O processo de liderança na perspectiva de enfermeiros da estratégia de saúde da família de Botucatu: uma pesquisa-ação

Pós-graduação em Enfermagem - FMB

Modeling of continuous thermal processing of a non-Newtonian liquid food under diffusive laminar flow in a tubular system

The classic conservative approach for thermal process design can lead to over-processing, especially for laminar flow, when a significant distribution of temperature and of residence time occurs. In order to optimize quality retention, a more comprehensive model is required. A model comprising differential equations for mass and heat transfer is proposed for the simulation of the continuous thermal processing of a non-Newtonian food in a tubular system. The model takes into account the contribution from heating and cooling sections, the heat exchange with the ambient air and effective diffusion associated with non-ideal laminar flow. The study case of soursop juice processing was used to test the model. Various simulations were performed to evaluate the effect of the model assumptions. An expressive difference in the predicted lethality was observed between the classic approach and the proposed model. The main advantage of the model is its flexibility to represent different aspects with a small computational time, making it suitable for process evaluation and design. (C) 2012 Elsevier Ltd. All rights reserved.

Avaliação de sistema eletrônico para documentação clínica de enfermagem

OBJETIVO: Apresentar a avaliação de um sistema eletrônico para documentação do processo de enfermagem (PE) na perspectiva de enfermeiras usuárias. MÉTODOS: Estudo exploratório, descritivo realizado com 16 enfermeiras do Hospital Universitário da Universidade de São Paulo. As enfermeiras avaliaram módulos e telas do sistema Sistema de Documentação Eletrônica do Processo de Enfermagem da Universidade de São Paulo- PROCEnf-USP, julgando o conforto visual, manuseio, clareza e abrangência da documentação, objetividade das informações e adequação do conteúdo ao registro de enfermagem em unidades clínico-cirúrgicas. RESULTADOS: A maioria das enfermeiras avaliou as características funcionais do PROCEnf-USP, como excelentes e muito boas, destacando o suporte ao raciocínio clínico ao apoiar decisões sobre diagnósticos, resultados e intervenções de enfermagem. Todas se posicionaram favoravelmente à implementação do PROCEnf-USP. CONCLUSÃO: Os resultados das avaliações mostraram que as enfermeiras estão estimuladas a adquirir novas habilidades técnicas e tecnológicas, com a adoção do PROCEnf-USP para a documentação do PE na realidade Institucional.

Patient perceptions of balance in prostate cancer screening decision aids

Purpose. Recent reports reveals that studies of decision aids reported concern about the balance and accuracy of information included in decision aids. This study explores measures of balance in patient decision aids through a review of prostate cancer screening decision aid studies and analysis of patients’ rating of a patient decision aid for prostate cancer screening. ^ Methods. A data-abstraction form was used to collect the key characteristics, pertaining to balance, of studies included in the review. The key characteristics included (1) sample characteristics (age, race, family history of prostate cancer, and education), (2) description of the decision aid and how it was implemented, and (3) if a measure of balance was used for process evaluation and the rating. A summary table was used to report the findings. Deidentified data was received from a decision aid control trial and logistic regression analysis was used to test the association between the dependent variable (balance) and the independent variables (age, family history, race, screening preference at baseline, education, health insurance status). ^ Conclusion. Three sociodemographic variables remained significant in the final regression model: African American race, education and PSA history. Further research is needed to determine if these variables can predict a man’s perception of balance in prostate cancer screening decision aids. If a patient’s perceptions of balance can be predicted based on specific characteristics, patient report may not be the most objective method of evaluating the acceptability of a decision.^

