Estágios e vivências no sistema único de saúde: Educação permanente em saúde produzindo interfaces Extensão-Ensino-Pesquisa

Trabalho apresentado no 31º SEURS - Seminário de Extensão Universitária da Região Sul, realizado em Florianópolis, SC, no período de 04 a 07 de agosto de 2013 - Universidade Federal de Santa Catarina.A estratégia de vivências e estágios no SUS compõe parte da política de educação na saúde do SUS e as experiências prévias demonstraram grande capacidade de interferir positivamente na formação, constituem importantes dispositivos que permitem o estudante experimentar um novo espaço de aprendizagem que é o cotidiano de trabalho das organizações de saúde, fortalecendo também a educação permanente em saúde. São realizados com base nos seguintes eixos: aprendizagem significativa, pedagogias problematizadoras, multiprofissionalidade, interdisciplinaridade e transdisciplinaridade e respeito e defesa radical dos princípios e diretrizes desse sistema. O SUS constituiu-se como cenário de formação e práticas em saúde, possui papel fundamental na ordenação de formação de trabalhadores da saúde, processo este de sua responsabilidade. A educação permanente pode ser entendida como aprendizagem-trabalho, ou seja, ela acontece no cotidiano das pessoas e das organizações. Ela é feita a partir dos problemas enfrentados na realidade e leva em consideração os conhecimentos e as experiências que as pessoas já têm. Os processos de educação permanente em saúde têm como objetivos a transformação das práticas profissionais e da própria organização do trabalho. Nesse sentido, além de interferir na formação dos profissionais, as iniciativas de vivências e educação permanente também têm a potência de qualificar os processos de trabalho desenvolvidos no interior dos serviços e sistemas. A edição de Verão/2012 do projeto foi realizado em 8 estado brasileiros: Rio Grande do Sul, Santa Catarina, Rio de Janeiro, Minas Gerais, Mato Grosso do Sul, Pernambuco, Ceará e Piauí. A edição de inverno de 2012 do projeto foi realizado em 11 estado brasileiros: Rio Grande do Sul, Rio de Janeiro, Minas Gerais, Mato Grosso do Sul, Mato Grosso, Pernambuco, Ceará, Bahia, São Paulo e Piauí. Os resultados da edição de Verão/2013 ainda não foram divulgados, pois em virtude da greve nas universidades federais algumas vivências ainda estão acontecendo

Salvage Percutaneous Nephrolithotomy: Analysis of Outcomes Following Initial Treatment Failure

Purpose Percutaneous nephrolithotomy has high potential for morbidity or failure. There are limited data regarding risk factors for failure and to our knowledge no published reports of surgical outcomes in patients with prior failed attempts at percutaneous stone removal. Materials and Methods We identified patients referred to 3 medical centers after prior failed attempts at percutaneous nephrolithotomy. A retrospective chart review was performed to analyze reasons for initial failure and outcomes of salvage percutaneous nephrolithotomy. Outcomes were compared to those in a prospectively maintained database of more than 1,200 patients treated with a primary procedure. Results Salvage percutaneous nephrolithotomy was performed in 31 patients. Unsuitable access to the stone was the reason for failure in 80% of cases. Other reasons included infection, bleeding and inadequate instrument availability in 6.5% of cases each. Compared to patients who underwent primary percutaneous nephrolithotomy those treated with salvage were more likely to have staghorn calculi (61.3% vs 31.4%, p <0.01) and a larger maximum stone diameter (3.7 vs 2.5 cm, p <0.01), and require a secondary procedure (65.5% vs 42.1%, p <0.01). There was no significant difference between the cohorts in the remaining demographics or perioperative outcomes. All patients were deemed completely stone free except one who elected observation for a 3 mm nonobstructing fragment. Conclusions Despite the more challenging nature and prior unsuccessful attempts at treatment, the outcomes of salvage percutaneous nephrolithotomy were no different from those of primary percutaneous nephrolithotomy when performed by experienced surgeons

The Geometry of Maximum Principles and a Bernstein Theorem in Codimension 2

We develop a general method to construct subsets of complete Riemannian manifolds that cannot contain images of non-constant harmonic maps from compact manifolds. We apply our method to the special case where the harmonic map is the Gauss map of a minimal submanifold and the complete manifold is a Grassmannian. With the help of a result by Allard [Allard, W. K. (1972). On the first variation of a varifold. Annals of mathematics, 417-491.], we can study the graph case and have an approach to prove Bernstein-type theorems. This enables us to extend Moser’s Bernstein theorem [Moser, J. (1961). On Harnack's theorem for elliptic differential equations. Communications on Pure and Applied Mathematics, 14(3), 577-591.] to codimension two, i.e., a minimal p-submanifold in $R^{p+2}$, which is the graph of a smooth function defined on the entire $R^p$ with bounded slope, must be a p-plane

Harmonic maps from surfaces of arbitrary genus into spheres

We relate the existence problem of harmonic maps into S2 to the convex geometry of S2. On one hand, this allows us to construct new examples of harmonic maps of degree 0 from compact surfaces of arbitrary genus into S2. On the other hand, we produce new examples of regions that do not contain closed geodesics (that is, harmonic maps from S1) but do contain images of harmonic maps from other domains. These regions can therefore not support a strictly convex functions. Our construction uses M. Struwe’s heat flow approach for the existence of harmonic maps from surfaces

Topological gauge-gravity equivalence: fiber bundle and homology aspects

In the works of A. Ach\'ucarro and P. K. Townsend and also by E. Witten, a duality between three-dimensional Chern-Simons gauge theories and gravity was established. First (Ach\'ucarro and Townsend), by considering an In\"on\"u-Wigner contraction from a superconformal gauge theory to an Anti-de Sitter supergravity. Then, Witten was able to obtain, from Chern-Simons theory (in two cases: Poincar\'e and de Sitter gauge theories), an Einstein-Hilbert gravity by mapping the gauge symmetry in local isometries and diffeomorphisms. In all cases, the results made use of the field equations. Latter, we were capable to generalize Witten's work (in Euclidean spacetime) to the off-shell cases, as well as to four dimensional Yang-Mills theory with de Sitter gauge symmetry. The price we paid is that curvature and torsion must obey some constraints under the action of the interior derivative. These constraints implied on the partial breaking of diffeomorphism invariance. In the present work, we, first, formalize our early results in terms of fiber bundle theory by establishing the formal aspects of the map between a principal bundle (gauge theory) and a coframe bundle (gravity) with partial breaking of diffeomorphism invariance. Then, we study the effect of the constraints on the homology defined by the interior derivative. The result being the emergence of a nontrivial homology in Riemann-Cartan manifolds.Comment: 14 pages; 5 figure