Violência como objeto da assistência em um hospital de trauma : o "olhar" da enfermagem

Este estudo trata da violência sob o olhar das trabalhadoras de enfermagem no cuidado aos pacientes hospitalizados vítimas de violência, em um hospital de pronto socorro em trauma. O Hospital de Pronto Socorro de Porto Alegre / HPS – RS atende pacientes vítimas de trauma de toda a região metropolitana e do interior do Estado. As internações decorrentes da violência, nos últimos anos, representam um aumento significativo na demanda dos atendimentos e internações. O estudo tem como objetivo geral conhecer e compreender o modo de olhar e o fazer das trabalhadoras de enfermagem no cuidado ao paciente vítima de violência, hospitalizado nesse serviço. Para tanto, se propõe caracterizar, do ponto de vista sociodemográfico e epidemiológico, o paciente hospitalizado no HPS por violência. Apóia-se na tipologia dos estudos híbridos que articulam bases teóricas e metodológicas de múltiplas origens e quantificações associadas a dados qualitativos. As unidades de internação do HPS são o campo de estudo. Os sujeitos são os pacientes hospitalizados por traumas decorrentes de violência, no período de janeiro a junho de 2001, e as trabalhadoras de enfermagem desse hospital Entre os resultados encontraram-se 697 pacientes hospitalizados, nesse período, vítimas de violência; 90,5% do sexo masculino; 73% brancos e 27% negros ou descendentes dessa etnia; 59% da faixa etária dos 20 aos 39 anos; a faixa etária dos 11 aos 39 anos corresponde a um percentual de 78,9% das internações; 47,9% agredidos por arma de fogo, 26,5% por arma branca, 25% vitimas de agressão física 0,3% foram vítimas de estupro. Entre os diagnósticos mais freqüentes encontram-se trauma abdominal, trauma torácico, traumatismos múltiplos, traumatismo crânio encefálico. 59.5% (415) são procedentes de Porto Alegre, e os bairros mais freqüentes são Partenon, Lomba do Pinheiro e Cristal. Em relação ao “olhar” da enfermagem no cuidado a esse paciente ficou evidente a preocupação das trabalhadoras e a dificuldade desse enfrentamento, visto que, no hospital, não existem estratégias definidas em relação à violência, num âmbito mais amplo, além do tratamento da lesão causada pelo trauma. Cada trabalhadora lida com esse cuidado da forma que acredita ser a mais adequada e utiliza as estratégias que dispõe para suportar e enfrentar essa realidade. Além disso, os serviços públicos de saúde necessitam se auto-avaliar e propiciar a criação de espaços e co-responsabilizar-se nesse processo.

Efeito do trans-resveratrol sobre a longevidade e o metabolismo de glicogênio de Drosophila melanogaster em diferentes idades

O trans-resveratrol é uma fitoalexina natural encontrada em uvas, amoras, amendoim e muitas espécies de plantas. Em uvas o trans-resveratrol é responsável pela proteção natural contra doenças e sua concentração depende da origem geográfica, da variedade e dos métodos de fabricação do vinho; sendo considerado por muitos autores como um geroprotetor. O objetivo do presente trabalho foi verificar o efeito do transresveratrol na longevidade e no metabolismo de carboidratos (glicogênio, atividade e expressão da enzima glicogênio fosforilase - GFT) de Drosophila melanogaster em diferentes idades (0, 7, 14, 18 e 21 dias). Para a análise da longevidade espécimes de D. melanogaster com idade de 10 dias foram colocados em vidros contendo meio de cultura padrão acrescido de água ou dimetilsulfóxido (DMSO) 0,03%, ou trans-resveratrol nas concentrações de 1, 10 ou 20μM para ovoposição durante 24 horas, a prole recebeu os seus respectivos tratamentos durante toda a vida. Para as análises do metabolismo de glicogênio os espécimes de D. melanogaster foram colocados em meio de cultura padrão adicionado de água ou dimetilsulfóxido 0,03% (DMSO) ou ainda, trans-resveratrol na concentração de 1μM dissolvido em DMSO (0,03%) para ovoposição; seus ovos foram mantidos até a eclosão, durante a fase adulta os animais continuaram a receber os seus respectivos tratamentos até os pontos em que foram feitas as determinações bioquímicas e moleculares. Os resultados indicam que o tratamento com trans-resveratrol modulou o metabolismo de carboidratos em fêmeas e em machos de forma diferenciada; contudo, este composto não foi capaz de alterar a expressão gênica da GFT. Nas fêmeas tratadas com trans-resveratrol 1μM verificou-se um aumento de 127% na longevidade quando comparado ao grupo controle. Já nos machos tratados com trans-resveratrol 1μM observou-se um acréscimo de 50% na longevidade quando comparado ao grupo controle. Em ambos sexos tratados com Trans-resveratrol 10 e 20μM não houve aumento significativo da longevidade. Com base nos resultados podemos sugerir que o trans-resveratrol como outros antioxidantes descritos na literatura tem seus efeitos benéficos na menor dose administrada, podendo nas doses mais elevadas estar atuando como um pró-oxidante. Os resultados obtidos sugerem que o trans-resveratrol modula o metabolismo do glicogênio tanto em machos como em fêmeas e aumenta a longevidade do modelo experimental testado.

