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1.
Ecol Lett ; 27(1): e14347, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38073068

RESUMO

Seed production and dispersal are crucial ecological processes impacting plant demography, species distributions and community assembly. Plant-animal interactions commonly mediate both seed production and seed dispersal, but current research often examines pollination and seed dispersal separately, which hinders our understanding of how pollination services affect downstream dispersal services. To fill this gap, we propose a conceptual framework exploring how pollen limitation can impact the effectiveness of seed dispersal for endozoochorous and myrmecochorous plant species. We summarize the quantitative and qualitative effects of pollen limitation on plant reproduction and use Optimal Foraging Theory to predict its impact on the foraging behaviour of seed dispersers. In doing so, we offer a new framework that poses numerous hypotheses and empirical tests to investigate links between pollen limitation and seed dispersal effectiveness and, consequently, post-dispersal ecological processes occurring at different levels of biological organization. Finally, considering the importance of pollination and seed dispersal outcomes to plant eco-evolutionary dynamics, we discussed the implications of our framework for future studies exploring the demographic and evolutionary impacts of pollen limitation for animal-dispersed plants.


Assuntos
Dispersão de Sementes , Animais , Sementes , Plantas , Pólen , Polinização
2.
Dig Dis ; 41(3): 500-505, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36099879

RESUMO

BACKGROUND: Capsule endoscopy (CE) is an emerging tool in the diagnosis and management of occult bleeding and overt obscure gastrointestinal bleeding (OOGIB). Maximizing the efficiency of CE can lead to rapid bleeding localization and shorter time to therapy. We investigated whether a trained registered nurse (RN) can accurately interpret bleeding by observing the CE findings in real time by measuring inter-observer agreement between RN and physician interpretation. METHODS: We conducted a prospective study of patients admitted for OOGIB who underwent live-view capsule endoscopy (LVCE) between December 2016 and November 2017. A matched control group who underwent standard CE was obtained through retrospective review. An RN received a 2-day training program for CE interpretation. RN bedside interpretation for bleeding was followed by interpretation by 2 gastrointestinal physicians blinded to LVCE findings. Outcomes were compared between groups using t-tests and χ2 tests. Cohen's kappa measured the agreement between the physicians and the RN. RESULTS: Ten subjects were in the LVCE group, and 12 subjects were in the standard-of-care group. The agreement between the physicians and the RN was 9/10 (90%), with a kappa of 0.73 (95% CI: 0.26-1.00; p = 0.016). Patients in the LVCE group had shorter duration to physician interpretation (0.6 vs. 0.7 days [p = 0.50]), shorter duration to endoscopy (1.8 days vs. 3 days [p = 0.240]), and shorter length of stay (8.1 vs. 11.4 days [p = 0.26]) compared to the standard-of-care group. CONCLUSION: This study utilizing an RN for LVCE interpretation found inter-observer agreement between RN and physician findings. Larger studies are needed to assess whether this RN-physician team approach can translate to improved outcomes.


Assuntos
Endoscopia por Cápsula , Humanos , Estudos Prospectivos , Sistemas Automatizados de Assistência Junto ao Leito , Hemorragia Gastrointestinal/diagnóstico , Endoscopia Gastrointestinal , Fatores de Tempo , Estudos Retrospectivos
3.
Gynecol Oncol ; 159(3): 773-777, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32951895

RESUMO

OBJECTIVE: The objective of this study was to evaluate the impact of a post-surgical restrictive opioid prescribing algorithm (ROPA) in gynecologic oncology patients. METHODS: This cohort study included gynecologic oncology patients undergoing any surgical procedure from 08/2018-7/2019 after implementation of a ROPA. Patients were compared to historical controls managed without a ROPA from 10/2016-9/2017. Patients were educated preoperatively about pain management goals, the ROPA, and opioid disposal. A 4-tiered system was developed to standardize prescriptions at discharge based on surgical complexity and inpatient opioid requirements. Patients were surveyed at their postoperative visit to assess home opioid use and satisfaction. Statistical analysis was performed using SPSS Statistics v.24. RESULTS: 2549 patients met inclusion criteria; 1321 in the historical control group and 1228 in the ROPA group. Demographics, including age, BMI, and performance status were similar. Compared with the control group, the average number of opioid pills prescribed was significantly lower in the ROPA group (30.5 vs 11.3; p < 0.001) along with the morphine milligram equivalents (MME) (152.5 MME vs. 83.3 MME; p < 0.001). The percentage of patients requiring opioid refill within 30 days was similar (13.0% vs. 12.6%; p = 0.71). 95.7% of patients surveyed were satisfied with their pain regimen. The total number of pills prescribed annually decreased from 34,130 in the control group to 13,888 in the ROPA group. CONCLUSIONS: A restrictive prescribing practice allows for a significantly lower number of opioids to be prescribed to postoperative patients while maintaining patient satisfaction. There was no increase in opioid refill requests using a ROPA in patients undergoing surgery.


