Genetic diversity in populations of African mahogany (Khaya grandioliola C. DC.) introduced in Brazil.

Given its high-valued wood, the African mahogany (Khaya grandifoliola) has been envisaged as a renewable source of tropical hardwoods in Brazil. However, there are concerns about the hypothesized low diversity among the few K. grandifoliola germplasm sources introduced in the country. Using eight microsatellite markers, we evaluated the genetic diversity and divergence among 53 superior trees selected from three provenances of K. grandifoliola located in the state of Para. These populations are among the oldest plantations (>15 years) in Brazil and, therefore, the country's main seed sources. The average number of alleles per locus was 5.9, expected heterozygosity was moderate (^=0.56) and lower than the high observed heterozygosity (HO=0.74). Therefore, the intrapopulation fixation index was negative (f=-0.31) indicating the possibility that selection of superior trees might have favored heterozygous plants with heterosis. No genetic structure was observed between provenances. The genetic diversity observed within selected trees, with an effective population size (Ne) of 30.4, is comparable to that of natural populations of African and Brazilian mahoganies. Therefore, our results contradict the idea that the genetic diversity of K. grandifoliola introduced in Brazil is low and show that our germplasm can be exploited for breeding purposes.

Isospora sagittulae McQuistion & Capparella, 1992 (Apicomplexa: Eimeriidae) from antbirds (Passeriformes: Thamnophilidae) in the Amazon and Atlantic Forest of Brazil: with notes on its distribution and dispersion in the Neotropical region.

In the current study, Isospora sagittulae McQuistion and Capparella, 1992 (Protozoa: Apicomplexa: Eimeriidae) is reported from white-shouldered fire-eyes Pyriglena leucoptera (Vieillot, 1818) in the Atlantic Forest in southeastern Brazil. To date, this coccidian species was described from antbirds in Ecuador and Brazilian Amazon. In this sense, oocysts and measurements of the description of I. sagittulae from Amazonian antbirds were required from the deposit for comparison between samples from the Amazon and Atlantic Forest. The morphology was similar in all aspects, despite the polymorphism associated with the oocyst shape. DNA sequences for the mitochondrial cytochrome c oxidase subunit 1 (cox1) locus of the oocysts had similarity of 100%. Therefore, these strong morphological, molecular, and ecological equivalences ensure the unique identification of I. sagittulae. Finally, this finding reveals the wide distribution of I. sagittulae in the Neotropical region and indicates that other antbirds in the Brazilian Cerrado should disperse I. sagittulae to the Amazon and Atlantic Forest.

Neural networks in spatialization of meteorological elements and their application in the climatic agricultural zoning of bamboo.

Bamboo has an important role in international commerce due to its diverse uses, but few studies have been conducted to evaluate its climatic adaptability. Thus, the objective of this study was to construct an agricultural zoning for climate risk (ZARC) for bamboo using meteorological elements spatialized by neural networks. Climate data included air temperature (TAIR, °C) and rainfall (P) from 4947 meteorological stations in Brazil from the years 1950 to 2016. Regions were considered climatically apt for bamboo cultivation when TAIR varied between 18 and 35 °C, and P was between 500 and 2800 mm year-1, or PWINTER was between 90 and 180 mm year-1. The remainder of the areas was considered marginal or inapt for bamboo cultivation. A multilayer perceptron (MLP) neural network with a multilayered "backpropagation" training algorithm was used to spatialize the territorial variability of each climatic element for the whole area of Brazil. Using the overlapping of the TAIR, P, and PWINTER maps prepared by MLP, and the established climatic criteria of bamboo, we established the agricultural zoning for bamboo. Brazil demonstrates high seasonal climatic variability with TAIR varying between 14 and 30 °C, and P varying between < 400 and 4000 mm year-1. The ZARC showed that 87% of Brazil is climatically apt for bamboo cultivation. The states that were classified as apt in 100% of their territories were Mato Grosso do Sul, Goiás, Tocantins, Rio de Janeiro, Espírito Santo, Sergipe, Alagoas, Ceará, Piauí, Maranhão, Rondônia, and Acre. The regions that have restrictions due to low TAIR represent just 11% of Brazilian territory. This agroclimatic zoning allowed for the classification of regions based on aptitude of climate for bamboo cultivation and showed that 71% of the total national territory is considered to be apt for bamboo cultivation. The regions that have restrictions are part of southern Brazil due to low values of TAIR and portions of the northern region that have high levels of P which is favorable for the development of diseases.

Pharmacological, toxicological and phytochemical analysis of Spondias dulcis parkinson.

