Nursing Activities Score: avaliação da carga de trabalho de enfermagem em unidade de terapia intensiva adulto

The sizing of nursing human resources is an essential management tool to meet the needs of the patients and the institution. Regarding to the Intensive Care Unit, where the most critical patients are treated and the most advanced life-support equipments are used, requiring a high number of skilled workers, the use of specific indicators to measure the workload of the team becomes necessary. The Nursing Activities Score is a validated instrument for measuring nursing workload in the Intensive Care Unit that has demonstrated effectiveness. It is a cross-sectional study with the primary objective of assessing the workload of nursing staff in an adult Intensive Care Unit through the application of the Nursing Activities Score. The study was conducted in a private hospital specialized in the treatment of patients with cancer, which is located in the city of Natal (Rio Grande do Norte – Brazil). The study was approved by the Research Ethics Committee of the hospital (Protocol number 558.799; CAAE 24966013.7.0000.5293). For data collection, a form of sociodemographic characteristics of the patients was used; the Nursing Activities Score was used to identify the workload of nursing staff; and the instrument of Perroca, which classifies patients and provides data related to the their need for nursing care, was also used. The collected data were analyzed using a statistical package. The categorical variables were described by absolute and relative frequency, while the number by median and interquartile range. Considering the inferential approach, the Spearman test, the Wald chi-square, Kruskal Wallis and Mann-Whitney test were used. The statistically significant variables were those with p values <0.05. The evaluation of the overall averages of NAS, considering the first 15 days of hospitalization, was performed by the analysis of Generalized Estimating Equations (GEE), with adjust for the variable length of hospitalization. The sample consisted of 40 patients, in the period of June to August 2014. The results showed a mean age of 62,1 years (±23,4) with a female predominance (57,5%). The most frequent type of treatment was clinical (60,0%), observing an average stay of 6,9 days (±6,5). Considering the origin, most patients (35%) came from the Surgical Center. There was a mortality rate of 27,5%. 277 measures of NAS score and Perroca were performed, and the averages of 69,8% (±24,1) and 22,7% (±4.2) were obtained, respectively. There was an association between clinical outcome and value of the Nursing Activities Score in 24 hours (p <0.001), and between the degree of dependency of patients and nursing workload (rp 0,653, p<0,001). The achieved workload of the nursing staff, in the analyzed period, was presented high, showing that hospitalized patients required a high demand for care. These findings create subsidies for sizing of staff and allocation of human resources in the sector, in order to achieve greater safety and patient satisfaction as a result of intensive care, as well as an environment conducive to quality of life for the professionals

Estudo da capacidade de remoção de óleo solúvel, em águas produzidas, por bentonitas hidrofobizadas

In this study we evaluated the capacity removal of PAHs in an oily solution between the bentonite hydrofobized with linseed oil and paraffin with natural bentonite. Analyses of natural bentonite and hydrofobized were made by the characterization techniques: (1) Thermogravimetric Analysis (TGA), which aimed to evaluate the thermal events due to mass loss, both associated with the exit of moisture and decomposition of clay as due to hidrofobizante loss agent. (2) Analysis of X-ray diffraction (XRD) in order to determine the mineralogical phases that make up the structure of clay and (3) Spectrophotometry in the infrared region used to characterize the functional groups of both the matrix mineral (bentonite) and the hidrofobizantes agents (linseed oil and paraffin). We used a factorial design 24 with the following factors; hidrofobizante, percent hidrofobizante, adsorption time and volume of the oily solution. Analyzing the factorial design 24 was seen that none of the factors apparently was more important than the others and, as all responses showed significant values in relation to the ability of oil removal was not possible to evaluate a difference in the degree of efficiency the two hidrofobizantes. For the new study compared the efficiency of the modified clay, with each hidrofobizante separately in relation to their natural form. As such, there are four new factorial designs 23 using natural bentonite as a differentiating factor. The factors used were bentonite (with and without hydrophobization), exposure time of the adsorbent material to the oily solution and volume of an oily solution, trying to interpret how these factors could influence the process of purifying water contaminated with PAHs. Was employed as a technique for obtaining responses to fluorescence spectroscopy, as already known from literature that PAHs, for presenting combined chains due to condensation of the aromatic rings fluoresce quite similar when excited in the ultraviolet region and as an auxiliary technique to gas chromatography / mass spectrometry (GC-MS) used for the analysis of PAHs in order to complement the study of fluorescence spectroscopy, since the spectroscopic method only allows you an idea of total number of fluorescent species contained in the oil soluble. The result shows an excellent adsorption of PAHs and other fluorescent species assigned to the main effect of the first factor, hydrophobization for the first planning 23 BNTL 5%, for 93% the sixth stop in the second test (+-+),factorial design 23 BNTL 10%, the fourth test (++-) with 94.5% the third factorial design 23 BNTP 5%, the second test (+--) with 91% and the fourth and final planning 23 BNTP 10%, the last test ( + + +) with 88%. Compared with adsorption of bentonite in its natural form. This work also shows the maximum adsorption of each hidrofobizante

