Background: Despite our distinct impression to the contrary, we are only conscious of a fraction of all the neural activity underlying our thoughts and behavior. Most neural processes occur non-consciously, and in parallel with our conscious experience. However, it is still unclear what the limits of non-conscious processes are in terms of higher cognitive functions. Many recent studies have shown that increasingly more advanced functions can operate non-consciously, but non-conscious information is still thought to be fleeting and undetectable within 500 milliseconds. Here we used various techniques to render information non-conscious, together with functional magnetic resonance imaging (fMRI), to investigate if non-consciously presented information can be retained for several seconds, what the neural substrates of such retention are, and if it is consistent with working memory maintenance. Results: In Study I we used an attentional blink paradigm to render stimuli (single letters) non-conscious, and a variable delay period (5 – 15 s) prior to memory test. It was found that non-conscious memory performance was above chance after all delay durations, and showed no signs of decline over time. Univariate fMRI analysis showed that the durable retention was associated with sustained BOLD signal change in the prefrontal cortex and cerebellum during the delay period. In Study II we used continuous flash suppression (CFS) to render stimuli (faces and tools) non-conscious, and a variable delay period (5 or 15 s) prior to memory test. The durable retention of up to 15 s was replicated, and it was found that stimuli identity and spatial position was retained until prospective use. In Study III we used CFS to render tools non-conscious, and a variable delay period (5 – 15 s) prior to memory test. It was found that memory performance was not better than chance. However, by using multi-voxel pattern analysis it was nonetheless possible to detect the presence vs. absence of non-conscious stimuli in the frontal cortex,and their spatial position (left vs. right) in the occipital cortex during the delay. Conclusions: Overall these findings suggest that non-consciously presented information (identity and/or position) can be retained for several seconds,and is associated with BOLD signal in frontal and posterior regions. These findings are consistent with working memory maintenance of non-consciously presented information, and thereby constrain models of working memory and theories of consciousness.

Bakgrund De flesta patienter som läggs in på en intensivvårdsavdelning för invasiv ventilation får sedering någon gång under vårdtillfället. Dagens forskning visar att det finns stora fördelar för patienten att vårdas lätt sederad eller vaken vid invasiv ventilation. Dagens sederingspraxis har gått mot att hålla patienten mer vaken. Invasiva metoder används inom intensivvård vilket kan upplevas som smärtsamt eller obehagligt. Även den högteknologiska vårdmiljön är speciell vilket kan bidra till obehag för patienten. Vårdpersonal beskriver att det tar mer tid i anspråk att vårda en patient som är vaken eller lätt sederad samtidigt som de upplever fördelar med att ha en mer vaken patient. Det finns då möjlighet att kommunicera och interagera med patienten i större utsträckning. Det framkommer även att vårdpersonal ser en utmaning i att vårda lätt sederade eller vakna patienter där de bland annat är oroliga för patientens trygghet och välbefinnande. Syfte Beskriva intensivvårdspatienters upplevelse av att vårdas lätt sederade eller vakna vid invasiv ventilation på en intensivvårdsavdelning. Metod En systematisk litteraturstudie har använts som metod. Kvalitativa artiklar har analyserats med hjälp av Bettany-Saltikov och McSherrys (2016) nio steg. Resultat De tre huvudkategorier som framkom under analysen var upplevelsen av fysiskt och psykiskt lidande, upplevelsen av att kommunicera och upplevelsen av sammanhang eller avsaknad av sammanhang. Slutsats Patienternas upplevelse av att vårdas lätt sederade eller vakna var både obehaglig och smärtsam. Många av patienterna föredrog trots detta att vårdas vakna eller lätt sederade. Dels för att ha kontroll men även för att kunna kommunicera och interagera. Däremot så framkom att just upplevelsen av kommunikation kunde vara mycket frustrerande då framförallt intubation var ett stort hinder för att kunna kommunicera. / Background Most patients admitted to an intensive care unit for invasive ventilation get sedation at some point during the stay. Today's research shows that there are great advantages for the patient to be cared for ligthly sedated or consious during invasive ventilation. Today's sedation practice has moved towards keeping the patient more awake. Invasive procedures are used in the intensive