Exploring nurses' reactions to a novel technology to support acute health care delivery

AIMS AND OBJECTIVES: To explore nurses' reactions to new novel technology for acute health care. BACKGROUND: Past failures of technology developers to deliver products that meet nurses' needs have led to resistance and reluctance in the technology adoption process. Thus, involving nurses in a collaborative process from early conceptualisation serves to inform design reflective upon current clinical practice, facilitating the cementing of 'vision' and expectations of the technology. DESIGN: An exploratory descriptive design to capture nurses' immediate impressions. METHODS: Four focus groups (52 nurses from medical and surgical wards at two hospitals in Australia; one private and one public). RESULTS: Nursing reactions towards the new technology illustrated a variance in barrier and enabler comments across multiple domains of the Theoretical Domains Framework. Most challenging for nurses were the perceived threat to their clinical skill, and the potential capability of the novel technology to capture their clinical workflow. Enabling reactions included visions that this could help integrate care between departments; help management and support of nursing processes; and coordinating their patients care between clinicians. Nurses' reactions differed across hospital sites, influenced by their experiences of using technology. For example, Site 1 nurses reported wide variability in their distribution of barrier and enabling comments and nurses at Site 2, where technology was prevalent, reported mostly positive responses. CONCLUSION: This early involvement offered nursing input and facilitated understanding of the potential capabilities of novel technology to support nursing work, particularly the characteristics seen as potentially beneficial (enabling technology) and those conflicting (barrier technology) with the delivery of both safe and effective patient care. RELEVANCE TO CLINICAL PRACTICE: Collaborative involvement of nurses from the early conceptualisation of technology development brings benefits that increase the likelihood of successful use of a tool intended to support the delivery of safe and efficient patient care.

Determinação da glico-hemoglobina : relação com a glicemia e aspectos analíticos

A glico-hemoglobina (HbA1c) é um parâmetro importante no controle glicêmico de pacientes diabéticos. Vários estudos clínicos mostraram claramente que a melhora no controle glicêmico está fortemente associada com a diminuição no desenvolvimento e/ou progressão das complicações microvasculares do diabetes. A medida exata e precisa da HbA1c é uma questão importante para os laboratórios clínicos. Vários fatores afetam os resultados e podem levar a resultados errôneos. Este trabalho analisou o efeito de fatores analíticos, estados patológicos e drogas nos resultados de HbA1c. Em um primeiro estudo, demonstramos que a fração lábil de HbA1c contribui significativamente para o resultado final. Quando está fração é separada inadequadamente, há a necessidade de um pré - tratamento na amostra, para evitarmos valores falsamente elevados. O armazenamento das amostras é um fator pré – analítico importante. Amostras mantidas sob refrigeração são estáveis por 10 dias e o armazenamento a longo prazo deve ser feito a – 80oC. No entanto, amostras congeladas a –20oC apresentam uma diminuição significativa nos valores de HbA1c, já nas primeiras 24h de armazenamento. Em um segundo estudo, relatamos que as hemoglobinas anômalas estão associadas com valores muito baixos de HbA1c. Adicionalmente, também demonstramos que a anemia é uma importante fonte de interferência negativa nos resultados. Sugerimos que, para a correta interpretação dos valores de HbA1c, o estado hematológico do paciente seja sempre considerado. Em um terceiro estudo, analisamos o uso crônico de aspirina, vitamina C e vitamina E nos níveis de HbA1c. Houve inexistência de efeito significativo nos resultados de HbA1c, medidos por 3 métodos rotineiramente utilizados pelos laboratórios clínicos, em indivíduos não - diabéticos. O clínico deve conhecer os fatores que afetam a determinação de HbA1c na população atendida e os resultados discordantes com a história clínica do paciente devem ser sempre investigado.

A customização no atendimento como fator de fidelização do cliente às lojas de decoração de alto estilo

This study investigates how far customization in attendance act as clients faithfulness factor in top style interior design stores in Great Vitoria. After relative economic stability was reached with ¿Plano Real¿, customers could visualize better their money and consequently gave it more value. When clients acquire a product and demand high quality attendance they consider much beyond price. They want something new. Something that surprise. They are not satisfied only with what is best. They want the utmost. Do what is best is no longer a competitive advantage. It is now just a duty. Emphasizes application of custom-made attendance according to client specific needs as a competitive advantage-key to be pursued by companies. Analyses using extensive literature review including the world wide web source, the problem main theoretical fundaments. An intentional sample was used and interviews with closed questions were carried out with 230 clients and 18 store managers, to collect directly involved agents impressions. Conclusions show a mature customer, highly educated with good income and that demand exclusive treatment. In majority the study shows that customized attendance creates client faithfulness to top style interior design stores provided that price and product quality are adequate. Knowledge acquired with this study on attendance customization can give important contributions to top style interior design segment giving stores stimulus in the adoption of this distinctive competence facing growing global competitive market.

