Bakgrund Våld i nära relationer är ett globalt samhällsproblem. Det bidrar till konsekvenser för samhället och kvinnan. Sjuksköterskor har det yttersta ansvaret för omvårdnadsarbetet. De ska främja hälsa, förebygga ohälsa och lindra lidande. I sin profession ska de förhålla sig till den etiska koden för sjuksköterskor. De ska med hjälp av kommunikationen skapa vårdmöte där kvinnornas behov och hälsoprocesser respekteras för att få kvinnorna delaktiga i sin vård. Kvinnorna ska känna en förtroendefull relation till sjuksköterskorna för att en mellanmänsklig relation ska kunna uppstå. Syfte Syftet var att belysa sjuksköterskors erfarenheter av vårdmötet med kvinnor som utsatts för våld i nära relationer. Metod ​En litteraturöversikt med tio vetenskapliga artiklar. Artiklar som hämtats från databaserna Cinahl Complete och PubMed har använts. Artiklarna analyserades med Fribergs analysmodell. Resultat I resultatet framkom det fyra teman; (1) Emotionella utmaningar för sjuksköterskor vid våld i nära relationer, (2) Sjuksköterskors engagemang och attityder, (3) Brist på kunskap och utbildning och (4) Sjuksköterskors erfarenheter av att identifiera våld i nära relationer. Sammanfattning Den brist på kunskap som framkom i resultatet visade att sjuksköterskor kände en osäkerhet i hur man på ett lämpligt sätt, utan att kränka kvinnornas integritet skulle ta upp frågan om våld i nära relation och hur man sedan skulle hantera svaret. Att se till kvinnornas autonomi är viktigt i omvårdnaden av de våldsutsatta kvinnorna, eftersom ett autonomistödjande förhållningsätt stärker kvinnornas integritet. / Background Intimate partner violence is a social problem on a global level. It contributes to consequences both for the society and for women. Nurses have the ultimate responsibility for the nursing of patients. They shall promote health, prevent illness and alleviate suffering. In their profession, they shall relate to the ethical code for nurses. They shall, through communication, create a health care- meeting, where the women´s needs and health processes are respected, to make sure the women are involved in their own care. The women should experience trust in order for an interpersonal relationship to arise- between women and the nurses.​ Aim The aim with this study was to shed light on nurses' experiences of the health care meeting with women who have been exposed to intimate partner violence.​ Method A literature review based on ten scientific articles. The article were retrieved from the databases Cinahl Complete and PubMed. The articles were analyzed using Friberg's analysis model.​ Results Four themes were identified in the results; (1) Emotional challenges for nurses in cases of intimate partner violence, (2) Nurses' commitment and attitudes, (3) Lack of knowledge and training and (4) Nurses' experiences of identifying intimate partner violence   Summary The lack of knowledge that were identified in the results showed that nurses felt uncertain about how to appropriately address the issue of intimate partner violence, without violating women's privacy and how to later approach their response. Taking care of the women's autonomy is important in the care of women who are exposed to violence, since an autonomy-supportive approach strengthens the women's integrity​

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Made available in DSpace on 2011-05-04T12:36:29Z (GMT). No. of bitstreams: 0 Previous issue date: 2010 / Introdução: Organizar a referência da mulher e da criança no pós-parto possibilita a realização de ações básicas, preconizadas pelo Ministério da Saúde (MS), para serem realizadas nos primeiros sete dias após o parto. Com o intuito de criar uma rede interligada de cuidados, entre unidades básicas e hospitais, facilitando o acesso das mães e recém-nascidos aos serviços de saúde logo após o nascimento, o Município do Rio de Janeiro desenvolveu a estratégia Acolhimento mãe-bebê . Objetivos: Avaliar o fluxo das crianças entre a alta da maternidade e o atendimento na unidade básica de saúde. Identificar os fatores associados à sua ocorrência de maneira completa. Metodologia: Foram entrevistadas 1082 mães de crianças menores de seis meses atendidas, em 27 unidades básicas de saúde do Sistema Único de Saúde que prestavam assistência pediátrica no Município do Rio de Janeiro em 2007. Foram excluídas cinco crianças em que não havia informação se tinham recebido ou não cartão de referência na maternidade. Considerou-se como variável desfecho a realização do acolhimento mãe-bebê. As análises foram realizadas incorporando ponderação e plano de amostragem no modelo de regressão hierarquizado. O estudo foi aprovado pelo