RCAAP Repository

The arise of HIV/AIDS and the design of the epidemy demanded changes in the sexual and reproductive health of men and women who live with the virus. The fact that survival and life quality improved with the advent of antiretroviral therapy highlighted the aspect of chronicity of HIV infection, outlining possibilities for affective-sexual and reproductive relationships in this new reality, in a complex scenery that involves concordant and discordant couples in contexts of life similar to non-infected people, in a process of re-signification of HIV/AIDS and of search for control of this pandemy. This study aimed to understand sexual and reproductive experience of people who live with HIV. The Humanistic Nursing Theory by Paterson and Zderad was used as a theoretical and methodological reference. This is a descriptive research with qualitative design, held at the infectology clinic of the School Hospital Santo Inácio, in Juazeiro do Norte-CE. The subjects of the study were 16 people who live with HIV/AIDS, 7 men and 9 women. Data were collected from July through November, 2007, through free observation, analysis of medical records and semi-structured interview. For the testimonies’ analysis the technique of content analysis was adopted, from which emerged three themes: 1. Sexual experience; 2. Reproductive experience, and 3. Marriage Experience. In these themes one identified eleven sub-themes: 1. The condom in sexual intercourses; 2. Changes in desire after the discovery of HIV seropositivity, 3. Changes in sexual practice after the discovery of HIV seropositivity, 4. Contraceptive methods used before the experience and living with HIV/AIDS; 5. The condom as a contraceptive reference and protection in sexual intercourses; 6. Ignorance about the use of other contraceptive methods in HIV infection; 7. Desire to have children; 8. Fear of vertical transmission of HIV; 9. (Lack of) knowledge about prophylactic measures to reduce the vertical transmission of HIV; 10. Modification in marital relationship due to self-care and care with the other; 11. The distrust in the partner because of HIV. Out of the people who experience and live with HIV/AIDS one got different experiences and meanings for sexual and reproductive experiences in complex life sceneries, still permeated by the stigma resulting from AIDS. The subjects of this study lived in marital union ranging from eight months through over fifteen years, eleven of whom lived in conjugal concordant relationship to HIV and five in discordant relationship. We did not notice divergence of data by the variable time of union. We noticed difficult socioeconomic situation and presence of children, including five conceived after the knowledge of HIV, and two women during pregnancy. The time spent living with the infection varied from less than a year to more than eleven years. In half the cases the context of discovery of HIV infection involved the gestational period, the others after opportunistic disease or by convincing of the partner, being a difficult moment due to proved marital infidelity. The results indicated that the condom was not part of their sexual routine until the knowledge of HIV, being the virus a determinant condition for joining the condom. The stability of the conjugal relationship served in the pre-infection phase as one of the factors that contributed to the non-use of condoms, causing larger contexts of vulnerability, where the genre appears as the main factor. The use of male condoms, after seroconversion, highlighted the difficulties in adhesion, especially among those who had never experienced this method of protection, revealing possible awareness of the need to adapt to the device in sexual intercourse, which is re-signified for these people. However, there is a bigger confrontation for the maintenance of the prevention practice by the use of condoms in discordant couples. The discovery of HIV seropositivity demanded changes in sexual routine, showing a decrease in sexual desire and change in sexual practices, with different aspects for men and women surveyed. There were changes in routine of contraceptive methods used before the seroconversion, using new methods, especially the male condom, in the presence of HIV. We highlighted the lack of knowledge of alternatives contraceptive methods face to HIV infection and AIDS. The desire to have children was observed in men and women, and the fear of vertical transmission appears as a strong determinant to deny that choice, with the lack of prophylactic measures to reduce vertical transmission. The difficulties in fighting against HIV/AIDS require changes in the daily life of the couple, highlighting a bilateral marital behavior of care for the other in an ambiguous relationship because of distrust with the knowledge of HIV infection. This study allowed us to realize that we must open channels of dialogue about sexual and reproductive experiences, stressing the important dimension that is given to the relationships between professionals and patients, as participants in the search of health promotion in a reality still in construction, of re-signification of life, of relationships and health. The gestational period is highlighted as an important moment for the diagnosis of HIV infection, to advise the recommendations and to reduce vertical transmission, beginning with early prevention of vertical transmission, through humanized care, free of judgments and prejudice. The assistance in sexual and reproductive health for people living with HIV demands several questions and challenges, but it points mainly to the need of integral and non-dichotomous assistance, where prevention and treatment work together, recognizing limits, possibilities, aims and priorities, in the individualization of human care.