Satisfação dos clientes de terceira idade com o auto-atendimento em uma agência do Banco do Brasil

Este trabalho de conclusão tem como seu objetivo principal verificar os serviços que são oferecidos nas Salas de Auto-Atendimento (SAA) para a terceira idade, em uma agência do Banco do Brasil, em Porto Alegre. Interessa saber como é a percepção desse público com relação ao tema proposto para sugerir à instituição bancária melhorias, bem como comprovação em futuros estudos. Diante das impressões dos consumidores dos produtos e serviços oferecidos no ambiente ora analisado, percebe-se que este público tem pouca familiaridade quando lida com a automação bancária, embora outros problemas paralelos foram destacados, como a necessidade permanente de funcionários para auxiliá-los durante as operações, as filas ocasionando cansaço físico, a segurança nas SAA, a pouca privacidade quando utilizam as máquinas e a necessidade de conforto nesse ambiente, como a disponibilização de cadeiras, bebedouros e vasos com plantas. A grande maioria ainda prefere o atendimento tradicional, ou seja, o contato humano. Para este público, este é o caminho mais seguro e agradável para acessar os produtos e serviços bancários. Notou-se a reduzida oferta de estudos sobre o assunto quando se trata de relacionar a automação bancária versus terceira idade, bem como a inexistência de uma política diferenciada de atendimento para esse público.

Processos digitais na prefeitura de Santos

O presente trabalho foi realizado com o intuito de identificar e acompanhar os principais desafios que a Prefeitura Municipal de Santos, por intermédio de sua Secretaria de Gestão, encontrou na implantação de seu programa de digitalização de processos administrativos. Realizaram-se entrevistas em campo com quatro visitas à cidade de Santos para verificar a formulação e aplicação concreta do programa, pesquisa de material legal, especialmente do Decreto e da Portaria Municipal que criaram efetivamente a obrigação para que todos os servidores do Município elaborem determinados processos administrativos de maneira unicamente digital. Ainda, outra base de pesquisa foi a comparação da experiência com as de outros entes, poderes e órgãos públicos brasileiros que já adotaram os processos administrativos eletrônicos. A metodologia utilizada para realizar o trabalho deu-se por meio de visitas in loco e entrevistas com os gestores responsáveis e, também, com os usuários do sistema, visando coletar informações a respeito do programa – inclusive seu histórico referente à fase de formulação –, bem como perceber as impressões e expectativas dos servidores. Devido à relevância e atualidade do tema, analisou-se se o programa poderia ser considerado uma política pública, o que resultou numa conclusão positiva, com desdobramentos potenciais para a discussão da implantação e modernização de processos no âmbito da administração pública. Buscou-se, por fim, contribuir com o município para a construção de uma metodologia de avaliação mediante a utilização de indicadores, por meio dos quais torna-se possível medir a eficiência e o impacto da nova sistemática.

A valorização da competência em liderança nas agências reguladoras federais

Os desafios impostos à Administração Pública são crescentes. Problemas públicos complexos e uma sociedade cada vez mais consciente de seus interesses e insatisfeita com a prestação dos serviços públicos a pressionam a buscar formas de enfrentar essas questões. A presença de lideranças capazes pode ser um meio de alavancar o caráter criativo e inovador das instituições públicas, assegurando agilidade e qualidade na resposta a essa sociedade mais atenta e conhecedora de seu valor. Nesse sentido, o presente estudo buscou identificar em que medida as agências reguladoras federais, autarquias especiais da Administração Pública indireta, têm valorizado suas lideranças. Reconhecidas pela elevada especialização técnica, fundamental para a atuação em setores dinâmicos e estratégicos para os interesses do país, é de se esperar que seus esforços sejam por assegurar o emprego de uma gestão moderna e eficaz. O estudo considerou as impressões colhidas a partir de entrevistas com os responsáveis pela gestão de pessoas dessas instituições. Como resultado foi possível concluir que, de fato, as agências reguladoras vêm envidando esforços no sentido de identificar, capacitar e fortalecer as suas lideranças, com vistas a aprimorar a gestão organizacional.

