O cuidado humanístico como foco institucional: um estudo sobre empatia dos profissionais de saúde na área obstétrica

Empathy is a basic facilitating element of the therapeutic helping relationship and the humanization process in health care. The objectives of this study were to identify the empathy level of health professionals working in the obstetrical sector of a university hospital recognized for its humanistic care and the perceptions of the women under their care regarding the empathic behavior shown by these professionals during hospitalization. We conducted a quanti/qualitative study with 47 health professionals that worked in the obstetrical sector (13 obstetricians, 12 nurses, 22 nurse technicians) and an intentional sample of 101 women that received cared from these professionals during the study period. We collected data by means of the Jefferson Empathy Scale for Health Professioals (JEPS-HR) and the Patient´s Perception of Health Professional Empathy (PPHPE), and two additional open questions designed to obtain the subjective opinion about the empathic behavior during the care. We utilized thematic analysis for the data obtained through the open questions and descriptive and inferential statistics for the quantitative data. We identified five thematic categories that represent the aspects valued by the professionals in their relationship with the women under their care: emotional involvement, communication, warm environment, integral vision and technical/scientific knowledge. The mean score on the JEPS-HR reported for the health professionals was 120,40, being that the maximum possible was 140.The Cronbach Alpha for the JEPS-HR was 0,83, indicating an acceptable level of reliability for this population. We consider therefore, that these professionals presented an acceptable empathy level when compared to other populations observed with the JEPS-HR. The results also indicated that women had statistically significant (p ≤ 0,05) higher scores than men and that professionals with higher working hours tended to have lower scores in the empathy scale (r = -0,288; p ≤ 0,05). The analysis of the subjective responses of the women indicated that they were satisfied with the humanistic care provided by the professionals but they also point out the existence of some power relationships. There were no significant differences in the empathy level of the medical or nursing team perceived by the women who registered means of 41,90 and 41,20 respectively on the PPHPE. In view of these results and considering the relevance of the element of empathy for care based on humanistic values, we reiterate the importance of further in-service training for the health team of the hospital in focus, on the topics of empathy and global aspects of humanized care for the implementation of its mission

Estratégias para elaboração de um plano de segurança da água para abastecimento humano do município do Natal/RN

This research study deals with the production and distribution of drinking water with quality and safety in order to meet the needs of the Man. Points out the limitations of the methodology for assessing water quality in use today. Approaches the recommendations of the World Health Organization (WHO) for adoption, by the companies responsible for producing and distributing water, of assessment methodologies and risk management (HACCP), in order to ensure the quality and safety of water drinking. Suggests strategies for implementing the plan for water safety plan. Uses the process of water production, composed by Maxaranguape river basin, the water treatment plant and distribution system, which is part of the Plan for Expansion of the Supply System of Natal, as case study. The results, it was possible to devise strategies for implementation of the Water Safety Plan (WSP), which comprises the following steps: a) a preliminary stage. b) assessment system. c) process monitoring. d) management plan and e) validation and verification of the PSA. At each stage are included actions for its implementation. The implementation of the PSA shows a new type of water production, in which the fountain as a whole (watershed and point of capture), the Water Treatment Plant (WTP) and distribution, shall compose the production process, over which to build quality and safety of the final product (drinking water)

Remoção biológica de nitrato em água de abastecimento humano utilizando o endocarpo de coco como fonte de carbono

The groundwater quality has been compromised as a result of the intensification of human activities over the years. Groundwater contamination by nitrate is one of the effects of this degradation, a socio-environmental problem that affects many regions of the world and particular the city of Natal (RN). Developing techniques for nitrate removal in water is intended to eliminate or reduce the concentration of this compound, and those that involve biological processes have produced economic and environmental advantages. This study proposes a technology for biological removal of nitrate in water supply for humans, using the endocarp s coconut as a carbon source and bacteria support. The experiments were performed in pilot scale anoxic, testing different areas of the substrate surface. Results showed high rates nitrate removal during the monitoring period, noting the occurrence of denitrification after the beginning of system operation. The best performance was achieved in the treatment system containing substrate surface area increased, indicating that the decrease in the endocarp size contributed to increased bacterial activity, improving the ability to remove nitrate. About the quality analyzed aspects of water, it was found that the proposed technology has the potential water use for human consumption

