Representação de acadêmicos de enfermagem acerca de sexualidade durante a amamentação / Perception of nursing students about sexuality during breastfeeding

Introdução: Durante o período da gravidez e da amamentação a mulher vivência mudanças fisiológicas, psicológicas e de ordem estrutural, essas mudanças podem trazer alterações na sexualidade feminina, devendo os profissionais de saúde ter uma atenção especial as suas necessidades particulares e com direitos sexuais. Objetivo: Conhecer as representações que os acadêmicos de enfermagem possuem acerca da sexualidade durante a amamentação. Método: Trata-se de uma pesquisa qualitativa, descritiva e exploratória. Participaram da pesquisa 16 acadêmicos de Enfermagem de uma universidade pública do interior da Bahia, Brasil. Para coleta dos dados empíricos foi utilizado à técnica projetiva de desenho-estória com tema e analisados mediante a técnica de análise de conteúdo. Resultado: Após análise, revelaram-se três categorias: sentimentos e desejos sexuais adormecidos devido à atenção dispensada para o bebê e os afazeres domésticos; sexualidade representada pela demonstração de amor, apoio, companheirismo, dedicação e respeito à mulher durante o período de amamentação e interferências na sexualidade permeada pelo comprometimento da autoimagem e autoestima da mulher. Conclusão: Conclui-se que a amamentação e a sexualidade foi percebida pelos acadêmicos de enfermagem através de conceitos estabelecidos socialmente, vivenciados ou não, assim é de extrema importância à abordagem desse tema na formação dos profissionais de saúde, para que possam descontruir alguns tabus enraizados durante a sua construção social.

Introducción: Durante el período de embarazo y lactancia, las mujeres experimentan cambios fisiológicos, psicológicos y estructurales. Estos cambios pueden provocar cambios en la sexualidad femenina, por lo cual las personas profesionales de la salud deben prestar especial atención a sus necesidades particulares y derechos sexuales. Objetivo: Conocer las representaciones que la población estudiantil de enfermería tiene sobre la sexualidad durante la lactancia. Método: Se trata de una investigación cualitativa, descriptiva y exploratoria. Dieciséis estudiantes de Enfermería de una universidad pública del interior de Bahía, Brasil, participaron de la investigación. Para recolectar los datos empíricos, se utilizó la técnica proyectiva de dibujo-cuento con tema y se analizó mediante la técnica de análisis de contenido. Resultado: Después del análisis, se revelaron tres categorías: sentimientos y deseos sexuales latentes debido a la atención al bebé y las tareas del hogar, la sexualidad representada por la demostración de amor, apoyo, compañerismo, entrega y respeto a la mujer durante el período de lactancia, e interferencia en la sexualidad permeada por el compromiso de la propia imagen y autoestima de la mujer. Conclusión: Se concluye que la lactancia materna y la sexualidad fueron percibidas por las personas estudiantes de enfermería a través de conceptos socialmente establecidos, experimentados o no. Por lo que, es de suma importancia abordar este tema en la formación de las personas profesionales de la salud, para que puedan deconstruir algunos tabúes arraigados durante su desarrollo social.

Introduction: During the period of pregnancy and breastfeeding, women experience physiological, psychological, and structural changes; these changes can impact their sexuality. Health professionals should pay special attention to their particular needs and sexual rights. Objective: To understand the perception that nursing students have about sexuality during breastfeeding. Method: This is qualitative, descriptive, and exploratory research. Sixteen nursing students from a public university in the interior of Bahia, Brazil participated in the research. To collect the empirical data, the projective technique of drawing a story about a given theme was used and the result was analyzed using the technique of content analysis. Result: After the analysis, three categories were revealed: dormant sexual feelings and desires due to the attention given to the baby and household chores; sexuality represented by the demonstration of love, support, companionship, dedication, and respect to women during the period of breastfeeding; and sexuality interference permeated by the commitment of the woman's self-image and self-esteem. Conclusion: It is concluded that breastfeeding and sexuality were perceived by nursing students through socially established concepts, experienced or not. Therefore, it is extremely important to approach this topic during the training of health professionals to help them deconstruct those socially ingrained taboos.

Explaining the stickiness of supply chain relations in the Brazilian soybean trade.

The global trade of agricultural commodities has profound social-ecological impacts, from potentially increasing food availability and agricultural efficiency, to displacing local communities, and to incentivizing environmental destruction. Supply chain stickiness, understood as the stability in trading relationships between supply chain actors, moderates the impacts of agricultural commodity production and the possibilities for supply-chain interventions. However, what factors determine stickiness, that is, how and why farmers, traders, food processors, and consumer countries, develop and maintain trading relationships with specific producing regions, remains unclear. Here, we use data on the Brazilian soy supply chain, a mixed methods approach based on extensive actor-based fieldwork, and an explanatory regression model, to identify and explore the factors that influence stickiness between places of production and supply chain actors. We find four groups of factors to be important: economic incentives, institutional enablers and constraints, social and power dimensions, and biophysical and technological conditions. Among the factors we explore, surplus capacity in soy processing infrastructure, (i.e., crushing and storage facilities) is important in increasing stickiness, as is export-oriented production. Conversely, volatility in market demand expressed by farm-gate soy prices and lower land-tenure security are key factors reducing stickiness. Importantly, we uncover heterogeneity and context-specificity in the factors determining stickiness, suggesting tailored supply-chain interventions are beneficial. Understanding supply chain stickiness does not, in itself, provide silver-bullet solutions to stopping deforestation, but it is a crucial prerequisite to understanding the relationships between supply chain actors and producing regions, identifying entry points for supply chain sustainability interventions, assessing the effectiveness of such interventions, forecasting the restructuring of trade flows, and considering sourcing patterns of supply chain actors in territorial planning.

