Terapia comportamental no controle da incontinência urinária da mulher idosa: uma ação de enfermagem na promoção do autocuidado

A incontinência urinária gera implicações negativas nos âmbitos emocional, social e econômico tanto para o indivíduo incontinente, como para seus cuidadores. A terapia comportamental é uma das abordagens não-invasivas para a incontinência urinária. A terapia comportamental é realizada durante as consultas de enfermagem e a atuação do enfermeiro consiste na aplicação de um protocolo de orientações sobre hábitos de vida, medidas de controle da micção, treinamento para realização do diário miccional, treinamento de exercícios perineais e avaliação da resposta da paciente à terapia. O estudo tem como base teórica a Teoria do autocuidado de Dorothea Elisabeth Orem, pois a terapia comportamental visa instrumentalizar o indivíduo a realizar práticas de autocuidado a partir do protocolo de atendimento do ambulatório. O objetivo da pesquisa é avaliar a efetividade da terapia comportamental aplicada pelo enfermeiro para o controle miccional e melhora da qualidade de vida da mulher idosa. Trata-se de um ensaio clínico não-controlado.40 Foram incluídas no estudo mulheres acima de 60 anos que participam do Ambulatório do Núcleo de Atenção ao Idoso com a queixa clínica de perda involuntária de urina encaminhadas para o ambulatório de urogeriatria. A população estudada foi composta por 13 participantes. Os dados da pesquisa foram coletados a partir dos instrumentos de avaliação do ambulatório de urogeriatria que foram arquivados nos prontuários das pacientes: o diário miccional, avaliação de enfermagem na terapia comportamental e o questionário sobre qualidade de vida em mulheres com incontinência urinária chamado de Kings Health Questionnaire. Estes instrumentos foram aplicados antes e depois da terapia comportamental. Foram colhidos dados das pacientes acompanhadas no ambulatório durante o período de abril de 2011 a junho de 2012. Os resultados foram que após a terapia comportamental todas as idosas responderam que ingerem líquidos no período diurno, 92,30% das idosas responderam que estabeleceram um ritmo miccional de 2/2 horas ou de 3/3 horas. Sobre o parâmetro miccional perda de urina ao final da terapia comportamental 75% das idosas apresentaram ausência de perda de urina. Além disso, após a terapia comportamental nenhuma das pacientes teve perda de urina durante a realização dos exercícios e 92,30% apresentaram contração eficiente dos músculos perineais. Deste modo, esta pesquisa demonstrou que as idosas que participaram da terapia comportamental obtiveram melhora do controle urinário e da qualidade de vida. A terapia é um sistema que sofre retroalimentação à medida que o paciente adere às práticas de autocuidado e o enfermeiro reforça as orientações a fim de atingir o objetivo maior que é a sensação de bem estar. A teoria de Dorothea Orem se adequou bem ao estudo, pois a terapia comportamental permitiu aos idosos a assumirem responsabilidade com o seu corpo e se empenharem efetivamente para melhorar a sua condição de saúde e qualidade de vida.

Long-Term Burden and Respiratory Effects of Respiratory Syncytial Virus Hospitalization in Preterm Infants — The SPRING Study

The health status of premature infants born 32(1)-35(0) weeks' gestational age (wGA) hospitalized for RSV infection in the first year of life (cases; n = 125) was compared to that of premature infants not hospitalized for RSV (controls; n = 362) through 6 years. The primary endpoints were the percentage of children with wheezing between 2-6 years and lung function at 6 years of age. Secondary endpoints included quality of life, healthcare resource use, and allergic sensitization. A significantly higher proportion of cases than controls experienced recurrent wheezing through 6 years of age (46.7% vs. 27.4%; p = 0.001). The vast majority of lung function tests appeared normal at 6 years of age in both cohorts. In children with pulmonary function in the lower limit of normality (FEV1 Z-score [-2; -1]), wheezing was increased, particularly for cases vs. controls (72.7% vs. 18.9%, p = 0.002). Multivariate analysis revealed the most important factor for wheezing was RSV hospitalization. Quality of life on the respiratory subscale of the TAPQOL was significantly lower (p = 0.001) and healthcare resource utilization was significantly higher (p<0.001) in cases than controls. This study confirms RSV disease is associated with wheezing in 32-35 wGA infants through 6 years of age.

