bluuebunny/crossref_metadata_2025_split huggingface dataset:
Os efeitos do racismo na autoestima da mulher negra
Authors: Queiroz Rafaele Cristina De Souza 
Published: November 2019

O racismo em relação a estética negra e a estrutura do cabelo negro crespo/cacheado tem impactos negativos na autoestima da mulher negra. Trata-se neste estudo dos efeitos do racismo na autoestima da mulher negra no que se diz a recusa do cabelo natural e as saídas para se enquadrar num padrão estético racista. Foi realizado um estudo de natureza bibliográfica onde se tem a predominância para a discussão as reflexões de Nilma Gomes, para melhor interpretação dos termos e conceitos apresentados na pesquisa. O trabalho em questão é parte de uma etnografia realizada no Instituto de Promoção Humana e Desenvolvimento Social e Cultural Encrespa Geral Encrespa o qual realiza ações em todo Brasil, e o desta etnografia é o Encrespa Geral Manaus, que realiza atividades voltadas para a valorização da estética negra e em grupos nas mídias sociais e com mulheres negras fora dessas esferas. Conta também com uma pesquisa quanti/qualitativa aplicada dentro dos grupos de mídias sociaisOs efeitos do racismo na autoestima da mulher negra[i]RESUMOO racismo em relação a estética negra e a estrutura do cabelo negro crespo/cacheado tem impactos negativos na autoestima da mulher negra. Trata-se neste estudo dos efeitos do racismo na autoestima da mulher negra no que se diz a recusa do cabelo natural e as saídas para se enquadrar num padrão estético racista. Foi realizado um estudo de natureza bibliográfica onde se tem a predominância para a discussão as reflexões de Nilma Gomes, para melhor interpretação dos termos e conceitos apresentados na pesquisa. O trabalho em questão é parte de uma etnografia realizada no Instituto de Promoção Humana e Desenvolvimento Social e Cultural Encrespa Geral Encrespa o qual realiza ações em todo Brasil, e o desta etnografia é o Encrespa Geral Manaus, que realiza atividades voltadas para a valorização da estética negra e em grupos nas mídias sociais e com mulheres negras fora dessas esferas. Conta também com uma pesquisa quanti/qualitativa aplicada dentro dos grupos de mídias sociais PALAVRAS-CHAVE: Cabelo Crespo. Racismo. Identidade Negra. Autoestima. Ressignificação.[i] O presente trabalho foi realizado com o apoio da Universidade Federal do Amazonas-UFAM por meio do Programa Institucional de Bolsas de Iniciação Científica (PIBIC)
Figurino de cinema e imagem feminina
Authors: Alba Nery de Mello Buest Andreana , Gomes de Carvalho Marilia 
Published: November 2019

Marlene Dietrich, Greta Garbo, Joan Crawford e Rita Hayworth. Símbolos do cinema, representantes da estratégia de penetração ideológica do "american way of life", discurso sóciocultural globalizante da indústria cinematográfica de Hollywood. Veiculo dos fazeres globais, da visão de mundo norte-americana, impondo aos saberes locais seu estilo de vida e reafirmando sua política de intervenção. O artigo enfoca a supervalorização de características físicas femininas na construção de sua imagem cinematográfica. A análise semiótica, fenomenológica e os estudos de gênero foram as perspectivas utilizadas para demonstrar as influências do uso do figurino como sistema de signos.
Les épreuves corporelles des bouchers et des bouchères
Authors: Zinn Isabelle 
Published: November 2019

