O processo de cuidar do enfermeiro em unidade de terapia intensiva: uma análise dos conhecimentos utilizados

Care has always been present in the history of humanity and in contemporary nursing it is considered to be a fundamental characteristic. In the Intensive Care Unit (ICU), care occurs within an environment that is known for its stressful factors, technological equipment, social isolation and discomfort. Whilst the reality of nursing practice in ICU demonstrates the lack of planned and systematized care, there is an indication that the professionals working in this setting utilize some type of knowledge. Based on that premise, in this study we aim to identify the knowledge that the nurses use in providing care in the ICU. We believe that the identification and characterization of this knowledge, and how it presents itself in practice, requires a reflective analysis process. Therefore, we utilized a qualitative perspective and Kim´s (1999) investigative methodology of reflective inquiry that is based on the precepts of Action Science proposed by Argyris et al. (1985). The study was conducted with 8 intensive care nurses of a public hospital. Data were collected by means of non-participative observation of the nursing care actions and a semi-structured interview conducted within the reflective mode that focused on the nurses practice in the ICU. The results enabled us no only to detect that the nurses utilized knowledge and patterns of knowledge acquired or constructed, but to identify them as: scientific, philosophic, religious, empirical, personal, ethical, and esthetic knowledge. The predominance of the scientific knowledge in the care process suggests that these nurses hold an acquired scientific substance that they utilize to provide specialized care directed toward critical treatment. The conception of this reality surpasses the theoretical limits, the techniques, and the known facts, and denotes the need for a reflective process in action to aide in the comprehension of the knowledge involved in the construction of excellent care

Contando histórias de cuidado à infância em unidade de terapia intensiva pediátrica

The tales of children's literature, in their plots, mark existential dilemmas belonging in human‟s lives, such as death, situations of separation, loss, abandonment, fear, challenges, achievements and other elements that make them suitable material to assist children in their developmental process. Such elements, present in children‟s storybooks, are close to the experiences lived by the children in the context of hospitalization in a special manner. With that said this study focus on the understanding of the therapeutic possibilities of the tales of children's literature in the care of hospitalized children in Pediatric Intensive Care Units (UTIPED) based on the Heidegger's concept of Care and adopting the Phenomenology as the method. The UTIPED of a state public hospital located in the municipality of Natal/RN was elected as the study site and four hospitalized children aged between six and nine years, all males, presenting different clinical conditions were selected to participate in the study following age and clinical conditions as the selective criteria. The procedure of corpus construction included eight individual sessions of storytelling accompanied by the use of ludic resources. The phenomenological understanding about the therapeutic possibilities of tales was structured under three main elements: (1) the ludic axis; (2) the reflective axis; and (3) the affective axis. The appropriateness of the proposed therapy in the context of the UTIPED and the potential of the tales as a protection factor to the child was evident. The storytelling activity framed a scenario of care unusual in the context of intensive care units, establishing a symbolic space for children‟s expression. Therefore, this study indicates this therapeutic proposal for children‟s care in the UTIPED that considers their evolutionary stage, their clinical conditions at the time and especially their emotional needs during their immersion in a diverse and foreign environment which is filled with potentially harmful elements to their full development.

Desistência ao tratamento de usuários de crack no centro de atenção pssicosocial em Campina Grande/PB

This study aimed to analyze the phenomenon of abdication of monitoring/treatment of crack users in a CAPS AD in Campina Grande-PB. That s an exploratory , description approach ,whose theoretical focus was historical-dialect of public politics on alcohol and drugs. The information collected was realized by using the technique of semi-structured interviews, combined with the crack users registered in CAPS AD in Campina Grande between 2007 and 2011.The material collected was subjected to thematic analysis method, obtaining the extraction of the following categories and subcategories of analysis: CATEGORY 1: Factors of abdication of monitoring/treatment in CAPS AD in Campina Grande PB with subcategory 1.1. Abdication on their own , 1.2. To take work/employment, 1.3 . Search for more intensive treatment , 1.4. Due to relapse; CATEGORY 2 : Treatment/monitoring in CAPS AD to the subcategory, 2.1. The dependence of crack and family support as reasons that led to frequent CAPS AD. CATEGORY 3: Living with crack addiction without treatment/monitoring in CAPS AD with the subcategory, 3.1. Religiosity as a therapeutic tool .The results showed a distance between priority for community treatment and the reality where there is lack of information about this kind of treatment and the admission as a solution. The discourse about the abdication of treatment of crack users make reference to the importance of family support, to the influence for the phenomenon of relapse and the affection to religious conceptions. Although the subjects recognize the qualifications of CAPS AD treatment, they try by themselves or by family influence, another ways of hospitalization. This leads us to conclude that it is necessary reflection and assessment of the work of CAPS AD. Counting on the social changes and the need of answers that the phenomenon requires

