Intervenção do Enfermeiro Junto do Adolescente/Família Hospitalizado

Com a adolescência chega a altura em que se esqueceu a infância e o "quando eu for grande..." é remetido para um plano longínquo... Ser do contra é um dos pressupostso da adolescência! Num período de vida tão atribulado, caracterizado por uma multiplicidade de aventuras individuais, como reagirá o adolescente/familia numa situação de hospitalização? Qual a percepção que ambos têm deste fenómeno? Quais os sentimentos que dái advém? E qual a conduta mais adequada, por parte dos enfermeiros para minimizar os efeitos adversos da hospitalização no adolescente? Estas e muitas outras questões se levantam quando se reflecte sobre as incertezas típicas da adolescência, as quais tomam novas dimensões numa situação de doença e hospitalização. Esta reflexão surgiu de uma necessidade sentida em diferentes contextos de trabalho, decorrente do contacto com o adolescente/familia em meio hospitalar. Para tal, estabelecemos como objectivo reflectir sobre o papel do enfermeiro junto do adolescente e familia hospitalizado. Como forma de enriquecer este artigo, realizámos conversas informais a adolescentes internados, com o intuito de obtermos a percepção destes sobre o conceito de saúde/doença e os sentimentos que vivem durante a hospitalização na Unidade de Adolescentes do Hospital Dona Estefânia.

O Colo do Pai

Este trabalho foi realizado no âmbito do Curso de Pós-Licenciatura da Especialização em Enfermagem de Saúde Infantil e Pediatria da Escola Superior de Saúde no ano lectivo 2006/2007. Na sociedade actual o pai está mais presente, tendo o seu papel sofrido grandes alterações nos últimos anos, tanto a nível social como familiar, sendo-lhe atribuído novo protagonismo. Este é um estudo de cariz qualitativo, que teve como objectivo o de conhecer, se a primeira vivência do colo do pai teve influência no posterior cuidar do filho. Foram levadas a cabo entrevistas semi-estruturadas num serviço de medicina de um Hopsital Pediátrico Central de Lisboa, a pais primíparos, considerados bons cuidadores segundo uma grelha de critérios pré-definida pelos autores deste estudo. Para serem incluídos na amostra deste estudo, além de preencherem estes critérios, os pais teriam de coabitar com a mãe e as crianças prímiparas, nascidas de parto eutócito teraim de se encontrar internadas em Abril de 2007 na institutição já mencionada. As entrevistas foram posteriormente sujeitas à análise do seu conteúdo. Os resultados obtidos revelam que nesta amostra, o primeiro colo do pai teve influência no cuidar, no entanto, outros factores como: desejar ser pai, acompanhar a gravidez e estar presente durante o trabalho de parto, foram determinantes para os pais serem considerados bons cuidadores.

Voimalaitoksen BoP-järjestelmien prosessikaavioiden ja -kuvausten suunnitteluohjeistus

Tässä työssä luodaan voimalaitoksen BoP- järjestelmien prosessikaavioiden- ja kuvausten suunnitteluohjeistus Sweco Industy Oy:n energia-yksikölle. BoP- järjestelmiin lukeutuvat tässä kaikki oleellisimmat voimalaitoksen apujärjestelmät kuten esimerkiksi suljettu jäähdytysvesipiiri. Tämä työ on tehty erään Keski-Euroopan alueella sijaitsevan voimalaitosprojektin yhteydessä ja tämä ohjeistus toimii pohjatietona myöhemmin tehtäville täydennyksille. Työn alkuosassa esitellään käytössä oleva piirto-ohjelma sekä sovellettava standardi KKS ja sen käyttö. Käytetyt kaaviotyypit ja niiden sisältö käydään pääpiirteissään läpi. Pääpaino työssä on PI-kaavioiden suunnittelemisen ja piirtämisen ohjeistaminen ja yhdenmukaistaminen. Piirtämiseen ja kaavioiden esittämiseen on kerätty olemassa olevaa tietoa eri suunnittelijoilta joiden avulla on valittu käyttöön tuleva esitystapa. Työn aikana ilmeni ongelmia prosessikaavioiden piirto-ohjelman kanssa. Piirto-ohjelmana käytetty Comos on vielä kehitysvaiheessa ja sen tietokannan ja toiminnan muokkaaminen yhtiön tarpeita vastaavaksi tulee viemään vielä aikaa. Tämä onkin tulevaisuutta ajatellen tärkein kehityskohde.

