Comunicación Terapéutica : Requisitos fundamentales para acompañar emocionalmente al paciente paliativo y su familia.

La comunicación entre los enfermeros y los pacientes oncológicos es fundamental en la construcción de la relación profesional y terapéutica y esencial para administrar unos cuidados realmente enfocados en la persona como ser holístico y no como entidad patológica. Diferentes estudios han demostrado la influencia positiva de la comunicación en la satisfacción del paciente e incluso se ha encontrado relación entre una comunicación efectiva y una mayor adherencia al tratamiento, mejor control del dolor y estado psicológico. La comunicación, como herramienta para establecer una relación terapéutica eficaz, a su vez básica para el cuidado de cualquier paciente, es entonces “la herramienta” y prerrequisito indispensable para cuidar estos pacientes desde una perspectiva holística. Pese a la centralidad en el cuidado enfermero, la comunicación no se emplea en modo correcto en muchos casos. Objetivos: Este trabajo tiene como objetivo individuar las principales habilidades (skills) para lograr una comunicación terapéutica eficaz y cómo emplearlas en la construcción y mantenimiento de la relación terapéutica con el paciente y su familia. Método: búsqueda bibliográfica con las siguientes palabras clave: comunicación, paliativos, enfermería. Se han incluido en la revisión 27 artículos de 17 revistas distintas. Resultados: Las habilidades y factores encontrados en la literatura han sido clasificados en: a. barreras a la comunicación terapéutica b. condiciones y habilidades facilitadoras de la comunicaciónvi c. habilidades de relación d. habilidades para solicitar información e. estrategias y modelos de comunicación Conclusiones: La comunicación es la herramienta principal del cuidado enfermero en cuidados paliativos, difiere de la comunicación social y tiene como objetivo aumentar la calidad de vida del paciente. La habilidad en comunicación no es un don innato sino que es el resultado de un proceso de aprendizaje continuo. Entre las habilidades más citadas y efectivas hay que recordar la escucha activa (entendida como conjunto de técnicas), el tacto terapéutico, el contacto visual, la empatía y la importancia fundamental de la comunicación no verbal. El modelo de comunicación COMFORT es el único centrado en el paciente y a la vez en su familia. Palabras clave: Habilidades comunicación, paliativos, enfermería

Population-based incidence of myeloid malignancies: fifteen years of epidemiological data in the province of Girona, Spain

Myeloid malignancies (MMs) are a heterogeneous group of hematologic malignancies presenting different incidence, prognosis and survival.1–3 Changing classifications (FAB 1994, WHO 2001 and WHO 2008) and few available epidemiological data complicate incidence comparisons.4,5 Taking this into account, the aims of the present study were: a) to calculate the incidence rates and trends of MMs in the Province of Girona, northeastern Spain, between 1994 and 2008 according to the WHO 2001 classification; and b) to predict the number of MMs cases in Spain during 2013. Data were extracted from the population-based Girona Cancer Registry (GCR) located in the north-east of Catalonia, Spain, and covering a population of 731,864 inhabitants (2008 census). Cases were registered according to the rules of the European Network for Cancer Registries and the Manual for Coding and Reporting Haematological Malignancies (HAEMACARE project). To ensure the complete coverage of MMs in the GCR, and especially myeloproliferative neoplasms (MPN) and myelodysplastic syndromes (MDS), a retrospective search was performed. The ICD-O-2 (1990) codes were converted into their corresponding ICD-O-3 (2000) codes, including MDS, polycythemia vera (PV) and essential thrombocythemia (ET) as malignant diseases. Results of crude rate (CR) and European standardized incidence rate (ASRE) were expressed per 100,000 inhabitants/year

Studies on the acid activation of Brazilian smectitic clays

Fuller's earth and acid activated smectitic clays are largely used as bleaching earth for the industrial processing of vegetable, animal and mineral oils and waxes. The paper comments about the nomenclature used for these materials, the nature of the acid activation of smectitic clays (bentonites), activation laboratory procedures and presents a review of the acid activation of bentonites from 20 deposits from several regions of Brazil. The activated clays were tested and show good decolorizing power for soybean, castor, cottonseed, corn and sunflower oils.

