Several factors can compromise patient safety, such as ineffective teamwork, failed organizational processes, and the physical and psychological overload of health professionals. Studies about ...associations between burn out and patient safety have shown different outcomes.
To analyze the relationship between burnout and patient safety.
A systematic review with a meta-analysis performed using PubMed and Web of Science databases during January 2018. Two searches were conducted with the following descriptors: (i) patient safety AND burnout professional safety AND organizational culture, and (ii) patient safety AND burnout professional safety AND safety management.
Twenty-one studies were analyzed, most of them demonstrating an association between the existence of burnout and the worsening of patient safety. High levels of burnout is more common among physicians and nurses, and it is associated with external factors such as: high workload, long journeys, and ineffective interpersonal relationships. Good patient safety practices are influenced by organized workflows that generate autonomy for health professionals. Through meta-analysis, we found a relationship between the development of burnout and patient safety actions with a probability of superiority of 66.4%.
There is a relationship between high levels of burnout and worsening patient safety.
The formation of an urban heat island (UHI) is one of the most common impacts of the urbanization process. To mitigate the effects of UHI, the planning of urban forests (e.g., creation of parks, ...forests and afforestation streets) has been the major tool applied in this context. Thus, the aim of this study is to evaluate the spatial and temporal distribution of heat islands in Vila Velha, ES, Brazil using the mono-window algorithm. The study followed these methodological steps: 1) mapping of urban green areas through a photointerpretation screen; 2) application of the mono-window algorithm to obtain the spatial and temporal patterns of land surface temperature (LST); 3) correlation between LST and the normalized difference vegetation index (NDVI) and normalized difference build-up index (NDBI); 4) application of ecological evaluation index. The results showed that the mean values of LST in urban areas were at least 2.34 to 7.19°C higher than undeveloped areas. Moreover, the positive correlation between LST and NDBI showed an amplifying effect of the developed areas for UHI, while areas with a predominance of vegetation attenuated the effect of UHI. Urban centers, clustered in some parts of the city, received the worst ecological assessment index. Finally, the adoption of measures to guide the urban forest planning within urban centers is necessary to mitigate the effect of heat islands and provide thermal comfort in urban areas.
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•Urbanization resulting in higher radiation absorption, causing the effect of UHI•Green areas attenuate the effect of UHI, provide thermal comfort.•Identification of UHI as indicators for urban management and planning•The methodology applied proved to be appropriate to identify the UHI.
Relato de experiência de atividades extensionistas. Objetivou: caracterizar o grupo atendido pelo projeto conforme o perfil de sexo, idade e classe econômica; descrever as experiências da equipe ...executora do projeto referentes à educação em saúde na modalidade lúdico-teatral realizadas em escola de Ensino Fundamental do município do Rio de Janeiro; discutir os significados das vivências da equipe quanto às ações realizadas junto ao público-alvo relativas à promoção da saúde. Público-alvo: crianças de 6 a 12 anos. A abordagem qualitativa do tipo etnográfica apoiada em Geertz possibilitou a identificação de significados das experiências da equipe. Os significados das temáticas das ações de educação em saúde são culturalmente apreendidos desde a infância, sendo constantemente reelaborados e reproduzidos no decorrer da vida, porém mantendo certo padrão. A centralidade das ações estava representada por significados relacionados predominantemente ao modelo biomédico, mas no decorrer das ações distintas percepções emergiram. Ressalta-se o potencial de reflexão/crítica dos escolares sobre a realidade.
Layered double hydroxides (LDHs) have been employed as nano-sized carriers for therapeutic/bio-active molecules, including small interfering RNAs (siRNAs). However, the potential of LDHs ...nanoparticles for an efficient and safe antisense oligonucleotide (AMO) delivery still requires studies. In this research, we have tested the suitability of a Mg–Al-LDH-based nanocarrier loaded with a miRNA-196b-5p inhibitor. LDHs (and LDH-Oligo complex) were synthesized by the coprecipitation method followed by physicochemical characterization as hydrodynamic size, surface charge, crystallinity, and chemical groups. Thymic endothelial cell line (tEnd.1) were transfected with LDH-Oligo and were evaluated for i. cell viability by MTT, trypan blue, and propidium iodide assays; ii. transfection efficiency by flow cytometry, and iii. depletion of miRNA-196b-5p by RT-qPCR. In addition, Drosophila melanogaster larvae were fed LDHs and evaluated for: i. larval motility; ii. pupation rate; iii. larval-pupal transition; iv. lethality, and v. emergence rate. We demonstrated that LDHs nanoparticles are stable in aqueous solutions and exhibit a regular hexagonal shape. The LDH-AMO complex showed a transfection efficiency of 93.95 ± 2.15 % and induced a significant depletion of miRNA-196b-5p 48h after transfection. No cytotoxic effects were detected in tEnd.1 cells at concentrations up to 50 μg/ml, as well as in Drosophila exposed up to 500 μg of LDH. In conclusion, our data suggest that LDHs are biocompatible and efficient carriers for miRNA inhibitors and can be used as a viable and effective tool in functional miRNA inhibition assays.
