Submitted by Erika Demachki (erikademachki@gmail.com) on 2014-10-08T21:42:51Z No. of bitstreams: 2 Dissertação - Bruna Lígia Ferreira de Almeida - 2013.pdf: 856377 bytes, checksum: bb3d1938f40e066ea7486b9a556bcf59 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2014-10-09T11:14:40Z (GMT) No. of bitstreams: 2 Dissertação - Bruna Lígia Ferreira de Almeida - 2013.pdf: 856377 bytes, checksum: bb3d1938f40e066ea7486b9a556bcf59 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Made available in DSpace on 2014-10-09T11:14:40Z (GMT). No. of bitstreams: 2 Dissertação - Bruna Lígia Ferreira de Almeida - 2013.pdf: 856377 bytes, checksum: bb3d1938f40e066ea7486b9a556bcf59 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Previous issue date: 2013-04-05 / The feminization of the epidemic have many consequences, among them, the increasing number of HIV-infected children with mother to child transmission as the main route of infection. In 2010, the Ministry of Health created the recommended prophylaxis manual of mother to child HIV transmission and antiretroviral therapy in pregnant women and other behaviors related to prevention of mother to child HIV transmission. The objective of this study was to analyze if the recommendations of the Ministry of Health as control of mother to child HIV transmission are being taken by pregnant women and health professionals of a public maternity hospital in Goiânia. Research conducted between March and May 2012, divided into two stages: cross-sectional study, which consisted in the analysis of medical records of 323 HIV positive pregnant women seen at a public hospital in the State of Goiás between years 2006 to 2011, and second it is cross-sectional study involving 25 professionals working in maternity and obstetric center of this institution. Among the 323 records analyzed, 48.9% of pregnant women were included in the age group between 25 to 34 years old, 68.7% were single, 65.6% brown, 50.5% had study time between 4-7 years and 74.9% were unemployed. We checked the main risks related to mother to child HIV transmission in the 323 analyzed records. Among of the professionals surveyed, 76% have inadequate knowledge about HIV testing in pregnant women, 80% unaware the gestational age in what is realized elective caesarean, 66% do not know the dose to attack AZT and the elapsed time before child-birth, 84% do not know which method is indicated for lactation inhibition. The data observed in our study are alarming and show gaps in care for HIV positive pregnant women and newborns exposed, through information obtained that contradict this practice. / Nos últimos anos houve uma mudança do perfil da epidemia do HIV/aids, chamado por feminização da epidemia de HIV, um número crescente de mulheres em todo o mundo estão infectadas, sendo que mulheres e meninas constituem quase metade de todas as pessoas que vivem com vírus. A feminização da epidemia têm numerosas consequências, dentre elas, o aumento do número de crianças infectadas pelo HIV tendo a transmissão vertical como principal via de infecção. Em 2010, o Ministério da saúde criou o manual de Recomendações de profilaxia de transmissão vertical do HIV e terapia antirretroviral em gestantes e as demais condutas relacionadas a profilaxia da transmissão vertical do HIV. Assim, o objetivo geral deste estudo foi analisar se as medidas recomendadas pelo Ministério da Saúde como controle da transmissão vertical do HIV estão sendo adotadas por gestantes e profissionais de saúde de uma maternidade pública de Goiânia, Goiás. Pesquisa realizada entre março a maio de 2012, dividida em duas etapas: a primeira trata-se de estudo transversal, que consistiu na análise de 323 prontuários de gestantes HIV positivo atendidas em uma maternidade pública do Estado de Goiás entre os anos de 2006 a 2011, e a segunda trata-se de um estudo transversal envolvendo 25 profissionais atuantes na Maternidade e Centro Obstétrico desta Instituição. Dentre o 323 prontuários analisados, 48,9% das gestantes estavam inseridas na faixa etária entre 25 a 34 anos de idade, 68,7% eram solteiras, 65,6% pardas, 50,5% possuíam tempo de estudo entre 4 a 7 anos e 74,9% não possuíam vínculo empregatício. Foram verificados os principais riscos relacionados à transmissão vertical do HIV nos 323 prontuários analisados. Dos profissionais investigados 76% apresentam conhecimento inadequado sobre o teste anti-HIV na gestantes, 80% desconhecem com que idade gestacional realiza-se a cesárea eletiva, 66% não sabem a dose para ataque do AZT e o tempo utilizado antes do parto, 84% não conhecem qual o método indicado para inibição da lactação. Os dados observados em nosso estudo são preocupantes e evidenciam lacunas existentes na assistência prestada às gestantes HIV positivos e RN expostos, através de informações obtidas que contradizem essa prática.

