bluuebunny/crossref_metadata_2025 huggingface dataset:
Estudo acerca da representação gráfica do fonema /s/ na escrita de alunos do 3º ano do ensino fundamental / Study About the Graphic Representation of the Phoneme /s/ in the Writing of Students of the 3rd Year of Elementary School
Authors: Ribeiro Marciano Renato , Martins Raquel Márcia Fontes
Published: September 2020

Resumo: Este artigo trata de um estudo sobre a aquisição da escrita infantil, em específico, sobre a multiplicidade de representação gráfica do fonema /s/ por alunos do 3o ano do Ensino Fundamental. Ressalta-se que a aquisição da escrita relacionada ao fonema /s/ é uma das mais complexas para o aprendiz da escrita no português, por envolver várias relações, inclusive de irregularidade, entre esse fonema e grafemas que o representam (LEMLE, 1994; MORAIS, 2008). Este estudo tem como fundamentação teórica Modelos Baseados no Uso (BYBEE, 2001; PIERREHUMBERT, 2001). Nesses modelos, que consideram a experiência de uso da língua na estruturação da gramática e do léxico (FERRARI, 2011), efeitos de frequência são importantes. Para proceder ao presente estudo, foi realizada uma coleta de dados escritos por alunos do 3o ano do Ensino Fundamental, de uma escola pública, do município de Bom Sucesso – MG. Os resultados deste trabalho indicam que o desenvolvimento da aquisição da escrita é baseado no uso, na experiência e que o fator frequência é relevante para o aprendizado da criança que se encontra no processo de aquisição ortográfica.Palavras-chave: aquisição da escrita; fonema /s/; ortografia, fonologia de uso.Abstract: This article reports a study on the acquisition of children’s writing, in particular, on the multiplicity of graphic representations of the phoneme /s/ by students of the 3rd year of Elementary School. It is noteworthy that the acquisition of writing related to the phoneme /s/ is highly complex for the learner of Portuguese writing, as it involves several relationships, including irregularity, between that phoneme and the graphemes that represent it (LEMLE, 1994; MORAIS, 2008). This study has Usage-based Models (BYBEE, 2001; PIERREHUMBERT, 2001) as theoretical basis. In these models, which consider the experience of using the language in structuring the grammar and lexicon (FERRARI, 2011), frequency effects are important. In order to proceed with the present study, a collection of data written by students of the 3rd year of Elementary School, from a public school in Bom Sucesso - MG, was carried out. The results of this work indicate that the development of writing acquisition is based on use and experience and that the frequency factor is relevant for the learning of the child in the process of orthographic acquisition.Keywords: acquisition of writing; phoneme /s/; orthography, phonology of use.
Estudo paleográfico de cartas manuscritas do final do século XIX no Amazonas / Paleographic Study of Handwritten Letters from the Late 19th Century in the Amazon
Authors: Siqueira Gislane Aparecida Martins
Published: September 2020

Resumo: Apoiado nos pressupostos teórico-metodológicos de Cambraia (2005), Costa (2006), Flexor (1990), Núñez Contreras (1994) e Riesco Terrero (1999), propõe-se um estudo paleográfico de três cartas manuscritas do ano de 1890, referentes a assuntos comerciais da empresa J. G. Araújo e Cia Ltda, as quais se encontram sob a guarda do Museu Amazônico na cidade de Manaus (AM), Brasil. No presente estudo paleográfico, trata-se de aspectos materiais, de elementos constitutivos da escrita, de características ortográficas, de desenvolvimento e tipologia de abreviaturas, de edições de cartas e, por fim, traça-se um paralelo entre especificidades gráficas das três cartas com outras três, também relativas ao final do século XIX, porém de outra região do Brasil.Palavras-chave: cartas manuscritas; crítica textual; estado do Amazonas; paleografia.Abstract: Supported by the theoretical-methodological assumptions of Cambraia (2005), Costa (2006), Flexor (1990), Núñez Contreras (1994) and Riesco Terrero (1999), we propose a paleographic study of three unpublished handwritten letters of 1890, referring to commercial affairs of the company J. G. Araújo e Cia Ltda, which are under the custody of the Amazonian Museum in the city of Manaus (AM), Brazil. The present study deals with material aspects, constitutive elements of writing, orthographic characteristics, development and typology of abbreviations, letter editions and, finally, a parallel is drawn between the graphic specificities of the three letters with three others letters, also related to the end of the nineteenth century, but from another region in Brazil.Keywords: handwritten letters; textual criticism; state of Amazonas; paleography.
La Possession dans la grammaire « pohétique » de Gellu Naum / Possession in Gellu Naum’s “pohetic” grammar
Authors: Galatanu Daniel Lucian
Published: September 2020

Résumé : Cet article est censé attirer l’attention sur le Surréalisme poétique roumain et sur son représentant le plus important, Gellu Naum qui, ayant assimilé les expériences pré-surréalistes, rimbaldiennes et apollinariennes, donne une réplique vigoureuse au grand Surréalisme français inauguré par Breton, et se lance, à travers les champs magnétiques de la langue roumaine, cette fois-ci, à la recherche d’un anti-langage, ou d’un sur-langage, qui puisse exprimer au mieux sa notion favorite de « pohème » surréel et plus vrai que la réalité. Pour y parvenir, il recourt à la perturbation voulue, ludique et onirique de la grammaire, aux confins de l’absurde infusé de l’humour amer du type ionescien, et avec une forte volonté programmatique de « crétiniser le langage ».Mots clés : Naum ; surréalisme ; crise du langage ; poésie ; littérature roumaine.Abstract: This article aims to draw attention to Romanian Poetic Surrealism and its most important author, Gellu Naum who, having assimilated the pre-surrealist Rimbaud’s and Apollinaire’s experiences, gives a vigorous replay to the great French surrealism inaugurated by Breton, and launches, through the magnetic fields of the Romanian language, this time, in search of an anti-language, or an over-language, which can best express its favorite notion of “poheme” surreal and more real than the reality itself. To achieve this, he resorts to the desired, playful and subconscious disturbance of grammar, on the edge of the absurd infused with the Eugène Ionesco type of bitter humor, and with a strong and programmatic will to “cretinize the language”.Keywords: Naum; surrealism; language crisis; poetry; Romanian literature.
Um olhar sobre a ficção animalista de João Guimarães Rosa: devires e metamorfoses / The Animal Fiction of João Guimarães Rosa at a Glance: Becomings and Metamorphoses
Authors: Neves Márcia Seabra
Published: September 2020

