Quando a morte antecede o nascimento: atuação do enfermeiro especialista em saúde materna e obstetrícia na assistência à mulher que vivência uma morte fetal

A perda gestacional é uma experiência dolorosa e complexa para a mãe/casal. O enfermeiro surge como promotor da adaptação á perda. Com esta intervenção, pretendo assegurar boas práticas de enfermagem na assistência às mulheres/casais em situação de perda gestacional. Foi realizado um estudo qualitativo em que se realizaram entrevistas a mulheres que vivenciaram perda gestacional e aos Enfermeiros Especialistas de Saúde Materna e Obstétrica como prestadores de cuidados. Os resultados mostram que os enfermeiros consideram a perda gestacional uma experiência difícil de vivenciar, identificando necessidades de formação. As mulheres referem diferenças na abordagem por parte dos enfermeiros aquando dos cuidados recebidos, falta de apoio e necessidade de encaminhamento após a alta hospitalar. Efetuou-se formação aos enfermeiros com peritos da área e desenvolveram-se procedimentos para uniformizar os cuidados. Foi criado um procedimento para uniformizar a prática e materiais de suporte para o apoio na prestação de cuidados de enfermagem; WHEN THE DEATH ANTECIPATES THE BIRTH: MIDWIVES' ROLE IN ASSISTANCE TO WOMENWHO EXPERIENCE FETAL DEATH. ABSTRACT: Pregnancy loss is a painful and complex experience to the mother/couple. The nurse is the promoting agent to the loss adaptation. With this project, I intend to ensure good nursing practices in assisting women/couples who experience a pregnancy loss. A qualitative study was performed, in which interviews were conducted to women who experienced a pregnancy loss and to nurse-midwives who provided care. Results demonstrated that nurse-midwives find pregnancy loss as a difficult experience, identifying educational needs. Women relate differences in the nurse-midwives’ approach during care, lack of support and the need of follow-up after hospital discharge. Nurse-midwives were subjected to training with experts and procedures were developed in order to standardize care. A practice standardizing procedure and educational materials were created to support nursing practice.

Respiratory monitoring practices during procedural sedation and analgesia in the cardiac catheterisation laboratory could be improved by using capnography to assess ventilation

Background: Procedural sedation and analgesia (PSA) administered by nurses in the cardiac catheterisation laboratory (CCL) is unlikely to yield serious complications. However, the safety of this practice is dependent on timely identification and treatment of depressed respiratory function. Aim: Describe respiratory monitoring in the CCL. Methods: Retrospective medical record audit of adult patients who underwent a procedure in the CCLs of one private hospital in Brisbane during May and June 2010. An electronic database was used to identify subjects and an audit tool ensured data collection was standardised. Results: Nurses administered PSA during 172/473 (37%) procedures including coronary angiographies, percutaneous coronary interventions, electrophysiology studies, radiofrequency ablations, cardiac pacemakers, implantable cardioverter defibrillators, temporary pacing leads and peripheral vascular interventions. Oxygen saturations were recorded during 160/172 (23%) procedures, respiration rate was recorded during 17/172 (10%) procedures, use of oxygen supplementation was recorded during 40/172 (23%) procedures and 13/172 (7.5%; 95% CI=3.59–11.41%) patients experienced oxygen desaturation. Conclusion: Although oxygen saturation was routinely documented, nurses did not regularly record respiration observations. It is likely that surgical draping and the requirement to minimise radiation exposure interfered with nurses’ ability to observe respiration. Capnography could overcome these barriers to respiration assessment as its accurate measurement of exhaled carbon dioxide coupled with the easily interpretable waveform output it produces, which displays a breath-by-breath account of ventilation, enables identification of respiratory depression in real-time. Results of this audit emphasise the need to ascertain the clinical benefits associated with using capnography to assess ventilation during PSA in the CCL.

Barriers to good occupational health and safety (OHS) practices by small construction firms

The construction industry has long been considered to have unacceptably high injury and fatality rates. Previous research has shown that small construction companies sustain higher injury rates than large companies. However, despite the industry being dominated by a very large number of such small companies, little is known of their occupational health and safety (OHS) needs, practices and constraints. This paper takes a first step in aiming to identify the principal barriers that affect good OHS performance of small construction companies so that effective OHS practices can be developed to improve this in future. The contents of the literature are first summarised, in which three critical barriers to good OHS practice in small construction firms are proposed. They are : cost, time, lack of safety awareness and concern. The results of a questionnaire survey carried out with South East Queensland construction personnel are presented, which largely confirm what is suggested by the literature research and also succeed in providing an indication of their ranking in terms of importance and suggestions for overcoming these barriers. The research results provide a better understanding of the issues that restrict good OHS practice in small construction companies and potential measures for improvement.

