Biossegurança e segurança do paciente: visão de professores e estudantes de enfermagem

Objective To identify the understanding of biosafety and patient safety from the perspective of nursing teachers and students in Brazil and Portugal. Methods This is a qualitative study involving 14 teachers and 44 students from 3 public educational institutions (2 in Brazil and 1 in Portugal). The study included students in their final year of high school as well as students enrolled in undergraduate and licensure courses because, by this stage of their studies, they had already covered topics related to biosafety and patient safety. It also included teachers of these subjects. Triangulation was used to collect data through interviews and observation. For organization and analysis, resources of the Atlas.ti 22 qualitative research software program were used in conjunction with the principles of thematic content analysis. Results It was evident in both countries that the teachers and students recognized the premises that involved biosafety and patient safety and that these should form part of nursing education in its transversality, emphasizing that biosafety and safety were interrelated in the prevention of adverse events. The importance of caring for oneself and others, the influence of the regulatory framework in guiding practice, and the existence of gaps in knowledge and practical application were all factors mentioned by the interviewees. Conclusion Biosafety and patient safety education and regulations, as well as the knowledge of teachers and students on these topics, affect safe practice and the quality of nursing care. Having a good understanding of these areas is therefore essential in health crises, especially for preventing infection, and it is important to raise awareness of the duty of safe health practices.info:eu-repo/semantics/publishedVersio

Gestor de Enfermagem em unidades de saúde mental: das atividades à utilização do tempo

Objective: to understand the use of time by nurse managers in psychiatry and mental health units, as they carry out their daily tasks. Methods: cross-sectional study, carried out by 48 managers from public psychiatric units and from the social sector. Data collection was made through an online questionnaire that is part of the Scale of Perception of Nurse Manager Work, including 43 items separated in five functional domains of nurse managers. The responses were in a Likert scale: does not take time, takes little time, takes some time, takes much time. Results: the activities inherent to ethical and legal professional practices and to the management of care and of human resources required more time from the manager when compared to policy interventions, and consulting and professional development. Conclusion: the managers recognize that managing time implies organization, planning work, and establishing priorities in the tasks to be developed.Objetivo: compreender a utilização do tempo dos gestores de enfermagem em unidades de Saúde Mental e Psiquiatria no desempenho das atividades diárias. Métodos: estudo transversal, constituído por 48 gestores de unidades psiquiátricas públicas e do setor social. Coleta de dados por meio de questionário online que integrava a Escala de Percepção do Trabalho dos Gestores em Enfermagem, inclui 43 itens, distribuídos por cinco domínios funcionais dos enfermeiros gestores. Respostas cotadas em escala tipo Likert: não ocupa tempo; ocupa pouco tempo; ocupa algum tempo; ocupa muito tempo. Resultados: as atividades inerentes às competências prática profissional ética e legal, e gestão de cuidados e de recursos humanos consumiam mais tempo ao gestor comparativamente com intervenção política e assessoria e desenvolvimento profissional. Conclusão: os gestores reconhecem que gerir o tempo implica organização, planejamento do trabalho e estabelecer prioridades nas tarefas a desempenhar.info:eu-repo/semantics/publishedVersio

A hermenêutica como método numa pesquisa sobre erros de enfermagem na mídia

O objetivo deste artigo é relatar como as concepções da hermenêutica de Paul Ricoeur utilizadas como referencial metodológico em uma tese de doutorado, contribuíram para a compreensão do fenômeno - erro de enfermagem na comunicação social. O referencial adotado se revelou coerente, com a proposta da pesquisa de abordagem qualitativa, documental, por proporcionar a interpretação de textos escritos pela mídia e suas interfaces diante do fenômeno “erro”. Destaca-se a importância do referencial para pesquisas na enfermagem, pelo diálogo que proporciona com o destinatário do trabalho da profissão - os seres humanos - e pelas possibilidades de interpretação do que é dito e escrito sobre a profissão, quando não há um desfecho favorável de sua práxisThe aim of this article is to report how the conceptions of Paul Ricoeur's hermeneutics, used as a methodological reference of the doctoral thesis contributed to the understanding of the phenomenon - social. The adopted framework proved to be coherent with the proposal of a qualitative and documentary approach, since it provides the interpretation of texts written by the media and their interfaces to the "error" phenomenon. Emphasis is placed on the importance of the referential for nursing research, for the dialogue it provides with the recipient of the profession's work - human beings - and for the possibilities of interpretation of what is said and written about the profession, when there is no favorable outcome of his praxisEl propósito de este artículo es describir cómo los conceptos de la hermenéutica de Paul Ricoeur, que se utiliza como un marco metodológico de una tesis doctoral contribuyeron a la comprensión del fenómeno error de enfermería en la comunicación social. El marco adoptado resultó coherente con la propuesta de la investigación cualitativa, en documentos, proporcionando la interpretación de los textos escritos por los medios de comunicación y sus interfaces del fenómeno de "error". Se destaca la importancia de referencia para la investigación en enfermería, el diálogo que proporciona el destinatario de la profesión - los seres humanos - y las posibilidades de interpretación de lo que se ha dicho y escrito acerca de la profesión cuando no hay un resultado favorable en su praxisinfo:eu-repo/semantics/publishedVersio

