Padrão de intervenções de enfermagem realizadas em vítimas de trauma segundo o Nursing Activities Score

RESUMO Objetivo Identificar o padrão de intervenções de enfermagem realizadas em vítimas de trauma nas primeiras 24 horas de internação na Unidade de Terapia Intensiva (UTI). Método Estudo prospectivo, realizado na UTI de um hospital em São Paulo, Brasil. O instrumento Nursing Activities Score (NAS) foi utilizado para identificar as intervenções de enfermagem. Resultados A casuística foi composta por 200 pacientes, a maioria homens, com idade média de 40,7 anos, vítimas de acidentes de transporte. A média do NAS foi de 71,3% e o padrão de intervenções de enfermagem identificado incluiu as atividades de monitorização e controles; investigações laboratoriais; medicação, exceto drogas vasoativas; procedimentos de higiene; cuidados com drenos; mobilização e posicionamento; suporte e cuidado aos familiares e pacientes; tarefas administrativas e gerenciais; suporte respiratório; cuidado com vias aéreas artificiais; e tratamento para melhora da função pulmonar. Nas intervenções de monitorização e mobilização, houve a necessidade de cuidados além do normalmente requerido por pacientes de UTI. Conclusão Os resultados desta pesquisa trazem importantes contribuições para o planejamento de ações que visem a capacitação e o dimensionamento da equipe de enfermagem na unidade crítica.

Avaliação da carga de trabalho no pós-operatório de cirurgia cardíaca segundo o Nursing Activities Score

RESUMO Objetivo Identificar os fatores associados à carga de trabalho de enfermagem no cuidado a pacientes no pós-operatório de cirurgia cardíaca. Método Estudo de coorte prospectivo, conduzido com 187 pacientes da Unidade de Terapia Intensiva Cirúrgica (UTI) do Instituto do Coração. Os dados foram coletados nas primeiras 24 e 72 horas do paciente na UTI. A variável dependente foi a carga de trabalho calculada por meio do Nursing Activities Score (NAS) e as independentes foram de natureza demográfico-clínicas e escores de morbimortalidade. Para análise dos dados utilizou-se os testes de Wilcoxon-Mann-Whitney e de correlação de Spearman, e a regressão linear com modelo de efeitos mistos. Resultados A maioria dos pacientes era do sexo masculino (59,4%), com média de idade de 61 anos (±12,7) e 43,9% desenvolveram algum tipo de complicação no pós-operatório. Nas 24 horas, a carga de trabalho foi de 82,4% (±3,4) e foi de 58,1% (±3,4) nas 72 horas. Os fatores associados ao aumento do NAS foram: tempo de internação do paciente na UTI (p=0,036) e a presença de complicações (p<0,001). Conclusão A gravidade do paciente nas 24 horas, em oposição a inúmeros estudos, não influenciou no aumento da carga de trabalho, a qual se mostrou associada ao tempo de internação e às complicações.

Interrater reliability of Nursing Activities Score among Intensive Care Unit health professionals

ABSTRACT Objective To analyze the interrater reliability of NAS among critical care nurses and managers in an ICU. Method This was a methodological study performed in an adult, general ICU in Norway. In a random selection of patients, the NAS was scored on 101 patients by three raters: a critical care nurse, an ICU physician and a nurse manager. Interrater reliability was analyzed by agreement between groups and kappa statistics. Results The mean NAS were 88.4 (SD=16.2) and 88.7 (SD=24.5) respectively for the critical care nurses and nurse managers. A lower mean of 83.7 (SD=21.1) was found for physicians. The 18 medical interventions showed higher agreement between critical care nurses and physicians (85.6%), than between critical care nurses and nurse managers (78.7). In the five nursing activities the Kappa-coefficients were low for all activities in all compared groups. Conclusion The study indicated a satisfactory agreement of nursing workload between critical care nurses and managers.

