Consensus must be found on intravenous fluid therapy management in trauma patients

Introduction: Trauma is an important cause of death among young people and 30-40% of this mortality rate is due to hypovolemic shock, intensified by trauma's lethal triad: Hypothermia, Acidosis, and Coagulopathy. Nurses are responsible for managing fluid therapy administration in trauma victims. The purpose of this study is to analyse the reasons why intravenous fluid therapy is recommended for trauma patients' hemodynamic stabilization. Methods: This narrative literature review included published and unpublished studies in English, Spanish or Portuguese between 1994 and January 2019. The search results were analyzed by two independent reviewers. Inclusion criteria encompasses quantitative studies involving trauma victims aged over 18 who underwent fluid therapy in a prehospital assessment context. Results&Discussion: 11 quantitative studies were included. 9 involved the use of fluid therapy for hypotension treatment and 2 of the studies analyzed involved the use of warmed fluid therapy for hypothermia treatment. The analysis performed reveals that the administration of aggressive fluid therapy seems to be responsible for the worsening of the lethal triad. In the presence of traumatic brain injury, permissive hypotension is not allowed due to the negative impact on cerebral perfusion pressure. Used as warming measure, warmed fluid therapy does not seem to have a significant impact on body temperature. Conclusions: There is no consensus regarding the administration of fluid therapy to trauma patients. This conclusion clearly supports the need to develop more randomized controlled trials in order to understand the effectiveness of such measure when it comes to control hypovolemia and hypothermia.info:eu-repo/semantics/publishedVersio

ANALYSIS OF THE HANDS SUPPORT IN EXTRA-PLUMMET CLIMBING SKILL

INTRODUCTION-The purpose of this study is to compare the hands support behaviour in two different extra-plummet climbing skills (as performed in climbing walls with angles between horizontal below 90°). These two extra-plummet climbing skills can be distinguished by basic body positions. Taking the pressure centre of hands support as reference the body balance is considered a stable balance because the hands have a higher positions than the feet. (Jodar, 1993). Therefore the level of body stability in these two skills, depends, basically, on the performers capacity of maintaining body contact with the wall by means of the hand grip. (Vert>ier, 1991). The capacity to maintain the hand's grip is the result of the relationship between friction force and the tangential forces applied by the c1imber on contact surface. The two studied skills have different basic body positions: in skill A tha basic body position is "body are" and in skill B the basic body position is "body suspense”. Taking the mathematical expression of friction force into account, the access to the behaviour of the friction force can be achieved through normal force (Hammil & Knutzen, 1995). Thus, the hand's support stability is accomplished by the quotient of each tangential and normal force appfied by the climber on contact with the surface. The registration of force values (Fx is the force acting in parallel direction to the sagittal plan, Fy is the force acting in parallel direction to the frontal plan and Fz is the normal force) in both skills and was achieved through the Kistler platform, model 9281 Sand appropriate software, fixed horizontally on an artificial climbing wall. RESULTS-The sample was composed of eight experimented c1imbers whose ages ranged from twenty-two to forty years old. Every subject performed five valid executions in both skills. In skill A, the arithmetical mean of Fx/Fz was 0,372, CV=0,352, and the arithmetical mean of Fy/Fz was 0,009, CV=6,83. In skili S, the arithmetical mean of Fx/Fz was 0,25, CV=0,311, and the arithmetical mean of Fy/Fz was 0,017, CV=1,089. The statistical method T of Pairs was applied to evaluate the differences between Fx/Fz data in both skills and also to evaluate the differences between Fy/Fz data in the same skills. CONCLUSIONS-The results give evidence that the values of Fy/Fz do not differ between the studied skills, but the value of Fx/Fz in skill S was significantly different from skill A. Therefore skill B has a greater potential to be used in further climbing skills, because it uses a smaller percentage (~25%) of normal force than skill A (~37,2%). REFERENCES• Hamill, Joseph; Knutzen, Kathleen M. (1995). Biomechanical Basis of Human Mouvement. Williams & Wilkins. Philadelphia. USA. 403-405. J6dar, Xavier Aguado (1993) Eficacia Y Teeniea Deportiva. INDE. Barcelona. Epana. 178-186. Verdier, Jean-Pierre (1991). Initiation et Perfectionement ä Esca/ade. Amphora. Paris. Franee. 29-36

