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Temporal lobe epilepsy (TLE) is a prevalent form of epilepsy originating in the temporal lobes. A common pathological feature is hippocampal sclerosis (HS), characterized by the loss of neuronal cells, which is associated with the typical temporal mesial lobe epilepsy (MTLE). In this study, we aimed to analyze gray matter alterations in patients with MTLE with right and left hemisphere HS using voxel-based morphometry and compare them with control groups. A meta-analysis was performed based on the guidelines contained in the Protocol Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), using the MEDLINE database, with the keywords: "gray matter" AND "temporal lobe epilepsy " AND ("hippocampal sclerosis" OR "hippocampal abnormalities") AND ("voxel-based morphometry" OR "VBM" OR "voxel-wise"). Of the 14 articles included in the review, 8 were added by the method, in which the meta-analysis was performed. Our results indicate that in the right hemisphere, the hippocampus, caudate nucleus, parahippocampal gyrus, thalamus, dorsalis medial nucleus, insula, and right claustrum were most commonly implicated. In the left hemisphere, a significant pattern of gray matter loss was observed in the putamen, lentiform nucleus, uncus, Brodmann areas 20 and 23, cingulate gyrus, caudate nucleus, cerebellum, and cuneus compared to healthy controls.Our study highlights distinct patterns of gray matter alteration in MLTE-HS and suggests that these regions may contribute to changes in verbal memory and visuospatial impairment based on their anatomical and hemispheric locations. Our findings can be potentially helpful for future diagnostic markers, therapeutic targets, and insights into disease progression, better understanding of these findings.

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Soybean gall midge, Resseliella maxima Gagné, was recently identified as a new species causing significant injury to soybean and is currently found in 164 counties across 7 midwestern states (NE, IA, SD, MN, MO, ND, and KS). Infestation of soybean begins in late spring, when adults emerge from last year's soybean field. Infestation of a new soybean crop depends on the presence of fissures which start to form at the base of the soybean plant around the V2 stage. Field observations indicate that these fissures are only present below the cotyledonary nodes or in the area within 3-5 cm above the soil surface. To determine the importance of these fissures for R. maxima infestation and plant injury, hilling or the movement of the soil to cover the base of soybean plants at the V2-V3 stage was compared with the standard practice (no-hilling). Field studies were conducted at 3 sites in east-central Nebraska during the 2021 growing season. The results showed a significant reduction in the frequency of infested plants, larval number per plant, and plant injury for hilled compared to no-hill treatment. This reduction in the presence of larvae and plant injury corresponded with a significantly greater yield for hilled compared to the no-hill treatment. These results highlight the importance of fissures on soybean for R. maxima adult infestation as well as the potential for hilling to be used as a management strategy for R. maxima.

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O contexto de pandemia do vírus Sars-Cov-2 contribuiu para a diminuição significativa do contato dos idosos com seus companheiros e familiares, além de desencadear sentimentos de vulnerabilidade e solidão. Além disso, o olhar sensível às subjetividades e demandas individuais deve ser continuamente estimulado durante todo o processo de educação médica, de modo a promover uma formação profissional mais sensível às necessidades do outro. Nesse sentido, a ação intitulada "Cartas aos Idosos" foi criada com o intuito de estabelecer uma comunicação entre idosos e estudantes por meio de cartas com conteúdo de afeto e suporte emocional. A ação "Cartas aos Idosos'', desenvolvida remotamente pela Federação Internacional das Associações de Estudantes de Medicina do Brasil (IFMSA Brazil) da Universidade Federal da Bahia, Campus Anísio Teixeira (UFBA-CAT), entre os meses de agosto e outubro, consistiu na escrita de cartas por estudantes de Medicina, de cunho pessoal, para idosos em situação asilar. O impacto da ação foi medido por meio de uma análise qualitativa dos envolvidos. A atividade foi bem-sucedida no que se refere ao acolhimento e ao amparo dos idosos envolvidos.

