Sigurnost rada u anatomskom laboratoriju s formalinom i inovativno praćenje procjene profesionalne izloženosti formaldehidu

This review is directed at preventive health professionals, anatomic pathologists and technicians to focus their attention on the rapidly growing field of safe formalin practices. An updated overview of the most recent improvements in preventive measures versus formaldehyde (FA) in the anatomic pathology laboratories (APL) is provided. The occupational hygienist role and the required knowledge for a modern and clear occupational exposure assessment are described. Real-time, in-continuous, commercial analyzers for repeated FA exposure assessment are considered to evaluate technical changes in air monitoring programs, introduced to mitigate FA emissions, in compliance with the adopted limit values. To better choose the adequate instrumentation, the main features of each FA monitoring instrument recently introduced on the market are listed. Moreover, the main features of the modern workflow setting in APL are summarized. A computer-based scientific and non-scientific reports search by key-words was performed on PubMed, Web of Science, Google Scholar and Google Patents databases, querying the following topics: i) grossing workstation for ergonomic layout, ii) commercially available direct reading tools to measure formalin, iii) real-time, in-continuous FA monitoring instruments for sale. This review represents a useful tool to summarize the technical requirements and expert know-how necessary to minimize FA emissions and produce an exhaustive FA assessment in the APL.Ovaj pregled usmjeren je na preventivne zdravstvene radnike, anatomske patologe i tehničare kako bi svoju pozornost usredotočili na brzo rastuće područje sigurnih formalinskih praksi. Ažurirani pregled nudi najnovija poboljšanja preventivnih mjera u odnosu na formaldehid (FA) u laboratorijima za anatomsku patologiju (APL). Opisana je uloga higijeničara na radu i potrebna znanja za modernu i jasnu procjenu izloženosti na radu. Komercijalni analizatori u stvarnom vremenu za kontinuiranu procjenu izloženosti FA razmatraju se za procjenu tehničkih promjena u programima praćenja zraka, uvedenim radi ublažavanja emisija FA, u skladu s prihvaćenim graničnim vrijednostima. Kako bi se bolje odabrala odgovarajuća instrumentacija, navedene su glavne značajke svakog instrumenta za praćenje FA koji je nedavno predstavljen na tržištu. Štoviše, sažete su glavne značajke suvremenih postavki tijeka rada u APL-u. Računalno zasnovano pretraživanje znanstvenih i neznanstvenih izvješća po ključnim riječima provedeno je u bazama podataka PubMed, Web of Science, Google Scholar i Google Patents, s težištem na sljedeće teme: i) prikupljanje radnih stanica za ergonomski raspored, ii) komercijalno dostupni alati za izravno očitanje mjerenja formalina, iii) instrumenti za kontinuirano praćenje FA u stvarnom vremenu u prodaji. Ovaj pregled predstavlja koristan alat za sažimanje tehničkih zahtjeva i stručnog znanja potrebnog za minimiziranje emisija FA i izradu iscrpne procjene FA u APL-u

La utillzación de la computadora como herramienta para la implementación del proceso de enfermería: la experiencia del Hospital São Paulo/UNIFESP

This article reports the pathway used to build a prototype of a computer nurse's clinical decision making support system, using NANDA, NIC and NOC classifications, as an auxiliary tool in the insertion of nursing data in the computerized patient record of Hospital São Paulo/UNIFESP.Se relata en este artigo el camino utilizado para la construcción de un prototipo de sistema de apoyo a la decisión computadorizado, utilizando las clasificaciones de enfermería NANDA, NIC Y NOC, para auxiliar en la inserción de los datos de la sistematización de la asistencia de enfermería en el prontuario electrónico de los pacientes dei Hospital São Paulo, de UNIFESP.O artigo relata o caminho utilizado para elaboração de protótipo de um sistema informatizado de apoio à decisão informatizado, utilizando as classificações de diagnósticos, intervenções e resultados de enfermagem (NANDA-NIC-NOC) para auxiliar a inserção dos dados da sistematização da assistência de enfermagem no prontuário eletrônico dos pacientes do Hospital São Paulo da UNIFESP.UNIFESP Departamento de Enfermagem Diretora de Enfermagem do Hospital São Paulo da UNIFESPUNIFESP Hospital São PauloUSP EERP Programa do Pós-GraduaçãoUNIFESP Programa de Pós-graduaçãoUNIFESP Departamento de EnfermagemHospital São Paulo Diretoria de EnfermagemUNIFESP, Depto. de Enfermagem Diretora de Enfermagem do Hospital São Paulo da UNIFESP, Hospital São PauloUNIFESP, Programa de Pós-graduaçãoUNIFESP, Depto. de EnfermagemHospital São Paulo Diretoria de EnfermagemSciEL

The Kids Are Alright (?). Infants’ Development and COVID-19 Pandemic: A Cross-Sectional Study

