Segurança do doente crítico portador de cateter venoso periférico / Safety of the critically ill patient with a peripheral venous catheter

A permanente evolução da sociedade estabelece constantemente novos parâmetros de exigência perante as instituições que a compõem. Isso requer que os enfermeiros evoluam no contexto da sua prática, adquirindo e aperfeiçoando conhecimentos e competências, que lhes permitam prestar um cuidado de excelência. A Pessoa em Situação Crítica encontra-se numa posição de fragilidade, o enfermeiro especialista tem um papel preponderante na prestação de cuidados de enfermagem baseados na evidência científica a estas pessoas. Inserido no Mestrado em Enfermagem, na área da pessoa em situação crítica, surge o presente relatório, no qual se analisam as atividades desenvolvidas ao longo do Estágio Final, de modo a desenvolver e adquirir as competências comuns e específicas do enfermeiro especialista em Enfermagem na Pessoa em Situação Crítica e do grau de Mestre em Enfermagem. Com base na metodologia de trabalho de projeto foi delineada a Intervenção Profissional Major, relativa à segurança da pessoa em situação crítica com cateter venoso periférico, através da qual foram desenvolvidas as competências de enfermeiro especialista e Mestre, tendo por objetivo identificar práticas inadequadas e uniformizar os cuidados de enfermagem prestados, tendo por base a mais recente evidência científica. Os resultados das atividades desenvolvidas foram alvo de reflexão, verificando-se que houve ganhos em termos de segurança para o utente em situação crítica e na qualidade dos cuidados de saúde, tendo os objetivos sido atingidos.

The permanent evolution of society constantly establishes new standards of demand for the institutions that make it up. This requires nurses to evolve in the context of their practice, acquiring and improving knowledge and skills, which allow them to provide excellent care. The Person in Critical Situation is in a fragile position, the specialist nurse has a leading role in providing nursing care based on scientific evidence to these people. Inserted in the Masters in Nursing, in the area of the person in critical situation, appears the present report, in which the activities developed during the Final Internship are analyzed, in order to develop and acquire the common and specific competences of the nurse specialist in Nursing in the Person in Critical Situation and a Master's Degree in Nursing. Based on the project work methodology, the Major Professional Intervention was designed, related to the safety of people in a critical situation with a peripheral venous catheter, through which specialist and Master nurse skills were developed, with the aim of identifying inappropriate practices and standardizing procedures. nursing care provided, based on the most recent scientific evidence. The results of the activities carried out were the subject of reflection, verifying that there were gains in terms of safety for the critically ill and in the quality of health care, with the objectives having been achieved.

Apelin is expressed in intimal smooth muscle cells and promotes their phenotypic transition.

During atherosclerotic plaque formation, smooth muscle cells (SMCs) switch from a contractile/differentiated to a synthetic/dedifferentiated phenotype. We previously isolated differentiated spindle-shaped (S) and dedifferentiated rhomboid (R) SMCs from porcine coronary artery. R-SMCs express S100A4, a calcium-binding protein. We investigated the role of apelin in this phenotypic conversion, as well as its relationship with S100A4. We found that apelin was highly expressed in R-SMCs compared with S-SMCs. We observed a nuclear expression of apelin in SMCs within experimentally-induced intimal thickening of the porcine coronary artery and rat aorta. Plasmids targeting apelin to the nucleus (N. Ap) and to the secretory vesicles (S. Ap) were transfected into S-SMCs where apelin was barely detectable. Both plasmids induced the SMC transition towards a R-phenotype. Overexpression of N. Ap, and to a lesser degree S. Ap, led to a nuclear localization of S100A4. Stimulation of S-SMCs with platelet-derived growth factor-BB, known to induce the transition toward the R-phenotype, yielded the direct interaction and nuclear expression of both apelin and S100A4. In conclusion, apelin induces a SMC phenotypic transition towards the synthetic phenotype. These results suggest that apelin acts via nuclear re-localization of S100A4, raising the possibility of a new pro-atherogenic relationship between apelin and S100A4.

