Cuidado perdido de enfermería desde la percepción de la supervisión durante la pandemia de COVID-19 / Missed nursing care from the perception of supervision during the COVID-19 pandemic / Cuidados de enfermagem perdidos como percebidos pela supervisão durante a pandemia de COVID-19

El cuidado perdido tiene un impacto negativo en los resultados en salud, los cuales son reconocidos como eventos adversos por los participantes de la investigación.

Missed care has a negative impact on health outcomes, which are recognized as adverse events by research participants.

A falta de cuidados tem um impacto negativo nos resultados da saúde, que são reconhecidos como eventos adversos pelos participantes da pesquisa.

Síndrome de Niño Agredido: aspectos médico legales y la importancia de los estudios radiológicos Reporte de caso / Battered Child Syndrome: medico-legal aspects and the importance of radiological studies Case report

Resumen El síndrome de niño(a) agredido(a) comprende múltiples aspectos desde la definición propia del abuso infantil, en donde se incluye tanto cualquier acto como la omisión que arremeta contra la salud o el desarrollo del menor. Siendo necesario la valoración integral de cada uno de los casos sospechosos abarcando tanto aspectos relacionados con posibles maltratos físicos como los correlacionables por omisión de cuido de menor. Se presenta el caso de una evaluada con denuncia por Abuso de Patria Potestad para ser valorada por sospecha de maltrato infantil.

Abstract The battered child syndrome encompasses multiple aspects from the very definition of child abuse, which covers any act or omission that affects the health or development of the minor. The comprehensive assessment of each of the suspected cases is necessary, covering both aspects related to possible physical abuse and those correlatable by omission of childcare. The case of female with a complaint for Abuse of Parental Authority to be assessed for suspicion of child abuse is presented.

Errores en el registro de datos del sistema intrahospitalario de distribución de medicamentos / Erros in the data registry of the intra-hospital system of drug distribution

INTRODUCCIÓN: los sistemas intrahospitalarios sobre la distribución de medicamentos comprenden múltiples procesos en cadena, con la participación de diferentes personas por lo que es susceptible a la generación de errores. OBJETIVO: el propósito fue conocer la generación de posibles errores durante el proceso de registro de datos en el sistema intrahospitalario de distribución de medicamentos del Instituto Gastroenterológico Boliviano Japonés de Cochabamba. METODOLOGÍA: estudio observacional, descriptivo y transversal; donde se utilizó una lista de cotejos para la revisión del registro realizado en los formularios: kardex, recetario/recibo y hoja de tratamiento en el servicio de internación, así como también el registro de medicamentos dispensados realizado en el servicio de farmacia. RESULTADOS: en el servicio de internación se identificó errores de omisión en el kardex de tratamiento, específicamente en el registro de la forma farmacéutica: comprimidos y frascos. En el servicio de farmacia también se encontró errores de omisión en el registro de las mismas formas farmacéuticas. En los servicios de internación y farmacia, se encontró errores de comisión con el registro de dosis diferente en los formularios recibo recetario y hoja de tratamiento y de medicamento dispensado respectivamente superior al 30% en todos los casos. CONCLUSIONES: los errores identificados en el servicio de internación fueron errores de registro de tipo omisión y comisión. En el servicio de farmacia, los errores encontrados fueron errores de registro de tipo comisión.

Introduction: the intra-hospital drug distribution system, comprise multiple chain processes, with the participation of different people, which is susceptible to the generation of errors. Objective: the purpose was to know the generation of possible errors during the data registration process in the intra-hospital drug distribution system of the Japanese Bolivian Gastroenterological Institute of Cochabamba. Methodology: observational, descriptive and cross-sectional study; where a checklist was used to review the record made in the forms: kardex, recipe book / receipt and treatment sheet in the hospitalization service, as well as the record of dispensed drugs made in the pharmacy service. Results: in the hospitalization service, errors of omission were identified in the treatment kardex, specifically in the registry of the pharmaceutical form: tablets and bottles. In the pharmacy service, errors of omission were also found in the registry of the same pharmaceutical formulations. In the hospitalization and pharmacy services, commission errors were found with the registration of different doses in the forms of prescription, receipt and treatment sheet and of dispensed medication, respectively, higher than 30% in all cases. Conclusions: the errors identified in the hospitalization service were omission and commission type registry errors. In the pharmacy service, the errors found were commission-type registration errors.

Liming and macronutrient on early growth of Eucalyptus benthamii / Calcário e macronutrientes no crescimento inicial de Eucalyptus benthamii

ABSTRACT: Macronutrient suppression is one way to identify which chemical elements is the most important in the early development of seedlings of forest species. This study evaluated the initial growth of Eucalyptus benthamii seedlings through morphological and physiological variables, submitted to doses of N, P and K, and liming. The experimental design to install the experiment was completely randomized, with a 2x9 factorial scheme, in which levels of factor "A" referred to absence and presence of liming and levels of factor "B", to the different treatments of NPK. Morphological variables of SD (stem diameter) and H (height) and the physiological variables of A (photosynthesis), E (transpiration), gs (stomatal conductance), Ci/Ca (relationship between intercellular and atmospheric CO2 concentration) and WUE (water use efficiency) were measured. For morphological variables, the absence of N directly affected the means and there was a direct relationship between increase of the dose and increase of SD and H. There was a positive relationship of P mainly in relation to shoot dry matter content (SDMC) and root dry matter content (RDMC). For the physiological variables, there was no direct response with the doses of N or P, with K being the element that most influenced the variables, especially when limestone was applied, resulting in higher averages for photosynthesis, transpiration and stomatal conductance. With the purpose of meeting the morphological and physiological demands, the recommendation for cultivation of Eucalyptus benthamii under the conditions of this study is the doses 150-200-150, without liming application.

