Evolution de l'autonomie fonctionnelle et des capacités d'auto-soins des patients âgés hospitalisés en médecine gériatrique : mieux comprendre pour mieux agir en soins infirmiers

De part le vieillissement démographique, la proportion de personnes âgées augmente et, certaines d'entre-elles nécessiteront des soins en milieu hospitalier. Chez l'aîné, l'expérience d'une maladie et d'une hospitalisation augmente le risque de perte d'autonomie dans les activités de la vie quotidienne (AVQ) et peut compromettre le retour à domicile, diminuer la qualité de vie et mobiliser des ressources du système socio-sanitaire. En Suisse, une étude a établi l'ampleur du problème de la dépendance dans les AVQ à domicile. Cependant, peu de connaissances récentes sont disponibles sur la perte d'autonomie à l'hôpital et aucune sur les trajectoires dans les AVQ. But : Le but de cette étude est d'actualiser et compléter les savoirs sur la perte d'autonomie et les trajectoires dans les AVQ des personnes âgées hospitalisées dans un hôpital tertiaire de Suisse romande. Cadre théorique : La présente étude se base sur la théorie du déficit en auto-soin de Dorothea Orem. Méthode : Cette étude descriptive corrélationnelle est une analyse secondaire des données recueillies dans l'unité pilote du projet Soins Aigus aux Séniors entre août 2011 et janvier 2012. Le déficit en auto-soin dans les AVQ a été mesuré avec l'Index de Katz, les habiletés de base avec le MiniCog, le MiniGDS et le CAM et, les facteurs prédisposant étaient l'âge, le genre, l'entourage et l'aide à domicile ainsi que l'état de santé. L'échantillon de 209 patients présentait un âge moyen de 85.4 ans (SD 7.2) et une proportion de 72.7% de femmes. Résultats : Les principaux résultats montrent que la majorité des patients ont une perte d'autonomie dans les AVQ avant l'admission à l'hôpital (56.2%) et que près d'un patient sur six (14.5%) continue d'expérimenter un déficit en auto-soin durant l'hospitalisation. Les facteurs prédisposant à une trajectoire de déficit en auto-soin entre le domicile et la sortie de l'hôpital identifiés ont été : l'état confusionnel aigu (OR=6.00, IC 95% 1.83 - 19.63), la dépendance en auto-soin à domicile (OR=1.44, IC 95% 1.02 - 2.02) et, une trajectoire de déficit en auto-soin entre le domicile et l'entrée à l'hôpital (OR=14.82, IC 95% 4.83 - 45.46). Conclusion : Cette étude met en évidence que les personnes âgées hospitalisées expérimentent des déficits dans les AVQ et qu'un des facteurs favorisants est la présence d'un état confusionnel aigu. D'autres recherches sont nécessaires pour renforcer et compléter ces résultats.

Identificação dos principais componentes do fungicida guazatine através da cromatografia a gás e cromatografia a gás acoplada com espectrometria de massas

Hexafluoroacetylaceton derivatives of some synthesized components of the guazatine fungicide were prepared, and their separation and identification performed through gas chromatography and gas chromatography-mass spectrometry. The chromatogram obtained from hexafluoroacetylacetone derivative of the commercial guazatine presented 14 major peaks, and 9 of them were identified through both techniques mentioned above.

Desenvolvimento de um detector piezelétrico para cromatógrafo a gás interfaceado a microcomputador

A piezoelectric detector based on a commercial quartz crystal of 3.57MHz is shown. A PTFE cell attached to the GC-column outlet holds the polymer-coated crystal, whose terminals were removed. Two TTL oscillators (reference and sensor) are used and the beating of their frequencies is monitored through a home-made counter card inserted in a microcomputer. The original thermal conductivity detector was also interfaced, but through a 12-bit analog-to-digital converter. In spite of the well-known fact that QCM has low sensitivity at high temperatures, results show significant peak deformation for low temperatures. In addition, the phenomenon is also dependent on the chemical composition of the absorbent film besides instantaneous partial pressure and chemical composition of the analyte.

O médico George Thomson e os primeiros desenvolvimentos do conceito de gás

The word gas was coined by the "chemical philosopher" Joan Baptista Van Helmont (1579 -- 1644) to name a very broad concept in his chemico-medical system. Eventually, some physicians who followed Helmontian ideas adopted the concept. The present paper aims to analyze the reception of the original idea of gas by an English Helmontian physician, George Thomson (1619 -- 1677). Thomson wrote that the "material cause" of the plague was a gas, and compared it to the "Gas of sulphur". He also related the human archeus to a gas, and explained some observations in the laboratory in terms of production of gases. We observe, however, that Thomson was not as interested as Van Helmont in discussing details about the structure of the matter. Thus, gas did not have the same relevance in Thomson's work as it had in Van Helmont's.

Os primeiros desenvolvimentos do conceito helmontiano de gás: parte II

This paper focuses on the early interpretations of the concept of gas, originally created by J. B. Van Helmont (1579 ¾ 1644). Our main interest is on the ideas of English physicians and chemical philosophers of the seventeenth century. Gas was usually associated with the material cause of diseases, with the vital spirit, or with a volatile spirit produced in some kinds of material transformations. As a general trend, however, the authors who did not want to embrace the details of the medico-chemical system proposed by Van Helmont preferred to use more well-known words (such as vapours, exhalations, effluvia, odours, spirits), avoiding the use of the neologism.

Sistema de alimentação gás-líquido para medidas de atividade catalítica

This note has as objective to present the advantages of the use of syringe-type pumps for the feeding of liquid reactants, together with mass flow controllers for gases, instead of the saturators, as it is generally accomplished. Among the advantages, the system with syringe pumps presents a greater flexibility in flow control as well as in composition compared with the system that uses saturator. In addition, the flow of the liquid reactants is known with precision in the syringe pump system.