Care delivery to newborn infants at the intensive care unit demands theoretical-practical knowledge on skin care, as different procedures lead to the breaking of this protective barrier and can cause severe injuries. Moreover, skin maturity needs to be stimulated in premature infants. Thus, this study aimed to examine the efficiency of the semipermeable membrane as a technological resource for use on premature newborn infants’ (PMNI) skin to reduce transepidermal water loss and electrolyte disorders. This experimental study is a randomized clinical trial and was carried out at the Neonatal Intensive Care Unit (NICU) of the Teaching Maternity Assis Chateaubriand – MEAC in Fortaleza-Ceará, Brazil, between March and August 2008. The sample included 42 PMNI who complied with the following inclusion criteria: birth weight ≤ 1,500 grams and gestational age ≤ 32 weeks; permanence of at least seven days at the unit; no severe malformations that affected skin integrity; and the consent of parents and/or persons responsible for the infants. The study variables were weight, water balance, urine density, glucose control, sodium dosage and daily water quota. The data were compiled in Excel and statistical analysis was performed in SPSS. A five-percent significance level was adopted and data were presented in tables and charts. All ethical recommendations were followed during all research phases. All PMNI were admitted from the Obstetric Center and the main medical diagnoses were: prematurity, respiratory discomfort syndrome and hyaline membrane disease. The PMNI were accommodated in a double wall incubator (100%), received mechanical ventilation (95,2%) and (100%), used intravenous hydration via central access (81%) and (100%) , commonly antibiotics therapy, parenteral nutrition (71,4%) and (95,2%), enteral feeding (81%) and (61,9%) , phototherapy (71,4%) and (66,7%). As to birth weight, a daily weight loss of 20g occurred in the intervention group (IG), against 18g in the control group (CG). What diuresis is concerned, data showed a statistically significant regression. As for glucose, 4,4 times more episodes of hyperglycemia were evidenced in CG than in IG. The results for the water quota showed a regression of 7,220 for IG, against 6,094 for CG. What the urine density results is concerned, a slight decrease of only 0,777 was found for IG, against a daily increase of 22.892 for CG, that is, the latter presented higher urine density than IC during the seven days. As to sodium, regression for IG was around 0,603, against 1,835 for CG. Infants in CG had 3.0 times higher chances of hypernatremia in the study period. It was found that the application of the semipermeable membrane, the PMNI for IG was associated with decreased sodium levels and daily fluid demands during the first week of life in PMNI, who also presented less episodes of hyperglycemia and whose urine density was maintained within normal standards in comparison with PMNI in CG. The semipermeable membrane is actually an effective therapeutic resource to minimize transepidermal water losses in PMNI.

Mother’s confidence in their ability to provide good care to their children has proven to be relevant when it comes to maternal health promotion. This dissertation aims to construct a scale in order to measure maternal self-efficacy for preventing infantile diarrhea, by creating its items and dimensions, as well as evaluating the instrument’s psychometric aspects (validity and reliability). The following is both a research on methodology and development, having the model proposed by Pasquali on scale elaboration (1997) as our theoretical landmark. In the pre-empirical part, we carefully examined infantile diarrhea prevention as our construct of interest. The bibliographical survey searched for the keywords “children”, “prevention and control”, “diarrhea” on the PubMed, CINAHL, Cochrane and LILACS database. The first version of the scale was led by the synthesis of 82 selected papers. It had 35 items and also presented four domains: alimentary habits, domestic environment, mother behavior and child hygiene. The 35 items were evaluated by 30 mothers (who performed the semantic analysis), by 31 other mothers who participated in the scale pre-test and also by seven experts in the construct field. After calculating the Content Validity Index (CVI) and making the proper alterations suggested by the mentioned participators, the pilot test was elaborated, containing itself 25 items. In the empirical part of this paper, the selected sample was formed by 448 mothers of less than 5 years old children. Those women were all registered on one of the six Family Health Centers in which the research took place. Data collection was performed from November of 2009 to February of 2010. A questionnaire on socio-demographic elements and child health aspects was used along with the pilot test. The analytical work involved the construct validity, the criterion validity, Cronbach’s alpha and Intraclass Correlation Coeficient (ICC). Construct validity, through the factor analysis, has indicated the need for exclusion of the item seven and has also shown the existence of two factors/domains (family hygiene, formed by 15 items; and alimentary/general habits, with 9 items) in the Maternal Self-Efficacy for Infantile Diarrhea Prevention Scale (MSIDPS). Regarding the construct validity, hypotheses were tested by contrasting groups comparison. A negative correlation has been observed between the higher maternal self-efficacy for infantile diarrhea prevention scores and the previous occurrence of diarrhea in the child (p=0,001).The higher self-efficacy scores were also associated with older mothers (p=0,018). By using predictive validity, the criterion validity has shown that higher levels of maternal self-efficacy turned out to be a protective factor against infantile diarrhea, according to specificity and to Negative Predictive Value. Cronbach’s alpha of the MSIDPS was 0,84, which indicates high internal consistency. ICC, after test-retest stability analysis, was 0,45, showing the scale’s applicability throughout time. This dissertation has come to the conclusion that the scale is reliable, valid and capable of evaluating maternal self-efficacy for infantile diarrhea prevention.

