A FORMAÇÃO DO ENFERMEIRO PARA A ASSISTÊNCIA DE PORTADORES DE NECESSIDADES ESPECIAIS, COM PARALISIA CEREBRAL, SUBMETIDOS À INTERNAÇÃO DOMICILIAR

This is an end of course work that has as its subject nurse training in the home care of special needs patients, particularly, of patients with cerebral paralysis. Its aim is to sensitize the nurse to the peculiarities of Attention Services at home and for patients with cerebral palsy. To direct the course of this work, we present as a study the problem of the identification of the main necessities of the patients with cerebral palsy in Attention Services at home. The general objective of this research will be to describe the training process of specialist nurses in home care and the specific objectives will be: To identify the main requirements of patients with special needs and cerebral palsy, and to describe how nurses are prepared for this type of care of patients and their family. It was opted to carry out a bibliographical research, contemplating a qualitative focus, of explorative nature, descriptive and explanatory, resulting in the following thematic categories: The perception of the importance of "being a nurse in home care" and the relevance of the knowledge of the needs of patients with cerebral palsy and their family, in regards to home internment. From its development, it was possible to perceive that the academic focus given to this type of service and to this type of patient is limited, and that a specific specialization for the peculiarities of the service of home care and the peculiarities of a patient with cerebral palsy is still restricted. We conclude that greater assessment and study of the service of home care, as well as the patient with cerebral palsy, is necessary. As much during study as after graduation because this is a service in expansion and the patient needs complete care. We hope that this study contributes to a greater interest in the subject, facilitating the assistance of patients in home care, particularly those with special needs.Este es un trabajo de finalización de curso, que tiene como tema la formación de enfermeras en la atención domiciliaria con una necesidad especial, más concretamente, para el cliente con parálisis cerebral; quiere aumentar la sensibilización, especialmente a la enfermera acerca de las peculiaridades del Servicio de Atención a domicilio y al paciente con parálisis cerebral. Para dirigir el progreso de este trabajo, se presenta como problema el estudio de la identificación de las principales necesidades presentadas por el cliente con parálisis cerebral en el servicio de cuidados en el hogar. El objetivo general de esta investigación es describir el proceso de formación de la enfermera especialista en cuidados en el hogar y los objetivos específicos: identificar las principales necesidades de la atención al cliente con necesidades especiales, con parálisis cerebral; describir cómo las enfermeras están preparadas para este tipo de asistencia a estos clientes y de su familia. Nuestra opción es realizar una búsqueda bibliográfica, se contempla un enfoque cualitativo, el carácter exploratorio, descriptivo y explicativo, por lo que en las siguientes categorías temáticas: La percepción de la importancia de "ser calificadas enfermeras en la atención a domicilio" y la importancia del conocimiento de las necesidades del cliente y de la familia del neuropata, frente al episodio de hospitalización en domicilio. A partir de su desarrollo, es posible percibir que el enfoque académico dispensado a este tipo de servicio y a ese tipo de cliente es limitada, y que está todavía limitada una especialización especifica tanto para las peculiaridades del servicio de atención domiciliaria, como las peculiaridades de un paciente neuropata. Llegamos a la conclusión de que necesitamos una mayor valoración y estudio del servicio de atención domiciliaria, así como a los clientes con parálisis cerebral, tanto durante como en la postgraduación, por el hecho de que este es un servicio en expansión y el cliente es un usuario que necesita toda la atención. Esperamos que este estudio contribuya a un mayor interés en el tema, facilitar la asistencia de los clientes sometidos a atención domiciliaria, especialmente los que tienen necesidades especiales.Trata-se de um trabalho de conclusão de curso, que tem como tema a formação do enfermeiro no atendimento domiciliar ao portador de necessidade especial, mais especificamente, ao cliente com paralisia cerebral, pretende sensibilizar, em especial ao enfermeiro quanto às peculiaridades do serviço de atendimento domiciliar e do paciente com paralisia cerebral. Para direcionar o andamento deste trabalho, apresentamos como problema de estudo a identificação das principais necessidades apresentadas pelo cliente com paralisia cerebral no serviço de atendimento domiciliar. O objetivo geral desta pesquisa foi descrever o processo de formação do enfermeiro especialista em atendimento domiciliar e os objetivos específicos: identificar as principais necessidades assistenciais do cliente portador de necessidades especiais com paralisia cerebral; descrever como o enfermeiro é preparado para essa assistência a esses clientes e sua família. Optou-se por realizar uma pesquisa bibliográfica, contemplando-se uma abordagem qualitativa, de natureza exploratória, descritiva e explicativa, resultando nas seguintes categorias temáticas: A percepção da importância do “ser enfermeiro capacitado em home care” e A relevância do conhecimento das necessidades do cliente e da família do neuropata, frente ao episodio de internação domiciliar. A partir do seu desenvolvimento, foi possível perceber que a abordagem acadêmica dispensada a esse tipo de serviço e a esse tipo de cliente é restrita, e que ainda é restrita também uma especialização especifica, tanto para as peculiaridades do serviço de atendimento domiciliar, como às peculiaridades de um paciente neuropata. Concluímos que é necessário maior valorização e estudo quanto ao serviço de atendimento domiciliar, assim como também ao cliente com paralisia cerebral, tanto no intra como na pós-graduação, pelo fato de que este é um serviço em expansão e esse cliente é um usuário em potencial, por ser um cliente que necessita de atenção integral. Desejamos que este estudo contribua de forma a impulsionar um maior interesse sobre o tema, facilitando a assistência de clientes submetidos à internação domiciliar, em especial àqueles que possuem necessidades especiais

