Os sentidos do trabalho para enfermeiras no cotidiano da profissão / Los significados del trabajo para enfermeras en la cotiano da profesión / The purpose of nursing job in a day-to-day professional view

Objetivo: Identificar quais os sentidos do trabalho atribuídos às enfermeiras em suas rotinas diárias de atuação. Método: A abordagem do estudo apresentou-se de forma qualitativa e, a coleta de dados, procedeu mediante entrevistas individuais com nove participantes no período de abril de 2019. As categorias de análise foram compostas no eixo dos sentidos do trabalho e seus seis constructos (utilidade social, oportunidades de aprendizagem e desenvolvimento, autonomia, cooperação e relacionamento com os demais colaboradores). Resultados: Os seis constructos foram identificados e correlacionados com a rotina de trabalho de cada profissional. Os resultados indicaram que o sentido do trabalho para cada profissional possui características polissêmicas e, muitas vezes, confrontantes. Conclusão: Esta pesquisa contribui com as discussões a respeito da sensibilização dos profissionais enfermeiros quanto aos sentidos do trabalho e a essência do cuidado à profissão(AU)

Objective: Identify the meanings of work attributed to nurses in their daily work routines. Methodology: The study approach was presented in a qualitative way and data collection proceeded through individual interviews with nine participants. The analysis categories were composed in the work senses axis and its six constructs (social utility, learning and development opportunities, autonomy, cooperation and relationship with other employees). Results: The six constructs were identified and correlated with the work routine of each professional. The results indicated that the meaning of work for each professional has polysemic and often confronting characteristics. Considerations: This research contributes to discussions regarding the awareness of professional nurses about the meanings of work and the essence of care for the profession.(AU)

Objectivo: Identificar los significados del trabajo atribuidos al enfermero en sus rutinas laborales diarias. Metodología: El enfoque del estudio se presentó de forma cualitativa y la recolección de datos se realizó a través de entrevistas individuales con nueve participantes. Las categorías de análisis se compusieron en el eje sentidos del trabajo y sus seis constructos (utilidad social, oportunidades de aprendizaje y desarrollo, autonomía, cooperación y relación con otros empleados). Resultados: Se identificaron los seis constructos y se correlacionaron con la rutina de trabajo de cada profesional. Los resultados indicaron que el significado del trabajo para cada profesional tiene características polisémicas y muchas veces enfrentadas. Consideraciones: Esta investigación contribuye a las discusiones sobre la conciencia de los profesionales de enfermería sobre los significados del trabajo y la esencia del cuidado para la profesión(AU)

Characteristics of autosomal dominant retinal diseases and gene therapy strategies / 中华实验眼科杂志

Inherited retinal diseases (IRDs), one type of the major eye diseases resulting in blindness, can be caused by more than 270 identified causative genes.The most common form of IRDs is retinitis pigmentosa.There is no generally accepted cure for vision impairment due to IRDs.In recent years, the first gene replacement therapy has been approved for the treatment of autosomal recessive IRDs.Because of the variety of pathogenesis, including gain-of-function and dominant-negative effects in addition to a few loss-of-function mutations, gene replacement therapy of autosomal dominant IRDs is not always effective.The clinical manifestations of autosomal dominant IRDs are extremely complex, and there is no appropriate treatment in clinical practice.The latest progresses in pathogenesis, clinical features, treatment strategies and directions of autosomal dominant IRDs globally were reviewed, and the most common genes causing autosomal dominant IRDs were summarized in this article in order to provide a deeper understanding of autosomal dominant IRDs.

Analysis and reflection on the research directions of clinical oncology projects of National Natural Science Foundation of China in 2019 / 中国肿瘤临床

Owing to the developments in cell biology and other related disciplines, basic oncological research has progressed. There has been a gradual increase in the quantity and quality of research applications for oncology. This paper provided an overview of the applications and fundings (General Program, Youth Program and Regional Program) for clinical oncology of the National Natural Science Foundation of China in 2019, analyzed the research directions of the General Program from different perspectives and discussed representative research directions including non- coding RNA, immunotherapy, microenvironment, metabolism, as well as frontiers such as lymphangiogenesis, pyroptosis and ferroptosis, lysosome and mitochondrion in the field of clinical oncology.

