926 resultados para Organization of nursing services
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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.
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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
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To assess knowledge of nursing undergraduate students about the use of contact precautions. Methodology. There were 106 nursing undergraduate students from three universities within the state of Sao Paulo. The data collection was done between April and May 2012. A questionnaire was elaborated with questions assessing knowledge regarding contact precautions. The data were submitted to statistical procedures in the package MINITAB version 16. The knowledge were rated as adequate, partially adequate and inadequate. Results. There was a predominance of females (86%) and age group between 20 and 29 years (70%). Regarding the definition of contact precaution of diseases in which these measures are used, undergraduate’s knowledge was partially adequate (92% and 44%, respectively). The knowledge was considered adequate for the preventive measures used during assistance (86%). As difficulties mentioned in the use of these measures were discomfort, lack of material, personnel and time. Conclusion. Although undergraduate students know what measures to be used in contact precaution, they do not have adequate knowledge about which diseases they should use them. The three participating universities should reflect on the quality of training for nursing students regarding biosecurity and contact precautions.
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Oocysts of Eimeria funduli were studied by transmission electron microscopy in naturally-infected livers of the Gulf killifish, Fundulus grandis. Tissues were cryo-processed because membranous structures in the oocyst appear to hinder routine fixation and embedment. The oocyst wall (about 25 nm thick) was adjacent to the host cell and consisted of an outer membrane that limited the host cell cytoplasm and an inner membrane separated from the outer membrane by a narrow space. In some specimens, dense material was applied to the inner face of the inner membrane. Individual sporocysts were surrounded by a membranous "veil" (about 25 nm thick) that consisted of two unit membranes. Sporopodia, projections of the sporocyst wall, supported the veil. The sporocyst wall (130-150 nm thick) consisted of two layers, a thin electron-lucent outer layer (about 10 nm thick) and a thick electron dense inner layer (about 130 nm thick). Depending on the plane of section, the inner layer had transverse striations with periods of 3 to 4 nm or 12 to 15 nm. A narrow fissure, broadest at the anterior pole of the sporocyst, extended about one-third the length of the sporocyst wall. The posterior pole of the sporocyst was characterized by a bulbous swelling. Although this swelling resembled a Stieda body in light microscopic preparations, ultrastructurally, the swelling was a knoblike thickening in the sporocyst wall and did not plug a gap in this wall
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Previous studies of the Social Gospel movement have acknowledged the fact that Social Gospelers were involved in multiple social reform movements during the Gilded Age and into the Progressive Era. However, most of these studies have failed to explain how the reform experiences of the Social Gospelers contributed to the development of the Social Gospel. The Social Gospelers’ ideas regarding the need to transform society and their strategies for doing so were largely a result of their personal experiences as reformers and their collaboration with other reformers. The knowledge and insight gained from interaction with a variety of reform methods played a vital role in the development of the ideology and theology of the Social Gospel. George Howard Gibson is exemplary of the connections between the Social Gospel movement and several other social reform movements of the time. He was involved in the Temperance movement, was a member of both the Prohibition Party and the People’s Party, and co-founded a Christian socialist cooperative colony. His writings illustrate the formation of his identity as a Social Gospeler as well as his attempts to find an organization through which to realize the kingdom of God on earth. Failure to achieve the changes he desired via prohibition encouraged him to broaden his reform goals. Like many Midwestern Social Gospelers Gibson believed he had found “God’s Party” in the People’s Party, but he rejected reform via the political system once the Populists restricted their attention to the silver issue and fused with the Democratic Party. Yet his involvement with the People’s Party demonstrates the attraction many Social Gospelers had to the reforms proposed in the Omaha Platform of 1892 as well as to the party’s use of revivalistic language and emphasis on producerism and brotherhood. Gibson’s experimentation with a variety of ways to achieve the kingdom of God on earth provides new insight into the experiences and contributions of lay Social Gospelers. Adviser: Kenneth J. Winkle
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The management of health services is a complex administrative practice due to the breadth of the field of health and the need to reconcile individual, corporate and collective interests that are not always convergent. In this context, the evaluation needs to have specific characteristics in order to fulfill its role. The scope of this study was to establish the characteristics that the evaluation for the management of health services should have to contribute to decision-making. Usefulness, opportunity, feasibility, reliability, objectivity and directionality represent the set of principles upon which the evaluation should be based. Evaluations should lead to decisions that guarantee not only their efficiency and effectiveness but also their implementation. The evaluation process should ensure that decisions involve all stakeholders in order to render the implementation of decisions feasible, and take into account the health needs of the population and the goals set for the services. The scope of this article is to elicit a debate among different stakeholders in the evaluation in the hope that it can contribute to the reflection on the real usefulness of evaluations in which the political component in management has been increasingly prevalent.