Resumo: Nas últimas décadas, a inscrição do animal na literatura tem assumindo novos contornos e complexidades, assistindo-se à emergência de uma zooliteratura fundada numa apreensão inédita da animalidade e no trespassamento das fronteiras entre o humano e o não humano. Cada vez mais, os escritores têm multiplicado as tentativas de encenar, por procuração ficcional, novas formas de interação com o animal, seja pela via do compartilhamento de sentidos e afetos, seja pela dos devires e metamorfoses. Neste contexto, a ficção animalista do escritor brasileiro João Guimarães Rosa, um dos maiores animalistas do século XX, constitui um paradigma modelar da figuração literária do animal, visto e escrito, não como simples constructo teórico-ficcional, mas antes como sujeito dotado de uma subjetividade própria e capaz de um olhar interrogante e judicativo sobre o Homem. É o que se tentará demonstrar, neste trabalho, através da leitura crítica de três dos seus contos: “O burrinho pedrês” e “Conversa de bois”, de Sagarana (1946), e “Meu tio o Iauaretê”, de Estas estórias (1969).Palavras-chave: animal; humano; interação; compartilhamento; devir; metamorfose.Abstract: Over the last decades, animal presence in literature has taken on new forms and disclosed new complexities, giving rise toa zooliterature founded upon a renewed insight into animality and the trespassing of the frontiers separating humans and non-humans. Writers have progressively multiplied attempts to enact, through fiction, new forms of interaction with the animal, either through sharing of meaning and affection, or through becoming and metamorphosis. In this context, the Brazilian writer João Guimarães Rosa’s animal fiction, one of the most remarkable 20th century animalist fiction writers, offers a perfect paradigm of the literary figuration of the animal, both seen and written, considered not as a mere theoretical and fictional artifact, but rather as a subject invested with its own ontology and capable of interrogating and judging human behavior. This is the argument we will seek to demonstrate in this article through the critical reading of three of Rosa’s short stories: “O burrinho pedrês” and “Conversa de bois”, included in Sagarana (1946), and “Meu tio o Iauaretê”, from Estas estórias (1969).Keywords: animal; human; interaction; sharing; becomings; metamorphosis.
Evre 2 kolon tümörlerinde klinikopatolojik faktörlerin sağkalımla ilişkisi
Authors: KILIÇ Salih , AYDIN Dinçer
Published: September 2020

Giriş ve Amaç: Kolorektal kanserler tüm dünyada ve ülkemizde sindirim sistemi kanserlerinin başında gelmektedir. Kolorektal kanserlerin prognozunu etkileyen ve tedavide değişikliğe yol açan birçok prognostik faktör bulunmaktadır. Bu prognostik faktörler hem genel sağkalımı hem de hastalıksız sağkalımı etkilediği gibi bazıları tedavinin takibinde de kullanılabilmektedir. Çalışmamızda kolorektal kanserin prognozunu etkileyen klinikopatolojik faktörlerin genel ve hastalıksız sağ kalım üzerine olan etkilerinin gösterilmesi planlanmıştır. Gereç ve Yöntem: Ocak 2000-Aralık 2014 arasında Kartal Dr. Lütfi Kırdar Eğitim ve Araştırma Hastanesi Tıbbi Onkoloji Polikliniğine başvuran ardışık 277 evre 2 kolorektal kanserli hasta çalışmaya alınmıştır. Hastalar histopatolojik verilerine göre değerlendirilmiş ve poliklinik ve patolojik kayıtları incelenerek hastalıksız sağ kalım ve genel sağ kalım süreleri belirlenmiştir. Bulgular: Çalışmaya 159 (%57.4) erkek 118 (%42.6) kadın olmak üzere toplam 277 kişi dahil edildi. Hastaların medyan yaşı 60 (aralık 28-89) idi. 277 hastanın medyan sağkalım süresi 21 (aralık 1-184) aydı. Sonuç: Perinöral invazyon ve tanı anındaki T evresinin genel sağkalım üzerine istatistiksel etkisi olduğu izlenirken; lenfovasküler invazyon, perinörel invazyon, T evresi, tümör yerleşimi ve obstrüksiyon varlığının hastalıksız sağkalım üzerine istatistiksel etkisi olduğu görüldü.
Muş bölgesindeki üst gastrointestinal sistem malignitelerinin özellikleri
Authors: PEKSÖZ Rıfat , BORAZAN Serkan
Published: September 2020

