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Στη παρούσα εργασία καταβάλλεται μια προσπάθεια ελέγχου των μονάδων παστερίωσης που αποκτώνται κατά τη διάρκεια της παστερίωσης, ακόμα και σε περιπτώσεις διακοπής της ομαλής της λειτουργίας. / In the present study,an attempt was made to control the pasteurization units acquired during the procedure of pasteurization,even in cases of disruption of normal operation.

Η περιοχή μελέτης βρίσκεται στη ΒΔ Κρήτη στον Ν. Χανίων στο φαράγγι του Κάμπου. Το φαράγγι αυτό βρίσκεται δίπλα από το χωριό Κάμπος από όπου πήρε και το όνομα του. Σκοπός της εργασίας αυτής είναι να μελετηθούν οι τεκτονικές δομές των αλπικών ενοτήτων στο φαράγγι του Κάμπου. Η μελέτη χωρίζεται σε δύο ενότητες, την τεκτονική ανάλυση των στοιχείων υπαίθρου και την μικροτεκτονική ανάλυση. Η τεκτονική ανάλυση βασίζεται σε μεσοσκοπικές παρατηρήσεις που συνοδεύτηκαν από μετρήσεις με πυξίδα τύπου Clar στην ύπαιθρο. Στην εργασία παρουσιάζεται γεωλογικός χάρτης της περιοχής με όλες τις λιθολογικές ενότητες και τις τεκτονικές δομές της περιοχής, γεωλογικές τομές της καθώς και προβολές των μετρήσεων σε δίκτυα Schmidt. Η μικροτεκτονική ανάλυση έγινε σε λεπτές τομές στο μικροσκόπιο από πετρώματα της περιοχής μελέτης. Από τις τομές αυτές τραβήχτηκαν φωτογραφίες κρυστάλλων που χρησιμοποιήθηκαν για τον προσδιορισμό του ποσού της παραμόρφωσης. / Description of the tectonic units in Kampos area in NW Crete in the mesoscopic file as well as in the microscopic field using slides in the microscope from the studying area.

Power system stabilizers (PSSs) provide the most economical way to improve damping of electro-mechanical oscillations in electrical power systems. Synchrophasor technology enables the use of remotely measured signals in the PSS allowing for greater flexibility in the design of the PSS. Issues related to the transmission of remote signals should be addressed before implementing such systems in practice. This study investigates two of the data transmission issues: (i) delays, and (ii) data dropout; using a synchrophasor-based PSS designed for a two-area four-generator power system model. A time delayed system is modeled using discrete transformation and the effect of the constant delay on the control action of improving damping of an electro-mechanical oscillation is determined analytically. The effect of random delays and data dropout is investigated using non-linear simulations considering viable remedies to overcome these effects. This research also identifies effective means of using synchrophasor signals for improving the performance of PSSs. Primarily, this research introduces a novel control design algorithm based on eigenstructure assignment that could utilize remotely measured signals to design a robust PSS considering different operating conditions at the design stage. Remote signals could be used as additional inputs to the controller, which introduces extra degrees of freedom. In eigenstructure assignment, these additional degrees of freedom are used to assign eigenvalues and eigenvectors to have adequate damping performance of the system over different operating conditions. The algorithm is formulated as a derivative-free non-linear optimization problem and solved using a single step of optimization by eliminating the use of eigenvalue sensitivities. The proposed algorithm is tested for the 68 bus model of the interconnected New England test system and New York power system. Three different control configurations that use local and remote signals are considered in the design. The algorithm is solved using non-linear simplex optimization considering different initial points for seeking a global solution. Delays in the remote signals are also incorporated into the design. The designed controllers are verified in a non-linear simulation platform. Finally, the reliability of synchrophasor-based PSS is discussed in brief. / February 2016

Thesis (MScFor (Forest and Wood Science))--University of Stellenbosch, 2011. / ENGLISH ABSTRACT: A lab scale combustion unit was designed, in order to characterise the performance of various woody and wood-based biofuels commonly used for energy production, cooking and heating. The unit was constructed in a way that it could be repeatedly reused and provide similar testing conditions, such as airflow for all samples. The requirements were that it was big enough to contain a fire large enough to yield good time/temperature profiles and at the same time easy to handle, operate and clean. It also had to allow the insertion of the thermocouples and flue gas probe. Time / temperature profiles were obtained and O2, CO2 and CO levels in the flue gas determined for each biofuel. The samples consisted of the five most commonly used fuel wood species in the Western Cape, namely Rooikrans, Camelthorn, Bluegum, Black wattle and vine stumps and five processed products, namely wood pellets, wood briquettes, commercial charcoal, commercial briquettes and handmade briquettes. Combustion time/temperature profiles were obtained for all samples and characteristic values, such as the maximum temperature and coal temperature compared. This allowed an indication of which product performed better than others in the different combustion phases and is more suitable for different requirements, such as industrial heating, or domestic cooking. Even