A relação de ajuda ao doente em fim de vida e família: o enfermeiro e o cuidar em fim de vida

Os cuidados ao doente em fim de vida tornam-se difíceis de suportar pelas pessoas envolvidas, pois, para além da sobrecarga física, existe um grande desgaste psicológico e emocional, pelo que se torna importante um acompanhamento e apoio por parte dos profissionais de saúde. A relação de ajuda é um elemento decisivo na atividade dos enfermeiros, desempenhando um papel central na resposta às necessidades concretas do doente em fim de vida e sua família. O objectivo do estudo foi identificar necessidades e dificuldades que os enfermeiros enfrentam no contexto da relação de ajuda ao doente em fim de vida e família. A metodologia utilizada foi a Revisão Sistemática da Literatura sendo aplicada a metodologia PICO. Recorreu-se às bases de dados B-on, LILACS e Scielo, tendo sido reunidos 14 artigos e analisados 7. Os resultados mostraram que muitos enfermeiros sentem dificuldade em comunicar com doentes terminais, apesar de valorizarem as relações interpessoais relacionadas com a comunicação, o conforto, o apoio e acompanhamento e as técnicas de alívio do sofrimento do doente e família, direcionadas para a gestão da dor e sofrimento. A falta de formação em cuidados paliativos é evidente, sendo que o desempenho das competências relacionais de ajuda está correlacionado com a formação que os enfermeiros desenvolvem acerca da relação de ajuda. As principais conclusões a que o estudo chegou foram que apesar da dedicação dos enfermeiros a relação de ajuda ao doente terminal e família nem sempre é conseguida. O desenvolvimento pessoal e profissional, o modo como gerem as dificuldades pessoais e relacionais com o doente e família no contexto de fim de vida, são considerados como os ingredientes major ao nível do cuidar e da relação de ajuda profissional.info:eu-repo/semantics/publishedVersio

Active cervical range of motion in babies with positional plagiocephaly: Analytical cross-sectional study

Positional plagiocephaly (PP) is a general term describing cranial distortion from preor postnatal forces on the infant head. Abnormal intrauterine forces, multiple births, primiparous mothers, obstetric interventions, prematurity, male sex, excessive time lying in the supine position, and mobility restrictions of the cervical spine have been considered as the main predisposing factors. The objective was to investigate the association between the severity of PP and the active cervical rotation and to analyze the influence of predisposing factors in babies with PP. An analytical crosssectional study was performed on 74 babies with moderate PP. Clinical and demographic data, cranial vault asymmetry, and active cervical rotation range of motion (ROM) were measured. Associations were analyzed with generalized linear models. The mean age was 16.8 ± 5.0 weeks, and 56.8% were male. A restriction in the ROM of active cervical rotation, especially to the left side, was observed. Our models showed that cranial asymmetry was related with left active cervical rotation ROM (p = 0.034) and with being transported in a pushchair (p < 0.001). Conclusions: An increased severity of PP was related with being transported in a baby pushchair and with a reduced active cervical rotation ROM toward the most restricted side. © 2021 by the authors. Licensee MDPI, Basel, Switzerland

Constraining the invisible neutrino decay with KM3NeT-ORCA

Several theories of particle physics beyond the Standard Model consider that neutrinos can decay. In this work we assume that the standard mechanism of neutrino oscillations is altered by the decay of the heaviest neutrino mass state into a sterile neutrino and, depending on the model, a scalar or a Majoron. We study the sensitivity of the forthcoming KM3NeT-ORCA experiment to this scenario and find that it could improve the current bounds coming from oscillation experiments, where three-neutrino oscillations have been considered, by roughly two orders of magnitude. We also study how the presence of this neutrino decay can affect the determination of the atmospheric oscillation parameters sin^2(θ_23) and Δm^2_31, as well as the sensitivity to the neutrino mass ordering

Low-density colloid centrifugation removes bacteria from boar semen doses after spiking with selected species

[EN] Single-layer centrifugation (SLC) with a low-density colloid is an efficient method for removing contaminating microorganisms from boar semen while recovering most spermatozoa from the original sample. This study tested the performance of this technique, using 50-ml tubes, by spiking commercial semen doses prepared without antibiotics with selected bacterial species followed by storage at 17 °C. The doses were spiked up to 102/ml CFU (colony forming units) of the bacteria Burkholderia ambifaria, Pseudomonas aeruginosa, and Staphylococcus simulans. The semen was processed by SLC (15 ml of sample and 15 ml of colloid) with the colloid Porcicoll at 20% (P20) and 30% (P30), with a spiked control (CTL) and an unspiked control (CTL0), analyzing microbiology and sperm quality on days 0, 3 and 7. SLC completely removed B. ambifaria and S. simulans, considerably reducing P. aeruginosa and overall contamination (especially P30, ∼104 CFU/ml of total contamination on day 7, median). Sperm viability was lower in P20 and P30 samples at day 0, with higher cytoplasmic ROS. Still, results were similar in all groups on day 3 and reversed on day 7, indicating a protective effect of SLC (possibly directly by removal of damaged sperm and indirectly because of lower bacterial contamination). Sperm chromatin was affected by the treatment (lower DNA fragmentation and chromatin decondensation) and storage (higher overall condensation on day 7 as per chromomycin A3 and monobromobimane staining). In conclusion, SLC with low-density colloids can remove most bacteria in a controlled contamination design while potentially improving sperm quality and long-term storage at practical temperatures.S

