bluuebunny/crossref_metadata_2025 huggingface dataset:
Perfil de Competência em Genética para Médicos do Brasil: uma Proposta da Sociedade Brasileira de Genética Médica e Genômica
Authors: Melo Débora Gusmão , Silva André Anjos da , Husny Antonette Souto El , Ferraz Victor Evangelista de Faria
Published: January 2020

ABSTRACT Training in genetics is fundamental to understanding the biological aspects of the health-disease binomial. Moreover, with the change in the epidemiological profile, genetically determined disorders have become more relevant as a public health concern. Thus, managing these disorders in an ethical and diligent manner, both in patients and in their families, and considering the logic and policies of the Brazilian Unified Health System (SUS), has become a desirable competency for all physicians, impacting on their undergraduate training. Viewing this issue as relevant, the Brazilian Society of Medical Genetics and Genomics (SBGM) defined the desirable competencies in genetics for Brazilian physicians, tied to the public policies related to medical genetics in Brazil. This paper is a theoretical essay that aims to contextualize and present the competency profile in Genetics for physicians proposed by the SBGM. The proficiency profile, presented and discussed in this essay, was structured based on four essential competencies: (1) to recognise the necessity for continuing education, regularly examining one’s own clinical competency, identifying learning gaps and the advances of genetics and of genomics over time; (2) to identify individuals that present or can develop a genetic disorder and know how and when to refer the patient to a specialist in medical genetics; (3) to manage patients with previously diagnosed genetic disorders and/or birth defects, employing established clinical guidelines in the scope of their professional role; and (4) to promote and stimulate clinical and education practices aimed at preventing genetic disorders and birth defects. The knowledge, skills and attitudes required for attaining these four competencies were identified. Therefore, a competency-based theoretical reference is presented to support the teaching of genetics during medical training. It is proposed that this essential competency profile in genetics should be adopted in all Brazilian medical schools with the purpose of training physicians better prepared for the current demands of the SUS. Furthermore, this competency profile can support continuing professional education actions in the area of Genetics, in order to qualify SUS staff in relation to genetic disorders and birth defects.
Social Accountability of Medical Schools and Social Representations of Medical Students in the Context of the More Doctors Program
Authors: Oliveira Felipe Proenço de , Santos Leonor Maria Pacheco , Shimizu Helena Eri
Published: January 2020

ABSTRACT Several debates, in the national and international context, have suggested the need for changes in medical education, so that it is in line with the organization of health systems. From this perspective, it is proposed that schools be guided by social accountability, which consists of ordering teaching, research and activities in service to meet health needs with a focus on areas that are difficult to reach. A more recent reference in medical education at the national level was the More Doctors Program, which provided for a new regulatory framework for medical education. It is evaluated that the modifications introduced by the Program can influence the elaboration of new social representations of medical students. Through the theory of social representations, a qualitative study was carried out to analyze the perception about the social accountability of the medical schools of 149 medical students, of the seventh semester of four courses of Federal Higher Education Institutions in the Northeast Region. Two of the courses are in the interior and were created by virtue of the More Doctors Program and another two correspond to courses in the state capital existing for more than 60 years. From the curriculum analysis of each course, they were termed “traditional” or “new”. In the results, it was observed that the students of the different courses resemble each other in terms of admission by quotas, but students of “new” courses have a greater entrance under affirmative action policies, including regional access criteria. Both groups of students have emphasized the term “duty” as a priority, which may refer to a more individual scope of the notion of accountability. The terms “citizenship” and “ethics” were also highlighted in both groups. Only for students in “new” schools were terms such as “commitment”, “justice” and “SUS” cited. This insight suggests a broader notion of social accountability in school students created under the More Doctors Program, despite insufficient national literature on this topic. The conclusion emphasizes the importance of the Program in the implantation of medical schools in regions that did not previously have this training. It also reinforces the relevance of the dedication of the teachers who implemented the courses in the interior of the Northeast, demonstrating the need to deepen in the themes that involve teacher development. It is suggested that there is a need to broaden the analysis of experiences such as these, so that they can be explored with the radicalism necessary to strengthen the Unified Health System.
O Ensino de Gestão de Antimicrobianos em Escola Médica do Rio de Janeiro
Authors: Silva André Ricardo Araujo da , Almeida Igor Melo de , Sacre Rafael Carvalho , Souza Cristina Letícia Passos de
Published: January 2020

RESUMO Introdução Programas de gestão de antimicrobianos (PGA) são ferramentas importantes para minimizar o problema global da resistência antimicrobiana. As bases destes programas devem começar idealmente na graduação médica. Objetivo Identificar a apresentação dos conceitos dos PGA no currículo de uma escola médica. Material e métodos Estudo transversal realizado com docentes da Universidade Federal Fluminense (UFF). O critério de inclusão utilizado foi ministrar conteúdos relativos a PGA para o curso de Medicina. Foram mensurados apresentação de componentes-chave dos PGA, carga horária destinada, metodologias de ensino e avaliações empregadas. Resultados Estudo realizado entre dezembro de 2017 e janeiro de 2018, sendo incluídos 6 dos 329 (1,8%) docentes que ministravam aulas para o curso de Medicina. A carga horária destinada à apresentação dos PGA totalizou 83 horas, com mediana de 3 h/docente, o que correspondeu a 1,1% da carga horária total do curso inteiro. Cinco dos seis professores (83,3%) apresentaram pelo menos um dos componentes-chave dos PGA. A frequência de apresentação dos componentes-chave dos PGA foi de: especificidade do tratamento (5/6 - 83,3%), duração do tratamento (4/6 - 66,7%), otimização do tempo de administração (4/6 - 66,7%), possibilidade de troca de via de administração (3/6 - 50%) e monitorização de níveis séricos (2/6 - 33,3%). Quatro dos seis docentes (66,7%) utilizaram combinações de metodologia de ensino, as quais foram reportadas nas seguintes frequências: aulas tradicionais (5/6 - 83,3%), estudos de casos clínicos (4/6 - 66,7%) e aprendizado baseado em problemas (4/6 - 66,7%). Cinquenta por cento dos docentes utilizaram combinações de avaliações para assimilação do conteúdo, e as mais utilizadas foram: respostas dissertativas curtas (3/6), casos clínicos (2/6), perguntas de múltipla escolha (2/6), resumos clínicos (1/6), seminários (1/6) e respostas dissertativas longas (1/6). Conclusões Verificamos que os componentes-chave relativos aos PGA foram apresentados em uma escola médica do Rio de Janeiro, sendo a combinação de diferentes metodologias de ensino a principal estratégia para transmissão dos conceitos. Metade dos docentes utilizou combinação de avaliações para mensurar o conteúdo apresentado. Há necessidade de ajustes para que aspectos importantes, como troca de via de administração e monitorização de níveis séricos, sejam mais debatidos na graduação.
Classificação dos Grupos de Interesse Especial (SIGs) da Rede Universitária de Telemedicina (Rute) em Grupos Homogêneos com base em Sua Produção em Comunicação, Cooperação e Coordenação (3C)
Authors: Brito Thiago Delevidove de Lima Verde , Lopes Paulo , Meireles Luan , Moraes Max , Messina Luiz , Haddad Ana Estela , Pisa Ivan Torres
Published: January 2020

