Search

Purpose The aim of the study was to verify the level of satisfaction of CI users with long periods of hearing deprivation, highlighting the positive and negative aspects of the use of the device and their quality of life. Methods This is a analytical research, of the type observational cross-sectional study. The study was performed with 24 patients from a private Institute of Otorhinolaryngology. Three surveys were applied: Satisfaction with Amplification in Daily Life (SADL), International Outcome Inventory - Cochlear Implant (IOI - CI) to assess cochlear implant satisfaction and WHOQOL- bref to assess the quality of life. The results in the pre and post lingual groups were compared. Results The highest degree of satisfaction was reported with regard to personal image, positive effects, and how the users feel about their CI. The lowest degree of satisfaction was reported regarding the cost-benefit of the CI and the competitive noise. In the WHOQOL-bref assessment, the highest scores were found in physical, psychological and social relations domains. When comparing the results of the surveys, the pre and post-lingual groups showed no difference in relation to the achieved scores. Conclusion The participants had a high level of satisfaction with the use of cochlear implants. The longer the sensory deprivation time, the greater the degree of satisfaction with the device. The use of the CI electronic device reflects on the individual's quality of life. RESUMO Objetivo Verificar o nível de satisfação de usuários de IC com longos períodos de privação auditiva, destacando os aspectos positivos e negativos do uso do dispositivo e avaliar a qualidade de vida desses indivíduos. Método Trata-se de uma pesquisa analítica, do tipo estudo observacional transversal. O estudo foi realizado com 24 pacientes de um instituto privado de Otorrinolaringologia. Foram aplicados três questionários: Satisfaction with Amplification in Daily Life (SADL), International Outcome Inventory- Implante Coclear (IOI - IC) para avaliar a satisfação com o implante coclear e WHOQOL-bref para avaliar a qualidade de vida. Os resultados nos grupos pré e pós-lingual foram comparados. Resultados O maior grau de satisfação foi relatado em relação à imagem pessoal, efeitos positivos e como os usuários se sentem em relação ao seu IC. O menor grau de satisfação ocorreu em relação ao custo-benefício do IC e ao ruído competitivo. Na avaliação do WHOQOL-bref, os maiores escores foram encontrados nos domínios físico, psicológico e relações sociais. Os grupos pré e pós-lingual não apresentaram diferença em relação aos escores alcançados. Conclusão Os participantes apresentaram alto nível de satisfação com o uso do implante coclear. Quanto maior o tempo de privação sensorial maior o grau de satisfação com o dispositivo. O uso do dispositivo eletrônico de IC reflete melhora na qualidade de vida do indivíduo.

Resumo: Os profissionais de saúde são elementos essenciais para a contenção de doenças infecciosas como o COVID-19. Diante dos longos turnos de trabalho, do alto risco de infecção e da insuficiência de medidas de proteção biológica, o sofrimento mental para os profissionais da saúde tornou-se subitamente evidente. Realizamos uma meta-análise atualizada para investigar os impactos psiquiátricos em profissionais da saúde diante das condições físicas e psicológicas em que estão submetidos em virtude da alta demanda pandêmica do COVID-19. Todos os artigos foram pesquisados em 04 bases de dezembro de 2019 até abril de 2020. No total, 08 artigos foram incluídos no estudo. Os profissionais da saúde atuantes no combate ao COVID-19 estão sendo acometidos mais intensamente por desordens psiquiátricas associadas à depressão, à ansiedade, à angústia e à insônia, estresse e traumatização indireta do que outros grupos ocupacionais. Não foram observadas diferenças significativas no viés de publicação. Existe uma forte associação entre repercussões psiquiátricas entre profissionais de saúde e COVID-19. Nossa meta-análise mostrou que profissionais de saúde têm um nível mais alto para a traumatização indireta, onde o grau de dano excede a tolerância psicológica e emocional e indiretamente leva a várias anormalidades psicológicas.Palavras-Chave: COVID-19; Profissionais de Saúde; Repercussões Psiquiátricas; Saúde Mental.Abstract: Health professionals are essential elements for the containment of infectious diseases such as COVID-19. Faced with the long work shifts, the high risk of infection and the insufficiency of biological protection measures, mental suffering for health professionals suddenly became evident. We carried out an updated meta-analysis to investigate the psychiatric impacts on health professionals in the face of the physical and psychological conditions they are subjected to due to the high demand of the COVID-19 pandemic. All articles were searched in 04 databases from December 2019 to April 2020. In total, 08 articles were included in the study. Health professionals working in the fight against COVID-19 are being more intensely affected by psychiatric disorders associated with depression, anxiety, anguish and insomnia, stress and indirect traumatization than other occupational groups. No significant differences in publication bias were observed. There is a strong association between psychiatric repercussions among healthcare professionals and COVID-19. Our meta-analysis showed that healthcare professionals have a higher rating for indirect traumatization, where the degree of harm exceeds psychological and emotional tolerance and indirectly leads to various psychological abnormalities.Keywords: COVID-19; Health professionals; Psychiatric Repercussions; Mental health.

