O processo de cuidar em Unidade de Terapia Intensiva

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

Assistência de enfermagem às urgências e emergências psiquiátricas no serviço de atendimento móvel de urgência em Mossoró-RN

This study aims to identify the concepts of professional nursing team on assistance in urgency and psychiatric emergencies in SAMU in Mossoró/RN, identifying the difficulties in implementing an emergency assistance to the user in psychiatric distress in this service and point strategies in pursuit of consolidation and expansion of comprehensive health care to the public. It is a descriptive research with qualitative and exploratory approach. The subjects were employees of the nursing staff of SAMU of that mentioned municipality. Semi-structured interviews are applied as tool for data collection. It was counted on the consent of the institution where the study was developed and approval by the Ethics Committee in Research of UFRN with CAAE No 17326513.0.0000.5537, besides signing the Informed Free Consent Term by the participants. Data analysis was done by means of thematic analysis proposed by Bardin. Thus , as a result of the research produced the following categories: mechanistic practice; dehumanization of care; need for qualification, barriers to assistance in urgency and psychiatric emergency and strategies in pursuit of comprehensive care, which proceeded in preparing two articles entitled "Nursing care to the emergency room and psychiatric emergencies in the mobile emergency care service" and "Barriers for emergency service and psychiatric emergencies in the mobile emergency care service". In the studied reality it was identified that nursing care offered to users in situations of urgency and psychiatric emergency is made based primarily on the use of chemical and physical restraints, as well as transportation to the general hospital, constantly using the police force support, which meets the guidelines of the Psychiatric Reform and thereby undermining the provision of an effective and humane care. This scenario is worsened by the lack of an organized network of services in mental health, where after the service the user is taken to a general hospital, considering that there is no ready or appropriate psychiatric emergency service as a Center of Psychosocial Care - CAPs III to reference it, thereby precluding the realization of a resolute and comprehensive care. Thus, it is concluded that nursing care is based on biologicist and medicine-centered model advocated by classical psychiatry, and that despite all the advances in psychiatric reform, still guides the mental health care, so the lack of service network organized in hierarchical and mental health, where the user in urgency and emergency service can be watched in full and the guidelines of the psychiatric reform can be realized in practice

O ensino de enfermagem gerontológica na formação do enfermeiro

At the current time of demographic changes in the world , it is observed that the health sector requires restructuring of its practices in caring for the elderly , in order to enable a comprehensive and humane care . In this sense, we identify the need for qualified professionals to assist the elderly and, therefore , it is important that training curricula are adequate to this reality . The study aims to analyze how it develops teaching gerontological nursing component in undergraduate nursing . This is a descriptive , exploratory study with a qualitative approach, in two higher education institutions in the city of Natal / RN . The population involved corresponded to the coordinators of graduate courses in nursing and teachers who teach content of health care for the elderly, a total of seven participants . The data collection instruments were used: a questionnaire containing questions related to the characterization of the participants and the teaching of gerontological nursing in undergraduate courses in nursing and a form with items of analysis for pedagogical projects . The results were presented descriptively in tables and analyzed from coming themes of the main themes of the instruments defined in: knowledge about the research participants , knowledge of teaching gerontological nursing component and knowledge of pedagogical projects , discussed under Resolution paragraph . 03 of 7/11/2001 , which establishes standards for the nursing program , the educational projects of educational institutions , the Theoretical Donald Shoon and thematically relevant literature . The results indicate that the majority of participants were female (four), all have graduate though , none of them stated in the qualification of aging or elderly health area; the organization of the contents of the component in the curriculum, workload theoretical- methodological and practical teaching strategies presented was heterogeneous and sometimes diverging at the same institution . On the definition of gerontological nursing component was identified that is not well defined along the pedagogical design of educational institutions surveyed . It was concluded that in the context of this study , teaching gerontological nursing is present in the course of nursing education, but needs reevaluation and updating in order to teach a wider range of driving and health practices

Humanização hospitalar, ambiente físico e relações assistenciais :a percepção de arquitetos especialistas