O gerenciamento de impressões e a qualidade dos serviços nos hotéis da Paraíba

The present study has got as its aim to show how the impressions management is being used by the hotels in Paraiba State. For that, the dramma or role play perspective has been adopted as a model for service management. From the theater metaphor, the physical environment and its components can be seen as a scenery of the service show. We conduct the reader to notice the importance of the consummer about the service quality demand and its influence on his satisfaction. A methodology with exploring and qualifying nature has been adopted by using the analyses of content technique in interviews applied to hotel managers lebeled as having 4 and 5 stars in the State, trying to check how impression management takes place, identifying impression management tools used in relation to the physical evidences and to contacting people, as well as checking managers views in the survey about the use of impression management for client satisfaction make. The information revealed that managers, maybe for being unaware about impression management theory, haven t considered neither the physical evidences yet, nor contacting people as marketing tools. About the physical evidences, we could see that hotels take actions in a pulverized way referring to environment decoration and colors, however there isn t a global usage of physical evidences to highlight the service. Contacting people by their turn, receive better importance and attention. It was possible to make sure that managers are aware about the influence of the employee over the attendance quality. This way, we may come into a conclusion that impression management at Paraiba hotels has been under used, as long as managers seem to be, most times, turned to actions related to contacting people, not having realized the planning importance and national-wide use of service scenery in a genaral way yet

Processamento e análise de imagens na caracterização da superfície do titânio submetido a um ensaio de cultura de células

This work aims to develop a methodology for analysis of images using overlapping, which assists in identification of microstructural features in areas of titanium, which may be associated with its biological response. That way, surfaces of titanium heat treated for 08 (eight) different ways have been subjected to a test culture of cells. It was a relationship between the grain, texture and shape of grains of surface of titanium (attacked) trying to relate to the process of proliferation and adhesion. We used an open source software for cell counting adhered to the surface of titanium. The juxtaposition of images before and after cell culture was obtained with the aid of micro-hardness of impressions made on the surface of samples. From this image where there is overlap, it is possible to study a possible relationship between cell growth with microstructural characteristics of the surface of titanium. This methodology was efficient to describe a set of procedures that are useful in the analysis of surfaces of titanium subjected to a culture of cells

Corpo e Velhice: um estudo da qualidade de vida de idosos da Vila Vicentina Júlia Freire em João Pessoa

The aim of this study was to follow the daily routine of elderly individuals residing at the Vila Vicentina Júlia Freire (VVJF) nursing home in João Pessoa, Brazil, observing and analyzing as much as possible, the way in which they live in a group and how they deal, through personal experiences, with their own body image and with that of others. The results were obtained from information considered relevant, according to the perspectives of the residents themselves, contained in narratives of their history and related to their quality of life. Our interest lays in how they coped with changes in their bodies at old age and adapted to the challenges of this new phase. To obtain this information, with significant expressions, we used the Narrative Interview (NI) as a research tool in order to redeem their life experience and develop an understanding of their impressions about the life experience at the current nursing home. We selected, among the housed, ten subjects - actors - to appear as a sample of the group together. The design of our sample had a hybrid model, combining two types: random sample (probability) and an intentional sample (not probability). After recording transcripts and ensuring that all the subjects showed common interests that were relevant to the group, we chose three categories for analysis as follows: a. the elderly as seen by themselves and by others; b. religiosity as a moral factor; c. intimacy and relationships. Our choice was based on the importance of the theme as a multidisciplinary topic in the quality of life of populations. The subjects, chosen as spokespersons for the VVJF, spoke, among other things, about the way in which they viewed the world, their own body and how they experienced the environment and their fellow residents, in an attitude of reflection and criticism that confirms the lucidity of an old age conditioned to an elderly institution. The method allowed us to investigate our subjects from a multidisciplinary point of view. We suggest other studies in assorted areas of the human sciences, having as principle, man at the center of all our scientific questionings. The paradigm that the elder is, necessarily, unhappy in his sheltered has been, in this job, broken through the testimonies collected, establishing multiple perspectives of the analyzed subjects by their respective narrative records. Involving the participation of researchers with major in Administration, Communication and Law, this study filled, in this aspect, the requirements of the multidisciplinarity of the Program of Pos-Graduation in Health Science

Stability and Local Toxicity Evaluation of a Liposomal Prilocaine Formulation

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Fixação biológica do nitrogênio e crescimento de plantas de leucena (Leucaena leucocephala (Lam.) de wit.) sob salinidade

This study aimed to evaluate the effects of salinity in the growth and nitrogen fixation in leucaena. Plants were cultivated in Leonard pots containing clean and sterilized sand. The treatments were distributed in a completely randomized design, in a 3x3 factorial, with five replicates. The first factor corresponded to no inoculation and inoculation with Bradyrhizobium sp SEMIA 6070 and SEMIA 6153 strains. The second factor corresponded to NaCl concentrations: 0, 25 and 50 mol m(-3). Were analyzed the height and dry matter accumulation, the number of nodules and nitrogen in plants. The inoculation of plants with the strain SEMIA 6070 provided higher growth and greater nitrogen accumulation in plants thar were not subject to salinity. Nodulation was not affected by salinity. Inoculation with SEMIA 6153 strain provided greater tolerance to salinity.

