Modulaçao do estresse social sobre parâmetros fisiológicos, comportamentais, cognitivos e plasticidade neuronal em saguis (Callithrix jacchus) juvenis: um modelo psiquiátrico e cognitivo

Nos períodos críticos de plasticidade neural ocorre uma maior permissividade do sistema nervoso ao ambiente, por isto, a ação do estresse sobre o individuo e suas repercussões sobre áreas responsáveis pelo controle dos sistemas de resposta ao estresse e por funções cognitivas complexas vem recebendo bastante atenção. A utilização de modelos experimentais translacionais tem sido imprescindível na elucidação destes mecanismos e das patologias associadas. Diante disto, este trabalho investigou os efeitos do estresse social sobre parâmetros fisiológicos, comportamentais, cognitivos e sobre a neurogênese no córtex pré-frontal (CPF) durante um período crítico de plasticidade cerebral, a fase juvenil, em machos de Callithrix jacchus. Durante cinco meses, 5 animais foram acompanhados em suas famílias (GF) e 5 animais foram isolados socialmente por 4 meses (GI), após um mês em observação em ambiente familiar (fase basal- FB). Ao final do 5º mês foram aplicados 2 testes de memória de trabalho (MT) nos animais GF e GI. Em seguida, 3 animais de cada grupo foram sacrificados para análise do fator de neurogênese BDNF ( Brain Derived Neurotrophic Factor) por imunofluorescência no CPF (sub-regiões orbitofrontal e lateral). Os animais do GF não variaram significativamente o cortisol ao longo do estudo, enquanto o GI elevou o cortisol e comportamentos indicadores de ansiedade (CA) na primeira semana do isolamento. Em seguida, o GI apresentou uma redução no cortisol, nos CA, no peso corporal e um aumento de comportamentos estereotipados e da anedonia, alterações tipicamente depressivas em primatas não-humanos. Ao final, o GI apresentaram níveis de cortisol menores que em FB. Ambos os grupos apresentaram dificuldades em realizar e aprender as tarefas cognitivas e a presença de BDNF no córtex pré-frontal foi independente do grupo (GF ou GI), porém correlacionou-se com os níveis de cortisol presentes na ultima semana do estudo, e os animais com presença de BDNF no CPF lateral e orbitofrontal apresentaram maiores níveis de cortisol. Estes resultados contribuem no processo de validação do sagui como um bom modelo psiquiátrico translacional e aponta para possibilidade de estudos sobre transtornos depressivos na juventude e suas repercussões posteriores. Além disto, os resultados observados para as tarefas cognitivas levou-nos a fazer uma releitura dos protocolos utilizados em estudos de memoria de trabalho com animais adultos desta espécie, com a finalidade de aprimora-los facilitando a aprendizagem em animais juvenis, naives e em situações de estresse. Ademais, evidenciou-se pela primeira vez a relação do estresse, cortisol e níveis de BDNF, em animais juvenis desta espécie, com a fim de contribuir com sua utilização como modelo animal neurocognitivo.

Lactação materna: a contribuição do pai

BRITO, Rosineide Santana de; ENDERS, Bertha Cruz; SOARES, Verônica Guedes. Lactação materna: a contribuição do pai. Revista Baiana de Enfermagem, Salvador, v.19/20,n.1-3, p.105-112, jan./dez. 2004,jan./dez. 2005.

