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UnlabelledAccurate patient risk perception of adverse health events promotes greater autonomy over, and motivation towards, health-related lifestyles.IntroductionWe compared self-perceived fracture risk and 3-year incident fracture rates in postmenopausal women with a range of morbidities in the Global Longitudinal study of Osteoporosis in Women (GLOW).MethodsGLOW is an international cohort study involving 723 physician practices across ten countries (Europe, North America, Australasia); 60,393 women aged ≥55 years completed baseline questionnaires detailing medical history and self-perceived fracture risk. Annual follow-up determined self-reported incident fractures.ResultsIn total 2,945/43,832 (6.8%) sustained an incident fracture over 3 years. All morbidities were associated with increased fracture rates, particularly Parkinson's disease (hazard ratio [HR]; 95% confidence interval [CI], 3.89; 2.78-5.44), multiple sclerosis (2.70; 1.90-3.83), cerebrovascular events (2.02; 1.67-2.46), and rheumatoid arthritis (2.15; 1.53-3.04) (all p < 0.001). Most individuals perceived their fracture risk as similar to (46%) or lower than (36%) women of the same age. While increased self-perceived fracture risk was strongly associated with incident fracture rates, only 29% experiencing a fracture perceived their risk as increased. Under-appreciation of fracture risk occurred for all morbidities, including neurological disease, where women with low self-perceived fracture risk had a fracture HR 2.39 (CI 1.74-3.29) compared with women without morbidities.ConclusionsPostmenopausal women with morbidities tend to under-appreciate their risk, including in the context of neurological diseases, where fracture rates were highest in this cohort. This has important implications for health education, particularly among women with Parkinson's disease, multiple sclerosis, or cerebrovascular disease.

UnlabelledWe evaluated healthcare utilization associated with treating fracture types in >51,000 women aged ≥55 years. Over the course of 1 year, there were five times more non-hip, non-spine fractures than hip or spine fractures, resulting in twice as many days of hospitalization and rehabilitation/nursing home care for non-hip, non-spine fractures.IntroductionThe purpose of this study is to evaluate medical healthcare utilization associated with treating several types of fractures in women ≥55 years from various geographic regions.MethodsInformation from the Global Longitudinal Study of Osteoporosis in Women (GLOW) was collected via self-administered patient questionnaires at baseline and year 1 (n = 51,491). Self-reported clinically recognized low-trauma fractures at year 1 were classified as incident spine, hip, wrist/hand, arm/shoulder, pelvis, rib, leg, and other fractures. Healthcare utilization data were self-reported and included whether the fracture was treated at a doctor's office/clinic or at a hospital. Patients were asked if they had undergone surgery or been treated at a rehabilitation center or nursing home.ResultsDuring 1-year follow-up, there were 195 spine, 134 hip, and 1,654 non-hip, non-spine fractures. Clinical vertebral fractures resulted in 617 days of hospitalization and 512 days of rehabilitation/nursing home care; hip fractures accounted for 1,306 days of hospitalization and 1,650 days of rehabilitation/nursing home care. Non-hip, non-spine fractures resulted in 3,805 days in hospital and 5,186 days of rehabilitation/nursing home care.ConclusionsWhile hip and vertebral fractures are well recognized for their associated increase in health resource utilization, non-hip, non-spine fractures, by virtue of their 5-fold greater number, require significantly more healthcare resources.

SummaryThe Global Longitudinal study of Osteoporosis in Women (GLOW) is a prospective cohort study involving 723 physicians and 60,393 women subjects >or=55 years. The data will provide insights into the management of fracture risk in older women over 5 years, patient experience with prevention and treatment, and distribution of risk among older women on an international basis.IntroductionData from cohort studies describing the distribution of osteoporosis-related fractures and risk factors are not directly comparable and do not compare regional differences in patterns of patient management and fracture outcomes.MethodsThe GLOW is a prospective, multinational, observational cohort study. Practices typical of each region were identified through primary care networks organized for administrative, research, or educational purposes. Noninstitutionalized patients visiting each practice within the previous 2 years were eligible. Self-administered questionnaires were mailed, with 2:1 oversampling of women >or=65 years. Follow-up questionnaires will be sent at 12-month intervals for 5 years.ResultsA total of 723 physicians at 17 sites in ten countries agreed to participate. Baseline surveys were mailed (October 2006 to February 2008) to 140,416 subjects. After the exclusion of 3,265 women who were ineligible or had died, 60,393 agreed to participate.ConclusionsGLOW will provide contemporary information on patterns of management of fracture risk in older women over a 5-year period. The collection of data in a similar manner in ten countries will permit comparisons of patient experience with prevention and treatment and provide insights into the distribution of risk among older women on an international basis.