Alterações físico-químicas dos óleos de girassol, milho e soja em frituras

The aim of this study is to determine the influence of frying time on the alterations of sunflower, corn and soybean oils during deep fat frying of potato chips. The analytical methods used to evaluate the oil alterations are: free fatty acids, peroxide value, refractive index and total polar compounds. An increase of free fatty acids, refractive index and total polar compounds with frying time were observed. The different behaviors observed for the three vegetables oils can be explained by the differences in the initial composition and quality of them.

Titulação potenciométrica aplicada na determinação de ácidos graxos livres de óleos e gorduras comestíveis

Free fatty acids are a measure of evaluating fats and oils, submitted to abusive conditions, besides being a quality characteristic of edible vegetable oils. The official method of determination (AOCS Ca 5a-40, 2004) is based on titration, using phenolphthalein as an indicator. For crude and degummed oils, the titration end point is difficult to be observed due to the high level of pigments, resulting in dark solutions. In this case and others, such as self-life studies, in which sample quantities are limited, potentiometric titration may be a very good alternative.

Variação química do óleo essencial de Hyptis suaveolens (L.) Poit., sob condições de cultivo

This study was performed to establish the correlation between the growth conditions and essential oil composition of Hyptis suaveolens from Alfenas (MG), Brazil. The plants were grown in a greenhouse, four treatments were used and they were harvested at two different periods of time (60 and 135-day-old plants). The essential oil composition was determined by GC-MS analysis. The terpenes spathulenol, globulol, dehydroabietol, a-cadinol and beta-phellandrene were the major constituents found in the essential oil. Oxygenated sesquiterpenes represented the main group of constituents in most of the treatments. The major changes in the essential oil composition were found in 135-day-old plants grown under NPK deficiency. We also identified three groups of volatile components that have not been previously described in H suaveolens.

Perfil de ácidos graxos e avaliação da alteração em óleos de fritura

The present study had the purpose of evaluating the profile of fatty acids and the total alteration of cottonseed, sunflower and palm oils brought about during discontinued frying processes of cassava frozen chips. An increase in the percentage of saturated fatty acids and a decrease in polyunsaturated fatty acids was observed, regardless of the type of oil used. With regard to the oil's global alteration, the results showed that palm oil, the most saturated one, underwent less alteration. However, none of the oils presented total polar compound values above the limits prescribed.

Tocoferois e tocotrienois em óleos vegetais e ovos

The distribution and content of vitamin E isomers was investigated in vegetable oils and raw and cooked egg yolk in commercial restaurants. The analysis of the eight vitamin E isomers was carried out by High Performance Liquid Chromatography (HPLC) with fluorescence detection. The tocopherol and tocotrienol composition of foods varied considerably. Tocopherols were detected in greater quantity and frequency. The α-tocopherol predominated in egg yolks and olive oil while γ-tocopherol was found in high quantities in soybean and canola oils. Cooking did not cause major losses for most of the vitamin E isomers in egg yolks.

Obtenção de biodiesel por transesterificação em dois estágios e sua caracterização por cromatografia gasosa: óleos e gorduras em laboratório de química orgânica

Methanolic transesterification of oils and fats was carried out in a two steps procedure, under basic and acidic catalysis. Palm, soybean, canola, corn, rice, grapeseed, sunflower, peanut, pequi and olive oils, besides tallow and lard were used as feedstock. Specific gravity, relative viscosity, thin layer chromatography and gas chromatography were used to characterize the biodiesel. Biodiesel was obtained in high yield and purity. Results were used to discuss the following key-concepts: 1 - triglycerides, composition and properties; 2 - nucleophilic acyl substitution under basic and acid conditions, 3 - thin layer chromatography, 4 - gas chromatography and its quantitative methods.

