El Burnout percibido o sensación de estar quemado en profesionales sanitarios: prevalencia y factores asociados

Depending on the various models explaining the burnout syndrome, different questionnaires have been developed to asses this topic, the most widely-used is the Maslach Burnout Inventory (MBI). Moreover, in trying to asses this syndrome in a faster and more practical way, several authors have developed other instruments with fewer items. The present investigation aims: 1. Study the prevalence of burnout syndrome perceived using a simple measure of self-reported burnout, and to analyse its association with the scales of MBI. 2. Study demographic and work conditions associated with the perceived burnout. 3. Relate the burnout to personal and work evaluations. The sample consist of 6150 health professionals in Latin America (mainly from Argentina but with representation from Mexico, Ecuador, Peru, Colombia, Uruguay, Guatemala and Spain, among others. The mean age of the sample was 42.4 years, 52.7% were males. They were supplied with an online questionnaire through the health web page ”Intramed” in order to measure characteristics, perceptions and professional opinions. The MBI and a simple question to assess perceptions of burnout (Do you feel burnt out ?) was also included. The results indicated that 36.3% of the sample has the perception of “burnt out” or burnout . The perceived burnout is closely related to emotional exhaustion and is independent of depersonalisation. The burnout is associated with the perceived sense of personal and family deterioration due to working conditions, and the idea of abandoning the profession

Retroalimentación docencia-asistencia-docencia: estudio sobre burnout en enfermeras de salud mental como estrategia de innovación y calidad docente

El síndrome de burnout se considera una vulnerabilidad en las profesiones de ayuda. La escasez de publicaciones sobre esta formación, orientó la creación de una asignatura optativa en el Grado de Enfermería de la Universidad de Barcelona (UB) en el curso 2009-2010. Igualmente, produjo interés por explorar esta temática en enfermeras asistenciales de salud mental cuya disciplina aborda la gestión del estrés. Se presenta un estudio descriptivo, transversal y de correlación, en una cohorte de 73 enfermeras que trabajaban en servicios asistenciales de salud mental en el año 2011. Los objetivos pretenden identificar si la muestra estudiada presenta afectación del síndrome de burnout y relacionar los resultados con las estrategias que dichas enfermeras declaran utilizar para hacer frente a las emociones negativas atribuidas a su trabajo. El instrumento empleado es el Maslach Burnout Inventory (MBI), una pregunta abierta y variables sociodemográficas y de salud. Los resultados indican que presentó burnout el 2,7% de la muestra estudiada junto con un nivel medio de despersonalización. Además presentan baja realización personal quienes trabajaban en unidades de enfermos crónicos. El cansancio emocional resulto mayor en mujeres que en hombres y esta presente en personal con contrato fijo y en quienes causaron baja en los dos últimos años. En general, se observa falta de formación y apoyo formal para gestionar el estrés en la muestra estudiada. Se concluye que la formación sobre burnout en el Grado de Enfermería, podría favorecer la gestión del estrés y prevenir su cronicidad hacia la desmotivación y el absentismo laboral.

Retroalimentación docencia-asistencia-docencia: estudio sobre burnout en enfermeras de salud mental como estrategia de innovación y calidad docente

