Relación entre la calidad del sueño y la calidad de vida del personal de salud en una institución de salud de iv nivel en caracas 2016

Introducción: La relación entre el sueño y la calidad de vida constituye una de las problemáticas de gran importancia en el ámbito de las condiciones de trabajo de funcionarios y personal médico de las unidades prestadoras de servicios hospitalarios. Estudios han evidenciado una relación entre la calidad del sueño y la calidad de vida y la falta de sueño se ha asociado con errores en los procedimientos y lesiones ocupacionales. Objetivo: Relacionar la calidad del sueño con la calidad de vida en personal de salud de una Institución de IV nivel, en la ciudad de Caracas (Venezuela). Materiales y métodos: Estudio de corte transversal con datos secundarios del personal de salud de un Hospital de IV nivel (93 registros) en la ciudad de Caracas (Venezuela). Se emplearon variables sociodemográficas, las relacionadas con calidad del sueño y provenientes de la encuesta “Índice de calidad de sueño de Pittsburgh” y con calidad de vida incluidas en el cuestionario SF-36. Se utilizo el programa estadístico SPSS para el análisis y se obtuvieron medidas de tendencia central y dispersión. Para relacionar las variables se emplearon las pruebas de Shapiro Wilk y el coeficiente de correlación de Spearman. Resultados: El total de los trabadores que ingresaron al estudio tuvieron un rango de edad entre 19 y 70 años y una desviación estándar de 10,9 años. Respecto al género, el 79,6% (n=74) fueron mujeres, y el 20,4% (n=19) fueron hombres. Con relación al componente de calidad de vida, se encontró que la mayor puntuación se asocia con el desempeño emocional (61,3%), la Vitalidad (73,5%), la Función Física (91%), el Dolor Físico (100%) y la Función Social (100%). Igualmente, se encontró que la totalidad de los trabajadores encuestados refirieron ser malos dormidores (91.4%). Al correlacionar la calidad de sueño con la calidad de vida, se encontró una asociación estadísticamente significativa, específicamente con el componente Latencia de sueño (p=0.008), Eficiencia habitual de sueño (p=0,001), Perturbaciones del Sueño (p=0,040) y Disfunción diurna (p= 0,008). Conclusión Este estudio reporto que la falta de sueño tiene relación con la calidad de vida del personal de salud y que la totalidad de los trabajadores de este estudio refirieron ser malos dormidores, hechos que demandan la atención de los programas de salud de las empresas, para promover medidas preventivas y correctivas respecto a las condiciones laborales como parte del bienestar de las personas.

Desarrollo de idea de negocio "TecniHogar"

La asistencia y reparación del hogar es un servicio fundamental que cualquier persona puede a llegar a necesitar ante cualquier emergencia o necesidad. En Colombia la presentación de estos servicios ha venido presentando inconvenientes, debido a que las personas no encuentran fácil la manera de contactar y contratar a un técnico que les ofrezca confianza y seguridad. Igualmente los precios varían mucho, ya que juegan con la necesidad y cara del cliente y por lo tanto cada día se evidencian más inconformidades por parte de las personas. En el sector se evidencia claramente un problema, el cual debe ser atendido y es por ese motivo que se desarrollara una nueva idea de negocio que consiste en la implementación de una aplicación móvil que brinda a usuarios una alternativa innovadora para solicitar y contratar servicios técnicos para la asistencia del hogar, y así mismo a los técnicos se les ofrece una oportunidad diferente para incrementar sus servicios diarios y beneficios. TecniHogar es la aplicación móvil más fácil y amigable de manejar para los usuarios y prestadores de servicios, conecta a los clientes con los técnicos de una manera rápida y fácil. El proyecto se llevó a cabo por medio de una investigación cuantitativa, complementada a nivel analítico y comprensivo con cada una de las respuestas encontradas en las encuestas que se realizaron tanto a personas como a técnicos. De esta manera se pudo concluir que con la aplicación de TecniHogar usuarios y técnicos obtendrán un servicio más fácil, rápido, confiable y seguro que finalmente cambiara la forma de consumo y prestación de estos servicios

Prenatal education: profile and expectations of the couples.

