Avaliação da eficácia analgésica no pós-operatório de revascularização do miocárdio: ensaio clínico randomizado controlado

A analgesia pós-operatória eficaz é especialmente importante após cirurgias torácicas, pois, além de aliviar a dor, facilita a retomada de atividades normais, incluindo a deambulação, a respiração e a tosse. Dessa forma, os objetivos deste estudo são: avaliar a eficácia analgésica da associação entre anestesia geral e raquianestesia com morfina e ropivacaína mais esquema multimodal em relação à anestesia geral e esquema multimodal em cirurgia de revascularização do miocárdio; analisar a eficácia analgésica da injeção subcutânea de lidocaína e analgesia multimodal na remoção de tubos torácicos em cirurgia de revascularização do miocárdio. A metodologia consiste em ensaio clínico randomizado, controlado, envolvendo 58 pacientes, de ambos os sexos, com idade média de 59,8  8,9 anos, estado físico ASA II e III. Os participantes foram alocados em dois grupos, sendo o GI composto por indivíduos submetidos à anestesia geral combinada à raquianestesia com morfina 400μg e 6 ml (30mg) a 8 ml (40mg) de ropivacaína a 0,5% e analgesia multimodal; já o GII foi composto por indivíduos submetidos à anestesia geral associada à analgesia multimodal. Foi avaliada a dor, ao despertar, nas primeiras 24 horas, e ao realizar exercício respiratório, ao retirar drenos de torácicos e o tempo para extubação. A análise estatística foi realizada pelos testes do Qui-quadrado e Teste t de Student e o teste de Fisher. O resultado obtido foi o seguinte: o GI apresentou menor intensidade de dor ao despertar (p= 0,001), nas primeiras 24 horas (p= 0,001) e durante a realização dos exercícios respiratórios (p= 0,004). Houve maior necessidade de analgesia complementar no grupo GII, com maior consumo de morfina (p= 0,05), e os efeitos colaterais leves, como náuseas (p= 0,001), vômito (p= 0,002), prurido (p= 0,030), predominaram no GI. Não houve diferença estatisticamente significante entre os grupos (P= 0,47), em relação à intensidade de dor na remoção dos drenos. Após as observações feitas, o estudo sugere que a anestesia geral combinada à raquianestesia com morfina associada à ropivacaína oferece melhor efeito analgésico no pós-operatório de cirurgia cardíaca. Adicionalmente, o estudo sugere que o efeito analgésico da injeção subcutânea de lidocaína 1% associado à analgesia multimodal não é eficaz

Osteopenia diabética e pós-menopausa: efeito metabólico do zinco na recuperação do volume ósseo trabecular

Diabetes mellitus has been associated with bone metabolism alterations, such as osteopenia and osteporosis. So, the search of new anabolic agents promote bone mass gain can be important to prevent osteoporosis. The aim of this study was evaluate zinc anabolic effect over bone in diabetic and post-menopausal osteopenic models. Diabetes was induced by STZ (45mg/Kg of body weight) administration and post-menopausal by bilateral ovariectomy. Adults female Wistar rats (n=65) were divided in 5 groups: control group (n=15), ovariectomized without (n=15) and with zinc supplementation (n=10) groups, diabetic and ovarioctomized without (n=15) and with zinc supplementation (n=10) groups. Studied periods had been untill 90 days. Diabetic condition was confirmed hiperglicemic state and alterations of state with polyuria, polyphagia, polydipsia and glucosuria. Histomorphometric analysis showed that zinc supplementation increased trabecular thickness and reduced trabecular distance significantly in diabetic groups with similar values to those showed in control group. Correlation analysis of histomorphometric parameters with serum glucose concentration showed that more time in hyperglycemia more bone damage, as well as, zinc supplementation contributed to prevent this damage. Elevated serum glucose caused hyperzincuria, phosphaturia and calciuria. Zinc supplementation promoted increased levels of calcium and phosphorous ions in 90th days diabetic group. No alteration was observed by ovariectomy in mineral (Ca, P and Zn) serum and urine concentrations. Total serum Alkaline Phosphatase activity increased in diabetic groups, supplemented or not, compared with control group. However, Tartarate-Resistant Acid Phosphatase, magnesium and serum zinc did not altered in studied groups. Serum albumin was reduced only in diabetic groups. Serum creatinine was unaltered. These results support the hypotesis that zinc can be used to prevent and treat diabetic and post-menopausal osteopenia

