Journal articles: 'Form completion paradigm' – Grafiati (2024)

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Summary This article seeks to lay a more solid foundation for the contemporary paradigm shift in the Christian theological thinking – that is, from theo-anthropology to theo-cosmology. In the new paradigm cosmic hope for the completion of the trinitarian project of creation, instead of human redemption from sin and death, comes to the fore as the most comprehensive horizon of Christian thinking. For this purpose the author reconstructs the underlying logic of the biblical faith in a narrative form from creation to eschatology.

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The current study investigated non-culminating accomplishments through an experimental lens. We used a well-established paradigm for studying real-time language processing using eye-tracking, the visual world paradigm. Our study was modeled after Altmann and Kamide’s (2007) investigation of processing of aspectual information contained in a perfect verb form (e.g., has eaten). We compared English-speaking adults’ interpretations of sentences like ‘The girl has eaten a cookie’ and ‘The girl was eating a cookie’ in the context of one of two visual scenes. In the Full Completion condition, the scene depicted two referents that were compatible with the predicate: one was compatible with the expected end state of the event (e.g., an empty plate), the other with an unrealized version of the event (e.g., an uneaten cookie). In the Partial Completion condition, the scene depicted a referent that was compatible with a partially-completed version of the event (e.g., part of a cookie on a plate) and an unrealized interpretation (e.g., an uneaten cookie). For verb forms in the perfect (e.g., has eaten) but not in the progressive, we found a difference between conditions; listeners preferred to look at the fully-affected referent in the Full Completion condition as compared to the partially-affected referent in the Partial Completion condition. We take the results as suggestive in favor of a pragmatic rather than semantic account of non-culmination interpretations in English.

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There are many examples where geometry and gravity are concepts that emerge from a theory of quantum mechanics without gravity. This suggests thinking of gravity as an exotic phase of matter. Quantifying this phase in the Landau paradigm requires some sort of symmetry principle or order parameter that captures its appearance. In this essay, we propose higher-form symmetries as a symmetry principle underlying emergent spacetime. We explore higher-form symmetries in gauge–gravity duality and explain how their breaking describes features of gravitational theory. Such symmetries imply the existence of nonlocal objects in the gravitational theory — in gauge–gravity duality these are the strings and branes of the bulk theory — giving an alternative way to understand the nonlocality necessary in any ultraviolet completion of gravity.

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Visual illusions and perceptual grouping phenomena offer an invaluable tool for probing the computational mechanism of low-level visual processing. Some illusions, like the Kanizsa figure, reveal illusory contours that form edges collinear with the inducing stimulus. This kind of illusory contour has been modeled by neural network models by way of cells equipped with elongated spatial receptive fields designed to detect and complete the collinear alignment. There are, however, other illusory groupings which are not so easy to account for in neural network terms. The Ehrenstein illusion exhibits an illusory contour that forms a contour orthogonal to the stimulus instead of collinear with it. Other perceptual grouping effects reveal illusory contours that exhibit a sharp corner or vertex, and still others take the form of vertices defined by the intersection of three, four, or more illusory contours that meet at a point. A direct extension of the collinear completion models to account for these phenomena tends towards a combinatorial explosion, because it would suggest cells with specialized receptive fields configured to perform each of those completion types, each of which would have to be replicated at every location and every orientation across the visual field. These phenomena therefore challenge the adequacy of the neural network approach to account for these diverse perceptual phenomena. I have proposed elsewhere an alternative paradigm of neurocomputation in the harmonic resonance theory (Lehar 1999, see website), whereby pattern recognition and completion are performed by spatial standing waves across the neural substrate. The standing waves perform a computational function analogous to that of the spatial receptive fields of the neural network approach, except that, unlike that paradigm, a single resonance mechanism performs a function equivalent to a whole array of spatial receptive fields of different spatial configurations and of different orientations, and thereby avoids the combinatorial explosion inherent in the older paradigm. The present paper presents the directional harmonic model, a more specific development of the harmonic resonance theory, designed to account for specific perceptual grouping phenomena. Computer simulations of the directional harmonic model show that it can account for collinear contours as observed in the Kanizsa figure, orthogonal contours as seen in the Ehrenstein illusion, and a number of illusory vertex percepts composed of two, three, or more illusory contours that meet in a variety of configurations.

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This paper considers parallel machine scheduling with incompatibilities between jobs. The jobs form a graph equivalent to a collection of disjoint cliques. No two jobs in a clique are allowed to be assigned to the same machine. Scheduling with incompatibilities between jobs represents a well-established line of research in scheduling theory and the case of disjoint cliques has received increasing attention in recent years. While the research up to this point has been focused on the makespan objective, we broaden the scope and study the classical total completion time criterion. In the setting without incompatibilities, this objective is well-known to admit polynomial time algorithms even for unrelated machines via matching techniques. We show that the introduction of incompatibility cliques results in a richer, more interesting picture. We prove that scheduling on identical machines remains solvable in polynomial time, while scheduling on unrelated machines becomes APX-hard. Next, we study the problem under the paradigm of fixed-parameter tractable algorithms (FPT). In particular, we consider a problem variant with assignment restrictions for the cliques rather than the jobs. We prove that, despite still being APX-hard, it can be solved in FPT time with respect to the number of cliques. Moreover, we show that the problem on unrelated machines can be solved in FPT time for reasonable parameters, in particular, the parameter combination: maximum processing time, number of job kinds, and number of machines or maximum processing time, number of job kinds, and number of cliques. The latter results are extensions of known results for the case without incompatibilities, and can even be further extended to the case of total weighted completion time. All of the FPT results make use of n-fold Integer Programs that recently received great attention by proving their usefulness for scheduling problems.

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The article justifies the approach to the essence of sovereign power from the point of view of the Western Christian theological paradigm. In this regard, the author considers the “miraculous” aspect of the power of the sovereign, derived from the idea of the absolute power of God, whose volitional decision is capable of limiting/suspending the operation of natural laws in the manifested form of a miracle. In the most general sense, a miracle is understood as a divine act that is extraordinary (exceptional) in nature, an act that interrupts the usual phenomenological series, proclaims the will of God and has the property of “salvation”. Thus, the theological concept of a miracle turns out to be a paradigm of secular sovereign power, based on the exclusive right to decide on a state of emergency. The concept of sovereignty, which includes the notion of the absoluteness and indivisibility of the supreme power, has a theological origin, since absolute power can only be an attribute of an absolute being, that is, God. The secularization and politicization of theological concepts build sovereign power on the basis of the equality between the sovereign and God, giving the state ruler the place that God occupied in the universe. The personified image of the sovereign represents a logically necessary completion of the hierarchical system of power. The transformation of the monarchic principle of sovereign power into the people’s democratic one leads to the formation of an administrative-bureaucratic state, where the criterion of sovereignty is not legitimacy, but the effectiveness of managerial actions, which involves the permanent use of emergency measures. The “salvation” of God’s miraculous actions finds its manifestation in the “salvific” purpose of emergency measures aimed at ensuring public safety by preventing fictitious threats. The totalization of the threat establishes a mode of functioning of the sovereign power, which within an exception to the law (“a miracle”) becomes equal to the law.

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For Ukraine, restoring and ensuring the sustainable growth of the national economy through the involvement of, first and foremost, internal factors become extremely important. Therefore, finding out the causes of unsustainable economic growth is an important task of economic science. It is shown that Ukraine’s economy entered a phase of unsustainable growth due to exhaustion of the potential of restorative growth, reduction of the flow of export earnings and foreign capital and increase of external debt. The nature of recessions and upsurges in various economic models is researched. It is found that the national economy is in a state of prolonged recession replaced by minor upsurges, which gives rise to the illusion of overcoming the crisis. It is proved that for Ukraine’s economy there persists a threat to remain in the parameters of stagnation and small growth. The nature of transformation cycle, which includes two phases, is disclosed. Such a cycle determines the boundaries of transition period. The completion of recession and the transition to a stage of sustainable growth are possible only when the mechanism of the capitalist reproductive cycle of industrial capital is launched. It is concluded that the industrial cycle is an immanent form of development of new equipment and technology in a market economy. It is acknowledged that during the years of market transformation, the contradictions inherent in the transition period are not solved. These unresolved contradictions have become essential features of the existing model of capitalism in Ukraine, which give it a specifically historical identity. It is noted that the deep causes of the crisis of the Ukrainian model are embodied in the system of social reproduction of industrial capital, which, under conditions of market mechanisms, caused a sharp contraction of manufacturing industries and expansion of the raw material sectors. The proposition is justified that a way out of current problems and transition to the sustainable development trajectory are possible on the basis of a new model that would combine market and state-regulated principles. The necessity to develop the comprehensive plan for updating the material and technological structure of the national economy is substantiated.

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Evolutionary and spiral acquisition are currently trends in use for acquisitions where the outcomes are uncertain. This paper looks beyond these processes to a concept emphasising trust and transparency within a transaction cost paradigm trust contracting. The evidence suggests that in this experimental trust contracting case study, there was a transaction cost advantage to the buyer of 55% over that of existing high tech acquisition processes. Where the end product (good or service) is largely unknown at the time of contract signature, trust contracting provides transparency and contractual safeguards for both contracting parties, and offers an alternative form of corporate governance which makes use of trust to improve buyer-seller relationships and outcomes for both, allocates risk according to the party best placed to carry the risk, speeds completion of contractual arrangements, and reduces transaction costs for both parties.

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This article brings within two purposes. First it validated the scale of the New Ecological Paradigm (NEP) and then analyzed the ecocentrist and anthropocentric attitudes of university students from a Brazilian higher education institution. The original NPE scale of 15 items was used, in the form of a questionnaire and applied in a sample of 241 university students. Before the self-completion of the questionnaires, the university students did not receive the basic concepts of environmental attitudes. Confirmatory factor analysis techniques were used to test the structural model and statistical procedures to describe the sample as to its properties of similarities between the groups of students. The NEP was reduced to 13 items, proving to be reliable and valid to investigate structured and multidimensional environmental attitudes of university students. When analyzing the segmentation of university students, it was identified that women presented a more intense ecocentrist attitude than men. For the other segmentation groups in relation to age range, area of knowledge, semester in progress and course period, they did not present statistically significant differences. However, overall, the scores of university students indicated more ecocentrist than anthropocentrist attitudes. The convenience sample of part of the courses offered by the higher education institution may cause a bias in the research, considering as a limitation of this study. However, with the confirmation of the two-factor model, the results indicate consistency and guide future research to activities related to the environment, such as sustainable tourism, preservation against environmental impacts, among others.

