Effectiveness of Enteral Nutritional Therapy in the Healing Process of Pressure Ulcers: A Systematic Review

OBJECTIVE To evaluate the effectiveness of enteral nutritional therapy (ENT) in the healing process of pressure ulcers (PU) in adults and the elderly. METHOD A systematic review whose studies were identified through the databases of Cochrane, MEDLINE/PubMed, SciELO, LILACS, EMBASE, CINAHL, Web of Science, and manual searches. It included randomized clinical trials (RCTs) without delimiting the period or language of publication, which addressed adults and elderly patients with pressure ulcers in a comparative treatment of enteral nutritional therapy and placebo or between enteral nutritional therapy with different compositions and dosages. RESULTS We included ten studies that considered different interventions. It resulted in more pressure ulcers healed in the groups that received the intervention. The included studies were heterogeneous with regard to patients, the type of intervention, the sample and the follow-up period, all of which made meta-analysis impossible. CONCLUSION Although the enteral nutritional therapy demonstrates a promotion of pressure ulcer healing, sufficient evidence to confirm the hypothesis was not found.

Usability of computerized nursing process from the ICNP® in intensive care units

OBJECTIVE To analyze the usability of Computerized Nursing Process (CNP) from the ICNP® 1.0 in Intensive Care Units in accordance with the criteria established by the standards of the International Organization for Standardization and the Brazilian Association of Technical Standards of systems. METHOD This is a before-and-after semi-experimental quantitative study, with a sample of 34 participants (nurses, professors and systems programmers), carried out in three Intensive Care Units. RESULTS The evaluated criteria (use, content and interface) showed that CNP has usability criteria, as it integrates a logical data structure, clinical assessment, diagnostics and nursing interventions. CONCLUSION The CNP is a source of information and knowledge that provide nurses with new ways of learning in intensive care, for it is a place that provides complete, comprehensive, and detailed content, supported by current and relevant data and scientific research information for Nursing practices.

Assessment of the teaching-learning process in students of the health area: cardiopulmonary resuscitation maneuvers

OBJECTIVETo evaluate the skills and knowledge of undergraduate students in the health area on cardiopulmonary resuscitation maneuvers with the use of an automatic external defibrillator.METHODThe evaluation was performed in three different stages of the teaching-learning process. A theoretical and practical course was taught and the theoretical classes included demonstration. The evaluation was performed in three different stages of the teaching-learning process. Two instruments were applied to evaluate the skills (30-items checklist) and knowledge (40-questions written test). The sample comprised 84 students.RESULTSAfter the theoretical and practical course, an increase was observed in the number of correct answers in the 30-items checklist and 40-questions written test.CONCLUSIONAfter the theoretical class (including demonstration), only one of the 30-items checklist for skills achieved an index ≥ 90% of correct answers. On the other hand, an index of correct answers greater than 90% was achieved in 26 (86.7%) of the 30 items after a practical training simulation, evidencing the importance of this training in the defibrillation procedure.

Impact of small variations in temperature and humidity on the reproductive activity and survival of Aedes aegypti (Diptera, Culicidae)

In short space of time increase in temperature and rainfall can affect vector populations and, consequently, the diseases for them transmitted. The present study analyzed the effect of small temperature and humidity variations on the fecundity, fertility and survival of Aedes aegypti. These parameters were analyzed using individual females at temperatures ranging from 23 to 27 °C (mean 25 °C); 28 to 32 °C (mean 30 °C) and 33 to 37 °C (mean 35 ºC) associated to 60±8% and 80±6% relative humidity. Females responded to an increase in temperature by reducing egg production, oviposition time and changing oviposition patterns. At 25 ºC and 80% relative humidity, females survived two-fold more and produced 40% more eggs when compared to those kept at 35 ºC and 80% relative humidity. However, in 45% of females kept at 35 ºC and 60% relative humidity oviposition was inhibited and only 15% females laid more than 100 eggs, suggesting that the intensity of the temperature effect was influenced by humidity. Gradual reductions in egg fertility at 60% relative humidity were observed with the increase in temperature, although such effect was not found in the 80% relative humidity at 25 º C and 30 º C. These results suggest that the reduction in population densities recorded in tropical areas during seasons when temperatures reach over 35 ºC is likely to be strongly influenced by temperature and humidity, with a negative effect on several aspects of mosquito biology.