Background/Aims In long-term conditions like rheumatic diseases, medical interventions are estimated to account for only 10-20% of the factors that impact on health outcomes. Social determinants of health and health-related behaviours account for 80-90%. While our department has a long history of embedding patient and public involvement and engagement (PPIE) in research, it is still a relatively new way of working in health service improvement. PPIE allows us to involve patients in what we do based on the principle of “no decision about me without me”. In 2021, a year into the pandemic, our Adolescent & Young Adult (AYA) Rheumatology team planned for our service improvements strategy. We aimed to engage service users using a co-production model. Methods Following two funding awards, we started the implementation of this project with the aim to enable young people (YP) and clinical staff to sustainably co-produce individual health outcomes and service improvement. Our baseline data identified significant variations in clinical consultations with no standardised approach to supporting YP with self-management, and a third of clinicians knew about health coaching (HC). HC is a technique that aims to “help patients gain the knowledge, skills, tools, and confidence to become active participants in their care so that they can reach their self-identified health goals”. Results We built our HC core capabilities for the whole AYA rheumatology multidisciplinary team. Four staff members completed European Mentoring & Coaching Council accredited HC training. A follow-up survey identified that clinicians started to embed HC into clinical consultation in 30% of our consultations with YP. We developed and embedded HC tools in our electronic health records to improve efficiency and standardisation in clinic consultation. We are piloting a dedicated HC clinic for YP with complex needs. We engaged with our service users, conducted one-to-one meetings with them, and organised workshops. We selected activities that matched our engagement aims. We used system thinking, structured coaching conversation, and quality improvement methodologies. Discussion between service users and clinicians fed into our two key projects: co-producing healthcare consultations, and setting up a peer support scheme. We now plan for three YP to participate in an internship scheme and work with us to deliver these projects. They will be part of our journey in co-creating health and service improvement for service users. Conclusion In this project, we aimed to embed co-production in the clinician-patient relationship using health coaching conversations and extended this approach into co-creating services with users. Like many other services, we are still learning from our improvement journey. Building relationships with YP and treating them as equal partners enables alignment of the service and its intended impacts with what matters most to the YP we serve. Disclosure S. Mavrommatis: None. A. Bouraoui: None. C. Fisher: None. I. Ahmed: None. R. Burman: None. N. Celik: None. A. Shah: None. K. Smith-Junkere: None. T. Al-Sulaim: None. S. Begum: None. C. Ciurtin: None. S. Devi Seegoolam: None. J. Gupta: None. R. Harvey-Regan: None. M. Leandro: None. S. Meyer: None. E. Williams: None. L. Williamson: None. D. Sen: None.

Background/Aims Previous research into B cell biomarkers of poor response to the anti-CD20 drug rituximab in autoimmune disease relates to insufficient B cell depletion. Expansion of memory B cell (MBC) subsets were also associated with poorer response. We investigated whether the relative expression of the target antigen CD20 on B cell subpopulations could also contribute to drug resistance. Methods Peripheral blood samples from 6 rituximab naïve (RTX-N) patients with autoimmune rheumatic diseases (active systemic lupus erythematosus and rheumatoid arthritis), 6 patients previously treated with rituximab (RTX-T), and 6 healthy controls (HC) were obtained. B cell subpopulations were defined using the relative expression of IgD and CD27 using flow cytometry. Results Patients in the RTX-N group had significantly higher frequency of CD19+CD20- B cells (median=25.9% of total B cells, compared to 1.26% in HC), p = 0.0022. CD19+CD20-B cells were predominantly switched MBC (IgD-CD27+) and double negative (IgDCD27-) MBC cells. All patients in the RTX-T group (median 22 months post-rituximab) had detectable CD19+CD20- B cells (median=52.25% of total B cells), of which the majority were switched MBC (median=4.54%, range 0.23-74%) and DN B cells (median=53.5%, range 11.6-98.1%). Collectively, we noted that the frequency of CD19+CD20- B cells in peripheral circulation was higher in RTX-T>RTX-N>HC. Conclusion Our preliminary results have identified greater frequency of CD19+CD20- population of B cells in peripheral blood of patients with autoimmune disease, particularly after treatment with rituximab, suggesting that they evade rituximab. These are predominantly of the switched MBC and DN B cell subpopulations. Given the potential of these cells to contribute to disease activity in autoimmune disease, alternative strategies targeting CD19 may help overcome rituximab resistance. Disclosure K. Shah: Grants/research support; Roche Glycart. C. Klein: Corporate appointments; Roche Glycart. Shareholder/stock ownership; Roche. G. Cambridge: None. D. Sen: None. M. Castelino: None. A. Akbar: None. D.A. Isenberg: None. M. Leandro: None. V.R. Reddy: Grants/research support; Roche Glycart, BRC UCLH.