Spondias dulcis Parkinson have been used in traditional medicine in Asia, Oceania, and South America, for different diseases conditions and as a functional food. The scientific literature described as different potential pharmacology such as antioxidant, anti-inflammatory, antimicrobial, thrombolytic and enzymatic inhibitor. This study aimed to: (1) establish the pharmacological activity in intestinal motility in vivo and antioxidant activity in vitro; (2) perform the acute toxicology test in mouse; (3) characterize the phytochemical profile based on counter-current chromatography (CCC) and NMR analysis. The results revealed a laxative effect of S. dulcis extract and a high antioxidant activity (IC50 = 5.10 for DPPH assay and 14.14 for hydrogen peroxide scavenging test). No side effects were observed in the oral acute toxicity test for a dose up to 2000 mg/kg. The chemical profile was identified by CCC and NMR, and the comparison of the data obtained with previous literature revealed the presence of the flavonoid rutin (Quercetin-3-O-rutinoside) in the extract.

Corrosion behavior of multi-layer friction surfaced structure from dissimilar aluminum alloys.

Friction surfacing (FS) is a solid-state coating technology for metallic materials, where the deposition of a consumable material on a substrate is enabled via friction and plastic deformation. The deposited layer material commonly presents a significantly refined microstructure, where corrosion could be an issue due to this grain refinement within the layer deposited, possibly creating micro galvanic pairs. The present work investigates the corrosion behavior of the FS deposited material as well as stud base material and substrate using cyclic polarization tests and open circuit potential (OCP) monitoring. Comparing the FS deposited material and the respective consumable stud base material (both AA5083), the grain size is correlated with the results from the corrosion tests, where the deposited material shows more equiaxed and refined grains in comparison to the stud base material. The cyclic potentiostatic polarization tests showed that the stud base material is more resistant to pitting nucleation presenting smaller pits and a lower amount of pits compared to deposited material and substrate. As a complement to OCP test, the stud base material is also more stable on a chloride solution compared to the substrate and the deposited material.

Optimized Electrical Stimulation of C-Nociceptors in Humans Based on the Chronaxie of Porcine C-Fibers.

Classically, to electrically excite C-nociceptors, rectangular pulses are used with a duration close to the estimated chronaxie of C-fibres (about 2 ms). Recent results using slow depolarizing stimuli suggest longer chronaxies. We therefore set out to optimize C-fiber stimulation based on recordings of single C-nociceptors in-vivo and C-fiber compound-action-potentials (C-CAP) ex-vivo using half-sine shaped stimuli of durations between 1 and 250ms. Single fiber (n = 45) recording in pigs revealed high chronaxie values for C-touch fibers (15.8 ms), polymodal- (14.2 ms) and silent-nociceptors (16.8 ms). Activation thresholds decreased 2 to 3-fold in all fibre classes when increasing the duration of half-sine pulses from 1 to 25 ms (P < .05). C-CAPs strength-duration curves of the pig saphenous nerve (n = 7) showed the highest sensitivity for half-sine durations between 10 and 25 ms. Half-maximum currents for C-CAPS were reduced 3-fold compared to rectangular pulses (P < .01) whereas the opposite was found for A-fiber compound action potentials. Psychophysics in humans (n = 23) revealed that half-sine stimulus durations >10 ms reduced detection thresholds, pain thresholds, and stimulus current amplitudes required to generate a pain rating of 3 on an 11-point Numeric Rating Scale (NRS) as compared to 1 ms rectangular pulses (P < 0.05). Increasing the duration from 1 to 25 ms led to a 4-fold amplitude reduction for pain-thresholds and stimuli caused an axon-reflex flare. Excitability of single polymodal nociceptors in animals paralleled human psychophysics and we conclude optimized half-sine pulses facilitate C-nociceptor activation. PERSPECTIVE: Electrical stimulation with longer lasting half-sine wave pulses preferentially activates C-nociceptors and changes in the strength duration curve may identify nociceptor hyperexcitability in patients with neuropathic pain.

Human pain ratings to electrical sinusoids increase with cooling through a cold-induced increase in C-fibre excitability.

ABSTRACT: Low-frequency sinusoidal current applied to human skin evokes local axon reflex flare and burning pain, indicative of C-fibre activation. Because topical cooling works well as a local analgesic, we examined the effect of cooling on human pain ratings to sinusoidal and rectangular profiles of constant current stimulation. Unexpectedly, pain ratings increased upon cooling the skin from 32 to 18°C. To explore this paradoxical observation, the effects of cooling on C-fibre responses to stimulation with sinusoidal and rectangular current profiles were determined in ex vivo segments of mouse sural and pig saphenous nerve. As expected by thermodynamics, the absolute value of electrical charge required to activate C-fibre axons increased with cooling from 32°C to 20°C, irrespective of the stimulus profile used. However, for sinusoidal stimulus profiles, cooling enabled a more effective integration of low-intensity currents over tens of milliseconds resulting in a delayed initiation of action potentials. Our findings indicate that the paradoxical cooling-induced enhancement of electrically evoked pain in people can be explained by an enhancement of C-fibre responsiveness to slow depolarization at lower temperatures. This property may contribute to symptoms of enhanced cold sensitivity, especially cold allodynia, associated with many forms of neuropathic pain.