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Este artigo relata a experiência na disciplina "Tópicos Especiais em Saúde da Família: ênfase em metodologias ativas", do Mestrado Profissional da Saúde da Família em uma Universidade do estado da Bahia, no ano de 2020. Trabalhou-se de forma modular em plataformas digitais, utilizando três fóruns de discussão com perguntas sobre o uso e o conhecimento de metodologias ativas. O produto final consistiu na apresentação de uma metodologia ativa, exemplificando uma ação realizada por mestrandos e mestrandas médicos na Unidade de Estratégia da Saúde da Família e/ou Universidade, relacionando-a às experiências dos sujeitos. O fórum de discussão para exposições dialogadas mostrou-se um importante instrumento de aprendizagem e de avaliação. A maioria citou exemplos de metodologias baseadas na problematização de suas práticas. As ações sinalizadas englobam as formas de aprender e de ensinar de maneira inovadora, o protagonismo dos aprendizes, o melhor aproveitamento do tempo para aprender, o foco na gestão do tempo, bem como a provisão de experiências de aprendizagem realmente significativas, centradas na simulação da realidade e também direcionadas à análise dos dados produzidos na interação do aprendiz com pessoas, conteúdos e ferramentas.

This article reports some experiences in the discipline "Special Topics in Family Health: emphasis on active methodologies", part of the Professional Master's Degree in Family Health at a university in the state of Bahia, in 2020. The work has been done on digital platforms, using three discussion forums with questions on the use and knowledge of active methodologies. The final product consisted of a presentation of an active methodology. It consisted of an action performed by the physicians and postgraduate students in the Family Health Strategy Unit and/or University, relating it to the experiences as examples of the subjects. The discussion forum for dialogue exhibitions proved to be an important tool for learning and evaluation. The most cited examples of methodologies were based on the problematization of their practices. The mentioned actions included ways to learn and teach in an innovative way, the protagonism of learners, the best use of time to learn, focus on time management, the provision of really meaningful learning experiences centered on the simulation of reality, and also targeting the analysis of data produced in the learner's interaction with people, content, and tools.

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Intestinal obstruction is the most frequent clinical manifestation of colon tumors, most of which are located in the descending and recto-sigmoid colon. Emergency bowel obstruction surgery is associated with high mortality and morbidity risks and the ideal approach remains controversial. Multi-stage procedures and the use of stents as bridges for surgery are promising options. A case of a 61-year-old patient with an acute obstructive abdomen secondary to colorectal neoplasm is presented, with emphasis on its diagnosis and treatmen (AU)

Obstrução intestinal é a manifestação clínica mais frequente de tumores de cólon sendo esses, em sua maioria, localizados no cólon descendente e reto-sigmoide. A cirurgia de emergência para obstrução intestinal é associada a altos riscos de mortalidade e de morbidade e a abordagem ideal permanece controversa. Procedimentos em vários estágios e o uso de stents como ponte para cirurgia são opções promissoras. É apresentado um caso de paciente de 61 anos, com abdome agudo obstrutivo secundário à neoplasia colorretal, com ênfase em seu diagnóstico e tratamento (AU)

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RESUMO: Obstrução intestinal é a manifestação clínica mais frequente de tumores de cólon sendo esses, em sua maioria, localizados no cólon descendente e reto-sigmoide. A cirurgia de emergência para obstrução intestinal é associada a altos riscos de mortalidade e de morbidade e a abordagem ideal permanece controversa. Procedimentos em vários estágios e o uso de stents como ponte para cirurgia são opções promissoras. É apresentado um caso de paciente de 61 anos, com abdome agudo obstrutivo secundário à neoplasia colorretal, com ênfase em seu diagnóstico e tratamento. (AU)

ABSTRACT: Intestinal obstruction is the most frequent clinical manifestation of colon tumors, most of which are located in the descending and recto-sigmoid colon. Emergency bowel obstruction surgery is associated with high mortality and morbidity risks and the ideal approach remains controversial. Multi-stage procedures and the use of stents as bridges for surgery are promising options. A case of a 61-year-old patient with an acute obstructive abdomen secondary to colorectal neoplasm is presented, with emphasis on its diagnosis and treatment. (AU)

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Abstract Introduction Occupational therapists are dedicated to the education service sector, however, this sector has had difficulties in advancing its universal accessibility, with a growing number of young people out of school, harming their condition of inclusion and social participation. Objective To map the production of scientific knowledge associated with occupational therapy, schools and youth, to answer the following questions: 1. How have occupational therapists contributed to youth in schools? 2. What proposals have these professionals disseminated in this context? Method A systematic mapping review carried out on the Scopus and Web of Science databases, which retrieved 46 publications covering from 1979 until 2019. Results Occupational therapists have not prioritized young population in their practices and studies. Noteworthy are the work to support young people with disabilities leaving high school, studies on mental health and an increasing number of works involving young people in situations of social vulnerability. Conclusion There is a need to increase and disseminate occupational therapy actions related to young people in schools, fostering theoretical and practical subsidies that offer better contours to this professional insertion.

