Estudo transversal sobre ausências de pacientes em consultas médicas agendadas em ambulatórios de hospital terciário / Cross-sectional Study On Patient Absences In Medical Consultations Scheduled In Outpatient Clinics Of Tertiary Hospital / Estudio Transversal Sobre Ausencias de Pacientes Em Citas Médicas Programadas Em Pacientes Ambulatorios de Hospitales Terciarios

Objetivo: Analisar variáveis relacionadas ao agendamento de consultas ambulatoriais que não se realizaram pela ausência dos pacientes. Métodos: Estudo transversal produzido em hospital público terciário de referência para o Sistema Único de Saúde. Foram sorteados aleatoriamente 493 pacientes, e a amostra final totalizou 317 pacientes que faltaram a consultas médicas. Variáveis investigadas: recebimento de mensagens via celular informando a data da consulta, intervalo entre a data do agendamento e da consulta e a realização de reagendamento. Os dados foram oriundos de relatórios informatizados de faltosos a consultas agendadas e entrevistas telefônicas. Análises estatísticas realizadas no programa SAS® for Windows, versão 9.3. Resultados: 49.8% dos pacientes informaram não terem recebido mensagem lembrando sobre a data da consulta. O tempo entre o agendamento e a data da consulta ficou entre 180 e 365 dias para 36,6% dos pacientes. Reagendaram a consulta 24,6% dos pacientes. Conclusão: É necessário ampliar procedimentos para prevenção de faltas às consultas, independentemente do tempo entre o agendamento e a consulta. (AU)

Objective: To analyze variables related to the scheduling of outpatient appointments that did not take place due to patient no-show. Methods: Cross-sectional study conducted in a tertiary public referral hospital providing services to the Brazilian Unified Health System. A total of 493 patients were randomly selected, and the final sample totaled 317 no-show patients. Variables investigated: receipt of messages via cell phones informing the appointment date, interval between the scheduling date and the appointment date, and rescheduling. Data were obtained from computerized reports regarding absenteeism from scheduled appointments and telephone interviews. Statistical analyses were performed using the SAS® for Windows software, version 9.3. Results: 49.8% of patients reported not having received a message reminding them of the appointment dates. The interval between scheduling and the appointment dates was from 180 to 365 days for 36.6% of patients. A total of 24.6% of patients rescheduled their appointments. Conclusion: It is necessary to expand procedures to prevent missed appointments regardless of the time between scheduling and the appointment. (AU)

Objetivo: Analizar variables relacionadas con la programación de consultas externas que no se realizaron por ausencia del paciente. Métodos: Estudio transversal realizado en un hospital público terciario de referencia del Sistema Único de Salud. Se seleccionó aleatoriamente a 493 pacientes y la muestra final fue de 317 pacientes que faltaron a las citas médicas. Variables investigadas: recepción de mensajes vía celular informando la fecha de la cita, intervalo entre la cita y la fecha de la cita y reprogramación. Los datos provienen de informes computarizados de ausencias n citas programadas y entrevistas telefónicas. Análisis estadísticos realizados en SAS® para Windows versión 9.3. Resultados: En el 49.8% de los pacientes informaron no haber recibido un mensaje recordando la fecha de la cita. Conclusión: Es necesario ampliar los procedimientos para evitar citas perdidas independientemente del tiempo entre citas y citas. (AU)

Evaluation of Different Pre-treatment Behaviour Modification Techniques in 4–7-year Olds: A Randomised Controlled Trial

Purpose: The aim of this study is to evaluate and compare the effectiveness of five pre?treatment behaviour modification techniques in 4–7?year olds in reducing dental anxiety by evaluating pulse rate, partial pressure of oxygen, systolic blood pressure, diastolic blood pressure, salivary flow rate, salivary pH, and through modified facial anxiety scale. Material and Methods: Using simple random sampling technique (drawing of lots), 125 children were equally distributed into 5 groups of 25 each: Group 1: tell?show?do (control); Group 2: tell?show?play?doh; Group 3: Playmobil Dentist; Group 4: mobile dentist games; Group 5: role play as dentist. Samples in each group were treated in a single appointment after using the behaviour modification techniques. Class I or Class II cavities were prepared on carious primary molar and restored using glass ionomer cement. Patient’s anxiety level was assessed by recording blood pressure, pulse rate, oxygen saturation, salivary pH, salivary flow rate, and facial anxiety scale at different time intervals, that is before the treatment, during the treatment, and after the treatment. Results: All the intervention Groups (Groups 2–5) showed reduced anxiety scores in both physiological and facial anxiety compared to the control group, that is tell, show do. The modified distraction techniques aid in better modification. Conclusion: Tell?show?play?doh, Playmobil dentist games, mobile dentist games and role play as dentist are effective distraction techniques as compared to conventional tell?show?do techniques which can be incorporated in day?to?day clinical practice to reduce dental anxiety in paediatric patients

Abandono do acompanhamento em saúde de bebês de mães com agravo de transmissão vertical / Abandonment of health monitoring of babies of mothers with vertical transmission grievance

