O cuidado de enfermagem à criança e ao adolescente vítima de queimaduras: implicações para a prática da enfermagem

Objetivou-se conhecer as implicações do cuidado à criança e ao adolescente vítimas de queimaduras para a prática da enfermagem. Realizou-se uma pesquisa descritiva e exploratória com abordagem qualitativa. Participaram dez profissionais da equipe de enfermagem de um Centro de Referência a Pacientes Queimados do sul do Brasil. Os dados foram coletados no segundo semestre de 2012 por meio de entrevistas semiestruturadas e analisados pela técnica de Análise de Conteúdo. Em relação aos sentimentos frente ao cuidado verificou-se que esses vivenciam ansiedade e tensão frente à dor do paciente, têm a sensação de doação querendo “fazer mais”, tristeza e abalo, sensação de utilidade e de competência ao ver os efeitos do cuidado, impotência por não terem controle sobre a situação vivenciada, revolta e raiva por não compreenderem o porquê este acidente aconteceu e pena dos pacientes e de seus familiares devido o seu sofrimento. Como facilidades para o cuidado referiram a ajuda mútua entre os membros da equipe aliada ao tempo de atuação no setor, o desenvolvimento de um bom relacionamento com a família da criança / adolescente, a sinceridade da criança ao manifestar seus sentimentos, uma identificação e afinidade maior para cuidar crianças e adolescentes e o adolescente ser mais aberto e entender com facilidade a linguagem utilizada no setor. Referiram como dificuldades à falta de preparo e a pouca habilidade para cuidar de crianças/ adolescentes com dor, o desconhecimento acerca do paciente, a falta de habilidades técnicas para realizar procedimentos em crianças/ adolescentes, lidar com o familiar, lidar com a necessidade de manipular o corpo do adolescente, comunicar-se com crianças que não sabem expressar-se, pacientes que não falam o português e adolescentes que possuem linguagem própria, explicar para o paciente a magnitude do trauma sofrido e conversar com esses acerca das sequelas, deformidades e limitações com as quais terão que (con)viver. Quanto às estratégias para se instrumentalizar para o cuidado utilizam a leitura sobre queimaduras e curativos, leituras de materiais de outras áreas da saúde, uso de técnicas de abordagem e interação com pacientes e familiares, a prática diária no setor e a busca de apoio na equipe e na instituição, realizando atividades de educação continuada. Quanto às estratégias utilizadas para cuidar referiram o estabelecimento de vínculo e de uma relação dialógica, o uso de brincadeiras e atividades lúdicas, o fornecimento de apoio, a introdução da família no processo de cuidado, o uso da criatividade, a valorização do aspecto psicológico do paciente, a adaptação do cuidado de acordo com a faixa etária do paciente e o uso da escuta atenta e sensível. A partir dos dados concluiu-se que o cuidado de enfermagem a crianças e adolescentes vítimas de queimaduras é complexo bem como causador de impacto para os profissionais atuantes em Centros de Queimados. Acredita-se que o estudo possibilitará discutir e refletir acerca da prática profissional da enfermagem no Centro de Queimados frente ao cuidado à criança e ao Adolescente vítima de queimaduras.

