A Systematic Review of Interventions Based on Judeo-Christian Principles for Patients with Substance Dependence.

Substance use disorders have significant consequences for patients and those around them. A qualitative systematic review was conducted to examine the effectiveness of religiosity and spirituality (R/S) interventions based on Judeo-Christian principles during the multidisciplinary treatment of patients with substance dependence disorder. Studies of patients of both sexes, at any age, of any nationality, and from any geographic location who were participating in treatment programs with religious elements explicitly tied to Christianity or Judaism were eligible for inclusion. Other religious interventions were excluded. Seven electronic databases were searched to identify eligible intervention studies published in English until August 2021. Two reviewers independently screened studies and extracted data. JBI tools were used to assess risk of bias. Of 146 articles retrieved for full text reading, five were ultimately included in this review published from July 2008 to August 2021. The R/S interventions used in the included studies were music therapy in a religious context, reading of the Bible or Torah, reflexive readings, personal prayer and reflection, and religiously integrated cognitive behavioral psychotherapy with or without a comparison group. Despite the broad search, there were found only a small number of studies and little homogeneity in the data of patients that reported positive impacts of treatments. Well-designed controlled studies are needed to truly investigate the efficacy of Judeo-Christian religious interventions for helping people with substance use problems, so as to strengthen the evidence of the benefits of these type of approaches in the treatment of drug addicts.

Geomorphometric environmental fragility of a watershed: a multicriteria spatial approach.

Knowledge and understanding of the functioning of watersheds is essential for constructing future scenarios that aim to minimize instability. However, new approaches including variables, methods, and techniques into traditional methodologies contribute to environmental planning and management of such territorial units. This study aims to propose a model based on a multicriterion spatial approach for the analysis of the geomorphometric environmental fragility of watersheds. This study was conducted in the Murundú-Paiol watershed, located in the state of São Paulo, Brazil. Morphometric, geological, pedological, hypsometric, slope, land use, and land cover data were evaluated and integrated using geotechnologies for processing and analytical hierarchy process (AHP) considering a weighted linear combination for an integrated spatial analysis of the watershed. The study area shows a greater predisposition to fragility in areas of flat and smooth reliefs, especially around the main river, where there is a greater presence of anthropic areas. The methodology proposed here, which uses a multicriterion spatial approach and AHP, combined with technical and scientific data, allows replicating the model to another watersheds. Modeling was validated in a cooperative way using an in-field, traditional method. The watershed evaluated showed that 49.13% and 26.83% of lands have medium and low fragility, respectively, while about 17% of lands have a high fragility and their management should be a priority. Modeling correlates strongly and positively with fragility class detailing, and field areas corroborate the model proposed here. This evidenced a robust analysis of factors that affect the geomorphometric environmental fragility of watersheds. The method is efficient in contributing to environmental planning and management of this territorial unit.

Valuation methodology of laminar erosion potential using fuzzy inference systems in a Brazilian savanna.

This study presents an approach on the evaluation of potential laminar erosion in the Ribeirão Sucuri Grande watershed. It is located in the northeast of the state of Goiás, Brazil, a conservation area under strong anthropogenic pressure. A Mamdani fuzzy inference system was designed using linguistic variables, pertinence functions, and a set of rules associated to a traditional laminar erosion prediction model through the environmental conditioners slope, erodibility, and degree of soil protection. The laminar erosion prediction model associated with fuzzy logic is a qualitative evaluation of erosive potential capable of being spatialized with a greater level of detail, increasing the traditional classification by two levels. The processing of environmental and soil conditioning factors using the fuzzy logic resulted in values between 2.5 and 9.1, which places the basin at a low to very high laminar erosion potential. The results indicate areas that demand a greater attention regarding soil management; 56.89% of the area has a medium to high laminar erosion and high to very high erosion (6.99%).

Upper and Lower Limbs Acute Fatigue Did Not Mitigate Male Trained Air Force Soldiers' Marksmanship.

