bluuebunny/crossref_metadata_2025 huggingface dataset:
Study of obstetric outcome in pregnancies with intrauterine growth retardation
Authors: Sinha Surbhi , Kurude Vilas N.
Published: April 2018

Background: The prevalence of low birth weight affects approximately 3-10% of live-born newborns in developed countries and 15-20% of newborns.in developing countries. The most common cause of low birth weight is considered to be intrauterine foetal growth restriction. IUGR being an outcome of multiple etiologies and as indicated by the literature survey varies upon population statistics in terms of economic status as well as maternal health conditions.Methods: This study includes 100 patients with foetal growth restriction in a tertiary health care centre in Mumbai over a period of 11/2 year (Jan 2015 to July2016) and the relevant data of these patients such as indoor registration number, maternal age, parity, antenatal registration and referral details, medical, obstetric, social risk factors and feto-maternal outcome were collected using a predesigned proforma.Results: Incidence of IUGR in our study population was found to be 2.13% of which maximum number of cases (48%) were seen in the age group of 21-25 years. Low socio-economic group, maternal high-risk factors like Pre-eclampsia and eclampsia were associated with low Mean Birth weights of babies. Symphysio-fundal height was found to be a sensitive predictor of IUGR and the ratio HC/AC was associated with prediction of type of IUGR (p=0.000). 83% cases were found to have asymmetric IUGR while 17% cases had symmetric IUGR. The Perinatal Mortality Rate was found to be 1.92 per 1000 live births with 5% still births and 8% neonatal deaths, the most common causes of neonatal death being sepsis (44.4%) and respiratory distress syndrome (44.4%).Conclusions: Accurate dating, provision of early registration with regular antenatal checkup, clinico- sonographic evaluation and correlation for fetal growth in high risk patients and strict antepartum surveillance after IUGR has been identified are recommended. Integration of foetal anatomy assessment, amniotic fluid dynamics, uterine, umbilical, and foetal middle cerebral artery Doppler is the most effective approach to differentiate potentially manageable placenta-based Fetal Growth Restriction(FGR) from IUGR due to aneuploidy, non- aneuploid syndromes, and viral infection.
Fever in pregnancy and its maternal and fetal outcome at tertiary care level
Authors: Poovathi M. , Prasanna N.
Published: April 2018

Background: The fever during pregnancy is the omnious sign. Early detection and prompt management of fever prevents maternal mortality and morbidity. Any maternal hyperthermia (>38.9°C) potentially affect the fetus. Hence study was conducted to know the outcome of fever in pregnancy.Methods: To study the outcome of pregnant women admitted with fever in obstetrics ward at MGMGH, Trichy over the period of 6 months from July 2017 to December 2017.Results: The incidence of fever was 6%. In this study the most common cause was viral fever among which dengue fever was most common. Hence outcome depends on its impact on pregnant mother and fetus. Many preterm labour (24%) were noted in this study which needs NICU admission of babies. Maternal mortality was 25%, most of it were associated with DIC, IUD and one or two combined risk factors.Conclusions: The incidence of fever was 6%. In this study the most common cause was viral fever among which dengue fever was most common. Hence outcome depends on its impact on pregnant mother and fetus. Many preterm labour (24%) were noted in this study which needs NICU admission of babies. Maternal mortality was 25%, most of it were associated with DIC, IUD and one or two combined risk factors.
Is emergency cesarean section more risky than elective cesarean section in women with previous cesarean section?
Authors: Dhillon Balwan Singh , Chandhiok Nomita , Rao M. Vishnu Vardhana
Published: April 2018

Background: Cesarean section is one of the most performed surgical procedures all over the world, but unfortunately cesarean sections are associated with a great deal of maternal morbidity and mortality. In the past the rate of cesarean section has increased for many avoidable and unavoidable indications both in developed and developing countries. The objective of this study was to compare maternal morbidity and mortality in elective repeat cesarean section (El-RCS) and emergency repeat cesarean section Em-RCS.Methods: Prospective data was recorded on management practices, associated complications and morbidity and mortality on 15664 consecutive cases of previous cesarean section reporting at 30 medical colleges/teaching hospitals for delivery.Results: Of the 15664 women with a previous cesarean section, 5399 (34.5%) women underwent elective repeat cesarean section, 7752 (49.5%) women who underwent emergency repeat cesarean section and 2513 (16.0%) had successful trial of labor (S-TOL). There was    failed trial of labor (F-TOL) in 1522 cases and requiring an emergency cesarean section for delivery of baby. Therefore, total no. of 7752 women had an emergency cesarean section. The overall maternal morbidity was 22.5%, 20.7% in Em-RCS and El-RCS respectively. Blood loss was more than 1000ml in 7.2% of Em-RCS where as in El-RCS it was 8.8%, blood transfusion was 7.5% in Em-RCS where as it was 6.5% in El-RCS, dehiscence of scar in Em-RCS was 4.7% as compared to 2.2% in El-RCS, uterine rupture was 1.2% in Em-RCS as compared to 0.7 % in El-RCS found statistically significant. Post-operative complication was 5.9% cases in Em-RCS where as in El-RCS was 5.8% (p=0.79 non-significant). Maternal mortality was reported in 12 (0.2%) cases of Em-RCS as compared to 5 (0.1%) cases in El-RCS (p=0.37) which was not statistically significant.  Conclusions: Maternal morbidity was found more in emergency repeat cesarean section than in elective repeat cesarean section. Complications and referral of women who are likely to undergo cesarean section should be diagnosed at an early stage so that the maternal   morbidity and mortality can be prevented.
Foley catheter with vaginal prostaglandin E2 gel versus vaginal prostaglandin E2 gel alone for induction of labour: a randomized controlled trial
Authors: Garg Ruchika , Vardhan Shailza , Singh Saroj , Singh Richa
Published: April 2018