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Attention is known to modulate itch intensity. In contrast, the reverse relationship, i.e. the degree to which the presence of an acute itch affects attention, is currently not well understood. The aims of this study were to investigate whether acute itch induces an attentional bias towards or away from visual itch-related stimuli, and if so, whether it occurs in the early or later stages of processing. A volunteer sample of 60 healthy individuals were subjected to a skin prick (either histamine or placebo), followed by completion of a spatial cueing paradigm using itch-related and neutral words as cues, in order to obtain reaction time estimates of attentional bias. The results suggest that experience of acute itch induces attentional avoidance of visual itch threats. This attentional avoidance occurs at a later processing stage in the form of facilitated disengagement of attention from itch and/or delayed disengagement from neutral information.

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In recent years, calls have grown for the implementation of heutagogy, a form of self-determined learning, in higher education settings. Although a key tenet of the heutagogic paradigm is a belief in the notion of human agency, our recent experiences as university tutors suggest that many students might not actually desire some of the aspects inherent in the approach, instead preferring more didactic, tutor-led modes of teaching and learning geared towards successful completion of assessed work. This paper reports the extent to which undergraduate students (N=35) at two different UK institutions, about to embark jointly on a module designed using a heutagogical approach, valued learner autonomy and self-determination in their studies. It also identified students’ major motivators when undertaking the module. Results suggest learner autonomy and self-determination were indeed valued by students, with four themes describing their main motivators: (a) achievement, (b) knowledge and understanding, (c), self-improvement, and (d) peer learning and interaction.

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The Outcome Measures in Rheumatology (OMERACT) Equity Special Interest Group (SIG) was established in 2008 to create a preliminary core set of outcome measures for clinical trials that can assess equity gaps in healthcare and the effectiveness of interventions to close or narrow gaps between advantaged and disadvantaged populations with musculoskeletal (MSK) conditions. At the OMERACT 11 meeting in 2012, the Equity SIG workshop focused on health assessment scales and their applicability for disadvantaged patients with MSK conditions. The intent was to determine whether the items and domains in 2 common questionnaires, the Health Assessment Questionnaire and the Medical Outcome Study Short Form-36 Survey, are appropriate for the activities and life experiences of certain disadvantaged populations, and whether completion of any of the scales would present a challenge to disadvantaged persons. To generate discussion, we considered the reading level of items in these questionnaires and whether they would be accessible to people with different levels of literacy. The group concluded that the choice of measurement instrument may contribute to “outcome measure–generated inequalities” because disadvantaged groups might have difficulty understanding some of the questions. The future work of the Equity SIG will explore the appropriateness of different measurement scales as they relate to inequities in arthritis as well as the risk of exacerbating disadvantages for patients with low literacy.

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In the spring of 2021, the University of San Diego’s Department of Integrated Engineering taught the course, “Integrated Approach to Energy”, the second offering of a new required course, to nine second-year engineering students. The sociotechnical course covered modern energy concepts, with an emphasis on renewable energies and sustainability, and it exposed the students to other ways of being, knowing, and doing that deviated from the dominant masculine Western White colonial discourse. Following the course completion, we interviewed five students by using a semistructured protocol to explore how they perceived of and communicated about engineers and engineering. We sought to identify the takeaways from their course exposure to sustainability and the sociotechnical paradigm, which were central to the course. The findings suggest that the students were beginning to form sociotechnical descriptions, and that they were still developing their understanding and perceptions of engineers and engineering. Moreover, we observed that they were still wrestling with how best to integrate sustainability into those perceptions. There was an a-la-carte feel to the students’ conceptualizations of sustainability as it related to engineering, as in, “you can ‘do’ sustainability with engineering, but do not have to”. We argue that engineering students likely need these pedagogical paradigms (sociotechnical engineering and sustainability) woven through the entirety of their engineering courses if they are to fully accept and integrate them into their own constructs about engineers and engineering.

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Object The aims of this study were to present the rationale for and the evolution of a staged, two-procedure paradigm for spinal surgery requiring pedicle screw instrumentation, and to evaluate the feasibility, safety, and efficacy of the technique. Methods The rationale for the new algorithm is presented for consideration in the form of unproven hypotheses subject to verification by subsequent studies. The first stage of the two-staged algorithm, performed in an interventional radiology (IR) setting, involves percutaneous placement of either headless pedicle screws or K-wire fragment placeholders of the trajectory for pedicle screws. The second stage, performed days or weeks later, involves open surgical completion of instrumentation placement and other surgical objectives. The techniques for IR percutaneous K-wire fragment and percutaneous screw placement evolved over the duration of the study. Instrumentation was placed in 126 pedicles in 25 patients. Efficacy was equated to the accuracy of screw placement, which was evaluated using computed tomography (CT). Algorithms incorporating correction for metal artifact were developed to determine deviation of the screws and K-wire fragments from proper position. Over 1500 measurements were made to evaluate K-wire fragment and screw position in the 116 instrumented pedicles for which CT data were available. Results Accuracy of placement (relative to both cortical and pedicle breaches or to only pedicle breaches) was 98 to 100% for K-wire fragments, 96 to 98% for screws following K-wire fragments, and 100% for percutaneous screws. The only adverse consequence of pedicle screw placement by this method was one infection that occurred 8 months postoperatively. Conclusions The staged, two-procedure paradigm for pedicle screw placement proved, within the limits of this study, to be feasible, safe, and effective; therefore, the unproven rationale behind the new paradigm merits further evaluation in a larger cohort of patients with randomized, matched controls.

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1093 Background: The “Intensive Trial of OMics in Cancer”-001 (ITOMIC-001; Clinicaltrials.gov ID: NCT01957514) enrolls patients with metastatic triple negative breast cancer (TNBC) who are platinum-naive and scheduled to receive cisplatin. Multiple biopsies (up to 7 metastatic sites) are performed under carefully controlled conditions prior to and upon completion of cisplatin treatment and following any subsequent therapies. Samples are chosen for DNA sequencing, RNA sequencing, and quantitative proteomics (GPS Cancer). Here we describe the -omic alterations acquired during treatment. Methods: We analyzed 74 biopsies from 17 patients taken at various clinical timepoints (e.g. initial diagnosis, initial trial recruitment, following cisplatin treatment, etc.) spanning 2 years on trial and over 8 years before recruitment. This dataset includes 64 whole genomes (with matched-normal blood samples), 44 RNAseq expression profiles, and 23 proteomic sets. GPS Cancer, which comprises whole genome sequencing, whole transcriptome sequencing, and targeted quantitative proteomics was used to detect somatic alterations, measure mutational burdens, and estimate expression profiles of both transcripts and proteins. PARADIGM pathway analysis was used to identify network-level changes through integration of all available data types. Results: While mutational profiles within patients were largely stable over time, we observed up to a 10-fold difference in the magnitude of mutational burden between patients. Following cisplatin treatment, the expression of over 300 genes were significantly perturbed, and an average of 270 mutations per patient were introduced. PARADIGM integrated pathway analysis shows differential activity in the MYC/MAX and ETS1 pathways during tumor progression. Conclusions: Using GPS Cancer we provide detailed characterizations of the molecular profiles of metastatic TNBC across space and over time. We demonstrate the potential for using this information to discover mechanisms underlying treatment resistance and disease progression. Our findings form the basis for molecularly informed QUILT trials for combination therapy.

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For junior high school pupils, research on the development of learning media is badly needed. Students' understanding and mastery of specific materials should improve as a result of the availability of learning media. The goals of this study are to (1) create a product in the form of a learning media called Noun Words Domino Card (NWDC) that is appropriate for seventh-graders at Satap Woja State Junior High School; and (2) develop a product in the form of a learning media called Noun Words Domino Card (NWDC) that is appropriate for eighth-graders at Satap Woja State Junior High School. (2) understand the use of NWDC learning media for students, and (3) understand the efficacy of NWDC learning media in improving student vocabulary knowledge. The ADDIE paradigm, which consists of five steps: Analyze, Design, Develop, Implement, and Evaluate, was used to conduct this research. The findings revealed: (1) The noun words domino card (NWDC) is a viable learning material for students to use and assess. The practicality is determined by material experts, who gave it a score of 3.7, and media experts, who gave it a score of 3.5. (2) The noun words domino card (NWDC) is a useful tool for pupils to improve their vocabulary mastery. (3) Learning media noun words domino card (NWDC) is helpful in developing student vocabulary knowledge, according to the student's reaction as a user of learning media with a total average score of 3.6. It was calculated using the average oral test score of students who met the English subject's minimal completion criteria.

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Background: Blood lipid profiles consist of total cholesterol (TC) and its fractions, high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL), non-high-density lipoprotein cholesterol (non-HDL), and triglycerides (TG). For several decades, studies have examined the effects of various factors on lipid status and its association with the risk of developing arteriosclerosis and cardiovascular disease. The beneficial effects of increased physical activity on cardiovascular health have been demonstrated by appropriate modulation of lipid profiles. For individuals with low physical activity, the literature recommends engaging in various forms of training that can improve physical fitness and resting lipid status. The aim of the study was to examine whether a specific original training program improves lipid profiles to the levels recommended for the male population. Methods: The study involved two equal (n = 15) groups of men (experimental and control groups, aged 35–40 years). The experimental group performed 60-min training sessions for 8 weeks (3 times a week) including a set of strength and endurance exercises. Before and after the training program, blood was drawn from both groups for serum determination of TC, HDL, LDL non-HDL, and TG, and a battery of four field physical performance tests was administered. Results: Statistically significant decreases (TC by 19.3%, TG by 23.7%, LDL by 15%), a non-significant decrease (10% for non-HDL), and no change for HDL were found in the experimental group. Control group showed a statistically significant decrease, by 7.4% for TC. The results confirm the effectiveness of the proposed training in improving health indices. Conclusions: The 8-week training program met the health-related fitness paradigm recommended for physical activity in men aged 35–40 years. After the completion of the program, all the participants expressed their satisfaction from participating in a health-promoting experiment.

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651 Background: The objective of this study was to determine the effect of online, case-based, continuing medical education (CME) on the knowledge and competence of oncologists regarding the management of metastatic renal cell cancer (mRCC). Methods: Oncologists participated in a text-based online CME activity composed of 2 patient cases with interactive questions. Evidence-based educational feedback was provided following each response. Three multiple-choice knowledge/competence and 1 self-efficacy question were selected from the set of intra-activity questions to be repeated after participation. These were used to assess the impact of the education in the form of a repeated pairs, in which each participant served as his/her own control. The analysis included: For all questions combined, McNemar’s chi-square test assessed the differences from pre- to post-assessment; P values <.05 are considered statistically significant; Effect size was calculated using Cramer’s V by determining the change in proportion of participants who answered questions correctly; The activity launched online 9/2016 and data collected through 10/2016. Results: Upon completion of the activity, an improvement was observed in oncologists’ ability to: Identify the most appropriate evidence-based regimen for a patient with mRCC that has progressed on a first line TKI (60% vs 18%, P =0.019); Recognize the symptoms of an irAE in a patient receiving an immune checkpoint inhibitor (55% vs 85%, P <0.001); Elicit patient preferences, goals, and values to help decide the best course of action in their care and disease management (26% vs 83%, P <0.001); Feel more confident in selecting the most appropriate option for a patient with mRCC whose disease has progressed on therapy (+17%). Conclusions: An online, interactive, case-based CME activity improved the knowledge/competence of oncologists, showing that unique educational methodologies and platforms, available on-demand, can be effective tools for advancing clinical decision making in the rapidly changing environment of mRCC disease management. Additional studies are needed to assess whether improved aptitude translates to improved performance during clinical practice.

