Quality of life of caregivers for patients of cerebrovascular accidents: association of (socio-demographic) characteristics and burden

OBJECTIVE Investigating the association between quality of life with socio-demographic characteristics and the burden of caregivers for individuals with cerebrovascular accident sequelae. METHOD A descriptive, cross-sectional study with a sample composed of 136 caregivers. For data collection, a semi-structured questionnaire, the Barthel, Burden Interview and Short-Form-36 scales were used. Correlation analysis, t-Student test and F-test were used for the analysis in order to compare averages. RESULTS Significant averages in quality of life were demonstrated in association with female caregivers and those over 60 years in the field 'functional capacity,' and in the domains of 'mental health' and 'vitality' for those with higher income. Regarding burden association, the highlighted areas were 'functional capacity,' 'physical aspects,' 'emotional aspects' and 'pain.' CONCLUSION The creation of public policies and social support to effectively reduce the burden on caregivers is a necessity.

Instrument for assessing the quality of mobile emergency pre-hospital care: content validation

OBJECTIVES To validate an instrument to assess quality of mobile emergency pre-hospital care. METHOD A methodological study where 20 professionals gave their opinions on the items of the proposed instrument. The analysis was performed using Kappa test (K) and Content Validity Index (CVI), considering K> 0.80 and CVI ≥ 0.80. RESULTS Three items were excluded from the instrument: Professional Compensation; Job Satisfaction and Services Performed. Items that obtained adequate K and CVI indexes and remained in the instrument were: ambulance conservation status; physical structure; comfort in the ambulance; availability of material resources; user/staff safety; continuous learning; safety demonstrated by the team; access; welcoming; humanization; response time; costumer privacy; guidelines on care; relationship between professionals and costumers; opportunity for costumers to make complaints and multiprofessional conjunction/actuation. CONCLUSION The instrument to assess quality of care has been validated and may contribute to the evaluation of pre-hospital care in mobile emergency services.

Cross-cultural adaptation of the Quality of Life Index Spinal Cord Injury - Version III

OBJECTIVE To translate and culturally adapt to Portuguese the Ferrans and Powers Quality of Life Index Spinal Cord Injury - Version III and characterize the sample in relation to sociodemographic and clinical aspects. METHOD A methodological study with view to cross-cultural adaptation, following the particular steps of this method: initial translation, translation synthesis, back-translation (translation back to the original language), review by a committee of judges and pretest of the final version. The pretest was carried out with 30 patients with spinal cord injury. RESULTS An index of 74 items divided into two parts (satisfaction/importance) was obtained. The criteria of semantic equivalence were evaluated as very adequate translation, higher than 87%, and vocabulary and were grammar higher than 86%. Idiomatic equivalence was higher than 74%, experimental greater than 78% and conceptual was greater than 70%. CONCLUSION After cross-cultural adaptation, the instrument proved semantic, idiomatic, experimental and conceptual adequacy, in addition to helping the evaluation of the quality of life of people with spinal cord injury.

Factors associated with the quality of prenatal care: an approach to premature birth

OBJECTIVETo assess the quality of prenatal care in mothers with premature and term births and identify maternal and gestational factors associated with inadequate prenatal care.METHODCross-sectional study collecting data with the pregnant card, hospital records and interviews with mothers living in Maringa-PR. Data were collected from 576 mothers and their born alive infants who were attended in the public service from October 2013 to February 2014, using three different evaluation criteria. The association of prenatal care quality with prematurity was performed by univariate analysis and occurred only at Kessner criteria (CI=1.79;8.02).RESULTSThe indicators that contributed most to the inadequacy of prenatal care were tests of hemoglobin, urine, and fetal presentation. After logistic regression analysis, maternal and gestational variables associated to inadequate prenatal care were combined prenatal (CI=2.93;11.09), non-white skin color (CI=1.11;2.51); unplanned pregnancy (CI=1.34;3.17) and multiparity (CI=1.17;4.03).CONCLUSIONPrenatal care must follow the minimum recommended protocols, more attention is required to black and brown women, multiparous and with unplanned pregnancies to prevent preterm birth and maternal and child morbimortality.

The influence of quality of life in treatment adherence of diabetic patients: a systematic review

AbstractOBJECTIVETo verify the influence of quality of life in treatment adherence of patients with diabetes mellitus.METHODSystematic review of the literature using the databases MEDLINE, CINAHL, Scopus, LILACS, SciELO and Web of Science with studies published between 2003 and 2014 in English, Portuguese or Spanish.RESULTSSix studies were included in the review, three were identified as having better quality of life scores, being related to better adherence to diabetes treatment measured by glycated hemoglobin or characteristics related to diet, exercise, use of medication and foot care. No association was found between quality of life and adherence in two investigations and a study found a negative association between these variables.CONCLUSIONThere is causal relationship between quality of life and adherence with diabetes treatment. It is suggested that psychosocial aspects of patients should be considered by health professionals in the search for better clinical outcomes in diabetes care.

