Nurses and the Manchester: rearranging the work process and emergency care?

Objective: to understand the changing roles of nurses in labor division organization in hospitals from the Manchester Triage System implementation in an emergency hospital. Methods: this is an ethnographic study that used different production techniques and data analysis. Results: the Manchester Triage System organized flows and places resulting in quality of care and changes in work processes. Conflict relationships related to disagreements in risk stratification were present. Final considerations: the traditional roles of nurses have been transformed, but it cannot be said that there was a structural change in their position in labor division organization in hospitals. The frontiers of autonomy, therefore of increasing the professionalization of nurses, are neither fixed nor stable, expanding or contracting according to the micropolitical changes in the governance of care.info:eu-repo/semantics/publishedVersio

Germinação de sementes de cactáceas in vitro.

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Spherical perspective

We survey the present state of spherical perspective, regarding both mathematical structure and drawing practice, with a view to applications in the visual arts. We define a spherical perspective as the entailment of a conical anamorphosis with a compact flattening of the visual sphere. We examine a general framework for solving spherical perspectives, exemplified with the azimuthal equidistant (“fisheye”) and equirectangular cases. We consider the relation between spherical and curvilinear perspectives. We briefly discuss computer renderings but focus on methods adapted to freehand sketching or technical drawing with simple instruments such as ruler and compass. We discuss how handmade spherical perspective drawings can generate immersive anamorphoses, which can be rendered as virtual reality panoramas, leading to hybrid visual creations that bridge the gap between traditional drawing and digital environments.info:eu-repo/semantics/publishedVersio

Desempenho inicial de clones de eucalipto no litoral do estado do Ceará.

Este trabalho teve por objetivo avaliar o desempenho silvicultural de diferentes clones de Eucalyptus spp. sob condições edafoclimáticas do litoral cearense

Asthma-COPD overlap: A Portuguese survey

Introduction: The overlap between asthma and chronic obstructive pulmonary disease (COPD) (ACO) has been discussed for many years but clinical recommendations for this entity have been diverse. This study is intended to reach a consensus on diagnosis, treatment and patient orientation for ACO, within the Portuguese medical community. Methods: This study was conducted by a multidisciplinary panel of experts from three distinct medical specialties (Pulmonology, Family Medicine and Immunoallergology). This panel selected a total of 190 clinicians, based on their expertise in obstructive airway diseases, to participate in a Delphi structured survey with three rounds of questionnaires. These results were ultimately discussed, in a meeting with the panel of experts and some of the study participants, and consensus was reached in terms of classification criteria, treatment and orientation of ACO patients. Results: The majority of clinicians (87.2%) considered relevant the definition of an overlap entity between asthma and COPD. A consensus was achieved on the diagnosis of ACO – presence of simultaneous clinical characteristics of asthma and COPD together with a fixed airflow obstruction (FEV1/FVC 300 eosinophils/μL or >5% of leukocytes); elevation of specific IgEs or positive skin tests for common allergens). A combination of inhaled corticosteroid (ICS) with long-acting beta2-agonist (LABA) or long-acting muscarinic antagonist (LAMA) was considered as first line pharmacological treatment. Triple therapy with ICS plus LABA and LAMA should be used in more severe or symptomatic cases. Non-pharmacological treatment, similar to what is recommended for asthma and COPD, was also considered highly important. A hospital referral of ACO patients should be made in symptomatic or severe cases or when there is a lack of diagnostic resources. Conclusions: This study highlights the relevance of defining ACO, within the Portuguese medical community, and establishes diagnostic criteria that are important for future interventional studies. Recommendations on treatment and patient's orientation were also achieved.Actelion Pharmaceuticals (undefined)info:eu-repo/semantics/publishedVersio

Anotações de doenças em espécies arbóreas no estado do Ceará.

A Embrapa Agroindústria Tropical implantou um campo de observação com diferentes espécies de árvores madeireiras nativas e exóticas no Município de Acaraú, na região compreendida pelo Distrito de Irrigação do Perímetro Baixo Acaraú, de maneira a acompanhar e observar o desenvolvimento dessas plantas em relação à adaptação das diferentes espécies.bitstream/item/174194/1/DOC18002.pd