RESUMO Introdução A Rede Universitária de Telemedicina (Rute) é uma iniciativa que visa, no Brasil, promover a integração em telemedicina e telessaúde de hospitais universitários, hospitais certificados de ensino, faculdades de Medicina e profissionais da área da saúde por meio de infraestrutura de tecnologia da informação e comunicação e dos grupos de interesse especial (SIGs). Nesses grupos, que são criados e coordenados por instituições integrantes da Rute, profissionais de saúde e pesquisadores planejam uma agenda de videoconferências e/ou webconferências para debater temas específicos. Este artigo apresenta resultados da classificação dos SIGs da Rute em grupos homogêneos com base em sua produção em comunicação, cooperação e coordenação (3C). Métodos Foi realizado um inquérito com coordenadores dos SIGs entre abril e maio de 2016. A classificação dos SIGs em grupos homogêneos considerou as atividades desenvolvidas na rede entre 2007 e o momento da aplicação do inquérito. O estudo é retrospectivo, baseado em dados históricos das unidades, instituições e SIGs. Os coordenadores de 71 SIGs Rute foram convidados a responder. Desses, 45 SIGs ativos responderam ao inquérito de avaliação por completo e foram considerados nas análises. Resultados Quase um terço dos coordenadores respondentes (35%) declarou que seus SIGs atuam no eixo ensino, 21% atuam nos eixos de assistência e pesquisa, desenvolvimento e inovação, enquanto 12% atuam em gestão e 11% em avaliação. Foi feita a classificação dos SIGs em três grupos homogêneos – colaboração emergente, colaboração em desenvolvimento e colaboração plena – e identificado que, fora das sessões, 71% dos 45 SIGs (11 do grupo colaboração emergente e 20 do grupo em desenvolvimento) usam correio eletrônico como principal ferramenta de comunicação. Quatro SIGs do grupo colaboração plena indicaram: uso de serviço de mensagens instantâneas (1 SIG), site próprio (1 SIG) e redes sociais (2 SIGs). Conclusão Os resultados deste estudo podem não aferir com precisão a real produção e colaboração que os SIGs desenvolvem. Sugere-se, portanto, apreciar esta análise como um ponto de partida ou um referencial para a comunidade Rute. Porém, os resultados indicam que o desenvolvimento da colaboração na Rute e nos SIGs verificado nas análises é significativo, apontando uma evolução positiva para a Rute quanto ao interesse, participação e divulgação de ações em telemedicina e telessaúde no País.
“Nunca Me Falaram sobre Isso!”: o Ensino das Sexualidades na Perspectiva de Estudantes de uma Escola Federal de Medicina
Authors: Val Alexandre Costa , Mesquita Leonardo Mendes , Rocha Vinícius de Abreu , Cano-Prais Hugo Alejandro , Ribeiro Gustavo Meirelles
Published: January 2020

RESUMO Estudantes e profissionais de saúde se mostram embaraçados ao se depararem com questões relativas às sexualidades de seus pacientes. Diante disso, não é incomum o estabelecimento de uma relação superficial, erros no diagnóstico e a impossibilidade de condução do tratamento. Pesquisas indicam que essa dificuldade decorre de uma formação inadequada dos profissionais, especialmente no que diz respeito ao cuidado de grupos vulneráveis, cujas experiências extrapolam os marcos heteronormativos hegemônicos que delimitam o campo sexual. No Brasil, poucos estudos buscaram compreender como esse assunto é tratado no ensino médico. Esta investigação se debruçou sobre essa questão e teve como objetivo conhecer, na perspectiva de estudantes de uma escola federal de Medicina, como os aspectos relacionados às sexualidades e aos gêneros são abordados em suas graduações. Trata-se de uma pesquisa qualitativa em que foram realizadas entrevistas semiestruturadas com 15 estudantes do último ano do curso. As falas foram gravadas, transcritas e examinadas por meio da análise de conteúdo. O diálogo entre as categorias empíricas que se sedimentaram ao longo da investigação e a literatura revelaram dificuldades dos alunos em lidar com um tema que não pode ser completamente apreendido por um saber técnico e operacional. A ideia de que não se fala sobre o assunto no curso de Medicina contribui para velar o fato de que se fala (e se fala muito) sobre tais questões. A abordagem, no entanto, se dá por um viés organicista, que contribui para a manutenção da crença em categorias binárias, naturalizadas e essencializadas, que reforçam as normas que regulam o campo da sexualidade. Apostando no protagonismo de todos aqueles envolvidos no ensino médico, discute-se, finalmente, a necessidade de alterações qualitativas no currículo que possibilitem a construção de novas formas de conhecimento e de atuação. Formas que, valorizando experiências, saberes e práticas pedagógicas diversas, possam romper com as dicotomias e com as hierarquias hegemônicas, transformando positivamente a realidade social.
Profissionalismo na Formação do Especialista Médico: Revisão Integrativa da Literatura
Authors: Feitosa Elaine Saraiva , Brilhante Aline Veras Morais , Cunha Sílvia de Melo , Sá Rejane Brasil , Nunes Rogevando Rodrigues , Carneiro Mariana Aroucha , Santos Zélia Maria de Sousa Araújo , Catrib Ana Maria Fontenelle
Published: January 2020