What is said and unspoken about the autonomy of a nurse: (dis) continuity in discourses.

OBJECTIVE: to know how autonomy is constituted in the nurse's professional practice in the hospital context. METHODS: Qualitative analytical study, based on Foucault's methodological theoretical framework. The empirical material consisted of articles published in the Revista Brasileira de Enfermagem and narrative interviews conducted with 18 nurses from a public hospital in southern Brazil. Data collection took place between December 2017 and May 2018, being analyzed through Foucauldian discourse analysis. RESULTS: Autonomy in the professional practice of nurses goes through the core of knowledge, the political positioning and the working conditions. These factors are revealed as power instruments in the construction of nurse governability. Final Considerations: It is believed that the investment focused on the debate of the nurse's autonomy interfaces could raise new attitudes about professional practice and favor the transformation of nursing practice.

Sympathetic efferent neurons are less sensitive than nociceptors to 4 Hz sinusoidal stimulation.

BACKGROUND: Sinusoidal current stimuli preferentially activate C-nociceptors. Sodium channel isoforms NaV1.7 and NaV1.8 have been implicated in this. Sympathetic efferent neurons lack NaV1.8 and were explored upon sinusoidal activation. METHODS: Quantitative Sudomotor Axon Reflex Test (QSART) was performed in hairy (n = 16) and glabrous (n = 12) skin. Responses of sympathetic efferents (n = 10) and nociceptive afferents (n = 21) to sinusoidal current stimulation (4 Hz, 0.05-0.15 mA) were recorded in humans by microneurography (n = 11). Activation of sympathetic units upon supra-threshold sinusoidal currents (>0.8 mA) was recorded in pigs (n = 8). RESULTS: Sinusoidal stimuli (4 Hz, 0.4 mA) evoked weak sweat output (30 ml/h/m2 ) in hairy skin compared to rectangular pulses (4 Hz, 5 mA, 53 ml/h/m2 , p < .00001, ANOVA). No change in sweat output was recorded from glabrous skin to sine wave stimuli. Sinusoidal current at intensities ranging from 0.05 to 0.15 mA activated almost all (85%) nociceptors but only 40% of sympathetic units in human. Stimuli lead to a significantly lower activation in sympathetic versus nociceptive fibres as measured by activity-dependent slowing (ADS) of conduction (sympathetic efferents average ADS 100 ± 0.2% vs. C-nociceptors average ADS 113 ± 4%, p < .003, ANOVA). CONCLUSIONS: Sympathetic efferent neurons are less apt to convert slow depolarizations into action potentials as compared to nociceptors. Distinctive sodium channel expression patterns between nociceptors and sympathetic efferent neurons may account for this difference. Sinusoidal stimulation therefore provokes weak sweat responses and provides no alternative for clinical assessment of autonomic function. SIGNIFICANCE: C-nociceptors in hairy skin are activated by 4 Hz sinusoidal current stimulation at lower intensities than myelinated fibres. Sympathetic efferent neurons-albeit also unmyelinated-are less responsive to sinusoidal activation than nociceptors within the same skin area. Cutaneous sympathetic efferent neurons apparently are less apt than nociceptors to convert slow depolarization into action potentials.

Recommendations for post-rehabilitation care of maxillofacial prostheses

Aim: This study aimed to review the scientific literature to describe the main care and hygiene protocols for different types of maxillofacial prostheses (MFP). Methods: A bibliographic search on the PubMed / Medline database using the following keywords: ["maxillofacial prosthesis" OR "ocular prostheses" OR "palatal obturators"] AND ["Cleaning" OR "disinfection"] AND ["care"] AND ["color stability"] OR ["denture cleansers" OR "cleansing agents"]. Articles addressing materials, cleaning and disinfection protocols, and care related to MFP were included. The following exclusion criteria were applied: no adequate methodology, incompatibility with the area of interest, and unavailability for reading in full. Results: The papers were grouped into the following topics: facial prostheses, ocular prostheses, maxillofacial intraoral prostheses, and retention systems. Conclusion: Despite the MFP changes over time, its degradation decreases upon following the recommendations and post-adaptation care. The guidelines for cleaning and disinfection must be individualized to guarantee the longevity of the prosthesis and the patient health

Chemistry and Pharmacology of the Kazakh Crataegus Almaatensis Pojark: An Asian Herbal Medicine.

