DINÂMICAS EDUCATIVAS JUNTO À EQUIPE DE ENFERMAGEM SOB A PERSPECTIVA CULTURAL DE CUIDADO À PUÉRPERA

This study was held in a hospital in Curitiba in order to reorient actions under a cultural care focus on mothers and their newly-born babies. The theoretical background was founded on the ideas as well as some concepts of Madeleine Leininger’s Cultural Care Universality and Diversity Theory in order to reach this goal. The work was effected through meetings and educational health dynamics. They aimed to promote individual and group values and help nursing professionals’ education towards the development of their initiative, organization skills, liveliness, comunicability, leadership, creativity, health education and cultural care effectiveness. It was possible to evidence, from the staff accounts, the impact of educational health dynamics, proving the relevance of the cultural focus on the quality of the nursing care provided to mothers at puerperium and their babies. It was also evidenced the importance of team work which brings about the team union, motivation and improvement on professional intergroup performance.Este trabalho foi realizado em uma instituiçãohospitalar de Curitiba e teve como objetivo desenvolverdinâmicas educativas junto à equipe de enfermagem nosentido de reorientar as ações para a perspectiva cultural docuidado de enfermagem à puérpera e seu bebê. Utilizou-secomo referencial teórico as idéias e alguns conceitos da Teoria da Diversidade e Universalidade do Cuidado Cultural de Madeleine Leininger. Procurou-se demonstrar a importância do cuidado de enfermagem que revela um compromisso cultural com a puérpera e seu bebê, bem como, a importância das ações educativas reflexivas que buscam odesenvolvimento de profissionais livres e conscientes de simesmos, envolvidos e decidindo por práticas que incluamsuas raízes, sua diversidade, onde o compromisso com asaúde possa ser um resgate de sua cidadania levando-os àatitude de promoção da saúde. O trabalho foi desenvolvidopor meio de encontros nos quais eram realizadas dinâmicaseducativas em saúde promovendo o desenvolvimento dosvalores individuais e coletivos no grupo, com o objetivo deincentivá-los à iniciativa, capacidade de organização,dinamismo, comunicabilidade, liderança, criatividade, àeducação em saúde e o compromisso com a efetividade docuidado cultural de enfermagem como terapêutico egratificante na obtenção dos resultados esperados. Atravésde relatos da equipe de enfermagem foi possível detectar oimpacto das dinâmicas educativas em saúde a partir daperspectiva cultural do cuidado de enfermagem à puérperacomo relevante para a qualidade do cuidado oferecido, assimcomo a importância do trabalho em grupo favorecendo aaproximação da equipe, motivação e melhoria norelacionamento inter-grupal

THE QUALITY OF THE NURSING CARE TROUGH A SURGICAL PERIOD ACCORDING TO CLIENTS’ FEEDBACK

Este estudo faz parte de um projeto do Grupo de Estudos Multiprofissional em Saúde do Adulto do Departamento de Enfermagem da UFPR. Teve como objetivo avaliar a qualidade dos cuidados de enfermagem prestados durante o período perioperatório segundo a opinião do cliente cirúrgico adulto, em um Hospital Universitário da cidade de Curitiba. Foram entrevistados 86 clientes de ambos os sexos submetidos a cirurgia geral, com capacidade de interação pessoal e que aceitaram participar voluntariamente da pesquisa. Os resultados demonstram que os maiores desvios quanto a qualidade dos cuidados foram quanto ao período pré-operatório imediato, principalmente caracterizados como ações menores nas atividades da área expressiva. Por outro lado, os cuidados de enfermagem na sala de recuperação anestésica foram os que mais se aproximaram de padrões de qualidade de cuidados humanizados.The Quality of the Nursing Care Through a Surgical Period According to Clients’ Feedback. This study is part of a project of the Multiprofessional Study Group on Adult Health of the Nursing Department at the UFPR. It aimed at evaluating the quality of the nursing care delivered through a surgical period at a University Hospital in the city of Curitiba, according to the opinion of surgical adult clients. Eight six (86) clients were interviewed, both sexes, who had gone through surgery, capable of personal interaction and voluntary participants of the research. The results demonstrated that the major quality biases occurred during the pre-surgical care period, characterized mostly by minor actions in the expressive field. On the other hand, nursing care at the postoperating room approached the quality standards demanded by the humanistic care

