Linking pollen limitation and seed dispersal effectiveness.

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.

How seasonality influences the thermal biology of lizards with different thermoregulatory strategies: a meta-analysis.

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.

Anal Dysplasia Screening in People Living with HIV: Long-Term Follow-Up in a Large Cohort from Northwest Spain.

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.

Autoestima de trabalhadores terceirizados do setor de conservação de higiene e limpeza de hospitais privados / Self-esteem of outsourced workers in the hygiene conservation and cleaning of private hospitals / Autoestima de trabajadores subcontratados en el sector de higiene y limpieza de hospitales privados

Objetivo: analisar aspectos positivos e negativos relacionados à autoestima de trabalhadores terceirizados de serviços de higiene e limpeza hospitalar. Método: estudo exploratório, de abordagem qualitativa, realizado em duas instituições hospitalares privadas. Os participantes foram trabalhadores terceirizados dos serviços de higiene e limpeza. Para a coleta de dados, utilizou-se um questionáriosociodemográfico e um roteiro de entrevista semiestruturada. Realizada análise temática indutiva. Resultados: a amostra constitui-se de 15 trabalhadores, do sexo feminino, que expressaram aspectos positivos e negativos que afetam sua autoestima, que estão relacionados à organização e ambiente de trabalho, às relações interpessoais e benefícios trabalhistas. Conclusão: aspectos positivos e negativos estão presentes entre esses trabalhadores e os gestores hospitalares devem refletir sobre o serviço de higiene e limpeza, estabelecendo estratégias educativas e coletivas para os trabalhadores relacionadas às práticas de trabalho realizadas neste contexto(AU)

Objective: to analyze positive and negative aspects related to the self-esteem of outsourced workers in hospital hygiene and cleaning services. Method: exploratory study, with a qualitative approach, carried out in two private hospital institutions. Participants were outsourced workers from hygiene and cleaning services. For data collection, a sociodemographic questionnaire and a semi-structured interview script were used. Inductive thematic analysis was performed. Results: the sample consisted of 15 female workers, who expressed positive and negative aspects that affect their self-esteem, which are related to the organization and work environment, interpersonal relationships and work benefits. Conclusion: positive and negative aspects are present among these workers and hospital managers should reflect on the hygiene and cleaning service, establishing educational and collective strategies for workers related to work practices carried out in this context(AU)

Objetivo: analizar aspectos positivos y negativos relacionados con la autoestima de trabajadores subcontratados en los servicios de higiene y limpieza hospitalaria. Método: estudio exploratorio, con enfoque cualitativo, realizado en dos hospitales privadas. Los participantes eran trabajadores subcontratados de los servicios de higiene y limpieza. Para la recolección de datos, se utilizó un cuestionario sociodemográfico y un guion de entrevista semiestructurada. Se realizó un análisis temático inductivo. Resultados: la muestra estuvo conformada por 15 trabajadoras, quienes expresaron aspectos positivos y negativos que inciden en su autoestima, los cuales están relacionados con la organización y clima laboral, las relaciones interpersonales y las prestaciones laborales. Conclusión: los aspectos positivos y negativos están presentes entre estos trabajadores y los administradores de hospitales deben reflexionar sobre el servicio de higiene y limpieza, estableciendo estrategias educativas y colectivas para los trabajadores, relacionadas con las prácticas de trabajo realizadas en este contexto(AU)

Managerial Decision-Making of Nurses in Hospitals: creation and validation of a simulation scenario / Tomada de Decisão Gerencial do Enfermeiro da Área Hospitalar: construção e validação de cenário de simulação / Toma de Decisiones Gerenciales del Enfermero en el Área Hospitalaria: construcción y validación de un escenario de simulación

Abstract 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.

