A nutrição clínica ampliada e a humanização da relação nutricionista-paciente: contribuições para reflexão

A concepção da clínica nutricional ampliada é uma temática nova para o campo da nutrição, sobretudo da nutrição clínica. Diante do processo de reformulações nos cenários de práticas em saúde no âmbito do Sistema Único de Saúde, esse tema instiga substancial interesse na produção científica, na formação e na prática clínica do nutricionista com a aplicação de competências comunicacionais e a ampliação do olhar técnico-nutricional perante o processo saúde-doença-cuidado, que podem contribuir para a reconfiguração da relação nutricionista-paciente a fim de ampliar sua humanização. Este ensaio mostra como a concepção de nutrição clínica ampliada pode contribuir para refletir sobre a ampliação da humanização da relação nutricionista-paciente no âmbito dos serviços de saúde. O ensaio é delineado em duas partes: o ponto de partida e o ponto de continuação. No ponto de partida, analisam-se publicações oficiais sobre a conformação sócio-histórica do modelo biomédico e sua repercussão na prática clínica. No ponto de continuação, observa-se a clínica nutricional como prática social e utiliza-se a concepção da clínica ampliada para discutir as possibilidades de reestruturar a nutrição clínica e ampliar seus saberes e suas técnicas para além de um modelo biomédico restrito e restritivo. Por fim, discute-se a nutrição clínica ampliada como possibilidade para repensar a relação nutricionista-paciente e propor, nesse sentido, sua humanização, a incorporação de conteúdos não biomédicos, a valorização da sabedoria prática e da escuta, a articulação de saberes e a exploração da dimensão dialógica no exercício legítimo da nutrição clínica na contemporaneidade

Erratum to: Thermal–mechanical behaviour of chitosan–cellulose derivative thermoreversible hydrogel films

CH, Chitosan; HPMC, (Hydroxypropyl)methyl cellulose; FT, Freeze-thaw; SC, Solvent casting; CH:HPMC (X:Y), pH Z, FT/SC, Chitosan and (hydroxypropyl)methyl cellulose hydrogel, at X and Y proportion (0-100), at Z pH (3.0-4.0) and prepared by freeze-thaw or solvent casting techniques; DSC, Differential scanning calorimetry; MDSC, Temperature modulated Differential scanning calorimetry; Tg, glass transition temperature; ΔH, enthalpy change; TGA, Thermogravimetric Analysis; TG, Thermogravimetry; DTG, Derivative or Differential thermogravimetry; σ, Tensile strength; ε, elongation at break; DMA, Dynamic mechanical analysis; X-Ray, X-radiation, FTIR-ATR, Attenuated total reflectance Fourier transform infrared spectroscopy; SEM, Scanning electron microscopy.The authors are thankful to the Chemistry and Physic Centres at Minho University (Pest-C/QUI/UI0686/2013 and PEST-C/FIS/UI607/2013), CNPq, FAPESP and CAPES for the financial support of this research. Sandra Cerqueira Barros and Carlos M. Costa acknowledge the Portuguese Foundation for Science and Technology for the Post-Doc and PhD grants provided (SFRH/BPD/85399/2012 and SFRH/BD/68499/2010) and M. M. Silva acknowledges to CNPq, for the mobility grant provided by this institution. The authors of this paper are grateful to the Company Devan-Micropolis, S.A., for the material support, namely the natural polymers chitosan (CH) and (hydroxypropyl)methyl cellulose (HPMC) employed in this study. JLGR acknowledges the support of Ministerio de Economía y Competitividad, MINECO, through the MAT2013-46467-C4-1-R project. CIBER-BBN is an initiative funded by the VI National R&D&i Plan 2008-2011, Iniciativa Ingenio 2010, Consolider Program, CIBER Actions and financed by the Instituto de Salud Carlos III with assistance from the European Regional Development Fund

The Pierre Auger Observatory III: Other Astrophysical Observations

Astrophysical observations of ultra-high-energy cosmic rays with the Pierre Auger Observator

The Pierre Auger Observatory I: The Cosmic Ray Energy Spectrum and Related Measurements

Studies of the cosmic ray energy spectrum at the highest energies with the Pierre Auger Observator

The Pierre Auger Observatory III: Other Astrophysical Observations

Astrophysical observations of ultra-high-energy cosmic rays with the Pierre Auger Observator

Injection techniques

International audienceIn this paper we introduce the concept of Lateral Trigger Probability (LTP) function, i.e., the probability for an extensive air shower (EAS) to trigger an individual detector of a ground based array as a function of distance to the shower axis, taking into account energy, mass and direction of the primary cosmic ray. We apply this concept to the surface array of the Pierre Auger Observatory consisting of a 1.5 km spaced grid of about 1600 water Cherenkov stations. Using Monte Carlo simulations of ultra-high energy showers the LTP functions are derived for energies in the range between 1017 and 1019 eV and zenith angles up to 65°. A parametrization combining a step function with an exponential is found to reproduce them very well in the considered range of energies and zenith angles. The LTP functions can also be obtained from data using events simultaneously observed by the fluorescence and the surface detector of the Pierre Auger Observatory (hybrid events). We validate the Monte-Carlo results showing how LTP functions from data are in good agreement with simulations

Search for signatures of magnetically-induced alignment in the arrival directions measured by the Pierre Auger Observatory

We present the results of an analysis of data recorded at the Pierre Auger Observatory in which we search for groups of directionally-aligned events (or `multiplets') which exhibit a correlation between arrival direction and the inverse of the energy. These signatures are expected from sets of events coming from the same source after having been deflected by intervening coherent magnetic fields. The observation of several events from the same source would open the possibility to accurately reconstruct the position of the source and also measure the integral of the component of the magnetic field orthogonal to the trajectory of the cosmic rays. We describe the largest multiplets found and compute the probability that they appeared by chance from an isotropic distribution. We find no statistically significant evidence for the presence of multiplets arising from magnetic deflections in the present data

The Pierre Auger Observatory IV: Operation and Monitoring

Technical reports on operations and monitoring of the Pierre Auger Observator

The Pierre Auger Observatory V: Enhancements

Ongoing and planned enhancements of the Pierre Auger Observator