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

Chemical, physical and morphological characterization of ZnNi films electrodeposited on 1010 steel substrate from acid baths containing polyalcohol

AbstractZnNi alloy electrodeposition on a 1010 steel electrode in boric-acid baths containing sorbitol, mannitol or glycerol was investigated by cyclic voltammetry. Electrodeposits obtained galvanostatically were characterized by SEM, EDS and XRD. It was found that in baths containing sorbitol or mannitol, the deposition current density (jd) was reduced, but in none of the baths was the initial deposition potential affected. SEM images of deposits revealed that the boric-sorbitol and boric-mannitol complexes refine the grain, even at high jd. XRD patterns of the ZnNi deposits produced at jd=50mAcm−2, in ZnNi1 bath and in ZnNi1 bath contained sorbitol or mannitol, indicated that the films were formed mainly of Zn and γ1 phases. To ZnNi2 baths contained glycerol the films were formed of γ and γ1 phases. The Ni content in the deposits produced in the bath without polyalcohol or containing glycerol increased from ~5 to 19wt.% with increasing jd. With sorbitol or mannitol, there was a smaller rise from ~7 to 10wt.% Ni. Thus, ZnNi deposits providing sacrificial protection can be obtained in baths with or without polyalcohol. The linear polarization method showed that ZnNi alloy deposited from baths contained polyalcohol have greate Rp

Eccentric and concentric cardiac hypertrophy induced by exercise training: microRNAs and molecular determinants

Among the molecular, biochemical and cellular processes that orchestrate the development of the different phenotypes of cardiac hypertrophy in response to physiological stimuli or pathological insults, the specific contribution of exercise training has recently become appreciated. Physiological cardiac hypertrophy involves complex cardiac remodeling that occurs as an adaptive response to static or dynamic chronic exercise, but the stimuli and molecular mechanisms underlying transduction of the hemodynamic overload into myocardial growth are poorly understood. This review summarizes the physiological stimuli that induce concentric and eccentric physiological hypertrophy, and discusses the molecular mechanisms, sarcomeric organization, and signaling pathway involved, also showing that the cardiac markers of pathological hypertrophy (atrial natriuretic factor, β-myosin heavy chain and α-skeletal actin) are not increased. There is no fibrosis and no cardiac dysfunction in eccentric or concentric hypertrophy induced by exercise training. Therefore, the renin-angiotensin system has been implicated as one of the regulatory mechanisms for the control of cardiac function and structure. Here, we show that the angiotensin II type 1 (AT1) receptor is locally activated in pathological and physiological cardiac hypertrophy, although with exercise training it can be stimulated independently of the involvement of angiotensin II. Recently, microRNAs (miRs) have been investigated as a possible therapeutic approach since they regulate the translation of the target mRNAs involved in cardiac hypertrophy; however, miRs in relation to physiological hypertrophy have not been extensively investigated. We summarize here profiling studies that have examined miRs in pathological and physiological cardiac hypertrophy. An understanding of physiological cardiac remodeling may provide a strategy to improve ventricular function in cardiac dysfunction

Characterization of angiotensin-converting enzymes 1 and 2 in the soleus and plantaris muscles of rats

Angiotensin-converting enzymes 1 (ACE1) and 2 (ACE2) are key enzymes of the renin-angiotensin system, which act antagonistically to regulate the levels of angiotensin II (Ang II) and Ang-(1-7). Considerable data show that ACE1 acts on normal skeletal muscle functions and architecture. However, little is known about ACE1 levels in muscles with different fiber compositions. Furthermore, ACE2 levels in skeletal muscle are not known. Therefore, the purpose of this study was to characterize protein expression and ACE1 and ACE2 activities in the soleus and plantaris muscles. Eight-week-old female Wistar rats (N = 8) were killed by decapitation and the muscle tissues harvested for biochemical and molecular analyses. ACE1 and ACE2 activities were investigated by a fluorometric method using Abz-FRK(Dnp)P-OH and Mca-YVADAPK(Dnp)-OH fluorogenic substrates, respectively. ACE1 and ACE2 protein expression was analyzed by Western blot. ACE2 was expressed in the skeletal muscle of rats. There was no difference between the soleus (type I) and plantaris (type II) muscles in terms of ACE2 activity (17.35 ± 1.7 vs 15.09 ± 0.8 uF·min-1·mg-1, respectively) and protein expression. ACE1 activity was higher in the plantaris muscle than in the soleus (71.5 ± 3.9 vs 57.9 ± 1.1 uF·min-1·mg-1, respectively). Moreover, a comparative dose-response curve of protein expression was established in the soleus and plantaris muscles, which indicated higher ACE1 levels in the plantaris muscle. The present findings showed similar ACE2 levels in the soleus and plantaris muscles that might result in a similar Ang II response; however, lower ACE1 levels could attenuate Ang II production and reduce bradykinin degradation in the soleus muscle compared to the plantaris. These effects should enhance the aerobic capacity necessary for oxidative muscle activity