Paulo Freire e a pedagogia do oprimido: afinidades pós-coloniais

The main objective of the present research is to reflect on the affinities between post-colonial theories - analytical perspectives directed toward the discussion of colonialism and its effects on the contemporary social fabric - and Brazilian educator, Paulo Freire‟s (1921-1997) Pedagogy of the Oppressed, written at the end of the 1960‟s. The study aims to make the argument that the present reflections on the featured work is an example of a post-colonial theoretical framework, delineating a critical modus operandi of colonialism, particularly in its cultural and epistemic dimensions, delineating a problematization of the processes of cognitive domination set, above all, by the European colonization of the Latin American continent, with the formation of the modern-world-system (WALLERSTEIN, 2007), dated from the 16TH Century forward. From this stand point, and especially supported by the contributions of Boaventura de Sousa Santos on the sociology of absence, the present work accentuates Pedagogy of the Oppressed as a set of reflections that bring the possibility of a pedagogy of absence (SANTOS, 1996), having in mind that, this book deals with, the presuppositions of an educational action, which considers the plurality of knowledge and social practices by way of the establishment of a pedagogical practice of collective construction, emancipator and dialogic that arises from the encounter to the indolent reason (SANTOS, 2009) in which the silencing of the voices of the oppressed, construct their conditions of invisibility, promoting also the absence of the social questions inherent to the processes of teaching and learning. It is with this perspective, however, that post colonialism is considered a theoretical site for the affirmation and the reinvention of the Pedagogy of the Oppressed, an obligatory reference in the construction of a prudent knowledge for a decent life (SANTOS, 2006)

Barreiras de sobrevivência: angústias e dilemas de jovens infratores pós-institucionalização

This study critically examines the effects of public policies, implemented by Fundação Estadual da Criança e do Adolescente (FUNDAC/RN), along with adolescents of both sexes, perpetrators of illegal acts in compliance by court order, by socio-educative measures , identifying the contradictions that permeate the understanding and treatment of issue. The aim is to investigate the chances that youths have by living in Centro Educacional Pitimbu and Centro Educacional Padre. João Maria (CEDUC), to become subjects in the exercise of their citizenship. The methodology adopted is the verbal history of life (MEIHY, 2005) of youths that had life experiences in these institutions from 2002 to 2005, allowing researchers to access directly to investigated individuals, through the place where they currently reside, and enabling the reconstitution of their life story, from semi-structured interviews. The young people s statements interviewed were grouped and analyzed from the following categories of analysis: the egress and family, the school and egress, the community and egress, the egress and work, the egress and CEDUC, the egress and experience infringement. The results indicate that, despite the advances in Brazilian legislation for the sector, the actions promoted by these institutions generally would have produced innocuous and stigmatized consequences. Moreover, they show in essence that they carry on their inner contradictions which fundamentally correspond to the interests of the dominant system and a society which uses mechanisms of social policy, in addition to favoring the control and repression. And thus, while such actions remain unable to produce important changes in the conditions of existence of young people who meet by social deprivation of liberty, it is possible to say that the chances are minimal so that they become autonomous subjects in a society that, preferring their punishment, denies them, stubbornly, access to their basic rights. In theory, the researcher dialogues with authors as Foucault, Goffman, Bourdieu, Offe, Bauman, Boaventura Santos, Takeuti, Germano, Ariès, Wacquant, among others

Os dias são maus : o ensino religioso cristão em dias pós-modernos o desafio de fazer crer perante a cultura da incredulidade

