Abordagem dos aspectos psicológicos da mulher infértil :um estudo quali-quantitativo

Purpose: assess the frequency of stress and anxiety levels in infertile women, correlate these aspects with risk factors and qualitatively analyze feelings resultant from the inability to conceive, in order to obtain data for specific psychological guidance. Methods: the case-control study included a total of 302 women, 152 being infertile (case group: 30.3 ± 5.4 years), and 150 non-fertile (control group: 25.7 ± 7.9 years). The quantitative approach involved the application of Lipp s Stress Symptoms Inventory (LSSI) and State-Trait Anxiety Inventory (STAI), whereas the qualitative approach consisted of a semi-structured interview. Response variables considered were: stress frequency and anxiety scores (State and Trait). Statistical analysis compared frequencies and medians between groups, by means of qui-squared and Mann-Whitney tests, respectively, and constructed logistical regression models to test associations between response variables and risk factors considered. Qualitative data were analyzed descriptively and categorized in order to perform correspondence analysis. The level of significance was 5%. Results: in the study sample, stress frequency was higher in the case group than in the control(61.8 and 36.0%, respectively), however, significant differences were not observed between groups in relation to stress phases and predominant symptomology type. With respect to anxiety, there were no significant differences between case and control groups as to median state scores [39.5 (35.0 46.0) and 41.0 (35.7 47.0 ); respectively) and anxiety trait scores [44.0 (34.0 51.0) and 42.0 (36.0 49.2); respectively). Risk factors significantly associated with greater risk for high anxiety scores in the case group were: primary infertility, unawareness of the causal factor, diagnostic phase investigation, religion, lack of children from other marriages and the fact that the woman was previously married. The qualitative approach demonstrated that infertility provokes emotional responses, such as sadness, anxiety, anger, fear and guilt. Conclusions: it can be concluded that infertile women are more vulnerable to stress; however, they are capable of adapting to stressful events without serious physical or psychological compromising

Atenção à saúde da pessoa idosa na estratégia saúde da família no município de Santo Antônio/RN: um estudo de caso

According to demographic estimates, by the year 2025 Brazil will be the sixth country in the world in number of elderly. For this reason, it is a purpose of public policies to help people to reach that age being healthier. The current health care model of health surveillance through the Family Health Strategy (EFS, in portuguese) is configured as a gateway into the care of the elderly in the Unified Health System (SUS, in portuguese). It is also an area of development of practices to promote health, prevention and control of chronic nondegenerative diseases. The aim of this study was to analyze the health care of the elderly provided by ESF professionals for the achievement of a full care. The study is descriptive case study with a quantitative approach, performed in the city of Santo Antônio/RN. The population included all health professionals, who are FHS members of the city that agreed to participate of the survey, a total of 80 professionals. Data were collected using a structured questionnaire, having mostly closed questions and divided into two parts: one containing sociodemographic information of health professionals and vocational training and the other, the activities carried on by the professionals in senior care, being analyzed from a database tabulated in a spreadsheet and discussed according to the descriptive statistics in tables, graphs and charts using frequencies, medians and values of central tendency. It was verified a predominance of professionals who finished highschool, mostly female, aged from 30 to 34 years old, with training completed in the last 10 years, without being graduated in the field of geriatrics or gerontology and mostly without training in gerontology. Family members and caregivers were the components of the social support network most identified by the professionals (66.3%).The elderly access to the Family Health Basic Unit was considered by83.8% of professionals as the most important factor that interferes in the activities of health care of the elderly. Considering the inclusion of the family in care: 98.8% of professionals consider the family as one of the goals of care, but 82.5% assist the family to know their role and participate in the care of the elderly, emphasizing that no professional makes use of tools for evaluating the functionality of the family. Regarding the actions taken to assist the elderly, 91.25% have home visits program to the elderly, 88.75% use the host program; 77.5% know the habits of life, cultural, ethical and religious values of the elderly, their families and their community ;51.25% complement the activities through intersectoral actions, 50%participate in groups of living with the elderly; 33.75% keeps track and maintain updated the health information of the elderly; 11.25% of the professionals perform the Single Therapy Planning (PTS, in portuguese) and few implement the actions to promote health according to PTS; there is a deficit in the number of professional categories in the identification and monitoring of the frail older people in their households. It is concluded that the health care of the elderly developed by ESF professionals differs among the professional categories. It was identified weaknesses in the promotion of an active and healthy aging and also in the establishment of an integrated and full care of the elderly. It is recommended the adoption of permanent educational activities by the City Management, initially for ESF professionals in the the perspective of the guidelines of the National Policy of Health Care for the Elderly and later to the other professionals that are part of the health care network of the elderly, at all levels of care in the city for the development of strategies and practices that promote the improvement of the quality of healthcare for the elderly, expecting concrete and effective results in terms of promoting health within Brazilian reality