Characterize the profile and describe the expectations of a sample of couple's participants in prenatal education programs integrated into the 'Tender Adventure - Preparation for childbirth and parenting' ", an outreach project of Nursing School of Coimbra.

Relação precoce mãe-filho. Revisão dos indicadores pós-parto do projeto Maternidade com Qualidade no CHBM-EPE

O aleitamento materno exclusivo é uma recomendação universal e o contacto pele-a-pele mãe/recém-nascido é fator de desenvolvimento para a díade. O trabalho académico desenvolvido centra-se nos indicadores de medida e evidência - amamentação na 1ª hora de vida & contacto pele a pele entre a díade. Tal enraíza-se no projeto Maternidade com Qualidade, da Ordem dos Enfermeiros Portugueses e em curso no Centro Hospitalar Barreiro-Montijo EPE. O projeto iniciou-se em setembro de 2015, seguindo-se os procedimentos que se relatam no atual documento. No diagnóstico de situação recolheu-se o estado dos indicadores. A vertente de investigação considerou como amostras profissionais e utentes do Centro Hospitalar Barreiro-Montijo e recolheu dados. A intervenção realizada produziu evolução positiva nos indicadores. O bonding em período sensível é reconhecido pelos profissionais como um elemento relevante nos cuidados. Com a implementação deste projeto contribuiu-se para a melhoria da qualidade dos cuidados na área de saúde materna; Mother-Child early relationship. Evaluating postpartum indicators from the Project Maternity with Quality at CHBM-EPE ABSTRACT: Exclusive breastfeeding is a universal recommendation and skin-to-skin mother / newborn is a development factor for the dyad. The academic work focuses on the measurement indicators and evidence - breastfeeding within the 1st hour of life & skin-to-skin between the dyad. This is rooted in the Maternity design with quality, of the Portuguese Nurses and ongoing in-Hospital Center Barreiro Montijo EPE. The project began in September 2015, following the procedures that are reported in the current document. In the situation analysis was collected status indicators. The research strand considers sample practitioners and users Barreiro-Montijo Hospital Center and collects data. The intervention performed produced positive results for these indicators. The bonding in the sensitive period is recognized by professionals as an important element in the care. With the implementation of this project contributed to improving the quality of care in maternal health.

Aspectos médicos e sociais no atendimento oftalmológico de urgência

Purpose: A survey was carried out on one hundred patients of the Emergency Service of the Ophthalmology Department of the Hospital das Clinicas of the University of Campinas (UNICAMP), in order to analyze the personal characteristics and the barriers against getting resolving ophthalmologic assistance. Variables, were the following: sex, age, home town, average distance between the place of initial symptoms and first visit to the hospital, time spent between the first examination (if performed in any other service) and the examination performed at the Hospital das Clinicas of University of Campinas, diagnosis, veracity of emergency, need to refer patients previously seen in other services to our Service and possibility of assistance and treatment at a secondary level. Methods: The sample showed the following characteristics: distances between 20 and 100 kilometers covered by 50.0% of the patients to be seen at University of Campinas. 75.0% of those patients needed someone to stay with them and 67.0% came from other municipalities. The long distances covered meant additional expenses for the treatment of diseases which should be treated locally. Results: Among the patients referred to University of Campinas by ophthalmologists of other services, 87.5% could have their diseases treated at a secondary level of assistance and 66.7% of real emergencies and 60% of false emergencies took longer than 7 days to reach the emergency room of University of Campinas. This shows the poor infrastructure of secondary services regarding excellence of emergency care and education of patients. Conclusions: We recommend education of general physicians and ophthalmologists for emergency eye care and also the supply of both secondary and tertiary public services or medicare, strategically setup in the whole state of Sao Paulo.

Conhecendo egressos do curso técnico de Enfermagem do PROFAE

O PROFAE (Projeto de Profissionalização dos Trabalhadores da Área de Enfermagem) foi uma iniciativa importante na educação profissional. Os objetivos do estudo foram descrever o perfil dos egressos do curso de técnico de enfermagem dos centros de formação da Secretaria de Estado da Saúde de São Paulo e conhecer os reflexos do curso para a atuação na profissão e a mobilidade no mercado de trabalho. A coleta de dados foi realizada por meio de questionário respondido por 216 egressos e por quatro grupos focais com egressos e enfermeiros supervisores. Os respondentes foram, em sua maioria, mulheres com média de 42,2 anos. O curso foi bem avaliado, destacando-se o apoio institucional e as resoluções do Conselho Regional de Enfermagem (COREN) como impulsionadores da procura por ele. Os egressos percebem ter maior iniciativa e preparo teórico após o curso. Na área, a função mais exercida atualmente ainda é a de auxiliar de enfermagem, o que gera insatisfação, pois, especialmente nos serviços públicos, não existem cargos de técnicos.