Crataegus almaatensis, an endemic ornamental plant in Kazakhstan is used in popular medicine due to its cardiotonic properties. The most studied species of the same genus are commonly found in Europe, which shows the importance of having the Kazakh species validated via its chemical and pharmacological studies. High-speed countercurrent chromatography (HSCCC) operated under optimized conditions enabled an isolation of the three main compounds from the aqueous phase of the leaves ethanol extract, further identified by nuclear magnetic resonance (NMR), as quercetin 3-O-rhamnoside (quercitrin) (4.02% of the crude extract-CECa); quercetin 3-O-ß-galactoside (hyperoside) (1.82% of CECa); kaempferol 3-O-α-L-rhamnoside (afzelin) (0.94% of CECa). The CECa, the aqueous phase of the crude extract (APCa) together with the isolates were evaluated for their vascular (vascular reactivity in human internal mammary artery-HIMA), anti-nociceptive (formalin-induced liking response and hot plate) and anti-inflammatory (subcutaneous air-pouch model-SAP) activities. CECa at the concentrations of 0.014 and 0.14 mg/mL significantly increased the maximum contractility response of HIMA to noradrenaline. The APCa CR curve (0.007-0.7 mg/mL) showed an intrinsic relaxation effect of the HIMA. APCa at the dose of 100 mg/kg i.p. significantly decreased the total leukocyte count and the IL-1ß release in the SAP wash.

Toxic activities of Brazilian centipede venoms.

Centipedes have a venom gland connected to a pair of forceps, which are used to arrest preys. Human victims bitten by centipedes usually manifest burning pain, paresthesia and edema, which may develop into superficial necrosis. The aim of this work was to characterize and compare toxic activities found in venoms of three species of Brazilian centipedes-Otostigmus pradoi, Cryptops iheringi and Scolopendra viridicornis. By SDS-PAGE (4-20%), important differences were noticed among venoms (between 7 and 205kDa). Few bands showed feeble caseinolytic, fibrinogenolytic and gelatinolytic activities by zymography, but strong hyaluronidase activity was observed in S. viridicornis and O. pradoi venoms. In addition, such activities could be inhibited by o-phenanthroline, indicating that these enzymes are metalloproteinases. All venoms induced nociception, edema and myotoxicity in mice, but only S. viridicornis induced mild hemorrhagic activity. No coagulant activity was detected in centipede venoms. Low phospholipase A(2) activity was observed exclusively in S. viridicornis and O. pradoi venoms, but these venoms had intense direct hemolytic activity on human erythrocytes. Cross-reactivity among venoms was observed using species-specific sera raised in rabbits. Differences were noticed among centipede venoms, but S. viridicornis is indeed the most toxic venom and thereby it could induce a more severe envenomation.

Comparative study on extracts from the tissue covering the stingers of freshwater (Potamotrygon falkneri) and marine (Dasyatis guttata) stingrays.

Stingrays are elasmobranchs found along the seacoast and in some rivers of Brazil. Pain is the most conspicuous symptom observed in patients wounded by the bilaterally retroserrate stingers located in the tail, which are covered by glandular and integument tissues. In addition, cutaneous necrosis is commonly observed in injuries caused by freshwater stingrays. The aim of this work was to characterize and compare certain properties of tissue extracts obtained from the glandular tissues covering the stinger apparatus of Potamotrygon falkneri and Dasyatis guttata stingrays. By sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE), tissue extracts have similar bands above 80 kDa, but most differences were observed below this molecular mass. Lethal, dermonecrotic and myotoxic activities were detected only in P. falkneri tissue extract. Edematogenic activity was similar and dose dependent in both tissue extracts. Nociceptive activity was verified in both tissue extracts, but P. falkneri presented a two-fold higher activity than D. guttata tissue extract. No direct hemolysis, phospholipase A2 and coagulant activities were observed in both tissue extracts. Antigenic cross-reactivity was noticed by ELISA and Western blotting, using antisera raised in rabbits. Species-specific sera reacted with several components of both tissue extracts, noticeably above 22kDa. Both tissue extracts presented gelatinolytic, caseinolytic and fibrinogenolytic activities, which were not caused by the action of metalloproteinases. Hyaluronidase activity was detected only in P. falkneri tissue extract. Our experimental observations suggest that P. falkneri tissue extract is more toxic than D. guttata tissue extract. These results may explain why injuries caused by freshwater stingrays are more severe in human accidents.

Role of IgG(T) and IgGa isotypes obtained from arachnidic antivenom to neutralize toxic activities of Loxosceles gaucho, Phoneutria nigriventer and Tityus serrulatus venoms.