comitê de ética e pesquisa da FIOCRUZ. Resultados: Tiveram acolhimento incompleto 59,2 por cento das crianças. A chance de acolhimento incompleto foi maior entre mulheres: sem companheiro; sem trabalho remunerado; idade menor que 20 anos; com pré-natal intermediário e inadequado; que não fizeram pré-natal na mesma unidade em que a criança foi atendida; realizaram cesárea; crianças que nasceram em maternidades não credenciadas na Iniciativa Hospital Amigo da Criança. Conclusão: Essa estratégia de referência da criança no pós-parto para o acompanhamento na unidade básica pode contribuir com uma maior integração dos serviços. Mas, ainda é necessário um treinamento e comprometimento maior dos profissionais nas maternidades para realização do encaminhamento e nas unidades básicas para o atendimento das mães e das crianças. / Introduction: To organize the reference of the post-partum woman and child in the postpartum period provides the implementation of basic actions, envisaged by the Ministry of Health to be performed in the first week after childbirth. In order to create an interconnected system of care, from basic units and hospitals, and facilitate the access of mothers and newborn health services soon after birth, the city of Rio de Janeiro has developed the strategy “mother-baby reception”. Objectives: To evaluate the flow of children from the maternity hospital discharge and medical care in primary care. To identify factors associated with their occurrence in full way. Methods: It was interviewed 1082 mothers of children under six months served on 27 basic health units of the National Health System that provided pediatric care to children under six months in Rio de Janeiro in 2007. Five children were excluded due to the missing information if the reference card at the hospital had received or not. It was considered as the outcome variable the realization of the mother-baby reception. The analysis were performed incorporating weighting and sampling plan in a hierarchical regression model. The study was approved by the FIOCRUZ ethical and research committee (IRB). Results: It had incomplete reception 59.2% of children. The chance of incomplete reception was higher among women: no partner, without paid work, age less than 20 years, with intermediate and inadequate prenatal, not received prenatal care in the same unit where the child has been met; performed cesarean section; children born in hospitals without Baby Friendly Initiative Hospital. Conclusion: This strategy of reference of the post-partum child to the follow up in the basic unit can contribute to greater integration of services. But it still needs more training of professionals in maternity hospitals to perform the routing and in the basic units for the care, development of actions and bond establishment.

This non-experimental, descriptive, quantitative survey attempted to evaluate IMCI implementation in the eThekwini district of KwaZulu -Natal. The study focused on IMCI implementation by IMCI trained registered nurses, health facility support and follow-up and supervision. The research population comprised of all IMCI trained registered nurses working in health facilities in the eThekwini district. The convenient sample consisted of 40 research subjects. Data was collected by means of an interview schedule and a checklist, and analysed using Microsoft Excel 2007. Findings of the study revealed that many of the IMCI trained registered nurses were unable to assess, classify and treat the sick child comprehensively and consistently. The recommended follow-up visit at six weeks after completion of IMCI training, and lack of on-going supervision remains an area of concern. Recommendations were that district or clinic supervisors can enhance the skills of IMCI trained registered nurses through recommended follow-up visits and on-going supervision and the provision of updated IMCI chart booklets. / Health Studies / M.A. (Health Studies)

Fine roots constitute a large part of the primary production in northern (arctic and boreal) ecosystems, and are key players in ecosystem fluxes of water, nutrients and carbon. Data on root dynamics are generally rare, especially so in northern ecosystems. However, those ecosystems undergo the most rapid climatic changes on the planet and a profound understanding of form, function and dynamics of roots in such ecosystems is essential. This thesis aimed to advance our knowledge about fine root dynamics in northern ecosystems, with a focus on fine root phenology in natural plant communities and how climate change might alter it. Factors considered included thickness and duration of snow cover, thawing of permafrost, as