Efeitos do treino resistido na capacidade funcional e na reatividade pressórica em pacientes intradialíticos

Pacientes com doença renal crônica (DRC) submetidos ao treinamento resistido durante a hemodiálise apresentam benefícios substanciais dos sistemas muscular e cardiovascular, da capacidade funcional e da sua qualidade de vida. Entretanto, as melhorias na reatividade pressórica ainda não estão bem esclarecidas. O objetivo foi analisar o efeito do treino resistido na melhora da capacidade funcional e da reatividade pressórica em pacientes hemodialisados, em Natal/RN no ano de 2014. Trata-se de um ensaio clínico controlado e randomizado, com amostra de 64 pacientes, com média de idade de 42,28 (±11,48) anos, distribuídos em grupo experimental (GE) e controle (GC). Para mensurar os ganhos de força de membros inferiores foram utilizados os testes de sentar e levantar e de levantar e caminhar, já para a reatividade pressórica o teste cold pressor, em ambos os grupos antes e após a intervenção. Além disso, apenas o GE participou do treinamento resistido durante a hemodiálise em 16 semanas, composto por 3 sessões semanais, 3 séries de 10 repetições máximas (RM) estimadas (para extensores de joelho e flexores de quadril e joelho), entre 50 a 70% de 10 RM. Para a intensidade do treinamento foi utilizada a escala de Borg entre 11 a 14 durante as seções. Os dados foram analisados utilizando o Teste t para amostras independentes (inter-grupos) bem como para comparar a diferença das médias nos grupos pré e pós-intervenção (intra-grupos) a partir do Teste t para amostras repetidas. Para todas as variáveis foi considerada a significância estatística de 5% executados no software SPSS® 20.0. O estudo foi aprovado pelo comitê de ética do Hospital Universitário Onofre Lopes (HUOL - UFRN) número 37992214.2.0000.5292. Após a intervenção, verificou-se que os pacientes do GE tiveram um desempenho melhor nos testes de força (p<0,001) em comparação ao GC. Resultado também observado na pressão arterial sistólica e diastólica (PAS e PAD) ambas de repouso que apresentaram redução dos níveis pressóricos apenas no GE (p<0,001). Na reatividade pressórica tanto nos períodos pré bem como após 2 minutos também demonstraram reduções estatisticamente significativas do GE (p<0,001 e p=0,012) respectivamente quando comparado ao GC. Conclui-se que o treinamento resistido melhorou desempenho nos testes de força de membros inferiores beneficiando a capacidade funcional dos pacientes em hemodiálise, como também a pressão arterial de repouso e os níveis de reatividade pressórica obtiveram reduções significativas de seus valores após a intervenção. Além disso, este tipo de treinamento também pode ser utilizado como uma estratégia de proteção aos fatores de risco cardiovascular em pacientes renais crônicos.

Fenômeno vivido por familiares de pacientes internados em unidade de terapia intensiva

COMASSETTO, Isabel, ENDERS, Bertha Cruz. Fenômeno vivido por familiares de pacientes internados em Unidade de Terapia Intensiva. Revista Gaúcha de Enfermagem., Porto Alegre(RS), v.30,n., p.46-53. Mar. 2009. Disponivel em: < http://www.seer.ufrgs.br/index.php/RevistaGauchadeEnfermagem/search/results>.

Violência intrafamiliar contra a criança: intervenção de enfermeiros da estratégia saúde da família

Objetivou analisar a atuação dos enfermeiros da Estratégia Saúde da Família frente à violência intrafamiliar contra a criança, visando identificar ações de prevenção do problema. Pesquisa descritiva e exploratória de cunho qualitativo, cujos dados foram analisados conforme análise de conteúdo. Participaram do estudo 14 enfermeiros da Estratégia de Saúde da Família do município de Mossoró-RN. Dados coletados utilizando-se questionário semiestruturado. As ações de promoção à saúde são atividades educativas desenvolvidas após detecção de casos. O medo de represálias do agente agressor, a sobrecarga de trabalho, a falta de apoio dos gestores e a dificuldade para a materialização da interdisciplinaridade, intersetorialidade e integralidade da atenção foram mencionadas como barreiras ao enfrentamento do problema

