Análise bioética do uso de artes expressivas no cuidado oncológico infantil em hospital público de Pernambuco

Dissertação (mestrado)—Universidade de Brasília, Faculdade de Ciências da Saúde, Programa de Pós-Graduação em Bioética, 2015.

La educación inicial en el cantón Sigsig de la provincia del Azuay: utilización de la metodología ambientes de aprendizaje

La investigación “Educación Inicial en el cantón Sígsig de la Provincia del Azuay: Utilización de la metodología Ambientes de Aprendizaje”, parte del reconocimiento de la Educación Inicial como una oportunidad para el ejercicio de Derechos de los niños y busca comprobar si la metodología implementada por el Ministerio de Educación se aplica con efectividad y permite el ejercicio de Derechos de los niños, tomando como referencia de análisis la visión de los Derechos Humanos desde el contexto. Inicia con una retrospectiva de la visión del niño, se acerca a las concepciones sobre el Pensamiento Crítico en relación con educación y acoge la visión de los Derechos Humanos desde el contexto definido como el conjunto de procesos que abren y consolidan espacios de lucha por la dignidad humana, para en base de ella, realizar el análisis de la realidad investigada y a partir de ello finaliza emitiendo conclusiones y recomendaciones.

Consideraciones críticas sobre el prestigio y la diginidad personal y profesional de los bibliotecarios

Esta ponencia expone unas reflexiones sobre el prestigio y la dignidad profesional de la bibliotecología en el estado de Nuevo León, México. Analiza y critica: a) la falta de categorías profesionales en Nuevo León en contraste con la UNAM; menciona también como varios bibliotecologos del IMSS Nuevo Leon lucharon porque se tipificara en el contrato colectivo la categoria de Bibliotecologo Profesional y cuya lucha ganaron; b) las actitudes represoras y dictatoriales por parte de las mafias administrativas y academicas de las principales universidades que no permiten la superacion de las amplias mayorias de bibliotecologos y que censuran la libertad de expresion y pensamiento en Nuevo Leon; c) aboga porque los bibliotecologos deban tener mistica de servicio como si se tratara de un "apostolado" en contra del "monetarismo" o "mercenarismo" que en la actualidad mueve a los bibliotecologos nuevoleoneses. En el aspecto gremial critica la charlataneria y oportunimo demagogico de gremios como los de AMBAC de Nuevo Leon, que se aprovechan de las ineptitudes de los gobiernos en todos los niveles en materia bibliotecaria y utilizan las desgracias naturales apelando a sentimentalismos de la gente solo para salir en la foto y en la prensa, pero sin analizar, criticar ni denunciar las fallas estructurales de fondo del Estado mexicano y de los tres niveles de gobierno. ABSTRACT This paper analyses some reflections about the professional prestige and dignity of librarianship in the state of Nuevo Leon, Mexico. It analyses and criticises: a) the lack of professional categories for librarians with B.A.s or Masters degrees in Nuevo Leon, in contrast, for example with Mexico’s National Autonomous University (UNAM); it also assesses how several librarians with B.A. undergraduate degrees from the Mexican National Institute of Social Security (IMSS) the national health service system) in the Nuevo Leon state-wide fought to obtain a Professional B.A. Undergraduate Degre Librarian Labor Cagegory status to be signed and included in the labor IMSS union collective contract and how eventually they won; b) it also criticises the repressive and dictatorial attitudes on the side of the top managerial and academic mafias from the major Nuevo Leon universities who do not allow free and equal academic and professional development opportunities of the vast majorities of librarians with or without B.A. degrees and whom also censor their freedom of expression and thought in Nuevo Leon librarianship; c) it advocates for librarians to have an honest service mystique as if they were doing a sort of "apostleship" against the "monetarist" and "mercenarist" practices that currently practice librarians in Nuevo Leon state. As for the library guild activities, it criticises the demogogical charlatanism and opportunism of guilds such as AMBAC (standing from the Mexico-wide Mexican Library Association, Nuevo Leon chapter), where their leaders only take advantage of the ineptitudes of the three levels of the Mexican government (municipal, state, and federal) on library issues, and they use the natural disasters against libraries or librarians by appealing to people’s sentimentalisms just to appear themselves in the picture and in the press, but without analysing, criticising and denouncing the deep structural faults underneath the Mexican State, and from all the three levels of the Mexican governments.