care, which can be experienced as painful or unpleasant. The high-tech care environment is also special, which can contribute to the discomfort of the patient. Nurses describe that it takes more time to care for patients who are awake or lightly sedated. They also experienced advantages of having a more alert patient, such as the possibility of communicating and interacting with the patient. Healthcare professionals also see a challenge in caring for easily sedated or conscious patients, where they are worried about the patient’s safety and well-being. Purpose Describe intensive care patients' experience of being cared for lightly sedated or consious during invasive ventilation in an intensive care unit. Method A systematic literature review has been used as a method. Qualitative articles have been analyzed with the help of Bettany-Saltikov and McSherrys (2016) nine steps. Results The three main categories that emerged during the analysis were the experience of physical and psychological suffering, the experience of communication and the experience of context or lack of context. Conclusion The patients' experience of being cared for lightly sedated or awake was both unpleasant and painful. Many of the patients nevertheless preferred to be cared for awake or lightly sedated. Partly to have control but also to be able to communicate and interact. On the other hand, it emerged that the experience of communication could be frustrating, as intubation was a major obstacle to communicating.

Objetivos: Avaliar a segurança e a eficácia do midazolam intranasal (MIN) para sedação para tomografia em crianças, bem como a qualidade dos estudos radiológicos obtidos com esta técnica. Material e métodos: Entre dezembro de 2011 e julho de 2012, este estudo prospectivo avaliou o MIN como sedativo para crianças submetidas à tomografia sem acesso venoso. Após aprovação do Comitê de Ética em Pesquisa e consentimento dos responsáveis, 0,4 mg/kg de MIN foi administrado, sendo feita dose adicional de 0,1 mg/kg se o nível de sedação avaliado pela Escala de Sedação de Ramsay não fosse atingida após 15 minutos da primeira dose. Os desfechos relacionados à sedação incluíram tempo para sedação e para atingir os critérios de alta; parâmetros fisiológicos como oximetria de pulso e frequência cardíaca foram registrados a cada cinco minutos até a alta. A qualidade dos exames tomográficos foi avaliada quanto à presença de artefatos de imagem e movimento. Resultados: 60 eventos de sedação foram realizados em 58 pacientes. A idade média foi de 15,5 meses, sendo 90,9% dos exames tomográficos de crânio. O tempo médio para sedação foi de 15,2 minutos (5-40) e o tempo médio para atingir os critérios de alta foi de 74,7 minutos. Eventos adversos foram observados em 5 crianças (8,4%), incluindo reação paradoxal (3), tempo de recuperação prolongado (1) e vômitos (1). Apenas 4 pacientes (6,7%) não foram adequadamente sedados com MIN. Imagens consideradas excelentes, sem artefatos, foram obtidas em 56 (93,3%) sedações. Não houve eventos como bradicardia, hipoxemia ou hipotensão. Conclusões: O midazolam intranasal, administrado via atomizador nasal, é um método simples e não-invasivo para sedação segura, eficaz e previsível para crianças na obtenção de estudos tomográficos de qualidade / Objective: To evaluate the safety, efficacy and image quality of sedation with aerosolized intranasal midazolam for pediatric CT studies. Materials and Methods: Between December 2011 to May 2012, this prospective study evaluated aerosolized intranasal (AIN) midazolam as a sedative for CT of children without intravenous access. After IRB approval and parental consent, 0,4 mg/kg of AIN midazolam was administered, and repeated with 0.1 mg/kg if adequate sedation evaluated by Ramsay Sedation Scale not achieved in 15 minutes after the first dose. Sedation outcome variables which included time to achieve sedation, to meet discharge criteria and physiological vital signs of pulse oximetry and heart rate, were recorded every five minutes until discharge. The quality of CT images was reviewed and graded for presence of motion and imaging artifacts, Results: 60 sedation encounters were performed in 58 children. Mean age was 15.5 months, and 90.9% of CT scans were brain scans. Mean time to sedation was 15.2 minutes (range 5-40) and mean time to achieve discharge criteria was 74.7 minutes. Adverse events were recorded in 5 children (8.4%) that underwent sedation - paradoxical reaction (3), prolonged recovery time (1) and vomiting (1). Only 4 patients (6.7%) failed to sedate. Excellent CT imaging, with no artifacts, were obtained in 56 (93.3%) of sedation encounters. No adverse events like bradycardia, hypoxia or hypotension were documented. Conclusions: The aerosolized route of administration of midazolam is a simple and noninvasive approach for predictable, effective and safe sedation of children for quality CT imaging studies

