Revisitando a agressividade / Revisiting aggressivenesss

Este artigo trata do tema da agressividade dentro do pensamento freudiano, no âmbito tanto da primeira quanto da segunda teoria pulsional. é considerada a relação entre masculinidade e agressividade bem como as relações de dominação, através de contribuições de autores pós-freudianos.

This paper addresses the issue of aggression within Freudian thinking, at both the first and the second drive theory. The relationship between masculinity and aggressiveness is taken into account, as well as the relations of domination, through the contribuitions od post-Freudian auhors.

Review of the use of physical restraints and lap belts with wheelchair users.

Wheelchair-related physical restraints, lap belts, and other alternatives are intended to provide safe and adequate seating and mobility for individuals using wheelchairs. Physical restraints and lap belts are also helpful for positioning people in their wheelchairs to reduce the risk of injury during wheelchair tips and falls. However, when used improperly or in ways other than intended, injury or even death can result. Although widely prescribed, little evidence is available to direct professionals on the appropriate use of these restraints and lap belts and for whom these restraints are indicated. The purpose of this study was to conduct a review of available literature from 1966-2006 to identify the risks and benefits associated with lap belts while seated in wheelchairs. Twenty-five studies that met the inclusion criteria were reviewed. Nine studies reported the frequency of asphyxial deaths caused by physical restraints, nine studies reported the long-term complication and indirect adverse effects of physical restraints and lap-belt use, and seven studies reported the benefits of physical restraints and lap belts with individuals using wheelchairs. Despite the weak evidence, the results suggest a considerable number of deaths from asphyxia caused by the use of physical restraints occurred each year in the U.S. The majority of the deaths occurred in nursing homes, followed by hospitals, and then the home of the person. Most deaths occurred while persons were restrained in wheelchairs or beds. Based on that, caution needs to be exercised when using restraints or positioning belts. In addition, other seating and environment alternatives should be explored prior to using restraints or positioning belts, such as power wheelchair seating options. Positioning belts may reduce risk of falls from wheelchairs and should be given careful consideration, but caution should be exercised if the individual cannot open the latch independently. Also, the duration of use of the physical restraint should be limited. Therefore, several factors should be considered when devising a better quality of physical-restraint services provided by health care professionals. These efforts can lead to improved safety and quality of life for individuals who use wheelchairs.

Is the Advanced Trauma Life Support simulation exam more stressful for the surgeon than emergency department trauma care?

BACKGROUND: Stress affects surgeons both during training and during professional activity. OBJECTIVE: To compare stress levels affecting surgical residents during the simulated initial assessment and management in the Advanced Trauma Life Support practical exam vs initial assessment and management of trauma patients in the emergency room. METHOD: Eighteen surgical residents were evaluated under basal conditions, during the Advanced Trauma Life Support simulation, and during emergency room initial care. Heart rate, systolic arterial pressure, and diastolic arterial pressure were measured. The Student t test was used to test for differences between means, with statistical significance declared when P < .05. RESULTS: Heart rate and systolic arterial pressure were increased at the beginning and at the end of Advanced Trauma Life Support simulation and emergency room initial care. Diastolic arterial pressure was only increased at the end of the Advanced Trauma Life Support simulation. Comparing values obtained during the Advanced Trauma Life Support simulation with those obtained during emergency room initial care, heart rate and systolic arterial pressure were significantly higher during the Advanced Trauma Life Support simulation both at the beginning and end of the test events. However, diastolic arterial pressure was only significantly higher for Advanced Trauma Life Support simulation compared emergency room at the end of the procedures. These results suggest that the simulation in the practical exam portion of the Advanced Trauma Life Support course is more stressful for the resident surgeon than is the actual initial assessment and care of trauma patients in an emergency room.

Is the advanced trauma life support simulation exam more stressful for the surgeon than emergency department trauma care?

OBJETIVO: Comparar os níveis de stress que afetam os residentes de cirurgia durante a avaliação inicial simulada nos cursos Advanced Trauma Life Support versus a avaliação do trauma do paciente na sala de emergência. MÉTODO: Dezoito residentes em cirurgia foram avaliados em condições basais no curso de Advanced Trauma Life Support e na sala de emergência. Foram medidas a freqüência cardíaca, pressões arterial sistólica e diastólica. ESTATÍSTICAS: Teste t do Estudante. Significantemente p<0.05. RESULTADOS: No início da avaliação no Advanced Trauma Life Support, a freqüência cardíaca e pressão arterial sistólica foram mais altas do que (e pressão arterial diastólica foi similar a) os valores basais respectivos; no começo da avaliação na sala de emergência foram observadas respostas similares. No fim da avaliação no Advanced Trauma Life Support e na sala de emergência, os valores de freqüência cardíaca, pressão arterial sistólica e pressão arterial diastólica foram maiores do que no começo, exceto que a pressão arterial diastólica não variou significantemente durante a avaliação inicial na sala de emergência. Comparando os dois procedimentos, observa-se que o Advanced Trauma Life Support produziu elevações significativamente maiores de freqüência cardíaca e pressão sistólica tanto no inicio quanto no final dos respectivos procedimentos. Esses resultados sugerem que a avaliação inicial simulada no curso Advanced Trauma Life Support é mais estressante para o cirurgião do que no cuidado inicial de pacientes com trauma na sala de emergência.

