Vena cava izquierda persistente, inusual anatomía para la resincronización cardíaca: experiencia de implante y posterior cambio de generador

Introducción: La presencia de una vena cava superior izquierda persistente, durante el implante de electrodos endocavitarios para la resincronización cardíaca, representa una anomalía poco habitual de gran relevancia, que puede presentarse de forma inesperada durante el abordaje venoso superior habitual. Planteando desafíos técnicos en su implante y dudas sobre su eficacia o seguridad a corto y largo plazo; existiendo aislados casos publicados. Caso clínico: Presentamos un caso complejo con esta inusual anomalía llevado a implante de este dispositivo de forma exitosa, con funcionamiento normal durante su seguimiento de 7 años, llevado posteriormente a cambio de generador. Conclusiones: La vena cava superior izquierda persistente es la anomalía del retorno venoso cardiaco más frecuente, aunque su prevalencia es baja, presenta una gran relevancia en el implante y posicionamiento de electrodos endocavitarios necesarios para la terapia de resincronización cardiaca. Existe una evidencia creciente sobre su factibilidad y seguridad a corto y largo plazo a pesar de sus dificultades técnicas asociadas.

Introduction: The presence of a persistent left superior vena cava, during the implantation of endocavitary electrodes for cardiac resynchronization, represents an unusual anomaly of great relevance, which can occur unexpectedly during the usual superior venous approach. It constitutes a technical challenge in your implant and doubts about its effectiveness or safety in the short and long term. There are isolated published cases. We present a complex case with this unusual anomaly that led to successful implantation of this device, with a normal functio during its 7-year follow-up It was followed by uneventul generator change. Conclusions: Persistent left superior vena cava is the most common cardiac venous return anomaly. Although its prevalence is low, it is of great relevance in the implantation and positioning of endocavitary electrodes necessary for cardiac resynchronization therapy. There is growing evidence about its feasibility and safety in the short and long term despite.

Corrigendum: Effects of weight divisions in time-motion of female high-level Brazilian Jiu-jitsu combat behaviors.

[This corrects the article DOI: 10.3389/fpsyg.2023.1048642.].

Effects of weight divisions in time-motion of female high-level Brazilian Jiu-jitsu combat behaviors.

Coaches and psychologists can use time-motion analysis to elaborate specific interventions for female BJJ athletes, increasing specific training context and reducing unnecessary psychological and physical demands and injuries. Therefore, the present study aimed to analyze high-level BJJ female athletes in the 2020 Pan-American Games by comparing the weight categories on the time-motion analysis. The time-motion analysis (i.e., approach, gripping, attack, defensive actions, transition, mounting, guard, side control, and submissions) of 422 high-level female BJJ combats was divided and compared by weight category as follows: Rooster (n = 8), Light Feather (n = 18), Feather (n = 122), Light (n = 84), Middle (n = 74), Medium Heavy (n = 44), Heavy (n = 36), Super Heavy (n = 36), using p ≤ 0.05. The main results indicated that the Super heavyweight category [3.1 (5.8;119.9) s] had a shorter gripping time than other weight categories, p ≤ 0.05. In contrast, roosters [7.2 (3.5;64.6) s] had longer gripping, transition [14.0 (4.8;29.6) s], and attack time [76.2 (27.7, 93.2)] than the light feather, middlers, and heavier weight categories, p ≤ 0.05. These findings should be considered for the psychological interventions and training prescription.

Prevalence of self-reported symptoms of temporomandibular disorders and associated factors in the period of distance learning.

