Strategies for self-management support by patients with stroke: integrative review

OBJECTIVE To analyze strategies for self-management support by patients with stroke in the light of the methodology of the five A's (ask, advice, assess, assist and arrange). METHODS Integrative review conducted at the following databases CINAHL, SCOPUS, PubMed, Cochrane and LILACS. RESULTS A total of 43 studies published between 2000 and 2013 comprised the study sample. All proposed actions in the five A's methodology and others were included. We highlight the Assist and Arrange, in which we added actions, especially with regard to the use of technological resources and joint monitoring between patients, families and professionals. No study included all five A's, which suggests that the actions of supported self-management are developed in a fragmented way. CONCLUSION The use of five A's strategy provides guidelines for better management of patients with stroke with lower cost and higher effectiveness.

Use of the swat model for hydro-sedimentologic simulation in a small rural watershed

Mathematical models have great potential to support land use planning, with the goal of improving water and land quality. Before using a model, however, the model must demonstrate that it can correctly simulate the hydrological and erosive processes of a given site. The SWAT model (Soil and Water Assessment Tool) was developed in the United States to evaluate the effects of conservation agriculture on hydrological processes and water quality at the watershed scale. This model was initially proposed for use without calibration, which would eliminate the need for measured hydro-sedimentologic data. In this study, the SWAT model was evaluated in a small rural watershed (1.19 km²) located on the basalt slopes of the state of Rio Grande do Sul in southern Brazil, where farmers have been using cover crops associated with minimum tillage to control soil erosion. Values simulated by the model were compared with measured hydro-sedimentological data. Results for surface and total runoff on a daily basis were considered unsatisfactory (Nash-Sutcliffe efficiency coefficient - NSE < 0.5). However simulation results on monthly and annual scales were significantly better. With regard to the erosion process, the simulated sediment yields for all years of the study were unsatisfactory in comparison with the observed values on a daily and monthly basis (NSE values < -6), and overestimated the annual sediment yield by more than 100 %.

Incubation methods for assessing mineralizable nitrogen in soils under sugarcane

Considering nitrogen mineralization (N) of soil organic matter is a key aspect for the efficient management of N fertilizers in agricultural systems. Long-term aerobic incubation is the standard technique for calibrating the chemical extraction methods used to estimate the potentially mineralizable N in soil. However, the technique is laborious, expensive and time-consuming. In this context, the aims of this study were to determine the amount of soil mineralizable N in the 0-60 cm layer and to evaluate the use of short-term anaerobic incubation instead of long-term aerobic incubation for the estimation of net N mineralization rates in soils under sugarcane. Five soils from areas without previous N fertilization were used in the layers 0-20, 20-40 and 40-60 cm. Soil samples were aerobically incubated at 35 ºC for 32 weeks or anaerobically incubated (waterlogged) at 40 ºC for seven days to determine the net soil N mineralization. The sand, silt and clay contents were highly correlated with the indexes used for predicting mineralizable N. The 0-40 cm layer was the best sampling depth for the estimation of soil mineralizable N, while in the 40-60 cm layer net N mineralization was low in both incubation procedures. Anaerobic incubation provided reliable estimates of mineralizable N in the soil that correlated well with the indexes obtained using aerobic incubation. The inclusion of the pre-existing NH4+-N content improved the reliability of the estimate of mineralizable N obtained using anaerobic incubation.

Organic Matter Fractions and Quality of the Surface Layer of a Constructed and Vegetated Soil After Coal Mining. II - Physical Compartments and Carbon Management Index

Soils constructed after mining often have low carbon (C) stocks and low quality of organic matter (OM). Cover crops are decisive for the recovery process of these stocks, improving the quality of constructed soils. Therefore, the goal of this study was to evaluate the effect of cover crops on total organic C (TOC) stocks, C distribution in physical fractions of OM and the C management index (CMI) of a soil constructed after coal mining. The experiment was initiated in 2003 with six treatments: Hemarthria altissima (T1), Paspalum notatum (T2), Cynodon dactylon (T3), Urochloa brizantha (T4), bare constructed soil (T5), and natural soil (T6). Soil samples were collected in 2009 from the 0.00-0.03 m layer, and the TOC and C stocks in the physical particle size fractions (carbon in the coarse fraction - CCF, and mineral-associated carbon - MAC) and density fractions (free light fraction - FLF; occluded light fraction - OLF, and heavy fraction - HF) of OM were determined. The CMI components: carbon pool index (CPI), lability (L) and lability index (LI) were estimated by both fractionation methods. No differences were observed between TOC, CCF and MAC stocks. The lowest C stocks in FLF and OLF fractions were presented by T2, 0.86 and 0.61 Mg ha-1, respectively. The values of TOC stock, C stock in physical fractions and CMI were intermediate, greater than T5 and lower than T6 in all treatments, indicating the partial recovery of soil quality. As a result of the better adaptation of the species Hemarthria and Brizantha, resulting in greater accumulation of labile organic material, the CPI, L, LI and CMI values were higher in these treatments, suggesting a greater potential of these species for recovery of constructed soils.

