Profile of medicines used via oral and gastrointestinal catheter in a Walk-in Service.

OBJECTIVE: To identify the profile of drugs prescribed via oral and gastrointestinal catheter in a Walk-in Service of a University Hospital. METHOD: Quantitative cross-sectional study in which data were collected from the medical records of hospitalized patients using medication via oral or gastrointestinal catheter at least once a day between April and October 2015. The analysis was performed through descriptive statistics. RESULTS: Out of 568 prescriptions (total), there were 143 different medications. The pharmaceutical form with the greatest number of prescriptions was solid (95.8%), of which 46.1% were simple tablets. The oral route had the highest number of administrations (97.3%). The most prescribed drug class was of anti-infectives (25.9%), but the Omeprazole drug was the most prescribed in the study (40%). CONCLUSION: There are indications that enable rethinking the care practice and establishing criteria and norms for contributing to the safety and efficacy of services provided in healthcare, especially regarding the preparation and administration of medications via gastrointestinal catheter.

Assessment of workers' exposure to aflatoxin B1 in a Portuguese waste industry.

Aflatoxin B1 (AFB1) is considered by different International Agencies as a genotoxic and potent hepatocarcinogen. However, despite the fact that the fungi producing this compound are detected in some work environments, AFB1 is rarely monitored in occupational settings. The aim of the present investigation was to assess exposure to AFB1 of workers from one Portuguese waste company located in the outskirt of Lisbon. Occupational exposure assessment to AFB1 was done with a biomarker of internal dose that measures AFB1 in the serum by enzyme-linked immunosorbent assay. Forty-one workers from the waste company were enrolled in this study (26 from sorting; 9 from composting; 6 from incineration). A control group (n = 30) was also considered in order to know the AFB1 background levels for the Portuguese population. All the workers showed detectable levels of AFB1 with values ranging from 2.5ng ml(-1) to 25.9ng ml(-1) with a median value of 9.9±5.4ng ml(-1). All of the controls showed values below the method's detection limit. Results obtained showed much higher (8-fold higher) values when compared with other Portuguese settings already studied, such as poultry and swine production. Besides this mycotoxin, other mycotoxins are probably present in this occupational setting and this aspect should be taken into consideration for the risk assessment process due to possible synergistic reactions. The data obtained suggests that exposure to AFB1 occurs in a waste management setting and claims attention for the need of appliance of preventive and protective safety measures.

Prevalence of pfmdr1 alleles associated with artemether-lumefantrine tolerance/resistance in Maputo before and after the implementation of artemisinin-based combination therapy.

BACKGROUND: Mozambique implemented artemisinin-based combinations therapy (ACT) using artemether-lumefantrine (AL) as the first-line treatment for uncomplicated malaria in 2009. AL remains highly efficacious, but widespread use may soon facilitate emergence of artemisinin tolerance/resistance. The prevalence of pfmdr1 different alleles in Maputo and Mozambique is not known, either after or before the introduction of ACT. Pfmdr1 molecular markers related to Plasmodium falciparum susceptibility were analysed before and after transition to ACT. METHODS: A first group of samples was collected between June 2003 and June 2005 and a second group in the period between March 2010 and March 2012. Three alleles were analysed by PCR-RFLP: N86Y, Y184F and D1246Y, in the pfmdr1 gene. RESULTS: Alleles N86, 184F and D1246 increased from 19.5, 19.6 and 74.4% in 2003-2005 to 73.2, 22.7 and 96.7% in 2010-2012, respectively. After implementation of ACT (2010-2012), pfmdr1 haplotypes, either two- and three-codon basis, were generally less diverse than before the implementation of ACT (2003-2005). The prevalence of haplotypes N86-184Y, N86-D1246 and 184Y-D1246 increased from 12,2, 27.3 and 71.7% in 2003-2005 to 59.4, 84.3 and 78.6% in 2010-2012. The three-codon basis haplotypes NFD and NYD also increased significantly during the same period. CONCLUSION: The alleles N86 and 184 F and the triple haplotype N86-184 F-D1246 showed a significantly increased prevalence after introduction of ACT.

[Clinical practice as an arborescent and rhizomorphic practice in surgical nursing work]. / A clínica como prática arborífica e rizomórfica do trabalho em enfermagem cirúrgica.

A qualitative and exploratory case study was conducted in a surgery unit of a university hospital. The study aimed to analyze the nurses' work from the perspective of health care production and clinical practice. The subjects of the study were six nurses. Non-participant observations, documentary research and in-depth interviews were carried out, followed by discursive textual analysis. Nursing work is organized according to two interconnected and interdependent perspectives: a clinical model, which forms the central structure of its practice, and a structure formed by multiple and heterogeneous elements. in this way, the clinical model of health care is organized as a centered structure that enables the fulfillment of biological needs and acts as a basis for connecting disparate knowledge and practices that expand practice through interconnections with the work environment.