The ability of IgG(T) and IgGa subclasses--isolated by liquid chromatography from equine arachnidic antivenom (AAV)-to neutralize toxic activities of Loxosceles gaucho, Phoneutria nigriventer and Tityus serrulatus venoms as well as to remove venom toxins from circulation was investigated. These subclasses showed similar antibody titers against L. gaucho, P. nigriventer and T. serrulatus venoms, and by immunoblotting few differences were observed in the recognition pattern of venom antigens. IgG(T) and IgGa neutralized 100% lethality induced by L. gaucho and 50% of P. nigriventer venom, but IgGa failed to neutralize T. serrulatus venom, in contrast to IgG(T). Both subclasses neutralized local reactions and dermonecrosis induced by L. gaucho venom in rabbits. In mice, IgG(T) and IgGa partially neutralized the edematogenic activity induced by P. nigriventer and T. serrulatus venoms, but only IgG(T) neutralized (ca. 81%) the nociceptive activity induced by T. serrulatus venom. Both subclasses failed to neutralize nociceptive activity induced by P. nigriventer venom. IgG(T) reduced the serum venom levels of animals injected with L. gaucho, P. nigriventer or T. serrulatus venoms, while IgGa solely reduced L. gaucho and P. nigriventer venoms levels. Our results demostrate that IgG(T) and IgGa subclasses neutralize toxic activities induced by P. nigriventer, T. serrulatus and L. gaucho venoms with different efficacies, as well as depurate these venoms from circulation.

Cobertura vacinal da Pentavalente e da Estratégia de Saúde da Família / Cobertura de vacunación de la Pentavalente y del Programa Estrategia de Salud de la Familia / Pentavalent Vaccine and Family Health Strategy Coverage

Objetivo: avaliar a cobertura vacinal da Pentavalente em menores de um ano nas regiões e capitais brasileiras e a cobertura da Estratégia de Saúde da Família (ESF). Método: estudo de série histórica de dados secundários provenientes de sistemas de gestão nacional de vacinas e da ESF, no período de 2014 a 2018, analisados por estatística descritiva. Resultados: as regiões brasileiras mantêm a cobertura vacinal da Pentavalente abaixo de 95%, desde 2017. A abrangência da ESF não impactou significativamente no alcance da meta vacinal preconizada. Conclusão: as baixas coberturas vacinais aumentam o risco de reintrodução de doenças controladas. O acesso aos serviços de saúde precisa ser facilitado e a vacinação priorizada no planejamento das ações da equipe da ESF. A enfermagem tem condições de criar ações locais para reverter este cenário, com o apoio dos gestores para intensificar campanhas e combater as causas que têm prejudicado o alcance das metas.

Objective: to evaluate Pentavalent vaccination coverage in children under one year old in the Brazilian regions and capitals and the coverage of the Family Health Strategy (FHS). Method: a study of a historical series with secondary data from national vaccine management systems and the FHS, from 2014 to 2018, analyzed by descriptive statistics. Results: the Brazilian regions have maintained Pentavalent vaccination coverage below 95% since 2017. The scope of the FHS did not significantly impact on the achievement of the recommended vaccination target. Conclusion: low vaccination coverage increases the risk for the reintroduction of controlled diseases. Access to the health services needs to be facilitated and vaccination prioritized when planning the actions of the FHS team. Nursing is able to create local actions to reverse this scenario, with the support of the managers to intensify campaigns and combat the causes that have hindered the achievement of the goals.

Objetivo: evaluar la cobertura de vacunación de la Pentavalente en menores de un año en las regiones y capitales de Brasil y la cobertura de la Estrategia de Salud de la Familia (ESF). Método: estudio de serie histórica de datos secundarios provenientes de sistemas de administración nacional de vacunas y de la ESF, en el período de 2014 a 2018, analizados por medio de estadística descriptiva. Resultados: las regiones de Brasil mantienen un nivel de cobertura de vacunación de la Pentavalente por debajo del 95% desde el año 2017. La cobertura de la ESF no tuvo un efecto significativo para alcanzar la meta de vacunación recomendada. Conclusión: los bajos índices de cobertura de vacunación aumentan el riesgo de reintroducción de enfermedades controladas. Debe facilitarse el acceso a los servicios de salud y se debe priorizar la vacunación en la planificación de las acciones del equipo del programa ESF. El área de Enfermería tiene las condiciones necesarias para diseñar acciones locales a fin de revertir esta situación, con el apoyo de los administradores para intensificar campañas y combatir las causas que han perjudicado el alcance de las metas.

What is said and unspoken about the autonomy of a nurse: (dis) continuity in discourses / Entre el dicho y el no dicho acerca de la autonomía del enfermero: (dis)continuidades en los discursos / Entre o dito e o não dito acerca da autonomia do enfermeiro: (des)continuidades nos discursos

ABSTRACT Objective: to know how autonomy is constituted in the nurse's professional practice in the hospital context. Methods: Qualitative analytical study, based on Foucault's methodological theoretical framework. The empirical material consisted of articles published in the Revista Brasileira de Enfermagem and narrative interviews conducted with 18 nurses from a public hospital in southern Brazil. Data collection took place between December 2017 and May 2018, being analyzed through Foucauldian discourse analysis. Results: Autonomy in the professional practice of nurses goes through the core of knowledge, the political positioning and the working conditions. These factors are revealed as power instruments in the construction of nurse governability. Final Considerations: It is believed that the investment focused on the debate of the nurse's autonomy interfaces could raise new attitudes about professional practice and favor the transformation of nursing practice.