This paper adopts the assumption that religion continues to be a major highlight in the dimension of the contemporary world - characterized by pluralism, the ideas of tolerance and freedom. But for certain streams of Christianity, the postmodern culture seems to be characterized as a highly damaging to their doctrines and principles, since this religious matrix carries a truth claim that would support all its significance, its definition values and their dissemination effort ( evangelism ). This is not to say that Christianity is the only religion that claims to the truth, which would be a gross mistake. Now, religion has been reputed as a phenomenon doomed to disappear, according to the " ideology " of Modernity, given the idea that scientific development would lead us inevitably to the statement that religion was merely a social institution based in the superstition, in fantasy, the imaginary and therefore had nothing "real " unless its existence as an institution capable of aggregating society (give it cohesion), provide values and meaning to different ontological anxieties and doubts of humankind. In the contemporary scenario - seeded by modernity - as Christian ideas, doctrines and principles are in harmony or conflict with postmodernity? These are our starting questions and issues that we intend to stop and reflect. From the assumption that the religious phenomenon has great force in the present day, this research aims to perform central analysis of how religious education, a Protestant denomination specific, harmonizes or clashes with the ideology or ideas more general and emphatic that we can observe in the western world is presented to us from the diagnoses made by the contemporary authors who debate about postmodernism and postmodernity, notably David Harvey, Jean - François Lyotard, Bauman Zygmunt and Fredric Jameson

O papel do BNB/FNE na economia nordestina pós 1990

O presente trabalho objetiva analisar o papel do crédito vinculado às tentativas de fomentar a modernização da estrutura econômica nordestina. Tal procedimento se sustenta nos financiamentos do BNB, o qual se configura como instituição financiadora do processo de industrialização da Região Nordeste. O principal fundo à essa finalidade é o FNE. Dessa maneira avaliaremos também a importância do crédito na dinâmica de regiões periféricas como o nordeste o é. Assim, indaga-se: tais mecanismos foram relevantes para eliminar os gargalos produtivos do Nordeste através da modernização de sua economia? O direcionamento do fundo ocorreu de forma a diminuir o hiato intra-regional? A suposição do trabalho é que tais fundos configuraram-se como essenciais à economia nordestina, no entanto, insuficientes para a finalidade a qual foram criados. Usa-se uma pesquisa bibliográfica alicerçada na literatura pertinente, associada a uma análise documental, a qual permite a utilização de dados estatísticos que demonstrem o desempenho do BNB referente ao objetivo do FNE. Finalmente, nota-se que, tanto houve uma concentração no direcionamento do fundo para setores menos complexos, o que contribuiu para a manutenção estrutural da economia nordestina, como o fundo atuou de forma espacialmente imperfeita garantindo a desconcentração de apenas algumas sub-regiões

Em busca de novas territorialidades pedagógicas para a identidade da Educação Física no Ensino Médio integrado: uma perspectiva pós-crítica

