Plano de alta hospitalar a pacientes com insuficiência cardíaca congestiva

This integrative review investigates how nurses plan the hospital discharge of patients with Congestive Heart Failure (CHF) since an inadequate discharge plan and patients subsequent non-adherence to instruction provided upon discharge are indicated as potential factors for re-hospitalization. A total of 24 papers were found in a search carried out in the LILACS and MEDLINE databases between 2004 and 2008, which given the inclusion criteria, were reduced to 14 papers. The papers were analyzed and categorized into Health Education , and Nursing Care . The synthesis of results indicates that the discharge plan devised by nurses is based on two categories. The actions of nurses to promote health education can enable patients with CHF to improve self-care.Artículo de revisión integradora que tiene por objetivo identificar como las enfermeras han planificado el alta de los pacientes con Insuficiencia Cardíaca Congestiva, ya que el plan de alta inadecuado y el no seguimiento de las orientaciones dadas son apuntados como posibles factores de rehospitalización. A través de la búsqueda en las bases de datos LILACS y MEDLINE, abarcando el período de 2.004 a 2.008, fueron encontrados 24 artículos, que por el criterio de selección de la muestra resultaron en 14. Los artículos fueron analizados y categorizados en Educación en Salud y Cuidado de Enfermería. Con eso fue posible sintetizar los resultados e identificar que el plan de alta realizado por los enfermeros está basado en estas dos categorías, ya que a través de las conductas del enfermero para promover la educación en salud será posible proporcionar al paciente con Insuficiencia Cardíaca Congestiva una mejoría en el autocuidado.Trata-se de artigo de revisão integrativa que teve por objetivo identificar como as enfermeiras têm planejado a alta dos pacientes com insuficiência cardíaca congestiva, pois o inadequado plano de alta e o não seguimento das orientações dadas são apontados como possíveis fatores de re-hospitalização. Através da busca nas bases de dados LILACS e MEDLINE, abrangendo o período de 2004 a 2008, foram encontrados 24 artigos que, pelo critério de seleção da amostra, resultaram em 14. Os artigos foram analisados e categorizados em Educação em Saúde e Cuidado de Enfermagem. Com isso, foi possível sintetizar os resultados e identificar que o plano de alta realizado pelos enfermeiros está baseado nessas duas categorias, pois as condutas do enfermeiro para promover a educação em saúde podem proporcionar ao paciente com insuficiência cardíaca congestiva melhora no autocuidado.Universidade de São Paulo Faculdade de Medicina Hospital das ClínicasUniversidade Federal de São Paulo (UNIFESP)Universidade Federal de São Paulo (UNIFESP) Escola Paulista de EnfermagemUNIFESP, EPESciEL

Millennial Business Owners\u27 Strategies To Survive in Business

Individuals in the millennial generation, born from 1980 to 1996, have many entrepreneurial opportunities; however, many people in the millennial generation lack the skills, motivation, and business strategies to survive in business. Because of the influx of competition, lack of experience, and lack of business-world strategies, entrepreneurs can miss opportunities and fail within the first few years of business operations. Grounded in the systems theory, the purpose of this multiple case study was to explore the strategies that business owners in the millennial generation used to survive in business longer than 6 years. Participants consisted of 5 business owners in the millennial generation in 5 businesses in northern Virginia with successful experience in implementing strategies to survive in business longer than 6 years. Data were collected through semistructured interviews and a review of relevant company documents. Data were analyzed using Yin\u27s 5-step process of compiling, disassembling, reassembling, interpreting, and concluding data. The 4 key themes derived from data analysis were marketing, support, lessons learned, and passion. The findings of this study might be beneficial to business owners who seek to survive in business longer than 6 years by demonstrating the need for using effective marketing strategies, recognizing the need for adequate support, learning from past mistakes, and having passion for operating the business. The implications of this study for positive social change include the potential for business owners to improve local job opportunities, increase the economic prosperity of their communities, and increase local community services through their contribution to the local tax base

Falsa coletivização de planos de saúde: expansão, reajustes e judicialização (2014-2019)

