A FORMAÇÃO EM ENFERMAGEM POR ÁREA DE COMPETÊNCIA: LIMITES E POSSIBILIDADES

Objetivo Analisar possibilidades e limites da formação em enfermagem por competência. Método Revisão integrativa da literatura acerca do assunto e analise dos resultados de uma pesquisa de avaliação de um curso de enfermagem desenvolvida por áreas de competência, estabelecendo um diálogo entre a revisão e os resultados dessa pesquisa. Resultados Quanto à vertente teórica de competência desses artigos, houve um predomínio da matriz construtivista, seguida da funcionalista e da dialógica. No diálogo entre a literatura e a pesquisa observaram-se limites e possibilidades no desenvolvimento de uma formação por áreas de competência. Conclusão A abordagem dialógica de competência é a proposição que mais se aproxima do perfil definido pelas DCN para a formação em enfermagem, identificada também na pesquisa de avaliação analisada. No entanto, verificou-se que há aspectos que precisam ser mais bem trabalhados, como: parceria escola e serviço, papel do docente, papel do estudante e processo avaliativo.Objetivo Analizar posibilidades y límites de la formación en enfermería por competencia. Método Revisión integrativa de la literatura sobre el asunto y análisis de los resultados de una investigación de evaluación de un curso de enfermería desarrollada por áreas de competencia, estableciendo un diálogo entre la revisión y los resultados de esa investigación. Resultados Cuanto a la vertiente teórica de competencia de esos artículos, hubo un predominio de la matriz constructivista, seguida de la funcionalista y de la dialógica. En el diálogo entre la literatura y la investigación se observaron límites y posibilidades en el desarrollo de una formación por áreas de competencia. Conclusión El abordaje dialógico de competencia es la proposición que más se aproxima del perfil definido por las DCN para la formación en enfermería, identificada también en la investigación de evaluación analizada. Aunque, se verificó que hay aspectos que precisan ser más bien trabajados, como: aparcería escuela y servicio, papel del docente, papel del estudiante y proceso de evaluación.Objective To analyze the possibilities and limits of competency-based training in nursing. Method An integrative review of the literature on the subject was carried out, and an analysis was made of the results of a survey evaluating a nursing course based on areas of competency. A dialog was then established between the review and the results of the research. Results On the question of which theoretical type of competency the articles from the literature relate to, there is a predominance of the constructivist perspective, followed by the functionalist approach and the dialog-based approach. In the dialog between the literature and the research, limits and possibilities were observed in the development of a training by areas of competency. Conclusion The dialog-based approach to competency is the proposition that most approximates to the profile defined by the National Curriculum Guidelines for training in nursing, and this was also identified in the evaluation survey that was studied. However, it is found that there are aspects on better work is needed, such as: partnership between school and the workplace, the role of the teacher, the role of the student, and the process of evaluation

A UTI Neonatal sob a ótica das mães

doi: 10.5216/ree.v12i4.7130 Este estudo trata dos sentimentos de mães de recém-nascidos (RN) internados em Unidade de Terapia Intensiva Neonatal (UTIN), considerando a necessidade de separação dos mesmos logo após o nascimento. Teve por objetivo compreender os sentimentos de mães de bebês internados em UTIN. Pesquisa exploratória de abordagem qualitativa, sendo os dados coletados por meio de entrevistas semi-estruturadas com doze mães de bebês internados na UTIN de hospital público do interior do Estado de São Paulo, entre novembro/2007 e março 2008. Os dados foram analisados com base na análise de conteúdo, modalidade temática, o que gerou a categoria "A UTI Neonatal sob a ótica das mães" e três subtemas: a busca do desconhecido, uma busca sem fim; os obstáculos frente à execução dos cuidados; e as necessidades das mães não percebidas pela equipe. Os resultados evidenciaram a necessidade de mudança na abordagem do cuidado de enfermagem para que as mães sejam atendidas em suas necessidades e, assim, possam participar do cuidado de seu RN, favorecendo a formação do vínculo afetivo mãe-bebê e gerando um ambiente mais agradável para a tríade mãe-bebê-equipe de saúde. Descritores: Unidades de Terapia Intensiva Neonatal; Recém-nascidos; Relações mãe-filho; Hospitalização; Humanização da assistência