ABSTRACT Introduction The construct professionalism is increasingly being recognized as an important component of medical education; fundamental to the physician’s role in society Objective: To group in a concise and systemized way the information available in scientific productions on the concept of medical professionalism and its applications in medical residency programs. Methods A total of 85 articles were found in 2018, of which 13 were excluded for duplication using the Mendeley platform. Of the 72 remaining articles, 35 were excluded for not answering the research question. Of the 37 articles selected for reading of the abstract, eight were not available, leaving 29 articles. After reading all articles for the final selection, 11 articles were excluded. Six papers did not fulfill the goals of the research, and five were opinion articles. Results The production included 18 articles, from which analysis emerged three thematic categories: (a) professionalism: multidimensional construct; (b) teaching of professionalism: role modeling and the curriculum; (c) evaluation of professionalism: multiple strategies in the curriculum. The most frequently cited domains were: altruism, responsibility, care, teamwork, self-control, ethical principles and clinic excellence. Ten articles highlighted the importance of role modeling by preceptors and members of the health team in the Medical Residency Program for teaching professionalism. Regarding the most commonly used strategies for the selection, feedback practices and the OSCE were highlighted in scenarios to evaluate the domains of professionalism. Conclusion Professionalism is a dynamic construct that is worked on in the form of teaching and assessment in Medical Residency Programs. There is no consensus on the professionalism concept, and thus, multiple strategies are used for the teaching, among which role modeling can be highlighted. The teaching of medical professionalism, as a construct, in the training of specialists can reduce lapses and foster assistance based on respect for the autonomy of people and social responsibility.
Facebook® como Ferramenta Pedagógica em Saúde Coletiva: Integrando Formação Médica e Educação em Saúde
Authors: Bernardes Viviane Pereira , Dias Lineker Fernandes , Pereira Monique Arantes , Fernandes Maria Eduarda , Raimondi Gustavo Antonio , Paulino Danilo Borges
Published: January 2020

RESUMO As mídias sociais conquistaram significativa importância na vida dos jovens contemporâneos, tanto no âmbito pessoal – para informação, divertimento – quanto no coletivo – para se projetarem como seres sociais e compartilharem informações com várias pessoas quase que instantaneamente. Diante disso, docentes da unidade curricular Saúde Coletiva III do curso de Medicina em uma universidade pública de Minas Gerais perceberam a influência do Facebook® na vida dos discentes e utilizaram-no para atingir objetivos de aprendizagem de conceitos e aplicações práticas de promoção em saúde e prevenção de agravos com a comunidade. A experiência foi conduzida durante dois semestres letivos consecutivos, por duas diferentes turmas do curso. Foi criada uma página do Facebook® com a finalidade de promover a saúde da população por meio de postagens criativas, críticas e acessíveis. Os acadêmicos tornaram-se protagonistas da atividade, uma vez que a escolha das temáticas, a busca ativa por fontes científicas de qualidade, a responsabilidade por cada postagem e o gerenciamento da página foram atribuídos a eles, sendo supervisionados pelos docentes. Obteve-se a interação com a comunidade para além da acadêmica, já que a página foi divulgada para atingir a população como um todo, contribuindo para a educação em saúde e consequentemente para a autonomia do cuidado pelos indivíduos. Dessa forma, as postagens dos discentes alcançaram muitos cidadãos, os quais, além de acessarem informações relevantes sobre saúde, podiam tirar dúvidas e fazer comentários sobre o tema. Portanto, a vivência permitiu o desenvolvimento de competências como Comunicação, Liderança, Atenção à Saúde e Administração e Gerenciamento, preconizadas nas Diretrizes Curriculares Nacionais. Entretanto, existem algumas limitações, como a necessidade de acesso à internet e a smartphones. À luz da vivência, pôde-se concluir que o uso de mídias sociais no curso de Medicina é uma forma efetiva de desenvolvimento de competências e de ampliação e consolidação do conhecimento, sendo os acadêmicos sujeitos fundamentais nesse processo, uma vez que a participação ativa deles é requisitada. Dessa forma, é proposta a replicação dessa experiência em outros ambientes de ensino-aprendizagem em Saúde, não somente pelo curso de Medicina, especialmente com utilização desse recurso pela Atenção Básica, favorecendo a formação de profissionais mais comprometidos com o cuidado integrado da população, em consonância com os princípios do Sistema Único de Saúde (SUS).
SYSTEMATIC REVIEW OF THE LITERATURE ON SURGICAL TREATMENT OF CHRONIC RHINOSINUSITIS IN CHILDREN: WHAT IS THE BEST APPROACH?
Authors: Vasco Camila Taniguti Cordeiro , Morais Heloisa Carvalho de , Avelino Melissa Ameloti Gomes
Published: January 2020

ABSTRACT Objective: To carry out a systematic literature review on the surgical treatment of chronic rhinosinusitis in the pediatric population. Data sources: A bibliographic review methodology was used, based on data from National Library of Medicine (Medline), PubMed, Latin American and Caribbean Health Sciences Literature (LILACS) and Scientific Electronic Library Online (SciELO), of the indexed works from 2006 to 2016, including the pediatric population from zero to 13 years of age. The search keywords according to Medical Subject Heading (MESH) and Health Sciences Descriptors (DeCS) were: child, surgery, sinusitis and chronic disease. A total of 318 articles were collected, five of which met the inclusion criteria and were used as a basis for this review. All articles were prospective cohort studies, level of evidence 2B, according to the criterion used by evidence-based medicine. Data synthesis: The literature agreed that the next step for the cases refractory to drug treatment in chronic rhinosinusitis in childhood would be surgery. Adenoidectomy would be the initial method, for the safety of the procedure and improvement in about 50% of the cases, although more significant results were found in patients who associated this procedure with facial sinus surgery. Conclusions: Surgical treatment should be indicated for chronic rhinosinusitis in childhood after treatment failure. The results pointed out that adenoidectomy, when associated with some type of approach to the facial sinus, present better results.
THE IMPACT OF SMALL INTESTINAL BACTERIAL OVERGROWTH ON THE GROWTH OF CHILDREN AND ADOLESCENTS
Authors: Santos Alexandre Neves da Rocha , Soares Ana Cristina Fontenele , Oliveira Ricardo Palmero , Morais Mauro Batista de
Published: January 2020

