bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of manual chest compression on expiratory flow bias during the positive end-expiratory pressure-zero end-expiratory pressure maneuver in patients on mechanical ventilation
Authors: Oliveira Ana Carolina Otoni , Lorena Daiane Menezes , Gomes Lívia Corrêa , Amaral Bianca Lorrane Reges , Volpe Márcia Souza
Published: March 2019

ABSTRACT Objective: To investigate the effects of manual chest compression (MCC) on the expiratory flow bias during the positive end-expiratory pressure-zero end-expiratory pressure (PEEP-ZEEP) airway clearance maneuver applied in patients on mechanical ventilation. The flow bias, which influences pulmonary secretion removal, is evaluated by the ratio and difference between the peak expiratory flow (PEF) and the peak inspiratory flow (PIF). Methods: This was a crossover randomized study involving 10 patients. The PEEP-ZEEP maneuver was applied at four time points, one without MCC and the other three with MCC, which were performed by three different respiratory therapists. Respiratory mechanics data were obtained with a specific monitor. Results: The PEEP-ZEEP maneuver without MCC was enough to exceed the threshold that is considered necessary to move secretion toward the glottis (PEF − PIF difference > 33 L/min): a mean PEF − PIF difference of 49.1 ± 9.4 L/min was achieved. The mean PEF/PIF ratio achieved was 3.3 ± 0.7. Using MCC with PEEP-ZEEP increased the mean PEF − PIF difference by 6.7 ± 3.4 L/min. We found a moderate correlation between respiratory therapist hand grip strength and the flow bias generated with MCC. No adverse hemodynamic or respiratory effects were found. Conclusions: The PEEP-ZEEP maneuver, without MCC, resulted in an expiratory flow bias superior to that necessary to facilitate pulmonary secretion removal. Combining MCC with the PEEP-ZEEP maneuver increased the expiratory flow bias, which increases the potential of the maneuver to remove secretions.
Primary bacillary resistance in multidrug-resistant tuberculosis and predictive factors associated with cure at a referral center in São Paulo, Brazil
Authors: Savioli Marcia Telma Guimarães , Morrone Nelson , Santoro Ilka
Published: March 2019

ABSTRACT Objective: To identify transmitted or primary resistance among cases of multidrug-resistant tuberculosis and predictive factors for cure in multidrug-resistant tuberculosis after the first treatment. Method: Descriptive study of a cohort from 2006 to 2010, in a reference unit of tuberculosis in São Paulo, Brazil. The data were obtained by the revision of medical records. Clinical criteria were used to classify transmitted and acquired resistance. Extended primary resistance was also defined, in this study, as cases initially treated with a standardized scheme, but with no therapeutic success, and the pre-treatment drug susceptibility test (DST) showed presence of resistance. Results: 156 patients with multidrug-resistant tuberculosis and their respective sputum samples were eligible for the study. Only 7% of the patients were positive for the human immunodeficiency virus (HIV). Previous treatment occurred in 95% of the sample. The cure rate after the first treatment was 54%. The median bacteriological conversion time of those who healed was one month. Bacillary resistance was considered acquired resistance in 100 (64%) and transmitted resistance in 56 (36%). By logistic regression, patients who presented primary multidrug-resistant tuberculosis (odds ratio-OR = 6,29), without comorbidity (OR = 3,37) and with higher initial weight (OR = 1.04) were associated with cure after the first treatment. Conclusion: The early detection of bacillary resistance and appropriate treatment are in favor of healing. Thus, it is crucial to know exactly the primary resistance rate avoiding the use of inadequate treatments, amplification of bacillary resistance and its transmission.
Desvendando a radiação Hawking
Authors: Santi Natali Soler Matubaro de , Santarelli Raphael
Published: March 2019

Resumo Buracos negros clássicos, descritos pela relatividade geral, podem absorver partículas, mas não podem emiti-las. Entretanto efeitos quânticos fazem com que buracos negros passem a emitir partículas e comportem-se como um corpo com temperatura diretamente proporcional a κ, a gravidade superficial do buraco negro em questão. Este artigo tem o objetivo de desvendar a radiação Hawking, para o colapso esfericamente simétrico, servindo de motivação e apoio para estudos introdutórios em teoria quântica de campos em espaços curvos.
A física na visão de Ernst Mach: De uma crítica a Newton às teorias gravitacionais
Authors: Gracia G.B. de
Published: March 2019

Resumo O presente trabalho possui como objetivo introduzir conceitos chave da filosofia da ciência do físico austríaco Ernst Mach, assim como analisar a sua influência sobre teorias gravitacionais. Para tal, mostraremos que ela culmina numa crítica à ideia de espaço absoluto de Newton. Essa crítica teve considerável influência sobre Albert Einstein, entusiasta da filosofia de Mach, e o motivou a construir uma teoria que englobasse boa parte dos seus conceitos. Finalmente, analisaremos dois dos trabalhos originais de Einstein a fim de analisar a compatibilidade entre sua teoria gravitacional e as ideias de E.Mach. Assim, também comentaremos a respeito de uma generalização de sua teoria que visava incorporar toda a epistemologia Machiana.
Rainfall climatology, variability, and trends in Veranópolis, Rio Grande do Sul, Brazil
Authors: Junges Amanda H. , Bremm Carolina , Fontana Denise C.
Published: March 2019

