Diagnósticos de Enfermagem identificados em gestantes durante o pré-natal Diagnósticos de Enfermería identificados en embarazos durante el prenatal Nursing Diagnoses identified in pregnant patients under prenatal care

Esta pesquisa descritiva objetivou analisar o perfil de Diagnósticos de Enfermagem identificados em gestantes de baixo-risco. Participaram onze gestantes atendidas no pré-natal de uma maternidade segura no estado de Goiás. Os dados foram classificados segundo a taxonomia II da North American Nursing Diagnosis Association (NANDA) e analisados à luz de referenciais da obstetrícia. Foram identificados 25 diferentes Diagnósticos de Enfermagem. Todas as gestantes apresentaram: Conhecimento deficiente (diferentes graus e assuntos), Padrão de sono perturbado, Intolerância à atividade percebida, Déficit do autocuidado (banho e higiene), Incontinência urinária por pressão e alguns diagnósticos de risco. Identificar Diagnóstico de Enfermagem da NANDA permite a determinação do grau de risco gestacional, detecção precoce de complicações e individualização da assistência de enfermagem.<br>Este estudio descriptivo pretende analizar el perfil de Diagnósticos de Enfermería identificados en embarazos de bajo riesgo. Participaron once embarazadas atendidas en el prenatal de una maternidad confiable en el estado de Goiás. Los datos fueron clasificados según la taxonomía II de la North American Nursing Diagnosis Association (NANDA/Asociación Norteamericana de Diagnósticos de Enfermería) y analizados bajo los referenciales de la obstetricia. Fueron identificados 25 diferentes Diagnósticos de Enfermería. Todas las embarazadas presentaron: Conocimiento insuficiente (diferentes grados y asuntos), Patrón de sueño alterado, Intolerancia a la actividad percibida, falta de auto-higiene (baño e higiene personal), Incontinencia urinaria por presión y algunos diagnósticos de riesgo. Identificar Diagnóstico de Enfermería de NANDA permite la determinación del grado de riego, detección precoz de complicaciones e individualización de la asistencia de enfermería.<br>This descriptive research aimed to analyze the Nursing Diagnoses identified in low-risk pregnant patients. Eleven pregnant women received prenatal care in a safe maternity in the state of Goiás. The data were classified under the NANDA (North American Nursing Diagnosis Association) taxonomy II and analyzed according to the referrals in obstetrics. Twenty-five different Nursing Diagnoses were identified. All pregnant women presented: insufficient knowledge (different levels and subjects), disturbed sleep pattern, activity intolerance, self-care deficit (bathing and hygiene), stress urinary incontinence, and some risk diagnoses. Identifying NANDA's Nursing Diagnoses allows the identification of the risk level, early detection of complications, and individualization in nursing assistance

A systematic review of the effectiveness of stroke self-management programs for improving function and participation outcomes: self-management programs for stroke survivors

Purpose: A systematic review of stroke self-management programs was conducted to: (i) identify how many and what self-management support strategies were included in stroke selfmanagement interventions and (ii) describe whether self-management programs effectively improved outcomes, focusing specifically on function and participation outcomes. Methods: Twelve databases were searched for the years 1986–2012 to identify self-management programs for stroke survivors. Pre-post, quasi-experimental and randomized controlled trial study designs were included. Descriptive information about the intervention was scrutinized to identify what self-management support strategies were present in the intervention and comparisons were made between programs using a group versus a one-to-one format. All outcomes were included and categorized. Results: The most prominent strategies identified in our review were goal setting and follow-up, and an individualized approach using structured information and professional support. There are indications that self-management programs can significantly increase participation and functional ability. However, the high level of clinical heterogeneity in program delivery, outcomes and level of stroke severity made it impossible to conduct a meta-analysis. Further examination of individual self-management support strategies, such as linking rehabilitation goal setting to post-acute self-management programs, the inclusion of family members and the contribution of peer-support is warranted.</p

Perturbação respiratória durante o sono em doença pulmonar obstrutiva crônica Respiratory disturbance during sleep in chronic obstructive pulmonary disease

A doença pulmonar obstrutiva crônica é uma condição freqüente e é hoje a quarta principal causa de mortes nos Estados Unidos. A prevalência de perturbação respiratória durante o sono, ou síndrome de superposição, como anteriormente denominada, ainda não foi determinada devido à publicação de relatos conflitantes. Esta condição deve continuar sendo investigada devido aos efeitos adversos causados por transtornos respiratórios relacionados ao sono em pacientes com doença pulmonar de base. Neste relato, discutiremos brevemente os mecanismos envolvidos na origem da perturbação respiratória durante o sono em doença pulmonar obstrutiva crônica e auxiliaremos o leitor a distinguir àqueles pacientes que se beneficiariam de uma avaliação do padrão do sono mais detalhada, com a discussão de tópicos de gerenciamento e opções de tratamento.<br>Chronic obstructive pulmonary disease is a prevalent condition and is currently the forth leading cause of mortality in the US. The prevalence of respiratory disturbance during sleep, or overlap syndrome as it was commonly known in the past, is still undetermined as conflicting reports have been published. Because of the adverse effects of sleep-related respiratory impairment in patients with underlying pulmonary disease, this condition deserves further investigation. In this report, we will briefly discuss the mechanisms involved in generating respiratory disturbance during sleep in Chronic Obstructive Pulmonary Disease and will guide the reader into distinguishing those patients who would benefit from a more detailed sleep evaluation, discussing management issues and treatment options

Extensive loss of past permafrost carbon but a net accumulation into present-day soils

Atmospheric concentrations of carbon dioxide increased between the Last Glacial Maximum (LGM, around 21,000 years ago) and the preindustrial era(1). It is thought that the evolution of this atmospheric carbon dioxide (and that of atmospheric methane) during the glacial-to-interglacial transition was influenced by organic carbon that was stored in permafrost during the LGM and then underwent decomposition and release following thaw(2,3). It has also been suggested that the rather erratic atmospheric delta C-13 and Delta C-14 signals seen during deglaciation(1.4) could partly be explained by the presence of a large terrestrial inert LGM carbon stock, despite the biosphere being less productive (and therefore storing less carbon)(5,6). Here we present an empirically derived estimate of the carbon stored in permafrost during the LGM by reconstructing the extent and carbon content of LGM biomes, peatland regions and deep sedimentary deposits. We find that the total estimated soil carbon stock for the LGM northern permafrost region is smaller than the estimated present-day storage (in both permafrost and non-permafrost soils) for the same region. A substantial decrease in the permafrost area from the LGM to the present day has been accompanied by a roughly 400-petagram increase in the total soil carbon stock. This increase in soil carbon suggests that permafrost carbon has made no net contribution to the atmospheric carbon pool since the LGM. However, our results also indicate potential postglacial reductions in the portion of the carbon stock that is trapped in permafrost, of around 1,000 petagrams, supporting earlier studies(7). We further find that carbon has shifted from being primarily stored in permafrost mineral soils and loess deposits during the LGM, to being roughly equally divided between peatlands, mineral soils and permafrost loess deposits today.</p