Resumen Marco contextual: El enfoque de los enfermeros debe abarcar los factores de vulnerabilidad para comprender la dimensión de la intensidad de sus intervenciones, para facilitar el proceso de transición a los cuidados paliativos. Objetivo: Determinar la percepción de los expertos en enfermería sobre los determinantes de la transición para Cuidados Paliativos. Metodología: Estudio cualitativo, con enfoque fenomenológico descriptivo, utilizando el método de análisis de contenido de Bardin. Entrevistas semiestructuradas con 9 expertos de una Unidad de Cuidados Paliativos. Los datos se interpretaron a la luz de la Teoría de las Transiciones, de Afaf Meleis y se organizaron con el software ATLAS.ti®. Resultados: Se identificaron factores facilitadores para la transición, como actitudes y significados positivos sobre Cuidados Paliativos, espiritualidad y religiosidad; y otros identificados como obstáculos, como apoyo familiar insuficiente, nivel socioeconómico bajo, expectativas poco realistas y desconocimiento sobre Cuidados Paliativos. Conclusión: Los enfermeros deben convertirse en agentes facilitadores de la transición a los Cuidados Paliativos, identificando barreras y enfatizando los factores facilitadores para una transición saludable.

Resumo: Enquadramento: O foco de atenção dos enfermeiros deve abarcar os fatores de vulnerabilidade para compreender a dimensão da intensidade das suas intervenções, de forma a facilitar o processo de transição para cuidados paliativos. Objetivo: Determinar a perceção dos peritos em enfermagem sobre as condicionantes da transição para cuidados paliativos. Metodologia: Estudo qualitativo, com abordagem fenomenológica descritiva, com recurso ao método de análise de conteúdo, de Bardin. Entrevistas semiestruturadas a 9 peritos de uma Unidade de Cuidados Paliativos. Os dados foram interpretados à luz da Teoria das Transições, de Afaf Meleis e organizados com o software ATLAS.ti®. Resultados: Identificaram-se fatores considerados facilitadores, tais como atitudes e significados positivos sobre os cuidados paliativos, a espiritualidade e religiosidade; e outros identificados como inibidores, tais como suporte familiar insuficiente, expectativas irrealistas e falta de conhecimento sobre cuidados paliativos. Conclusão: Os enfermeiros devem tornar-se agentes facilitadores da transição para cuidados paliativos, identificando as barreiras e enfatizando os fatores facilitadores com vista a uma transição saudável.

Abstract Background: Nurses’ focus should include vulnerability factors to understand the intensity range of their interventions, in order to facilitate the transition process to palliative care. Objective: To determine the conditioning factors for the transition to Palliative Care from the Clinical Nurse Specialist’ perception. Methodology: Qualitative study, with a descriptive phenomenological approach, using Bardin's method of content analysis. Semi-structured interviews with 9 experts from a Palliative Care Unit. Data were interpreted in the light of Afaf Meleis' Theory of Transitions and organized with the ATLAS.ti®. Results: Facilitating factors were identified, such as positive attitudes and meanings about palliative care, spirituality and religiosity; and others identified as inhibiting conditions, such as insufficient family support, unrealistic expectations and lack of knowledge about palliative care. Conclusion: Nurses must become the facilitators of the patient’s transition process to the palliative care identifying and stepping in the obstacles to their development according to the individual, their family and the caregivers’ needs.