El síndrome de burnout se considera una vulnerabilidad en las profesiones de ayuda. La escasez de publicaciones sobre esta formación, orientó la creación de una asignatura optativa en el Grado de Enfermería de la Universidad de Barcelona (UB) en el curso 2009-2010. Igualmente, produjo interés por explorar esta temática en enfermeras asistenciales de salud mental cuya disciplina aborda la gestión del estrés. Se presenta un estudio descriptivo, transversal y de correlación, en una cohorte de 73 enfermeras que trabajaban en servicios asistenciales de salud mental en el año 2011. Los objetivos pretenden identificar si la muestra estudiada presenta afectación del síndrome de burnout y relacionar los resultados con las estrategias que dichas enfermeras declaran utilizar para hacer frente a las emociones negativas atribuidas a su trabajo. El instrumento empleado es el Maslach Burnout Inventory (MBI), una pregunta abierta y variables sociodemográficas y de salud. Los resultados indican que presentó burnout el 2,7% de la muestra estudiada junto con un nivel medio de despersonalización. Además presentan baja realización personal quienes trabajaban en unidades de enfermos crónicos. El cansancio emocional resulto mayor en mujeres que en hombres y esta presente en personal con contrato fijo y en quienes causaron baja en los dos últimos años. En general, se observa falta de formación y apoyo formal para gestionar el estrés en la muestra estudiada. Se concluye que la formación sobre burnout en el Grado de Enfermería, podría favorecer la gestión del estrés y prevenir su cronicidad hacia la desmotivación y el absentismo laboral.

Formulation and characterization of poloxamer 407®: thermoreversible gel containing polymeric microparticles and hyaluronic acid

The influence of the composition and preparation method on the sol-gel transition temperature (Tsol-gel) and rheological response of poloxamer-based formulations was determined. Manual and more complex mechanical stirring were found to provide similar results. In addition, a linear dependence of Tsol-gel on the poloxamer content was observed in the range of concentrations analyzed, and a Poloxamer 407® concentration of 18% was selected. The addition of hyaluronic acid did not lead to significant changes in the Tsol-gel values. In contrast, the addition of microparticles caused a reduction in Tsol-gel without a significant reduction in gel strength, and pseudoplastic characteristics were observed, indicating that a thermoreversible gel was obtained with a rheology suitable for application in the treatment of burn wounds.

Synthesis and characterization of activated carbon fibers from Kevlar

Kevlar [poly (p-phenilylene terephtalamide)], was used as a precursor in the preparation of activated carbon fibers. For this intention, physical and chemical activations were carried out. Activated fibers were physically prepared from the carbonization of the Kevlar and its later activation with CO2 and steam of water, by the other hand; the chemically activated fibers were obtained by means of the impregnation of the material with phosphoric acid and their later carbonization. Different conditions were used and preliminary analyses of the precursor were taken into account (TGA-DTA / IR). The resulting fibers were characterized by N2 (77K) adsorption, infrared spectroscopy, SEM, and immersion calorimetry. Yields and Burn off were also evaluated. The results shows that if you want to synthesize activated carbon fibers from Kevlar strong conditions respect to the commonly used such as water steam, high phosphoric acid concentrations and methods of impregnation are the ones who allows the development of optimal surface areas and pore volumes.

A tutoria como estratégia educacional no ensino médico

A relação de tutoria é anterior à invenção da linguagem escrita. Desde seu surgimento, ocorreram mudanças em sua estrutura, mas não se perdeu a essência de promover o desenvolvimento do aprendiz. A tutoria é um processo de aprendizado individualizado, numa relação dinâmica, tendo hoje grande importância como ferramenta de ensino em cursos de graduação e treinamentos profissionais. Na educação médica, está relacionada positivamente à percepção de suporte acadêmico, à satisfação com a carreira, à produção científica, à diminuição do risco de burn-out e ao desenvolvimento de relações dentro da profissão. Entretanto, existem limitações, como o pequeno número de tutores preparados, a falta de tempo dos participantes e o restrito apoio institucional. Este trabalho revê os conceitos sobre tutoria, a função dos integrantes e a relação estabelecida entre eles, e avalia a importância, as expectativas e as limitações da tutoria na educação médica, em especial nas escolas de Medicina do Brasil. Foi realizada revisão de artigos científicos do período 2005-2011, no banco de dados PubMed, além de referências citadas nos artigos selecionados.