Background: Induction of labour is significant when continuing pregnancy possess adverse effect on health of mother and her unborn baby. Different methods have been used for induction of labour. At present there is very less literature regarding simultaneous use of Foleys catheter and PGs.  The present study was done to compare the efficacy of using intracervical Foleys catheter and PGE2 gel simultaneously versus PGE2 gel alone for induction of labour.Methods: Prospective study, conducted in department of obstetrics and gynaecology for duration of 6 months. 100 women requiring induction of labour were included in the study and were randomly divided into two groups. 50 women were included in group A (simultaneous use of intracervical Foley catheter with PGE2 gel) and 50 women were included in Group B (intravaginal insertion of PGE2 gel only).Results: Maternal age, gestation age, parity, indication of induction and primary Bishops score were comparable in both the groups. Mean induction to active phase interval in both groups which was 5.8±0.80 hours in Group A and 6.23±0.40 hours in Group B. Also mean time taken from induction to delivery in Group A was 10.08±5.6 hours and in Group B was 14.6±6.9 hours which was significantly less in Group A. The rate of vaginal delivery in group A and Group B was 66% and 58% respectively which was slightly more in Group A but was not significant.Conclusions: In the present study we conclude that simultaneous use of mechanical method with Foleys catheter and PGE2 gel is better and more effective method for induction of labour than PGE2 alone. However, large sample size is required to reach more confirmatory results.
Observational study of HSG with laparoscopic correlation in infertility patients
Authors: Dubbewar Avinash , Nath Saumen Kanti
Published: April 2018

Background: Uterine abnormalities contribute to 10% of infertility cases and 50% of women with recurrent early pregnancy loss whereas fallopian tube abnormalities contribute to 20% of such cases.Methods: Total 61 patients of infertility and subfertility undergoing evaluation and treatment at our centre were selected for HSG. Total 25 patients from this group have undergone diagnostic laparoscopy, their findings were correlated with HSG findings retrospectively.Results: All the patients in the study group were either primary or secondary infertility patients. Of the 61 patients of infertility, 49 were in primary infertility group and 12 were in secondary infertility group. The age of patients was between 23 and 35 years. The average duration of primary infertility was 5 years and secondary infertility was 3.5years. Total 61 patients underwent HSG, 42(68.8%) patients had normal findings and 19(31.14%) patients had abnormal findings. In abnormal findings 4(6.55%) were Mullerian abnormalities and 15(24.59%) were either unilateral or bilateral tubal block. Total 25 patients underwent diagnostic laparoscopy out of 61 patients. The sensitivity of HSG was 90% and specificity was 60 % with positive predictive value of 60% and negative predictive value of 90% as compared to diagnostic laparoscopy. Tubal block was defined as any form of tubal occlusion detected at HSG and finally confirmed on laparoscopy.  In our laparoscopy findings, peri-adnexal adhesions were found in 5 (20%) of the blocked tubes on laparoscopy. Endometriosis was detected in 1 (4%) of the blocked tubes and suspected intra-tubal block in 2 (8%).Pelvic inflammatory disease was found to contribute in 3 (12%).Conclusions: HSG demonstrates high sensitivity in our study. So, it should be used as the initial investigation for identifying uterine abnormality and tubal patency. As the specificity is less, we suggest that laparoscopy is necessary to recognize those cases of tubal block, which were unrecognized or wrongly recognized on HSG. In addition, the patients who were found to have tubal block on HSG, laparoscopy helps in finding the cause of infertility like existence of peritubal adhesions and endometriosis that can guide appropriate therapy.
A comparative study between intramuscular oxytocin and intramuscular methyl ergometrine in the active management of third stage of labour
Authors: Hema Swapnika Devi Reddy , G. Prema Priya , Senthil Priya S. , Allirathinam A. S.
Published: April 2018

Background: To compare the efficacy of prophylactic IM oxytocin 10U and IM methyl ergometrine 0.2mg on duration of third stage of labour, amount of blood loss during the third stage of labour and associated side effects.Methods: 50 low risk antenatal women with singleton pregnancy at term gestation in vertex presentation admitted for vaginal delivery, were randomly allocated into 2groups of 25 each and managed actively in the third stage of labour either with 10 U oxytocin IM or with 0.2mg methyl ergometrine IM immediately after the birth of the baby. The main outcome measures were the difference between the 2groups with regard to: duration of third stage of labour, blood loss by volume, difference in haemoglobin and haematocrit, need for blood transfusion, additional uterotonics and side effects of drugs.Results: The mean duration of third stage of labour in the oxytocin group was 6.68±2.17min and in methergine group was 6.4±1.93 min. Mean blood loss was 302±75.6ml and 282.8±58.27ml. Mean fall in Hb was 0.92gm% and 0.812gm%. Mean fall in PCV was 2.36% and 1.88%. 2women in oxytocin group and 1woman in methergine group received additional 0.2mg methergine. 3women in both groups received 1unit of blood transfusion. 8women who received methergine had side effects while only one in the oxytocin group, with a p value 0.004 which is statistically significant.Conclusions: This study has shown that both oxytocin and methylergometrine were equally efficacious. However, oxytocin had significantly better safety profile and lesser contraindications for usage.
A five year retrospective study on maternal and perinatal outcome in pregnancy after cardiac surgery
Authors: Rathore Swati , Shankar Ravi , Vijjeswarapu Annie P. , Abraham Anuja , Yadav Bijesh
Published: April 2018

