Práticas sustentáveis no âmbito hospitalar: percepção dos enfermeiros

Aim: to know nurses’ perceptions about the environmental sustainability within the hospital environment. Method: this is an exploratory-descriptive study, with a qualitative approach, performed in four hospitals of the 1st, 4th, 17th and 18th Regional Health Coordinations of the State of Rio Grande do Sul. It was developed between September 2013 and February 2014, with the participation of 26 nurses. Data analysis complied with the precepts of Discursive Textual Analysis. Results: the reports originating from the interviewees highlighted that nursing practices in hospital sustainability are exclusively shown under the obedience of hospital organizational structures, dependence on legislation and in the construction of organizational values. Final Considerations: the construction of sustainable practices is linked to the inheritance of the bureaucratic, normative and categorical administrative model in the decision-making process of the formation of sustainable beliefs and values.Objetivo: conocer las percepciones de los enfermeros sobre la sostenibilidad ambiental en el ámbito hospitalario. Método: estudio exploratorio-descriptivo, de perspectiva cualitativa, realizado en cuatro hospitales de la 1ª, 4ª, 17ª y 18ª Coordinaciones Regionales de Salud del Estado de Rio Grande do Sul. Fue desarrollado entre los meses de septiembre de 2013 y febrero de 2014, con 26 enfermeros. El análisis de los datos siguió los preceptos del Análisis Textual Discursivo. Resultados: los informes originarios de los encuestados señalaron que las prácticas de enfermería sobre sostenibilidad hospitalaria se presentan exclusivamente por la obediencia de estructuras organizacionales de los hospitales, el cumplimiento de la legislación y la construcción de valores organizacionales. Consideraciones Finales: la construcción de prácticas sostenibles está relacionada con la herencia del modelo administrativo burocrático, normativo y categórico en el proceso decisorio de la formación de credos y valores sostenibles.Objetivo: conhecer as percepções de enfermeiros acerca da sustentabilidade ambiental no âmbito hospitalar. Método: estudo exploratório-descritivo, com abordagem qualitativa, realizado em quatro hospitais da 1ª; 4ª; 17ª e 18ª Coordenadorias Regionais de Saúde do Estado do Rio Grande do Sul. Foi desenvolvido entre os meses de setembro de 2013 e fevereiro de 2014, tendo como participantes 26 Enfermeiros. Análise dos dados seguiu os preceitos da Análise Textual Discursiva. Resultados: os relatos emergentes dos entrevistados indicaram que as práticas de enfermagem na sustentabilidade hospitalar apresentam-se exclusivamente sob obediência de estruturas organizacionais dos hospitais, dependência da legislação e na construção de valores organizacionais. Considerações Finais: a construção de práticas sustentáveis está atrelada à herança do modelo administrativo burocrático, normativo e categórico no processo decisório da formação de crenças e valores sustentáveis

Experimental behavior of masonry wall-to-timber elements connections strengthened with injection anchors

Out-of-plane failure mechanisms observed in stone masonry buildings subjected to seismic action are often a direct result of poor connections between structural elements. During a seismic event these weak connections become incapable of assuring proper load transmission. Therefore, the need to prevent these phenomena is of critical importance in understanding the behavior of unstrengthened masonry buildings along with the necessity of developing effective strengthening solutions. This paper presents injection anchors as a viable option to improve anchorage between masonry and timber elements on historical buildings, as for example wall-to-timber framed wall or wall-to-timber diaphragm connections. The experimental campaign consisted of quasi-static monotonic and cyclic pullout tests performed on real scale specimens, representative of wall-to-timber framed wall connections found in late 19th century buildings of downtown Lisbon, Portugal. Combined cone-bond failure was obtained in all 7 tests. Boundary conditions of the specimens greatly affected the results in terms of maximum pullout force, dissipated energy, and strength degradation. Displacement ductility of the strengthened connections is high. The force-displacement curves clearly pointed out the influence on the results of the wall's compressive stress state and the contribution of friction in the grout/masonry interface.This work was partially funded by project FP7-ENV-2009-1-244123-NIKER of the 7th Framework Program of the European Commission, which is gratefully acknowledged. Authors would like to thank the technical staff of the Structures Lab. of University of Minho for the assistance provided preparing and carrying out the tests and also, Monumenta, Ltd. for the construction of the masonry walls and Cintec (R) for the installation of the injection anchors