RESUMO: A supressão dos macronutrientes é uma das maneiras de identificar qual ou quais dos elementos químicos é o mais importante no desenvolvimento inicial das mudas de espécies florestais. O estudo objetivou avaliar o crescimento inicial de mudas de Eucalyptus benthamii por meio de variáveis morfológicas e fisiológicas, submetidas a doses de N, P e K, e calagem. O delineamento experimental para instalação do experimento foi em delineamento inteiramente casualizado, com esquema fatorial 2x9, em que os níveis do fator "A" se referiram a ausência e a presença de calagem e os níveis do fator "B" aos diferentes tratamentos de NPK. Variáveis morfológicas de DAC (diâmetro a altura do colo) e H (altura) e as variáveis fisiológicas de A (fotossíntese), E (transpiração), gs (condutância estomática), Ci/Ca (relação entre a concentração intercelular e atmosférica de CO2) e WUE (eficiência no uso da água) foram determinadas. Para as variáveis morfológicas, a ausência do N afetou diretamente as médias, havendo uma relação direta entre o aumento da dose com o aumento das variáveis. Há uma relação positiva do P principalmente em relação a MSPA e MSPR. Para as variáveis fisiológicas, não houve resposta direta com as doses de N ou P, sendo o K o elemento que mais influenciou as variáveis, principalmente quando o calcário foi aplicado, resultando em maiores médias para fotossíntese, transpiração e condutância estomática. Com o objetivo de atender às demandas morfológicas e fisiológicas, a recomendação para o cultivo de Eucalyptus benthamii nas condições deste estudo é a dose 150-200-150, sem aplicação de calagem.

Comportamiento clínico y enfoque terapéutico de los trastornos alimentarios en personas con diabetes mellitus tipo 1 / Clinical Behavior and Therapeutic Approach of Eating Disorders in People with Type 1 Diabetes Mellitus

Introducción: El comportamiento clínico de la diabetes mellitus tipo 1 y el enfoque terapéutico de los trastornos de la conducta alimentaria se complejizan cuando estos coinciden en una misma persona. Objetivo: Describir algunos aspectos del comportamiento clínico y enfoque terapéutico de los trastornos de la conducta alimentaria en personas con diabetes mellitus tipo 1. Métodos: Se realizó una búsqueda de literatura relevante sobre el tema en el primer semestre de 2019. Se utilizaron como buscadores de información científica a Pubmed y a Google Académico. Como criterios iniciales de elegibilidad, se evaluaron artículos de revisión, de investigación y páginas Web que, en general, tenían menos de 10 años de publicados, en idioma español, portugués e inglés, y que hicieran referencia específicamente al tema de estudio a través del título. Fueron excluidos los artículos que no cumplieron con estas condiciones. Esto permitió el estudio de 65 artículos, de los cuales 33 fueron referenciados. Conclusiones: El comportamiento clínico de los trastornos de la conducta alimentaria en pacientes con diabetes mellitus tipo 1 combina síntomas y signos propios de ambas dolencias. Ambas entidades nosológicas se deben prevenir, pesquisar, diagnosticar e intervenir desde los servicios de atención primaria de salud, a través de una perspectiva interdisciplinaria. El tratamiento endocrinológico, unido a la terapia individual, la psicoeducación relacionada con los trastornos de la conducta alimentaria, la terapia familiar y un plan de tratamiento integral para la salud mental son imprescindibles desde el primer nivel de atención(AU)

Introduction: The clinical behavior of type 1 diabetes mellitus and the therapeutic approach to eating disorders become more complex when they coincide in the same person. Objective: To describe some aspects of the clinical behavior and therapeutic approach of eating disorders in people with type 1 diabetes mellitus. Methods: A search of relevant literature on the subject was carried out in the first semester of 2019. We used, as search engines for scientific information, Pubmed and Google Scholar. As initial eligibility criteria, we evaluated review articles, research articles, and web pages which, in general, were published less than 10 years ago, in Spanish, Portuguese and English, and which made, in their titles, specific reference to the topic of the study. Articles that did not meet these conditions were excluded. This allowed the study of 65 articles, of which 33 were referenced. Conclusions: The clinical behavior of eating disorders in patients with type 1 diabetes mellitus combines symptoms and signs typical of both conditions. Both nosological entities must be prevented, screened, diagnosed and intervened, starting in primary health care services, through an interdisciplinary perspective. Endocrinological treatment, together with individual therapy, eating disorders-related psychoeducation, family therapy, and a comprehensive treatment plan for mental health are essential, starting in the first level of care(AU)

Hacia un definición y consenso del término "diabulimia" / Toward a definition and consensus of the term "diabulimia"

