Hospital catering systems and their impact on the sensorial profile of foods provided to older patients in the UK

Impaired sensorial perception is very common in older people and low sensorial quality of foods is associated with decreased appetite and dietary intake. Hospital undernutrition in older patients could be linked to sensorial quality of hospital food if the quality were low or inappropriate for older people. The aim of this study was to examine changes in the sensorial quality of different foods that occur as a result of the food journey (i.e. freezing, regeneration, etc.) in the most common hospital catering systems in the UK. A trained sensory panel assessed sensorial descriptors of certain foods with and without the hospital food journey as it occurs in the in-house and cook/freeze systems. The results showed effects of the food journey on a small number of sensorial descriptors related to flavour, appearance and mouthfeel. The majority of these effects were due to temperature changes, which caused accumulation of condensation. A daily variation in sensorial descriptors was also detected and in some cases it was greater than the effect of the food journey. This study has shown that changes occur in the sensory quality of meals due to hospital food journeys, however these changes were small and are not expected to substantially contribute to acceptability or have a major role in hospital malnutrition.

Recent progress in understanding and projecting regional and global mean sea-level change

Considerable progress has been made in understanding the present and future regional and global sea level in the 2 years since the publication of the Fifth Assessment Report (AR5) of the Intergovernmental Panel on Climate Change. Here, we evaluate how the new results affect the AR5’s assessment of (i) historical sea level rise, including attribution of that rise and implications for the sea level budget, (ii) projections of the components and of total global mean sea level (GMSL), and (iii) projections of regional variability and emergence of the anthropogenic signal. In each of these cases, new work largely provides additional evidence in support of the AR5 assessment, providing greater confidence in those findings. Recent analyses confirm the twentieth century sea level rise, with some analyses showing a slightly smaller rate before 1990 and some a slightly larger value than reported in the AR5. There is now more evidence of an acceleration in the rate of rise. Ongoing ocean heat uptake and associated thermal expansion have continued since 2000, and are consistent with ocean thermal expansion reported in the AR5. A significant amount of heat is being stored deeper in the water column, with a larger rate of heat uptake since 2000 compared to the previous decades and with the largest storage in the Southern Ocean. The first formal detection studies for ocean thermal expansion and glacier mass loss since the AR5 have confirmed the AR5 finding of a significant anthropogenic contribution to sea level rise over the last 50 years. New projections of glacier loss from two regions suggest smaller contributions to GMSL rise from these regions than in studies assessed by the AR5; additional regional studies are required to further assess whether there are broader implications of these results. Mass loss from the Greenland Ice Sheet, primarily as a result of increased surface melting, and from the Antarctic Ice Sheet, primarily as a result of increased ice discharge, has accelerated. The largest estimates of acceleration in mass loss from the two ice sheets for 2003–2013 equal or exceed the acceleration of GMSL rise calculated from the satellite altimeter sea level record over the longer period of 1993–2014. However, when increased mass gain in land water storage and parts of East Antarctica, and decreased mass loss from glaciers in Alaska and some other regions are taken into account, the net acceleration in the ocean mass gain is consistent with the satellite altimeter record. New studies suggest that a marine ice sheet instability (MISI) may have been initiated in parts of the West Antarctic Ice Sheet (WAIS), but that it will affect only a limited number of ice streams in the twenty-first century. New projections of mass loss from the Greenland and Antarctic Ice Sheets by 2100, including a contribution from parts of WAIS undergoing unstable retreat, suggest a contribution that falls largely within the likely range (i.e., two thirds probability) of the AR5. These new results increase confidence in the AR5 likely range, indicating that there is a greater probability that sea level rise by 2100 will lie in this range with a corresponding decrease in the likelihood of an additional contribution of several tens of centimeters above the likely range. In view of the comparatively limited state of knowledge and understanding of rapid ice sheet dynamics, we continue to think that it is not yet possible to make reliable quantitative estimates of future GMSL rise outside the likely range. Projections of twenty-first century GMSL rise published since the AR5 depend on results from expert elicitation, but we have low confidence in conclusions based on these approaches. New work on regional projections and emergence of the anthropogenic signal suggests that the two commonly predicted features of future regional sea level change (the increasing tilt across the Antarctic Circumpolar Current and the dipole in the North Atlantic) are related to regional changes in wind stress and surface heat flux. Moreover, it is expected that sea level change in response to anthropogenic forcing, particularly in regions of relatively low unforced variability such as the low-latitude Atlantic, will be detectable over most of the ocean by 2040. The east-west contrast of sea level trends in the Pacific observed since the early 1990s cannot be satisfactorily accounted for by climate models, nor yet definitively attributed either to unforced variability or forced climate change.