Resumo Objetivo: construir e validar um cenário de simulação clínica sobre a competência tomada de decisão gerencial do enfermeiro hospitalar para estudantes de graduação em enfermagem. Método: estudo descritivo e metodológico realizado em uma instituição de ensino superior, com a participação de 10 juízes e cinco atores. Utilizou-se o modelo conceitual de simulação proposto por Jeffries e guias padronizadas da International Nursing Association for Clinical Simulation in Learning para a elaboração do cenário e do checklist. Resultados: o cenário ficou denominado como "Tomada de decisão gerencial do enfermeiro diante de eventos adversos no contexto hospitalar". Construiu-se o script do cenário e o checklist para a sua validação. Realizou-se validação de face e conteúdo do checklist. Posteriormente, juízes de posse do checklist, validaram o cenário que, em sua versão final, ficou composto por Prebriefing (sete itens), Cenário em Ação (18 itens) e Debriefing (sete itens). Conclusão: o cenário mostrou-se uma estratégia de ensino capaz de antecipar a realidade do futuro enfermeiro, trazendo autoconfiança na execução de suas atividades, contribuindo para agir de forma crítica e reflexiva durante o processo de tomada de decisão.

Resumen Objetivo: construir y validar un escenario de simulación clínica sobre la competencia en la toma de decisiones gerenciales del enfermero hospitalario para estudiantes del grado en enfermería. Método: estudio descriptivo y metodológico realizado en una institución de educación superior, con la participación de 10 jueces y cinco actores. Se utilizó el modelo conceptual de simulación propuesto por Jeffries y guías estandarizadas de la International Nursing Association for Clinical Simulation in Learning para la elaboración del escenario y del checklist. Resultados: el escenario se denominó "Toma de decisiones gerenciales del enfermero ante eventos adversos en el contexto hospitalario". Se construyó el script del escenario y el checklist para su validación. Se realizó la validez aparente y el contenido del checklist. Posteriormente, los jueces en posesión del checklist, validaron el escenario que, en su versión final, quedó compuesto por Prebriefing (siete ítems), Escenario en Acción (18 ítems) y Debriefing (siete ítems). Conclusión: el escenario demostró ser una estrategia de enseñanza capaz de anticipar la realidad del futuro enfermero, trayendo autoconfianza en la ejecución de sus actividades, contribuyendo para actuar de forma crítica y reflexiva durante el proceso de toma de decisiones.

A systematic review of the added value of perioperative pain neuroscience education.

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.

Indomethacin Induces Spermidine/Spermine-N1-Acetyltransferase-1 via the Nucleolin-CDK1 Axis and Synergizes with the Polyamine Oxidase Inhibitor Methoctramine in Lung Cancer Cells.

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.

Managerial Decision-Making of Nurses in Hospitals: creation and validation of a simulation scenario.

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.

Bedside Live-View Capsule Endoscopy in Evaluation of Overt Obscure Gastrointestinal Bleeding: A Pilot Point-of-Care Study.

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.

Refletindo sobre a tomada de decisão como competência do enfermeiro hospitalar / Reflecting on decision-making as a competence of the hospital nurse / Reflexionando sobre la toma de decisiones como competencia del enfermero que trabaja en hospital

Objetivo: refletir sobre a tomada de decisão gerencial como competência profissional do enfermeiro para a prática hospitalar na atualidade. Conteúdo: estudo atual, reflexivo, cuja fundamentação baseia-se na formulação discursiva sobre a tomada de decisão gerencial como competência do enfermeiro, sustentado pela literatura nacional e internacional. Foram acessadas bases de dados eletrônicas e consultados estudos entre o período de janeiro de 2016 a dezembro de 2021. A tomada de decisão é competência fundamental ao desempenho clínico dos enfermeiros hospitalares. Proporcionar o envolvimento de outros profissionais da equipe na tomada de decisão possibilita que a escolha feita seja a mais adequada para a situação, permitindo o compartilhamento de ideias e pensamentos, julgamento clínico e validação do planejamento de cuidados. Conclusão: É relevante refletir sobre esta temática desde a formação do futuro profissional enfermeiro. Assim, centros formadores e gestores hospitalares devem pensar estratégias que auxiliem enfermeiros na tomada de decisão assertiva.

