Tradução e adaptação da escala de dependência de substâncias do Millon Clinical Multiaxial III para o Brasil

Millon describes the normal personality by means of adaptation styles that are effective in normal environments and personality disorders such as unadapted operating styles. To operacionalize his theoretical model, Millon has built several instruments, including the Millon Clinical Multiaxial Inventory III (MCMI-III), wich consists of a self report inventory composed by 175 true or false response items, containing four verification scales, and others scales wich evaluates 14 personality patterns and 10 clinical syndromes. The Substance Dependence scale (T) is placed along with Clinical Syndromes scales. This research is justified by the lack of a Brazilian instrument to assess personality psychopathological aspects, and aims to translate and semantically adapt the MCMI-III to the Brazilian context, checking validity elements of the Substance Dependence scale, and developing a computer application for assisting the evaluation of assessment results. To this intent, 2.588 individuals data was collected, male and female, aged between 18 and 85 years, characterized as belonging to a clinical or non-clinical group, who took part in the survey via the internet or in person. Respondents completed the MCMI-III, a socio-demographic questionnaire and a subgroup also answered to the Goldberg General Health Questionnaire (GHQ). Besides descriptive statistics, we performed the analysis using the Student t test, principal components analysis and internal consistency. Despite difficulties related to translating very specific English terms, the assessment by judges, experts on Millon´s theory, and the back translation, attested the adequacy of the Brazilian version. Factorial analysis indicated the grouping of translated T scale items into three factors (social activities prejudice, lack of impulse control, and oppositional behavior), by presenting a single item on a fourth factor (apparently related to seeking pleasurable stimuli). The Cronbach alpha for this set of items was 0,82, indicating an acceptable scale reliability. The data analysis resulted in distinction of scores between clinical and non-clinical groups and between men and women; the relationship between high scores on the scale T and the other scales; scores of drug users according to the declared used substance; and the relationship between high scores on T and the verification of disorder or risk on GHQ mental health factor, indicating the instrument´s adequate sensistivity in identifying psychopathologies and the relationship between the different disorders or psychopathological personality patterns. Although further studies are necessary to develop the scores transformation factors, the computerized correction tool was adequate.

O afeto além dos muros e portões : o apego a vizinhanças na cidade do Natal

Place Attachment is a positive affective bond between people and environments, and its main characteristic is the desire to maintain closeness to the place of attachment. Neighborhoods, in turn, are spaces close to the dwelling, which varies according to environmental, social and cultural characteristics. Facing the contemporary scenario of diminishment of neighborhood relations and its importance to the understanding of cities social-environmental context, the present work aimed to investigate the attachment to neighborhoods at the city of Natal-RN. This study had two stages. The first stage consisted on investigating, through an experts panel, the main characteristics of attached neighborhoods, aspects that contributes to the development of these neighborhoods, the ones that difficult, as well as look for indications of neighborhoods at the city of Natal that may be identified by these elements. In the following stage I interviewed 11 residents of two indicated neighborhoods at the district of Alecrim, to better comprehend the main characteristics of this attachment and the elements of the context that enable its development. The content of the interviews, categorized and evaluated by judges, indicated that, due to the 10 participant experts, the main characteristics of attached neighborhoods encompass elements of socialization, cooperation, physical space usage, intimacy and identity. According to them, these are characteristics enabled by temporal and rootedness aspects, by spatial contact, familiarity between neighbors, and cultural inheritance. The interviews with residents showed that attachment to the studied neighborhoods is specially grounded on support and cooperation networks between neighbors, on satisfaction with the proximity of services, and on the bond to symbolic aspects and local traditions. In addition to be enabled by spatial organization, by low displacement of residents, and by the district s history, relations at these neighborhoods are fostered by an intention to establish this kind of ties, carried by cultural values