O império do desentendimento humano: representações da realidade em textos de dalton trevisan

This work has the general proposal of studying the composition of the trevisanian fictional universe, the aesthetic expression engineered to formulate this universe, and last, the representations of reality that emanates from this aesthetic-narrative construction. It seemed to us, however, that it would be impossible to cover, even superficially, so vast and voluminous set of texts as the trevisanian. Therefore, so that we could accomplish this task, and still do it in a way that was, at the same time, plausible and thorough, it was necessary an objective cut within that library. Then we selected a book, representative of the whole trevisanian work, which served as the object of study: Cemitério de Elefantes, 1964, one of the first books of short stories by this author. Within this one, we focused even more our sight, then moving towards what we call a reality forked in paralytic world and world in violence . Supported by the theories and methodologies of Auerbach (2011), Candido (2002, 2006), Adorno (2003), Gennete (1995), Friedman (2002), and still moved by the spirit of Russian Formalism (1973), we built our criticism. Our approach was based then in three steps: first we are dedicated to comment the general context of the trevisanian work, supported strongly by reading two of the biggest critics of his literature, Miguel Sanches Neto and Berta Waldman, secondly, we turn us to comment on the detailed formal construction of language and narrative elements of the trevisanian prose; finally we raised our criticism to the level of reading representations of reality, and then we started to comment the construction of the trevisanian fictional universe, focusing in splitting this universe in paralytic world and world in violence

Foucault e a arte do cuidado de si: uma nova possibilidade de Discussão para a formação continuada de professores de língua inglesa

This thesis proposes a new thinking on the English teacher and their continuing education, leaving the picture emerging of a new professional, who is producing and being produced. From this perspective, I present an analysis of self writing of thirteen student-teachers, teachers on how they position themselves to be discursively constituted as subjects in the context of continuing education. As part of Applied Linguistics, the theory and method that supports the analysis of data are articulate key elements of Foucault notions, namely:The care of the self, seeking their connection with one another and care of and the self writing. In the theoretical notions of these elements are implied notions of others, such as speech, ethics, technology of the self, subject and truth. (Foucault, 1984, 1995, 2004c, 2006), and questioning the ethics of the subject. I propose to examine selected excerpts from the self writings of student teachers with a specialization in Teaching and Learning the English Language, seeking linguistic processes in the material production of subjectivities.In order to analyze the process of subjectivation, I examine the discursive statements of selected cuts, aiming to learn more specifically, the points of identification and fragments of the uniqueness of the teachers, showing how they care for themselves and reflect upon them in building their subjectivity from the technologies of the self, to occupy the position of English Language teachers. The results show that, in the exercise of self writing, the subject falls, and a practice of asceticism, discursively construct her/his subjectivity

Avaliação do transplante de medula óssea alogênico por meio do estudo de regiões de repetições seqüenciais no genoma humano (VNTRs e STRs)

Os objetivos deste estudo foram estabelecer um protocolo para a análise de minissatélites ou VNTRs e microssatélites ou STRs em pacientes que se submeteram ao TMO alogênico; verificar a validade da metodologia e dos loci estudados e avaliar o tipo de recuperação do paciente. Foram analisados o DNA do paciente anterior e posterior ao transplante de 14 indivíduos e dos respectivos doadores. Amplificações por PCR de seis loci: D1S80, SE33, HumTH01, 33.6, HumARA e HumTPO foram realizadas. Os produtos amplificados foram separados por eletro­forese vertical em gel de poliacrilamida, e os fragmentos visualizados por coloração pela prata. Esse procedimento mostrou ser válido na verificação da recuperação alogênica, autóloga e provavelmente na quimérica. da somatória dos loci estudados, 63,1% apresentaram resultados possíveis de serem avaliados e, desses, 19,0% mostraram resultado informativo, 13,1% parcialmente informativo e 31,0% não informativo. Os 36,9% restantes não foram possíveis de avaliação. Dos loci avaliados, o que demostrou maior índice de resultado informativo foi o SE33, parcialmente informativo o HumTPO e não informativo o HumTH01, sendo o locus 33.6 o que mais apresentou resultados não possíveis de serem avaliados. Por outro lado, determinou-se a recuperação do paciente posterior ao transplante em 71,4% dos indivíduos, sendo que, desses, 90% apresentaram recuperação alogênica e 10% recuperação autóloga.

