International journal of food, nutrition and public health, Jun 15, 2016
Objetiva-se identificar na literatura os fatores, representações e efeitos da Síndrome de Burnout... more Objetiva-se identificar na literatura os fatores, representações e efeitos da Síndrome de Burnout em profissionais de enfermagem hospitalar. Trata-se de uma revisão de literatura. Foram incluídos artigos em português relacionados à temática, publicados no período de 2010 a 2020, encontrados nas bases Scientific Electronic Library Online (SCIELO), Biblioteca Virtual em Saúde (BVS) e Portal de Busca Integrada/USP (PBI), utilizando como descritores: Burnout, Enfermagem e Psicologia. Verificou-se como principais potencializadores da SB em profissionais de enfermagem a sobrecarga de trabalho, situações críticas de assistência ao paciente, falta de estrutura hospitalar, cobrança de grupo e pessoal, falta de material, relacionamento crítico entre colegas de trabalho e falta de reconhecimento. Quanto às implicações do Burnout na qualidade de vida desses profissionais, constatou-se impactos físicos como apneia do sono, distúrbios no sistema nervoso, dores no corpo, crises de enxaqueca, náuseas, taquicardia e cefaleia. Sensação de cansaço extremo, angústia, estresse, distanciamento das pessoas, frustação, autocobrança, tensão, sentimentos depreciativos e despersonalização. As sugestões de intervenções e prevenção a SB, estão associadas a um acompanhamento psicoterapêutico, ginastica laboral, cartilha conscientizando sobre o estresse, realização de atividades físicas e de hábitos simples como: pensamentos mais positivos, horas de lazer e leitura. Em suma, os fatores potencializadores e as implicações da SB, podem impactar na realização dos cuidados aos pacientes. Para os profissionais, as consequências psicossociais tornam a SB uma síndrome psicológica que traz consigo problemas físicos que interferem na qualidade de vida dos profissionais da enfermagem, tornando-se necessário a realização de estratégias de enfrentamento.
Aqueous solutions of poly(ethylene glycol) (PEG) exhibit some remarkable properties, among which ... more Aqueous solutions of poly(ethylene glycol) (PEG) exhibit some remarkable properties, among which is the small changes in water activity compared to the volumes occupied by the PEG: For example, the water in a 20% mass fraction solution of 6000 Da PEG has an activity of 0.9939. We have investigated PEGs with molecular weights 200, 400, 1000, 2000, 4000, and 8000 Da in the concentration range 1% to 17% mass fraction at neutral pH and with added KCl concentrations of 10 mmol L À1 in aqueous solutionseconditions near those for promoting protein crystallization. These solutions exhibit a structural change at around 6% mass fraction as seen in the solution viscosities, compressibilities, and infrared spectra. Raman spectroscopy shows that the PEGs remain in the same structural form over the concentration range, and the infrared spectra indicate that the change must be due to a local shift in the water structure. Modeling of the results from small-angle neutron scattering (SANS) on the solutions suggests that the structures of the PEGs in the molecular mass range 2000 Da to 8000 Da are paired in the solution, and the separation distance decreases with increasing PEG concentration. From the structure, it becomes clear that the small effect on water activity occurs because of screening by the more weakly bound outer layers. From the bulk measurement of a w and with reasonable assumptions, a free energy DG can be assigned to each of the fourth, third, and second hydration layers.
Alanine aminotransferase (ALT) is a hepatic enzyme that could be used as markers of hepatocellula... more Alanine aminotransferase (ALT) is a hepatic enzyme that could be used as markers of hepatocellular injury. Liver enzyme elevations are frequent in human immune deficiency virus (HIV)-infected patients which may be caused by the HIV virus in those without other risk factors for liver damage. This study was designed to evaluate the correlation between HIV viral load and serum levels of ALT, a marker of hepatic damage. This was a cross-sectional analytic study performed among HIV infected naive patients without other risk factor for liver disease. The results of the study shows that of the 166 participants recruited into this study, 104 (62.7%) were females. The participants' mean CD4 count was 180.04 ± 38.08 (95% confidence interval (CI), 164.11 to 195.96). The mean viral load log 10 (copies/ml) was 5.18 ± 4.28, and ALT (UI/L) was 24.80 ± 1.29 (95% CI, 22.26 to 27.35). Sixty (36.2%) of the studied participants had high viral load ≥ 100,000 copies/ml, while 22 (13.3%) had high ALT (≥ 40 IU/L). A positive correlation (Pearson correlation coefficient, r = 0.274, P = 0.000) between HIV viral load and ALT was observed. After adjusting for age, sex and CD4 count in a multivariable linear regression model, the correlation between HIV viral load and ALT remained significant (p = 0.003). The finding of positive correlation between HIV viral load and ALT levels in HIV infected naive patients suggests a linear relation between ALT level and HIV-1 viral load in HIV patients without other risk factor for liver damage. We recommend evaluating patients with high ALT for early anti-retroviral therapy (ART) in those without risk factor for liver damage regardless of the CD4+ cell count, especially where facility for estimating viral load is not available.
