Evaluating the impact of filming on the number of errors committed by nursing students to determine the efficacy of simulated clinical situations

Clinic simulation as a training and knowledge method allows people experiment a real event representation with the aim of acquiring knowledge, abilities and aptitudes. The filming of the staging represents a useful tool to review the decisions taken and the actions they did, with the purpose to highlight the strengths, weaknesses and the areas for improvement. The article describes a study carried out by a group of students in second course of nursing, and it tries to evaluate if there is any influence if somebody is filming you during the clinic simulation, does it make you do more errors or not?

Management of severe blunt hepatic injury in the era of computed tomography and transarterial embolization: A systematic review and critical appraisal of the literature.

BACKGROUND: During the last decade, the management of blunt hepatic injury has considerably changed. Three options are available as follows: nonoperative management (NOM), transarterial embolization (TAE), and surgery. We aimed to evaluate in a systematic review the current practice and outcomes in the management of Grade III to V blunt hepatic injury. METHOD: The MEDLINE database was searched using PubMed to identify English-language citations published after 2000 using the key words blunt, hepatic injury, severe, and grade III to V in different combinations. Liver injury was graded according to the American Association for the Surgery of Trauma classification on computed tomography (CT). Primary outcome analyzed was success rate in intention to treat. Critical appraisal of the literature was performed using the validated National Institute for Health and Care Excellence "Quality Assessment for Case Series" system. RESULTS: Twelve articles were selected for critical appraisal (n = 4,946 patients). The median quality score of articles was 4 of 8 (range, 2-6). Overall, the median Injury Severity Score (ISS) at admission was 26 (range, 0.6-75). A median of 66% (range, 0-100%) of patients was managed with NOM, with a success rate of 94% (range, 86-100%). TAE was used in only 3% of cases (range, 0-72%) owing to contrast extravasation on CT with a success rate of 93% (range, 81-100%); however, 9% to 30% of patients required a laparotomy. Thirty-one percent (range, 17-100%) of patients were managed with surgery owing to hemodynamic instability in most cases, with 12% to 28% requiring secondary TAE to control recurrent hepatic bleeding. Mortality was 5% (range, 0-8%) after NOM and 51% (range, 30-68%) after surgery. CONCLUSION: NOM of Grade III to V blunt hepatic injury is the first treatment option to manage hemodynamically stable patients. TAE and surgery are considered in a highly selective group of patients with contrast extravasation on CT or shock at admission, respectively. Additional standardization of the reports is necessary to allow accurate comparisons of the various management strategies. LEVEL OF EVIDENCE: Systematic review, level IV.

Repetitive Deliberate Fires: Critical Review of the Situation and Proposal of a Follow-Up Process and Systematic Analysis

Deliberate fires appear to be borderless and timeless events creating a serious security problem. There have been many attempts to develop approaches to tackle this problem, but unfortunately acting effectively against deliberate fires has proven a complex challenge. This article reviews the current situation relating to deliberate fires: what do we know, how serious is the situation, how is it being dealt with, and what challenges are faced when developing a systematic and global methodology to tackle the issues? The repetitive nature of some types of deliberate fires will also be discussed. Finally, drawing on the reality of repetition within deliberate fires and encouraged by successes obtained in previous repetitive crimes (such as property crimes or drug trafficking), we will argue that the use of the intelligence process cycle as a framework to allow a follow-up and systematic analysis of fire events is a relevant approach. This is the first article of a series of three articles. This first part is introducing the context and discussing the background issues in order to provide a better underpinning knowledge to managers and policy makers planning on tackling this issue. The second part will present a methodology developed to detect and identify repetitive fire events from a set of data, and the third part will discuss the analyses of these data to produce intelligence.