Health systems encourage switching from originators to biosimilars as biosimilars are more cost-effective. The speed and completeness of biosimilar adoption is a measure of efficiency. We describe the approach to biosimilar adoption at a single hospital and compare its efficiency against the English average. We additionally follow up patients who reverted to a previously used biologic, having switched to a biosimilar, to establish whether they benefitted from re-establishing prior treatment. The approach we describe resulted in a faster and more complete switch to biosimilars, which saved an additional £380,000 on drug costs in 2021/22. Of patients who reverted to their original biologic, 85% improved short-term where the concern was tolerability, and 90% where it was efficacy. Patients remained on treatment for a prolonged period after reverting. Our approach to biosimilar adoption outperformed the English average and permits patients to revert to their original biosimilar post-switch if appropriate.

In response to the global COVID-19 pandemic, the UK has experienced three national lockdowns and a public health campaign designed to stop the spread of the virus. The first national lockdown, starting in March 2020, led to the closure of university campuses, and laboratories having to pause practical research and move research student supervision online. During this time, laboratories had to develop way for research activities to resume whilst also complying with public health measures. The entomology group at Harper Adams University is in the Agriculture and Environment Department and forms part of the Centre for Integrated Pest Management. At present our group consists of seven staff members, ranging from early career researchers to those with over 20 years of experience in academia and industry, who collectively supervise 10 PhD students at varying stages of their research. Two of these students are completing their research at an external institute. The group carries out research across multiple sites, office buildings, research laboratories, including the Jean Jackson Entomology Laboratory (https://www.infraportal.org.uk/node/1880), as well as field and glasshouse facilities. Here we provide a narrative account of the challenges in maintaining an active research group during a year of highly restricted activities. We begin by outlining the impact that national lockdowns and public health measures had on researchers working on PhD projects through to larger UKRI and levy-funded multi-institute, multi-year projects. We address four key areas: i) maintaining productivity, ii) student-supervisor interactions, iii) accessibility and widening participation and iv) well-being and mental health. We then outline how lessons learnt from lockdown can inform best practice for a research group. Many aspects will be useful for researchers working part-time, flexible hours, remotely or at multiple sites, but we emphasise that the aim of this contribution is to share our personal experiences and not to cover every theme in what is an extremely complex set of global circumstances.

Resumo Este estudo objetiva analisar o discurso do movimento social “Direitos Urbanos” (DU) e compreender como esse movimento se articula para desafiar discursos hegemônicos do urbanismo moderno e promover discursos alternativos ao modelo neoliberal. Para tal, utilizamos o aporte teórico da teoria dos Novos Movimentos Sociais (NMS). A arqueologia foucaultiana, com o objetivo de identificar as estratégias de construção do discurso do DU a partir dos sujeitos que o constituem, foi utilizada. As análises indicaram o DU como um centro contra-hegemônico, resistente e combativo ao modelo de gestão urbana desenvolvido na cidade do Recife, afirmando um projeto alternativo de cidade. O DU possui hierarquia fluida, estratégias dinâmicas e contingenciais, atua em rede e aglomera-se para demandas específicas. Abstract This study aims to analyze the discourse of the social movement “Urban Rights” (UR) and understand how this movement is articulated to challenge hegemonic discourses of modern urbanism and promote discourses that are alternative to the neoliberal model. We used the theoretical contribution of the New Social Movements (NSMs) theory. Foucault's archeology was employed in order to identify the strategies for constructing the UR discourse based on the subjects that constitute it. The analyses indicated that UR is a counter-hegemonic and resistant center that combats the urban management model developed in the city of Recife, affirming an alternative city project. UR has a fluid hierarchy, dynamic and contingency strategies, operates in a network, and agglomerates for specific demands.