Behaviour and performance of lactating sows housed in different types of farrowing rooms during summer

AbstractThirty mixed-parity Landrace×Large White sows were used to evaluate the effects of the type of farrowing room on 28-day lactation behaviour under tropical conditions during summer. The sows were allocated in a completely randomised design with three treatments with 10 replicates according to parity number and body weight, with each animal being considered an experimental unit. The treatments consisted of a conventional farrowing room (T1); a conventional farrowing room with floor cooling under the sow (T2); and a semi-outdoor farrowing room without a cage and with access to a fenced field (T3). The sows from T1 and T2 groups were exposed to mean maximum and minimum environmental temperatures of 25.7 and 21.0°C, respectively, and the sows from the T3 group to average maximum and minimum environmental temperatures of 26.5 and 20.7°C, respectively. The feed consumption of T3 sows was numerically higher than the T1 and T2 sows (+9.5% on average). The body-weight loss was influenced at 28days (P<0.10) by treatment, being that the T3 sows gained weight (+4.7kg) while the T1 and T2 sows lost weight (−11.9 and −3.7kg, respectively for T1 and T2). The T3 sows showed a higher percentual litter mortality than the T1 and T2 sows (3.2% vs. 0% vs. 7.8%, respectively for T1, T2 and T3 sows). From farrowing until day 28 of lactation, the T2 and T3 sows showed higher lactation efficiency when compared with the T1 sows (72% vs. 87% vs. 88%, respectively for T1, T2 and T3 sows). The T1 sows showed higher (P<0.01) frequencies of visits to the feeder and drinker (+38% on average). The T3 sows spent more time (P<0.01) at the drinker than T1 and T2 sows (23 vs. 23 vs. 32min, respectively for T1, T2 and T3 sows). The T3 sows showed a higher (P<0.10) frequency of nursing than the other treatments (+15% on average). T1 and T2 sows were found to spend more time (P<0.01) performing other postures during 24h than sows maintained in T3 (50 vs. 51 vs. 22min/d, respectively for T1, T2 and T3). It is concluded that cooling of the floor under the sow in the conventional farrowing room or the use of semi-outdoor farrowing rooms improves the thermal environment and the lactation efficiency of the sows housed in hot ambient temperatures at 28-day lactation in the summer period, indicating an improved welfare

Ammonia levels on in vitro degradation of fibrous carbohydrates from buffel grass

This study was carried out to examine the degradation dynamics of neutral detergent fibre (NDF) and the profile of volatile fatty acids that originate from the fermentation of buffel grass (Cenchrus ciliaris, L.) with various levels of ammonia in the growth medium. The treatments consisted of six levels of ammonia in the growth medium (0, 5, 10, 15, 20 and 30 mg/dL), which were obtained by adding urea. These in vitro incubation times were evaluated in three replicates per time for 0, 3, 6, 9, 12, 24, 36, 48, 72 and 96 hours. Rumen concentrations of acetate and propionate responded quadratically to the ammonia levels. The treatment with 15 mg/dL of ammonia nitrogen in the rumen fluid provided mean acetate and propionate contents of 57.6 mM and 23.1 mM, respectively. Urea addition elevated the degradation rate of potentially degradable fraction of NDF (pdNDF) from 2.5% to 20.1% in comparison with the treatment without urea and to a reduction in estimated discrete lag time from 0.34 to 2.31 hours. Urea supplementation increased the specific microorganism growth rate from 2.6% to 20.1%. At the end of the incubation trial, NDF degradation showed a quadratic response, with maximum value obtained at 17.76 mg/dL of ammonia in the rumen fluid. Urea improves the degradation dynamics of NDF from deferred buffel grass and increases the concentrations of acetate and propionate.Keywords: Cenchrus ciliaris, degradation kinetics, non-protein nitrogen, ure

INFLUÊNCIA ESTRUTURAL NA COMPARTIMENTAÇÃO DO RELEVO NA BACIA DO RIO JUNDIUVIRA SP

Este trabalho é oriundo de uma pesquisa de iniciação cientifica, vinculada ao grupo de estudos do Quaternário da UFSCar. A área de estudos, a bacia hidrográfica do Rio Jundiuvira, se localiza na região da Serra do Japi. Com um aporte metodológico sistêmico, elaboração e interpretação de mapas temáticos, buscou-se a relação dos lineamentos de relevo e drenagem com a compartimentação geomorfológica, que atuam com influências importantes na compartimentação

Interface state contribution to the photovoltaic effect in organic phototransistors:Photocapacitance measurements and optical sensing