Assuntos
Analgésicos Opioides/administração & dosagem , Neoplasias dos Genitais Femininos/cirurgia , Procedimentos Cirúrgicos em Ginecologia/efeitos adversos , Dor Pós-Operatória/tratamento farmacológico , Padrões de Prática Médica/organização & administração , Padrões de Prática Médica/estatística & dados numéricos , Adulto , Idoso , Analgésicos Opioides/efeitos adversos , Prescrições de Medicamentos/normas , Prescrições de Medicamentos/estatística & dados numéricos , Registros Eletrônicos de Saúde/estatística & dados numéricos , Feminino , Ginecologia/organização & administração , Ginecologia/normas , Ginecologia/estatística & dados numéricos , Implementação de Plano de Saúde , Humanos , Oncologia/organização & administração , Oncologia/normas , Oncologia/estatística & dados numéricos , Pessoa de Meia-Idade , Epidemia de Opioides/prevenção & controle , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Transtornos Relacionados ao Uso de Opioides/etiologia , Transtornos Relacionados ao Uso de Opioides/prevenção & controle , Manejo da Dor/métodos , Manejo da Dor/normas , Manejo da Dor/estatística & dados numéricos , Dor Pós-Operatória/etiologia , Satisfação do Paciente/estatística & dados numéricos , Guias de Prática Clínica como Assunto , Padrões de Prática Médica/normas , Avaliação de Programas e Projetos de Saúde , Estudos Prospectivos , Estados Unidos/epidemiologia
4.
Am Heart J ; 184: 121-132, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28224926

RESUMO

BACKGROUND: Cardiovascular disease (CVD) is the leading cause of death worldwide. With atherosclerosis as the underlying cause for many CVD events, prevention or reduction of subclinical atherosclerotic plaque burden (SAPB) through a healthier lifestyle may have substantial public health benefits. OBJECTIVE: The objective was to describe the protocol of a randomized controlled trial investigating the effectiveness of a 30-month worksite-based lifestyle program aimed to promote cardiovascular health in participants having a high or a low degree of SAPB compared with standard care. METHODS: We will conduct a randomized controlled trial including middle-aged bank employees from the Progression of Early Subclinical Atherosclerosis cohort, stratified by SAPB (high SAPB n=260, low SAPB n=590). Within each stratum, participants will be randomized 1:1 to receive a lifestyle program or standard care. The program consists of 3 elements: (a) 12 personalized lifestyle counseling sessions using Motivational Interviewing over a 30-month period, (b) a wrist-worn physical activity tracker, and (c) a sit-stand workstation. Primary outcome measure is a composite score of blood pressure, physical activity, sedentary time, body weight, diet, and smoking (ie, adapted Fuster-BEWAT score) measured at baseline and at 1-, 2-, and 3-year follow-up. CONCLUSIONS: The study will provide insights into the effectiveness of a 30-month worksite-based lifestyle program to promote cardiovascular health compared with standard care in participants with a high or low degree of SAPB.


Assuntos
Aterosclerose/prevenção & controle , Doenças Cardiovasculares/prevenção & controle , Monitores de Aptidão Física , Promoção da Saúde/métodos , Entrevista Motivacional , Serviços de Saúde do Trabalhador/métodos , Comportamento de Redução do Risco , Adulto , Pressão Sanguínea , Peso Corporal , Dieta , Exercício Físico , Feminino , Humanos , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Postura , Comportamento Sedentário , Fumar , Abandono do Hábito de Fumar , Resultado do Tratamento , Local de Trabalho
5.
Rev Esc Enferm USP ; 51: e03206, 2017 Apr 03.
Artigo em Inglês, Português | MEDLINE | ID: mdl-28380158