Repercussões do tempo operatório em pulmões de ratos idosos

A duração das operações pode representar um fator importante para uma série de complicações pós-operatórias, especialmente para os indivíduos idosos. Objetivo: estudar a repercussão nos pulmões, de operações de diferentes tempos de duração. Métodos: Vinte ratos idosos (18 meses) e 20 jovens (3 meses) foram separados aleatoriamente em grupos A e B respectivamente. Os grupos foram divididos em A1, A2, A3, A4, B1, B2, B3 and B4, com cinco ratos cada. Os animais foram anestesiados com pentobarbital (20mg/Kg) intraperitoneal. No subgrupo A1 e B1 foi feita operação com duração de 30 minutos, nos grupos A2 and B2 60 minutos, em A3 and B3 a operação foi feita em 120 minuto e os animais A4 e B4 (controle) não foram operados. O procedimento consistiu de laparotomia xifopubiana que foi aberta e fechada tantas vezes quanto necessário para atingir os tempos estipulados. Após o quinto dia pós-operatório os animais foram mortos com superdose de anestésico e biópsias de ambos os pulmões foram realizadas. Os achados histopatológicos foram transformados em escores. Resultados: os grupos de ratos jovens atingiram os escores: A1= escore 6, A2=11; A3=28; A4=5. Os ratos idosos tiveram os escores: B1=12; B2=34; B3=51 e B4=6. A análise estatística revelou diferenças significantes entre os escores dos grupos A e B. Conclusões: O tempo prolongado nas operações realizadas em ratos idosos contribuiu para o aparecimento de alterações pulmonares de modo significante. Quanto maior o tempo operatório, mais intensas e mais freqüentes as complicações pulmonares

Repercussões do tempo operatório em pulmões de ratos idosos

A duração das operações pode representar um fator importante para uma série de complicações pós-operatórias, especialmente para os indivíduos idosos. Objetivo: estudar a repercussão nos pulmões, de operações de diferentes tempos de duração. Métodos: Vinte ratos idosos (18 meses) e 20 jovens (3 meses) foram separados aleatoriamente em grupos A e B respectivamente. Os grupos foram divididos em A1, A2, A3, A4, B1, B2, B3 and B4, com cinco ratos cada. Os animais foram anestesiados com pentobarbital (20mg/Kg) intraperitoneal. No subgrupo A1 e B1 foi feita operação com duração de 30 minutos, nos grupos A2 and B2 60 minutos, em A3 and B3 a operação foi feita em 120 minuto e os animais A4 e B4 (controle) não foram operados. O procedimento consistiu de laparotomia xifopubiana que foi aberta e fechada tantas vezes quanto necessário para atingir os tempos estipulados. Após o quinto dia pós-operatório os animais foram mortos com superdose de anestésico e biópsias de ambos os pulmões foram realizadas. Os achados histopatológicos foram transformados em escores. Resultados: os grupos de ratos jovens atingiram os escores: A1= escore 6, A2=11; A3=28; A4=5. Os ratos idosos tiveram os escores: B1=12; B2=34; B3=51 e B4=6. A análise estatística revelou diferenças significantes entre os escores dos grupos A e B. Conclusões: O tempo prolongado nas operações realizadas em ratos idosos contribuiu para o aparecimento de alterações pulmonares de modo significante. Quanto maior o tempo operatório, mais intensas e mais freqüentes as complicações pulmonares

A satisfação dos clientes internos e o comprometimento organizacional: um estudo à luz do modelo ASH nas indústrias alimentícias no RN

