Coupled C, H, N, S and Fe biogeochemical cycles operating in the continental deep subsurface of the Iberian Pyrite Belt.

Microbial activity is a major contributor to the biogeochemical cycles that make up the life support system of planet Earth. A 613 m deep geomicrobiological perforation and a systematic multi-analytical characterization revealed an unexpected diversity associated with the rock matrix microbiome that operates in the subsurface of the Iberian Pyrite Belt (IPB). Members of 1 class and 16 genera were deemed the most representative microorganisms of the IPB deep subsurface and selected for a deeper analysis. The use of fluorescence in situ hybridization allowed not only the identification of microorganisms but also the detection of novel activities in the subsurface such as anaerobic ammonium oxidation (ANAMMOX) and anaerobic methane oxidation, the co-occurrence of microorganisms able to maintain complementary metabolic activities and the existence of biofilms. The use of enrichment cultures sensed the presence of five different complementary metabolic activities along the length of the borehole and isolated 29 bacterial species. Genomic analysis of nine isolates identified the genes involved in the complete operation of the light-independent coupled C, H, N, S and Fe biogeochemical cycles. This study revealed the importance of nitrate reduction microorganisms in the oxidation of iron in the anoxic conditions existing in the subsurface of the IPB.

Ulva rigida Valorization into Poly(3-hydroxybutyrate), Organic Acids and Functional Ingredients.

Halomonas elongata 1H9T is a moderate halophilic strain able to produce poly(3-hydroxybutyrate) (P(3HB)), a biodegradable plastic, and gluconic acid, a valuable organic acid with wide industrial applications. In this work, the green alga Ulva rigida was used as platform to produce cultivation substrates for microbial conversion as well as functional ingredients, targeting its full valorization. The liquor obtained by autohydrolysis presented the highest concentration of oligosaccharides and protein, being an interesting feedstock to produce functional ingredients. The acid and/or enzymatic hydrolysis liquors are adequate as substrates for microbial processes. Shake flask assays with H. elongata revealed that the N-rich liquor produced after acidic treatment was the best suited for cell growth while the N-poor liquor produced by the enzymatic treatment of acid-pretreated algae residues produced the highest P(3HB) titers of 4.4 g/L. These hydrolysates were used in fed-batch cultivations as carbon and protein sources for the co-production of gluconic acid and polymer achieving titers of 123.2 g/L and 7.2 g/L, respectively. Besides gluconic acid, the Krebs cycle intermediate 2-oxoglutaric acid, also called alpha-ketoglutaric acid (KGA), was produced. Therefore, the co-production of P(3HB) and acids may be of considerable interest as an algal biorefinery valorization strategy.

Analysis of etiological factors of nursing diagnosis of impaired comfort in children and adolescents with cancer.

AIM: To analyse the etiological factors of the nursing diagnosis of impaired comfort in children and adolescents with cancer. DESIGN: This cross-sectional study was carried out in the referral unit for the treatment of childhood cancer in a tertiary hospital located in northeastern Brazil. METHODS: A total of 200 children and adolescents who were undergoing cancer treatment were included in this study. Data collection instruments and protocols were constructed with operational and conceptual definitions of clinical indicators and etiological factors for the nursing diagnosis of impaired comfort. A latent class model with adjusted random effects was used to determine impaired comfort and measures of sensitivity and specificity of clinical indicators. A univariate logistic regression analysis was performed for each etiological factor of impaired comfort. RESULTS: The analysis of etiological factors for the nursing diagnosis of impaired comfort in children and adolescents with cancer showed the high prevalence of four factors: noxious environmental stimuli, insufficient situational control, insufficient resources and insufficient environmental control. Illness-related symptoms, noxious environmental stimuli, and insufficient environmental control increased the chance of impaired comfort occurring. CONCLUSION: The etiological factors with the highest prevalence and most significant impact on the occurrence of impaired comfort were noxious environmental stimuli, insufficient situational control and illness-related symptoms. IMPACT: The results obtained in this investigation can support more accurate nursing diagnostic inference of impaired comfort in children and adolescents with cancer. Moreover, the results can inform direct interventions for the modifiable factors that trigger this phenomenon to avoid or minimize the signs and symptoms of the nursing diagnosis.

