Vivendo e aprendendo no ambiente hospitalar: Percepções de crianças sobre a doença

This study focuses on the child within the hospital environment. Its purpose is to describe children s perceptions of their illness and time in hospital and to identify their main hardships during treatment. This study has a qualitative nature and is theoretically and methodologically supported by the creative and sensitive method developed by Cabral (1998), studies by Piaget, Vygotsky and Wallon on child development, and studies conducted by Pinto (2005), Collet (2004), Chiattone (2003), Silva (2002), Lima et.al (1999) on in-patient children. For this study, 13 children between the ages of 7 and 12 at a public hospital institution specialized in child care in the city of Natal, Rio Grande do Norte, were interviewed. As a criterion for taking part in this study the children would have to have been in hospital for over three days and be fully capable of physically and emotionally interacting with the researcher at the time the interview took place. Analysis drew on the study of the empirical material made up of interviews and a field diary where notes had been entered for the children s reactions, expressions and gestures. Results show that there is some understanding, on the part of these children, of their illness, with their parents as the main informants. They accept being in hospital because they need treatment, but they realize that life becomes different especially on account of the constraints resulting from the illness and the hospital itself. The main hardships during treatment are: lack of recreational activities in the evenings and on the weekends within the hospital environment; absence of family members, especially brothers and sisters; and lack of explanation on the part of health professionals regarding some procedures as these are being carried out. Our conclusion is that children perceive illness and the hospital environment as something that changes the rhythm of their lives bringing on them perturbations, fears and anxieties. Hence, we suggest that professionals working with in-patient children should be especially prepared to deal with these children and their parents, aiming at bringing down fears and anguishes, clear their doubts and, in addition, advise the parents in respect of their children s treatment while in hospital and after hospital discharge. The hospital environment should also be cheerful and colorful and have a toy room under the coordination of persons especially prepared for that purpose

Gritos de silêncio: na voz dos familiares cuidadores de portadores da doença de Alzheimer

This work is an investigation related to issues of those who take home care of people who suffer from Alzheimer disease (AD). Thus, it is justified by the need to acknowledge how these relatives perform this task and in which ways they do this. The study has is analytical and qualitative methodology with the use of a thematic oral history approach. The subjects of the research were nine relatives of those who suffer from AD that participate in the home care group in the Candelária neighborhood in the city of Natal in Rio Grande do Norte-Brazil. The data was collected using a semi-structured questionnaire and interview that was booked in advance and had full support from the care takers. After information collection, three thematic axles were defined. After this procedure, three analisys subcategories were also defined. The first thematic axle emphasizes the so called movement of rite of passage, when the relative becomes a care taker of a person with AD. The second category deals with the care takers strategies, either related to their own behalf or on their relative. It is possible to infer that amongst other forms of help, the care taker needs to rely on a support network, such as health services, groups composed by multiprofessionals that enable better articulation between family and collaborators. The dimension related to faith and spirituality was also observed and pointed out as an important aspect in the emotional support process for these relatives. In the third axle the perspectives of struggle, conquests of the right to health and life quality of those who suffer from AD as well as their relatives was observed. These also deal with dreams and hope

Avaliação do impacto do treinamento de clínica em hanseníase e sua contribuição para o aumento da detecção da doença no Estado do Rio Grande do Norte