Resumo Introdução Os terapeutas ocupacionais têm se inserido profissionalmente em serviços que compõem o setor da educação, no entanto, este setor tem encontrado dificuldades em avançar em sua acessibilidade universal, com um número crescente de jovens fora da escola, prejudicando sua condição de inserção e participação social. Objetivo Mapear a produção do conhecimento científico associado à terapia ocupacional, escolas e juventude, para responder às seguintes questões: Como os terapeutas ocupacionais têm contribuído para a juventude nas escolas? Quais propostas esses profissionais realizam nesse contexto? Método Revisão sistemática de mapeamento realizada nas bases de dados Scopus e Web of Science, sendo recuperadas 46 publicações no período de 1979 a 2019. Resultados Os terapeutas ocupacionais não têm priorizado a população jovem em suas práticas e estudos. Destacam-se o trabalho de apoio a jovens com deficiência egressos do ensino médio, estudos sobre saúde mental e um número crescente de trabalhos envolvendo jovens em situação de vulnerabilidade social. Conclusão Há necessidade de aumentar e divulgar as ações de terapeutas ocupacionais dedicadas aos jovens nas escolas, fomentando subsídios teóricos e práticos que ofereçam melhores contornos a essa inserção profissional.

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O presente artigo tem como objetivo trazer algumas contribuições da psicanálise para o esclarecimento da questão da violência contra a mulher, um fenômeno que se repete na história das sociedades. Buscando pensar sobre as bases estruturais dessa violência, recorremos à teoria lacaniana dos gozos fálico e gozo Outro, feminino, propondo uma diferenciação entre o que se supõe como gozo Outro e o que se estabelece como gozo do Outro. Seguindo o caminho aberto por Lacan, lançamos a hipótese de que o gozo do Outro pode estar relacionado com a vivência no sujeito posicionado do lado do masculino, de um gozo intrusivo e devastador atribuído a um Outro vivido como absoluto, mobilizando reações misóginas e mesmo feminicidas. Tal distinção foi operativa no sentido de nos possibilitar pensar no que aqui designamos como "devastação no masculino" e sua possível relação com o que no artigo discernimos como "violência contra o feminino na mulher".

This article aims to provide some contributions from psychoanalysis to clarify the issue of violence against women, a phenomenon that has occurred repeatedly in the history of societies. To analyze the structural bases of that kind of violence, we resort to the Lacanian theory of phallic jouissance and Other jouissance, feminine, proposing a differentiation between what is supposed to be Other jouissance and what is established as jouissance of the Other. Following the path proposed by Lacan, we suggest the hypothesis that jouissance of the Other may be related to the experience by the subject positioned on the masculine side, of an intrusive and devastating jouissance attributed to an Other, lived as absolute, mobilizing misogynous and even feminicide reactions. This distinction was operative in the sense that it allowed us to think about what we call here "devastation in the masculine" and its possible relationship with what we discern as "violence against the feminine in women" in this article.

Cet article vise à apporter quelques contributions de la psychanalyse pour adresser la question de la violence contre les femmes, phénomène qui se répète dans l'histoire des sociétés. Cherchant à réfléchir sur les fondements structurels de cette violence, nous recourons à la théorie lacanienne des jouissances phalliques et de la jouissance Autre, féminine, proposant une différenciation entre ce qui est supposé être la jouissance Autre et ce qui s'établit comme jouissance de l'Autre. En suivant la voie ouverte par Lacan, nous avançons l'hypothèse que la jouissance de l'Autre pourrait être liée à l'expérience du sujet positionné du côté masculin, d'une jouissance intrusive et dévastatrice attribuée à un Autre vécu comme absolu, mobilisant des réactions misogynes et même féminicides. Cette distinction était opérative dans le sens qu'elle nous permettait de penser ce que nous désignons ici comme la « dévastation chez le masculin ¼ et sa relation possible avec ce que nous discernons dans l'article comme « violence contre le féminin chez la femme ¼.