A falsa coletivização é um fenômeno crescente no mercado brasileiro de planos e seguros de saúde. Ela decorre diretamente de decisões regulatórias que afetam o setor, especialmente as diferenças entre regras aplicáveis a contratos individuais e coletivos. O objetivo deste trabalho foi analisar a evolução recente do fenômeno sob três aspectos: (i) a expansão desse tipo de contrato, simultânea à redução de planos individuais; (ii) o diferencial acumulado de reajustes para os falsos coletivos; (iii) a sua judicialização e o tratamento dado ao tema pelo Poder Judiciário. Foram utilizados dados da Agência Nacional de Saúde Suplementar, desagregados por empresa, entre 2014 e 2019; do banco de dados de Notas Técnicas de Registro de Produto da agência, entre 2015 e 2019; e dados primários produzidos pela análise de acórdãos do Tribunal de Justiça de São Paulo, proferidos em 2018 e 2019. Os resultados evidenciaram o crescimento do fenômeno dos “falsos coletivos”, associado à gradual redução dos planos individuais. Demonstraram, também, o sistemático reajuste das mensalidades acima do teto definido pela Agência Nacional de Saúde Suplementar para planos individuais. A análise de acórdãos mostrou que o entendimento da questão pelo Poder Judiciário não é uniforme, nem em termos do resultado do julgamento, nem de sua fundamentação jurídica. Os resultados apoiam a interpretação de que esses contratos permitem às operadoras burlar aspectos relevantes da regulação do setor, impor reajustes superiores e, quando reclamadas judicialmente, escamotear a legislação consumerista.False collectivization is a growing phenomenon in the Brazilian health insurance market, stemming directly from regulatory decisions that affect the sector, especially the diferences between the rules applicable to individual and collective contracts. Hence, this paper sought to analyze the recent evolution of this phenomenon under three aspects: (i) expansion of this type of contract, simultaneous to the disappearance of individual private health plans; (ii) premium increases for “false collectives”; (iii) its judicialization and treatment in the jurisprudence. Data was collected from the Brazilian Regulatory Agency for Private Health Insurance and Plans, detailed by company, between 2014 and 2019; the agency’s Product Registration Technical Notes database, between 2015 and 2019; and primary data produced by analyzing rulings by the São Paulo Court of Justice, issued in 2018 and 2019. Results show the growth of “false collectives,” associated with the gradual disappearance of individual private health plans. They also demonstrate the gap between premium increases and the ceiling set by the Brazilian Regulatory Agency for Private Health Insurance and Plans for individual private health plans. Analysis of the rulings reveal that the Judiciary’s understanding on the matter is not uniform, neither in terms of the outcome, nor of its legal reasoning. These findings support the interpretation that such contracts allow insures to circumvent relevant aspects of the sector’s regulation, to impose higher premiums and, when contested in court, to evade consumer legislation

Resenha do livro Cinemas latino-americanos em circulação: em busca do público perdido

Resenha do livro Cinemas latino-americanos em circulação: em busca do público perdido, que apresenta importantes estudos sobre o público de cinema e a circulação de filmes na América Latina

Marguerite Yourcenar and the mythological dimension of the historical novel

Century after century, the words uttered in the ast have been echoed in the present. It is the epic That mediates between past and present days. It is the poet who succeeds in carrying the ardor of past ages through to this generation. For him, History is an attempt to explain a genealogy. In the intellectual scenery of Antiquity and the Middle Ages, the memory of the past is expressed as a mythical absorption. One wishes to meet the primeval facts which determined the evolution of the different societies — as well as the individual's role in this development. That explains why in the Greek mythology the goddess Mnemosene is the mother of the Muses. It is by her evocation that the poet gives shape and beauty to the "gests", being at the same time a messenger, who makes manifest to mankind the secret of its origin.Century after century, the words uttered in the ast have been echoed in the present. It is the epic That mediates between past and present days. It is the poet who succeeds in carrying the ardor of past ages through to this generation. For him, History is an attempt to explain a genealogy. In the intellectual scenery of Antiquity and the Middle Ages, the memory of the past is expressed as a mythical absorption. One wishes to meet the primeval facts which determined the evolution of the different societies — as well as the individual's role in this development. That explains why in the Greek mythology the goddess Mnemosene is the mother of the Muses. It is by her evocation that the poet gives shape and beauty to the "gests", being at the same time a messenger, who makes manifest to mankind the secret of its origin