Nursing Activities Score: an updated guideline for its application in the Intensive Care Unit

ABSTRACT Objective To describe nursing workload in Intensive Care Units (ICU) in different countries according to the scores obtained with Nursing Activities Score (NAS) and to verify the agreement among countries on the NAS guideline interpretation. Method This cross-sectional study considered 1-day measure of NAS (November 2012) obtained from 758 patients in 19 ICUs of seven countries (Norway, the Netherlands, Spain, Poland, Egypt, Greece and Brazil). The Delphi technique was used in expertise meetings and consensus. Results The NAS score was 72.8% in average, ranging from 44.5% (Spain) to 101.8% (Norway). The mean NAS score from Poland, Greece and Egypt was 83.0%, 64.6% and 57.1%, respectively. The NAS score was similar in Brazil (54.0%) and in the Netherlands (51.0%). There were doubts in the understanding of five out 23 items of the NAS (21.7%) which were discussed until researchers’ consensus. Conclusion NAS score were different in the seven countries. Future studies must verify if the fine standardization of the guideline can have a impact on differences in the NAS results.

The use of the Nursing Activities Score in clinical settings: an integrative review

ABSTRACT Objective analyze how studies have approached the results obtained from the application of the Nursing Activities Score (NAS) based on Donabedian’s model of healthcare organization and delivery. Method CINAHL and PubMed databases were searched for papers published between 2003 and March 2015. Results 36 articles that met the inclusion criteria were reviewed and double-coded by three independent coders and analyzed based on the three elements of Donabedian’s health care quality framework: structure, process and outcome. The most frequently addressed, but not always tested, variables were those that fell into the structure category. Conclusion variables that fell into the process category were used less frequently. Beside NAS, the most frequently used variables in the outcome category were mortality and length of stay. However, no study used a quality framework for healthcare or NAS to evaluate costs, and it is recommended that further research should explore this approach.

The effect of university culture and stakeholders' perceptions on university-business linking activities

The present work discusses the effects of university culture and structure on university-business relations, focusing on knowledge transfer activities. It puts forward the thesis that when links between university and business are introduced into the university system as a turn-key proposition rather than as developmental process, the prevailing university culture and structure will exert resistance against change and will oppose the creation of appropriate structures to promote them, with deleterious effects for the university.

Aging and the lateralization of oscillatory activities related to external and internal motor preparation

Selection of action may rely on external guidance or be motivated internally, engaging partially distinct cerebral networks. With age, there is an increased allocation of sensorimotor processing resources, accompanied by a reduced differentiation between the two networks of action selection. The present study examines the age effects on the motor-related oscillatory patterns related to the preparation of externally and internally guided movements. Thirty-two older and 30 younger adults underwent three delayed motor tasks with S1 as preparatory and S2 as imperative cue: Full, laterality instructed by S1 (external guidance); Free, laterality freely selected (internal guidance); None, laterality instructed by S2 (no preparation). Electroencephalogram (EEG) was recorded using 64 surface electrodes. Motor-Related Amplitude Asymmetries (MRAA), indexing the lateralization of oscillatory activities, were analyzed within the S1-S2 interval in the mu (9-12 Hz) and low beta (15-20 Hz) motor-related frequency bands. Reaction times to S2 were slower in older than younger subjects, and slower in the Free than in the Full condition in older subjects only. In the Full condition, there were significant mu MRAA in both age groups, and significant low beta MRAA only in older adults. The Free condition was associated with large mu MRAA in younger adults and limited low beta MRAA in older adults. In younger subjects, the lateralization of mu activity in both Full and Free conditions indicated effective external and internal motor preparation. In older subjects, external motor preparation was associated with lateralization of low beta in addition with mu activity, compatible with an increase of motor-related resources. In contrast, absence of mu and limited low beta lateralization in internal motor preparation was concomitant with reaction time slowing and suggested less efficient cerebral processes subtending free movement selection in older adults, indicating reduced capacity for internally driven action with age.

