Pais frente à malformação craniofacial do filho: uma contribuição da enfermagem para a equipe interdisciplinar

Trata-se de uma pesquisa qualitativa descritiva que teve como objeto de estudo as estratégias de enfrentamento dos pais com o nascimento de uma criança com anomalia craniofacial. Objetivou identificar o impacto causado nos pais frente ao nascimento de um filho portador de anomalia craniofacial; descrever as estratégias de enfrentamento que os pais utilizam para estabelecer vinculação com o filho que apresenta malformação. Utilizou o método Narrativa de Vida, através da entrevista gravada com 15 mães e sete pais de crianças com malformação craniofacial. O estudo foi aprovado pelo Comitê de Ética da Universidade do Estado do Rio de Janeiro. A coleta de dados foi realizada entre junho e agosto de 2014. As narrativas apontaram para a emergência de três categorias: Ter um filho com anomalia craniofacial: situação impactante; Estratégias de enfrentamento utilizadas por pais de crianças com malformação craniofacial; Pais e profissionais da equipe de saúde: uma relação conturbada. As categorias puderam explicitar que a notícia da malformação gera impacto e crise na vida dos pais e no seio familiar. A grande expectativa na gravidez pelo bebê perfeito se transforma em frustração, choque e culpa. Diante dessa adversidade, as famílias começam a desenvolver estratégias de enfrentamento que auxiliam vinculação com seu filho malformado. Essa capacidade de desenvolver forças e habilidades para se adaptar à nova realidade, minimizando os efeitos negativos, é chamada de resiliência. As narrativas apontam a experiência religiosa e a rede de apoio como as principais estratégias de enfrentamento utilizadas pelos participantes. A equipe de saúde é chamada a apoiar os pais ao longo do processo de adaptação com o filho malformado. Os profissionais de saúde podem auxiliar no suporte e adaptação destes pais, diante da nova condição, sendo agentes promotores da escuta terapêutica. Compreender o que há por detrás de cada história desvelada, traz subsídios para potencializar a resiliência no acolhimento institucional dos pais e sua família.

Building social and ecological resilience to climate change in Roviana, Solomon Islands: PASAP country activity for Solomon Islands: Brief review: climate change trends and projections for Solomon Islands

As part of the Australian Government’s International Climate Change Adaptation Initiative (ICCAI), the Pacific Adaptation Strategy Assistance Program (PASAP) aims to enhance the capacity of partner countries to assess key vulnerabilities and risks, formulate adaptation strategies and plans, mainstream adaptation into decision-making, and inform robust longterm national planning and decision-making in partner countries. The Department of Climate Change and Energy Efficiency contracted University of Queensland (UQ) and University of California, Santa Barbara (UCSB) to lead the project: “Building social and ecological resilience to climate change in Roviana, Solomon Islands” (2010-2012). Under this project The WorldFish Center was subcontracted to undertake outputs 5 and 6 of Objective three: (5) Review of climate change evidence and projections for the study area and (6) Vulnerability and adaptation assessment for the study area. This report addresses the first of these and comprises a desktop review of climate change evidence and projections for the study area.

Violência nas relações de namoro de adolescentes em situação de acolhimento institucional: um olhar da enfermagem