Factors affecting the quality of cardiopulmonary resuscitation in inpatient units: perception of nurses

Abstract OBJECTIVE To identify, in the perception of nurses, the factors that affect the quality of cardiopulmonary resuscitation (CPR) in adult inpatient units, and investigate the influence of both work shifts and professional experience length of time in the perception of these factors. METHOD A descriptive, exploratory study conducted at a hospital specialized in cardiology and pneumology with the application of a questionnaire to 49 nurses working in inpatient units. RESULTS The majority of nurses reported that the high number of professionals in the scenario (75.5%), the lack of harmony (77.6%) or stress of any member of staff (67.3%), lack of material and/or equipment failure (57.1%), lack of familiarity with the emergency trolleys (98.0%) and presence of family members at the beginning of the cardiopulmonary arrest assistance (57.1%) are factors that adversely affect the quality of care provided during CPR. Professional experience length of time and the shift of nurses did not influence the perception of these factors. CONCLUSION The identification of factors that affect the quality of CPR in the perception of nurses serves as parameter to implement improvements and training of the staff working in inpatient units.

Health-Related Quality of Life in patients with hepatitis C in double and triple therapy

Abstract OBJECTIVE Comparing Health-Related Quality of Life (HRQoL) scores in patients with chronic hepatitis C undergoing double and triple antiviral therapy and analyzing possible factors related to HRQoL. METHOD HRQoL was assessed using the Short Form 36 and Chronic Liver Disease Questionnaire, which were applied at baseline and at weeks 4, 12 and 16 of treatment to 32 patients divided into two groups: double therapy with pegylated interferon (IFN-PEG) and ribavirin, and triple therapy with PEG-IFN, ribavirin and telaprevir. RESULTS The reduction of HRQoL was greater in patients receiving triple therapy compared to those treated with two drugs, the most critical time is at 12 weeks in both groups. After removal of telaprevir, the triple therapy group significantly improved their HRQoL scores. Anxiety and depression before treatment, employment status and race are significantly related to diminished HRQoL. CONCLUSION Patients undergoing double and triple therapy have diminished HRQoL indexes, but the addition of telaprevir chooses a more significant decrease.

Variability of apparently homogeneous soilscapes in São Paulo state, Brazil: II. quality of soil maps

The quality of semi-detailed (scale 1:100.000) soil maps and the utility of a taxonomically based legend were assessed by studying 33 apparently homogeneous fields with strongly weathered soils in two regions in São Paulo State: Araras and Assis. An independent data set of 395 auger sites was used to determine purity of soil mapping units and analysis of variance within and between mapping units and soil classification units. Twenty three soil profiles were studied in detail. The studied soil maps have a high purity for some legend criteria, such as B horizon type (> 90%) and soil texture class (> 80%). The purity for the "trophic character" (eutrophic, dystrophic, allic) was only 55% in Assis. It was 88% in Araras, where many soil units had been mapped as associations. In both regions, the base status of clay-textured soils was generally better than suggested by the maps. Analysis of variance showed that mapping was successful for "durable" soil characteristics such as clay content (> 80% of variance explained) and cation exchange capacity (≥ 50% of variance explained) of 0-20 and 60-80 cm layers. For soil characteristics that are easily modified by management, such as base saturation of the 0-20 cm layer, the maps had explained very little (< 15%) of the total variance in the study areas. Intermediate results were obtained for base saturation of the 60-80 cm layer (56% in Assis; 42% in Araras). Variance explained by taxonomic groupings that formed the basis for the legend of the soil maps was similar to, often even smaller than, variance explained by mapping units. The conclusion is that map boundaries have been very carefully located, but descriptions of mapping units could be improved. In future mappings, this could possibly be done at low cost by (a) bulk sampling to remove short range variation and enhance visualization of spatial patterns at distances > 100 m; (b) taking advantage of correlations between easily measured soil characteristics and chemical soil properties and, (c) unbending the link between legend criteria and a taxonomic system. The maps are well suited to obtain an impression of land suitability for high-input farming. Additional field work and data on former land use/management are necessary for the evaluation of chemical properties of surface horizons.

The effect of nitrogen and sulphur fertilization on yield and quality of kohlrabi (Brassica oleracea, L.)

