Idoneidade formativa dos campos de prática clínica - caso particular de uma unidade de saúde personalizada

A Ordem dos Enfermeiros (OE) aprovou em Assembleia Geral de 2007 uma proposta de alteração estatutária em termos de regulação e desenvolvimento profissional. Surge assim o Modelo de Desenvolvimento Profissional (MDP) que traz uma nova dimensão à certificação de competências de enfermeiro e enfermeiro especialista. Se até aqui a OE certificava estas competências a partir dos documentos académicos apresentados, a partir desta alteração a certificação passa por uma prática tutelada de exercício profissional e só depois de dará a atribuição do título profissional. O Exercício Profissional Tutelado (EPT) só poderá ocorrer em serviços de saúde com idoneidade formativa acreditada pela OE. Para determinar esta idoneidade formativa dos contextos de prática clínica de enfermagem, é construído um referencial, que parte do documento “Padrões de Qualidade dos Cuidados de Enfermagem”, tendo como eixo organizador o enunciado descritivo sobre “A organização dos cuidados de enfermagem”. Este trabalho reflete o estágio realizado num contexto de prática clínica (Unidade de Cuidados de Saúde Personalizados) onde foi feita uma avaliação em termos de idoneidade formativa. De Abril a Junho de 2011 foi feita observação documental e da prática de enfermagem, aplicada uma grelha de avaliação de idoneidade formativa e entrevistado o enfermeiro chefe. Os resultados apresentados são de não evidência de idoneidade formativa, após o que se tentou estabelecer um Plano de Acção, para cumprimento dos critérios estabelecidos para a certificação. Com base no mesmo enunciado, a organização dos cuidados de enfermagem, foram delineadas algumas intervenções que, a seu tempo, poderão certificar esta unidade para a prática do exercício profissional tutelado. Destacamos o necessário envolvimento de todos os elementos de enfermagem, com uma condução de liderança forte e motivadora, no sentido criar um contexto de prática clínica congruente com as orientações da OE para a certificação e, em simultâneo, melhorar a qualidade dos cuidados de enfermagem prestados.

Acesso à alimentação como direito social no Brasil : implicações para a sociedade e para o sistema nacional de informações

A Emenda Constitucional 64/2010 garantiu Direito Humano à Alimentação como direito básico e social, alterando o Artigo 6º da Constituição Federal. O artigo analisa as significativas implicações desta alteração na gestão das políticas públicas brasileiras Ao assegurar o Direito à Alimentação como direito básico e social, a Carta constituiu um dever, ou uma obrigação positiva do Estado brasileiro. O artigo discute também o significado desta mudança para o sistema brasileiro de informações, argumentando que já existem fontes de dados e sistema de indicadores construídos para o monitoramento consistente das situações de (in)segurança alimentar e nutricional no país, restando agora ao governo federal e aos gestores do Sistema Brasileiro de Informações Estatísticas e Geográficas definir a regularidade e a frequência da aplicação e divulgação destes instrumentos. Nossa atenção se concentrará basicamente nas possibilidades de uso da Pesquisa de Orçamentos Familiares e da Pesquisa Nacional por Amostra Domiciliar como fontes de dados. _______________________________________________________________________________ ABSTRACT

Chemical changes and heavy metal partitioning in an oxisol cultivated with maize (Zea mays, L.) after 5 years disposal of a domestic and an industrial sewage sludge.

The need for solutions to minimize the negative environmental impacts of anthropogenic activities Fhas increased. Sewage sludge is composed of predominantly organic matter and can be used to improve soil characteristics, such as fertility. Therefore, its application in agriculture is an adequate alternative for its final disposal. However, there is a lack of information on its long-term effects on soil changes in tropical areas. Thus, the objectives of this study were to determine (i) the effect of sewage sludge application on heavy metal build-up in soil and maize grains and leaves, and (ii) the effects of soil amendment with sewage sludge on the chemical properties of a Brazilian oxisol. Besides the increasing levels of Zn, Cu, Ni, and Cr, amending soil with sewage sludge also alters the distribution of these metals by increasing the mobile Phases, which correlated significantly with the increase in metal extraction with two single extractants, Mehlich 1 and DTPA (Diethylene triamine pentaacetic acid). The levels of Fe, Mn, Zn, and Cu in maize grains and leaves increased with the type and rate of sewage sludge application. Nevertheless, metal build-up in soil and plants was within the allowed limits. Significant differences were also found in soil characteristics like humic fractionation with the applied sewage doses. The data obtained does not indicate any expressive drawbacks in the use of sewage sludge as a soil amendment, as the heavy metal concentrations observed are unlikely to cause any environmental or health problems, even overestimated loadings, and are in accordance with the Brazilian regulations on farming land biosolid disposal.