Low level laser therapy (LLLT) decreases pulmonary microvascular leakage, neutrophil influx and IL-1 beta levels in airway and lung from rat subjected to LPS-induced inflammation

Background and Objective. Low level laser therapy (LLLT) is a known anti-inflammatory therapy. Herein we studied the effect of LLLT on lung permeability and the IL-1 beta level in LPS-induced pulmonary inflammation. Study Design/Methodology. Rats were divided into 12 groups (n = 7 for each group). Lung permeability was measured by quantifying extravasated albumin concentration in lung homogenate, inflammatory cells influx was determined by myeloperoxidase activity, IL-1P in BAL was determined by ELISA and IL-1P mRNA expression in trachea was evaluated by RT-PCR. The rats were irradiated on the skin over the upper bronchus at the site of tracheotomy after LPS. Results. LLLT attenuated lung permeability. In addition, there was reduced neutrophil influx, myeloperoxidase activity and both IL-1 beta in BAL and IL-1 beta mRNA expression in trachea obtained from animals subjected to LPS-induced inflammation. Conclusion. LLLT reduced the lung permeability by a mechanism in which the IL-1 beta seems to have an important role.

Low-Frequency Noise in Field-Effect Devices Functionalized With Dendrimer/Carbon-Nanotube Multilayers

Low-frequency noise in an electrolyte-insulator- semiconductor (EIS) structure functionalized with multilayers of polyamidoamine (PAMAM) dendrimer and single-walled carbon nanotubes (SWNT) is studied. The noise spectral density exhibits 1/f(gamma) dependence with the power factor of gamma approximate to 0.8 and gamma = 0.8-1.8 for the bare and functionalized EIS sensor, respectively. The gate-voltage noise spectral density is practically independent of the pH value of the solution and increases with increasing gate voltage or gate-leakage current. It has been revealed that functionalization of an EIS structure with a PAMAM/SWNTs multilayer leads to an essential reduction of the 1/f noise. To interpret the noise behavior in bare and functionalized EIS devices, a gate-current noise model for capacitive EIS structures based on an equivalent flatband-voltage fluctuation concept has been developed.

Palaeodrainage on Marajo Island, northern Brazil, in relation to Holocene relative sea-level dynamics

A large area in northeastern Marajo Island, northern Brazil, has been characterized geomorphologically, applying information acquired from Landsat imagery. This study was combined with detailed sedimentologic analysis of continuous cores, which provided a record of depositional settings developed in this area through the Holocene. The results revealed well-preserved, meandering to anastomosed drainage networks of wide palaeochannels that were superimposed by a narrower palaeochannel system. In both cases, the sedimentary record consists of sands, heterolithic deposits and muds, locally rich in plant debris. The strata are organized into fining upward successions that reach approximately 18 m thick in the wide channels and 4 m thick in the narrow channels. Sedimentary features suggestive of a coastal location for the wider palaeochannels and reworking of sediments by tidal currents include the prevalence of well to moderately sorted, rounded to sub-rounded, fine- to medium-grained sands displaying foreset packages separated by mud couplets, suggestive of tidal cycles. The data presented herein point to a rise in relative sea level reaching the Lake Arari area during the early to late/mid Holocene. This event was followed by a relative sea level drop. Tectonics seem to have contributed to an overall lowering in relative sea level in the study area since the mid-Holocene, which does not follow the same pattern recorded in other areas along the northern Brazilian coast.

Avaliação da dor pós-operatória: análise em pacientes submetidos a cirurgias abdominais em um hospital universitário de Natal/RN

It is an exploratory and descriptive study made by a quantitative approach, developed among February and May 2010, aiming to assess the pain of patients underwent abdominal surgeries in a University Hospital, in Natal/RN; to identify the local and intensity of the pain based on Numerical Estimative Scale; to analyze the pain related to the sensorial-discriminative, motivational-affective and cognitive-assessment dimensions, using the McGill Questionnaire pain; to establish a relation between the pain process and age, gender, religion, and king of surgery; to identify the medicines efficiency used to control postoperative pain. The sample was composed by 253 patients underwent abdominal surgeries. The results showed a total of 63.63% females between 38 and 47 years of age (21.34%); illiterates (21.73%); married (64.03%), living in Natal and surroundings (67.97%) and Catholics (74.30%). In their first assessment, 84.19% showed postoperative pain; the pain was considered light in 18.97% of them, moderate in 21.74% and severe in 43.48%. The mean number of descriptors chosen through the McGill Questionnaire Pain was 10.78 (DP= 6.09) and pain rating 23.65 (DP= 15.93). The descriptors selected with higher frequency were: sickening pain (69.01%), tired (65.25%), thin (62.44%), bored (58.69%), ardor (46.48%), pointed (38.50%) and colic (35.21%). In their second assessment, 57.71% of patients didn t relate any postoperative pain and 42.29% were still complaining about the pain. After taking analgesic medication, just 41.90% of patients who had complete pain relief. The Pharmacological groups most used were: simple analgesic (37.86%), weak opioids (32.98%), AINES (19.85%) and strong opioid (9.31%). It was not found a significant postoperative pain variation related to the sexes, religion and kind of surgery. It was concluded there were a high level in the number of patients with postoperative pain, mainly in a severe scale. Less than half of patients had the pain relief. Then, it was observed there was not coherence between the pain intensity and the analgesic it was used. To solve or relieve this kind of problems is necessary a permanent education to the health professionals who works in this area