Química e sustentabilidade: novas fronteiras em biocombustíveis

This contribution discusses the state of the art and the challenges in producing biofuels, as well as the need to develop chemical conversion processes of CO2 in Brazil. Biofuels are sustainable alternatives to fossil fuels for providing energy, whilst minimizing the effects of CO2 emissions into the atmosphere. Ethanol from fermentation of simple sugars and biodiesel produced from oils and fats are the first-generation of biofuels available in the country. However, they are preferentially produced from edible feedstocks (sugar cane and vegetable oils), which limits the expansion of national production. In addition, environmental issues, as well as political and societal pressures, have promoted the development of 2nd and 3rd generation biofuels. These biofuels are based on lignocellulosic biomass from agricultural waste and wood processing, and on algae, respectively. Cellulosic ethanol, from fermentation of cellulose-derived sugars, and hydrocarbons in the range of liquid fuels (gasoline, jet, and diesel fuels) produced through thermochemical conversion processes are considered biofuels of the new generation. Nevertheless, the available 2nd and 3rd generation biofuels, and those under development, have to be subsidized for inclusion in the consumer market. Therefore, one of the greatest challenges in the biofuels area is their competitive large-scale production in relation to fossil fuels. Owing to this, fossil fuels, based on petroleum, coal and natural gas, will be around for many years to come. Thus, it is necessary to utilize the inevitable CO2 released by the combustion processes in a rational and economical way. Chemical transformation processes of CO2 into methanol, hydrocarbons and organic carbonates are attractive and relatively easy to implement in the short-to-medium terms. However, the low reactivity of CO2 and the thermodynamic limitations in terms of conversion and yield of products remain challenges to be overcome in the development of sustainable CO2 conversion processes.

MICROEMULSÕES: COMPONENTES, CARACTERÍSTICAS, POTENCIALIDADES EM QUÍMICA DE ALIMENTOS E OUTRAS APLICAÇÕES

Microemulsions (MEs) are thermodynamically stable systems consisting of nanosized droplets dispersed in a solvent continuous medium (known as pseudo-phase), which is immiscible with the dispersed phase. These systems consist of water, a hydrophobic solvent called "oil," an amphiphile and often, a co-surfactant that is normally a medium chain alcohol. A large number of publications describe the importance of MEs in many branches of chemistry, and there is an intensive search for new applications. In addition, MEs have been applied in many areas, including oil extraction, removal of environmental pollutants from soils and effluents, dissolution of additives in lubricants and cutting oils, cleaning processes, dyeing and textile finishing, as nanoreactors to obtain nanoparticles of metals, semiconductors, superconductors, magnetic and photographic materials, and latex. However, only some studies indicate the potential applications of MEs in food and even fewer evaluate their chemical behavior. Potential applications of MEs in food comprise dissolution of lipophilic additives, stabilization of nutrients and biologically active compounds, using as an antimicrobial agent and to maximize the efficiency of food preservatives. This work consists of a literature review focusing on composition and physical and chemical characteristics of microemulsions. Despite the small number of studies on the subject reported in the literature, we demonstrate some potential applications of MEs in food chemistry.

DESENVOLVIMENTO DE ENSAIO PARA ANÁLISE QUALITATIVA DE BIODIESEL EM MISTURAS DIESEL-BIODIESEL PARA APLICAÇÃO EM POSTOS REVENDEDORES DE COMBUSTÍVEIS

In this study, we developed a method for the visual detection of biodiesel in petrodiesel-biodiesel (BX) blends through the aminolysis of the methyl or ethyl esters of fatty acids that are found in biodiesel and that are absent from diesel and vegetable oils. This method is based on three reactional stages, which produce a dark red and easily visualized complex in the presence of biodiesel. In the absence of biodiesel, there is no dark red coloring, whereas in the presence of diesel or vegetable oil, there is a light red to yellow coloring. This simple, practical, inexpensive, and effective procedure may be applied by petrol stations to guarantee to consumers and resellers the presence of biodiesel in diesel blends, regardless of the BX blend's initial coloring or of the sulfur found in the diesel. In short, it ensures a safe fuel tank fill-up with BX blend.

