Las Competencias de Salud Global para Estudiantes de Enfermería: Percepciones de Docentes en América Latina / Global Health Competencies among Nursing Students: Perceptions of Teachers in Latin America / As Competências de Saúde Global para Estudantes de Enfermagem: Percepções de Docentes na América Latina

Resumen: Objetivo: El propósito de este estudio fue describir las percepciones de docentes de enfermería de habla hispana en América Latina, sobre las competencias relacionadas a la salud global que deben mostrar los estudiantes de enfermería del pregrado. Métodos: Este estudio descriptivo fue basado en una muestra de docentes de escuelas de enfermería miembros de la Asociación Latinoamericana de Escuelas y Facultades de Enfermería (ALADEFE) y de la Asociación de Escuelas de la Zona Centro Sur de México, las cuales recibieron un correo electrónico con una liga para responder una encuesta electrónica por Survey Monkey©. La encuesta incluyó una lista de 30 competencias en salud global dividida en seis dimensiones. Los docentes indicaron en una escala Likert de 4 puntos la relevancia de cada competencia para la educación de enfermería en el nivel de pregrado (1 = Completamente en desacuerdo; 2 = En desacuerdo; 3 = De acuerdo; 4 = Completamente de acuerdo). Resultados: En total, 110 profesores de nueve países respondieron a la encuesta. El promedio de cada ítem fue entre 3.0 - 4.0, esto indica que los profesores estuvieron de acuerdo en que todas las competencias son relevantes para la formación de estudiantes de enfermería a nivel de pregrado. Conclusiones: Los resultados de este estudio sugirieron que estas competencias deben ser incluidas en los currículos de enfermería a nivel de pregrado, para formar a los estudiantes en su labor como enfermeras y enfermeros en un mundo globalizado y prepararlos para contribuir a la Cobertura y el Acceso Universal a la Salud (Salud Universal).

Abstract: Objective: To describe the perceptions of Spanish-speaking nursing teachers in Latin America on the global health competences which, undergraduate nursing students should demonstrate. Methods: This descriptive study was based on a sample of teachers of nursing schools belonging to the Latin American Association of Nursing Schools and Faculties, and the Association of Schools of the Center-South Zone in Mexico. These institutions received an invitation via e-mail to respond to a survey through the Survey Monkey© platform. The survey included a list of 30 Global Health competencies grouped in 6 dimensions. Teachers indicated through a 4-point Likert scale their perception on the relevance to undergraduate nursing education of each of these competencies (1 = total disagreement, 2 = disagreement, 3 = agreement, 4 = total agreement). Results: In total, 110 professors of 9 countries responded to the survey. The average score per item was 3.0 - 4.0 suggesting that the teachers agreed that all competencies are relevant to the formation of undergraduate nursing students. Conclusions: These results suggested that these competencies should be part of the objectives of undergraduate nursing curricula in order to prepare the students to contribute to the Coverage and Access to Universal Health agenda.

Resumo: Objetivo: O propósito deste estudo foi descrever as percepções de docentes de enfermagem de fala hispana na América Latina, sobre as competências relacionadas à saúde global que devem mostrar os estudantes de enfermagem de graduação. Métodos: Este estudo descritivo foi baseado em uma amostra de docentes de escolas de enfermagem membros da Associação Latino-americana de Escolas e Faculdades de Enfermagem (ALADEFE) e da Associação de Escolas da Zona Centro Sul do México, as quais receberam um e-mail electrónico com um link para responder uma enquete electrónica por Survey Monkey©. A enquete incluiu uma lista de 30 competências em saúde global dividida em seis dimensões. Os docentes indicaram em uma escala Likert de 4 pontos a relevância de cada competência para a educação de enfermagem no nível de graduação (1 = Completamente em discordância; 2 = Em discordância; 3 = Em concordância; 4 = Completamente em concordância). Resultados: Em total, 110 professores de nove países responderam à enquete. A média de cada item foi entre 3.0-4.0, isto indica que os professores concordaram em que todas as competências são relevantes para a formação de estudantes de enfermagem a nível de graduação. Conclusões: Os resultados deste estudo sugeriram que estas competências devem ser incluídas nos currículos de enfermagem a nível de graduação, para formar aos estudantes em seu labor como enfermeiras e enfermeiros em um mundo globalizado e prepará-los para contribuir à Cobertura e o Acesso Universal à Saúde (Saúde Universal).