Las pequeñas y medianas empresas, comúnmente llamadas pymes tienen la necesidad de contar con herramientas tecnológicas que apoyen la ciberseguridad en sus procesos brindando un grado de confianza a sus socios comerciales, los cuales las incluyen en su cadena de suministros como elementos claves en el desarrollo de sus productos y servicios. Entre algunos de los problemas que estas tienen, se puede mencionar la falta de conciencia en ciberseguridad, falta de presupuesto para realizar inversiones en tecnología y ciberseguridad, lo que las coloca en desventaja frente a las grandes multinacionales que asignan un buen porcentaje de presupuesto a tecnología y ciberseguridad. Es por eso que el uso de sistemas de detección de intrusos basados en código abierto implementados en dispositivos de bajo costo o de placa simple se convierte en una excelente alternativa tecnológica, con las mismas características, servicios y ventajas de un sistema de detección de intrusos comercial, reduciendo la desigualdad tecnológica que afecta el desarrollo comercial y económico de las pymes.

This article aims to approach Sanjuanist mysticism from a queer perspective. It is not a monolithic apology to queer people, nor a treatise on mystical interpretation, but an effort to recognize and validate the spiritual experience of LGBTIQ+ people. It takes some mystical passages from St. John of the Cross that help to read the experience of queer life in a mystical key. With this, the potential of mysticism to combat those phobic, segregating, and unjust ideologies that mistreat so many people because of their sexual orientation and gender identity dissidence is manifested. Although it is problematic, talking about this is an act of epistemic, sociocultural, and religious justice.

The question of the spray volume for applying agrochemicals to plants has and still demands studies to continuously search for guiding parameters for technicians due to the several variables involving application technology. This experiment aimed to determine the best spray volume for applying pesticides with a boom sprayer to soybean (Glycine max) and wheat (Triticum aestivum) crops. The experiment had a completely randomized blocks design with five treatments and five replications. In soybean (crop year 2011/12), the treatments were the control (no pesticide application) and spray volume applications of 50, 100, 150, and 200 L ha-1. For wheat (crop year 2012), the treatments were the control and spray volumes of 75, 100, 125, and 150 L ha-1. The variables analyzed were the yield components. The study concluded the need for applying foliar fertilizers and performing the chemical control of diseases and pests in soybean and wheat crops. The spray volumes of 50 L ha-1 for soybeans and 75 L ha-1 for wheat were satisfactory for spraying agrochemicals with a ground bar sprayer on plants.

RESUMO Objetivo analisar a correlação entre função sexual, sintomatologia depressiva e qualidade de vida de pessoas em tratamento hemodialítico. Método estudo transversal desenvolvido com 54 participantes. A coleta de dados ocorreu entre os meses de março a maio de 2020. Os dados foram analisados com os testes de Mann-Whitney e Correlação de Spearman, com intervalo de confiança de 95%. Resultados a correlação entre a função sexual e a sintomatologia depressiva somente foi clinicamente relevante para as mulheres (ρ= -0,724). Já em relação à qualidade de vida, observou-se que a função sexual geral dos homens está negativamente correlacionada com a dimensão dor (ρ= -0,349) e com a função social (ρ= -0,347). Já para as mulheres, a função sexual geral está positivamente correlacionada com a função física (ρ= 0,501), saúde geral (ρ= 0,737), componente mental (ρ= 0,497), sono (ρ= 0,753), qualidade da interação social (ρ= 0,621) e com a satisfação do paciente (ρ= 0,457). Conclusão e implicações para a prática o aumento da função sexual esteve fortemente correlacionado com a redução de sintomatologia depressiva e com o aumento da qualidade de vida, implicando a necessidade de fortalecer as abordagens sexuais por meio de protocolos que ofereçam fluxos de encaminhamento às equipes transdisciplinares especializadas.