ABSTRACT The objective of this study was to characterize the rainfall climatology in Veranópolis, Rio Grande do Sul, Brazil, through analyses of means, variabilities related to El Niño Southern Oscillation (ENSO), and temporal trends, using a 60-year data series (1956-2015). Descriptive statistics of annual, monthly and seasonal rainfall were used to characterize the rainfall climatology. The differences between seasons, and influence of ENSO were evaluated using analysis of variance and the Duncan’s test. Rainfall trends were evaluated by the Mann Kendall test. The local average annual rainfall is 1,683 mm and the average monthly rainfall is 140 mm, varying from 109 (May) to 182 mm (September). The annual rainfall has high interannual (standard deviation of 327 mm), monthly (60-100 mm) and seasonal (124-183 mm) variabilities, which should be considered in non-irrigated agricultural systems using rainfall as the main source of water supply to plants. Although autumn presents lower average rainfall (346 mm) than the other seasons, its average percentages were similar to the total annual rainfall (21-28%), and the rainfalls are well-distributed in the seasons. Differences between ENSO events occurred in the spring; La Niña years showed lower rainfall (385 mm) than El Niño (549 mm) and neutral (481 mm) years. The annual rainfall tended to increase by 6.3 mm per year (p < 0.01), with increases of 2.5 mm in spring and 1.9 mm in winter (p < 0.10) in the period analyzed.
Sowing operation direction and population densities in corn growing
Authors: Corrêa Rafael D. G. , Furlani Carlos E. A. , Zerbato Cristiano , Oliveira Danilo T. de , Noronha Rafael H. de F. , Warikoda Newton K.
Published: March 2019

ABSTRACT Among the factors that may influence corn yield are sowing operation direction and plant population, since they alter the shade index between crop rows, and consequently the efficiency of interception of the photosynthetically active radiation by the leaves of plants. The aim of this study was to evaluate the influence of sowing direction and plant populations on P2830VYH hybrid corn yield. The experiment was conducted at the facilities of FCAV-UNESP, latitude 21º 14’ S and longitude 48º 16’ W in Jaboticabal (SP). The treatments were composed of three sowing directions (North-South, Northeast-Southwest, and East-West) and three population densities (40,000, 60,000 and 80,000 plants ha-1). The treatment with 80,000 plants ha-1 had the lowest cost per sack of corn and profitability 21% higher than that of the treatment with 60,000 plants ha-1, and 45% higher than that of the treatment with 40,000 plants ha-1. Sowing direction had no influence on grain yield when environmental conditions were favorable to the development of the crop. Lower plant densities lead to higher individual results in relation to the number of cobs, length of cobs and number of grains per row.
Growth of seedlings and young plants of coffee in composts of textile industry residues
Authors: Neiva Júnior Eudes , França André C. , Grazziotti Paulo H. , Porto Douglas W. B. , Araújo Fausto H. V. , Leal Felipe D. S.
Published: March 2019

ABSTRACT The final destination of solid industrial waste is one of the main environmental problems currently facing, due to its potential for contamination. With the evolution of environmental policy and awareness, the proper destination of these wastes is stimulated, seeking new technologies to fulfil the demand for the products generated. One of the solutions to this environmental problem is to use these residues as fertilizers in agriculture. The objective of this study was to evaluate the use of toxic textile residues as a substrate component of coffee seedlings and as fertilizer in the initial growth of coffee plants. The study was divided into three experiments: production of seedlings, initial growth of potted plants and in the field. In the production of seedlings, the treatments consisted of different proportions of organic compost residues from the textile industry: 0, 4, 8, 16 and 32% and a conventional treatment of seedling production. In pots and in the field, the same treatments were used with organic compound, and a conventional planting treatment. In the three experiments, plant growth and nutritional analyses were performed. The conventional treatment provided better development of the seedlings and the potted and field coffee plants for most of the evaluated parameters. The treatments between 8 and 16% of organic compost showed an acceptable development of coffee plants, demonstrating their potential as fertilizer.
Welfare and spatial distribution of noise levels in swine nursery
Authors: Damasceno Flavio A. , Oliveira Carlos E. A. , Ferraz Gabriel A. e S. , Nascimento João A. C. do , Saraz Jairo A. O. , Brandão Leidimar F.
Published: March 2019

ABSTRACT The aim of this study was to evaluate the welfare and spatial distribution of noise levels in a swine nursery during the first three weeks of animal’s life. The climatic conditions were evaluated through the dry-bulb temperature (Tdb), relative humidity (RH) and black globe temperature and humidity index (BGHI) and allowed us to observe that the heating system influenced the conditions in the environment, and the use of the air conditioning system did not guarantee animal’s comfort conditions. The analysis on the spatial distribution of noise levels was performed using geostatistics and demonstrated the occurrence of spatial variability inside the facilities. The highest frequencies of noise levels were concentrated between 60 and 70 dB, and the highest noise values were observed near the fans. The mean BGHI values were below the thermal comfort range for piglets in all systems tested.
Thermal environment of masonry-walled poultry house in the initial life stage of broilers
Authors: Coelho Diogo J. de R. , Tinôco Ilda F. F. , Souza Cecília F. , Baptista Fátima J. F. , Barbari Matteo , Oliveira Kelle P.
Published: March 2019

ABSTRACT The aim of this study was to monitor and evaluate the thermal environment and undertake a complete mapping of the variables air temperature, air relative humidity, and temperature-humidity index for broilers. The research was conducted during the winter, in Brazil, in a commercial poultry house fully walled with concrete-block masonry, equipped with a full-time negative-pressure mechanized ventilation system and indoor-environment air heating by a wood-burning furnace located outside the facility. The shed was fully automated and housed 30,000 birds at a density of 15 birds m-2. Thermal-environment data analysis revealed that the masonry-wall model did not ensure homogeneous thermal distribution within the poultry house, with the central region showing the highest air temperature and lowest air relative humidity values. The indoor environment did not provide thermal comfort to the housed birds, which were under thermal discomfort in certain situations in some internal regions of the shed.
Characterization of noise emitted by a power tiller through geostatistics
Authors: Gonçalves Luana M. , Ferraz Gabriel A. e S. , Oliveira Marcelo S. de , Barbosa Brenon D. S. , Silva Carlos J. da , Ferraz Patrícia F. P.
Published: March 2019