Processamento do milho para vacas leiteiras em pastejo / Processing of corn for grazing dairy cows

Doze vacas lactantes Holandês-Gir (1/2), em sistema de pasto rotativo de Panicum maximum cv. Mombaça, foram suplementadas com concentrados contendo milho seco finamente moído (MM), milho expandido (ME), milho floculado a vapor (MF) ou milho moído reidratado e ensilado (MU). O delineamento experimental adotado foi o de quadrado latino 4 x 4, com três repetições. O consumo de pasto foi maior quando as vacas foram suplementadas com MF, o que se refletiu em maior consumo de MS, PB, FDN para o mesmo tratamento. A digestibilidade aparente da MS foi maior para as dietas de MF e MM. A digestibilidade aparente da FDN foi menor para MU. A produção e composição do leite das vacas não diferiram entre os tratamentos, entretanto a eficiência alimentar foi menor para MF...

Twelve lactating Holstein-Gyr (1/2) cows in a rotational grazing system with Panicum maximum cv. Mombasa were supplemented with different concentrates containing finely ground dried corn (MM), expanded corn (ME), steam flaked corn (MF) or silage of re-hydrated ground corn (MU). The experiment was arranged in a 4 x 4 Latin square design with three replications. Pasture intake was higher when cows were supplemented with MF, which resulted in higher DM, CP, and NDF. The apparent digestibility of DM was higher for MF and MM diets. The NDF apparent digestibility was lower for MU. Milk yield and composition did not differ between treatments; however, feed efficiency was lower for MF...

Healthcare context and nursing workforce in a main city of Angola.

BACKGROUND: Angola is one of the largest African countries with continuing levels of insecurity, considerable weakness in terms of respect for human rights, destroyed infrastructure and low transparency and social accountability levels. The health system displays gaps and nursing represents the main contingent among human resources in health. AIM: This research aims to understand the healthcare context in Angola from the perspective of Brazilian nurses who were involved in helping their Angolan colleagues. This general view of health services is followed by a description of nursing workforce particularities at a tertiary health service in the province of Luanda. METHODS: Data were extracted from the database of the Global Network of World Health Organization Collaborating Centres for Nursing and Midwifery Development, constructed based on technical visits to Angola in 2009. Information related to health service characteristics was used, focusing on nursing human resource activities at two tertiary, one secondary and one primary health institutions located in the province of Luanda. The study data were analysed through descriptive statistics. FINDINGS: Among the problems the nursing workforce faces, the lack of human, material and financial resources stands out, as well as insufficient professional qualification, excessive work journeys, low remunerations, non-valuation of professionals, leading to unsatisfactory work environments and discouraged human resources. CONCLUSIONS: Nursing in Angola is conquering its professional space. Therefore, regulatory policies are fundamental, defining the rights and obligations of all categories involved, with a view to determining nurses' function in the health team, including respect for and acknowledgement of their role in the community.

Environments for nursing scholarship and journal impact factor in five countries.

BACKGROUND: Universities worldwide are seeking objective measures for the assessment of their faculties' research products to evaluate them and to attain prestige. Despite concerns, the impact factors (IF) of journals where faculties publish have been adopted. RESEARCH OBJECTIVE: The study aims to explore conditions created within five countries as a result of policies requiring or not requiring faculty to publish in high IF journals, and the extent to which these facilitated or hindered the development of nursing science. DESIGN: The design was a multiple case study of Brazil, Taiwan, Thailand (with IF policies, Group A), United Kingdom and the United States (no IF policies, Group B). Key informants from each country were identified to assist in subject recruitment. METHODS: A questionnaire was developed for data collection. The study was approved by a human subject review committee. Five faculty members of senior rank from each country participated. All communication occurred electronically. FINDINGS: Groups A and B countries differed on who used the policy and the purposes for which it was used. There were both similarities and differences across the five countries with respect to hurdles, scholar behaviour, publishing locally vs. internationally, views of their science, steps taken to internationalize their journals. CONCLUSIONS: In group A countries, Taiwan seemed most successful in developing its scholarship. Group B countries have continued their scientific progress without such policies. IF policies were not necessary motivators of scholarship; factors such as qualified nurse scientists, the resource base in the country, may be critical factors in supporting science development.