Investigations of the prevalence and virulence of Candida albicans in periodontal and endodontic lesions in diabetic and normoglycemic patients

Pulpal and periodontal tissues have similar microbiota that allows cross-contamination between the pulp and periodontal tissues. Objective The aim of this study was to investigate the prevalence of isolated Candida albicans from periodontal endodontic lesions in diabetic and normoglycemic patients, and the fungi's virulence in different atmospheric conditions. Material and Methods A case-control study was conducted on 15 patients with type 2 diabetes mellitus (G1) and 15 non-diabetics (G2) with periodontal endodontic lesions. Samples of root canals and periodontal pockets were plated on CHROMagar for later identification by polymerase chain reaction (PCR) and virulence test. Results C. albicans was identified in 79.2% and 20.8% of the 60 samples collected from diabetic and normoglycemic patients, respectively. Of the 30 samples collected from periodontal pockets, 13 showed a positive culture for C. albicans, with 77% belonging to G1 and 23% to G2. Of the 11 positive samples from root canals, 82% were from G1 and 18% from G2. Production of proteinase presented a precipitation zone P

Bio-behavioral survey of syphilis in homeless men in Central Brazil: a cross-sectional study

The objective of this study was to investigate the prevalence and factors associated with syphilis in homeless men in Central Brazil. It is a cross-sectional study conducted with 481 individuals attending four therapeutic communities between October and December 2015. A structured interview was conducted to collect sociodemographic data and risk factors for syphilis. Rapid/point-of-care and VDRL tests were performed to determine exposure to syphilis and the presence of active syphilis, respectively. Poisson regression analysis was used to verify the risk factors associated with the outcomes investigated. Of the study participants, 10.2% were reactive to the rapid test, and 5.4% had active syphilis. At the multiple regression analysis, schooling (adjusted prevalence ratio - APR: 0.89; p = 0.005), history of genital ulcer (APR: 2.59; p = 0.002), STI history (APR: 1.97; p = 0.042), and sexual intercourse under drug effects (APR: 1.60; p = 0.022) were independent factors associated with lifetime syphilis. Also, history of genital ulcer (APR: 2.19; p = 0.019), STI history (APR: 1.74; p = 0.033) and number of sexual partners in the last year (APR: 1.02; p = 0.044) were associated with active syphilis. The prevalence of syphilis among homeless men was rather high, confirming the vulnerability of this group to this infection. These results emphasize the need for educational intervention, improvement of risk reduction programs, availability of diagnostic tests, especially the rapid test, and treatment

Uzgoj bakterije Methylobacterium organophilum u metanolu za istodobnu proizvodnju proteina i korisnih metabolita