Objectives: The study aimed to assess and compare the global development in six-month-old infants before and during the pandemic restrictive social distancing measures. Methods: This cross-sectional nested study involved infants assessed through the Griffiths Scales of Child Development (GSCD) between September 2019 and April 2021. Infants were classified in a pre-COVID or a COVID group, considering the evaluation date and the restrictive measures in place. GSCD subscales and General Development Scores (GDS) were calculated and compared. Results: One hundred and four healthy term-born infants were evaluated. GDS in the COVID group (n:70; median: 94; IQR: 90–100) appeared significantly lower than in the pre-COVID group (n:34; median: 98; IQR: 97–103; p < 0.001). Language and personal-social-emotional subareas scores appeared the most affected. A decreasing trend of GDS along with the severity of restriction was observed. Conclusion: A reduction in infant development scores was observed during pandemic social distancing. Further studies are needed to systematize these findings and to address effective public health policies for infants and families during long-term forced isolation periods

Predominance of CTX-M–type extended-spectrum β-lactamase genes among enterobacterial isolates from outpatients in Brazil

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Ažuriranje podataka o prožimanju zaštitnih medicinskih rukavica antineoplastičnim lijekovima

Occupational exposure to antineoplastic drugs (ADs) handling and administration is one of the main risks in the healthcare sector. Dermal absorption represents the primary route of exposure to ADs. Personal preventive equipment, especially medical gloves, is crucial to safeguard the workers health in ADs handling; thus, chemicals permeating through protective materials is an essential aspect to estimate and consider. Several studies on permeation through medical gloves reported that breakthrough time and permeation rate are the values that must be studied, observing that physical-chemical properties of drugs, PPE materials and thickness, and temperature are crucial features to estimate them. In the European Union, standardized permeation testing is not mandatory for gloves used in ADs manipulation, in contrast with the United States, that proposed stringent requirements in the American Society of Testing and Materials International standard D6978-05. This review would help identify the main characteristics of the best protective glove used by employees frequently exposed to ADs: the major aspects implicated in permeation, reported in the literature, are listed and discussed.Radna izloženost rukovanju i primjeni antineoplastičnih lijekova (AD) jedan je od glavnih rizika u zdravstvenom sektoru. Kožna apsorpcija predstavlja primarni put izlaganju AD-ima. Osobna preventivna oprema, posebno medicinske rukavice, presudna je za zaštitu zdravlja radnika u radu s AD-ima; prema tome, kemikalije koje prodiru kroz zaštitne materijale bitan su aspekt za procjenu i razmatranje. Nekoliko studija o prožimanju kroz medicinske rukavice izvijestilo je da su vrijeme proboja i brzina prodiranja vrijednosti koje se moraju proučavati, primjećujući da su fizičko-kemijska svojstva lijekova, OZO materijali i debljina i temperatura ključne značajke za njihovu procjenu. U Europskoj uniji, standardizirano ispitivanje prožimanja nije obvezno za rukavice koje se koriste u manipulaciji ADs, za razliku od Sjedinjenih Država koje su predložile stroge zahtjeve u međunarodnom standardu D6978-05 Američkog društva za ispitivanje i materijale. Ovaj pregled pomogao bi identificirati glavne karakteristike najbolje zaštitne rukavice koju koriste zaposlenici često izloženi AD-ima: glavni aspekti uključeni u prožimanje, priopćeni u literaturi, navedeni su i raspravljeni

Situaciones causantes de ansiedad y estrategias para su control entre enfermeras: estudio preliminar

The purposes of this study were: to identify situations that are considered sources of anxiety in nurse's daily activities and to identify the conscious strategies these nurses use in order to lower the level of anxiety. The sample was composed of 54 nurses from a larger general teaching hospital that answered a questionnaire with open and closed questions. The answers pointed situations, both quotidian and unsuspected, that generate anxiety in the following areas: direct care, management and teaching. Nurses also pointed the activities they usually do in order to cope with stress, during the crisis or in their quotidian life. Findings demonstrate that even though the nurses are exposed to stressing situations that generate anxiety, they also use adequate coping strategies. We observe that more studies are needed, in order to propose new alternatives to improve nurses' quality of life.Los objetivos de este estudio fueron: identificar las situaciones consideradas fuentes de ansiedad en las actividades diarias de las enfermeras e identificar las estrategias conscientes que estas enfermeras utilizan para disminuir los niveles de ansiedad. La muestra estuvo constituida por 54 enfermeras de un hospital universitario de gran porte, que respondieron a un cuestionario de preguntas abiertas y cerradas. Las respuestas mostraron situaciones generadoras de ansiedad, inesperadas o cotidianas, en las áreas de: atención directa, administración y enseñanza. También se determinaron los mecanismos utilizados por las enfermeras para enfrentar la ansiedad, tanto en los momentos de crisis como en su cotidiano. Los resultados demostraron que a pesar de encontrarse estas profesionales realmente sujetas a situaciones generadoras de ansiedad, ellas también utilizan estrategias de enfrentamiento adecuadas. Se evidencia la necesidad de realización de otros estudios sobre este tema, buscando la propuesta de nuevas alternativas para mejorar la calidad de vida de las enfermeras.Este estudo teve como objetivos: identificar situações que são consideradas fontes geradoras de ansiedade, na atuação cotidiana das enfermeiras, e identificar estratégias conscientes utilizadas pelas mesmas para diminuir os níveis de ansiedade. A amostra foi constituída de 54 enfermeiras de um hospital geral de ensino, de grande porte, que responderam a um questionário contendo perguntas abertas e fechadas. As respostas apontaram situações geradoras de ansiedade, inesperadas ou cotidianas, nas áreas: assistencial, de gerenciamento e de ensino. Foram também apontados os mecanismos utilizados pelas enfermeiras para enfrentar a ansiedade, tanto nos momentos de crise como no seu cotidiano. Os resultados demonstram que, embora as profissionais estejam realmente sujeitas a situações ansiogênicas, elas também se utilizam de estratégias de enfrentamento adequadas.Verifica-se a necessidade de realização de outros estudos sobre o assunto, a fim de se proporem novas alternativas que possam melhorar a qualidade de vida das enfermeiras

