Adequação bioclimática para os espaços urbanos abertos do centro de Fortaleza, CE

This research presents a study investigating the correlation between the environmental-physycal charcateristics of cities and the formation of its micro-climates. The study was conducted in the central area of Fortaleza characterized as a stable and consolidated area, where the city originated and currently faces serious problems in its urban dynamics. The points of measurements were determined by the elaboration and analysis of topography maps, height of buildings, land use, type of surface coating and vegetation, following the methodology of Katzschner (1997). A zoning map was then determined, according to common morphological characteristics of the 12 measurement points, which were based on a set of Romero s (2001) bioclimatic criteria. Air measurements, temperature, humidity, intensity and direction of winds were made in transect form in two different circuits in the study area, with six points of data collection in each area, in three different times: 6:00 am, 1:00pm and 7:00pm, during two periods of the year: August 2008 and March 2009. The results verified the influence of different environmental-physical types in the behavior of the climatic variables that were collected. A verticalização tão condenada em algumas situações se bem equilibrada e controlada pode reduzir as temperaturas do ar através do sombreamento dos espaços urbanos e possibilidade de maior permeabilidade a ventilação natural. The highest average air temperature and lower humidity were recorded at the point I at all times. This situation may have been in result of the high density, poor vegetation and extended paving of the ground. According to the results, it s clear the positive influence vegetation has on easing air temperature. Another indicator observed that areas with a greater variation in building heights tend to present decreased average air temperature. High rise structure, planned in accordance to urban air quality parameters, can reduce air temperatures by the shading of urban spaces and the possibility of greater penetration of natural ventilation

Diagnósticos de enfermagem em pacientes submetidos à hemodiálise: semelhanças entre o modelo de adaptação e a NANDA internacional

The nurses in the hemodialysis has an important role in the nursing process implementation, in the context of a theoretical referential. Among the nursing theories, highlights the Roy´s adaptations model, who considers a person as an holistic adaptive system that aims to adapt customers to different living conditions. Thus, it is believed that the Roy´s nursing process will guide nursing care to patients on dialysis. Therefore, the study aimed to analyze the nursing diagnosis present in patients with chronic kidney disease on hemodialysis based on the theoretical model of Roy and NANDA-International. Descriptive and cros-sectional study, performed at a dialysis center in a city in northeastern Brazil. Sample of 178 patients and consecutive sampling by convenience. Data collection ocurred from October/2011 until February/2012, through interview and physical examination forms. Data analysis was initiated by clinical reasoning, diagnosis judgment and similarity relation. Then, the data were entered into SPSS program, 16.0 version, generating descriptive statistics. The project was approved by the Ethics Research Committee (protocol nº 115/11) with a Presentation Certificate for Ethics Appreciation (in 0139.0.051.000-111) and was funded by the Universal edict MCT / CNPq 14/2010. The results revealed that most patients were male (52.2%), married (62.9%) and residents in the Natal´s metropolitan region (54.5%). The mean age was 46.6 years and the years of study, 8,5. Regarding nursing diagnosis obtained an average of 6.6, especially: Risk of Infection (100%), excessive fluid volume (99.4%) and hypothermia (61.8%). On the other hand the adaptive problems average was 6.4, and the most common: intracellular fluid retention (99.4%); Hyperkalemia (64.6%); Hypothermia (61.8%) and edema (53.9%). Were established 20 similarity relations between the NANDA-International nursing diagnosis and adaptive problems of Roy, namely: risk of falls / injury risk and potential for injury, impaired physical mobility and walking mobility and / or restricted coordination, dressing self-care deficit and loss of self-care ability; hypothermia and hypothermia; impaired skin integrity and impaired skin integrity; excessive fluid volume and intracellular fluid retention / Hyperkalemia / Hypocalcemia / edema; imbalanced nutrition: less than body requirements and Nutrition less than the body's needs; constipation and constipation, acute pain and acute pain, chronic pain and chronic pain, sensorial perception disturbed: visual, tactile and auditory disabilities and a primary sense: sight, hearing and tactile; sleep deprivation and insomnia, fatigue and intolerance to activities; ineffective self health and fails in the role; sexual dysfunction and sexual dysfunction; situational low self-esteem and low self-esteem, and diarrhea and diarrhea. We conclude that there is similarity between the typologies and was required a model´s analysis, because they present different ways to establish the nursing diagnosis. Moreover, the nursing process use, under the context of a theory and a classification system, subsidizes the care and contributes to the strengthening of nursing science