Objetivo. Os estudos sobre envolvimento religioso e espiritual para os pacientes idosos com doenças crônicas e a concepção que os profissionais de saúde têm frente a este processo são quase inexpressivos no Brasil. Realizou-se uma pesquisa com o objetivo de identificar o significado da intervenção médica e da fé religiosa para o paciente idoso com câncer, e também de identificar o significado atribuído pelos profissionais de saúde a fé religiosa no tratamento e na vida do paciente idoso com câncer. Métodos. A pesquisa foi descritiva e utilizou o método qualitativo. A amostra foi intencional, composta por 20 médicos, 20 pacientes idosos com câncer, 10 enfermeiras, 1 O psicólogos e cinco capelães. A coleta de dados ocorreu mediante a técnica da entrevista semi-estruturada e foi desenvolvida de 9.01 a 28.03.01 no Hospital do Servidor Público Estadual \"Francisco Morato de Oliveira\" - IAMSPE e no Hospital Pérola Byington/Núcleo de referência em saúde da mulher, São Paulo. Para o tratamento dos dados empregou-se a análise temática do Discurso do Sujeito Coletivo, sendo utilizadas três figuras metodológicas: a Idéia Central (/C), as Expressões-chave(EC) e o Discurso do Sujeito Coletivo (DSC). Resultados. Os pacientes apresentaram 20 ICe 20 DSC, os médicos, os enfermeiros e os capelães 10 IC e 10 DSC, e os psicólogos 8 IC e 8 DCS. Os resultados são discursivos, demandando extenso volume de material. Considerações Finais. Os discursos dos profissionais de saúde se apresentaram em várias tendências, no sentido da importância e do fortalecimento da fé, enquanto recurso de enfrentamento dos desafios da vida. Quanto aos discursos dos pacientes idosos com câncer houve destaque para as situações de conforto, otimismo e segurança frente à intervenção médica instituída A fé ou fé religiosa na vida dos idosos foi instrumento muito valorizado e dotado grande capacidade para proporcionar conforto e esperança, como meio importante para o enfrentamento de doenças ameaçadoras. / Objective. Studies about religious and spiritual involvement in the lives of elderly patients with chronic illnesses and the concept that health professionals have to face this process are scarce in Brazil. Research was done with the objective of identifYing the meaning o f medicai intervention and religious faith in the life o f the elderly patient with cancer, as well as identifYing their meaning for health professionals in the treatment and life of the patient. Methods. This study was descriptive and used the qualitative method. The sample was intentional, composed of 20 physicians, 20 elderly patients with cancer, 1 O nurses, I O psychologists and 5 chaplains. The semistructured interview technique was used in the data collection and developed from January 9th 2001 to March 28th 2001 at \"Francisco Morato de Oliveira\" State Workers\' Hospital - IAMSPE and at Pérola Byington Hospitai!Women\'s Health Center, São Paulo. The thematic analysis Discourse of the Collective Subject was used to treat the data. Three methodological figures were used: I) the Central Idea (CI), 2) Key Expressions (KE) and 3) the Discourse ofthe Collective Subject (DCS). Results. The patients presented 20 CI and 20 DCS, the physicians, nurses and chaplains I O CI and I O DCS, the psychologists 8 CI and 8 DCS. The results are discursive, demanding an extensive volume of material. Final considerations. The discourses of the health professionals presented various tendencies regarding the importance and strengthening o f faith while facing the challenges o f life. As regards the discourses ofthe elderly patients with cancer, situations ofcomfort, optirnism and security in the face of medicai intervention predominated. Faith or religious faith in the Iives o f the elderly was highly valued instrument and endowed with great ability to provide comfort and hope as essential means to face threatening illnesses.

