Modelo de compet��ncias dos enfermeiros com fun����es de gest��o em Portugal: estudo explorat��rio

Nas ��ltimas d��cadas assistimos a transforma����es econ��micas, tecnol��gicas, pol��ticas e sociais, que influenciaram diretamente o modo de pensar e agir nas organiza����es. O conceito de compet��ncias, com uma valoriza����o crescente, surge como uma alternativa �� abordagem da gest��o de recursos humanos por fun����es, respondendo aos desafios atuais do mercado: necessidade de flexibilidade, de adapta����o a mudan��as cont��nuas, exig��ncias crescentes do mercado e competitividade das organiza����es nesse mercado. A ��rea da sa��de, e concretamente a profiss��o de Enfermagem tamb��m tem evolu��do, surgindo em 2009, uma nova forma de operacionalizar a carreira destes profissionais. No que diz respeito aos enfermeiros com fun����es de gest��o, o conte��do funcional est�� descrito, contudo, n��o existe uma defini����o clara das compet��ncias requeridas para estes profissionais. Este trabalho de investiga����o, de cariz explorat��rio, utilizando uma metodologia qualitativa, pretendeu propor uma estrat��gia de defini����o de um modelo de compet��ncias para os enfermeiros com fun����es de gest��o em Portugal. Para isso, definimos categorias de compet��ncias, atrav��s da an��lise da literatura e da legisla����o. Seguiu-se a realiza����o de entrevistas a um painel de doze peritos, e uma an��lise de conte��do dos dados (categoriza����o do tipo misto). Procedemos a uma compara����o da recolha emp��rica de compet��ncias com as da recolha te��rica, e definimos uma lista de 10 compet��ncias para as fun����es de gest��o dos enfermeiros: Compet��ncias T��cnicas de Gest��o; Compet��ncias Interpessoais; Comunica����o; Gest��o de Recursos Humanos; Pensamento Cr��tico; Conhecimento de Pol��ticas de Sa��de; Compet��ncias T��cnicas de Enfermagem; Organiza����o e Planeamento; Trabalho de Equipa; Preocupa����o pela Qualidade. De forma a complementar o estudo, pretendemos identificar a perce����o das lacunas de compet��ncias nos enfermeiros com fun����es de gest��o, e identificar os processos de desenvolvimento de compet��ncias considerados mais relevantes para estes profissionais. As lacunas identificadas nas compet��ncias dos atuais enfermeiros com fun����es de gest��o, face ��s mais valorizadas, s��o reduzidas e dispersas, pelo que consideramos pouco significativas. A forma de desenvolvimento de compet��ncias mais valorizado pelo painel de peritos foi a forma����o (acad��mica e em contexto profissional). Foi tamb��m real��ada a import��ncia do empenho individual neste processo, assim como a avalia����o de compet��ncias antes dos enfermeiros assumirem fun����es de gest��o.Consideramos que esta investiga����o traz contributos quer para a literatura da Gest��o por Compet��ncias, quer para a literatura da defini����o de compet��ncias das fun����es dos enfermeiros com fun����es de gest��o, quer para a profiss��o de enfermagem, (nomeadamente, para as fun����es de gest��o dos enfermeiros), quer para o pr��prio SNS, j�� que faz algumas propostas e sugest��es para a evolu����o das pr��ticas de gest��o de pessoas.

Self-reported conflict management competence among nursing students on the point of graduating and registered nurses with professional experience

Objective: It has been shown that specific competence is necessary for preventing and managing conflicts in healthcare settings. The aim of this descriptive and correlation study was to investigate and compare the self-reported conflict management competence (CMC) of nursing students who were on the point of graduating (NSPGs), and the CMC of registered nurses (RNs) with professional experience. Methods: The data collection, which consisted of soliciting answers to items measuring CMC in the Nurse Professional Competence (NPC) Scale, was performed as a purposive selection of 11 higher education institutions (HEIs) in Sweden. Three CMC items from the NPC Scale were answered by a total of 569 nursing students who were on the point of graduating and 227 RN registered nurses with professional experience. Results: No significant differences between NSPGs and RNs were found, and both groups showed a similar score pattern, with the lowest score for the item: ���How do you perceive your ability to develop the group and strengthen competence in conflict management and problem-solving, based on knowledge of group dynamics?���. RNs with long professional experience (>24 months) rated their overall CMC as significantly better than RNs with short (<24 months) professional experience did (p = .05). NSPGs who had experience of international studies during their nursing education reported higher CMC, compared with those who did not have this experience (p = .03). RNs who reported a high degree of utilisation of CMC during the previous month scored higher regarding self-reported overall CMC (p < .0001). Conclusions: Experience of international studies during nursing education, or long professional experience, resulted in higher self-reported CMC. Hence, the CMC items in the NPC Scale can be suitable for identifying self-reported conflict management competence among NSPGs and RNs