Seasonal flight and resource collection patterns of colonies of the stingless bee Melipona bicolor schencki Gribodo (Apidae, Meliponini) in an Araucaria forest area in southern Brazil

Melipona bicolor schencki occurs in southern Brazil and at high elevations in southeastern Brazil. It has potential for use in meliponiculture but this stingless bee species is vulnerable to extinction and we have little knowledge about its ecology. In order to gather essential information for species conservation and management, we made a study of seasonal flight activities in its natural environment. We sampled bees entering the nests with pollen, nectar/water and resin/mud, in five colonies during each season. In parallel, we analyzed the influence of hour of the day and meteorological factors on flight activity. Flights were most intense during spring and summer, with daily mean estimates of 2,100 and 2,333 flights respectively, while in fall and winter the daily flight estimate was reduced to 612 and 1,104 flights, respectively. Nectar and water were the most frequently-collected resources, followed by pollen and building materials. This preference occurred in all seasons, but with variations in intensity. During spring, daily flight activity lasted over 14 hours; this period was reduced in the other seasons, reaching eight hours in winter. Meteorological factors were associated with 40.2% of the variation in flight and resource collection activity. Apparently, other factors that we did not measure, such as colony needs and availability of floral resources, also strongly influence the intensity of resource collection.

Insects associated with the composting process of solid urban waste separated at the source

Sarcosaprophagous macroinvertebrates (earthworms, termites and a number of Diptera larvae) enhance changes in the physical and chemical properties of organic matter during degradation and stabilization processes in composting, causing a decrease in the molecular weights of compounds. This activity makes these organisms excellent recyclers of organic matter. This article evaluates the succession of insects associated with the decomposition of solid urban waste separated at the source. The study was carried out in the city of Medellin, Colombia. A total of 11,732 individuals were determined, belonging to the classes Insecta and Arachnida. Species of three orders of Insecta were identified, Diptera, Coleoptera and Hymenoptera. Diptera corresponding to 98.5% of the total, was the most abundant and diverse group, with 16 families (Calliphoridae, Drosophilidae, Psychodidae, Fanniidae, Muscidae, Milichiidae, Ulidiidae, Scatopsidae, Sepsidae, Sphaeroceridae, Heleomyzidae, Stratiomyidae, Syrphidae, Phoridae, Tephritidae and Curtonotidae) followed by Coleoptera with five families (Carabidae, Staphylinidae, Ptiliidae, Hydrophilidae and Phalacaridae). Three stages were observed during the composting process, allowing species associated with each stage to be identified. Other species were also present throughout the whole process. In terms of number of species, Diptera was the most important group observed, particularly Ornidia obesa, considered a highly invasive species, and Hermetia illuscens, both reported as beneficial for decomposition of organic matter.

Spatial variability of the chemical, physical and biological properties in lowland cultivated with irrigated rice

In the areas where irrigated rice is grown in the south of Brazil, few studies have been carried out to investigate the spatial variability structure of soil properties and to establish new forms of soil management as well as determine soil corrective and fertilizer applications. In this sense, this study had the objective of evaluating the spatial variability of chemical, physical and biological soil properties in a lowland area under irrigated rice cultivation in the conventional till system. For this purpose, a 10 x 10 m grid of 100 points was established, in an experimental field of the Embrapa Clima Temperado, in the County of Capão do Leão, State of Rio Grande do Sul. The spatial variability structure was evaluated by geostatistical tools and the number of subsamples required to represent each soil property in future studies was calculated using classical statistics. Results showed that the spatial variability structure of sand, silt, SMP index, cation exchange capacity (pH 7.0), Al3+ and total N properties could be detected by geostatistical analysis. A pure nugget effect was observed for the nutrients K, S and B, as well as macroporosity, mean weighted diameter of aggregates, and soil water storage. The cross validation procedure, based on linear regression and the determination coefficient, was more efficient to evaluate the quality of the adjusted mathematical model than the degree of spatial dependence. It was also concluded that the combination of classical with geostatistics can in many cases simplify the soil sampling process without losing information quality.

Perennial grasses for recovery of the aggregation capacity of a reconstructed soil in a coal mining area in southern Brazil

