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Background and study aims A comparative study was conducted to evaluate the efficacy of argon plasma coagulation (APC) therapy in treating post Roux-en-Y gastric bypass (RYGB) weight regain and the incidence of complications related to this procedure, using a sham treatment group as a control. Patients and methods Forty-one patients with a minimum weight regain of 10 kg and a minimum postoperative time of 36 months were randomized into two groups. Results In the APC group (n = 21), the mean initial weight was 100.4 kg and the mean weight regain was 24.94 kg. In the sham group (n = 20), the mean initial weight was 103.65 kg, and the mean weight regain was 25.18 kg. Anastomotic stenosis occurred only after the first APC session. The results for the comparison of APC with the sham group showed a percentage weight regain loss of 63.95 compared to -.65, and weight loss of 15.02 and –0.57), percentage total weight loss of 14.46 and –0.62, excess weight loss of 54.32 % and –2.34 %), and BMI reduction of 5.38 and –0.21, with P

The state military police of the Brazilian state of São Paulo (PMESP) has the lowest number of police officers in the institution since the 1990s, compared to itself, with a vast number of unpaid leave and resignation requests. Low salaries appear to be a reason, but the police say that this is not the only factor to be rectified; lack of recognition and difficulties in overcoming trauma are also frequently mentioned. This picture refers to a situation that can be understood as low motivation, loss of meaning, and psychological suffering. This study aimed to understand whether there is a general loss of meaning at work in PMESP, together with well-being and psychological suffering. Using structural equation modeling, the study sought to understand the factors that give meaning to the work of these professionals and their consequences for well-being and psychological distress at work. Social usefulness and learning and development opportunities showed a meaningful relationship with meaning of work, with learning and development opportunities being the most important for the surveyed military police officers. Regarding the consequent constructs of meaning of work, significant relationships between psychological well-being at work and psychological suffering were verified. The study indicates that when meaning is constructed (via social utility and learning), there is an increase in psychological well-being, as well as a decrease in the effect of psychological suffering. [ABSTRACT FROM AUTHOR]

Purpose – This study aims to identify the countries’ innovation factors that are determinant for them to achieve higher levels of development. In addition, the research identified which of these factors should be prioritized so the countries can move up in the rank of the most competitive. Design/methodology/approach – The study used the indicators of innovation and the stage of development of 137 countries proposed by the Global Competitiveness Report published by the World Economic Forum and techniques of multivariate data analysis. Findings – The results indicated that all the factors tested are determinant to lead the countries throughout their stages of development. The research highlights that the factors “Quality of scientific research institutions” and “Patent Cooperation Treaty (PCT) patent applications” should be equally prioritized for the countries’ development. Practical implications – The results suggested that the factors Capacity for Innovation, Quality of Scientific Research Institutions, Company Spending on Research and Development (R&D), University–Industry Collaboration in R&D, Government Procurement of Advanced Technology Products, Availability of Scientists and Engineers and PCT Patent Applications are decisive for positioning countries in terms of their stage of development and should be part of their public policy and enterprises’ strategic planning. Originality/value – The findings show that countries should prioritize the factors Quality of Scientific Research Institutions and PCT Patent Applications, as these factors, when acting together, predict the evolution to higher stages of development.

ABSTRACT Background: Abdominal obesity or android obesity, that is, the increase in adipose tissue in the abdominal region, is considered a risk factor for several morbidities. Different ways of quantifying it have been proposed, one method is the measurement of the abdominal fat area by computed tomography. Aim: To establish correspondence between the groups defined by degree of obesity in relation to the total, subcutaneous and visceral fat area. Methods: Cross-sectional observational study carried out through the analysis of tomographic examinations. Horos v3.3.5 medical image visualization software was used, with abdominal tomography in a single cut including the L4 vertebral body and the umbilical scar, to obtain the areas of total, visceral and subcutaneous fat. Results: Of the 40 patients, 10 had grade II obesity, 23 grade III and 7 superobese. The amount of total fat showed an increase in relation to the degree of obesity. Visceral fat did not show significant differences between the degrees of obesity, but the data showed a lower average in the group of obesity grade II. The area of subcutaneous fat, as well as total fat, showed an increase in its measurements, according to the progression of the patients’ BMI, but there was no statistical significance in this difference between the groups of grade II and super-obese individuals. Conclusion: The area of total and subcutaneous fat showed an increase in its measurements according to the progression of the BMI groups, which did not happen with visceral fat.

