Herpetofauna associada à bromélia rupícola, encholirium spectabile, no semiárido brasileiro: revisão da literatura, ecologia das espécies e comportamento de psychosaura agmosticha (squamata: mabuyidae)

Bromeliads are an important microhabitat for the herpetofauna, for being widely used as refuge from predators and their leaf architecture allows humidity maintenance and relatively constant temperature inside, setting a favorable environment for amphibians and reptiles, especially in areas under hydric stress. However, studies addressing this relationship are still incipient and more concentrated in fitotelmatas bromeliad. For non-fitotelmatas rupicolous bromeliads of the gender Encholirium, which develops into rocky outcrops and contains species of semi-arid regions such as the Caatinga, animal-plant relationships are almost unknown. In this context, this study aimed to know the herpetological fauna inhabitant of macambiras bromeliads, Encholirium spectabile, analyzing occupation and use of these bromeliads by different taxa, and the behavioral ecology of the lizard Psychosaura agmosticha, seeking to identify factors associated with this strict relationship in Caatinga. An extensive review of the world literature on the subject “lizards in bromeliads” subsidized this study from the ecological perspective of this association. The field work was carried out at Fazenda Tanques, municipality of Santa Maria / RN, mesoregion of Agreste Potiguar. The observations and/or data collection in daytime and in the evening was conducted monthly during three consecutive days, from January 2011 to August 2012, totaling 450 hour.man of sampling effort. Sixteen species were registered: six lizards (Mabuyidae, Tropiduridae, Gekkonidae and Phyllodactylidae Families), six snakes (Boidae and Dipsadidae Families) and four of amphibians of Hylidae Family. The effect of the forest edge on the distribution of species along the outcrop was significant, with most species found in outcrop edges. Significant difference was found between some pairs of species concerning use of bromeliads, and almost total niche overlap in the use of microhabitat. 62.5% of the species are nocturnal and use these plants for sheltering, breeding and feeding. Regarding the relations between 4 the lizard Psychosaura agmosticha and macambiras bromeliads, behaviors of thermoregulation and foraging in the dry and wet seasons were recorded. Activity periods were concentrated between 7 and 10 am and between 3 and 5 pm in both seasons, showing a clear bimodal pattern. The species basically used the green leaves and there were no significant differences between males and females in the use of bromeliads. Positive associations were found between body temperature and temperatures of bromeliads and air. This species spent 1.95% ± 3.8 of the time moving (PTM) and moved on average 0:36 ± 2.1 seconds per minute (MPM), with significant differences between the wet and dry to PTM, and between the average time of stop and average duration of movements, being considered a sedentary forager. Psychosaura agmosticha, in the study area, is bromelicolous and uses macambiras primarily for thermoregulation and foraging. The results of this study elevate the rupicolous bromeliads Encholirium spectabile as key elements for the maintenance of amphibians and reptiles associated with it, and a clear advantageous association for the conservation of the groups involved.

Segurança do paciente em terapia intensiva neonatal: identificação e análise de eventos adversos