The use of Inactivated Polio Vaccine (IPV) in routine immunization to replace Oral Polio Vaccine ... more The use of Inactivated Polio Vaccine (IPV) in routine immunization to replace Oral Polio Vaccine (OPV) is crucial in eradicating polio. In June 2014, Nigeria launched an IPV campaign in the conflict-affected states of Borno and Yobe, the largest ever implemented in Africa. We present the initiatives and lessons learned. The 8-day event involved two parallel campaigns. OPV target age was 0-59 months, while IPV targeted all children aged 14 weeks to 59 months. The Borno state primary health care agency set up temporary health camps for the exercise and treated minor ailments for all. The target population for the OPV campaign was 685 674 children in Borno and 113 774 in Yobe. The IPV target population for Borno was 608 964 and for Yobe 111 570. OPV coverage was 105.1 per cent for Borno and 103.3 per cent for Yobe. IPV coverage was 102.9 per cent for Borno and 99.1 per cent for Yobe. (Where we describe coverage as greater than 100 per cent, this reflects original underestimates of the target populations.) A successful campaign and IPV immunization is viable in conflict areas.
Background: Nigeria was polio free for almost 2 years but, with the recent liberation of areas un... more Background: Nigeria was polio free for almost 2 years but, with the recent liberation of areas under the captivity of insurgents, there has been a resurgence of polio cases. For several years, these inaccessible areas did not have access to vaccination due to activities of Bokoharam, resulting in a concentration of a cohort of unvaccinated children that served as a polio sanctuary. This article describes the processes of engagement of security personnel to access security-compromised areas and the impact on immunization outcomes. Methods: We assessed routine program data from January 2016 to July 2016 in security-inaccessible areas and we evaluated the effectiveness of engaging security personnel to improve access to settlements in securitycompromised Local Government Areas (LGAs) of Borno state. We thereafter evaluated the effects of this engagement on postcampaign evaluation indicators. Results: From 15 LGAs accessible to vaccination teams in January 2016, there was a 47% increase in July 2016. The number of wards increased from 131 in January to 162 in July 2016, while the settlement numbers increased from 6050 in January to 6548 in July 2016. The average percentage of missed children decreased from 8% in January to 3% in July 2016, while the number of LGAs with ≥ 80% coverage increased from 85% in January to 100% in July 2016. Conclusion: The engagement of security personnel in immunization activities led to an improved access and improvement in postcampaign evaluation indicators in security-compromised areas of a Nigerian state. This approach promises to be an impactful innovation in reaching settlements in security-compromised areas.
The use of Inactivated Polio Vaccine (IPV) in routine immunization to replace Oral Polio Vaccine ... more The use of Inactivated Polio Vaccine (IPV) in routine immunization to replace Oral Polio Vaccine (OPV) is crucial in eradicating polio. In June 2014, Nigeria launched an IPV campaign in the conflict-affected states of Borno and Yobe, the largest ever implemented in Africa. We present the initiatives and lessons learned. The 8-day event involved two parallel campaigns. OPV target age was 0-59 months, while IPV targeted all children aged 14 weeks to 59 months. The Borno state primary health care agency set up temporary health camps for the exercise and treated minor ailments for all. The target population for the OPV campaign was 685 674 children in Borno and 113 774 in Yobe. The IPV target population for Borno was 608 964 and for Yobe 111 570. OPV coverage was 105.1 per cent for Borno and 103.3 per cent for Yobe. IPV coverage was 102.9 per cent for Borno and 99.1 per cent for Yobe. (Where we describe coverage as greater than 100 per cent, this reflects original underestimates of the target populations.) A successful campaign and IPV immunization is viable in conflict areas.Journal of Public Health Policy advance online publication, 5 November 2015; doi:10.1057/jphp.2015.34.
