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Étude pilote SimCode : évaluation de l'impact andragogique d'un simulateur à haute fidélité sur la performance d'une équipe multidisciplinaire de réanimation cardio-respiratoire : une étude piloteMarquis, François January 2008 (has links)
Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal.
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The relations between objectively measured moderate-to-vigorous physical activity, chronic aerobic exercise and cognitive control in children and adolescentsPindus, Dominika January 2015 (has links)
Physical inactivity among young people is a public health concern. Markers of physical inactivity, such as low cardio-respiratory fitness (CRF) and obesity are adversely related to higher order cognitive functions, which underpin goal directed behaviour (i.e. cognitive control) and are implicated in academic achievement. Regular aerobic exercise can benefit cognitive control in children. However, it remains unknown whether daily physical activity behaviour is associated with cognitive control. Investigating this is important as targeting increments in daily moderate-to-vigorous physical activity (MVPA) may initially be a more realistic policy goal than developing aerobic exercise interventions. Nominal number of studies assessed this relationship using objective monitoring of physical activity (accelerometry), and yielded mixed results. None of the studies into objectively measured physical activity and cognitive function in young people controlled for CRF, which is posited to mediate the relationship between regular aerobic exercise and cognitive control. Likewise, other important confounders such as intelligence, have yet to be addressed in the literature. Moreover, it is unknown whether this relationship varies with age, as extant studies looked solely at younger adolescents. For example, meta-analytical findings (Fedewa & Ahn, 2011) suggest that children can benefit more cognitively from CRF and chronic aerobic exercise than adolescents as greater effect sizes have been observed for younger compared to older youngsters. Alternatively, chronic aerobic exercise may be specifically needed for cognitive benefits to emerge. However, none of the aerobic exercise interventions included objective assessments of baseline physical activity and few studies assessed the effects of chronic aerobic exercise interventions on multiple indices of cognitive control. This thesis aimed to address the limitations of previous research and to investigate: 1) the associations between objectively measured daily MVPA and cognitive control in older adolescents (study 1), and 2) in preadolescent children (study 2), while controlling for CRF, general intellectual ability and a number of important confounders (e.g. adiposity, attention-deficit hyperactivity disorder); 3) the relationship between daily MVPA and academic achievement (study 2); 4) the effects of chronic aerobic exercise intervention on cognitive control in children, while controlling for objectively measured daily MVPA and time sedentary at baseline (study 3). Methods: Study 1. A sample of 667 adolescents (Mage = 15.4, SD = .17, 55.5% girls) from the Avon Longitudinal Study of Parents and Children was included in the analyses. MVPA was measured with ActiGraph, GT1M accelerometer. CRF was assessed with sub-maximal cycle ergometer test and expressed as weight adjusted predicted physical work capacity at the heart rate of 170 beats per minute (PWC-170). Attentional control was measured with Stop Signal task. Study 2. A sample of 81 children (Mage = 8.64 years, SD = .57, 45.7 % girls) was included in the analyses. MVPA was objectively measured using the ActiGraph, wGT3X+ accelerometer. CRF was measured using a maximal graded exercise test on a treadmill. Inhibitory control was assessed with a modified Eriksen flanker task, working memory with Operation Span Task; and academic achievement with Kaufman Test of Educational Achievement. Study 3. 32 children (Mage = 8.64, SD = .58, 56.2% girls) were randomised into a physical activity intervention (FITKids2) or a waitlist control group. Changes in VO2max were measured using a maximal graded treadmill exercise test and changes in MVPA were objectively monitored for 7 days using the ActiGraph, wGT3X+ accelerometer. Behavioural measures of inhibition (reaction time, and accuracy) and working memory (accuracy) were taken using computerised laboratory tasks (modified Eriksen flanker task and Operation Span Task). Results: Study 1. MVPA was not significantly related to cognitive processing speed or variability of cognitive performance in hierarchical linear regression models. In simple regression models, CRF was negatively related to mean RT on the simple go condition (R2 = 2.6%, F(1, 308) = 8.28, p = .004). Study 2. No significant associations were noted between MVPA and either inhibition, working memory, or academic achievement. In contrast, CRF explained 4.7% of variance in accuracy interference (ΔR2 = .047, p = .045; β = -.22, t(78) = 2.03, p = .045, F(2, 78) = 4.95, p = .009). Study 3. FITKids2 physical activity intervention had a positive effect on the speed of responding during incongruent condition of flanker task (F(1, 30) = 4.69, p = .038, ηp2 = .13). A significant increase in BMI percentile was observed in the control (Z = 2.17, p = .03) but not in the intervention group (p = .53). Discussion: Study 1. Our results suggest that aerobic fitness, but not MVPA, was associated with cognitive processing speed under less cognitively demanding task conditions. The results thus indicate a potential global effect of aerobic fitness on cognitive functions in adolescents but this may differ depending on the specific task characteristics. Study 2. The results of this study suggest that CRF but not objectively measured MVPA was associated with better interference control in preadolescent children. Given the intermittent nature of children s daily MVPA, it is possible that aerobic exercise, which increases CRF is needed for cognitive benefits to emerge. Study 3. FITKids2 after-school physical activity intervention had a positive effect on children s inhibitory control, namely this cognitive function, which is closely related to academic achievement and future job and health outcomes. Thus, the results of this study convey a positive public health message, where promoting child s engagement in aerobic exercise can engender benefits to their cognitive function. Conclusions: The findings from this thesis can inform development of physical activity interventions to benefit cognitive functions in young people and contribute to the evidence base to inform future health and educational policies.
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Étude pilote SimCode : évaluation de l'impact andragogique d'un simulateur à haute fidélité sur la performance d'une équipe multidisciplinaire de réanimation cardio-respiratoire : une étude piloteMarquis, François January 2008 (has links)
Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal
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Evaluation of interactive effects between temperature and air pollution on health outcomesRen, Cizao January 2007 (has links)
A large number of studies have shown that both temperature and air pollution (eg, particulate matter and ozone) are associated with health outcomes. So far, it has received limited attention whether air pollution and temperature interact to affect health outcomes. A few studies have examined interactive effects between temperature and air pollution, but produced conflicting results. This thesis aimed to examine whether air pollution (including ozone and particulate matter) and temperature interacted to affect health outcomes in Brisbane, Australia and 95 large US communities. In order to examine the consistency across different cities and different countries, we used two datasets to examine interactive effects of temperature and air pollution. One dataset was collected in Brisbane City, Australia, during 1996-2000. The dataset included air pollution (PM10, ozone and nitrogen dioxide), weather conditions (minimum temperature, maximum temperature, relative humidity and rainfall) and different health outcomes. Another dataset was collected from the 95 large US communities, which included air pollution (ozone was used in the thesis), weather conditions (maximum temperature and dew point temperature) and mortality (all non-external cause mortality and cardiorespiratory mortality). Firstly, we used three parallel time-series models to examine whether maximum temperature modified PM10 effects on cardiovascular hospital admissions (CHA), respiratory hospital admissions (RHA), cardiovascular emergency visits (CEV), respiratory emergency visits (REV), cardiovascular mortality (CM) and non-external cause mortality (NECM), at lags of 0-2 days in Brisbane. We used a Poisson generalized additive model (GAM) to fit a bivariate model to explore joint response surfaces of both maximum temperature and particulate matter less than 10 μm in diameter (PM10) on individual health outcomes at each lag. Results show that temperature and PM10 interacted to affect different health outcomes at various lags. Then, we separately fitted non-stratification and stratification GAM models to quantify the interactive effects. In the non-stratification model, we examined the interactive effects by including a pointwise product for both temperature and the pollutant. In the stratification model, we categorized temperature into two levels using different cut-offs and then included an interactive term for both pollutant and temperature. Results show that maximum temperature significantly and positively modified the associations of PM10 with RHA, CEV, REV, CM and NECM at various lags, but not for CHA. Then, we used the above Poisson regression models to examine whether PM10 modified the associations of minimum temperature with CHA, RHA, CEV, REV, CM and NECM at lags of 0-2 days. In this part, we categorized PM10 into two levels using the mean as cut-off