High-Sensitivity C-Reactive Protein and Cardiovascular Disease Across Countries and Ethnicities

Despite substantial differences in ethnicities, habits, cultures, the prevalence of traditional cardiovascular risk factors and affordable therapies, atherosclerosis remains the major cause of death in developing and developed countries. However, irrespective of these differences, inflammation is currently recognized as the common pathway for the major complications of atherosclerosis, stroke, and ischemic heart disease. A PubMed search was conducted for “high-sensitivity C-reactive protein” (hs-CRP) in combination with the terms race, ethnicity, gender, prevalence, geographic, epidemiology, cardiovascular, obesity, diabetes, hypertension, cholesterol, smoking, ischemic heart disease, stroke, and mortality. This review includes the articles that pertained to the topic and additional articles identified from the reference lists of relevant publications. This review describes the marked differences in cardiovascular mortality across countries and ethnicities, which may be attributed to inequalities in the prevalence of the classic risk factors and the stage of cardiovascular epidemiological transition. However, hs-CRP appears to contribute to the prognostic information regarding cardiovascular risk and mortality even after multiple adjustments. Considering the perception of cardiovascular disease as an inflammatory disease, the more widespread use of hs-CRP appears to represent a valid tool to identify people at risk, independent of their ancestry or geographic region. In conclusion, this review reports that the complications associated with vulnerable atherosclerotic plaques are triggered by the major mechanisms of dyslipidemia and inflammation; whereas both mechanisms are influenced by classic risk factors, hs-CRP contributes additional information regarding cardiovascular events and mortality

Atitudes do enfermeiro face às infecções associadas aos cuidados de saúde

ENQUADRAMENTO: As infecções adquiridas em consequência da prestação de cuidados constitui um problema grave, com morbilidade e mortalidade significativas. Estas infecções são evitáveis em cerca de um terço dos casos, pelo que a capacidade de as prevenir pode constituir um dos indicados de qualidade dos cuidados. É um problema escondido, transversal que nenhuma instituição ou país ainda conseguiu resolver. Em cada ano, centenas de milhares de doentes em todo o mundo são afectados pelas IACS, sendo considerado o evento adverso mais frequente durante a prestação de cuidados, em todo o mundo. OBJECTIVOS: Caracterizar as Atitudes adoptadas pelos Enfermeiros face às IACS; Analisar em que medida as variáveis sócio-profissionais e a formação acerca das IACS influenciam as atitudes do Enfermeiro MÉTODOS: O estudo transversal de natureza observacional assenta numa lógica de análise descritivo – correlaciona e foi realizado numa amostra definida pelo método não probabilístico, de forma acidental, durante um período de tempo, constituída por 142 Enfermeiros prestadores de cuidados na ULS da Guarda. O perfil médio revela enfermeiros do sexo feminino (76,80%), com idade média de 36 anos, a exercer a profissão entre os 10-19 anos (40,80%) com uma média 13,04 anos, licenciados (69,50%), com a categoria profissional de Enfermeiro graduado (50,00%), com horário na instituição de 35h/semana (70,40%), com vínculo à Função pública (61,30%) e sem duplo emprego (77,47%). De forma a caracterizar as atitudes do enfermeiro, utilizou-se um instrumento de colheita de dados constituído por uma caracterização sócio-profissional e formação acerca das IACS, a Escala de Atitudes face às IACS (Barroca, Cruz, Gaspar e Valdemar, 2006) e uma resposta aberta acerca das condições no serviço que favorecem a infecção nosocomial. RESULTADOS: Constatou-se que os enfermeiros adoptam atitudes consideradas adequadas, com uma média de 103 respostas adequadas. Nas variáveis pessoais (sexo e idade) infere-se que não há relação entre o sexo e as atitudes do enfermeiro face às IACS. Das variáveis profissionais dos enfermeiros, apenas o duplo emprego influência as atitudes do enfermeiro face às IACS. Por outro lado inferimos que existe uma relação de dependência entre os enfermeiros com formação acerca das IACS e as atitudes do enfermeiro face às IACS. A idade, o tempo de exercício profissional e o número de horas de formação não se revelam preditoras das atitudes do enfermeiro face às IACS. CONCLUSÕES: As evidências encontradas neste estudo referem que o duplo emprego e a formação dos profissionais acerca das IACS influência as atitudes do enfermeiro face a esta problemática. As soluções para os problemas das IACS baseiam-se em medidas de prevenção e controlo de infecção, que requerem a responsabilização e a mudança de comportamentos por parte dos profissionais de saúde.ABSTRACT FRAMEWORK: Acquired infections as a result of prevision of care remain a serious problem of significant morbidity and mortality. These infections are avoidable by almost a third of the cases thus the preventing capacity could be a quality indication of cares. This is a hidden transversal problem which still has been solved by neither institution nor country. Each year, many hundreds of thousands of patients worldwide are affected by the IACS, it may be viewed as the most frequent adverse event during the prevision of care elsewhere in the world. OBJECTIVES: To characterize the attitude adopted by nurses in the face of IACS; to analyse what extent the socio-professional variables and the formation regarding the IACS influence the nurse´s attitudes. METHODS: The transversal study of the observational nature is based on descriptive analysis defined accidentally not by the provavilistic method– It was made during a certain period of time with a random sample composed of 142 nurses care providers at the ULS in Guarda. The average profile shows nurses of the female sex (76,80%), with average of 36 years of age, practising the profession between 10 to 19 years (40,80%) an average of 13,04 years, graduates (69,50%), with the professional category of graduated nurse (50,00%), with institution's schedule of 35-hour workweek (70,40%), connected with the public service (61,30%) and without double employment (77,47%). In order to characterise the nurse´s attitudes, collection of data was made with an instrument constituted by a socio-professional characterization and formation , the scale of attitudes regarding the IACS (Barroca, Cruz, Gaspar e Valdemar, 2006) as well as an open answer regarding the conditions of the service which can lead to nosocomial infection. RESULTS: It was found the nurses adopt attitudes considered adequate, with an average of 103 adequate answers. In relation to the personal variables (gender and age) we can conclude that there is no relation between the gender of the nurse and his attitude towards the IACS. Relative to the nurse professional variables, only double employment influences his attitude towards the IACS. In other hand, we can conclude that there is a dependent relation between nurses with preparation on IACS and is attitude towards the IACS. Age, professional experience and number of formation hours cannot predict the conduct from nurses towards IACS. CONCLUSIONS: We found evidences in this study that double employment and formation from the professional about the IACS, influences his conduct towards this problem. Solutions to the IACS problem reside in prevention and control of infection which requires responsibility and change in the health professional’s behaviour

