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Resumo: Este trabalho tem como objetivo demonstrar o contexto histórico do Programa Parceladas na região do Araguaia, bem como verificar as contribuições do Programa Parceladas na formação inicial dos egressos do curso de Matemática. Para isso, analisamos documentos dos cursos de graduação em Matemática ofertados no período de 2003 a 2011. Os documentos selecionados foram: as ementas do projeto político pedagógico; relatório de autorização e processo de reconhecimento dos cursos; os planos de aula dos professores que ministraram aulas nas disciplinas de Educação Matemática e o questionário aplicado aos alunos egressos dessas turmas. Os resultados encontrados possibilitaram identificar o processo de consolidação do Programa Parceladas. Palavras-chave: Programa Parceladas; Araguaia; Formação inicial.

Background: Pharmacological prophylaxis during hospital admission can reduce the risk of acquired blood clots (venous thromboembolism) but may cause complications, such as bleeding. Using a risk assessment model to predict the risk of blood clots could facilitate selection of patients for prophylaxis and optimise the balance of benefits, risks and costs., Objectives: We aimed to identify validated risk assessment models and estimate their prognostic accuracy, evaluate the cost-effectiveness of different strategies for selecting hospitalised patients for prophylaxis, assess the feasibility of using efficient research methods and estimate key parameters for future research., Design: We undertook a systematic review, decision-analytic modelling and observational cohort study conducted in accordance with Enhancing the QUAlity and Transparency Of health Research (EQUATOR) guidelines., Setting: NHS hospitals, with primary data collection at four sites., Participants: Medical and surgical hospital inpatients, excluding paediatric, critical care and pregnancy-related admissions., Interventions: Prophylaxis for all patients, none and according to selected risk assessment models., Main Outcome Measures: Model accuracy for predicting blood clots, lifetime costs and quality-adjusted life-years associated with alternative strategies, accuracy of efficient methods for identifying key outcomes and proportion of inpatients recommended prophylaxis using different models., Results: We identified 24 validated risk assessment models, but low-quality heterogeneous data suggested weak accuracy for prediction of blood clots and generally high risk of bias in all studies. Decision-analytic modelling showed that pharmacological prophylaxis for all eligible is generally more cost-effective than model-based strategies for both medical and surgical inpatients, when valuing a quality-adjusted life-year at £20,000. The findings were more sensitive to uncertainties in the surgical population; strategies using risk assessment models were more cost-effective if the model was assumed to have a very high sensitivity, or the long-term risks of post-thrombotic complications were lower. Efficient methods using routine data did not accurately identify blood clots or bleeding events and several pre-specified feasibility criteria were not met. Theoretical prophylaxis rates across an inpatient cohort based on existing risk assessment models ranged from 13% to 91%., Limitations: Existing studies may underestimate the accuracy of risk assessment models, leading to underestimation of their cost-effectiveness. The cost-effectiveness findings do not apply to patients with an increased risk of bleeding. Mechanical thromboprophylaxis options were excluded from the modelling. Primary data collection was predominately retrospective, risking case ascertainment bias., Conclusions: Thromboprophylaxis for all patients appears to be generally more cost-effective than using a risk assessment model, in hospitalised patients at low risk of bleeding. To be cost-effective, any risk assessment model would need to be highly sensitive. Current evidence on risk assessment models is at high risk of bias and our findings should be interpreted in this context. We were unable to demonstrate the feasibility of using efficient methods to accurately detect relevant outcomes for future research., Future Work: Further research should evaluate routine prophylaxis strategies for all eligible hospitalised patients. Models that could accurately identify individuals at very low risk of blood clots (who could discontinue prophylaxis) warrant further evaluation., Study Registration: This study is registered as PROSPERO CRD42020165778 and Researchregistry5216., Funding: This award was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: NIHR127454) and will be published in full in Health Technology Assessment ; Vol. 28, No. 20. See the NIHR Funding and Awards website for further award information.

