Individual variation in psychological and psychomotor symptoms following smoking cessation: the implications for treatment

Some commonly experienced signs and symptoms occur during abstinence from tobacco, but specific signs and symptoms and their intensity vary greatly from individual to individual. The aim of this study was to re-examine psychological and psychomotor symptoms in smokers in the general population, and to explore the individual variation in these. Quitting smokers (n = 123) reported their experiences pre- and post-cessation, on a questionnaire developed for the study. Analysis of variance and frequency analysis showed significant decreases between pre- and post-cessation on positive experiences (F = 9.81, p < 0.0001) but no significant change on negative experiences, suggesting a loss of pleasure rather than increased negative affect upon quitting. The variance of the pre- to post-cessation difference score suggested wide variation in the reporting of withdrawal symptoms. These results lead us to consider the implications for treatment, using cognitive therapies and moderating the significant emphasis that is at present put on withdrawal.

Site-specific and geographical segmental social, environmental and ethical disclosures by the Ghanaian mining sector

Purpose: This paper explores the extent of site-specific and geographic segmental social, environmental and ethical reporting by mining companies operating in Ghana. We aim to: (i) establish a picture of corporate transparency relating to geographic segmentation of social, environmental and ethical reporting which is specific to operating sites and country of operation, and; (ii) gauge the impact of the introduction of integrated reporting on site-specific social, environmental and ethical reporting. Methodology/Approach: We conducted an interpretive content analysis of the annual/integrated reports of mining companies for the years 2009, 2010 and 2011 in order to extract site-specific social, environmental and ethical information relating to the companies’ mining operations in Ghana. Findings and Implications: We found that site-specific social, environmental and ethical reporting is extremely patchy and inconsistent between the companies’ reports studied. We also found that there was no information relating to certain sites, which were in operation, according to the Ghana Minerals Commission. This could simply be because operations were not in progress. Alternatively it could be that decisions are made concerning which site-specific information is reported according to a certain benchmark. One policy implication arising from this research is that IFRS should require geographic segmental reporting of material social, environmental and ethical information in order to bring IFRS into line with global developments in integrated reporting. Originality: Although there is a wealth of sustainability reporting research and an emergent literature on integrated reporting, there is currently no academic research exploring site-specific social, environmental and ethical reporting

Association between rhythmic masticatory muscle activity during sleep and masticatory myofascial pain: A polysomnographic study

Aims: To test for an association between rhythmic masticatory muscle activity during sleep, as assessed according to polysomnographic criteria for sleep bruxism (RMMA-SB), and myofascial pain (MFP), as well as the chance of occurrence of MFP in patients with RMMA-SB. Methods: Thirty MFP patients (diagnosed according to the Research Diagnostic Criteria for Temporomandibular Disorders) and 30 age- and gender-matcbed asymptomatic controls underwent a polysomnographic examination. Also, any self-reporting of daytime clenching (DC) was registered in 58 of these subjects. Results: Most MFP patients reported mild or moderate pain (46.67% and 43.33%, respectively), and only 3 (10%) reported severe pain. Pain duration ranged from 2 to 120 months (mean 34.67 +/- 36.96 months). Significant associations were observed between RMMA-SB and MFP as well as between DC and MFP. Conclusions: (1) RMMA-SB is significantly associated with MFP; (2) although RMMA-SB represents a risk factor for MFP, this risk is low; and (3) DC probably constitutes a stronger risk factor for MFP than RMMA-SB.

Våld på jobbet : Beskrivningar av våld i arbetslivet 1978–2004 i facklig press

Violence at work as a social problem: a study of the media coverage on workplace violence in Swedish trade union journals 1978–2004 The main purpose of this study was to find out the extent of the unions media coverage on workplace violence and the ways in which the topic was framed. The study shows that the reporting of violence in the workplace described in journals is on a stable level during the period 1978–98. However from the year 2000 and onwards, there is a clear increase in the attention. Four categories of workplace violence were used to identify and recognize different types of violence: intrusive-, consumer-, relationship-and organizational violence. This shows that much of the attention over time has shifted from intrusive violence to organizational violence and consumer violence. What seems to have happened is that workplace violence has become more than just robberies and assaults in the retail business. The stereotypical image of the criminal is challenged by non-traditional criminals like nurses, elderly people and companies. Certain groups, e.g. care workers, come to account for an increasing proportion of attention, both as perpetrators and victims of violence. This study is an important step in understanding the increased reports of workplace violence in Sweden.