Acoustic and psychoacoustic analysis of the noise produced by the police force firearms

Police officers are exposed to impact noise coming from firearms, which may cause irreversible injuries to the hearing system.Aim: To evaluate the noise exposure in shooting stands during gunfire exercises, to analyze the acoustic impact of the noise produced by the firearms and to associate it with tonal audiometry results.Study design: Cross-sectional.Materials and methods: To measure noise intensity we used a digital sound level meter, and the acoustic analysis was carried out by means of the oscillations and cochlear response curves provided by the Praat software. 30 police officers were selected (27 males and 3 females).Results: The peak level measured was 113.1 dB(C) from a .40 pistol and 116.8 dB(C) for a .38 revolver. The values obtained for oscillation and Praat was 17.9 +/- 0.3 Barks, corresponding to the rate of 4,120 and 4,580 Hz. Audiometry indicated greater hearing loss at 4,000Hz in 86.7% of the cases.Conclusion: With the acoustic analysis it was possible to show cause and effect between the main areas of energy excitation of the cochlea (Praat cochlear response curve) and the frequencies of low hearing acuity.

Can vitamins C and E restore the androgen level and hypersensitivity of the vas deferens in hyperglycemic rats?

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Affective disorders, hospital admissions, and seasonal variation of mania in a subtropical area, southern hemisphere

Hospital admissions (n = 15,450) to a state psychiatric hospital in Botucatu, São Paulo State, Brazil, over a 10-year period (1982-1991) were reviewed. 157 (1%) patients received a probable diagnosis of affective disorder according to DSM-III-R criteria. Among them, 46% had been diagnosed by the staff psychiatrists, and their diagnoses were sustained by the researchers, whereas 54% were diagnosed only by one of the researchers (F.K.C.). These last patients had previously received a diagnosis of paranoid schizophrenia or unspecified psychosis (ICD-9). Most of the patients with affective disorders were bipolar: 72 and 8%, respectively, presented manic and depressive episodes. Thus, only 20% received a diagnosis of major depression. A seasonal pattern in hospital admission was observed only for mania in women, their episodes occurring more often (p < 0.02) in spring and summer. No significant seasonal pattern in hospital admission for depression was found.

Sentimentos e percepções de puérperas com relação à assistência prestada pelo serviço materno-infantil de um hospital universitário

OBJETIVOS: avaliar percepções e sentimentos de puérperas adultas e adolescentes, relacionados ao filho e a assistência materno-infantil, em hospital universitário de nível terciário. MÉTODOS: estudo transversal, envolvendo 180 puérperas, no Alojamento Conjunto (AC) e no Berçário Interno (BI) do Hospital das Clínicas da Faculdade de Medicina de Botucatu , entrevistadas no segundo e terceiro dia pós-parto e distribuídas em três grupos: adultas primíparas, adultas multíparas e adolescentes. Para comparação entre grupos e locais de internação utilizou-se o chi2 ou teste de Fisher. RESULTADOS: ultrasom obstétrico e cardiotocografia tiveram impacto positivo na emoção materna. Houve pouca diferença entre os grupos quanto aos sentimentos antes e após o parto, sendo felicidade, amor, responsabilidade, ansiedade e medo os mais freqüentes. A culpa predominou nas adolescentes do BI. As percepções relacionadas ao filho, a avaliação da assistência e equipe, não diferiram entre adultas e adolescentes. Nas duas enfermarias o relacionamento entre mães e cuidadores foi bom, as mães mostraram-se satisfeitas com a equipe e a assistência, mas o aleitamento materno foi pouco valorizado e poucas mães conheciam o médico. CONCLUSÕES: está ocorrendo um processo de humanização na assistência materno-infantil deste hospital universitário, mas alguns aspectos precisam ser melhorados, especialmente a valorização do aleitamento materno e a individualização no contato médico-paciente.