Extração de esteróides em frutos de Ottonia martiana Miq., Piperaceae, com gás liqüefeito

A new extraction method for sterols was tested in fruits of Ottonia martiana Miq., a shrub belonging to the family Piperaceae, popularly known as "anestésica" due to the use of its roots and aerial parts, in alcoholic preparations, in treatment of odontological problems. For this purpose, a portable extraction equipment was developed, to operate with liquified gases, which showed to be practical, fast and effective, besides being economical and ecological. In the chromatographic analysis of the extracts obtained in this equipment, it was demonstrated the presence of two sterols, isomers of b-sitosterol and stigmasterol.

Estudo do nitrogênio na combustão do gás natural

Nitrogen content in natural gas was studied in experimental and computational investigations to identify its influence on the emission level of exhaust gases from combustion facilities. Changes in natural gas composition with different N2 concentrations may result from introducing a new source gas into the system. An industrial burner fired at 75 kW, housed in a laboratory-scale furnace, was employed for runs where the natural gas/N2 proportion was varied. The exhaust and in-furnace measurements of temperature and gas concentrations were performed for different combustion scenarios, varying N2 content from 1-10 %v. Results have shown that the contamination of natural gas with nitrogen reduced the peak flame temperature, the concentration of unstable species, the NO X emission level and the heat transfer rate to the furnace walls, resulting from the recombination reactions.

Síntese e caracterização de perovskitas LaNi(1-x)Co xO3 como precursores de catalisadores para a conversão do metano a gás de síntese pela reforma com CO2

LaNiO3 perovskite was modified by partial substitution of nickel by cobalt in order to increase the stability and resistance to carbon deposition during the methane CO2 reforming. The results showed that a suitable combination of precipitation and calcination steps resulted in oxides with the desired structure and with important properties for application in heterogeneous catalysis. The partial substitution of Ni by Co resulted in lower rates of conversion of both the reactants, but the catalyst stability was highly increased. The LaNi0.3Co0.7O3 catalyst, calcined at 800 ºC, was the most active under the reaction conditions.

Emissão de mercúrio para a atmosfera pela queima de gás natural no Brasil

Increasing natural gas use in Brazil triggered a discussion of its role as a Hg source. We show that Hg emissions to the atmosphere from fossil fuel combustion for power generation in Brazil contribute with 6.2% (4.2 t yr-1) to the total anthropogenic Hg atmospheric emissions, with coal combustion and biomass burning as major sources. Natural gas contributes with 0.04 t yr-1, mostly from electricity generation (88%) and industrial uses (7.6%). Preliminary results on Hg concentrations in natural gas suggest that a large fraction of it is trapped during refining and transport, which may create Hg point sources between extraction and consumption.

Influência de M/C (M = Mo, Cu, Fe e W) incorporado à camada difusora do eletrodo de difusão de gás frente à reação de oxidação de hidrogênio na presença de CO

The performance of proton exchange membrane fuel cells (PEMFC) with Pt-based anodes is drastically lowered when CO-containing hydrogen is used to feed the system, because of the strong adsorption of CO on platinum. In the present work the effects of the presence of a conversion layer of CO to CO2 composed by several M/C materials (where M = Mo, Cu, Fe and W) in gas diffusion anodes formed by Pt catalysts were investigated. The diffusion layers formed by Mo/C e W/C show good CO-tolerance, and this was attributed to the CO removal by parallel occurrence of the water-gas shift reaction and the so-called bifunctional mechanism.

Comparação de diferentes abordagens para avaliação da incerteza na cromatografia gasosa do gás natural

The evaluation of uncertainty associated with an analytic result is an essential part of the measurement process. Recently, several approaches to evaluate the uncertainty in measurement have been developed. Here, the gas chromatography assay uncertainty for natural gas is compared by some of these approaches: the guide to the expression of uncertainty in measurement (GUM) approach, top-down approach (reproducibility estimate from an inter-laboratory study), Barwick & Ellison (data from validation), study of variability and fuzzy approach. The comparison shows that GUM, Barwick & Ellison and fuzzy approaches lead to comparable uncertainty evaluations, which does not happen with the top-down approach and study of variability by the absence of data normality.

Interpretação do mecanismo de difusão no processo gás-sólido da reação de dessulfurização

The present paper aims to interpret the SO2 diffusion mechanism process for two different limestones: a calcite and a dolomite. In previous study, the apparent activation energies for sulfation reaction were between 3.03 and 4.45 kJ mol-1 for the calcite, and 11.24 kJ mol-1 for the dolomite. Using nitrogen porosimetry it was possible to observe that the dolomite presents mesopores of 0.03 μm, while the calcite presents mesopores of 0.01 μm. The evaluation of limestones porous structure together with their kinetic parameters, allowed concluding that the diffusion mechanism follows Fick law and Knudsen law for dolomite and calcite, respectively.

Determinação de bifenilos policlorados em soro de cordão umbilical através de extração por hidrólise ácida seguida de cromatografia a gás acoplada a um microdetector de captura de elétrons

The present work describes the determination of polychlorinated biphenyls in 123 umbilical cord serum samples by liquid-liquid extraction method with acid hydrolyze step and analysis by GC-mECD. The analytical method was evaluated with following figures of merit for all PCBs: linearity (>0.997); precision (<12.55%); recoveries (73-119%); limit of detection (0.1 ng mL-1); limit of quantification (0.25-0.5 ng mL-1). The results showed high contamination in the analyzed samples. PCB more frequent was 138 (66.7%), followed by 180 (55.3%) and 52 (51.3%).