Derechos colectivos de las y los servidores públicos al amparo de las Enmiendas Constitucionales de 2015

La Constitución de la República del Ecuador vigente desde el año 2008, reconoce y garantiza derechos para los ciudadanos domiciliados en el país, entre ellos trabajadores/as y servidoras y servidores públicos. En diciembre de 2015, la Asamblea Nacional del Ecuador, mediante el procedimiento de Enmienda Constitucional unificó el régimen laboral de las personas que prestan sus servicios laborales en las instituciones y organismos estatales, debiendo adecuarse la normativa legal y secundaria a esta modificación de la Carta Magna hasta junio de 2016. En el presente trabajo abordaremos en su primer capítulo antecedentes históricos del derecho al trabajo en general y la legislación histórica que ha regido en nuestro país. En el segundo capítulo nos centraremos en distinguir cuales son las características del régimen laboral público y del privado en Ecuador y realizaremos recomendaciones en relación a derechos individuales de los servidores públicos. En el tercer capítulo haremos referencia a los Convenios Internacionales de la OIT ratificados y no ratificados por nuestro país. En el cuarto capítulo estableceremos similitudes y diferencias entre las legislaciones regionales en razón del reconocimiento de derechos colectivos para servidores públicos. En el capítulo cinco detallaremos criterios doctrinarios sobre los derechos de ejercicio colectivo, es decir: huelga, convenio colectivo y sindicalización en el sector público para finalmente en el sexto y último capítulo dar recomendaciones para la inminente reforma a la Ley Orgánica de Servicio Público, LOSEP.

The influence of organic amendments on soil aggregate stability from semiarid sites

Restoring the native vegetation is the most effective way to regenerate soil health. Under these conditions, vegetation cover in areas having degraded soils may be better sustained if the soil is amended with an external source of organic matter. The addition of organic materials to soils also increases infiltration rates and reduces erosion rates; these factors contribute to an available water increment and a successful and sustainable land management. The goal of this study was to analyze the effect of various organic amendments on the aggregate stability of soils in afforested plots. An experimental paired-plot layout was established in southern of Spain (homogeneous slope gradient: 7.5%; aspect: N170). Five amendments were applied in an experimental set of plots: straw mulching; mulch with chipped branches of Aleppo Pine (Pinus halepensis L.); TerraCotten hydroabsobent polymers; sewage sludge; sheep manure and control. Plots were afforested following the same spatial pattern, and amendments were mixed with the soil at the rate 10 Mg ha-1. The vegetation was planted in a grid pattern with 0.5 m between plants in each plot. During the afforestation process the soil was tilled to 25 cm depth from the surface. Soil from the afforested plots was sampled in: i) 6 months post-afforestation; ii) 12 months post-afforestation; iii) 18 months post-afforestation; and iv) 24 months post-afforestation. The sampling strategy for each plot involved collection of 4 disturbed soil samples taken from the surface (0–10 cm depth). The stability of aggregates was measured by wet-sieving. Regarding to soil aggregate stability, the percentage of stable aggregates has increased slightly in all the treatments in relation to control. Specifically, the differences were recorded in the fraction of macroaggregates (≥ 0.250 mm). The largest increases have been associated with straw mulch, pinus mulch and sludge. Similar results have been registered for the soil organic carbon content. Independent of the soil management, after six months, no significant differences in microaggregates were found regarding to the control plots. These results showed an increase in the stability of the macroaggregates when soil is amended with sludge, pinus mulch and straw much. This fact has been due to an increase in the number cementing agents due to: (i) the application of pinus, straw and sludge had resulted in the release of carbohydrates to the soil; and thus (ii) it has favored the development of a protective vegetation cover, which has increased the number of roots in the soil and the organic contribution to it.

Measuring the Impact of Melaleuca quinquenervia Biochar Application on Soil Quality, Plant Growth, and Microbial Gas Flux

Biochar has been heralded a mechanism for carbon sequestration and an ideal amendment for improving soil quality. Melaleuca quinquenervia is an aggressive and wide-spread invasive species in Florida. The purpose of this research was to convert M. quinquenervia biomass into biochar and measure how application at two rates (2% or 5% wt/wt) impacts soil quality, plant growth, and microbial gas flux in a greenhouse experiment using Phaseolus vulgaris L. and local soil. Plant growth was measured using height, biomass weight, specific leaf area, and root-shoot ratio. Soil quality was evaluated according to nutrient content and water holding capacity. Microbial respiration, as carbon dioxide (CO2), was measured using gas chromatography. Biochar addition at 5% significantly reduced available soil nutrients, while 2% biochar application increased almost all nutrients. Plant biomass was highest in the control group, p2 flux decreased significantly in both biochar groups, but reductions were not long term.

