Os 600 transplantes renais do Hospital das Clínicas da Faculdade de Medicina de Botucatu (HC da FMB) - UNESP: Mudanças ao longo do tempo

Introdução: Os resultados alcançados pelos transplantes renais nas últimas décadas têm melhorado progressivamente. Objetivo: A fim de determinar a extensão desse progresso, conduzimos uma análise dos resultados obtidos em nosso programa de transplantes através de três períodos diferentes. Métodos: Avaliamos os 600 transplantes renais realizados no HC FMB-UNESP até dezembro de 2011, subdividindo-os em três eras, de acordo com a imunossupressão vigente. Era 1: de 1987 a 2000 (n = 180); associação de ciclosporina e azatioprina. Era 2: de 2001 a 2006 (n = 120); associação de ciclosporina e micofenolato e Era 3: de 2007 a 2011 (n = 300); associação de tacrolimus e micofenolato. Resultados: Os resultados mostram aumento da idade média do receptor, da prevalência de diabetes e do número de transplantes com doador falecido (60%) na terceira era. O uso de terapia de indução foi de 75% era atual contra 46,6% (Era 2) e 3,9% (Era 1), p < 0,0001. Os dados de sobrevida geral por tipo de doador mostram dados semelhantes à literatura. Houve progressivo aumento da sobrevida do enxerto com doadores falecidos em 5 anos, saindo de 13,7% (Era 1) para 81,9% (Era 3). Conclusão: Houve significativas diferenças ao longo do tempo, culminando com aumento do volume de transplantes na atual era (média de 14 transplantes/ano na Era 1 para 75 transplantes/ano na Era 3). Inverteu-se o perfil de transplantes na era atual com predomínio de doador falecido. A melhor sobrevida com doador falecido da atual era foi atribuída a maior experiência do centro e aos esquemas de imunossupressão baseados na combinação de tacrolimus com micofenolato associados a esquema de indução.

Sementes esverdeadas em soja: testes alternativos para determinar a sua qualidade

A comercialização antecipada de soja é uma realidade em Mato Grosso. Isso implica na necessidade de testes rápidos, confiáveis e que permitam minimizar riscos futuros, principalmente, quando existe um agente complicador a armazenabilidade, como é o caso de sementes com retenção de clorofila. Mudanças associadas à deterioração com conseqüente perda de vigor e viabilidade são observadas nesse tipo de semente, fazendo-se necessário o conhecimento da localização e abrangência dos pontos deteriorativos. Objetivando avaliar testes que sejam factíveis e tenham potencial de determinar a qualidade de sementes esverdeadas, foi realizado este estudo. FMT-Tucunaré, ciclo semi-precoce, e EMGOPA 313, FMT-Arara Azul e M-SOY 9350, ciclo tardio, que apresentavam 25,7%, 26,8%, 22,6% e 15,6%, respectivamente, de sementes esverdeadas, foram as cultivares estudadas. Para cada cultivar foi utilizada uma amostra testemunha, isenta de pigmento verde. Cada amostra constituiu um tratamento. A qualidade foi avaliada em duas épocas (inicial, maio/2001 e final, novembro/2001), através dos testes de germinação, tetrazólio, emergência em areia, envelhecimento acelerado (24 horas e 48 horas), utilizando tetrazólio em substituição à germinação, e massa seca de plântulas. No teste de tetrazólio, a subclasse DU 4-5 indica a deterioração por umidade, como principal problema fisiológico evolutivo e o tetrazólio, em substituição à germinação no teste de envelhecimento acelerado, 24 horas, pode avaliar o risco do potencial fisiológico do lote com sementes esverdeadas, na época inicial de armazenagem.

Efeito de Colletotrichum gloeosporioides Penz, agente etiológico da mancha manteigosa, na germinação e viabilidade de sementes de cafeeiro

Foi avaliada a influência de Colletotrichum. gloeosporioides na sanidade, germinação, viabilidade e vigor de sementes de cafeeiro. Sementes das cultivares Catuaí Vermelho, provenientes de plantas com sintomas de mancha manteigosa, e de lavouras sadias de Catuaí Vermelho IAC 44 e Mundo Novo 379-19 foram submetidas a inoculação por C. gloeosporioides, pelo contato direto com a colônia do fungo, por 0; 24; 48; 72; 96 e 120 horas. As variáveis analisadas foram sanidade, germinação, índice de velocidade de emergência e viabilidade pelo teste de tetrazólio. Verificou-se aumento da incidência de C. gloeosporioides com o do tempo de exposição ao fungo, sendo esta de 26% em Catuaí Vermelho, 21,5% em Catuaí Vermelho IAC-44 (21,5%) e de 11,0% em Mundo Novo IAC 379-19. O fungo afetou a germinação das sementes e o índice de velocidade de emergência das sementes da cultivar Catuaí Vermelho e Catuaí Vermelho IAC 44 a partir de 96 horas de exposição. O efeito de C. gloeosporioides na germinação e no estabelecimento de plântulas de cafeeiro é variável, dependendo da cultivar utilizada, da presença do pergaminho e do tempo de exposição ao fungo, mas a viabilidade das sementes decresce com o aumento do tempo de exposição ao fungo.