Physical Properties of a Hapludox after Three Decades under Different Soil Management Systems

ABSTRACT Changes in soil physical properties due to different management systems occur slowly, and long-term studies are needed to assess soil quality. The objectives of this study were to evaluate the effects of soil management systems and liming methods on the physical properties of a Latossolo Bruno Alumínico típico (Hapludox). A long-term experiment that began in 1978 with conventional and no-tillage systems was assessed. In addition, different liming methods (no lime, incorporated lime, and lime on the soil surface) have been applied since 1987 and were also evaluated in this study. Moreover, an area of native forest was evaluated and considered a reference for the natural condition of the soil. Soil physical properties were evaluated in layers to a depth of 1.00 m. Compared to native forest, the conventional tillage and no-tillage systems had higher soil bulk density, penetration resistance, and microporosity, and lower aggregate stability and macroporosity. Compared to the conventional tillage system, long-term no-tillage improved the structure of the Hapludox, as evidenced by increased microporosity and aggregate stability, especially in the soil surface layer. In no-tillage with lime applications sporadically incorporated, soil physical properties did not differ from no-tillage without lime and with lime applied on the soil surface, indicating that this practice maintains the physical quality of soil under no-tillage. Liming in a conventional tillage system improved soil aggregation and reduces penetration resistance in the soil layers near the soil surface. No-tillage was the main practice related to improvement of soil physical quality, and liming methods did not influence soil physical properties in this soil management system.

Improving node number simulation in soybean

The objective of this study was to improve the simulation of node number in soybean cultivars with determinate stem habits. A nonlinear model considering two approaches to input daily air temperature data (daily mean temperature and daily minimum/maximum air temperatures) was used. The node number on the main stem data of ten soybean cultivars was collected in a three-year field experiment (from 2004/2005 to 2006/2007) at Santa Maria, RS, Brazil. Node number was simulated using the Soydev model, which has a nonlinear temperature response function [f(T)]. The f(T) was calculated using two methods: using daily mean air temperature calculated as the arithmetic average among daily minimum and maximum air temperatures (Soydev tmean); and calculating an f(T) using minimum air temperature and other using maximum air temperature and then averaging the two f(T)s (Soydev tmm). Root mean square error (RMSE) and deviations (simulated minus observed) were used as statistics to evaluate the performance of the two versions of Soydev. Simulations of node number in soybean were better with the Soydev tmm version, with a 0.5 to 1.4 node RMSE. Node number can be simulated for several soybean cultivars using only one set of model coefficients, with a 0.8 to 2.4 node RMSE.

Modeling growth and yield of loblolly pinestands under intensive management

Abstract:The objective of this work was to develop and validate a prognosis system for volume yield and basal area of intensively managed loblolly pine (Pinus taeda) stands, using stand and diameter class models compatible in basal area estimates. The data used in the study were obtained from plantations located in northern Uruguay. For model validation without data loss, a three-phase validation scheme was applied: first, the equations were fitted without the validation database; then, model validation was carried out; and, finally, the database was regrouped to recalibrate the parameter values. After the validation and final parameterization of the models, a simulation of the first commercial thinning was carried out. The developed prognosis system was precise and accurate in estimating basal area production per hectare or per diameter classes. There was compatibility in basal area estimates between diameter class and whole stand models, with a mean difference of -0.01 m2ha-1. The validation scheme applied is logic and consistent, since information on the accuracy and precision of the models is obtained without the loss of any information in the estimation of the models' parameters.

