Nursing Activities Score: avaliação da carga de trabalho de enfermagem em unidade de terapia intensiva adulto

The sizing of nursing human resources is an essential management tool to meet the needs of the patients and the institution. Regarding to the Intensive Care Unit, where the most critical patients are treated and the most advanced life-support equipments are used, requiring a high number of skilled workers, the use of specific indicators to measure the workload of the team becomes necessary. The Nursing Activities Score is a validated instrument for measuring nursing workload in the Intensive Care Unit that has demonstrated effectiveness. It is a cross-sectional study with the primary objective of assessing the workload of nursing staff in an adult Intensive Care Unit through the application of the Nursing Activities Score. The study was conducted in a private hospital specialized in the treatment of patients with cancer, which is located in the city of Natal (Rio Grande do Norte – Brazil). The study was approved by the Research Ethics Committee of the hospital (Protocol number 558.799; CAAE 24966013.7.0000.5293). For data collection, a form of sociodemographic characteristics of the patients was used; the Nursing Activities Score was used to identify the workload of nursing staff; and the instrument of Perroca, which classifies patients and provides data related to the their need for nursing care, was also used. The collected data were analyzed using a statistical package. The categorical variables were described by absolute and relative frequency, while the number by median and interquartile range. Considering the inferential approach, the Spearman test, the Wald chi-square, Kruskal Wallis and Mann-Whitney test were used. The statistically significant variables were those with p values <0.05. The evaluation of the overall averages of NAS, considering the first 15 days of hospitalization, was performed by the analysis of Generalized Estimating Equations (GEE), with adjust for the variable length of hospitalization. The sample consisted of 40 patients, in the period of June to August 2014. The results showed a mean age of 62,1 years (±23,4) with a female predominance (57,5%). The most frequent type of treatment was clinical (60,0%), observing an average stay of 6,9 days (±6,5). Considering the origin, most patients (35%) came from the Surgical Center. There was a mortality rate of 27,5%. 277 measures of NAS score and Perroca were performed, and the averages of 69,8% (±24,1) and 22,7% (±4.2) were obtained, respectively. There was an association between clinical outcome and value of the Nursing Activities Score in 24 hours (p <0.001), and between the degree of dependency of patients and nursing workload (rp 0,653, p<0,001). The achieved workload of the nursing staff, in the analyzed period, was presented high, showing that hospitalized patients required a high demand for care. These findings create subsidies for sizing of staff and allocation of human resources in the sector, in order to achieve greater safety and patient satisfaction as a result of intensive care, as well as an environment conducive to quality of life for the professionals

Validação do conteúdo do diagnóstico de enfermagem proteção ineficaz para pacientes submetidos à hemodiálise

Methodological study, in order to validate the content of the nursing diagnosis protection ineffective in patients undergoing hemodialysis. The research took place in two stages, namely: concept analysis and content analysis of the instrument by experts. T he first step was operationalized through an integrative review of the databaes LILACS, CINAHL, PubMed, Scopus and Cochrane, with the key words protection and hemodialysis, in October and November 2013. The sample consisted of 32 articles, which were analyz ed by a c areful reading to identify the sections that correspond ed to the defining attributes , antecedents and consequences of protection in patients undergoing hemodialysis. T he interpretation for the diagnosis of effective protection was made by transpos ing the components of the diagnosis (definition, defining characteristics and related factors) to the denial form . In the second stage, we elaborated an instrument with the components of the nursing diagnostic s studied and proceeded to the analysis conduct ed in April 2014 by 22 specialists in nephrology and in the terminology of the NANDA International, selected by means of th e Lattes Platform . We used the binomial test to assess the proportion of experts who rated each item as appropriate, considering a si gnificance level of 5%. The project was approved by the Ethics Committee of the institution responsible for the research, an opinion on num b er 387 837 and CAAE 18486413.0.0000.5537. The results show that the proposal for the nursing diagnosis of ineffectiv e protection in patients undergoing hemodialysis is: definition - the same as that presented in the NANDA International Taxonomy II, location - domain safety / protection and class injury. Related factors are: Absence of routine vaccines; Non - adherence to care related to vascular access; Non - adherence to infection control measures; Non - adherence to prescribed diet; Non - adherence to drug therapy; Presence of comorbidities; Drug abuse; Immune disorders; Extremes of age; Abnormal blood profiles; Drugs that red uce immunity; and side effects and adverse treatment - related. The defining characteristics are: Presence of invading the bloodstream; Nutritional disorders; Increase in the number of hospitalizations; Uncontrolled dry weight; Infected vascular access; Vasc ular inadequate access; Increased blood pressure; fever; Bleeding disorder; Disability immunity; fatigue; weakness; itching; and maladaptive response to stress. It follows that the identification of the defining attributes, antecedents and consequences inc reased the wealth of vocabulary, allowing the construction of theoretical and empirical definitions for a broader understanding of the concept protection. Furthermore, the study contributed to the enrichment of nursing specific body of knowledge, as well a s in the direction of nursing care for patients undergoing hemodialysis.

