Carga de trabalho de enfermagem em pronto-socorro geral: proposta metodológica

OBJECTIVE: This study aimed to propose a methodology for identifying the nursing workload in the Emergency Department (ED). METHODS: this is methodological research, undertaken in a public general hospital in the municipality of São Paulo, Brazil, in the areas: triage, shock room, emergency room, suturing room, and medication/procedures for adult and pediatric patients rooms, using different strategies and instruments. Due to the characteristics of the data collection, distinct samples were obtained in each of the areas. RESULTS: The average daily workload, in hours, corresponded to: triage 48; shock room 30.9; emergency 170.6; observation of adult patients 293.6; observation of pediatric patients 108.7; medication/procedures in adult patients 175.5; medication/procedures in pediatric patients 60.4; and suturing 7.9. CONCLUSION: The instruments used for data collection were shown to be appropriate and made it possible to construct a methodological proposal for identification of workload of nursing professionals in E.D. in a general public hospital.OBJETIVO: Este estudio propone una metodología para identificación de la carga de trabajo de enfermería en sala de emergencias (SE). MÉTODOS: Se trata de un estudio metodológico, realizado en SE del hospital general público en Sao Paulo, en las áreas: salas de detección de riesgo, choque, emergencia, sutura, medicamentos/procedimientos para pacientes adultos y pediátricos y observación pacientes adultos y pediátricos, utilizando diversas estrategias e instrumentos. Como resultado de la característica de la recolecta de datos, diferentes muestras se obtuvieron en cada una de las áreas. RESULTADOS: La carga promedia de trabajo diario en horas corresponden: detección de riesgo 48; descarga 30,9; emergencia 170,6; observación de pacientes adultos 293,6; observación de pacientes pediátricos 108,7; medicamentos/procedimientos pacientes adultos 175,5; medicamentos/procedimientos pacientes pediátricos 60,4; sutura 7,9. CONCLUSIÓN: Los instrumentos utilizados para la recolección de datos fueron adecuados y permiten construir una metodología para la identificación de la carga de trabajo del personal de enfermería en el SE del hospital general público.OBJETIVO: neste estudo o objetivo foi propor metodologia para identificar a carga de trabalho de enfermagem em pronto-socorro (PS). MÉTODOS: trata-se de pesquisa metodológica, realizada em PS de hospital geral público, no município de São Paulo, nas áreas: triagem de risco, salas de choque, emergência, sutura, medicação/procedimentos de pacientes adultos e pediátricos e observação de pacientes adultos e pediátricos, utilizando-se diferentes estratégias e instrumentos. Pela característica da coleta de dados, obtiveram-se amostras distintas em cada uma das áreas. RESULTADOS: a carga média diária de trabalho, em horas, correspondeu à triagem de classificação de risco 48, choque 30,9, emergência 170,6,observação de pacientes adultos 293,6, observação de pacientes pediátricos 108,7, medicação/procedimentos de pacientes adultos 175,5, medicação/procedimentos de pacientes pediátricos 60,4 e sutura 7,9. CONCLUSÃO: os instrumentos utilizados para coleta de dados mostraram-se adequados, possibilitando a construção de proposta metodológica para identificação de carga de trabalho dos profissionais de enfermagem em PS de hospital geral público

Nursing care time in the Intensive Care Unit: evaluation of the parameters proposed in COFEN Resolution Nº 293/04