RESUMO O objetivo deste trabalho foi determinar a digestibilidade do farelo de palmiste (Elaeis guineensis) para o tambaqui (Colossoma macropomum), em duas classes de peso: 1 (210 alevinos de 4,45±1,18g) e 2 (54 juvenis de 115,91±4,01g). Os coeficientes de digestibilidade aparente (CDA) da matéria seca, proteína bruta e energia bruta do farelo de palmiste foram avaliados pela metodologia de substituição da dieta referência, utilizando-se 0,1% de óxido crômico como indicador externo. Os dados foram analisados pelo teste t de Student, a 5% de probabilidade. Os CDAs da matéria seca, proteína bruta e energia bruta do ingrediente foram iguais (P>0,05) nas classes de peso avaliadas. Os CDAs observados nas classes 1 e 2, respectivamente, foram: matéria seca (17,52% e 20,75%), proteína bruta (62,83% e 63,75%) e energia bruta (14,16% e 22,43%). A capacidade do tambaqui para digerir os nutrientes do farelo de palmiste não foi influenciada pelo peso corporal, e o aproveitamento satisfatório da proteína (63,29%) faz desse ingrediente uma potencial fonte alternativa de proteína em dietas para a espécie.

ABSTRACT The objective of this work was to determine the digestibility of palm kernel meal (Elaeis guineensis) in tambaqui (Colossoma macropomum), in two weight classes: 1 (210 fingerlings of 4.45±1.18g) and 2 (54 juveniles of 115.91±4.01g). The apparent digestibility coefficients (ADC) of dry matter, crude protein and crude energy of the palm kernel meal were evaluated by the substitution of the reference diet methodology, using 0.1% chromic oxide as an external indicator. Data were analyzed by Student's t-test at 5% probability. The dry matter, crude protein and crude energy ADCs of the ingredient were the same (P> 0.05) in the weight classes evaluated. The ADCs observed in classes 1 and 2, respectively, were: dry matter (17.52% and 20.75%), crude protein (62.83% and 63.75%) and crude energy (14.16% and 22.43%). The ability of tambaqui to digest the nutrients of palm kernel meal was not influenced by body weight, and satisfactory protein utilization (63.29%) makes this ingredient a potential alternative source of protein in diets for the species.

Studies have shown that the frequency or worsening of sleep disorders tends to increase with age and that the ability to perform circadian adjustments tends to decrease in individuals who work the night shift. This condition can cause consequences such as excessive sleepiness, which are often a factor in accidents that occur at work. The present study investigated the effects of age on the daytime and nighttime sleep patterns using polysomnography (PSG) of long-haul bus drivers working fixed night or day shifts. A total of 124 drivers, free of sleep disorders and grouped according to age (<45 years, N = 85, and ≥45 years, N = 39) and PSG timing (daytime (D) PSG, N = 60; nighttime (N) PSG, N = 64) participated in the study. We observed a significant effect of bedtime (D vs N) and found that the length of daytime sleep was shorter [D: <45 years (336.10 ± 73.75 min) vs N: <45 years (398 ± 78.79 min) and D: ≥45 years (346.57 ± 43.17 min) vs N: ≥45 years (386.44 ± 52.92 min); P ≤ 0.05]. Daytime sleep was less efficient compared to nighttime sleep [D: <45 years (78.86 ± 13.30%) vs N: <45 years (86.45 ± 9.77%) and D: ≥45 years (79.89 ± 9.45%) and N: ≥45 years (83.13 ± 9.13%); P ≤ 0.05]. An effect of age was observed for rapid eye movement sleep [D: <45 years (18.05 ± 6.12%) vs D: ≥45 years (15.48 ± 7.11%) and N: <45 years (23.88 ± 6.75%) vs N: ≥45 years (20.77 ± 5.64%); P ≤ 0.05], which was greater in younger drivers. These findings are inconsistent with the notion that older night workers are more adversely affected than younger night workers by the challenge of attempting to rest during the day.