Perspectiva das mulheres na avaliação do Programa de Humanização do Pré-Natal e Nascimento

OBJETIVO: Analisar a importância da inclusão da perspectiva das mulheres na avaliação do Programa de Humanização do Pré-Natal e Nascimento. PROCEDIMENTOS METODOLÓGICOS: Estudo qualitativo realizado em base a dados primários coletados para a avaliação do Programa de Humanização do Pré-Natal e Nascimento, do Ministério da Saúde, em 2003, em sete municípios das cinco regiões do Brasil, selecionados a partir de dados extraídos de sistemas de bancos de dados oficiais já existentes. Um dos atores considerado fundamental para a coleta de informações foi a mulher atendida pelo Programa, abordada por meio de dezesseis grupos focais realizados em unidades de saúde. Para o tratamento dos dados empíricos foi utilizado o método do Discurso do Sujeito Coletivo. A análise e discussão foram realizadas com o apoio dos conceitos em saúde pública de acessibilidade e Saúde Paidéia. ANÁLISE DOS RESULTADOS: O Programa estudado normatiza para todos os serviços de saúde do país os procedimentos para a atenção ao pré-natal e o parto e os fluxos a serem observados. A análise do discurso das gestantes, nos grupos focais realizados, trouxe clareza quanto à dissonância existente entre muitas dessas recomendações e os desejos e necessidades da mulher, o que faz com que ela procure traçar para si um outro fluxo de atendimentos. Esta ocorrência traz prejuízos ao vínculo que estabelece com o serviço de saúde, além de dificuldades de controle pelo serviço do seguimento real que está sendo oferecido. CONCLUSÕES: A reflexão realizada do Programa, tomando por base a perspectiva das mulheres atendidas, identificou aspectos cuja consideração no momento da avaliação poderia resultar em maior efetividade e humanização do controle pré-natal oferecido

Gender Differences in Life Expectancy and Disability-Free Life Expectancy Among Older Adults in Sao Paulo, Brazil

Background: Research on life expectancy has demonstrated the negative impact of disability on the health of older adults and its differential effects on women as evidenced by their higher disabled life expectancy (DLE). The goal of the present study was to investigate gender differences in total life expectancy (TLE), disability-free life expectancy (DFLE), and DLE; examine gender differences on personal care assistance among older adults in Sao Paulo, Brazil; and discuss the implications for public policies. Methods: The sample was drawn from two waves (2000, 2006) of the dataset of Salud, Bienestar, y Envejecimiento, a large longitudinal study conducted in Sao Paulo (n = 2,143). The study assessed disability using the activities of daily living (ADL). The interpolation of Markov Chain method was used to estimate gender differences in TLE, DLE, and DFLE. Findings: TLE at age 60 years was approximately 5 years longer for women than men. Women aged 60 years were expected to live 28% of their remaining lives twice the percentage for men with at least one ADL disability. These women also lived more years (M = 0.71, SE = 0.42) with three or more ADL disabilities than men (M = 0.82, SE = 0.16). In terms of personal care assistance, women received more years of assistance than men. Conclusion: Among older adults in Sao Paulo, women lived longer lives but experienced a higher and more severe disability burden than men. In addition, although women received more years of personal assistance than men, women experienced more unmet care assistance needs. Copyright (C) 2011 by the Jacobs Institute of Women`s Health. Published by Elsevier. Inc.