Application of pediatric evaluation disability inventory in children with cerebral palsy quadriplegic spastic

This study presents some data collected through Pediatric Evaluation Disability Inventory (PEDI), using a sample of children with spastic tetrapresis. The application in each child has been done twice within intervals from 12 to 24 months. Although the descriptive analysis has shown an average evolution between those applications, only in the self - care area the difference has proved meaningful (p < 0,005) while the mobility area has presented less progress. In this article, although with a reduced sample, the potential of this instrument as a parameter of evolution for these children will be discussed.No presente artigo são analisados os dados coletados através do Inventário de Avaliação Pediátrica de Incapacidade (PEDI) em amostra de 10 crianças portadoras de tetraparesia espástica. A aplicação em cada criança foi feita em dois instantes, com intervalos que variaram entre 12 e 24 meses. Embora a análise descritiva tenha mostrado uma evolução média entre as duas aplicações do PEDI, somente na área de Auto-Cuidado a diferença se mostrou significativa (p < 0,005) sendo que visivelmente a Mobilidade foi a área que menos progrediu. Neste artigo será discutido o potencial deste instrumento como parâmetro de evolução para estas crianças, ressalvado o fato de a amostra ser bem reduzida

Using the Web In Multimedia Production In The Field Of Fine Arts

O presente trabalho aborda o uso da web em uma proposta pedagógica colaborativa a partir de uma produção multimídia na área de artes visuais. Tal proposta constitui-se da produção de videoclips, realizados por alunos da 6ª série do ensino fundamental de um colégio da rede privada. Buscou-se investigar como produzir construções imagéticas digitais nas interpretações associativas entre as diversas linguagens: visual, verbal e sonora. Nas imagens digitais habitam uma usina de signos que devem ser navegados e (re)significados. Os videoclips se apresentam como produção coletiva que se constitui como um efeito de contingências de um processo criativo e emerge como uma obra original e singular, já que é criada a partir dos jogos pertinentes aos agenciamentos entre os sujeitos/máquina e obra, compostos por elementos singulares em um recorte de espaço/tempo histórico. Afirma-se, aqui, a importância de práticas pedagógicas que se fundamentam sobre metodologias multimídia a partir de processos abertos e colaborativos. Palavras-chave Multimídia, web, colaboração, arte.This work discusses the use of the web in a cooperative educational proposal from a multimedia production in the field of Fine Arts. Such proposal is a videoclip produced by six graders from a private school. The videoclips were developed during six months in the School Computing Lab by pairs of students who have initially chosen the songs and prepare the screenplay. Then, the clip images were selected from the web and the school image database, and worked in an image editing software in order to re-signify and appropriate them. The goal was investigating the way of producing imagetic pieces in the associating interpretations among several languages: visual, verbal and sound. Within the digital images there is a source of signs which shall be navigated and re-signified. The importance of educational practices based upon the multimedia methodologies from open and cooperative processes is herein assessed. Keywords Multimedia, web, cooperation, art