Emergency airway management by intensive care unit nurses with the intubating laryngeal mask airway and the laryngeal tube

When using the laryngeal tube and the intubating laryngeal mask airway (ILMA), the medium-size (maximum volume 1100 ml) versus adult (maximum volume 1500 ml) self-inflating bags resulted in significantly lower lung tidal volumes. No gastric inflation occurred when using both devices with either ventilation bag. The newly developed medium-size self-inflating bag may be an option to further reduce the risk of gastric inflation while maintaining sufficient lung ventilation. Both the ILMA and laryngeal tube proved to be valid alternatives for emergency airway management in the experimental model used.

Comunidades de pr��tica nas organiza����es de sa��de: proposta de modelo numa organiza����o hospitalar

Mestrado em Interven����o S��cio-Organizacional na Sa��de - Ramo de especializa����o: Pol��ticas de Administra����o e gest��o de Servi��os de Sa��de

Peroxisomal beta-oxidation--a metabolic pathway with multiple functions.

Fatty acid degradation in most organisms occurs primarily via the beta-oxidation cycle. In mammals, beta-oxidation occurs in both mitochondria and peroxisomes, whereas plants and most fungi harbor the beta-oxidation cycle only in the peroxisomes. Although several of the enzymes participating in this pathway in both organelles are similar, some distinct physiological roles have been uncovered. Recent advances in the structural elucidation of numerous mammalian and yeast enzymes involved in beta-oxidation have shed light on the basis of the substrate specificity for several of them. Of particular interest is the structural organization and function of the type 1 and 2 multifunctional enzyme (MFE-1 and MFE-2), two enzymes evolutionarily distant yet catalyzing the same overall enzymatic reactions but via opposite stereochemistry. New data on the physiological roles of the various enzymes participating in beta-oxidation have been gathered through the analysis of knockout mutants in plants, yeast and animals, as well as by the use of polyhydroxyalkanoate synthesis from beta-oxidation intermediates as a tool to study carbon flux through the pathway. In plants, both forward and reverse genetics performed on the model plant Arabidopsis thaliana have revealed novel roles for beta-oxidation in the germination process that is independent of the generation of carbohydrates for growth, as well as in embryo and flower development, and the generation of the phytohormone indole-3-acetic acid and the signal molecule jasmonic acid.

Report to Secretary General on: Travel associated with Management - Union Partnership Activities, and in which Department officials participated, and Funding for Management -Union Partnership activities other than SKILL

Report to Secretary General on: Travel associated with Management – Union Partnership Activities, and in which Department officials participated, and Funding for Management -Union Partnership activities other than SKILL Download this document as a PDF 58KB Also… Subsistence Allowances PDF 1.19MB Extracts from the Health Service National Partnership Forum’s Financial Statements for the year ended 31 December 2000 PDF 338KB Foreign Travel claims relating to Skills & Partnership PDF 13KB Details of Funding Provided to Nursing Unions from 12/6/2000 – 5/11/2004 PDF 360KB Partnership Investigation PDF 428KB

Gliotransmission in the hippocampus, mechanisms and interaction with synaptic functions