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The article considers the paradigm of the concept of death in the lyrics by Ostap Tarnavsky as a subject of his poetic philosophical thinking and interpretations.O. Tarnavsky’s lyrical poetry, in which the poet highlights the problems of human existence, moral and psychological aspects of the finiteness of earthly existence, reveals the dualism of the author's thoughts. The poet sought to comprehend death, on the one hand, as the end of human existence, which implied facing its tragic irreversibility and then overcoming the fear of death for achieving the authenticity of being. On the other hand, he admitted coexistence with death, which is the guide of a man on the path to eternity. The philosophical concept of coexistence as a common being of the human self with others and with the world was substantiated by the Italian existentialist philosopher Nicola Abbagnano in his work “Introduzione all'esistenzialismo” (1942). Poetic and philosophical understanding of the concept of death as a transition from earthly existence to eternity was unfolded by O. Tarnavsky in a wreath of sonnets within the collection “Life”. In the 11th sonnet “The order of the world creates in the head…” the author equates death with immortality because only after the completion of the earthly path a person approaching God in life – “perceives the One who creates” and gets Him. In his poems, O. Tarnavsky comprehends the earthly space and time as a certain section of moving to eternity and seeks to outline its coordinates (“Phantoms in Emptiness”). Death is only a coexistent form of eternity that changes one stage into another. The situation of birth and death, according to the Italian philosopher-existentialist N. Abbaniano, is the very depth of coexistence. In the poem “Where do you call to go, princess?..” the paradigm of the concept of death is narrowed and existentially personalized to ‘my death’, which eventually transforms into the author’s vision of death. In his philosophical lyrics, O. Tarnavsky covers the problems of human existence – earthly and eternal, psycho-spiritual and moral-psychological aspects of the last stage of earthly life. The poet represents the dialectic of life and death and, in particular, the paradigm of death, from religious, philosophical, and axiological points of view. At the same time, he demonstrates purely psychological reflections, expressed in spiritual and emotional experiences.

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Higher education institutions are the main institutions in creating young people who can be ready to enter the world of work and industry, and one of the educational programs that take part in vocational education. Vocational education is higher education that is directed at focusing certain applied skills. Harapan Bersama of Polytechnic is one of the vocational education institutions that provides Human Resources (HR) to become the younger generation as practitioners in industry, companies, or other stoke holders. In the D3 Computer Engineering Study Program, each batch can graduate approximately 300 graduates, where each graduate will produce one scientific work from the final project research conducted. Likewise, with students who do practical work (KP), every student who does KP will produce scientific papers. But all the results of this scientific work, namely the research report of the Final Project and the Job Training Report are still being submitted to the Study Program in one compact disk (CD). This turned out to be a problem for the Study Program because from each batch, around 300 compact disks (CDs) were collected from the results of scientific work from the practical work and 300 compact disks (CDs) from the final project research outputs. Physical data in the form of a compact disk (CD) requires a large space for its placement. Meanwhile, the condition of the D3 Computer Engineering study program room makes it impossible to place the physical form. And along with technological developments, this physical form can be replaced by soft files in the form of e-journals or e-reports. This needs to be done in line with the paradigm shift from conventional libraries to e-libraries. With the existence of SIPESTA or the information system for the completion of this Final Project, the results of writing scientific papers are uploaded and become a digital trace of all scientific papers that have been carried out by all D3 Computer Engineering students. And so if this data is needed it will be easy to find because the database has been well managed.

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This article is devoted to the problem of theory and practice of public administration in modern conditions. Actualization is carried out by searching for a new paradigm approach in order to determine the starting points regarding optimization and increasing the efficiency of the corresponding sphere of public relations. The self-organizational approach, developed as a synergistic-information approach, corresponding to the methodological principles of the modern postnonclassical paradigm of scientific rationality, which was the result of the development of ideas of cybernetics, tectology, theory of systems and theory of dissipative structures, represents a special (different from the “classical” (mechanistic)) view on the relations of organization and management of state processes. It is established that the process of organization is aimed at revealing new socially constructive qualities of the becoming systemic form and provides fixation and completion of the corresponding self-organizing structures of the state mechanism. Self-organization is included in the organizational process, providing flexibility and adaptive capacity of purposefully created structures. However, in this process, at the same time, there are stable structures of static importance, forming subsystems of management, designed to preserve the static form, regardless of their social value. The objective conservatism of these formations stagnates the creative renewal of the way of activity of social individuals, thus closing the process of formation of society as a whole and turning it into a system of final type. In this case, self-organization manifests itself as an opposing party to such a state and on a historical scale destroys the rigid structures of public administration, with their inherent anomalies of the state apparatus. In the synergistic-informational understanding of the meaning of the state, its administrative purpose is to provide conditions for the dynamic formation of society capable of overcoming extreme, crisis processes. As a result, it is possible to consider the provision on the unity of forms of public order - self-organization, organization and means of their provision - public administration. The latter is considered not only as a function of organization and manifestation of self-organization, but as a means of implementing public order in both forms. This implies overcoming the mismatch between the interests of the people and the system of power in the state policy. Since the formation of such a policy of the state is associated with the transition from the power base of regulation of public relations to the information one, this process acquires an objective meaning and cannot but form the basis for the development of the strategy of socio-economic and socio-political development of the country, all socially significant administrative projects.

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The paradigm shift during the Covid-19 pandemic requires educational institutions to follow current technological developments. Online learning is the main choice to avoid the spread of the virus. The purpose of the study was to determine the inhibiting factors for online learning in nursing students. This type of research is descriptive study. The population is all nursing students with Total Sampling technique. The sample criteria are nursing students, willing to be respondents, in good health, not in clinical practice. The number of samples in this study was 209 people. Data collection through questionnaires using the Google Form application. The author sent an electronic survey via WhatsApp Group (WAG) students from April 1 to June 30, 2020. The questionnaire used a combination of multiple choice, Likert scale, and open-ended questions containing demographics (gender and level of education), barriers to online learning, and access to technology. The results of the univariate analysis through the frequency distribution are obtained that majority of respondents are female (94.3%), majority of respondents are DIII Nursing (92.3%), the inhibiting factors consisted of internet instability (54.5 %), power outages (89%), smartphones that were not supported (44%), Tech stuttering (58.9%), insufficient quota subsidies from campus (35.6 %) and parental support have not been maximized (43.1%). Conclusion: the most important inhibiting factor for online learning is power outages. The need for online application socialization and support for adequate facilities and infrastructure at home. For future research, it is recommended to study the effect of online learning in improving student competencies and attitudes. To improve optimal online learning at home, I hope that there will be family motivation so that students can follow the learning process to completion.

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Purpose – The purpose of this study was twofold: first, to optimize the Environmental Attitudes Inventory (EAI) and second, to establish a baseline of the difference in environmental attitudes between first and final year students, taken at the start of a university’s declaration of commitment to EfS. Design/methodology/approach – The psychometrically designed EAI was used to overcome the problems and limitations of the much-used, but controversial, revised New Environmental Paradigm (NEP) Scale. The performance of the original 72-item EAI was compared with our 37-item reduced form using a population of first- and final-year university students. Findings – The reduced 37-item EAI provides a reliable and valid tool for investigating structured, multi-dimensional environmental attitudes of university students while reducing response burden and increasing response and completion rates compared with the longer versions of the EAI. Research limitations/implications – No attempt is made to link elements of the university experience with changes in attitude between first- and third-year students. The authors expect the 12-faceted EAI to provide more detailed feedback on the affective outcomes of EfS initiatives than currently used instruments. Originality/value – This research contributes to establishing the EAI as a gold standard with which to monitor students’ environmental attitudes. Although most studies aimed at understanding the impact of EfS measure attitude change over relatively short periods of time – typically using the brief NEP scale administered immediately before and after a specific semester course – the approach developed here is designed to detect attitudinal change that may be ascribed to the entire university experience between students’ first and final year.

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PURPOSE: The majority of patients with epithelial ovarian cancer (EOC) who achieve a complete remission with front-line chemotherapy develop recurrent disease. Carboplatin and pacl*taxel are used for patients with platinum-sensitive recurrent disease, although there is little information regarding the response and survival in unselected patients treated with this strategy. We sought to determine the outcomes for patients with EOC treated with carboplatin and pacl*taxel at the time of first recurrence. In addition, we sought to define a new paradigm for disease transition in patients with EOC. PATIENTS AND METHODS: Eighty-nine patients were identified who had a complete response to front-line platinum-based chemotherapy for EOC, relapsed 6 months after completion of front-line chemotherapy, and were treated with carboplatin and pacl*taxel as second-line therapy. RESULTS: Eighty-four cases were available for analysis of survival end points, and 66 were assessable for response. The median follow-up was 27 months. The overall response rate was 70%. The median progression-free interval for the cohort was 13 months (95% confidence interval [CI], 10.7 to 13.8 months). The 3-year survival rate was 72% (95% CI, 59.4 to 86.1%). Toxicity was limited, and no deaths from treatment were observed. Using this data, it is possible to construct a disease states model of EOC, which provides risk estimates for transitions between clinically distinct categories. CONCLUSION: Re-treatment with carboplatin and pacl*taxel is effective as initial therapy in recurrent EOC. This should form the basis of a randomized trial to determine the best agents for initial treatment of relapse from EOC in potentially platinum-sensitive patients.

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INTRODUCTION:Cost-effectiveness analysis is probably the most often applied analysis in the field of Health Technology Assessment. Yet, there are major issues related to this analytical approach. Apart from the discussions about discounting, and which type of costs should be included in the analysis, there is discussion about the measurement of the health effects. The dominant economic and decision-making research paradigm that underpins present protocols to value health show flaws and limitations.METHODS:All existing generic health instruments (for example,. EuroQol five dimensions questionnaire, EQ-5D; Health Utilities Index, HUI; Short Form, SF-6D) used to collect values for health states use a small, fixed set of health domains. Descriptions of health states are created based on these domains and their levels. Subsequently, these descriptions are valued with special preference-based methods (measuring the quality or importance of something). When developing those instruments, patients’ opinions were not actively incorporated in the choice of domains, nor have patients’ preferences been considered in assessing weights to the domains and their levels.RESULTS:We developed a novel preference-based health measurement methodology that combines the strength of two existing measurement models for subjective phenomena: the discrete choice model and Rasch item response theory (1-3). This new approach is referred to as the multi-attribute preference response (MAPR) model. This is the first generic health preference-based model that is fully based on the perception and reporting from patients (experienced based) and is insensitive to adaptation mechanisms. Apart from being grounded on measurement theory, the valuation tasks are easy and attractive to perform in a self-completion setting. A first application based on this novel model has been worked out in a mobile app to measure the overall health condition of infants (reported by mothers).CONCLUSIONS:Our recently introduced and informative health measurement model overcomes many problems associated with the conventional methods.