Study on the Intervention Effect of Music on Insomnia of College Students.

In this study, we have analyzed the intervention effect of music on insomnia of college students. For this purpose, we have selected college students of grade 2019 facing insomnia in our school and randomly selected 96 of them as research objects after the informed consent of the students. 96 subjects were randomly divided into two groups, observation group and control group, 48 cases in each group. No music intervention was applied to the control group, while music intervention was applied to the observation group. After intervention, all college students in the observation group and the control group were given PSQI scale and filled it out. The score was collected on the spot and counted immediately to evaluate the intervention effect of music on college students' insomnia. After music intervention, the score of each dimension of PSQI showed that the observation group was significantly better than the control group in falling asleep time, quality of sleep, hypnotic drugs, sleep efficiency, sleep disorders, and daytime dysfunction, and the results were statistically significant (P < 0.05). There was a statistically significant difference in insomnia between the two groups (P < 0.05), and the intervention efficacy of insomnia in the observation group was better than that in the control group. The observation group had a higher satisfaction with the insomnia intervention effect, and the total satisfaction was 89.58%. The control group had low satisfaction with the intervention effect of insomnia, the total satisfaction was 52.08%, and the difference was statistically significant (P < 0.05). Through the application of the music intervention method, the sleep quality of college students had been improved, and the insomnia intervention effect was obvious; therefore, music intervention for college students' insomnia had a good intervention effect and had the value of promotion.

Targeting transthyretin in Alzheimer's disease: Drug discovery of small-molecule chaperones as disease-modifying drug candidates for Alzheimer's disease.

Transthyretin (TTR) has a well-established role in neuroprotection in Alzheimer's Disease (AD). We have setup a drug discovery program of small-molecule compounds that act as chaperones enhancing TTR/Amyloid-beta peptide (Aß) interactions. A combination of computational drug repurposing approaches and in vitro biological assays have resulted in a set of molecules which were then screened with our in-house validated high-throughput screening ternary test. A prioritized list of chaperones was obtained and corroborated with ITC studies. Small-molecule chaperones have been discovered, among them our lead compound Iododiflunisal (IDIF), a molecule in the discovery phase; one investigational drug (luteolin); and 3 marketed drugs (sulindac, olsalazine and flufenamic), which could be directly repurposed or repositioned for clinical use. Not all TTR tetramer stabilizers behave as chaperones in vitro. These chemically diverse chaperones will be used for validating TTR as a target in vivo, and to select one repurposed drug as a candidate to enter clinical trials as AD disease-modifying drug.

Motivations and Career Decisions in Occupational Therapy Course: A Qualitative Inquiry of Asia-Pacific International Students in Australia.

PURPOSE: This study aims to understand the motivations of academic voyage and post-graduation career decisions of occupational therapy international students in Australia. The following two research questions guided this study: why do international students choose to study in Australia instead of ones in their own countries? And why do international students choose to study occupational therapy program(s) in Australia instead of ones in their own countries? PATIENTS AND METHODS: A qualitative design with phenomenology was employed to recruit 20 participants for the data collection procedures, including interview sessions, focus group activity, and member checking interview. The participants were studying one of the accredited occupational therapy programs in Australia as international students. RESULTS: Six themes were yielded. All participants expressed that due to the excellent education, reasonable tuition fees and living standard, and the positive career opportunities, almost all expressed their positive experiences of their Australian voyage as international students and tended to stay in Australia after they gained the registration career development. More importantly, the notions of contribution to Australian communities are captured as many considered Australia as an important place in their lives. CONCLUSION: University leaders may wish to take action in upgrading their international students' services, particularly career development services. Government agencies may take this study as a blueprint for upgrading the current regulations for international students, particularly in establishing a targeted immigration visa for recent graduates who want to establish their own businesses or invest in Australia.