•Mg-Al-LDH nanoparticles are biocompatible to t.End cells and Drosophila melanogaster.•Mg-Al-LDH nanoparticles are effective in delivering microRNA inhibitors to cells.•The complex Mg-Al-LDH and miR-196b inhibitor modulate efficient gene expression knockdown.
Imposex is is a well-documented deleterious effect caused by tributyltin (TBT) in females of hundreds of Caenogastropoda species and it is a well-established way of predicting BTs occurrence in ...marine systems. This study presents the very first information on the presence and distribution of imposex in Stramonita brasiliensis (Claremont and Reid, 2011) in the Brazilian Legal Amazon, within a Ramsar site, during a 6-year appraisal after the TBT global ban in 2008 (2012–2017). Imposex was evidenced in six out of the seven sampling sites, with 39.7% of the total affected females, most of them showing VDSI <1. The temporal appraisal allowed the identification of the introduction of new sources of TBT in some sites, as well as populational recovery in other sampling points. In addition, the dilution effect present in São Marcos Bay was also likely to play an important role in the imposex distribution.
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•The first appraisal of imposex in Stramonita brasiliensis from Brazil's Legal Amazon.•Imposex was ubiquitous in most of the sampling sites.•Dilution effect may have influenced imposex distribution.•Levels of imposex represent concerns in the region.
O parkinsonismo é um distúrbio do sistema nervoso de maior incidência masculina do que feminina, visto que, por mecanismos fisiológicos, o estrogênio possui efeitos neuroprotetores, com funções como ...aumento da dopamina, um neurotransmissor essencial para o controle das funções motoras. Além disso, previne a formação dos corpúsculos de Lewy e da agregação da α-sinucleína, responsáveis pela progressão da Doença de Parkinson. Por isso, a doença se apresenta diferentemente nas mulheres. A remoção cirúrgica de ambos os ovários em mulheres na pré-menopausa para a prevenção do câncer de ovário parece favorecer o surgimento da doença, tendo em vista a perda da produção do hormônio protetor. Assim, o objetivo do estudo é analisar a associação entre a ooforectomia bilateral precoce e o desenvolvimento de parkinsonismo e Doença de Parkinson em mulheres na pré-menopausa. Trata-se de uma revisão bibliográfica sistemática, do tipo quantitativa, que utilizou as plataformas do PubMed, SciELO e Cochrane Library como bases de dados para seleção dos artigos, todos na língua inglesa. Foram utilizadas literaturas publicadas com recorte temporal de 2017 a 2022. De acordo com as literaturas analisadas, a ooforectomia bilateral precoce em mulheres na pré-menopausa aumenta o risco do desenvolvimento de parkinsonismo. Desse modo, a diminuição dos procedimentos cirúrgicos profiláticos para câncer de ovário nas pacientes com risco médio de malignidade reduziria o risco dessa condição.
A encefalite anti-NMDAR associada a tumores ovarianos é uma condição neurológica rara caracterizada pela presença de anticorpos anti-receptores NMDA no sistema nervoso central, frequentemente ...relacionada a teratomas ovarianos. Nesse sentido, o presente estudo tem como objetivo analisar casos sobre a encefalite anti-NMDAr associada a tumores ovarianos e realizar uma revisão bibliográfica. A revisão foi conduzida por meio de buscas nas bases de dados PubMed, Cochrane Library e SciELO, usando descritores MeSH relacionados à encefalite anti-NMDAR e teratomas ovarianos, com um recorte temporal de 2013 a 2023, com artigos na língua inglesa. Foram selecionados artigos que abordavam achados clínicos, diagnóstico, tratamento e desfechos de pacientes com essa síndrome. Os achados clínicos incluíram sintomas como psicose, convulsões, movimentos involuntários e comportamento agressivo. O diagnóstico envolveu avaliação clínica, exames de imagem e detecção de anticorpos anti-NMDA. A terapia incluiu ressecção cirúrgica de teratomas, pulsoterapia de imunoglobulina intravenosa (IVIG) e corticosteroides. Todos os pacientes apresentaram recuperação completa. A compilação dos resultados revelou a eficácia da terapia, com melhora estatisticamente significativa nos sintomas e respostas clínicas após tratamento. A remoção cirúrgica dos teratomas e a terapia imunomodulatória resultaram em recuperação completa. A abordagem de tratamento combinada foi eficaz na redução da resposta autoimune. A análise dos casos também destacou a importância do diagnóstico precoce para melhores resultados. Em resumo, a encefalite anti-NMDAR associada a teratomas ovarianos é uma condição complexa, mas tratável. A abordagem terapêutica combinada, a qual inclui ressecção cirúrgica e terapia imunomoduladora, cuja dose recomendada é de 0,4 g/kg/dia por 5 dias, seguida de corticoides para reduzir a inflamação cerebral, demonstrou eficácia na recuperação completa dos pacientes.
