Sistematização da assistência de enfermagem (SAE) em um hospital pediátrico de ensino: uma pesquisa-ação

The incessant search if nurse for qualify nursing care makes the Nursing Assistance Systematization, a current topic of discussion throughout the country, not only in order to comply the legal requirements of their practice, but especially by the expected benefits of its application. In this meaning, this research had a qualitative approach, developed for a way of research-action. The general purpose was to analyze the change in the nursing practices in a pediatric teaching hospital, based on construction and implementation of Nursing Assistance Systematization by the nursing team. The results had the thematic analysis of Paulo Freire and were shown in the form of reports. To achieve these purposes, it began by steps pre-trial, to review the charts of the institution and an approach with the managers. In the situational diagnosis of nursing practices without the systematization followed by applying a questionnaire with a nursing team and a focal group with nurses. These ways supported the implementation stage of the Nursing Assistance Systematization which developed actions associate such as focal group with the nurses about the nursing history, capacity with the nursing team about the Nursing Assistance Systematization, development, application and reworking of printed, and discussions in the small groups. The evaluations of the changes after the actions of the research occurred through individual interview with the nurses, to check the results. The charts review confirmed the deficit in the records performed by the nurse on the chart, which reinforced the need for implementation of Nursing Assistance Systematization, an argument used on the meeting with the managers, who promptly agree with the search. The questionnaire and the focal group with the nurses reveal a process of nursing work without systematization, showing gaps in practices, but also obtained relate of expectations of improvements in quality of care as of Nursing Assistance Systematization, furnishing data to the development of ways following-up. The prints were gradually used and modified as the team understood the Nursing Assistance Systematization and its purposes through capacity course. The final evaluation pointed to the partial implementation of the stages of Nursing Assistance Systematization had been institutionalized at the history and the development of nursing, beyond difficulties with diagnosis and prescription of nursing, in later representing a paradigm shift. This search collaborated to change the view about the Nursing Assistance Systematization by nursing team at the institution had been revealed through introduction of new practices in the process of nursing work, as examination of physical exam of the patient, the interview in the admission of customers on service and the daily monitoring by nursing through development of nursing. Before addition, it was noted which the purposes of this search were achieved, since were analyzed the changes in the nursing practices with the systematization. The research-action achieved proposes of the involvement of nursing team in changing their practices. This search contributed to the implementation of the Nursing Assistance Systematization in a pediatric teaching hospital and showed which is possible to seek resolution of problems when the objective is of the group and gave access for further searches within this theme

Registro de enfermagem no prontuário em um hospital universitário: uma busca pela humanização do cuidado

T he aim of this study is to analyze the view of nurses about nursing records in the patient chart, in perspective of the record of humanized care. This is a case study, with qualitative approach. For its achievement, was sought and granted authorization from the direction of the Hospital Universitário Onofre Lopes (HUOL) and the Ethics Committee in Research of HUOL as Statement No. 422/10. During data collection, interviews were conducted with 20 nurses of the institution. The data analysis was based on the theoretical framework of Minayo to thematic content analysis, grounded in authors who work with themes, nursing records and quality care. With the empirical material, we constructed a framework of analysis, which was identified four categories thus nominated, "Reading and learning from those who register," "nursing records and quality of care," "the essence of nursing records" and "intention and action on the record of the subjective aspects of the patient." The results show that the records are insufficient, even in the case of the procedures performed with the patients often do not inform about the aspects that deal with the subjectivity that surround it, and admit that the records do not represent a parameter for evaluating the quality of care at least at that institution. In summary, the respondents recognize the importance of valuing subjectivity of the patient in their treatment, yet admit to neglect this aspect as significant for comprehensive health care, humane and quality