Validation of Clinical Indicators of the Nursing Diagnosis of Ineffective Protection in Adolescents With Cancer.

PURPOSE: To validate the clinical indicators of the nursing diagnosis of Ineffective protection in adolescents with cancer based on diagnostic accuracy measurements. DESIGN AND METHODS: Measurements of sensitivity and specificity for the indicators were calculated using latent class analysis with random effects in a sample of 127 adolescents between 10 and 19 years of age. RESULTS: The prevalence of diagnosis was estimated at 93.7%. The indicators deficient immunity and weakness showed higher sensitivity values, whereas opportunistic infections, recurrent infections, insomnia, mucosal lesions, and coughing showed high specificity. CONCLUSIONS: Seven indicators were clinically validated. PRACTICE IMPLICATIONS: The validation of clinical indicators provides nurses with the knowledge of useful signs and symptoms to identify early spectra of a nursing diagnosis or confirm their presence in a specific population. In clinical practice, this knowledge contributes to an accurate diagnostic inference and the planning of nursing interventions directed to the idiosyncrasies of individuals.

Heliimonas saccharivorans gen. nov., sp. nov., a member of the family Chitinophagaceae isolated from a mineral water aquifer, and emended description of Filimonas lacunae.

Two isolates, with optimum growth temperature and pH of about 30 °C and 6.0-7.0, were recovered from a borehole head of a mineral water aquifer in Portugal. The closest relatives based on 16S rRNA gene sequence analysis were species of genera of the family Chitinophagaceae. Strains L2-4(T) and L2-109 formed translucent colonies and non-motile pleomorphic cells. Strains were strictly aerobic, and oxidase- and catalase-positive. The major fatty acids of strains L2-4(T) and L2-109 were 17 : 0 iso 3-OH, 15 : 0 iso and 15 : 1 iso G. The major polar lipids were phosphatidylethanolamine, one unidentified phospholipid, four unidentified aminophospholipids, four unidentified aminolipids and three unidentified polar lipids. Menaquinone 7 was the only respiratory quinone. The G+C content of the DNA of strains L2-4(T) and L2-109 was 42.0 and 41.4 mol%, respectively. Based on 16S rRNA gene sequence analysis, physiological and biochemical characteristics, strains L2-4(T) ( = CECT 8122(T) = LMG 26919(T)) and L2-109 ( = CECT 8121 = LMG 26920) are considered to represent a novel species of a new genus, for which the name Heliimonas saccharivorans gen. nov., sp. nov. is proposed. The type strain of Heliimonas saccharivorans is L2-4(T). Due to additional results obtained in this study an emended description of Filimonas lacunae is provided.

Co-Production of Poly(3-hydroxybutyrate) and Gluconic Acid from Glucose by Halomonas elongata.

Polyhydroxyalkanoates (PHA) are biopolyesters regarded as an attractive alternative to petroleum-derived plastics. Nitrogen limitation and phosphate limitation in glucose cultivations were evaluated for poly(3-hydroxybutyrate) (P(3HB)) production by Halomonas elongata 1H9T, a moderate halophilic strain. Co-production of P(3HB) and gluconic acid was observed in fed-batch glucose cultivations under nitrogen limiting conditions. A maximum P(3HB) accumulation of 53.0% (w/w) and a maximum co-production of 133 g/L of gluconic acid were attained. Fed-batch glucose cultivation under phosphate limiting conditions resulted in a P(3HB) accumulation of only 33.3% (w/w) and no gluconic acid production. As gluconic acid is a valuable organic acid with extensive applications in several industries, this work presents an interesting approach for the future development of an industrial process aiming at the co-production of an intracellular biopolymer, P(3HB), and a value-added extracellular product, gluconic acid.

[Clinical indicators of "ineffective breathing pattern" in children with congenital heart disease]. / Indicatori clinici di "Modello di respirazione inefficace" nei bambini con cardiopatie congenite.

