A importância do suporte emocional aos pais de bebês internados num CTI pediátrico: aspectos teóricos e práticos de um trabalho com grupos

Este trabalho, realizado num hospital, apresenta a prática de Grupo com pais de bebês internados em Centro de Tratamento Intensivo. Tal prática visa basicamente o atendimento aos pais no sentida de lhes oferecer as condições necesárias para a manutenção e preservação do vínculo afetivo bebê-pais, e consequentemente aceitação deste bebê doente, tanto durante o período de internação como também após sua alta. Visa, portanto, revelar a importância de um suporte emocional aos pais de tais bebês, sem o que, acredita-se, dificilmente ais pais teriam condições de superar a situação de crise emocional por que passam diante ao nascimento de um filho doente ou que adoece logo ao nascer. o trabalho com os Grupos realiza-se uma vez por s~ mana. tendo a duração de 1DJla hora. A coordenação destes grupos é feita em co~terap:ta por UltlJllédico peaiatra e um psicõl~ go. Baseia-se na livre expressão dos participantes. e tanto o médico quanto o psicólogo. oferecem informações sobre o estado de saúde do bebê ao mesmo tempo em que buscam compreen -der na fala dos pais os aspectos emocionais nela subentendi -dos. .' Essencialmente, tornaram-se temas centrais deste trabalho os que dizem respeito a ligação afetiva dos pais com o bebê, aos sentimentos de culpa pela doença do mesmo e os relativos i preocupação dos pais com o desenvolvimento futuro de seu filho. Os referidos temas foram denominados com os seguintes títulos: Vínculos e Separações, Sentimentos de Culpa e O Espaço da Criança, e neles foram abordados os aspectos teóricos de cada questão, visando uma melhor compreensão das ansiedades dos pais e na esperança de fornecer suporte emocional aos mesmos, a fim de que possam melhor amparar seus filhos.

The challenges faced by the external audit industry in Brazil: an exploratory study

The auditing role in the contemporaneous business environment, and increasing interest in and demand for governance and transparency, has become an element even more important to the society, as a whole, in order to build solid basis to the development of businesses and generation of wealth through technical knowledge, independence, transparency, credibility, and ethics. Nevertheless, the external financial audit industry in the world and also particularly in Brazil has faced several challenges which threaten its success and evolution. In this sense, since the external audit industry in Brazil has been immersed in a deep crisis with features that are explored through this study, allow me to create an analogy over this study saying that the external financial audit industry is like a sick person with a chronic disease, but the disease has not yet been diagnosed and the person has been dealing with the isolated symptoms. This person, the external audit industry, has struggled with this disease for many years and it is getting worse. It is fundamental to highlight that the challenges faced by the external audit industry in Brazil, ultimately, have not harmed the industry only, but they also materialize themselves as chronic issues for the corporate governance and the capital markets since they harm every interested party. In my point of view, the hardest affected are the investors or shareholders whose interest the independent auditor’s work seeks to preserve. Therefore, the purpose of this study is to have a picture of the challenges faced by the external audit industry in Brazil and understand those challenges as a requirement to analyze the potential alternatives to solve them or, analogically, to diagnose this disease. The research purpose is to map and identify the challenges faced by the external audit industry in Brazil based on the understanding of professionals seasoned in the area. Those challenges are mapped and understood through a methodological approach, a questionnaire answered by auditors with experience in the Brazilian auditing market. The challenges were preliminarily listed based on over 16 years of experience of the author in the area of auditing and financial and accounting services, discussions and interviews about the topic with seasoned professionals, and analyses of pieces of news, publications and academic studies. The questionnaire was used in order to validate the challenges, observations, perspectives, and perceptions gathered through those resources. Despite of the fact that the study is highly relevant, it was not found, through my research, other analyses on this topic with a similar approach which is intended by this study. It looks like the external audit industry in Brazil has walked through these new age dealing with problems on a daily basis and the real challenges of the industry may be concealed by the economic conditions in Brazil and other explanations. As in any problematic scenario, in which a critical analysis is needed, having an accurate picture and understanding of the challenges is a crucial step to start exploring alternatives to address them.

Lifestyle factors, direct and indirect costs for a Brazilian airline company

OBJECTIVE: To analyze lifestyle risk factors related to direct healthcare costs and the indirect costs due to sick leave among workers of an airline company in Brazil. METHODS: In this longitudinal 12-month study of 2,201 employees of a Brazilian airline company, the costs of sick leave and healthcare were the primary outcomes of interest. Information on the independent variables, such as gender, age, educational level, type of work, stress, and lifestyle-related factors (body mass index, physical activity, and smoking), was collected using a questionnaire on enrolment in the study. Data on sick leave days were available from the company register, and data on healthcare costs were obtained from insurance records. Multivariate linear regression analysis was used to investigate the association between direct and indirect healthcare costs with sociodemographic, work, and lifestyle-related factors. RESULTS: Over the 12-month study period, the average direct healthcare expenditure per worker was US$505.00 and the average indirect cost because of sick leave was US$249.00 per worker. Direct costs were more than twice the indirect costs and both were higher in women. Body mass index was a determinant of direct costs and smoking was a determinant of indirect costs. CONCLUSIONS: Obesity and smoking among workers in a Brazilian airline company were associated with increased health costs. Therefore, promoting a healthy diet, physical activity, and anti-tobacco campaigns are important targets for health promotion in this study population.

The influence of lifestyle and gender on sickness absence in brazilian workers

Background: Despite an increasing body of knowledge concerning gender and lifestyle factors as determinants of sickness absence in well-developed countries, the relationship between these variables has not been elucidated in emerging economic power countries, where the burden of non-communicable diseases is particularly high. This study aimed to analyze the relationships among lifestyle-related factors and sick leave and to examine whether gender differences in sickness absence can be explained by differences in socio-demographic, work and lifestyle-related factors among Brazilian workers. Methods: In this longitudinal study with a one year follow-up among 2.150 employees of a Brazilian airline company, sick leave was the primary outcome of interest. Independent variables collected by interview at enrolment in the study were gender, age, educational level, type of work, stress, and lifestyle-related factors (body mass index, physical activity and smoking). In addition, the risk for coronary heart disease was determined based on measurement of blood pressure, total cholesterol and glucose levels. The total number of days on sick leave during 12 months follow-up was available from the company register. Logistic regression analysis was used to determine the influence of socio-demographic, type of work and lifestyle-related factors on sick leave. Results: Younger employees, those with lower educational level, those who worked as air crew members and those with higher levels of stress were more likely to have sick leave. Body mass index and level of physical activity were not associated with sick leave. After adjustment by socio-demographic variables, increased odds for 10 or more days of sick leave were found in smokers (OR = 1.51, CI = 1.05-2.17), and ex-smokers (OR = 1.45, CI = 1.01-2.10). Women were more likely to have 10 or more days of sick leave. Gender differences were reduced mainly when adjusted for type of work (15%) and educational level (7%). Conclusions: The higher occurrence of sick leave among women than among men was partly explained by type of work and educational level. Our results suggest that type of work, a stressful life, and smoking are important targets for health promotion in this study population