ABSTRACT Noise is one of the harmful and stressful physical agents present in the workplace. Research performed with geostatistics to adjust the semivariogram of tractor noise were performed using the Gaussian and spherical model. In this way, the aim was to map the spatial variability of the noise emitted by a power tiller through the sine wave model, besides testing other fitting methods, in order to identify health zones for the workers. The experiment was performed with an agricultural power tiller (10.3 kW) placed in a working regime (1500 rpm), coupled to a brushcutter, and a digital sound level meter to collect noises in points distributed along a regular grid sampling of 2.0 × 2.0 m around the tractor. The spatial dependence of noise was analyzed through semivariogram fitting by different methods and by the wave model to obtain the spatial distribution map interpolated by kriging. It was possible to characterize the structure and the magnitude of the spatial dependence of the noise levels emitted by the tractor, as well as to map the spatial distribution. A maximum noise level of 96.5 dB was observed close to the tractor engine, a value above the limit of 85.0 dB for 8 h of daily exposure (NR-15). Thus, the use of ear protectors is recommended for both the tractor driver and the professionals who support agricultural operation within a radius of 6 m from the emitting source under the conditions studied.
Potential risk of drift from inclined fan nozzles
Authors: Moraes Eder D. de , Saab Otávio J. G. A. , Gandolfo Marco A. , Marubayashi Rodrigo Y. P. , Gandolfo Ulisses D.
Published: March 2019

ABSTRACT Pest, disease and weed control in large-scale crops depend on the application of agrochemicals. These applications are subject to several factors that can lead to drift. The objective of this study was to evaluate the effect of spray nozzles with inclined flat jet, on the drift. The drift was collected in a 10 m wind tunnel, with a spray system inside. The samples were collected in 5 horizontal points, from 2.0 to 6.0 m away from the spray nozzle and 5 points in the vertical, from 0.1 to 0.5 m away from the lower base of the wind tunnel, totaling 25 sample points. The mixture applied was glyphosate (isopropylamine salt, 1080 g a.e. ha-1) with 2,4-D (dimethylamine salt, 1.005 g a.e. ha-1). The nozzles J3D 100 025, JGC 120 02, JAP 110 015 and ADI 110 015 (control), inclined by 37.5º, 20º, 15º and 0º, respectively, were used in two directions of spray: upwind and downwind of the air flow direction. The nozzles J3D, JGC and JAP, when inclined downwind reduced the drift by 16.1, 2.6 and 39.0%, respectively, relative to the control, and when inclined upwind, reduced drift by 53.4, 3.9 and 18.6%, respectively, relative to the control. Spray nozzles with second-generation air-induction inclined flat jet (JAP) and standard inclined flat jet (J3D) reduce the collected drift compared to the nozzle without inclination, regardless of wind flow direction.
Avaliação do manchamento e da rugosidade superficial de materiais restauradores diretos após diferentes sistemas de polimento: estudo in vitro
Authors: ALMEIDA Leonardo de , SANTIN Daniella Cristo , MARAN Bianca Medeiros , NAUFEL Fabiana Scarparo , SCHMITT Vera Lúcia
Published: March 2019

Resumo Introdução Com o avanço estético e tecnológico dos compósitos restauradores diretos, a procura pela Odontologia Éstética tem aumentado. Objetivo Avaliar o manchamento e a rugosidade superficial dos compósitos Filtek Z350 (3M ESPE) e Filtek Bulk Fill (3M ESPE), polidos por diferentes sistemas: Disco SofLex e Disco SofLex diamantado espiral (ambos da 3M ESPE), após exposição repetitiva ao café. Material e método Neste estudo in vitro, um total de 80 discos de resina foi confeccionado, com 40 espécimes para cada compósito avaliado. Os espécimes foram ainda subdivididos em grupos (n=10) de acordo com o método de polimento ‒ SofLex e SofLex diamantado ‒ e a solução de armazenamento ‒ água deionizada (controle) e café (experimental). Após 24 horas de armazenamento em água deionizada, foi realizada a avaliação de cor e rugosidade inicial, bem como a execução dos protocolos de polimento testados. Posteriormente, os espécimes foram expostos ao processo de manchamento em café e água deionizada durante 42 dias. Após esse período, a cor e a rugosidade foram reavaliadas. Resultado A análise estatística paramétrica evidenciou que o manchamento superficial foi influenciado significativamente pelos fatores compósito e solução, mas não pelo fator polidor ou ainda por qualquer interação entre os fatores. Para o fator compósito, Filtek Z350 exibiu maior manchamento, e para o fator solução, foi observado maior manchamento para o café. Já na análise de rugosidade, não houve diferenças significativas. Conclusão Independentemente do sistema de polimento, a solução experimental de café alterou a cor de ambos os compósitos avaliados e verificou-se que a rugosidade não foi alterada.
Rely XTM U200 versus Rely XTM ARC: uma comparação da resistência à microtração
Authors: DA-RÉ Eduardo , GASQUE Kellen Cristina da Silva , MORETTI NETO Rafael Tobias
Published: March 2019