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Abstract Hematological toxicity is a significant dose limiting side effect in the aggressive treatment of Diffuse Large B Cell Lymphoma (DLBCL). In the current study, pegfilgrastim was given to patients following each cycle of DA R-EPOCH. ANC and platelet nadirs were then compared to a previous report utilizing filgrastim. Pegfilgrastim is a covalent conjugate form of filgrastim, whereby a molecule is covalently bonded to the N terminal of filgastrim, allowing the molecule to be cleared slower than filgastrim. The prolonged effect on the promotion of granulocyte proliferation allows for pegfilgrastim to be given once every 2 weeks in comparison to filgrastim which is injected daily. In this study, records of 5 patients treated with DA R-EPOCH for DLBCL were examined. There were a total of 20 cycles with 15 cycles qualifying for analysis in regards to hematological toxicity. To qualify each cycle met the following criteria: i) treatment with R-EPOCH at starting dose or dose-escalation; ii) pegfilgrastim was administered 24 to 48 hours after completion of chemotherapy at the standard dose of 6mg sc; iii) follow-up of at least two weeks following each cycle; iv) CBC monitored at least once weekly. Of the cycles excluded, 3 cycle did not have at least 2 weeks of follow-up, 1 cycle was followed by filgrastim and 1 cycle was treated with R-CHO. Nadir was defined as lowest value obtained from initiation of one cycle to initiation of next cycle or to two weeks from last day of all chemotherapy. Hematological toxicities were graded according to WHO criteria. Grade 4 neutropenia (ANC less than 0.5 x 109/L) occurred in 13% (2/15) of cycles. There was no Grade 3 neutropenia (ANC 0.5 – 1.0 x 109/L). Range of ANC nadir was 0.02 – 4.4 x 109/L with mean of 2.4 x 109/L. There was no Grade 3 thrombocytopenia (Platelet 25 – 50 25 x 109/L) nor Grade 4 thrombocytopenia (Platelet &lt; 25 x 109/L). Range of platelet nadir was 53 – 230 x 109/L with mean of 130. Examining treatment records, 13 cycles of 20 were candidates for dose escalation. Each cycle was included if it followed a cycle of R-EPOCH and the patient had received pegfilgrastim for neutropenic support. Excluded cycles included 5 cycles at starting doses, 1 cycle in which filgrastim was administered prior, and 1 cycle in which the R-CHO was given prior. Following the criteria for allowable DA EPOCH according to the paradigm published in Blood Apr 15, 2002, Vo 99, No 8 pp 2685– 2693, dose escalation was allowed for ANC of at least 0.5 x 109/L and platelets of at least 25 x 109/L. 11 of 13 (85%) cycles in this study were eligible for dose escalation based on the above mentioned paradigm. In the previous mentioned publication filgrastim was given after completion of each cycle of EPOCH with 49% of cycles complicated by Grade 4 neutropenia and 7% complicated by Grade 4 thrombocytopenia. 58% of the cycles were dose escalated in the previous study. In conclusion this study indicates that pegfilgrastim results in less hematological toxcity in DA R-EPOCH. This allows for DA in a higher percentage of treatment cycles. In addition, examination of the cost reveals the average whole sale price of a single 6 mg dose of pegfilgrastim is $3127, while the average whole sale price of a daily dose of 480 mcg of filgrastim for 10 days is $3500.

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The problematic of the categorical aspect of the term of the soul through the prism of the principle of systematicity (organization) has been reviewed in the article. The problematic of the place of the category of a soul in the categorical apparatus of theoretical psychology have been shown through the context of general categories of the structure of the human – an organism, an individual, an individuality, a personality, the I, the subject. The problematic of analysis and disclosure of the meaning load of the specified of categories which is due to the application of the principle of determinism to their analysis has been noted. The possibility of building a hierarchical range of categories as levels of concretization (organization) of a mental structure of the one by analogy with respect to such a range of levels of concretization (organization) of a living that have been shown. It has been noted that specifics for a range of levels of organization of a living one is its start with a unit of analysis of what is alive – an organism, also specific is its completion represented as a unit of development of a living form of life – a body. The conceptual filling of range of levels of an organization that is characteristic to a mental structure is appropriate of general categories of the structure human in accordance with the principle of systemicity has been proposed. The article also deals with the connection of the concept of a soul with categories that lie beyond the scope of psychological science per se, like philosophy. The necessity of the said action is justified by the historical context of the humanity's literary and social practices that include the notion of the soul. The article concludes with the outline of the future direction for theoretical research of the outlined problematic aimed at making space for the notion of the soul in psychological science and the system of its concepts. Overall, the work is dedicated to the efforts of bringing more clarity to the use of the concept of the soul within the existing paradigm of psychology.

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The article discusses the expediency of abandoning the tool of social forecasting in the practice of public administration in favor of planning and design methods. The methodological basis rests on the conceptual imperative of the impossibility to produce adequate forecasts in the modern world, which is supported by such respected researchers as Douglas North, George Soros, Nassim Taleb and Arnold Toynbee. The fairness of this thesis is illustrated using methods of comparison and analysis. The study analyses the main factors that cast doubt on the possibility and expediency of preserving the tool of social prognostics: the failure of the scenario forecast format; the need for foreknowledge of events rather than values of traditional macro-parameters; the extension of Arnold Toynbee’s principle from a historical retrospective to studying the prospects; the economic growth rate indicator (GDP) losing its indicative universality and the emergence of alternative measures of social development (Gross National Happiness, culture and environment preservation); critical attitude of the intellectual elite to the possibility of social forecasting; unreliability of the source statistics; the expectation of the end of economic growth, a change in the development regime and quantitative forecasting devaluation by the leading experts – Douglas North, Robert Lucas, Tom Piketty, Richard Heinberg; the completion of the mission of capitalism in the form of the Neo-Malthusian trap and robotomics (mass introduction of robots to the economy). The authors prove that amid fading interest in traditional forecasting, alternative prognostication methods are emerging, such as planning, designing, futurology, foresight and strategic intelligence. Devaluation of forecast tools leads to the need to change the old doctrine of public administration, based on forecast documents, to a new one implying a transition to active construction of the future through directive designing and planning. The theoretical and practical significance of the study lies in substantiating the principles of a new management system: expanding the planning and design horizon (up to 30 years); introducing a mechanism for implementing plans and projects; introducing mechanisms for pre-project foresight; creating a twolevel economic management system; and moving from the quantity paradigm to the quality one.

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Object Given the pragmatic difficulties in developing randomized controlled trials in patients with disorders of the spine, the Wisconsin Spine Outcome Group has adopted the use of a prospective registry design to perform comparative effectiveness research on treatments for degenerative lumbar disorders. The goal of the Wisconsin Spine Outcome Study–Pilot (WISPOS-P) was to establish a Web-based, Health Insurance Portability and Accountability Act–compliant registry and to implement a patient registration paradigm that demonstrates at least 80% compliance in collecting pre- and posttreatment data in patients with lumbar disorders, regardless of the treatment they receive. The primary outcome measures were the percentage of patients with lumbar spine disorders who completed a Web-based survey preappointment, and at 1 and 3 months postappointment; the percentage of patients receiving a physician-assigned diagnosis in the registry; and the success of electronic data transition from the Web-based interface to a locally controlled registry. Methods The WISPOS-P uses a prospective, diagnosis-based registry design. A universally accessible and secure Internet-based data management platform was created that accrues self-entered patient data on validated disability indices, including the visual analog pain scale, Oswestry Disability Index (ODI), and the 36-Item Short Form Health Survey questionnaire. Data were obtained on patients, preappointment and at 1 and 3 months postappointment, regardless of the treatment rendered. A physician-entered diagnosis was assigned to each patient for data stratification. Results One hundred patients were invited into the WISPOS-P; 90 patients participated, and 10 withdrew for various reasons. Eighty-eight of 90 patients were assigned a diagnosis by the evaluating physician. Preliminary and qualitative assessment of the data shows that the major difference between patients who withdrew from the study and those who participated was the number of days between study invitation and clinic appointment (median 11 vs 20.5 days, respectively). In evaluating patients by mode of survey completion, the 2 largest groups were those who completed their intake forms electronically before their clinic appointment and those who used the paper format. The median age of patients electronically completing this survey was 14.34 years younger than those using the paper format. A significantly higher proportion of patients who completed their forms electronically had listed an email address. The 3 major diagnoses were disc disease (32 patients), stenosis (24 patients), and nonsurgical pain of spinal origin (14 patients). Patients with stenosis were older than those in the other 2 groups. Patients with nonsurgical pain of spinal origin had lower ODI scores compared with the other 2 groups. Conclusions A diagnosis-based registry design is effective in collecting pretreatment data for patients with lumbar disorders. When stratified by diagnosis, comparative effectiveness analyses can be performed to identify optimum treatments for lumbar disorders given individual patient characteristics. The WISPOS-P has established a mechanism and proof of principle for the participation of patients in an outcomes registry.

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The article overviews the basic assumptions and limitations of conceptual blending theory (CBT) as applied to music, and reconsiders the implications of the theory for musical creativity. CBT accounts of music have until now relied quite extensively on examples of music-as-product, and rarely considered the various levels of mediation between composition, performance and listening. It is therefore argued that an investigation of more process-based paradigms could hold significant ramifications for CBT. This argument is elaborated through a discussion of three intermedial, open-form scores by Earle Brown, Pauline Oliveros and Jennifer Walshe. The scores are considered as documents of situations where one or more performers partake, as active agents, in the composition, completion and elaboration of new cross-domain blends, as well as in the disintegration of already blended concepts. This conscious disintegration or unpacking of blends in performance is discussed as a significant aspect of the musical blending process as such, and one that deserves further consideration in creative conceptual blending research.

