A influência da liderança no clima organizacional

O presente estudo se baseia na reflexão concernente à relação entre liderança e clima organizacional. Discute-se o conceito de liderança, a partir de desenvolvimentos históricos e características predominantes de líderes eficazes. Assim como se firma o juízo de clima organizacional, mediante abordagem de tipos de clima, fatores que o influenciam e a importância de sua avaliação. Objetivando visualizar na prática a dependência entre esses, aplicou-se a técnica de pesquisa de levantamento, em que a partir de questionários, com perguntas abertas e fechadas, coletaram-se dados de duas empresas localizadas em Brasília. A pesquisa consubstanciou-se na participação de 16 colaboradores, os quais responderam sobre a percepção das variáveis dimensões do clima organizacional, bem como a respeito da liderança; baseou-se, também, na colaboração de 2 gestores, responsáveis pela auto avaliação condizente à maneira como lideram. Assim, a pesquisa se sustenta diante da análise prática em afronto à base teórica, para melhor discutir a respeito da influência da liderança no clima organizacional, em que se fará possível nortear as ações de uma empresa, mediante investimento no clima organizacional e no desenvolvimento de uma liderança mais eficaz

Sugar-free chewing gum and dental caries : a systematic review

OBJECTIVE: To appraise existing evidence for a therapeutic / anti-cariogenic effect of sugar-free chewing gum for patients. METHOD: 9 English and 2 Portuguese databases were searched using English and Portuguese keywords. Relevant articles in English, German, Portuguese and Spanish were included for review. Trials were excluded on lack of randomisation, control group, blinding and baseline data, drop out rate >33%, no statistical adjustment of baseline differences and no assessment of clinically important outcomes. Reviews were excluded on lack of information, article selection criteria, search strategy followed, search keywords, searched databases or lack of study-by-study critique tables. In cases of multiple reports from the same study, the report covering the longest period was included. Two reviewers independently reviewed and assessed the quality of accepted articles. RESULTS: Thirty-nine articles were included for review. Thirty were excluded and 9 accepted. Of the 9 accepted, 2 trials of reasonable and good evidence value did not demonstrate any anti-cariogenic effect of sugar-free chewing gum. However, 7 articles, with 1 of strong, and 6 of good evidence value, demonstrated anti-cariogenic effects of chewing Sorbitol, Xylitol or Sorbitol/Xylitol gum. This effect can be ascribed to saliva stimulation through the chewing process, particularly when gum is used immediately after meals; the lack of sucrose and the inability of bacteria to metabolize polyols into acids. Conclusion: The evidence suggests that sugar-free chewing gum has a caries-reducing effect. Further well-designed randomised trials are needed to confirm these findings

The process of working in an oncology outpatient clinic in the perception of the nursing technical team

Objective: To describe how the technical nursing staff perceives and describes the work process in an Oncology Clinic. Method: A qualitative study. Data was obtained through the use of focus groups and analyzed using content analysis method Result: From the analysis of the participant’s reports emerged the following category: (re)organization of team work. The units of analysis were established to organize and sequence discussions: Barriers in health care network; Work organization focused on professional; Assistance provided to the patient as the central character; Difficulty in linking the micro processes carried out at the clinic. Conclusion: It is concluded that the work is exercised in a fragmented way and that the work process reorganizes, changing its components, but maintaining the same product.Objective: To describe how the technical nursing staff perceives and describes the work process in an Oncology Clinic. Method: A qualitative study. Data was obtained through the use of focus groups and analyzed using content analysis method Result: From the analysis of the participant’s reports emerged the following category: (re)organization of team work. The units of analysis were established to organize and sequence discussions: Barriers in health care network; Work organization focused on professional; Assistance provided to the patient as the central character; Difficulty in linking the micro processes carried out at the clinic. Conclusion: It is concluded that the work is exercised in a fragmented way and that the work process reorganizes, changing its components, but maintaining the same product

