3D Groundwater flow model at the Upper Rhine Graben scale to delineate preferential target areas for geothermal projects

International audienceAny deep unconventional geothermal project remains risky because of the uncertainty regarding the presence of the geothermal resource at depth and the drilling costs increasing accordingly. That's why this resource must be located as precisely as possible to increase the chances of successful projects and their economic viability. To minimize the risk, as much information as possible should be gathered prior to any drilling. Usually, the position of the exploration wells of geothermal energy systems is chosen based on structural geology observations, geophysics measurements and geochemical analyses. Confronting these observations to results from additional disciplines should bring more objectivity in locating the region to explore and where to implant the geothermal system. The Upper Rhine Graben (URG) is a tectonically active rift system that corresponds to one branch of the European Cenozoic Rift System where the basin hosts a significant potential for geothermal energy. The large fault network inherited from a complex tectonic history and settled under the sedimentary deposits hosts fluid circulation patterns. Geothermal anomalies are strongly influenced by fluid circulations within permeable structures such as fault zones. In order to better predict the location of the geothermal resource, it is necessary to understand how it is influenced by heat transport mechanisms such as groundwater flow. The understanding of fluid circulation in hot fractured media at large scale can help in the identification of preferential zones at a finer scale where additional exploration can be carried out. Numerical simulations is a useful tool to deal with the issue of fluid circulations through large fault networks that enable the uplift of deep and hot fluids. Therefore, we build a numerical model to study groundwater flow at the URG scale (150 x 130km), which aims to delineate preferential zones. The numerical model is based on a hybrid method using a Discrete Fracture Network (DFN) and 3D elements to simulate groundwater flow in the 3D regional fault network and in sedimentary deposits, respectively. Firstly, the geometry of the 3D fracture network and its hydraulic connections with 3D elements (sedimentary cover) is built in accordance with the tectonic history and based on geological and geophysical evidences. Secondly, data from previous studies and site-specific geological knowledge provide information on the fault zones family sets and on respective hydraulic properties. Then, from the simulated 3D groundwater flow model and based on a particle tracking methodology, groundwater flow paths are constructed. The regional groundwater flow paths results are extracted and analysed to delineate preferential zones to explore at finer scale and so to define the potential positions of the exploration wells. This work is conducted in the framework of the IMAGE project (Integrated Methods for Advanced Geothermal Exploration, grant agreement No. 608553), which aims to develop new methods for better siting of exploitation wells

Adapted numerical modelling strategy developed to support EGS deployment.

International audienceThe exploitation of Enhanced/Engineered Geothermal Systems (EGS), for electricity and/or heat production, is a promising way to increase the amount of renewable energies contribution in the energetic mix in Europe. In regard to the required production characteristics (production temperature and flowrate) for the economical viability of EGS, the favourable targeted geological systems are deep and fractured. In order to reduce the risks and the prohibitive costs linked to the depth of such geothermal systems, numerical modelling is a useful tool to understand such deep fractured systems and to help in the construction and in the management of the deep infrastructures (wells architecture, stimulation of wells, implementation of adapted network of wells). Nevertheless, this forces to a change of paradigm in comparison to « classical » reservoir modelling based on mechanics of continuum media. Indeed 3D Discrete Fracture Network (DFN) approach looks fairly adapted to catch the mechanical and hydraulic phenomena in the fractured rock mass around wells and to understand the global systems in the network of wells. The conceptualisation of the fractured rock mass is a crucial step for such DFN models not only for the geometry but also to constrain the constitutive behaviour of singularities (fault zones, fractures etc.), depending on the tectonic context. We present some results illustrating how DFNs can be used to study the EGS behaviour at several scales