Giriş ve Amaç: Özofagus ve mide kanserleri tüm dünyada görülen önemli mortalite ve morbidite nedenlerindendir. Özofagogastroduodenoskopi tanı için altın standart yöntemdir. Çalışmamızda ülkemizin doğusunda yer alan Muş Bölgesi’nde tespit edilen üst gastrointestinal sistem malignitelerinin demografik özellikleri, başvuru şikayetleri, tümörün lokalizasyonu ve histopatolojik özellikleri gibi bulguların literatür bilgileri eşliğinde tartışılması amaçlanmıştır. Gereç ve Yöntem: Muş Devlet Hastanesi Endoskopi Ünitesi’nde Ocak 2016 – Ocak 2020 tarihleri arasında üst gastrointestinal sistem endoskopisi yapılan 8131 ve patoloji sonucu malignite olarak raporlanan 72 hasta hasta retrospektif olarak incelendi. Bulgular: Endoskopi ünitemizde özofagogastroduodenoskopi yapılan 8131 hastanın %53'ünden biyopsi alındı. Yetmiş iki (%0.88) hastanın histopatoloji sonucu malign olarak tespit edildi. Malignitelerin 25’i özofagusta (%34.7), 47’si midede (%65.3) saptandı. Hastaların 38’i erkek (%52.7), 34’ü kadın (%47,3) olup hastaların yaş ortalaması 64.5±12.4 yıldır. Histopatolojik analizlerde özofagus kanseri tanılı hastaların %80’i skuamöz hücreli karsinom, %20’si adenokarsinom idi. Mide tümörlerinin ise %85.1’i adenokarsinom, %10.6'sı intramukozal invaziv karsinom ve %4.3'ü nöroendokrin karsinom idi. Sonuç: Muş Bölgesinde üst gastrointestinal sistem kanserleri görülme sıklığı Doğu Anadolu Bölgesi’ndeki bazı bölgelerle benzer, bazı bölgelerle farklı özellikler göstermektedir. Bu çalışmanın bölge kanser epidomiyolojik çalışmalarına katkı sağlayacağını düşünmekteyiz.
Cervical cytology profile by Papanicolaou smear in a rural setting in mid-Kerala
Authors: Jayaprakash Megha , Menon Sreenija , Eralil Georgy Joy , K. P. Alok , Jose Rajany
Published: September 2020

Background: With no systematic national screening programme, the rates of cervical epithelial cell abnormalities as reported by various studies range from 1.32% to 25% in India. Majority are epithelial squamous cell abnormalities that include atypical squamous cells of undetermined significance (ASCUS) and low-grade squamous intraepithelial lesion (LSIL). Worldwide incidence of adenocarcinoma and its precursors have increased over past few decades. Objectives were to study the clinical and cervical cytological profile among women attending camps in rural areas of Thrissur district of Kerala.Methods: A cross sectional study was conducted in 214 women in the 25-65 years age group who attended cancer screening camps in rural areas of Thrissur district. Papanicolaou (Pap) smear was done using standard technique and reported using latest Bethesda classification. Pap smear results were considered as abnormal when the report was ASCUS, atypical glandular cells of undetermined significance, LSIL, high grade squamous intraepithelial lesion or invasive lesion.Results: Of all the smears, 41.6% were negative for intraepithelial lesion or malignancy. Inflammatory smears (nonspecific and specific infection associated) were seen in 57%. Glandular cell abnormality was found in 1.4% and these women were in 31-50 years age group. Among patients with glandular cell abnormality most common symptom was discharge per vaginum.Conclusions: The results of this study may be a pointer to an increase in glandular cytological abnormalities in our population and needs further large-scale studies to confirm. Current screening methods of Pap smear alone may not be adequate to pick up these lesions.
The beneficial role of N-acetylcysteine as an adjunctive drug in treatment of COVID-19 patients in a tertiary care hospital in India: an observational study
Authors: Bhattacharya Raja , Mondal Maitry , Naiya Subhendu Bikash , Lyngdoh Lamsaka , Mukherjee Rishav , Singh Prabhat K.
Published: September 2020

Background: N-acetyl cysteine, a mucolytic agent, demonstrates free radical scavenging and anti-inflammatory properties, and prevents endothelial dysfunction by inhibition of NF-KB and formation of no adducts. This has a potential role to tackle cytokine storms, endothelial dysfunction and prothrombotic state observed in COVID-19 manifestations like ARDS and Multi organ dysfunction.Methods: Institution based descriptive cross sectional study, 164 patients from laboratory confirmed RT PCR positive COVID-19 patients, in the study period from 27th May 2020 to 10th August 2020, were assessed, in medical college Kolkata, a dedicated COVID-19 care facility.Results: It was observed that moderate-severe patients who received N-acetyl cysteine along with standard therapy had average hospital stay duration of 12 days, higher rate of discharge, average duration of oxygen therapy of 8 days, less number of deaths and reduced transfer to critical care facilities.Conclusions: N-acetyl cysteine can be considered as an adjunctive therapy with standard protocol driven care, due to its beneficial anti-inflammatory and free radical scavenging properties.
Comparison of platelet count by manual and automated method
Authors: Jain Dileep Kumar
Published: September 2020

Background: Since the emergence of dengue fever in the past few years, platelet count has become a routine test in every pathology lab. Common methods are by peripheral blood smears made from blood collected in ethylenediaminetetraacetic acid (EDTA) tubes, by neubaeur chamber, automated method by hematology cell counter.Methods: Blood samples of 460 adult patients and 72 children (<15 years), including indoor and outdoor, between May to August 2019, attending Hind institute of medical sciences, were collected in EDTA tubes. Samples were properly mixed on blood shaker and immediately peripheral blood smears were made and stained with Leishman stain. Platelet count of every sample was done by peripheral blood smear and by Mindray (BC5150) automated cell counter, simultaneously.Results:  Results by manual slide method are slightly higher than automated method but significantly not different from automated method.Conclusions: Traditional slide method can also be used if done carefully comparable to automated method especially useful in small labs which can’t afford automated cell counter.
Clinical profile of patients with moderate to severe obstructive sleep apnea syndrome in a centre from South Kerala
Authors: Krishna S Veni , Ninan Mathew , J Balachandran , Sukumaran P , Thomas Beena
Published: September 2020

Obstructive sleep apnea syndrome (OSAS), a common but under-recognized sleep-related breathing disorder (SRBD) which is associated with significant morbidity and increased mortality. The aim of this study done in South Kerala was to assess the clinical profile and comorbidities of patients with moderate to severe form of OSAS

Patients included in the study were from a speciality sleep clinic and had symptoms of OSAS or risk factors for significant sleep apnea. They underwent a supervised polysomnography (PSG) with a portable equipment at home after history taking, relevant clinical evaluation, and pre-requisite workup.