RESUMO Objetivo analisar o abandono do acompanhamento em saúde de bebês de mães com agravo de transmissão vertical. Métodos estudo documental retrospectivo. Os dados foram oriundos de prontuários de crianças estratificadas como alto risco pelo Programa Rede Mãe Paranaense, devido serem filhas de mulheres com diagnóstico de sífilis, toxoplasmose ou Vírus da Imunodeficiência Humana no período gestacional, atendidas em centro de referência de atendimento materno-infantil. Para a análise dos fatores associados ao abandono do tratamento, realizou-se análise univariada e Teste Exato de Fisher com as variáveis sociodemográficas. Todos os preceitos éticos foram observados. Resultados foram analisados 136 prontuários. Os casos com maior taxa de abandono foram de filhos de mulheres com toxoplasmose e sífilis gestacional, apresentando taxas de 48,4% e 45,7%, respectivamente. Conclusão o abandono do acompanhamento de saúde dos bebês é recorrente. Os motivos de abandono frequentes foram: falta de busca ativa, falta de transporte e imprevisto familiar.

ABSTRACT Objective to analyze the abandonment of the health monitoring of babies of mothers with vertical transmission grievance. Methods a retrospective documental study. The data came from children's records stratified as high risk by the Paranaense Mother Network Program, due to being daughters of women diagnosed with syphilis, toxoplasmosis or Human Immunodeficiency Virus in the gestational period, attended in a reference center of maternal-infant care. For the analysis of factors associated with abandonment of treatment, univariate analysis and Fisher's Exact Test with sociodemographic variables were performed. All ethical precepts were observed. Results a total of 136 medical records were analyzed. The cases with the highest abandonment rate were the children of women with toxoplasmosis and gestational syphilis, presenting rates of 48.4% and 45.7%, respectively. Conclusion the abandonment of baby health monitoring is recurrent. The reasons for frequent abandonment were: lack of active search, lack of transportation and unforeseen family events.

Comportamento faltoso em serviços de saúde materno-infantil: revisão integrativa da literatura / Non-attendance in maternal-child health services: an integrative literature review

Objetivo: identificar evidências científicas acerca dos motivos de não comparecimento em consultas nos serviços de saúde materno-infantil. Método: revisão integrativa conduzida nas bases CINAHL, BDENF, Scopus, Web of Science, PubMed, EMBASE, Science Direct e BVS, sem limitação do ano de publicação, seguindo a ferramenta PRISMA. Definiu-se como população os pacientes faltosos nas consultas agendadas. Resultados: identificaram-se 308 estudos, destes selecionaram-se 63 para a leitura na íntegra e três para amostra final. Os principais motivos relacionados ao comportamento faltoso, envolveram condições socioeconômicas, acessibilidade geográfica e a compreensão dos usuários quanto à importância do comprometimento com a saúde, todas situações que podem favorecer um desfecho desfavorável ao binômio. Conclusão: concluiu-se que a escassez de artigos acerca do tema justifica a realização de novos estudos voltados ao aprofundamento acerca das dificuldades encontradas pelas famílias, a fim de traçar estratégias que auxiliem a minimizar os efeitos deletérios da falta de acompanhamento.

Objective: to identify scientific evidence about the reasons for not attending appointments at maternal and child health services. Method: integrative review conducted at the bases CINAHL, BDENF, Scopus, Web of Science, PubMed, EMBASE, Science Direct and VHL databases, without limitation of the year of publication, following the PRISMA tool. The population was defined as patients who missed scheduled appointments. Results: 308 studies were identified, 63 were selected for full reading and three for the final sample. The main reasons related to defaulting behavior involved socioeconomic conditions, geographic accessibility and users' understanding of the importance of health commitment, all situations that can favor an unfavorable outcome for the binomial. Conclusion: it was concluded that the scarcity of articles on the topic justifies further studies aimed at deepening the difficulties encountered by families, in order to devise strategies that help to minimize the harmful effects of lack of follow-up.

The Effectiveness of Using MySMS in Reducing No-show Rate in Dietetic Clinic, Hospital Sultan Ismail, Johor Bahru (Keberkesanan Penggunaan MySMS dalam Mengurangkan Kadar Ketidakhadiran di Klinik Dietetik, Hospital Sultan Ismail, Johor Bahru) / Jurnal Sains Kesihatan Malaysia

@#No-show or non-attendance at outpatient appointments are one of the most challenging operational issues in health care clinics, including dietetics outpatient clinics. No-show has a negative impact on the efficiency and effectiveness of delivery of outpatient care in a hospital setting. This can negatively affect the patient’s short term and long-term wellbeing due to missed opportunity to address the patient’s nutrition issue in a timely manner. This study aims to investigate the reasons for no-show and thus to reduce the no-show rate in diet clinic from baseline of 40.7% to standard of less than 25%. The initial phase of the study was conducted from June to September 2017 at Hospital Sultan Ismail’s diet clinic. No-show cases were identified using system data. No-show patients or guardian of no-show patients were contacted to record the reason for missing the appointments. Descriptive analysis was used to analyze the results. Strategy for change was planned and implemented to target the major reason for no-show. The pre-remedial phase result shows a no-show rate of 40.7%. A total of 102 patients were contacted (34%, n=102) to identify their reason of non-attendance to diet clinic. Paediatric patients aged 1 to 12 year-old contributed the highest percentage of no-show (37.3%, n=38). The major reasons identified for no-show are forgetting and remembered wrong appointment date (35.3%, n=36), followed by ill or admitted to ward (13.7%, n=14) and others (12.7%, n=13) such as personal issues and school examination. Remedial measure using Short Message Service (MySMS) resulted in a reduction of no-show rate to 22.2% which achieved our standard of less than 25% (p<0.05). Automated reminder using Short Message System (MySMS) is found to be effective in reducing no-show rate. Periodic audit is needed to ensure continuous effectiveness of remedial measure. Further studies need to be conducted in weighing the cost effectiveness of this method for long term run.