Research background. This study aims to monitor the growth of the methylotrophic bacteria Methylobacterium organophilum in a culture medium with methanol as a carbon source and to verify the production of unicellular proteins and other biomolecules, such as carotenoids, exopolysaccharides and polyhydroxyalkanoates, making them more attractive as animal feed. Experimental approach. Bacterial growth was studied in shake flasks using different carbon/nitrogen (C:N) ratios to determine their best ratio for achieving the highest volumetric productivity of cells and substrate consumption rate. This optimal parameter was further used in a fed-batch operating bioreactor system to define the kinetic profile of cell growth. Methanol consumption was measured by HPLC analysis and the extracted pigments were analyzed by liquid chromatography/mass spectrometry. Chemical composition and rheological properties of the produced exopolysaccharides were also determined. Results and conclusions. The best experimental parameters were verified using an initial methanol concentration of 7 g/L in the culture medium. The same initial substrate concentration was used in the fed-batch operation and after 60 h of cultivation 5 g/L of biomass were obtained. The accumulation of carotenoids associated with cell growth was monitored, reaching a concentration of 1.6 mg/L at the end of the process. These pigments were then analyzed and characterized as a set of xanthophylls (oxidized carotenoids). In addition, two other product types were identified during the fed-batch operation: exopolysaccharides, which reached a concentration of 8.9 g/L at the end of the cultivation, and an intracellular granular structure that was detected by transmission electron microscopy (TEM), suggesting the accumulation of polyhydroxyalkanoate (PHA), most likely polyhydroxybutyrate. Novelty and scientific contribution. Methylobacterium organophilum demonstrated a unique ability to produce compounds of commercial interest. The distinct metabolic diversity of this bacterium makes room for its use in biorefineries.Pozadina istraživanja. Svrha je ovoga istraživanja bila pratiti rast metilotrofne bakterije Methylobacterium organophilum u podlozi s metanolom kao izvorom ugljika, te potvrditi sposobnost tog jednostaničnog organizma da proizvodi proteine i druge biomolekule, kao što su karotenoidi, egzopolisaharidi i polihidroksialkanoati, a koji se mogu upotrijebiti u proizvodnji stočne hrane. Eksperimentalni pristup. Rast bakterije ispitan je na tresilici pri različitim omjerima ugljika i dušika (C:N), radi utvrđivanja njihovog optimalnog omjera za postizanje najveće volumetrijske produktivnosti stanica i najboljeg iskorištenja supstrata. Zatim je pomoću tog optimalnog omjera hranjiva određen kinetički profil rasta stanica u šaržnom bioreaktoru. Potrošnja metanola mjerena je metodom HPLC, a izolirani su pigmenti ispitani tekućinskom kromatografijom spregnutom s masenom spektrometrijom. Također su određeni kemijski sastav i reološka svojstva dobivenih egzopolisaharida. Rezultati i zaključci. Najbolji eksperimentalni parametri potvrđeni su pri početnoj koncentraciji metanola u podlozi od 7 g/L. Ista je početna koncentracija korištena u šaržnom bioreaktoru, gdje je nakon 60 h uzgoja dobiveno 5 g/L biomase. Tijekom uzgoja je praćena akumulacija karotenoida, čija je koncentracija pri završetku procesa bila 1,6 mg/L. Pigmenti su zatim ispitani i okarakterizirani kao ksantofili (podvrsta karotenoida). Osim toga, tijekom šaržne fermentacije identificirana su još dva proizvoda: egzopolisaharidi, čija je koncentracija na kraju uzgoja bila 8,9 g/L; te granularna struktura otkrivena pomoću transmisijskog elektronskog mikroskopa, koja upućuje na to da je u stanici došlo do nakupljanja polihidroksialkanoata (PHA), i to najvjerojatnije polihidroksibutirata. Novina i znanstveni doprinos. Bakterija Methylobacterium organophilum ima jedinstveno svojstvo proizvodnje spojeva od komercijalnog interesa. Iznimna metabolička raznolikost ove bakterije omogućuje njezinu primjenu u biorafinerijama

Prevalence and risk factors for intestinal protozoa infection in elderly residents at Long Term Residency Institutions in Southeastern Brazil