In a greenhouse pot experiment with kohlrabi, variety Luna, we explored the joint effect of N (0.6 g N per pot = 6 kg of soil) and S in the soil (25-35-45 mg kg-1 of S) on yields, on N, S and NO3- content in tubers and leaves, and on alterations in the amino acids concentration in the tubers. S fertilisation had no effect on tuber yields. The ranges of N content in tubers and leaves were narrow (between 1.42-1.48 % N and 1.21-1.35 % N, respectively) and the effect of S fertilisation was insignificant. S concentration in the tubers ranged between 0.59 and 0.64 % S. S fertilisation had a more pronounced effect on the S concentration in leaf tissues where it increased from 0.50 to 0.58 or to 0.76 % S under the applied dose. The NO3- content was higher in tubers than in leaves. Increasing the S level in the soil significantly reduced NO3- concentrations in the tubers by 42.2-53.6 % and in the leaves by 8.8-21.7 %. Increasing the S content in the soil reduced the concentration of cysteine + methionine by 16-28 %. The values of valine, tyrosine, aspartic acid and serine were constant. In the S0, S1, and S2 treatments the levels of threonine, isoleucine, leucine, arginine, the sum of essential amino acids and alanine decreased from 37 to 9 %. The histidine concentration increased with increasing S fertilisation. S fertilisation of kohlrabi can be recommended to stabilize the yield and reduce the undesirable NO3- contained in the parts used for consumption.

Physical quality of an Oxisol cultivated with maize submited to cover crops in the pre-cropping period

The intensive use of land alters the distribution of the pore size which imparts consequences on the soil physical quality. The Least Limiting Water Range (LLWR) allows for the visualization of the effects of management systems upon either the improvement or the degradation of the soil physical quality. The objective of this study was to evaluate the physical quality of a Red Latosol (Oxisol) submited to cover crops in the period prior to the maize crop in a no-tillage and conventional tillage system, using porosity, soil bulk density and the LLWR as attributes. The treatments were: conventional tillage (CT) and a no-tillage system with the following cover crops: sunn hemp (Crotalaria juncea L.) (NS), pearl millet (Pennisetum americanum (L.) Leeke) (NP) and lablab (Dolichos lablab L.) (NL). The experimental design was randomized blocks in subdivided plots with six replications, with the plots being constituted by the treatments and the subplots by the layers analyzed. The no-tillage systems showed higher total porosity and soil organic matter at the 0-0.5 m layer for the CT. The CT did not differ from the NL or NS in relation to macroporosity. The NP showed the greater porosity, while CT and NS presented lower soil bulk density. No < 10 % airing porosity was found for the treatments evaluated, and value for water content where soil aeration is critical (θPA) was found above estimated water content at field capacity (θFC) for all densities. Critical soil bulk density was of 1.36 and 1.43 Mg m-3 for NP and CT, respectively. The LLWR in the no-tillage systems was limited in the upper part by the θFC, and in the bottom part, by the water content from which soil resistance to penetration is limiting (θPR). By means of LLWR it was observed that the soil presented good physical quality.

Structural quality of soils cultivated with coffee and pasture in an environmental protection area

Studies of soils in Environmental Protection Areas (EPAs) are of great importance, because they are an essential component of ecosystems, directly interfering in environmental sustainability. The objective of this study was to evaluate the structural quality of soil cultivated with coffee and used as pasture in the Capituva's River microbasin, which is located in the Environmental Protection Area in Coqueiral, south of the state of Minas Gerais. Uniaxial compression test (preconsolidation test) and soil resistance to penetration were used. Undisturbed samples were taken from the surface layer (0-5 cm) of the soils in the area: a typic dystrophic Red Latosol (LVd - Oxisol), a typic eutrophic Red Argisol (PVe - Ultisol), and a typic dystrophic Haplic Cambisol (CXbd - Inceptisol). A significant linear positive correlation was observed between the results of the preconsolidation test and soil resistance to penetration. Load bearing capacity of soil could be estimated accordingly by means of penetration resistance for LVd, PVe, and CXbd. Cambisol - CXbd showed lower loading support capacity and resistance to penetration than LVd and PVe, due to the better crop management in this soil that resulted in higher physical quality which accounts for higher production and environmental sustainability.

Physical quality of a yellow latossol under integrated crop-livestock system

Soil physical quality is essential to global sustainability of agroecosystems, once it is related to processes that are essential to agricultural crop development. This study aimed to evaluate physical attributes of a Yellow Latossol under different management systems in the savanna area in the state of Piaui. This study was developed in Uruçuí southwest of the state of Piauí. Three systems of soil management were studied: an area under conventional tillage (CT) with disk plowi and heavy harrow and soybean crop; an area under no-tillage with soybean-maize rotation and millet as cover crop (NT + M); two areas under Integrated Crop-Livestock System, with five-month pasture grazing and soybean cultivation and then continuous pasture grazing (ICL + S and ICL + P, respectively). Also, an area under Native Forest (NF) was studied. The soil depths studied were 0.00-0.05, 0.05-0.10 and 0.10-0.20 m. Soil bulk density, as well as porosity and stability of soil aggregates were analyzed as physical attributes. Anthropic action has changed the soil physical attributes, in depth, in most systems studied, in comparison to NF. In the 0.00 to 0.05 m depth, ICL + P showed higher soil bulk density value. As to macroporosity, there was no difference between the management systems studied and NF. The management systems studied changed the soil structure, having, as a result, a small proportion of soil in great aggregate classes (MWD). Converting native forest into agricultural production systems changes the soil physical quality. The Integrated Crop-Livestock System did not promote the improvement in soil physical quality.

