As fronteiras brasileiras vêm sendo observadas com mais atenção por pesquisadores das ciências sociais e, especialmente, pelas políticas de segurança pública brasileiras. Esse interesse é recente e ...inédito, ainda sabe-se pouco sobre os cerca de dezessete mil quilômetros que separam e aproximam o Brasil dos seus países vizinhos. Entretanto, muitos conceitos vêm sendo discutidos no intuito de tornar a temática das fronteiras menos “romântica” e mais acadêmica, ao menos em tese. Como por exemplo o de Cidades-gêmeas, de Zona de Fronteira etc. Nesse contexto, a região sul do país, a que faz fronteira com a República Oriental do Uruguai e com a Argentina, torna-se um espaço frutífero para análises empíricas, tendo em vista que é a que possui mais municípios conurbados, cento e noventa e sete só no estado do Rio Grande do Sul. Dessa forma, o presente estudo visa compreender um pouco das dinâmicas urbanas dessas cidades-gêmeas, analisando alguns processos de socialização como é o caso dos Palestinos, especialmente na fronteira de Sant’Ana do Livramento (BR) e Rivera (ROU), utilizando-se dos conceitos de Pórtico e de Cidade para pensar esses espaços que não são nem brasileiros nem uruguaios.
Introduction: In the nuclear medicine practice, a variety of radionuclides are handled for diagnostic and therapy which represents a significant risk of internal and external exposure for workers. ...Such occupational exposure requires the implementation of a routine monitoring plan, including intakes of radionuclides. Currently, in Brazil, approximately 90 Nuclear Medicine Services (NMS) are authorized by the Nacional Nuclear Energy Commission of Brazil to handle 131I for therapy purposes 1, resulting in a significant number of workers routinely exposed to internal exposures. 131I remains as one of the most frequently used radionuclides in NMS, and presents higher risks of intake and internal doses. The International Atomic Energy Agency recommends implementing an internal monitoring program of this group of workers. However, in Brazil there are not qualified laboratories to attend the demand of internal monitoring 2. The IRD has developed several studies proposing the use of detectors available in NMS for 131I occupational monitoring. Among such detectors, the gamma camera stands out to present the highest sensitivities for the proposed application. This work presents a comparison of the performances of gamma cameras available in six NMS in Brazil for 131I in vivo monitoring purpose. Methodology: The technique consists basically in (i) determining the calibration factors for the measurement of 131I in the thyroid, (ii) estimation of the minimum detectable activities and the corresponding Minimum detectable intakes and effective doses. The IRD neck-thyroid phantom containing a 133Ba source certified by the LNMRI of IRD was used to calibrate the medical devices evaluated in this study. The standard geometry consisted in positioning the phantom at 12 cm distance to the Gamma Cameras (GC) detectors. The count time was determined according to detectors sensitivity for a measurement performed at 1 and 7 days after the intake, considering a weekly generic monitoring frequency, resulting in 48 monitoring periods per year. Calibration of the Detection System The Calibration Factor (CF) is calculated as follows: CFctg/Bq = (total counts – total background counts) / 131I Eq Ac Where: 131I Eq Ac = Equivalent activity of 131I in neck-thyroid phantom, corrected for the calibration date. Evaluation of the Sensitivity of the Methods The Minimum Detectable Activity (MDA) 3 is calculated as follows: MDABq = (4,65 x √N) / CF Where: N = Total background counts ; and CF = Calibration factor of the technique. The Minimum Detectable Intake (MDI) is calculated as follows: MDIBq = AMD / m(t). Where: MDA = Minimum Detectable Activity; and m(t) = Retention fraction of 131I at time t. The Minimum Detectable Effective Dose (MDED) is calculated as follows: MDEDmSv = IMD x e(g). Where: MDI = Minimum detectable intake; and e(g) = Dose coefficient in mSv/Bq intake of 131I by inhalation. In order to be considered useful for internal dosimetry purposes, the technique should, at least, be able to detect an activity that would result in an annual effective dose below 1 mSv for the most likely internal exposure scenario 5. The monitoring period is determinant to evaluate the sensitivity of the proposed method to be applied in routine internal monitoring in a given NMS. This evaluation can be made by the following equation: Annual Sensitivity mSv = MDED x n. Where: MDED = Minimum detectable effective dose; and n = Total number of measurements in 1 year. Results: Seven gamma cameras of six different NMS were included in this study. Table 1 presents the results for MDA and Annual Sensitivity for each equipment calibrated in those facilities. Table 1: MDA and Annual Sensitivities of the detectors analyzed for 48 monitoring periods per year. Manufacturer Model Facility Count Time MDA (Bq) Annual Sensitivity (mSv) 1 day 7 days Phillips BrightView XCT A 3 130 0.5 0.9 GE Millennium B 7 134 0.6 0.9 GE Discovery MN/CT 670 C 3 146 0.6 1.0 Siemens e.cam 180 D 3 151 0.6 1.0 Elscint Apex SPX-6 E 3 146 0.6 1.0 Siemens Symbia E 3 129 0.5 0.9 GE Millennium F 2 131 0.5 0.9 In order to avoid disturbing the routine of the NMS, the count time was optimized to be as low as possible but keeping the necessary sensitivity of the method for the application in occupational monitoring. Furthermore the monitoring plan must be established according to the schedule of the radionuclide handling of the facility. Conclusions: The gamma camera performance can be evaluated by analyzing the MDA of the detection system as well as the count time required for the system to reach the minimum sensitivity to be considered useful for internal monitoring purpose. This study evaluated modern and older gamma camera models, and despite the difference of year of manufacture between the models, all gamma cameras presented enough sensitivity, considering a generic weekly monitoring frequency, for use as a monitoring device up to 7 days after intake. In most cases, the appropriate sensitivity was achieved setting the count time to 3 minutes, which can be considered a feasible and short count time. It shows that in addition to being simple, the implementation of the proposed methodology is easy and inexpensive.