International journal of food, nutrition and public health, Jun 15, 2016
Objetiva-se identificar na literatura os fatores, representações e efeitos da Síndrome de Burnout... more Objetiva-se identificar na literatura os fatores, representações e efeitos da Síndrome de Burnout em profissionais de enfermagem hospitalar. Trata-se de uma revisão de literatura. Foram incluídos artigos em português relacionados à temática, publicados no período de 2010 a 2020, encontrados nas bases Scientific Electronic Library Online (SCIELO), Biblioteca Virtual em Saúde (BVS) e Portal de Busca Integrada/USP (PBI), utilizando como descritores: Burnout, Enfermagem e Psicologia. Verificou-se como principais potencializadores da SB em profissionais de enfermagem a sobrecarga de trabalho, situações críticas de assistência ao paciente, falta de estrutura hospitalar, cobrança de grupo e pessoal, falta de material, relacionamento crítico entre colegas de trabalho e falta de reconhecimento. Quanto às implicações do Burnout na qualidade de vida desses profissionais, constatou-se impactos físicos como apneia do sono, distúrbios no sistema nervoso, dores no corpo, crises de enxaqueca, náuseas, taquicardia e cefaleia. Sensação de cansaço extremo, angústia, estresse, distanciamento das pessoas, frustação, autocobrança, tensão, sentimentos depreciativos e despersonalização. As sugestões de intervenções e prevenção a SB, estão associadas a um acompanhamento psicoterapêutico, ginastica laboral, cartilha conscientizando sobre o estresse, realização de atividades físicas e de hábitos simples como: pensamentos mais positivos, horas de lazer e leitura. Em suma, os fatores potencializadores e as implicações da SB, podem impactar na realização dos cuidados aos pacientes. Para os profissionais, as consequências psicossociais tornam a SB uma síndrome psicológica que traz consigo problemas físicos que interferem na qualidade de vida dos profissionais da enfermagem, tornando-se necessário a realização de estratégias de enfrentamento.
Aqueous solutions of poly(ethylene glycol) (PEG) exhibit some remarkable properties, among which ... more Aqueous solutions of poly(ethylene glycol) (PEG) exhibit some remarkable properties, among which is the small changes in water activity compared to the volumes occupied by the PEG: For example, the water in a 20% mass fraction solution of 6000 Da PEG has an activity of 0.9939. We have investigated PEGs with molecular weights 200, 400, 1000, 2000, 4000, and 8000 Da in the concentration range 1% to 17% mass fraction at neutral pH and with added KCl concentrations of 10 mmol L À1 in aqueous solutionseconditions near those for promoting protein crystallization. These solutions exhibit a structural change at around 6% mass fraction as seen in the solution viscosities, compressibilities, and infrared spectra. Raman spectroscopy shows that the PEGs remain in the same structural form over the concentration range, and the infrared spectra indicate that the change must be due to a local shift in the water structure. Modeling of the results from small-angle neutron scattering (SANS) on the solutions suggests that the structures of the PEGs in the molecular mass range 2000 Da to 8000 Da are paired in the solution, and the separation distance decreases with increasing PEG concentration. From the structure, it becomes clear that the small effect on water activity occurs because of screening by the more weakly bound outer layers. From the bulk measurement of a w and with reasonable assumptions, a free energy DG can be assigned to each of the fourth, third, and second hydration layers.
Alanine aminotransferase (ALT) is a hepatic enzyme that could be used as markers of hepatocellula... more Alanine aminotransferase (ALT) is a hepatic enzyme that could be used as markers of hepatocellular injury. Liver enzyme elevations are frequent in human immune deficiency virus (HIV)-infected patients which may be caused by the HIV virus in those without other risk factors for liver damage. This study was designed to evaluate the correlation between HIV viral load and serum levels of ALT, a marker of hepatic damage. This was a cross-sectional analytic study performed among HIV infected naive patients without other risk factor for liver disease. The results of the study shows that of the 166 participants recruited into this study, 104 (62.7%) were females. The participants' mean CD4 count was 180.04 ± 38.08 (95% confidence interval (CI), 164.11 to 195.96). The mean viral load log 10 (copies/ml) was 5.18 ± 4.28, and ALT (UI/L) was 24.80 ± 1.29 (95% CI, 22.26 to 27.35). Sixty (36.2%) of the studied participants had high viral load ≥ 100,000 copies/ml, while 22 (13.3%) had high ALT (≥ 40 IU/L). A positive correlation (Pearson correlation coefficient, r = 0.274, P = 0.000) between HIV viral load and ALT was observed. After adjusting for age, sex and CD4 count in a multivariable linear regression model, the correlation between HIV viral load and ALT remained significant (p = 0.003). The finding of positive correlation between HIV viral load and ALT levels in HIV infected naive patients suggests a linear relation between ALT level and HIV-1 viral load in HIV patients without other risk factor for liver damage. We recommend evaluating patients with high ALT for early anti-retroviral therapy (ART) in those without risk factor for liver damage regardless of the CD4+ cell count, especially where facility for estimating viral load is not available.
