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Extreme environments are aggressive for concrete structures, hence a performance-based design is crucial to guarantee the durability during the service life. Nonetheless, there is a knowledge gap regarding the influence of cracks on standard and self-healing concrete. This research focuses on monitoring cracked self-healing concrete with two commercial healing agents: a bacteria-based healing agent (BAS) and a crystalline admixture (CA). After crack formation and a healing process of three months in wet/dry conditions (4 days/3 days), several extreme conditions were considered: (1) submerged in artificial seawater, (2) submerged in a solution with 33 g/L sodium chloride and (3) freeze-thaw (FT) cycling with de-icing salts. Microscopic images were used to quantify the healing efficiency of the two different healing agents, while chloride ingress and scaling were measured to determine durability. The results of the microscopic measurements indicated significant healing efficiency for both healing agents after the healing regime reaching 72% for CA, and 67% for BAS. After exposure to a marine environment, this efficiency increased to 95% and 92%, respectively. The uncracked BAS samples achieved a scaling reduction of 93% under FT exposure relative to the uncracked REF samples, while this was 49% for the CA samples. In cracked samples, scaling was reduced by 50% for BAS and 24% for CA, relative to the cracked REF samples. In all tested conditions, the BAS samples partially prevented the chloride ingress through the crack, while CA samples showed a great reduction. Overall, both healing agents reduced the degradation and could decrease the chloride ingress.

Among the various possibilities to tackle the issue of concrete damage within its structural service life, the biomimetic approach has favoured the development of innovative solutions such as the use of 3D printed vascular networks suitably incorporated into concrete structural elements to inject and convey the most suitable healing agent upon crack occurrence. These systems, able to cope with damage of different intensities, may lead to improvements of the structure’s durability, through the closure of cracks, and a consequent reduction of the frequency of major maintenance activities. The present work investigates the environmental sustainability of the aforesaid self-healing technology through a Life Cycle Assessment (LCA) analysis. The attention has been also focused on the 3D printing process of the network due to the key role that it could play, in terms of environmental burdens, when upscaled to real-life size applications. The case study of a beam healed by means of polyurethane injected through the network and exposed to a chloride environment is reported to better predict the potential improvements in terms of overall durability and consequent sustainability within the pre-defined service life.

Vascular self-healing concrete is an innovative technology that can potentially improve the durability and longevity of concrete structures. However, limited research is available concerning this type of self-healing compared to intrinsic or capsule-based healing. As the rheology and curing properties of a healing agent can dictate the optimal design configuration of a vascular network, a series of testing procedures for evaluating healing agents is further explored. In this study, the suitability of various commercially available healing agents is considered using a vascular network system in mechanical loading and water absorption test set-ups. In this particular configuration, high sealing efficiencies were obtained for most of the healing agents used, and the polyurethanes and epoxy resin that were studied showed high load regain values. This work provides a testing methodology to select a healing agent in terms of its mechanical load regain, sealing efficiency, rheology, and curing properties, and can be used to determine a suitable healing agent for vascular healing applications.

Microbially induced calcium carbonate precipitation (MICP) presents a sustainable, environmentally friendly solution for repairing cracks in cement-based materials, such as mortar and concrete. This self-healing approach mechanism enables the matrix to autonomously close its own cracks over time. In this study, specimens (50 mm in diameter and 25 mm in height) were exposed to submersion and a wet–dry cycle environment. The solution considered a nutrient-rich suspension with calcium lactate, urea, calcium nitrate, and Bacillus subtilis or Sporosarcina pasteurii in a biomineralization approach. The self-healing efficiency was assessed through optical microscopy combined with image processing, focusing on the analysis of the superficial crack closure area. S. and B. subtilis exhibited notable capabilities in effectively healing cracks, respectively, 8 mm2 and 5 mm2 at 35 days. Healing was particularly effective in samples placed in a submerged environment, especially with a 69 mM concentration of calcium lactate in bacterial suspensions containing B. subtilis, where 87.5% of a 4 mm2 crack was closed within 21 days. In contrast, free calcium ions in the solution, resulting from anhydrous cement hydration, proved ineffective for S. pasteurii biomineralization in urea-rich environments. However, the addition of an external calcium source (calcium nitrate) significantly enhanced crack closure, emphasizing the critical role of calcium availability in optimizing MICP for bio-agents in cement-based materials. These findings highlight the potential of MICP to advance sustainable self-healing concrete technologies.