Perspective d'un développement rural durable : le cas des Hmongs du Laos

Résumé : Le développement durable est un processus d'évolution dans lequel toutes les ethnies coexistent en harmonie avec un environnement sain. Depuis une quarantaine d'années, le Laos a connu de nombreux bouleversements. Des groupes minoritaires, dont les Hmongs, ont subi les contrecoups des changements socio-politiques et économiques. Les Hmongs, qui habitent les régions montagneuses et qui pratiquent l'agriculture itinérante, sont particulièrement touchés par des inégalités économiques et sociales malgré la politique d'égalité ethnique. Les transformations progressives de leur méthode d'utilisation du sol, de leur mode de production et de leur mode de vie itinérants en sédentarisation durable deviennent fondamentales et cruciales. Les Hmongs défavorisés aspirent fortement à de meilleures conditions de vie tout comme les populations qui vivent dans les plaines. En effet, les Hmongs, qui habitent dans les régions de Lakhasipsong et de Longsan, province de Vientiane, s'adaptent aux nouvelles conditions de transformation socio-économique, soient la sédentarisation du mode de production et du mode de vie. On peut affirmer que le développement rural et communautaire permet la sédentarisation des Hmongs et que ces derniers sont aptes à s'adapter à la vie moderne. La méthode d'enquête par entrevue sur la base d'un sondage employée sur le terrain nous a permis de découvrir les caractéristiques de développement durable autant socio-économique que politique dans la province de Vientiane avec application particulière aux Hmongs. Les résultats de l'enquête démontrent que les stratégies de sédentarisation sans relocalisation et avec relocalisation sur l'initiative soit personnelle soit gouvernementale ont fait leurs preuves. Des changements dans les modes de production et de vie ont non seulement permis une meilleure utilisation du sol, une augmentation de la production et une amélioration des conditions de vie mais aussi une meilleure préservation de l'écosystème.||Abstract : Sustainable development is an evolutionary process in which all ethnie groups live in harmony with a healthy environment. For approximately forty years, Laos has been subjected to many disruptions. Minority groups, like the Hmong, have felt the full impact of the numerous socio-political and economic changes that took place in the country. The Hmong, in particular, who live in mountainous regions and practice slash and burn agriculture, have suffered from economic and social inequality policies praticed by previous governments. The progressive transformation of their methods of land use, their mode of production and their migrant life style must clearly be understood before any attempt at a sedentary life style with a view to a sustainable development be undertaken. The underprivileged Hmong aspire to better living conditions comparable to those of people living in the plains. More precisely, the Hmong, who live in Lakhasipsong and Longsan in the province of Vientiane, adapt to their new conditions of social and economic transformation by fixing into place their mode of production and their lifestyle. We can state that the rural community development taking place allows an effective sédentarisation for the Hmong and, that they are able to adapt themselves to modem life. The survey method by interview and randown sampling on the ground permits us to discover elements of farming development within the socio-economic as well as political life in Vientiane province with a particular application to the Hmong. The survey results in showing that settling down strategies without relocation or with relocation on personal or governmental initiative are truly operational. Changes in the mode of production and life style have not only permitted a better land use, an increased production and a better life style but also, a better conservation of the environment.

Modélisation de la régénération de l’épinette noire suite au passage d’un feu en forêt boréale fermée

Face à l’augmentation observée des accidents de régénération en forêt boréale et leur impact sur la productivité et la résilience des peuplements denses d’épinette noire, une meilleure compréhension des mécanismes de résilience et une surveillance des risques d’accident de régénération sont nécessaires. L’objectif principal de cette étude visait donc le développement de modèles prédictifs et spatialement explicites de la régénération de l’épinette noire. Plus particulièrement, deux modèles ont été développés soit (1) un modèle théorique, développé à l’aide de données in situ et de données spatiales et (2) un modèle cartographique, utilisant uniquement des données spatiales accessibles telles que les inventaires forestiers provinciaux et l’indice spectral de sévérité des feux « differenced Normalized Burn Ratio » (dNBR). Les résultats obtenus ont permis de constater que la succession rapprochée (< 55 ans) d’une coupe et d’un feu n’entraîne pas automatiquement une ouverture des peuplements d’épinette noire. Tout d’abord, les peuplements affectés par la coupe de récupération de brûlis (1963), immatures lors du feu de 2005, sont caractérisés par une faible régénération. En contrepartie, la régénération à la suite du feu de 2005, observé dans les peuplements coupés entre 1948 et 1967, est similaire à celle observée dans les peuplements non perturbés dans les 60 années précédant le feu. Le modèle théorique sélectionné à l’aide des critères d’information d’Akaike a, quant à lui, permis d'identifier trois variables déterminantes dans le succès ou l’échec de la régénération de l’épinette noire soit (1) la végétation potentielle, (2) le pourcentage de recouvrement du sol par les sphaignes et (3) la sévérité du feu évaluée à l’aide du dNBR. Des validations bootstrap et croisée ont permis de mettre en évidence qu’un modèle utilisant ces trois variables explique 59 % de la variabilité de la régénération observée dans le territoire d’étude., Quant à lui, le modèle cartographique qui utilise uniquement les variables végétation potentielle et dNBR explique 32 % de la variabilité. Finalement ce modèle a permis la création d’une carte de risque d’accident de régénération. Basée sur la précision du modèle, cette carte offre un potentiel intéressant afin de cibler les secteurs les plus à risque et ainsi appuyer les décisions relatives aux reboisements dans les zones incendiées.

