13 resultados para requirement for consent discontinuance
em Repositório Institucional UNESP - Universidade Estadual Paulista "Julio de Mesquita Filho"
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Objective To compare the effect of intraperitoneal (IP) or incisional (INC) bupivacaine on pain and the analgesic requirement after ovariohysterectomy in dogs.Study design Prospective, randomized clinical study.Animals Thirty female dogs undergoing ovariohysterectomy (OHE).Methods Dogs admitted for elective OHE were anesthetized with acepromazine, butorphanol, thiopental and halothane. Animals were randomly assigned to one of three groups (n = 10 per group). The treatments consisted of preincisional infiltration with saline solution (NaCl 0.9%) or bupivacaine with epinephrine and/or IP administration of the same solutions, as follows: INC and IP 0.9% NaCl (control group); INC 0.9% NaCl and IP bupivacaine (5 mg kg(-1), IP group); INC bupivacaine (1 mg kg(-1)) and IP 0.9% NaCl (INC group). Postoperative pain was evaluated by a blinded observer for 24 hours after extubation by means of a visual analog scale (VAS) and a numeric rating scale (NRS). Rescue analgesia (morphine, 0.5 mg kg(-1), IM) was administered if the VAS was > 5/10 or the NRS > 10/29.Results At 1 hour after anesthesia, VAS pain scores were [medians (interquartile range)]: 6.4 (3.1-7.9), 0.3 (0.0-2.6) and 0.0 (0.0-7.0) in control, IP and INC groups, respectively. VAS pain scores were lower in the IP compared to the control group. Over the first 24 hours, rescue analgesia was administered to 7/10, 5/10 and 3/10 dogs of the control, INC and IP groups, respectively. Total number of dogs given rescue analgesia over the first 24 hours did not differ significantly among groups.Conclusions and clinical relevance Intraperitoneal bupivacaine resulted in lower pain scores during the first hour of the postoperative period and there was a trend towards a decreased need for rescue analgesia after OHE in dogs.
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Ten isonitrogenous casein-gelatin-based diets were formulated to contain five estimated metabolizable energy concentrations (10.92, 12.29, 13.63, 14.82 and 16.16 kJ g -1) at two carbohydrate-to-lipid ratios (CHO : L, 5.3 and 12.8, g : g) in a 5 × 2 factorial arrangement. Each diet was assigned to triplicate groups of 11 piracanjuba fingerlings (5.25 ± 0.14 g) and fed to apparent satiation twice a day for 90 days. Higher daily weight gain was obtained by fish fed the 13.63 kJ g -1 diets for both CHO : L ratios. There was a significant reduction of feed consumption when dietary energy concentration increased above 13.63 kJ g -1. Feed conversion ratio and apparent net energy retention improved as dietary energy increased. Apparent net protein retention tended to be lower in the highest and lowest dietary energy concentrations. The results suggest that dietary lipid energy was more efficiently utilized by piracanjuba fingerlings than carbohydrate energy. Body composition and hepatosomatic index (HSI) were not influenced by dietary CHO : L ratio. However, an increase in dietary energy concentration beyond 13.63 kJ g -1 resulted in a significant increment in lipid deposition, while body moisture and HSI decreased. Our findings indicate that at 300 g kg -1 dietary crude protein, a CHO : L ratio of 5.3 is recommended for piracanjuba, and the required energy is either 13.63 kJ g -1 if raised for aquaculture or 14.82 kJ g -1 if destined to stock enhancement. © 2006 Blackwell Publishing Ltd.
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Juvenile Nile tilapia, Oreochromis niloticus, were fed to apparent satiation twice daily with purified diets containing 0, 1.0, 2.0, 4.0, 8.0, and 16.0 mg/kg and 0, 2.0, 4.0, 8.0, 16.0, and 32.0 mg/kg of thiamin in separate 14- and 8-wk trials (Experiments 1 and 2, respectively). Fish fed the diet devoid of thiamin developed neurological disorders, anorexia, reduced growth, and feed efficiency and increased mortality (Experiment 2 only) within 4-6 and 8-10 wk for Experiments 2 and 1, respectively. Low red blood cell count (RBC) and hematocrit (Ht) were observed in fish fed the thiamin-deficient diet. Serum pyruvate was elevated in fish fed the thiamin unsupplemented diet. Serum lactate was not affected by dietary thiamin levels. Whole body protein was unaffected by dietary levels of thiamin. Body moisture and ash increased whereas body lipid decreased in fish fed the thiamin unsupplemented diets. None of these abnormalities were observed in fish fed the thiamin-supplemented diets. Using the response curves determined by PROC NLMIXED to estimate dietary thiamin levels required for various response variables, a dietary thiamin level of 3.5 mg/kg diet was adequate for optimum growth, feed intake and efficiency, survival, prevention of neurological symptoms, and maintaining normal levels of RBC, Ht, serum pyruvate, and proximate body composition. © 2011.