Evaluation of prevalence's of pfdhfr and pfdhps mutations in Angola.

BACKGROUND: Malaria is the major cause of morbidity and mortality in Angola. The most vulnerable groups to Plasmodium falciparum infection are pregnant women and children under five years of age. The use of an intermittent preventive treatment (IPT) with sulphadoxine/pyrimethamine (SP) in pregnant women was introduced in Angola in 2006 by the National Malaria Control Programme, and currently this strategy has been considered to be used for children malaria control. Considering the previous wide use of SP combination in Angola, together to the reported cases of SP treatment failure it is crucial the evaluation of the prevalence of five mutations in pfdhfr and pfdhps genes associated to P. falciparum resistance to SP before the introduction of S/P IPT in children. METHODS: The study was conducted in five provinces, with different transmission intensities: Huambo, Cabinda, Uíge, Kwanza Norte, and Malanje. The detection of the mutations in pfdhfr and pfdhps genes was carried out in 452 P. falciparum blood samples by PCR RFLP. RESULTS: For pfdhfr gene, 90,3% of the samples carried the mutation 51I, with 7.5% of mixed infections; 51% carried wild type allele 59C, with 29.2% mixed infections and; 99.1% of isolates harboured the mutant allele 108N. Concerning, pfdhps gene, 83,1% were mutant type 437G with 11% mixed infections , while 87% of the studied isolates were wild type for codon 540. DISCUSSION: This is the first representative epidemiological study of the whole Angola country on the prevalence of the genotypes associated with SP chemoresistance. A high frequency of individual mutations in both genes (51I and 108N in pfdhfr, and 437G in pfdhps) was found, besides a low prevalence of the quintuple mutation. CONCLUSION: The data showed that the implementation IPT using SP in children needs to be reviewed.

A review of antimalarial plants used in traditional medicine in communities in Portuguese-speaking countries: Brazil, Mozambique, Cape Verde, Guinea-Bissau, São Tomé and Príncipe and Angola.

The isolation of bioactive compounds from medicinal plants, based on traditional use or ethnomedical data, is a highly promising potential approach for identifying new and effective antimalarial drug candidates. The purpose of this review was to create a compilation of the phytochemical studies on medicinal plants used to treat malaria in traditional medicine from the Community of Portuguese-Speaking Countries (CPSC): Angola, Brazil, Cape Verde, Guinea-Bissau, Mozambique and São Tomé and Príncipe. In addition, this review aimed to show that there are several medicinal plants popularly used in these countries for which few scientific studies are available. The primary approach compared the antimalarial activity of native species used in each country with its extracts, fractions and isolated substances. In this context, data shown here could be a tool to help researchers from these regions establish a scientific and technical network on the subject for the CPSC where malaria is a public health problem.

Bis-alkylamine quindolone derivatives as new antimalarial leads.

Quindolone derivatives, designed to target the malaria parasite digestive vacuole and heme detoxification pathway, have been synthesized by reaction with 2-chloro-N,N-diethylethanamine. This reaction gave N,O-, N,N- and O-alkylated products containing one or two basic side-chains. The compounds were evaluated for antiplasmodial activity against the chloroquine-resistant Plasmodium falciparum W2 strain and for cytotoxicity in HepG2 A16 hepatic cells. By incorporating alkylamine side chains and chlorine atoms in the quindolone nucleus we transformed the inactive tetracyclic parent quindolones into moderate or highly active and selective antimalarial compounds. The most active and selective compound, 5c, showed an IC(50)=51 nM for P. falciparum and a selectivity ratio of 98.

Risk perception in family health work: study with workers in Southern Brazil.

This analytical and qualitative study aimed to identify how workers in the Family Health Strategy perceive the risks they are exposed to at work. Thematic analysis and the reference framework of the work process were used to examine the contents of interviews with 48 subjects (community health agents, nurses, nursing auxiliaries and physicians). The workers noticed the following risks: physical and moral violence, typical work accident, emotional exhaustion, lack of problem-solving ability and occupational disease. The results predominantly show the connection with the object / subject of the work and the social environmental characteristics of the related communities. The study adds to the body of knowledge and can systemize collective and individual technological processes for occupational health risk management in primary health care.

Prevalence of pfmdr1, pfcrt, pfdhfr and pfdhps mutations associated with drug resistance, in Luanda, Angola.