well as natural gradients in temperature. Experiments and observational studies were located around Abisko (68°21' N, 18°45' E), and in a boreal forest close to Vindeln (64°14'N, 19°46'E), northern Sweden. Root responses included root growth, total root length, and root litter input, always involving seasonal changes therein, measured with minirhizotrons. Root biomass was also determined with destructive soil sampling. Additionally, aboveground response parameters, such as phenology and growth, and environmental parameters, such as air and soil temperatures, were assessed. This thesis reveals that aboveground patterns or responses cannot be directly translated belowground and urges a decoupling of above- and belowground phenology in terrestrial biosphere models. Specifically, root growth occurred outside of the photosynthetically active period of tundra plants. Moreover, patterns observed in arctic and boreal ecosystems diverged from those of temperate systems, and models including root parameters may thus need specific parameterization for northern ecosystems. In addition, this thesis showed that plant communities differ in root properties, and that changes in plant community compositions can thus induce changes in root dynamics and functioning. This underlines the importance of a thorough understanding of root dynamics in different plant community types in order to understand and predict how changes in plant communities in response to climate change will translate into root dynamics. Overall, this thesis describes root dynamics in response to a variety of factors, because a deeper knowledge about root dynamics will enable a better understanding of ecosystem processes, as well as improve model prediction of how northern ecosystems will respond to climate change.

The problem of this study is to compare prior health care experience with satisfactory adjustment in a long-term care facility. Both quantity and quality of prior experience in a health care facility are examined in terms of the significance to successful relocation. Demographic data and perceived control of health are examined in relation to significance of the findings.

Fine roots constitute a large part of the primary production in northern (arctic and boreal) ecosystems, and are key players in ecosystem fluxes of water, nutrients and carbon. Data on root dynamics are generally rare, especially so in northern ecosystems. However, those ecosystems undergo the most rapid climatic changes on the planet and a profound understanding of form, function and dynamics of roots in such ecosystems is essential. This thesis aimed to advance our knowledge about fine root dynamics in northern ecosystems, with a focus on fine root phenology in natural plant communities and how climate change might alter it. Factors considered included thickness and duration of snow cover, thawing of permafrost, as well as natural gradients in temperature. Experiments and observational studies were located around Abisko (68°21' N, 18°45' E), and in a boreal forest close to Vindeln (64°14'N, 19°46'E), northern Sweden. Root responses included root growth, total root length, and root litter input, always involving seasonal changes therein, measured with minirhizotrons. Root biomass was also determined with destructive soil sampling. Additionally, aboveground response parameters, such as phenology and growth, and environmental parameters, such as air and soil temperatures, were assessed. This thesis reveals that aboveground patterns or responses cannot be directly translated belowground and urges a decoupling of above- and belowground phenology in terrestrial biosphere models. Specifically, root growth occurred outside of the photosynthetically active period of tundra plants. Moreover, patterns observed in arctic and boreal ecosystems diverged from those of temperate systems, and models including root parameters may thus need specific parameterization for northern ecosystems. In addition, this thesis showed that plant communities differ in root properties, and that changes in plant community compositions can thus induce changes in root dynamics and functioning. This underlines the importance of a thorough understanding of root dynamics in different plant community types in order to understand and predict how changes in plant communities in response to climate change will translate into root dynamics. Overall, this thesis describes root dynamics in response to a variety of factors, because a deeper knowledge about root dynamics will enable a better understanding of ecosystem processes, as well as improve model prediction of how northern ecosystems will respond to climate change.