In this study, we aimed to investigate the impact of acute fatigue on pistol shooting performance among Air Force marksmen. We compared the accuracy, precision, speed-accuracy trade-off, shooting cycle time, and hits on a silhouette target among 12 Brazilian Air Force servicemen (M age = 21.5, SD - 1.6 years) under both fatigue and non-fatigue conditions in a crossover design. In the fatigued condition, the participants performed a fatigue protocol composed of side runs, vertical jumps, push-ups, running, and burpees exercises before shooting. Participants performed the countermovement jump and the plyometric push-ups tests on a contact mat before and immediately after the fatigue protocol to compare the heights achieved pre- and post-fatigue. Paired t-tests showed a significant performance reduction of 34.36% and 40.02% for the countermovement jump and plyometric push-ups, respectively, indicating that participants were fatigued in their lower and upper limbs. In the non-fatigued condition, no exercise was performed before shooting. Results indicated no significant differences between conditions on shooting precision (p = .125; ES: .54), speed-accuracy trade-off (p = .261; ES = .33), hits within the silhouette (p = .167; ES = .41), or shooting cycle times (p = .868; ES = .05); but accuracy was greater (p = .025; ES: .54) when fatigued. We concluded that overall shooting performance was not impaired by physical fatigue, and shooting accuracy appeared to be improved. Perhaps physical fatigue was not enough to impair shooting accuracy in this young adult group, as accuracy decline is expected instead when shooters are in an exhausted state. Further research is needed to confirm these findings and test this presumption.

Coronavirus: a clinical update of Covid-19.

A covid-19 pandemic decreed by WHO has raised greater awareness of it. The infection reached the mark of 350,000 patients in 33 countries and affected as comorbidities the presence of comorbidities and advanced age. The transmissibility calculated so far is similar to the H1N1 epidemic, but with lower mortality rates. The SARS-CoV-2 virus, of the Coronaviridae family, has the capacity for cellular invasion through the angiotensin-converting enzyme 2 does not have a lower respiratory epithelium and in the cells of the small intestine mucosa. A presentation can be divided into mild (fever, fatigue, cough, myalgia, and sputum) and severe (cyanosis, dyspnoea, tachypnea, chest pain, hypoxemia and need for clinical measurement) and has an estimated estimate of 2%.allows the detection of viral load in CRP-TR of patients with high clinical suspicion. Based on supportive measures and infection control. In severe cases, the use of medications such as hydroxychloroquine and azithromycin or medication can be promising. Take care to avoid the use of corticosteroids. There are no restrictions on the use of resources and ACEIs / ARBs.

Sars-CoV-2: A clinical update - II.

INTRODUCTION: A covid-19 pandemic decreed by WHO has raised greater awareness of it. EPIDEMIOLOGY: The infection, reached the mark of 2,000,000 patients in 33 countries and caused the risk of the presence of comorbidities and advanced age. TRANSMISSIBILITY: The transmissibility calculated so far is similar to the H1N1 epidemic, but with lower mortality rates. PHYSIOPATHOLOGY: The SARS-CoV-2 virus, of the Coronaviridae family, has the capacity for cellular invasion through the angiotensin-converting enzyme 2 does not have a lower respiratory epithelium and in the cells of the small intestine mucosa. CLINICAL MANIFESTATIONS: a presentation can be divided into mild (fever, fatigue, cough, myalgia, and sputum) and severe (cyanosis, dyspnoea, tachypnea, chest pain, hypoxemia and need for clinical measurement) and has an estimated estimate of 2%. DIAGNOSIS: allows the detection of viral load in CRP-TR of patients with high clinical suspicion. TREATMENT: based on supportive measures and infection control. In severe cases, the use of medications such as hydroxychloroquine and azithromycin or medication can be promising. Take care to avoid the use of corticosteroids. There are no restrictions on the use of resources and IECAs / BRAs.

Sleep and immunity in times of COVID-19.

BACKGROUND: Analyze how the COVID-19 (SARS-CoV-2) pandemic and its social restriction measures affect sleep quality and the immunological system. METHODS: An integrative bibliographical review was carried out using scientific articles from the last five years, from the PUBMED databases, with the descriptors: Sleep; Quarantine; COVID-19; Immunity; Mental Health. Besides the books "Oxford textbook of sleep disorders", "Cellular and molecular immunology", and "Treaty of Infectology". RESULTS: Sleep affects immunity. This happens through the regulation of immunological markers and their cells. Therefore, the COVID-19 pandemic can promote sleep disturbances and harm the immune system function. CONCLUSION: Sleep exercises a direct influence on immunity maintenance and immunological response. Circadian rhythm alterations, associated with the psychological problems imposed by the COVID-19 pandemic compromise the quality of sleep and, for that reason, the immune system.