Disentangling the numbers behind agriculture-driven tropical deforestation.

Tropical deforestation continues at alarming rates with profound impacts on ecosystems, climate, and livelihoods, prompting renewed commitments to halt its continuation. Although it is well established that agriculture is a dominant driver of deforestation, rates and mechanisms remain disputed and often lack a clear evidence base. We synthesize the best available pantropical evidence to provide clarity on how agriculture drives deforestation. Although most (90 to 99%) deforestation across the tropics 2011 to 2015 was driven by agriculture, only 45 to 65% of deforested land became productive agriculture within a few years. Therefore, ending deforestation likely requires combining measures to create deforestation-free supply chains with landscape governance interventions. We highlight key remaining evidence gaps including deforestation trends, commodity-specific land-use dynamics, and data from tropical dry forests and forests across Africa.

Teamwork in Pediatric Resuscitation: Training Medical Students on High-Fidelity Simulation.

Background: Simulation training and teamwork for medical students are essential to improve performance in pediatric cardiopulmonary resuscitation. Purpose: To evaluate if a specific approach to teamwork improves technical and nontechnical performance. Methods: We performed quasiexperimental, prospective, pre- and postinterventional, and nonrandomized research with 65 students in the fourth year of their medicine course. This was a case-control study in which teams used a customized TeamSTEPPS protocol (n=34) or not (n=31) for cardiopulmonary arrest training in children using high-fidelity simulation. All participants answered a sociodemographic and satisfaction questionnaire and underwent theory and practice pre- and posttesting. The survey data were collected in 2019 and analyzed using χ2, Mann-Whitney, κ, and Wilcoxon tests. p<0.05 was considered significant. Results: Intervention and control groups achieved better scores in theory posttesting (p<0.001 and p=0.049), but there was no difference between them in pre- (p=0.291) and posttesting (p=0.397). In the checklist of the practice test, all groups obtained their best outcomes in posttesting and the intervention group achieved higher scores (p<0.001). All groups increased the number of teamwork events and reduced the time span to perform resuscitation first steps (p<0.001) in posttesting. Conclusion: The use of teamwork training based on a customized TeamSTEPPS protocol improved performance in team behavior and group technical achievement. The evaluation of the students about the training was positive.

Addressing indirect sourcing in zero deforestation commodity supply chains.

The trade in agricultural commodities is a backbone of the global economy but is a major cause of negative social and environmental impacts, not least deforestation. Commodity traders are key actors in efforts to eliminate deforestation-they are active in the regions where commodities are produced and represent a "pinch point" in global trade that provides a powerful lever for change. However, the procurement strategies of traders remain opaque. Here, we catalog traders' sourcing across four sectors with high rates of commodity-driven deforestation: South American soy, cocoa from Côte d'Ivoire, Indonesian palm oil, and Brazilian live cattle exports. We show that traders often source more than 40% of commodities "indirectly" via local intermediaries and that indirect sourcing is a major blind spot for sustainable sourcing initiatives. To eliminate deforestation, indirect sourcing must be included in sectoral initiatives, and landscape or jurisdictional approaches, which internalize indirect sourcing, must be scaled up.

A Commodity Supply Mix for More Regionalized Life Cycle Assessments.

Supply chain information is invaluable to further regionalize product life cycle assessments (LCAs), but detailed information linking production and consumption centers is not always available. We introduce the commodity supply mix (CSM) defined as the trade-volume-weighted average representing the combined geographic areas for the production of a commodity exported to a given market with the goal of (1) enhancing the relevance of inventory and impact regionalization and (2) allocating these impacts to specific markets. We apply the CSM to the Brazilian soybean supply chain mapped by Trase to obtain the mix of ecoregions and river basins linked to domestic consumption and exports to China, EU, France, and the rest of the world, before quantifying damage to biodiversity, and water scarcity footprints. The EU had the lowest potential biodiversity damage but the largest water scarcity footprint following respective sourcing patterns in 12 ecoregions and 18 river basins. These results differed from the average impact scores obtained from Brazilian soybean production information alone. The CSM can be derived at different scales (subnationally, internationally) using existing supply chain information and constitutes an additional step toward greater regionalization in LCAs, particularly for impacts with greater spatial variability such as biodiversity and water scarcity.

Conhecimento geral, atitude psicológica e sua associação com a concentração de HbA1C em pacientes portadores de Diabetes Mellitus tipo 2 / General knowledge, psychological attitude and its association with the concentration of HbA1C in patients with Type 2 Diabetes Mellitus

Objetivo: Diabetes mellitus (DM) é uma doença relacionada a várias complicações e alta morbimortalidade, com comprometimento significativo da qualidade de vida do paciente, afetando sua saúde física e mental, bem como sua motivação ao autocuidado. Este estudo objetivou avaliar o conhecimento geral e a atitude psicológica para o DM, correlacionando a concentração de hemoglobina glicada (HbA1C) com escores do DKN-A e ATT-19 de pacientes portadores de DM tipo 2 (DM2). Métodos: Estudo observacional transversal com amostra de 65 participantes, 24,6% homens e 75,4% mulheres, com idade média de 57±12, avaliados entre novembro/2016 e fevereiro/2017. A avaliação do conhecimento geral e da atitude psicológica para o DM foi realizada pela aplicação do Diabetes Knowledge Questionnaire (DKN-A) e do Diabetes Attitude Questionnaire (ATT-19). O SPSS 20.0 foi utilizado para as análises estatísticas. Resultados: Para os escores de conhecimento (r=0,005; p=0,966) e de atitude (r=0,034; p=0,790) não houve correlação significante com a HbA1C, sendo que (94%) dos pacientes não atingiram o ponto de corte do ATT-19. Considerando o grupo com pontuação >8 para o escore de conhecimento, foi observada diferença negativa e significativa entre este escore e o de atitude (r=-0,444; p=0,0018). Conclusão: O conhecimento em relação à doença não traduziu em melhor controle da glicemia na população estudada, sugerindo que o controle eficiente da HbA1C não depende exclusivamente do conhecimento sobre a doença, mas sim de diversos outros fatores, que também precisam ser considerados na conduta do DM2.

