Does severe maternal morbidity affect female sexual activity and function? Evidence from a brazilian cohort study

To assess Female Sexual Function Index (FSFI) scores and delay to resume sexual activity associated with a previous severe maternal morbidity. This was a multidimensional retrospective cohort study. Women who gave birth at a Brazilian tertiary maternity between 2008 and 2012 were included, with data extraction from the hospital information system. Those with potentially life-threatening conditions and maternal near miss episodes (severe maternal morbidity) were considered the exposed group. The control group was a random sample of women who had had uncomplicated pregnancy. Female sexual function was evaluated through FSFI questionnaire, and general and reproductive aspects were addressed through specific questions. Statistical analyses were performed using Mann-Whitney and Pearson's Chi-square for bivariate analyses. Logistic regression was used to identify variables independently associated with lower FSFI scores. 638 women were included (315 at exposed and 323 at not exposed groups). The majority of women were under 30 years-old in the control group and between 30 and 46 years-old in the exposed group (p = 0.003). Women who experienced severe maternal morbidity (SMM) had statistically significant differences regarding cesarean section (82.4% versus 47.1% among deliveries without complications, p< 0.001), and some previous pathological conditions. FSFI mean scores were similar among groups ranging from 24.39 to 24.42. It took longer for exposed women to resume sexual activity after index pregnancy (mean 84 days after SMM and 65 days for control group, p = 0.01). Multiple analyses showed no significant association of FSFI below cut-off value with any predictor. FSFI scores were not different in both groups. However, they were lower than expected. SMM delayed resumption of sexual activity after delivery, beyond postpartum period. However, the proportion of women in both groups having sex at 3 months after delivery was similar. Altered sexual response may be evaluated as one of possible long-term consequences after SMM episodes. Further studies on the growing population of women surviving severe maternal conditions might be worth for improvement of care for women1012CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO - CNPQ471142/2011-

O uso do mind map como ferramenta de gestão de projetos em áreas de consultoria e desenvolvimento de negócios e produtos

Esta dissertação tem como objetivo o estudo da aplicabilidade e dos eventuais benefícios do Mind Map na gestão de projetos em áreas de consultoria, desenvolvimento de negócios e produtos. Como objetivos secundários, este estudo apresenta aplicações práticas do Mind Map, no ambiente empresarial, além de trazê-lo ao ambiente acadêmico brasileiro. O referencial teórico, dividido em duas partes, introduz, primeiramente, a gestão de projetos, a partir da visão de seus principais autores acadêmicos. A segunda parte traz, com maior profundidade, uma revisão bibliográfica do Mind Map, apresentando sua definição, princípios, leis, benefícios, aplicações e quatro casos de sucesso no mercado corporativo. A metodologia de pesquisa adotada nesta dissertação foi estudo de caso múltiplo, com cinco gestores, de quatro organizações atuantes no setor de serviços, que utilizam o Mind Map como ferramenta de gestão de projetos de consultoria, desenvolvimento de negócios e produtos. Como instrumento de coleta de dados, foram feitas entrevistas roteirizadas individuais com cada um dos gestores, realizadas pelo próprio pesquisador, além da coleta de dados secundários de domínio público. As conclusões, apresentadas neste trabalho, revelam que o Mind Map potencializa várias das habilidades necessárias a um bom gestor de projetos, permitindo uma melhor qualidade da sua prática de gerenciamento, principalmente no que tange ao planejamento e acompanhamento do escopo do projeto. Entretanto, ficou evidente a necessidade de um software de Mind Map, muitas vezes apoiado por outros programas clássicos normalmente utilizados em gestão de projetos, para que os objetivos fossem atingidos mesmo diante da complexidade dos casos analisados

Does Severe Maternal Morbidity Affect Female Sexual Activity and Function? Evidence from a Brazilian Cohort Study.

to assess Female Sexual Function Index (FSFI) scores and delay to resume sexual activity associated with a previous severe maternal morbidity.This was a multidimensional retrospective cohort study. Women who gave birth at a Brazilian tertiary maternity between 2008 and 2012 were included, with data extraction from the hospital information system. Those with potentially life-threatening conditions and maternal near miss episodes (severe maternal morbidity) were considered the exposed group. The control group was a random sample of women who had had uncomplicated pregnancy. Female sexual function was evaluated through FSFI questionnaire, and general and reproductive aspects were addressed through specific questions. Statistical analyses were performed using Mann-Whitney and Pearson´s Chi-square for bivariate analyses. Logistic regression was used to identify variables independently associated with lower FSFI scores.638 women were included (315 at exposed and 323 at not exposed groups). The majority of women were under 30 years-old in the control group and between 30 and 46 years-old in the exposed group (p = 0.003). Women who experienced severe maternal morbidity (SMM) had statistically significant differences regarding cesarean section (82.4% versus 47.1% among deliveries without complications, p<0.001), and some previous pathological conditions. FSFI mean scores were similar among groups ranging from 24.39 to 24.42. It took longer for exposed women to resume sexual activity after index pregnancy (mean 84 days after SMM and 65 days for control group, p = 0.01). Multiple analyses showed no significant association of FSFI below cut-off value with any predictor.FSFI scores were not different in both groups. However, they were lower than expected. SMM delayed resumption of sexual activity after delivery, beyond postpartum period. However, the proportion of women in both groups having sex at 3 months after delivery was similar. Altered sexual response may be evaluated as one of possible long-term consequences after SMM episodes. Further studies on the growing population of women surviving severe maternal conditions might be worth for improvement of care for women