Aspectos éticos considerados na relação médico-paciente: vivências de anestesiologistas

BACKGROUND AND OBJECTIVE: Ethical principles guide professional conduct, particularly in establishing the doctor-patient relationship and, therefore, require constant reflection. The purpose of this study is to analyze ethical experiences of anesthesiologists in their interaction with the patient under their care. METHOD: This was an exploratory study involving 16 active anesthesiologists at a university hospital in João Pessoa, Paraíba. We collected data through semi-structured interviews and analyzed qualitatively using the content analysis technique. RESULTS: The study findings show that the classification of ethical experiences of the study participants regarding the doctor-patient relationship were classified into five categories: respect for the patient, humane treatment, equal treatment, professional secrecy, and respect for patient autonomy. CONCLUSION: We conclude that respondents recognize the ethical and humanistic values that should guide the relationship with their patients.

Escola em tempo de inclusão: ensino comum, educação especial e ação do fonoaudiólogo

This article refl ects about the action of the school speech therapist presented in a panel discussion proposed by the Public Health Department entitled: “School time of inclusion: common teaching, special education and speech therapist’s action” during the 19th SBFa’s Congress at the WTC Sheraton in São Paulo. The refl ections triggered aimed to provide elements for the systematization of actions from different sectors guided by ethical principles, theory and practice that enable collaborative relationships between educators and speech therapists. The text mantained the order of presentations that have focused on: 1) the challenges of speech-language intervention in the processes of inclusion and exclusion of the school: from the promotion of oral and written language, to the approaches of the so-called language disorders; 2) the interface between Speech Therapy and Education; 3) the role of the speech therapist in the context of Inclusive and Special Education. The authors support the position that the work done at the interface Speech Therapy and Education has the potential to contribute to school’s inclusion processes that will be capable to subvert the discriminatory logic that imposes in daily school the binomium inclusion / exclusion. The theoretical and methodological approaches presented by the authors are supported in a humane and civic vision care, training and social participation.

Avaliação da qualidade da atenção ao parto nos colegiados de gestão regional Cuesta Botucatu e Vale do Jurumirim

The humanization of childbirth implies the understanding of this event as an important experience, and requires the redefinition of human relationships from the review of the assistance project, the understanding of pregnant women condition and human rights. To evaluate child birth assistance using a score that was developed by Botucatu Cuesta Regional Management and Jurumirim Valley Collegiates. This is an epidemiological, descriptive study that is inserted in the field of evaluation of services, programs or health projects. The data has been obtained by direct observation of deliveries, emphasizing the humane care. Results: Approximately one third of the women gave birth in a tertiary hospital (34.1%) and it was their first babies (33%).24.8% of the women received prenatal care in high-risk services. 67.1% of the births were normal, and 84.7% had no companions in the delivery room. In 47.1% of the cases the delivery was performed by obstetrician who used anesthesia in 44.7% and episiotomy in 48.2% of the deliveries. More than half of the newborns were attended by the pediatrician in the delivery room and had a delivery graph completed. Although the present study shows that 67.1% of the births were normal, caesarean rate can be considered excessive, as the WHO points out that c-sections above 15% are unlikely to be justifiable. It is important to emphasize that the Ministry of Health has to have a commitment with all women to promote safe motherhood, even in cases when the pregnancy involves a risk for both the mother and the fetus. It is noteworthy that the created score allowed us to assess variables related to the humanization of childbirth and only average and quite similar situations among the three services were evidenced. We hope that with this study, managers and professionals that work in this area can be subsidized in order to offer effective humane assistance and quality service in the delivery

Pesquisas em animais: uma reflexão bioética

Animal models are an important tool in scientific research. It is known that this practice must be based on bioethical principles in order to impose limits about pain and suffering, or for inspecting proceedings and research site. This study has as aim to evaluate and present current legislation ruling animal research in Brazil, comparing it with other countries, as well as fostering bioethical reflection about this issue. For this, we present current Brazilian legislation and we have carried out international literature review and discussion. The articles were searched in PubMed data base, using the key words "bioethics" and "animal welfare". Nineteen articles from 1997 to 2013 were included. It was concluded the evident contribution of animal research for scientific research in several fields. It is morally relevant for humans, as rational beings, to secure humane treatment to animals contributing to research. The safest way to follow this path is establishing clear norms and studies well designed, involving society for assigning ethical norms. Thus, animal welfare would be guarantee.