Malaria prevention in Kenyan women of childbearing age

The objective of this program is to reduce malaria incidence in Kenya. Malaria poses a large public health challenge in Kenya, and although public health efforts have traditionally been focused on treatment of infected patients, due to increased drug resistance and lack of drug-adherence, prevention strategies are needed. This program targets Kenyan women, the likely caretakers in the home, and promotes malaria prevention behaviors through health education. ^ A planning group will be assembled and a needs assessment will be performed, verifying risk factors and conditions associated with malaria, as well as personal and external determinants. Behavioral and environmental outcomes will be determined, and performance objectives for each outcome will be established. Matrices of change objectives will be created, and detailed methods and strategies will be linked to each change objective. Program elements include media, education, and incentives. All materials used in this program will be subjected to pre-test to ensure cultural relevance and fidelity. Matrices of change objectives will be created for program adopters and implementers, as well as correlating methods and strategies associated with each change objective. Performance objectives will also be compiled for program maintainers. A program evaluation plan will follow "Pre-Post Comparison Group" design. Outcome evaluation and process evaluation will be conducted. The sample population will be screened based on age and gender so as to maintain comparability to the target population. Measurements will be taken before the program to establish baseline, directly following the program to determine short-term effects, and three months after the program is completed to determine long-term effects. ^ One limitation of this program is selection bias, due to the nature of quasi-experimental studies. Thorough screening prior to sample selection will minimize selection bias and ensure group homogeneity. Another limitation is attrition, and this will be minimized where possible through the use of incentives. In cases where loss to follow-up is not avoidable, such as death or natural disasters, the attrition effect will be estimated using structural equation modeling after reviewing the sample size, differential attrition and total attrition. ^ This intervention is based heavily on health promotion theories, but it is important to remember that in the field, the program plan will likely include only the necessary practical strategies. The target population, Kenyan women of childbearing age, will be significant in decreasing the malaria disease burden in Kenya.^

Validity and reliability of using MVP 4 Function Walk4Life digital pedometers to assess physical activity levels among preschool-aged Head Start children

The Surgeon General recommends preschoolers 3-5 years old accumulate 60 minutes of moderate-to-vigorous physical activity (MVPA) per day. However, there is limited data measuring physical activity (PA) and MVPA amongst this population. The purpose of this cross-sectional study is to determine the validity, reliability, and feasibility of using MVP 4 Function Walk4Life digital pedometers (MVP-4) in measuring MVPA among preschoolers using the newly modified direct observational technique, System for Observing Fitness Instruction Time-Preschool Version (SOFIT-P) as the gold standard. An ethnically diverse population of 3-5 year old underserved children were recruited from two Harris County Department of Education (HCDE) Head Start centers. For 2 days at baseline and 2 days at post-test, 75 children enrolled wore MVP-4 pedometers for approximately 6-hours per observation day and were observed using SOFIT-P during predominantly active times. Statistical analyses used Pearson "r" correlation coefficients to determine mean minutes of PA and MVPA, convergent and criterion validity, and reliability. Significance was set at p = <0.05. Feasibility was determined through process evaluation information collected during this study via observations from data collectors and teacher input. Results show mean minutes of PA and MVPA ranged between 30-42 and 11-14 minutes, respectively. Convergent validity comparing BMI percentiles with MVP-4 PA outcomes show no significance at pre-test; however, each measurement at post-test showed significance for MVPA (p = 0.0247, p = 0.0056), respectively. Criterion validity comparing percent MVPA time between SOFIT-P and MVP-4 pedometers was determined; however, results deemed insufficient due to inconsistency in observation times while using the newly developed SOFIT-P. Reliability measures show no significance at pre-test, yet show significant results for all PA outcomes at post-test (p = 0.001, p = 0.001, p = 0.0010, p = 0.003), respectively. Finally, MVP-4 pedometers lacked feasibility due to logistical barriers in design. Researchers feel the significant results at post-test are secondary to increased familiarity and more accurate placement of pedometers across time. Researchers suggest manufacturers of MVP-4 pedometers further modify the instrument for ease of use with this population, following which future studies ought to determine validity using objective measures or all-day direct observation techniques.^

Determining the feasibility and acceptability of a garden-based nutrition curriculum for preschoolers