Trabalho e família: um estudo da interação de papéis com secretários executivos

The balance between the demands of two important spheres of human life, work and family, has become a challenge due to the pressures of the contemporary that is expanding around the difficulties of reconciling these two comínios. In this sense, this research aimed to understand the work-family interaction in the perception of executive secretaries. The analysis approach used was qualitative research, by worrying about a reality that can not be quantified due to the subjectivity of his goal. The data collection technique used was the semistructured interview to twenty executive secretaries, servants of a Federal Institution of Higher Education. For the understanding and interpretation of the data, we used the technique of content analysis. The results of both analyzes identified the existence of conflict as enrichment in this interaction. The time was identified as the largest generator of conflict work. The overload, relationship stress and conflict emerged as elements common to both domains. As main implications of labor disputes, were revealed: problamas health for secretaries and stress. As main implications of family conflicts emerged: motivation for work, lower performance and lack of concentration. The attempt at balance was identified as the strategy most used by secretaries to minimize work-family conflict. The work-family enrichment was seen as resources that contribute to improving the lives of the secretary in both domains. The opportunity to add knowledge was highlighted as enriching element of work and family values ​​as elements enriching family. The support and experience emerged as enrichment items common to both domains. Regarding the implications of enrichment resulting from the interaction of work and family, the more perceived by respondents were: increased knowledge and skills, material and psychological benefits, improved quality of life and personal and professional fulfillment. From the perception of executive secretaries, work and family spheres of human life are essential and complementary, and that help is contrary, however, this relationship is the primary management of conflicts, ie, how the individual sees and manages the negative side of the work-family

Novo método para estimativa do gradiente de fratura para poços de petróleo

The development of oil wells drilling requires additional cares mainly if the drilling is in offshore ultra deep water with low overburden pressure gradients which cause low fracture gradients and, consequently, difficult the well drilling by the reduction of the operational window. To minimize, in the well planning phases, the difficulties faced by the drilling in those sceneries, indirect models are used to estimate fracture gradient that foresees approximate values for leakoff tests. These models generate curves of geopressures that allow detailed analysis of the pressure behavior for the whole well. Most of these models are based on the Terzaghi equation, just differentiating in the determination of the values of rock tension coefficient. This work proposes an alternative method for prediction of fracture pressure gradient based on a geometric correlation that relates the pressure gradients proportionally for a given depth and extrapolates it for the whole well depth, meaning that theses parameters vary in a fixed proportion. The model is based on the application of analytical proportion segments corresponding to the differential pressure related to the rock tension. The study shows that the proposed analytical proportion segments reaches values of fracture gradient with good agreement with those available for leakoff tests in the field area. The obtained results were compared with twelve different indirect models for fracture pressure gradient prediction based on the compacting effect. For this, a software was developed using Matlab language. The comparison was also made varying the water depth from zero (onshore wellbores) to 1500 meters. The leakoff tests are also used to compare the different methods including the one proposed in this work. The presented work gives good results for error analysis compared to other methods and, due to its simplicity, justify its possible application

Avaliação bioquímica e hostológica de fígado de ratas wistar diabéticas e tratadas com tamoxifeno

Tamoxifen (TX), a drug used in the treatment of breast cancer, may cause hepatic changes in some patients. The consequences of its use on the liver tissues of rats with or without diabetes mellitus (DM) have not been fully explored. The purpose of this multidisciplinary study was to evaluate the correlation between plasma hepatic enzyme levels and the presence of iron overload in the hepatic tissue of female Wistar rats with or without streptozotocin-induced DM and using TX. Female rats were studied in control groups: C-0 (non-drug users), C-V (sorbitol vehicle only) and C-TX (using TX). DM (diabetic non-drug users) and DM-TX (diabetics using TX) were the test groups. Sixty days after induced DM, blood samples were collected for glucose, alanine aminotransferase (ALT), aspartate aminotransferase (AST) alkaline phosphatase (ALP) and bilirubin measures. Hepatic fragments were processed and stained with hematoxylin and eosin (H&E), Masson s trichrome, Perls. The hepatic iron content was quantified by atomic absorption spectrometry. AST, ALT and ALP levels were significantly elevated in the DM and DM-TX groups, with unchanged bilirubin levels. Liver iron overload using Perls stain and atomic absorption spectrometry were observed exclusively in groups C-TX and DM-TX. There was positive correlation between AST, ALT and ALP levels and microscopic hepatic siderosis intensity in group DM-TX. In conclusion, TX administration is associated with liver siderosis in diabetic and non-diabetic rats. In addition, TX induced liver iron overload with unaltered hepatic function in 2 non-diabetic rats and may be a useful tool for investigating the biological control of iron metabolism