Muito além dos muros

The art of dealing with the similar goes beyond simply contact a service provider to the recipient of the service , after the mouth is only part of the individual. The design PET - Saúde provides the academic experience of exploring the world beyond the walls of the college, which is simply phenomenal. This is the best way to form the dental professional with a humanist , critical and reflective view . Providing students the opportunity to encounter the reality of payphones and develop the general skills of the dentist , as communication with other professionals , experiencing multiprofessionality and transdisciplinarity , important in health promotion . During visits to municipalities were executed activities of health care with prevention and rehabilitation . Even against a background of lack of resources , lack of certain materials , common clinical presentation not prevented the carrying out of procedures and care . This experience is essential because it helps in decision making and establishment of costeffectiveness in their professional careers , based not only on scientific evidence , but also the needs of a given population . Therefore , the experience of participating in the PET allows the complete formation of the academic , also marked the Humanities and Social Sciences . Therefore, going beyond the walls of the college provides a comprehensive and humane view of the patient , which is no longer restricted to just one sick " part " , because it may have its context understood and integrated into the vision of each petiano .

Qualitative methodogy: revealing a new path for research in dentistry

Currently, it is easy to find health professionals who not only attach importance to qualitative methods, but also recognize their help to better understand their patients' lives. However, its use in dentistry is still incipient, either due to ignorance or because of technical / operational difficulties in identifying possibilities for their use in research. Thus, the purpose of this study was to review the literature on the characteristics and peculiarities of the qualitative methodology, demonstrating their techniques of collecting, recording and analyzing data. For this, we performed a descriptive literature, from a survey in the "LILACS", "BBO" and "PUBMED" databases, by keywords related to the theme, selecting only the papers that mentioned the "importance" of qualitative research, the "characteristics and fundamentals," and the "techniques of collecting, recording and data analysis" involving this methodology. It was found that all studies have highlighted the importance of qualitative research to the construction of new knowledge that cannot be achieved by quantitative data. We found many different techniques to gather, record and analyze qualitative data applied to the dentistry field. It was concluded that qualitative research represents a new path to be followed by dentistry, so that we are able to plan actions in ethical and humane public health dentistry, bringing better results to the population, because of the depth of knowledge that your date can.

Editando vidas: focos do DSM na medicalização social

Pós-graduação em Educação - IBRC

Efeito do manejo pré-abate de bovinos no bem–estar e qualidade da carcaça

Pós-graduação em Zootecnia - FCAV

Indo-Pacific Bottlenose Dolphin Assessment Workshop Report

A workshop on the assessment of Indo-Pacific bottlenose dolphins (Tursiops aduncus), with the Solomon Islands as a case study, took place from 21-23 August 2008 in Apia, Samoa. It was planned and organized under the auspices of the Cetacean Specialist Group and attended by 19 invited participants from eight countries. Financial support was provided by WWF (International), The Ocean Conservancy, Animal Welfare Institute, Humane Society of the United States, Whale and Dolphin Conservation Society, U.S. Marine Mammal Commission and U.S. National Oceanic and Atmospheric Administration. The workshop was hosted by the Secretariat of the Pacific Regional Environment Program (SPREP). Live-capture, holding in captivity and export of Indo-Pacific bottlenose dolphins from the Solomon Islands began in 2003. These activities stimulated global interest and generated concern about the potential conservation implications. The IUCN Global Plan of Action for the Conservation of Cetaceans had stated that as a general principle, small cetaceans should not be captured or removed from a wild population unless that specific population has been assessed and shown capable of sustaining the removals. A principal goal of the present workshop was to elaborate on the elements of an assessment that would meet this standard. Participants noted that an assessment involving delineation of stock boundaries, abundance, reproductive potential, mortality and trend cannot necessarily be achieved quickly or inexpensively.

