A. A. Coelho

Magnetic properties and magnetocaloric effect of the HoAgGa compound

Magnetic properties and magnetocaloric effect (MCE) of the HoAgGa compound are investigated by magnetization and heat capacity measurements. A giant reversible MCE was observed around TC = 7.2 K. The maximum values of magnetic entropy change and adiabatic temperature are found to be 16 J kg−1 K−1 and 6 K, respectively, with a refrigerant capacity value of 262 J kg−1 for field change of 5 T. These magnetocaloric parameters also remain large for a wide range of temperature above TC. The large MCE as well as no hysteresis loss make HoAgGa an attractive candidate for low temperature magnetic refrigerant.

Medication prescription by nurses and the case of the Brazil: what can we learn from international research?

The role of the nurse in the process of medication scription and ordering diagnostic tests and clinical minations has intensified worldwide. For the Internaal Council of Nursing (ICN), these actions are innovaelements that contribute to advanced nursing practice , 2011). The term prescription by nurses encompasses versity of practices within which we can highlight three dels: the independent or substitute prescriber, the i-autonomous or complementary prescriber, and the up protocol (Patient Group Directions) (Consejo Genl de Enfermerı́a, 2006; Kroezen et al., 2011). Among the ntries where prescription and the requisition of clinical minations by nurses is already consolidated, the United gdom (UK), Sweden, United States, Canada, Australia, Zealand, South Africa and Ireland stand out (Van Ruth l., 2008; Krozen et al., 2012; Latter et al., 2010). The UK particular, has both an extensive form of nurse scribing, embracing all three models above, and a well eloped evidence base from research into its acceptlity and effectiveness. But not all countries have progressed so far. In this torial we consider the implications of this evidence base countries where the practice is still developing. We us on our country, Brazil, as an example and use the rnational evidence and reviews to illuminate the rent situation of nurses in Brazil and offer recommenions for progress. The prescription of medication through group protocols nurses is a legally permissible practice in Brazil within ary health care, following authorization from the istry of Health. Prescribing protocols are designed to be d in strategic areas (child health, women’s health, onic and acute diseases), where nurses are normally cticing. Examples of protocols that are inclusive of scribing for diseases or injuries include: tuberculosis; rosy; hypertension and diabetes mellitus; prenatal e; child nutrition; and HIV and other Sexually nsmitted Diseases (STD). Medicines that can be ivered by nurses include antibiotics, analgesics, antiammatory agents and bronchodilators. The evolution of the use of Patient Group Directions by nurses in Brazil coincides with the growth of the availability of health care services and the public’s lack of access to medical professionals in many areas in primary health care, in a context of reduction of expenditure on health care (Oguisso and Freitas, 2007). Whilst improvement in care for patients and better use of nurses’ skills has ostensibly driven the expansion of prescribing in countries such as the UK, in Brazil, like other countries such as Canada and Australia, forces external to the nursing profession have motivated the introduction of prescription by nurses. These include reduction of health care expenditure, efficient use of time and resources (Van Ruth et al., 2008; Consejo General de Enfermerı́a, 2006), reduction of doctors’ workload, resolution of the problem of lack of doctors and to assist with coverage of patients in remote areas (Kroezen et al., 2011). The fact that these are externally driven forces may have contributed to the situation that, despite the legislation enabling nurses to prescribe using Patient Group Directions in Brazil, the current context is problematic and in practice the extent to which nurses are prescribing remains very limited. A study on prenatal care performed by nurses in São Paulo found that only 40 of a total of 131 nurses used therapeutic protocols to treat infections of pregnant women and their partners (Narchi, 2010). Other studies show that nurses demonstrate fear and insecurity in prescriptive actions (Ximenes Neto et al., 2007) or that they do not prescribe for fear of complaints (Moura et al., 2007). There may be several possible reasons for this lack of prescribing. Firstly, there is no requirement for nurse training prior to the initiation of prescriptive practice. In contrast, the ICN recommends specialized knowledge, clinical experience and registration as a prescriber, as pre-requisites for prescribing. This acquisition of specialized knowledge through educational preparation varies internationally with respect to the duration and the level of training. In the UK, qualified nurses with at least three years’ experience undertake a degree level training programme of 26 days, with 12 days supervision

Large magnetocaloric effect and refrigerant capacity near room temperature in as-cast Gd5Ge2Si2−xSnx compounds

Large values of isothermal entropy change (ΔST) and refrigerant capacity have been found in Gd5Ge2Si2−xSnx compounds. Values of the order of 20 J kg−1 K−1 for −ΔST were obtained in as-cast samples when submitted to a magnetic field variation of 2 T. First-order-magneto-structural transition is induced by the substitution of silicon by tin and it is shifted to lower temperatures with the tin content. It means that the magnetocaloric effect on this series can be properly tuned to a specific practical thermodynamic cycle, including near room temperature range.

