5,226 research outputs found
Formação em serviço: impacto de novas estratégias
A formação em enfermagem contribui para o desenvolvimento de competências
cognitivas e técnicas, mas também relacionais que possam ser transferíveis para o
contexto de trabalho pelo que se deve privilegiar a formação em serviço como forma
de manter actualizados, aprofundar e desenvolver os conhecimentos adquiridos.
Faz parte do descritivo de funções do enfermeiro e consta dos seus princípios
orientadores da prática, a constante actualização através da formação. (ver OE ….)
Identificada a irregular e reduzida formação interna que ocorre no serviço (obrigatória
ou não), a par de identificação de lacunas em temas fulcrais, foi implementada no
serviço de Cardiologia do Hospital Fernando Fonseca E.P.E. múltiplas estratégias de
intervenção que visem o desenvolvimento profissional dos enfermeiros e auxiliares de
acção médica através do aumento da formação na sua globalidade. A diversas
estratégias preconizadas consistem na contabilização das horas de formação como
horas de serviço, inscrição dos formandos para as formações com disponibilização do
dia expresso em horário, possibilidade de negociação de objectivos para as avaliações
de desempenho anuais, existência de um cronograma anual, de um Manual do
Formador como guia orientador à prática formativa, abordagem de diferentes áreas
focado nas necessidades de serviço e também no interesse individual, com
apresentações frequentes e que abranja todos os profissionais, formações semanais
de curta duração a decorrer em passagem de turno, formações mensais de uma hora
em sala de formação, trabalhos disponibilizados a toda a equipa.
Esta etapa formativa decorreu ao longo de todo o ano de 2014, cabendo em fase
posterior, a sua análise e avaliação, com base em indicadores de formação em serviço,
como sendo indicadores de execução como a taxa de número de horas de formação e
taxa de número de acções de formação, acrescida da avaliação de satisfação individual
dos participantes e suas opiniões face às estratégias implementadas, através da
realização de questionários aos mesmos. Acresce a avaliação da variação de adesão à
formação não obrigatória face às formações disponibilizadas, comparativamente com
as obrigatórias realizadas face à totalidade de formação obrigatórias. A análise dos referidos dados, revelam-nos uma percentagem significativa de acções
de formação ocorridas, assim como elevado número de horas formativas, pelo que
sugere um método eficaz de acção.
Uma análise preliminar revela satisfação e interesse equiparados às taxas formativas.
Daqui se poderá depreender que o conjunto de estratégias implementadas veio ao
encontro dos objectivos estabelecidos.
Cabe, em fase posterior, a análise do impacto formativo na melhoria das práticas,
eventualmente com base em indicadores adequados a cada formação,
complementada com os dados trimestrais das auditorias aos cuidados de enfermagem
do HFF
Langerhans cell histiocytosis involving the liver of a male smoker: a case report
<p>Abstract</p> <p>Introduction</p> <p>Langerhans' cell histiocytosis is a proliferative histiocytic disorder of unknown cause originating from dendritic cells.</p> <p>Case presentation</p> <p>The authors report a case of Langerhans' cell histiocytosis in a 48-year-old man with multisystemic disease presentation, including liver involvement.</p> <p>Conclusion</p> <p>Hepatic involvement is an uncommon feature in this rare disease and there is no consensus on the most effective therapeutic approach.</p
Content of Lipids, Fatty Acids, Carbohydrates, and Proteins in Continental Cyanobacteria: A Systematic Analysis and Database Application
The lipid, fatty acid, protein, and carbohydrate contents in cyanobacterial strains and biomass can vary by orders of magnitude. Many publications (thousands of peer-reviewed articles) require more work to extract their precise concentration values (i.e., different units, inaccurate data), which makes them not easily exploitable. For this purpose, tables have been compiled from the literature data, including lipids, fatty acids, proteins, and carbohydrates composition and quantities in cyanobacteria. A lot of data (323) were collected after careful a literature search, according to selected criteria in order to distinguish separately cyanobacteria, and according to categories of genus and species and generate average values of the contents of these cell components. These data are exploited in a first systematic analysis of the content in types of strains. Our database can be a powerful tool for biologists, chemists, and environmental agencies to determine the potential concentration of high-value chemical building blocks directly from low-value bloom biomass, cell cultures, or debris in the sediment, offering the potential to minimize environmental waste and add value to the agro-industrial residues. The database can also support strategies for food manufacturers to develop new products with optimized properties for veterinarian applications
Structure of Extreme Correlated Equilibria: a Zero-Sum Example and its Implications
We exhibit the rich structure of the set of correlated equilibria by
analyzing the simplest of polynomial games: the mixed extension of matching
pennies. We show that while the correlated equilibrium set is convex and
compact, the structure of its extreme points can be quite complicated. In
finite games the ratio of extreme correlated to extreme Nash equilibria can be
greater than exponential in the size of the strategy spaces. In polynomial
games there can exist extreme correlated equilibria which are not finitely
supported; we construct a large family of examples using techniques from
ergodic theory. We show that in general the set of correlated equilibrium
distributions of a polynomial game cannot be described by conditions on
finitely many moments (means, covariances, etc.), in marked contrast to the set
of Nash equilibria which is always expressible in terms of finitely many
moments
