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Julgamento clínico e autoeficácia de enfermeiros para o manejo da sepse: uso da simulação clínica
(Universidade Federal de São Carlos, 2018-11-23) Carvalho, Lilian Regina de; Zem-Mascarenhas, Silvia Helena; https://lattes.cnpq.br/0185144417072417; https://lattes.cnpq.br/8329953593386274
The use of active methodologies has demonstrated efficacy in the teaching and learning process in nursing. Thus, realistic simulation emerges as a strategy that, in addition to allowing real experimentation without the exposure of a patient, allows reflection on the actions developed within the scenario. The aim of the study was to evaluate the efficacy and clinical judgment of nurses for the management of sepsis based on high fidelity clinical simulation. The research was carried out in two stages. In stage I, a methodological study was carried out, with a quantitative approach, consisting of three phases: i) elaboration of the clinical simulation scenario and knowledge test on sepsis; ii) validation of the content by nine judges; and iii) scenario test with nurses . The theoretical framework used was that of meaningful learning. For the construction of the clinical scenario, we chose the Simulation model of the National League for nursing and the content was based on the protocols proposed by the Latin American Sepsis Institute. The analysis of content was given by the Content Validity Index, considering a value> 0.90. In stage II, a quasi-experimental study of the before and after type was performed, consisting of 28 nurses from a teaching hospital. Participants were submitted to three moments of the research: (i) prior to delivery of the study material; (ii) prior to the simulation; and (iii) after the simulation to evaluate clinical judgment, self-efficacy, and knowledge test on sepsis. For the analysis of this step, Spearman correlations and scatter plots were used to compare the relationship of clinical judgment and self-efficacy. The nonparametric Wilcoxon test was used for independent samples and the orthogonal contrasts were applied to compare the times. The results of stage I demonstrated that the instruments were adequate, obtaining general value> 0.90. Nevertheless, some adjustments of the scenario and the test, regarding the clarity of the writing, the functionalities and the pertinence of protocols were changed, according to suggestion of the judges. While in stage II, the mean values at the three times of each outcome were high. The clinical judgment presented a statistically significant difference between the times. The clinical judgment (p = 0.0252) and self-efficacy (p = 0.0269) of the participants in the simulation scenario were statistically higher in relation to the listeners and a strong correlation was found between self-efficacy and clinical judgment (p = 0.001). It is expected that the knowledge test and the clinical simulation scenario on sepsis will be facilitators for teachers and professionals of the permanent / continuing education centers of health institutions in the training of nurses and nursing students. In addition, it is expected that more training with the use of the simulation will be performed with professionals trained for risk-free care, ensuring patient safety.
Pesquisa em consolidação do fechamento de vazios internos em produtos forjados no aço W.Nr. 1.2738 modificado
(Universidade Federal de São Carlos, 2018-11-23) Campos, Gustavo Acarine Ferraz de; Jorge Júnior, Alberto Moreira; https://lattes.cnpq.br/6360362248108490; https://lattes.cnpq.br/4134533370793592
During steel ingot solidification, internal voids are expected to be formed in its interior. Such voids, if they stay in the final product after the forging step, will hurt the performance and properties of the final product, and, therefore, they must be eliminated. Aiming voids elimination, forging process parameters must be chosen in a way possible to allow diffusion bonding. So far, there are no standardized tests to analyze the influence of processing variables. Thus, this work aims to develop a test that physically simulates thermomechanical conditions to subsequently realize tests to determine the conditions of strain and temperature so that the diffusion bonding may occur in steels' molds for polymers. The interface region was analyzed through optical microscopy to determinate the effectiveness of the phenomena of healing voids. The ideal process parameters to a satisfactorily bond were found, and it is intended, in a next step, to implement them in a real process.