La hermenéutica como método en la investigación sobre errores de enfermería en los medios de comunicacion

O objetivo deste artigo é relatar como as concepções da hermenêutica de Paul Ricoeur utilizadas como referencial metodológico em uma tese de doutorado, contribuíram para a compreensão do fenômeno - erro de enfermagem na comunicação social. O referencial adotado se revelou coerente, com a proposta da pesquisa de abordagem qualitativa, documental, por proporcionar a interpretação de textos escritos pela mídia e suas interfaces diante do fenômeno “erro”. Destaca-se a importância do referencial para pesquisas na enfermagem, pelo diálogo que proporciona com o destinatário do trabalho da profissão - os seres humanos - e pelas possibilidades de interpretação do que é dito e escrito sobre a profissão, quando não há um desfecho favorável de sua práxis.The aim of this article is to report how the conceptions of Paul Ricoeur's hermeneutics, used as a methodological reference of the doctoral thesis contributed to the understanding of the phenomenon - social. The adopted framework proved to be coherent with the proposal of a qualitative and documentary approach, since it provides the interpretation of texts written by the media and their interfaces to the "error" phenomenon. Emphasis is placed on the importance of the referential for nursing research, for the dialogue it provides with the recipient of the profession's work - human beings - and for the possibilities of interpretation of what is said and written about the profession, when there is no favorable outcome of his praxis.El propósito de este artículo es describir cómo los conceptos de la hermenéutica de Paul Ricoeur, que se utiliza como un marco metodológico de una tesis doctoral contribuyeron a la comprensión del fenómeno error de enfermería en la comunicación social. El marco adoptado resultó coherente con la propuesta de la investigación cualitativa, en documentos, proporcionando la interpretación de los textos escritos por los medios de comunicación y sus interfaces del fenómeno de "error". Se destaca la importancia de referencia para la investigación en enfermería, el diálogo que proporciona el destinatario de la profesión - los seres humanos - y las posibilidades de interpretación de lo que se ha dicho y escrito acerca de la profesión cuando no hay un resultado favorable en su praxis. Descriptores: Hermenéutica; Investigación cualitativa; Enfermería; Seguridad del paciente.info:eu-repo/semantics/publishedVersio

Challenges faced by nurse-managers at work in brazilian and portuguese hospitals: A mixed-methods study