BACKGROUND: Malaria is the infectious disease causing the highest morbidity and mortality in Angola and due to widespread chloroquine (CQ) resistance, the country has recently changed its first-line treatment recommendations for uncomplicated malaria, from CQ to artemisinin combination therapies (ACT) in adults, and sulphadoxine/pyrimethamine (S/P) in pregnant women. Loss of SP sensitivity is, however, progressing rapidly in Africa and, in this study, were investigated a number of molecular markers associated to CQ and S/P. METHODS: Blood samples were collected from 245 children with uncomplicated malaria, admitted at the Pediatric Hospital Dr. David Bernardino (HPDB), Angola, and the occurrence of mutations in Plasmodium falciparum was investigated in the pfmdr1 (N86Y) and pfcrt (K76T) genes, associated with CQ resistance, as well as in pfdhfr (C59R) and pfdhps (K540E), conferring SP resistance. RESULTS: The frequencies of pfmdr1 mutations in codon 86 were 28.6% N, 61.3% Y and 10.1% mixed infections (NY). The frequency of pfcrt mutations in codon 76 were 93.9% K, 5.7% T and 0.4% mixed infections (KT). For pfdhfr the results were in codon 59, 60.6% C, 20.6% R and 18.8% mixed infections (CR). Concerning pfdhps, 6.3% of the isolates were bearers of the mutation 540E and 5.4% mixed infections (K540E). CONCLUSION: The results of this epidemiologic study showed high presence of CQ resistance markers while for SP a much lower prevalence was detected for the markers under study.

Analysis of sulphadoxine/pyrimethamine resistance-conferring mutations of Plasmodium falciparum from Mozambique reveals the absence of the dihydrofolate reductase 164L mutant.

BACKGROUND: Plasmodium falciparum is the predominant human malaria species in Mozambique and a lead cause of mortality among children and pregnant women nationwide. Sulphadoxine/pyrimethamine (S/P) is used as first line antimalarial treatment as a partner drug in combination with artesunate. METHODS: A total of 92 P. falciparum-infected blood samples, from children with uncomplicated malaria attending the Centro de Saude de Bagamoyo in the Province of Maputo-Mozambique, were screened for S/P resistance-conferring mutations in the pfdhfr and pfdhps genes using a nested mutation-specific polymerase chain reaction and restriction digestion (PCR-RFLP). The panel of genetic polymorphisms analysed included the pfdhfr 164L mutation, previously reported to be absent or rare in Africa. RESULTS: The frequency of the S/P resistance-associated pfdhfr triple mutants (51I/59R/108N) and of pfdhfr/pfdhps quintuple mutants (51I/59R/108N + 437G/540E) was 93% and 47%, respectively. However, no pfdhfr 164L mutants were detected. CONCLUSION: The observation that a considerably high percentage of P. falciparum parasites contained S/P resistance-associated mutations raises concerns about the validity of this drug as first-choice treatment in Mozambique. On the other hand, no pfdhfr 164L mutant was disclosed, corroborating the view that that this allele is still rare in Africa.

Discussing the Notion of Decent Work: Senses of Working for a Group of Brazilian Workers without College Education.

Despite recent stability and socioeconomic development, Brazil's history is marked by social inequality, informality, precarious work, and psychosocial vulnerability, with little opportunity for decent and meaningful work, as recommended by the International Labour Office (ILO), for people in the country. Nevertheless, based on a social constructionist view, the hypothesis can be raised that there is no substantive definition of decent work, but rather a psychosocial one, constructed based on the discourse, narratives, and practices produced through the relational processes which grant sense and meaning to work. Therefore, the examination of narratives and discourses is an important methodological strategy to understand the socio-occupational reality of Brazil. Thus, this study aims to understand the senses attributed to working through content analysis of the narratives produced by a set of 20 urban workers and contrast them with the ILO definition of decent work, in an effort to analyze the relationships, similarities, and differences between an established collective social discourse and the interviewees' singular narratives. The main results point out that the participants look for working with fair wages, social protection, safety, and personal development opportunities, as the ILO recommends. The main difference is that these characteristics do not derive from the State's actions, as in the employment and formal qualification model, but come from informal sources, such as family and community relationship networks. The informal relationship networks produce job opportunities as well as social protection; qualification takes place through practical learning from more experienced colleagues; the opportunity to be able to keep working (employed or working informally) leads to success and safety; and the possibility to make choices and have control over one's life translates into personal and occupational development. In conclusion, the participants searched for working according to the principles recommended by the ILO. Nevertheless, in contexts of vulnerability and with restricted support from the State, these principles are constructed in the community and not offered by the public power, which generates distinguished forms of decent work.

Guidelines for a Comprehensive Care Program to Ostomized Patients and Families: a Nursing proposal.

OBJECTIVES: describe care needs and demands that mark the discursive practices of ostomized clients and family members and discuss guidelines for a comprehensive care program to ostomized clients and their families, organized by macrosociological categories. METHOD: Creative and Sensitive, involving 17 ostomized subjects and family members at a municipal outpatient clinic. The ethical aspects were complied with. A characterization form was used, as well as Creativity and Sensitivity Dynamics: "speaking map", "body-knowledge" and "calendar". Critical Discourse Analysis was applied. RESULTS: the health needs and care demands of the ostomized patients and their family members, in their multiple dimensions, were constituted in the home and community, outpatient and social context, implying new orientations for nursing care. The unveiling of the data brought elements that constituted guidelines, in a macrosociological approach, to achieve the expanded integrality of nursing care. CONCLUSION: the ostomized clients are unique in their genre/peculiar from Latin sui generis, calling for strategies that respond to and distinguish their specificities. Elaborating a Public Health Policy that improves and reorganizes the care demands, taking into account these individual biopsychosocial and spiritual aspects, is a possible and irrevocable target in the attempt to achieve better conditions of health and wellbeing.