RESUMEN Introducción: El vocablo "diabulimia" resulta de la combinación de dos palabras, diabetes mellitus y bulimia. Una de las características de los pacientes afectados es la restricción deliberada de insulina, con el objetivo de controlar el peso corporal. Objetivo: Describir la definición y consenso actual acerca del término diabulimia. Métodos: Se realizó una búsqueda de la literatura relevante sobre el tema. Se utilizaron como buscadores de información científica a Pubmed y a Google Académico. Como criterios de elegibilidad, se evaluaron artículos de revisión, de investigación y páginas Web que, en general, tenían menos de 10 años de publicados, en idioma español, portugués e inglés, que hicieran referencia específicamente al tema de estudio, y que abordaran la temática a través de cualquier metodología de investigación (cuantitativa, cualitativa, investigación operativa, otras). Fueron excluidos los artículos que no cumplieron con estas condiciones. Esto permitió el estudio de 33 artículos, de los cuales 20 son referenciados en el presente artículo. Conclusiones: La descripción del vocablo diabulimia genera retos importantes. Existen diferentes definiciones, lo cual tiende a confundir a los pacientes e inclusive a los profesionales de la salud. En la actualidad, aun no se ha logrado consensar esta definición, por lo cual continuará siendo un término coloquial y no será reconocido oficialmente como una enfermedad. Reconocer la relevancia del tema y poder identificar indicadores de su presencia es importante, pues su padecimiento expone a los pacientes con diabetes mellitus a efectos deletéreos sobre su salud y calidad de vida(AU)

ABSTRACT Introduction: The term "diabulimia" results from the combination of two words: diabetes mellitus and bulimia. One of the characteristics of the patients affected is the deliberate restriction of insulin with the aim of controlling body weight. Objective: To describe the definition and current consensus on the term diabulimia. Methods: It was carried out a search of important literature on the subject. There were used as search engines of scientific information Pubmed and Google Scholar. As eligibility criteria, there were assessed review articles, research and web pages that, in general, were less than 10 years of been published, in Spanish, Portuguese and English languages, which would make specific reference to the studied topic, and that would address the issue through any research methodology (quantitative, qualitative, operations research, others). There were excluded the articles that did not comply with these conditions. This allowed the study of 33 articles, of which 20 are referenced in this article. Conclusions: The description of the term diabulimia generates significant challenges. There are different definitions, which tends to confuse patients and even health professionals. At present, it has not been possible to achieve a consensus on this definition that is why it will continue to be a slang term and will not be officially recognized as a disease. It is important to admit the relevance of diabulimia and to be able to identify indicators of its presence, since this condition exposes patients with diabetes mellitus to deleterious effects on their health and quality of life(AU)

Fatores ambientais relacionados à omissáo dos cuidados de enfermagem

RESUMO Objetivo: Identificar, na literatura cientifica, os fatores associados à omissão dos cuidados na assistência de enfermagem. Material e Métodos: Revisão integrativa cuja pesquisa bibliográfica foi realizada nos meses de novembro de 2019 a janeiro de 2020, utilizando cinco bases de dados: PubMed, CINAHL, Scopus, Web of Science e LILACS. A pergunta de pesquisa foi elaborada com base na estratégia PICO em que o problema era "omissão de cuidado", o fenómeno de interesse era "fatores ambientais" e o contexto era "cuidado de enfermagem". Os critérios de inclusão foram: artigos de estudos primários, publicados no idioma inglês, português ou espanhol e que abrangessem a temática em estudo, resultando ao final em 30 artigos primários. Resultados: Os preditores do ambiente de trabalho corroboram para a omissão dos cuidados de enfermagem, dentre eles destacam-se: número de recurso humano e materiais inadequados, turno de trabalho, menor idade dos integrantes da equipe, elevada carga de trabalho, exaustão emocional, insatisfação com o trabalho. Conclusão: Verificou-se que o ambiente interfere na assistência de enfermagem, comprometendo os cuidados. A temática é relevante para instituições de saúde que visam acreditação nos serviços prestados, bem como para a atualização e/ou melhor atuação dos profissionais e pesquisadores da área da saúde hospitalar.

ABSTRACT Objective: To identify, in the scientific literature, the factors associated with the omission of nursing care. Materials and Methods: Integrative review whose bibliographic search was carried out in the months of November 2019 to January 2020, using five electronic databases: PubMed, CINAHL, Scopus, Web of Science and LILACS. The research question was formulated according to a PICO strategy in which the problem was "omission of care", the phenomenon of interest was "environmental factors" and the context was "nursing care". The inclusion criteria were articles from primary studies, published in English, Portuguese or Spanish and covering the subject under study, which resulted in 30 primary articles. Results: Predictors of the work environment corroborate the presence of factors of omission of nursing care, including inadequate number of staff and resources, work shifts, younger age of staff members, high workload, emotional exhaustion, job dissatisfaction. Conclusion: The environment was found to interfere with nursing care by compromising care. This subject is relevant for the accreditation of services provided by health institutions, as well as for the development and/or better performance of professionals and researchers in the field of hospital health.