Análisis por activación de neutrones en el estudio de elementos de corrosión en polímeros compatibles BOP.F

Tesis (Maestría en Ciencias, con especialidad en Ingeniería Nuclear). U. A. N. L.

The BoP approach and its links to main related research fields: sense-making of the current discussion

A Base-da-Pirâmide (Base ofthePyramid- BoP) é referida na literatura como sendo o segmento sócio-econômico mais baixo em termos de paridade do poder de compra. Esse segmento encontrase geralmente excluído do sistema capitalista global. Esta tese analisa o tema BoP e discute dentro de um contexto sócio-econômico, como essa abordagem se relaciona com outras áreas de pesquisa, assim como a teoria do desenvolvimento internacional e a teoria de negócios internacionais. Estas duas teorias são identificadas como tendo uma relação mais forte com BoP. No que se segue, a abordagem BoP é incorporada nessas duas teorias com o objetivo de tornar este conceito mais claro e abrangente. Seguindo este raciocínio a abordagem BoP vem identificar contribuições no tocante a cada uma dessas abordagens teóricas. O argumento principal da tese é que a abordagem BoP é capaz de ligar essas duas teorias (teoria do desenvolvimento internacional e a teoria de negócios internacionais) em um só modelo teórico, mostrando assim que essas duas abordagens teóricas distintas podem na realidade serem complementares.

Reengenharia social: reconstruindo o BOP em novas bases sociais

Esta pesquisa propõe um modelo teórico chamado de Reengenharia Social onde os quatro atores governo, sociedade civil, academia e empresas atuam de forma interconectada com o objetivo de promover o inferior da pirâmide para o topo. Considerou-se os conceitos de Responsabilidade Social Corporativa, Sustentabilidade e Estratégia voltados para os países em desenvolvimento sob um novo olhar para o BOP: como mercado produtivo. O modelo retrata o processo através do qual os quatro atores atuam num ciclo virtuoso com oportunidades para o inferior da pirâmide com benefícios mútuos, sugerindo como consequência a redução da pobreza. As implicações deste modelo são examinadas para futuras pesquisas no processo de redução da pobreza.

Hybrid partnerships and social technology at the BoP: a case study

A crescente expectativa dos vários stakeholders, bem como as diferentes partes interessadas nas áreas de atuação de várias empresas, recentemente tem levado diversas corporações a se envolverem em iniciativas que visam o desenvolvimento social e a erradicação da pobreza. Porém, apesar das inúmeras tentativas, resultados convincentes ainda não foram produzidos, mantendo a separação entre os indivíduos que vivem na base da pirâmide económica e aqueles pertencentes às camadas mais elevadas quase inalterada. Consequentemente alguns estudiosos criticaram a falta de contextualização das práticas de gestão existentes, atribuindo o mesmo à forte influência das ideologias ocidentais, que impedem que as iniciativas sociais se adaptem às necessidades dos diferentes contextos geopolíticos. Por meio da análise de um conjunto de iniciativas sociais da Coca-Cola Brasil ("Projetos Coletivo") implementadas em várias comunidades brasileiras, o presente estudo mostra como Coca-Cola Brasil tentou produzir, em colaboração com os ONG locais, um tipo de "tecnologia social" universal, que poderia ser facilmente adaptada a diferentes contextos, acelerando o processo de implementação das iniciativas sociais e ampliando o seu impacto.

Mentally ill inmates : BOP plans to improve screening and care in federal prisons and jails : report to Congressional requesters /

"B-242958"--P. 1.

