Biogeochemical cycles and biodiversity as key drivers of ecosystem services provided by soils

Soils play a pivotal role in major global biogeochemical cycles (carbon, nutrient and water), while hosting the largest diversity of organisms on land. Because of this, soils deliver fundamental ecosystem services, and management to change a soil process in support of one ecosystem service can either provide co-benefits to other services or can result in trade-offs. In this critical review, we report the state-of-the-art understanding concerning the biogeochemical cycles and biodiversity in soil, and relate these to the provisioning, regulating, supporting and cultural ecosystem services which they underpin. We then outline key knowledge gaps and research challenges, before providing recommendations for management activities to support the continued delivery of ecosystem services from soils. We conclude that although there are knowledge gaps that require further research, enough is known to start improving soils globally. The main challenge is in finding ways to share knowledge with soil managers and policy-makers, so that best-practice management can be implemented. A key element of this knowledge sharing must be in raising awareness of the multiple ecosystem services underpinned by soils, and the natural capital they provide. The International Year of Soils in 2015 presents the perfect opportunity to begin a step-change in how we harness scientific knowledge to bring about more sustainable use of soils for a secure global society.

Limites e possibilidades da gestão sob o enfoque holístico

O tema Gestão sob o enfoque holístico surgiu a partir de uma leitura da revista HSM Management de setembro-outubro/2000. O artigo abordava o novo paradigma de gerenciar funcionários, que privilegia a busca do bem-estar, onde muitas empresas estão sendo obrigadas a revisar suas políticas de recursos humanos para enfocar as três dimensões de um indivíduo - corpo, mente e espírito. Segundo a reportagem, pesquisas da PricewaterhouseCoopers, Universum e outras organizações constataram que o equilíbrio trabalho/vida não é apenas uma demanda dos atuais empregados, mas também uma das principais prioridades dos formandos em universidades do mundo todo. A intensa luta para atrair funcionários de alto gabarito colocará a empresa com abordagem mais holística um degrau acima de suas concorrentes. Para as empresas, atender as verdadeiras necessidades individuais de seus funcionários é um novo paradigma na maneira de gerenciar seus negócios. O que mudou é a percepção de que o ser humano é fator primordial de competitividade e deixou de ser insumo. O ser humano passou a ser tendencialmente o centro, o foco das relações. Ainda que este conceito aparente estar longe da realidade organizacional brasileira, em função da distância entre o discurso e a prática de um modelo de gestão que considere o funcionário como um ser integral, já temos exemplos de empresas que estão adotando este princípio. A necessidade do equilíbrio entre os aspectos físico, mental, emocional e espiritual para ser feliz, tem levado as pessoas a superarem o medo do desconhecido e caminhar com detenninação em direção ao autodesenvolvimento. Este estudo analisou a utilização da gestão sob o enfoque holístico em duas diferentes empresas. Os resultados evidenciaram que a abordagem holística não está no âmbito da utopia, antes trata-se de um desafio para os gestores das organizações que, para um sucesso na adoção desta prática, precisam, mais do que implantá-la, adotá-la como filosofia de vida, incorporando-a a seus valores e visão de mundo. A prática cotidiana do modelo de gestão holística a partir do corpo diretivo é que vai possibilitar a verdadeira transformação da cultura organizacional tradicional para uma cultura organizacional holística, cuja conseqüência é o reflexo positivo nos resultados econômico-financeiros. C onstatamos, por outro lado, as limitações na utilização desse modelo de gestão tanto por parte dos funcionários quanto por parte dos altos executivos. Quanto aos funcionários, nem todos estão preparados para assumir novas responsabilidades ou preparados para o seu desenvolvimento pessoal, através do auto conhecimento. As crenças adquiridas no período educacional, tanto no lar quanto na escola, bem como suas recentes experiências profissionais podem inibir a descoberta de novas possibilidades, até que se sintam compelidos a lidar com os novos conhecimentos por necessidade de empregabilidade. Quanto aos executivos, por se tratar de um modelo de gestão relativamente novo, sem comprovação científica aliado à dificuldade de encontrar instrumentos de medição objetivos e ao elevado nível de exigência quanto a resultados crescentes no curto prazo, acabam priorizando a administração por objetivos, por se sentirem mais confortáveis quanto à certeza de obtenção de resultados econômico-financeiros no curto prazo. Esquecem-se, no entanto, dos efeitos desastrosos no clima organizacional, que vão comprometer os resultados de médio e longo prazos, seja pela possibilidade de elevado turnover como pela desmotivação generalizada, onde os funcionários só trabalham sob pressão. Por sua vez, cientes da importância do ser humano no novo cenário de elevada competitividade, não são poucos os empresários que já estão começando a trabalhar seus valores intrinsecos com a ajuda de terapeutas, filósofos, psicólogos, estimulando primeiro o auto conhecimento pessoal, para que possam futuramente empreender essa nova maneira de ver o mundo em suas respectivas empresas.