Clima e cultura de segurança do paciente em uma maternidade escola: percepção dos profissionais de enfermagem em terapia intensiva

Since the publication of the report "To Err is Human" by the Institute of Medicine (IOM) , which estimated that between 44.000 to 98.000 Americans die annually as a result of errors in health care, patient safety spent gaining prominence, emerging studies assess the safety culture by measuring the safety climate. In this context, the aim of this study was to identify safety culture perceived by nursing professionals working in the intensive care unit of a maternity school in Natal/RN through the Security Attitudes Questionnaire (SAQ). This was a descriptive study, cross-sectional and quantitative approach undertaken in the Intensive Care Unit Maternal and Neonatal a maternity school in Natal/RN. The project was submitted to and approved by Brazil Platform Zip/UFRN under number 309 540 and CAAE 16489713.7.0000.5537. It was used to collect data two instruments: a questionnaire in order to collect socio-demographic data of the subjects and the Questionário Atitudes de Segurança , a cultural adaptation to Portuguese of the instrument of the World Health Organization titled Safety Attitudes Questionnaire - (SAQ ) Short Form 2006. The collected data were analyzed quantitatively by the organization in electronic databases in Microsoft Excel 2010 spreadsheet and exported to statistical software for free access to be coded, tabulated and analyzed using descriptive statistics. The study included a total of 50 nurses, 31 and 19 of the NICU Maternal ICU, predominantly female, mean age 35 years, median time of 10 years training and working in maternity, mostly, less than 05 anos. As a result, two articles were produced. The first refers to the first two domains of the instrument entitled "climate of teamwork" and "climate security" . The scores of the two areas were slightly higher in Maternal ICU compared to the NICU, but no sector has reached the ideal minimum score of 75: in the first domain Maternal ICU had an average of 74.77, with medians of 75 and 100, while Neonatal ICU reached an average of 69.61 with median also 75 and 100, while the second field means were 69.35 and 66.01 for Maternal and Neonatal ICUs respectively, with a median of 100 in the two sectors. The second article relates to the field "Perception Management Unit and Hospital", which 9 assessed the perception of management units and motherhood by professionals. In general, the items of the domain in question also obtained scores below the ideal minimum: 63.68 to 51.02 and maternal ICU for neonatal, featuring a clear separation between the management and the professionals who work in direct care. These findings indicate a warning sign for the institution and point to the need to implement actions aimed at patient safety

Caracterização do conteúdo de fossas e tanques sépticos na cidade de Natal

Only 32% of the population of Natal is attended by sewage, while the remaining population use pits and septic tanks. The characterization of the contents of septic tanks and pits contributes to the performance of such system and may guide the decision on treatment of these contents. The main of this research is to characterize the contents of interior residential pits and septic tanks in the greater Natal, with the following specific goals: to develop and manufacture a sampler capable of collecting a representative sample of the entire column (the surface scum, the clarified liquid and sludge bottom); to compare the contents of the tanks with the pits; to compare the contents of the septage from vacuum trucks; to relate the composition content with socioeconomic characteristics of households; to compare the content in both chambers of the septic tanks in series; to assess the situation of the content before and six months after the cleanness; and ultimately propose a pilot scale plant for treatment of septage. Once the sampler was developed, samples were collected within 14 septic tanks and 10 pits in many districts of Natal. Medians of the 24 systems were obtained: temperature, pH, conductivity, oil and grease, total solids, total suspended solids and sediments of 28.0 °C, 6.95; 882 mS/cm, 75.2 mg/L; 10,169 mg/L, 6,509 mg/L and 175 mL/L respectively; 111.0 mgN/L for ammonia, 130.5 mgN/ L for organic nitrogen, 0.2 mgN/L for nitrite, 0.4 mg/L for nitrate; 8935 mgO2/L for COD, 29.2 mgP/L for total phosphorus, thermotolerant coliforms from 9.95 E +06 CFU/100mL helminth eggs and 9.2 eggs/L with a maximum concentration of 688 eggs/L and minimum of 0 eggs/L. Medians of organic nitrogen and TKN were significantly different between groups of tanks and pits. The systems with cleanness gap from 11 and 20 years presented the higher concentrations for most variables. The effluent from the toilets and bathrooms participate more effectively in contributing fractions of solids, alkalinity, nitrogen, COD, total phosphorus, thermotolerant coliforms and helminth eggs. The systems used by socioeconomics class with income from R$ 3,700.00 to R$ 7,600.00, presented higher concentrations for COD, nitrogen, solids and helminth eggs. The first of the two chambers had always presented higher concentrations over the second compartment. The analysis of variance for most variables, showed that the values of septic tanks, pits and septage from vacuum trucks belong to the same group. In the samples taken after cleanness, the median of pH and temperature increased, while alkalinity, COD, organic nitrogen, total phosphorus, ammonia and helminth eggs decreased. The oils and greases and thermotolerant coliforms had slightly varied due to the continuous release of sewage into the systems that maintained their steady state concentrations.

