Promoção, comunicação e educação em saúde: a prática da acupuntura e da fitoterapia

Esta pesquisa discute a Comunicação em Saúde no contexto das Práticas Integrativas e Complementares (PIC) no Sistema Único de Saúde (SUS), no que concerne ao tratamento do câncer realizado num hospital público de Campinas. O arcabouço teórico se debruça sobre as diretrizes do ideário da Promoção da Saúde e sobre as discussões da Educação em Saúde, por serem premissas fundamentais para que a Comunicação em Saúde seja participativa e democrática, e que a Comunicação das PIC conquiste maior espaço na Saúde Pública. O objetivo geral foi investigar o processo de comunicação entre profissionais de saúde e usuários do SUS participantes do Projeto de Construção do Cuidado Integrativo (PCCI). A metodologia utilizada foi a qualitativa tendo como instrumentos pesquisa documental e entrevistas semi-estruturadas para a coleta dos dados. Os participantes do estudo foram usuários que fizeram parte do grupo de Acupuntura e de Fitoterapia e usaram práticas complementares ao tratamento convencional do câncer, e também os profissionais de saúde envolvidos no PCCI realizado no Hospital de Clínicas da Universidade Estadual de Campinas (UNICAMP)/SP. Os dados foram analisados por meio da análise temática de conteúdo de Bardin, que permitiu identificar as seguintes categorias: Medo da intervenção, Analgesia como resultado, Continuidade do tratamento, Falta de informação e Divulgação das práticas. Os resultados mostraram que houve dificuldades de comunicação, indicando lacunas importantes em relação à infraestrutura, à falta de divulgação e continuidade do tratamento complementar com as PIC, a falta de valorização da participação popular e estímulo à autonomia como preconiza o ideário da Promoção da Saúde. Concluiu-se que o modelo de saúde vigente, de base biomédica, não tem permitido a participação dos usuários, e, mais ainda, tem dificultado o desenvolvimento da comunicação democrática, humanizada e solidária. O Projeto (PCCI) foi importante em sua execução, uma vez que trouxe resultados positivos com o uso das PIC por melhorar as condições da qualidade de vida dos usuários e ter promovido analgesia, conferido maior disposição e recuperação dos movimentos. Entretanto, o Projeto (PCCI) não teve potencial o suficiente para provocar uma mudança na lógica do tratamento convencional que está hegemonicamente imerso no modelo biomédico, com isso limitando a inserção e a comunicação das PIC na Saúde Pública e dificultando a abertura para o diálogo entre os diferentes saberes. Entende-se que este é um dos principais desafios da Medicina Tradicional e Complementar (MTC).

Fadiga cíclica flexural de instrumentos Hyflex CM e TF Adaptive em diferentes situações experimentais

O presente estudo teve como objetivo avaliar a resistência à fadiga cíclica flexural dos instrumentos de níquel- titânio, Hyflex CM (Coltène, EUA) e TF Adaptive (SybronEndo, EUA) em diferentes situações experimentais. Todas as limas que foram selecionadas possuíam conicidade 0,04 e diâmetro de ponta 35. Utilizou-se um dispositivo desenvolvido especificamente para realizar o ensaio flexural dinâmico. Os instrumentos TF Adaptive foram divididos em 3 grupos de acordo com o ângulo de curvatura do ensaio: 45º, 60º e 90º e cada grupo subdividido em 2 subgrupos de acordo com o tipo de movimento: rotação contínua e Adaptive. Cada subgrupo era composto por 15 instrumentos TF Adaptive, totalizando 90 instrumentos. Quinze instrumentos Hyflex CM formavam o grupo 4, no ensaio com ângulo de curvatura 90 graus e rotação contínua. A simulação foi realizada em canais artificiais de aço com ângulo de 45, 60, 90 graus e raio 5m m. O número de ciclos e o tempo em segundos até a fratura foram tabulados e analisados. Entretanto, a fadiga cíclica flexural foi significante maior nos três grupos em movimento Adaptive. E as limas TF Adaptive em seu próprio movimento tiveram maior número de ciclos e tempo até a fratura quando comparadas as Hyflex CM no ensaio de 90 graus. Portanto, conclui-se que o sistema Adaptive (limas TF Adaptive + movimento Adaptive) foi mais seguro à resistência á fadiga flexural, e no ensaio de 90 graus o sistema Adaptive foi mais resistente quando comparado com as limas Hyflex CM no movimento de rotação contínua.