Os mecanismos da atividade osteoclástica: revisão da literatura

Bone tissues are continually being remodeled depending on the organic situation, with hard tissue resorption and neoformation. Homeostasis and inflammatory conditions concerning bone may bring about the activation of hematopoietic cells with the ability to generate or dissolve bone matrix for a number of organic needs. The mechanisms used by osteoclasts to resorb hard tissues and the basic cell to cell interactions, with the participation of immune cells such as lymphocytes, along with other substances, as well as bone composition are described in this review.O tecido ósseo é continuamente remodelado dependendo da situação orgânica, com reabsorção dos tecidos duros e neoformação óssea. A homeostasia e condições inflamatórias envolvendo o osso podem ativar células hematopoiéticas com a capacidade de gerar ou dissolver a matriz óssea para uma grande variedade de necessidades orgânicas. Os mecanismos usados pelos osteoclastos para reabsorver tecidos duros e as interações básicas intercelulares, com a participação de células imunológicas tais como linfócitos, junto com outras substâncias, bem como a composição óssea são descritas nesta revisão

Genotypic characterization of psittacid herpesvirus isolates from Brazil

AbstractThirty-six isolates of psittacid herpesvirus (PsHV), obtained from 12 different species of psittacids in Brazil, were genotypically characterized by restriction fragment length polymorphism (RFLP) analysis and PCR amplification. RFLP analysis with the PstI enzyme revealed four distinct restriction patterns (A1, X, W and Y), of which only A1 (corresponding to PsHV-1) had previously been described. To study PCR amplification patterns, six pairs of primers were used. Using this method, six variants were identified, of which, variants 10, 8, and 9 (in this order) were most prevalent, followed by variants 1, 4, and 5. It was not possible to correlate the PCR and RFLP patterns. Twenty-nine of the 36 isolates were shown to contain a 419bp fragment of the UL16 gene, displaying high similarity to the PsHV-1 sequences available in GenBank. Comparison of the results with the literature data suggests that the 36 Brazilian isolates from this study belong to genotype 1 and serotype 1

Prevalence of potential drug interactions of clinical importance in primary health care and its associated factors / Prevalência de potenciais interações medicamentosas de importância clínica na atenção primária à saúde e seus fatores associados

Introduction: older patients usually had multiple diseases and so use many medicines. The elevated risks of pharmacotherapy in this population justified the development of ratings for unsafe medicines.Objective: to estimate the prevalence of potential drug interactions of clinical importance in primary health care and its associated factors, improving prescription practices and increasing patient safety.Methods: a cross-sectional study of dependent variable “number of potential drug-drug interactions of clinical importance”, in all medicines and patients who accessed medicines via public primary health care, 2013. The independent variables were socio demographic, accessibility of health services and pharmacotherapy. Multivariate analyses were performed using the Statistical Learning Theory with Exaustive-CHAID algorithm, with test Pearson's chi-square adjusted by the Bonferroni method.Results: a total of 4,037 patients were included in this study and the patient prevalence of at least one drug-drug interaction was 36.5% with severity moderate (66.2%) or major (28.5%). The most prevalent conduct for management of them were monitor the patient (59.0%), adjust the dosage of the medicines (21.9%) and monitoring signs and symptoms (16.7%). In the multivariate analysis by the Theory of Statistical Learning when we compared the “patients who had at least one drug interaction of clinical importance” with those who did not have them at the first hierarchical level of relevance, the variable “number of drugs in use” prevailed with a p value <0.0001. The analysis also proposed 7 different risk strata to explain the distinction between having at least one interaction of clinical importance, namely: 1, 2, 3, 4, 5, 6-7 and> 8 drugs. When comparing patients with 2 medications and those with 8 or more medications, the prevalence of drug interactions increases by about 80%. Using polypharmacy (5 or more drugs) as the cutoff point to make the same comparison, the increase is about 45%. Other variables with statistical relevance to explain having or not having hair were “multiple drug dispensations per month” (p = 0.003 and p = 0.01) and “being elderly” (p = 0.003). Having “multiple drug dispensations per month” reduced the prevalence of interactions by about 10% for both patients with 3 medications (p = 0.003) and those with 6 or 7 medications.Conclusions: the drug-drug interactions showed be different in primary care of hospitals and other place for health care. And the number of medications in use by the patient seems to be the main marker for patient selection for this type of analysis, with polypharmacy being a relevant cutoff point, but above all the use of 8 or more medications indicates a prevalence of more than 90% patients of at least one interaction of clinical importance. There are few studies of potential drug-drug interactions in public primary health care, especially with analysis of the severity and management of them. We recommend more studies for clarify prevalence, types and associated factors

