Caracterização e Impacte das quedas de doentes, como indicador de qualidade, num hospital E.P.E.

RESUMO - Introdução: As quedas dos doentes são um dos principais eventos adversos que podem ocorrer em contexto hospitalar, levando por um lado, ao aumento de encargos económicos e sociais, e por outro a consequências físicas e psicológicas nos doentes e respectiva família. Para a sua prevenção, é necessário investir na segurança do doente através de uma avaliação e consequente gestão do risco de quedas. Este trabalho insere-se na estratégia de melhorar a segurança do doente e a qualidade dos cuidados prestados. Objectivos: Avaliar em que medida o formulário existente responde às actuais necessidades de gestão do risco de quedas e suas consequências. Por outro lado, com base numa extensa revisão da literatura nacional e internacional, e tendo em conta as dinâmicas de qualidade e segurança do doente que têm sido criadas no hospital em estudo, propor um formulário mais eficaz que permita responder aos desafios que se colocam nos dias de hoje. Metodologia: Tratou-se de um estudo descritivo exploratório assente no paradigma quantitativo. A população do estudo foi constituída por 98 doentes que sofreram quedas durante o internamento no ano de 2010, num hospital E.P.E. (Entidade Pública Empresarial) Conclusão: As quedas ocorreram mais frequentemente em indivíduos do sexo masculino com doenças cérebro-vasculares e infecciosas, sendo que na maioria das vezes não resultaram em consequências graves. O formulário que aqui se recomenda tem a vantagem de ser informatizado e caracterizar aspectos relacionados com os custos. ---------------- ABSTRACT - Introduction: Falls of patients are one of the main adverse events that may occur in a hospital context, leading on the one hand, to an increase of economic and social burden, and, on the other hand, physical and psychological consequences for patients and their families. For its prevention, we need to invest in patient safety through an assessment and consequent management of the fall risk. This work is inserted in the strategy to improve the Patient safety and the quality of health care. Objectives: To assess the extent to which the form responds to current needs of managing the fall risk and their consequences. On the other hand, on the basis of an extensive review of national and international literature, and taking into account the dynamics of quality and safety of the patient that are created at the hospital in study, to propose a form more efficient in order to respond to the challenges that we face nowadays. Methodology: It was an exploratory descriptive study based on the quantitative paradigm. The population study was constituted by 98 patients who had suffered falls during hospitalization in the year 2010, in a hospital E.P.E. Conclusion: Falling occurred more frequently in male individuals with cerebral-vascular and infectious diseases, and in most of the time, falls have not resulted in serious consequences. The form recommended here has the advantage of being computerized and characterize aspects related with costs

CONFORTO TÉRMICO NA ESCOLA PÚBLICA EM CUIABÁ-MT: ESTUDO DE CASO

Durante muito tempo, as questões relacionadas ao desempenho térmico das edificações tiveram pouca importância. Assim como para as edificações escolares, além de não atender as condições mínimas de conforto requeridas pelos usuários, coloca-se em comprometimento o ensinoaprendizagem, a saúde física e psicológica, provocam um aumento excessivo do consumo de energia elétrica para condicionar ambientes, e a deterioração de materiais devido a problemas de condensação e ventilação insuficiente. Cuiabá apresenta condições climáticas caracterizadas por duas estações bem definidas, sendo uma seca e outra chuvosa, ventilação fraca, sendo predominantemente quente durante o ano todo. A maioria das edificações escolares municipais e estaduais apresenta partidos arquitetônicos e sistemas construtivos sem levar em conta as características da área e do clima, caracterizando um espaço que não satisfaz as necessidades básicas de conforto ambiental. Certamente, estas condições interferem negativamente na motivação e concentração dos seus alunos. Desta forma,este trabalho tem como objetivo analisar os índices de conforto térmico de uma escola, propondo soluções para atender as necessidades de conforto térmico, visando um ambiente agradável e que favoreça o aprendizado por parte dos alunos

Avaliação externa do Programa Escolhas - 2ª Geração: alguns desafios teórico-metodológicos