The current Physical Education addresses important roles in social formation and practices of regular physical activity, showing that through the teacher students learn to agree in a group, respect indifference and a very important aspect not to stop practicing regular physical activities not only in the school environment . The present work aims to show the reality in the school environment experience of high school students in Physical Education classes. Assessing the level of physical activity, through the SOFIT evaluation system and relating the results to the theoretical foundations, thus obtaining the true role of Physical Education practice in the development of socialization among students. Relating the importance of Physical Education classes and the applicability of activities that work on interpersonal relationships making students more active and mainly forming conscious and autonomous citizens, through the practice of physical activity. It is clear that there is little participation and interest in the practice of Physical Education classes in high school, due to the lack of activities that stimulate students. In the study, the Quanti-Qualitative, Exploratory and Observational approach is highlighted, in which (15 girls and 15 boys) from a high school in the city of Itapeva / SP were observed, which were evaluated through the system SOFIT. There was a low proportion of students who actively participated in Physical Education classes with regard to student behavior, with approximately (40%), and they remained lying down (20%), sitting (93.3%), standing (63.3%) and walking (63.3%). Regarding the contexts worked in classes, the results indicated more the practice of games (73.3%) and other contexts (33.3%). As for the teacher's behavior at classes, they occurred in management (13.3%), observation (86.7%) and other tasks (60%). It is concluded that few high school students in the school surveyed practice regular physical activities, due to the lack of application of content and activities that instigate participation in classes. The teacher becomes very important in the creation, applicability and interference of the activities worked in class, leading the student to participate and relate building according to the time I like to practice regular physical activity, especially when talking about students who are soon going to include in adult society.

This theological reflection is a motivation to walk in the footsteps of Marcella Althaus-Reid to discover the disruptive principles of Latin American Queer Theology. Between tangos and popular music, libertine evocations and dissident stories, prosthetic considerations, and transit strategies, this indecent text indicates some revitalizing ideas that manifest the need to think and inhabit the Global South in a more queer way. The voice of the South is powerfully theological and potentially revolutionary.

The pineal gland is an endocrine organ located in the cranial vault. Its endocrine function has been extensively studied and has been found to be the cause of important regulatory functions in the physiology of the human body. Although the initial approaches to the suggestive action of this organ on the organism were of a philosophical and spiritual nature, in the last century technological advances have made it possible to clearly elucidate its effector function as an endocrine gland. In this order of ideas, the objective of this review is to address basic and recent descriptions of the physiology of the pineal gland.

The deforestation of urban forest remnants has stimulated the debate among perspectives associated with the value of the property and the right of ownership and its inherent value for conservation and social function. To make objective the analysis and valuation of the ecological component we propose a methodology scientifically based on GIS environment to assist decision-makers at different times of a real estate development: i) in architectural planning and site design; ii) in landscaping as a strategy of conservation and environmental compensation; iii) in the process of environmental licensing and definition of environmental compensation; iv) building and construction site; and, if necessary, v) in the judicial process. The model was structured through indicators and indexes of ecological relevance (DAP and height, frequency, regional threat status to the species, preferential succession stage, presence and abundance of epiphytes, fruiting, and landscape value) and analysis of the spatial distribution of these attributes. As a reference for the adequacy of the model, the result expressed in Management Zones after IDW interpolation was compatible with the analysis of the distribution and quality of the forest remnant interpreted in a time series of about 40 years based on current image interpretation and of 1980 and 2004 ones. This demonstrates the feasibility of the model as an objective reference of the relative importance of each tree, species, and association in areas with distinct relevance.