Currently the organizations are passing for continuous cycles of changes due to necessity of survival in the work market. The administration of the future points a way to the organizations of today and tomorrow, the search of the competitiveness from loyalty and motivation of its staff. Of this form, the model of the Auditoria do Sistema Humano (ASH), developed for Spanish researchers and that now it is being applied in Brazil, contemplates a series of dimensions about Human Resources management quality in the companies and the organizational effectiveness, such as the environment where the company is inserted, the strategies, the organizational drawing, the psychological and psychosocial processes, e the reached results. In this direction, the present research analyzed the factors of job satisfaction and organizational commitment, making, also, a relation of causality between the same ones. The quantitative-descriptive research had as population the employees of twenty three nourishing industries of the State of Rio Grande do Norte (Brazil), registered in the Federacy of the Industries of the state. The collection of the data occurred for the months of October of 2005 and March of 2006, by means of the application of questionnaire of model ASH. The sample was composed for 197 employees, however it was observed presence of five outliers, that they had been excluded from the analysis of the data. To extract the dimensions of the satisfaction and the commitment and identification the factorial analysis was used, with extraction method of principal components, rotation Varimax and normalization Kaiser. The gotten dimensions had been evaluated with the calculation of the coefficient Alpha of Cronbach. The factorial analysis of the pointers of the organizational commitment and identification had extracted ten factors. Of these, four had gotten significance of the analyses inside: affective commitment, values commitment, continuance commitment and necessity commitment. The result of the analysis of the pointers of job satisfaction indicated four factors: extrinsic, motivations, relation with the friends and auto-accomplishment. To deal with the data the relation between job satisfaction and organizational commitment it was used technique of multiple regression. The correlation between commitment and satisfaction was satisfactory, detaching the affective commitment with bigger index of correlation, followed of the affective one

Avaliação da ecotoxicidade de percolados em áreas de disposição de resíduos na região metropolitana de Natal/RN

Leachates are effluent produced by decomposition of solid waste, they have complex composition and can be highly toxic. Therefore such percolated liquid should be collected and treated properly to avoid environmental contamination of soil and of water bodies. The objective of this study was to evaluate the toxicity through ecotoxicological tests with Ceriodaphnia dubia (Cladocera - Crustacea) of percolated liquids generated in two different systems of municipal solid waste (MSW) disposal in the city of Natal/ RN: A Sanitary Landfill in the Metropolitan Region of Natal/ RN, and in a dump off area. Furthermore, it was evaluated the possible contamination of the underground water of the dump off area. Two monthly samples were taken at four points between the months of May/2009 and January/2010. The Point "A" corresponds to the end of the pond leachate treatment in ASRMN; The Point "B" corresponds to a containment pond at the dump. The Point "C" is an area near one of the cells of the dump off area where the leachate outcrops; The Point "D" stands for an underground water well at the area. The last point, called "E" was sampled only once and corresponds to the slurry produced by temporary accumulation of solid waste in the open area of the dump. The ecotoxicological tests, acute and chronic, followed the ABNT 13373/2005 rules, with some modifications. The samples were characterized by measuring the pH number, the dissolved oxygen (DO), the salinity, BOD5, COD, Cd, Cu, Pb, Cr, Fe, Mg, Ni, and Zn. At Point A, the average number of EC50-48h ranged between 1.0% and 2.77% (v/v), showing a high toxicity of the leachate to C.dubia in all months. To this point, positive correlations were found between the EC50- 48 with precipitation. Negative correlations were found between the EC50- 48h with salinity. At point B there was no response of the acute exposure of organisms to the test samples. At point C the EC50-48h ranged from 17.68% to 35.36% in just two months of the five ones analyzed, not correlated meaning. Point D, the EC50-48h level ranged between 12.31% and 71.27%, showed a negative correlation with, only, precipitation. Although it was observed toxicity of underground water in the Landfill Area, there was no evidence of water contamination by leachate, however, due to the toxic character of this water, additional tests should be conducted to confirm the quality of water that is used for human supply. At point E there was no acute toxicity. These results support the dangers of inappropriate disposal of MSW to water bodies due to the high toxicity of the leachate produced highlighting the necessity of places of safe confinement and a treatment system more effective to it

Ecologia reprodutiva do peixe-donzela, Stegastes fuscus cuvier, 1830 (osteichthyes: pomacentridae) em arrecifes rochosos da praia de Búzios, Rio Grande do Norte, Brasil

