mHealth e saúde pública: a presença digital do Sistema Único de Saúde do Brasil por meio de aplicativos de dispositivos móveis / mHealth and public health: the digital presence of the Brazilian Unified Health System through mobile device applications / mHealth y salud pública: la presencia digital del Sistema Único de Salud de Brasil a través de aplicaciones para dispositivos móviles

A evolução das Tecnologias da Informação e Comunicação permitiu que, ao longo da história, os campos da comunicação, da tecnologia e da saúde criassem diversas interseções. Entre elas, estão os aplicativos para dispositivos móveis que são estratégias de saúde digital móvel (mHealth). Há, porém, poucas evidências do uso desses avanços na saúde pública. A partir da identificação de 43 aplicativos ligados a Secretarias Municipais de Saúde, a Secretarias de Estado de Saúde e ao Ministério da Saúde, este artigo objetiva mapear e analisar essas iniciativas de presença digital no Sistema Único de Saúde. Os resultados mostram que as cidades têm grande destaque, liderando o uso dos apps, sobretudo no Sul do país. Os apps foram baixados mais de 28 milhões de vezes, receberam média de avaliação de 3,7, e a maioria (53%) tinha sido recém-atualizada. Essas tecnologias podem auxiliar o SUS nas políticas de comunicação e saúde digital

The evolution of Information and Communication Technologies has allowed, throughout history, the fields of communication, technology, and health to create different intersections. Among them are applications for mobile devices which are mobile digital health (mHealth) strategies. There is, however, little evidence of the use of these advances in public health. Based on the identification of 43 applications linked to Municipal Health Secretariats, State Health Secretariats and the Ministry of Health, this article aims to map and analyze these digital presence initiatives of the Unified Health System. The results show that cities stand out, leading the use of apps, especially in the southern region of the country. The apps had over 28 million downloads, received an average rating of 3.7, and most (53%) had been updated recently. These technolo-gies can help the Unified Health System in communication and digital health policies

La evolución de las tecnologías ha permitido, a lo largo de la historia, que los campos de la comunicación, la tecnología y la salud hayan creado diferentes intersecciones, como las aplicaciones para dispositivos móviles, que son estrategias de salud digital móvil (mHealth). Sin embargo, hay poca evidencia del uso de estos avances en la salud pública. A partir de la identificación de 43 aplicaciones vinculadas a las Secretarías Municipales de Salud, Secretarías Estatales de Salud y el Ministerio de Salud, este artículo tiene como objetivo mapear y analizar estas iniciativas de presencia digital del Sistema Único de Salud. Los resultados muestran que las ciudades se destacan, liderando el uso de apps. Las aplicaciones se han descargado más de 28 millones de veces, recibieron una calificación promedio de 3.7 y la mayoría (53%) se actualizaron recientemente. Estas tecnologías pueden ayudar al SUS en las políticas de comunicación y salud digital

Presenteeism and noise perception at work: a cross-sectional study using association analysis

ABSTRACT BACKGROUND: Presenteeism refers to the presence of a worker at work with reduced performance due to illness, and it is a common public health problem. Exposure to noise during production processes brings risk to workers' health. OBJECTIVE: To analyze the health profile of workers in the automotive industry and identify the association between noise perception and presenteeism among workers in the Brazilian automotive industry. DESIGN AND SETTING: This was a cross-sectional study utilizing a case study design analyzing the automotive industry in the interior of São Paulo state, Brazil. METHODS: This study included 306 workers using the Presenteeism Work Limitations Questionnaire protocol. Multiple logistic regression was used for data analysis. RESULTS: Male workers with reports of headache, tension, and limited well-being at work, having perceived that noise exposure interferes with productivity, showed a positive association with the occurrence of presenteeism. Physical demand had the highest score in terms of interfering with the presenteeism index. CONCLUSION: Workers' perceptions of noise were associated with presenteeism.

Presença comum: dispositivos para invenção na formação em Saúde / Common presence: invention devices in health education and training / Presencia común: dispositivos para invención en la formación en salud

Movidos pelo desejo de arriscar a invenção com o que se tinha à mão, realizamos um projeto de pesquisa e extensão universitária denominado Metodologias da Presença para estudantes em formação da área da Saúde. Tratou-se de uma plataforma remota de criação para encorajar os participantes a produzir e compartilhar exercícios artísticos por meio de três ativações de presença. Esta experiência contou com a participação de uma comunidade provisória. Impulsionados pela prática limiar pedagógica e artística, seguimos indagando como foi possível a instauração desse estado sensível e vitalizador no grupo? Que tipos de composição impulsionaram as transformações singulares e coletivas mediante a materialização das produções artísticas? Quais as distintas qualidades de presença que puderam ser ali mobilizadas? A produção artística, a presença comum e a construção de grupalidade podem existir em comunicações tecnomediadas na formação em Saúde?(AU)

