14 resultados para purposes

em Repositório Institucional UNESP - Universidade Estadual Paulista "Julio de Mesquita Filho"


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Background: The identification of patterns of inappropriate antimicrobial prescriptions in hospitals contributes to the improvement of antimicrobial stewardship programs (ASP). Methods: We conducted a cross-sectional study to identify predictors of inappropriateness in requests for parenteral antimicrobials (RPAs) in a teaching hospital with 285 beds. We reviewed 25% of RPAs for therapeutic purposes from y 2005. Appropriateness was evaluated according to current guidelines for antimicrobial therapy. We assessed predictors of inappropriateness through univariate and multivariate models. RPAs classified as 'appropriate' or 'probably appropriate' were selected as controls. Case groups comprised inappropriate RPAs, either in general or for specific errors. Results: Nine hundred and sixty-three RPAs were evaluated, 34.6% of which were considered inappropriate. In the multivariate analysis, general predictors of inappropriateness were: prescription on week-ends/holidays (odds ratio (OR) 1.67, 95% confidence interval (CI) 1.20-2.28, p = 0.002), patient in the intensive care unit (OR 1.57, 95% CI 1.11-2.23, p = 0.01), peritoneal infection (OR 2.15, 95% CI 1.27-3.65, p = 0.004), urinary tract infection (OR 1.89, 95% CI 1.25 -2.87, p = 0.01), combination therapy with 2 or more antimicrobials (OR 1.72, 95% CI 1.15-2.57, p = 0.008) and prescriptions including penicillins (OR 2.12, 95% CI 1.39-3.25, p = 0.001) or 1(st) generation cephalosporins (OR 1.74, 95% CI 1.01-3.00, p = 0.048). Previous consultation with an infectious diseases (ID) specialist had a protective effect against inappropriate prescription (OR 0.34, 95% CI 0.24-0.50, p < 0.001). Factors independently associated with specific prescription errors varied. However, consultation with an ID specialist was protective against both unnecessary antimicrobial use (OR 0.04, 95% CI 0.01-0.26, p = 0.001) and requests for agents with an insufficient antimicrobial spectrum (OR 0.14, 95% CI 0.03-0.30, p = 0.01). Conclusions: Our results demonstrate the importance of previous consultation with an ID specialist in assuring the quality of prescriptions. Also, they highlight prescription patterns that should be approached by ASP policies.

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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The sugar cane crop according to several authors can generate, besides the industrialized stalks, an amount of crop residues from the order of 15 to 30% in weight of the aerial part of the plants, depending on the field conditions. The sugar cane area in Brazil is around 5.5×106 hectares, with an amount of 400.106 tons of stalks, with stalks yield of 72 tons.ha-1 (Unica, 2005). This study took place in a sugar cane plot (Latitude 22°46'S, Longitude 47°23'W and 600m of altitude) with 3% of slope, located in São Paulo State. The sugar cane variety was SP 80-1816, in its forth cut, 11 months old and with a planted row spacing of 1.40m. By other side, several sugar mills are bringing the crop residue to their patio to produce energy with the bagasse. One way for that is the baling operation to bring the crop residue at the sugar mill. Some fundamental variables were obtained to define the best set of machines to work with in sugar cane crop residue removal in the baling system among the studied ones, some of the variables were: Soil Index (T1 = 0.83%, T2 = 0.46%, T3 = 0.65%, T4 = 0.57%); Energy Efficiency (T1 = 82.48%, T2 = 83.88%, T3 = 82.83% and T4 = 82.97%) of the system and Effective Cost for Equivalent Energy in US$.EBP-1 (T1 = 11.10, T2= 10.46, T3 = 11.47 and T4 = 10.57) of the baled trash delivered at the sugar mill.

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This project has been developed to evaluate the possible relationship between the cesspit (pit latrine) in as far as it degrades the quality of underground water. Its importance is due to the fact that in the rural communities in the State of São Paulo (Brazil) this type of cesspit is very common as a means of sewage disposal and these communities use underground water for their supply of drinking water. Rural properties distributed over the rural area in the municipality of São José do Rio Preto were selected. A preliminary study was then set up to determine the social situation and health of the households as well as qualitative evaluations on the type of water supply and sewage disposal of these communities. Campaigns of water sampling then followed and laboratory analyses of water taken from wells were carried out. Parameters were set up to evaluate the potability according to Brazilian legislation (2004) paying attention to microbiologic (coliforms, Crytosporidium sp., and adenovirus). The analyses showed evidence of possible interaction between the wells and the sewage effluents and drainage in these communities. A PCR reaction to detect adenovirus showed a presence in 53.3% of the samples. The tests for the detection of Cryotosporidium sp all showed a negative result.

