953 resultados para Nutritional state assessment


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Noise mapping has been used as an instrument for assessment of environmental noise, helping to support decision making on urban planning. In Brazil, urban noise is not yet recognized as a major environmental problem by the government. Besides, cities that have databases to drive acoustic simulations, making use of advanced noise mapping systems, are rare. This study sought an alternative method of noise mapping through the use of geoprocessing, which is feasible for the Brazilian reality and for other developing countries. The area chosen for the study was the central zone of the city of Sorocaba, located in So Paulo State, Brazil. The proposed method was effective in the spatial evaluation of equivalent sound pressure level. The results showed an urban area with high noise levels that exceed the legal standard, posing a threat to the welfare of the population.

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OBJECTIVES: Due to the high prevalence of renal failure in transcatheter aortic valve replacement (TAVR) candidates, a non-contrast MR technique is desirable for pre-procedural planning. We sought to evaluate the feasibility of a novel, non-contrast, free-breathing, self-navigated three-dimensional (SN3D) MR sequence for imaging the aorta from its root to the iliofemoral run-off in comparison to non-contrast two-dimensional-balanced steady-state free-precession (2D-bSSFP) imaging. METHODS: SN3D [field of view (FOV), 220-370 mm(3); slice thickness, 1.15 mm; repetition/echo time (TR/TE), 3.1/1.5 ms; and flip angle, 115°] and 2D-bSSFP acquisitions (FOV, 340 mm; slice thickness, 6 mm; TR/TE, 2.3/1.1 ms; flip angle, 77°) were performed in 10 healthy subjects (all male; mean age, 30.3 ± 4.3 yrs) using a 1.5-T MRI system. Aortic root measurements and qualitative image ratings (four-point Likert-scale) were compared. RESULTS: The mean effective aortic annulus diameter was similar for 2D-bSSFP and SN3D (26.7 ± 0.7 vs. 26.1 ± 0.9 mm, p = 0.23). The mean image quality of 2D-bSSFP (4; IQR 3-4) was rated slightly higher (p = 0.03) than SN3D (3; IQR 2-4). The mean total acquisition time for SN3D imaging was 12.8 ± 2.4 min. CONCLUSIONS: Our results suggest that a novel SN3D sequence allows rapid, free-breathing assessment of the aortic root and the aortoiliofemoral system without administration of contrast medium. KEY POINTS: • The prevalence of renal failure is high among TAVR candidates. • Non-contrast 3D MR angiography allows for TAVR procedure planning. • The self-navigated sequence provides a significantly reduced scanning time.

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Background: Choosing the method of nutritional assessment is essential for proper follow-up of the nutritional status of patients undergoing liver transplantation. Objectives: Evaluate and compare the nutritional status of cirrhotic patients before and after liver transplantation over a year by different methods of nutritional assessment. Methods: Patients undergoing liver transplantation were assessed in five phases: pre-transplant, 1, 3, 6 and 12 months after transplantation at the hospital Santa Casa de Misericordia de Porto Alegre, RS, Brazil. The methods used for nutritional assessment were anthropometry, grip strength of the non-dominant hand (HGS) by dynamometry, thickness of the adductor pollicis muscle (APM) and phase angle (PA) by bioelectrical impedance analysis (BIA). In all evaluations, the same measurements were taken. Results: Evaluations were performed in 22 patients. Methods that showed a higher prevalence of malnourished patients before transplantation were PA by BIA (25%), arm muscle circumference (AMC) (21.9%) and arm circumference (AC) (18.8%). When comparing the nutritional status of patients during follow-up, there was a significant difference only in the evaluation methods AC, triceps skinfold thickness and PA by BIA. At the end, the methods of nutritional assessment were compared again. They showed a significant statistical difference, with HGS being the best method for detecting malnutrition. Conclusions: In conclusion, it is suggested that the method PA by BIA could be widely used with this population since the results are consistent with other findings in the literature and they are significant, reliable, and reproducible.