SIZING UP HUMAN RESOURCES IN NURSING

O dimensionamento de pessoal de enfermagem é a etapa inicial do processo de provimento de recursos humanos, que tem como objetivo definir a previsão da quantidade de funcionários para o atendimento das necessidades de assistência de enfermagem prestada à clientela. Os diferentes métodos de provisão escolhidos vão garantir ou não, os aspectos qualitativos que devem ser observados para assegurar uma assistência adequada e de qualidade. Para abordar estas questões, foi desenvolvido um estudo descritivo com o objetivo de investigar os diferentes métodos teóricos ou empíricos utilizados pelos enfermeiros para cálculo de pessoal de enfermagem. As unidades selecionadas foram: Centro Cirúrgico, Centro de Material e Clínica Médica de 02 (dois) hospitais de grande porte e 02 (dois) de médio porte, na cidade de Curitiba. Concluiu-se que a fórmula tradicional foi a mais citada. Ficou evidenciado que ainda há uma lacuna no embasamento teórico-científico na utilização de métodos de dimensionamento de Recursos Humanos. Esta carência dificulta a justificativa para o aumento do número de funcionários que se mostrou deficitário neste estudo.Sizing up nursing staff is the initial step of the provision process of human resources, which objectifies the prediction of the number of personnel required to render clients nursing assistance. The different methods of provision selected will reassure (or not) qualitative aspects which must be observed to deliver safe and prime-quality assistance. A descriptive-exploratory study was carried out to approach those issues. Such a study objectified to analyze different theoretical empirical methods used by nurses to figure out nursing personnel. The selected units were: Surgical Unit, Supply Unit and Medical Unit of 2(two) big hospitals and 2(two) medium-sized hospitals in Curitiba. It was concluded that the traditional formula was the most mentioned. It was evidenced a lack in theoretical-scientific ground regarding the use of methods for sizing up human resources. Such lack hinders the increase in the number of employees, which evidenced a deficit in this study

Estruturando o trabalho de prevenção de Infecções Sexualmente Transmissíveis (IST) em idosos: oficinas educativas

Background and Objectives: Report educational experiences orienting the elderly population about sexuality and prevention of sexually transmitted diseases. Case description: A professional experience report of STD prevention group in the elderly at a specialized clinic. The educational gerontology was used as a methodology in the production of workshops held from November/2012 to December/2014 to service users. The workshops entitled “Tenda da Sabedoria”, “Baile dos Idosos” and “Roda de Conversa”addressed the sexuality of the elderly, knowledge about transmission and how to prevent it. Actions are always accompanied by the distribution of educational materials, condoms and referrals to testing users for Hepatitis B and C, HIV and syphilis. The group noticed satisfaction of the elderly, interest and effective participation through learning in a simple and enjoyable way. It was also possible to identify elderly interested in multiplying the knowledge with peers and family. Conclusions: The participatory educational process promotes strengthening of elderly network support, enabling an active channel of communication between staff and users, offering subsidies appropriated to prevention work and treatment of diseases. Keywords: Health of the Elderly; Health Education; Communicable Disease Prevention; Health Promotion.Justificativa e Objetivos: Relatar vivências educativas na orientação à população idosa sobre sexualidade e prevenção das infecções sexualmente transmissíveis (IST). Descrição do caso: Trata-se de relato de experiência do grupo de prevenção de IST no idoso em ambulatório especializado. A gerontologia educacional foi utilizada como metodologia na produção das oficinas educativas realizadas entre novembro de 2012 e dezembro de 2014 para idosos usuários do serviço. As oficinas intituladas “Tenda da Sabedoria”, “Baile dos Idosos” e “Roda de Conversa” abordaram a sexualidade do idoso, o conhecimento acerca da transmissão das doenças e formas de prevenção. As ações são sempre acompanhadas da distribuição de materiais educativos, preservativos bem como encaminhamentos e testagem para sorologia de Hepatites B e C, HIV e Sífilis. Observou se a satisfação dos idosos, interesse e efetiva participação, ocorrendo aprendizado de forma simples e lúdica. Também foi possível identificar idosos interessados em multiplicar com seus pares e familiares o conhecimento construído. Conclusões: O processo educativo participativo promove o fortalecimento da rede de apoio ao idoso, tornando-se um canal ativo de comunicação entre equipe e usuário, oferecendo subsídios adequados ao trabalho de prevenção e tratamento das doenças. DESCRITORES: Saúde do Idoso. Educação em Saúde. Prevenção de Doenças Transmissíveis. Promoção da Saúde