The reproductive ecology of fish plays a key role both for rational exploitation methods and for protective measures of natural stocks. The purpose of this study was to analyze the reproductive aspects of the damsel-fish, Stegastes fuscus, during October 2004 to September 2005, in the coastal rocky reefs of Búzios Beach, Nísia Floresta, RN. Fish were captured using hooks and hand nets, during low tide. Reproduction was determined using sexual ratio, mean length of first maturation (L50), absolute fecundity and macroscopic characteristics of gonads. The following parameters were related to gonadosomatic index (GSI): condition factor (CF), hepatosomatic index (HSI), rain fall and temperature. In relation to sex distribution, it was observed that 78% were females and 22% were males. The L50 was 6.2 cm for females and 7.0 for males. Average fecundity was 6832 oocytes. Results showed that S. fuscus had better body condition in the months prior to spawning, particularly during initial and intermediate stages of maturation. Five stages of gonadal maturation were identified through macroscopic analysis: immature, in maturation, mature, spent and resting. The HSI was inversely related to the GSI. This was possibly due to the reproductive cycle of this species which was associated to the dry period of this region. During this period, low rain fall and high temperatures provide an propitious reproductive condition for the study species

Análise mecânica e microestrutural das ligas de cobalto-cromo de uso odontológico após sucessivas refundições

The cobalt-chromium alloy is extensively used in the Odontology for the confection of metallic scaffolding in partial removable denture. During the last few years, it has been reported an increasing number of premature imperfections, with a few months of prosthesis use. The manufacture of these components is made in prosthetic laboratories and normally involves recasting, using parts of casting alloy and parts of virgin alloy. Therefore, the objective of the present study was to analyze the mechanical properties of a commercial cobalt-chromium alloy of odontological use after successive recasting, searching information to guide the dental prosthesis laboratories in the correct manipulation of the cobalt-chromium alloy in the process of casting and the possible limits of recasting in the mechanical properties of this material. Seven sample groups were confectioned, each one containing five test bodies, divided in the following way: G1: casting only with virgin alloy; G2: casting with 50% of the alloy of the G1 + 50% of virgin alloy; G3: casting with 50% of the alloy of the G2 + 50% of virgin alloy; G4: casting with 50% of the alloy of the G3 + 50% of virgin alloy; G5: 50% of alloy of the G4 + 50% of virgin alloy; G6: 50% of alloy of the G5 + 50% of virgin alloy and finally the G7, only with recasting alloy. The modifications in the mechanical behavior of the alloy were evaluated. Moreover, it was carried the micro structural characterization of the material by optic and electronic scanning microscopy, and X ray diffraction.and fluorescence looking into the correlatation of the mechanical alterations with structural modifications of the material caused by successive recasting process. Generally the results showed alterations in the fracture energy of the alloy after successive recasting, resulting mainly of the increasing presence of pores and large voids, characteristic of the casting material. Thus, the interpretation of the results showed that the material did not reveal significant differences with respect to the tensile strength or elastic limit, as a function of successive recasting. The elastic modulus increased from the third recasting cycle on, indicating that the material can be recast only twice. The fracture energy of the material decreased, as the number of recasting cycles increased. With respect to the microhardness, the statistical analyses showedno significant differences. Electronic scanning microscopy revealed the presence of imperfections and defects, resulting of the recasting process. X ray diffraction and fluorescence did not show alterations in the composition of the alloy or the formation of crystalline phases between the analyzed groups. The optical micrographs showed an increasing number of voids and porosity as the material was recast. Therefore, the general conclusion of this study is that the successive recasting of of Co-Cr alloys affects the mechanical properties of the material, consequently leading to the failure of the prosthetic work. Based on the results, the best recommendadition is that the use of the material should be limited to two recasting cycles

Acesso aos serviços odontológicos e incidência de cárie em adolescentes e fatores de risco em município do Nordeste Brasileiro, 2006