Resumo Introdução A voz é importante meio de comunicação além de ser considerado um instrumento de trabalho fundamental. Em função das interações do ambiente físico e social, o trabalho pode ...interferir na qualidade da voz e, por consequência, na vida do trabalhador. Objetivo Investigar a associação entre presença de problemas vocais com sexo, tempo de trabalho, função desempenhada e o estresse percebido entre servidores de uma universidade federal brasileira. Método Estudo observacional, transversal e quantitativo. O público da pesquisa foram os servidores efetivos que estavam em atividade no segundo semestre de 2016 de qualquer dos campi da Universidade Federal do Rio Grande. O instrumento de avaliação foi enviado por e-mail. O questionário foi composto por perguntas que inquiriam dados demográficos e duas avaliações padronizadas: Qualidade de vida em voz e Escala de Estresse Percebido. A análise descritiva tratou da frequência absoluta e relativa. O nível de significância estatístico utilizado foi de 5% para testes bicaudais. Resultados A amostra foi de 708 servidores (36,1% do total). A prevalência de problemas vocais encontrada foi de 24,3% (IC95% 21,1% a 27,4%). Os problemas vocais foram mais frequentes nos servidores que atuavam há mais de 10 anos, principalmente em indivíduos do sexo masculino e em técnicos administrativos. Os resultados demonstram que os indivíduos com maior nível de estresse apresentam menos problemas vocais. Conclusão Concluiu-se que houve maior ocorrência de problemas vocais nos servidores com maior tempo de trabalho e em indivíduos com menor nível de estresse.
Abstract Background Voice is an important means of communication and is considered a fundamental working tool. Due to physical and social interference, work can interfere with the quality of the voice and, consequently, with the life of the worker. Objective To investigate the association between thevocal problems and gender, work time, role performed and perceived stress among servants of a Brazilian federal university. Method This is an observational, transversal and quantitative study. The research participants were the effective servers that were active in the second half of 2016 of any of the campuses of the Federal University of Rio Grande. The evaluation instrument was sent by e-mail. The questionnaire was composed of questions that asked for demographic data and two standardized evaluations: Quality of life in voice and Perceived Stress Scale. The absolute and relative frequency were the descriptive analysis. The level of statistical significance was 5% for two-tailed tests. Results The sample was of 708 servers, (36.1% of the total). The prevalence of vocal problems was 24.3% (95% CI 21.1% to 27.4%). The vocal problems were more frequent in the servers that had been working for more than 10 years, mainly in males and administrative technicians. The results showed that individuals with higher levels of stress have fewer vocal problems. Conclusion It was concluded that there was a greater occurrence of vocal problems in servers with longer working hours and in individuals with lower stress level.