Adequabilidade ambiental dos biomas brasileiros à ocorrência do lobo-guará (Chrysocyon brachyurus) e efeitos da composição da paisagem em sua ecologia espacial, atividade e movimentação

O lobo-guará é uma espécie de ampla distribuição na América do Sul, tendo no Brasil sua maior área de ocorrência. No entanto, as modificações das áreas naturais principalmente destinadas à agropecuária tornam a espécie vulnerável à extinção. A investigação objetivou conhecer em larga escala a área de distribuição potencial gerada por atributos ambientais favoráveis e áreas adequadas à sua ocorrência nos biomas brasileiros e investigar como a espécie responde à estrutura da paisagem, avaliando os efeitos de ambientes modificados pelo homem na sua ecologia espacial, nos padrões de atividade e na movimentação. Modelos de distribuição de espécie foram gerados pelo Maxent, utilizando uma base de pontos de localização de presença a partir de 2000 para o Cerrado (Ce), Pantanal (Pa), Mata Atlântica (MA) e Pampas (Pp) e um conjunto de onze variáveis ambientais não correlacionadas (topográficas, climáticas e paisagísticas). Para análises de ecologia espacial, das atividades e de movimentação, utilizou-se localizações de telemetria (GPS) de animais habitantes de áreas protegidas (AP), e indivíduos em paisagens modificados (AM). Análises de áreas de vida (AV) foram realizadas utilizando o estimador AKDE e associadas com classificação da paisagem local. Os modelos de distribuição do lobo-guará apresentaram uma área de distribuição potencial de 78% do total dos biomas. Apesar de possuírem grandes proporções de áreas adequadas (Ce, 90%; Pa, 93%; MA, 65% e Pp, 6%), somente um pequeno percentual (4,4% do Ce e 4,7% da MA) possui adequabilidade ambiental acima de 50%. Dos atributos que favorecem sua presença, a altitude (para todos os biomas), a precipitação (Ce e Pa), diferenças de temperatura e uso e cobertura do solo (Ma e Pp) foram os mais importantes. Em nível local, animais apresentaram média de AV de 90Km2 em AP e 41Km2 em AM, uma diferença significativa (p<0,01) com áreas diretamente proporcionais ao percentual de áreas naturais na paisagem. Ainda, apesar dos padrões regulares de atividade não mostrarem grandes mudanças, o período de repouso foi significativamente maior (p<0,01) entre os animais AM (46% do dia) que em animais AP (25% do dia). Lobos-guarás de AP e AM não apresentaram grandes diferenças no deslocamento diário com média geral de 14km caminhados por dia, com comprimentos de passos de 1Km. Diferenças no comprimento de passo foram relacionadas à composição da diversidade de contato de classes da paisagem com a proporção de ambientes naturais no passo (quanto maior as variáveis, maior o passo). Passos menores refletem menor persistência de movimento interferindo no deslocamento diário. Com os resultados desse estudo identificou-se a MA e Pa muito importantes, mas o Ce como bioma mais adequado à espécie. Foram encontrados indícios de que a estrutura de suas AV, o uso da paisagem, as atividades e movimentação são afetados pela paisagem modificada. Isso pode comprometer a viabilidade populacional, interferindo na presença em uma área e refletindo no seu potencial de distribuição. As estratégias de manejo de uso do solo, e a recuperação e conexão de áreas adequadas são urgentes e necessárias para que o lobo-guará permaneça presente e funcional nas paisagens dos biomas brasileiros.