though Bluegum and Camelthorn performed best overall they were not necessarily suited, for example, for large scale industrial use. It was found that wood pellets and charcoal were the best biofuel for industrial purposes, whereas Rooikrans was found to be the best option for small scale use. / AFRIKAANSE OPSOMMING: ‘n Laboratoriumskaal verbrandingseenheid was ontwerp vir die toets en karakterisering van verskeie houtgebaseerde biomassa soorte algemeen in gebruik vir energie opwekking, kook en verhitting. Daar was besluit om ‘n eenheid te bou vir herhaalde gebruik wat die omstandinghede vir elke toets konstant kan hou, bv. ‘n damper om lugvloei deur die sisteem the beheer. Die eenheid moet groot genoeg wees om veilig ‘n groot genoeg vuur the bevat waarmee ‘n goeie tyd/temperatuur profiel verkry kan word, maar terselfdetyd klein genoeg wees om te hanteer, operateer en skoon te maak. Die eenheid moes ook voorsiening maak vir die insteek van die termostate en gas peilstif. Tyd/temperatuur profiele is verkry en O2, CO2 en CO vlakke in die uitlaatgas is bepaal vir elke bio-brandstof. Die monsters was saamgestel uit vyf van die mees algemeen gebruikte brandhout spesies in die Wes Kaap, naamlik Rooikrans, Kameeldoring, Bloekom, Swartwattel en wingerdstompies, asook vyf geprosesseerde produkte naamlik houtpille, houtbrikette, kommersiële steenkool, kommersiële brikette and handgemaakte brikette. Verbranding tyd/temperatuur profiele is verkry vir al die monsters en verteenwoord waardes is daarvan afgelees, bv. die maksimum temperatuur wat bereik is of die temperatuur waar die vlamme uitgesterf het en slegs koolhitte gemeet word. Hierdie profiele het dit moontlik gemaak om te identifiseer watter produk het beter gevaar as ander gedurende die verskillende verbrandingsfases en is beter gepas vir verskillende gebruike, bv. huishoudelike kook en verhitting. Resultate het gedui dat die Bloekom en Kameeldoring die beste gevaar het oor all die toetse heen, maar was nie noodwendig ideaal vir elke spesifieke doel nie. Dit was bevind dat die steenkool en houtpille die beste gepas is vir industriele gebruik en dat die Rooikrans beter geskik is vir huishoudelike en kleinskaalse gebruik.

Introduction: Limited facilities exist at rural hospitals for the management of newborn infants with respiratory distress syndrome (RDS). Furthermore, the secondary and tertiary hospitals are under severe strain to accept all the referrals from rural hospitals. Many of these infants require intubation and ventilation with a resuscitation bag which must be sustained for hours until the transport team arrives. Not only is lung damage inflicted by the prolonged ventilation, but transferring the infant by helicopter and ambulance is expensive. CPAP (continuous positive airway pressure), a non-invasive form of ventilatory support, has been used successfully at regional (Level 2) and tertiary (Level 3) neonatal units, to manage infants with RDS. It is cost-effective for infants with mild to moderate grades of RDS to be managed at the rural hospital instead of being transferred to the regional secondary or tertiary hospital. CPAP was introduced to Ceres Hospital, a rural Level 1 hospital, in February 2008 for the management of infants with RDS. Aim: To determine the impact of CPAP on the management of infants with RDS in a rural level 1 hospital and whether it can reduce the number of referrals to regional hospitals. Study setting: Nursery at Ceres District Hospital, Cape Winelands District, Western Cape. Study design: Prospective cohort analytical study with an historic control group (HCG). Patients and Methods: The study group (SG) comprised all neonates with respiratory distress born between 27/02/2008 and 26/02/2010. The infants were initially resuscitated with a Neopuff® machine in labour-ward and CPAP was commenced for those with RDS. The survival and referral rates of the SG were compared to an historic control group (HCG) of infants born between 1/2/2006 to 31/01/2008 at Ceres Hospital. Results: During the 2 years of the study, 51 neonates received CPAP (34 <1800g, 17>1800g). Twenty (83%) of the SG infants between 1000g and 1800g and 23 (68%) of the infants between 500g and 1800g survived. Those <1800g that failed CPAP, had either a severe grade of RDS which required intubation and ventilation or were <1000g. Seventeen (33%) of the infants that received CPAP, were in the >1800g group. Thirteen (76%) of these infants were successfully treated with CPAP only. The four infants that failed CPAP suffered from congenital abnormalities and would not have benefited from CPAP. There was no statistically significant difference in the survival between the SG and HCG (80%) (p=0.5490) but the number of referrals decreased significantly from 21% in the HCG to 7% in the SG (p=0.0003). No complications related to CPAP treatment, such as pneumothorax, were noted. The nursing and medical staff quickly became proficient and confident in applying CPAP and were committed to the project. Conclusion: CPAP can be safely and successfully practised in infants with mild to moderate RDS in a rural Level 1 hospital. The survival rate stayed the same as the HCG, even though a higher risk infants were treated in the SG. The transfers were significantly reduced from 21% to 7%. This resulted in significant cost savings for the hospital.