O Programa Idosos em Segurança: Estudo de Caso do Destacamento Territorial de Sintra

O presente relatório, intitulado “O Programa Idosos em Segurança: Estudo de Caso do Dter de Sintra”, baseia-se num estudo da análise do trabalho que é desenvolvido pelos militares do Destacamento Territorial de Sintra e tem a finalidade de avaliar o impacto e influência do Programa Idosos em Segurança na população adstrita a este Destacamento. O envelhecimento é uma realidade inevitável e que deve, cada vez mais ser preparada e antecipada, permitindo, a quem pretender participar na vida ativa da sua comunidade, que tal seja possível. Para aqueles que, não têm possibilidades de o fazer, deve garantir-se assegurada, em todas as situações a sua dignidade enquanto pessoa humana. O envelhecimento ativo é também uma temática abordada que carece de tratamento pela sua novidade e extrema relevância no contexto atual. Para que tais realidades sejam coincidentes é imperioso que o policiamento de proximidade se efetue e que se abram portas ao desenvolvimento das capacidades de resposta dos diferentes órgãos de apoio social e das Forças de Segurança. Para conseguirmos responder à Questão de Partida, formulámos quatro Questões Derivadas e consequentes Hipóteses que, através da sua verificação, validação ou refutação, nos permitiram responder às questões anteriormente levantadas. Foram realizadas Entrevistas e Questionários, que nos permitiram aceder às diferentes perspetivas que trabalham e são alvo deste Programa. A Guarda Nacional Republicana possui um grande reconhecimento junto das entidades externas e dos idosos com quem trabalha. Foram, no entanto, encontradas algumas falhas ao nível do efetivo, da formação, especialização e verificação do trabalho desenvolvido, a vários níveis. De salientar que muitas falhas são colmatadas pela boa capacidade de adaptação dos militares, o que evita que tais fragilidades afetem o serviço prestado e transpareçam para o exterior.

Aspectos de uma transição : a reconstrução do Direito Civil para um Direito Civil-Constitucional à luz da teoria dos sistemas, da tópica e da dignidade da pessoa humana

Dissertação (mestrado)—Universidade de Brasília, Faculdade de Direito, Programa de Pós-Graduação em Direito, 2016.

End of life management of adult patients in an Australian metropolitan intensive care unit : a retrospective observational study

Background Death in the intensive care unit is often predictable. End of life management is often discussed and initiated when futility of care appears evident. Respect for patients wishes, dignity in death, and family involvement in the decision-making process is optimal. This goal may often be elusive. Purpose Our purpose was to review the end of life processes and family involvement within our Unit. Methods We conducted a chart audit of all deaths in our 10 bed Unit over a 12-month period, reviewing patient demographics, diagnosis on admission, patient acuity, expectation of death and not-for-resuscitation status. Discussions with the family, treatments withheld and withdrawn and extubation practices were documented. The presence of family or next-of-kin at the time of death, the time to death after withdrawal of therapy and family concerns were recorded. Results There were 70 patients with a mean age of 69 years. Death was expected in 60 patients (86%) and not-for-resuscitation was documented in 58 cases (85%). Family discussions were held in 63 cases (90%) and treatment was withdrawn in 34 deaths (49%). After withdrawal of therapies, 31 patients (44%) died within 6 h. Ventilatory support was withdrawn in 24 cases (36%). Family members were present at the time of death in 46 cases (66%). Family concerns were documented about the end of life care in only 1 case (1.4%). Conclusion Our data suggests that death in our Unit was often predictable and that end of life management was a consultative process.