The experience of women with abortion during adolescence as demanded by their mothers

OBJECTIVE: to understand the experience of women who induced an abortion during adolescence as demanded by their mothers. METHOD: qualitative study with a social phenomenology approach conducted in 2010 with three women through interviews with open questions. RESULTS: the participants tried to hide their pregnancies from their mothers and when the mothers found out about the pregnancies they decide to interrupt it, demanding that their daughters have an abortion, which was performed in an unsafe manner, regardless of the adolescents' desire. After the abortion, the adolescents experienced suffering, guilt, and regret for not having fought against their mothers' decisions. These women expect to be autonomous to make their own decisions, take care of their own health and become pregnant again. CONCLUSION: the study evidenced the decision for an abortion was centered on the adolescents' mothers, a result that deserves to be further explored in future research deepening the relationship established between daughter and mother in the situation of an induced abortion. We suggest the creation of opportunities for the triad of health professional/adolescent/family to dialogue, especially the mother, who in the context of family relations, can help the daughter to safely deal with an early pregnancy and prevent it instead of influencing the adolescent to induce an abortion.

Experiencia de mulheres com aborto provocado na adolescencia por imposicao da mae

OBJECTIVE: to understand the experience of women who induced an abortion during adolescence as demanded by their mothers. METHOD: qualitative study with a social phenomenology approach conducted in 2010 with three women through interviews with open questions. RESULTS: the participants tried to hide their pregnancies from their mothers and when the mothers found out about the pregnancies they decide to interrupt it, demanding that their daughters have an abortion, which was performed in an unsafe manner, regardless of the adolescents' desire. After the abortion, the adolescents experienced suffering, guilt, and regret for not having fought against their mothers' decisions. These women expect to be autonomous to make their own decisions, take care of their own health and become pregnant again. CONCLUSION: the study evidenced the decision for an abortion was centered on the adolescents' mothers, a result that deserves to be further explored in future research deepening the relationship established between daughter and mother in the situation of an induced abortion. We suggest the creation of opportunities for the triad of health professional/adolescent/family to dialogue, especially the mother, who in the context of family relations, can help the daughter to safely deal with an early pregnancy and prevent it instead of influencing the adolescent to induce an abortion.OBJETIVO: comprender la experiencia de mujeres que provocaron el aborto en la adolescencia por imposición de la madre. MÉTODO: es una investigación cualitativa, con abordaje de la fenomenología social, realizada en 2010, con tres mujeres, por medio de entrevista con preguntas abiertas. RESULTADOS: las participantes trataron de esconder de la madre el embarazo, quien al descubrirlo, decidió que ellas deberían interrumpirlo, imponiendo el aborto, el cual fue realizado de modo inseguro, independientemente de la voluntad de las hijas. Después del acontecimiento, lo que restó fue sufrimiento, culpa y arrepentimiento por no haber luchado contra la decisión materna. Esas mujeres tienen como expectativas tener autonomía para tomar sus propias decisiones, cuidar de la salud y quedar embarazadas nuevamente. CONCLUSIÓN: el estudio evidenció la decisión por el aborto centrada en la madre de la adolescente, lo que merece ser explorado en otras investigaciones que profundicen la relación establecida entre madre e hija en la situación de aborto provocado. Se sugiere la creación de espacios de diálogo para la tríade profesionales de la salud/adolescente/familia, con destaque para la madre, que, en el contexto de las relaciones familiares, puede ayudar a la hija a enfrentar de modo seguro el embarazo precoz y hacer su prevención, en vez de influenciarla a realizar el aborto.OBJETIVO: compreender a experiência de mulheres que provocaram o aborto na adolescência por imposição da mãe. MÉTODO: pesquisa qualitativa com abordagem da fenomenologia social, realizada em 2010, com três mulheres, por meio de entrevista com questões abertas. RESULTADOS: as participantes tentaram esconder da mãe a gravidez, e essa, ao descobrir, decidiu que elas deveriam interrompê-la, impondo o aborto, o qual foi realizado de modo inseguro, independentemente da vontade das filhas. Após o acontecimento, o que restou foi sofrimento, culpa e arrependimento por não ter lutado contra a decisão materna. Essas mulheres têm como expectativas ter autonomia para tomar suas próprias decisões, cuidar da saúde e engravidar novamente. CONCLUSÃO: o estudo evidenciou a decisão sobre o aborto centrada na mãe da adolescente, o que merece ser explorado em outras investigações que aprofundem a relação estabelecida entre mãe e filha na situação de aborto provocado. Sugere-se a criação de espaços de diálogo para a tríade profissional saúde/adolescente/família, com destaque para a mãe, que, no contexto das relações familiares, pode ajudar a filha a enfrentar de modo seguro a gravidez precoce e a fazer sua prevenção, em vez de influenciá-la sobre a realização do aborto

Using video as a nutrition education strategy for adolescents: eating... the fruit or the product?