Cet article aborde les épreuves corporelles des professionnel·le·s de la branche carnée en Suisse d’un point de vue du genre et analyse les places assignées aux femmes et aux hommes dans ce secteur. La posture de l’auteure est de ne pas imposer de lecture genre a priori à son terrain, mais sa propre expérience d’ethnographe-femme dans ce milieu masculin a mis en évidence la mobilisation récurrente de la catégorie de sexe comme variable explicative, en particulier de la définition du « bon boucher ». Grâce à des vignettes ethnographiques tirées de notes de terrain, l’auteure montre ainsi comment un lien direct est établi entre une catégorie de sexe et une activité de travail, jugée soit « masculine » (l’abattage et le dépeçage de la viande), soit « féminine » (activités liées à la commercialisation de la viande). Les conditions de la production des corps au travail ne sont donc pas les mêmes pour les bouchers et les bouchères. Cette différenciation s’inscrit dans les réformes récentes de la branche (ouverture de nouvelles filières, en particulier de commercialisation) qui à la fois attirent un nouveau public, notamment féminin, et créent une reconfiguration de la ségrégation au sein de la profession.
Endotracheal Suctioning With or Without Instillation of Isotonic Sodium Chloride Solution in Critically Ill Children
Authors: Ridling Debra A. , Martin Lynn D. , Bratton Susan L. 
Published: November 2019

• Background Instillation of isotonic sodium chloride solution for endotracheal tube suctioning is controversial. Research has focused on the effect of such instillation in adults; no studies in children have been published.• Objectives (1) To describe differences in oxygen saturation depending on whether or not isotonic sodium chloride solution is instilled during suctioning and (2) to describe the rates of occlusion of endotracheal tubes and nosocomial pneumonia.• Methods A convenience sample of 24 critically ill patients were enrolled before having suctioning and after informed consent had been given. Ages ranged from 10 weeks to 14 years. Patients were randomized to 1 of 2 groups. In group 1, subjects received between 0.5 and 2.0 mL of isotonic sodium chloride solution, depending on their age, once per suctioning episode. In group 2, subjects received no such solution. A total of 104 suctioning episodes were analyzed. Oxygen saturation was recorded at predetermined intervals before and for 10 minutes after suctioning. Occlusion of endotracheal tubes and rates of nosocomial pneumonia also were compared.• Results Patients who had isotonic sodium chloride solution instilled experienced significantly greater oxygen desaturation 1 and 2 minutes after suctioning than did patients who did not. No occlusions of endotracheal tubes and no cases of nosocomial pneumonia occurred in either group.• Conclusions Results of this study support a growing body of evidence that instillation of isotonic sodium chloride solution during endotracheal tube suctioning may not be beneficial and actually may be harmful.
Family Presence During Cardiopulmonary Resuscitation and Invasive Procedures: Practices of Critical Care and Emergency Nurses
Authors: MacLean Susan L. , Guzzetta Cathie E. , White Cheri , Fontaine Dorrie , Eichhorn Dezra J. , Meyers Theresa A. , Désy Pierre 
Published: November 2019

• Background Increasingly, patients’ families are remaining with them during cardiopulmonary resuscitation and invasive procedures, but this practice remains controversial and little is known about the practices of critical care and emergency nurses related to family presence.• Objective To identify the policies, preferences, and practices of critical care and emergency nurses for having patients’ families present during resuscitation and invasive procedures.• Methods A 30-item survey was mailed to a random sample of 1500 members of the American Association of Critical-Care Nurses and 1500 members of the Emergency Nurses Association.• Results Among the 984 respondents, 5% worked on units with written policies allowing family presence during both resuscitation and invasive procedures and 45% and 51%, respectively, worked on units that allowed it without written policies during resuscitation or during invasive procedures. Some respondents preferred written policies allowing family presence (37% for resuscitation, 35% for invasive procedures), whereas others preferred unwritten policies allowing it (39% for resuscitation, 41% for invasive procedures). Many respondents had taken family members to the bedside (36% for resuscitation, 44% for invasive procedure) or would do so in the future (21% for resuscitation, 18% for invasive procedures), and family members often asked to be present (31% for resuscitation, 61% for invasive procedures).• Conclusions Nearly all respondents have no written policies for family presence yet most have done (or would do) it, prefer it be allowed, and are confronted with requests from family members to be present. Written policies or guidelines for family presence during resuscitation and invasive procedures are recommended.
Administration of Sedatives and Level of Sedation: Comparative Evaluation via the Sedation-Agitation Scale and the Bispectral Index
Authors: de Wit Marjolein , Epstein Scott K. 
Published: November 2019