Driven by the desire to take the risk of inventing with what is at hand, we conducted a research and university outreach project for health students called "Methodologies of Presence". We developed a remote content creation platform to encourage participants to produce and share artistic exercises from three presence activations. The experience included the participation of a temporary community. Propelled by threshold pedagogical and artistic practice, we inquired how was it possible to establish this sensitive and vitalizing state within the group. What types of composition drove the singular and collective transformations spurred by the materialization of artistic productions? Which different qualities of presence were mobilized? Can artistic production, common presence, and the construction of groupality exist within techno-mediated communications in health education and training?(AU)

Movidos por el deseo de arriesgar la invención con lo que estaba a mano, realizamos un proyecto de investigación y extensión universitaria denominado "Metodologías de la presencia" para estudiantes en formación del área de la salud. Se trató de una plataforma remota de creación para alentar a los participantes a producir y compartir ejercicios artísticos a partir de tres activaciones de presencia. Esta experiencia contó con la participación de una comunidad provisional. Impulsados por la práctica inicial pedagógica y artística, continuamos indagando: ¿Cómo fue posible la instauración de ese estado sensible y vitalizador en el grupo? ¿Qué tipos de composición impulsaron las transformaciones singulares y colectivas a partir de la materialización de las producciones artísticas? ¿Cuáles fueron las distintas cualidades de presencia que pudieron movilizarse? ¿La producción artística, la presencia común y la construcción de grupalidad pueden existir en comunicaciones tecnomediadas en la formación en salud?(AU)

Memória da presença e desenvolvimento emocional em Winnicott / Presence memory and emotional development in Winnicott

O presente artigo busca mostrar como a constituição do si mesmo winnicottiano está ancorada na experiência de sustentação oportunizada por um ambiente suficientemente bom. Ambiente que se inscreve na experiência do bebê como uma memória da presença, assim designada por nós. Essa memória da presença constitui-se nas marcas da presença materna que o bebê já é capaz de sentir e confiar, pelas repetidas experiências em que ele pôde se retirar do mundo "objetivo" tranquilamente, retornando ao seu mundo subjetivo, no descanso e relaxamento propiciados por um ambiente adaptado à sua necessidade de criação do mundo, vivendo a ilusão de onipotência na relação primitiva mãe-bebê. Discutimos ainda como o paciente constituído pela memória da presença poderá apresentar necessidades especificas na clínica, por meio da regressão à dependência.

This paper aims to show how the constitution of the Winnicottian self is grounded on the experience of support that is made possible by a good enough environment. This environment gets inscribed into the baby's experience as a memory of presence, as we call it. The memory of presence comprises marks of a mother's presence, which babies can already feel and trust, and which repeatedly allows them to make themselves calmly absent from the "objective" world, thus returning to their subjective world at state of rest and relaxation. This is rendered possible by an environment adapted to the baby's need for the creation of a world, while living under the illusion of omnipotence in the primitive mother-baby relationship. The paper also discusses how the patient constituted by the memory of presence may exhibit specific needs while in clinical sessions, by regressing to dependency.

Percepções dos moradores do bairro da Engomadeira sobre UNEB-BA / Perceptions of the Residents of the Engomadeira Neighborhood on the UNEB-BA / Las Percepciones de los Habitantes del barrio de Engomadeira sobre UNEB-BA

Este trabalho tem como objetivo analisar as percepções dos moradores do Bairro Engomadeira sobre a Universidade do Estado da Bahia (UNEB), Campus I, Salvador, para assim propor melhorias nas relações estabelecidas entre a Comunidade e a Universidade. Para a discussão, utilizaram-se autores como Fialho, Midlej e Santos. A pesquisa foi desenvolvida numa abordagem qualitativa, utilizando como instrumento de coleta de dados a entrevista semiestruturada e questionários fechados, aplicados em amostra não probabilística de 20 (vinte) moradores, dividindo-se em três grupos, por escolaridade: nível fundamental, nível médio e nível superior, para identificar e analisar as suas percepções. Recorreu-se à análise de conteúdo de Bardin (2002) e à luz de autores como Midlej e Santos, para tratamento dos dados coletados. Notou-se no referido estudo que as percepções dos moradores da Engomadeira sobre a Uneb diferem pelo nível de escolaridade, em que os moradores de nível fundamental e médio percebem a universidade com relações positivas e os de nível superior com relações negativas.

