Programa de inserção profissional para equipes de enfermagem de um hospital do interior paulista / Professional insertion program for the nursing team of a hospital in the interior of São Paulo

Os programas de inserção profissional são essenciais para a melhor adaptação dos trabalhadores recém contratados em hospitais e facilitam seu desenvolvimento e integração. Este estudo objetivou analisar um Programa de Inserção Profissional para Enfermeiros, Técnicos e Auxiliares de Enfermagem de um hospital no interior do estado de São Paulo e elaborar estrutura de um website educativo com conteúdos que norteiam a prática laboral da equipe de enfermagem recém contratada. Trata-se de um estudo descritivo, metodológico e de abordagem quantitativa, sendo a coleta de dados realizada no último trimestre de 2020. Os critérios de inclusão estabelecidos foram o trabalhador ter participado do Programa, estar regularmente contratado no hospital e fora do período de experiência e estar apto para a realização de suas funções. Utilizou-se dois instrumentos; o primeiro foi o de caracterização sociodemográfica e laboral e o segundo foi o Impacto do Treinamento no Trabalho. As análises estatísticas foram apresentadas por meio de frequências absolutas e relativas para as variáveis qualitativas e média, desvio padrão, mediana, mínimo e máximo para as quantitativas. A associação entre a resposta média para cada questão do instrumento Impacto do Treinamento no Trabalho e as características dos trabalhadores foi verificada por meio dos testes Man-Whitney e Kruskal-Wallis. As análises foram realizadas no software IBM-SPSS v.21.0 e o nível de significância adotado foi de 5%. Participaram deste estudo 104 trabalhadores, sendo 78 técnicos de enfermagem (75%), 22 enfermeiros (21,2%) e quatro auxiliares de enfermagem (3,8%); 62 (59,8%) eram formados de um a nove anos, 80 (76,5%) não trabalharam anteriormente no hospital em estudo e 56 (53,8%) não possuíam outros vínculos empregatícios. A idade média dos trabalhadores foi 32 anos, 84 (80,8%) eram do sexo feminino, 46 (44,2%) solteiros, 102 (98,1%) tinham filhos e dentre os que possuíam filhos, 89 (85,6%) tinham de um a dois filhos. Em relação a renda mensal, 62 (59,6%) recebiam de um a dois salários mínimos (R$ 1.045,00 a R$ 2.090,00), 56 (54,2%) se declararam católicos, 52 (50%) eram brancos e 70 (67,3%) residiam na mesma cidade em que o hospital se localiza. Quanto ao tempo de participação no Programa de Inserção, 48 (46,2%) dos pesquisados haviam participado dele há menos de um mês da data de coleta de dados. Em relação ao impacto do treinamento no trabalho, verificou-se que as médias se mantiveram entre 4,1 e 4,7 retratando bons índices de concordância, quando comparadas a outros estudos descritos na literatura e não verificou-se associações entre os dados sociodemográficos e laborais e o impacto do treinamento no trabalho. No que se refere ao desempenho dos trabalhadores no ambiente de trabalho, o programa em questão foi considerado satisfatório. Contudo, nas questões referentes às atitudes dos trabalhadores no ambiente de trabalho, observou-se a necessidade de otimizar a autoconfiança destes profissionais. A análise do impacto dos treinamentos realizados no ambiente laboral pode estabelecer subsídios para intervenções que promovam melhorias contínuas na qualidade e segurança dos serviços prestados pela equipe de enfermagem nos ambientes hospitalares, visando os trabalhadores, os usuários do Serviço e a instituição