Background/Aims There is increasing evidence from large observational cohort studies that rituximab may result in more severe COVID-19 disease and increase the risk of death. There is also concern that rituximab impairs response to the COVID-19 vaccination. We aimed to determine the outcome of patients with inflammatory arthritis treated with rituximab during the current COVID-19 pandemic. Methods We conducted a single-centre retrospective observational study of patients with rheumatoid arthritis (RA) or juvenile idiopathic arthritis (JIA) treated with rituximab under follow-up in a dedicated clinic from the start of the COVID-19 pandemic in February 2020 until September 2021. We assessed the outcomes of those with COVID-19 infection and serological response to COVID-19 vaccination in patients tested for SARS-CoV-2 Spike antibodies. Results So far, 139 patients have been included (82.0% female, mean age 63.0 [SD 15.6] years). 132 patients had RA and 7 had JIA. 18 patients (12.9%) reported testing positive for COVID-19 infection. Of these, 11 patients (61.1%) were hospitalised. 9 (50%) did not require supplemental oxygen, 2 (11.1%) required supplemental oxygen, 6 (33.3%) required non-invasive ventilation or high-flow oxygen, and 1 (5.6%) required invasive mechanical ventilation. 4 patients (12.2%) died, average number of days from COVID-19 symptom onset to death was 27 (SD 5.2). 8 patients (44.4%) made a full recovery, 6 patients (33.3%) were left with permanent health defects. There was a trend toward higher levels of care in patients who had received more rituximab cycles. Of 21 patients who received both COVID-19 vaccination doses and had COVID-19 serology performed, only 9 patients (42.9%) had positive COVID-19 serology post vaccination. There was a significant difference in the number of days from last infusion to second vaccination dose between those with a positive serological response (median 231.0, IQR [285.0-194.3] days) compared with those with a negative response (median 504.0, IQR [266.0-580.0] days) (p = 0.007, Mann-Whitney U test). Of 3 patients who had not been vaccinated but had previously confirmed COVID-19 infection (positive PCR), only 1 patient had positive COVID-19 serology. Mean duration from positive PCR test to serology test 83.3 (SD 14.4) days. Since February 2020, at least 19 patients (13.7%) paused rituximab or switched to an alternative biologic due to concerns over COVID-19 risk. Of 17 patients that switched, the most common alternative biologics were abatacept (11), baracitinib (3) and sarilumab (2). 5 patients continued rituximab at a reduced dose of 1 gram per cycle. Conclusion Given the potential for an increased risk of severity of COVID-19 infection and reduced response to COVID-19 vaccination in patients treated with rituximab, ‘pausing’ or ‘delaying’ it and use of alternative therapies to maintain disease control should be considered. The risks and benefits need to be carefully considered on a case-by-case basis. Disclosure J. Kimpton: None. C. Bradbury: None. R. Gravell: None. S. Moore: None. P. Buck: None. M. Leandro: Consultancies; ML has received fees for participating in Advisory Board from Genentech. Grants/research support; ML has received research grant from Roche Basel paid directly to employer, University College London.

ResumoEste estudo objetiva realizar uma explanação crítica do discurso de um movimento social urbano e compreender como este movimento se articula para desafiar discursos hegemônicos do urbanismo moderno e promover discursos alternativos às questões urbanas. Para tal, utilizamos a Teoria do Discurso de Laclau e Mouffe. O campo empírico da pesquisa foi a ação coletiva do movimento social Direitos Urbanos (DU) na cidade do Recife. Os dados foram coletados por meio de documentos oficiais, entrevistas e observação participante no período entre 2012 e 2014. As análises indicaram que o discurso em estudo é um centro contra-hegemônico, resistente e combativo ao modelo de gestão urbana desenvolvido na cidade do Recife e, especificamente, ao projeto urbanístico “Novo Recife”, afirmando um projeto alternativo de cidade (“Recife Possível”). Identificamos as lógicas sociais, políticas e fantasmáticas que fundamentam e validam as ações do movimento social Direitos Urbanos e sua “Recife Possível”, enquanto articulação de diferentes sujeitos políticos e demandas em disputa em torno do significado de urbanismo.Palavras-Chave: Teoria do Discurso, Urbanismo Crítico, Direitos Urbanos (DU) AbstractThis study aims to provide a critical explanation of the discourse of an urban social movement and to understand how this movement articulates to challenge hegemonic discourses of modern urbanism and to promote discourses that are alternative to urban issues. For this, we operate with Laclau and Mouffe's Theory of Discourse. The empirical field of the research was the collective action of the social movement Urban Rights (DU) in the city of Recife. Data were collected through official documents, interviews and participant observation in the period between 2012 and 2014. The analyzes indicated that the discourse under study is a counter-hegemonic, resistant and combative approach to the urban management model developed in the city of Recife and, specifically, to the “Novo Recife” urban project, affirming an alternative city project (“Recife Possível''). We have identified social, political and phantasmic logics that underlie and validate the actions of the Urban Rights social movement and its “Recife Possível'', as the articulation of different political subjects and disputing demands around the meaning of urbanism.Keywords: Discourse Theory, Critical Urbanism, Urban Rights (DU)

O presente texto tem por escopo analisar de que forma a educacao das emocoes e a imaginacao narrativa podem se tornar potencialmente produtivas para constituir uma concepcao alargada de formacao humana. Para a filosofa americana Martha Nussbaum (2015; 2014; 2013; 2012; 2005) o ensino da literatura e das artes pode estimular a compreensao de diversas formas de vivencias, desenvolver o “olhar interior” dos alunos, que os ponha em contato com questoes de genero, raca, etnia e cooperacao transcultural. O artigo procurara responder satisfatoriamente a seguinte questao: Por que a educacao das emocoes e a imaginacao narrativa podem se tornar produtivas para construir uma concepcao alargada de formacao humana? Trata-se de um estudo qualitativo, exploratorio e bibliografico, ancorado no metodo analitico-hermeneutico. Na primeira secao do texto sera abordado o enfoque das capacidades e a ideia de uma nocao alargada de educacao; na segunda secao tratara do papel imaginacao narrativa como pilar basico do cultivo da humanidade e de que forma a literatura pode contribuir para o desenvolvimento da imaginacao narrativa; por fim, a ultima secao tratara da relacao entre educacao das emocoes e formacao humana.