The present research tested the idea that a self-determined orientation may help people manage death-related thoughts and anxieties, and mitigate the effects of death awareness on well-being. Seven studies ( N = 3,331), using a diversity of measures and manipulations, were consistent with that idea. First, mortality salience (vs. other topic primes) increased death-thought accessibility, but not if participants had high need-satisfaction (Study 1, n = 160; Study 2, n = 216) or were prompted to recall self-determined experiences (Study 3, n = 188). Second, need-satisfaction was associated with reduced death anxiety (Study 4a, n = 301; Study 4b, n = 1,848), and priming self-determined concepts eliminated the effect of mortality salience on death anxiety (Study 5, n = 119). Third, heightened death-thought accessibility was related to lower satisfaction with life (Study 6, n = 271) and happiness (Study 7, n = 228), but not among those with high need-satisfaction. Supplemental analyses suggested the effects of need-satisfaction were not due to associations with affect (Studies 1, 6, 7), epistemic certainty (ideological dogmatism, Study 4a), or mindfulness (Studies 5b and 6); need-satisfaction mitigated the effects of existential concern via self-esteem but not via growth orientation (Study 4b) nor due to its relationship with Openness (Studies 6 and 7). Together, these findings suggest a self-determined orientation can help buffer existential concern and buoy well-being and point to a potential existential protective function beyond its known growth-oriented functions. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Objective: To identify whether hospice workers hold unique and theoretically-informative perspectives about death, especially as they relate to terror management processes., Method: Twelve hospice workers from two hospices in Tucson, Arizona, United States, participated in semi-structured interviews. Interview and analytic practices were guided by Grounded Theory (Glaser & Strauss, 1967)., Results: Three categories were identified in relation to death attitudes: effects of chronic confrontation with death; reasons for working in hospice; and perceptions of death in others., Conclusions: Two theoretically informative trends appeared. First, hospice workers largely manage death anxiety as identified by existing literature with the notable exception that hospice workers overall seem to integrate death and dying into their worldviews as a meaningful category, as opposed to avoiding thinking about death. Second, even among those regularly exposed to death, there seems to be a range across participants on a continuum from avoiding to confronting the topic of death., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objective: This pre-registered study was designed to test whether reminders of death and coronavirus would have similar or different effects on health behavior intentions concerning COVID-19 (e.g., mask wearing, social distancing) and whether the type of framing of these behaviors would moderate these effects., Design: The study utilized a 3 (threat: mortality salience vs. coronavirus reminder vs. control topic) x 3 (framing: autonomy-supportive vs. controlled vs. neutral) design. Measures of perceived threat of COVID-19, reactance proneness, and political orientation were included as individual differences., Results: Although the interaction between threat and framing conditions was not significant, the data revealed that (1) lower perceived threat of COVID-19 was associated with lower health behavior intentions to reduce the spread of the virus; (2) after an induction to express their thoughts and feelings about COVID-19, participants with low perceived threat of COVID-19 significantly increased their health intentions; (3) perceived threat of COVID-19 moderated the relationship between reactance proneness and health intentions, such that those high in reactance proneness reported lower intentions unless they had high perceptions of threat; and (4) politically conservative participants reported lower intentions to engage in healthy behaviors, and this relationship was mediated by their lower perceived threat of COVID-19.

Pulmonary embolism (PE) can present with a range of severity. Prognostic risk stratification is important for efficacious and safe management. This second of two review articles discusses the management of high-, intermediate- and low-risk PE. We discuss strategies to identify patients suitable for urgent outpatient care in addition to identification of patients who would benefit from thrombolysis. We discuss specific subgroups of patients where optimal treatment differs from the usual approach and identify emerging management paradigms exploring new therapies and subgroups., Competing Interests: Competing interests: DEH was a topic expert for NICE NG158 and QS201, regarding the diagnosis and management of venous thromboembolic disease and venous thromboembolism in adults, respectively. DEH was also a coauthor on the BTS guidelines for the outpatient management of PE and the accompanying national quality standards. JC, PS, KdW and MJR have no conflicts of interest to declare., (© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.)

The current investigation tested if people's basic belief in the notion that human beings have developed from other animals (i.e., belief in evolution) can predict human-to-human prejudice and intergroup hostility. Using data from the American General Social Survey and Pew Research Center (Studies 1-4), and from three online samples (Studies 5, 7, 8) we tested this hypothesis across 45 countries, in diverse populations and religious settings, across time, in nationally representative data ( N = 60,703), and with more comprehensive measures in online crowdsourced data ( N = 2,846). Supporting the hypothesis, low belief in human evolution was associated with higher levels of prejudice, racist attitudes, and support for discriminatory behaviors against Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ), Blacks, and immigrants in the United States (Study 1), with higher ingroup biases, prejudicial attitudes toward outgroups, and less support for conflict resolution in samples collected from 19 Eastern European countries (Study 2), 25 Muslim countries (Study 3), and Israel (Study 4). Further, among Americans, lower belief in evolution was associated with greater prejudice and militaristic attitudes toward political outgroups (Study 5). Finally, perceived similarity to animals (a construct distinct from belief in evolution, Study 6) partially mediated the link between belief in evolution and prejudice (Studies 7 and 8), even when controlling for religious beliefs, political views, and other demographic variables, and were also observed for nondominant groups (i.e., religious and racial minorities). Overall, these findings highlight the importance of belief in human evolution as a potentially key individual-difference variable predicting racism and prejudice. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

