Partial replacement of mineral fertilisers with animal manures in an apple orchard: Effects on GHG emission.

Partial replacement of mineral fertilisers (MF) with animal manures is a good alternative to reduce MF use and increase both nutrient cycling in agriculture and soil organic matter. However, the adoption of this practice must not lead to increased environmental impacts. In this two-year study conducted in an apple orchard, MF were partially replaced with various animal manures, including cattle slurry (CS), acidified cattle slurry (ACS), solid cattle manure (CsM), or poultry manure (PM), and their impacts on greenhouse gas emission (GHG: CO2, N2O and CH4) were examined. A control (CTRL) receiving only MF served as the baseline, representing the conventional scenario in orchard fertilisation. Overall, replacing MF with manures increased GHG emissions, with the magnitude of the impacts depending on the specific characteristics of the manures and the amount of nutrients and organic matter applied. Comparing to the CTRL, application of ACS and CS led to higher CH4 and N2O emissions, while PM application increased both N2O and CO2 emissions. In contrast, replacement with PM and CsM decreased CH4 emissions. Nevertheless, results varied between the two years, influenced by several factors, including soil conditions. While acidification showed potential to mitigate CH4 emissions, it also led to increased N2O emissions compared to CS, particularly in 2022, suggesting the need for further investigation to avoid emission trade-offs. Replacement with CS (20.49 t CO2-eq ha-1) and CsM (20.30 t CO2-eq ha-1) showed comparable global warming potential (GWP) to the conventional scenario (CTRL, 19.49 t CO2-eq ha-1), highlighting their potential as viable MF substitutes.

Analysis of cardiovascular risk factors for the viability of cornea donors: a case-control study.

OBJECTIVE: The main objective of the study was to evaluate the influence of arterial hypertension, diabetes, dyslipidaemia, smoking, alcoholism and COPD (chronic obstructive pulmonary disease) on the viability of the extracted tissue as well as the donor. DESIGN: Observational case-control study. SETTING: Regional hospital in Northern Spain. PARTICIPANTS: 1517 corneas were registered. INTERVENTIONS: Patients' medical history was reviewed after corneal donation and evaluation. Previous medical information (age, sex and cardiovascular risk factors (CVRFs)) and data related to the donor (type of donor), the corneal tissue and its evaluation, and the viability of the implant were collected. RESULTS: A total of 1517 corneas were registered and 81.5% of the donors presented at least one CVRF. In relation to the viability of the donor, it was observed that having suffered from COPD reduced the viability of the donor (no COPD: 93.8% vs COPD: 88%; OR=0.49; 95% CI: 0.28 to 0.84) while alcohol consumption increased it (drinker or ex-drinker: 95.8% vs non-drinker: 92.5%; OR=1.84; 95% CI: 1.01 to 3.33). Regarding tissue viability, decreased viability was observed in the presence of COPD (no COPD: 72.5% vs COPD: 64; OR=0.67; 95% CI: 0.47 to 0.96) and diabetes mellitus (no diabetes: 72.9% vs diabetes: 67.2%; OR=0.76; 95% CI: 0.58 to 0.99). As regards the viability of the implant, a total of 1039 corneas (68.9%) were suitable, observing decreased viability when suffering from COPD (no COPD: 69.8% vs COPD: 60.7%; OR=0.67; 95% CI: 0.47 to 0.94) and increased when having an active smoking habit (no habit: 65.3% vs habit: 74.1%; OR=1.52; 95% CI: 1.21 to 1.91). CONCLUSIONS: Through this study, it can be concluded that in the absence of absolute exclusion criteria for donors, the assessment of how CVRF, alcoholism and COPD may affect the donor provides details about the quality of the tissue to be obtained.

Outcomes of lung and liver transplantation after simultaneous recovery using abdominal normothermic regional perfusion in donors after the circulatory determination of death versus donors after brain death.

Normothermic regional perfusion (NRP) in controlled donation after the circulatory determination of death (cDCD) is a growing preservation technique for abdominal organs that coexists with the rapid recovery of lungs. We aimed to describe the outcomes of lung transplantation (LuTx) and liver transplantation (LiTx) when both grafts are simultaneously recovered from cDCD donors using NRP and compare them with grafts recovered from donation after brain death (DBD) donors. All LuTx and LiTx meeting these criteria during January 2015 to December 2020 in Spain were included in the study. Simultaneous recovery of lungs and livers was undertaken in 227 (17%) donors after cDCD with NRP and 1879 (21%) DBD donors (P < .001). Primary graft dysfunction grade-3 within the first 72 hours was similar in both LuTx groups (14.7% cDCD vs. 10.5% DBD; P = .139). LuTx survival at 1 and 3 years was 79.9% and 66.4% in cDCD vs. 81.9% and 69.7% in DBD (P = .403). The incidence of primary nonfunction and ischemic cholangiopathy was similar in both LiTx groups. Graft survival at 1 and 3 years was 89.7% and 80.8% in cDCD vs. 88.2% and 82.1% in DBD LiTx (P = .669). In conclusion, the simultaneous rapid recovery of lungs and preservation of abdominal organs with NRP in cDCD donors is feasible and offers similar outcomes in both LuTx and LiTx recipients to transplants using DBD grafts.