RESUMEN Objetivo: Identificar, en la literatura científica, los factores asociados a la omisión de los cuidados en la atención en enfermería. Material y Métodos: Revisión integrativa cuya búsqueda bibliográfica se llevó a cabo en los meses de noviembre de 2019 a enero de 2020, utilizando cinco bases de datos: PubMed, CINAHL, Scopus, Web of Science y LILACS. La pregunta de investigación fue elaborada en base a estrategia PICO en donde el problema fue "omisión de cuidados", el fenómeno de interés fue "factores ambientales" y el contexto fue "atención de enfermería". Los criterios de inclusión fueron: artículos de estudios primarios, publicados en inglés, portugués o español y que cubrieran el tema en estudio, lo que resultó en 30 artículos primarios. Resultados: Los predictores del entorno laboral corroboran la presencia de factores de omisión de los cuidados de enfermería, entre los que se destacan: número inadecuado de personal y recursos, turno de trabajo, edad más joven de los miembros del equipo, alta carga de trabajo, agotamiento emocional, insatisfacción con el trabajo. Conclusión: Se constató que el ambiente interfiere en la asistencia de enfermería comprometiendo los cuidados. El tema es relevante para las acreditaciones de los servicios prestados por las instituciones de salud, al igual que para la actualización y/o mejor desempeño de los profesionales e investigadores en el campo de la salud hospitalaria.

Desempeño académico, y su relación con calidad de vida y hábitos saludables / Academic Performance and its Association with Quality of Life and Healthy Habits

Introducción: El estudiante de Medicina enfrenta, en muchas ocasiones, entornos de vida y condiciones de aprendizaje poco favorables, así como aspectos psicológicos que pueden impactar de modo negativo en su calidad de vida y rendimiento académico. Objetivo: Evaluar el desempeño académico de los aspirantes a estudiar Medicina en relación con la autopercepción de la calidad de vida y los hábitos saludables. Métodos: Se realizó un estudio transversal, observacional y analítico. Se aplicó una encuesta sociodemográfica y la encuesta WHOQOL-Bref a una muestra de estudiantes del curso propedéutico de Medicina. Resultados: Se encontraron diferencias entre los alumnos que aprobaron y no aprobaron el curso propedéutico en autopercepción de Calidad de Vida (p = 0,01), y los dominios de Salud Física (p = 0,04), Salud Psicológica (p = 0,02) y Ambiente (p = 0,003). También entre los alumnos que desayunaban y los que omitían el desayuno en Autopercepción de Calidad de Vida (p = 0,012), Autopercepción de Salud Física (p = 0,009), y los dominios Salud Psicológica (p = 0,009) y Ambiente (p = 0,024). Conclusiones: Los altos puntajes en la prueba WHOQOL-Bref se correlacionan con el elevado desempeño académico; además, el hábito de omitir el desayuno conlleva a un bajo rendimiento escolar y una menor calidad de vida en los discentes(AU)

Introduction: Medical students face, many times, unfavorable living environments and learning conditions, as well as psychological aspects that can impact negatively on their quality of life and academic outcomes. Objective: To assess the academic performance of applicants to study Medicine in association with self-perception of quality of life and healthy habits. Methods: A cross-sectional, observational and analytical study was carried out. A sociodemographic survey and the WHOQOL-Bref survey were conducted on a sample of medical students of the propaedeutic course. Results: Differences were found between students who passed and those who did not pass the propaedeutic course regarding self-perception of quality of life (p=0.01), and the domains of physical health (p=0.04), psychological health (p=0.02) and environment (p=0.003). Also, we found differences between students who had breakfast and those who omitted breakfast regarding self-perception of quality of life (p=0.012), physical health (p=0.009), and domains of psychological health (p=0.009) and environment (p=0.024). Conclusions: The high scores in the WHOQOL-Bref test are in correlation with high academic performance; also, the habit of omitting breakfast leads to poor school performance and lower quality of life in students(AU)

Reinforcement omission effects in rats with bilateral lesions in the substantia nigra pars compacta and ventral tegmental area

Reinforcement omission effects (ROEs) are characterized by higher response rates after reinforcement omission than after reinforcement delivery. This pattern of behavior is interpreted in terms of motivational and attentional processes. Recent studies from our laboratory have shown that the amygdala, nucleus accumbens, and medial prefrontal cortex are involved in ROE modulation. Also, the literature has demonstrated a role of other areas such as substantia nigra pars compacta (SNc) and the ventral tegmental area (VTA) in processes related to surprising events, such as prediction error and presentation or omission of an event (exteroceptive stimulus and reinforcement). Since these structures send projections to areas related to ROE modulation such as the amygdala, nucleus accumbens, and prefrontal cortex, the objective of the present study was to determine whether the SNc and VTA also integrate the circuit involved in ROE modulation. Rats were trained on a fixed-interval 12 s with limited-hold 6 s signaled schedule of reinforcement (Pre-lesion training). After acquisition of stable performance, the rats received bilateral neurotoxic lesions of the SNc (Experiment 1) and VTA (Experiment 2). Following postoperative recovery, the rats were submitted to two refresher sessions (Post-lesion training). Subsequently, the training was changed from a 100 to a 50% schedule of reinforcement (Post-lesion testing). In both experiments, the results showed that there was no difference in performance between sham rats and rats with bilateral lesions of the SNc or the VTA.