Esta tese trata do romance de Machado de Assis e da reflexão sobre o gênero do romance e suas possibilidades narrativas ficcionalizadas em sua obra. Pretende-se analisar as diferentes propostas narrativas empregadas pelo autor que, após encaminhar discussões sobre a literatura brasileira, intervindo criticamente e propondo alternativas de abordagem aos autores de sua geração, em ensaios como \"Notícia da atual literatura brasileira instinto de nacionalidade, de 1873, e \"A nova geração, de 1879, passou a ficcionalizar a sua reflexão sobre o gênero romanesco em seus romances, sendo o conjunto de obras pós-1881 o que mais radicaliza o processo. A Crise do título se refere ao período da década de 1870, quando Machado buscou uma espécie de conciliação com o gênero romanesco, uma conciliação conflituosa em busca de um público e em desacordo com os modelos adotados; Destruição se refere à série de romances iniciada com Memórias Póstumas de Brás Cubas. Pretende-se analisar a obra romanesca em contraste e sintonia com a produção ficcional da década de 1870, por meio de um recorte sincrônico ao momento de publicação dos romances. O objetivo é apreender, a partir disso, a sua visão problematizadora do gênero. / This dissertation refers to Machado de Assis novel, his reflection on the novel genre and the fiction narrative presented on his work. It seeks to analyze the writer`s different narrative proposals. Machado de Assis led the discussions about the Brazilian literature through critical interventions and offered alternative approaches to the author from his generation on his essays Notícia da atual literatura brasileira instinto de nacionalidade (1873) and A nova geração (1879). Afterwards, the author began to render into fiction his reflections about the novel genre, especially on his opus after 1881. The Crisis on the title denotes the 1870s when Machado sought to come to terms with the novel genre, though a conflicted conciliation seeking an audience and disagreeing with the set models. Destruction refers to the novel series beginning with Posthumous memoirs of Bras Cubas. This study analyzes the novel comparing and contrasting the production of fiction in the 1870s using a synchronic frame from the novels publishing times. Based on that, the aim is to learn his problematizing perspective on the genre.

Esta tese trata do romance de Machado de Assis e da reflexão sobre o gênero do romance e suas possibilidades narrativas ficcionalizadas em sua obra. Pretende-se analisar as diferentes propostas narrativas empregadas pelo autor que, após encaminhar discussões sobre a literatura brasileira, intervindo criticamente e propondo alternativas de abordagem aos autores de sua geração, em ensaios como \"Notícia da atual literatura brasileira instinto de nacionalidade, de 1873, e \"A nova geração, de 1879, passou a ficcionalizar a sua reflexão sobre o gênero romanesco em seus romances, sendo o conjunto de obras pós-1881 o que mais radicaliza o processo. A Crise do título se refere ao período da década de 1870, quando Machado buscou uma espécie de conciliação com o gênero romanesco, uma conciliação conflituosa em busca de um público e em desacordo com os modelos adotados; Destruição se refere à série de romances iniciada com Memórias Póstumas de Brás Cubas. Pretende-se analisar a obra romanesca em contraste e sintonia com a produção ficcional da década de 1870, por meio de um recorte sincrônico ao momento de publicação dos romances. O objetivo é apreender, a partir disso, a sua visão problematizadora do gênero. / This dissertation refers to Machado de Assis novel, his reflection on the novel genre and the fiction narrative presented on his work. It seeks to analyze the writer`s different narrative proposals. Machado de Assis led the discussions about the Brazilian literature through critical interventions and offered alternative approaches to the author from his generation on his essays Notícia da atual literatura brasileira instinto de nacionalidade (1873) and A nova geração (1879). Afterwards, the author began to render into fiction his reflections about the novel genre, especially on his opus after 1881. The Crisis on the title denotes the 1870s when Machado sought to come to terms with the novel genre, though a conflicted conciliation seeking an audience and disagreeing with the set models. Destruction refers to the novel series beginning with Posthumous memoirs of Bras Cubas. This study analyzes the novel comparing and contrasting the production of fiction in the 1870s using a synchronic frame from the novels publishing times. Based on that, the aim is to learn his problematizing perspective on the genre.