One hundred and forty patients were included in the study and 87.9% (123) of the patients were detected to have moderate or severe OSAS (Apnea Hypopnea Index AHI>15 episodes/hour), 81 % (100) of these patients with significant ( moderate or severe) sleep apnea were males having a mean age of 47.9 years, mean body mass index of 33.6 kg/mand an average neck circumference of 41.2 cm. 80% of patients with moderate to severe OSAS were between the ages of 31-60 years.61.7% and 41% of patients with significant OSAS had hypertension and diabetes respectively. Body mass index and neck circumference had a direct correlation with the severity of OSAS.

The data was analysed using SPSS 20.0. The factors and co-morbidities associated with OSAS were analysed using Chi-square tests and Independent Sample t-tests. Pearson's correlation coefficient and a linear regression model was made to find out the possible predictors for AHI Scores and a p value of less than 0.05 was taken as significant.

Our study on the clinical profile of patients with obstructive sleep apnea syndrome from a centre in South Kerala shows male predilection, frequent association with obesity and cardiovascular co-morbidities such as hypertension and diabetes.
Mental Health and Access to Active Labor Market Programs
Authors: Bråthen Magne , Van der Wel Kjetil A. , Løyland Borghild
Published: September 2020

This paper examines the often-overlooked precondition for successful implementation of active labor market policy, namely equal access to labor market programs. Focusing on a cohort of social assistance recipients, we compare program participation between individuals who were eligible for vocational training and had reported psychological distress, to possible participants with other health or social challenges. The study covers a period of six years. The results indicate that social services prioritize training for those without mental health problems. This is true independently of observed differences between the two groups in terms of demographic and human capital characteristics, work motivation and self-efficacy. Hence, the study concludes that there seems to be a mental health access bias in program participation among disadvantaged groups. Policy makers and future research should address possible organizational barriers to equal program access
Significados de la profesión médica desde la ideología de las y los profesionales de la medicina
Authors: Rodríguez Torres Alejandra , Jarillo Soto Edgar C. , Casas Patino Donovan
Published: September 2020

Se aborda la ideología de las y los profesionales de la medicina, desde la teoría de Thompson, para entender los significados de la profesión médica, a partir de las categorías: autonomía, normas y valores, y reconocimiento social. Se realizaron 24 entrevistas semiestructuradas a profesionales de la medicina en cuatro ámbitos de trabajo: institucional público, institucional privado, ejercicio privado y ejercicio mixto, en Amecameca, municipio del Estado de México, en el período comprendido de marzo a octubre de 2019. El análisis de los significados expresados por las y los profesionales de la medicina en cada una de las categorías de interés muestra una base condicionada por la estructura del control estatal y por la economía mercantilizada, que valora con mayor significación formas de práctica médica privada. En la conformación ideológica de la profesión médica subsiste un componente práctico inmerso en un romanticismo liberal en un escenario casi extinto que subsiste en la actualidad, sin articularlo a los procesos sociales más generales.
Panorama da nutrigenômica no Brasil sob a perspectiva da Bioética
Authors: Fischer Marta Luciane , Cini Ricardo de Amorin , Zanata Amanda Amorin , Nohama Norton , Hashimoto Mauro Seigi , Da Rocha Valquiria Batista , Rosaneli Caroline Filla
Published: September 2020

A nutrigenômica tem configurado, no meio científico e popular, como alternativa para prevenir doenças, cuja predisposição determinada geneticamente pode ser evitada ou estimulada, de- pendendo do ambiente no qual o indivíduo se insere. Este estudo questionou o potencial da nutrigenômica em mitigar ou gerar vulnerabilidades. Objetivou-se traçar o panorama da nutrigenômica no Brasil sob a perspectiva da Bioética. O estudo consistiu em um mapeamento quantitativo do panora- ma da nutrigenômica no cenário científico e popular do Brasil, e em uma análise bibliográfica exploratória com o intuito de identificar os agentes e pacientes morais, bem como as vulnerabilidades com vistas a promover uma reflexão à luz da Bioética. O cenário da nutrigenômica no Brasil, elaborado a partir de 18 textos científicos e de 600 conteúdos populares, indicou a prematuridade da área no contexto científico em confronto com uma ampla incorporação pelo meio popular. A incorporação da Bioética na questão foi analisada em 44 artigos científicos, a partir dos quais foram identificados como aspectos condicionantes de decisões do agente moral os contextos filosófico, biológico, cultural, legal e sanitário nos quais se insere. Foram elencadas as vulnerabilidades e mudanças de paradigmas necessárias para sua implementação no Brasil, a fim de diminuir o potencial de geração de vulnerabilidades. A Bioética pode e deve ter uma atuação mais ampla e efetiva nas questões da nutrigenômica ao normatizar, balizar e orientar o desenvolvimento dessa área promissora. Assim, deve visar às mudanças de paradigmas da ciência, dos profissionais, do mercado, do paciente e do consumidor para serem suprimidos os aspectos potenciais de geração das vulnerabilidades identificadas e contribuir para a qualidade de vida de todos os seres vivos desta e de futuras gerações.
Bioética e sociedade
Authors: Franco Janaína Oliveira Barbosa , Batistão Rosa Silva , Santos Denise Cristina , Ferreira Wellington Fernando Silva , Vasconcelos Cláudia Ribeiro
Published: September 2020