Low-density colloid centrifugation removes bacteria from boar semen doses after spiking with selected species

Single-layer centrifugation (SLC) with a low-density colloid is an efficient method for removing contaminating microorganisms from boar semen while recovering most spermatozoa from the original sample. This study tested the performance of this technique, using 50-ml tubes, by spiking commercial semen doses prepared without antibiotics with selected bacterial species followed by storage at 17 degrees C. The doses were spiked up to 102/ml CFU (colony forming units) of the bacteria Burkholderia ambifaria, Pseudomonas aeruginosa, and Staphylococcus sim-ulans. The semen was processed by SLC (15 ml of sample and 15 ml of colloid) with the colloid Porcicoll at 20% (P20) and 30% (P30), with a spiked control (CTL) and an unspiked control (CTL0), analyzing microbiology and sperm quality on days 0, 3 and 7. SLC completely removed B. ambifaria and S. simulans, considerably reducing P. aeruginosa and overall contamination (especially P30, similar to 104 CFU/ml of total contamination on day 7, median). Sperm viability was lower in P20 and P30 samples at day 0, with higher cytoplasmic ROS. Still, results were similar in all groups on day 3 and reversed on day 7, indicating a protective effect of SLC (possibly directly by removal of damaged sperm and indirectly because of lower bacterial contamination). Sperm chromatin was affected by the treatment (lower DNA fragmentation and chromatin decondensation) and storage (higher overall condensation on day 7 as per chromomycin A3 and monobromobimane staining). In conclusion, SLC with low-density colloids can remove most bacteria in a controlled contamination design while potentially improving sperm quality and long-term storage at practical temperatures

¿Adelantan el diagnóstico de la diabetes tipo 2 los nuevos criterios de la Asociación Americana de Diabetes?

ObjetivoAnalizar el intervalo temporal entre la primera hiperglucemia basal ocasional (HBO) y el diagnóstico de diabetes mellitus tipo 2 (DM2) al aplicar los criterios de la OMS y de la Asociación Americana de Diabetes (ADA).DiseñoEstudio observacional, retrospectivo. Ámbito del estudio. Centro de atención primaria urbano.SujetosUn total de 104 pacientes con DM2, diagnosticados entre 1991 y 1995, con antecedentes de HBO.Mediciones o intervencionesEdad, género y otros factores de riesgo, fechas de la primera HBO (glucemia basal 3 110 mg/dl), del diagnóstico según criterios OMS (2 glucemias basales 3 140 mg/dl o 3 200 mg/dl a las 2 horas de la sobrecarga oral de glucosa [SOG]) y aplicando criterios ADA (2 glucemias basales 3 126 mg/dl) y los intervalos en meses entre ellas.ResultadosDe los 222 pacientes diagnosticados, 104 (47%) presentaban antecedentes de HBO. La edad en el momento del diagnóstico fue 60,8 años (DE, 10,1), siendo un 53% mujeres. En 51 casos (49%) se realizó SOG. La mediana (rango) del intervalo entre la primera HBO y el diagnóstico fue de 16 meses (0–101) en los que se realizó la SOG y de 45 (1–104) en los que no se practicó (p = 0,003). En estos últimos, los criterios ADA lo redujeron a 31 meses (0–97) (p < 0,001) y en 27 de ellos que no cumplían ambos criterios a la vez el intervalo fue de sólo 10 meses (0–93) (p < 0,001). Conclusiones. La no realización de la SOG comporta un retraso en el diagnóstico que puede ser contrarrestado con la aplicación de los criterios de la ADA.ObjectiveTo analyze the period of time between the first occasional fasting hyperglycaemia (OFH) and the diagnosis of type 2 diabetes mellitus (DM2), using the World Health Organization (WHO) criteria or the American Diabetes Association (ADA) criteria.DesignRetrospective, observational study.SettingUrban primary care centre.Subjects104 patients with DM2 diagnosed between 1991 and 1995 who had a previous OFH.MeasurementsAge, gender and other risk factors, dates of the first OFH (fasting plasma glucose 3 110 mg/dl), the diagnosis according to WHO criteria (2 fasting plasma glucose 3 140 mg/dl or 3 200 mg/dl two hours after the oral glucose test tolerance (OGTT)) or with the ADA criteria (2 fasting plasma glucose 3 126 mg/dl), and the intervals in months between them.ResultsOf the 222 diagnosed patients, 104 (47%) had previous OFH. Age at diagnosis was 60.8 (SD 10.1) and 53% were women. OGTT was performed in 51 cases (49%). The median (range) of the interval between the first OFH and diagnosis was 16 months (0–101) for those who were undertaken an OGTT, and 45 months (1–104) for those who were not (p = 0.003). In these last ones, ADA criteria reduced the interval to 31 months (0–97) (p < 0.001). In 27 of these patients who did not satisfy both criteria at the same time, ADA criteria reduced the interval to 10 months (0–93) (p < 0.001).ConclusionsNot performing the OGTT means a delay in diagnosis which can be countered by applying the ADA criteria