The creation of the Humanization Program of Hospital Care and the increasing number of academic works and journal articles that discuss more humane practices in the health care services express the emphasis given to the theme in Brazil. In these discussions, however, it is not usual to find reference to architecture as a relevant factor in the humanization of hospitals, even though it is known that the physical structure of the building may help the recovering of the patients; elements such as gardens, the use of colors and open spaces may soften the impact caused by the hospital routine on patients. Considering the contribution the architectural project may bring to the humanization of hospitals, the aim of this study was to verify how the architects perceive the hospital humanization process. Besides having searched for subsides in informal interviews with health professionals, in visits to hospitals and in related seminars, the study was based on semi-structured interviews with architects of Natal, Rio Grande do Norte, who are specialists in this kind of projects. The content analysis of the interviews showed that physical space and attendance are essential to the humanization process. Those professionals see two humanization tendencies: while private hospitals have the structural physical appearance considered as humanized, public hospitals emphasize the humanization in attendance, fact that illustrates the contradictions in Brazilian health system. The interviewees consider the post-occupancy evaluation of the building as a learning exercise that contributes to new projects, but surprisingly they do not mention the patients opinion as part of it. Two annoying facts have emerged from the interviews, as also seen in preliminary stages of the study: rare are the works that focus on the person-environment relationship, and the definition of humanized hospital environments is still broad and inaccurate. This suggests the need of new studies in order to better understand how the two factors shown in this study attendance and physical space interact towards a true hospital humanization

Escuta clínica e atitude fenomenológica no atendimento à pessoa surda: reflexões sobre um processo psicoterápico

Psychology uses listening as a work resource. When it comes to psychotherapy, listening establishes communication and makes psychologist-client dialogue easier. This qualitative research aims to discuss the clinic listening in phenomenological attitude in existential-phenomenological psychotherapy with deaf people. This perspective is based on the thinking of German philosopher Martin Heidegger, who considers humane a being-with and being-in-the-world, always unveiling meanings. Regarding the deaf people, Libras is currently the natural language of Brazilian deaf people. In this new language configuration, communication occurs in a visual-spatial modality. Thus, listening and speech gain new dimensions, demanding different ways of understanding in the field of psychotherapy. To the development of this research, we present excerpts from therapeutic sessions narratives with a deaf client, interpreted in the light of Heidegger s hermeneutics. We consider that it is possible for the psychotherapist to listen to deaf people in phenomenological attitude. Such position, which does not naturalize and limit the humane, helps so that the clients do not feel responsible for their existence and can hermeneutically converse in their language. In this context, the psychologist must be qualified to conduct the treatment in Libras. We hope that this research can, somehow, fill the existing gap of the scientific production about such theme in the field of Psychology and, mainly, instigate discussion in the context of Psychology courses on the importance and need to qualify psychologists for the management of clinical practice with deaf people

Sentimentos e percepções de puérperas com relação à assistência prestada pelo serviço materno-infantil de um hospital universitário

OBJETIVOS: avaliar percepções e sentimentos de puérperas adultas e adolescentes, relacionados ao filho e a assistência materno-infantil, em hospital universitário de nível terciário. MÉTODOS: estudo transversal, envolvendo 180 puérperas, no Alojamento Conjunto (AC) e no Berçário Interno (BI) do Hospital das Clínicas da Faculdade de Medicina de Botucatu , entrevistadas no segundo e terceiro dia pós-parto e distribuídas em três grupos: adultas primíparas, adultas multíparas e adolescentes. Para comparação entre grupos e locais de internação utilizou-se o chi2 ou teste de Fisher. RESULTADOS: ultrasom obstétrico e cardiotocografia tiveram impacto positivo na emoção materna. Houve pouca diferença entre os grupos quanto aos sentimentos antes e após o parto, sendo felicidade, amor, responsabilidade, ansiedade e medo os mais freqüentes. A culpa predominou nas adolescentes do BI. As percepções relacionadas ao filho, a avaliação da assistência e equipe, não diferiram entre adultas e adolescentes. Nas duas enfermarias o relacionamento entre mães e cuidadores foi bom, as mães mostraram-se satisfeitas com a equipe e a assistência, mas o aleitamento materno foi pouco valorizado e poucas mães conheciam o médico. CONCLUSÕES: está ocorrendo um processo de humanização na assistência materno-infantil deste hospital universitário, mas alguns aspectos precisam ser melhorados, especialmente a valorização do aleitamento materno e a individualização no contato médico-paciente.