to fit the stratification model. The results show that PM10 significantly modified the effects of temperature on CHA, RHA, CM and NECM at various lags. The enhanced adverse temperature effects were found at higher levels of PM10, but there was no clear evidence for synergistic effects on CEV and REV at various lags. Three parallel models produced similar results, which strengthened the validity of these findings. Thirdly, we examined whether there were the interactive effects between maximum temperature and ozone on NECM in individual communities between April and October, 1987-2000, using the data of 60 eastern US communities from the National Morbidity, Mortality, and Air Pollution Study (NMMAPS). We divided these communities into two regions (northeast and southeast) according to the NMMAPS study. We first used the bivariate model to examine the joint effects between temperature and ozone on NECM in each community, and then fit a stratification model in each community by categorizing temperature into three levels. After that, we used Bayesian meta-analysis to estimate overall effects across regions and temperature levels from the stratification model. The bivariate model shows that temperature obviously modified ozone effects in most of the northeast communities, but the trend was not obviously in the southeast region. Bayesian meta-analysis shows that in the northeast region, a 10-ppb increment in ozone was associated with 2.2% (95% posterior interval [PI]: 1.2%, 3.1 %), 3.1% (95% PI: 2.2%, 3.8 %) and 6.2 % (95% PI: 4.8%, 7.6 %) increase in mortality for low, moderate and high temperature levels, respectively, while in the southeast region, a 10-ppb increment in ozone was associated with 1.1% (95% PI: -1.1%, 3.2 %), 1.5% (95% PI: 0.2%, 2.8%) and 1.3% (95% PI: -0.3%, 3.0 %) increase in mortality. In addition, we examined whether temperature modified ozone effects on cardiovascular mortality in 95 large US communities between May and October, 1987-2000 using the same models as the above. We divided the communities into 7 regions according to the NMMAPS study (Northeast, Industrial Midwest, Upper Midwest, Northwest, Southeast, Southwest and Southern California). The bivariate model shows that temperature modified ozone effects in most of the communities in the northern regions (Northeast, Industrial Midwest, Upper Midwest, Northwest), but such modification was not obvious in the southern regions (Southeast, Southwest and Southern California). Bayesian meta-analysis shows that temperature significantly modified ozone effects in the Northeast, Industrial Midwest and Northwest regions, but not significant in Upper Midwest, Southeast, Southwest and Southern California. Nationally, temperature marginally positively modified ozone effects on cardiovascular mortality. A 10-ppb increment in ozone was associated with 0.4% (95% posterior interval [PI]: -0.2, 0.9 %), 0.3% (95% PI: -0.3%, 1.0%) and 1.6% (95% PI: 4.8%, 7.6%) increase in mortality for low, moderate and high temperature levels, respectively. The difference of overall effects between high and low temperature levels was 1.3% (95% PI: - 0.4%, 2.9%) in the 95 communities. Finally, we examined whether ozone modified the association between maximum temperature and cardiovascular mortality in 60 large eastern US communities during the warmer days, 1987-2000. The communities were divided into the northeast and southeast regions. We restricted the analyses to the warmer days when temperature was equal to or higher than the median in each community throughout the study period. We fitted a bivariate model to explore the joint effects between temperature and ozone on cardiovascular mortality in individual communities and results show that in general, ozone positively modified the association between temperature and mortality in the northeast region, but such modification was not obvious in the southeast region. Because temperature effects on mortality might partly intermediate by ozone, we divided the dataset into four equal subsets using quartiles as cut-offs. Then, we fitted a parametric model to examine the associations between temperature and mortality across different levels of ozone using the subsets. Results show that the higher the ozone concentrations, the stronger the temperature-mortality associations in the northeast region. However, such a trend was not obvious in the southeast region. Overall, this study found strong evidence that temperature and air pollution interacted to affect health outcomes. PM10 and temperature interacted to affect different health outcomes at various lags in Brisbane, Australia. Temperature and ozone also interacted to affect NECM and CM in US communities and such modification varied considerably across different regions. The symmetric modification between temperature and air pollution was observed in the study. This implies that it is considerably important to evaluate the interactive effect while estimating temperature or air pollution effects and further investigate reasons behind the regional variability.