Avaliação da qualidade da assistência à mulher e ao filho durante o parto normal

The practices developed in the everyday life of obstetric services are sometimes out of step with the recommendations of the public health policies. Accordingly, this research had the objective of assessing the quality of the care provided to women and children during cases of natural childbirth in municipal public maternity wards of the city of Natal/RN, Brazilian Northeast. We developed a cross-sectional and quantitative study in two maternity wards that provide care actions to pregnant women at regular risk (maternity wards A and B). The participants were 314 puerperal women who were treated during the period between April and July 2014, whose children were born alive, through transpelvic way, with spontaneous or induced beginning of labor and that showed physical and emotional conditions to respond to the proposed questions. The data collection instrument was constructed on the basis of the recommendations of the World Health Organization focused on the care of normal childbirth and validated by skilled judges, and the final version has obtained optimum agreement (k = 0,96; IVC = 0,99). Associated with these recommendations, we used three indicators: percentage of women with induced labor or subjected to elective cesarean section (Indicator A); percentage of women served by a qualified health professional during labor and childbirth (Indicator B); and Bologna Index (Indicator C). The research obtained a favorable opinion of the Research Ethics Committee from the Federal University of Rio Grande do Norte, under the nº 562.313 and Certificate of Presentation for Ethics Appreciation: 25958513.0.0000.5537. The analysis of categories related to the recommendations of the World Health Organization was conducted by means of absolute and relative frequency and the Chi-square Pearson’s and Fisher’s exact tests made the comparison of the differences observed between the two maternity wards. Furthermore, we calculated the percentage of the indicators A and B and with the results of the Indicator C, the quality was assessed as follows: the closer to 5, the better will be the quality, and the closer to 0, the worst will be the quality, and the Mann-Whitney U test was used to compare the differences of the obtained averages. The significance level of 5% was considered in all statistical tests. The differences between the maternity wards were identified with regard to the provision of liquids orally (p=0,018), stimulus for non-supine positions (p=0,002), existence of partograph (p=0,001), support or welcoming by health professionals (p= 0,047), intravenous infusion (p<0,001), supine position (p<0,001), use of oxytocin (p<0,001), food and liquid restriction (p= 0,002) and, lastly, the fact of the touch is performed by more than 1 examiner (p=0,011). The indicators A and B showed percentages of 13,09% and 100%, respectively. The overall average of the Indicator C was equal to 2,07 (± 0,74). There was a statistically significant difference between the averages of the maternity wards (p<0,001). The care actions provided during the process of labor and childbirth is inappropriate, especially in the maternity ward B. It is necessary to implement improvements and redesign the obstetric model in force

Construção e validação de instrumento de coleta de dados do casal grávido no âmbito da atenção básica

The research aimed to construct and validate a data collection instrument of pregnant couple as part of primary care. It was considered hypothesis that level of agreement from 70% among participants to validate the expert panel. The document has been based on the Theory of Human Needs by Horta and adjusted by Garcia and Cubas. It is a study of methodological type developed in four stages: identification of empirical indicators to pregnant women through an integrative literature review; evaluation of empirical indicators and their relation to human needs by focus group; structuring of the second version of instrument by categorization of indicators and appearance and content validation of the third version of instrument by judges, by use of Delphi technique. The collection of data was the first stage in months from August to October 2014 in the Journal of Midwifery and Women's Health and Scopus, PubMed, Lilacs, CINAHL, Cochrane databases. The remaining steps were carried out from November 2014 to February 2015. For the focus group was counted with participation of six experts through two meetings. As for the judges, it was obtained a population of 63 and final sample of 51 judges divided into 46 basic health units of Municipal City Health Natal/RN, Brazil. The study was approved by the Research Ethics Committee of Universidade Federal do Rio Grande do Norte, under Protocol number 876.200. For data analysis of the first stage it was used descriptive statistics and results are presented in tables and charts. At that stage were identified 162 empirical indicators and, when they were related to human needs, 64 by them were on psycobiological, 97 on psychosocial and one (1) on psychospiritual needs. Regarding the second and third stages, data were treated by process of categorizing and analyzing the Content Validity Index. The indicators obtained a 100% validation index. In appearance and content validation phase of instrument non-validated items were excluded and other items obtained index above 70%. Furthermore, it obtained 99% content validity index in the second version and 95.7% in the third version of the instrument as a whole and, therefore, validated tool. This instrument contains Health Institution, pregnant woman and her partner identification data, information on the human needs of the pregnant and items pertaining to systematize the collection of pregnant couple data during prenatal care. By the conclusion of the study, nurse shall have an instrument to collect the data of pregnant couple in primary care innovative by considering psychobiological, psychosocial and psychospiritual pregnant needs and insert health and sociodemographic data of pregnant partner in the context of pregnancy. Also, the document will serve as a tool for teaching and research in obstetrical nursing.