Objective: to reflect on managerial decision-making as a professional competence of nurses in hospital practice today. Contents: this current, reflective study was based on discursive formulations on managerial decision-making as a competence of nurses, and supported by the Brazilian and international literature. Electronic databases were accessed and studies published between January 2016 and December 2021 were consulted. Decision making is a fundamental competence for hospital nurses' clinical performance. Engaging other team professionals in decision-making enables the choices made to be the most appropriate to the situation, by allowing the sharing of ideas and thoughts, clinical judgment and validation of care planning. Conclusion: it is important to reflect on this topic during training of future professional nurses. Accordingly, training centers and hospital managers should think of strategies that help nurses in assertive decision-making.

Objetivo: reflexionar sobre la toma de decisión gerencial como competencia profesional de los enfermeros para la práctica hospitalaria hoy en día. Contenido: estudio actual, reflexivo, cuyo fundamento se basa en la formulación discursiva sobre la toma de decisión gerencial como competencia del enfermero, sustentado en la literatura nacional e internacional. Se accedió a bases de datos electrónicas y se consultaron estudios entre enero de 2016 y diciembre de 2021. La toma de decisión es una competencia fundamental para el desempeño clínico de los enfermeros que trabajan en hospitales. Proporcionar la participación de otros profesionales del equipo en la toma de decisiones permite que la elección sea la más adecuada para la situación, lo que permite compartir ideas y pensamientos, el juicio clínico y la validación de la planificación de la atención. Conclusión: Es relevante reflexionar sobre este tema desde la formación del futuro profesional de enfermería. Así siendo, los centros de formación y los gestores de hospitales deben pensar en estrategias que ayuden a los enfermeros a hacer tomas de decisiones asertivas.

Educational strategy to develop nursing students' management competencies in hospital practice.

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.

Competências gerenciais e estratégias de ensino para estudantes de graduação em enfermagem: visão de docentes / Management competences and teaching strategies for undergraduate nursing students: the teachers' view / Habilidades gerenciales y estrategias de enseñanza para estudiantes universitarios de enfermería: el punto de vista de los profesores

Objetivo: descrever as competências gerenciais desenvolvidas na formação do enfermeiro voltadas ao contexto hospitalar e as estratégias de ensino para seu fortalecimento na perspectiva docente. Método: estudo exploratório, qualitativo. Participaram 12 docentes de enfermagem de uma Instituição de Ensino Superior Pública. A coleta ocorreu em 2020 por meio de grupos focais. Para análise dos dados, utilizou-se análise temática indutiva. Resultados: elucidaram competências gerenciais prioritárias, como: Comunicação; Tomada de decisão gerencial; Liderança e Relacionamento Interpessoal. Dentre as estratégias para o seu aperfeiçoamento, destaca-se: simulação, estudos de caso clínico, além de reestruturação do estágio e do currículo formativo. Conclusão: os resultados da pesquisa contribuem para reflexão das competências necessárias ao ensino, e para reflexão de centros formadores em enfermagem quanto a reorganização dos currículos, incluindo estratégias de ensino ativas que facilitem o desenvolvimento de competências. Além disso, espera-se sensibilizar a comunidade hospitalar sobre o aprimoramento de competências.

Objective: to describe the managerial skills developed in the training of nurses focused on the hospital context and the teaching strategies for their strengthening from the teacher's perspective. Method: exploratory, qualitative study. Twelve nursing teachers from a Public Higher Education Institution participated. The collection took place in 2020 through focus groups. For data analysis, inductive thematic analysis was used. Results: elucidated priority managerial skills, such as: Communication; Management decision making; Leadership and Interpersonal Relationships. Among the strategies for its improvement, the following stand out: simulation, clinical case studies, in addition to restructuring the internship and the training curriculum. Conclusion: the research results contributed to the reflection of the necessary skills for teaching, and to the reflection of nursing training centers regarding the reorganization of the curricula, including active teaching strategies that facilitate the development of competences. In addition, it is expected to sensitize the hospital community about the improvement of skills.