Modelling and validation of near-field Diesel spray CFD simulations based on the Σ -Y model

[EN] Diesel spray modelling still remains a challenge, especially in the dense near-nozzle region. This region is difficult to experimentally access and also to model due to the complex and rapid liquid and gas interaction. Modelling approaches based on Lagrangian particle tracking have struggled in this area, while Eulerian modelling has proven particularly useful. An interesting approach is the single-fluid diffuse interface model known as Σ-Y, based on scale separation assumptions at high Reynolds and Weber numbers. Liquid dispersion is modelled as turbulent mixing of a variable density flow. The concept of surface area density is used for representing liquid structures, regardless of the complexity of the interface. In this work, an implementation of the Σ-Y model in the OpenFOAM CFD library is applied to simulate the ECN Spray A in the near nozzle region, using both RANS and LES turbulence modelling. Assessment is performed with measurements conducted at the Advanced Photon Source at Argonne National Laboratory (ANL). The ultra-smallangle x-ray scattering (USAXS) technique has been used to measure the interfacial surface area, and x-ray radiography to measure the fuel dispersion, allowing a direct evaluation of the Σ-Y model predictions.Authors acknowledge that part of this work was partially funded by the Spanish Ministry of Economy and Competitiveness in the frame of the COMEFF (TRA2014-59483-R) project. Parts of this research were performed at the 7-BM and 9-ID beam lines of the Advanced Photon Source at Argonne National Laboratory. Use of the APS is supported by the U.S. Department of Energy (DOE) under Contract No. DEAC02-06CH11357. The research was partially funded by DOE's Vehicle Technologies Program, Office of Energy Efficiency and Renewable Energy. The authors would like to thank Team Leaders Gurpreet Singh and Leo Breton for their support of this workDesantes Fernández, JM.; García Oliver, JM.; Pastor, J.; Pandal, A.; Naud, B.; Matusik, K.; Duke, D.... (2017). Modelling and validation of near-field Diesel spray CFD simulations based on the Σ -Y model. En Ilass Europe. 28th european conference on Liquid Atomization and Spray Systems. Editorial Universitat Politècnica de València. 98-105. https://doi.org/10.4995/ILASS2017.2017.4715OCS9810

Predation impact on threatened spur-thighed tortoises by golden eagles when main prey is scarce

A reduction in adult survival in long-living species may compromise population growth rates. The spur-thighed tortoise (Testudo graeca) is a long-lived reptile that is threatened by habitat loss and fragmentation. Golden eagles (Aquila chrysaetos), whose breeding habitats overlap that of tortoises, may predate them by dropping them onto rocks and breaking their carapaces. In SE Spain, the number of golden eagles has increased in the last decades and the abundance of their main prey (i.e., rabbits Oryctolagus cuniculus) has decreased. Our aims were to 1) describe the role of tortoises in golden eagles’ diet, and 2) estimate the predation impact of golden eagles on tortoises in eagles’ territories and in the regional tortoise population. We collected regurgitated pellets and prey remains under eagle nests and roosts, and obtained information on tortoise abundance and population structure and rabbit abundance. We found that tortoises were an alternative prey to rabbits, so that eagles shifted to the former where the latter were scarce. The average predation rate on tortoises was very low at the two studied scales. However, eagles showed a marked selection for adult female tortoises, which led the tortoise sex ratio to be biased towards males in those eagle territories with higher tortoise predation. Whether this may compromise the spur-thighed tortoise long-term population viability locally deserves further attention.Much information on the spur-thighed tortoise populations and the regional abundance model was obtained with Projects CGL2012-33536 and CGL2015-64144 funded by the Spanish Ministry of Science and the European Regional Development Fund, Grant PID2019-105682RA-I00, funded by MCIN/AEI/10.13039/501100011033 and AICO/2021/145 funded by the Regional Valencian Government. MM was supported by a Ramón y Cajal research contract from MINECO (RYC-2015-19231), MCM by a pre-doctoral grant of the Spanish Ministry of Science (FPU1700633), and RCRC by a postdoctoral grant funded by the Regional Valencian Government (APOSTD/2020/090) and by the European Union-Next Generation EU in the Maria Zambrano Program (ZAMBRANO 21-26). The Dirección General de Gestión del Medio Natural of Andalusian Government (SGB/FOA/AFR) and the Dirección General de Medio Natural of the Murcia Region authorised and facilitated the sampling of golden eagle territories (AUF20140061) and the spur-thighed tortoise populations (SGYB/AF/DBP, SGYB/AFR/DBP, AUF20160056, AUF20140057)