Trajetória de vida dos pescadores vítimas de lesão medular por mergulho: experiências, representações sociais e estresse

Spinal cord injury causes permanent disabling manifestations, affecting the anatomic integrity, bodily changes and functional limitations related to the disability state. It was aimed to analyze the social representation, stress level and experiences of fishermen victims of spinal cord injury caused by diving accident in the Northern beaches of Brazil. It is a descriptive - exploratory study with quantitative, qualitative and representational data developed i n fishermen’s villages in nine beaches of Northern shore/RN, between October 2013 to August 2014, after the approval of the Ethics Committee in Research of the Universidade Federal do Rio Grande do Norte, under the number 431.891/2013, CAAE 20818913.0.0000 .5537. The sample was composed by 44 fishermen with spinal cord injury, defined from inclusion and exclusion criteria of the participants. It was used as instrument to collect the data a semi structured interview. Quantitative data was analyzed by descrip tive statistics, showing the data through table, boxes and graphics by Microsoft Excel. Data from interviews were submitted to the software called Analyse Lexicale par Contexte d’un Ensemble de Segments de Texte (ALCESTE) using the analysis of the Social R epresentation Theory and Center Core Theory. It is shown the outcomes of the research through four articles, following the normative recommendations of the journals. Participants of the study were all male, age mean 49,6 years, elementary school (68,2%), m arried (77,3%); paraplegia sequel (50,0%). Most of them showed stress (75,0%), almost in the exhaustion stage (33,3%), prevalent insomnia symptoms (95,5%) in the last hours; hypertension (97,7%) in the last week and sexual troubles (95,5%) in the last mont h). Decompressive illness caused spinal cord injury (57,1%), occurred prevalently in low summer (75,0%), northern shore (96,4%), having as main consequences the paresthesia and pain in the upper and lower limbs (67,9%), followed by death (25,0%). Interview analysis under the understanding of Social Representation of spinal cord injury allowed the appearance of seven categories: Treatment: limitation and expectative; Spinal Cord injury: before and after; Retirement: reality yet to come; Disability: dependenc y, incapacity, vulnerability; Overcoming and autonomy; Self feelings: physics losses and new start; Life and labor: impediments, plans and changes. The center core of the representation is found in the first category by the expectative and limitation on th e treatment, meanwhile the outskirt elements are in seventh and third categories. Physics limitation for fishing activities and retirement expectative is the most outstanding of the structure. Social representation concerning spinal cord injury is found in a transaction moment between before and after with the prevented fishing activity, coping of the situation with the potential remaining. The anchoring is established in the desire for changes related to the improvements of life and health conditions exper ienced day by day through faith. This study finishes pointing out the range of the objectives, which topic is relevant for public health of fishermen. It is suggested prevention measures, promotion and health recovery of fishermen, besides safe, healthy an d worthy conditions as a compromise of social and health politics.

