The impact of patient navigation on glycemic control, adherence to self-care and knowledge about diabetes: an intervention study.

BACKGROUND: Patient navigation helps with better adherence to treatment, as well as better knowledge about diabetes and greater interest in performing, monitoring, and seeking health care. Therefore, this study aims to evaluate the effect of patient navigation on glycemic control, disease knowledge, adherence to self-care in people with type 1 diabetes mellitus. METHODS: This is an intervention study using a single group pre-test post-test design, carried out in a tertiary public teaching hospital in Southern Brazil. Participants over 18 years of age and diagnosed with type 1 diabetes were included. In total, three teleconsultations and one face-to-face consultation were carried out, with three-month intervals, until completing one year of follow-up. The nurse navigator conducted diabetes education based on the guidelines of the Brazilian Diabetes Society and the Nursing Interventions Classification. The differences between glycated hemoglobin, adherence to self-care, and knowledge about initial and final diabetes were estimated to verify the effect of patient navigation by nurses, according to the tool applied in the first and last consultations. Interaction analyses between variables were also performed. Student's t-test, Generalized Estimating Equations, Wilcoxon test, and McNemar test were used. RESULTS: The final sample consisted of 152 participants, of which 85 (55.9%) were women, with a mean age of 45 ± 12 years, and diabetes duration of 23.6 ± 11.1 years. Nurse navigators conducted 812 teleconsultations and 158 face-to-face consultations. After the intervention, glycemic control improved in 37 (24.3%) participants (p < 0.001), and knowledge about diabetes also improved in 37 (24.3%) participants (p < 0.001). Adherence to self-care increased in 82 (53.9%) patients (p < 0.001). The analysis of the interaction between glycemic control and the results from the questionnaire of knowledge about diabetes showed an interaction effect (p = 0.005). However, we observed no interaction effect between glycemic control and the results from the questionnaire on adherence to self-care (p = 0.706). CONCLUSIONS: Our results showed improvement in glycemic control, adherence to self-care, and knowledge of diabetes in the study participants. In addition, they suggest that patient navigation performed by nurses is promising and feasible in improving care for patients with type 1 diabetes.

Knowledge about diabetes and its association with adherence to self-care and glycemic control in patients with type 1 diabetes in Southern Brazil.

Objective: To evaluate the association between knowledge about the disease, adherence to self-care, and glycemic control in people diagnosed with type 1 diabetes mellitus. Subjects and methods: A cross-sectional study of patients aged over 18 years diagnosed with type 1 diabetes mellitus, treated at an outpatient clinic of a Brazilian university hospital. Participants with other types of diabetes, cognitive impairment, pregnancy, and outpatient discharge were excluded. Data were collected from January to March 2021 (by telephone call), with questions about the participants' profile, diabetes knowledge questionnaire (DKN-A), and self-care inventory revised (SCI-R) translated into and adapted for Brazilian Portuguese. Data analysis involved chi-square associations, Mann-Whitney U tests, and Poisson regression. Results: Among 198 adult participants, the mean age was 42 ± 12 years, 53.5% were women, the mean glycated hemoglobin was 8.6 ± 1.6%, 140 (70.8%) had satisfactory knowledge about diabetes, 65 (32.8%) had adherence to self-care, and 46 (23.2%) had adequate glycemic control. We found an association between knowledge and adherence to self-care (p < 0.001). Knowledge was not associated with glycemic control (p = 0.705). Conclusion: Knowledge about diabetes was associated with greater adherence to self-care in people with type 1 diabetes mellitus, but it did not reflect in better glycemic control.

Correction: da Silva et al. Increased Sulphur Amino Acids Consumption as OH-Methionine or DL-Methionine Improves Growth Performance and Carcass Traits of Growing-Finishing Pigs Fed under Hot Conditions. Animals 2022, 12, 2159.

In the original publication [...].

Knowledge about diabetes and its association with adherence to self-care and glycemic control in patients with type 1 diabetes in Southern Brazil

ABSTRACT Objective: To evaluate the association between knowledge about the disease, adherence to self-care, and glycemic control in people diagnosed with type 1 diabetes mellitus. Subjects and methods: A cross-sectional study of patients aged over 18 years diagnosed with type 1 diabetes mellitus, treated at an outpatient clinic of a Brazilian university hospital. Participants with other types of diabetes, cognitive impairment, pregnancy, and outpatient discharge were excluded. Data were collected from January to March 2021 (by telephone call), with questions about the participants' profile, diabetes knowledge questionnaire (DKN-A), and self-care inventory revised (SCI-R) translated into and adapted for Brazilian Portuguese. Data analysis involved chi-square associations, Mann-Whitney U tests, and Poisson regression. Results: Among 198 adult participants, the mean age was 42 ± 12 years, 53.5% were women, the mean glycated hemoglobin was 8.6 ± 1.6%, 140 (70.8%) had satisfactory knowledge about diabetes, 65 (32.8%) had adherence to self-care, and 46 (23.2%) had adequate glycemic control. We found an association between knowledge and adherence to self-care (p < 0.001). Knowledge was not associated with glycemic control (p = 0.705). Conclusion: Knowledge about diabetes was associated with greater adherence to self-care in people with type 1 diabetes mellitus, but it did not reflect in better glycemic control.