Research on olfactory stimulation indicates that it can influence human cognition and behavior, as in the perception of facial expressions. Odors can facilitate or impair the identification of facial expressions, and apparently its hedonic valence plays an important role. However, it was also demonstrated that the presentation of happiness and disgust faces can influence the emotional appraisal of odorants, indicating a bilateral influence in this phenomenon. Hence, it's possible that odor influences on emotional categorization vary depending on the intensity of expressions. To investigate this hypothesis, we performed an emotion recognition task using facial expressions of five emotional categories (happiness, fear, disgust, anger and sadness) with ten different intensities. Thirty-five participants completed four blocks of the task, each with a different olfactory condition, and we found that odorants' effects varied according to the facial expressions intensity. Odorants enhanced the Reaction Time (RT) differences between threshold and high-intensity expressions for disgust and fear faces. Also, analysis of the RT means for high-intensity facial expressions revealed that the well-known advantage in recognition of happiness facial expressions, compared to other emotions, was enhanced in the positive olfactory stimulation and decreased in the negative condition. We conclude that olfactory influences on emotional processing of facial expressions vary along intensities of the latter, and the discrepancies of past research in this field may be a result of a bilateral effect in which the odorants influence the identification of emotional faces just as the facial expressions influence the emotional reaction to the odor.

Esta pesquisa, de abordagem qualitativa e quantitativa, procura refletir sobre os métodos avaliativos utilizados antes e durante o período de distanciamento social provocado pela pandemia de covid-19, utilizando uma rede pública de instituições de ensino superior profissional do estado de São Paulo como objeto de estudo. A partir do referencial teórico e do questionário enviado aos docentes e gestores da rede, a percepção dos respondentes acerca da avaliação do processo de aprendizagem dos alunos das graduações tecnológicas, em comparação a procedimentos utilizados antes das medidas de isolamento, sugere a necessidade de revisão sobre a prevalência de conteúdos a serem avaliados e reflexão sobre a mensuração dos resultados esperados dos alunos de cursos superiores de educação profissional.

Purpose – This study seeks to investigate whether a good management environment in companies determines results in terms of country competitiveness. Additionally, it aims to verify if innovation plays a role in contributing to this. Design/methodology/approach – The study used structural equation modeling and data on 138 countries contemplated in The Global Competitiveness Report 2016/2017 (2016 World Economic Forum). A number of theories have been used to relate competitiveness to innovation and to management practices. This discussion was expanded, taking these variables into account in a more comprehensive framework. Findings – The analysis performed indicates the role of best management practices as a mediator in the relationship that exists between innovation and global competitiveness, which reinforces the importance of a good level of management Originality/Value- There have been many studies and discussions about global competitiveness. The factors in the literature used to explain a country´s degree of competitiveness include cheap labor, abundant raw materials, the amount of capital available for investment, and, especially, the capacity to innovate. Some authors point to a fifth factor: best management practices. The paper shows how this factor improves competitiveness. The most important contribution of this study is to demonstrate that innovation alone cannot by itself ensure competitiveness in companies or nations, and requires the simultaneous presence of best management practices.

IntroductionIn this study we compared the effects of a mindfulness-based intervention (MBI) with a story reading intervention (SI) on the executive functions and psychological profile of children in two different public schools in São Paulo, Brazil.MethodsIn this controlled clinical trial, 207 children aged 8 to 9 years old responded to the Five-Digit Test (FDT), stress levels, depression, anxiety, positive and negative affect, at baseline (T0) and 8 weeks later (T1). From T0 to T1, school 1 participated in MBI classes and school 2 in IS classes.ResultsIn school 1 (MBI), children improved their scores on all tests except reading (errors) and counting (errors) compared with school 2. No differences were observed between groups in terms of emotional health.ConclusionIt is feasible to implement MBI or SI in Brazilian public schools. Students in the MBI group presented broader effects in executive functions, while students in the SI group showed a trend toward reduced negative affect and depression symptoms.