Sentidos do trabalho para gerentes de Unidades Básicas de Saúde em contextos de vulnerabilidades / Sense of work for managers of Basic Health Units in contexts of vulnerability

Com a descentralização do Sistema Único de Saúde (SUS), os municípios assumiram o protagonismo na gestão de seus territórios, responsabilizando-se pela Atenção Primária à Saúde. Nesse contexto, o gerente passou a desempenhar papel de destaque, imprimindo direção e sentido às ações dos trabalhadores em contextos específicos. O desempenho da função gerencial a fim de alcançar os objetivos institucionais requer do gerente o entendimento do processo de trabalho e a atribuição de sentido às ações colocadas em prática. Um trabalho adquire sentido quando é considerado importante, útil e verdadeiro. Este estudo teve como objetivo compreender os sentidos do trabalho para os gerentes das Unidades Básicas de Saúde localizadas em uma Regional com alto índice de vulnerabilidade. Trata-se de estudo qualitativo, interpretativo e analítico, cujos cenários foram as Unidades Básicas de Saúde da Regional Norte do Município de Belo Horizonte, Minas Gerais, do qual dezenove gerentes participaram da pesquisa. Foram utilizados como instrumentos de coleta de dados duas fontes de evidência: a entrevista individual com roteiro semiestruturado e a observação. A coleta aconteceu entre os meses de setembro de 2018 a março de 2019 e, durante a permanência do entrevistador na unidade básica para a realização da entrevista, ocorreu concomitantemente a observação. As impressões da pesquisadora foram registradas em um diário de campo. Para análise dos dados, utilizou-se a metodologia de Análise de Conteúdo proposta por Bardin (2016). Os resultados foram categorizados em dois temas: sentidos do trabalho do gerente na atenção primária e, a interface da vulnerabilidade no contexto do trabalho do gerente. Os sentidos do trabalho foram analisados à luz das dimensões individual, organizacional e social, perpassadas pelo trabalho cotidiano. A identidade dos gerentes foi construída com base no trabalho realizado e também nas relações estabelecidas com trabalhadores, usuários e comunidade. Quanto à segunda categoria temática, referente às singularidades do local de trabalho do gerente, caracterizado por alto índice de vulnerabilidade, foi identificada a necessidade de mobilização de competências e perfis diferenciados. A atuação do gerente junto às populações em situação de vulnerabilidade influenciou a configuração da sua identidade e a atribuição de sentidos ao trabalho realizado. Considerou-se o gerente como um ator de extrema relevância na organização dos serviços de saúde, haja vista seu papel como articulador e na efetivação das políticas propostas pelo SUS. Sua atuação demanda uma formação que propicie, sobretudo, o estabelecimento de relações interpessoais e o reconhecimento das necessidades específicas da população que atende. O excesso de atividades realizadas interfere negativamente na gestão do cuidado. Iniciativas direcionadas para a redefinição dos processos de trabalho podem ser necessárias para que o gerente assuma efetivamente as suas reais atribuições. Portanto, no que se refere às dimensões do sentido do trabalho percebe-se que os elementos elencados na dimensão individual e, principalmente, na social se sobrepõem aos da organizacional. Há que se chamar a atenção para o fato de os aspectos dificultadores terem se destacado na dimensão organizacional. A atuação do gerente, junto a populações em situação de vulnerabilidade, influencia de forma significativa nessa construção.(AU)