Objetiva-se compreender a síndrome de Münchhausen a partir da descrição das suas causas, dos critérios de identificação, dos sinais clínicos, do diagnóstico e do tratamento, bem como das assistências realizadas pela Enfermagem e pela equipe interdisciplinar com interface da Bioética. Trata-se de uma revisão narrativa de literatura de caráter exploratório reflexivo, com abordagem qualitativa. Realizaram-se buscas de estudos em periódicos publicados entre 2009 e 2019; a amostra final constituiu-se por 30 artigos, além de livros, manuais e normativas. Os resultados apresentados evidenciam o conhecimento da quinta edição do Manual Diagnóstico e Estatístico de Transtornos Mentais, no qual a expressão “síndrome de Münchhausen imposto a si próprio” foi substituída por “transtorno factício autoimposto”, e a “síndrome de Münchhausen por procuração” foi alterada para “transtorno factício imposto a outro”, quanto à bioética. Indivíduos com o distúrbio factício tendem a buscar tratamento para si mesmo ou para outro. O comportamento desses pacientes aumenta a probabilidade de terem realmente uma doença física e até mesmo ir a óbito, causado pelo excesso de uso de medicações e pelos diversos procedimentos invasivos. Portanto, conclui-se que identificar o quadro clínico pode ser uma das primeiras iniciativas para a detecção e a prevenção. O tratamento deve se concentrar no manejo, com a possibilidade do uso da psicoterapia e de antidepressivos, antipsicóticos e ansiolíticos. A equipe de enfermagem e a multiprofissional devem estar atentas a sinais e sintomas para uma intervenção precisa e precoce, pois desempenham importante papel na identificação adequada do diagnóstico.
Experiencia del cuidador familiar ante la muerte del niño con cáncer
Authors: Carreño-Moreno Sonia , Chaparro-Díaz Lorena , López-Rangel Roc´io , Cardenas-Fandiño Marcela , Carrillo-González Mabel , Gómez-Ramírez Olga
Published: September 2020

En este estudio se trazó como objetivo la descripción de la experiencia del cuidador familiar ante la muerte del niño con cáncer. Para ello, se utilizó como método un estudio cualitativo con enfoque fenomenológico descriptivo bajo la perspectiva de Colaizzi, en el que se incluyeron 18 participantes que cumplieron con los criterios de inclusión de ser padre o madre de un niño con cáncer que haya fallecido en un periodo de 5 meses a 5 años. Se realizaron entrevistas a profundidad hasta lograr saturación teórica. Como resultados, se obtuvieron seis temas que describen la experiencia del cuidador: idealización del niño fallecido, batalla perpetua, vínculo inquebrantable, pérdida de sentido, levantarse y seguir, y lucha espiritual; estos representan la percepción y vivencia de los cuidadores en el duelo. Como conclusiones se consideró que las expresiones de dolor, incertidumbre y vacío son sentimientos y sensaciones descritas por los cuidadores, que hacen parte del proceso de duelo, pero también describen su paso hacia la aceptación y trascendencia, en la que dan importancia al ser espiritual del niño como una forma de creer que sigue junto a ellos.
Problemas bioéticos na prática interequipes em uma unidade de Atenção Primária à Saúde no Brasil
Authors: Marin Juliana , Ribeiro Carlos Dimas Martins
Published: September 2020

O objetivo deste trabalho é analisar a origem e os problemas bioéticos que emergem no processo de trabalho entre equipes em uma unidade de Atenção Primária à Saúde no Brasil. Esta investigação qualitativa conta com três etapas de operacionalização: etnografia, entrevista e grupo focal. O principal problema bioético encontrado, que compromete a produção do cuidado nesse nível de atenção, é a falta de solidariedade entre os profissionais das equipes e destes com os pacientes que não pertencem ao setor do território sob a sua responsabilidade. As razões desse problema bioético estão associadas à cobrança da gestão municipal para o incremento da produção e o alcance de metas, à falta de valorização dos trabalhadores das equipes e dos esforços empreendidos por eles no trabalho por parte da gestão e à estima assimétrica. Nesse sentido, a Bioética, no contexto da saúde pública, volta-se para a compreensão e discussão dos problemas vivenciados a fim de estabelecer um quadro de consciência moral e agir ético. Em determinados momentos, para a efetividade de uma equipe, é necessário o aporte solidário das outras, concretizado pelo reconhecimento de pertença a essa produção.
Adherencia terapéutica, interacción equipo médico-paciente y justicia social en población indígena Mixteca de Guerrero, México
Authors: Chávez Victorino Omar , Morales Chávez Germán , Marcos Solano Rogelio , Carpio Ramírez Claudio
Published: September 2020

