[The deinstitutionalization process]. / Algumas considerações sobre o processo de desinstitucionalização.

This study develops some considerations about the deinstitutionalization process considering the conception and stigma of madness, and the difficulties to reverse it in society as it was constructed through history. Authors analyse the consolidation of the necessary infrastructure to this process, making direct relations with all social subjects and policy determination.

[Psychiatric nursing research: concepts and expectations of nurses in psychiatric institutions]. / Pesquisa em enfermagem psiquiátrica: concepções e expectativas de enfermeiros que atuam em instituições psiquiátricas.

This research has as objects of study the conceptions and expectations of the clinical nurses in psychiatric institutions about the research developed in this area. It has the purpose to identify conceptions and expectations, enabling the identification of the process of dissemination and utilization of the research in the attention and administration of psychiatric nursing care. It was developed with nurses that work in psychiatric institutions at Salvador, in March, 1997. 25 nurses who worked in the period were interviewed expressing their opinions concerning the theme in study, through semi-structured interview. Results were quantitatively analysed, based on the theoretical-methodological design of the Social Representations. It was possible to conclude that the great part of the nurses interviewed mentioned that they did not have access to research in this area, as well as demonstrated difficulty of find the relations and influence of these research in their service, however they admit its importance to personal and professional development, that certainly, reflects on nursing care.

Hip fracture prognosis: could bioimpedance be an alternative to conventional nutritional assessment?

BACKGROUND: Risk-factors for mortality in hip fractures encompass nutritional status, nominally body mass index, but not body composition. Given the difficulty of anthropometric assessment in bedridden patients a prospective study with bioimpedance analysis was designed. METHODS: Elderly patients with hip fracture were consecutively recruited. Biochemical tests, primitive bioimpedance measurements (resistance, reactance and phase angle) and follow-up till one year were targeted. RESULTS: Patients (N = 69, 81.2 ± 8.1 years old, 72.5% females) stayed in the hospital for 15.5 ± 17.1 days, and 18.8% (13/69) required further hospitalization during the ensuing months. Mortality was 11.6% within 30 days, coinciding with hospital mortality, and an additional 11.6% till one year, thus reaching 23.2%. Anemia, hypoalbuminemia and low transferrin, along with elevated glucose and urea were frequent, suggesting undernutrition with metabolic derangements. Reactance, urea and creatinine were different in patients suffering both early and late demise. Resistance, white blood cell count and osteoporosis were risk factors for early mortality only , and anemia exclusively for late mortality. CONCLUSIONS: Primitive bioimpedance measurements, which had not been hitherto investigated , were prognostically related to early and late mortality. These markers of disease-related malnutrition and especially reactance should be further studied in patients unfit for anthropometric evaluation due to fracture and immobility.