Avaliação da estrutura e processo de trabalho dos centros de atenção psicossocial

Objective: Evaluate the work structure and process in Psychos ocial Care Centers (CAPS) and the professionals profile, the satisfaction, conditions and work overload. Methods: Cross - sectional study conducted in five CAPS in Campina Grande city. The study sample consisted of five coordinators, 42 graduate professional s, 26 mid - level (technical and auxiliary nurses, and caregivers), and the medical records pertaining to 413 users followed up. Data were collected using validated questionnaires (CAPSUL - rating CAPS in southern Brazil) and adapted to the study, between July and October 2014. The questionnaires were double entered and submitted to validation in the sub - program “Validate Epi Info 3.5.4” , used along with the “SPSS 17.0” for processing the statistical analyzes. Measures of central tendency and dispersion were ap plied to the descriptive analyzes; “Fisher's” exact test to check the CAPS impact on hospital admissions and the “Bonferroni” adjusted to verify the diagnoses according to sex. 5% significance level was adopted. The study was approved by the Ethics Committ ee of the Rio Grande do Norte Federal University (UFRN), protocol 719.435, of 05.30.2014. Results: From the structure analysis were identified contextual factors that influenced the work process of CAPS professionals, such as: deficiencies with regard to h uman resources; forms of health professionals employment and qualifications; temporary contract existence. As to process dimension, it was found that the home visits performance by health professionals shows to be ineffective, given its insufficiency and i rregularity, which can be explained by the high demand, reduced staff and transportation lack. It was low coverage of items inherent to Therapeutic Individual Project, as the income generation program, insertion at work and home visit. The reference and co unter reference flow are still not satisfactorily organized. There was statistically significant difference for the diagnosis, with a predominance of mood disorders related to stress among women and those related to alcohol and other drugs among men (p <0. 05). There was an association between the degree of health professionals satisfaction and working conditions, overload and factors related to the content and working conditions, the security measures, comfort and CAPS appearance, contact between the teams and users, families treatment by the teams, temporary employment relationship. Conclusion: The data collected indicate the need for the CAPS organization through increased investments in the sector in order to enhance the infrastructure as potentiating el ement of practices with a view to changing the care model for mental health proposed by the Psychiatric Reform. It is hoped therefore that this research will contribute to better planning in CAPS unit management, with another tool to improve the dimensions involving the structure and the professional work process and improve this mental health care model.

Atuação dos profissionais no atendimento às famílias nos centros de atenção psicossocial