U.S. Pacific Marine Mammal Stock Assessments

Under the 1994 amendments to the Marine Mammal Protection Act, the National Marine Fisheries Service (NMFS) and the U.S. Fish and Wildlife Service (USFWS) were required to produce stock assessment reports for all marine mammal stocks in waters within the U.S. Exclusive Economic Zone. This document contains the stock assessment reports for the U.S. Pacific marine mammal stocks under NMFS jurisdiction. Marine mammal species which are under the management jurisdiction of the USFWS are not included in this report. A separate report containing background, guidelines for preparation, and .a summary of all stock assessment reports is available from the NMFS Office of Protected Resources. This report was prepared by staff of the Southwest Fisheries Science Center, NMFS and the Alaska Fisheries Science Center, NMFS. The information presented here was compiled primarily from published sources, but additional unpublished information was included where it contributed to the assessments. The authors wish to thanks the members of the Pacific Scientific Review Group for their valuable contributions and constructive criticism: Hannah Bernard, Robin Brown, Mark Fraker, Doyle Hanan, John Heyning, Steve Jeffries, Katherine Ralls, Michael Scott, and Terry Wright. Their comments greatly improved the quality of these reports, We also thanks the Marine Mammal Commission, The Humane Society of the United States, The Marine Mammal Center, The Center for Marine Conservation, and Friends of the Sea Otter for their careful reviews and thoughtful comments. Special thanks to Paul Wade of the Office of Protected Resources for his exhaustive review and comments, which greatly enhanced the consistency and technical quality of the reports. Any ommissions or errors are the sole responsibility of the authors. This is a working document and individual stock assessment reports will be updated as new information becomes available and as changes to marine mammal stocks and fisheries occur; therefore, each stock assessment report is intended to be a stand alone document. The authors solicit any new information or comments which would improve future stock assessment reports. This is Southwest Fisheries Science Center Technical Memorandum NOAA-TM-NMFS-SWFSC- 219, July 1995. 111

A review of existing and potential New World and Australasian vertebrate pesticides with a rationale for linking use patterns to registration requirements

Registration is a necessarily sophisticated evaluation process applied to vertebrate pesticide products. Although conducted to minimize any potential impacts upon public health, the environment and food production, the all-encompassing process of registration can stifle innovation. Vertebrate pesticides are rarely used to control pest animals in food crops. In contrast to agrochemicals, relatively small amounts of vertebrate pesticides are used (50.1%), usually in solid or paste baits, and generally by discrete application methods rather than by broad-scale spray applications. We present a hierarchy or sliding scale of typical data requirements relative to application techniques, to help clarify an evolving science-based approach which focuses on requiring data to address key scientific questions while allowing waivers where additional data have minor value. Such an approach will facilitate the development and delivery of increasingly humane, species-targeted, low residue pesticides in the New World, along with the phasing out of less desirable chemicals that continue to be used due to a lack of alternatives.

An Evaluation of Diazacon as a Potential Contraceptive in Non-Native Rose-Ringed Parakeets

Rose-ringed parakeets (Psittacula krameri) have become widely established outside their native range through accidental or deliberate release. Potential economic impacts on agriculture, conservation concerns, and mixed public opinion regarding the species have highlighted the need to develop effective but humane management options. Fertility control might provide such a solution if a safe and environmentally benign contraceptive was available. The chemical 20,25-diazacholesterol dihydrochloride (diazacon) has previously been used to reduce reproductive output in avian species through reduction of blood cholesterol and cholesterol-dependent reproductive hormones. We orally dosed captive rose-ringed parakeets with a solution of either 9 mg/kg or 18 mg/kg of diazacon for up to 10 days and found that a dose of 18 mg/kg for 10 days temporarily reduced blood cholesterol levels with no adverse side effects. We evaluated this dose level in a captive population in semi-natural conditions during the 2008 breeding season and found a significant decrease in fertility. We concluded that diazacon has potential for fertility control in this species if a suitable formulation and delivery system is developed for free-living populations.