Fixation pattern analysis with microperimetry in nystagmus patients

Objective: To assess the usefulness of microperimetry (MP) as an additional objective method for characterizing the fixation pattern in nystagmus. Design: Prospective study. Participants: Fifteen eyes of 8 subjects (age, 12–80 years) with nystagmus from the Lluís Alcanyís Foundation (University of Valencia, Spain) were included. Methods: All patients had a comprehensive ophthalmologic examination including a microperimetric examination (MAIA, CenterVue, Padova, Italy). The following microperimetric parameters were evaluated: average threshold (AT), macular integrity index (MI), fixating points within a circle of 1° (P1) and 2° of radius (P2), bivariate contour ellipse area (BCEA) considering 63% and 95% of fixating points, and horizontal and vertical axes of that ellipse. Results: In monocular conditions, 6 eyes showed a fixation classified as stable, 6 eyes showed a relatively unstable fixation, and 3 eyes showed an unstable fixation. Statistically significant differences were found between the horizontal and vertical components of movement (p = 0.001), as well as in their ranges (p < 0.001). Intereye comparison showed differences between eyes in some subjects, but only statistically significant differences were found in the fixation coordinates X and Y (p < 0.001). No significant intereye differences were found between microperimetric parameters. Between monocular and binocular conditions, statistically significant differences in the X and Y coordinates were found in all eyes (p < 0.02) except one. No significant differences were found between MP parameters for monocular or binocular conditions. Strong correlations of corrected distance visual acuity (CDVA) with AT (r = 0.812, p = 0.014), MI (r = –0.812, p = 0.014), P1 (r = 0.729, p = 0.002), horizontal diameter of BCEA (r = –0.700, p = 0.004), and X range (r = –0.722, p = 0.005) were found. Conclusions: MP seems to be a useful technology for the characterization of the fixation pattern in nystagmus, which seems to be related to the level of visual acuity achieved by the patient.

Dionne Brand, Austin Clarke, and Tessa McWatt: Blackening Canada

This project analyzes contemporary black diasporic writing in Canada, arguing that Dionne Brand, Austin Clarke and Tessa McWatt evince a unique form of double-consciousness in their writings. Their work transforms African-American double-consciousness by locating it simultaneously within both the black diaspora and the practice of Canadian multiculturalism. The objective of this project is to offer a critical framework for situating these writers within the legacy of both Black Atlantic and Canadian cultural production. These writers do not aim to resolve their double-consciousness but rather dwell within that contradictory doubleness and hyphenation, forcing nation and diaspora to contend with one another in a discomfiting and unsettling dialogue. These authors employ the absences of the black diaspora to imagine new forms of black cultural production, multicultural citizenship and national identity. Their works produce a grammar of diasporic double-consciousness that locates the absented origins of diaspora within Canada. Brand’s depiction of temporality and Clarke’s tracing of movement explore the continuities between nation and diaspora while re-membering neglected aspects of the history of black Canada, such as the life and death of Albert Johnson. McWatt extends this blackening of nation by depicting coalitions between diasporic, indigenous, raced and sexed subjects. These authors transform hegemonic Canadian narratives of nation by dwelling in the hyphen, while their evocation of memory, absence, trauma, and desire gives blackness new meaning and legitimacy.

Changing Attitudes And Expectations In A University Setting: A Case Study

First and second year students enrolled in a four-year movement education based university Physical Education program completed a questionnaire regarding their expectations on entering university. In addition, graduates of the program were interviewed, one year after graduation, with regard to their understanding of and attitude towards movement education and how these had developed relative to their overall degree program. Most students had no knowledge of movement education prior to entering the program and the selection of this particular program was simply coincidental with their desire to pursue physical education. Whereas the students did participate in an activity course and a theory course in Year 1, it was only when participating in a Year 2 movement course which combined theory and practice within the same course that students recognized the movement base of the content. The progress of the students through the program reflects distinct declarative and procedural stages in knowledge development followed by an ability to generalize that knowledge a conceptual stage. The real understanding of movement education came as the students were required to teach movement education to students, children, and other groups.

