Assistência em cuidados paliativos a pessoa idosa na atenção primária a saúde

This study aims to understand the significance of palliative care for the elder health care professionals working in primary health care. Descriptive study of qualitative approach. Conducted in three health units of the Family and a core of support for Health, the Felipe Camarão neighborhood, District of Natal Health West, RN. Of the 25 participants, 19 are professionals of the Family Health Strategy and six of the Center for Support to Health, the majority being women, with minimal professional work experience, a year in primary health care. The study was approved by the Ethics Committee of the Federal University of Rio Grande do Norte, under CAAE no. 43895815.4.0000.5537. There were individual interviews between July and September 2015, with the use of questionnaire containing open and closed questions on the topic of study. Our results were recorded in MP4 and transcribed into written language, and analyzed using the open coding process medium in which the categories were interpreted and identified, followed by axial coding, where categories were developed and systematically related. Three categories emerged: enhancement of elder health professionals in palliative care, behavioral health professionals across care in palliative care in primary care and disjointed Meaning between palliative care and health professionals. The categories were interpreted and analyzed by the theoretical framework of social phenomenology of Alfred Schütz. Regarding the valuation of subjective perception of professionals, it is clear the issue of the complexity of multiple relationships through various aspects of his central task: focus a philosophy of the world's reality, namely a phenomenology of natural attitude; Before the professional behavior were identified: the discovery and depth of assumptions through the structure, and meaning in a common sense, and at the meaning of the disconnection between the health professionals-including that reality imminent can be represented by individuality special interest of the experience. It follows that health professionals understand there is a difficulty facing the assistance in palliative care to the elderly in primary care, and this difficulty, characterized by the complexity of social interactions across the joint teamwork. Although, I believe that the articulation between the teams, work and family, is essential for the subsequent improvement of care in palliative care favoring the health context surrounding the Elder.

Student Independent Projects Environmental Studies 2011: A Values Profile for a Healthy, Sustainable Corner Brook Community

We now live in a world where urbanization has become the norm. Approximately half the world now lives in cities(O'brien, 2008). In recent years for a province like Newfoundland and Labrador which has relied heavily on one industry, the fishery, this statistic holds a lot of meaning. For well over a century there has been a continuing movement from Newfoundland to other parts of Canada and the US. Between 1971 and 1998 alone, net out-migration amounted 20% of the provinces population. This exodus has become a significant part of Newfoundland culture (Bowering Delisle, 2008). Communities have declining populations because families can no longer afford to live in their communities. For places like Corner Brook though citizens do not feel the urge to move to bigger urban centers like St. John's or places on the mainland. The purpose of this paper is to outline values which maybe keeping Corner Brook residents from uprooting their families to move to bigger urban centers such as St. John's, in order to be able to support ther families, get experience in their fields or to just acquire a job like many other people around the province.

Comparison between transperineal ultrasound and digital dectection of levator ani trauma : can we improve the odds?

Aims To investigate the predictive ability of four digital assessment parameters to detect levator ani (LA) muscle defects (avulsion injury) and compare these to transperineal tomographic ultrasound images. Methods This was an observational study imbedded in a larger quasi-experimental cohort study for women with urinary incontinence. Seventy-two women, ≥60 years who had attended or were going to attend physiotherapy for treatment of urinary incontinence, were included in the study. Inclusion criteria from the parent study were symptoms of stress, urge or both types of urinary incontinence. The predictive ability of the following digital parameters: direct palpation of a discontinuity of the LA muscle from insertion on the pubic ramus; palpation of the distance between the muscle insertion sites; palpation of LA strength; palpation of LA tone, were analyzed against findings from tomographic transperineal ultrasound images. Correlation between methods was measured using Cohen's kappa for each of the individual parameters. Results Seventeen women (24%) presented with a complete or partial avulsion of the puborectalis muscle as diagnosed with tomographic ultrasound imaging. Nine women (13%) had complete avulsions, one of which was bilateral. The predictive ability of the digital assessment parameters varied from poor (k = 0.187, 95% CI [0.02–0.36]) to moderate (k = 0.569, 95% CI [0.31–0.83]). The new parameter of ‘width between insertion sites’ performed best. Conclusions Adding the parameter of “width between insertion sites” appears to enhance our ability to detect avulsion of the levator ani (LA) muscle by digital examination however it does not distinguish between unilateral or bilateral avulsion.

