Formação de estudantes em ensino clínico: intervenção supervisiva do tutor

O presente estudo incide sobre a forma como os enfermeiros tutores entendem ser o seu papel no acompanhamento de estudantes do Curso de Licenciatura em Enfermagem durante a sua aprendizagem clínica. Tem como finalidade central construir subsídios para a estruturação do trabalho do enfermeiro tutor no acompanhamento dos estudantes de Cursos de Licenciatura em Enfermagem que desenvolvem a sua prática clínica. Como se refere ao longo do estudo, o papel do tutor é muito complexo e multidimensional, pois é um elemento com atividades clínicas que acumula a responsabilidade de acompanhar e apoiar os estudantes em ensino clínico. Para melhor enquadramos a problemática em estudo, abordamos um conjunto de informação teórica sobre conceções da formação inicial em enfermagem, contextos de formação, epistemologia da enfermagem, formação contínua, processos supervisivos e supervisão clínica em enfermagem. A pesquisa adota uma perspetiva de inspiração fenomenológica. Optamos pela realização de um estudo multicasos com abordagem etnográfica em três contextos distintos. Os dados foram recolhidos através da observação participante, entrevistas etnográficas, questionário, análise documental e pareceres de um grupo de peritos. O tratamento de dados foi essencialmente qualitativo, tendo por base a análise de conteúdo. Os principais resultados permitem compreender que o acompanhamento de estudantes remete para uma implicação pessoal e profissional do tutor. O tutor recorre a diversas estratégias pedagógicas, que no entanto nem sempre são fáceis de dinamizar e utilizar devido a dificuldades inerentes aos locais da prática mas também à diversidade curricular existente entre as Escolas. As atividades de cuidar e formar em simultâneo encerram um conjunto de dimensões que se interligam numa teia donde se salientaram as dinâmicas da qualidade, os processos de integração e de socialização, as parcerias entre instituições (escola e unidade de cuidados), a gestão dos cuidados e gestão de emoções, os estilos de aprendizagem dos estudantes e o recurso às estratégias supervisivas (reflexão, observação, comunicação e avaliação). Ao longo deste estudo emergem subsídios para se repensar a organização do trabalho do enfermeiro tutor e subsídios para as práticas de supervisão que devem decorrer em três etapas: planificação do estágio, implementação e uma última etapa de avaliação do processo. Tentamos, ao longo do estudo, designadamente na discussão e nas conclusões, integrar no debate sobre a intervenção do tutor novas dimensões e aspetos relevantes para a aprendizagem dos estudantes.The present study focuses on how nurse tutors understand their role in attending the nursing students during their clinical training. Its main purpose is to make contributions for structuring the tutor’s work in the supervision of the nursing students who develop their clinical practices. As referred throughout the study, the role of the tutor is overly complex and multidimensional as it is an element with clinical wards that accumulates the responsibility to accompany and support students in clinical training and works as a nurse. To better frame the problem under study, we approached a set of theoretical information about conceptions of initial training in nursing, nursing contexts, nursing epistemology, further training, supervising processes and nursing clinical supervision. The research takes a perspective of phenomenological inspiration. We select a multi-stage study with an ethnographic approach in three different contexts. Data were collected through participant observation, ethnographic interviews, questionnaire, document analysis and expert group opinions. Data processing was mainly qualitative, based on content analysis. The main results allow us to understand that student supervision asks to a personal and professional involvement of the tutor. The nurse tutor uses several pedagogical strategies, which however are not always easy to promote and use due to inherent difficulties in the places of practice but also to the diversity of curricular between the schools. Activities to care for and form simultaneously enclose a set of dimensions that are interconnected in a web highlighting the dynamics of quality, the processes of integration and socialization, the partnerships between institutions (school and care units), the management of care and management of emotions, student learning styles and the use of supervising strategies (reflection, observation, communication and evaluation). Throughout this study some contributions were emerging to rethink the organization of the tutor nurse's work and for supervision practices that should take place in three stages: internship planning, implementation and a final stage of process evaluation. We have tried throughout the study, namely in the discussion and conclusions, to integrate new dimensions and aspects relevant to students' learning into the debate related to the tutor’s intervention on the clinical learning.Programa Doutoral em Educaçã