This work aims to analyze the perceptions of residents of Bairro Engomadeira about the State University of Bahia (UNEB), Campus I, Salvador, to propose improvements in the relations established between the Community and the University. For the discussion, authors such as Fialho (1998), Midlej (2004) and Santos (2014) were consulted. The research was developed in a qualitative approach, using semi-structured interviews and closed questionnaires as a data collection instrument, applied to a non-probabilistic sample of 20 (twenty) residents, dividing into three groups, by level of education: elementary level, medium level and higher level, to identify and analyze their perceptions. Content analysis by Bardin (2002) was used, and in the light of authors such as Midlej (2004) and Santos (2008), for the treatment of the collected data. It was noted in that study, that the perceptions of the residents of the Ironing Company about Uneb differ by the level of education, where the residents of elementary and high school perceive the university with positive relationships and those with higher education, with negative relationships.

Este trabajo tiene como objetivo analizar las percepciones de los habitantes del Barrio Engomadeira sobre la Universidad Estatal de Bahía (UNEB), Campus I, Salvador, con el fin de proponer mejoras en las relaciones establecidas entre la Comunidad y la Universidad. Para la discusión se utilizaron autores como Fialho (1998), Midlej (2004) y Santos (2014). La investigación se desarrolló con un enfoque cualitativo, utilizando entrevistas semi-estructuradas y cuestionarios cerrados como instrumento de recolección de datos, aplicados a una muestra no probabilística de 20 (veinte) residentes, divididos en tres grupos, por nivel de educación: nivel básico, nivel medio y nivel superior, para identificar y analizar sus percepciones. Se utilizó el análisis de contenido de Bardin (2002), ya la luz de autores como Midlej (2004) y Santos (2008), para el tratamiento de los datos recolectados. Se constató en dicho estudio, que las percepciones de los vecinos de la Empresa de Planchado sobre la Uneb difieren por el nivel de educación, donde los residentes de primaria y secundaria perciben la universidad con relaciones positivas y los de educación superior, con relaciones negativas.

The analyst's presence: place and function of the body of the psychoanalyst in different contexts of action / A presença do analista: lugar e função do corpo do psicanalista em diferentes contextos de atuação

RESUMO: Com base nas propostas de Freud e Lacan, visamos tratar do lugar e da função do corpo do analista como condições para a sustentação da clínica. Para isso, destacamos quatro diferentes contextos de atuação: o consultório; o trabalho nos dispositivos das redes de saúde e assistência psicossocial; o acompanhamento terapêutico e atendimentos online. Pensando a clínica psicanalítica em termos de tática, estratégia e política, encontramos que o ato analítico seria norteado pela ética da psicanálise e assegurado na sustentação da posição do analista enquanto presença - ponto de convergência que permite a inserção do psicanalista nos campos de atuação citados.

Abstract: Based on the propositions of Freud and Lacan, we aim to approach the place and function of the analyst's body as conditions for the sustenance of the clinic. For this, we highlight four different work contexts: the clinic; public healthcare networks and psychosocial care; therapeutic accompaniment and online treatment. Thinking the psychoanalytic clinic in terms of tactic, strategy and politics, we found that the analytical act to be guided by the ethics of psychoanalysis and ensured in sustenance of the position of the analyst as a presence - a point of convergence that allows the insertion of the psychoanalyst in the aforementioned work contexts.

Trauma e reconhecimento na clínica psicanalítica / Trauma and recognition in psychoanalytic clinic / Trauma et reconnaissance à la clinique psychanalytique / Trauma y reconocimiento en la clínica psicoanalítica

O presente artigo objetiva traçar considerações acerca do reconhecimento na clínica psicanalítica. Para tal, traçaremos um contraponto deste com o trauma. Nesse contexto, nos deparamos com o reconhecimento que, por sua vez, se apresenta não apenas como a forma de cuidado promovido por uma adaptação ambiental suficientemente boa, como também enquanto um posicionamento ético assumido na própria clínica. Por outro lado, o traumático surge como uma falha do ambiente em reconhecer as necessidades do indivíduo e mediar sua vulnerabilidade na relação com o meio.

This article aims to outline considerations about recognition in the psychoanalytic clinic by contrasting it with trauma. In this context, recognition presents itself not only as a form of care promoted by sufficient environmental adaptation, but also as an ethical position assumed in the clinic itself. On the other hand, trauma emerges when the environment fails to recognize the individual's needs and to mediate his vulnerability in his relationship with the environment.