RESUMO

OBJECTIVE: To assess the frequency of the leadership practices performed by the manager nurses of hospital institutions and their association with the variables of the socioprofessional profile. METHOD: Cross-sectional, descriptive, correlational study conducted in four hospitals in a city of the state of São Paulo. A sociodemographic questionnaire and the instrument Leadership Practices Inventory were used. Data collection and analysis were based on an exemplary Leadership Practices Model. RESULTS: Eighty-four manager nurses participated in the study. The mean values of the leadership practices used by the nurses were: enable others to act (50.6); encourage the heart (48.2); model the way (46.7); challenge the process (43.3); and inspire a shared vision (43.1). Data analysis also evidenced a correlation between the practice encourage the heart and the variables time of care and employment relationship. CONCLUSION: The study evidenced the presence of manager nurses exercising moderate leadership, and promoting teamwork, an environment of trust, and a horizontal vision. However, moderate values also reveal managerial aspects to be improved by the leaders by means of organizational strategies and/or tools aimed at best leadership practices. OBJETIVO: Avaliar a frequência das práticas de liderança executadas pelos enfermeiros gerentes de instituições hospitalares e sua associação às variáveis do perfil socioprofissional. MÉTODO: Estudo transversal, descritivo e correlacional, realizado em quatro hospitaisde um município do interior paulista. Utilizou-se de questionário sociodemográfico e do instrumento Leadership Practices Inventory. A coleta e a análise de dados foram fundamentadas em um Modelo de Práticas para Liderança exemplar. RESULTADOS: Participaram 84 enfermeiros gerentes. As médias das práticas de liderança utilizadas pelos enfermeiros foram: capacitar os outros a agir (50,6), encorajar o coração (48,2), traçar o caminho (46,7), desafiar o processo (43,3) e inspirar uma visão compartilhada (43,1). Na análise dos dados também se constatou correlação entre a prática encoraje o coração e as variáveis tempo de assistência e vínculo empregatício. CONCLUSÃO: O estudo constatou a presença de enfermeiros gerentes exercendo liderança moderada, promovendo o trabalho em equipe, propiciando um clima de confiança e visão horizontalizada. No entanto, os valores moderados também revelam aspectos gerenciais a serem aprimorados pelos líderes, por meio de ferramentas e/ou estratégias organizacionais em busca de melhores práticas de liderança.


Assuntos
Liderança , Enfermeiros Administradores , Recursos Humanos de Enfermagem Hospitalar , Adulto , Brasil , Correlação de Dados , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Autorrelato
6.
Rev Esc Enferm USP ; 50(3): 474-81, 2016.
Artigo em Inglês, Português | MEDLINE | ID: mdl-27556719

RESUMO

OBJECTIVE: To analyze nurses' competencies with regard to their work in post-operative heart surgery and the strategies implemented to mobilize these competencies. METHOD: This was an exploratory study with a qualitative approach and a methodological design of collective case study. It was carried out in three post-operative heart surgery units, consisting of 18 nurses. Direct observation and semi-structured interviews were employed to collect data. Data were construed through thematic analysis. RESULTS: nine competencies were found, as follows: theoretical-practical knowledge; high-complexity nursing care; nursing supervision; leadership in nursing; decision making; conflict management; personnel management; material and financial resources management; and on-job continued education. Organizational and individual strategies were employed to develop and improve competencies such as regular offerings of courses and lectures, in addition to the individual pursuit for knowledge and improvement. CONCLUSION: the study is expected to lead future nurses and training centers to evaluate the need for furthur training required to work in cardiac units, and also the need for implementing programs aimed at developing the competencies of these professionals. OBJETIVO: Analisar as competências dos enfermeiros para atuarem no pós-operatório de cirurgia cardíaca e estratégias implementadas para a mobilização dessas competências. MÉTODO: Estudo exploratório, com abordagem qualitativa e desenho metodológico estudo de caso coletivo. Foi realizado em três unidades pós-operatórias de cirurgias cardíacas, com 18 enfermeiros. Na coleta de dados utilizou-se observação direta e entrevista semiestruturada. Para interpretação dos dados optou-se pela análise temática. RESULTADOS: Foram identificadas nove competências, sendo: conhecimento teórico-prático, cuidados de enfermagem de alta complexidade, supervisão e liderança em enfermagem, tomada de decisão, gerenciamento de conflitos, de recursos humanos, materiais, financeiros e educação continuada em serviço. Estratégias organizacionais e individuais são realizadas a fim de desenvolver e aprimorar competências, tais como: oferecimento de cursos e palestras periodicamente, além da busca individual por conhecimento e aperfeiçoamento. CONCLUSÃO: O estudo deve provocar a reflexão de futuros enfermeiros e dos centros formadores quanto à formação necessária para atuar em unidades cardíacas e sobre a necessidade de implementação de programas que visam desenvolver competências nestes profissionais.