Este artículo tiene como objetivo presentar algunos aportes del psicoanálisis para aclarar el tema de la violencia contra la mujer, un fenómeno que se repite en la historia de las sociedades. Buscando reflexionar sobre las bases estructurales de esta violencia, recurrimos a la teoría lacaniana del goce fálico y del goce Otro, femenino, proponiendo una diferenciación entre lo que se supone que es el goce Otro y lo que se establece como goce del Otro. Siguiendo el camino abierto por Lacan, lanzamos la hipótesis de que el goce del Otro puede estar relacionado con la experiencia del sujeto ubicado al lado de lo masculino, de un goce intrusivo y devastador atribuido a un Otro vivido como absoluto, movilizando reacciones misóginas e incluso feminicidas. Esta distinción fue pertinente para permitirnos pensar en lo que designamos aquí como "devastación en lo masculino" y su posible relación con lo que en el artículo discernimos como "violencia contra lo femenino en la mujer".

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To compare the 1-year clinical performance of lithium disilicate and resin composite CAD/CAM onlay restorations. Twenty patients that required two restorations in posterior teeth, with at least one cusp to be covered, received two onlays. One was made with IPS e.max CAD (Ivoclar-Vivadent) and the other with Lava Ultimate (3M Oral Care). Two blind observers evaluated the restorations at baseline and 1 year after the onlays were cemented, according to FDI criteria. At each recall, digital photographs, bite-wing radiographs and impressions of the restorations were taken for SEM evaluation of the interface. Results were analyzed by Mann-Whitney U and Wilcoxon tests (p < 0.05). At baseline and in the 1-year recall, both CAD/CAM materials exhibited excellent results in most criteria with similar esthetic, functional and biological properties (p > 0.05). However, deterioration in surface lustre (p = 0.020) and color match/translucency (p = 0.039) were detected for IPS e.max CAD onlays after 1-year. Under SEM evaluation, there were no statistically differences in micromorphological criteria at baseline nor after a year between IPS e.max CAD and Lava Ultimate onlays. Conclusion: After 1 year of clinical service IPS e.max CAD and Lava Ultimate onlays showed a similar clinical performance that needs to be confirmed in long-term evaluations.

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Resumo O presente texto é resultado de um seminário do Grupo de Pesquisa "Cidadania, Ação Social, Educação e Terapia Ocupacional", ocorrido em 2019, entre os integrantes da linha "Escola, Terapia Ocupacional e Inclusão Radical", que se debruçaram sobre o livro "Best practices of Occupational Therapy in Schools". Editado em 2013, esse livro teve grande circulação nos Estados Unidos da América, compondo parte dos esforços da American Occupational Therapy Association para ofertar e ampliar subsídios teórico-práticos que garantissem tanto a inserção como a qualificação da atuação dos terapeutas ocupacionais em serviços e ações junto ao setor da educação. Consideramos que compartilhar uma síntese desse material, bem como as reflexões críticas que foram fomentadas pelo seu estudo, em diálogo contextualizado no cenário brasileiro, possa inspirar novas proposições para terapeutas ocupacionais que têm se dedicado a esse setor, mas também colocar em debate os riscos que transposições lineares podem causar, uma vez que determinados modelos e abordagens respondem a contextos situados, histórica e politicamente. Explicitadas nossas diferenças, que a circulação das propostas desse livro possa, sobretudo, contribuir para alavancar novas e eficientes estratégias para ampliarmos o número de profissionais envolvidos com o setor da educação.

Abstract This text is the result of a seminar by the Research Group "Citizenship, Social Action, Education and Occupational Therapy", which took place in 2019, among the members of the "School, Occupational Therapy and Radical Inclusion" line, who have investigated the book "Best Practices of Occupational Therapy in Schools". Published in 2013, this book was widely read in the United States of America, as part of the efforts of the American Occupational Therapy Association to offer and expand theoretical and practical subsidies that would guarantee both the insertion and the qualification of performance of the occupational therapists in services and actions tied to the education sector. We believe that sharing a synthesis of this material, as well as critical reflections that were fostered by your study, in a contextualized dialogue in the Brazilian scenario, may inspire new proposals for occupational therapists who have dedicated themselves to this sector, but also discuss the risks that model transpositions can cause, since certain models and approaches respond to historically and politically situated contexts. With our differences explained, we wish that the circulation of the proposals in this book may, above all, contribute to leverage new and efficient strategies to expand the number of professionals involved in the education sector.