Cet étude s agit du domaine de l Éducation Physique comme composante curriculaire dans le contexte de l Ensino médio integrado (l enseignement secondaire professionnel intégré) dans le IFRN, Campus Natal Zona Norte (Régio Nord). Son objectif principal est sur le plan éducatif des actions de l enseingant au procès des convivialités avec la culture corporale à partir des expériences, désires, besoins et volontés des apprenants dans la perspective de l imersion dans le monde de la créativité, de la recherche, de la connaissance et de la transformation de l identité pédagogique de la composante curriculaire. Dans ce sens, l étude a eu comme objectif l élaboration d une propisition pédagogique, fondamentée sur la Théorie Post-critique de l éducation qui contribue pour la configuration de l identité de l Éducation Physique dans les cours téchniques intégrés de niveau secondaire. La recherche s est configuré dans une intervention pédagogique fondamenté sur les préssuppositions methodologique d une expérience empirique du genre recherche-action apliqué dans l univers scolaire des cours thécniques intégrés de l enseignement secondaire de l IFRN, Campus Natal Zona Norte. Les sujets qui ont participé de la recherche, sont les apprenants des groupes de la première année du cours de Commerce et Éléctronique de la soirée (13h à 18h), inscrit à partir de l année 2012. Les instruments utilisés pour la recherche ont été deux questionaires et une cahier de bord. Les résultats obtenus sont disposés dans des graphiques qui représentent les paroles des sujets après le procès d intervantion et les analyses réalisées sous l étude-recherche, qui ont été faites por l analyse de contenu, de l image principale de la population recherchée. On considère que les résultats de la recherche ont été plausibles à la mesure que au-delà du support et de la participation dans la recherche, les réponses obtenues ont démontré que le procès d intervantion pédagogique a été pertinent pour les apprenants des cours téchniques intégrés de niveau secondaire de Commerce et Électronique de l IFRN, Campus Natal Zona Norte. Le sense essentielle de cette thèse s est concentrée dans la dimension interculturelle pour l Éducation Physique dans le secondaire intégré, comme un travail fondamenté à partir des temoignage des apprenants et par la conception post-critique du curriculum qui refuse les explications évidentes et instituées comme des véritées finales dans l objectif de réguler et controler les sujets de l éducation. L option faite par cet abordage de thèse a été pour rompre avec l établi à partir de la proposition d un dialògue, avec les apprenants, à la recherche de nouveaux territoires pédagogiques pour l Education Physique à l enseignement intégré de l IFRN, Campus Natal Zona Norte. Des territoires qui occupent des espaces dans la culture scolaire, dans une dynamique dialogique avec les apprenants, qui se défine politique et pédagogiquement pour la diversité culturelle du mouvement, qui aborde le concept de mouvement dans la proximité des actions corporales cotidiennes et qui propose de nouvelles possibilités et de recréations pour les pratiques de la culture corporale. La perspective post-critique ouvre des possibilités pour de nouvelles langages en fortifiant les narratives de ce qui ont toujours entendu et cependant ont silencié ses voix et ainsi, la thèse a confirmé que, l étude présent et la recherche supporté par la théorie post-critique du curriculum ont possibilité une nouvelles configuration pour l identité pédagogique de l Éducation Physique dans la condition de composant curriculaire des cours téchniques intégrés de niveau secondaire de l IFRN au Campus Natal Zona Norte

Associação entre consumo alimentar e atividade física com a síndrome metabólica em mulheres na pós-menopausa

Post-menopause is characterized as the period beginning one year after the permanent cessation of menstrual cycles, which is typically related to medical disorders that, in association with Metabolic Syndrome (MS), represent a set of cardiovascular risk factors. Objective: To assess dietary intake and the prevalence of metabolic syndrome in postmenopausal women, according to the level of physical activity. Methods: The sample consisted of 82 women, evaluated in the Northern Zone of the city of Natal / RN who were participants in the Natal Active Program. People completed a Food Frequency Consumption Questionnaire (FFCQ) and were interviewed about physical activity. Anthropometric measurements and biochemical tests were used to diagnose MS (Metabolic Syndrome). Result: The active women consumed more protective foods (flaxseed, nuts, whole wheat bread, brown rice and olive oil) than inactive women. Risky foods (sugar, crackers, white bread, white rice, margarine and beef) were consumed more by the group of inactive women. The prevalence of MS was higher in inactive women (53.30%) than in physically active women (46.70%). Conclusion: Active post-menopausal women had a higher daily intake of protective foods in relation to cardiovascular disease, while the inactive post-menopausal women had higher intake of risky foods for such diseases

Avaliação da dor pós-operatória: análise em pacientes submetidos a cirurgias abdominais em um hospital universitário de Natal/RN

