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OBJECTIVE: to compare the decision-making of Nursing students, before and after theoretical training on basic life support, using the practice of high-fidelity simulation and medium-fidelity simulation. METHOD: an experimental study was developed, pre- and post-test type, with quantitative, descriptive and inferential analysis, with theoretical training on basic life support and clinical simulation practices, and with evaluation of knowledge and decision-making of Nursing students, at three different moments - before the simulation scenario (T0), after the simulation scenario (T1) and after clinical teaching (T2). RESULTS: 51 students participated in the research, with an average age of 20.25±3.804, of which 92.2% were female. Statistically significant differences (F=6.47; p=0.039) were evident regarding the definition of the problem and development of objectives in decision-making in the experimental group. CONCLUSION: Nursing students demonstrate an adequate level of knowledge and a good decision-making process, based on the most current instruments produced by scientific evidence, in clinical simulation scenarios in basic life support, and this innovative methodology should be deepened in the Nursing teaching. HIGHLIGHTS: (1) Clinical simulation promotes good decision-making of Nursing students.(2) Students demonstrated adequate knowledge about basic life support.(3) Knowledge and practice define the fidelity of clinical simulation.(4) Basic life support can be developed by high-fidelity simulation.

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Abstract Objective: to compare the decision-making of Nursing students, before and after theoretical training on basic life support, using the practice of high-fidelity simulation and medium-fidelity simulation. Method: an experimental study was developed, pre- and post-test type, with quantitative, descriptive and inferential analysis, with theoretical training on basic life support and clinical simulation practices, and with evaluation of knowledge and decision-making of Nursing students, at three different moments - before the simulation scenario (T0), after the simulation scenario (T1) and after clinical teaching (T2). Results: 51 students participated in the research, with an average age of 20.25±3.804, of which 92.2% were female. Statistically significant differences (F=6.47; p=0.039) were evident regarding the definition of the problem and development of objectives in decision-making in the experimental group. Conclusion: Nursing students demonstrate an adequate level of knowledge and a good decision-making process, based on the most current instruments produced by scientific evidence, in clinical simulation scenarios in basic life support, and this innovative methodology should be deepened in the Nursing teaching.

Resumo Objetivo: comparar a tomada de decisão dos estudantes de Enfermagem, antes e após a formação teórica sobre suporte básico de vida, com recurso à prática de simulação de alta-fidelidade e simulação de média-fidelidade. Método: desenvolveu-se um estudo experimental, tipo pré e pós-teste, com análise quantitativa, descritiva e inferencial, com realização da formação teórica sobre suporte básico de vida e práticas de simulação clínica, e com avaliação dos conhecimentos e tomada de decisão dos estudantes de Enfermagem, em três momentos distintos - antes do cenário de simulação (T0), após o cenário de simulação (T1) e após a realização de ensino clínico (T2). Resultados: participaram da pesquisa 51 estudantes, com uma média de idade de 20,25±3,804, dos quais 92,2% eram do sexo feminino. Foram evidenciadas diferenças estatisticamente significativas (F=6,47; p=0,039) perante a definição do problema e desenvolvimento dos objetivos na tomada de decisão no grupo experimental. Conclusão: os estudantes de Enfermagem demonstram um nível de conhecimentos adequado e um bom processo de tomada de decisão, com base nos instrumentos mais atuais produzidos pela evidência científica, perante cenários de simulação clínica em suporte básico de vida, devendo esta metodologia inovadora ser aprofundada no ensino de Enfermagem.