No presente trabalho, de natureza conceitual e didático-experimental, encontra-se uma pesquisa que procura compreender quais são as contingências, situações ou momentos que constituem a base formativa para a emergência do sujeito. O marco inicial para o referido estudo são as teses dos autores da reconhecida Escola de Vigotski, e outros que estejam afinados com as concepções marxistas. Para isso, a partir de uma revisão de literatura, foi realizado um epítome teórico daquilo que se considera uma definição de sujeito, bem como a caracterização do mesmo. O que se procurou evidenciar foi uma crescente sistematização de conceitos que permitam a compreensão da constituição do sujeito no sentido do gênero humano. Os estudos foram organizados por etapas, sendo que a primeira consta da delimitação conceitual do que envolve o homem cultural adulto segundo uma visão dialética de mundo e de sujeito. Nesse percurso, estão explanadas as condições pelas quais o homem nasce na condição de indivíduo e, aos poucos, se torna sujeito. Tal mudança de status, qualitativa, ocorre somente quando o homem passa a ser possuidor das características de pensamento teórico e consciência de classe. Ainda, subjacente a esse processo, se encontram as características típicas do humano que são a capacidade de planejamento e de orientar a ação no mundo de modo intencional. A tese da emergência do sujeito será demonstrada na história, num experimento didático e na emergência do sujeito pesquisador. Num primeiro momento, procura-se demonstrar, de forma contigua, ao longo do trabalho, a forma e as condições que fizeram com que os sujeitos emergissem ao longo da história do desenvolvimento da humanidade, com suas respectivas visões de mundo (conhecimento e consciência do mundo). Para isso, se faz uma caracterização das condições histórias no sentido temporal e, de forma mais minuciosa e resenhada, a caracterização do pensamento dos autores selecionados. O intuito é mostrar o condicionamento da percepção de mundo, da consciência ou visão de mundo dos sujeitos pelas condições materiais de vida dos mesmos, ou seja, o condicionamento do indivíduo pela atividade na qual está inserido tese de Leontiev, o que equivale dizer, Teoria da Atividade. Observou-se, num experimento didático, que os indivíduos inseridos na atividade pedagógica, conduzida de forma planejada e intencional, dentre outras características, emergem como sujeitos após determinado período de vivência coletiva e prática na qual lhe são possibilitadas as condições de apropriação de um modo geral de ação. A apropriação desse modo geral de ação dá aos investigados, estagiários do Clube de Matemática, consciência o bastante para, por sua vez, agirem na atividade pedagógica de forma planejada e intencional, isto é, dominando e guiando a própria conduta. Por fim, analisando a emergência do sujeito pesquisador é possível dizer que o indivíduo se torna sujeito em atividade e, tanto a sua consciência, quanto a sua ação no mundo estão condicionadas pelo processo formativo que acontece sob o direcionamento intencional e planejado dos membros da coletividade a qual participa. Somente depois de se tornar sujeito é que o indivíduo adquire características como conduta voluntária, ação intencional e/ou ação planejada. Tal posição permite não somente compreender os problemas de formação no processo escolar como históricos, mas, inclusive, indicar possibilidades práticas para o enfrentamento do processo formativo. / In this paper of natural concept and experimental-educational, within there´s a research that aims to understand which contingence, situation or moments that build the formative base for the rising of the subject. The initial landmark for this study is the theses of authors of the well-known Vygotski School and others that are tuned with the Marxist concepts. For that, from a literature review, a theory summary was made of what was considered as a definition of the subject, as well as the characterization itself. What was tried to bring to attention was an increasing systemization of concepts that allowed a comprehension of the constitution of the subject in a human sense. The studies were organized by steps. Within the first one is the concept delimitation that revolves around the grown adult man according to the dialectic view of the world and the subject. Through this path the conditions by which the man is born as an individual and slowly becomes a subject is explained. This chance of status only occurs when the man possesses the theory thought and class