Gerenciamento do tempo no processo de trabalho dos enfermeiros em Unidade de Terapia Intensiva / Time management in the work process of nurses in the intensive care unit / Gestión del tiempo en el proceso de trabajo de enfermeros de la unidad de cuidados intensivos

Objetivo: analisar o gerenciamento do tempo dispensado por enfermeiros em intervenções de cuidados diretos e indiretos, em atividades associadas ao trabalho e atividades pessoais. Método: estudo quantitativo, transversal, realizado em Unidade de Terapia Intensiva de um hospital universitário no Rio de Janeiro em janeiro de 2017. Foram realizadas observações diretas das atividades realizadas pelos enfermeiros em 18 plantões, totalizando 216 horas. O "Instrumento para mensuração da carga de trabalho" foi utilizado para estruturar a observação. Resultados: os resultados mostraram que 21,5% do tempo dos enfermeiros foram dedicados às intervenções de cuidados diretos 44,7% aos cuidados indiretos, 6,1% às atividades associadas e 27,7% às atividades pessoais. Conclusão: os enfermeiros utilizam maior parte do tempo em atividades não relacionadas ao cuidado direto ao paciente. Os achados podem ser utilizados pelos gestores para revisão e adequação do dimensionamento de profissionais na assistência direta e indireta e do processo de trabalho na Unidade.

Objective: to analyze time management by nurses in direct and indirect care interventions, in work-related and personal activities. Method: this quantitative, cross-sectional study was conducted in the Intensive Care Unit of a university hospital in Rio de Janeiro in January 2017. Direct observations were made of nurses' activities in 18 shifts, totaling 216 hours. Mello's "Workload Measuring Tool" was used to structure the observations. Results: 21.5% of nurses' time was devoted to direct care, 44.7% to indirect care, 6.1% to work-related activities and 27.7% to personal activities. Conclusion: nurses spend most of their time on activities unrelated to direct patient care. These findings can be useful to managers in reviewing and adjusting both staffing in direct and indirect care and the unit's work process.

Objetivo: analizar la gestión del tiempo que brindan los enfermeros en las intervenciones asistenciales directas e indirectas, en actividades asociadas al trabajo y actividades personales. Método: estudio cuantitativo, transversal, realizado en la Unidad de Cuidados Intensivos de un hospital universitario de Rio de Janeiro en enero de 2017. Se realizaron observaciones directas de las actividades realizadas por enfermeras en 18 turnos, totalizando 216 horas. Se utilizó la "Herramienta de medición de la carga de trabajo" para estructurar la observación. Resultados: los resultados mostraron que el 21,5% del tiempo de los enfermeros se dedicó a intervenciones de cuidados directos, el 44,7% a cuidados indirectos, el 6,1% a actividades asociadas y el 27,7% a actividades personales. Conclusión: los enfermeros dedican la mayor parte de su tiempo a actividades no relacionadas con la atención directa al paciente. Los hallazgos pueden ser utilizados por los gestores para revisar y adecuar el dimensionamiento de profesionales en la atención directa e indirecta y el proceso de trabajo en la Unidad.

Gerenciamento do tempo no processo de trabalho dos enfermeiros em Unidade de Terapia Intensiva / Gestión del tiempo en el proceso de trabajo de enfermeros de la unidad de cuidados intensivos / Time management in the work process of nurses in the intensive care unit

RESUMO Objetivo analisar o gerenciamento do tempo dispensado por enfermeiros em intervenções de cuidados diretos e indiretos, em atividades associadas ao trabalho e atividades pessoais. Método estudo quantitativo, transversal, realizado em Unidade de Terapia Intensiva de um hospital universitário no Rio de Janeiro em janeiro de 2017. Foram realizadas observações diretas das atividades realizadas pelos enfermeiros em 18 plantões, totalizando 216 horas. O "Instrumento para mensuração da carga de trabalho" foi utilizado para estruturar a observação. Resultados os resultados mostraram que 21,5% do tempo dos enfermeiros foram dedicados às intervenções de cuidados diretos 44,7% aos cuidados indiretos, 6,1% às atividades associadas e 27,7% às atividades pessoais. Conclusão os enfermeiros utilizam maior parte do tempo em atividades não relacionadas ao cuidado direto ao paciente. Os achados podem ser utilizados pelos gestores para revisão e adequação do dimensionamento de profissionais na assistência direta e indireta e do processo de trabalho na Unidade.

