Comfort of the patient's family in an Intensive Care Unit related to welcoming

This study aimed to identify the level of comfort of families of patients in a critical health condition related to the welcoming practices performed by the hospital staff. Interviews were conducted with 250 relatives in hospitals of the state Bahia, using a Likert scale. Data were analyzed as percentages and quartiles. For nine of the 12 statements of the scale, most relatives scored their comfort level between very and totally comfortable, median of 4,revealing kindness, tranquility and friendly communication with family members. More than half of the sample scored its level as not at all to more or less comfortable, median of 3, for statements about demonstration of interest towards the relative by the staff and flexible visiting of the patient. The necessity of greater interest of the team in the condition and needs of the family was observed. Promoting comfort from the dimension of welcoming demands interdisciplinary actions grounded in humanistic philosophy, in which the nurse has an important role to play.

Cancer Patients Caregivers Comfort

Cross-sectional study, carried out at the outpatient clinic of an oncology hospital. Data were collected from 88 caregivers of cancer patients using the Caregiver General Comfort Questionnaire (GCQ) to assess the caregivers’ comfort. The caregivers’ GCQ score mean was 203.9; better comfort scores was associated with age, care time and current occupation; positive aspects of comfort were related to the fact that caregivers felt loved, to patients’ physical and environmental comfort and to caregivers’ spirituality. 203.9; better comfort scores were associated with age of the caregiver and current occupation; positive aspects of comfort were related to the fact that caregivers felt loved, to patients’ physical and environmental comfort and to caregivers’ spirituality. Caregivers, who didn’t have a paid job or leisure’s activities showed a worse GCQ. The GCQ scale can help to identify factors that interfere in caregivers’ comfort, as well as needs that can be modified through health professionals’ interventions.


Thermal comfort indices in individual shelters for dairy calves with different types of roofs

Among the building materials used in rural facilities, roofs are noteworthy for being largely responsible for thermal comfort, influencing the thermal balance within the shelter. This study aimed to evaluate the influence of roof on the Enthalpy (H), Thermal Load of Radiation (TLR), and Black Globe Temperature and Humidity Index (BGHI) in individual shelters for dairy calves. The design was completely randomized with three treatments: Z - zinc tile, AC - asbestos-cement tile and ACW - asbestos-cement tile painted white on the upper side. The averages were compared by the Scott Knott test at 1% probability. The results showed no statistical difference between treatments (P<0.01) and the external environment for H. For TLR, there was statistical difference among all treatments, where ACW showed the lowest TLR, 489.28 W m-2, followed by AC with 506.72 W m-2 and Z with the highest TLR, 523.55 W m-2. For BGHI, the lowest values were observed for ACW (76.8) and AC (77.4), differing significantly from Z, which obtained the highest value (81.6). The tiles with white paint on the upper side promoted the lowest TLR and the lowest BGHI, favoring the thermal environment in the shelter.

Environmental comfort in constructions for Sindi and Guzera calves in the agreste region of the State of Paraiba, Brazil

The objective of this study was to evaluate the quality of air, bioclimatic indexes of facilities and physiological indices of Guzera and Sindhi calves, reared in climatic conditions of Agreste. The study was conducted at the experimental station of Alagoinha, PB, Brazil, using 16 calves of Sindi and Guzerá races. The average concentration of oxygen (20.85%), ammonia (1.99 ppm), carbon monoxide (<0.01 ppm), methane (0.13 ppm) and hydrogen sulfide (<0.01) within facilities, were within the limits established by the Brazilian and international standards, for both animals and workers. The bioclimatic index of temperature and humidity and the temperature of the black globe and humidity index were within the thermal comfort zone for cattle in most of the experimental period, the mean values of respiratory frequency (26.0 min mov-1) and skin temperature (32.3 °C) were higher in the hottest time of the day (1 pm) and rectal temperature (39.3 ºC) in the late afternoon (5 pm), but remained within normal ranges for the studied races. The races have good adaptability to climatic conditions in the region of the Paraibano Agreste, Brazil.

Nocturnal thermal comfort in facilities for growing swines

In most of Brazilian pig farms, the environmental acclimatization systems run manually. For night and early morning periods, this practice isn't appropriate, because, in general, there are not employees available to run these manual systems. This research aimed to compare the bioclimatic profile of two differently constructed facilities to the external environment, considering the period from 6 p.m. to 6 a.m. during the spring, in order to show that night and early morning temperatures do not coincides with growing pig's thermoneutral zone. For this reason, acclimatization must be also carried out at these periods. It was analyzed the dry bulb temperature, relative air humidity, temperature-humidity index (THI) and enthalpy data of the sheds and external areas. Under the studied conditions, it was possible to conclude that the constructively appropriate shed appeared to be less influenced by the external environment, allowing better thermal control for growing pigs. Further research must be conducted to verify if automatic cooling systems is needed during night and early morning.