Gestação após gastroplastia para tratamento de obesidade mórbida: série de casos e revisão da literatura

Objetivo: relatar a evolução de uma série de casos de gestação em mulheres previamente submetidas à cirurgia de bypass gástrico para tratamento de obesidade grave. Métodos: cinco casos consecutivos de gravidez após gastroplastia ocorridos entre 2001 e 2004 foram avaliados. As pacientes tinham idade entre 30 e 34 anos e todas haviam sido submetidas à cirurgia de Capella. Aspectos clínicos, laboratoriais e do acompanhamento materno e fetal foram considerados, durante o período gestacional e após o parto. Foi realizada revisão da literatura internacional, por meio das bases de dados MEDLINE e Web of Science, utilizando os seguintes unitermos: gastroplasty, gastric bypass surgery, bariatric surgery e pregnancy. Resultados: todas as gestações observadas foram únicas e não ocorreram complicações obstétricas, durante o seguimento pré-natal e parto. Também não houve registro de recém-nascidos prematuros ou de baixo peso ao nascimento. Conclusão: nossos dados sugerem que a gravidez após gastroplastia é segura para a mãe e feto. Entretanto, em virtude do limitado volume de informação disponível sobre o tema, investigações adicionais são necessárias para estabelecer recomendações apropriadas com relação ao seguimento dessas gestações _________________________________________________ABSTRACT Purpose: we report a small series of pregnant women who underwent gastric bypass surgery for severe obesity, with a review of the literature on this topic. Methods: five consecutive cases of pregnancy after gastroplasty between 2001 and 2004 were evaluated, and clinical, laboratory and therapeutic features were considered. Patients were 30 to 34 years old and all had been submitted to gastroplasty by the Capella technique. The outcomes for both the pregnant woman and the fetus were evaluated. A search of the English language literature was done through MEDLINE and Web of Science databases with the following terms: gastroplasty, gastric bypass surgery, bariatric surgery, and pregnancy. Results: all 5 pregnancies were singleton. No major obstetric complications were observed and there were no premature or lowbirth weight infants. Conclusion: our data suggest that pregnancy following gastroplasty is safe for mother and fetus. However, since information about this topic is limited, further investigations are required to establish appropriate recommendations concerning the follow-up of these pregnancies

Efetividade dos exercícios em cadeia cinética aberta e cadeia cinética fechada no tratamento da síndrome da dor femoropatelar

FEHR, Guilherme Lotierso et al. Efetividade dos exercícios em cadeia cinética aberta e cadeia cinética fechada no tratamento da síndrome da dor femoropatelar. Revista Brasileira de Medicina do Esporte, [s.l], v. 12, n. 2, p.66-70, mar./abr. 2006. Bimestral. Disponível em: . Acesso em: 04 out. 2010.

Organização e tratamento do acervo de instrumentos musicais: o caso da Instrumentoteca da Escola de Música da Universidade Federal do Rio Grande do Norte

Analisa os processos para organização e tratamento do acervo de instrumentos musicais no âmbito da Instrumentoteca da Escola de Música da Universidade Federal do Rio Grande do Norte. Discorre o conceito de biblioteca especializada, suas características e finalidades. Procura verificar os procedimentos utilizados pela Instrumentoteca quanto à organização do acervo, identifica regras para representação descritiva de instrumentos musicais, tendo como parâmetro o Código Anglo-americano de Catalogação. Exemplifica a representação descritiva e de conteúdo de instrumentos musicais; sugere medidas que venham facilitar o processo de organização e acondicionamento dos instrumentos musicais. Utiliza como metodologia o estudo de caso , tendo como suporte teórico a pesquisa bibliográfica em fontes impressas e eletrônicas . Conclui mostrando a melhor maneira de organizar coleções de instrumentos musicais por meio do Código Anglo-americano de Catalogação, e enfatiza que essas regras podem ser aplicadas para organizar diferentes tipos de suporte de informação.