This study aimed to evaluate the work of professionals to care for families in Psychosocial Care Centers ( C APS) of Rio Grande do Norte ( RN), from the roles and functions performed by these professional services. For this, it was pointed out the following objectives: To describe the profile and the activities conducted by mental health teams in the RN CAPS ; Know the opinion of professionals in the mental health teams of the poli ti c , practices and training in mental health; Check the suitability of the roles and functions of professionals working in the RN CAPS in relation to care for families . This is an analytic al cross - sectional study of quantitative and qualitative approach . Data were c ollected through a questionnaire in 33 CAPS RN, between March and October 2014 , after being approved by the Research Ethics Committee / UFRN , opinion nº217.808 , CAAE : 10650612.8. 1001.5537 , on March 1 2013. T he sample was adopted , defined by inclusion and exclusion criteria , and is composed of 183 professionals. The database preparation followed two steps: 1. Preparation and processing of data of closed questions of the questionnai re concerning the characterization and practices in mental health research subjects through informational resource Statistical Package for Social Scienses (SPSS) Statistics version 20.0 ; 2. To check the significance level was chosen by applying the chi - squ are test. Preparation and treatment of the corpus formed by the answers to open questions relating to the policies, practices and training in psychiatry through Analyse lexicale pair Contexte software d' un Ensemble of Segments of Texte ( ALCESTE) together a nd categorized by content analysis technique , Bardin (2004) . The data analysis is supported in the literature . It m ade explicit the results through three articles waxing the following results. In the first, participants profile was characterized by a predo minance of females (76.5 %), aged 40 - 58 years ( 61.7 %). They work between 30 and 40 hours per week (63.5 %), working in mental health for over 10 years ( 98.4%). The sample directs the care of family groups ( 65.7%), predominantly the care team of social worke rs, nurses, psychologists and occupational therapists . The doctor performs emergency care without interaction with the staff (48.6%) . On the difficulties encountered in services are ranked in : materials and supplies ( 75.1%), financial ( 78.5%) and structura l ( 66.9%). The second article contains qualitative data organized into five categories : Promoting the rehabilitation of users of CAPS ; Needs training ; Conflicts and satisfactions of teamwork ; Practices developed in CAPS ; Effective difficulties of Mental He alth Policy . The third article highlights the inadequacy of care for families ( 93.4%) and comparing the care families and groups in CAPS both types show to be inadequate : family ( 92.63%), groups ( 92, 60%). The main data obtained reveal the urgent need for transformation in psychosocial care . It shows also the importance of investments in inputs, physical structure and training of human resources for the CAPS.

Análise imuno-histoquímica das proteínas RANK, RANKL e OPG em dentes de ratos reimplantados

The RANK / RANKL / OPG sy stem plays an important role in bone formation and resorption . This finding has been regarded as one of the m ost important advances in the understanding of bone biology with respect to osteoclastogenesis. The aim of this study was to investigate the expression of RANKL / RANK / OPG markers in reimplanted t eeth of rats, and to observe the relationship between the expression of these markers and to oth and bone resorption. Thirty male Wistar rats (Rattus norvegicus albinos) had their maxillary right incisors extrac ted , and were divided into 2 groups according to the period that the extracted teeth were kept in dry air before reimplantation : G1 (n = 15) - 5 minutes , and G2 (n = 15) - 60 minutes . After reimplantation, teeth were analyzed at intervals of 1, 3 and 7 da ys. After these experimental periods, the animals were euthanized. Longitudinal sections with 5μm thick were obtained and stained with Hematoxylin and Eosin for histological analysis , while 3μm thick sections were subjected to immunohistochemical analysis of OPG , RANK and RANKL. The results showed that the RANK / RANKL / OPG system actively participates in both the repair process, as well as tooth and bone resorption . Extr a - alveolar time of 60 minutes before replantation caused minor expressions of RANKL a nd OPG, not influencing the expression of RANK; RANKL immunostaining showed higher in both groups when compared to other biomarkers, participating in all phases of bone and tooth resorption; RANKL was associated to both osteoclastogenesis and c ell ular proliferation , and was expressed in both groups.

Análise comparativa da imunoexpressão de GLUT-1, GLUT-3 e M-CSF em lesão periférica e central de células gigantes