A teoria da perspectiva e as mudanças de preferência no mainstream: um prospecto Lakatoseano

The theory of the perspective and the changes of preference in the mainstream: a Lakatosean prospect. For many decades over the 20th Century, the mainstream of economics adopted a normative and axiomatic theory of individual behavior in which maximizing procedures were carried out by rationally unbounded agents. This status has been challenged on many grounds and alternative views from fields like psychology have found a way into the core of economics research frontier. Prospect theory, developed by psychologists Daniel Kahneman and Amos Tversky since the 1970s, has provided a more empirical, inductive and descriptive theory of decision making. It has made significant inroads into mainstream microeconomics, shaking the habits of some of its practitioners. This paper first takes stock of its main developments and then uses a Lakatosian framework to draw out its negative and positive heuristics. In what follows, its heuristics are compared to those of traditional rational decision-making theories. The differences between them are highlighted, pointing to changes in the mainstream of the profession and to new opportunities for research.

Crise global, mudanças geopolíticas e inserção do Brasil

This paper has as its purpose to analyze the insertion of Brazil in the international economic order, considering the fundaments of the world power, the global crisis, the geopolitical changes and their consequences on the global order. The text attempts to present the advantages and structural challenges for an adequate international insertion of technology are the key elements in a process of economic and social innovation whose goals are to build a richer society, more just and compassionate, and environmentally sustainable.

Do professor informante ao professor parceiro: Reflexões sobre o papel da universidade para o desenvolvimento profissional de professores e as mudanças na escola

Este trabalho advoga a idéia de que os relacionamentos colaborativos entre universidade e escolas de 1º e 2º graus representam alternativa metodológica privilegiada tanto para investigação, quanto para atuação sobre o desenvolvimento profissional de professores e suas condições de trabalho. Projetos de natureza coletiva, que aproximam a pesquisa da realidade a ser estudada, como a pesquisa-ação colaborativa, constituem exemplos muito positivos de parceria entre universidade e escolas de 1º e 2º graus, porque geram oportunidades de exercício de práticas inovadoras no interior das escolas e o desenvolvimento de profissionais reflexivos em educação. Por se voltarem para a renovação simultânea de ambas as instituições envolvidas (universidade e escolas), de seus profissionais e de suas práticas, projetos colaborativos permitem, especialmente, que aprendamos mais sobre formas alternativas de iniciar e consolidar mudanças educacionais.

Value Creation of Professional Services

The aim of this qualitative thesis is to research, how professional services create value, and what are the key factors affecting on this process. A model describing value creation process in professional services will be explained, based on the existing literature and three in depth discussions with professional service representatives. Professional services are such services that are tend to base on problem solving and require high skills and knowledge of a professional. These services often have a consultative or an advisory nature, and they often involve both client and a company in service process. As the service is often delivered in somewhat collaboration so is the value created. The results of this thesis revealed that value is created in collaboration or co-operation in professional services. Therefore, value co-creation, as a concept, is exact to describe the value creation process in professional services. This thesis also revealed that value is co- created in continuous communication between a client and a company and no value or only a little value can be created if there is no effective communication during the professional service process.

Changing roles of nurse educators employed in acute and chronic care settings : the impact of professional and statutory mandates in Ontario at four sites of one hospital corporation /