ABSTRACT Objective: To evaluate the association between small intestinal bacterial overgrowth (SIBO) and weight and height impairment in children and adolescents with gastroenterology diseases. Methods: Observational and retrospective study. All 162 patients aged less than 19 years old who underwent breath test in search of SIBO between 2011 and 2016 were studied. Breath test was collected after the intake of 10 grams of lactulose. The concentration of hydrogen and methane was measured for 180 minutes after the beginning of the test by 12i QuinTronMicroLyzer device. Results: SIBO was identified in 51 (31.5%) patients. There was no difference between the age of those with (mean=8.7y.o; 25th and 75th percentile: 4.6 and 11.3) and without (mean=7.9y.o 25th and 75th percentile: 4.8 and 12.2) SIBO (p=0.910). There was no association between gender and SIBO (male 26.3% vs. female 36.3%, p=1.00). A lower median of height-for-age Z score (mean=-1.32; 25th and 75th percentile: -2.12 and -0.08 vs. mean=-0.59; 25th and 75th percentile: -1.57 and 0.22; p=0.04) was demonstrated in children with SIBO when compared with children without it. There was no difference between the BMI-for-age Z score of patients with (mean=-0.48) and without SIBO (mean=-0.06) (p=0.106). The BMI of patients with SIBO (median=15.39) was lower than of those without it (median=16.06); however, the statistical analysis was not significant (p=0.052). The weight-for-age Z score was lower in patients with SIBO (mean=-0.96) than in those without SIBO (mean=-0.22) (p=0.02) Conclusions: Children and adolescents with SBIO associated with diseases of the gastrointestinal tract have lower weight and height values.
ASSESSMENT OF THE QUALITY OF PEDIATRIC CARDIOPULMONARY RESUSCITATION USING THE IN SITU MOCK CODE TOOL
Authors: Kuzma Gabriela de Sio Puetter , Hirsch Camila Bellettini , Nau Angélica Luciana , Rodrigues Analiz Marchini , Gubert Eduardo Maranhão , Soares Leonardo Cavadas Costa
Published: January 2020

ABSTRACT Objective: To evaluate the quality of individual and team care for cardiac arrest in a pediatric hospital using clinical surprise simulation (in situ mock code). Methods: We conducted an observational study with a sample of the hospital staff. Clinical simulations of cardiorespiratory arrest were performed in several sectors and work shifts. The mock code occurred in vacant beds of the sector without previous notification to the teams on call. One researcher conducted all mock codes and another evaluated individual and team attendance through a questionnaire contemplating recommendation for adequate cardiopulmonary resuscitation, based on the Pediatric Advanced Life Support (PALS) guidelines. At the end of the simulations, the research team provided a debriefing to the team tested. Results: Fifteen in situ mock code were performed with 56 nursing professionals (including nurses, nursing residents and technicians) and 11 physicians (including two pediatric residents and four residents of pediatric subspecialties). The evaluation showed that 46.7% of the professionals identified cardiac arrest checking for responsiveness (26.7%) and pulse (46.7%); 91.6% requested cardiac monitoring and venous access. In one case (8.3%) the cardiac compression technique was correct in depth and frequency, while 50% performed cardiopulmonary resuscitation correctly regarding the proportion of compressions and ventilation. According to PALS guidelines, the teams had a good performance in the work dynamics. Conclusions: There was low adherence to the PALS guidelines during cardiac arrest simulations. The quality of cardiopulmonary resuscitation should be improved in many points. We suggest periodical clinical simulations in pediatric services to improve cardiopulmonary resuscitation performance.
SCHISTOSOMAL MYELORADICULOPATHY IN A NON-ENDEMIC AREA
Authors: Oliveira Lívia Souza de , Kuzma Gabriela de Sio Puetter , Costa Luisa Carolina Vinhal , João Paulo Ramos David
Published: January 2020

ABSTRACT Objective: To report a schistosomal myeloradiculopathy case in a non-endemic area. Case description: A previously healthy 11-year-old boy, stricken by an acute loss of strength on his lower limbs, followed by a loss of strength on his upper limbs and upper body, associated with altered sensitivity of the vesical globe formation. The patient’s cerebrospinal fluid analysis showed eosinophilic meningitis, in addition to peripheral eosinophilia. The investigation resulted in a positive serology for Schistosoma mansoni. The treatment included steroids and praziquantel 60mg/kg, with a new dose after a month, as well as physical therapy for rehabilitation. The patient evolved with clinical improvement in the neurological exam, with a medullary section initially at C6, but now at T6. The patient is kept at prednisolone use (30mg/day) and longterm urinary catheter dependence. Comments: The schistosomiasis is endemic in many regions of Brazil; however, it has low incidence in the south of the country. Among its main manifestations, the schistosomal myeloradiculopathy is the most severe ectopic form of the disease, and should be suspected in patients with low back pain, strength and/or sensibility disorder of the lower limbs or urinary tract’s disturbance. Early diagnosis and treatment should be done in order to reduce severe neurological sequelae. Treatment includes schistosomiasis drugs, corticosteroids and/or surgery.
Vulnerabilidade de homens jovens e suas necessidades de saúde
Authors: Martins Elizabeth Rose Costa , Medeiros Andressa da Silva , Oliveira Karoline Lacerda de , Fassarella Letícia Guimarães , Moraes Paula Costa de , Spíndola Thelma
Published: January 2020