SUMMARYAstrocytes represent the largest cell population in the human brain. In addition to a well established role as metabolic support for neuronal activity, in the last years these cells have been found to accomplish other important and, sometimes, unexpected functions. The tight enwrapping of synapses by astrocytic processes and the predominant expression of glutamate uptake carriers in the astrocytic rather than neuronal plasma membranes brought to the definition of a critical involvement of astrocytes in the clearance of glutamate from synaptic junctions. Moreover, several publications showed that astrocytes are able to release chemical transmitters (gliotransmitters) suggesting their active implication in the control of synaptic functions. Among gliotransmitters, the best characterized is glutamate, which has been proposed to be released from astrocytes in a Ca2+ dependent manner via exocytosis of synaptic-like microvesicles.In my thesis I present results leading to substantial advancement of the understanding of the mechanisms by which astrocytes modulate synaptic activity in the hippocampus, notably at excitatory synapses on dentate granule cells. I show that tumor necrosis factor- alpha (TNFa), a molecule that is generally involved in immune system functions, critically controls astrocyte-to-synapse communication (gliotransmission) in the brain. With constitutive levels of TNFa present, activation of purinergic G protein-coupled receptors in astrocytes, called P2Y1 receptors, induces localized intracellular calcium ([Ca2+]j) elevation in astrocytic processes (measured by two-photon microscopy) followed by glutamate release and activation of pre-synaptic NMDA receptors resulting in synaptic potentiation. In preparations lacking TNFa, astrocytes respond with identical [Ca2+]i elevations but fail to induce neuromodulation. I find that TNFa specifically controls the glutamate release step of gliotransmission. Addition of very low (picomolar) TNFa concentrations to preparations lacking the cytokine, promptly reconstitutes both normal exocytosis in cultured astrocytes and gliotransmission in hippocampal slices. These data provide the first demonstration that gliotransmission and its synaptic effects are controlled not only by astrocyte [Ca2+]i elevations but also by permissive/homeostatic factors like TNFa.In addition, I find that higher and presumably pathological TNFa concentrations do not act just permissively but instead become direct and potent triggers of glutamate release from astrocytes, leading to a strong enhancement of excitatory synaptic activity. The TNFa action, like the one observed upon P2Y1R activation, is mediated by pre-synaptic NMDA receptors, but in this case the effect is long-lasting, and not reversible. Moreover, I report that a necessary molecular target for this action of TNFa is TNFR1, one of the two specific receptors for the cytokine, as I found that TNFa was unable to induce synaptic potentiation when applied in slices from TNFR1 knock-out (Tnfrlv") mice. I then created a double transgenic mouse model where TNFR1 is knocked out in all cells but can be re-expressed selectively in astrocytes and I report that activation of the receptors in these cells is sufficient to reestablish TNFa-dependent long-lasting potentiation of synaptic activity in the TNFR1 knock-out mice.I therefore discovered that TNFa is a primary molecule displaying both permissive and instructive roles on gliotransmission controlling synaptic functions. These reports might have profound implications for the understanding of both physiological and pathological processes associated to TNFa production, including inflammatory processes in the brain.R��SUM��Les astrocytes sont les cellules les plus abondantes du cerveau humain. Outre leur r��le bien ��tabli dans le support m��tabolique de l'activit�� neuronale, d'autres fonctions importantes, et parfois inattendues de ces cellules ont ��t�� mises en lumi��re au cours de ces derni��res ann��es. Les astrocytes entourent ��troitement les synapses de leurs fins processus qui expriment fortement les transporteurs du glutamate et permettent ainsi aux astrocytes de jouer un r��le critique dans l'��limination du glutamate de la fente synaptique. N��anmoins, les astrocytes semblent ��tre capables de jouer un r��le plus int��gratif en modulant l'activit�� synaptique, notamment par la lib��ration de transmetteurs (gliotransmetteurs). Le gliotransmetteur le plus ��tudi�� est le glutamate qui est lib��r�� par l'exocytose r��gul��e de petites v��sicules ressemblant aux v��sicules synaptiques (SLMVs) via un m��canisme d��pendant du calcium.Les r��sultats pr��sent��s dans cette th��se permettent une avanc��e significative dans la compr��hension du mode de communication de ces cellules et de leur implication dans la transmission de l'information synaptique dans l'hippocampe, notamment des synapses excitatrices des cellules granulaires du gyrus dentel��. J'ai pu montrer que le �� facteur de n��crose tumorale alpha �� (TNFa), une cytokine commun��ment associ��e