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BACKGROUND: Throughout the world, schools have become an important place for professional integration for occupational therapists. OBJECTIVE: To map the production of knowledge on research related to the keywords "occupational therapy" and "school." METHOD: A mapping review was performed, searching the terms "occupational therapy" and "school" in the Scopus and Web of Science databases. The data were used to construct a descriptive map of the production of knowledge about occupational therapy and school. The following data were categorized and extracted: years of publication, journals of publication, authors' and coauthors' countries, descriptors, informant population, beneficiary population, place of research, and occupational therapy propositions. RESULTS: It included 127 research articles covering from 1988 to 2017. This has been a scientific field under construction for at least 30 years, largely centralized in the United States of America, mostly dedicated to children, and focused on disabilities, with an emphasis on rehabilitation through descriptions and analyses of interventions for individuals or, when it was for groups, with the final goal of benefitting individuals with disabilities. Implications. Examining the existing scientific production invites us to reflect on whether the dominant focus in this field has responded to the contemporary problems of schools.

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Cupuaçu [Theobroma grandiflorum (Wild ex Spreng.) K. Schum] seeds have been employed for a long time in the Amazon region for food purposes. Similar to cocoa, processed cupuaçu pulp and seeds can be used to produce juices, ice creams, confectionary products and cupulate®, which is a similar product to chocolate. However, its market penetration requires the mastery of all processing stages to improve the food quality and safety and to make possible an efficient technology transfer to the local small farmers and communities. Based on the above, the current research work aimed at monitoring and optimizing the consecutive fermentation and drying processes of cupuaçu seeds over 7 days each, as well as storage for 90 days. A greenhouse structure incorporating the fermenter and solar drying terrace was designed to be inexpensive, versatile, easily scalable, and easy to maintain and operate by the local small farmers after a short period of training. This research effort also aimed at giving a vision for the future creation of an integrative and sustainable cupuaçu system covering the economic, social, cultural and environmental vectors. The experimental design comprised 5 batches of 100 kg of seeds each. Several microbiological and physicochemical parameters were performed and correlated with processing variables. Microbiological parameters encompassed viable counts of mesophilic microorganisms, coliforms, yeasts, and molds, whereas physicochemical measures included fermentation and drying temperature, pH, acidity, dry matter, ashes, water activity, color, total proteins, lipids and carbohydrates, and energy. The average seed fermentation temperature varied from ca. 28 to 44 °C, reaching the maximum on day 3 and a final value of ca. 31 °C. Regarding solar drying, the average seed temperatures ranged from ca. 24 °C (at the end) to 39 °C on day 3, and an initial value of ca. 29 °C. The average final seed pH value of drying was 5.34 and was kept during storage. During storage, results demonstrated the existence of significant correlations among several experimental parameters under scrutiny. Finally, bean viable counts obtained during storage unfolded acceptable values of total mesophilic bacteria well below the maximum limit. Viable counts of yeast and molds were generally found between 3 and 4 log(CFU/gsample), and total coliforms were also detected, although both were at acceptable levels and well beneath the established maximum limits for food safety.

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Resumo Introdução Os Estados Unidos da América (EUA) destacam-se pela quantidade expressiva de terapeutas ocupacionais atuando profissionalmente em escolas e pela produção de regulamentações específicas dessa ação profissional. Este artigo deriva de uma revisão sistemática de mapeamento, por meio da qual reunimos 190 textos em torno da temática "terapia ocupacional e escolas". Destes, 10 eram textos (ensaios teóricos, artigos de reflexão, um documento oficial e um artigo "informativo") que se voltavam para a atuação dos "school-based occupational therapists" (SBOTs). Objetivo Conhecer os caminhos pelos quais a regulamentação dessa atuação profissional ocorreu nos EUA, tomando-se legislações, documentos e publicações. Método Realizou-se uma análise compreensiva das publicações selecionadas (10) e da legislação relacionada reunida (5), consideradas como documentos a serem também descritos, produzindo-se um panorama geral sobre o tema e uma historicização da regulamentação da atuação dos SBOTs no país. Resultados Desde 1986, publicam-se artigos para o debate teórico e a reflexão acerca do desenvolvimento da terapia ocupacional estadunidense nas escolas. A essas, somam-se publicações na direção de constituir fundamentos teórico-práticos, compondo consensos operativos com vistas a viabilizar a contratação do serviço terapêutico-ocupacional nesse setor. Evidenciou-se o papel da associação profissional nacional estadunidense (AOTA), perpassando toda essa construção. Contudo, ao criarem-se determinados consensos, delimitou-se a ação profissional ao campo da deficiência, notadamente voltada a crianças e adolescentes. Conclusão Compreender essa trajetória pode nos inspirar quanto às estratégias eficientes criadas pelos terapeutas ocupacionais nos EUA, não obstante, seja necessário apreender nossas singularidades e construir formas orgânicas de ampliarmos esse campo no Brasil.