The patient safety is a major concern in health services for its global dimension, as evidenced by the fragility of care processes that predispose an occurrence of adverse events. These events in a neonatal intensive care unit are considered serious and hazardous to lives of newborns. The present study aimed to identify and analyze adverse events in a neonatal intensive care unit based in Trigger Tool. It is an epidemiological, cross-sectional , exploratory, retrospective study with quantitative, descriptive and analytical approach, performed in 2015 at a school hospital. The sample was not probabilistic, involving 116 newborns who met the eligibility criteria. Data collection was performed by retrospective review of medical records, using a specific kind of "trigger" instrument, composed of sentinel events in neonatology, adapted from the American model used by the Vermont-Oxford Network. Data were analyzed using descriptive and inferential statistics. The chi-square test for linear trend was used to assess the associations between the variables of interest. The research received a favorable agreement from Ethics Committee of the Federal University of Rio Grande do Norte, under number 1055533, and Presentation Certificate for Ethics Assessment 43894515.6.0000.5537. The results show among investigated newborns, 110 experienced at least one adverse event during their stay, with a total of 391 medical records analyzed and rate of 3.37 events per patient. Prevailed the preterm newborns with low birth weight, from mother who had hypertensive diseases during pregnancy and urinary tract infection. The average hospitalization time was 25 days, associated with hospital-acquired infections events (p = 0.01). Among the identified adverse events stood out the events related to thermoregulation disorders (39.0%), with prevalence of hypothermia (26.0%), followed by health care-related infections (16.4%) and blood glucose disorders, hypoglycemia (9.00%) and hyperglycemia (6.64%). Most of these incidents were classified in categories E and F, which represents that there was damage small proportion. Due to these damages come from the care practice with newborn, 78% were classified as avoidable. There was statistically significant association between the variable birth weight with infections (p = 0.006) as well as peri/intraventricular bleeding (p = 0.02), hypoglycemia (p = 0.021), hyperglycemia (p = 0.001), hyperthermia (p = 0.39) and death (p=0,02). Gestational age was associated with seizures (p = 0.002), hyperglycemia (p=0.017) e hyperthermia (p=0.027). The security institution culture was reported by the health workers as intermediate, even though the number of adverse events found in only one unit of service indicates that there is much to be done. Thus the high rate of adverse events identified in the neonatal intensive care unit reinforces the necessity to elaborate specific preventive strategies for this risk environment.

Segurança do paciente em terapia intensiva neonatal: identificação e análise de eventos adversos

The patient safety is a major concern in health services for its global dimension, as evidenced by the fragility of care processes that predispose an occurrence of adverse events. These events in a neonatal intensive care unit are considered serious and hazardous to lives of newborns. The present study aimed to identify and analyze adverse events in a neonatal intensive care unit based in Trigger Tool. It is an epidemiological, cross-sectional , exploratory, retrospective study with quantitative, descriptive and analytical approach, performed in 2015 at a school hospital. The sample was not probabilistic, involving 116 newborns who met the eligibility criteria. Data collection was performed by retrospective review of medical records, using a specific kind of "trigger" instrument, composed of sentinel events in neonatology, adapted from the American model used by the Vermont-Oxford Network. Data were analyzed using descriptive and inferential statistics. The chi-square test for linear trend was used to assess the associations between the variables of interest. The research received a favorable agreement from Ethics Committee of the Federal University of Rio Grande do Norte, under number 1055533, and Presentation Certificate for Ethics Assessment 43894515.6.0000.5537. The results show among investigated newborns, 110 experienced at least one adverse event during their stay, with a total of 391 medical records analyzed and rate of 3.37 events per patient. Prevailed the preterm newborns with low birth weight, from mother who had hypertensive diseases during pregnancy and urinary tract infection. The average hospitalization time was 25 days, associated with hospital-acquired infections events (p = 0.01). Among the identified adverse events stood out the events related to thermoregulation disorders (39.0%), with prevalence of hypothermia (26.0%), followed by health care-related infections (16.4%) and blood glucose disorders, hypoglycemia (9.00%) and hyperglycemia (6.64%). Most of these incidents were classified in categories E and F, which represents that there was damage small proportion. Due to these damages come from the care practice with newborn, 78% were classified as avoidable. There was statistically significant association between the variable birth weight with infections (p = 0.006) as well as peri/intraventricular bleeding (p = 0.02), hypoglycemia (p = 0.021), hyperglycemia (p = 0.001), hyperthermia (p = 0.39) and death (p=0,02). Gestational age was associated with seizures (p = 0.002), hyperglycemia (p=0.017) e hyperthermia (p=0.027). The security institution culture was reported by the health workers as intermediate, even though the number of adverse events found in only one unit of service indicates that there is much to be done. Thus the high rate of adverse events identified in the neonatal intensive care unit reinforces the necessity to elaborate specific preventive strategies for this risk environment.