Este trabalho objetiva refletir acerca do ensino de música nas experiências pedagógicas envolvendo a formação docente no curso de Licenciatura em Educação do Campo: habilitação em Artes e Música, da Universidade Federal do Tocantins (UFT), campus de Tocantinópolis, Estado do Tocantins, Brasil. Para tanto, buscamos na literatura alguns estudos que tratam do fenômeno da educação na perspectiva da Educação Musical em diálogo com a Educação do Campo. Trata-se de uma pesquisa de natureza bibliográfica, de abordagem qualitativo-interpretativista. Os resultados da pesquisa mostram que, enquanto professores, necessitamos saber refletir em busca da construção de uma prática docente mais humanizada, que esteja sensível às relações entre as pessoas e a música. Para tanto, cabe aos educadores promover não só a aquisição de conhecimento, mas, especialmente, conscientização, sensibilização e desejo por transformação no processo ensino-aprendizagem. A Educação Musical na perspectiva do campo, portanto, pode ser vista para além das fronteiras estabelecidas pelo eurocentrismo, concebendo novas possibilidades educacionais, conduzindo-nos a uma formação musical que esteja além da música, onde possamos habitar o campo brasileiro, sem subjugá-lo pelos nossos saberes.

The literature presents several auto-tunning systems for compiler optimizations, which employ a variety of techniques; however, most systems do not explore the premise that a large amount of program runtime is spent by hot functions which are the portions at which compiler optimizations will provide the greatest benefit. In this paper, we propose Pinhão, an auto-tunning system for compiler optimizations that uses hot functions to guide the process of exploring which compiler optimizations should be enabled during target code generation. Pinhão employs a hybrid technique - a machine learning technique, as well as an iterative compilation technique - to find an effective compiler optimization sequence that fits the characteristics of the unseen program. We implemented Pinhão as a LLVM tool, and the experimental results indicate that Pinhão finds effective sequences evaluating a few points in the search space. Furthermore, Pinh~ao outperforms the well-engineered compiler optimization levels, as well as other techniques.

Este artigo se antepara em uma pesquisa de abordagem qualitativa que teve como sujeitos sociais músicos portugueses e brasileiros que se tornaram docentes. O trabalho assume como objetivo discutir o percurso e os processos pelos quais construíram o reconhecimento de si como professores de música, a partir de entrevistas narrativas, e refletir sobre as potencialidades desta estratégia de contar histórias da sua história de vida na investigação na área da educação musical. Os resultados interpretados alcançam um conjunto complexo de momentos e acontecimentos, desenhando caminhos para alguns inesperados e não desejados, que no conjunto vão proporcionando experiências nas quais percebem o sentido de ser na relação com o outro e nas quais constroem os saberes que mobilizam no seu cotidiano profissional, permitindo que o “saber docente” escape a exclusividade da formação acadêmica, sendo construído também por meio do constante deslocamento do passado e do futuro destes sujeitos sociais.

Objective: Describe the clinical management of an atypical Le Fort I fracture case. Case presentation: A 33-year-old patient was brought to the Surgical and Maxillofacial Traumatology Service of Humberto Lucena Senatorial Emergency and Trauma Hospital in Joao Pessoa (PB), Brazil, after undergoing physical aggression. The patient was conscious and lucid. Clinical examination revealed sinking of the middle third of the face with edema and bilateral periorbital ecchymosis. Visual acuity and ocular motricity were preserved in both eyes. A cut-contusion injury on the upper lip, maxillary mobility when handled and discrete occlusal dystopia were also observed. Imaging examination identified a high bilateral Le Fort I fracture. The therapeutic approach chosen was fracture reduction and fixation with plates and screws. After a period of two months, the patient is healing well without any apparent functional or aesthetic alteration. Conclusions: Atypical Le Fort I fractures are not frequent; however, a number of etiologies besides the impact force may bring about them. Treatment should be based on the one for classical Le Fort I fractures with adjustments to the surgical access approach.