End of life care - the importance of advance care planning

Background: Communication about end of life care may involve difficult conversations for patients, family members and health professionals. However, a lack of understanding of a person's wishes about their future care may result in a loss of dignity for the person, and additional distress for their family members and health professionals and burden to the healthcare system. Objective: This article discusses the barriers to advance care planning and provides some guidance for the general practitioner in undertaking advance care planning with patients and their families. Tips for initiating end of life discussions with patients and families utilising the 'PREPARED' acronym, and ensuring appropriate care delivery are included. Discussion: Involving patients and their family members in advance care planning may be challenging and time consuming for GPs. However, there are a number of resources to support this activity in relation to training, communication support and Medicare item funding.

Pediatric donation after circulatory determination of death: Respecting the interests of children through routine consideration of donation opportunities

Overby and colleagues (2015) highlight the complexities of consent to or authorization for organ procurement in the setting of controlled donation after circulatory determination of death (cDCDD). They note that decision making about cDCDD is complicated by clinical uncertainties and ethical controversies regarding protocols for the determination of death by circulatory criteria and the use of perimortem interventions to support organ procurement, and that these uncertainties and controversies may be exacerbated in the pediatric context. Suggesting that parents and clinicians may “unconsciously” compromise the best interests of their own children and patients in order to achieve organ procurement goals, Overby and colleagues argue that children are at risk of instrumentalization when the option of cDCDD is presented. This claim is further grounded in their belief that children lack autonomy and can have no interest in becoming organ donors. In this commentary, we contest these assumptions, the implications of which extend beyond cDCDD and threaten to undermine programs of pediatric deceased donation, including donation after the neurologic determination of death (DNDD). We argue that routine consideration of the possibility of organ donation by critically ill children is consistent with respect for children’s best interests and, most importantly, their human dignity.

The Doha model of organ donation and transplantation: thinking beyond citizenship

This paper reviews the policy and practice of organ donation and transplantation in Qatar that has developed since January 2011. The important features of the Doha Model (the ‘Model’) are explored, including: (i) all legal residents of Qatar have an equal right to access deceased donor organs and transplantation regardless of their citizenship status; (ii) no prioritisation in organ allocation is given to Qatari citizens; (iii) a multilingual and multicultural education and promotional program about donation has been implemented to engage the diverse national communities resident within Qatar; (iv) financial incentives or fungible rewards for living or deceased donation are prohibited. The ethical framework of this policy will be examined in the light of the national self-sufficiency paradigm, which advocates reciprocity and solidarity among resident populations seeking to meet all needs for transplantation equitably. We review some preliminary evidence of the impact of the Model with respect to engagement of a highly diverse multinational population in a donation and transplantation program, and argue that the Model may inform policy and practice in other countries, particularly those with non-citizen resident populations.

'We just do the dirty work': dealing with incontinence, courtesy stigma and the low occupational status of carework in long-term aged care facilities.

AIMS AND OBJECTIVES: To systematically examine, describe and explain how continence care was determined, delivered and communicated in Australian long aged care facilities. BACKGROUND: Incontinence is a highly stigmatising condition that affects a disproportionally large number of people living in long-term aged care facilities. Its day-to-day management is mainly undertaken by careworkers. We conducted a Grounded theory study to explore how continence care was determined, delivered and communicated in long-term aged care facilities. This paper presents one finding, i.e. how careworkers in long-term aged care facilities deal with the stigma, devaluation and the aesthetically unpleasant aspects of their work. DESIGN: Grounded theory. METHODS: Eighty-eight hours of field observations in two long-term aged care facilities in Australia. In addition, in-depth interviews with 18 nurses and careworkers who had experience of providing, supervising or assessment of continence care in any long-term aged care facility in Australia. RESULTS: Occupational exposure to incontinence contributes to the low occupational status of carework in long-term aged care facilities, and continence care is a symbolic marker for inequalities within the facility, the nursing profession and society at large. Careworkers' affective and behavioural responses are characterised by: (1) accommodating the context; (2) dissociating oneself; (3) distancing oneself and (4) attempting to elevate one's role status. CONCLUSION: The theory extends current understandings about the links between incontinence, continence care, courtesy stigma, emotional labour and the low occupational status of carework in long-term aged care facilities. RELEVANCE TO CLINICAL PRACTICE: This study provides insights into the ways in which tacit beliefs and values about incontinence, cleanliness and contamination may affect the social organisation and delivery of care in long-term aged care facilities. Nurse leaders should challenge the stigma and devaluation of carework and careworkers, and reframe carework as 'dignity work'.

