Quality indicators in support of intravenous therapy in a university hospital: a contribution of nursing

Objectives: to understand the indicators of quality of care for intravenous therapy in the neonatal intensive care unit of a university hospital. Method: a non-experimental descriptive study with a quantitative approach in the NICU of a university hospital, through a systematic survey on the protocol of intravenous care: peripheral venous access, PICC and central venous catheter. Excel and presented in tables - statistical treatment, where the data were pooled and processed in Microsoft Office program was conducted. The study was approved by the CEP HUAP/UFF under Protocol 01660412.9.0000.5243 . Results: in the data analysis, the results showed a greater need for technical training and maintenance of venous access catheter peripheral, PICC, and umbilical catheter. Conclusion: so, the health professional should facilitate and promote patient safety for the sake of your well being and quality of life, avoiding the risks and adverse effects

Clinical management of pain in the newborn: perception of nurses from the neonatal intensive care unit

Objective: analyzing the perceptions of nurses about the clinical pain in neonates in neonatal intensive care unit. Method: a descriptive, exploratory study, of a qualitative approach conducted with ten nurses in the neonatal intensive care unit of the University Hospital Antônio Pedro applying a semi-structured interview for data collection, and analyzed according to thematic content analysis method. Results: understanding the mechanism of neonatal pain, which does not depend upon complete formation of myelination; lack of verbalization of the newborn and this fact complicates the assessment of pain; however we must be sensitive to other physiological and behavioral signs, such as: facial mimicry, heart and respiratory rate, systolic blood pressure, oxygen saturation, palmar sweating and vagal tone. Conclusion: it is a practice to be rethought the use of protocols and scales for the evaluation of indicators of neonatal pain

The lactation in women with premature babies: reconstructing the nursing care

Objetivo: compreender as estratégias utilizadas pelos enfermeiros na Unidade de Terapia Intensiva Neonatal do HUAP, no manejo clínico da amamentação junto às mães de recém-nascidos pré-termo. Método: pesquisa descritiva, exploratória, qualitativa, aprovada pelo Comitê de Ética em Pesquisa da Faculdade de Medicina do HUAP sob protocolo: 0199.0.258.000-11, viabilizando o início da coleta de dados realizada entre junho e agosto de 2012, mediante entrevista semiestruturada junto a vinte e dois (22) enfermeiros atuantes naquela Unidade. Resultados: verificou-se insuficiência de conhecimento e habilidade dos sujeitos para manejar adequadamente as situações que podem obstaculizar a amamentação bem sucedida. Os enfermeiros devem atuar como educadores, responsáveis pelo gerenciamento do cuidado, sendo também capazes de definir estratégias para que haja sucesso no processo de aleitamento materno. Conclusão: assim, o processo educativo do enfermeiro é essencial para a promoção, proteção e apoio do aleitamento materno

The lactation in women with premature babies: reconstructing the nursing care

Objetivo: compreender as estratégias utilizadas pelos enfermeiros na Unidade de Terapia Intensiva Neonatal do HUAP, no manejo clínico da amamentação junto às mães de recém-nascidos pré-termo. Método: pesquisa descritiva, exploratória, qualitativa, aprovada pelo Comitê de Ética em Pesquisa da Faculdade de Medicina do HUAP sob protocolo: 0199.0.258.000-11, viabilizando o início da coleta de dados realizada entre junho e agosto de 2012, mediante entrevista semiestruturada junto a vinte e dois (22) enfermeiros atuantes naquela Unidade. Resultados: verificou-se insuficiência de conhecimento e habilidade dos sujeitos para manejar adequadamente as situações que podem obstaculizar a amamentação bem sucedida. Os enfermeiros devem atuar como educadores, responsáveis pelo gerenciamento do cuidado, sendo também capazes de definir estratégias para que haja sucesso no processo de aleitamento materno. Conclusão: assim, o processo educativo do enfermeiro é essencial para a promoção, proteção e apoio do aleitamento materno