RESUMEN Objetivo analizar la gestión del tiempo que brindan los enfermeros en las intervenciones asistenciales directas e indirectas, en actividades asociadas al trabajo y actividades personales. Método estudio cuantitativo, transversal, realizado en la Unidad de Cuidados Intensivos de un hospital universitario de Rio de Janeiro en enero de 2017. Se realizaron observaciones directas de las actividades realizadas por enfermeras en 18 turnos, totalizando 216 horas. Se utilizó la "Herramienta de medición de la carga de trabajo" para estructurar la observación. Resultados los resultados mostraron que el 21,5% del tiempo de los enfermeros se dedicó a intervenciones de cuidados directos, el 44,7% a cuidados indirectos, el 6,1% a actividades asociadas y el 27,7% a actividades personales. Conclusión los enfermeros dedican la mayor parte de su tiempo a actividades no relacionadas con la atención directa al paciente. Los hallazgos pueden ser utilizados por los gestores para revisar y adecuar el dimensionamiento de profesionales en la atención directa e indirecta y el proceso de trabajo en la Unidad.

ABSTRACT Objective to analyze time management by nurses in direct and indirect care interventions, in work-related and personal activities. Method this quantitative, cross-sectional study was conducted in the Intensive Care Unit of a university hospital in Rio de Janeiro in January 2017. Direct observations were made of nurses' activities in 18 shifts, totaling 216 hours. Mello's "Workload Measuring Tool" was used to structure the observations. Results 21.5% of nurses' time was devoted to direct care, 44.7% to indirect care, 6.1% to work-related activities and 27.7% to personal activities. Conclusion nurses spend most of their time on activities unrelated to direct patient care. These findings can be useful to managers in reviewing and adjusting both staffing in direct and indirect care and the unit's work process.

Fábrica de cuidados: uma tecnologia social para construção de modelos de cuidar em saúde / Care factory: a social technology for building health care models / Fábrica de cuidados: una tecnología social para la construcción de modelos asistenciales

Objetivo: Relatar a experiência da execução do Programa de Extensão Fábrica de Cuidados como tecnologia social para construção de modelos de cuidar em saúde. Método: trata-se de estudo descritivo do tipo relato de experiência. Resultados: Como Tecnologia Social, o Programa de Extensão Fábrica de Cuidados propicia conhecimentos de reconverter nosso pensamento de atenção, para inclusão social e relação de ajuda. Considerações finais: A implementação do Programa de Extensão Fábrica de Cuidados como tecnologia social exige de seus mentores habilidades criativas e motivacionais, conhecimentos e disponibilidade para assegurar a autonomia da Enfermagem. É preciso acreditar no investimento social do conhecimento como a "riqueza extraordinária" e dos nossos "infinitos fluxos" para ajudar o outro. (AU)

Objective: To report the experience of implementing the Care Factory Extension Program as a social technology for building health care models. Methods: This is a descriptive study of the experience report type. Results: As Social Technology, Care Factory Extension Program provides knowledge to reconvert our thought of attention to social inclusion and a helping relationship. Conclusion: The implementation of Care Factory Extension Program as a social technology requires from its mentors creative and motivational skills, knowledge, and availability to ensure Nursing autonomy. It is necessary to believe in the social investment of knowledge as the "extraordinary wealth" and our "infinite flows" to help others. (AU)

Objetivo: Dar a conocer la experiencia de implementación del Programa de Extensión Fábrica de Cuidados como tecnología social para la construcción de modelos de atención en salud. Métodos: Se trata de un estudio descriptivo del tipo relato de experiencia. Resultados: Como Tecnología Social, Programa de Extensión Fábrica de Cuidados aporta conocimientos para reconvertir nuestro pensamiento de atención a la inclusión social y la relación de ayuda. Conclusión: La implementación de Programa de Extensión Fábrica de Cuidados como tecnología social requiere de sus mentores habilidades creativas y motivacionales, conocimientos y disponibilidad para asegurar la autonomía de Enfermería. Es necesario creer en la inversión social del conocimiento como la "riqueza extraordinaria" y nuestros "flujos infinitos" para ayudar a los demás. (AU)

Assistência de enfermagem ao paciente com suspeita de neoplasia em cabeça/pescoço: relato de experiência / Nursing assistance to patients with suspected neoplasia in head / neck: experience report

Objetivo: Relatar diante da história clínica deste paciente dos sinais sintomas apresentados, diagnóstico médico e tratamento, apresentar quais os cuidados de enfermagem necessários ao paciente com suspeita de neoplasia de cabeça e pescoço. Método: Trata-se de um estudo descritivo de abordagem qualitativa, do tipo relato de experiência. Para a realização do estudo foram utilizadas informações do prontuário do paciente e histórico de enfermagem. O estudo foi aprovado por Comitê de Ética. Resultado: Dentre os cuidados de enfermagem, cita-se: Realizar balanço hídrico, manter cabeceira elevada, auxiliar na alimentação, orientar sobre a doença, entre outros. Através da vivência foi possível observar a importância de cuidados específicos para o paciente, através da aplicação processo de enfermagem. Conclusão: Em vista disso concluímos que a assistência de enfermagem prestada ao paciente com câncer cabeça e pescoço são essenciais para a qualidade do cuidado e para sua efetiva recuperação. Neste sentido o enfermeiro deve se fazer presente como um profissional de referência por meio de conhecimento técnico e baseado em evidência.(AU)