O direito fundamental à igualdade no contexto da identidade sexual no Brasil: um estudo da situação jurídico-constitucional com ênfase no exame da suposta inconstitucionalidade por omissão do legislador civil

This dissertation analyses the Brazilian Supreme Court’s judgement in the Non-compliance Action of the Fundamental Precept 132/RJ and in the Direct Action of Unconstitutionality 4277/DF, which created in the country the same-sex civil union. In This decision, the STF interpreted according to the constitution Article 1.723 of the Civil Code, invoking several fundamentals reaffirmed in the Constitution. From all these laws invoked by the Supreme Court to support the pretorian creation, the content of consitutional Law regarding equality is the only that corresponds, and it is sufficient to evidence the necessity of the creation, by legislator, of the institute for civil rights, since the Constitution forbids distinctions that is not expressly provided for in the Constitution (Art. 3º, IV, of Federal Constitution). In this way, Article 226, § 3º is not an exception capable of satisfying the condition of the consitutional foresight because although it protect, according its content only the civil union “between the man and the woman”, it is not able to forbid the creation, by legislator, of another kinds of families, including the same-sex civil union. As such, the reasoning, now legitimate according to the legislator, is not support the creation of institute by Constitutional Court, because the Court may enforce the Law, interpreting in the purviews allowed by the legal text and its constitutionality. In regard to the civil union of individuos of the same sex, the Court could not deduce that such union was implied by Law, like the interpretation according to the Constitution given by judges, on grounds of semantic purviews of the words man and woman, existents in both articles. The Court could not created it either, exceeding the legal system role. So, upon the institute creation, the STF, exceeded two limits: the interpretation and Law enforcement.

Os limites do poder regulamentar do Conselho Nacional de Justiça no contexto do Estado constitucional brasileiro

The creation of the National Council of Justice (CNJ) through the Constitutional Amendment nº 45/2004, derived from countless gaps in Brazilian law, mainly relating to procedural delays, ineffectiveness of judicial decisions, and the lack of mechanisms that enable, effectively, disciplinary accountability of judges. The council is constitutionally designed as a member of the Judiciary, which has administrative nature and laid assignments in art. 103-B, § 4 of the current Constitution, among which is to edit regulations to instrument its performance. However, since it came into force, the amendment raised extensive discussions, linked in particular to the constitutionality of the CNJ, which was made through the direct action of unconstitutionality nº 3367, against the alleged violation of the principles of separation of powers and federative form, as well as the limits of its regulatory powers, as has fanned out in ADI nº 3823/ DF, this one dealing on Resolution nº 07, which regulates the seal of nepotism practice in the judiciary. However, despite the Supreme Court has already pronounced on the matter, recognizing the constitutionality of the council, as well as the resolution already said, the debate is in a state of latency, and may erupt again with each new manifestation of regulatory CNJ, given the lack of agreement between doctrine and jurisprudence around the constitutional treatment of its regulatory powers. In this context undeniably reflection on the definition of the regulatory power of the CNJ, presents itself as extremely relevant, and current, in particular in the ambience of the Constitutional Rule of Law, where he strives for legal certainty and consolidation of regulatory institutions. So that it could reach a satisfactory result, skilled at resolving the problems raised, the present study analyzed the reasons that gave rise to the creation of the CNJ, demonstrating their indispensability, but also sought to characterize the status of their administrative and constitutional body, noting finally, the compatibility of its regulatory activities to constitutional principles. From this perspective, we adopted the deductive method and carried out research and bibliographic nature documentary.