The construction of a soil after surface coal mining involves heavy machinery traffic during the topographic regeneration of the area, resulting in compaction of the relocated soil layers. This leads to problems with water infiltration and redistribution along the new profile, causing water erosion and consequently hampering the revegetation of the reconstructed soil. The planting of species useful in the process of soil decompaction is a promising strategy for the recovery of the soil structural quality. This study investigated the influence of different perennial grasses on the recovery of reconstructed soil aggregation in a coal mining area of the Companhia Riograndense de Mineração, located in Candiota-RS, which were planted in September/October 2007. The treatments consisted of planting: T1- Cynodon dactylon cv vaquero; T2 - Urochloa brizantha; T3 - Panicum maximun; T4 - Urochloa humidicola; T5 - Hemarthria altissima; T6 - Cynodon dactylon cv tifton 85. Bare reconstructed soil, adjacent to the experimental area, was used as control treatment (T7) and natural soil adjacent to the mining area covered with native vegetation was used as reference area (T8). Disturbed and undisturbed soil samples were collected in October/2009 (layers 0.00-0.05 and 0.10-0.15 m) to determine the percentage of macro- and microaggregates, mean weight diameter (MWD) of aggregates, organic matter content, bulk density, and macro- and microporosity. The lower values of macroaggregates and MWD in the surface than in the subsurface layer of the reconstructed soil resulted from the high degree of compaction caused by the traffic of heavy machinery on the clay material. After 24 months, all experimental grass treatments showed improvements in soil aggregation compared to the bare reconstructed soil (control), mainly in the 0.00-0.05 m layer, particularly in the two Urochloa treatments (T2 and T4) and Hemarthria altissima (T5). However, the great differences between the treatments with grasses and natural soil (reference) indicate that the recovery of the pre-mining soil structure could take decades.

Determination of sulfate in the wet-process of phosphoric acid by reverse flow injection

An improved method based on reverse flow injection is proposed for determining sulfate concentration in the wet-process of phosphoric acid (WPA). The effect of reagent composition, flow rate, temperature, acid concentration, length of the reaction coil, and linear response range on the flow system is discussed in detail. Optimal conditions are established for determining sulfate in the WPA samples. Baseline drift is avoided by a periodic washing step with EDTA in an alkaline medium. A linear response is observed within a range of 20 - 360 mg L-1, given by the equation A = 0.0020C (mg L-1) + 0.0300, R² = 0.9991. The detection limit of the proposed method for sulfate analysis is 3 mg L-1, and the relative standard deviation (n = 12) of sulfate absorbance peak is less than 1.60%. This method has a rate of up to 29 samples per hour, and the results compare well with those obtained with gravimetric method.

The use of fluorescent probes to assess viability of the plant pathogenic bacterium Clavibacter michiganensis subsp. michiganensis by flow cytometry

Determination of the viability of bacteria by the conventional plating technique is a time-consuming process. Methods based on enzyme activity or membrane integrity are much faster and may be good alternatives. Assessment of the viability of suspensions of the plant pathogenic bacterium Clavibacter michiganensis subsp. michiganensis (Cmm) using the fluorescent probes Calcein acetoxy methyl ester (Calcein AM), carboxyfluorescein diacetate (cFDA), and propidium iodide (PI) in combination with flow cytometry was evaluated. Heat-treated and viable (non-treated) Cmm cells labeled with Calcein AM, cFDA, PI, or combinations of Calcein AM and cFDA with PI, could be distinguished based on their fluorescence intensity in flow cytometry analysis. Non-treated cells showed relatively high green fluorescence levels due to staining with either Calcein AM or cFDA, whereas damaged cells (heat-treated) showed high red fluorescence levels due to staining with PI. Flow cytometry also allowed a rapid quantification of viable Cmm cells labeled with Calcein AM or cFDA and heat-treated cells labeled with PI. Therefore, the application of flow cytometry in combination with fluorescent probes appears to be a promising technique for assessing viability of Cmm cells when cells are labeled with Calcein AM or the combination of Calcein AM with PI.

EVALUATION OF TECHNOLOGICAL INTENSITY OF EXPORTS IN THE FORESTRY SECTOR

ABSTRACT One of the fastest growing sectors in the domestic industry is the forestry, which has contributed significantly to economic development, job creation, income taxes, putting Brazil in a prominent position in the world market. This paper analyzes the evolution of the technological intensity of 12 main products exported by the sector, from 2000 to 2011. For that, utilizes an indicator called PRODY, which allows classifying different products according to their technological intensity or income content and considers the GDP per capita of exporting countries of each product, weighted by its revealed comparative advantage. It can be seen by the results, a continuous growth in all products' technology indicators and their decomposition into income effects, comparative advantage and joint effects, allowed to verify the main causes of this growth. Products with lower PRODY values are those that presented a higher evolution during the period studied. Products of higher processing, and those from pulp and paper industry, had greater technological advances, thanks to a joint effect, while the ones of lower processing, had a technological improvement due to the increase in GDP per capita in exporting countries. Sawn wood was the standout product, being the only one who proved to be dependent of comparative advantage effect, confirming that this industry has been reinventing itself and incorporating, in fact, more technology. This study revealed the importance of technological intensification to generate comparative advantage and be able to stand against international competition.