Professional insertion programs are essential for the better adaptation of newly hired workers in hospitals and facilitate their development and integration. This study aimed to analyze a Professional Insertion Program for Nurses, Technicians and Nursing Assistants of a hospital in the state of São Paulo and to develop a structure of an educational website with contents that guide the work practice of the newly hired nursing team. It is a descriptive, methodological and quantitative study, and data collection was performed in the last quarter of 2020. The inclusion criteria established were the worker having participated in the Program, being regularly hired in the company outside the period of experience and being able to perform his/her duties. Two instruments were used; the first was the socio-demographic and labor characterization and the second was the Impact of Training at Work. Statistical analyses were presented by means of absolute and relative frequencies for the qualitative and mean variables, standard deviation, median, minimum and maximum for quantitative variables. The association between the mean answer for each question of the Work Training Impact instrument and the characteristics of the workers was verified using the Man-Whitney and Kruskal-Wallis tests. The analyses were performed in the IBM-SPSS v.21.0 software and the level of significance adopted was 5%. This study included 104 workers, 78 (75%) nursing technicians, 22 (21.2%) nurses and four (3.8%) nursing assistants; 62 (59.8%) had been in the form for one to nine years, 80 (76.5%) did not previously work at the hospital under study and 56 (53.8%) had no other employment ties. The average age of the workers was 32 years, 84 (80.8%) were female, 46 (44.2%) were single, 102 (98.1%) had children and among those who had children, 89 (85.6%) had one to two children. Regarding monthly income, 62 (59.6%) received one to two minimum wages (R$ 1,045.00 to R$ 2,090.00), 56 (54.2%) declared themselves Catholic, 52 (50%) were white and 70 (67.3%) lived in the same city where the hospital is located. Regarding the time of participation in the Insertion Program, 48 (46.2%) of the surveyed had participated in it less than one month from the date of data collection. Regarding the impact of training at work, it was found that the means remained between 4.1 and 4.7 portraying good concordance indices, when compared to other studies described in the literature and in the associations of sociodemographic and work data and the impact of training at work. As regards the performance of workers in the work environment, the programme in question was considered satisfactory. However, in the questions related to the attitudes of workers in the work environment, it was observed the need to optimize the self-confidence of these professionals. The analysis of the impact of training performed on the work environment can establish subsidies for interventions that promote continuous improvements in the quality and safety of the services provided by the nursing team in hospital environments, aiming at workers, users of the Service and the institution

Influência das relações familiares na saúde e no estado emocional dos adolescentes / Influence of family relations on the health and emotional state of adolescents / Influencia de las relaciones familiares sobre la salud y el estado emocional de los adolescentes

A saúde dos adolescentes pode sofrer a influência de diferentes fatores, incluindo as relações familiares. Neste estudo, o objetivo foi verificar quais dimensões das relações familiares podem predizer o bem-estar durante a adolescência. Participaram 203 adolescentes, entre 12 e 18 anos, de escolas públicas de Santo Antônio de Jesus, Bahia. Os instrumentos utilizados foram: Inventário Beck de Depressão; Questionário de Saúde Geral de Goldberg; Inventário de Autoavaliação para Jovens; Familiograma; e Inventário do Clima Familiar. Para análise de dados, utilizaram-se estatística descritiva, comparação de grupos e análise de regressão múltipla. Os resultados demonstraram maior influência das dimensões conflito e baixa afetividade como variáveis que contribuem para a presença de sintomas depressivos, baixos escores de saúde geral e maiores escores de problemas de comportamento. Conclui-se que, para o bem-estar dos adolescentes, a família deverá ser incluída nas estratégias de avaliação e intervenção em saúde.

Adolescent health might be influenced by different factors, including family relationships. In this study, the objective was to verify which dimensions of family relationships might predict well-being during adolescence. The participants of the study were 203 adolescents, between 12 and 18 years, of public schools in Santo Antônio de Jesus, Bahia. The instruments used were: Beck Inventory of Depression; Goldberg General Health Questionnaire; Self-Assessment Inventory for Young People; Familiogram; and Family Climate Inventory. For data analysis, descriptive statistics, group comparison, and multiple regression analysis were used. The results showed a greater influence of conflict dimensions and low affectivity as variables that contribute to the presence of depressive symptoms, low general health scores, and higher scores of behavioral problems. It is concluded that, for the adolescents' well-being, the family should be included in health assessment and intervention strategies.