UNLABELLED: Clinical indicators of ineffective breathing pattern in children with congenital heart disease. OBJECTIVES: To analyze the accuracy of clinical predictors of nursing diagnosis "Ineffective breathing pattern in children with congenital heart disease". METHOD: 1:1 case-control study with 30 children with congenital heart disease. Fifteen children with the nursing diagnosis "Ineffective breathing pattern" (cases) were compared with other 15 without this diagnosis (controls). A total of 15 clinical indicators were analyzed for their sensibility, specificity, predictive values, likelihood ratios and area under the ROC curve. RESULTS: Four indicators showed an area under the ROC curve > 70%: chest x-ray findings (0.750), adventitious breath sounds (0.737), coughing (0.710) and asymmetric chest expansion (0.702). The indicators of the chest x-ray findings and adventitious breath sounds had a better overall performance for the identification of ineffective breathing pattern. DISCUSSION: These findings suggest that both indicators can be useful for inference of ineffective breathing pattern. Moreover, the presence of the diagnosis was associated with a greater likelihood of the presence of cough, and its absence with an increased probability of the absence of asymmetric chest expansion and percussive sounds. CONCLUSIONS: The comparison among populations with different diseases and carriers of the same nursing diagnosis shows that the predictive ability of clinical indicators can be influenced.

Draft Genome Sequence of Shewanella sp. Strain T2.3D-1.1, Isolated from 121.8 Meters Deep in the Subsurface of the Iberian Pyrite Belt.

Shewanella sp. strain T2.3D-1.1 was isolated from the deep subsurface of the Iberian Pyrite Belt. We report its draft genome sequence, consisting of 49 scaffolds, with a chromosome of ≈4.6 Mb and a 23.8-kb plasmid. The chromosome annotation identified 4,068 coding DNA sequences, 1 rRNA operon, and 108 tRNA genes.

Development of middle-range theories in nursing.

OBJECTIVE: To identify in the literature how Middle-Range Theories (MRT) are being developed in Nursing. METHOD: Integrative review on the databases Lilacs (Latin American and Caribbean Literature in Health Sciences), Scopus, Cinahl (Cumulative Index to Nursing and Allied Health Literature), Web of Science and PubMed portal, using the keywords middle range theory and nursing, as well its Portuguese correspondents (Lilacs), and the Boolean operator AND. The sample included 25 articles. RESULTS: All articles presented concepts related to MRT. Most developed a synthesis picture. Some theories have formulated specific propositions, hypotheses, and names. Only 16 articles cited the methodological framework, while 22 used theories or models for theoretical foundation and 11 carried out literature reviews. FINAL CONSIDERATIONS: The development of MRT included the presentation of fundamental concepts, synthesis, propositions, hypotheses and specific name. The MRT is recognized as a way of developing knowledge to guide the nursing practice.

Study of methanogenic enrichment cultures of rock cores from the deep subsurface of the Iberian Pyritic Belt.

Two deep boreholes were drilled at 320 and 620 meters below surface in the Iberian Pyritic Belt (IPB) at Peña de Hierro (Huelva, Southwestern Spain). Cores were sampled and used for the establishment of enrichment cultures with methanogenic activity. The cultivable diversity of these enrichments was accessed using different cultivation techniques and several isolates were recovered in pure culture from various depths in both boreholes. Although no archaeal isolates were obtained in pure culture, strict anaerobes and facultative anaerobic bacteria belonging to the phyla Proteobacteria, Firmicutes, Actinobacteria and Bacteroidetes were isolated and identified using the 16S rRNA gene sequence. Analysis of three selected enrichment cultures by amplification of both bacterial and archaeal 16S rRNA gene followed by pyrosequencing revealed further information on the populations enriched. The archaeal sequences obtained from the methanogenic enrichment cultures belonged to the orders Methanosarcinales and Methanocellales. To best of our knowledge this is the first report of enrichment in members of the Methanocellales in a deep terrestrial subsurface ecosystem. Several bacterial populations, predominantly consisting of Firmicutes and Proteobacteria, were also enriched. The prevalent microbial populations enriched as detected by pyrosequencing analysis, as well as the bacterial isolates cultivated were affiliated with known fermentative, sulfate reducing and acetogenic bacteria or methanogenic archaea. Our results show a great diversity in the microbial communities of the IPB deep subsurface.

Classification tree to screen for the nursing diagnosis Ineffective airway clearance.