RESUMEN Objetivo: saber cómo se constituye la autonomía en la práctica profesional de los enfermeros en el contexto hospitalario. Métodos: investigación analítica, cualitativa, basada en el marco teórico metodológico de Foucault. El material empírico consistió en artículos publicados en la Revista Brasileira de Enfermagem y en entrevistas narrativas realizadas con 18 enfermeros de un hospital público en el sur de Brasil. El período de recolección de datos fue de diciembre de 2017 y mayo de 2018. Se adoptó el discurso de Foucault para el análisis de datos. Resultados: la autonomía en la práctica profesional de los enfermeros pasa por la centralidad del conocimiento, el posicionamiento político y las condiciones de trabajo. Estos factores se revelan como dispositivos de poder en la construcción de la gobernabilidad de los enfermeros. Consideraciones finales: la inversión en espacios centrados en el debate de las interfaces de autonomía de los enfermeros puede generar nuevas actitudes sobre la práctica profesional y favorecer la transformación de la práctica de enfermería.

RESUMO Objetivo: conhecer como se constitui a autonomia na prática profissional do enfermeiro no contexto hospitalar. Métodos: estudo qualitativo, analítico, assentado no referencial teórico metodológico de Foucault. O material empírico foi composto por artigos publicados na Revista Brasileira de Enfermagem e entrevistas narrativas realizadas com 18 enfermeiros de um hospital público da região Sul do Brasil. A coleta de dados ocorreu entre os meses de dezembro de 2017 a maio de 2018. O discurso foucaultiano foi adotado para a análise de dados. Resultados: a autonomia na prática profissional do enfermeiro perpassa pela centralidade do saber, pelo posicionamento político e pelas condições de trabalho. Esses fatores se revelam como dispositivos de poder na construção da governabilidade do enfermeiro. Considerações Finais: o investimento em espaços voltados para o debate das interfaces da autonomia do enfermeiro pode suscitar novas posturas sobre a prática profissional e favorecer a transformação da prática de enfermagem.

Responsabilidade socioambiental no contexto hospitalar: revisão integrativa / Social and environmental responsibility in the hospital context: an integrative review / Responsabilidad social y ambiental en el contexto hospitalario: una revisión integradora

Objetivo: analisar o que tem sido produzido sobre responsabilidade socioambiental no contexto hospitalar. Método: revisão integrativa nas bases de dados LILACS e PUBMED/MEDLINE, no período de março a abril de 2014. Os dados foram registrados em um quadro sinóptico e a leitura foi realizada de forma a caracterizar as publicações e a identificar as categorias relevantes na construção do conhecimento sobre o tema, as quais sofreram um processo de análise e interpretação. Resultados: analisaram-se 14 produções. Após análise dessas, emergiram duas categorias relevantes: << Adoção de estratégias sustentáveis por parte de instituições hospitalares >>, e << O papel da enfermagem frente à problemática ambiental >>. Conclusão: em âmbito mundial, há estudos que sinalizam para os prejuízos ambientais advindos das atividades assistenciais de saúde, apontando estratégias que podem ser executadas com o objetivo de diminuir os danos causados. No entanto, não foram encontrados estudos com foco no aprofundamento teórico conceitual, nem que visassem a responsabilidade socioambiental por parte dos trabalhadores da saúde.(AU)

Objective: to analyze what has been produced about socio and environmental responsibility in the hospital context. Method: it forms an integrative review with the databases LILACS and PubMed/ MEDLINE, between March and April 2014. Data were recorded in a summary table and the reading was performed in order to characterize the publications and identify the relevant categories for the construction of knowledge about the subject, which have undergone a process of analysis and interpretation. Results: there were analyzed 14 productions. After analysis two relevant categories emerged: << Adoption of sustainable strategies by the part of the hospitals >> and << The role of Nursing before environmental issues >>. Conclusion: worldwide, there are studies that indicate to the environmental damages arising from health-care activities, indicating strategies that can be implemented in order to reduce the caused damage. However, there were not found studies focusing on conceptual theoretical issues, neither concerning social and environmental responsibility by the part of health workers.(AU)

Objetivo: analizar lo que se ha producido en respecto a la responsabilidad ambiental en el contexto hospitalario. Método: una revisión integradora hecha en las bases de datos LILACS y PubMed/ MEDLINE, entre marzo y abril de 2014. Los datos se registraron en una tabla resumen y la lectura se realizó con el fin de caracterizar las publicaciones e identificar las categorías relevantes en la construcción de conocimientos acerca del tema, que han sido sometidas a un proceso de análisis e interpretación. Resultados: 14 producciones fueron analizadas. Tras el análisis de estos trabajos surgieron dos categorías relevantes: << La adopción de estrategias sostenibles por los hospitales >> y << El papel de la enfermería a las cuestiones ambientales >>. Conclusión: en todo el mundo hay estudios que indican que los daños sociales y ambientales derivados de las actividades de atención de la salud, señalando las estrategias que se pueden implementar con el fin de reducir los daños causados. Sin embargo, no hay estudios que se centran en estudios teóricos conceptuales o que estaban destinados a la responsabilidad social y ambiental por parte de los trabajadores de la salud.(AU)

