Stress influence on genesis, onset and maintenance of cardiovascular diseases: literature review

Background. Recent mortality profiles in Brazil show that circulatory diseases are the leading cause of death in Brazil. These disorders contribute to 34% of deaths, with 50% of those deaths occurring in people under 50 years of age, that is, in people who are still active in the workforce. We assume that the growing incidence of cardiovascular diseases has occurred as the globalization of Brazil continues and brings with it the associated health risk factors of modern lifestyles, including stress.Aim. This paper reports the. evidence on the influence of stress in the development, onset and progress of cardiovascular diseases. We aim to define the concept of stress and to point systematically to the interrelationships between its emotional and bodily manifestations through a discussion of the history and study of stress. We then suggest that factors leading to the experience of stress in Brazil are no different than in any other modern nation. We further offer a perspective on nursing interventions currently undertaken in Brazil in both hospital and community settings, with their more recent emphasis on health. promotion and prevention.Methods. An extensive literature review was undertaken. the data presented here were selected from reviews and clinical studies described in MEDLINE, LILACS, SciELO databases, as well as in the classical literature. We also refer to the current Brazilian literature on the prevalence of cardiovascular diseases and their associated risk factors.Conclusions. the incidence of cardiovascular diseases in Brazil is rising. Because of the globalization of Brazilian society, with its consequent competitiveness and accelerated modern lifestyles, Brazilians are no less immune,to the usual health risk factors associated with cardiovascular diseases. Stresses associated with a modern lifestyle, however, are emerging as a new and major risk for developing cardiovascular diseases in Brazil.Universidade Federal de São Paulo, UNIFESP, EPM, Dept Nursing, São Paulo, BrazilHosp São Paulo, São Paulo, BrazilUniversidade Federal de São Paulo, EPM, Med Psychiat & Psychol Dept, São Paulo, BrazilUniversidade Federal de São Paulo, UNIFESP, EPM, Dept Nursing, São Paulo, BrazilHosp São Paulo, São Paulo, BrazilUniversidade Federal de São Paulo, EPM, Med Psychiat & Psychol Dept, São Paulo, BrazilWeb of Scienc

Disaster Exercises to Prepare Hospitals for Mass-Casualty Incidents : Does it Contribute to Preparedness or is it Ritualism?

Introduction: The central question this study sought to answer was whether the team members of Strategic Crisis Teams (SCTs) participating in mass-casualty incident (MCI) exercises in the Netherlands learn from their participation. Methods: Evaluation reports of exercises that took place at two different times were collected and analyzed against a theoretical model with several dimensions, looking at both the quality of the evaluation methodology (three criteria: objectives described, link between objective and items for improvement, and data-collection method) and the learning effect of the exercise (one criterion: the change in number of items for improvement). Results: Of all 32 evaluation reports, 81% described exercise objectives; 30% of the items for improvement in the reports were linked to these objectives, and 22% of the 32 evaluation reports used a structured template to describe the items for improvement. In six evaluation categories, the number of items for improvement increased between the first (T1) and the last (T2) evaluation report submitted by hospitals. The number of items remained equal for two evaluation categories and decreased in six evaluation categories. Conclusion: The evaluation reports do not support the ideal-typical disaster exercise process. The authors could not establish that team members participating in MCI exercises in the Netherlands learn from their participation. More time and effort must be spent on the development of a validated evaluation system for these simulations, and more research into the role of the evaluator is needed. Verheul MLMI, Dückers MLA, Visser BB, Beerens RJJ, Bierens JJLM. Disaster exercises to prepare hospitals for mass-casualty incidents: does it contribute to preparedness or is it ritualism? Prehosp Disaster Med

[Air quality measurements during the conflagration at a polymer-plant in Uithoorn. Investigations of grass and soil from neighbouring pastures and of deposited and half-burned materials.]