HORTA, JARDINAGEM E ARTESANATO COMO TERAPIA OCUPACIONAL NO CENTRO DE ATENÇÃO PSICOSSOCIAL (CAPS) DE VIDEIR

O projeto horta terapêutica vem sendo desenvolvido no Centro de Atenção Psicossocialde Videira-SC (CAPS) desde 2017, com ótimos resultados na terapia de pacientes.Objetiva o manejo de hortaliças, atividades de jardinagem e artesanato como recursoterapêutico para os pacientes inseridos no grupo de Terapia Ocupacional. Tambémobjetiva incentivar o trabalho social dos alunos do curso Técnico em Agropecuária doInstituto Federal Catarinense campus Videira, que juntamente com os docentes orientamos pacientes sobre as técnicas de plantio e cuidados com as hortaliças e flores. Esteprojeto tem proporcionado resultados significativos como terapia dos pacientes

Perinatal and postnatal exposure to phthalates and early neurodevelopment at 6 months in healthy infants born at term

BackgroundPhthalates are non-persistent chemicals largely used as plasticizers and considered ubiquitous pollutants with endocrine disrupting activity. The exposure during sensible temporal windows as pregnancy and early childhood, may influence physiological neurodevelopment.Aims and ScopeThe aim of this study is to analyze the relationship between the urinary levels of phthalate metabolites in newborn and infants and the global development measured by the Griffiths Scales of Children Development (GSCD) at six months.MethodsLongitudinal cohort study in healthy Italian term newborn and their mothers from birth to the first 6 months of life. Urine samples were collected at respectively 0 (T0), 3 (T3), 6 (T6) months, and around the delivery for mothers. Urine samples were analyzed for a total of 7 major phthalate metabolites of 5 of the most commonly used phthalates. At six months of age a global child development assessment using the third edition of the Griffith Scales of Child Development (GSCD III) was performed in 104 participants.ResultsIn a total of 387 urine samples, the seven metabolites analyzed appeared widespread and were detected in most of the urine samples collected at any time of sampling (66-100%). At six months most of the Developmental Quotients (DQs) falls in average range, except for the subscale B, which presents a DQ median score of 87 (85-95). Adjusted linear regressions between DQs and urinary phthalate metabolite concentrations in mothers at T0 and in infants at T0, T3 and T6 identified several negative associations both for infants’ and mothers especially for DEHP and MBzP. Moreover, once stratified by children’s sex, negative associations were found in boys while positive in girls.ConclusionsPhthalates exposure is widespread, especially for not regulated compounds. Urinary phthalate metabolites were found to be associated to GSCD III scores, showing inverse association with higher phthalate levels related to lower development scores. Our data suggested differences related to the child’s sex

Optimasi Portofolio Resiko Menggunakan Model Markowitz MVO Dikaitkan dengan Keterbatasan Manusia dalam Memprediksi Masa Depan dalam Perspektif Al-Qur`an

Risk portfolio on modern finance has become increasingly technical, requiring the use of sophisticated mathematical tools in both research and practice. Since companies cannot insure themselves completely against risk, as human incompetence in predicting the future precisely that written in Al-Quran surah Luqman verse 34, they have to manage it to yield an optimal portfolio. The objective here is to minimize the variance among all portfolios, or alternatively, to maximize expected return among all portfolios that has at least a certain expected return. Furthermore, this study focuses on optimizing risk portfolio so called Markowitz MVO (Mean-Variance Optimization). Some theoretical frameworks for analysis are arithmetic mean, geometric mean, variance, covariance, linear programming, and quadratic programming. Moreover, finding a minimum variance portfolio produces a convex quadratic programming, that is minimizing the objective function ðð¥with constraintsð ð 𥠥 ðandð´ð¥ = ð. The outcome of this research is the solution of optimal risk portofolio in some investments that could be finished smoothly using MATLAB R2007b software together with its graphic analysis