Serum amyloid A and muscle activity biomarkers in horses submitted to equestrian show jumping / Biomarcadores de amilóide sérica A e de atividade muscular em cavalos submetidos a salto equestre

The aim of this study was to evaluate the serum amyloid A (SAA) and biomarkers of muscle activity of horses submitted to show jumping activity. To do this, the variables SAA, glucose, lactate and the biomarkers creatine kinase (CK) and aspartate amino transferase (AST) were evaluated in 10 horses submitted to the show jumping exercise in a tournament for beginners. The evaluations occurred before exercise (T0), immediately after (T1), 30 minutes (T2), 60 minutes (T3) and 24 hours after the end (T4). Data were evaluated using analysis of variance for repeated measures. The statistical software SAEG 9.1 was used to verify the level of significance between the moments for P<0.05. Glucose presented a difference between the moments T0 (97.7±13.3mg/dL) and T1 (79.7±14.1mg/dL). Lactate presented elevation in T1 (15.3±6.1mmol/L) compared to the others T0 (3.8±0.8mmol/L), T2 (6.5±3.9mmol/L), T3 (5.3±2.2mmol/L) and T4 (5.1±1.6mmol/L). The CK showed a significant difference between T0 (82.8±51.2U/L) and T1 (140.1±58.5U/L) and between T4 (74.4±43.1U/L) with T1 (140.1±58.5U/L). The AST presented no difference between moments. The show jumping activity with one-meter obstacles did not induce changes in the SAA protein between the moments.(AU)

O objetivo deste estudo foi avaliar a amilóide sérica A (SAA) e biomarcadores de atividade muscular de equinos submetidos a atividade de salto, ou hipismo clássico. Para tanto, foram avaliadas as variáveis SAA, glicose, lactato e os biomarcadores creatina quinase (CK) e aspartatoaminotransferase (AST) em 10 equinos submetidos ao exercício de saltos em torneio para iniciantes. As avaliações ocorreram antes do exercício (T0), imediatamente após (T1), 30 minutos (T2), 60 minutos (T3) e 24 horas após o término (T4). Os dados foram avaliados utilizando análise de variância para medidas repetidas. O software estatístico SAEG 9.1 foi utilizado para verificar o nível de significância entre os momentos para P<0,05. A glicose diferenciou-se entre os momentos T0 (97.7±13.3mg/dL) e T1 (79.7±14.1mg/dL). O lactado apresentou elevação comparada com o momento T1(15.3±6.1mmol/L) e os demais T0 (3.8±0.8mmol/L), T2 (6.5±3.9mmol/L), T3 (5.3±2.2mmol/L) e T4 (5.1±1.6mmol/L). A CK mostrou diferença significativa entre T0 (82.8±51.2U/L) e T1 (140.1±58.5U/L) e entre T4 (74.4±43.1U/L) com T1 (140.1±58.5U/L). A AST não apresentou diferença entre os momentos. A atividade de hipismo clássico com obstáculos de um metro não induziu alterações na proteína SAA entre os momentos.(AU)

Comparative evaluation of the effectiveness of a mobile app (Little Lovely Dentist) and the tell-show-do technique in the management of dental anxiety and fear: a randomized controlled trial

BACKGROUND: Behavior guidance is a technique used to subdue inappropriate behavior by establishing communication that meets the needs of a child. This study aimed to measure the effectiveness of a mobile app (Little Lovely Dentist) compared to the tell-show-do (TSD) technique in managing anxious children during their first dental visit.METHODS: Fifty children (30 boys and 20 girls) without any past dental experience, aged from 7 to 11 years, were randomly allocated into either the dental app group or the TSD group. The pre- and post-operative anxiety of children who underwent prophylactic cleaning was assessed both physiologically and subjectively using a heart rate measurement and the RMS pictorial scale, respectively.RESULTS: The intragroup comparison of heart rate and RMS scores for children allocated to the dental app group was statistically significant (P value ≤ 0.001). However, a significant reduction only occurred in the RMS scores, but not the heart rate measurements, in the TSD group. Conversely, there was an increase in heart rates in the TSD group.CONCLUSION: Educating the child prior to a dental procedure using a smartphone application such as Little Lovely Dentist can significantly alleviate the anticipatory anxiety and engage children in dental treatment during their first visit.