Rede de apoio e sustentação de pacientes com síndrome metabólica / Support network and sustenance of patients with the metabolic syndrome

Objetivo: O presente estudo teve como objetivo conhecer a rede de apoio e sustentação de pacientes com síndrome metabólica, atendidos no ambulatório especializado de um hospital universitário no extremo sul do Brasil. Método: Estudo qualitativo, descritivo e exploratório, realizado com 33 pacientes com síndrome metabólica, mediante entrevista individual semiestruturada, no primeiro semestre de 2019. Os dados foram analisados por meio da Análise Temática de Conteúdo. Resultados: A maioria dos participantes tinha idade entre 50 e 74 anos, era do sexo feminino, cor branca. Foram identificadas três categorias: I - Rede de apoio e sustentação no dia-a-dia: as pessoas que ajudam sempre de maneira mais próxima, formada pela família, vizinhos e profissionais de saúde que os acompanham; II - Rede de apoio e sustentação diante de intercorrências de saúde: estratégias e fluxo que os pacientes buscam ao enfrentar as intercorrências; e III - Rede de apoio e sustentação para acompanhamento no ambulatório especializado: relações e fluxo do serviço. Conclusões: A rede de apoio e sustentação demonstrou ser essencial para a manutenção e continuidade do tratamento. Contudo, é necessário maior esclarecimento dos pacientes quanto ao funcionamento dos serviços, desde a atenção básica ao atendimento especializado. (AU)

Objective: This research aims to know the support network and sustenance of patients with the metabolic syndrome seen in the specialized outpatient clinic of a Hospital university in the south of Brazil. Methods: It is a qualitative, descriptive, and exploratory research, realized in 33 patients with metabolic syndrome, through ­ individual and semi-structured interviews in the first semester of 2019. The data were analyzed through the Thematic Analysis of Content. Results: The majority of the participants were about 50 and 74 years old, female, white color. In the research three categories were identified: I - Support network and sustenance on daily basis: people who always help in a closer way, formed by family, neighbors, and healthcare professionals who accompany them. II - Support network and sustenance in the face of health complications: strategies and flow that the patients seek to find when facing some complications, and III - Support network and sustenance to attendance in the specialized outpatient clinic: service relations and flow. Conclusion: The support network and sustenance has proved to be essencial to the maintenance and continuity of the treatment. However, it is necessary a further clarification of the patients in relation of the functioning of the services, since basic attention to the specialized care. (AU)

Objetivo: Este estudio tenía como objetivo conocer la red de apoyo de los pacientes con síndrome metabólico tratados en la clínica ambulatoria especializada de un hospital universitario en el extremo sur del Brasil. Métodos: Estudio cualitativo, descriptivo y exploratorio, realizado con 33 pacientes con síndrome metabólico, mediante entrevista individual semiestructurada en el primer semestre de 2019. Los datos fueron analizados a través del Análisis de Contenido Temático. Resultados: La mayoría de los participantes tenían entre 50 y 74 años, eran mujeres, blancas. Se identificaron tres categorías: I - Red de apoyo y soporte en la vida cotidiana: personas que ayudan siempre de forma más cercana, formadas por familiares, vecinos y profesionales de la salud que les acompañan; II - Red de apoyo y soporte ante las intercurrencias sanitarias: estrategias y flujo que buscan los pacientes ante las intercurrencias; y III - Red de apoyo y soporte para el seguimiento en la consulta externa especializada: relaciones y flujo del servicio. Conclusion: La red de apoyo y respaldo ha demostrado ser esencial para el mantenimiento y la continuidad del tratamiento. Sin embargo, es necesario aclarar a los pacientes sobre el funcionamiento de los servicios, desde la atención básica hasta la atención especializada. (AU)

La depresión y su influencia en los cambios neuropsicológicos del adulto mayor con trastorno neurocognitivo leve debido a la enfermedad de Alzheimer / Depression and its Influence on Neuropsychological Changes in the Elderly with Mild Neurocognitive Disorder due to Alzheimer's Disease