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Modern philosophical anthropology reveals more and more complicated structure of a person’s inner world. While in the classic paradigm when reviewing the essence of a human the attention was paid to the importance of the person’s essential features, that is to the existence of certain circ*mstances (social determinants, divine origin, etc…), contemporary science considers it as something that splits into many epihpenomas, stratifies in its own ambiguity, which brings it to losing meaningfulness of the personal existence, takes away its objective reality and comprehension of its own existence and its self-completeness.In such circ*mstances, it is relevant to study the phenomena of human existence, which could update its life, «turn it face to face» with its life and itself. A human is the only creature, whose being is not determined by the fact of birth («to be a human» is not the same as «to belong to biological species»). It is transcendence that goes beyond the limits of the biological sphere and opens the existential dimension of the personality and forms the «humaneness in a human being».The essence of a person acts like «indefinite-definite»: while he / she is alive nothing is known for sure about him/ her and when death comes, it’s impossible to change anything. Life consists of many events, phenomena of existence, «singularities», «temporal identities», which together form a single integrity. Each of the «here-and-now» phenomena of life can affect a personal «I» as a whole and change it.In this sense, self-consciousness can be considered as the analogy of the fractal, as eye visualization of the idea of «chaotic» complexity, endless formation and incompleteness of many socio-cultural phenomena, that is, it is considered a stochastic system. The essence of the personality in the existential sense is constant transcendence, going out of the bounds of certainty, openness to the world, constant dialogue, etc. In this dialogue, the existence means both the beginning, or the «starting point», and a prospect, or an opportunity. Death is the end of any projects and opportunities.«We do not know where and when death awaits us, so let’s live as if it were near...» It is the comprehension of the phenomenon of death, death here and now that can annually determine its own certainty, opens to the person its own self in the unity, integrity of the manifestations of the phenomena. Therefore, the comprehension of the phenomenon is death (unavoidable and possible here and now) comes into collision with «here and now essence», «a meeting dialogue» with one of the «temporary self-independence». This is the dialogue between what you are now and what you would like to be. An essential feature of an individual, an existential identity consists of a set of «temporary» identities, each of which can become primordial and final. A person as «I-fractal» unfolds possible projects, self-identification. So, in this sense, the attainment of one’s own mortality can become an existential birth, a transition to higher levels of being. Human as «I-fractal» is a stochastic, indefinite system until its completion, and hence the change of completed Self-independence can be over at any time.

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Many practical planning problems necessitate the generation of a plan under incomplete information about the state of the world. In this paper we propose the notion of Assumption-Based Planning. Unlike conformant planning, which attempts to find a plan under all possible completions of the initial state, an assumption-based plan supports the assertion of additional assumptions about the state of the world, often resulting in high quality plans where no conformant plan exists. We are interested in this paradigm of planning for two reasons: 1) it captures a compelling form of \emph{commonsense planning}, and 2) it is of great utility in the generation of explanations, diagnoses, and counter-examples -- tasks which share a computational core with We formalize the notion of assumption-based planning, establishing a relationship between assumption-based and conformant planning, and prove properties of such plans. We further provide for the scenario where some assumptions are more preferred than others. Exploiting the correspondence with conformant planning, we propose a means of computing assumption-based plans via a translation to classical planning. Our translation is an extension of the popular approach proposed by Palacios and Geffner and realized in their T0 planner. We have implemented our planner, A0, as a variant of T0 and tested it on a number of expository domains drawn from the International Planning Competition. Our results illustrate the utility of this new planning paradigm.

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Abstract Survey of career path that students plan after completing their undergraduate in statistics department was carried out through questionnaire on google form from May 6 to May 24, 2021. There were 114 students who filled out the questionnaire, consisting of 20 students from class 2018, 23 students from class 2019, and 71 students from class 2020. Dependent variable is career path plan (Y), while independent variables are tendency to choose career paradigm (CPC), gender (GDR), Grade Point Average (GPA), parental occupation (POC), number of siblings (NOS), place of birth (POB) and year of university entrance (YOE). The data are analysed by binary logistic model with logit transformation and the result is g ( Y ) = ln [ π ( Y ) 1 − π ( Y ) ] = − 13 , 525 + 2 , 332 ( CPC ) − 1 , 036 ( GDR ) + 4 , 466 ( GPA ) + 2 , 421 ( POC 1 ) − 0 , 405 ( POC 2 ) + 2 , 390 ( POC 3 ) + 0 , 236 ( NOS ) − 1 , 817 ( POB ) + 0 , 448 ( YOE 1 ) − 2 , 660 ( YOE 2 ) Results of the analysis show that predictive power of the model to explain tendency of students to choose career according to statistics is around 34% to 56% based on variables in the model. Beside that tendency of career paradigm choice (CPC), Grade Point Average (GPA), parental occupation (POC1 civil servant), place of birth (POB), and year of entry (YOE2 2019) significantly affect chosen career goals by student.

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O objetivo deste estudo foi identificar a utilização do referencial teórico da Complexidade proposto por Edgar Morin na produção do conhecimento sobre cuidado de enfermagem. Trata-se de uma revisão integrativa da literatura, realizada nas bases de dados Biblioteca Virtual em Saúde e PubMed, no período de 2009 a 2020. Para a seleção dos artigos utilizou- a estratégia PICo. Foram incluídos artigos completos e originais. Para auxiliar a análise dos dados, as informações foram operacionalizadas no software IRAMUTEQ®. Foram selecionados 14 artigos, publicados em periódicos nacionais e internacionais, com predomínio de pesquisas qualitativas. Após análise minuciosa originou-se duas classes - Classe 1: O paradigma da Complexidade e os cuidados de enfermagem diante as adversidades da assistência. Classe 2: Complexidade dos cuidados nas fases da infância e adolescência. A Teoria da Complexidade é utilizada para compreender as relações e os fenômenos que circundam a assistência de enfermagem como um todo.

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<p>In everyday life, one’s experience is usually highly structured, coherent, and predictable, a regularity stemming from the many constraints (e.g., cultural and physical constraints) operating upon the natural and social worlds. Consider that events that are experienced in an office meeting are usually not experienced in the great outdoors, and vice versa. This predictability of the outside world is capitalized upon by the brain, which is highly prospective and incessantly extracts meaningful patterns from event sequences. Despite these considerations, to our knowledge there have been no investigations into the ways that the brain copes with experiences that violate this structured regularity. Here we demonstrate a novel paradigm designed to tax this prospective system (by presenting the brain with a rapid series of random events) and show that such exposure reliably induces negative affect. Participants are exposed to <em>Rapid, Random Semantic Activation</em> (RRSA) prior to completing a mood scale; compared to a mood baseline, RRSA yields a consistent pattern of negative affect. This pattern did not emerge in a control group that completed a task with identical stimuli. While previous research has focused on randomness in terms of humans’ ability to produce and detect random sequences, our paradigm explores this issue as it relates to human experience. Our findings are consistent with the idea that, due to the prospective nature of the brain and one’s “epistemic needs” (Kruglanski, 1980), gross violations in the regularity of experience produce some form of negative subjective experience.<strong></strong></p><p><br /><strong></strong></p>

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Pesquisa quantitativa, descritiva, do tipo série histórica, que teve como objetivos: caracterizar a demanda assistida nas Delegacias Especializadas de Atendimento à Mulher (DEAMs) na região metropolitana do Rio de Janeiro quanto ao perfil sociodemográfico, tipo de violência e relação da mulher com o acusado da agressão; e analisar estes dados diante da situação da violência de gênero à luz da discussão temática. Os dados foram coletados a partir de 38.009 registros de ocorrência de violência à mulher no período de 2003 a 2008, cedidos pelo Instituto de Segurança Pública após aprovação pelo Comitê de Ética. As mulheres eram jovens, brancas, com ensino fundamental completo, solteiras e com ocupação. A maioria residia na zona norte da cidade. O local de ocorrência do delito foi a residência. Predominou a agressão psicológica. Os agressores eram membros próximos da família. Violência é uma forma de expressão dessas famílias, sendo necessária mudança de paradigma de civilização.

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The co-creation process within the New Zealand luxury accommodation sector has, until recently, been under researched. However, in 2016, a doctoral thesis was completed [1] with the key question, ‘how is the luxury accommodation experience created?’ Following an interpretivist paradigm, data were collected that included 81 interviews (of 27 guests, 27 employees and 27 managers) within six luxury properties (three luxury hotels and three luxury lodges) which were selected via purposive sampling. Drawing from the findings of the thesis, this article aims to show that co-creation is a valuable tool for hoteliers. Co-creation is about customers creating value for themselves through an interactive relationship with a company. The hospitality industry is a complete veteran at this; for example, the use of à-la-carte menus, whereby a customer has the ability to compose a meal that has value specifically for them. The possible scope of the co-creation process, beyond à-la-carte menus, is now being recognised by the luxury accommodation sector. Co-creation can be described as a joint process that involves a customer and an organisation resulting in an output of value [2]. Co-creation permits and indeed encourages a more active involvement from the customer [1], and is important to organisations as it can ensure that any personal interaction that their customers have adds value to their experience [3]. If co-creation is used to its full potential, it can give an organisation a competitive advantage due to increased customer satisfaction resulting in a positive impact on customer loyalty [4]. Co-creation can also provide continual feedback for improving existing services, presenting a business with constant opportunities to increase their revenue and success [5]. In summary, the main finding of the doctoral research was the consensus among guests, employees and managers that the luxury accommodation experience is materialised through a process of co-creation, involving the many different forms of interaction happening between guests, employees and managers, as well as with external contributors outside of the properties [1]. The practical implications of co-creation cannot be determined without luxury properties first identifying what makes their accommodation a luxury experience. When this has been defined, more interaction between guests, employees and managers should be encouraged to ensure that this particular brand of luxury accommodation experience is created. This could include having staff members dedicated to interacting with guests, and having certain ‘touch points’ throughout the guests’ stay that ensure the type and the amount of engagement that is required happens. External co-creation should also be encouraged; for example, staff visiting the local producers of food and wine, which in turn would enable them to talk more informatively to guests about these products when they are interacting with them during their stay. Another example would be to build relationships with external agents who offer activities to the guests, to enable the continuation of the experience when guests are away from the property. Luxury properties also need to apply co-creation strategies that would enable guests to innovate new products and services. One such strategy is in the form of a digital customer relationship management tool; an example of this being HGRM – Happy Guest Relationship Management, although this technology is still quite innovative. Hotels and lodges need to make sure that they are using Web 2.0 applications such as videos, blogs, fora, wiki, podcasts, chat rooms, YouTube, Twitter and Facebook to encourage communication and social interaction, which is the customer engagement that enables co-creation. For any business that is involved in customer experience, especially hospitality, there is every good reason to go down the route of co-creation, especially when it can give that business a competitive advantage. If you would like to read the PhD thesis this research is based on you can access it here: http://aut.researchgateway.ac.nz/bitstream/handle/10292/9925/HarkisonT.pdf?sequence=3 Corresponding author Tracy is a Senior Lecturer in Hospitality at Auckland University of Technology, New Zealand. Her research passions are hospitality education and the co-creation of luxury accommodation experiences. This has resulted in the completion of her PhD thesis on how the luxury accommodation experience is created. Tracy Harkison can be contacted at: tracy.harkison@aut.ac.nz References (1) Harkison, T. How is the Luxury Accommodation Experience Created? Case Studies from New Zealand; Ph.D. Thesis, Auckland University of Technology, 2016. (2) Prahalad, C. K.; Ramaswamy, V. Co-creation Experiences: The Next Practice in Value Creation. Journal of Interactive Marketing 2004, 18(3), 5–14. https://doi.org/10.1002/dir.20015 (3) Chathoth, P. K.; Ungson, G. R.; Harrington, R. J.; Chan, E. S. Co-creation and Higher Order Customer Engagement in Hospitality and Tourism Services: A Critical Review. International Journal of Contemporary Hospitality Management 2016, 28(2), 222–245. (4) Oyner, O.; Korelina, A. The Influence of Customer Engagement in Value Co-creation on Customer Satisfaction: Searching for New Forms of Co-creation in the Russian Hotel Industry. Worldwide Hospitality and Tourism Themes 2016, 8(3), 327–345. (5) Thomas, A. K.; James, P. S.; Vivek, N. Co-creating Luxury Hotel Services: A Framework Development. Life Sciences Journal 2013, 10(7s), 1005–1012. http://www.lifesciencesite.com 162

