1,720,955 research outputs found
Abordagem da via aérea com tubo endotraqueal versus dispositivo supraglótico no contexto de emergência
Get PDFA manutenção da via aérea é um dos aspetos mais importantes na abordagem do doente crítico, sendo por vezes necessário tomar medidas mais invasivas. A entubação endotraqueal é o goldstandard para a manutenção da via aérea, mas esta tarefa pode ser dificultada em cenários de emergência. Quando esta não é possível, quer pela existência de uma via aérea difícil, quer pelas condições do local, os dispositivos supraglóticos representam uma alternativa eficaz. Existem vários modelos e algumas das vantagens que todos partilham, são a rápida curva de aprendizagem, o facto de dispensarem laringoscopia e a necessidade de pouca mobilização da cabeça e pescoço.
O tipo de profissional que aborda a via aérea pode ser tão importante, como a técnica que se usa. Quando realizada por médicos apresenta taxas de sucesso superiores, bem como, menos complicações. O treino, a simulação e a quantidade de técnicas também são determinantes para o sucesso.
Objetivo: Analisar o uso de entubação endotraqueal e a utilização de dispositivos supraglóticos no contexto de emergência, bem como comparar as duas técnicas.Airway support is one of the most important aspects in critical patients management and sometimes more invasive measures are necessary. Endotracheal intubation is the goldstandard for airway maintenance, but it can be difficult in emergency settings. When it is not possible, by a difficult airway or the scene conditions, supraglottic devices represent an effective option. There are several models and all share some advantages like a fast learning curve, the fact that they don’t need laryngoscopy and the need of limited mobilization of the head and neck.
The professional that approaches the airway is as important as the technique used. When performed by doctors has superior success rates and less complications. Practice, simulation and number of techniques conducted are important for success.
Objective: analyze the use of endotracheal intubation and supraglottic devices in pre-hospital emergency, and compare both techniques
Expectativas e grau de satisfação da puérpera com o recurso à analgesia epidural durante o trabalho de parto
Get PDFIntrodução: Durante o período gestacional, a grávida constrói expectativas em relação ao
parto que, dependendo da forma como é percecionado, influenciam o seu grau de satisfação
face a essa mesma experiência. A dor associada ao trabalho de parto e o nível de eficácia da
analgesia administrada são fatores de grande impacto psicológico, podendo ser relembrados
pelas puérperas de forma precisa, decorrido algum tempo após o parto. A epidural, como
técnica analgésica de eleição para controlo da dor no trabalho de parto, bloqueia a condução
nervosa sensitiva sem afectar fibras nervosas motoras, provocando alívio da dor distalmente
às primeiras vértebras lombares e permitindo que a parturiente participe ativamente no
nascimento do filho.
Objetivos: O presente estudo teve como principal objetivo avaliar as expectativas e o grau de
satisfação das puérperas que recorreram à analgesia epidural para alívio da dor no trabalho
de parto. Secundariamente, pretende-se que este estudo seja o ponto de partida para uma
melhoria de cuidados ao nível da saúde materna, desde a gravidez ao puerpério.
Métodos: A amostra do estudo é constituída por 75 utentes do Departamento de Saúde da
Mulher e da Criança, do Serviço de Ginecologia e Obstetrícia, do Centro Hospitalar Cova da
Beira, E.P.E., no período compreendido entre janeiro de 2015 e fevereiro de 2016. O facto da
puérpera ter sido submetida a analgesia epidural durante o trabalho de parto, no período
supracitado, constituiu o único critério de inclusão no estudo. Definiu-se que partos
decorridos por cesariana seriam excluídos. Aplicou-se um inquérito pós-parto de 40 questões
(Anexo 1), presencialmente ou via telefónica, para avaliar o grau de satisfação da puérpera
face à analgesia epidural e a comparação da experiência realmente vivida com as
expectativas que haviam sido geradas durante o período gestacional.
Resultados: A maioria das puérperas tem idades compreendidas entre os 29 e os 39 anos, é
de nacionalidade portuguesa, encontra-se empregada, casada, em regime de união de facto
ou a coabitar com o companheiro, possui habilitações literárias superiores à escolaridade
mínima obrigatória (> 12 anos), teve um tempo de gestação compreendido entre as 37 e 42
semanas, é primigesta e primípara. A decisão sobre recorrer à analgesia epidural foi, para a
maioria das puérperas do estudo, tomada no decorrer do trabalho de parto, tendo sido,
também para a maioria, uma decisão própria e justificada pela vontade de diminuir a dor. É
de salientar que, no que diz respeito à influência exercida por terceiros, a opinião médica
prevaleceu e foi a que teve mais peso na decisão. O tipo de parto foi, na maioria dos casos,
eutócico, seguido de uma minoria de partos distócicos. Em relação às condições físicas do serviço onde decorreu o parto, à qualidade dos cuidados prestados pelos profissionais de
saúde e ao tempo que demorou todo o processo, a avaliação da experiência foi de encontro
ou superou as expectativas, na generalidade dos casos, traduzindo-se em sentimentos
satisfatórios face aos mesmos parâmetros. Analisando o grau de satisfação face à epidural
propriamente dita, constatou-se que mais de metade ficou “muito satisfeita” com o alívio da
dor que a analgesia proporcionou e cerca de um quarto ficou “satisfeita”. No que diz respeito
às decisões futuras, conclui-se que a maioria das puérperas deseja ter outro filho, pondera
optar pelo mesmo tipo de analgesia num próximo parto, admite que terá o próximo filho na
maternidade do mesmo hospital e aconselha a epidural a outras grávidas ou parturientes.