Cuidado de si e hermenêutica do sujeito em Michael Foucault

The work, here present, has as its objective to present in a clear and distinct manner the object of study of Michel Foucault in his last years of teaching at the College de France, namely, the care of the self. We present the care of the self in its birth, in its origin, from the character Socrates and its development until the beginning of the Christian age. With a keen eye, we present Foucault with a work of return and rescue of the care of the self to the personal and academic discussions; we propose, from the self care, to the contemporary subject a problematization of their life so that from this questioning he creates for herself ways of life that are coherence, knowledge and care with which he has of must particular, his himself. Passing by the sources that served as the source of study for Foucault to sketch the birth of care of the self, we design the form with which Foucault has dealt with the documents that speak of the care of self. We present Socrates as one who by excellence ensures that the other will give birth to the forms of knowledge and care of the self or, in other words, we present the care of the self socratic-foucauldian as a constant worry of the other to pay attention to ways in which he conducts her life, it creates for themselves ways of being and, therefore, creates ethics of existence. We present, finally, the care of the self as the cause of continuous immanence of modes of subjectivation of the subject that configure themselves in a non-accepting a determined essence, but a continually updated form . The care of the self leads to a single relationship and educator of modes of subjectivation of the subject; he creates, on the dynamics of temporality, ethical ways of living, which are sustained by an internal coherence of the subject with herself; he admits no stationary nature in the training of the subject, always wants a more beautiful work of himself; he is not isolation, he needs and is made with the other. The care of the self is the principle and the telos of battles and conquests of the subject within his temporality and existence

Lazer na terceira idade: desenvolvimento humano e qualidade de vida

The article aimed to understand the concept of leisure and understanding that older people have about their benefits to the quality of life as part of the idleness of the population. We used a sample of subjects living in the city of Bauru, SP, aged less than fifty years, of both sexes and economically disadvantaged class. It was used in literature, documentary and field. We developed an intervention project that aimed to education for leisure. It was the conclusion that public policies are necessary and qualified professionals for construction projects and equipment to expand the Recreation, spreading it and reaching the people of old age since previous stages of life. Materials with simple and low cost, the project of intervention, it reached the recreation-education and education for leisure satisfactorily.

Avaliação in vitro da adesão e proliferação de células mesenquimais do ligamento periodontal humano em diferentes superfícies de titânio

In the last years, many scientific researches in implantology have been focused on alternatives that would provide higher speed and quality in the process of osseointegration. Different treatment methods can be used to modify the topographic and chemical properties of titanium surface in order to optimize the tissue-implant reactions by a positive tissue response. This study aimed to evaluate the adhesion and proliferation of mesenchymal cells from human periodontal ligament on two different titanium surfaces, using cell culture techniques. Grade II titanium discs received different surface treatments, forming two distinct groups: polished and cathodic cage plasma nitriding. Human periodontal ligament mesenchymal cells were cultured on titanium discs in 24-well cell culture plates, at a density of 2 x 104 cells per well, including wells with no discs as positive control. Data obtained by counting the cells that adhered to the titanium surfaces (polished group and cathodic cage group) and to the plastic surface (control group), in the 24, 48 and 72-hour periods after plating, were used to analyze cell adhesion and proliferation and to obtain the cell growing curve in the different groups. The data were submitted to nonparametric analysis and the differences between groups were compared by Kruskal-Wallis and Friedman statistical tests. No statistically significant differences were found in the cells counts between the groups (p>0.05). It was concluded that both treatments produced surfaces compatible with the adhesion and proliferation of human periodontal ligament mesenchymal cells

