Cultura de segurança do doente pediátrico num centro hospitalar da zona norte

Enquadramento: O doente pediátrico, pelas características inerentes ao seu desenvolvimento e crescimento está mais suscetível a sofrer eventos adversos. Torna-se importante que todos os profissionais orientem a sua prática de cuidados no sentido de construir e assegurar uma cultura de segurança do doente, de modo a alcançarem melhores níveis de segurança e de qualidade nos cuidados à criança. Objetivo: Identificar fatores que influenciam a perceção da cultura de segurança do doente pediátrico num centro hospitalar da região Norte. Metodologia: Estudo quantitativo, descritivo-correlacional e transversal, realizado a partir da aplicação da escala Hospital Survey on Patient Safety Culture (Agency for Healthcare Research and Quality, 2014), a uma amostra de 80 profissionais de saúde. São maioritariamente do sexo feminino (88,8%), com idades entre os 25 e os 61 anos, tendo a maioria entre 13 a 20 anos de experiência na prestação de cuidados à criança (30,0%%). Resultados: Do total da amostra, 81,3% não fez qualquer notificação de eventos/ocorrências nos últimos 12 meses. Apenas a dimensão “Trabalho em equipa” se revelou ser um ponto forte, as dimensões “Dotação de profissionais”, “Apoio à segurança do doente pela gestão”, “Resposta ao erro não punitiva” e “Frequência de notificação de eventos”, são aspetos “críticos/problemáticos”. A perceção da cultura de segurança do doente pediátrico difere significativamente quanto às categorias dos fatores: sexo, grupo etário, serviço onde trabalha, formação em segurança e gestão de risco e conhecimento do sistema nacional de notificação de incidentes. Conclusão: A cultura de segurança do doente pediátrico, percecionada pelos participantes no estudo, caracteriza-se como uma cultura de receio de resposta punitiva ao erro e de não notificação de eventos adversos. Consideramos que é importante refletir em conjunto nos aspetos identificados como mais críticos, para implementar medidas de melhoria e desenvolver uma cultura de segurança.Abstract Background: The pediatric patient, due to the characteristics inherent to his/her development and growth is more likely to suffer adverse events. It is important that all professionals guide their practice of care in order to build and ensure a patient safety culture, so that they can achieve better levels of safety and quality in childcare. Objective: To identify factors that influence the perception of the pediatric patient safety culture in a hospital of the North. Methodology: Quantitative, descriptive-correlational and cross-sectional study conducted from the application range Hospital Survey on Patient Safety Culture (Agency for Healthcare Research and Quality, 2014), to a sample of 80 health professionals. They are mostly female (88.8%), aged between 25 and 61 years, and most of them have between 13 and 20 years of experience in providing child care (30.0 %%). Results: Of the total sample, 81.3% hasn’t made any event/occurrences reports in the last 12 months. Only the dimension "Team Work" turned out to be a strength, the dimensions "Professional Allocation", "Support for Patient Safety by Management", "Response Not Punitive to Error" and "Frequency of Event Report", are "critical/problematic" aspects. The perception of the pediatric patient safety culture differs significantly in the categories of factors: gender, age group, service where he/she works, safety training and risk management and knowledge of the national system of incident reporting. Conclusion: The safety culture of the pediatric patient, perceived by the participants in the study, is characterised as a culture of fear of a punishing answer to error and the no report of adverse events. We believe it is important to consider together about the aspects identified as the most critical to implement improvement measures and develop a culture of safety

Effect of disorder on the vortex-lattice melting transition

We use a three dimensional stacked triangular network of Josephson junctions as a model for the study of vortex structure in the mixed state of high Tc superconductors. We show that the addition of disorder destroys the first order melting transition occurring for clean samples. The melting transition splits in two different (continuous) transitions, ocurring at temperatures Ti and Tp (>Ti). At Ti the perpendicular-to-field superconductivity is lost, and at Tp the parallel-to-field superconductivity is lost. These results agree well with recent experiments in YBaCuO.Comment: 4 pages + 2 figure

Configuração do espaço híbrido e multimodal: Literaturalização das Ciências na Educação Superior

As tecnologias potencializam de maneira mais intensa e rápida as transformações em diferentes segmentos. Na Educação identificamos a configuração do espaço por meio do hibridismo entre elementos distintos, separáveis e contraditórios e da multimodalidade na tessitura entre educação presencial e on-line. Assim, destacamos tendências em compreender as Ciências de forma literaturada e metafórica. Logo, emerge a questão: De que forma a literaturalização das ciências participa da configuração do espaço híbrido e multimodal na Educação Superior? Articulamos as pesquisas desenvolvidas no COTEDIC UNILASALLE/CNPq e no LERSEM IRSA-CRI, de natureza exploratória e qualitativa. Evidenciamos que a configuração a partir da literaturalização das ciências ocorre na tensão entre paradigmas dominantes e emergentes; nas redes de conhecimentos e no hibridismo das linguagens; em práticas pedagógicas dialógicas contemplando espaços geográficos e digitais virtuais e com tecnologias analógicas e digitais