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A Machine Learning Approach to Assess the Separation of Seismocardiographic Signals by RespirationSolar, Brian 01 January 2018 (has links)
The clinical usage of Seismocardiography (SCG) is increasing as it is being shown to be an effective non-invasive measurement for heart monitoring. SCG measures the vibrational activity at the chest surface and applications include non-invasive assessment of myocardial contractility and systolic time intervals. Respiratory activity can also affect the SCG signal by changing the hemodynamic characteristics of cardiac activity and displacing the position of the heart. Other clinically significant information, such as systolic time intervals, can thus manifest themselves differently in an SCG signal during inspiration and expiration. Grouping SCG signals into their respective respiratory cycle can mitigate this issue. Prior research has focused on developing machine learning classification methods to classify SCG events as according to their respiration cycle. However, recent research at the Biomedical Acoustics Research Laboratory (BARL) at UCF suggests grouping SCG signals into high and low lung volume may be more effective. This research aimed at com- paring the efficiency of grouping SCG signals according to their respiration and lung volume phase and also developing a method to automatically identify the respiration and lung volume phase of SCG events.
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The Physical Activity and Skills StudyBarnett, Lisa Michele January 2009 (has links)
Doctor of Philosophy(PhD) / PURPOSE:The aims of this study were to i) investigate the relationship between childhood motor skill proficiency and adolescent physical activity participation, cardiorespiratory endurance (fitness) and perceived sports competence, ii) assess the long-term impact of a one year primary school intervention to improve motor skills on physical activity and motor skill proficiency and iii) determine whether the observed relationships varied according to gender.METHODS: The Physical Activity and Skills Study (PASS) followed up participants of a primary school intervention (Move It Groove It - MIGI) to improve motor skill proficiency. Participants were initially assessed in 2000 as part of the intervention. In 2006/07, they were re-assessed for motor skill proficiency and also measured for physical activity level (Adolescent Physical Activity Recall Questionnaire), cardiorespiratory fitness (Multistage Fitness Test) and perceived sports competence (Physical Self-Perception Profile). Composite object control (kick, catch, throw) and locomotor (hop, side gallop, vertical jump) skill scores were constructed for analysis. Linear regressions examined relationships between childhood skill proficiency and adolescent: i) time in physical activity intensities and type, controlling for gender and school grade and ii) cardiorespiratory fitness, controlling for gender. Structural equation modelling was used to determine whether perceived sports competence mediated between childhood object control skill proficiency and subsequent adolescent physical activity and cardiorespiratory fitness. A general linear model examined the relationship between being an intervention/control student and time in physical activity adjusting for childhood skill and gender. RESULTS:From 928 original participants in 2000, 481 were located in 28 schools and 276 (57%) were assessed with at least one follow-up measure in 2006/07. Slightly more than half were female (52.4%) with a mean age of 16.4 years (range 14.2 to 18.3 yrs). Childhood object skill proficiency significantly impacted on later skill proficiency, physical activity and fitness, for both genders. Furthermore, perceived sports competence acted as a mediator between childhood object control skill proficiency and subsequent adolescent physical activity and fitness. Locomotor proficiency was not predictive of any outcome variable. Six years after the intervention, participants from the intervention schools still performed better than controls in one object control skill, but were no more active.CONCLUSION: Childhood proficiency in object control skills is an important influence on subsequent positive health-related behaviours and outcomes. Childhood interventions to improve object control skills may have a lasting impact. Results may inform intervention designs to promote physical activity and fitness in youth.