Thermal comfort in reduced models of broilers' houses, under different types of roofing materials

The research was developed to evaluate the use of different types of roofing materials regularly used in poultry houses. Measurements of thermal comfort were made through the use of techniques such as the Black Globe and Humidity Index (BGHI), the Thermal Heat Load (THL) and Enthalpy (H). Conducted in the State University of Goiás, during the months of April and May, 2011, the experiment was composed of five different treatments: AC - Asbestos cement tiles, BA -Bamboo tiles, BAP - Bamboo tiles painted in white, FB -Vegetable fiber tiles and bitumen, FBP -Vegetable fiber tiles and bitumen painted in white. The experiment consisted in 15 repetitions, which were considered the different days of measurements taken. Throughout the studied period, the time of the day considered the least comfortable was the one observed at 2:00pm, and the coverage of vegetable fiber and bitumen showed the highest value of BGHI (84.1) when compared to other types of coverage, characterizing a situation of lower thermal comfort, and no difference was found for THL and H on treatments in the studied region.

Thermal comfort temperature update for broiler chickens up to 21 days of age

Due to changes in genetics and nutrition, as well as in acclimatization of broiler chickens to the Brazilian climate, temperature values currently accepted as optimal may be outdated. The objective of this research was to update the environment temperatures that characterize the thermal comfort for broilers chickens from one to 21 days of age, under Brazilian production conditions. This research was conducted with 600 COBB birds, which were distributed in five growth chambers maintained at different temperatures during the first three weeks of age. During the experimental period, temperature values were progressively reduced, consisting in five treatments: T2724/21, T30/27/24, T33/30/27, T36/33/30 and T39/36/33. It was observed that the birds maintained in the T30(27-24) treatment presented better performance compared to other environment conditions. Based on the obtained regression models, the environment temperature values that provide greater weighing gain for the broiler chicken growth in the initial period were 31.3, 25.5 and 21.8 ºC, respectively for the first, second and third week of age.

Impact of urban atmospheric environment on hospital admissions in the elderly

OBJECTIVE: To analyze the impact of intra-urban atmospheric conditions on circulatory and respiratory diseases in elder adults. METHODS: Cross-sectional study based on data from 33,212 hospital admissions in adults over 60 years in the city of São Paulo, southeastern Brazil, from 2003 to 2007. The association between atmospheric variables from Congonhas airport and bioclimatic index, Physiological Equivalent Temperature, was analyzed according to the district's socioenvironmental profile. Descriptive statistical analysis and regression models were used. RESULTS: There was an increase in hospital admissions due to circulatory diseases as average and lowest temperatures decreased. The likelihood of being admitted to the hospital increased by 12% with 1ºC decrease in the bioclimatic index and with 1ºC increase in the highest temperatures in the group with lower socioenvironmental conditions. The risk of admission due to respiratory diseases increased with inadequate air quality in districts with higher socioenvironmental conditions. CONCLUSIONS: The associations between morbidity and climate variables and the comfort index varied in different groups and diseases. Lower and higher temperatures increased the risk of hospital admission in the elderly. Districts with lower socioenvironmental conditions showed greater adverse health impacts.