The aims of this study were to analyze the access of dental services by child population, to determine the prevalence of dental caries, gingivitis and malocclusion in resident children from the municipal district of Sobral Ceará and to evaluate the incidence of the dental decay in adolescents associated with the factors related to socioeconomic condition, access to health services and self-perception. This study had as main factor the multidisciplinary represented by the participation of health professional (doctors, dentists, nurses) in the development of the survey's initial reference; student from Human Sciences area to apply the structured questionnaire in domiciliary visits; statistics professionals in the orientation of the analysis to be held and family health team (community health agents, dentists and dental clinic assistants) in the scheduling of domiciliary visits and the accomplishment of oral exam. The sample was determined from the domicile record that included children born between 1990 and 1994 to develop the research Children health conditions in the municipal district of Sobral Ceará . The first sample comprised 3425 parents of children from 5 to 9 years old, living in the urban area at the municipal district of Sobral Ceará, aiming at identifying the most important factors associated to the access to dental service. From this sample, 1021 children were selected in a systematic way, for the accomplishment to the epidemiological study of decay, gingivitis and malocclusion. In the study's third phase, in order to arrange the group to be followed, 688 adolescents were examined and interviewed, by means of the active search from the 1021 individuals that had been previously examined. It was observed that 50.9% of the children had access to dental service at least once in a lifetime. Of this total, 65.3% accomplished it during the last year, and 85.4% of these did in public services, what allows to identify the importance of this sector in the access to dental services. It was observed that the factors that most affected the access to dental 129 services were related to socioeconomic condition, such as the access to health plan, the possession of toothbrush, garbage collecting, mother s schooling, sewerage treatment and malnutrition. In relation to oral diseases, an increase in the DMF-T index according the age was observed, from 0.10 in five years old to 1.66 in the nine years old, while with the dmf-t index, the inverse happened, since the index decreased from 3.59 in five years old to 2.69 in nine years old. In relation to gingivitis, an average 32.7% of the children presented gum bleeding. In what concerns malocclusion, it was observed that 60.3% of the children didn't present any problem, 30.17% had light malocclusion and 9.5% severe malocclusion. The average incidence of dental caries was 1.86 teeth per youngster. Among the studied variables, tooth pain in the last six months, mother's income and school snack, adjusted by the perception about the need of treatment, the mother's schooling and the dentist's appointment at least once in a lifetime, were the variables that presented positive relationship with the high incidence of dental caries on this population by logistic regression. Variables of socioeconomic nature, related to the access to health services and behavior and biological variables presented a relationship with the high caries incidence. The study point out to the need of developing health actions in a humanized way, by an oral health team effectively bound to the population's interest, with the great objective to provide, with the public health services managers, adequate conditions to improve oral health

Síndrome metabólica e fatores associados: estudo comparativo com mulheres que apresentaram pré-eclâmpsia e gravidez normal, acompanhadas cinco anos após o parto

Preeclampsia is defined as an extremely serious complication of the pregnancy-puerperium cycle with delayed emergence of cardiovascular risk factors, including metabolic syndrome. The research aimed estimate the prevalences of metabolic syndrome and associated factors in women with preeclampsia and normal pregnancy followed five years after childbirth. This is a cross-sectional observational study using a quantitative approach, conducted at a maternity school in the city of Natal in Rio Grande do Norte state. The sample was composed of 70 women with previous preeclampsia and 75 normal selected by simple random probability sampling. Subjects were analyzed for sociodemographic, obstetric, clinical, anthropometric and biochemical parameters. International Diabetes Federation criteria were adopted to diagnose metabol ic syndrome. The Kolmogorov-Smirnov, Mann-Whitney, Student s t, Pearson s chi-squared, and Fisher s exact tests, in addition to simple logistic regression, were used for data analysis, at a 5% significance level (p ≤ 0.05). Statistical tests demonstrated elevated body mass index (p = 0.001), predominance of family history of diabetes mellitus (p = 0.022) and significantly higher prevalence of metabolic syndrome in the preeclampsia group (37.1%) when compared to normal (22.7%) (p = 0.042). Intergroup comparison showed a high number of metabolic syndrome components in women with previous preeclampsia. Altered systolic and diastolic blood pressure (p < 0.001) was the most prevalent, followed by low concentrations of high-density lipoproteins (p = 0.049), and hyperglycemia (p=0.030). There was a predominance of the metabolic syndrome in women with schooling 0-9 years (42.4%) (p = 0.005), body mass index above 30Kg.m 2 (52.3%) (p < 0.001), uric acid high (62.5%) (p = 0.050 and family history of hypertension (38.5%) (p< 0.001). Multivariate analysis of the data showed that the body mass index above 30 kg.m2, education level less than 10 years of study (p < 0.001) and family history of hypertension (p = 0.002) remained associated with the metabolic syndrome after multivariate analysis of the data. It is considered Women with previous preeclampsia exhibited high prevalence of metabolic syndrome and their individual components in relation to normal, especially, altered systolic and diastolic blood pressure, low concentrations of high-density lipoproteins and hyperglycemia. The factors associated to this ou tcome were obesity, less than 10 years of schooling, and family history of hypertension. Overall, this study identified young women with a history of PE exposed to a higher cardiovascular risk than normal