Resumo Objetivo Compreender as possibilidades e obstáculos ao cuidado compartilhado na atenção primária à saúde sob a perspectiva de médicos, enfermeiros e pessoas chave com vistas a reflexão sobre a implementação da prática avançada de enfermagem. Métodos Estudo exploratório de abordagem qualitativa realizado com médicos e enfermeiros da atenção primária (atuando nos estados do Paraná e Rio de Janeiro) e representantes de entidades associativas de ambas categorias profissionais (em nível regional e nacional). Foram realizados três grupos focais online e um grupo focal presencial, em 2022, com um total de 29 participantes. A análise de conteúdo foi realizada segundo Bardin. Resultados Os profissionais mencionaram já realizar cuidado compartilhado, intercalando consultas entre médicos e enfermeiros nas áreas de puericultura e pré-natal e nas condições crônicas e atenção aos idosos, potencializando o cuidado. Eles identificaram que esse cuidado é mais harmônico em unidades com residências multiprofissionais médica ou de enfermagem. Refletiram que as restrições a essa expansão são condicionadas por assimetrias de poder entre médicos e enfermeiros que poderão ser desconstruídas ao longo do tempo. Eles também destacaram a importância de melhor conhecer as funções de cada profissional referindo a sobrecarga de trabalho como um desafio. Conclusão As atividades atualmente desenvolvidas e compartilhadas entre enfermeiros e médicos na Atenção Primária à Saúde possibilitarão implementar a prática avançada de enfermagem. Porém, é necessário ampliar o entendimento sobre essa prática entre esses profissionais e otimizar as condições para seu exercício efetivo. Resumen Objetivo Analizar las posibilidades y los obstáculos del cuidado compartido en la atención primaria de salud desde la perspectiva de los médicos, enfermeros y personas clave a fin de reflexionar sobre la implementación de la práctica avanzada de enfermería. Métodos Estudio exploratorio de enfoque cualitativo realizado con médicos y enfermeros de la atención primaria, que trabajan en los estados de Paraná y Rio de Janeiro, y con representantes de las entidades asociativas de ambas clases profesionales (a nivel regional y nacional). En el año 2022, se realizaron tres grupos focales virtuales y un grupo focal presencial con un total de 29 participantes. El análisis de contenido se realizó de acuerdo con el modelo de Bardin. Resultados Los profesionales mencionaron que ya realizaban prácticas de cuidado compartido e intercalaban consultas entre médicos y enfermeros en el área de puericultura y de control prenatal y en afecciones crónicas y atención a adultos mayores, para potencializar el cuidado. Identificaron que ese cuidado es más armónico en unidades con residencias multiprofesionales médicas o de enfermería. Observaron que las restricciones de esa expansión están condicionadas por asimetrías de poder entre médicos y enfermeros, que podrán deconstruirse a lo largo del tiempo. También destacaron la importancia de conocer mejor las funciones de cada profesional en lo que se refiere a la sobrecarga de trabajo como un desafío. Conclusión Las actividades que actualmente realizan y comparten los enfermeros y los médicos en la atención primaria de salud permitirán implementar la práctica avanzada de enfermería. Sin embargo, es necesario ampliar la comprensión sobre esta práctica entre los profesionales y optimizar las condiciones para su efectivo ejercicio. Abstract Objective To explore the opportunities and challenges of shared care in primary healthcare from the perspectives of physicians, nurses, and key stakeholders, with the aim of reflecting on the implementation of Advanced Nursing Practice. Methods This is an exploratory study with a qualitative approach carried out with primary care physicians and nurses (working in the states of Paraná and Rio de Janeiro) and representatives of associative entities of both professional categories (at regional and national levels). Three online focus groups and one in-person focus group were held in 2022, with a total of 29 participants. Content analysis was performed according to Bardin. Results Professionals report that they already provide shared care, alternating consultations between physicians and nurses in the areas of childcare and prenatal care and chronic conditions and elderly care, thereby enhancing the overall quality of care. They identified that shared care is more harmonious in units with multiprofessional medical or nursing residences. They reflected that restrictions on shared care are promoted by power asymmetries between physicians and nurses, which can be deconstructed over time. They also emphasized the importance of better understanding each professional’s role, naming work overload as a particular challenge. Conclusion The activities currently shared between nurses and physicians in primary healthcare lay the groundwork for the implementation of Advanced Nursing Practice. However, it is essential to deepen the understanding of this practice among these professionals and optimize the conditions for its effective execution.

