Contribuições da Saúde Coletiva para o trabalho de enfermeiros

Objective: Analyze the perceptions of undergraduate nursing students about the contributions of public health to nursing practice in the Unified Health System. Method: Qualitative Descriptive Study. Data collection was carried out through semi-directed interviews with 15 students. The language material was analyzed according to content and thematic analysis. Results: Thematic categories were established, namely: "Perceptions about Public Health" and "Contribution of Public Health to nursing practice in the Unified Health System". Final considerations: Perceptions about Public Health are diversified, but converge to the recognition of this field as the basis for training nurses qualified to work in the SUS with technical competence, autonomy and focusing on the integrality in health care.Objetivo: Analisar as percepções de alunos do curso de bacharelado em Enfermagem acerca das contribuições da Saúde Coletiva para o trabalho de enfermeiros no Sistema Único de Saúde. Método: Estudo descritivo, com abordagem qualitativa. A coleta de dados foi realizada mediante a técnica da entrevista semidirigida com 15 alunos. O material de linguagem foi analisado segundo a técnica de análise de conteúdo temático-categorial. Resultados: Foram produzidas as categorias temáticas "Percepções acerca da Saúde Coletiva" e "Contribuição da Saúde Coletiva ao trabalho do enfermeiro no Sistema Único de Saúde". Considerações finais: As percepções sobre a Saúde Coletiva são plurais, mas convergem para o reconhecimento desse campo como base de sustentação da formação de enfermeiros habilitados a trabalhar no SUS com competência técnica, autonomia e com foco na integralidade do cuidado em saúde.Univ Fed Sao Paulo, Paulista Sch Nursing, Dept Publ Hlth, Sao Paulo, BrazilUniv Estado Rio de Janeiro, Sch Nursing, Dept Publ Hlth Nursing, Rio De Janeiro, BrazilUniv Estado Rio de Janeiro, Pedro Ernesto Univ Hosp, Nurse Residency Program Neonatol, Rio De Janeiro, BrazilUniv Fed Sao Paulo, Paulista Sch Nursing, Dept Publ Hlth, Sao Paulo, BrazilWeb of Scienc

Trnsys simulation results of an existing monitored small scale CHCP system and mathematical model adaptations of the air-cooled ammonia chiller and CHP prototypes

This work is a TRNSYS simulation of solar thermal system working together with an existing small sized CHCP (Combinet Heat Cooling and Power) demonstration project, included in the workpackage 5 (simulation) of the PolySMART project. The first objective of this work is to fine tune simulation parameters of the simulation Units (or Types), based on monitoring data collected during the first semester of 2010. The second objective is to further develop the mathematical models of type 107 (Hot Water-Fired Single-Effect Absorption Chiller) and type 120 (HYDROGEMS: Diesel Engine Generator System (DEGS) - Version 1.1). This will tackle the remaining differences between the real and simulated systems. These differences are due to the fact that both the CHP and the Ammonia-Water Air Cooled Chiller are prototypes. The third objective is to simulate the performance of different thermal collectors, some of which are also prototypes, and choose a proper solution for future experiments. The forth objective is to compare local weather data sets, collected on site since 2007, with proven standard data sets. Further work may be developed regarding the fan coils used to carry in/out heat

Monitoring Results of a Small Scale CHCP System

A small scale trigeneration system for combined heat, cold and power production was developed and installed at the Laboratório Nacional de Energia e Geologia, I.P. campus in Lisbon, Portugal. This system is one of the twelve experimental trigeneration systems being developed and tested across Europe within the PolySMART project. The CHCP system main constituents are a purpose made CHP prototype with an estimated 27kW maximum heat capacity and 9,6kW maximum electrical capacity and a TDC prototype with 8kW cooling power. The hydraulic scheme is presented and briefly analyzed. The data obtained during the monitoring of the system during heat and cold seasons is presented and analyzed for the global system. Main components behavior is analyzed with regard of their real performance when installed on a CHCP system

Comparação entre os Modelos de CMIP5 e a Climatologia da Precipitação Semanal Sobre o Brasil Tropical