Adaptação e validação da escala GenCat de calidade de vida para a população adulta portuguesa com deficiência

Para melhorar o apoio social prestado às pessoas com deficiência em Portugal, urge perceber como esta população perceciona a própria Qualidade de Vida (QV). Este trabalho tem como objetivos: adaptar e validar a escala Gencat de Calidade de vida à população portuguesa adulta com deficiência; estudar como se manifesta a Qualidade de Vida na população portuguesa adulta com deficiência; analisar a relação de QV com algumas variáveis socio demográficas da população portuguesa adulta com deficiência, tipos de incapacidades e gravidade da amostra. A escala Gencat foi aplicada a 303 pessoas com perturbações motoras, sensitivas e/ou do desenvolvimento. Foi realizada a caraterização sociodemográfica do informador e da pessoa avaliada e a caracterização da gravidade da perturbação sofrida. O estudo psicométrico resultou numa escala de 54 itens e 8 domínios: Autodeterminação, Suporte Institucional, Satisfação Ocupacional, Bem-Estar Emocional, Inclusão Social, Condições Habitacionais e Comunitárias, Auto-eficácia e Bem-estar Físico. A escala apresenta boas propriedades psicométricas. A idade está inversamente correlacionada com as dimensões apoio institucional e bemestar físico da escala de Gencat. A população analfabeta apresenta menor QV global, nomeadamente na autodeterminação, suporte institucional, inclusão social e bem-estar físico. As pessoas institucionalizadas relativamente às que vivem em contexto familiar apresentam valores mais baixos de QV, nomeadamente na autodeterminação, suporte institucional, inclusão social e auto-eficácia, mas apresentam pontuações melhores condições habitacionais e comunitárias. O grau de incapacidade e a intensidade das perturbações cognitiva, motora, autismo e cegueira correlaciona-se inversamente com a QV, nomeadamente na autodeterminação, no suporte institucional, na inclusão social e o bem-estar físico.

"Suffragettes of the Harem": The Evolution of Sympathy and the Afterlives of Sentimentality in American Feminist Orientalism, 1865-1920

This project examines narrative encounters in space identified as “harem,” produced by authors with biographical ties to the vanguard of the American Suffrage Movement. I regard these feminists’ circulations East, to the domestic space of the Other, as a hitherto unstudied, yet critical component of transnationalism in the history of U.S. Suffrage. This literary record also crucially reveals the extent to which sentimentality was plotted as a potential force for the reform of other cultures. An urge to sympathize denied in the space of the harem illustrates the colonial anxieties that subtended sentimentality’s prospective deployment beyond national borders. In five chapters on the work of Anna Leonowens, Susan Elston Wallace, Demetra Vaka Brown, Charlotte Perkins Gilman, and Edith Wharton, I examine how Suffrage-minded authors writing the harem strategically abandon an activist praxis of fellow feeling. Such a reluctance to transform sentimental literature into a colonial literature consequently informs that genre’s postbellum decline. The sentiments that run dry for American feminists in the harem additionally foreground the costly failures of Wilsonian Idealism, a doctrine that appropriated a discourse of sentimentality in order to script the United States’ expanded involvement in global affairs.

Comparison between transperineal ultrasound and digital dectection of levator ani trauma : can we improve the odds?

Aims To investigate the predictive ability of four digital assessment parameters to detect levator ani (LA) muscle defects (avulsion injury) and compare these to transperineal tomographic ultrasound images. Methods This was an observational study imbedded in a larger quasi-experimental cohort study for women with urinary incontinence. Seventy-two women, ≥60 years who had attended or were going to attend physiotherapy for treatment of urinary incontinence, were included in the study. Inclusion criteria from the parent study were symptoms of stress, urge or both types of urinary incontinence. The predictive ability of the following digital parameters: direct palpation of a discontinuity of the LA muscle from insertion on the pubic ramus; palpation of the distance between the muscle insertion sites; palpation of LA strength; palpation of LA tone, were analyzed against findings from tomographic transperineal ultrasound images. Correlation between methods was measured using Cohen's kappa for each of the individual parameters. Results Seventeen women (24%) presented with a complete or partial avulsion of the puborectalis muscle as diagnosed with tomographic ultrasound imaging. Nine women (13%) had complete avulsions, one of which was bilateral. The predictive ability of the digital assessment parameters varied from poor (k = 0.187, 95% CI [0.02–0.36]) to moderate (k = 0.569, 95% CI [0.31–0.83]). The new parameter of ‘width between insertion sites’ performed best. Conclusions Adding the parameter of “width between insertion sites” appears to enhance our ability to detect avulsion of the levator ani (LA) muscle by digital examination however it does not distinguish between unilateral or bilateral avulsion.