KINEMATICAL AND DYNAMICAL ANALYSIS OF LONG JUMP TAKE-OFF: A FOUR CASES STUDY

INTRODUCTION-The take-off is one of. the most important phases of the long jump. Once there is no available knowledge on kinematic vs. dynamic relationships on the take-of, the purposes of this study were: (i) to analyse the biomechanical variations that occur at take-off; (ii) to establish relationships between kinematic and dynamic variables; (iii) to verify which of the moments of the take-off is more important to the production of the vertical velocity as well as the best result. METHODS~ Subjects for this 4-casesstudy research were well trained jumpers. Each athlete performed 6 trials, all videotaped (JVC-SVHS) in the sagitai plane for kinematical analysis (50 Hz). Simultaneously, dynamic analysis was performed through a Kistler 9218 B force plate (250 Hz). The kinematic parameters studied were: (i) resulting velocity of the center mass (VCM); (ii) horizontal velocity of the center mass (Vx); (iii) vertical velocity of the center mass (Vy); (iv) horizontal velocity of the lead leg knee (VeIK); (v) horizontal velocity of the touchdown foot (VeITd); (vi) loss of horizontal velocity (LVx); (vii) gain of vertical velocity (GVy); (viii) center mass / heel angle in the instants of touchdown and take-off (AngCM-he); (ix) knee angle (AngK); (x) support time (ST); (xi) touchdown distance (TdD); (xii) take-off angle (AngT). The described velocities and angles were determined in the following instants: (i) touchdown; (ii) maximum knee flexion and (iii) take off. The dynamical parameters studied were: fi) vertical impulse (Iz): (ii) maximum vertical force (Fzmax): (iii) time course to achieve maximum vertical force (lH/Fz max); (iv) passive impulse (lzPass}: (v) time course of the passive impulse (lHPass); (vi) active impulse (lzAct); (vii) time course of the active impulse (ßTAct); (viii) horizontal anterior posterior impulse (Iy); (ix) horizontal lateral impulse (Ix) RESULTS-The main results of this study showed that, in all cases, the major loss of the Vx and the major gain of the Vy were observed between the touchdown and the maximum knee flexion We also noticed that the knee of the lead leg has its maximum velocity at the moment of the maximum knee flexion for all subjects. This variables contribute significantly, in all cases, to the increase of the AngK in the take-off instant (psO.05), which is theoretically advantageous to the performance. One other finding was that when the values for AngCM-he in the touchdown and take-off instants were out of the theoretical limits defined by Fischer (1975), a reduced performance was observed. The observation of results also showed: (i) a increased Fzmax was always related with a higher jump length, with a higher % IZPass / IzAct, with a reduction both on ßTAct and ST, despite the correlation analysis did not always provide significant r values. CONCLUSIONS-Long jumpers should pay a special attention to the phase between the touchdown and the maximum knee flexion, where the main production of Vy occurs. There, a reduclion on ST during the take-off should be searched. Attention should also be paid to the values of the AngCM-he during the touchdown. REFERENCES Fischer, R. (1975). Weitsprung. Biomechanische untersuchungen am schweizerischen weitsprungkader mittels filmanalyse und messugen mir der mehrkomponenrenmessplattform. Diplamarbeil in biomechanik, ETH, Zurich

Improving patient health literacy in imaging departments

Health Literacy is a key issue in the healthcare and its operational definition developed for the National Library of Medicine mention that is the “the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions” 1. Health literacy skills are needed for dialogue and discussion, reading health information, making decisions about participating in research activities, using medical tools for personal or familial health care, and even for voting on health or environmental...info:eu-repo/semantics/publishedVersio

Biodistribuição do 18FDG em ratos nude balb-c nu/nu normaiS

Resumo do poster apresentado ao XII Congresso Nacional de Medicina Nuclear, 12-14 Novembro 2009, Mealhad

Socio-educative intervention in marginalized territories: agents of local development or keepers of the school order?

O artigo discute as representações e práticas geradas pelo Programa Territórios Educativas de Intervenção Prioritária (TEIP), no âmbito da relação entre escola e comunidade, centrando-se na ação dos técnicos contratados para gabinetes de cariz socioeducativo. Com base nos resultados de um projeto de investigação em sete territórios e de uma tese de mestrado em quatro deles, utilizando a metodologia do estudo de caso (incluindo análise documental, questionários, entrevistas, focus groups e observação direta), observa-se como os projetos TEIP – e, em particular, os técnicos contratados – foram mobilizados, sobretudo, para atividades de acompanhamento dos alunos e de enriquecimento curricu- lar, com impacto na pacificação do ambiente escolar. Sendo um conceito legi- timador da intervenção, o desenvolvimento local raramente se consubstancia em ações concretas e consistentes. A partir de uma abordagem crítica, o artigo estrutura-se em quatro secções: (1) discussão teórica, (2) apresentação da me- todologia, (3) a intervenção socioeducativa nos projetos TEIP, (4) os perfis pro- fissionais e modalidades de ação que têm caracterizado os técnicos contrata- dos. No final, advoga-se que, para romper os círculos de privação e reprodução que marcam as experiências educativas nestes territórios, é necessária uma política não apenas “compensatória” ou “reparatória”, mas transformadora das estruturas escolares e comunitárias

Factors Affecting the Body Mass Index in Adolescents in Portuguese Schools

The prevalence of overweight and obesity among children is increasing; hence, it was aimed to assess the Body Mass Index (BMI) in school children aged from 10 to 18 years for girls and to 17 for boys, as well as to identify the factors influencing BMI. This study included 742 students who answered a questionnaire previously approved for application in schools. The results showed some sociodemographic factors associated with BMI classes: age, school year, practicing high competition sport, being federate in a sport or having a vegetarian diet. The educational factors associated with BMI classes included only seminars given at school by a nutritionist. Behavioural factors significantly associated with BMI included: learning in classes, playing in the open air, reading books or use of internet. As conclusion, the results demonstrated that several factors affect BMI, and hence some actions could be taken in order to change them so as to reduce the prevalence of overweight, namely reinforcing the role of school and a more active participation of nutritionists in the education of the adolescents