A saúde psíquica de quem faz saúde: uma análise crítica sobre a humanização direcionada ao profissional de saúde

It is noticeable that pressure, tension and overwork are frequent in health professionals routine. The work related to the ward area demands deep attention and surveillance. Because of that, it is essential to have a specific look at the humanization directed at health professionals, considering that taking care of other human beings is the essence of their job. This study has analyzed the psychic health levels, as well as the stress health professionals are submitted to, providing a debate about the humanization in 06 public hospitals (03 of them awarded by actions of humanization, and 03 not awarded) in Rio Grande do Norte state, Brazil. A study with 126 active health professionals (doctors, nurses, psychologists, nutritionists and social workers) in ward areas in their respective institutions was carried out. The thesis presented, with multi-disciplinary characteristic, counted on the support of statisticians (to calculate samples and data analysis), psychologists, social workers and administrators (linked to the human resources sector in each hospital). A cross-sectional study was performed, taking into consideration both quantitative and qualitative factors. The tools used for that were a semistructured questionnaire with socio-demographic characteristics, work and humanization; Lipp's Stress Symptoms Inventory for Adults (ISSL), and the Goldberg s General Health Questionnaire (QSG). The workers are predominantly women (84,9%), married (54,8%), between 46 and 55 years old (40,5%), working in the same institution for more than 20 years (22,2%), and between 16 and 20 years (20,6%), respectively. They work 40 hours a week (71,4%) and have multiple jobs (61,9%). Although most of these individuals global psychic health is in a good level, there are a significant number of people that is gradually getting worse concerning psychic stress (F1) showed by QSG (54,7%), and stress showed by ISSL(42,1%). Observing the categories, nurses (41,5%). Nutritionists (20,8%), doctors and social workers (18,9%), were among the most affected. About general health (F6), 63% of the awarded hospitals and 70% of the not awarded ones, presented good health levels (ranging from 5 to 50%). It was also noticed that, in the groups mentioned above, 25 and 20% respectively, were inserted in scores between 55 to 90%, what means that they are in worsening phase. The fact that the hospital is awarded or well recognized doesn t interfere in health professionals stress level and in their psychic health. Through what was heard from these individuals, it was possible to verify that they know little about humanization, once few of them identify or know that the service they offer is in an adoption process by Ministerial Policies. It was also detected the necessity of developing actions aimed at worker s health. Such results showed the importance of have more investments in programs that are directed to workers well-being, because they deal with other people s health and it is known that it is difficult for them to offer high-quality assistance if there are not suitable physical, psychological and material conditions to help them develop their jobs. As a warning, it is fair to say that investments in actions that provide humanized care to health professionals, mainly concerning preventive care for their health and life quality in their work

Morte como desafio afetivo para o profissional da saúde: ansiedade e sentimentos de quem lida com o paciente terminal com câncer

It is a Cross-sectional and multi-disciplinary study whose population selection was made by department of human resources (composed by a Manager, an Oncologist and a Psychologist) from the hospital where this research was realized. They also collaborated with important information about the work of that professionals in the hospital. We also counted on a Statistic who made study design calculating the sample and analyzing data. This research issued Evaluating health professionals anxiety levels who care for cancer terminally ill and their feelings about that work as well as identifying the factors which have influence on it. 100 health professionals from the Hospital which is a reference on cancer caring in Brazil situated in the city of Natal, state of Rio Grande do Norte, participated of this research. There was a sample loss of 21%. Data were collected through a questionnaire and State-Trait Anxiety Inventory (STAI). Results showed that 15% of the professionals have low State Anxiety levels, 70% Medium State Anxiety levels and 15% high State anxiety levels. The Number of Patients and Working in another Institution have interfered in the anxiety levels. Doctors and Nursing Assistants and Technicians have got the highest high State Anxiety percentage (25%). 73% of them declare to feel some sort of different behavior and/or feelings in caring for terminally ill. The most remarkable professionals feelings were Suffering and Sadness, and Terminally ill Children was the most difficult age group to care for. We conclude that work overload and having more than one job can interfere in professional stress levels and anxiety. Dealing with terminally ill, specially children one, can cause on the professionals psychological suffering. It s recommended the development of supporting and training strategies to reduce and/or to prevent Stress and Anxiety high levels