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The Physical Activity and Skills StudyBarnett, Lisa Michele January 2009 (has links)
Doctor of Philosophy(PhD) / PURPOSE:The aims of this study were to i) investigate the relationship between childhood motor skill proficiency and adolescent physical activity participation, cardiorespiratory endurance (fitness) and perceived sports competence, ii) assess the long-term impact of a one year primary school intervention to improve motor skills on physical activity and motor skill proficiency and iii) determine whether the observed relationships varied according to gender.METHODS: The Physical Activity and Skills Study (PASS) followed up participants of a primary school intervention (Move It Groove It - MIGI) to improve motor skill proficiency. Participants were initially assessed in 2000 as part of the intervention. In 2006/07, they were re-assessed for motor skill proficiency and also measured for physical activity level (Adolescent Physical Activity Recall Questionnaire), cardiorespiratory fitness (Multistage Fitness Test) and perceived sports competence (Physical Self-Perception Profile). Composite object control (kick, catch, throw) and locomotor (hop, side gallop, vertical jump) skill scores were constructed for analysis. Linear regressions examined relationships between childhood skill proficiency and adolescent: i) time in physical activity intensities and type, controlling for gender and school grade and ii) cardiorespiratory fitness, controlling for gender. Structural equation modelling was used to determine whether perceived sports competence mediated between childhood object control skill proficiency and subsequent adolescent physical activity and cardiorespiratory fitness. A general linear model examined the relationship between being an intervention/control student and time in physical activity adjusting for childhood skill and gender. RESULTS:From 928 original participants in 2000, 481 were located in 28 schools and 276 (57%) were assessed with at least one follow-up measure in 2006/07. Slightly more than half were female (52.4%) with a mean age of 16.4 years (range 14.2 to 18.3 yrs). Childhood object skill proficiency significantly impacted on later skill proficiency, physical activity and fitness, for both genders. Furthermore, perceived sports competence acted as a mediator between childhood object control skill proficiency and subsequent adolescent physical activity and fitness. Locomotor proficiency was not predictive of any outcome variable. Six years after the intervention, participants from the intervention schools still performed better than controls in one object control skill, but were no more active.CONCLUSION: Childhood proficiency in object control skills is an important influence on subsequent positive health-related behaviours and outcomes. Childhood interventions to improve object control skills may have a lasting impact. Results may inform intervention designs to promote physical activity and fitness in youth.
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Toxicidade da deltametrina (formulação Butox® CE25) nas respostas cardio-respiratórias da tilápia-do-Nilo (Oreochromis niloticus)Silva, Aline Callegari 18 November 2011 (has links)
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Previous issue date: 2011-11-18 / Financiadora de Estudos e Projetos / Deltamethrin is a synthetic pyrethroid pesticide, type II, considered of low persistence in the environment and widely utilized in agriculture and aquaculture to control plagues and aquatic parasites respectivamently. In spite of it low toxicity in mammals, this pesticide can be extremely toxic for fish. In this study, we evaluate the effects of a sub-lethal concentration (7.3 μg L-1, 50% of LC50-96h) of deltamethrin (formulation BUTOX®CE25) on the in vivo cardio-respiratory function of Nile tilapia (Oreochromis niloticus), are species of high economic potential. The cardio-respiratory parameters (O2 uptake - V&O2 , respiratory frequency fR, gill ventilation - G V& , ventilatory tidal volume VT, O2 extraction from the ventilatory current EO2, and heart frequency fH) were measured in a group of intact fish (GC), under normoxic conditions, during 24 h. After this period, another group of fish (GE) was exposed to deltamethrin and kept under these conditions for another 24 h