Hansen´s disease is considered a serious public health problem. In 2006, the Ministry of Health reported that worldwide, Brazil ranked 2nd in the number of cases of the disease, surpassed only by India. The North region is the geographical area in Brazil that presents the most cases. In the state of Rio Grande do Norte, the disease is considered to be eliminated because its prevalence has been identified as 1 per 10.000 inhabitants, criteria established by the State Elimination Letter of 2005. Training programs have been offered by the Coordination for the Control of Hansen´s Disease Program of Rio Grande do Norte, PCH-RN since 1997, with the support of the English governmental agency Leprosy Relief Association, LRA, with no evaluation having been conducted. The objective of this study was to evaluate the training programs in clinical diagnosis of Hansen´s disease and their contribution to the detection of the disease in the state of Rio Grande do Norte. The study was conducted in seven municipalities that are known as Regional Public Health Units (URSAPs): São José de Mipibu URSAP I, Mossoró URSAP II, João Câmara URSAP III, Caicó URSAP IV, Santa Cruz URSAP V, Pau dos Ferros URSAP VI and Natal, capital city of the State, in the Metropolitan Region. Physicians and nurses of the Family Health Program PSF were interviewed as to their perceptions of the implementation of the training program in clinica diagnosis of Hansen´s Disease conducted by the PCH-RN. They evaluated their own practice and the training program. These professionals presented a positive evaluation of the program and gave suggestions for future courses. The results of this study suggest the need for permanent education. Data of the disease obtained from the official records of the Secretariat of Health and from the interviews indicate that health education is the means to control Hansen´s disease effectively

Tuberculose: conhecimentos, representações sociais e experiências da doença na visão do portador

Tuberculosis is considered one of the most ancient human diseases, cases were registered 3900 years before Christ, and it is currently regarded as a serious public health problem in the world due to several factors such as income mismanagement, precarious standard of life and some sort of prejudice comprised by the word tuberculosis. Taking this into consideration, it was developed a descriptive and exploratory study aiming at analyzing the social representations of tuberculosis made by its patient from the Unidades de Saúde da Família (Family Health Units a public health program) in Campina Grande City PB, in relation to the decentralization of the policies that administrate the disease. It was interviewed 34 tuberculosis patient that were being treated from 2007 to 2008. The age group of the interviewees varied from 10 to 60 years old, but most of them were between 36 and 60 years old (58,8%, n=20), some were young adult and adult (21 35 years old), with 11 (32,3%) respondents, and, less frequent, children and teenagers (11 20 years old), with 03 (8,8%) participants. Data was collected through semi-structured interview. The questions that guided the research were elaborated based on the operational recommendations of DOTS strategy; that is: access to laboratory examinations; medication guarantee; directly observed treatment. Besides that, the experiences of the patient were considered in their relation with the family and the different social groups. The analysis of the discursive material was submitted to the Analyse Lexicale par Context d un Ensemble de Segments de Texte software - ALCESTE 4.7. Data interpretation showed five categories for the social representations of the tuberculosis patient that participated in DOTS strategy: 1) the accessibility of the health assistance service; 2) the patient perspective of the disease; 3) the change in the operation of the productive life; 4) the signals and symptoms of the tuberculosis disease; 5) the rearrangement and mechanisms used to face the disease. The Central Nucleus reveals that tuberculosis is a transmissible disease that can be prevented by people through educational practices, health promotion, active search for symptomatic respiratory and control of the carriers communication; these mechanisms should be incorporated to the routine of all participants of the family health groups. The Intermediate Elements, based on quotidian life, as well as the individual experiences of the tuberculosis patient, reveals prejudiced attitude and beliefs that lead to isolation and restriction of interpersonal relationship. Peripheral Elements were constituted by themes that showed the patient feelings of indignation because of the social barriers they had to face in the Family Health Units during the treatment. These elements demonstrate a negative perspective of the representation concerning the accessibility, i.e. inadequate structure of the health service; long distance to the Health Centre, this factormakes it difficult for the patient to continue the treatment; scheduling delay; and limited service regarding other requests (doctor, dentist etc). One expects to contribute for the construction of a new perspective of the health question between the different agents who make the assistencial institutions and formation of professionals, either in central or local scope

ATIVIDADE MICROBIANA E PROPRIEDADES BIOQUÍMICAS do SOLO RESULTANTES da APLICAÇÃO DE GESSO AGRÍCOLA NA CULTURA do REPOLHO

Conselho Nacional do Desenvolvimento Científico e Tecnológico (CNPq)

Atividade e população microbiana envolvida nas transformações do enxofre em solos com diferentes vegetações