Versão breve da social rhythm metric: um instrumento para avaliar ritmo social de pacientes com acidente vascular cerebral

Stroke is a neurological disorder caused by restriction of blood flow to the brain, which generates directly a deficit of functionality that affects the quality of life of patients. The aim of this study was to establish a short version of the Social Rhythm Scale (SRM), to assess the social rhythm of stroke patients. The sample consisted of 84 patients, of both sexes, with injury time exceeding 6 months. For seven days, patients recorded the time held 17 activities of SRM. Data analysis was performed using a principal components factor analysis with varimax rotation of the full version of SRM in order to determine which activities could compose brief versions of SRM. We then carried out a comparison of hits, the ALI (Level Activity Index) and SRM, between versions, by Kruskal-Walls and the Mann-Whitney test. The Spearman correlation test was used to evaluate the correlation between the score of the full version of SRM with short versions. It was found that the activities of SRM were distributed in three versions: the first and second with 6 activities and third with 3 activities. Regarding hits, it was found that they ranged from 4.9 to 5.8 on the first version; 2.3 to 3.8 in version 2 and 2.8 to 6.2 in version 3, the first the only version that did not show low values. The analysis of ALI, in version 1, the median was 29, in version 2 was 14 and in version 3 was 18. Significant difference in the values of ALI between versions 1 and 2, between 2 and 3 and between versions 1 and 3. The highest median was found in the first version, formed by activities: out of bed, first contact, drink coffee, watch TV in the evening and go to bed. The lowest median was observed in the second version and this was not what had fewer activities, but which had social activities. The medians of the SRM version 1 was 6, version 2 was 4 and version 3 was 6. Significant difference in the values of SRM between versions 1 and 2 and between 2 and 3, but no significant difference between versions 1 and 3. Through analysis, we found a significant correlation only between the full version and the version 1 (R2 = 0.61) (p <0.05), no correlation was found with version 2 (R2 = 0.007) nor with version 3 (R2 = 0.002), this was finally a factor to consider version 1 as the short brazilian version of the Social Rhythm Metric for stroke patients

Caracterização química e toxicológica da água produzida descartada em plataformas de óleo e gás na costa brasileira e seu comportamento dispersivo no mar

The production of oil and gas is usually accompanied by the production of water, also known as produced water. Studies were conducted in platforms that discharge produced water in the Atlantic Ocean due to oil and gas production by Petrobras from 1996 to 2006 in the following basins: Santos (Brazilian south region), Campos (Brazilian southeast region) and Ceara (Brazilian northeast region). This study encompasses chemical composition, toxicological effects, discharge volumes, and produced water behavior after releasing in the ocean, including dispersion plumes modeling and monitoring data of the marine environment. The concentration medians for a sampling of 50 samples were: ammonia (70 mg L-1), boron (1.3 mg L1), iron (7.4 mg L-1), BTEX (4.6 mg L-1), PAH (0.53 mg L-1), TPH (28 mg L-1); phenols (1.3 mg L-1) and radioisotopes (0.15 Bq L-1 for 226Ra and 0.09 Bq L-1 for 228Ra). The concentrations of the organic and inorganic parameters observed for the Brazilian platforms were similar to the international reference data for the produced water in the North Sea and in other regions of the world. It was found significant differences in concentrations of the following parameters: BTEX (p<0.0001), phenols (p=0.0212), boron (p<0.0001), iron (p<0.0001) and toxicological response in sea urchin Lytechinus variegatus (p<0.0001) when considering two distinguished groups, platforms from southeast and northeast Region (PCR-1). Significant differences were not observed among the other parameters. In platforms with large gas production, the monoaromatic concentrations (BTEX from 15.8 to 21.6 mg L-1) and phenols (from 2 to 83 mg L-1) were higher than in oil plataforms (median concentrations of BTEX were 4.6 mg L-1 for n=53, and of phenols were 1.3 mg L-1 for n=46). It was also conducted a study about the influence of dispersion plumes of produced water in the vicinity of six platforms of oil and gas production (P-26, PPG-1, PCR-1, P-32, SS-06), and in a hypothetical critical scenario using the chemical characteristics of each effluent. Through this study, using CORMIX and CHEMMAP models for dispersion plumes simulation of the produced water discharges, it was possible to obtain the dilution dimension in the ocean after those discharges. The dispersion plumes of the produced water modelling in field vicinity showed dilutions of 700 to 900 times for the first 30-40 meters from the platform PCR-1 discharge point; 100 times for the platform P-32, with 30 meters of distance; 150 times for the platform P-26, with 40 meters of distance; 100 times for the platform PPG-1, with 130 meters of distance; 280 to 350 times for the platform SS-06, with 130 meters of distance, 100 times for the hypothetical critical scenario, with the 130 meters of distance. The dilutions continue in the far field, and with the results of the simulations, it was possible to verify that all the parameters presented concentrations bellow the maximum values established by Brazilian legislation for seawater (CONAMA 357/05 - Class 1), before the 500 meters distance of the discharge point. These results were in agreement with the field measurements. Although, in general results for the Brazilian produced water presented toxicological effects for marine organisms, it was verified that dilutions of 100 times were sufficient for not causing toxicological responses. Field monitoring data of the seawater around the Pargo, Pampo and PCR-1 platforms did not demonstrate toxicity in the seawater close to these platforms. The results of environmental monitoring in seawater and sediments proved that alterations were not detected for environmental quality in areas under direct influence of the oil production activities in the Campos and Ceara Basin, as according to results obtained in the dispersion plume modelling for the produced water discharge