Chemoresistance persists as a significant, unresolved clinical challenge in many cancer types. The tumor microenvironment, in which cancer cells reside and interact with non-cancer cells and tissue structures, has a known role in promoting every aspect of tumor progression, including chemoresistance. However, the molecular determinants of microenvironment-driven chemoresistance are mainly unknown. In this review, we propose that the TP53 tumor suppressor, found mutant in over half of human cancers, is a crucial regulator of cancer cell-microenvironment crosstalk and a prime candidate for the investigation of microenvironment-specific modulators of chemoresistance. Wild-type p53 controls the secretion of factors that inhibit the tumor microenvironment, whereas altered secretion or mutant p53 interfere with p53 function to promote chemoresistance. We highlight resistance mechanisms promoted by mutant p53 and enforced by the microenvironment, such as extracellular matrix remodeling and adaptation to hypoxia. Alterations of wild-type p53 extracellular function may create a cascade of spatial amplification loops in the tumor tissue that can influence cellular behavior far from the initial oncogenic mutation. We discuss the concept of chemoresistance as a multicellular/tissue-level process rather than intrinsically cellular. Targeting p53-dependent crosstalk mechanisms between cancer cells and components of the tumor environment might disrupt the waves of chemoresistance that spread across the tumor tissue, increasing the efficacy of chemotherapeutic agents.

Acutely ill, hospitalized medical patients are at risk of VTE. Despite guidelines for VTE prevention, prophylaxis use in these patients is still poor, possibly because of fear of bleeding risk. We used data from the International Medical Prevention Registry on Venous Thromboembolism (IMPROVE) to assess in-hospital bleeding incidence and to identify risk factors at admission associated with in-hospital bleeding risk in acutely ill medical patients. [ABSTRACT FROM AUTHOR]

Background: Pulmonary embolism (PE) has been cited as the most common preventable cause of death in hospitalized patients. The objectives of this study were to determine recent trends in clinical outcomes and resource utilization for hospitalized patients with a clinically recognized episode of acute PE.Methods: Patients with primary or secondary PE who had been discharged from US acute care hospitals were identified from the Nationwide Inpatient Sample during the 8-year period between 1998 and 2005. The major clinical outcomes assessed included hospital mortality and length of hospitalization. To assess resource utilization for the treatment of PE, average hospital charges for these admissions were assessed, normalized to 2005 US dollars, and adjusted to reflect the US consumer price index.Results: Between 1998 and 2005, the number of patients with primary or secondary PE on discharge from the hospital increased from 126,546 to 229,637; hospital case fatality rates for these patients decreased from 12.3 to 8.2% (p < 0.001); length of hospital stay decreased from 9.4 days to 8.6 days (p < 0.001); and total hospital charges increased from $25,293 to $43,740 (p < 0.001).Conclusions: Between 1998 and 2005, significant improvements were observed in outcomes for patients hospitalized for clinically recognized PE, including decreases in mortality and length of hospital stay. Charges for this hospital care increased during this time period. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To identify patients with non-ST-elevation acute coronary syndrome (NSTE-ACS) with a low likelihood of any adverse in-hospital event. Design, setting and PATIENTS: Data were analysed from 24 097 patients with NSTEMI or unstable angina included in the Global Registry of Acute Coronary Events (January 2001 to September 2007). MAIN OUTCOME MEASURES: In-hospital events were myocardial infarction, arrhythmia, congestive heart failure or shock, major bleeding, stroke or death. Two-thirds of the patients were randomly chosen for model development and the remainder for model validation. Multiple logistic regression identified predictors of freedom from an in-hospital event, and a Freedom-from-Event score was developed. RESULTS: Of the 16 127 patients in the model development group, 19.1% experienced an in-hospital adverse event. Fifteen factors independently predicted freedom from an adverse event: younger age; lower Killip class; unstable angina presentation; no hypotension; no ST deviation; no cardiac arrest at presentation; normal creatinine; decreased pulse rate; no hospital transfer; no history of diabetes, heart failure, peripheral arterial disease, or atrial fibrillation; prehospital use of statins, and no chronic warfarin. In the validation group, 18.6% experienced an adverse event. The model discriminated well between patients experiencing an in-hospital event and those who did not in both derivation and validation groups (c-statistic = 0.77 in both). Patients in the three lowest risk deciles had a very low in-hospital mortality (<0.5%) and an uncomplicated clinical course (>93% event-free in hospital). The model also predicted freedom from postdischarge events (death, myocardial infarction, stroke; c-statistic = 0.77). CONCLUSIONS: The GRACE Freedom-from-Event score can predict the in-hospital course of NSTE-ACS, and identifies up to 30% of the admitted population at low risk of death or any adverse in-hospital event. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To compare the characteristics, management, and outcomes of patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS) who would have been eligible for inclusion in clinical trials of glycoprotein (GP) IIb/IIIa inhibitors with those of ineligible patients. DESIGN: Multinational, prospective, observational study (GRACE, Global Registry of Acute Coronary Events). SETTING: Patients hospitalised for a suspected acute coronary syndrome and enrolled in GRACE between April 1999 and December 2004. PATIENTS: 29 039 patients with NSTE ACS. MAIN OUTCOME MEASURES: Characteristics and outcomes were compared for trial-eligible (75.0%) and trial-ineligible (25.0%) patients. RESULTS: GP IIb/IIIa inhibitors were administered to 20.0% of eligible and 15.3% of ineligible patients. Compared with eligible patients, ineligible patients who received GP IIb/IIIa inhibitors had significantly higher rates of hospital death (6.8% vs 3.7%) and major bleeding (4.9% vs 2.2%). After adjustment for their higher baseline risk, ineligible patients still experienced higher hospital death rates (adjusted odds ratio (OR) 1.60; 95% confidence interval (CI) 1.01 to 2.39), but not higher bleeding rates, than the eligible group. Use of GP IIb/IIIa inhibitors was associated with a trend towards lower 6-month mortality in eligible (OR 0.86, 95% CI 0.72 to 1.02) and ineligible (OR 0.82, 95% CI 0.65 to 1.05) patients compared with those in whom this therapy was not used. CONCLUSIONS: GP IIb/IIIa inhibitors were markedly underused in the real-world population, irrespective of whether patients were trial-eligible or not. Despite the higher risk of ineligible patients, the benefits of GP IIb/IIIa inhibitors appear to be no less than in eligible patients. [ABSTRACT FROM AUTHOR]

