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Introduction: Bioelectrical impedance vector analysis (BIVA) is a non-invasive and low-cost strategy. The methods used to assess malnutrition in patients undergoing HD are still a challenge. The aim of the present study was to compare BIVA to 7-Point Subjective Global Assessment (7-point SGA) to identify malnutrition. We also investigated the sensitivity and specificity of the previously proposed cutoffs point for BIVA parameters., Methods: Patients of both sexes, over 20 years of age, on HD treatment were included. Anthropometric parameters, laboratory data, and bioelectrical impedance analysis (BIA) were evaluated. Values of resistance (R) and reactance (Xc) obtained by mono-frequency BIA were normalized to body height (H) to generate a graph of the bioimpedance vector with the BIVA software. The analysis of the area under the receiver operating curve ROC (AUC) was performed., Results: Among the included 104 patients, the mean age was 51.70 (±15.10) years, and 52% were male. The BIVA had a sensitivity of 35% for diagnosing malnutrition. The specificity of BIVA for identifying the well-nourished patients was 85.7%. The diagnostic accuracy between the BIVA and 7-point SGA was AUC=0.604; 95%CI 0.490-0.726, higher than the previously established cutoff values (AUC=0.514; 95%CI: 0.369-0.631). The 95% confidence ellipses did not overlap (p<0.05)., Conclusion: Our study showed low accuracy of BIVA for diagnosing malnutrition using a 7-point SGA as a reference standard. However, it is a complementary method for assessing nutritional status as it provides data on cellularity and hydration, which are important aspects for the HD population.

Objective: To describe the methodological aspects of the Piauí home healthcare survey (ISAD-PI) and assess the relation between sampling plan, precision, and design effects, assuming that population health surveys are relevant instruments for health monitoring., Methods: ISAD-PI was a population-based cross-sectional study that analyzed the living conditions and health status of the population residing in urban areas in the municipalities of Teresina and Picos, in Piauí. Sampling was carried out by conglomerates in two stages: Primary Sampling Units and households. To calculate the sample size, we considered the stratification of the population in both cities, according to the age of the individuals. We evaluated the "non-response" rate (NRR) and estimated the proportions according to sex and age, as well as the prevalence of social determinants of health in order to assess the compliance of the sampling plan. Analyses related to the precision according to the coefficient of proportion variation of the standard error (Cv-pˆ) and the design effect (deff). Cv-pˆ less than 20% and deff less than 1.5 were considered adequate. The total NRR of households was 38.2% in Teresina and 38.3% in Picos. We carried out twenty-four proportion estimates in relation to age and sex and 48 prevalence of social and health determinants estimates, totaling 72 estimates. Among them, 71 had Cv-pˆ less than 20% and 61 had deff less than or equal to 1.5., Conclusion: Data generated from the ISAD-PI may contribute to the assessment of health and morbidity conditions in the population. Furthermore, methodological aspects employed in this research may serve as a basis for studies carried out in other cities in Brazil.

Objective: To explore the reorganization of the health system in response to the COVID-19 pandemic., Methods: We conducted an ecological, descriptive-exploratory study with analysis of spatio-temporal clusters by epidemiological week in Brazilian municipalities. Secondary data sources were used, from the National Health Establishment Registry (April 2020) and on COVID-19 cases, February to August 2020. Intensive Care Units (ICU) availability was overlaid on incidence and mortality hot spots in order to assess expanded access in critical regions., Results: Of the 5,570 municipalities analyzed, 54% were identified as incidence hot spots and 31% as mortality hot spots. Of the municipalities in incidence hot spots and with scarce access, 28% were covered by ICU expansion, while with regard to mortality 14% were covered., Conclusion: The opening of new beds was not able to provide broad coverage for critical regions and could be optimized with the use of spatial analysis techniques.

Objective: To identify the most used social networks and the most consumed contents by women seeking support and further understanding of breastfeeding/breast milk., Data Source: An integrative literature review was performed using the Psychology & Behavioral Sciences Collection, MEDLINE Complete, CINAHL Complete, MedicLatina, Academic Search Complete and ERIC databases. The search was conducted in April, 2020. The inclusion criteria were: publications in Portuguese, English or Spanish with several keywords, such as "Breastfeeding", "Social Networking", "Social Media", "Breastfeeding Promotion", in the title and in the abstract, with the combination of the Boolean operators "AND" and "OR", in original articles of primary source, which were available in full text and were published between 2015 and 2020., Data Synthesis: Out of the 93 articles that were first examined, 10 were used in the descriptive summary. Studies from the United States, Sweden, New Zealand, Brazil, Australia, Indonesia, and Switzerland were included in the review. Women were found to use several social networks, which is facilitated by an easy access to the Internet and to its content through several electronic resources, often using more than one device simultaneously. Most issues were universally recognized as some of the most common reasons for interrupting breastfeeding., Conclusions: The analyzed studies show that women seek to clarify their doubts outside the traditional health services' environment, using Facebook, apps, websites, online videos, podcasts and e-mail. We stress the importance of these support groups for promoting breastfeeding and the need for health professionals to introduce themselves in social networks to reach mothers.