Upgrading Nursing Students' Foreign Language and Communication Skills: A Qualitative Inquiry of the Afterschool Enhancement Programmes.

Learning a foreign language is not easy for many students, particularly for nursing students who need to complete their internships in the hospital. However, motivation always drives them to the foreign language classrooms. The purpose of this study was to understand the motivations and reasons behind why these nursing students decided to study Mandarin Chinese as part of their personal development and enhancement beyond the curriculum. One main question and one sub-research question were written, why would nursing students decide to take Chinese as the tool for foreign language and culture development? What and why are the reasons and motivations for nursing students to take Chinese beyond their curriculum? The qualitative case study method was employed in order to investigate 36 nursing university students in the United Kingdom. The results of this study concluded that nursing students tend to study Chinese due to personal development and career goals. School leaders, department heads, government leaders, policymakers, human resources professionals, vocational trainers, and researchers may take this study as the opportunity to reform their current human resource and education plans to offer foreign language courses to university students, members of the public, learners, and interested parties for both personal development and career enhancements.

Promoting Sexual Health Knowledge through a Social Workers' Mentorship Programme: A Study of Gay Young Adults.

Mentorship of counselling for men who have sex with other men and gay youths is understudied. The purpose of this study was to explore the effectiveness of how the Mentor Modelling Programme may increase the sexual health knowledge and practices of gay youths. As an expansion of a previous study with the application of the conceptual framework, this study mapped a sexual health promotion plan and the six-month-long Mentor Modelling Programme with the coordination of eight health and social care professionals and 40 gay youths. The researcher found positive and supportive feedback of how the Mentor Modelling Programme could increase sexual health knowledge, promote long-term relationships, and encourage referral of other vulnerable people. The results indicated two directions. The first solicited the perspectives of health and social care professionals and gay youths on how they would describe the relationship, application to, and experience of the Mentor Modelling Programme and second, assessed how this Mentor Modelling Programme influenced and changed the ideas and senses about counselling services and mentorship. This study reflected the current limited sexual promotion between traditional and inclusive sexual health materials. It further indicated the necessary concerns and areas of attention needed to upgrade the materials and host inclusive sexual health materials for both youths and adults in the communities.

Indoor Path-Planning Algorithm for UAV-Based Contact Inspection.

Nowadays, unmanned aerial vehicles (UAVs) are extensively used for multiple purposes, such as infrastructure inspections or surveillance. This paper presents a real-time path planning algorithm in indoor environments designed to perform contact inspection tasks using UAVs. The only input used by this algorithm is the point cloud of the building where the UAV is going to navigate. The algorithm is divided into two main parts. The first one is the pre-processing algorithm that processes the point cloud, segmenting it into rooms and discretizing each room. The second part is the path planning algorithm that has to be executed in real time. In this way, all the computational load is in the first step, which is pre-processed, making the path calculation algorithm faster. The method has been tested in different buildings, measuring the execution time for different paths calculations. As can be seen in the results section, the developed algorithm is able to calculate a new path in 8-9 milliseconds. The developed algorithm fulfils the execution time restrictions, and it has proven to be reliable for route calculation.

Stress, Burnout, and Low Self-Efficacy of Nursing Professionals: A Qualitative Inquiry.

Nursing professionals face a high level of stress and burnout due to overloaded responsibilities, which may cause a low level of self-efficacy. From the perspective of nursing professionals, the research aims to understand what are the sources of stress and burnout which would reduce the self-efficacy and the unbalanced patient ratio and how would nursing professionals describe their experiences, sources of stress and burnout, and self-efficacy. Based on the snowball sampling strategy, 60 nursing professionals were invited for qualitative research data collection. Based on the lens of the self-efficacy approach, the results indicated that the environmental factors, including workplace bullying, family stress, misunderstanding of public members, and personal development and career enhancement took important roles in increasing their stress and burnout and in reducing their self-efficacy. The outcomes of this study discovered the social status and discrimination toward nursing professionals. Government leaders, policymakers, and researchers should take this research as an opportunity to reform their policy for human resource management and education for the respectfulness of medical and nursing professionals in the public health system.