Sobre a criação e a gestão do conhecimento organizacional

Destaca o papel da enfermeira no processo de gestão do conhecimento, posicionando-a na interseção dos fluxos horizontais e verticais de informação, e na criação de uma vantagem competitiva sustentável.

The effect of supplementation with expanded sunflower seed on carcass and meat quality of lambs raised on pasture.

The use of conventional concentrates in the supplementation of grass-based fed lambs may induce improvements in growth performance and/or carcass quality but may be disadvantageous in fatty acid profile of tissues, with a negative impact in some nutritional indexes. The objective of this trial was to evaluate the effects on growth performance, carcass and meat quality of using unprotected, unsaturated fat as a supplement for grass-fed based lambs. Twenty-four Merino Branco ram lambs raised on pasture, were supplemented with corn whole grain plus sunflower meal or corn whole grain plus expanded sunflower seed, from 20 to 30 kg live weight. The supplement had no effects on growth performance, carcass quality traits, or meat pH, colour estimates (L(∗), a(∗), b(∗)), water-holding capacity, shear force and sensorial attributes. However, lambs supplemented with expanded sunflower seed showed higher proportions of cis-9, trans-11 octadecadienoic acid and trans-vaccenic acid in intramuscular and subcutaneous fat, showing that the inclusion of unprotected lipids in lambs diet was effective in preventing the reduction of rumenic acid (C18:2 cis-9, trans-11) that occurs when conventional concentrates are used as a supplement.

[Analysis of difficulties related with the daily activities of adolescents and children with type-1 diabetes mellitus: mothers' accounts]. / Análise das dificuldades relacionadas às atividades diárias de crianças e adolescente com diabetes mellitus tipo 1: depoimento de mães.

This descriptive study aimed at analyzing the difficulties faced by mothers of type-1 diabetic teenagers and children in view of the child's daily activities and based on the principle that emotional, social, personal and economic factors concerning the family interfere with achieving good metabolic control. Data were obtained by means of a semi-structured interview guide applied to 30 mothers. Data analysis followed the standards preconized for descriptive studies in which directed interviews are used. Results showed that: mothers have difficulties in dealing with children's daily activities such as social gatherings, in motivating them to develop physical activities, diet, school adjustment, relationship with the health team as well as with the children's behaviors regarding their brothers/sisters. Results indicated the need for planned and integrated work by a multiprofessional team with the families, considering all the aspects addressed in this study and their interdependence, aiming at a successful care to diabetic children and adolescents.

[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.

[Analysis of expectations on the nurse's leadership in the light of Grid's theories]. / Análise de expectativas sobre a liderança do enfermeiro à luz das teorias Grid.

Based on the understanding that leadership is a fundamental resource for nurses in health institutions, the aim of the authors was to analyze, under the light of Blake & Mouton's Grid Theories, the expectations of the Nursing team regarding nurse's leadership. The analysis was based on four investigations performed in different contexts of Brazilian Nursing and data were collected through the application of the "Grid & Leadership in Nursing Instrument" developed by Trevizan. Results show that the subjects prefer the Grid style 9.9. The authors discuss the results and emphasize the need for the development of leadership in Nursing.

[The challenge of caring for children and adolescents with type 1 diabetes at home]. / O desafio para o controle domiciliar em crianças e adolescentes diabéticas tipo 1.

This is a descriptive study concerning mothers of children and adolescents with type-1 diabetes. Its purpose is to identify available resources and analyze the difficulties that these mothers find to control the disease at home. To that end, direct interviews were used and the results enabled us to reach the following conclusions: the resources used for the control of diabetes at home are scarce and, when available, they are not handled adequately; communication between mothers and the health care team was limited. The results also pointed to the need for equity in the assistance to families of children and adolescents with type-1 diabetes by providing support for such families to manage children with chronic diseases.

[Drug administration and information dissemination via online]. / Administração de medicamentos ea comunicação de conhecimento via online.

