Eficiencia y eficácia del desempeño de la enfermería en procedimientos técnicos

This was a non-experimental inter-relational retrospective study that aimed at providing performance indicators for nurses in their decision-making process in team work management. The sample was constituted by 56 ICU in-patient records during the ten first days of admission, measuring efficiency and efficacy of nursing team with relation to technical procedures along nursing work shifts. Results demonstrated efficiency to be as an operational performance indicator, pointing significant variations of amount different of zero in all nursing shifts and variation of value in afternoon shift. In relation to efficacy it is not possible to affirm inefficacy of procedures. It was conclude that the definition of a continuous flow of information allows the managers to handle consistent data in the establishment of a protocol for actions control.Tratase de una investigación no-experimental interrelacional retrospectiva que objetivó ofrecer a los enfermeros indicadores de desempeño operacional en la toma de decisiones en la gestión del equipo de trabajo. La muestra fue constituida por 56 prontuarios de pacientes de Unidad de Terapia Intensiva, en los 10 primeros días de internación, mensurando la eficiencia y la eficacia del equipo de enfermería en la ejecución de procedimientos técnicos en los turnos de trabajo. Los resultados demostraron la eficacia como indicador de desempeño operacional, apuntando variaciones de cantidad significativamente diferentes de cero en todos los turnos y variación de valores solamente en el periodo de la tarde. Cuanto a la eficacia no se puede afirmar ineficacia de los procedimientos. Se concluyó que la definición de un flujo continuo de informaciones permite a los gestores disponer de datos consistentes en la elaboración de referencial en acciones de control.Trata-se de uma pesquisa não-experimental com desenho inter-relacional retrospectivo com o objetivo de oferecer aos enfermeiros indicadores de desempenho operacional na tomada de decisões no gerenciamento da equipe de trabalho. A amostra foi composta por 56 prontuários de pacientes internados em UTI, abrangendo os dez primeiros dias de internação, mensurando a eficiência e eficácia da equipe de enfermagem na execução de procedimentos técnicos nos turnos de trabalho. Os resultados demonstraram a eficiência como indicador de desempenho operacional, apontando variações de quantidade significantemente diferentes de zero em todos os turnos e variação de valor no período da tarde. Quanto à eficácia não se pode afirmar ineficácia dos procedimentos. Concluiu-se que a definição de um fluxo contínuo de informações permite aos gestores dispor de dados consistentes na elaboração de referencial em ações de controle.Universidade Federal de São Paulo (UNIFESP) Departamento de EnfermagemUNIFESP, Depto. de EnfermagemSciEL

Harsh parenting and child conduct and emotional problems:parent- and child-effects in the 2004 Pelotas Birth Cohort

In high-income countries, links between harsh and abusive parenting and child conduct and emotional problems are well-documented. However, less is known about these relationships in low- and middle-income countries, where harsh parenting may be more widely accepted and higher rates of conduct or emotional problems may exist which could influence the strength of these associations. We sought to investigate these relationships in a large population-based, prospective longitudinal study from Brazil, which also allowed us to test for sex differences. Using data from the 2004 Pelotas Birth Cohort Study (N = 4231) at ages 6 and 11 years, we applied cross-lagged path analysis to examine the relationships between harsh parenting (Conflict Tactics Scale Parent–Child version), and child conduct and emotional problems (Strengths and Difficulties Questionnaire). We found reciprocal relationships between harsh parenting and child conduct problems, with harsh parenting at age 6 predicting child conduct problems at age 11, and vice versa, even after adjusting for initial levels of conduct problems and harsh parenting, respectively. For child emotional problems, only unidirectional effects were found, with harsh parenting at age 6 predicting child emotional problems at age 11, after adjusting for initial levels of emotional problems, but not vice versa. No significant sex differences were observed in these relationships. These observations based on a middle-income country birth cohort highlight the potential universality of detrimental effects of harsh parenting on child conduct and emotional problems and affirm the importance of addressing parent- and child-effects in preventive and treatment interventions, especially those targeting conduct problems. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00787-021-01759-w

Efficacy and safety of avelumab treatment in patients with metastatic Merkel cell carcinoma: experience from a global expanded access program