This article explores the use of spatial artificial intelligence to estimate the resources needed to implement Brazil's COVID-19 immu nization campaign. Using secondary data, we conducted a cross-sectional ecological study adop ting a time-series design. The unit of analysis was Brazil's primary care centers (PCCs). A four-step analysis was performed to estimate the popula tion in PCC catchment areas using artificial in telligence algorithms and satellite imagery. We also assessed internet access in each PCC and con ducted a space-time cluster analysis of trends in cases of SARS linked to COVID-19 at municipal level. Around 18% of Brazil's elderly population live more than 4 kilometer from a vaccination point. A total of 4,790 municipalities showed an upward trend in SARS cases. The number of PCCs located more than 5 kilometer from cell towers was largest in the North and Northeast regions. Innovative stra tegies are needed to address the challenges posed by the implementation of the country's National COVID-19 Vaccination Plan. The use of spatial artificial intelligence-based methodologies can help improve the country's COVID-19 response.

Objective: To identify the perception of health professionals about neonatal palliative care., Method: A phenomenological qualitative study, a non-probabilistic sample, of 15 health professionals from a neonatal intensive care unit in northern Portugal. Content analysis was performed., Results: Despite their lack of training in palliative care, the health professionals showed concern for the dignity, quality of life and comfort of the newborn and family. They expressed emotional and relational difficulties in following the trajectories of serious illness and death and in the ethical decisions regarding the end-of-life., Conclusion: It is emphasized that professionals are sensitive to pain and suffering and reveal dedicated and committed in the care of the newborn and family. They are available to train and embrace the current challenges posed by the constitution of pediatric palliative care teams and to help achieve an organizational culture that advances in such care.

Objective: to assess the health care Primary Health Care professionals provide to diabetes mellitus patients from the perspective of the Modelo de Atenção às Condições Crônicas., Method: qualitative study, using the theoretical framework of Complex Thinking and the Modelo de Atenção às Condições Crônicas and the methodological framework of assessment research. To collect the data, 38 interviews were held with health professionals and managers; observation of the activities by the health teams; and analysis of 25 files of people who received this care. The data analysis was supported by the software ATLAS.ti, using the directed content analysis technique., Results: at the micro level, care was distant from the integrality of the actions needed to assist people with chronic conditions and was centered on the biomedical model. At the meso level, there was disarticulation among the professionals of the Family Health Strategy, between them and the users, family and community. At the macro level, there was a lack of guiding strategies to implement public policies for diabetes in care practice., Conclusion: the implementation of the Modelo de Atenção às Condições Crônicas represents a great challenge, mainly needing professionals and managers who are prepared to work with chronic conditions are who are open to break with the traditional model.

Background:: Hypertension is the most prevalent risk factor for cardiovascular disease, and its proper control can prevent the high morbidity and mortality associated with this disease., Objective:: To assess the degree of compliance of antihypertensive prescriptions with the VI Brazilian Guidelines on Hypertension and the blood pressure control rate in primary care., Methods:: Cross-sectional study conducted between August 2011 and November 2012, including 332 adults ≥ 45 years registered in the Family Doctor Program in Niteroi and selected randomly. The analysis included the prescribed antihypertensive classes, doses, and frequencies, as well as the blood pressure (BP) of the individuals., Results:: The rate of prescription compliance was 80%. Diuretics were the most prescribed medications, and dual therapy was the most used treatment. The most common non-compliances were underdosing and underfrequencies. The BP goal in all cases was < 140/90 mmHg, except for diabetic patients, in whom the goal was set at < 130/80 mmHg. Control rates according to these goals were 44.9% and 38.6%, respectively. There was no correlation between prescription compliance and BP control., Conclusions:: The degree of compliance was considered satisfactory. The achievement of the targets was consistent with national and international studies, suggesting that the family health model is effective in BP management, although it still needs improvement., Fundamento:: A hipertensão arterial é o fator de risco mais prevalente para a doença cardiovascular e seu controle adequado pode prevenir a elevada morbi-mortalidade associada a esta doença., Objetivo:: Avaliar o grau de conformidade das prescrições de anti-hipertensivos com as VI Diretrizes Brasileiras de Hipertensão e a taxa de controle pressórico na atenção básica., Métodos:: Estudo transversal conduzido entre agosto de 2011 e novembro de 2012, incluindo 332 adultos ≥ 45 anos cadastrados no Programa Médico de Família de Niterói e selecionados aleatoriamente. Foram analisadas as classes de anti-hipertensivos prescritos, suas doses e frequências, bem como a pressão arterial (PA) dos indivíduos., Resultados:: A taxa de conformidade das prescrições foi de 80%. Diuréticos foram as medicações mais prescritas e a terapia dupla foi o tratamento mais utilizado. As não conformidades mais comuns foram subdoses e subfrequências. A meta de PA para todos os casos foi < 140/90 mmHg, exceto para diabéticos, que foi < 130/80 mmHg. As taxas de controle de acordo com essas metas foram de 44,9% e 38,6%, respectivamente. Não houve correlação entre conformidade da prescrição e controle pressórico., Conclusões:: O grau de conformidade foi considerado satisfatório. O alcance das metas foi compatível com estudos nacionais e internacionais, sugerindo que o modelo de saúde da família é efetivo no manejo da PA, embora ainda necessite aprimoramento. (Arq Bras Cardiol. 2017; [online].ahead print, PP.0-0).