Background: Pregnancy is a hypercoaguable state with physiological haemodynamic changes occurring during pregnancy. There is a progressive increase in intravascular volume in second trimester of pregnancy and increase in cardiac output. Pregnancy makes a significant impact on cardiovascular system. It is important to evaluate and study the effect of pregnancy on women with surgically corrected heart conditions so as to preempt potential complications.Methods: This is a retrospective study of patients with prior history of cardiac surgery and their pregnancy outcomes in a tertiary center of Southern India over a period of five years from January 2011 to December 2016.Results: In this study, descriptive statistical analysis was done in 87 women with pregnancy following cardiac surgery. 58.6% were nulliparous. Around 52% had associated obstetric risk factors. The most common cardiac surgery in this population was Mitral valve replacement (40.2%) and Atrial septal defect closure (37.9%). Women belonged to NYHA class I in 90.8% of cases. 58.6% had vaginal delivery and 36.8% had caesarean section. 6 women had postpartum haemorrhage which was medically managed, and 6 women needed ICU care.74.7% women had term deliveries. 18.4 % of the babies were less than 2.5 kg weight at birth. 13 babies required Neonatal ICU care.Conclusions: Maternal and neonatal outcome mainly depends on the functional cardiac status of women before conception. In this study we emphasize on the importance of multidisciplinary team approach involving cardiologist, obstetrician and neonatologist in the management of women with prior cardiac surgery.
OASIS: clinical audit in a tertiary care centre
Authors: Soman Sruthy , Nair Sobha S. , J. N. Janani , K. Radhamany , John Kurien Ann
Published: April 2018

Background: Obstetric anal sphincter injury involves injury to the anal sphincter and rectal mucosa sustained at time of vaginal delivery and can result in significant long-term morbidity. These injuries have been defined as 3rd and 4th degree lacerations that involve disruption of the anal sphincter and rectal mucosa respectively. Objectives of this study were to find out the incidence of obstetrical anal sphincter injuries, to identify the risk factors for of OASIS and the outcome of primary repair in terms of anal incontinence and its associated complications.Methods: We did a descriptive study of OASIS by retrospective analysis of the labour case records. The study period was 1 year between August 2016 to July 2017. Inclusion criteria were singleton pregnancy, vertex presentation, instrumental and normal vaginal delivery. Exclusion criteria were multiple pregnancy, non-vertex presentation and caesarean section. Proforma was developed to capture the age, parity, gestational age in weeks, induction of labour, epidural analgesia, delivery duration, type of episiotomy, instrumentation, shoulder dystocia, occipito posterior position,manual support, weight of the baby, suturing method. Postnatal evaluation after 6 weeks and 6 months for perineal discomfort, pain, incontinence, wound infection, breakdown, fistula were noted. Results: The incidence of OASIS was 1.4%. 81.8% women had 3rd degree perineal and 18.1% had 4th degree perineal tear. The mean age of the patients were 27.9 years, gestational age of 39.45 weeks, 72.7% were primiparous. Induction of labour with prostaglandins was done in 36.36% and Pitocin augmentation for 81.81%. The duration of second 36.36% had 60-89 min and 27.27% had duration more than 90 min. 54.54% had epidural analgesia, 36.36% had shoulder dystocia, 36.36% had instrumental delivery. 72.72% babies had birth weight between 3-3.5 kg, 9% between 3.5-4 kg. Ano vaginal fistula developed in 9%.Conclusions: Appropriate training, anticipating and identifying major degrees of perineal tear helps in reducing the complications. Anovaginal fistula is distressing and disabling the patient and to her near ones.
Analysis of repeat LSCS in a tertiary care centre
Authors: Poovathi M. , T. S. Suilharsini
Published: April 2018

Background: Caesarean section (CS) rates continue to increase worldwide, particularly in middle and high-income countries without evidence indicating substantial maternal and perinatal benefits from the increase and some studies showing negative consequences for maternal and neonatal health. The objective of this study is to analyse the repeat caesarean section rates in a tertiary centre.Methods: This is a retrospective study carried out in the Department of Obstetrics and Gynaecology, Pudhukottai Medical College, Tamil Nadu, India for a 12-month period from January 2017 to December 2017 with the aim to analyse the rate and indications for caesarean section and to identify the measures to decrease its incidence if possible. A total of 2654 cesarean deliveries were conducted in one year, out of which 1380 (51.99%) were primary cesarean sections and 1274(48%) were repeat cesarean sections.Results: Repeat LSCS is more common in age group of 21-30 years (80%) and in second gravida (90.42%). The incidence of caesarean section is 94.6%. Patients who had successful trial of scar were 73. In all these patients, measures were taken to shorten the 2nd stage of labour either by giving episiotomy alone or by application of outlet forceps or vacuum. Out of these 62 (84.9%) patients were delivered by episiotomy alone.Conclusions: Caesarean section has become one of the commonly performed surgeries in obstetric practice. Implementation of standard labour management strategies can reduce primary caesarean section rate without compromising maternal and fetal safety. One important strategy is ROBSON ‘S 10 GROUP classification system for caesarean section needs to be adopted. Targets of care needs to be set up which also depends on the available resources and expertise. With continuous critical review as described and frequent comparison with other delivery units, the caesarean section rate in each individual unit can be reduced to an appropriate level.
Prospective study on sonographic measurement of umbilical cord thickness, foetal fat layer, interventricular septal thickness as predictors of macrosomia in fetus of women with gestational diabetes mellitus
Authors: N. Janani , D. Vimala , N. Gayathri
Published: April 2018