RESUMO Objetivos Identificar as condutas de saúde dos homens jovens universitários; conhecer a percepção dos homens jovens universitários sobre o cuidar de sua saúde; e descrever as práticas adotadas para a prevenção das infecções sexualmente transmissíveis. Método Estudo descritivo e exploratório, com abordagem qualitativa, desenvolvido com 25 jovens universitários entre 18-29 anos numa universidade pública do Rio de Janeiro. Para análise dos dados, utilizou-se a técnica de análise de conteúdo. Resultados Os homens jovens universitários percebem o cuidar como feminino, desconhecendo suas próprias particularidades, com a percepção de que não adoecem e, com isso, só procuram o serviço de saúde em situações de emergência. Conclusão e Implicações para a prática Existem desafios a serem vencidos na prática da assistência, como a visão de invulnerabilidade desses homens, a ausência na busca pelos serviços de saúde, o despreparo dos serviços de saúde para atender às necessidades desses jovens, com base em estratégias que contemplem, de forma singular e holística, essa população. As brechas identificadas no estudo permitem levantar futuras questões e provocar mudanças de atitudes voltadas a situações do contexto masculino, a fim de reverter vulnerabilidades ainda existentes e, também, as consequências dessas atitudes na saúde desses homens.
Book review
Authors: Thurlow Phillip G.
Published: January 2020

Chernobyl – History of a Tragedy
Global and local sand–geosynthetic interface behaviour
Authors: Lashkari Ali , Jamali Vahid
Published: January 2020

The influence of overall particle shape, mean particle size, initial relative density and effective normal stress on the global and local soil–geosynthetic interaction is investigated here through an extensive series of direct shear interface tests between six sands in contact with one multifilament woven geotextile, one non-woven geotextile and one geomembrane. Analysis of the soil–geosynthetic data highlights mobilisation of higher peak friction angles with increases in initial relative density and angularity of sand particles and decrease in the effective normal stress. The average frictional efficiencies of the sand–geosynthetic interfaces are 0·95 and 0·79, respectively, for the sand–geotextile and sand–geomembrane interfaces. It is shown that the interface slip increases with the initial relative density of sand and regularity of particles, and decreases with increasing the mean particle size and effective normal stress. Analysis of the local particle movements by means of digital particle image velocimetry revealed that the average thickness of the shear zone for the sand–geosynthetic interfaces tested ranges from 3·8 to 11·9 (with an average of 7·0) times the mean particle size of the contact sand. The experimental data indicate that thicknesses of the shear and dilation zones are almost equal for the sand–geosynthetics interfaces tested.
EVALUASI PENANGANAN IRADIASI BATU TOPAZ PADA OPERASI REAKTOR SIKLUS 94 DAN 95
Authors: Pardi Pardi , Fauzan Banyu Rizki
Published: January 2020

EVALUASI PENANGANAN IRADIASI BATU TOPAZ PADA OPERASI REAKTOR SIKLUS 94 DAN 95. Untuk memaksimalkan penggunaan reaktor RSG-GAS dalam memenuhi kepentingan pihak pengguna antara lain adalah melayani iradiasi target batu topaz saat reaktor operasi. Keandalan operasi reaktor perlu dijaga dan tingkatkan tanpa mengurangi faktor keselamatannya, salah satu keandalan operasi reaktor adalah kemampuan batang kendali pengatur (reg-rod) dalam mengimbangi perubahan reaktivitas di teras reaktor akibat gangguan dari pemasukan/penarikan target iradiasi. Reaktivitas, kecepatan, panjang langkah batang kendali pengatur (reg-rod) dan reaktivitas maksimum pada satu posisi iradiasi < 0,5% ditentukan dalam LAK , untuk penanganan iradiasi target batu topaz nilai reaktivitas sebesar ±0,0741% diperlukan kehati-hatian dengan membuat gerakan pemasukan/penarikan target sambil melihat kanal pemantau daya dan display daya digital. Pada makalah ini dilakukan evaluasi kegiatan penanganan target iradiasi batu topaz pada siklus operasi 94 dan 95, dengan menganalisis data kegiatan yang tercatat dalam buku induk operasi dan formulir iradiasi target batu topaz. Hasil evaluasi pada siklus operasi 94: iradiasi target topaz total sebanyak = 360 kali dengan massa total 324 kg dan pada siklus operasi 95: sebanyak = 576 kali dengan massa total 864 kg. Dalam melakukan radiasi target topaz tidak terjadi gangguan karena telah dilakukan analisis keselamatan terlebih dahulu serta pelaksanaan yang sesuai dengan SOP sehingga tidak mempengaruhi reaktivitas di teras begitu pula keselamatan radiasi untuk personil harus di jaga.Kata kunci : evaluasi, penanganan target iradiasi batu topaz
Evaluasi Kemampuan Sistem Pendingin Reaktor Setelah Revitalisasi Menara Pendingin
Authors: Sigit Sukarno
Published: January 2020

Evaluasi Kemampuan Sistem Pendingin Reaktor Setelah Revitalisasi Menara Pendingin. Sistem pendingin RSG-GAS terdiri dari sistem pendingin primer dan sekunder. Sistem pendingin primer berfungsi untuk mengambil panas dari teras reaktor sedangkan sistem pendingin sekunder berfungsi untuk mengambil panas sistem pendingin primer melalui heat exchanger dan melepasnya ke lingkungan. Sistem pendingin reaktor telah beroperasi lebih dari 28 tahun sehingga perlu dilakukan revitalisasi. Salah satu bagian yang diganti adalah menara pendingin. Kemampuan sistem pendingin reaktor setelah revitalisasi dapat diketahui melalui perbandingan daya kalorimetri sistem pendingin sekunder dan primer serta membandingkan temperatur masuk (Tinlet) dan keluar (Toutlet) sistem pendingin reaktor dengan nilai desainnya. Dari hasil perbandingan menunjukan perubahan daya kalorimetri di sisi primer sebanding dengan perubahan daya kalorimetri sisi sekunder. Hal ini menunjukan tranfer panas dari sistem pendingin primer ke sekunder dan proses pelepasan panas ke lingkungan berjalan dengan baik. Untuk hasil perbandingan Tinlet -Toutlet pendingin reaktor pada daya penuh 30 MW, Tinlet -Toutlet sistem pendingin primer dan sekunder tidak melampaui nilai batas maksimal desain. Dari semua perbandingan menunjukan menara pendingin baru sistem pendingin sekunder memberikan tingkat kemampuan pembuangan panas yang lebih baik pada saat reaktor beroperasi.Kata kunci: Reaktor RSG-GAS, sistem pendingin reaktor, daya kalorimetri.
Kajian Penggunaan Opc Server Untuk Pembuatan Penampil Daya Reaktor
Authors: Sigit Sukarno , Suherkiman Heri , Susanto Susanto
Published: January 2020