Dado o crescimento exponencial no número de casos de coronavírus (COVID-19) ao redor do mundo, a Organização Mundial de Saúde – OMS decretou a Pandemia do Novo Coronavírus. O mundo está empenhado em “achatar a curva” da propagação do vírus com medidas de distanciamento social, uso de máscaras e limpeza das mãos e este também é o momento oportuno para “acelerar a curva” da saúde digital (TOROUS et al., 2020). Entretanto, há um longo caminho a percorrer em curto prazo, de modo que o uso imediato de tecnologias móveis ajudará a humanidade a enfrentar o desafio de saúde pública. Exploramos exemplos de aplicativos como estratégias para combater a crise por meio do (i) monitoramento da mobilidade da população e, (ii) diagnóstico de saúde relacionado ao COVID-19, além disso, contribuímos com reflexões a respeito do uso do mobile para auxiliar as ações da população no relaxamento do isolamento social. A tecnologia móvel, é bastante útil posto que as estratégias iniciais de muitos países de restringir o acesso aos serviços, não podem perdurar por muito tempo. Os apps são alternativas de enfrentamento dos impactos do isolamento social, como o uso de apps para a realização de reuniões e aulas à distância. São inúmeros os benefícios ensejados pelo uso de aplicativos, seja como forma de controle social ou como meio de promover o bem-estar e saúde. Apesar de existir um risco de novas ondas de contágio do COVID-19, estas podem ser mitigadas com tecnologias móveis.

To analyse and compare drug-survival of adalimumab and etanercept (and their biosimilars) in biologic-naïve patients with ERA (Enthesitis-Related Arthritis).In this retrospective observational study, conventional statistics and machine-learning were applied to compare drug-survival (adalimumab, etanercept and their biosimilars initiated: 2009-2019) in ERA and identify determinants. The primary outcome was discontinuation of treatment due to primary- or secondary-failure and adverse drug-reactions.During the observation period, 99 of 188 patients with ERA on first-line TNF inhibitors (etanercept-n=108, adalimumab-n=80) discontinued their treatment (median survival-time 3.9years, 95%CI 2.6-4.9years). Adalimumab was associated with longer drug-survival compared to etanercept especially after an initial positive response, with the median time to treatment discontinuation 4.9years (95% CI 3.9-5.7) for adalimumab, compared to 2years (95%CI 1.4-4.0) for etanercept (HR of treatment-discontinuation-0.49, 95%CI 0.32--0.75, p=0.001). Adjusted by propensity-score, adalimumab-methotrexate combination was associated with longer drug survival, compared to adalimumab-monotherapy (HR-0.41, 95%CI 0.20-0.85), etanercept-monotherapy (HR-0.28, 95%CI 0.15-0.53), and etanercept-methotrexate combination (HR-0.39, 95%CI 0.21-0.73). The presence of HLA-B27 was associated with longer drug-survival (HR-0.50, 95%CI 0.29-0.87) following an initial positive response. Higher-CRP at baseline was associated with higher rate of primary-failure (HR-1.68, 95%CI 1.08-2.62). Axial-ERA (sacroiliitis±spinal-involvement) was associated with poorer drug-survival for both primary- and secondary-failure (overall HR-2.03, 95%CI 1.22-3.40). Adjusted by propensity-score, shorter drug-survival was observed in patients with baseline-CRP≥12.15 mg/L, but only in the context of axial-ERA, not in peripheral-ERA (no sacroiliitis/spinal-involvement) (HR-2.28, 95%CI 1.13--3.64).Following an initial positive primary response, continuing methotrexate with adalimumab was associated with the longest drug-survival compared to adalimumab-monotherapy or etanercept-based regimens. Axial-ERA was associated with a poorer drug-survival. A CRP12.15 in patients with axial-ERA was associated with a higher rate of primary-failure. Further prospective studies are required to confirm these findings.