Development of Nicarbazin as a Reproductive Inhibitor for Resident Canada Geese

Expanding populations of resident Canada geese that remain in suburban and urban areas year-round often result in increased conflicts with humans. Non-lethal and humane means are needed for managing the size of Canada goose flocks residing near or on airports, golf courses, industrial parks, government sites, and city parks. A side effect of nicarbazin, a veterinary drug used to control coccidiosis in chickens, is decreased egg production and hatching. Exploiting this side effect, studies of nicarbazin for reducing the hatchability of eggs from Canada geese were conducted. An initial study in Coturnix quail verified reduction in hatchability in a species other than chickens. Because plasma nicarbazin was not routinely measured, a study in chickens was conducted to determine the relationship between plasma and egg nicarbazin. A comparative study in chickens, mallards, and Canada geese showed that nicarbazin absorption was lowest in geese. Studies in both penned and wild Canada geese showed that reduction in hatchability was possible but neither study used bait suitable for general field application. Bait development led to the OvoControl-G® (Innolytics LLC) bait, which resulted in reduction in hatchability of 51% at treated sites compared to control sites in the field. Previous studies showed that nicarbazin is practically non-toxic and is environmentally friendly; timing and management of baiting will minimize non-target hazards. OvoControl-G® 2500 ppm nicarbazin bait is recommended for incorporation into a comprehensive management plan as a reproductive inhibitor for use in controlling resident Canada goose flock sizes.

Sex differences in the excretion of fecal glucocorticoid metabolites in the Syrian hamster

We verified the relevance of measuring fecal glucocorticoid metabolites (FGM) to assess the stress response of the Syrian hamster. Male and female hamsters (n = 10 each) were submitted to an adrenocorticotropic hormone (ACTH) challenge test, whereas animals in the control group received 0.5 mL of sterile isotonic saline solution. All feces voided by each animal were collected at 4 h intervals from 24 h before (baseline) until 48 h after injections. FGM were quantified using an 11-oxoetiocholanolone enzyme immunoassay (EIA). Basal concentrations of FGM were almost four times higher in males than in females. Following ACTH administration, FGM levels started rising from 8 h onwards, reaching peak concentrations 20 or 28 h post injection in males and females, respectively. Despite the much higher absolute concentrations present in males, the relative increase (500%) in response to the ACTH stimulation was similar in both sexes. Sex differences in FGM levels are in accordance with results reported by others regarding the hamster adrenal physiology. The comparison of the adrenocortical response of males and females to an ACTH challenge provided new information about the amplitude and the timing of such a response and the excretion of glucocorticoids in both sexes. We demonstrated for the first time in the Syrian hamster that adrenocortical activity can be monitored in fecal samples in a noninvasive way. Our study provides a humane, practical, and noninvasive alternative to blood removal and therefore a powerful tool for stress-related studies in a species frequently used as an animal model in medical research.

Contribution to economic evaluation of systems that value animal welfare at farm

The demand for "welfare friendly" products increases as public conscience and perception on livestock production systems grow. The public and policy-makers demand scientific information for education and to guide decision processes. This paper describes some of the last decade contributions made by scientists on the technical, economical and market areas of farm animal welfare. Articles on animal welfare were compiled on the following themes: 1) consumer behavior, 2) technical and economical viability, 3) public regulation, and 4) private certification policies. Most studies on the economic evaluation of systems that promote animal welfare involved species destined to produce export items, such as eggs, beef and pork. Few studies were found on broilers, dairy cows and fish, and data regarding other species, such as horses, sheep and goats were not found. Scientists understand that farm animal welfare is not only a matter of ethics, but also an essential tool to gain and maintain markets. However, it is unfortunate that little attention is paid to species that are not economically important for exports. Studies that emphasize on more humane ways to raise animals and that provide economic incentives to the producer are needed. An integrated multidisciplinary approach is necessary to highlight the benefits of introducing animal welfare techniques to existing production systems.