I Want to Become a Registered Nurse as a Non-Traditional, Returning, Evening, and Adult Student in a Community College: A Study of Career-Changing Nursing Students.

The current significant human resource and workforce shortages of registered nurses (RNs) are impacting urban, suburban, and rural hospitals and healthcare facilities all over the globe, regardless of the entities' economic and financial backgrounds. The purpose of this research study is to understand why non-traditional, returning, evening, and adult (NTREA) students decided to enrol at the Associate Degree in Nursing programme during their mid-adulthood? 40 s-career nursing students who are pursuing their nursing programme were invited to individual interview sessions and focus group activities on sharing and expressing the motivations in the New England region in the United States. Based on the theoretical framework of Social Cognitive Career Theory, the researcher concluded that family consideration and higher social status were two of the major themes. The study provided a blueprint for human resource professionals, health and social caring leaders, government agencies, policymakers, and researchers to reform their current nursing curriculum and health workforce policy to attract potential second-career nursing joining the nursing profession.

The Relationship between the COVID-19 Pandemic and Nursing Students' Sense of Belonging: The Experiences and Nursing Education Management of Pre-Service Nursing Professionals.

The COVID-19 pandemic has changed the orders and structures of societies, particularly in the fields of medical and nursing professions. The researcher aims to understand the experiences, sense of belonging, and decision-making processes about Japanese pre-service nursing students and how the COVID-19 pandemic, social distancing, and lockdown has influenced their understanding as pre-service nursing professionals in Japan. As this study focuses on the issues of pre-service nursing students, the researcher invited forty-nine pre-service nursing students for a virtual interview due to the recommendation of social distancing. To increase the coverage of the population, the researcher employed snowball sampling to recruit participants from all over Japan. Although the COVID-19 pandemic influenced the overall performance of the medical and nursing professions, all participants showed a sense of belonging as Japanese citizens and nursing professionals due to the natural disaster of their country. More importantly, all expressed their desires and missions to upgrade and improve the overall performance of the public health system due to the influence of the COVID-19 pandemic. The results discovered that many Japanese nursing students advocated that Japan's national development, the benefits and advantages of their country, were of a greater importance than their own personal development and goals.

How Does COVID-19 Pandemic Influence the Sense of Belonging and Decision-Making Process of Nursing Students: The Study of Nursing Students' Experiences.

Financial consideration, internal and external influence, personal goal, and educational achievement always influence the decision-making process and behavior of individuals. Using nursing students as the population, the researcher employed the Social Cognitive Career Theory as the theoretical framework to examine the nursing human resources shortages and how would the COVID-19 pandemic influence the experiences, sense of belonging, and career decision-making process of 58 nursing students in South Korea. The researcher categorized the sharing into two groups, which were before the influence of the COVID-19 pandemic, and the changes during the COVID-19 pandemic. The results indicated that financial consideration was the significant reason why South Korean nursing students decided to study nursing regardless of the COVID-19 pandemic. More importantly, almost all participants decided to leave the nursing profession due to the COVID-19 pandemic and the consideration between financial factor and personal sacrifice. The outcomes of this study provided a blueprint for human resources professionals, government leaders, policymakers, school leaders, and hospital managers to reform their current curriculum and human resources planning to overcome the potential human resources gaps in the soon future due to the COVID-19 pandemic.

Male Nursing Practitioners and Nursing Educators: The Relationship between Childhood Experience, Social Stigma, and Social Bias.