Entre serras e sertões A(s) (trans)formaç(ões) de centralidade(s) da Região Metropolitana do Cariri/CE

This study reviews the spatial configuration from the road network of an urban compound formed by the cities of Crato, Juazeiro do Norte and Barbalha (the Crajubar - core of the Cariri metropolitan region, in the State of Ceará, Brazil), in order to establish nexus (or relations) between different levels of accessibility and the formation/ transformation and specialization of centralities in local and metropolitan scales. Stemming from the Social Logic of Space theoretical and operational apparatus, the study explores modeling possibilities (with axial lines, segments and lines of continuity) which is then confronted to empirical observations concerning movement flows and land use, within a Geographic Information System database. At different scales of analysis, the results suggest evidences of continuity were found in the permanence of intra-urban centres and sub-centres within each town, whereas evidences of change pointed out to the formation of a new centrality of metropolitan magnitude in the neighbourhood referred to as the Triângulo, in the municipality of Juazeiro, where high levels of topological accessibility coincides with the appearance of new business buildings as well as with the emergence of urban equipment of a scale more adequate to meet a regional demand

Avaliação da gravidade do trauma em condutores de motocicleta vítimas de acidentes de trânsito no Rio Grande do Norte

Descriptive exploratory study, prospective, with quantitative approach, performed on the Monsenhor Walfredo Gurgel Hospital Complex (MWGHC), in Natal/RN, aiming to identify injuries by body area and wound severity on drivers who suffered motorcycle accidents, evaluate the severity of injuries and trauma on these drivers and identify the existence of association between wound and trauma severity and some of the accident s characteristics. The population comprised 371 motorcycle drivers, with data collected between October and December 2007. We used as instruments the Abberviated Injury Scale (AIS), Injury Severity Score (ISS) and the Glasgow Coma Scale (GCE1). The results show that, concerning characterization, there was a predominance of the male gender (88.4%), aged between 18 and 24 years (39.90%), originating from the Natal metropolitan region (55.79%), with fundamental-level instruction (51.48%), catholic (75.78%), married (47.98%). 23.18% work on commerce-related activities and 75.20% have income of up to 2 minimum wages. As for the accident s characteristics, the predominant shift was the afternoon (46.36%), received up to one hour after the event (50.67%), transported by countryside ambulances colleagues and relatives (51.21%), 25.34% had the accident on Sunday; 53.91% suffered falls and vehicle rolls; among the collisions there was a predominance of the motorcycle-automoblie type (28.03%); 52,6% were licensed and among these 50.76% had up to one year of license; 65.50% declared not having suffered previous accidents; 65.77% declared waring helmets in the time of the accident; 57.41% said not to have used drugs, and among those who used, alcohol was the most consumed (98.10%). The lowest score evaluated by GCS1 (3 to 8) was linked to drivers who suffered accidents on Saturday (10.3%), those who were not wearing helmets (14.29%) and the victims of motorcycle-pedestrian/animal crashes (13.33%). The body areas most affected had AIS between 1 and 3 (95.76%) and were: external surface (39.90%) and head/neck (33.20%). As for trauma severity, the highest scores (ISS>25) belonged to those who consumed alcohol (30.73%), suffered falls or vehicle rolls (48.9%) and those attended to 3 hours or longer after the accident (50%). We conclude that for motorcycle drivers who suffered accidents, age, gender, weekday, type of accident, use of drugs and the absence of helmet use signal both to the risk of occurrence of these events, as well as for the greater severity of injuries and trauma.

Caracterização do acidente de trânsito e gravidade do trauma: um estudo em vítimas de um hospital de emergência de Natal