Sagittal spinal alignment in paraplegics: a new paradigm for the rehabilitation under neuromuscular electrical stimulation

Study design: Radiographic analysis of sagittal spinal alignment of paraplegics in a standing position under surface neuromuscular electrical stimulation (NMES). Objectives: Describing the radiographic parameters of the sagittal spinal alignment of paraplegics going through a rehabilitation program with NMES. Setting: The University Hospital`s Ambulatory (UNICAMP), Campinas, Sao Paulo, Brazil. Methods: Panoramic X-ray images in profile were taken for 10 paraplegics. All patients participated in the rehabilitation program and were able to perform gait through NMES of the femoral quadriceps muscles. The radiographic parameters used for the analysis were the same as those described in the literature for healthy people. The results were didactically organized into three groups: anatomical shape of the spine, morphology and kinetics of the pelvis and spinopelvic alignment. Results: The physiological curvature of the spine in paraplegics showed average values similar to those described in the literature for healthy patients. The inversion of the pelvic tilt and the increase in the sacral slope were defined by the anterior backward rotation of the pelvis. The existing theoretical mathematical formulas that define lumbar lordosis, pelvic incidence and pelvic tilt showed normal values, despite the anterior intense sagittal imbalance. Conclusions: The adaptive posture of the spine in paraplegics standing through the stimulation of the femoral quadriceps does not allow for a neutral sagittal alignment. This novel radiographic detailed description of the various segments of the spine can be of assistance toward the understanding of the global postural control for such subjects. Spinal Cord (2010) 48, 251-256; doi: 10.1038/sc.2009.123; published online 29 September 2009

Broad spectrum bioactive sunscreens

The development of sunscreens containing reduced concentration of chemical UV filters, even though, possessing broad spectrum effectiveness with the use of natural raw materials that improve and infer UV absorption is of great interest. Due to the structural similarities between polyphenolic compounds and organic UV filters, they might exert photoprotection activity. The objective of the present research work was to develop bioactive sunscreen delivery systems containing rutin, Passiflora incarnata L. and Plantago lanceolata extracts associated or not with organic and inorganic UV filters. UV transmission of the sunscreen delivery system films was performed by using diffuse transmittance measurements coupling to an integrating sphere. In vitro photoprotection efficacy was evaluated according to the following parameters: estimated sun protection factor (SPF); Boot`s Star Rating category; UVA/UVB ratio; and critical wavelength (lambda(c)). Sunscreen delivery systems obtained SPF values ranging from 0.972 +/- 0.004 to 28.064 +/- 2.429 and bioactive compounds interacted with the UV filters positive and negatively. This behavior may be attributed to: the composition of the delivery system: the presence of inorganic UV filter and quantitative composition of the organic UV filters; and the phytochemical composition of the P. incarnate L and P. lanceolato extracts. Among all associations of bioactive compounds and UV filters, we found that the broad spectrum sunscreen was accomplished when 1.68% (w/w) P incarnata L. dry extract was in the presence of 7.0% (w/w) ethylhexyl methoxycinnamate, 2.0% (w/w) benzophenone-3 and 2.0% (w/w) TiO(2). It was demonstrated that this association generated estimated SPF of 20.072 +/- 0.906 and it has improved the protective defense against UVA radiation accompanying augmentation of the UVA/UVB ratio from 0.49 to 0.52 and lambda(c) from 364 to 368.6 nm. (c) 2008 Elsevier B.V. All rights reserved.

Nitric oxide photorelease from hydrogels and from skin containing a nitro-ruthenium complex

Nitric oxide (NO) is a gaseous molecule that has specific functions dictated by its localization and its kinetics of release. As NO-donors have a range of potential uses in the skin, much attention has been paid to the development of topical NO delivery systems. The aim of this work was to study the release rate and the skin penetration of the NO-donor cis[Ru(NO(2))(bpy)(2)(4-pic)](+) from different gel formulations and their potential as topical NO delivery systems under light stimuli. Among the formulations developed, the anionic gel retarded the nitro-ruthenium complex diffusion and also obstructed NO release after light irradiation. On the other hand, NO release before light irradiation was observed when the complex was dispersed in the cationic chitosan gel, possibly due to oxi-redox reactions between the amino groups of the polymer and the drug molecule. Finally, the non-ionic gel released the NO after light irradiation to the same extent as a drug aqueous solution at the same pH. The drug dispersed in this gel also penetrated into the stratum corneum skin layer, and the nitro-ruthenium complex present in the skin was able to release the NO after light stimuli, suggesting the potential use of this formulation as a topical NO delivery system. (C) 2010 Elsevier B.V. All rights reserved.