Objective: To report, in view of the clinical history of this patient, of the signs and symptoms presented, medical diagnosis and treatment, to present what nursing care is necessary for the patient with suspected head and neck cancer. Method: This is a descriptive study with a qualitative approach, an experience report type. To carry out the study, information from the patient's medical record and nursing history were used. The study was approved by the Ethics Committee. Result: Among the nursing care, the following are cited: Perform water balance, keep the headboard elevated, assist in feeding, advise on the disease, among others. Through the experience it was possible to observe the importance of specific care for the patient, through the application of the nursing process. Conclusion: In view of this, we conclude that the nursing care provided to patients with head and neck cancer are essential for the quality of care and for their effective recovery. In this sense, the nurse must be present as a reference professional through technical knowledge and based on evidence.(AU)

Objetivo: Describir, a la vista de la historia clínica del paciente, signos, síntomas, diagnóstico médico y tratamiento evidenciados, presentar los cuidados de enfermería necesarios para los pacientes con sospecha de cáncer de cabeza y cuello. Método: Se trata de un estudio descriptivo con enfoque cualitativo, del tipo relato de experiencia. Para la realización del estudio se utilizó información de la historia clínica del paciente y del historial de enfermería. El estudio fue aprobado por el Comité de Ética. Resultado: Entre los cuidados de enfermería se citan los siguientes: Realizar balance hídrico, mantener elevado el cabecero, asistir en la alimentación, asesorar sobre la enfermedad, entre otros. A través de la experiencia, fue posible observar la importancia del cuidado específico para el paciente, a través de la aplicación del proceso de enfermería. Conclusión: Ante esto, se concluye que los cuidados de enfermería que se brindan a los pacientes con cáncer de cabeza y cuello son fundamentales para la calidad de la atención y para su efectiva recuperación. En este sentido, el enfermero debe estar presente como un profesional de referencia a través de conocimientos técnicos y con base en la evidencia.(AU)

Presenteeism and Productivity: The Role of Biomarkers and Hormones.

PURPOSE: This study aimed to assess whether self-reported productivity despite presenteeism may be affected by biomarkers and hormones and how these physiological indicators can interact with each other to explain the presenteeism dimensions. METHODS: This pilot study included 180 healthy participants with a mean age of 41.22 years (SD = 13.58), 76.11% of whom were female. The dependent variable included a self-reported measure of productivity loss due to presenteeism: the Stanford Presenteeism Scale 6. This study also includes physiological indicators such as biomarkers (C-reactive protein (CRP) and blood glucose) and hormones (cortisol and TSH thyroid hormone). RESULTS: Multiple linear regression analyses revealed that CRP moderated the relationship between cortisol levels and productivity despite presenteeism. Moreover, the increase of TSH moderated the relationship between cortisol, glycemia, and employees' capacity to complete work tasks while sick. CONCLUSIONS: The results highlight TSH's moderating role in decreasing employees' capacity to fulfill tasks when these individuals have high levels of glycemia and cortisol in their blood. These findings have practical and theoretical implications based on a fuller understanding of how biomarkers and hormones explain productivity despite presenteeism.

Virtual M-Mode for Echocardiography: A New Approach for the Segmentation of the Anterior Mitral Leaflet.

Rheumatic heart disease can result from repeated episodes of acute rheumatic fever, which damages the heart valves and reduces their functionality. Early manifestations of heart valve damage are visible in echocardiography in the form of valve thickening, shape changing and mobility reduction. The quantification of these features is important for a precise diagnosis and it is the main motivation for this work. The first step to make this quantification is to accurately identify and track the anterior mitral leaflet throughout the cardiac cycle. An accurate segmentation and tracking with minimum user interaction is still an open problem in literature due to low image quality, speckle noise, signal dropout and nonrigid deformations. In this work, we propose a novel approach for the identification of the anterior mitral valve leaflet in all frames. The method requires a single user-specified point on the posterior wall of the aorta as input, in the first frame. The echocardiography videos are converted into a new image space, the Virtual M-mode, which samples the original echocardiography image over automatically estimated scanning lines. This new image space not only provides the motion pattern of the posterior wall of the aorta, the anterior wall of the aorta and the posterior wall of the left atrium, but also provides the location of the structures in each frame. The location information is then used to initialize the localized active contours, followed by segmenting the anterior mitral leaflet. Results shown that the new image space has robustly identified the anterior mitral valve leaflet, without any failure. The median modified Hausdorff distance error of the proposed method was 2.3 mm, with a recall of 0.94.