Air monitoring for synthetic cannabinoids in a UK prison: Application of personal air sampling and fixed sequential sampling with TD-GC×GC-TOF MS analysis

In recent years there have been increasing complaints from staff working in UK prisons of secondary exposure to psychoactive drug fumes, often believed to be synthetic cannabinoids. Our pilot study aimed to provide an initial evidence base for this issue and reveal compounds of interest within indoor prison air. Here we present a new method for the detection of synthetic cannabinoids in air, and demonstrate its application in a UK prison. Air sampling was conducted using a fixed sequential sampler, alongside personal air sampling units worn by prison officers within an English prison. Air samples were collected onto thermal desorption (TD) tubes and analysed via comprehensive two-dimensional gas chromatography coupled to time-of-flight mass spectrometry (GC×GC-TOF MS). This study is the first of its kind in a prison setting and the approach is of importance to analytical scientists, policy makers and public health employees tasked with the health and safety of prison staff. GC×GC-TOF MS analysis was able to separate and identify a range of compounds present in the prison air samples. Analysis of the TD tubes did not reveal any synthetic cannabinoids from the fixed pump air samples or the personal pump samples worn by prison officers. Air monitoring in prisons presents a challenge of logistics as well as science. Fixed sequential air sampling combined with personal air monitoring devices allowed air from multiple locations within a prison to be collected, providing a comprehensive approach to evaluating the air that prison staff are exposed to during a fixed time period

Nut production in Bertholletia excelsa across a logged forest mosaic: implications for multiple forest use

Although many examples of multiple-use forest management may be found in tropical smallholder systems, few studies provide empirical support for the integration of selective timber harvesting with non-timber forest product (NTFP) extraction. Brazil nut (Bertholletia excelsa, Lecythidaceae) is one of the world’s most economically-important NTFP species extracted almost entirely from natural forests across the Amazon Basin. An obligate out-crosser, Brazil nut flowers are pollinated by large-bodied bees, a process resulting in a hard round fruit that takes up to 14 months to mature. As many smallholders turn to the financial security provided by timber, Brazil nut fruits are increasingly being harvested in logged forests. We tested the influence of tree and stand-level covariates (distance to nearest cut stump and local logging intensity) on total nut production at the individual tree level in five recently logged Brazil nut concessions covering about 4000 ha of forest in Madre de Dios, Peru. Our field team accompanied Brazil nut harvesters during the traditional harvest period (January-April 2012 and January-April 2013) in order to collect data on fruit production. Three hundred and ninety-nine (approximately 80%) of the 499 trees included in this study were at least 100 m from the nearest cut stump, suggesting that concessionaires avoid logging near adult Brazil nut trees. Yet even for those trees on the edge of logging gaps, distance to nearest cut stump and local logging intensity did not have a statistically significant influence on Brazil nut production at the applied logging intensities (typically 1–2 timber trees removed per ha). In one concession where at least 4 trees ha-1 were removed, however, the logging intensity covariate resulted in a marginally significant (0.09) P value, highlighting a potential risk for a drop in nut production at higher intensities. While we do not suggest that logging activities should be completely avoided in Brazil nut rich forests, when a buffer zone cannot be observed, low logging intensities should be implemented. The sustainability of this integrated management system will ultimately depend on a complex series of socioeconomic and ecological interactions. Yet we submit that our study provides an important initial step in understanding the compatibility of timber harvesting with a high value NTFP, potentially allowing for diversification of forest use strategies in Amazonian Perù