Abstract Introduction United States of America (USA) stands out for the expressive number of occupational therapists working in schools and for the production of specific regulations for this professional action. This article derives from a systematic mapping review, in which we collected 190 texts on the theme 'occupational therapy and schools.' Ten of them were related to the SBOTs practice (theoretical essays, reflection papers, one official document, and one 'informative' paper). Objective To know how this professional regulation took place in the USA, taking laws, documents, and publications. Method A comprehensive analysis of the selected publications (10) and the related legislation (5) was carried out, resulting in a general overview of the subject and a historicization of the regulation of the SBOTs in that country. Results Since 1986, articles have been published for the theoretical debate and reflection on the development of USA occupational therapy practices in schools. Also, publications aimed to constitute theoretical-practical foundations, composing operational consensuses to make feasible the contracting of that service in this sector. The role of the American Occupational Therapy Association (AOTA) was evident, passing through all this construction. However, when certain consensuses were created, professional action was limited to the field of disability, especially focus on children and adolescents. Conclusion Understanding this trajectory may inspire us about the efficient strategies created by occupational therapists in the USA, nevertheless, it is necessary to apprehend our singularities and to construct organic ways of expanding this field in Brazil.

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Objetivo: conhecer as histórias de vida de quatro mulheres participantes de oficinas de geração, trabalho e renda. Métodos: a coleta de dados foi realizada no ano de 2012 e incluiu quatro mulheres que, entre 2010 e 2012, participavam ativa e diariamente das oficinas de Geração de Trabalho e Renda propostas pela Reabilitação Trabalho e Arte, no sul do Brasil. O método foi história oral de vida. Resultados: as histórias coletadas articulam elementos comuns pertencentes à vida das mulheres pertencentes aos grupos populares ­ a necessidade de parar de estudar para trabalhar e ajudar no sustento da casa; o casamento como ferramenta de libertação e rito de passagem para a vida adulta, e; o papel feminino relacionado ao cuidado e o masculino de provimento. Considerações Finais: as dinâmicas regidas por obrigações morais de reciprocidade orientaram e atribuíram significado as relações estabelecidas com a família e com a sociedade

Objective: to get to know life stories of four women who take part on creation of labor and income workshops. Method: data collection was carried out during 2012, and included four women an active part of the Creation of Labor and Income workshops, as proposed by Rehabilitation, Work and Art, in the south of Brazil. The method chosen was oral life history. Results: the stories collected articulate common elements that belong to women living in poor strata - the need to stop studying in order to work and help proving for the family; marriage as way of freedom and a rite of passage into adult life; and the female role towards caring, and male role towards providing. Final considerations: dynamics that are ruled by moral obligations of reciprocity have guided and provided meaning to relationships established with family and society

Objetivo: conocer la historia de vida de cuatro mujeres que participan de los talleres de generación del trabajo y renda. Métodos: los datos se recopilaron en 2012 e incluyeron cuatro mujeres que participaron de manera activa y diaria en los talleres de generación del trabajo e ingreso, en sur del Brasil. El método utilizado fue la historia oral de vida. Resultados: las historias recopiladas articulan elementos comunes relacionados con la vida de las mujeres pertenecientes a los grupos populares: la necesidad de dejar de estudiar para trabajar y ayudar a mantener el hogar; el matrimonio como herramienta de liberación y rito de paso a la edad adulta, y; El papel femenino relacionado con la atención y el papel masculino de la provisión. Consideraciones finales: la dinámica regida por obligaciones morales de reciprocidad guió y atribuyó significado a las relaciones establecidas con la familia y con la sociedad)

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BACKGROUND: Healthcare organizations have invested efforts on hospital-based health technology assessment (HB-HTA) and enterprise risk management (ERM) processes for novel systems to obtain more accurate data on which to base strategic decisions. This study proposes to analyze how HB-HTA and ERM processes can share personal resources and skills to achieve principles with value-oriented results. METHODS: Literature on ERM and HB-HTA and data from interviews with healthcare managers compose the research data sources, which were submitted to a qualitative data analysis. It was oriented to identify the association between ERM and HB-HTA application in hospitals and the common principles between both processes, in addition to proposing the capability to share personal resources between both teams in a matrix. RESULTS: The common principles and personal background suggested for HB-HTA and ERM teams allowed the build of a matrix identifying how both teams can work in an integrated manner being more effective and value-oriented. The shared resource matrix reports how each professional (with a specific background) may interact with each activity associated to HB-HTA or ERM implementation guidelines. CONCLUSIONS: The identification of common principles and capabilities between ERM and HB-HTA suggested advances with the literature from both research areas. The opportunity to share personal resources also contributes to the implementation of those processes in hospitals with less financial resources, approaching its own management to be more efficient with the care chain.

