ABSTRACT
Resumo Obsolescência programada é um conjunto de ações empreendidas por parte do produtor com o objetivo de estabelecer o decaimento gradativo de algum atributo de uma mercadoria para, assim, estimular artificialmente a demanda pelo consumo. A literatura sobre o fenômeno tem apontado como vítimas somente indivíduos e, como forma de manifestação do fenômeno, objetos. Este trabalho aponta a ocorrência do fenômeno de obsolescência programada em serviços públicos de saúde. Para isso, é empreendido um estudo exploratório-interpretativo de abordagem qualitativa e utilizado como estratégia de pesquisa o estudo de caso. A unidade de análise foi a nomeada Máfia das Próteses e, para coleta de dados, foram empregadas as técnicas de pesquisa bibliográfica e documental. Como resultado, foram selecionados e expostos três casos da ocorrência do fenômeno em cirurgias. Foi também realizado um esforço interpretativo dos condicionantes, da dinâmica e dos efeitos da prática de sabote cirúrgico com objetivo de estimular a demanda por serviços médicos e equipamentos médico-hospitalares. Como contribuição, este estudo realiza o delineamento dos elementos que caracterizam a ocorrência deste fenômeno em serviços médicos. Além disso, inaugura uma agenda de futuros estudos que abordam tanto o Estado sendo vitimado pela prática, quanto a ocorrência do fenômeno no setor de serviços.
Abstract Planned obsolescence is a set of actions undertaken by the producer to establish the gradual decay of some attribute of a commodity, artificially stimulating the demand for consumption. The literature on the phenomenon has identified only individuals as victims and objects as forms of expression. This study reports the occurrence of planned obsolescence in public health services. To this end, it consists of an exploratory-interpretative study with a qualitative approach, using the case study of the so-called Prosthetic Mafia. Data were collected by means of bibliographic and documentary research, resulting in three cases that expose the phenomenon occurrence in surgeries. The results were analyzed through an attempt to interpret the conditions, dynamics, and effects of the practice of surgical sabotage to stimulate the demand for medical services and medical-hospital equipment. This study outlines the elements that characterize planned obsolescence occurrence in medical services, inaugurating an agenda of future studies that address both the State being victimized by the practice and the phenomenon in the service sector.
Subject(s)
Humans , Male , Female , Orthotic Devices , Prostheses and Implants , Science, Technology and Society , Hospital Administration , Materials Management, HospitalABSTRACT
BACKGROUND: The fracture of femoral neck in adults is very common. Most of them can be cured by operation or conservative treatment, but a few can develop into old fracture. At present, there is no clear and effective treatment for old fracture of femoral neck in adults. OBJECTIVE: To explore the clinical effect of sartorius pedicle iliac bone flap combined with proximal femoral locking plate in the treatment of old femoral neck fracture in adults. METHODS: Twelve adult patients with old femoral neck fracture were treated with sartorius pedicle iliac bone flap combined with proximal femoral locking plate, 9 males and 3 females, aged 18-47 years, with an average age of 33. 5 years. Garden classification: Type I in 0 cases, type II in 1 case, type III in 7 cases, and type IV in 4 cases. All of them were incised by Smith Petersen (S-P) approach. The 2/3 sartorius pedicle iliac bone flap of the anterior superior iliac spine was chiseled with a bone knife, about 4. 0 cm×1. 0 cm×1. 0 cm in size. After reduction, the proximal femur was fixed with steel plate and screw. Finally, the sartorius pedicle iliac bone flap was implanted into the defect of the femoral neck and fixed. At 3, 6, 12, and 24 months after the operation, X-ray films were reexamined to evaluate the fracture healing and Harris score of hip joint was used to evaluate the recovery of hip joint function. RESULTS AND CONCLUSION: (1) Twelve patients were followed up for at least 24 months. (2) Harris scores of hip were significantly higher at 3, 6, 12, and 24 months after surgery (54. 4±6. 4, 68. 7±6. 8, 82. 3±4. 2, 90. 3±4. 6) than those before surgery (46. 3±6. 1) (P < 0. 05). (3) There were no complications, such as wound nonunion, infection, or venous thrombosis. Finally, 11 patients finally achieved bony healing at the fracture site. One patient had nonunion at 28 months postoperatively with avascular necrosis of the femoral head (ARCO stage IV), followed by artificial hip replacement. Harris score before operation was 38, and Harris score at 3 months postoperatively was 98. (4) The results show that the combination of sartorius pedicle iliac bone flap and proximal femoral locking plate is a good method for the treatment of old femoral neck fracture in adults, with high healing rate and low necrosis rate of femoral head.