Wide spectrum of NR5A1-related phenotypes in 46,XY and 46,XX individuals
Steroidogenic factor 1 (NR5A1, SF-1, Ad4BP) is a transcriptional regulator of genes involved in adrenal and gonadal development and function. Mutations in NR5A1 have been among the most frequently identified genetic causes of gonadal development disorders and are associated with a wide phenotypic spectrum. In 46,XY individuals, NR5A1-related phenotypes may range from disorders of sex development (DSD) to oligo/azoospermia, and in 46,XX individuals, from 46,XX ovotesticular and testicular DSD to primary ovarian insufficiency (POI). The most common 46,XY phenotype is atypical or female external genitalia with clitoromegaly, palpable gonads, and absence of Müllerian derivatives. Notably, an undervirilized external genitalia is frequently seen at birth, while spontaneous virilization may occur later, at puberty. In 46,XX individuals, NR5A1 mutations are a rare genetic cause of POI, manifesting as primary or secondary amenorrhea, infertility, hypoestrogenism, and elevated gonadotropin levels. Mothers and sisters of 46,XY DSD patients carrying heterozygous NR5A1 mutations may develop POI, and therefore require appropriate counseling. Moreover, the recurrent heterozygous p.Arg92Trp NR5A1 mutation is associated with variable degrees of testis development in 46,XX patients. A clear genotype-phenotype correlation is not seen in patients bearing NR5A1 mutations, suggesting that genetic modifiers, such as pathogenic variants in other testis/ovarian-determining genes, may contribute to the phenotypic expression. Here, we review the published literature on NR5A1-related disease, and discuss our findings at a single tertiary center in Brazil, including ten novel NR5A1 mutations identified in 46,XY DSD patients. The ever-expanding phenotypic range associated with NR5A1 variants in XY and XX individuals confirms its pivotal role in reproductive biology, and should alert clinicians to the possibility of NR5A1 defects in a variety of phenotypes presenting with gonadal dysfunction
Low temperature scattering with the R-matrix method: the Morse potential
Experiments are starting to probe collisions and chemical reactions between
atoms and molecules at ultra-low temperatures. We have developed a new
theoretical procedure for studying these collisions using the R-matrix method.
Here this method is tested for the atom -- atom collisions described by a Morse
potential. Analytic solutions for continuum states of the Morse potential are
derived and compared with numerical results computed using an R-matrix method
where the inner region wavefunctions are obtained using a standard nuclear
motion algorithm. Results are given for eigenphases and scattering lengths.
Excellent agreement is obtained in all cases. Progress in developing a general
procedure for treating ultra-low energy reactive and non-reactive collisions is
discussed.Comment: 18 pages, 6 figures, 3 tables, conferenc
CONHECIMENTOS E PRÁTICAS DOS CIRURGIÕES DENTISTAS DA CIDADE DE ANÁPOLIS NO TRATAMENTO DE PACIENTES QUE FIZERAM OU FAZEM USO DE BISFOSFONATOS
Pacientes com câncer avançado frequentemente apresentam complicações ósseas que podem comprometer consideravelmente sua qualidade de vida. Com isso os bisfosfonatos tornaram-se a principal arma terapêutica na prevenção de complicações ósseas de doença maligna, com eficácia na normalização do cálcio sérico, além de aliviar a dor óssea. Em contra partida, houve um aumento de osteonecrose nos maxilares durante o tratamento odontológico cirúrgico, como por exemplo, extrações dentárias e implantes dentários
Sri Lankan tsunami refugees: a cross sectional study of the relationships between housing conditions and self-reported health
BACKGROUND: On the 26th December 2004 the Asian tsunami devastated the Sri Lankan coastline. More than two years later, over 14,500 families were still living in transitional shelters. This study compares the health of the internally displaced people (IDP), living in transitional camps with those in permanent housing projects provided by government and non-government organisations in Sri Lanka. METHODS: This study was conducted in seven transitional camps and five permanent housing projects in the south west of Sri Lanka. Using an interviewer-led questionnaire, data on the IDPs' self-reported health and housing conditions were collected from 154 participants from transitional camps and 147 participants from permanent housing projects. Simple tabulation with non-parametric tests and logistic regression were used to identify and analyse relationships between housing conditions and the reported prevalence of specific symptoms. RESULTS: Analysis showed that living conditions were significantly worse in transitional camps than in permanent housing projects for all factors investigated, except 'having a leaking roof'. Transitional camp participants scored significantly lower on self-perceived overall health scores than those living in housing projects. After controlling for gender, age and marital status, living in a transitional camp compared to a housing project was found to be a significant risk factor for the following symptoms; coughs OR: 3.53 (CI: 2.11-5.89), stomach ache 4.82 (2.19-10.82), headache 5.20 (3.09-8.76), general aches and pains 6.44 (3.67-11.33) and feeling generally unwell 2.28 (2.51-7.29). Within transitional camp data, the only condition shown to be a significant risk factor for any symptom was household population density, which increased the risk of stomach aches 1.40 (1.09-1.79) and headaches 1.33 (1.01-1.77). CONCLUSION: Internally displaced people living in transitional camps are a vulnerable population and specific interventions need to be targeted at this population to address the health inequalities that they report to be experiencing. Further studies need to be conducted to establish which aspects of their housing environment predispose them to poorer health
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