Cet article vise à discuter la reconnaissance en clinique psychanalytique en contrepoint au traumatisme. Dans ce contexte, nous sommes confrontés à la reconnaissance qui, à son tour, se présente non seulement comme la forme de soins promue par une adaptation environnementale suffisamment bonne, mais aussi comme une position éthique assumée dans la clinique elle-même. D'autre part, le traumatique émerge comme un échec de l'environnement à reconnaître les besoins de l'individu et à médiatiser sa vulnérabilité dans sa relation à l'environnement..

Trazando un contrapunto entre el reconocimiento y el trauma, este artículo tiene como objetivo elaborar consideraciones sobre el reconocimiento en la clínica psicoanalítica. En este contexto, nos deparamos con el reconocimiento que, a su vez, no sólo se presenta como una forma de atención promovida por una adaptación ambiental suficientemente buena, sino también como una postura ética asumida en la propia clínica. Por otro lado, lo traumático surge cuando el ambiente falla al reconocer las necesidades del individuo y al mediar su vulnerabilidad en su relación con el medio.

Trauma e reconhecimento na clínica psicanalítica / Trauma and recognition in psychoanalytic clinic / Trauma et reconnaissance à la clinique psychanalytique / Trauma y reconocimiento en la clínica psicoanalítica

O presente artigo objetiva traçar considerações acerca do reconhecimento na clínica psicanalítica. Para tal, traçaremos um contraponto deste com o trauma. Nesse contexto, nos deparamos com o reconhecimento que, por sua vez, se apresenta não apenas como a forma de cuidado promovido por uma adaptação ambiental suficientemente boa, como também enquanto um posicionamento ético assumido na própria clínica. Por outro lado, o traumático surge como uma falha do ambiente em reconhecer as necessidades do indivíduo e mediar sua vulnerabilidade na relação com o meio.

This article aims to outline considerations about recognition in the psychoanalytic clinic by contrasting it with trauma. In this context, recognition presents itself not only as a form of care promoted by sufficient environmental adaptation, but also as an ethical position assumed in the clinic itself. On the other hand, trauma emerges when the environment fails to recognize the individual's needs and to mediate his vulnerability in his relationship with the environment.

Cet article vise à discuter la reconnaissance en clinique psychanalytique en contrepoint au traumatisme. Dans ce contexte, nous sommes confrontés à la reconnaissance qui, à son tour, se présente non seulement comme la forme de soins promue par une adaptation environnementale suffisamment bonne, mais aussi comme une position éthique assumée dans la clinique elle-même. D'autre part, le traumatique émerge comme un échec de l'environnement à reconnaître les besoins de l'individu et à médiatiser sa vulnérabilité dans sa relation à l'environnement..

Trazando un contrapunto entre el reconocimiento y el trauma, este artículo tiene como objetivo elaborar consideraciones sobre el reconocimiento en la clínica psicoanalítica. En este contexto, nos deparamos con el reconocimiento que, a su vez, no sólo se presenta como una forma de atención promovida por una adaptación ambiental suficientemente buena, sino también como una postura ética asumida en la propia clínica. Por otro lado, lo traumático surge cuando el ambiente falla al reconocer las necesidades del individuo y al mediar su vulnerabilidad en su relación con el medio.

Revisión rápida: monitoreo de la presencia e infectividad del virus SARS-CoV-2 y otros coronavirus en aguas residuales / Quick review: monitoring the presence and infectivity of SARS-CoV-2 and other coronaviruses in wastewater

Resumen: Objetivo: Describir la evidencia sobre la presencia e infectividad de SARS-CoV-2 y otros coronavirus en aguas residuales y su potencial uso como herramienta de vigilancia epidemiológica. Material y métodos: Búsqueda de publicaciones en PubMed y medRxiv desde enero 2003 hasta el 8 de junio de 2020 de acuerdo con la guía de revisiones rápidas de Cochrane. Resultados: Se incluyeron 29 publicaciones. El ARN de SARS-CoV-2 no infectivo se encontró en agua residual hospitalaria, agua residual cruda, tratada y lodos de plantas de tratamiento. Los niveles cuantitativos de ARN viral en agua residual presentan relación con el número de casos de Covid-19. SARS-CoV-1 y otros coronavirus permanecieron infectivos en agua residual cruda hasta por dos días. Conclusiones: Hasta esta revisión no existe evidencia sobre la presencia de virus infectivos de SARS-CoV-2 en agua residual cruda o tratada. La cuantificación de ARN de SARS-CoV-2 en agua residual es útil para la vigilancia epidemiológica.