OBJECTIVE: to identify the defining characteristics of Ineffective airway clearance with better predictive power using classification trees. METHOD: the predictive power of the defining characteristics of Ineffective airway clearance was evaluated based on classification trees generated from the data of 249 children with acute respiratory infection. RESULTS: Ineffective cough and adventitious breath sounds were identified as the main defining characteristics when screening for Ineffective airway clearance in accordance with trees based on three different computational algorithms. CONCLUSION: Ineffective coughing and adventitious breath sounds had better predictive capacity for Ineffective airway clearance in the sample.

Impaired comfort in children and adolescents with cancer.

OBJECTIVE: To determine the strength of the association between the clinical indicators of Impaired Comfort and the evaluation sector in the hospital, age group and sex of patients with cancer. METHOD: Cross-sectional study, conducted in a children's hospital, with 192 children and adolescents. For the collection, we used an instrument developed for the study. RESULTS: The majority of the sample was male, with mean age of 11 years. The indicators most evidenced among the hospitalized patients were Crying, Report of lack of satisfaction with the situation, Report of feeling cold, and Report of feeling uncomfortable. Crying and Fear were more prevalent in children compared with adolescents, and boys were the ones that verbalized the most the Report of lack of satisfaction with the situation. CONCLUSION: This study enabled determining the strength of the association of the indicators of Impaired Comfort expressed by children and adolescents with cancer.

Complete Genome Sequence of Tessaracoccus sp. Strain T2.5-30 Isolated from 139.5 Meters Deep on the Subsurface of the Iberian Pyritic Belt.

Here, we report the complete genome sequence of Tessaracoccus sp. strain T2.5-30, which consists of a chromosome with 3.2 Mbp, 70.4% G+C content, and 3,005 coding DNA sequences. The strain was isolated from a rock core retrieved at a depth of 139.5 m in the subsurface of the Iberian Pyritic Belt (Spain).

Clinical indicators for nursing diagnosis Ineffective protection in adolescents with cancer.

OBJECTIVE: To investigate scientific evidence related to the term protection and clinical indicators and etiologic factors for nursing diagnosis Ineffective protection in adolescents with cancer. METHOD: Integrative literature review in the databases of Scopus, Web of Science, National Library of Medicine and National Institutes of Health (PubMed) and Cochrane; by intersection of the descriptors protection and childhood cancer, which resulted in seven articles. These were insufficient for a comprehension of the term protection and aspects related to its impairment, therefore it was necessary to include a further three reference books. RESULTS: Five clinical indicators and three etiologic factors associated to Ineffective protection were identified some of which were not cited in NANDA-International. CONCLUSIONS: There are clinical and etiologic factors important for the identification of ineffective protection in adolescents with cancer.

Knowledge and practice of the nurse about leprosy: actions of control and elimination.

OBJECTIVE: to assess the knowledge and practice of primary health care nurses about control and elimination actions of leprosy. METHOD: evaluation study with qualitative approach, using the Discourse of the Collective Subject, data were collected through semi-structured interviews conducted with 16 nurses. RESULTS: the data collected revealed that health professionals have sufficient knowledge about the National Policy on Control and Elimination of Leprosy (NPCEL) and that the main actions preconized were applied, however, notification of suspected or confirmed cases and social reintegration of the patient were not mentioned. CONCLUSION: keeping patients in treatment, overload of work, lack of interdisciplinarity and treatment performed at other locations outside of the community were difficulties reported by professionals. Nurses know the actions addressed at assistance of leprosy patients, however, the study points to the need for a practice which is more aligned to what advocates NPCEL.

Development of middle-range theories in nursing / Desarrollo de las teorías de medio alcance en enfermería / Desenvolvimento das teorias de médio alcance na enfermagem

ABSTRACT Objective: To identify in the literature how Middle-Range Theories (MRT) are being developed in Nursing. Method: Integrative review on the databases Lilacs (Latin American and Caribbean Literature in Health Sciences), Scopus, Cinahl (Cumulative Index to Nursing and Allied Health Literature), Web of Science and PubMed portal, using the keywords middle range theory and nursing, as well its Portuguese correspondents (Lilacs), and the Boolean operator AND. The sample included 25 articles. Results: All articles presented concepts related to MRT. Most developed a synthesis picture. Some theories have formulated specific propositions, hypotheses, and names. Only 16 articles cited the methodological framework, while 22 used theories or models for theoretical foundation and 11 carried out literature reviews. Final considerations: The development of MRT included the presentation of fundamental concepts, synthesis, propositions, hypotheses and specific name. The MRT is recognized as a way of developing knowledge to guide the nursing practice.