Esta pesquisa tem como objeto de estudo a violência nas relações de namoro de adolescentes em situação de acolhimento. Objetivos: identificar as características das relações de namoro das adolescentes em situação de acolhimento; analisar as vivências da violência nas relações de namoro das adolescentes em situação de acolhimento; descrever as repercussões da violência na vivência das adolescentes. Estudo qualitativo, descritivo e exploratório, tendo como cenário de pesquisa uma unidade pública municipal de acolhimento para adolescentes, localizado na Zona Norte do município do Rio de Janeiro. Os dados foram coletados no período de março a maio de 2014, após a aprovação pelo Comitê de Ética em Pesquisa. O estudo foi realizado com sete adolescentes que residem na unidade de acolhimento, com idades de 12 a 18 anos e que responderam a entrevista semiestruturada. Os dados foram analisados através da técnica de análise de conteúdo tendo emergido três categorias: Características das relações de namoro na perspectiva das adolescentes; A violência nas relações afetivas de adolescentes em situação de acolhimento; repercussões da violência nas relações de namoro das adolescentes. Ao analisarmos as características das relações de namoro na perspectiva das adolescentes, as jovens apontaram suas percepções sobre as características referentes ao comportamento masculino e do parceiro. Algumas percepções são associadas ao comportamento do parceiro com carinho, cumplicidade, apoio e amor. E outras aos comportamentos de mentira, excesso de ciúme e agressividade, a não escolha do parceiro certo, entre outras. Em relação à percepção sobre suas relações afetivas, as adolescentes apontaram ser necessário conhecer primeiro o parceiro, ter uma relação sem briga e sem discussão; expressaram atitudes de submissão, omissão, desilusão amorosa, desvalorização do parceiro, desgaste por desvalorização e não gostar de conversar com o parceiro sobre o relacionamento. Os tipos de violência mais comumente vivenciados e indicados pelas adolescentes em suas relações de namoro foram: violência física e sexual; violência patrimonial; e violência psicológica, verbal e moral. As adolescentes apontaram que tais violências nas relações de namoro trazem repercussões à sua saúde, tais como: repercussão à saúde mental, sentimentos como a autopercepção desvalorizada, um ceticismo, impotência, insegurança e medo. Contudo, cabe destacar que algumas adolescentes em situação de acolhimento, em função das adversidades e história de vida, também apontaram certo grau de resiliência diante das violências vivenciadas. Considerando essa primeira aproximação da realidade das relações de namoro das adolescentes em situação de acolhimento verifica-se a necessidade de ações de cuidado no atendimento à essa clientela. As unidades de acolhimento são cenários facilitadores para ações educativas e de cuidado junto à população de adolescentes, o que facilita a construção de medidas de promoção à saúde sexual e reprodutiva de adolescentes. A enfermagem ao reconhecer que o cuidar constitui um processo dialético entre o indivíduo e o cuidador, mas que também é influenciado histórico e socialmente, tem papel fundamental na proposição de ações de enfretamento à violência nas relações de namoro das adolescentes em serviços de acolhimento.

Collaborating for Resilience: a practitioner’s guide

In many countries, resource conflict is a leading risk to livelihoods. For some communities, it is a matter of survival. Yet, many development interventions aiming to address these challenges fail or fall far short of their potential. Common reasons include conflicting agendas, power and politics; poor local commitment and leadership; lack of coordination; plus high costs and low sustainability, as programs often unravel when development finance ends. Overcoming these obstacles requires a shift from typical approaches to planning, implementing and evaluating rural development and natural resource management initiatives. This manual introduces one approach to achieving such breakthroughs in collective action, called Collaborating for Resilience. The manual presents a set of principles and field-tested guidance on exploring the potential for collaboration, facilitating dialogue and action, evaluating outcomes, and sustaining collaboration over time.

Energy efficiency, resilience to future climates and long-term sustainability: the role of the built environment

Just under half of all energy consumption in the UK today takes place indoors, and over a quarter within our homes. The challenges associated with energy security, climate change and sustainable consumption will be overcome or lost in existing buildings. A background analysis, and the scale of the engineering challenge for the next three to four decades, is described in this paper.

Energy efficiency, resilience to future climates and long-term sustainability: the role of the built environment.

Just under half of all energy consumption in the UK today takes place indoors, and over a quarter within our homes. The challenges associated with energy security, climate change and sustainable consumption will be overcome or lost in our existing buildings. A background analysis, and the scale of the engineering challenge for the next three to four decades, is described in this paper.

Designing for resilience: Using a Delphi study to identify resilience issues for hospital designs in a changing climate

Hospitals are facing a triple challenge - meeting mandatory climate change targets and refurbishing aging infrastructure while simultaneously providing quality of care. With the potential of more frequent disruptive weather events, a UK government-funded project was launched in 2009 to investigate practical strategies for the National Health Service to increase its resilience to climate change. This paper presents the process of defining resilience by using the Delphi method and demonstrates its applicability within healthcare design. A Delphi survey is nearing completion which has determined the significant resilience issues and temperature ranges for ideal and critical conditions. Our preliminary findings identified six priorities that lead towards increasing resilience. Using the Delphi method can be a useful tool in clarifying the focus for healthcare design considerations. Copyright © 2002-2012 The Design Society. All rights reserved.