The peripheral giant cell lesion ( PG CL ) and the central giant cell lesion ( CGC L) are lesions histologically similar affecting the head and neck region . The study aimed to analyze the immunohistochemical expression of markers GLUT - 1 , GLUT - 3 and M - CSF in a series of cases of PGCL and CGCL , in trying to understand the different biological behavior of these pathologies . The sample consisted of 20 tissue specimens of PGCL 20 central lesion of not aggressive giant cell ( CLNAGC) and 20 central lesi on of aggressive giant cell ( CLAGC), coming from the Pathology Unit of Oral Pathology of the Department of Dentistry of UFRN . W as performed the s emi - quantitative and qualitative analysis of immunohistochemical expression of the markers in giant cells and m ononuclear cells . In relation to the GLUT - 1, it was found a statistically significant difference (p < 0.05) in the number of mononuclear cells immunomarked between the PGCL and the CLNAGC and between the PGCL and CLAGC . Regarding the intensity of staining w as also observed a statistically significant difference both at the mononuclear cells as in giant cells between PL and CLNAGC and between PGCL and CLAGC , at the giant cells there was also a statistically significant difference between the CLNAGC and CLAGC . In relation to GLUT - 3 , was found a statistically significant difference between PGCL and CLAGC and between CLAGC and CLNAGC in amount of mononuclear cells immunomarked . Regarding the intensity of labeling for such protein was found a statistically signifi cant difference at the giant cells between PL and CLAGC . To the M - CSF was observed only a statistically significant difference in the intensity of labeling at the mononuclear cells between PGCL and CLNAGC and between PGCL and CLAGC . Based on these results, we can conclude the participation of GLUT - 1, GLUT - 3 and M - CSF in the pathogenesis of the lesions studied. The bigger immunostaining of these proteins in mononuclear cells show that these cells perform a higher metabolic activity and osteoclastogenic, espe cially in CLAGC . It was found that the mononuclear cells were more related to the pathogenesis of the studied lesions than properly the giant s cell s.

Manifestações oculares em mulheres com síndrome dos ovários policísticos: prevalência e associação com fatores de risco metabólicos e inflamatórios

Objetivos: Estimar a prevalência de alterações do filme lacrimal e da doença do olho seco (DOS), comparar as mudanças na pressão intraocular (PIO) e comparar as espessuras macular e da camada de fibras nervosas da retina (CFNR), entre mulheres com síndrome dos ovários policísticos (SOP) e mulheres saudáveis, estratificando-as em condições clínicas, metabólicas e inflamatórias. Metodologia: O estudo incluiu 45 mulheres com SOP e 47 mulheres saudáveis ovulatórias submetidas a avaliações clínico-ginecológicas e oftalmológicas, incluindo propedêuticas para a avaliação do filme lacrimal e medida da PIO, e medição da espessura macular, da CFNR e parâmetros do disco óptico usando tomografia de coerência óptica. Resultados: Tempo de ruptura do filme lacrimal (TRFL; p=0.001) e impregnação por fluoresceína (p=0.006) apresentaram diferenças estatisticamente significantes entre os grupos estudados. A prevalência de DOS foi de 44,4% nas portadoras de SOP. Houve redução estatisticamente significativa do TRFL na presença de SOP (p=0.001). Além disso, houve efeito estatisticamente significativo de intolerância à glicose e síndrome metabólica/inflamação na impregnação por fluoresceina (p=0.004; p=0.015, respectivamente). A PIO encontrou-se estatisticamente mais elevada no grupo SOP que no grupo controle (p=0.011). Houve um aumento na média do IPC (índice pressão-córnea) com a associação entre SOP e da síndrome metabólica (p = 0.005); A média da espessura da CNFR superior ao redor do nervo óptico foi estatisticamente mais espessa nas voluntárias com SOP que nas voluntárias saudáveis (p=0.036); Após estratificação pela presença de resistência insulínica, as médias dos subcampos das espessuras maculares “macular interno temporal, macular interno inferior, macular interno nasal e macular externo nasal, foram mais espessas no grupo SOP que no grupo controle (p<0.05); Houve associação significativa entre obesidade e resistência insulínica (p=0.037), e intolerância à glicose (p=0.001), com aumento médio do componente principal 1 (CP1), e, na presença de síndrome metabólica (p<0.0001), com aumento médio do componente principal 2 (CP2), respectivamente, em relação à espessura macular total. Na presença de obesidade e inflamação, houve redução no escore médio da CP2 (p=0.034), em relação à espessura da CFNR na mácula. xviii Conclusões: Há uma associação da SOP, suas alterações metabólicas e inflamatórias com alterações do filme lacrimal e com mudanças na PIO. A diminuição na espessura da CFNR macular e aumento da espessura total macular estão possivelmente associadas às alterações metabólicas, e, o aumento na espessura da CFNR ao redor do nervo óptico estão provavelmente associadas às alterações hormonais, inerentes à SOP.