The use of different technologies have contributed to the increase in durability facing the aggressive agents that damage the concrete structures. Therefore, it is possible to reduce the capillary porosity in concrete lowering the ratio water/binder; using pozzolan, hydrophobic or waterproofing products in the mixture; applying hydrophobic products or waterproofing in the concrete surface; replacing pure cements for compounds cements, pozzolanic cements or cements with blast furnace slag; among other actions. The waterproofing has the function to prevent the water or fluid passage in liquid or steam state, thereby protecting structures. The waterproofing creates a barrier when coating is applied to close surface pores with the aim of preventing the water pervasion by any transport mechanism. This paper has evaluated the use of crystalline waterproofing as admixtures, as well as a coating, sanding and no-sanding, in order to know the benefits it can bring to the concrete water absorption, comparing their performance with other concretes with or without silica fume admixture. Developed tests were: total absorption, under pressure water penetration (30 kPa) and compressive strength test. The results have showed that the silica fume admixture is more efficient than the analyzed crystalline waterproofing, as it has contributed to the compressive strength increase and decrease of water absorption and penetration. The crystalline waterproofing admixture has contributed to compressive strength increase; however, there was also an increase in the absorption and penetration. On the other hand, the coating waterproofing has not influenced the compressive strength, but reduced absorption and penetration when sanded.

The durability assurance in reinforced concrete is necessary during the design conception and mix design as a preventive measure. Permeability in cementitious materials is a crucial durability indicator that can be influenced by many factors, from capillary porosity to cracks. Under those circumstances, it might be helpful to have concrete with the ability to reduce permeability. In this paper, the effectiveness of incorporating a crystalline admixture, both as an admixture and surface treatment, through characterisation tests, durability tests, and self-healing analyses. A concrete with silica fume as an admixture was also produced for comparison to the use of crystalline admixture (CA). The silica fume showed more efficiency in all assessed properties relative to both the reference and CA for condition with limited water availability. Crystalline admixture is also beneficial over reference concrete when used as an admixture, increasing the compressive strength and decreasing the ingress of chloride and carbon dioxide. The concrete with surface treatment had similar behaviour of reference concrete. Additionally, healing products from the use of crystalline admixture take the form of a needle shape in concrete.

