ongoing activation could be caused by the underlying patchy lateral connectivity. Since long-range lateral connections share many features, i.e. clustering, orientation selectivity, with visual inter-hemispheric connections (VIC) through the corpus callosum we used the latter as a model for long-range lateral connectivity. In order to address the question of how the lateral connectivity contributes to spontaneously generated maps of one hemisphere we investigated how these maps react to the deactivation of VICs originating from the contralateral hemisphere. To this end, we performed experiments in eight adult cats. We recorded voltage-sensitive dye (VSD) imaging and electrophysiological spiking activity in one brain hemisphere while reversible deactivating the other hemisphere with a cooling technique. In order to compare ongoing activity with evoked activity patterns we first presented oriented gratings as visual stimuli. Gratings had 8 different orientations distributed equally between 0º and 180º. VSD imaged frames obtained during ongoing activity conditions were then compared to the averaged evoked single orientation maps in three different states: baseline, cooling and recovery. Kohonen self-organizing maps were also used as a means of analysis without prior assumption (like the averaged single condition maps) on ongoing activity. We also evaluated if cooling had a differential effect on evoked and ongoing spiking activity of single units. We found that deactivating VICs caused no spatial disruption on the structure of either evoked or ongoing activity maps. The frequency with which a cardinally preferring (0º or 90º) map would emerge, however, decreased significantly for ongoing but not for evoked activity. The same result was found by training self-organizing maps with recorded data as input. Spiking activity of cardinally preferring units also decreased significantly for ongoing when compared to evoked activity. Based on our results we came to the following conclusions: 1) VICs are not a determinant factor of ongoing map structure. Maps continued to be spontaneously generated with the same quality, probably by a combination of ongoing activity from local recurrent connections, thalamocortical loop and feedback connections. 2) VICs account for a cardinal bias in the temporal sequence of ongoing activity patterns, i.e. deactivating VIC decreases the probability of cardinal maps to emerge spontaneously. 3) Inter- and intrahemispheric long-range connections might serve as a grid preparing primary visual cortex for likely junctions in a larger visual environment encompassing the two hemifields.

The influence of interhemispheric connections on ongoing and evoked orientation preference maps and spiking activity in the cat primary visual cortex

In the primary visual cortex, neurons with similar physiological features are clustered together in columns extending through all six cortical layers. These columns form modular orientation preference maps. Long-range lateral fibers are associated to the structure of orientation maps since they do not connect columns randomly; they rather cluster in regular intervals and interconnect predominantly columns of neurons responding to similar stimulus features. Single orientation preference maps – the joint activation of domains preferring the same orientation - were observed to emerge spontaneously and it was speculated whether this structured ongoing activation could be caused by the underlying patchy lateral connectivity. Since long-range lateral connections share many features, i.e. clustering, orientation selectivity, with visual inter-hemispheric connections (VIC) through the corpus callosum we used the latter as a model for long-range lateral connectivity. In order to address the question of how the lateral connectivity contributes to spontaneously generated maps of one hemisphere we investigated how these maps react to the deactivation of VICs originating from the contralateral hemisphere. To this end, we performed experiments in eight adult cats. We recorded voltage-sensitive dye (VSD) imaging and electrophysiological spiking activity in one brain hemisphere while reversible deactivating the other hemisphere with a cooling technique. In order to compare ongoing activity with evoked activity patterns we first presented oriented gratings as visual stimuli. Gratings had 8 different orientations distributed equally between 0º and 180º. VSD imaged frames obtained during ongoing activity conditions were then compared to the averaged evoked single orientation maps in three different states: baseline, cooling and recovery. Kohonen self-organizing maps were also used as a means of analysis without prior assumption (like the averaged single condition maps) on ongoing activity. We also evaluated if cooling had a differential effect on evoked and ongoing spiking activity of single units. We found that deactivating VICs caused no spatial disruption on the structure of either evoked or ongoing activity maps. The frequency with which a cardinally preferring (0º or 90º) map would emerge, however, decreased significantly for ongoing but not for evoked activity. The same result was found by training self-organizing maps with recorded data as input. Spiking activity of cardinally preferring units also decreased significantly for ongoing when compared to evoked activity. Based on our results we came to the following conclusions: 1) VICs are not a determinant factor of ongoing map structure. Maps continued to be spontaneously generated with the same quality, probably by a combination of ongoing activity from local recurrent connections, thalamocortical loop and feedback connections. 2) VICs account for a cardinal bias in the temporal sequence of ongoing activity patterns, i.e. deactivating VIC decreases the probability of cardinal maps to emerge spontaneously. 3) Inter- and intrahemispheric long-range connections might serve as a grid preparing primary visual cortex for likely junctions in a larger visual environment encompassing the two hemifields.