Este estudo apresenta uma visão geral do desempenho dos modelos climáticos globais que participam do Projeto de Intercomparação de Modelos Acoplados Fase 5 (CMIP5) na simulação da variabilidade semanal da precipitação pluvial sobre o Brasil Tropical (BrT). As médias semanais calculadas para regiões específicas de chuva do BrT foram comparadas com as simuladas por oito modelos do CMIP5. As análises mostram que os modelos geralmente são capazes de simular o sinal do padrão semanal médio tanto do ponto de vista espacial e como temporal, porém alguns apresentam pouca sensibilidade à magnitude

A brighter future : the impact of rural school electrification programs on the dropout rate in primary education in Brazil

This work is licensed under a Creative Commons IGO 3.0 Attribution-Non Commercial-No Derivatives (CC-IGO BY-NC-ND 3.0 IGO) license (http://creativecommons.org/licenses/by-nc-nd/3.0/igo/legalcode)School electrification can decrease the gap between rural and urban education. The Brazilian policy focusing on electricity access in school decreased student’s dropout rate. Rural electrification programs – like Light for All – have been successful in increasing access to electricity services in Brazil, where 99.3% of the population has access. In terms of the public policy viewpoint, the cost-benefit analysis must consider not only the direct impact of the programs but also its positive externalities. In this paper, we study Light for All in Schools (LFAS, “Luz para Todos nas Escolas”), a program focused on providing access to electricity to rural schools. The study aims to measure the effect of access to electricity in rural schools on the dropout rate of students in primary education. Our goal is to create a dialogue between the studies on the benefits of electricity in vulnerable areas and the studies on education outcomes. Our results show that electrification programs, like the LFAS, have a significant effect on the dropout rate at rural schools. Schools that received electricity via the program before 2013 had an improvement of 16% (or 0.7 percentage points) in the dropout rate in three years, and schools that received benefits from program between 2013 and 2016 had an improvement of 27% (or 1 percentage point) in three years due to the access to electricity

Design and evaluation of a choreography-based virtual reality authoring tool for experiential learning in industrial training

The use of virtual reality (VR) for industrial training helps minimize risks and costs by allowing more frequent and varied use of experiential learning activities, leading to active and improved learning. However, creating VR training experiences is costly and time-consuming, requiring software development experts. Additionally, current authoring tools lack integration with existing data and are desktop-oriented, which detach the pedagogic process of creating the immersive experience from experiencing it in a situated context. In this article, we present a novel interactive approach for immersive authoring of VR-based experiential training by the trainers themselves, from inside the virtual environment and without the support of development experts. The design includes identifying interactable elements, such as 3-D models, equipment, tools, settings, and environment. The trainer also specifies by demonstration the actions to be performed by trainees, as a virtual choreography. During course execution, trainees’ activities are also registered as virtual choreographies and matched to those specified by the trainer. Thus, trainer and trainee are culturally situated within their area semantics and social discourse, rather than adopting concepts of the VR system for the learning content. We conducted a usability case study with professionals from an international wind energy company, using detailed models of wind turbines and real-world procedures. Trainers set up a training course using the immersive authoring tool, and trainees executed the course. The learning experience and usability were analyzed, and the training was certified by comparing real-world task completion between a user who had undergone virtual training and a user who did not.Manuscript received 25 June 2021; revised 30 November 2021 and 18 February 2022; accepted 2 March 2022. Date of publication 7 March 2022; date of current version 21 October 2022. This work was supported in part by the ERDF - European Regional Development Fund through the Operational Programme for Competitiveness and Internationalisation - COMPETE 2020 under the Portugal 2020 Partnership Agreement, in part by the Portuguese National Innovation Agency (ANI) under Project POCI-01-0247-FEDER038524, and in part by Portuguese funding agency, FCT - Fundação para a Ciência e a Tecnologia, under Project UIDB/50014/2020. An earlier version of this paper was presented in part at the 2021 IEEE Conference on Virtual Reality and 3D UserInterfaces[DOI: 10.1109/VRW52623.2021.00199].(Corresponding author: Fernando Cassola.) Fernando Cassola, Daniel Mendes, and Ant onio Coelho are with the INESC TEC, and Faculty of Engineering, University of Porto, 4099-002 Porto, Portugal (e-mail: [email protected]; [email protected]; [email protected]). Manuel Pinto and Hugo Paredes are with the INESC TEC and University of Tras-os-Montes e Alto Douro, 5000-801 Vila Real, Portugal (e-mail: [email protected]; [email protected]). Leonel Morgado is with the INESC TEC and Universidade Aberta, 1250-100 Lisboa, Portugal (e-mail: [email protected]). Sara Costa, Luıs Anjos, David Marques, Filipe Rosa, Ana Maia, and Helga Tavares are with the Vestas Wind Systems, 2670-327 Loures, Portugal (email: [email protected]; [email protected]; [email protected]; [email protected]; [email protected]; [email protected]). Digital Object Identifier 10.1109/TLT.2022.3157065info:eu-repo/semantics/publishedVersio

Are we giving it too much credit?