TENDÊNCIAS EMPREENDEDORAS DOS ENFERMEIROS DE UM HOSPITAL UNIVERSITÁRIO

Estudo quantitativo que objetivou identificar tendências empreendedoras dos enfermeiros de um hospital universitárioe relacioná-las com idade, tempo de trabalho e conclusão do curso de enfermagem. Estudo quantitativo, transversalcontemporâneo realizado em 2010. Todos os 60 enfermeiros responderam ao questionário “Tendência EmpreendedoraGeral”, com cinco categorias. Na categoria “criatividade”, um enfermeiro obteve dois pontos, em “necessidade derealização”, um enfermeiro somou 12 pontos; em “impulso e determinação”, quatro enfermeiros alcançaram maiorpontuação; em “riscos calculados/moderados”, a maior pontuação foi 10 pontos; em “autonomia/independência”,nove enfermeiras obtiveram um ponto. Idades entre 27 e 33 anos mostraram maior tendência empreendedora. Existedecréscimo da tendência empreendedora dos enfermeiros com idades superiores a 43 até 56 anos, com mais de 17anos de conclusão de curso e com maior tempo de trabalho. São necessárias ações que estimulem enfermeiros nafaixa etária em declínio da tendência empreendedora e aqueles com maior tempo de formação e trabalho

ESTÁGIO SUPERVISIONADO EM COMPUTAÇÃO: NO ENSINO FUNDAMENTAL I – A IMPORTÂNCIA DO USO DE RECURSOS TECNOLÓGICOS NAS SALAS DE AULA

Este artigo tem como objetivo apresentar a experiência do estágio supervisionado que faz parte do curso de Licenciatura em Computação oferecido pela Universidade do Estado do Amazonas (UEA) para a formação integral do aluno, e relatar suas experiências nas atividades que aconteceram entre julho e agosto de 2022 na Escola Estadual Presidente Kennedy, localizada no município de Coari -AM. O programa de estágio consistiu em três etapas: Observação, onde é possível conhecer a rotina dos funcionários e alunos envolvidos; Coparticipação, momento em que os estagiários podem acompanhar e auxiliar o professor em suas aulas , conhecendo o perfil da turma; e a Regência, período em que, após observar o ambiente escolar e auxiliar o professor na condução das aulas, o estagiário assume o papel de professor e, junto com um professor, passa a ministrar conteúdos selecionados de disciplina e realização de aulas com os alunos como forma de avaliação.This article aims to present the experience of the supervised internship that is part of the Computer Science Degree course offered by the Amazonas State University (UEA) for the integral formation of the student, and to report their experiences in the activities that took place between July and August 2022 at the Presidente Kennedy State School, located in the municipality of Coari -AM. The internship program consisted of three stages: Observation, where it is possible to get to know the routine of the employees and students involved; Co-participation, a time when interns can accompany and assist the teacher in their classes, knowing the profile of the class; and Regency, a period in which, after observing the school environment and assisting the teacher in conducting classes, the intern assumes the role of teacher and, together with a teacher, starts to teach selected subject content and conduct classes with students as a form of evaluation.Este artículo tiene como objetivo presentar la experiencia de la pasantía supervisada que forma parte de la carrera de Licenciatura en Informática ofrecida por la Universidad Estadual de Amazonas (UEA) para la formación integral del estudiante, y relatar sus vivencias en las actividades realizadas entre julio y agosto de 2022 en la Escuela Estadual Presidente Kennedy, ubicada en el municipio de Coari -AM. El programa de prácticas constó de tres etapas: Observación, donde es posible conocer la rutina de los funcionarios y alumnos involucrados; Coparticipación, momento en que los pasantes pueden acompañar y auxiliar al profesor en sus clases, conociendo el perfil de la clase; y Regencia, período en que, después de observar el ambiente escolar y auxiliar al profesor en la conducción de las clases, el pasante asume el papel de profesor y, junto con un docente, comienza a enseñar contenidos de asignaturas seleccionadas y a realizar clases con los alumnos como forma de evaluación.Este artigo tem como objetivo apresentar a experiência do estágio supervisionado que faz parte do curso de Licenciatura em Computação oferecido pela Universidade do Estado do Amazonas (UEA) para a formação integral do aluno, e relatar suas experiências nas atividades que aconteceram entre julho e agosto de 2022 na Escola Estadual Presidente Kennedy, localizada no município de Coari -AM. O programa de estágio consistiu em três etapas: Observação, onde é possível conhecer a rotina dos funcionários e alunos envolvidos; Coparticipação, momento em que os estagiários podem acompanhar e auxiliar o professor em suas aulas , conhecendo o perfil da turma; e a Regência, período em que, após observar o ambiente escolar e auxiliar o professor na condução das aulas, o estagiário assume o papel de professor e, junto com um professor, passa a ministrar conteúdos selecionados de disciplina e realização de aulas com os alunos como forma de avaliação