The population of nurses and nursing educators is facing significant human resource shortages. One of the pathways to combat this shortage is to recruit male individuals. However, due to social bias and social stigma, the social context may prevent male individuals from joining. There are two purposes of this study. First, this study aims to explore how the childhood experiences of these male nursing practitioners and nursing educators influence their educational decision. Second, from the perspectives of male nursing practitioners and nursing educators, the study aims to explore how the participants describe the relationships between their childhood experiences and lived stories. Based on Interpretative Phenomenological Analysis, the researcher collected data from 10 experienced male nursing practitioners and nursing educators in the United States. The general inductive approach was employed to categorize the themes. The results indicated that early life experiences, positive working experiences, and sense of belonging in the field of nursing always allowed the participants to overcome the social bias and stigma regarding the occupational bias of the nursing profession. The outcomes of this study provide clear recommendations to educators, policymakers, school leaders, and human resource planners to encourage gender social justice and improve their current curriculum for potential nursing professionals.

I Teach Nursing as a Male Nursing Educator: The East Asian Perspective, Context, and Social Cognitive Career Experiences.

Social and cultural backgrounds, as well as understanding, play key roles in workforce development and human resource shortages, which are associated with the transition to nursing education and teaching from frontline nursing practices. A qualitative method, with the direction of the general inductive approach, was employed in this study. The researcher collected information from 18 male nursing educators who switched their senior roles (from the frontline and practicing fields to nursing education) at nursing schools in South Korea, Japan, Taiwan, China, and Malaysia. Three interview sessions were used to collect information. Three themes were merged from the information: (i) gender-oriented knowledge, teaching and learning; (ii) respect; and (iii) health promotion. More importantly, participants advocated that their male roles and identities provided uniqueness to patients, students, parents, and the general public concerning Asian customs and practices. Based on the social cognitive career theory, personal goals and achievements of career satisfaction took important roles. Although the general public may not agree with these career decisions, due to gender and social biases, participants continued to contribute their energy and knowledge in the health and social caring professions.

Stress, Burnout, and Turnover Issues of Black Expatriate Education Professionals in South Korea: Social Biases, Discrimination, and Workplace Bullying.

The purpose of this study is to understand expatriate educators' overall teaching experiences and opinions about living in South Korea. The research study sought to explore the relationship between stressors and social biases against Black individuals and their suicidal behaviours and turnover decisions. The approach of stress, burnout, career decision, and suicide guided this study as the lens. The research method for this study included a phenomenological analysis of two sessions of semi-structured interviews with 18 Black expatriates in the field of education in South Korea. The results indicate that their experiences were impacted by unfairness against individuals based on their skin colour and nationalities. The outcomes of this study highlight the major difficulties experienced by foreign professionals living in South Korea. They can be used by human resource professionals, school administrators, and government leaders to reform their current policy and improve expatriate experiences so as to prevent turnover.

The Challenges of Public Health, Social Work, and Psychological Counselling Services in South Korea: The Issues of Limited Support and Resource.

Public health, social work, and psychological counselling professions in South Korea are facing challenges of human resource shortage and shortage of professionals who can provide multilingual services. The purpose of this study was to explore and understand why public health, social work, and psychological counselling services degree graduates and professionals with multilingual skills in South Korea decide to leave their professional field to the hospitality and business industries, particularly for those who completed their initial training at one of the international universities. Based on the approach of the Social Cognitive Career Theory, individuals' self-efficacy, outcome expectations, interests, and goals were examined and considered. The data were collected from 12 participants with the methodology of interpretative phenomenological analysis. The general inductive approach was employed to categorize the themes for reporting. The results indicated that public health, social work, and psychological counselling services-related positions are not available, modelling from peers, and lack of career development skills are the primary difficulties of public health, social work, and psychological counselling services graduates. The completion of this study provides clear recommendations to educators, policymakers, school leaders, human resource planners, and university administrators to improve their curricula and school counselling for public health, social work, and psychological counselling services graduates and the next generation.

I Am a Nursing Student but Hate Nursing: The East Asian Perspectives between Social Expectation and Social Context.

