O Cuidador de Enfermagem e o Cuidar em Uma Unidade de Terapia Intensiva; The Nursing Caregiver and the Caring in Intensive Care Units

There are several aggressive factors in Intensive Care Units (ICU), which reach not only patients, but the nursing caregivers, since they participate in complex procedures and death of patients. Nursing caregivers may have difficulties on their daily work routine that can influence the way of care. The goal of this study was to identify the aspects of nursing caregivers working in adult ICU. It is a describe-exploratory study with qualitative approach, developed among 21 ICU adult nursing caregivers of a school hospital in Paraná. The data were collected in May and July, 2009 by recorded and transcribed semi-structured interviews. Four categories for analysis were identified: the aspects of ICU assistance, the meaning of healthcare for the nursing caregivers, the understanding of healthcare positive aspects and disclosing the difficulties of caring. The results revealed that caring is related to some factors such as mixed feelings, the mental and physical damage caused by stress; the understanding of total caring, scientific-technique procedures, family engagement in the assistance and humanization. The positive aspects are related to the welfare due to satisfaction in the work done and recognition of work. The difficulties involved death situations, psychological and biological damages, establishing links with patients and the uncaring toward the nursing caregivers.

Sexuality in older age: essential considerations for healthcare professionals

This review describes the fact that many elderly people enjoy an active sex life and examines the evidence against the general perception of an 'asexual' old age. It offers an overview of the evidence for healthcare professionals who had not previously considered the sexuality of their older patients. It also describes some of the sexual problems faced by older people, especially the difficulties experienced in disclosing such problems to healthcare professionals. It examines why healthcare professionals routinely avoid discussing sexual problems with older patients, and how this can be improved. It also offers some recommendations for future research in the area, as well as a word of caution regarding the temptation of over-sexualising the ageing process.

The Corporate Gini Index (CGI) determinants and advantages: lessons from a multinational retail company case study

This article identifies and compares the determinants of CEO compensation to median employee earnings with those of the Corporate Gini Index (CGI). Using a multinational retail company, the article posits that the CGI is an advantageous corporate alternative pay inequality measure that concerns CEO pay multiples to median employee earnings, which regulators should consider using and disclosing in proxy statements. Although CGI and the official measure of multiples of CEO pay to median employee earnings share some of the challenges, the advantages of CGI as an alternative measure are greater. Our findings suggest that the CGI is a much better measure of corporate income inequality bringing clear benefits at both micro and macro levels of intervention.

Investigating preferences for dynamic electricity tariffs: the effect of environmental and system benefit disclosure

Dynamic electricity pricing can produce efficiency gains in the electricity sector and help achieve energy policy goals such as increasing electric system reliability and supporting renewable energy deployment. Retail electric companies can offer dynamic pricing to residential electricity customers via smart meter-enabled tariffs that proxy the cost to procure electricity on the wholesale market. Current investments in the smart metering necessary to implement dynamic tariffs show policy makers’ resolve for enabling responsive demand and realizing its benefits. However, despite these benefits and the potential bill savings these tariffs can offer, adoption among residential customers remains at low levels. Using a choice experiment approach, this paper seeks to determine whether disclosing the environmental and system benefits of dynamic tariffs to residential customers can increase adoption. Although sampling and design issues preclude wide generalization, we found that our environmentally conscious respondents reduced their required discount to switch to dynamic tariffs around 10% in response to higher awareness of environmental and system benefits. The perception that shifting usage is easy to do also had a significant impact, indicating the potential importance of enabling technology. Perhaps the targeted communication strategy employed by this study is one way to increase adoption and achieve policy goals.