Análise das mutações C282Y e H63D no gene da proteína HFE em pacientes com hiperferritinemia

Hereditary Hemochromatosis (HH) is a genetic disease caused by high iron absorption and deposition in several organs. This accumulation results in clinical disturbances such as cirrhosis, arthritis, cardiopathies, diabetes, sexual disorders and skin darkening. The H63D and C282Y mutations are well defined in the hemochromatosis etiology. The aim of this paper was that of identifying the H63D and C282Y genetical mutations in the hemochromatosis gene and the frequency assessment of these mutations in the HFE protein gene in patients with hyperferritin which are sent to the DNA Center laboratory in Natal, state of Rio Grande do Norte. This paper also evaluates the HH H63D and C282Y gene mutations genotype correlation with the serum ferritin concentration, glucose, alanine aminotransferasis, aspartato aminotransferasis, gama glutamil transferasis and with the clinical complications and also the interrelation with life habits including alcoholism and iron overload. The biochemical dosages and molecule analyses are done respectively by the enzymatic method and PCR with enzymatic restriction. Out of the 183 patients investigated, 51,4% showed no mutation and 48,6% showed some type of mutation: 5,0% were C282Y heterozygous mutation; 1,1%, C282Y homozygous mutation; 31%, H63D heterozygous mutation; 8,7%, H63D homozygous mutation; and 3,3%, heterozygous for the mutation in both genes. As to gender, we observed a greater percentage of cases with molecular alteration in men in relation to women in the two evaluated mutations. The individuals with negative results showed clinical and lab signs which indicate hemochromatosis that other genes could be involved in the iron metabolism. Due to the high prevalence of hemochromatosis and taking into account that hemochromatosis is considered a public health matter, its gravity being preventable and the loss treatment toxicity, the early genetic diagnosis is indicated, especially in patients with high ferritin, and this way it avoids serious clinical manifestations and increases patients' life expectation. Our findings show the importance of doing such genetic studies in individuals suspected of hereditary hemochromatosis due to the high incidence of such a hereditary disease in our region

Atenção ao usuário em um centro de referência HIV/Aids: perspectiva de profissionais e usuários

We study the health care focused on care in an intercessor and dialogical relationship with the User, which involves the construction of therapeutic projects essential to the quality of the treatment of the user in health services, and it is necessary individual and collective actions. It is intended to acknowledge and analyze the perception of social subjects, users and professionals on the treatment given to a user of a Specialized Outpatient Service (Serviço Ambulatorial Especializado SAE) in STD/HIV/AIDS state reference in Natal, RN. The study is structured in a transdisciplinary vision of science and knowledge, theoretical and methodological principles that give meaning to the expression of the institutional features of care and health care reconnecting them to the social context. As a research strategy we seek the expressions of 56 subjects of social research, which agreed to participate in the sample, from a symbolic map of the attention, coupled with the techniques of observation and semi-structured interview. For the analysis of the results, five categories of analysis were established: the meaning of the service, care perception, process of communication and interaction, treatment perception and organization and evaluation of the service. It is argued that the attention and care are developed in a technical health care assistance to the disease, focusing on attention based on treatment, on diagnostic and drug therapy of antiretroviral drugs, reflecting the traditional biomedical paradigm of attention to the disease. This is also the mode of organization of practical actions in daily SAE: the therapy proves to be fragmented in several specialties, vertical and feeds the same model, generating tension and overload for professionals; showing impersonal care focused on structured and informative technology, unrelated to an interactive dialogic. From the speech of the subjects, the SAE is understood as the place of confrontation with the disease, but also enables greater elaboration of the illness by meeting their peers. Living with HIV and AIDS is living with concern, apprehension and fear, but mainly with the stigma, prejudice and exclusion, which require that the disease is kept in secret. There is a movement of forces and power, expressed in the knowledge-power of those who dominate the technical and administrative capabilities, devices that concentrate the maintenance of the medicalization of care, rapid consultations and with little attention, making it difficult to interact with and listen to, combined with structural failures, organizational and inadequate management of the service. We conclude that there are dimensions that are not considered in the internal dynamics of the care service multiple forms, characterized by care conflicting models, marked by individual interventions related to the disease. The subject is not considered together with his speech as technical discourse is imposed and care production based on material technology is observed