Resumen Objetivo: Identificar las alteraciones neuropsicológicas asociadas a la depresión en adultos mayores con trastorno neurocognitivo (TNC) leve debido a la enfermedad de Alzheimer, de la Unidad Médica de Alta Especialidad (UMAE) del Instituto Mexicano del Seguro Social (IMSS). Cuadro teórico: Los hallazgos han demostrado que los cambios neurocognitivos son más evidentes cuando existe depresión en el adulto mayor. Metodología: Participaron en esta investigación un total de 785 adultos mayores con Alzheimer, divididos en dos grupos: El experimental, en el que participaron mayores con diagnóstico clínico de depresión, y el de Control, cuyos participantes no presentaban depresión. Todos fueron evaluados a través del Inventario de Depresión de Beck II (BDI-II) y la Batería Neuropsicológica NEUROPSI. Resultados: Existen correlaciones significativas entre la depresión y las funciones neuropsicológicas y, además, la depresión presenta una influencia significativa en la orientación, atención y concentración, memoria, lenguaje y funciones ejecutivas. Conclusiones: Los procesos neuropsicológicos en adultos mayores con TNC leve debido a la enfermedad de Alzheimer, presentan deterioro funcional negativo y reducido, de modo que el nivel de disminución está relacionado con el nivel de depresión.

Abstract Objective: Identifying the neuropsychological alterations associated with depression on the elderly with mild neurocognitive disorder due to Alzheimer's disease, of the High Specialty Medical Unit (UMAE) at the Mexican Social Security Institute (IMSS). Theoretical: The findings have also shown that all neurocognitive changes are more evident when depression emerges in the elderly. Methodology: 785 elderly people with Alzheimer's disease participated in the research, divided in two groups: the experimental group, where elderly had a clinical diagnosis of depression and the control group, whose participants do not suffer from depression. Participants were evaluated with the administration of the Beck II Depression Inventory (BDI-II), and the NEUROPSI Neuropsychological Battery. Results: Statistically meaningful effects were found between depression and neuropsychological mechanisms; in addition, depression has a significant influence in orientation, attention and concentration, memory, language and executive functions. Conclusions: Considering the results, it can be verified that the neuropsychological processes have a negative and reduced functioning impairments, considering that the level of decrease is related to depression level.

Erros na terapia medicamentosa e as consequências para a enfermagem / Errors in medicinal therapy and the consequences for nursing / Errores en la terapia de medicamentos y consecuencias para la enfermería

Objetivo: Identificar as consequências dos erros na terapia medicamentosa sob a ótica da equipe de enfermagem. Método: Pesquisa descritivo-exploratória de caráter transversal com abordagem qualitativa, realizada junto a quatro enfermeiros, três auxiliares e dezenove técnicos de enfermagem. Coleta de dados mediante entrevistas semiestruturadas analisadas por meio da Análise de Conteúdo de Bardin. Resultados: As consequências dos erros foram consideradas negativas nos casos de demissões, troca de setor, impacto emocional/moral. Entretanto, desmitificou-se que erros trazem somente consequências negativas, pois situações como o diálogo, oferta de educação permanente, autocrítica do trabalhador e melhor atenção no preparo/administração dos medicamentos exemplificaram que o erro pode reverter-se para a melhoria das práticas de cuidado. Conclusão: os resultados deste estudo poderão encorajar a implementação de uma cultura de segurança mais consistente nas instituições de saúde, não personificando o erro a quem o cometeu diretamente

Objective: To identify the consequences of errors in drug therapy from the point of view of the nursing team. Method: Descriptive exploratory cross-sectional study with qualitative approach, performed with four nurses, three auxiliaries and 19 nursing technicians. Data collection through semi-structured interviews analyzed through the Bardin Content Analysis. Results: The consequences of the errors were considered negative in the cases of layoffs, sector change, emotional/ moral impact. However, it was demythologized that errors only have negative consequences, because situations such as dialogue, permanent education offer, self-criticism of the worker and better attention in the preparation/administration of medications exemplified that the error can be reverted to the improvement of care practices. Conclusion: the results of this study may encourage the implementation of a more consistent safety culture in health institutions, not by personifying the error to those who committed it directly

Objetivo: Identificar las consecuencias de los errores en la terapia medicamentosa bajo la óptica del equipo de enfermería. Método: Investigación descriptiva-exploratoria de carácter transversal con abordaje cualitativo, realizada junto a cuatro enfermeros, tres auxiliares y 19 técnicos de enfermería. Recolección de datos mediante entrevistas semiestructuradas analizadas por medio del Análisis de Contenido de Bardin. Resultados: Las consecuencias de los errores se consideraron negativas en los casos de despidos, cambio de sector, impacto emocional/ moral. Sin embargo, se desmitificó que errores traen solamente consecuencias negativas, pues situaciones como el diálogo, oferta de educación permanente, autocrítica del trabajador y mejor atención en la preparación/administración de los medicamentos ejemplificaron que el error puede revertirse a la mejora de las prácticas de cuidado. Conclusión: Los resultados de este estudio pueden alentar la implementación de una cultura de seguridad más consistente en las instituciones de salud, no personificando el error a quien lo cometió diretamente

Promovendo a saúde auditiva no programa saúde na escola de Macaé / Promoting hearing health in the health school programe of Macaé