OBJECTIVE: Assess the prevalence of self-reported TMD symptoms and anxiety and check the quality of sleep and life during the distance learning period in university students at the University of Brasilia (UnB). MATERIALS AND METHODS: The participants were students from the Health Sciences College and Medicine College at UnB. Self-administered questionnaires were used to evaluate symptoms of TMD, quality of life, and sleep quality. One-way analysis of variance, followed by Bonferroni test, and Kruskal-Wallis test, followed by Dunn's test, were performed (P < 0.05). For qualitative data analysis, the chi-square test was applied (P < 0.05). RESULTS: Total 156 students were included; prevalence of TMD, anxiety, sleep disturbance, and poor sleep quality was 73.1%, 84%, 12.8%, and 62.8%, respectively. A greater prevalence of painful TMD was observed in students with severe anxiety (P = 0.007). Students with symptoms of painful TMD, severe anxiety, and sleep disorders had statistically worse quality of life. CONCLUSIONS: The implementation of distance learning in health courses to replace classroom teaching during the COVID-19 pandemic has impacted TMD prevalence, anxiety, quality of life, and sleep quality. CLINICAL RELEVANCE: Psychological factors are directly associated with TMD symptoms and quality of life, TMD conditions are related to quality of life as well. COVID-19 pandemic and the distance learning in health courses are new situations that can lead to a great impact on mental health and in consequence to TMD conditions and quality of life.

Traumatic brain injury caused by Brazil-nut fruit in the Amazon: A case series.

BACKGROUND: Traumatic brain injury (TBI) represents one of the leading public health problems and a significant cause of neurological damage. Unintentional causes of TBI are the most frequent. However, fruit falling over the head causing TBI is extremely rare. In the Amazon region, accidents with ouriços, a coconut-like shell fruit, seem relatively common. However, to the best our knowledge, it has never been described in a scientific journal before. Therefore, we aim to evaluate a series of TBI caused by this tropical fruit. METHODS: This study is a retrospective review of 7 TBI cases due to the fall of ouriços admitted to two tertiary hospitals in the Amazon region from January 2017 to December 2018. The collected data included: age, Glasgow Coma Scale, skull fracture, venous sinus injury, hematoma, surgical treatment, and outcome. RESULTS: All patients were men, with an average age of 38, ranging from 8 to 77-years-old. Four out of seven had skull fractures. Five patients developed an epidural hematoma, and two of them had an associated subdural hematoma. Dura mater injury was observed in two patients, whereas four patients were operated. There was one related death. CONCLUSION: This case series is the first to describe an unconventional but potentially fatal cause of TBI in the Amazon: the falling of the Brazil-nut fruit. Most patients were diagnosed with mild TBI. Nevertheless, patients may have cranial fractures and epidural hematomas, leading to death when there's a delay in medical assistance.

Competition of onion genotypes in the soil and climatic conditions of Guarapuava, State of Paraná

The use of genotypes more adapted to climatic conditions can contribute to increase the yield of onion producers. The goal of this study was to evaluate the agronomic performance of 15 onion genotypes in the soil and climatic conditions of Guarapuava, state of Paraná. The study was conducted in the experimental area of Horticulture, Cedeteg campus, Universidade Estadual do Centro-Oeste (UNICENTRO), Guarapuava, state of Paraná, Brazil, from July to November 2018. The experimental design used was randomized blocks, with four replications, and the treatments consisted of four commercial cultivars Optima F1, Bella Dura, Sirius F1, Soberana F1 and eleven experimental genotypes N1, N2, N3, N4, N5, N6, N7, N8, N9, AF4241 and AF4243. Biometric characteristics of the plants, production components and early flowering were evaluated. Plants presented between 6 and 9 leaves, in which N1, N3, N4 and N6 had less than 7 leaves, differing statistically from the others. The cultivar Optima F1 and the genotypes N2, N3, N5, N6, N7 and N8 presented the tallest plants, with 66.1 to 76.0 cm. The pseudostem diameter did not differ significantly between genotypes, showing values between 15.2 and 20.4 mm. Total productivity was higher in genotypes N2, N6, N5, N4, N3, N7 with values from 43.6 to 50.3 t ha-1. The highest average bulb mass was found in N2, N4, N6, Sirius F1, Optima F1 and Soberana F1

Competition of onion genotypes in the soil and climatic conditions of Guarapuava, State of Paraná