Classificação bibliográfica: as diversas contribuições para o tratamento da informação

PEREIRA, Edinete do Nascimento et al. Classificação bibliográfica: as diversas contribuições para o tratamento da informação. In: SEMINÁRIO DE PESQUISA DO CCSA, 15., 2009. Anais... Natal: UFRN, 2009.

Gestação após gastroplastia para tratamento de obesidade mórbida: série de casos e revisão da literatura

relatar a evolução de uma série de casos de gestação em mulheres previamente submetidas à cirurgia de bypass gástrico para tratamento de obesidade grave. Métodos: cinco casos consecutivos de gravidez após gastroplastia ocorridos entre 2001 e 2004 foram avaliados. As pacientes tinham idade entre 30 e 34 anos e todas haviam sido submetidas à cirurgia de Capella. Aspectos clínicos, laboratoriais e do acompanhamento materno e fetal foram considerados, durante o período gestacional e após o parto. Foi realizada revisão da literatura internacional, por meio das bases de dados MEDLINE e Web of Science, utilizando os seguintes unitermos: gastroplasty, gastric bypass surgery, bariatric surgery e pregnancy. Resultados: todas as gestações observadas foram únicas e não ocorreram complicações obstétricas, durante o seguimento pré-natal e parto. Também não houve registro de recém-nascidos prematuros ou de baixo peso ao nascimento. Conclusão: nossos dados sugerem que a gravidez após gastroplastia é segura para a mãe e feto. Entretanto, em virtude do limitado volume de informação disponível sobre o tema, investigações adicionais são necessárias para estabelecer recomendações apropriadas com relação ao seguimento dessas gestações

Diagnóstico, estadiamento e tratamento cirúrgico do adenocarcinoma de pâncreas

O adenocarcinoma pancreático é um dos tumores sólidos de pior prognóstico, sendo o tratamento cirúrgico o único potencialmente curativo. Na grande maioria dos pacientes o tumor é diagnosticado em fase avançada, comumente na presença de doença metastática. A introdução de modernos métodos diagnósticos associados ao aperfeiçoamento dos já existentes tem gerado controvérsia quanto à melhor maneira de se estabelecer o diagnóstico e estadiamento do tumor. Da mesma forma, o papel da cirurgia na paliação e aspectos técnicos da ressecção de lesões localizadas estão longe de alcançarem consenso na prática. Método - Revisão da literatura sobre os aspectos controversos relacionados ao tema e um algoritmo para a abordagem dos pacientes com suspeita de tumor de pâncreas são apresentados. Foram utilizados os descritores: “adenocarcinoma” e “pâncreas” para pesquisa no PubMed (www.pubmed.com) e na Bireme (www.bireme.br) e a seguir selecionadas as publicações pertinentes a cada tópico escolhido com atenção especial para metanálises, estudos clínicos controlados, revisões sitemáticas e ainda publicações de grandes centros especializados em doenças pancreáticas. Conclusões - Na suspeita de adenocarcinoma de pâncreas é possível realizar estadiamento muito próximo do real sem a necessidade da exploração cirúrgica sistemática em virtude da disponibilidade na prática de exames modernos e eficientes. Isso permite que paliação menos invasiva seja praticada na maioria dos pacientes com lesões avançadas e incuráveis. Nos em que a cura é possível, a operação deve ser realizada objetivando-se, essencialmente, a remoção da lesão com margens livres e com aceitáveis índices de morbi-mortalidade

Do tratamento das reclamações à gestão da insatisfação: o comportamento de empresas hoteleiras mediante a insatisfação de seus clientes