It is an exploratory and descriptive study made by a quantitative approach, developed among February and May 2010, aiming to assess the pain of patients underwent abdominal surgeries in a University Hospital, in Natal/RN; to identify the local and intensity of the pain based on Numerical Estimative Scale; to analyze the pain related to the sensorial-discriminative, motivational-affective and cognitive-assessment dimensions, using the McGill Questionnaire pain; to establish a relation between the pain process and age, gender, religion, and king of surgery; to identify the medicines efficiency used to control postoperative pain. The sample was composed by 253 patients underwent abdominal surgeries. The results showed a total of 63.63% females between 38 and 47 years of age (21.34%); illiterates (21.73%); married (64.03%), living in Natal and surroundings (67.97%) and Catholics (74.30%). In their first assessment, 84.19% showed postoperative pain; the pain was considered light in 18.97% of them, moderate in 21.74% and severe in 43.48%. The mean number of descriptors chosen through the McGill Questionnaire Pain was 10.78 (DP= 6.09) and pain rating 23.65 (DP= 15.93). The descriptors selected with higher frequency were: sickening pain (69.01%), tired (65.25%), thin (62.44%), bored (58.69%), ardor (46.48%), pointed (38.50%) and colic (35.21%). In their second assessment, 57.71% of patients didn t relate any postoperative pain and 42.29% were still complaining about the pain. After taking analgesic medication, just 41.90% of patients who had complete pain relief. The Pharmacological groups most used were: simple analgesic (37.86%), weak opioids (32.98%), AINES (19.85%) and strong opioid (9.31%). It was not found a significant postoperative pain variation related to the sexes, religion and kind of surgery. It was concluded there were a high level in the number of patients with postoperative pain, mainly in a severe scale. Less than half of patients had the pain relief. Then, it was observed there was not coherence between the pain intensity and the analgesic it was used. To solve or relieve this kind of problems is necessary a permanent education to the health professionals who works in this area

Diagnósticos de enfermagem em pacientes no pós-operatório imediato de prostatectomia de um Hospital Universitário de Natal-RN

The characterization of the nursing diagnoses in prostatectomized patients is important to provide an unique nursing language, facilitating the communication between professionals and patients. The objective of this study was to analyze the nursing diagnoses of patients in the immediate prostatectomy postoperative period. This is a cross-sectional and descriptive study, developed at the surgical-clinic of Onofre Lopes University Hospital, in the Natal City RN - Brazil. The sample was composed of 50 patients included by the criteria: have presented a diagnosis of a benign prostatic hyperplasia or a prostate cancer, have been subjected to a prostate surgery at the mentioned hospital, and have been in the immediate postoperative period at the moment of the data collection. The exclusion criteria were: haven t been in an appropriate physical and mental condition, have presented a brain vascular disease, a lung disease, an advanced liver disease, a heart disease or a extensive coronary artery disease. The data collection instruments were: the script of an interview and physical examination. The data collection period was between November 2010 and April 2011. The data were organized in two phases: the diagnostic process and the construction of the database. The project was approved by the Ethics Committee of the Federal University of Rio Grande do Norte The results showed that most patients came from the countryside, was living with partners, had an average of 67.78 years, was pensionerthose with low schooling, Catholic and often did not perform preventive examinations of prostatic disease. The patients showed an average of 9.48 nursing diagnoses, defining characteristics 21.70 and 20.72 related or risk factors per patient. We identified 30 nursing diagnoses, of which 7 were above the 75 percentile: Risk of falls, Impaired ambulation, Risk of infection, Self-care deficit bath / hygiene and dress up and Risk for deficient fluid volume. The top six nursing diagnoses were in all patients, and therefore could not apply any statistical test. The others ND were associated with their defining characteristics and related or risk factors. We conclude that the nursing diagnoses identified in this study contribute to the progress of the nursing care to the prostatectomized patients in post-surgery period, allowing the deployment of nursing actions for the effective resolution of identified problems

Análise dos marcos teóricos e estruturais do currículo de graduação em enfermagem no Rio Grande do Norte