Nuances da dominação do conhecimento em gestão: caso de programa de mestrado internacional no Brasil

O propósito deste trabalho foi compreender como a prática de um programa internacional de educação em gestão desvela a dominação do conhecimento ao se internacionalizar para países emergentes. O cenário utilizado leva em consideração as alterações ocorridas no contexto internacional contemporâneo, principalmente em termos da inserção de países emergentes tais como Índia, China e Brasil entre os parceiros acadêmicos dos programas de educação em gestão. Mais especificamente, a contribuição do artigo decorre da abordagem crítica focada em educação em gestão que reconhece o papel dos países periféricos tanto na produção quanto no consumo do conhecimento. A problematização do tema, de caráter qualitativo, está baseada na descrição e análise do caso IMPM (International Masters in Practice Management), com recentes parcerias acadêmicas na China e no Brasil. Os resultados obtidos indicam que os programas internacionais de educação em gestão estão interessados em realizar atividades em países emergentes, mas estas parceiras nem sempre resultam em um papel legítimo que desloque os parceiros de suas posições periféricas para o centro da produção de conhecimento em gestão. Por fim, levantamos o questionamento de que os programas internacionais de educação em gestão, mesmo que presentes nestes países pela realização de módulos locais e pela participação de indivíduos de diversas origens, continuam funcionando como instrumentos de disseminação do conhecimento em gestão universal.

Gestão participativa em educação: compasso e descompasso de uma experiência de democracia no espaço escolar

This work aims at investigating the strategies of management used by State School Joaquim Jose de Medeiros, located in the city of Cruzeta - RN, as award practice of "School of Reference in Management", with a state title in 1999 at the beginning of the decade from 2000, being "Outstanding Brazil" from best management strategies nationally. In 2005, it is ranked among the best experiences of the state. It has been become complex by experiencing in that institution, but at the same time an enjoyable practice, mainly by using a social research, in a qualitative and quantitative approach, and a analysis of the institutional performance of two management practices: from 1995 to 2002 and from 2003 to 2007 . To understand the object, a investigative questionnaire was used with representatives of the school community and carried out an analysis of assessment of institutional and documents of institutional organization of the periods above in order to identify management strategies and examine the influences of the share capital, public policies , the institutional evaluation, in the process of democratic construction that has allowed achievements, highlighting Cruzeta, in the Seridó in the state of Rio Grande do Norte, semi-arid northeast, in the national and international juncture of well-successful experiences in management in institutional categories and leadership. This study becomes relevant to allow understand that the cultural practices of seridoenses that symbolize a capital generated by principles of trust, reciprocity, civic culture, as a driving force in overcoming the problems community and the conquest of democratic principles, worked for the school become a national reference in educational administration. Another aspect that made it natural that school was the collective creation of educational project with the participation and civic culture of self-evaluation as a way to understand the institutional practice and establish guidelines to improve the teaching and practice management in its many dimensions educational, social, administrative - financial and legal

Bolton freeware: aplicativo de avaliação de discrepância de massa dentária desenvolvido pelo programa de pós-graduação em odontologia/UFRN