Papilomavírus humano (HPV) e células de Langerhans em carcinoma epidermóide oral

The Human Papillomavirus (HPV) has been strongly implicated on development of some cases of oral squamous cell carcinoma (OSCC). However, the immunological system somehow reacts against the presence of this virus. Among the cells involved on such mechanism of defense detaches the Langerhans cells (LC), which are responsible for processing and presenting antigens. The purpose of this study was to evaluate the immunohistochemical reactivity for Langerhans cells between HPV positive and HPV negative OSCC, as well as, the relation of the immunoreactivity for this cells and the histological grading of malignancy proposed by Bryne (1998) and modified by Miranda (2002). Additionally, HPV infection was evaluated in relation to sex, age, lesion localization and histological grading of malignancy. In the total, 27 cases of OSSC were evaluated, 09 of them HPV positive and 18 HPV negative. Anti S-100 antibody was utilized for the immunohistochemical labelling, followed by the counting of LCs in 5 highpower fields (400x). No statistically significant difference was verified between the variables sex, age, lesion localization, histological grading of malignancy and HPV presence in OSSC. There was neither association between the immunohistochemical labeling for LCs (S-100+) and HPV infection nor correlation between the quantity of LCs labeled and the histological grading of malignancy of OSSC. The results suggest that despite the absence of statistically significant difference, the presence of HPV in such cases of OSCC can alter the immunological system, particularly the Langerhans cells

Estudo da detecção do DNA do papiloma vírus humano (HPV) e da expressão imuno-histoquímica de proteína do ciclo celular no carcinoma epidermóide oral

Oral squamous cell carcinoma (OSCC) is the most common malignancy in oral cavity and human papillomavirus (HPV) may have an important role in its development. The aim of this experiment was to investigate the HPV DNA and viral types in 90 cases of OSCC. Moreover, a comparative analysis between the cases of OSSC with and without HPV DNA was performed by using cell cycle markers p21 and pRb in order to detect a possible correlation of these proteins and HPV infection. DNA was extracted from paraffin embedded tissue and amplified by PCR (polymerase chain reaction) with primers PCO3+ e PCO4+ for a fragment of human β-globin gene. After this procedure, PCR for HPV DNA detection was realized using a pair of generic primers GP5+ e GP6+. Immunohistochemical study was performed by streptoavidin-biotin technique and antibodies against p21 and pRb proteins were employed. Eighty-eight cases were positive for human β-globin gene and HPV DNA was found in 26 (29.5%) of then. It could not be detected significant correlation between HPV and age, sex and anatomical sites of the lesion. The most prevalent viral type was HPV 18 (80.8%). Regarding the immunohistochemical analysis, it was detected significant association between HPV presence and pRb immunoexpression (p=0,044), nevertheless, the same was not observed in relation to p21 protein (p =0,416). It can be concluded that the low detection of HPV DNA in OSCC by the present experiment suggests a possible role of the virus in the development and progression in just a subset of this disease

Influência do estado nutricional materno em vitamina A sobre os níveis de imunoglobulina A no colostro humano

Mothers with good vitamin A nutritional status during gestation and lactation are better able to nourish and protect their infant with maternal milk. Our hypothesis is that women with more serum retinol have more retinol and secretory immunoglobulin A in colostrum. 190 healthy puerperal women from a Brazilian public maternity were recruited and divided according to the cutoff point for serum retinol (30 μg/dL). A number of the women was supplemented with 200000 UI (60 mg) of retinyl palmitate in the immediate postpartum. Serum and colostrum were collected on the 1st day postpartum and colostrum again on the following day. Retinol (serum and colostrum) was analyzed by HPLC and SIgA (colostrum) by turbidimetry. The mothers presented with adequate biochemical indicators of nutritional status, according to serum retinol (44.6 μg/dL). There were significant differences (p= 0.0017 and p= 0.043, respectively) in retinol and SIgA levels in the colostrum of mothers with serum retinol > 30 μg/dL and < 30 μg/dL. The concentration of SIgA in the colostrum of non-supplemented mothers on the 1st day postpartum was 822.6 mg/dL, decreasing after 24 hours to 343.7 mg/dL. Supplemented mothers showed levels of SIgA in colostrum of 498.9 mg/dL on the 2nd day postpartum (p= 0.00006). The colostrum of women with good vitamin A nutritional status had more retinol and SIgA. Additionally, maternal supplementation increases the levels of SIgA in colostrum. The higher levels of SIgA on the 1st day postpartum showed the importance of early breastfeeding, given that it provides considerable immunological benefits to newborn infants

A percepção das características da face infantil por adultos e crianças sob uma perspectiva evolucionista