ABSTRACT This work aims at evaluating and discriminating crambe genotypes regarding tolerance to water deficit by means of morpho-agronomic and physiological traits. The trial was carried out in a ...greenhouse under a randomized complete block design with four blocks, in a 2 x 8 factorial scheme, being two environments (with and without stress) and eight genotypes (FMS CR 1101, FMS CR 1106, FMS CR 1203, FMS CR 1305, FMS CR 1307, FMS CR 1312 and FMS CR 1326 and cultivar FMS Brilhante). The genotypes were evaluated according to physiological and morpho-agronomic traits. The significance of the mean squares was tested by the F test (P < 0.05) and the genetic parameters were estimated as ratio b between the genetic (CVg) and experimental (CVe) coefficients of variation, broad-sense heritability at genotypic mean level ( h ^ m 2), intraclass correlation (r) and selective accuracy (Ac). In general, water deficit did not cause severe physiological limitations to the plants. Plant height (PH), total dry mass (TDM) and grain yield (GY) were the traits that stood out for presenting the highest estimates of ratio b, h ^ m 2), CVg and r, revealing the possibility of genetic gains with the selection. Nevertheless, after evaluating the performance of genotypes in terms of physiological and morpho-agronomic traits, it was concluded that cultivar FMS Brilhante and inbred lines FMS CR 1326 and FMS CR 1106 had the most favorable traits for the selection, therefore, presenting potential for water deficit tolerance.
Aim
Older adults are the main risk group for coronavirus disease 2019 (COVID‐19). This study aimed to describe the clinical manifestations and factors associated with mortality from COVID‐19 among ...older adults in Brazil.
Methods
A cross‐sectional observational study was carried out with data from 9807 cases of COVID‐19 among older adults in the state of Alagoas, Brazil. We determined the case fatality rate between age groups and clinical factors associated with mortality.
Results
A total of 52.5% (n = 5145) were women, and with an average age of 70.21 ± 8.37 years. The fatality rate was 11.9%, with a higher rate in men (14.4%) compared with women (9.8%). The fatality rate increased with age. The most common manifestations were fever (n = 4926; 50.2%), cough (n = 5737; 58.5%), headache (n = 1980; 20.2%) and fatigue (n = 2022; 20.6%). The most prevalent comorbidities were diabetes (n = 1528; 5.6%), cardiovascular disease (n = 1528; 15.6%) and systemic arterial hypertension (n = 597; 6.1%). The factors associated with mortality were male sex (OR 1.54), age ≥75 years (OR 2.40), dyspnea (OR 2.92), diabetes (OR 2.33), hypertension (OR 1.53) and chronic kidney disease (OR 2.02).
Conclusions
The profile and the risk factors evidenced show the need to adopt mechanisms to protect the elderly population.
Key points
The case fatality rate was 11.9%, with a higher rate in men (14.4%) compared to women (9.8%).
The case fatality rate increased with age, with 7.5% in the elderly aged 60–70 years and reaching 26.2% in those over 90 years of age. Individuals with 75 or more had 2.8 more chances of death.
The factors associated with mortality were male sex (OR 1.54), age ≥ 75 years (OR 2.40), dyspnea (OR 2.92), diabetes (OR 2.33), hypertension (OR 1.53) and chronic kidney disease (OR 2.02).
Geriatr Gerontol Int 2020; 20: 1177–1181.
(Mart.) Coville (Fabaceae) is a tree species native to the Brazilian Cerrado commonly known as barbatimão. In traditional medicine, decoctions or infusions of the stem bark of this plant are used in ...the treatment of several diseases. The objective of this study was to analyze the chemical composition of
aqueous extracts (SAAE) prepared from the stem bark to assess their antioxidant activity and anticancer effects as well as characterize cell death mechanisms against murine B16F10Nex-2 melanoma cells. From the SAAE, gallic acid, gallocatechin, epigallocatechin, dimeric and trimeric proanthocyanidins mainly composed of prodelphinidin units and the isomeric chromones
-hexosyl- and
-pentosyl-5,7-dihydroxychromone were identified. The SAAE showed antioxidant activity through direct free-radical scavenging as well as through oxidative hemolysis and lipid peroxidation inhibition in human erythrocytes. Furthermore, SAAE promoted apoptosis-induced cell death in melanoma cells by increasing intracellular reactive oxygen species (ROS) levels, inducing mitochondrial membrane potential dysfunction and activating caspase-3. Together, these data show the antioxidant and anticancer effects of
. These results open new perspectives for studies against other tumor cell lines and in vivo models as well as for the identification and isolation of the chemical constituents responsible for these effects.
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