Use of photodynamic therapy in the treatment of bovine subclinical mastitis.

BACKGROUND: Bovine mastitis is a disease that causes a severe drawback in dairy production. Conventional treatments with antibiotic could leave antibiotic residues in the milk. The aim of this study was to evaluate the effect of photodynamic therapy in the treatment of bovine subclinical mastitis to develop an in vivo therapeutic protocol that could be used in routine farm practice, favoring the early return to production. METHODS: Forty cows with subclinical mastitis (n = 40) were divided into 4 groups (control, photodynamic therapy - PDT, light irradiation - LED, and photosensitizer - PS). Control group received no treatment, PDT group received application of 1.0 mL of 2.5% toluidine blue photosensitizer followed by LED irradiation at λ = 635 nm, the LED group was treated with LED irradiation alone, and the PS group received only 2.5% toluidine blue dye. LED irradiation was applied to the mammary gland by means of an acrylic light guide coupled to the LED equipment. The PDT and LED groups were irradiated with 200 J/cm2 at three different positions inside the mammary gland. Milk samples were collected at 0 h, 12 h, 24 h after treatment for microbial identification and total bacterial count. RESULTS: The treatment of the PDT group showed significant difference p < 0.05, characterizing the efficiency of this technique with the reduction of the microorganisms Streptococcus dysgalactiae and coagulase-negative Staphylococcus. CONCLUSION: Photodynamic therapy was effective when applied in vivo for subclinical bovine mastitis. There was no need to separate the animal from production.

Rhabdomyolysis after bariatric surgery.

BACKGROUND: Rhabdomyolysis is a potential threat after bariatric surgey. The severity ranges from asymptomatic elevations of serum muscle enzyme levels to life-threatening cases associated with muscle necrosis, compartment syndrome, acute renal failure and cardiac arrest. METHODS: We studied 98 consecutive obese patients who underwent primary uncomplicated bariatric surgery during a 1-year period. A database was created for all patients (sex, age, BMI, duration of the operation); serum creatinine phosphokinase (CPK) was systematically measured before surgery and on the first and second postoperative day. RESULTS: The study sample consisted of 35 males (35.7%) and 63 females (64.3%) with preoperative CPK level 156.6 +/- 41.1 U/L (40 to 220), 24 hours postoperatively 1,075.2 +/- 596.5 U/L, (85 to 2,790 U/L) and 48 hours postoperatively 967.3 +/- 545.3 U/L (79 to 2,630). There was no difference in mean BMI (P=0.1) and mean duration of operation (P=0.5) between males and females. However, a statistically significant difference in mean elevation of CPK between males and females (P=0.003) was found. The variables sex, age, weight and duration of surgery were analyzed by multivariate logistic regression, but did not show a statistically significant difference. CONCLUSION: Rhabdomyolysis is a potentially fatal complication of surgical procedures in obese patients, and can be minimized with simple measures such as additional padding, aggressive hydration and urine alkalinization. Diagnosis requires a high level of physician awareness.

Sleep habits, sleepiness and accidents among truck drivers.

OBJECTIVE: To evaluate the quality of sleep, shift work, alcohol and psychostimulant drug use, and the prevalence of accidents among truck drivers. METHOD: Data were collected using a demographic questionnaire, the Epworth Sleepiness Scale (ESS) and the Pittsburgh sleep quality index (PSQI). Statistical analysis was conducted using the Student t, chi-square, Pearson and Fisher tests. RESULTS: 43.2% of the drivers drove over 16 h a day, and 2.9% worked shifts. Mean number of sleep hours/day was 5.97+/-1.47; 23.8% slept <5 hours; 50.9% made use of alcohol, 95.6% of caffeine, and 11.1% of amphetamines. Mean PSQI was 4.95+/-2.56; 35.4% had a PSQI >5; 23 subjects snored more than three times a week (11.1%). Mean ESS was 6.56+/-4.2; 21.7% had a score >10. In the preceding five years, 27 drivers (13.1%) were involved in accidents, 5 of which resulted in injuries and 3 in deaths. CONCLUSION: Results showed a high prevalence of sleep disorders, use of alcohol and psychostimulant drugs, and accidents.