Abstract: Objective: To describe the current evidence on the presence and infectivity of SARS-CoV-2 and other coronaviruses in wastewater; and its potential use as an epidemiological surveillance tool. Materials and methods: A search was performed in PubMed and medRxiv databases from January 2003 to June 8, 2020 according to the Cochrane Rapid Review Guide. Results: Twenty-nine publications were included. Non-infective RNA of SARS-CoV-2 has been detected in hospital sewage; raw and treated wastewater, and primary sludges from sewage treatment plants. Quantitative levels of viral RNA in wastewater are related with the number of Covid-19 cases. SARS-CoV-1 and other coronaviruses remained infective in wastewater up to two days. Conclusions: Currently, there is no evidence of the presence of infective SARS-CoV-2 in wastewater and its inactivation through treatment/disinfection has been proven. Quantification of SARS-CoV-2 RNA in wastewater can be a useful epidemiological surveillance tool.

Visita domiciliar pela Estratégia Saúde da Família: limites e possibilidades no contexto da violência urbana no Rio de Janeiro / Home visit by the Family Health Strategy: limits and possibilities in the context of urban violence in Rio de Janeiro / Visita domiciliar por la Estrategia Salud de la Familia: límites y posibilidades en el contexto de la violencia urbana en Río de Janeiro

A Estratégia Saúde da Família (ESF) se organiza sobre uma base territorial, considerando as características locais e possibilitando às equipes conhecer o perfil da clientela e as situações vivenciadas no seu cotidiano. Nos últimos anos, o município do Rio de Janeiro expandiu a ESF para territórios altamente vulneráveis e as equipes aproximaram-se de áreas onde a violência urbana está fortemente presente. O objetivo foi compreender se a Visita Domiciliar (VD) permanece como uma ferramenta possível para a ESF, em contextos de violência urbana. Foi realizado um estudo de natureza qualitativa, com aplicação de entrevistas com roteiro semiestruturado e análise de conteúdo. Os resultados apontam que a VD é, prioritariamente, destinada à busca de usuários com alguma limitação de acesso à unidade, restrição ao leito ou domicílio. Segundo o relato dos profissionais, situações frequentes como incursão policial, confronto armado entre a polícia e traficantes, a presença de caveirões e o som de tiros e bombas, são limitadores para a realização da VD. A qualidade da atenção prestada fica prejudicada e as atividades no território sofrem grandes prejuízos, trazendo medo e insegurança, inclusive aos profissionais. A ESF se consolida como um serviço próximo a territórios marcados pela violência urbana, enfrentando desafios diários para aplicação de suas ferramentas, em especial a VD.

The Family Health Strategy (ESF) is organized on a territorial basis, considering the local characteristics and enabling teams to know the profile of their clientele and situations experienced in their daily lives. In recent years, the municipality of Rio de Janeiro has expanded the ESF to highly vulnerable territories and has approached to areas where urban violence is strongly present. The objective was to understand if the Home Visit (VD) remains as a possible tool for ESF, in contexts of urban violence. A qualitative study was carried out, using interviews with semi structured script and content analysis. The results indicate that the VD is, primarily, aimed to search for users with some limitation of access, restriction to the bed or domicile. According to professionals reports, frequent situations such as police incursions, armed clashes between police and drug dealers, the presence of caveirões and the sound of shots and bombs, are limiting for the accomplishment of VD. The quality of care provided is impaired and activities in territory suffer great losses, bringing fear and insecurity, including to professionals. The ESF consolidates itself as a service close to territories marked by urban violence, facing daily challenges for application of its tools, especially the RV.

La Estrategia Salud de la Familia (ESF) está organizada sobre una base territorial, considerando las características locales y permitiendo a los equipos conocer el perfil de la clientela y las situaciones experimentadas en su vida diaria. En los últimos años, el municipio de Río de Janeiro ha expandido la ESF a territorios altamente vulnerables y los equipos se han acercado a áreas donde la violencia urbana está fuertemente presente. El objetivo era comprender si la Visita Domiciliaria (VD) sigue siendo una posible herramienta para la ESF en contextos de violencia urbana. Se realizó un estudio cualitativo, usando entrevistas con guiones semiestructurados y análisis de contenido. Los resultados indican que la VD está destinada principalmente a la búsqueda de usuarios con alguna limitación de acceso a la unidad, restricción de lecho o domicilio. Según el informe de los profesionales, las situaciones frecuentes como redadas policiales, enfrentamientos armados entre la policía y los traficantes, la presencia de caveirões y el sonido de disparos y bombas, son limitantes para la realización de la VD. La calidad de la atención se ve afectada y las actividades en el territorio sufren grandes daños, lo que genera temor e inseguridad, incluso para los profesionales. La ESF se consolida como un servicio cercano a los territorios marcados por la violencia urbana, enfrentando desafíos diarios para aplicar sus herramientas, especialmente la VD