CANTUÁRIO, Maria Zelma de Araújo Madeira. A maternidade simbólica na religião Afro-Brasileira: aspectos socioculturais da mãe-de-santo na umbanda em Fortaleza. 2009. 251 f. Tese(Doutorado em Sociologia) – Universidade Federal do Ceará, Departamento de Ciências Sociais, Programa de Pós- Graduação em Sociologia, Fortaleza-CE, 2009.

The problem of environmental education (EE) is complex and plural. It also has a worrying importance when faced to the socio-environmental crisis spread in the globe. Investigating such theme demands an understanding about the EE academic process, as well as the teachers‟ conceptions about it − built in their jobs on the camp − especially in Ceará State. Having in mind that all kind of education must be environmental, we got quite interested to investigate the conceptions about that issue in the speech of teachers and students, confronting with the current legal framework, law 9.795/99, constitutional text, besides specific international documents of the camp. This study was developed based on a critical, systematic and axiological way of analyzing the already mentioned documents, with special emphasis on the National Policy of Environmental Education (PNEA) − where definition, principles, objectives and execution of environmental education were taken from. The first chapter points out the normative dimension of the legal and philosophical conceptions found in EE. The second chapter analyses the factors that make the execution of EE difficult, considered − on this research − as a challenge on the training of environmental educators. The discussion aimed establishing the limits and possibilities on the execution of EE and teacher training. The third chapter presented the results of a collecting data research where questionnaires to academics and students were the instruments analyzed. 176 academics from different courses of the Federal University of Ceará (UFC) − including the ones who don‟t teach in training for teaching undergraduate courses whereas EE must be transversal in formal education answered the questionnaire. The objective of analyzing the answers of 49 professors from the same state (Fortaleza, Iguatu, Limoeiro do Norte, Maracanaú, Sobral e Crateús) was evaluating: the amplitude of their conceptions about the environment, EE, knowledge about important documents, and their practices in the area. The answers of those questionnaires revealed the context of teachers and students in EE conceptions. They also helped us to better understand the different kinds of activities used in EE in formal education. The last chapter presented the web site: “Environmental Educators” (www.educadoresambientais.com.br) whose objective is spreading EE to support environmental educators‟ formation.

CORDEIRO, Maria Paula Jacinto. Entre chegadas e partidas: dinâmicas das romarias em Juazeiro do Norte. 2010. 242f. Tese(Doutorado em Sociologia) – Universidade Federal do Ceará, Departamento de Ciências Sociais, Programa de Pós-Graduação em Sociologia, Fortaleza-CE, 2010.

BENEVIDES, Mário Henrique Castro. Sertões em guerra: civilização e mudança social em Euclydes da Cunha. 2009. 134f. Dissertação (Mestrado em Sociologia) – Universidade Federal do Ceará, Departamento de Ciências Sociais, Programa de Pós-Graduação em Sociologia, Fortaleza-CE, 2009.

SOUSA, Maria Alda de. A propósito do protagonismo juvenil: quais discursos e significados?. 2011. 151 f. Dissertação (Mestrado em Sociologia) – Universidade Federal do Ceará,Departamento de Ciências Sociais, Programa de Pós-Graduação em Sociologia, Fortaleza-CE, 2011.