O processo de cuidar em Unidade de Terapia Intensiva

The environment of Intensive Care Unit (ICU) is commonly referred to as a place where caring is inextricably linked to high technology. The care in ICU often changes the patient into a taxpayer being left apart from its complexity and sometimes seen through a reductionist perspective. Thus, studies circa the care process are needed oriented from a historical ransom, raising the prospect of a more centralized human care. Hence, this study aimed to analyze the care process in a nursing intensive care unit from the perspective of the professional, family and patients. The study is characterized from a qualitative, descriptive and exploratory methodological approach. The actors were participating nursing professionals, patients and family members of an intensive care unit of Mossoró / RN. Data were collected in the period of May-June 2011, through interviews and observation of activities performed by nursing professionals, and their records in the chart. Data analysis was divided into topics and subtopics representing the phases and shapes that formed the collection. The analysis and discussion of the interviews were based on Bardin's proposal, when we created categories from a process of sorting and grouping criteria adequately defined. The observation of nursing records intended to observe the emphasis which is described in those notes as well as their consistency with practice of FCN and resolution 358/2009. The analysis showed that the nursing staff also performs work focused on mechanized activities and technical-bureaucratic institution that seem to override the needs of patients. In an overview, the care provided by professionals occurs either fragmented or insipient, however there is a service that involves other aspects beyond technical-curative practice, considering that major attention is given to the family and patient, focused on the concern of Nursing guiding their actions in not only the performance of procedures. However, the process of humanizing not always ends with an engagement between professional and patient, which mischaracterizes the true meaning of human care. The records also showed a tendency to focus on caring in a positivist line, where, in most cases, the factors of the disease and the obligation to meet the productivity have overshadowed other relevant aspects to a holistic understanding of caring. Regarding FCN Resolution No. 358/2009, which guides a systematization of nursing care, it is confirmed a technical view, a fragmented and superficial view of the patient, as well as a weakness of care, caused by ignorance and unpreparedness of the entire team. The perspective of caring demonstrates a reality with dialectic between what is proposed in a humane nursing and what happens in this performance space. Besides, it was shown a daily full of important considerations that arise in professional practice, in their views and also those people who were participants in the process

Utilização do controle estatístico do processo para monitoramento do peso médio de cápsulas de Tuberculostáticos: estudo de caso no NUPLAM- RN

This Master Thesis presents a case study on the use of Statistical Process Control (SPC) at the Núcleo de Pesquisas em Alimentos e Medicamentos (NUPLAM). The SPC basic tools have been applied in the process of the tuberculostáticos drugs encapsulation, primarily concerning the objective to choose, between two speeds, which one is the best one to perform the tuberculostatics encapsulation. Later on, with the company effectively operating, the SPC was applied intending to know the variability of the process and, through the tracking of the process itself, to arrive at an estimated limit for the control of future lots of tuberculostatics of equal dosage. As special causes were detected acting in the process, a cause-and-effect diagram was built in order to try to discover, in each factor that composes the productive process, the possible causes of variation of the capsules average weight. The hypotheses raised will be able to serve as a base for deepened the study to eliminate or reduce these interferences in the process. Also a study on the capacity of the process to attend the specifications was carried out, and this study has shown the process´s inaptitude to take care of them. However, on the side of NUPLAM exists a real yearning to implant the SPC and consequently to improve the existing quality already present on its medicines

Controle on-line por atributos para o número de não-conformidades no item inspecionado com base em uma sequência de inspeção

This paper proposes a procedure to control on-line processes for attributes, using an Shewhart control chart with two control limits (warning limit and control limit) and will be based on a sequence of inspection (h). The inspection procedure is based on Taguchi et al. (1989), in which to inspect the item, if the number of non-conformities is higher than an upper control limit, the process needs to be stopped and some adjustment is required; and, if the last inspection h, from all items inspected present a number of non-conformities between the control limit and warning limit. The items inspected will suffer destructive inspection, being discarded after inspection. Properties of an ergodic Markov chain are used to get the expression of average cost per item and the aim was the determination of four optimized parameters: the sampling interval of the inspections (m); the constant W to draw the warning limit (W); the constant C to draw the control limit (C), where W £ C, and the length of sequence of inspections (h). Numerical examples illustrate the proposed procedure

Dimensional analysis of soil properties after treatment with the rotary paraplow, a new conservationist tillage tool

This study examined a new conservation tillage tool, the rotary paraplow. Emphasis was placed on evaluating the tool's conservation potential using dimensionless graph analysis. The dynamic conditions of the soil were investigated in terms of physical soil properties. Having determined the variables to be measured, dimensional analysis was used to plan the experiments. Two variations were considered for each dependent variable (linear speed, working depth, and rotation velocity), totaling eight treatments, allotting in each an experimental strip with five data collection points. This arrangement totaled 16 experimental strips, with 80 data collection points for all variables. The rotary paraplow generates a trapezoidal furrow for planting with a very wide bottom and narrower at the top. The volumetric subsoiling action generates cracks on the sides of the band. Because of their specific geometry the blades of rotary paraplow generate a soil failure according to its natural crack angle, optimizing the energy use, while preserving the natural soil properties. Results showed the conservation character of the rotary paraplow, capable of breaking up clods for planting without changing the original physical soil properties.