Saúde mental na atenção básica: uma rede rizomática para infância e adolescência

Objective: to map mental health care for children and adolescents, its flows, lines and connections based on the articulation of the Psychosocial Care Centers for Children and Adolescents (Centros de Atenção Psicossocial Infantojuvenil, CAPSi) and Primary Health Care (PHC). Method: a qualitative and cartographic research study conducted between August and December 2017 in a municipality from Rio Grande do Sul. The study participants were CAPSi and PHC professionals. Results: the cartographic experience with the rhizomatic network made it possible to monitor CAPSi's articulation with PHC services; planning and sharing care according to workers' collective action, and also the “knots” and challenges of the child and youth mental health network. Insecurity to deal with the demand, lack of knowledge and the need for training as a support modality are challenges mentioned by PHC professionals for networked assistance. Conclusion: care-related arrangements can articulate/share the assistance provided, evoking a “rhizomatic network” of connections, flows and varied lines.Objetivo: cartografiar la atención en salud mental para niños y adolescentes, sus flujos, líneas y conexiones a partir de la articulación de los Centros de Atención Psicosocial Infantojuvenil (CAPSi) y la Atención Primaria (AP). Método: investigación cualitativa y cartográfica realizada en un municipio de Rio Grande do Sul entre agosto y diciembre de 2017. Los participantes del estudio fueron profesionales del CAPSi y de AP. Resultados: la experiencia cartográfica con la red rizomática permitió monitorear la articulación del CAPSi con servicios de AP, la planificación y cooperación en la atención conforme a la acción colectiva de los trabajadores, y también los “nodos” y desafíos de la red de salud mental infanto-juvenil. La inseguridad para lidiar con la demanda, añadida a la falta de conocimiento y a la necesidad de capacitación como forma de apoyo, son desafíos mencionados por los profesionales de AP para brindar asistencia en red. Conclusión: implementar disposiciones asistenciales específicas puede ser útil para articular/compartir la atención provista, evocando una “red rizomática” de conexiones, flujos y líneas variadas.Objetivo: cartografar o cuidado em saúde mental à criança e ao adolescente, seus fluxos, linhas e conexões a partir da articulação do Centro de Atenção Psicossocial Infantojuvenil (CAPSi) e Atenção Básica (AB). Método: pesquisa qualitativa e cartográfica, realizada em   município do Rio Grande do Sul, de agosto a dezembro de 2017. Participaram do estudo profissionais do CAPSi e AB. Resultados: a experiência cartográfica com a rede rizoma permitiu acompanhar a articulação do CAPSi com serviços da AB; o planejamento e compartilhamento do cuidado segundo o agir coletivo dos trabalhadores, e também os “nós” e desafios da rede de saúde mental infantojuvenil. A insegurança para lidar com a demanda, com a falta de conhecimento e a necessidade de capacitação como forma de apoio são desafios mencionados pelos profissionais da AB para uma assistência em rede. Conclusão: arranjos assistenciais podem articular/compartilhar cuidados, evocando uma “rede rizomática” de conexões, fluxos e variadas linhas

Nursing and self-care in the world of psychiatric care

Objective: Understanding self-care among nursing professionals in mental health. Method: qualitative study conducted in a psychiatric unit of a teaching hospital in Rio Grande do Sul, Brazil. Merleau-Ponty's phenomenology of perception was used as a philosophical theoretical framework and Paul Ricoeur's hermeneutic phenomenology was used as a methodological framework. The research was conducted with 10 nursing professionals in mental health, out of a total population of 15 professionals, by means of open interview, within the period from September to December 2010. Results: through the metaphor of discourses, the theme emerged: the world of psychiatry. Conclusion: care in the world of psychiatry is unveiled as a stage of intense interpersonal exchanges, matches and mismatches with the other involved in care. This space of objective and subjective relationships and events interferes with care for the other and each nursing professional's self-care

Sonhos e utopias para a Rede de Atenção Psicossocial: perspectivas de trabalhadores

Objective: to identify the dreams of workers about how the future of work in the Psychosocial Care Network (RAPS - Rede de Atenção Psicossocial) could be. Method: appreciative, qualitative research, with a participatory approach, guided by the Discovery, Dream, Planning and Destination Cycle, articulated to the theoretical framework of Paulo Freire. Thirteen RAPS workers from Santa Maria, Rio Grande do Sul, Brazil participated. Data were produced from December 2019 to July 2020, with semi-structured interviews and recorded discussion groups. Data analysis was performed through coding, categorization and identification of themes. Results: workers dream of a network with sufficient human and structural resources; care flow defined collectively; approach to management; work in the territory; committed workers, appreciation and attention to their mental health. Conclusion: dreams converged with what is already advocated in public policies, but require an organized and committed collective that fights for change.Objetivo: identificar los sueños de los trabajadores sobre cómo podría ser el futuro del trabajo en la Red de Atención Psicosocial (RAPS). Método: investigación apreciativa, cualitativa, con abordaje participativo, orientada por el Ciclo Descubrimiento, Sueño, Planificación y Destino, articulada al referencial teórico de Paulo Freire. Participaron 13 trabajadores de la RAPS de Santa Maria, Rio Grande do Sul, Brasil. La producción de los datos tuvo lugar de diciembre de 2019 a julio de 2020, con entrevistas semiestructuradas y grupos de discusión grabados. El análisis de los datos fue realizado por medio de la codificación, categorización e identificación de temas. Resultados: los trabajadores sueñan con una Red con recursos humanos y estructurales suficientes; flujo asistencial definido colectivamente; aproximación con la gestión; trabajo en el territorio; trabajadores comprometidos, valorización y atención a su salud mental.  Conclusión: los sueños convergieron con lo que ya es preconizado en las políticas públicas, pero requieren un colectivo organizado y comprometido, que luche por los cambios.Objetivo: identificar os sonhos dos trabalhadores sobre como poderia ser o futuro do trabalho na Rede de Atenção Psicossocial (RAPS). Método: pesquisa apreciativa, qualitativa, com abordagem participativa, orientada pelo Ciclo Descoberta, Sonho, Planejamento e Destino, articulada ao referencial teórico de Paulo Freire. Participaram 13 trabalhadores da RAPS de Santa Maria, Rio Grande do Sul, Brasil. A produção dos dados ocorreu de dezembro de 2019 a julho de 2020, com entrevistas semiestruturadas e grupos de discussão gravados. A análise dos dados foi realizada por meio da codificação, categorização e identificação de temas. Resultados: os trabalhadores sonham com uma Rede com recursos humanos e estruturais suficientes; fluxo assistencial definido coletivamente; aproximação com a gestão; trabalho no território; trabalhadores comprometidos, valorização e atenção à sua saúde mental.  Conclusão: os sonhos convergiram com o que já é preconizado nas políticas públicas, mas requerem um coletivo organizado e comprometido, que lute pelas mudanças

