139 research outputs found
CUIDADOS PALIATIVOS: DESAFIOS PARA O ENSINO NA PERCEPÇÃO DE ACADÊMICOS DE ENFERMAGEM E MEDICINA
Objetivo: identificar as dificuldades na abordagem dos cuidados paliativos e da terminalidade na percepção de acadêmicos de Enfermagem e Medicina de uma universidade pública. Método: trata-se de estudo exploratório, descritivo, com abordagem qualitativa, cuja coleta de dados foi realizada entre setembro de 2019 e janeiro de 2020, por meio de entrevista semiestruturada. Resultados: emergiram duas categorias temáticas principais: Desafios da comunicação em cuidados paliativos e Despreparo para lidar com o morrer e a morte. Considerações finais: identificou-se que os acadêmicos de Enfermagem e Medicina apresentam dificuldades relacionadas à comunicação na assistência em cuidados paliativos e em situações de fim de vida. Demonstrou-se ainda o seu despreparo em lidar com a morte, o sofrimento humano e os conflitos morais decorrentes de crenças religiosas.Descritores: Cuidado Paliativo. Cuidados de Conforto. Educação de Graduação em Medicina. Educação em Enfermagem. Formação Profissional em Saúde. Cuidados de Conforto. Educação de Graduação em Medicina. Educação em Enfermagem. Formação Profissional em Saúde.
Teorias de enfermagem e sua articulação com a prática: Relato de experiência / Nursing theories and their articulation with practice: Experience report
A teoria é uma representação simbólica de aspectos da realidade que são descobertos ou inventados para descrever, explicar, prever ou prescrever respostas, acontecimentos, situações, condições ou relações. Dessa forma, o presente estudo tem como objetivo descrever a experiência de uma discente sobre as teorias de enfermagem e sua articulação com a prática. Trata-se de um estudo descritivo com abordagem qualitativa, do tipo relato de experiência, desenvolvido na disciplina Fundamentos teóricos e técnicos para o cuidar em Enfermagem I. Foi realizado em três instituições de saúde privadas, no período de outubro a novembro de 2018. As principais teorias identificadas foram: Teoria ambientalista; Teoria Interpessoal; Teoria do Autocuidado; Teoria das necessidades básicas; Teoria da adaptação e a Teoria da comunicação. A teoria de Florence esteve presente nas três instituições visitadas, pela sua importância na prática de enfermagem, cuidado com o paciente e preocupação com o ambiente propício para o conforto, reabilitação ou cura. A vivência foi de suma importância, pela possibilidade de transcender os espaços tradicionais da sala de aula, possibilitando experiências em espaços que atendem públicos com diferentes perfis
revisão integrativa da literatura
ntrodução: O Cancro (CCR) é definido como um tumor maligno que acomete o cólon e o reto, e é mais comum em idades avançadas. Trata-se de uma das neoplasias mais frequentes na população adulta mundial, apresentando incidência e mortalidade crescentes em diversos países, com forte impacto na qualidade de vida (QV) dos doentes. Objetivo: Identificar as intervenções e fatores associados ao tratamento oncológico que causam impacto na qualidade de vida dos doentes adultos e idosos com CCR, disponíveis na literatura, visando a melhoria do cuidado de enfermagem. Métodos: Trata-se de uma revisão integrativa realizada por meio das bases de dados PubMed, LILACS e SciELO, onde foram selecionados 38 artigos publicados no período de 2007 a 2017 e excluídos aqueles que não apresentavam relação com a problemática do estudo. Resultados:Os estudos selecionados avaliaram a qualidade de vida dos doentes com CCR como satisfatória. Observou-se que o instrumento mais utilizado foi o QLQ-C30 e os domínios mais afetados foram o Psicológico/Emocional e o Físico, enquanto que o domínio Social foi o mais bem preservado. Verificou-se ainda que a prática de exercício físico, boa nutrição, suporte psicossocial, apoio familiar e a adoção de terapias complementares que englobam, desde a oração individual e aspectos relacionados à espiritualidade até a suplementação com Glutamina e o uso de outras substâncias bioativas, podem melhorar a QV desses doentes. Em contrapartida, os efeitos colaterais da quimioterapia antineoplásica e/ou radioterapia (dor, principalmente), bem como as consequências da cirurgia (confecção de estoma e alteração do hábito intestinal, por exemplo) são os principais fatores que pioram a QV. As principais queixas dos doentes submetidos à quimioterapia estavam relacionadas ao trato gastrointestinal e os sintomas mais frequentes foram fadiga, dor e insônia, além de irritação e depressão. Houve discordância na avaliação da QV dos doentes ostomizados, entendendo que a ostomia pode não influenciar ou piorar a QV dependendo das estratégias de gestão da doença adotadas. Os homens obtiveram maiores escores de QV em comparação com as mulheres, principalmente na preservação das funções emocionais e cognitivas, já na avaliação financeira, não foram demonstradas dificuldades decorrentes da doença. Considerações: Diante disso, deve-se salientar a importância da atuação do enfermeiro no controle de sintomas e planeamento de uma assistência de qualidade, a partir de uma avaliação individualizada, humanizada e sistemática, que leve em conta todos os aspectos e peculiaridades que envolvem o processo de saúde e doença no qual o doente com CCR se encontra inserido. Apesar das limitações de alguns