Statement of the Declaration of Istanbul Custodian Group regarding payments to families of deceased organ donors

Governmental and private programs that pay next of kin who give permission for the removal of their deceased relative's organs for transplantation exist in a number of countries. Such payments, which may be given to the relatives or paid directly for funeral expenses or hospital bills unrelated to being a donor, aim to increase the rate of donation. The Declaration of Istanbul Custodian Group-in alignment with the World Health Organization Guiding Principles and the Council of Europe Convention Against Trafficking in Human Organs-has adopted a new policy statement opposing such practices.Payment programs are unwise because they produce a lower rate of donations than in countries with voluntary, unpaid programs; associate deceased donation with being poor and marginal in society; undermine public trust in the determination of death; and raise doubts about fair allocation of organs. Most important, allowing families to receive money for donation from a deceased person, who is at no risk of harm, will make it impossible to sustain prohibitions on paying living donors, who are at risk.Payment programs are also unethical. Tying coverage for funeral expenses or healthcare costs to a family allowing organs to be procured is exploitative, not "charitable." Using payment to overcome reluctance to donate based on cultural or religious beliefs especially offends principles of liberty and dignity. Finally, while it is appropriate to make donation "financially neutral"-by reimbursing the added medical costs of evaluating and maintaining a patient as a potential donor-such reimbursement may never be conditioned on a family agreeing to donate.

Ethical-moral courses of action and active citizenship in health students

Abstract Introduction: The practice of active citizenship, ethical-moral courses of action and civic, moral and ethics education are essentials for ethical decision making in health. Objetive: To determine if gender influences students’ ethical- moral course of action. Methods: Descriptive study with a non-probabilistic sample of 85 students enrolled in the 1st cycle of the health degree. Results: Of the participants surveyed 61.2% were found to say that action should take into account their moral principles, with ethical/ moral subjectivism prevailing; 44.7% consider that one should “Do what will have the best consequences for the greatest number of people”, with the principle of utilitarianism being significant; 55.3% think that “An action is ethically good” if “It is in accordance with morality”, thereby highlighting subjectivism/relativism; 45.9% believe that “ethical-moral values” “are relative and vary from society to society” agreeing with relativism as an explanatory principle for action. Males showed a greater tendency to support their decision-making with the principle of objectivism, (Fischer=.010). Conclusion: The results suggest that students’ ethical-moral education is required to promote an ethical-moral course of action in their professional practice. Thus, universities with their health courses should be at the forefront of this education, making their graduates ambassadors/interveners of a way of knowing and of being as well as promoters of the dignity of the citizen of the modern world.

Perceção da terminologia legal e dos procedimentos judiciais por menores em conflito com a lei