Filtration of effluents for microirrigation systems

Clogging, measured through head loss across filters, and the filtration quality of different filters using different effluents were studied. The filters used were: 115, 130, and 200 m disc filters; 98, 115, 130, and 178 m screen filters; and a sand filter filled with a single layer of sand with an effective diameter of 0.65 mm. The filters were used with a meat industry effluent and secondary and tertiary effluents of two wastewater treatment plants. It was observed that clogging depended on the type of effluent. With the meat industry effluent, the poorest quality effluent, disc filters clogged more than the other filter types. When the wastewater treatment plant effluents were used, the disc filters showed less frequent clogging. Several physical and chemical parameters, such as total suspended solids, chemical oxygen demand, turbidity, electrical conductivity, pH, and number of particles, were analyzed in the effluents at the entry and exit points of the filters. In general, filters did not reduce the values of the main clogging parameters to a great degree. It was found that the parameter that explained the clogging, expressed as Boucher’s filterability index, was different depending on the type of effluent and filter. The best quality of filtration was achieved with a sand filter when the meat industry effluent was used. No significant differences were observed between the quality of filtration of disc and screen filters when operating with the secondary and tertiary effluents

Ultrasound-guided fine-needle aspiration of thyroid nodules: assessment of the ideal number of punctures

OBJECTIVE: To determine the number of punctures in fine-needle aspiration biopsies required for a safe cytological analysis of thyroid nodules. MATERIALS AND METHODS: Cross-sectional study with focus on diagnosis. The study population included 94 patients. RESULTS: The mean age of the patients participating in the study was 52 years (standard-deviation = 13.7) and 90.4% of them were women. Considering each puncture as an independent event, the first puncture has showed conclusive results in 78.7% of cases, the second, in 81.6%, and the third, in 71.8% of cases. With a view to the increasing chance of a conclusive diagnosis at each new puncture, two punctures have showed conclusive results in 89.5% of cases, and three punctures, in 90.6% of cases with at least one conclusive result. CONCLUSION: Two punctures in fine-needle aspiration biopsies of thyroid nodules have lead to diagnosis in 89.5% of cases in the study sample, suggesting that there is no need for multiple punctures to safely obtain the diagnosis of thyroid nodules.

Towards a Network Government? A critical analysis of current assessment methods for e-Government

Contemporary public administrations have become increasingly more complex, having to cordinate actions with emerging actors in the public and the private spheres. In this scenario the modern ICTs have begun to be seen as an ideal vehicle to resolve some of the problems of public administration. We argue that there is a clear need to explore the extent to which public administrations are undergoing a process of transformation towards a netowork government linked to the systematic incorporation of ICTs in their basic activities. Through critically analysing a selection of e-government evaluation reports, we conclude that research should be carried out if we are to build a solid government assessment framework based on network-like organisation characteristics.

El deporte como instrumento de desarrollo de la capacidad crítica de los adolescentes. Experiencias realizadas en cuatro centros de secundaria = Sport as a tool in the development of critical capacity of teenagers. Experiments carried out in four centres of Secondary education

In the article we resume four experiments of an interdisciplinary nature carried out in four different secondary education centres. The nexus of the union of these didactic proposals is that of looking at values in sport and the critical capacity of the students from distinct perspectives: violence, mass media, politics and gender and the treatment of body in our society

Minimum number of assessment times to compare chemical control treatments for papaya fruit anthracnose

The chemical treatment evaluation in the field to control post-harvest fruit anthracnose (Colletotrichum gloeosporioides) requires a suitable disease incidence assessment on harvested papaya (Carica papaya) fruits. The minimum number of papaya fruit harvests was determined for valid treatment comparison in field trials for anthracnose chemical control. Repeatability analysis was done using previously published data. The coefficient determination (R²) estimate range, using four methods, and based on means of 12 assessment times, was 92.58 < R² < 94.45%. The number of assessment times required for R²=90% varied from seven to nine. The R² values of 85.1 < R² < 91.3% estimated by ANOVA suggested that any seven successive assessment times were sufficient for treatment comparison.

Influence of distance, geometry and number of control stations on quality of local geodetic networks for the purpose of georeferencing of rural properties

The implementation of local geodetic networks for georeferencing of rural properties has become a requirement after publication of the Georeferencing Technical Standard by INCRA. According to this standard, the maximum distance of baselines to GNSS L1 receivers is of 20 km. Besides the length of the baseline, the geometry and the number of geodetic control stations are other factors to be considered in the implementation of geodetic networks. Thus, this research aimed to examine the influence of baseline lengths higher than the regulated limit of 20 km, the geometry and the number of control stations on quality of local geodetic networks for georeferencing, and also to demonstrate the importance of using specific tests to evaluate the solution of ambiguities and on the quality of the adjustment. The results indicated that the increasing number of control stations has improved the quality of the network, the geometry has not influenced on the quality and the baseline length has influenced on the quality; however, lengths higher than 20 km has not interrupted the implementation, with GPS L1 receiver, of the local geodetic network for the purpose of georeferencing. Also, the use of different statistical tests, both for the evaluation of the resolution of ambiguities and for the adjustment, have enabled greater clearness in analyzing the results, which allow that unsuitable observations may be eliminated.