[Antologus and heterotopic splenic regeneration in rats]. / Estudo da regeneração esplênica autóloga e heterotópica em ratos.

PURPOSE: verify the cytological and histological aspects of the regeneration of fragments of autologous and heterotopic spleen implanted in peritoneal cavity and subcutaneous screen in Wistar albino rats. METHODS: forty four Wistar rats were assigned to one of two groups A (n=22) and B (n=22), which received their implants in subcutaneous screen and peritoneal cavity, respectively, under anesthesia. Those groups were redistributed in two other subgroups A1 (n=11) and B1 (n=11), which received one and four splenic fragments in the areas of study. The remaining spleen was guided for cytological and histological processing, and was used as a control group. After five weeks, they were submitted to euthanasia, and peritoneal cavity opening took place as well as subcutaneous screen was taken off in order to search for regenerated splenic tissue. Cytological and histological assessment in the regenerated splenic tissue was performed, and the results were compared to the control group. Statistical analysis no parametric tests (p => 0.05) were used for. RESULTS: there were no statistically significant differences in relation to regenerated splenic tissue in subcutaneous screen (n=22) and the peritoneal cavity (n=22). In relation between presence and absence of regeneration, they're no statistically significant differences (p = 0.182). Cytological and histological assessment did not show any statistically significant difference in relation to the control group. CONCLUSION: regeneration of autologous and heterotopic splenic tissue in mice is viable, and occurs frequently. Cytological and histological aspects are similar to normal spleen.

Sars-CoV-2: A clinical update - II

SUMMARY INTRODUCTION A covid-19 pandemic decreed by WHO has raised greater awareness of it. EPIDEMIOLOGY The infection, reached the mark of 2,000,000 patients in 33 countries and caused the risk of the presence of comorbidities and advanced age. TRANSMISSIBILITY The transmissibility calculated so far is similar to the H1N1 epidemic, but with lower mortality rates. PHYSIOPATHOLOGY The SARS-CoV-2 virus, of the Coronaviridae family, has the capacity for cellular invasion through the angiotensin-converting enzyme 2 does not have a lower respiratory epithelium and in the cells of the small intestine mucosa. CLINICAL MANIFESTATIONS a presentation can be divided into mild (fever, fatigue, cough, myalgia, and sputum) and severe (cyanosis, dyspnoea, tachypnea, chest pain, hypoxemia and need for clinical measurement) and has an estimated estimate of 2%. DIAGNOSIS allows the detection of viral load in CRP-TR of patients with high clinical suspicion. TREATMENT based on supportive measures and infection control. In severe cases, the use of medications such as hydroxychloroquine and azithromycin or medication can be promising. Take care to avoid the use of corticosteroids. There are no restrictions on the use of resources and IECAs / BRAs.

RESUMO INTRODUÇÃO A pandemia de Covid-19 decretada pela OMS suscita maior conhecimento acerca da doença. EPIDEMIOLOGIA A infecção atingiu a marca de 2 milhões de pacientes em 33 países e levantou como fatores de risco a presença de comorbidades e a idade avançada. TRANSMISSIBILIDADE A transmissibilidade calculada até o momento é similar à da epidemia de H1N1, contudo, com taxa de mortalidade inferior. FISIOPATOLOGIA O vírus Sars-CoV-2, da família Coronaviridae, tem capacidade de invasão celular através da enzima conversora de angiotensina 2 presente no epitélio respiratório inferior e nas células da mucosa do intestino delgado. MANIFESTAÇÕES CLÍNICAS A apresentação pode ser dividida em leve (febre, fadiga, tosse, mialgia e escarro) e grave (cianose, dispneia, taquipneia, dor torácica, hipoxemia e necessidade de ventilação mecânica) e tem mortalidade estimada de pouco mais de 2%. DIAGNÓSTICO Dá-se pela detecção da carga viral no PCR-TR de pacientes com alta suspeição clínica. TRATAMENTO Baseado em medidas de suporte e de controle de infecção. Em casos graves, uso de medicamentos como hidroxicloroquina e azitromicina ou remdesevir pode ser promissor. Deve-se evitar o uso de corticosteroides. Não há evidências suficientes para abster-se do uso de ibuprofeno e IECAs/BRAs.