Background: The objectives of the study were to evaluate the Prediction of foetal macrosomia based on sonographic measurements of foetal fat layer, Interventricular septal thickness and umbilical cord thickness in Gestational Diabetes Mellitus at term.Methods: After assessment of inclusion and exclusion criteria 100 antenatal women of gestational age more than 37 weeks selected for study in the Department of Obstetrics and Gynaecology of Vinayaka Mission’s Kirupananda variyar medical college and hospital, Salem. Participants underwent a third trimester scan and three extra measurements i.e. Umbilical cord thickness, Interventricular septal thickness and foetal fat layer are measured in addition to the normal examination.Results: In present study umbilical cord thickness had good sensitivity and negative predictive value. Hence, if umbilical cord thickness is less than 90th centile the chance of macrosomia is less, the cut off of foetal fat layer ≥5 mm as predictor of macrosomia had sensitivity of 84.2% and specificity of 86.4% and cut off of Interventricular septal thickness ≥3.9mm as a predictor of macrosomia had sensitivity of 84.2%, specificity of 64.2%, negative predictive value of 95.9%. Thus, interventricular septal thickness and foetal fat layer is a reliable predictor of macrosomia.Conclusions: From this study authors concluded that Umbilical cord thickness, foetal fat layer and Interventricular septal thickness are good predictors of foetal macrosomia. In the assessment of risk of macrosomia in addition to the ultrasonographic measurements the clinical risk factors must be considered.
A study on association of preoperative anaemia and obesity with causes and postoperative outcome in women undergoing hysterectomy for abnormal uterine bleeding
Authors: Parkavi S. Manju , Jayasree M. , Sasikala R.
Published: April 2018

Background: Abnormal uterine bleeding is most commonly encountered in 10-20% of women in reproductive age.  The objectives of the study are to assess the proportion and association with causes and postoperative outcome of preoperative anaemia and obesity in women with abnormal uterine bleeding who underwent hysterectomy.Methods: This was a retrospective observational record-based study conducted in the Dept. of Obstetrics and Gynaecology of Sri Manakula Vinayagar Medical College and Hospital(SMVMCH), Pondicherry. The study population consisted of 169 patients who were admitted for abnormal uterine bleeding and underwent hysterectomy from January 2016 to December 2016 for a period of one year.Results: The mean age was 43years.The mean value of haemoglobin on admission was 9.89g/dl. The distribution frequencies of patients by WHO BMI classification as underweight, normal, overweight and obesity are 8, 59, 78 and 24 respectively. The distribution frequencies of patients by WHO anaemia classification as no anaemia, mild, moderate are 34, 37 and 98 respectively. Seventy-six patients had blood transfusion. Six patients had urinary tract infection and all of them were anaemic and obese. Two patients had developed respiratory tract infection and none of the patients had developed deep vein thrombosis.  Conclusions: Preoperative anaemia was more common in patients with fibroid and associated with increased morbidity in immediate postoperative period. There is more prevalence of SSI among overweight and obese women.
A case of fatal acute fatty liver of pregnancy and literature review
Authors: Perera Irushna Antonette , Pradeepan Jebananthy Anandaselvam , Mayorathan Uruthirapasupathy , Kumanan                             Thirunavukarasu Kum Thirunavukarasu , Muhunthan Kopalasuntharam , Selvaratnam Gowry
Published: April 2018

AFLP, though rare, is an obstetric emergency which carries a high incidence of maternal and perinatal mortality, despite optimal care. We report a case of a 23-year-old primi mother, who presented to us with vague symptoms of feeling unwell and abdominal pain, was diagnosed with AFLP, and was managed accordingly with the highest level of care available but succumbed a few days into her illness though timely delivery was able to save the baby. By this case report we once again wish to emphasize the value of a timely diagnosis with a high level of clinical suspicion and supportive laboratory investigations including imaging; the need for early termination of pregnancy; and adequate supportive care as the key management options for AFLP. Further, we wish to explore the current treatment options available for AFLP and discuss a few novel therapeutic strategies such as plasma exchange in treating such cases and the pros and cons associated with these treatment modalities.
A rare case of cervical ectopic: potential life-threatening condition managed conservatively with uterine artery embolisation and Methotrexate
Authors: Bhowmik Joyita , Kyal Amit , Mukherjee Aprateem , Das Indrani , Berwal Vidhika , Das Pijush Kanti
Published: April 2018

A case of cervical pregnancy managed successfully in Medical College, Kolkata by injection Methotrexate and uterine artery embolization. Cervix is a rare implantation site for ectopic pregnancy. Either during surgical management should be carefully considered due to the risk of severe hemorrhage. A 33 years old patient (P2+4 with 1 living issue) with USG diagnosed 6 weeks cervical pregnancy was admitted in Gynaecology and Obstetrics department of Medical College, Kolkata with slight bleeding per vaginum and pain abdomen. USG was repeated along with beta hCG quantification and other routine investigations. Following admission, the bleeding and pain subsided. Patient was counselled regarding the prognosis and management options available. The patient was desirous to preserve her fertility and as the patient was hemodynamically stable with low initial beta hCG of 5200 mIU/ml, we opted for a medical treatment with MTX and uterine artery embolization. Following treatment with 3 doses of weekly Methotrexate (50 mg/m2 each i.m.) and UAE the beta hCG reduced significantly. The patient was discharged with advice of weekly follow up with beta hCG report. Within 2 months of follow-up, ß-hCG level was <10 mIU/mL with TVS showing normal cervical canal and empty uterine cavity.
Celiac disease and pregnancy in Indian scenario
Authors: Verma Anupam , Tyagi Preeti , Singh Anu
Published: April 2018