Objetivo: describir las habilidades gerenciales desarrolladas en la formación de enfermeros enfocados al contexto hospitalario y las estrategias didácticas para su fortalecimiento desde la perspectiva docente. Método: estudio exploratorio, cualitativo. Participaron doce profesores de enfermería de una Institución de Educación Superior Pública. La recolección se realizó en 2020 a través de grupos focales. Para el análisis de los datos se utilizó el análisis temático inductivo. Resultados: fueron dilucidadas habilidades gerenciales prioritarias, tales como: Comunicación; Toma de decisiones gerenciales; Liderazgo y Relaciones Interpersonales. Entre las estrategias para su perfeccionamiento se destacan: simulación, estudios de casos clínicos, además de reestructurar la internado y el currículo de formación. Conclusión: los resultados de la investigación contribuyen a la práctica de las habilidades necesarias para la docencia, y a la reflexión de los centros de formación de enfermería en cuanto a la reorganización de los currículos, incluyendo estrategias de enseñanza activa que faciliten el desarrollo de habilidades. Además, se espera sensibilizar a la comunidad hospitalaria sobre la mejora de habilidades.

Educational strategy to develop nursing students' management competencies in hospital practice / Estrategia educativa para desarrollar competencias administrativas en estudiantes de Enfermería para actuación hospitalaria / Estratégia educativa para desenvolver competências gerenciais em estudantes de Enfermagem para atuação hospitalar

ABSTRACT 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.

RESUMEN Objetivos: aplicar y analizar estrategia educativa para desarrollar competencias administrativas en discentes de Enfermería para actuación hospitalaria. Métodos: estudio exploratorio, de intervención, con abordaje cualitativo, realizado de febrero de 2020 a 2021. Participaron 54 discentes de Enfermería de una institución de enseñanza superior pública. Aplicados 13 talleres de discusión con discentes sobre casos administrativos. Posteriormente, realizadas entrevistas semiestructuradas. Utilizado análisis temático inductivo. Resultados: los estudios de caso abordaron competencias administrativas de comunicación, toma de decisión, liderazgo y relación interpersonal. Pos intervención, realizada mediante entrevistas evaluación de la estrategia utilizada, en que fueron identificados aspectos positivos cuanto a adquisición de conocimientos; y otros limitantes, como tiempo limitado para discusión de los casos. Consideraciones Finales: los talleres mostrados eficaces como estrategias de enseñanza a los discentes, agregando nuevos saberes administrativos que deberán auxiliar su desempeño como futuros enfermeros, capaces de reflexión, mientras sujeto constructor del conocimiento para la práctica profesional de enfermería.

RESUMO Objetivos: aplicar e analisar estratégia educativa para desenvolver competências gerenciais em discentes de Enfermagem para atuação hospitalar. Métodos: estudo exploratório, de intervenção, com abordagem qualitativa, realizado de fevereiro de 2020 a 2021. Participaram 54 discentes de Enfermagem de uma instituição de ensino superior pública. Aplicaram-se 13 oficinas de discussão com discentes sobre casos gerenciais. Posteriormente, realizaram-se entrevistas semiestruturadas. Utilizou-se análise temática indutiva. Resultados: os estudos de caso abordaram as competências gerenciais de comunicação, tomada de decisão, liderança e relacionamento interpessoal. Após intervenção, realizou-se mediante entrevistas avaliação da estratégia utilizada, em que foram identificados aspectos positivos quanto a aquisição de conhecimentos; e outros limitantes, como tempo limitado para discussão dos casos. Considerações Finais: as oficinas mostraram-se eficazes como estratégias de ensino aos discentes, agregando novos saberes gerenciais que deverão auxiliar seu desempenho como futuros enfermeiros, capazes de reflexão, enquanto sujeito construtor do conhecimento para a prática profissional da enfermagem.