Increased Sulphur Amino Acids Consumption as OH-Methionine or DL-Methionine Improves Growth Performance and Carcass Traits of Growing-Finishing Pigs Fed under Hot Conditions.

This study aimed to evaluate the impact of DL-Methionine (DL-Met) or OH-Methionine (OH-Met) when supplemented beyond the usually accepted requirements in sulfur amino acids (SAA) on the performance and carcass traits of growing-finishing pigs. Two hundred mixed sex pigs were distributed in a randomized block (body weight and sex), under a 2 × 2 factorial design with two methionine sources, DL-methionine, or OH-Methionine and two methionine doses (100% SAA or 120% of the SAA level present in the control). Diets were formulated to meet amino acids recommendations of the Brazilian Tables for Poultry and Swine (2017), except for SAA, which varied with the methionine doses. Daily feed intake, daily weight gain, and feed conversion were evaluated. Moreover, the carcasses were measured electronically for fat thickness (FT), longissimus dorsi muscle depth (LD), and lean meat (%). During the growing phase II (92 till 122 days of age), daily feed intake (p < 0.001) and daily weight gain (p < 0.05) increased with the high SAA levels. High SAA levels also provided greater daily weight gain during the entire period of the trial (0.90 versus 0.86 kg; p < 0.05) No significant interaction was observed between the methionine source and the SAA level for any carcass traits. However, animals that received OH-Met had greater (p < 0.05) loin depth (58.37 versus 55.21 mm) and those that received higher doses of methionine presented heavier (p < 0.05) carcass weight (78.16 versus 74.70 kg), and more (p < 0.05) lean meat weight (43.69 versus 41.90 kg). Taken together, these results demonstrated that supplementation of high sulfur amino acids levels under hot conditions provided heavier carcasses and more lean meat.

Quality of care in patients with type 1 diabetes during the COVID-19 pandemic: a cohort study from Southern Brazil.

BACKGROUND: Optimal glycemic control is the main goal for patients with diabetes. The results of type 1 diabetes patients' neglected demands during the pandemic can determine a long-term negative clinical, social, and economic impact, and result in worse diabetes control and a higher incidence of chronic complications. Therefore, this study aims to evaluate the impact of the COVID-19 outbreak in the quality of care of patients with type 1 diabetes in Southern Brazil. METHODS: Cohort study based on electronic medical records of patients with type 1 diabetes, with scheduled appointments between January 1st 2020, and November 6th 2020, at a university public hospital. The quality indicators used were: assessment of albuminuria and/or serum creatinine, lipid profile, thyroid-stimulating hormone, glycated hemoglobin, retinopathy, and neuropathy. McNemar test was used to analyze categorical variables and the Wilcoxon test for continuous variables. RESULTS: Out of 289 patients, 49.5% were women aged 40 ± 12 years old. During the pandemic, 252 patients had at least one face-to-face appointment canceled. The quality of care indicators showed a significant worsening during the COVID-19 pandemic compared to the previous year (p < 0.001). In 2019, 23.2% of the participants had all the indicators evaluated, while in 2020, during the pandemic, only 3.5% had all of them evaluated. CONCLUSION: The COVID-19 pandemic hindered the offer of comprehensive and quality care to patients with type 1 diabetes.

Quality of life and eating habits of patients with obesity during the COVID-19 pandemic.

OBJECTIVE: to verify the quality of life and eating habits of patients with obesity during the COVID-19 pandemic. METHOD: cross-sectional study with 68 outpatients, candidates for bariatric surgery, at university hospital in the Southern Brazil. Data collection was carried out by telephone, with questions about the profile of the participants and social distancing; questionnaires on quality of life and eating habits were also used. The data analysis, the logistic regression model, Spearman correlation, Mann-Whitney U and Student t-tests were used for independent samples. RESULTS: the general quality of life was 57.03 points and the eating habit with the highest score was cognitive restraint (61.11 points). Most patients (72.1%) were socially distancing themselves and 27.9% had not changed their routine. The chance of isolation was 3.16 times greater for patients who were married. There is a positive correlation between the domains of the Quality of Life questionnaire and cognitive restraint from the questionnaire about eating habits. CONCLUSION: we found that the participants tended to have a better quality of life as cognitive restraint increased.