Ensaio clínico duplo-cego controlado e randômico, comparando a eficácia da Clofazimina com a Cloroquina, no tratamento das lesões cutâneas do Lúpus Eritematoso Sistêmico

PURPOSE: To evaluate the capacity of clofazimine (CFZ) to control cutaneous activity of systemic lupus erythematosus (SLE), compared with chloroquine diphosphate (CDP). METHODS: A prospective, randomized, controlled, double blind clinical trial was carried out in thirty-three patients with SLE and cutaneous lesions (malar rash and/or discoid lupus and/or subacute cutaneous lupus), after approval by the respective Ethics Committee. Sixteen patients received clofazimine - 100mg/day (CFZ group) and 17 received chloroquine diphosphate - 250mg/day (CDP group), during six months. Both groups applied broad-spectrum sunscreens twice a day. The dose of prednisone was kept stable during the study. Cutaneous lesions were evaluated by 2 blinded observers and photographed at baseline and at months 1, 2, 4 and 6. RESULTS: Thirty-three patients began and 27 completed the 6 months of treatment. The groups were homogeneous and comparable in terms of demographic and clinical characteristics. Five CFZ-patients and one CDP-patients dropped out due to severe flare of disease requiring other treatment. At the end of the study, 12 CFZ-patients (75%) and 14 CDP-patients (82,4%) presented complete or near-complete remission of skin lesions; intention-to-treat analysis showed no significant difference in the response rates between groups. Side effects in both groups were frequent, but patients didn t have to discontinue the drugs. CONCLUSIONS: Clofazimine and chloroquine were effective in controlling cutaneous lesions in SLE patients

Ajudando os inimigos: espécies nativas facilitam a invasão do semiárido brasileiro por árvores exóticas

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Narrativas infantis: o que nos contam as crianças de suas experiências no hospital e na classe hospitalar

This dissertation focuses on the narratives of children hospitalized with chronic diseases. The overall goal is to deduce, from the look of the child health care, hospital class contributions to the process of school inclusion. The research is part of the qualitative ethnographical approach and is based on the principles and research methods (auto)biographical in education and schooling in hospital. Participated in the investigation 05(five) children, aged between 06 (six) and 12 (twelve) years of age, treated at the Center for Children s Onco-Hematology, Varela Santiago Children s Hospital in Natal-RN. The corpus used for the analysis comprises five (05) narrative interviews, 03 (three) drawings made by children as well as records in the researcher s field diary. The sources were collected during the months of August 2010 to February 2011. The analysis revealed that the inclusion of the hospital class, and ensure the right to education, contributes to the construction of strategies for coping with illness and hospitalization, as it promotes autonomy, comfort, playfulness and self-knowledge, the rand the world, easing the stress of hospitalization. The figure of the teacher took the class hospital in the voices of children, a reliever and minimizing the role of double exclusion that cause illness and hospitalization, showing the contributions to (re) construction of identity and subjectivity constitution strengthened. The children interviewed said that the hospital class leave the hospital more cheerful. The playfulness and learning experiences in the hospital are seen by children as actions that go beyond the physical treatment of the disease, since it provides them with acceptance and understanding of hospitalization and illness, to give them affective security and emotional. In conclusion, the narratives of children confirm that the service class hospital ensures continuity of schooling, but they reveal, namely, that this service provides them socialization among peers and with adults, strengthening the emotional, social and cognitive biopsychosocial perspective of attention