estudos, pôde-se obter uma visão geral sobre a evidência na literatura relacionada à qualidade de vida desses doentes, destacando-se os fatores que exercem influência positiva ou negativa na sua percepção.Introduction: Colorectal Cancer (CRC) is defined as a malignant tumor that affects the colon and rectum, more common in advanced ages. It is one of the most frequent neoplasms in the adult population worldwide, presenting increasing incidence and mortality in several countries, with a strong impact on patient’s quality of life. Objective: To identify interventions and factors associated with oncological treatment that impact the quality of life of adult and elderly patients with CRC, available in the literature, aiming at the improvement of nursing care. Methods: This is an integrative review carried out using the PubMed, LILACS and SciELO databases, where 38 articles published in the period 2007 to 2017 were selected, excluding those that were not related to the study problem. Results: The selected studies evaluated the quality of life (QoL) of patients with CRC as satisfactory. It was observed that the most used instrument was the QLQ-C30 and the most affected areas were Psychological / Emotional and Physical, while the Social domain was preserved. It was also verified that the practice of physical exercise, good nutrition, psychosocial support, family support and the adoption of complementary therapies that encompass, from individual prayer and aspects related to spirituality to Glutamine supplementation and the use of other bioactive substances, may improve the QoL of these patients. On the other hand, the side effects of antineoplastic chemotherapy and /or radiotherapy (pain, especially), as well as the consequences of surgery (for example, stomatostomy and altered bowel habits) are the main factors that worsen QoL. The main complaints of patients undergoing chemotherapy were related to the gastrointestinal tract and the most frequent symptoms were fatigue, pain and insomnia, in addition to irritation and depression. There was disagreement in the evaluation of QoL of ostomized patients, understanding that ostomy may not influence or worsen QoL depending on the coping strategies adopted. Men had higher QoL scores compared to women, mainly in the preservation of emotional and cognitive functions and in the financial evaluation, no difficulties were demonstrated due to the disease. Considerations: Therefore, the importance of nurse’s performance in symptom control and quality care planning should be emphasized, based on an individualized, humanized and systematic evaluation that takes into account all aspects and peculiarities that involve the process of health and disease in which the CRC patient is inserted. Therefore, the limitations of some studies could provide an overview of the evidence in the literature related to the quality of life of these patients, highlighting the factors that have a positive or negative influence on their perception.info:eu-repo/semantics/publishedVersio
Production of He-4 and (4) in Pb-Pb collisions at root(NN)-N-S=2.76 TeV at the LHC
Results on the production of He-4 and (4) nuclei in Pb-Pb collisions at root(NN)-N-S = 2.76 TeV in the rapidity range vertical bar y vertical bar <1, using the ALICE detector, are presented in this paper. The rapidity densities corresponding to 0-10% central events are found to be dN/dy4(He) = (0.8 +/- 0.4 (stat) +/- 0.3 (syst)) x 10(-6) and dN/dy4 = (1.1 +/- 0.4 (stat) +/- 0.2 (syst)) x 10(-6), respectively. This is in agreement with the statistical thermal model expectation assuming the same chemical freeze-out temperature (T-chem = 156 MeV) as for light hadrons. The measured ratio of (4)/He-4 is 1.4 +/- 0.8 (stat) +/- 0.5 (syst). (C) 2018 Published by Elsevier B.V.Peer reviewe
HOSPITAL MORBIDITY AND COLORECTAL CANCER MORTALITY: IMPLICATIONS FOR PUBLIC HEALTH IN BRAZIL
Multiplicity dependence of light (anti-)nuclei production in p–Pb collisions at sNN=5.02 TeV
The measurement of the deuteron and anti-deuteron production in the rapidity range −1 < y < 0 as a function of transverse momentum and event multiplicity in p–Pb collisions at √sNN = 5.02 TeV is presented. (Anti-)deuterons are identified via their specific energy loss dE/dx and via their time-of- flight. Their production in p–Pb collisions is compared to pp and Pb–Pb collisions and is discussed within the context of thermal and coalescence models. The ratio of integrated yields of deuterons to protons (d/p) shows a significant increase as a function of the charged-particle multiplicity of the event starting from values similar to those observed in pp collisions at low multiplicities and approaching those observed in Pb–Pb collisions at high multiplicities. The mean transverse particle momenta are extracted from the deuteron spectra and the values are similar to those obtained for p and particles. Thus, deuteron spectra do not follow mass ordering. This behaviour is in contrast to the trend observed for non-composite particles in p–Pb collisions. In addition, the production of the rare 3He and 3He nuclei has been studied. The spectrum corresponding to all non-single diffractive p-Pb collisions is obtained in the rapidity window −1 < y < 0 and the pT-integrated yield dN/dy is extracted. It is found that the yields of protons, deuterons, and 3He, normalised by the spin degeneracy factor, follow an exponential decrease with mass number