Todos os seres humanos, independentemente da sua fase no ciclo vital ou qualquer tipo de condição, são seres plenos de direitos e merecem ser tratados com dignidade e respeito. Os jovens, por se encontrarem numa etapa inicial do desenvolvimento humano, requerem atenção e assistência especiais. A presença de crianças e jovens envolvidos no sistema de justiça é cada vez mais frequente e devido à sua idade precoce, inúmeras leis e documentos foram desenvolvidos para proteger os menores, com o objetivo de fornecer uma justiça adaptada à sua maturidade cognitiva e emocional em todas as fases do processo judicial (antes, durante e após). Quando estas questões são referentes a jovens na qualidade de ofensores, tomam particular pertinência, devido à possibilidade do seu direito de defesa ficar comprometido. Uma vez que, em Portugal, a literatura existente acerca de como o sistema de justiça interage com os jovens em conflito com a Lei é escassa, o presente estudo é revestido de particular pertinência. Assim, esta investigação visa apresentar um estudo quantitativo que pretende compreender a perceção que os jovens em conflito com a Lei têm da terminologia legal e dos procedimentos judiciais. A recolha de dados realizou-se baseada no método de inquérito suportado pela técnica de questionário fechado. Elaborou-se um instrumento constituído por 69 questões dicotómicas, com um tempo de realização estimado de 15 minutos. Para a realização da investigação foram obtidas as autorizações necessárias (i.e. Comissão de Ética da Universidade Fernando Pessoa e Direção Geral de Reinserção e Serviços Prisionais) e os respetivos consentimentos informados dos participantes. Os resultados revelam que, em geral, os jovens inquiridos têm um relativo bom conhecimento da terminologia legal e dos procedimentos judiciais que ocorreram durante o processo tutelar de que foram alvo. Verificou-se uma diferença de conhecimento/experiência significativa entre os Centros Educativos do Porto e da Guarda, sendo que os jovens do Porto revelarem maiores conhecimentos que os jovens da Guarda. Apesar dos jovens apresentarem conhecimento acerca do sistema, existem determinadas lacunas às quais se deve atentar. Assim, depreende-se que o sistema jurídico português possa estar a empenhar-se de forma a cumprir as normas e legislações nacionais e internacionais e garantir o bem-estar e esclarecimento do jovem em conflito com a lei. Contudo, reconhece-se que é da responsabilidade dos intervenientes judiciais com contacto direto com a criança (e.g. advogado, juiz) esta função, pelo que os lapsos identificados devem ser colmatados de forma a garantir que o jovem seja (como é) um cidadão pleno de direitos e dignidade quando contacta com o sistema jurídico.

Qualidade de vida no trabalho e o acolhimento como intervenção

A qualidade de vida no trabalho é, cada vez mais, tema de relevância no mundo atual. As organizações estão atentas aos conflitos existentes dentro do tema e a forma mais adequada de se lidar com ele, no sentido de propiciar, aos sujeitos no mundo do trabalho, mais dignidade em seu cotidiano laboral. A evolução da qualidade de vida no trabalho dentro do Instituto Federal Minas Gerais– Campus Ouro Preto foi o objetivo deste estudo, mas, principalmente, verificou-se uma estratégia de intervenção para a evolução da qualidade de vida no trabalho: o acolhimento. Para tanto, era necessário saber que tipo de situações acontecem dentro do universo do trabalho que interferem na sua produção e na qualidade de vida. Também era importante conhecer a motivação, a saúde mental e o trabalho, enfim, as contextualizações conceituais que embasassem o universo da qualidade de vida no trabalho, e como o acolhimento como estratégia de intervenção poderia ser utilizado. Para que a estratégia de intervenção tivesse uma linha de condução eficaz, algumas informações relevantes foram utilizadas, como os dados do órgão responsável pela saúde ocupacional do servidor público federal, o SIASS (Subsistema Integrado de Atenção a Saúde do Servidor), e um estudo piloto sobre Qualidade de Vida no Trabalho, também elaborado pelo SIASS, dentro da instituição em questão. A elaboração do projeto permitiu-nos concluir que, dentro do universo institucional de educação, o acolhimento como forma preventiva de vários tipos de desgaste pode ser um instrumento pertinente e eficaz.

La litterature francophone de l’Afrique subsaharienne en Suède : Les Femmes font place à la honte

The aim of the article is to present the place and the role of contemporary Francophone Sub-Saharan African literature in Sweden. This study attempts to compare three levels in the circulation of literary works: translation, reception, and content. These dimensions converge in the analysis in order to pin down the place and the role of this literature in the Swedish context. The study is delimited to writers born after the independencies. The results show that contemporary francophone novels translated and categorized as African are dominated by female writers. The critique reveals a semantic field stressing the theme of shame in the novels by these six female authors, which is examined through in-depth analysis of one novel from each author. Preliminary conclusions are that Francophone African literature is present on the Swedish market since the independencies and even before, though, contemporary works translated into Swedish are produced in the diaspora. A comparison between the three studied levels show that female writers contribute to the shaping of African literature in Sweden to a great extent, even though literary critics sometimes judge them severely. Their explorations of aesthetic forms marry a new discretely engaged literature, constructive rather than vindictive. In this literature, the core issue of facing the shame is presented as a way to reach individual and collective dignity.