A missão política do Supremo Tribunal Federal: análise de sua importância como corte constitucional para o controle do poder no Brasil

The following study proposes an analysis of the politic process which the brazilian constitutional justice faces, emphasizing the Supremo Tribunal Federal . For that purpose, we start by examining the intimate relationship between Politics and Law, in view of the most recent social systems theories, so that the political system is distinguished by the exclusiveness of using the physical force, intending to make coletive tying decisions, and the juridical system as a congruent generalization of the expectations towards the rules and principles, brought together under an interdependence by which both gather legitimacy and effectiveness. In this manner we can notice the political effects of the constitutional interpretation conducted by Judges as well as by other juridical professionals, because these ones decrease the overload of expectations which are pointed to the Judicature. Constitutional interpretation is democratized since the participative democracy arises and stablishes a permanent state of awareness around the exercise of power and favours the preservation of the pluralism (counter-majoritary principle) where we can find the origin of the democratic nature of constitutional courts, once, in most cases, their members are not elected by the people. After that, we analyse the historical posture of the Supremo Tribunal Federal as a constitutional court in Brazil, so we can realize the attempts to make it vulnerable to the appeals of governability and economical aims, agains which this court somehow has resisted, stressing its particularities. At the end, it s concluded that even the so-called acts of government, whose judiciary control is mostly repelled, are subjected to a constitutional analysis, last frontier to be explored by the Supremo Tribunal Federal in its role of exposing our republican Constitution

Trabalho e formação docente na rede municipal de ensino de natal

The study Teacher work and education in the municipal schools of Natal objectifies the analysis of the education and work conditions of the teachers in the municipal schools of Natal, placing them within the scenario of the public policies outlined for Basic Education (2005-2010). The thesis is based on the perspective that the educational reforms implemented by the Brazilian government in an attempt to answer to the new contextual demands originated from the world of work and globalization, demanding increasingly higher levels of qualification and constant extension of the teaching functions in school from the teachers, have been configured withal as a strategy for intensifying the teacher s work. The empirical field of study was constituded by thirteen municipal schools that offer basic education. Four hundred and seventeen teacher subjects that work in the municipal school system of Natal, two representatives of the Secretaria Municipal de Educação de Natal (SME)1 that work in the pedagogical team and one representative of the Sindicato dos Trabalhadores em Educação do Rio Grande do Norte2 took part in the study. The procedures/instruments used in the research were: bibliographic review, document research, questionnaires and recording of information in a field journal. The study confirmed that the majority of the teachers that work in the municipal school system were admitted by means of public entry exams, therefore meeting the requirements set by Law 9.394/96. Most of the teachers have the initial education demanded to work in basic education, although with some limitations due to the fact that they do not correspond to the needs of the educational system. The SME has a plan for continued training of the teachers in accordance to the current ideas defended by researchers of this field. There is, although, a disconnection between the purpose of the plan and the training strategies, because, in truth, predominate repetitive and specific actions that do not contemplate the training needs of the teachers, nor the demands of the system. Although the work conditions are evaluated, by the teachers, as relatively good, limits in relation to the physical structure of the schools are observed (dirty walls with holes in them, broken ceiling fans, old chairs and desks, old and stained black boards, inadequate restroom installations, poor maintenance of the computers, amongst other items). It was also verified the an increase in the functions of the teachers and an intensification of their work, materialized through an overburden of activities undertaken daily at school (and outside of it) and through the demand in taking part in activities that go beyond those inherent to the teaching process, such as the elaboration of political-pedagogical projects, participation in collegiate, registration of student information solicited by the SME and the participation in commissions, has been happening

O trabalho do gestor escolar: intensificação e implicações administrativas e pedagógicas na gestão da escola