July 8th 1992 an explosion in a production vessel followed by a conflagration took place at a polymer-plant in Uithoorn, the Netherlands. This disaster resulted in an enormous havoc and an emission of combustion products and volatile compounds. Half burned materials were blown away and deposited on neighbouring pastures. The section Environmental Incidents and Environmental Medicine of RIVM arrived within two hours at the accident site and carried out many measurements on air quality. Due to the enormous heat of the fire and a corresponding rise of the flue gasses, an exposition of the neighbouring population was unlikely during the first phase of the fire. In the second stage of less fire, the flue gasses reached the earth surface. Near the seat of fire the levels of compounds like toluene, ethylbenzene and xylene were measured in concentrations up to 40 ppm. In the surrounding residential quarters the concentrations have been below 2 ppm. Also nitrogenoxyde, ozone, dust and polycyclic aromatic hydrocarbons proved to occur at background level, benzene was not detected. A few days later half-burned material has been collected from neighbouring pastures. It contained lead in contents up to 76 g/kg. Also the lead contents of grass and soil proved to be enhanced. It is unlikely that the high lead and also the high polycyclic aromatic hydrocarbon level of grass and soil have been caused by the explosion. Former measurements (1985) of the lead and polycyclic aromatic hydrocarbon contents of soil from the surroundings showed increased levels also. In the phase of evaporation, a few days after the fire, rather high concentrations of benzene (up to 507 mug/m3) and other lower aromates could be measured near the demolished plant.RIMH/NHRVI/NH-ZH-

Onderzoek naar de luchtkwaliteit tijdens en na de brand op 8 juli 1992 bij Nevcin Polymers te Uithoorn. Onderzoek van gras, grond en neergedaalde verbrandingsresten afkomstig van percelen weiland te Amstelveen

July 8th 1992 an explosion in a production vessel followed by a conflagration took place at a polymer-plant in Uithoorn, the Netherlands. This disaster resulted in an enormous havoc and an emission of combustion products and volatile compounds. Half burned materials were blown away and deposited on neighbouring pastures. The section Environmental Incidents and Environmental Medicine of RIVM arrived within two hours at the accident site and carried out many measurements on air quality. Due to the enormous heat of the fire and a corresponding rise of the flue gasses, an exposition of the neighbouring population was unlikely during the first phase of the fire. In the second stage of less fire, the flue gasses reached the earth surface. Near the seat of fire the levels of compounds like toluene, ethylbenzene and xylene were measured in concentrations up to 40 ppm. In the surrounding residential quarters the concentrations have been below 2 ppm. Also nitrogenoxyde, ozone, dust and polycyclic aromatic hydrocarbons proved to occur at background level, benzene was not detected. A few days later half-burned material has been collected from neighbouring pastures. It contained lead in contents up to 76 g/kg. Also the lead contents of grass and soil proved to be enhanced. It is unlikely that the high lead and also the high polycyclic aromatic hydrocarbon level of grass and soil have been caused by the explosion. Former measurements (1985) of the lead and polycyclic aromatic hydrocarbon contents of soil from the surroundings showed increased levels also. In the phase of evaporation, a few days after the fire, rather high concentrations of benzene (up to 507 mug/m3) and other lower aromates could be measured near the demolished plant.<br

Evaluation of expected outcomes of nursing interventions to address the nursing diagnosis of fatigue among patients with congestive heart failure Evaluación de las intervenciones y de los resultados esperados para el diagnóstico de enfermería fatiga, en pacientes con insuficiencia cardiaca congestiva Avaliação das intervenções e dos resultados esperados para o diagnóstico de enfermagem fadiga, em portadores de insuficiência cardíaca