The use of genotypes more adapted to climatic conditions can contribute to increase the yield of onion producers. The goal of this study was to evaluate the agronomic performance of 15 onion genotypes in the soil and climatic conditions of Guarapuava, state of Paraná. The study was conducted in the experimental area of Horticulture, Cedeteg campus, Universidade Estadual do Centro-Oeste (UNICENTRO), Guarapuava, state of Paraná, Brazil, from July to November 2018. The experimental design used was randomized blocks, with four replications, and the treatments consisted of four commercial cultivars Optima F1, Bella Dura, Sirius F1, Soberana F1 and eleven experimental genotypes N1, N2, N3, N4, N5, N6, N7, N8, N9, AF4241 and AF4243. Biometric characteristics of the plants, production components and early flowering were evaluated. Plants presented between 6 and 9 leaves, in which N1, N3, N4 and N6 had less than 7 leaves, differing statistically from the others. The cultivar Optima F1 and the genotypes N2, N3, N5, N6, N7 and N8 presented the tallest plants, with 66.1 to 76.0 cm. The pseudostem diameter did not differ significantly between genotypes, showing values between 15.2 and 20.4 mm. Total productivity was higher in genotypes N2, N6, N5, N4, N3, N7 with values from 43.6 to 50.3 t ha-1. The highest average bulb mass was found in N2, N4, N6, Sirius F1, Optima F1 and Soberana F1, wit

Perianastomotic cyst following rectosigmoidectomy due to adenocarcinoma of the proximal rectum: a case report / Cisto perianastomótico pós-retossigmoidectomia por adenocarcinoma dereto alto: relato de caso

ABSTRACT The implantation cyst occurs from the imprisonment and subsequent proliferation of the colonic mucosa below the submucosa during mechanical stapling. The understanding and definition of the evaluation protocol of these lesions is important, since they can generate the need for a new complex surgical procedure and cause anxiety in patients and surgeons. This case reports the occurrence of a subepithelial lesion in follow-up imaging of a patient who underwent videolaparoscopic rectosigmoidectomy for adenocarcinoma of the proximal rectum, submitted to an endoscopic attempt to drain/detangle the lesion and subsequent histopathological analysis showing colic mucosa without changes. In line with Katsumata,it is suggested to asymptomatic patients without alteration of the CEA or suspicious imaging signs a follow up with periodic imaging methods. For symptomatic patients with normal CEA, or whose lesions are growing at follow-up exams, it is suggested to continue with the investigation, with biopsy and/or effluent sample for histopathological study in addition to an attempt at symptomatic resolution. Finally, in the presence of an alteration in CEA, despite symptoms, it is suggested that the lesion be managed as a suspected local tumor recurrence.

RESUMO O cisto de implantação ocorre a partir do aprisionamento e subsequente proliferação da mucosa colônica abaixo da submucosa durante o grampeamento mecânico. A compreensão e definição do protocolo de avaliação dessas lesões é importante, pois podem gerar a necessidade de um novo procedimento cirúrgico complexo e causar ansiedade em pacientes e cirurgiões. Este caso relata a ocorrência de uma lesão sub-epitelial na imagem de seguimento de um paciente submetido à retossigmoidectomia por via videolaparoscópica devido a adenocarcinoma do reto proximal, submetido a uma tentativa endoscópica de drenar/remover a lesão e subsequente análise histopatológica mostrando a mucosa cólica sem alterações. De acordo com Katsumata, sugere-se que pacientes assintomáticos sem alteração do CEA ou sinais de imagem suspeitos tenham um seguimento com métodos de imagem periódicos. Para pacientes sintomáticos com CEA normal, ou cujas lesões mostrem crescimento nos exames de seguimento, sugere-se continuar a investigação, com biópsia e / ou amostra de efluente para estudo histopatológico, além de uma tentativa de resolução sintomática. Finalmente, na presença de uma alteração no CEA, apesar dos sintomas, sugere-se que a lesão seja tratada como uma suspeita de recorrência local do tumor.