Evolution of welfare indicators of pigs housed in deep bedding systems during growing and finishing phases: assessment of good health principles and housing conditions.

The aim of the study was to monitor the evolution of welfare indicators of pigs throughout growing and finishing phases housed in a deep bedding system by principles of good health and housing. In all, 16,500 animals, distributed in 15 facilities, were evaluated over a 4-month period. Three assessments were carried out in each facility by a single evaluator, according to the following time distribution: phase one (75 to 85 days old), phase two (86 to 161 days old), and phase three (162 to 180 days old). Only the parameters related to good health and good housing were considered. Data were analyzed by logistic regression for longitudinal data. Poisson distribution was used on the coughing and sneezing data, with subsequent chi-square analysis. There were no cases of poor body condition, shivering, panting, huddling, tail biting, pumping, twisted snout, rectal prolapse, lameness, and skin conditions. The final evaluations were associated with greater chances of hernia and bursitis, with greater prevalence in males than in females. The prevalence of wound and manure on the body parameters was influenced by the interaction of the evaluation and animal category. The incidence of coughing and the number of animals presenting this symptom gradually increased, becoming considerably higher in the final stage of evaluation. Health-related problems change throughout the production cycle. The evaluation of a broad and reliable view on animal welfare allows for the most appropriate management of production systems using deep bedding.

Quality of life and eating habits of patients with obesity during the COVID-19 pandemic / Calidad de vida y conducta alimentaria de pacientes con obesidad durante la pandemia de COVID-19 / Qualidade de vida e comportamento alimentar de pacientes com obesidade durante a pandemia por COVID-19

Objective: to verify the quality of life and eating habits of patients with obesity during the COVID-19 pandemic. Method: cross-sectional study with 68 outpatients, candidates for bariatric surgery, at university hospital in the Southern Brazil. Data collection was carried out by telephone, with questions about the profile of the participants and social distancing; questionnaires on quality of life and eating habits were also used. The data analysis, the logistic regression model, Spearman correlation, Mann-Whitney U and Student t-tests were used for independent samples. Results: the general quality of life was 57.03 points and the eating habit with the highest score was cognitive restraint (61.11 points). Most patients (72.1%) were socially distancing themselves and 27.9% had not changed their routine. The chance of isolation was 3.16 times greater for patients who were married. There is a positive correlation between the domains of the Quality of Life questionnaire and cognitive restraint from the questionnaire about eating habits. Conclusion: we found that the participants tended to have a better quality of life as cognitive restraint increased.

Objetivo: evaluar la calidad de vida y la conducta alimentaria de los pacientes con obesidad durante la pandemia de COVID-19. Método: estudio transversal con 68 pacientes atendidos en un servicio ambulatorio de cirugía bariátrica de un hospital universitario del sur de Brasil. La recolección de datos se realizó por vía telefónica, con preguntas sobre el perfil de los participantes y el distanciamiento social; también se utilizaron cuestionarios sobre calidad de vida y conducta alimentaria. Para el análisis de los datos se utilizó el modelo de regresión logística, la correlación de Spearman, las pruebas de la U de Mann-Whitney y la t de Student para muestras independientes. Resultados: la calidad de vida general fue de 57,03 puntos y la conducta alimentaria con mayor puntuación fue la restricción cognitiva (61,11 puntos). La mayoría de los pacientes (72,1%) mantenía el distanciamiento social y el 27,9% no habían cambiado la rutina. La probabilidad de adherir al aislamiento fue 3,16 veces mayor para los pacientes casados. Existe una correlación positiva entre los dominios del cuestionario de calidad de vida y la restricción cognitiva de las preguntas sobre la conducta asociada a los hábitos alimentarios. Conclusión: se verificó que los participantes tendían a tener una mejor calidad de vida a medida que aumentaba la restricción cognitiva.

Objetivo: verificar a qualidade de vida e o comportamento alimentar de pacientes com obesidade durante a pandemia por COVID-19. Método: estudo transversal com 68 pacientes atendidos em ambulatório de cirurgia bariátrica em hospital universitário do sul do Brasil. A coleta de dados foi realizada por telefone, com perguntas sobre o perfil dos participantes e o distanciamento social; também foram utilizados questionários de qualidade de vida e de comportamento alimentar. Para a análise de dados, foram utilizados o modelo de regressão logística, a correlação de Spearman e os testes U de Mann-Whitney e t de Student, para amostras independentes. Resultados: a qualidade de vida geral foi de 57,03 pontos e o comportamento alimentar que apresentou maior pontuação foi a restrição cognitiva (61,11 pontos). Grande parte dos pacientes (72,1%) estava fazendo distanciamento social e 27,9% não haviam mudado a rotina. A chance de fazer isolamento foi 3,16 vezes maior para os pacientes que estavam casados. Existe uma correlação positiva entre os domínios do questionário de qualidade de vida e a restrição cognitiva das perguntas sobre o comportamento associado ao hábito alimentar. Conclusão: verificou-se que os participantes apresentaram tendência em ter uma melhor qualidade de vida conforme a restrição cognitiva aumentava.