Facilitators and barriers to applying a national quality registry for quality improvement in stroke care

BACKGROUND: National quality registries (NQRs) purportedly facilitate quality improvement, while neither the extent nor the mechanisms of such a relationship are fully known. The aim of this case study is to describe the experiences of local stakeholders to determine those elements that facilitate and hinder clinical quality improvement in relation to participation in a well-known and established NQR on stroke in Sweden. METHODS: A strategic sample was drawn of 8 hospitals in 4 county councils, representing a variety of settings and outcomes according to the NQR's criteria. Semi-structured telephone interviews were conducted with 25 managers, physicians in charge of the Riks-Stroke, and registered nurses registering local data at the hospitals. Interviews, including aspects of barriers and facilitators within the NQR and the local context, were analysed with content analysis. RESULTS: An NQR can provide vital aspects for facilitating evidence-based practice, for example, local data drawn from national guidelines which can be used for comparisons over time within the organisation or with other hospitals. Major effort is required to ensure that data entries are accurate and valid, and thus the trustworthiness of local data output competes with resources needed for everyday clinical stroke care and quality improvement initiatives. Local stakeholders with knowledge of and interest in both the medical area (in this case stroke) and quality improvement can apply the NQR data to effectively initiate, carry out, and evaluate quality improvement, if supported by managers and co-workers, a common stroke care process and an operational management system that embraces and engages with the NQR data. CONCLUSION: While quality registries are assumed to support adherence to evidence-based guidelines around the world, this study proposes that a NQR can facilitate improvement of care but neither the registry itself nor the reporting of data initiates quality improvement. Rather, the local and general evidence provided by the NQR must be considered relevant and must be applied in the local context. Further, the quality improvement process needs to be facilitated by stakeholders collaborating within and outside the context, who know how to initiate, perform, and evaluate quality improvement, and who have the resources to do so.

O suicídio em Freud

Este trabalho é um estudo teórico sobre o suicídio em uma perspectiva psicanalítica. O que se pretendeu foi elaborar uma visão compreensiva das motivações inconscientes presentes nos processos autodestrutivos através da retomada das observações que a este respeito estão contidas na obra de Sigmund Freud, correlacionando-as com uma ordenação de suas ideias seu pensamento em termos do desenvolvimento de Inicialmente, Freud faz apenas algumas observações esparsas sobre o suicídio, e suas contribuições posteriores repousam basicamente sobre a concepção de que os impulsos autodestrutivos revelam o sentimento de culpabilidade e a necessidade de autopunição decorrente do ódio inconsciente dirigido a pessoas queridas e do desejo, também inconsciente, de que elas morram. Com a introdução dos conceitos de narcisismo, identificação primária e ideal do ego, Freud amplia seus recursos teóricos identificando a melancolia com a autodestruição. A seguir, investiga-se o aparecimento do conceito de pulsão de morte e as modificações que este conceito acarretou na teoria do suicídio. Examina-se, ainda, a compulsão à repetição, a nova concepção de pulsão como expressão da natureza conservadora dos seres vivos, a fusão pulsional e o problema econômico do masoquismo. A extrema complexidade do fenômeno nos faz concluir que, apesar das contribuições metapsicológicas que nos permitem, à luz da psicanálise, compreender a natureza inconsciente da autodestruição não se pode prescindir, no estudo de casos individuais, de uma perspectiva que leve em conta a singularidade das motivações que contribuem para a tessitura múltipla da rede de fatores que impulsionam a busca da própria morte. A história individual, o contexto sócio-cultural, e a visão que tem do suicídio a sociedade, contribuem para a trama singular, específica e acessível à análise dos atos destrutivos.