Consumer dissatisfaction, when properly handled, is a significant information source for the manager. Studies in this area allow broadening the understanding of certain customer attitudes and behaviors, such as loyalty, repurchase intention or satisfaction and trust increase. Above and beyond supporting consumer feedback, dissatisfaction can provide significant opportunities for organizational learning. Starting from dissatisfied customer information, companies can detect service flaws and develop new products. This work presents the results of an investigation on the behavior of businesses belonging to the hotel sector in Natal, RN, through the dissatisfaction of their customers. We have sought to map the main problems presented by customers to hotels, in the perception of managers and employees, as well as to understand both the process of dissatisfactionrelated data collection, analysis, and processing, and the utilization of such information by businesses. Beyond this, we have compared the habits of organizations to the company reaction approaches described in the literature: Complaint Handling, Complaint Management, and Dissatisfaction Management. The used methodology has been based on case study. Data was collected via indepth interviews with managers and employees in six hotels, two independent ones and four belonging to national and international hotel networks. We have also made use of documents provided by the organizations, such as guest complaint registers and reports from satisfaction surveys on which content analysis was subsequently performed. The results of the investigation point to a high level of awareness in the companies concerning the importance of consumer dissatisfaction. Even though the maximum grade in the procedure scale is not achieved, it has been observed that answer to dissatisfaction is given in planned and systematic form, geared towards consumer satisfaction and improvement of products and processes. Hotel businesses still have to look into other possibilities for mapping consumer dissatisfaction, which implies, among other aspects, articulation with a range of public and private organizations in such a way as to guarantee sustainability of touristic activities in the long term

Racionalidade substantiva no processo decisório: um estudo em instituições que lidam com o tratamento oncológico infantojuvenil na cidade de Natal-RN

The present study regards an applied social research (qualitative) performed in two institutions which lead children s cancer treatment in Natal, Rio Grande do Norte. The main goal of this study is, as of a literature review at works which characterizes the first generations of study about substantive rationality, to detect Decision Making process related aspects that may serve as a basis to elaborate analysis categories from decision making process, aggregating them into a new study that may provide an advance to the theme in administrative science. The academic works based on the analysis model created by Mauricio Serva served as a basis to deep research into such theme, which verifies the predominant rationality in eleven administrative internal processes in productive organizations. This dissertation intends to go beyond the identification of the predominant rationality by elaborating new categories of analysis, and making possible the continuity of the subject in administrative science. Based on Guerreiro Ramos s work, which sees a kind of ideal organization, as known as isonomies, this study still calls upon Karl Polanyi s thoughts, which with the objective of comprehending the independent economic phenomenon of the value that allows considering non-market economies, find that the economy of the men is submerged in his social relations; it also rescues the studies from Max Weber who investigates the meaning of social action to better understand the rationality, and refers to the study of Jürgen Habermas, who proposes a broader conception about rationality, within the theory of communicative action. As a result of this theme s review, seven analysis categories of the decision making process have been formulated. They were applied in the institutions that had been chosen and helped to detect the type of predominant rationality in the categories of the decision making process. The results confirm that, although the decisions making process involves rational elements, such as information, identification of alternatives, there are also specific values of each individual with his experience and view oh the world, permeated not only by instrumental rationality, but also by substantive rationality. The study has verified that two similar institutions may show different types of rationality in the decision making process, when decision factors may tend to instrumental rationality, according to administration classic way, as well as they may emerge from substantive rationality, thus contributing to the process of emancipation of the human being in his sphere of work

Modulação da expressão da proteína XPA em resposta ao tratamento com azul de metileno fotossensibilizado

Reactive oxygen species (ROS) are produced by aerobic metabolism and react with biomolecules, such as lipids, proteins and DNA. In high concentration, they lead to oxidative stress. Among ROS, singlet oxygen (1O2) is one of the main ROS involved in oxidative stress and is one of the most reactive forms of molecular oxygen. The exposure of some dyes, such as methylene blue (MB) to light (MB+VL), is able to generate 1O2 and it is the principle involved in photodynamic therapy (PDT). 1O2 e other ROS have caused toxic and carcinogenic effects and have been associated with ageing, neurodegenerative diseases and cancer. Oxidative DNA damage is mainly repaired by base excision repair (BER) pathway. However, recent studies have observed the involvement of nucleotide excision repair (NER) factors in the repair of this type of injury. One of these factors is the Xeroderma Pigmentosum Complementation Group A (XPA) protein, which acts with other proteins in DNA damage recognition and in the recruitment of other repair factors. Moreover, oxidative agents such as 1O2 can induce gene expression. In this context, this study aimed at evaluating the response of XPA-deficient cells after treatment with photosensitized MB. For this purpose, we analyzed the cell viability and occurrence of oxidative DNA damage in cells lines proficient and deficient in XPA after treatment with MB+VL, and evaluated the expression of this enzyme in proficient and complemented cells. Our results indicate an increased resistance to treatment of complemented cells and a higher level of oxidative damage in the deficient cell lines. Furthermore, the treatment was able to modulate the XPA expression up to 24 hours later. These results indicate a direct evidence for the involvement of NER enzymes in the repair of oxidative damage. Besides, a better understanding of the effects of PDT on the induction of gene expression could be provided