Objective: Diabetes mellitus (DM) is a disease related to several complications and high morbidity and mortality, with significant impairment of the patient's quality of life, affecting his physical and mental health, as well as his motivation to self-care. The aim of this study was to evaluate the knowledge and attitude about type 2 DM (DM2) in its patients, correlating Diabetes Knowledge Questionnaire (DKN-A) and Diabetes Attitudes Questionnaire (ATT-19) scores with the concentration of glycated hemoglobin (HbA1c). Methods: Cross-sectional observational study with a sample of 65 participants, 24.6% male and 75.4% female, with a mean age of 57 ± 12, with low schooling, between November / 2016 and February / 2017. The evaluation of the knowledge and attitude about DM was carried out by the application of the DKN-A and ATT-19. SPSS 20.0 was used for statistical analysis. Results: There were no statistically significant correlations with HbA1c (r = 0.005, p = 0.966) and attitude (r = 0.034, p = 0.790), and 61 patients (94%) did not reach the cutoff point of ATT-19. Considering the group with scores higher than 8 points for the knowledge score, a negative and significant correlation was observed between this score and the attitude score (r = -0.444; p = 0.0018). Conclusion: Knowledge and attitude towards the disease did not translate into better glycemic control in the study population. The efficient control of HbA1c is multifactorial, involving genetic, comorbid, behavioral, drugs, health services, among others, that should be considered in the conduct.

Transition of blind women to motherhood from the perspective of Transitions Theory.

OBJECTIVE: to analyze the transition of blind women to motherhood from the perspective of Transitions Theory. METHOD: a qualitative, descriptive study, which had as participants 11 blind women. An open interview was conducted using the narrative method. Analysis occurred in the light of Transitions Theory, with approval from the Research Ethics Committee with Human Beings. RESULTS: the age group was 32 to 63 years, mostly Catholic, with social security benefits. Transition to motherhood mainly evidenced the experience when becoming a mother and feelings related to this new phase of life. FINAL CONSIDERATIONS: the women in the study adapted themselves to the maternal role, even with difficulties, developed healthy relationships with their children, overcame their disability and nurtured dreams and desires. They were aware of their role, achieving with mastery a healthy transition. It was evidenced scarcity of nursing therapies.

Acknowledging uncertainty in evolutionary reconstructions of ecological niches.

Reconstructing ecological niche evolution can provide insight into the biogeography and diversification of evolving lineages. However, comparative phylogenetic methods may infer the history of ecological niche evolution inaccurately because (a) species' niches are often poorly characterized; and (b) phylogenetic comparative methods rely on niche summary statistics rather than full estimates of species' environmental tolerances. Here, we propose a new framework for coding ecological niches and reconstructing their evolution that explicitly acknowledges and incorporates the uncertainty introduced by incomplete niche characterization. Then, we modify existing ancestral state inference methods to leverage full estimates of environmental tolerances. We provide a worked empirical example of our method, investigating ecological niche evolution in the New World orioles (Aves: Passeriformes: Icterus spp.). Temperature and precipitation tolerances were generally broad and conserved among orioles, with niche reduction and specialization limited to a few terminal branches. Tools for performing these reconstructions are available in a new R package called nichevol.

Factors associated with traffic accidents among drivers: findings from a population-based study. / Fatores associados a acidentes de trânsito entre condutores de veículos: achados de um estudo de base populacional.

This study aimed to identify associated factors with drivers' involvement in traffic accidents (TA). Thus, in 2013, a household survey was conducted with 1,406 drivers in Jequié, Bahia, Brazil. A hierarchical conceptual model was established and consisted of four blocks of exposure factors, considering the proximal-distal relationships between them and the outcome. Multilevel logistic regression was applied to estimate the Odds Ratio (OR) and 95% Confidence Intervals (95%CI). Higher TA probability was observed among drivers aged 15-29 years (OR=3.15; 95%CI 1.24-8.02), with black or brown skin color (OR=1.56; 95%CI 1.03-2.35), motorcyclists (OR=1.73; 95%CI 1.15-2.60), with a history of traffic tickets (OR=1.75; 95%CI 1.04-2.94), who reported drinking and driving (OR=1.68; 95%CI 1.12-2.53) and used cell phone while driving (OR=1.63; 95%CI 1.09-2.43). Proximal factors changed the exposure association measures concerning higher levels of determination of the hierarchical model, mainly regarding the gender variable. The results emphasize the behavioral factors and reaffirm the TAs' preventable potential due to the occurrence of avoidable conditions associated with the outcome.

O estudo teve por objetivo identificar fatores associados ao envolvimento em acidentes de trânsito (AT) entre condutores de veículos. Para isso, realizou-se inquérito domiciliar na cidade de Jequié, Bahia, em 2013, com 1.406 condutores. Elaborou-se um modelo conceitual hierarquizado composto por quatro blocos de fatores de exposição, considerando as relações proximais-distais entre estes e o desfecho. Foi empregado modelo de regressão logística multinível para as estimativas de Razão de Chances (RC) e Intervalos de Confiança a 95% (IC95%). Observou-se maior chance de AT entre condutores de 15 a 29 anos (RC=3,15; IC95% 1,24-8,02); de cor da pele preta ou parda (RC=1,56; IC95% 1,03-2,35); motociclistas (RC=1,73; IC95% 1,15-2,60); com antecedentes de multa no trânsito (RC=1,75; IC95% 1,04-2,94); que referiram beber e dirigir (RC=1,68; IC95% 1,12-2,53) e usar telefone celular durante a condução (RC=1,63; IC95% 1,09-2,43). Os fatores proximais modificaram as medidas de associação das exposições dos níveis superiores do modelo hierarquizado, principalmente da variável sexo. Os resultados enfatizam os fatores comportamentais e ratificam o potencial de prevenção dos AT, em virtude da ocorrência de condições evitáveis associadas ao desfecho.

