Available metals in soil Nutrients and toxic elements a b s t r a c tThe aim of this study was to evaluate the presence of nutrients and toxic elements in coffees cultivated during the process of conversion, on organic agriculture, in southwest Bahia, Brazil. Levels of the nutrients and toxic elements were determined in samples of soils and coffee tissues from two transitional organic farms by atomic absorption spectrometry (FAAS). The metals in soil samples were extracted by Mehlich1 and USEPA-3050 procedures. Coffee samples from both farms presented relatively high levels of Cd, Zn and Cu (0.75, 45.4 and 14.9 lg g À1 , respectively), but were still below the limits specified by the Brazilian Food Legislation. The application of statistical methods showed that this finding can be attributed to the addition of high amounts of organic matter during the flowering tree period which can act on the bioavailability of metal ions in soils.
Malnutrition is prevalent in trauma victims because of intense muscle wasting triggered by traumatic events and is a mortality risk. The Academy of Nutrition and Dietetics–American Society for Parenteral and Enteral Nutrition (AND‐ASPEN) tool has the potential to diagnose malnutrition in this population. This study aims to evaluate this criterion as a malnutrition diagnostic tool and as a hospital mortality predictor in critically ill trauma patients.
We performed an observational prospective cohort study from April 2015 to February 2017 in a Brazilian hospital. Patients were >18 years old, remained in the intensive care unit (ICU) >48 hours, and had completed data regarding the recommended clinical characteristics (RCCs) for malnutrition. The main exposure of interest was malnutrition assessed by a specialist dietitian using AND‐ASPEN. The primary outcome was all causes of mortality during hospital stay. Secondary outcome was the RCCs assessment, to predict malnutrition and hospital mortality.
Included were 414 trauma patients. Malnutrition prevalence was 26.8% at ICU admission. The main analysis showed that malnutrition increases mortality chances 1.96 times (95% CI, 1.13–3.30; P = .015). Secondary analysis showed that all 5 RCCs were significantly associated with malnutrition. The only RCC associated with mortality was energy intake (odds ratio 1.5; 95% CI, 1.1–2.0; P = .008).
AND‐ASPEN criterion is a feasible and accurate method to recognize malnutrition and predict hospital mortality when applied by trained dietitians for the critical care trauma population. Further studies are needed considering patient subgroups such as obese and elderly.
We showed that S. obtusifolium presents a potent anti-inflammatory activity, due to the presence of the N-methyl-(2S,4R)-trans-4-hydroxy-l-proline(NMP) in the plant extract. This action is related to the inhibition by NMP of TNF-alpha and inflammatory enzymes.
Rationale, aims, and objectives:Counselling is essential in drug dispensing, since it enables patients to receive and understand the information to correctly use their medicines. Although counselling is a quality indicator on drug dispensing, models that guide pharmacists in this practice are scarce. Thus, this study aimed to develop and validate the content of an instrument to support pharmaceutical counselling for dispensing of prescribed medicines.
Method:A two-stage validation study was conducted out from February to October 2017. The first stage involved the development of the instrument, and the second involved content validation. Instrument development included the following three steps: (1) drafting of the prototype; (2) an academic brainstorming meeting, and (3) a pre-Delphi process. Content validation was then conducted using the Delphi technique. At this stage, 40 pharmacists who were experts in drug dispensing, were invited to assess the instrument. Consensus among experts was calculated according to the content validity index (CVI).
Results:The development stage generated three versions of the instrument: the prototype, Version 1 (modified after brainstorming meeting), and Version 2 (modified after the pre-Delphi process). Version 2 underwent the content validation process, in which 29 pharmacists participated during the first round (rate of return: 72.5%) and 23 of these during the second round (rate of return: 79.31%). All items obtained CVI > 0.82 and were thus considered to be validated. The final instrument comprised three components: suggestions for questions, dispensing process reasoning, and suggestions for counselling, and other conduct in 11 stages, each representing a step in the clinical reasoning process.
Conclusions:An instrument was developed to support pharmaceutical counselling for dispensing of prescribed medicines, suggesting main questions, counselling, and conduct to be taken by pharmacists, and its content validity was verified.
Objetivo Comparar os efeitos da massagem manual perilaríngea e do treinamento vocal tradicional em professores com queixas vocais. Métodos Quarenta e dois professores universitários foram selecionados aleatoriamente para um dos dois grupos: grupo de massagem manual perilaríngea (G1), ou grupo de treinamento vocal (G2). Avaliações realizadas : autoavaliação vocal e da dor, relato de sintoma vocal, avaliação da tensão da musculatura cervical, análises perceptivo-auditiva e acústica da voz. Resultados Não houve diferença entre os grupos para idade, gênero e tempo de magistério. Os sintomas vocais mais referidos foram sensação de secura na garganta e rouquidão. Nos dois grupos houve redução dos sintomas vocais. Não houve diferença entre as intervenções, quanto aos escores parciais e total do questionário de autoavaliação vocal e à análise acústica. O G1 apresentou diferença intragrupo para autopercepção vocal e parâmetro acústico “energia de ruído glótico”. O G2, para os escores “efeitos na comunicação diária”, “efeitos na emoção”, “limitação das atividades”, escore total, parâmetros shimmer e “energia de ruído glótico”. O G1 apresentou diferença intragrupo para autopercepção da dor e houve redução da tensão cervical e do grau discreto de disfonia, aumentando a porcentagem de sujeitos com grau normal. O G2 manteve o resultado da análise perceptivo-auditiva da voz, após a intervenção, e não apresentou diferença na avaliação da tensão. Conclusão : As duas intervenções contribuíram para melhorar o bem-estar e a qualidade vocal dos participantes, cabendo ao profissional fonoaudiólogo decidir qual utilizará, observando as queixas e a demanda vocal do professor.
Forest restoration is a strategy to reverse forest loss and degradation. We overviewed deforestation in the period 1975-2018 in the Brazilian Amazon and the projects, techniques, and scientific publications conducted to recover forest in the area by 2019. We used GIS to assess forest loss and a systematic data collection gathered from 12 universities, five major environmental agencies, and an ad-hoc bibliographic survey that rendered information from 405 restoration projects and 152 published studies. The Brazilian Amazon has undergone an accelerated deforestation in the last 43 years, resulting in 20% (788,353 km 2) of its territory deforested
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