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Trypanosoma cruzi, the agent of Chagas disease, is a complex of genetically diverse isolates highly phylogenetically related to T. cruzi-like species, Trypanosoma cruzi marinkellei and Trypanosoma dionisii, all sharing morphology of blood and culture forms and development within cells. However, they differ in hosts, vectors and pathogenicity: T. cruzi is a human pathogen infective to virtually all mammals whilst the other two species are non-pathogenic and bat restricted. Previous studies suggest that variations in expression levels and genetic diversity of cruzipain, the major isoform of cathepsin L-like (CATL) enzymes of T. cruzi, correlate with levels of cellular invasion, differentiation, virulence and pathogenicity of distinct strains. In this study, we compared 80 sequences of genes encoding cruzipain from 25 T. cruzi isolates representative of all discrete typing units (DTUs TcI-TcVI) and the new genotype Tcbat and 10 sequences of homologous genes from other species. The catalytic domain repertoires diverged according to DTUs and trypanosome species. Relatively homogeneous sequences are found within and among isolates of the same DTU except TcV and TcVI, which displayed sequences unique or identical to those of TcII and TcIII, supporting their origin from the hybridization between these two DTUs. In network genealogies, sequences from T. cruzi clustered tightly together and closer to T. c. marinkellei than to T. dionisii and largely differed from homologues of T. rangeli and T. b. brucei. Here, analysis of isolates representative of the overall biological and genetic diversity of T. cruzi and closest T. cruzi-like species evidenced DTU- and species-specific polymorphisms corroborating phylogenetic relationships inferred with other genes. Comparison of both phylogenetically close and distant trypanosomes is valuable to understand host-parasite interactions, virulence and pathogenicity. Our findings corroborate cruzipain as valuable target for drugs, vaccine, diagnostic and genotyping approaches.
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PURPOSE: Apply the educational software Fuzzy Kitten with undergraduate Brazilian nursing students. METHODS: This software, based on fuzzy logic, generates performance scores that evaluate the ability to identify defining characteristics/risk factors present in clinical cases, relate them with nursing diagnoses, and determine the diagnoses freely or using a decision support model. FINDINGS: There were differences in student performance compared to the year of the course. The time to perform the activity did not present a significant relation to the performance. The students' scores in the diagnoses indicated by the model was superior (p = .01). CONCLUSIONS: The software was able to evaluate the diagnostic accuracy of students. IMPLICATIONS: The software enables an objective evaluation of diagnostic accuracy.
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The peroxisome proliferator-activated receptors (PPARs) regulate genes involved in lipid and carbohydrate metabolism, and are targets of drugs approved for human use. Whereas the crystallographic structure of the complex of full length PPAR gamma and RXR alpha is known, structural alterations induced by heterodimer formation and DNA contacts are not well understood. Herein, we report a small-angle X-ray scattering analysis of the oligomeric state of hPPAR gamma alone and in the presence of retinoid X receptor (RXR). The results reveal that, in contrast with other studied nuclear receptors, which predominantly form dimers in solution, hPPAR gamma remains in the monomeric form by itself but forms heterodimers with hRXR alpha. The low-resolution models of hPPAR gamma/RXR alpha complexes predict significant changes in opening angle between heterodimerization partners (LBD) and extended and asymmetric shape of the dimer (LBD-DBD) as compared with X-ray structure of the full-length receptor bound to DNA. These differences between our SAXS models and the high-resolution crystallographic structure might suggest that there are different conformations of functional heterodimer complex in solution. Accordingly, hydrogen/deuterium exchange experiments reveal that the heterodimer binding to DNA promotes more compact and less solvent-accessible conformation of the receptor complex.
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Este estudo teve como objetivo analisar a discursividade de gestores sobre a relação entre a organização dos serviços de saúde e a gestão do cuidado à tuberculose (TB) em um município da região metropolitana de João Pessoa/PB. Conduzido pela pesquisa qualitativa no campo analítico da Análise de Discurso de linha francesa, participaram 16 trabalhadores de saúde que atuavam como integrantes de equipes gestoras. Os depoimentos transcritos foram organizados com uso do software Atlas.ti versão 6.0. Após leitura minuciosa do material empírico procurou-se observar nos discursos os processos parafrásicos, polissêmicos e metafóricos, os quais possibilitaram a identificação da seguinte formação discursiva: organização dos serviços de saúde e a relação com a gestão do cuidado à TB; o plano e a prática. Nos discursos dos gestores evidencia-se a fragmentação das ações de controle da tuberculose, a falta de articulação entre os serviços e os setores, o cumprimento de atividades específicas à TB, bem como a falta de planejamento estratégico para gestão do cuidado da doença. Nesse sentido, para que a organização dos serviços de saúde seja efetiva, se faz necessário que a tuberculose seja prioridade na agenda da gestão e reconhecida como um problema social.
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Madrepora is one of the most ecologically important genera of reef-building scleractinians in the deep sea, occurring from tropical to high-latitude regions. Despite this, the taxonomic affinities and relationships within the genus Madrepora remain unclear. To clarify these issues, we sequenced the mitochondrial (mt) genome of the most widespread Madrepora species, M. oculata, and compared this with data for other scleractinians. The architecture of the M. oculara mt genome was very similar to that of other scleractinians, except for a novel gene rearrangement affecting only cox2 and cox3. This pattern of gene organization was common to four geographically distinct M. oculata individuals as well as the congeneric species M. minutiseptum, but was not shared by other genera that are closely related on the basis of cox1 sequence analysis nor other oculinids, suggesting that it might be unique to Madrepora. (C) 2012 Elsevier Inc. All rights reserved.