Titanium phosphate for Fuel Cell Proton Conduction Membranes

Environmental issues due to increases in emissions of air pollutants and greenhouse gases are driving the development of clean energy delivery technologies such as fuel cells. Low temperature Proton Exchange Membrane Fuel Cells (PEMFC) use hydrogen as a fuel and their only emission is water. While significant advances have been made in recent years, a major limitation of the current technology is the cost and materials limitations of the proton conduction membrane. The proton exchange membrane performs three critical functions in the PEMFC membrane electrode assembly (MEA): (i) conduction of protons with minimal resistance from the anode (where they are generated from hydrogen) to the cathode (where they combine with oxygen and electrons, from the external circuit or load), (ii) providing electrical insulation between the anode and cathode to prevent shorting, and (iii) providing a gas impermeable barrier to prevent mixing of the fuel (hydrogen) and oxidant. The PFSA (perfluorosulphonic acid) family of membranes is currently the best developed proton conduction membrane commercially available, but these materials are limited to operation below 100oC (typically 80oC, or lower) due to the thermochemical limitations of this polymer. For both mobile and stationary applications, fuel cell companies require more durable, cost effective membrane technologies capable of delivering enhanced performance at higher temperatures (typically 120oC, or higher. This is driving research into a wide range of novel organic and inorganic materials with the potential to be good proton conductors and form coherent membranes. There are several research efforts recently reported in the literature employing inorganic nanomaterials. These include functionalised silica phosphates [1,2], fullerene [3] titania phosphates [4], zirconium pyrophosphate [5]. This work addresses the functionalisation of titania particles with phosphoric acid. Proton conductivity measurements are given together with structural properties.

Barriers faced by MSEs: evidence from Mozambique

Purpose - The purpose of this research is to shed light on the main barriers faced by Mozambican micro and small enterprises (MSEs) and their implications in respect to the support policies available for these enterprises. Design/methodology/approach - A literature review was made on those barriers faced by the MSEs and on the policies and governmental instruments of assistance available for MSEs. Then, a two-step research was conducted. The first phase consisted of collecting data from 21 MSEs in Mozambique, mainly by means of interviews where the main barriers faced by those interviewed were identified and hence, this led to the second phase, which was interviewing governmental/support entities in order to know what they had done to minimize those barriers which had been identified by the entrepreneurs. Findings - The results show that financial and competitive barriers are the main barriers faced by the analyzed MSEs. These barriers vary according to the field of activity of the enterprises. Originality/value - This study serves to enrich the state of the art on the subject of smaller enterprises in Africa and will specially. help to fill the lack of academic research available about Mozambique.

Two-stage transvaginal cervical length screening for preterm birth in twin pregnancies

Aim: To compare cervical length (CL) at 18-21 and 22-25 weeks` gestation in twin pregnancies in prediction of spontaneous preterm delivery and to examine cervical shortening. Methods: Retrospective cohort study of CL measured at 18-21 and 22-25 weeks` gestation in twin pregnancies. Results: Receiver operating characteristics (ROC) curve revealed area of 0.64 (95% CI 0.53-0.75) and 0.80 (95% CI 0.72-0.88) for measurements at 18-21 and 22-25 weeks, respectively (P <= 0.001). Sensitivities of 33.3% and 23% and negative predicting value (NPV) of 97.3% and 86.8% for delivery at <28 and <34 weeks gestation were reached for measurements at 18-21 weeks. Sensitivities of 71.4% and 38.2% and NPV of 99.1% and 91.4% for delivery at <28 and <34 weeks` gestation were reached for measurements at 22-25 weeks. Cervical length shortening analysis showed an area under ROC curve of 0.81 (95% CI 0.73-0.89) and best cut-off was at >= 2 mm/week. Sensitivities of 80% and 60.8% and NPV of 98.9% and 90.6% for delivery at <28 and <34 weeks gestation were reached. Conclusions: In twin gestations, assessment of CL at 22-25 weeks is better than assessment at 18-21 weeks to predict preterm delivery before 34 weeks. Cervical shortening at a rate of >= 2 mm/weeks between 18 and 25 weeks gestation was a good predictor of spontaneous preterm birth in this high-risk population.