Objective: Clinical Pharmacy Services (CPS) are considered standard of care and they are endorsed by the Joint Commission International, the American Academy of Pediatrics, and the American College of Clinical Pharmacy. In Brazil, single experiences have been discreetly arising and the importance of these services to children and adolescents care has led to interesting results, but certainly are under reported. This short report aims to discuss the effect of implementing a bedside CPS at a Brazilian Pediatric Intensive Care Unit (PICU)., Methods: This is a cross-sectional study conducted in a 12 bed PICU community hospital, from Campo Largo/Brazil. Subjects with<18 years old admitted to PICU were included for descriptive analysis if received a CPS intervention., Results: Of 53 patients accompanied, we detected 141 preventable drug-related problems (DRPs) which were solved within clinicians (89% acceptance of all interventions). The most common interventions performed to improve drug therapy included: preventing incompatible intravenous solutions (21%) and a composite of inadequate doses (17% due to low, high and non-optimized doses). Among the top ten medications associated with DRPs, five were antimicrobials. By analyzing the correlation between DRPs and PICU length of stay, we found that 74% of all variations on length of stay were associated with the number of DRPs., Conclusions: Adverse drug reactions due to avoidable DRPs can be prevented by CPS in a multifaceted collaboration with other health care professionals, who should attempt to use active and evidence-based strategies to reduce morbidity related to medications., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2016. Publicado por Elsevier Editora Ltda.)

Objective: identify the compliance of health care product processing in Primary Health Care and assess possible differences in the compliance among the services characterized as Primary Health Care Service and Family Health Service., Method: quantitative, observational, descriptive and inferential study with the application of structure, process and outcome indicators of the health care product processing at ten services in an interior city of the State of São Paulo - Brazil., Results: for all indicators, the compliance indices were inferior to the ideal levels. No statistically significant difference was found in the indicators between the two types of services investigated. The health care product cleaning indicators obtained the lowest compliance index, while the indicator technical-operational resources for the preparation, conditioning, disinfection/sterilization, storage and distribution of health care products obtained the best index., Conclusion: the diagnosis of compliance of health care product processing at the services assessed indicates that the quality of the process is jeopardized, as no results close to ideal levels were obtained at any service. In addition, no statistically significant difference in these indicators was found between the two types of services studied.

Objective: to investigate the association between resilience and sociodemographic variables and the health of people with chronic kidney disease and / or type 2 diabetes mellitus., Method: a cross-sectional observational study performed with 603 people with chronic kidney disease and / or type 2 diabetes mellitus. A tool to collect socio-demographic and health data and the Resilience Scale developed by Connor and Davidson were applied. A descriptive and multivariate analysis was performed., Results: the study participants had on average 61 years old (SD= 13.2), with a stable union (52.24%), religion (96.7%), retired (49.09%), with primary education (65%) and income up to three minimum wages. Participants with kidney disease showed less resilience than people with diabetes., Conclusion: the type of chronic illness, disease duration, body mass index and religious beliefs influenced the resilience of the study participants.

Background: Obstructive sleep apnea syndrome (OSAS) is a chronic, progressive disease with high morbidity and mortality. It is underdiagnosed, especially among women., Objective: To study the prevalence of high risk for OSAS globally and for the Berlin Questionnaire (BQ) categories, and to evaluate the reliability of the BQ use in the population studied., Methods: Observational, cross-sectional study with individuals from the Niterói Family Doctor Program, randomly selected, aged between 45 and 99 years. The visits occurred between August/2011 and December/2012. Variables associated with each BQ category and with high risk for OSAS (global) were included in logistic regression models (p < 0.05)., Results: Of the total (616), 403 individuals (65.4%) reported snoring. The prevalence of high risk for OSA was 42.4%, being 49.7% for category I, 10.2% for category II and 77.6% for category III., Conclusion: BQ showed an acceptable reliability after excluding the questions Has anyone noticed that you stop breathing during your sleep? and Have you ever dozed off or fallen asleep while driving?. This should be tested in further studies with samples mostly comprised of women and low educational level individuals. Given the burden of OSAS-related diseases and risks, studies should be conducted to validate new tools and to adapt BQ to better screen OSAS.