The Relationship between the SNAP-25 Polymorphism and Omission Errors in Korean Children with Attention Deficit Hyperactivity Disorder

OBJECTIVE: This study aimed to investigate the association between the synaptosomal-associated protein 25 kDa (SNAP-25) genotype and performance on the continuous performance test (CPT) in Korean children with attention-deficit/hyperactivity disorder (ADHD). METHODS: Eighty-seven children with ADHD (mean age, 9.23±1.99 years) participated in this study. Omission errors, commission errors, reaction time, and reaction time variability on the CPT were analyzed. The single-nucleotide polymorphism (SNP) rs3746544 (1065 T>G) of SNAP-25 was genotyped to examine the association with CPT performance. RESULTS: We found significantly more omission errors on the CPT among children with the TT genotype of SNAP-25 (t=2.56, p=0.012) after correcting for multiple testing. CONCLUSION: Our results suggest the possible involvement of the SNAP-25 1065 T>G polymorphism in the inattention phenotype in children with ADHD. Further studies with more refined neuropsychological measures and much larger sample sizes are needed to confirm our findings.

O supremo tribunal federal e o discurso da implementação de políticas públicas na jurisprudência brasileira: a atuação justificada na omissão / The Brazilian Federal Supreme Court and the discourse of public politics implementation in Brazilian jurisprudence: a proceeding justified in a omission

A importância da formulação de políticas públicas que assegurem direitos fundamentais sociais, em especial o direito à saúde - aqui analisado - é inegável. No tocante ao direito à saúde, observa-se que uma da principais formas de concretização do direito se encontra na formulação e execução de tais políticas, dado seu caráter coletivo, visando a garantia ao cidadão de direitos assegurados em nossa Constituição Federal. Contudo, é crescente o número de demandas judiciais buscando a realização desse direito, o qual, embora encontre respaldo no rol de direitos sociais do artigo 6º da Constituição brasileira, ainda não tem sua completa concretização. Diante desse fator, o presente artigo busca analisar, com base na jurisprudência do mais alto Tribunal brasileiro, como tem ocorrido a intervenção, por parte do Supremo Tribunal Federal, em matéria de políticas públicas. A omissão ou inércia governamental é o pano de fundo à intervenção, servindo como justificativa para que o Poder Judiciário determine uma atuação do Poder Público em nome da proteção de preceitos constitucionais. Pretende-se analisar, portanto, como é tratada referida intervenção e como se coloca o Princípio da Separação de Poderes na relação interventiva que se estabelece. Busca-se, dessa forma, compreender como ocorre - e se ocorre - a determinação de criação e execução de políticas públicas por parte do Poder Judiciário em nosso país.

The value of the formulation of public politics that come to assure fundamental social rights, specially health rights – which wean analyze here – is undeniable. In the matter of health rights, we are able to notice that one of the main forms to materialize these rights are in the accomplishment and formulation of such politics, giving its public character, aiming the assurance for our citizen soft heir rights provided by our Federal Constitution. However, the number of judicial demands looking for the realization of this right is growing, which, although finds its support in the social rights list of article 6 of the Brazilian Constitution, does not have yet its full verification. With this matter in mind, this article seeks analyze, basing itself on the jurisprudence of the highest Brazilian Court, how is happening the intervention, by the Brazilian Supreme Court, in the public politics matter. The governmental omission or inertias the intervention background, being something as an excuse in order for the Judiciary Power to demand to the Public Power an intervention on behalf of the constitutional provisions protection. Therefore, it is intended to analyse, how is treated the intervention exposed and how to apply the Principle to the Separation of Powers in the intervention al relation that’s been established. Along these lines, is sought to comprehend how it happens – and if it happens – the determination of public politics criation and execution by the Judicial Power in our country.

Prevalência de omissão do café da manhã e seus fatores associados em adolescentes de São Paulo: estudo ISA-Capital / Prevalence of breakfast omission and associated factors among adolescents in São Paulo: ISA-Capital

Objective: To describe the patterns of food intake for breakfast, the prevalence of omission of this meal, its relative share in the total intake of energy and nutrients, and the factors associated with its omission. Methods: A population-based, cross-sectional study (ISA - Capital) with 795 adolescents. The prevalence of omission of breakfast was analyzed using Chi-square test and Poisson regression considering a significance level of 5%. Differences in the intake of energy and nutrients among adolescents who omit and have breakfast was determined by the Student?s t-test and differences in the relative share of breakfast were verified by the test of proportion. The pattern of consumption of breakfast was investigated by factor analysis. Results: The prevalence of omission of breakfast was 38%, higher among female adolescents. The energy contribution of breakfast was 23%, with contribution in vitamins ranging from 17% in vitamin C, for males, up to 37% in vitamin A and D, for females. Through factor analysis, 12 food groups consumed for breakfast were characterized in five factors that demonstrate a pattern of consumption. Conclusion: The results show the need for actions that promote regular consumption and selection of appropriate food for this meal.