Proposição e aplicação de um core set da classificação internacional de funcionalidade, incapacidade e saúde (CIF) para saúde física de idosos

Para aumentar a viabilidade do uso da Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF), core sets começaram a ser desenvolvidos, e objetivam estabelecer uma seleção de categorias adaptada para representar os padrões de avaliação multiprofissional de grupos específicos de pacientes. Com o objetivo de propor um core set da CIF para classificar a saúde física de idosos, formou-se uma comissão de especialistas para julgar o instrumento por meio da técnica Delphi, o que mostra a interface multidisciplinar do projeto. Finalizada a participação da comissão, o core set foi proposto contendo 30 categorias. Após aplicação em uma amostra com 340 idosos dos municípios de Natal/RN e Santa Cruz/RN, o core set foi submetido à análise fatorial, tendo ficado com 19 categorias. A análise ainda proporcionou gerar uma pontuação para cada idoso por meio do escore fatorial, tendo provado ser uma forma fidedigna e confiável de se pontuar um core set.

O trabalho em equipe na atenção primária à saúde: situação de Portugal e do Brasil

Introdução: Na Atenção Primária à Saúde, nos contextos internacional e nacional, o trabalho em equipe tem sido reconhecido como estratégia decisiva para a organização de processos que visam à integralidade do cuidado, além de possibilitar melhorias na satisfação dos usuários com os serviços de saúde. Neste sentido, o objetivo, deste estudo, é analisar o trabalho em equipe na Atenção Primária à Saúde. Método: Trata-se de uma pesquisa em banco de dados secundários. Realizou-se três estudos: a) O trabalho em equipe na Atenção Primária à Saúde, em Portugal, pesquisa avaliativa, de natureza qualitativa, tipo estudo de caso descritivo, que representou um recorte dos resultados derivados da pesquisa integrada ao projeto “Implantação das Unidades de Saúde Familiar em Portugal”, que teve como procedimentos entrevistas semiestruturadas, roteiro de coleta de informações (check list) e análise documental. Foi realizada a estratégia de triangulação dos dados com análise de conteúdo; b) trabalho em equipe, acesso e qualidade na Atenção Primária à Saúde, no Brasil, estudo transversal, de abordagem quantitativa, realizado a partir dos dados obtidos da “Pesquisa de Avaliação Externa do Programa de Melhoria do Acesso e da Qualidade da Atenção Básica”, no Brasil, em 2013. Amostra composta de 17202 profissionais e 65391 usuários. Utilizou-se entrevista estruturada, com análise estatística realizada pelas frequências absolutas e relativas das variáveis através do programa Statistical Package for Social Sciences. c) satisfação dos usuários com o trabalho em equipe na Atenção Primária à Saúde, no Brasil, estudo transversal, de abordagem quantitativa, realizado a partir dos dados obtidos da “Pesquisa de Avaliação Externa do Programa de Melhoria do Acesso e da Qualidade da Atenção Básica”, no Brasil, em 2013. Amostra composta de 65391 usuários. Realizou-se análise estatística das frequências absolutas e relativas das variáveis através do programa Statistical Package for Social Sciences. Utilizou-se, ainda, o Teste X2 , com nível de significância de 5%; análise de regressão logística múltipla. O modelo final foi ajustado pelo teste de Hosmer/Lemeshow, o qual indicou um ajuste de 66%. Resultados: Sobre o trabalho em equipe na Atenção Primária à Saúde, em Portugal, destacou-se a formação das equipes de forma voluntária, por meio de afinidades pessoais, a existência de “carteira básica de serviços”, juntamente com x intervenções de vigilância, promoção da saúde e prevenção de doença, cuidados em situação de doença aguda, acompanhamento clínico de doença crônica e de patologia múltipla, cuidados domiciliares, interligação e colaboração em rede com outros serviços (cuidados hospitalares), sistemas informatizados nas unidades de saúde. Os dados revelaram dificuldades quanto ao atendimento domiciliar. No Brasil, foi destaque o processo de trabalho, com avanços relacionados a realização de planejamento e programação das ações e o apoio da gestão. Existência de território definido e de prontuários familiares. É destaque a agenda compartilhada e pactuada entre os profissionais. As equipes realizam acolhimento e reuniões, cujos temas, discutidos, giram em torno do processo de trabalho e planejamento. Os desafios, enfrentados, estão relacionados ao agendamento dos usuários; ao número de pessoas sob a responsabilidade das equipes; à existência de população descoberta nas áreas adscritas à Unidade de Saúde; à incipiência na ação intersetorial e ao pouco envolvimento da comunidade pelas equipes. Quanto aos fatores associados à satisfação do usuário foi marcante: a faixa etária; a escolaridade; a raça; se a falta de material prejudica o atendimento e se a equipe consegue marcar consulta para outros profissionais. Conclusões: Constatou-se o trabalho em equipe como elemento central no processo de mudança na Atenção Primária à Saúde, tanto no contexto de Portugal quanto no do Brasil, o qual ampliou o acesso e a qualidade na oferta de serviços de saúde e obteve, ainda, o reconhecimento social, mesmo que, em ambas as realidades, não tenha avançado na coordenação do cuidado e no estímulo à participação social. Os fatores, associados com a satisfação do usuário, estão relacionados diretamente ao cuidado prestado e refletem a expectativa, por parte do usuário, de resolução concreta de suas necessidades.