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The software industry has become more and more concerned with the appropriate application of activities that composes requirement engineering as a way to improve the quality of its products. In order to support these activities, several computational tools have been available in the market, although it is still possible to find a lack of resources related to some activities. In this context, this paper proposes the inclusion of a module to aid in the requirements specification to a tool called Requirements Elicitation Support Tool. This module allows to specify requirements in accordance with IEEE 830 standard, thus contributing to the documentation of the requirements established for a software system, besides supporting the learning of concepts related to the requirements specification, which improves the skills of users of the tool. © 2012 IEEE.
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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There is a growing search for continuous improvement within the companies which creates an obligation of reducing and when it is possible eliminating waste. Production Planning and Control Department (PCP) is not out of this question, making necessary the application of methods and creation of tools that eliminate steps which do not add value to the planning process. This paper aims to develop a tool which concentrates in just one place all the necessary information to make the packaging material requirement planning (MRP) in a agribusiness company. Besides, it also aims, in a more visual way and using devices that prevent mistakes (Poka-Yoke), to reduce the number of reviews and mistakes made by analysts. As a result, an Excel spreadsheet was developed. This spreadsheet shows what happens with the status of planning and receiving of packaging, giving some advices when some critical situation happens. The use of Lean Manufacturing Method and the action research method helped to well define the problem and to reduce the number of steps, spreadsheets and time of process in 80%, 60% and 75%, respectively
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This study was performed as a requirement of the final course in Nursing. The study is cross-cutting, in order to identify associations between socioeconomic factors, education, child hospitalization in the ICU or not, degree of depression and level of social support (material, affective, emotional, informational and positive social interaction) and how to identify subgroups of mother - child vulnerable. Constitute themselves as subjects, mothers of children 0 to 17 years, 11 months and 29 days in hospital after the second day of hospitalization in the pediatric unit of a State Hospital Interior Paulista. Data collection was initiated after obtaining the assent of the Research Ethics Committee, as well as signing the consent form. We used the following instruments to collect data: the data form for socioeconomic and hospitalization; Beck Depression Inventory and Medical Outcomes Study (MOS). We obtained the result that there is a strong association between availability and social support and income per capita and the degree of depression, but did not find an association between time and hospital stay and whether the child was admitted to the ICU or not. We conclude that it is necessary to establish treatment services from the patient’s family, plus an appropriate social service support to meet this big demand for mothers who need support
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It is required that patients are provided information about therapeutic possibilities, showing the risks, benefits, prognosis and costs of each possible and indicated alternative. This is an ethical and legal resolution. However, health professionals possess the clinical/technical/scientific knowledge and determine what information will be (or not) provided. The patient in question decides to undergo a treatment, providing his/her free and informed consent on the basis of the data presented. Unfortunately, some professionals may not provide all the information necessary for making an informed decision or, after obtaining the consent of the patient, may provide him information that causes the patient to give up on the treatment initially accepted. Such information, if relevant, and not a supervening fact, should have been provided initially. However, the information may not be entirely true, and bring the patient, for instance, to decide based on inadequately presented risks. The craniofacial rehabilitation of the temporomandibular joint (TMJ) by means of TMJ prosthesis, is indicated in many situations. Often, patients in need of such prostheses have aesthetic and functional problems and the rehabilitation expectations run high. This work presents a case and discusses ethical and legal issues, including the liability of partial and inadequate information to a patient.
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To understand the perception of the participants in controlled clinical trials (CCTs) about the informed consent and describe the meaning of their participation in the research. Qualitative study using the focus group technique. The sample was composed of 19 patients who participated in clinical trials about hypertension and coronary disease in a specialized cardiologic hospital located in the city of Sao Paulo. The methodological framework used was the content analysis. Some of the participants were aware of the real objective of these studies while others had misperceptions. The reading of the informed consent is not always done and, when it is done, the patient does not understand it. The lack of understanding about the term ''placebo'' was mentioned by some participants. The motivation to participate was the personal benefit. This study shows that obtaining the informed consent in CCTs is complex and that there is the need to adapt the structure and application of this document, in order to protect the participants and improve the quality of clinical trials performed in the country.