Mode operasi reaktor RSG-GAS meliputi daya rendah (kW) hingga daya tinggi (MW). Saat ini penampil daya hanya menampilkan daya dalam orde MW. Untuk itu perlu dibuat penampil daya yang mampu menampilkan daya dalam range yang lebih lebar untuk melengkapi penampil daya yang ada. Perangkat penampil digital daya reaktor dibangun dengan perangkat OPC server, labview dan memanfaatkan kanal daya JKT04 yang digunakan sebagai pedoman penentuan besar daya reaktor. Dari hasil pengujian, program penampil digital daya reaktor berhasil menampilkan daya reaktor dari orde kW sampai dengan MW dan perhitungan faktor konversi arus JKT04 (ampere) ke skala daya (watt) dapat dilakukan secara akurat dan otomatis. Semua hasil perhitungan program dapat disimpan ke dalam file dalam format excel sebagai basis data. Perangkat ini dapat diterapkan di RSG-GAS dengan harapan dapat digunakan sebagai penampil daya untuk operasi daya rendah hingga daya tinggi dan sebagai sarana untuk menunjang penelitian tentang daya kalorimetri reaktor.Kata Kunci :Penampil daya, Faktor Konversi, Kanal daya, OPC server
Frans Lion Cachet en die herstel van die Nederduitse Gereformeerde Kerk in die Zuid-Afrikaansche Republiek rondom 1866
Authors: Strauss P
Published: January 2020

Die Nederduitse Gereformeerde Kerk (NG Kerk) en die Nederduitsch Hervormde Kerk (NH Kerk) in Transvaal of die Zuid-Afrikaansche Republiek (ZAR) skei finaal in die jare 1865-1866. Hierdie skeiding word by twee kerkvergaderings voltrek: die Kommissie van die Algemene Kerkvergadering van die Nederduitsch Hervormde Kerk in Junie 1865 op Rustenburg en die Algemene Kerkvergadering van hierdie kerk in Pretoria in November daardie jaar. Agterna beskou het die Kommissievergadering van die Algemene Kerkvergadering op Rustenburg die breuk wat by die Algemene Kerkvergadering in Pretoria plaasgevind het, ingelei. Die twee uitstaande redes vir die breuk, naamlik die naam van die kerk en die plek en gesag van sy belydenisskrifte, is in Junie 1865 bespreek en na die Novembervergadering vir 'n beslissing verwys. Vanaf die kant van die Nederduitse Gereformeerde Kerk het hul segsman en voorloper, ds. Frans Lion Cachet, daarop gewys dat die naam van die kerk nie deurslaggewend is nie, maar dat die naam "Hervormd" van die Gereformeerde Kerk in Nederland deur die staatsowerheid met 'n reglement in 1816 aan hom opgelê is. Dit is verkeerd, omdat die kerk self sy naam moet kies. Dieselfde het in die ZAR gebeur waar die Nederduitsch Hervormde Kerk se naam - as staatskerk - sonder enige kennisgewing aan die kerk in artikel 20 van die ZAR-Grondwet van 1855 -1858 bepaal is. Daarby wou Lion Cachet en die NG Kerk dat die belydenisskrifte van die kerk die Drie Formuliere van Eenheid sal wees wat by die gereformeerde Nasionale Sinode van Dordrecht in 1618-1619 in Nederland aanvaar is. Belydenisse wat aanvaar word omdat die leer daarin vervat in alles met die Skrif ooreenkom. Vir predikante van die Nederduitsch Hervormde Kerk in die ZAR was hierdie blik op die belydenisskrifte onaanvaarbaar. Met ds. Frans Lion Cachet aan die spits het die Nederduitse Gereformeerde Kerk in die ZAR in Desember 1866 te Utrecht sy eie koers ingeslaan met sy eerste Algemene Kerkvergadering. Tydens hierdie byeenkoms én by 5 latere algemene vergaderings was ds. Lion Cachet die voorsitter. In 1873 verhuis hy egter uit die ZAR na Nederland. Menslik gesproke, was Lion Cachet die groot dryfkrag agter die herorganisasie van die NG Kerk en sy gemeentes in die ZAR.
Verskuif die klaskamer ter wille van die oorlewing van Afrikaans as wetenskapstaal
Authors: Durand F
Published: January 2020

