Prática e percepção do enfermeiro gestor quanto à efetivação do programa saúde da família

As políticas públicas de saúde surgem em decorrência do reconhecimento de um cenário desumano e incoerente frente às condições sociais e de saúde da população, este cenário favoreceu a inclusão da família como foco de atenção nas políticas públicas. Neste contexto o profissional enfermeiro vem se destacando como agente dinamizador das ações dentro do Programa Saúde da Família(PSF). A partir desta premissa este estudo objetivou conhecer as atividades gerenciais desenvolvidas pelo enfermeiro gestor no Programa Saúde da Família, a percepção do enfermeiro gestor sobre a efetivação das metas á serem alcançadas pelo Programa Saúde da Família, e as dificuldades encontradas na prática cotidiana deste profissional para efetivação das metas a serem alcançadas no Programa Saúde da Família. Trata-se de um estudo descritivo com abordagem qualitativa, realizado em Belém do Pará. Os dados foram obtidos por meio de entrevistas semi-estruturadas junto a 45 enfermeiros gestores de 30 unidades saúde da família na região metropolitana de Belém. As informações coletadas foram organizadas conforme preceitos à análise de conteúdo segundo Bardin (1977). Da análise dos discursos emergiram cinco categorias. Os resultados deste estudo demonstraram que são inúmeras as atividades gerenciais do enfermeiro, que sua maior dificuldade na prática cotidiana deve-se ao fato da comunidade ainda estar fortemente arraigada ao atendimento hospitalocêntrico, além da insatisfação na função de gerência, ligadas as várias dificuldades como falta de perfil do agente comunitário de saúde, infraestrutura das unidades, falta do profissional médico em algumas unidades, não adesão do tratamento e ações educativas pelas famílias adstritas , além da impossibilidade em alcançar os objetivos propostos pelo Programa Saúde da Família, de acordo a maioria dos informantes. Essa realidade tem sido vivenciada pelo enfermeiro gestor, caracterizada como forma de tensão interna do sistema, gerando a construção peculiar para enfrentar tais dificuldades. Apesar das dificuldades e limitações dos enfermeiros gestores, estes profissionais realizam suas funções com responsabilidade, buscando cada vez mais autonomia, e consideram que este programa, é o marco nas políticas públicas de saúde.

A actuação do enfermeiro como gestor na unidade de terapia intensiva do Hospital Regional do Baixo Amazonas-Santarém-Pará-Brasil : um estudo de caso

Estudo descritivo que teve como objetivo avaliar a atuação do enfermeiro como gestor da Unidade de Terapia Intensiva do Hospital Regional do Baixo Amazonas Dr. Waldemar Pena – HRBA, o qual obteve o selo de Acreditado em Nível 1 em 2012. Para a obtenção dos dados utilizou-se um questionário elaborado com 10 perguntas subjetivas e aplicado aos enfermeiros gerentes que atuam nas Unidades de Terapia Intensiva e CTI do HRBA. Verificou-se nesse estudo que são indivíduos na faixa etária de 25 a 45 anos, com predominância do gênero feminino, com especialização em áreas diversas da enfermagem. Na atuação no setor de gerência, os enfermeiros estabelecem prioridades, direcionando sua equipe para os atendimentos assistenciais complexos aos pacientes, ficando o trabalho burocrático para ser realizado por último. Os entraves relatados são a insatisfação e o desgaste no exercício da função de gerente da unidade devido ao excesso de funcionários sem experiência em UTI, falta de autonomia, dupla jornada de trabalho, excesso de burocracia entre outras situações que se tornam motivos de estresse. Concluiu-se que a atuação do enfermeiro como gerente se respalda na função assistencial ao paciente através de cuidados diretos e indiretos e na organização dos trabalhos burocráticos na Unidade de Terapia Intensiva.

Shrubs, granivores and annual plant community stability in an arid ecosystem

Compensatory population dynamics among species stabilise aggregate community variables. Inter-specific competition is thought to be stabilising as it promotes asynchrony among populations. However, we know little about other inter-specific interactions, such as facilitation and granivory. Such interactions are also likely to influence population synchrony and community stability, especially in harsh environments where they are thought to have relatively strong effects in plant communities. We use a manipulative experiment to test the effects of granivores (harvester ants) and nurse plants (dwarf shrubs) on annual plant community dynamics in the Negev desert, Israel. We present evidence for weak and inconsistent effects of harvester ants on plant abundance and on population and community stability. By contrast, we show that annual communities under shrubs were more species rich, had higher plant density and were temporally less variable than communities in the inter-shrub matrix. Species richness and plant abundance were also more resistant to drought in the shrub under-storey compared with the inter-shrub matrix, although population dynamics in both patch types were synchronised. Hence, we show that inter-specific interactions other than competition affect community stability, and that hypothesised mechanisms linking compensatory dynamics and community stability may not operate to the same extent in arid plant communities.