au syst��me immunitaire, est aussi fondamentale pour la communication entre astrocyte et synapse. Lorsqu'un niveau constitutif tr��s bas de TNFa est pr��sent, l'activation des r��cepteurs purinergiques P2Y1 (des r��cepteurs coupl��s �� prot��ine G) produit une augmentation locale de calcium (mesur��e en microscopie bi-photonique) dans l'astrocyte. Cette derni��re d��clenche ensuite une lib��ration de glutamate par les astrocytes conduisant �� l'activation de r��cepteurs NMDA pr��synaptiques et �� une augmentation de l'activit�� synaptique. En revanche, dans la souris TNFa knock-out cette modulation de l'activit�� synaptique par les astrocytes n'est pas bien qu'ils pr��sentent toujours une excitabilit�� calcique normale. Nous avons d��montr�� que le TNFa contr��le sp��cifiquement l'exocytose r��gul��e des SLMVs astrocytaires en permettant la fusion synchrone de ces v��sicules et la lib��ration de glutamate �� destination des r��cepteurs neuronaux. Ainsi, nous avons, pour la premi��re fois, prouv�� que la modulation de l'activit�� synaptique par l'astrocyte n��cessite, pour fonctionner correctement, des facteurs �� permissifs �� comme le TNFa, agissant sur le mode de s��cr��tion du glutamate astrocytaire.J'ai pu, en outre, d��montrer que le TNFa, �� des concentrations plus ��lev��es (celles que l'on peut observer lors de conditions pathologiques) provoque une tr��s forte augmentation de l'activit�� synaptique, agissant non plus comme simple facteur permissif mais bien comme d��clencheur de la gliotransmission. Le TNFa provoque 1'activation des r��cepteurs NMD A pr��-synaptiques (comme dans le cas des P2Y1R) mais son effet est �� long terme et irr��versible. J'ai d��couvert que le TNFa active le r��cepteur TNFR1, un des deux r��cepteurs sp��cifiques pour le TNFa. Ainsi, l'application de cette cytokine sur une tranche de cerveau de souris TNFR1 knock-out ne produit aucune modification de l'activit�� synaptique. Pour v��rifier l'implication des astrocytes dans ce processus, j'ai ensuite mis au point un mod��le animal doublement transg��nique qui exprime le TNFR1 uniquement dans les astrocytes. Ce dernier m'a permis de prouver que l'activation des r��cepteurs TNFR1 astrocytaires est suffisante pour induire une augmentation de l'activit�� synaptique de mani��re durable.Nous avons donc d��couvert que le TNFa poss��de un double r��le, �� la fois un r��le permissif et actif, dans le contr��le de la gliotransmission et, par cons��quent, dans la modulation de l'activit�� synaptique. Cette d��couverte peut potentiellement ��tre d'une extr��me importance pour la compr��hension des m��canismes physiologiques et pathologiques associ��s �� la production du TNFa, en particulier lors de conditions inflammatoires.R��SUM�� GRAND PUBLICLes astrocytes repr��sentent la population la plus nombreuse de cellules dans le cerveau humain. On sait, n��anmoins, tr��s peu de choses sur leurs fonctions. Pendant tr��s longtemps, les astrocytes ont uniquement ��t�� consid��r��s comme la colle du cerveau, un substrat inerte permettant seulement de lier les cellules neuronales entre elles. Il n'y a que depuis peu que l'on a d��couvert de nouvelles implications de ces cellules dans le fonctionnement c��r��bral, comme, entre autres, une fonction de support m��tabolique de l'activit�� neuronale et un r��le dans la modulation de la neurotransmission. C'est ce dernier aspect qui fait l'objet de mon projet de th��se.Nous avons d��couvert que l'activit�� des synapses (r��gions qui permettent la communication d'un neurone �� un autre) qui peut ��tre potentialis��e par la lib��ration du glutamate par les astrocytes, ne peut l'��tre que dans des conditions astrocytaires tr��s particuli��res. Nous avons, en particulier, identifi�� une mol��cule, le facteur de n��crose tumorale alpha (TNFa) qui joue un r��le critique dans cette lib��ration de glutamate astrocytaire.Le TNFa est surtout connu pour son r��le dans le syst��me immunitaire et le fait qu'il est massivement lib��r�� lors de processus inflammatoires. Nous avons d��couvert qu'en concentration minime, correspondant �� sa concentration basale, le TNFa peut n��anmoins exercer un r��le indispensable en permettant la communication entre l'astrocyte et le neurone. Ce mode de fonctionnement est assez probablement repr��sentatif d'un processus physiologique qui permet d'int��grer la communication astrocyte/neurone au fonctionnement g��n��ral du cerveau. Par ailleurs, nous avons ��galement d��montr�� qu'en quantit�� plus importante, le TNFa change son mode de fonctionnement et agit comme un stimulateur direct de la lib��ration de glutamate par l'astrocyte et induit une activation persistante de l'activit�� synaptique. Ce mode de fonctionnement est assez probablement repr��sentatif d'un processus pathologique.Nous sommes ��galement arriv��s �� ces conclusions gr��ce �� la mise en place d'une nouvelle souche de souris doublement transg��niques dans lesquelles seuls les astrocytes (etnon les neurones ou les autres cellules c��r��brales) sont capables d'��tre activ��s par le TNFa.