Critical analysis of thoracotomies performed in the emergency room in 10 years

OBJECTIVE: To conduct a critical analysis of thoracotomies performed in the emergency rooms.METHODS: We analyzed mortality rates and survival as outcome variables, mechanism of injury, site of injury and anatomic injury as clinical variables, and gender and age as demographic variables of patients undergoing thoracotomy in the emergency room after traumatic injury.RESULTS: Of the 105 patients, 89.5% were male. The average age was 29.2 years. Penetrating trauma accounted for 81% of cases. The most common mechanism of trauma was wound by a firearm projectile (gunshot), in 64.7% of cases. Patients with stab wounds (SW) accounted for 16.2% of cases. Overall survival was 4.7%. Survival by gunshot was 1.4%, and by SW, 23.5%. The ERT following blunt trauma showed a 100%mortality.CONCLUSION: The results obtained in the Emergency Hospital of Porto Alegre POA-HPS are similar to those reported in the world literature.

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.

Interaction between the mineral content and the occurrence number of aquatic fungi in leaves submerged in a stream in the Atlantic rainforest, São Paulo, Brazil

Leaves of Ficus microcarpa L. f., Quercus robur L., and Alchornea triplinervia (Spreng.) Muell. Arg., submerged in a stream of the Atlantic rainforest in the "Reserva Biológica do Alto da Serra de Paranapiacaba", State of São Paulo, Brazil, were collected monthly, from April to November 1990, in order to determine the number of fungal occurrences (zoosporic fungi and aquatic Hyphomycetes), and the content of total N (%), total P (%), K+ (%), Ca+2 (%), Mg+2 (%), S+3 (%), Fe+3 (ppm), Cu+3 (ppm), Mn+2 (ppm), Zn+2 (ppm), Bo (ppm), Na+2 (ppm) and Al+3 (ppm). According to the tests of Kruskal-Wallis, Mann-Whitney and Wilcoxon, the means of the mineral content of the three types of leaves were significantly different, except for Mg+2 (%), Mn+2 (ppm), Zn+2 (ppm) and Na+2 (ppm). On comparing the mineral content with the number of fungal occurrence, an independence test showed a positive correlation between the presence of zoosporic fungi on the leaves of A. triplinervia and the total nitrogen, phosphorus and S+3 content, whereas the aquatic Hyphomycetes depended on the amount of Ca+2 available. Regarding leaves of F. microcarpa, the occurrence of zoosporic fungi was linked to the S+3 level, and the presence of aquatic Hyphomycetes, to the content of K+, Ca+2, S+3 and Bo. On Q. robur leaves, zoosporic fungi showed a positive correlation with the Ca+2 content, but a negative one with Fe+3 and Al+3 levels, while the occurrence of aquatic Hyphomycetes was influenced by the content of Ca+2, Mg+2, Fe+3, Al+3, Mn+2, Zn+2 and Na+2. The correlation between the occurrence number of aquatic Hyphomycetes and a high mineral content indicates that their nutritional requirements may be more complex than those of zoosporic fungi. Further studies are still required to understand the implications of this tendency on the diversity of aquatic native mycota.

Number of buried seeds and seedlings emergence in cerradão, cerrado and gallery forest soils at Pedregulho, Itirapina (SP), Brazil

This study was carried out at the site named Pedregulho in the "Estação Experimental de Itirapina", Itirapina, state of São Paulo, Brazil. Soil samples were collected in the rainy and in the dry season at three depths in the gallery forest, cerrado and cerradão. The total number of seeds was counted after being separated from the soil by wet sieving and the number of viable seeds was determined by emergence of seedlings in soil samples in a greenhouse. The number of seeds and of emerged seedlings decreases as soil samples become deeper. The number of seeds was much larger in the cerrado in the dry season than in the rainy season, but it was lower in the dry than in the rainy season in the gallery forest. The number of seeds in the cerradão was similar in both seasons. There was a heavy discrepancy between the total number of seeds and that of emerged seedlings.