Imitating art – estratégia inovadora de educação médica: identificando desafios e possibilidades

Este estudo de caráter qualitativo, com base em metodologia pesquisa – ação, procurou descrever características funcionais da estratégia de ensino „Imitating Art”, construída com base em métodos de dramatização, solução de problemas e tempestade cerebral e alicerçada no processo de ensino de arte do conhecer, apreciar e fazer arte. Participaram da pesquisa 96 alunos do ensino em saúde com idade média de 21 anos. Com o objetivo de desenhar as características funcionais da estratégia, a mesma foi planejada, descrita, modificada e avaliada em 4 etapas: experimentação, metodização, adequação e replicação. Cada etapa foi verificada a partir de avaliação observacional pelos docentes envolvidos e análise de conteúdo sobre as respostas dos alunos participantes, em instrumento de avaliação próprio. Da fase experimental participaram 14 alunos dos quais 100 % aprovaram a estratégia. A análise de conteúdo mostrou Identificação de ferramentas cognitivas e afetivas (30,6%), características da atividade (22,2%), e mediação de trabalho em grupo (16,7%). A observação identificou ativo trabalho atitudinal em uma dinâmica de grupo criativa. Na fase de metodização participaram 31 alunos, dos quais 96,9% aprovaram a estratégia. Na análise de conteúdo, as ideias mais presentes foram, dificuldades encontradas pelos participantes (28%), identificação de ferramentas cognitivas e afetivas (17,6%), Implicação da estratégia no cotidiano profissional (13,2%) e mediação do trabalho em grupo (13,2%). Na fase de Adequação, participaram 32 alunos, dos quais 90,7% demonstraram aprovação da estratégia. A avaliação dos participantes evidenciou como mais importante a mediação do trabalho em grupo (29,6%), identificação de ferramentas cognitivas e afetivas (21,3%) e características da atividade (19,7%). A fase de replicação teve 19 alunos, dos quais 100% aprovaram a estratégia e cuja avaliação demonstrou principalmente dificuldades encontradas pelo participante (27,8%), mediação do trabalho em grupo (25%) e Habilidade criativa da atividade (22,2%). A avaliação bidimensional mostrou que se constitui como uma estratégia de abordagem ativa e colaborativa, podendo ser usada como instrumento linear de diagnóstico e incremento de competências atitudinais tais como criatividade e trabalho em grupo.

Efeito agudo do exercício aeróbio vigoroso sobre as funções executivas em adolescentes

Executive functions are determinant cognitive processes for student success, since they execute and control complex cognitive activities such as reasoning, planning and solving problems. The development of the executive functions performances begin early at childhood going through the adolescence until adulthood, concomitant with the neuroanatomical, functional and blood perfusion changes over the brain. In this scenario, exercise has been considered an important environmental factor for neurodevelopment, as well as for the promotion of cognitive and brain health. However, there are no large scientific studies investigating the effects of a single vigorous aerobic exercise session on executive functions in adolescents. Objective: To verify the acute effect of vigorous aerobic exercise on executive functions in adolescents. Methods: A randomized controlled trial (RCT) with crossover design was used. 20 pubescent from both sexes/gender with age between 10 and 16 years were submitted to two sessions of 30min each: 1) The aerobic exercise session intensity was between 65 and 75% of heart rate reserve, in which 5min for warm-up, 20min at the target intensity and 5min of cool down; and 2) control session watching cartoons. The computerized Stroop test – Testinpacs and trail making test were used to evaluate the inhibitory control and cognitive flexibility assessment respectively, before and after both experimental and control sessions. The reaction time (RT) and number of errors (n) of Stroop test were recorded. The total time (TT) and the number of errors (n) of the trail making test were also recorded. Results: The control session’s RT did not present significant differences in the Stroop test. On the other hand, the exercise session’s RT decreased significantly (p<0.01) after the session. The number of errors made at the Stroop test had no significant differences in control and exercise sessions. The ΔTT of trail making test of exercise session was significantly (p<0.001) lower than the control session’s. Errors made in trail making test did not show significant differences between control and exercise sessions. Additionally, there was significant and positive association among the Stroop test ΔRT of exercise session with xiii chronological age (r= 0.635, p=0.001; r 2 = 0.404, p=0.003) and sexual maturation (rs= 0.580, p=0.007; r 2 = 0.408, p=0.002). Differently, there was no association among the control session ΔRT and chronological age (r= – 0.144, p=0.273; r 2 = 0.021, p=0.545) or sexual maturation (rs= –0.155, p=0.513; r 2 = 0.015, p=0.610). Conclusion: Vigorous aerobic exercise seems to improve acutely executive functions in adolescents. The effect of exercise on inhibitory control performance was associated to pubertal stage and chronological age. In other words, the benefits of exercise were more evident in early adolescence (↑ ΔRT) and its magnitude decreases along the growing up process.