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Thinking about nursing education implies articulating this issue with the expressions of theoretical frameworks, from the perspective of a pedagogical aspect that includes both constructivism and competencies. The objective was to characterize, from a longitudinal view, the construction of care competencies that exist in the teaching plans of nursing undergraduate programs. This exploratory-descriptive study used a qualitative approach. Documentary analysis was performed on the nine teaching plans of undergraduate care subjects. The ethical-legal aspects were guaranteed, so that data was collected only after the study had been approved by the Research Ethics Committee. The data evidenced a curriculum organization centered on subjects, maintaining internal rationales that seem to resist summative organizations. Signs emerge of hardly substantial links between any previous knowledge and the strengthening of critical judgment and clinical reasoning. As proposed, the study contributed with reconsiderations for the teachinglearning process and showed the influence of constructivism on the proposal of clinical competencies.

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The TV is a potential midia of communication that affects all social classes and it is available in 98% of Brazilian homes. It has been used as a distributor of educational materials since the 1950s. By 2016 the Open Digital TV (ODTV) in Brazil might cover the entire national territory, replacing the TV with analog signals. Concerns about accessibility for People with Special Needs (PSN) in that media have become more intense since the 1990s worldwide. In Brazil, it is estimated 24.6 million of PSN, 23% of them having some type of hearing loss. Of these, 2.9% are reported as deafs. Brazilian Sign Language (LIBRAS) is considered the first literacy language for deaf people in Brazil. In this context, this paper presents a proposal to facilitate the generation of educational content for ODTV based on two components. One is called SynchrLIBRAS and allows subtitles synchronization in Portuguese and a LIBRAS translator window of videos downloaded from the Web. The second component allows the visualization of this content through the Brazilian System of Digital TV and IPTV - environments that implement the middleware Ginga-NCL. The main focus of this paper is the presentation of the first component: SynchrLIBRAS. This proposal has educational purposes, contributing to teach LIBRAS to people who may collaborate with social inclusion of the deaf people.

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In this work, experimental results are reported for a small scale cogeneration plant for power and refrigeration purposes. The plant includes a natural gas microturbine and an ammonia/water absorption chiller fired by steam. The system was tested under different turbine loads, steam pressures and chiller outlet temperatures. An evaluation based on the 1st and 2nd Laws of Thermodynamics was also performed. For the ambient temperature around 24°C and microturbine at full load, the plant is able to provide 19 kW of saturated steam at 5.3 bar (161 °C), corresponding to 9.2 kW of refrigeration at -5 °C (COP = 0.44). From a 2nd law point-of-view, it was found that there is an optimal chiller outlet temperature that maximizes the chiller exergetic efficiency. As expected, the microturbine presented the highest irreversibilities, followed by the absorption chiller and the HRSG. In order to reduce the plant exergy destruction, it is recommended a new design for the HRSG and a new insulation for the exhaust pipe. © 2013 Elsevier Ltd. All rights reserved.

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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The broader knowledge about physical and mechanical properties of wood allows reliable timber structures design. Even little addressed in the literature, in several situations Poisson's ratios are required for the evaluation of stresses acting on structural elements. This study aimed to obtain values of Poisson's ratios (ν), plans Longitudinal-Radial (νLR) and Longitudinal-Tangential (νLT), for species Peroba Rosa (Aspidosperma polyneuron) and Jatobá (Hymenaea courbaril L.). For this purpose, forty samples Peroba Rosa and eight samples of Jatobá were prepared for testing in compression parallel to the grain, following the recommendations of ABNT NBR 7190 standard. The results of means confidence intervals, considered at the level of 5% significance, revealed that the Poisson's ratios νLR e νLT to Peroba Rosa are 0.27 and 0.42, respectively, and 0.25 and 0.43 to Jatobá.