Panoramic snapshot of serum soluble mediator interplay in pregnant women with convalescent COVID-19: an exploratory study

IntroductionSARS-CoV-2 infection during pregnancy can induce changes in the maternal immune response, with effects on pregnancy outcome and offspring. This is a cross-sectional observational study designed to characterize the immunological status of pregnant women with convalescent COVID-19 at distinct pregnancy trimesters. The study focused on providing a clear snapshot of the interplay among serum soluble mediators.MethodsA sample of 141 pregnant women from all prenatal periods (1st, 2nd and 3rd trimesters) comprised patients with convalescent SARS-CoV-2 infection at 3-20 weeks after symptoms onset (COVID, n=89) and a control group of pre-pandemic non-infected pregnant women (HC, n=52). Chemokine, pro-inflammatory/regulatory cytokine and growth factor levels were quantified by a high-throughput microbeads array.ResultsIn the HC group, most serum soluble mediators progressively decreased towards the 2nd and 3rd trimesters of pregnancy, while higher chemokine, cytokine and growth factor levels were observed in the COVID patient group. Serum soluble mediator signatures and heatmap analysis pointed out that the major increase observed in the COVID group related to pro-inflammatory cytokines (IL-6, TNF-α, IL-12, IFN-γ and IL-17). A larger set of biomarkers displayed an increased COVID/HC ratio towards the 2nd (3x increase) and the 3rd (3x to 15x increase) trimesters. Integrative network analysis demonstrated that HC pregnancy evolves with decreasing connectivity between pairs of serum soluble mediators towards the 3rd trimester. Although the COVID group exhibited a similar profile, the number of connections was remarkably lower throughout the pregnancy. Meanwhile, IL-1Ra, IL-10 and GM-CSF presented a preserved number of correlations (≥5 strong correlations in HC and COVID), IL-17, FGF-basic and VEGF lost connectivity throughout the pregnancy. IL-6 and CXCL8 were included in a set of acquired attributes, named COVID-selective (≥5 strong correlations in COVID and <5 in HC) observed at the 3rd pregnancy trimester.Discussion and conclusionFrom an overall perspective, a pronounced increase in serum levels of soluble mediators with decreased network interplay between them demonstrated an imbalanced immune response in convalescent COVID-19 infection during pregnancy that may contribute to the management of, or indeed recovery from, late complications in the post-symptomatic phase of the SARS-CoV-2 infection in pregnant women

Inovação Como Estratégia de Diferenciação. Produção de Vinho Kosher no Vale dos Vinhedos

A inovação proporciona às empresas desenvolvimento e crescimento, bem como aumento dos lucros sustentáveis no mercado competitivo. Inovar constantemente coloca as empresas em posição de liderança, de modo a gerar lucros a partir da diferenciação. Neste cenário, a certificação de produtos kosher, em especial os vinhos abordados neste estudo, garante que os produtos alimentícios pas-saram por processos regidos, com diretrizes e regulamentos religiosos que orientam o consumo. Assim, em meio a esta complexidade, é considerado um produto diferenciado. Com isso, o objetivo desta pesquisa foi descrever como ocorreram as inovações na produção do vinho kosher em uma vinícola do Vale dos Vinhedos. Para esse fim foi realizado um estudo de caso, com entrevistas em profundidade, baseadas em um roteiro prévio, e com a aplicação da técnica de pesquisa qualitativa, de caráter descritivo. Os resultados mostram que a vinícola busca fontes de conhecimento externas, por meio do contato próximo com os clientes e da sua política comercial, assim como a visão ampla da gestão da empresa em buscar compreender diferentes culturas e proporcionar produtos diferenciados a seus clientes, o que garante alento a inovações e contribui para manter vantagem competitiva