Assuntos
Procedimentos Cirúrgicos Cardíacos/enfermagem , Competência Clínica , Adulto , Feminino , Humanos , Masculino , Enfermagem Perioperatória/organização & administração , Enfermagem Perioperatória/normas , Adulto Jovem
7.
Oecologia ; 174(1): 173-81, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-23897500

RESUMO

Anthropogenic disturbance can have important indirect effects on ecosystems by disrupting species interactions. Here we examine the effects of anthropogenic disturbance on distance dispersal by ants for the diaspores of myrmecochorous Euphorbiaceae in Brazilian Caatinga. Rates of diaspore removal and distances removed of Croton sonderianus and Jatropha mollissima were observed at 24 sites ranging from low to very high disturbance (primarily grazing by livestock, hunting and firewood collection). Despite a large number of seed-disperser ant species, there were only two species providing high-quality distance-dispersal services, Dinoponera quadriceps (40% of all observed seed removals) and Ectatomma muticum (33%). D. quadriceps was responsible for 97% of all removals >2 m, and 100% of all removals >5 m. Removal rates did not vary with disturbance for C. sonderianus (small elaiosome), but declined with increasing disturbance for J. mollissima (large elaiosome). The number of removals by Ectatomma was highest at intermediate levels of disturbance, whereas those by Dinoponera decreased systematically with increasing levels of disturbance. Mean dispersal distance was four times higher at sites experiencing low disturbance, where removals >5 m represented a third of all removal events, compared with very highly disturbed sites, where no removals >5 m were observed. Despite high overall diversity there is very limited functional redundancy in disperser ant species, resulting in low disperser resilience in relation to disturbance. This is likely to have important implications for recruitment by myrmecochorous plants, and therefore on vegetation composition and structure, at sites subject to high anthropogenic disturbance.


Assuntos
Formigas , Meio Ambiente , Euphorbiaceae/fisiologia , Dispersão de Sementes , Animais , Brasil , Monitoramento Ambiental , Atividades Humanas
8.
Oecologia ; 174(2): 493-500, 2014 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-24085639

RESUMO

Recent evidence suggests that the traditional view of myrmecochory as a highly diffuse interaction between diaspores and a wide range of ant species attracted to their elaiosomes may not be correct. The effectiveness of dispersal varies markedly among ant species, and combined with differential attractiveness of diaspores due to elaiosome size and composition, this raises the potential for myrmecochorous plants to target ant species that offer the highest quality dispersal services. We ask the question: Do particular physical and chemical traits of elaiosomes result in disproportionate removal of Euphorbiaceae diaspores by high-quality disperser ants in Caatinga vegetation of north-eastern Brazil? We offered seeds of five euphorb species that varied in morphological and chemical traits of elaiosomes to seed-dispersing ants. High-quality seed-disperser ants (species of Dinoponera, Ectatomma and Camponotus) were identified as those that rapidly collected and transported diaspores to their nests, often over substantial distances, whereas low-quality disperser ants (primarily species of Pheidole and Solenopsis) typically fed on elaiosomes in situ, and only ever transported diaspores very short distances. Low-quality disperser ants were equally attracted to the elaiosomes of all study species. However, high-quality dispersers showed a strong preference for diaspores with the highest elaiosome mass (and especially proportional mass). As far as we are aware, this is the first study to identify a mechanism of diaspore selection by high-quality ant dispersers based on elaiosome traits under field conditions. Our findings suggest that myrmecochorous plants can preferentially target high-quality seed-disperser ants through the evolution of particular elaiosome traits.


Assuntos
Formigas/fisiologia , Euphorbiaceae , Dispersão de Sementes , Sementes/anatomia & histologia , Animais , Brasil , Ácidos Graxos/química , Fenótipo , Sementes/química
9.
Biol Rev Camb Philos Soc ; 99(2): 409-429, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-37872698

RESUMO

Ectotherms that maintain thermal balance in the face of varying climates should be able to colonise a wide range of habitats. In lizards, thermoregulation usually appears as a variety of behaviours that buffer external influences over physiology. Basking species rely on solar radiation to raise body temperatures and usually show high thermoregulatory precision. By contrast, species that do not bask are often constrained by climatic conditions in their habitats, thus having lower thermoregulatory precision. While much focus has been given to the effects of mean habitat temperatures, relatively less is known about how seasonality affects the thermal biology of lizards on a macroecological scale. Considering the current climate crisis, assessing how lizards cope with temporal variations in environmental temperature is essential to understand better how these organisms will fare under climate change. Activity body temperatures (Tb ) represent the internal temperature of an animal measured in nature during its active period (i.e. realised thermal niche), and preferred body temperatures (Tpref ) are those selected by an animal in a laboratory thermal gradient that lacks thermoregulatory costs (i.e. fundamental thermal niche). Both traits form the bulk of thermal ecology research and are often studied in the context of seasonality. In this study, we used a meta-analysis to test how environmental temperature seasonality influences the seasonal variation in the Tb and Tpref of lizards that differ in thermoregulatory strategy (basking versus non-basking). Based on 333 effect sizes from 137 species, we found that Tb varied over a greater magnitude than Tpref across seasons. Variations in Tb were not influenced by environmental temperature seasonality; however, body size and thermoregulatory strategy mediated Tb responses. Specifically, larger species were subjected to greater seasonal variations in Tb , and basking species endured greater seasonal variations in Tb compared to non-basking species. On the other hand, the seasonal variation in Tpref increased with environmental temperature seasonality regardless of body size. Thermoregulatory strategy also influenced Tpref , suggesting that behaviour has an important role in mediating Tpref responses to seasonal variations in the thermal landscape. After controlling for phylogenetic effects, we showed that Tb and Tpref varied significantly across lizard families. Taken together, our results support the notion that the relationship between thermal biology responses and climatic parameters can be taxon and trait dependent. Our results also showcase the importance of considering ecological and behavioural aspects in macroecological studies. We further highlight current systematic, geographical, and knowledge gaps in thermal ecology research. Our work should benefit those who aim to understand more fully how seasonality shapes thermal biology in lizards, ultimately contributing to the goal of elucidating the evolution of temperature-sensitive traits in ectotherms.