A New Method for the Anterior Mitral Leaflet Segmentation in Echocardiography Videos using the Virtual M-mode Space.

Rheumatic heart disease is responsible for the heart valve damage, caused by repeated episodes of rheumatic fever. The disease commonly inflames and scars the mitral valve of the heart, resulting in thicker, less mobile leaflets, with associated decrease in cardiac efficiency. It is important to measure and quantity the early manifestations of this disease, including variations of the thickness, shape and mobility of the leaflets. These manifestations are visible in an echocardiographic screening process. The first step towards the defined objective is to segment the anterior mitral leaflet throughout the cardiac cycle, enabling the future automatic quantification of mentioned clinical parameters. In this work, a new algorithm for the segmentation of the whole region of the anterior mitral leaflet in the virtual M-mode space is proposed. The algorithm requires a single initialization point on the posterior wall of the aorta, in the first frame of the video. A junction point is then computed, showing the location where the two leaflets connect. This junction point helps to automatically redefine the range of virtual M-mode images required to completely segment the region of the anterior mitral leaflet. The segmented anterior mitral leaflet region in the virtual M-mode space is transferred back to regular image space and its shape refined using localized active contours. Results suggest the suitability of the proposed algorithm for the segmentation of anterior mitral leaflet with a median Dice Similarity Coefficient of 0.63, and with median precision and recall of 58% and 73% respectively.

Extracting Thickness Profiles of Anterior Mitral Leaflets in Echocardiography Videos.

Rheumatic heart disease is the serious consequence of repeated episodes of acute rheumatic fever. It is the major cause of heart valve damage resulting in morbidity and mortality. Its early detection is considered vital to control the disease's progression. The key manifestations that are visible in the early stages of this disease are changes in the thickness, shape and mobility of the mitral valve leaflets. Echocardiography based screening is sensitive enough to identify these changes in early stages of the disease. In this work, an automatic approach is proposed to measure, quantify and analyze the thickness of the anterior mitral leaflet, in an echocardiographic video. The shape of the anterior mitral leaflet is simplified via morphological skeletonization and spline modelling to get the central line of the leaflet. To analyze the overall thickness from the tip to its base, the anterior mitral leaflet is divided into four quartiles. In ach quartile the thickness is measured as the length of the line segment resulting from the intersection of the contour with the normal direction of the central point of each quartile. Finally, the thickness is analyzed by measuring the variance per quartile, divided by leaflet position (open, straight and closed). The comparison between the normal and pathological leaflets are also presented, exhibiting statistical significant differences in all quartiles, especially near the tip of the leaflet.

[Knowledge and attitudes toward organ donation among health professionals in a third level hospital]. / Conocimientos y actitudes ante la donación de órganos de los profesionales sanitarios de un hospital de tercer nivel.

OBJECTIVE: The Spanish model is the model adopted by many countries to increase their donation rate, being the implication of the healthcare professionals one of the keys to this success. The attitude of these before the donation is crucial for the hour of influence on the population. Organ transplantation has been established as an effective treatment that has been improving over the years. The objective was to determine the knowledge and attitudes of health professionals before the donation of organs. METHODS: Cross-sectional descriptive study. An ad hoc questionnaire was conducted and distributed among the health professionals (medical staff, nurses and nursing assistants) of a tertiary hospital during February 2015. A total of 615 potential participants were estimated in the different areas of the hospital. A total of 342 completed questionnaires were collected (55%). The statistical analysis with SPSS® Statistics for Windows. Version 20.0. A level of significance P lower than 0.05 was used in all the analyses. RESULTS: The average age of the respondents was 43.34 (SD = 10.37) years, being 86.6% women and 60% nurses. 35.5% showed good knowledge about the donation process, being higher in men (51.1% Vs 33.1%, p lower than 0.05), medical personnel (55% vs 34.3% vs 31.9%). %; p lower than 0.05) and lower in those services with a direct relationship with the donation process (36.8% vs 31.9%, p lower than 0.05). 71% of the professionals expressed their willingness to donate their organs, with special sensitivity towards donation those services in direct relation with the donation program (82.2% vs 65.9%, OR: 1.24, p lower than 0.001 ). 50% of the professionals would donate the organs of a family member; the medical group had the highest percentage (70% vs 50.7% vs 40.4%, OR: 3.8, p lower than 0.05). 74.5% knew some Spanish legal document about donation and transplants. CONCLUSIONS: Health professionals as a whole have a low level of knowledge; but a good attitude towards donation.