The calculation of tooth mass discrepancy, essential for good planning and a proper orthodontic finishing, when performed manually, besides being laborious, requires considerable time consumption. The aim of this study was to develop and test Bolton Freeware, a software for analysis of the tooth mass discrepancy of Bolton, aiming to minimize the consumption of time in a less onerous way. The digital analysis of the software was done by means of two-dimensional scanning of plaster study models and compared to manual evaluation (gold standard), using 75 pairs of stone plaster study models divided into two groups according to the magnitude of the Curve of Spee (group I from 0 to 2 mm, group II greater than 2 to 3mm). All the models had permanent dentition and were in perfect condition. The manual evaluation was performed with a digital caliper and a calculator, and the time required to perform the analysis for both methods was recorded and compared. In addition, the software was evaluated by orthodontists regarding its use, by means of questionnaires developed specifically for this purpose. Calibration was performed prior to manual analysis, and excellent levels of inter-rater agreement were achieved, with ICC > 0.75 and r > 0.9 for total and anterior proportion. It was observed in the evaluation of error of the digital method that some teeth showed a significant systematic error, being the highest measured at 0.08 mm. The analysis of total tooth mass discrepancy performed by Bolton Freeware, for those cases in which the curve of Spee is mild and moderate, differ from manual analysis, on average, 0.09 mm and 0.07 mm respectively, for each tooth evaluated, with r> 0, 8 for total and anterior proportion. According to the specificity and sensitivity test, Bolton Freeware has an improved ability to detect true negatives, i.e. the presence of discrepancy. The Bolton analysis digitally performed was faster, with an average difference of time consumed to perform the analysis of Bolton between the two methods of approximately 6 minutes. Most experts interviewed (93%) approved the usability of the software

O significado para o enfermeiro do processo de trabalho na UTIS de um hospital universitário do estado de São Paulo

Pós-graduação em Enfermagem (mestrado profissional) - FMB

Meaning of the Systematization of Nursing Care for nurse managers

OBJETIVO:Compreender o significado que os enfermeiros gerentes atribuem à sistematização da assistência de enfermagem, desenvolvido em seu cotidiano de trabalho.MÉTODOS:Método fenomenológico, referencial da estrutura do fenômeno situado. Os sujeitos foram treze enfermeiros, gerentes de um hospital universitário. A análise incluiu transcrição e leituras dos depoimentos visando a essência por meio da tematização, interpretação e a síntese do fenômeno.RESULTADOS:As categorias temáticas foram: recursos humanos na realização da sistematização da assistência de enfermagem; sua relevância para o trabalho do enfermeiro; dificuldades na sua implementação; capacitação para a sua realização.CONCLUSÃO:O significado que os enfermeiros gerentes atribuem à sistematização da assistência de enfermagem relacionam-se aos aspectos legais da prática profissional, ao trabalho em equipe, ao dimensionamento adequado de recursos humanos.

The reasons of the nursing staff to notify adverse events

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Informatização do consultório odontológico

Dental software allow for a practical management of clinical and administrative tasks of the dental office. The aim of this study was to correlate different software (ProDent, Is-Odonto, ExDental, DentalPro, Dental Office, Dental Clinic, Dentalis, EasyDental), through research in specialized sites on the internet, enumerating their advantages and disadvantages. Due to the variety of software in the market, the dentist should be aware of some aspects such as: friendliness of use, presence of a calendar base and administrative controls, storage of treatments and images, broader coverage of the dentist competency, direct contact with software developers, and the pertinent ethical issues.

Avaliação do bandeamento cromossômico por digestão enzimática e tratamento com solução tampão citratado

Pós-graduação em Pesquisa e Desenvolvimento (Biotecnologia Médica) - FMB

Estratégias de sustentabilidade na prática odontológica

Dentists have widely discussed environmental issues with a view to the implementation of sustainability strategies in dental practice. It is unacceptable the practice of dentistry today as merely the solution of dental problems. The Dentist has a social responsibility to incorporate into your daily work concrete actions to reduce the impact of its production process. The purpose of this study is to characterize the development and application of performanceoriented model of social responsibility in dental practice, built to preserve the environmental cause in dentistry in order to trace change scenario that allows the environmental management without compromising the quality of services offered.

