Estresse dos enfermeiros atuantes em UTI nas regiões do Brasil

Introduction: This research is based on a survey regarding he level of stress and the stressors in ICU nurses in the regions of Brazil. The study received approval from the Local Research Ethics Committee.Methodology: The data were collected from May to December 2005. The Bianchi Stress Scale, constituted by a socio-demographic categorization and 51 items about activities performed by nurses, was used.Sample: The sample was comprised of 263 ICU nurses working in high - complexity hospitals of Brazilian state capitals. The sample was predominantly female (91.6%) and young (80.2% < 40 years old). Of the total sample, 87.8% were assistential nurses and 74.5% held a postgraduate degree.Results: Considering the stressors score by region, the results showed that Southeast (SE) > Central-West (CW) > North (N) > Northeast (NE) > South (S). Nurses in the Southeast region had higher levels of stress when compared with those in the Northeast in domain C, and this result is statistically significant.Conclusion: The study evidentiates the need to better prepare nurses to overcome difficulties by providing them with accessible tools in order to assess stressors based on the available coping mechanisms, thus lowering the occurrence of individual stress.Introducción: El estudio propone un informe del nivel de estrés y de los estresores presentes en los enfermeros que actúan en las UCIs de las regiones de Brasil. El estudio fue sometido y aprobado por la Comissão de Ética em Pesquisa local.Metodología: Los datos fueron colectados en el período de mayo a diciembre de 2005, utilizándose la Escala Bianchi de Stress, constituida por caracterización sociodemográfica y 51 items que versan sobre las actividades desempeñadas por los enfermeros.Resultados: La población fue de 263 enfermeros actuantes en las UCIs de hospitales de alta complejidad de las capitales de los estados brasileños. La muestra tuvo predominio femenino (91,6%), jóvenes (80,2% < 40 anos), siendo 87,8% asistenciales y 74,5% con post-graduación. Considerándose la puntuación de estresores por región, se obtuvo que Sudeste>Centro-Oeste>Norte>Nordeste>Sur. Los enfermeros de la Región Sudeste presentaron niveles de estrés más elevados comparados a los del Nordeste en el dominio C, siendo estadísticamente significante.Conclusión: En el estudio resulta evidente la necesidad de instrumentalizar cada vez más al enfermero para que la evaluación del estresor sea hecha basándose en los mecanismos de enfrentamiento disponibles, posibilitando la menor ocurrencia de estrés para el individuo.Introdução: O estudo propõe um levantamento do nível de estresse e dos estressores presentes nos enfermeiros que atuam nas UTIs das regiões do Brasil. O estudo foi submetido e aprovado pela Comissão de Ética em Pesquisa local.Metodologia: Os dados foram coletados no período de maio a dezembro de 2005, utilizando-se a Escala Bianchi de Stress, constituída por caracterização sociodemográfica e 51 itens que versam sobre as atividades desempenhadas pelos enfermeiros.Resultados: A população foi de 263 enfermeiros atuantes nas UTIs de hospitais de alta complexidade das capitais dos estados brasileiros. A amostra teve predomínio feminino (91,6%), jovens (80,2% < 40 anos), sendo 87,8% assistenciais e 74,5% com pós-graduação. Considerando-se o escore de estressores por região, obteve-se que Sudeste>Centro-Oeste>Norte>Nordeste>Sul. Os enfermeiros da Região Sudeste apresentaram níveis de estresse mais elevados comparados aos da Nordeste no domínio C, sendo estatisticamente significante.Conclusão: No estudo fica evidente a necessidade de se instrumentalizar cada vez mais o enfermeiro para que a avaliação do estressor seja feita com base nos mecanismos de enfrentamento disponíveis, possibilitando a menor ocorrência de estresse para o indivíduo

Energy end-use flexibility of the next generation of decision-makers in a smart grid setting: an exploratory study

Demand Response (DR) mechanisms have been developed to reshape consumption patterns in face of price signals, enabling to deal with the increasing penetration of intermittent renewable resources and balance electricity demand and supply. Although DR mechanisms have been in place for some time, it is still unclear to what extent end-users are ready, or willing, to embrace DR programs that can be complex and imply adjustments of daily routines. This work aims to understand how the next generation of Portuguese decision makers, namely young adults in higher education, are prepared to deal with energy decisions in the context of the challenges brought by the smart grids. Results demonstrate that cost savings and the contribution to environmental protection are found to be important motivating factors to enroll into DR programs, which should be further exploited in future actions for the promotion of end-user engagement. Moreover, DR solutions are well-accepted by higher education students, although with limited flexibility levels. In addition, there is room to exploit the willingness to adopt time-differentiated tariffs, yet savings should be clearer and more attractive to end-users. Also, the framing effect should be considered when promoting this type of time-differentiated tariffs.This work was partially supported by project grants UID/MULTI/00308/2013 and UID/CEC/00319/2013 and by the European Regional Development Fund through the COMPETE 2020 Programme, FCT—Portuguese Foundation for Science and Technology with in projects ESGRIDS (POCI-01-0145-FEDER-016434), Learn2Behave (02/SAICT/2016-023651), MAnAGER (POCI-01-0145-FEDER-028040), and POCI-01-0145-FEDER-007043, as well as by the Energy for Sustainability Initiative of the University of Coimbra

Effects of pre-procedural remote ischaemic pre-conditioning on the outcomes of elective percutaneous coronary intervention. A systematic review and meta-analysis