OBJETIVO: El modelo español es el modelo adoptado por numerosos países para aumentar su tasa de donación siendo una de las claves de este éxito la implicación de los trabajadores sanitarios. La actitud de estos ante la donación resulta crucial a la hora de influir sobre la población. El trasplante de órganos se ha establecido como un tratamiento efectivo que ha ido mejorando a lo largo de los años. El objetivo de este estudio fue determinar los conocimientos y actitudes de los profesionales sanitarios ante la donación de órganos. METODOS: Estudio descriptivo transversal. Se realizó un cuestionario ad hoc y se distribuyó entre los profesionales sanitarios (personal médico, enfermería y auxiliares de enfermería) de un hospital de tercer nivel durante febrero 2015. Se estimó un total de 615 potenciales participantes en las diferentes áreas del hospital. Se recogieron un total de 342 cuestionarios cumplimentados en su totalidad (55%). El análisis estadístico se realizó con SPSS® versión 20.0 versión Windows. Se utilizó un nivel de significación P menor de 0.05 en todos los análisis. RESULTADOS: El promedio de edad de los encuestados fue de 43,34 (DT=10,37) años, siendo el 86,6% mujeres y el 60% enfermeras. El 35,5% mostraron buenos conocimientos sobre el proceso de donación, siendo mayor en hombres (51,1% Vs 33,1%;p menor de 0,05), personal médico (55% vs 34,3% vs 31,9%;p menor de 0,05) e inferior en aquellos servicios con una relación directa con el proceso de donación (36,8% vs 31,9%;p menor de 0,05). El 71% de los profesionales manifestaron estar dispuestos a donar sus órganos, con especial sensibilidad hacia la donación aquellos servicios en relación directa con el programa de donación (82,2% vs 65,9%; OR:1,24;p menor de 0,001). El 50% de los profesionales donarían los órganos de un familiar; siendo el colectivo médico el que presentaba un porcentaje mayor (70% vs 50,7% vs 40,4%; OR:3,8; p menor de 0,05). El 74,5% conocía algún documento legal español sobre donación y trasplantes. CONCLUSIONES: Los profesionales de la salud en su conjunto tienen un bajo nivel de conocimiento, pero una buena actitud hacia la donación.

Projetando imagem e pensando o corpo nos diferentes espaços / Proyectando imagen y pensando el cuerpo en diferentes espacios / Effects designing image and thinking the body in different spaces

Objectives: produce dialogues from the creation of an individual design on the perception of the own body as a health care element; place the body in the institutional space and collectively discuss their occupation in the professional fields of expertise, and political power. Method: Playful production in class in graduate school, with nurses, doctors, engineers and physiotherapists in the first half of 2016. If made content analysis. Results: The body generates flows, sensitivity, territory and imagination. They emerged from the psychodynamic categories, psychological effects, metamorphosis and desire. They recognize the importance of transit in the three fields, predominantly 93% in the professional space, 53% political and 53% in power. Some opted for two spaces simultaneously and there was no new creation. Conclusion: The strategy of playing to teach the dialogic environment allowed active participation and resized thinking necessary for employment and unemployment transverse spaces at work.

Objetivos: produzir diálogos a partir da criação de um desenho individual sobre a percepção do próprio corpo como elemento do cuidado em saúde; situar o corpo no espaço institucional e discutir coletivamente sua ocupação nos campos de atuação profissional, político e de poder. Método: Produção lúdica em sala de aula em curso de doutorado, com enfermeiros, médico, engenheiro e fisioterapeutas, no primeiro semestre de 2016. Se efetuou análise de conteúdo. Resultados: O corpo gera fluxos, sensibilidade, território e imaginação. Emergiram as categorias: psicodinâmica, psicopatogenia, metamorfose e desejo. Reconhecem a importância de transitar nos três campos, predominando 93% no espaço profissional, 53% no político e 53% no de poder. Alguns optaram por dois espaços simultaneamente e não houve nova criação. Conclusão: A estratégia do brincar para ensinar no ambiente dialógico permitiu participação ativa e redimensionou o pensar necessário à ocupação e desocupação dos espaços transversais no trabalho.

Objetivos: producir diálogos a partir de la creación de un diseño individual sobre la percepción del propio cuerpo como elemento de cuidado en salud; situar el cuerpo en el espacio institucional y discutir colectivamente su ocupación en los campos de actuación profesional, político y de poder. Método: Producción lúdica en aula de clase del curso de doctorado, con enfermeros, fisioterapeutas, médico e ingeniero, primer semestre de 2016. Se efectuó análisis de contenido. Resultados: El cuerpo genera flujos, sensibilidad, territorio e imaginación. Emergieron las categorías psicodinámica, psicopatogenia, metamorfosis y deseo; reconocen la importancia de transitar en los tres campos predominando 93% en el espacio profesional, 53% en el político y 53% en el de poder. Algunos optaron por dos espacios simultáneamente y no hubo nueva creación. Conclusión: La estrategia del juego para enseñar en un ambiente dialógico permitió pensar en la ocupación y desocupación de espacios transversales en el trabajo.

Tracking large Anterior Mitral Leaflet displacements by incorporating optical flow in an active contours framework.