Modeling Forest Growth with Management Data: A Matrix Approach for the Italian Alps

Summary

Basement depths in the Parecis Basin (Amazon) with receiver functions from small local earthquakes in the Porto dos Gauchos seismic zone

Receiver functions from small local earthquakes were used to determine sediment thicknesses in Porto dos Gauchos seismic zone (PGSZ), Parecis basin, Amazonian craton, Brazil. The high velocity contrast between basement and sediments (P-wave velocities of 6.1 and 3.0 km/s, respectively) favors the generation of clear P-to-S converted phases (Ps) seen in the radial component, and also S-to-P conversions (Sp) seen in the vertical component. A reference 10 velocity model determined with shallow refraction experiment in PGSZ helped to convert Ps P time differences to basement depths at 15 stations deployed for aftershocks studies. The results of receiver function integrated with the shallow refraction reveal that the basement depths in the PGSZ increases from the basin border in the north up to about 600 m depth in the south. The basement topography, however, does not vary smoothly and a basement high with a steep topography was detected near the epicentral area. A 400 m elevation difference within 1.7 km distance suggests a possible border fault of a buried graben. This feature seems to be oriented roughly WSW-ENE and could indicate basement structures related to the seismicity of the Porto dos Gauchos Seismic Zone. (C) 2011 Elsevier Ltd. All rights reserved.

Generalized solutions of a nonlinear parabolic equation with generalized functions as initial data

In [H. Brezis, A. Friedman, Nonlinear parabolic equations involving measures as initial conditions, J. Math. Pure Appl. (9) (1983) 73-97.] Brezis and Friedman prove that certain nonlinear parabolic equations, with the delta-measure as initial data, have no solution. However in [J.F. Colombeau, M. Langlais, Generalized solutions of nonlinear parabolic equations with distributions as initial conditions, J. Math. Anal. Appl (1990) 186-196.] Colombeau and Langlais prove that these equations have a unique solution even if the delta-measure is substituted by any Colombeau generalized function of compact support. Here we generalize Colombeau and Langlais` result proving that we may take any generalized function as the initial data. Our approach relies on recent algebraic and topological developments of the theory of Colombeau generalized functions and results from [J. Aragona, Colombeau generalized functions on quasi-regular sets, Publ. Math. Debrecen (2006) 371-399.]. (C) 2009 Elsevier Ltd. All rights reserved.

Bone morphogenetic protein-7 is a MYC target with prosurvival functions in childhood medulloblastoma

Medulloblastoma (MB) is the most common malignant brain tumor in children. It is known that overexpression and/or amplification of the MYC oncogene is associated with poor clinical outcome, but the molecular mechanisms and the MYC downstream effectors in MB remain still elusive. Besides contributing to elucidate how progression of MB takes place, most importantly, the identification of novel MYC-target genes will suggest novel candidates for targeted therapy in MB. A group of 209 MYC-responsive genes was obtained from a complementary DNA microarray analysis of a MB-derived cell line, following MYC overexpression and silencing. Among the MYC-responsive genes, we identified the members of the bone morphogenetic protein (BMP) signaling pathway, which have a crucial role during the development of the cerebellum. In particular, the gene BMP7 was identified as a direct target of MYC. A positive correlation between MYC and BMP7 expression was documented by analyzing two distinct sets of primary MB samples. Functional studies in vitro using a small-molecule inhibitor of the BMP/SMAD signaling pathway reproduced the effect of the small interfering RNA-mediated silencing of BMP7. Both approaches led to a block of proliferation in a panel of MB cells and to inhibition of SMAD phosphorylation. Altogether, our findings indicate that high MYC levels drive BMP7 overexpression, promoting cell survival in MB cells. This observation suggests the potential relevance of targeting the BMP/SMAD pathway as a novel therapeutic approach for the treatment of childhood MB.

Calculating track thrust with track functions

In e+e��� event shapes studies at LEP, two different measurements were sometimes performed: a ���calorimetric��� measurement using both charged and neutral particles and a ���track-based��� measurement using just charged particles. Whereas calorimetric measurements are infrared and collinear safe, and therefore calculable in perturbative QCD, track-based measurements necessarily depend on nonperturbative hadronization effects. On the other hand, track-based measurements typically have smaller experimental uncertainties. In this paper, we present the first calculation of the event shape ���track thrust��� and compare to measurements performed at ALEPH and DELPHI. This calculation is made possible through the recently developed formalism of track functions, which are nonperturbative objects describing how energetic partons fragment into charged hadrons. By incorporating track functions into soft-collinear effective theory, we calculate the distribution for track thrust with next-to-leading logarithmic resummation. Due to a partial cancellation between nonperturbative parameters, the distributions for calorimeter thrust and track thrust are remarkably similar, a feature also seen in LEP data.

Automatic granularity-aware parallelization of programs with predicates, functions, and constraints

Abstract is not available