Coronavirus: a clinical update of Covid-19

SUMMARY INTRODUCTION A covid-19 pandemic decreed by WHO has raised greater awareness of it. EPIDEMIOLOGY The infection reached the mark of 350,000 patients in 33 countries and affected as comorbidities the presence of comorbidities and advanced age. TRANSMISSIBILITY The transmissibility calculated so far is similar to the H1N1 epidemic, but with lower mortality rates. PHYSIOPATHOLOGY The SARS-CoV-2 virus, of the Coronaviridae family, has the capacity for cellular invasion through the angiotensin-converting enzyme 2 does not have a lower respiratory epithelium and in the cells of the small intestine mucosa. CLINICAL MANIFESTATIONS a presentation can be divided into mild (fever, fatigue, cough, myalgia, and sputum) and severe (cyanosis, dyspnoea, tachypnea, chest pain, hypoxemia and need for clinical measurement) and has an estimated estimate of 2%. DIAGNOSIS allows the detection of viral load in CRP-TR of patients with high clinical suspicion. TREATMENT based on supportive measures and infection control. In severe cases, the use of medications such as hydroxychloroquine and azithromycin or medication can be promising. Take care to avoid the use of corticosteroids. There are no restrictions on the use of resources and ACEIs / ARBs.

RESUMO INTRODUÇÃO A pandemia de covid-19 decretada pela OMS suscita maior conhecimento acerca da doença. EPIDEMIOLOGIA A infecção atingiu a marca de 350.000 pacientes em 33 países e levantou como fatores de risco a presença de comorbidades e a idade avançada. TRANSMISSIBILIDADE A transmissibilidade calculada até o momento é similar à da epidemia de H1N1, contudo, com taxa de mortalidade inferior. FISIOPATOLOGIA O vírus SARS-CoV-2, da família Coronaviridae, tem capacidade de invasão celular através da enzima conversora de angiotensina 2 presente no epitélio respiratório inferior e nas células da mucosa do intestino delgado. MANIFESTAÇÕES CLÍNICAS A apresentação pode ser dividida em leve (febre, fadiga, tosse, mialgia e escarro) e grave (cianose, dispneia, taquipneia, dor torácica, hipoxemia e necessidade de ventilação mecânica) e tem mortalidade estimada de pouco mais de 2%. DIAGNÓSTICO Dá-se pela detecção da carga viral no PCR-TR de pacientes com alta suspeição clínica. TRATAMENTO Baseado em medidas de suporte e de controle de infecção. Em casos graves, uso de medicamentos como hidroxicloroquina e azitromicina ou remdesivir podem ser promissores. Evitar o uso de corticosteroides. Não há evidências suficientes para abster-se do uso de ibuprofeno e IECAs/BRAs.

Sleep and immunity in times of COVID-19

SUMMARY BACKGROUND Analyze how the COVID-19 (SARS-CoV-2) pandemic and its social restriction measures affect sleep quality and the immunological system. METHODS An integrative bibliographical review was carried out using scientific articles from the last five years, from the PUBMED databases, with the descriptors: Sleep; Quarantine; COVID-19; Immunity; Mental Health. Besides the books "Oxford textbook of sleep disorders", "Cellular and molecular immunology", and "Treaty of Infectology". RESULTS Sleep affects immunity. This happens through the regulation of immunological markers and their cells. Therefore, the COVID-19 pandemic can promote sleep disturbances and harm the immune system function. CONCLUSION Sleep exercises a direct influence on immunity maintenance and immunological response. Circadian rhythm alterations, associated with the psychological problems imposed by the COVID-19 pandemic compromise the quality of sleep and, for that reason, the immune system.