Estudo do domínio segurança/proteção da NANDA internacional em pacientes de unidade de terapia intensiva

The study aimed to analyze the field of nursing diagnoses safety / protection of NANDA International present in patients in the Intensive Care Unit. This is a crosssectional study in intensive care complex of a university hospital in northeastern Brazil. The research took place in two stages. The first step was to collect data through an interview form and physical examination, with 86 patients admitted to the unit, during the months of December 2013 to May 2014. Spreadsheets were built in Microsoft Office Excel 2010 Software in which were marked by the researcher of this study, the presence or absence of defining characteristics, related factors and risk factors of the 31 studied diagnoses. In the second stage, held between July and August 2014, the sheets were sent to three diagnosticians, previously trained to perform the diagnostic inference. Data were analyzed using descriptive and inferential statistics for the diagnoses that showed higher frequencies than 50%, using IBM SPSS version 20.0 for Statistic Windows.O project was approved by the 440/414 and Presentation Certificate for Ethics Assessment number 22955113 .2.0000.5292. The results indicated the presence of 29 field of nursing diagnoses safety / protection in hospital clientele in the Intensive Care Unit, of which five were present in 100% of patients, namely: Risk of contamination, injury risk, falls risk,risk of allergic response and risk of trauma. Diagnoses that presented more frequently than 50% were: Risk of infection, dry eye risk, poisoning risk, vascular trauma risk, impaired skin integrity, impaired dentition, bleeding risk, risk imbalance in body temperature, Risk perioperative positioning injury, impaired tissue integrity, peripheral neurovascular dysfunction Risk, Risk adverse response to contrast media with iodine, shock Hazard and Risk of aspiration. For these analyzes, we identified 35 risk factors, 11 defining characteristics and three related factors showed statistically significant association with the studied diagnoses. For diagnostics: Risk of contamination, injury risk, falls risk, allergic response risk, trauma Risk, Risk of infection, dry eye risk and risk poisoning there was no association with any of their risk factors. We conclude that most of the area of nursing diagnoses safety / protection feature is prevalent in critically ill patients, with special attention to the risk diagnoses. There was a significant association between these diagnoses and its components. It is noteworthy, therefore, that the lifting of this profile contributes relevant clues to the inference of the priority nursing diagnoses domain safety / protection in the study population, supporting the practice of nursing and stimulating knowledge on the subject.