Estudo comparativo da cicatrização de enterorrafias em planos aposicional e invaginante no cólon descendente de eqüinos

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Interspecies variation in orbital bone structure of psittaciform birds (with emphasis on Psittacidae)

Objectives: This text presents an anatomical study of the normal bony orbital structure of a sample of different bird species belonging to the order Psittaciformes.Procedures: the bony anatomy of Psittaciformes' skulls was examined and described using cadavers of birds that were presented already dead to the Federal University of Parana, Brazil or had been euthanized for humane reasons. Dissections of the orbital cavity were performed under 2-4 x magnification, and descriptions of the orbital bones were made from observations of macerated skulls that had been boiled and cleaned. The present paper discusses the main features of the bony orbit of psittaciform birds, describing known anatomical information but also bringing new information, mainly concerning species differences that might help not only veterinary anatomists but also zoologists, clinicians, researchers, and students of veterinary ophthalmology to better comprehend this order of birds.Results and conclusions: Variations in the anatomic conformation of the bony elements of the orbit were observed in different species of Psittaciformes. Based on these differences, Psittaciformes were classified into two different groups. The first group of Psittaciformes shows an enclosed (complete) bony orbit formed by the junction of the orbital with the postorbital processes, creating a suborbital arch. The second group of Psittaciformes essentially lacked a suborbital arch, presenting an open (incomplete) bony orbit, typical of most modern birds. In the latter group, orbital and postorbital processes are present.

Analise citotoxica de esparfloxacino e seus produtos de degradaçao em células mononucleares humanas

Sparfloxacin, a difluorquinolone derivative, is a potent antibacterial agent active against a wide range of gram-positive and gram-negative organisms including Streptococcus pneumoniae, Staphylococcus aureus, methicillin resistant S. aureus, Legionella spp, Mycoplasma spp; Chlamydia spp. and Mycobacteria. A drawback of fluorquinolones is their photoreactivity. Sparfloxacin has been studied in terms of therapeutic activities. However, few reports about analytical methods of sparfloxacin are available in the literature. The aim of this study was to determine cytotoxic effects, using sparfloxacin reference substance (SPAX-SR), sparfloxacin tablets (SPAX-COMP) and sparfloxacin tablets submitted UV light during 36 hours (SPAX-COMP.36) solution, and two isolated products (7 and 9) of SPAX-SR submitted UV-C light, in concentrations of 31.25, 62.5, 125 and 250 μg/mL by in vitro mononuclear humane culture cells. The results, statistically analyzed by Teste de Tukey, showed SPAX, SPAX-COMP and SPAX-COMP.36 solutions could reduce the cells number in these conditions. These results could not be observed for products 7 or 9. These results can suggest that isolated product can be less cytotoxic than SPAX-SR, is method can also be used to identified products degradation of sparfloxacin in stability study. However, the low activity achieved with sparfloxacin submitted to UV-light is a source of concern and requires further investigation about its photodegradation mechanism.

Efeito da rampa isolante na insensibilização de frangos de corte e seus reflexos sobre o bem-estar e qualidade da carcaça

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

A produção de conhecimento científico da educação física na Sociedade Brasileira para o Progesso da Ciência (SBPC)

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

A percepção da equipe de enfermagem de um hospital especilizado sobre o seu processo de trabalho