Relationship between early factors life stress and college students’ risk-taking behaviors: gender difference and situational influence / 中华行为医学与脑科学杂志

Objective:To explore the differences in risk-taking behaviors of individuals with early life stress between different genders under the control of social situation.Methods:A total of 160 college students including 78 males and 82 females were selected by the child psychological abuse and neglect scale.Then the subjects were divided into the early life stress group ( n=80) and the non-early life stress group ( n=80) according to the scores of the above scales.According to the presence or absence of peers, the subjects in the two groups were randomly assigned to peer presence group ( n=80) or no peer presence group ( n=80). The study adopted an experimental design of 2 (early life stress, non-early life stress) ×2 (peer presence, no peer presence) ×2 (male, female) among the subjects.All subjects performed the task of simulating risky behavior, and the number of times they chose "forward" and did not crash in the task was used as the measurement index of risky behavior.Three-factor ANOVA and Bonferroni simple effect test were carried out using SPSS 22.0 software under various conditions. Results:There were significant differences in the main effects of early life stress ( F(1, 152)=162.06, P<0.01, η2=0.52). In the simulated risk behavior task, the risk behavior of the early life stressed individuals was higher than that of the non-early life stressed individuals (no peer presence: (59.11±11.48) vs (34.91±7.42), P<0.01); peer presence: (59.24±8.59) vs (55.08±10.32), P<0.01). The interaction between early life stress and the presence of peers was statistically significant ( F(1, 152)=65.35, P<0.01, η2=0.30), for non-early life stressed individuals, the risk-taking behaviors in the peer presence group was significantly higher than that in the no peer presence group ((55.08±10.32) vs (34.91±7.42), P<0.01, but the difference was not significant for early life stressed individuals ((59.24±8.59) vs (59.11±11.48), P>0.05). The interaction of early life stress, peer presence and gender was statistically significant ( F(1, 152) =5.92, P=0.016, η2=0.04). In the presence of companions, female early-life stressed individuals exhibited higher risk behaviors than non-early life stressed individuals ((53.91±5.12) vs (46.30±4.57), P<0.01), while the difference between male early life stressed individuals and non-early life stressed individuals was not statistically significant ((65.75±7.42) vs (62.27±7.78), P>0.05). Conclusion:The influence of early life stress on individual risk-taking behavior is related with presence and gender.

Construction and application of the model for learning based on immersive virtual reality / 中华医学教育探索杂志

Based on stimulus-organism-response (SOR) paradigm, this study proposes a conceptual framework of immersive virtual reality (IVR) learning model. To investigate the effect of IVR on learning process, this study has designed and implemented an educational application of appendectomy using IVR. The results indicate that IVR-based cognitive response, emotional response and learning results are significantly better than traditional learning. IVR learning model has a high level of immersion and user acceptance, and is expected to be employed to influence the learning satisfaction by the mediating effect of IVR presence in the future.

O analista está presente: performance e clínica / The analyst is present: performance and clinic

O que pode a clínica? O que pode a arte? Qual a potência presente nesses domínios? Em que ponto a arte e a clínica se transversalizam, ou seja, em que ponto comungam? Este artigo tem estas questões como direção e busca respondê-las a partir de uma aposta na abordagem transdisciplinar da clínica. Transdisciplinaridade compreendida como contágio entre diferentes disciplinas, como experimentação das interferências que um domínio pode produzir sobre outro. A performance "A artista está presente" de Marina Abramovic é tomada neste artigo como canal de expressão para a arte do encontro entre analista e paciente, encontro produtor de novas possibilidades de vida. O trabalho da artista sérvia, preocupada com o que se passa entre artista e público, nos permite problematizar o que se passa entre analista e paciente e, para tanto, desenvolvemos o conceito de Presença, certa partilha afetiva que pode se dar no encontro com o outro.(AU)

What can clinic do? What can art do? What is the power present in these areas? At what point art and clinic find a mainstream, that is, at what point do they commune? This essay has those questions as a direction and seeks to answer them based on a focus on a transdisciplinary approach to clinic. Transdisciplinarity understood as a contagion between different disciplines, as an experimentation on the interferences one domain can perform upon the other. The performance "The artist is present" of Marina Abramovic is taken in this article as an expression channel through the art of the analyst and patient encounter. A life-changing encounter. The work of this Serbian artist, worried about what goes on between the artist and the public allow us to problematize what goes on between the analyst and the patient, therefore developing the concept of the Presence, one affection share that can befall the encounter with the other.(AU)