Nitric oxide (NO) donors produce NO-related activity when applied to biological systems. Among its diverse functions, NO has been implicated in vascular smooth muscle relaxation. Despite the great importance of NO in biological systems, its pharmacological and physiological studies have been limited due to its high reactivity and short half-life. In this review we will focus on our recent investigations of nitrosyl ruthenium complexes as NO-delivery agents and their effects on vascular smooth muscle cell relaxation. The high affinity of ruthenium for NO is a marked feature of its chemistry. The main signaling pathway responsible for the vascular relaxation induced by NO involves the activation of soluble guanylyl-cyclase, with subsequent accumulation of cGMP and activation of cGMP-dependent protein kinase. This in turn can activate several proteins such as K+ channels as well as induce vasodilatation by a decrease in cytosolic Ca2+. Oxidative stress and associated oxidative damage are mediators of vascular damage in several cardiovascular diseases, including hypertension. The increased production of the superoxide anion (O2-) by the vascular wall has been observed in different animal models of hypertension. Vascular relaxation to the endogenous NO-related response or to NO released from NO deliverers is impaired in vessels from renal hypertensive (2K-1C) rats. A growing amount of evidence supports the possibility that increased NO inactivation by excess O2- may account for the decreased NO bioavailability and vascular dysfunction in hypertension.

Flight safety is one of the most important and frequently discussed issues in aviation. Recent accident inquiries have raised questions as to how the work of flight crews is organized and the extent to which these conditions may have been contributing factors to accidents. Fatigue is based on physiologic limitations, which are reflected in performance deficits. The purpose of the present study was to provide an analysis of the periods of the day in which pilots working for a commercial airline presented major errors. Errors made by 515 captains and 472 copilots were analyzed using data from flight operation quality assurance systems. To analyze the times of day (shifts) during which incidents occurred, we divided the light-dark cycle (24:00) in four periods: morning, afternoon, night, and early morning. The differences of risk during the day were reported as the ratio of morning to afternoon, morning to night and morning to early morning error rates. For the purposes of this research, level 3 events alone were taken into account, since these were the most serious in which company operational limits were exceeded or when established procedures were not followed. According to airline flight schedules, 35% of flights take place in the morning period, 32% in the afternoon, 26% at night, and 7% in the early morning. Data showed that the risk of errors increased by almost 50% in the early morning relative to the morning period (ratio of 1:1.46). For the period of the afternoon, the ratio was 1:1.04 and for the night a ratio of 1:1.05 was found. These results showed that the period of the early morning represented a greater risk of attention problems and fatigue.

To evaluate the effect of smoking habits on sleep, data from 1492 adults referred to the Sleep Institute were accessed and divided into 3 categories of smoking status: current, former and non-smokers. Categories of pack-years (<15 and ≥15) defined smoking severity. The association of smoking status and smoking severity with sleep was analyzed for sleep parameters, especially apnea and hypopnea index (AHI) ≥5, more than 5% of total sleep time (TST) spent with oxyhemoglobin saturation (SaO2) <90%, and arousal index. The arousal index was higher among current (21 ± 17) and former smokers (20 ± 17) than non-smokers (17 ± 15; P < 0.04). Former smokers had a higher percent of TST at SaO2 <90% than non-smokers (9 ± 18 vs 6 ± 13; P < 0.04). Former smokers with pack-years ≥15 compared to <15 exhibited higher AHI (22 ± 24 vs 16 ± 21; P < 0.05) and arousal index (22 ± 19 vs 18 ± 15; P < 0.05). Current smokers with pack-years ≥15 compared to <15 exhibited higher arousal index (23 ± 18 vs 18 ± 16; P < 0.05) and percent of TST at SaO2 <90% (11 ± 17 vs 6 ± 13; P < 0.05). Smoking status and pack-years were not associated with AHI ≥5 on logistic regression analysis, but current smokers with pack-years ≥15 were 1.9 times more likely to spend more than 5% of TST at SaO2 <90% than non-smokers (95%CI = 1.21-2.97; P = 0.005). The variability of arousal index was influenced by gender, AHI and current smokers with pack-years ≥15 (all P < 0.01). Smoking habits seem to be associated with arousal and oxyhemoglobin desaturation during sleep, but not with AHI. The effect was more pronounced in current than former smokers.

