Ampliando vozes sobre violência obstétrica: recomendações de advocacy para enfermeira(o) obstetra / Expandiendo las voces sobre la violencia obstétrica: recomendaciones para la advocacy por enfermera(o) obstetra / Amplifying voices on obstetric violence: recommendations for advocacy by an obstetric nurse

Resumo Objetivos explorar as demandas das mulheres, bem como do público em geral, para melhorar a qualidade da assistência obstétrica; discutir as mudanças potenciais sugeridas pelos respondentes para tal prática assistencial. Método pesquisa multicêntrica realizada por meio da plataforma Opinio, explorando opiniões dos participantes de três cidades da região Sudeste do Brasil. Tratamento dos dados por estatística descritiva e análise temática. Resultados respondentes (n=414) na faixa etária 33-37 anos (26%), incluindo mulheres (75%) com mais de 15 anos de escolaridade, casadas (45%) e com um filho (35%), revelaram lacuna de conhecimentos sobre a violência obstétrica e os direitos da mulher. Jornal, rádio e televisão são as principais fontes de informação. O enfrentamento da violência obstétrica dar-se-ia por apoio familiar. Para a práxis renovada sugeriu-se a educação coletiva sobre direitos aos cuidados obstétricos (53,1%) e o atendimento humanizado (38,2%) mobilizando o poder profissional para consolidar a humanização. Temas analíticos centrais incluíram situação vivenciada pelas mulheres e contexto idealizado de prática. Conclusão e Implicações para a prática o debate incrementa a humanização e a governança compartilhada. Recomendações propostas para advocacy coadunam com a perspectiva global da promoção de saúde das mulheres e liderança social.

Resumen Objetivos explorar las demandas de las mujeres, así como del público en general, para mejorar la calidad de la atención obstétrica; Discutir los posibles cambios sugeridos por los encuestados para esta práctica de cuidado y, Proponer recomendaciones para la promoción por la enfermera en cuestiones de violencia obstétrica. Método investigación multicéntrica realizada a través de la plataforma Opinio, explorando las opiniones de los participantes de tres ciudades en el sureste de Brasil. Tratamiento de datos mediante estadísticas descriptivas y análisis temáticos. Resultados demandados (n-414) de 33 a 37 años (26%) incluyendo mujeres (75%) con más de 15 años de escolarización, casado (45%) y con un niño (35%) reveló una brecha de conocimiento sobre la violencia obstétrica y los derechos de las mujeres. El periódico, la radio y la televisión son las principales fuentes de información. La confrontación se basaría en el apoyo de la familia. Para la renovada praxis, se sugirió la educación colectiva sobre los derechos de atención obstétrica (53,1%) y la atención humanizada (38,2%) movilizar el poder profesional para consolidar la humanización. Los temas analíticos centrales incluyeron una situación experimentada por las mujeres y un contexto idealizado de práctica. Conclusión e implicaciones para la práctica el debate aumenta la humanización y la gobernanza compartida. Las recomendaciones propuestas para la promoción son coherentes con la perspectiva mundial de la promoción de la salud y el liderazgo social de las mujeres.

Abstract Objectives Explore women's and the general public's demands to improve the quality of obstetric care. Discuss respondents' suggestions to improve obstetric care, and propose recommendations for nursing advocacy in matters of obstetric violence. Method A multi-site online survey (in three cities in Brazil's southeastern region) hosted by Opinio platform exploring the respondents' opinions. Data was analyzed by descriptive statistics and thematic analysis. Results Respondents (n=414) aged 33-37 years (26%), including women (75%) with more than 15 years of schooling, who are married (45%) and with one child (35%), demonstrated a knowledge gap on obstetric violence and women's rights. Newspapers, radio, and television were cited as the main sources of information. Family support was a suggested strategy to deal with obstetric violence. For the renewed praxis, collective education on obstetric care rights (53.1%) and humanized care (38.2%) were suggested to mobilize professional power to consolidate humanization in care. Central analytical themes included situations faced by women and an idealized context of practice. Conclusion and implications for practice Discussion in organizations increases humanization and shared governance. Recommendations proposed for advocacy are consistent with the global perspective of women's health promotion and social leadership.

Can microcomputed tomography measure retrieved polyethylene wear? Comparing fixed-bearing and rotating-platform knees.