Estudo da influência dos genes LRP5, TGFB1, IGF1 e IGF1R no metabolismo ósseo de pacientes com diabetes mellitus tipo 1

Conselho Nacional de Desenvolvimento Científico e Tecnológico - CNPq

Estimulação transcraniana por corrente contínua (ETCC) sobre o córtex motor na modulação autonômica em pessoas com lesão medular com diferentes graus e níveis de lesão

Introduction: Transcranial Direct Current Stimulation (tDCS) has been used in studies for the treatment of chronic pain, but their effects on the autonomic nervous system (ANS) are non-existent. Therefore, the need for studies is of fundamental importance, as these individuals have autonomic imbalance and the intensity of this is dependent on the degree and level of injury. Objective: We investigated the effect of tDCS on the ANS in people with spinal cord injury (SCI) with different degrees and levels of injury. Methods: Randomized, placebo-controlled, double-blind, applied anodal tDCS or sham on the primary motor cortex (M1), bilaterally. The subjects (lower incomplete injury, n = 7; lower complete injury, n = 9; and high complete thoracic injury, n = 3) visited the laboratory three times and received active or sham tDCS for 13min. The heart rate variability (HRV) was measured before, during and after stimulation and analyzed the variables LF, HF and LF / HF. Results: The tDCS modulated the ANS in different ways among the groups. In individuals with SCI high complete thoracic the tDCS did not change the HRV. However, for individuals with SCI low incomplete, tDCS changed the HRV in order to increase sympathetic (LF, p = 0.046) and reduced parasympathetic (HF, p = 0.046). For individuals SCI low complete to tDCS changed the HRV reduction sympathetic (LF, p = 0.017) and increased parasympathetic (HF, p = 0.017). Conclusions: The present study suggests that anodal tDCS applied on the motor cortex bilaterally could modulate the ANS balance in people with spinal cord injury and that this effect is dependent on the degree and level of injury.

Apontamentos sobre Educação Integral, Programa Mais Educação, Programa Segundo Tempo e Educação Física Escolar

In today's educational context of Brazil the theme of integral education has deserved having to induce policy, nowadays, the More Education Program. In this sense, this thesis focuses on the aspects of integral education that emerged in the country's history to reach the More Education Program (MEP) and offers some thoughts on how physical education is presented within the institutionalization of intent of Integral Education in Brazil. Thus we have as main objective to discuss the pedagogical setting of Second Half Program (PST) in the MEP, and to identify possibilities to integrate their actions with the School Physical Education. In the case study methodology was adopted, with the appropriate schools accompanied by Team Collaborator 3 of the Ministry of Sport, using as a source of evidence the first assessment protocol carried out by the Cooperating Teams of Educational Monitoring and Administration of the Second Time in Brazil specifically evaluations carried out by Team Collaborator 3 (EC3), under the Department of Physical Education, Federal University of Rio Grande do Norte, which followed the covenants of the More xi Education Program in the municipalities of Bayeux / PB, Araruna / PB, Natal / RN and Parnamirim / RN, in the year 2012. in our case it is noticed that the activities developed by PST, accompanied in schools, have an organization and pedagogical practices that converge with each other, but are configured with disjointed practices of Education classes physical, aspect that differs in what would be thinking pedagogical actions to comprehensive education schools.

