TEORIAS DE ENFERMAGEM: IMPORTÂNCIA DA CORRETA APLICAÇÃO DOS CONCEITOS

Theoretical-reflexive research, whose aim is to analyze the clarity of concept stimulus in the Roy Model, for best comprehension in nursing practice. It was developed in three phases: 1- Search of studies that utilized the Roy Model; 2- Conducted reading for comprehension of the concept stimulus and 3- Analysis of clarity of the concept. The three studies were conducted at master level. The analysis of the studies shows deficiency in the clarity of the concept stimulus, being predominant the ambiguity in the classification and differentiation of the focal and contextual stimuli, without the existence of consistency and uniformity. The need arises to deepen the theories of nursing for adequate application in the areas of research: nursing education and practice, optimizing and improving its use, as well as, enabling the comprehension of determined concepts that are not sufficiently clear. The worries that arise among the nurses will provide a more profound approach to the study, enabling the advance of theories, as well as new findings, leading to necessary changes.  Investigación teórico-reflexiva cuyo objetivo fue analizar la claridad del concepto estímulo según el  modelo de Roy, para mayor comprensión en la práctica de enfermería. Desarrollada en tres etapas: 1ª- Levantamiento de estudios que utilizaron el Modelo de Roy; 2ª - Lectura dirigida hacia la comprensión del concepto estímulo y 3ª - Análisis de la claridad del concepto. Fueron utilizados tres estudios, a  nivel de maestrado. El análisis de los estudios demuestra deficiencia en la claridad del concepto estímulo, predominando ambigüedad en la clasificación y diferenciación de los estímulos focales y contextuales, sin consistencia y uniformidad. Se evidencia la necesidad de profundizar en las teorías de enfermería, para su aplicación adecuada en las áreas de investigación, enseñanza y práctica, optimizando y mejorando su uso, además de posibilitar la comprensión de determinados conceptos no suficientemente claros. Las inquietudes surgidas entre los enfermeros podrán motivar un abordaje más profundo de los estudios, posibilitando el avance de las teorías, así  como nuevos descubrimientos, dirigiendo los cambios necesariosPesquisa teórico-reflexiva, objetivando analisar a clareza do conceito estímulo no modelo de Roy, para maior compreensão na prática de enfermagem. Desenvolvido em três etapas: 1ª- Levantamento de estudos que utilizaram o Modelo de Roy; 2ª - Leitura dirigida para a compreensão do conceito estímulo e 3ª - Análise da clareza do conceito. Foram utilizados três estudos, em nível de mestrado. A análise dos estudos demonstra deficiência na clareza do conceito estímulo, predominando ambigüidade na classificação e diferenciação dos estímulos focais e contextuais, não existindo consistência e uniformidade. Evidencia-se a necessidade do aprofundamento nas teorias de enfermagem, para a aplicação adequada nas áreas de pesquisa, ensino e prática, otimizando e aprimorando seu uso, além de possibilitar a compreensão de determinados conceitos, não suficientemente claros. As inquietações surgidas entre os enfermeiros poderão proporcionar o aprofundamento nos estudos, possibilitando o avanço das teorias, assim como novos achados, direcionando as mudanças necessárias

An evaluation of enteral nutrition practices and nutritional provision in children during the entire length of stay in critical care

<b>Background</b> Provision of optimal nutrition in children in critical care is often challenging. This study evaluated exclusive enteral nutrition (EN) provision practices and explored predictors of energy intake and delay of EN advancement in critically ill children.<p></p> <b>Methods</b> Data on intake and EN practices were collected on a daily basis and compared against predefined targets and dietary reference values in a paediatric intensive care unit. Factors associated with intake and advancement of EN were explored.<p></p> <b>Results</b> Data were collected from 130 patients and 887 nutritional support days (NSDs). Delay to initiate EN was longer in patients from both the General Surgical and congenital heart defect (CHD) Surgical groups [Median (IQR); CHD Surgical group: 20.3 (16.4) vs General Surgical group: 11.4 (53.5) vs Medical group: 6.5 (10.9) hours; p <= 0.001]. Daily fasting time per patient was significantly longer in patients from the General Surgical and CHD Surgical groups than those from the Medical group [% of 24 h, Median (IQR); CHD Surgical group: 24.0 (29.2) vs General Surgical group: 41.7 (66.7) vs Medical group: 9.4 (21.9); p <= 0.001]. A lower proportion of fluids was delivered as EN per patient (45% vs 73%) or per NSD (56% vs 73%) in those from the CHD Surgical group compared with those with medical conditions. Protein and energy requirements were achieved in 38% and 33% of the NSDs. In a substantial proportion of NSDs, minimum micronutrient recommendations were not met particularly in those patients from the CHD Surgical group. A higher delivery of fluid requirements (p < 0.05) and a greater proportion of these delivered as EN (p < 0.001) were associated with median energy intake during stay and delay of EN advancement. Fasting (31%), fluid restriction (39%) for clinical reasons, procedures requiring feed cessation and establishing EN (22%) were the most common reasons why target energy requirements were not met.<p></p> <b>Conclusions</b> Provision of optimal EN support remains challenging and varies during hospitalisation and among patients. Delivery of EN should be prioritized over other "non-nutritional" fluids whenever this is possible.<p></p&gt