Child facial cues evoke attention, parental care behaviors and modulate for infant- caretaker interactions. Lorenz described the baby schema ( Kindchenschema ) as a set of infantile physical features such as the large head, round face, high and protruding forehead, big eyes, chubby cheeks, small nose and mouth. Previous work on this fundamental concept was restricted to positive perception to infant face, and did not show consistent results about the development individuals perceptions, regarding the physical attributes that worked as markers of cuteness. Here, we experimentally tested the effects of baby schema on the perception of cuteness of infant faces by children and adults. We used 60 none graphically manipulated photos of different stimulus children faces from 4 to 9 years old. In the first task for the adults experimental subjects, ten stimulus photos were shown, whereas for children experimental subjects, four stimulus photos were shown at a time, with a total of six rounds. The second task involved only adults, who indicated the motivation of affective behaviors and care directed to children through a Likert scale. Our results suggest that both participants judged similarly the cuteness of children's faces, and the physical features markers of this perception were observed only for younger stimulus children. Adults have attributed more motivations of positive behaviors to cuter stimulus children. The recognition of the baby schema by individuals of different ages and genders confers the universality and power of children's physical attributes. From the evolutionary perspective the responsiveness to baby schema is significant to ensure aloparental and parental investment, and the consequent children survival

Cuidado ao filhote de boto cinza, Sotalia guianensis (van Benédén, 1864)

In some species parental care is vital to survival. Many studies have reported various parental care behaviours in cetaceans. In Sotalia guianensis, some behaviours have been already described and linked to parental care. However, many aspects are still unknown and all these information might be important for the species conservation. The aim of the present study was minimize these gaps, showing the options involved in the marine tucuxi parental care. The observations took place in Enseada do Curral, located in Pipa, Tibal do Sul, Rio Grande do Norte Coast. Between January and December of 2005 the local population of tucuxi was observed during 42 days. The methods used were Focal Animal and Ad Libitum. The results suggest that calves are present in the bay all year long. Groups with calves had a mean of 6,9 animals, allowing the animals to participate in different activities in the group besides caring. The calves created different associations, being usually followed by an adult. In groups, the calves stay mainly in the centre, which offers them protection. Calves remained next to the adults tail, facilitating breastfeeding. The calves most noticeable activities were those in the surface and the behaviour frequencies decreased, in general, in the presence of human swimmers and boats, what could be considered a threat to the animals. Adults shared positions when caring for calves, suggesting allomaternal care; food transfer from adults to calves was observed, which might be related to diet acquisition; three non-described behaviours were seen, indicating a diversified behavioural repertoire for this species

Aspectos do cuidado cooperativo em dois grupos de Callithrix jacchus selvagens

The Callitrichidae family presents cooperative breeding, where breeders and non breeders take care of the offspring. The aspects of care analyzed in this study were infant carrying, supervision, proximity and food transfer. Three sets of infants from two wild groups of Callithrix jacchus were studied in the environments of Caatinga (Assu group) and Atlantic Forest (Jundiaí group). The methods used in the study were instantaneous focal sampling (infant carrying, supervision and proximity) and continuous focal sampling (food transfer). In the two sets observed in Assu group, the father carried and transferred food to infants more than the rest of the group. The biggest contribution in supervision was from the father and from another adult male. The members that remained in proximity to the infants in both groups were the younger in the groups (juveniles and sub-adults). In the Jundiaí group, the father and the adult male helper of the group were the main caregivers; one of the sub-adult females was responsible for supervision of the infants. With the disappearance of the reproductive male and one of the sub-adults females in 3º month of infants life, the care was redistributed and the only adult male left in the group was the animal that contributed more in provisioning of the infant. In the Assu group, there were adult females in its composition which were involved in agonistic interactions with breeders and adult males, and seemed to influence their low participation in care. Food transfer initiates early in the development of the infants, as a way to encourage nutritional independence. Different types of food transfer (active food transfer, food steal, food steal attempt, passive food transfer and food handling) were observed in the study and frequency of each one varied with developmental phase and tolerance by the members. One relevant data of the study was the presence of active food transfer in Assu group, since in literature there are very few registers of this type of transfer for this species. It is important that groups from distinct environments and composition be studied for a better understanding of the dynamics of infants development