Objective: Despite evidence-based guidelines for venous thromboembolism (VTE) prevention after total hip or knee arthroplasty (THA/TKA), many patients may not receive effective prophylaxis. Our objective was to analyze data from the multinational Global Orthopaedic Registry (GLORY) to evaluate the compliance of surgeons with the American College of Chest Physicians (ACCP) guidelines for VTE prevention.Research Design and Methods: Data from 8160 patients who had undergone a primary, unilateral, elective THA (n = 3950) or TKA (n = 4210), and had at least 3 months of follow-up were analyzed.Results: Almost all patients received a form of recommended prophylaxis. Compliance with guidelines in terms of type, duration, start time, and dose was achieved for 47% of THA and 61% of TKA patients in the USA, and 62% of THA and 69% of TKA patients outside the USA. Warfarin use, mostly in the USA, was fully compliant in 33% of THA and 48% of TKA patients. Low-molecular-weight heparin use was fully compliant in 63% of THA and 72% of TKA patients in the USA, and 67% of THA and 73% of TKA patients outside the USA.Conclusion: Although almost all THA and TKA patients both inside and outside the USA received prophylaxis, a large proportion did not receive treatment in accordance with the ACCP guidelines. Our study may have overestimated the use of recommended prophylaxis as some participating investigators may have had a specific interest in VTE prophylaxis. Furthermore, although analyses were restricted to approximately three-quarters of patients who had outpatient follow-up data, their characteristics were similar to those in the entire population. [ABSTRACT FROM AUTHOR]