Facilidades e dificuldades do trabalho em terapia intensiva: um olhar da equipe de enfermagem / Facilidades y dificultades del trabajo en terapia intensiva: desde una perspectiva del equipo de enfermería / Difficulties and facilities in intensive care work: a nursing staff’s perspective

Objective: to recognize the facilities and difficulties met in the every day work routine of the nursing staff of an adult Intensive Care Unit (ICU). Method: exploratory-descriptive study of qualitative approach. The data were collected with 11 nursing workers of an adult ICU of a university hospital, between June and July, 2012, through a semi-structured interview. The findings were analyzed based on content analysis. Results: several factors interfere in the development of the work, among them, facilities are: the use of technology and the small and restricted environment. Obstacles faced by the subjects were: personal conflicts, lack of commitment among colleagues and lack of human resources and of materials. Conclusion: despite of the difficulties found during the development of ICU work, this activity is still seen as something rewarding by the nursing workers...

Objetivo: conhecer facilidades e dificuldades encontradas no cotidiano de trabalho da equipe de enfermagem de uma UTI Adulto. Método: estudo descritivo-exploratório de abordagem qualitativa. Os dados foram coletados com 11 trabalhadores de enfermagem, de uma UTI Adulto de um hospital universitário, entre os meses de junho e julho de 2012, por meio de entrevista semiestruturada. Os achados foram analisados por meio de análise de conteúdo. Resultados: diversos fatores interferem no desenvolvimento do trabalho, dentre eles, atribui-se como facilitadores:o uso da tecnologia, o ambiente pequeno e fechado. Já, os conflitos pessoais, a falta de comprometimento de colegas e a carência de recursos humanos e materiais surgem como alguns obstáculos enfrentados pelos sujeitos. Conclusão: conclui-se que apesar de muitas dificuldades serem encontradas para o desenvolvimento do trabalho em UTI, essa atividade ainda é vista, pelos trabalhadores de enfermagem, como algo gratificante...

Objetivo: conocer facilidades y dificultades encontradas en el trabajo diario del equipo de enfermería de una UTI Adulto. Método: estudio descriptivo exploratorio de abordaje cualitativo. Los datos fueron recolectados con 11 trabajadores de enfermería, de una UTI Adulto de un hospital universitario, entre los meses de junio y julio de 2012, por medio de entrevistas semiestructuradas. Los resultados fueron analizados por medio de análisis de contenido. Resultados: diversos factores interfieren en el desarrollo del trabajo, entre ellos, se atribuyen como facilitadores: el uso de la tecnología, el ambiente pequeño y cerrado. Ya, los conflictos personales, la falta de comprometimiento de compañeros y la carencia de recursos humanos y materiales surgen como algunos obstáculos enfrentados por los sujetos. Conclusión: se concluye que apesar de las varias dificultades encontradas para el desarrollo del trabajo en UTI, esa actividad aún es vista, por los trabajadores de enfermaría, como algo gratificante...

Percepções de pacientes pós alta da unidade de cuidados intensivos sobre a hospitalização nesse setor / Perceptions of patients post-discharge from intensive care units about hospitalization in this sector

A Unidade de Cuidados Intensivos é um ambiente hospitalar destinado a pacientes graves, porém, com quadro clínico recuperável. Objetivou-se conhecer as percepções dos pacientes em período pós-alta de Unidades de Cuidados Intensivos. Trata-se de um estudo do tipo descritivo-exploratório com abordagem qualitativa, desenvolvido com os pacientes que estiveram internados nas Unidades de Terapia Intensiva Geral Adulto e de Cardiologia. Os dados foram coletados por meio de entrevista semiestruturada e analisados com base nos pressupostos da análise de conteúdo temática de Minayo(8). A partir da análise dos dados, emergiram duas categorias: a experiência da hospitalização e a religiosidade como estratégia de enfrentamento. Evidencia-se que, embora a hospitalização nesse setor possa ser encarada como algo ruim, também pode ser percebida de forma mais tranquila, especialmente quando há uma interação positiva com a equipe de saúde. A religiosidade é a estratégia mais utilizada para o enfrentamento dessa situação. Conclui-se que a internação em Unidades de Cuidados Intensivos pode ser vivenciada de forma menos assustadora, quando a equipe utiliza estratégias e práticas de humanização da assistência, especialmente associadas à busca de interação e estímulo à religiosidade...