Determination of silica content in wood by flame atomic absorption spectroscopy versus ultraviolet-visible spectroscopy

O presente trabalho teve como objetivo comparar o desempenho de duas t\ue9cnicas anal\uedticas, espectroscopia de absor\ue7\ue3o at\uf4mica de chama (FAAS) e espectroscopia no ultravioleta-vis\uedvel (UV-VIS), na determina\ue7\ue3o do teor de s\uedlica em materiais lignocelul\uf3sicos. Os m\ue9todos foram testados em amostras de madeira de tr\ueas \ue1rvores de Apuleia leiocarpa (Vog.) Macbride. Os resultados mostraram que ambas as t\ue9cnicas apresentam bons resultados, no entanto, a FAAS apresenta melhor precis\ue3o, rapidez e simplicidade operacional. Entretanto, a aplica\ue7\ue3o da espectroscopia UV-VIS \ue9 justificada pelo fato de os custos de aquisi\ue7\ue3o e manuten\ue7\ue3o de um espectrofot\uf4metro UV-VIS serem muito inferiores \ue0queles de um espectr\uf4metro de absor\ue7\ue3o at\uf4mica. O uso da t\ue9cnica FAAS deve ser preferido apenas quando os teores de s\uedlica a serem determinados forem muito baixos, tendo em vista que a espectroscopia UV-VIS, nesses casos, n\ue3o apresenta boa precis\ue3o.The objective of this work was to compare the performance of two analytical techniques, flame atomic absorption spectroscopy (FAAS) and ultraviolet-visible spectroscopy (UV-VIS), in the determination of the silica content in lignocellulosic materials. The methods were tested in wood specimens of three trees of Apuleia leiocarpa (Vog.) Macbride. The results showed that both techniques present good performance, but the FAAS presents better precision, speed and operational simplicity. However, the application of the UV-VIS spectroscopy is justified by the fact of the acquisition and maintenance costs of an UV-VIS spectrophotometer are lower when compared to those of a spectrometer of atomic absorption. The use of the FAAS technique should just be chosen when the silica content is expected to be very low, once the UV-VIS spectroscopy, in those cases, does not present good precision

Association of the Calcification Score of the Abdominal Aorta, Common Iliac, and Renal Arteries with Outcomes in Living Kidney Donors

Background: Vascular calcification is an ever-more-common finding in protocoled pre-transplant imaging in living kidney donors. We intended to explore whether a connection could be found between the Agatston calcification score, prior to kidney donation, and post-donation renal function. Methods: This is a retrospective analysis of 156 living kidney donors who underwent living donor nephrectomy between January 2010 and December 2016. We quantified the total calcification score (TCaScore) by calculating the Agatston score for each vessel, abdominal aorta, common iliac, and renal arteries. Donors were placed into two different groups based on their TCaScore: <100 TCaScore group and ≥100 TCaScore group. The relationship between TCaScore, 1-year eGFR, proteinuria, and risk of 1 measurement of decreased renal function (eGFR < 60 mL/min/1.73 m2) over 5 years of follow-up was investigated. Results: The ≥100 TCaScore group consisted of 29 (19%) donors, with a median (interquartile range) calcification score of 164 (117-358). This group was significantly older, 56.7 ± 6.9 vs. 45.5 ± 10.6 (p < 0.001), had a higher average BMI (p < 0.019), and had a lower preoperative eGFR (p < 0.014). The 1-year eGFR was similarly diminished, 69.9 ± 15.7 vs. 76.3 ± 15.5 (p < 0.048), while also having an increased risk of decreased renal function during the follow-up, 22% vs. 48% (p < 0.007). Conclusions: Our study, through univariate analyses, found a relationship between a TCaScore > 100, lower 1-year eGFR, and decreased renal function in 5 years. However, a higher-than-expected vascular calcification should not be an excluding factor in donors, although they may require closer monitoring during follow-up.info:eu-repo/semantics/publishedVersio

Ranking descriptive analysis in the sensory characterization of strawberry flavored diet yogurt enriched with whey protein concentrate

This study evaluated the sensory characteristics of diet strawberry flavored yogurt enriched with whey protein concentrate (WPC). Three formulations containing 0,5%, 1% and 1.5% of WPC (F2, F3 and F4 in order of increasing concentration) and a controlled formulation without the addition of WCP (F1) were developed and evaluated by Ranking Descriptive Analysis. Twenty selected and trained panelists evaluated the samples characterized by attributes: pink color, viscosity, characteristic aroma of strawberry yogurt, characteristic flavor of strawberry yogurt, sweet taste, sour taste and consistency. The formulations differed significantly (p < 0.05) in the attributes sweet taste and consistency. Samples F3 and F4 showed greater consistency confirming the efficiency of the WPC in increasing the consistency.31366166