ABSTRACT
Objetivo: La finalidad de la presente investigación fue evaluar de forma interna y externa la revista Enfermería Universitaria de la ENEO-UNAM en el periodo comprendido del 2004-2006, a fin de identificar la calidad científica y editorial de la revista. Metodología: Las variables a identificar son las siguientes; de productividad, de estabilidad y obsolescencia, de calidad editorial, de calidad científica y de infraestructura. Tomando como base cada uno de estos indicadores se realizaron las preguntas de los cuestionarios. El tipo de investigación fue descriptivo, analítico, retrospectivo, longitudinal y de corte cuantitativo. El diseño fue no experimental. Los cuestionarios utilizados fueron de tres tipos: una guía de indicadores de los para los 9 ejemplares de la revista y dos cuestionarios para la evaluación externa, uno de ellos para las y los autores y el otro para las y los lectores. La aplicación de los cuestionarios fue para 50 autores y para 116 lectores. La investigación se realizó en el año 2007. Resultados: En la evaluación externa, el 90.5% de los autores fueron enfermeras en docencia e investigación y de los lectores, el 98% son enfermeras en administración, docencia e investigación. En cuanto a la calidad científica del 70-81% de las y los lectores y autoras/es refirió que la revista es un medio de comunicación primordial para enfermería que aporta información relevante. En relación con la calidad editorial entre el 75-85 % de las y los lectores y autoras/es indicó que los artículos son evaluados por pares, arbitrados localmente de manera anónima. En lo referente al diseño editorial, entre el 50 y el 99%, el diseño informativo es el adecuado pero requiere mejoras. La escala de grises y el tipo de letra es apropiada. Los espacios son suficientes. De la evaluación interna, se publicaron 9 ejemplares 80 artículos en siete secciones principalmente por profesorado y alumnado de la ENEO-UNAM y en una mínima proporción por autoras/ es de otras Universidades e Instituciones de salud del país y del extranjero. Se citaron 613 referencias: 210 de enfermería y 403 de otros profesionales de la salud, el número de citas promedio por artículo por ejemplar fue de 7 con un intervalo de 3.9 a 10.4. El idioma en que se cita fue predominantemente el español, el estilo de elaboración de citas es Vancouver. La revista a su corta edad es un vínculo de comunicación del pensamiento de enfermería en el país, fue publicada cuatrimestralmente y se constituyó en un recurso valioso para el desarrollo del conocimiento de la disciplina de Enfermería en México. Conclusiones: La evaluación realizada arrojó datos positivos. Sin embargo, la revista debe ser mejorada y fortalecida en todas sus debilidades para lograr la calidad científica y editorial.
Objective: The purpose of this research was to analyze the internal and external evaluation of the college of nursing journal ENEO-UNAM in the period of 2004-2006, to assess the scientific and publishing the magazine. Methodology: The identify the variables are as follow; productivity, stability and obsolescence of editorial quality and infrastructure. Each of these dimensions was measured with their indicators. Based on each of these indicators were the questions related to the questionnaires. The type of research was descriptive, analytical, retrospective, longitudinal and cutting quantity. The design was not experimental. The questionnaires were used in three types: a guide to indicators of the 9 copies of the magazine and two questionnaires for the external evaluation, one of them and to the authors and to the readers. The implementation of the questionnaires was for 50 to authors and 116 to readers. The research was conducted in 2007. Results: In the Internal evaluation, the 90.5% of the perpetrators was nurses in teaching and research. Of the readers 98% in nursing administration, teaching and research. In terms of scientific quality 70-81% of the readers and authors are said that the magazine is a primary means of communication for nursing that brings relevant information. In connection with the editorial quality between 75-85% of the readers and authors indicated that the items are evaluated by peers, locally arbitrated on an anonymous basis. Regarding the editorial design, between 50 and 99%, design information is adequate but needs improvement. The gray scale and the font are appropriate. The spaces are sufficient. Of internal evaluation, 9 copies were published 80 articles in seven sections, mostly by faculty and students from the UNAM-ENEO and a minimum proportion by the authors from other universities and institutions of health of the country and abroad. 613 references were cited: 210 nurses and 403 other health professionals, the average number of citations per article was 7 per copy with a range of 3.9 to 10.4. The language in which it cited was predominantly Spanish, the style of developing are Vancouver. The magazine to his young age he was thinking of the communication link of nurses in the country, was published quarterly. Was founded in those years into a valuable resource for the development of knowledge of the discipline of Nursing in Mexico. Conclusions: The assessment carried out showed positive data. However, the magazine should be improved and strengthened in all its weaknesses to achieve scientific and editorial.