International Nosocomial Infection Control Consortiu (INICC) report, data summary of 43 countries for 2007-2012. Device-associated module
We report the results of an International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2007-December 2012 in 503 intensive care units (ICUs) in Latin America, Asia, Africa, and Europe. During the 6-year study using the Centers for Disease Control and Prevention's (CDC) U.S. National Healthcare Safety Network (NHSN) definitions for device-associated health care–associated infection (DA-HAI), we collected prospective data from 605,310 patients hospitalized in the INICC's ICUs for an aggregate of 3,338,396 days. Although device utilization in the INICC's ICUs was similar to that reported from ICUs in the U.S. in the CDC's NHSN, rates of device-associated nosocomial infection were higher in the ICUs of the INICC hospitals: the pooled rate of central line–associated bloodstream infection in the INICC's ICUs, 4.9 per 1,000 central line days, is nearly 5-fold higher than the 0.9 per 1,000 central line days reported from comparable U.S. ICUs. The overall rate of ventilator-associated pneumonia was also higher (16.8 vs 1.1 per 1,000 ventilator days) as was the rate of catheter-associated urinary tract infection (5.5 vs 1.3 per 1,000 catheter days). Frequencies of resistance of Pseudomonas isolates to amikacin (42.8% vs 10%) and imipenem (42.4% vs 26.1%) and Klebsiella pneumoniae isolates to ceftazidime (71.2% vs 28.8%) and imipenem (19.6% vs 12.8%) were also higher in the INICC's ICUs compared with the ICUs of the CDC's NHSN
Systematic studies of correlations between different order flow harmonics in Pb-Pb collisions at = 2.76 TeV
The correlations between event-by-event fluctuations of anisotropic flow harmonic amplitudes have been measured in Pb-Pb collisions at sNN=2.76 TeV with the ALICE detector at the Large Hadron Collider. The results are reported in terms of multiparticle correlation observables dubbed symmetric cumulants. These observables are robust against biases originating from nonflow effects. The centrality dependence of correlations between the higher order harmonics (the quadrangular v4 and pentagonal v5 flow) and the lower order harmonics (the elliptic v2 and triangular v3 flow) is presented. The transverse momentum dependences of correlations between v3 and v2 and between v4 and v2 are also reported. The results are compared to calculations from viscous hydrodynamics and a multiphase transport (AMPT) model calculations. The comparisons to viscous hydrodynamic models demonstrate that the different order harmonic correlations respond differently to the initial conditions and the temperature dependence of the ratio of shear viscosity to entropy density (η/s). A small average value of η/s is favored independent of the specific choice of initial conditions in the models. The calculations with the AMPT initial conditions yield results closest to the measurements. Correlations among the magnitudes of v2, v3, and v4 show moderate pT dependence in midcentral collisions. This might be an indication of possible viscous corrections to the equilibrium distribution at hadronic freeze-out, which might help to understand the possible contribution of bulk viscosity in the hadronic phase of the system. Together with existing measurements of individual flow harmonics, the presented results provide further constraints on the initial conditions and the transport properties of the system produced in heavy-ion collisions
Relative particle yield fluctuations in Pb-Pb collisions at TeV
First results on K/, p/ and K/p fluctuations are obtained with the ALICE detector at the CERN LHC as a function of centrality in Pb-Pb collisions at TeV. The observable , which is defined in terms of the moments of particle multiplicity distributions, is used to quantify the magnitude of dynamical fluctuations of relative particle yields and also provides insight into the correlation between particle pairs. This study is based on a novel experimental technique, called the Identity Method, which allows one to measure the moments of multiplicity distributions in case of incomplete particle identification. The results for p/ show a change of sign in from positive to negative towards more peripheral collisions. For central collisions, the results follow the smooth trend of the data at lower energies and exhibits a change in sign for p/ and K/p.First results on , and K/p fluctuations are obtained with the ALICE detector at the CERN LHC as a function of centrality in collisions at . The observable , which is defined in terms of the moments of particle multiplicity distributions, is used to quantify the magnitude of dynamical fluctuations of relative particle yields and also provides insight into the correlation between particle pairs. This study is based on a novel experimental technique, called the Identity Method, which allows one to measure the moments of multiplicity distributions in case of incomplete particle identification. The results for show a change of sign in from positive to negative towards more peripheral collisions. For central collisions, the results follow the smooth trend of the data at lower energies and exhibits a change in sign for and K/p
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