Este artigo utiliza um modelo dinâmico de equilíbrio geral, calibrado para a economia brasileira, para quantificar os ganhos de produto e bem-estar associados à cobrança direta pelo uso da infraestrutura pública, considerando que esta forma alternativa de financiamento dos gastos públicos não distorce as decisões dos agentes econômicos, ao contrário do tradicional financiamento através da arrecadação de impostos. De acordo com as simulações realizadas, impondo-se a restrição de não haver reduções nas transferências às famílias, elevar a receita proveniente de pagamentos pelo uso da infraestrutura pública pode implicar consideráveis ganhos de bem-estar, caso esta seja direcionada à redução de alíquotas de impostos sobre a renda do capital privado. Adicionalmente, ganhos de bem-estar ainda maiores podem ser obtidos a partir de uma política de subsídios à oferta privada de infraestrutura, financiada a partir de receitas oriundas da infraestrutura pública.

This paper analyzes in a recursive macroeconomic model, calibrated to the Brazilian economy, the growth and welfare e¤ects of public expenditures under two alternative modes of nancing: the traditional tax-collection mechanism and a user fee for public infrastructure. According to the model-based simulations, when public transfers to household are not allowed to decrease, there might exist substantial welfare net gains if the government increases its revenue by charging a higher user fee for public infrastructure, as long as this policy comes with a reduction in private capital taxes or tax incentives to private infrastructure.

Taking into account the great technological development on renewable energy systems and their applications on power electronics, this work presents a new concept of converters applied to renewable systems and batteries charging with a reduced number of energy processing stages. This work approaches three different high voltage gain converters topologies with only one processing stage, and with bidirectional capability, with batteries, and with photovoltaic panels. The operation of these converters allow that the inputs (PVpanels or batteries), work independently or simultaneously, in order to compose a single DC bus. Also, proposed topologies present natural soft-switching operation. At last, the three prototypes were developed to work with a nominal power of 500W, validating the operation principle of the proposed system, featuring high efficiency, high voltage gain, and good voltage regulation on the DC bus.

Using a new panel dataset of the Brazilian States, it was estimated, by means of econometric models, the effect of social expenditure on enforcement and welfare on criminality during the period of 2001 to 2003. In contrast to past works developed in Brazil, which used basically data on murder, four kinds of offenses are analyzed: murder, robbery, larceny and kidnapping. Based on the economic theory of crime, we have evaluated the direction and the size of the effect of public spending, in addition to social factors, on the criminal behavior in the Brazilian States. Our results, using fixed effects and first differences to take unobserved effects into account, pointed out income inequality as an important factor to explain criminal behavior. Aiming to control simultaneity between spending on public safety and crime, it was still used instrumental variables, examining if there is a deterrence effect from law enforcement. It was observed that, even when the endogeneity issue is taken into account, there seems not to be a consistent deterrence effect of public spending on safety on crime in Brazil. In most estimates, public spending on welfare displayed a negative and robust effect on criminality, suggesting that this kind of expenditure is an important factor to reduce crime.

Our objective is to investigate the effects of unexpected changes in the worker’s obligations on the decision to retire. We considered, throughout this paper, that the firm does not know the level of the worker’s obligations, and is unable to determine the right moment for the worker to retire. We found that the wage rate decreases when the worker obtains the right to retire and that it is necessary that the retirement benefits be greater than the unemployment insurance in order to have flows of workers from unemployment to retirement, while it is not necessary that this be greater than the wage rate to realize flows of workers from employment to retirement. We also verified that the more difficult it is to obtain the right to retire, the higher will be the job creation flow.

This paper analyzes the process of agricultural micro-regional convergence using a threshold effect model for the period from 1970 to 1996. The results show the existence of three clubs of convergence. One formed by the group of richer micro-regions, concentrated in the South and Southeast regions; other formed by the group of poorer micro-regions,located primarily in the Northeast; and a third intermediate group that concentrates the micro-regions of the Center-West and North of Brazil. The results also show that physical capital is more important than human capital to explain the Brazilian agricultural growth process.

MELLO, Marcos Paulo Campos Cavalcanti de. Quando os assentados chegaram: tempo e experiência social no MST. 2011. 169f. Dissertação (Mestrado em Sociologia) – Universidade Federal do Ceará, Departamento de Ciências Sociais, Programa de Pós-Graduação em Sociologia, Fortaleza-CE, 2011.