The use of Inactivated Polio Vaccine (IPV) in routine immunization to replace Oral Polio Vaccine ... more The use of Inactivated Polio Vaccine (IPV) in routine immunization to replace Oral Polio Vaccine (OPV) is crucial in eradicating polio. In June 2014, Nigeria launched an IPV campaign in the conflict-affected states of Borno and Yobe, the largest ever implemented in Africa. We present the initiatives and lessons learned. The 8-day event involved two parallel campaigns. OPV target age was 0-59 months, while IPV targeted all children aged 14 weeks to 59 months. The Borno state primary health care agency set up temporary health camps for the exercise and treated minor ailments for all. The target population for the OPV campaign was 685 674 children in Borno and 113 774 in Yobe. The IPV target population for Borno was 608 964 and for Yobe 111 570. OPV coverage was 105.1 per cent for Borno and 103.3 per cent for Yobe. IPV coverage was 102.9 per cent for Borno and 99.1 per cent for Yobe. (Where we describe coverage as greater than 100 per cent, this reflects original underestimates of the target populations.) A successful campaign and IPV immunization is viable in conflict areas.
Background: Nigeria was polio free for almost 2 years but, with the recent liberation of areas un... more Background: Nigeria was polio free for almost 2 years but, with the recent liberation of areas under the captivity of insurgents, there has been a resurgence of polio cases. For several years, these inaccessible areas did not have access to vaccination due to activities of Bokoharam, resulting in a concentration of a cohort of unvaccinated children that served as a polio sanctuary. This article describes the processes of engagement of security personnel to access security-compromised areas and the impact on immunization outcomes. Methods: We assessed routine program data from January 2016 to July 2016 in security-inaccessible areas and we evaluated the effectiveness of engaging security personnel to improve access to settlements in securitycompromised Local Government Areas (LGAs) of Borno state. We thereafter evaluated the effects of this engagement on postcampaign evaluation indicators. Results: From 15 LGAs accessible to vaccination teams in January 2016, there was a 47% increase in July 2016. The number of wards increased from 131 in January to 162 in July 2016, while the settlement numbers increased from 6050 in January to 6548 in July 2016. The average percentage of missed children decreased from 8% in January to 3% in July 2016, while the number of LGAs with ≥ 80% coverage increased from 85% in January to 100% in July 2016. Conclusion: The engagement of security personnel in immunization activities led to an improved access and improvement in postcampaign evaluation indicators in security-compromised areas of a Nigerian state. This approach promises to be an impactful innovation in reaching settlements in security-compromised areas.
The use of Inactivated Polio Vaccine (IPV) in routine immunization to replace Oral Polio Vaccine ... more The use of Inactivated Polio Vaccine (IPV) in routine immunization to replace Oral Polio Vaccine (OPV) is crucial in eradicating polio. In June 2014, Nigeria launched an IPV campaign in the conflict-affected states of Borno and Yobe, the largest ever implemented in Africa. We present the initiatives and lessons learned. The 8-day event involved two parallel campaigns. OPV target age was 0-59 months, while IPV targeted all children aged 14 weeks to 59 months. The Borno state primary health care agency set up temporary health camps for the exercise and treated minor ailments for all. The target population for the OPV campaign was 685 674 children in Borno and 113 774 in Yobe. The IPV target population for Borno was 608 964 and for Yobe 111 570. OPV coverage was 105.1 per cent for Borno and 103.3 per cent for Yobe. IPV coverage was 102.9 per cent for Borno and 99.1 per cent for Yobe. (Where we describe coverage as greater than 100 per cent, this reflects original underestimates of the target populations.) A successful campaign and IPV immunization is viable in conflict areas.Journal of Public Health Policy advance online publication, 5 November 2015; doi:10.1057/jphp.2015.34.
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