BackgroundAvelumab, a human anti–programmed death-ligand 1 immunoglobulin G1 monoclonal antibody, showed favorable efficacy and safety in patients with metastatic Merkel cell carcinoma (mMCC) in the phase II JAVELIN Merkel 200 trial, leading to approval in multiple countries. We describe real-world experience with avelumab in patients with mMCC from an expanded access program.MethodsEligible patients had mMCC and progressive disease during or after chemotherapy or were ineligible for chemotherapy or clinical trial participation. Patients received an initial 3-month supply of avelumab (administered as 10 mg/kg intravenously every 2 weeks until progressive disease or unacceptable toxicity); resupply was allowed following complete response, partial response, stable disease, or clinical benefit per physician assessment.ResultsBetween December 15, 2015, and March 4, 2019, 558 of 620 requests from 38 countries were medically approved, and 494 patients received avelumab. Among 240 evaluable patients, the objective response rate was 46.7% (complete response in 22.9%, including 3 of 16 potentially immunocompromised patients), and the disease control rate was 71.2%. The median duration of treatment in evaluable patients with response was 7.9 months (range, 1.0–41.7) overall and 5.2 months (range, 3.0–13.9) in immunocompromised patients. No new safety signals were identified. The expanded access program closed for new requests on December 31, 2018, as required after regulatory approval; benefitting patients continued to receive avelumab.ConclusionsThe avelumab expanded access program for patients with mMCC demonstrated efficacy and safety in a real-world setting, consistent with the results from JAVELIN Merkel 200, and provided a treatment for patients with limited options

Optimal plant density and nitrogen rates for improving off-season corn yields in Brazil

Integrating plant density and nitrogen (N) management is a strategy for improving corn yields, especially for off-season corn production in the tropics. This study tested the hypothesis that increasing plant densities and N rates promotes yield gains for off-season corn production in high-yielding environments. The aim of the study was to investigate the yield performances of two hybrid versions (DKB PRO and DKB PRO3) submitted to three plant densities (55,000; 65,000 and 75,000 plants ha−1) and four N rates (control, 60, 120 and 180 kg ha−1 N). Field trials were undertaken at Uberlândia-MG (site1 and 2) and Pedro Afonso-TO (site 3), Brazil from which data on corn yield parameters were collected and analyzed. Multivariate analysis separated the three trial areas into two groups, presenting high (sites 1 and 2) and low yields (site 3), which were related to weather conditions. There was no influence of a hybrid version or plant densities on crop yields at site 1 or 2. In contrast, there was a positive response to increasing plant densities and the use of DKB PRO3 at site 3. A significant response to N was observed at sites 2 and 3, following a plateau model. Our results suggest that N application rates and plant densities do have the potential to increase off-season corn yields in low yielding environments

Desafio do Talude / Slope Challenge

No começo do ano letivo de 2019, com a entrada de novos calouros, viu-se a necessidade de oferecer a eles a oportunidade de se ter um maior contato com o curso e com as instituições que cercam o Departamento de Engenharia Civil (DEC). Com isso, realizou-se uma nova edição do Desafio do Talude, o qual consiste na simulação da construção de um talude, durante a 1º edição da Semana de Iniciação Acadêmica, realizada pelo Centro Acadêmico de Engenharia Civil (CAEC). Por ser uma obra de terra com conceitos pouco conhecidos para aqueles que recém chegaram ao curso, a atividade propôs aguçar a curiosidade dos calouros sobre essa área que a Engenharia Civil abrange, de modo que eles pudessem sair dali conhecendo um pouco mais sobre o assunto

Projeto Graduação: melhoria no aprendizado/ Graduation Project: improving learning

O Projeto Graduação visa compreender os dados obtidos por meio de questionários destinados à discentes e docentes sobre os possíveis aspectos responsáveis pelo alto índice de evasão do curso de Engenharia Civil na Universidade Estadual Maringá. O intuito do trabalho é melhorar a qualidade do curso e consequentemente do aprendizado para que menos alunos abandonem a graduação

Azimuthal anisotropy of charged jet production in root s(NN)=2.76 TeV Pb-Pb collisions

We present measurements of the azimuthal dependence of charged jet production in central and semi-central root s(NN) = 2.76 TeV Pb-Pb collisions with respect to the second harmonic event plane, quantified as nu(ch)(2) (jet). Jet finding is performed employing the anti-k(T) algorithm with a resolution parameter R = 0.2 using charged tracks from the ALICE tracking system. The contribution of the azimuthal anisotropy of the underlying event is taken into account event-by-event. The remaining (statistical) region-to-region fluctuations are removed on an ensemble basis by unfolding the jet spectra for different event plane orientations independently. Significant non-zero nu(ch)(2) (jet) is observed in semi-central collisions (30-50% centrality) for 20 <p(T)(ch) (jet) <90 GeV/c. The azimuthal dependence of the charged jet production is similar to the dependence observed for jets comprising both charged and neutral fragments, and compatible with measurements of the nu(2) of single charged particles at high p(T). Good agreement between the data and predictions from JEWEL, an event generator simulating parton shower evolution in the presence of a dense QCD medium, is found in semi-central collisions. (C) 2015 CERN for the benefit of the ALICE Collaboration. Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).Peer reviewe