Treatment of Human Sporotrichosis Caused by <i>Sporothrix brasiliensis</i>

We describe the successful treatment of a series of 30 zoonotic sporotrichosis cases from southern Brazil. Sporothrix brasiliensis was the species genotypically identified in all 25 confirmed cases. Five other cases were classified as probable, without laboratory confirmation, but with clinical and epidemiological data of cat-transmitted sporotrichosis. Two isolates were sequenced by translation elongation factor-1 alpha (EF1α) loci in order to compare their sequences, and both of them showed distinct genotypes from S. brasiliensis strains from other Brazilian states. Itraconazole (ITZ) or potassium iodide (KI) were the first choice treatment in 28 and 2 cases, respectively. Microdilution assay showed a wild-type profile of S. brasiliensis isolates to ITZ. However, a lack of clinical response occurred in 42% of cases, especially those treated with ITZ 100 mg/day, and treatment needed modifications, by either increased doses or antifungal combinations. Clinical cure required a mean of 187 days of treatment, which was dependent on the clinical form of the disease and age of patients. Therapy, including dosages and durations, for cutaneous forms of sporotrichosis requires re-evaluation, since cases caused by S. brasiliensis may influence treatment efficacy

Improving Strength and Fatigue Resistance in Post-Polio Syndrome Individuals with REAC Neurobiological Treatments

Post-Polio Syndrome (PPS) is a chronic condition characterized by the emergence of new symptoms and functional decline in individuals who previously had polio. Despite advances in medical understanding, management of PPS remains challenging. This study aimed to evaluate the use of neurobiological modulation treatments using Radio Electric Asymmetric Conveyer (REAC) technology on fatigue and muscle strength. An open-label study was conducted with 17 patients submitted to four neuromodulation protocols: Neuro Postural Optimization (NPO), Neuro Psycho Physical Optimization (NPPO), Neuro Psycho Physical Optimization—Cervico Brachial (NPPO-CB), and Neuromuscular Optimization (NMO). The Time Up and Go (TUG) test, Handgrip Strength Test, and Revised Piper Fatigue Scale (RPFS) were used to assess participants’ fatigue and muscle strength, being applied at the beginning and end of each protocol. The results obtained from the improvement in strength, physical endurance, and particularly the RPFS behavioral dimension, affective dimension, and psychological sensory dimension, through the utilization of REAC neurobiological modulation treatments, highlight this correlation. These results suggest that these treatments could be considered as a potential therapeutic approach for PPS

Homeostatic model assessment of adiponectin (HOMA-Adiponectin) as a surrogate measure of insulin resistance in adolescents: comparison with the hyperglycaemic clamp and homeostatic model assessment of insulin resistance

Background Studies on adults have reported inverse association between the homeostatic model assessment (HOMA) of adiponectin (HOMA-Adiponectin) and the insulin resistance assessed by the glucose clamp technique. To our knowledge, in the pediatric population this association has not been previously investigated. Objectives To evaluate the association between the HOMA-Adiponectin and the insulin resistance assessed by the glucose clamp technique in adolescents, and to compare the accuracy of HOMA-Adiponectin and HOMA-insulin resistance (HOMA-IR) for identifying insulin resistance. Methods This was a cross-sectional study of 56 adolescents (aged 1018 years). Insulin resistance was assessed using the HOMA-IR, HOMA-Adiponectin and the hyperglycaemic clamp technique. The clamp-derived insulin sensitivity index, HOMA-Adiponectin, and HOMA-IR were log-transformed to get closer to a normal distribution before analysis. Results In the multivariable linear regression analysis controlling for sex and Tanner stage, HOMA-Adiponectin was inversely associated with the clamp-derived insulin sensitivity index (unstandardized coefficient [B] = -0.441; P < 0.001). After additional adjustment for waist circumference-to-height ratio, this association remained significant (B = -0.349; P = < 0.001). Similar results were observed when HOMA-IR replaced HOMA-Adiponectin in the model (B = -1.049 and B = -0.968 after additional adjustment for waist circumference-to-height ratio); all P < 0.001. The area under the receiver operating characteristic curve for predicting insulin resistance was 0.712 (P = 0.02) for HOMA-Adiponectin and 0.859 (P < 0.0001) HOMA-IR. Conclusions The HOMA-Adiponectin was independently associated with insulin resistance and exhibited a good discriminatory power for predicting it. However, it did not show superiority over HOMA-IR in the diagnostic accuracy143CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO - CNPQFUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO - FAPESP563664/2010-02013/21476-