Obesity rates around the nation have risen to epidemic proportions. Rates of childhood obesity are at very high levels with 24.4% of preschool-aged children in the U.S. currently considered as overweight or obese. The percentage of childhood obesity is much higher in the southern part of the United States as compared to the rest of the nation. Minority populations, especially African American and Hispanic, are affected more than other ethnic groups. Obesity prevention programs are needed targeting young children <6 years of age from minority populations. Currently, there are few obesity prevention programs that have been implemented and evaluated in children <6 years of age. Gardening programs have been successful in improving the health status of elementary school children by increasing fruit and vegetable intake and increasing preferences for healthier food choices. However, there is no evidence of the feasibility and acceptability of a garden-based obesity prevention program among preschoolers. This pretest study, a classroom-based gardening curriculum program with 16 lesson plans and coordinating activities for preschool age children (3-5 years old) enrolled in Head Start, provides the opportunity to address this need. The study included 103 preschoolers from two centers and 9 teachers or teachers' aides. Qualitative data on feasibility and acceptability was collected from process evaluation forms of individual lesson plans and focus groups with teachers. Teacher questionnaires assessed individual teacher characteristics and provided feedback regarding the curriculum. Quantitative measures of teachers' self-efficacy, attitudes, and knowledge pertaining to nutrition were analyzed from pre and post-test surveys. Results revealed this preschool garden-based nutrition curriculum was both feasible and acceptable. The program improved teacher's self-efficacy, knowledge, and attitudes about nutrition, with teacher's confidence in ability to teach a gardening curriculum increasing from a mean score of 2.14 to 3.00 from pre to post test (P value = 0.0046). These results indicate implementing garden-based nutrition lessons within preschools is achievable. Employing garden-based nutrition lessons in the classroom is the first step in teaching children about nutrition and gardening concepts. Constructing gardening beds for more hands-on learning is the next proposed step in the larger parent study of this program.^

Evaluación del proceso de compostaje de dos mezclas de residuos avícolas

Los residuos del sector avícola, principalmente guano (aves ponedoras) y cama de parrilleros (aves de engorde), pueden generar un impacto negativo en el ambiente contribuyendo a la contaminación de suelo, agua y aire. La estabilización aeróbica a través del compostaje es una alternativa de tratamiento para reducir la contaminación. El objetivo de este trabajo fue evaluar el proceso de compostaje en dos mezclas con diferentes porcentajes de residuos avícolas (guano de aves ponedoras y cama de pollos parrilleros). Se compostaron dos mezclas que contenían 81% y 70% de residuos avícolas durante 16 semanas. Las variables analizadas fueron: temperatura (T°), pH, conductividad eléctrica (CE), humedad (H), capacidad de intercambio catiónico (CIC), carbono orgánico total (COT), amonio (NH4+), nitrato (NO3 - ), nitrógeno total (NT ) y carbono soluble (CS). Las características finales de los compost A y B fueron: pH 7,1 - 6,8, CE 3,3 - 2,9 (mS. cm- 1), COT 14,8 - 17,9 %, NT 0,97 - 0,88 %, NH4 + 501 - 144,9 mg kg-1, NO3-552,3 - 543,0 mg kg-1 respectivamente. El proceso de compostaje podría ser una herramienta para estabilizar los residuos avícolas minimizando su impacto en el ambiente.

TÁTICAS DE PROFESSORES: UMA REFLEXÃO SOBRE O CENÁRIO AVALIATIVO NO REGIME DE PROGRESSÃO CONTINUADA.

Este estudo qualitativo foi elaborado por meio de pesquisa bibliográfica de estudiosos do tema da avaliação do rendimento de alunos, como Luckesi (2005), Hoffmann (2003), Paro (2003), Hadji (1994) e Figari (1996), e de pesquisa de campo, com o objetivo de investigar como está ocorrendo a avaliação do ensino fundamental da rede pública paulista, na vigência do regime de progressão continuada. Considerando que os fundamentos da prática avaliativa distam quase sempre dos apregoados pela política educacional instituída e com o propósito de verificar se isto está ocorrendo com a política de progressão continuada, participei, durante um ano letivo, das atividades educacionais de uma escola pública da periferia da Grande São Paulo, observando, colhendo depoimentos e anotando cuidadosamente tudo o que vivenciei nesse período. Para empreender uma leitura dos dados coletados, busquei também o apoio no construto teórico de Michel de Certeau, para quem aos "produtos impostos" códigos, leis, políticas culturais, etc. rigorosamente organizados de forma a atribuir um lugar, um papel ao homem ordinário, contrapõem-se práticas construídas no processo de apropriação desses produtos. Por meio de suas "artes de fazer", os usuários reinventam o cotidiano. Utilizando-se de "táticas astuciosas", o usuário da cultura reapropria-se dos espaços, altera-lhes os códigos e deles faz uso "a seu jeito". Nesta pesquisa, que enfoca as relações dos protagonistas de processos avaliativos escolares, confirmam-se os postulados de Certeau, que não conferem ao consumidor da política um lugar passivo. Como já foi caracterizado por este instigante pensador, o usuário da política (o instituinte), enquanto portador de astúcias, move-se no campo espacial do outro (o instituído) e, taticamente, fazendo uso de práticas não previstas, escreve uma "outra história". O principal objetivo deste trabalho foi contribuir com reflexões que mostrem a importância de se analisar as tensões geradas por políticas educacionais impostas, desprovidas de sentido para aqueles que não participam de sua elaboração, o que tem provocado movimentos táticos de seus usuários, neste caso, os docentes, os quais, sem as condições objetivas necessárias para promover a política instituída, enunciada no discurso, utilizam-se do seu potencial instituinte de transformação, escrevendo uma "outra história".