Resumen Objetivo: comparar la toma de decisiones de estudiantes de Enfermería, antes y después de la formación teórica sobre soporte vital básico, utilizando la práctica de simulación de alta fidelidad y simulación de mediana fidelidad. Método: se desarrolló un estudio experimental, tipo pretest y postest, con análisis cuantitativo, descriptivo e inferencial, con formación teórica sobre soporte vital básico y prácticas de simulación clínica, y con evaluación del conocimiento y la toma de decisiones de los estudiantes de Enfermería, en tres momentos distintos: antes del escenario de simulación (T0), después del escenario de simulación (T1) y después de la enseñanza clínica (T2). Resultados: participaron de la investigación 51 estudiantes, con edad promedio de 20,25±3,804 años, de los cuales 92,2% eran mujeres. Se evidenciaron diferencias estadísticamente significativas (F=6,47; p=0,039) en cuanto a la definición del problema y desarrollo de los objetivos en la toma de decisiones en el grupo experimental. Conclusión: los estudiantes de Enfermería demuestran un nivel adecuado de conocimientos y un buen proceso de toma de decisiones, basados en los instrumentos más actuales producidos por la evidencia científica, en escenarios de simulación clínica en soporte vital básico, y esta metodología innovadora debe profundizarse en la enseñanza de Enfermería.

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Este relatório de Ensino Clínico (EC) surge no âmbito da Unidade Curricular - Estágio de Enfermagem à Pessoa em Situação Crítica com Relatório - inserida no Plano de Estudos do Mestrado em Enfermagem Médico-Cirúrgica (EMC) - Área de Especialização de Enfermagem à Pessoa em Situação Crítica (EPSC), da Escola Superior de Saúde (EssLei), do Politécnico de Leiria. De acordo com as competências do Enfermeiro Especialista (EE), a realização de um projeto de investigação torna-se fulcral. Este constitui-se um projeto de melhoria da qualidade dos cuidados de enfermagem no Serviço de Urgência Geral (SUG) do Hospital de Santo André (HSA) do Centro Hospitalar de Leiria (CHL) e, após discussão com alguns elementos da equipa de enfermagem do mesmo, contatou-se a existência de uma problemática relevante para a melhoria da qualidade dos cuidados prestados. Este tem como área de investigação a Prevenção e Controlo da Infeção (PCI), nomeadamente a importância das Precauções Básicas do Controlo da Infeção (PBCI) na prevenção e controlo das Infeções Associadas aos Cuidados de Saúde (IACS), sendo intitulado "Práticas dos enfermeiros na aplicação das Precauções Básicas do Controlo da Infeção no Serviço de Urgência". Por estágios clínicos entende-se os momentos de observação e intervenção em contextos de serviços de saúde e afins, com o objetivo de desenvolver capacidades, atitudes e competências (Alarcão & Rua, 2005)

This report on Clinical Teaching (CE) is part of the Curricular Unit - Internship in Nursing Internship in Critical Condition with Report - included in the Study Plan of the Master's Degree in Medical-Surgical Nursing - Specialization Area of Nursing in Critical Condition The course is part of the study plan of the Master's Degree in Medical-Surgical Nursing - Area of Specialization in Critical Care Nursing (EPSC), Escola Superior de Saúde (EssLei), of the Polytechnic of Leiria. According to the competences of the Specialist Nurse (NS), the completion of a research project is essential. This is a project to improve the quality of nursing care in the General Emergency Service (SUG) of the Santo André Hospital (HSA) of the Leiria Hospital Center (CHL). After discussion with some members of the nursing team, a relevant issue for improving the quality of care was identified. The research area of this study is Infection Prevention and Control (ICP), namely the importance of Basic Precautions for Infection Control (BCCI) in the prevention and control of Healthcare-associated Infections (HAIs), and it is entitled "Nurses' Practices in the Application of Basic Precautions for Infection Control in the Emergency Department". Clinical internships are moments of observation and intervention in health services and related settings, with the purpose of developing skills, attitudes and skills (Alarcão & Rua, 2005)

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Abstract Malignant syphilis is an uncommon variant of syphilis, most often (but not always) found in immunosuppressed individuals. This report describes the case of a 57-year-old man, infected with the acquired human immunodeficiency virus (HIV), with a generalized picture of erythematous-squamous papules that rapidly progressed to painful and ulcerated plaques and nodules, some covered with a black rupioid crust. The analytical study performed revealed positive VDRL (Venereal Disease Research Laboratory) and RPR (Rapid Plasma Reagin). The skin biopsy was nonspecific; however, the immunohistochemical analysis disclosed the presence of spirochetes. The patient was then treated with benzathine penicillin G 2.4 MU once a week IM for three weeks, with progressive resolution of the lesions. Considering its rarity, this atypical form of syphilis that needs to be known to better recognize its clinical presentation and provide more prompt treatment to patients.

