O processo de mudança em um hospital de Belo Horizonte: a visão da enfermeira-gerente

Aiming at analizing manager-nurses’ perceptions and wits as to processes of structural and managerial changes in a hospital organization this work was written. It is a case study- qualitative approach- carried out in a extra-sized charity hospital in Belo Horizonte. Data were collected through semi-structured interviews with 10 manager-nurses, submitted to analisis of content. According to the results obtained it was verified that the managers realize, as facilitators, the managerial and structural changes occurred in the organization, namely the decentralization of decision-making, the increase in the managerial groups’ autonomy, the improvement in the communication and information system, as well as the re-definition of the nurses’professional role. Also identified was a new workspace for the orderly in hospital management and changes in the managers’ professional posture which showed themselves as being open to innovation, to the challenges imposed by the job and the need to obtain further knowledge in order to perform such job. The innovator character of the changes in the hospital organization as well as the participation of the nurse/orderly in the process of management deserve special attention in their diverse aspects, for they can come to constitute an important professional alternative for the nurse and for other hospital organizations in a moment of turbulence and transition in the health sector.manager-nurses, hospital, changes,

Human head temperature and electric field investigations under ECT

Electroconvulsive therapy (ECT) is a non-invasive technique used to treat psychiatric conditions. A high strength low frequency electrical stimulation is delivered through two electrodes. The aim of this work is to develop an ECT finite element human head model to investigate the electric field and the increase in temperature due to the electrical stimulation. The bio-heat transfer equation combined with Laplace equation and their initial and boundary conditions are used to define the physics of the models. Firstly, finite ele-ment spherical human head models are created in COMSOL Multiphysics and the behaviour of the thermal field due to ECT electrical stimulation is analysed. Hetero-geneity was considered and thermal anisotropy of the skull layer was applied to the finite element models. Secondly, a realistic human head model is created using magnetic resonance images (MRI). Similar physics is applied to define the thermal and electrical problems, and the anisotropic conductivity of the skull is considered. The realistic models contain anatomical features and realistic tissue conductive properties. Through these models we investigate the role of stimulation parameters such as: electrode montages, strength of stimulation, temperature behaviour, etc. Later on, another realistic human head model with a brain tumor is created and a diffusion tensor image is included. Based on this model the white matter anisotropy is considered and the effect on the electric field is analysed. The results show that high temperatures only occur on external areas of the head, such as scalp and fat. The thermal conductivity anisotropy is insignificant from a heat-transferring point of view. However, the electrical anisotropy does need to be included in order to get more accurate outcomes. If ECT was applied to a patient with a brain tumor, then factors such as tumor location, aggressiveness, electrode montage, etc would need to be considered. Further work can be undertaken through computational simulation to make personal ECT treatment feasible in clinical practice

Effect of photodynamic therapy and non-thermal plasma on root canal filling: analysis of adhesion and sealer penetration

Objective The aim of this study was to evaluate the effect of photodynamic therapy (PDT) and non-thermal plasma (NTP) on adhesion and sealer penetration in root canals. Material and Methods Sixty single-rooted premolars were used. The teeth were prepared using a crown-down technique. NaOCl and EDTA were used for irrigation and smear layer removal, respectively. The root canals were divided into three groups: control, PDT, and NTP. After treatments, the roots were filled using gutta-percha and either AH Plus (AHP) or MTA Fillapex (MTAF) sealers. Samples were sectioned at 4, 8, and 12 mm from the apex (1-mm slices)and analyzed by the push-out bond strength test (adhesion) and confocal laser scanning microscopy (sealer penetration). Data were statistically evaluated using Kruskal-Wallis, Dunn’s, and Spearman’s tests. Results Regarding AHP, bond strength was similar in the NTP group and in the control group, but significantly lower in the PDT group. As to MTAF, both therapies showed lower values than the control group. In the confocal analysis of AHP, maximum and mean penetration, and penetrated area were statistically higher in the control group than in the PDT and NTP groups. Penetrated perimeter was similar among groups. Regarding MTAF, all parameters yielded better results in the NTP than in the control group. The PDT and control groups showed similar results except for penetrated area. Conclusion PDT and plasma therapy affected the adhesion and sealer penetration of root canals filled with AH Plus and MTA Fillapex and there is no positive correlation between adhesion and sealer penetration

Educação ambiental e paradigmas de interpretação da realidade : tendencias reveladas

Orientador: Mansur LutfiTese (doutorado) - Universidade Estadual de Campinas, Faculdade de EducaçãoDoutorad

Dimensões do desenvolvimento territorial sustentável na análise da cidade turística de Matinhos, costa sul do Brasil – a construção histórica do território vista desde o processo de regulamentação do uso e ocupação do solo