The Democratic Dynamics of Government Consultations. Speaking Freely and Listening Properly

There is a growing use of consultation and e-consultation procedures by governments. This chapter seeks to examine the role of consultation as part of a new technology of government. Consultation on policy development can reinvigorate democratic engage- ment but often it can silence views through a sort of participatory disempowerment; it can loosen the democratic anchorage of the public service within the state. The chapter develops a governmentality perspective interrogating what participation, democratic engagement and free speech mean in this context, and how ideas of publicness are constructed, managed and controlled. The focus is on the nature of consultation, its relationship to ideas of free speech and speaking freely, and its potential to empower subaltern counterpublics which can formulate oppositional interpretations and urge alternative conclusions. The aim is to develop an idea of the democratic adequacy of the consultation process and draw out a sense of how democratic engagement here can be structured – for good or ill.

Parading through the Peace Process:Anthropology, Governance and Crisis in Northern Ireland

Because the authors both did work on the North Ireland parades, they became integrally involved as fieldworking anthropologists in the monitoring of these events, and in the creation of policy for their management. They detail how they worked with individuals and groups at every level, from protestors on the street up to the Secretary of State for the region. Later funded to examine legal and policing approaches to protests in other countries, especially South Africa, they show how they used this comparative knowledge to urge the implementation of measures which appear to have led to a diminution of violence in the parades. Finally, they assess their own contribution to the peace process in terms of contingency, timing, luck, flexibility, and industry.

Microwave Plasma Assisted ALD Development for the Deposition of Gate Oxides & ALD of High-k Dielectrics

The semiconductor industry's urge towards faster, smaller and cheaper integrated circuits has lead the industry to smaller node devices. The integrated circuits that are now under volume production belong to 22 nm and 14 nm technology nodes. In 2007 the 45 nm technology came with the revolutionary high- /metal gate structure. 22 nm technology utilizes fully depleted tri-gate transistor structure. The 14 nm technology is a continuation of the 22 nm technology. Intel is using second generation tri-gate technology in 14 nm devices. After 14 nm, the semiconductor industry is expected to continue the scaling with 10 nm devices followed by 7 nm. Recently, IBM has announced successful production of 7 nm node test chips. This is the fashion how nanoelectronics industry is proceeding with its scaling trend. For the present node of technologies selective deposition and selective removal of the materials are required. Atomic layer deposition and the atomic layer etching are the respective techniques used for selective deposition and selective removal. Atomic layer deposition still remains as a futuristic manufacturing approach that deposits materials and lms in exact places. In addition to the nano/microelectronics industry, ALD is also widening its application areas and acceptance. The usage of ALD equipments in industry exhibits a diversi cation trend. With this trend, large area, batch processing, particle ALD and plasma enhanced like ALD equipments are becoming prominent in industrial applications. In this work, the development of an atomic layer deposition tool with microwave plasma capability is described, which is a ordable even for lightly funded research labs.

Representações Sociais da Cannabis no Concelho de Góis

A cannabis permanece como a substância ilícita mais consumida no mundo. Defendida por uns e “diabolizada” por outros, constitui uma das substâncias psicoactivas mais polémicas. Alguns autores destacaram já, a importância do estudo das representações sociais das substâncias psicoactivas. No entanto, desconhecem-se investigações que abordem a representação social desta substância num espaço rural. São objectivos deste estudo: 1) conhecer as representações sociais da cannabis no que diz respeito à substância, ao consumidor e ao contexto da utilização, 2) identificar as diferenças existentes entre utilizadores e não utilizadores desta substância da amostra em estudo. Para concretizar estes objectivos, foi realizado um estudo qualitativo que recorreu a uma dupla abordagem etno-metodológica e fenomenológica. Foram realizadas 30 entrevistas a indivíduos residentes nas duas maiores freguesias do concelho de Góis que, depois de transcritas, foram objecto de análise de conteúdo. No espaço rural considerado, a cannabis é maioritariamente representada como uma “droga”, indutora de uma sensação de mal-estar e causadora de dependência. Para os participantes o utilizador é percebido como detentor de características de personalidade negativas, que o induzem ao consumo. Relativamente ao eixo espacial, o espaço rural, e mais especificamente o concelho de Góis é representado como local de consumo e de produção da cannabis herbácea. Há uma distinção clara entre a representação social dos participantes que não utilizam a substância e os que utilizam. O último grupo representa-a como uma “droga leve”, e mostra-se esclarecido sobre as possíveis consequências da sua utilização. Neste grupo é ainda evidente a valorização da cannabis herbácea, em detrimento dos seus derivados. /