This paper describes the evaluation of the video Eating... the fruit or the product?, conceived as a nutrition education strategy for adolescents. The purposes of the research were to identify the elements of the video that stimulated the participants' reflection about the argumentation topics and to identify the elements of the script that made it easier or more difficult for adolescents to understand the theme. The method was based on qualitative and quantitative analyses. The subjects were 14 office-boys from a public institution in the state of São Paulo, Brazil. The data were collected in two phases: the first one included a workshop with the group, and the second phase involved an individual interview, three months later. The elements that stimulated the adolescents' reflection were the characters symbolizing the brand influence and the advertising power, and a scene of a man eating in the garbage. Difficulties came from scenes which were silent, abstract or based on values different from the ones of the office-boys' social class.Este artigo consiste na avaliação do vídeo Comer... o fruto ou o produto?, concebido como estratégia de educação nutricional para trabalhar com adolescentes. Os objetivos da pesquisa foram identificar elementos do vídeo que despertaram reflexão dos participantes sobre os tópicos da argumentação e identificar elementos do roteiro facilitadores e dificultadores da aproximação ao tema. O método caracterizou-se pelo emprego de análises qualitativas e quantitativas. Os sujeitos foram 14 mensageiros de instituição pública. Os dados foram levantados em dois momentos: o primeiro, coletivamente, em oficina, e o segundo, individualmente, através de entrevista, três meses após assistirem ao vídeo. Os elementos que despertaram reflexão nos adolescentes foram os personagens simbolizando a influência das marcas e o poder da publicidade, e uma cena de um homem comendo no lixo. Os fatores dificultadores foram as cenas mudas, as muito abstratas e as baseadas em valores de classe social diferente daquela a qual pertenciam os mensageiros.28129

The experience of women with abortion during adolescence as demanded by their mothers

OBJECTIVE: to understand the experience of women who induced an abortion during adolescence as demanded by their mothers. METHOD: qualitative study with a social phenomenology approach conducted in 2010 with three women through interviews with open questions. RESULTS: the participants tried to hide their pregnancies from their mothers and when the mothers found out about the pregnancies they decide to interrupt it, demanding that their daughters have an abortion, which was performed in an unsafe manner, regardless of the adolescents' desire. After the abortion, the adolescents experienced suffering, guilt, and regret for not having fought against their mothers' decisions. These women expect to be autonomous to make their own decisions, take care of their own health and become pregnant again. CONCLUSION: the study evidenced the decision for an abortion was centered on the adolescents' mothers, a result that deserves to be further explored in future research deepening the relationship established between daughter and mother in the situation of an induced abortion. We suggest the creation of opportunities for the triad of health professional/adolescent/family to dialogue, especially the mother, who in the context of family relations, can help the daughter to safely deal with an early pregnancy and prevent it instead of influencing the adolescent to induce an abortion.

Avaliação da atenção pré-natal na perspectiva dos diferentes modelos na atenção primária

OBJECTIVES: to evaluate the quality of the pre-natal care delivered in primary care, comparing the traditional model and the Family Health Strategy. METHOD: a service evaluation study, grounded in the public health policies. The data was obtained from interviews with managers, observation in the health centers, and analysis of patient records of pregnant women, selected at random. Differences in the indicators for structure and process were evaluated using the Chi-squared test, adopting pOBJETIVOS: Evaluar la calidad del cuidado prenatal desarrollado en la atención primaria, comparando los modelos tradicional y Estrategia Salud de la Familia. MÉTODO: estudio de evaluación de servicio, pautado en las políticas públicas de salud. Los datos fueron recolectados por entrevista con gerentes, observación en las unidades de salud y análisis de archivos de gestantes elegidos aleatoriamente. Diferencias en los indicadores de estructura y proceso fueron evaluadas mediante el test ji cuadrado, adoptándose pOBJETIVOS: avaliar a qualidade do cuidado pré-natal desenvolvido na atenção primária, comparando os modelos tradicional e Estratégia Saúde da Família. MÉTODO: estudo de avaliação de serviço, pautado nas políticas públicas de saúde. Os dados foram obtidos por meio de entrevista com gerentes, observação nas unidades de saúde e análise de prontuários de gestantes, selecionados aleatoriamente. Diferenças nos indicadores de estrutura e processo foram avaliadas pelo teste qui-quadrado, adotando-se