Taxonomia do conhecimento sobre história da enfermagem / Taxonomy of knowledge about history of nursing

Estudo epistemológico delineado à luz do modelo evolucionário de análise/exploração de conceito de Beth Rodgers, que explorou a reverberação dos fenômenos do conceito principal - História da Enfermagem, na perspectiva de evidenciar novos conceitos (unidades de conhecimento) dele derivados e agrupados segundo os cinco componentes do processo de trabalho da Enfermagem. Tem como objetivo propor uma taxonomia do conhecimento sobre História da Enfermagem, a partir da análise da produção científica brasileira, disponível nos Catálogos de Teses e Dissertações do CEPEn/ABEn desde 1963. Foram classificados 204 produtos sobre História da Enfermagem datados de 1988-2015, segundo as variáveis: objeto de estudo, fontes, descritores, método, titulação, ano de defesa, orientador, localização geográfica e programa de procedência, possibilitando delinear essa produção, e propor a Taxonomia do Conhecimento sobre História da Enfermagem derivada de sua análise. A maior parte da produção se dedicou à História do Ensino, da Participação Política e da Administração em Enfermagem. A proposta buscou inovar na apresentação dos achados, dando perspectiva epistemológica ao saber científico tratado no conceito geral de História da Enfermagem, resultando em um modelo de taxonomia do conhecimento que integra 30 unidades de conhecimento do saber científico derivado do conceito geral de História da Enfermagem, segundo cinco componentes do processo de trabalho da Enfermagem. O produto apresentado é uma primeira proposta que deverá ser validada e aperfeiçoada pelas críticas emanadas pela comunidade científica da Enfermagem.

Resinous adhesive systems differentially affect the expression of cytokines by human monocytes stimulated or not with Streptococcus mutans in vitro.

OBJECTIVES: The polymerization of adhesive systems is incomplete and the residual monomers that have been released have a cytotoxic capacity. Some teeth develop into pulp necrosis after composite resin restorations. Considering frequent pulpal inflammation in response to cariogenic bacteria, substances released from the patches could affect the cells of the inflammatory infiltrate and interfere with the mechanisms of defense against microorganisms and protection of pulpal tissue. The aim of this study was to evaluate the effect of substances released by different resinous adhesive systems on cell viability and cytokine expression by human monocytes stimulated in vitro with Streptococcus mutans. DESIGN: Peripheral blood mononuclear cells from 10 healthy subjects were stimulated with S. mutans and then incubated with supernatants obtained from the Single Bond Universal (SBU) or Clearfil SE Bond (CSEB) adhesive systems for eight hours. Staining with Annexin V and 7AAD for analysis of apoptosis were performed and detection of monocytes expressing cytokines IL-1α, IL-6, IL-8, IL-10, IL-12 and TNF-α were performed by flow cytometry. RESULTS: No treatment significantly affected apoptosis in monocytes. SBU supernatant increased the frequency of monocytes expressing IL-8 and decreased the monocytes expressing IL-10. Considering S. mutans-stimulated cells, while SBU increased the frequency of IL-8+ monocytes, CSEB reduced the frequency of IL-6 and TNF-α positive monocytes. CONCLUSIONS: Products released from SBU seem to induce proinflammatory effects on monocytes while those from CSEB show an anti-inflammatory outcome. These effects may interfere in the control of cytokine-mediated immunoinflammatory pulp reactions, both in the presence and absence of stimulation by cariogenic bacteria.

A Viagem Fantástica em Cordel Pela História da Enfermagem / The Fantastic Cordel Journey For the History of Nursing

O livro - A VIAGEM FANTÁSTICA EM CORDEL PELA HISTÓRIA DA ENFERMAGEM, publicado em 2019 pela Editora Cuidarte, com a colaboração do Fundo de Apoio à Cultura, Secretaria do Estado da Cultura e Economia Criativa do Distrito Federal, faz parte da série - Historia de Enfermagem em Cordel. Sua narrativa em versos e rimas de cordel perpassa pela história da enfermagem, das profissões e suas personalidades desde os tempos primórdios até a atualidade. A obra aborda práticas do cuidar e destaca personalidades da enfermagem brasileira e de outros países. Composto por sete capítulos sobre a história da enfermagem, os leitores vão passear de forma leve e inusitada para conhecer ações, conquistas e dedicações da profissão, dentre outros assuntos.