Objetos (in)visíveis: psicanálise, espetáculo e a arte de Vik Muniz / (In)visible objects: psychoanalysis, spectacle and the art of Vik Muniz / Objeto (in)visible: psicoanálisis, espectáculo y el arte de Vik Muniz / Objets (in)visibles: psychanalyse, spectacle et l'art de vik muniz

As questões propostas neste ensaio nascem de três encontros: o primeiro, com a teoria lacaniana a respeito da constituição do sujeito a partir do campo do Outro; o segundo, com a obra de Guy Debord sobre A Sociedade do Espetáculo; o terceiro, com o trabalho do artista brasileiro Vik Muniz. O que une esses três encontros é o desejo de pensar nas relações do sujeito com o social e nas questões que suscitam a respeito do laço social em nossa sociedade capitalista, na qual visibilidade e cidadania se confundem com a capacidade de consumo. Se o sujeito depende do olhar do outro para se estruturar, e é o poder aquisitivo que, nesse contexto, lhe dá lugar no espaço público, já não basta consumir, é preciso mostrar aquilo que se consome, transformando a si mesmo em objeto consumível. Este ensaio propõe que o espetáculo, conforme o definiu Debord, é o modo como o laço social se apresenta a partir da estrutura que Lacan definiu como discurso capitalista, e que produz efeitos de reificação e de apagamento da singularidade do sujeito através da antecipação de respostas para as questões que o desejo coloca. No entanto, nem todas as imagens que vemos são iguais, nem todas estão submetidas à lógica espetacular. A arte propõe imagens a partir de outro lugar, compartilhado com a psicanálise: aquele que busca desestabilizar o eixo dos discursos prontos e das produções de sentido. E é esta também a proposta de trabalho de Vik Muniz ao criar ilusões que não iludem, mas revelam os elementos que as constituem. Assim, diante dos imperativos do espetáculo, da arte e da psicanálise, ao sustentarem a potência do nome que falta, possibilitam que o sujeito de desejo encontre brechas por onde resistir.

The questions proposed in this essay arise from three meetings: the first, with the Lacanian theory regarding the constitution of the subject from the field of the Other; the second, with Guy Debord's The Society of the Spectacle; the third, with the work of Brazilian artist Vik Muniz. What unites these three meetings is the desire to think about the relations of the subject with the social and the issues that raise about the social bond in our capitalist society, in which visibility and citizenship are mixed with the capacity of consumption. If the subject depends on the other's eyes to structure, and it is the purchasing power that, in this context, gives him place in the public space, it is not enough to consume, it is necessary to show what is consumed, transforming itself into consumable object. This essay proposes that the spectacle, as defined by Debord, is the way in which the social bond presents itself from the structure that Lacan defined as capitalist discourse, and which produces effects of reification and erasure of the singularity of the subject through the anticipation of responses to the questions that the desire poses. However, not all the images we see are the same, not all of them are subjected to spectacular logic. Art proposes images from another place, shared with psychoanalysis: the one that seeks to destabilize the axis of the ready discourses and the productions of meaning. And this is also the proposal of Vik Muniz's work in creating illusions that do not deceive, but reveal the elements that constitute them. Thus, in view of the imperatives of the spectacle, art and psychoanalysis, in sustaining the power of the missing name, they enable the subject of desire to find loopholes to resist.

Las cuestiones propuestas en este ensayo nacieron de tres encuentros: el primero, con la teoría lacaniana relacionada con la constitución del sujeto a partir del campo del Otro; el segundo, con la obra de Guy Debord sobre La Sociedad del Espectáculo; el tercero, con el trabajo del artista brasileño Vik Muniz. Lo que une estos tres encuentros es el deseo de pensar en las relaciones del sujeto con el social y en las cuestiones que suscitan a respecto del lazo social en nuestra sociedad capitalista, en la cual visibilidad y ciudadanía se confunden con la capacidad de consumo. Si el sujeto depende de la mirada del otro para estructurarse, y es el poder adquisitivo que, en este contexto, le da lugar en el espacio público, consumir ya no es lo suficiente. Es necesario enseñar lo que se consume, transformando a si mismo en objeto consumible. Este ensayo propone que el espectáculo, según definición de Debord, es el modo como el lazo social se presenta a partir de la estructura que Lacan definió como discurso capitalista, y que produce efectos de reificación y de supresión de la singularidad del sujeto por medio de la anticipación de respuestas para las cuestiones que el deseo impone. Sin embargo, no todas las imágenes que vemos son iguales, ni todas están sometidas a la lógica espectacular. El arte propone imágenes a partir de otro lugar, compartidos con el psicoanálisis: aquel que busca desestabilizar el eje de los discursos listos y de las producciones de sentido. Esta también es la propuesta de trabajo de Vik Muniz al crear ilusiones que no ilusionan, pero revelan los elementos que las constituyen. Así, ante los imperativos del espectáculo, del arte y del psicoanálisis, al sostener la potencia del nombre que falta, posibilitan que el sujeto de deseo encuentre huecos por donde resistir.