ASSOCIATION BETWEEN LEUKEMIC EVOLUTION AND UNCOMMON CHROMOSOMAL ALTERATIONS IN PEDIATRIC MYELODYSPLASTIC SYNDROME

Background and objective: Pediatric myelodysplastic syndrome (pMDS) is a group of rare clonal neoplasms with a difficult diagnosis and risk of progression to acute myeloid leukemia (AML). The early stratification in risk groups is essential to choosing the treatment and indication for allogeneic hematopoietic stem cell transplantation (HSCT). According to the Revised International Prognostic Scoring System, cytogenetic analysis has demonstrated an essential role in diagnosis and prognosis. In pMDS, abnormal karyotypes are present in 30-50% of the cases.  Monosomy 7 is the most common chromosomal alteration associated with poor prognosis. However, the rarity of specific cytogenetic alterations makes its prognosis uncertain. Thus, this study aimed to describe uncommon cytogenetic alterations in a cohort of 200 pMDS patients and their association with evolution to AML. Methods: The cytogenetic analysis was performed in 200 pMDS patients by G-banding and fluorescence in situ hybridization between 2000 to 2022. Results: Rare chromosome alterations were observed in 7.5% (15/200) of the cases. These chromosome alterations were divided into four cytogenetic groups: hyperdiploidy, biclonal chromosomal alterations, translocations, and uncommon deletions, which represented 33.3%, 33.3%, 20%, and 13.3%, respectively. Most of these patients (10/15) were classified with advanced MDS (MDS-EB and MDS/AML) and the initial subtype was present in five patients (RCC). The leukemic evolution was observed in 66.66% (10/15) of the patients. Most patients had poor clinical outcomes and they were indicated for HSCT.  Conclusion: The study of uncommon cytogenetic alterations in pMDS is important to improve the prognosis and guide early indication of HSCT.  Keywords: Pediatric MDS; Leukemic evolution; rare chromosomal altwerations; HSCT, Childre

Programa educativo em medidas de precaução universais: uma metodologia de abordagem

An updating program on measures of universal precautions (M.U.P.) was developed at the Center of Whole Care of Woman's Health (Centro de Atenção Integral à Saúde da Mulher - CAISM). These measures and the procedures in the case of work accident were published in a booklet. First, servants should be aware of the matter of stress and its influence on the quality of life. Then, updating was carried through encouraging the reflection on the consequences of the non-adoption of M.U.P. The answers to 286 pre-tests and 242 post-tests were analyzed and the results showed a significantly higher index of correct answers (p< 0,01), mainly regarding the appropriate use of glove.El Centro de Atención Integral a la Salud de la Mujer (CAISM) desarrolló un programa de reciclaje sobre Medidas de Precaución Universales (MPU). Se divulgó por medio de un material educativo (cartilla) las MPU y procedimientos en caso de accidentes de trabajo. En primer lugar se cuestionó al funcionário sobre el stress y su influencia en la calidad de vida, llevando se a cabo el reciclaje en el cual se promovió la reflexión sobre consecuencias cuando las MPU no son adoptadas. Fueron respondidas y analizadas 286 pre-test y 242 pos-test con un índice de acierto significativamente mayor en este último (p < 0,01), principalmente con relación al uso adecuado de los guantes.No Centro de Atenção Integral à Saúde da Mulher (CAISM) desenvolveu-se um programa de reciclagem sobre as Medidas de Precaução Universais (MPU) e divulgou-se, através de uma cartilha, essas medidas e os procedimentos em caso de acidente de trabalho. Primeiramente, o funcionário era sensibilizado para a questão do estresse e sua influência sobre a qualidade de vida e, após, era realizada a reciclagem promovendo-se a reflexão sobre as conseqüências da não adoção das MPU. Foram respondidos e analisados 286 pré-testes e 242 pós-testes com um índice de acertos significativamente maior nestes últimos (

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

The Amazon Tall Tower Observatory (ATTO): Overview of pilot measurements on ecosystem ecology, meteorology, trace gases, and aerosols

The Amazon Basin plays key roles in the carbon and water cycles, climate change, atmospheric chemistry, and biodiversity. It has already been changed significantly by human activities, and more pervasive change is expected to occur in the coming decades. It is therefore essential to establish long-term measurement sites that provide a baseline record of present-day climatic, biogeochemical, and atmospheric conditions and that will be operated over coming decades to monitor change in the Amazon region, as human perturbations increase in the future. The Amazon Tall Tower Observatory (ATTO) has been set up in a pristine rain forest region in the central Amazon Basin, about 150 km northeast of the city of Manaus. Two 80 m towers have been operated at the site since 2012, and a 325 m tower is nearing completion in mid-2015. An ecological survey including a biodiversity assessment has been conducted in the forest region surrounding the site. Measurements of micrometeorological and atmospheric chemical variables were initiated in 2012, and their range has continued to broaden over the last few years. The meteorological and micrometeorological measurements include temperature and wind profiles, precipitation, water and energy fluxes, turbulence components, soil temperature profiles and soil heat fluxes, radiation fluxes, and visibility. A tree has been instrumented to measure stem profiles of temperature, light intensity, and water content in cryptogamic covers. The trace gas measurements comprise continuous monitoring of carbon dioxide, carbon monoxide, methane, and ozone at five to eight different heights, complemented by a variety of additional species measured during intensive campaigns (e.g., VOC, NO, NO2, and OH reactivity). Aerosol optical, microphysical, and chemical measurements are being made above the canopy as well as in the canopy space. They include aerosol light scattering and absorption, fluorescence, number and volume size distributions, chemical composition, cloud condensation nuclei (CCN) concentrations, and hygroscopicity. In this paper, we discuss the scientific context of the ATTO observatory and present an overview of results from ecological, meteorological, and chemical pilot studies at the ATTO site. © Author(s) 2015

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple organism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region's vulnerability to environmental change. 15%–18% of the most neglected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lost