We investigated the relationship between sleep-disordered breathing (SDB) and Cheyne-Stokes respiration (CSR) while awake as well as mortality. Eighty-nine consecutive outpatients (29 females) with congestive heart failure (CHF; left ventricular ejection fraction, LVEF <45%) were prospectively evaluated. The presence of SDB and of CSR while awake before sleep onset was investigated by polysomnography. SDB prevalence was 81 and 56%, using apnea-hypopnea index cutoffs >5 and >15, respectively. CHF etiologies were similar according to the prevalence of SDB and sleep pattern. Males and females were similar in age, body mass index, and LVEF. Males presented more SDB (P = 0.01), higher apnea-hypopnea index (P = 0.04), more light sleep (stages 1 and 2; P < 0.05), and less deep sleep (P < 0.001) than females. During follow-up (25 ± 10 months), 27% of the population died. Non-survivors had lower LVEF (P = 0.01), worse New York Heart Association (NYHA) functional classification (P = 0.03), and higher CSR while awake (P < 0.001) than survivors. As determined by Cox proportional model, NYHA class IV (RR = 3.95, 95%CI = 1.37-11.38, P = 0.011) and CSR while awake with a marginal significance (RR = 2.96, 95%CI = 0.94-9.33, P = 0.064) were associated with mortality. In conclusion, the prevalence of SDB and sleep pattern of patients with Chagas' disease were similar to that of patients with CHF due to other etiologies. Males presented more frequent and more severe SDB and worse sleep quality than females. The presence of CSR while awake, but not during sleep, may be associated with a poor prognosis in patients with CHF.

Mitochondrial mutations are responsible for at least 1% of the cases of hereditary deafness, but the contribution of each mutation has not yet been defined in African-derived or native American genetic backgrounds. A total of 203 unselected hearing-impaired patients were screened for the presence of the mitochondrial mutation A1555G in the 12S rRNA gene and mutations in the tRNA Ser(UCN) gene in order to assess their frequency in the ethnically admixed Brazilian population. We found four individuals with A1555G mutation (2%), which is a frequency similar to those reported for European-derived populations in unselected samples. On the other hand, complete sequencing of the tRNA Ser(UCN) did not reveal reported pathogenic substitutions, namely A7445G, 7472insC, T7510C, or T7511C. Instead, other rare substitutions were found such as T1291C, A7569G, and G7444A. To evaluate the significance of these findings, 110 "European-Brazilians" and 190 "African-Brazilians" unrelated hearing controls were screened. The T1291C, A7569G and G7444A substitutions were each found in about 1% (2/190) of individuals of African ancestry, suggesting that they are probably polymorphic. Our results indicate that screening for the A1555G mutation is recommended among all Brazilian deaf patients, while testing for mutations in the tRNA Ser(UCN) gene should be considered only when other frequent deafness-causing mutations have been excluded or in the presence of a maternal transmission pattern.

O desenvolvimento de alimentos é uma constante nas indústrias, nas universidades e nos institutos de pesquisa visando otimizar processamentos, agregar diferentes ingredientes em produtos já existentes, entre outros fatores. Após o desenvolvimento de um produto, informações adicionais podem ser obtidas pela determinação do rendimento e do custo do produto final. O objetivo deste trabalho foi estimar o rendimento e o custo de queijos Minas frescal tradicionais e adicionados de extrato hidrossolúvel de soja desengordurado (EHS) processados com coalho bovino e com coagulante microbiano (Aspergillus niger var. awamori). A introdução de 8% do EHS (em relação ao teor de sólidos totais do leite) no queijo Minas frescal processado com coalho bovino proporcionou rendimento em gramas de sólidos totais por litro de leite (g ST/L) superior de 16,67% em relação ao queijo Minas frescal tradicional processado com o mesmo coalho. O queijo tipo Minas frescal processado com coagulante microbiano e com 8% de EHS apresentou rendimento (g ST/L) superior de 16,54%, quando comparado ao seu tradicional. O custo das formulações-base (kg de queijo/100L de leite) processadas com coalho bovino e com coagulante microbiano foi US$ 36,75 e US$ 37,50, respectivamente, ao passo que os queijos tradicionais processados com os mesmos agentes coagulantes apresentaram custo equivalente a US$ 35,12 e US$ 35,36.