Perguntou o juiz ao tutor pela pessoa deste órfão: os magistrados na ordem sócio educacional do Seridó (século XIX)

This work has the objective to analyze the presence of justice, embodied in the orphans of judges, the encouragement, guidance and custody of minor heirs of the Village of Currais Novos, the area called Seridó of Rio Grande do Norte, especially with regard to education in the century XIX. Aims the meaning of the performance of judges in education and their practices, whereas this figure had a power that went beyond its mere function, but played a political role, taking responsibility for guarding and protection of property left by families of the Imperial period. The study focuses on the set of notary offices documents, inventories, sharing, self accounts and orders, belonging to the District of Currais Novos Forum in the period between the years 1822 to 1829. Finally, the conclusion demonstrates how Judges controlled the education of orphans, through tutors, and it is used for this purpose, the account acts as a procedural mechanism and documentary of its judicial activity.

Um estudo do gênero ata de audiência na esfera jurídico-trabalhista

The activities in labor judicial sphere are permeated by the use of diverse text genres, which are indispensable instruments to the accomplishment of actions that involve the jurisdictional realm. Among the genres that circulate in this domain, we selected the genre minutes of hearing as the object of study of this research, because it is a document supporting the actions, procedures and deliberations agreed, in hearings, by members involved in work-related litigation. In this study we aim to describe the elements that constitute the referred genre in what concerns its pragmatic, organizational and linguistic dimensions. Therefore, we use the postulations of Sociodiscursive Interactionism as theoretical framework, through the writings of Bronckart (2006; 2007; 2012), supported by Marcuschi studies (2008; 2010; 2011), Koch and Favero (1987), Elias Koch (2011; 2012) and Zanotto (2012). In methodological terms, it is characterized as a qualitative approach research (BOGDAN; BIKLEN, 1994; CHIZZOTTI, 2000; MOREIRA; CALEFFE, 2006) with aspects of an ethnographic work (ANDRÉ, 1995; CANÇADO, 1994). The discussion proposed inserts into the field of Applied Linguistics for it focalizes ―social issues and creates intelligibility about the social practices in which language plays the main role‖ (MOITA LOPES, 2006, p.14). The analyses indicate – regarding the pragmatic dimension – that the genre in focus constitutes artefact that enables the register of actions, deliberations, testimonials, procedures and occurrences established during the hearings and has as its interlocutors judges, litigants and their legal representatives. Concerning the organizational dimension, despite the genre in scope present a proposal of standardized writing, their examples contemplate variations and flexibility especially with regard to the development and outcome of the text. As for linguistic aspects, it is noticeable the presence of lexical choices inherent in the language used by labor law discourse community. Lastly, stand out the relevance of the research lies in the fact that it approaches, from the perspective of the Applied Linguistics, the forensic writing and, consequently, offers contributions to the understanding of such genre.

Análise de conteúdo e validação clínica do diagnóstico de enfermagem autocontrole ineficaz da saúde