A compreensão de pais acerca da importância da participação familiar no cuidado de crianças com transtorno fonológico
(Universidade Federal de São Carlos, 2018-11-23) Fernandes, Delta Regina; Souto, Bernardino Geraldo Alves; https://lattes.cnpq.br/7264826508407685; https://lattes.cnpq.br/1907601156035840
The speech sound disorder (SSD) has a high prevalence among children and it is characterized by mistakes in the production, perception and mental organizations of the sound of speech. Early recognition and appropriate speech intervention reduce the risks of harm, such as difficulties in reading and writing acquisition and development, as well as the emotional, social and cognitive shortfalls in children. Considering that active family involvement is indispensable to therapeutic efficiency, this research aim is to understand parents' and caregivers’ perceptions of children in speech treatment regarding the importance of family involvement in the process of care. Through a clinical qualitative study, thirteen parents and caregivers were interviewed, and their speech was subjected to the analysis of its thematic content. The findings were interpreted regarding the Humanization in Health Care, Patient-centered Care and Family-centered Care. It was found that the subjects had SSD awareness and waited for the phonological reorganization of the language and its secondary gains. Family participation in the caring process was recorded through its attendance during the clinical sessions and the achievement of procedures assigned by the speech and language therapists to be done at home. Some of the families regarded their involvement as important and participated actively. Others, nonetheless, reinforced that contextual and personal problems made their involvement in the therapeutic project outside of the ambulatory scenario difficult. There were also, families who did not understand the need for their involvement and focused their critics on the assistance. Therefore, it is important that the practitioner regards the singularity of the SSD, with its meanings and repercussions for children, their caregivers, and family in the therapeutic project, to go beyond the reorganization of the phonological aspects of the language. Speech and language therapists need to understand the sufferings the SSD cause both children and their caregivers as well as the possibility of the increase of these sufferings due to expectations not yet fulfilled during treatment.
Produção e caracterização de mantas de nanofibras poliméricas eletrofiadas contendo proantocianidinas e sua potencial aplicação no tratamento de lesões cutâneas
(Universidade Federal de São Carlos, 2018-11-23) Locilento, Danilo André; Corrêa, Daniel Souza; https://lattes.cnpq.br/0461451015026948; https://lattes.cnpq.br/6340423945262697
The development of novel biodegradable and biocompatible nanofibrous membranes are highly desirable for biomedical applications, including drug delivery and wound dressing. Thus, the present thesis focused on the development using electrospinning technique of biodegradable and biocompatible nanofibrous membranes with antioxidant properties through the encapsulation of natural antioxidants. The membranes were obtained using the polylactic acid (PLA), polyethylene oxide (PEO) and Aloe Vera extract (ALOE) as a matrix, with the addition of grape seed extract (GSE), which is a rich source of natural antioxidants. The membranes compositions and morphological characteristics were optimized to obtain homogeneous nanofibers displaying hydrophilicity. Specifically, nanofibers mats of PLA, PLA/PEO e PLA/ALOE without and with GSE (10% and 20%) were characterized in terms of composition, morphology and biocompatibility, which presented uniform morphology, random orientation and diameters in the range 149 - 306 nm. The PLA/PEO nanofibers presented hydrophilic feature, while the other nanofiber mats presented hydrophobic feature. The PLA, PLA/PEO and PLA/ALOE nanofibers showed high encapsulation efficiency, with a percentage close to 90%. The antioxidant action of GSE was also determined confirming the high antioxidant capacity of GSE even after the electrospinning process. Experimental data obtained by the in vitro release studies showed that GSE is released by diffusional transport, corresponding satisfactorily to the Korsmeyer-Pepas model. In addition, a more controlled release of GSE was observed for the PLA/PEO/GSE and PLA/ALOE/GSE membrane. The viability of human fibroblast growth (HFF1) was also evaluated, confirming the biocompatibility of all the obtained membranes, especially the PLA/PEO membrane with GSE, which presented better cell attachment and proliferation when compared to PLA/GSE and PLA/ALOE/GSE membranes. Thus, the results indicate the high potential of membranes loaded with GSE for topical drug-delivery system as wound dressing.