ABSTRACT Background: As the number of bariatric operations increases, there is a greater interest in knowledge, experience and skills in the operative and anesthetic management of obese people. Anesthetic recovery is an important point in the therapeutic approach and less adverse effects delaying discharge of these patients are necessary to be kept in mind by the surgical team. Aim: To compare anesthetic-analgesic techniques in the opioid-sparing era through epidural administration of local anesthetic associated with low-dose morphine vs. clonidine and analyze the impact of analgesia on the effectiveness of postoperative recovery by comparing these two techniques. Methods: Randomized, double-blind clinical trial with 66 patients candidates for Roux-en-Y gastrojejunal bypass divided into two groups: morphine group and clonidine group. Multimodal analgesia included epidural anesthesia with 0.375% ropivacaine 20 ml at the eighth thoracic vertebra with the association of morphine (morphine group) at a dose of 15 mcg / kg or clonidine (clonidine group) at a dose of 1 mcg / kg. Results: The groups were homogeneous and statistical significance was found when analyzing the difference in pain between them in the first postoperative period. The pain was higher in the clonidine group, as in this period, analgesic rescue was also better in this group. In the other times, there was no significance in the differences regarding pain and rescue. The return of intestinal motility in the morphine group was earlier in the first postoperative period. Nausea, vomiting and hospital discharge did not show significant differences between groups. Conclusion: Epidural anesthesia with low-dose morphine allowed less pain during the entire hospital stay, with a positive impact on patient recovery.

Abstract Background Women have been assuming more responsibilities and higher positions in major companies, which exposes them to high levels of stress. Higher perceived work stress is related to higher emotional reactivity. Difficulties with emotional regulation can lead to anxiety and mood disorders, which are more prevalent in women than men. Indeed, women leaders are more likely to experience emotional fatigue than men due to excessive empathy. Our aim was to evaluate the associations between self-compassion (SC) scores to depression symptoms, perceived stress and mindfulness, as well as with brain responses to high-arousal unpleasant and pleasant pictures from the International Affective Picture System (IAPS), as measured through functional Magnetic Resonance Imaging (fMRI) in women managers. Methods Forty-six participants were selected for the study. All participants filled the Self Compassion Scale (SCS), Beck Depression Inventory (BDI), Mindful Awareness Attention Scale (MAAS) and the Perceived Stress Scale (PSS). After that they were scanned during an fMRI affective response paradigm. Correlation analysis were performed among these variables. Results Our data suggest that women with higher SC scores respond to affective stimuli with higher activation of the precuneus (a brain region related to self-referential processing), lower levels of stress and depression and show greater attention in everyday activities. Conclusion SC may be an important characteristic for women leaders because of its association with higher sensitivity to emotional stimuli and mindfulness. These skills may allow them to be more aware of others while being less susceptible for stress and depression symptoms.

Purpose: As cancer burden has risen worldwide, physicians, patients, and their advocates have become aware that the clinical cancer trial research paradigm is not ubiquitous. Furthermore, the number and characteristics of trials that are registered in low- and middle-income countries (LMICs) compared with that in high-income countries (HICs) are unknown. Methods: We collected retrospective data on trials for breast, lung, and cervical cancer registered in ClinicalTrials.gov or with the WHO International Clinical Trial Registry Platform between 2010 and 2017. The data were then classified as trials within LMICs or HICs using definitions from the World Bank. Results: Included in these analyses were 6,710 trials, of which 3,164 (47%) were breast cancer trials, 3,283 (49%) were lung cancer trials, and 263 (4%) were cervical cancer trials. There were 1,951 (29%) trials from LMICs and 4,759 (71%) trials from HICs (P < .001). Although the proportion of phase III trials in HICs versus LMICs was similar (18% v 17%; P = .66), the number of phase I trials in LMICs was significantly lower than that of HICs (20% v 2%; P < .001). For several LMICs with the highest mortality-to-incidence ratios for breast, lung, or cervical cancer, there were no cancer trials registered in the registration data bases searched for this work. Conclusion: There are differences in access to cancer clinical trials in LMICs compared with HICs. Several factors, such as excessive cost and a lack of infrastructure and expertise, may explain these differences.

In recent years concerns have been expressed about the impact of products on the environment. Consumers and manufacturers have directed their attention to environmentally friendly products, energy-saving actions, organic food products, lead-free inks, recyclable paper, non-phosphate detergents, among others. This survey provides a brief review of environmental issues and identifies consumers' sustainable purchasing behavior, their level of awareness about environmental issues and green products according to the variables accessibility, sustainable awareness, brand, price and quality. The data collection was performed with an electronic questionnaire, obtaining 302 respondents. Results revealed that brand is the factor with the greatest influence on sustainable purchasing behavior, not having a concern with price and quality. Accessibility to sustainable products and sustainable consumer awareness also influence their product acquisition practices.