With the decentralization of the Unified Health System (SUS, in Portuguese acronym), the municipalities assumed the leading role in the management of their territories, being responsible for Primary Health Care. In this context, the manager began to play a prominent role, giving direction and meaning to the workers' actions in specific contexts. The performance of the managerial function in order to achieve the institutional objectives requires the manager to understand the work process and to assign meaning to the actions put into practice. A job makes sense when it is considered important, useful and true. This study aimed to understand the meanings of work for managers of Basic Health Units located in a local branch office with high index of vulnerability. This is a qualitative, interpretative and analytical study, whose scenarios were the Basic Health Units of the Northern Region of Belo Horizonte, state of Minas Gerais, in which nineteen managers participated in the research. Two sources of evidence were used as data collection instruments: the face-to-face interviews with semi-structured script and observation. The data collection took place between September 2018 and March 2019 and, during the interviewer's stay in the Basic Unit for the interview, it happened simultaneously to the observation of the facts. The researcher's impressions were recorded in a field journal. Regarding the data analysis, the content analysis methodology proposed by Bardin (2016) was used. The results were categorized into two themes: directions of the manager's work in primary care and the interface of vulnerability in the manager's work context. The meanings of work were analyzed in the light of individual, organizational and social dimensions, permeated by daily work. Managers' identities were built on the work done and also on the relationships established with workers, users and the community. As for the second thematic category, referring to the singularities of the manager's workplace, characterized by high vulnerability index, the need for mobilization of competences and differentiated profiles was identified. The role of the manager in vulnerable populations influenced the configuration of their identity and the attribution of meanings to the work performed. The manager was considered as an extremely relevant player in the organization of health services, given his role as an articulator and in the implementation of policies proposed by SUS. His performance demands a formation that promotes, above all, the establishment of interpersonal relationships and the recognition of the specific needs of the population he serves. The excess of activities performed negatively interferes in the management of care. Initiatives aimed at redefining work processes may be necessary for the manager to effectively assume his or her actual duties. Therefore, regarding the dimensions of the meaning of work, it is clear that the elements listed in the individual dimension and especially in the social one overlap those of the organizational one. Attention should be drawn to the fact that the hindering aspects have stood out in the organizational dimension. The role of the manager in vulnerable populations significantly influences this construction.(AU)

A study on optimizing technical parameters for diffusion tensor imaging of elbow ulnar nerve / 实用放射学杂志

Objective To optimize the parameters for the diffusion tensor imaging (DTI)of the ulnar nerve in elbow.Methods 5 groups of DTI sequences with different b values and numbers of diffusion gradient directions (NDGDs)were used to collect ulnar nerve images from 13 volunteers,and then the diffusion tensor tractography (DTT)was established.The fractional anisotropy (FA),apparent diffusion coefficient (ADC),length of ulnar nerve fiber and DTI image quality were compared under different imaging parameters. Results DTI results for 18 normal ulnar nerves were included in the study.Under different imaging conditions,FAs showed no significant differences.With constant NDGDs,increasing b value decreased both image quality and ADCs of the ulnar nerve.NDGDs had no significant effects on ADCs or image quality.When b=1 000 s/mm2 and NDGDs=20,the length of the ulnar nerve fiber was the longest and DTT had the best subjective scoring in image quality.Conclusion b=1 000 s/mm2 and NDGDs=20 is recommended for DTI of elbow ulnar nerve,so as to obtain high image quality and stable observing targets.

Effect of Increasing Diffusion Gradient Direction Number on Diffusion Tensor Imaging Fiber Tracking in the Human Brain