The role of the hospital-employed nurse educator is evolving. Factors influencing this change include the introduction of standards for nurse educators by the College of Nurses of Ontario (CNO), a change in the way nurses are educated, the emergence of nursing as a profession, and hospital restructuring as a result of budgetary constraints. Two of these influencing factors: the introduction of the updated Standards of Practice for Registered Nurses and Registered Practical Nurses (1996) and hospital restructuring occurred over the last 7 years at several hospitals in southern Ontario. Current literature as well as the Standards of Practice (1996) were utilized to examine the current roles and responsibilities of nurse educators and subsequently develop a questionnaire to study the impact of these influencing factors on the role of the nurse educator. This questionnaire was piloted and revised before its distribution at 4 hospitals in southern Ontario. Twenty-five of the 41 surveys (61%) distributed were returned for analysis. The data reflected that the Standards of Practice had a positive influence on the role of the nurse educator, while hospital restructuring had a negative impact. In addition, many of the roles and responsibilities identified in the literature were indeed part of the current role of nurse educators, as well as several responsibilities not captured in the literature. The predictions for the future of this role in its current state were not positive given the financial status of the health care system as well as the lack of clarity for the role and the current level ofjob satisfaction among practicing nurse educators. However, a list of recommendations were generated which, if implemented, could add clarity to the role and improve job satisfaction. This could enhance the retention of current nurse educators and the possibility of recruiting competent nurse educators to the role in the future.

Private versus public : how one gay professor negotiates the boundaries between his personal and professional lives /

This study examined how one university professor negotiated the boundaries between his personal life as a gay man and his professional life as a teacher. Using his sexual orientation as a focal point, the study explored the circumstances and underlying assumptions that influenced this professor's decisions to disclose information of a personal nature. Data collection was solicited from a number of sources: (a) In-depth interviews with the participant, his colleagues, students, and friends; (b) Field observation of the participant teaching over a 3 -day period; and (c) A document review of lesson plans, course outlines, student feedback forms, and the participant's teaching portfolio. The researcher maintained both observation journals and reflective journals during this process. Data analysis using the constant comparative method elicited several themes. The participant engaged in a variety of strategies in disclosing his sexual orientation that included: (a) no disclosure at all, (b) assuming people knew, (c) casually mentioning it in conversation, and (d) deliberately planning to tell someone. The participant also engaged in an ongoing assessment of his environment that included evaluating the level of risk in disclosing his sexual orientation and assessing the listener's ability to receive the information. The participant cited numerous reasons for disclosing his sexual orientation. Further inquiry revealed a number of belief systems that underlined these reasons. These belief systems included beliefs around privacy, authenticity, teaching, manners, professionalism, and homosexuality. The conclusions suggested that the participant utilized a consistent process in both his personal and professional lives to determine what information was kept private and what information was made public. While the process used to determine the degree of disclosure was consistent, the actual disclosures themselves varied widely in nature.

Teacher professional growth in an authentic learning environment

The last several decades have been marked by tremendous changes in education - technological, pedagogical, administrative, and social. These changes have led to considerable increments in the budgets devoted to professional development for teachers ~ with the express purpose of helping them accommodate their practices to the new realities oftheir classrooms. However, research has suggested that, in spite of the emphasis placed on encouraging sustained change in teaching practices, little has been accomplished. This begs the question of what ought to be done to not only reverse this outcome, but contribute to transformational change. The literature suggests some possibilities including: a) considering teachers as learners and applying what, is known about cognition and learning; b) modifying the location and nature ofprofessional development so that it is authentic, based in the classroom and focusing on tasks meaningful to the teacher; c) attending to the infrastructure underlying professional development; and d) ensuring opportunities for reflective practice. This dissertation looks at the impact of each ofthese variables through an analysis ofthe learning journeys of a group ofteachers engaged in a program called GrassRoots in one midsized school board in Ontario. Action research was conducted by the researcher in his role as consultant facilitating teacher professional growth around the use of Web sites as culminating performance tasks by students. Research focused on the pedagogical approach to the learning of the teachers involved and the infrastructure underlying their learning. Using grounded theory, a model for professional development was developed that can be used in the future to inform practices and, hopefully, lead to sustained transformational school change.

Exploring the personal and professional lives of teachers in the search for authenticity /

"We teach who we are" (Palmer, 1998, p. 2). This simple, yet profound, statement was the catalyst that began my thesis journey. Using a combination of self-study and participant narratives, Palmer's idea was explored as search for authenticity. The self-study component of this narrative was enhanced by the stories of two other teachers, both women. I chose to use narrative methodology to uncover and discover the relationship between the personal and professional lives of being a teacher. Do teachers express themselves daily in their classrooms? Do any lessons from the classroom translate into teachers' personal lives? The themes of reflection, authenticity, truth, and professional development thread themselves throughout this narrative study. In order to be true to myself as a teacher/researcher, arts-based interpretations accompany my own and each participant's profile. Our conversations about our pasts, our growth as teachers and journeys as individuals were captured in poetry and photographic mosaics. Through rich and detailed stories we explored who we are as teachers and how we became this way. The symbiotic relationship between our personal and professional lives was illustrated by tales of bravery, self-discovery, and reflection. The revelations uncovered illustrate the powerful role our past plays in shaping the present and potentially the friture. It may seem indulgent to spend time exploring who we are as teachers in a time that is increasingly focused on improving student test scores. Yet, the truth remains that, "Knowing myself is as crucial to good teaching as knowing my students and my subject" (Palmer, 1998, p. 2).