Este artigo apresenta uma matriz metodológica para análise de anúncios publicitários em websites, e a sua construção está embasada nas teses de Marshall McLuhan e Neil Postman, sob a vertente ecológica, e também nas propostas de Pinho, Sebastião, McMillan, Fernandes e Duarte. A matriz foi construída utilizando a cartografia como estratégia metodológica, pois permite acompanhar os movimentos de transformação da paisagem e seus resultados evidenciam que as possibilidades oferecidas pela tecnologia são responsáveis por mudanças nas práticas publicitárias, considerando-se que a cada novo aspecto inserido, novas experiências foram proporcionadas e a publicidade foi construindo o seu espaço na web.

Resumo Servidores públicos comprometidos e orientados por valores do éthos público é um dos principais desafios da gestão de pessoas. Conhecer o que lhes dá sentido ao trabalho pode ser um caminho para ações pertinentes, fora de estigmas e más interpretações sobre a relação entre o indivíduo e seu trabalho no setor público. O propósito deste artigo é avaliar os fatores antecedentes da experiência de sentido do trabalho, bem como sua relação com bem-estar psicológico, sofrimento psicológico e comprometimento afetivo em peritos criminais da Polícia Federal. Trata-se de pesquisa de natureza quantitativa, com uso de análise fatorial confirmatória e modelagem de equações estruturais. Os resultados indicam que os peritos veem sentido em seu trabalho, o qual advém de sua utilidade social e das oportunidades de aprendizagem e desenvolvimento. O sentido está positivamente relacionado com bem-estar psicológico e comprometimento afetivo e negativamente com sofrimento psicológico. São discutidos os resultados da aplicação do modelo à luz de um marco de responsabilidade gerencial para desenvolvimento da função pública e conclui-se que ele oferece boa contribuição para gestão de pessoas no setor público possibilitando discutir fatores que favorecem a experiência de comprometimento e qualidade de vida psíquica no ambiente de trabalho.

This academic work features a case study about the flows of P-13 containers among supply markets of a Distribution Company of LPG. The study was performed considering the supply in Minas Gerais (MG) state, and with the analysis of supply of the companies, and it was concluded that there are two regions where the flow of containers occurs: one of them is the border region of Espírito Santo state and another is the border region of Rio de Janeiro (RJ) state. An inside flow to MG was observed, with an average flow of 5,356 containers per month. In the second region, the flow was observed in the other direction, to RJ, and an average flow of 14,011 containers leaving MG per month. These quantities were determined using concepts of Average Sales by Region of all companies, Return Percentage of other brand containers after the return of empty ones, as well as considering all companies, and Market Share by region of supply. The study shows the impact that the supply gap among the companies can generate in the reverse logistics of the enterprises studied, especially when the containers are moved from one region to the other.

Meditation and positive psychology have been reported as promising approaches to deal with stress. This exploratory pilot study aims to evaluate the efficacy of meditation and positive psychology-based intervention on stress. Two experiments are reported; in the first one, 29 healthcare professionals were included (intervention = 14; control = 15), and the second one included 57 women managers (intervention = 27; control = 30). All participants were evaluated before and after eight weeks for levels of stress, anxiety, depression, and psychiatric symptoms. In Experiment 1, intervention group participants showed a reduction in stress levels and anxiety symptoms, and in Experiment 2, participants in the intervention group showed a decrease in stress, psychiatric symptoms, and sleep quality, when compared to the control group. A multi-component intervention based on positive psychology and meditation practices was effective at reducing stress as well as improving related stress parameters such as anxiety, psychiatric symptoms, and sleep quality.

The original purpose of this study was to conduct an exploratory analysis of the meaning of work to nursing professionals, comparing meanings by hierarchical level (non-degree and college-degreed levels) and by characteristics of the work environment. We applied a structured questionnaire containing scales for the meaning of work, affective commitment, and work stress. Results were treated with descriptive statistics, exploratory factor analysis, correlation analysis, and mean comparison, and confirmed that hierarchical level and work environment define differences in the perception of work meaning and related constructs. Since our field work demanded long hours of permanence in hospitals, the study was enriched with observations and conversations. This combination of methods allowed expanding the knowledge about the factors that elicit experiencing the meaning of work in nursing. Meaning can emerge from factors such as increase in employability, social distinction, work-family harmonization, and the nature of the relationship with managers and leaders. Loss of meaning can cause a drop in productivity and be associated with resistance behaviors or even retaliatory behaviors in the form of absenteeism and changing jobs.

