Qual o contributo que o enfermeiro especializado poderá dar para a identificação de um potencial dador de órgãos?

Mestrado , Enfermagem em Pessoa em Situação Crítica, 2013, Escola Superior de Enfermagem de LisboaA escassez de órgãos para transplantação é uma problemática atual. O número de pessoas em lista de espera para um transplante é elevado e, o número de dadores é manifestamente insuficiente para satisfazer estas necessidades. O enfermeiro pela sua proximidade aos clientes na prestação de cuidados, ocupa uma posição privilegiada para a identificação de potenciais dadores. O tratamento ativo dos potenciais dadores requer conhecimentos e competências para as quais o enfermeiro especializado em pessoa em situação critica deverá estar desperto. Este trabalho procura refletir o percurso vivenciado para o desenvolvimento e consolidação dos conhecimentos e competências necessárias para a especialização nesta área. Para a sua concretização realizei estágios em locais e instituições de referência na doação e transplantação, que me permitiram prestar cuidados de excelência ao potencial dador e sua família, tendo por base as competências especificas estabelecidas pela Ordem dos Enfermeiros para o Enfermeiro Especialista em Pessoa em Situação Crítica. A análise efetuada foi de acordo com o Modelo Transacional de Afaf Meleis. Procurei atingir na área de Colheita e Transplantação um grau de perita, em conformidade com o referencial teórico de Patrícia Benner. Na unidade de cuidados intensivos neurocirurgicos, pude observar a identificação de mais do que um potencial dador, e tive a oportunidade de realizar o seu tratamento ativo. Acompanhei o incansável trabalho da Coordenadora de colheita e transplantação do mesmo Hospital na tentativa de identificação de potenciais dadores. Em Espanha assisti ao trabalho realizado por um dos Gabinetes de Coordenação de Colheita e Transplante com maior atividade a nível mundial, fiquei a conhecer o protocolo de dador de coração parado existente numa das comunidades de Espanha e, que se relaciona de forma muito restrita com o seu serviço de emergência Pré-hospitalar. Esta relação levou-me a considerar pertinente a realização de estágio nesse mesmo Pré-hospitalar, de forma a acompanhar desde o início o protocolo. Durante todo este percurso foi possível concretizar as atividades previamente estabelecidas e que permitiram alcançar as competências delineadas para a pessoa em situação crítica e, especialmente, para a área da colheita e transplantação de órgãos, arriscando afirmar ter logrado obter o grau de perita nesta mesma área

O pensamento algébrico na resolução de problemas com sistemas de duas equações do 1º grau com duas incógnitas em alunos do 8º ano de escolaridade

Relatório da Prática de Ensino Supervisionada, Mestrado em Ensino de Matemática, Universidade de Lisboa, Instituto de Educação, 2016O presente estudo pretendeu compreender o pensamento algébrico de alunos do 8.º ano de escolaridade na resolução de problemas com sistemas de duas equações do 1.º grau com duas incógnitas. Com este intuito, procurei compreender os significados que atribuíram à simbologia matemática e quais as principais dificuldades que revelaram, apurar qual(is) a(s) estratégia(s) mais utilizada(s) na resolução de problemas e perceber as razões dessa escolha e, por fim, compreender as principais dificuldades associadas à tradução e à resolução de situações contextualizadas ou não. O estudo assenta num paradigma interpretativo, seguindo uma abordagem mista, usando dados quantitativos e qualitativos. Posicionei-me como observadora participante e os principais métodos de recolha de dados foram a observação direta, a recolha das produções escritas dos alunos, as entrevistas e um questionário anónimo. A turma esteve envolvida na realização das tarefas, no entanto, selecionei quatro pares de alunos para aprofundamento do estudo, aos quais realizei entrevistas em dois momentos da intervenção letiva. A análise dos dados seguiu a análise de conteúdo. As questões de natureza ética foram consideradas neste estudo. Os resultados obtidos evidenciam que os alunos desenvolveram o pensamento algébrico. A maioria revelou ter sentido de símbolo, estando a principal dificuldade ligada ao formalismo do método de substituição. O sentido de variável estava bem desenvolvido, mas os alunos apresentaram dificuldades na atribuição de significado à incógnita quando esta não era explicitada no enunciado. A representação algébrica foi a mais escolhida pelos alunos e a principal razão apontada para esta escolha foi o saber/controlar o que estavam a fazer. Os alunos demonstraram maior facilidade na interpretação e resolução de problemas de índole geométrica e nas situações descontextualizadas. A interpretação das situações dos problemas verbais que traduzem situações próximas ao quotidiano foram dificuldades acrescidas, não pelo contexto, mas sim pela definição das variáveis.This study aimed to understand the algebraic thinking of students of the 8th grade in solving problems with systems of two equations of 1st degree with two unknowns. To this end, I sought to understand the meanings they attributed to the mathematical symbols and the main difficulties they revealed, in order to determine and understand which strategy(s) is/are most used to solve problems and the reasons for that choice and finally to recognize the main difficulties associated with the translation and resolution of contextualized situations or not. The study is based on an interpretative paradigm, following a mixed approach, using quantitative and qualitative data. I positioned myself as a participant observer and the main data collection methods were direct observation, collection of written productions of the students, interviews and an anonymous questionnaire. The class was involved in the tasks; however, I selected four pairs of students for further study, to whom I conducted interviews in two moments of the teaching intervention. Data analysis followed the content analysis. Ethical issues were considered in this study. The results obtained show that the students developed algebraic thinking. Most of them have revealed knowing the sense of symbol and the main difficulty shown is linked to the formalism of the replacement method. The sense of variable was well developed, but the students had difficulties in assigning meaning to the unknown when it was not made explicit in the statement. The algebraic representation was the most chosen by the students and the main reason given for this choice was the knowledge/control of knowing what they were doing. Students demonstrated greater competence in interpretation and resolution of geometric problems and decontextualized situations. The interpretation of the situations of verbal problems which translate situations close to everyday life were added difficulties, not due to the context, but due to the definition of the variables