En México habitan diversos grupos sociales, entre ellos se encuentra el pueblo indígena de los mixtecos, que en su mayoría se caracteriza por vivir en condiciones de extrema pobreza, situación que posibilita estados desfavorables de salud por las características sociales y físicas particulares. Además, estos grupos indígenas utilizan sistemas médicos propios, distintos al sistema biomédico. Cuando el Gobierno amplía su cobertura a estas comunidades se presentan dificultades debido a la incompatibilidad de sistemas médicos. Se ha observado que el uso de habilidades interculturales, tales como los componentes verbales valorativos y transcriptivos, favorece un ajuste entre los pacientes y los sistemas biomédicos de salud. Con el objetivo de revisar si los profesionales que prestan sus servicios a comunidades indígenas presentan habilidades interculturales, se llevó a cabo un estudio descriptivo, no experimental, y transversal para identificar el uso de componentes verbales interculturales por parte del equipo médico de la Unidad Médica Rural, ubicada en la comunidad de Dos Ríos, municipio de Cochoapa el Grande, Guerrero. Se observó la interacción equipo médico-paciente durante 6 meses, con un total de 103 consultas registradas. Asimismo, se contempló que los profesionales tienen un escaso uso de los componentes verbales interculturales y que no han incorporado estrategias que permitan el ajuste médico de los pacientes mixtecos al sistema biomédico. Los datos se analizan con relación a los aspectos bioéticos y de justicia social implicados en el comportamiento de las instituciones oficiales de salud.
AÇÕES DA COMISSÃO DE CONTROLE DE INFECÇÃO HOSPITALAR FRENTE AO NOVO CORONAVÍRUS
Authors: Oliveira Elizandra cassia Da silva , Da Silva Felicialle Perreira , Pereira Emanuella Batista ferreira e , De Oliveira Regina Celia
Published: September 2020

Objetivo: relatar a experiência vivenciada por enfermeiros executores da comissão de controle de infecção hospitalar, em um hospital público, no combate ao novo coronavírus. Método: trata-se de um relato de experiência sobre as medidas de prevenção e controle ao novo coronavírus à luz das recomendações da Agência Nacional de Vigilância Sanitária, realizado no período de março a maio de 2020. Resultados: evidenciam-se mudanças de práticas, normas e rotinas por toda a equipe de saúde que visam a qualidade e segurança da assistência à saúde ao paciente, bem como a proteção aos trabalhadores dos serviços de saúde. Conclusão: o cenário atual exigiu da comissão de controle de infecção hospitalar desenvolver competências e ações para o enfrentamento do novo coronavírus e a implementação de um plano de contingência no ambiente hospitalar. A coparticipação da equipe interdisciplinar foi fundamental para efetivação do novo processo de trabalho frente à pandemia.

Descritores: Coronavírus. Infecção Hospitalar. Saúde do Trabalhador. Segurança do Paciente.
Interrogating the Administrative and Institutional framework of Social Security provisioning in Botswana Prospects and Challenges
Authors: Mogomotsi Ntseane Dolly , Solo Kholisani
Published: September 2020

This paper seeks to explore the administrative and institutional framework of social security provisioning in Botswana.  It commences by locating social security within the socio political context.  It then considers its cultural dimension.  It then proceeds to consider the provision of indirect social services, health care, settlement and housing and then water and sanitation.  Finally, it discusses the institutional framework upon which the above are based and prospects and challenges
Projeto Automático de Controladores com Duas Malhas no Espaço de Estados Aplicado a Conversores de Potência
Authors: Mattos Everson , Borin Lucas C. , Osório Caio R. D. , Koch Gustavo G. , Hollweg Guilherme V. , Jank Henrique , Venturini William A. , Martins Mário L. S. , Bisogno Fábio E. , Montagner Vinícius F.
Published: September 2020

Este trabalho propõe um procedimento sistemático de projeto no espaço de estados para os ganhos de uma malha interna e de uma malha externa de controle aplicável a conversores estáticos de potência. Uma vantagem da abordagem é a sintonia automática dos controladores, de modo offline, capaz de reduzir a dependência da experiência do projetista e o tempo despendido em estágios de projeto por tentativa e erro, em especial para sistemas com grande número de variáveis de estado. Outra característica favorável é que os ganhos de controle das duas malhas são encontrados simultaneamente por meio de um algoritmo de otimização que minimiza um critério quadrático baseado no erro e no sinal de controle. A estabilidade e o desempenho do sistema em malha fechada são testados para intervalos de valores dos parâmetros da planta, certificando a robustez contra incertezas paramétricas. Os ganhos projetados são aplicados em um conversor buck e no estágio de saída de uma fonte ininterrupta de energia, utilizando um processador digital de sinais para implementar a lei de controle e hardware-in-the-Loop para a emulação do estágio de potência em tempo real. Os resultados indicam a viabilidade do procedimento proposto.
Critical Analysis of Pensions Taking into Account Selected Aspects of Financial Literacy
Authors: Zureck Alexander , Daus Viktoria , Krahnhof Philippe
Published: September 2020

In this study we investigate the impact of government debt on the economic growth of General financial education, so-called financial literacy, which plays an essential role in private retirement provisions. A study by the Organization for Economic Co-operation and Development (OECD) in 2015 shows that financial literacy is not prevalent in Germany (OECD, 2015). The aim of this scientific paper is to underline the importance of financial literacy for private retirement provisions. Due to the falling level of pensions in Germany, investments in a private pension are essential. Therefore, a regression analysis is carried out. An academic goal is to analyze if gender, net income and academic degree have a positive impact on financial literacy. In summary, it can be said that there is a significant influence of gender. With regard to the significant imbalance in the gender distribution (three quarters are male), the data should be expanded in the future. While net income as well as academic degree both have positive effect, correlation was only shown for net income. An ideal level of private retirement provisions was not determined in the empirical study. Based on these empirical insights, it is recommended that the federal states should invest in the financial education of their citizens to counteract poverty in age.
Dimensiones cognitivo-motivacionales y aprendizaje autorregulado
Authors: Valle Arias Antonio , González Cabanach Ramón , Barca Lozano Alfonso , Núñez Pérez José Carlos
Published: September 2020