Physical fitness test performance probability with increasing age: suggestions for practical applications in military physical training / Probabilidade de desempenho no teste de aptidão física e o aumento da idade: sugestões de aplicações práticas no treinamento físico militar

Abstract This article analyzes the Physical Fitness Test (PFT) which is performed by the Brazilian Navy to check the physical parameters of its military members in order to present the performance of probabilities with increasing age. We analyzed 702 PFT data in this study, separated into three groups based on the age of those assessed by the PFT, as follows: young adults (YA, n=91, age range between 20-30 years), adults (A, n=243, age range between 30-40 years) and mature adults (MA, n=368, age range between 40-50 years old). PFT measurements were: Body Mass Index (BMI), 100 m freestyle swimming, 3,200 m running, 1 min sit-ups, Pull-up on the bar and Push-up test. The main results indicated significant differences between groups when compared Body mass (YA: 79.1±11.4kg and A: 82.1±14kg < MA: 84.1±12.3kg), BMI (YA: 25.4±2.9 < A: 26.4±4.3 < MA: 27.5±4),Pull-ups (YA: 10.8±4.6 freq./min < A: 10±3.6 freq./min < MA: 8.5±4.7 freq./min), 3,200 m running time (YA: 1282,1±172,4s < A: 1421±199.8s < MA: 1566.7±192.4s) and 100 m swimming time (YA: 140.1±45.6s < A: 149.7±37.9s < MA: 180.8±50s) and the regression analysis demonstrated that 3,200 m running and pull-ups were the most affected variable of aging process (p<0.05). In summary, it is possible to carry out a practical application, considering aging process and the decline of the aerobic capacity and the upper limbs strength-power in Military Physical Training.

Resumo Este artigo analisou o Teste de Aptidão Física (PFT), realizado pela Marinha do Brasil para medir os parâmetros físicos de seus militares, a fim de apresentar as probabilidades de desempenho com o aumento da idade. Analisamos 702 dados de PFT, separados em três grupos com base na idade, como segue: adultos jovens (YA, n=91, faixa etária entre 20-30 anos), adultos (A, n=243, faixa etária entre 30-40 anos) e adultos de meia idade (MA, n=368, faixa etária entre 40-50 anos). As medidas da PFT foram: Índice de Massa Corporal (BMI), natação de 100m livre, 3.200m de corrida, 1min de abdominais, flexão na barra e flexão de braço. Os principais resultados indicaram diferenças significativas entre os grupos quando comparados a massa corporal (YA: 79,1±11,4kg e A: 82,1±14kg <MA: 84,1±12,3kg), IMC (IA: 25,4±2,9 <A: 26,4±4,3 <MA: 27,5±4,0), Pull-ups (YA: 10,8±4,6 freq./min <A: 10,0±3,6 freq./min <MA: 8,5±4,7 freq./min), 3.200 m de tempo de execução (YA: 1282,1±172,4s <A: 1421±199,8s <MA: 1566,7±192,4s) e 100m de natação (YA: 140,1±45,6s <A: 149,7±37,9s <MA: 180,8±50s) e a análise de regressão demonstrou que 3.200m de corrida e flexões de braço foram a variável mais afetada do processo de envelhecimento (p<0,05). Em resumo, é possível realizar uma aplicação prática, considerando o processo de envelhecimento e o declínio da capacidade aeróbica e da força-força dos membros superiores no treinamento físico militar.