Objetivos: descrever as experiências de graduandos dos cursos de Medicina, Enfermagem e Nutrição, integrantes de um projeto de extensão da Universidade Federal do Rio de Janeiro, Campus UFRJ/Macaé, Brasil, em uma ação de promoção à saúde auditiva no espaço escolar da rede pública de ensino de Macaé. Métodos: Realizouse um relato de experiências a partir da abordagem de educadores (cinco bolsistas e dois voluntários, graduandos de três cursos da área da saúde) de um projeto extensionista, que organizaram e executaram uma ação educativa intitulada "Os cinco sentidos e os cuidados com a audição", em 2017; voltada aos préescolares e escolares (educandos) de uma escola da rede pública de ensino. Foram realizadas duas reuniões, utilizando-se a roda de conversa como estratégia para a construção da prática dialógia nas quais os educadores apresentaram suas experiências vivenciadas na ação realizada. Resultados: Ao analisar os relatos, observaram-se cinco palavras chaves, com suas respectivas ideias centrais: expectativas e interação [quanto ao tipo de estratégia de educação em saúde (roda de conversa, dramatização, ludicidade) e receptividade dos educandos]; relevância (importância do tema abordado); formação/capacitação profissional (aquisição de experiências tanto no âmbito pessoal como profissional); assimilação (entendimento do tema pelos educandos); avaliação das atividades (quanto aos objetivos alcançados). Conclusões: As experiências vivenciadas pelos educadores do projeto proporcionaram interação, a aproximação do tema com os educandos, o que permitiu aos educadores um novo olhar sobre o tema abordado devido a forma como foi bem recebida pelos educandos

Objectives: To describe the experiences of undergraduate students of Medicine, Nursing and Nutrition courses, members of an extension project of the Federal University of Rio de Janeiro, Campus UFRJ - Macaé, Brazil, in an action to promote the hearing health in school space of public - school system of Macaé. Methods: An experiment was carried out based on the approach of educators (five fellows and two volunteers graduating from three health courses) of an extension project, who organized and carried out an educational action entitled "The five senses and the hearing care ", in 2017; directed to preschoolers and schoolchildren (learners) of a school in the public -school system. Two meetings were held, using the talk wheel as a strategy for the construction of the dialogical practice, in which the educators presented their lived experiences in the accomplished action. Results: When analyzing the reports, five key words were observed, with their respective central ideas: expectations and interaction [about the type of health education strategy (talk wheel, dramatization, playfulness) and receptivity of learners]; relevance (importance of the topic addressed); professional training (acquisition of experience in both the personal and professional spheres); assimilation (understanding of the subject by learners); evaluation of the activities (regarding the objectives reached). Conclusions: The experiences of the project educators provided the interaction, the approach of the subject with the learners, which allowed the educators a new look on the topic addressed due to the way it was well received by the learners.

Ventilatory determinants of self-selected walking speed in chronic heart failure.

PURPOSE: In healthy subjects, the self-selected walking speed (SSWS) corresponds to the lowest cost of transport (CT). This study tested the hypothesis that SSWS could be determined by the work of breathing instead of the CT in patients with chronic heart failure (CHF). METHODS: Seventeen patients with CHF due to left ventricular systolic dysfunction and 17 healthy controls were compared. Both groups were submitted to a walking cost protocol on the treadmill at the SSWS, at two speeds below (-0.5 and -1.0 km·h), and two speeds above (+0.5 and +1.0 km·h). The CT and ventilatory efficiency, as determined by the ventilatory equivalent for carbon dioxide (V˙E/V˙CO2), were compared. RESULTS: CHF patients had a lower SSWS than healthy controls (0.75 ± 0.14 vs 0.98 ± 0.30 m·s, P < 0.01). Among the five speeds, the controls' SSWS was the most economical. For CHF patients, the SSWS was less economical than the higher speeds. However, V˙E/V˙CO2 at the SSWS was lower when compared with other speeds in both groups. CONCLUSIONS: In contrast to what happens with healthy subjects, where the SSWS has the lowest CT, CHF patients choose an SSWS with higher CT, but with lower ventilatory cost. These findings are compatible with the concept that interventions that enhance ventilatory efficiency may increase SSWS in CHF.

Construção moral do estudante de graduação em Enfermagem como fomento da humanização do cuidado / Desarrollo moral del estudiantes de postgrado en Enfermería como insentivo para humanización de la atención / Moral construction of undergraduate Nursing students to promote care humanization

RESUMO Objetivo: refletir sobre como a construção moral do estudante de graduação em enfermagem pode fomentar a humanização do cuidado. Método: trata-se de uma reflexão teórica pautada em duas diferentes correntes: piagetina e a kohebergina. Resultados: mencionam-se como possíveis encaminhamentos desta reflexão: o reconhecimento da dimensão moral do cuidado; a necessidade de considerar a cultura dos sujeitos envolvidos no cuidado; a superação do tecnicismo na enfermagem, contemplando-se também a dimensão ética do cuidado e, finalmente, a instrumentalização de docentes para que sejam habilitados a trabalhar a moralidade humana como um exercício de cidadania em todos os momentos acadêmicos. Conclusão: acredita-se que a formação acadêmica em enfermagem dedicada à construção moral pode auxiliar na constituição de um enfermeiro capaz de cuidar de maneira humanizada.