Objetivo: analisar os desafios presentes no trabalho de enfermeiros gestores no contexto hospitalar, no Brasil e em Portugal. Método: pesquisa de métodos mistos, abordagem explanatório sequencial, realizada com enfermeiros gestores de quatro hospitais, entre março de 2019 e março de 2020. O estudo iniciou com a etapa quantitativa, aplicando um survey a 143 participantes e dados analisados por estatística analítica e inferencial. A etapa qualitativa foi realizada com 71 destes participantes utilizando entrevistas, para compreender os desafios deste trabalho, e os dados foram submetidos à análise de conteúdo. A integração dos achados foi realizada por meio de conexão de dados. Resultados: na etapa quantitativa os resultados evidenciaram que as atividades de gestão realizadas pelos enfermeiros por cenário, incluíram planejamento, gestão de pessoas, de processos assistenciais, de materiais, da qualidade e liderança, com maiores médias para os quatro primeiros. A qualitativa permitiu aprofundar os achados anteriores, contrastando a invisibilidade do planejamento, confirmando a gestão de pessoas como o desafio comum às realidades, explicando as médias nas realidades nacional e portuguesa. A integração dos achados detalhou na gestão de pessoas e liderança a relevância dos conflitos e do déficit de profissionais. Conclusão: gerenciar pessoas, processos assistenciais e materiais se mostram desafios dos enfermeiros na gestão hospitalar nos dois países. Os enfermeiros carecem de suporte estrutural e formação continuada para melhor gestão e aprimoramento do planejamento e liderança.Objective: to analyze the challenges found in nurse-managers' work in the Brazilian and Portuguese hospital contexts. Method: a mixed-methods research study with a sequential explanatory approach, carried out between March 2019 and March 2020 with nurse-managers from four hospitals. The study was initiated with the quantitative stage, applying a survey to 143 participants and analyzing the data by means of analytical and inferential statistics. The qualitative stage was carried out with 71 of these participants using interviews, in order to understand the challenges inherent to this job, and the data were submitted to content analysis. Integration of the findings was performed through data connection. Results: in the quantitative stage, the results evidenced that the managerial activities carried out by nurses by scenario included planning, people management, management of care processes, management of materials, quality management and leadership, with higher mean values for the first four. The qualitative stage allowed deepening the previous findings, contrasting invisibility of the planning, confirming people management as the common challenge to the realities, explaining the mean values in the national and Portuguese scopes. Integration of the findings detailed the relevance of the conflicts and the deficit of professionals in people management and leadership. Conclusion: managing people, care processes and materials are challenges for nurses in hospital management in both countries. Nurses lack structural support and ongoing training for better management and improvement of planning and leadership.info:eu-repo/semantics/publishedVersio

Escherichia coli phylogenetic group determination and its application in the identification of the major animal source of fecal contamination

<p>Abstract</p> <p>Background</p> <p><it>Escherichia coli </it>strains are commonly found in the gut microflora of warm-blooded animals. These strains can be assigned to one of the four main phylogenetic groups, A, B1, B2 and D, which can be divided into seven subgroups (A₀, A₁, B1, B2₂, B2₃, D₁and D₂), according to the combination of the three genetic markers <it>chuA</it>, <it>yjaA </it>and DNA fragment TspE4.C2. Distinct studies have demonstrated that these phylo-groups differ in the presence of virulence factors, ecological niches and life-history. Therefore, the aim of this work was to analyze the distribution of these <it>E. coli </it>phylo-groups in 94 human strains, 13 chicken strains, 50 cow strains, 16 goat strains, 39 pig strains and 29 sheep strains and to verify the potential of this analysis to investigate the source of fecal contamination.</p> <p>Results</p> <p>The results indicated that the distribution of phylogenetic groups, subgroups and genetic markers is non-random in the hosts analyzed. Strains from group B1 were present in all hosts analyzed but were more prevalent in cow, goat and sheep samples. Subgroup B2₃was only found in human samples. The diversity and the similarity indexes have indicated a similarity between the <it>E. coli </it>population structure of human and pig samples and among cow, goat and sheep samples. Correspondence analysis using contingence tables of subgroups, groups and genetic markers frequencies allowed the visualization of the differences among animal samples and the identification of the animal source of an external validation set. The classifier tools Binary logistic regression and Partial least square -- discriminant analysis, using the genetic markers profile of the strains, differentiated the herbivorous from the omnivorous strains, with an average error rate of 17%.</p> <p>Conclusions</p> <p>This is the first work, as far as we are aware, that identifies the major source of fecal contamination of a pool of strains instead of a unique strain. We concluded that the analysis of the <it>E. coli </it>population structure can be useful as a supplementary bacterial source tracking tool.</p

Health Effects of Naturally Radioactive Water Ingestion: The Need for Enhanced Studies

Background: Radiological pollution is a potentially important aspect of water quality. However, relatively few studies have been conducted to document its possible health effects

Physiotherapists’ barriers and facilitators to the implementation of a behaviour change-informed exercise intervention to promote the adoption of regular exercise practice in patients at risk of recurrence of low back pain: a qualitative study