A influência das políticas de saúde nos indicadores gerados pelo sistema de informações hospitalares do SUS

O uso das informações e indicadores provenientes do Sistema de Informações Hospitalares do SUS (SIH/SUS), tanto para análise de situação de saúde da população como para análise do desse, SUS, é cada vez mais frequente. Tal sistema é, desde sua concepção, fortemente influenciado pelas políticas públicas na área de atenção à saúde, como as definidas pelas Normas Operacionais e os incentivos e restrições a determinadas práticas. Alterações na operação do sistema introduzem descontinuidades e vieses nas informações, provocando eventuais imprecisões ou mesmo distorções nos resultados da extração de dados do sistema. Para que se possa avaliar o resultados de políticas, a situação da assistência à saúde ou as condições de saúde de uma população, é necessário, portanto, que se tenha uma visão clara e objetiva de quais informações são disponíveis, a sua evolução e como utiliza-las, considerando devidamente as influências exógenas e endógenas do sistema. O presente estudo está estruturado de acordo com o contexto do Sistema de Informações Hospitalares. Como componente da Previdência Social, é estudada a criação do Sistema de Assistência médico-Hospitalar da Previdência Social (SAMHPS), as suas origens e seus eixos estruturantes, assim como a sua expansão para a rede filantrópica e de ensino, com a ampliação de sua cobertura. Já no contexto do Sistema Único de Saúde (SUS), é estudada a incorporação do SAMHPS ao SUS, levando à criação do SIH/SUS, com a expansão para a rede pública e a sua universalização. A influência das políticas de saúde é analisada a partir da implantação de incentivos e restrições que afetam a assistência hospitalar e seu reflexo nas informações do SIH/SUS. A forma de categorização e a identificação dos prestadores são também examinadas, tendo em vista a sua importância na análise e determinação de políticas de saúde. Outro aspecto que é analisado é a forma de apropriação das informações do diagnóstico que levou à internação: a adoção da 10 Revisão da Classificação Internacional de Doenças, o caso específico das causas externas e a implantação da Tabela de Compatibilidade entre Procedimentos e Diagnósticos. Para identificar as mudanças políticas e operacionais do SUS, da regulamentação da assistência hospitalar e do SIH/SUS, foi pesquisada sua legislação Leis, Decretos, Normas Operacionais, Portarias, Instruções e Manuais. O relacionamento entre as informações e as políticas é analisado identificando a implantação destas políticas e verificando o efeito sobre os indicadores da assistência hospitalar obtidos do SIH/SUS. Como conclusão, foi visto que análises que utilizem as séries históricas devem, obrigatoriamente, levar em consideração as modificações, tanto do SUS como do SIH/SUS, para que possam chegar a conclusões mais precisas. Descontinuidades nas séries históricas efetivamente mostram modificações das políticas e da operação do sistema. A facilidade de acesso, a disponibilidade, a oportunidade e rapidez de atualização das informações do SIH/SUS são fatores positivos do sistema; é possível analisar o efeito de determinada ação pouco após a sua implantação. A análise das informações do diagnóstico denota a necessidade de treinamento dos codificadores no uso da CID-10 em morbidade e de uma ampla revisão da Tabela de Compatibilidade entre Diagnóstico Principal e o Procedimento Realizado.

