application of survey on energy consumption and occupancy in residential buildings an experience in southern italy

Abstract The aim of the study was to create and administer a questionnaire to collect data and obtain typical occupancy profiles of residential buildings. The survey was developed by considering previous experiences conducted in the University of Calabria since 2012, and it was distributed among 80 families via email, face-to-face and through social network. Different levels of occupancy (high, medium and low) and different sub-categories of high occupancy (morning, afternoon, and intermediate) were individuated by processing the gathered data. Buildings energy consumption was investigated with regard to occupancy categories, and correlations were found

Reliability and use of Copenhagen Burnout Inventory in italian sample of university professors

Academics often have to face with burnout syndrome at work. This cross-sectional study evaluates the reliability of the Italian version of the Copenhagen Burnout Inventory (CBI) in a sample of Academics of Sapienza University of Faculty of Medicine and Pharmacy, through an online questionnaire composed of the CBI, SF12 Health Survey, and Positivity Scale. Univariate, bivariate, multivariate analyses, and Cronbach α coefficients of CBI were performed. Ninety-five participants completed the questionnaire (response rate 85%). Cronbach’s α of the three domains were high (0.892, 0.868, and 0.836). Women, younger and part time professors reported higher score in personal (p = 0.025; 0.060) and work burnout. In multivariate analysis decreasing age (β = −0.263; p = 0.001); being a professor in environmental technicians (β = −0.120; p = 0.098); and low mental (β = −0.263; p = 0.020), physical (β = −0.319; p ≤ 0.001) and positivity scores (β = −0.237; p = 0.031) predict significantly higher personal burnout. Low physical (β = −0.346; p < 0.001) and mental (β = − 0.249; p = 0.013) positivity (β = −0.345; p = 0.001) scores; fewer years of work (β = −0.269; p ≤ 0.001); and being a medical or nursing professor (β = 0.169; p = 0.016) predicts high work burnout. Low MCS predicts a high level of student burnout. Results suggest that the Italian version of the CBI is a reliable instrument. Further research should focus on the prevalence of burnout in academics

Inside the Phenomenological Aspects of Wet Granulation: Role of Process Parameters

Granulation is a size-enlargement process by which small particles are bonded, by means of various techniques, in coherent and stable masses (granules), in which the original particles are still identifiable. In wet granulation processes, the powder particles are aggregated through the use of a liquid phase called binder. The main purposes of size-enlargement process of a powder or mixture of powders are to improve technological properties and/or to realize suitable forms of commercial products. A modern and rational approach in the production of granular structures with tailored features (in terms of size and size distribution, flowability, mechanical and release properties, etc.) requires a deep understanding of phenomena involved during granules formation. By this knowledge, suitable predictive tools can be developed with the aim to choose right process conditions to be used in developing new formulations by avoiding or reducing costs for new tests. In this chapter, after introductive notes on granulation process, the phenomenological aspects involved in the formation of the granules with respect to the main process parameters are presented by experimental demonstration. Possible mathematical approaches in the granulation process description are also presented and the one involving the population mass balances equations is detailed