La salud del adolescente puede verse influenciada por diferentes factores, incluidas las relaciones familiares. En este estudio, el objetivo era verificar qué dimensiones de las relaciones familiares pueden predecir el bienestar durante la adolescencia. Participaron 203 adolescentes, entre 12 y 18 años, de escuelas de Santo Antônio de Jesus, Bahia. Los instrumentos: Inventario Beck de Depresión; Cuestionario de Salud General de Goldberg; Autoevaluación para Jóvenes; Familiograma; e Inventario del Clima Familiar. Para el análisis de datos, se utilizó estadística descriptiva, comparación de grupos y regresión múltiple. Los resultados demostraron mayor influencia de las dimensiones conflicto y baja afectividad como variables que contribuyen a la presencia de síntomas depresivos, bajos escores de salud general y mayores escores de problemas de comportamiento. Se concluye que, para el bienestar de los adolescentes, la familia deberá ser incluida en las estrategias de evaluación y intervención en salud.

Current applications and different approaches for microbial L-asparaginase production

ABSTRACT L-asparaginase (EC 3.5.1.1) is an enzyme that catalysis mainly the asparagine hydrolysis in L-aspartic acid and ammonium. This enzyme is presented in different organisms, such as microorganisms, vegetal, and some animals, including certain rodent's serum, but not unveiled in humans. It can be used as important chemotherapeutic agent for the treatment of a variety of lymphoproliferative disorders and lymphomas (particularly acute lymphoblastic leukemia (ALL) and Hodgkin's lymphoma), and has been a pivotal agent in chemotherapy protocols from around 30 years. Also, other important application is in food industry, by using the properties of this enzyme to reduce acrylamide levels in commercial fried foods, maintaining their characteristics (color, flavor, texture, security, etc.) Actually, L-asparaginase catalyzes the hydrolysis of L-asparagine, not allowing the reaction of reducing sugars with this aminoacid for the generation of acrylamide. Currently, production of L-asparaginase is mainly based in biotechnological production by using some bacteria. However, industrial production also needs research work aiming to obtain better production yields, as well as novel process by applying different microorganisms to increase the range of applications of the produced enzyme. Within this context, this mini-review presents L-asparaginase applications, production by different microorganisms and some limitations, current investigations, as well as some challenges to be achieved for profitable industrial production.

Current applications and different approaches for microbial L-asparaginase production

ABSTRACT L-asparaginase (EC 3.5.1.1) is an enzyme that catalysis mainly the asparagine hydrolysis in L-aspartic acid and ammonium. This enzyme is presented in different organisms, such as microorganisms, vegetal, and some animals, including certain rodent's serum, but not unveiled in humans. It can be used as important chemotherapeutic agent for the treatment of a variety of lymphoproliferative disorders and lymphomas (particularly acute lymphoblastic leukemia (ALL) and Hodgkin's lymphoma), and has been a pivotal agent in chemotherapy protocols from around 30 years. Also, other important application is in food industry, by using the properties of this enzyme to reduce acrylamide levels in commercial fried foods, maintaining their characteristics (color, flavor, texture, security, etc.) Actually, L-asparaginase catalyzes the hydrolysis of L-asparagine, not allowing the reaction of reducing sugars with this aminoacid for the generation of acrylamide. Currently, production of L-asparaginase is mainly based in biotechnological production by using some bacteria. However, industrial production also needs research work aiming to obtain better production yields, as well as novel process by applying different microorganisms to increase the range of applications of the produced enzyme. Within this context, this mini-review presents L-asparaginase applications, production by different microorganisms and some limitations, current investigations, as well as some challenges to be achieved for profitable industrial production.

Potenciais interações medicamentosas identificadas em prescrições a pacientes hipertensos / Potential drug interactions identified in prescriptions to hypertensive patients

