The core characteristics and nursing care activities in psychiatric intensive care units in Sweden

Internationally, research on psychiatric intensive care units (PICUs) commonly reportsresults from demographic studies such as criteria for admission, need for involuntary treatment, andthe occurrence of violent behaviour. A few international studies describe the caring aspect of thePICUs based specifically on caregivers’ experiences. The concept of PICU in Sweden is not clearlydefined. The aim of this study is to describe the core characteristics of a PICU in Sweden and todescribe the care activities provided for patients admitted to the PICUs. Critical incident techniquewas used as the research method. Eighteen caregivers at a PICU participated in the study bycompleting a semistructured questionnaire. In-depth interviews with three nurses and two assistantnurses also constitute the data. An analysis of the content identified four categories that characterizethe core of PICU: the dramatic admission, protests and refusal of treatment, escalating behaviours, andtemporarily coercive measure. Care activities for PICUs were also analysed and identified as controlling– establishing boundaries, protecting – warding off, supporting – giving intensive assistance, andstructuring the environment. Finally, the discussion put focus on determining the intensive aspect ofpsychiatric care which has not been done in a Swedish perspective before. PICUs were interpreted asa level of care as it is composed by limited structures and closeness in care.

Parent’s experiences of feeding their preterm infant in Neonatal Units in Sweden. : Ethnographic design

Introduction: Studies have shown that having a preterm infant may cause stress and powerlessness for parents. It is important to support parents around the feeding situation, and that the Neonatal Intensive Care Unit (NICU) has appropriate space and place to help the family to bond to each other. For the healthcare professionals it is important to promote skin-to-skin contact and breastfeeding; particularly for preterm infants. There are many studies on parent’s experiences of NICUs and a few studies on parent’s experiences of feeding their infant in the NICU. Objective: The objective of this study was to explore parents experiences of feeding their infant in the NICU. Design: The study was conducted using an ethnographic design. Results: A global theme of ‘The journey in feeding’ was developed from four organising themes: ‘Ways of infant feeding’; ‘Environmental influences’; ‘Relationships’ and ‘Emotional factors’. These themes illustrate the challenges mothers reported with different methods of feeding. The environment had a big impact on parent’s experiences of infant feeding. Some mothers felt that breastfeeding seemed unnatural because their infant was so tiny but breastfeeding and skin-to-skin contact helped them to bond to their infant. The mothers thought it was difficult to keep up with the milk production by only pumping. Routines were not inviting parents to find their own rhythm. They also felt stressed about the weighing. Healthcare professionals had positive and negative influences on the parents. Conclusions: This study demonstrates that while all parents expressed the wish to breastfeed, their ‘journey in feeding’ was highly influenced by method of feeding, environmental, relational and emotional factors. The general focus upon routines and assessing milk intake generated anxiety and reduced relationality. Midwives and neonatal nurses need to ensure that they emphasise and support the relational aspects of parenting and avoid over-emphasising milk intake and associated progress of the infant

"We sold a million units": the role of advertising past-sales

In a market where past-sales embed information about consumers’ tastes (quality), we analyze the seller’s incentives to invest in a costly advertising campaign to report them under two informational assumptions. In the …rst scenario, a pooling equilibrium with past-sales advertising is derived. Information revelation only occurs when the seller bene…ciates from the herding behaviour that the advertising campaign induces on the part of consumers. In the second informational regime, a separating equilibrium with past-sales advertising is computed. Information revelation always happens, either through prices or through costly advertisements.

Geographical externalities and the Pacifying Police Units Program in Rio de Janeiro

The paper quantifies the effects on violence and police activity of the Pacifying Police Unit program (UPP) in Rio de Janeiro and the possible geographical spillovers caused by this policy. This program consists of taking selected shantytowns controlled by criminals organizations back to the State. The strategy of the policy is to dislodge the criminals and then settle a permanent community-oriented police station in the slum. The installation of police units in these slums can generate geographical spillover effects to other regions of the State of Rio de Janeiro. We use the interrupted time series approach proposed by Gonzalez-Navarro (2013) to address effects of a police when there is contagion of the control group and we find that criminal outcomes decrease in areas of UPP and in areas near treated regions. Furthermore, we build a model which allows to perform counterfactuals of this policy and to estimate causal effects in other areas of the State of Rio de Janeiro outside the city.

