Mid- to late-Holocene paleoceanographic changes on the southeastern Brazilian shelf based on grain size records

; High-resolution grain size analyses of three AMS (14)C-dated cores from the Southeastern Brazilian shelf provide a detailed record of mid- to late-Holocene environmental changes in the Southwestern Atlantic Margin. The cores exhibit millennial variability that we associate with the previously described southward shift of the Inter Tropical Convergence Zone (ITCZ) average latitudinal position over the South American continent during the Holocene climatic maximum. This generated changes in the wind-driven current system of the SW Atlantic margin and modified the grain size characteristics of the sediments deposited there. Centennial variations in the grain size are associated with a previously described late-Holocene enhancement of the El Nino-Southern Oscillation (ENSO) amplitude, which led to stronger NNE trade winds off eastern Brazil, favouring SW transport of sediments from the Paraiba do Sul River. This is recorded in a core from off Cabo Frio as a coarsening trend from 3000 cal. BP onwards. The ENSO enhancement also caused changes in precipitation and wind pattern in southern Brazil, allowing high discharge events and northward extensions of the low-saline water plume from Rio de la Plata. We propose that this resulted in a net increase in northward alongshore transport of fine sediments, seen as a prominent fine-shift at 2000 cal. BP in a core from similar to 24 degrees S on the Brazilian shelf. Wavelet-and spectral analysis of the sortable silt records show a significant similar to 1000-yr periodicity, which we attribute to solar forcing. If correct, this is one of the first indications of solar forcing of this timescale on the Southwestern Atlantic margin.

Post-operative mediastinitis in a Heart Hospital of Recife: contributions for nursing care

The objective of this study was to determine the prevalence of post-operative mediastinitis with the purpose to contribute to nursing care knowledge. To do this, an analysis was performed on 896 medical records of patients who underwent heart surgery involving sternotomy at the Cardiology Emergency Room of Recife-PE, in the period between June 2007 and June 2009. The following variables were considered: gender, age, type of surgery, personal history, length of stay, use of antibiotics, and culture of the surgical wound. A high death rate from mediastinitis was observed (33.3%). Several risk factors were identified, including: systemic arterial hypertension (80.9%); smoking (61.9%); diabetes mellitus (42.8%); and obesity (33.3%), most of which (76.2%) were identified in patients who underwent surgery for myocardial revascularization. It is concluded that mediastinitis is a serious infection that needs continuous nursing supervision and preventive measures to assure an early diagnosis and, thus, reduce mortality.

Complete denture wear during sleep in elderly sleep apnea patients-a preliminary study

There is no consensus in the literature about the impact of complete denture wear on obstructive sleep apnea (OSA). The goal of this randomized clinical study was to assess if complete denture wear during sleep interferes with the quality of sleep. Elderly edentulous OSA patients from a complete denture clinic were enrolled and received new complete dentures. An objective sleep analysis was determined with polysomnography performed at the sleep laboratory for all patients who slept either with or without their dentures. Twenty-three patients (74% females) completed the study with a mean age of 69.6 years and a mean body mass index of 26.7 kg/m(2). The apnea and hypopnea index (AHI) was significantly higher when patients slept with dentures compared to without (25.9 +/- 14.8/h vs. 19.9 +/- 10.2/h; p > 0.005). In the mild OSA group, the AHI was significantly higher when patients slept with the dentures (16.6 +/- 6.9 vs. 8.9 +/- 2.4; p < 0.05), while in moderate to severe OSA patients, the AHI was not significantly different when sleeping with dentures (.30.8 +/- 15.6 vs. 25.7 +/- 7.5; p = 0.2). The supine AHI in mild patients was related to a higher increase in AHI while wearing dentures (12.7 +/- 8.4/h vs. 51.9 +/- 28.6/h; p < 0.001). A limitation of the study is that the mild OSA patients had a higher BMI when compared to the moderate to severe OSA patients. Ten out of 14 patients who preferred to sleep with their upper and lower dentures showed an increase in their AHI while wearing dentures to sleep. Contrary to previous studies, we found that OSA patients may experience more apneic events if they sleep with their dentures in place. Specifically, in mild OSAS patients, the use of dentures substantially increases the AHI especially when in the supine position.

Toward the optimal dose metric in continuous renal replacement therapy

Purpose: There is no consensus on the optimal method to measure delivered dialysis dose in patients with acute kidney injury (AKI). The use of direct dialysate-side quantification of dose in preference to the use of formal blood-based urea kinetic modeling and simplified blood urea nitrogen (BUN) methods has been recommended for dose assessment in critically-ill patients with AKI. We evaluate six different blood-side and dialysate-side methods for dose quantification. Methods: We examined data from 52 critically-ill patients with AKI requiring dialysis. All patients were treated with pre-dilution CWHDF and regional citrate anticoagulation. Delivered dose was calculated using blood-side and dialysis-side kinetics. Filter function was assessed during the entire course of therapy by calculating BUN to dialysis fluid urea nitrogen (FUN) ratios q/12 hours. Results: Median daily treatment time was 1,413 min (1,260-1,440). The median observed effluent volume per treatment was 2,355 mL/h (2,060-2,863) (p<0.001). Urea mass removal rate was 13.0 +/- 7.6 mg/min. Both EKR (r(2)=0.250; p<0.001) and K-D (r(2)=0.409; p<0.001) showed a good correlation with actual solute removal. EKR and K-D presented a decline in their values that was related to the decrease in filter function assessed by the FUN/BUN ratio. Conclusions: Effluent rate (ml/kg/h) can only empirically provide an estimated of dose in CRRT. For clinical practice, we recommend that the delivered dose should be measured and expressed as K-D. EKR also constitutes a good method for dose comparisons over time and across modalities.