Evolution of the nutritional support pattern in Pediatric Intensive Care

OBJECTIVES: to evaluate patterns of usage and monitoring of nutritional support in a Pediatric ICU of a teaching hospital and the role of an education program in nutritional support given throughout the resident physician training. DESIGN: in a historical cohort study, records from children who received nutritional support during the year 1992 were analyzed. Thereafter a continuing education program in Nutritional Support was conveyed to the residents. In a second phase of the study, the same parameters were reevaluated in children who received nutritional support throughout the year 1995. SETTING: Pediatric Intensive Care Unit of Department of Pediatrics, Escola Paulista de Medicina. PATIENTES: all the children who were given nutritional support during a period of five days or more. Based on this criteria 37 children were selected for the first phase of this study, and 35 for the second one. INTERVENTION: the education program included theoretical lectures about basic themes of nutritional support and journal article reading sessions. It was given to successive groups of residents on a weekly schedule. MEASUREMENTS: Daily records of fluid, protein, caloric and micronutrient supply, nutritional assessment and metabolic monitoring. RESULTS: In the first phase of the study, an exclusively parenteral route was utilized for 80.5%, and a digestive route 19.5% of the time period. Nutritional assessment was performed on 3 children; no patient had the nutritional goals set. The nitrogen to nonprotein calories ratio and the vitamin supply were inadequate, whilst the supply of trace elements was adequate except for zinc. Nutritional monitoring was performed on almost all patients but without uniformity. In the second phase, the exclusive parenteral route was used for 69.7% and the digestive route for 30.3% of the time period; no significant increase in the use of the digestive route was detected. The nonprotein calories to nitrogen ratio and micronutrient supply were adequate. The frequency of nutritional assessment increased, but deficiency in nutritional monitoring and infrequent enteral feeding were still detected. CONCLUSION: There were deficiencies in the implementation of nutritional support, which were partially corrected in the second phase of the study by the training of the residents. Reinforcement of the education program, which should be applied to the whole medical staff, and the organization of a multidisciplinary team in charge of coordinating the provision of nutritional support are suggested.OBJETIVOS: avaliar o padrão terapêutico e de monitoração de suporte nutricional em uma UTI Pediátrica de um hospital escola, e o papel de um programa de educação continuada em suporte nutricional ministrado aos residentes. DESENHO: em estudo de coorte histórico foram inicialmente estudadas crianças internadas durante o ano de 1992 que receberam suporte nutricional. Seguiu-se a esta avaliação um programa de educação continuada nesta área, administrado para os residentes da unidade. Em uma segunda faze do estudo os mesmo parâmetros foram reavaliados nas crianças que receberam suporte nutricional durante o ano de 1995. LOCAL: UTI Pediátrica do Hospital São Paulo - Departamento de Pediatria da Escola Paulista de Medicina. PARTICIPANTES: Todas as crianças que receberam suporte nutricional por um tempo igual ou superior a 5 dias perfazendo um total de 37 crianças na primeira fase e 35 crianças na segunda fase do estudo. INTERVENÇÃO: Curso de educação continuada, ministrado semanalmente e constituído por aulas teóricas e leitura de artigos de revista sobre suporte nutricional. MENSURAÇÃO: Foram analisados os registro diários de oferta hídrica, protéico-energética e de micronutrientes, de avaliação nutricional e de monitoração de suporte nutricional no decorrer da terapêutica. RESULTADOS: na primeira etapa do estudo via parenteral exclusiva foi utilizada em 80,5% do tempo e a via digestiva em 19,5%. A avaliação nutricional prévia foi feita em 3 pacientes (8,1%). A relação nitrogênio: calorias não protéicas e a oferta de vitaminas foram inadequadas e a oferta de oligoelementos por via parenteral foi adequada, exceção feita ao zinco. A monitoração nutricional foi efetuada na maior parte dos pacientes, embora de modo não uniforme. Na segunda fase, a via parenteral exclusiva foi utilizada em 69,7% e a via digestiva em 30,3%, não se observando diferenças significantes entre as duas fases. Avaliação nutricional previa foi feita em 13 pacientes (37,1%), A relação nitrogênio: calorias não protéicas e a oferta de micronutrientes foram adequadas mas permaneceram as deficiências de monitoração nutricional e metabólica e o uso pouco freqüente da nutrição enteral. CONCLUSÕES: o suporte nutricional apresentou falhas na implementação que foram parcialmente corrigidas na segunda etapa do estudo. Sugere-se a reformulação do programa de educação continuada, a sua extensão à totalidade do corpo clínico e a criação de uma equipe multidisciplinar encarregada de coordenar o fornecimento de suporte nutricional.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Department of PediatricsUNIFESP, EPM, Department of PediatricsSciEL

A pilot study of the effects of hormone therapy on normal breast tissue of postmenopausal women

