Cuidado à criança com asma: o discurso de familiares / Caring for the child with asthma: relatives’ discourse

Objetivo: descrever os cuidados desenvolvidos pelos familiares à criança com asma. Método: utilizou-se o método criativo sensível desenvolvendo-se a dinâmica de criatividade e sensibilidade mapa falante. Os participantes foram familiares/cuidadores de crianças com diagnóstico de asma. Os dados foram submetidos à análise de discurso Pechetiana. Resultados: o cuidado era cotidiano e desenvolvido prioritariamente por mulheres da família, com ênfase na prevenção das crises. As marcas discursivas nas falas das cuidadoras foram: a preocupação, a insegurança e os mitos sobre a doença. Considerações finais: o cotidiano de cuidados dessas crianças é permeado pelo medo de uma nova crise asmática. Como implicação para a prática clínica, sugere-se realizar atividades educativas com as famílias em uma perspectiva emancipatória, promovendo uma aliança de saberes.

Objective: to describe the care developed by relatives to the child with asthma. Method: thesensitive creative method was carried out by developing the dynamics of creativity and sensitivityof the speaking map. Participants were relatives/ caregivers of children diagnosed with asthma. Thedata were submitted to Pechetiana discourse analysis. Results: care was daily and developedprimarily by women in the family, with an emphasis on crisis prevention. The discursive marks in thespeeches of caregivers were: the concern, the insecurity and the myths about the disease. Finalconsiderations: the daily care of these children is permeated by the fear of a new asthmatic crisis.As an implication for clinical practice, it is suggested to carry out educational activities with familiesin an emancipatory perspective, promoting an alliance of knowledge.

[Communication with the patient. A question of quality]. / Comunicación con el paciente. Una cuestión de calidad.

Interpersonal communication as a means to promote health and well-being is presented as a strategical orientation in the nursing care process. Meanwhile, in our medium, we have observed the development of communication from a perspective much more related to complying with a service. This article has these objectives: a) to investigate this theme by highlighting analytical instruments of interaction found in bibliographical references, b) to disclose the results of research about nurse-patient communication indicators, in the context as a forum for reflection, bearing in mind the quality of treatment. The authors highlight the need to assume a responsibility shared by teaching nurses and assistants, with the goal to constantly seek to develop communicative competence and thus to contribute to a greater efficiency and an improvement in the quality of nursing care.

[Motivation in nursing team work]. / A motivação no Trabalho da equipe de enfermagem.

This is a descriptive study conducted in a university hospital with the purpose to apprehend some aspects influencing human motivation and their implications to work results. A recorded semi-structured interview was used for data collection which was applied to 18 members of a nursing team, of whom 6 were nurses and 12 were nursing auxiliaries and technicians. The apprehended material was submitted to the content analysis technique, which enabled the identification of "Work Itself" as the most frequently cited category considered to be motivating and "Work Organization" as the most unmotivating. The most cited suggestions referred to "Work Organization" and to "Interpersonal Relationship".

[Learning leadership: nurses opinion about their academic education]. / Aprendizagem da liderança: opinião de enfermeiros sobre a formação acadêmica.

The purpose of the present study was to identify nurses opinion about aspects of their academic undergraduate education directed to form leaders of the nursing team. Therefore, authors interviewed 17 nurses from a public federal hospital who experience the condition of being staff leaders. The collected material was analyzed through the technique of content analysis. Results evidenced a dissatisfaction concerning their academic training on leadership. The approached aspects showed the importance of a reflection about the need of teaching-learning strategies that allow students to develop leadership skills.

[Expectations of nursing managers and assistants as to the managerial style of an executive director of a teaching hospital]. / Expectativas de gerentes e assessores de enfermagem quanto ao estilo gerencial do diretor executivo de um hospital de ensino.

The present study focussed the expectations of 13 nurses from a University hospital regarding to the executive director's managerial style. The Managerial Grid of BLAKE & MOUTON (1987) was used as a theoretical reference and a questionnaire was applied based on the Grid & Leadership in Nursing Instrument elaborated by TREVIZAN (1993). Results evidenced that the most expected style corresponds, considering the Managerial Grid, to "team management", or 9.9. The second style was the "management of men organization", or 5.5. Authors concluded that there are important expectations for these nurses related to a management that enhances values such as trust, respect, commitment, personal investment and team work in order to achieve the organization goals.