Subject(s)
Evaluation Studies as Topic , Nursing , Periodicals as TopicABSTRACT
Se analizó estadísticamente la relación existente entre la desactualización del fondo bibliográfico y el comportamiento de la asistencia y de los préstamos en la biblioteca del Hospital Gineco-obstétrico "Ramón González Coro", con el objetivo de determinar si ésta influye o no en el desarrollo de los conocimientos de los usuarios. Se plantea la similitud de los resultados obtenidos con el estado actual del resto de las bibliotecas gineco-obstétricas de la Ciudad de La Habana. Se pone de manifiesto la falta de correspondencia de estos resultados con el desarrollo alcanzado por Cuba en materia de salud materno-infantil, y se esboza un conjunto de posibles soluciones.
The relationship existing between the outdated bibliographic collection and the behavior of the attendance to and of the loans in the library of the "Ramón González Coro" Ginecoobstetric Hospital was analized aimed at determining whether if influences or not on the development of the users knowledge. The similarity of the results obtained with the present state of the rest of the ginecoobstetric libraries in Havana City was stated. The non-correspondance of these results with the development attained by Cuba in the field of maternal and child health is shown, an a set of posiible solutions is outlined.
ABSTRACT
Glomerular obsolescence is a common histologic feature in various renal diseases, of which histogenesis remains unclarified especially in renal tuberculosis, and little has been attributed for the postulation of low prevalence of hypertension in such occasion. One hundred and fifty consecutive nephrectomy specimens with renal tuberculosis under the age of 50 were histopathologically analyzed along with comparison of 18 cases of chronic pyelonephritis, 15 hydronephrosis and 10 acute traumatic kidneys. Glomerular sclerosis following tuberculous glomerulitis seemed little significant in its histogenesis except in one case, which presented epitheliold cell reaction and crescent formation. Wrinkling and thickening of glomerular basement membrane and subsequent simplification of tufts with mesangiolysis(Stage I and II) represented the major alternative glomerulopathy in nodular renal tuberculosis, whereas in confluent ulcero-cavitary lesion the development of hyalin-knot within the Bowman's space and collapse of the tufts (Stage III and IV) comprised the bulk, aside from frequent intraglomerular shunt formation between afferent and efferent arterioles mostly in autonephrectomized cases, Arteriolosclerosis was found in 17.2 % among nodular type, while 26.7% in ulcero-cavitary, variety, partly responsible for the histogenesis of glomerular obsolescence. Those cases with moderate arterio and arteriolar sclerosis showed a high tendency of transformation into stage III-IV obsolescence especially in ulcero-cavitary tuberculosis. Relative prevalence rate of systolic hypertension in ulcerocavitary tuberculosis was 5.8%, two times higher than nodular type, but in only one case the post-operative blood pressure returned to normal range. With the above findings it is assumed that glomerular oboslescence of so-called hypertensive glomerulopathy is a subtype of ischemic nature, and induced not only by vascular is chemic changes but also compromised through the intra-renal tubular obstruction and intraglomerular capillary shunt formaion may attribute to the development of secondary hypertension, though rare, in renal tuberculosis associated with arteriosclerot ic changes as well.