Desempenho da cultura do feijão-caupi sob efeitos de adubos verdes em Itaquiraí, Mato Grosso do Sul.

bitstream/item/68912/1/043-moitinho-desempenho.pdfPublicado também no Cadernos de Agroecologia, v. 7, n.2, 2012

CT volumetry performs better than nuclear renography in predicting estimated renal function one year after living donation

The evaluation of split renal function (SRF) is a critical issue in living kidney donations and can be evaluated using nuclear renography (NR) or computerized tomography (CT), with unclear comparative advantages. We conducted this retrospective study in 193 donors to examine the correlation of SRF assessed by NR and CT volumetry and compared their ability to predict remaining donor renal function at 1 year, through multiple approaches. A weak correlation between imaging techniques for evaluating the percentage of the remaining kidney volume was found in the global cohort, with an R2 = 0.15. However, the Bland-Altman plot showed an acceptable agreement (95% of the difference between techniques falling within - 8.51 to 6.11%). The predicted and observed eGFR one year after donation were calculated using the CKD-EPI, and CG/BSA equations. CT volume showed a better correlation than NR for both formulas (adjusted R2 of 0.42. and 0.61 vs 0.37 and 0.61 for CKD-EPI and CG/ BSA equations, respectively). In non-nested modeling tests, CT volumetry was significantly superior to NR for both equations. CT volumetry performed better than NR in predicting the estimated renal function of living donors at 1-year, independently from the eGFR equation.info:eu-repo/semantics/publishedVersio

Geographical distribution of e-cadherin germline mutations in the context of diffuse gastric cancer: A systematic review

Hereditary diffuse gastric cancer (HDGC) is a complex and multifactorial inherited cancer predisposition syndrome caused by CDH1 germline mutations. Nevertheless, current CDH1 genetic screening recommendations disregard an unbalanced worldwide distribution of CDH1 variants, impacting testing efficacy and patient management. In this systematic review, we collected and analyzed all studies describing CDH1 variants in gastric cancer patients originating from both highand low-prevalence countries. Selected studies were categorized as family study, series study, and unknown study, according to the implementation of HDGC clinical criteria for genetic testing. Our results indicate that CDH1 mutations are more frequently identified in gastric cancer low-incidence countries, and in the family study group that encompasses cases fulfilling criteria. Considering the type of CDH1 alterations, we verified that the relative frequency of mutation types varies within study groups and geographical areas. In the series study, the missense variant frequency is higher in high-incidence areas of gastric cancer, when compared with non-missense mutations. However, application of variant scoring for putative relevance led to a strong reduction of CDH1 variants conferring increased risk of gastric cancer. Herein, we demonstrate that criteria for CDH1 genetic screening are critical for identification of individuals carrying mutations with clinical significance. Further, we propose that future guidelines for testing should consider GC incidence across geographical regions for improved surveillance programs and early diagnosis of disease.This manuscript was supported by the Italian Ministry of Health (Project Code GR‐2016‐ 02361655) and was partially supported by the Ricerca Corrente and 5 × 1000 funds, and financed by FEDER funds through the Operational Programme for Competitiveness Factors (COMPETE 2020), Programa Operacional de Competitividade e Internacionalização (POCI) and Programa Operacional Regional do Norte (Norte 2020); and by the Portuguese Foundation for Science and Technology (FCT projects PTDC/MED‐GEN/30356/2017 and PTDC/BIM‐ONC/0281/2014). We acknowledge the American Association of Patients with Hereditary Gastric Cancer “No Stomach for Cancer” for funding Figueiredo’s research

Areas of natural occurrence of melipona scutellaris Latreille, 1811(Hymenoptera: Apidae) in the state of Bahia, Brazil.

The bee Melipona scutellaris is considered the reared meliponine species with the largest distribution in the North and Northeast regions of Brazil, with records from the state of Rio Grande do Norte down to the state of Bahia. Considering the importance of this species in the generation of income for family agriculture and in the preservation of areas with natural vegetation, this study aimed at providing knowledge on the distribution of natural colonies of M. scutellaris in the state of Bahia. Literature information, interviews with stinglessbee beekeepers, and expeditions were conducted to confirm the natural occurrence of the species. A total of 102 municipalities showed records for M. scutellaris, whose occurrence was observed in areas ranging from sea level up to 1,200-meter height. The occurrence of this species in the state of Bahia is considered to be restricted to municipalities on the coastal area and the Chapada Diamantina with its rainforests. Geographic coordinates, elevation, climate and vegetation data were obtained, which allowed a map to be prepared for the area of occurrence in order to support conservation and management policies for the species