Hospital waste: can we reduce the environmental impact of a large university hospital?

Introduction: As technology advances, society must reflect on the destination of materials which are no longer needed. Hospital waste requires special attention due to the associated risk of disease transmission and biological accidents. Also, it tends to increase proportionally to the economic development and is associated with increased use of disposable material. The purpose of this study is to analyze the management of hospital waste at the Hospital de Clínicas de Porto Alegre (HCPA) and to evaluate the effectiveness and feasibility of the measures adopted by the institution to mitigate the impact of its waste on the environment. Methods: Observational study with field research. Hospital waste management is divided into generation, disposal, storage and final destination. Results: Between 2010 and 2015, the HCPA produced 21.4 tons of biological and sharps waste, 23,000 liters of chemical waste and 113,9 tons of solid waste per month. The main improvements include the implementation of a inspection of the hospital's waste bins every 2 months, a reduction from 29.42% to 2.79% in the rate of inappropriate disposal of hazardous waste, a 313% increase in investments in staff training, the expansion and adaptation of external areas for temporary storage of hospital waste and the collection of more than 1 ton of waste generated by the local community (sharps, X-ray films, kitchen oil, batteries), as well as the establishment of contracts which will guarantee the appropriate treatment of all types of health care waste. Conclusions: These results demonstrate that mitigating the impact of hospital waste on the environment is possible and should encourage the adoption of similar measures at other institutions (AU)

Compreensão psicodinâmica do ciclo vital de Daenerys Targaryen, personagem da série Game of Thrones / Psychodynamic understanding of "Daenerys Targaryen's" life cycle, character from the series "Game of Thrones"

Este artigo analisa os aspectos psicológicos da personagem Daenerys Targaryen, da série Game of thrones, buscando essencialmente avaliar sua evolução cognitiva, social e comportamental, bem como os conflitos vivenciados em seu ciclo vital e os respectivos mecanismos de enfrentamento das adversidades. Por meio da interpretação subjetiva das simbologias metafóricas citadas na narrativa, extrapola-se a leitura literal da obra, com vistas a compreender também as representações da esfera inconsciente da personagem. Daenerys tem infância conturbada pela morte dos pais, pela fuga da cidade natal, pelo exílio e pelos maus-tratos cometidos pelo irmão. Ademais, são-lhe impostos casamento e erotização precoces, eventos que desrespeitam seu tempo de amadurecimento psíquico, desencadeando encurtamento das fases do seu ciclo vital e desestabilização do processo de latência e desenvolvimento puberal. Contudo, as experiências que vivencia no período, tais quais a gestação e a emancipação por que passa, associadas a variantes inatas da sua personalidade - a exemplo do temperamento dócil, inteligência e autoconfiança na capacidade de resolução de vicissitudes -, permitem a expressão de uma figura icônica de resiliência, com ativação de defesas maduras frente a crises vitais ou acidentais. O estudo permitiu discutir aspectos da realidade contemporânea do desenvolvimento humano e proceder à observação de diversos mecanismos de funcionamento psíquico, além da interação entre variantes intrínsecas e extrínsecas moduladoras da expressão de resiliência frente às dificuldades. Este artigo visa a contribuir para o estudo da teoria psicodinâmica e deve interessar a profissionais da medicina e da psicologia.(AU)

This article analyzes the psychological aspects of character Daenerys Targaryen, from Game of Thrones' series, seeking essentially to evaluate her cognitive, social and behavioral evolution, as well as the conflicts experienced to each stage of her life cycle and related adversity coping mechanisms. Through subjective interpretation of metaphoric symbols mentioned in the narrative, the literal reading of the story is extrapolated in order to also comprehend representations of the character's unconscious domain. Daenerys goes through a troubled childhood due to her parents' death, fleeing from her home city, exile and mistreatment committed by her brother. Furthermore, events like marriage and early erotization are imposed to her, which disrespect her psychic development timing, causing shortening of her life cycle's stages, and destabilization of the latency phase process and her pubertal development. Nevertheless, the experiences she goes through in this period, such as pregnancy and emancipation, associated to innate variants of her personality - docile temperament, high cognition and self-confidence in the ability of resolving difficulties -, allow the expression of a resilient iconic figure, with the activation of mature defenses when facing vital or accidental crises. The study allows transpositions to contemporaneous reality of human development and observation of several mechanisms of psychic functions, besides the interaction between intrinsic and extrinsic variants, which modulate the expression of resilience when confronting distress. It contributes to the study of psychodynamic theory and may be of interest to doctors and psychologists, especially those directly involved in psychic development.(AU)