Effects of encapsulated sodium butyrate and phytogenic on growth performance, carcass traits and health of growing-finishing pigs / Efeitos do butirato de sódio encapsulado e fitogênico sobre o desempenho, características da carcaça e saúde de suínos em fase de crescimento e terminação

ABSTRACT: The aim of this study was to evaluate two feed additives, one based on encapsulated sodium butyrate (Adimix® Precision) (AD) and the other, a phytogenic (Apex® 5) (AX), associated or not with an antimicrobial growth promoter (tylosin) during the growth and finishing phases on performance, carcass characteristics and health conditions. A total of 300 barrows and females were distributed in six treatments in a randomized block design with ten replicates. The treatments consisted of a negative control (NC), positive control (PC) (tylosin), AD (encapsulated sodium butyrate), AX (phytogenic), PC+AD (tylosin+encapsulated sodium butyrate), and PC+AX (tylosin+phytogenic). The performance (live weight, daily feed intake, average daily gain and feed conversion) and carcass data (carcass weight, backfat thickness, loin depth, lean meat on the carcass) were submitted to ANOVA plus Tukey's test, and the health conditions (occurrence of diseases, culling, and spontaneous deaths) were analyzed by χ2. Animals of the AD group had the highest average daily gain (ADG) over the evaluation period and the highest live weight at 120, 140, and 164 days of age, in addition to the highest carcass weight compared to NC and PC groups. The AX treatment increased the ADG in growth phase II and the live weight at 120 and 140 days of age in relation to the NC. The PC+AX group had a higher final live weight compared to the NC and PC groups and higher carcass weight in relation to the NC group. There was no difference among treatments for backfat thickness, percentage of lean meat in the carcass, or occurrence of diseases and deaths. The inclusion of encapsulated sodium butyrate (AD treatment) was effective in increasing ADG, final live weight, and carcass weight compared to supplementation with tylosin (PC treatment), as was the inclusion of a phytogenic (AX treatment) on FC compared to the PC.

RESUMO: O objetivo deste estudo foi avaliar dois aditivos alimentares, um a base de butirato de sódio encapsulado (Adimix® Precision) (AD) e outro a base de um fitogênico (Apex® 5) (AX), associados ou não a um antibiótico promotor de crescimento (tilosina), durante as fases de crescimento e terminação, sobre o desempenho, características da carcaça e status de saúde. Foram utilizados 300 suínos machos castrados e fêmeas distribuídos em seis tratamentos em um delineamento em blocos casualizados com dez repetições. Os tratamentos consistiram em um controle negativo (CN), controle positivo (CP) (tilosina), AD (butirato de sódio encapsulado), AX (fitogênico), CP+AD (tilosina+butirato de sódio encapsulado) e CP+AX (tilosina+fitogênico). Os dados de desempenho (peso vivo, consumo diário de ração, ganho de peso médio diário e conversão alimentar) e de carcaça (peso de carcaça, espessura de toucinho, profundidade do lombo e carne magra na carcaça) foram submetidos à ANOVA seguido por teste de Tukey, e os dados de condição de saúde (ocorrência de doenças, animais eutanasiados e mortos espontaneamente) foram analisados pelo teste de χ2. Os animais do grupo AD apresentaram maior ganho de peso diário (GPD) durante o período de avaliação e maior peso vivo aos 120, 140 e 164 dias de idade, além de maior peso de carcaça em comparação aos grupos CN e CP. O tratamento AX aumentou o GPD na fase crescimento II e o peso vivo aos 120 e 140 dias de idade em relação ao CN. O grupo CP+AX apresentou maior peso final em relação aos grupos CN e CP e maior peso de carcaça em relação ao CN. Não houve diferença entre os tratamentos para espessura de toucinho, porcentagem de carne magra na carcaça e ocorrência de doenças e óbitos. A inclusão de butirato de sódio encapsulado (tratamento AD) foi efetiva no aumento de GPD, peso final e peso de carcaça em comparação à suplementação com tilosina (tratamento CP), assim como a inclusão fitogênico (tratamento AX) melhorou a conversão alimentar em comparação ao grupo CP.