Costa Rican personalities

In the chair Creating and Maintaining Database of the School of Library, Documentation and Information, in 1998, students created a database called "Biblos" with information on 632 libraries and information centers and documentation of Costa Rica. A valuable work needed more time to verify, debug, analyze the results statistically, prepare a report, a catalog and indexes required to publish the document: "Libraries Rican."In 1999, finding the students are excited and committed to this document, I suggested we call the project work: "Personalities Rican," which was to develop a database and use it as input to design a Web page that can be installed on Internet or burn a CD. Students were identified and committed to the project. Providing an innovative practices, apply creativity, awareness of acquired knowledge, skills and abilities needed to provide users with products and innovative information services.

Acute burns of the hands – physiotherapy perspective.

Background: Acute burns of the hands are complex and may impact on various aspects of a person’s life. Physiotherapy rehabilitation and restoration of hand function is critical for the patient’s independence and re-integration into society. Purpose: This study aimed to explore the perceptions and experiences of physiotherapists in the management of patients with their hand burn injuries. Method: Five focus groups consisting of physiotherapists and physiotherapy assistants working with burn injured patients from each of the five selected public hospitals in KwaZulu-Natal were recruited. An explorative qualitative approach was adopted. Results: Physiotherapists emphasised that the acute management of the hand was trivialised due to a primary focus on the survival of the burn sufferer. Therapists identified several factors that determined the patients’ level of participation and motivation in therapy one of which was the procedural pain experienced. The role of the therapists’ within the rehabilitation framework was found to be critical to their recovery however there appeared to be a breakdown in the collaboration and communication among health care professionals to the detriment of effective intervention. Conclusion: A multidisciplinary team approach is the foundation in the management of acute burn injuries and during the trajectory of the trauma care continuum.

Job satisfaction among primary school personnel in Madagascar

This article analyzes the job satisfaction of primary school teachers in Madagascar. Based on the estimation of multilevel models, low wages and problems getting paid, job insecurity, lack of in-service training, high pupil-teacher ratios, and lack of basic infrastructure and teaching materials are identified as the main reasons for dissatisfaction. Principals’ control of teachers’ activities also adversely affects satisfaction, suggesting that, in Malagasy schools, neither school directors nor teachers have succeeded in adopting organizational cultures based on cooperation among their members. These results are likely to stimulate debates on educational policy, both in Madagascar and in many other developing countries.

Establishing a children’s orthopaedic hospital for Malawi: A review after 10 years

Background BEIT CURE International Hospital (BCIH) opened in 2002 providing orthopaedic surgical services to children in Malawi. This study reviews the hospital’s progress 10 years after establishment of operational services. In addition we assess the impact of the hospital’s Malawi national clubfoot programme (MNCP) and influence on orthopaedic training. Methods All operative paediatric procedures performed by BCIH services in the 10th operative year were included. Data on clubfoot clinic locations and number of patients treated were obtained from the MNCP. BCIH records were reviewed to identify the number of healthcare professionals who have received training at the BCIH. Results 609 new patients were operated on in the 10th year of hospital service. Patients were treated from all regions; however 60% came from Southern regions compared with the 48% in the 5th year. Clubfoot, burn contracture and angular lower limb deformities were the three most common pathologies treated surgically. In total BCIH managed 9,842 patients surgically over a 10-year period. BCIH helped to establish and co-ordinate the MNCP since 2007. At present the program has a total of 29 clinics, which have treated 5748 patients. Furthermore, BCIH has overseen the full or partial training of 5 orthopaedic surgeons and 82 orthopaedic clinical officers in Malawi. Conclusion The BCIH has improved the care of paediatric patients in a country that prior to its establishment had no dedicated paediatric orthopaedic service, treating almost 10,000 patients surgically and 6,000 patients in the MNCP. This service has remained consistent over a 10-year period despite times of global austerity. Whilst the type of training placement offered at BCIH has changed in the last 10 years, the priority placed on training has remained paramount. The strategic impact of long-term training commitments are now being realised, in particular by the addition of Orthopaedic surgeons serving the nation.

Work engagement among school directors and teachers' behavior at work

Using data from a representative sample of public primary schools in Madagascar, this paper analyzes engagement at work among school directors and investigates the impact of school heads' supervisory roles on teachers' behavior at work. The results show clear signs of weak management within public primary schools. We find that school heads' engagement at work is positively associated with their employment conditions, job satisfaction, and overall working environment. The results also indicate that principals' management styles have a positive effect on teachers’ commitment at work, but no significant impact on absenteeism.

