Instrumentos de avaliação do aleitamento materno e seu uso na prática clínica

RESUMO Objetivos Identificar instrumentos de avaliação da amamentação e sua aplicação na prática clínica, validação e adaptação transcultural. Método Revisão integrativa, realizada em seis bases de dados e em uma biblioteca eletrônica, entre agosto/2014-dezembro/2015, sem limitação temporal. Resultados Foram identificados 19 instrumentos de avaliação do AM. Destes, 12 foram validados e cinco foram adaptados transculturalmente. Quanto à aplicação, destacam-se seu uso para a avaliação do risco de desmame (BAPT) e a percepção/comportamento da mulher em amamentar (BSES-SF e IIFAS). Conclusão A identificação dos instrumentos disponíveis e de suas indicações para a avaliação do AM pode auxiliar profissionais na escolha pelo instrumento a ser utilizado, qualificando a assistência materno-infantil

Temperature alters dicyandiamide (DCD) efficacy for multiple reactive nitrogen species in urea-amended soils: Experiments and modeling

Dicyandiamide (DCD) is a nitrification inhibitor (NI) used to reduce reactive nitrogen (N) losses from soils. While commonly used, its effectiveness varies widely. Few studies have measured DCD and temperature effects on a complete set of soil N variables, including nitrite (NO₂¯) measured separately from nitrate (NO₃‾). Here the DCD reduction efficiencies (RE) for nine N availability metrics were quantified in two soils (a loam and silt loam) using aerobic laboratory microcosms at 5–30 °C. Both regression analysis and process modeling were used to characterize the responses. Four metrics accounted for NO₃‾ production and included total mobilized N, net nitrification, maximum nitrification rate, and cumulative NO₃‾ (cNO₃‾). The REs for these NO₃‾ -associated production variables decreased linearly with temperature, and in all cases were below 60% at temperatures ≥22 °C, except for cNO₃‾ in one soil. In contrast, REs for NO₂‾ and nitric oxide (NO) gas production were less sensitive to temperature, ranging from 80 to 99% at 22 °C and 50–95% at 30 °C. Addition of DCD suppressed nitrous oxide (N₂O) production in both soils by 20–80%, but increased ammonia volatilization by 36–210%. The time at which the maximum reduction efficiency occurred decreased exponentially with increasing temperature for most variables. The two-step nitrification process model (2SN) was modified to include competitive inhibition coupled to first-order DCD decomposition. Model versus data comparisons suggested that DCD had indirect effects on NO₂‾ kinetics that contributed to the greater suppression of NO₂‾ and NO relative to NO₃‾. This study also points to the need for NIs that are more stable under increased temperature. The methods used here could help to assess the efficacy and temperature sensitivity of other NIs as well as new microbial inhibitors that may be develope

Estudo comparativo das indicações de cesariana entre um hospital público-universitário e um hospital privado Comparative study of cesarean section indications between a public university hospital and a private hospital

OBJETIVOS: analisar a incidência e as indicações de cesariana realizadas no Hospital Escola da Falculdade de Medicina do Triângulo Mineiro e um hospital privado, ambos localizados em Uberaba, Minas Gerais, Brasil. MÉTODOS: trata-se de estudo transversal desenvolvido a partir da coleta nos prontuários dos hospitais, consistindo da idade, procedência, situação conjugal, escolaridade, paridade e indicações de cesariana. RESULTADOS: a incidência de cesariana foi de 24,3% no Hospital Escola contra 89,2% no hospital privado. As indicações mais freqüentes de cesariana no Hospital Escola foram a cesárea iterativa (26,7%), distócia (22,4%) e o sofrimento fetal agudo (18,2%), e no hospital privado foram cesárea iterativa (36%) e distócia (36%). As pacientes do hospital privado tinham maior escolaridade. CONCLUSÕES: os dados sugerem que o aumento de cesarianas no hospital privado foi decorrente de iteratividade, distócia e a escolaridade mais elevada das pacientes.<br>OBJECTIVES: to analyse the incidence and the indications of cesarean section performed in the University Hospital of the "Triângulo Mineiro Faculty of Medicine " and a private hospital in Uberaba, Minas Gerais, Brazil. METHODS: a cross sectional study was carried out by using the data source of the medical files from both hospitals consisting of patient age, place of origin, marital status, education level, parity and cesarean sections indications. RESULTS: the cesarean sections rate was 24,3 % (325 of 1.441 births) at the university hospital against 89,2% (100 of 112 births) of the private hospital. The most frequent indications in the University Hospital were previous cesarean sections (26,7%), dystocia (22,4%) and acute fetal distress (18,2%). In the private hospital, indications were previous cesarean section (36%) and dystocia (36%). The private hospital's patients had higher education levels. CONCLUSIONS: the higher rate of cesarean sections observed in the private hospital resulted from previous cesarean section, dystocia and higher education levels