Understanding consumer evaluations of personalised nutrition services in terms of the privacy calculus: a qualitative study

Background: Personalised nutrition (PN) may provide major health benefits to consumers. A potential barrier to the uptake of PN is consumers’ reluctance to disclose sensitive information upon which PN is based. This study adopts the privacy calculus to explore how PN service attributes contribute to consumers’ privacy risk and personalisation benefit perceptions. Methods: Sixteen focus groups (n = 124) were held in 8 EU countries and discussed 9 PN services that differed in terms of personal information, communication channel, service provider, advice justification, scope, frequency, and customer lock-in. Transcripts were content analysed. Results: The personal information that underpinned PN contributed to both privacy risk perception and personalisation benefit perception. Disclosing information face-to-face mitigated the perception of privacy risk and amplified the perception of personalisation benefit. PN provided by a qualified expert and justified by scientific evidence increased participants’ value perception. Enhancing convenience, offering regular face-to face support, and employing customer lock-in strategies were perceived as beneficial. Conclusion: This study suggests that to encourage consumer adoption, PN has to account for face-to-face communication, expert advice providers, support, a lifestyle-change focus, and customised offers. The results provide an initial insight into service attributes that influence consumer adoption of PN.

Changes in physical activity following a genetic-based internet-delivered personalized intervention: randomized controlled trial (Food4Me)

Background: There is evidence that physical activity (PA) can attenuate the influence of the fat mass- and obesity-associated (FTO) genotype on the risk to develop obesity. However, whether providing personalized information on FTO genotype leads to changes in PA is unknown. Objective: The purpose of this study was to determine if disclosing FTO risk had an impact on change in PA following a 6-month intervention. Methods: The single nucleotide polymorphism (SNP) rs9939609 in the FTO gene was genotyped in 1279 participants of the Food4Me study, a four-arm, Web-based randomized controlled trial (RCT) in 7 European countries on the effects of personalized advice on nutrition and PA. PA was measured objectively using a TracmorD accelerometer and was self-reported using the Baecke questionnaire at baseline and 6 months. Differences in baseline PA variables between risk (AA and AT genotypes) and nonrisk (TT genotype) carriers were tested using multiple linear regression. Impact of FTO risk disclosure on PA change at 6 months was assessed among participants with inadequate PA, by including an interaction term in the model: disclosure (yes/no) × FTO risk (yes/no). Results: At baseline, data on PA were available for 874 and 405 participants with the risk and nonrisk FTO genotypes, respectively. There were no significant differences in objectively measured or self-reported baseline PA between risk and nonrisk carriers. A total of 807 (72.05%) of the participants out of 1120 in the personalized groups were encouraged to increase PA at baseline. Knowledge of FTO risk had no impact on PA in either risk or nonrisk carriers after the 6-month intervention. Attrition was higher in nonrisk participants for whom genotype was disclosed (P=.01) compared with their at-risk counterparts. Conclusions: No association between baseline PA and FTO risk genotype was observed. There was no added benefit of disclosing FTO risk on changes in PA in this personalized intervention. Further RCT studies are warranted to confirm whether disclosure of nonrisk genetic test results has adverse effects on engagement in behavior change.

Replacement of the arginine biosynthesis operon in Xanthomonadales by ateral gene transfer

The role of lateral gene transfer (LGT) in prokaryotes has been shown to rapidly change the genome content, providing new gene tools for environmental adaptation. Features related to pathogenesis and resistance to strong selective conditions have been widely shown to be products of gene transfer between bacteria. The genomes of the gamma-proteobacteria from the genus Xanthomonas, composed mainly of phytopathogens, have potential genomic islands that may represent imprints of such evolutionary processes. In this work, the evolution of genes involved in the pathway responsible for arginine biosynthesis in Xanthomonadales was investigated, and several lines of evidence point to the foreign origin of the arg genes clustered within a potential operon. Their presence inside a potential genomic island, bordered by a tRNA gene, the unusual ranking of sequence similarity, and the atypical phylogenies indicate that the metabolic pathway for arginine biosynthesis was acquired through LGT in the Xanthomonadales group. Moreover, although homologues were also found in Bacteroidetes (Flavobacteria group), for many of the genes analyzed close homologues are detected in different life domains (Eukarya and Archaea), indicating that the source of these arg genes may have been outside the Bacteria clade. The possibility of replacement of a complete primary metabolic pathway by LGT events supports the selfish operon hypothesis and may occur only under very special environmental conditions. Such rare events reveal part of the history of these interesting mosaic Xanthomonadales genomes, disclosing the importance of gene transfer modifying primary metabolism pathways and extending the scenario for bacterial genome evolution.