Les questions proposées chez cet essai découlent de trois rencontres: la première, avec la théorie lacanienne par rapport à la constitution du sujet à partir de l'Autre; la seconde, avec l'oeuvre de Guy Debord sur La Société du spectacle et la troisième, avec le travail de l'artiste brésilien Vik Muniz. Ce qui unit ces trois rencontres, c'est le désir de réfléchir aux relations du sujet avec le social et aux questions qui se posent par rapport au lien social dans notre société capitaliste, où la visibilité et la citoyenneté se mélangent avec la capacité de consommation. Si le sujet dépend du regard de l'autre pour se structurer, et s'il est le pouvoir d'achat qui, dans ce contexte, lui donne une place dans l'espace public, il ne suffit plus de consommer, il faut montrer ce qui est consommé, en transformant soi-même dans un objet consommable. Cet essai propose que le spectacle, tel que défini par Debord, est la manière comme le lien social se présente à partir de la structure définie par Lacan comme discours capitaliste, ce qui produit des effets de réification et d'effacement de la singularité du sujet par l'anticipation des réponses aux questions posées par le désir. Pourtant, la plupart des images qu'on voit ne sont pas identiques, elles ne sont pas toutes soumises à une logique spectaculaire. L'art propose des images à partir d'un autre lieu, ce qui est partagé avec la psychanalyse, lequel cherche à déstabiliser l'axe des discours préparés et des productions de sens. Et c'est aussi la proposition du travail de Vik Muniz, quand il croit des illusions qui ne trompent pas, mais révèlent les éléments qui les constituent. Ainsi, face aux impératifs du spectacle, de l'art et de la psychanalyse, qui soutiennent le pouvoir du nom manquant, ils permettent le sujet du désir de trouver des échappatoires où il peut résister.

Association between genetic evaluation and show-ring judging for dairy and beef cattle / Asociación entre la evaluación genética y el juzgamiento en pista de bovinos lecheros y de carne / Associação entre a avaliação genética e a aparência externa na pista de julgamento de bovinos de leite e de corte

Background: a concern for breeders is whether an animal ranking based on genetic evaluations is similar to that obtained from show-ring judging. Objective: to determine the association between rankings for Braunvieh (BR) and Brown Swiss (BS) cattle of Mexico based on show-ring judging and their respective expected progeny differences (EPDs) or predicted transmitted abilities (PTAs). Methods: ranking values from judging were transformed using the rankit transformation. For each breed, Pearson correlation analyses were performed between the transformed rank values of the animals obtained from judging at the show-ring and their EPD or PTA values. Results: using the complete databases, in both breeds the correlation coefficient estimates were low (<0.18) but different from zero (p<0.05). The correlation coefficient considering PTAs for milk yield in BS was slightly higher than those obtained for any EPD for growth traits in BR. Correlations in adult animals (0.18 to 0.23) were different from zero (p<0.05) and higher than those of young animals or calves, while those within males or females were similar. Correlations within years of judging in the show-ring were variable and did not indicate any specific trend. Conclusions: show-ring rank results are associated with genetic evaluation of animals, although the magnitude is low. Selection of breeding animals based on show-ring judgment could be used as a complementary tool to genetic evaluation.

Antecedentes: una preocupación de los criadores es si la jerarquización de los animales basada en evaluaciones genéticas es similar a la del juzgamiento en la pista. Objetivo: determinar la asociación entre la jerarquización de animales con base en el juzgamiento en pista y sus respectivas diferencias esperadas en la progenie (EPDs) o habilidades de transmisión predicha (PTAs), para animales Pardo Suizo Europeo (BR) y Americano (BS) de México. Métodos: los valores jerárquicos del juzgamiento fueron transformados usando la transformación rankit. Para cada raza, análisis de correlación de Pearson fueron realizados entre los valores jerárquicos transformados de los animales obtenidos del juzgamiento en la pista y sus valores de EPD o PTA. Resultados: usando las bases de datos completas, en ambas razas los coeficientes de correlación estimados fueron bajos (<0,18) y diferentes de cero (p<0,05). El coeficiente de correlación considerando las PTAs para producción de leche en BS fue ligeramente mayor que los obtenidos con cualquier EPD de las características de crecimiento en BR. Las correlaciones en animales adultos (0,18 a 0,23) fueron diferentes de cero (p<0,05) y mayores que las de animales jóvenes o becerros; mientras que para hembras y machos fueron similares. Correlaciones por año de juzgamiento en pista fueron variables y sin tendencia específica. Conclusiones: la jerarquización de animales usando los resultados de juzgamiento en la pista y las evaluaciones genéticas están asociadas pero en baja magnitud. La selección de animales con base en su juzgamiento en pista puede usarse como herramienta complementaria a la evaluación genética.

Antecedentes: uma preocupação dos criadores é se a classificação dos animais baseada em avaliações genéticas é similar na pista de julgamento. Objetivo: determinar a associação entre a classificação de animais baseada no julgamento em pista e suas respectivas diferenças esperadas na progênie (EDPs) o habilidades de transmissão preditas (PTAs), para as animais Braunvieh (BR) e Brown Swiss (BS) do México. Métodos: os valores de classificação dos animais durante o julgamento foram transformados por meio da metodologia rankit. Para cada raça, análises de correlação de Pearson foram realizadas entre os valores de classificação transformados obtidos pela avaliação na pista de julgamento e seus valores de EPD o PTA. Resultados: usando a base de dados completa, em ambas as raças os coeficientes de correlação foram baixos (<0,18) e diferentes de zero (p<0,05). O coeficiente de correlação considerando as PTAs para produção de leite na BS foi ligeiramente maior que os obtidos com qualquer EPD das características de crescimento na BR. Correlações em animais adultos (0,18 a 0,23) foram diferentes de zero (p<0,05) e mais elevadas do que aquelas de animais jovens ou bezerros; enquanto que para as fêmeas e os machos foram semelhantes. Correlações por anos na pista de julgamento foram variáveis e sem tendência específica. Conclusões: a classificação de animais usando os resultados na pista de julgamento e as avaliações genéticas estão associadas, mas em baixa magnitude. A seleção de animais baseada nos resultados na pista de julgamento pode usar-se apenas como ferramenta complementar à avaliação genética.