Photography-based taxonomy is inadequate, unnecessary, and potentially harmful for biological sciences

The question whether taxonomic descriptions naming new animal species without type specimen(s) deposited in collections should be accepted for publication by scientific journals and allowed by the Code has already been discussed in Zootaxa (Dubois & Nemésio 2007; Donegan 2008, 2009; Nemésio 2009a–b; Dubois 2009; Gentile & Snell 2009; Minelli 2009; Cianferoni & Bartolozzi 2016; Amorim et al. 2016). This question was again raised in a letter supported by 35 signatories published in the journal Nature (Pape et al. 2016) on 15 September 2016. On 25 September 2016, the following rebuttal (strictly limited to 300 words as per the editorial rules of Nature) was submitted to Nature, which on 18 October 2016 refused to publish it. As we think this problem is a very important one for zoological taxonomy, this text is published here exactly as submitted to Nature, followed by the list of the 493 taxonomists and collection-based researchers who signed it in the short time span from 20 September to 6 October 2016

TRY plant trait database – enhanced coverage and open access

Plant traits - the morphological, anatomical, physiological, biochemical and phenological characteristics of plants - determine how plants respond to environmental factors, affect other trophic levels, and influence ecosystem properties and their benefits and detriments to people. Plant trait data thus represent the basis for a vast area of research spanning from evolutionary biology, community and functional ecology, to biodiversity conservation, ecosystem and landscape management, restoration, biogeography and earth system modelling. Since its foundation in 2007, the TRY database of plant traits has grown continuously. It now provides unprecedented data coverage under an open access data policy and is the main plant trait database used by the research community worldwide. Increasingly, the TRY database also supports new frontiers of trait‐based plant research, including the identification of data gaps and the subsequent mobilization or measurement of new data. To support this development, in this article we evaluate the extent of the trait data compiled in TRY and analyse emerging patterns of data coverage and representativeness. Best species coverage is achieved for categorical traits - almost complete coverage for ‘plant growth form’. However, most traits relevant for ecology and vegetation modelling are characterized by continuous intraspecific variation and trait–environmental relationships. These traits have to be measured on individual plants in their respective environment. Despite unprecedented data coverage, we observe a humbling lack of completeness and representativeness of these continuous traits in many aspects. We, therefore, conclude that reducing data gaps and biases in the TRY database remains a key challenge and requires a coordinated approach to data mobilization and trait measurements. This can only be achieved in collaboration with other initiatives

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK.