Optimising sorting and washing of home-grown maize to reduce fumonisin contamination under laboratory-controlled conditions

Subsistence farming communities with low socio-economic status reliant on a mono cereal maize diet are exposed to fumonisin levels that exceed the provisional maximum tolerable daily intake of 2 mu g kg(-1) body weight day(-1) recommended by the Joint FAO/WHO Expert Committee on Food Additives. In the rural Centane magisterial district, Eastern Cape Province, South Africa, it is customary during food preparation to sort visibly infected maize kernels from good maize kernels and to wash the good kernels prior to cooking. However, this customary practice seems not to sufficiently reduce the fumonisin levels. This is the first study to optimise the reduction of fumonisin mycotoxins in home-grown maize based on customary methods of a rural population, under laboratory-controlled conditions. Maize obtained from subsistence farmers was analysed for the major naturally occurring fumonisins (FB1, FB2 and FB3) by fluorescence HPLC. Large variations were observed in the unsorted and the experimental maize batches attributable to the non-homogeneous distribution of fumonisin contamination in maize kernels. Optimised hand-sorting of maize kernels by removing the visibly infected/damaged kernels (fumonisins, 53.7 +/- 15.0 mg kg(-1), 2.5% by weight) reduced the mean fumonisins from 2.32 +/- 1.16 mg kg(-1) to 0.68 +/- 0.42 mg kg(-1). Hand washing of the sorted good maize kernels for a period of 10 min at 25 degrees C resulted in optimal reduction with no additional improvement for wash periods up to 15 h. The laboratory optimised sorting reduced the fumonisins by 71 +/- 18% and an additional 13 +/- 12% with the 10 min wash. Based on these results and on local practices and practicalities the protocol that would be recommended to subsistence farmers consists of the removal of the infected/damaged kernels from the maize followed by a 10 min ambient temperature water wash. (C) 2010 Elsevier Ltd. All rights reserved.

Good practices in monitoring and reporting on the Millennium Development Goals: National lessons from Latin America

Includes bibliography

Compendium of technical recommendations and good practices for preparing directories of enterprises and establishments

Includes bibliography

Performance evaluation of low environmental impact asphalt concretes using the mechanistic empirical design method based on laboratory fatigue and permanent deformation models