Uso de técnicas de Geoprocessamento e Sensoriamento Remoto no levantamento e integração de dados necessários a gestão ambiental dos campos de extração de óleo e gás do Canto do Amaro e Alto da Pedra no município de Mossoró - RN

The objective of this work is to identify, to chart and to explain the evolution of the soil occupation and the envirionment vulnerability of the areas of Canto do Amaro and Alto da Pedra, in the city of Mossoró-RN, having as base analyzes it multiweather of images of orbital remote sensors, the accomplishment of extensive integrated works of field to a Geographic Information System (GIS). With the use of inserted techniques of it analyzes space inserted in a (GIS), and related with the interpretation and analyzes of products that comes from the Remote Sensoriamento (RS.), make possible resulted significant to reach the objectives of this works. Having as support for the management of the information, the data set gotten of the most varied sources and stored in digital environment, it comes to constitute the geographic data base of this research. The previous knowledge of the spectral behavior of the natural or artificial targets, and the use of algorithms of Processing of Digital images (DIP), it facilitates the interpretation task sufficiently and searchs of new information on the spectral level. Use as background these data, was generated a varied thematic cartography was: Maps of Geology, Geomorfológicals Units soils, Vegetation and Use and Occupation of the soil. The crossing in environment SIG, of the above-mentioned maps, generated the maps of Natural and Vulnerability envirionmental of the petroliferous fields of I Canto do Amaro and Alto da Pedra-RN, working in an ambient centered in the management of waters and solid residuos, as well as the analysis of the spatial data, making possible then a more complex analysis of the studied area

Avaliação de lesões brancas de cáries: um estudo de prognóstico

Objective: The aim of the present study is to assess the current situation of white enamel lesions on vestibular surfaces of permanent upper incisors, diagnosed 6 years ago, without clinical intervention. Methods: A prospective study reassessed 53 students of both sexes, aged between 13 and 18 years old, all attending the public school system in Natal, Brazil. Data collection was performed by duly calibrated examiners, and a clinical chart consisting of demographic data on dental caries, oral hygiene, and gingival condition was prepared. A tactile-visual examination was conducted using a clinical mirror and periodontal probe. Data compilation and analysis were carried out using a SPSS software. In this analysis the chi-squared test was used for qualitative independent variables. To identify the net effect of treatment, multiple logistic analysis with forward stepwise model selection was performed. Results: The final sample was composed of 106 lesions in the 53 individuals, with mean age of 15.02 years, visible plaque index (VPI) of 23.34%, and gingival blood indices (GBI) of 25.92%. A statistically significant relationship (p = 0.003) was found between initial DMFS and prognosis of white enamel lesion. Conclusions: We observed that past caries experience and dental plaque were the main predictive factors for negative lesion outcomes, demonstrating the need for oral hygiene control through continuing preventive measures