Characterization of bacterial endophytes from the roots of native and cultivated Brazil nut trees (Bertholletia excelsa)

Brazil nut is a very important nontimber forest product in the Amazon region. Propagation of this tree still represents a challenge due to slow and uneven seed germination. In this context, plant growth-promoting bacteria can facilitate the process of propagation. The aims of this study were to isolate and characterize endophytic bacteria from the roots of Brazil nut trees in native terra firme forest and cultivation areas in northern Brazil, and to identify mechanisms by which bacteria act in plant growth promotion. Overall, 90 bacterial isolates were obtained from the roots of Brazil nut trees in monoculture, agroforestry and native forest areas by using different semisolid media. The isolates were characterized by sequencing the 16S rRNA gene. Plant growth-promoting characteristics were evaluated by the presence of the nifH gene, aluminum phosphate solubilization and the production of indole compounds. The isolates were affiliated with 18 genera belonging to 5 different classes (α-Proteobacteria, ß-Proteobacteria, γ-Proteobacteria, Bacilli and Actinobacteria). The genus Bacillus was predominant in the forest and monoculture areas. Fourteen isolates presented the nifH gene. Most of the bacteria were able to solubilize aluminum phosphate and synthetize indole compounds. The results indicated high diversity of endophytic bacteria present among the roots of Brazil nut trees, mainly in the agroforestry area, which could be related to soil attributes. Among the 90 isolates, the 22 that presented the best results regarding plant growth promotion traits were good candidates for testing in seedling production of Brazil nut trees. (AU)

Trajetória da criação e implantação da ouvidoria da Coordenadoria Regional de Saúde Sul da cidade de São Paulo / Trajectory of the creation and implementation of the ombudsman’s office of the Regional Coordination of Health South of the city of São Paulo

Estudo histórico documental sobre a criação e implantação da Ouvidoria da Coordenadoria Regional de Saúde Sul, subordinada à Secretaria Municipal de Saúde da cidade de São Paulo. O marco inicial da pesquisa foi posicionado em 2001, quando a Ouvidoria Geral da cidade de São Paulo foi instituída por meio do Decreto nº 40.248. O recorte final foi posicionado no ano de 2010, quando a 15ª Conferência Municipal de Saúde propôs resolução especifica para ser implementada pelas Ouvidorias, consolidando, ao tempo que lhes prescreveu ações, sua inserção e participação nos mecanismos de controle social. Como fontes diretas, foram utilizadas as documentações disponíveis no acervo institucional. A análise dos documentos organizados em fichas as quais foram agrupadas por similaridade e pertinência temáticas, resultando na construção de três categorias: “Conceito, funcionamento e organização”, “Atores e processo de trabalho” e “Interlocução e demandas”. Concluiu-se que a criação e a implantação da Ouvidoria foram concretizadas porque foram estruturadas como um setor de assessoria técnica administrativa, atendendo às necessidades institucionais. Uma conjunção de fatores favoreceu esse processo, dentre os quais estão à natureza do seu trabalho e o modo como esse serviço foi organizado e empreendido, numa ação que respondeu a necessidades institucionais e sociais.

Clinical decision support system (CDSS)--effects on care quality.

PURPOSE: Despite their efficacy, some recommended therapies are underused. The purpose of this paper is to describe clinical decision support system (CDSS) development and its impact on clinical guideline adherence. DESIGN/METHODOLOGY/APPROACH: A new CDSS was developed and introduced in a cardiac intensive care unit (CICU) in 2003, which provided physicians with patient-tailored reminders and permitted data export from electronic patient records into a national quality registry. To evaluate CDSS effects in the CICU, process indicators were compared to a control group using registry data. All CICUs were in the same region and only patients with acute coronary syndrome were included. FINDINGS: CDSS introduction was associated with increases in guideline adherence, which ranged from 16 to 35 per cent, depending on the therapy. Statistically significant associations between guideline adherence and CDSS use remained over the five-year period after its introduction. During the same period, no relapses occurred in the intervention CICU. PRACTICAL IMPLICATIONS: Guideline adherence and healthcare quality can be enhanced using CDSS. This study suggests that practitioners should turn to CDSS to improve healthcare quality. ORIGINALITY/VALUE: This paper describes and evaluates an intervention that successfully increased guideline adherence, which improved healthcare quality when the intervention CICU was compared to the control group.