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© 2016 The Author(s). Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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The U.S. Nuclear Regulatory Commission implemented a safety goal policy in response to the 1979 Three Mile Island accident. This policy addresses the question “How safe is safe enough?” by specifying quantitative health objectives (QHOs) for comparison with results from nuclear power plant (NPP) probabilistic risk analyses (PRAs) to determine whether proposed regulatory actions are justified based on potential safety benefit. Lessons learned from recent operating experience—including the 2011 Fukushima accident—indicate that accidents involving multiple units at a shared site can occur with non-negligible frequency. Yet risk contributions from such scenarios are excluded by policy from safety goal evaluations—even for the nearly 60% of U.S. NPP sites that include multiple units. This research develops and applies methods for estimating risk metrics for comparison with safety goal QHOs using models from state-of-the-art consequence analyses to evaluate the effect of including multi-unit accident risk contributions in safety goal evaluations.

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Dissertação de Mestrado Integrado em Medicina Veterinária

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Introduction: Hospital malnutrition risk has prevalence values of 20%-50%, and it is a major health problem in the health institutions worldwide. Objective: To assess the accomplishment of nutritional screening and the prevalence of hospital malnutrition risk in a University Hospital. Materials and methods: A retrospective analysis was carried out with nutritional screening, using primary data from six clinical areas obtained in the period between July 2012 and December 2013. According to previous results in Mexican health institutions and considering a mean malnutrition risk prevalence of 50%, it was calculated that a sample size of 3200 subjects was required for the assessment of valid risk values. Patients with values ≥3 on the Nutritional Risk Screening (NRS, 2002) were classiied as carriers of nutritional risk. Results: A total of 5611 patients (38% of all patients admitted) were studied. The rate of screening declined from 55% in 2012 to 31% in 2013. During the whole period, 3034 patients were classiied with risk of malnutrition (54% prevalence). Conclusions: The prevalence of hospital malnutrition risk was high. The accomplishment of the nutritional screening was deicient, and declined between 2012 and 2013. The lack of nutritional screening does not meet the vital care requirements of hospitalized patients and prevents the timely treatment of those at malnutrition risk.

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Dissertação de Mestrado, Neurociências Cognitivas e Neuropsicologia, Faculdade de Ciências Humanas e Sociais, Universidade do Algarve, 2016

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Dos vários aspectos inerentes à aquicultura, a eutrofização devido ao manejo alimentar tem efeitos diretos no viveiro e no sistema aquático no qual ele está inserido. Neste contexto, o presente estudo objetivou analisar a qualidade da água do sistema aquático de um viveiro. em uma criação de tilápia do Nilo (Oreochromis niloticus), foram realizadas coletas de água em seis pontos do sistema aquático, durante um ciclo de engorda (seis meses), compreendendo a água de abastecimento, o viveiro, o efluente e sua mistura com as águas do sistema. Das variáveis ambientais analisadas nas amostras, a aplicação de uma análise de componentes principais revelou que as concentrações de clorofila-a, nitrogênio e fósforo total e o teor de matéria orgânica foram responsáveis pelas variações observadas no sistema durante o cultivo. Variações extrínsecas ao viveiro de cultivo deixaram evidente que o manejo deve ser aplicado a todo o sistema aquático, minimizando efeitos ambientais negativos.

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Multiple indices of biotic integrity and biological condition gradient models have been developed and validated to assess ecological integrity in the Laurentian Great Lakes Region. With multiple groups such as Tribal, Federal, and State agencies as well as scientists and local watershed management or river-focused volunteer groups collecting data for bioassessment it is important that we determine the comparability of data and the effectiveness of indices applied to these data for assessment of natural systems. We evaluated the applicability of macroinvertebrate and fish community indices for assessing site integrity. Site quality (i.e., habitat condition) could be classified differently depending on which index was applied. This highlights the need to better understand the metrics driving index variation as well as reference conditions for effective communication and use of indices of biotic integrity in the Upper Midwest. We found the macroinvertebrate benthic community index for the Northern Lakes and Forests Ecoregion and a coldwater fish index of biotic integrity for the Upper Midwest were most appropriate for use in the Big Manistee River watershed based on replicate sampling, ability to track trends over time and overall performance. We evaluated three sites where improper road stream crossings (culverts) were improved by replacing them with modern full-span structures using the most appropriate fish and macroinvertebrate IBIs. We used a before-after-control-impact paired series analytical design and found mixed results, with evidence of improvement in biotic integrity based on macroinvertebrate indices at some of the sites while most sites indicated no response in index score. Culvert replacements are often developed based on the potential, or the perception, that they will restore ecological integrity. As restoration practitioners, researchers and managers, we need to be transparent in our goals and objectives and monitor for those results specifically. The results of this research serve as an important model for the broader field of ecosystem restoration and support the argument that while biotic communities can respond to actions undertaken with the goal of overall restoration, practitioners should be realistic in their expectations and claims of predicted benefit, and then effectively evaluate the true impacts of the restoration activities.

