Facilidades e dificuldades da família no cuidado à criança com paralisia cerebral

Pesquisa qualitativa, exploratória, descritiva, que objetivou apreender as facilidades e as dificuldades da família nocuidado às crianças com paralisia cerebral. Os dados foram coletados com sete famílias, entre março e abril de 2009,por meio de entrevista semiestruturada. A análise seguiu os princípios da interpretação temática. As dificuldades sãomais evidenciadas que as facilidades e trazem repercussões nas atividades de vida diária. Lidar com convulsões dedifícil controle, espasticidade, alterações de tônus postural, presença de reflexos primitivos implicam na complexidadeem tarefas simples, como alimentação, banho, locomoção, pois as crianças ficam, cada dia, mais dependentes doscuidadores. Com o tempo, as dificuldades cedem lugar à rotina e à adaptação à vida diária da criança. Estreitarrelações com a família, melhorando o vínculo e desenvolvendo ações de qualidade e integrais, promovem o bemestarda família/criança com paralisia cerebral

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

Forest restoration with Araucaria angustifolia (Bertol.) Kuntze on Campos do Jordao state park, SP: fire effects on tree and shrub structure

Restoration actions aimed at Mixed Ombrophilous Forests are limited due to the scarce knowledge about composition and structure of these communities on different successional stages, and also the effects of frequent disturbances on its dynamics, such as fire. The present work aimed at evaluating the effect of an accidental fire on the horizontal, vertical and diametric structure of an Araucaria angustifolia planted forest, located on Campos do Jordao State Park, SP, nine years after the disturbance. This study also intends to appraise the potential of these forests on inducing the secondary succession. Two Araucaria angustifolia forests were selected, with similar ages and environmental conditions, called Forests RI and Rh. On RI, there's no account of fire since its planting, in 1959 (control). RII, which was planted in 1958, was affected by an accidental fire in July 2001. During the upper strata survey (circumference at breast height (CBH) >= 15cm), 17 and 8 permanent plots of 10x20m were established on forests RI and RII, respectively. In each one of these plots five sub-plots of 1x1m were randomly chosen, in order to survey the lower strata (total height >= 30cm and CBH < 15cm). In forest RI, 836 trees and shrubs were surveyed, while on forest Rh I 175 individuals were sampled. Forest RI presented significantly higher values than II for density on both strata and dominance on upper strata (absolute totals). The diametric structure follows an inverted J-pattern in both areas. Nevertheless, the fire seems to significantly have reduced the number of individuals of the first diameter classes. Forest RII seems to still express the effect of burning, which was more severe in the lower strata; in case the above hypothesis is correct. However, due to favorable landscape conditions, we hope that both forests continue their natural succession, resembling the surrounding forest matrix in the long term.409427929

Mixed rain forest in southeastern Brazil: tree species regeneration and floristic relationships in a remaining stretch of forest near the city of Itabera, Brazil

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)The aim of this work was to evaluate the floristic composition, richness, and diversity of the upper and lower strata of a stretch of mixed rain forest near the city of Itabera, in southeastern Brazil. We also investigated the differences between this conservation area and other stretches of mixed rain forest in southern and southeastern Brazil, as well as other nearby forest formations, in terms of their floristic relationships. For our survey of the upper stratum (diameter at breast height [DBH] >= 15 cm), we established 50 permanent plots of 10 x 20 m. Within each of those plots, we designated five, randomly located, 1 x 1 m subplots, in order to survey the lower stratum (total height >= 30 cm and DBH < 15 cm). In the upper stratum, we sampled 1429 trees and shrubs, belonging to 134 species, 93 genera, and 47 families. In the lower stratum, we sampled 758 trees and shrubs, belonging to 93 species, 66 genera, and 39 families. In our floristic and phytosociological surveys, we recorded 177 species, belonging to 106 genera and 52 families. The Shannon Diversity Index was 4.12 and 3.5 for the upper and lower strata, respectively. Cluster analysis indicated that nearby forest formations had the strongest floristic influence on the study area, which was therefore distinct from other mixed rain forests in southern Brazil and in the Serra da Mantiqueira mountain range.2717186Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)CNPq [479084/2007