Afrikaans het grotendeels as onderrigtaal op universiteite verdwyn ten spyte daarvan dat Afrikaans een van die tale is wat die meeste in Suider-Afrika gepraat word en wat gevestigde vaktale het. Afrikaanssprekendes is as wetenskaplikes werksaam in sowel die privaat sektor as staatsinstansies. Afrikaanssprekendes was al vir groot deurbrake in die wetenskap verantwoordelik en talle werk as vakkundiges oorsee, al het hulle hul opleiding op skool en op universiteit in Afrikaans ontvang. Duidelik is mense wat in Afrikaans onderrig is, nie daardeur benadeel nie en kan hulle in elke opsig by internasionale wetenskaplikes kers vashou. Afrikaans as onderrigtaal word tans nog by sekere skole toegelaat, maar die druk op hierdie skole word al hoe groter. Die aantal Afrikaanssprekende onderwysers wat gedwing word om op universiteit in Engels onderrig te ontvang en wat daarna by ŉ Afrikaanse skool klasgee, word al hoe groter. ŉ Alternatief moet gevind word om Afrikaans as taal van die wetenskap en onderrig te laat oorleef, nie slegs vir die behoud van ŉ unieke inheemse taal wat oor eeue heen ontstaan het nie, maar ook vir die behoud van die Afrikaanssprekende gemeenskap en die handhawing van kommunikasie en onderrig binne hierdie gemeenskap, wat almal van kleuter tot akademikus, van boer tot konsultant, van navorser tot onderwyser insluit. Afrikaanse vakinhoud op die internet vir graad R tot universiteit waarby leerders, onderwysers en ouers baat sal vind, word as alternatief vir staatsbeheerde Engelstalige vakonderrig voorgestel.
"Ek het uiteindelik op straat beland; dis ŉ harde lewe": Uitdagings van kwesbare vroue wat alkohol of dwelms misbruik
Authors: Slabbert I
Published: January 2020

Daar is wêreldwyd ŉ toename in die misbruik van alkohol- en/of dwelms. Dit is veral kwesbare vroue wat alkohol of dwelms misbruik, wat gespesialiseerde behandeling benodig. Die doel van die studie was om die uitdagings wat hierdie groep vroue die hoof moet bied, te ondersoek. Die ekologiese perspektief is as teoretiese raamwerk gekies. ŉ Kwalitatiewe studie met ŉ eksplorerende en beskrywende aard is gedoen om dié doel van die studie te bereik. Vyftien deelnemers is gewerf as steekproef vir die studie deur ŉ nieregeringsorganisasie. Die onderhoude wat met hulle gevoer is, is getranskribeer en in vyf temas verdeel, naamlik traumatiese kinderjare, teenspoed in die volwasse lewe, uitdagings in die omgewing, gebruik van alkohol of dwelms om die lewe te hanteer, en hoop. Data-verifikasie is ook gedoen. Etiese klaring is vir die studie verkry. Die gevolgtrekking van die studie is dat kwesbare vroue wat alkohol of dwelms misbruik, verskeie uitdagings in die gesig staar en gespesialiseerde intervensie benodig. Daar word aanbeveel dat meer navorsing gedoen word oor hierdie kwessie.
Posisionering van voortgesette selfgerigte leervaardighede in een-en-twintigste-eeuse onderwys
Authors: du Toit-Brits C , Blignaut H
Published: January 2020

Selfgerigte leer (SGL) word in een-en-twintigste-eeuse raamwerke as ŉ kritieke vaardigheid vir leerders beskou ten einde hulle te kan voorberei op ŉ onvoorspelbare, snelveranderende opvoedingswêreld, waar gefokus moet word op die eise van die vierde industriële revolusie. Hierby aansluitend behoort 'n geslaagde onderwysstelsel die leemte tussen hoe en wat leerders leer en wat die ekonomie vereis sinvol aan te spreek deur geskooldes toe te rus om vaardighede te ontwikkel wat tersaaklik vir die arbeidsomgewing is. Die rasionaal van hierdie artikel is derhalwe dat opvoedkundige investering in die ekonomie - en daarmee skoling van leerders in voortgesette (lewenslange) SGL - onontbeerlik is en 'n sinvolle onderwysstelsel onderlê.
Die toepassing van inklusiewe onderwys: Internasionale verwagtinge en Suid-Afrikaanse realiteite
Authors: Engelbrecht P
Published: January 2020

Onderwys vir leerders met leerbehoeftes wat as uitdagend beskou word, het die afgelope 30 jaar beweeg van ŉ benadering van aparte onderwysgeleenthede vir sulke leerders tot die internasionaal ondersteunde benadering van inklusiewe onderwys, naamlik die plasing van alle leerders in hoofstroomskole. Hierdie benadering word sterk gelei deur internasionale organisasies, met inbegrip van die Verenigde Nasies. Deur ŉ sistematiese literatuuroorsig te gebruik, fokus hierdie artikel op internasionale verwagtinge vir die instelling van inklusiewe onderwys soos vervat in internasionale verklarings en verslae, en op die realiteite met betrekking tot die toepassing daarvan in Suid-Afrika. Spesifieke sistemiese elemente van die toepassing van inklusiewe onderwys wat gereeld deur internasionale organisasies gemonitor word, en die realiteite van Suid-Afrikaanse pogings om dit te verwesenlik, word grondig bespreek. Dit word duidelik dat indien begrip vir die komplekse Suid-Afrikaanse kultuurhistoriese agtergrond en huidige sosioëkonomiese situasie nie in ag geneem word nie, die meeste van hierdie internasionaal gestelde elemente nie na verwagting verwesenlik kan word nie. Daar word tot die gevolgtrekking gekom dat unieke raamwerke vir die toepassing van inklusiewe onderwys in die Suid-Afrikaanse konteks ontwikkel behoort te word wat op die internasionale oorkoepelende doelwit van die reg op onderwys gebaseer is maar wat die uniek Suid-Afrikaanse positiewe, maar ook negatiewe, realiteite in onderwys in berekening bring.
Die onderrig van Letterkunde in die Verdere Onderwys- en Opleidingfase binne die raamwerk van die Kurrikulum- en Assesseringsbeleidsverklaring
Authors: Schultz A , le Cordeur M
Published: January 2020