• Objectives To compare levels of sedation in patients receiving continuous intravenous infusions of sedative/hypnotic or narcotic agents with levels in patients not receiving infusions and to compare subjective (Sedation-Agitation Scale) and objective (Bispectral Index) evaluations of sedation.
• Methods Patients receiving mechanical ventilation in a medical intensive care unit were evaluated prospectively. Level of sedation was assessed with the Sedation-Agitation Scale (range 1–7, unarousable to dangerous agitation) and the Bispectral Index (range 0–100, flat line to awake waveform) recorded before and after stimulation. Patients were classified as receiving continuous infusions if an infusion had been administered within 24 hours preceding assessment.
• Results Nineteen patients were evaluated on 80 occasions. Scores on the Sedation-Agitation Scale ranged from 1 to 5 (mean 2.6 and median 2) and correlated highly with values for the Bispectral Index (R2 = 0.48 before and 0.44 after stimulation, P &lt; .001). Patients receiving continuous infusions were more deeply sedated than were patients receiving boluses or no medication (mean [SD] scores, Sedation-Agitation Scale: 2.1 [1.2] vs 3.3 [1.0], P &lt; .001; Bispectral Index before stimulation: 63 [24] vs 86 [13], P &lt; .001). Patients receiving continuous infusions were more likely to have a score of 2 or less on the Sedation-Agitation Scale (32/44 vs 8/35, P &lt; .001).
• Conclusion Objective and subjective assessments of sedation are highly correlated. Use of continuous infusions is associated with deeper levels of sedation, and patients receiving continuous infusions are more likely to be oversedated. Sedation therapy should be guided by subjective or objective assessment.
Pattern and Predictors of Early Rejection After Lung Transplantation
Authors: DeVito Dabbs Annette , Hoffman Leslie A. , Iacono Aldo T. , Wells Chris L. , Grgurich Wayne , Zullo Thomas G. , McCurry Kenneth R. , Dauber James H. 
Published: November 2019

• Background Most lung transplant recipients experience improvement in their underlying pulmonary condition but are faced with the threat of allograft rejection, the primary determinant of long-term survival. Several studies examined predictors of rejection, but few focused on the early period after transplantation.• Objectives To describe the pattern and predictors of early rejection during the first year after transplantation to guide the development of interventions to facilitate earlier detection and treatment of rejection.• Methods Data for donor, recipient, and posttransplant variables were retrieved retrospectively for 250 recipients of single or double lung transplants.• Results Most recipients (85%) had at least 1 episode of acute rejection; 33% had a single episode; 23% had recurrent rejection; 3% had persistent rejection; 13% had refractory rejection; and 14% had clinicopathological evidence of chronic rejection. Serious rejection (refractory acute rejection or chronic rejection) developed in 27% of recipients. Compared with other recipients, recipients who had serious rejection had more episodes of acute rejection (P = .004), and the first acute episodes occurred sooner after transplantation (P = .01) and were of a higher grade (P = .002).• Conclusions Recipients who experienced higher grades for their first episode of acute rejection (P=.03) and higher cumulative rejection scores (P = .004) were significantly more likely than other recipients to have serious rejection during the first year after transplantation.
Skin Care Intervention for Patients Having Cardiac Surgery
Authors: Pokorny Marie E. , Koldjeski Dixie , Swanson Melvin 
Published: November 2019