AbstractObjectivesTrials of remote ischemic pre-conditioning (RIPC) have suggested this intervention reduces complications of percutaneous coronary intervention and coronary by-pass surgery. The aims of this work were to (i) conduct a systematic review and meta-analysis of the effects of RIPC on cardiac and renal damage in patients undertaking elective percutaneous coronary intervention (PCI); (ii) summarize the results in an evidence-based clinical context.MethodsWe conducted a systematic search of published randomized controlled trials of RIPC for elective PCI up until May 1st, 2015. Studies of peri- or post-ischemic conditioning or emergency PCI were excluded.ResultsNine studies, totalling 1253 patients were included. Compared to control, RIPC groups exhibited reduced peri-procedural myocardial infarction (MI) Odds Ratio (OR) 0.72 (95% CI 0.54 to 0.97, p=0.03); ST-segment deviation OR 0.42 (95% CI 0.28 to 0.63, p<0.0001); major adverse cardiac events (MACE) OR 0.41 (95% CI 0.21 to 0.84, p=0.01); and acute kidney injury (AKI) OR 0.47 (95% CI 0.26 to 0.86, p=0.01), but not mortality OR 1.00 (95% CI 0.27 to 3.73, p=1.00).ConclusionsRIPC is likely to prevent major adverse cardiac and renal events in patients undertaking elective PCI

Development of a LAMP assay for detection of Leishmania infantum infection in dogs using conjunctival swab samples

Background: Leishmania infantum infections in dogs play a crucial role in the transmission of pathogens causing visceral leishmaniasis to humans in the Gansu province, northwest China. To be able to control zoonotic transmission of the parasite to humans, a non-invasive loop-mediated isothermal amplification (LAMP) assay to specifically detect L. infantum infections in dogs was developed. Methods: The primers used in the LAMP assay were designed to target kinetoplast DNA minicircle sequences of the L. infantum isolate MCAN/CN/90/SC and tested using DNA isolated from promastigotes of different Leishmania species. The LAMP assay was evaluated with conjunctional swab samples obtained from 111 and 33 dogs living in an endemic and a non-endemic region of zoonotic visceral leishmaniasis in the Gansu province, respectively. The LAMP assay was also compared with conventional PCR, ELISA and microscopy using conjunctional swab, serum and bone marrow samples from the dogs, respectively. Results: The LAMP assay detected 1 fg of L. infantum DNA purified from cultured promastigotes which was 10-fold more sensitive than a conventional PCR test using Leishmania genus-specific primers. No cross reaction was observed with DNA isolated from promastigotes of L. donovani, L. major, L. tropica, and L. braziliensis, and the L. infantum reference strain MHOM/TN/80/IPT1. The L. infantum-positive rates obtained for field-collected samples were 61.3%, 58.6%, 40.5% and 10.8% by LAMP, PCR, ELISA and microscopy, respectively. As only one out of the 33 samples from control dogs from the non-endemic region of zoonotic visceral leishmaniasis was positive by the LAMP assay and the PCR test, the observed true negative rate (specificity) was 97% for both methods. Conclusion: This study has shown that the non-invasive, conjunctional swab-based LAMP assay developed was more sensitive in the detection of leishmaniasis in dogs than PCR, ELISA and microscopy. The findings indicate that the LAMP assay is a sensitive and specific method for the field surveillance of domestic dogs, particularly of asymptomatic canines, in ZVL-endemic areas in western China

Inference of gene regulatory networks from time series by Tsallis entropy

Background: The inference of gene regulatory networks (GRNs) from large-scale expression profiles is one of the most challenging problems of Systems Biology nowadays. Many techniques and models have been proposed for this task. However, it is not generally possible to recover the original topology with great accuracy, mainly due to the short time series data in face of the high complexity of the networks and the intrinsic noise of the expression measurements. In order to improve the accuracy of GRNs inference methods based on entropy (mutual information), a new criterion function is here proposed. Results: In this paper we introduce the use of generalized entropy proposed by Tsallis, for the inference of GRNs from time series expression profiles. The inference process is based on a feature selection approach and the conditional entropy is applied as criterion function. In order to assess the proposed methodology, the algorithm is applied to recover the network topology from temporal expressions generated by an artificial gene network (AGN) model as well as from the DREAM challenge. The adopted AGN is based on theoretical models of complex networks and its gene transference function is obtained from random drawing on the set of possible Boolean functions, thus creating its dynamics. On the other hand, DREAM time series data presents variation of network size and its topologies are based on real networks. The dynamics are generated by continuous differential equations with noise and perturbation. By adopting both data sources, it is possible to estimate the average quality of the inference with respect to different network topologies, transfer functions and network sizes. Conclusions: A remarkable improvement of accuracy was observed in the experimental results by reducing the number of false connections in the inferred topology by the non-Shannon entropy. The obtained best free parameter of the Tsallis entropy was on average in the range 2.5 <= q <= 3.5 (hence, subextensive entropy), which opens new perspectives for GRNs inference methods based on information theory and for investigation of the nonextensivity of such networks. The inference algorithm and criterion function proposed here were implemented and included in the DimReduction software, which is freely available at http://sourceforge.net/projects/dimreduction and http://code.google.com/p/dimreduction/.Fundacao de Amparo e Amparo a Pesquisa do Estado de Sao Paulo (FAPESP)Coordenacao de Aperfeicofamento de Pessoal de Nivel Superior (CAPES)Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq

Diets containing sea cucumber (Isostichopus badionotus) meals are hypocholesterolemic in young rats

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