A better Amazon road network for people and the environment.

The rapidly expanding network of roads into the Amazon is permanently altering the world's largest tropical forest. Most proposed road projects lack rigorous impact assessments or even basic economic justification. This study analyzes the expected environmental, social and economic impacts of 75 road projects, totaling 12 thousand kilometers of planned roads, in the region. We find that all projects, although in different magnitudes, will negatively impact the environment. Forty-five percent will also generate economic losses, even without accounting for social and environmental externalities. Canceling economically unjustified projects would avoid 1.1 million hectares of deforestation and US$ 7.6 billion in wasted funding for development projects. For projects that exceed a basic economic viability threshold, we identify the ones that are comparatively better not only in terms of economic return but also have lower social and environmental impacts. We find that a smaller set of carefully chosen projects could deliver 77% of the economic benefit at 10% of the environmental and social damage, showing that it is possible to have efficient tradeoff decisions informed by legitimately determined national priorities.

Satisfação profissional de enfermeiros que atuam no bloco cirúrgico de um hospital de excelência / Professional satisfaction of nurses at a surgicenter in an excellence hospital / Satisfacción profesional de enfermeras que trabajan en centro quirúrgico de un hospital de excelencia

Objetivos: Analisar e comparar o índice de satisfação profissional (ISP) de enfermeiros do bloco cirúrgico (BC). Método: Estudo de campo, comparativo e quantitativo que utilizou o ISP na avaliação da autonomia, interação, remuneração, normas organizacionais, status profissional e requisitos do trabalho de enfermeiros atuantes do BC de um hospital privado de São Paulo. Resultados: Dos 49 enfermeiros da amostra, 39 atuavam em centro cirúrgico (CC) e sala de recuperação pós-anestésica (SRPA) e 10 no centro de material e esterilização (CME). A interação foi o componente de maior importância, e o status profissional, o de menor, no entanto status profissional obteve o maior nível de satisfação, e requisitos do trabalho, o menor. O ISP foi 11,04 (baixo nível), considerando possível variação entre 0,9 e 37,1. Houve diferença significante para interação, com maior satisfação dos enfermeiros do CC/SRPA em comparação com os do CME. Conclusão: A satisfação profissional de enfermeiros do BC avaliada pelo ISP foi baixa. Conhecer os fatores que influenciam nesse índice é importante, pois a satisfação interfere diretamente na qualidade da assistência, previne doenças ocupacionais, além de ser indicador de resultados no processo de trabalho.

Objectives: To analyze and compare the professional satisfaction index (PSI) of surgical block (SB) nurses. Method: Comparative and quantitative field study that used the PSI in the evaluation of autonomy, interaction, compensation, organizational standards, professional status and work requirements of nurses working in the SB of a private hospital in São Paulo. Results: Of the 49 nurses in the sample, 39 worked in the operating room (OR) and post-anesthesia recovery room (PARR) and 10 worked in the material and sterilization center (MSC). Interaction was the most important component, and professional status was the least important. However, professional status obtained the highest level of satisfaction, while work requirements received the lowest. The PSI was 11.04 (low level), considering possible variation between 0.9 and 37.1. There was a significant difference for interaction, with greater satisfaction of OR/PARR nurses compared to MSC nurses. Conclusion: Professional satisfaction of SB nurses assessed by PSI was low. It is important to have knowledge of the factors that influence this index, as satisfaction directly interferes in the quality of care and prevents occupational diseases, besides being an indicator of results in the work process.

Objetivos: analizar y comparar el índice de satisfacción profesional (ISP) de las enfermeras en el quirófano. Método: Estudio de campo, comparativo y cuantitativo que utilizó el ISP en la evaluación de autonomía, interacción, remuneración, normas organizacionales, estatus profesional y requisitos de trabajo de enfermeras que trabajan en el BC de un hospital privado en São Paulo. Resultados: De las 49 enfermeras de la muestra, 39 trabajaron en el centro quirúrgico (CQ) y la sala de recuperación postanestésica (SRPA) y 10 en el centro de material y esterilización (CME). La interacción fue el componente más importante, y el estado profesional, el más bajo, sin embargo, el estado profesional obtuvo el mayor nivel de satisfacción y los requisitos laborales, el más bajo. El ISP fue 11.04 (nivel bajo), considerando una posible variación entre 0.9 y 37.1. Hubo una diferencia significativa en la interacción, con una mayor satisfacción de las enfermeras de CQ/SRPA en comparación con las de CME. Conclusión: La satisfacción profesional de las enfermeras de quirófano evaluadas por el ISP fue baja. Es importante conocer los factores que influyen en este índice, ya que la satisfacción interfiere directamente con la calidad de la atención, previene enfermedades ocupacionales, además de ser un indicador de resultados en el proceso de trabajo.