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In Latin America different policies sustained in State-Civil Society alliances are implemented in order to warrant the right to education in marginalized sectors. Uruguay and Argentina carry out “bridge” programs and “completion” plans for adolescents, youngsters and adults to enter, re-enter or finish Medium Level Studies. I compare the characteristics of the alliance State-Civil Society in the co-management of the “Aulas Comunitarias” (Communitarian Classrooms) Program (PAC, Uruguay, 2007) and the “Plan de Finalización de Estudios Secundarios para Jóvenes y Adultos” (Finalization of Secondary Studies for youngsters and adults Plan) (FinEs 2, Argentina, 2008), aiming to understand their contributions to the processes of educational inclusion, as well as their limits. I analyze their genesis, political-institutional design/ways of organization and form of co-management contemplating: a) political-institutional approach to analyze public policy, b) Neo-institutionalism: sociopolitical as well as organizational and historic, c) co-management, d) educational management (paradigms: administrative and strategic). I implement a qualitative methodology, selecting co-management (as performed until December, 2015) as the unit of analysis. The findings show that PAC y FinEs 2 warrant the right to education supported by the attachment of several actors and sectors to their objectives. The quality of the contribution of alliances differs according the political-institutional design, kind of organization and forms of co-management: PAC shows a strategic co-management and FinEs 2 and administrative co-management.

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O presente estudo trata de uma revisão integrativa da literatura, cujo recorte temporal foi do período compreendido entre os anos 2000 e 2013. A questão norteadora da pesquisa foi: “Como era a saúde dos escravos no Brasil?” Os descritores utilizados para delimitar o tema da pesquisa foram: ‘saúde’, ‘escravos’ e ‘escravidão’. Os critérios de inclusão foram: artigos completos em língua portuguesa, inglesa e espanhola, disponíveis online para consulta gratuita nas bases de dados da Biblioteca Virtual em Saúde (BVS) e em revistas eletrônicas de universidades públicas brasileiras. Os aspectos gerais da saúde dos escravos foram negligenciados no descrever da história, ocupando pouco destaque nos relatos realizados por cientistas sociais, principalmente por historiadores e no período colonial, uma vez que a grande maioria dos estudos tomou por base o período Imperial. Entende-se que a saúde do escravo foi tratada com descaso pelos proprietários de terra, uma vez que se tratava de uma mercadoria, uma coisa, numa dinâmica em que não se estabeleciam relações interpessoais, mas sim relações entre sujeito e objeto. Esse paradigma foi vigente até meados do século XIX, frente ao maior controle sobre o tráfico de escravos e rascunhos da abolição da escravidão, quando a mercadoria em questão se tornou ainda mais valiosa, rara e que deveria ser preservada. Com base nas leituras realizadas, percebe-se uma explícita negligência política e acadêmica com a saúde dos escravos brasileiros.

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Introdução: As mulheres negras sofrem dupla discriminação, pois vivem em condições desiguais de gênero em uma sociedade que perpetua as desigualdades étnico-raciais. No que se refere às condições de saúde, em relação às mulheres brancas, as negras têm piores indicadores de saúde e maior vulnerabilidade ao adoecimento. Objetivo: Analisar as atuais condições de saúde da mulher negra brasileira. Métodos: Trata-se de uma revisão sistemática integrativa de artigos publicados entre os anos de 2008 a 2019 nas bases de dados LILACS, PubMed e SciELO. Para a busca, foram utilizados os descritores “Saúde”, “Acessibilidade aos Serviços de saúde”, “População negra”, “Desigualdade Racial em Saúde”, “Racismo” nos idiomas português e inglês. Foram incluídos artigos publicados em inglês, português ou espanhol e que abordassem estritamente as relações entre saúde e mulheres negras brasileiras. Resultados: Foram encontrados 982 artigos, dos quais 14 foram selecionados através de critérios de elegibilidade, por meio da leitura de títulos, resumos e textos completos. Conclusão: Mulheres negras possuem sistematicamente maiores taxas de mortalidade materna e neonatal, maior prevalência de agravamento de doenças benignas, maior risco de violência sexual e de gênero e maiores taxas de omissão de socorro e negligência médica quando comparadas com mulheres brancas. Diante de um cenário marcada ainda por diversas práticas de racismo institucional e preconceitos de gênero, elas se destacam como grupo detentor de vulnerabilidades dentro da saúde da mulher, portanto, faz-se necessário um novo paradigma e novas propostas dentro dos modelos de saúde atuais.

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ABSTRACT Objectives: to identify whether nurses recognize the completion of the technical procedure of installation of nasal CPAP in newborns and trigger the pain, and to propose, from the results obtained, the insertion of this technique, the list of procedures painful. Methods: this is a descriptive, exploratory study, which uses the quantitative approach. It was conducted in March 2009 at the intensive care unit neonatal (NICU) of a Federal institution from Rio de Janeiro city. The data were collected through a questionnaire, which were quantitatively, and analysis was performed using the frequencies and relative percentage. The study was approved by the Research Ethics Committee of the Federal University of Rio de Janeiro (protocol number 0044/08). Results: from the 11 nurses interviewed, only 2 (18%) signaled the nasal CPAP as painful. The reality is that pain and its management in infants receive little attention in clinical practice. Conclusion: we conclude that there is need for a paradigm shift with regard to installation of nasal CPAP, which needs to be reviewed under a scientific approach, critical and reflective, considering the complexity of making it so we can play and do not care only a nurse. Descriptors: Premature; pressure continuous positive airway; nursing care; pain. RESUMOObjetivos: identificar se os enfermeiros reconhecem a realização do procedimento técnico de instalação do CPAP nasal em recém-nascido como desencadeante da dor; propor, a partir dos resultados obtidos, a inserção desta técnica, no rol dos procedimentos dolorosos. Métodos: trata-se de um estudo descritivo, exploratório, que se utiliza da abordagem quantitativa. Foi realizado durante o mês de março de 2009, em uma unidade de terapia intensiva neonatal (UTIn) de uma Instituição Federal do Rio de Janeiro. Os dados foram coletados através de um questionário, os quais foram tratados quantitativamente, e a análise foi realizada por meio das frequências percentual e relativa. O estudo foi aprovado pelo Comitê de Ética em Pesquisa da Universidade Federal do Rio de Janeiro (número do protocolo 0044/08). Resultados: dos 11 enfermeiros entrevistados, apenas 2(18%) sinalizaram o CPAP nasal como doloroso. A realidade é que a dor e o seu manejo no RN recebem pouca atenção na prática clínica. Conclusão: conclui-se que há necessidade de uma mudança de paradigma com relação à instalação do CPAP nasal, a qual precisa ser revista sob um enfoque científico, crítico e reflexivo, considerando toda a complexidade de que se reveste, para que possamos reproduzir o cuidado e não apenas uma técnica de enfermagem. Descritores: prematuro; pressão positiva contínua nas vias aéreas; assistência de enfermagem; dor. RESUMENObjetivo: identificar si las enfermeras reconocen la realización del procedimiento técnico de la instalación de CPAP nasal en los recién nacidos y desencadenar el dolor; proponer, a partir de los resultados obtenidos, la inserción de esta técnica, la lista de procedimientos dolorosa. Método: este es un estudio descriptivo y exploratorio, que utiliza el enfoque cuantitativo. Se llevó a cabo durante el mes de marzo de 2009 en una unidad de cuidados intensivos, neonatales (UCIN) de una institución federal ubicado en la ciudad de Río de Janeiro. Los datos fueron recolectados a través de un cuestionario, que fueron cuantitativamente, y el análisis se realizó utilizando las frecuencias y el porcentaje relativo. Resultado: de las 11 enfermeras entrevistadas, sólo 2(18%) señaló la CPAP nasal como dolorosos. La realidad es que el dolor y su gestión en los niños reciben poca atención en la práctica clínica. El estudio fue aprobado por el Comité de Ética en Investigación de la Universidad Federal del Rio de Janeiro (número del protocolo 0044/08). Conclusión: concluimos que existe la necesidad de un cambio de paradigma con respecto a la instalación de CPAP nasal, que debe ser analizada en virtud de un enfoque científico, crítica y reflexiva, teniendo en cuenta la complejidad de lo que es lo que puede jugar y no les importa sólo una enfermera. Descriptores: recién nacido; presión positiva continua, la atención de enfermería, el dolor.