O objetivo do artigo é evidenciar como o processo de regulamentação relativo ao uso e ocupação do solo influenciou a conformação de três dimensões do desenvolvimento territorial sustentável (ecológica, espacial e institucional), considerando a trajetória da cidade litorânea de Matinhos, localizada no sul do Brasil, cuja ocupação está relacionada ao turismo de segundas residências. A pesquisa foi baseada no método histórico-documental que possibilitou a realização da análise de eventos sob a perspectiva cronológica, em caráter longitudinal. As principais fontes da pesquisa histórica foram os documentos relativos ao uso e ocupação do solo que incidiram diretamente sobre o município. A análise permitiu a identificação de três eixos que explicitam as dimensões, constatando que no processo de construção do território pesquisado as mudanças institucionais e normativas da gestão do território ocorreram, mas se mostraram mecanismos insuficientes para configurar um tipo de desenvolvimento territorial sustentável. The objective of the article is to explain and understand how the regulation process related to land use and occupation influenced the conformation of three dimensions of sustainable territorial development (ecological, spatial and institutional), considering the trajectory of the coastal city of Matinhos, located in southern Brazil, whose occupation is related to second home tourism. The research was based on the historical-documentary method that made it possible to carry out the analysis of events from a chronological perspective, in a longitudinal character. The treatment of the documentary base was carried out using the document comment tool. The main sources of historical research were the documents related to the use and occupation of the land that were directly related to the municipality. The analysis allowed the identification of three axes that explain the dimensions of the territory. In terms of results, it was found that in the process of construction of the surveyed territory, the institutional and normative changes in the management of the territory occurred; however, insufficient mechanisms were shown to configure a type of sustainable territorial development

Práticas pedagógicas na escola inclusiva: entre adaptar e reinventar

Esta pesquisa surge de inquietações com as políticas da educação especial, que vêm desafiando o contexto escolar. Em especial, nesta investigação, tratamos das concepções e práticas pedagógicas que estão sendo construídas em meio às mudanças na educação. Nosso objetivo geral é compreender as concepções que compõem as práticas pedagógicas consideradas “práticas de adaptação curricular” desenvolvidas no contexto da educação inclusiva. A metodologia caracteriza-se como pesquisa qualitativa de abordagem narrativa sociocultural; para a coleta dos dados, utilizamos a entrevista narrativa semiestruturada. As colaboradoras foram quatro professoras de uma escola da rede municipal de ensino de Santa Maria (RS). Nossa escrita fundamenta-se, além dos documentos legais, nos estudos de Bolzan (2002), Beyer (2008), Michels et al. (2010), Carvalho (2013), Libâneo (2013) e Ball et al. (2016), entre outros. Com esta investigação, entendemos que no grupo de professoras há uma “sintonia” profissional, na busca de fazer e ser o mais correspondente possível para/no contexto da educação inclusiva. Assim, a escola ora configura as práticas a partir da vontade de adaptar e reafirmar o já instituído, ora anuncia uma vontade de ressignificação, propondo não um currículo adaptado para alguns, mas a sua reinvenção visando ao todo

The effects of dietary supplementation with Agaricales mushrooms and other medicinal fungi on breast cancer: Evidence-based medicine

Breast cancer is the most prevalent cancer in women. The most frequent therapeutic approaches for the treatment of this disease are chemotherapy, radiotherapy, hormone therapy, and surgery. Conventional pharmacological treatments cause many harmful side effects in patients. To improve the quality of life of breast cancer patients, researchers have sought alternative adjuvant treatment strategies. To assess the effects of fungi and other basidiomycetes Agaricales on the co-adjuvant treatment of breast cancer, we conducted a literary review of the available scientific evidence. We selected articles published in refereed journals from 1990 to 2011 in Medline, Lilacs, CAPES, Scielo, and Pubmed. Articles written in English, Spanish, and Portuguese were reviewed. We used the following descriptors: Agaricales, medicinal mushroom/fungus, breast cancer, dietary supplementation, synonyms, and related terms. The pharmacological effects of nutritional and medicinal mushrooms have been reported in several experimental clinical studies and have shown promising results in the adjuvant treatment of breast cancer. Adjuvant treatment with mushrooms is associated with improvements in the immunological and hematologic parameters of breast cancer, as well as in the quality of life of these patients. Randomized clinical studies are needed to elucidate the possible mechanisms of action and clinical benefits of these fungi with respect to survival time, disease progression, and metastasis in breast cancer

Perception of cost-consciousness among medical students: an 11-item scale

Introduction: Managing healthcare resources in a cost-conscious way is an important topic in medical education.  A validated instrument to measure the perception of cost-conscious attitudes of medical students could be an important tool for university staff to understanding them and to plan and evaluate educational interventions to address them. Objectives: To validate a scale to measure the perception of cost-conscious attitudes among medical students. Method: Thirteen items from a survey to measure cost-conscious attitudes in medical students were used. Semantic validation and psychometric analysis (exploratory factor analysis, Cronbach alpha, and composite reliability test) were carried out. Results: A sample of 275 participants, of which 62% were female, with an average age of 25±3.1 years, completed the questionnaire. The best structure to measure the perceptions is the one-factor solution, with 11 of the 13 items remaining in the final version. Substantial Cronbach's alpha for this questionnaire was obtained 0.66 and composite reliability was 0.77. Conclusion: The results suggest that the questionnaire has a satisfactory psychometric quality and is therefore able to measure the perception of medical students about cost-conscious attitudes