OBJECTIVE: To assess the effects of varying the number of diffusion gradient directions (NDGDs) on diffusion tensor fiber tracking (FT) in human brain white matter using tract characteristics. MATERIALS AND METHODS: Twelve normal volunteers underwent diffusion tensor imaging (DTI) scanning with NDGDs of 6, 11, 15, 21, and 31 orientations. Three fiber tract groups, including the splenium of the corpus callosum (CC), the entire CC, and the full brain tract, were reconstructed by deterministic DTI-FT. Tract architecture was first qualitatively evaluated by visual observation. Six quantitative tract characteristics, including the number of fibers (NF), average length (AL), fractional anisotropy (FA), relative anisotropy (RA), mean diffusivity (MD), and volume ratio (VR) were measured for the splenium of the CC at the tract branch level, for the entire CC at tract level, and for the full brain tract at the whole brain level. Visual results and those of NF, AL, FA, RA, MD, and VR were compared among the five different NDGDs. RESULTS: The DTI-FT with NDGD of 11, 15, 21, and 31 orientations gave better tracking results compared with NDGD of 6 after the visual evaluation. NF, FA, RA, MD, and VR values with NDGD of six were significantly greater (smallest p = 0.001 to largest p = 0.042) than those with four other NDGDs (11, 15, 21, or 31 orientations), whereas AL measured with NDGD of six was significantly smaller (smallest p = 0.001 to largest p = 0.041) than with four other NDGDs (11, 15, 21, or 31 orientations). No significant differences were observed in the results among the four NDGD groups of 11, 15, 21, and 31 directions (smallest p = 0.059 to largest p = 1.000). CONCLUSION: The main fiber tracts were detected with NDGD of six orientations; however, the use of larger NDGD (> or = 11 orientations) could provide improved tract characteristics at the expense of longer scanning time.

Humanização da assistência médica e de enfermagem ao paciente no perioperatório em um hospital universitário / Humanization of medical and nursing assistance to perioperative patient at auniversity hospital / Humanización de la atención médica y de enfermería al paciente en el perioperatório en un hospital universitario

O paciente cirúrgico vive momentos de medo e angústias, que podem ser sanados com uma assistência humanizada e individualizada. Os objetivos foram identificar os sentimentos vividos no período perioperatório, verificar a existência das orientações pré-operatórias e a satisfação dos pacientes quanto à assistência prestada. Realizou-se estudo descritivo, mediante o método estatístico. A população foi constituída por 100 pacientes com idade acima de 18 anos, de ambos os sexos. A coleta dos dados aconteceu em um hospital universitário do sul de Minas Gerais, de fevereiro a julho de 2007, através da aplicação de um questionário adaptado com questões abertas e fechadas. Os resultados revelaram que, no período pré-operatório, 68% dos entrevistados apresentaram sentimentos de medo, e 32% não receberam nenhuma orientação. Quanto à assistência prestada, 17% apresentaram queixas. Os dados mostraram que há necessidade de melhoria das ações e de atitudes voltadas para a humanização da assistência ao cliente durante a hospitalização...

The surgical patient undergoes moments of fear and anxiety, which can be overcome with humanized and individualized assistance. This study aimed at identifying feelings experienced in the perioperative period, preoperative directions, and patients’ satisfaction regarding the care provided. This is a descriptive study on the basis of the statistic method. Population consisted of 100 patients of both sexes, aged over 18 years old. Data was collected through the application of an adapted questionnaire with open and closed questions. It took place at a university hospital in southern Minas Gerais, Brazil, from February to July, 2007. Results showed that in the preoperative period 68% of respondents experienced fear, and 32% of patients received no directions. As for assistance 17% had complaints. Data showed there is need for improvement actions and attitudes aimed at humanizing assistance to the client during hospitalization...

El paciente quirúrgico vive momentos de miedo y ansiedad, que pueden ser remediados con una asistencia humanizada e individualizada. Los objetivos fueron identificar los sentimientos experimentados en el período perioperatorio, verificar la existencia de orientaciones preoperatorias y la satisfacción de los pacientes en relación a la atención recibida. Se trata de un estudio descriptivo mediante el método estadístico. La población estuvo constituida por 100 pacientes de más de18 años, de ambos sexos. La recolección de datos se llevó a cabo en un hospital universitario en el sur de Minas Gerais-Brasil, de febrero a julio de 2007, a través de la aplicación de un cuestionario adaptado con preguntas abiertas y cerradas. Los resultados revelaron que en el preoperatorio, 68% de los encuestados tenían sentimientos de miedo, y 32% de los pacientes no recibieron ninguna orientación. Cuanto a la asistencia prestada, 17% tenían quejas. Los datos mostraron que existe la necesidad de acciones de mejora y actitudes dirigidas para la humanización de la asistencia al cliente durante la hospitalización...