Conferências Nacionais de Saúde e o Serviço de Ouvidoria no Brasil / National health conferences and ombusman service in Brazil

O estudo objetivou identificar, descrever e analisar o que os relatórios finais das 10 ª, 11ª, 12ª e13ª Conferências Nacionais de Saúde mencionaram sobre ouvidoria na saúde. Estudo históricodocumental,que examinou os relatórios finais das conferências mencionadas, disponíveis no sitedo Ministério da Saúde. Esses documentos foram lidos e analisados conforme sua sequênciacronológica. Os achados foram compilados e organizados em categorias de análise, empregandoseos critérios de similaridade e pertinência temática. O presente estudo apontou o conteúdo e opercurso das ações propostas pelas 10ª, 11ª, 12ª e 13ª Conferências Nacionais de Saúde para ainstitucionalização da Ouvidoria como instrumento de controle social do Sistema Único de Saúdepelos conselhos de saúde.

Boletim Informativo do Coren-SP (1992-1996): Personagens/Autores Participantes / Newsletter of COREN-SP (1922-1966): actors participants

Trata-se de estudo histórico documental que objetivou descrever as características predominantesassociadas aos atores participantes das matérias publicadas no Boletim Informativo do COREN-SP,no período de 1992 a 1996, descrevendo suas posições acadêmico-profissionais. Para isso utilizouse,como fontes primárias, 12 exemplares do Boletim Informativo do COREN-SP, publicados noperíodo de dezembro de 1992 a dezembro de 1996. A análise se deu por meio da leitura e seleçãode textos pertinentes ao objeto de estudo, em busca de similaridades e significados contidos nasproposições. Os documentos pesquisados evidenciaram frequências quantitativas, queapresentaram o seguinte perfil dos atores: especialização na área de administração, cargosprofissionais de liderança nas instituições, sendo que parte significativa desses atores mencionouvinculação à Universidade de São Paulo, especialmente ao seu hospital-escola.

Insights into physician scheduling: a case study of public hospital departments in Sweden.

PURPOSE: The purpose of this paper is to describe current physician scheduling and concomitant opportunities for improvement in public hospital departments in Sweden. DESIGN/METHODOLOGY/APPROACH: A total of 13 departments spread geographically across Sweden covering seven different specialties participated in the study. Data were collected through interviews with individuals involved in creating physician schedules. All departments investigated provided copies of the documents necessary for physician scheduling. FINDINGS: Physician scheduling required the temporal coordination of patients, physicians, non-physician staff, rooms and equipment. A six-step process for creating physician schedules could be distinguished: capacity and demand overview, demand goal and schedule setting, vacation and leave requests, schedule creation, schedule revision, and schedule execution. Several opportunities for improvement could be outlined; e.g. overreliance on memory, lacking coordination of resources, and redundant data entering. RESEARCH LIMITATIONS/IMPLICATIONS: The paucity of previous studies on physician scheduling lends an exploratory character to this study and calls for a more thorough evaluation of the feasibility and effects of the approaches proposed. The study excluded the scheduling of non-physician staff. PRACTICAL IMPLICATIONS: To improve physician scheduling and enable timeliness, three approaches are proposed: reinforcing centralisation, creating learning opportunities, and improving integration. ORIGINALITY/VALUE: This paper is among the few to investigate physician scheduling, which is essential for delivering high quality care, particularly concerning timeliness. Several opportunities for improvement identified in this study are not exclusive to physician scheduling but are pervasive in healthcare processes in general.

