Identification of nurses` competencies in primary health care through a Delphi study in southern Brazil

Objective: This investigation aimed to identify and analyze the general and specific competencies of nurses in the primary health care practice of Brazil. Design: The Delphi Technique was used as the method of study. Sample: 2 groups of participants were selected: One contained primary health care nurses (n=52) and the other specialists (n=57), including public health nurses and public or community health faculty. Measurements: 3 questionnaires were developed for the study. The first asked participants to indicate general and specific competencies, which were compiled into a list for each group. A Likert scale of 1-5 was added to these 2 lists in the second and third questionnaires. A consensus criterion of 75% for score 4 or 5 was adopted. Results: In the nurses` group, 17 general and 8 specific competencies reached the consensus criterion; 19 general and 9 specific competencies reached the criterion in the specialists` group. These competencies were classified into 10 domains: professional values, communication, teamwork, management, community-oriented, health promotion, problem solving, health care, and education and basic public health sciences. Conclusions: These competencies reflect Brazilian health policy and constitute a reference for health professional practice and education.

Analyses of Individual and Organizational Competences Associated with Knowledge Management Practice

The research analyzed critical aspects of the knowledge management process based on the analyses of knowledge, abilities and attitudes required to individual knowledge workers and to organizations responsible for the management process. In the present work a characterization of the knowledge management process was developed and information and knowledge wokers defined. Competence concept was discussed and specialists gave opinions about critical competences to knowledge management process. The opinions were organized and analyzed by the Delphi method. The results aggregate to the management context by discussing an extremely important resource to organizations - knowledge - and because they support its management process. The research identified wide critical aspects that are compatible with current organizational challenges, directing the process management to important themes as: the worker able to create, the organization able to convert individual knowledge into organizational knowledge, knowledge sharing while still tacit, the maximization organizational knowledge use, information and knowledge generation and preservation, among others important topics to be observed by knowledge workers and by administrators responsible for the knowledge management process.

Enabling International Communication among Brazilian Occupational Therapists: Seeking Consensus on Occupational Terminology

The purpose of this study was to examine how key occupational therapy terminologies are used by Brazilian occupational therapists. A nominal group approach combined with a Delphi technique involving 31 Brazilian occupational therapists was applied. A sociolinguistic approach was adopted since it broadens our understanding of the social and cultural determinants of terminology consolidation. Brazilian occupational therapists were found to adopt the term activity more often than human action or doing. Even less often were praxis and occupation applied. No consensus was reached regarding which of the terms is most preferred. While Brazilian occupational therapists have been developing their profession from international standards, it is still embedded in local demands and policies. Additionally, the political context must be considered when building an international dialogue between members of a professional body. Such a dialogue could engage professionals from different countries in meaningful exchanges about their practices. These exchanges may lead to the development of solid professional communities that can contribute meaningfully to social change. Copyright (C) 2010 John Wiley & Sons, Ltd.

Protein Adsorption onto Polyelectrolyte Layers: Effects of Protein Hydrophobicity and Charge Anisotropy

Ellipsometry was used to investigate the influence of ionic strength (I) and pH on the adsorption of bovine serum albumin (BSA) or beta-lactoglobulin (BLG) onto preabsorbed layers of two polycations: poly(diallyldimethylammonium chloride) (PDADMAC) or poly(4-vinylpyridine bromide) quaternized with linear aliphatic chains of two (QPVP-C2) or five (QPVP-C5) carbons. Comparisons among results for the three polycations reveal hydrophobic interactions, while comparisons between BSA and BLG-proteins of very similar isoelectric points (pI)-indicate the importance of protein charge anisotropy. At pH close to pI, the ionic strength dependence of the adsorbed amount of protein (Gamma) displayed maxima in the range 10 < I < 25 mM corresponding to Debye lengths close to the protein radii. Visualization of protein charge by Delphi suggested that these ionic strength conditions corresponded to suppression of long-range repulsion between polycations and protein positive domains, without diminution of short-range attraction between polycation segments and locally negative protein domains, in a manner similar to the behavior of PE-protein complexes in solution.(1-4) This description was consistent with the disappearance of the maxima at pH either above or below pI. In the former case, Gamma values decrease exponentially with I(1/2), due to screening of attractions, while in the latter case adsorption of both proteins decreased at low I due to strong repulsion. Close to or below pI both proteins adsorbed more strongly onto QPVP-C5 than onto QPVP-C2 or PDADMAC due to hydrophobic interactions with the longer alkyl group. Above pI, the adsorption was more pronounced with PDADMAC because these chains may assume more loosely bound layers due to lower linear charge density.