The complexity of the nursing work in hospiatl for custody and psychiatric treatment

Objective: to analyse the ways in which professional nurses to lead with the complexity of the work at the Hospital for Custody and Psychiatric Treatment. Method: Descriptive and qualitative research with 15 professional nurses. Data collection occurred through the semi-structured interview, and thematic analysis content. Results: the main prevention and protection strategy to the health worker's was the interdisciplinarity in the actions. Conclusion: it was evidenced the need for educational measures to define the role of the Hospital for Custody and Psychiatric Treatment in society and in the psychotic offenders lives and the restructuring of work organization in an interdisciplinary way to became in opportunities of creation and realization to the worker, regarding to their physical and mental apparatus

Células-tronco mesenquimais em modelo de lesão cutânea induzida experimentalmente por nitrogênio líquido em ratos Wistar

A criocirurgia tem sido utilizada no tratamento de diferentes enfermidades de sistemas e órgãos, tanto na medicina humana quanto na medicina veterinária, sendo sua maior indicação o tratamento de dermatopatias. Contudo, efeitos adversos como a cicatrização lenta, cicatrizes extensas, disfunção estética e funcional, são relatados após a aplicação da substância criogênica. Ainda, existem as lesões que ocorrem naturalmente pela exposição ao frio extremo, afetando principalmente o nariz, dedos das mãos e pés ou orelhas. Na maioria das vezes resultam em gangrena e são bem comuns nos habitantes dos polos, turistas e praticantes de modalidades na neve. O presente trabalho tem como objetivo avaliar a influência das células-tronco mesenquimais de origem adiposa (ADSCs) na cicatrização de feridas cutâneas padronizadas e induzidas pelo nitrogênio líquido em ratos em duas fases da cicatrização cutânea: fase de proliferação e fase de remodelação. Utilizaram-se 83 ratos Wistar, machos, hígidos, com oito semanas de idade, sendo três animais usados como doadores de tecido adiposo para posterior obtenção das ADSCs e, 80 animais divididos aleatoriamente em oito grupos de tratamento (n=10). Através da aplicação do nitrogênio líquido pela técnica do spray aberto, realizou-se a indução de uma ferida, de aproximadamente 15 mm de diâmetro, na região dorsal de cada rato. A ferida recebeu o tratamento de acordo com o grupo ao qual pertencia: a) aplicação das ADSCs, por via subcutânea, no 15º dia (T1), no 30º dia (T2) ou nos dois tempos mencionados (T3) após a indução da lesão; b) aplicação da solução cloreto de sódio 0,9%, por via subcutânea, no 15º dia (S1), no 30º dia (S2) ou nesses dois tempos (S3) após a indução da lesão; c) nenhuma intervenção até o momento da eutanásia dos animais no 45º dia (C1) ou no 60º dia (C2). Macroscopicamente, a cada cinco dias, analisaram-se as medidas das lesões e calculou- se a área e a taxa de contração cicatricial das mesmas. No 45º ou no 60º dia pós- operatório, procedeu-se à coleta das biópsias para avaliação histopatológica e imuno- histoquímica. Com base nos resultados obtidos concluiu-se que: 1) o grupo T1 apresenta as maiores taxas de contração média das feridas no 20º e 25º dia; 2) o grupo T3 obteve a maior taxa de contração média das feridas no 30º dia pós-operatório; 3) o grupo T2 apresenta as maiores taxas de contração média das feridas no 55º e 60º dia; 4) o grupo T1 obteve diferença estatisticamente significativa em relação ao grupo sham (S3) quanto à neovascularização, avaliada pela técnica de imuno-histoquímica com o VEGF; 5) o grupo sham (S1) obteve diferença estatística significativa em relação aos grupos tratados com as ADSCs (T2 e T3) quanto à proliferação epitelial, avaliada pela técnica de imuno-histoquímica com o anticorpo Ki-67; 6) a terapia com as ADSCs proporciona uma relevante evolução clínica das feridas, podendo ser constatada ao final do período de avaliação por cicatrizes mais estreitas e compridas com as medidas da área final