From the East Asian social and cultural perspectives and contexts, this study aimed to understand the relationships and behaviors between nursing students' sense of filial piety and their decision-making behind selecting nursing education as their major. Forty-two traditional-age nursing students (i.e., six men and 36 women) at their final year of a bachelor's degree program in nursing were invited. The findings indicated that many nursing students disliked their university major and the potential career pathway as a nursing professional, as none of them selected the major based on their choice and interest. The environmental context and family's recommendations were the major impacts to influence the decision-making process of the participants. The result also indicated that filial piety, parents' recommendations, and elderly people's suggestions were the key factors to influence the selections and decisions of university major and career development pathways. The study provided a blueprint for related staff and professionals to create and design career counselling and services for East Asian youths to enable life investment and development.

Promoting Safer Sexual Behaviours by Employing Social Cognitive Theory Among Gay University Students: A Pilot Study of A Peer Modelling Programme.

Unsafe and unprotected sexual behaviours are some of the significant challenges of health promotions and planning for current school environment. Although schools and health specialists constantly host conferences and workshops for adolescents and university students, the results are not significant. Particularly for sexual minorities, the heterosexual-oriented materials may not satisfy their needs due to the differences. As a recommendation, the current pilot study established a Peer Modelling Programme which engaged gay social workers and gay university students who have associated with unsafe and unprotected sexual activities. The outcomes of this Peer Modelling Programme indicated that gay undergraduate students tended to accept the recommendations and peer modelling exchanges from their gay social workers who understood their difficulties and sexual needs as sexual minorities based on the guideline of Social Cognitive Theory. In conclusion, this study may be used to develop additional social work materials, sexual health promotions and health plans for sexual minorities and people with special needs in the society. This research serves as a guideline to social workers who care about the issues of LGBT and sexual minorities.

Rural Public Health Workforce Training and Development: The Performance of an Undergraduate Internship Programme in a Rural Hospital and Healthcare Centre.

Workforce shortages in the field of public health and healthcare are significant. Due to the limitations of career opportunities and compensation, rural hospitals and healthcare centres usually have on-going career openings for all departments. As a result, university departments of public health and healthcare management, and rural hospitals and health centres may need to establish internship and training programmes for undergraduate senior-year students in order to provide opportunities and human resource opportunities for both students and public health professions. The research examined the performance, feedback, and opinions of a university-based one-year-long on-site internship training programme between a university public health and healthcare undergraduate department and a regional hospital and healthcare centre in a rural region in the United States. Individual interview data were collected from management trainees and focus group activities data were collected from hospital departmental supervisors who have completed this one-year-long on-site internship training programme. The results offered an assessment of performance and evaluation of how a one-year-long internship programme could be beneficial to hospitals and health centres in the areas of human resources, manpower management, and skill training to prospective professionals in rural and regional communities. Also, the study provided a blueprint and alternative for universities and partnered sites to redesign and improve their current internship programmes which may better fit their needs for their actual situations.

The Cultural Cognitive Development of Personal Beliefs and Classroom Behaviours of Adult Language Instructors: A Qualitative Inquiry.

The researcher employed personal belief system (PBS) theory as the theoretical foundation for this study because it holds that teachers' PBSs may influence their teaching behaviours, teaching styles, and pedagogies in classroom practice due to cultural influences. The purpose of this qualitative study was to explore how teachers' personal beliefs influence how they teach and how their approach may align with or diverge from cultural expectations in a private adult learning facility for English learning in Macau Special Administrative Region, China. The participants in this study were classroom teachers in a learning community who believe in collaborating to create environments for best practices. Two main research questions guided this study: (1) What is the relationship between teachers' personal belief systems and their classroom practice; and (2) How does a teacher's educational experience as a K-12 student affect their pedagogy in an adult English language learning program? Three types of data collection methods were employed: interview, classroom observation, and field note taking. The findings showed that teachers utilize their personal belief systems to engage their students through interactive teaching strategies, which was counter-intuitive for both teachers and students who had been taught with Eastern teaching styles. This study contributed to personal belief system theory and broadens the understanding of the perspectives and concepts of English teaching and supervision. The beliefs of teachers influenced their understanding of teaching and their classroom practices.