lt;p align="justify"gt;The Health Service Residuals (HSR) are the ones generated in a facility related to human or animal health. They represent 1% of the total of solid residuals and the inadequate manipulation is a source of risk for human health and the environment. Small-sized municipal districts also suffer from the problem of residuals and the greatest challenge is serving the legislation. The aim of this work is evaluating the HSR management and proposing low cost measures for its implementation and operation. It was a qualiquantitative approach, through the application of checklist, semi-structure and structured interviews, and a photographic record. Analyzing the classification, segregation, conditioning, identification, storing and transportation steps, not all the institutions attended the legal requirements. The municipal district has assumed that the responsibility of external transportation and final disposition didn’t attend the required technical specifications. The legal responsibility is from the generator source. It was perceived the lack of knowledge from professionals about HSR and the limitations in the use of individual protective equipment. It can be concluded that it is possible to attend the RDC 306/04 legislation highlighting low cost measures, in the focus on integrated management of shared residuals and responsibilities, and that these proposed measures can be applicable to the reality of other small-sized municipal districts.lt;/pgt; / lt;p align="justify"gt;Os Resíduos de Serviços de Saúde – RSS são aqueles gerados em estabelecimento relacionados à saúde humana e animal e mesmo representando apenas 1% do total de resíduos sólidos no município, o seu manejo inadequado representa grande risco para o meio ambiente. Nesse particular, os municípios de pequeno porte, apesar de produzirem pequena quantidade de RSS, enfrentam sérias dificuldades para gerir esses resíduos, considerando-se as limitações técnicas e financeiras para atender às legislações vigentes. O objetivo deste trabalho foi avaliar a percepção da gestão de RSS na cidade de Inhapim, Estado de Minas Gerais, e propor medidas de baixo custo para a operação dos serviços em todas as suas etapas, conforme preconiza a Resolução Deliberativa Colegiada (RDC) 306/04. Para isso, foi realizado o diagnóstico de percepção qualiquantitativo dos RSS gerados nos estabelecimentos de saúde localizados no município. Foram aplicados questionários (entrevistas estruturadas e semi-estruturadas) a gestores e servidores dos estabelecimentos de saúde, além de visitas in loco a todos os estabelecimentos de saúde e registro fotográfico. Foi analisada a gestão dos RSS em todas as suas etapas (classificação, segregação, acondicionamento, identificação, armazenamento e transporte) e chegou-se à conclusão de que os estabelecimentos de saúde de Inhapim não atenderam às exigências preconizadas pela RDC 306/04. Apesarda responsabilidade legal pela gestão dos RSS ser do gerador, o município de Inhapim tem assumido a responsabilidade do transporte externo e disposição final desses resíduos, mesmo dos estabelecimentos privados. De forma geral, conclui-se que há um desconhecimento dos gestores e servidores dos estabelecimentos de saúde sobre RSS e limitações no uso de equipamentos de proteção individual. Acredita-se que é possível atender à legislação RDC 306/04, valorizando medidas de baixo custo, dentro da ótica da gestão integrada de resíduos e responsabilidades compartilhadas, e que podem ser aplicáveis à realidade de outros municípios de pequeno porte.lt;/pgt;

Made available in DSpace on 2016-03-15T19:34:10Z (GMT). No. of bitstreams: 1 Paulo Vitor Bergamo Braga.pdf: 1950582 bytes, checksum: 3584bdf838b79f0b4c68d299d6487e3d (MD5) Previous issue date: 2014-10-23 / The right to health has a new outline under the Constitution of 1988. A right formerly guaranteed only to insured parties and dependents of the social security system, became right to all people and a duty of the State, effected through social and economic policies. In this context, the demands related to the realization of social rights, especially the right to health, are each day more taken to the analysis of legal scholars, who became real agents participating in the implementation of public policies. This phenomenon has transferred to legal scholars, upon justiciability of social rights, the burden of examining certain conditions of public policies that had previously been restricted to public administrators. Thus, this thesis will analyze the positioning of the chief judges of the Federal Circuit Court of the 3rd Circuit in relation to certain economic arguments that impact on the achievement, by the judiciary, of social rights, notably, in this dissertation, the supply of medicines. / O direito à saúde ganhou um novo contorno com a Constituição de 1988. De um direito garantido somente aos segurados e dependentes do sistema previdenciário, passou a ser direito de todos e dever do Estado, efetivado mediante políticas sociais e econômicas. Nesse contexto, cada vez mais as demandas relacionadas à concretização dos direitos sociais, sobretudo do direito à saúde, são levadas à análise dos atores jurídicos, que se transformaram em verdadeiro agente participante da implementação de políticas públicas. Esse fenômeno transferiu aos atores jurídicos, quando da judicialização dos direitos sociais, o ônus do exame de determinadas condicionantes das políticas públicas que, até então, eram restritas aos administradores públicos. Assim, a presente dissertação analisará o posicionamento dos desembargadores federais do Tribunal Regional Federal da 3ª Região em relação a determinados argumentos de cunho econômico que impactam na concretização, pelo Judiciário, dos direitos sociais, notadamente, nesta dissertação, do fornecimento de medicamentos.