Escolha de parceiros na adolescência

Mate choice is a component of sexual selection. Trying to understand the patterns of this process, several studies have emphasized the adaptive value of sexual differences and their influence on the assessment of the market value. The pattern for adults presented on the scientific literature, which is based on the preference for certain characteristics, shows that men search a partner who shows high value of fecundity and fertility, thus looking for partners with the ability of being pregnant and nursing their offspring. On the other hand, women look for partners with high socioeconomic status, which is strongly associated with the ability to protect and provide resources for them and their offspring. Surprisingly, there is few works that investigated the mate choice patterns during the beginning of the period of sexual differentiation on the morphological, physiological and behavioral traits. The aim of this study was to investigate mate choice patterns in adolescence in order to describe their preferences and contribute to the understanding of human reproductive behavior. Took part of this research 1,232 students from educational institutions of Natal, Brazil, and visitors to the Scientific, Technological and Cultural Fair UFRN. In the Experimental Study 1, we applied a questionnaire to evaluate the importance of certain characteristics, assessed the degree of romantic involvement and real and ideal partners age preference. In the Experimental Study 2, we did a survey of characteristics considered relevant and evaluate the importance of these characteristics in mate choice. The Experimental Study 3 brought an investigation of mate choice patterns based on self-assessment of adolescents, evaluating ideal partner for a short-term and long-term relationships and actual partner. We found that adolescents are motivated to live romantic experiences. We also observed a preference for partners of similar age to that described for adults. Finally, we found similarities and differences in the preferences for characteristics in real and ideal partners in relation to the adult pattern. In addition, we observed high similarity on the self-assessment and assessment of real and ideal partners. We suggest that in the mate choice, adolescents are similar to young adults in some aspects but not all. Our results show the relevance of the reproductive behavior investigation in this human developmental period and reinforce that further studies should contribute to the understanding of human behavior in terms of ontogenetic development and their evolutionary history.

Fatores que influenciam a cooperação em humanos

Human cooperation is fundamentally affected by reciprocal exchange, but it is also remarkably common on the context of large and symbolically marked in-groups, which promote cooperation through the feeling of belonging to a group. In this thesis, two empirical articles were produced in order to investigate how human cooperation is affected by factors such as reciprocity, in-group behavior, in-group markers and gender. We investigated this subject through the administration of online games consisting of token donations, on which the subjects faced virtual players controlled by the experiment. We found that cooperative behavior is strongly influenced by reciprocity, and it is also affected by the in-group behavior, observed on the context of the social variables place of birth, ethnicity, and religions, once all of them acted as in-group markers. The subjects´ in-group behavior was enhanced when they played with generous in-group opponents, but weakened when their in-group opponents were non-generous. It was also found that cooperation is not affected by gender, but men and women cooperated in different ways under the influence of reciprocity and in-group behavior. Women are much more reciprocal on their cooperative behavior and men are less willing to cooperate with outgroupers, even when they act generously. The overall results contribute to a better understanding of the adaptive value of cooperation, reciprocity and in-group behavior on the solution of important challenges through the human evolutionary history

Ausência do pai ao longo do desenvolvimento ontogenético e indicadores de desconto de futuro: uma contribuição da psicologia evolucionista

The new Evolutionary Psychology (E. P.) paradigm has been trying to understand how the human beings make their decisions over time regarding the most diverse variables, always bearing in mind that such a cognitive process is due to a complex natural selection process that occurred millions of years ago. One of the main topics discussed by this new paradigm is the issue of parental investment, i.e., the care the parents provide to an offspring at the expense of the investment into a new one. The present work sought to integrate these two topics, trying to understand how some variables modulate the process of decision making in a sample of the city of Natal, Rio Grande do Norte state. It was investigated the hypothesis that the presence of both parents, along the individual development, could signal a more favorable environment, providing clues to the individual that he could assume a competitive position at the socio-biological market. His decisions, therefore, could be guided by long-term investments with aims to obtain more robust rewards. On the contrary, those who has suffered for some moment the absence of one the parents could develop theirselves in a not so competitive way, starting to choose immediate benefits - but lesser ones -, since the future would be less predictable due to their worse development conditions. This study involved 152 individuals from three higher education institutions, one of them being public and the others being private ones. In the results found, there was no difference between children of coupled parents and children of deceased or divorced parents concerning discount rates. The levels of hopelessness did not affect the discount rates of children of single parents when compared to children of coupled parents. Not having one of the parents because of divorce made the child to tend to present lower scores in the domain of social relations of WHOQOL - Bref, whilst the absence of the father by death made the scores lower in the domain of environment. The results indicate that loosing one of the parents along the development influences the individual's quality of life perception, but the measurement method of future discounting rates by means of financial choices is not sensitive to this variation