This study determined the prevalence of intestinal protozoa in Long Term Residency Institutions for the Elderly (ILPI) in elders, nurses and food handlers, identifying the risk factors associated with the infections. Stool samples taken from the elderly (n = 293), nurses (63) and food handlers (19) were studied. Questionnaires were used with questions related to sociodemographic variables, health, behavior and health characteristics. Stool samples were examined using the techniques of Faust and Ziehl Neelsen, and the prevalence of G. duodenalis, Cryptosporidium spp., E. histolytica/dispar in the elderly was 4.0%, 1.0% and 0.3% respectively. Nurses and food handlers showed 4.8% and 5.2% positivity only for G. duodenalis, respectively. The origin of the individuals and contact with domestic animals has been associated with infection by G. duodenalis in the elderly, and contact with domestic animals was considered a risk factor for infection. The last stool examinations were related to Cryptosporidium spp.. None of the variables were associated with E. histolytica/dispar. The frequency of hand washing was significantly associated with G. duodenalis among nurses. The frequency of positive samples of G. duodenalis, Cryptosporidium spp., E. histolytica/dispar showed that ILPIs environments are conducive to this occurring due to contact between the elderly, nurses and food handlers, which are often poorly trained in hygiene procedures and food handling.Este estudo determinou a prevalência de protozoários intestinais em Instituições de Longa Permanência para Idosos (ILPI), enfermeiros, manipuladores de alimentos identificando fatores de risco associados às infecções. Amostras de fezes de idosos (n = 293), enfermeiros (63), manipuladores de alimentos (19) foram estudadas. Foram aplicados questionários relacionados a variáveis sociodemográficas, de higiene, comportamento e características de saúde. As amostras de fezes foram examinadas pelas técnicas de Faust e Ziehl Neelsen e a prevalência de G. duodenalis, Cryptosporidium spp., E.histolytica/dispar nos idosos foi de 4,0%, 1,0% e 0,3%, respectivamente. Enfermeiros e manipuladores de alimentos apresentaram 4,8% e 5,2% de positividade apenas para G. duodenalis, respectivamente. A origem dos indivíduos, o contato com animais domésticos foram associados à infecção por G. duodenalis nos idosos, sendo que o contato com animais domésticos foi considerado um fator de risco para a infecção, o tempo do último exame coproparasitológico foi relacionado a Cryptosporidium spp.. Nenhuma das variáveis apresentaram associação com E. histolytica/dispar. A frequência da lavagem das mãos foi associada significativamente com G. duodenalis entre enfermeiros. As frequências de amostras positivas para G. duodenalis, Cryptosporidium spp., E. histolytica/dispar demonstram que ILPIs são ambientes propícios para esta ocorrência devido ao contato entre idosos, enfermeiros, manipuladores de alimentos, que muitas vezes são mal treinados em procedimentos de higiene e manipulação de alimentos

Diarrhea: a missed D in the 4D glucagonoma syndrome

Glucagonoma is a rare and slow-growing pancreatic tumor that usually manifests as glucagonoma syndrome. It is mainly characterized by a typical Dermatosis named necrolytic migratory erythema (NME), Diabetes and glucagon oversecretion. Deep vein thrombosis and Depression complete this set. We report the case of an advanced glucagonoma with liver spread, where all these 4D symptoms occurred but a chronic secretory Diarrhea was the most relevant feature. A 65-year-old man was referred to our center to investigate multiple hepatic nodules evidenced by abdominal tomography. He had a recent diagnosis of diabetes and complained of significant weight loss (25 kg), crusted skin lesions and episodes of a large amount of liquid diarrhea during the past 6 months. On admission, there were erythematous plaques and crusted erosions on his face, back and limbs, plus angular cheilitis and atrophic glossitis. The typical skin manifestation promptly led dermatologists to suspect glucagonoma as the source of our patient’s symptoms. A contrast-enhanced abdominal computed tomography showed a hypervascularized pancreatic lesion and multiple hepatic nodules also hypervascularized in the arterial phase. Despite initial improvement of diarrhea after subcutaneous octreotide, the patient’s impaired nutritional status limited other therapeutic approaches and he died of respiratory failure due to sepsis. His high levels of serum glucagon were not yet available so we performed an autopsy, confirming the diagnosis of metastatic glucagonoma with NME on histology. Chronic diarrhea is not a common feature in glucagonoma syndrome; however, its severity can lead to serious nutritional impairment and set a poor outcome

Avaliação do nível de distress em pacientes oncológicos atendidos em um ambulatório de quimioterapia