BACKGROUND: Evidence-based guidelines recommend that acutely ill hospitalized medical patients who are at risk of venous thromboembolism (VTE) should receive prophylaxis. Our aim was to characterize the clinical practices for VTE prophylaxis in acutely ill hospitalized medical patients enrolled in the International Medical Prevention Registry on Venous Thromboembolism (IMPROVE). METHODS: IMPROVE is an ongoing, multinational, observational study. Participating hospitals enroll the first 10 consecutive eligible acutely ill medical patients each month. Patient management is determined by the treating physicians. An analysis of data on VTE prophylaxis practices is presented. RESULTS: From July 2002 to September 30, 2006, 15,156 patients were enrolled from 52 hospitals in 12 countries, of whom 50% received in-hospital pharmacologic and/or mechanical VTE prophylaxis. In the United States and other participating countries, 52% and 43% of patients, respectively, should have received prophylaxis according to guideline recommendations from the American College of Chest Physicians (ACCP). Only approximately 60% of patients who either met the ACCP criteria for requiring prophylaxis or were eligible for enrollment in randomized clinical trials that have shown the benefits of pharmacologic prophylaxis actually received prophylaxis. Practices varied considerably. Intermittent pneumatic compression was the most common form of medical prophylaxis utilized in the United States, although it was used very rarely in other countries (22% vs 0.2%, respectively). Unfractionated heparin was the most frequent pharmacologic approach used in the United States (21% of patients), with low-molecular-weight heparin used most frequently in other participating countries (40%). There was also variable use of elastic stockings in the United States and other participating countries (3% vs 7%, respectively). CONCLUSIONS: Our data suggest that physicians' practices for providing VTE prophylaxis to acutely ill hospitalized medical patients are suboptimal and highlight the need for improved implementation of existing evidence-based guidelines in hospitals. [ABSTRACT FROM AUTHOR]

Objective: To determine whether revascularisation is more likely to be performed in higher-risk patients and whether the findings are influenced by hospitals adopting more or less aggressive revascularisation strategies. Methods: GRACE (Global Registry of Acute Coronary Events) is a multinational, observational cohort study. This study involved 24,189 patients enrolled at 73 hospitals with on-site angiographic facilities. Results: Overall, 32.5% of patients with a non-ST elevation acute coronary syndrome (ACS) underwent percutaneous coronary intervention (PCI; 53.7% in ST segment elevation myocardial infarction (STEMI)) and 7.2% underwent coronary artery bypass grafting (CABG; 4.0% in STEMI). The cumulative rate of in-hospital death rose correspondingly with the GRACE risk score (variables: age, Killip class, systolic blood pressure, ST segment deviation, cardiac arrest at admission, serum creatinine, raised cardiac markers, heart rate), from 1.2% in low-risk to 3.3% in medium-risk and 13.0% in high-risk patients (c statistic = 0.83). PCI procedures were more likely to be performed in low- (40% non-STEMI, 60% STEMI) than medium- (35%, 54%) or high-risk patients (25%, 41%). No such gradient was apparent for patients undergoing CABG. These findings were seen in STEMI and non-ST elevation ACS, in all geographical regions and irrespective of whether hospitals adopted low (4.2-33.7%, n = 7210 observations), medium (35.7-51.4%, n = 7913 observations) or high rates (52.6-77.0%, n = 8942 observations) of intervention. Conclusions: A risk-averse strategy to angiography appears to be widely adopted. Proceeding to PCI relates to referral practice and angiographic findings rather than the patient's risk status. Systematic and accurate risk stratification may allow higher-risk patients to be selected for revascularisation procedures, in contrast to current international practice. [ABSTRACT FROM AUTHOR]