How TV programs with health information can be improved

Although the role of mass media as a communicator of health information has continuously expanded, some programs with incorrect health and medical information have negative impacts on television viewers. Public benefit, objectivity of information, and impartiality of effectiveness should be considered from the initial stage of program production in promoting public health. Furthermore, program producers, professional performers, medical associations and government organizations should redefine their roles and cooperation and setting up a mutual-assistance system is needed to produce good programs for health and medical information.

Imaginação e processos de criação na perspectiva histórico-cultural: análise de uma experiência / Imagination and creation processes within a historical cultural perspective: Analysis of an experience

Este artigo aborda a imaginação como processo psicológico fundamental do ser humano, tomando como base os trabalhos de Vigotski e seus interlocutores, e tendo como eixo reflexivo uma pesquisa-intervenção desenvolvida em uma Organização Não Governamental de arte-educação. A investigação se caracterizou pela oferta de oficinas de percussão, produção de espetáculo musical e produção de vídeo sobre esse espetáculo, tendo como sujeitos crianças e jovens de 9 a 14 anos que frequentavam a entidade. Uma análise da experiência vivida por esses sujeitos na relação com os pesquisadores toma como base a imaginação e seus desdobramentos no processo de criação. Nesse processo de criação, a experiência (re)significada pelos sujeitos vai compondo núcleos de memória, de forma que a atividade imaginativa se apresenta como um processo psicológico (re)combinador, objetivada em um novo produto.

This paper deals with imagination as a fundamental psychological process of human beings, based on the work of Vygotsky and his interlocutors. The intervention research was developed at a Non-Governmental Organization in Art Education. The investigation was characterized by offering percussion workshops, musical show production and video production about the show, to a group of 9 to 14-year-old children who attended the Non-Governmental Organization. The analysis of the experience of these subjects with the researchers was based on imagination and its developments in the creation process. In this process of creation, the (re)signified experience of the subjects forms memory cores in a way that the imaginative activity emerges as a (re)combining psychological process objectified in a new product.

Efeito do treinamento sobre a cinemática de equinos no salto de obstáculos / Effects of training on kinematic traits of jumping horses

Este trabalho teve como objetivo avaliar o efeito do treinamento sobre as variáveis da cinemática de equinos jovens da raça Brasileiro de Hipismo no salto em liberdade. Foram utilizados 14 equinos da raça Brasileiro de Hipismo com idade de 40 a 42 meses, peso vivo de 436,3±11,6kg e 448,2±12,7kg e altura na cernelha de 1,57±0,03m e 1,58±0,03m ao início e ao final do experimento, respectivamente. Os equinos realizaram dois protocolos de avaliação de salto, um antes e outro após o treinamento. O treinamento teve a duração de cinco meses e consistiu em 50 minutos de atividade física por dia, montados, sendo dois dias de flexionamento, dois dias de condicionamento físico e dois dias de trabalho específico de salto de obstáculos. Nos protocolos de avaliação, foram filmados cinco saltos em liberdade sobre um obstáculo oxer, com o primeiro e o segundo elemento na altura de 0,90m e 1,00m de altura, respectivamente, e 0,90m de largura. Foram fixados marcadores reflexivos nos equinos em pontos anatômicos utilizados como pontos de referência para a avaliação das características cinemáticas no salto. As filmagens foram realizadas com câmera de 100Hz, e as imagens, processadas no Simi Reality Motion Systems (r). Os resultados das variáveis avaliadas foram comparados com o teste de t pareado (P<0,05). O treinamento resultou no aumento das variáveis (P<0,05): velocidade da passada anterior ao salto, velocidade do salto, deslocamento horizontal da cernelha no salto, ângulo escapuloumeral, distância vertical entre as articulações escapuloumeral e metacarpofalângica, ângulo coxofemoral e ângulo femorotibial. No entanto, os valores dos ângulos umerorradial e tibiometatarsiano apresentaram redução após o treinamento (P>0,05). Conclui-se que o treinamento específico para salto com cinco meses de duração altera algumas variáveis cinemáticas dos equinos no salto de obstáculo proporcionando melhoria, principalmente, na trajetória do salto...

