O enfermeiro na educação de adultos em pré-operatório: uma abordagem andragógica /

Dissertação (mestrado) - Universidade Federal de Santa Catarina, Centro de Ciências da Saúde.O presente estudo objetivou avaliar as possibilidades de aplicação de um modelo de educação de adultos na assistência de enfermagem a clientes em pré-operatório. A abordagem foi qualitativa, fundamentada na pesquisa participante, como dezenove clientes que estavam aguardando cirurgias eletivas em uma instituição hospitalar pública a cidade de Cuiabá, Mato Grosso, no período de outubro de 1998 a junho de 1999. Os encontros para a coleta de dados ocorreram antes da internação, e os locais, na instituição ou no domicílio, foram definidos em comum acordo entre os participantes (enfermeiro/cliente e familiar). Esta prática educativa permitiu ao cliente estar efetivamente co-participando da relação terapeuta-cliente e co-responsabilizando-se pelo planejamento de sua assistência. Além disso, demonstrou, também, a possibilidade de delineamento de novas formas de cuidar dos ser humano adulto em situação cirúrgica, trazendo subsídios para o aperfeiçoamento do ensino de enfermagem

The Agile Clinical Nurse Specialist

Purpose/objectivesThis article describes the contributions of the clinical nurse specialist in navigating the challenges of the COVID-19 pandemic to ensure patient and staff safety while providing science-based quality of care.DescriptionThe group of clinical nurse specialists using advanced practice knowledge and skills within the 3 spheres of impact (ie, patient, organization, and nurse) developed and implemented strategies that supported frontline clinicians and met emerging organizational needs during the COVID-19 pandemic.OutcomesThe clinical nurse specialist's agility was imperative in navigating the challenges of the pandemic to ensure the safety of patients and staff by providing strategies and standardization to workflow processes across the organization.ConclusionThe group's combined clinical expertise and support of frontline nurses positioned the clinical nurse specialist to rapidly escalate the bedside nurse's concerns and provide recommendations to improve workflow while maintaining patient and staff safety

De Novo ACTG1 Variant Expands the Phenotype and Genotype of Partial Deafness and Baraitser–Winter Syndrome

Actin molecules are fundamental for embryonic structural and functional differentiation; γ-actin is specifically required for the maintenance and function of cytoskeletal structures in the ear, resulting in hearing. Baraitser–Winter Syndrome (B-WS, OMIM #243310, #614583) is a rare, multiple-anomaly genetic disorder caused by mutations in either cytoplasmically expressed actin gene, ACTB (β-actin) or ACTG1 (γ-actin). The resulting actinopathies cause characteristic cerebrofrontofacial and developmental traits, including progressive sensorineural deafness. Both ACTG1-related non-syndromic A20/A26 deafness and B-WS diagnoses are characterized by hypervariable penetrance in phenotype. Here, we identify a 28th patient worldwide carrying a mutated γ-actin ACTG1 allele, with mildly manifested cerebrofrontofacial B-WS traits, hypervariable penetrance of developmental traits and sensorineural hearing loss. This patient also displays brachycephaly and a complete absence of speech faculty, previously unreported for ACTG1-related B-WS or DFNA20/26 deafness, representing phenotypic expansion. The patient’s exome sequence analyses (ES) confirms a de novo ACTG1 variant previously unlinked to the pathology. Additional microarray analysis uncover no further mutational basis for dual molecular diagnosis in our patient. We conclude that γ-actin c.542C > T, p.Ala181Val is a dominant pathogenic variant, associated with mildly manifested facial and cerebral traits typical of B-WS, hypervariable penetrance of developmental traits and sensorineural deafness. We further posit and present argument and evidence suggesting ACTG1-related non-syndromic DFNA20/A26 deafness is a manifestation of undiagnosed ACTG1-related B-WS