[The Brazilian Universal Health System and the delivery of nursing care in a Brazilian hospital]. / O Sistema Unico de Saúde e as ações do enfermeiro em uma instituição hospitalar brasileira.

There are few studies on the delivery of nursing services in hospitals participating in the Brazilian universal public health system (Sistema Unico de Saúde), which was put in place in 1988. This study, which examined possible changes in the delivery of these services since universal health care was implemented, was based on interviews carried out between July and September 1995 with 31 nurses working at a teaching hospital in the city of Ribeirão Preto, in the state of São Paulo. The nurses had begun working at the hospital between May 1980 and May 1987. Thematic analysis was used to assess their answers. According to the nurses, patients treated after the universal system was implemented have had more complex medical needs and a higher socioeconomic status. In addition, nurses reported an increase in the complexity of patient demands and in the variety of medical specialties offered by the hospital, as well as a decrease in the length of inpatient stays. Forty-six percent of the interviewees reported a change in the work done by nursing staff (for example, nurses have less time available for each patient). Not all of the problems the nurses mentioned are related to the public health system (understaffing is one example). It is essential that nurses examine national health policy and that they engage in the (re)construction of the practice of health care delivery. Nurses ought to understand the reality of their institutions and carry out a management process geared towards the expectations of patients and of health care workers.

[Factual and virtual dimension in nursing management]. / Dimensões factual e virtual no gerenciamento da enfermeira.

Through an historical analysis of the hospital organization as well as of nursing practice in the bureaucratic context of hospitals, authors found that the studied institution delegates to nurses several management functions, mainly bureaucratic ones. This was verified through empirical data about nurse's role in the units, demonstrating that, among her functions, the management ones are privileged in that institution. Results showed that in the hospital field, nurses can not avoid the management function, although there is an expectation of a different management role than the one normally found. Considering this factual dimension, authors also analyse the virtual dimension of this process, in order to investigate the expectations of the nursing personnel regarding nurses' behaviour as managers/leaders. Authors conclude the study demonstrating the importance of the conciliation of the factual-virtual duality in female nurse's management and leadership.

[Changes in hospital nursing care due to the Brazilian Unified Health System]. / Modificações no atendimento de enfermagem hospitalar decorrentes do sistema único de saúde (SUS).

Considering changes in the Health System, this survey analyses the view of 31 nurses from a hospital institution linked to the Brazilian Unified Health System (SUS) in order to learn how they face the changes and their actions in 1995. To better understand the content of the interviews, authors use a thematic analysis proposed by BARDIN (1977). This analysis shows that some nurses recognize a different action after the SUS inclusion and others do not. However, when their actions are analysed as a whole, they are mainly directed to be a physician complementary action. The inadequate management by the nurse has contributed for a not entire nursing care. Authors suggest the management improvement of nurses in order to redirect nursing actions.

[Leadership and communication in nursing management]. / Liderança e comunicação no cenário da gestão em enfermagem.

Considering communication and leadership, authors examine the role of the leader as a focus of reception and transmission of information, based on the classification of Mintzberg related to their informative roles, such as the leader acting as monitor, disseminator and spokesman. Contextualizing this approach in the scenery of nursing management, authors study the dimension of nurses-leaders role as an essential element of communication in the systems of organization of nursing care.

[The leadership style exercised by nurses in surgical wards focuses on situational leadership]. / O estilo de liderança exercido pelo enfermeiro de unidade de internação cirúrgica sob o enfoque da liderança situacional.

The present study was oriented to the leadership theme focussing nurses inside surgical ward unities. As a theoretical reference, the authors used the Situational Leadership Model proposed by Hersey and Blanchard. This study aimed at analysing the correspondence between the opinions of nurses and auxiliary personnel about the leadership style exerted by nurses in the surgical ward unit regarding the six categories of the assistance activity that were studied. Authors noticed that nurses, from the two studied hospitals, adopted the directive leadership styles (E2/selling or E1/telling) with the auxiliary personnel.

Metal accumulation in a biological indicator (Ulva rigida) from the lagoon of Venice (Italy).