A INSTITUCIONALIZAÇÃO COMO FORMA DE DIFERENCIAÇÃO FRENTE AO ISOMORFISMO ORGANIZACIONAL

Face às questões que envolvem a sobrevivência das organizações, seus processos de gestão tendem a se apresentarem cada vez mais isomórficos, restando a possibilidade de institucionalização como uma alternativa de diferenciação. Por este motivo, o objetivo da presente pesquisa foi identificar se as pessoas identificam organizações institucionalizadas em suas relações sociais a nível estadual e federal, razão pela qual, como estratégia de pesquisa aplicou-se um questionário a estudantes universitários, o que possibilitou, através da sua análise que as instituições de ensino são consideradas como institucionalizadas pelo reconhecimento que possuem da sociedade

As boas práticas de fabricação de medicamentos e suas determinantes

Good Manufacturing Practices (GMP) ensure that drugs are consistently produced and controlled according to previously established quality standards. They are designed to manage and minimize the inherent risks involved in the manufacture of drugs in order to ensure the quality, efficacy and safety of the finished product. Since their inception as we know them today, several versions have taken place in Brazil and worldwide. This work proposes to analyze GMP, through the analysis of the content of Brazilian regulatory frameworks, identifying the determinants that can explain their evolution over the last decades. GMP were broken down into topics and subtopics and their versions present in the five regulatory frameworks studied were evaluated. It was possible to verify, in the evolution of drug manufacturing requirements, the interference of technological innovation and the influence of new practices related to quality, identifying the GMP transformation dynamics.As Boas Práticas de Fabricação (BPF) garantem que os medicamentos sejam consistentemente produzidos e controlados de acordo com padrões de qualidade previamente estabelecidos. Têm por objetivo gerenciar e minimizar os riscos inerentes à fabricação de medicamentos com vista a garantir a qualidade, eficácia e segurança do produto acabado. Desde o seu surgimento da forma como conhecemos hoje, várias versões se sucederam no Brasil e no mundo. Esse trabalho se propõe a analisar as BPF, por meio da análise de conteúdo dos marcos regulatórios brasileiros, identificando as determinantes que podem explicar a sua evolução através das últimas décadas. As BPF foram decompostas em temas e subtemas e suas versões, presentes nos cinco marcos regulatórios estudados, foram avaliadas. Foi possível comprovar, na evolução dos requisitos de fabricação de medicamentos, a interferência da inovação tecnológica e a influência de novas práticas relacionadas à qualidade, identificando, dessa forma, a dinâmica de transformação das BPF