Estudos sobre thrombose cardiaca e endocardite parietal de origem não valvular

1.-Since the parietal endocarditis represents a chapter generally neglected, owing to the relative lack of cases, and somewhat confused because there various terms have been applied to a very same morbid condition, it justifies the work which previously we tried to accomplish, of nosographic classification. Taking into account the functional disturbances and the anatomical changes, all cases of parietal endocarditis referred to in the litterature were distributed by the following groups: A-Group-Valvulo-parietal endocarditis. 1st . type-Valvulo-parietal endocarditis per continuum. 2nd. type-Metastatic valvulo-parietal endocarditis. 3rd. type-Valvulo-parietal endocarditis of the mitral stenosis. B-Group-Genuine parietal endocarditis. a) with primary lesions in the myocardium. b) with primary lesions in the endocardium. 4th type-Fibrous chronic parietal endocarditis (B A Ü M L E R), « endocarditis parietalis simplex». 5th type-Septic acute parietal endocarditis (LESCHKE), «endocarditis parietalis septica». 6th type-Subacute parietal endocarditis (MAGARINOS TORRES), «endocarditis muralis lenta». 2.-Studying a group of 14 cases of fibrous endomyocarditis with formation of thrombi, and carrying together pathological and bacteriological examinations it has been found that some of such cases represent an infectious parietal endocarditis, sometimes post-puerperal, of subacute or slow course, the endocardic vegetations being contamined by pathogenic microörganisms of which the most frequent is the Diplococcus pneumoniae, in most cases of attenuated virulence. Along with the infectious parietal endocarditis, there occur arterial and venous thromboses (abdominal aorta, common illiac and femural arteries and external jugular veins). The case 5,120 is a typical one of this condition which we name subacute parietal endocarditis (endocarditis parietalis s. muralis lenta). 3.-The endocarditis muralis lenta encloses an affection reputed to be of rare occurrence, the «myocardite subaigüe primitive», of which JOSSERAND and GALLAVARDIN published in 1901 the first cases, and ROQUE and LEVY, another, in 1914. The «myocardite subaigüe primitive» was, wrongly, in our opinion, included by WALZER in the syndrome of myocardia of LAUBRY and WALZER, considering that, in the refered cases of JOSSERAND and GALLAVARDIN and in that of ROQUE and LEVY, there are described rather considerable inflammatory changes in the myocardium and endocardium. The designation «myocardia» was however especially created by LAUBRY and WALZER for the cases of heart failure in which the most careful aetiologic inquiries and the most minucious clinical examination were unable to explain, and in which, yet, the post-mortem examination did not reveal any anatomical change at all, it being forcible to admit, then, a primary functional change of the cardiac muscle fibre. This special cardiac condition is thoroughly exemplified in the observation that WALZER reproduces on pages 1 to 7 of his book. 4.-The clinical picture of the subacute parietal endocarditis is that of heart failure with oedemas, effusion in the serous cavities and passive chronic congestion of the lungs, liver, kideys and spleen associated, to that of an infectious disease of subacute course. The fever is rather transient oscillating around 99.5 F., being intersected with apyretic periods of irregular duration; it is not dependent on any evident extracardiac septic infection. In other cases the fever is slight, particularly in the final stage of the disease, when the heart failure is well established. The rule is to observe then, hypothermy. The cardiac-vascular signs consist of enlargement of the cardiac dullness, smoothing of the cardiac sounds, absence of organic murmurs and accentuated and persistent tachycardia up to a certain point independent of fever. The galloprhythm is present, in most cases. The signs of the pulmonary infarct are rather expressed by the aspect of the sputum, which is foamy and blood-streaked than by the classic signs. Cerebral embolism was a terminal accident on various cases. Yet, in some of them, along with the signs of septicemia and of cardiac insufficiency, occurred vascular, arterial (abdominal aorta, common illiac and femurals arteries) and venous (extern jugular veins) thromboses. 5. The autopsy revealed an inflammatory process located on the parietal endocardium, accompanied by abundant formation of ancient and recent thrombi, being the apex of the left ventricle, the junction of the anterior wall of the same ventricle, with the interventricular septum, and the right auricular appendage, the usual seats of the inflammatory changes. The region of the left branch of HIS’ bundle is spared. The other changes found consist of fibrosis of the myocardium (healed infarcts and circumscribed interstitial myocarditis), of recent visceral infarcts chiefly in lungs, spleen and brain, of recent or old infarcts in the kidneys (embolic nephrocirrhosis) and in the spleen, and of vascular thromboses (abdominal aorta, common illiacs and femurals arteries and external jugular veins), aside from hydrothorax, hydroperitoneum, cutaneous oedema, chronic passive congestion of the liver, lungs, spleen and kidneys and slight ictericia. 6. In the subacute parietal endocarditis the primary lesions sometimes locate themselves at the myocardium, depending on the ischemic necrosis associated to the arteriosclerosis of the coronariae arteries, or on an specific myocarditis. Other times, the absence of these conditions is suggestive of a primary attack to the parietal endocardium which is then the primary seat of the lesions. It matters little whatever may be the initial pathogenic mechanism; once injured the parietal endocardium and there being settled the infectious injury, the endocarditis develops with peculiar clinical and anatomical characters of remarkable uniformity, constituting an anatomo-clinical syndrome. 7.-The histologic sections show that recent lesions…

Content validation of the nursing diagnosis Nausea

This study aimed to evaluate the content validity of the nursing diagnosis of nausea in the immediate post-operative period, considering Fehring’s model. Descriptive study with 52 nurses experts who responded an instrument containing identification and validation of nausea diagnosis data. Most experts considered the domain 12 (Comfort), Class 1 (Physical Comfort) and the statement (Nausea) adequate to the diagnosis. Modifications were suggested in the current definition of this nursing diagnosis. Four defining characteristics were considered primary (reported nausea, increased salivation, aversion to food and vomiting sensation) and eight secondary (increased swallowing, sour taste in the mouth, pallor, tachycardia, diaphoresis, sensation of hot and cold, changes in blood pressure and pupil dilation). The total score for the diagnosis of nausea was 0.79. Reports of nausea, vomiting sensation, increased salivation and aversion to food are strong predictors of nursing diagnosis of nausea.