Is NHS Direct meeting the needs of mental health callers?

Background: NHS Direct is a new service that offers 24-hour advice from trained nurses. The National Service Framework for Mental Health and the National Strategy for Carers both mention NHS Direct as an important source of support for people with mental health problems. Aims: This paper reports findings from an evaluation of the Department of Health's NHS Direct mental health initiative. This initiative was established to ensure that NHS Direct can meet the needs of callers with mental health problems by offering additional training to all staff and improving the database of mental health services. Method: The findings reported here are based on routine computer data provided by 12 out of 17 NHS Direct sites, 552 data forms completed by nurse advisers from the 17 sites, and 111 questionnaires administered over the telephone with callers to the 17 sites. Results: Mental health calls accounted for 3% of NHS Direct's workload, although these calls were often longer and more complex than other calls. The majority of callers to the service were in touch with other services for their mental health problems (59%), typically their GP. Most callers had 'moderate' mental health problems, as indicated by the Global Assessment of Functioning Scale. Generally callers were satisfied with the service they received, although satisfaction was lower in some areas than previous studies of NHS Direct. Conclusions: Improvements could be made in the mechanisms for referring callers on to other services, and training to increase nurse advisers' knowledge of mental health problems.

Aletheia

The abstract concept Aletheia, Truth, is personified in literature as a daughter of Zeus (Pind. Ol. 10.3–4 and fr. 205) and nurse of Apollo (Plut. Symp. 657e).

The perception of support received from breast care nurses by depressed patients following a diagnosis of breast cancer

INTRODUCTION Due to their specialist training, breast care nurses (BCNs) should be able to detect emotional distress and offer support to breast cancer patients. However, patients who are most distressed after diagnosis generally experience least support from care staff. To test whether BCNs overcome this potential barrier, we compared the support experienced by depressed and non-depressed patients from their BCNs and the other main professionals involved in their care: surgeons and ward nurses. PATIENTS AND METHODS Women with primary breast cancer (n = 355) 2–4 days after mastectomy or wide local excision, self-reported perceived professional support and current depression. Analysis of variance compared support ratings of depressed and non-depressed patients across staff types. RESULTS There was evidence of depression in 31 (9%) patients. Depressed patients recorded less surgeon and ward nurse support than those who were not depressed but the support received by patients from the BCN was high, whether or not patients were depressed. CONCLUSIONS BCNs were able to provide as much support to depressed patients as to non-depressed patients, whereas depressed patients felt less supported by surgeons and ward nurses than did non-depressed patients. Future research should examine the basis of BCNs' ability to overcome barriers to support in depressed patients. Our findings confirm the importance of maintaining the special role of the BCN.

Working at night and work ability among nursing personnel: when precarious employment makes the difference

To test the association between night work and work ability, and verify whether the type of contractual employment has any influence over this association. Permanent workers (N = 642) and workers with precarious jobs (temporary contract or outsourced; N = 552) were interviewed and filled out questionnaires concerning work hours and work ability index. They were classified into: never worked at night, ex-night workers, currently working up to five nights, and currently working at least six nights/2-week span. After adjusting for socio-demography and work variables, current night work was significantly associated with inadequate WAI (vs. day work with no experience in night work) only for precarious workers (OR 2.00, CI 1.01-3.95 and OR 1.85, CI 1.09-3.13 for those working up to five nights and those working at least six nights in 2 weeks, respectively). Unequal opportunities at work and little experience in night work among precarious workers may explain their higher susceptibility to night work.