A utilização de recursos tecnológicos na área da saúde e da enfermagem vem sendo cada vez mais presente na realidade prática. Essas ferramentas são desenvolvidas e aplicadas no meio assistencial, assim como no meio acadêmico por enfermeiros e por discentes. Diante desta nova realidade, é exigido dos enfermeiros preparo, conhecimento e domínio da tecnologia para adequar-se a estas novas tendências de ações em enfermagem, sem, contudo, afastar-se da essência do cuidado ou distanciar a relação existente entre professor e aluno. Dentre as práticas do enfermeiro, cita-se a atenção em planejamento familiar e anticoncepção. Passando pelos aspectos tecnológicos e assistenciais, torna-se oportuno articular o uso de tecnologia, educação e enfermagem em planejamento familiar, desenvolvendo uma hipermídia educacional. Assim, objetivou-se construir uma hipermídia educacional em planejamento familiar, com ênfase à contracepção. O desenvolvimento deste estudo foi baseado na teoria da interação social de Vygostsky. O estudo é do tipo de desenvolvimento, ou seja, a construção e desenvolvimento de softwares e outras estratégias tecnológicas que são implementadas no ambiente educacional ou assistencial. A construção da hipermídia ocorreu no período de maio a outubro de 2009. Em seguida, foi realizada avaliação por juízes especialistas em planejamento familiar-contracepção e em tecnologia. Após análise pelos juízes, foram implementadas as sugestões e correções, as quais resultaram na última versão do hipermídia. O desenvolvimento foi baseado na proposta de Falkembach (2005), que cita como fases de concepção e desenvolvimento de uma hipermídia: o planejamento; a modelagem, que consistiu na elaboração do roteiro de aulas; implementação, que consistiu na criação do curso no Ambiente Virtual de Aprendizagem (AVA) Solar e na avaliação. Esta ocorreu por meio de avaliação de especialistas técnicos e em conteúdo, selecionados com base em critérios de produtividade e experiência na área relacionada. Feita a avaliação, foram realizadas as alterações sugerias, resultando em uma última versão da hipermídia. Foram seguidos os aspectos éticos. Os juízes validaram a hipermídia em termos técnicos e termos de conteúdo ao atribuírem valoração que classificou a hipermídia como adequada a ser utilizada junto a acadêmicos de enfermagem. A hipermídia mostrou-se como uma ferramenta a ser utilizada no processo ensino-aprendizagem relacionado a temática planejamento familiar em contracepção. A criação e utilização dos recursos em tecnologia vêm se mostrando cada vez mais úteis e eficientes, sendo sua aplicação na prática docente ou assistencial algo cada vez mais explorado na enfermagem e, mais precisamente no ambiente de ensino. A criação destes recursos na enfermagem se faz de grande importância para a elevação da profissão e da qualidade da assistência.

Two decades after the beginning of the AIDS epidemic, it has been observed how one generation of children has been affected by HIV. They experience a childhood marked by their parent’s becoming ill, by being orphans and by the stigma caused by the illness. Some of these children whether they are the virus’ bearer or not have to be taken to institutions. Thus, living in an institution is, most of the times, the most viable option for the children. It was intended to analyze how children who were born exposed to HIV live inserted in support houses/orphanages in Fortaleza, Ceará. The option chosen was the articulation of the research with the qualitative and quantitative approach which was used to provide elements of the way the case study should follow. The modality of thematic oral history research was also used. The population used was composed of 24 children exposed to HIV on birth that live in full or part-time system in two institutions (support house and orphanage). The study was carried out during the first semester of 2010, in Fortaleza-Ceará, Northeastern region of Brazil. Two institutions registered in a public organ and which function as reference institutions in the state of Ceará, are responsible by the children’s care of children exposed to HIV on birth or infected during their lives. Both took part in the study: the “Casa do Sol Nascente” [House of Rising Sun (full-time permanence)] and the “Centro de Convivência Madre Regina” [Social Center Madre Regina (semi-full permanence)]. To collect the data were used: interviews semi-structured to collect epidemiologic, clinical and social data of the children and their parents; primary data obtained from the children’s health registers; life stories produced by the people in charge of the institutions and by the mothers and reports of prejudice situations experienced by the children. For the quantitative analysis, the institutions were compared by means of distribution of bivariad frequencies. It was observed that the children have access to the items indispensable for their adequate growth and development, facing, however, important markers of vulnerability. The differences between the two institutions were most of the time attributed to the mother’s presence in the care dedicated to the children of the semi-full time institutions. An inter-sectional work should be suggested and a full-time care according to the needs characteristic of each institution, each family and each child, in a more humanized resolute practice as a way of promoting life.