Caracterização química e toxicológica da água produzida descartada em plataformas de óleo e gás na costa brasileira e seu comportamento dispersivo no mar

The production of oil and gas is usually accompanied by the production of water, also known as produced water. Studies were conducted in platforms that discharge produced water in the Atlantic Ocean due to oil and gas production by Petrobras from 1996 to 2006 in the following basins: Santos (Brazilian south region), Campos (Brazilian southeast region) and Ceara (Brazilian northeast region). This study encompasses chemical composition, toxicological effects, discharge volumes, and produced water behavior after releasing in the ocean, including dispersion plumes modeling and monitoring data of the marine environment. The concentration medians for a sampling of 50 samples were: ammonia (70 mg L-1), boron (1.3 mg L1), iron (7.4 mg L-1), BTEX (4.6 mg L-1), PAH (0.53 mg L-1), TPH (28 mg L-1); phenols (1.3 mg L-1) and radioisotopes (0.15 Bq L-1 for 226Ra and 0.09 Bq L-1 for 228Ra). The concentrations of the organic and inorganic parameters observed for the Brazilian platforms were similar to the international reference data for the produced water in the North Sea and in other regions of the world. It was found significant differences in concentrations of the following parameters: BTEX (p<0.0001), phenols (p=0.0212), boron (p<0.0001), iron (p<0.0001) and toxicological response in sea urchin Lytechinus variegatus (p<0.0001) when considering two distinguished groups, platforms from southeast and northeast Region (PCR-1). Significant differences were not observed among the other parameters. In platforms with large gas production, the monoaromatic concentrations (BTEX from 15.8 to 21.6 mg L-1) and phenols (from 2 to 83 mg L-1) were higher than in oil plataforms (median concentrations of BTEX were 4.6 mg L-1 for n=53, and of phenols were 1.3 mg L-1 for n=46). It was also conducted a study about the influence of dispersion plumes of produced water in the vicinity of six platforms of oil and gas production (P-26, PPG-1, PCR-1, P-32, SS-06), and in a hypothetical critical scenario using the chemical characteristics of each effluent. Through this study, using CORMIX and CHEMMAP models for dispersion plumes simulation of the produced water discharges, it was possible to obtain the dilution dimension in the ocean after those discharges. The dispersion plumes of the produced water modelling in field vicinity showed dilutions of 700 to 900 times for the first 30-40 meters from the platform PCR-1 discharge point; 100 times for the platform P-32, with 30 meters of distance; 150 times for the platform P-26, with 40 meters of distance; 100 times for the platform PPG-1, with 130 meters of distance; 280 to 350 times for the platform SS-06, with 130 meters of distance, 100 times for the hypothetical critical scenario, with the 130 meters of distance. The dilutions continue in the far field, and with the results of the simulations, it was possible to verify that all the parameters presented concentrations bellow the maximum values established by Brazilian legislation for seawater (CONAMA 357/05 - Class 1), before the 500 meters distance of the discharge point. These results were in agreement with the field measurements. Although, in general results for the Brazilian produced water presented toxicological effects for marine organisms, it was verified that dilutions of 100 times were sufficient for not causing toxicological responses. Field monitoring data of the seawater around the Pargo, Pampo and PCR-1 platforms did not demonstrate toxicity in the seawater close to these platforms. The results of environmental monitoring in seawater and sediments proved that alterations were not detected for environmental quality in areas under direct influence of the oil production activities in the Campos and Ceara Basin, as according to results obtained in the dispersion plume modelling for the produced water discharge