RESUMO OBJETIVOS Analisar como a pandemia de COVID-19 (Sars-CoV-2) e as medidas de restrição social afetam a qualidade do sono e o sistema imunológico. MÉTODOS Fez-se uma revisão bibliográfica integrativa usando-se artigos científicos dos últimos cinco anos, das bases de dados PubMed, com os descritores: Sono; Quarentena; COVID-19; Imunidade; Saúde mental. Além dos livros Oxford textbook of sleep disorders, Cellular and molecular immunology e Tratado de infectologia. RESULTADOS O sono afeta a imunidade. Isso se dá por meio da regulação de marcadores imunológicos e suas células. Dessa forma, a pandemia de COVID-19 pode corroborar distúrbios de sono e prejudicar o funcionamento do sistema imune. CONCLUSÃO O sono exerce influência direta na manutenção da imunidade e da resposta imunológica. A alteração do ritmo circadiano, atrelada aos problemas psicológicos impostos pela pandemia de COVID-19, compromete a qualidade do sono e, dessa forma, o sistema imune.

Insomnia and hypnotic use in Campo Grande general population, Brazil.

The insomnia prevalence in general population was determined by means of 408 home interviews of adults, in a representative sample of Campo Grande city, Brazil. The random sample was stratified by sex, age and economic social status. Insomnia subtypes evaluated were the disorders of sleep initiation (DSI), sleep maintenance (DSM) and early awakening (DEA). A structured questionnaire was used with the consent from the interviewed subjects. Statistics used chi-square, and Fisher tests; and inferences based on binomial distribution parameters; the significance level was 5% and confidence interval (CI) was 95%. The general prevalence of insomnia was 19.1% (sd=2.0%), mostly women (p=0.0015), and people of less years of schooling (p=0.0317), subtype DSI (14.2%, p=0.0043), and chronic (p=0.7022). Hypnotic drugs were used by 6.9%(sd=1.3%) in the last month. Use in the last 2 years, 70.3% mostly insomniacs (p<0.0001), women (p=0.0372) and people over 30 years of age (p=0.0536).

Excessive daytime sleepiness in Campo Grande general population, Brazil.

The prevalence of excessive daytime sleepiness (EDS) in general population was determined by means of 408 home interviews of adults, in a representative sample of Campo Grande city, Brazil. The random sample was stratified by sex, age and economic social status. EDS was considered in those with indexes 11 or more in the Epworth Sleepiness Scale. Statistics used chi-square, Fisher and Pearson tests; and inferences based on binomial distribution parameters; the significance level was 5% and confidence interval (CI) was 95%. The prevalence of EDS was 18.9% of the general population ( SD=1.9%; CI 15.1% to 22.7%). No significant association was found between EDS and the use of hypnotics, nor with insomnia, body mass index, sex, age, years of schooling, economic social status, marital status, occupation and the use of alternative means to improve sleep. When the sample was separated according to sex, only the male group showed significant association between EDS and actual insomnia (p=0.005).

Facilidades e limitações do enfermeiro no processo do raciocínio clínico / Facilities and limitations of the nurse in the clinical reaction process / Facilidades y limitaciones del enfermero en el proceso (nuevo) del raciocinio clínico

O objetivo desse estudo foi conhecer os facilidades e limitações dos enfermeiros para desenvolver o raciocínio clínico. Estudo quantitativo, descritivo, de corte transversal, que procurou averiguar as "facilidades e limitações dos enfermeiros no processo do raciocínio clínico" de 163 enfermeiros dos sete hospitais do Município de Dourados/MS, no primeiro semestre de 2016, sendo 79,8% são do sexo feminino, 65,4% são especialistas e 85,9% são do regime de Consolidação das Leis trabalhistas. Os participantes apontaram "educação permanente" (62%) como o principal facilitador e "pouco tempo para estudar" (45,39%) como a maior limitação para desenvolverem o raciocínio clínico. Conclui-se ser preciso criar estratégias na rede hospitalar que possibilitem aos enfermeiros se atualizarem dentro da própria instituição que trabalha e averiguar os fatores que contribuem para essa falta de tempo que o grande grupo optou como processo que limita o raciocínio clínico.(AU)

The aim of this study was to know the facilities and limitations of nurses to develop clinical reasoning. A quantitative, descriptive, cross-sectional study that sought to ascertain the "facilities and limitations of nurses in the clinical reasoning process" of 163 nurses from the seven hospitals in the City of Dourados/MS, in the first half of 2016, of which 79.8 % are female, 65.4% are specialists and 85.9% are from the Consolidation of Labor Laws. Participants pointed to "permanent education" (62%) as the main facilitator and "little time to study" (45.39%) as the greatest limitation to develop clinical reasoning. It's concluded that is necessary to create strategies in the hospital network that allow nurses to update themselves within the institution that works and to investigate the factors that contribute to this lack of time that the large group has chosen as a process that limits the clinical reasoning.(AU)