Mating disruption with low density diffusers for the management of oriental fruit moths (Lepidoptera: Tortricidae) in apple orchards under subtropical climate in southern Brazil

The oriental fruit moth, Grapholita molesta Busck, and fruit flies, Anastrepha fraterculus L., are the important apple pests under Subtropical climate in Southern Brazil, and control is normally accomplished with insecticides. An alternative strategy for the control of G. molesta is mating disruption, through the use of pheromones. Mating disruption strategies using a low density of dispensers (20) per hectare were tested in comparison with conventional pesticides for control of G. molesta in commercial Gala apple orchards in Fraiburgo, SC, for a period of five years. The average field efficiency period of mating disruption formulation over five years was 113 days. In this period the mating interruption index on mating disruption plots was 84.8% over five years. Damage to Gala apples by oriental moth larvae was low (<0.1%) in mating disruption plots but did not differ from conventional plots, except in the third year. The use of mating disruption allowed for an average reduction of 5.2 insecticide treatments per year in Gala orchards during field efficiency period. It was necessary to apply 1.0 and 1.2 applications of insecticide to control of G. molesta and A. fraterculus, respectively. Mating disruption with a low density of diffusers proved to be an effective alternative to conventional methods for control of G. molesta in Gala apple orchards in subtropical climate in southern Brazil.

Learning on human resources management in the radiology residency program

Objective To investigate the process of learning on human resource management in the radiology residency program at Escola Paulista de Medicina – Universidade Federal de São Paulo, aiming at improving radiologists' education. Materials and Methods Exploratory study with a quantitative and qualitative approach developed with the faculty staff, preceptors and residents of the program, utilizing a Likert questionnaire (46), taped interviews (18), and categorization based on thematic analysis. Results According to 71% of the participants, residents have clarity about their role in the development of their activities, and 48% said that residents have no opportunity to learn how to manage their work in a multidisciplinary team. Conclusion Isolation at medical records room, little interactivity between sectors with diversified and fixed activities, absence of a previous culture and lack of a training program on human resources management may interfere in the development of skills for the residents' practice. There is a need to review objectives of the medical residency in the field of radiology, incorporating, whenever possible, the commitment to the training of skills related to human resources management thus widening the scope of abilities of the future radiologists.

Celiac plexus block: an anatomical study and simulation using computed tomography

Objective: To analyze anatomical variations associated with celiac plexus complex by means of computed tomography simulation, assessing the risk for organ injury as the transcrural technique is utilized. Materials and Methods: One hundred eight transaxial computed tomography images of abdomen were analyzed. The aortic-vertebral, celiac trunk (CeT)-vertebral, CeT-aortic and celiac-aortic-vertebral topographical relationships were recorded. Two needle insertion pathways were drawn on each of the images, at right and left, 9 cm and 4.5 cm away from the midline. Transfixed vital organs and gender-related associations were recorded. Results: Aortic-vertebral - 45.37% at left and 54.62% in the middle; CeT-vertebral - T12, 36.11%; T12-L1, 32.4%; L1, 27.77%; T11-T12, 2.77%; CeT-aortic - 53.7% at left and 46.3% in the middle; celiac-aortic-vertebral - L-l, 22.22%; M-m, 23.15%; L-m, 31.48%; M-l, 23.15%. Neither correspondence on the right side nor significant gender-related associations were observed. Conclusion: Considering the wide range of abdominal anatomical variations and the characteristics of needle insertion pathways, celiac plexus block should not be standardized. Imaging should be performed prior to the procedure in order to reduce the risks for injuries or for negative outcomes to patients. Gender-related anatomical variations involved in celiac plexus block should be more deeply investigated, since few studies have addressed the subject.

Solutions in radiology services management: a literature review

AbstractObjective:The present study was aimed at reviewing the literature to identify solutions for problems observed in radiology services.Materials and Methods:Basic, qualitative, exploratory literature review at Scopus and SciELO databases, utilizing the Mendeley and Illustrator CC Adobe softwares.Results:In the databases, 565 papers – 120 out of them, pdf free – were identified. Problems observed in the radiology sector are related to procedures scheduling, humanization, lack of training, poor knowledge and use of management techniques, and interaction with users. The design management provides the services with interesting solutions such as Benchmarking, CRM, Lean Approach, ServiceBlueprinting, continued education, among others.Conclusion:Literature review is an important tool to identify problems and respective solutions. However, considering the small number of studies approaching management of radiology services, this is a great field of research for the development of deeper studies.