The study aims to analyze the content and measures of accuracy of the nursing diagnosis Ineffective Self Health in patients undergoing hemodialysis. Study of nursing diagnosis validation carried out in two stages, namely: content analysis by judges and accuracy of clinical indicators. In the first stage, 22 judges evaluated the setting and location of the diagnosis, clinical indicators and etiological factors and their conceptual and empirical definitions. We used the binomial test to determine the proportion of the judges of the relevance of the components of the nursing diagnosis. In the second stage, we used the Latent Class Analysis for the diagnostic accuracy by evaluating 200 patients in a hemodialysis clinic in northeastern Brazil. Research approved by the Ethics Committee, under the Opinion No 387 837 and CAAE 18486413.0.0000.5537. The results show that the judges evaluated as pertinent clinical indicators 12 and 22 etiological factors. Proposed amendment of the nomenclature of five indicators and six factors and the implementation of a clinical indicator for etiology and three etiological factors for clinical indicators. In conceptual and empirical definitions, judges judged as not relevant the conceptual and empirical definitions of a clinical indicator, the conceptual definitions of two etiological factors and empirical definitions four etiological factors. Still, changes were suggested in the conceptual and empirical definitions of two clinical indicators, the conceptual definitions of 12 etiological factors and empirical definitions of 11 etiological factors. Clinical indicators analyzed in the first stage were validated clinically in patients undergoing hemodialysis. The most frequent clinical indicators were Changes in laboratory tests (100%) and daily life choices ineffective to achieve health goals (81%); and three etiological factors had a higher frequency, they are: unfavorable demographic factors (94.5%), beliefs (79%) and comorbidities (77.5%). From Latent class analysis, diagnosis prevalence was estimated at 66.28%. Clinical indicators that showed the best sensitivity measures for the nursing diagnosis Ineffective Self Health were: daily life choices ineffective to achieve health goals and Expression of difficulty with prescribed regimens. In turn, the clinical indicators of inappropriate medication use, no expression of desire to control the disease, irregular attendance to the dialysis sessions and infection were more specific as to that diagnosis. Non-adherence to treatment was the only indicator that showed confidence intervals with values for sensitivity and specificity, statistically above 0.5, being the one who has better diagnostic accuracy as the inference of the nursing diagnosis Ineffective Self Health in hemodialysis clientele. Thus, it is believed that the improvement of the components of diagnosis in question will contribute to the development of more reliable nursing interventions to the health status of the individual in hemodialysis, providing a more scientifically qualified care.

Análise de conteúdo e validação clínica do diagnóstico de enfermagem autocontrole ineficaz da saúde

The study aims to analyze the content and measures of accuracy of the nursing diagnosis Ineffective Self Health in patients undergoing hemodialysis. Study of nursing diagnosis validation carried out in two stages, namely: content analysis by judges and accuracy of clinical indicators. In the first stage, 22 judges evaluated the setting and location of the diagnosis, clinical indicators and etiological factors and their conceptual and empirical definitions. We used the binomial test to determine the proportion of the judges of the relevance of the components of the nursing diagnosis. In the second stage, we used the Latent Class Analysis for the diagnostic accuracy by evaluating 200 patients in a hemodialysis clinic in northeastern Brazil. Research approved by the Ethics Committee, under the Opinion No 387 837 and CAAE 18486413.0.0000.5537. The results show that the judges evaluated as pertinent clinical indicators 12 and 22 etiological factors. Proposed amendment of the nomenclature of five indicators and six factors and the implementation of a clinical indicator for etiology and three etiological factors for clinical indicators. In conceptual and empirical definitions, judges judged as not relevant the conceptual and empirical definitions of a clinical indicator, the conceptual definitions of two etiological factors and empirical definitions four etiological factors. Still, changes were suggested in the conceptual and empirical definitions of two clinical indicators, the conceptual definitions of 12 etiological factors and empirical definitions of 11 etiological factors. Clinical indicators analyzed in the first stage were validated clinically in patients undergoing hemodialysis. The most frequent clinical indicators were Changes in laboratory tests (100%) and daily life choices ineffective to achieve health goals (81%); and three etiological factors had a higher frequency, they are: unfavorable demographic factors (94.5%), beliefs (79%) and comorbidities (77.5%). From Latent class analysis, diagnosis prevalence was estimated at 66.28%. Clinical indicators that showed the best sensitivity measures for the nursing diagnosis Ineffective Self Health were: daily life choices ineffective to achieve health goals and Expression of difficulty with prescribed regimens. In turn, the clinical indicators of inappropriate medication use, no expression of desire to control the disease, irregular attendance to the dialysis sessions and infection were more specific as to that diagnosis. Non-adherence to treatment was the only indicator that showed confidence intervals with values for sensitivity and specificity, statistically above 0.5, being the one who has better diagnostic accuracy as the inference of the nursing diagnosis Ineffective Self Health in hemodialysis clientele. Thus, it is believed that the improvement of the components of diagnosis in question will contribute to the development of more reliable nursing interventions to the health status of the individual in hemodialysis, providing a more scientifically qualified care.