Controle na administração pública: uma proposta para o sistema de controle interno do Poder Executivo do Estado do Rio de Janeiro

Este trabalho tem por objetivo propor diretrizes para o sistema de controle interno do Poder Executivo do Estado do Rio de Janeiro, de forma a inserir atividades de correição, de ouvidorias e de transparência e prevenção à corrupção. O cenário atual deste sistema estadual é regido pelo Decreto 43.463, de 14 de fevereiro de 2012, e deixou de fora aquelas atividades. O trabalho contextualiza a importância de que tais atividades integrem um sistema único, a fim de desenvolver e manter permanente interlocução das informações produzidas por cada atividade. Como o controle interno é instrumento de accountability, tal integração pode fomentar a transparência, podendo contribuir para as ações do controle social. A premissa para a proposta de diretrizes do presente trabalho é o modelo federal e o modelo de alguns estados da federação, os quais já estruturaram seu sistema de controle interno do Poder Executivo, contemplando as atividades de controle interno, de correição, de ouvidorias e de transparência e prevenção à corrupção.

1930, a Paraíba e o inconsciente político da revolução: a narrativa como ato socialmente simbólico

This work is an attempt to show that the ideological conflict that has been developed by the hegemony of the 1930 Revolution historical events in Paraíba, conceptually turned into an insoluble social contradiction. It ocurred due to imaginary or formal resolutions of the literature that ended up by altering the epistemological rules of the relation between fiction and reality. The present work is based on The unconscious politics: a narrative as a socially symbolic act , book in which all the literary or cultural texts can and should be read as symbolic resolutions to insoluble social contradictions. From string to contemporary literature this phenomenon has been registered by the several ways of textual production turning the 1930 Revolution into one of the main elements which guides the political scene of Paraíba. The ideological groups still centered on the political resentment and committed to a political conflict forged the existence of two historical truths: one which suits the liberais , the winners, and another is of the 1930 conflict. This work argues in favour of the unconscious politics of the 1930 Revolution. This thesis considers necessarily the relation that the Paraibana society maintains with its past and how this past reaches in the present the liberation of a hidden and repressed truth through its narrativization. Beyond that, how the ideological partiality generated the political resentment through the way of thinking of the rivals under the perspective of the good and evil reveals its insoluble social contradiction. Process which comprehends varied narrative forms of the mass culture products and literary production, as in the methodological perspective pointed by Fredric Jameson that all literary or cultural texts can and shall be read as symbolic resolutions of true political and social contradictions. In the case of Paraiba we will have resolutions that search for the reasons which caused the death of João Pessoa: forgery and publicity of love letters, dispute over the official version of suicide commited by João Dantas, the man who assassinated João Pessoa

Modelo arquitetural de comunicação para monitoramento de pacientes baseado em middleware, computação móvel e ubíqua

Hospital Automation is an area that is constantly growing. The emergency of new technologies and hardware is transforming the processes more efficient. Nevertheless, some of the hospital processes are still being performed manually, such as monitoring of patients that is considered critical because it involves human lives. One of the factors that should be taken into account during a monitoring is the agility to detect any abnormality in vital signs of patients, as well as warning of this anomaly to the medical team involved. So, this master's thesis aims to develop an architecture to automate this process of monitoring and reporting of possible alert to a professional, so that emergency care can be done effectively. The computing mobile was used to improve the communication by distributing messages between a central located into the hospital and the mobile carried by the duty

Ideações e tentativas de suicídio em adolescentes com práticas sexuais hetero e homoeróticas

Esta pesquisa, que teve como população-alvo adolescentes com idade entre 12 e 20 anos, residentes em três municípios do interior Paulista, buscou conhecer as associações entre orientação sexual e ideações e tentativas de suicídio. Corroborando com as pesquisas internacionais, evidenciou-se que os não heterossexuais têm mais chances de pensarem e tentarem suicídio, comparativamente aos heterossexuais. Todavia, encontrou-se que, dentre o grupo de adolescentes que se assumiram não heterossexuais, os que estão mais vulneráveis são aqueles que se autodefiniram bissexuais e outros, os quais constituem o grupo de pessoas menos assumidas, dentre os não heterossexuais. do mesmo modo, constatou-se que os respondentes apresentam diversas opiniões e valores homofóbicos, sexistas e heterocentrados, o que revela ser o espaço escolar, onde se encontram esses jovens não heterossexuais, bastante carregado de posicionamentos discursivos discriminatórios. Conclui-se que a questão do suicídio é uma problemática de saúde pública e que a população de jovens não heterossexuais necessita de abordagens específicas para a prevenção e de atenção relativas a essa conduta.