High genetic diversity in field isolates of Trypanosoma theileri assessed by analysis of cathepsin L-like sequences disclosed multiple and new genotypes infecting cattle in Thailand

In this study, we describe the first survey in Thailand of Trypanosoma theileri, a widespread and prevalent parasite of cattle that is transmitted by tabanid flies. Investigation of 210 bovine blood samples of Thai cattle from six farms by hematocrit centrifuge technique (HCT) revealed 14 samples with trypanosomes morphologically compatible to T. theileri. Additional animals were positive for T. theileri by PCR based on the Cathepsin L-like sequence (TthCATL-PCR) despite negative by HCT, indicating cryptic infections. Results revealed a prevalence of 26 +/- 15% (95% CI) of T. theileri infection. Additionally, 12 samples positive for T. theileri were detected in cattle from other 11 farms. From a total of 30 blood samples positive by HCT and/or PCR from 17 farms, seven were characterized to evaluate the genetic polymorphism of T. theileri through sequence analysis of PCR-amplified CATL DNA sequences. All CATL sequences of T. theileri from Thai cattle clustered with sequences of the previously described phylogenetic lineages TthI and TthII, supporting only two major lineages of T. theileri in cattle around the world. However, 11 of the 29 CATL sequences analyzed showed to be different, disclosing an unexpectedly large polymorphic genetic repertoire, with multiple genotypes of T. theileri not previously described in other countries circulating in Thai cattle. (C) 2011 Elsevier B.V. All rights reserved.

A revolução do consumidor

This study aims at disclosing the roots of contemporary consumer culture. By emphasizing the relationship between consumption and cultural and political dimensions of social life, this analysis focuses on some processes that took place in Europe since the end of Middle Ages throughout the XVIII century - e.g. the rise of absolutism, the development of royal courts and of a new life-style among them (they are the social group in which the first modern consumption features came to light), the upcoming of present (and no longer past) as the main reference frame for action, a new balance between tradition and novelty, the emergence of individualism - which are crucial to understand the genesis of present consumer standards and values.

Análise de projetos de investimentos : uma abordagem teórico-prática

The objective of this work is to search a real case of capital budgeting, relating the practical technical aspects of the elaboration of project, with theoretical referential and following secondary objectives: (i) to analyze the relations established between the bibliographical material and the found practical technical problems of capital budgeting in the enterprise; (ii) to search and to describe the necessary pacing to the economic and financial elaboration of an project, from the prospecting of the demand, the projection of revenues and expenditures and the evaluation of the necessary investments to its development; (iii) to relate and to exemplify the influences of the restrictions presented for the methods of capital budgeting, correlating the practical theoretical referential with the enterprise; (iv) to analyze the yield of the investment project, (v) to verify the influence of the financing, on the yield of the project; and, finally, (vi) to demonstrate the choice process among some alternatives of supply, when used as tools of aid to the purchase decision, the methods of the Internal Tax of Return and the Net Present Value. To the end of the study one concluded that the methods of the Internal Tax of Return and the Net Present Value are powerful tools in the yield evaluation and viability of investments projects. However, to only understand the methods through what they teach in books is not enough for the daily practical of capital budgeting. Literature starts from two basic points: (i) the investments analyst dominates all the countable revenues, expenditures, and investments concepts.(ii) the numerical examples are simple and easy to understand, to infer its practical applications is a contouring question to be raised and passed by the analyst. This study intends to show the conjunction of the bibliography with the practical one, therefore, from the instant that demonstrates the countable concept of the prescription, it also explains as it was constituted from the calculation of the demand, until its inclusion in the project. Thus, searching concepts of revenues, expenditures, depreciation and capital assets, disclosing its constitution and, over all, the application inside of the project, it all takes the analyst to the final part of the process, that consists in the determination of the numerical calculations, allowing to dedicate more time to the difficult task to interpret the data. Finally, understood the analysis of the economic viability of the project, the study guides the purchase of the equipment under the economic-financial point of view.