A relação de amizade nas redes sociais de estudantes universitários de Natal/RN

The basis of sociability in humans is based on cooperation. The relationship of friendship is vital to the social, emotional and cognitive development of an individual and can be understood as a consequence of selection for reciprocal altruism in humans. The period of adulthood is considered very suitable and appropriate for the investigation of the relations of friendship, but the Brazilian literature on friendship in adults is still nascent. Therefore, the objective was to characterize the relationship of friendship among college students. The study gathered 500 students from higher education institutions in the city of Natal-RN, Brazil, and 250 women (average age 24.1 ± 7.66 years) and 250 men (mean age 26.77 ± 9.64 years). Two questionnaires anonymously and individual were applied: a sociodemographic questionnaire and the other with the desired characteristics in idealized friends. Study 1 assessed the degree of importance of characteristics in the process of choosing a friend of the same sex and opposite sex of the participant. Study 2 investigated the relationship between patterns of idealization of friends and self-assessment of participants. Overall, were the preferred characteristics "Companionship" and "Sincerity" to idealized friends. We also found the influence of sex on the characteristics attributed to an female ideal friend, with emphasis on men for "Beauty/Good looks" and "Intelligence" and women to "Companionship" and "Sincerity". Finally, we observed a positive correlation between participants' self-assessment and preferences for the characteristics of the friends devised. This study revealed important elements for understanding the relationship of friendship, specifically the process of choosing friends. The results reinforce the importance of studying the relationship of friendship to a better understanding of human social behavior.

Influência da densidade de estocagem sobre o crescimento, ciclo de muda e o comportamento em juvenis do camarão marinho Litopenaeus vannamei

One of the factors that may interfere with the cultivation of Litopenaeus vannamei is the population density. This study aimed to assess the effect of density on growth, mortality, physical integrity and behavior of shrimp. The study was divided into two stages. At first, the shrimp were placed in tanks at densities of 50, 75 and 100 shrimp m-2. The animals were monitored in relation to the degree of proventricular filling, the stage of the molt cycle and physical integrity three times a week and in relation to the weight and length once a week. Mortality, growth and proventricular filling were not influenced by the density; frequency of records in specific stages of the molt cycle varied according to the density. The lower proportion of broken appendages and higher frequency of necrotic lesions occurred in lower density. The second stage of the research, conducted in aquaria, was divided into two parts. The first described social or feeding behavioral categories: slow displacement by contact, slow displacement by approximation, abrupt displacement by contact, abrupt displacement by approximation, reactivity, cannibalism, occupying the tray, get feed in the tray and get feed outside the tray. In the second part, these and other behavioral categories, described in the literature, were recorded in densities of 50, 75 and 100 shrimp m-2. Mortality was more frequent in higher density. The frequency of most behaviors mentioned above was very low, not differing between densities or being too low to determine differences between them. The behavioral profile of animals in different densities was, in general, very similar, with no difference in exploration, digging and cleaning between the densities. Even so, inactivity, feeding, crawling, burrowing, swimming, and proximity between animals were influenced by the density. These results suggest that some behaviors suffer greater interference from population density. However, the density may not have a broader influence on the animals when other factors, such as physico-chemical parameters of water and feed offering, are adequate

Lógica por trás dos contratos sociais

Natural selection shapes body and behavior of each species. For primates, the social environment constituted one of the greatest selective pressure for the development of their cognition. When we consider gender differences, we see that sexual selection also operates through different selective pressures for men and women not only in physical terms but in terms of cognitive skills. Among these, the primary cognitive abilities - that emerge naturally - and secondary - that rely on an artificial environment for learning - develop differently for each sex, making them suitable for specific tasks in different capacities. Previous studies utilized the Wason Selection Test a conditional logic tool - to measure, among several other things, the ability to recognize violation of rules in abstract contexts and social contexts. Subjects generally had better performance in the latter, however, in these studies possible differences motivated by learning in formal logic or genre were not considered. Our study investigated these two variables, as well as the time spent to solve each task. Furthermore, we used an index to take into account the rights and wrongs of the participants in tasks. We realized that although learning in formal logic does not bring significant differences in solving tests, the gender differences are strongly observed when we consider the social contexts and abstract. Women perform better in social tasks. This can be explained due to different sexual selective pressures for this gender in terms of one-on-one relationships within the group. Men are better at tasks of abstract context and this is probably due to the same reason. Their capabilities for territory defense, habitat navigation and forming coalitions depends on primary cognitive abilities that support secondary cognitive skills of abstraction. Thus, gender differences are a factor to be taken into account in controlling future experiments with the same tool

Amor como medida de satisfação marital

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