Presenteísmo na enfermagem: repercussões para a saúde do trabalhador e a organização hospitalar

O presente estudo tem como objeto o presenteísmo em trabalhadores de enfermagem e as repercussões para a saúde do trabalhador e para a organização do trabalho. Considerando a natureza do objeto e as questões norteadoras, elaboraram-se os seguintes objetivos: Identificar a visão dos trabalhadores de enfermagem de um hospital geral sobre o presenteísmo na enfermagem; descrever os fatores que contribuem para o presenteísmo em trabalhadores de enfermagem de um hospital geral; e analisar as repercussões do presenteísmo para a saúde do trabalhador de enfermagem e para o processo de trabalho hospitalar. O estudo foi aprovado pelo Comitê de Ética em Pesquisa e protocolado com o número 419.673. Optou-se pelo método qualitativo do tipo exploratório e descritivo. O campo foi um hospital universitário situado no município do Rio de Janeiro. Participaram do estudo 39 trabalhadores de enfermagem (vinte e cinco técnicos de enfermagem e quatorze enfermeiros) lotados nas unidades de internação clínica. Na coleta dos dados, trabalhou-se com a técnica de entrevista do tipo semiestruturada mediante um roteiro, sendo os dados obtidos no mês de dezembro de 2013. Na caracterização dos entrevistados, utilizou-se um instrumento autoaplicado. No tratamento dos depoimentos recorreu-se à análise de conteúdo do tipo temática, que apontou os seguintes resultados: os participantes do estudo identificaram o presenteísmo no ambiente laboral, pelo fato de terem vários trabalhadores que comparecem ao serviço com problemas de saúde crônicos e agudos, que afetam a dinâmica e a qualidade do serviço ofertado. Diante desta realidade laboral, os trabalhadores se posicionam no sentido de manter a coesão grupal e acolher o trabalhador. No entanto, existe insatisfação por parte do grupo por se sentir sobrecarregado diante das demandas dos pacientes e demais atividades, sendo a qualidade do serviço afetada. Sobre os fatores que contribuem para o presenteísmo, identificou-se a precarização da força de trabalho, o comprometimento profissional com a instituição e os aspectos psicossociais; ou seja, fatores externos ao trabalho. Quanto às repercussões do presenteísmo para a saúde do trabalhador e o processo de trabalho, evidenciou-se que o presenteísmo é um fator que piora o estado de saúde do trabalhador, com necessidade de afastamento temporário do posto de trabalho e procura por atendimento médico durante o expediente. Como não há substituição de pessoal, a equipe tem de se reorganizar para atender as demandas de cunho técnico e assistencial, gerando conflitos no grupo. Conclui-se que, na visão dos trabalhadores o presenteísmo além de contribuir para a piora do estado de saúde do trabalhador, afeta negativamente o relacionamento interpessoal e a qualidade do serviço ofertado. Há necessidade de se diagnosticar e monitorar as condições de saúde dos trabalhadores por parte do Serviço de Saúde Ocupacional, através de exames admissionais e periódicos, de modo que sejam garantidos tratamento e acompanhamento adequados ao estado de saúde. Ratifica-se a relevância de condições de trabalho adequadas e que não exponham ainda mais os trabalhadores aos riscos presentes no ambiente laboral. Recomenda-se a continuidade de estudos sobre o presenteísmo tendo em vista o atual modelo neoliberal e o processo de precarização da força de trabalho no setor saúde.

Desigualdade socioeconômica e obesidade abdominal: uma apreciação crítica e pragmática em epidemiologia.

Esta dissertação buscou uma apreciação crítica e pragmática da relação entre desigualdade socioeconômica e obesidade abdominal, em resposta a proposição internacional de monitoramento das desigualdades em saúde e a escassez de estudos desta natureza relativos à obesidade abdominal. Dois artigos foram elaborados a fim de estimar o grau de desigualdade educacional na ocorrência de obesidade abdominal e revisar os estudos de associação entre posição socioeconômica e obesidade abdominal. O primeiro artigo utilizou o índice angular de desigualdade e o índice relativo de desigualdade em dados seccionais de 3.117 participantes da linha de base do Estudo Pró-Saúde, 1999-2001, e o segundo artigo abarcou os resultados de estudos conduzidos em população adulta no Brasil. Os índices de desigualdade resumiram a tendência monotônica e inversa observada entre escolaridade e obesidade abdominal na população feminina, proporcionando estimativas quantitativas desta desigualdade (artigo 1). Em concordância, observou-se que a associação entre indicadores de posição socioeconômica e obesidade abdominal foi majoritariamente inversa entre as mulheres, principalmente com relação à escolaridade, e estatisticamente não significativa entre os homens (artigo 2). Tal cenário epidemiológico evidencia que a obesidade abdominal tem afetado desproporcionalmente as mulheres de posição socioeconômica mais baixa e que a desigualdade de gênero na prevalência de obesidade abdominal tende a aumentar com menor posição socioeconômica. Em suma, a presente dissertação visou à produção de conhecimento epidemiológico relevante ao enfrentamento das desigualdades em saúde, com o objetivo premente de subsidiar políticas públicas de fato realizáveis e individualmente aceitáveis.