Objective: To analyze the care provided to tuberculosis cases in primary health care services according to the elements of the Chronic Care Model., Method: Cross-sectional study conducted in a capital city of the northeastern region of Brazil involving 83 Family Health Strategy professionals.A structured tool adapted to tuberculosis-related care in Brazil was applied.Analysis was based on the development of indicators with capacity to produce care varying between limited and optimum., Results: The organization of care for tuberculosis and supported self-care presented reasonable capacity.In the coordination with the community, the presence of the community agent presented optimum capacity.Partnership with organizations of the community and involvement of experts presented limited capacity.The qualification of professionals, the system for scheduling and monitoring tuberculosis in the community, and the clinical information system presented basic capacity., Conclusion: The capacity of the primary health care services to produce tuberculosis-related care according to the elements of the Chronic Care Model is still limited.Overcoming the fragmentation of care and prioritizing a systemic operation between actions and services of the health care network remains as a major challenge., Objetivo: Analisar,segundo os elementos doChronicCareModel,a produção do cuidado aos casos de tuberculose nos serviços de Atenção Primária à Saúde., Método: Estudo transversal, realizado em capital do nordeste brasileiro, envolvendo 83 profissionais da Estratégia Saúde da Família. Aplicou-se um instrumento estruturado, adaptado para atenção à tuberculose no Brasil. A análise pautou-se na construção de indicadores, cujacapacidade para produção de cuidados variou entre limitada a ótima., Resultados: A organização da atenção à tuberculose e o autocuidado apoiado apresentaram capacidade razoável. Na articulação com a comunidade, a presençadoagente comunitário de saúde apresentou capacidade ótima. A parceria com organizações da comunidade e o envolvimento de especialistas obtiveram capacidade limitada. A capacitação dos profissionais, o sistema de agendamento e monitoramento da tuberculose na comunidade e o sistema de informação clínica alcançaram capacidade básica., Conclusão: A capacidade dos serviços da Atenção Primária à Saúde para produção do cuidado aos casos de tuberculose,segundo os elementos doChronicCareModel,ainda é limitada.Superar a fragmentação do cuidado e priorizar um funcionamento sistêmico entre ações e serviços da rede de atenção à saúde é ainda um grande desafio.

The care offer to people living with HIV/AIDS must transcend specialized outpatient services and include the participation of the Family Health Strategy. By understanding the importance of integration between these two points in the care network, the study aimed to build a decision support model to assist professionals of specialized health services in identifying behavior patterns in the use of Family Health Strategy services by people living with HIV/AIDS attended in the outpatient clinic. Thus, was proposed a model called decision tree, created from a database of 141 people with AIDS, users of a specialized outpatient clinic. The decision-making variable was the use of Family Health Strategy services by evaluating the integration of care. The model enabled the establishment of 23 rules with 80.1% hit percentage, what may support the decision-making of professionals in identifying situations in which it is necessary to stimulate the use of the Family Health Strategy by users.

This study aimed to describe the dynamics of intergenerational family relationships from the viewpoint of the elderly. It is a study of qualitative approach, developed with 32 elderly people registered in the coverage area of a Family Health Program in a city in the state of Bahia. Data were collected through semi-structured interviews during the first half of 2013, through home visits. We applied to thematic content analysis, and four categories emerged: harmonic intergenerational family relationships; conflicting intergenerational family relationships; family relationships permeated by intergenerational carefor the elderly; intergenerational relationships permeated by elderly caring for their grandchildren. The categories enabled an understanding of the dynamics of intergenerational family relationships from the viewpoint of elderly, unveiling family relationships guided in the care, support, family unity and even conflicts.

Objective: Evaluating the performance of primary care services for the treatment of tuberculosis according to the assessment referential of health services (structure/process) in Cabedelo, a port city in the state of Paraíba., Method: An evaluation quantitative, cross-sectional study, in which were carried out 117 interviews with health professionals using a structured instrument. The analysis was based on the construction of indicators using a standardized value for the reduced variable (z=1)., Results: The structural indicators showed regular performance for the following variables: professional training, access to record instruments and coordination with other services. The process indicators related to external actions and information about the disease had unsatisfactory performance. The directly observed treatment and the flows of reference/counter-reference had regular performance., Conclusion: The focused professional qualification, the fragmentation of practices and the unsystematic home care constitute obstacles for carrying out actions aimed at providing expanded, continuous and resolute care.

Prison inmates are more vulnerable to HIV and other Sexually Transmitted Infections (STIs) due to risk factors such as needle sharing and unprotected sex with homosexuals. The aim of this work was to determine the seroprevalence and risk factors associated with the human immunodeficiency virus (HIV-1/2) and syphilis among male inmates in Caruaru, State of Pernambuco, Brazil. A cross-sectional study was performed between May and July 2011, when 1,097 inmates at a prison in Caruaru were assessed by means of interviews and blood sample collection for performing the respective tests. The prevalence was 1.19% for HIV infection and 3.92% for syphilis. HIV infection showed a statistically significant association (p <0.05), with injected drug use, homosexuality and blood transfusions. With respect to HIV status and syphilis, factors related to sex life were statistically significant (p <0.05). The prison population is a high risk group for the diseases investigated. The prevalence rates identified indicate the need to implement prevention programs, helping to contain such diseases in this particular population group.

Objective: The objective is to present an update on the diagnosis and treatment of hypovitaminosis D, based on the most recent scientific evidence., Materials and Methods: The Department of Bone and Mineral Metabolism of the Brazilian Society of Endocrinology and Metabology (SBEM) was invited to generate a document following the rules of the Brazilian Medical Association (AMB) Guidelines Program. Data search was performed using PubMed, Lilacs and SciELO and the evidence was classified in recommendation levels, according to the scientific strength and study type., Conclusion: A scientific update regarding hypovitaminosis D was presented to serve as the basis for the diagnosis and treatment of this condition in Brazil.