Orações relativas no português brasileiro em perspectiva histórica

In this study, we focus on the relativization strategies, in diachronic corpus of Brazilian Portuguese (BP). Generally speaking, we aim to investigate the use of the relative in a historical perspective on BP, focusing on semantic-cognitive and discursive-pragmatic motivations involved and the correlation with the discursive traditions. The theoretical perspective underlying our study is the North-American Functional Linguistics, inspired by Talmy Givón, Sandra Thompson, Paul Hopper, Joan Bybee, Elizabeth Traugott, Mario Martelotta, Angelica Furtado da Cunha, among others, combined with contributions of Discursive Traditions, based on authors such as Kabatek, Koch and Oesterreicher. As for the methodology, our research is eminently qualitative, in the sense that it seeks to elucidate semantic-cognitive and discursive-pragmatic motivations related to the use of relativization strategies in BP; and it has quantitative support, with respect to measurable data aspect and characterization of the object of study and its frequency of use. For this investigation, we use the corpora of the project Para a História do Português Brasileiro (PHPB), more specifically, the particular, official, reader and redactor letters written between the eighteenth and twentieth centuries, from four states: Minas Gerais, Paraná, Pernambuco and Rio de Janeiro. The results of this research reveal the variation in relativization strategies, in view of the increase in the relativa cortadora (prepositional chopping strategy) percentage in the corpus of this investigation, even though the occurrence of this strategy is more restricted to private letters. In addition, we found factors of cognitive nature such as reduction in cognitive cost and economy related to the occurrence of that relative strategy, principally in private letters; aspects such as the need for expressiveness and clearness related to the use, even if infrequent, of the relativa copiadora (resumptive strategy), especially in official letters; and factors of communicative order such as the public sphere of circulation of the sample letters, as in the redactor and reader letters, and the gap between the parties most directly involved in the use of the standard relative of our sample.

Adequação bioclimática para os espaços urbanos abertos do centro de Fortaleza, CE

This research presents a study investigating the correlation between the environmental-physycal charcateristics of cities and the formation of its micro-climates. The study was conducted in the central area of Fortaleza characterized as a stable and consolidated area, where the city originated and currently faces serious problems in its urban dynamics. The points of measurements were determined by the elaboration and analysis of topography maps, height of buildings, land use, type of surface coating and vegetation, following the methodology of Katzschner (1997). A zoning map was then determined, according to common morphological characteristics of the 12 measurement points, which were based on a set of Romero s (2001) bioclimatic criteria. Air measurements, temperature, humidity, intensity and direction of winds were made in transect form in two different circuits in the study area, with six points of data collection in each area, in three different times: 6:00 am, 1:00pm and 7:00pm, during two periods of the year: August 2008 and March 2009. The results verified the influence of different environmental-physical types in the behavior of the climatic variables that were collected. A verticalização tão condenada em algumas situações se bem equilibrada e controlada pode reduzir as temperaturas do ar através do sombreamento dos espaços urbanos e possibilidade de maior permeabilidade a ventilação natural. The highest average air temperature and lower humidity were recorded at the point I at all times. This situation may have been in result of the high density, poor vegetation and extended paving of the ground. According to the results, it s clear the positive influence vegetation has on easing air temperature. Another indicator observed that areas with a greater variation in building heights tend to present decreased average air temperature. High rise structure, planned in accordance to urban air quality parameters, can reduce air temperatures by the shading of urban spaces and the possibility of greater penetration of natural ventilation