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

Main technical differences in the processing of broilers: a comparison between slaughterhouses in Brazil and UK

Rapid technological advances in chicken processing in plants around the world have meant that different techniques are being employed regarding the slaughter’s flow process. This paper aimed to compare and contrast systems and practices in two large slaughterhouses—one in UK and the other in Brazil. Annotated observations were made during inspection visits to chicken slaughterhouses in the two countries between 2014 and 2016. Whilst there were similarities in the two systems, there are also clear differences. The Brazilian case is evidently adapted for a more tropical condition, rather than the temperate one in UK. The handling practices of birds used during transportation, waiting, stunning as well as pre-cooling differ in techniques employed and consequently likely their efficiencies. In UK, the practices are more geared towards water and energy saving. The difference in market conditions and the length of the respective supply chains also determine the type of primary packaging used in final products. Both countries adhere to similar rulings applied to slaughterhouses. However, in the Brazilian case, it tended to comply with mainly external market demands. In conclusion, managers in the Brazilian poultry system could consider looking into adopting some of the practices used in UK, such as cage/crate dimension which reduce bird’s lesions and bruises; the use of stunning by modified atmosphere and pre-cooling for resource efficiency reasons and improvement in animal welfare. Finally, when distances between sites of production and consumption are great such as in Brazil, the use of modified atmosphere technology could be also further explored to ensure better quality of the final product

The VMC survey III : Mass-loss rates and luminosities of LMC AGB stars

Context. Asymptotic giant branch (AGB) stars are major contributors to both the chemical enrichment of the interstellar medium and the integrated light of galaxies. Despite its importance, the AGB is one of the least understood phases of stellar evolution. The main difficulties associated with detailed modelling of the AGB are related to the mass-loss process and the 3rd dredge-up efficiency Aims. We provide direct measures of mass-loss rates and luminosities for a complete sample of AGB stars in the Large Magellanic Cloud, disentangling the C- and O-rich stellar populations. Methods. Dust radiative transfer models are presented for all 374 AGB stars candidates in one of the fields observed by the new VISTA survey of the Magellanic Clouds (VMC). Mass-loss rates, luminosities and a classification of C-and O-rich stars are derived by fitting the models to the spectral energy distribution (SED) obtained by combining VMC data with existing optical, near-, and mid-infrared photometry. Results. The classification technique is reliable at a level of - at worst -75% and significantly better for the reddest dusty stars. We classified none of the stars with a relevant mass-loss rate as O-rich, and we can exclude the presence of more than one dusty O-rich star at a similar to 94% level. The bolometric luminosity function we obtained is fully consistent with most of the literature data on the LMC and with the prediction of theoretical models, with a peak of the C-star distribution at M-bol similar or equal to -4.8 mag and no stars brighter than the classical AGB tip, at M-bol = -7.1 mag. Conclusions. This exploratory study shows that our method provides reliable mass-loss rates, luminosities and chemical classifications for all AGB stars. These results offer already important constraints to AGB evolutionary models. Most of our conclusions, especially for the rarer dust-enshrouded extreme AGB stars, are however strongly limited by the relatively small area covered by our study. Forthcoming VMC observations will easily remove this limitation.Peer reviewe

Ictiofauna De Riachos Da Bacia Do Baixo Rio Iguaçu, Estado Do Paraná, Brasil

The drainages of the Iguaçu River basin, as well as the main channel of the river, have peculiar characteristics resulting from geomorphological processes in this area, including the formation of the Iguaçu River Falls. This slope in the lower portion of the basin is a biogeographical barrier to many organisms. In this study was inventoried the fish fauna of streams of the lower Iguaçu River basin, evaluating possible differences in the species composition upstream and downstream of this biogeographical barrier. Sampling were conducted between 2004 and 2013, in five streams, three upstream and two downstream of the Iguaçu River Falls, using electrofishing. The nMDS analysis was run to investigate possible groupings of similar fauna between the streams sampled. The scores of this test were tested as to the significance of groupings with the Hotelling T2 test. The indicator value method (IndVal) was used to detect the distribution of species among the groups of the streams upstream and downstream of the Iguaçu River Falls. We collected 18,908 individuals of six orders, 11 families, and 40 species. Siluriformes and Characiformes had the highest species richness; Cyprinodontiformes presented the highest abundance. Considering the species recorded, 21 are considered natives to the Iguaçu River basin, including 15 endemic, wich were found only in streams upstream of the falls. Additional 18 species were verified only in the streams downstream of such barrier. Four species were common to both stretches. The axis 1 of the nMDS separated two groups: streams upstream (S1, S2 and S3) and streams downstream of the Iguaçu River Falls (S4 and S5). The indicator species analysis also indicated a distinction between the groups of streams, that were significantly different (Hotelling’s T2 = 234.36, p < 0.0001). The number of endemic species in the streams upstream of the Falls (15 spp.) evidences a significant effect of isolation promoted by the Iguaçu River Falls, and confirms the role of this barrier in the vicariant processes and endemism typical of this basin. These results emphasize the importance of conserving these ecosystems, once the extinction of species in this region means the irreversible loss of them. © 2016, Universidade Estadual de Campinas UNICAMP. All rights reserved.16311