Objective: To assess the patency of the pedicled right internal thoracic artery with an anteroaortic course and compare it to the patency of the left internal thoracic artery , in anastomosis to the left anterior descending artery in coronary artery bypass grafting by using coronary CT angiography at 6 months postoperatively., Methods: Between December 2008 and December 2011, 100 patients were selected to undergo a prospective coronary artery bypass grafting procedure without cardiopulmonary bypass. The patients were randomly divided by a computer-generated list into Group-1 (G-1) and Group-2 (G-2), comprising 50 patients each, the technique used was known at the beginning of the surgery. In G-1, coronary artery bypass grafting was performed using the left internal thoracic artery for the left anterior descending and the free right internal thoracic artery for the circumflex, and in G-2, coronary artery bypass grafting was performed using the right internal thoracic artery pedicled to the left anterior descending and the left internal thoracic artery pedicled to the circumflex territory., Results: The groups were similar with regard to the preoperative clinical data. A male predominance of 75.6% and 88% was observed in G-1 and G-2, respectively. Five patients migrated from G-1 to G-2 because of atheromatous disease in the ascending aorta. The average number of distal anastomoses was 3.48 (SD=0.72) in G-1 and 3.20 (SD=0.76) in G-2. Coronary CT angiography in 96 re-evaluated patients showed that all ITAs, right or left, used in situ for the left anterior descending were patent. There were no deaths in either group., Conclusion: Coronary artery bypass grafting surgery involving anastomosis of the anteroaortic right internal thoracic artery to the left anterior descending artery has an outcome similar to that obtained using the left internal thoracic artery for the same coronary site.

This study aimed to know the types of support offered by the network of social support and implications on hypertensive life. Qualitative study whose methodology was based on Grounded Theory. 35 people were interviewed between October 2008 and August 2010, 22 hypertensive compulsorily enrolled in HIPERDIA at a Health Unit in Belém / PA, 5 family members, 5 health professionals and 3 representatives of community institutions, referenced by hypertensive patients, as members of the network support Data were subjected to coding procedures: analysis, comparison and categorization. The category "Identifying the types of social support offered to people in their living with hypertension" was the Intervening Condition of the Theory The types of emotional informational and instrumental support originated mainly from family relationships and may mean alternative treatments,featuring a care focused on people with hypertension and their network of relationships which requires attention from healthcare professionals, including nurses.

In the last ten years the hemostatic agents and tissue adhesives have been frequently used and they are positive alternatives to prevent excessive blood loss. The objective of this review is to discuss the characteristics of each of these agents to facilitate the surgeon's decision when choosing the most suitable product for every type of bleeding and nature of hemorrhage. A survey of the literature on the subject, in English and in Portuguese, was conducted using PubMed (www.pubmed.com) and Google (www.google.com.br) to find recent articles on the topic. Based on these studies, the authors conducted a didactic review on the hemostatic agents and tissue adhesives and concluded that there is a hemostatic agent to be used in each specific scenario.

The present text is a theoretical reflection upon the importance of Nursing care models for the consolidation of this discipline, concerning the contribution of Convergent Care Research (Pesquisa Convergente Assistencial -PCA) in elaborating such models. Beyond this, this article discusses the importance of Convergent Care Research in the convergence of the academic and practical worlds of nursing, which aid towards a safe practice, systematize care, and establish connections between pragmatism and scientism, leading nurses to adopt more solid knowledge construction postures.

Unlabelled: Pharyngotonsillitis by β-hemolytic Streptococcus mostly affects children and immunocompromised, being Streptococcus pyogenes (Group A) the most common agent in bacterial pharyngotonsillitis., Aim: This work targeted the research of β-hemolytic Streptococcus Group-A (SBHGA) and No-A (SBHGNA) in the oropharynx of individuals with special health needs from the APAE (Maceió-AL)., Method: A prospective study with oropharynx samples from patients with Down syndrome and other mental disorders (test) and students from a private school (control) aged 5-15 years. Cultures in blood agar (5%) were identified through Gram/catalase tests and bacitracin/trimethoprim-sulfamethoxazole disk diffusion method, applying the chi-squared statistical analysis., Results: A total of 222 bacterial colonies were isolated in 74 individuals from APAE and 65 in the control group. In the test group, previous episodes of pharyngotonsillitis were reported by 36.49% (27/74) and 9.46% (7/74) were diagnosed with symptoms and/or signs suggestive of oropharynx infection. No positive sample of S. pyogenes was confirmed at APAE, being all samples classified as SBHGNA, with 5 SBHGA in the control group., Conclusion: The early identification of β-hemolytic Streptococcus is important for the fast treatment of pharyngotonsillitis and the absence of S. pyogenes avoid future suppurative or not-suppurative sequels in the group from APAE.

It is a qualitative research, which aimed to evaluate the user embracement and attachment in the humanization of nursing care for people with Diabetes Mellitus in a public specialized outpatient service. The theoretical support was the National Policy of Humanization of the Health Ministry / Brazil. Data was collected through semi-structured interviews with twenty people with type 1 or type 2 diabetes, between 2010 March and May. The analysis resulted in four categories that explore listening and dialogue, relationships, problem solving and access. People with diabetes recognize the user embracement and attachment as part of humanized attention given, which is highlighted by the appreciation of the patients' subjective dimension.