Prevalence and antimicrobial resistance patterns of methicillin-resistant staphylococci (MRS) isolated in a Veterinary Teaching Hospital in Brazil

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Estudo do perfil térmico de fornos do tipo "caipira" utilizados pelo setor de cerâmica vermelha em parelhas na região Seridó-RN

The present study aimed to characterize the thermal profile of wood fired oven used by the red ceramic industry in Parelhas, in the Seridó region/RN, aiming to propose structural interventions that can contribute to increasing productivity and product quality, optimize wood consumption and mitigate existing losses during the burning process. The study was conducted at Cerâmica Esperança in the city of Parelhas -RN, Brazil, during the period from August 2012 to September 2013. Four treatments were performed with three replicates, ie, with, a total of 12 experimental units (burnings). In the first stage 4 treatments were performed with three replicates, totaling 12 experimental units (firings). In the second stage 2 treatments were performed with three replications, totaling 6 experimental units (firings). The physical characteristics of the wood were analyzed using standard NBR 11941 and NBR 7190 for basic density and moisture, respectively. The clay was used as a reference parameter for distinguishing treatments. For both the analysis and characterization was carried out using techniques of fluorescence X (XRF) rays, X-ray diffraction (XRD) analysis, particle size analysis (FA). In the first and second stages were monitored: the time during the firing process, the amount of wood used at each firing, the number of parts enfornadas for subsequent determination of the percentages of losses, but also product quality. To characterize the thermal profile of the oven, we measured the temperature at 15 points scored in the surface charge put into the oven. Measurements were taken every 30 minutes from preheat until the end of burning, using a pyrometer laser sight sighting from preheating until the end of burning. In the second step 12 metal cylinders distributed on the oven walls, and the cylinder end walls 8 of the furnace 2 and rollers on each side walls are installed equidistant to 17 cm from the soil and the surface 30 of the wall are installed. The cylinders distributed on the front were placed 50 cm above the furnace, and the base of the oven 20 cm distant from the ground. 10 also thermocouples were installed, and five thermocouples distributed 1.77 cm above the combustion chambers, and one thermocouple on each side, and three thermocouples in front of the oven. We carried out the measurements of the temperatures every 1 hour during the burning two hours in cooling the cylinders with a pyrometer and thermocouples for dattaloger. These were fixed with depth of 30 cm from the wall. After statistical analysis it was found that: the thermal profile of the furnace surface and at different heights was heterogeneous; and the ranges of density and moisture content of wood are within recommended for use as an energy source standards. We conclude that even at low temperatures reached during firing there was a significant production of good quality products, this is due to high concentrations of iron oxide and potassium oxide found in clay, which lowers the melting point of the piece. The average burn time for each step varied 650-2100 minutes wood consumption was on average 20 m3, product quality was on average 16% of first quality, 70% second, third and 5% to 10% loss . The distance between the wire and the surface of the oven was a significant parameter for all treatments, but with different variations, meaning that the wire should not be so generic and unique form, used as a criterion for completion of the burn process. The central part of the furnace was the area that reached higher temperature, and in a unified manner, with the highest concentration of top quality products. The ideal temperature curve, which provided the highest quality of ceramic products was achieved in the central part of the furnace

Soil CO2 emission and its relation to soil properties in sugarcane areas under Slash-and-burn and Green harvest

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Isolation of Pseudomonas aeruginosa strains from dental office environments and units in Barretos, state of São Paulo, Brazil, and analysis of their susceptibility to antimicrobial drugs

Uma ampla variedade de patógenos oportunistas tem sido detectadas nos tubos de alimentação de água dos equipos odontológicos, particularmente no biofilme formado na superfície do tubo. Entre os patógenos oportunistas encontrados nos tubos de água, Pseudomonas aeruginosa é reconhecida como uma das principais causadoras de infecções nosocomiais. Foram coletadas 160 amostras de água e 200 amostras de fomites em quarenta clinicas odontológicas na cidade de Barretos, São Paulo, Brasil, durante o período de Janeiro a Julho de 2005. Setenta e seis cepas de P. aeruginosa, isoladas a partir dos fomites (5 cepas) e das amostras de água (71 cepas), foram analisadas quanto à susceptibilidade à seis drogas antimicrobianas freqüentemente utilizadas para o tratamento de infecções provocadas por P. aeruginosa. As principais suscetibilidades observadas foram para a ciprofloxacina, seguida pelo meropenem. A necessidade de um mecanismo efetivo para reduzir a contaminação bacteriana dentro dos tubos de alimentação de água dos equipos odontológicos foi enfatizada, e o risco da exposição ocupacional e infecção cruzada na prática odontológica, em especial quando causada por patógenos oportunistas como a P. aeruginosa foi realçado.