Descriptive exploratory study, with quantitative approach and prospective data performed on the Monsenhor Walfredo Gurgel Hospital Complex (MWGH), in Natal/RN, aiming to classify the type of motor vehicle involved in the accident, the public roadway s user quality and the more frequent injuries; to evaluate the severity of trauma in traffic accident victims; characterized the severity of the injuries and the trauma, and the type of motor vehicle involved. The population comprises 605 traffic accident victims, with data collected between October and December 2007. We used as a support for the evaluation of severity of injuries and trauma the Glasgow Coma Scale (GCSl), the Condensed Abbreviated Injury Scale (CAIS) and the Injury Severity Score (ISS). The results show that 82.8% of the victims were male; 78.4% were aged 18 to 38; the victims originating from the State s Countryside prevailed (43.1%); 24.3% of the population had completed middle-level instruction; 23.1% worked on commerce and auxiliary activities; most (79.4%) was catholic; 48.8% were married/consensual union; 76.2% earned up to two monthly minimum wages; Sunday was the day with the most accidents (25.1%); 47.4% were attended to in under an hour after the event; the motorcycle on its own was responsible for 53.2% of the accidents; 42.3% were attended to by the SAMU; 61.8% were victims of crashes; over half (53.4%) used individual protection equipment (IPE); 49.4% were helmets and 4.0% the seatbelt; 61.3% were motorcycle drivers; 43.3% of the accidents took place in the afternoon shift; from 395 drivers, 55.2% were licensed, and 50.7% among those had been licensed for 1 to 5 years; 90.7% of the victims had GCS1 between 13 and 15 points at the time of evaluation; the body area most affected was the external surface (35.9%); 38.8% of the injuries were light or moderate (AIS=1 and AIS=2); 83.2% had light trauma (ISS between 1 and 15 points). In face of the results, we can conclude that there is a risk for the elevation of injury severity and trauma resulting from traffic accidents, when these events are related to certain variables such as gender, age, weekday, the interval between the accident and the first care, ingestion of drugs, type of accident, the public roadway s user quality, the use of IPE, day shift, body regions and the type of motor vehicle involved in the accident

Trauma em idosos atendidos pelo serviço pré-hospitalar móvel

O The aim of this study was to characterize the occurrence of trauma in the elderly population served by the mobile pre-hospital service, in Natal, Rio Grande do Norte. This is a descriptive, transversal and quantitative approach and whose population consisted of 2,080 trauma victims. The sample, of systematic random type, consisted of 400 elderly people, aged from 60 years old, assisted by the Office of Mobile Emergency in Natal / RN, between January 2011 and December 2012. Data collection began after consent and assent of the institution of a Research Ethics Committee under No. 309 505. It was proceeded to documentary retrospective analysis of records of this service through a form of self-development, validated by expert judges considered reliable (α> 0.75) and valid (CVI = 0.97) in their clarity and relevance. Data were tabulated by the Statistical Package for Social Sciences, version 20.0. The results show that older victims have an average age of 74.19 years old, with a prevalence of female involvement by chronic diseases, especially hypertension, average usage of 2.2 routine medications with vital signs within normal limits. The trauma prevailed during the daytime, in the residence of the victims, north of the city and on weekends. Among the mechanisms of trauma were falls, traffic accidents and physical aggression, whose most common type was brain-cerebral trauma and the main consequences were suture wounds and closed fractures. Basic Support Units were as more driven to pre-hospital care (87.8%) and the main destination place consisted of a referral hospital for emergency of the state (57.5%). Among the most commonly performed procedures by nursing staff immobilization with rigid board and neck collar and the peripheral venipuncture, and the main component used for volume replacement to saline were highlighted. There was a significant relationship between the deaths and the mechanism of injury, mechanism of injury and procedures, except medication administration procedures carried out, except immobilization and unit for service. It is highlighted the prevalence of trauma in the elderly, poor follow-up Pre-Hospital Trauma Life Support protocol and the paucity of records and nursing procedures performed. There is need for a protocol of care specific to elderly trauma victims and education strategies for the prevention of such events

Antimycobacterial and antitumor activities of Palladium(II) complexes containing isonicotinamide (isn): X-ray structure of trans-[Pd(N-3)(2)(isn)(2)]

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Existência e liberdade: a trans-descendência extática da vida no livro A religião e o nada de Nishitani Keiji

The dialog between the East philosophy and the Western thinking allow us to think the problems inherent to our time from several point of views. Nishitani Keiji, from the Kyoto School, sees the contemporaneity, or the time of the technic, for Heidegger, as derivation and as an immediate consequence of perspective introduced in the modern era form the Cartesian s cogito which creates a barrier that separates man and world. Scientific thinking that dominates our era was created from the thinking that ennobles human reason to the detriment of the others things in the world, determining that the knowledge just can be produced by the man himself and his set of rational powers. However, alerts us Nishitani, this point of view derived from modern thought which imposes subjectivity egocentric type besides not apprehend things in their truth, neither achieves the true self of man. In an attempt to overcome the abuses produced in modernity and that reverberates in our way of be until today, our philosopher will propose the point of view of the nothingness (śūnyatā) as a way to trans-descendance, that is, to overcome the traditional thinking overvalues the reason for the encounter with the original face of man, which by no longer impose its cognitive power can know all things in their true, in the tathatā

Analysis of natural cis- and trans-polyisoprene mixtures by near-infrared spectrophotometry

Natural trans- and cis-polyisoprenes and mixtures of these polymers were analysed by near-infrared spectrophotometry. The relative absorptivity data versus the amount of isomers in synthetic mixtures showed a non-linear behaviour. The results are compared with literature data from polyisoprenes extracted from other vegetal species. (C) 2000 Elsevier B.V. Ltd. All rights reserved.