inferiores às cicatrizes dos grupos controle (C1 e C2) e sham (S1, S2 e S3). Propõem-se a necessidade de novos estudos com as ADSCs na cicatrização de lesões cutâneas provocadas pela criocirurgia ou por outra modalidade de congelamento, realizando biópsias com análises histopatológicas e imuno-histoquímicas em períodos de tempo menores e maiores aos realizados nesse estudo, a fim de detectar, respectivamente, diferenças no processo de cicatrização imediatamente após a aplicação das ADSCs e, também, acompanhar o remodelamento da cicatriz por um período mais longo.Cryosurgery has been used to treat different diseases of systems and organs in both human and veterinary medicine. Although treatment of skin disorders is the leading indication, adverse effects such as delayed wound healing, large scars, esthetical deformation and functional impairment have been reported from administration of cryogenic substance. Beside that there are injuries caused naturally by the exposure to extreme cold weather conditions, which affect specially nose, fingers, toes and ears, mostly resulting in gangrene. These frostbites are very common in people who live in the Poles, tourists and snowboarders. This study aims to evaluate the influence of adipose-derived stem cells (ADSCs) on cutaneous wound healing that were standardized and induced by liquid nitrogen in rats according to two phases of cutaneous healing: proliferation phase and remodelling phase. For research purposes, 83 male, healthy and eight-weeks-old Wistar rats were required. Among 83 rats, three were used as adipose tissue donor for later ADSCs obtention and 80 Wistar rats were randomly divided in eight treatment groups (n=10). Through the application of liquid nitrogen by spraying technique, a 15 millimetres in diameter lesion was produced in the dorsal region of each rat. The wound received treatment according to the group it belonged: a) subcutaneously ADSCs application on the 15th day (T1), on the 30th day (T2) or in both periods mentioned (T3) after wound induction; b) subcutaneously application of 0.9% sodium chloride solution on the 15th day (S1), on the 30th day (S2) or in both periods mentioned (S3) after wound induction; c) no intervention until euthanasia on the 45th day (C1) or 60th day (C2) Macroscopically, every five days, the wounds were measured to calculate their area and healing rate. On the 45th and 60th postoperative day, biopsies were performed for histopathological and immunohistochemical evaluations. By the obtained results, the study concludes that:1) T1 group shows the highest wound average contraction rate on the 20th and 25th day; 2) T3 group presents the highest wound average contraction rate on the 30th postoperative day; 3) T2 group has the highest wound average contraction rate on the 55th and 60th day; 4) T1 group got a significant statistical difference in relation to sham group (S3) when it refers to neovascularization, which was evaluated by immunohistochemical technique with VEGF; 5) sham group (S1) obtained a significant statistical difference when compared to ADSCs groups (T2 and T3) with respect to epithelial proliferation, that was evaluated by immunohistochemical technique using antibody Ki-67; 6) the ADSCs therapy provides an important clinical evolution of wounds. This was verified at the end of evaluation period through narrower and longer scars with bottom end area measurements inferior to control group scars (C1 and C2) and sham group scars (S1, S2 and S3). Lastly, this paper proposes the necessity of new studies about the uses of ADSCs for cutaneous wound healing caused by cryosurgery or other sort of freeze. Furthermore it is opportune taking an action on studies that do biopsies with histopathological and immunohistochemical analyses using shorter and longer periods of time that those executed on this paper. Thus it will be possible to find out, respectively, differences on the healing process immediately after applying ADSCs and also follow up the scar remodelling for a longer period