A grande transformação epidemiológica pela qual passa a saúde bucal no Brasil, demostrando o declínio da cárie e uma elevada prevalência de maloclusões, faz com que seja necessário a incorporação de procedimentos ortodônticos pelo setor público de saúde. Entretanto, os serviços de saúde existentes no país ainda são deficientes em recursos financeiros para fornecer atenção odontológica básica e principalmente, ortodôntica. Nesse contexto, surgiu o Projeto de Extensão de “Educação Continuada em Ortodontia Preventiva e Interceptiva” com o objetivo de conferir resolutividade a demanda de pacientes infantis com maloclusões, bem como promover a qualificação profissional dos alunos da graduação com subsídios teóricos e práticos que permitem a capacitação dos mesmos na área da Ortodontia Preventiva e Interceptiva. Os pacientes do Projeto de Extensão são provenientes da clínica da graduação da Disciplina de Clínica Infantil II da Universidade Federal do Rio Grande do Norte, onde o tratamento ortodôntico é iniciado. Desde que foi implantado em 2003, o Projeto atendeu uma média de 220 pacientes até o primeiro semestre de 2013. As principais maloclusões tratadas são: mordida aberta anterior, mordida cruzada posterior, apinhamento dentário, perda precoce de dentes decíduos e classe II e III esqueléticas. A abordagem terapêutica é realizada de acordo com o diagnóstico de cada caso através da utilização de diversos tipos de aparelhos com finalidade de prevenir ou interceptar essas diferentes maloclusões. Iniciativas como esta minimizam as deficiências em fornecimento de serviços ortodônticos à população carente, articulando ensino-pesquisa com as atividades de extensão voltadas para a comunidade, colaborando para reafirmar o papel social da Universidade Pública. Ambicionamos que com a continuidade do projeto possamos maximizar os benefícios gerados, com uma maior oferta de serviço de alta qualidade a toda comunidade e oferecer oportunidade de iniciação científica, aprendizagem e experiência clínica aos alunos de graduação e pós-graduação na área de Ortodontia Preventiva e Interceptiva.

Atualmente se ouve falar muito em redes sociais, e, quanto às empresas que usam a publicidade dentro das redes, estas têm influenciado o comportamento dos usuários que possuem perfil cadastrado nestas redes. Saber o que se passa na cabeça desse novo consumidor digital é um mistério para os profissionais de marketing que atuam dentro das empresas, pois mapeando melhor seus clientes e suas necessidades se podem criar produtos e serviços que os atendam. O presente trabalho busca analisar como a publicidade veiculada dentro das redes sociais na internet vem atingindo seus usuários e se elas influenciam o processo de decisão de compra de determinadas marcas/produtos ou serviços dentro destas redes. Palavras-chave: Redes sociais. Twitter. Facebook. Orkut. Internet.

Objective: This study aimed to evaluate morphologic changes, as well as chondroprotective and intra-articular effects of meloxicam on joint repair in rabbits induced by experimental trochleoplasty, minimizing possible adverse side effects. Methods: Thirty-five rabbits were divided into four groups: the control group, which did not undergo surgery, and operated groups, which used different ways of administering the anti-inflammatory agent: systemic, 0.2 mg/kg; intra-articular, 0.5 mg/kg; positive group control, without meloxicam. Each operated group was divided according to the periods of 7 or 30 days evaluation after surgery. Results: Regarding macroscopic and histological evaluation of cartilage, after 30 days, most animals showed almost complete joint repair, the presence of few or no inflammatory cells; whereas part of the animals treated with meloxicam presented necrosis in the trochlear ridge and absence of inflammatory cells after 7 days. In positive control group, it was observed moderate inflammation and connective tissue proliferation. None of the animals in the operated groups showed irregularities 30 days after surgery. Conclusion: Either intra-articular or systemic, meloxicam revealed to be favorable to be used for joint repair and control of inflammatory reaction.

A segurança da informação destaca-se como uma das principais preocupações em diversas organizações. Para garantir que as informações e os sistemas de informações estejam protegidos contra ameaças de todos os tipos é necessário definir processos gerenciados e assegurar a confidencialidade, integridade e disponibilidade delas. Com esta finalidade, as normas ABNT NBR ISO/IEC 27001 e ABNT NBR ISO/IEC 27002 provem um conjunto de técnicas para estabelecer, implementar, operar, monitorar, analisar criticamente, manter e melhorar um Sistema de Gestão de Segurança da Informação (SGSI). Porém, ainda é preciso definir uma metodologia para aplicar os conceitos identificados nas normas. Este artigo traz uma metodologia para implantar um SGSI, tomando como base a ABNT NBR ISO/IEC 27001 e 27002 simplificando o processo de planejamento, implantação, análise crítica e modificação do sistema. Através do modelo sugerido, será possível classificar a informação, identificar os riscos relevantes que atingem as informações, selecionar controles das normas e construir um plano de ação para a implantação do SGSI em qualquer tipo de organização.