Análise não-linear de pórticos planos de madeira com ligações semi-rígidas

Orientador : Nilson Tadeu MasciaTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Engenharia AgricolaDoutorad

REPRESENTAÇÕES DE SUPERVISÃO NA PERSPECTIVA DOS ENFERMEIROS COORDENADORES DE UM HOSPITAL DE ENSINO

Objetivo: compreender a percepção dos Coordenadores de Áreas Assistenciais de Enfermagem sobre a supervisão de enfermagem realizada pelos enfermeiros assistenciais no contexto hospitalar. Método: estudo de abordagem qualitativa, fundamentado na Teoria das Representações Sociais. Foram entrevistados 16 coordenadores de enfermagem de um hospital de ensino. Os dados foram analisados pelo método Conteúdo Qualitativo-Temático. Emergiram três categorias empíricas: Supervisão de Enfermagem: Ferramenta Gerencial que Qualifica o Cuidado, Imbricamento entre Administrar e Cuidar e Supervisionar: Reflexo do Processo Formativo e Contexto Institucional. Resultados: a significação dada pelo grupo social dos coordenadores sobre a supervisão de enfermagem praticada revela uma prática gerencial de controle e pouco educativa, porém com impacto positivo para a qualidade assistencial. Conclusão: a percepção dos Coordenadores de Áreas Assistenciais de Enfermagem sobre a supervisão de enfermagem revelou deficiências na implementação atribuídas às lacunas da formação, às demandas excessivas no trabalho e à falta de capacitação em relação à prática da supervisão.Descritores: Enfermagem. Teoria das Representações Sociais. Supervisão de Enfermagem

Trajetórias da Educomunicação nas Políticas Públicas e a Formação de seus Profissionais

Esta obra é composta com os trabalhos apresentados no primeiro subtema, TRAJETÓRIA – Educação para a Comunicação como Política pública, nas perspectivas da Educomunicação e da Mídia-Educação, do II Congresso Internacional de Comunicação e Educação. Os artigos pretendem propiciar trocas de informações e produzir reflexões com os leitores sobre os caminhos percorridos, e ainda a percorrer, tendo como meta a expansão e a legitimação das práticas educomunicativas e/ou mídia-educativas como política pública para o atendimento à formação de crianças, adolescentes, jovens e adultos, no Brasil e no mundo

Photography-based taxonomy is inadequate, unnecessary, and potentially harmful for biological sciences

The question whether taxonomic descriptions naming new animal species without type specimen(s) deposited in collections should be accepted for publication by scientific journals and allowed by the Code has already been discussed in Zootaxa (Dubois & Nemésio 2007; Donegan 2008, 2009; Nemésio 2009a–b; Dubois 2009; Gentile & Snell 2009; Minelli 2009; Cianferoni & Bartolozzi 2016; Amorim et al. 2016). This question was again raised in a letter supported by 35 signatories published in the journal Nature (Pape et al. 2016) on 15 September 2016. On 25 September 2016, the following rebuttal (strictly limited to 300 words as per the editorial rules of Nature) was submitted to Nature, which on 18 October 2016 refused to publish it. As we think this problem is a very important one for zoological taxonomy, this text is published here exactly as submitted to Nature, followed by the list of the 493 taxonomists and collection-based researchers who signed it in the short time span from 20 September to 6 October 2016

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure &lt;= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

Vigas de madeira de seção composta com alma em chapa de compensado

Orientador: Nilson Tadeu MasciaDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Engenharia CivilResumo: A vantagem estrutural das vigas de madeira com alma em chapa de compensado advem da sua elevada rigidez e resistência, ao mesmo tempo em que são leves e de fácil execução. São compostas de mesas de madeira maciça e de almas de chapa de compensado, unidas através de pregos para formar seções / ou caixão de alta eficiência. As mesas, distanciadas entre si, têm como função transmitir a maior parte das tensões normais, e as almas, as tensões tangenciais. A principal aplicação dessas vigas é na construção de coberturas. Neste trabalho, no estudo teórico, foi investigado o comportamento da viga composta, tendo sido incluídos os efeitos que influenciam em sua rigidez, particularmente, a deformação da ligação. Uma abordagem segundo equações de equilíbrio foi feita, e foram desenvolvidas expressões para o cálculo dos deslocamentos e das tensões. Um estudo da influência da deformação tangencial foi incluído. Dentro do estudo experimental, foram realizados ensaios de flexão de modelos reduzidos, com o objetivo da determinação da rigidez da viga composta, deformações e deslocamentos para a comparação com a teoria. Nesse contexto, o comportamento da viga foi descrito, tendo sido avaliada a relevância dos efeitos considerados, o que permitiu trazer uma contribuição para um maior conhecimento desse elemento estrutural altamente racionalizadoAbstract: The structural advantage of plywood-webbed timber composite beams derives from their high stiffness and strength, and at the same time, their lightness and easy fabrication. They are composed of timber flanges and plywood webs, nailed to the flanges in order to form an efficient box or I-section. The timber flanges, spaced apart from each other, carry most of the bending stresses, and the plywood webs transmit the shear stresses. Their commonest application is in roof construction. In this work, in a theoretical study, the behavior of the beam was investigated, including the effect of deformation of the joint. An approach based on equilibrium equations was made, and the expressions for computing displacements and stresses were developed. An investigation of the effect of shear deformation was also included. In an experimental study, bending tests on reduced models were carried out, with the aim of determining the beam stiffness, strains and displacements for comparison with theory. In this context, the performance of the beam was described, and the relevance of included effects was evaluated, contributing to a further knowledge of this highly efficient structural elementMestradoEstruturasMestre em Engenharia Civi

Evaluation of the equivalent slip modulus of nailed connections for application in linear analysis of plywood timber beams

The study of the stiffness of laterally loaded semi-rigid connections in plywood-timber beams is justified by the influence that the deformation of the connection has on the overall displacements of the structure. Semi-rigid connections are characterized by the occurrence of a slip between the connected pieces. The characterization of a connection is usually based on an isolated single connector behavior, which is described by its load-slip relationship expressed by the slip modulus, and so it is extended to the group of connectors. Although the method of analysis is well established, the concept of equivalent slip modulus, defined as the slip modulus per unit length of a connection, has not been totally explored. In this study, we focus on the experimental determination of the equivalent slip modulus for mechanically analyzing plywood-timber beams with continuous connections. The results demonstrated that the test is suitable for obtaining experimental values of the equivalent slip modulus