Assuntos
Lagartos , Humanos , Animais , Lagartos/fisiologia , Filogenia , Regulação da Temperatura Corporal , Temperatura , Biologia , Temperatura Corporal
10.
AIDS Patient Care STDS ; 38(1): 5-13, 2024 01.
Artigo em Inglês | MEDLINE | ID: mdl-38117576

RESUMO

Anal squamous cell carcinoma (SCC) is not a common disease in the general population, although its incidence is higher in people living with human immunodeficiency virus (PLWH). Anal SCC is caused by human papillomavirus (HPV) infection and arises from premalignant lesions termed squamous intraepithelial lesions (SILs). SIL surveillance programs are based on the early detection and treatment of SILs, especially those with a higher risk of transforming into cancer. An anal surveillance program has been under development in our institution since 2011. In this context, we performed a retrospective cohort study at the anal dysplasia unit of Álvaro-Cunqueiro Hospital (Spain). Epidemiological and clinical data were gathered from our Infectious Diseases Sample Collection (an open sample cohort including PLWH) from January 2011 to January 2022. A total of 493 PLWH were considered, 122 (24.7%) of whom were diagnosed with anal dysplasia at baseline, including 2 cases of anal SCC. Briefly, most of individuals were young men (median age, 38 years old) born in Spain (76%), whose vaccination rate before their inclusion in the program was scarce (<3%). Throughout the study period, 81 (16.4%) cases were diagnosed with high-grade squamous-intraepithelial lesions (HSILs) and 3 with anal SCC. At the baseline, severe immunosuppression (i.e., nadir CD4+ lymphocyte count below 200 cell/µL), and prior diagnosis of condyloma acuminata were more frequent within the group with SILs. Conversely, the baseline CD4+ lymphocyte count was similar among both groups. HPV-16 was related to a higher risk of HSILs (odds ratio: 2.76). At the end of the follow-up, 385 PLWH had been retained in care; one patient had died of anal cancer. Anal dysplasia was common (25% of cases), especially among patients infected by HPV-16, diagnosed with condyloma acuminata, and who were severely immunosuppressed. HPV-16 was the main risk factor for the presentation of HSILs.


Assuntos
Neoplasias do Ânus , Carcinoma in Situ , Infecções por HIV , Infecções por Papillomavirus , Lesões Intraepiteliais Escamosas , Masculino , Humanos , Adulto , Seguimentos , HIV , Infecções por HIV/complicações , Infecções por HIV/epidemiologia , Estudos Retrospectivos , Espanha/epidemiologia , Neoplasias do Ânus/diagnóstico , Neoplasias do Ânus/epidemiologia , Neoplasias do Ânus/patologia , Carcinoma in Situ/epidemiologia , Carcinoma in Situ/patologia , Canal Anal/patologia , Infecções por Papillomavirus/complicações , Infecções por Papillomavirus/diagnóstico , Infecções por Papillomavirus/epidemiologia , Lesões Intraepiteliais Escamosas/epidemiologia , Papillomaviridae/genética
11.
An Acad Bras Cienc ; 85(3): 1025-34, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24068090

RESUMO

Life history traits are considered key indicators of plant invasibility. Among them, the germination behavior of seeds is of major relevance because it is influenced by environmental factors of invaded ecosystem. Here, we investigated how seed traits and seed tolerance to environmental factors on seed germination of Calotropis procera vary depending on the invaded ecosystems in northeastern Brazil. We have tested seeds from two vegetation types - Caatinga and Restinga - to different levels of light intensity, salinity, and water stress. Previous to those experiments, seed-set and morphometric analysis were carried out for both studied populations. We have observed a higher seed-set in Caatinga. Seeds produced in this ecosystem had lower seed moisture content. Seeds from Restinga showed lower germination time when light intensity decreased. We observed a reduction in both the germinability and the synchronization index with decreasing osmotic potential and increasing salinity. Nevertheless, both populations exhibited changes in photoblastism when seeds were submitted to water and saline stress. In conclusion, C. procera seeds are tolerant to environmental factors assessed. That characteristic ensures the colonization success and wide distribution of this plant species in the studied ecosystems.