Celiac disease is a chronic lifelong inflammatory condition of gastrointestinal tract specifically the small intestine. We report a case of pregnancy outcome in a patient with celiac disease (gluten sensitive enteropathy) diagnosed during the investigations of recurrent abortions and intermittent diarrhoea since childhood.  A 32 years old patient who had four abortions and loss of a premature baby was diagnosed as celiac disease during investigations of recurrent abortions and diarrhoea since childhood. After stabilisation of disease she conceived spontaneously. Patient had regular follow up in some private institute. She was referred to our hospital as a case of IUGR with color Doppler changes with breech presentation with sluggish fetal movements at 37 weeks and emergency caesarean section was performed. A male fetus with 2.25 kg AS 7, 9 at birth was delivered. The cause of her recurrent pregnancy losses and previous preterm birth was celiac disease. Celiac disease (CD) is an immune-mediated enteropathy caused by a permanent sensitivity to gluten in genetically susceptible individual. It may also lead to serious maternal and fetal complications because of systemic effects of disease however a successful pregnancy outcome is possible when pre-gestational diagnosis is made and proper management of disease during pregnancy is achieved.
Assessment of risk factors in cardiac failure after myocardial infarction
Authors: Reddy P. Vijaya Narasimha , Reddy R. Jaya Prakash
Published: April 2018

Background: Cardiac failure is a clinical syndrome that may result from any structural or functional cardiac disorders that impairs the pumping ability of the heart. Post infarction cardiac failure is one of the common complications of Acute Myocardial Infarction which is influenced by factors like extent of MI, Life style, associated co-morbid conditions.Methods: The present study comprises of 50 cardiac failure patients with history of MI in the past and who presented with myocardial infarction with cardiac failure were included in this study. This study was conducted at Rajivgandhi Institute of Medical Sciences, Kadapa, YSR District, Andhra Pradesh. The study was carried out for a period of 2 years. Informed consent was taken from each and every patient included in the study.Results: In our study 42 (84%) are males and 8 (16%) are females. Out of 50 patients 37 (74%) are smokers and 32 (64%) are alcoholics. In our study maximum number of patients i.e. 60% of the patients are sedentary in nature. Among 42 male patients 28 are having WHR >0.9 and 8 female patients WHR >0.8 is quite significant.Conclusions: Post MI cardiac failure is more common in males and sedentary lifestyles. Smoking, alcohol consumption and associated co morbid conditions have linear relationship with incidence of post infarction Cardiac failure. Abdominal obesity has positive effect on incidence of post MI cardiac failure.
A trajetória histórica da constituição do marco legal das Ações Afirmativas
Authors: Mocelin Cassia Engres , Martinazzo Celso José , Guimarães Gleny Terezinha Duro
Published: April 2018

Este artigo, construído a partir de revisão bibliográfica e documental, versa sobre o processo sócio-histórico de constituição do marco legal das Ações Afirmativas no Brasil, por meio da sistematização das proposituras no âmbito do Legislativo e do Executivo. Somado a isso, destaca o protagonismo do movimento negro brasileiro em agendar o debate acerca da questão racial e compelir o Estado a assumir uma postura mais ativa como resposta ao processo de exclusão e discriminação social vivenciado pela população negra no país. Evidencia a compreensão da questão racial como uma das expressões da questão social que se apresenta cotidianamente à intervenção profissional do assistente social. Razão pela qual deve ser tema de problematização e produção de conhecimento, tendo vista a necessidade de criação de ações e mediações profissionais que estejam direcionadas a essa demanda contemporânea.
Insuficiência de leitos de UTI: crise do capital e mercantilização da saúde.
Authors: Medeiros Rodrigo de Souza
Published: April 2018

Este artigo problematiza a relação entre a insuficiência do número de leitos de Unidades de Terapia Intensiva (UTI) com o movimento de mercantilização da saúde no contexto de desenvolvimento do SUS. Constitui uma pesquisa bibliográfica e documental de natureza quanti-qualitativa, na qual destacamos os dados sistematizados pelo CFM acerca dos leitos de UTI no Brasil, bem como pesquisas sobre a relação entre crise da saúde, crise do capital e mercantilização da saúde. Conclui-se que por envolver alta densidade tecnológica, pessoal especializado e serem serviços de alto custo com reduzida margem de lucro, o setor privado não tem interesse em ampliar leitos de UTI, de forma que tanto no SUS quanto no sistema suplementar de saúde há insuficiência de leitos de UTI determinada por interesses mercantilistas que hegemonizam as relações entre capital e saúde no Brasil.
Políticas de saúde no Mercosul: relevância e funcionalidade da dimensão jurídico-norativa
Authors: Fagundes Helenara Silveira , Nogueira Vera Maria Ribeiro , Kreutz Ineiva Terezinha
Published: April 2018

Este artigo aborda a institucionalidade das políticas de saúde no MERCOSUL a partir da dimensão jurídico-normativa, constituídas pelas iniciativas e regulações emanadas do próprio bloco e acordos bilaterais entre os Estados Parte. Sinaliza para sua funcionalidade na ampliação da cidadania social e aponta os limites para sua concretização nas áreas fronteiriças. Em termos metodológicos procedeu-se ao resgate das iniciativas e normativas do MERCOSUL e dos acordos bilaterais entre os países relativos às políticas de saúde. Evidencia a relevância dos acordos em sua dimensão normativa na construção da cidadania social, a qual é limitada no trânsito para a região fronteiriça em decorrência das particularidades históricas, culturais, econômicas e sociais vigentes e do valor atribuído à cidadania em cada um dos Estados Parte.
Reformas regressivas e política de saúde
Authors: Ferraz Ana Targina Rodrigues , Bernardes Franciani
Published: April 2018

Editorial do V.10, N.01 da revista Argumentum.
Expediente
Authors: Keys Eugenia Magna Broseguini
Published: April 2018