ANEMIA FALCIFORME:ASPECTOS DA DOR E SEU MANEJO PELA EQUIPE DE SAÚDE

A Anemia Falciforme é uma doença genética na qual a molécula de Hemoglobina(Hb) é alterada acarretando distúrbios, é um subtipo das doenças falciformes, na qual o indivíduo é homozigoto para o gene que decodifica Hemoglobina S(HbS).Objetivou-se o delineamento da dor e suas manifestações clínicas associadas, seus aspectos psicológicos e seu manejo. Para tal, utilizou-se uma revisão integrativa da literatura onde asbuscasforam realizadas nas bases de dados BVS, PubMed e Cochrane para elencar o que há de mais atual e recorrente.Realizou-se a leitura exploratória dos título e resumos após a aplicação dos filtros e critérios de inclusão. Após a seleção dos textos para elaboração dos resultados e inferências foi realizada a leitura analítica na integra. A amostra foi composta por21 para composição da amostra. Pode-se inferir 3 categorias: Dor e Complicações Clínicas, Aspectos psicológicos da dor em crianças e adultos e Manejo da dor/anemia falciforme pela equipe de saúde. Delas podemos evidenciar que as manifestações álgicas são no geral de cunho torácico, osteomolecular e aquelas devido às infecções. Tanto crianças, como adolescentese adultos apresentam alterações psíquicas, podendo causar distúrbios de auto-imagem e auto-estima e há também casos de depressão, todos causados pela cronicidade da doença , suas limitações e resquícios que ela imprime aos doentes. O manejo farmacológico é constituído pelos analgésicos opioides, não opiodes e antiinflamatórios não esteroidais, uma vez que as crises álgicas são em maior parte dos casos aguda. Além disso, usa-se hidroxiureia, que quase sempre é indicada para o uso de rotina. Por fim, analisou-se a maneira pela qual a equipe de saúde recebe, trata e acompanha os falcêmicos, e concluiu-se que há grandes falhas e enormes reparos a serem providenciados

Transplante de Microbiota Fecal no tratamento da infecção por Clostridioides difficile: uma revisão da literatura / Fecal Microbiota transplantation in the treatment of Clostridioides difficile infection: a literature review

Racional: Clostridioides difficile é uma bactéria anaeróbia Gram-positiva, produtora de toxinas, causadora da colite-associada a antibióticos. Constitui uma das infecções nosocomiais mais frequentes, dotada de significativa morbimortalidade. Caracteriza-se por um espectro de manifestações que vão desde o portador assintomático até a infecção severa e fulminante. A antibioticoterapia é a primeira linha de tratamento, entretanto a recorrência da infecção ocorre em até 20% a 30% dos pacientes. O transplante de microbiota fecal tem demonstrado em trabalhos uma eficácia de 87% a 91%. Objetivos: Realizar uma revisão integrativa das diferentes formas de transplante de microbiota fecal e seus resultados. Métodos: Revisão integrativa da literatura, com 12 ensaios clínicos controlados randomizados selecionados entre 333 artigos encontrados nas bases PubMed e Biblioteca Virtual em Saúde, com os descritores “Fecal Microbiota Transplantation AND Pseudomembranous Colitis OR Clostridium difficile”, entre 2017 e 2022. Resultados: Comparam vias de administração, efeitos terapêuticos, alterações na microbiota dos receptores, riscos e efeitos adversos. Conclusão: O transplante de microbiota fecal surge como uma nova e promissora proposta terapêutica na infecção recorrente por C. difficile. Mais estudos são necessários para estabelecer a sua eficácia como terapêutica única ou adjuvante, composição ideal das cepas e protocolos de uso nos diferentes espectros de gravidade dessa infecção