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Malignant syphilis is an uncommon variant of syphilis, most often (but not always) found in immunosuppressed individuals. This report describes the case of a 57-year-old man, infected with the acquired human immunodeficiency virus (HIV), with a generalized picture of erythematous-squamous papules that rapidly progressed to painful and ulcerated plaques and nodules, some covered with a black rupioid crust. The analytical study performed revealed positive VDRL (Venereal Disease Research Laboratory) and RPR (Rapid Plasma Reagin). The skin biopsy was nonspecific; however, the immunohistochemical analysis disclosed the presence of spirochetes. The patient was then treated with benzathine penicillin G 2.4 MU once a week IM for three weeks, with progressive resolution of the lesions. Considering its rarity, this atypical form of syphilis that needs to be known to better recognize its clinical presentation and provide more prompt treatment to patients.

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BACKGROUND: Abdominal adiposity is a cardiovascular risk factor; it is assumed that the combination of radiofrequency and physical exercise may decrease this excess of adipose tissue. PURPOSE: To understand whether an aerobic physical exercise session associated with abdominal radiofrequency increases the level of lipolytic activity. METHODOLOGY: The study analyzes the effect of a combined aerobic exercise session with radiofrequency. Participants were 30 healthy female volunteers, aged 18-28 years, randomly assigned to an experimental group and placebo group. They were characterized by a sociodemographic questionnaire, the International Physical Activity Questionnaire and the Food Frequency Questionnaire. The groups performed an abdominal radiofrequency session followed by moderate aerobic exercise, assessing glycerol concentration and lipid profile values before and after the intervention. In the experimental group, a percentage of potency was used that allowed to maintain the temperature between 40º C and 42º C to the epidermis. In the placebo group, the power of the radiofrequency was 0 Watt. To compare results, Student's t test was used for a significance level of 0.05. RESULTS: There were no significant changes in glycerol concentrations between groups (P > 0.05). There were no changes in the lipid profile of both groups after the intervention (P > 0.05). CONCLUSION: The association of exercise with radiofrequency did not present an increased effect on lipolytic activity when compared to the isolated exercise. The application of this technique is a safe intervention.

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BACKGROUND: Abdominal adiposity is a cardiovascular risk factor; it is assumed that the combination of radiofrequency and physical exercise may decrease this excess of adipose tissue. PURPOSE: To analyze the effect of four intervention sessions on abdominal adipose tissue. METHODOLOGY: The study analyzes the effect of four sessions of aerobic exercise combined with radiofrequency. Participants were 28 healthy female volunteers, aged 18-28 years, randomly assigned to an experimental group and a placebo group. They were characterized by a sociodemographic questionnaire, the International Physical Activity Questionnaire and the Food Frequency Questionnaire. The groups performed four sessions of abdominal radiofrequency followed by moderate aerobic exercise, assessing body mass, body mass index, fat mass, waist circumference, waist/height ratio, subcutaneous adipose thickness, and horizontal abdominal adipose fold at the first and fourth sessions. In the experimental group, a percentage of potency was used that allowed to maintain the temperature between 40°C and 42°C to the epidermis. In the placebo group, the power of the radiofrequency was 0 W. To compare results, Student's t test was used for a significance level of 0.05. RESULTS: There was a statistically significant decrease in waist circumference, abdominal subcutaneous adipose thickness, and horizontal abdominal fold in the experimental group compared to the placebo group (P < 0.05). CONCLUSION: Combined exercise intervention with radiofrequency has been shown to be effective in reducing abdominal adiposity.