Las adicciones en México: una visión terapéutica de sus mitos y metas / Addictions in Mexico: a therapeutic view of their myths and goals

Resumen Las adicciones producen cuadros clínicos diversos causantes de graves complicaciones de salud, legales y socioeconómicas. No obstante, muchas permanecen sin diagnosticar. La pobre respuesta terapéutica mundial deriva de la naturaleza heterogénea del problema, gravedad, comorbilidad, motivación, duración del tratamiento, estados emocionales afectivos, rasgos de personalidad, habilidades para la adaptación, impulsividad, etc. La oferta comunitaria de servicios debe considerar la historia natural del trastorno, estrategias de sensibilización e información y de detección oportuna, así como los sistemas interpersonales que los involucran. El marco humanista que la aloja ayuda a los pacientes a entender y manejar su enfermedad, propiciando la posibilidad de transformar a la persona-objeto, en persona-sujeto, vía control de su cuadro y mejoría de su autoestima y seguridad. Esta propuesta ofrece una visión científica; unificación del lenguaje; de los propósitos y metas diagnósticas, y la génesis del entendimiento y superación de las resistencias de los protagonistas, cuyo referente fomenta la realización institucional de la tarea; mejores y más específicos procedimientos que benefician el amplio espectro del manejo de casos, donde las modalidades psicoterapéuticas complementan el manejo farmacológico y favorecen la prevención de recaídas y la abstinencia productiva. Las instituciones deben asumir marcos jurídicos operacionales que supervisen al personal, desde su formación hasta la función laboral específica, y el cumplimiento de las disposiciones inherentes a sus acciones. Se requiere un programa nacional de tratamiento integral de las adicciones cuyo apego a cánones éticos respalde la profesionalización y produzca una experiencia digna y benéfica para todos los involucrados.

Abstract Addictions produce different clinical manifestations, causing serious health, legal and socio-economic complications. However, many remain undiagnosed. The poor global therapeutic response is derived from the heterogeneous nature of the problem; in addition to its severity, comorbidity, motivation, treatment duration, affective-emotional states, personality traits, adaptation skills, impulsiveness, etc. Community supply of services must consider the natural history of the disorder, information, awareness, and early detection strategies, as well as the interpersonal systems involved. The humanist framework that hosts it helps patients understand and manage their disease, making more likely the transformation of the person-object into a person-subject, through the control of the symptoms and improving selfesteem and security. This proposal offers a scientific view, unification of language and diagnostic purposes and goals, and the genesis of understanding and overcoming the resistance of the protagonists, fostering the institutional accomplishment of the task; better and more specific procedures that benefit the broad spectrum of case management, where psychotherapeutic modalities complement the pharmacological management and promote relapse prevention and productive abstinence. The institutions must assume operational frameworks to monitor staff, from their training to the specific job function, and the fulfillment of the responsibilities inherent to their actions. A National Program for the Integral Treatment of Addictions is required, which attachment to ethical norms supports professionalization and produces a worthy experience and beneficial for all those involved.

Policy Directions Addressing the Public Health Impact of Climate Change in South Korea: The Climate-change Health Adaptation and Mitigation Program

Climate change, caused by global warming, is increasingly recognized as a major threat to mankind's survival. Climate change concurrently has both direct and modifying influences on environmental, social, and public health systems undermining human health as a whole. Environmental health policy-makers need to make use of political and technological alternatives to address these ramifying effects. The objective of this paper is to review public health policy in Korea, as well as internationally, particularly as it relates to climate change health adaptation and mitigation programs (such as C-CHAMP of Korea), in order to assess and elicit directions for a robust environmental health policy that is adaptive to the health impacts of climate change. In Korea, comprehensive measures to prevent or mitigate overall health effects are limited, and the diffusion of responsibility among various government departments makes consistency in policy execution very difficult. This paper proposes integration, synergy, and utilization as the three core principles of policy direction for the assessment and adaptation to the health impacts of climate change. For specific action plans, we suggest policy making based on scientifically integrated health impact assessments and the prioritization of environmental factors in climate change; the development of practical and technological tools that support policy decisions by making their political implementation more efficient; and customized policy development that deals with the vulnerability of local communities.