Aging increases oxidative stress and renal expression of oxidant and antioxidant enzymes that are associated with an increased trend in systolic blood pressure

The aim of this study was to investigate whether the effects of aging on oxidative stress markers and expression of major oxidant and antioxidant enzymes associate with impairment of renal function and increases in blood pressure. To explore this, we determined age-associated changes in lipid peroxidation (urinary malondialdehyde), plasma and urinary hydrogen peroxide (H2O2) levels, as well as renal H2O2 production, and the expression of oxidant and antioxidant enzymes in young (13 weeks) and old (52 weeks) male Wistar Kyoto (WKY) rats. Urinary lipid peroxidation levels and H2O2 production by the renal cortex and medulla of old rats were higher than their young counterparts. This was accompanied by overexpression of NADPH oxidase components Nox4 and p22phox in the renal cortex of old rats. Similarly, expression of superoxide dismutase (SOD) isoforms 2 and 3 and catalase were increased in the renal cortex from old rats. Renal function parameters (creatinine clearance and fractional excretion of sodium), diastolic blood pressure and heart rate were not affected by aging, although slight increases in systolic blood pressure were observed during this 52-week period. It is concluded that overexpression of renal Nox4 and p22phox and the increases in renal H2O2 levels in aged WKY does not associate with renal functional impairment or marked increases in blood pressure. It is hypothesized that lack of oxidative stress-associated effects in aged WKY rats may result from increases in antioxidant defenses that counteract the damaging effects of H2O2

Need-Opportunity-Accessibility, how to engage them?

Funding Information: We thank Professor Helder Trindade to promote the study and investigation, Dr. Jo?o Paulo Almeida Sousa for supporting the research, and ONT ? Organizaci?n Nacional de Trasplantes for data supplementation. The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Publisher Copyright: © 2021Background: Despite all efforts, the demand for organs increases. New and better strategies are still needed, critical in a crisis like pandemics. Methodology: A mathematical approach that integrates need, Opportunity, and Accessibility to kidney transplantation, was created. NOA method, corresponds to the lateral surface area of a trigonal pyramid with the need, Opportunity, and Accessibility as axis, resulting in an intuitional chart output (NOA chart) and a percentage score (NOA score). Higher NOA scores are associated with larger NOA chart areas. Method Application: We found some natural variability among the European Member States regarding Need, Opportunity, and Accessibility to kidney transplantation, concomitant with NOA scores. In 2019, in the European Union, 129 patients pmp on the waiting list for a kidney transplant were registered, 47 kidneys pmp were procured, and 36 kidneys pmp were transplanted, corresponding to 25% of kidney transplantation's response capacity. Conclusion: Transplantation is frequently the better treatment for end-stage kidney failure. NOA method may be, in the future, an indicator for evaluating the overall transplantation performance regarding the need for it and a tool for policy definition. With NOA method we seek to contribute for: • A transplantation overall performance normalizing score; • Transplantation response capacity evaluation.publishersversionpublishe

Litterfall, litter stock and water holding capacity in post-mining forest restoration ecosystems, Eastern Amazon

The objective of this study was to evaluate the litterfall deposition, the decomposition rate (KL) and the water holding capacity (WHC) of litter stored in the soil in two areas degraded by mining submitted to different methods of forest restoration: induction of natural regeneration (NR) and planting seedlings of native forest species (PS) with a forest fragment (FF) used as reference. The litterfall deposition was collected monthly over 12 months in collectors of 0.25 m2. The KL was estimated by the relation between annual litter production and litter stock in the soil surface. WHC was determined in the rainy and dry period. The litterfall deposition was lower in PS with values of 6.61 ± 0.20, 10.75 ± 0.52 and 11.83 ± 0.72 Mg ha-1 yr-1 for PS, NR and FF respectively. The KL and WHC were significantly lower in PS when compared to NR and FF, and WHC decreased significantly from the rainy season to the dry season. The induction of natural regeneration was the more effective restoration method for degraded areas regarding litterfall deposition, decomposition and water retention capacity, surpassing planting native tree species and approaching a native forest fragmentinfo:eu-repo/semantics/publishedVersio

ANTHROPOGENIC IMPACTS ON THE MORPHOLOGICAL EVOLUTION OF THE PACOTI ESTUARY, NORTHEAST BRAZIL

The problem of anthropogenic occupation on the banks of estuaries and rivers has been a factor of concern and frequently addressed around the world. In the State of Ceará, this problem has been persistent, despite the reasonable environmental legislation dealing with this issue. Along the Pacoti River Estuary, this problem was addressed in this study and added to the analysis of the wind action in the evolution of this coastal environment. Thus, direct and indirect methods were applied, mainly based on field work and remote sensing based in the use of tools from a GIS platform. The results show persistent and continuous participation of aeolian activity, notably dunes migration, in the evolution process of this estuary. Additionally, human interference over 63 years, whether in the form of exploitation of natural resources and/or urban occupation on the banks of the estuary and in the possible area of "‹"‹expansion of this environment, has produced serious environmental damage and restricted the natural area of this important coastal ecosystem. This process of environmental degradation was largely accelerated from the occupation of the area to the east of the estuary by the Beach Park development, and to the west by the Alphaville Residential Condominium