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Controle da neoplasia maligna do colo de útero: a resolutividade na atenção básica

A quantitative, descriptive, cross-sectional and retrospective study, using technical procedures of document consultation from secondary sources and health household survey with application form for face to face inter views, with the assent nº.039/2011 from the Ethics Committee of the Federal University of Rio Grande do Norte. The aim of this study was to analyze the cervix cancer control in the area47 of the Health Family Centre Nova Natal II. The cancer cervix is the second most common cancer among women worldwide. In Brazil screening for early detection and treatment of disease has been poorly done and follow-up to reduce mortality has not been executed. From a total of1170women belonging to area 47, who under went screening by the Pap test in the period from 2005 to 2010,was elected a sample of 38 women with positive cervical changes, over 18 years old. The calculation of frequency analysis of socio demographic and clinical and epidemiological selected variables with the results of cervical changes, using the X2 test and taking as significance level of p<0.05 was not statistically significant. The predominant age range was 25 to 64 years (68.9%), most no white women (60.5%), predominantly with primary education (57.9%), most married (68.4%) and housewives (68.4%) with early age of sexual activity (86.8%), the minority smokers (13.2%), with a sexual partner (36.8%). At the time of interview, 42.1% of the women voiced complaint of discharge, while only 2.6% reported bleeding. In relation to the occurrence of STDs (including HPV), 10.5% of women reported being a carrier. The use of oral contraceptives was 32.3% of women, from 2 to 4 years (44.4%). The result of the last screening test performed, showed prevalence of immature squamous metaplasia (55.3%), followed by intraepithelial low- grade lesion (including the cytopathologic HPV effect and cervical intra epithelial neoplasia grade I) (31.6%); intraepithelial high-grade lesion (including cervical intraepithelial neoplasia grade II and III) (7.9%), atypical squamous non neoplastic cells (5.3%). There was no squamous cell carcinoma and adenocarcinoma. Most women received information about the action that should be done after the last screening test result (55.3%), but how to perform follow, most women did not report having done so (55.3%). The follow-up group of women studied, with varying degrees of cervical abnormalities, should only be completed with the discharge by cure, established inconsecutive negative cytology, a goal that is not being achieved in the area 47 of the Health Family Centre of Nova Natal II

Diagnósticos de enfermagem em pacientes submetidos à hemodiálise: semelhanças entre o modelo de adaptação e a NANDA internacional

The nurses in the hemodialysis has an important role in the nursing process implementation, in the context of a theoretical referential. Among the nursing theories, highlights the Roy´s adaptations model, who considers a person as an holistic adaptive system that aims to adapt customers to different living conditions. Thus, it is believed that the Roy´s nursing process will guide nursing care to patients on dialysis. Therefore, the study aimed to analyze the nursing diagnosis present in patients with chronic kidney disease on hemodialysis based on the theoretical model of Roy and NANDA-International. Descriptive and cros-sectional study, performed at a dialysis center in a city in northeastern Brazil. Sample of 178 patients and consecutive sampling by convenience. Data collection ocurred from October/2011 until February/2012, through interview and physical examination forms. Data analysis was initiated by clinical reasoning, diagnosis judgment and similarity relation. Then, the data were entered into SPSS program, 16.0 version, generating descriptive statistics. The project was approved by the Ethics Research Committee (protocol nº 115/11) with a Presentation Certificate for Ethics Appreciation (in 0139.0.051.000-111) and was funded by the Universal edict MCT / CNPq 14/2010. The results revealed that most patients were male (52.2%), married (62.9%) and residents in the Natal´s metropolitan region (54.5%). The mean age was 46.6 years and the years of study, 8,5. Regarding nursing diagnosis obtained an average of 6.6, especially: Risk of Infection (100%), excessive fluid volume (99.4%) and hypothermia (61.8%). On the other hand the adaptive problems average was 6.4, and the most common: intracellular fluid retention (99.4%); Hyperkalemia (64.6%); Hypothermia (61.8%) and edema (53.9%). Were established 20 similarity relations between the NANDA-International nursing diagnosis and adaptive problems of Roy, namely: risk of falls / injury risk and potential for injury, impaired physical mobility and walking mobility and / or restricted coordination, dressing self-care deficit and loss of self-care ability; hypothermia and hypothermia; impaired skin integrity and impaired skin integrity; excessive fluid volume and intracellular fluid retention / Hyperkalemia / Hypocalcemia / edema; imbalanced nutrition: less than body requirements and Nutrition less than the body's needs; constipation and constipation, acute pain and acute pain, chronic pain and chronic pain, sensorial perception disturbed: visual, tactile and auditory disabilities and a primary sense: sight, hearing and tactile; sleep deprivation and insomnia, fatigue and intolerance to activities; ineffective self health and fails in the role; sexual dysfunction and sexual dysfunction; situational low self-esteem and low self-esteem, and diarrhea and diarrhea. We conclude that there is similarity between the typologies and was required a model´s analysis, because they present different ways to establish the nursing diagnosis. Moreover, the nursing process use, under the context of a theory and a classification system, subsidizes the care and contributes to the strengthening of nursing science