El objetivo de este estudio fue conocer las facilidades y limitaciones de los enfermeros para desarrollar el raciocinio clínico. Estudio cuantitativo, descriptivo, de corte transversal, que buscó averiguar las "facilidades y limitaciones de los enfermeros en el proceso del raciocinio clínico" de 163 enfermeros de los siete hospitales del municipio de Dourados/MS, en el primer semestre de 2016, siendo 79,8 % son del sexo femenino, 65,4% son especialistas y 85,9% son del régimen de Consolidación de las Leyes laborales. Los participantes apuntaron "educación permanente" (62%) como el principal facilitador y "poco tiempo para estudiar" (45,39%) como la mayor limitación para desarrollar el raciocinio clínico. Es necesario crear estrategias en la red hospitalaria que posibilite que los enfermeros se actualicen dentro de la propia institución que trabaja y averiguar los factores que contribuyen a esa falta de tiempo que el gran grupo optó como proceso que limita el raciocinio clínico.(AU)

A percepção de caminhoneiros sobre o uso de substâncias psicoativas no trabalho: um estudo etnográfico / The perception of truck drivers on the use of psychoactive substances at work: an ethnographic study / La percepción de camioneros sobre el uso de sustancias psicoactivas en el trabajo: un estudio etnográfico

OBJETIVO: compreender a experiência subjetiva de caminhoneiros em relação ao uso de substâncias psicoativas. MÉTODO: utilizou-se método qualitativo de caráter etnográfico. RESULTADOS: os elementos encontrados, tais como elevado índice de consumo de substâncias, corroboram estudos epidemiológicos acerca da temática, acrescentando, todavia, sentidos subjetivos e depoimentos. CONCLUSÃO: há uma divergência de opiniões que enfraquece a categoria em relação à negociação por melhores condições de trabalho, ao mesmo tempo que o uso de substâncias ilícitas é considerado normal e não é questionado por parte dos participantes.

OBJECTIVE: to understand the subjective experience of truck drivers regarding the use of psychoactive substances. METHOD: an ethnographic approach to qualitative research was employed. RESULTS: the discovered elements, such as high levels of substance abuse, corroborate epidemiological research about the theme including, however, subjective feelings and testimonials. CONCLUSIONS: there is a divergence of opinions that weakens the category regarding negotiation for better working conditions, while the use of illicit substances is considered normal and is unquestioned by the subjects.

OBJECTIVOS: comprender la experiencia subjetiva de camioneros con respecto al uso de sustancias psicoactivas. MÉTODO: se utilizó el método cualitativo de carácter etnográfico. RESULTADOS: los elementos encontrados, como el alto índice de uso de sustancias, corroboran los estudios epidemiológicos sobre el tema, agregando, sin embargo, sentimientos subjetivos y testimonios. CONCLUSIONES: existe una divergencia de opiniones que debilita la categoría en relación con la negociación para mejorar las condiciones de trabajo, mientras que el uso de sustancias ilícitas se considera normal y no se cuestiona por los sujetos.

Quality of life of orthopedists in Mato Grosso do Sul.

OBJECTIVE: Evaluate QOL and its implications for health care providers specialized in orthopedics. METHODS: In this quantitative, descriptive, cross-sectional study two questionnaires, World Health Organization Quality of Life (WHOQOL-100) and sociodemographic, were sent to 117 orthopedic surgeons, with 29 doctor's response. Statistical analysis was performed using three different tests: Analysis of Variance (ANOVA), Student t-test, and Pearson's linear correlation. The tests were applied with a reliability of 95%. RESULTS: Twenty-nine orthopedic surgeons responded to the questionnaire. The studied variables regarding domains were age and employment duration, which have a positive relationship with the environment and social relationships domains; income, which positively influences the level of independence and environment domains; and workload, which negatively influences the psychological domain. CONCLUSION: Orthopedic physicians had high scores in the WHOQOL-100 domains and, in their perception, good quality of life had higher scores compared to other professions.