Expediente v. 10, n.1, jan./abr.2018
CURSOS DE LETRAS: o (quase não) lugar da formação tecnológica do professor
Authors: Porto Ana Paula Teixeira , Porto Luana Teixeira
Published: April 2018

Este artigo aborda a formação de professores de Letras para uso de tecnologias com o objetivo de discutir a formação tecnológica desses profissionais para atuação na docência de língua portuguesa e literatura. Para tanto, contempla análise documental de leis, resoluções e pareceres que balizam a formação de professores e diretrizes para oferta de cursos de Letras e apresenta exame de propostas de cursos presenciais de licenciatura em Letras que com habilitação em Língua Portuguesa e Literatura, indicados em 2017 como cursos de excelência em avaliações do Ministério da Educação. A análise revela que a inserção da tecnologia em currículos de Letras é escassa em termos quantitativos, indicando compromentimento de seu uso pelo docente.
INTERACT: Um modelo baseado em contextos para motivação de interações em Redes Sociais Educacionais
Authors: Barbosa Jorge Luis Victória , Santos Marcelo da Silva dos , Costa Cristiano André da
Published: April 2018

Redes Sociais Educacionais (RSE) podem proporcionar espaços de interação e trocas entre aprendizes, mas não garantem motivação para que estas aconteçam. O INTERACT se utiliza do histórico contextual dos usuários para potencializar interações entre usuários de RSE. Além do modelo, é apresentado o protótipo desenvolvido. A avaliação se deu com coleta de dados gerados pelas atividades de voluntários no experimento e em questionários, tendo como observações centrais a participação, recomendação e reação dos participantes. Resultados apontaram aumento no volume de interações nos momentos de atuação do protótipo. Por fim, são apresentadas percepções dos voluntários quanto à qualidade e assertividade das ações do INTERACT.
TRANSMÍDIA E REDES SOCIAIS: aspectos da inovação no telejornalismo
Authors: Cunha Elaide Martins da , Castro Mariana , Vinagre Isabelle
Published: April 2018

A partir de um olhar direcionado ao Jornal da Record News, esta pesquisa procura compreender os usos e apropriações da transmídia e das redes sociais digitais enquanto aspectos de inovação nos modos de fazer telejornalismo. O JR News se autointitula o primeiro telejornal transmídia do Brasil e usa as redes sociais para transmitir suas edições, chamadas e até reuniões de pauta, ao vivo, com a participação do público. Adotando-se entrevista semiestruturada e observação direta como procedimentos metodológicos, este artigo ampara-se em Charron e Bonville (2016), Recuero (2009), Alzamora e Tárcia (2012), Zago e Bastos (2013), Canavilhas (2013), Martins, Castro e Vinagre (2017), dentre outros, para discutir intersecções entre transmidialidade e redes sociais como alternativa para o jornalismo frente às mudanças na contemporaneidade.
A RECONSTRUÇÃO DA REALIDADE NO TELEJORNALISMO: uma análise da coprodução via WhatsApp
Authors: Siqueira Fabiana Cardoso de
Published: April 2018

O presente artigo analisa as mudanças provocadas no telejornalismo pela participação dos coprodutores (VIZEU; SIQUEIRA, 2009), especialmente, através do envio de imagens pelo aplicativo de celular WhatsApp. O objetivo foi compreender de que forma os jornalistas selecionam essas imagens e operam ações de construção da realidade na TV. Foi feita uma análise de conteúdo do Bom Dia Paraíba, da TV Cabo Branco, afiliada da Rede Globo, em João Pessoa, na Paraíba e foram aplicadas entrevistas abertas semiestruturadas com editores do telejornal. Constatamos que os jornalistas operam ações de reconstrução da realidade unindo o recorte da realidade feito previamente pelos coprodutores, as próprias experiências e conhecimentos e as práticas jornalísticas.
“G1 EM 1 MINUTO” E A NOVA LÓGICA DE APRESENTAÇÃO DAS NOTÍCIAS: da linguagem ao figurino
Authors: Cirne Lívia , Belém Vitor Curvelo Fontes , Aquino Agda Patrícia Pontes de
Published: April 2018

O presente trabalho discorre sobre a nova lógica de apresentação empreendida pelo boletim “G1 em 1 minuto”, uma edição jornalística da Rede Globo integrada ao portal de notícias da emissora, o G1, que foi lançada em 2015. Trata-se da observação de três aspectos mais gerais que, aparentemente, buscam não só a renovação do gênero jornalístico, mas também podem ser encarados como uma estratégia de aproximação com a audiência jovem. Sendo assim, as três perspectivas relatadas no texto são: rompimento de um “padrão jornalístico”, transformação na forma como o conteúdo se manifesta e o emprego do figurino juvenil.
JORNALISMO NA ERA DA PÓS-VERDADE: fact-checking como ferramenta de combate às fake news
Authors: Spinelli Egle Müller , Santos Jéssica de Almeida
Published: April 2018

Este artigo pretende relatar como o trabalho das agências de fact-checking, com suas metodologias de checagem de dados para o incentivo à transparência do processo jornalístico, pode auxiliar as empresas informativas no combate às notícias falsas. Por meio de revisão de literatura são abordados os impactos da pós-verdade e da disseminação de fake news na sociedade – em que fatos objetivos são menos influentes na opinião pública do que emoções e crenças pessoais. Como resultado conclui-se que o trabalho sério de apuração de fatos e defesa da credibilidade é fundamental para que a própria audiência refute fake news e compartilhe as informações produzidas por veículos de credibilidade.
50 ANOS DE MEDELLÍN – 5 ANOS DE FRANCISCO: PERSPECTIVAS TEOLÓGICO-PASTORAIS
Authors: Aquino Júnior Francisco de
Published: April 2018