Climate resilience of schools: a case study

Social and political concerns are frequently reflected in the design of school buildings, often in turn leading to the development of technical innovations. One example is a recurrent concern about the physical health of the nation, which has at several points over the last century prompted new design approaches to natural light and ventilation. The most critical concern of the current era is the global, rather than the indoor, environment. The resultant political focus on mitigating climate change has resulted in new regulations, and in turn considerable technical changes in building design and construction. The vanguard of this movement has again been in school buildings, set the highest targets for reducing operational carbon by the previous Government. The current austerity measures have moved the focus to the refurbishment and retrofit of existing buildings, in order to bring them up to the exacting new standards. Meanwhile there is little doubt that climate change is happening already, and that the impacts will be considerable. Climate scientists have increasing confidence in their predictions for the future; if today’s buildings are to be resilient to these changes, building designers will need to understand and design for the predicted climates in order to continue to provide comfortable and healthy spaces through the lifetimes of the buildings. This paper describes the decision processes, and the planned design measures, for adapting an existing school for future climates. The project is at St Faith’s School in Cambridge, and focuses on three separate buildings: a large Victorian block built as a substantial domestic dwelling in 1885, a smaller single storey 1970s block with a new extension, and an as-yet unbuilt single storey block designed to passivhaus principles and using environmentally friendly materials. The implications of climate change have been considered for the three particular issues of comfort, construction, and water, as set out in the report on Design for Future Climate: opportunities for adaptation in the built environment (Gething, 2010). The adaptation designs aim to ensure each of the three very different buildings remains fit for purpose throughout the 21st century, continuing to provide a healthy environment for the children. A forth issue, the reduction of carbon and the mitigation of other negative environmental impacts of the construction work, is also a fundamental aim for the school and the project team. Detailed modelling of both the operational and embodied energy and carbon of the design options is therefore being carried out, in order that the whole life carbon costs of the adaptation design options may be minimised. The project has been funded by the Technology Strategy Board as part of the Design for Future Climates programme; the interdisciplinary team includes the designers working on the current school building projects and the school bursar, supported by researchers from the University of Cambridge Centre for Sustainable Development. It is hoped that lessons from the design process, as well as the solutions themselves, will be transferable to other buildings in similar climatic regions.

Tomorrow's cities - a framework for building resilience

Urbanisation is the great driving force of the twenty-first century. Cities are associated with both productivity and creativity, and the benefits offered by closely connected and high density living and working contribute to sustainability. At the same time, cities need extensive infrastructure – like water, power, sanitation and transportation systems – to operate effectively. Cities therefore comprise multiple components, forming both static and dynamic systems that are interconnected directly and indirectly on a number of levels, all forming the backdrop for the interaction of people and processes. Bringing together large numbers of people and complex products in rich interactions can lead to vulnerability from hazards, threats and even trends, whether natural hazards, epidemics, political upheaval, demographic changes, economic instability and/or mechanical failures; The key to countering vulnerability is the identification of critical systems and clear understanding of their interactions and dependencies. Critical systems can be assessed methodically to determine the implications of their failure and their interconnectivities with other systems to identify options. The overriding need is to support resilience – defined here as the degree to which a system or systems can continue to function effectively in a changing environment. Cities need to recognise the significance of devising adaptation strategies and processes to address a multitude of uncertainties relating to climate, economy, growth and demography. In this paper we put forward a framework to support cities in understanding the hazards, threats and trends that can make them vulnerable to unexpected changes and unpredictable shocks. The framework draws on an asset model of the city, in which components that contribute to resilience include social capital, economic assets, manufactured assets, and governance. The paper reviews the field, and draws together an overarching framework intended to help cities plan a robust trajectory towards increased resilience through flexibility, resourcefulness and responsiveness. It presents some brief case studies demonstrating the applicability of the proposed framework to a wide variety of circumstances.

Tomorrow's cities: a framework to assess urban resilience

Urbanisation is one of the great driving forces of the twenty-first century. Cities generate both productivity and creativity, and the benefits offered by high-density living and working contribute to sustainability. Cities comprise multiple components, forming both static and dynamic systems that are interconnected directly and indirectly on a number of levels. Bringing together large numbers of people within a complex system can lead to vulnerability from a wide range of hazards, threats and trends. The key to reducing this vulnerability is the identification of critical systems and determination of the implications of their failure and their interconnectivities with other systems. One emerging approach to these challenges focuses on building resilience – defined here as the degree to which a system can continue to function effectively in a changing environment. This paper puts forward a framework designed to help engineers, planners and designers to support cities in understanding the hazards, threats and trends that can make them vulnerable, and identify focus areas for building resilience into the systems, which allow it to function and prosper. Four case studies of cities whose resilience was tested by recent extreme weather events are presented, seeking to demonstrate the application of the proposed framework.

Adaptive capacity and learning to learn as leverage for social-ecological resilience

Ioan Fazey, John A. Fazey, Joern Fischer, Kate Sherren, John Warren, Reed F. Noss, Stephen R. Dovers (2007) Adaptive capacity and learning to learn as leverage for social?ecological resilience. Frontiers in Ecology and the Environment 5(7),375-380. RAE2008

Homeopatia em Pediatria

Projeto de Pós-Graduação/Dissertação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Ciências Farmacêuticas