BACKGROUND: Wear of total knee polyethylene has been quantified gravimetrically with thickness measurements and evaluation of surface wear modes. However, these techniques do not localize volumetric wear. QUESTIONS/PURPOSES: We used micro-CT scans of retrieved total knee liners and unworn, new liners to determine the volume and location of wear. METHODS: We retrieved 12 fixed and 12 rotating-platform bearings after a mean 52 months of use. Inserts were weighed and thickness was measured. Micro-CT scans of retrieved and matched new liners were superimposed to compare the location and magnitude of wear. RESULTS: The average total wear was 254 ± 248 mm(3). The average wear rate was 58 ± 41 mm(3)/year. Wear was 69% of penetration, demonstrating the contribution of deformation to knee wear. Rotating-platform wear rate was 43 ± 25 mm(3)/year and the fixed-bearing rate was 74 ± 49 mm(3)/year. Five percent of the rotating-platform wear rate came from the backside compared with 14% of the fixed-bearing wear rate. CONCLUSIONS: Micro-CT can determine the volume and location of wear of retrieved tibial liners. Because the magnitude of the manufacturing tolerances was approximately half the magnitude of the total wear on average, accounting for the potential influence of tolerances is important to accurately measure volumetric wear if the unworn (preimplantation) geometry of the insert is unknown. Without accounting for tolerances, this technique may not be applicable for retrievals with a short followup that have low wear. However, application of micro-CT could be of value in determining the exact location of wear in knee simulator studies in which the same insert is measured repeatedly and manufacturing tolerances are not a concern.

Analysis of wear in retrieved mobile and fixed bearing knee inserts.

One purported advantage for mobile bearing (MB) knee implants is reduced polyethylene wear. Twenty-three retrieved Low Contact Stress (LCS) MB and 31 Anatomic Modular Knee (AMK) fixed bearing tibial polyethylene inserts, both Enduron (Depuy, Warsaw, IN) and sterilized by gas plasma, were graded for top and backside wear using the Hood grading system. For articular surface wear, there was no statistical difference between pitting and scratching, but burnishing was twice as much for MB inserts (P = .003). For backside scores, there was a minimal amount of pitting for both, but the scratching score was twice (P = .000) and the burnishing score was 3 times greater for MB inserts (P = .000). At more than 5 years in situ, the linear wear measurements were similar for the 2 groups (mean penetration was 0.329 mm for MB and 0.320 mm for fixed bearing).

Cross-Reactive Sensor Array for Metal Ion Sensing Based on Fluorescent SAMs.

Fluorescent self assembled monolayers (SAMs) on glass were previouslydeveloped in our group as new sensing materials for metal ions. These fluorescent SAMs arecomprised by fluorophores and small molecules sequentially deposited on a monolayer onglass. The preorganization provided by the surface avoids the need for complex receptordesign, allowing for a combinatorial approach to sensing systems based on small molecules.Now we show the fabrication of an effective microarray for the screening of metal ions andthe properties of the sensing SAMs. A collection of fluorescent sensing SAMs wasgenerated by combinatorial methods and immobilized on the glass surfaces of a custom-made 140 well microtiter-plate. The resulting libraries are easily measured and show variedresponses to a series cations such as Cu2+ , Co2+ , Pb2+ , Ca2+ and Zn2+ . These surfaces are notdesigned to complex selectively a unique analyte but rather they are intended to producefingerprint type responses to a range of analytes by less specific interactions. The unselectiveresponses of the library to the presence of different cations generate a characteristic patternfor each analyte, a "finger print" response.

A simple approach to sensor discovery and fabrication on self-assembled monolayers on glass.

Self-assembled monolayers (SAMs) on glass were used as a platform to sequentially deposit fluorophores and small molecules for ion sensing. The preorganization provided by the surface avoids the need for complex receptor design, allowing for a combinatorial approach to sensing systems based on small molecules. The resulting libraries are easily measured and show varied responses to a series of both cations and anions. This technology is transferable from the macro- to the microscale both via microcontact printing (microCP), where the fluorophore is printed onto a glass surface, and via direct attachment of the fluorophore to microchannel walls. The ease of miniaturization of this technology may make the generation of a wide variety of simple yet efficient microarrays possible.