Resumo Introdução Os cimentos resinosos são extensivamente utilizados na fixação de restaurações indiretas de cerâmica e cerômero, sendo classificados em duas categorias: os cimentos resinosos convencionais, que não apresentam uma adesão inerente à estrutura dental e requerem o uso de um sistema adesivo e os cimentos resinosos autoadesivos, que não requerem um tratamento adesivo prévio do substrato dentário. Objetivo Avaliar a resistência de união de dois cimentos resinosos, convencional e autoadesivo, quando utilizados na cimentação de restaurações cerâmicas e ceroméricas, trazendo elementos para propiciar melhor compreensão da interação adesiva em procedimentos de cimentação com as referidas categorias de cimentos resinosos. Material e método Dentes humanos (n=20), cedidos pelo banco de dentes da Universidade Federal de Alfenas (UNIFAL), foram preparados para que cilindros de cerâmica ou de cerômero fossem cimentados utilizando-se dois tipos de cimentos resinosos (autoadesivo e convencional). Após a cimentação, 20 palitos foram obtidos e submetidos ao teste de tração, avaliando-se a força necessária para a fratura. Os valores obtidos foram submetidos à análise estatística empregando-se a análise de variância (ANOVA) e o teste de Tukey. Resultado As forças mínimas e máximas necessárias ao rompimento do cimento convencional foram superiores às mesmas requeridas para o rompimento da união promovida pelo cimento autoadesivo, bem como as medianas e as médias aritméticas, independentemente do material restaurador empregado. O teste de Tukey demonstrou que as diferenças entre os cimentos empregados são estatisticamente significantes, independentemente do material restaurador. Conclusão Os resultados deste trabalho sugerem que o material utilizado para a confecção dos corpos de prova (cerâmica ou cerômero) não influenciou na resistência à tração, sendo que o cimento convencional apresentou valores superiores de resistência.
Prevalence of and factors associated with frailty in elderly users of the Family Health Strategy
Authors: Neves Ádila de Queiroz , Silva Ageo Mário Cândido da , Cabral Juliana Fernandes , Mattos Inês Echenique , Santiago Lívia Maria
Published: March 2019

Resumo Objetivo : analisar a prevalência e fatores associados à fragilidade em idosos usuários da Estratégia Saúde da Família. Método : estudo epidemiológico de corte transversal com 377 idosos. A variável dependente, a fragilidade, foi investigada através do Tilburg Frailty Indicator (TFI). As variáveis independentes foram as sociodemográficas e as condições de saúde (avaliadas através dos instrumentos validados: Escala de Katz, Escala de Lawton, Escala de Depressão Geriátrica - GDS-15, Miniavaliação Nutricional - MAN, CIRS-G e polifarmácia). Foi realizada análise descritiva das variáveis categóricas e numéricas. Na análise bivariada calculou-se as razões de prevalência através do teste qui-quadrado de Mantel Haenszel e, na análise múltipla, utilizou-se a regressão de Poisson. Resultados : a prevalência estimada de fragilidade para a amostra foi de 65,25%. Na análise múltipla as variáveis estado civil (divorciado ou separado, viúvo ou solteiro), presença de sintomas depressivos, dependência em atividades instrumentais de vida diária, estado nutricional (desnutrição/risco de desnutrição) e presença de comorbidades se mantiveram associadas, com significância estatística, à fragilidade. Conclusão : o presente estudo apontou elevada prevalência de fragilidade, ressaltando a importância no conhecimento dessa temática a fim de estimular ações preventivas para minimizar desfechos adversos na população idosa, como hospitalização, quedas, fraturas e morte.
Self-medication and adherence to drug treatment: assessment of participants of the Universidade do Envelhecer (the University of Aging) program
Authors: Garcia Antonio Leonardo de Freitas , Kaya Andréia Naomi Madoz , Ferreira Eduardo Antonio , Gris Eliana Fortes , Galato Dayani
Published: March 2019

Abstract Objectives : to evaluate the use of medication (for continuous use and self-medication) and adherence to treatment among elderly and non-elderly participants of the Universidade do Envelhecer (UniSer). Method : an observational, quantitative and cross-sectional study, using the interview technique, was carried out at UniSer with 215 subjects. A structured instrument was used for the collection of sociodemographic variables and self-medication data. The 1986 Morisky-Green-Levine Scale (MGL) and the Brief Medication Questionnaire (BMQ) regimen screening tool were used to assess adherence. Descriptive analyzes of the data were performed, and the chi-squared Test and Fisher’s Exact Test were applied to evaluate the association between variables of interest. Results : of the participants, 127 (59.1%) were elderly (< 60 years old), of whom 81.9% were women. Regarding self-medication, 22.9% of elderly and 21.7% of non-elderly persons practiced it in the previous seven days (p=0.848), even if they considered it dangerous (p=0.472). A total of 45.8% of the elderly and 55.6% of the non-elderly irrationally self-medicated within the analyzed period, while 76.4% of the elderly and 64.8% of the non-elderly used medications of continuous use (p=0.063). A total of 78.8% of the elderly and 76.1% of the non-elderly were not adherent to treatment (p=0.719) according to the MGL scale, while the BMQ Regimen Screen found that 36.7% of the elderly and 41.1% of the non-elderly were not adherent (p=0.595). Conclusion : these findings demonstrate that there were no significant differences between the groups studied and health education actions should be carried out with an emphasis on guidelines on adherence and the rational use of medicines.
Agreement among methods for study estimation of elderly height at the nutrition ambulatory
Authors: Sant’Anna Bruna Calixto , Lage Gisella Meireles de Castro , Dores Silvia Maria Custódio das , Velarde Luis Guillermo Coca , Barroso Sérgio Girão , Rocha Gabrielle de Souza
Published: March 2019