Short-Term effect of COX-2 selective inhibitor as an adjunct for the treatment of periodontal disease: a clinical double-blind study in humans

Adjunctive therapeutic strategies that modulate the inflammatory mediators can play a significant role in periodontal therapy. In this double-blind, placebo-controlled study, 60 subjects diagnosed as periodontitis patients were evaluated for 28 days after periodontal treatment combined with selective cyclooxygenase-2 (COX-2) inhibitor. The experimental group received scaling and root planning (SRP) combined with the Loxoprofen antiinflammatory drug (SRP+Loxoprofen). The control group received SRP combined with placebo (SRP+placebo). Plaque index (PI), probing pocket depth (PD) and bleeding on probing (BOP) were monitored with an electronic probe at baseline and after 14 and 28 days. Both groups displayed clinical improvement in PD, PI and BOP. They also showed statistically similar values (p>0.05) of PD reduction on day 14 (0.4 mm) and on day 28 (0.6 mm). At the baseline, few deeper sites (>7 mm) from SRP+Loxoprofen group were responsible and most PD reduction was observed after 14 days (p<0.05). The percentage of remaining deep pockets (>7 mm) after 14 days in the SRP+Loxoprofen group was significantly lower (p<0.05) than in the SRP+placebo group. Loxoprofen presents potential effect as an adjunct of periodontal disease treatment, but long-term clinical trials are necessary to confirm its efficacy.

Relationship between periodontitis and rheumatoid arthritis and the effect of non-surgical periodontal treatment

This study analyzed the association of periodontal disease (PD) and rheumatoid arthritis (RA). Seventy-five 35-60-year-old patients were assigned to 5 groups according to the presence (+) or not (-) of PD and RA and the treatment received (TR+) or not (TR-) for PD. Group 3 uses total prosthesis (TP). Clinical and laboratory evaluations were performed at baseline, 3 and 6 months of follow-up by probing pocket depth, bleeding on probing and plaque index for PD, HAQ, DAS28, SF-36 and laboratory: AAG, ESR, CRP for RA. Statistically significant differences for PD after 3 (p=0.0055) and after 6 months (p=0.0066) were obtained in Group 1 (RA+PD+TR+) and 2(RA+PD+TR-); significant reduction in the % of BOP after 6 months (p=0.0128) and significant reduction in the % of Pl after 3 (p=0.0128) and 6 months (p=0.0002) in Group 1. Statistically significant differences between Groups 1 and 3 (RA+TP) for DAS28 at baseline and after 3 months were observed, but not after 6 months. No other parameters for RA were significantly affected. The relationship between RA and PD disease activities is not clear, but the importance of periodontal treatment in the control of inflammation to avoid tooth extraction is evident.

Analysis of the periodontal status of patients with mandibular-bonded retainers

PURPOSE: This clinical study evaluated the periodontal status of patients with bonded retainers as compared to a non-treated control group. METHODS: Forty dental students were included in the sample and divided into the following two groups: 1) a test group of 20 subjects that, after orthodontic treatment, have been bonded retainer users for at least 2 years and 2) a control group of 20 patients that never experienced orthodontic treatment nor used any bonded retainer. The region associated with the retainer in the test group and the lower canine-to-canine region in the control group were examined according to the following clinical parameters: plaque index (PI), bleeding on probing (BOP), gingival recession (GR), clinical attachment level (CAL) and probing depth (PD). RESULTS: No differences were observed for GR or BOP (P>0.05). In contrast, the test group showed higher values of CAL and PD at proximal sites when compared to controls (P<0.05). In addition, IP was significantly increased at buccal and lingual sites (P<0.05). CONCLUSION: The placement of orthodontic bonded retainers negatively affected periodontal health, resulting in increased PI, PD and CAL.