Cultura e consumo: o fluxo dos bens

It is an ethnographic work that has an objective of verifying devices throngh the residents of a low income suburban area, and the way they deal with their social relations through sonsumerism (and the aspiration connected to it), the symbolic character acquired through consumer goods, understood as one of the fundamental components for the comprehension of the web as relations that established, Though consumerism, individuais will reveal ways of communication, of the status, of creating new forms of action and identification. Using the principal that believes in a web of symbolic significance where own individuais develop their impressions, as a resource to look at their own bodies, a social order (yet unstable), and the process of inclusion in a broader society. In conclusion, the act of consuming is more than a perspective that establishes statistics on consumer goods, with their ways of production, circulation and economic functioning: it is also a way of perceiving a collection mapped by consumers individually and socially, and by those means organizing, classifying and identifyring the social world

Transplantes: re-inserção social e qualidade de vida dos transplantados cardíacos do Estado do RN

The experience of transplantation is a very serious situation from the clinical standpoint. Therefore, there must be some subjective and social breakdown in people who have been undergone such a procedure. Recent product of modernity, the transplanted is someone who owns his recover to the scientific advances of contemporary society and a deceased donor. This paper aims at examine the implications, from the changes in patterns of behavior and thought that occur after the experience of an extreme and critical situation, as the process of illness and its consequent transplant surgery. The symbolism of the heart suggests that some social impressions about the organ itself are also reflected in how the transplanted interprets the experience of this type of procedure. So investigating how the changes occurred throughout the process interfere in the re-insertion of these people to social life, after his recovery, is the purpose of this work. The concept of habitus coined by Pierre Bourdieu will be used to measure conceptually how this experience (clinical, modern and symbolic) fits in the contemporary discussion of sociology

De socialidades mediadas e do homer a propósito do espectador-reativo em Jesús Martín-Barbero

This study aims to examine the contemporary viewer and also propose a review of the literature surrounding the spanish researcher Jésus Martín-Barbero. The proposed review, based on Martín-Barbero observations and the Latin American Cultural Studies analysis, observes the individual as part of the processes of communication and research on the concept of cultural mediation, the viewer as component/agent/object of the production of meaning. The study will perceive it as an element of inaccuracy/inadequacy and understand it as a subject of these reactive processes that contain complex and involve communication and culture, in contrast the impressions that resulted from a discussion between a television professional and a communication researcher and of these findings on the same viewer. The work also aims to point the viewer as a component of the possible mapping desired by Martín-Barbero to massive contemporary interpretation of the processes and its concept of night map

Miguilins no sertão da cabaça azul: incandescência, infância e devaneios poéticos em Mutum

Cette thèse concerne dans une lecture poétique du roman Campo Geral, de Guimarães Rosa, du film Mutum - basé sur le roman mentionné et réalisé par Sandra Kogut, et de l investigation das les villes de Minas Gerais/MG impliqués dans la production du film. Le but de cette lecture est de communiquer l'expérience onirique faite à partir d'une oeuvre cinématographique, à partir d un récit littéraire et la rencontre avec cinq acteurs non-professionnels et de trois membres de l'équipe de Mutum. Pour ça, le rêve poétique, proposé par Gaston Bachelard, il est utilisé comme une ressource cognitive à l'expérience de la réalité de semi-imaginaire l'homme, a partir de l actionnement du double dans le processus de participation affective (MORIN, 1997). Le film choisi abord des impressions d un enfant qui vit avec ses parents, avec ses frères, avec sa grand-mère et avec sa chienne Rebeca, dans un place appelé Mutum. Sous la perspective de l être rêveur, qui medite sur les images de l enfance onirique dans le contexte des régions sèches de la campagne, des régions qui sont transformées et étendues à travers le rêve poétique, nous arrivons à l enfance méditative (BACHELARD, 2006). Tout au long de la narration de cette recherche, Guimarães Rosa, la réalisatrice Sandra Kogut, moi-même comme un individu / chercheur et les interlocuteurs de la famille Mutum que j'ai trouvé dans Minas Gerais, nous sommes tous pris comme Miguilins qui rêvent de La région Cabaça Azul. Incandescents, multiples, primitives, ces Miguilins sont porteurs des papiers colores et avec elle ils comprennent la participation de l'homme dans le Grand Récit (SERRES, 2005)