TÁTICAS DE PROFESSORES: UMA REFLEXÃO SOBRE O CENÁRIO AVALIATIVO NO REGIME DE PROGRESSÃO CONTINUADA.

Este estudo qualitativo foi elaborado por meio de pesquisa bibliográfica de estudiosos do tema da avaliação do rendimento de alunos, como Luckesi (2005), Hoffmann (2003), Paro (2003), Hadji (1994) e Figari (1996), e de pesquisa de campo, com o objetivo de investigar como está ocorrendo a avaliação do ensino fundamental da rede pública paulista, na vigência do regime de progressão continuada. Considerando que os fundamentos da prática avaliativa distam quase sempre dos apregoados pela política educacional instituída e com o propósito de verificar se isto está ocorrendo com a política de progressão continuada, participei, durante um ano letivo, das atividades educacionais de uma escola pública da periferia da Grande São Paulo, observando, colhendo depoimentos e anotando cuidadosamente tudo o que vivenciei nesse período. Para empreender uma leitura dos dados coletados, busquei também o apoio no construto teórico de Michel de Certeau, para quem aos "produtos impostos" códigos, leis, políticas culturais, etc. rigorosamente organizados de forma a atribuir um lugar, um papel ao homem ordinário, contrapõem-se práticas construídas no processo de apropriação desses produtos. Por meio de suas "artes de fazer", os usuários reinventam o cotidiano. Utilizando-se de "táticas astuciosas", o usuário da cultura reapropria-se dos espaços, altera-lhes os códigos e deles faz uso "a seu jeito". Nesta pesquisa, que enfoca as relações dos protagonistas de processos avaliativos escolares, confirmam-se os postulados de Certeau, que não conferem ao consumidor da política um lugar passivo. Como já foi caracterizado por este instigante pensador, o usuário da política (o instituinte), enquanto portador de astúcias, move-se no campo espacial do outro (o instituído) e, taticamente, fazendo uso de práticas não previstas, escreve uma "outra história". O principal objetivo deste trabalho foi contribuir com reflexões que mostrem a importância de se analisar as tensões geradas por políticas educacionais impostas, desprovidas de sentido para aqueles que não participam de sua elaboração, o que tem provocado movimentos táticos de seus usuários, neste caso, os docentes, os quais, sem as condições objetivas necessárias para promover a política instituída, enunciada no discurso, utilizam-se do seu potencial instituinte de transformação, escrevendo uma "outra história".

A criatividade como competência essencial no desenvolvimento progressivo do aluno em artes visuais

Relatório da Prática de Ensino Supervisionada, Mestrado em Ensino das Artes Visuais, Universidade de Lisboa, Instituto de Educação, 2016

Processos e práticas de avaliação de centros novas oportunidades: o caso do CNO da escola secundária Gabriel Pereira

A presente investigação assentou na temática da Educação e Formação de Adultos, nomeadamente no processo de Reconhecimento, Validação e Certificação de Competências. Sob a configuração metodológica de um estudo de caso, teve como objeto de estudo o Centro Novas Oportunidades da Escola Secundária Gabriel Pereira. Neste trabalho de investigação procurou-se não só analisar os resultados em matéria de satisfação pessoal e profissional, decorrentes da realização de um processo de RVCC, manifestados pelos diferentes intervenientes (adultos certificados, famílias e entidades empregadoras de adultos certificados e equipa técnico-pedagógica) como também, compreender até que ponto a avaliação do processo permite consubstanciar esses mesmos resultados. Ao longo de toda a pesquisa foi definida uma estratégia metodológica que permitiu combinar uma variedade de métodos, incluindo técnicas de natureza quantitativa e qualitativa. Com o desenvolvimento desta investigação foi possível concluir que os resultados alcançados pelos adultos certificados são, do ponto de vista dos diferentes participantes, mais positivos no domínio da satisfação pessoal comparativamente à dimensão profissional, corroborando, aliás, outros estudos dirigidos à mesma problemática.