Nucleus of permanent education in nursing: perspectives in a teaching hospital

Objective: To describe how nurses realize the core of Permanent Education in nursing. Method: Descriptive nature research with qualitative approach held in a teaching hospital in the South of the country, with 17 nurses and hospital units leased. The research project has been approved by the Ethics Committee of the Federal University of Santa Maria, Rio grande do Sul, in 0111.0.243.000-09 Protocol CAAE. Results: From the depositions two thematic nuclei consist: Easinesses for implementation of the NEPE and difficulties for implementation of the NEPE. Conclusion: There are possibilities of transformation of the institutional Policy in NEPE HUSM, sustained by national policy of Permanent Education, as reference in educational actions focused reflection of daily practices, contributing to the professional development, in improving the quality of nursing care and user satisfaction

ANÁLISE DOS PROJETOS PEDAGÓGICOS DE CURSOS DE GRADUAÇÃO EM ENFERMAGEM

As Diretrizes Curriculares Nacionais (DCNs) de graduação orientam quanto aos aspectos da formação do profissional de Enfermagem, como a articulação teórica e prática de maneira crítica e reflexiva com caráter de prática social que atenda às necessidades de saúde da população e ao perfil profissional esperado para se engajar no Sistema Único de Saúde (SUS). Este artigo objetiva conhecer os Projetos Pedagógicos dos Cursos (PPC) de graduação em Enfermagem das universidades públicas do estado do Rio de Janeiro. Trata-se de uma pesquisa descritiva de caráter documental cujos dados foram obtidos dos sites dos cursos e/ou universidades. Foi construída uma matriz de análise considerando os elementos de um PPC. Concluiu-se que os PPCs de graduação em enfermagem das universidades públicas do estado do Rio de Janeiro adotam parcialmente as DCNs

Redes sociais de apoio no cuidado à pessoa com transtorno mental: reflexões

Aim: to reflect on the formal and informal social support networks in the care for the person with mental disorder centered on the psychosocial paradigm. Method: a theoretical-reflective study based on the epistemological Brazilian Psychiatric Reform, which redirects the care model in mental health. Results: the family is the primary source of social network resource in informal support and is sometimes the key to the effectiveness of the care provided by the formal social support network. It is important that the services develop support a strategy so that the person with mental disorder and his/her family can clarify his/her doubts and minimize the challenges that cover mental health care. Conclusions: the social support network is an aspect that needs to be valued by the health professional, since it enables mental health care planning.Objetivo: refletir acerca das redes sociais de apoio formais e informais no cuidado à pessoa com transtorno mental centrado no paradigma psicossocial. Método: estudo teórico-reflexivo tendo como base epistemológica a Reforma Psiquiátrica Brasileira, que redireciona o modelo assistencial em saúde mental. Resultados: a família é fonte primária de recurso na rede social de apoio informal e, por vezes, é a chave para a efetividade do cuidado fornecido pela rede social de apoio formal. É importante que os serviços desenvolvam estratégias de apoio para que a pessoa com transtorno mental e sua família possam esclarecer suas dúvidas e minimizar os desafios que envolvem o cuidado em saúde mental. Conclusões: a rede social de apoio é um aspecto que necessita ser valorizado pelo profissional de saúde, pois a partir dela é possível planejar o cuidado em saúde mental

Skin picking treatment with the Rothbaum cognitive behavioral therapy protocol : a randomized clinical trial

Introduction: Although behavioral therapies can effectively treat skin picking disorder (SPD), there is no standardized treatment for improving SPD and its comorbidities and there is no group intervention option. This trial aimed to adapt the Rothbaum trichotillomania protocol to SPD (Study 1) and test its efficacy for treating SPD and comorbidities in individual and group formats (Study 2). Methods: The adapted protocol was applied to 16 SPD patients, who were allocated to group or individual treatment (Study 1). Afterwards, 54 patients were randomly allocated to treatment in an individual (n=27) or group format (n=27) (Study 2). In both studies, assessments of SPD severity, anxiety, depression, clinical status and skin lesion severity were performed at baseline and the endpoint. Results: The adapted protocol was feasible in both treatment modalities (Study 1) and led to high SPD remission rates (individual 63%; group 52%), with no significant difference between intervention types (p = 0.4) (Study 2). SPD, anxiety, and depression symptoms and objective patient lesion measures improved after treatment. There was large effect size for SPD symptom improvement in both treatment types (Cohen’s d: group = 0.88; individual = 1.15) (Study 2). Conclusion: The adapted Rothbaum protocol was effective for SPD remission, comorbidities, and skin lesions, both in individual and group formats