Fatores associados a acidentes de trânsito entre condutores de veículos: achados de um estudo de base populacional / Factors associated with traffic accidents among drivers: findings from a population-based study

Resumo O estudo teve por objetivo identificar fatores associados ao envolvimento em acidentes de trânsito (AT) entre condutores de veículos. Para isso, realizou-se inquérito domiciliar na cidade de Jequié, Bahia, em 2013, com 1.406 condutores. Elaborou-se um modelo conceitual hierarquizado composto por quatro blocos de fatores de exposição, considerando as relações proximais-distais entre estes e o desfecho. Foi empregado modelo de regressão logística multinível para as estimativas de Razão de Chances (RC) e Intervalos de Confiança a 95% (IC95%). Observou-se maior chance de AT entre condutores de 15 a 29 anos (RC=3,15; IC95% 1,24-8,02); de cor da pele preta ou parda (RC=1,56; IC95% 1,03-2,35); motociclistas (RC=1,73; IC95% 1,15-2,60); com antecedentes de multa no trânsito (RC=1,75; IC95% 1,04-2,94); que referiram beber e dirigir (RC=1,68; IC95% 1,12-2,53) e usar telefone celular durante a condução (RC=1,63; IC95% 1,09-2,43). Os fatores proximais modificaram as medidas de associação das exposições dos níveis superiores do modelo hierarquizado, principalmente da variável sexo. Os resultados enfatizam os fatores comportamentais e ratificam o potencial de prevenção dos AT, em virtude da ocorrência de condições evitáveis associadas ao desfecho.

Abstract This study aimed to identify associated factors with drivers' involvement in traffic accidents (TA). Thus, in 2013, a household survey was conducted with 1,406 drivers in Jequié, Bahia, Brazil. A hierarchical conceptual model was established and consisted of four blocks of exposure factors, considering the proximal-distal relationships between them and the outcome. Multilevel logistic regression was applied to estimate the Odds Ratio (OR) and 95% Confidence Intervals (95%CI). Higher TA probability was observed among drivers aged 15-29 years (OR=3.15; 95%CI 1.24-8.02), with black or brown skin color (OR=1.56; 95%CI 1.03-2.35), motorcyclists (OR=1.73; 95%CI 1.15-2.60), with a history of traffic tickets (OR=1.75; 95%CI 1.04-2.94), who reported drinking and driving (OR=1.68; 95%CI 1.12-2.53) and used cell phone while driving (OR=1.63; 95%CI 1.09-2.43). Proximal factors changed the exposure association measures concerning higher levels of determination of the hierarchical model, mainly regarding the gender variable. The results emphasize the behavioral factors and reaffirm the TAs' preventable potential due to the occurrence of avoidable conditions associated with the outcome.

Transition of blind women to motherhood from the perspective of Transitions Theory / Transición de mujeres ciegas para la maternidad en la perspectiva de la Teoría de las Transiciones / Transição de mulheres cegas para a maternidade na perspectiva da Teoria das Transições

ABSTRACT Objective: to analyze the transition of blind women to motherhood from the perspective of Transitions Theory. Method: a qualitative, descriptive study, which had as participants 11 blind women. An open interview was conducted using the narrative method. Analysis occurred in the light of Transitions Theory, with approval from the Research Ethics Committee with Human Beings. Results: the age group was 32 to 63 years, mostly Catholic, with social security benefits. Transition to motherhood mainly evidenced the experience when becoming a mother and feelings related to this new phase of life. Final considerations: the women in the study adapted themselves to the maternal role, even with difficulties, developed healthy relationships with their children, overcame their disability and nurtured dreams and desires. They were aware of their role, achieving with mastery a healthy transition. It was evidenced scarcity of nursing therapies.

RESUMEN Objetivo: analizar la transición de mujeres ciegas para la maternidad en la perspectiva de la Teoría de las Transiciones. Método: investigación cualitativa, descriptiva, con 11 mujeres ciegas participando. Se realizó una entrevista abierta utilizando el método Narrativa de la vida y el análisis se realizó a la luz de la Teoría de la transición, con la aprobación del Comité de ética en investigación con seres humanos. Resultados: el grupo de edad tenía entre 32 y 63 años, la mayoría católicos con beneficios de seguridad social. La transición de la maternidad mostró principalmente la experiencia de convertirse en madre y los sentimientos relacionados con esta nueva fase de la vida. Consideraciones finales: las mujeres que participaron en el estudio se adaptaron al papel materno, a pesar de las dificultades, desarrollaron relaciones saludables con sus hijos, superaron la discapacidad y cultivaron sueños y deseos, conscientes de su papel, logrando el dominio de la transición saludable. Había escasez de terapias de enfermería.

RESUMO Objetivo: analisar a transição de mulheres cegas para a maternidade na perspectiva da Teoria das Transições. Método: pesquisa qualitativa, descritiva, que teve como participantes 11 mulheres cegas. Realizou-se entrevista aberta por meio do método de Narrativa de Vida, e a análise ocorreu à luz da Teoria das Transições, com aprovação do Comitê de Ética em Pesquisa com Seres Humanos. Resultados: a faixa etária foi de 32 a 63 anos, a maioria era católica e com benefícios da seguridade social. A transição da maternidade evidenciou principalmente a experiência vivenciada ao se tornar mãe e sentimentos relacionados a essa nova fase da vida. Considerações finais: as mulheres participantes do estudo se adaptaram ao papel materno, mesmo com as dificuldades, desenvolveram relações saudáveis com os filhos, superaram a deficiência e cultivaram sonhos e desejos, conscientes de seu papel, alcançando a maestria da transição saudável. Evidenciou-se a escassez das terapêuticas de enfermagem.