Recent advances in the treatment of Chagas disease

Descoberta há cem anos, a doença de Chagas afeta a mais de quinze milhões de pessoas em toda a América Latina e, ainda hoje, não há tratamentoeficaz. O fármaco benznidazol, utilizado como única opção de tratamento no Brasil, é ineficaz na fase crônica da doença. Problemas relacionados à biodisponibilidade do medicamento comercial limitam sua eficácia, principalmente na fase crônica, quando os parasitos estão confinados em tecidos profundos e em lenta replicação. Nesse contexto, pesquisas lideradas por grupos brasileiros e argentinos vêm sendo conduzidas com o objetivo de desenvolver formulações de benznidazol mais eficientes. Diversas formas farmacêuticas sólidas e líquidas foram propostas nos últimos anos com resultados pré-clínicos promissores, sendo descritas melhorias acentuadas nas características farmacocinéticas desse fármaco. Espera-se que as formas inovadoras apresentadas possam ser avaliadas em ensaios clínicos e incorporadas à produção industrial em breve.Discovered about a hundred years ago, Chagas disease currently affects more than fifteen million people in Latin America, and it still remains without any effective treatment. Although benznidazole has been used as the only pharmacotherapeutic option to treat Chagas disease in Brazil, it is ineffective in the chronic phase of the disease, when the parasites are confined to deep tissue layers and slowly replicate. This happens mainly due to problems related to the bioavailability of the drug, which is currently in the market. In this context, Brazilian and Argentinean research groups have conducted studies to develop more efficient benznidazole formulations. Several solid and liquid formulations have been proposed over the last few years with promising preclinical results. Improvements in the pharmacokinetic properties of this drug have been described. Therefore, it is expected, that such innovative drugs and formulations be assessed in clinical trials and soon incorporated to industrial production.Fil: da Cunha Filho, Marcílio Sérgio Soares . Universidade Do Brasilia; BrasilFil: de Sá-Barreto, Lívia Cristina lira . Universidade Do Brasilia; BrasilFil: Leonardi, Darío. Universidad Nacional de Rosario. Facultad de Ciencias Bioquímicas y Farmacéuticas; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Rosario. Instituto de Química Rosario; ArgentinaFil: Lamas, Maria Celina. Universidad Nacional de Rosario. Facultad de Ciencias Bioquímicas y Farmacéuticas; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Rosario. Instituto de Química Rosario; ArgentinaFil: Salomon, Claudio Javier. Universidad Nacional de Rosario. Facultad de Ciencias Bioquímicas y Farmacéuticas; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Rosario. Instituto de Química Rosario; Argentin

Caracterização físico-química do fármaco antichagásico benznidazol

Currently, benznidazole (BNZ) is a unique therapeutic alternative available in Brazil to treat Chagas disease. Despite its traditional medical use, little is known about the chemical nature of this drug. A detailed study of the physicochemical properties of BNZ was performed using multiple assays. Thermal, diffractometric, morphological and reological drug profiles were obtained. The partition coefficient and solubility results allowed this drug to be classified as a class IV drug according to the biopharmaceutical classification system. This information will be useful for the development of more effective BNZ formulations and for establishing the quality profile of BNZ

Blood Parameters of Lactating Cows Fed Calcium Salts as Energetic Source

Background: The negative energetic balance of lactating cows that occurs during the few weeks postpartum shifts the hormonal profile of the animal. These alterations may lead to metabolic disturbance as ketosis and lipid infiltration. Hypocalcemia is another metabolic problem that occurs in the peripartum period, it is characterized by the reduction in blood levels of calcium (Ca2+) near birth. Blood parameters illustrates the nutritional status of milking cows. The serum levels of glucose, β-hydroxybutyrate (BHB) and cholesterol are parameters that reveal liver condition and it is very important for the metabolism of milking cows. The objective of this study was to evaluate three additives in the form of a calcium salts on blood parameters of lactating cows.Materials, Methods & Results: Two Latin square 4x4 were used, whereas one comprehended of early lactation cows and the other of mid lactation cows. Animals of 2nd and 3rd parity were used only. Parity was distributed evenly among groups. The trial consisted of 4 groups with 4 treatments as follow: T1: 300 g of calcium acetate, T2: 200 g of calcium propionate, T3: 200 g of calcium salts of fatty acids, and T4: control without any calcium additive. Blood samples were collected for analysis of serial calcium, glucose, β-hydroxybutyrate (BHBA) and cholesterol. The calcium levels were higher in T1 than T3 in early lactation. There was no significant difference of glucose levels between groups. Groups T1 and T2 had lower amounts of BHBA. Cholesterol was higher in T3 and T1 in the early lactation and just in T3 was higher in the mid lactation.Discussion: Adjust the Ca2+ flow due to high feed consumption and milk production near birth is a big challenge for milking cows due to the difficulties to maintain normal serial levels of Ca2+ in the early lactation. The lower serial levels of Ca2+ in the group supplemented with calcium salts of fatty acids is due to its physical characteristics that reduces its effects on ruminal microbiota and also reduced absorption of fatty acids in intestine. The evaluation of total cholesterol can be a parameter to judge the productive capacity of milking cows, because it demonstrates the capacity of corporal fat mobilization and ingestion of energy to produce milk. An increase of total cholesterol in cows supplemented with calcium salts of fatty acids is justified by the higher intake of fatty acids in the feed containing fat, which leads to a greater lipid metabolism in blood. As the literature has limited information about calcium acetate, it is believed that the animals supplemented with calcium acetate showed higher levels of cholesterol because the acetate is converted to Acetyl coenzime A, it is the basis for cholesterol biosynthesis in lactating cows. The BHBA can be considered as an indicator of negative energetic balance due to its correlation between energetic demand and energy reserves. As propionate is produced by ruminal fermentation and is the principal source for gluconeogenesis in peripartum cows, it lowered level of BHBA in the propionate supplemented group. The acetate availability is fundamental to attend the energetic requirements of lactating cows. The acetate enters in the synthesis of fatty acids as Acetyl coenzyme-A or enters in Krebs cycle through condensation with oxaloacetate, this explains the lower serial levels of BHB in group T1. It was concluded that T1 and T2 lowered the values of BHBA in early lactation cows and the animals supplemented with calcium salts of fatty acids and calcium acetate shower higher levels of cholesterol in early lactation and the T3 group in the mid lactation