Objetivos: Caracterizar os padrões de café da manhã, verificar a prevalência e os fatores associados à omissão desta refeição, e a participação relativa na ingestão calórica total e de nutrientes entre adolescentes. Metodologia: Estudo transversal de base populacional (ISA - Capital), com 795 adolescentes. O padrão de consumo de café da manhã foi analisado através da análise fatorial. Para verificar a prevalência de omissão do café da manhã, foram utilizados os Testes qui-quadrado e regressão de Poisson, considerando um nível de significância de 5%. Diferenças da ingestão de energia e nutrientes entre adolescentes que omitem ou consomem o café da manhã, foi determinado pelo Teste t-Student. As diferenças na participação relativa do café da manhã foram verificadas através do teste de proporção. Resultados: Observou-se elevada omissão de café da manhã (38%), além de padrões não saudáveis, incluindo consumo de refrigerantes e salgados. Café e açúcares de adição contribuíram significativamente para o primeiro fator; pães, margarinas e manteigas contribuíram significativamente para o segundo fator; e leite e achocolatados foram os alimentos que contribuíram para o terceiro fator. No quarto fator estão embutidos e refrigerantes e no quinto fator, queijos e frutas. A contribuição energética foi de 23%, com contribuição em vitaminas variando de 17% em vitamina C, para o sexo masculino e 37% em vitaminas A e D, para o sexo feminino. Conclusão: Os resultados apontam para a necessidade de ações que visem não só estimular o consumo do café da manhã, mas também incentivar a oferta e seleção de alimentos ricos em fibras, vitaminas e minerais.

Deficiências de macronutrientes no estado nutricional de mudas de bananeira tipo prata / Deficiencies of macronutrients on nutritional status of prata type bananas seedlings

Objetivou-se avaliar o efeito da deficiência dos macronutrientes no crescimento e estado nutricional de mudas de bananeira tipo Prata. Os tratamentos foram dois genótipos Prata-Anã e seu híbrido PA42-44 cultivados em solução nutritiva na presença e ausência dos macronutrientes. Após 100 dias foram avaliados a área foliar, a massa seca das raízes, rizoma e folhas e, os teores de macronutrientes na massa seca de cada parte da planta. Com esses resultados calcularam-se os índices: eficiência de absorção, de transporte e de utilização dos macronutrientes. As deficiências de N para Prata-Anã e Mg para híbrido PA42-44 foram as que mais limitaram o crescimento dos genótipos. O acúmulo de nutrientes correspondeu à seguinte ordem N > K > Ca > P > Mg > S para Prata-Anã e N > K > Ca > P > S > Mg para o híbrido PA42-44, o que reflete as exigências da planta. O híbrido PA42-44 apresentou maior eficiência de absorção de todos macronutrientes, em solução completa. Os tratamentos não diferiram quanto a eficiência de transporte dos macronutrientes, exceto na omissão de Mg, onde a maior eficiência ocorreu no híbrido PA 42-44. A omissão de P, K, Ca, Mg e S na nutrição dos dois genótipos de banana resulta em maior eficiência de utilização, comparado com as plantas nutridas adequadamente.

This work objective to evaluate the effect of macronutrient deficiencies no growth and nutritional status of banana seedlings type Prata. The treatments were two genotypes Prata-Anã and its hybrid PA42-44 grown in nutrient solution in the presence and absence of macronutrients. Leaf area, dry matter of roots, rhizome and leaves, and the macronutrient dry mass of each plant were evaluated after 100 days. With these results was calculated the indices: absorption, transport and utilization efficiency of macronutrientes. The deficiencies of N for Prata-Anã and Mg for PA42- 44 hybrid were most limited the growth of genotypes. The nutrient accumulation corresponded to the following order N > K > Ca > P > Mg > S for the Prata-Anã and N > K > Ca > P > S > Mg for the PA42-44 hybrid, which reflect the plant requirements. The PA 42-44 hybrid showed higher absorption efficiency of all macronutrients, in complete solution. The treatments no differ regarding to the macronutrients transport efficiency, except the omission of Mg, where higher efficiency occurred in hybrid PA 42-44. The P, K, Ca, Mg and S omission in the nutrition of two banana genotypes results in increased utilization efficiency, compared with plants growing adequately.

Algunos de los escollos para la erradicación de la violencia familiar en niños, niñas y adolescentes: ley, prácticas sociales, consecuencias médicas, omisión de denuncia / Some of the obstacles to the erradication of domestic violence on children and adolescents: law, social practices, medical consequences, failure to report

En el presente artículo, partiendo de las normas legales aplicables, se abordan lo, que al parecer de las autoras, constituyen algunos de los escollos para la erradicación o mitigación del ejercicio de la violencia hacia niños, niñas y adolescentes; como así también las principales secuelas médicas que este flagelo trae aparejado para víctimas menores de edad.

In this article, based on legal norms applicable, address what apparently of theauthors, they are some of the pitfalls for the elimination or mitigation of theexercise of violence towards boys, girls and adolescents, as well as the mainmedical consequences that this scourge brings rigged for underage victims.