Perfil da infecção bacteriana em ambiente hospitalar

Infecções relacionadas à assistência à saúde ligada a patógenos multirresistentes e o uso indiscriminado de antibióticos contribuempara a aquisição de mecanismos de resistência bacteriana, consequentemente ocasionando um impacto significativo no ambientehospitalar e em toda a comunidade. Objetivo: Conhecer os principais agentes causadores de infecções no ambiente hospitalar,analisar os tratamentos utilizados e os desfechos de cura e reincidências e assim determinar o perfil das infecções bacterianas empacientes internados em um hospital público do município de Patos no Estado da Paraíba. Metodologia: Fez-se um estudo de coorteobservacional transversal retrospectivo a partir da pesquisa direta e aplicação de um questionário sobre os dados dos prontuários dospacientes internados na UTI e que fizeram uso de antibióticos durante os meses de março e abril de 2014. E dos pacientes submetidosa cirurgias realizadas durante os meses de julho a setembro de 2015. Resultados: Analisou-se 76 prontuários dos meses de março eabril de 2014 dos pacientes da UTI e 193 prontuários referentes a pacientes submetidos a cirurgias realizadas durante o período dejulho a setembro 2015. Segundo informações dos prontuários referentes aos pacientes da UTI, nenhum antibiograma foi realizadono período, enquanto que nos pacientes submetidos a cirurgias foi realizado um antibiograma. O antibiótico mais utilizado foi acefalotina com 29,7% na UTI e 39,5% nas cirurgias. Conclusão: Houve a utilização de 12 tipos de antibióticos diferentes destacandoo uso de cefalotina na maioria dos casos. Não foi possível identificar os principais agentes causadores de infecções devido ao baixoíndice de cultura/antibiograma

Análise da sala de situação numa USF: um olhar sobre a saúde da mulher

Rationale and Objectives: Among the Brazilian health care programs, there is the Program for Integral Attention to Women’s Health (PAISM), which offers full assistance to the female population in accordance with the principles and guidelines of SUS within primary care policy. This study aimed to analyze the monthly monitoring in 2009 and 2010 through epidemiological indicators of the situation room regarding women’s health in a Family Health Unit (FHU) of Recife-PE. Methods: This is a descriptive epidemiological, comparative and exploratory study carried out in a FHU of the Health District V, located in Recife-PE and called Planet of the Apes II, a member of PET-Health. A total of eight indicators were assessed, representing 100% of the data in spreadsheets presented in the Situation Room in the abovementioned years. Results: The assessed Family Health Unit, in general, reached the goals established by the Ministry of Health regarding PAISM in the analyzed indicators for prenatal care and collection of cytopathologic specimens for uterine cancer surveillance. Conclusion: The FHU must always be instructed and trained to provide comprehensive care to women’s health, a perspective that includes health promotion, control of the most prevalent diseases in this group and ensuring the right to health. However, it is worth emphasizing that the results shown here cannot be interpreted alone, or be the only source of information and evaluation of care. KEYWORDS: Women’s Health. Primary Health Care. Health PoliciesJustificativa e Objetivos: Dentre os programas de atenção à saúde está o Programa de Atenção Integral à Saúde da Mulher (PAISM), que oferece assistência integral à população feminina em conformidade com os princípios e diretrizes do SUS, dentro da política da atenção básica. Este trabalho teve por objetivo analisar o espelho de acompanhamento mensal do ano de 2009 e 2010 através dos indicadores epidemiológicos da sala de situação referentes à saúde da mulher de uma Unidade de Saúde da Família (USF) de Recife-PE. Metodologia: Trata-se de um estudo epidemiológico descritivo, comparativo e ao mesmo tempo exploratório, realizado em uma USF do Distrito Sanitário V, localizada em Recife-PE e denominada Planeta dos Macacos II, integrante do PET-Saúde. Um total de oito indicadores foram consultados, o que representa 100% dos dados das planilhas dispostas na própria Sala de Situação, nos anos referidos acima. Resultado: A Unidade de Saúde da Família acompanhada, de maneira geral, atingiu as metas preconizadas pelo Ministério da Saúde em relação ao PAISM nos indicadores analisados para realização de pré-natal e coleta de citopatológico para câncer uterino. Conclusão: A USF deve estar sempre orientada e capacitada para a atenção integral à saúde da mulher, numa perspectiva que contemple a promoção da saúde, o controle de patologias mais prevalentes nesse grupo e a garantia do direito à saúde. No entanto, vale enfatizar que os índices apresentados não podem ser interpretados isoladamente e nem ser a única fonte de informação e avaliação da assistência