Increasing doses of phytase from Citrobacter braakii in diets with reduced inorganic phosphorus and calcium improve growth performance and lean meat of growing and finishing pigs.

The objective of this study was to evaluate the effect of increasing doses of bacterial phytase (RONOZYME HiPhos) on performance and carcass characteristics of growing and finishing pigs. The study included 120 castrated males with initial weight of 23.21 ± 1.91 kg and 68 days of age, distributed in a randomized block design with five treatments and eight replicates with three animals each. The pigs were fed five corn-soybean meal-based diets: positive control (PC), supplemented with inorganic phosphorus and calcium; negative control (NC), with 0.13% reduction in available phosphorus and 0.11% in calcium; and three NC diets supplemented with 1,000, 2,000, and 3,000 phytase units (FYT)/kg in the feed. Compared with the NC diets without phytase, diets with 1,000, 2,000, and 3,000 FYT/kg inclusion increased the daily weight gain by +12% (quadratic, p<0.05) during the growing I period; +2.9, +2.9, and +10.5% (linear, p<0.01), respectively, during the growing II period; and +4.1, +5.1, and +8.2% (linear, p<0.001), respectively, over the entire experimental period. The daily feed intake increased by 0, +2.8, and +4.3% (linear, p<0.05), respectively, considering the entire experimental period; and the final live weight increased by +3.2, +4.2, and +6.1% (linear, p<0.001), respectively. The phytase treatments did not influence feed conversion ratio, carcass weight and yield, backfat thickness, loin depth and carcass lean meat. According to the European Carcass Classification (SEUROP), however, the animals fed the PC diet and the three phytase levels had more carcasses classified as E (between 55-60% lean meat) when compared to carcasses of pigs fed the NC. Supplementing increasing levels of phytase to a corn- and soybean meal-based diet with inorganic P and Ca reduction improved daily weight gain and feed intake of growing pigs, and such effects were maintained until slaughter age.

Gestão por competências: preparo do processo avaliativo pelos enfermeiros de uma unidade de internação / Gestión por competencias: preparación del proceso evaluativo por enfermeros de una unidad de internación / Competence-based management: the preparation of the assessment process conducted by nurses at an inpatient unit

Contemporaneamente, o modelo de gerenciamento por competências tem alcançado o âmbito da avaliação do trabalhador na saúde e enfermagem. Nesta perspectiva, o processo avaliativo requer planejamento e organização. O objetivo geral consistiu em compreender como ocorre o preparo do processo avaliativo dos técnicos e auxiliares de enfermagem pelos enfermeiros de uma unidade de internação clínica adulto do Hospital de Clínicas de Porto Alegre, na perspectiva da gestão por competências. O estudo, caracterizado como descritivo, de abordagem qualitativa, foi desenvolvido com 13 enfermeiros e os dados coletados entre maio e junho de 2017, por meio de entrevistas semiestruturadas. A análise de conteúdo temática resultou em três categorias: processo avaliativo, uma trajetória a ser discutida; no momento da avaliação, aspectos intervenientes; e, gestão por competências, um novo modelo de avaliação. Os resultados indicam que os enfermeiros se organizam para realizar as avaliações dos técnicos e auxiliares de enfermagem no último trimestre do ano, geralmente em duplas, estabelecendo um cronograma e posterior comunicação aos avaliados. Noções sobre conhecimentos, habilidades e atitudes perpassam o entendimento dos entrevistados sobre avaliação por competências, embora ainda de modo incipiente. Houve referência à modificação no comportamento dos avaliados em momentos que antecedem à apreciação e às inconveniências logísticas relacionadas ao local das avaliações e ao tempo disponível, comprometendo a privacidade da entrevista avaliativa. Conclui-se sobre a importância de se apropriar de conhecimentos, habilidades e atitudes, bem como dos recursos proporcionados pelo sistema de gestão por competências da instituição para realizar avaliações com responsabilidade e compromisso.

Currently, the competence-based management model has reached the scope of employee assessment in health and nursing. Under this perspective, the evaluation process requires planning and organization. The general objective of this study was to understand how the nurses at an adult inpatient unit at Hospital de Clínicas dePorto Alegre prepare the assessment process of the unit's nursing technicians and assistants based on the competence-based management perspective. This qualitative descriptive study was developed with 13 nurses, and data were collected between May and June, 2017 through semi-structured interviews. The analysis of the thematic content resulted in three categories: 1) evaluation process: a path yet to be discussed; 2) aspects that affect the moment of the evaluation; and 3) competence-based management: a new assessment model. The results indicate that the nurses usually get organized in pairs to conduct the evaluations of nursing technicians and assistants in the last quarter of the year. They design a schedule and subsequently inform these staff members. The interviewees demonstrated, although still in an incipient way, some understanding of the knowledge, skills, and attitudes involved in competence-based assessment. Changes in the behavior of the nursing technicians and assistants some moments before the assessment were reported. In addition, logistic inconveniences related to the venue and the time available for the assessment compromised the privacy of the evaluation interview. It can be concluded that it is important for the institution's competence-based management system to master the required knowledge, skills, and attitudes, as well as to provide the necessary resources, in order to carry out evaluations with responsibility and commitment.