Transition of blind women to motherhood from the perspective of Transitions Theory / Transición de mujeres ciegas para la maternidad en la perspectiva de la Teoría de las Transiciones / Transição de mulheres cegas para a maternidade na perspectiva da Teoria das Transições

ABSTRACT Objective: to analyze the transition of blind women to motherhood from the perspective of Transitions Theory. Method: a qualitative, descriptive study, which had as participants 11 blind women. An open interview was conducted using the narrative method. Analysis occurred in the light of Transitions Theory, with approval from the Research Ethics Committee with Human Beings. Results: the age group was 32 to 63 years, mostly Catholic, with social security benefits. Transition to motherhood mainly evidenced the experience when becoming a mother and feelings related to this new phase of life. Final considerations: the women in the study adapted themselves to the maternal role, even with difficulties, developed healthy relationships with their children, overcame their disability and nurtured dreams and desires. They were aware of their role, achieving with mastery a healthy transition. It was evidenced scarcity of nursing therapies.

RESUMEN Objetivo: analizar la transición de mujeres ciegas para la maternidad en la perspectiva de la Teoría de las Transiciones. Método: investigación cualitativa, descriptiva, con 11 mujeres ciegas participando. Se realizó una entrevista abierta utilizando el método Narrativa de la vida y el análisis se realizó a la luz de la Teoría de la transición, con la aprobación del Comité de ética en investigación con seres humanos. Resultados: el grupo de edad tenía entre 32 y 63 años, la mayoría católicos con beneficios de seguridad social. La transición de la maternidad mostró principalmente la experiencia de convertirse en madre y los sentimientos relacionados con esta nueva fase de la vida. Consideraciones finales: las mujeres que participaron en el estudio se adaptaron al papel materno, a pesar de las dificultades, desarrollaron relaciones saludables con sus hijos, superaron la discapacidad y cultivaron sueños y deseos, conscientes de su papel, logrando el dominio de la transición saludable. Había escasez de terapias de enfermería.

RESUMO Objetivo: analisar a transição de mulheres cegas para a maternidade na perspectiva da Teoria das Transições. Método: pesquisa qualitativa, descritiva, que teve como participantes 11 mulheres cegas. Realizou-se entrevista aberta por meio do método de Narrativa de Vida, e a análise ocorreu à luz da Teoria das Transições, com aprovação do Comitê de Ética em Pesquisa com Seres Humanos. Resultados: a faixa etária foi de 32 a 63 anos, a maioria era católica e com benefícios da seguridade social. A transição da maternidade evidenciou principalmente a experiência vivenciada ao se tornar mãe e sentimentos relacionados a essa nova fase da vida. Considerações finais: as mulheres participantes do estudo se adaptaram ao papel materno, mesmo com as dificuldades, desenvolveram relações saudáveis com os filhos, superaram a deficiência e cultivaram sonhos e desejos, conscientes de seu papel, alcançando a maestria da transição saudável. Evidenciou-se a escassez das terapêuticas de enfermagem.

Fractal correlations and linear analyses of heart rate variability in healthy young people with different levels of physical activity.

Changes in cardiac autonomic regulation, expressed by increased sympathetic activity and decreased heart rate variability, have an important relationship with the onset of lethal cardiac phenomena. Therefore, we aimed to evaluate the cardiac autonomic behaviour in young people according to their level of physical activity. Through the International Physical Activity Questionnaire, 55 healthy young non-smokers with no history of previous diseases and whose parents did not suffer from metabolic syndrome were assessed and divided into groups: sedentary (n=12), insufficiently active (n=16), active (n=14), and very active (n=13). We collected respiratory rate, systolic and diastolic blood pressure at rest, and body mass index. Subjects remained supine at rest, and without mental stress for 15 minutes in a controlled environment. Using a cardiofrequency meter (Polar® RS800CX), data were analysed in the time domain, frequency domain, and detrended fluctuation analysis. For the sedentary group, the mean RR and rMSSD were significantly lower, and the insufficiently active group showed higher means, but significantly only for rMSSD. The insufficiently active group showed in the detrended fluctuation analysis that α2 was significantly lower compared with the sedentary, active, and very active groups. We conclude that young, healthy, sedentary individuals present an increased heart rate and that insufficiently active individuals present a decreased fractal correlation and increased parasympathetic activity.

Brincadeiras indígenas do povo tembé do alto rio guamá: diálogo entre a tradição e a modernidade / Indigenous churches of the people tembé of the high river guamá: dialogue between tradition and modernity / Indigenous churches of the people tembé of the high river guamá: dialogue between tradition and modernity

O objetivo do estudo foi analisar as brincadeiras de raízes indígenas do povo Tembé do Alto Rio Guamá, considerando a existência de uma relação ambivalente entre tradição e modernidade. Para tanto, delimita o olhar sobre as brincadeiras tradicionais direcionadas pela abordagem qualitativa. Num primeiro momento, foi realizado um levantamento bibliográfico e, posteriormente, trabalho em campo para coleta de dados que aconteceu por meio de entrevistas guiadas com participação indígenas. Analisou-se a influência social e cultural do uso das tecnologias no cotidiano das crianças indígenas, onde as mesmas têm se apropriado da identidade de sua comunidade, substituindo silenciosamente os hábitos tradicionais que geravam interação com a comunidade e o meio ambiente. Relacionando as brincadeiras que fazem parte da cultura indígena com as brincadeiras atuantes de culturas externas buscou-se respostas para os seguintes questionamentos: As brincadeiras de raiz do povo Tembé do Alto Rio Guamá tem se modificado com a influência tecnológica dos povos externos? De que forma é possível manter a tradição das brincadeiras tradicionais frente aos avanços da tecnologia no mundo moderno?