Marketing in the pre-development process of agricultural machines: a reference model

The theme of the research is the development of the domain of marketing knowledge in the design of agricultural machinery. It is developed throughout the design of agricultural machinery in order to identify the corporate and customers needs and to develop strategies to satisfy these needs. The central problem of the research questions which marketing tools to apply on pre-development process of farm machinery, in order to increase the market value of the products and of the company and, consequently, generate competitive advantage to the manufacturers of agricultural machinery. As methodology, it was developed bibliographical research and multicase study of the development process of agricultural machinery developed by small, medium and large companies and the academy. As a result, a marketing reference model was elaborated for the pre-development stage of agricultural machinery, which outlines the activities, tasks, mechanisms and controls that can be used in strategic planning and in products planning of agricultural machinery manufacturers, contributing to explain the explicit knowledge in the marketing field.

Analysis of the relationship intensity, duration, frequency of disaggregated daily rainfall in southern Rio Grande do Sul, Brazil

The intensity, duration, and frequency relationship (IDF) of rainfall occurrence may be done through continuous records of pluviographs or daily pluviometer values . The objective of this study was to estimate the intensity-duration-frequency relationships of precipitation, using the method of daily rainfall disaggregation, at weather stations located to the southern half of the state of Rio Grande do Sul; comparing them with those obtained by rain gauge records, in places considered homogeneous from the meteorological point of view. The IDF equation parameters were estimated from daily rainfall disaggregation data, using the method of nonlinear optimization. To validate the equations confidence indices and efficiency and the "t" Student test, among maximum intensity values obtained from the disaggregated daily rainfall durations of 10; 30; 60 min and 6; 12 and 24 h and those extracted from existing IDF equations. For all studied stations and return periods, the trust index values were regarded as "optimal", i.e., greater than 0.85. The maximal intensity of rainfall obtained by daily rainfall disaggregation have similarity with those obtained by relations IDF standards. Thus, the method constitutes a feasible alternative in obtaining the IDF relationships.

Yield of cotton/cowpea and sunflower/cowpea crop rotation systems during the reclamation process of a saline-sodic soil

The objective of this study was to evaluate the use of subsoiling, gypsum and organic matter associated with the cultivation of cotton, sunflower and cowpea in crop rotation, seeking the reclamation and use of a saline-sodic soil. The treatments were arranged in a randomized block design in split plots with four replications, during two crop cycles (2009/2010 and 2010/2011). The plots were formed by the treatments: T1. Subsoiling (S); T2. S + 20 Mg ha-1 of gypsum; T3. S + 40 Mg ha-1 of organic matter; T4. S + 10 Mg ha-1 of gypsum + 20 Mg ha-1 of organic matter; T5. S + 20 Mg ha-1 of gypsum + 40 Mg ha-1 of organic matter and the sub-plots consisted of the cotton-cowpea (C/CP) and sunflower-cowpea (S/CP) crop rotation. The use of gypsum and organic matter contributed to decrease the soil salinity and sodicity. Cotton was not affected by the treatments, while the sunflower crop was favored by the application of amendments only in the second production cycle. Higher yields of cowpea in T5 treatment, during the 2009/2010 cycle, are indicative that higher doses of gypsum and organic matter applied in this treatment accelerate the reclamation process. For other treatments with amendment application there was a beneficial effect for this crop only in the second cycle, when the values of productivity were similar to T5.

Nuss procedure for Pectus excavatum repair: critical appraisal of the evidence

Objective: To evaluate the effectiveness and safety of correction of pectus excavatum by the Nuss technique based on the available scientific evidence.Methods: We conducted an evidence synthesis following systematic processes of search, selection, extraction and critical appraisal. Outcomes were classified by importance and had their quality assessed by the Grading of Recommendations Assessment, Development and Evaluation (GRADE).Results: The process of selection of items led to the inclusion of only one systematic review, which synthesized the results of nine observational studies comparing the Nuss and Ravitch procedures. The evidence found was rated as poor and very poor quality. The Nuss procedure has increased the incidence of hemothorax (RR = 5.15; 95% CI: 1.07; 24.89), pneumothorax (RR = 5.26; 95% CI: 1.55; 17.92) and the need for reintervention (RR = 4.88; 95% CI: 2.41; 9.88) when compared to the Ravitch. There was no statistical difference between the two procedures in outcomes: general complications, blood transfusion, hospital stay and time to ambulation. The Nuss operation was faster than the Ravitch (mean difference [MD] = -69.94 minutes, 95% CI: -139.04, -0.83).Conclusion: In the absence of well-designed prospective studies to clarify the evidence, especially in terms of aesthetics and quality of life, surgical indication should be individualized and the choice of the technique based on patient preference and experience of the team.