Risk Factors for Maternal Vitamin D Deficiency within the United Arab Emirates

Introduction: Vitamin D deficiency during pregnancy is a public health problem and it has been associated with negative pregnancy outcomes for both mothers and infants. Aim: To estimate the prevalence of vitamin D deficiency in pregnant women in the United Arab Emirates (UAE) and to identify the contribution of risk factors to the 25(OH)D levels. Methods: It is a cross-sectional study in which vitamin D levels of 1088 adult pregnant women were assessed. Information on vitamin D intake was available in a sub-sample of 266 women. Results: The mean serum 25(OH)D was 26.2 nmol/L (95% CI 25.2-27.1 range 5-129.1 nmol/L) with 69% of women being vitamin D deficient (<30 nmol/L). In the bivariate analysis, showed that no predictors could have been indicated as no values exceeded significance (p<0.2). Stepwise multiple linear regression analysis could not be applied to identify predictors of vitamin D levels as no values exceeded p=0.2. Conclusion: Due to the high prevalence of vitamin deficiency in UAE, there is an urge for interventions focusing on supplementation, fortification and diet diversity for preventing health consequences during a critical period of development.

Envelhecer… Embelecer… Envilecer: comprometimento ou desvinculação com a vida? Atividade e sociabilidade dos idosos da Alta de Coimbra

Este estudo surgiu com o intuito de compreender se os mais velhos continuam, após a transição para a reforma, a participar na esfera da economia, formal e informal, e da sociabilidade, analisando com mais pormenor no que se refere a esta última faceta o sentimento de solidão. Partindo dos diferentes enquadramentos teóricos sobre o contributo socioeconómico dos idosos o objetivo foi compreender, no campo empírico, a posição dos sujeitos relativamente à transição para a reforma e de que forma os mesmos se percecionavam em áreas ligadas à produtividade e sociabilidade. A amostra foi intencional (N=30) e abrangeu sujeitos com idade igual ou superior a sessenta e cinco anos, com pelo menos um ano de reforma e residentes na Alta de Coimbra. A entrevista semiestruturada e a observação direta foram os instrumentos selecionados para aprofundar as vivências dos participantes. No que respeita ao tratamento dos dados recorremos à técnica da análise de conteúdo, com base em Bardin, que nos permitiu captar a singularidade de cada sujeito, sem descurar a totalidade das observações. No final concluiu-se que os sujeitos entrevistados vivenciam a transição para a reforma de maneiras distintas, reforçando assim a heterogeneidade deste grupo, e que são dotados de um capital social e económico que urge potencializar, quer no seio da sociedade civil, quer de forma específica no âmbito da Gestão de Recursos Humanos. / This study aims to understand if, after they retire, the elderly continue to get involved in areas like economy, formal and informal, and sociability, analyzing in detail the feeling of loneliness. Bearing in mind the different theories about the elderly’s social and economic contribution, the goal was to empirically understand the attitude of these individuals towards their transition to retirement, and to see how they perceive themselves and their role in productivity and sociability. The sample was intentional (N=30) and has included people aged sixty five and over sixty five, who have been retired for at least one year, and living in Alta de Coimbra. The semisstructured interview and direct observation were used to know the participants’ way of live. In what comes to data processing, we followed the content analysis technique, based on Bardin, which allows us to capture the singularity of each individual, without forgetting the whole set of observations. In the end we have concluded that the interviewed individuals live the transition into retirement in different ways, thus reinforcing the heterogeneity of this group and their social and economic capital, which needs to be put to use, both in civil society and more specifically in the sphere of the human management resources.

Aspectos sociais e de saúde de portadores da coinfecção hiv/tuberculose

Objetivou-se avaliar os aspectos sociais e de saúde e a percepção diante do diagnóstico de indivíduos com a coinfecção HIV/tuberculose. Estudo descritivo, com abordagem quantiqualitativa, realizado em hospital de referência em Fortaleza, Ceará, de janeiro a abril de 2009, utilizando-se entrevista semiestruturada em ambiente privativo. Os dados foram analisados de modo descritivo e por análise de conteúdo. Participaram 16 pacientes com coinfecção HIV/tuberculose, 56,25% do sexo masculino, com faixa etária predominante entre 31 a 39 anos (43,75%), com pouca escolaridade e renda familiar mensal de aproximadamente um salário mínimo. A forma predominante da apresentação da tuberculose foi a pulmonar (62,50%). A percepção sobre a descoberta da coinfecção foi demonstrada por duas categorias: Medo e angústia face ao diagnóstico e Mudanças nos hábitos de saúde e no estilo de vida. Urge, diante dos achados, a promoção do bem-estar psicológico e físico desses pacientes, por meio de ações políticas e de saúde