Food products development occur in industries, universities and research centers with the aim of optimizing processes, to include different ingredients to existing products or for other reasons. After developing a product, additional information may be obtained by determining yield and cost of the final product. The objective of this research was to estimate yield and cost of traditional Minas fresh cheese and those produced with added fat free soybean hydro-soluble extract powder (SEP), with curd formed by rennet or microbial coagulant (Aspergillus niger var. awamori). Minas fresh cheese with addition of 8% of SEP (in relation to total milk solids), processed with rennet had a yield (g TS/L) 16.67% higher in comparison to the traditional cheese processed with the same rennet. The cheese processed with microbial coagulant and 8% of SEP had a yield (g TS/L) 16.54% higher, when compared to the traditional cheese. The cost of the basic formulations with 8% of SEP (kg of cheese/100L of milk) processed with rennet or with microbial coagulant was US$36.75 and US$ 37.50 respectively, whilst that the traditional cheeses, processed with the same coagulants cost US$ 35.12 and US$35.36.

ABSTRACT The cockroach Blattella germanica is one of the most known species. They are found in houses, restaurants, storehouses, hospitals, supermarket and food industries. The traditional control have been made through different methods; the most used is insecticide pulverization. The technology of insecticides application have given conditions to improve the application and to obtain better efficiency the spraying process. The spray nozzle is one the components that most influences the success of insecticide application, which is composed by different parts, the spray tip being the most important one because it regularizes the flowing out, the size of the drops and the shape of the drops imitted. The spray tip used in this study were TT11001-VP, DG110015, TXA8001 VK (Spraying Systems Co®) and K9717 (Guarany®). The insecticides used were the chlorpyrifos (Dursban 4E®), lambdacyhalothrin (Demand CS 2,5®) and betacyfluthrin (Responsar 1,5®) in doses recommended under pressure of 50 lb/pol2 and volume of application of 40mL/L. The type of spray tip interfered on the residual efficiency of insecticides for Blattella germanica control while the spray tips TT11001 VP, DG110015, TXA 8001 VK were superior to K9717. species houses restaurants storehouses hospitals industries methods pulverization process parts out imitted TT11001VP, TT11001VP TTVP VP TT TT11001-VP DG110015 DG TXA800 Spraying Co® Co K K971 Guarany®. Guarany Guarany® . (Guarany®) Dursban 4E®, 4E E 4E® , 4E®) Demand 2,5® 25 2 5 Responsar 1,5® 15 1 lbpol2 lbpol lb pol2 pol lb/pol 40mLL mLL 40mL L mL 40mL/L TT1100 800 DG11001 TXA80 K97 (Guarany® 2,5 1,5 TT110 80 DG1100 TXA8 K9 (Guarany 2, 1, TT11 8 DG110 TT1 DG11 DG1