A educação é condição-chave para a consciência ambiental, ou seja, faz despertar nas pessoas a responsabilidade com a natureza e preocupação com novas relações comprometidas com o meio ambiente. Neste contexto, esta investigação se propôs realizar uma pesquisa-ação, na qual o enfermeiro insere-se na escola efetuando ações relacionadas à educação ambiental num espaço de debate e crescimento coletivo com adolescentes. Objetivou-se promover um espaço crítico-reflexivo acerca da saúde ambiental junto ao adolescente. Trata-se de um estudo descritivo-exploratório, com abordagem qualitativa, realizado na Escola de Ensino Fundamental Manoel Pereira de Brito, pertencente à rede municipal de ensino, com sede em Bolso, no Município de São Gonçalo do Amarante- Ceará, a qual localiza-se nas proximidades da proposta de implantação de uma usina termelétrica a carvão mineral. A população do estudo foi composta por um grupo com dezessete adolescentes. O período da investigação aconteceu de janeiro a setembro de 2009. Os instrumentos e procedimentos que foram utilizados foi observação, diário de campo, gravador e abordagem grupal. No primeiro encontro, foi utilizado o desenho estória com tema, tomando o seguinte eixo norteador: O que você entende como saúde ambiental? Logo depois, fora apresentado pelos participantes o relato da estória do desenho. No segundo encontro, foi solicitado aos jovens que tirassem fotografias da sua região adjacente para descobrirmos na percepção deles o que seria saúde ambiental para que, posteriormente, essas imagens fossem desencadeadoras da discussão, caracterizando-se como fichas de cultura. No terceiro encontro, foi elaborada letras de músicas, paródias ou poemas pelos alunos, sendo um produto das discussões no que se relaciona à saúde ambiental. O quarto encontro foi elaborado a partir da avaliação do terceiro, com a finalidade de formular no quinto encontro um folheto educativo. Então, foi proposta uma ação grupal de reflexão de itens importantes que deveriam estar presentes neste folheto educativo. E, por fim, o quinto encontro, que foi o seguimento do quarto, sendo um processo avaliativo final, no qual os adolescentes fizeram um folheto sobre saúde ambiental, contextualizado a comunidade local. A análise dos dados foi baseada nas práticas discursivas das narrativas realizadas pelos participantes. O estudo foi submetido à apreciação do Comitê de Ética em Pesquisa da Universidade Federal do Ceará e aprovado na reunião do dia 19 de dezembro de 2008, número do protocolo 252/08. Nessa pesquisa-ação, constatou-se que o enfermeiro pode ser um educador ambiental, inserir-se nesse espaço para proporcionar aos grupos discussões contextualizadas à realidade deles, favorecendo reflexões sobre relações comprometidas com o socio-ambiental. Na pesquisa em enfermagem, é necessário utilizar diferentes métodos de coleta para explorar a técnica grupal, pois permite uma troca mútua pelo estabelecimento do diálogo. O cuidado de enfermagem na saúde ambiental é escasso, contudo, é uma área que precisa de intervenção, e o enfermeiro pode inserir-se por meio da promoção da saúde em prol do bem-estar ecológico e, consequentemente, humano.