O processo de responsabilização socioeducativa : da medida à responsabilidade

Dissertação (mestrado)—Universidade de Brasília, Instituto de Psicologia, Programa de Processos de Desenvolvimento Humano e Saúde, 2015.A polissemia em torno do conceito de responsabilização, presente no Estatuto da Criança e do Adolescente (ECA), no Sistema Nacional de Atendimento Socioeducativo (SINASE), e na literatura jurídica em geral, pode estar gerando interpretações errôneas sobre a função da medida e do atendimento ao adolescente no sistema socioeducativo. Por mais que a medida socioeducativa apareça como um importante elemento de promoção da responsabilidade jurídica, a simples execução dela não será suficiente para que o adolescente se posicione diante dos seus atos e rompa com as práticas infracionais. Por esse motivo, este estudo investiga as concepções sobre responsabilização socioeducativa e como tal conceito se expressa no atendimento ao adolescente autor de ato infracional. Trata-se de uma pesquisa de natureza quali-quantitativa. Optou-se pela combinação dos dois métodos de pesquisa por considerar que apenas um não conseguiria favorecer a aproximação ao fenômeno, e assim atender tanto ao caráter exploratório, característico da pesquisa qualitativa, como o aspecto de mensuração, peculiar ao método quantitativo. Integraram a pesquisa os seguintes procedimentos: a análise documental de textos normativos da prática socioeducativa e da literatura da área; e o desenvolvimento e aplicação de um instrumento do tipo Escala Likert, com aplicação on-line, a profissionais de diferentes estados brasileiros que atuam em diversas áreas do sistema socioeducativo – Judiciário e Executivo. Como resultado do estudo, observou-se que a vinculação entre punição, culpabilização e práticas promotoras de responsabilização está perdendo força entre os profissionais da socioeducação. No entanto, ainda foram observadas ideologias e representações que valorizam tal vinculação para que haja um processo de responsabilização eficaz. Por meio desse estudo, houve a possibilidade de contribuir para a minimização da ambiguidade jurídica, pedagógica e social do conceito de responsabilização no âmbito da socioeducação, bem como de indicar que as falhas observadas no sistema socioeducativo não estão embasadas no pouco conhecimento dos seus profissionais sobre as leis e normas que regem o sistema; mas, sim, nas ideologias punitivas que seguem se fazendo presentes no cotidiano dos serviços de atendimento aos adolescentes.Polysemy around the concept of accountability, which is present in ECA, SINASE and legal literature in general, may be generating misinterpretations of the role of measurement and assistance to adolescents in the socio-educational system. Although socio-educational measures emerge as an important element to promote legal accountability, their mere implementation will not be enough for adolescents to take responsibility for their actions and refrain from criminal activities. Therefore, this study investigates the conceptualization of socio-educational accountability and how this concept is translated into assistance to adolescent offenders. This is a qualitative and quantitative research based on the combination of the two research methods, since one method alone would not be conducive to an approach to the phenomenon, thus meeting both the exploratory character of the study, which is a feature of qualitative research, and the measurement aspect, which is typical of the quantitative method. The research includes the following procedures: a documentary analysis of normative texts on socio-educational practices and literature in the area; and the development and use of an instrument of the Likert Scale type, with online application for professionals from different Brazilian states working in various areas of the socio-educational system –the Judiciary and the Executive branches. As a result of the study, it was observed that the link between punishment, culpability and practices to promote accountability is losing steam among professionals in the socio-educational area. However, ideologies and representations that value this link for an effective accountability process have also been observed. This study has afforded us the possibility to contribute to reducing the legal, educational and social ambiguity of the accountability concept in the context of socio-education, as well as to indicate that the flaws observed in the socio-educational system are not founded on the little knowledge of its professionals about the laws and regulations governing the system, but rather on punitive ideologies that persist in the daily routine of assistanceservices to adolescents

Nursing care to elderly with bone fractures: an integrative review

Objective: To describe the profile of the elderly victims of bone trauma and as how nursing has been active in assisting these clients. Method: integrative Review, held in LILACS database with the keywords: Elderly, Nursing and Trauma, in order to answer the following question: >. Results: people over 80 years old suffer more trauma primarily with neuromotor weaknesses, using multiple medications and comorbidities. Nursing care for the elderly is still traumatized poor because there was a significant incidence of iatrogenic complications. Conclusion: the risk factors for the occurrence of traumatic events in the elderly favor the loss of quality of life, increased functional dependence, burden for caregivers and institutionalization. The records of care provide visibility and ensure continuity of care in a qualified way

Spatial distribution and uncertainties of nitrogen budgets for agriculture in the Tagus river basin in Portugal - implications for effectiveness of mitigation measures

The present study describes a methodology to quantify the gross soil nitrogen balance (SNB) for agricultural land use in the Tagus Nitrate Vulnerable Zone (TVZ) between 1989 and 2016, including effects of implementation of the EC Nitrates Directive (ND, 91/676/EEC) since 2004. The study uses decadal information from National Agricultural Census at parish level and is supported by a Geographical Information System (GIS). The average SNB of the TVZ decreased significantly (p < 0.001) from 125 kg ha−1 in 1989 to 63 kg ha−1 in 2016 (on average 1.8 kg ha−1 yr−1). The N input via irrigation water was particularly high in seven municipalities where it represents up to 35% of the total inputs. Using a Monte Carlo approach, the average uncertainty of the SNB was calculated at 12%. The most important sources of uncertainty were mineral fertilization, nitrate concentration in groundwater used for irrigation and the percentage of farmers complying with ND measures. GIS analysis shows that, at the scale of municipalities, the SNB has decreased since the ND implementation in regions dominated by irrigated intensive crop production, while the SNB has stabilized in municipalities in the south of TVZ with intensive livestock production (75% of area). We conclude that the implementation of ND and national measures to reduce the SNB was not equally effective across the TVZ. Our results indicate that the most effective measures to reduce the SNB in the future are increasing compliance of farmers with the ND related measures and measures increasing the nitrogen use efficiency of livestock manuresinfo:eu-repo/semantics/publishedVersio