period. During these periods the cardio-respiratory variables were continuously monitored. In another series of experiments, a group of non-intoxicated fish (GCH) was exposed to normoxia (PwO2 ~ 140 mmHg) and subsequently submitted to graded hypoxia (PwO2 = 100, 70, 50, 30 and 20 mmHg), while the above cardio-respiratory variables were continuously measured. A fourth group (GEH) was exposed to deltamethrin and submitted to the same hypoxic leves. Just after the exposure to deltamethrin fish presented a reduction in 2 V&O (mLO2.kg-1.h-1) which recovered gradually and reached initial (control) values after 18 h. Meanwhile fR (breaths.min- 1) remained unchanged in response to the toxicant. The G V& (mLH2O.Kg-1.min-1), however, increased significantly in the first 6 h of exposure to deltamethrin, returning to the initial values after 9 h. The G V& increased as a consequence of a proportional enhancement in VT (mLH2O.kg-1.resp-1). Immediately after the toxicant administration, fish presented a significant reduction in fH (bpm) and this bradicardia remained for a period of 12 h, after which this variable returned to the control values. Fish exposed to deltamethrin and submitted to graded hypoxia presented a significant reduction in 2 V&O , while their critical oxygen tension (PcO2) increased in relation to the control group. This indicates impairment in the capacity of oxyregulation of intoxicated fish. Also during graded hypoxia G V& and VT of fish exposed to deltamethrin increased progressively, while fR did not change. The fH was significant lower (bradicardia) in all hypoxic tensions. In conclusion, when Nile tilapia is exposed to sub-lethal concentrations of deltamethrin (formulation BUTOX ®CE25), the cardio-respiratory variables of this species stabilize after about 24 h, indicating a fast recovery to the toxicity of this pesticide. The cardio-respiratory responses to hypoxia, however, are impaired by deltamethrine exposure, suggesting that an adequate aerobic metabolism is important in the detoxification of this pesticide. / Deltametrina é um pesticida piretróide sintético do tipo II, considerado de baixa persistência no ambiente, amplamente utilizado na aquacultura e na agricultura no combate a parasitas aquáticos e no controle de pragas respectivamente. Apesar de sua baixa toxicidade em mamíferos, este piretróide pode ser extremamente tóxico para peixes. No presente estudo avaliou-se os efeitos da exposição da deltametrina (na formulação BUTOX®CE25), em uma concentração subletal (7,3 μg L-1, 50% da CL50-96 h), sobre a função cardio-respiratória in vivo de tilápia-do-Nilo, Oreochromis niloticus, espécie de grande importância para a piscicultura e pesca esportiva. Os parâmetros cardio-respiratórios (tomada de O2 - V&O2 , freqüência respiratória fR, ventilação branquial - G V& , volume ventilatório VT, extração de O2 pela corrente ventilatória EO2, freqüência cardíaca fH) foram medidos, em condições normóxicas, em um grupo de peixes intactos (grupo GC). Em seguida os peixes foram expostos à deltametrina e mantidos nessas condições por um período de 24 h (grupo GE). Durante esses períodos experimentais as variáveis cardio-respiratórias foram constantemente monitoradas e medidas. Em outra série de experimentos, um grupo controle de peixes (GCH) foi submetido a normóxia (PwO2 ~ 140 mmHg) e posteriormente submetidos à hipóxia gradual (PwO2 = 100, 70, 50, 30 and 20 mmHg). Outro grupo (GEH) foi exposto à mesma concentração subletal de deltametrina e submetido às mesmas tensões hipóxicas acima descritas. Observou-se, no decorrer de 24 h em normóxia, que a deltametrina reduziu imediatamente a 2 V&O (mLO2.kg-1.h-1), sendo que esta variável retornou a seus valores iniciais (controle) após 18 h de contaminação. Não foi observada nenhuma alteração na fR (resp.min-1) durante todo o período experimental. Entretanto, a G V& (mLH2O.Kg-1.min-1) aumentou significativamente nas primeiras 6 h de exposição, retornando aos valores iniciais após 9 h. Esse aumento na G V& deveu-se a um equivalente aumento no VT (mLH2O.kg-1.resp-1). Imediatamente após a administração da deltametrina, a fH (bpm) sofreu uma significativa redução (bradicardia) que se manteve por um período de 12 h, após o qual a fH retornou aos valores controle. Durante a hipóxia gradual a 2 V&O reduziu-se significativamente e progressivamente e a tensão crítica de O2 (PcO2) dos animais intoxicados aumentou, o que significa uma diminuição na capacidade de manutenção da 2 V&O em hipóxia em comparação com os animais controle. Também, durante a hipóxia, a G V& e o VT dos peixes intoxicados com deltametrina aumentaram progressivamente enquanto que a fR não se alterou. Da mesma forma a fH manteve-se significativamente mais baixa em todas as PO2 experimentais. Concluise que a deltametrina na formulação BUTOX ®CE25 é tóxica para tilápia-do-Nilo . Todavia quando essa espécie é submetida a uma concentração subletal desse inseticida por um curto período de tempo (24 h) os parâmetros cardio-respiratórios se restabelecem ao longo desse período. Isto indica que há uma possível recuperação da espécie em resposta à toxicidade da deltametrina. A hipóxia ambiental pode agravar os efeitos deste pesticida na função cardiorespiratória da tilápia-do-Nilo, mostrando que a manutenção de um metabolismo aeróbico é importante na detoxificação deste pesticida.
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Modelling of cardiac impedance signals / Modelling of cardiac impedance signalsMatušek, Adam January 2012 (has links)
Tato diplomová práce se zabývá vytvořením modelu signálu impedančního měření srdce (ICG signál). Impedanční kardiografie podává informaci o změně srdečního objemu během srdečního cyklu. Modelování signálu předchází statistická analýza vzájemné pozice ICG signálu vzhledem k dalším mechanickým srdečním signálům. Konstrukce modelu vychází z reálných nasnímaných signálů. Konečný ICG model je začleněn do již existujícího modelu mechanických interakcí mezi srdcem a plícemi. Výsledkem je funkční model kardio-respiračních interakcí, který bude sloužit v dalších částech výzkumu laboratoře PRETA.
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Vivência de uma equipe multiprofissional de atendimento avançado pré-hospitalar móvel ao adulto em situação de parada cardiorrespiratória / Experience of a multi professional team of advanced pre-hospitalar attendance movable to the adult in situation of cardiorespiratory emergencyCristina, Jane Aparecida 31 July 2006 (has links)
Este estudo de abordagem qualitativa, descritivo e de caráter exploratório tem como objetivo investigar a vivência da equipe multiprofissional na assistência ao adulto em situação de parada cardiorrespiratória, numa unidade de suporte avançado de vida de Atendimento Pré-Hospitalar móvel (APH) da Secretaria Municipal de Saúde de Ribeirão Preto-SP. Para a coleta de dados, foi utilizada a entrevista semi-estruturada que compreendeu questões sobre o perfil sociodemográfico, profissional e questões norteadoras sobre o tema. A amostra foi constituída por 16 profissionais, médicos, enfermeiros e condutores de veículo de urgência terrestre integrantes da Unidade de Suporte Avançado (USA). Os dados foram organizados por meio da análise de conteúdo proposta por Bardin (1977), sendo identificados quatro temas: o trabalho no APH móvel avançado, os sentimentos e emoções da equipe multiprofissional de APH móvel avançado frente ao atendimento à Parada Cardiorrespiratória (PCR), identificação dos agentes estressores ao atendimento à PCR e as reações de estresse no atendimento à PCR. Na presente pesquisa, a equipe multiprofissional relata a sua vivência nesse tipo de atividade com a visão de um serviço desafiante e difícil, por vivenciar diariamente situações inesperadas, desconhecidas e angustiantes, mas que, com tudo isso, também são capazes de perceber satisfações pessoais e realização profissional. Na análise, evidenciaram-se também nas demais categorias, as expressões: conhecimento e constante capacitação técnica e tecnológica, habilidade e agilidade, tomada de decisões, trabalho em equipe, a dificuldade de lidar com o sofrimento dos familiares na cena do agravo, envolvimento emocional em situações de grande sofrimento e dor, trabalhar em altas temperaturas, dificuldades em lidar com a morte, principalmente em situações inesperadas e com vítimas jovens, trazendo sentimentos de impotência, frustração e tristeza. Portanto essa equipe multiprofissional vivencia diariamente a real possibilidade de sofrimento psíquico e mostra por meio deste estudo, a necessidade de que a equipe promova momentos para reflexão e discussão acerca dos aspectos técnicos, científicos e éticos referentes ao cuidado dos pacientes críticos, em parada