Effect of Vitamin C Supplementation on Colonic Anastomotic Healing in the Presence of Peritonitis- An Experimental Study in Rats.

ascorbic acid plays a critical role in wound repair and healing/regeneration process as it stimulates collagen synthesis. Its effect on jejunal and colonic anastomosis is already established. We assessed its role on colonic anastomosis healing in presence of peritonitis and without peritonitis. Assessment was done by recording bursting pressure of anastomosis and histological features of healing.METHODSThis experimental study was conducted in 48 Albino Rats (mean weight of 180 g). All rats were subjected to exploratory laparotomy with colonic resection anastomosis and were divided into six groups. Group A and B control, Group C and D were supplemented with Vitamin C in low dose i.e. 100 mg/Kg body, Group E and F high dose of Vitamin C i.e. 200 mg/Kg body wt. Vitamin C was given for seven days intra muscularly. Peritonitis was created by cecal ligation and puncture (CLP) in half the number of rats (n=24), in each group. Every rat was re-explored on 7th post-operative day and anastomotic segments were harvested for bursting pressure measurement and then sent for histopathology examination.RESULTSBursting Pressure of group D (100 mg) was significantly raised (p<0.05) as compared to group B in the presence of peritonitis. Group F (200 gm vit C) showed significantly higher bursting pressure than group D (p<0.05). The findings of analysis of variance (ANOVA) showed that the mean BP of all the groups differs significantly from each other (p<0.05). High dose vitamin C supplementation gave more strength to anastomosis than low dose even in presence of peritonitis. The average histopathological examination score was 5.24 (Group E) (p<0.05). i.e., best healing among all groups. It had better effect even in presence of peritonitis - 4.62 in Group F. Healing score in this group was greater than group A, B, C, D and less than in group E.CONCLUSIONSPresence of fecal peritonitis hampers the process of healing of colonic anastomosis by impairing reparative collagen synthesis, its deposition and anastomotic strength reflected by decreasedbursting pressure and decrease HPE score. Supplementation of systemic ascorbic acid increases intestinal anastomotic healing by increasing collagen accumulation reflected by increasedbursting pressure and increase HPE score even in presence of peritonitis. High dose ascorbic acid supplementation had better effect on intestinal anastomotic healing. Importance of ascorbic acid in colonic anastomosis healing is yet to be evaluated in human beings.

Regressão à dependência e o brincar: novos sentidos da transferência em Winnicott / Regression to dependency and play: new meanings of transference in Winnicott

O texto reflete sobre o significado da transferência para Winnicott. Apoiado num caso, o texto busca articular esse conceito aos de regressão à dependência, brincar e presença viva do analista como suportes da análise.

The text reflects on the meaning of the transference to Winnicott. Supported in one case, the text seeks to articulate this concept with those of regression to dependency, play and the analyst's living presence as support for analysis.

Drosophila ananassae: a species characterized by spontaneous male recombination in appreciable frequency

Mutation and recombination are primarily responsible for generating the genetic variability in natural populations of microorganisms, plant and animal species including humans. Upon such genetic variations, elemental forces of evolution such as natural selection, random genetic drift and migration operate to bring about micro-evolutionary changes. Recombination or crossing-over produces new combinations of genes due to interchange of corresponding segments between nonsister chromatids of homologous chromosomes, thus, it is an important evolutionary factor. Since the time of T. H. Morgan, Drosophila has been subjected to extensive investigations on crossing over while employing a number of markers, which were used for gene mapping. Interestingly, recombination occurs in females of D. melanogaster but not in males. Later on, male crossing over was investigated in various species and its occurrence was reported in D. melanogaster, D. ananassae, D. simulans, D. willistoni, D. littoralis and D. bipectinata. Recombination occurs at very low rate in all these species except for D. ananassae, which shows spontaneous male crossing over in appreciable frequency, which is meiotic in origin. This unusual phenomenon in D. ananassae is influenced by various genetic factors as well as it shows strain variation as far as frequency of male recombination is concerned. Further, the presence of chiasmata during meiosis in males at a frequency capable of accounting for the observed recombination frequency extends evidence for meiotic origin of recombination in males of D. ananassae.