Actualmente, el modelo de gestión por competencias ha alcanzado el ámbito de la evaluación del trabajador en salud y enfermería. En esta perspectiva, el proceso evaluativo requiere planificación y organización. El objetivo general constituye en comprender cómo ocurre la preparación del proceso evaluativo de técnicos y auxiliares de enfermería por los enfermeros de una unidad de internación clínica adulta del Hospital de Clínicas de Porto Alegre, en la perspectiva de la gestión por competencias. El estudio, caracterizado como descriptivo, de enfoque cualitativo, ha sido desarrollado con 13 enfermeros, y los datos recogidos entre mayo y junio de 2017, a través de entrevistas semiestructuradas. El análisis de contenido temático ha resultado en 3 categorías: proceso evaluativo, una trayectoria a debatirse; en el momento de la evaluación, aspectos intervinientes; y, gestión por competencias, un nuevo modelo de evaluación. Los resultados indican que los enfermeros se organizan para realizar las evaluaciones de los técnicos y auxiliares de enfermería en el último periodo trimestral del año, generalmente en parejas, estableciendo un cronograma y posterior comunicación de los evaluados. Nociones de conocimientos, habilidades y actitudes atraviesan el entendimiento de los entrevistados sobre evaluación por competencias, aunque aún de manera incipiente. Ha sido referenciada la modificación en el comportamiento de los evaluados en momentos que anteceden la apreciación y también las inconveniencias logísticas relacionadas al local y al tiempo disponible para las evaluaciones, lo que compromete la privacidad de la entrevista evaluativa. Se concluye sobre la importancia de apropiarse de conocimientos, habilidades y actitudes, así como de los recursos proporcionados por el sistema de gestión por competencias de la institución para realizar evaluaciones con responsabilidad y compromiso.

Gestão por competências: preparo do processo avaliativo pelos enfermeiros de uma unidade de internação / Gestión por competencias: preparación del proceso evaluativo por enfermeros de una unidad de internación / Competence-based management: the preparation of the assessment process conducted by nurses at an inpatient unit

Resumo OBJETIVO Compreender como ocorre o preparo do processo avaliativo dos técnicos e auxiliares de enfermagem pelos enfermeiros de uma unidade de internação clínica adulto, na perspectiva da gestão por competências. MÉTODO Estudo descritivo, qualitativo, desenvolvido com 13 enfermeiros de um hospital universitário. Os dados coletados entre maio e junho de 2017, por meio de entrevistas semiestruturadas, foram submetidos à análise de conteúdo temática. RESULTADOS Emergiram duas categorias: gestão por competências, um novo modelo de avaliação; e, processo avaliativo, uma trajetória a ser discutida. CONCLUSÃO O planejamento da avaliação ao longo do ano por meio de reuniões periódicas sobre a temática é importante para o preparo do processo avaliativo. Além disso, o conhecimento prévio dos percalços avaliativos subsidia o enfermeiro na organização da avaliação.

Resumen OBJETIVO Comprender como ocurre la preparación del proceso evaluativo de los técnicos y auxiliares de enfermería de una unidad de internación clínica adulta, en la perspectiva de la gestión por competencias. MÉTODO Estudio descriptivo, cualitativo, desarrollado con 13 enfermeros de un hospital universitario. Se sometieron los datos, recogidos entre mayo y junio de 2017, a través de entrevistas semiestructuradas, a un análisis de contenido temático. RESULTADOS Emergieron dos categorías: gestión por competencias, un nuevo modelo de evaluación; y proceso evaluativo, una trayectoria a debatirse. CONCLUSIÓN La planificación de la evaluación a lo largo del año, a través de reuniones periódicas sobre la temática, es importante para la preparación del proceso evaluativo. Además, el conocimiento anterior de los percances evaluativos subsidia al enfermero en la organización de la evaluación.

Abstract OBJECTIVE To understand the preparation of the evaluation process of nursing technicians and assistants by nurses at an adult inpatient care unit, from the competence-based management perspective. METHOD Descriptive and qualitative study, developed with 13 nurses at a university hospital. The data were collected between May and June of 2017, through semi-structured interviews, and were submitted to thematic content analysis. RESULTS Two categories emerged: competence-based management, a new model of evaluation; and, evaluation process, a trajectory to be discussed. CONCLUSION Planning the evaluation throughout the year in periodic meetings about the subject is important to the preparation of the evaluation process. Furthermore, the previous knowledge of evaluation mishaps subsidizes the nurse in the organization of the evaluation.