Effects of Ga substitution on the structural and magnetic properties of half metallic Fe2MnSi Heusler compound

The so-called half-metallic magnets have been proposed as good candidates for spintronic applications due to the feature of exhibiting a hundred percent spin polarization at the Fermi level. Such materials follow the Slater-Pauling rule, which relates the magnetic moment with the valence electrons in the system. In this paper, we study the bulk polycrystalline half-metallic Fe2MnSi Heusler compound replacing Si by Ga to determine how the Ga addition changes the magnetic, the structural, and the half-metal properties of this compound. The material does not follow the Slater-Pauling rule, probably due to a minor structural disorder degree in the system, but a linear dependence on the magnetic transition temperature with the valence electron number points to the half-metallic behavior of this compound.

Acesso potencial à atenção primária em saúde: o que mostram os dados do programa de melhoria do acesso e da qualidade do Brasil?

Objective: to analyze the influence of contextual indicators on the performance of municipalities regarding potential access to primary health care in Brazil and to discuss the contribution from nurses working on this access. Method: a multicenter descriptive study based on secondary data from External Evaluation of the National Program for Access and Quality Improvement in Primary Care, with the participation of 17,202 primary care teams. The chi-square test of proportions was used to verify differences between the municipalities stratified based on size of the coverage area, supply, coordination, and integration; when necessary, the chi-square test with Yates correction or Fishers exact test were employed. For the population variable, the Kruskal-Wallis test was used. Results: the majority of participants were nurses (n=15.876; 92,3%). Statistically significant differences were observed between the municipalities in terms of territory (p=0.0000), availability (p=0.0000), coordination of care (p=0.0000), integration (p=0.0000) and supply (p=0.0000), verifying that the municipalities that make up area 6 tend to have better performance in these dimensions. Conclusion: areas 4,5 and 6 performed better in every analyzed dimension, and the nurse had a leading role in the potential to access primary health care in Brazil.Objetivo: analisar a influencia de indicadores contextuais no desempenho dos municipios, no que tange ao acesso potencial a Atencao Primaria a Saude no Brasil e, ainda, discutir a contribuicao do trabalho da enfermagem nesse acesso. Metodo: estudo descritivo multicentrico, a partir de dados secundarios da Avaliacao Externa do Programa de Melhoria do Acesso e da Qualidade da Atencao Basica no Brasil, com a participacao de 17.202 Equipes de Atencao Basica. Recorreu-se ao teste qui-quadrado de proporcoes para verificar diferencas entre os estratos de municipios, no que se refere as dimensoes territorializacao, oferta, coordenacao, integracao, e, quando necessario, foram considerados os testes qui-quadrado com correcao de Yates ou exato de Fisher. Para a variavel populacao, foi aplicado o teste Kruskal-Wallis. Resultados: a maioria dos participantes era de enfermeiro (n=15.876; 92,3%). Observaram-se diferencas estatisticamente significativas entre os municipios em termos de territorializacao (p=0,0000), disponibilidade (p=0,0000), coordenacao do cuidado (p=0,0000), integracao (p=0,0000) e oferta (p=0,0000), verificando-se que o municipios que compoem o estrato 6 tendem a ter melhor performance nessas dimensoes. Conclusao: verificou-se que os estratos 4, 5 e 6 apresentam melhor desempenho em todas as dimensoes analisadas e, tambem, o papel preponderante do enfermeiro no acesso potencial a Atencao Primaria a Saude no Brasil.

Potential access to primary health care: what does the National Program for Access and Quality Improvement data show?