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Objetiva-se analisar e discutir o perfil da formação pré e pós-admissional dos enfermeiros de uma UTI. Estudo descritivo com 20 enfermeiros de uma UTI num hospital de ensino no Rio de Janeiro. Foi realizada uma entrevista contendo variáveis sociais e formação pré e pós-admissional. Os dados foram analisados por estatística descritiva. A média de idade dos enfermeiros foi de 39,4 anos e 12 (60%) foram admitidos na UTI com algum tipo de especialização médico-cirúrgica. No que tange à formação em stricto sensu, somente (3) 15% tinham essa formação pré-admissão, sendo que houve aumento de 8 (40%) na formação pós-admissional, distribuídos entre lato e stricto sensu. Conclui-se que há o domínio da formação lato sensu, reflexo de uma formação voltada para a prática, porém já é possível observar a presença de mestres profissionais e doutorandos demonstrando a preocupação com sua autonomia e aprimoramento permanente de alto nível.(AU)

The aim of this study is to analyze and discuss the profile of pre and post admission training of nurses at an ICU. A descriptive study with 20 nurses from an ICU in a teaching hospital in Rio de Janeiro. An interview was conducted containing social variables and pre and post admission training. Data were analyzed by descriptive statistics. The mean age of the nurses was 39.4 years and 12 (60%) were admitted to the ICU with medical-surgical specialization. Concerning training in stricto sensu, only (3) 15% had this pre-admission training, and there was an increase of 8 (40%) in post-admission training, distributed between lato and stricto sensu. It is concluded that there is mastery of the lato sensu training, reflecting a practical formation, but it is already possible to observe the presence of professional masters and doctoral students demonstrating the concern with their autonomy and permanent improvement of high level.(AU)

Se pretende analizar y discutir el perfil de la formación pre y post-admisional de los enfermeros de una UTI. Estudio descriptivo con 20 enfermeros de una UTI en un hospital de enseñanza en Río de Janeiro. Se realizó una entrevista que contenía variables sociales y formación pre y post-admisional. Los datos fueron analizados por estadística descriptiva. La media de edad de los enfermeros fue de 39,4 años y 12 (60%) fueron admitidos en la UTI con algún tipo de especialización médico-quirúrgica. En lo que se refiere a la formación en stricto sensu, solamente (3) 15% tenían esa formación pre-admisión, siendo que hubo aumento de 8 (40%) en la formación post-admisional, distribuidos entre lato y stricto sensu. Se concluye que existe el dominio de la formación lato sensu, reflejo de una formación orientada a la práctica, pero ya es posible observar la presencia de maestros profesionales y doctorandos demostrando la preocupación por su autonomía y perfeccionamiento permanente de alto nivel.(AU)

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O artigo explora o tema da acessibilidade e da inclusão na era tecnológica, a partir de um inventário das minhas próprias vivências, tendo nascido cega, e, por obra da necessidade da educação especial, tendo sido alfabetizada através do método braile, depois enveredar na era tecnológica, onde se revelou, ora como campo de pesquisa, ora como seara para a militância, o tema da acessibilidade e da inclusão. Parto de uma premissa subjetiva já explorada anteriormente, a de pensar a cegueira como um lugar de onde posso olhar o mundo, avanço, porém, para a outra face da mesma: como o mundo tem olhado para a cegueira? Conclui-se apresentando um cenário ao mesmo tempo promissor e paradoxal para a acessibilidade e a inclusão. Pessoas cegas conquistaram a ciberesfera, desempenham-se bem na web, entretanto, barreiras de acessibilidade são forjadas todos os dias nos ambientes virtuais, o que impacta diretamente nas vidas laborais e socioculturais desses indivíduos. Persiste, na contemporaneidade, espécies de conjuntos de comportamentos cristalizados na cultura, os quais atravessaram toda a história da cegueira, e que podem ser configurados como o fenômeno da invisibilidade em múltiplos processos socioeconômicos e culturais....(AU)