Conhecimento de si e unidade: considerações sobre a alma em Plotino

L'obiettivo di questa tesi è quello di sviluppare una analisi dell'idea dell'immortalità dell'anima dalle Enneadi di Plotino attraverso la comprensione del discorso dell'anima come eterno, e unità-pluralità ricerca di semplicità con la Uno sulla temporalità del corpo multiple. Per fare ciò, abbiamo iniziato cercando di analizzare brevemente le plotinianas ipostasi (l'Uno, lo spirito e l'anima) per stabilire meglio le basi del pensiero di Plotino quando si discute l'idea dell'anima e la sua immortalità. Cerchiamo di esaminare il pensiero epistéme di Plotino e la sua dialettica, al fine di sviluppare una comprensione del rapporto tra materia e forma sensibile e intelligibile. In questo modo, si sviluppa nelle Enneadi di Plotino il ruolo fondamentale del Logos e il Logoi nella formazione dell'anima. Analizziamo anche la processione (Proódos) e ritorno (Epistrophé) le implicazioni degli aspetti dell'eternità sulla purificazione dell'anima nella temporalità del corpo. Cerchiamo in ultima analisi, l'idea dell'immortalità dell'anima dalla conoscenza stessa immortalità sulla semplicità di Colui, cioè, l'ultima volta che la ricerca della conoscenza di sé dalla dimenticanza di sé per è solo con l'Uno: il "Elimina ogni cosa" (Aphele pánta).

Caracterização de água de lavagem de filtros em estações de tratamento de água de filtração direta

The water supply and treatment is considered as a great benefit considering that, if done efficiently, provides public health. However, considering the WTP (Water Treatment Plant) is an industry, with its inputs and waste generation, they must be constantly evaluated and monitored to verify the best and most appropriate way to process and dispose their waste, minimizing therefore the potential impacts to the environment. By volume, the most significant waste is the rapid filter backwash water. It is very common the disposal of this waste without treatment in water sources, which are used, for the most part, as a water supply source of a downstream population. This study evaluated quantitative and qualitative parameters in filter backwash water in three WTP - Itaitinga, Maranguape and Pacatuba, located in Ceará State, northeast of Brazil. It was found that the Maranguape WTP, in terms of treatment capacity, is the larger. The Itaitinga WTP is the one that consumes more water during filters washing. The Pacatuba WTP exhibited higher concentration of total suspended and settleable solids, COD and aluminum in the filters backwash water. It is noteworthy that the settleable solids and total suspended solids in all three WTP are above the effluent discharge standard recommended by Resolution 154/2002 of SEMACE (State Superintendent of Environment of Ceará). It was concluded that the filter backwash water from the study WTP exceeded the allowed values for legislation to be disposed directly into surface water bodies. It is suggested as an alternative to treat and recycle the filter backwashing water the construction of sludge settling ponds.