Propriedades psicométricas da escala de presença em tecnologias ubíquas / Psychometric properties of presence on ubiquitous technologies' scale / Propiedades psicométricas de la escala de presencia en tecnologías ubicuas

Este estudo teve como objetivo desenvolver uma escala de presença nas tecnologias ubíquas. O processo de desenvolvimento do instrumento teve como etapas 1) a escolha dos atributos comportamentais referentes ao objeto de estudo e à operacionalização do construto, 2) a apresentação a três juízes, dois grupos focais, 3) uma aplicação-piloto em uma amostra reduzida (n = 30) e, por fim, 4) uma aplicação com a 458 participantes. Foram realizadas análises de consistênciainterna, análise fatorial confirmatória e análise fatorial confirmatória multigrupo. A versão final da "Escala de Presença em Tecnologias Ubíquas (EPTU)" conta com 14 itens, agrupados em três fatores independentes (autopresença, presença espacial e presença social), e apresenta um bom índice de consistência interna (α = 0,905) e índices de ajuste aceitáveis (χ2 = 116,83; gl = 74; p < 0,01; CFI = 0,99; RMSEA= 0,035; SRMR = 0,053), com parâmetros psicométricos equivalentes por gênero

This study aimed to develop a scale of presence in ubiquitous technologies. The development process of the instrument had 4 stages: 1) the choice of behavioral attributes related to the object of study and the operation of the construct, 2) the presentation to three judges, two focus groups and a 3) pilot application in a reduced sample (n = 30) and 4) an application with 458 participants. In order to obtain validity and reliability evidences we performed internal consistency analyzes, confirmatory factor analysis and multigroup confirmatory factorial analysis. The final version of the Presence Scale in Ubiquitous Technologies has 14 items, grouped into three independent factors (Self-Presence, Spatial Presence and Social Presence), and has a good internal consistency index (alpha = 0.905) and an acceptable adjustment index (χ2 = 116.83, gl = 74, p <0.01, CFI = 0.99, RMSEA = 0.035, SRMR = 0.053), with equivalent psychometric parameters by gender

Este estudio tuvo como objetivo el desarrollo de una escala de presencia en las tecnologías ubicuas. El proceso de desarrollo del instrumento tuvo como etapas 1) la elección de los atributos comportamentales referentes al objeto de estudio y la operacionalización del constructo, 2) la presentación a tres jueces, dos grupos focales, 3) una aplicación piloto en una muestra reducida (n = 30), y por último, 4) una aplicación con 458 participantes. Se realizaron análisis de consistencia interna, análisis factorial confirmatorio y análisis factorial confirmatorio multigrupo. La versión final de la Escala de Presencia en Tecnologías Ubíquicas cuenta con 14 ítems, agrupados en tres factores independientes (Autopresencia, Presencia Espacial y Presencia Social), y presenta un buen índice de consistencia interna (alfa = 0,905) y un índice de ajuste aceptable (χ2 = 116,83; gl = 74; p < 0,01; CFI = 0,99; RMSEA = 0,035; SRMR = 0,053) con parámetros psicométricos equivalentes por género

Survey of the Circumstances of Cancer Patients Treated at Home and the Presence of Doctors and Nurses at the Time of Death

In recent years, the system for providing home medical care and palliative care has been improved, and the number of cancer patients who are treated at home until the end is increasing. The aim of this study was to investigate the circumstances of cancer patients who died at home and the presence of doctors and nurses at the moment of death. We conducted a prospective survey of end-oflife cancer patients receiving home visits from home care and palliative care clinics in Japan from 1st July to 31st December 2017. During the study period, we analyzed the mortality status of 676 patients who died in their homes, serviced by 45 clinics. Of these patients, 91% were living with families, 49% died on holidays or at night, and the doctor and nurse was present at the time of death in only 5.6% and 9.9% of cases, respectively. Most of the patients who died at home lived with their families, with few doctors and nurses present at the time of their patients’ death.

Hypervascular retained products of conception: dilemma of diagnosis and management

Retained products of conception (RPOC) are a partial retention of placental tissue after dilation and curettage (D&C) procedures or vaginal deliveries. Ultrasound scan reports sometimes mention the presence of increased endometrial / sub‐endometrial vascularity in the context of retained products of conception. This raises the possibility of serious intra‐operative haemorrhage because of the possibility of arterio‐venous malformation. The aim of this article is to discuss the diagnosis and management options of retained products of conception (RPOC) with increased vascularity where simple dilatation and curettage may lead to life threatening haemorrhage and endanger the life of the patient and to enlighten the importance of evaluation of vascularity in all cases of RPOC prior to dilatation and curettage in order to avoid the dreaded complication of massive haemorrhage.