Efeito do tratamento térmico do titânio sobre a proliferação de células pré-osteoblásticas

Titanium is a biomaterial widely employed in biomedical applications (implants, prostheses, valves, stents). Several heat treatments are usually used in order to obtain physical properties required to different applications. This work studied the influence of the heat treatment on microstructure of commercial pure titanium, and their consequences in growth and proliferation of MC3T3-E1 cells. Discs of titanium were treated in different temperatures, and characterized by optical microscopy, image analysis, wettabillity, roughness, hardness and X-ray diffraction. After the heat treatment, significant modifications in these properties were observed. Pattern images of titanium, before and after the cell culture, were compared by overlapping to analyze the influence of microstructure in microstructure and preferences guidance cells. However, in general, titanium discs that showed a higher residual strength also presented an increase of cells numbers on surface

Aproveitamento da fibra do epicarpo do coco babaçu em compósito com matriz epóxi: estudo do efeito do tratamento da fibra

Nowadays the environmental issues are increasingly highlighted since the future of humanity is dependent on the actions taken by man. Major efforts are being expended in pursuit of knowledge and alternatives to promote sustainable development without compromising the environment. In recent years there has been a marked growth in the development of reinforced composite fiber plants, as an alternative for economic and ecological effects, especially in the substitution of synthetic materials such as reinforcement material in composites. In this current study the chemical- physical or (thermophysics )characteristics of the babassu coconut fiber, derived from the epicarp of the fruit (Orbignyda Phalerata), which the main constituents of the fiber: Klason lignin, insoluble, cellulose, holocellulose, hemicellulose and the content of ash and moisture will be determined. A study was conducted about the superficial modification of the fibers of the epicarp babassu coconut under the influence of chemical treatment by alkalinization, in an aqueous solution of NaOH to 2.5% (m/v) and to 5.0% to improve the compatibility matrix / reinforcement composite with epoxy matrix. The results of the changes occurred in staple fibers through the use of the techniques of thermogravimetric analyses (TG) and differential scanning calorimetry (DSC). The results found on thermal analysis on samples of fiber without chemical treatment (alkalinities), and on fiber samples treated by alkalinization show that the proposed chemical treatment increases the thermal stability of the fibers and provides a growth of the surface of area fibers, parameters that enhance adhesion fiber / composite. The findings were evaluated and compared with published results from other vegetable fibers, showing that the use of babassu coconut fibers has technical and economic potential for its use as reinforcement in composites

Tratamento termoquímico do titânio auxiliado por plasma de ar - N2 - O2

Discs were grade II cp Ti oxynitride by plasma of Ar - N2 - O2 using different proportions of individual gases. These ratios were established from analysis of optical emission spectroscopy (OES) of plasma species. The proportions that resulted in species whose spectra showed an abrupt change of light intensity were chosen for this study. Nanohardness tests revealed that there was a correlation between the intensity of N2 + species with the hardness, because the treatments where they had a higher intensity, obtained a higher value nanohardness, although the crystalline phases have remained unchanged. With respect to topography, it was observed that in general, the surface roughness is related to the intensities of plasma species, because they may have different values depending on the behavior of the species. Images obtained by optical microscopy revealed a surface with grains of different colors to optical reflectance showed a peak of reflection in the red area. Measures the contact angle and surface tension showed hydrophilic properties and hydrophilic with little variation of polar and dispersive components of surface tension