El artículo analiza el aprendizaje escolar donde una perspectiva cognitivo- motivacional, en la que se destacan una serie de ideas relevantes de profundizar en la comprensión de los factores cognitivo-motivacionales que inciden en el aprendizaje escolar.
Características familiares de los hogares pobres que contribuyen al bajo rendimiento o al fracaso escolar de los niños
Authors: Jadue Gladys
Published: September 2020

El artículo trata sobre las características más evidentes en hogares de nivel socioeconómico bajo, que afectan tanto el desarrollo cognitivo y psicosocial de los niños, como su desempeño escolar. Se sugiere que para mejorar las oportunidades de lograr un mejor desempeño escolar, las madres deberán ser entrenadas en estrategias y prácticas que apoyen el proceso de enseñanza/aprendizaje de sus niños.
The perspectives of application of statins under pulmonary hypertension
Authors: Baksheev Vladimir I. , Kolomoetz N. M , Shklovskiy B. L , Oynotkinova O. Sh
Published: September 2020

The present publications' review considers perspectives of application of statins under pulmonary hypertension. Nowadays, there are quite encouraging experimental data concerning positive versatile effect of statins on lesser blood circulation. The results of study of this issue with participation of patients are singular and continue to be controversial still. The clinical substantiation of application of new pharmaceuticals effecting molecular mechanisms of pathogenesis of pulmonary hypertension (re-modeling, endothelial dysfunction, function of right ventricle) requires carrying out of large investigations placebo-controlled by design and statistical processing. Precisely in this context the application of statins is of interest as potentially strategic direction in treatment of pulmonary hypertension.
The clinical diagnostic aspects of acute pancreatic encephalopathy
Authors: Strutsenko A. A , Damulin I. V , Mazurtchik N. V , Ogurtsov P. P
Published: September 2020

The pancreatic encephalopathy is characterized by various focal neurological symptomatic and sporadic fast development of dementia is considered as a rare complication of acute pancreatitis developing in 9-35% of patients with diseases of pancreas. Factually every patient with acute pancreatitis has a risk of development of pancreatic encephalopathy that significantly makes severer course of disease and increases lethality. The review article considers particular aspects of clinical manifestations and probable diagnostic algorithm of neurological disorders observed in patients with acute pancreatitis. The actuality of development of diagnostic algorithm of pancreatic encephalopathy is emphasized. This algorithm will permit ultimately early, probably at pre-clinical stage, discover the mentioned complication of acute pancreatitis with the purpose of not only ultimate early detection of pancreatic encephalopathy but also development of pathogenically conditioned therapeutic algorithm considering all chains of pathogenesis.
The differential diagnostic of anemias associated with iron metabolism
Authors: Andreichev Nail’ A. , Andreicheva E. N
Published: September 2020

The iron-deficiency conditions continue to be an actual problem all over the world being present in half of population of the terrestrial globe. The development of iron deficiency often depends on gender and age. In females specific role is played by hypermenorrhea and repeated pregnancies (iron deficiency and iron-deficiency anemia are found 6 times more often in females than in males). The anemia of chronic diseases by it prevalence takes second place after iron-deficiency anemia. The prevalence of anemia of chronic diseases in elder and senile age varies within range 2,9-61% in males and 3,3-41% in females. In young and mature age anemia of chronic diseases more often occurs in females. There are anemias when content of iron in organism and its resources are within limits of norm or higher - sideroahrestical anemias. The percentage of them in structure of hypochromic anemias is smallish. The diagnostic and differential diagnostic of anemias related to iron metabolism. The anemias are diverse according to clinical hematological characteristics. At selection of diagnostic schemes, treatment of anemias differs on leading pathogenic mechanism. However, to facilitate diagnostic and differential diagnostic the color indicator and morphological classifications are considered. The differentiated diagnostic of anemias is based on data of clinical, laboratory and instrumental analysis. The blood analysis under anemia is to take into account indices of Hb, size of erythrocytes, their saturation with Hb, average volume of erythrocytes, and average content of hemoglobin in erythrocytes, amount of reticulocytes and other cells permitting judging about character and activity of erythropoiesis. The article presents algorithm of examination of patient under hypochromic and microcytic anemia, diagnostic and differentiated diagnostic of acute post-hemorrhagic anemia, anemia of chronic course, iron-deficiency anemia, anemia of chronic diseases, sideroahrestical anemia, iron-saturated anemia due to leaden intoxication, inherent iron-saturated anemia of pharmaceutical genesis, thyroprival anemia and thalassemia.
The hyperprolactinemia
Authors: Sebko Tat’yana V. , Kheydar L. A , Koneeva S. S
Published: September 2020

The hyperprolactinemia is one of the most frequent symptoms of pathology of hypophysis. This pathology is accompanied with by prolactinomas (60%), sterility (40%) galactorrhea, metabolic disorders (65%). The article deals with modern techniques of diagnostic, clinic and treatment of hyperprolactinemia in women. The particular attention is paid to tactics of treatment with prolactin and also pregnancy.
The family hypercholesterolemia
Authors: Pshennova Veronika S.
Published: September 2020

The family hypercholesterolemia is among causes of premature development of cardiovascular diseases in patients of young age. At this disease, high level of cholesterol of lipoproteins of low density are registered and family anamnesis is traced. However, nowadays there is no unified international criterion for diagnostic of hypercholesterolemia. The issue of diagnostic and treatment of hypercholesterolemia continues to be actual. With every year, new and yet new gene mutations resulting in hypercholesterolemia are discovered. The actual article presents review of publications presenting modern view on this problem.
The morbidity of obliterating atherosclerosis of arteries of lower extremities in workers of enterprise of nuclear industry
Authors: Azizova Tamara V. , Kuznetsova K. V , Bannikova M. V , Sumina M. V , Bagaeva Ya. P , Azizova E. V , Fotyeva N. P , Krupenina L. N
Published: September 2020