O cuidador familiar de pessoa com doença de Alzheimer: história oral de vida

The aim of the present study was to understand the feelings and the difficulties faced by the family caregiver in the care of the person affected by Alzheimer`s Disease (AD). It is a descriptive, exploratory study with a qualitative approach, using the oral life history proposed by Bom Meihy as the method. Data collection was conducted in the Basic Health Unit of Candelaria, located in Natal -RN, with five collaborators that carry out the role of family caregivers for people affected by Alzheimer`s disease (AD) and are members of the Group "Caring for those who Care". Caregi vers who resided with the affected family member for at least one year were selected for the study, and as a collection tool, it was opted to use semi-structured interviews via a script of open questions, recorded by permission of the collaborators, then t ranscribed and subsequently returned to respondents for checking the contents described. To analyze the results, the collaborators narrative technique was used in conjuction with the specific literature on the subject.The discussions were organized around five themes inherent to the guiding questions, and defined as follows: the incorporation of the role of the family caregiver; life before and after assuming the role of caregiver, the caregiver`s feelings and attitudes after assuming the care, difficulti es in caring, participation of the group as a foundation for caregivers. The stories showed many difficulties in the daily routine of the caregivers, and also that their participation in the group "Caring for those who Care" helps them in maintaining the q uality of their lives. The results open possibilities for the construction of new forms of approach and care for the people who fulfill the role of family caregiver contributing to strengthening of subsidies that help them better face the daily difficulti es.This study helped shed light on the fact that being a family caregiver of a person affected by AD is a suffered, exhausting and stressful condition involving much self-denial in one´s life. The situation experienced by these collaborators is considered a public health issue, and thus highlights the urgency for governmental political -social actions, besides the programs of care and health promotion for this target group.

Enxofre disponível para a soja e atividade de arilsulfatase em solo tratado com gesso agrícola