Toward the Optimization of an e-Tongue System Using Information Visualization: A Case Study with Perylene Tetracarboxylic Derivative Films in the Sensing Units

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Genetic diversity and antifungal susceptibility testing of Trichosporon asahii isolated of Intensive Care Units patients

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Forest natural regeneration and biomass production after slash and burn in a seasonally dry forest in the Southern Brazilian Amazon

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Ação educativa sobre queimaduras infantis para familiares de crianças hospitalizadas

OBJETIVO: Analisar o potencial informativo de uma ação educativa sobre queimaduras infantis com responsáveis por crianças internadas em ambiente hospitalar. MÉTODOS: Foram aplicados questionários estruturados, antes e imediatamente após a ação educativa, que incluiu intervenções verbais e folheto educativo, em 37 acompanhantes de crianças e adolescentes internados no Setor Público de Pediatria de dois hospitais de uma cidade do interior do Estado de São Paulo. As informações obtidas antes e após a ação educativa foram comparadas, utilizando-se o teste estatístico do quiquadrado e considerando-se significante p<0,05. RESULTADOS: Na comparação pré- e pós-ação educativa, notou-se aumento de 95% para 100% na indicação da residência como local mais propício para ocorrência de queimaduras infantis; de 46% para 78% na indicação da faixa etária mais acometida (zero a três anos); de 76% para 78% no gênero mais acometido (masculino); de 43% para 78% na indicação do principal agente agressor (água quente); de 32% para 78% na região corporal mais atingida (tórax); e de 89% para 97% na possibilidade de prevenção da queimadura infantil. CONCLUSÕES: A ação educativa mostrou bom potencial informativo pela elevação do percentual de respostas corretas em todos os aspectos apresentados, sugerindo sua utilidade no contexto hospitalar e em outros locais, como unidades de atenção primária e secundária à saúde e instituições de educação infantil e superior.

Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA): molecular background, virulence, and relevance for public health

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Knowledge and attitudes of health care workers from intensive care units regarding nosocomial transmission of influenza: a study on the immediate pre-pandemic period

The transmission of influenza in health care settings is a major threat to patients, especially those with severe diseases. The attitude of health care workers (HCWs) may influence the transmission of countless infections. The current study aimed to quantify knowledge and identify attitudes of HCWs involved in intensive care units (ICUs) regarding the risk of nosocomial influenza transmission. A questionnaire was applied through interviews to HCWs who worked in one of the five ICUs from a teaching hospital. Questions about influenza were deliberately dispersed among others that assessed several infectious agents. Forty-two HCWs were interviewed: nine physicians, ten nurses and 23 nursing technicians or auxiliaries. Among the 42 HCWs, 98% were aware of the potential transmission of influenza virus in the ICUs, but only 31% would indicate droplet precautions for patients with suspected infection. Moreover, only 31% of them had been vaccinated against influenza in the last campaign (2008). Nursing technicians or auxiliaries were more likely to have been vaccinated, both by univariate and multivariable analysis. When asked about absenteeism, only 10% of the study subjects stated that they would not go to work if they had an influenza-like illness. Those findings suggest that, in non-pandemic periods, influenza control in hospitals requires strategies that combine continuous education with changes in organizational culture.

Nutritional, immunological and microbiological profiles of burn patients

A burn is a lesion on an organic tissue resultant from direct or indirect action of heat on the organism. The present study aimed to evaluate the nutritional, immunological and microbiological status of burn patients at the Bauru State Hospital, São Paulo state, Brazil, in 2007. Eight patients, aged more than 18 years and injured up to 24 hours, were evaluated at the moment of hospitalization and seven days later. All victims were males with a mean age of 38 years. on average, 17.5% of their body surfaces were burned and 50% of the patients were eutrophic. There were significant alterations in levels of erythrocytes, hemoglobin, hematocrit, total protein and albumin due to increased endothelial permeability, direct destruction of proteins in the heat-affected area and blood loss from lesions or debridement. At a second moment, cytokines IL-6 and TNF-alpha had augmented significantly, with IL-6 presenting elevated levels in relation to controls at the first moment. Microbiological analysis showed that 100% of the samples collected at hospital admission were negative and after one week Staphylococcus aureus was found in all cultures. Therefore, a burn patient may be considered immunosuppressed and these results indicate significant nutritional, immunological and microbiological alterations that can interfere in his recovery.