Comparación entre la gravedad del paciente y la carga de trabajo de la enfermería antes y después de la ocurrencia de eventos adversos en ancianos con cuidados críticos

Indexación: Scopus.Objective: to compare the patient severity and the nursing workload before and after the occurrence of moderate and severe adverse events in elderly hospitalized at intensive care units. Method: comparative study developed at nine intensive therapy units of a University Hospital in São Paulo. The events were collected from the patient histories and classified as moderate and severe according to the World Health Organization. For the severity analysis, the Simplified Acute Physiologic Score II was used and, for the workload analysis, the Nursing Activities Score was applied 24 hours before and after the moderate and severe event. The t-test with 5% significance was used to compare the mean clinical severity and workload scores before and after the event. Results: the sample consisted of 315 elderly, 94 (29.8%) of whom were victims of moderate and severe events at the units. Among the 94 events, the clinical process and procedure type was predominant (40.0%). The installation and maintenance of therapeutic artifacts and catheters were the prevalent interventions that resulted in moderate (76.5%) physiopathological damage (66.0%). The mean workload score (75.19%) dropped 24 hours after the occurrence of the event (71.97%, p=0.008), and the severity, represented by the probability of death, increased from 22.0% to 29.0% after the event (p=0.045). Conclusion: in the patient safety context, the identification of the changes in clinical conditions and the nursing workload in elderly victims of events supports the prevention of these occurrences. © 2018, Universidade Federal de Santa Catarina. All rights reserved.Objetivo: comparar a gravidade do paciente e a carga de trabalho de enfermagem antes e após a ocorrência de evento adverso moderado e grave em idosos internados em unidades de terapia intensiva. Método: estudo comparativo, realizado em nove unidades de terapia intensiva de um Hospital Universitário de São Paulo. Os eventos foram coletados dos prontuários dos pacientes e classificados em moderados e graves segundo a Organização Mundial de Saúde. A análise da gravidade foi realizada segundo o Symplified Acute Phsiologic Score II e a carga de trabalho segundo o Nursing Activities Score, 24 horas antes e depois do evento moderado e grave. O teste t, com significância de 5%, foi utilizado para a comparação das médias da gravidade clínica e da carga de trabalho, antes e após o evento. Resultados: a amostra foi composta por 315 idosos, sendo que 94 (29,8%) sofreram eventos moderados e graves nas unidades. Dos 94 eventos, predominou o tipo processo clínico e procedimento (40,0%). A instalação e manutenção de artefatos terapêuticos e cateteres foram as intervenções prevalentes que resultaram em danos fisiopatológicos (66,0%), de grau moderado (76,5%). A média de pontuação da carga de trabalho (75,19%) diminuiu 24 horas após a ocorrência do evento (71,97%, p=0,008) e, a gravidade, representada pela probabilidade de morte, aumentou de 22,0% para 29,0% depois do evento (p=0,045). Conclusão: no contexto da segurança do paciente, a identificação das alterações nas condições clínicas e na carga de trabalho de enfermagem em idosos que sofrem eventos subsidiam a prevenção dessas ocorrências.Objetivo: comparar la gravedad del paciente y la carga de trabajo en enfermería antes y después de ocurrir un evento adverso moderado y grave en ancianos internados en unidades de terapia intensiva. Método: estudio comparativo realizado en nueve unidades de terapia intensiva de un Hospital Universitario de São Paulo. Los eventos fueron obtenidos a través de los prontuarios de los pacientes y clasificados en moderados y graves según la Organización Mundial de la Salud. El análisis sobre la gravedad fue realizado de acuerdo al Symplified Acute Physiologic Score II y la carga de trabajo se hizo conforme al Nursing Activities Score, 24 horas antes y después del evento moderado y grave. El test t, con una significancia del 5%, fue utilizado para la comparación de los promedios de la gravedad clínica y de la carga de trabajo antes y después del evento. Resultados: la muestra incluyó 315 ancianos, siendo que 94 (29,8%) sufrieron eventos moderados y graves en las unidades. De los 94 eventos, predominó el tipo de proceso clínico y el procedimiento (40,0%). La instalación y mantenimiento de artefactos terapéuticos y catéteres fueron las intervenciones prevalentes que resultaron en daños fisiopatológicos (66,0%) y de grado moderado (76,5%). El promedio de puntuación de la carga de trabajo (75,19%) disminuyó 24 horas después de ocurrido el evento (71,97%, p=0,008) y la gravedad, representada por la probabilidad de muerte, aumentó de 22,0% para 29,0% después del evento (p=0,045). Conclusion: en el contexto de seguridad del paciente, la identificación de las alteraciones en las condiciones clínicas y en la carga de trabajo de enfermería en los ancianos que sufren eventos subsidia la prevención de tales ocurrencias.http://ref.scielo.org/wcg6x