BACKGROUND: A safe and efficacious vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), if deployed with high coverage, could contribute to the control of the COVID-19 pandemic. We evaluated the safety and efficacy of the ChAdOx1 nCoV-19 vaccine in a pooled interim analysis of four trials. METHODS: This analysis includes data from four ongoing blinded, randomised, controlled trials done across the UK, Brazil, and South Africa. Participants aged 18 years and older were randomly assigned (1:1) to ChAdOx1 nCoV-19 vaccine or control (meningococcal group A, C, W, and Y conjugate vaccine or saline). Participants in the ChAdOx1 nCoV-19 group received two doses containing 5 × 1010 viral particles (standard dose; SD/SD cohort); a subset in the UK trial received a half dose as their first dose (low dose) and a standard dose as their second dose (LD/SD cohort). The primary efficacy analysis included symptomatic COVID-19 in seronegative participants with a nucleic acid amplification test-positive swab more than 14 days after a second dose of vaccine. Participants were analysed according to treatment received, with data cutoff on Nov 4, 2020. Vaccine efficacy was calculated as 1 - relative risk derived from a robust Poisson regression model adjusted for age. Studies are registered at ISRCTN89951424 and ClinicalTrials.gov, NCT04324606, NCT04400838, and NCT04444674. FINDINGS: Between April 23 and Nov 4, 2020, 23 848 participants were enrolled and 11 636 participants (7548 in the UK, 4088 in Brazil) were included in the interim primary efficacy analysis. In participants who received two standard doses, vaccine efficacy was 62·1% (95% CI 41·0-75·7; 27 [0·6%] of 4440 in the ChAdOx1 nCoV-19 group vs71 [1·6%] of 4455 in the control group) and in participants who received a low dose followed by a standard dose, efficacy was 90·0% (67·4-97·0; three [0·2%] of 1367 vs 30 [2·2%] of 1374; pinteraction=0·010). Overall vaccine efficacy across both groups was 70·4% (95·8% CI 54·8-80·6; 30 [0·5%] of 5807 vs 101 [1·7%] of 5829). From 21 days after the first dose, there were ten cases hospitalised for COVID-19, all in the control arm; two were classified as severe COVID-19, including one death. There were 74 341 person-months of safety follow-up (median 3·4 months, IQR 1·3-4·8): 175 severe adverse events occurred in 168 participants, 84 events in the ChAdOx1 nCoV-19 group and 91 in the control group. Three events were classified as possibly related to a vaccine: one in the ChAdOx1 nCoV-19 group, one in the control group, and one in a participant who remains masked to group allocation. INTERPRETATION: ChAdOx1 nCoV-19 has an acceptable safety profile and has been found to be efficacious against symptomatic COVID-19 in this interim analysis of ongoing clinical trials. FUNDING: UK Research and Innovation, National Institutes for Health Research (NIHR), Coalition for Epidemic Preparedness Innovations, Bill & Melinda Gates Foundation, Lemann Foundation, Rede D'Or, Brava and Telles Foundation, NIHR Oxford Biomedical Research Centre, Thames Valley and South Midland's NIHR Clinical Research Network, and AstraZeneca

Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK

Background A safe and efficacious vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), if deployed with high coverage, could contribute to the control of the COVID-19 pandemic. We evaluated the safety and efficacy of the ChAdOx1 nCoV-19 vaccine in a pooled interim analysis of four trials. Methods This analysis includes data from four ongoing blinded, randomised, controlled trials done across the UK, Brazil, and South Africa. Participants aged 18 years and older were randomly assigned (1:1) to ChAdOx1 nCoV-19 vaccine or control (meningococcal group A, C, W, and Y conjugate vaccine or saline). Participants in the ChAdOx1 nCoV-19 group received two doses containing 5 × 1010 viral particles (standard dose; SD/SD cohort); a subset in the UK trial received a half dose as their first dose (low dose) and a standard dose as their second dose (LD/SD cohort). The primary efficacy analysis included symptomatic COVID-19 in seronegative participants with a nucleic acid amplification test-positive swab more than 14 days after a second dose of vaccine. Participants were analysed according to treatment received, with data cutoff on Nov 4, 2020. Vaccine efficacy was calculated as 1 - relative risk derived from a robust Poisson regression model adjusted for age. Studies are registered at ISRCTN89951424 and ClinicalTrials.gov, NCT04324606, NCT04400838, and NCT04444674. Findings Between April 23 and Nov 4, 2020, 23 848 participants were enrolled and 11 636 participants (7548 in the UK, 4088 in Brazil) were included in the interim primary efficacy analysis. In participants who received two standard doses, vaccine efficacy was 62·1% (95% CI 41·0–75·7; 27 [0·6%] of 4440 in the ChAdOx1 nCoV-19 group vs71 [1·6%] of 4455 in the control group) and in participants who received a low dose followed by a standard dose, efficacy was 90·0% (67·4–97·0; three [0·2%] of 1367 vs 30 [2·2%] of 1374; pinteraction=0·010). Overall vaccine efficacy across both groups was 70·4% (95·8% CI 54·8–80·6; 30 [0·5%] of 5807 vs 101 [1·7%] of 5829). From 21 days after the first dose, there were ten cases hospitalised for COVID-19, all in the control arm; two were classified as severe COVID-19, including one death. There were 74 341 person-months of safety follow-up (median 3·4 months, IQR 1·3–4·8): 175 severe adverse events occurred in 168 participants, 84 events in the ChAdOx1 nCoV-19 group and 91 in the control group. Three events were classified as possibly related to a vaccine: one in the ChAdOx1 nCoV-19 group, one in the control group, and one in a participant who remains masked to group allocation. Interpretation ChAdOx1 nCoV-19 has an acceptable safety profile and has been found to be efficacious against symptomatic COVID-19 in this interim analysis of ongoing clinical trials