O papel dos fundos soberanos na economia mundial

Este trabalho faz uma resenha da literatura sobre Fundos Soberanos, destacando tópicos como suas origens, objetivos, impactos de seus investimentos, transparência e atuação destes instrumentos governamentais na recente crise financeira global. Analisa ainda a criação do Fundo Soberano Brasileiro buscando ressaltar seus prós e contras. Ressaltamos a necessidade de se observar superávits consistentes em Conta Corrente no Balanço de Pagamentos para justificar a constituição destes instrumentos. A simples existência de elevados volumes de reservas internacionais não serve como prerrogativa para sua criação, devendo-se analisar a sustentabilidade e volatilidade das fontes das divisas. Ainda, destacamos que os Fundos Soberanos são veículos de investimentos governamentais cuja relevância no mercado financeiro não justifica os temores que possam causar desequilíbrios relevantes, apesar das críticas e questionamentos em relação à falta de transparência na divulgação de informações acerca de seus investimentos.

Responsabilidade socioambiental: a divulgação de relatórios na América Latina

Este trabalho tem o objetivo de analisar comparativamente as informações socioambientais divulgadas pelas companhias latino-americanas nos seus relatórios. Foi efetuada uma análise de conteúdo das informações socioambientais divulgadas por uma amostra de 226 organizações, no período de 2004 a 2009, segregadas por país, empresa, setor e ano. Foram utilizadas as diretrizes voluntárias da Global Reporting Initiative como escopo para analisar o conteúdo dos relatórios anuais, relatórios de sustentabilidade e Formulários 20F, disponibilizados pelas organizações, nos seus websites ou nas bolsas de valores em que negociam suas ações. A maioria das companhias de capital aberto na região não disponibiliza informações socioambientais nos seus relatórios anuais ou em relatórios específicos sobre o tema. No âmbito das multinacionais que operam na América Latina e que foram selecionadas para este estudo, percebeu-se maior concentração dessas na Argentina, Chile e Peru e foram as companhias que mais divulgaram informações socioambientais nos relatórios analisados nesses países. Entre os países latino-americanos, verificou-se que o nível de aderência às diretrizes voluntárias de divulgação de informações socioambientais é baixo, mas as companhias estabelecidas no Brasil são as que têm maior e melhor nível de aderência a tais diretrizes. O referencial teórico indicou as várias influências históricas que contribuíram para esse resultado, como a organização e adesão do setor empresarial à questão socioambiental, além do apoio de ONGs que se especializaram em difundir o tema. O Instituto Ethos de Empresas e Responsabilidade Social, além de outras entidades, como IBASE e GIFE, exerceram e exercem importante papel na difusão e profissionalização das ações socioambientais das companhias brasileiras. Nos demais países, o assunto ainda é incipiente, apesar de haver várias instituições locais voltadas para a participação empresarial na elaboração e divulgação de relatórios voltados para o tema, o assunto começou a ser amplamente divulgado há poucos anos. As companhias que compuseram a amostra deste trabalho estão entre as de maior porte dos seus respectivos países. No caso do Brasil e do México, a indústria local tem sua maneira própria de elaborar ações socioambientais, bem como, divulgá-las em relatórios específicos. Quanto à evolução e forma de divulgação de informações socioambientais, tem-se o relatório anual como o principal canal utilizado pelas companhias para destacar tais informações, seguido do relatório de sustentabilidade, divulgado como parte do relatório anual, ou como uma publicação específica.