Relação amorosa e tentativa de suicídio na adolescência : uma questão de (des)amor

Suicide rates have been rising all over the world. In Rio Grande do Norte state, a study carried out by Dutra (1999) investigated suicide rates among youngsters and found that in 1997 alone 244 cases of suicide attempt were registered. The author took an interest in studying this phenomenon among adolescents after reviewing Dutra s study and the technical literature on suicide. In addition to that, another topic caught her attention and raised new research questions: suicide attempts motivated by love, i.e., the end of a relationship, the fantasy of being abandoned by a partner. These have made the author to question how love manifested itself among adolescents and how it could become a reason for adolescents to give up their lives. Based on the data she analyzed and the research questions she developed, her research objective was to understand how adolescents who have attempted suicide because of love-related reasons have gone through this experience. The theoretical reference for the research was the Client-centered Therapy and more specifically, the construct self , according to Carl Rogers. The methodological strategy was inspired by the existential-phenomenological strategy. It used the narrative as a research instrument, inspired by the work of Walter Benjamim (1994) which was developed into a research strategy by Schmidt (1990). Four youngsters (three male and one female) have participated in this study. They have attempted suicide for love-related reasons during dolescence, when they were 12 to 18 years old. The interviews were recorded on cassette tapes, transcribed and literalized into narratives. The understanding of the narratives was based on the meanings that emerged from the youngsters speeches, as well as from the moments that touched the author. These moments highlighted the meaning of the experience of giving up life and the experience of love-based relationship as experienced by the youngsters. The study detected, among the adolescents who were interviewed, the existence of impulsiveness related to the suicide attempt. Also, the majority of the interviewees came from unstructured family backgrounds and had lost of one of their parents or had to face their parents divorce. The suicide was attempted by these youngsters through the ingestion of medicines. The research also revealed that the youngsters had regretted attempting suicide and felt guilty about it. With regards to their self-evaluation, the author observed that the youngsters had low self-esteem, negative perceptions about themselves and distorted views of themselves. These findings helped the author to reflect on the close relationship between the construct self and the suicide attempt. She also observed that a few factors, i.e., family context, education, social and cultural values, have influenced the way the youngsters perceived themselves . The results of this research confirm the idea that we have to understand the suicide attempt as a multi-determined phenomenon. This study contributed to the analysis and reflection on the factors that contribute to suicide attempts thus providing a foundation for the development of public health programs and policies to deal with this topic

Doenças de Veiculação Hídrica em Trechos da Bacia do Rio Piranhas-Assu: ocorrência de bactérias oportunistas, caracterização epidemiológica e concepções de professores e agentes de saúde

Water is essential to life and all living organisms and their supply is necessary for economic development and quality of life of human populations, but their quality has been altered by human actions. In semi-arid northeast, the water is an issue of concern, especially its quality. This region is common to the construction of reservoirs that capture rain water, streams and temporary rivers in search of ease this situation, being intended for various purposes. Water scarcity is a limiting factor for the economic and social development of the region and contributes to the maintenance of waterborne diseases. About 80% of diseases that occur in developing countries are infected by waterborne pathogens. Therefore, this study aimed to determine in two environments that are part of semilênticos Armando Ribeiro Gonçalves reservoir, and a stretch of the river Assu, all located in the semiarid RN, the occurrence of opportunistic pathogenic bacteria; check the conceptions of teachers and health workers about the issues "waterborne diseases" and "bacteria" and a diagnosis of diarrheal diseases that affect the population in some municipalities of the semi-arid region of RN from a survey of epidemiological data. For identification of bacteria using commercial kits and the diagnosis of diarrheal disease was based on information from databases. The previous conceptions of teachers and health workers were obtained through questionnaires. The results confirmed the presence of opportunistic bacteria in the studied area, showing the importance of monitoring water quality. There was an under-reporting of cases of diarrhea pointing out flaws in the monitoring of Diarrheal Diseases and indicating the need to improve it. It was felt also the need to implement educational activities on topics dealt with both with teachers and health workers, since they were identified misconceptions on the subject