BACKGROUND: COVID-19 is a new form of acute respiratory failure leading to multiorgan failure and ICU admission. Gathered evidence suggests that a 3-fold rise in D-dimer concentrations may be linked to poor prognosis and higher mortality. PURPOSE: To describe D-dimer admission profile in severe ICU COVID19 patients and its predictive role in outcomes and mortality. METHODS: Single-center retrospective cohort study. All adult patients admitted to ICU with COVID19 were divided into 3 groups: (1) Lower-values group (D-dimer levels < 3-fold normal range value [NRV] [500ng/mL]), Intermediate-values group (D-dimer ≥3-fold and <10-fold NRV) and Higher-value group (≥10-fold NRV). RESULTS: 118 patients (mean age 63 years, 73% males) were included (N = 73 Lower-values group, N = 31 Intermediate-values group; N = 11 Higher-values group). Mortality was not different between groups (p = 0.51). Kaplan-Meier survival curves revealed no differences (p = 0.52) between groups, nor it was verified even when gender, age, ICU length of stay, and SOFA score were considered as covariables. CONCLUSIONS: In severe COVID19 patients, the D-dimer profile does not retain a predictive value regarding patients' survivability and should not be used as a surrogate of disease severity.publishersversionpublishe

An unattended sepsis population with high mortality risk

©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.BACKGROUND: Coronavirus disease 2019 (COVID-19) can be associated with life-threatening organ dysfunction due to septic shock, frequently requiring intensive care unit (ICU) admission, respiratory and vasopressor support. Therefore, clear clinical criteria are pivotal for early recognition of patients more likely to need prompt organ support. Although most patients with severe COVID-19 meet the Sepsis-3.0 criteria for septic shock, it has been increasingly recognized that hyperlactatemia is frequently absent, possibly leading to an underestimation of illness severity and mortality risk. AIM: To identify the proportion of severe COVID-19 patients with vasopressor support requirements, with and without hyperlactatemia, and describe their clinical outcomes and mortality. METHODS: We performed a single-center prospective cohort study. All adult patients admitted to the ICU with COVID-19 were included in the analysis and were further divided into three groups: Sepsis group, without both criteria; Vasoplegic Shock group, with persistent hypotension and vasopressor support without hyperlactatemia; and Septic Shock 3.0 group, with both criteria. COVID-19 was diagnosed using clinical and radiologic criteria with a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive RT-PCR test. RESULTS: 118 patients (mean age 63 years, 87% males) were included in the analysis (n = 51 Sepsis group, n = 26 Vasoplegic Shock group, and n = 41 Septic Shock 3.0 group). SOFA score at ICU admission and ICU length of stay were different between the groups (P < 0.001). Mortality was significantly higher in the Vasoplegic Shock and Septic Shock 3.0 groups when compared with the Sepsis group (P < 0.001) without a significant difference between the former two groups (P = 0.713). The log rank tests of Kaplan-Meier survival curves were also different (P = 0.007). Ventilator-free days and vasopressor-free days were different between the Sepsis vs Vasoplegic Shock and Septic Shock 3.0 groups (both P < 0.001), and similar in the last two groups (P = 0.128 and P = 0.133, respectively). Logistic regression identified the maximum dose of vasopressor therapy used (AOR 1.046; 95%CI: 1.012-1.082, P = 0.008) and serum lactate level (AOR 1.542; 95%CI: 1.055-2.255, P = 0.02) as the major explanatory variables of mortality rates (R 2 0.79). CONCLUSION: In severe COVID-19 patients, the Sepsis 3.0 criteria of septic shock may exclude approximately one third of patients with a similarly high risk of a poor outcome and mortality rate, which should be equally addressed.publishersversionpublishe