RESUMEN Objetivo: reflexionar sobre cómo la construcción moral del estudiante de enfermería, de grado, puede promover la humanización de la atención. Método: se trata de un estudio reflexivo que Resultados: se mencionan como posibles referencias de esta reflexión: el reconocimiento de la dimensión moral de la atención; la necesidad de considerar la cultura de los sujetos involucrados en el proceso; la superación de tecnicismo en la enfermería, también es contemplada la dimensión ética de la atención y, por fín, la instrumentalización a los profesores para que sean capaces de trabajar, a lo largo del momento académico, la moralidad humana como un ejercicio de la ciudadanía. Conclusión: se cree que la educación de enfermería académica dedicada a la construcción moral puede ayudar en la creación de un enfermero capaz de cuidar de manera humana.

ABSTRACT Objective: to reflect on how the moral construction of the undergraduate nursing student can promote the humanization of care. Method: this is a theoretical reflection based on two different frameworks: Piaget and Kohlberg. Results: the following are mentioned as possible consequences of this reflection: the recognition of the moral dimension of care; the need to consider the culture of the subjects involved in care; overcoming technicality in nursing, also considering the ethical dimension of care and, finally, the provision of instruments to teachers in order to enable them to address human morality as an exercise of citizenship at all academic times. Conclusion: we believe that academic nursing education dedicated to the moral construction can help to prepare nurses who are capable of humanized care.

Uso de medicamentos com ação anti-infecciosa via sonda gastroenteral: recomendações para a enfermagem / Uso de medicamentos con acción antiinfecciosa por sonda gastroenteral: recomendaciones para la enfermería / Use of anti-infective medications via the gastrostomy catheter: recommendations for nursing

RESUMO: Objetivo: apresentar recomendações específicas no preparo e administração de medicações anti-infecciosas via sonda gastroenteral no Serviço de Pronto Atendimento de um Hospital Universitário no Sul do Brasil. Método: estudo quali-quantitativo, descritivo-exploratório e de corte transversal, realizado entre abril e outubro de 2015. Quantitativamente utilizou-se a estatística descritiva e qualitativamente uma revisão não sistemática da literatura, em publicações nacionais e internacionais, a partir da combinação das palavras chave: perfil e medicações via sonda. Resultados: entre 568 prescrições analisadas, houve 143 medicamentos diferentes prescritos, com prevalência da classe de anti-infecciosos (25,9%) e predominância das apresentações sólidas; contudo, 83,3% dos medicamentos apresentavam alguma restrição de uso via sonda mesmo havendo opções de substituição disponíveis, demonstrando necessidade de protocolo assistencial. Considerações finais: entre a maioria das medicações sólidas prescritas via sonda gastroenteral, havia opções de substituição disponíveis, sendo necessária sua substituição por outras apresentações e o seguimento de recomendações específicas pela equipe de enfermagem/saúde.

RESUMEN: Objetivo: presentar recomendaciones específicas acerca del preparo y de la administración de medicamentos antiinfecciosos por medio de sonda gastroenteral en el Servicio de emergencia de un Hospital Universitario en Sur de Brasil. Método: estudio cualitativo y cuantitativo, descriptivo exploratorio y de cohorte transversal, que se realizó entre abril y octubre de 2015. Para el análisis cuantitativo, se utilizó la estadística descriptiva y, para el análisis cualitativo, una revisión no sistemática de la literatura en publicaciones nacionales e internacionales, por medio de la combinación de las palabras clave: perfil y medicamentos por medio de sonda. Resultados: entre 568 prescripciones analizadas, hubo 143 medicamentos distintos prescriptos, con prevalencia de los antiinfecciosos (25,9%) y predominancia de las presentaciones sólidas; sin embargo, 83,3% de los medicamentos presentaban alguna restricción de uso por sonda mismo existiendo opciones de sustitutos disponibles, lo que muestra necesidad de protocolo asistencial. Consideraciones finales: entre la mayoría de los medicamentos sólidos prescriptos por sonda gastroenteral, había opciones de sustitución disponibles, siendo necesario sustituirlos por otras presentaciones además de obedecer a las recomendaciones específicas por el equipo de enfermería/salud.