The objective of the study was to analyze the indigenous roots of the Tembé people of the high Rio Guamá, considering the existence of an ambivalent relationship between tradition and modernity. To do so, it delimits the look on the jokes directed by the qualitative approach. At first, a bibliographical survey was carried out and, later, fieldwork for data collection that happened through guided interviews with indigenous participation. It was analyzed the social and cultural influence of the use of technologies in the daily life of indigenous children, where they have appropriated the identity of their community, silently replacing the traditional habits that generated interaction with the community and the environment. Relating the jokes that are part of the indigenous culture to the playful acts of external cultures, we sought answers to the following questions: Have the root games of the Tembé people of the high Rio Guamá been modified by the technological influence of the external peoples? In what way is it possible to maintain the tradition of traditional games against the advances of technology in the modern world?

A maternidade de mulheres cegas na perspectiva da Teoria das Transições: contribuições para o cuidado de enfermagem / La maternidad de las mujeres ciegas desde la perspectiva de la teoría de las transiciones: contribuciones al cuidado de enfermería / The maternity of blind women from the perspective of Transitions Theory: contributions to nursing care

Este estudo teve como objeto a maternidade de mulheres cegas, na perspectiva da Teoria das Transições de Afaf Meleis. Como objetivo geral: Analisar a maternidade de mulheres cegas na perspectiva da Teoria das Transições; e específicos: Compreender como a mulher cega vivencia o processo de transição para a maternidade; Identificar os sentimentos vivenciados pela mulher cega ao se tornar mãe; Descrever facilidades e dificuldades percebidas pela mulher cega ao exercer a maternidade; Discutir o processo de transição da maternidade na perspectiva da mulher cega, à luz da Teoria das Transições. Pesquisa qualitativa, descritiva, desenvolveu-se no município de Jequié (Bahia) em uma associação de cegos. Fizeram parte deste estudo 11 mulheres que já eram cegas ao vivenciarem a maternidade, contatadas através de um banco de dados da referida associação. Foi aprovada pelo Comitê de Ética em Pesquisa com seres humanos do Instituto Multidisciplinar em Saúde da Universidade Federal da Bahia e, somente, após parecer favorável deu-se início a coleta das narrativas. Um roteiro para caracterização das participantes foi aplicado. As informações foram coletadas por meio de entrevista aberta, utilizou o método Narrativa de vida. A análise dos dados obtidos ocorreu a partir da discussão sobre a maternidade da mulher cega conforme o referencial teórico da Teoria das Transições de Meleis, e sobre a categoria de análise que emergiu das narrativas de vida: Processo de transição da maternidade de mulheres cegas na perspectiva de Afaf Meleis e suas três subcategorias: Experiências vivenciadas pelas mulheres cegas ao se tornar mãe; Facilidades e dificuldades das mulheres cegas no contexto da maternidade e Terapêutica de enfermagem na transição da maternidade das mulheres cegas. Foram discutidas à luz da teoria das transições e com referenciais conceituais. As participantes alcançaram a maestria da transição saudável para a maternidade, foram resilientes diante das situações impostas pela vida, capazes de lidar com os problemas encontrados, adaptar-se às mudanças, superar os obstáculos e ao final reagir positivamente. Ao discutir o processo de transição da maternidade na perspectiva da mulher cega, à luz da Teoria das Transições, evidenciou-se que a contribuição da enfermagem no cuidado transicional é de extrema relevância para as mulheres cegas que desejam ser mãe. Foi possível identificar, a partir das narrativas de vida, os diversos momentos em que a enfermagem atuaria para atender às necessidades dessas mulheres e em quais momentos e situações o cuidado de enfermagem é essencial para o processo de transição para a maternidade das mulheres cegas. O direcionamento de um olhar mais apurado para as mulheres com deficiência nas comunidades atendidas e serviços de saúde utilizados pelas práticas de ensino e estágio supervisionado das universidades pode ser uma excelente oportunidade de se trabalhar a dupla vulnerabilidade nesses casos.

This study had as object the maternity of blind women, from the perspective of Afaf Meleis Theory of Transitions. As a general objective: To analyze the maternity of blind women in the perspective of Transition Theory; and specific: To understand how the blind woman experiences the process of transition to motherhood; Identify the feelings experienced by the blind woman when becoming a mother; To describe the facilities and difficulties perceived by the blind woman when exercising maternity; Discuss the transition process of motherhood from the perspective of blind women in the light of Transition Theory. Qualitative, descriptive research, it was developed in the municipality of Jequié (Bahia) in an association of the blind. This study included 11 women who were already blind when they experienced motherhood, contacted through a database of the association. It was approved by the Human Research Ethics Committee of the Multidisciplinary Health Institute of the Federal University of Bahia, and only after a favorable opinion did the collection of the narratives begin. A script for characterization of the participants was applied. The information was collected through an open interview, using the Narrative method of life. The analysis of the data obtained came from the discussion about the maternity of the blind woman according to the theoretical reference of the Theory of Transitions of Meleis, and about the category of analysis that emerged from the life narratives: Transition process of the maternity of blind women in perspective of Afaf Meleis and its three subcategories: Experiences experienced by blind women when becoming a mother; Facilities and difficulties of blind women in the context of maternity and Nursing Therapy in the transition of the maternity of blind women. They were discussed in the light of the theory of transitions and with conceptual references. The participants achieved the mastery of the healthy transition to motherhood, were resilient to the situations imposed by life, able to deal with the problems encountered, adapt to change, overcome obstacles and finally respond positively. In discussing the transition process of motherhood from the perspective of the blind woman, in light of the Theory of Transitions, it was shown that the contribution of nursing to transitional care is extremely relevant for blind women who wish to be a mother. It was possible to identify, from the life narratives, the different moments in which the nursing would act to attend the needs of these women and in what moments and situations the nursing care is essential for the process of transition to the maternity of the blind women. Directing a more accurate look at women with disabilities in the assisted communities and health services used by university teaching and supervised internships can be an excellent opportunity to work with dual vulnerability in these cases.