Soil organic matter pools in a tropical savanna under agroforestry system in Northeastern Brazil

This study aimed at quantifying total organic carbon stocks and its pools in Acrisol under agroforestry systems with six (AFS6) and thirteen years old (AFS13), slash-and-burn agriculture (SBA) and savanna native forest (SNF) in northeastern Brazil. Soil samples were collected at 0-0.05 m, 0.05-0.10 m, 0.10-0.20 m and 0.20-0.40 m depths in the dry and rainy seasons to evaluate total organic carbon (TOC) stocks and labile carbon (LC), fulvic acid fraction (C-FAF), humic acid fraction (C-HAF), humin (C-HF) and microbial biomass carbon (Cmic) contents. Additionally, carbon management index (CMI) was determined. Higher TOC stocks (97.7 and 81.8 Mg ha-1 for the 0-0.40 m depth in the dry and rainy seasons, respectively) and LC, humic substances and Cmic contents were observed in the AFS13 in all the depths. CMI also was higher in the AFS13 (0-0. 05 m: 158 and 86; 0.05-0.10 m: 171 and 67, respectively for the dry and rainy seasons) especially when compared to the SBA (0-0.05 m: 5.6 and 5.4; 0.05-0.10 m: 5.3 and 5.8, respectively for dry and rainy seasons). The agroforestry systems increased soil quality through the conservation of organic matter and can be considered an excellent strategy to assurance sustainability in tropical soil of Northeastern Brazil

Esofagectomia na perfuração esofágica com diagnóstico tardio

Esophageal perforations are related to high mortality rates, especially if there is a delayed diagnostic and treatment. We report an esophageal perforation caused by caustic ingestion, in a suicidal attempt, successfully treated by esophagectomy after a long period of misdiagnosis that lead to infectious complications.

Ensinar cirurgia: como e para quem?

O autor discute a crise atual de formação de médicos e de cirurgiões fazendo uma revisão de dados de literatura atual, referentes ao quantitativo de médicos e discussão de referências éticas e filosóficas da profissão. Há uma diminuição crescente na formação de médicos e cirurgiões, com uma crescente participação de mulheres. Os médicos jovens buscam qualidade de vida e autonomia profissional como principais requisitos profissionais. As síndromes de burn-out são comuns entre os médicos em atividade, e a perda de autonomia profissional tem papel preponderante na determinação da doença. A crise que atinge a profissão médica e as especialidades cirúrgicas tem bases éticas, sociais e financeiras. É necessário e fundamental discutir novos paradigmas de educação e atuação profissional na sociedade moderna.

Validation of a 3D model for oxygen combustion in a circulating fluidized bed

In this thesis, a model called CFB3D is validated for oxygen combustion in circulating fluidized bed boiler. The first part of the work consists of literature review in which circulating fluidized bed and oxygen combustion technologies are studied. In addition, the modeling of circulating fluidized bed furnaces is discussed and currently available industrial scale three-dimensional furnace models are presented. The main features of CFB3D model are presented along with the theories and equations related to the model parameters used in this work. The second part of this work consists of the actual research and modeling work including measurements, model setup, and modeling results. The objectives of this thesis is to study how well CFB3D model works with oxygen combustion compared to air combustion in circulating fluidized bed boiler and what model parameters need to be adjusted when changing from air to oxygen combustion. The study is performed by modeling two air combustion cases and two oxygen combustion cases with comparable boiler loads. The cases are measured at Ciuden 30 MWth Flexi-Burn demonstration plant in April 2012. The modeled furnace temperatures match with the measurements as well in oxygen combustion cases as in air combustion cases but the modeled gas concentrations differ from the measurements clearly more in oxygen combustion cases. However, the same model parameters are optimal for both air and oxygen combustion cases. When the boiler load is changed, some combustion and heat transfer related model parameters need to be adjusted. To improve the accuracy of modeling results, better flow dynamics model should be developed in the CFB3D model. Additionally, more measurements are needed from the lower furnace to find the best model parameters for each case. The validation work needs to be continued in order to improve the modeling results and model predictability.