European student mobility and intercultural learning at a portuguese university

The purpose of this study is to understand, impact and evaluate the development of intercultural communicative competencies among European credit-seeking exchange students and other sojourners through purposeful intercultural pedagogy. This pedagogy encompasses intentional intercultural- educational approaches which aim to support and enhance sojourners’ intercultural learning throughout the study abroad cycle (pre-departure, in-country and reentry phases). To test and validate these pedagogies a 20-hour intervention was designed and implemented among two cohorts of 31 sojourners during the in-country phase of their sojourn in Portugal. The process to develop and validate the intercultural intervention was driven by a mixed-methods methodology which combined quantitative and qualitative data to triangulate, complement and expand research results from a pragmatic stance. The mixed methods research design adopted is multi-phased and encompasses a multi-case study and an evaluative component. The multi-case component is embodied by sojourner cohorts: (1) the primary case study involves 19 incoming students at the University of Aveiro (Portugal) as participants in the European exchange program Campus Europae; (2) the second case study comprises three incoming Erasmus students and nine highly skilled immigrants at the same university. All 31 sojourners attended two intermediate Portuguese as Foreign Language classrooms where the intervention was employed. Data collection was extensive and involved collecting, analyzing and mixing quantitative and qualitative strands across four research phases. These phases refer to the: (1) development, (2) implementation and (3) evaluation of the intervention, as well as to (4) a stakeholder analysis of the external value of the intervention and of the Campus Europae program. Data collection instruments included pre and posttest questionnaires and semi-structured interviews. Results confirm the intercultural effectiveness of the intervention and the positive impact upon research participants’ intercultural gains. This impact was, however, greater in case study 2. Among explanatory variables, three stand out: (1) participant meaning-making abilities, (2) host language proficiency and related variables, and (3) type of sojourn or exchange programs. Implications for further research highlight the need to systematize purposeful intercultural pedagogy in sojourner populations in general, and in European credit student mobility in particular. In the latter case, these pedagogies should be part of the design and delivery of credit-bearing exchange programs in pre- departure, in-country and re-entry phases. Implications for practice point to the urge to improve intercultural practices in: macro (higher education institutions), mezzo (exchange programs) and micro (sojourner language classrooms) contexts where this research took place, and wider social scenarios they represent.

Conceção de um sistema informático de gestão do pessoal do ISCED – Cabinda

Com um aumento significativo dos dados nos setores empresariais, urge a necessidade de criar formas de facilitar o seu tratamento para um ganho do tempo na execução das atividades, garantindo uma maior eficiência dos sistemas e também proporcionando a maximização do lucro às empresas, quando for esse o caso. O sucesso de uma empresa depende bastante dos seus recursos humanos e estes, constituem o seu “instrumento” mais importante. É (ou seria) das pessoas que a empresa define ações estratégicas, constituindo ganhos de diversas naturezas (de conhecimento, de marca, económicas ou financeiras). O objetivo principal desta dissertação é permitir que a instituição universitária ISCED – Cabinda se adapte ao potencial digital pelo recurso às tecnologias de informação e comunicação, no contexto da sua gestão de Recursos Humanos. Em consequência, a instituição beneficiará com a maior facilidade e rapidez do acesso à informação e a facilidade na atualização dos dados do sistema. Uma vez automatizado, o sistema poderá facilitar o acesso aos dados a fim de responder a uma determinada necessidade que possa existir, independentemente de estar prevista ou não (tornando o sistema mais flexível e adaptável a novas realidades). Com uma Base de dados, far-se-á o cadastro dos dados dos funcionários da instituição fazendo assim evoluir a gestão de Recursos Humanos e proporcionando a busca de informação relativa a um determinado funcionário de uma forma fácil, rápida, precisa, fiável e coerente. Recorrendo ao desenvolvimento de uma aplicação móvel baseada na arquitetura cliente-servidor, as operações de consultas (adicionar, modificar, eliminar), ficam facilitadas e permitem ainda uma maior exploração de dados. A apresentação de uma aplicação móvel para a consulta no âmbito da gestão de Recursos Humanos é complementada com uma agenda de trabalhos a serem desenvolvidos para garantir a proposta de um sistema de gestão de Recursos Humanos para o ISCED.