cardiorrespiratória, quanto às diferentes possibilidades de situações que os envolva durante o atendimento, com vistas à melhoria da qualidade do atendimento e do relacionamento interpessoal. Levando em consideração os resultados e conclusões da nossa investigação, é relevante a questão da saúde mental desses profissionais no exercício de suas funções, diante do exposto nos seus próprios relatos, e até que ponto os mecanismos de enfrentamento utilizados pelos mesmos são eficientes, ou seja, são métodos eficazes de elaboração do estresse. Sugerimos como métodos que podem ser eficazes: buscar informações e discutir o assunto em grupos; aceitar os acontecimentos, buscando o lado positivo da situação, buscar auxílio de especialistas, psicólogos ou psiquiatras e seguir suas orientações. Diante da importância desse serviço, vemos a necessidade de propor formas alternativas dentro dessa equipe, para que ela alcance um equilíbrio no estresse individual e coletivo e que efetivamente não atinja os limites de sofrimento psíquico. Assim são necessárias outras investigações, porque as seqüelas advindas podem comprometer a vida social e pessoal do indivíduo. / This study of qualitative boarding and of exploratory character has as objective investigate the experience of the multi-professional team in the assistance for the adults in situations of cardiorespiratory emergency in a unity of advanced support of life and movable pre-hospitalar attendance (APH) of the Municipal Secretary of Health from Ribeirão Preto?SP. To collect the data was utilized a semi-structuralized interview that was included questions about the sociodemographic profile and professional and questions directed to the topics. The sample was constituted of 16 professionals, doctors, nurses and conductors by the way of the USA. Data were organized and analyzed the content proposed by Bardin (1977), identifying four topics: The Work in the APH advanced movable, the feelings and emotions of the multi professional team of APH advanced movable in front of the attendance to PCR, identification of the stresses agents in the attendance to PCR. In the present search the multi-professional team relate their experience in this kind of activities with the vision of a hard and challenger job by experience the daily of non waiting situations, unknown and overwhelming but even with of all of this they are also able to percept personal satisfactions and professional realization. In the analyze evidence too in the others categories the expressions: knowledge and constant technique qualification and technologic, ability and agility, taken decisions, group work, the difficult to deal with the pain of the familiars in the scene of the aggravate, emotional involvement and situations of a lot suffer and pain, work in high temperatures, difficult to deal with the death, principally in unexpected situations and of young victims bringing feelings of incapacitation, frustration and sadness. Therefore this multi-professional team experience daily the real possibility of psychic suffer, and show trough this study the necessity that the team promote moments of reflection and discussion around of the techniques aspects, scientifics and ethical referring to the cautions of the critics patients in cardio respiratory problems and of the different possibilities of situations that involve them during the attendance with vision on better quality of the attendance and the interpersonal relation. Considering the results and conclusions of our investigation is important the aspect of mental healthiness of this professionals in the act of their functions based in their own experiences and the mechanisms of fronting utilized by the team are efficient so are methods of elaboration of stress. So we suggest how methods can be efficient: search for informations and discuss the subject in group; accept the knowledge looking for the good side of the situation, search aid of specialists, psychologist or psychiatrist, and follow their orientations. Once that is necessary this kind of service we see the necessity to propose alternatives ways inside of this team, to got a equilibrium of personal stress and of the group that don?t affect the limits of psychic suffer. So it makes necessary others investigations because the symptoms can interfere in the personal life.
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