O constante uso de fertilizantes que não contêm S, aliado ao baixo teor de matéria orgânica de alguns solos, pode resultar em limitação desse nutriente para as culturas. Graças à alta mobilidade do íon sulfato no perfil da maioria dos solos, é importante conhecer o efeito residual da aplicação do gesso agrícola feita com a finalidade de fornecimento de S, visando estimar sua freqüência de realização. em dois anos agrícolas, foram efetuados experimentos em campo para avaliar o efeito da aplicação de gesso agrícola nos teores de S-sulfato, S-reserva e atividade da arilsulfatase de um Latossolo Vermelho distrófico cultivado com soja, bem como nos teores de macronutrientes nas folhas e na produtividade de grãos da cultura. Os tratamentos consistiram na aplicação de: 0, 67, 133, 267, 533 e 1.067 kg ha-1 de gesso agrícola, em delineamento inteiramente casualizado, com quatro repetições. Realizaram-se amostragens de solo nas profundidades de 0-20 e 20-40 cm a cada 21 dias durante o ciclo da cultura, totalizando seis por ano. A primeira amostragem de cada ano foi feita antes da aplicação do gesso. No segundo ano, a distribuição dos tratamentos foi feita sobre as mesmas parcelas do ano anterior. O gesso agrícola aumentou os teores de S-sulfato no solo nas épocas próximas à aplicação, os quais diminuíram com o tempo, em decorrência da precipitação pluvial. No primeiro ano, o S-sulfato foi lixiviado para além da profundidade de 20-40 cm, sem efeito residual de um ano para o outro. A atividade da arilsulfatase foi maior a 0-20 cm, de forma semelhante ao observado para o S-reserva, havendo correlação positiva entre essas variáveis. A aplicação de gesso agrícola não influenciou a produção de grãos e, à exceção do teor de S no segundo ano, não alterou os teores de macronutrientes nas folhas de soja.

Atividade de proteases e disponibilidade de nitrogênio para laranjeira cultivada em Latossolo Vermelho distrófico

O conhecimento do potencial da mineralização dos compostos orgânicos nitrogenados do solo é fundamental para o uso eficiente do N em sistemas de produção agrícola. Com o objetivo de avaliar a atividade de proteases e suas relações com os teores de diferentes formas de N em Latossolo Vermelho distrófico cultivado com laranjeira, foram coletadas amostras de solo em duas profundidades (0-10 e 10-20 cm), na linha de projeção da copa e nas entrelinhas, nos meses de novembro e dezembro/98, fevereiro e março/99. em março/99, época recomendada para a diagnose foliar, também foram coletadas amostras de folhas. As amostras de solo foram avaliadas com relação à atividade de proteases e aos teores de N-amoniacal, N-nitrato, N-total, N-amoniacal obtido após incubação anaeróbia (N-pot) e N-amoniacal extraído por solução de CaCl2 sob autoclavagem (N-autoclave). Nas amostras de folha, determinou-se o teor de N-total. A atividade de proteases foi influenciada pelo local e pela profundidade de amostragem, tendo sido mais elevada na linha de projeção da copa e profundidade de 0-10 cm. A aplicação de fertilizante orgânico causou aumento na atividade de proteases, principalmente na camada de 0-10 cm. O coeficiente de correlação entre atividade de proteases e outros métodos para avaliação da disponibilidade de N dependeu da época, do local e da profundidade de amostragem. A correlação entre o N-foliar, obtido na época indicada para diagnose foliar, a atividade de proteases e as demais formas para avaliar disponibilidade de N (N-amoniacal, N-nitrato, N-autoclave e N-pot) variou com a época de amostragem. A atividade de proteases foi positiva e altamente correlacionada com o N-foliar, obtido na época indicada para fins de diagnose foliar, para amostras de terra retiradas nas entrelinhas (0-10 cm), no mês de dezembro/1998.

Avaliação da atividade dos inibidores de tripsina após digestão enzimática em grãos de soja tratados termicamente

Este trabalho avalia a reativação dos inibidores de tripsina, após proteólise in vitro, de grãos de soja tratados termicamente. Para a inativação térmica dos inibidores, os grãos foram embebidos em água destilada (1:5 p/v) durante 12 horas e aquecidos em placas sob refluxo por 30 minutos. A reativação dos inibidores foi avaliada em comparação com a atividade das amostras cruas e aquecidas. A digestibilidade in vitro das proteínas variou de 47% ('OC-13') a 59% (Paraná), apresentando uma melhora, em média, de 32,6% com o aquecimento. A atividade dos inibidores de tripsina para os grãos crus variou de 122 a 206 UTI/mg de amostra, e os valores correlacionaram-se negativamente com a porcentagem de digestibilidade (r = -0,9177). Os inibidores tiveram suas atividades totalmente inativadas com o aquecimento dos grãos, os quais apresentaram porcentagem de recuperação, em média, de 40%. Com o aquecimento, a inativação dos inibidores provavelmente ocorre por complexação com os componentes do grão, o que leva à recuperação da atividade com o processo de digestão enzimática.