consciousness. Subjacent to this process, there are the typical human characteristics that are the planning capability and intentionally guiding the action in the world. The rising of the subject theses will be demonstrated in history, in an educational experiment and in the rising of the researcher subject. At first, the intention is to demonstrate throughout this paper the means and conditions that made the subjects rise throughout the history of the development of the humanity, with their own visions of the world (knowledge and conscious of the world). Therefore there is a characterization of the historical conditions in a time way and in a more minimalist and detailed description of the characterization of the thoughts of the selected authors. The goal is to show the conditioning of the perception of the world, the conscious or the vision the subject has of the world through the material condition of their life, which means individual conditioning through the activity in which he is inserted Leontievs theses, which also means, Activity Theory was observed in a educational experiment that the inserted individuals in the pedagogical activity, conducted in a planned and intentional structure, within other characteristic rise as subjects after certain periods of group experience and also practice in which it is given the possibility to make an assumption of a general model of action. The assumption of this general model of action gives the ones investigated, interns of the Mathematics Club enough conscious to act on the pedagogical activity in a planned and intentional way, which means to dominate and guide their own conduct. At last the analyzing the rising of the researcher subject it is possible to say that the individual becomes a subject in the activity and not only his consciousness but also his actions in the world are conditioned by the formative process that happens under the intentional guiding and planning of all the members of the group in which he is inserted. Only after becoming a subject the individual acquires some characteristics such as voluntary conduct, intentional action and/or planned action. This position not only allows the understanding the formation problems in the scholastic process such as historical but also indicates the practical possibilities to face the formative process.

The classic distinction between the body schema and the body image received renewed interest in cognitive psychology, in part because of the attempts by the leading psychologist Charles Spence and his co-authors to synthesise a mounting body of research into the multisensory nature and functional properties of the neural structures in primate cortex that are sensitive and responsive to cross-modal stimuli generated from the body and objects located close to the body, and the famous rubber hand illusion which purported to illustrate how the perception and understanding of what counts as one’s body, i.e., our body image, can be manipulated to include foreign, body-part-like, objects such as a rubber hand. This approach was intended to settle age old questions about how the body schema – the system sub-personal sensorimotor system that shapes, facilitates and regulates motor control – is implemented in the brain and address historic confusions about how the body schema should be understood as an explanatory concept, as well as the problems surrounding the body schema and image distinction on the grounds of the persistent conflation between the two concepts. However, after offering several proposals as to how the body schema should be used to organise and interpret the empirical data, the distinction fell out of favour with Spence and his colleagues on the grounds of the very problems they intended to resolve. The proposed solution is an alternative theoretical framework that, I shall argue, never materialised. Instead, the various definitions they disseminate, I will claim, simply serve to further perpetuate the same problems and confusions about the body schema. Thus, the current state of the literature on the body image and schema in cognitive psychology is in dire need of a conceptual framework that would help us situate and interpret the important empirical data. I propose that we revisit the philosophical debates that were inspired by the philosopher Shaun Gallagher as part of his project to provide a conceptual analysis of the body schema and image distinction and vindicate its status as an important explanatory device for the explanatory ambitions of embodied cognition. Gallagher’s