EFEITO DO TEMPO DE CONSOLIDAÇÃO NAS PRESSÕES HORIZONTAIS EXPERIMENTAIS E NORMATIZADAS EM SILOS VERTICAIS

The study of the pressures that the stored product exerts on the silo walls is a relevant factor, the present work has the objective of determining, empirically and experimentally, the loading and unloading pressures along the circular section of the vertical metal silo exerted by the stored product and the influence of the consolidation time. For the determination of horizontal and frictionpressures, devices composed of pairs of load cells were used, fixed to square sections of the silo of the silo with 2.5 m of body height and 0.64 m of internal diameter and tremonha with 0.51 m height and inclination of approximately 60° with the horizontal, made of smooth steel with 1 mm thickness. The corn loading and unloading tests were in quintupleata, and three consolidation times were adopted, which were 6, 12 and 24 hours. The experimentally determined pressures were compared to the values found from the equations contained in the standards AS 3774 (1990) and BS EN 1991/4 (2006). It was evidenced that the experimental data of horizontal pressure during loading were always lower than those standardized, considering that the standards increase the values due to the use of safety coefficients and although the calculations were performed with the subtraction of this coefficient, no interference of the consolidation times analyzed in the pressures was observed.El estudio de las presiones que el producto almacenado ejerce sobre las paredes del silo es un factor relevante, el presente trabajo tiene el objetivo de determinar, empírica y experimentalmente, las presiones de carga y descarga a lo largo de la sección circular del silo metálico vertical ejercido por el producto almacenado y la influencia del tiempo de consolidación. Para la determinación de las presiónes horizontales y de fricción, se utilizaron dispositivos compuestos por pares de células de carga, fijadas a secciones cuadradas del silo del silo con 2,5 m de altura del cuerpo y 0,64 m de diámetro interno y tremonha con 0,51 m de altura e inclinación de aproximadamente 60° con la horizontal, fabricado en acero liso de 1 mm de espesor. Las pruebas de carga y descarga de maíz fueron en quintupleata, y se adoptaron tres tiempos de consolidación, que fueron de 6, 12 y 24 horas. Las presiones determinadas experimentalmente se compararon con los valores encontrados a partir de las ecuaciones contenidas en las normas AS 3774 (1990) y BS EN 1991/4 (2006). Se evidenció que los datos experimentales de presión horizontal durante la carga fueron siempre inferiores a los estandarizados, considerando que los estándares aumentan los valores debido al uso de coeficientes de seguridad y aunque los cálculos se realizaron con la sustracción de este coeficiente, no se observó interferencia de los tiempos de consolidación analizados en las presiones.O estudo das pressões que o produto armazenado exerce nas paredes do silo é um fator relevante, o presente trabalho possui o objetivo de determinar, empírica e experimentalmente, as pressões de carregamento e descarregamento ao longo da seção circular do silo vertical metálico exercidas pelo produto armazenado e a influência do tempo de consolidação. Para a determinação das pressões horizontais e de atrito, foram utilizados dispositivos compostos por pares de células de carga, fixados a seções quadradas do silo da parede lisa do silo com 2,5 m de altura de corpo e 0,64 m de diâmetro interno e tremonha com 0,51 m de altura e inclinação de aproximadamente 60° com a horizontal, confeccionados em aço liso com 1 mm de espessura. Os ensaios de carregamento e descarregamento do milho foram em quintuplicata, sendo adotados três tempos de consolidação sendo estes de 6, 12 e 24 horas. As pressões determinadas experimentalmente foram comparadas aos valores encontrados á partir das equações contidas nas normas AS 3774 (1990) e BS EN 1991/4 (2006). Foi evidenciado que os dados experimentais de pressão horizontal durante o carregamento foram sempre inferiores aos normatizados, tendo em vista que as normas majoram os valores devido a utilização de coeficientes de segurança e embora realizado os cálculos com a subtração deste coeficiente, não foi observado interferência dos tempos de consolidação analisados nas pressões