Avaliação da atividade antimicrobiana de três cimentos de ionômero de vidro / Evaluation of the antimicrobial activity of three glass-ionomer cements

Objetivo: Avaliar a capacidade antimicrobiana de três cimentos de ionômero de vidro tendo como grupo controle uma pasta de hidróxido de cálcio, sobre cultura bacteriana mista proveniente da cavidade bucal de crianças. Método: Os materiais empregados nos ensaios laboratoriais foram: Vidrion R (SS White, Brasil), Ketac Molar (Espe 3M), Meron R (Voco) e Biocal (Biodinâmica). Para verificar esta ação antimicrobiana, foi utilizada cultura mista coletada do biofilme de quatro pacientes pediátricos da disciplina de odontopediatria e utilizado o teste de difusão com Agar sangue. Os materiais em forma de corpos de prova foram acomodados em escavações circulares realizadas no meio de cultura, onde foram semeadas as diluições das culturas bacterianas. Os halos de inibição foram medidos em milímetros e os resultados submetidos à Análise de Variância (ANOVA) e teste Tukey (p<0,05). Resultados: O Vidrion R (9,26±0,79) e o Ketac Molar (8.96±0,56) não apresentaram diferença estatística significante entre si (p>0,05), porém em todas as outras combinações dos materiais, houve diferenças estaticamente significantes (p<0,05). O cimento Meron R (12,33±2,06) apresentou maiores halos de inibição e os menores foram com o Biocal (5.59±0,76). Conclusão: Todos os materiais estudados apresentaram ação antimicrobiana positiva, sendo que o maior poder antimicrobiano foi demonstrado pelo cimento de ionômero de vidro Meron R...

Objective: To evaluate the antimicrobial activity of three glass-ionomercements against a mixed bacterial culture from children?s oral cavity, having a calcium hydroxide paste as the control group. Method: The materials used for laboratory test were: Vidrion R (SS White), Ketac Molar (3M ESPE), Meron R (Voco) and Biocal (BiodinÔmica). The antimicrobial action of the cements was assessed using the agar blood diffusion test with mixed culture collected from the biofilm of four pediatric patients of the Pediatric Dentistry discipline. Specimens from the materials were inserted in wells prepared in the culture medium with a sterile straw where dilutions of the bacterial cultures had been seeded. The inhibition zones were measured in millimeters and the results subjected to analysis of variance and Tukey?s test (p<0.05). Results: No statistically significant difference was found between Vidrion R (9.26±0.79) and Ketac Molar (8.96±0.56) (p>0.05), but significant differences were observed for all the other combinations of materials (p<0.05). Meron R (12.33±2.06) and Biocal (5.59±0.76) exhibited the largest and smallest inhibition zones, respectively. Conclusion: All the evaluated materials exhibited a positive antimicrobial action, with Meron R glass-ionomer cement presenting the greatest activity...

Ofício-circular: inquérito sobre as condições das escolas de enfermagem no ano de 1966 / OFFICE CIRCULAR: SURVEY ON THE CONDITIONS OF THE NURSING SCHOOLS ‐ YEAR 1966

O estudo objetiva descrever o conteúdo de documentos enviados às escolas de enfermagem do país, por Waleska Paixão, relatora da Comissão de Especialistas de Ensino de Enfermagem (CEEEnfermagem) do Ministério da Educação e Cultura, e analisá‐los à luz do contexto sociopolítico da época. O intuito da comissão era realizar um inquérito sobre as condições das escolas de enfermagem, para recomendar a distribuição de verbas pelo Ministério da Educação e Cultura. Para desenvolver esse estudo histórico, realizado por meio de análise documental, utilizou‐se, como fonte primária, um ofício, datado de 9 de agosto de 1966, e seus seis anexos. O documento pesquisado evidenciou a preocupação da CEEEnfermagem com as condições das escolas de enfermagem do país, objetivando a melhoria do ensino e qualificação dos profissionais, além da presença marcante de Waleska Paixão, suas estratégias políticas e o compromisso com a profissão, demonstrando a forma por ela encontrada para operacionalizar, justa e eticamente, a distribuição de recursos do Ministério da Educação e Cultura.