Desenvolvimento e caracterização de compósitos poli(tereftalato de etileno) reciclado (PET reciclado) com flocos de vidro.

The growing concern with the solid residues management, observed in the last decade, due to its huge amount and impact, has motivated the search for recycling processes, where these residues can be reprocessed to generate new products, enlarging the cycle of materials and energy which are present. Among the polymeric residues, there is poly (ethylene terephthalate) (PET). PET is used in food packaging, preferably in the bottling of carbonated beverages. The reintegration of post-consumer PET in half can be considered a productive action mitigation of environmental impacts caused by these wastes and it is done through the preparation of several different products at the origin, i.e. food packaging, with recycling rates increasing to each year. This work focused on the development and characterization mechanical, thermal, thermo-mechanical, dynamic mechanical thermal and morphology of the pure recycled PET and recycled PET composites with glass flakes in the weight fraction of 5%, 10% and 20% processed in a single screw extruder, using the following analytical techniques: thermogravimetry (TG), differential scanning calorimetry (DSC), tensile, Izod impact, Rockwell hardness, Vicat softening temperature, melt flow rate, burn rate, dynamic mechanical thermal analysis (DMTA) and scanning electron microscopy (SEM). The results of thermal analysis and mechanical properties leading to a positive evaluation, because in the thermograms the addition of glass flakes showed increasing behavior in the initial temperatures of thermal decomposition and melting crystalline, Furthermore was observed growing behavior in the mechanical performance of polymer composites, whose morphological structure was observed by SEM, verifying a good distribution of glass flakes, showing difference orientation in the center and in the surface layer of test body of composites with 10 and 20% of glass flakes. The results of DMTA Tg values of the composites obtained from the peak of tan ä showed little reductions due to poor interfacial adhesion between PET and recycled glass flakes.

Regimes of spray vaporization and combustion in counterflow configurations

This article addresses the problem of spray vaporization and combustion in axisymmetric opposed-jet configurations involving a stream of hot air counterflowing against a stream of nitrogen carrying a spray of fuel droplets. The Reynolds numbers of the jets are assumed to be large, so that mixing of the two streams is restricted to a thin mixing layer that separates the counterflowing streams. The evolution of the droplets in their feed stream from the injection location is seen to depend fundamentally on the value of the droplet Stokes number, St, defined as the ratio of the droplet acceleration time to the mixing layer strain time close to the stagnation point. Two different regimes of spray vaporization and combustion can be identified depending on the value of St. For values of St below a critical value, equal to 1/4 for dilute sprays with small values of the spray liquid mass loading ratio, the droplets decelerate to approach the gas stagnation plane with a vanishing axial velocity. In this case, the droplets located initially near the axis reach the mixing layer, where they can vaporize due to the heat received from the hot air, producing fuel vapor that can burn with the oxygen in a diffusion flame located on the air side of the mixing layer. The character of the spray combustion is different for values of St of order unity, because the droplets cross the stagnation plane and move into the opposing air stream, reaching distances that are much larger than the mixing layer thickness before they turn around. The vaporization of these crossing droplets, and also the combustion of the fuel vapor generated by them, occur in the hot air stream, without significant effects of molecular diffusion, generating a vaporization-assisted nonpremixed flame that stands on the air side outside the mixing layer. Separate formulations will be given below for these two regimes of combustion, with attention restricted to the near-stagnation-point region, where the solution is self-similar and all variables are only dependent on the distance to the stagnation plane. The resulting formulations display a reduced number of controlling parameters that effectively embody dependences of the structure of the spray flame on spray dilution, droplet inertia, and fuel preferential diffusion. Sample solutions are given for the limiting cases of pure vaporization and of infinitely fast chemistry, with the latter limit formulated in terms of chemistry-free coupling functions that allow for general nonunity Lewis numbers of the fuel vapor.