ABSTRACT: Objective: to present specific recommendations in the preparation and administration of anti-infective medications via the gastrostomy catheter in the Emergency Unit of a University Hospital in the South of Brazil. Method: a descriptive-exploratory, cross-sectional, qualitative-quantitative study conducted between April and October 2015. Quantitative descriptive statistics were used, with a qualitative non-systematic review of the literature, considering national and international publications, from the combination of the keywords: profile and medications via catheter. Results: among the 568 prescriptions analyzed, there were 143 different medications prescribed, with prevalence of the anti-infectious class (25.9%) and predominance of solid forms; however, 83.3% of the medications presented some restriction in use with catheter even though there were substitution options available, demonstrating the need for a care procedure. Final considerations: among the majority of the prescribed solid medications for use via gastrostomy catheter, replacement options were available, demonstrating the need for their substitution with other forms and for the follow-up of specific recommendations by the nursing/health team.

Estratégias que contribuem para a visibilidade do trabalho do enfermeiro na central de material e esterilização / Estrategias que contribuyen para la visibilidad del trabajo del enfermero en el centro de equipos y materiales / Strategies that contribute to nurses' work exposure in the material and sterilization central

RESUMO Objetivo: identificar estratégias para promover o reconhecimento e a visibilidade do fazer do enfermeiro na Central de Material e Esterilização. Método: pesquisa qualitativa, descritiva, realizada com enfermeiros de um hospital do sul do Brasil, de outubro a novembro de 2014, totalizando 17 participantes, através de entrevista semiestruturada e análise textual discursiva. Resultados: dentre as estratégias, destacaram-se a troca de vivência entre os enfermeiros da Central de Material e Esterilização e os enfermeiros de outras unidades; seleção dos trabalhadores, a partir de critérios necessários para a atuação no local e Serviço de Educação Permanente, com temáticas voltadas ao setor. Estas estratégias suscitaram mudanças no modo de perceber uma área da enfermagem, ainda pouco visível, apesar de tão essencial para as atividades realizadas no hospital. A visibilidade do trabalho realizado na Central de Material e Esterilização ainda se apresenta distorcida, pois, apesar de o trabalho desenvolvido no setor ser considerado importante pelos profissionais externos, muitos não conheciam a diversidade de atividades realizadas nem possuíam o conhecimento específico exigido. Conclusão: a pesquisa evidenciou a necessidade de engajamento dos próprios enfermeiros da Central de Material e Esterilização para se fazerem perceber e modificarem a imagem do setor e a maneira como a administração das instituições de saúde vem lidando com os avanços do processamento dos artigos médico-cirúrgicos.

RESUMEN Objetivo: identificar las estrategias para promover el reconocimiento y la visibilidad del hacer del enfermero en el Centro de Equipos y Materiales. Método: investigación cualitativa, descriptiva, realizada con enfermeros de un hospital del sur de Brasil, de octubre a noviembre de 2014, totalizando 17 participantes, a través de entrevista semi-estructurada y análisis textual discursiva. Resultados: dentro de las estrategias se destacaron el intercambio de vivencia entre los enfermeros del Centro de equipos y materiales y los enfermeros de otras unidades; selección de los trabajadores, a partir de criterios necesarios para la actuación en el local y Servicio de Educación Permanente, con temáticas vinculadas para el sector. Estas estrategias suscitaron cambios en el modo de percibir un área de la enfermería, aún poco visible, a pesar de tan esencial para las actividades realizadas en el hospital. La visibilidad del trabajo realizado en el Centro de equipos y materiales aún se presenta alterada, pues, a pesar del trabajo desarrollado en el sector a ser considerado importante por los profesionales externos, muchos no conocían la diversidad de actividades realizadas ni poseían el conocimiento específico exigido. Conclusión: la investigación evidenció la necesidad del compromiso de los mismos enfermeros del Centro de materiales y equipos para hacerse percibir y modificar la imagen del sector y la manera como la administración de las instituciones de salud vienen lidiando con los avances del proceso de los artículos médico-quirúrgicos.

ABSTRACT Objective: to identify strategies to promote the recognition and visibility of the nursing work performed in the Central Supply and Sterilization. Method: qualitative, descriptive research with nurses from a hospital in Southern Brazil, from October to November 2014, totaling 17 participants, data collection was performed through semi structured interviews and discursive textual analysis. Results: among the strategies, the exchange of experiences between the nurses of the Central Supply and Sterilization department and the nurses of other units were highlighted; Selection of workers was based on the criteria required for the on-site performance and Permanent Education Service, with topics focused on the sector. These strategies have led to changes in the way of perceiving a nursing area, which is still not very visible, although it is essential for the activities performed at the hospital. The visibility of the work performed in the Central Supply and Sterilization department is still distorted, as although the work developed in the sector is considered important by external professionals, many were not aware of the diversity of activities performed or had the specific knowledge required. Conclusion: the research evidenced the need for the nurses of the Central Supply and Sterilization department to engage, perceive and modify the image of the sector and the way in which the administration of health institutions has been dealing with the advances in the processing of medical and surgical articles.