Three-dimensional Reconstruction of Ovaries of Leaf-cutting Ant (Atta sexdens rubropilosa) Queens (Hymenoptera: Formicidae)

In this study, the ovary morphology of newly emerged ant queens of Atta sexdens rubropilosa was studied in whole mount preparations by confocal microscopy. The ovaries are composed of approximately 40 ovarioles, showing non-synchronic oocyte maturation. The terminal filament with clusters of undifferentiated cells was found at the distal end of the ovarioles. Next to this region is the germarium, composed of several elongated cystocytes interconnected by cytoplasmic bridges. The nurse cells (23-28 cells) result from asymmetric mitosis. Cytoskeleton analysis showed F-actin concentrated at the muscle cells of the external tunica and in fusomes inside the ovarioles. Microtubules were concentrated around the nuclei of the nurse and follicular cells. In contrast, the oocytes and the external tunica showed faint staining for tubulin.

Virtual Office Hours Using Blackboard Collaborate

Virtual Office Hours are a possibility that any professor can take advantage of using Blackboard Collaborate. Why not cater to your online students by allowing them to have live chats with you as if you were face to face during regular office hours? Come learn about this innovative way to use Blackboard Collaborate with your students.

Application of Narrative Pedagogy to Promote Excellence in the Clinical Setting

The clinical setting has become increasingly complex in recent years. Nurse educators have recognized the limitations of traditional pedagogies in the clinical setting. The need for innovative, student-centered learning is essential in order to transfer knowledge to practical situations and discover new ways of thinking about clinical situations. Narrative pedagogy which emphasizes how students learn and experience learning is an effective evidence-based approach to clinical education.

Undervisning till patienter med diabetes typ 2.Faktorer som påverkar resultatet av egenvården- En systematisk litteraturstudie

Syftet med studien var att belysa vilka faktorer i patientundervisningen som kan påverka resultatet av egenvård för patienter med diabetes typ 2 samt att kartlägga gruppundervisningens betydelse och dess innehåll. Studien baseras på 13 vetenskapliga artiklar daterade från år 1991 och fram till år 2003. Litteraturen har sökts manuellt och via databaserna PubMed, SweMed och Elsevier. Sökorden som använts i olika kombinationer var: education, diabetes type 2, support, obesity, self- management, changes lifestyle, factors affecting, empowerment, diabetes nurse, nurse, individually, group, diabetes typ 2, stöd, sjuksköterska, undervisning och egenvård. Urvalet av de vetenskapliga artiklarna gjordes med tanke på litteraturstudiens syfte och frågeställningar. Resultatet visade att undervisningen bör vara en ständigt pågående process. Kontinuitet, hänsyn, tillgänglighet och stöd av hela diabetesteamet under en längre tid är viktiga faktorer i behandlingen. Andra viktiga faktorer som kan påverka resultatet av egenvård är patientens självkänsla, motivation och upplevd ensamhet. Det är viktigt att undervisarens förhållningssätt varieras och anpassas efter patientens individuella resurser och behov. Undervisningsprogram som innehåller både grupp- och individuell undervisning i kombination med teoretisk- och praktisk undervisning har en positiv betydelse för patientens egenvård. Diskussioner och sociala aktiviteter i grupp, visade sig ha en god inverkan på patientens livsstilsförändringar.

Malnutritionsproblem vid cancersjukdom : En litteraturstudie

Det primära syftet med denna litteraturstudie var att beskriva hur cancerrelaterad malnutrition uppkom och hur kroppen påverkades. Vidare syftade studien till att beskriva hur patienterna upplevde nutritionsproblemen och dess konsekvenser. Studien syftade även till att beskriva hur patienternas livskvalitet påverkades av nutritionsproblemen, samt vilka åtgärder sjukvårdspersonalen kunde vidta för att förbättra nutritionen hos patienter med cancer. Artikelsökningen har skett via databaserna Elin@Dalarna, Blackwell Synergy och EBSCO Host. Sökorden som användes var cancer, healthcare, nutrition, malnutrition, nurse, nursing, quality of life och experiences. Resultatet visade att malnutrition ökade risken för komplikationer. Många av patienterna avled på grund av malnutrition och inte av cancern i sig. Malnutrition orsakades av att patienten inte kunde äta på grund av både cancern och dess behandling. Patienterna tyckte det var omöjligt att både äta, dricka och till och med svälja sin egen saliv på grund av rädsla för outhärdlig smärta. Konsekvensen av detta var att de inte hade styrka eller energi till att göra någonting. Nutritionsproblem ledde även till en känsla av brist på gemenskap och en försämrad livskvalitet. Nutritionsintaget var den viktigaste faktorn till en bra livskvalitet. Genom att ta nutritionsstatus tidigt och med jämna mellanrum följa upp nutritionsstatus på patienten så kunde sjuksköterskan motarbeta malnutrition.