O presente artigo resulta de um processo de avaliação externa do Programa Escolhas 2ª Geração desenvolvido pelo Centro de Estudos Territoriais (CET/ISCT E) entre Dezembro de 2005 e Junho de 2007. Mais do que descrever o processo avaliativo e apresentar resultados pretende-se reflectir sobre aspectos particulares do Programa e questionamentos suscitados pela avaliação desenvolvida. A qualidade global do Programa colocou, naturalmente, um desafio adicional à avaliação externa, atravessada por um elevado número de questões e interrogações relativamente ao seu objecto: exclusão infanto-juvenil e equidade territorial na distribuição dos recursos; especificidade das metodologias participativas com crianças e jovens; avaliação de componentes Web no contexto de sistemas de monitorização e avaliação e de informação e comunicação, são alguns dos temas que desafiaram a equipa de avaliação, cuja reflexão aqui se partilha

Chemical characterization, antioxidant and antimicrobial activities of winemaking industry by-products

The exploitation of bioactive compounds trom agri-food by-products has been attracting an increasing interest from different industries within a circular economy context since several of compounds may have health properties or be used as natural colorants or preservatives. So far, several studies have been developed on the characterization of red wine grape pomace and its components (seeds, skins, and stems). However, less attention has been paid to other by-products, such as grape pomace from white wine, the residues after distillation, wine lees, and diatomaceous earth, the latter used in the filtration of wine and corresponding to about 250 tons/year of waste in Portugal. In this work, samples of these by-products were evaluated for their chemical composition by HPLC-DAD-ESI-Msn and bioactivities (antioxidant activity by TBARS, DPPH, and reducing power assays, and antimicrobial activity against eight bacteria and two fungi). Fifteen non-anthocyanin phenolic compounds were found, including 5 phenolic acids, 4 flavan-3-0Is, 2 0- glycosylated flavanols, 3 flavanol aglycones, and one unknown. In the red wine byproducts 12 anthocyanins were detected, most being malvidin derivatives. Wine lees and white grape pomace before distillation presented the highest contents of phenolic compounds. Ali samples showed antibacterial and antifunga! activity against most of the tested microorganisms, with red and white grape pomace and diatomaceous earth having the best bacteriostatic activity, while the lees stood out against fungi. Ali samples showed promising antioxidant capacity, with very good results obtained on TBARS for the white pomace after distillation and diatomaceous earth. Overall, the results show that besides grape pomace other wine industry byproducts are also good sources of bioactive compounds with high potential for exploitation.To Campelo for the winemaking residues. To projecl "BacchusTech - Inlegrated Approach for lhe Valorization of Winemaking Residues" (POCI-01-0247-FEDER-069583) and national funds FCT/MCTES to CIMO (UIDB/00690/2020). L. Barros, M. Dias, S. Heleno Ihank FCT, P.L, for Iheir scienlific employmenl program-contractinfo:eu-repo/semantics/publishedVersio

Chemical composition and biological activity of different residues obtained from the wine industry