The present study aims at verifying and describing how on-line communication of nursing knowledge concerning administration of medication is taking place. In order to assess the websites, the search tool Meta Busca-Terra (www.terra.com.br) was used. One hundred and sixty-six websites were found; however, only 45 were related to the topic. These were analyzed and categorized according to types of presentation, websites, languages, and homepages. It was verified that they presented common characteristics, such as: Articles (18), Informative Bulletins (8) and Medication Advertisements (7). Regarding the websites, Yahoo distinguished from the others, since it featured 34 websites. The predominant language was English, which was found in 36 websites. The on-line communication of knowledge is fundamental in regard to administration of medication for it allows the dissemination of knowledge at a faster and more productive pace. Undoubtedly, clients and professionals will be highly benefited.

[Nursing research projects in CNPQ (National Council for Scientific and Technologic Development): their trajectory, themes and adherences--1998/2000]. / Os projetos de pesquisa de enfermagem no CNPq: seu percurso, suas temáticas, suas aderências--1998/2000.

The present study analyses the themes proposed by research projects in nursing. It focuses on the projects that were sent to a Brazilian governmental research fomentation agency--CNPq--in the period of time between November 1998 and November 2000. The objective of this work is to identify the recurrent themes proposed in nursing research projects, and discuss its adherence to lines of research under study by nursing professionals which have the support of CAPES. It also relates these themes to the priorities of research established by CNPq. In order to achieve the objectives mentioned, an exploratory and descriptive study was carried out. The primary sources were evaluation grids of research projects. The secondary sources were studies, written and statistics reports from CNPq. Results show that most of the scholarships awarded by CNPq are in the southeast region of Brazil, where a larger number of researchers and post-graduation programs are concentrated. It also reveals that there is a diversity of themes being explored and that there is a relation between the themes and the parameters adopted for the studies.

[Contribution of teaching organizations to the process of partnership between faculty and clinical nurses]. / Contribuição das disciplinas da organização de aprendizagem ao processo de parceria docente-assistencial na enfermagem.

The rapid changes that are occurring in the societies have affected daily life of organizations that also need to equip and adapt themselves to correspond to this need. The first initiatives were related to the search for transformations in the organization structure and in the applied management model in order to form work teams, exchange and share information. The main purpose of this study is to point out five disciplines on the learning organization proposed by SENGE (1990) as a reference that can contribute to the process of faculty and clinical nursing partnership. Authors believe that continuous development and learning of those disciplines by nurses can enable the consolidation of this partnership between academic and clinical nursing institutions.

[Nurses' leadership in the perspective of postmodern ethics]. / Liderança da enfermeira na perspectiva da ética pós-moderna.

The administrative models arising from modernity are becoming increasingly obsolete in view of the needs of organizations, especially those which provide health care such as health institutions and their human capital. Since rationality is an essential element for the accomplishment of organizational objectives, modern ethics requires only that workers adjust to their prescribed functions and perform their tasks according to the rules. Post-modernity is characterized by saturation of information and consumption, pleasure of using goods and services, lack of values and meaning of life, reflecting a post-modern apathy. Without projects man's interior life has no substance. Health organizations are being strongly influenced by this context. Hence, ethics needs to be treated in a new way. Thus, the purpose of this paper is to approach nurse's leadership in light of post-modern ethics.

[Humanistic approach to nursing communication: the case of a hospitalized adolescent female]. / Enfoque humanístico à comunicação em enfermagem: o caso de uma adolescente hospitalizada.

Nursing is a profession committed to the promotion of human beings. It takes into consideration their freedom, uniqueness and dignity. Therefore, communication plays an important role within the nursing process and its results, and it is also a fundamental component of the treatment. However, in the context of Brazilian hospitals, communication between nurses and patients is limited to the performance of these professionals' technical role. The purpose of this study is to analyse the case of a hospitalized female adolescent, focusing on the communication that happens between her and the nursing professionals who provide her assistance. This analysis was based on Bales' categories. Through the technique of direct observation, the behavior resultant from the interaction between nurses and the adolescent was analysed on a total of 30 hours during five days. The observation showed 428 units of interaction which were classified, by qualified professionals, in positive, negative and neutral socio-emotional areas. Considering the high incidence of interactions in the neutral area (89.2%), authors recommend a humanistic correction in the communication during the nursing process. This change in communication can qualify patient's care as well as generate satisfaction at work through empathy and solidarity.