Avaliação do cuidado de enfermagem na perspectiva da segurança do paciente em unidades de terapia intensiva: na visão de profissionais, pacientes e familiares

Technological advances combined with healthcare assistance bring increased risks related to patient safety, causing health institutions to be environments susceptible to losses in the provided care. Sectors of high complexity, such as Intensive Care Units have such characteristics highlighted due to being spaces designed for the care of patients in serious medical condition, when the use of advanced technological devices becomes a necessity. Thus, the aim of this study was to assess nursing care from the perspective of patient safety in intensive care units. This is an evaluative research, which combines various forms of data collection and analysis in order to conduct a deepened investigation. Data collection occurred in loco, from April to July 2014 in hospitals equipped with adult intensive care unit services. For this, a checklist instrument and semi-structured interviews conducted with patients, families, professionals were used in order to evaluate the structure-process-outcome triad. The instrument for nursing care assessment regarding Patient Safety included 97 questions related to structure and processes. Interviews provided data for outcome analysis. The selection of interviewees/participants was based on the willingness of potential participants. The following methods were used to collect data resulting from the instrument: statistical analysis of inter-rater reliability measure known as kappa (K); observations from judges resulting from the observation process; and added information obtained from the literature on the thematic. Data analysis from the interviews was carried out with IRAMUTEQ software, which used Descending Hierarchical Classification and Similarity analysis to aid in data interpretation. Research steps followed the ethical principles presented by Resolution No. 466 of December 12, 2012, and the results were presented in three manuscripts: 1) Evaluation of patient safety in Intensive Care Units: a focus on structure; 2) Health evaluation processes: a nursing care perspective on patient safety; 3) Patient safety in intensive care units: perception of nurses, family members and patients. The first article, related to the structure, refers to the use of 24 items of the employed instrument, showing that most of the findings were not aligned with the adequacy standards, which indicates poor conditions in structures offered in health services. The second article provides an analysis of the pillar of Processes, with the use of 73 items of the instrument, showing that 50 items did not meet the required standards for safe handling due to the absence of adequate scientific guidance and effective communication in nursing care process. For the third article, results indicate that intensive care units were safe places, yet urges for changes, especially in the physical structure and availability of materials and communication among professionals, patients and families. Therefore, our findings suggest that the nursing care being provided in the evaluated intensive care units contains troubling shortcomings with regards to patient safety, thereby evidencing an insecure setting for the assistance offered, in addition to a need for urgent measures to remedy the identified inadequacies with appropriate structures and implement protocols and care guidelines in order to consolidate an environment more favorable to patient safety.

A conduta judicial ética teórica e aplicada contida em princípios e regras deontológicos abrangidos pelo sistema constitucional

Research on Legal Deontology dedicated to theoretical and applied ethics on judicial conduct grounded in legal principles and rules set out in the Constitution of the Federative Republic of Brazil and the Organic Law of the National Judiciary, also contemplating propositional instruments covered by the constitutional system, which conveys behavioural paradigms inserted in the Bangalore Principles of Judicial Conduct, in the Universal Statute of the Judge and in the Latin-American Code of Judicial Ethics, as well as highlight the influence of those instruments in the Brazilian Ethical Code of the Magistrates and in the official complementary training of judges in charge of Judiciary Schools. The study provides the theoretical influxes of moral norm, passing by behavioural social norm to consolidate the ideal standards of judicial conduct into legal standards and related instruments. The Legal Deontology directed to the ethical judicial conduct is confronted with the stereotype that society expressed in relation to the judge's person, who is the political agent that interprets the law for making decisions which directly influences the realization of access to justice, that is constitutionally guaranteed to all. Core values inserted in the constitutional system intended to discipline the judicial conduct are presented and analysed under a critical view, since they are enclosed in prescriptive language that conveys behavioural aspects open to interpretation and which compliance is revealed as a proposition focused on promoting a better solution of interest’s conflicts under the responsibility of those who constitute the distinctive corporation of the Judiciary. The theme’s contextualization also focuses on applied ethics, based on the approach of normative and propositional instruments of deontological content, still focusing on the study of real cases examined by the Brazilian National Council of Justice, as part of its correctional goals.