The purpose of this study is to present an understanding of the experience of Brazilian homemakers with type 2 diabetes mellitus (DM2). A descriptive exploratory design was used and semi-structured interviews were conducted with 25 Brazilian homemakers concerning their experience. The interviews were recorded, transcribed, and the resulting text was analyzed using the sequential step method. Data converged to one dominant category, "constructing one's identity in the family context", which is comprised of three categories: gender differences; day-to-day concerns; and incongruity between knowledge and behavior related to DM2. These findings suggest that participants construct their identities within the family context and that their experience of living with DM2 is integral to their self-identification as wives and mothers. This, in turn, has implications for the design and implementation of programs to assist women in managing DM2 effectively.

The study aimed to analyze the perception of patients with colostomy in the use of the collection bag. It was conducted a descriptive qualitative approach, on the Center for Integrated Health Lineu Araujo, Teresina-PI, Brazil. Ten clients with colostomy bag participated in the survey. Data were generated through semi-structured interviews. Content analysis has revealed the feelings, the changes and how the process of adaptation of the person with the colostomy bag occurs. It was found that the relationship between the collection bag and the person with a colostomy is filled with negative feelings, significant changes in physical, psychological and sexual order, and in the web of his/her social relationships.

Purpose: to assess the validity of several fetal weight charts, commonly used in Portugal, to classify its population., Methods: observational retrospective study. Singleton birth data was analyzed, from a two- year period (May 2008 to April 2010), from pregnancies with an ultrasound in the same institution, between the 8th and 14th gestational week. Upon data validation, percentiles for each completed gestational week were created, smoothed by a quadratic function, analyzed and compared to the tables more commonly utilized, in the institution and country, by using Z-scores, percentile comparison, sample 10th percentile detection sensibility and birthweight means comparison., Results: a total of 5,378 newborns (NB) were born in the period; 2,195 (42%) NB were included, born from the 24th to 42nd gestational week, allowing statistical analysis from the 34th to the 41st week. There were differences in the mean birthweight for each gestational age, between references and with the sample, as well as between sexes. The 10th percentile from some references has shown differences ranging from -288g at 37 weeks (-11% in Lubchenco et al. data), with and +133g at 34 weeks (+7,6% with Carrascosa et al. data) compared to the values found with the sample. Differences were also found concerning the sensitivity of the identification of a sample birthweight below the 10th percentile, which was between 14.1 and 100%, depending on the reference used., Discussion: the limitation of these kinds of reference values must be remembered and minimized, with the adoption of regionally or nationally produced references, contemplating other variables, such as sex, with precisely known gestation duration and with validation of the utilized references in loco.

Purpose: To investigate the self-reported morbidity rate of riverbank dwellers from Porto Rico, PR, Brazil., Methods: The case study compared the self-reported morbidity of two groups of residents. The sample consisted of 63 individuals of the three affordable housing complexes of that municipality. Information was collected through home surveys, during the months of June 2005 and January 2006., Results: Most interviewed subjects had a positive perception of their health. The main health problems recalled were associated with arterial hypertension, nervous system conditions, depression, heart and respiratory problems and assorted infections. Alcohol was mentioned more often by group B and tobacco by group A., Conclusion: Health education, with emphasis on adopting healthy life habits helps in facing adverse health situations and promotes health.

Diffuse plane normolipemic xanthoma is a rare disease, of a group of clinical syndromes called histiocytoses, characterized by the presence of yellowish or yellow-orange plaques, distributed symmetrically on the cutaneous surface and usually accompanied by xanthelasma. It affects mainly adults and it may cause discrete changes in serum lipids. The case of an 85-year-old female patient who has been showing extensive asymptomatic yellow-orange plaques in the trunk and abdomen for a year is reported. Laboratory tests did not show an increase in serum lipids or the occurrence of reticuloendothelial disorders.

Objective: The objective was to analyze the functional capacity and quality of life of elderly individuals with ischemic stroke comparing these with and without dysphagia., Method: Cross sectional study was realized in 60 elderly individuals after ischemic stroke, 30 with dysphagia and 30 without. Their cognitive state was evaluated with the Mini-Mental test. The scales used were: KATZ, Lawton, Barthel and SF-36., Results: The functional capacity was similar in both groups studied. In the SF-36, the group without dysphagia presented more pain and a better general health. Functional capacity, physical limitations those due to emotional aspects, general state of health , social vitality, mental health limitation were similar in both groups. Among men, for all scales used, functional capacity was similar. Among women, functional capacity was similar in both groups; however, in the quality of life, the domain 'vitality' was higher in the group without dysphagia. The income bracket did not influence the functional capacity or the quality of life. There was no difference between groups whether they had or not a care provider., Conclusions: 1) Functional capacity was similar in both groups studied. 2) The group without dysphagia presented better general health.