Structured Physical Activity and Dietary Education Program for Obese Adolescents: An Evaluation of a Quality Improvement Project at a Rural Primary Care Clinic

Childhood obesity is a worldwide epidemic. In the United States, approximately 17% of adolescents are obese; and 13% of the general population is overweight. Obese adolescents are at threefold risk for developing chronic health conditions in adulthood, including type II diabetes, hypertension, and heart disease. The purpose of this project was to evaluate the results of a quality improvement program to reduce adolescent obesity as measured by BMI 5% over 18 months in a rural health primary care clinic. The health belief model and theory of planned behavior guided the project as adolescents need to first understand the risks associated with obesity and the benefits derived from a healthier lifestyle Then, they can be prepared to engage in regular exercise and good eating behaviors. A convenience sample of 100 adolescents was randomly assigned to an intervention group with structured physical activity regimen and dietary education classes and a standard care group with normal counseling. Two separate one-sided t tests with 90% confidence intervals were used to analyze the data. Also, run charts were constructed to assess the effectiveness of the program. The result of the t test revealed the weight for the intervention group at 18 months (M = 42.85, SD = 0.79) was significantly lower than it was for those in the non-intervention group (M = 45.06, SD = 0.59), t(36) = -9.79, p \u3c 0.01. Furthermore, the run charts demonstrate the average BMI for those in the interventional group steadily decreased over 18 months while the non-intervention group steadily increased. Positive social change was achieved at the organization level as adolescent obesity was reduced with the evidence-based interventions. This project serves as a potential model for replication in other rural health primary care clinics

Kohti parempaa unta : toiminnallinen opinnäytetyö nuoren unenlaatuun vaikuttavista tekijöistä

Uni on elintärkeää ihmisen terveydelle ja laadukasta riittävää unta voidaankin pitää jopa terveyden perustana. Nuorelle uni on erityisen tärkeää, sillä se tukee kasvua, sosiaalista kehitystä ja jaksamista. Lisäksi riittävä uni auttaa nuoria suoriutumaan paremmin koulussa, sillä se tukee muistia, keskittymistä ja uudentiedon omaksumista. Tämän opinnäytetyön tarkoituksena oli tarkastella unen merkitystä hyvinvoinnin eri osa-alueilla sekä saada selville, miten elintavat, medialaitteet sekä nukkumisympäristö- ja käytännöt vaikuttavat nuoren uneen. Opinnäytetyö oli luonteeltaan toiminnallinen, johon olennaisena osana kuului suunnitella, toteuttaa ja arvioida toiminnallinen terveyden edistämisen piste Pumpkin Tube nimisessä tapahtumassa Salossa. Tavoitteena oli kannustaa nuoria pohtimaan unta edistäviä sekä heikentäviä tekijöitä erilaisten tehtävien avulla. Opinnäytetyön toimeksiantaja on Salon Kiekkohait ry. Pumpkin Tube tapahtuma onnistui tavoittamaan suuren joukon nuoria. Nuoret osallistuivat hyvin aktiivisesti ja uskoivat oppineensa jotain uutta unesta. Omien unitottumusten tarkastelu on tärkeää, sillä kun tiedostaa, millaiset tavat ja rutiinit vaikuttavat uneen, on mahdollista tehdä tarvittavia muutoksia paremman unen edistämiseksi.Sleep is indispensable for human health, and high-quality, sufficient sleep can even be considered the foundation of well-being. For adolescents, sleep is especially important as it supports growth, social development, and the ability to cope with daily challenges. In addition, adequate sleep helps adolescents perform better in school as it supports memory, concentration, and the acquisition of new information. The purpose of this thesis was to examine the significance of sleep in different aspects of well-being and to explore how lifestyle habits, media devices and sleep environments and practices affect adolescents’ sleep. This thesis was functional in nature and involved the planning implementation, and evaluation of a health promotion activity point at an event called Pumpkin Tube in Salo. The aim was to encourage adolescents of reflect on factors that promote or impair through various interactive tasks. The thesis was commissioned by Salon Kiekkohait ry. The Pumpkin Tube event successfully reached a large number of adolescents. The adolescents participated actively and believed they had learned something new about sleep. Reflecting on one’s own sleep habits is important because recognizing the routines and behaviors that affect sleep makes it possible to make the necessary changes to improve sleep quality