analysis opens up important questions about how the sub-personal multisensory processes of the body schema not only facilitate moment-by-moment motor behaviours, but how they shape and optimise motor control across developmental timelines, as well the importance of the embodied configuration of an agent and its particular eco-niche for shaping and facilitating its motor behaviours. The second important argument of the thesis is that the response to Gallagher’s analysis has simply served to suppress the line of research that Gallagher inspired because the questions his analysis raises have been overshadowed by more general disputes between Gallagher and his opponents about the shape an analysis of the body schema from the perspective of embodied cognition should take. As such, potentially promising lines of research in relation to the body schema have since dried up. As part of my attempt to make progress on the issues that are laid out at the first and second stages of the thesis, the third stage will involve an exploration into the seminal Bayesian approach to understanding cross-modal cue optimisation as it applies to object perception (Banks & Ernst, 2002) and the recent extension of this paradigm to the multimodal sensorimotor processes that underpin motor behaviour in action-oriented cognitive science (e.g., Friston, 2010). The conclusion of the thesis is that the move from an embodied to an action-oriented analysis of the body schema, and the conceptual distinction of which it is part, provides us with the right kind of theoretical resources to begin to pursue fruitful avenues of research that allow us to begin to address the questions set out by Gallagher’s analysis whilst avoiding (some of) the pitfalls that beset the embodied approach. In the final chapter I use this model of the body schema to illustrate how it can provide the basis for working back up towards a comprehensive theory of the body image and schema distinction, which I then bring to bear on current, as-yet-unaddressed, issues in developmental psychology.

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / O medo à uma caracterÃstica fundamental do ser humano. à o medo que ativa respostas fisiolÃgicas que farÃo frente a ameaÃas reais ou imaginÃrias, possibilitando ao organismo as opÃÃes de luta ou fuga. Quando este medo, ou a ansiedade gerada por ele, interpÃe-se entre o paciente e cuidados de saÃde, torna-se urgente a adoÃÃo de medidas que visem aboli-lo ou minimizÃ-lo. Ainda hoje, muitos pacientes nÃo procuram o atendimento odontolÃgico em decorrÃncia do medo e da ansiedade. O Ãxido nitroso, como meio de sedaÃÃo, vem sendo usado no mundo todo com ampla margem de sucesso. O objetivo deste trabalho foi uma avaliaÃÃo comparativa entre os parÃmetros cardiovasculares e saturaÃÃo de oxigÃnio de dois grupos de 20 pacientes, classificados como ASA I e II, selecionados para cirurgia de extraÃÃo de terceiros molares inclusos. No grupo de estudo (n=20), os pacientes foram submetidos à cirurgia sob anestesia local, associada à sedaÃÃo com Ãxido nitroso (70%) e oxigÃnio (30%); no grupo controle (n=20), os pacientes foram submetidos ao mesmo tipo de procedimento cirÃrgico, com a utilizaÃÃo Ãnica da anestesia local. Os resultados mostraram que a sedaÃÃo com o Ãxido nitroso, mesmo na concentraÃÃo mÃxima permitida â 70% â à um procedimento seguro e efetivo. Os parÃmetros cardiovasculares, do grupo sob sedaÃÃo, mostraram uma estabilidade hemodinÃmica maior que a observada no grupo que recebeu somente a anestesia local, nÃo tendo sido observado em nenhum dos grupos, qualquer episÃdio de dessaturaÃÃo ou alteraÃÃes eletrocardiogrÃficas de significado clÃnico, todos os procedimentos foram finalizados com sucesso e nenhum evento adverso foi observado / Fear is a fundamental human emotion. It is fear that triggers physiological responses that prepare the body for action against real or imaginary threats, allowing the individual to decide whether to fight or flee. When fear, or resulting anxiety, interferes with the provision of healthcare causing patients to delay or avoid care, it is necessary to take measures to eliminate or minimize this feeling. Even today, patients avoid dental care due to fear or anxiety. To those, classified as âphobicâ, are added patients with special needs and non-cooperative children. In these cases, hypnotic and anxiolytic drugs have been used, as well as general anesthesia. As an alternative to the use of such drugs, the mixture of nitrous oxide and oxygen, also called conscious