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Large-area paper batteries have been explored in this paper, correlating electrode materials and screen printing with the electrochemical performances. The use of office paper embedded in salt solution with two electrodes performed by an easy and large-scale application technique opens doors to a new concept of energy storage. The proposed device is Li-free and uses zinc and silver powder-based screen printable pastes to deposit the electrodes. Cyclic voltammetry and charge-discharge curves reveal the performance of the produced devices using NaCl and KOH solutions in different concentrations. The simulation of electrochemical impedance spectroscopy measurements gave clue of a similar working mechanism to conventional Li-ion batteries. After charging, a single paper battery achieves 1.83 V with 60 mA/cm2 and 90.6% charge-discharge efficiency. As a proof of concept, a small paper battery and a set integrated in series and parallel were used to power a commercial red light-emitting diode.

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BACKGROUND: Equipment that acts in the reduction in adipose tissue are becoming widely investigated. One of the resources that begin to gain recognition is radiofrequency. PURPOSE: To verify the existence of scientific evidence and the methodological quality of the articles on the effects of radiofrequency in the reduction in adipose tissue. METHODOLOGY: Systematic review with meta-analysis on the effects of radiofrequency on adipose tissue. The research was carried out using several databases and including experimental studies only in humans. The evaluation of the methodological quality of the articles was done based on the PEDro Scale. RESULTS: Twelve articles related with adipose tissue and cellulitis were included. There was a great variability of protocols, and the methodological quality was generally low and the methods most used for the evaluation of results were anthropometry, photography, and histopathology. Clinical results suggest a positive effect of radiofrequency on the reduction in adipose tissue, proving an increase in adipocyte lipolysis. After statistical analysis, it was verified that the anthropometry presented questionable results. CONCLUSION: The clinical results of the studies point to the positive effects of radiofrequency on the reduction in adipose tissue; however, the low methodological make this topic still debatable, requiring more controlled studies.

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O interesse pela temática do erro de medicação surge do confronto do investigador com a sua realidade laboral e da tentativa de compreender os fatores que intervêm na sua ocorrência. Enveredou-se pelo estudo transversal, de índole exploratória-descritiva, com abordagem qualitativa assente no paradigma interpretativo. O estudo propõe-se concretizar os seguintes objetivos gerais: compreender as circunstâncias associadas ao erro de medicação e sensibilizar a equipa de enfermagem para a importância do relato do erro. Na colheita de dados recorremos à entrevista semi-estruturada, procurando dar resposta para seguinte questão de investigação: Quais as circunstâncias que envolvem a ocorrência dos erros de medicação, vivenciados pelos enfermeiros, num serviço de internamento de um hospital central? O guião de entrevista foi orientado pelo modelo ?patient safety event taxonomy? (PSET) da Join Commission on Accreditation of Healthcare Organization adaptado por Castilho e Parreira (2012). Participaram no estudo todos os enfermeiros, de um serviço de um Hospital central, que cumpriram os critérios de inclusão. Como principais resultados salientamos que todos os participantes já experienciaram vários incidentes de segurança durante o processo de gestão da medicação, relatando situações quer de evento adverso quer de near miss. A troca de doentes apresenta-se como um evento adverso predominante na fase da administração. Identificam no mecanismo do erro, falhas de performance clínica valorizando as falhas ao nível da gestão do processo. Nas falhas humanas salientam a violação método individual de trabalho, a etiquetagem incorreta, distrações/fadiga, falha na comunicação e excesso de confiança. Nos fatores sistémicos salientam o elevado volume de trabalho, as múltiplas interrupções, a confusão/agitação, sistema informático inadequado, condições arquitetónicas inadequadas, desatualização/inadequação do material e a ausência de rampa de oxigénio em todas as unidades. Salientam ainda como período crítico o turno da tarde, próximo da hora de jantar. Relativamente ao impacto, tendem a considerar que o impacto no doente é mínimo. No impacto na organização é valorizado sobretudo o aumento do gasto de materiais. Nas consequências para o enfermeiro valorizam o impacto negativo mas também a oportunidade de aprendizagem. Identifica-se uma preocupação de adoção de estratégias imediatas de redução do dano sendo sugeridas algumas estratégias de prevenir novas ocorrências. Espera-se que os resultados deste estudo contribuam para estimular a reflexão em equipa sobre esta temática e fomentar uma cultura de notificação de eventos adversos.

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