Natural fiber-reinforced thermoplastic starch composites obtained by melt processing

Thermoplastic starch (TPS) from industrial non-modified corn starch was obtained and reinforced with natural strands. The influence of the reinforcement on physical-chemical properties of the composites obtained by melt processing has been analyzed. For this purpose, composites reinforced with different amounts of either sisal or hemp strands have been prepared and evaluated in terms of crystallinity, water sorption, thermal and mechanical properties. The results showed that the incorporation of sisal or hemp strands caused an increase in the glass transition temperature (T-g) of the TPS as determined by DMTA. The reinforcement also increased the stiffness of the material, as reflected in both the storage modulus and the Young's modulus. Intrinsic mechanical properties of the reinforcing fibers showed a lower effect on the final mechanical properties of the materials than their homogeneity and distribution within the matrix. Additionally, the addition of a natural latex plasticizer to the composite decreased the water absorption kinetics without affecting significantly the thermal and mechanical properties of the material. (c) 2012 Elsevier Ltd. All rights reserved.

Income inequality and elderly self-rated health in Sao Paulo, Brazil

Purpose: To test the association between income inequality and elderly self-rated health and to propose a pathway to explain the relationship. Methods: We analyzed a sample of 2143 older individuals (60 years of age and over) from 49 distritos of the Municipality of Sao Paulo, Brazil. Bayesian multilevel logistic models were performed with poor self-rated health as the outcome variable. Results: Income inequality (measured by the Gini coefficient) was found to be associated with poor self-rated health after controlling for age, sex, income and education (odds ratio, 1.19; 95% credible interval, 1.01-1.38). When the practice of physical exercise and homicide rate were added to the model, the Gini coefficient lost its statistical significance (P>.05). We fitted a structural equation model in which income inequality affects elderly health by a pathway mediated by violence and practice of physical exercise. Conclusions: The health of older individuals may be highly susceptible to the socioeconomic environment of residence, specifically to the local distribution of income. We propose that this association may be mediated by fear of violence and lack of physical activity. (C) 2012 Elsevier Inc. All rights reserved.

Psicoterapia como estratégia de tratamento dos transtornos alimentares: análise crítica do conhecimento produzido

O objetivo deste estudo foi empreender uma análise crítica acerca do conhecimento científico produzido sobre a utilização das psicoterapias como estratégia de tratamento dos transtornos alimentares. A partir de buscas nas bases PsycINFO, PePSIC e SciELO, no período entre 1999 e 2011, foram recuperados 35 artigos, categorizados em: psicoterapias breves, grupais, psicodinâmicas, complementares, bem como psicoterapias aliadas a outros tratamentos, como o psicofarmacológico. As abordagens mais frequentemente mencionadas foram psicodinâmicas e cognitivo-comportamentais. A modalidade de atendimento predominante foi a grupal. Ainda que preconizando o uso combinado de diversas estratégias, a literatura é unânime em destacar a importância das psicoterapias no tratamento. A análise crítica evidenciou necessidade de leituras que transcendam a mera identificação de técnicas psicoterápicas consideradas mais eficazes para o tratamento dos transtornos alimentares. Deve-se considerar o contexto mais amplo no qual os tratamentos são propostos, bem como promover um diálogo aberto entre enfoques teóricos, valorizando a pluralidade de saberes e a psicoterapia como prática em permanente transformação.

Microclimate under different shading screens in greenhouses cultivated with bromeliads

This study had as its objective the evaluation of the influence of shading screens of different colors on the different microclimate variables in a greenhouse covered with transparent low-density polyethylene (LDPE). The experiment was conducted with five treatments: thermo-reflective screen (T1); a control - without screen (T2); red screen (T3); blue screen (T4); and black screen (T5), all of them with 70% of shading. An automatic micrometeorological station was installed in each treatment, measuring air temperature (T), relative humidity (RH), incoming solar radiation (Rg), photosynthetically active radiation (PAR) and net radiation (Rn) continuously. The control (T2) and red screen (T3) treatments promoted the highest solar radiation transmissivity, respectively 56.3 and 27%. The black screen (T5) had the lowest solar radiation transmissivity (10.4%). For PAR and Rn the same tendency was observed. The highest temperature was observed under blue screen (T4) treatment, which was 1.3 °C higher than external condition. Blue screen (T4) treatment also presented the highest relative humidity difference between inside and outside conditions.