The teaching practicum as an opportunity for professional growth: perceptions of three associate-teachers /

The purpose of this study was to examine the student-teaching practicum as an opportunity for professional growth for associate-teachers. Three associate-teachers from one school board in southern Ontario were purposefully selected to participate in the study. Participants were interviewed before and after one 4-week teaching practicum. They were asked to keep a reflective journal during the practicum, and provided with questions to guide their reflection. The literature suggests that meaningful professional development is contextual and requires reflection on practice. For example, Schon's (l987b) hall of mirrors phenomenon occurs when teachers reflect on their own practice while observing and guiding the practice of others. Findings from this study suggest the teaching practicum has the potential to be a valuable professional development opportunity for associateteachers, but that the university and the school board affiliated with the participants do not conceptualize it as such. As well, the research suggests that although all participants found the teaching practicum valuable, the extent to which they were able to grow professionally depended on their professional personality. In addition, it was found that the reflective journal enhanced opportunities for associate teacher reflection. This research suggests that universities and school boards may wish to consider the studentteacher practicum as a professional development opportunity.

An exploration of women elementary school teachers' perceptions of how their decision to return to teaching part-time from a maternity leave influences their professional and personal lives /

The purpose of this research was to explore women elementary teachers' perceptions of how their decision to return to teaching part-time from a maternity leave influences their professional and personal lives. The investigation focused on the decisions surrounding a mother's choice to reenter the teaching profession parttime in a field where each mother had previously been employed full-time. A collective case study was undertaken based on an in-depth interview with five mothers who had made the choice to return to the classroom part-time. The data collected in this study were analyzed and interpreted using qualitative methods. The following four major themes emerged from the interviews: decisionmaking process, challenges faced by mothers who teach part-time, the importance of support, and the enhancement of instructional practice from parenthood. Using these four themes, an analysis was conducted to examine the similarities and differences among the experiences of the participants. The mothers' reflections, my analysis, and the related literature were used at the conclusion of this report to compile implications for teaching practice, theory, and further research.

Developing and nurturing professional learning communities: principles used by elementary administrators /

This study examined the strategies used by elementary school principals to facilitate and nurture the development of professional learning communities (PLC) within their school settings. Using a reputational sample of administrators whose schools were demonstrating observable characteristics of PLCs, this study documented and described the strategies and actions taken by the principals to move their schools forward. Data collection included the use of open-ended interviews as well as observations capturing the means by which the principals addressed the areas of culture, processes, and structures within their school setting. A grounded theory approach to data analysis uncovered 4 guiding principles used by the principals to facilitate the development of the PLCs within their school: (a) protecting the purpose; (b) attending to relationships; (c) sharing the responsibility; and (d) valuing the journey. The guiding principles were used by each administrator to anchor the decisions they made and develop responsive, contextspecific strategies to support the PLC at their school. The results highlighted the complex role of the principal and the supports required to tackle the difficult work of facilitating PLCs.

Elements that contribute to staff nurses' commitment to lifelong professional development

This research explored the elements that contribute to staff nurses' commitment to lifelong professional development. This exploration has been undertaken to provide insights into those factors that motivate individuals to continue their education for professional development and for clinical practice improvement. This study was conducted in an acute care hospital in Southern Ontario, and investigated the thoughts and experiences ofhealth care staffworking within that setting. A qualitative case study was undertaken which involved the collection of interview, document, and class observation data. Two exemplary clinical nurse educators and two motivated, professionally committed staffnurses were interviewed during the study. Teaching document review and observation ofclasses involving the clinical nurse educators were conducted to facilitate triangulation of fmdingswith data sources and strategies. These participants provided rich data that were captured in field notes and coded for conceptual meaning. Emerging from the data were the identification ofthree major elements of influence that contribute to staffnurses' commitment to lifelong professional development. Identified within the three intersecting spheres of influence upon staff nurses' lifelong commitment to professionalleaming were the environment, the clinical nurse educator, and the staff nurse. This research explored the intersecting spheres of influence and the elements within the partnership model ofprofessional education for staff nurses.