Objective: to analyze the influence of contextual indicators on the performance of municipalities regarding potential access to primary health care in Brazil and to discuss the contribution from nurses working on this access. Method: a multicenter descriptive study based on secondary data from External Evaluation of the National Program for Access and Quality Improvement in Primary Care, with the participation of 17,202 primary care teams. The chi-square test of proportions was used to verify differences between the municipalities stratified based on size of the coverage area, supply, coordination, and integration; when necessary, the chi-square test with Yates correction or Fishers exact test were employed. For the population variable, the Kruskal-Wallis test was used. Results: the majority of participants were nurses (n=15.876; 92,3%). Statistically significant differences were observed between the municipalities in terms of territory (p=0.0000), availability (p=0.0000), coordination of care (p=0.0000), integration (p=0.0000) and supply (p=0.0000), verifying that the municipalities that make up area 6 tend to have better performance in these dimensions. Conclusion: areas 4,5 and 6 performed better in every analyzed dimension, and the nurse had a leading role in the potential to access primary health care in Brazil.Objetivo: analisar a influencia de indicadores contextuais no desempenho dos municipios, no que tange ao acesso potencial a Atencao Primaria a Saude no Brasil e, ainda, discutir a contribuicao do trabalho da enfermagem nesse acesso. Metodo: estudo descritivo multicentrico, a partir de dados secundarios da Avaliacao Externa do Programa de Melhoria do Acesso e da Qualidade da Atencao Basica no Brasil, com a participacao de 17.202 Equipes de Atencao Basica. Recorreu-se ao teste qui-quadrado de proporcoes para verificar diferencas entre os estratos de municipios, no que se refere as dimensoes territorializacao, oferta, coordenacao, integracao, e, quando necessario, foram considerados os testes qui-quadrado com correcao de Yates ou exato de Fisher. Para a variavel populacao, foi aplicado o teste Kruskal-Wallis. Resultados: a maioria dos participantes era de enfermeiro (n=15.876; 92,3%). Observaram-se diferencas estatisticamente significativas entre os municipios em termos de territorializacao (p=0,0000), disponibilidade (p=0,0000), coordenacao do cuidado (p=0,0000), integracao (p=0,0000) e oferta (p=0,0000), verificando-se que o municipios que compoem o estrato 6 tendem a ter melhor performance nessas dimensoes. Conclusao: verificou-se que os estratos 4, 5 e 6 apresentam melhor desempenho em todas as dimensoes analisadas e, tambem, o papel preponderante do enfermeiro no acesso potencial a Atencao Primaria a Saude no Brasil.

Tuberculosis care: an evaluability study

tlng=es 23. Santos Filho ET, Gomes ZMS. Estrategias de controle da tuberculose no Brasil: articulacao e participacao da sociedade civil. Rev Saude Publica. [Internet]. 2007. [accessed on Jul 6, 2012]; 41 Supl 1:111-6. doi: 10.1590/S0034-89102007000800015.OBJECTIVE: to verify whether the tuberculosis control program (TCP) is evaluable and to examine the feasibility of building an evaluation model in apriority municipality for the control of tuberculosis. METHOD: this evaluability study was conducted in a municipality in northeastern Brazil. For data collection, documental analysis and interviews with key informants were performed. For indicator validation, the nominal group technique was adopted. RESULTS: the details of TCP were described, and both the logical model and the classification framework for indicators were developed and agreed up on, with the goal of characterizing the structural elements of the program, defining the structure and process indicators, and formulating the evaluation questions. CONCLUSION: TCP is evaluable. Based on logical operational analysis, it was possible to evaluate the adequacy of the program goals for the control of tuberculosis. Therefore, the performance of a summative evaluation is recommended, with a focus on the analysis of the effects of tuberculosis control interventions on decreasing morbidity and mortality.

Medication and test prescription by nurses: contributions to advanced practice and transformation of care

ABSTRACT Objective: To carry out a documentary study on the rules, guidelines, policies and institutional support for the nurse to prescribe medicines and request tests with a view to the advanced practice in the scope of Primary Health Care. Methods: Documentary research using open-access institutional documents - Federal Nursing Council (COFEN), its regional representations in the respective Brazilian states (COREN) and the Brazilian Nursing Association (ABEN). Results: Most of the news/notices were issued by the Regional Nursing Councils in the different Federative Units. The argumentation regarding the prescription of medicines and request for tests by nurses is based on three categories: Autonomy and competencies for the prescription of medicines and/or request of tests; Corporate policies that undermine the full exercise of nursing; and Transformation of health and nursing care in Primary Health Care. Conclusion: The prescriptive practice by nurses integrates health care and has been defended by the institutions that represent the category. It emerges as an important element of advanced practice and in the transformation of care in the context of health teams.