Matriz de competências coletivas do enfermeiro na assistência perioperatória / Matriz de competencias colectivas de enfermeros en cuidados perioperatorios / Matrix of collective competences of nurses in perioperative care

RESUMO Objetivo desenvolver uma matriz de competências coletivas do enfermeiro na assistência perioperatória. Método estudo qualitativo, com a participação de 43 enfermeiros perioperatórios atuantes em cinco instituições hospitalares. Utilizou-se a técnica de grupo focal, no período de janeiro a abril de 2018, e para interpretação dos dados, análise temática indutiva. Estudo aprovado pelo Comitê de Ética da instituição Proponente. Resultados identificaram-se competências coletivas, tais como: conhecimento das especificidades do cuidado e da unidade perioperatória; gerência de recursos materiais e financeiros; gestão de pessoas e trabalho em equipe. A matriz de competências foi construída a partir das discussões que emergiram dos grupos focais, acrescida da literatura, incluindo seus significados e comportamentos associados a cada competência. Conclusões uma matriz de competências coletivas dos enfermeiros deve direcionar os talentos humanos disponíveis na organização para os cargos/funções, ao permitir reconhecer competências existentes e identificar lacunas na formação deste profissional para atuação na assistência perioperatória.

RESUMEN Objetivo desarrollar una matriz de competencias colectivas de enfermeros en cuidados perioperatorios. Método estudio cualitativo, con participación de 43 enfermeros perioperatorios que laboran en cinco instituciones hospitalarias. Se utilizó la técnica del grupo focal, de enero a abril de 2018 y, para la interpretación de los datos, análisis temático inductivo. Estudio aprobado por el Comité de Ética de la institución proponente. Resultados se identificaron competencias colectivas, como: conocimiento de las especificidades del cuidado y de la unidad perioperatoria; gestión de recursos materiales y financieros; gestión de personas y trabajo en equipo. La matriz de competencias se construyó a partir de las discusiones que surgieron de los grupos focales, además de la literatura, incluyendo sus significados y comportamientos asociados a cada competencia. Conclusiones una matriz de competencias colectivas de los enfermeros debe orientar los talentos humanos disponibles en la organización para puestos/funciones, permitiendo el reconocimiento de competencias existentes e identificando brechas en la formación de este profesional para su trabajo en cuidados perioperatorios.

ABSTRACT Objective to develop a matrix of collective competences of nurses in perioperative care. Method in this qualitative study, 43 perioperative nurses working in five hospital institutions participated in focus groups, from January to April 2018. The data were interpreted by inductive thematic analysis. The study was approved by the research ethics committee of the proponent institution. Results the collective competences identified included: knowledge of the specifics of care and the perioperative unit; management of material and financial resources; and people management and teamwork. The competency matrix was built up from the focus group discussions, plus the literature, which included the meanings and behaviors associated with each competency. Conclusions a matrix of nurses' collective competences should direct the human talents available in the organization towards positions and functions by identifying these professionals' existing competences and gaps in their training to provide perioperative care.

Matriz de competências coletivas do enfermeiro na assistência perioperatória / Matrix of collective competences of nurses in perioperative care / Matriz de competencias colectivas de enfermeros en cuidados perioperatorios

Objetivo: desenvolver uma matriz de competências coletivas do enfermeiro na assistência perioperatória. Método: estudo qualitativo, com a participação de 43 enfermeiros perioperatórios atuantes em cinco instituições hospitalares. Utilizou-se a técnica de grupo focal, no período de janeiro a abril de 2018, e para interpretação dos dados, análise temática indutiva. Estudo aprovado pelo Comitê de Ética da instituição Proponente. Resultados: identificaram-se competências coletivas, tais como: conhecimento das especificidades do cuidado e da unidade perioperatória; gerência de recursos materiais e financeiros; gestão de pessoas e trabalho em equipe. A matriz de competências foi construída a partir das discussões que emergiram dos grupos focais, acrescida da literatura, incluindo seus significados e comportamentos associados a cada competência. Conclusões: uma matriz de competências coletivas dos enfermeiros deve direcionar os talentos humanos disponíveis na organização para os cargos/funções, ao permitir reconhecer competências existentes e identificar lacunas na formação deste profissional para atuação na assistência perioperatória.