Made available in DSpace on 2016-03-15T19:43:22Z (GMT). No. of bitstreams: 1 Gilberto Garcia da Costa Jr.pdf: 1348683 bytes, checksum: fb564ac68e4a84c4375f41b36e7be230 (MD5) Previous issue date: 2008-08-04 / Fundo Mackenzie de Pesquisa / This study is based on the assumption that art necessarily touches people and that everybody can have an aesthetic experience, regardless of previous knowledge about the universe of art. For the purpose of this work, we chose as corpus the 27th Bienal de São Paulo and its back stage professionals, a term that here encompasses security guards/audience ushers, cleaning personnel and assemblers of the event. There is always an aesthetic experience when someone deeply analyzes a piece of art. This work focus on the historical panorama of art shows and concentrates on the 27th Bienal de São Paulo, that had as theme How to Live Together. The concept the curators used was extracted from lectures and seminars given in the seventies of the last century by the French semiotician Roland Barthes. One finding of the work was that the professionals involved at the back stage of Bienal did not see themselves as belonging to the universe where they were inserted at the moment. A reason for this fact is that the own institution does not take into consideration those professionals as a target audience of the event, a wish that was manifested in the spoken statements. We can also observe that, along the show, the back stage professionals created own specific manners of speaking, or used the ones assimilated from other people, to describe the works of art. / Esta investigação parte dos pressupostos de que a arte, necessariamente, atinge as pessoas e de que todos podem compartilhar de uma experiência estética, independentemente do conhecimento prévio sobre o universo da arte. Para isso, escolhemos como corpus do trabalho a 27ª Bienal de São Paulo e os seus profissionais de bastidores, termo que abrange seguranças/orientadores de público, faxineiros e montadores desse evento. Sempre existe uma experiência estética quando alguém se debruça sobre uma obra de arte. O trabalho resgata o panorama histórico das Bienais para concentrar-se na 27ª Bienal de São Paulo, que teve no Como Viver Junto, o seu tema gerador. O conceito utilizado pela curadoria foi extraído de palestras e seminários proferidos na década de setenta do século XX pelo semiólogo francês Roland Barthes. O trabalho constata que os profissionais envolvidos nos bastidores da Bienal não se vêem como pertencentes ao universo no qual, no momento, estavam inseridos. E um dos motivos é o fato de a própria instituição não levar em consideração esses profissionais como público do evento, desejo que é manifestado por eles nos depoimentos coletados. Podemos perceber também que, no decorrer da mostra, os profissionais de bastidores criaram discursos. Sejam eles próprios ou apropriados dos discursos de outras pessoas (artistas, monitores, público).

Bakgrund: Sexuella- och könsminoriteter faller utanför hetero- och tvåkönsnormen som finns i samhället och utsätts för diskriminering på olika sätt överallt i världen. Personer inom gruppen sexuella- och könsminoriteter har rapporterat negativa erfarenheter av vårdmötet, till exempel i form av homofoba och transfoba attityder, vilket kan medföra att hbtq-personer undviker att söka vård. Sjuksköterskan kan vara med och förbättra detta då hen har ett ansvar att främja insatser som tar särskild hänsyn till utsatta gruppers hälsa och sociala behov.  Syfte: Syftet var att beskriva vilka faktorer som påverkar upplevelsen av bemötande från vårdpersonal enligt personer som ingår i gruppen sexuella- och könsminoriteter. Metod: Deskriptiv litteraturöversikt användes som metod och i resultatanalysen ingick 14 originalartiklar som undersökte sexuella- och könsminoriteters upplevelse av vårdmötet. Resultat: Det visade sig vara viktigt när vårdpersonal gav personcentrerad vård, respekterade patientens identitet och att de utvecklade en tillits- och förtroendefull relation. Det var även viktigt att vårdpersonal hade specifik kunskap inom området och använde ett könsneutralt språk i vårdmötet. Negativa faktorer var upplevelse av diskriminering och att vårdpersonal gjorde hetero- eller cisnormativa antaganden.  Slutsats: Vårdpersonal bör vara medveten om att normer och förutfattade meningar kan påverka vårdmötet utan att de tänker på det. För att undvika stereotypt bemötande bör vårdpersonal respektera patientens identitet och ha mer kunskap om behov som är unika för sexuella- och könsminoriteter. / Background: Sexual and gender minorities do not conform to heterosexual and gender-binary social norms and are subjected to different forms of discrimination all over the world. Members of these minorities have reported instances of negative experiences of healthcare encounters which can result in a hesitation to seek further care. Given their responsibility to promote healthcare interventions tailored to the needs of marginalised groups, nurses could play an important role in resolving this issue. Aim: The aim of the study was to describe which factors affect the experience of an encounter with a health professional according to people who identify as a sexual or gender minority.  Method: The study comprised a descriptive literature review of 14 empirical studies which explored the experience of sexual and gender minorities in relation to the healthcare encounter. Result: The following factors were revealed to be particularly influential in determining the healthcare experiences of sexual and gender minorities. Positive factors included: when health professionals delivered person-centered care, respected the patient’s sexual and gender identity, and when they could develop a trusting relationship with a healthcare professional. It was also important that health professionals were knowledgeable and used gender-neutral language. Negative factors included instances of discrimination and when health professionals made hetero- or cis-normative assumptions.  Conclusion: Health professionals need to be aware of the impact that norms and preconceptions can have on the healthcare encounter. To avoid stereotypical treatment, health professionals should respect the patient’s identity and have more knowledge about sexual and gender minority-specific needs.