Structural quality of a no-tillage red latosol 50 months after gypsum aplication

Gypsum application may enhance the soil quality for plants in terms of soil chemical and physical properties. The objective of this study was to evaluate the effects of gypsum application on the structural quality of a no-tillage Red Latosol. The experiment was initiated in September 2005 in Guarapuava-PR, with gypsum applications of 0; 4; 8; and 12 Mg ha-1 on the soil surface. In November 2009, two soil blocks were sampled from the 0-0.3 m layer for visual evaluation of the soil structure quality (Sq) and to determine the aggregate-tensile strength (ATS). Soil penetration resistance (PR) and gravimetric moisture (H%) of the 0-0.300 m layer were evaluated, and soil cores were collected (layers 0.000-0.075 and 0.075-0.150 m), to determine soil bulk density (BD), total soil porosity (TP), microporosity (Mi), and macroporosity (Ma). Data were subjected to analysis of regression at 5 %. No significant effects of gypsum application on ATS and H % of aggregates were observed, but for Sq, a quadratic effect (0.000-0.075 m) and linear increase (0.075-0.150 and 0.150-0.300 m) were stated, indicating soil quality decrease, although Sq remained mostly below 3.0, with good to intermediate soil quality. Soil PR increased with gypsum, but also remained below critical levels. No effect was observed for soil H % at the moment of PR determination on the field. The gypsum applications decreased BD in the 0.075-0.150 m layer, and increased PT and Ma, while in 0.000-0.075 m some Ma was converted to Mi, without affecting PT and BD. These last results indicate a gain in soil structural quality by gypsum applications, but the higher scores of soil structure and values of soil penetration resistance, though still below thresholds, should be monitored to prevent limitations to soil use in the future.

Impacts of different management systems on the physical quality of an Amazonian Oxisol

The physical quality of Amazonian soils is relatively unexplored, due to the unique characteristics of these soils. The index of soil physical quality is a widely accepted measure of the structural quality of soils and has been used to specify the structural quality of some tropical soils, as for example of the Cerrado ecoregion of Brazil. The research objective was to evaluate the physical quality index of an Amazonian dystrophic Oxisol under different management systems. Soils under five managements were sampled in Paragominas, State of Pará: 1) a 20-year-old second-growth forest (Forest); 2) Brachiaria sp pasture; 3) four years of no-tillage (NT4.); 4) eight years of no-tillage (NT8); and 5) two years of conventional tillage (CT2). The soil samples were evaluated for bulk density, macro and microporosity and for soil water retention. The physical quality index of the samples was calculated and the resulting value correlated with soil organic matter, bulk density and porosity. The surface layers of all systems were more compacted than those of the forest. The physical quality of the soil was best represented by the relations of the S index to bulk density and soil organic matter.

Physical quality of an oxisol under different uses

The use of a soil induces changes in the physical properties according to the management, tillage intensity and type of crop. The objective of this work was to measure the alterations of some of the soil physical properties and evaluate the physical quality by the S index, an indicator proposed by Dexter (2004), comparing the land uses: eucalyptus plantations at different ages, grazing pasture, annual crops, and an area of preserved secondary vegetation with an area of preserved native forest (National Forest Araripe - NFA) as control. The study was carried out on an Oxisol on the Fazenda Redenção, in Jardim, State of Ceará, Brazil. The experiment was arranged in a completely randomized design with seven treatments and three replications in the layers 0-0.1 and 0.1-0.2 m. The soil was analyzed for the following physical properties: bulk density, particle density, total pore volume, micro and macroporosity, soil water retention curves and water availability. Based on the S index, the hypothesis that the use of a soil deteriorates the physical quality was accepted. Clearly, native forest (NFA) was the land use with the best conditions in all physical properties studied, followed closely by the area reforested with 20 year-old eucalyptus. The use as grazing pasture affected the soil physical conditions most, especially in the surface layer (0-0.1 m), as evidenced by increased bulk density and a substantial reduction in soil porosity, mainly in macroporosity. Microporosity was not influenced by any of the uses and in any layer studied.