H 2 And H ∞ Filtering Design Subject To Implementation Uncertainty

This paper presents new filtering design procedures for discrete-time linear systems. It provides a solution to the problem of linear filtering design, assuming that the filter is subject to parametric uncertainty. The problem is relevant, since the proposed filter design incorporates real world implementation constraints that are always present in practice. The transfer function and the state space realization of the filter are simultaneously computed. The design procedure can also handle plant parametric uncertainty. In this case, the plant parameters are assumed not to be exactly known but belonging to a given convex and closed polyhedron. Robust performance is measured by the H 2 and H ∞ norms of the transfer function from the noisy input to the filtering error. The results are based on the determination of an upper bound on the performance objectives. All optimization problems are linear with constraint sets given in the form of LMI (linear matrix inequalities). Global optimal solutions to these problems can be readily computed. Numerical examples illustrate the theory. © 2005 Society for Industrial and Applied Mathematics.442515530Gevers, M., Li, G., (1993) Parametrizations in Control, Estimation and Filtering Problems, , Springer-Verlag, LondonWilliamson, D., Finite wordlength design of digital Kalman filters for state estimation (1985) IEEE Trans. Automat. Control, 30, pp. 930-939Williamson, D., Kadiman, K., Optimal finite wordlength linear quadratic regulators (1989) IEEE Trans. Automat. Control, 34, pp. 1218-1228Liu, K., Skelton, R.E., Grigoriadis, K., Optimal controllers for finite wordlength implementation (1992) IEEE Trans. Automat. Control, 37, pp. 1294-1304Hwang, S.Y., Minimum uncorrelated unit noise in state-space digital filtering (1977) IEEE Trans. Acoustics Speech Signal Process, 25, pp. 273-281Amit, G., Shaked, U., Minimization of roundoff errors in digital realizations of Kalman filters (1989) IEEE Trans. Acoustics Speech Signal Process, 37, pp. 1980-1982De Oliveira, M.C., Skelton, R.E., Synthesis of controllers with finite precision considerations (2001) Digital Controller Implementation and Fragility: A Modern Perspective, pp. 229-251. , R. S. H. Istepanian and J. F. Whidborne eds., Springer-Verlag, New YorkKeel, L.H., Bhattacharyya, S.P., Robust, fragile or optimal (1997) IEEE Trans. Automat. Control, 42, pp. 1098-1105Keel, L.H., Bhattacharyya, S.P., Authors' reply to: "Comments on 'Robust, fragile or optimal' " by P. M. Mäkilä (1998) IEEE Trans. Automat. Control, 43, p. 1268Dorato, P., Non-fragile controller design: An overview (1998) Proceedings of the 1998 American Control Conference, 5, pp. 2829-2831. , Philadelphia, IEEE, Piscataway, NJFamularo, D., Dorato, P., Abdallah, C.T., Haddad, W.H., Jadbabaie, A., Robust non-fragile LQ controllers: The static state feedback case (2000) Internat. J. Control, 73, pp. 159-165Yang, G.H., Wang, J.L., Robust nonfragile Kalman filtering for uncertain linear systems with estimator gain uncertainty (2001) IEEE Trans. Automat. Control, 46, pp. 343-348Haddad, W.M., Corrado, J.R., Robust resilient dynamic controllers for systems with parametric uncertainty and controller gain variations (2000) Internat. J. Control, 73, pp. 1405-1423Keel, L.H., Bhattacharyya, S.P., Stability margins and digital implementation of controllers (1998) Proceedings of the 1998 American Control Conference, 5, pp. 2852-2856. , (Philadelphia), IEEE, Piscataway, NJGeromel, J.C., Optimal linear filtering under parameter uncertainty (1999) IEEE Trans. Signal Process, 47, pp. 168-175Nesterov, Y., Nemirovskii, A., (1994) Interior-Point Polynomial Algorithms in Convex Programming, , SIAM, PhiladelphiaGeromel, J.C., Bernussou, J., Garcia, G., De Oliveira, M.C., H 2 and H ∞ robust filtering for discrete-time linear systems (2000) SIAM J. Control Optim., 38, pp. 1353-1368Geromel, J.C., De Oliveira, M.C., Bernussou, J., Robust filtering of discrete-time linear systems with parameter dependent Lyapunov functions (2002) SIAM J. Control Optim., 41, pp. 700-711De Oliveira, M.C., Bernussou, J., Geromel, J.C., A new discrete-time robust stability condition (1999) Systems Control Lett., 37, pp. 261-265Sayed, A.H., A framework for state-space estimation with uncertain models (2001) IEEE Trans. Automat. Control, 46, pp. 998-1013Balakrishnan, V., Huang, Y., Packard, A., Doyle, J.C., Linear matrix inequalities in analysis with multipliers (1994) Proceedings of the 1994 American Control Conference, 2, pp. 1228-1232. , Baltimore, MD, IEEE, Piscataway, NJGeromel, J.C., Peres, P.L.D., Bernussou, J., On a convex parameter space method for linear control design of uncertain systems (1991) SIAM J. Control Optim., 29, pp. 381-40