Assuntos
Calotropis/crescimento & desenvolvimento , Ecossistema , Germinação/fisiologia , Espécies Introduzidas , Brasil , Sementes/crescimento & desenvolvimento
12.
Rev Lat Am Enfermagem ; 31: e3768, 2023.
Artigo em Inglês, Português, Espanhol | MEDLINE | ID: mdl-36888789

RESUMO

OBJECTIVE: to build and validate a clinical simulation scenario on hospital nurse managerial decision-making competence for undergraduate nursing students. METHOD: a descriptive and methodological study was carried out in a higher education institution, with the participation of 10 judges and five players. To do so, the conceptual simulation model proposed by Jeffries and standards of the International Nursing Association for Clinical Simulation and Learning were used to prepare the scenario and the checklist. RESULTS: the scenario was called "Managerial decision-making of nurses in the face of adverse events in a hospital". The scenario script and checklist were built for validation. The checklist was face- and content-validated. Afterward, judges used the checklist to validate the scenario, which, in its final version, was composed of Prebriefing (seven items), Scenario in Action (18 items) and Debriefing (seven items). CONCLUSION: the scenario proved to be a teaching strategy that anticipates the reality of future nurses, bringing them the self-confidence to perform their activities and helping them to act critically and reflectively during decision-making processes.


Assuntos
Bacharelado em Enfermagem , Enfermeiras e Enfermeiros , Estudantes de Enfermagem , Humanos , Simulação de Paciente , Aprendizagem , Competência Clínica
13.
Patient Educ Couns ; 117: 107984, 2023 12.
Artigo em Inglês | MEDLINE | ID: mdl-37742593

RESUMO

OBJECTIVE: To identify and summarize evidence about the benefits of perioperative pain neuroscience education (PNE) on pain-related and psychosocial outcomes. METHODS: Included were reports written in English that carried out PNE or its synonyms; perioperative period; aged ≥ 18 years; interventional studies and observational studies. Secondary studies, conference abstracts, and editorials were excluded. There was no time limitation. INFORMATION SOURCES: PubMed, Virtual Health Library, Cochrane Library, and Science Direct. Search: June 20th 2023. The risk of bias was assessed using the Joanna Briggs Institute checklists, and synthesis followed the recommendations of the Synthesis Without Meta-analysis (SWiM) guideline. Register: Center for Open Science website (10.17605/OSF.IO/ZTNEJ). RESULTS: The sample consisted of 18 reports. For pain outcomes, it was not possible to attribute PNE benefits because ten reports found improvements in both intervention and control groups. For psychosocial outcomes, fourteen reports found benefits for PNE groups. All the analyzed reports showed low risk of bias. CONCLUSION: PNE had additional benefits beyond those obtained with conventional treatment for psychosocial outcomes. PRACTICAL IMPLICATIONS: Due to the lack of evidence, it was not possible to indicate the clinical use of PNE. It is suggested that further studies are needed aimed at clarifying the possible benefits.


Assuntos
Neurociências , Dor , Período Perioperatório , Humanos , Neurociências/educação , Dor Pós-Operatória
14.
Biomolecules ; 13(9)2023 09 12.
Artigo em Inglês | MEDLINE | ID: mdl-37759783

RESUMO

Indomethacin is a non-selective NSAID used against pain and inflammation. Although cyclooxygenase (COX) inhibition is considered indomethacin's primary action mechanism, COX-independent ways are associated with beneficial effects in cancer. In colon cancer cells, the activation of the peroxisome proliferator-activated receptor-γ (PPAR-γ) is related to the increase in spermidine/spermine-N1-acetyltransferase-1 (SSAT-1), a key enzyme for polyamine degradation, and related to cell cycle arrest. Indomethacin increases the SSAT-1 levels in lung cancer cells; however, the mechanism relying on the SSAT-1 increase is unclear. Thus, we asked for the influence of the PPAR-γ on the SSAT-1 expression in two lung cancer cell lines: H1299 and A549. We found that the inhibition of PPAR-γ with GW9662 did not revert the increase in SSAT-1 induced by indomethacin. Because the mRNA of SSAT-1 suffers a pre-translation retention step by nucleolin, a nucleolar protein, we explored the relationship between indomethacin and the upstream translation regulators of SSAT-1. We found that indomethacin decreases the nucleolin levels and the cyclin-dependent kinase 1 (CDK1) levels, which phosphorylates nucleolin in mitosis. Overexpression of nucleolin partially reverts the effect of indomethacin over cell viability and SSAT-1 levels. On the other hand, Casein Kinase, known for phosphorylating nucleolin during interphase, is not modified by indomethacin. SSAT-1 exerts its antiproliferative effect by acetylating polyamines, a process reverted by the polyamine oxidase (PAOX). Recently, methoctramine was described as the most specific inhibitor of PAOX. Thus, we asked if methoctramine could increase the effect of indomethacin. We found that, when combined, indomethacin and methoctramine have a synergistic effect against NSCLC cells in vitro. These results suggest that indomethacin increases the SSAT-1 levels by reducing the CDK1-nucleolin regulatory axis, and the PAOX inhibition with methoctramine could improve the antiproliferative effect of indomethacin.