Thesis (MNutr)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: Introduction: Malnutrition, as defined by the Malnutrition Universal Screening Tool (MUST), Mini-Nutritional Assessment-Short Form (MNA-SF), Subjective Global Assessment (SGA), Nutritional Risk Screening Tool-2002 (NRS-2002), Short Nutritional Assessment Questionnaire (SNAQ), Nutritional Risk Indicator (NRI) and Malnutrition Screening Tool (MST), has been associated with adverse outcomes in hospitalised patients. Therefore nutritional risk screening is recommended for all hospitalised patients to improve the recognition and treatment of malnutrition. However, little is known about the use of screening tools in an intensive care unit (ICU) setting. The aim of this study was to assess which of these screening tools could best predict clinical outcomes in ICU patients and to comment on their feasibility, in order to make suggestions on their applicability for this patient population. Methods: Over an eight month study period all patients (>18years) with a surgical ICU stay of >48 hours were included. Patients were screened within 48 hours of admission using each of the seven screening tools. Clinical outcomes (mortality, APACHE II score, length of stay (LOS), length of ventilation (LOV), complications, serum-albumin, white cell count (WCC) and C-reactive protein) were recorded until discharge or death. Feasibility and applicability of the screening tools were also assessed. Results: A total of 206 patients (62.6% males) were included. The average age was 49.5 ±17.4 years and average LOS was 5.7 ± 5.5 days. Screening was not feasible in 18.3% of patients. The MUST classified 18.9% of patients as at risk of malnutrition and 30.1% as malnourished, but was not predictive of any clinical outcomes. According to the MNA-SF, 52.2% of patients were at risk of malnutrition and 16.5% were malnourished. This was associated with progressively decreasing serum-albumin levels (p<0.01) and WCC (p=0.01). The SGA classified 30.6% of patients as moderately and 18.4% of patients as severely malnourished and was significantly associated with LOS (p=0.03), LOV (p=0.01), mild complications (p=0.04) and serum-albumin (p=0.01). However, except for serum-albumin which progressively declined with a poorer nutritional status, the moderately malnourished patients showed the worst outcomes and the severely malnourished patients the best. According to the NRS-2002, 72.8% of patients were malnourished; and this correlated significantly with LOV (p=0.02) and the development of moderate (p=0.04) and total (p=0.01) complications. A non-significant but consistent trend for worse results in the malnourished group was also seen for the other outcomes studied. The SNAQ classified 35.9% of patients as malnourished or at risk thereof. This was associated with lower serum-albumin levels (p=0.04), but also with decreased LOV (p<0.01). The NRI classified 2.3% of patients as mildly malnourished, 21.0% as moderately malnourished and 75.0% as severely malnourished and only effectively predicted serum-albumin (p<0.01). The MST classified 78.2% of patients as malnourished and this was predictive of developing more complications (p<0.01). Almost all of the other variables also showed worse outcomes for the malnourished group, but this was not significant. Conclusion: Screening in an ICU seems to have only moderate feasibility and applicability and limited value. Only the NRS-2002 and MST showed potential for predicting clinical outcomes in ICU patients. / AFRIKAANSE OPSOMMING: Inleiding: Wanvoeding, soos gedefinineer deur die “Malnutrition Universal Screening Tool” (MUST), “Mini-Nutritional Assessment-Short Form” (MNA-SF), “Subjective Global Assessment” (SGA), “Nutritional Risk Screening Tool-2002” (NRS-2002), “Short Nutritional Assessment Questionnaire” (SNAQ), “Nutritional Risk Indicator” (NRI) en die “Malnutrition Screening Tool” (MST), is al met nadelige uitkomste in hospitaal pasiënte geassosieer. Daarom word voedings-risiko-sifting vir alle gehospitaliseerde pasiënte aanbeveel om die herkenning en behandeling van wanvoeding te verbeter. Daar is egter min bekend oor die gebruik van siftingshulpmiddele in ‘n intensiewe sorg eenheid (ISE) omgewing. Die doel van die studie was om te assesseer watter van hierdie siftingshulpmiddele kliniese uitkomste in ISE pasiënte die beste kon voorspel en om kommentaar te lewer op die uitvoerbaarheid daarvan, om sodoende voorstelle te maak oor die toepaslikheid daarvan vir hierdie pasiënt populasie. Metodes: Alle pasiënte (>18 jaar) met ‘n chirurgiese ISE verblyf van >48 uur gedurende ‘n ag maande studieperiode is ingesluit. Pasiënte is binne 48 uur na toelating gesif m.b.v. al sewe siftingshulpmiddele. Kliniese uitkomste (mortaliteit, APACHE II telling, lengte van verblyf (LVVer), lengte van ventilasie (LVVen), komplikasies, serum-albumien, witseltelling (WST) en C-reaktiewe proteïen) is genoteer tot en met ontslag of dood. Uitvoerbaarheid en toepaslikheid van die siftingshulpmiddele is ook geassesseer. Resultate: ‘n Totaal van 206 pasiënte (62.6% manlik) is ingesluit. Die gemiddelde ouderdom was 49.5 ±17.4 jare en die gemiddelde LVVer was 5.7 ± 5.5 dae. Siftings was onuitvoerbaar in 18.3% van die pasiënte. Die MUST het 18.9% van die pasiënte as wanvoeding-risikogevalle geklassifiseer en 30.1% as wangevoed, maar kon nie enige kliniese uitkomste voorspel nie. Volgens die MNA-SF was 52.2% van die pasiënte wanvoeding-risikogevalle en 16.5% was wangevoed. Dit was geassosieer met progressief dalende serum-albumienvlakke (p<0.01) sowel as WST (p=0.01). Die SGA het 30.6% van pasiënte as matig en 18.4% as erg wangevoed geklassifiseer en het ‘n beduidende assosiasie met LVVer (p=0.03), LVVen (p=0.01), ligte komplikasies (p=0.04) en serum-albumien (p=0.01) getoon. Behalwe vir serum-albumien wat progressief verlaag het met ‘n swakker voedingstatus, het die matig wangevoede pasiënte egter die swakste uitkomste getoon en die erg wangevoede pasiënte die beste. Volgens die NRS-2002 was 72.8% van die pasiënte wangevoed en dit het ‘n beduidende korrelasie met LVVen (p=0.02) en die ontwikkeling van matige (p=0.04) en totale (p=0.01) komplikasies gehad. ‘n Nie-beduidende, maar konsekwente neiging vir swakker resultate in die wangevoede groep is ook vir die ander studie-uitkomste gesien. Die SNAQ het 35.9% van pasiënte as wangevoed of as risikogevalle daarvoor geklassifiseer. Dit was geassosieer met laer serum-albumienvlakke (p=0.04), maar ook met ‘n korter LVVen (p<0.01). Die NRI het 2.3% van pasiënte as lig, 21.0% as matig en 75.0% as erg wangevoed geklassifiseer en het slegs serum-albumien effektief voorspel (p<0.01). Die MST het 78.2% van pasiënte as wangevoed geklassifiseer en dit het die ontwikkeling van meer komplikasies (p<0.01) voorspel. Amper al die ander veranderlikes het ook swakker uitkomste getoon in die wangevoede groep, maar dit was nie-beduidend. Gevolgtrekking: Dit blyk of sifting in ‘n ISE slegs matige uitvoerbaarheid en toepaslikheid en beperkte waarde het. Slegs die NRS-2002 en die MST het potensiaal gewys om kliniese uitkomste in ISE pasiënte te voorspel.