Objective: to develop a matrix of collective competences of nurses in perioperative care. Method: in this qualitative study, 43 perioperative nurses working in five hospital institutions participated in focus groups, from January to April 2018. The data were interpreted by inductive thematic analysis. The study was approved by the research ethics committee of the proponent institution. Results: the collective competences identified included: knowledge of the specifics of care and the perioperative unit; management of material and financial resources; and people management and teamwork. The competency matrix was built up from the focus group discussions, plus the literature, which included the meanings and behaviors associated with each competency. Conclusions: a matrix of nurses' collective competences should direct the human talents available in the organization towards positions and functions by identifying these professionals' existing competences and gaps in their training to provide perioperative care.

Objetivo: desarrollar una matriz de competencias colectivas de enfermeros en cuidados perioperatorios. Método: estudio cualitativo, con participación de 43 enfermeros perioperatorios que laboran en cinco instituciones hospitalarias. Se utilizó la técnica del grupo focal, de enero a abril de 2018 y, para la interpretación de los datos, análisis temático inductivo. Estudio aprobado por el Comité de Ética de la institución proponente. Resultados: se identificaron competencias colectivas, como: conocimiento de las especificidades del cuidado y de la unidad perioperatoria; gestión de recursos materiales y financieros; gestión de personas y trabajo en equipo. La matriz de competencias se construyó a partir de las discusiones que surgieron de los grupos focales, además de la literatura, incluyendo sus significados y comportamientos asociados a cada competencia. Conclusiones: una matriz de competencias colectivas de los enfermeros debe orientar los talentos humanos disponibles en la organización para puestos/funciones, permitiendo el reconocimiento de competencias existentes e identificando brechas en la formación de este profesional para su trabajo en cuidados perioperatorios.

Organização do processo de trabalho para atenção integral: potencialidades e desafios / Organización del proceso de trabajo para atención integral: potenciales y desafios / Organization of the work process for comprehensive care: strengths and challenges

Objetivo: Caracterizar a influência da organização do processo de trabalho de equipes de saúde da família na atenção integral à saúde da população. Método: Pesquisa descritiva, qualitativa, em dez unidades. Participaram 78 profissionais. Utilizou-se técnica de grupo focal guiada pelo roteiro Autoavaliação para Melhoria do Acesso e da Qualidade da Atenção Básica. Resultados: Da análise agruparam-se categorias: Potencialidades na coordenação do cuidado nas unidades de saúde da família e Desafios para uma abordagem integral nas unidades de saúde da família. O pouco tempo de atuação, a rotatividade e o baixo investimento na formação complementar na área da atenção primária podem corroborar para os achados. Conclusão: Reforça a importância do investimento em recursos humanos, nesta área, capazes de conduzir o processo de trabalho para efetivar melhores práticas de atenção à abordagem integral(AU)

Objective: To characterize the influence of family health team organization of the work process on the comprehensive health care for the population. Method: Descriptive research, qualitative, in ten units. 78 professionals participated. Target group technique guided by the Self-Assessment guide for Improving Access and Quality of Primary Care. Results: From the analysis, categories were grouped: Strengths in the coordination of care in family health units and Challenges for a comprehensive approach in family health units. The short time of work, the turnover and the low investment in complementary training in the area of primary care can corroborate the findings. Conclusion: It reinforces the importance of investing in human resources, capable of conducting the work process in order to implement better practices of attention to the comprehensive(AU)

Objetivo: Caracterizar la influencia de la organización del proceso de trabajo de los equipos de salud de la familia en la atención integral a la salud de la población. Método: Investigación descriptiva, cualitativo, en diez unidades. Participaron 78 profesionales. Técnica de grupo focal, conducida por Autoevaluación para la Mejora del Acceso y la Calidad de la Atención Primaria. Resultados: Del análisis se agruparon las categorías: Potencialidades en la coordinación de la atención en las unidades de salud de la familia y Desafíos para un abordaje integral en las unidades de salud de la familia. El breve tiempo de trabajo, la rotación y la baja inversión en formación complementaria en el área de atención primaria pueden confirmar los hallazgos. Conclusión: Refuerza la importancia de invertir en recursos humanos capaces de liderar el proceso de trabajo para llevar a cabo las mejores prácticas de atención al enfoque integral(AU)

Efecto de la música en el glaucoma. Reporte de caso / Music effect in glaucoma. A case report