Impacto de una adecuada codificación de la desnutrición relacionada con la enfermedad en los índices hospitalarios

Introducción: la desnutrición relacionada con la enfermedad (DRE) afecta al menos a una cuarta parte de los pacientes hospitalizados, aumentando la morbimortalidad del paciente durante su hospitalización y al alta. Sin embargo, su repercusión en la actividad hospitalaria no está bien cuantificada. Objetivo: determinar el impacto de una adecuada codificación de la DRE y los procedimientos empleados para revertirla en el peso medio del hospital y otros índices hospitalarios. Material y métodos: estudio comparativo realizado en todos los pacientes subsidiarios de soporte nutricional artificial seguidos por la Unidad de Nutrición Clínica y Dietética de la Sección de Endocrinología y Nutrición (UNCyD-SEyN) del Complejo Asistencial Universitario de León durante los años 2008 y 2013. Se realizó un informe de codificación nutricional del diagnóstico, el tratamiento nutricional y la vía de acceso según la CIE-9-MC. Se comparó el peso medio depurado del hospital, el índice de estancia media ajustada (IEMA), la casuística e índice de funcionamiento previo a la codificación nutricional y tras la misma. Resultados: el peso medio depurado del hospital se incrementó tras la codificación, tanto en 2008 (+ 4,1%) como en 2013 (+1,7%) y especialmente en aquellos servicios en los que se realiza cribado nutricional (Hematología, +10,5%). El IEMA se redujo por debajo de 1 (-5,7% y -0,2% en 2008 y 2013), indicando un mejor funcionamiento, y también disminuyó el índice funcional (-5,6% y -0,4% en 2008 y 2013), lo que supondría una mayor eficiencia. Conclusión: la correcta codificación del diagnóstico y el tratamiento nutricional del paciente con desnutrición aumenta el peso medio depurado de un hospital de tercer nivel, y mejora el IEMA y el índice de funcionamiento.

Estudo de massa cerâmica triaxial visando à otimização do ciclo de queima da indústria de cerâmica estrutural

Over recent years the structural ceramics industry in Brazil has found a very favorable market for growth. However, difficulties related to productivity and product quality are partially inhibiting this possible growth. An alternative for trying to solve these problems and, thus, provide the pottery industry the feasibility of full development, is the substitution of firewood used in the burning process by natural gas. In order to contribute to this process of technological innovation, this paper studies the effect of co-use of ceramic phyllite and kaolin waste on the properties of a clay matrix, verifying the possible benefits that these raw materials can give to the final product, as well as the possibility of such materials to reduce the heat load necessary to obtain products with equal or superior quality. The study was divided into two steps: characterization of materials and study of formulations. Two clays, a phyllite and a residue of kaolin were characterized by the following techniques: laser granulometry, plasticity index by Atterberg limits, X-ray fluorescence, X-ray diffraction, mineralogical composition by Rietveld, thermogravimetric and differential thermal analysis. To study the formulations, specifically for evaluation of technological properties of the parts, was performed an experimental model that combined planning involving a mixture of three components (standard mass x phyllite x kaolin waste) and a 23 factorial design with central point associated with thermal processing parameters. The experiment was performed with restricted strip-plot randomization. In total, 13 compositional points were investigated within the following constraints: phyllite ≤ 20% by weight, kaolin waste ≤ 40% by weight, and standard mass ≥ 60% by weight. The thermal parameters were used at the following levels: 750 and 950 °C to the firing temperature, 5 and 15 °C/min at the heating rate, 15 and 45min to the baseline. The results showed that the introduction of phyllite and/or kaolin waste in ceramic body produced a number of benefits in properties of the final product, such as: decreased absorption of water, apparent porosity and linear retraction at burn; besides the increase in apparent specific mass and mechanical properties of parts. The best results were obtained in the compositional points where the sum of the levels of kaolin waste and phyllite was maximal (40% by weight), as well as conditions which were used in firing temperatures of 950 °C. Regarding the prospect of savings in heat energy required to form the desired microstructure, the phyllite and the residue of kaolin, for having small particle sizes and constitutions mineralogical phases with the presence of fluxes, contributed to the optimization of the firing cycle.

Impacto da utilização de ácido gálhico, ácido ferúlico e eugenol em modo contínuo na suscetibilidade de Pseudomonas aeruginosa

Dissertação de Mestrado, Biologia Molecular e Microbiana, Faculdade de Ciências e Tecnologia, Universidade do Algarve, 2016

A novel approach to reduce fire exposure and promote nature conservation in Mediterranean ecosystems: the case study of Reserva Natural da Serra da Malcata, Portugal

Mestrado Mediterranean Forestry and Natural Resources Management - Instituto Superior de Agronomia - UL

Caracterização de um ecossistema sujeito a desflorestação e conversão do uso do solo na região de Quibala, Angola

Mestrado em Engenharia Agronómica - Instituto Superior de Agronomia - UL