RESUMO: A celebração dos 50 anos da Conferência de Medellín (1968) coincide com os 5 anos de ministério pastoral do papa Francisco (2013). Essa coincidência cronológica é uma ocasião privilegiada para explicitar e destacar a coincidência teológico-pastoral entre ambos. Ela ajuda a compreender melhor tanto o processo de renovação eclesial desencadeado por Francisco, quanto a atualidade do dinamismo eclesial desencadeado por Medellín. O texto começa destacando a importância de Medellín e de Francisco na Igreja e na sociedade. Explicita a perspectiva teológico­-pastoral fundamental de ambos. E indica, a partir dessa perspectiva, alguns dos principais desafios com os quais a Igreja é confrontada hoje em sua missão evan­gelizadora: desafios que dizem a respeito à compreensão e configuração da Igreja e sua missão (eclesiologia) e aos apelos e exigências que brotam de nossa situação histórica atual (sinais dos tempos).ABSTRACT: The 50 years celebration of the Conference of Medellin (1968) coin­cides with the 5 years of Pope Francis’ pastoral ministry (2013). This chronological coincidence is a prime occasion to clarify and emphasize the theological-pastoral coincidence between both. It helps to understand better the process of ecclesial renewal triggered by Francis and the current relevance of the ecclesial dynamism, unleashed by Medellin. First, the text highlights the importance of Medellin and of Francis in the Church and in society. It then explains the fundamental theological/pastoral perspective of both. And, from that perspective, it addresses some of the major challenges the Church is faced with today in her mission of evangelization: challenges regarding the understanding and setup of the Church and her mission (Ecclesiology), and the appeals and demands that spring from our present historical situation (signs of the times).
MEDELLÍN: FERTILE SEEDS OF PASTORAL CONVERSION IN THE UNITED STATES
Authors: Deck Allan Figueroa
Published: April 2018

SUMMARY: This article explores the way in which the event of Medellín as well as the document have played a significant part in the unfolding of pastoral and social ministries with and for Hispanic/Latinos in the United States over the past fifty years. The reception in the United States of Medellín in the wider context of the follow-up to the Second Vatican Council has been wide and deep in terms of several developments outlined here. Faith-based social ministries in Hispanic/Latino communities in the form of grass root community organizations in the tradition of Saul Alinsky found inspiration in Medellin’s option for the poor and pastoral de conjunto. Many other examples of Medellín’s impact are placed in the wider historical context of the past fifty years, the half century in which Hispanics/Latinos emerged as the majority of U.S. Catholics under the age of 35.RESUMO: Este artigo investiga a forma pela qual tanto o evento como o documento de Medellín tiveram papel significativo na evolução dos ministérios pastorais e sociais da população de origem latino-americana dos Estados Unidos nos últimos cinquenta anos. A recepção de Medellín nos Estados Unidos, dentro do contexto mais amplo que se seguiu ao Concílio Vaticano II, foi ampla e profunda, e é aqui delineada em seus muitos desdobramentos. Naquelas comunidades de origem latino-americana, na forma de organizações comunitárias de base conforme a tra­dição de Saul Alinsky, os ministérios sociais de cunho confessional foram influen­ciados pela opção pelos pobres e pela pastoral de conjunto lançadas por Medellín. Vários outros exemplos do impacto causado por Medellín são aqui situados no seu contexto histórico mais amplo da última metade de século, período no qual a população de origem latino-americana despontou como majoritária entre todos os católicos norte-americanos na faixa etária até 35 anos.
KOMUNIKASI VERBAL ANAK PESISIR USIA 7-8 TAHUN PADA TRANSAKSI PENJUALAN PRODUK KEBUDAYAAN DENGAN TURIS MANCANEGARA
Authors: Rustan Edhy , Subhan Subhan
Published: April 2018

This study aims to obtain a description of childrenâ€™s second language verbal communication skills aged 7-8 years in the activity of buying and selling transactions with foreign tourists. This research was conducted in South Coastal Coast of Central Lombok Regency of West Nusa Tenggara. This research is a qualitative study of case study by Milles and Hubberman model data analysis technique with four stages of interalain analysis (1) data collection, (2) data reduction, (3) data display and (4) drawing conclusion. The results of this study indicate that the verbal communication skills of coastal children are obtained partially covering three linguistic components; vocabulary, shipping and grammatical arrangement. The process of acquiring verbal communication skills is influenced by two factors, namely family pressure and self-exposure of children to the coastal tourism environment that encourages children to sell cultural products to foreign tourists. For these purposes, coastal children use two common patterns of second language verbal communication, ie direct verbal communication patterns (spoken word) and indirect verbal communication patterns (writing word).
Keyword: Verbal communication skill, Children aged 7-8 years.
Penelitian ini bertujuan untuk memeroleh gambaran kemampuan komunikasi verbal bahasa kedua anak usia 7-8 tahun dalam kegiatan transaksi jual beli dengan turis mancanegara. Penelitian ini dilakukan di Pesisir Pantai Selatan Kabupaten Lombok Tengah Nusa Tenggara Barat. Penelitian ini adalah studi kasus dengan teknik analisis data model Milles dan Hubberman dengan empat tahapan analisis yang meliputi (1) pengumpulan data, (2) reduksi data, (3) display data, dan (4) penarikan kesimpulan. Hasil analisis menunjukkan bahwa kemampuan komunikasi verbal anak pesisir pantai cenderung diperoleh secara parsial; mencakup tiga komponen kebahasaan antaralain kosakata, pelafalan  dan susunan gramatikal. Adapun proses pemerolehan kemampuan komunikasi verbal tersebut dipengaruhi oleh dua faktor yaitu tekanan keluarga dan ekspos diri anak pada lingkungan pariwisata pantai yang mendorong anak untuk berjualan produk-produk kebudayaan kepada para turis mancanegara. Untuk kepentingan tersebut, anak pesisir pantai menggunakan dua pola umum komunikasi verbal bahasa kedua, yaitu pola komunikasi verbal langsung (spoken word) dan pola komunikasi verbal tidak langsung (writing word).
Kata Kunci: kemampuan komunikasi verbal, anak usia 7-8 tahun
PROFIL KETERAMPILAN PEMECAHAN MASALAH ANAK USIA DINI DALAM PEMBELAJARAN PROYEK DI TAMAN KANAK-KANAK
Authors: Syaodih Ernawulan , Setiasih Ocih , Romadona Nur Faizah , Handayani Hany
Published: April 2018