Edge detection and noise removal by use of a partial differential equation with automatic selection of parameters

This work deals with noise removal by the use of an edge preserving method whose parameters are automatically estimated, for any application, by simply providing information about the standard deviation noise level we wish to eliminate. The desired noiseless image u(x), in a Partial Differential Equation based model, can be viewed as the solution of an evolutionary differential equation u t(x) = F(u xx, u x, u, x, t) which means that the true solution will be reached when t ® ¥. In practical applications we should stop the time ''t'' at some moment during this evolutionary process. This work presents a sufficient condition, related to time t and to the standard deviation s of the noise we desire to remove, which gives a constant T such that u(x, T) is a good approximation of u(x). The approach here focused on edge preservation during the noise elimination process as its main characteristic. The balance between edge points and interior points is carried out by a function g which depends on the initial noisy image u(x, t0), the standard deviation of the noise we want to eliminate and a constant k. The k parameter estimation is also presented in this work therefore making, the proposed model automatic. The model's feasibility and the choice of the optimal time scale is evident through out the various experimental results.

Noise and ultraviolet divergences in the dynamics of the chiral condensate in QCD

The time evolution of the matter produced in high energy heavy-ion collisions seems to be well described by relativistic viscous hydrodynamics. In addition to the hydrodynamic degrees of freedom related to energy-momentum conservation, degrees of freedom associated with order parameters of broken continuous symmetries must be considered because they are all coupled to each other. of particular interest is the coupling of degrees of freedom associated with the chiral symmetry of QCD. Quantum and thermal fluctuations of the chiral fields act as noise sources in the classical equations of motion, turning them into stochastic differential equations in the form of Ginzburg-Landau-Langevin (GLL) equations. Analytic solutions of GLL equations are attainable only in very special circumstances and extensive numerical simulations are necessary, usually by discretizing the equations on a spatial lattice. However, a not much appreciated issue in the numerical simulations of GLL equations is that ultraviolet divergences in the form of lattice-spacing dependence plague the solutions. The divergences are related to the well-known Rayleigh-Jeans catastrophe in classical field theory. In the present communication we present a systematic lattice renormalization method to control the catastrophe. We discuss the implementation of the method for a GLL equation derived in the context of a model for the QCD chiral phase transition and consider the nonequilibrium evolution of the chiral condensate during the hydrodynamic flow of the quark-gluon plasma.

Effect of tranquilization and anesthesia on high-resolution electrocardiographic indices of dogs in the chronic chagasic myocardiopathy

Avaliou-se o efeito da tranquilização e da anestesia sobre os índices da eletrocardiografia de alta resolução (ECGAR) em cães portadores de doença-de-chagas na fase crônica indeterminada. Foram utilizados oito cães, adultos, sem raça definida, fêmeas, submetidas a seis protocolos (grupos). No grupo 1, os animais estavam sem efeito de tranquilização ou anestesia; no grupo 2, foram tranquilizados com acepromazina; no 3, foram tranquilizados com a associação acepromazina e buprenorfina; no 4, estavam sob anestesia geral inalatória com isofluorano; no 5, sob anestesia geral inalatória com sevofluorano; e no 6, sob anestesia com propofol. Os animais foram submetidos a todos os protocolos, com um período de 15 dias entre cada avaliação. Não se verificou alteração significativa na duração do complexo QRS e do LAS40 entre os grupos, e o RMS40 permaneceu sem alteração significativa. O nível de ruído foi significativamente menor nos grupos 4, 5 e 6 em relação ao grupo 1. A anestesia facilitou o registro da ECGAR sem alterar os índices eletrocardiográficos .

Evaluation of the performance of pharmacists in terms of providing health assistance at a university hospital

OBJETIVE: This study aimed to assess the practices of pharmacists in Hospital Care. Method - we interviewed 20 pharmacists from the Pharmacy Division by applying a structured instrument, in September 2005. This instrument addressed aspects related to the main activities at the Hospital Pharmacy, which were assessed according to indicators organized into five areas: sector management, hospital pharmacotechniques, committee activities, information and pharmacotherapeutic follow-up, as well as teaching and research activities.RESULTS: the Pharmacy Division considered all structural aspects under analysis as essential for the good development and application of its services. We found that some essential services, such as the Medication Information Service and Pharmacotherapeutic Follow-up, were absent. Pharmacist professionals were dissatisfied about human resource and physical structure dimensioning, and they presented as not very active in terms of Pharmaceutical Care.CONCLUSION: Results indicate that care is still centered on the drug, with few clinical activities. We suggest reformulations in service management, particularly in the management of pharmacists.

Low-level laser therapy for pain relief after episiotomy: a double-blind randomised clinical trial

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