Desigualdade socioeconômica e obesidade abdominal: uma apreciação crítica e pragmática em epidemiologia.

Esta dissertação buscou uma apreciação crítica e pragmática da relação entre desigualdade socioeconômica e obesidade abdominal, em resposta a proposição internacional de monitoramento das desigualdades em saúde e a escassez de estudos desta natureza relativos à obesidade abdominal. Dois artigos foram elaborados a fim de estimar o grau de desigualdade educacional na ocorrência de obesidade abdominal e revisar os estudos de associação entre posição socioeconômica e obesidade abdominal. O primeiro artigo utilizou o índice angular de desigualdade e o índice relativo de desigualdade em dados seccionais de 3.117 participantes da linha de base do Estudo Pró-Saúde, 1999-2001, e o segundo artigo abarcou os resultados de estudos conduzidos em população adulta no Brasil. Os índices de desigualdade resumiram a tendência monotônica e inversa observada entre escolaridade e obesidade abdominal na população feminina, proporcionando estimativas quantitativas desta desigualdade (artigo 1). Em concordância, observou-se que a associação entre indicadores de posição socioeconômica e obesidade abdominal foi majoritariamente inversa entre as mulheres, principalmente com relação à escolaridade, e estatisticamente não significativa entre os homens (artigo 2). Tal cenário epidemiológico evidencia que a obesidade abdominal tem afetado desproporcionalmente as mulheres de posição socioeconômica mais baixa e que a desigualdade de gênero na prevalência de obesidade abdominal tende a aumentar com menor posição socioeconômica. Em suma, a presente dissertação visou à produção de conhecimento epidemiológico relevante ao enfrentamento das desigualdades em saúde, com o objetivo premente de subsidiar políticas públicas de fato realizáveis e individualmente aceitáveis.

Saline-saturated DMSO-EDTA as a storage medium for microbial DNA analysis from coral mucus swab samples

