Memórias dos profissionais de enfermagem do Hospital Nereu Ramos em época de aids (1986 - 1996)

Dissertação (mestrado) - Universidade Federal de Santa Catarina, Centro de Ciências da Saúde. Programa de Pós-Graduação em Enfermagem.Trata-se de uma pesquisa qualitativa com abordagem histórica, cujo objetivo foi historicizar as memórias dos profissionais de enfermagem acerca do surgimento da aids e sua evolução no Hospital Nereu Ramos (HNR) de Florianópolis/Santa Catarina (SC), no período compreendido entre 1986 e 1996. A escolha do período de tempo deve-se ao fato de, em 1986, terem sido notificados os três primeiros casos de aids em Florianópolis e, em 1996, o Ministério da Saúde ter instituído a política de acesso universal à terapia anti-retroviral no Brasil. Foram realizadas entrevistas semi-estruturadas com três enfermeiros, dois técnicos de enfermagem e dois auxiliares de enfermagem, recorrendo à história oral como método-fonte-técnica e à memória como referencial. A pesquisa respeitou as Diretrizes e Normas Regulamentadoras da Pesquisa envolvendo Seres Humanos recomendadas pela Resolução nº 196/96 e foi aprovada pelo Comitê de Ética em Pesquisa da UFSC, com o parecer nº 0336/06. Para a análise e interpretação dos dados utilizou-se a análise de conteúdo temática, do qual surgiram as seguintes categorias e subcategorias: a memória sobre os enfrentamentos dos profissionais de enfermagem em época de aids # os enfrentamentos face à aids, às pessoas que viviam com HIV no HNR, ao risco de infecção pelo HIV, frente à família, amigos, sociedade, profissionais e instituições de saúde; do estigma ao reconhecimento do HNR como modelo de referência no tratamento da aids em SC; recordar o passado como espaço fortalecedor/vivificador do conceito de identidade e satisfação profissional na enfermagem. A discussão dos resultados permitiu constatar que a aids provocou mudanças expressivas no HNR como um todo e no comportamento dos profissionais de enfermagem que lá atuaram. O advento da aids e suas repercussões levaram a que os profissionais se mobilizassem no sentido de enfrentarem a doença, de se capacitarem para o cuidado de pessoas que vivem com HIV e para a melhoria dos cuidados e das condições de trabalho dentro da instituição. Isto tudo fez com que o HNR passasse de um hospital esquecido pela sociedade, para um hospital respeitado e reconhecido no tratamento da aids em SC. É possível concluir também, que passados mais de vinte anos do seu surgimento, a aids continua a representar um grande desafio para quem trabalha nessa área, e também para a sociedade, devido ao seu caráter estigmatizante e discriminatório. This is a qualitative research with a historical approach, that aimed to historicize the memories of the nursing professionals about the appearance and development of AIDS at the Nereu Ramos Hospital (HNR) of Florianópolis/Santa Catarina (SC), between 1986 and 1996. The selection of this period of time is due to the fact that, in 1986, were declared the 3 first cases of AIDS in Florianópolis, and in 1996, the Ministry of Health established the policy of universal access to antiretroviral therapy in Brazil. Semi-structured interviews were conducted with three nurses, two nursing technicians and two nursing assistants, using verbal history as a method-source-technique and memory as referential. The research followed the ethical principles recommended by Resolution 196/96 and it was approved by the Research Ethics Board of the UFSC, under the protocol nº 0336/06. Thematic content analysis was used for the study and interpretation of data, from which the following categories and sub-categories emerged: the memory of the nursing professionals coping with AIDS # coping with AIDS, with people who lived with HIV at the HNR, with the risk of HIV infection, with family, friends, society, professionals and institutions; from stigma to the recognition of the HNR as a model of reference in the treatment of AIDS in SC; recalling the past as a strengthening space of the identity concept and professional satisfaction in nursing. The analysis of the results allows us to conclude that AIDS caused significant changes in HNR and in the behavior of the nursing professionals who worked there. The advent of AIDS and its consequences led professionals to develop efforts against the disease, conceive training programmes to take care of people living with HIV, and to improve care and working conditions within the institution. All this changed the HNR from a forgotten hospital by society into a respected and recognized hospital in the treatment of AIDS in SC. It is also possible to conclude that, more than twenty years after its appearance, AIDS still represents a major challenge for those who work in this area, and also for society, because of its stigmatizing and discriminating characte

Pressure ulcer incidence and Braden subscales: Retrospective cohort analysis in general wards of a Portuguese hospital

Aim: To study the influence of Braden subscales scores (at the first pressure ulcer risk assessment) on pressure ulcer incidence using a univariate and a multivariate time to event analysis. Materials and methods: Retrospective cohort analysis of electronic health record database from adult patients admitted without pressure ulcer(s) to medical and surgical wards of a Portuguese hospital during 2012. The hazard ratio of developing a pressure ulcer during the length of inpatient stay was calculated by univariate Cox regression for each variable of interest and by multivariate Cox regression for the Braden subscales that were statistically significant. Results: This study included a sample of 6552 participants. During the length of stay, 153 participants developed (at least) one pressure ulcer, giving a pressure ulcer incidence of 2.3%. The univariate time to event analysis showed that all Braden subscales, except “nutrition”, were associated with the development of pressure ulcer. By multivariate analysis the scores for “mobility” and “activity” were independently predictive of the development of pressure ulcer(s) for all participants. Conclusion: (Im)“mobility” (the lack of ability to change and control body position) and (in)“activity” (the limited degree of physical activity) were the major risk factors assessed by Braden Scale for pressure ulcer development during the length of inpatient stay. Thus, the greatest efforts in managing pressure ulcer risk should be on “mobility” and “activity”, independently of the total Braden Scale score.info:eu-repo/semantics/publishedVersio

Characterisation of microbial attack on archaeological bone

As part of an EU funded project to investigate the factors influencing bone preservation in the archaeological record, more than 250 bones from 41 archaeological sites in five countries spanning four climatic regions were studied for diagenetic alteration. Sites were selected to cover a range of environmental conditions and archaeological contexts. Microscopic and physical (mercury intrusion porosimetry) analyses of these bones revealed that the majority (68%) had suffered microbial attack. Furthermore, significant differences were found between animal and human bone in both the state of preservation and the type of microbial attack present. These differences in preservation might result from differences in early taphonomy of the bones. © 2003 Elsevier Science Ltd. All rights reserved