Optical networks are essential in today’s global communications, and the study of planning tools that efficiently allocate network resources is crucial to network providers. The assignment of wavelengths, alongside routing, are critical functions in all optical network planning tools. This dissertation focuses on the study of wavelength assignment algorithms based on Graph Coloring techniques. In this dissertation, we analyse the performance of the usual Greedy heuristic, a well-known Graph Coloring heuristic applied to optical network planning, as well as the Degree of Saturation (DSATUR) and Recursive Largest First (RLF) heuristics, in several real net- work scenarios. These last two heuristics, to the best of our knowledge, have not yet been applied in the context of optical networks. Extensive simulations have been performed, using real network topologies, such as COST 239, and CONUS networks, considering a full mesh logical topology, and we conclude that DSATUR and RLF heuristics can out-perform Greedy heuristic in network scenarios where there are several network clusters interconnected by only one or two links. In these cases, the RLF and DSATUR heuristics provide less 9 and 5 wavelengths respectively than the Greedy heuristic. Despite generating fewer wavelengths, we have verified that these heuristics need a higher computing time than the Greedy heuristic. Besides these heuristics, the traditional First Fit and Most-Used heuristics were also studied, and lead to performance similar to the Greedy heuristics. As redes óticas são essenciais nas comunicações globais atuais e, o estudo de ferramentas de planeamento que utilizem eficientemente os recursos da rede são cruciais aos operadores de rede. A atribuição de comprimentos de onda, juntamente com o encaminhamento, são funções críticas em todas as ferramentas de planeamento de redes óticas. Esta dissertação foca-se no estudo de algoritmos de atribuição de comprimentos de onda baseados em técnicas de Coloração de Grafos. Na presente dissertação analisamos o desempenho da heuríıstica Greedy, uma heurística de Coloração de Grafos tipicamente aplicada ao planeamento de redes óticas, assim como as heurísticas Degree of Saturation (DSATUR) and Recursive Largest First (RLF), em diversos cenários de redes reais. Estas duas últimas heurísticas, tanto quanto sabemos, ainda não foram aplicadas no contexto de redes óticas. Foram realizadas inúmeras simulações, utilizando topologias de redes reais, como as redes COST 239, e CONUS considerando uma topologia lógica em malha completa e concluímos que as heurísticas DSATUR e RLF podem superar a heurística Greedy em cenários de rede onde existem vários clusters de rede interligados por apenas uma ou duas ligações. Nestas redes, as heurísticas RLF e DSATUR, proporcionam menos 9 e 5 comprimentos de onda, respetivamente, do que a heurística Greedy. Apesar de gerarem menos comprimentos de onda, verificamos que estas heurísticas necessitam de um tempo de computação superior ao da heurística Greedy. Além de terem sido estudadas estas heurísticas, também foram estudadas as heurísticas tradicionais First Fit e Most-Used e concluímos que têm um desempenho semelhante à heurística Greedy.

INTRODUÇÃO: A hemofilia é uma doença crônica de origem genética causada por uma mutação dos genes que codificam os fatores de coagulação sanguíneos. Uma das consequências dessa alteração é o acometimento do sistema musculoesquelético, o que pode influenciar na postura desses indivíduos. OBJETIVO: Estimar a frequência de alterações posturais em portadores de hemofilia, e identificar possíveis fatores associados. MÉTODOS: Estudo descritivo de corte transversal, conduzido com indivíduos com idade ? 18 anos, com diagnóstico de hemofilia, em acompanhamento na Fundação de Hematologia e Hemoterapia da Bahia (HEMOBA). Os participantes foram submetidos à avaliação postural, por meio da análise visual, teste de Adams e aplicação de um formulário semi-estruturado. Empregou-se o Epi Info® (v.3.5.2) para análise dos dados e, para verificar a existência de associações entre as variáveis do estudo foram utilizados os Testes exato de Fisher, Qui-quadrado (bicaudal) e Qui-Quadrado com a correção de Yates. Consideradas como estatisticamente significantes associações com p

O presente trabalho teve por objetivo avaliar os argumentos que constituem os diferentes discursos acerca do Planejamento Urbano e o Direito à Cidade tendo como foco a construção de um Grande Projeto Urbano (GPU) denominado “Novo Recife”. Para tal, acessamos três posições discursivas sobre o assunto: das empresas que formam o consórcio responsável pela construção, da Prefeitura do Recife e de um movimento social organizado denominado Direitos Urbanos (DU). O método adotado foi a arqueologia foucaultiana e sua análise de discurso. Nossos achados apontam para cinco formações discursivas antagônicas: duas favoráveis e três contestadoras do modelo de planejamento urbano adotado no Recife. Palavras-chave: Gestão Pública, GPU, Urbanismo Crítico