OBJECTIVE: To evaluate expected outcomes of nursing interventions to address the nursing diagnosis of fatigue. METHODS: A cross-sectional quasi-experimental design was used. The sample consisted of 30 coronary care unit in-patient with congestive heart failure and fatigue. A specific tool designed for this study was used to collect specific data on outcomes of nursing interventions to manage the nursing diagnosis of fatigue. RESULTS: Nursing interventions to manage patients' fatigue had positive outcomes. CONCLUSION: The use of the nursing process to identify the nursing diagnosis of fatigue, design and implement specific nursing interventions, and evaluate patient outcomes leads to quality nursing care.<br>OBJETIVO: Evaluar los resultados alcanzados después de las intervenciones de enfermería para el diagnóstico de enfermería Fatiga. MÉTODOS Se trata de un estudio, cuasi-experimental, tiempo serie y transversal, realizado en un Hospital Universitario por medio de la implementación de intervenciones y evaluación diaria de los resultados en 30 pacientes con diagnóstico de insuficiencia cardiaca y de enfermería fatiga, internados en la Unidad de Cardiología y UCI Coronaria. Fue elaborado un instrumento de recolección de datos compuesto por intervenciones y resultados de enfermería. RESULTADOS: Fue observada buena evolución de todos los indicadores evaluados. Las intervenciones de enfermería alcanzaron de manera satisfactoria los resultados esperados. CONCLUSIÓN: Al sistematizar la asistencia de enfermería, alcanzamos resultados favorables en sus evidencias clínicas.<br>OBJETIVO: Avaliar os resultados alcançados após intervenções de enfermagem para o diagnóstico de enfermagem Fadiga. MÉTODOS: Estudo, quase-experimental, tempo série e transversal, realizado em Hospital Universitário por meio da implementação de intervenções e avaliação diária dos resultados em 30 pacientes com diagnóstico de insuficiência cardíaca e de enfermagem fadiga, internados na Unidade de Cardiologia e UTI Coronária. Foi elaborado um instrumento de coleta de dados composto por intervenções e resultados de enfermagem. RESULTADOS: Foi observada boa evolução de todos os indicadores avaliados. As intervenções de enfermagem atingiram satisfatoriamente os resultados esperados. CONCLUSÃO: Ao sistematizar a assistência de enfermagem, alcançamos resultados favoráveis em suas evidências clínicas

Associação entre o estado de saúde autorreferido de adultos e a área de localização do domicílio: uma análise de regressão logística ordinal usando a PNAD 2008 Association between self-reported state of health among adults and the location of the home: ordinal logistic regression analysis using PNAD 2008

O ambiente urbano influencia a saúde e os comportamentos humanos, sendo necessário um melhor entendimento dos determinantes da saúde das populações que vivem nas cidades. A partir dos dados da Pesquisa Nacional por Amostra de Domicílios (PNAD) 2008, usando modelos logísticos ordinais incorporando o plano amostral, o presente artigo avalia a associação entre a área de localização do domicílio (urbana e rural) e o estado de saúde autorreferido da população adulta brasileira, controlando para um conjunto de fatores individuais e do ambiente intradomiciliar e extradomiciliar. Os resultados indicam que ao controlar por fatores individuais e ambientais, a associação entre a área de localização do domicílio e o estado de saúde autorreferido dos adultos se modifica (passando de OR=1,51 para OR=0,96) e perde a sua significância estatística (p-valor=0,208). Entretanto, foram observadas interações estatisticamente significantes entre a área de localização do domicílio e as seguintes variáveis: sexo, cor/raça, morbidade autorreferida, posse de bens básicos e percentual de domicílios adequados quanto a qualidade de moradia.<br>The urban environment influences human health and behavior, and a clearer understanding of the health determinants of populations living in cities is needed. Using data from the National Household Sampling Survey (PNAD) 2008, with ordinal logistic models incorporating the sampling plan, this study assessed the association between the location of the home (urban or rural) and the self-reported state of health of the adult Brazilian population, taking into account a set of individual and environmental factors inside and outside the home. The results indicated that after allowing for individual and environmental factors, the association between the location of the home and the self-reported state of health is changing (going from OR = 1.51 to OR = 0.96) and losing its statistical significance (p-value = 0.208). However, statistically significant interactions were observed between the location of the home and the following variables: sex, color/race, self-reported morbidity, possession of basic goods and percentage of households with adequate living conditions