Made available in DSpace on 2016-04-26T14:54:52Z (GMT). No. of bitstreams: 1 Gilda Amaral Carvalho Momo.pdf: 2485919 bytes, checksum: a1982f3c3d3569cc5c367341143371d1 (MD5) Previous issue date: 2014-06-16 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / In recent years, Brazil has been experiencing frequent influx of foreign professionals seeking work in the country. As a result of Brazil's resilience to the global financial crisis started in 2008, the country has become an increasingly attractive destination for immigrants, constituting a unique opportunity to attract talent in the international market and thus promote the development of the country more effectively. The objective of this dissertation is to study the high-skilled immigration in Brazil in the 21st century. Through survey data obtained from the Ministry of Labour of Brazil (2012) more than 73,000 immigrants arrived in Brazil in the year 2012, which represents an increase of over 50% compared to 2009. Much of this contingent is made up of professionals with higher education and with high technical expertise. They are highly qualified which made them wanted by any transnational company in a globalized world where knowledge is the key requirement to develop a country like Brazil. We intend to analyze these immigrants, their countries of origin, professional activity, in which areas they work in Brazil, gender and level of education. We will start a field research through interviews with immigrants to know about their trajectories, the reasons that brought them to Brazil and their experiences in working in a country so distant and multiethnic. It is therefore an empirical research, exploratory and incorporates bibliographies and surveys of a documentary nature, from which yielded quantitative and qualitative information. The work raises chances that the international economic crisis and social networking were important factors in the decision to migrate to Brazil. Hypotheses that will be confirmed by the search result. Although the phenomenon of skilled immigration is not recent, it is little studied and the dissertation will enrich that study by presenting a single fact in the history of Brazilian immigration with a wealth of amazing data about this new international migratory flow which begins in the 21st century, where high professional qualification requirement determines human mobility on the world stage / O Brasil vem presenciando nos últimos anos um aumento frequente de profissionais estrangeiros que buscam trabalho qualificado no país. Como resultado da resiliência brasileira perante a crise financeira internacional iniciada em 2008, o país se tornou um destino cada vez mais atraente para os imigrantes, o que constitui uma oportunidade única para atrair talentos no mercado internacional que possam contribuir de uma maneira efetiva para o desenvolvimento do país. O objetivo do trabalho é discutir e analisar a imigração qualificada para o Brasil no século XXI. De acordo com dados fornecidos pelo Ministério do Trabalho e Emprego do Brasil, mais de 73.000 imigrantes chegaram ao Brasil no ano de 2012, o que equivale a um aumento de mais de 50% em relação a 2009. Grande parte deste contingente é constituída por profissionais com ensino superior completo e com alta especialização técnica. São profissionais altamente qualificados que os fazem serem requisitados por qualquer empresa transnacional no mundo, mas principalmente no Brasil que ainda não os dispõe em número suficiente para satisfazer as necessidades de crescimento do país. Pretendemos analisar a imigração qualificada no Brasil, identificando estes imigrantes, a partir de critérios como nacionalidade, escolaridade, atividade profissional, em que setores atuam no Brasil, estado civil, gênero. Daremos início a uma pesquisa de campo através de entrevistas com os imigrantes para saber sobre suas trajetórias, os motivos que os trouxeram para o Brasil e suas experiências em trabalhar num país tão distante e multiétnico. Trata-se, portanto, de uma pesquisa empírica, de caráter exploratório e que incorpora levantamento de natureza bibliográfica e documental, a partir do qual se produziram informações quantitativas e qualitativas. O trabalho levanta as hipóteses de que a crise econômica internacional e as redes sociais foram fatores importantes na decisão de imigrar para o Brasil. Hipóteses que se confirmarão com o resultado da pesquisa. Embora o fenômeno da imigração qualificada não seja recente, é pouco estudado e o presente trabalho inovará ao apresentar essa nova face da imigração brasileira e internacional que se inicia no século XXI, onde a exigência de alta qualificação profissional determina a mobilidade humana no cenário mundial

Background: Difficulties with anxiety among children and young people are common and can impact upon their developmental trajectory leading to adverse outcomes in later life. There is, therefore, a need to increase access to early intervention services. Existing research has indicated that school-based cognitive behavioural interventions are effective for children and young people experiencing difficulties with anxiety, yet there remains a proportion of the population for whom they are not effective. In addition, there is a lack of research on how these may be implemented in real world settings as opposed to a research trial. The present research focuses on the provision of cognitive behavioural school-based interventions in two parts: a systematic review of psychological, interpersonal and social variables as predictors, mediators and moderators of mental health outcomes following a school-based intervention