The Intensive Care Unit is a hospital setting destined for severely ill patients, but with recoverable clinical diagnoses. The objective was to understand the perceptions of patients post-discharge from intensive care units. This is a study with a descriptive, exploratory and qualitative approach, developed with patients who were hospitalized in the Adult IntensiveCare and Cardiology Units. Data were collected through semi-structured interviews and analyzed based on the assumptions of content analysis by Minayo. From the analysis of the data, two categories emerged: the experience of hospitalization, and religion as a coping strategy. It is evident that although hospitalization in this sector can be seen as something bad, it can also be perceived more smoothly, especially when there is a positive interaction with the healthcare team. Religion is the main strategy used for comfort in this situation. It was concluded that admission to intensive care units can beexperienced as less frightening when the team uses strategies and humanized assistance practices, especially related to interaction and stimulation of religion...

La Unidad de Cuidados Intensivos es un entorno de hospital para los pacientes gravemente enfermos, sin embargo, concuadro clínico recuperable. El objetivo fue conocer las percepciones de los pacientes después del alta de las unidads de cuidados intensivos. Se trata de un estudio de abordaje cualitativo, descriptivo y exploratorio, desarrollado con pacientes que fueron hospitalizados en Unidades de Cuidados Intensivos de Adultos general y Cardiología. Los datos fueronrecolectados por medio de entrevistas semi-estructuradas y analizados bajo los supuestos del análisis de contenidotemático de Minayo. A partir del análisis de los datos, emergieron dos categorías: la experiencia de la hospitalización y lareligiosidad como estrategia de afrontamiento. Es evidente que aunque la hospitalización en este sector puede ser visto como algo malo, también puede ser percibido sin problemas, especialmente cuando hay una interacción positiva con el equipo de salud. La religiosidad es la principal estrategia para enfrentar esta situación. Se concluye que la admisión aunidades de cuidados intensivos se puede experimentar menos atemorizante, cuando el equipo utiliza estrategias y prácticas de asistencia de humanización, especialmente relacionado con buscar la interacción y la religiosidad estimulación...

A responsabilidade ambiental sob a ótica de trabalhadores da atenção básica à saúde / La responsabilidad ambiental bajo la óptica de trabajadores de la atención básica de salud / Environmental responsibility through the view of basic health attention workers

Objective: recognizing the perception of basic health attention workers about their environmental responsibility. Method: an exploratory and descriptive research, with a qualitative approach, conducted with basic health attention units‟ workers. The data were collected through a semi-structured interview and were analyzed based on the reference for content analysis. Results: the subjects mentioned the separation of recyclables as the main environmental-related activity. They demonstrated having difficulties in expressing their environmental responsibility, but they understand this as inherent to everybody. They also showed concerns about the community´s lack of care and education and the lack of government incentive to approach this topic. Conclusion: it is necessary to ponder about the personal and professional attitudes starting from their instruction as health workers; to make the community conscious in order to play its active part in the construction of health and to make stronger public policies of socio-environmental aims.

Objetivo: conhecer a percepção dos trabalhadores da atenção básica à saúde acerca de sua responsabilidade ambiental. Método: pesquisa exploratória e descritiva, com abordagem qualitativa, realizada com trabalhadores de unidades de atenção básica à saúde. Os dados foram coletados através de entrevista semiestruturada e analisados com base no referencial para análise de conteúdo. Resultados: os sujeitos citaram a segregação de materiais como principal atividade de cunho ambiental. Apresentaram dificuldade em expressar-se sobre sua responsabilidade ambiental, mas entendem isso como inerente as pessoas. Também teceram preocupações quanto à falta de cuidado e educação da comunidade, e ao não incentivo governamental para trabalhar com a temática. Conclusão: faz-se necessário refletir sobre as posturas pessoais e profissionais dos trabalhadores desde a sua formação; sensibilizar a comunidade para que exerça seu papel de voz ativa na construção da saúde; e fortalecer políticas públicas de cunho socioambiental.

Objetivo: conocer la percepción de los trabajadores de la atención básica de salud sobre su responsabilidad ambiental. Método: investigación exploratoria y descriptiva, con enfoque cualitativo, realizada con trabajadores de unidades de atención básica de salud. Los datos fueron recolectados por medio de entrevista semiestruturada y analizados con base en el referencial para análisis de contenido.Resultados: los sujetos citaron la segregación de materiales como la principal actividad de cuño ambiental. Presentaron dificuldades en expresarse sobre su responsabilidad ambiental, pero entienden eso como inherente a las personas. También demostraron preocupaciones relativas a la falta de cuidado y educación de la comunidad, y a falta de incentivo governamental para trabajar con la temática.Conclusión: se hace necesario reflexionar sobre las posturas personales y profesionales de los trabajadores desde su formación; sensibilizar la comunidad para que ejerza su papel de voz activa en la construcción de la salud; y fortalecer las políticas públicas de cuño socioambiental.