Introducción: Documentamos el caso de un paciente músico profesional de instrumento de viento, con glaucoma de ángulo abierto secundario a aumento de la presión venosa epiescleral como consecuencia de su actividad musical, y cómo esto afecta la presión intraocular y la progresión de la enfermedad. Objetivo: Evidenciar la asociación existente entre tocar instrumentos de viento y el desarrollo de glaucoma y su progresión acelerada. Resumen del caso: Varón de 62 años, músico profesional (instrumento de viento de alta resistencia: trombón de vara). Procedente de otra institución con diagnóstico de glaucoma de tensión normal, con fluctuaciones de presión intraocular (PIO) > 10 mmHg en monitoreo con curva de 24 horas, posterior a tocar el instrumento. Se evidenciaron fluctuaciones en la tonometría de hasta 6 mmHg (promedio por toma) al ser tomada en reposo y 20 minutos después de tocar el instrumento. Finalmente, se diagnostica glaucoma crónico de ángulo abierto secundario a aumento de la presión venosa epiescleral, asociado probablemente a su profesión. Conclusiones: Este reporte evidencia que tocar instrumentos de viento genera elevaciones de la PIO, que al ser repetitivas pueden influir en el desarrollo de glaucoma y su progresión

Introduction: We document the case of a professional wind instrument musician patient, with open-angle glaucoma secondary to increased episcleral venous pressure as a consequence of his musical activity, and how this affects intraocular pressure and disease progression. Objective: To demonstrate the association between playing wind instruments with the development of glaucoma and its accelerated progression. Case summary: 62 year old male patient, professional musician (high resistance wind instrument: rod trombone). Extrainstitutionally, they give a diagnosis of normal tension glaucoma, with IOP fluctuations > 10 mmHg in 24-hour monitoring of the curve, after playing the instrument. Fluctuations in tonometry of up to 6 mmHg (average per dose) were observed when taken at rest and 20 minutes after playing the instrument. Finally, chronic open-angle glaucoma was diagnosed secondary to increased episcleral venous pressure, probably associated with his profession. Conclusions: This report shows how playing wind instruments generates IOP elevations, which, being repetitive, can influence the development of glaucoma and its progression

Fatores associados a competência de comunicação entre enfermeiros cirúrgicos / Factores asociados con la competencia de comunicación entre las enfermeras quirúrgicas / Factors associated with communication competence among surgical nurses

Objetivo: identificar os fatores associados a comunicação como competência, entre os enfermeiros de centros cirúrgicos. Método: estudo exploratório, qualitativo. Participaram 43 enfermeiros de cinco instituições hospitalares privadas do interior de Minas Gerais. A coleta ocorreu em 2018 por meio de seis encontros de grupos focais. Os dados foram analisados por análise temática indutiva. Resultados: evidenciou-se que a competência de comunicação está associada a fatores, como: qualidade e segurança no cuidado, relacionamento na equipe de trabalho, formas de se comunicar e interagir; informatização da passagem de plantão e interação com outros setores da instituição. Conclusão: considerando a comunicação como competência essencial ao enfermeiro cirúrgico, identificar fatores que possam influenciá-la de forma positiva ou limitante deve provocar a reflexão de futuros profissionais e gestores na elaboração e implantação de estratégias, no ambiente laboral, que promovam o desenvolvimento de uma comunicação eficaz.

Objective: to identify the factors associated with communication as competence among nurses in surgical centers. Method: exploratory, qualitative study. The participants were 43 nurses from five private hospital institutions in the countryside of Minas Gerais participated. The collection occurred in 2018 through six meetings of focus groups. The data were analyzed by inductive thematic analysis. Results: communication competence is associated with factors such as: care quality and safety, relationship in the work team, ways of communicating and interacting; computerization of the shift and interaction with other sectors of the institution. Conclusion: considering communication as an essential competence for surgical nurses, identifying factors that can influence it in a positive or limiting way should provoke the reflection of future professionals and managers in the development and implementation of strategies in the work environment that promote the development of effective communication.