and an empirical mixed methods evaluation of the facilitators and barriers to the implementation of a school-based intervention. Method: A systematic search of electronic databases for studies examining interpersonal, psychological and social predictors, moderators and mediators of mental health outcome following school-based cognitive behavioural interventions was conducted. Effect sizes for these analyses were calculated and the quality of eligible studies was assessed using a standardised rating tool. Within the empirical project, the implementation of a school-based cognitive behavioural intervention was evaluated through a mixed methods approach. Semi-structured interviews with stakeholders in the intervention were analysed using grounded theory integrated with framework analysis. Quantitative data on the reach of the intervention, practitioner evaluation of training and coaching as well as routine outcome measures from children and young people receiving the intervention was collected. Results: Within the systematic review, twenty-two studies (N=22) met the predefined eligibility criteria. There was heterogeneity in the variables explored, effect size of these on treatment outcome and the quality of the literature within the included studies. Cognitive style was found to mediate treatment outcome, but there was limited evidence for other predictors, mediators and moderators of treatment outcome within the review. Quantitative results of the empirical project indicated that the model of the intervention was acceptable to both practitioners and children and young people, and preliminary data indicated a significant improvement in mental health outcomes. Facilitators that emerged from qualitative data included an enabling context, therapeutic engagement, motivation and congruence, self-efficacy and containment and encouragement. The exclusivity of the intervention, a lack of systemic understanding and transparency as well as demands and pressure on resources were barriers to implementation. Conclusions: Although preliminary evidence for potential predictors, mediators and moderators is presented, further research with improvements in the design and reporting of explanatory variables on treatment outcome is required prior to informing clinical decision-making. The successful implementation of school-based interventions requires multi-agency integration and collaboration as well as on-going support in managing systemic pressures and skill development.

Bakgrund: Våld i nära relationer mot kvinnor är ett globalt folkhälsoproblem och skapar ett lidande hos de utsatta på flera plan och dessa kvinnor är i särskilt behov av stöd. Vårdpersonal har en viktig roll i att möta dessa kvinnor, där hela människan måste tas i beaktande. Kunskapsbrist och organisatoriska brister försvårar mötet med kvinnor som blivit utsatta för våld. Syfte: Beskriva hur kvinnor som blivit utsatta för våld i nära relationer upplevde omvårdnaden från vårdpersonalen. Metod: Litteraturöversikt där elva kvalitativa artiklar analyserades. Resultat: I resultatet framkommer det fyra huvudteman och två subteman. (1) Vårdpersonalens attityder och bemötande; vikten av tid, utsatt patientgrupp. (2) Betydelsen av att vårdpersonal frågar om våld. (3) Fokus på symtom. (4) Upplevelser av stöd och hjälp. Konklusion: Vårdpersonal behöver mer utbildning, tydliga riktlinjer och stöd/handledning från arbetsplatsen. Relationen mellan vårdpersonal och den utsatta kvinnan behöver präglas av en trygg miljö, tillit och medmänsklighet. / Background: Violence against women is a major public health problem and creates a suffering on several levels and these women are in particular need of support. Healthcare professionals have an important role in meeting these women, where the whole person must be considered. Lack of knowledge and organizational shortcomings complicate the encounter with women who have been exposed to violence. Aim: The aim of this study was to describe women’s experiences of care whom been a victim of violence in close relationship. Method: Literature review where eleven qualitative articles were analyzed. Result: The result shows four main themes and two sub-themes. (1) Attitudes and treatment of healthcare professionals; the importance of time, exposed patient group. (2) The importance of healthcare professionals asking about violence. (3) Focus on symptoms. (4) Experiences of support and help. Conclusion: Healthcare professionals need more education, clear guidelines and support/supervision from the workplace. The relationship between healthcare professionals and the women needs to be characterized by a safe environment, trust and compassion.

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Cultural competence and ethical decision making are two separate, yet intrinsically related concepts which are central to services rendered by all health care professionals. Cultural competence is based on ethical principles and informs ethical decision making. In spite of this important connection, the interrelationship of these two concepts does not receive the attention it deserves in the literature. This issue is addressed by appraising the training and assessment of cultural competence and ethical decision making in the health care professions. The integrated relationship of these two concepts is illustrated within the broader contexts of higher education, research and clinical practice. Health care professionals who incorporate cultural competence and ethical decision making will be empowered to provide the best services to their clients/ patients in multicultural contexts to ensure optimum outcomes.