Este estudio tuvo como objeto la maternidad de mujeres ciegas, en la perspectiva de la Teoría de las Transiciones de Afaf Meleis. Como objetivo general: Analizar la maternidad de mujeres ciegas en la perspectiva de la Teoría de las Transiciones; y específicos: Comprender cómo la mujer ciega vive el proceso de transición a la maternidad; Identificar los sentimientos vivenciados por la mujer ciega al hacerse madre; Describir las facilidades y dificultades percibidas por la mujer ciega al ejercer la maternidad; Discutir el proceso de transición de la maternidad en la perspectiva de la mujer ciega, a la luz de la Teoría de las Transiciones. Investigación cualitativa, descriptiva, se desarrolló en el municipio de Jequié (Bahia) en una asociación de ciegos. En este estudio participaron 11 mujeres que ya eran ciegas al vivenciar la maternidad, contactadas a través de un banco de datos de dicha asociación. Fue aprobada por el Comité de Ética en Investigación con seres humanos del Instituto Multidisciplinario en Salud de la Universidad Federal de Bahía y, solamente, después de un dictamen favorable se dio inicio a la recolección de las narrativas. Se aplicó un itinerario para la caracterización de las participantes. La información fue recogida por medio de una entrevista abierta, utilizó el método Narrativa de vida. El análisis de los datos obtenidos ocurrió a partir de la discusión sobre la maternidad de la mujer ciega conforme al referencial teórico de la Teoría de las Transiciones de Meleis, y sobre la categoría de análisis que emergió de las narrativas de vida: Proceso de transición de la maternidad de mujeres ciegas en la perspectiva de Afaf Meleis y sus tres subcategorías: Experiencias vivenciadas por las mujeres ciegas al hacerse madre; Instalaciones y dificultades de las mujeres ciegas en el contexto de la maternidad y Terapéutica de enfermería en la transición de la maternidad de las mujeres ciegas. Se discutieron a la luz de la teoría de las transiciones y con referencias conceptuales. Las participantes alcanzaron la maestría de la transición sana para la maternidad, fueron resilientes ante las situaciones impuestas por la vida, capaces de lidiar con los problemas encontrados, adaptarse a los cambios, superar los obstáculos y al final reaccionar positivamente. Al discutir el proceso de transición de la maternidad en la perspectiva de la mujer ciega, a la luz de la Teoría de las Transiciones, se evidenció que la contribución de la enfermería en el cuidado transicional es de extrema relevancia para las mujeres ciegas que desean ser madre. Fue posible identificar, a partir de las narrativas de vida, los diversos momentos en que la enfermería actuaría para atender a las necesidades de esas mujeres y en cuáles momentos y situaciones el cuidado de enfermería es esencial para el proceso de transición hacia la maternidad de las mujeres ciegas. El direccionamiento de una mirada más apurada para las mujeres con discapacidad en las comunidades atendidas y servicios de salud utilizados por las prácticas de enseñanza y práctica supervisada de las universidades puede ser una excelente oportunidad de trabajar la doble vulnerabilidad en esos casos.

A maternidade de mulheres cegas: possíveis contribuições de enfermagem / The motherhood of blind women: possible nursing contributions / La maternidad de mujeres ciegas: posibles contribuciones de enfermería

Objetivo: identificar o estado da arte do contexto da maternidade de mulheres cegas. Método: revisão integrativa através de busca on-line de artigos indexados em periódicos do sítio Portal de Periódicos CAPES e da Biblioteca Virtual em Saúde, utilizando termos em Português e seus correspondentes em Inglês: mães e deficiência visual; mãe cega. Adotou-se como critérios de inclusão para a seleção: todos os artigos publicados entre 2000 e 2016, em Português e Inglês, disponíveis na íntegra, com enfoque na deficiência visual e maternidade. Resultados: a comunicação e interação mãe/filho são destacadas nos estudos examinados. Conclusão: a realização de estudos sobre mães cegas - seus anseios, suas experiências de vida com relação a elas mesmas e a seu novo papel social - pode fortalecer e aprimorar o cuidado em saúde e indicar para quais aspectos a enfermagem pode efetivamente direcionar o cuidado em saúde.

Objective: to identify the state of the art of the maternity context of blind women. Method: This integrative literature review was conducted by an online search for articles indexed in CAPES Journal Portal and the Virtual Health Library, using the terms in Portuguese and their correspondent in English: mothers and visual impairement; blind mother. The inclusion criteria were: all articles published between 2000 and 2016, in Portuguese and English, with full text available, focusing on visual impairment and maternity. Results: the examined studies highlighted mother/child communication and interaction as the main concern. Conclusion: the studies of blind mothers - their longings, their life experiences regarding themselves and their new social role - can strengthen and improve health care and indicate to which issues the nursing can effectively direct the health care.

Objetivo: identificar el estado del arte del contexto de maternidad de las mujeres ciegas. Método: revisión integradora de literatura llevada a cabo mediante una búsqueda en línea de artículos indexados en el Portal de Peiodicos CAPES y en la Biblioteca Virtual de Salud, utilizando los términos en portugués y su corresponsal en inglés: madres y discapacidad visual; madre ciega Los criterios de inclusión fueron: todos los artículos publicados entre 2000 y 2016, en portugués e inglés, con texto completo disponible, centrado en la discapacidad visual y la maternidad. Resultados: los estudios examinados destacaron la comunicación e interacción madre / hijo como la principal preocupación. Conclusión: los estudios de madres ciegas (sus anhelos, sus experiencias de vida con respecto a sí mismos y su nueva función social) pueden fortalecer y mejorar la atención en salud e indicar a qué temas la enfermería puede dirigir efectivamente la atención en salud.