Analyze the work of the school manager who now faces the changes experienced in school management for the last two decades. We propose that there have been changes in school management that have generated a larger number of activities to be developed by managers, causing both the intensification of work and a greater involvement of professionals in the financial-administrative dimension of their work in opposition to the political and pedagogical dimension. This study has a historic-critic approach. That is why we performed semi-structured interviews with school managers of the city schools in Natal RN, BR as a methodological procedure. We also analyzed the literature as well as the documentation relevant to this subject. From the study it was possible to conclude that changes in the field of school management and also teaching have led to an intensification of work of school managers and that such changes have not been followed by corresponding improvement in working conditions and teaching career of these professionals. They, as a rule, are considered by controlling agencies and by the school community as the primarily responsible for the school condition and for creating actions or projects that may improve the institutional objectives and results, including even the maintenance of the institution. Moreover, the growing number of administrative activities represents for obvious reasons extra work for these managers, who, when trying to cope with the growing bureaucratic situations, end up misplacing other political and educational aspects of school work, which may undermine the final purpose of school itself. We stress that we must broaden the discussions on the functions of the school manager, so that this worker can actualize a pedagogical project more committed to an emancipatory nature, despite all the challenge in keeping the school running in often-precarious conditions

Descompassos nas políticas educacionais: a reorganização da educação rural em Jardim de Piranhas/RN

The present work has as aim to analyze the reorganization process of the rural education in Jardim de Piranhas-RN, on the context of the education policies, in particular of the period of 1999-2006, having as reference the transformations in the political, cultural and socio-economic setting in the national, regional and local level, above all from the decade of 1990. The studies carried out in diverse sources made possible to understand from the context in which they had developed the education policies, in particular, that one directed for the rural way, as well as the mediation of this with the education reorganization in the local scope. Besides these research procedures, we carry out interviews - semi-structuralized - with managers and teachers, and we analyze documents from the produced ones in national level to those local ones. From the viewpoint theoretician-methodological, we focus the national discussion that comes developing under a new ideological political configuration and, being entitled by the Field Education, understood as a policy directed to education specifities in this sector and consolidated in the Operational Guidelines for the Basic Education in the Field Schools (CNE/MEC/2002). As particularity of this object in Jardim de Piranhas-RN, we emphasize events occurred that had marked the rural education reorganization in that city, especially from the creation of the Rural Education named Center Teacher Maria Edite Batista. Studies make possible to realize that until the Center creation, the schools functioned in rather precarious infrastructure and physical conditions, that is, without electric energy and water supplying, as well as the lack of school snack and the management structure. There was not a project or specific pedagogical accompaniment for the sector. Moreover, the teachers worked predominantly with several grade classes and still they fulfilled the manager functions, caretakers, and cook- in some cases as school secretary. However, exactly with the creation of the Rural Education Center, the education municipal system did not become capable to overcome problems as of the evasion and school failure, as well as decreasing the work overload of teachers, neither to give greater consistency to the pedagogical project of the field schools in that city

Vivências de familiares do paciente internado em unidade de terapia intensiva: estudo fenomenológico

This study originated from my concerns as critical care nurse, regarding the lived experience of the family member of the patient that is hospitalized in the intensive care unit - ICU. The purpose of the study was to comprehend the experience of the family members while having a loved one interned in an ICU, and to identify the common elements of the phenomenon, based on the descriptions of their experiences. Considering that the object of study involves subjective and social questions, the study was conducted using some fundamental ideas of descriptive phenomenology as a referential and the situated phenomenon as suggested by Martins and Bicudo (1989). Ten (10) family members of patients that were interned in the ICU of private hospital in Natal, RN were interviewed using the following leading question: What is it like to have a member of your family interned in the ICU? Five thematic structural categories emerged from the comprehensive analysis of the interviews: Fear of the family member s death; Lack of humanization; Social isolation; Confidence in the ICU; and Overload to the personal life. The description of the phenomenon enabled a new look at how the care team relates to the family members of the patients interned in the ICU, providing some guidance on how to construct a humanized care that involves the family and that is based on affective human relations. This involves a rethinking of the care provided by team to the family and stimulates the reformulation of personal and social attitudes, and of hospital organizational norms