Composting of different agro-food wastes: Effects of the phenolic and lignocellulosic fractions on greenhouse gases emissions

Currently, society faces a number of challenges related to the large amounts of organic wastes generated and accumulated by the increasing expansion of agroindustrial activities1. Most of these wastes are rich in lignocellulosic compounds, which represents a major fraction of all plant biomass (of above 90%), so, its degradation is crucial for global carbon cycle2. These organic wastes may be introduced directly on agriculture sector as soil organic amendment, however, these might contain phytochemicals, such as phenolic compounds which may introduce toxic effects to soil and to beneficial organisms. Transformation and degradation of these renewable organic wastes into composts (COMPOSTING) is a possible solution for these problems and an environmentally friendly processes that allows make use of natural resources efficiently3. The main potential handicap is generation and emission of greenhouse gases such as carbon dioxide (CO2 ), methane (CH4 ) and nitrous oxide (N2O) and another ones which may led serious problems like nitric oxide (NO) and ammonia (NH3) 4. For this reason, quantification of GHG emissions from composting and finding possible relations with the chemical and structural composition of the wastes used is crucial to the development of technologies for mitigating emissions and should help to make decisions concerning waste management.

Effects of charcoal-enriched goat manure on soil fertility parameters and growth of pearl millet (Pennisetum glaucum L.) in a sandy soil from northern Oman

The effect of charcoal feeding on manure quality and its subsequent application to enhance soil productivity has received little attention. The objectives of the present study therefore were to investigate the effects of (i) charcoal feeding on manure composition, and (ii) charcoal-enriched manure application on soil fertility parameters and growth of millet (Pennisetum glaucum L.). To this end, two experiments were conducted: First, a goat feeding trial where goats were fed increasing levels of activated charcoal (AC; 0, 3, 5, 7, and 9% of total ration); second, a greenhouse pot experiment using the manure from the feeding trial as an amendment for a sandy soil from northern Oman. We measured manure C, N, P, and K concentrations, soil fertility parameters and microbial biomass indices, as well as plant yield and nutrient concentrations. Manure C concentration increased significantly (P<0.001) from 45.2% (0% AC) to 60.2% (9% AC) with increasing dietary AC, whereas manure N, P, and K concentrations decreased (P<0.001) from 0% AC (N: 2.5%, P: 1.5%, K: 0.8%) to 9% AC (N: 1.7%, P: 0.8%, K: 0.4%). Soil organic carbon, pH, and microbial biomass N showed a response to AC-enriched manure. Yield of millet decreased slightly with AC enrichment, whereas K uptake was improved with increasing AC. We conclude that AC effects on manure quality and soil productivity depend on dosage of manure and AC, properties of AC, trial duration, and soil type.

Efeito do agregado na diminuição da retracção de argamassas

Na actualidade, face ao desenvolvimento de betões de alto desempenho caracterizados por apresentarem muito baixa razão água cimento (A/C), tornou-se pertinente o estudo da retracção autogénea, por motivos relacionados com a resistência, durabilidade e estética destes materiais. Nesta dissertação foi elaborado um estudo prático com o intuito de avaliar o impacto da adição de agregado na redução da retracção autogénea, em seis misturas cimentícias. Através de ensaios foram obtidos valores reais de retracção autogénea, sendo estes posteriormente comparados com os valores obtidos teoricamente com recurso ao modelo proposto por Hobbs na década de 70. Tendo em consideração os valores teóricos e sua comparação com os valores reais obtidos nos ensaios é proposta uma alteração ao modelo teórico, que tem em conta a maior resistência à compressão dos betões actuais. Esta modificação permitiu estimar com maior exactidão os valores de retracção autogénea nas diferentes misturas. /ABSTRACT: Nowadays the development of high performance concretes characterized by a low water-to­ cement ratio (W/C), it became relevant to study the autogenous shrinkage, for reasons relating to the strength, durability and aesthetics of these materials. ln this study the effect of adding aggregate in six cementitious mixtures was evaluated. The results obtained in the experimental test were compared with theoretical values from a model propose by Hobbs in the 70's for autogenous shrinkage. Given the theoretical values and its comparison with the actual values obtained in the tests an amendment is proposed to the theoretical model that takes into account the higher compressive strength of actual concrete. This modification allowed us to estimate accurately the values of autogenous shrinkage in the different mixtures.