sedation or inhalation analgesia, have been used throughout the world with a high degree of success. The objective of this study was to perform a comparative analysis of cardiovascular parameters and pulse oximetry values in two groups of 20 patients, classified as ASA I and II according to the American Society of Anesthesiologists (ASA) classification, who were referred for surgical removal of impacted third molars. Patients in the experimental group (n=20) underwent surgery under local anesthesia with sedation consisting of 70% nitrous oxide and 30% oxygen, while patients in the control group (n=20) underwent the same surgical procedure but only under local anesthesia. The results demonstrated that sedation with 70% nitrous oxide is a safe and effective procedure. The cardiovascular parameters in the group given sedation showed more hemodynamic stability than those observed in the group that only received local anesthesia. In none of the groups, desaturation episodes or electrocardiographic changes of clinical significance were observed

Objetivos: Avaliar a segurança e a eficácia do midazolam intranasal (MIN) para sedação para tomografia em crianças, bem como a qualidade dos estudos radiológicos obtidos com esta técnica. Material e métodos: Entre dezembro de 2011 e julho de 2012, este estudo prospectivo avaliou o MIN como sedativo para crianças submetidas à tomografia sem acesso venoso. Após aprovação do Comitê de Ética em Pesquisa e consentimento dos responsáveis, 0,4 mg/kg de MIN foi administrado, sendo feita dose adicional de 0,1 mg/kg se o nível de sedação avaliado pela Escala de Sedação de Ramsay não fosse atingida após 15 minutos da primeira dose. Os desfechos relacionados à sedação incluíram tempo para sedação e para atingir os critérios de alta; parâmetros fisiológicos como oximetria de pulso e frequência cardíaca foram registrados a cada cinco minutos até a alta. A qualidade dos exames tomográficos foi avaliada quanto à presença de artefatos de imagem e movimento. Resultados: 60 eventos de sedação foram realizados em 58 pacientes. A idade média foi de 15,5 meses, sendo 90,9% dos exames tomográficos de crânio. O tempo médio para sedação foi de 15,2 minutos (5-40) e o tempo médio para atingir os critérios de alta foi de 74,7 minutos. Eventos adversos foram observados em 5 crianças (8,4%), incluindo reação paradoxal (3), tempo de recuperação prolongado (1) e vômitos (1). Apenas 4 pacientes (6,7%) não foram adequadamente sedados com MIN. Imagens consideradas excelentes, sem artefatos, foram obtidas em 56 (93,3%) sedações. Não houve eventos como bradicardia, hipoxemia ou hipotensão. Conclusões: O midazolam intranasal, administrado via atomizador nasal, é um método simples e não-invasivo para sedação segura, eficaz e previsível para crianças na obtenção de estudos tomográficos de qualidade / Objective: To evaluate the safety, efficacy and image quality of sedation with aerosolized intranasal midazolam for pediatric CT studies. Materials and Methods: Between December 2011 to May 2012, this prospective study evaluated aerosolized intranasal (AIN) midazolam as a sedative for CT of children without intravenous access. After IRB approval and parental consent, 0,4 mg/kg of AIN midazolam was administered, and repeated with 0.1 mg/kg if adequate sedation evaluated by Ramsay Sedation Scale not achieved in 15 minutes after the first dose. Sedation outcome variables which included time to achieve sedation, to meet discharge criteria and physiological vital signs of pulse oximetry and heart rate, were recorded every five minutes until discharge. The quality of CT images was reviewed and graded for presence of motion and imaging artifacts, Results: 60 sedation encounters were performed in 58 children. Mean age was 15.5 months, and 90.9% of CT scans were brain scans. Mean time to sedation was 15.2 minutes (range 5-40) and mean time to achieve discharge criteria was 74.7 minutes. Adverse events were recorded in 5 children (8.4%) that underwent sedation - paradoxical reaction (3), prolonged recovery time (1) and vomiting (1). Only 4 patients (6.7%) failed to sedate. Excellent CT imaging, with no artifacts, were obtained in 56 (93.3%) of sedation encounters. No adverse events like bradycardia, hypoxia or hypotension were documented. Conclusions: The aerosolized route of administration of midazolam is a simple and noninvasive approach for predictable, effective and safe sedation of children for quality CT imaging studies