Non Mycobacterial Virulence Genes in the Genome of the Emerging Pathogen Mycobacterium abscessus

Mycobacterium abscessus is an emerging rapidly growing mycobacterium (RGM) causing a pseudotuberculous lung disease to which patients with cystic fibrosis (CF) are particularly susceptible. We report here its complete genome sequence. The genome of M. abscessus (CIP 104536T) consists of a 5,067,172-bp circular chromosome including 4920 predicted coding sequences (CDS), an 81-kb full-length prophage and 5 IS elements, and a 23-kb mercury resistance plasmid almost identical to pMM23 from Mycobacterium marinum. The chromosome encodes many virulence proteins and virulence protein families absent or present in only small numbers in the model RGM species Mycobacterium smegmatis. Many of these proteins are encoded by genes belonging to a “mycobacterial” gene pool (e.g. PE and PPE proteins, MCE and YrbE proteins, lipoprotein LpqH precursors). However, many others (e.g. phospholipase C, MgtC, MsrA, ABC Fe(3+) transporter) appear to have been horizontally acquired from distantly related environmental bacteria with a high G+C content, mostly actinobacteria (e.g. Rhodococcus sp., Streptomyces sp.) and pseudomonads. We also identified several metabolic regions acquired from actinobacteria and pseudomonads (relating to phenazine biosynthesis, homogentisate catabolism, phenylacetic acid degradation, DNA degradation) not present in the M. smegmatis genome. Many of the “non mycobacterial” factors detected in M. abscessus are also present in two of the pathogens most frequently isolated from CF patients, Pseudomonas aeruginosa and Burkholderia cepacia. This study elucidates the genetic basis of the unique pathogenicity of M. abscessus among RGM, and raises the question of similar mechanisms of pathogenicity shared by unrelated organisms in CF patients

A inclusão da equipe de saúde bucal na Estratégia Saúde da Família: entraves, avanços e desafios

O objetivo deste artigo é discutir a inclusão da saúde bucal na Estratégia Saúde da Família, em cidades de uma microrregião do sudeste do Brasil, sob a perspectiva dos recursos humanos. Foram aplicados questionários aos integrantes do serviço de saúde bucal: dentistas, auxiliares e gestores. O instrumento considerou três dimensões: como e porque se adotou o novo modelo, como o serviço está se reorganizando e que avanços foram percebidos pelos profissionais. O motivo mais mencionado pelos gestores, para inclusão da Saúde Bucal foi a possibilidade de mudança do modelo tecno-assistencial. Dentistas e auxiliares quando questionados sobre sua motivação, também consideraram prioritariamente a possibilidade de mudança na prática. Observou-se ainda que existem nós críticos na contratação e capacitação de recursos humanos para atuar na equipe de saúde bucal e na integração entre os profissionais de saúde. Mas o acesso está melhor, seja pela organização efetuada, seja pela expansão de equipes. Os municípios da microrregião ainda enfrentam percalços para que o funcionamento do serviço de saúde bucal, após a Saúde da Família, apresente avanços reais nas práticas de atenção. Porém, os avanços existem e estes devem ser reforçados, para consolidação do sistema de saúde e melhoria na qualidade de vida da população

A review of the distribution of particulate trace elements in urban terrestrial environments and its application to considerations of risk

We review the evolution, state of the art and future lines of research on the sources, transport pathways, and sinks of particulate trace elements in urban terrestrial environments to include the atmosphere, soils, and street and indoor dusts. Such studies reveal reductions in the emissions of some elements of historical concern such as Pb, with interest consequently focusing on other toxic trace elements such as As, Cd, Hg, Zn, and Cu. While establishment of levels of these elements is important in assessing the potential impacts of human society on the urban environment, it is also necessary to apply this knowledge in conjunction with information on the toxicity of those trace elements and the degree of exposure of human receptors to an assessment of whether such contamination represents a real risk to the city’s inhabitants and therefore how this risk can be addressed