O estudo teve por objetivo avaliar os parâmetros preconizados pela Resolução COFEN nº293/04, enquanto referência para o dimensionamento de pessoal de Enfermagem em e Terapia Intensiva Adulto (UTIA). A pesquisa foi desenvolvida em seis hospitais da cidade de São Paulo. Os quantitativos médios diários de profissionais, necessários para o atendimento dos pacientes, foram calculados conforme parâmetros preconizados pelo COFEN. Os resultados obtidos foram comparados ao quantitativo diário de pessoal existente nessas unidades. Observou-se que as proporções recomendadas pelo COFEN, para a categoria enfermeiro, são superiores às utilizadas pelos hospitais estudados, configurando-se em um desafio para a Enfermagem brasileira. Constatou-se que os valores referentes aos tempos médios de assistência são adequados e constituem importante referencial para o dimensionamento do quantitativo mínimo de profissionais, nas UTIAs. Com este estudo, evidenciaram-se contribuições para a validação dos parâmetros indicados pela Resolução COFEN nº293/04, para o dimensionamento de pessoal de Enfermagem em UTIA.Este estudio tuvo como objetivo evaluar los parámetros establecidos por la Resolución COFEN 293/04, referencia para dimensionamiento de personal de enfermería en unidades de cuidados intensivos adultos (UCIA). La investigación se realizó en seis hospitales de la ciudad de São Paulo. La cantidad media diaria de profesionales necesarios para la asistencia al paciente se calculó de acuerdo a los parámetros establecidos por COFEN. Los resultados se compararon al cuantitativo diario de personal existente en estas Unidades. Se observó que las proporciones recomendadas por COFEN, categoría enfermera, son superiores a las utilizadas por los hospitales convirtiéndose desafío para la enfermería brasileña. Se encontró que los valores del tiempo medio de asistencia son adecuadas y representan importante referencia para el dimensionamiento del cuantitativo mínimo de profesionales en UCIA. Este estudio evidencia contribuciones para validación de los parámetros especificados en la Resolución COFEN 293/04, para el dimensionamiento del personal de enfermería en UCIA.This study aimed to evaluate the parameters established in COFEN Resolution 293/04 concerning nursing staff dimensioning in adult intensive care units (AICU). The research was conducted in six hospitals in São Paulo City. The daily quantitative average of professionals needed for patient care was calculated according to the parameters established by COFEN. The obtained results were compared with the existing number of daily staff members in these units. It was observed that the proportions recommended by COFEN for the nurse category are superior to those used in the hospitals studied, which represents a challenge for Brazilian nursing. Mean care time values were found appropriate and represent important standards for dimensioning the minimum number of professionals in AICU. This study contributed to the validation of the parameters indicated in Resolution 293/04 for nursing staff dimensioning in the AICU

Characterization of blood redox status of early and mid-late lactating dairy cows

The effect of the stage of lactation on blood redox homeostasis of bovine and buffalo cows was evaluated. The investigation was carried out on early lactating and mid-late lactating cows, reared in a farm located in Campania (southern Italy). Plasma concentration of α-tocopherol and ascorbate, the total antioxidant capacity (TAC), glutathione peroxidase (GPx), and superoxide dismutase activities were higher (P < 0.01) in mid-late lactating cows, thus suggesting a higher consumption of antioxidants during early lactation. Plasma concentration of protein-bound carbonyls (PC) and nitrotyrosine (N-Tyr), and the level of lipid hydroperoxides (LPO) were higher (P < 0.01) in early lactating cows, thus suggesting that lipid peroxidation and peroxynitrite production are crucial in determining oxidative modifications in plasma. TAC was positively correlated with ascorbate concentration (P < 0.03), and negatively correlated with PC concentration (P < 0.002), and ascorbate was negatively correlated with PC (P < 0.03) in mid-late lactating group. These findings demonstrate that circulating ascorbate plays a major role in preventing protein modifications induced by carbonyls, and that ascorbate scavenging effect is impaired during early lactation. We calculated a protein oxidative stress index as the ratio (PC + N-Tyr)/TAC multiplied by 100, and we found that this parameter was higher (P < 0.0001) in early lactating cows. Therefore, it could be useful for assessing the extent of protein oxidative damage in relation to the whole antioxidant status. Further, we suggest that the LPO/GPx ratio multiplied by 100 might be used as lipid oxidative stress index in lactating cows. This index was higher (P < 0.0001) in early lactating cows, and might represent a standard parameter for evaluating the lipid damage depending on a deficiency of the enzymatic antioxidant defence. These parameters are proposed for a possible effective description of physiological changes associated with lactation

Experiences of Exclusion in Children in Institutions

Institutionalization is seen as a developmental risk factor, which, strengths the social stigma and exclusion that institutionalized children already face. The aims of this study was to investigate how the condition of being under care permeates the experiences and relationships of institutionalized children, from their own perspective and that of the professionals of the foster institution. The participants of this study were two girls and two boys, 10 to 13 years-old, attending the same institution, its coordinator and pedagogue. Semi-structured interviews were realized with all participants and some narratives produced by children on proposed themes. Some episodes which emphasize aspects of children’s relationship at school have been selected and analyzed. Children described their interactions at school as conflictive and often violent. Professionals of the foster institution related those facts to their condition of being under care, pointing to attitudes of prejudice and exclusion. Those results emphasize the discourse that positions institutionalized children as unsuccessful people, stimulating the social exclusion that they are victims. It also suggests that the school is being unsuccessful as an inclusive institution