This study was carried out to evaluate the effect of training on the kinematic traits of young Brazilian Sport Horse in free jumping. 14 Brazilian Sport Horse were used, aged between 40 and 42 months, with body weight of 436.3±11.6kg and 448.2±12.7kg and height withers of 1.58±0.03m and 1.58±0.03m at the beginning and end of training, respectively. Two jumping evaluation protocols were used: before and after training. The training had the duration of five months and consisted of 50 minutes of exercise activities by day with a rider; two days of flexing, two days of physical conditioning and two days of specific jumping exercises. The evaluations were carried out, and five free jumps in each evaluation were record in an oxer, with the front fence of 0.90m and the back fence of 1.00m height and 0.90m of width. The horse's anatomical points were highlighted by reflective markers. The recordings were performed with 100Hz camera and the images processed in Simi Reality Motion Systems(r). The results were analyzed as paired data (P<0.05). The training increased the traits kinematics (P<0.05): last stride velocity speed prior to jumping, jumping velocity, horizontal withers displacement at jumping, scapulohumeral angle, vertical distance between scapulohumeral and metacarpophalangeal joint, coxofemoral angle and femorotibial angle. However, the kinematic traits reduced with training: humeroradial angle and tibiometatarsal angle (P<0.05). In conclusion, the jumping training with a five month duration changed some kinematic traits of free jumping in horses, especially the jumping trajectory...

The Value and Limitation of“Inside Diseases Show Signs Outside” / 浙江中医药大学学报

On the basis of defining the philosophical topic essence of“inside diseases show signs outside”and affirming its TCM application value, from the philosophical and clinical angles, it ful y analyses its limitations, i.e. unification is just one aspect of co-relation between inside and outside, appearance and essence, both opposition and integration are al and the essence of their relation, this is why the condition“inside diseases show signs outside”exists in clin-ic;on the other side, the integration of inside and outside, appearance and essence has complex to some extent, the TCM with prerequisite of “inside dis-eases show signs outside”and the method of “knowing inside with outer signs”have their own shortcomings and advantages, doctors shal foster the strengths and circumvent the weakness.

Revista do globo: as mulheres porto-alegrenses nas práticas equestres / Revista do globo magazine: Porto Alegre’s women in equestrian practices

O turfe e o hipismo são assuntos veiculados pela Revista do Globo, editada em Porto Alegre, capital do estado do Rio Grande do Sul, de 1929 até 1967. O objetivo deste estudo histórico foi identificar que representações das mulheres nas práticas equestres em Porto Alegre foram produzidas pela Revista do Globo no período de sua publicação. Realizou-se uma análise de conteúdo das reportagens da revista acerca destas práticas. As reportagens sugerem duas imagens sobre as mulheres no contexto das práticas equestres: no turfe, a presença feminina é limitada à assistência, associada à elegância, à fragilidade; no hipismo, as mulheres competem com igualdade com os homens, alcançando vitórias. Este olhar remete à análise do contexto sociocultural e político-econômico porto-alegrense que sustentou tais práticas equestres, cada qual reservando à mulher distintas possibilidades de atuação. Tais representações construídas pela revista podem resultar das distintas origens históricas e étnico-culturais do turfe e do hipismo.

Turf and show jumping are topics diffused by Revista do Globo magazine, edited in Porto Alegre, Rio Grande do Sul’s capital state, from 1929 until 1967. The aim of this study was to identify which women’s representations in equestrian practices in Porto Alegre were produced by Revista do Globo magazine in its publication period. A content analysis of the magazine´s reports about these practices was carried out. The reports suggest two images about women in equestrian practices context: in turf, feminine presence limited to assistance and to elegance and frailty. In show jumping, women, competing with equality with men, reaching victories. This magazine’s look remits to social cultural and political economical Porto Alegre´s context analysis which sustained both equestrian practices, each one reserving different possibilities of actuation to the woman. These representations constructed for women by the magazine can result from the different historical and ethnic-cultural origins of turf and show jumping.

A Case of Retinal Injury During a Laser Show

PURPOSE: To report a case of macular injury after exposure to a high energy laser beam used in a laser show. CASE: A 19-year-old female presented 2 days after exposure to a high energy laser beam at a laser show in a night club with decreased vision in her right eye. The patient's best corrected visual acuity of the right eye was hand motion. Fundus examination reveald a retinal swelling in the macular area approximately 5 disc diameter in size and a submacular hemorrhage. Fluorescein angiography of the right eye showed marked hypofluorescence in the macular area and optical coherence tomography (OCT) showed a neurosensory retinal detachment with a macular edema. Three years after exposure, the visual acuity of the right eye improved to 20/600. The fundus revealed scar and depigmented area at the macula. CONCLUSIONS: High-energy laser devices at laser shows should be used carefully with safety education and strict control and can provoke irreversible eye damage if not managed adequately.

The Usability of Infraorbital Approach on the Patients with Orbito-Zygomatic Fracture

PURPOSE: There are various approaches for open reduction surgery for orbitozygomatic fractures. After the incisions are performed, patients might have various complications. In this point of view, we conducted a retrospective study of the usability of infraorbital incision on elderly patients, generally more vulnerable to scleral show and ectropion. METHODS: In this study, 20 patients who are relatively more vulnerable to scleral show and ectropion through snap-back test having infraorbital incision were reviewed. We monitored the duration of the surgery, and complications resulted from the incision. We evaluated the scars with the researcher's observations and with the patient's level of satisfaction on a scale of 1 to 5. RESULTS: On average, 5 minutes was spent between the skin incision and the fracture exposure. No case of scleral show and ectropion occurred. One year follow-up observation revealed 4 cases of visible scars, 9 cases of barely visible scars, and 7 cases of invisible scars. The subjective satisfaction level of the patients' scar is an average of 4.0. CONCLUSION: Infraorbital incision has many advantages. First, it can reduce the complications such as scleral show and ectropion. Second, it can shorten the operation time. Third, it can diminish incision-related scars.