Quantum Acoustics with Surface Acoustic Waves

It has recently been demonstrated that surface acoustic waves (SAWs) can interact with superconducting qubits at the quantum level. SAW resonators in the GHz frequency range have also been found to have low loss at temperatures compatible with superconducting quantum circuits. These advances open up new possibilities to use the phonon degree of freedom to carry quantum information. In this paper, we give a description of the basic SAW components needed to develop quantum circuits, where propagating or localized SAW-phonons are used both to study basic physics and to manipulate quantum information. Using phonons instead of photons offers new possibilities which make these quantum acoustic circuits very interesting. We discuss general considerations for SAW experiments at the quantum level and describe experiments both with SAW resonators and with interaction between SAWs and a qubit. We also discuss several potential future developments.Comment: 14 pages, 12 figure

Characterization of Lifestyle in Spinocerebellar Ataxia Type 3 and Association with Disease Severity

BACKGROUND: Lifestyle could influence the course of hereditary ataxias, but representative data are missing. OBJECTIVE: The objective of this study was to characterize lifestyle in spinocerebellar ataxia type 3 (SCA3) and investigate possible associations with disease parameters. METHODS: In a prospective cohort study, data on smoking, alcohol consumption, physical activity, physiotherapy, and body mass index (BMI) were collected from 243 patients with SCA3 and 119 controls and tested for associations with age of onset, disease severity, and progression. RESULTS: Compared with controls, patients with SCA3 were less active and consumed less alcohol. Less physical activity and alcohol abstinence were associated with more severe disease, but not with progression rates or age of onset. Smoking, BMI, or physiotherapy did not correlate with disease parameters. CONCLUSION: Differences in lifestyle factors of patients with SCA3 and controls as well as associations of lifestyle factors with disease severity are likely driven by the influence of symptoms on behavior. No association between lifestyle and disease progression was detected. © 2021 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society

Balanço e análise da sustentabilidade energética na produção orgânica de hortaliças.

Os insumos e serviços utilizados na produção vegetal representam custo energético. Dependendo desses fatores e das produtividades obtidas, a conversão da produção em energia determinará a eficiência energética do sistema. A agricultura orgânica somente atingirá a missão de preservação ambiental se tiver comprovada sustentabilidade energética. Neste trabalho, objetivou-se caracterizar os balanços energéticos dos cultivos orgânicos e analisar sua sustentabilidade, em comparação aos sistemas convencionais. Monitoraram-se campos de produção de dez culturas, de 1991 a 2000 em Domingos Martins-ES. Os dados do sistema convencional foram obtidos pelas médias dos coeficientes técnicos da região. Quantificaram-se os coeficientes técnicos, convertendo suas grandezas físicas em equivalentes energéticos, expressos em kcal. O sistema orgânico gastou 4.571.159 kcal ha-1 e apresentou 12.696.712 kcal ha-1 de energia inserida na colheita, mostrando balanço médio de 2,78. Esse valor foi similar ao obtido no sistema convencional (1,93). As participações dos componentes nos gastos do sistema orgânico foram embalagem (35,8%), composto orgânico (17,2%), irrigação (12,6%), sementes/mudas (12,4%) e mão-de-obra (11,0%), serviços mecânicos (5,0%) e frete (4,5%). Se os custos com embalagens fossem eliminados, os gastos do sistema orgânico seriam reduzidos para 2.930.113 kcal ha-1, aumentando sua eficiência. A maioria dos cultivos orgânicos pode ser considerada sustentável em transformação de energia, com balanços superiores a 1,00 e produção média diária de 80.421 kcal ha-1 por dia, superior à necessidade mínima de 58.064 kcal ha-1

Nursing diagnoses of newborns with sepsis in a Neonatal Intensive Care Unit

OBJECTIVES: to elaborate the Nursing Diagnoses of newborns with sepsis in a neonatal intensive care unit and characterize the profile of the neonates and their mothers.METHOD: a cross-sectional and quantitative study, with a sample of 41 neonates. A physical examination and consultation of the hospital records were undertaken, using an instrument. The elaboration of the Nursing Diagnoses followed a process of diagnostic inference and was based on the North American Nursing Diagnosis Association 2012-2014.RESULTS: the mothers were around 25 years old, had a low average number of pre-natal consultations, and various complications during the pregnancy; and the newborns were predominantly premature and with very low birth weights. Five Nursing Diagnoses predominated, and all the neonates presented Risk of Shock and Risk of fluid volume imbalance.CONCLUSION: the Nursing Diagnoses of the neonates with sepsis can guide the formulating of specific assistential plans. The study contributes to the generation of new knowledge and found various relationships between the Nursing Diagnoses and the variables selected in the characterization of the neonates, which deserve to be elucidated in greater detail based on further research on the issue