Spatial and seasonal distribution of invertebrates in Northern Apennine rheocrene springs

72011 BOTE 1openInternationalItalian coauthor/editorFour perennial rheocrene springs located between 919 and 1252 m a.s.l. on substrata characterized by different lithologies were studied. Water samples and invertebrates were collected seasonally for one year. The crenic fauna was collected using three sampling techniques: moss washing, drift tubes and benthic traps. Each sampling technique was particularly efficient for collecting specific taxa typical of the different habitats (crenophilous crustaceans and crenoxenic benthic insects were dominant in benthic traps and moss; crenophilic, stygophilic and stygobiotic crustaceans in drift tubes). A total of 3,284 invertebrates belonging to 54 taxa were collected. Ostracoda, Harpacticoida, and Diptera were the most abundant taxa. Species assemblages collected at each spring, in each season, in traps and mosses, differed among springs, and, based on invertebrate assemblages, the ordination of the investigated springs did not correspond to that based on environmental parameters. Of the environmental variables only pH and temperature explained the diversity pattern. Assemblages collected from different habitats also differed: benthic traps collected mainly Chironomidae, Ostracoda, other Diptera, crenophilous Harpacticoida, and Gastropoda; in moss assemblages, the fauna was mostly represented by crenophilic Harpacticoida, Ostracoda, Plecoptera, Chironomidae. Finally, the groundwater assemblages, collected with drift tubes, were dominated by crenophilous Harpacticoida, Chironomidae and Plecoptera. Variation in number of taxa over time was observed in traps and moss samples, whereas drift tubes showed no seasonality. Meiofauna (i.e., permanent meiofauna, represented by Nematoda, Copepoda, Ostracoda, and Hydrachnidia, and temporary meiofauna, represented by early instars of insect larvae) dominated all habitats, probably because of constant flow and favourable habitats such as moss. The presence of mosses was a factor that increased the species diversity of the investigated springs; drift tubes allowed most of the stygobiotic taxa to be collected, although this technique did not necessarily increase the total number of taxa collected. In addition to the array of habitats, other factors, such as geology, might influence the structure of invertebrate communities. The diversity of the investigated springs was strictly dependent on the presence of different microhabitats and local environmental conditions.openBottazzi, E.; Bruno, M.C.; Pieri, V.; Di Sabatino, A.; Silveri, L.; Carolli, M.; Rossetti, G.Bottazzi, E.; Bruno, M.C.; Pieri, V.; Di Sabatino, A.; Silveri, L.; Carolli, M.; Rossetti, G

a multicenter study

(1) Background: The Commercial Kit SIRE Nitratase® PlastLabor, is a drug susceptibility test kit used to detect Mycobacterium tuberculosis resistance to first-line TB treatment drugs. The present study aimed at evaluating its performance in a multicenter study. (2) Methods: To determine its accuracy, the proportion methods in Lowenstein Jensen medium or the BACTECTMMGITTM960 system was used as a gold standard. (3) Results: The study revealed that the respective accuracies of the kit with 190 M. tuberculosis clinical isolates, using the proportion methods in Lowenstein Jensen medium or BACTECTMMGITTM960 system as a gold standard, were 93.9% and 94.6%, 96.9% and 94.6%, 98.0% and 97.8%, and 98.0% and 98.9%, for streptomycin, isoniazid, rifampicin, and ethambutol, respectively. (4) Conclusion: Thus, the kit can rapidly screen resistance to streptomycin, isoniazid, rifampicin, and ethambutol. Additionally, it does not require sophisticated equipment; hence, it can be easily used in the laboratories of low and middle income countries.publishersversionpublishe

Cohort profile: The Observational cohort for the study of DOlutegravir in Antiretroviral Combination REgimens (ODOACRE)

The Observational cohort for the study of DOlutegravir in Antiretroviral Combination REgimens (ODOACRE) cohort was established in Italy in 2016 to evaluate the overall efficacy and tolerability of dolutegravir (DTG)-based antiretroviral (ARV) regimens in clinical practice