The purpose. The evaluation of indices of morbidity of arteriosclerosis obliterans of arteries of lower extremities in cohort of workers exposed to professional chronic radiation. Material and methods. The retrospective cohort study included 22 377 workers of enterprise of nuclear industry "Maiak" with verified diagnosis of arteriosclerosis obliterans of arteries of lower extremities. The "crude" and standardized indices of morbidity were calculated. The indirect technique of standardization was applied for standardization of indices. The results. In the studied cohort of workers, at the end of period of observation (December 31 2008), 938 cases of arteriosclerosis obliterans of arteries of lower extremities were registered. It is demonstrated that morbidity of arteriosclerosis obliterans of arteries of lower extremities in studied cohort of workers statistically significant depended on gender, attained age, status of smoking, alcohol consumption (in males) and body mass index (in females). The morbidity of arteriosclerosis obliterans of arteries of lower extremities is statistically significant higher in males exposed to chronic external gamma-radiation in total dose higher than 1.0 grays and/or internal alpha-radiation from incorporated plutonium in total dose absorbed by liver dose more than 0.025 grays. Conclusion. The morbidity of arteriosclerosis obliterans of arteries of lower extremities in cohort of workers exposed to professional chronic radiation depended on both non-radiation and radiation factors.
Epidemiology, detection and problems of control of coinfection of HIV and tuberculosis in the republic of Karelia
Authors: Markelov Yuriy M. , Pakhomova E. V
Published: September 2020

The dynamics, characteristics of prevalence of HIV-infection combined with tuberculosis during last 5 years were investigated on the territory of the Republic of Karelia. The sampling of 107 medical records of patients with HIV-infection combined with tuberculosis during 2001-2014 was analyzed. It is established that against the background of wide prevalence of strains of mycobacteria of tuberculosis with multiple medicinal resistance in the region (primary multiple medicinal resistance - 46.5%) occurs late diagnostic of HIV-infection combined with tuberculosis in the Republic of Karelia (IV-V stage of HIV-infection - 72.9%). This situation, along with significant annual influx of patients with combined infection from the system of Federal penitentiary service of Russia into civil sector, facilitates further prevalence of this infection on the territory of the Republic of Karelia. The revealed characteristics of social structure and prevalence of combined infection require development of special programs of accurate monitoring of risk groups including measures of social support concerning persons without fixed address and persons leaving Federal penitentiary service of Russia into civil sector. With regard to frequent addition of other consecutive infections and atypical clinical radiologic picture of tuberculosis. frequent detection of multiple medicinal resistance of mycobacteria of tuberculosis it is necessary, for accelerated etiologic diagnostic, implementing molecular genetic diagnostic (Gene X-pert) in case of suspicion of occurrence of this disease in individuals with combined pathology (tuberculosis and HIV-infection).
The manifestation of HIV-infection in oral cavity of children
Authors: Sundukova Kseniya A. , Kiselnikova L. P , Gadzhikulieva M. M
Published: September 2020

The article presents publication review concerning the most typical affections of oral cavity in HIV-infected patients of children age. Among them are diseases of mucous tunic, salivary glands and also affections of solid tissues of teeth. The degree of their manifestation directly depends on immunity condition and viral load in blood. The effect of anti-retroviral therapy on condition of oral cavity in children with HIV-infection is demonstrated too.
Comparative assessment of tolerability and risk of pharmacotherapy with botulinum toxin type a drugs in children with cerebral palsy with severe spasticity syndrome
Authors: Arkhipov Vladimir V. , Goryachev Dmitry V. , Chebanenko Natalia V. , Solovyova Anna P.
Published: September 2020

This paper presents a comprehensive assessment of safety monitoring of the use of botulinum toxin type A (BTA) drugs in the WHO databases (VigiBase) and automated information system (AIS) Roszdravnadzor-Pharmacovigilance, as well as a comparison of the dynamics of receipt of messages.
The authors present a post-marketing study of domestic experience in the use of BTA drugs (Dysport, Botox, and Xeomin) based on a retrospective clinical and pharmacological analysis of 169 medical records of children with cerebral palsy in whom these drugs were used to treat spasticity syndrome.
Analysis of the spectrum of adverse events, which were mentioned in 10 (5.9%) medical records, showed that their nature corresponded to the data set out in the instructions for medical use. Serious adverse reactions according to the criteria of severity death and threat to life, with a high degree of reliability of cause-and-effect relationship were not revealed during the study, which confirms a sufficiently high safety profile of these drugs.
This paper focuses on improving the methodology for assessing the effectiveness and safety of BTA drugs for the treatment of spasticity syndrome in children and the need to identify and report all adverse drug reactions.
Amyloid cardiomyopathy in the elderly: clinical options, difficulties in diagnosis and treatment
Authors: Ettinger Ol’ga A. , Gendlin Gennadiy E. , Stepanova Elena A. , Ganieva Irina I. , Borisovskaya Svetlana V. , Fedorov Il’ya G. , Nikitin Igor’ G.
Published: September 2020

This article analyzes the frequency and features of cardiac amyloidosis in the elderly. The morphology and pathogenesis of amyloid cardiomyopathy are presented. The features of the clinical picture of the heart and aortic lesions in systemic and local variants of amyloidosis are analyzed. Polymorbidity in older people, which complicates the diagnosis of cardiac amyloidosis and leads to a delay in treatment, is reviewed. The diagnostic methods of various types of cardiac amyloidosis are evaluated. Modern trends in the treatment of amyloidosis are presented.