The "sustainability" concept relates to the prolonging of human economic systems with as little detrimental impact on ecological systems as possible. Construction that exhibits good environmental stewardship and practices that conserve resources in a manner that allow growth and development to be sustained for the long-term without degrading the environment are indispensable in a developed society. Past, current and future advancements in asphalt as an environmentally sustainable paving material are especially important because the quantities of asphalt used annually in Europe as well as in the U.S. are large. The asphalt industry is still developing technological improvements that will reduce the environmental impact without affecting the final mechanical performance. Warm mix asphalt (WMA) is a type of asphalt mix requiring lower production temperatures compared to hot mix asphalt (HMA), while aiming to maintain the desired post construction properties of traditional HMA. Lowering the production temperature reduce the fuel usage and the production of emissions therefore and that improve conditions for workers and supports the sustainable development. Even the crumb-rubber modifier (CRM), with shredded automobile tires and used in the United States since the mid 1980s, has proven to be an environmentally friendly alternative to conventional asphalt pavement. Furthermore, the use of waste tires is not only relevant in an environmental aspect but also for the engineering properties of asphalt [Pennisi E., 1992]. This research project is aimed to demonstrate the dual value of these Asphalt Mixes in regards to the environmental and mechanical performance and to suggest a low environmental impact design procedure. In fact, the use of eco-friendly materials is the first phase towards an eco-compatible design but it cannot be the only step. The eco-compatible approach should be extended also to the design method and material characterization because only with these phases is it possible to exploit the maximum potential properties of the used materials. Appropriate asphalt concrete characterization is essential and vital for realistic performance prediction of asphalt concrete pavements. Volumetric (Mix design) and mechanical (Permanent deformation and Fatigue performance) properties are important factors to consider. Moreover, an advanced and efficient design method is necessary in order to correctly use the material. A design method such as a Mechanistic-Empirical approach, consisting of a structural model capable of predicting the state of stresses and strains within the pavement structure under the different traffic and environmental conditions, was the application of choice. In particular this study focus on the CalME and its Incremental-Recursive (I-R) procedure, based on damage models for fatigue and permanent shear strain related to the surface cracking and to the rutting respectively. It works in increments of time and, using the output from one increment, recursively, as input to the next increment, predicts the pavement conditions in terms of layer moduli, fatigue cracking, rutting and roughness. This software procedure was adopted in order to verify the mechanical properties of the study mixes and the reciprocal relationship between surface layer and pavement structure in terms of fatigue and permanent deformation with defined traffic and environmental conditions. The asphalt mixes studied were used in a pavement structure as surface layer of 60 mm thickness. The performance of the pavement was compared to the performance of the same pavement structure where different kinds of asphalt concrete were used as surface layer. In comparison to a conventional asphalt concrete, three eco-friendly materials, two warm mix asphalt and a rubberized asphalt concrete, were analyzed. The First Two Chapters summarize the necessary steps aimed to satisfy the sustainable pavement design procedure. In Chapter I the problem of asphalt pavement eco-compatible design was introduced. The low environmental impact materials such as the Warm Mix Asphalt and the Rubberized Asphalt Concrete were described in detail. In addition the value of a rational asphalt pavement design method was discussed. Chapter II underlines the importance of a deep laboratory characterization based on appropriate materials selection and performance evaluation. In Chapter III, CalME is introduced trough a specific explanation of the different equipped design approaches and specifically explaining the I-R procedure. In Chapter IV, the experimental program is presented with a explanation of test laboratory devices adopted. The Fatigue and Rutting performances of the study mixes are shown respectively in Chapter V and VI. Through these laboratory test data the CalME I-R models parameters for Master Curve, fatigue damage and permanent shear strain were evaluated. Lastly, in Chapter VII, the results of the asphalt pavement structures simulations with different surface layers were reported. For each pavement structure, the total surface cracking, the total rutting, the fatigue damage and the rutting depth in each bound layer were analyzed.

The need for transparency and good practices in the qPCR literature

Two surveys of over 1,700 publications whose authors use quantitative real-time PCR (qPCR) reveal a lack of transparent and comprehensive reporting of essential technical information. Reporting standards are significantly improved in publications that cite the Minimum Information for Publication of Quantitative Real-Time PCR Experiments (MIQE) guidelines, although such publications are still vastly outnumbered by those that do not.

Detecting Good Practices and Pitfalls when Publishing Vocabularies on the Web

The uptake of Linked Data (LD) has promoted the proliferation of datasets and their associated ontologies bringing their semantic to the data being published. These ontologies should be evaluated at different stages, both during their development and their publication. As important as correctly modelling the intended part of the world to be captured in an ontology, is publishing, sharing and facilitating the (re)use of the obtained model. In this paper, 11 evaluation characteristics, with respect to publish, share and facilitate the reuse, are proposed. In particular, 6 good practices and 5 pitfalls are presented, together with their associated detection methods. In addition, a grid-based rating system is generated. Both contributions, the set of evaluation characteristics and the grid system, could be useful for ontologists in order to reuse existing LD vocabularies or to check the one being built.

Good and bad practices in pv plants

The PVCROPS project (PhotoVolta ic Cost r€duction, Reliability, Operational performance, Prediction and Simulation), cofinanced by European Commission in the frame of Seventh Framework Programme, has compiled in the “Good and bad practices: Manual to improve the quality and reduce the cost of PV systems” a collection of good and bad practices in actual PV plants . All the situations it collects represent the state-of-the-art of existing PV installations all around Europe. They show how the different parts of an installation can be implem ented properly or not. The aim of this manual is to represent a reference text which can help any PV actor (installers, electricians, maintenance operators, owners, etc.) not only to check and improve an already existing installation but will also, and mainly, avoid the previously known bad practices for the construction of a new PV installation. Thus, solving a priori the known errors, new PV installations will be more reliable, efficient and cost-effective and can recover the initial investment in a shorter time. The manual is going to be free available in the PVCROPS website in several languages.

Fiberglass layup and sprayup : good practices for employees.

Mode of access: Internet.