Study on the School of Traditional Japanese Medicine in the Dose and the Usage Directions of Medication / 日本東洋医学雑誌

The authors studied the doses and usage directions for some of the first Traditional Japanese Medicines (TJM) and reached the following conclusions. Since Dosan Manase, who had strong influence on TJM, adopted a method of selecting drugs one by one and refused to use fixed prescriptions, it has been hard to comprehend how much of any drug he administered. As criterion, he showed a half common system of weights. Ekiken Kaibara defined an extremely small dose as 1 ∼ 2 <i>qian</i>. Todo Yoshimasu set around 3 <i>qian</i> as the quantity for one dose, although he calculated that 1 <i>liang</i> was equivalent to about 2 <i>qian</i> (7.5g). Additionally, the Koshogaku school proposed that 1 <i>liang</i> was equivalent to 1.4g.

As incidências éticas subentendidas/entrelidas nos "artigos técnicos" de Sigmund Freud / The ethical incidences presents in Freud's

Inicialmente, perguntamo-nos se é coerente, ética e doutrinariamente, chamar de técnica a prática psicanalítica? Daí investigamos se há, principalmente nos chamados "artigos técnicos", evidências ou ao menos indícios de que o tratamento criado por Freud esteja fundado em uma ética própria à psicanálise, não sendo possível reduzi-lo ao mero manejo de uma técnica. Sustentado no que foi sua "auto-análise", na teoria e na metodologia daí decorrentes, Freud deu mostras de que, na direção do tratamento, não há condução do sujeito, que o lugar/posição/função do analista não é o de mestre e, acima de tudo, que a psicanálise não deve servir a nenhum ideal do eu ou da cultura. O artigo pretende demonstrar como é possível inferir, do texto freudiano principalmente a partir da leitura feita por Lacan uma ética voltada para o desejo. Por decorrência, este artigo evidencia a consistência da teoria freudiana, nitidamente nas dimensões ética e clínica.

At the beginning, we ask if it is coherent, ethically and doctrinally, to call the psychoanalysis' practice a technique. Then, we investigate if there are, especially on the so called "technical papers", evidences or at least clues that Freud's treatment is based in a self-ethical psychoanalysis, not being possible to reduce it to the simple handlings of a technique. Based on what was his "auto-analysis", on the following theory and methodology, Freud seemed to show that, in treatment, there is no carriage of the subject, and that the place/position/function of the psychoanalyst isn't the position of a master and, above all, psychoanalysis shouldn't serve no ideals of the proper "self", or either cultural. This paper has the intention to demonstrate how it's possible to infer, in Freud's texts, an ethic about desire. As arising, this paper elucidates Freud's theory firmness, especially in the ethical and clinical dimensions.

Research Analysis on Medication Compliances of Tuberculosis Patients / 中国药房

OBJECTIVE:To probe into the status quo of medication compliances and problems in the medication of patients with tuberculosis so as to direct their use of drugs.METHODS:Information on medication compliances of tuberculosis patients who experienced regular physical examinations was investigated by interview and questionnaires,and which were analyzed statistically.RESULTS:Of the562cases investigated,54%followed or almost followed medication directions;46%failed to follow normal drug therapy for different reasons.CONCLUSION:The pharmacists should do their utmost to expand the range of pharmaceutical care so as to improve patients'medication compliances.

Design and Application of the Database for Hospital Drug Electronic-Directions / 中国药房

OBJECTIVE:To provide electronic drug directions for hospital staffs.METHODS:Based on the military hospital information system,a system that can provide electronic drug directions was developed by establishing the database,collecting and sorting drug directions.RESULTS&CONCLUSION:This system is characterized by friend user interface,convenient input,quick inquiry,easy maintenance and widespread service,which can help hospital staffs to get the drug di?rections quickly and exactly and hence to better serve patients.