Abstract Objective: to evaluate methods of elderly height estimation attended at the Nutrition ambulatory. Method: a total of 43 elderly individuals of both genders were evaluated during nutrition consultations. Sociodemographic data were collected from charts and height, knee height, arms wingspan and semi-span were measured. Statistical analysis were made through Bland-Altman test to evaluate concordance among statures estimated by predictive formulas and the height measured. Results: the values found were: height measured in meters 1.53 (±0.08), height estimated by the wingspan 1.60 (±0.10), by the semi-span 1.61 (±0.11) and by the knee height 1.56 (±0.10). According to the Bland-Altman graph, the height estimated by knee height showed a better agreement with the measured height. Conclusion: according to this study results, poor predictive formulas concordance in height estimation in elderly, using the measures: arms wingspan and semi-span with real stature measured were observed. Knee height, using Chumlea formula, presented the best concordance with measured stature and seems to be a good way for stature estimation at the studied population.
Body image satisfaction, nutritional status, anthropometric indicators and quality of life among the elderly
Authors: Martins Renata Breda , Farias Raquel Rousselet , Stahnke Douglas Nunes , Kik Raquel Milani El , Schwanke Carla Helena Augustin , Resende Thais de Lima
Published: March 2019

Abstract Objective: to determine the prevalence of body image satisfaction in elderly subjects, as well as its relationship with nutritional status, anthropometric indicators and quality of life. Method: a cross-sectional, descriptive and analytical study was carried out with elderly individuals from Primary Care units (Family Health Strategy) from all the health districts of Porto Alegre, in the state of Rio Grande do Sul. The variables studied were: sociodemographic (gender; age; marital status and schooling), anthropometric (weight; height; body mass index; arm, calf, waist and hip circumference; waist-hip ratio and triceps skinfold), nutritional (Mini Nutritional Assessment), and clinical (quality of life; body image satisfaction). The Stunkard Silhouettes Scale, the Mini Nutritional Assessment and the Flanagan quality of life scale were applied. For data analysis, logistic regression (five steps) was performed with the Conditional Backward method. Results: a total of 532 elderly users (68.96 (7.14) years) were evaluated, mostly women (64.8%) who were dissatisfied with their body image (71.7%). The predictors of body image satisfaction were: eutrophic/underweight body mass index, eutrophy/insufficient arm circumference, and higher mean quality of life scores. Conclusion: in general, a low prevalence of body image satisfaction was identified among the elderly. Subjects with lower body mass index, smaller arm circumference measures and better quality of life had a greater chance of being satisfied with their body image.
Validation of a questionnaire for the evaluation of informal social support for the elderly: section 1
Authors: Guedes Marcello Barbosa Otoni Gonçalves , Lima Kenio Costa , Lima André Luiz , Guedes Thais Sousa Rodrigues
Published: March 2019

Abstract Objectives: to construct and carry out content (CV) and response process (RPV) validation for a questionnaire to assess informal social support for the elderly. Method: a descriptive, observational, quantitative study was performed between January and December 2016 in the city of Natal (Rio Grande do Norte) and other locations in Brazil. The inclusion criteria were: proven experience in the area of social support (for experts) or 60 years of age or older and with preserved cognitive status (for the elderly). The CV stage evaluated the relevance of the items according to the general Content Validity Index (CVI) and per item as well as the assembly of the panel based on the observations of the experts. In the RPV stage, the understanding of the items by the target audience was evaluated. Results: the CV stage included a total of 40 interviewees. The overall CVI was 0.88 and only one item had a CVI considered poor. In the RPV stage 41 people were interviewed. Conclusion: the questionnaire exhibited good relevance for the proposed items and the observations of the interviewees allowed an approximation of the language used in the instrument to the language of the elderly.
Perceptions of aging and falling ill: a study with elderly persons in palliative care
Authors: Ribeiro Mariana dos Santos , Borges Moema da Silva
Published: March 2019

Abstract Objective: to learn the perceptions of elderly persons in palliative care regarding coping with aging and illness. Method: an exploratory, descriptive, qualitative study was carried out. The study included 11 elderly persons in palliative care because of oncologic disease. Semi-structured interviews were carried out which were analyzed with the aid of the ALCESTE software. Results: two axes were identified from the content analysis. The first, Resist to Survive and Live, has two categories: the first, aging with integrity, portrays the positive perception of the participants regarding the aging process, and coping strategies used to deal with aging and with illness; the other category, resilient development, refers to the life trajectories of the participants and the adversities of the process of development and aging. The second axis, Resist to Die Well, has only one category and refers to the perceptions of the elderly about the stress related to illness. Conclusion: the results show that the perceptions of aging and falling ill involved resilience, as the participants focused on what they had gained rather than their losses. In this context, they used resilient coping strategies: spiritual support, cognitive restructuring, and acceptance.
Approaches of psychoanalysis in the care of the elderly: an integrative review
Authors: Santos Álvaro da Silva , Albino Araceli , Santos Vitória de Ávila , Granero Gabriela Souza , Barros Maria Teresa Mendonça de , Farinelli Marta Regina
Published: March 2019

Abstract Objective: to map publications about the clinical psychoanalytical care of the elderly and describe their characteristics. Method: an integrative review was carried out, considering the period 2008 to 2017 using the following databases: Index-Psychology, LILACS, MedLine, PubMED, SciELO and RedALyC, irrespective of language. The terms Elderly (Idoso), Aging (Envelhecimento) and Psychoanalysis (Psicanálise) were used. The guiding question was: what scientific literature exists about the elderly and psychoanalytical clinical care? A total of 33 articles were considered. Results: five categories were constructed: "Elderly clinical care with a psychoanalytical approach" (15), "Psychoanalytical Approaches in old age” (9), "Psychoanalytical Interventions in long-term care facilities" (6), "Representations of old age for health professionals in the light of psychoanalysis" (2) and "Generationality and psyche" (1). The concern of psychoanalysis for the elderly is incipient and precedes epistemological issues, meaning that production regarding clinical practice is greater; in turn, there are fewer research studies, as most of the articles are reflective in nature. Conclusion: the published studies indicate the possibility of employing psychoanalysis with the elderly, as the unconscious does not age and symptoms are continuously updated. The timidity of psychoanalysis in contrast to the increase in the numbers of elderly persons may be criticized. It is also emphasized that the losses, the effects on the body and the reduction of social ties require adjustments in clinical care, such as the inclusion of group activities and activities beyond the analytical setting, especially hospitals, homes and LTCFs.
Risk of malnutrition and associated factors in institutionalized elderly persons
Authors: Damo Cássia Cassol , Doring Marlene , Alves Ana Luisa Sant’Anna , Portella Marilene Rodrigues
Published: March 2019