RESUMEN Objetivo: Identificar en la literatura cómo las Teorías de Medio Alcance (TMA) se están desarrollando en enfermería. Método: Revisión integrativa en las bases de datos: LILACS (Literatura Latinoamericana y del Caribe en Ciencias de la Salud), Scopus, Cinahl (Cumulative Index to Nursing and Allied Health Literature), Web of Science y PubMed, utilizando la palabra clave middle range theory, el descriptor nursing y sus equivalentes en portugués (LILACS) y el operador booleano AND. La muestra constó de 25 artículos. Resultados: Todos los artículos presentaron conceptos relacionados con las TMA. La mayoría desarrolló un cuadro resumen. Algunas teorías presentaron proposiciones, plantearon hipótesis y nombres específicos. Solamente 16 artículos citaban el referencial metodológico, mientras que 22 utilizaban teorías o modelos en la fundamentación teórica y 11 hicieron revisión de la literatura. Consideraciones finales: El desarrollo de las TMA incluyó la presentación de conceptos fundamentales, de cuadro resumen, de proposiciones, hipótesis y nombre específico. Se reconocen las TMA como forma de desarrollar conocimiento para orientar la práctica en enfermería.

RESUMO Objetivo: Identificar na literatura como as Teorias de Médio Alcance (TMA) têm sido desenvolvidas na enfermagem. Método: Revisão integrativa nas bases Lilacs (Literatura Latino-Americana e do Caribe em Ciências da Saúde), Scopus, Cinahl (Cumulative Index to Nursing and Allied Health Literature), Web of Science e portal PubMed, utilizando a palavra-chave middle range theory, o descritor nursing, seus correspondentes em português (Lilacs) e o operador booleano AND. A amostra incluiu 25 artigos. Resultados: Todos os artigos apresentaram conceitos relacionados às TMA. A maioria desenvolveu quadro síntese. Algumas teorias formularam proposições, hipóteses e nomes específicos. Apenas 16 artigos citavam o referencial metodológico, enquanto 22 usavam teorias ou modelos para fundamentação teórica e 11 utilizavam revisão na literatura. Considerações finais: O desenvolvimento das TMA incluiu apresentação de conceitos fundamentais, quadro síntese, proposições, hipóteses e nome específico. Reconhece-se as TMA como forma de desenvolver conhecimento para orientar a prática de enfermagem.

Prevalência dos diagnósticos de enfermagem respiratórios em Unidades de Terapia Intensiva Neonatal / Prevalence of respiratory nursing diagnoses in Neonatal Intensive Care Units

Identificar a prevalência dos diagnósticos de enfermagem: Padrão respiratório ineficaz (PRI), Troca de gases prejudicada (TGP) e Ventilação espontânea prejudicada (VEP) e de seus indicadores clínicos em recém-nascidos internados em Unidades de Terapia Intensiva Neonatal. Estudo de abordagem quantitativa, transversal, com 154 recém-nascidos. Os dados foram coletados pela inspeção e avaliação da gasometria. Para análise, foram utilizados: Teste Qui-quadrado de Pearson e teste exato de Fisher. Os diagnósticos apresentaram prevalência elevada: VEP 94,2%; TGP 88,3% e PRI 87,7%. Dispneia e Uso aumentado de musculatura acessória foram os indicadores clínicos mais prevalentes de VEP e PRI. Para TGP, Dispneia e Cor da pele anormal. A associação evidenciou correlação significante para alguns indicadores prevalentes: dispneia, pressão parcial de oxigênio diminuída/hipoxemia, uso aumentado de musculatura acessória, padrão respiratório anormal, taquipneia, bradpneia, dióxido de carbono diminuído e gases sanguíneos arteriais.VEP, TGP e PRI apresentaram alta prevalência em recém-nascidos das Unidades de Terapia Intensiva.