• Background Pressure ulcers are a major problem after cardiovascular surgery, occurring in 9.2% to 38% of patients.• Objectives To determine the effectiveness of a skin care intervention program in preventing development of ulcers or progression from one stage to another and to determine the extent to which selected risk factors were associated with development and progression of pressure ulcers.• Methods A simple interrupted time series design was used. The protocol involved interrelated assessment, staging, and type of intervention provided. The Braden Scale was used to determine risk for skin breakdown.• Results Of the 351 patients in the study, 327 (93%) maintained skin integrity and 24 (7%) had skin breakdown. Breakdown by stages was as follows: stage 1, 62% (n = 15); stage 2, 29% (n = 7); stage 3, 4% (n = 1); and stage 4, 4% (n = 1). Age, sex (female), and heart failure were statistically significant risk factors for breakdown (P = &lt;.001, .02, and .02, respectively). The mean scores on the Braden Scale of the breakdown group differed significantly from those of the skin integrity group from days 2 through 5 after surgery (P = .01). Seventeen (71%) of the breakdowns occurred during the first 4 days after surgery.• Conclusions Skin assessments and nursing interventions should be increased on the day of surgery and the first to fifth postoperative days, including multiple assessments and skin care focused on maintaining skin integrity.
New-Generation Pulse Oximetry in the Care of Critically Ill Patients
Authors: Giuliano Karen K. , Higgins Thomas L. 
Published: November 2019

• Objective To review the published, peer-reviewed studies to date on use of the new-generation pulse oximeters, which are manufactured with algorithms to filter out patients’ body motions, and describe the application of new-generation pulse oximetry in clinical practice in critical care.
• Methods MEDLINE was used to locate appropriate articles on pulse oximetry for the years 1995 to 2003. Each article was examined for scientific merit, content, and applicability to clinical practice.
• Results A total of 17 relevant articles on the clinical performance of the new-generation pulse oximeters were reviewed, and the data were organized into a table.
• Conclusions The combination of studies done in both clinical and laboratory settings did not provide any strong and convincing evidence that the performance of any single new-generation device was superior to that of any other new-generation device. However, the clinical performance of all the new-generation pulse oximetry devices was better than that of earlier devices.
Time Out! Is Timepiece Variability a Factor in Critical Care?
Authors: Ferguson Elizabeth A. , Bayer Carey Roth , Fronzeo Susan , Tuckerman Cheryl , Hutchins Larissa , Roberts Kathryn , Verger Judy , Nadkarni Vinay , Lin Richard 
Published: November 2019

• Background Accurate documentation of time is essential in critical care for treatments, interventions, research, and medicolegal and quality improvement activities.
• Objectives To assess use of timepieces in critical care and to determine practical methods for improving their accuracy.
• Methods Providers were surveyed to identify timepieces used during routine and emergency care. Times displayed on standard unit and personal timepieces were compared with coordinated universal time. Four models of atomic clocks were assessed for drift for 6 weeks and for resynchronization for 1 week. Bedside monitors were manually synchronized to coordinated universal time and were assessed for drift.
• Results Survey response was 78% (149/190). Nurses (n = 93), physicians (n = 32), and respiratory therapists (n = 24) use wall clocks (50%) and personal timepieces (46%) most frequently during emergencies. The difference from coordinated universal time was a median of −4 minutes (range, −5 minutes to +2 min) for wall clocks, −2.5 minutes (−90 minutes to −1 minute) for monitors, and 0 minutes (−22 minutes to +12 minutes) for personal timepieces. Kruskal-Wallis testing indicated significant variations for all classes of timepieces (P&lt;.001) and for personal timepieces grouped by discipline (P=.02). Atomic clocks were accurate to 30 seconds of coordinated universal time for 6 weeks when manually set but could not be synchronized by radiofrequency signal. Drift of bedside monitors was 1 minute.
• Conclusions Timepieces used in critical care are highly variable and inaccurate. Manually synchronizing timepieces to coordinated universal time improved accuracy for several weeks, but the feasibility of synchronizing all timepieces is undetermined.
Outcomes of Care Managed by an Acute Care Nurse Practitioner/Attending Physician Team in a Subacute Medical Intensive Care Unit
Authors: Hoffman Leslie A. , Tasota Frederick J. , Zullo Thomas G. , Scharfenberg Carmella , Donahoe Michael P. 
Published: November 2019