European Integration and Europeanisation: Benefits and Disadvantages for Business. Bruges European Economic Policy (BEEP) Briefing 29/2013

European integration is a project of great economic importance for the 500 million consumers and 21 million companies in Europe. With the economic borders between Member States removed, Europeanisation becomes inevitable for companies. The paper proposes a framework to analyse the benefits and disadvantages for business that come with the process of European integration, structured according to the logic of the four fundamental freedoms of movement within the Internal Market (freedom of movement of goods, services, capital and people) complemented by the section on technology and innovation, and the general EU regulatory environment. Whereas the business decisions need to be taken on a case-by-case basis, taking into consideration firm’s own capabilities and resources as well as industry specificities, several recommendations for companies willing to Europeanise are made, based on an analysis of the regulatory macro-environment of the EU. Above all, any company willing to be successful in the EU has to become a learning organisation, responsive to the advancements of the macro-environment. The ability to anticipate the regulatory developments and to adjust one’s own business and corporate strategy accordingly is the key to achieving sustainable competitive advantage in the European Union.

The EU Counter-Terrorism Policy Responses to the Attacks in Paris: Towards an EU Security and Liberty Agenda. CEPS Liberty and Security in Europe No. 81/February 2015

This paper examines the main EU-level initiatives that have been put forward in the weeks following the attacks in Paris in January 2015, which will be discussed in the informal European Council meeting of 12 February 2015. It argues that a majority of these proposals predated the Paris shootings and had until that point proved contentious as regards their efficacy, legitimacy and lawfulness. The paper finds that EU counterterrorism responses raise two fundamental challenges: A first challenge is posed to the freedom of movement, Schengen and EU citizenship. Priority is being given to the expanded use of large-scale surveillance and systematic monitoring of all travellers including EU citizens, which stands in contravention of Schengen and the free movement principle. A second challenge concerns EU democratic rule of law. Current pressures calling for the adoption of measures such as the EU Passenger Name Record challenge the scrutiny roles held by the European Parliament and the Court of Justice of the EU on counterterrorism measures in a post-Lisbon Treaty setting. The paper proposes that the EU adopts a new European Agenda on Security and Liberty based on an EU security (criminal justice-led) cooperation model that is firmly anchored in current EU legal principles and rule of law standards. This model would call for ‘less is more’ concerning the use, processing and retention of data by police and intelligence communities. Instead, it would pursue better and more accurate use of data meeting the quality standards of evidence in criminal judicial proceedings.

The Schengen Governance Package-another missed opportunity?. IES Policy Brief Issue 2015/1, February 2015

The Schengen Area of free movement is considered to be one of the most substantial and, in the eyes of many, most successful achievements of European integration. In 2014, the ‘Schengen Governance Package’, which alters the rules of the Schengen co-operation, came into force. It is a response to conflict among Member States in maintaining the common zone of freedom of movement. This Policy Brief aims to analyse how this package was developed and to assess whether it represents a suitable response to the conflict and difficulties within the Schengen agreement. The Brief argues that the Governance Package only touches on one part of the problem, namely border controls, whereas it does not deal with solidarity and burden-sharing and hence represents another missed opportunity to improve cooperation in the Schengen Area.

Schengen Anniversary - EPC Special Collection

To mark the 30th anniversary of the Schengen Agreement, the EPC has put together a special collection of EPC papers on Schengen's developments between 2011 and 2014. Signed by France, Germany, Belgium, the Netherlands and Luxembourg on 14 June 1985, the Schengen Agreement has paved the way for the development of one of the EU’s most symbolic achievements: the freedom of movement without internal border checks. Although the agreement has been one of the EU’s biggest successes, the Schengen story has not always been a ‘long fleuve tranquille’, particularly in recent years. This year’s anniversary offers the opportunity to revisit the latest developments in the Schengen cooperation and look back at the accomplishments of this landmark agreement.