PURPOSE: to analyze breast tissue of postmenopausal women before and after six months of continuous combined estrogen-progestin replacement therapy (0.625 mg conjugated equine estrogens associated with 2.5 mg medroxyprogesterone acetate). METHODS: all patients were evaluated before treatment and considered eligible to receive the drug. The material was obtained from the upper outer left quadrant, through a percutaneous large-core breast biopsy. Epithelial density and nuclear volume on hematoxylin-eosin-stained plates were evaluated for the morphological study. Morphometry was graphically analyzed by optical microscopy (400X) after acquisition of image by a digital image-capturing system (Vidcap 32) and image analysis system (Imagelab 2000 Software®). RESULTS: after six months of estrogen-progestin replacement therapy, there was a significant increase in nuclear volume in late postmenopausal women (103.6 to 138.1 µm³). There was no difference in epithelial density with the treatment (before 0.08 and later 0.10). CONCLUSIONS: estrogen-progestin combined replacement therapy for six months induced an enhacement in nuclear volume of breast epithelial cells, suggesting an increase in their metabolic activity. However, it is important to emphasize that this finding was observed only in late postmenopausal women. The increased nuclear volume could precede other events that confirm the stimulation of cellular proliferation by these hormones.OBJETIVOS: avaliou-se o tecido mamário de mulheres antes e depois de seis meses de terapia estroprogestativa combinada contínua (0,625 mg de estrogênios conjugados eqüinos associados a 2,5 mg de acetato de medroxiprogesterona). MÉTODOS: todas as pacientes foram avaliadas antes de se instituir o tratamento e consideradas aptas para este. Foram obtidos fragmentos de tecido mamário por meio de biópsia percutânea com agulha grossa (acoplada a um propulsor automático - core-biópsia). O material foi fixado e os cortes corados por hematoxilina-eosina. Avaliou-se a densidade epitelial e o volume nuclear do epitélio mamário antes e após a terapia hormonal. Esses parâmetros morfométricos foram analisados graficamente com auxílio do programa Imagelab 2000 ®, após captura da imagem microscópica pelo sistema Vidcap 32. Esse programa permite que sejam selecionadas as áreas de interesse, possibilitando o cálculo de área, volume ou a relação da área ocupada entre diferentes estruturas. RESULTADOS: depois do uso da terapia, o volume nuclear nas mulheres em que o tratamento foi instituído em período mais tardio após a menopausa mostrou um aumento de cerca de 33% (de 103,6 para 138,1 µm³). A densidade epitelial não se modificou de forma significativa: o valor médio antes da terapia hormonal foi de 0,08 e após de 0,10. CONCLUSÕES: a terapia estroprogestativa combinada contínua empregada por seis meses induziu à alteração no volume nuclear das células epiteliais das mamas, sugerindo aumento de sua atividade metabólica. Provavelmente, esse evento precede outros que confirmariam o estímulo da proliferação celular por esses hormônios.Universidade Federal de São Paulo (UNIFESP) Departamento de GinecologiaUniversidade Federal de São Paulo (UNIFESP) Departamento de Anatomia PatológicaUNIFESP, Depto. de GinecologiaUNIFESP, Depto. de Anatomia PatológicaSciEL

Nursing diagnoses and interventions for people with decompensated heart failure

Objective:to identify nursing diagnoses and interventions for people with decompensated heart failure. Method: descriptive, observational and cross-sectional study, clinical case report type. The locus was the intensive care unit of a tertiary teaching hospital. Authors used the nomenclature Nursing Diagnoses and Interventions developed and validated for that hospital, according to the terms of the International Classification for Nursing Practice (ICNP®). Results: nursing diagnoses were established from the clinical signs and symptoms during the admission of patients with decompensated heart failure. The identified terms common to the disease were: dyspnea, edema, fatigue, decreased cardiac output and arrhythmia. Conclusion: the nursing diagnoses/ interventions have contributed to the work of nurses in decision-making and management of patients with decompensated heart failure, allowing the systematization of an effective and problem-solving nursing care