Background: Recurrences of low back pain (LBP) are frequent and associated with high levels of disability and medical costs. Regular exercise practice may be an effective strategy to prevent recurrences of LBP, however, the promotion of this behaviour by physiotherapists seems to be challenging. This study aims to explore physiotherapists' perceived barriers and facilitators to the implementation of a behaviour change-informed exercise intervention to promote the adoption of regular exercise practice by patients at risk of recurrence of low back pain. Methods: Two focus groups with primary healthcare physiotherapists were conducted, based on a semi-structured interview schedule informed by the Behaviour Change Wheel, including the Capability, Opportunity, Motivation-Behaviour (COM-B) model and the Theoretical Domains Framework (TDF). All focus groups were held through videoconference, audio and video recorded and transcribed verbatim. A deductive content analysis, using a coding matrix based on the COM-B and TDF, was performed by two independent researchers. A third researcher was approached to settle disagreements. Results: In total, 14 physiotherapists participated in the focus groups. The analysis revealed a total of 13 barriers (4 COM-B components and 7 TDF domains) and 23 facilitators (5 COM-B and 13 TDF) to physiotherapists' implementation of a behaviour change-informed exercise intervention. The most common barriers were the lack of skills and confidence to implement the proposed intervention. These were explained by the fact that it differs from the usual practice of most participants and requires the learning of new skills applied to their contexts. However, for those who had already implemented other similar interventions or whose rationale is aligned with the new intervention, there seemed to exist more positive determinants, such as potential benefits for physiotherapists and the profession, improvement of quality of care and willingness to change clinical practice. For others who did not previously succeed in implementing these types of interventions, more context-related barriers were mentioned, such as lack of time to implement the intervention, schedule incompatibilities and lack of material and human resources. Conclusions: This study identified modifiable barriers and facilitators to physiotherapists' implementation of a behaviour change-informed exercise intervention for patients at risk of recurrence of LBP in primary healthcare. The findings of this study will allow the systematic and theory-based development of a behaviour change-informed training programme, aimed at physiotherapists and supporting the successful implementation of the exercise intervention.info:eu-repo/semantics/publishedVersio

Nestedness across biological scales

This is the final published version. Available from Public Library of Science via the DOI in this record.All data sets are available for download in the repository https:// bitbucket.org/maucantor/unodf_analyses/src.Biological networks pervade nature. They describe systems throughout all levels of biological organization, from molecules regulating metabolism to species interactions that shape ecosystem dynamics. The network thinking revealed recurrent organizational patterns in complex biological systems, such as the formation of semi-independent groups of connected elements (modularity) and non-random distributions of interactions among elements. Other structural patterns, such as nestedness, have been primarily assessed in ecological networks formed by two non-overlapping sets of elements; information on its occurrence on other levels of organization is lacking. Nestedness occurs when interactions of less connected elements form proper subsets of the interactions of more connected elements. Only recently these properties began to be appreciated in one-mode networks (where all elements can interact) which describe a much wider variety of biological phenomena. Here, we compute nestedness in a diverse collection of one-mode networked systems from six different levels of biological organization depicting gene and protein interactions, complex phenotypes, animal societies, metapopulations, food webs and vertebrate metacommunities. Our findings suggest that nestedness emerge independently of interaction type or biological scale and reveal that disparate systems can share nested organization features characterized by inclusive subsets of interacting elements with decreasing connectedness. We primarily explore the implications of a nested structure for each of these studied systems, then theorize on how nested networks are assembled. We hypothesize that nestedness emerges across scales due to processes that, although system-dependent, may share a general compromise between two features: specificity (the number of interactions the elements of the system can have) and affinity (how these elements can be connected to each other). Our findings suggesting occurrence of nestedness throughout biological scales can stimulate the debate on how pervasive nestedness may be in nature, while the theoretical emergent principles can aid further research on commonalities of biological networks.Conselho Nacional de Desenvolvimento Científico e TecnológicoSão Paulo Research FoundationKillam TrustsThe Brazilian Federal Agency for Support and Evaluation of Graduate Education within the Ministry of Education of BrazilFundação de Amparo à Pesquisa e Inovação do Estado de Santa Catarin

Processo de trabalho: fundamentação para compreender os erros de enfermagem

Objective: To identify work process-related causes associated with nursing errors reported in newspapers. Method: This was a documentary and qualitative study based on the work process theory and hermeneutic analysis that examined 112 news articles published between 2012 and 2016 in 21 high-circulation Brazilian newspapers, organized and codified using Atlas.ti software. Results: The causes associated with the reported errors were associated with workforce (lack of professionals and training, turnover, work overload, lack of information, recklessness, negligence, and distraction); work instruments (similar labels or packages, storage, lack of product identification and information, and medical prescriptions); and the object of nursing work (overcrowding and specific characteristics of patient). Conclusion: Analysis of the possible causes of reported errors identified the negative outcomes of nursing work, while also identifying elements of the work process that influenced these results. The findings emphasize the importance of understanding these errors so they can be avoided and of reviewing nursing work conditions to guarantee quality and safety of care.info:eu-repo/semantics/publishedVersio