Behavior of Pigs Reared in Enriched Environment: Alternatives to Extend Pigs Attention.

Three trials were carried out in a completely randomized design aiming to assess the behavior of pigs in growth phase in enriched environments. Trial 1 evaluated the effects of frequency of availability of environmental enrichment. The animals were assigned to four treatments: 1) control with no enrichment object; 2) objects provided for six consecutive days uninterruptedly; 3) objects provided on alternate days, and 4) objects provided for six consecutive days taken away by the end of the afternoon and replaced at dawn. Trial 2 assessed the effects of scent on animals' acceptance and maintenance of interest in objects. Animals were assigned to four treatments: 1) unscented object; 2) object with banana scent; 3) object with rum scent; 4) object with scents alternated every other day. Trial 3 aimed to assess the influence of environmental enrichment based on providing rewards at different difficulty levels. Animals were assigned to three treatments: 1) object with no reward; 2) object with a reward at an easy level; 3) object with a reward at a difficult level. Each trial had six days of behavioral observations every ten minutes for eight hours each day using images from video cameras. Enrichment objects stimulated the animals' natural behavior of nuzzling and exploring the environment. The way the objects were available did not impact the success of their use. Offering enrichment on alternate days or removing the objects by the end of the day was not an effective strategy to extend the animals' interest. The olfactory stimulus in environmental enrichment objects had no positive effect on extending the animals' interest on them, nor did alternating the aromas. The tactile stimulus was a key factor for object attractiveness. Providing environmental enrichment objects with rewards stimulated the exploratory behavior of pigs. The level of difficulty to obtain the reward may discourage the animals.

Performance and plasma urea nitrogen of immunocastrated males pigs of medium genetic potential / Rendimiento y nitrógeno de urea en plasma de cerdos machos inmunocastrados de potencial genético medio

Objective. A study was carried out to evaluate the performance and the plasma urea nitrogen (PUN) of male pigs of medium genetic potential for lean meat deposition in carcass, which underwent immunocastration. Materials and methods. Forty-five seventy-days old Large White x Landrace crossbred were used. The pigs were distributed in a randomized design in three treatments: castrated males, females and immunocastrated males. Each treatment group was replicated three times with five pigs per replicate. The trial period was of 70 days, divided into phases of growing (70 to 110 days old) and finishing (111 to 140 days old). The pigs were weighed four times: at the beginning of the trial, at the first immunocastration vaccine dose (80 days old), at the second immunocastration vaccine dose (110 days old) and just before slaughter (140 days old). Blood samples were taken on the same day that the animals were weighed. Results. Between 80 and 110 days old, there was an increase in PUN value, only for castrated males and females. No differences were found in weight gain between the studied groups within the periods. Immunocastrated males had lower feed intake than females and these had a lower feed intake than castrated males. To 110 days old, immunocastrated animals showed feed conversion ratio similar to females and better than castrated males. However, after the second dose of the vaccine, feed conversion was similar between groups. Conclusions. The benefits of immunocastration are prominent in animals with low to medium genetic potential.

Objetivo. Se realizó un estudio para evaluar el rendimiento y la concentración de urea en plasma (PUN) de los cerdos machos de medio potencial genético de carne magra en la canal sometidos a la inmunocastración. Materiales y métodos. Se utilizaron 45 cerdos de 70 días de edad Landrace x Large White. Los animales se distribuyeron en un diseño completamente al azar con tres tratamientos: machos castrados, hembras y machos inmunocastrados. Cada tratamiento consistió en tres repeticiones, con cinco animales por réplica. El período experimental fue de 70 días, divididos en las etapas de crecimiento (70 a 110 días de edad) y terminación (111 a 140 días de edad). Los cerdos fueron pesados cuatro veces: al inicio del experimento, en la primera dosis de vacuna de inmunocastración (80 días de edad), en la segunda dosis de la vacuna de inmunocastración (110 días de edad) y antes de el sacrificio (140 días de edad). Las muestras de sangre se recogieron en el mismo día en que se pesaron los animales. Resultados. Entre 80 y 110 días de edad, hubo un aumento en la cantidad de PUN, sólo para machos castrados y hembras. No hubo diferencias en la ganancia de peso entre los grupos en ninguno de los períodos estudiados. Machos inmunocastrados tuvieron menor consumo de alimento que las hembras y éstas mostraron un menor consumo que los machos castrados. En 110 días de edad, los animales inmunocastrados mostraron la conversión de alimento similar a las hembras y mejor que los machos castrados. Sin embargo, después de la segunda dosis de la vacuna, la conversión alimenticia fue similar entre los grupos. Conclusiones. Los beneficios de inmunocastración son prominentes en animales con bajo a médio potencial genético.