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<p><em><strong>Resumo: </strong>Tratou-se neste artigo de relevar o papel da Cartografia e das formas de analisar e representar o espaço, utilizando métodos qualitativos e quantitativos. Foram consideradas, em especial, as novas tendências e desafios das Tecnologias da Informação Geográfica, diante dos principais paradigmas que estão em foco no debate atual na Geografia. A partir do trabalho de Kuhn, em 1970, muitos geógrafos e estudiosos da evolução do pensamento geográfico aplicaram o modelo da mudança de paradigmas ao desenvolvimento conceitual desta ciência. No entanto, analisando a evolução da Geografia do século XX e início do XXI, tem-se observado certa regularidade de mudanças paradigmáticas entre os chamados “períodos de desenvolvimento da ciência normal”, com ciclos de duração entre 20 e 25 anos (Buzai, 1999). Mas também verificou-se que em nenhum momento um paradigma eliminava por completo o anterior, mas o deslocava no tempo. Assim vemos o atual ressurgimento da Geografia Quantitativa, com uma quantidade expressiva de trabalhos e novas propostas de cálculo, análise e modelagem temática complexa, derivadas do impacto que têm exercido as tecnologias da informação neste campo, o que tem dado lugar às denominadas Tecnologias da Informação Geográfica, ou Geotecnologias. No entanto, percebe-se também a presença ativa do chamado Paradigma Humanista, mediante o qual se tem construído uma visão espacial alternativa e independente, seguindo certos fundamentos iniciais, a partir dos estudos culturais de vertentes geográfico-antropológicas (Sauer, 1925, 1927, 1963), e daqueles outros relacionados com os mapas mentais urbanos (Cauvin, 2002; Strauss, 1987; Lynch, 1960). Aqui, a Geografia Humana centra seu foco na relação do mundo interior com o mundo exterior do ser humano, tais como a percepção, as atitudes e a valoração do meio geográfico. Neste sentido, foram analisados diferentes exemplos de aplicações dos SIG diante de uma série de problemáticas territoriais cujos propósitos, estratégias de investigação e conhecimento obtidos se agrupam dentro do reforço do paradigma quantitativo e também na construção de modelos qualitativos, mapas mentais, participativos e colaborativos, dentro do Paradigma Humanista. Estas aplicações mostraram, em geral, opções de soluções aplicadas, com base no desenvolvimento tecnológico e na Geografia atual, como disciplina central. Embora os Sistemas de Informação Geográfica, isoladamente, não sejam considerados como parte da Ciência da Informação Geográfica (Capel, 2005), o desenvolvimento recente (e crescente) das Tecnologias da Informação Geográfica indica que sim, está acontecendo uma mudança paradigmática, que levará, mediante o estabelecimento de fundamentos teóricos, conceituais e ontológicos profundos, à consolidação da Ciência da Informação Geográfica. O desenvolvimento deste processo beneficiará incontestavelmente, todas as expressões do conhecimento geográfico, independentemente de ter ênfase maior nos aspectos físicos ou humanos.</em></p>

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If a whole body reaching task is produced when standing or adopting challenging postures, it is unclear whether changes in attentional demands or the sensorimotor integration necessary for balance control influence the interaction between visuomotor and postural components of the movement. Is gaze control prioritized by the central nervous system (CNS) to produce coordinated eye movements with the head and whole body regardless of movement context? Considering the coupled nature of visuomotor and whole body postural control during action, this study aimed to understand how changing equilibrium constraints (in the form of different postural configurations) influenced the initiation of eye, head, and arm movements. We quantified the eye-head metrics and segmental kinematics as participants executed either isolated gaze shifts or whole body reaching movements to visual targets. In total, four postural configurations were compared: seated, natural stance, with the feet together (narrow stance), or while balancing on a wooden beam. Contrary to our initial predictions, the lack of distinct changes in eye-head metrics; timing of eye, head, and arm movement initiation; and gaze accuracy, in spite of kinematic differences, suggests that the CNS integrates postural constraints into the control necessary to initiate gaze shifts. This may be achieved by adopting a whole body gaze strategy that allows for the successful completion of both gaze and reaching goals. NEW & NOTEWORTHY Differences in sequence of movement among the eye, head, and arm have been shown across various paradigms during reaching. Here we show that distinct changes in eye characteristics and movement sequence, coupled with stereotyped profiles of head and gaze movement, are not observed when adopting postures requiring changes to balance constraints. This suggests that a whole body gaze strategy is prioritized by the central nervous system with postural control subservient to gaze stability requirements.

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ABSTRACTrRNAs of dormant spores ofBacillus subtiliswere >95% degraded during extended incubation at 50°C, as reported previously (E. Segev, Y. Smith, and S. Ben-Yehuda, Cell 148:139–114, 2012, doi:http://dx.doi.org/10.1016/j.cell.2011.11.059), and this was also true of spores ofBacillus megaterium. Incubation of spores of these two species for ∼20 h at 75 to 80°C also resulted in the degradation of all or the great majority of the 23S and 16S rRNAs, although this rRNA degradation was slower than nonenzymatic hydrolysis of purified rRNAs at these temperatures. This rRNA degradation at high temperature generated almost exclusively oligonucleotides with minimal levels of mononucleotides. RNase Y, suggested to be involved in rRNA hydrolysis duringB. subtilisspore incubation at 50°C, did not play a role inB. subtilisspore rRNA breakdown at 80°C. Twenty hours of incubation ofBacillusspores at 70°C also decreased the already minimal levels of ATP in dormant spores 10- to 30-fold, to ≤0.01% of the total free adenine nucleotide levels. Spores depleted of rRNA were viable and germinated relatively normally, often even faster than starting spores. Their return to vegetative growth was also similar to that of untreated spores forB. megateriumspores and slower for heat-treatedB. subtilisspores; accumulation of rRNA took place only after completion of spore germination. These findings thus strongly suggest that protein synthesis is not essential forBacillusspore germination.IMPORTANCEA recent report (L. Sinai, A. Rosenberg, Y. Smith, E. Segev, and S. Ben-Yehuda, Mol Cell 57:3486–3495, 2015, doi:http://dx.doi.org/10.1016/j.molcel.2014.12.019) suggested that protein synthesis is essential for early steps in the germination of dormant spores ofBacillus subtilis. If true, this would be a paradigm shift in our understanding of spore germination. We now show that essentially all of the rRNA can be eliminated from spores ofBacillus megateriumorB. subtilis, and these rRNA-depleted spores are viable and germinate as well as or better than spores with normal rRNA levels. Thus, protein synthesis is not required in the process of spore germination.

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Abstract BACKGROUND Nearly 1 in 5 Canadians will suffer from a mental health condition, with most of these diagnoses beginning in childhood and adolescence. Few children and youth with developmental and mental health conditions have adequate access to necessary clinical, community and social services. Patient navigator programs can bridge this gap by facilitating connections to social services, supporting family coping strategies and advocating for patient clinical services, yet there remain few programs in Canada for this patient population. OBJECTIVES To use a health behaviour change paradigm to develop and implement a paediatric patient navigator program for vulnerable children and youth living in a large urban centre in Canada DESIGN/METHODS A needs assessment was performed to identify navigation needs from the perspective of paediatric healthcare providers in an urban, inner-city district in Canada. Using these results, a referral and intake form were developed and pilot tested. To change provider behaviour with respect to utilization of the new navigation service, all providers, including paediatricians and allied health, participated in a workshop prior to implementation of the referral program and text reminders were posted throughout the clinic. RESULTS Patient navigation to access therapy services for children with developmental or mental health conditions, community services and assistance with completing funding information were identified as key services a paediatric patient navigator should offer. Participation in the workshop resulted in a significant increase in knowledge uptake for the role of the patient navigator and the referral process (p=0.01, 2-tailed T-test). 51 new referrals were received within one month of launching the paediatric patient navigation program, of which only 2 did not meet criteria CONCLUSION Patient navigation for children and youth with developmental and mental health diagnoses can be successfully implemented in an inner-city setting in a large urban centre. More research is needed to demonstrate the impact of patient navigation on patient health outcomes.

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Desde a Revolução de 1959, as relações dos Estados Unidos com Cuba entraram em uma era de antagonismo e tensões políticas. Após quase meio século de uma proximidade íntima, os dois países passaram a ser inimigos em pleno contexto de Guerra Fria. O resultado disso foi que os Estados Unidos se engajaram em uma estratégia austera de política exterior com Cuba, cortando relações diplomáticas e impondo um embargo comercial que viria a se perpetuar por meio século. Mesmo com o fim do conflito bipolar, as relações antagônicas entre os dois países se mantiveram inalteradas e Cuba permaneceu um país em isolamento graças ao embargo comercial estadunidense. Foi somente em 2014 que a administração Obama apostou em uma estratégia diferente, quebrando um paradigma político de décadas e promovendo uma reaproximação com Cuba. Ainda assim, o processo de normalização nunca foi completo e evidenciou como a estratégia de política externa dos Estados Unidos para Cuba depende de diferentes atores domésticos e seus distintos interesses. Para compreender esse fenômeno é preciso entender como se formou a estratégia antiga, por que ela se perpetuou e quais foram as condições que levaram a que fosse possível sua quebra. Este artigo traz um estudo histórico dos principais eventos entre Cuba e Estados Unidos que ocorreram a partir da Revolução, buscando melhor explicar a formação e a mudança da estratégia de política externa estadunidense para Cuba, passando por eventos como a invasão da Baía dos Porcos, a Crise dos Mísseis, as diversas crises migratórias até o processo de normalização e ruptura da antiga estratégia promovido pelo governo Obama.

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An aim of considerations is to present the selected determinants of functioning of internal systems of ensuring the quality of education related to Polish universities. The author’s attention is focused on the international standards and guidelines concerning elements of the system of quality ensuring connected with the Bologna Process and the selected legal regulations in this respect in force in Poland. The Standards and guidelines for quality assurance in the European Higher Education Area (ESG) were adopted by the Ministers responsible for higher education in 2005 following a proposal prepared by the European Association for Quality Assurance in High-er Education (ENQA) in cooperation with the European Students’ Union (ESU)1, the European Association of Institutions in Higher Education (EURASHE) and the European University Association (EUA). Since 2005, considerable progress has been made in quality assurance as well as in other Bologna action lines such as qualification frameworks, recognition and the promotion of the use of learning outcomes, all these contributing to a paradigm shift towards student-centred learning and teaching. Student-centred learning and teaching plays an important role in stimulating students’ motivation, self-reflection and engagement in the learning process. This means careful consideration of the design and delivery of study programmes and the assess-ment of outcomes. The teacher’s role is essential in creating a high quality student experience and enabling the acquisition of knowledge, competences and skills. The diversifying student population and stronger focus on learning outcomes require student-centred learningand teaching and the role of the teacher is, there-fore, also changing. Providing conditions and support that are necessary for students to make progress in their academic career is in the best interest of the individual students, programmes, institutions and systems. It is vital to have fit-for-purpose admission, recognition and completion procedures, particularly when students are mobile within and across higher education systems. It should be noted that the results of this article can be used to compare the Polish and Ukrainian systems of quality assurance in higher education, as well as the domestic quality assurance procedures It is important that access policies, admission processes and criteria are implemented consistently and in a transparent manner. Induction to the institution and the programme is provided. Institutions need to put in place both processes and tools to collect, monitor and act on information on student progression

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Introdução: A adolescência é caraterizada como um período de construção sócio-histórica, com manifestações fortemente influenciadas pelos fatores socioeconômicos, políticos e culturais do meio onde o adolescente vive. Desta forma, destaque para elaboração e construção de políticas que direcione para práticas promotoras de saúde. Objetivo: Analisar as práticas sustentáveis utilizadas para fortalecer ações promotoras de saúde para adolescentes alinhadas ao Objetivo do Desenvolvimento Sustentável 3. Método: Revisão integrativa, realizada no período de janeiro de 2020. O cruzamento foi realizado no Portal de Periódicos da CAPES, com uso dos descritores em saúde: Sustainable Development, Health Care, Adolescent, Sustainable Development Indicators, nas bases de dados MEDLINE, LILASC, W Web of Science, Scielo. Elencou como critérios inclusão: trabalhos completos, disponíveis e nos idiomas português, inglês e espanhol. Como critérios de exclusão: artigos que não disponibilizarem resumos, editoriais, reflexões teóricas, estudos duplicados, relatos de experiência, resenhas, monografias e resumos em anais de eventos. Todos os cruzamentos foram realizados em língua estrangeira, idioma inglês, com o uso do operador booleano AND. A amostra final foi composta por final de 12 artigos. Resultados: Aponta a implementação práticas sustentáveis ao público adolescente que possa romper com uma assistência em saúde pontual e fragmentada, ressaltando a ampliação de práticas voltadas para o acesso aos serviços de saúde que possa de fato atender as suas reais necessidades de saúde, programas de geração de renda, e adoção de alimentação saudável, equidade nos serviços de saúde e educação em saúde. Evidencia que a implementação de práticas sustentáveis se apresenta como uma ferramenta para se alcançar a promoção da saúde e como uma mudança de paradigma na assistência a saúde do adolescente. Conclusão: Verificou a necessidade de políticas e ações em saúde para o adolescente que possa contribuir para o desenvolvimento de uma assistência em saúde voltadas para a promoção em saúde. Assim, evidencia a necessidade de ruptura de práticas de saúde pontuais com foco apenas na doença, tornando um desafio o desenvolvimento de práticas sustentáveis ao adolescente quanto a mudanças de ações em uma perspectiva promotora de saúde.