The Schengen governance package - another missed opportunity? IES Policy Brief Issue 2015/1 February 2015

The Schengen Area of free movement is considered to be one of the most substantial and, in the eyes of many, most successful achievements of European integration. In 2014, the ‘Schengen Governance Package’, which alters the rules of the Schengen co-operation, came into force. It is a response to conflict among Member States in maintaining the common zone of freedom of movement. This Policy Brief aims to analyse how this package was developed and to assess whether it represents a suitable response to the conflict and difficulties within the Schengen agreement. The Brief argues that the Governance Package only touches on one part of the problem, namely border controls, whereas it does not deal with solidarity and burden-sharing and hence represents another missed opportunity to improve cooperation in the Schengen Area.

Dennis Fitzgerald, UM football, 1961, in leather helmet

[Fitzgerald was last Michigan player to wear a leather helmet. Pictured holding the model worn by other players, says leather helmet fits better and gives him more freedom of movement. (from note in neg. envelope.)]

Micro-meso-macro

Building on the ontology of evolutionary realism recently proposed by Dopfer and Potts (forthcoming), we develop an analytical framework for evolutionary economics with a micro-meso-macro architecture. The motive for reconception is to make clear the highly complex and emergent nature of existence and change in economic evolution. For us, the central insight is that an economic system is a population of rules, a structure of rules, and a process of rules. The economic system is a rule-system contained in what we call the meso. From the evolutionary perspective, one cannot directly sum micro into macro. Instead, we conceive of an economic system as a set of meso units, where each meso consists of a rule and its population of actualizations. The proper analytical structure of evolutionary economics is in terms of micro-meso-macro. Micro refers to the individual carriers of rules and the systems they organize, and macro consists of the population structure of systems of meso. Micro structure is between the elements of the meso, and macro structure is between meso elements. The upshot is an ontologically coherent framework for analysis of economic evolution as change in the meso domain - in the form of what we call a meso trajectory - and a way of understanding the micro-processes and macro-consequences involved. We believe that the micro-meso-macro analytical framework can greatly enhance the focus, clarity, and, ultimately, power, of evolutionary economic theory.

Trade and culture history across the Vitiaz Strait, Papua New Guinea: The emerging post-Lapita coastal sequence

This paper, focusing principally on post-Lapita times, outlines the course and outcomes of work undertaken over the last two decades in the West New Britain-Vitiaz Strait-north New Guinea coastal region. It presents two principal arguments. The first is that major periods of movement and abandonment documented in the archaeological sequences of this region from about 3,500 years ago coincide with the record of volcanism in the Talasea-Cape Hoskins area. The second is that the post-Lapita sequences of this region differ significantly from the post-Lapita sequences emerging in the island arc reaching from Manus via New Ireland to southern and eastern island Melanesia, which show continuous occupation and pottery production.

Changes in head and neck position affect elbow joint position sense

Changes in the position of the head and neck have been shown to introduce a systematic deviation in the end-point error of an upper limb pointing task. Although previous authors have attributed this to alteration of perceived target location, no studies have explored the effect of changes in head and neck position on the perception of limb position. This study investigated whether changes in head and neck position affect a specific component of movement performance, that is, the accuracy of joint position sense (JPS) at the elbow. Elbow JPS was tested with the neck in four positions: neutral, flexion, rotation and combined flexion/rotation. A target angle was presented passively with the neck in neutral, after a rest period; this angle was reproduced actively with the head and neck in one of the test positions. The potential effects of distraction from head movement were controlled for by performing a movement control in which the head and neck were in neutral for the presentation and reproduction of the target angle, but moved into flexion during the rest period. The absolute and variable joint position errors (JPE) were greater when the target angle was reproduced with the neck in the flexion, rotation, and combined flexion/rotation than when the head and neck were in neutral. This study suggests that the reduced accuracy previously seen in pointing tasks with changes in head position may be partly because of errors in the interpretation of arm position.