Kunnossapito-ohjelman rakentaminen RCM - menetelmän avulla

Työn tarkoituksena oli luoda UPM Kaukaan sellutehtaan kaustisointi- ja meesauunialueelle kunnossapito-ohjelma, RCM eli luotettavuuskeskeinen kunnossapitomenetelmää käyttäen. Tavoitteena oli luoda ennakkohuolto-ohjelma, joka pohjautuu laitekriittisyyksiin sekä optimoida kohdealueen laitteiden varaosien varastointia. Perustaksi työlle luotiin uusi kriittisyysluokittelumalli, joka perustuu PSK 6800 standardiin. Tarvittavien ennakkohuoltotoimenpiteiden määrittämisen apuna käytettiin toimenpiteiden määritysmatriisia. Varaosavaraston optimointia varten luotiin varaosien varastointitarpeen määritysmatriisi. Prosessin suorittamisessa korostui laaja ja osaava projektiryhmä, jonka avulla asioiden läpikäynnissä oli tarvittavat tiedot saatavilla. Projektiryhmässä oli mukana sekä kunnossapidon että käytön henkilöitä. Kunnossapito-ohjelmasta muodostui erittäin kattava. Seisokkia vaativat toimenpiteet ovat aikataulutettu siten, että niitä suoritetaan tasaisesti vuoden aikana. Uusien huoltorivien ansiosta alueen kunnossapito selkeytyy paljon.

Morphological and physiological alterations induced by lactofen in soybean leaves are reduced with nitric oxide

Lactofen is a diphenylether herbicide recommended to control broad-leaved weeds in soybean (Glycine max) fields and its mechanism of action is the inhibition of protoporphyrinogen-IX oxidase (Protox), which acts in the chlorophyll biosynthesis. This inhibition results in an accumulation of protoporphyrin-IX, which leads to the production of reactive oxygen species (ROS) that cause oxidative stress. Consequently, spots, wrinkling and leaf burn may occur, resulting in a transitory crop growth interruption. However, nitric oxide (NO) acts as an antioxidant in direct ROS scavenging. Thus, the aim of this work was to verify, through phytometric and biochemical evaluations, the protective effect of NO in soybean plants treated with the herbicide lactofen. Soybean plants were pre-treated with different levels of sodium nitroprusside (SNP), a NO-donor substance, and then sprayed with 168 g a.i. ha-1 lactofen. Pre-treatment with SNP was beneficial because NO decreased the injury symptoms caused by lactofen in young leaflets and kept low the soluble sugar levels. Nevertheless, NO caused slower plant growth, which indicates that further studies are needed in order to elucidate the action mechanisms of NO in signaling the stress caused by lactofen in soybean crop.

INFLUENCE OF SUGARCANE STRAW AND SOWING DEPTH ON THE EMERGENCE OF WEED SPECIES

ABSTRACT This study aimed to understand the influence of sowing depth and the amount of sugarcane straw on the emergence of weed species Luffa aegyptiaca Miller (Cucurbitaceae); Mucuna aterrima Piper & Tracy (Fabaceae - Leguminosae) and Ricinus communis (Euphorbiaceae). A completely randomized design with a 5 x 4 x 3 factorial layout with four replications was used, at five sowing depths (0, 2, 4, 8 and 10 cm), four different amounts of sugarcane straw (0, 5, 10 and 15 t ha-1) and three different evaluation periods (7, 14 and 21 days after sowing). After sowing, different amounts of sugarcane straw (0, 5, 10 and 15 t ha-1) were deposited on soil. Seedling emergence was analyzed at 7, 14 and 21 days after sowing, counting the number of seedlings that had emerged. At the end of the trial, weed height (cm), leaf area (cm2) and shoot dry mass (g) were measured. In relation to emergence ability, studied species presented different responses according to sowing depth and to the amount of sugarcane straw deposited on the soil. For the L.aegyptiacaand M.aterrima, no significant difference was observed in the interaction between depth and sugarcane straw, showing the adaptation of these species to no-burn sugarcane system. For R.communis, seeds placed at 0 cm of sugar cane straw depth were observed to favor the emergence of seedlings.