The mucus surface layer of corals plays a number of integral roles in their overall health and fitness. This mucopolysaccharide coating serves as vehicle to capture food, a protective barrier against physical invasions and trauma, and serves as a medium to host a community of microorganisms distinct from the surrounding seawater. In healthy corals the associated microbial communities are known to provide antibiotics that contribute to the coral’s innate immunity and function metabolic activities such as biogeochemical cycling. Culture-dependent (Ducklow and Mitchell, 1979; Ritchie, 2006) and culture-independent methods (Rohwer, et al., 2001; Rohwer et al., 2002; Sekar et al., 2006; Hansson et al., 2009; Kellogg et al., 2009) have shown that coral mucus-associated microbial communities can change with changes in the environment and health condition of the coral. These changes may suggest that changes in the microbial associates not only reflect health status but also may assist corals in acclimating to changing environmental conditions. With the increasing availability of molecular biology tools, culture-independent methods are being used more frequently for evaluating the health of the animal host. Although culture-independent methods are able to provide more in-depth insights into the constituents of the coral surface mucus layer’s microbial community, their reliability and reproducibility rely on the initial sample collection maintaining sample integrity. In general, a sample of mucus is collected from a coral colony, either by sterile syringe or swab method (Woodley, et al., 2008), and immediately placed in a cryovial. In the case of a syringe sample, the mucus is decanted into the cryovial and the sealed tube is immediately flash-frozen in a liquid nitrogen vapor shipper (a.k.a., dry shipper). Swabs with mucus are placed in a cryovial, and the end of the swab is broken off before sealing and placing the vial in the dry shipper. The samples are then sent to a laboratory for analysis. After the initial collection and preservation of the sample, the duration of the sample voyage to a recipient laboratory is often another critical part of the sampling process, as unanticipated delays may exceed the length of time a dry shipper can remain cold, or mishandling of the shipper can cause it to exhaust prematurely. In remote areas, service by international shipping companies may be non-existent, which requires the use of an alternative preservation medium. Other methods for preserving environmental samples for microbial DNA analysis include drying on various matrices (DNA cards, swabs), or placing samples in liquid preservatives (e.g., chloroform/phenol/isoamyl alcohol, TRIzol reagent, ethanol). These methodologies eliminate the need for cold storage, however, they add expense and permitting requirements for hazardous liquid components, and the retrieval of intact microbial DNA often can be inconsistent (Dawson, et al., 1998; Rissanen et al., 2010). A method to preserve coral mucus samples without cold storage or use of hazardous solvents, while maintaining microbial DNA integrity, would be an invaluable tool for coral biologists, especially those in remote areas. Saline-saturated dimethylsulfoxide-ethylenediaminetetraacetic acid (20% DMSO-0.25M EDTA, pH 8.0), or SSDE, is a solution that has been reported to be a means of storing tissue of marine invertebrates at ambient temperatures without significant loss of nucleic acid integrity (Dawson et al., 1998, Concepcion et al., 2007). While this methodology would be a facile and inexpensive way to transport coral tissue samples, it is unclear whether the coral microbiota DNA would be adversely affected by this storage medium either by degradation of the DNA, or a bias in the DNA recovered during the extraction process created by variations in extraction efficiencies among the various community members. Tests to determine the efficacy of SSDE as an ambient temperature storage medium for coral mucus samples are presented here.

Poverty in the fisheries, inductors, causes and intervention

The study is prompted by the poverty that persisted among the fishing communities of lake victoria at time of considerable cash inflow into the fisheries development of fish processing industry. There has been need for understanding of the poverty and what strategies would be most appreciate for it's reduction.This study has attempted to respond to the needby identifying the nature and distribution of the poverty within the fisheries lake victoria,Uganda, the factor responsible for itand the options for poverty reduction intervention. The study examined the global and regional perspectives of poverty and wealth distribution, noting that wide disparities existed between the developed and the developing world and also between the developing countries themselves. A historical review of development policies and strategies revealed that while successive strategies were able to contribute to growth, their achievement towards poverty alleviation were less than satisfactory, hence the need for continually developing new strategies. A background to Uganda’s society and economy is provided, examining the demographic, political, environmental and economic conditions of the country. Uganda’s development strategies are reviewed, highlighting the role of the Poverty Eradication Action Plan, Uganda’s main strategy for implementing the policy of poverty reduction and wealth distribution. At the agricultural sector level, the Plan for the Modernisation of Agriculture has been formulated, followed by the National Fisheries Policy, aimed at providing a policy framework for the management and development of the fisheries. An appropriate definition of poverty was formulated, considered relevant to the situation of Lake Victoria. The dimensions of poverty included inadequate basic necessities, low education and health achievements, a sense of insecurity and exposure to risk. The research methodology was enhanced by the examination of the Lélé Model of the Poverty–Environmental Degradation problem, the World Bank Model of Poverty Causation and the subsequent Lake Victoria Model developed in this study. It has provided a plan for the research, the consideration of criteria and a data collection plan. The data collection instruments included secondary data search, key informant interviews and a sample survey based on a structured questionnaire. The study identified all the four dimensions of poverty in the fisheries, provided poverty profiles with respect to the different activities, groups of people and regions in the fisheries, based on consumption poverty. Among the people identified to be in poverty were the fishing labourers, fishers of Oreochromis niloticus and those operating with non-powered boats. In the post-harvest fisheries, large proportions of processors involved in salting and sun-drying, market stall and bicycle traders were in the poverty category. The ethnic groups most affected included the Samia, Basoga and Bakenye while the Districts of Jinja, Bugiri and Busia had the highest proportions of fishers in the poverty category. With respect to the other dimensions of poverty, the study showed that educational achievement was low within the fishing communities. The health status was poor, due mainly to the prevalence of malaria, diarrhoea, bilharzia and HIV/AIDS. There was a sense of insecurity within certain sections of the fishing community, due to leadership weaknesses within the local as well as the Government institutions. Some community members operated in a state of risk because they were vulnerable to episodes of income, health and education. The causes of poverty in fisheries included weaknesses within the institutional and social environment, limitations in the technology available to the poor, resource degradation and unfavourable economic factors. The recommendations of the study for poverty reduction included strengthening of policies, developing links, improving capacities and increasing resources, to be applied at the levels of Central Government, Local Government and of the community. In view of the achievements of the methodology used on this study, involving reference to the models, it is recommended that future research should build upon this model approach, as it will continue to produce results, especially when attempting to forecast changes relating to interventions.