Reaching out to promote physical activity in Australia: A statewide randomized controlled trial of a stage-targeted intervention

Purpose. This study examined the broader use of a print-media intervention, which was previously shown to be effective at promoting physical activity to participants recruited from a regional Australian community, as a strategy suitable for a more diverse statewide Population sample. Methods. Participants were randomly selected adults who responded to a telephone interview conducted by the New South Wales Health Department and consented to Participate in a randomized controlled trial. Consenters were allocated to either intervention (n = 361) or control (n = 358) conditions. The intervention, a personalized letter plus stage-targeted booklets, was sent 1 week postbaseline. Data were collected via telephone inter view at baseline and 2 and 8 months and were analyzed using repeated measures analysis of variance (ANOVA) and chi(2) statistics. Results. The groups were similar at baseline (mean age 43 +/- 3 years; 64% women). Process evaluation showed high intervention recall (76% at 2 months) and high follow-up response rules (>85% at 8 months) were achieved. Nonsignificant increases in physical activity were observed (F-1,F-719 = 2.18, p =.14). Discussion. A single mailing of stage-targeted print materials was not effective in promoting increases in physical activity among participants selected from the statewide population. Future research could. examine how the effectiveness of print media might be enhanced, possibly by using supplementary media, community-based Prompts, or other incentives.

Acceptability and feasibility of a community-based screening programme for melanoma in Australia

The evaluation of a community-based screening programme for melanoma (SkinWatch) in 18 regional communities (total adult population >30 years 63 035) in Queensland, Australia is described. The aim of the SkinWatch programme was to promote whole-body skin screening for melanoma by primary care physicians. The programme included community education, education and support for local medical practitioners and open-access skin screening clinics. Programme delivery was achieved through assistance of local volunteers. All programme activities and resources were recorded for process evaluation. A baseline telephone survey (n = 3110) and a telephone survey four months after programme launch (n = 680) assessed community awareness of the SkinWatch programme and, 37 face-to-face interviews with community members, doctors and community leaders were conducted to assess satisfaction with the programme. A sample of 1043 of 16 383 residents who attended the skin screening clinics provided as part of the programme were interviewed to assess reasons for attending, and positive and negative aspects of SkinWatch programme. Community awareness of the SkinWatch programme increased by over 30% (p < 0.001) within four months of the start of the programme. Interview participants described the SkinWatch programme as a useful service for the communities and 90% stated they would revisit the clinics. A total of 43% of all attendees were over 50 years old, and nearly 50% were men. These findings demonstrate the acceptability and feasibility of a community-based screening programme for melanoma in rural areas. Volunteers were instrumental in increasing community ownership of and involvement in the SkinWatch programme.

Engagement and retention of participants in a physical activity website

Background. Websites have the potential to deliver enhanced versions of targeted and tailored physical activity programs to large numbers of participants. We describe participant engagement and retention with a stage-based physical activity website in a workplace setting. Methods. We analyzed data from participants in the website condition of a randomized trial designed to test the efficacy of a print- vs. website-delivered intervention. They received four stage-targeted e-mails over 8 weeks, with hyperlinks to the website. Both objective and self-reported website use data were collected and analyzed. Results. Overall, 327 were randomized to the website condition and 250 (76%) completed the follow-up survey. Forty-six percent (n = 152) visited the website over the trial period. A total of 4,114 hits to the website were recorded. Participants who entered the site spent on average 9 min per visit and viewed 18 pages. Website use declined over time; 77% of all visits followed the first e-mail. Conclusions. Limited website engagement, despite the perceived usefulness of the materials, demonstrates possible constraints on the use of e-mails and websites in delivering health behavior change programs. In the often-cluttered information environment of workplaces, issues of engagement and retention in website-delivered programs require attention. (C) 2004 The Institute For Cancer Prevention and Elsevier Inc. All rights reserved.