THE INTERNATIONAL CLASSIFICATION OF PUBLIC HEALTH NURSING PRACTICES - CIPESC (R): A PEDAGOGICAL TOOL FOR EPIDEMIOLOGICAL STUDIES

The CIPESC (R) is a tool that informs the work of nurses in Public Health and assists in prioritizing their care in practice, management and research. It is also a powerful pedagogical instrument for the qualification of nurses within the Brazilian healthcare system. In the teaching of infectious diseases, using the CIPESC (R) assists in analyzing the interventions by encouraging clinical and epidemiological thinking regarding the health-illness process. With the purpose in mind of developing resources for teaching undergraduate nursing students and encouraging reflection regarding the process of nursing work, this article presents an experimental application of CIPESC (R), using meningococcal meningitis as an example.

Percepção do médico sobre pagamento por desempenho no gerenciamento de doenças cardiovasculares: o caso de uma operadora de plano de saúde

Desde os anos 50, os fatores de risco para as doenças cardiovasculares passaram a ser valorizados. O gerenciamento de doenças cardiovasculares (PGC) busca a construção da autonomia e melhoria da qualidade de vida dos pacientes. Em alguns países, para alcançar esses objetivos, tem sido apontada a utilização de programas de pagamento por desempenho (PPP) aos médicos como um dos elementos de melhoria nos processos e nos resultados dos pacientes e na condição de remuneração. O objetivo deste estudo é analisar o ponto de vista dos médicos sobre a implantação dos pagamentos por desempenho vinculados ao PGC em uma operadora de plano de saúde. Trata-se de investigação de caráter qualitativo, do tipo estudo de caso, apresentando entrevistas semiestruturadas com médicos participantes ou não do PGC, em setembro de 2009, tendo como referência as ações implantadas em 2008. Foram entrevistados 23 médicos (14 homens e 09 mulheres). Como resultado foi observado que o incentivo financeiro é reconhecido pelos médicos como importante, mas não determinante da inclusão de pacientes no PGC. O principal motivo apresentado foi a organização do cuidado, no qual o paciente é mais bem acompanhado e controlado, e o trabalho médico, avaliado segundo parâmetros preestabelecidos. O PGC e o PPP têm potencial de transformação do cuidado em saúde. O trabalho multidisciplinar e a maior produtividade nos atendimentos no consultório foram os principais efeitos positivos identificados. Outros estudos são necessários para acompanhar a evolução e os efeitos do pagamento por desempenho no trabalho médico.

Development of Clinical Decision Support Systems based on Mathematical Models of Physiological Systems