Lesions of the orbitofrontal cortex do not affect the reinforcement omission effect in rats

The reinforcement omission effect (ROE), reflected by response rates that are higher after reinforcement omission than after reinforcement delivery, has been attributed to both motivational and attentional consequences of the surprising reinforcement omission. These processes depend on the operation of separate amygdala areas and their connections with other brain systems. The interaction between the amygdala and orbitofrontal cortex has been suggested to be important in the modulation of motivational processes. The present study sought to verify whether the mechanisms involved in the ROE depend on the integrity of the orbitofrontal cortex. Prior to acquisition training, rats received bilateral excitotoxic lesions of the orbitofrontal cortex or sham lesions. Following postoperative recovery, the rats were trained on a fixed-interval 12 s limited-hold 6 s signaled schedule of reinforcement. After the acquisition of stable performance, the training was changed from a 100% to 50% schedule of reinforcement. The results showed that rats in both groups exhibited the ROE, with no differences in performance between groups following nonreinforcement. These data do not support the hypothesis that the orbitofrontal cortex is included in the neural substrates related to ROE modulation. The results also showed no difference in response rates between groups in the periods that preceded and followed nonreinforcement. These findings confirm previous studies that showed that the ROE is not related to the facilitation of behavior induced by nonreinforcement...

Quality of Prescriptions in a Tertiary Care Hospital in South-West Nigeria.

The quality of prescribing influences to a large extent the health outcomes of patients as errors made could result in adverse drug reactions. The aim of this study was to assess the quality of prescription written by medical doctors in a tertiary healthcare facility in rural south-west Nigeria. A cross-sectional retrospective analysis of randomly selected prescriptions from all adult outpatient clinics of the hospital between October 1, 2010 and March 31, 2011 was carried out. The prescriptions were checked for the completeness of the patients’ bio-data (name, age, sex, and hospital number), accuracy of drug dosage and formulation, prescribing by generic name, use of abbreviation, legibility of prescriber’s writing, the name and signature of the prescriber. Six hundred and two (602) prescriptions were collected and used for analysis. A total of 2167 medications were prescribed with a mean of 3.6 ± 1.6 per encounter. All the prescriptions had patient’s name and hospital numbers written. The age, hospital number and address of the patients was recorded in 421 (69.9%), 480 (79.7%) and 323 (53.7%) respectively. The doctor’s name, signature and date of encounter was indicated 587 (97.5%), 546 (90.7%) and 556 (92.7%) respectively. The mean legibility score was 2.53 ± 0.51 out of a possible score 4. The findings of our study show that there is a need for improvement in the quality of prescription written by Nigerian doctors. The adoption of a computer –aided prescribing system would go a long way in achieving this objective.

Role of the amygdala in the reinforcement omission effect

The reinforcement omission effect (ROE) has been attributed to both motivational and attentional consequences of surprising reinforcement omission. Recent evidence suggests that the basolateral complex of the amygdala is involved in motivational components related to reinforcement value, whereas the central nucleus of the amygdala is involved in the processing of the attentional consequences of surprise. This study was designed to verify whether the mechanisms involved in the ROE depend on the integrity of either the basolateral amygdala complex or central nucleus of the amygdala. The ROE was evaluated in rats with lesions of either the central nucleus or basolateral complex of the amygdala and trained on a fixed-interval schedule procedure (Experiment 1) and fixed-interval with limited hold signaled schedule procedure (Experiment 2). The results of Experiment 1 showed that sham-operated rats and rats with lesions of either the central nucleus or basolateral area displayed the ROE. In contrast, in Experiment 2, subjects with lesions of the central nucleus or basolateral complex of the amygdala exhibited a smaller ROE compared with sham-operated subjects. Thus, the effects of selective lesions of amygdala subregions on the ROE in rats depended on the training procedure. Furthermore, the absence of differences between the lesioned groups in either experiment did not allow the dissociation of attentional or motivational components of the ROE with functions of specific areas of the amygdala. Thus, results did not show a functional double-dissociation between the central nucleus and basolateral area in the ROE.

O efeito da omissão de reforço no repertório de ratos com lesão no complexo basolateral e no núcleo central da amígdala / The reinforcement omission effect on behavioral repertoire of rats with lesions in the basolateral complex and central nucleus of the amygdala

Reinforcement omission has been used as a procedure for the evaluation of attentional and motivational processes. Studies show that the activation of some amygdala nuclei may be involved in the modulation of these processes. This study examined the reinforcement omission effects on behavioral repertoire of rats with lesions in the central nucleus and basolateral complex of the amygdala, using classical conditioning and non-contingent reinforcement schemes. Each trial constituted of a 20 second tone, always followed by the delivery of water, in the 19th second. In the sessions involving omission, the water was delivered in half of the trials. The results showed that all groups responded to the omission and only the Basolateral group showed effect in the "Rearing" category, in the period after the omission. These results highlight the need to consider the involvement of a more complex neural network for evaluation of these effects.

A omissão de reforço tem sido usada como procedimento de avaliação dos processos atencionais e motivacionais. Estudos mostram que a ativação de alguns núcleos da amígdala pode estar envolvida na modulação destes processos. O presente trabalho examinou os efeitos da omissão do reforço no repertório comportamental de ratos com lesões no núcleo central e complexo basolateral da amígdala, utilizando-se de esquemas de condicionamento clássico e reforçamento não-contingente. Cada prática constituía de um sinal sonoro de 20 segundos, sempre seguido da liberação de água, no 19º segundo. Nas sessões que envolviam omissão, a água era liberada em metade das práticas. Os resultados mostraram que todos os grupos responderam à omissão e somente o grupo Basolateral apresentou efeito na categoria "Levantar-se", no período após a omissão. Estes resultados apontam a necessidade de se considerar o envolvimento de uma rede neural mais complexa para avaliação destes efeitos.