Abstract Objective To explore the opportunities and challenges of shared care in primary healthcare from the perspectives of physicians, nurses, and key stakeholders, with the aim of reflecting on the implementation of Advanced Nursing Practice. Methods This is an exploratory study with a qualitative approach carried out with primary care physicians and nurses (working in the states of Paraná and Rio de Janeiro) and representatives of associative entities of both professional categories (at regional and national levels). Three online focus groups and one in-person focus group were held in 2022, with a total of 29 participants. Content analysis was performed according to Bardin. Results Professionals report that they already provide shared care, alternating consultations between physicians and nurses in the areas of childcare and prenatal care and chronic conditions and elderly care, thereby enhancing the overall quality of care. They identified that shared care is more harmonious in units with multiprofessional medical or nursing residences. They reflected that restrictions on shared care are promoted by power asymmetries between physicians and nurses, which can be deconstructed over time. They also emphasized the importance of better understanding each professional’s role, naming work overload as a particular challenge. Conclusion The activities currently shared between nurses and physicians in primary healthcare lay the groundwork for the implementation of Advanced Nursing Practice. However, it is essential to deepen the understanding of this practice among these professionals and optimize the conditions for its effective execution. Resumo Objetivo Compreender as possibilidades e obstáculos ao cuidado compartilhado na atenção primária à saúde sob a perspectiva de médicos, enfermeiros e pessoas chave com vistas a reflexão sobre a implementação da prática avançada de enfermagem. Métodos Estudo exploratório de abordagem qualitativa realizado com médicos e enfermeiros da atenção primária (atuando nos estados do Paraná e Rio de Janeiro) e representantes de entidades associativas de ambas categorias profissionais (em nível regional e nacional). Foram realizados três grupos focais online e um grupo focal presencial, em 2022, com um total de 29 participantes. A análise de conteúdo foi realizada segundo Bardin. Resultados Os profissionais mencionaram já realizar cuidado compartilhado, intercalando consultas entre médicos e enfermeiros nas áreas de puericultura e pré-natal e nas condições crônicas e atenção aos idosos, potencializando o cuidado. Eles identificaram que esse cuidado é mais harmônico em unidades com residências multiprofissionais médica ou de enfermagem. Refletiram que as restrições a essa expansão são condicionadas por assimetrias de poder entre médicos e enfermeiros que poderão ser desconstruídas ao longo do tempo. Eles também destacaram a importância de melhor conhecer as funções de cada profissional referindo a sobrecarga de trabalho como um desafio. Conclusão As atividades atualmente desenvolvidas e compartilhadas entre enfermeiros e médicos na Atenção Primária à Saúde possibilitarão implementar a prática avançada de enfermagem. Porém, é necessário ampliar o entendimento sobre essa prática entre esses profissionais e otimizar as condições para seu exercício efetivo. Resumen Objetivo Analizar las posibilidades y los obstáculos del cuidado compartido en la atención primaria de salud desde la perspectiva de los médicos, enfermeros y personas clave a fin de reflexionar sobre la implementación de la práctica avanzada de enfermería. Métodos Estudio exploratorio de enfoque cualitativo realizado con médicos y enfermeros de la atención primaria, que trabajan en los estados de Paraná y Rio de Janeiro, y con representantes de las entidades asociativas de ambas clases profesionales (a nivel regional y nacional). En el año 2022, se realizaron tres grupos focales virtuales y un grupo focal presencial con un total de 29 participantes. El análisis de contenido se realizó de acuerdo con el modelo de Bardin. Resultados Los profesionales mencionaron que ya realizaban prácticas de cuidado compartido e intercalaban consultas entre médicos y enfermeros en el área de puericultura y de control prenatal y en afecciones crónicas y atención a adultos mayores, para potencializar el cuidado. Identificaron que ese cuidado es más armónico en unidades con residencias multiprofesionales médicas o de enfermería. Observaron que las restricciones de esa expansión están condicionadas por asimetrías de poder entre médicos y enfermeros, que podrán deconstruirse a lo largo del tiempo. También destacaron la importancia de conocer mejor las funciones de cada profesional en lo que se refiere a la sobrecarga de trabajo como un desafío. Conclusión Las actividades que actualmente realizan y comparten los enfermeros y los médicos en la atención primaria de salud permitirán implementar la práctica avanzada de enfermería. Sin embargo, es necesario ampliar la comprensión sobre esta práctica entre los profesionales y optimizar las condiciones para su efectivo ejercicio.