E-Procurement and Innovation in the Portuguese Municipalities: When Change Is Mandatory

Changing the traditional pattern of public procurement for an electronic paradigm is a radical innovation involving major organizational changes, the breaking up of traditional processes and practices, obsolescence of knowledge and skills. Going beyond the European Commission's recommendations, in 2009 Portugal pioneered in making e-procurement mandatory in the pre-award phase, in a European context of multiple technical standards and lack of interoperability of electronic platforms across the EU countries. Six years later, when the creation of a European e-procurement single market is a EU mission and a major legislative amendment is underway in Portugal, this study looks at the relationship between e-procurement and innovation in the Portuguese municipalities aiming to understand the extent into which the adoption of e-procurement embraced a real organizational change or, on the other hand, if it just represented a mere adaptation of the usual procurement practices. The study draws on data from an electronic survey to all municipalities in mainland Portugal and the analysis is mainly descriptive and exploratory. The paradigm shift in public procurement involves major organizational changes but, overall, the results suggest that most municipalities do not have a clear understanding of the innovative scope (depth and diversity) implied by e-procurement. E-procurement shows advantages over the paper-based model but an unbalanced perception of the innovation dimensions has influenced the implementation of e-procurement and the degree of organizational change.

Estratégias de fitorremediação de duas minas abandonadas - Tinoca e Mostardeira

O presente trabalho teve como objectivo a implementação de estratégias de remediação de duas minas abandonadas na região do Alto Alentejo, a mina da Tinoca e a mina da Mostardeira. Neste trabalho foram realizados ensaios de fitoremediação com as espécies Brassica juncea (L.) Czern, Solanum nigrum L., Piptatherum miliaceum (L.)Coss. e Spergularia purpurea (Persoon)G. Don fil. As misturas utilizadas como suporte para desenvolvimento das plantas resultaram da mistura (1:1) de resíduos de escombreira e solo. Estas misturas foram realizadas para as duas minas independentemente. A estas misturas foram adicionados correctivos minerais e um correctivo orgânico. Dos estudos realizados observou-se que medidas de atenuação/diluição não se mostraram suficientemente eficazes para permitir uma estabilização da zona superficial em causa, pelas espécies de plantas estudadas. Por outro lado, a adição de um correctivo orgânico, juntamente com a subida do pH do solo, conduziu a um melhoramento das características físicas e químicas das misturas originais facilitando a sua revegetação. ABSTRACT: This study was designed to implement remediation strategies in two abandoned mines in the region of Alto Alentejo, the Tinoca mine and Mostradeira mine. Phytoremediation tests were carried out with the species Brassica juncea (L.) Czern, Solanum nigrum L., Piptatherum miliaceum (L.) Coss. and Spergularia purpurea (Persoon) G. Don fil. The mixtures used to support plant growth resulted from the admixture (1:1) of waste tailings and soil and were performed independently for the two mines. Soil mineral correctives and organic fertilizers were added to these mixtures. The study showed that mitigation/dilution measures were not sufficiently effective to allow the stabilization of the area with the plant species studied. However, the addition of an organic corrective, along with the rise of soil pH, led to an improvement in the physical and chemical properties of the original amendment soil mixtures, hence facilitating its phytorestoration.

Atrazine sorption in soil treated with biochar.

Biochar has been used worldwide as soil amendment. Due to the high sorption capacity of organic compounds by charcoal in general, the use of biochar can change the soil sorptive properties, that could result in a environmental protective strategy in one hand and/or in need of higher pesticides doses in another hand. However no data in the literature is available about the long term effect of biochar application in the sorptive properties of the soil, even studies about the sorptive properties of soil treated with biochar are scarce, the few available papers are with pure biochar. This unprecedented work, evaluating the sorption of atrazine in a clayed soil treated with biochar, under experimental field conditions, evaluated the sorption isotherms one and three years after the single biochar application (16 Mg ha-1 of biochar). One year after the biochar application the Kf was two times higher for the biochar amended soil than for the control one (without biochar). This effect decreases after three years from the application, but it is even significantly higher (50% higher) than the control treatment.

Desafíos contemporáneos para el socialismo en Cuba (A propósito de las reformas políticoeconómicas en la fase actual de la revolución)

This essay analyzes on the origin and impact of the amendment process currently undertaken by the Cuban government authorities considering it as the result of --what I call-- super structural imbalance. Such imbalance is caused by the application of the System for Management and Planning of the Economy. To our judgment, the process of amendment both structurally and super structurally conforms the new phase in the construction of the Socialism in the island from a coherent point of view to what it has been until now as a political constant of the revolution: the vindication of the human being as the promoter of its historical reality.