Pós-graduação em Enfermagem (mestrado profissional) - FMB

Marx e o imperativo da mais-valia

A obra de Karl Marx é um complexo orgânico cuja a categoria central é o trabalho. O trabalho funda o ser social e estabelece mediações que remetem para além de si, num desenvolvimento contínuo que impulsiona a humanidade a um desenvolvimento omnilateral, isto é, em todas as suas dimensões, um desenvolvimento que abrange todas as necessidades reais do ser humano. O desenvolvimento do complexo de relações geradas pelo trabalho, designadas como forças produtivas, foi exponencialmente ampliado pelo modo de produção do capital, no entanto, o capital dissocia o trabalhador de seus meios de produção, de maneira que a evolução das forças produtivas não reflete o desenvolvimento das propriedades verdadeiramente humanas. Isto acontece porque o capital possui como necessidade sociometabólica acumular-se e expandir-se initerruptamente, fenômeno só alcançado com a extração do sobretrabalho do trabalhador, que consiste no prolongamento da duração da jornada de um mesmo processo de trabalho, ou seja, um dispêndio excessivo da força de trabalho, uma exploração do trabalhador, denominado de mais-valia. É este movimento que gera um excedente sobre o valor original investido pelo capitalista, que altera na esfera da circulação a grandeza de seu valor. O trabalho excedente ou sobretrabalho que produz a maisvalia é um imperativo ou uma imposição objetiva do capital, sem esta não há continuidade no ciclo capitalista de produção. A produção da riqueza, sob o regime do capital, revela sempre seu par, a produção da miséria absoluta para a maioria esmagadora da humanidade. Enquanto as relações de produção forem mediadas pelo imperativo da extração da mais-valia, o capital resiste e contraria todas as teses a respeito de um “capitalismo humanitário”, pois a mais-valia é a essência da exploração, da dominação e da opulência do capital às custas do trabalhador. Portanto, só poderá haver uma verdadeira satisfação das necessidades humanas com a superação da mais-valia que garante a valorização do capital, isto significa que se para o capital é imperativo a apropriação constante da mais-valia, para a humanidade é imperativo a emancipação do capital, isto significa, uma radical transcendência da divisão hierárquica do trabalho e a superação completa de todas as relações do capital.

As letras humanas: os povos indígenas e o ensino da língua portuguesa na Amazônia Pombalina (1751-1763)

Os povos indígenas que habitavam o Vale do Amazonas durante o período da colonização portuguesa foram submetidos em distintos momentos, por diferentes agentes e por variados instrumentos, a incisivos processos de aculturação visando sua inserção no mundo “civilizado”. Sendo o uso das letras humanas, compreendido pela prática da leitura e da escrita na língua portuguesa sua maior evidencia. Durante um século (1650-1750) a Companhia de Jesus destacou-se entre as ordens regulares que se estabeleceram na região como aquela que mais implantou aldeias missionárias objetivando além da catequese o ensino das letras humanas aos povos nativos. Na segunda metade do século dezoito no contexto da chamada “Era Pombalina” o Estado Luso, a partir especialmente das cartas e relatórios de Francisco Xavier de Mendonça Furtado Governador do Estado do Grão- Pará e Maranhão entre 1751 e 1759, oficializou a visão que denunciava o lamentável “estado do ensino” no Vale do Amazonas evidenciado no descaso das ordens missionárias em geral e dos jesuítas em particular, com o ensino da língua do Rei aos súditos nativos. Prova maior desta incômoda realidade era o uso massificado da chamada Língua Geral em detrimento da língua portuguesa. Em face desta realidade e considerando que o uso da língua portuguesa se constituía a “base fundamental da civilidade” conforme expressava o texto do Directório que se deve observar nas povoações dos índios do Pará e Maranhão, O Estado encampa e assume a tarefa de promover o ensino das letras humanas nas Vilas, Lugares e Povoações do Vale do Amazonas. Tarefa que o sucessor de Mendonça Furtado o Governador Manuel Bernardo de Mello e Castro (1759-1761) envidará grande esforço e particular empenho para cumprir, em face dos enormes obstáculos estruturais e conjunturais que se apresentavam. Esta dissertação tem como objetivo essencial “melhor compreender” estes eventos, perscrutando o seu processo, destacando seus percalços e refletindo sobre suas consequências para os povos indígenas que o vivenciaram.

A influência dos fatores socioeconômicos na sobrevida global dos pacientes submetidos ao transplante de células tronco hematopoéticas

Pós-graduação em Pesquisa e Desenvolvimento (Biotecnologia Médica) - FMB