Translating the agricultural N surplus hazard into groundwater pollution risk: Implications for effectiveness of mitigation measures in nitrate vulnerable zones

In the Nitrate Vulnerable Zones farmers are required to implement measures to reduce the nitrogen (N) surplus. Nevertheless, in some cases the status of the water bodies show that the effect of these measures remains insufficient despite the global decrease in N surpluses. The present work aims to contribute with a method that produces an appropriate indicator for the N mitigation measures effectiveness for reducing groundwater nitrate pollution. The Global Risk Index (GRI) results from overlaying the agricultural N surplus hazard and aquifer vulnerability. It includes both irrigation activity and precipitation contribution to water recharge calculated at the municipality level. It integrates a range of regional datasets combined with monitored nitrate (NO3 ) concentrations in groundwater under a GIS framework. Results show that the pollution status of the Tagus Vulnerable Zone (TVZ) aquifers has been aggravating in spite of the overall reduction in the N surpluses that resulted from the implementation of the Nitrates Directive measures. Twelve years after the TVZ designation, the GRI indicates high and moderate NO3- pollution risk, respectively in 33 % and 66 % of the territory. Scenario analysis indicates the potential of targeted measures for ending high risk areas and reducing moderate risk areas to 13 %. This supports that N mitigation measures must be reformulated and spatially targeted according to site specific hazards and vulnerabilitiesinfo:eu-repo/semantics/publishedVersio

CONFORTO FAMILIAR A UM PARENTE INTERNADO NA UNIDADE DE TERAPIA INTENSIVA

Objetivo: verificar o nível de conforto de familiares com um membro em unidade de terapia intensiva. Método: estudo quantitativo, de corte transversal, que entrevistou 98 familiares de um hospital público em Feira de Santana - Bahia, aplicando-se a Escala de Conforto para Familiares de Pessoas em Estado Crítico de Saúde (ECONF). Os dados foram analisados pela estatística descritiva. Resultados: a média do nível global de conforto foi de 3,83 (±0,53). Para a dimensão Segurança foi de 4,38 (±0,54), Interação familiar e ente de 4,19 (±0,70) e Suporte de 2,92 (±0,74). Conclusão: os níveis de conforto evidenciaram que os familiares se sentiam mais confortáveis ao perceberem a competência técnico científica e de relacionamento interpessoal da equipe hospitalar, a possibilidade de recuperação do parente e de apoio ao mesmo. Menor conforto foi relacionado a limites para estar com ou próximo ao parente e lacunas no sistema de informação hospitalar. Descritores: Cuidados de conforto; Família; Enfermagem

The Drivers of Political Communication on Messaging Apps: Habits and Perceptions of Brazilians in 2020

Since the 2018 elections, WhatsApp has gained centrality on debates about political communication on the internet. In that year, reports of bulk messaging have marked the elections, and messaging apps became the central concern regarding the use of digital tools by electoral campaigns. Many studies have investigated the strategies to influence the political debate in these spaces, finding signs of coordination, articulation and automation in open chat groups on the platform. The relation of the user with those strategies and this space, however, is still a field to be explored.The research published on August 8 reveals that the year of 2018 was a turning point for users on WhatsApp: of the 3113 users interviewed in the period of December 7 to 16, 2020, 71% affirm having somehow changed their behavior on the app since that year's elections, policing themselves more on what they talk about in WhatsApp groups, while 50% affirm having seen a change in group rules regarding what can be shared. From the split of groups or changes in behavior in order to avoid political arguments, to the emergence of shared rules in different groups, the users' experiences in that election impacted the way they interact and react on messaging apps.This movement engendered by the 2018 elections highlights the relevance of individual habits and of each group's rules to the way political contents circulate on messaging apps. The research carried out by InternetLab in partnership with Rede Conhecimento Social aimed at investigating the behaviors and perceptions of users of messaging apps that are able to shape the dissemination of electoral and political content. By adopting a multi-method approach – that combined discussion groups for collecting qualitative data and a sample survey –, the research aimed at focusing on the user's perspective, with the goal of shedding light about their role in the political communication dynamics