Adherence and perceptions regarding simulation training in undergraduate health Sciences

BACKGROUND: Simulation techniques are spreading rapidly in medicine. Suc h resources are increasingly concentrated in Simulation Laboratories. The MSRP-USP is structuring such a laboratory and is interested in the prevalence of individual initiatives that could be centralized there. The MSRP-USP currently has five full-curriculum courses in the health sciences: Medicine, Speech Therapy, Physical Therapy, Nutrition, and Occupational Therapy, all consisting of core disciplines. GOAL: To determine the prevalence of simulation techniques in the regular courses at MSRP-USP. METHODS: Coordinators of disciplines in the various courses were interviewed using a specifically designed semi-structured questionnaire, and all the collected data were stored in a dedicated database. The disciplines were grouped according to whether they used (GI) or did not use (GII) simulation resources. RESULTS AND DISCUSSION: 256 disciplines were analyzed, of which only 18.3% used simulation techniques, varying according to course: Medicine (24.7.3%), Occupational Therapy (23.0%), Nutrition (15.9%), Physical Therapy (9.8%), and Speech Therapy (9.1%). Computer simulation programs predominated (42.5%) in all five courses. The resources were provided mainly by MSRP-USP (56.3%), with additional funding coming from other sources based on individual initiatives. The same pattern was observed for maintenance. There was great interest in centralizing the resources in the new Simulation Laboratory in order to facilitate maintenance, but there was concern about training and access to the material. CONCLUSIONS: 1) The MSRP-USP simulation resources show low complexity and are mainly limited to computer programs; 2) Use of simulation varies according to course, and is most prevalent in Medicine; 3) Resources are scattered across several locations, and their acquisition and maintenance depend on individual initiatives rather than central coordination or curricular guidelines

Evaluation of the surface erosion from different timber yarding methods in Honduras

Surface runoff and sediment production from different timber yarding practices, some using Best Management Practices (BMPs) recommended for Honduras, were monitored in experimental plots during the rainy seasons of two consecutive years in pine forest highlands of central Honduras. Different timber yarding systems were applied to pseudo-replicated plots during the rainy seasons of 1999 and 2000. In 1999, two treatments were studied: tractor yarding and skyline cable (a recommended BMP). In 2000, four treatments were evaluated: tractor skidding, skyline cable, animal skidding (another recommended BMP), and undisturbed forest (reference). During the rainy seasons of these years, surface runoff volumes and sediment yield were measured at five 1.5m x 10m erosion plots in each treated area. The results showed significant differences between traditional tractor yarding and the recommended skyline cable and animal skidding methods. Tractor yarding produced six to ten times more erosion during the rainy seasons than cable and animal yarding. The improved soil retention of cable and animal yarding was especially important during September when the highest rainfall occurred in this climate.

Simulation of moisture profiles in a Latossol in Dourados region, in the State of Mato Grosso do Sul, Brazil

The understanding of unsaturated soil water flow at process-level is essential to develop proper management actions for environmental protection in agricultural systems. One important tool for simulation of soil water flow that has been used worldwide is the SWAP model. The aim of this work was to test and to calibrate the SWAP model by inverse modeling to describe moisture profiles in a Brazilian very clayey Latossol in Dourados, State of Mato Grosso do Sul, Brazil. The SWAP model was tested in an experimental field of 0.09 ha cultivated with soybean and soil profiles were sampled eight times between December 2006 and October 2007. The SWAP input values (i.e. soil water retention curves and meteorological data) were based on in-situ measurements. Simulations with uncalibrated soil water retention curves resulted in moisture profiles that were too wet for almost all sampling dates, in particular between 0-10 cm depth. After calibration of soil water retention curves, there was a good improvement in the simulated moisture profiles, which were within the range of measured values for almost all depths and sampling dates.

Determination of management zones from normalized and standardized equivalent produtivity maps in the soybean culture

Through the site-specific management, the precision agriculture brings new techniques for the agricultural sector, as well as a larger detailing of the used methods and increase of the global efficiency of the system. The objective of this work was to analyze two techniques for definition of management zones using soybean yield maps, in a productive area handled with localized fertilization and other with conventional fertilization. The sampling area has 1.74 ha, with 128 plots with site-specific fertilization and 128 plots with conventional fertilization. The productivity data were normalized by two techniques (normalized and standardized equivalent productivity), being later classified in management zones. It can be concluded that the two methods of management zones definition had revealed to be efficient, presenting similarities in the data disposal. Due to the fact that the equivalent standardized productivity uses standard score, it contemplates a better statistics justification.