Made available in DSpace on 2018-12-11T16:50:21Z (GMT). No. of bitstreams: 0 Previous issue date: 2018-01-01Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Instituto Nacional de Ciência e Tecnologia em Eletrônica OrgânicaWe report the results of an investigation into the contribution that trapping in interface states makes to the photovoltaic effect observed in organic phototransistors. To isolate this effect from other processes that occur in the transistor structure when under illumination, we focus attention on the photo-response of metal-insulator-semiconductor (MIS) capacitors - the core structure of transistors. The capacitors comprised poly(3-hexylthiophene), (P3HT), as the active semiconductor in combination with one of three insulators, namely, poly(amide-imide), (PAI), SU-8 photoresist and polysilsesquioxane (PSQ). Following initial characterization in the dark, the capacitor response was measured both during and after irradiation with light in the wavelength range 400–700 nm. Three different approaches were employed to study the photo-response, each providing a different insight into the processes occurring. Capacitance-voltage sweeps before, during and after illumination provided direct evidence supporting the view that the photovoltaic effect occurred as a result of electron trapping in interface states of density up to ∼2 × 1012 cm−2 in the P3HT/PAI combination but lower for SU-8 and PSQ. The dynamic photo-response, in which device capacitance was held constant by changing the applied bias, showed a fast component related to optically induced photoconduction in the semiconductor and a slower component reflecting the dynamics of interface electron trapping. Finally, photo-induced capacitance changes occurring with constant applied voltage were used to demonstrate a simple 3 × 3 imaging array.School of Electronic Engineering Bangor University, Dean StreetBrazilian Nanotechnology National Laboratory (LNNano) Brazilian Centre of Research in Energy and Materials (CNPEM)Department of Physics São Paulo State University (UNESP), PO Box 266Institute of Physics of São Carlos University of São Paulo (USP), PO Box 369Catarinense Federal Institute of Education Science and Technology, PO Box 21Department of Physics São Paulo State University (UNESP), PO Box 26

A Combination Of The -α3.7 And -medii Alleles Causing Hemoglobin H Disease In A Brazilian Patient

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)39180832014/00984-3, FAPESP, Fundação de Amparo à Pesquisa do Estado de São PauloFundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Effect of raw sugar cane bagasse on performance and ingestive behavior of beef cattle

Avaliou-se o efeito da utilização do bagaço de cana-de-açúcar in natura (BIN), obtido por dois métodos de extração do açúcar, moagem convencional ou difusão, como fonte de fibra em dietas que continham bagaço tratado sob pressão e vapor (BTPV), como principal fonte de volumoso sobre o desempenho e o comportamento ingestivo de bovinos confinados. Para avaliação do desempenho, foram utilizados 84 machos não castrados das raças Nelore, Canchim e Holandesa, com média de peso inicial de 270kg, distribuídos em delineamento de blocos ao acaso. Para a avaliação do comportamento ingestivo, foram utilizados quatro garrotes da raça Nelore, em delineamento de quadrado latino 4 x 4. Os tratamentos consistiram na substituição do BTPV pelo BIN na matéria seca, constituindo as dietas experimentais: 5% BIN moagem convencional; 5% BIN difusão, 10% BIN difusão e 15% BIN difusão. O consumo de MS foi menor no tratamento com 15% de BIN obtido por difusão (BINdif), em relação ao teor de inclusão de 10%. Não houve diferença (P>0,05) entre os tratamentos para ganho diário de peso, conversão alimentar e peso vivo final entre os tratamentos. Os tempos despendidos com as atividades de ruminação (minutos/kg de MS) e mastigação (minutos/kg de MS ou de FDN) foram maiores (P<0,05) no tratamento com 15% de BINdif na dieta. O BINdif pode ser utilizado como fonte de fibra íntegra em até 15% da MS da dieta sem prejudicar o desempenho dos animais.This study was conducted to evaluate effects of replacing steam pressure treated sugar cane bagasse by two types of raw sugar cane bagasse extracted through grinding or diffusion, on performance and ingestive behavior of beef cattle. Eighty four young bulls (Nelore, Canchim and Holstein) with 270kg of body weight at the beginning of the experiment were used in a randomized block design. Ingestive behavior was evaluated using four Nelore young bulls in a 4 x 4 Latin square design. Treatments were the direct substitution of steam pressure treated sugarcane bagasse by raw bagasse (RB), corresponding to the experimental treatments: 5% RB from grinding; 5% RB from diffusion; 10% RB from diffusion and 15% RB from diffusion. Dry matter intake was lower in treatment with 15% of bagasse obtained by diffusion (BINdif) in comparison to 10% BINdif. There were no differences (P>0.05) among treatments for average daily gain, feed conversion and final live weight. Ruminating time (minutes/kg of DM) and chewing time (minutes/kg of DM or NDF) was greater (P>0.05) when BINdif was added at 15% level to diets. BINdif can be added up to 15% of the dietary DM with no detrimental effect on beef cattle performance