In the last years of research, I focused my studies on different physiological problems. Together with my supervisors, I developed/improved different mathematical models in order to create valid tools useful for a better understanding of important clinical issues. The aim of all this work is to develop tools for learning and understanding cardiac and cerebrovascular physiology as well as pathology, generating research questions and developing clinical decision support systems useful for intensive care unit patients. I. ICP-model Designed for Medical Education We developed a comprehensive cerebral blood flow and intracranial pressure model to simulate and study the complex interactions in cerebrovascular dynamics caused by multiple simultaneous alterations, including normal and abnormal functional states of auto-regulation of the brain. Individual published equations (derived from prior animal and human studies) were implemented into a comprehensive simulation program. Included in the normal physiological modelling was: intracranial pressure, cerebral blood flow, blood pressure, and carbon dioxide (CO2) partial pressure. We also added external and pathological perturbations, such as head up position and intracranial haemorrhage. The model performed clinically realistically given inputs of published traumatized patients, and cases encountered by clinicians. The pulsatile nature of the output graphics was easy for clinicians to interpret. The manoeuvres simulated include changes of basic physiological inputs (e.g. blood pressure, central venous pressure, CO2 tension, head up position, and respiratory effects on vascular pressures) as well as pathological inputs (e.g. acute intracranial bleeding, and obstruction of cerebrospinal outflow). Based on the results, we believe the model would be useful to teach complex relationships of brain haemodynamics and study clinical research questions such as the optimal head-up position, the effects of intracranial haemorrhage on cerebral haemodynamics, as well as the best CO2 concentration to reach the optimal compromise between intracranial pressure and perfusion. We believe this model would be useful for both beginners and advanced learners. It could be used by practicing clinicians to model individual patients (entering the effects of needed clinical manipulations, and then running the model to test for optimal combinations of therapeutic manoeuvres). II. A Heterogeneous Cerebrovascular Mathematical Model Cerebrovascular pathologies are extremely complex, due to the multitude of factors acting simultaneously on cerebral haemodynamics. In this work, the mathematical model of cerebral haemodynamics and intracranial pressure dynamics, described in the point I, is extended to account for heterogeneity in cerebral blood flow. The model includes the Circle of Willis, six regional districts independently regulated by autoregulation and CO2 reactivity, distal cortical anastomoses, venous circulation, the cerebrospinal fluid circulation, and the intracranial pressure-volume relationship. Results agree with data in the literature and highlight the existence of a monotonic relationship between transient hyperemic response and the autoregulation gain. During unilateral internal carotid artery stenosis, local blood flow regulation is progressively lost in the ipsilateral territory with the presence of a steal phenomenon, while the anterior communicating artery plays the major role to redistribute the available blood flow. Conversely, distal collateral circulation plays a major role during unilateral occlusion of the middle cerebral artery. In conclusion, the model is able to reproduce several different pathological conditions characterized by heterogeneity in cerebrovascular haemodynamics and can not only explain generalized results in terms of physiological mechanisms involved, but also, by individualizing parameters, may represent a valuable tool to help with difficult clinical decisions. III. Effect of Cushing Response on Systemic Arterial Pressure. During cerebral hypoxic conditions, the sympathetic system causes an increase in arterial pressure (Cushing response), creating a link between the cerebral and the systemic circulation. This work investigates the complex relationships among cerebrovascular dynamics, intracranial pressure, Cushing response, and short-term systemic regulation, during plateau waves, by means of an original mathematical model. The model incorporates the pulsating heart, the pulmonary circulation and the systemic circulation, with an accurate description of the cerebral circulation and the intracranial pressure dynamics (same model as in the first paragraph). Various regulatory mechanisms are included: cerebral autoregulation, local blood flow control by oxygen (O2) and/or CO2 changes, sympathetic and vagal regulation of cardiovascular parameters by several reflex mechanisms (chemoreceptors, lung-stretch receptors, baroreceptors). The Cushing response has been described assuming a dramatic increase in sympathetic activity to vessels during a fall in brain O2 delivery. With this assumption, the model is able to simulate the cardiovascular effects experimentally observed when intracranial pressure is artificially elevated and maintained at constant level (arterial pressure increase and bradicardia). According to the model, these effects arise from the interaction between the Cushing response and the baroreflex response (secondary to arterial pressure increase). Then, patients with severe head injury have been simulated by reducing intracranial compliance and cerebrospinal fluid reabsorption. With these changes, oscillations with plateau waves developed. In these conditions, model results indicate that the Cushing response may have both positive effects, reducing the duration of the plateau phase via an increase in cerebral perfusion pressure, and negative effects, increasing the intracranial pressure plateau level, with a risk of greater compression of the cerebral vessels. This model may be of value to assist clinicians in finding the balance between clinical benefits of the Cushing response and its shortcomings. IV. Comprehensive Cardiopulmonary Simulation Model for the Analysis of Hypercapnic Respiratory Failure We developed a new comprehensive cardiopulmonary model that takes into account the mutual interactions between the cardiovascular and the respiratory systems along with their short-term regulatory mechanisms. The model includes the heart, systemic and pulmonary circulations, lung mechanics, gas exchange and transport equations, and cardio-ventilatory control. Results show good agreement with published patient data in case of normoxic and hyperoxic hypercapnia simulations. In particular, simulations predict a moderate increase in mean systemic arterial pressure and heart rate, with almost no change in cardiac output, paralleled by a relevant increase in minute ventilation, tidal volume and respiratory rate. The model can represent a valid tool for clinical practice and medical research, providing an alternative way to experience-based clinical decisions. In conclusion, models are not only capable of summarizing current knowledge, but also identifying missing knowledge. In the former case they can serve as training aids for teaching the operation of complex systems, especially if the model can be used to demonstrate the outcome of experiments. In the latter case they generate experiments to be performed to gather the missing data.