IMPACTOS E LEGADOS DE UM DESASTRE EM UM HOSPITAL UNIVERSITÁRIO: REFERENCIAL PARA A PREPARAÇÃO

RESUMO Objetivo: o atendimento de vítimas de desastres estabelece o desafio, para as instituições hospitalares, do preparo para atender ao aumento da demanda, ao mesmo tempo em que os serviços essenciais precisam continuar em funcionamento. Foi realizada pesquisa qualitativa do tipo estudo de caso com o objetivo de identificar e descrever os impactos e legados do atendimento às vítimas do incêndio na Boate Kiss para a gestão de recursos do Hospital de Clínicas de Porto Alegre. Método: a coleta de dados foi desenvolvida em entrevistas e consulta a documentos. Participaram 17 profissionais envolvidos no gerenciamento do atendimento. Resultados e discussão: os dados foram analisados por meio de análise de conteúdo do tipo temático. Foram identificados impactos na gestão dos recursos humanos, com recrutamento, capacitações e treinamentos; na gestão de recursos materiais com o aumento de insumos e materiais não padronizados; na gestão de recursos físicos com o provimento de leitos e espaço para acolhimento dos familiares. Entre os legados, um Plano Institucional de Apoio a Catástrofes Externas foi desenvolvido: Conclusão: os resultados confirmam as evidências de que a aprendizagem sobre a gestão de risco acontece a partir de eventos vivenciados pelas instituições de saúde, cujo legado reflete-se na qualificação do planejamento e do atendimento em situação de desastres. Os impactos e legados identificados constituem subsídios para a qualificação do atendimento hospitalar em desastres

Source attribution of human echinococcosis: A systematic review and meta-analysis

Author summary Echinococcus granulosusandE.multilocularisare zoonotic parasites that cause human cystic (CE) and alveolar (AE) echinococcosis, respectively, in humans: both diseases resulting in a substantial burden of disease. They are transmitted to humans via wild or domestic caniid definitive hosts. This study aimed at finding and evaluating the source attribution of echinococcosis and provides evidence that transmission by direct contact with the definitive hosts perhaps results in 26.1% and 34.4% cases of CE and AE, respectively. Indirect transmission by contaminated water may result in 29.4% and 24.8% of cases of CE and AE, respectively. There is evidence that indirect transmission through contaminated food may result in 23.5% of cases of CE globally. Contaminated food may result in 32.5% of cases of AE, but only in low incidence regions such as Europe. In areas of high human incidence such as China, the evidence for foodborne AE was not convincing. Other sources of transmission such as contact with a contaminated environment result in approximately 30.4% of CE cases and 11.1% of AE cases. Background A substantial proportion of echinococcosis transmission to humans via contamination of food has been assumed. However, the relative importance of food as a transmission vehicle has previously been estimated through expert opinion rather than empirical data. Objective To find and evaluate empirical data that could be used to estimate the source attribution of echinococcosis, in particular the proportion that is transmitted through contaminated food. Methods A systematic review was undertaken to identify reports on the risk factors for human cystic (CE) and alveolar (AE) echinococcosis. Data bases searched included PubMed, Scopus, Web of Knowledge, Cab Direct, Science Direct, Google Scholar, eLIBRARY.RU, CyberLeninka, CNKI and VIP. Search terms included Echinococc*, hydatid, epidemiology, logistic regression, risk factors, odds ratio, relative risk, risk factors. Reports, including grey literature where available, that had suitable data were selected and data were extracted. The main pathways of transmission were hypothesised to be contact with the definitive host, contaminated water, contaminated food and contaminated environment (other than food). For each study the attributable fraction for these potential sources of infection was calculated from the data presented. A meta-analysis was then undertaken to obtain pooled estimates for the relative contribution of these transmission pathways. Results Data from 28 cross-sectional studies and 14 case-control studies were extracted. There was strong evidence for transmission by direct contact with dogs for both CE and AE. The estimated attributable fractions were 26.1% (CI 13.8%-39.6%) and 34.4% (CI 20.7% -48.2%) respectively. Transmission through contaminated water was estimated to be responsible for approximately 29.4% (CI 12.1%-51.7%) for CE and 24.8% (CI 10.6% to 42.6%) for AE. Contaminated food may be responsible for approximately 23.4% of CE cases (CI 2.1%-47.3%). Globally, there was insufficient evidence to conclude AE can be transmitted by food, although case control studies from low human incidence areas suggested that possibly 32.5% (CI 10.0%-53.2%) could be transmitted by food. There was also insufficient evidence that direct contact with foxes was a significant source of human disease. There were no suitable studies with a risk of environmental contact reported, but the residual attributable fraction thatwould likely include this pathway was approximately 30.4% for CE and 11.1% for AE. Conclusions The results support the hypothesis that dog contact and drinking contaminated water are major pathways of transmission of both CE and AE. For contaminated food, the results are less consistent, but suggest that it is an important transmission pathway and provide better evidence than expert elicitations as previously used

Avaliação de estados de humor nos exames da Royal Academy of Dance

This qualitative study investigated the mood states of students, participants in of the Royal Academy of Dance examinations. The exploratory research used the POMS (Profile of Mood States), administered before and after the examination, to an intentional sample of 12 dance students, aged 18 to 40 years. The descriptive analysis, comparing the data collectionsin the pre and post-test showed an increase in fatigue and decreased vigor and minimum indices of tension states, depression, anger and confusion. Further studies are needed in order to improve the approaches to the subjective states involving practice, background training in dance and performance assessments, aspects largely unexplored in the academic ambit.Este estudo qualitativo investigou os estados de humor de alunos participantes dos Exames da Royal Academy of Dance. A pesquisa exploratória utilizou o POMS (Profle of Mood States), aplicado antes e após o exame, a uma amostra intencional composta por 12 estudantes de dança, faixa etária de 18 a 40 anos. A análise descritiva, ao se comparar os dados obtidos no pré e pós-teste, evidenciou um aumento da fadiga e uma diminuição do vigor e índices mínimos dos estados de tensão, depressão, raiva e confusão mental. Novos estudos se fazem necessários, visando ao aprimoramento das abordagens acerca dos estados subjetivos envolvendo as práticas, a formação em dança e as avaliações das performances, aspectos ainda pouco explorados em âmbito acadêmico