Made available in DSpace on 2014-06-11T19:32:54Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-02-26Bitstream added on 2014-06-13T20:24:18Z : No. of bitstreams: 1 oliveira_ac_dr_jabo.pdf: 650394 bytes, checksum: 3022a3790349efbed366f6fa0374267e (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Foram estudadas 180 amostras de água de 45 consultórios odontológicos da cidade de Barretos-SP, com o objetivo de isolar, identificar, determinar a contagem de isolados de Pseudomonas aeruginosa UFC/mL, determinar o perfil clonal e avaliar a diversidade genômica dos isolados e a suscetibilidade das mesmas frente a diferentes antibióticos. As amostras de água foram filtradas em filtro Millipore® e a membrana colocada sobre o centro de uma placa de Petri contendo agar cetrimida, As colônias típicas de bactérias do gênero Pseudomonas foram identificadas pelo método de Gram, inoculação em TSI agar (Triple Sugar Iron), crescimento a 42ºC, produção de pigmento, produção de alginato, oxidase, motilidade e alcalinização da acetamida. O teste utilizado para análise genômica foi o ERIC-PCR. Dos 76 (42,2%) isolados de Pseudomonas aeruginosa, 15 eram provenientes das amostras de torneira de lavagem das mãos, 18 de reservatório de garrafa pet, 23 de seringa tríplice e 20 do motor de alta rotação. Todos os isolados de Pseudomonas aeruginosa foram submetidos ao teste de suscetibilidade segundo a técnica de Kirby- Bauer. Dos antibióticos testados o que apresentou melhor resultado quanto à sensibilidade (65,8%) foi a ciprofloxacina. Quanto à similaridade genética dos isolados dos diferentes pontos analisados, foram encontrados nove “clusters” de 100% de similaridade. / The biofilm found in water supplies and lines of hospitals and dental units is extremely important because it presents a large number of bacteria, leading to risk of infection in immunocompromised patients vulnerable to opportunistic pathogens such as the Pseudomonas aeruginosa. One hundred eighty water samples from dental units of the city of Barretos-SP were evaluated. The water samples filtered in Millipore® filter were incubated in plates containing Cetrimide ágar. The bacteria colonies were identified through the gram-staining test, inoculation in agar T.S.I (triple sugar Iron), growth at 42 ° C, pigment production, production of alginate, oxidase acetamide alkalization and motility observation. All Pseudomonas aeruginosa bacteria were submitted to the susceptibility test according to the Kirby-Bauer technique. The test used for genomic analysis was the ERIC-PCR. From the total microorganisms studied, 76 (42,2%) were positive for Pseudomonas aeruginosa, isolates from 180 water samples, where 15 strains were from hand washing incoming local water supplies, 18 from PET bottled water, 23 from 3-in-1 syringes and 20 from the high speed handpiece. In relation to the antibiotics tested, the one presenting the best result with regard to sensibility was ciprofloxacin with 65.8%. The genetic similarity of isolates from different points analyzed, there were nine clusters of 100% similarity.

Made available in DSpace on 2014-12-17T14:46:48Z (GMT). No. of bitstreams: 1 TheoDC_DISSERT.pdf: 1103452 bytes, checksum: d35fccfc8efd5462605307cfa7f54aaf (MD5) Previous issue date: 2011-10-10 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / The environment of Intensive Care Unit (ICU) is commonly referred to as a place where caring is inextricably linked to high technology. The care in ICU often changes the patient into a taxpayer being left apart from its complexity and sometimes seen through a reductionist perspective. Thus, studies circa the care process are needed oriented from a historical ransom, raising the prospect of a more centralized human care. Hence, this study aimed to analyze the care process in a nursing intensive care unit from the perspective of the professional, family and patients. The study is characterized from a qualitative, descriptive and exploratory methodological approach. The actors were participating nursing professionals, patients and family members of an intensive care unit of Mossor? / RN. Data were collected in the period of May-June 2011, through interviews and observation of activities performed by nursing professionals, and their records in the chart. Data analysis was divided into topics and subtopics representing the phases and shapes that formed the collection. The analysis and discussion of the interviews were based on Bardin's proposal, when we created categories from a process of sorting and grouping criteria adequately defined. The observation of nursing records intended to observe the emphasis which is described in those notes as well as their consistency with practice of FCN and resolution 358/2009. The analysis showed