Abstract Objective : to evaluate the risk of malnutrition and associated factors in institutionalized elderly persons. Method : a cross-sectional study was carried out with elderly persons living in long-term care facilities in the municipal regions of Passo Fundo (Rio Grande do Sul) and Carazinho (Rio Grande do Sul) in 2017. A standardized, pre-codified questionnaire with sociodemographic variables was used, along with anthropometric data and the Mini Nutritional Assessment. Cognitive decline and non-intentional weight loss were also evaluated. The qualitative variables were presented in terms of univariate frequencies and the quantitative variables were described through measures of central tendency and dispersion. In order to verify the association between the categorical variables, the Pearson’s correlation coefficient, Chi-Squared test and the Fisher Exact test were applied, and in the crude and adjusted analysis the Poisson regression was used with robust variance. The level of significance was 5%. Results : a total of 399 elderly people were included, of whom 69.9% were female, 54.5% were aged 80 years or older and 88.4% were white. Of these elderly people, 61.7% lived in non-profit facilities. In the evaluation of nutritional status, 26.6% of the elderly were found to be malnourished, 48.1% were at risk of malnutrition and 25.3% had normal nutritional status. The highest prevalence ratio of at risk of malnutrition/malnutrition was with cognitive decline and unintentional weight loss (p<0.001). Conclusion : through the results, identifying nutritional status and the characteristics associated with the risk of malnutrition contribute to effective evaluation and nutritional monitoring, assisting in the prevention of diseases related to this condition.
Which factors are associated with sarcopenia and frailty in elderly persons residing in the community?
Authors: Pillatt Ana Paula , Patias Rutiana Silva , Berlezi Evelise Moraes , Schneider Rodolfo Herberto
Published: March 2019

Abstract Objective: to broaden knowledge about the factors associated with sarcopenia and frailty in elderly persons residing in the community. Method: an integrative systematic review based on the PRISMA recommendations was carried out, using articles published from 2012 to March 2017 in the PubMED, SciELO, Virtual Health Library, CINAHL and Springer electronic databases with the following descriptors: frail elderly, sarcopenia and etiology and their synonyms. The articles identified by the initial search strategy were independently assessed by two researchers, according to the eligibility criteria, and the articles selected were evaluated for methodological quality. Results: the results of this survey show that frailty may be associated with sarcopenia, low serum vitamin D levels, anemia, subclinical hyperthyroidism in men, while the greatest evolution in women was for osteoporosis. An association between sarcopenia and advanced age was also observed, with worsening quality of life, physical-functional capacity, nutritional status and comorbidities, as well as an increased risk of death in sarcopenic elderly persons. Conclusion: this systematic review showed that low serum levels of vitamin D are associated with frailty and factors that predispose this condition. It is therefore important to monitor the serum levels of this vitamin in the elderly population, and it is suggested that new studies are carried out related to supplements of this vitamin in frail elderly persons.
Protocolo para tratamento de prolapso de órgãos pélvicos com pessário vaginal
Authors: Ferreira Hellen Lívia Oliveira Catunda , Bezerra Karrine de Castro , Freitas Vívien Cunha Alves de , Silva Tatiane Moura , Moura Escolástica Rejane Ferreira , Vasconcelos Camila Teixeira Moreira , Pinheiro Ana Karina Bezerra , Aquino Priscila de Souza
Published: March 2019

Resumo Objetivo Desenvolver um protocolo clínico para o tratamento conservador do prolapso de órgãos pélvicos com pessário vaginal. Métodos Pesquisa de desenvolvimento ocorrida de julho de 2015 a janeiro de 2016 e realizada em etapas: refinamento dos tópicos/questões do protocolo; estabelecimento de recomendações para pesquisa e atualização; revisão por pares. A análise se deu por programa estatístico e pelo Índice de Validade de Conteúdo. Resultados O protocolo foi desenvolvido e avaliado por meio da técnica Delphi quanto aos critérios objetivos, conteúdo e apresentação e relevância por profissionais da área, sendo calculado o Índice de Validade de Conteúdo total de cada domínio e global. O Índice de Validade de Conteúdo total do domínio objetivos foi 1,00, do critério conteúdo e apresentação foi 0,98 e do domínio relevância, 0,96. Obteve-se o Índice de Validade de Conteúdo global de 0,98. Dessa forma, verificou-se concordância entre os participantes da técnica Delphi, com valor acima de 0,85, considerando o protocolo clínico válido. Conclusão Acredita-se que os profissionais de saúde, ao utilizar o protocolo clínico, terão maior embasamento na prática, oferecendo um cuidado de maior qualidade, pois é uma ferramenta válida e pautada cientificamente.
Ansiedade e desfechos clínicos em pacientes coronariopatas submetidos ao cateterismo não programado
Authors: Batista Letícia de Carvalho , Calache Ana Lúcia Siqueira Costa , Butcher Rita de Cassia Gengo e Silva
Published: March 2019