Biogeochemical study of poly aromatic hydrocarbons (PAHs) and its physiological affection response in mudskipper (Boleophthalmus dussumieri) at coast of Khuzestan

Study on the biomarkers types to assess health status of marine ecosystems in environmental biomonitoring has an important value. Accordingly, accumulation of polycyclic aromatic hydrocarbons(PAHs) in sediment, water and tissues (liver and gill) of mudskipper(i.e. Boleophthalmus dussumieri) and some physiological responses like lysosomal membrane change performed on haemocytes, stability of red blood cell membrane and the Glutathione-S Transferase (GST) activity in the liver were measured in mudskipper. Samples were obtained from five sites along north western coast of the Persian Gulf (Khuzestan coast). Red blood cell membrane changes after different concentration of PAHs at different time was also studied to evaluate impact of PAHs compound on cell membrane. PAHs concentration was measured by HPLC method. The activity of GST enzyme was analysed by spectrophotometric method. Lysosomal membrane change was measured by NRR time method and stability of red blood cell membrane was evaluated by EOF test. Total PAH concentrations in the coastal sea water, the sediments, the liver and the gill tissues ranged between 0.80-18.34 μg/l, 113.50-3384.34 ng g-1 (dry weight), 3.99-46.64 ng g-1 dw and 3.11-17.76 ng g-1 dw, respectively. Highest PAHs pollution was found at Jafari while the lowest was detected at Bahrakan sampling sites. The lowest enzymatic activity was identified at Bahrakan (7.19 ± 1.541 nmol/mg protein/min), while the highest was recorded at Jafari (46.96 ± 7.877 nmol/mg protein/min). Comparative analysis of GST activity in the liver of mudskippers showed significant difference (p < 0.05) between the locations of Jafari and Bahrakan, and with other sites. Moreover, no significant difference was detected between the locations of Arvand, Zangi and Samayeli (p < 0.05). The mean RT was below 90 minutes in all sampling sites. Values of mean RT of the dye ranged from 34 (for the blood samples of mudskipper collected from Jafari site) to 78 minutes (for the blood samples of mudskipper collected from Bahrakan site). Spatial evaluation revealed the longest RT in fish from Bahrakan as compared with those from other sites. Preliminary results showed a significant difference (p < 0.05) among sampling sites except between Arvand and Zangi (p > 0.05). Osmotic fragility curves indicated that erythrocytes collected from mudskippers at Jafari were the most 009 fragile followed by Zangi> Arvand> Samayeli> and Bahrakan. The mean erythrocyte fragility was significantly higher at Jafari site (p < 0.05) when compared to other sites. Significant differences were found between the various sites (p < 0.05).The result indicated no significant differences between the control and treatments of mudskipper RBC exposed to field concentrations of PAHs (P>0.05). The results further indicated significant differences (P<0.05) between the control and treatments of mudskipper RBC exposed to acute. Potency Divisor concentrations. It is clear from the present result that chronic. Potency Divisor concentrations protect red cells against osmotic hemolysis. This study, however, showed that PAH concentrations in this region are not higher than the available standards. The findings showed that Lysosomal membrane destabilization, liver GST activities and fragility of red cell membrane are highly sensitive in the mudskipper, B. dussumieri. Thus, mudskipper perceived to be good sentinel organisms for PAH pollution monitoring. Sediment PAH concentrations were strongly correlated with biomarkers, indicating that PAH type pollutants were biologically available to fish. One of the possible risk assessment implications of this study is that biomarkers can be applied not only to characterize biological effects of pollution exposures, but also to determine the bioavailability of pollution in aquatic systems. The results also indicated that PAHs compound possess anti haemolytic property.