Background and study aims Obesity is a serious disease, resulting in significant morbidity and mortality. Intragastric balloons (IGBs) have been in use since the 1980s. After the insertion of an IGB, complications such as migration of the device and even severe gastric perforation can occur, requiring laparoscopic surgery. Here, we report three cases of gastric perforation after IGB insertion. In all three cases, the perforation was successfully repaired through an exclusively endoscopic approach.

Background: Weight regain occurs in about 20% of patients after Roux-en-Y gastric bypass (RYGB). Studies have reported that in most cases this regain is associated with dilatation of the gastrojejunal anastomosis. To correct this dilatation, one of the methods used is the application of argon plasma coagulation (APC). Case: The authors report the case of a 39-year-old woman submitted to RYGB who had weight regain. In the endoscopic evaluation, the patient presented with dilatation of the gastrojejunal anastomosis, for which treatment with APC and an adjusted diet was proposed. After 3 sessions of APC, the patient presented with a reduction of the anastomosis diameter, weight loss, and increased satiety to food, with an increased gastric emptying time evidenced by scintigraphy. Conclusion: APC proved to be a safe and efficacious method.

Atualmente métodos de investigação de usabilidade desempenham papel significativo durante o ciclo de desenvolvimento de um produto, uma vez que tal construto pode ser um indicador de maior ou menor adequação dos consumidores aos novos lançamentos e consequentemente sobre sua decisão de compra. O objetivo deste trabalho foi a identificação da influência de gênero, idade, escolaridade e renda failiar na usabilidade de telefones celulares no mercado brasileiro. A coleta de dados foi realizada por qeustionário adaptado com vistas à avaliação de produtos eletrônicos móveis, verificando-se a usabilidade em seus seis componentes hierárquicos (Facilidade de Aprendizagem e Uso, Disponibilidade e Capacidade de Resolver Problemas, Aspectos Afetivos e Propriedades Multimidia, Comandos e Mínima Carga de Memória, Controle e Eficiência, e Tarefas Típicas para Telefone Celular). Gênero e idade foram as variáveis que se mostraram com maior poder de influência. A Facilidade de Aprendizagem e Uso não mostrou a unifatorialidade mostrada no trabalho original e deve ser motivo de futuros estudos, pois aparentemente o construto contém os fatores Facilidade de Aprendizagem, Ferramentas Oferecidas pelo Aparelho e Facilidade de Uso todos juntos sob o mesmo guarda-chuva, o que não se mostrou uma verdade estatística.

One of the main problems faced by large retailers is related to the lack of supply in display racks, the so called stock-out points. Studies have been made since the sixties, which show that progress related to this subject is limited. Stock-out levels are around 8.3%. Furthermore, literature on the subject is insufficient, as very few studies have been dedicated to investigating the causes of stock-out. The present study aims to collect stock-out data from a large textile retailer for a product category and elaborate a tree of stock-out causes. Qualitative and quantitative methods were used in this research, through software and interviews, in order to generate and refine our results. From this approach, it was possible to identify that 38% of the causes of stock-outs are within the store, that is, the product is not available in the sales area, but in the back end.

The Hedgehog pathway (HhP) plays an important role in normal embryonic development and its abnormal function has been linked to a variety of neoplasms. Recently, the complex mechanisms involved in this pathway have been deciphered and the cross talks with other important pathways involved in carcinogenesis have been characterized. This knowledge has led to the development of targeted therapies against key components of HhP, which culminated in the approval of vismodegib for the treatment of advanced basal cell carcinoma in 2012. Since then, other compounds have been developed and evaluated in preclinical and clinical studies with interesting results. Today, several medications against components of the HhP have demonstrated clinical activity as monotherapies and in combination with cytotoxic treatment or other targeted therapies against mitogenic pathways that are linked to the HhP. This review aims to clarify the mechanism of the HhP and the complex crosstalk with others pathways involved in carcinogenesis and to discuss both the evidence associated with the growing number of medications and combined therapies addressing this pathway and future perspectives.