Letterkunde speel 'n noodsaaklike rol in sowel die kurrikulum as die ontwikkeling van leerders as wêreldburgers. Suid-Afrika is 'n uiters diverse land en dit is 'n moeilike taak om 'n letterkunde-kurrikulum te skep wat aan almal se behoeftes voldoen. 'n Probleem wat dikwels voorkom, is dat die sosiale konteks van die voorgeskrewe werke nie noodwendig in lyn is met dié van alle leerders nie en daarom word sommige leerders uitgesluit en akademies benadeel. Met hierdie ondersoek het ons probeer vasstel of daar 'n groot genoeg verskeidenheid sosiale kontekste in die voorgeskrewe werke aangespreek word om alle leerders in die Verdere Onderwys en Opleiding-fase (VOO) te akkommodeer, sowel as die moontlike verbeteringe wat aangebring kan word. Daar is van kwalitatiewe sowel as kwantitatiewe data-insamelingsmetodes in die vorm van vraelyste en onderhoudvoering gebruik gemaak. Die deelnemers het bestaan uit drie Afrikaans Huistaal VOO-fase onderwysers van verskillende sosiale kontekste asook studente in hul vierde jaar wat die Nagraadse Onderwyssertifikaat (NOS) volg. Vraelyste is aan die NOS-studente uitgedeel en onderhoude is met ŉ deursnit van hierdie studente gevoer. Die meerderheid deelnemers was tevrede met die letterkunde-kurrikulum en is van mening dat die probleem eerder by die lys voorgeskrewe werke lê. Dit wil voorkom asof die poësie-afdeling voorsiening maak vir die meerderheid leerders, maar by die prosawerke word erge probleme ervaar. Daar is bevind dat die Kurrikulum- en Assesseringsbeleidsverklaring (KABV) te voorskriftelik is, dat daar te veel assesserings plaasvind en dat die handboeke nie versoenbaar is met die kurrikulum nie. Indien die aanbevelings in hierdie artikel geïmplementeer sou word, sou die KABV beduidend verbeter kon word.
Achter de schermen. Hendrik Swellengrebel en de Kaapse Patriotten
Authors: Schutte G
Published: January 2020

Hendrik Swellengrebel, geboren aan de Kaap, hereboer, regent en reiziger (Kaap 1776-1777), informeerde, bemiddelde en critiseerde zowel de Kaapse Patriotten als de Compagniesdienaren in Kaapstad en Amsterdam, op basis van een omvangrijke netwerk van correspondenten. Hij was het in principe eens met de klachten van de Kaapse Patriotten over het gebrek aan vrijheid en handelsmogelijkheden, maar hij probeerde de Representanten van de Patriotten de contra-productieve persoonlijke aanvallen jegens de Kaapse bestuurders in te trekken. Tegelijkertijd probeerde hij de Compagniesdienaren zich in te houden in hun reacties op de Patriottenbeweging. De Bewindhebbers van de Compagnie waren conservatieven, tegen alle burgerrechten, en bovendien druk bezig met binnenlandse en buitenlandse problemen. Beslissingen op de memories van de Kaapse Patriotten werden uitgesteld en zelfs Swellengrebels aanbod benoemd te worden tot Gouverneur van de Kaap en de reorganisatie aan de Kaap ter hand te nemen, werd afgewezen, in hoogste instantie door Opperbewindhebber Stadhouder Willem V. Dit artikel beschrijft hoe decennia lang de politiek rondom de Kaap en de Kaapse Patriotten beweging achter de schermen van de Compagnie verliep.
Visual motor integration delay in preschool children infected with HIV
Authors: Odejayi Ramona , Franzsen Denise , de Witt Patricia
Published: January 2020

INTRODUCTION: It is estimated that more than 200 000 children under the age of 14 years are living with human immunodeficiency virus (HIV) in South Africa. These children - including those on antiretroviral therapy - may present with neurocognitive delay and may find it difficult to participate in educational activities. This study aimed to determine the extent of the delay of visual motor integration (VMI) which correlates significantly with academic achievement in pre-school children with vertically transmitted HIV. METHOD: This was a descriptive quantitative study in which 71 children infected with HIV aged between 5 - 6 years, attending a HIV clinic in South Africa, were assessed using the Beery Developmental Test of Visual Motor Integration (DTVMI). The results were compared to the normative DTVMI scores, and correlated with health factors related to HIV such as CD4 count and socioeconomic factors such as attendance at crèche or preschool. RESULTS: Results confirm that a delay exists in VMI and visual perception (VP) in the at risk category. Mean scores on the motor coordination (MC) fell in the average range. Visual perception was the most affected in this sample with an average delay of between 11 and 17 months found. Visual perception also showed a moderate positive correlation with CD4 count, while VMI had a moderate relationship to attendance at crèche or preschool and mother's level of education. CONCLUSION: This study confirms children with HIV are at risk for neurodevelopmental delay related to visual motor integration and visual perception, particularly in children with a low CD4 count. These aspects need to be assessed as part of routine neurodevelopmental monitoring. Key words: Neurodevelopmental delay, HIV preschool children, visual motor integration delay, visual perception delay, motor coordination
Cuidado de enfermagem no pós-operatório de cirurgia cardíaca pediátrica: revisão integrativa
Authors: Batista Cabral João Victor , Chaves Juliana Sousa de Castro
Published: January 2020

OBJETIVO: Identificar a atuação do enfermeiro no pós-operatório de cirurgia cardíaca no paciente pediátrico. METODOLOGIA: Trata-se de uma revisão integrativa através da execução de seis etapas, com amostragem realizada por meio de levantamento e análise bibliográfica, após busca dos artigos no sítio da BVS, nas bases LILACS, MEDLINE, BDENF entre 2009 a 2018, com combinação dos descritores selecionados. RESULTADOS: A partir dos dados emergiram dois eixos temáticos: o enfermeiro e sua própria percepção no cuidado ao paciente pediátrico no pós-operatório, no qual ele se torna num ser-com que assume a responsabilidade de assegurar à criança um cuidado completo, providenciando insumos, monitorando-a constantemente e propiciando um cuidado integral; e os principais diagnósticos e intervenções de enfermagem, que variam de diagnósticos de risco a diagnósticos reais, orientando o enfermeiro para condutas de prevenção, de avaliação e de recuperação ou reabilitação. CONCLUSÃO: A atuação do enfermeiro se traduz por meio de uma condução sistemática, complexa e minuciosa, que assume a responsabilidade de assegurar à criança um cuidado completo, providenciando insumos, monitorando-a constantemente e propiciando um cuidado integral orientado pelos diagnósticos e intervenções de enfermagem.