This research aims to identify problem-solving profile ability in an early-aged child using the project-based learning in kindergarten. Methods used in this research is through collaborative classroom action research.This research was done in 3 (three) kindergarten in Cimahi. The technique used to collect data was done through semi-structured observation technique of 1 (one) class from each kindergarten to discover children's problem-solving ability.Furthermore, 6 (six) teachers were interviewed to identify children's problem-solving ability and to discover the learning process using the project-based learning.Whereas the data analysis used in this research is thematic data analysis technique. Moreover, the next step is to construct the problem-solving profile ability in an early-aged child. Based on the research outcome, it is clear that children's problem-solving profile ability with the project-based learning is relatively well. Most of the problem-solving ability indicator can be met, such as the observing ability using their own senses and the ability to communicate, even though stimulus and motivation to ask and answer questions from the teachers are still needed.  
Keywords: Problem Solving Skills, Learning Project, Early Childhood Education
Penelitian ini bertujuan untuk mengetahui profil keterampilan pemecahan masalah anak usia dini dengan menggunakan model pembelajaran proyek di taman kanak-kanak. Metode penelitian yang  digunakan dalam penelitian ini adalah collaborative classroom action research. Penelitian ini dilaksanakan di tiga TK di Kota Cimahi. Teknik pengumpulan data dilakukan melalui teknik observasi semi terstruktur terhadap 1 (satu) kelas masing-masing TK untuk mengetahui keterampilan pemecahan masalah yang dimilikinya. Selain itu dilakukan wawancara terhadap 6 (enam) orang guru selain untuk mengetahui keterampilan pemecahan masalah anak dan untuk mengetahui proses pembelajaran dengan menggunakan model pembelajaran proyek. Sedangkan analisis data yang digunakan dalam penelitian ini adalah teknik analisis data tematik, dan langkah selanjutnya menyusun  profil keterampilan pemecahan masalah anak usia dini. Berdasarkan hasil penelitian diperoleh bahwa profil keterampilan pemecahan masalah anak dengan pembelajaran proyek rata-rata berada pada kategori baik. Sebagian besar indikator keterampilan pemecahan masalah dapat dipenuhi dengan baik, hal ini terlihat dari indikator keterampilan mengamati anak sudah mampu melakukann  pengamatan dengan menggunakan inderanya dengan baik, begitu pula pada indikator keterampilan mengumpulkan informasi dan keterampilan mengkomunikasikan, akan tetapi masih perlu stimulus dan motivasi untuk lebih berani bertanya ataupun menjawab pertanyaan dari guru
Kata kunci: Keterampilan Pemecahan Masalah, Pembelajaran Proyek, Pendidikan Anak Usia Dini.
MODEL PERMAINAN ESTAFET BAIT LAGU UNTUK MENINGKATKAN KEMAMPUAN PEMUSATAN PERHATIAN PADA ANAK
Authors: Ismaniar Ismaniar
Published: April 2018

The motivated this research is by the still low development of attention concentration ability in early childhood.The purpose of this study is to develop a model of selective attention playing for children in group B kindergarten Al Ittihaad Bekasi. The study was a Research and Development (R&D), developed by Borg & Gal. Model development through three stages is (1) needs analysis process, (2) product development process, and (3) tesing process.After the experimental process in the research as well as input from teachers using this model,has been very encouraging and axpert advices add the finishing touch.The model effectiveness tes showed a significant increase in the process of assisting children with low selective attention ability. Estafet Bait Lagu Model is consist of guide book, medias, and assesment.
Keyword: The ability of selective attention, development, play model, estafet bait lagu
 
Latar belakang penelitian ini adalah  masih rendahnya perkembangan kemampuan pemusatan perhatian pada anak usia dini. Penelitian bertujuan untuk mengembangkan model permainan pemusatan perhatian pada anak-anak di kelompok B TK Al Ittihaad Bekasi. Penelitian ini merupakan Penelitian dan Pengembangan (R&D), menggunakan desain yang dikembangkan oleh Borg & Gall. Pengembangan model melalui tiga tahapan yaitu (1)proses analisis kebutuhan,(2) proses pengembangan produk dan (3) proses pengujian. Setelah dilakukan beberapa kali uji coba, masukan dari guru pengguna model ini sudah sangat menggembirakan dan sentuhan terakhir dengan menambahkan pendapat dan masukan pakar. Pengujian efektivitas model memperlihatkan terjadi peningkatan yang cukup signifikan dalam hal proses membantu anak-anak yang memiliki kemampuan pemusatan perhatian yang rendah. Model Estafet Bait Lagu terdiri dari buku panduan, media, dan penilaian.
Kata kunci; kemampuan pemusatan perhatian, pengembangan, model permainan, estafet bait lagu