Thermal and physical properties of crude palm oil with higher oleic content

Interspecific hybridization of oil palms (E. guineensis × E. oleifera) was initially exploited to provide disease resistance and, consequently, increased oleic acid content. Besides the growing importance of this cultivar to the market, there is little information about this oil’s properties. In this context, this study aimed to determine a comprehensive physicochemical and thermal characterization of hybrid palm oil (HOPO) compared with the better-known African palm oil (APO). Differences in the distribution of fatty acids, carotenoids, and tocols were observed. Minor differences in density and viscosity were found between the oils, with no relevance for the materials’ processing design. Nevertheless, HOPO showed unique crystallization behavior, which potentially can affect industrial operations, such as fractionation. HOPO did not present the two thermal characteristic regions of APO, attributed to olein and stearin fractions. The HOPO demonstrated a decrease in the melting point of more than 3 °C in relation to APO, and a reduction in the crystallization point of more than 6 °C. Furthermore, besides the higher content of unsaturated fatty acids, HOPO was more stable than APO due to a higher antioxidant content. These results could be useful to establish operation conditions for processes using palm oil from hybrid oil palm

Assessment of GFRP bond behaviour for the design of sustainable reinforced seawater concrete structures

Freshwater is an increasingly scarce resource. Its use in the production of concrete is one important contributor to its fast depletion. Alternatively, the use of seawater for reinforced concrete production, combined with the use of glass fibre reinforced polymers (GFRP) as reinforcement, may represent an interesting solution to increase concrete sustainability. The objective of this paper is to explore this promising solution through the development of concrete compositions with seawater. Additionally, it is also an objective to assess the bond behaviour between GFRP rods and concrete, in a design perspective. The influence of concrete age, rod diameter and anchorage length were also investigated. An analytical model capable of determining the local bond stress-slip laws was used. Results demonstrated that the use of seawater had no relevant effects on neither concrete mechanical properties nor bond behaviour.The study presented in this paper is a part of the research project “NEXT-SEA: Next Generation Monitoring of Coastal Systems in a Scenario of Global Change”, financed by CCDRN and FEDER funds in the scope of the Next-sea project (NORTE-01-0145-FEDER-000032). The authors acknowledge all the companies that have been involved supporting and contributing for the development of this study, mainly: S&P Clever Reinforcement Ibérica Lda., Burgoparaíso – Unipessoal Lda., Secil, Sika Portugal – Produtos Construção e Indústria S.A. The first and the last authors wishes also to acknowledge the grants SFRH/BD/131913/2017 and SFRH/BSAB/150266/2019, respectively, provided by FCT, financed by European Social Fund and by national funds through the FCT/MCTES