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Several modern-day cooling applications require the incorporation of mini/micro-channel shear-driven flow condensers. There are several design challenges that need to be overcome in order to meet those requirements. The difficulty in developing effective design tools for shear-driven flow condensers is exacerbated due to the lack of a bridge between the physics-based modelling of condensing flows and the current, popular approach based on semi-empirical heat transfer correlations. One of the primary contributors of this disconnect is a lack of understanding caused by the fact that typical heat transfer correlations eliminate the dependence of the heat transfer coefficient on the method of cooling employed on the condenser surface when it may very well not be the case. This is in direct contrast to direct physics-based modeling approaches where the thermal boundary conditions have a direct and huge impact on the heat transfer coefficient values. Typical heat transfer correlations instead introduce vapor quality as one of the variables on which the value of the heat transfer coefficient depends. This study shows how, under certain conditions, a heat transfer correlation from direct physics-based modeling can be equivalent to typical engineering heat transfer correlations without making the same apriori assumptions. Another huge factor that raises doubts on the validity of the heat-transfer correlations is the opacity associated with the application of flow regime maps for internal condensing flows. It is well known that flow regimes influence heat transfer rates strongly. However, several heat transfer correlations ignore flow regimes entirely and present a single heat transfer correlation for all flow regimes. This is believed to be inaccurate since one would expect significant differences in the heat transfer correlations for different flow regimes. Several other studies present a heat transfer correlation for a particular flow regime - however, they ignore the method by which extents of the flow regime is established. This thesis provides a definitive answer (in the context of stratified/annular flows) to: (i) whether a heat transfer correlation can always be independent of the thermal boundary condition and represented as a function of vapor quality, and (ii) whether a heat transfer correlation can be independently obtained for a flow regime without knowing the flow regime boundary (even if the flow regime boundary is represented through a separate and independent correlation). To obtain the results required to arrive at an answer to these questions, this study uses two numerical simulation tools - the approximate but highly efficient Quasi-1D simulation tool and the exact but more expensive 2D Steady Simulation tool. Using these tools and the approximate values of flow regime transitions, a deeper understanding of the current state of knowledge in flow regime maps and heat transfer correlations in shear-driven internal condensing flows is obtained. The ideas presented here can be extended for other flow regimes of shear-driven flows as well. Analogous correlations can also be obtained for internal condensers in the gravity-driven and mixed-driven configuration.

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Property taxes serve as a vital revenue source for local governments. The revenues derived from the property tax function as the primary funding source for a variety of critical local public service systems. Property tax appeal systems serve as quasi-administrative-judicial mechanisms intended to assure the public that property tax assessments are correct, fair, and equitable. Despite these important functions, there is a paucity of empirical research related to property tax appeal systems. This study contributes to property tax literature by identifying who participates in the property tax appeal process and examining their motivations for participation. In addition, the study sought to determine whether patterns of use and success in appeal systems affected the distribution of the tax burden. Data were collected by means of a survey distributed to single-family property owners from two Florida counties. In addition, state and county documents were analyzed to determine appeal patterns and examine the impact on assessment uniformity, over a three-year period. The survey data provided contextual evidence that single-family property owners are not as troubled by property taxes as they are by the conduct of local government officials. The analyses of the decision to appeal indicated that more expensive properties and properties excluded from initial uniformity analyses were more likely to be appealed, while properties with homestead exemptions were less likely to be appealed. The value change analyses indicated that appeals are clustered in certain geographical areas; however, these areas do not always experience a greater percentage of the value changes. Interestingly, professional representation did not increase the probability of obtaining a reduction in value. Other relationships between the variables were discovered, but often with weak predictive ability. Findings from the assessment uniformity analyses were also interesting. The results indicated that the appeals mechanisms in both counties improved assessment uniformity. On average, appealed properties exhibited greater horizontal and vertical inequities, as compared to non-appealed properties, prior to the appeals process. After, the appeal process was completed; the indicators of horizontal and vertical equity were largely improved. However, there were some indications of regressivity in the final year of the study.