Instrument for assessing the quality of mobile emergency pre-hospital care: content validation

OBJECTIVES To validate an instrument to assess quality of mobile emergency pre-hospital care. METHOD A methodological study where 20 professionals gave their opinions on the items of the proposed instrument. The analysis was performed using Kappa test (K) and Content Validity Index (CVI), considering K> 0.80 and CVI ≥ 0.80. RESULTS Three items were excluded from the instrument: Professional Compensation; Job Satisfaction and Services Performed. Items that obtained adequate K and CVI indexes and remained in the instrument were: ambulance conservation status; physical structure; comfort in the ambulance; availability of material resources; user/staff safety; continuous learning; safety demonstrated by the team; access; welcoming; humanization; response time; costumer privacy; guidelines on care; relationship between professionals and costumers; opportunity for costumers to make complaints and multiprofessional conjunction/actuation. CONCLUSION The instrument to assess quality of care has been validated and may contribute to the evaluation of pre-hospital care in mobile emergency services.

Predicting chick body mass by artificial intelligence-based models

The objective of this work was to develop, validate, and compare 190 artificial intelligence-based models for predicting the body mass of chicks from 2 to 21 days of age subjected to different duration and intensities of thermal challenge. The experiment was conducted inside four climate-controlled wind tunnels using 210 chicks. A database containing 840 datasets (from 2 to 21-day-old chicks) - with the variables dry-bulb air temperature, duration of thermal stress (days), chick age (days), and the daily body mass of chicks - was used for network training, validation, and tests of models based on artificial neural networks (ANNs) and neuro-fuzzy networks (NFNs). The ANNs were most accurate in predicting the body mass of chicks from 2 to 21 days of age after they were subjected to the input variables, and they showed an R² of 0.9993 and a standard error of 4.62 g. The ANNs enable the simulation of different scenarios, which can assist in managerial decision-making, and they can be embedded in the heating control systems.

Outdoor/indoor air quality in primary schools in Lisbon: a preliminary study

Simultaneous measurements of outdoor and indoor pollution were performed at three schools in Lisbon. Volatile organic compounds (VOCs), formaldehyde and NO2 were passively monitored over a two-week period. Bacterial and fungal colony-forming units and comfort parameters were also monitored at classrooms and playgrounds. The highest indoor levels of CO2 (2666 μg/m³), NO2 (40.3 μg/m³), VOCs (10.3 μg/m³), formaldehyde (1.03 μg/m³) and bioaerosols (1634 CFU/m³), and some indoor/outdoor ratios greater than unity, suggest that indoor sources and building conditions might have negative effects on air indoors. Increasing ventilation rates and use of low-emission materials would contribute towards improving indoor air quality.

Effects of thermal environment and supplementation levels on the physiological parameters of moxotó goats in confined and semi-confined rising systems

The objective of this work was to determine the effect of environmental variables and supplementation levels on physiological parameters of Moxotó goats in confined and semi-confined rising systems, in the Brazilian semi-arid region. The semi-confined individuals were kept on a grass based diet during the day and arrested in the end of the afternoon. The confined animals were kept in a management center, receiving two diets composed by forage cactus and maniçoba hay into two different levels (0.5 and 1.5% of the body weight). Inside the management center and in the external environment the environmental comfort parameters were set high during the afternoon period characterizing a situation of thermal discomfort for the animals. During the morning the semi-confined animals presented an average respiratory frequency (69.5 mov min-1) and rectal temperature (39.5 ºC) higher than the confined ones (62.6 mov min-1 and 39.0 ºC, respectively). The confined and semi-confined animals were able to maintain their rectal temperature within normal limits, with increase in the cardiac beatings rate and respiratory frequency. The greater percentage of the used supplementations (1.5%) seemed to increase rectal temperature in the two studied rising systems.

Benefits of automated acclimatization during the pre-milking phase of lactating girolando cows

The aim of this paper was to evaluate the automated acclimatization effects during pre-milking of cows on thermal conditioning, physiology, milk production and cost-benefit of the automated adiabatic evaporative cooling system (AECS). The treatments 20; 30; 40 min and control consisted of exposure time of pre-milking cows to the automated AECS. Sixteen cows were used with an average daily milk yield of 19 kg, distributed in a 4 x 4 Latin square design. The Tukey's test (P<0.05) was used to compare the means. The environmental variables, dry bulb temperature (DBT, ºC) and relative humidity (RH, %), were recorded every minute, which allowed the determination of the system efficiency through the Temperature and Humidity Index (THI). The respiratory rate (RR), rectal temperature (RT) and temperature of the coat (TC) were measured before and after the acclimatization. The 40 min treatment kept the environmental variables and the comfort indexes within recommended limits. The physiological variables (RR, RT and TC) were lower in the 40 min treatment and reflected positively on milk production, which increased 3.66% compared to the control treatment. The system was profitable, having a 43 days return on investment and a monthly revenue increase of R$ 1,992.67.