This first of two practice reviews addresses pulmonary embolism (PE) diagnosis considering important aspects of PE clinical presentation and comparing evidence-based PE testing strategies. A companion paper addresses the management of PE. Symptoms and signs of PE are varied, and emergency physicians frequently use testing to 'rule out' the diagnosis in people with respiratory or cardiovascular symptoms. The emergency clinician must balance the benefit of reassuring negative PE testing with the risks of iatrogenic harms from over investigation and overdiagnosis., Competing Interests: Competing interests: JC, PS, KdW and MJR have no conflicts of interest to declare. DEH was a topic expert for NICE NG158 and QS201, regarding the diagnosis and management of venous thromboembolic disease and venous thromboembolism in adults, respectively. DEH was also a coauthor on the BTS guidelines for the outpatient management of pulmonary embolism and the accompanying national quality standards., (© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Most headache presentations to emergency departments (ED) have benign causes; however, approximately 10% will have serious pathology. International guidelines recommend that patients describing the onset of headache as 'thunderclap' undergo neuroimaging and further investigation. The association of this feature with serious headache cause is unclear. The objective of this study was to determine if patients presenting with thunderclap headache are significantly more likely to have serious underlying pathology than patients with more gradual onset and to determine compliance with guidelines for investigation., Methods: This was a planned secondary analysis of an international, multicentre, observational study of adult ED patients presenting with a main complaint of headache. Data regarding demographics, investigation strategies and final ED diagnoses were collected. Thunderclap headache was defined as severe headache of immediate or almost immediate onset and peak intensity. Proportion of patients with serious pathology in thunderclap and non-thunderclap groups were compared by χ² test., Results: 644 of 4536 patients presented with thunderclap headache (14.2%). CT brain imaging and lumbar puncture were performed in 62.7% and 10.6% of cases, respectively. Among patients with thunderclap headache, serious pathology was identified in 10.9% (95%CI 8.7% to 13.5%) of cases-significantly higher than the proportion found in patients with a different headache onset (6.6% (95% CI 5.9% to 7.4%), p<0.001.). The incidence of subarachnoid haemorrhage (SAH) was 3.6% (95% CI 2.4% to 5.3%) in those with thunderclap headache vs 0.3% (95% CI 0.2% to 0.5%) in those without (p<0.001). All cases of SAH were diagnosed on CT imaging. Non-serious intracranial pathology was diagnosed in 87.7% of patients with thunderclap headache., Conclusions: Thunderclap headache presenting to the ED appears be associated with higher risk for serious intracranial pathology, including SAH, although most patients with this type of headache had a benign cause. Neuroimaging rates did not align with international guidelines, suggesting potential need for further work on standardisation., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.)

This research explored the relationship between the death of a close other (DOCO) and terror management processes. In Study 1 ( n  = 810), university students who experienced DOCO (vs. not) reported higher university and American identification; greater self-esteem and meaning in life; lower death-thought accessibility; greater "death-as-passage" representations; and higher belief in an everlasting soul. We pre-registered Study 2 ( n  = 497) as an attempt to replicate these findings; although the patterns of means were consistent with Study 1, the tests did not reach statistical significance. However, analyses on the merged data ( N  = 1,307) supported the present theoretical analysis.

Objective: Atraumatic back pain is an increasingly common presentation to the ED. A minority of these cases will have significant structural pathology, resulting in acute cauda equina compression (CEC). Although clinicians often look for 'red flags' to identify potential CEC, the prognostic accuracy of these presenting symptoms and clinical examination findings is unclear. We sought to evaluate the accuracy of individual clinical features in a large cohort of ED patients with atraumatic backpain and reference standard imaging, for the diagnosis of CEC., Methods: A retrospective case note review from 2014 to 2018 within an established ED atraumatic back pain pathway, undertaken at the largest tertiary spinal referral centre in the UK. We analysed routine data, collected prospectively by treating clinicians within a structured electronic health record clinical proforma. Data on signs and symptoms in 996 patients with suspected CEC referred for definitive MRI over a 4-year study period were extracted and compared against a final reference standard diagnosis., Results: We identified 111 patients with radiological evidence of CEC within the cohort referred for definitive imaging (111/996, 11.1%), of whom 109 (98.2%) underwent operative intervention. Patients with CEC were more likely to present with bilateral leg pain (OR=2.2), dermatomal sensory loss (OR 1.8) and bilateral absent ankle or ankle and knee jerks (OR=2.9). Subjective weakness was found to be associated with CEC on univariate but not multivariate analysis. We found no relationship between digital rectal examination findings and the diagnosis of CEC., Conclusions: In our cohort, factors independently associated with CEC diagnosis on MRI included bilateral leg pain, dermatomal sensory loss. Loss of lower limb reflexes was strongly suggestive of CES (likelihood ratio 3.4 on multivariate logistic regression). Our findings raise questions about the diagnostic utility of invasive digital rectal examination., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.)

Using terror management theory and research findings, we expand the framework provided by Lee and Schwarz to highlight the potential link between separation and connection effects to existential, death-related concerns. Specifically, we address how death awareness may motivate separation and connection behaviors and how engaging in these behaviors may serve a protective terror management function.