Prevalência de fatores de risco para doenças crônicas: inquérito populacional mediante entrevistas telefônicas em Botucatu, São Paulo, 2004

OBJETIVO: Descrever resultados da aplicação de um sistema de monitoramento de fatores de risco para doenças crônicas não transmissíveis (DCNT) por meio de entrevistas telefônicas (SIMTEL) no município de Botucatu/SP. MÉTODOS: Entrevistou-se amostra probabilística (n = 1.410) da população de indivíduos com 18 ou mais anos de idade residente em domicílios do município de Botucatu/SP, conectados à rede de telefonia fixa. A amostragem foi realizada em três etapas: sorteio de linhas do cadastro da companhia telefônica; seleção de linhas residenciais ativas; sorteio para entrevista de um morador com 18 ou mais anos de idade por linha elegível. A taxa de sucesso (entrevistas realizadas: linhas elegíveis sorteadas) foi de 86,9%, sendo de 5,8% a proporção de recusas. Foi aplicado um questionário com 74 questões sobre consumo alimentar, atividade física, tabagismo, consumo de bebidas alcoólicas, peso e estatura recordados e auto-referência a diagnósticos médicos de hipertensão arterial e diabetes. Apresentam-se estimativas brutas da prevalência de fatores de risco/proteção para DCNT e estimativas ajustadas que levam em conta a distribuição segundo idade, sexo e escolaridade da população adulta total do município no Censo Demográfico de 2000. RESULTADOS: Foram observadas altas prevalências de excesso de peso (46.7%) e sedentarismo (57.9%). Houve desvantagem para os homens quanto ao consumo excessivo de bebidas alcoólicas e vantagem no que se refere à prática de atividade física em 1 ou mais dias da semana. Nas mulheres, observou-se associação inversa entre escolaridade e os seguintes fatores de risco: obesidade, excesso de peso, sedentarismo, consumo de carnes com gordura e hábito de fumar. Resultado semelhante foi observado para homens, exceto com relação a obesidade e excesso de peso. CONCLUSÕES: A segunda experiência de aplicação do SIMTEL confirmou o desempenho satisfatório e a utilidade do sistema em nosso meio.

Responsabilidade do profissional de saúde sobre a notificação de casos de violência doméstica

A notificação da violência doméstica pelos profissionais de saúde contribui para o dimensionamento epidemiológico do problema, permitindo o desenvolvimento de programas e ações específicas. O objetivo do trabalho foi verificar a responsabilidade desses profissionais em notificar a violência, especialmente a doméstica e as possíveis implicações legais e éticas a que estão sujeitos. Assim, foi realizada pesquisa na legislação brasileira e códigos de ética da medicina, odontologia, enfermagem e psicologia. Quanto à legislação, as sanções estão dispostas na Lei das Contravenções Penais, Estatuto da Criança e Adolescente, Estatuto do Idoso e na lei que trata da notificação compulsória de violência contra a mulher. Também existem penalidades em todos os códigos de ética analisados. Conclui-se que o profissional de saúde tem o dever de notificar os casos de violência que tiver conhecimento, podendo inclusive responder pela omissão.

Stressful life events and occupational accidents

Objective: The purpose of this study was to examine the association between stressful life events and occupational accidents. Methods: This was a population-based case-control study, carried out in the city of Botucatu, in southeast Brazil. The cases consisted of 108 workers who had recently experienced occupational accidents. Each case was matched with three controls. The cases and controls answered a questionnaire about recent exposure to stressful life events. Results: Reporting of environmental problems, being a victim of assault, not having enough food at home and nonoccupational fatigue were found to be risk factors for work-related accidents with estimated incidence rate ratios of 1.4 [95% confidence interval (95% CI) 1.1-1.7], 1.3 (95% CI 1.1 1-1.7), 1.3 (95% CI 1.1-1.6), and 1.4 (95% CI 1.2-1.7) respectively. Conclusions: The findings of the study suggested that nonwork variables contribute to occupational accidents, thus broadening the understanding of these phenomena, which can support new approaches to the prevention of occupational accidents.