• Background Many academic medical centers employ nurse practitioners as substitutes to provide care normally supplied by house staff.• Objective To compare outcomes in a subacute medical intensive care unit of patients managed by a team consisting of either an acute care nurse practitioner and an attending physician or an attending physician and critical care/pulmonary fellows.• Methods During a 31-month period, in 7-month blocks of time, 526 consecutive patients admitted to the unit for more than 24 hours were managed by one or the other of the teams. Patients managed by the 2 teams were compared for a variety of outcomes.• Results Patients managed by the 2 teams did not differ significantly for any workload, demographic, or medical condition variable. The patients also did not differ in readmission to the high acuity unit (P = .25) or subacute unit (P = .44) within 72 hours of discharge or in mortality with (P = .25) or without (P = .89) treatment limitations. Among patients who had multiple weaning trials, patients managed by the 2 teams did not differ in length of stay in the subacute unit (P = .42), duration of mechanical ventilation (P = .18), weaning status at time of discharge from the unit (P = .80), or disposition (P = .28). Acute Physiology Scores were significantly different over time (P = .046). Patients managed by the fellows had more reintubations (P=.02).• Conclusions In a subacute intensive care unit, management by the 2 teams produced equivalent outcomes.
Nutritional Adequacy in Patients Receiving Mechanical Ventilation Who Are Fed Enterally
Authors: O’Leary-Kelley Colleen M. , Puntillo Kathleen A. , Barr Juliana , Stotts Nancy , Douglas Marilyn K. 
Published: November 2019

• Background Inadequate nutritional intake in critically ill patients can lead to complications resulting in increased mortality and healthcare costs. Several factors limit adequate nutritional intake in intensive care unit patients given enteral feedings.
• Objective To examine the adequacy of enteral nutritional intake and the factors that affect its delivery in patients receiving mechanical ventilation.
• Methods A prospective, descriptive design was used to study 60 patients receiving enteral feedings at target or goal rate. Energy requirements were determined for the entire sample by using the Harris-Benedict equation; energy requirements for a subset of 25 patients were also determined by using indirect calorimetry. Energy received via enteral feeding and reason and duration of interruptions in feedings were recorded for 3 consecutive days.
• Results Mean estimated energy requirements (8996 kJ, SD 1326 kJ) and mean energy intake received (5899 kJ, SD 3058 kJ) differed significantly (95% CI 3297-3787; P &lt; .001). A total of 41 patients (68.3%) received less than 90% of their required energy intake, 18 (30.0%) received within ±10%, and 1 (1.7%) received more than 110%. Episodes of diarrhea, emesis, large residual volumes, feeding tube replacements, and interruptions for procedures accounted for 70% of the variance in energy received (P&lt;.001). Procedural interruptions alone accounted for 45% of the total variance. Estimated energy requirements determined via indirect calorimetry and mean energy received did not differ.
• Conclusions Most critically ill patients receiving mechanical ventilation who are fed enterally do not receive their energy requirements, primarily because of frequent interruptions in enteral feedings.
Moral Distress of Staff Nurses in a Medical Intensive Care Unit
Authors: Elpern Ellen H. , Covert Barbara , Kleinpell Ruth 
Published: November 2019

• Background Moral distress is caused by situations in which the ethically appropriate course of action is known but cannot be taken. Moral distress is thought to be a serious problem among nurses, particularly those who practice in critical care. It has been associated with job dissatisfaction and loss of nurses from the workplace and the profession.• Objectives To assess the level of moral distress of nurses in a medical intensive care unit, identify situations that result in high levels of moral distress, explore implications of moral distress, and evaluate associations among moral distress and individual characteristics of nurses.• Methods A descriptive, questionnaire study was used. A total of 28 nurses working in a medical intensive care unit anonymously completed a 38-item moral distress scale and described implications of experiences of moral distress.• Results Nurses reported a moderate level of moral distress overall. Highest levels of distress were associated with the provision of aggressive care to patients not expected to benefit from that care. Moral distress was significantly correlated with years of nursing experience. Nurses reported that moral distress adversely affected job satisfaction, retention, psychological and physical well-being, self-image, and spirituality. Experience of moral distress also influenced attitudes toward advance directives and participation in blood donation and organ donation.• Conclusions Critical care nurses commonly encounter situations that are associated with high levels of moral distress. Experiences of moral distress have implications that extend well beyond job satisfaction and retention. Strategies to mitigate moral distress should be developed and tested.