To identify the prevalence ofthe nursing diagnoses: Ineffectivebreathing pattern (IBP), Impaired gas exchange (IGE) and, Impaired spontaneous ventilation (ISV) and their clinical indicators in newborns admitted in Neonatal Intensive Care Units. This is a cross-sectional study, with a quantitative approach,carried out with 154 newborns. The data were collected through gasometry inspection and assessment. For the analysis, the testsused were: Pearson's Chi-Square test and Fisher's Exact test. The diagnoses presented high prevalence: ISV 94.2%; IGE 88.3% and, IBP 87.7%. Dyspnea and Increase in accessory muscle use were the most prevalent clinical indicators for ISV and IBP. For IGE, they were Dyspnea and Abnormal skin color. The association showed a significant correlation for few prevalent indicators: dyspnea, decrease in partial pressure of oxygen/hypoxemia, increase in accessory muscle use, abnormal breathing pattern, tachypnea, bradypnea, a decreasein carbon dioxide and, arterial blood gases. ISV, IGE, andIBP were highly prevalent in newborns of Intensive Care Units.

Árvore de classificação para identificação de Padrão respiratório ineficaz em crianças com infecção respiratória aguda / Classification tree for identifying ineffective breathing pattern in children with acute respiratory infection

O estudo teve como objetivo verificar as características definidoras com melhor poder de predição para auxiliar na classificação de Padrão respiratório ineficaz, utilizando árvores de classificação, em crianças com infecção respiratória aguda. Estudo transversal, realizado em dois hospitais pediátricos juntamente a 249 crianças com infecção respiratória aguda. Para a coleta, foi utilizado um instrumento específico desenvolvido para o estudo. Empregaram-se três algoritmos de indução para a geração das árvores, CHi-square Automatic Interaction Detection, Classification and Regression Treese Quick, Unbiased, Efficient Statistical Tree. Construíram-se três árvores para auxiliar na identificação de Padrão Respiratório ineficaz. As árvores de classificação geradas apresentam probabilidades condicionais à ocorrência do diagnóstico associada a dispneia e alterações na profundidade respiratória. Padrão respiratório ineficaz esteve presente 65,5% da amostra. Assim, a probabilidade da ocorrência do referido diagnóstico nas crianças com infecção respiratória aguda foi de 100% com a presença de dispneia e de alterações na profundidade respiratória.

The objective of the study was to verify defining characteristics with greater predictive power to aid in the classification of ineffective breathing pattern using classification trees in children with acute respiratory infections. A cross-sectional study was carried out in two pediatric hospitals with 249 children with acute respiratory infection. For data collection, a specific instrument developed for the study was used. Three induction algorithms were used to generate the trees: Chi-square Automatic Interaction Detection, Classification and Regression Trees, and Quick, Unbiased, Efficient Statistical Tree. Three trees were constructed to aid in the identification of ineffective breathing pattern. The classification trees generated present probabilities conditionalto the occurrence of the diagnosis associated with dyspnea and changes in respiratory depth. Ineffective breathing pattern was present in 65.5% of the sample. Thus, the probability of occurrence of this diagnosis in children with acute respiratory infection was 100% with the presence of dyspnea and changes in respiratory depth.

Classification tree to screen for the nursing diagnosis Ineffective airway clearance / Árvore de classificação para detecção do diagnóstico de enfermagem Desobstrução ineficaz de vias aéreas / Árbol de clasificación para la detección del diagnóstico enfermero Limpieza ineficaz de las vías aéreas

ABSTRACT Objective: to identify the defining characteristics of Ineffective airway clearance with better predictive power using classification trees. Method: the predictive power of the defining characteristics of Ineffective airway clearance was evaluated based on classification trees generated from the data of 249 children with acute respiratory infection. Results: Ineffective cough and adventitious breath sounds were identified as the main defining characteristics when screening for Ineffective airway clearance in accordance with trees based on three different computational algorithms. Conclusion: Ineffective coughing and adventitious breath sounds had better predictive capacity for Ineffective airway clearance in the sample.