This research had as its guiding question: what theoretical and structural milestone of graduation nursing curriculum of public universities in the State of Rio Grande do Norte? The objectives of this study were: Analyze theoretical and structural milestones of graduation nursing curriculum of public universities in the State of Rio Grande do Norte; Identify the theoretical milestone and training models that guide the structural milestones of nursing curriculum courses of public universities studied; Analyze the training concepts of curriculums from the voices of the coordinators of the courses. This is a qualitative study, analytical, with discussions of the documentary and empirical research. Ten teachers participated who act as coordinators of the graduation courses in nursing or academic advisors, in UFRNCentral Campus in Natal and Health Sciences College (Facisa), in Santa Cruz-and on UERN -Campus Caicó, Mossoró and Pau dos Ferros. The information collected by interview was analyzed by sociology or symbolic cartography of Boaventura de Sousa Santos. The research was approved by the Research Ethics Committee of the UERN by the CAAE: 03610912.7.0000.5294. All the participants signed the Free Consent and clarified Term The results and discussion were presented in four scientific articles. The first article, titled the Pedagogical projects in nursing analysis in the light of the symbolic cartography, features the use of cartographic method in the researches and in the study of nursing curriculums. In the article The Analysis of theoretical-philosophical, structural and referential milestones in nursing curriculums, these milestones are renowned in curriculums of UERN and UFRN. The main challenges faced in the implementation of supervised internship in nursing provide a reflection on the difficulties that the internship supervisors present, especially with the relationship between education/service and the articulation theory/practice. In the last article are discussed the changes in nursing training from the former student profile, who won a boost from the curricular changes proposed by the national curriculum guidelines. The study concluded, by the analysis of theoretical and structural milestones of nursing curriculum courses of public universities of Rio Grande do Norte, that there is an explicit intention to train nurses for the health system and a search on innovative teaching projects in accordance with the national curriculum guidelines for the area of nursing. The thesis defended in this investigation was that the curriculum of public institutions of higher education in nursing in the State of Rio Grande do Norte advanced from a training focusing on biologicist model, flexneriana guidelines, for teaching able to articulate the health with the social, political and cultural issues

Ensino do processo de enfermagem: visão dos discentes de graduação de Natal/RN

The nursing process (NP) it s the systematized way of offering humanized care with the objective of reaching the expected results. The concern of the health and education institutions of elaborating implementation strategies of it is growing. The objective of this research was to know the vision of the senior students of the nursing graduation courses from Natal/RN, about the teaching of the NP. It s about a descriptive and exploratory study of the qualitative and quantitative type, done in five teaching institutions of the undergraduate nursing course of the municipality of Natal- RN in 2011. The research was composed by 48 students of the last 2 years of the nursing course. The gathering of the data was done through an online survey with open and closed questions via SurveyMonkey. For the quantitative data it was used the descriptive statistics from Microsoft Office Excel and for the qualitative data the Content Analysis of Bardin. The results pointed a predominance of female students (81,25%) with an age between 21- 39 years old (75,00%) and in the last year of the course (62,50%). As the opinion of the students about the NP two categories emerged: 1) Nursing Process as grounded method in scientific knowledge and established in two stages; 2) Nursing Assistance Quality, with two subcategories: Nursing Process as Nursing Practice and Nursing Process as instrument of improvement of the aid quality and promotion of well-being. In relation to the tuition of the NP the students (45,83%) said that the knowledge on the subject of the instructor was good; 81,25% reported that the professors use a traditional teaching methodology with the problem solving components and 45,83% answered that is addressed in specific disciplines in an isolated way starting from the professional line. The phase of NP that the nursing students have more difficulties of learning and implementing, being mentioned 22 times (29,70%). In relation to the student s difficulties, in the fields of supervised internships, in applying the NP it was stated for 83,50% that the barriers were related to the non implementation of the practice, overwork and the lack of trust of the nurse in the NP. The teaching-care strategies described as the internship fields were: the training of nurses to be able to contribute with the University in the implementation of the service and teaching; and the need of the universities to focus, continuously throughout the course, the NP with the involvement and incentive of the instructors in this process. These results show that the NP for the nursing students is a work methodology of the profession that needs to be implemented effectively in the practical reality for its teaching to turn effective and for the future professionals to be able to bring real contributions in the achievement of systematized actions trying to improve the assistance quality and the nursing actions. It is expected that this study could help bringing some strategies to facilitate the merging between theory and practice in teaching the NP and stimulate a discussion about the topic at the Nursing Schools where the research was held together with the coordinators, instructors and students