In recent years, the bioactive compounds present in agri-food sub-products have attracted increased attention due to their health benefits and advantages within a circular economy context. Annually, wine production is responsible for the production of large amounts of phytotoxic waste, which elimination is considered challenging since these residues can be hazardous to the environment when used as fertilizers or just discarded. Phenolic compounds are secondary metabolites processed by plants that have shown several health benefits, acting as antioxidants, antimicrobials, anticarcinogenic, or antidiabetics, among others. Bioactive phenolic molecules have attracted considerable attention from the pharmaceutical, cosmetic, and food industries. So far, several studies have been developed on the characterization of grape pomace and its components (seeds, skins, and stems), especially directed to the residues of red varieties.1 However, less attention has been paid to other by-products generated during winemaking, such as waste from the production of white wine, wine lees and diatomaceous earth. The latter is used in the filtration of wine and constitutes about 250 tons/year of waste from the wine sector in Portugal alone, making it a very pertinent residue with still scarce information being found in the literature. In this context, within the framework of the BacchusTech project that seeks to develop new innovative processes, comprising the extraction, purification, and concentration of bioactive compounds present in winemaking residues, different residues including pomace, lees and diatomaceous earth were evaluated for their chemical composition and bioactivities. Residues were extracted using an hydroalcoholic solvent (80%, v/v), total phenolic compounds were estimated using the Folin- Ciocalteu reagent and individual phenolic compounds were identified and quantified by liquid chromatography coupled to mass spectrophotometry (HPLC-DAD-ESI-MSn). Additionally, the biological activity was assessed through TBARS, DPPH, and reducing power assays to determine the antioxidant activity, and the antimicrobial activity was evaluated by broth microdilution against eight bacteria and two fungi. The phenolic composition was in accordance with the previously reported in red wines.2,3 Fifteen non-anthocyanin phenolic compounds were found, five phenolic acids (gallic acid and derivatives, p-hydroxybenzoic and p-coumaric acid), four flavan-3-ols (procyanidin dimers), two O-glycosylated flavanols (isorhamnetin and quercetin derivatives), three flavanol aglycones (quercetin, kaempferol, and myricetin), and one unknown compound. Regarding anthocyanins, five compounds were found, namely malvidin derivatives linked to acyl groups. Wine lees and white grape pomace before distillation presented the highest contents of phenolic compounds; however, only diatomaceous earth sample reveal the presence of O-glycosylated flavonoids. All samples showed antibacterial and antifungal activity against most of the tested microorganisms. The best bacteriostatic activity was evidenced by the red and white grape pomace before distillation and diatomaceous earth, while the wine lees stood out for their fungistatic activity. In general, all samples showed promising antioxidant capacity, with very good results being obtained on TBARS assay, particularly for the white pomace after distillation (EC50 = 0.016±0.002 mg/mL), diatomaceous earth (EC50 = 0.063±0.001 mg/mL) and red pomace before distillation (EC50 = 0.08±0.04 mg/mL). Overall, the results obtained showed that the residues analyzed are good sources of bioactive compounds, namely anthocyanins and other phenolic compounds, which can be used as raw materials for the steps of concentration, purification and/or isolation of compounds of added value.To Campelo for supplying the winemaking residues. To project “BacchusTech - Integrated Approach for the Valorization of Winemaking Residues” (POCI-01-0247-FEDER-069583). L. Barros, M.I. Dias, and S. Heleno (CEECIND/00831/2018) thank the national funding by FCT, P.I., through the institutional and individual scientific employment program-contract for their contract. Funding: This work was financially supported by the Competitiveness and Internationalization Operational Program (COMPETE 2020), under the PORTUGAL 2020 Partnership Agreement, through the European Regional Development Fund (ERDF) and Foundation for Science and Technology (FCT, Portugal) through national funds FCT/MCTES to the CIMO (UIDB/00690/2020). The GIP-USAL is financially supported by the Spanish “Ministerio de Ciencia and Innovación” (PID2019-106167RB-I00) and “Junta de Castilla y León” (SA093P20 and CLU-2018-04).info:eu-repo/semantics/publishedVersio

General, verbal, and non-verbal cognitive functioning of children and adolescents with 22q11.2 Deletion Syndrome

ABSTRACT Background: Cognitive dysfunctions are frequently found in the 22q11.2 Deletion Syndrome, being an aggravating factor in the impairment of social relationships and communication, strongly impacting the functionality of the individual. Increasing the knowledge regarding cognitive skills may provide contributions to the diagnostic process and the intervention planning. Objectives: To estimate the general, verbal, and non-verbal cognitive functioning of children and adolescents with 22q11.2 Deletion Syndrome. Methods: This is a cross-sectional, descriptive, and case series study regarding 15 individuals between 7-18 years-old diagnosed with 22q11.2 Deletion Syndrome. An assessment of the cognitive functions was performed using the Wechsler Abbreviated Scale of Intelligence (WASI). For data analysis we used a descriptive statistics analysis, having absolute frequencies for variables, and mean, median, standard deviation, minimum and maximum values for numerical variables. Results: In the group analysis, we observed an important cognitive impairment degree. Most of the sampling (n=8; 53.33%) presented a considerably low total intelligence quotient score. Cases showing lower performances also presented greater difficulties regarding Visual Motor and Visuospatial coordination. Regarding the intelligence quotient representative punctuation in the WASI scale, the sample showed a large variability in the results (between 40 and 92 points), with the median total of 83. Conclusions: We observed important dysfunctions, cognitive difficulties, and intellectual, verbal, and non-verbal disabilities in the population studied. These findings indicate the need for an early intervention to assist not only the cognitive aspect, but also the socio-emotional development of children with the 22q11.2 Deletion Syndrome, aiming at their participation in society

Performance evaluation of primary care services for the treatment of tuberculosis