Made available in DSpace on 2019-10-04T12:39:40Z (GMT). No. of bitstreams: 0 Previous issue date: 2019-04-01. Added 1 bitstream(s) on 2021-07-15T15:04:56Z : No. of bitstreams: 1 S1413-99362019000200035.pdf: 257674 bytes, checksum: 8a7209a027e612205e07be892e9fd138 (MD5) This article discusses the documentary heritage as a presentation of the patrimonial universe still negligibly explored, which can bring inquiries about its legitimacy as well as its role in this context. A closer relation between the documentary heritage and the society is a fundamental, but finds itself unclear, be it in its practice, or in its theory. From this debate, we studied two cases that legally integrate the Heritage Lists: Brasilia as a World Heritage, and the NovaCap Fond as Documentary Heritage, reflecting about the place of documents in the patrimonial context. Univ Estadual Paulista, Marilia, SP, Brazil Univ Fed Estado Rio de Janeiro UNIRIO, Dept Arquivol, Rio De Janeiro, RJ, Brazil Univ Estadual Paulista, Dept Ciencia Informacao, Campus Marilia, Marilia, SP, Brazil Univ Estadual Paulista, Programa Posgrad Ciencia Informacao, Campus Marilia, Marilia, SP, Brazil Univ Estadual Paulista, Marilia, SP, Brazil Univ Estadual Paulista, Dept Ciencia Informacao, Campus Marilia, Marilia, SP, Brazil Univ Estadual Paulista, Programa Posgrad Ciencia Informacao, Campus Marilia, Marilia, SP, Brazil

Submitted by Cristina Afonso (cac@lisboa.ucp.pt) on 2018-12-19T10:29:13Z No. of bitstreams: 1 Tese_CatarinaVasconcelos_Maio2018.pdf: 618841 bytes, checksum: 8638dc9b732558c60c89706b2310f8be (MD5) Approved for entry into archive by Cristina Afonso (cac@lisboa.ucp.pt) on 2018-12-19T10:29:25Z (GMT) No. of bitstreams: 1 Tese_CatarinaVasconcelos_Maio2018.pdf: 618841 bytes, checksum: 8638dc9b732558c60c89706b2310f8be (MD5) Made available in DSpace on 2018-12-19T10:29:26Z (GMT). No. of bitstreams: 1 Tese_CatarinaVasconcelos_Maio2018.pdf: 618841 bytes, checksum: 8638dc9b732558c60c89706b2310f8be (MD5) Previous issue date: 2018-10-30

O presente trabalho teve como objetivo analisar o discurso do projeto urbanístico “Novo Recife” pelas perspectivas da Prefeitura do Recife e do Consórcio responsável pela obra. Utilizando o método arqueológico de Foucault (2008) encontramos um discurso regulado pela ideia de crescimento econômico como condição de possibilidade de uma cidade mais sustentável. Nossos achados apontaram para a presença do discurso do planejamento estratégico na administração pública do Recife, bem como a utilização dos Grandes Projetos Urbanos (GPUs) como ferramentas adequadas para a construção de uma cidade mais sustentável e para o crescimento econômico. O conjunto de significados inter-relacionados identificados nos remeteram ao estabelecimento de uma grande formação discursiva denominada de “Crescimento Econômico gera sustentabilidade”. The present work had as objective to analyze the discourse of the urban project "New Recife" from the perspectives of the City Hall of Recife and the Consortium responsible for the work. Using the archaeological method of Foucault (2008) we find a discourse regulated by the idea of economic growth as a condition for the possibility of a more sustainable city. Our findings pointed to the presence of the strategic planning discourse in the public administration of Recife, as well as the use of the Large Urban Projects (LUPs) as appropriate tools for the construction of a more sustainable city and for economic growth. The set of interrelated meanings identified led us to establish a great discourse formation called "Economic Growth generates sustainability".

CNPq Este estudo objetiva realizar uma explanação crítica do discurso de um movimento social urbano e compreender como este movimento se articula para desafiar discursos hegemônicos do urbanismo moderno e promover discursos alternativos às questões urbanas. Para tal, utilizamos o aporte teórico da teoria dos Novos Movimentos Sociais (NMS), do Urbanismo Crítico e da Teoria do Discurso de Laclau e Mouffe (1985). O campo empírico da pesquisa foi a ação do movimento Direitos Urbanos (DU) na cidade do Recife. O DU é portador de um discurso que o insere no campo dos NMS e do Urbanismo Crítico. Utilizamos como inspiração metodológica para esse estudo a Lógica da Explanação Crítica (LEC) de Glynos e Howarth (2007) com o objetivo de identificar as estratégias de construção do discurso do DU a partir dos sujeitos que o constituíram. As análises indicaram que o discurso em estudo é um centro contra-hegemônico, resistente e combativo ao modelo de gestão urbana desenvolvido na cidade do Recife, afirmando um projeto alternativo de cidade (“Recife Possível”), que implica na possibilidade de existência do mesmo no campo discursivo. O DU configura-se como um Novo Movimento Social. Possui hierarquia fluida, estratégias dinâmicas e contingenciais, atua em rede, se aglomera para demandas específicas e não possui ideologia clara. Identificamos o Direito à Cidade como o ponto nodal para uma “Recife Possível”, o que permitiu articular diferentes sujeitos políticos e suas demandas em torno do seu significado. This study aims to perform a critical explanation of the discourse of an urban social movement and to understand how this movement articulates to challenge hegemonic discourses of modern urbanism and to promote discourses that are alternative to urban issues. For this, we use the theoretical contribution of New Social Movements theory (NMS), Critical Urbanism and Discourse Theory by Laclau and Mouffe (1985). The empirical field of research was the action of the Urban Rights movement (DU) in the city of Recife. The DU is the bearer of a discourse that inserts it in the field of NMS and Critical Urbanism. We used as a methodological inspiration for this study the Critical Explanation Logic (LEC) of Glynos and Howarth (2007) with the objective of identifying the strategies of construction of the discourse of the DU from the subjects that constituted it. The analysis indicated that the discourse under study is a counter-hegemonic center, resistant and combative to the urban management model developed in the city of Recife, affirming an alternative city project ("Possible Recife"), which implies the possibility of existence of the same in the discursive field. The DU sets itself up as a New Social Movement. It has fluid hierarchy, dynamic and contingent strategies, acts in network, agglomerates for specific demands and has no clear ideology. We identified the Right to the City as a nodal point for a "Possible Recife", which allowed to articulate different political subjects and their demands around its meaning.