ABSTRACT BACKGROUND: Stroke is the principal cause of disability around the world and the ensuing functional dependence (FD) can be correlated with different factors. OBJECTIVE: To determine how ...demographic factors and clinical characteristics after stroke distinguish patients who achieve functional independence from those who do not. DESIGN AND SETTING: Observational study at specialized neurovascular clinic in Alagoas, Brazil. METHODS: FD was classified according to the modified Rankin scale (mRs): 0 to 2 points were classified as independent (FD-), and 3 to 5 points were classified as dependent (FD+). Logistic regression analysis included age, sedentary lifestyle, the Center for Epidemiological Studies – Depression Scale (CES-D) and the National Institutes of Health Stroke Scale (NIHSS). The Mann-Whitney test and χ2 test were used to compare groups. RESULTS: We included 190 stroke patients with a mean age of 60.02 ± 14.22 years. We found that 34.8% of the patients were classified as FD+. Lower NIHSS and CES-D scores were more associated with achieving functional independence. Most of the patients had access to physical therapy, and the mean duration of rehabilitation therapy was 65.2 minutes per week. Females had higher prevalence of depressive symptoms (P = 0.005) and rehabilitation time was shorter for hemorrhagic stroke (P = 0.02). CONCLUSION: We found a FD rate four times greater than in another Brazilian study. Lower stroke severity and fewer depressive symptoms were associated with achieving functional independence. Less than half of the patients were referred to a rehabilitation service at hospital discharge and few had access to multidisciplinary treatment.
Objetivo: Identificar as necessidades psicossociais referidas nos estudos sobre gestação de alto risco buscando os diagnósticos correspondentes na Classificação Internacional das Práticas de ...Enfermagem em Saúde Coletiva (CIPESC®). Método: Estudo qualitativo de revisão narrativa. Inicialmente, realizou-se um levantamento bibliográfico na base de dados Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS). Após leitura e organização dos dados, os aspectos psicossociais abordados nos estudos foram listados e relacionados com os diagnósticos da CIPESC@ correspondentes. Resultados: Fatores como relação profissional-paciente, reações emocionais negativas, redes de apoio, insegurança, aceitação e conflitos apresentavam correspondentes específicos na CIPESC®. Em contrapartida, circunstâncias que se caracterizavam como riscos psicossociais a estas gestantes não tinham diagnósticos correspondentes, sendo abordadas de forma abrangente nesta classificação. Conclusão: O presente estudo reforça a complexidade do uso de classificações no âmbito psicossocial e convida os profissionais e pesquisadores a repensarem seus planos de cuidado e práticas assistenciais às gestantes de alto risco. NURSING DIAGNOSES IN HIGH-RISK PREGNANT WOMEN: THE PSYCHOSOCIAL NEEDS IN FOCUS.Objective: To identify the psychosocial needs mentioned in studies on high-risk pregnancies seeking the corresponding diagnoses in the International Classification of Nursing Practices in Public Health (CIPESC®). Method: Qualitative study of narrative review. Initially, a bibliographic survey was carried out in the database “Latin American and Caribbean Literature in Health Sciences (LILACS)”. After reading and organizing the data, the psychosocial aspects covered in the studies were listed and related to the corresponding CIPESC® diagnoses. Results: Factors such as professional-patient relationship, negative emotional reactions, support networks, insecurity, acceptance and conflicts had specific correspondents CIPESC®. On the other hand, circumstances that were characterized as psychosocial risks to these pregnant women did not have corresponding diagnoses, being addressed comprehensively in this classification. Conclusion: Present study reinforces the complexity of the use of classifications in the psychosocial context and invites professionals and researchers to rethink their care plans and care practices for high-risk pregnant womenDescriptors: Pregnancy High-Risk; Nursing Diagnosis; Mental Health. DIAGNÓSTICOS DE ENFERMERÍA EN MUJERES EMBARAZADAS DE ALTO RIESGO: LAS NECESIDADES PSICOSOCIALES EN FOCO.Objetivo: Identificar las necesidades psicosociales a las que se refieren los estudios sobre embarazos de alto riesgo que buscan los diagnósticos correspondientes en la Clasificación Internacional de Prácticas de Enfermería en Salud Pública (CIPESC®). Método: Estudio cualitativo de la revisión narrativa. Inicialmente, se realizó una encuesta bibliográfica en la base de datos “Literatura latinoamericana y caribeña en ciencias de la salud (LILACS)”. Después de leer y organizar los datos, se enumeraron los aspectos psicosociales abordados en los estudios y se relacionaron con los diagnósticos CIPESC@ correspondientes. Resultados: Factores como la relación profesional-paciente, reacciones emocionales negativas, redes de apoyo, inseguridad, aceptación y conflictos tuvieron corresponsales específicos en CIPESC®. Por otro lado, las circunstancias que se caracterizaron como riesgos psicosociales para estas mujeres embarazadas no tuvieron los diagnósticos correspondientes, y se abordaron de manera integral en esta clasificación. Conclusión: El presente estudio refuerza la complejidad del uso de clasificaciones en el contexto psicosocial e invita a profesionales e investigadores a repensar sus planes de atención y prácticas de atención para mujeres embarazadas de alto riesgo.Descriptores: Embarazo de Alto Riesgo; Diagnóstico de Enfermería; Salud Mental.
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