RESUMO A barata Blattella germanica é uma das espécies mais conhecidas, encontrada em residências, restaurantes, depósitos, hospitais, supermercados e indústrias alimentícias. O controle tradicionalmente tem sido realizado por meio de diversos métodos, destacando-se as pulverizações com inseticidas. A tecnologia de aplicação de defensivos tem fornecido subsídios para a melhoria das aplicações e obtenção do melhor rendimento da pulverização, um processo mecânico de geração de um grande número de pequenas gotas por meio da aplicação de um inseticida sobre um alvo definido. O bico de pulverização é um dos componentes de grande influência para o sucesso na aplicação de um inseticida. Este conjunto é composto de várias partes e a ponta de pulverização é a mais importante, pois regula a vazão, o diâmetro e deposição das gotas. Empregou-se as pontas de pulverização TT11001-VP, DG110015, TXA8001 VK (Spraying Systems Co®) e K9717 (Guarany®). Foram utilizados os inseticidas clorpirifós (Dursban 4E®), lambdacialotrina (Demand CS 2,5®) e betaciflutrina (Responsar 1,5®) nas dosagens recomendadas sob uma pressão de 50 lb/pol2 (333 kPa) e volume de aplicação de 40 mL/m2. O tipo de ponta de pulverização interferiu na eficiência residual de inseticidas no controle de Blattella germanica. As pontas de pulverização TT11001 VP, DG110015, TXVS4 foram superiores ao K9717. conhecidas residências restaurantes depósitos hospitais alimentícias métodos destacandose destacando se definido importante vazão Empregouse Empregou TT11001VP, TT11001VP TTVP VP TT TT11001-VP DG110015 DG TXA TXA800 Spraying Co® Co K K971 Guarany®. Guarany Guarany® . (Guarany®) Dursban 4E®, 4E E 4E® , 4E®) Demand 2,5® 25 2 5 Responsar 1,5® 15 1 lbpol2 lbpol lb pol2 pol lb/pol 333 (33 kPa 4 mLm2 mLm mL m2 m mL/m2 TT1100 TXVS DG11001 TXA80 K97 (Guarany® 2,5 1,5 33 (3 mL/m TT110 DG1100 TXA8 K9 (Guarany 2, 1, 3 ( TT11 DG110 TT1 DG11 DG1

A análise de performance psicomotora de crianças institucionalizadas é de fundamental importância no planejamento de atividades educativas. Estudos anteriores têm mostrado prejuízos desta função em crianças de creches. OBJETIVO. Comparar o desempenho no teste de triagem de Denver em crianças de 2 a 6 anos de idade, de creches conveniadas com a Prefeitura de São Paulo, antes e após seis meses de intervenção nutricional com suplemento alimentar enriquecido com ferro. MÉTODO. Foram analisadas 130 crianças de 2 a 6 anos de idade, em três creches municipais de São Paulo, aplicando-se o teste de Denver, por psicólogas treinadas, comparando-se os resultados de acordo com o sexo, faixa etária e estado nutricional, antes e após período de suplementação alimentar. RESULTADOS. A maior parte das crianças teve desempenho normal, tanto na primeira aplicação (70,80%), como na segunda (80,80%), sem modificação do estado nutricional. Na comparação dos resultados, 76,92% não modificaram o desempenho e 18,46% melhoraram significativamente. Em relação ao sexo, não foram encontradas diferenças significantes, enquanto que, para a faixa etária, houve melhora significante entre as crianças de 4 a 6 anos. CONCLUSÕES. Além do aspecto nutricional, fatores como prontidão para aprendizagem, organização familiar e orientação psicopedagógica das creches devem estar favorecendo o desenvolvimento, mesmo considerando-se o baixo nível socioeconômico da população estudada.

Psychomotor and development analysis must be emphasized when studying institutionalized children. Many previous investigations have been showing deleterious effects of day care centers over developmental performance in children. OBJECTIVE. This study is aimed at comparing the performance in the Development Screening Test (Denver) in children attending day care centers, before and after nutritional intervention with an energetic supplement enriched with iron. METHOD. 130 children from 2 to 6 years old, attending three municipal day care centers, were evaluated by means of the application of the Denver test, by trained psychologists, comparing the collected data according to sex and age group, before and after six months intervention with iron enriched protein energetic supplement. RESULTS. Most of the children had normal performance, both in first application (70.80%), and in the second one (80.80%). When comparing these results, 76.92% of the children had not altered their performance and 18.46% improved it substantially. As to sex, no significant differences were found and as to age group, there was significant improvement among children aged 4 to 6 years of age. CONCLUSIONS. Besides the nutritional aspects, factors such as learning readiness, family organization, and psychopedagogic orientation to the day care centers, must have fostered development, even if the low socioeconomic level of the studied population is considered.