Echocardiography is an important tool to detect early evidence of mitral valve degradation associated with rheumatic heart disease. The segmentation and tracking of the Anterior Mitral Leaflet helps to quantify the morphologic valve anomalies, such as the leaflet thickening, shape and the mobility changes. The tracking of this leaflet throughout the cardiac cycle is still an open challenge in the research community. The widely used active contours segmentation framework fails when faced with large leaflet displacement. In this work, we propose the integration of optical flow in an open-ended active contour framework to address this difficulty. This additional information promotes solutions with contours next to high leaflet displacements, resulting in superior performance. The algorithm was tested on 9 fully annotated real clinical videos, acquired from the parasternal long axis view. The algorithm is compared with our previous work. Results show a clear improvement in situations where the leaflet exhibits large displacement or irregular shapes, with an average error of 4.5 pixels and a standard deviation of 2 pixels.

Cenas de situações de cuidar e implicações éticas: uma experiência com estudantes de graduação no espaço de ensinar / Scenes of care situations and ethical implications: an experience with undergraduate students in the teaching space / Escenas de situaciones de cuidado y las implicaciones éticas: una experiencia con estudiantes de pregrado en el espacio de la enseñanza

Objetivo: apresentar simulações de situações de cuidar como atividade acadêmica da disciplina Ética. Método: estudo cartográfico de natureza qualitativa. O cenário de investigação institucional consiste em uma universidade pública localizada no estado do Rio de Janeiro, destinada a formar profissionais enfermeiros. Participaram deste estudo 22 estudantes. O estudo foi submetido ao comitê de ética em pesquisa da instituição de Ensino Superior e aprovado sob o Parecer n. 685-11. Resultados: produção imagética de 5 situações simuladas de cuidar seguida de discussão e indicação de temas que, reorganizados, deram origem a 3 núcleos de análise: implicações éticas para o cuidado; implicações éticas para o ensino; e implicações éticas nos aspectos tecnológicos. Conclusão: a estratégia de produção de cenas simuladas é uma pedagogia possível, que provoca nos estudantes diferentes formas de pensar, de aprender e posicionar-se de forma ética nas situações de cuidar.(AU)

Objective: to introduce simulations of care situations as an academic activity of the subject Ethics. Method: cartographic study with a qualitative nature. The institutional research scenario consists in a public university located in the Rio de Janeiro state, Brazil, aimed at providing professional nurses with education. This study had 22 students as participants. The study was submitted to the research ethics committee of the Higher Education institution and approved under the Opinion 685-11. Results: imagistic production of 5 simulated care situations followed by discussion and indication of themes that, reorganized, led to 3 analysis cores: ethical implications for care; ethical implications for teaching; and ethical implications on technological aspects. Conclusion: the strategy of producing simulated scenes is a feasible pedagogy, which leads students to various ways of thinking, learning, and positioning themselves in an ethical manner during care situations.(AU)

Objetivo: presentar simulaciones de situaciones de atención como una actividad académica de la asignatura Ética. Método: estudio cartográfico con un carácter cualitativo. El escenario de investigación institucional consiste en una universidad pública ubicada en el estado de Río de Janeiro, Brasil, diseñada para capacitar a enfermeros profesionales. Este estudio tuvo 22 estudiantes como participantes. El estudio fue presentado al comité de ética en investigación de la institución de Enseñanza Superior y aprobado bajo la Opinión 685-11. Resultados: producción de imágenes de 5 situaciones de cuidado simuladas seguida por discusión e indicación de temas que, reorganizados, llevaron a 3 núcleos de análisis: implicaciones éticas para la atención; implicaciones éticas para la enseñanza; e implicaciones éticas acerca de aspectos tecnológicos. Conclusión: la estrategia de producción de escenas simuladas es una pedagogía posible, que hace que los estudiantes tengan diferentes formas de pensar, de aprender y de posicionarse de una manera ética en situaciones de atención.(AU)

Technique of uniportal VATS major pulmonary resections.

The surgical approach to lung resections is evolving constantly. Since the video-assisted thoracoscopic surgery (VATS) anatomic lobectomy for lung cancer was described two decades ago, many units have successfully adopted this technique. The VATS lobectomy can be defined as the individual dissection of veins, arteries and bronchus, with a mediastinal lymphadenectomy, using a videothoracoscopic approach visualized on screen and involving 2 to 4 incisions or ports, with no rib spreading. However, the surgery can be performed by only one incision with similar outcomes. Since 2010, when the uniportal approach was introduced for major pulmonary resections, the technique has been spreading worldwide. This technique provides a direct view of the target tissue. The parallel instrumentation achieved during the single-port approach mimics the maneuvers performed during open surgery. It represents a less invasive approach than the multiport technique, and minimizes the compression of the intercostal nerve. As the surgeon's experience with the uniportal VATS lobectomy grows, more complex cases can be performed by using this approach, thus expanding the indications for single-incision thoracoscopic lobectomy.

Uniportal video-assisted thoracoscopic lymph node dissection.