Clinical Outcomes of Ductal Carcinoma In Situ of the Breast Treated with Partial Mastectomy without Adjuvant Radiotherapy

PURPOSE: Some recent trials suggest that postoperative adjuvant radiotherapy (RT) may be safely omitted after breast-conserving surgery (BCS) for some patients with ductal carcinoma in situ (DCIS). In this study, we reviewed clinical outcomes of patients with DCIS treated with partial mastectomy (PM) without adjuvant RT. MATERIALS AND METHODS: Medical records of 28 patients (29 breasts) with DCIS who were treated with PM, but without RT, between April 1991 and December 2010 were retrospectively analyzed. Based on established criteria (2.0 cm or less in size and no comedonecrosis), 18 patients were treated without RT after PM. Seven patients (8 breasts) who did not receive RT due to refusal were also included in this study. Three other patients were excluded because data concerning comedonecrosis were not available. RESULTS: For the 25 patients included in this study, the mean age of the 18 patients who met the criteria was 47.9+/-6.2 years, and 47.6+/-12.7 years for the 7 patients who did not. The mean sizes of the primary tumors were 0.6+/-0.4 cm and 0.9+/-0.3 cm, respectively, in these two groups. Among these 25 patients (26 breasts) treated without RT, we observed no ipsilateral breast tumor recurrence or mortality within a mean follow-up of 84 months. CONCLUSION: Based on this small number of cases, patients with DCIS, who were selected for tumor size less than 2 cm and absence of comedonecrosis, may be treated successfully with BCS; adjuvant RT may be omitted.

Errores o equivocaciones por acción u omisión en acciones de promoción y prevención dirigidas a gestantes en Manizales, 2007 / Erros ou equivocos por ação ou omissão em ações de promoção dirigida a gestantes em Manizales, 2007 / Errors and mistakes due to action or omission in promotional and preventional actions directed to pregnant mothers in Manizales, 2007

El propósito del presente trabajo es mostrar los resultados de la investigación sobre errores y equivocaciones por acción u omisión en acciones de promoción y prevención dirigidas a gestantes en Manizales realizada durante el año 2007. El estudio realizado fue de tipo descriptivo retrospectivo y evaluativo. Éste se llevó a cabo con usuarios de los programas de promoción y prevención y profesionales responsables de dicho programa; la muestra de los usuarios a encuestar se determinó mediante un muestreo aleatorio simple con una confianza del 95% y un error del 5%, y la de los profesionales se realizó a conveniencia tendiendo en cuenta quiénes realizaban los controles o consultas. Se aplicó una entrevista individual. Se analizó en Epiinfo 2002 y SPSS. Entre los resultados, queremos mencionar que los errores y equivocaciones más frecuentes por parte de los usuarios fueron inasistencia a actividades propias del programa, automedicación y escaso cumplimiento de recomendaciones de autocuidado; entre los errores y equivocaciones por parte de los profesionales se resaltan falta de interrogatorio, no seguimiento a inasistentes, escasas explicaciones durante el control o la consulta y omisión de exámenes paraclínicos; también se identificaron errores en el sistema relacionados con falta de oportunidad en la entrega de medicamentos y en la asignación de citas

The purpose of this paper is to show the research results on the errors and mistakes due to action or omission in promotion and prevention aimed at pregnant mothers in Manizales in 2007. It was a retrospective, descriptive and evaluative study, that was carried out with users of promotion and prevention programs, and the responsible professionals of these programs. The sample of users was determined with a random sample, with a confidence margin of 95% and a margin error of 5%. The sample of the professionals was conducted in concordance with the people who were in charge of the check-ups or consultations. Individual interviews were carried out, with the data being analyzed with Epiinfo 2002 and SPSS. Among the results, we would like to mention that the most frequent errors and mistakes by users had been the absence in program activities, self-medication and not thoroughly following medical indications. The most relevant professional mistakes include few questions regarding the patients’ clinical history; not following-up on absent patients; few explanations on the importance of controls, and omission of paraclinical exams. Errors in the system regarding convenient medicine delivery and in the assignment of medical appointments were also identified

O propósito da presente pesquisa é apresentar os resultados da averiguação sobre erros e equivocos por ação ou omissão em ações de promoção e prevenção dirigidas a gestantes em Manizales feitas durante o ano 2007. A pesquisa realizada foi de tipo descritivo retrospectivo e de avaliação. A pesquisa foi realizada com usuários dos programas de promoção e prevenção e profissionais responsáveis de programa, a amostra de usuários a serem visitadas foi determinada por uma amostra aleatória simples com uma confiança de 95% e 5% de erro, e profissionais foi realizada por conveniência tendo em conta que realizou as inspeções ou consultas. Aplicamos uma única entrevista. Foram analisados no EpiInfo 2002 e SPSS. Entre os resultados, podemos dizer que os erros mais comuns e erros por parte dos usuários eram não-comparecimento às atividades do programa, a auto-medicação e má aderência com recomendações de auto-atendimento, entre os erros e os erros por falta de interrogatório destaques profissionais, no seguimento aos faltosos explicação, insuficiente para a supervisão ou consulta e falta de exames laboratoriais; erros do sistema identificou também relacionadas com a falta de pontualidade na entrega de medicamentos e agendamento.