Made available in DSpace on 2016-04-27T14:31:00Z (GMT). No. of bitstreams: 1 Andyara de Santis Outeiro.pdf: 1178627 bytes, checksum: 2e54e41cbc46534145255d57ecefe2fb (MD5) Previous issue date: 2012-09-05 / Can a bank employee become an educator? Based on the theory of interdisciplinarity, this research aims to demonstrate that the answer to that question is yes. Brazilian society is experiencing a period of strong credit exposure, although it has not matured culturally to deal with the currency's stability. The natural convergence between credit growth and the short-term culture is debt and, consequently, the loan default rate. Therefore, there is an urgent need to educate people regarding the proper use of money and credit. This is an economical environmental and social issue, because its impacts are derived directly from the way individuals define as they practice their spending habits. Thus, it is a question related to sustainability. By understanding the bank's role as the main financial agent of the society, therefore most responsible for contributing with its proper financial education, the main objective of this research was to investigate the contribution of an educational interdisciplinary action proposed to reframe the role of the bank employee to financial educator in the society. We tried to prove the hypothesis of the course Economy of Value , designed to develop employees of a bank to exercise the role of financial advisors, can be considered an educational interdisciplinary action. Then, we tried to verify if and how this action helps to reframe the role of the bank employee to financial educator. We performed a literature review on categories related to sustainability, financial education and interdisciplinarity, and a review of documents on the educational model of the financial institution surveyed. Next, we investigated the prescribed and lived curriculum in order to verify the presence of the principles of interdisciplinarity. Study subjects are participants of the course, questioned on two occasions about his perspective on the role of banking in society, assessing whether and how the course contributed to the expansion of their way of looking. The results obtained in the research have given rise to four stages of contribution of the course to broaden the participants' gaze toward their role as financial educators / Pode um bancário tornar-se um educador? Embasada na teoria de interdisciplinaridade, esta pesquisa pretende demonstrar que a resposta a essa pergunta é sim. A sociedade brasileira vive um momento de forte exposição ao crédito, embora não tenha amadurecido culturalmente para lidar com a estabilidade da moeda. A convergência natural entre aumento do crédito e cultura de curto prazo é o endividamento e, por conseqüência, a inadimplência. Por isso, existe uma necessidade urgente de educar as pessoas quanto ao bom uso do dinheiro e do crédito. Esta questão é tão econômica, quanto ambiental e social, pois seus impactos derivam diretamente da forma como os indivíduos definem e praticam seus hábitos de consumo. Assim, trata-se de uma questão ligada à sustentabilidade. Compreendendo o papel do banco como principal agente financeiro da sociedade, portanto maior responsável por contribuir com sua adequada educação financeira, o objetivo principal desta pesquisa foi investigar a contribuição de uma proposta de ação educativa interdisciplinar no movimento de ressignificar o papel de bancário a educador financeiro da sociedade. Buscou-se comprovar a hipótese de que o curso Economia de Valor, criado para desenvolver funcionários de um banco a exercerem o papel de orientadores financeiros, pode ser considerado uma ação educativa interdisciplinar. Em seguida, procurou-se verificar se e como esta ação contribui para ressignificar o papel do bancário a educador financeiro. Foi realizada uma revisão bibliográfica sobre categorias ligadas a sustentabilidade, educação financeira e interdisciplinaridade, além da revisão documental sobre o modelo educativo da instituição financeira pesquisada. Em seguida, investigou-se o currículo prescrito e vivido da ação a fim de verificar a presença dos princípios da interdisciplinaridade. Os sujeitos pesquisados são os participantes do curso, questionados em dois momentos sobre sua perspectiva quanto ao papel do bancário na sociedade, avaliando se e como o curso contribuiu para a ampliação de seu olhar. A análise dos resultados obtidos na pesquisa fez emergir quatro estágios de contribuição do curso para ampliar o olhar dos sujeitos participantes em direção à atuação como educadores financeiros