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BACKGROUND Most European birds of prey find themselves in a poor state of conservation, with electrocution as one of the most frequent causes of unnatural death. Since early detection of electrocution is difficult, treatment is usually implemented late, which reduces its effectiveness. By considering that electrocution reduces tissue temperature, it may be detectable by thermography, which would allow a more rapid identification. Three individuals from three endangered raptor species [Spanish imperial eagle (Aquila adalberti), Lammergeier (Gypaetus barbatus) and Osprey (Pandion haliaetus)] were studied thermographically from the time they were admitted to a rehabilitation centre to the time their clinical cases were resolved. CASES PRESENTATION The three raptors presented lesions lacking thermal bilateral symmetry and were consistent with electrocution of feet, wings and eyes, visible by thermography before than clinically; lesions were well-defined and showed a lower temperature than the surrounding tissue. Some lesions evolved thermally and clinically until the appearance of normal tissue recovered, while others evolved and became necrotic. A histopathological analysis of a damaged finger amputated off a Lammergeier, and the necropsy and histopathology examination of an osprey, confirmed the electrocution diagnosis. CONCLUSIONS These results suggest that thermography is effective and useful for the objective and early detection and monitoring of electrocuted birds, and that it may prove especially useful for examining live animals that require no amputation or cannot be subjected to invasive histopathology.

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This paper applies a SRT framework to the study of two case studies, namely the recent campaign of opposition to the legalization of hydraulic fracking in the State of New York and the more ongoing debate on land leasing in Africa. In relation to both campaigns, the analysis accounts for the arguments of a major financial institution and industry representatives who stress the safe and value-adding dimensions of these practices, as well as the views of opponents who refute the validity of industry's position and point to the unacceptable risks posed to the community, health and the environment. In spite of a number of obvious differences between these two case studies, not least differences arising from contrasting socio-economic and geo-political settings, there were also some notable similarities. First, was a tendency amongst protesters in both cases to formulate their role as contemporaries in a historically extended struggle for democratic justice. All perceived of themselves as guardians of their community's right to resist a corporate 'invasion' of their territories, like their forefathers and mothers before them. A theme of colonialism was explored in both settings through various identity and thematic anchoring devices that deliberately evoked shared understandings and historical memories of exploitation and human suffering. The evocation of powerful symbols of identity through visual narratives of protest further reinforced the cultural comprehensibility of opponents' message of protest in both contexts.

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Mitochondrial diseases (MD) are the most frequent inborn errors of metabolism. In affected tissues, MD can alter cellular oxygen consumption rate leading to potential decreases in whole-body resting energy expenditure (REE), but data on pediatric children are absent. We determined, using indirect calorimetry (IC), whole-body oxygen consumption (VO2), carbon dioxide production (VCO2), respiratory quotient (RQ) and REE in pediatric patients with MD and healthy controls. Another goal was to assess the accuracy of available predictive equations for REE estimation in this patient population. IC data were obtained under fasting and resting conditions in 20 MD patients and 27 age and gender-matched healthy peers. We determined the agreement between REE measured with IC and REE estimated with Schofield weight and FAO/WHO/UNU equations. Mean values of VO2, VCO2 (mL·min-1·kg-1) or RQ did not differ significantly between patients and controls (P = 0.085, P = 0.055 and P = 0.626 respectively). Accordingly, no significant differences (P = 0.086) were found for REE (kcal·day-1 kg-1) either. On the other hand, although we found no significant differences between IC-measured REE and Schofield or FAO/WHO/UNU-estimated REE, Bland-Altman analysis revealed wide limits of agreement and there were some important individual differences between IC and equation-derived REE. VO2, VCO2, RQ and REE are not significantly altered in pediatric patients with MD compared with healthy controls. The energy demands of pediatric patients with MD should be determined based on IC data in order to provide the best possible personalized nutritional management for these children.