The aphid Sipha flava (Forbes) is a pest on elephant grass, but little is known about its biology. The objective of this work was to evaluate the temperature effects on the development, survival and reproduction of S. flava fed on Pennisetum purpureum. Twelve-hour-old nymphs were individualized on sections of elephant grass blades and maintained at 12, 16, 20, 24, 28 and 32 degrees C+/-1 degrees C, UR 70+/-10% and 12 h photophase. A total of 150 nymphs were used per treatment divided in 30 replicates, using a totally random design. The lower threshold temperatures (LTT) for first, second, third and fourth instars were 0.83, 1.05, 3.01 and 4.98 degrees C, respectively, indicating a change in thermal requirements as the development progress. The LTT for the whole nymphal stage was 2.08 degrees C, pointing to the tolerance of this species to low temperatures. A significant reduction in survival was observed at high temperatures (28 and 32 degrees C). Although the reproductive periods were longer and insects lived longer at 12 degrees C as compared with those at higher temperatures, the total fecundity was substantially reduced. The overall life cycle duration was almost twice as long at 12 degrees C than at 24 degrees C. The greatest daily production of nymphs and greatest number of nymphs produced overall occurred at 24 degrees C. The temperatures of 20 degrees C and 24 degrees C were more suitable to S. flava development and reproduction.

This is a qualitative study with the purpose to understand the social representations of the diabetic foot for people with type 2 diabetes mellitus. Semi-structured interviews were held with ten people with diabetes mellitus, who participated in a support group. Two categories emerged from the content analysis: the foot disease with perceived alterations and present threats, and feet care, with care as a concern with the future, and non-care as a feeling of guilt. The results show that the subjects seek hopes of not developing foot disease or controlling the situation, influenced by the representations of alterations and threats. When non-care occurs, the feeling of guilt emerges, since the subjects knew about the necessary care but did not use it. The social representations contributed in the search for comprehension of how the subjects with diabetes mellitus build the knowledge that that express their identity and guide their behavior, especially regarding the diabetic foot.

This study aimed at investigating the absenteeism disease in an Adult-ICU. The descriptive-exploratory study was carried out with 56 nurses who worked in the ICU in 2006. The frequency (fi)rate and the wasted-time percentage for the absenteeism disease were calculated. Most of the nurses are female (76.79%), between 30 and 39 years old (42.86%), and with a statutory bond (66.07%). The average of the missed workdays was higher in medium nursing workers (2.93), female (3.19), with a short-period bond (4.37), and from the night shift (6.22). The fi average of the team was 0.27 and the Wtp was 1.76%. The absenteeism disease was considered high and thus more studies are necessary in order to find its causes.

This study is a report on care practice. Its objective was to develop a proposal for education in health care from a group of people with tuberculosis, seeking to increase the effectiveness of their treatment. The data was obtained through a proposal for education in health care, developed through a living group. Two interrelated themes resulted from the process of analyzing the data: the perception of tuberculosis and its care and treatment, and social isolation. These represent the elements that influence education in health care for people with tuberculosis, as well as the meaning that such a situation has to these people.

The demographic and clinical characteristics of individuals with accidental tetanus in Ceará are described. This was retrospective analysis of 131 cases of accidental tetanus notified in a state referral hospital between 2002 and 2005. Most of these cases (84.8%) occurred among men and among people living in the urban zone (93.2%). The age group with highest incidence was between 35 and 49 years old (35.2%). A complete vaccination history was reported in four (3%) cases. Puncturing/cutting wounds were the cause most commonly observed and the legs were the area most affected. Trismus (lockjaw) was reported in 86.2% of the cases, followed by muscle contractions (54.1%). Among the notified cases, 95.5% were confirmed and 33 patients (26.4%) died. We conclude that accidental tetanus in Ceará significantly affects the population, in spite of being a disease that is preventable by immunization. The health authorities and health administration entities are urged to program strategies that aim towards changes in public policies concerning the vaccination coverage for susceptible individuals, particularly adults.

This study aimed at discussing the need of stimulating innovative and integrating management practices based on the offer of quality products in order to promote new Nursing thinking/practices. Several factors intervene in this process: complexity of the human life, competitiveness, customer's requirement level, globalization, and particularly information technology revolution. In order to supply these requirements and to overcome complexities, the use of tools capable of improving the supplied services, such as management practices based on quality services, along with the implementation of humanization services, is necessary.

Recent advances in analytical techniques allow identifying pesticide pollution in water systems. In small rural communities, the negative effects of pesticide pollution can be aggravated by the lack of infrastructure and adverse socioeconomic conditions. This study investigated pesticide pollution in potential water supply sources in a tomato growing area in Paty do Alferes, Rio de Janeiro State, Brazil. The study selected 27 points where five monthly samples were collected. Pesticide pollution was determined by analyzing acetyl-cholinesterase inhibition. In 19 of the 27 sample points, some pesticide pollution was detected, and in two points the pesticide pollution was above the permitted limits. The results thus proved the incidence of pesticide pollution in water sources in Paty do Alferes that could jeopardize the local population's health.

This convergent care research was carried out in a social group of persons with chronic respiratory diseases and aimed to identify the elements affecting the quality of life of persons with chronic respiratory problems, and to understand how the educative practice in a social group has contributed to the quality of life of persons with a chronic health condition. Data were collected at group meetings, during which the statements of eleven subjects and two family members were tape-recorded. Data analysis showed that controlling conflicting feelings, continuing to fight for a better life, overcoming one's limitations brought about by disease and treatment and getting family support are factors that affect the quality of life of persons with chronic respiratory problems. The study also made evident that health education acquired through social groups brings effective outcomes in promoting quality of life among the study participants.