Steroidien selektiivinen erottaminen sähköavusteisesti mikroemulsioita käyttäen

Mikroemulsiosähkökineettinen kromatografia on sähköavusteinen erotusmenetelmä. Yhdisteiden erottuminen tapahtuu mikroemulsiopisaroiden vaikutuksesta, kun nanometrien kokoiset öljypisarat ovat dispergoituneena veteen valmistettuun puskuriliuokseen. Yleensä mikroemulsiot valmistetaan raakaöljynkin sisältämistä hiilivedyistä, joita ovat esimerkiksi oktaani ja heptaani. Työn kokeellisessa osassa perehdyttiin seitsemän hydrofobisen ja varauksettoman steroidihormonin erottamiseen mikroemulsioliuoksessa kapillaarielektroforeesitekniikalla. Työssä valmistettiin öljyistä koostuvia mikroemulsioita, joista osan koostumus valittiin kirjallisuuden perusteella. Työssä kokeiltiin myös uusia mikroemulsiokoostumuksia, joissa käytettiin luonnosta peräisin olevia öljyjä: rypsi-, oliivi-, pellavansiemen- ja saksanpähkinäöljyä. Seitsemästä steroidihormonista viisi yhdistettä saatiin erottumaan optimoiduilla menetelmillä. Steroidien erotus perustuu niiden oktanoli-vesi jakautumiskertoimien avulla saatavaan migraatiojärjestykseen. Mikroemulsiossa, jossa käytettiin 1-oktanolia, steroidihormonit erottuivat nopeammin, kuin saksanpähkinäöljyä käytettäessä. Lyhyimmät migraatioajat saatiin mikroemulsiolla, jossa öljyfaasina käytettiin 1-heksanolia ja viidentenä yhdisteenä asetonitriiliä. Selektiivisimmillään menetelmä on, kun erotus tapahtuu liuoksessa, joka koostuu etyyliasetaatista, natriumdodekyylisulfaatista, butanolista, asetonitriilistä ja natriumtetraboraatista. Toteamisrajat tutkituille steroidihormoneille olivat 0,20–0,43 mg/L mikroemulsioissa.

Skannausratkaisun ja yleisarkiston käyttöönotto potilasasiakirjojen käsittelyyn terveydenhuollossa

Julkinen terveydenhuolto on muutoksen ja monien haasteiden edessä, kun palveluiden kysyntä ja laatuvaatimukset kasvavat. Julkisen sektorin taloudellinen tilanne aiheuttaa paineita kustannusten pienentämiseksi ja toimintojen keskittämiseen. Muutoksista huolimatta terveydenhuollon henkilökunnalla tulee olla mahdollisimman helppo ja nopea pääsy potilasta koskeviin ajantasaisiin ja olennaisiin tietoihin. Tämä diplomityö tarkastelee tietojärjestelmän käyttöönottoprosessia, paperisten potilasasiakirjojen digitalisointia ja niiden hyödyntämistä hoitoprosessissa. Tutkimuksessa esitellään paperilähetteiden käsittely, skannausratkaisun käyttöönotto ja integrointi HUS:n XDS-yleisarkistoon. Tutkimuksen teoreettinen viitekehys koostuu käyttöönottoprosessista ja siihen liittyvistä haasteista, onnistumiseen vaikuttavista tekijöistä sekä onnistumiseen mittaamiseen käytettävissä olevista malleista ja mittareista. Tietojärjestelmän käyttöönoton onnistumiseen vaikutti erityisesti ennakkosuunnittelu ja muutosvastarinnan ymmärtäminen. Tietojärjestelmän käyttöönotossa havaittiin, että muutos hyväksytään käyttäjien osalta, kun se vastaa käyttäjien todelliseen tarpeeseen. Erityisesti lähetteiden käsittely sähköisessä muodossa koettiin hyödylliseksi ja tarpeelliseksi, koska tämä mahdollisti potilastietojen saatavuuden paikasta ja ajasta riippumatta ja tuki potilaan hoitoprosessia. Käyttöönotossa havaittiin, että skannausprosessi ei voi olla samanlainen kaikkialla, koska eri yksiköissä tapahtuva skannaus voi olla potilaskeskeistä tai asiakirjatyyppien mukaan tai kompeksista ja suuriin määriin perustuvaa.

Deep-fat frying of meat products in palm olein

This study investigated the discontinuous frying of breaded meat products in palm olein in a 28 L-electric fryer maintained at 182 ºC for 8 hours a day. Three 400-500 g batches of meat products were fried for 4.5 minutes daily. For comparison purpose, thermoxidation tests were performed using inert material with added moisture and without the addition of f ood (heating only). The total polar compound content did not reach the 25% limit, and nor did the formation of polymerized products exceed 5%, which indicates the good frying performance of palm olein for frying. Other analytical parameters and rapid tests were also evaluated. The sensory attributes, such as odor, colour, and foam formation determined when the frying oils should be discarded. The addition of water to the inert material contributed to the final value of 1.00 ± 0.01% (in palmitic acid), while the oil subjected only to heating reached respectively 0.26 ± 0.02%, and the oils used to fry breaded meat and breaded chicken reached 0.38 ± 0.00% and 2.35 ± 0.01%, respectively. This suggests a protective effect of the water during frying since the oil subjected only to heating was more prone to degradation.