Atlantic Forest succession over calcareous soil, Parque Estadual Turístico do Alto Ribeira - PETAR, SP

The forest succession after abandonment of slash-and-burn agriculture over calcareous soil in Brazilian Atlantic Forest was assessed. This is one of the world's most threatened Biome, with only 8% remaining. The study area is located over calcareous soil inside the Alto Ribeira Touristic State Park (PETAR), southeast Brazil. The phytossociological survey showed a successional pattern dominated by species of Leguminosae, especially Piptadenia gonoacantha (Mart.) J.F. Macbr. This species occurs in calcareous soils as a substitute of Tibouchina pulchra (Cham.) Cogn. (Melastomataceae) that is the most usual dominant tree species in early succession over acidic soil, which is the most common situation in this Biome. These results are important for a better understanding of Neotropical forest biodiversity and characterize a unique genetic bank in this highly endangered Biome. They are also decisive to support actions regarding rehabilitation of degraded lands and a potential tool for Neotropical forest sustainable management, both inside and around the conservation unit.

Vedyn käytön tarkastelu Kemira Chemicals Oy:n Joutsenon tehtailla

Kemira Chemicals Oy:n Joutsenon tehtailla valmistetaan lipeää, suolahappoa, natriumhypokloriittia sekä natriumkloraattia. Lipeää, suolahappoa ja natriumhypokloriittia valmistetaan lipeätehtaassa. Natriumkloraattia valmistetaan kloraattitehtaassa. Kloraatti- ja lipeätehtaan tuotteet valmistetaan elektrolyysimenetelmällä. Elektrolyysien sivutuotteena syntyy vetykaasua, joka voidaan käyttää suolahapon valmistukseen, vetyvoimalaitoksen polttoaineena tai myydä asiakkaalle. Työn tavoitteena oli tarkastella vedyn käyttöä Joutsenon tehtailla. Tarkastelun tavoitteena oli löytää mahdollisia kehitys- tai jatkotutkimuskohteita vety- ja höyryjärjestelmästä. Koska vetyä käytetään myös vetyvoimalaitoksen polttoaineena, joka tuottaa tehtailla tarvittavan prosessihöyryn, tarkasteltiin työssä myös höyryn käyttöä tehtailla. Tarkastelua varten tehtiin Microsoft Excel-pohjainen taselaskentamalli, jolla simuloitiin vedyn ja höyryn käyttöä tehtailla. Työn tuloksena saatiin Excel-pohjainen simulointimalli, jolla pystyttiin tutkimaan vedyn ja höyryn käyttöä. Vedyn ja höyryn käyttöä tutkittiin viidessä eri skenaariossa. Skenaariossa yksi määritettiin pienimmät mahdolliset elektrolyysiin syötettävät sähkövirran arvot, joilla tehtaita on turvallista käyttää. Skenaariossa kaksi määritettiin pienimmät mahdolliset elektrolyysiin syötettävät sähkövirran arvot, joilla voimalaitoksen turbiini pysyisi ajossa. Skenaariossa kolme määritettiin tehtaiden tämän hetkinen maksimi kapasiteetti. Skenaarioissa neljä ja viisi tutkittiin, miten mahdollinen tehtaiden tuotantojen kasvattaminen vaikuttaisi vety- ja höyryjärjestelmään. Työn tuloksien perusteella kehitys- ja jatkotutkimuskohteita olisivat lipeän haihdutuksen höyryn kulutuksen pienentäminen, turbiinin käyttöajan kasvattaminen sekä eri lähteistä saatavan hukkalämmön parempi hyödyntäminen kaukolämmön tuotannossa. Tehtaiden tuotantoja kasvatettaessa on syytä kiinnittää huomioita myös voimalaitoksen pääkattilan ja turbiinin kapasiteettiin.