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Abstract Introduction: Health care delivery programs specific to the needs of adolescents and young adults ages 15-39 (AYAs) with cancer are increasingly being developed in the United States. Guidelines primarily focused on supportive care, fertility and therapeutic regimen for a few cancer types are now established, but best practice metrics and outcome standards are lacking. Malignant hematologic conditions are common in AYAs and challenges of care delivery for this disparate group are accentuated by fragmentation of management within the health system, between pediatric and medical oncology and between academic and community sites. Optimal place of care between academic and community systems is not established, but most of AYAs are diagnosed and cared for in the community. We describe our experience with treating AYAs with acute leukemia and lymphoma in a multi-disciplinary, community-based AYA program, with a focus on metrics and outcomes. Methods: Medical record review under an IRB approved retrospective study was conducted of all AYAs seen by a dedicated AYA Cancer Care team at a single institution in a Southeast United States community. Descriptive analysis was used for demographic data, including age, cancer type, insurance status, gender and ethnicity. Basic statistical analysis was used for guideline and pre-established metrics, including therapy regimens; completion of therapy; study accrual; fertility documentation, referral and intervention; sedated procedures. Kaplan-Meier estimates were applied for newly diagnosed patients for event free and overall survival for each cancer type in newly diagnosed population. Results: Bon Secours St. Francis AYA Cancer Care is an immersive program where a pediatric oncologist is employed by a non-academic, medical oncology, hospital-owned practice that sees 1500 new cancer patients annually and is located in Greenville, SC. Since 2012, AYA Cancer Care has seen 107 patients newly diagnosed, relapsed or in survivorship, 58 (54%) of whom with a diagnosis of acute leukemia or lymphoma. Median age was 25 (range 15-39), and 43%, 31% and 31% were female, minority and uninsured at time of first visit, respectively. Metrics and outcomes for acute lymphoblastic leukemia, acute myelogenous leukemia, Hodgkin lymphoma, and non-Hodgkin lymphoma are shown in Table 1. Despite a high rate of no insurance at diagnosis, all patients received guideline-driven therapy, most were cared for by the AYA team and 65% of LPs/BMAs were sedated with MAC. All newly diagnosed ALL patients except 1 were treated with pediatric-inspired therapy. Males were more likely to be referred to fertility specialists, but females were nearly twice as likely to have intervention in the form of chemoprophylaxis. No Children's Oncology Group trials for indicated cancer types were available via CTSU during the study period, and 31% of patients were enrolled on therapeutic trial, 19% sponsored by biopharmaceutical companies and 12% sponsored by the NCI. EFS and OS for newly diagnosed patients are as follows: AML, 90%/90% (median f/u 40 weeks); ALL, 29%/71% (3.2 yrs); HL, 89%/100% (4.5 yrs); NHL, 89%/100% (5 yrs). Conclusions: We report a high rate of guideline-driven care for AYAs with acute leukemia and lymphoma seen by a multidisciplinary team solely focused on AYA care delivery within a community practice setting. Metrics are derived from best practices from both pediatric (pediatric inspired therapy in AML, ALL; sedation for procedures) and adult (ABVD for HL, NCI and pharma-sponsored trials) oncology paradigms. Immersive AYA programs in non-academic settings are potentially effective models of reducing health disparities and improving outcomes in AYAs. Table 1. Table 1. Disclosures Crosswell: Seattle Genetics: Other: stock ownership in Seattle Genetics.

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O momento histórico atual é marcado por uma das maiores e mais longas crises do sistema capitalista, mais profunda do que a crise de 1929. Mais recentemente, esta mesma gerou condições materiais propícias para eclodir uma pandemia, cujo patógeno é o novo coronavírus. Sabe-se que a existência do capitalismo é marcada por crises, que nascem da produção desordenada e da contradição gerada entre a extensão do consumo e a realização do lucro. Isso porque, para ampliar o consumo das massas, seria necessário aumento salarial, reduzindo a taxa de mais valor apropriada pela burguesia e, consequentemente, seus lucros. Para contornar essa situação, o mercado busca expandir-se constantemente, intensificando os termos da contradição exposta. Na contemporaneidade, o capital tem sua principalidade no processo de financeirização, o que implica compreender a crise atual a partir de duas principais tendências articuladas entre si: a) a tendência declinante da taxa de lucro com certas recuperações anêmicas que caracterizam o caminho da decadência capitalista; e b) a dominância do capital portador de juros, na sua forma de capital fictício (capital financeiro). Ocorre que, toda tendência é acompanhada de seu contrário, contratendências, cuja existência impede o caráter absoluto dessas prospecções. Não obstante, à luz da lógica dialética, a pandemia de COVID-19 deve ser compreendida como um dos produtos do capital em crise, ao mesmo tempo que impõe a ele uma nova dinâmica para realização das relações de exploração e expropriação que lhe caracterizam. Um dos desdobramentos desse novo cenário é a modificação das formas contratendenciais existentes a uma das tendências centrais no desenvolvimento do capital – a lei tendencial da queda da taxa de lucros. Nesse sentido, torna-se fundamental conhecer as tentativas que os capitalistas têm utilizado para contra-arrestar seus prejuízos neste cenário em que a COVID-19 é um subproduto de sua própria ganância e superexploração. Revisar criticamente as formas de contratendência à lei tendencial da queda da taxa de lucro durante a pandemia de COVID-19. Como objetivos específicos, este trabalho busca: a) identificar as formas de contratendência à lei tendencial da queda da taxa de lucro efetivadas durante a pandemia de COVID-19; e b) analisar os impactos das formas de contratendência à lei tendencial da queda da taxa de lucro sobre o processo de acumulação capitalista. Trata-se de uma revisão sistemática crítica de literatura, utilizando como fontes revistas e anais de eventos científicos que publicam conteúdo marxista. A pergunta utilizada para guiar a busca foi: “o que a literatura científica marxista apresenta sobre as formas de contratendência à lei tendencial da queda da taxa de lucro durante a pandemia de COVID-19?”. A partir dela, derivou-se os seguintes termos livres, divididos em dois polos: 1) contratendência, lei tendencial, tendência declinante da taxa de lucro, queda da taxa de lucro, queda de lucratividade, lei da queda tendencial da taxa de lucro; e 2) COVID-19, pandemia de coronavírus, novo coronavírus, SARS-CoV-2. Foram eleitos como fontes de dados inicialmente 55 revistas marxistas brasileiras, latino-americanas, americanas, europeias e australianas, bem como em três anais de eventos científicos marxistas. Considerando a data de início da pandemia do novo coronavírus, o recorte temporal utilizado para a busca foram os anos de 2020, 2021 e 2022. Na primeira etapa de identificação os termos livres e suas traduções em inglês e espanhol foram buscados sem aspas em cada uma das fontes. Nas fontes que ultrapassaram 50 publicações recuperadas, refez-se a busca com os termos livres e suas traduções utilizando aspas. Por fim, uma terceira etapa de identificação foi realizada utilizando os termos livres de cada um dos polos combinados por meio do operador booleano ‘AND’ sem o uso de aspas. Ao final, foram identificadas 1.049 publicações distribuídas em três revistas marxistas brasileiras, uma latino-americana, 25 americanas e europeias, uma australiana e um anais de evento científico. O critério de inclusão utilizado foi a recuperação de publicações contendo ao menos um termo livre de cada polo. Ainda, quatro revistas foram excluídas por apresentarem problemas com seu sistema de busca. Na sequência, foram excluídas as publicações com título repetido (n = 695) e selecionadas apenas aquelas que se encontravam em formato de artigo (n = 331). Em seguida avaliou-se o título de cada artigo a partir da presença dos seguintes marcadores textuais: capital, lucro, taxa, queda, lei, tendência, neoliberal, capitalismo, crise, pandemia, coronavírus, COVID-19. Após a avaliação dos resumos e verificação de disponibilidade para leitura na íntegra, 33 artigos foram selecionados para avaliação do texto completo. Até o momento 13 artigos foram avaliados em relação ao paradigma de análise apresentado, país de origem, metodologia, caso exposto, contexto apresentado, forma(s) de contratendência(s) à lei tendencial da queda da taxa de lucros durante a pandemia de COVID-19 e relação da(s) contratendência(s) com a dinâmica de reprodução capitalista. Entre eles, nove foram avaliados como marxistas e quatro keynesianos. Em relação à origem, 11 são do Brasil, um do Reino Unido e um dos Estados Unidos. As formas de contratendência mais identificados foram o aumento da precarização das condições de trabalho implementadas por meio de medidas legislativas, ampliando o grau de exploração da força de trabalho. A parcela da classe trabalhadora mais atingida pela precarização e pelo desemprego é composta por mulheres, sobretudo mulheres negras, imigrantes e trabalhadores de aplicativos de entrega e transporte. Ainda, destacam-se as transferências de recursos públicos para os setores empresarial e financeiro na forma de pacotes econômicos, concessão de créditos, alívios tributários, compras de títulos privados e modificações na taxa de câmbio, capitaneados pelo Estado, com destaque para os países centrais capitalistas. Os resultados apontam para a intensificação das medidas de contratendência à lei tendencial da queda da taxa de lucros, implementadas majoritariamente pelo Estado, demonstrando seu papel em salvaguardar os lucros da classe dominante.