Objetivo Avaliar o desempenho dos serviços de Atenção Básica para o tratamento da tuberculose segundo o referencial de avaliação dos serviços de saúde (estrutura/processo) em Cabedelo, município portuário da Paraíba. Método Pesquisa avaliativa, quantitativa, de corte transversal onde foram realizadas 117 entrevistas com os profissionais de saúde, através de um instrumento estruturado. A análise pautou-se na construção de indicadores, utilizando-se valor padronizado para a variável reduzida (z=1). Resultados Os indicadores estruturais apresentaram desempenho regular para as variáveis: capacitação profissional; acesso a instrumentos de registro; articulação com outros serviços. Quanto ao processo, os indicadores relacionados às ações externas e informações sobre a doença apresentaram desempenho insatisfatório. O tratamento diretamente observado e os fluxos de referência/contrarreferência tiveram desempenho regular. Conclusão A qualificação profissional focalizada, a fragmentação das práticas e a atenção domiciliária assistemática, constituem em obstáculos para o desempenho de ações voltadas à prestação do cuidado ampliado, contínuo e resolutivo.Objetivo Evaluar el desempeño de los servicios de Atención Básica para el tratamiento de la tuberculosis según el marco de referencia de evaluación de los servicios de salud (estructura/proceso) en Cabedelo, municipio portuario de Paraíba. Método Investigación evaluativa, cuantitativa, de corte transversal en donde se llevaron a cabo 117 entrevistas con los profesionales de salud, mediante un instrumento estructurado. El análisis se pautó en la construcción de indicadores, utilizándose valor estandarizado para la variable reducida (z=1). Resultados Los indicadores estructurales presentaron desempeño regular para las variables: capacitación profesional; acceso a instrumentos de registro; articulación con otros servicios. En cuanto al proceso, los indicadores relacionados con las acciones exteriores e informaciones acerca de la enfermedad presentaron desempeño insatisfactorio. El tratamiento directamente observado y los flujos de referencia/contrarreferencia tuvieron desempeño regular. Conclusión La cualificación profesional enfocada, la fragmentación de las prácticas y la atención domiciliaria asistemática se constituyen en obstáculos para el desempeño de acciones dirigidas a la prestación del cuidado ampliado, continuo y resolutivo.Objective Evaluating the performance of primary care services for the treatment of tuberculosis according to the assessment referential of health services (structure/process) in Cabedelo, a port city in the state of Paraíba. Method An evaluation quantitative, cross-sectional study, in which were carried out 117 interviews with health professionals using a structured instrument. The analysis was based on the construction of indicators using a standardized value for the reduced variable (z=1). Results The structural indicators showed regular performance for the following variables: professional training, access to record instruments and coordination with other services. The process indicators related to external actions and information about the disease had unsatisfactory performance. The directly observed treatment and the flows of reference/counter-reference had regular performance. Conclusion The focused professional qualification, the fragmentation of practices and the unsystematic home care constitute obstacles for carrying out actions aimed at providing expanded, continuous and resolute care.


Phytochemical analysis and antifungal activity of extracts from leaves and fruit residues of brazilian savanna plants aiming its use as safe fungicides

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)The increasing demand for safe food without preservatives or pesticides residues has encouraged several studies on natural products with antifungal activity and low toxicity. In this study, ethanolic extracts from leaves and fruit residues (peel and seeds) of three Brazilian savanna species (Acrocomia aculeata, Campomanesia adamantium and Caryocar brasiliense) were evaluated against phytopathogenic fungi. Additionally, the most active extract was chemically characterized by ESI-MS and its oral acute toxicity was evaluated. Extracts from C. brasiliense (pequi) peel and leaves were active against Alternaria alternata, Alternaria solani and Venturia pirina with minimal inhibitory concentrations between 350 and 1000 mu g/mL. When incorporated in solid media, these extracts extended the lag phase of A. alternata and A. solani and reduced the growth rate of A. solani. Pequi peel extract showed better antifungal activity and their ESI-MS analysis revealed the presence of substances widely reported as antifungal such as gallic acid, quinic acid, ellagic acid, glucogalin and corilagin. The oral acute toxicity was relatively low, being considered safe for use as a potential natural fungicide. [GRAPHICS] .The increasing demand for safe food without preservatives or pesticides residues has encouraged several studies on natural products with antifungal activity and low toxicity. In this study, ethanolic extracts from leaves and fruit residues (peel and seeds6195204FAPESP - FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULOFundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)2011/19057-7; 2012/21395-0We are grateful to São Paulo Research Foundation for the financial support of this research and for the fellowships awarded to C.A.B. (FAPESP No. 2011/19057-7) and G.A.B. (FAPESP No. 2012/21395-0) and to Study Group of Cerrado Agro-industrial Processes (