O sistema público de saúde brasileiro tem sido convocado a dar resposta a um cenário ao qual se observa transição epidemiológica composta por um emergente aumento de condições crônicas de saúde. Em oposição ao sistema fragmentado, com foco nas condições agudas, voltado para o atendimento individual e isolado, que age de forma reativa e episódica em relação à demanda das pessoas usuárias, surge a Rede de Atenção à Saúde (RAS) com o objetivo de prestar a atenção certa, no lugar certo, com o custo certo e no tempo certo. Para tanto a RAS baseia-se na Atenção Primária à Saúde (APS) como eixo estrutural, esta sendo o centro de comunição das RAS e a porta de entrada do sistema. Assim, cabe a APS a função de coordenação do cuidado e da ordenação da RAS de acordo com as necessidades de saúde das pessoas. Objetivo: Verificar a presença e extensão dos elementos de coordenação do cuidado e de ordenação da rede de atenção pela APS em diferentes tipos de serviços públicos de APS em Porto Alegre. Método: É um estudo transversal de base populacional em adultos adscritos à rede pública de APS de Porto Alegre (Unidade Básica de Saúde, Estratégia Saúde da Família, Centro de Saúde Escola Murialdo e Serviço de Saúde do Grupo Hospitalar Conceição). A análise consiste em questões do PCATool-Brasil, as quais, segundo os autores relacionam-se com as funções de coordenação e ordenação. Resultados: Observa-se que o escore médio de Coordenação e Ordenação pela APS geral é de 5,7 (5,5: 5,9). Quanto aos tipos de serviço, o GHC com escore médio de 6,78 (0,12) foi o único que ficou com valor ligeiramente superior ao valor do ponto de corte (6,6) da escala arbitrária para Coordenação e Ordenação. Os escores médios de coordenação e ordenação da UBS foi 4,85 (0,17); do CSEM 5,48 (0,17) e do ESF foi 5,95 (0,09). Conclusões: Observase que, na experiência dos usuários entrevistados, os serviços públicos de APS de Porto Alegre ainda são incipientes quanto ao desempenho das funções de Coordenação do Cuidado e Ordenação das RAS. / The Brazilian public health system has been called to respond to a scenario where the observed epidemiological transition consists of an emergent increase in chronic health conditions. In contrast to the fragmented system, focusing on acute conditions facing individual care and isolated, which acts in a reactive and episodic in relation to people's demand users, there is the Health Care Network (HCN) with the objective of providing the right attention at the right place, at the right cost and at the right time. For both the RAS is based on Primary Health Care (PHC) as a structural axis, this being the communication center of the HCN and the gateway system. Thus, it is the function of the PHC care coordination and ordering of HCN according to the health needs of the people. Objective: To determine the presence and extent of the elements of care coordination and ordering of the care network by PHC in different types of public PHC in Porto Alegre. Method: It is a population-based cross-sectional study in adults ascribed to public PHC of Porto Alegre (Basic Health Unit, Family Health Strategy, Health Centre Murialdo and Health Service of the Conceição Hospital). The analysis consists of questions PCATool-Brazil, which, according to the authors relate to the functions of coordination and ordering. Results: It was observed that the mean score for the Coordination and Ordination by PHC overall is 5.7 (5.5: 5.9). As for the types of service, the GHC with a mean score of 6.78 (0.12) was the only one who got slightly higher than the cutoff value (6.6) of arbitrary scale for Coordination and Sorting. Mean scores of coordination and ordenation of UBS was 4.85 (0.17), the CSEM 5.48 (0.17) and FHS was 5.95 (0,09). Conclusions: We observed that, in the opinion of the users interviewed, utilities PHC Porto Alegre are still incipient as the performance of functions of the Care Coordination and Ordination of HCN. / Telemedicina