Feita uma análise comparativa entre as expectativas pré-parto e o grau de satisfação da
puérpera, percebeu-se que quanto mais positiva foi a perceção da experiência em relação ao
esperado, maior o sentimento de eficácia e de satisfação consigo própria.
Conclusão: Serviu o presente estudo para comprovar a eficácia da epidural como analgesia
para o trabalho de parto, tendo-se obtido percentagens bastante significativas de puérperas
que se mostraram “satisfeitas” ou “muito satisfeitas” com o recurso a esta técnica analgésica
para alívio das dores intra-parto. Estes resultados vêm demonstrar o impacto positivo que a
analgesia pode ter na perceção da experiência, no envolvimento ativo da parturiente em todo
o processo e na tomada de decisões, e ainda na disponibilidade física e mental para acolher o
filho no momento do nascimento e nos cuidados que lhe prestará após o parto. De facto,
quase a totalidade da amostra, e apesar das dificuldades e da dor sentida durante o trabalho
de parto, se mostrou satisfeita com a forma como decorreu todo o processo e preparada para
enfrentar um próximo parto, sob as mesmas condições.Background: During pregnancy, the woman creates expectations about the childbirth, which
depending on how it is perceived, influence her satisfaction with the experience. The labour
pain and the effectiveness of analgesia are factors of high psychological impact and can be
accurately remembered by mothers, for a long time after birth. Epidural as the choicest
analgesic technique for pain control in labour, blocks the sensory nerve conduction without
affecting motor nerve fibers, causing pain relief distally to first lumbar vertebrae and
allowing the mother to actively participate in her son's birth.
Goals: This study was designed with the aim of evaluating the expectations and level of
satisfaction of mothers who resorted to epidural analgesia for pain relief in labour.
Secondarily, it is intended that this study be the starting point for improving maternal health
care from pregnancy to puerperium.
Methods: The study population consists of 75 patients of the Women's Health and Children
Department, from Gynecology and Obstetrics Service of Hospital Cova da Beira, E.P.E., in the
period between January 2015 and February 2016. The fact that the mother has been
participated in a labour with epidural analgesia, during the aforementionet period, was the
only criterion for inclusion in the study. It was defined that cesareans were the only exclusion
criterion. There were applied 40 postpartum questions (Appendix 1), in person or by
telephone, to evaluate the level of satisfaction of mothers that experienced epidural
analgesia during labour and to compare the experience with the expectations that had been
created during pregnancy.
Results: Most mothers are aged between 29 and 39 years old, is Portuguese, is employed,
married or cohabiting with the life partner, has qualifications above minimum compulsory
education (> 12th grade), had a gestation period comprised between 37 and 42 weeks, had
recently experienced the first pregnancy and the first childbirth. The decision of applying
epidural analgesia was, for most of the mothers in the study, taken during labour, it was their
own decision, and was justified by the desire to lessen the pain. Furthermore, in those cases
that other people influenced the decision, the medical opinion prevailed. The type of
delivery was eutocic for most mothers, followed by a minority of dystocic births. In relation
to the building conditions of the hospital, to the quality of health care provided by
professionals and the time spent in labour, the evaluation of the experience was similar or
exceeded the expectations, in most cases, and had the same positive impact in terms of
satisfaction’s parameters. After analysing the satisfaction with the epidural analgesia itself, it
was found that more than half was "very satisfied" with the pain relief that analgesia provided and about a quarter was "satisfied". With regard to future decisions, it is concluded that most
mothers is thinking about having another child, they’re also considering epidural analgesia
during labour in the next delivery, at the same maternity or hospital, and they also advise
epidural to other women. A comparative analysis between antepartum expectations and
postpartum satisfaction demonstrated that the more positive was the perception of the
experience in relation to expectations, the greater the feeling of efficacy and satisfaction
with herself.
Conclusion: The present study proved the efficacy of epidural analgesia for labour. It was
shown that a significant percentage of mothers were “satisfied” or “very satisfied” with the
use of this analgesic technique for intrapartum pain relief. These results demonstrate the
positive impact that epidural analgesia may have in the perception of the experience.
Mothers can get actively involved in the whole process, they can also participate in the
therapeutic decisions and get physical and mentally prepared to welcome the baby born,
providing him appropriate health care. Despite the difficulties and pain felt during labour,
almost all of study’s population is “satisfied” with the delivery experience and prepared to
face a next childbirth, in the same analgesia conditions
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Get PDFWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
koamabayili/VECTRON-author-checklist: VECTRON author checklist
No full textWe have done our best to complete the author checklist relating to the use of animals in the hut study. Note that the objective for the hut study was to evaluate the IRS treatment applications for residual efficacy against Anopheles mosquitoes, including the local An. coluzzii mosquito population. Cows were only used to attract mosquitoes into the huts and no tests were carried out directly on the cows. The author checklist is intended for use with studies where experiments are carried out on animals, which is why we have had such difficulty in completing this for the hut study, as many of the questions do not relate to how the cows were used
Author-wise bibliometric analysis based on entropy.
No full textAuthor-wise bibliometric analysis based on entropy.</p
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