JUSTIFICATIVA E OBJETIVOS: A hipertensão arterial (HA) é uma disfunção crônica com alta prevalência entre a população brasileira e mundial. A resposta terapêutica depende, na maioria dos casos, de politerapia o que propicia interações que podem impedir os benefícios do tratamento ou ainda causar sérios riscos à saúde dos pacientes. O objetivo deste estudo foi apresentar dados epidemiológicos descritivos acerca das interações medicamentosas presentes em prescrições, no sentido de apontar os potenciais riscos à saúde dos pacientes atendidos em centro médico público em uma cidade do interior do Estado de São Paulo. MÉTODO: Foi avaliada a população (600 pacientes de ambos os gêneros) que recebeu prescrições com, no mínimo, um medicamento anti-hipertensivo, tendo sido adquiridos na farmácia comunitária do Centro Médico "Januário Theodoro de Souza", Pradópolis, SP, entre fevereiro e março de 2009. RESULTADOS: Do total das prescrições, apenas 16,30% se baseou na monoterapia. Ao todo, foram prescritos 1855 medicamentos, ou seja, três medicamentos/paciente, não necessariamente fármacos anti-hipertensivos. Verificou-se 1440 interações, sendo 192 tipos diferentes, com média de 2,4 interações/paciente. Dos fármacos não anti-hipertensivos, os mais prescritos foram ácido acetilsalicílico (24,5%) e dipirona (14,0%). A maioria dos hipertensos foi submetida à politerapia e, portanto, frequentemente expostos às interações, principalmente com anti-inflamatórios não esteroides, o que, dentre outros efeitos adversos, corroboram para o aumento da pressão arterial. CONCLUSÃO: A politerapia anti-hipertensiva, inerente à prescrição, tem potencial para acarretar prejuízos à eficácia e segurança terapêutica (incluindo falta de adesão ao tratamento), devido às elevadas possibilidades de interações negativas.

BACKGROUND AND OBJECTIVES: Hypertension is a chronic disorder with high prevalence among the Brazilian and worldwide population. The therapeutic response depends, in most cases, on the polytherapy, which provides interactions that may avoid the benefits of treatment or cause serious health risks to patients. The aim of this study was to present descriptive epidemiological data about drug interactions in the prescriptions, in order to point out potential risks to the health of patients treated in a Public Medical Center in a cityin the São Paulo state. METHOD: It was evaluated the population (600 patients of both genders) who received prescriptions containing, at least one, antihypertensive medication, which were acquired in the community pharmacy of the Medical Center "Januário Theodoro de Souza," Pradópolis, SP, between February and March/2009. RESULTS: Of the total prescriptions, only 16.3% were based on monotherapy. A total of 1855 drug prescriptions were recorded considering antihypertensive and other drugs, an average of three drugs per patient. There were 1440 drug interactions of 192 different types, with an average of 2.4 interactions per patient. Considering the non-antihypertensive drugs the most prescribed were acetylsalicylic acid (24.5%) and dipyrone (14.0%). Most hypertensive patients underwent polytherapy and therefore were frequently exposed to interactions, particularlyof antihypertensive with steroidal anti-inflammatory drugs, which, amongst other adverse effects, corroborate to increase blood pressure. CONCLUSION: The antihypertensive polytherapy, inherent in the prescription for treating this disorder, is potentially harmful to the efficacy and safety (including lack of adherence to treatment), due to high chances of negative interactions.

Planejamento familiar na perspectiva do desenvolvimento / Family planning under the view of development

O presente ensaio tem como objetivo analisar criticamente as limitações atuais do planejamento familiar aplicado na saúde pública e propor mudanças considerando o modelo das ciências sociais aplicadas à saúde e a perspectiva do desenvolvimento familiar. A proposta deste trabalho surgiu do elevado número de mulheres que solicitara o auxílio maternidade na região do Recôncavo da Bahia no ano de 2006. Através da análise das variáveis e dos métodos envolvidos no planejamento familiar, foi possível verificar as seguintes falhas: responsabilidade e participação exclusiva das mulheres, foco no indivíduo, o número de filhos como principal meta do planejamento, modelo biológico, desconsideração dos aspectos socioculturais. Neste ensaio, apresentamos a proposta de planejamento familiar na perspectiva do desenvolvimento, que será testada como modelo de intervenção em um estudo futuro.

The present essay has as objective to critically analyze the current limitations of the family planning applied in public health and to consider changes considering the model of social sciences applied to health and the perspective of the family development. The proposal of this work appeared because of the high number of women who requested maternity assistance in the region of the Recôncavo of Bahia in the year of 2006. By analyzing the variables and methods involved in the family planning, it was possible to verify the following fault: responsibility and exclusive participation of the women, focus in the individual, the number of children as main goal of the planning, biological model, disrespect of the cultural aspects of the partner. In this essay we present the proposal of family planning of the perspective of the development that will be tested as a model of intervention in a future study.