Objetivo: identificar los factores asociados a la comunicación como competencia entre las enfermeras de los centros quirúrgicos. Método: estudio exploratorio y cualitativo. Participaron 43 tres enfermeras de cinco instituciones hospitalarias privadas del interior de Minas Gerais. La recogida se produjo en 2018 a través de seis reuniones de grupos focales. Los datos fueron analizados mediante análisis temáticos inductivos. Resultados: se evidenció que la competencia en comunicación está asociada a factores tales como: calidad y seguridad en la atención, relación en el equipo de trabajo, formas de comunicarse e interactuar; informatización del cambio e interacción con otros sectores de la institución. Conclusión: considerando la comunicación como una competencia esencial para las enfermeras quirúrgicas, identificar factores que puedan influir en ella de una manera positiva o limitante debe provocar la reflexión de futuros profesionales y gerentes en el desarrollo e implementación de estrategias en el entorno laboral que promuevan el desarrollo de una comunicación eficaz.

A competência relacional de enfermeiros em unidades de centros cirúrgicos / Relational competence of nurses in surgical center units / Competencia relacional de enfermeras em unidades de centros quirúrgicos

Objetivo: identificar e descrever como é desenvolvida a competência relacional no cotidiano do trabalho de enfermeiros cirúrgicos e identificar em que momento/situações o enfermeiro utiliza essa competência. Método: estudo exploratório, qualitativo. O cenário foram unidades cirúrgicas pertencentes a cinco instituições hospitalares privadas de um município no Estado de Minas Gerais e a amostra composta por 43 enfermeiros atuantes destas unidades. Foi realizada a técnica de grupo focal em 2018 e os dados foram interpretados pela análise temática indutiva. Resultados: evidenciou-se que a competência relacional se dá por meio do desenvolvimento de capacidades a serem adquiridas pelos enfermeiros, tais como o gerenciamento de conflitos, comunicação assertiva, gestão de pessoas por meio do dimensionamento de pessoal e inteligência emocional. Considerações finais: O ambiente cirúrgico demanda atividades que potencializam o desgaste físico e emocional do enfermeiro com demais membros da equipe de saúde, o que torna imprescindível o aprimoramento de capacidades/aptidões associadas a competência relacional.

Objective: to identify and describe how relational competence is developed in surgical nurses' day-to-day work and identify when and in what situations nurses use this competence. Method: qualitative, exploratory study. The scenario were surgical units at five private hospitals in a municipality in Minas Gerais, and the sample comprised 43 nurses working in these units. The focal group technique was applied in 2018 and the data were interpreted by inductive thematic analysis. Results: relational competence was found to be developed by the nurses' acquiring and developing capacities/skills, such as conflict management, assertive communication, people management by appropriate personnel scaling, and emotional intelligence. Final considerations: the surgical environment demands activities that heighten nurses' physical and emotional exhaustion, and its effects on other members of the health team, making it essential to improve capacities/skills in relational competence.

Objetivo: identificar y describir cómo se desarrolla la competencia relacional en el trabajo diario del enfermero quirúrgico e identificar cuándo y en qué situaciones el enfermero utiliza esta competencia. Método: estudio exploratorio cualitativo. El escenario fueron unidades quirúrgicas de cinco hospitales privados de un municipio de Minas Gerais, y la muestra estuvo conformada por 43 enfermeras que laboran en estas unidades. La técnica del grupo focal se aplicó en 2018 y los datos se interpretaron mediante análisis temático inductivo. Resultados: se encontró que la competencia relacional es desarrollada por las enfermeras adquiriendo y desarrollando capacidades / habilidades, tales como manejo de conflictos, comunicación asertiva, manejo de personas por escalamiento apropiado del personal e inteligencia emocional. Consideraciones finales: el ambiente quirúrgico demanda actividades que aumenten el agotamiento físico y emocional del enfermero, y sus efectos sobre otros miembros del equipo de salud, por lo que es fundamental mejorar las capacidades / habilidades en la competencia relacional.

Work-related psychosocial risks of the Family Health nurse and management strategies. / Riscos psicossociais relacionados ao trabalho do enfermeiro da Saúde da Família e estratégias de gerenciamento.

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.