Acceso potencial a la atención primaria de salud: ¿qué muestran los datos del programa de mejoría del acceso y de la calidad de Brasil?

Objective: to analyze the influence of contextual indicators on the performance of municipalities regarding potential access to primary health care in Brazil and to discuss the contribution from nurses working on this access. Method: a multicenter descriptive study based on secondary data from External Evaluation of the National Program for Access and Quality Improvement in Primary Care, with the participation of 17,202 primary care teams. The chi-square test of proportions was used to verify differences between the municipalities stratified based on size of the coverage area, supply, coordination, and integration; when necessary, the chi-square test with Yates correction or Fishers exact test were employed. For the population variable, the Kruskal-Wallis test was used. Results: the majority of participants were nurses (n=15.876; 92,3%). Statistically significant differences were observed between the municipalities in terms of territory (p=0.0000), availability (p=0.0000), coordination of care (p=0.0000), integration (p=0.0000) and supply (p=0.0000), verifying that the municipalities that make up area 6 tend to have better performance in these dimensions. Conclusion: areas 4,5 and 6 performed better in every analyzed dimension, and the nurse had a leading role in the potential to access primary health care in Brazil.Objetivo: analisar a influencia de indicadores contextuais no desempenho dos municipios, no que tange ao acesso potencial a Atencao Primaria a Saude no Brasil e, ainda, discutir a contribuicao do trabalho da enfermagem nesse acesso. Metodo: estudo descritivo multicentrico, a partir de dados secundarios da Avaliacao Externa do Programa de Melhoria do Acesso e da Qualidade da Atencao Basica no Brasil, com a participacao de 17.202 Equipes de Atencao Basica. Recorreu-se ao teste qui-quadrado de proporcoes para verificar diferencas entre os estratos de municipios, no que se refere as dimensoes territorializacao, oferta, coordenacao, integracao, e, quando necessario, foram considerados os testes qui-quadrado com correcao de Yates ou exato de Fisher. Para a variavel populacao, foi aplicado o teste Kruskal-Wallis. Resultados: a maioria dos participantes era de enfermeiro (n=15.876; 92,3%). Observaram-se diferencas estatisticamente significativas entre os municipios em termos de territorializacao (p=0,0000), disponibilidade (p=0,0000), coordenacao do cuidado (p=0,0000), integracao (p=0,0000) e oferta (p=0,0000), verificando-se que o municipios que compoem o estrato 6 tendem a ter melhor performance nessas dimensoes. Conclusao: verificou-se que os estratos 4, 5 e 6 apresentam melhor desempenho em todas as dimensoes analisadas e, tambem, o papel preponderante do enfermeiro no acesso potencial a Atencao Primaria a Saude no Brasil.

CRYSTALLITE SIZE DEPENDENCE ON MAGNETOCALORIC EFFECT OF GdAl2 INTERMETALLIC COMPOUND

In this work, the magnetic, magnetocaloric and structural properties of rare earth based GdAl2 intermetallic compound on nanometric scale were studied, focusing on the crystallite size dependence of the magnetocaloric effect. The nanoparticles were obtained in a mechanical milling process in which the alloys, previously synthetized in an arc furnace under argon atmosphere, were crushed inside a planetary high energy ball system also in an argon atmosphere at different milling times. The nanoparticles structure were analyzed by X-ray diffraction, as well as lattice strain and crystallite size values. Rietveld refinement method analysis of the experimental data has confirmed the existence of a single cubic phase for the GdAl2 series, as expected for a Laves phase compound. As the milling time increases, one has observed the crystallite size decreases down to 19 nm the minimum value. The lattice values increases due to atomic disorder induced by the mechanical milling process. Magnetic properties are also strongly crystallite size dependent, evidenced by the temperature interval enlargement of the second order magnetic transition as the particle size decreases. A table-like behavior with improved RCP (Relative Cooling Power) was obtained for larger crystallite size samples, while smaller crystallite size ones exhibited an increased |DSMmáx| at cryogenic temperatures, associated with the superparamagnetism. Therefore, the magnetocaloric effect on the GdAl2 nanostructured compounds was optimized in comparison to the bulk sample. CRYSTALLITE SIZE DEPENDENCE ON MAGNETOCALORIC EFFECT OF GdAl2 INTERMETALLIC COMPOUND