Treatment of Lower Eyelid Retraction

With the average life expectancy increasing and a larger percent of the population aging, more patients of an older demographics are undergoing periocular facial rejuvenation procedures. One of the most common procedures performed for periocular rejuvenation is the lower lid blepharoplasty. As interest in this type of surgery increases however, we are seeing more complications associated with this procedure. One of the most common and challenging postoperative complication after this procedure is lower lid retraction. The degree of lower lid retraction can present in a varying range from lateral canthal rounding and scleral show to cicatricial ectropion. Causes of lower eyelid retraction seem to be multifactorial and there are a variety of surgical approaches for correction of lower eyelid retraction. According to the cause and degree of lower lid retraction, the author must incorporate a customized approach for each deformity. In this study, 33 patients had corrective surgery to treat lower eyelid retraction between July 2004 and June 2006. Of these, only one patient presented for primary correction all others were secondary cases. Techniques used to correct lower lid retraction included a midface lift, a lateral canthopexy or canthoplasty, an oculi muscle suspension, or a spacer graft. There was noted improvement in all cases performed, however a mild degree of recurrence was noted in 6 cases. To effectively correct lower lid retraction, the surgeon must have a sound understanding of the anatomy of the lower eyelid. Technically, key essential fundamentals to correcting lower lid retraction include: knowledge of elevating the mid face, anchoring the lateral canthal tendon securely, and proper insertion of the spacer graft. This article presents multiple techniques to correct significant postsurgical lower lid malposition without the use of skin grafts.

Lower Eyelid Retraction and Scleral Show induced by Subciliary Approach in Inferior Orbital Rim Fracture

PURPOSE: The objective of this study is to prevent postoperative lower eyelid retraction and scleral show. There are several approaches for orbital rim reconstruction. But these techniques are sometimes difficult to perform, and have some merits and faults. Maybe most common unwanted and unpleasant result that we have experienced by subciliary incision preseptal approach is the lower eyelid retraction and the scleral show. Therefore, I want to find out the causes and the solutions for such complication. We must know the mechanics for those unpleasant result first of all. METHODS: We conducted a comparison of postoperative photographs between retroseptal approach group and preseptal approach group, both with subciliary incision. In experimental retroseptal group, incision was applied at subciliary region. After elevating skin flap to preserve pretarsal muscle, not with muscle flap elevation, but direct oblique incision through the muscle, retroseptal dissection was applied to the ROOF and the septum. Fixating fracture line, periosteal and septal repair was followed by skin repair. The light compressive dressings and protection were kept in place for 7 days. The effectiveness of this operative method was made comparison with control group which the preseptal approach was applied to, by postoperative 2nd week and 2nd month. RESULTS: Author's technique had been used in 20 patients and control group was composed of 50 patients over 19months period. There were better results in experimental group than in control group and all of experimental group had no complaint about the lower eyelid retraction and the scleral show. CONCLUSION: It must be known about the reason of the lower eyelid retraction and the scleral show induced by subciliary and preseptal approach. Mechanically it can be easily proved. And the solution maybe will be easier if we get more information about the mechanics. I recommend the retroseptal subciliary approach

Efficacy of Topiramate Using Lower Dose and Slower Dose-Titration in Refractory Partial Epilepsies: A Multicenter Open Clinical Trial / 대한간질학회지

PURPOSE AND BACKGROUND: Korean Topiramate Study Group (KTSG) was organized to evaluate the efficacy and safety of lower dose (300 mg/day) and slower dose-titration of topiramate as add-on therapy in medically intractable partial epilepsies. METHODS: This study was a multicenter open clinical trial consisting of each 8 weeks of baseline phase, titration phase, and maintence phase. The patient should have partial epilepsies refractory to the maximally tolerable doses of one to two antiepileptic drugs and should have at least two or more episodes of clinical seizures every 4 weeks during the baseline phase. The target dose of topiramate (TPM) was 300 mg/day. TPM was started at the initial dose of 25 mg/day and increased by 25 mg/day every week until 100 mg/day was reached. Thereafter, the dose was increased by 50 mg/day every week. RESULTS: A total of 213 patients entered to the titration phase, 198 patients entered to the maintenance phase, and 182 patients finished the trial as planned. Median baseline seizure frequency was 3.7 episodes/4 weeks which was decreased to 2.1 episodes/4 weeks after the introduction of TPM. Median seizure frequency reduction rate (MSFRR) was 44.8%, responder rate was 47.6% and seizure free rate (SFR) was 9%. Adverse events (AE) occurred in 22% of patients with dizziness being the most common (10.0%). Premature withdrawl from the study due to AE occurred in 13 patients (6.1%). CONCLUSION: TPM 300 mg/day was as effective as TPM 600 mg/day and safety was markedly improved by a slower dose titration. We did not find any dose-response relationship of TPM in this study.