Improving Transition Outcomes: Resource Mapping Workshop: Activities

Activities used during the Improving Transition Outcomes Resource Mapping Workshops

Report of Highway Research Board Research and Development Activities FY2007

The Highway Division of the Iowa Department of Transportation (Iowa DOT) engages in research and development for two reasons: first, to find workable solutions to the many problems that require more than ordinary, routine investigation; second, to identify and implement improved engineering and management practices. This report, entitled “Iowa Highway Research Board Research and Development Activities FY2007” is submitted in compliance with Sections 310.36 and 312.3A, Code of Iowa, which direct the submission of a report of the Secondary Road Research Fund and the Street Research Fund respectively. It is a report of the status of research and development projects, which were in progress on June 30, 2007; it is also a report on projects completed during the fiscal year beginning July 1, 2006, and ending June 30, 2007. Detailed information on each of the research and development projects mentioned in this report is available in the Research and Technology Bureau in the Highway Division of the Iowa Department of Transportation.

Review of Targeted Small Business (TSB) procurement activities for the period July 1, 2007 through September 30, 2007

Review of Targeted Small Business (TSB) procurement activities for the period July 1, 2007 through September 30, 2007

Review of targeted small business procurement activities for the year ended June 30, 2008

Review of targeted small business procurement activities for the year ended June 30, 2008

Annual Report of Iowa Highway Research Board Research and Development Activities FY 08

RESEARCH AND DEVELOPMENT The Highway Division of the Iowa Department of Transportation (Iowa DOT) engages in research and development for two reasons: first, to find workable solutions to the many problems that require more than ordinary, routine investigation; second, to identify and implement improved engineering and management practices. This report, entitled "Iowa Highway Research Board Research and Development Activities FY2008" is submitted in compliance with Sections 310.36 and 3 I2.3A, Code of Iowa, which direct the submission of a report of the Secondary Road Research Fund and the Street Research Fund respectively. It is a report of the status of research and development projects in progress on June 30, 2008; it is also a report on projects completed during the fiscal year beginning July 1, 2007, and ending June 30, 2008. Detailed information on each of the research and development projects mentioned in this report is available in the Research and Technology Bureau in the Highway Division of the Iowa Department of Transportation. IOWA HIGHWAY RESEARCH BOARD In developing a progressive, continuing and coordinated program of research and development, the Highway Division is assisted by the Iowa Highway Research Board. This advisory group was established in 1949 by the Iowa State Highway Commission to respond to the research denoted in Section 310.36 of the Code of Iowa and now is denoted by 312.3A. The Research Board consists of 15 regular members: seven Iowa county engineers, four Iowa DOT engineers, one representative from Iowa State University, one from The University of Iowa, and two engineers employed by Iowa municipalities. Each regular member may have an alternate who will serve at the request of the regular member. The regular members and their alternates are appointed for a three-year term. The membership of the Research Board as of June 30, 2008, is listed in Table I. The Research Board held nine regular meetings during the period ofJuly 1, 2007, to June 30, 2008. Suggestions for research and development were reviewed at these meetings and recommendations were made by the Board.

Critical Role of the GM-CSF Signaling Pathway in Macrophage Pro-Repair Activities.

OBJECTIVE: Macrophages play a critical role in intestinal wound repair. However, the molecular pathways that regulate macrophage wound repair activities remain poorly understood. The aim of this study was to evaluate the role of GM-CSF receptor signaling in the wound repair activities of macrophages. METHODS: Murine macrophages were differentiated from bone marrow cells and human macrophages from monocytes isolated from peripheral blood mononuclear cells of Crohn's disease (CD) patients. In vitro models were used to study the repair activities of macrophages. RESULTS: We provide evidence that GM-CSF receptor signaling is required for murine macrophages to promote epithelial repair. In addition, we demonstrate that the deficient repair properties of macrophages from CD patients with active disease can be recovered via GM-CSF therapy. CONCLUSION: Our data support a critical role of the GM-CSF signaling pathway in the pro-repair activities of mouse and human macrophages. © 2014 S. Karger AG, Basel.