Ulva rigida (C. Agardht) was collected from the Palude della Rosa (lagoon of Venice), a particular area characterized by a salinity gradient, from December 1991 to June 1993. Metal contents (Al, Mn, Fe, Cu, Zn, Cr, Co, Ni, Cd, and Pb) were determined by atomic absorption spectrophotometry and statistically analysed for differences between months and sampling sites. The mean seasonal variability is very significant (p < 0.001) for all studied metals. Seasonal trends are comparable for groups of metals according to possible functional similarities. A significant positive correlation was calculated for the pairs Fe-Al and Fe-Pb. Mechanisms regulating metal uptake are discussed, particularly the role of Fe and its linear relationship with Al. Metal concentrations in relation to salinity also were studied. Larger amounts of Fe, Zn, and Cd accumulated in correspondence of lower salinity, may be owing to both higher metal activity and burden of bioavailable metals in freshwater flowing into the Palude. Calculation of concentration factor (CF) indicates that U. rigida specifically accumulates Fe. CF linearly correlates with dissolved metal concentrations, suggesting that U. rigida is a good bioindicator of metal bioavailability, although seasonal active accumulation occurs in some cases (Mn). Metal concentrations determined in this macroalga support the conclusion that the studied area is rich in bioavailable Fe and poor in toxic metals. In any case, a great affinity for Al in U. rigida may be proposed.

[Characterization of the daily activities of a nurse section chief in a university hospital]. / Caracterização das atividades diárias do enfermeiro chefe de seção em um hospital universitário.

This descriptive study has the purpose of identifying if nursing care planning takes part of the daily activities of 19 head nurses in an University hospital through thematic analysis of their interviews. It was checked out that from 309 reported activities, 71.51% are administrative, 19.43% delegated, 18.74% of assistance and 0.32% related to teaching, considering that the activities related to research were not reported by them. Among the administrative tasks, the formal planning of nursing assistance was not mentioned as daily activities of these head nurses. Based on these results the authors made recommendations to the Institution and to Nursing Undergraduation Courses.

[Expectations of hospital administrators about administrative functions of nurses]. / Expectativa do administrador hospitalar frente as funções administrativas realizadas pelo enfermeiro.

The objective of the present study was to investigate hospital administrator's expectations about the administrative role played by nurses, utilizing functions proposed by the Neoclassical Theory of Administration: planning, organization, direction, and control as theoretical references. An instrument established in TREVIZAN (1989) was applied to 11 hospital administrators. The results showed they expect the four functions to be done by nurses. Therefore, the interaction between nurses and hospital administrators is critical to improve the patient's assistance.

[The instruction for undergraduate graduation at the Ribeirao Preto Nursing School of Sao Paulo--its prospects]. / O ensino de graduação na escola de enfermagem de Ribeirão Preto da Universidade de São Paulo-suas prospectivas.

Authors focused the undergraduate education at the College of Nursing, University of São Paulo at Ribeirão Preto Campus, through its historical and conceptual mark since its establishment in the 1950's. In the 1980's, a study of curriculum modification originated from a wide process of discussion, culminated in a proposal of formation of generalized nurses and the introduction of a new curriculum in 1989. According to authors' version, the prospectives to nursing education depend on the schools' reflection about the University's role in the reorientation of health services and formation of students aiming at political, scientific and technical competence to actuate at different levels of community health assistance. A new educational model will require a curriculum reorientation and the insertion of schools in the health services as a strategic component of the integration of education with professional practice.

Response of Pleurotus ostreatus to cadmium exposure.

The possibility of utilizing agroindustrial wastes in the production of edible, high-quality products (e.g., mushrooms) implies the risk of bringing toxic substances, such as heavy metals, into the human food chain. Thus, growth in the presence of cadmium and cadmium accumulation limits have been studied in the industrially cultivated fungus P. ostreatus. Fruit body production is substantially unaffected in the presence of 25, 139, and 285 mg Cd/kg of dried substrate. Cadmium concentration in fruit bodies is related to cadmium substrate level, the metal being present at higher levels in caps (22-56 mg/kg dry wt) than in stems (13-36 mg/kg dry wt). Concentration factor (CF), very low in the controls (about 2), further decreases in treated specimens. The presence of a cadmium control mechanism in this fungi species is suggested. Fruit body cadmium levels could, however, represent a risk for P. ostreatus consumers, according to FAO/WHO limits related to weekly cadmium intake.