Lymphadenectomy is an important part of lung cancer surgery. At the moment, video-assisted thoracoscopic (VATS) is the most common approach to remove these tumors, when it is technically possible. With our current experience in VATS in major resections we have obtained a radical videothoracoscopic mediastinal lymphadenectomy, and single-port provides us with the best anatomic instrumentation and a direct view.

Management of complications by uniportal video-assisted thoracoscopic surgery.

Since the video-assisted thoracoscopic surgery (VATS) anatomic lobectomy for lung cancer was described two decades ago, many units have successfully adopted this technique. VATS lobectomy is a safe and effective approach for the treatment not only of early stage lung cancer but also for more advanced disease. It represents a technical challenge. As the surgeon's experience grows, more complex or advanced cases are approached using the VATS approach. However, as VATS lobectomy has been applied to more advanced cases, the rate of conversion to open thoracotomy has increased, particularly early in the surgeon's learning curve, mostly due to the occurrence of complications. The best strategy for facing complications of VATS lobectomy is to prevent them from happening. Avoiding complications is subject to an appropriate preoperative workup and patient selection. Planning for a VATS resection as safely as possible involves the consideration of the patient´s characteristics and the anticipated technical aspects of the case. Awareness of the possibility of intraoperative complications of VATS lobectomy is mandatory to avoid them, and the development of management strategies is necessary to limit morbidity if they occur.

Semiologia do encontro: imagens das práticas entre docentes e alunos do ensino médio e universitário / Semiología de la reunión: imágenes de las prácticas entre profesores y alumnos de la escuela secundaria y de la universidad / Semiology of meeting: images of practices among teachers and high school and academic students

Objetivos: Mostrar imagens das reuniões com docentes e discentes do 3º e 2º graus como indutores de uma Semiologia do Encontro e analisar discutindo inferencialmente as imagens produzidas como indutoras de uma Semiologia do Encontro. Método: Qualitativo, com a utilização do método cartográfico de KASTRUP e ESCOSSIA1. Resultados: 74 imagens contendo 135 estudantes dos dois graus e 06 docentes, além de 35 imagens (fotos) de 90 estudantes que dependendo do espaço e de quem falava nas reuniões, apresentam-se com os corpos ouvintes ou contidos em si mesmos (17), relaxados e alegres (28) e atenciosos e expectantes (45). Conclusão: Este estudo é o primeiro passo para uma Semiologia do Encontro, a qual tem sentido como um procedimento técnico do acolher. Essa concepção pode nos indicar a criação de novos domínios para a enfermagem, em instâncias cada vez mais diferenciadas da vida social, incorporando em nós novos vetores e expectativas de natureza diversa no contexto atual.

Objectives: To show pictures of the meetings with teachers and High School and academic students as an inductor of a Semiology of Meeting, as well as to analyze by inferentially discussing on the produced images as an inductor of a Semiology of Meeting. Method: Qualitative, by making use of the cartographic method of KASTRUP and ESCOSSIA1. Results: 74 images containing 135 students of two different degrees and 06 teachers, besides 35 images (pictures) of 90 students who, depending on situation and who spoke at the meetings, presented their bodies aware or contained in itself (17), relaxed and cheerful(28) and mindful and expectant (45). Conclusion: This study is the first step towards the Semiology of Meeting, which makes sense as a technical procedure of welcoming. This conception might indicate us the creation of further nursing domains, in increasingly differentiated ambits of the social life, by bringing us new vectors and expectations arising from a diverse nature in the current context.

Objetivos: Mostrar imágenes de los encuentros con profesores y estudiantes de los grados 3 º y 2 º como un inductor de una semiología del encuentro e analizar debatiendo de modo inferencial las imágenes producidas en la inducción de una semiología del encuentro. Método: Estudio cualitativo, mediante la utilización el método cartográfico de ESCOSSIA1 y KASTRUP. Resultados: 74 imágenes conteniendo 135 estudiantes de diferentes grados y 06 profesores, que muestran 35 imágenes (fotos) de 90 estudiantes que, dependiendo del espacio y del orador de las reuniones, se quedan oyentes y tienen los cuerpos contenido en su mismo (17), relajado y feliz (28) y atento y expectante (45). Conclusión: Este estudio es el primer paso a una semiología del encuentro que tiene sentido como un procedimiento técnico de abrigar. Este diseño puede revelar la expansión de nuevas áreas de la enfermería en casos cada vez más diferenciados de la vida social, incorporando en nosotros los nuevos vectores de expectativas de índole diversa en el contexto actual.

Gerenciando inter(rel)ações humanas no programa fábrica de cuidados / Managing human interrelationships in the Fábrica de Cuidados Program

Trata da experiência de oito anos de implantação do Programa "Fábrica de Cuidados - um espaço para criar modelos e tecnologias em saúde". Questão norteadora: quanto tempo é necessário para a criação de relações seguras/sustentáveis entre docentes e comunidade e que problemas/dificuldades são vividos no cotidiano de gerenciar um programa comunitário?...