Assessing the influence of wheelchair technology on perception of participation in spinal cord injury.

OBJECTIVE: To investigate factors related to the wheelchair, impairment, and environment that affect perception of participation of persons with spinal cord injury (SCI) in activities performed in 3 settings: in the home, in the community, and during transportation. DESIGN: Cross-sectional study. SETTING: Research centers and a specialized assistive technology (AT) clinic in Pittsburgh (Pitt). Research centers and community-based rehabilitation technology suppliers in Saint Louis (SL). PARTICIPANTS: Seventy wheelchair users with SCI. INTERVENTIONS: Subjects from Pitt and SL completed a written survey of AT usage in daily activities. MAIN OUTCOME MEASURES: Subjects were asked 5 questions within each setting (home, community, transportation) related to their perceived reason for functional limitations. RESULTS: The wheelchair was the most commonly cited factor limiting participation, followed by physical impairment and physical environment. Twenty-one percent of subjects with paraplegia reported pain as a limiting factor for their transportation use, significantly more (P=.047) than subjects with tetraplegia (3%). A trend (P=.099) was seen toward a higher percentage of subjects with tetraplegia (tetraplegia, 7%; paraplegia, 3%) reporting lack of equipment as a limiting factor for use of transportation. Differences were also seen across sites. CONCLUSIONS: The wheelchair was the most commonly cited limiting factor, followed by physical impairment and physical environment. The wheelchair is the most important mobility device used by persons with SCI and the one that users most associate with barriers.

Integrated control and related technology of assistive devices.

Assistive devices are now available that allow persons with severe physical disabilities to complete tasks independently. When the user has severe physical limitations, it may be advantageous to have an integrated control system where a single control interface (e.g., joystick, head switches, voice recognition system, keypad) is used to operate two or more assistive devices (e.g., power wheelchairs, augmentative communication devices, computers, environmental control units, and other devices that are controlled electronically). The advantages of integrated control are that persons with limited motor control can access several devices with one access site without assistance, and the user does not need to learn a different operating mechanism for each device. The purpose of this review is to convey the depth and breadth of the research that has been conducted on integrated control systems, as well as to provide some insights into future directions. We reviewed research works pertaining to communication and environmental control, computer access, and wheelchair guidance systems. Information gathered in this study will help people become fully aware of the status of contemporary integrated control technology in order to increase the quality of life of people who use electronic assistive devices.

A construção de um contexto de conversação reflexiva com um grupo da "terceira idade" em um curso de atualização cultural

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Desejo masculino de maternidade: texto inspirado em um conto de Jorge Luis Borges / Masculine yearning for maternity: text inspired by a tale by Jorge Luis Borges

Através de passagens do conto Ruínas Circulares, que enunciam o 'propósito sobrenatural' de um homem de conceber outro homem em sonhos, são discutidas concepções freudianas de feminino e masculino. Levando em consideração a inveja do pênis como organizadora da feminilidade e o papel da 'teoria' cloacal no imaginário da masculinidade, e levantada a hipótese de um 'desejo masculino de maternidade' (AU)

Desejo masculino de maternidade: texto inspirado em um conto de Jorge Luis Borges / Masculine yearning for maternity: text inspired by a tale by Jorge Luis Borges

Através de passagens do conto Ruínas Circulares, que enunciam o "propósito sobrenatural" de um homem de conceber outro homem em sonhos, são discutidas concepções freudianas de feminino e masculino. Levando em consideração a inveja do pênis como organizadora da feminilidade e o papel da "teoria" cloacal no imaginário da masculinidade, e levantada a hipótese de um "desejo masculino de maternidade"

Mulher e exclusao: sentidos da subjetividade castrada

O presente artigo aborda uma perspectiva de feminilidade decorrente do complexo de castracao sinalizando aspectos relativos a identificacao e a tematica do narcisismo. E considerada a constituicao do sujeito feminino frente a diferenca de generos e a exclusao da mulher.