Assuntos
Antineoplásicos , Neoplasias Pulmonares , Humanos , Acetiltransferases/genética , Proteína Quinase CDC2 , Ciclo-Oxigenase 2 , Indometacina/farmacologia , Neoplasias Pulmonares/tratamento farmacológico , Oxirredutases , Receptores Ativados por Proliferador de Peroxissomo , Poliamina Oxidase , Nucleolina
15.
Rev Bras Enferm ; 75(6): e20210928, 2022.
Artigo em Inglês, Português | MEDLINE | ID: mdl-35766757

RESUMO

OBJECTIVES: to apply and analyze an educational strategy to develop management skills in nursing students to work in hospital practice. METHODS: exploratory, intervention, qualitative study conducted from February 2020 to 2021. Fifty-four nursing students from a public higher education institution participated in this study, in which thirteen workshops were held to discuss management cases. Subsequently, semi-structured interviews were conducted using inductive thematic analysis. RESULTS: the case studies addressed the management competencies of communication, decision making, leadership, and interpersonal relationships. After the intervention, the strategy was evaluated through interviews, identifying positive aspects regarding knowledge acquisition; and other limiting aspects, such as limited time to discuss the cases. FINAL CONSIDERATIONS: the workshops proved to be effective as teaching strategies for students, adding new management knowledge that should help their performance as future nurses, capable of reflection, and the subjects of knowledge construction for the professional practice of nursing.


Assuntos
Bacharelado em Enfermagem , Estudantes de Enfermagem , Competência Clínica , Currículo , Hospitais , Humanos , Pesquisa Qualitativa
16.
Rev Esc Enferm USP ; 54: e03602, 2020 Sep 07.
Artigo em Português, Inglês | MEDLINE | ID: mdl-32901656

RESUMO

OBJECTIVE: To analyze the work-related psychosocial risks of Family Health nurses and the management strategies to minimize them. METHOD: Exploratory, qualitative study with nurses from teams of the Family Health Strategy (FHS). Data collection took place in July 2018 through semi-structured interviews and subsequently, an inductive thematic analysis was carried out. RESULTS: Participation of 18 nurses. Psychosocial risks related to the work context were identified, namely: insufficient professional training, compromised interpersonal relationships, work-family interface and psychological violence; as well as those related to work content: insufficient work equipment, lack of human resources and heavy workload. In addition, strategies for managing these risks were identified, such as using the family, spirituality, music and reading. CONCLUSION: The study should provoke the reflection of nurses about the eventual presence of risks in their work and contribute to fill knowledge production gaps in the area. It also provides subsidies for health managers' knowledge of the psychosocial risks to which these professionals are exposed, with a view to adopting measures.


Assuntos
Saúde da Família , Enfermeiras e Enfermeiros , Local de Trabalho , Humanos , Relações Interpessoais , Pesquisa Qualitativa , Carga de Trabalho
17.
Rev Bras Enferm ; 73(6): e20190584, 2020 Sep 07.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32901743

RESUMO

OBJECTIVE: to build and to describe an Individual Skills Matrix for nurses working in surgical units and their associated behaviors / attitudes. METHOD: Exploratory, qualitative study. 43 nurses from five surgical units participated, and data collection was carried out between April and September 2017. The focus group technique was used and for data interpretation an inductive thematic analysis was performed. The competence matrix was built from the testimonies of the participants plus a search in the literature for concepts directed to each competence and description of the expected behaviors and / or attitudes. RESULTS: For the Matrix, the following individual skills were identified: Planning; Communication, Relational Competence, Leadership, Decision Making and Ethics. FINAL CONSIDERATIONS: The construction of a Matrix should assist managers in recognizing the professional profile and assessing their performance, strengthening the achievement of professional and organizational objectives, as well as contributing to the quality and effectiveness of the care provided by nurses in these places.