O que é ser mãe de uma criança com fibrose cística

Conhecer o que é ser mãe de uma criança que apresenta fibrose cística é fundamental para o cuidado desses indivíduos, pois geralmente ela divide as responsabilidades relacionadas ao tratamento com o filho que apresenta essa doença grave e sem cura. Nesse sentido, este estudo teve como objetivo conhecer a vivência de ser mãe de uma criança com fibrose cística. Trata-se de um estudo descritivo-exploratório, qualitativo, de caráter fenomenológico. Foram entrevistadas 14 mulheres e a coleta de dados foi realizada por meio de uma entrevista semiestruturada. A análise das falas transcritas na íntegra seguiu direcionamentos propostos pela fenomenologia. Essa é uma experiência que a tristeza, angústia, dúvidas, sofrimento e medo estão presentes, levando essas mulheres a refletirem sobre suas vidas e a de seus filhos, promovendo mudanças em seu mundo vida e uma reorganização de toda a família

Presença da família nas unidades de terapia intensiva pediátrica e neonatal: visão da equipe multidisciplinar Presencia de la familia en las unidades de terapia intensiva pediátrica y neonatal: visión del equipo multidisciplinar Family presence in the pediatric and neonatal intensive therapy unit: the view of the multidisciplinary team

O presente estudo tem por objetivo compreender a visão da equipe multidisciplinar quanto à presença da família nas Unidades de Terapia Intensiva (UTI) pediátrica e neonatal. A pesquisa teve como eixo norteador a abordagem qualitativa. Para a análise e interpretação dos dados, optou-se pela análise de conteúdo. Os dados foram coletados em junho de 2006, por meio de entrevista semi-estruturada junto a 25 profissionais atuantes nas UTI pediátrica e neonatal de dois hospitais na região noroeste do Estado do Paraná. Do discurso destes profissionais, desvelou-se o conflito íntimo vivenciado por cada um com relação à presença da família nas unidades. Conclui-se que o primeiro passo para a mudança e melhor aceitação dos familiares dentro da UTI é sensibilizar os profissionais quanto à importância da presença da família para a criança em momentos de crise, como na hospitalização.<br>El presente estudio tiene por objetivo comprender la visión del equipo multidisciplinar en cuanto a la presencia de la família en las Unidades de Cuidados Intensivos (UCI) pediátricos y neonatal. La investigación ha tenido como eje norteador el abordaje cualitativo. Para el análisis e interpretación de los datos, se optó por el análisis de contenido. Los datos fueron colectados en junio de 2006, por medio de encuesta semiestructurada junto a los profesionales actuantes en las unidades de cuidados intensivos pediátricos y neonatal de dos hospitales en la región noroeste de la provincia de Paraná. Veinticinco profesionales fueron informantes. De los discursos de estos profesionales, se desveló el conflicto íntimo vivido por cada uno com relación a la presencia de la familia en estas unidades. Sensibilizar a los profesionales para la importancia de la familia, en la vida del niño en momentos de crisis, como en la hospitalización es el primer paso para una mudanza de comportamiento y una mejor aceptación de los familiares dentro de las UCI.<br>The present study has the aim to understand the view of a multidisciplinary team as for the presence of family in the Units of Pediatric and Neonatal Intensive Care (ICU). The research has had as a guide axis the qualitative approach. For the analysis and data interpretation, it has been opted for the content analysis. Data were collected in June of 2006, through a semi-structured interview with 25 professionals in action at the pediatric and neonatal Intensive Care Unit of two hospitals in the northwest area of Paraná State. From the statements of these professionals, the intimate conflict was revealed, lived by each one, regarding the presence of the family in the units. The first step for behavioral changing and better acceptance of parents in the ICU is sensitizing the professionals for the importance of the family into the child's life in moments of crisis, as well as in the hospitalization