Sows' parity and coconut oil postnatal supplement on piglets performance / Número de partos y la suplementación de aceite de coco para lechones recién nacidos

Objective. The study aimed to evaluate the effect of sows' of different parities and the supplement of coconut oil for piglets, on the development of litter. Materials and methods. A total of 51 sows of different parities and their 642 piglets were used in the trial. Each piglet was weighed and identified at birth in a sequential order. They were randomly distributed in two treatments (CG=control group and TG=test group). TG piglets had the first access to a dosage of 3.0 ml of coconut oil 12 hours after birth, and the second at 36 h after the first. Piglets were weighed at 21 days. In order to analyze the effect of the coconut oil supplement as a function of the weight at birth, piglets were grouped according to their weight (0.600 to 0.900 kg; 1.000 to 1.499kg; 1.500 to 1.999 kg; and 2.000 to 2.499 kg). Results. Sows parity affected the number and weight of born piglets. Sows in 4th, 5th and 7th parity had a larger litter than those from the 2nd parity. Sows from 2nd and 3rd parity had a lower number of piglets but heavier litter. No effect of the coconut oil supplement on neonatal piglets' performance was found. Conclusions. The coconut meal was neither beneficial to neonatal piglets nor to those with low weight at birth, which usually present low body energy.

El objetivo del estudio fue evaluar el efecto del número de partos y el suplemento de aceite de coco en lechones recien nacidos. Materiales y métodos. Se utilizaron 51 cerdas de diferentes partos y sus 642 lechones. Cada lechón se pesó y se identificó al nacer en orden secuencial. Fueron distribuidos aleatoriamente en dos grupos (CG = control y TG=tratamiento). Lechones TG tenían el primer acceso a una dosis de 3.0 ml de aceite de coco 12 horas después del nacimiento, y el segunda a las 36 h después de la primera. Los lechones fueron pesados a los 21 días. Con el fin de analizar el efecto de los suplementos de aceite de coco con relación al peso al nacer. Los lechones fueron agrupados de acuerdo con su peso (0.600 a 0.900 kg; 1.000 a 1.499 kg; 1.500 a 1.999 kg y 2.000 a 2.499 kg). Resultados. El número de partos afectó el peso y el número de lechones nacidos. Cerdas en cuarto, quinto y séptimo parto, tuvieron una camada mayor que las de segundo parto. Las cerdas de segundo y tercer parto tuvieron menor número de lechones y con peso mayor. No se encontró efecto del suplemento de aceite de coco en el desarrollo de los lechones recién nacidos. Conclusiones. Lo aceite de coco no es favorable para los lechones recién nacidos, tampoco para aquellos con el bajo peso al nacer, que normalmente presentan la energía corporal baja.

Piglets' surface temperature change at different weights at birth.

The study was carried out in order to verify the effects of piglets' weight at birth on their surface temperature change (ST) after birth, and its relationship with ingestion time of colostrum. Piglets from four different sows were weighed at birth and divided into a totally randomized design with three treatments according to birth weight (PBW): T1 - less than 1.00 kg, T2 - 1.00 to 1.39 kg, and T3 - higher than or equal to 1.40 kg. The time spent for the first colostrum ingestion was recorded (TFS). Images of piglets' surface by thermal imaging camera were recorded at birth (STB) and 15, 30, 45, 60, and 120 min after birth. The air temperature and relative humidity were recorded every 30 min and the indexes of temperature and humidity (THI) were calculated. A ST drop after 15 min from birth was observed, increasing again after sixty minutes. Positive correlations were found between the PBW and the ST at 30 and 45 min after birth. The PBW was negatively correlated with the TFS. The THI showed high negative correlations (-0.824 and -0.815) with STB and after 15 min from birth. The piglet's surface temperature at birth was positively correlated with temperature thereof to 15 min, influencing therefore the temperatures in the interval of 45 to 120 min. The birth weight contributes significantly to postnatal hypothermia and consequently to the time it takes for piglets ingest colostrum, requiring special attention to those of low birth weight.

Empresa de material cirúrgico: atuação do enfermeiro / Company of surgical materials: nurse's performance

Este estudo teve como objetivos relatar a experiência de trabalho do enfermeiro em uma empresa de materiais cirúrgicos, descrever seu papel e apresentar sua importância na empresa, além de servir de reflexão sobra a atuação do enfermeiro em uma área de trabalho não assistencial....