Based on an inventory of my own experiences, this paper explores the theme of accessibility and inclusion in the technological era. I was born blind, was educated using the Braille method because of the need for special education, and then embarked on the technological era, where the theme of accessibility and inclusion was revealed in both the research and the militancy fields. I start from a subjective premise already explored: to think of blindness as a place from which I can look at the world, but I go through to another side: How has the world looked at blindness? The conclusion presents a both promising and paradoxical scenario for accessibility and inclusion. Blind people have conquered the cybersphere, performing well on the web; however, accessibility barriers are forged every day in virtual environments, which directly impacts on the work and sociocultural lives of these individuals. A set of behaviors crystallized in the culture persists in the contemporaneity. These behaviors have gone through the whole history of blindness and can be configured as the phenomenon of invisibility in multiple socioeconomic and cultural processes....(AU)

El artículo explora el tema de la accesibilidad y la inclusión en la era tecnológica, a partir de un inventario de mis propias vivencias, habiendo nacido ciega, y, por obra de la necesidad de la educación especial, ser alfabetizada a través del método braille, después emprender en la era tecnológica, donde se reveló, ora como campo de investigación, ya como una mina para la militancia, el tema de la accesibilidad y de la inclusión. Parto de una premisa subjetiva ya explotada anteriormente, la de pensar la ceguera como un lugar de donde puedo mirar el mundo, avanzo, pues, hacia la otra cara de la misma: ¿cómo el mundo ha mirado hacia la ceguera? Se concluye presentando un escenario al mismo tiempo prometedor y paradójico para la accesibilidad y la inclusión. Las personas ciegas conquistaron la ciberesfera, se desempeñan bien en la web, sin embargo, las barreras de accesibilidad son forjadas todos los días en los ambientes virtuales, lo que impacta directamente en las vidas laborales y socioculturales de esos individuos. Persiste, en la contemporaneidad, unas especies de conjuntos de comportamientos cristalizados en la cultura, los cuales atravesaron toda la historia de la ceguera, y que pueden ser configurados comoel fenómeno de la invisibilidad en múltiples procesos socioeconómicos y culturales....(AU)

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OBJECTIVE: to report the application of a participatory teaching-learning method on the themes death, dying, and associate care to highlight its applicability to the students. METHOD: report of application of participatory method in 22 students from the 6th period of the undergraduate program in Nursing and Obstetrics of a public university. The first stage focused on personal experiences of the students and the second on professional prospects. As resources for data collection we used music, drawing, drama, and photography. RESULTS: after applying the method, the students assigned meanings to death and nursing care, reflected, criticized, and resignified experiences on the theme. CONCLUSION: the method was considered applicable and effective to achieve the objective, that is, it enables learners to act as protagonists of the teaching-learning process, building together a new perspective of end-of-life care.

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BACKGROUND: The first phase of an enterprise risk management (ERM) program is the identification of risks. Accurate identification is essential to a proactive and effective ERM function. The authors identified a lack of such risk identification in the literature and in practical cases when interviewing the chief risk officers from healthcare organizations. A risk inventory specific to healthcare organizations that includes detailed risk scenarios and risk impacts currently does not exist. Thus, the objective of this research is to develop an enterprise risk inventory for healthcare organizations to create a common understanding of how each type of risk impacts a healthcare organization. METHOD: ERM guidelines and data from 15 interviews with chief risk officers were analyzed to create the risk inventory. The identified risks were confirmed through a survey of risk managers from a range of global healthcare organizations during the ASHRM conference in 2017. Descriptive statistics were developed and cluster analysis was performed using the survey results. RESULTS: The risk inventory includes 28 risks and their specific risk scenarios. Cyberattack was ranked as the principal risk by the participants, followed by sentinel events and risks associated with human capital management (organizational culture, use of electronic medical records and physician wellness). The data analysis showed that the specific characteristics of the survey participants, such as the length of time working in risk management, the size of the organization, and the presence of a school of medicine, do not impact an individual's opinion of the importance of the risks identified. A personal background in risk management (clinical or enterprise) was a characteristic that showed a small difference in the perceived importance of the risks from the proposed risk inventory. CONCLUSIONS: In addition to defining specific risk scenarios, the enterprise risk inventory presented in this research can contribute to guiding the risk identification phase of an ERM program and thereby support the development of a risk culture. Patient data security in hospitals that operate with high levels of technology is fundamental to delivering high quality and safe care to patients. At the top of the risk ranking, the identification of cyberattacks reflects the importance that healthcare risk managers place on this risk by allocating time and other resources. Exploring opportunities to improve cyber risk management and evaluating the benefits of using the risk inventory at the beginning of the risk identification phase in an ERM program are suggestions for future studies.

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