The aim of this study was to describe the socio-economic, occupational and clinical characteristics of cancer patients undergoing outpatient chemotherapy treatment and to assess the level of distress during chemotherapy treatment, using the Distress Thermometer instrument. This was a descriptive, cross-sectional study with a quantitative approach, developed at the chemotherapy outpatient clinic of a University Hospital, with 30 cancer patients. The Distress Thermometer instrument was used, and the data were analyzed using Software R (4.0.0). As a result, it was identified that the majority were men, average age of 59.5 years, married, employed and monthly income between 1 and 5 minimum wages. The result of the Distress Thermometer observed a high degree of suffering (>4), with a mean of 6.3 and standard deviation of 2.54. Associations between explanatory variables and outcome were not statistically significant. It was concluded that the instrument evaluated the level of distress of patients, being an important tool in nursing consultations in chemotherapy, favoring the perception and monitoring of stressors.O objetivo deste estudo foi descrever as características socioeconômico–ocupacionais e clínicas dos pacientes oncológicos em tratamento quimioterápico ambulatorial e avaliar o nível de distress no tratamento quimioterápico, utilizando o instrumento Termômetro do Distress. Este estudo foi descritivo, de corte transversal e abordagem quantitativa, desenvolvido no ambulatório de quimioterapia de um Hospital Universitário, com 30 pacientes oncológicos. Utilizou-se o instrumento Termômetro do Distress, sendo os dados analisados através do Software R (4.0.0). Como resultados, identificou-se que a maioria era homem, média de idade de 59,5 anos, casados, empregados e renda mensal entre 1 e 5 salários-mínimos. O resultado do Termômetro do Distress observou alto grau de sofrimento (>4), com média de 6,3 e desvio padrão de 2,54. As associações entre as variáveis explanatórias e desfecho não foram estatisticamente significantes. Concluiu-se que o instrumento avaliou o nível de distress dos pacientes, sendo ferramenta importante nas consultas de enfermagem em quimioterapia, favorecendo a percepção e o acompanhamento dos fatores estressores

Avaliação do nível de distress em pacientes oncológicos atendidos em um ambulatório de quimioterapia

The aim of this study was to describe the socio-economic, occupational and clinical characteristics of cancer patients undergoing outpatient chemotherapy treatment and to assess the level of distress during chemotherapy treatment, using the Distress Thermometer instrument. This was a descriptive, cross-sectional study with a quantitative approach, developed at the chemotherapy outpatient clinic of a University Hospital, with 30 cancer patients. The Distress Thermometer instrument was used, and the data were analyzed using Software R (4.0.0). As a result, it was identified that the majority were men, average age of 59.5 years, married, employed and monthly income between 1 and 5 minimum wages. The result of the Distress Thermometer observed a high degree of suffering (>4), with a mean of 6.3 and standard deviation of 2.54. Associations between explanatory variables and outcome were not statistically significant. It was concluded that the instrument evaluated the level of distress of patients, being an important tool in nursing consultations in chemotherapy, favoring the perception and monitoring of stressors.O objetivo deste estudo foi descrever as características socioeconômico–ocupacionais e clínicas dos pacientes oncológicos em tratamento quimioterápico ambulatorial e avaliar o nível de distress no tratamento quimioterápico, utilizando o instrumento Termômetro do Distress. Este estudo foi descritivo, de corte transversal e abordagem quantitativa, desenvolvido no ambulatório de quimioterapia de um Hospital Universitário, com 30 pacientes oncológicos. Utilizou-se o instrumento Termômetro do Distress, sendo os dados analisados através do Software R (4.0.0). Como resultados, identificou-se que a maioria era homem, média de idade de 59,5 anos, casados, empregados e renda mensal entre 1 e 5 salários-mínimos. O resultado do Termômetro do Distress observou alto grau de sofrimento (>4), com média de 6,3 e desvio padrão de 2,54. As associações entre as variáveis explanatórias e desfecho não foram estatisticamente significantes. Concluiu-se que o instrumento avaliou o nível de distress dos pacientes, sendo ferramenta importante nas consultas de enfermagem em quimioterapia, favorecendo a percepção e o acompanhamento dos fatores estressores

Atividades mão na massa: um método de sala de aula invertida para o ensino de física na Universidade Federal do Pará / Hand-mass activities: an inverted classroom method for physical education at the Federal University of Pará

Visando preencher as lacunas na aprendizagem dos alunos de física, o Laboratório de Inovação Didática em Física (LIDF) desenvolveu uma sequência didática envolvendo ciclos de ensino cujas atividades se baseiam na Taxonomia de Bloom do Domínio Cognitivo e nos princípios da sala de aula invertida. Nos ciclos, encontra-se as atividades Mão na Massa, cujo propósito é inserir problemáticas a serem resolvidas por meio da experimentação em sala de aula. Esse produto educacional apresentou grande adesão dos alunos, cujo engajamento em situações desafiadoras é fundamental para o desenvolvimento de competências