This qualitative study aims to characterize nurses' actions in care for children during emergency situations, at a pediatric unit from a hospital in the interior of São Paulo State, Brazil, by means of semi structured interviews with eight nurses. The interview included questions about professional profile and, next, the research question. The analysis was guided by Bardin's content analysis (1997), which resulted in the theme: the nurses as a mediator in child care in the emergency room, based on four subthemes: child care planning, child's admission and evaluation, acting in child and family care and care training. Nursing actions in emergency situations with children and their families demand knowledge, technical and technological training, ability and agility, decision-making and teamwork, transmitting security, tranquility, empathy and rationality.

Objective: To assess the results of a technical modification of tricuspid valvuloplasty in Ebstein's anomaly., Methods: From November 1993 to August 2002, 21 patients with Ebstein's anomaly of the tricuspid valve, with ages ranging from 20 months to 37 years (mean, 23 years), underwent a new technique of tricuspid valvuloplasty. This technique consisted of total or almost total detachment of the anterior tricuspid megaleaflet from the ventricular wall and valvular ring, transforming it into a cone, whose vertex remained fixed in the right ventricular tip, and the base was sutured to the tricuspid ring, after its plication, adjusting it to the size of the base of the cone (tricuspid ring), including the septal region., Results: One (4.7%) patient with cardiomyopathy caused by chronic hypoxia died in the hospital due to low cardiac output. The mean follow-up lasted 4 years, and the recent echocardiograms showed good morphology of the right ventricle and tricuspid valve with mild or minimal insufficiency in 18 patients and moderate insufficiency in 2 patients. In 2 of the 3 patients with an anomalous bundle, it could be located and sectioned during surgery. No atrioventricular block occurred., Conclusion: The technique used was efficient in repairing tricuspid insufficiency and restoring right ventricular morphology, being applicable to all anatomic types of Ebstein's anomaly, except for Carpentier classification type D.

This is a convergent-assistance research, which has as its objective the identification of the factors affecting the quality of life of people suffering from Chronic Kidney Failure and who are undergoing hemodialysis. Data were collected in a health education program, developed for a companionship group, across hemodialysis sessions. During the analysis, four categories were identified, representing the elements that are considered as causes for the life quality conditions of those people: health assistance; acceptance and coping with the health condition; support received, and hoping for a better future. In spite of living with an illness which has important consequences on the physical well-being and social roles, persons referred to a life where quality can be achieved, although sometimes it may be difficult to perceive or conquer such quality.

The present study is a descriptive and exploratory research which has as its objective accomplishing a critical analysis of the magazine "Texto e Contexto-Enfermagem" (Nursing--Text and Context), as a thematic option. Eighteen issues of the magazine, published between 1992 and 2000, were analyzed. Two instruments were used to evaluate the inter-relation of the themes with the lines of research of the Post Graduation Program of Nursing in the Federal University of Santa Catarina (PEN/UFSC) in Brazil; the type of articles published; and the origin and profile of the authors of the magazine. It was verified that: the themes in the magazine are linked to the lines of research of PEN/UFSC; the average of articles published per issue is 23.88%; the majority of the articles are reflections and researches; most of the authors have a masters or doctors degree and do not teach at UFSC; and the rejection rate of the articles was 11.86%. The magazine bears most of the essential and complementary criteria established by CAPES and has great acceptance of among the Brazilian scientific community, since it brought a new dimension to the health care publications.

The purpose of this study was to identify the rates of absenteeism of nursing workers from a University Hospital due to diseases. Therefore, the author verified the number of absences due to health problems registered during 12 months, calculating the frequency rate as well as the percentage of wasted time. Data were collected and transcribed after consultation to reports organized by the human resources department of the institution studied. Results showed that the higher rate of absence occurred in the Pediatric Unit (If = 0.35) and the higher percentage of wasted time occurred in the Emergency Unit (Tp = 4.19). The author concluded that the rate of absenteeism due to disease was high among the workers, indicating the need of creating a database in order to optimize the registration of absences and their control as well as of stimulating the development of future research.

The aim of this study was to assess the way used by nurses for evaluate the family care and the caregiver. The method used was a quali-quantitative one. A semi-structure interview was the instrument chosen to collect data. It was applied to 20 (twenty) nurses from a University Hospital within the months of April and May, 1996. Data analysis was based on the Bardin's Content Analysis Technique (1994). The results demonstrated that nurses are not systematic in evaluating family care and the caregiver, but they use their intuition, based on momentaneous decisions. This reveal a difficulty of integration between the formal and the informal care caused by lack of interaction or effective valorization of the family care process.

This study reveals some aspects of ostomy patients life experience. The data were obtained by using the participant observation technique during the monthly meeting session of the Ostomy Patients Association from July 1989 to August 1991. The findings showed that the ostomized patients were concerned with: 1) the ostomy pouch (how to get it); 2) other persons opinion about ostomized patients; 3) their sexuality, and stoma care. The patients perceived themselves as physically disable and inferior persons. Some of them perceived themselves as having a normal life. Other patients also had to cope with the stigma of cancer.