Assuntos
Competência Clínica , Liderança , Comunicação , Grupos Focais , Humanos , Pesquisa Qualitativa
18.
Rev Bras Enferm ; 72(4): 834-840, 2019 Aug 19.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31432935

RESUMO

OBJECTIVE: To characterize the presence of psychosocial risks related to the work of the nurse in a psychiatric hospital and the strategies for managing these risks. METHODS: Qualitative, in which 25 nurses from a psychiatric hospital participated using semi-structured interviews from November 2014 to January 2015. Data analysis was performed using the thematic method. RESULTS: The results showed psychosocial risks related to the work of psychiatric nurses, such as: insufficient academic training; lack of preparation and maintenance of equipment; poor relationship with colleagues; shortage of human resources and lack of capacity building; conflict between the demands of the home and work, as well as strategies for managing psychosocial risks such as family, cinema, music, reading, among others. FINAL CONSIDERATIONS: This study should provoke the reflection of managers and future nurses regarding the working conditions in a psychiatric hospital and possible psychosocial risks to which they are exposed.


Assuntos
Enfermeiras e Enfermeiros/psicologia , Enfermagem Psiquiátrica/métodos , Estresse Psicológico/complicações , Adulto , Atitude do Pessoal de Saúde , Brasil , Feminino , Hospitais Psiquiátricos/organização & administração , Hospitais Psiquiátricos/estatística & dados numéricos , Humanos , Entrevistas como Assunto/métodos , Satisfação no Emprego , Masculino , Pessoa de Meia-Idade , Enfermeiras e Enfermeiros/estatística & dados numéricos , Enfermagem Psiquiátrica/tendências , Pesquisa Qualitativa , Estresse Psicológico/psicologia
19.
Rev Lat Am Enfermagem ; 27: e3184, 2019 Oct 14.
Artigo em Português, Inglês, Espanhol | MEDLINE | ID: mdl-31618385

RESUMO

OBJECTIVE: to evaluate the frequencies attributed to the professional competences of hospital nurses, discussing the ones that obtained higher and lower frequencies. METHOD: descriptive, cross-sectional, quantitative study with 45 nurses of a hospital of high complexity in the interior of São Paulo state. The study used the Competences Evaluation Questionnaire, translated and validated in Brazil, composed of 27 items in five domains: professionalism, communication, management, nursing process and problem solving. Data were analyzed using descriptive statistics. RESULTS: it was found that 80% of the participants were female and 20% were male. The age ranged between 25 and 63 years, with an average of 40.02 years, and the average length of professional experience was 13.39 years. The competences "Communication with the hospital's administrative staff" and "Participation in scientific research and / or application of results" had the lowest frequencies, while "Commitment to punctuality and workload" and "Commitment to the ethical principles of the profession" were evaluated with the highest frequencies. CONCLUSION: evaluating the performance by competences becomes essential for managers and training centers, since it contributes to the identification of gaps in knowledge, skills and attitudes of professionals, by promoting the elaboration and implementation of strategies for their development.


Assuntos
Avaliação de Desempenho Profissional/estatística & dados numéricos , Recursos Humanos de Enfermagem Hospitalar/estatística & dados numéricos , Competência Profissional/estatística & dados numéricos , Adulto , Atitude do Pessoal de Saúde , Brasil , Comunicação , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Carga de Trabalho
20.
Rev Gaucha Enferm ; 40: e20180155, 2019 Jun 10.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31188987

RESUMO

OBJECTIVE: Describe the process of translation and adaptation to Brazilian culture of the Competency Evaluation Questionnaire for hospital nurses. METHOD: Methodological study of translation and cross-cultural adaptation, including the steps translation of the original instrument into Portuguese, consensual evaluation of translated versions, back - translation, validation by judges and pilot with 29 hospital nurses. RESULTS: They presented the stages of process of cross-cultural adaptation of the instrument, with adjustments proposed by a Judges Committee, composed of 27 items distributed in five domains of competencies for hospital nurses. The instrument adapted to Portuguese presented semantic, idiomatic, experimental and conceptual equivalence with the original, and the total value of the Cronbach Alpha 0.932, in addition to the relative validation. CONCLUSIONS: The Competency Evaluation Questionnaire has been shown to be a reliable instrument that can be used but does not exclude the need for future statistical tests aiming at psychometric validity.


Assuntos
Comparação Transcultural , Avaliação de Desempenho Profissional/métodos , Recursos Humanos de Enfermagem Hospitalar/normas , Inquéritos e Questionários , Traduções , Atitude do Pessoal de Saúde , Brasil , Competência Clínica , Humanos , Idioma
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