A study on the accuracy and precision of external mass transfer and diffusion coefficients jointly estimated from pseudo-experimental simulated data

Optimal experimental designs for maximum precision in the estimation of diffusivities (D) and mass transfer coefficients (Kc) for solute transport from/to a solid immersed in a fluid were determined. Diffusion in the solid was considered to take place according to Fick's second law. It was found that the optimal design was dependent on the Biot number. In the range of Biot numbers tested (0.1±200), the first sampling time corresponded to values of fractional loss/uptake between 0.10 and 0.32, and the second sampling time corresponded to values of fractional loss/uptake between 0.67 and 0.82. Pseudo-experimental data were simulated by applying randomly generated sets of errors, taken from a normal distribution with 5% standard deviation, to data calculated using given values of the model parameters. Both optimal and heuristic designs (for which the sampling times corresponded to values of fractional loss/uptake from 0.30 to 0.95) were analyzed. The accuracy and precision of the estimates obtained by non-linear regression were compared. It was confirmed that optimal designs yield best results in terms of precision, although it was concluded that the joint estimation of D and Kc should, in general, be avoided. For intermediate values of the Biot number, reasonably precise and accurate estimates can however be obtained if the experimental error is smal

Using hierarchical information-theoretic criteria to optimize subsampling of extensive datasets

This paper addresses the challenge of subsampling large datasets, aiming to generate a smaller dataset that retains a significant portion of the original information. To achieve this objective, we present a subsampling algorithm that integrates hierarchical data partitioning with a specialized tool tailored to identify the most informative observations within a dataset for a specified underlying linear model, not necessarily first-order, relating responses and inputs. The hierarchical data partitioning procedure systematically and incrementally aggregates information from smaller-sized samples into new samples. Simultaneously, our selection tool employs Semidefinite Programming for numerical optimization to maximize the information content of the chosen observations. We validate the effectiveness of our algorithm through extensive testing, using both benchmark and real-world datasets. The real-world dataset is related to the physicochemical characterization of white variants of Portuguese Vinho Verde. Our results are highly promising, demonstrating the algorithm's capability to efficiently identify and select the most informative observations while keeping computational requirements at a manageable level

Epidemiology and pathology of bovine schistosomiasis in Mozambique

AIM: To study the epidemiology and pathology of bovine schistosomiasis in Mozambique. BACKGROUND: - Bovine schistosomiasis is of great importance in Africa. It is caused by Schistosoma bovis; - In bovines the symptoms are similar to humans, mainly intestinal, hepato-splenic, vesical and genital; - It has been shown to be endemic through all Africa and in some Mediterranean countries (Portugal, Spain, Italy, Iraque and Israel); - Hybrids of S. haematobium and S. bovis are known to infect humans.N/

Gravitational Collapse in Higher Dimensional Husain Space-Time

We investigate exact solution in higher dimensional Husain model for a null fluid source with pressure $p$ and density $\rho$ are related by the following relations (i) $p=k\rho$, (ii) $p=k\rho-\frac{B(v)}{\rho^{\alpha}}$ (variable modified Chaplygin) and (iii) $p=k\rho^{\alpha}$ (polytropic). We have studied the nature of singularity in gravitational collapse for the above equations of state and also for different choices of the of the parameters $k$ and $B$ namely, (i) $k=0$, $B=$ constant (generalized Chaplygin), (ii) $B=$ constant (modified Chaplygin). It is found that the nature of singularity is independent of these choices of different equation of state except for variable Chaplygin model. Choices of various parameters are shown in tabular form. Finally, matching of Szekeres model with exterior Husain space-time is done.Comment: 12 latex pages, No figure, RevTex styl

Influence of olive anthracnose and olive fruit fly on bioactive compounds of Cobrançosa olive oils

Phenolic compounds are the most important bioactive compounds in olives and since 2012 a health claim can be declared for the olive oil if it contains more than 5 mg of hydroxytyrosol (Hyt) and its derivatives per 20 g of oil1. In turn, β-carotene is a precursor of vitamin A that essentially functions in many biological processes including vision. However, the presence of bioactive compounds in olive oils depends on cultivar, agro-ecological conditions, harvest time, post-harvest, extraction technology and storage.This study was funded by the FCT, Portugal (research project PTDC/ASP-PLA/28547/2017).info:eu-repo/semantics/publishedVersio