Qualidade de vida medida pelo "WHOQOL-bref": estudo comparativo de pacientes em hemodiálise e pós-transplante renal

Exploratory descriptive study, prospective with quantitative approach, performed in the nefrology outpatient service from the Onofre Lopes University Hospital (HUOL), Natal/RN, aiming to identify aspects that concern Quality of Life (QOL) on transplanted and hemodialysis patients, as measured by WHOQOL-bref and describe the aspects that differentiate QL between the two groups as measured by the same instrument. The population was of 62 renal patients in hemodialysis and 58 transplantd, with data collected from february to march 2006. The instrument used was WHOQOL-bref, translated to and validated for Portuguese by the multicentric group of the World Health Organization (WHO) in Brazil. The results show predominance of the masculine gender both in the post-transplant group (55,17%), as well as in the hemodialysis group (51,61%); the age strip of 28 to 43 prevailed, among which were 53,45% transplanted and 48,99% hemodialysis patients; 79,93% of the hemodialysis patients and 62,07% of the transplanted were provenient from ouside the capital of the state; from the hemodialysis population, 59,68% were married, while among the transplanted 48,28% were single; 58,06% of the hemodialisys patients had 1 to 3 children, while the majority of the transplanted, 44,83%, had no children; regarding scholarity level on both groups, there was a predominance of incomplete fundamental school, representing 62,9% of the hemodialysis patients and 46,6% of the transplanted; regarding work status, 98,39% of those in hemodialysis informed not to be working, and the same applied to the transplanted, with 75,86%; regarding treatment time, most patients of both populations were in the 1- to 4-year interval, of which were 62,9% of the hemodialisys patients and 53,45% of the transplanted. The analysis of WHOQOL-bref reliability through Crobach s Alpha coefficient had a value of 0,8816, demonstrating good internal consistency for the instrument. Regarding description of QOL tests, the average scores of the post-transplant were (Q-1) 18,14 e (Q-2) 18,69, and 12,3 (Q-1) and 11,29 (Q-2) for the group in hemodialisys. Regarding the aspects that differentiate QOL on the two groups observed through average scores from the Domains: Physical, 15,91 for the post-transplant group and 12,71 for the hemodialisys group; Psychological, 16,75 for the post-transplant group and 14,84 for the hemodialisys group; Social Relations, 17,79 on the post-transplant group and 16,58 on the hemodialisys group; Environment, 14,16 on the post-transplant group and 12,38 on the hemodialisys group. On every evaluated item, the post-transplant group achieved higher scores when compared to the hemodialisys group. The diference in QOL for both populations was significant on all items evaluated with a p<0,005

Enfermeiros pós-graduados: continuidades e rupturas no cotidiano profissional de hospitais universitários