The implementation of surgical procedures in the Basic Health Unit is recommended and described in the literature. However, such practice has been less and less applied in primary care. In a context of overcrowding of tertiary hospitals and consequent inoperability of elective surgical procedures it is of utmost importance and resolutivity carrying out these procedures in the Family Clinic/Basic Health Unit. In this article, we present a case of a patient who underwent excision of a crippling giant lipoma in the left popliteal fossa, with 12 years of evolution and unsuccessful attempts of surgical resolution in a tertiary hospital. Los procedimientos quirúrgicos en la Unidad Básica de Salud se recomiendan y se describen en la literatura. Sin embargo, esta práctica se está convirtiendo en una menor aplicación en atención primaria. En un contexto de hacinamiento en hospitales de tercer nivel de atención y dando como resultado la inoperabilidad de las quirugías menores electivas, es extremadamente importante realizar estos procedimientos en la Clínica de la Familia/Unidad Basica de Salud. En este trabajo, se presenta un caso de un paciente que se submetió a la extirpación de incapacitante lipoma gigante en la fosa poplítea izquierda con 12 años de evolución y frustra resolución quirúrgica en un hospital de tercer nivel. A realização de procedimentos cirúrgicos na Unidade Básica de Saúde é preconizada e descrita na literatura. No entanto, tal prática vem sendo cada vez menos aplicada na atenção primária. Em um contexto de superlotações de hospitais terciários e consequente inoperação de cirurgias eletivas, é de extrema importância a realização desses procedimentos na Clínica da Família. Nesse trabalho, apresenta-se um caso de um paciente submetido à exérese de lipoma gigante incapacitante, na fossa poplítea esquerda, com 12 anos de evolução e com tentativa frustrada de resolução cirúrgica em um hospital terciário.

Systemic autoimmune rheumatic diseases encompass a vast array of autoantibodies which are very useful to confirm a suspected diagnosis. This article gives an overview of the most common autoantibodies, how they are tested and the significance of a positive test in a clinical context.

O objetivo central deste artigo é explorar o discurso da construção da Usina Belo Monte sob a ótica dos usuários e seguidores de mídias sociais na internet. Procurou-se entender que imagem está sendo construída pela sociedade sobre esse movimento e através de que argumentos os indivíduos procuram legitimar suas opiniões. A abordagem desse trabalho desenvolve-se na perspectiva da Teoria do Discurso proposta por Ernesto Laclau e Chantal Mouffe e estudos de recepção nos meios de comunicação de Stuart Hall.

The aim of this paper is to explore the discursive construction of BeloMonte Plant from the perspective of users and followers of social media on theinternet. We seek to understand what image is being constructed by the societyabout motion and arguments through which individuals seek to legitimize theiropinions. The approach of this work is developed from the perspective of DiscourseTheory proposed by Ernesto Laclau and Chantal Mouffe and the receptionstudies in the media of Stuart Hall. El objetivo central de este trabajo es explorar el discurso de la construcciónde Planta Belo Monte desde la perspectiva de los usuarios y seguidoresde las redes sociales en Internet. Tratamos de entender lo que la imagen estásiendo construida por la sociedad sobre esta moción y los argumentos a travésde los cuales los individuos tratan de legitimar sus opiniones. El enfoque de estetrabajo se desarrolla desde la perspectiva de la Teoría del Discurso propuesta porErnesto Laclau y Chantal Mouffe y los estudios de recepción en los medios decomunicación de Stuart Hall. O objetivo central deste artigo é explorar o discurso da construção da Usina Belo Monte sob a ótica dos usuários e seguidores de mídias sociais na internet. Procurou-se entender que imagem está sendo construída pela sociedade sobre esse movimento e através de que argumentos os indivíduos procuram legitimar suas opiniões. A abordagem desse trabalho desenvolve-se na perspectiva da Teoria do Discurso proposta por Ernesto Laclau e Chantal Mouffe e estudos de recepção nos meios de comunicação de Stuart Hall.