A fiscalização do exercício profissional no Conselho Regional de Enfermagem do Rio Grande do Norte: um debate ético

The present investigation had as its study subject the history of professional monitoring, at the Regional Nursing Council of Rio Grande do Norte (Coren-RN). It assumes that the fiscalization by the Council is an important tool for improving the quality of nursing care. This study aims to analyze the history of monitoring of the nursing profession in Rio Grande do Norte, in the period from 1993 to 2013. It was marked in the ethical-philosophical contribution of Fourez and Vázquez. This is a study of social history, descriptive and analytical, with a qualitative approach, using the methods of documentary research and the technique of oral history. It had the Coren-RN as locus of the empirical research, with its documents and the participation of inspectors and presidents. The history of monitoring was built based on documents and interviews with those who lived through this path. The project was approved by the Research Ethics Committee of UFRN as Opinion 562 400/2014 (CAAE: 25452113.7.0000.5537). The results indicate that the Coren-RN, during these twenty years faced many difficulties such as the shortage of inspectors, the precarious reality of most health services, lack of professional qualification, the illegality of professional practice and structural deficiency in the institution. Nevertheless, it must be recognized that the monitoring process exercised by the Council, has evolved over the years. This evolution is expressed in increasing the number of inspectors, in the acquisition of a new seat and three vehicles, the creation of the subsections in the cities of Natal, Caicó and Pau dos Ferros, the referral of ethical procedures, among other achievements. Similarly, it is registered an improvement in the credibility of nursing professionals and other regulatory agencies. In summary, the monitoring as core activity of the Council is going through a process of transformation, in order to make the dialogue between the disciplinary design and the pedagogical design, in defense of nursing care quality. Therefore, it is an unfinished process, in continuous construction.

Construção de um ambiente virtual de aprendizagem para aplicação do processo de enfermagem baseado na Nanda International, NOC, NIC e CIPE®

This study aimed to build a virtual learning environment for application of the nursing process based on the NANDA-I, NOC, NIC and ICNP® . Faced with problems related to learning of the nursing process and classifications, there is an urgent need to develop innovative teaching resources that modify the relationship between students and teachers. The methodology was based on the steps inception, development, construction and transition, and the software development process Rational Process Unifield. The team involved in the development of this environment was composed by researchers and students of The Care and Epidemiological Practice in Health and Nursing and Group of the Software Engineering curse of the Federal University Rio Grande do Norte, with the participation of the Lisbon and Porto Schools of Nursing, in Portugal. In the inception stage the inter research communication was in order to define the functions, features and tools for the construction process. In the preparation, step the planning and modeling occurred, which resulted in the creation of a diagram and a architectural drawings that specify the features and functionality of the software. The development, unit testing and integrated in interfaces of the modules and areas (administrator, teacher, student, and construction of the NP). Then the transition step was performed, which showed complete and functioning system, as well as the training and use by researchers with its use in practice. In conclusion, this study allowed for the planning and the construction of an educational technology, and it is expected that its implementation will trigger a substantial change in the learning of the nursing process and classifications, with the student being active agent of the learning process. Later, an assessment will be made of functional performance, which will enable the software development, with a feedback, correction of defects and necessary changes. It is believed that the software increment after the reviews, this tool grow further and help insert this methodology and every language under the educational and health institutions, promoting paradigmatic desired change by nursing.