Investigation on the ecological impact of constructing and activities of petrochemical industries of petrochemical special economic zone of Mahshahr on the abundance and diversity of macrobenthic fauna in Jafari Creek, north-west of the Persian Gulf

The impact of Petrochemical Special Economic Zone (PETZONE) activities on the health status of Jafari Creek was studied by assessing the changes in macroinvertebrate assemblages in nine sites during September 2006- January 2008. Furthermore to evaluate the ecological status of the Jafari Creek the WFD indices (i.e. AMBI, M-AMBI) were used. The relationship between spatial pattern of macro invertebrate assemblages and ambient factors (i.e. water temperature, salinity, pH, dissolved oxygen, turbidity, electrical conductivity, total dissolved solid, total hardness, total nitrogen, ammonia, total phosphorous, chemical oxygen demand, biological oxygen demand, sediment grain size distribution, sediment organic content, heavy metals contents) was measured. Background Enrichment indices, Contamination factor and Contamination degree, were used to assess the health status in the study area based on Nickel, Lead, Cadmium and Mercury contents of the sediments. The macrobenthic communities had a low diversity and were dominated by opportunistic taxa, and the AMBI and M-AMBI indices need to be calibrated before using in Persian Gulf and its coastal waters. The BIO-ENV analysis identified pH, dissolved oxygen, TDS, and the total organic content of sediments as the major environmental variables influencing the infaunal pattern. This suggests that management should attempt to ensure minimal disturbance to environmental variables underlying the spatial variation in macroinvertebrate assemblages. Background Enrichment indices showed that the health of Jafari Creek has declined over time due to the constant discharge of heavy metals to the Creek system. Furthermore WQS index shows that the quality condition of the water column in Jafari Creek, regard to the calculated number (3) is week. These indices also identified a significant degree of pollution in the study area. The decrease in the ecological potential of Jafari Creek was best highlighted by the alteration in macrobenthic assemblages.

黄土高原丘陵沟壑区草地植物群落健康动态评价

植被恢复重建是遏制水土流失的有效措施之一,研究植被恢复重建过程、评价植物群落健康状况对加速植被建设具有重要的实践意义。本文根据黄土丘陵沟壑区的特点,建立了植物群落健康评价指标体系,对草地植被恢复重建过程中的不同阶段的植物群落的健康状况进行了评价。结果表明:植被群落活力变化过程呈抛物线型;群落组织力基本呈波动性变化;恢复力的变化则与活力变化过程相反,在群落活力达到最高水平时,群落的恢复力降至最低;土壤健康呈波动性上升的变化趋势。综合评价表明,植物群落健康水平随着演替过程的发展呈波动性且逐渐上升的变化过程。