Resumo Objetivos Descrever o nível de ansiedade traço e estado em pacientes com síndrome coronariana aguda submetidos a cateterismo não programado; verificar a influência da ansiedade traço na ansiedade estado antes e após o cateterismo e verificar se a ansiedade (traço e estado) é preditiva da ocorrência de arritmias não fatais, da gravidade dos pacientes medida pela classificação Killip e pelo índice de comorbidade de Charlson, e do tempo de permanência hospitalar. Métodos Estudo observacional, correlacional e longitudinal, no qual foram avaliados participantes com síndrome coronariana aguda aguardando cateterismo cardíaco não programado. No encontro inicial (Ti) foram coletados dados sociodemográficos e clínicos, aplicados inventários de ansiedade traço e estado (IDATE) e de depressão de Beck. No encontro final (Tf), aplicou-se o IDATE-estado. Os participantes foram acompanhados até alta hospitalar ou óbito quanto a ocorrência de arritmias não fatais e tempo de permanência hospitalar. Resultados Foram incluídos 100 participantes (62,2±11,4 anos; 61% do sexo masculino). O escore do IDATE-traço foi 42,2±10,4 e influenciou o escore do IDATE-estado em Ti e Tf (p<0,005). O IDATE-estado diminuiu significativamente de Ti para Tf (40,2±10,4 vs 37,2±11,2, respectivamente, p=0,002). Não se observou associação do IDATE-traço ou do IDATE-estado com os índices de gravidade, tempo de permanência hospitalar ou ocorrência de arritmias. Entretanto, o escore de depressão aumentou 9,5% a chance de ocorrência de arritmias (OR=1,009; IC95%=0,913-1,115). Conclusão O nível de ansiedade reduziu de forma significativa após a realização do cateterismo, e não foi um preditor de desfechos clínicos em curto prazo.
Validação de instrumento de avaliação da segurança de pacientes renais em hemodiálise
Authors: Aguiar Letícia Lima , Guedes Maria Vilani Cavalcante , Galindo Neto Nelson Miguel , Melo Geórgia Alcântara Alencar , Almeida Paulo César de , Oliveira Roberta Meneses , Caetano Joselany Áfio
Published: March 2019

Resumo Objetivo Construir e validar um instrumento de avaliação da segurança de pacientes renais crônicos em hemodiálise. Métodos Estudo metodológico que abrangeu elaboração do instrumento e validação de conteúdo por 14 juízes; e avaliação da compreensão, por nove enfermeiros. A construção foi fundamentada na legislação sanitária sobre hemodiálise e padrões internacionais de segurança de pacientes. Para análise da concordância dos juízes, foi calculado o Coeficiente de Correlação Intraclasse, Índice de Validade de Conteúdo e teste binomial. Resultados Os itens do instrumento do tipo Likert foram distribuídos nas seis metas internacionais de segurança de pacientes, obtiveram Coeficiente de Correlação Intraclasse de 0,98. O instrumento final ficou com 57 itens com Índice de Validade de Conteúdo de 0,96 e teste binomial ≥0,86. Conclusão O instrumento foi considerado compreensível, relevante e condizente com os padrões de segurança, tendo demonstrado validade de conteúdo e compatibilidade para avaliar a segurança do paciente em ambientes de tratamento hemodialítico.
Autonomia da enfermeira na Atenção Primária: das práticas colaborativas à prática avançada
Authors: Pereira Juliana Guisardi , Oliveira Maria Amélia de Campos
Published: March 2019

Resumo Objetivo Verificar como enfermeiras da Atenção Primária à Saúde (APS) identificam sua autonomia profissional no cotidiano do trabalho e como essa autonomia é percebida por outros profissionais da equipe multiprofissional. Métodos Pesquisa exploratória, descritiva, cujo referencial teórico-metodológico foi a hermenêutica dialética, ancorada nas premissas da Sociologia das Profissões. Os dados foram coletados por meio de entrevistas semiestruturadas com 27 enfermeiras da Estratégia Saúde da Família (ESF) e 10 profissionais do Núcleo de Apoio à Saúde da Família (NASF), do município de São Paulo. O material empírico resultante foi submetido à análise de discurso. Resultados Os achados revelaram que a autonomia profissional da enfermeira da APS é percebida através das seguintes categorias: a autonomia possível, a autonomia ditada pelos protocolos e a subordinação ao trabalho médico. Conclusão O estudo revelou que houve a ampliação do escopo clínico da enfermeira da APS, a aproximando, em certa medida do trabalho médico, e por outro a desafiando a superar tal aproximação no sentido da prática colaborativa interprofissional e da prática avançada de enfermagem.
Liderança transformacional na prática dos enfermeiros em um hospital universitário
Authors: Ferreira Vanêska Brito , Amestoy Simone Coelho , Silva Gilberto Tadeu Reis da , Felzemburgh Ridalva Dias Martins , Santana Neuranides , Trindade Letícia de Lima , Santos Ises Adriana Reis dos , Varanda Patrícia Alves Galhardo
Published: March 2019