L'intention, l'attitude, la norme subjective et la perception du contrôle chez des adolescents-es espagnols-es en regard de l'utilisation du Double Dutch

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

Dosage form preference consultation study in children and young adults:paving the way for patient-centred and patient-informed dosage form development

Objectives: The current study aims to evaluate dosage form preferences in children and young adults together with identifying the key pragmatic dosage form characteristics that would enable appropriate formulation of orally disintegrating tablets (ODTs). Methods: International, multisite, cross-sectional questionnaire of children and young adults aged from 6 to 18 years. Eligibility was based on age, ability to communicate and previous experience in taking medications. The study was carried out at three locations: the UK, Saudi Arabia and Jordan. The questionnaire instrument was designed for participant self-completion under supervision of the study team.Results 104 questionnaires were completed by the study cohort (n=120, response rate 87%). Results: showed that ODTs were the most preferred oral dosage forms (58%) followed by liquids (20%), tablets (12%) and capsules (11%). The preferred colours were pink or white while the preferred size was small (<8 mm) with a round shape. With regard to flavour, strawberry was the most preferred (30.8%), while orange was the least preferred (5.8%). The results also showed that the most important physical characteristics of ODTs were disintegration time followed by taste, size and flavour, respectively. Conclusions: The results of our study support the WHO's claim for a shift of paradigm from liquid towards ODTs dosage forms for drug administration to young children older than 6 years. Data from this study will also equip formulators to prioritise development of key physical/performance attributes within the delivery system.

Can aberrometry provide rapid and reliable measures of subjective depth of focus following multifocal intraocular lens implantation?

Purpose: To determine whether the ‘through-focus’ aberrations of a multifocal and accommodative intraocular lens (IOL) implanted patient can be used to provide rapid and reliable measures of their subjective range of clear vision. Methods: Eyes that had been implanted with a concentric (n = 8), segmented (n = 10) or accommodating (n = 6) intraocular lenses (mean age 62.9 ± 8.9 years; range 46-79 years) for over a year underwent simultaneous monocular subjective (electronic logMAR test chart at 4m with letters randomised between presentations) and objective (Aston open-field aberrometer) defocus curve testing for levels of defocus between +1.50 to -5.00DS in -0.50DS steps, in a randomised order. Pupil size and ocular aberration (a combination of the patient’s and the defocus inducing lens aberrations) at each level of blur was measured by the aberrometer. Visual acuity was measured subjectively at each level of defocus to determine the traditional defocus curve. Objective acuity was predicted using image quality metrics. Results: The range of clear focus differed between the three IOL types (F=15.506, P=0.001) as well as between subjective and objective defocus curves (F=6.685, p=0.049). There was no statistically significant difference between subjective and objective defocus curves in the segmented or concentric ring MIOL group (P>0.05). However a difference was found between the two measures and the accommodating IOL group (P<0.001). Mean Delta logMAR (predicted minus measured logMAR) across all target vergences was -0.06 ± 0.19 logMAR. Predicted logMAR defocus curves for the multifocal IOLs did not show a near vision addition peak, unlike the subjective measurement of visual acuity. However, there was a strong positive correlation between measured and predicted logMAR for all three IOLs (Pearson’s correlation: P<0.001). Conclusions: Current subjective procedures are lengthy and do not enable important additional measures such as defocus curves under differently luminance or contrast levels to be assessed, which may limit our understanding of MIOL performance in real-world conditions. In general objective aberrometry measures correlated well with the subjective assessment indicating the relative robustness of this technique in evaluating post-operative success with segmented and concentric ring MIOL.

L'intention, l'attitude, la norme subjective et la perception du contrôle chez des adolescents-es espagnols-es en regard de l'utilisation du Double Dutch

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

Redefining Attitude Importance: The Possible Existence of Associative and Subjective Types of Importance Under a Global Definition

Traditionally, importance has been measured using subjective measures. The present thesis explores the possibility of a second type of importance, designated as “associative importance”. A new measure, the IIAT, was designed to capture the strength of association between an object and the attribute of importance. This thesis then evaluated the validity of the IIAT via an intervention paradigm in 2 studies, and by using the measure to predict a memory outcome in 2 other studies. Subjective measures of importance were also included in these studies and correlations between subjective measures and IIAT results were examined. Across all 4 studies, subjective-objective correlations were weak to modest and non-significant. The intervention studies provided promising evidence that interventions do affect associative importance as measured by the IIAT. The prediction studies provided somewhat mixed, but encouraging evidence that the IIAT may be able to predict memory performance. Notably, subjective measures were not able to predict memory performance at all, whereas the IIAT was able to predict some memory indices. Overall, there is some evidence supporting the existence of an associative importance construct, and that the IIAT provides valid results that are nonetheless different from that of subjective measures of attitude importance.