Atividade enzimática pancreática de frangos de corte alimentados com dietas contendo enzima ou probiótico

Este trabalho foi realizado para avaliar o efeito da adição de enzima e/ou probiótico, bem como do estresse calórico sobre a atividade de enzimas digestivas de frangos de corte aos 7, 14, 28 e 42 dias de idade. O delineamento experimental utilizado foi o inteiramente casualizado em parcelas subdivididas com 6 tratamentos primários, constituindo um esquema fatorial 6x2 (rações x temperatura) e 4 tratamentos secundários (idades de amostragem), com 2 repetições. Não foi verificado efeito significativo dos tratamentos sobre a atividade específica das enzimas, exceto para as atividades de amilase aos 14 dias e tripsina aos 28 dias de idade, nas quais a adição de enzima proporcionou maiores atividades. Já a idade de criação afetou significativamente todas as enzimas quantificadas, sendo que a atividade específica de lipase diminuiu e as atividades específicas de amilase, tripsina e quimotripsina aumentaram com a idade das aves. A temperatura ambiente (calor) também afetou a produção enzimática de acordo com a idade dos frangos de corte, com um aumento na atividade de lipase e redução na tripsina e amilase.

Efeito dos taninos condensados de forrageiras nativas do semi-árido nordestino sobre o crescimento e atividade celulolítica de Ruminococcus flavefaciens FD1

Avaliaram-se o crescimento da população, a atividade in vitro da enzima 1,4-b-endoglucanase e a taxa de digestão de celulose em culturas de Ruminococcus flavefaciens FD1 na presença de 50, 100, 200 e 400µg/ml de taninos purificado das leguminosas Mimosa hostilis (Jurema Preta), Mimosa caesalpinifolia (Sabiá) e Bauhinia cheilantha (Mororó). O crescimento bacteriano, a atividade da endoglucanase e a digestão de celulose foram fortemente inibidos pela presença dos taninos condensados purificados das três espécies, entretanto, a intensidade da inibição foi variável em função da espécie da leguminosa e da concentração de tanino.

Ergonomia, sustentabilidade sócio-ambiental e atividade de pesca artesanal com jangadas: estudo de caso na Praia de Ponta Negra, Natal-RN

The fishing is made possible by the handiwork of a fisherman, not using appliances that achieve the same levels of industrial fishing productivity and not causing environmental impacts on fish stocks with the same intensity. The adoption of sustainability practices in this type of fishing has been requested for the achievement of environmental and socioeconomic improvements, since its production has been decreasing over the years and overfishing has led to reduced stocks also stand out environmental aggressions such as pollution. Thus, this research aims to analyze the interference of environmental aspects/impacts that permeate the activity performed by fisherman on the beach of Ponta Negra, Natal-RN, in order to propose recommendations for environmental sustainability. We used a methodology based on the ergonomic work analysis (WISNER, 1987; GUERIN, 2001; VIDAL, 2008) using techniques such as observational and interactional observation protocols, photographs, videos, conversational action, and listening to verbalizations. To understand the vulnerability of the environment in which the activity is carried fisherman and the interferences that it suffers, we used the study of environmental aspects/impacts (SÁNCHEZ 2008). As a result, it appears that from the observations located and reports raftsmen, changes in the sea, the search for new fishing grounds farther from the coast, reducing fishery production, waste generation and pollution of the workplace, and the difficulty in docking rafts, factors arising from the pressures both for society as Seen by fisherman, denoting the necessity of drawing up recommendations and actions proposed by management activity by promoting discussion among raftsmen and accountable institutions, and training through workshops on environmental education, aiming to positive changes in the activity fisherman from Ponta Negra and the environment in which raftsmen are inserted in order to seek a sustainable activity, preserving its characteristics