Qualitative study having as subject, the communication between mothers and adolescent daughters in the family context. Objectives 1. Know, based on experience with mothers of adolescents, their views and experiences on issues related to gender, sexuality and reproduction, the dialogue between mothers and daughters. 2. Identify the mothers´ difficulties/ potentialities, with support in their lived experiences.3. Discover the processes of communication between mothers and daughters, made collectively through dialogue, negotiation and argumentation.4. Propose the practice of Health Education as a mediator of communication between mothers and daughters in the family context. Methodology: The social agents of the research were seven mothers of female adolescents, participants from non-governmental organization Acartes, residents in the District of Pirambu in Fortaleza-CE. The theoretical framework used was the Theory of Diversity and Universality of the Care of Madeleine Leininger. Data collection followed the model Observation-Participation Reflection, proposed by Leininger; semi-structured interviews and eleven meetings with the group, addressing the stages of development of the daughters: birth, childhood, puberty and adolescence. The project was submitted and approved by the Ethics Committee of the UFC under Protocol No 17/08. Results: social and cultural factors in the community contribute to the vision of sexuality of women and make difficult the dialogue with their daughters. The early pregnancy is a factor in their story of life, and when they project this fact to their daughters, the pregnancy has already occurred, or report that their daughters are likely to become pregnant early. That experience, the fruit of social development, creates barriers, which, alone, women can not overcome, and what happens is the continuation of a cycle in which the relationship of non-dialogue between mother and daughter are reproduced over the generations. In this reality, many times women, placed in a particular cultural background, have little or no degree of motivation of the family or community. When they remember their experiences of adolescence, feelings such as fear and shame are reported in adulthood and relate these feelings as still present in their lives. In relation to dialogue with their daughters, the argument is used by the pregnancy issue, linking it to the future of these barriers in life. For STD, are little discussed as an argument for prevention, not on explaining signs and symptoms, making the vision of adolescents at the preventive issue. The TV is seen as an area that provides the reasoning and negotiation. Conclusions: The study may prompt a renewed vision in the field of sexual and reproductive health in the family, which considers the relational dimension of sexuality, sex and reproduction, aiming to contribute to the promotion of the dialogue between mother and daughter. The intervention of the nurse as part of the team of Health of the Family through the Health Education helps to improve self-esteem and perception of the women´s world, encouraging them to a greater degree of autonomy and power to decide about questions related to sexuality. The reflection of the experiences through the memories of the life cycle can encourage them to think about new projects for their lives and shows that even with difficulties, the dialogue between mothers and daughters can occur, whereas it is never too late to learn

Infants in the Neonatal Intensive Care Unit (NICU) often get skin lesions on account of the many stressful procedures they are exposed to. This prospective, quantitative and descriptive study was carried out at a public health facility in Fortaleza (Northeastern Brazil) from March to May 2007, in order to investigate skin lesion patterns in infants in the NICU setting. The study population consisted of 137 hospitalized infants. Informed written consent was obtained from the infants’ caretakers. The data collection instrument registered skin lesions through direct observation during bathing, change of diapers, catheters and eye patches and during removal of semi-permeable membranes, elastic adhesive bandages and/or micropores, electrodes and hydrocolloid dressings applied to the skin during punction, among other procedures. Eighty percent of the infants were premature, 63% were male, 61% were caesarean births, 40% presented first-minute apgar scores of 7-10, 49% were diagnosed with moderate prematurity, 74% were full-term, 39% had low birth weight and 44% measured 41–47cm. Thirty-six infants had skin lesions (total 51 lesions) in the form of bruises (46%), erythema (18%), excoriation (12%), ecchymosis (10), pustulas (6%), scaling (4%), myelomeningocele (2%) or gastroschisis (2%). The lesions were inflicted while the infants were being treated with intravenous hydration (84%), antibiotics (78%), mechanical ventilation (53%), phototherapy (33%), parenteral nutrition (27%), blood transfusion (8%), oxygen hood (8%), nasal cpap (6%) or circulating oxygen (4%), or were in a heated incubator (86%), transport incubator (10%) or heated crib (4%). Lesions were observed most often on limbs (52%), torso (24%), head (16%) and other sites (8%). The causes identified were arterial puncture (32%), leaking (14%), contact dermatitis (14%), vein puncture (8%), impetigo (4%), undetermined (4%), congenital malformation (4%), removal of the caul (4%), removal of adhesive bandage (4%), skin dryness (4%), infection (2%), removal of hypoallergenic tape (2%) and birth traumatism (2%). Forty percent of lesions measured < 1cm2 and 68% measured 1-2cm. Most were well defined (38%) and/or localized (92%). Infants with lesions presented prematurity (92%), syndrome of respiratory distress (43%), asphyxia (24%), full-term delivery (8%); risk of infection (6%), risk of hypoglycemia (6%), gastroschisis (2%) or myelomeningocele (2%). Most (47%) weighed 550-999g at birth, with lesions occurring at 455-999g in 47%. Most were newborn (84%) and lesions appeared before the seventh day of life in 47% of cases. Among the parameters lesion type, diagnosis, PN, IG and prematurity, only the latter presented a statistically significant association (p=0.496, by the Fisher-Freeman-Halton test). The study shows the importance of providing the newborn with good-quality holistic nursing care with a view to the special needs of this patient population.