A formação acadêmica do enfermeiro para o SUS na percepção de docentes e discentes da faculdade de enfermagem/UERN

The model of attention to health in Single Health System (Sistema Único de Saúde SUS) presupposes a human-resources policy which prepares professionals of health to guide the services and sanitary practices. The nurse, a member of health staff, takes over an important role in implementation of principles and standards of SUS, being its professional formation necessary to labor organization in this purpose. In this way this study objectifies to analyse the process of formation of the male nurse in the Politic-Pedagogical Project (Projeto Político-Pedagógico PPP) in the perception of learning and teaching of the Faculty of nursing FAEN of the University of The Rio Grande do Norte State UERN. It treats about a descriptive-exploratory study with qualitative and quantitative approach carried out with learning and teaching of the graduation nursing course. In the field research carried out between the months of november, 2006 and february, 2007, were used like instruments the documental research below PPP´s, structured interview directed to the learning and the closed questionnaire applied to the students of eighth and ninth semesters of graduation course. The results of data about the questionnaires elaborated according to National Curricular Patters (Diretrizes Curriculares Nacionais DCN) and the Instrument of Evaluation Course of Graduation MEC were organized according to six lists about the profile of the learning and teaching that participate of the research; of the didactical-pedagogical organization and PPP´s objectives to the just-graduates person to the didactical-pedagogical curriculum organization. For considering the interviews it was adopted thematic analysis of content discribed in lexical analysis by informatical program ALCESTE which provided the organization of the material in five categories: daily problems of SUS consolidation versus nurse formation, dichotomies about FAEN´s nursing course of curriculum versus principles of integralization of graduating process, the just-graduated one from FAEN and its professional insertion united to SUS politic-pedagogical project and the concern about the overcoming of dichotomies of graduation process abilities and necessary competences to the SUS performing nurse. The analysis of informations deriving from documental performance and field research resulted on the verification that, in spite of good intentions, the implementation strategies showed themselves fragile to cope with the rendering of expressed ideal on PPP. There is still a great gap between what´s thought as innovating graduating process and what´s being really implemented

O sofrimento do paciente na UTI : escutando a sua experiência

In tertiary care, the Intensive Care Unit (ICU) is nowadays one of the most complex settings in providing care to critically ill patients and could make the difference in favor of life. Nevertheless, the stigma of death which pervades the imagination when the ICU is mentioned and the excessive importance placed on machines rather than on the human being end up by causing distress to some extent. As the purpose of this investigation is to understand the distress caused to a patient in an ICU, it has been grounded on the following question: What kind of distress does a patient go through during his/her experience in an ICU? This study has, therefore, an analytical and reflexive character embedded in a qualitative dimension of a phenomenological approach based on narratives. To this purpose, five patients were interviewed from November to December 2008. Out of the empirical material gathered from these narratives we were able to identify several factors that cause distress to ICU patients. Among them were: the certainty that they are critically ill and fear death, a closed room, too much lighting, a typical loneliness arising from being isolated from family members and dear ones, lack of communication with the professional staff, and noise; besides having to undergo therapeutic procedures. In summary, although the ICU is seen as a place of distress, in many aspects and in accord with this research, such distress can and should be relieved. On the other hand, being near to death leads them to a redefinition of life, said the patients.