Periodontal disease in gestational and type 1 diabetes mellitus pregnant women

Objective: The present study evaluated the relationship between periodontal disease and its clinical variables in Brazilian non-diabetic pregnant women (C), gestational diabetes mellitus (GDM), or type 1 diabetes mellitus (T1DM). Subjects and methods: A periodontal exam was performed in one hundred and sixty-one pregnant women (GDM:80; T1DM:31; C:50) by a single-blinded calibrated examiner who recorded plaque index (PI), gingival index (GI), bleeding index (BI), gingival margin location (GM), probing depth (PD), clinical attachment level (CAL), bleeding on probing (BOP), and tooth mobility index (MI). The medical variables were age, pregestational body mass index (pre-BMI), fasting plasma glucose (FPG), and glycated hemoglobin (HbA(1c)). Results: The GI, GM, PD, CAL, BOP, and MI were significantly higher (P < 0.01) among GDM and T1DM than for C. The PI was higher in GDM and similar between C and T1DM. The Adjusted Final Model for medical variables to evaluate the effects of groups on periodontal parameters confirmed these results. Conclusions: The presence of periodontal disease was significantly higher in Brazilian diabetic pregnancies (GDM and T1DM) when compared to non-diabetic pregnant women (C). The degree of periodontal disease was similar between the GDM and T1DM groups. Age, pregestational BMI, and HbA(1c) were factors related to CAL development in these two types of diabetes mellitus.

Gingival Overgrowth Among Patients Medicated With Cyclosporin A and Tacrolimus Undergoing Renal Transplantation: A Prospective Study

Background: The aim of this study is to make a longitudinal evaluation of the incidence and severity of gingival overgrowth (GO) induced by immunosuppressive agents, such as tacrolimus (Tcr) and cyclosporin A (CsA), in the absence of calcium channel blockers in patients undergoing renal transplantation (RT). Methods: This longitudinal study is conducted in 49 patients with RT who were divided into a CsA group (n = 25) and Tcr group (n = 24). The individuals were assessed at four time intervals: before transplant and 30, 90, and 180 days after RTs. Demographic data and periodontal clinical parameters (plaque index, cemento-enamel junction to the gingival margin, probing depth, clinical attachment level, bleeding on probing [BOP], and GO) were collected at all time intervals. Results: The mean GO index was significantly lower in the Tcr group compared to the CsA group after 30 (P = 0.03), 90 (P = 0.004), and 180 (P = 0.01) days of immunosuppressive therapy. One hundred eighty days after RTs, a clinically significant GO was observed in 20.0% of individuals in the CsA group and 8.3% of individuals in the Tcr group. However, this difference was not statistically significant (P = 0.41). There was a reduction in periodontal clinical parameters regarding the time of immunosuppressive therapy for PI and BOP (P<0.001) in both groups. Conclusion: Although there was no statistical difference in the incidences of clinically significant GO after 180 days of immunosuppressive therapy, it was observed that GO occurred later in the Tcr group, and the severity of GO in this group was lower than in patients who used CsA. J Periodontol 2011;82:251-258.

Oral status and Candida colonization in patients with Sjogren`s Syndrome

Objective: To determine the oral status, salivary flow rate, Candida carriage in saliva, and prevalence of Candida albicans colonization in several areas of the mouth in patients with primary and secondary Sjogren`s syndrome as opposed to those of healthy subjects. Study design: Thirty-seven patients with Sjogren`s syndrome (SS), [14 patients with primary SS (SS-1) and 23 patients with secondary SS (SS-2)], along with 37 healthy controls were examined in regard to number of teeth, pro-bing pocket depth (PPD), approximal plaque index (API), bleeding on probing (BOP), presence of prosthetic appliances and smoking habits. Salivary flow rate (SFR), Candida carriage in saliva, presence of Candida albicans colonization on buccal, angular, palatal and sulcular areas, on dentures and on the tongue`s dorsal surface were determined. Statistical analyses were performed using the 2-tailed Fisher exact and Kruskal-Wallis test. Results: No statistically significant difference was found between SS-1 and SS-2 groups based on the parameters analysed. Statistically significant differences were observed between patients with SS and healthy subjects in terms of SFR, oral signs and symptoms, API, BOP, C. albicans colonization on tongue and buccal area, and Candida carriage in saliva. In the gingival crevicular fluid positive C. albicans colonization was found in only one subject of SS subgroup. Conclusions: SS patients carry a higher risk of having periodontitis and are more predisposed to develop candidiasis. C. albicans is scarcely detected in gingival crevicular fluid despite high scores on C. albicans colonization in different areas of the oral cavity in SS patients.