Organizações sociais em Pernambuco: o desenho institucional do controle externo sobre os contratos de gestão

O objetivo desta pesquisa foi analisar o desenho institucional do controle externo sobre os contratos de gestão no âmbito do Tribunal de Contas do estado de Pernambuco quanto a sua aderência aos conteúdos da lei estadual que disciplina as Organizações Sociais e quanto a sua observância por parte dos atores envolvidos: Administração Pública, técnicos do tribunal de contas e membros do seu corpo julgador. Foram assumidas as seguintes premissas: que os novos arranjos de prestação de serviços públicos, por meio de parcerias com as Organizações Sociais, demandam por parte dos Tribunais de Contas desenhos institucionais de fiscalização específicos, que a pesar de variáveis devem primar por sua capacidade de revelar informações; que o processo de formatação destes desenhos institucionais deve ser dinâmico, permitindo-se que as contigências experimentadas na sua implementação possam contribuir no seu aperfeiçoamento; e que esses desenhos institucionais geram impacto no comportamento dos atores envolvidos. O estudo foi realizado por meio de pesquisa documental. A metodologia qualitativa de análise de conteúdo foi escolhida para análise dos dados. Os resultados da pesquisa permitiram concluir que o desenho institucional de controle dos contratos de gestão no âmbito do TCE-PE caracteriza-se por sua fragilidade como mecanismo de revelação de informação e, consequentemente, não contribui para a redução da assimetria de informação que se estabelece com a implementação dos contratos de gestão. Adicionalmente, compromete e limita o desempenho do Tribunal de Contas no controle destes ajustes. Verificou-se, também, uma a baixa observância do desenho institucional identificado, em que pese sua fragilidade, por parte dos atores envolvidos no controle dos contratos de gestão, implicando em uma baixa institucionalização deste desenho. Os resultados devem proporcionar uma rediscussão acerca dos mecanismos de controle dos contratos de gestão por parte do TCE-PE, que poderá resultar em um novo desenho institucional com vistas a conferir maior transparência às parcerias com as Organizações Sociais.

Escândalos políticos e o clima econômico dos países sul-americanos: evidências baseadas na confiança de especialistas

Qual o impacto dos escândalos políticos sobre o clima econômico dos países sul-americanos? O presente trabalho busca responder essa pergunta ao avaliar a confiança de especialistas na economia de sete países sul-americanos durante a ocorrência de escândalos políticos em um recorte temporal de 10 anos (de 2005 até 2014). Entendemos os escândalos políticos como sendo eventos noticiados pela mídia envolvendo os presidentes das repúblicas sul-americanas em episódios de corrupção ou abuso de poder. Já o clima econômico é medido a partir da avaliação da economia por especialistas regularmente consultados pela Sondagem Econômica da América Latina, uma pesquisa que gera a construção do Índice de Clima Econômico da América Latina. Evidências apontam a influência de determinantes políticos sobre a avaliação econômica realizada pelo público geral. Poucos estudos exploram o processo de formação da confiança econômica de especialistas. Utilizamos o modelo de regressão em painel para verificar a correlação entre escândalos políticos e o Índice de Clima Econômico. Nenhuma correlação pôde ser verificada quando adotamos um modelo relacionado à economia internacional. Surpreendentemente, encontramos uma correlação significante e positiva quando adicionamos variáveis econômicas domésticas à análise. Acreditamos que futuras contribuições para o tema devam levar em conta a importância do papel das instituições como elemento fundamental na confiança de especialistas.

A representação social do cuidado no programa saúde da família na cidade de Natal

RODRIGUES, M. P.; LIMA, K. C.; RONCALLI, A. G. A representação social do cuidado no programa saúde da família na cidade de Natal. Ciênc. Saúde Coletiva, v. 13, n. 1, p. 71-82. 2008. ISSN 1413-8123.