The evolutionary implications of hemipenial morphology of rattlesnake crotalus durissus terrificus (Laurent, 1768) (Serpentes: Viperidae: Crotalinae)

FAPESP - FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULOCNPQ – CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICOMost amniotes vertebrates have an intromittent organ to deliver semen. The reptile Sphenodon and most birds lost the ancestral penis and developed a cloaca-cloaca mating. Known as hemipenises, the copulatory organ of Squamata shows unique features between the amniotes intromittent organ. They are the only paired intromittent organs across amniotes and are fully inverted and encapsulated in the tail when not in use. The histology and ultrastructure of the hemipenes of Crotalus durissus rattlesnake is described as the evolutionary implications of the main features discussed. The organization of hemipenis of Crotalus durissus terrificus in two concentric corpora cavernosa is similar to other Squamata but differ markedly from the organization of the penis found in crocodilians, testudinata, birds and mammals. Based on the available data, the penis of the ancestral amniotes was made of connective tissue and the incorporation of smooth muscle in the framework of the sinusoids occurred independently in mammals and Crotalus durissus. The propulsor action of the muscle retractor penis basalis was confirmed and therefore the named should be changed to musculus hemipenis propulsor. The retractor penis magnus found in Squamata has no homology to the retractor penis of mammals, although both are responsible for the retraction of the copulatory organ86FAPESP - FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULOCNPQ – CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICOFAPESP - FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULOCNPQ – CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICOFAPESP [2011/11828-4]sem informaçãosem informaçã

Space-time inhomogeneity, anisotropy and gravitational collapse

We investigate the evolution of non-adiabatic collapse of a shear-free spherically symmetric stellar configuration with anisotropic stresses accompanied with radial heat flux. The collapse begins from a curvature singularity with infinite mass and size on an inhomogeneous space-time background. The collapse is found to proceed without formation of an even horizon to singularity when the collapsing configuration radiates all its mass energy. The impact of inhomogeneity on various parameters of the collapsing stellar configuration is examined in some specific space-time backgrounds.Comment: To appear in Gen. Relativ. Gra

Dilatonic current-carrying cosmic strings

We investigate the nature of ordinary cosmic vortices in some scalar-tensor extensions of gravity. We find solutions for which the dilaton field condenses inside the vortex core. These solutions can be interpreted as raising the degeneracy between the eigenvalues of the effective stress-energy tensor, namely the energy per unit length U and the tension T, by picking a privileged spacelike or timelike coordinate direction; in the latter case, a phase frequency threshold occurs that is similar to what is found in ordinary neutral current-carrying cosmic strings. We find that the dilaton contribution for the equation of state, once averaged along the string worldsheet, vanishes, leading to an effective Nambu-Goto behavior of such a string network in cosmology, i.e. on very large scales. It is found also that on small scales, the energy per unit length and tension depend on the string internal coordinates in such a way as to permit the existence of centrifugally supported equilibrium configuration, also known as vortons, whose stability, depending on the very short distance (unknown) physics, can lead to catastrophic consequences on the evolution of the Universe.Comment: 10 pages, ReVTeX, 2 figures, minor typos corrected. This version to appear in Phys. Rev.

Soil cover plants on water erosion control in the South of Minas Gerais

Water erosion is responsible for soil, water, carbon and nutrient losses, turning into the most important type of degradation of Brazilian soils. This study aimed to evaluate the influence of three cover plants under two tillage systems on water erosion control in an Argisol at south of Minas Gerais state, Brazil. The cover plants utilized in the study were pigeon pea, jack bean and millet, under contour seeding and downslope tillage. Experimental plots of 4 x 12 m, with 9% slope, under natural rainfall were used for the quantification of losses of soil, water, nutrients, and organic matter. One experimental plot was kept without plant cover (reference). Higher erosivity was observed in December and January, although a great quantity of erosive rainfall was detected during the whole raining period. Contour seeding provided a greater reduction of water erosion than downslope tillage, as expected. The jack bean under contour seeding revealed the lowest values of soil, water, nutrients and organic matter losses