Performance Report for Fiscal Year, 2007

I am pleased to present the performance report for the Iowa Department for the Blind for fiscal year 2007. This report is provided in compliance with sections 8E.210 and 216B.7 of the Code of Iowa. It contains valuable information about the services the Department and its partners provided for Iowans during the past fiscal year in the areas of Vocational Rehabilitation, Independent Living, Library Services, and Resource Management. The Department determines its competitive success in a number of ways. We look at the federal standards and indicators to learn our ranking in relation to the performance of other public rehabilitation agencies. We compare our library's production and circulation figures with those from previous years to determine trends. We set our own standards for success by looking at such factors as the number of successful case closures, average hourly wage at case closure, skills training provided, and compliance with regulations. Results show that the Department is working positively toward achieving its strategic goals of increasing the independence and productivity of blind Iowans and improving access to information for blind Iowans. Major accomplishments of the year included the selection of our Library as the only agency authorized to distribute educational materials using the National Instructional Materials Accessibility Standard (NIMAS) to students in Iowa. Our Independent Living program received the Shining Star award at the Governor's Conference on Aging for its work with and outreach to older blind Iowans. The Department, the Iowa Braille School, and the Department of Education implemented new cooperative efforts to improve the coordination and delivery of services to blind and visually impaired students in Iowa. Finally, earnings ratios and the percentage of employment for vocational rehabilitation clients of the Department remain among the best in the nation, as measured by the U.S. Rehabilitation Services Administration, which on June 27, 2007 released data on federal standards and indicators for the year ended September 30, 2006. Overall, we met or exceeded 11 of 16 results targets included in this report. A discussion of the Department's services, customers, organizational structure, and budget appears in the "Department Overview" that follows. The success of the Department's programs is evident in the success achieved by blind Iowans. It is reflected in the many blind persons who can be seen traveling about independently, going to their jobs and to the community and family activities in which they participate. Sincerely, Allen C. Harris Director, Iowa Department for the Blind

Annual Report of Iowa Highway Research Board Research and Development Activities 2007

RESEARCH AND DEVELOPMENT The Highway Division of the Iowa Department of Transportation (Iowa DOT) engages in research and development for two reasons: first, to find workable solutions to the many problems that require more than ordinary, routine investigation; second, to identify and implement improved engineering and management practices. This report, entitled "Iowa Highway Research Board Research and Development Activities FY2008" is submitted in compliance with Sections 310.36 and 3 I2.3A, Code of Iowa, which direct the submission of a report of the Secondary Road Research Fund and the Street Research Fund respectively. It is a report of the status of research and development projects in progress on June 30, 2008; it is also a report on projects completed during the fiscal year beginning July 1, 2007, and ending June 30, 2008. Detailed information on each of the research and development projects mentioned in this report is available in the Research and Technology Bureau in the Highway Division of the Iowa Department of Transportation. IOWA HIGHWAY RESEARCH BOARD In developing a progressive, continuing and coordinated program of research and development, the Highway Division is assisted by the Iowa Highway Research Board. This advisory group was established in 1949 by the Iowa State Highway Commission to respond to the research denoted in Section 310.36 of the Code of Iowa and now is denoted by 312.3A. The Research Board consists of 15 regular members: seven Iowa county engineers, four Iowa DOT engineers, one representative from Iowa State University, one from The University of Iowa, and two engineers employed by Iowa municipalities. Each regular member may have an alternate who will serve at the request of the regular member. The regular members and their alternates are appointed for a three-year term. The membership of the Research Board as of June 30, 2008, is listed in Table I. The Research Board held nine regular meetings during the period ofJuly 1, 2007, to June 30, 2008. Suggestions for research and development were reviewed at these meetings and recommendations were made by the Board.