Cinematic and Aesthetic Cartographies of Subjective Mutation

This article examines the use of cinema as a mapping of subjective mutation in the work of Deleuze, Gauttari and Berardi. Drawing on Deleuze's distinction between the reduction of the art-work to the symptom and the idea of art as symptomatology, the article focuses on Berardi's use of cinematic examples, posing the question in each case of to what extent they function as symptomatologies or mere symptoms of cultural and subjective mutations in examples ranging from Bergman's Persona to Van Sant's Elephant to finish on speculations about Fincher's The Social Network as a critical engagement with subjective mutation in the 21st Century.

Incertidumbre y actitudes pro-redistributivas: mercados de trabajo y modelos de bienestar en Europa

La articulación entre las políticas de empleo y las políticas sociales condicionan la percepción subjetiva de incertidumbre los individuos. El modelo de mercado laboral tiene un peso determinante en la percepción de incertidumbre. El empleo en sí mismo ya no es suficiente garantía de ingresos seguros. El empleo a tiempo parcial y los contratos temporales generan una creciente demanda de políticas de redistribución de los ingresos en los países del Sur y Este de Europa. En los países escandinavos los mismos tipos de contratos laborales generan menos desigualdad porque el empleo público contribuye a generar un “círculo virtuoso” que favorece las políticas de igualdad y la conciliación entre la vida laboral y familiar. A nivel individual las actitudes pro-redistributivas las impulsan las mujeres, aquellas personas con incertidumbre en sus ingresos económicos y con bajo nivel de estudios. Por el contrario, quienes más confían en el éxito individual y el mérito son los jóvenes con estudios universitarios y aquellos que perciben ingresos económicos altos.

Chemotherapy patient perception regarding communication with the healthcare staff

Purpose: To qualitatively explore the communication between healthcare professionals and oncology patients based on the perception of patients undergoing chemotherapy.Method: Qualitative and exploratory design. Participants were 14 adult patients undergoing chemotherapy at different stages of the disease. A socio-demographic and clinical data form was utilized along with semi-structured interviews. The interviews were audio-recorded, transcribed and content analysis was performed. Two independent judges evaluated the interview content in regards to emerging categories and obtained a Kappa index of 0.834.Results: Three categories emerged from the data: 1) Technical communication without emotional support, in which the information provided is composed of strictly technical information regarding the diagnosis, treatment and/or prognosis; 2) Technical communication, in which the information provided is oriented towards the technical aspects of the patient’s physical condition, while also providing psychological support for the patients’ subjective needs; and 3) Insufficient technical communication, win which there are gaps in the information provided causing confusion and suffering to the patient.Conclusions: Communication with emotional support contributes to greater satisfaction of chemotherapy patients. Practical implications: the results provide elements for the training of healthcare professionals regarding the importance of the emotional support that can be offered to cancer patients during their treatment.

Alcoholic Beverage Preference and Dietary Habits in Elderly across Europe: Analyses within the Consortium on Health and Ageing: Network of Cohorts in Europe and the United States (CHANCES) Project

INTRODUCTION: The differential associations of beer, wine, and spirit consumption on cardiovascular risk found in observational studies may be confounded by diet. We described and compared dietary intake and diet quality according to alcoholic beverage preference in European elderly.

METHODS: From the Consortium on Health and Ageing: Network of Cohorts in Europe and the United States (CHANCES), seven European cohorts were included, i.e. four sub-cohorts from EPIC-Elderly, the SENECA Study, the Zutphen Elderly Study, and the Rotterdam Study. Harmonized data of 29,423 elderly participants from 14 European countries were analyzed. Baseline data on consumption of beer, wine, and spirits, and dietary intake were collected with questionnaires. Diet quality was assessed using the Healthy Diet Indicator (HDI). Intakes and scores across categories of alcoholic beverage preference (beer, wine, spirit, no preference, non-consumers) were adjusted for age, sex, socio-economic status, self-reported prevalent diseases, and lifestyle factors. Cohort-specific mean intakes and scores were calculated as well as weighted means combining all cohorts.

RESULTS: In 5 of 7 cohorts, persons with a wine preference formed the largest group. After multivariate adjustment, persons with a wine preference tended to have a higher HDI score and intake of healthy foods in most cohorts, but differences were small. The weighted estimates of all cohorts combined revealed that non-consumers had the highest fruit and vegetable intake, followed by wine consumers. Non-consumers and persons with no specific preference had a higher HDI score, spirit consumers the lowest. However, overall diet quality as measured by HDI did not differ greatly across alcoholic beverage preference categories.

DISCUSSION: This study using harmonized data from ~30,000 elderly from 14 European countries showed that, after multivariate adjustment, dietary habits and diet quality did not differ greatly according to alcoholic beverage preference.