Resumo Objetivo Analisar o exercício da liderança transformacional na prática dos enfermeiros em um hospital universitário. Métodos Estudo de métodos mistos explanatório sequencial. Na etapa quantitativa, com amostra não probabilística por conveniência, aplicou-se um questionário de atitudes frente a estilos de liderança adaptado para a frequência de adoção dos comportamentos de liderança transformacional a 152 enfermeiros do referido hospital. Estes dados passaram por testes estatísticos descritivos e analíticos. Na etapa qualitativa, 25 participantes da primeira etapa foram sorteados e responderam a uma entrevista semiestruturada, analisadas mediante análise temática de conteúdo. Resultados Identificou-se a prática da liderança transformacional de forma frequente entre os enfermeiros. Entretanto, eles apresentam dificuldades para exercer esse modelo de liderança, devido a carência de apoio da instituição que, majoritariamente adota uma liderança verticalizada, pela falta de capacitação para os enfermeiros assistenciais, e fragilidades na comunicação e discussão dos problemas antes das tomadas de decisões. Conclusão A prática da liderança transformacional encontra resistências pelo maior exercícios da liderança verticalizada pelos gestores, entretanto os enfermeiros acreditam que uma liderança com comportamento horizontalizado pode favorecer mudanças estruturais e comportamentais da instituição.
Simulação clínica e treinamento para as Práticas Avançadas de Enfermagem: revisão integrativa
Authors: Ribeiro Vanessa dos Santos , Garbuio Danielle Cristina , Zamariolli Cristina Mara , Eduardo Aline Helena Appoloni , Carvalho Emilia Campos de
Published: March 2019

Resumo Objetivo Analisar a contribuição do uso da simulação clínica como estratégia para o ensino e treinamento das práticas avançadas de enfermagem. Métodos Foi realizada uma Revisão Integrativa e feito as buscas nas bases de dados Embase, LILACS, PubMed, CINAHL e Scopus, com os descritores e palavras-chaves Advanced practice nursing AND simulation. Resultados Foram identificados 68 artigos; após serem excluídos os duplicados e os que não respondiam à questão norteadora, foram analisados 11 artigos. Os dados evidenciaram que a simulação permitiu um exame aprofundado para avaliar o desempenho dos alunos nas práticas avançadas em relação a abordagem do paciente e liderança; este método auxiliou o aluno a assumir responsabilidade nas tomadas de decisões, a conduzir os cuidados com o paciente, a direcionar a equipe, interagir com a família, além de demonstrar liderança, priorização, delegação, colaboração e profissionalismo. Conclusão Os trabalhos analisados evidenciaram que a simulação clínica contribuiu para o ensino das práticas avançadas de enfermagem aumentando a consciência clínica e o desenvolvimento de competências para manejo clínico avançado, habilidades de liderança e de trabalho em equipe; a maioria dos trabalhos foram realizados com pós-graduandos.
Cultura de segurança no processo de doação de órgãos: revisão de literatura
Authors: Cabral Amanda Santos , Knihs Neide da Silva , Magalhães Aline Pestana , Alvarez Ana Graziela , Catarina Alessandra Antunes , Martins Sabrina Regina , Ramos Saulo Fábio , Paim Sibele Maria Schuantes
Published: March 2019

Resumo Objetivo Avaliar o desenvolvimento da cultura de segurança no processo de doação de órgãos e transplantes na literatura científica. Métodos Revisão integrativa da literatura a partir das bases de dados CINAHL, LILACS, PubMed, Scopus, Web of Science e na biblioteca eletrônica SciELO, de 2012 a 2016, com sintaxe de palavras-chaves e descritores para cada base, sendo selecionados 14 artigos para análise. Resultados Foram detectados 1.659 estudos, desses, 33 foram lidos na íntegra, sendo definido para coleta dos dados 14 estudos. As informações obtidas foram analisadas criticamentre e agrupadas em duas categorias: Na Categoria 1 – Cultura de segurança no uso de medicamentos no período pós-transplante: destaca-se como fundamental o envolvimento da equipe multidisciplinar na orientação da alta hospitalar no transplante e ainda, os principais fatores de erros no uso dos fármacos. Na Categoria 2 – Cultura de segurança nas unidades transplantadoras: apresenta-se questões relacionadas à segurança dos pacientes submetidos aos transplantes nos períodos pré e intra-operatórios. Conclusão Por meio desse estudo, observou-se que a temática da cultura de segurança no processo de doação e transplante de órgãos está incipiente na literatura sendo necessário desenvolvimento de estudos bem delineados e relacionando à cultura de segurança do paciente em todas as etapas do processo de doação e transplantes.
Práticas de enfermagem ao paciente com dor crônica: revisão integrativa
Authors: Antunes Juliane de Macedo , Daher Donizete Vago , Ferrari Maria Fernanda Muniz , Pereira Lara Clarete Cavalcante Muniz , Faria Magda , Sveichtizer Mariana Cabral , Morete Marcia , Izidoro Cecília
Published: March 2019

Resumo Objetivo Conhecer os benefícios das práticas de enfermagem aos pacientes com dor acompanhados na clinica de dor. Métodos Revisão integrativa de literatura, sendo utilizado o portal eletrônico SCIELO, e base de dados CINAHL e PubMed Central, com recorte temporal de 2008 a 2018 e período de coleta de dados entre junho e julho de 2018. Como descritores em saúde (DeCs): Pacientes, Dor crônica, Cuidados de Enfermagem, Clínicas de dor; e, o Medical Subject Heading (MeSH): Patients, Chronic pain, Nurse Care, Pain clinic. Resultados Evidenciou-se que a produção analisada é, majoritariamente, sobre práticas de enfermagem não farmacológica a pacientes com dor crônica, com publicações reduzidas no Brasil e tendem a se concentrar nos últimos cinco anos. O paciente com este tipo de agravo, vivencia condições multifatoriais que influenciam diretamente na condição de saúde, e necessitando de acompanhamento integral por equipe interprofissional, com inclusão da rede cuidadora, através intervenções qualificadas e resolutivas, visando adaptação e ou melhora da sua condição de saúde. Conclusão Os estudos indicam benefícios gerados pelas práticas sistematizadas implementadas por enfermeiros, por meio de instrumentos e ferramentas para detecção, intervenção e avaliação, além de apoio clínico.