本科实习男护生压力源、应对方式与心理健康关系的研究

Objectives:To investigate stressor and stress level,coping styles and mental health of male nursing undergraduates in clinical practice;To find out the factors that influence mental health of male nursing undergraduates in clinical practice and to put forward some suggestions to improve the mental health status of male nursing undergraduates. Methods: After doing many literaturere search both at home and abroad,I gather further consulting many nursing undergraduates in clinical practice,Finally I formulate the “Nursing Student's Clinical Stressor Scale”.80 male nursing ungraduates from Bengbu Medical Colledge were recruited. While 140 female nursing ungraduates who were in clinical practice in the same period of time were taken as a comparative group.The following questionnaire package including a background questionnair,Nursing Student's Clinical Stressor Scale NSCSS,Simplified Coping Style Questionnaire SCSQ,The Symptom Checklist 90 SCL-90 were distributed and collected together in the 14th week during the clinical practice.Of the 220 questionnaires were distributed and 198 were found to valid,the valid callback rate was 92%.The endudeed 77 were male and 121 were female .Statistices analysis was performed by SPSS13.0 and AMOS5.0 software. Results： 1.25% of male nursing undergraduates had a higher level of stress, mainly from employment,major,working nature,working contents and so on.Compared with female nursing undergraduates,male nursing undergraduates underwent a higher pressure in the employment and the profession aspect,but lower in their insufficient knowledge and ability.There was a significant negative correlation between the male undergraduates’ stress level and their satisfaction degree to clinical nursing teaching and the professional title of the clinical teachers,but it was positively correlated with their family monthly income. Stress level of female nursing undergraduates positively related with the number of children in their families,but negatively correlated with their family monthly income; 2.Male nursing undergraduates' coping style both positive and negative coping styles were adopted by male nursing undergraduates but mean at while positive coping styles.The positive coping styles adopted by male nursing undergraduates were significantly lower than that adopted by female nursing undergraduates; 3.The scores of depression,interpersonal sensitivity and anxiety in male nursing undergraduates were significantly higher than those of the nationwide youths norm.Alist all subscales scores of male nursing group were more than those of female nursing undergraduates except for fear subscale. Mental health of male nursing undergraduates was inversly correlated with the professional title of the clinical teachers and satisfaction of their majors; 4.Among male nursing undergraduates,the total score of stress and most subscale(except working nature and working contents,employment)scores of stress were positively correlated with the negative coping styles.The scores of stress level was positively correlated with the scores of SCL-90,Negative coping styles was positively correlated with the scores of SCL-90 among male nursing undergraduates,while positive coping styles were inversly correlated with most subscales(except phobic,paranoia,psychoticism)scores of SCL-90. Conclusions： 1.25% male nursing undergraduates have a higher level of stress,which is from employment, profession,working nature and working contents,financial difficulties and so on.The coping styles adopted by male nursing undergraduates were mainly positive coping styles.The mental health of male nursing undergraduates were lower; 2.Different genders have significant differences between stressors, coping style and mental health; 3.Stress,coping style,satisfaction degree to clinical nursing teaching and the professional title of the clinical teachers are predietors of mental health among male nursing undergraduates.

Centenarians and their hearts: a prospective registry with comprehensive geriatric assessment, electrocardiogram, echocardiography, and follow-up

Background Data on the cardiac characteristics of centenarians are scarce. Our aim was to describe electrocardiogram (ECG) and echocardiography in a cohort of centenarians and to correlate them with clinical data. Methods We used prospective multicenter registry of 118 centenarians (28 men) with a mean age of 101.5 ± 1.7 years. Electrocardiogram was performed in 103 subjects (87.3%) and echocardiography in 100 (84.7%). All subjects underwent a follow-up for at least 6 months. Results Centenarians with abnormal ECG were less frequently females (72% vs 93%), had higher rates of previous consumption of tobacco (14% vs 0) and alcohol (24% vs 12%), and scored lower in the perception of health status (6.8 ± 2.0 vs 8.3 ± 6.8). Centenarians with significant abnormalities in echocardiography were less frequently able to walk 6 m (33% vs 54%). Atrial fibrillation/flutter was found in 27 subjects (26%). Mean left ventricular (LV) ejection fraction was 60.0 ± 10.5%. Moderate or severe aortic valve stenosis was found in 16%, mitral valve regurgitation in 15%, and aortic valve regurgitation in 13%. Diastolic dysfunction was assessed in 79 subjects and was present in 55 (69.6%). Katz index and LV dilation were independently associated with the ability to walk 6 m. Age, Charlson and Katz indexes, and the presence of significant abnormalities in echocardiography were associated with mortality. Conclusions Centenarians have frequent ECG alterations and abnormalities in echocardiography. More than one fifth has atrial fibrillation, and most have diastolic dysfunction. Left ventricular dilation was associated with the ability to walk 6 m. Significant abnormalities in echocardiography were associated with mortality.

Nutrição Artificial nos Serviços Farmacêuticos Hospitalares

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

Nutrigenómica

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