A presente pesquisa teve como objetivo analisar as transformações do cotidiano profissional do enfermeiro do hospital universitário após a realização do curso de mestrado. Trata-se de um estudo com abordagem qualitativa, realizado no Complexo Hospitalar Universitário da UFRN, composto pelo Hospital Universitário Onofre Lopes (HUOL), Maternidade Escola Januário Cicco (MEJEC), e Hospital de Pediatria Professor Heriberto Ferreira Bezerra (HOSPED) localizados em Natal-RN; e pelo Hospital Universitário Ana Bezerra (HUAB) situado em Santa Cruz-RN. A população foi composta por vinte e dois enfermeiros, com título de mestre em enfermagem, que trabalham nessas instituições. Após encaminhamento e aprovação pelo Comitê de ética em pesquisa, conforme Parecer nº 268.498 e CAAE: 13922713.1.0000.5537, as entrevistas foram iniciadas, utilizando-se um roteiro semiestruturado, organizado em questões orientadas em conformidade com os objetivos do estudo. Do material empírico, emergiram as categorias que foram trabalhadas com base na análise de conteúdo temática, tendo como aporte teórico os estudos de Agnes Heller acerca do cotidiano e os de Paulo Freire sobre educação e mudanças, buscando a possível interlocução entre esses autores. Os resultados demonstram que o cotidiano dos enfermeiros nos hospitais universitários, após cursarem o mestrado, modifica-se a partir da própria motivação em cursálo e do apoio institucional recebido. As continuidades e rupturas apontadas estão distribuídas nas categorias: a inércia da cotidianidade, na qual os enfermeiros relatam a dificuldade em mudar seu cotidiano devido à rotina exaustiva e à falta de apoio; reconhecem mudanças particulares, compreendendo a formação de um olhar crítico/reflexivo/analítico, e a qualificação para o ensino e pesquisa; e as rupturas do cotidiano, que se referem às mudanças ocorridas no serviço, como a melhoria da assistência, pela implantação de resultados; e uma prática diferenciada por ter um profissional qualificado. Portanto, considera-se que a realização do mestrado contribuiu para o crescimento do intelectual e profissional do enfermeiro e, consequentemente, para o serviço, no cotidiano do Complexo Hospitalar Universitário, sendo reconhecido pelos enfermeiros o compromisso com uma maior responsabilidade social. Porém, ainda são necessárias reflexões sobre maneiras de minimizar as dificuldades apontadas, como forma de incentivar essa qualificação

A formação de conceitos no ensino de graduação em enfermagem à luz da teoria da aprendizagem significativa

The Theory of Meaningful Learning (TML) described by David Paul Ausubel offers a proposal for the teaching strategies to provide a more active and effective student learning. The projection of the TML practice is demonstrated through the development of concept maps (CM) technique, created by Joseph Donald Novak, which presents as a strategy, method or schematic feature, which is an indicator to identify the cognitive organization of the knowledge acquired by students. The survey was conducted in the light of TML in relation to learning concepts involving students of undergraduate nursing in a public university in the state of Rio Grande do Norte. Thus, the study aimed to compare the concept learning of students of undergraduate nursing, when subjected to different forms of education, to point approaches that promote more effective and meaningful results. It was a quasi - experimental study with a qualitative analysis, conducted with students of the Undergraduate Nursing of the Universidade Federal do Rio Grande do Norte (UFRN), approved by the Research Ethics Committee/UFRN Certification of Presention for Ethics Appreciation (CPEA) in 11706412.3.0000.5537. The study took place at two different times and involved content on complications mediate postoperative surgical wound in the same discipline with students who attended the 5th semester of the degree course in Nursing. For the viability of data collection, in the second half of 2013, we used the technique of CM, to represent the concept of complications mediate postoperative surgical wound covered in the classroom. CM were built at a different time from that of the discipline, with the support of tutors and preceded by a brief description and explanation about the form of preparation and application. In this study were subjected, 31 students of undergraduate nursing, registered in the discipline of Integral Attention to health I. In the first stage, 18 students participated in the survey, they had the teaching intervention based on TML, and in the second stage, all students participated in the lesson provided curriculum with the responsible teacher of the subject, on the same issue occurred. At the end of each meeting, the students 11 developed concept maps with the aid of software Cmap Tools®. Data analysis happened upon the technique of content analysis, supported by a conceptual map "glass", previously developed by researchers and aid in the preparation of the categories in which the concepts found were classified. The study found that the teaching intervention based on TML with the help of CM, managed to develop in students a more expressive teaching learning process than just classroom curriculum with the traditional teaching method, and also that the association between the intervention motion teaching with the traditional method and the use of the technique of CM encourages the student the ability to articulate the various acquired knowledge as well as apply them in real situations