that the nursing staff also performs work focused on mechanized activities and technical-bureaucratic institution that seem to override the needs of patients. In an overview, the care provided by professionals occurs either fragmented or insipient, however there is a service that involves other aspects beyond technical-curative practice, considering that major attention is given to the family and patient, focused on the concern of Nursing guiding their actions in not only the performance of procedures. However, the process of humanizing not always ends with an engagement between professional and patient, which mischaracterizes the true meaning of human care. The records also showed a tendency to focus on caring in a positivist line, where, in most cases, the factors of the disease and the obligation to meet the productivity have overshadowed other relevant aspects to a holistic understanding of caring. Regarding FCN Resolution No. 358/2009, which guides a systematization of nursing care, it is confirmed a technical view, a fragmented and superficial view of the patient, as well as a weakness of care, caused by ignorance and unpreparedness of the entire team. The perspective of caring demonstrates a reality with dialectic between what is proposed in a humane nursing and what happens in this performance space. Besides, it was shown a daily full of important considerations that arise in professional practice, in their views and also those people who were participants in the process / O ambiente da Unidade de Terapia Intensiva (UTI) ? referido comumente como um local onde o cuidar est? intrinsecamente ligado ? alta tecnologia. O cuidar na UTI transforma, muitas vezes, o paciente em um sujeito passivo, sendo sua complexidade deixada ? parte e, por vezes, compreendida em uma perspectiva reducionista. Com isso, fazem-se necess?rios estudos voltados para o processo cuidar a partir de um resgate hist?rico, trazendo a perspectiva de uma assist?ncia mais centralizada no ser humano. Desta forma, este estudo teve como objetivo analisar o processo de cuidar em Enfermagem de uma unidade de terapia intensiva a partir da ?tica do profissional, do familiar e dos pacientes. O estudo caracteriza-se a partir de uma abordagem metodol?gica qualitativa do tipo descritivoexplorat?ria. Os atores participantes foram os profissionais de Enfermagem, os pacientes e os familiares de uma unidade de terapia intensiva de Mossor?/RN. Os dados foram obtidos, no per?odo de maio a junho de 2011,atrav?s de entrevistas e observa??o das atividades realizadas pelos profissionais da Enfermagem, bem como seus registros no prontu?rio. A an?lise dos dados foi dividida em t?picos e subt?picos representativos das fases e formas que delinearam a coleta. A an?lise e a discuss?o das entrevistas basearam-se na proposta de Bardin, em que criamos categorias a partir de um processo de classifica??o e agrupamento segundo crit?rios devidamente definidos. A observa??o dos registros de Enfermagem teve como ?nfase observar o que ? descrito nessas anota??es, bem como sua coer?ncia com sua pr?tica e a resolu??o 358/2009 do COFEN. A an?lise demonstrou que a equipe de Enfermagem ainda realiza um trabalho centrado em atividades mecanizadas e t?cnico-burocr?ticas da institui??o que parecem se sobrepor ?s necessidades dos pacientes. Em uma vis?o geral, o cuidado realizado pelos profissionais ocorre de forma fragmentada ou insipiente, por?m existe uma assist?ncia que envolve outros aspectos al?m do fazer t?cnico-curativo, considerando importante a aten??o que ? fornecida ? fam?lia e ao paciente, focalizada na preocupa??o da Enfermagem em n?o direcionar suas a??es somente ? realiza??o de procedimentos. Contudo, o processo de humanizar nem sempre se finaliza com um envolvimento entre profissional e paciente, o que descaracteriza o verdadeiro sentido do cuidar humano. Os registros tamb?m evidenciaram uma tend?ncia em focar o cuidar em uma linha positivista, em que, na maioria das vezes, os fatores da doen?a e a obriga??o de atender ? produtividade se sobrepuseram aos demais aspectos relevantes para uma compreens?o hol?stica de cuidar. Em rela??o ? resolu??o COFEN n? 358/2009, que norteia uma sistematiza??o da assist?ncia de Enfermagem, confirma-se uma vis?o tecnicista, fragmentada e superficial do paciente, bem como uma fragilidade da assist?ncia, causada pelo desconhecimento e despreparo de toda a equipe. A vis?o do cuidar que acontece nesse espa?o demonstra uma realidade com uma dial?tica entre o que se prop?e em uma Enfermagem humanizada e o que acontece nesse espa?o de atua??o. Al?m disso, mostrou-se um cotidiano repleto de considera??es importantes, que se apresentam na pr?tica do profissional, em suas concep??es e tamb?m naquelas pessoas que foram part?cipes do processo