RESUMO Objetivo: identificar as características definidoras de Desobstrução ineficaz de vias aéreas com melhor poder preditivo usando árvores de classificação Método: o poder preditivo das características definidoras da Desobstrução ineficaz de vias aéreas foi avaliado com base em árvores de classificação geradas a partir dos dados de 249 crianças com infecção respiratória aguda. Resultados: tosse ineficaz e ruídos adventícios respiratórios foram identificados como as principais características definidoras na detecção de Desobstrução ineficaz de vias aéreas de acordo com as árvores, com base em três diferentes algoritmos computacionais. Conclusão: Tosse ineficaz e ruídos adventícios respiratórios tiveram melhor capacidade preditiva para Desobstrução ineficaz de vias aéreas na amostra.

RESUMEN Objetivo: identificar las características definitorias de la Limpieza ineficaz de las vías aéreas con un mejor poder predictivo utilizando árboles de clasificación. Método: el poder predictivo de las características definitorias de Limpieza ineficaz de las vías aéreas se evaluó basado en los árboles de clasificación generados a partir de los datos de 249 niños con infección respiratoria aguda. Resultados: La tos ineficaz y los sonidos respiratorios anormales se identificaron como las principales características definitorias cuando se realizaba una Limpieza ineficaz de las vías aéreas de acuerdo con los árboles en función de tres algoritmos computacionales diferentes. Conclusión: La tos ineficaz y los sonidos respiratorios anormales tienen una mejor capacidad predictiva para la Limpieza ineficaz de las vías aéreas en la muestra.

Impaired comfort in children and adolescents with cancer / Conforto perjudicado en niños y adolescentes con cáncer / Conforto prejudicado em crianças e adolescentes com câncer

ABSTRACT Objective: To determine the strength of the association between the clinical indicators of Impaired Comfort and the evaluation sector in the hospital, age group and sex of patients with cancer. Method: Cross-sectional study, conducted in a children's hospital, with 192 children and adolescents. For the collection, we used an instrument developed for the study. Results: The majority of the sample was male, with mean age of 11 years. The indicators most evidenced among the hospitalized patients were Crying, Report of lack of satisfaction with the situation, Report of feeling cold, and Report of feeling uncomfortable. Crying and Fear were more prevalent in children compared with adolescents, and boys were the ones that verbalized the most the Report of lack of satisfaction with the situation. Conclusion: This study enabled determining the strength of the association of the indicators of Impaired Comfort expressed by children and adolescents with cancer.

RESUMEN Objetivo: Verificar la fuerza de la asociación entre los indicadores clínicos de Conforto perjudicado y el sector de evaluación en el hospital, la franja de edad y el sexo de pacientes con cáncer. Método: Estudio transversal, realizado en un hospital pediátrico, con 192 niños y adolescentes. Para la recogida, se utilizó un instrumento desarrollado para el estudio. Resultados: La parte más grande de la muestra era del sexo masculino, con edad promedio 11 años. Llanto, Relato de falta de satisfacción con la situación, Relato de sentir frío y Relato de sentirse no confortable fueron los indicadores más evidenciados entre los pacientes internados. Llanto y Miedo estuvieron más prevalentes en los niños en comparación a los adolescentes, siendo que los niños fueron los que más verbalizaron el Relato de falta de sentirse a gusto con la situación. Conclusión: El estudio posibilitó verificar la fuerza de la asociación de los indicadores de Conforto perjudicado manifestados por niños y adolescentes con cáncer.

RESUMO Objetivo: Verificar a força da associação entre os indicadores clínicos de Conforto prejudicado e o setor de avaliação no hospital, a faixa etária e o sexo de pacientes com câncer. Método: Estudo transversal, realizado em um hospital pediátrico, com 192 crianças e adolescentes. Para a coleta, utilizou-se um instrumento desenvolvido para o estudo. Resultados: A maior parte da amostra era do sexo masculino, com idade mediana de 11 anos. Choro, Relato de falta de satisfação com a situação, Relato de sentir frio e Relato de sentir-se desconfortável foram os indicadores mais evidenciados entre os pacientes internados. Choro e Medo estiveram mais prevalentes nas crianças em comparação aos adolescentes, sendo que os meninos foram os que mais verbalizaram o Relato de falta de sentir-se à vontade com a situação. Conclusão: O estudo possibilitou verificar a força de associação dos indicadores de Conforto prejudicado manifestados por crianças e adolescentes com câncer.