Assessment of the responsiveness of a public health service from the perspective of older adults.

PubMed

Melo, Denise da Silva; Martins, René Duarte; Jesus, Renata Patrícia Freitas Soares de; Samico, Isabella Chagas; Santo, Antônio Carlos Gomes do Espírito

2017-06-26

To assess the quality of health care of older adults using as a parameter the assessment of the responsiveness of the service. This is a descriptive cross-sectional study conducted in a reference unit of the Brazilian Unified Health System at the outpatient level. The sample was probabilistic and had 385 older adults; data collection occurred in 2014. The domains assessed were: choice, autonomy, confidentiality, dignity, communication, physical facilities, and fast service. To this end, we used Pearson correlation test and Fisher's exact test. The domains of dignity, confidentiality, and communication reached the highest level of adequate responsiveness. On the other hand, freedom of choice and fast service received the worst assessments. Participation in decision-making regarding treatment was significantly lower among the older adults who had no education. In addition, the older adults that self-reported as black receive a lower quality of care regarding clear explanation and respected privacy in the appointment, when compared to users of any other race. Although most domains studied have receive a positive assessment, we have found a need for an equal care by the health professionals, regardless of race, education level, or any other adjective characteristic of older adults, users of public health services. Avaliar a qualidade da atenção à saúde da população idosa usando como parâmetro a avaliação da responsividade do serviço. Trata-se de um estudo descritivo, de corte transversal, realizado em uma unidade de referência do Sistema Único de Saúde em nível ambulatorial. A amostra foi probabilística composta por 385 idosos e a coleta de dados ocorreu em 2014. Foram avaliados os domínios: escolha, autonomia, confidencialidade, dignidade, comunicação, instalações físicas e atendimento rápido. Para tanto, foram utilizados o teste de correlação de Pearson e o teste de Fisher. Os domínios dignidade, confidencialidade e comunicação atingiram o maior nível de responsividade adequada. Por outro lado, a liberdade de escolha e o atendimento rápido receberam as piores avaliações. A participação na tomada de decisões a respeito do tratamento foi significativamente menor entre os idosos que não frequentaram a escola. Além disso, os idosos que se autodeclararam negros receberam um atendimento de menor qualidade no que diz respeito à explicação clara e a privacidade respeitada mediante consulta, quando comparados aos usuários de outra raça. Apesar de a maioria dos domínios estudados receberem uma avaliação positiva, evidenciou-se a necessidade de um atendimento igualitário por parte dos profissionais de saúde, independentemente de raça, nível de escolaridade ou qualquer outra característica adjetiva referente aos usuários idosos atendidos nos serviços de saúde públicos.

Quality of life of elderly people with chronic kidney disease in conservative treatment.

PubMed

Pereira, Roberta Maria de Pina; Batista, Marcelo Aparecido; Meira, Aline de Sousa; Oliveira, Marília Pilotto de; Kusumota, Luciana

2017-01-01

To describe the quality of life (QOL) of elderly people with Chronic Kidney Disease (CKD) in conservative treatment, correlating it with sociodemographic and health-related aspects. This is a quantitative, cross-sectional, and descriptive study that used: a previously validated instrument for data collection; the WHOQOL-BREF and WHOQOL-OLD QOL scales; and the Mini-Mental State Examination. Thirty-five elderly people (54.30% females), with mean age of 68.26 years, took part in the study. They reported, on average, 3.70 comorbidities and 5.60 complications related to CKD. Regarding QOL, the "psychological" domain (54.40±16.29) and the "death and dying" facet (37.32±23.79) were considered the most damaged ones; the most strengthened were "social relationships" (70.36±18.32) and "intimacy" (66.61±16.80). A positive correlation was verified between comorbidities and complications (p = 0.015), and an inverse correlation between the number of complications and QOL (p = 0.004). These results, if considered during the care planning, may help improving the quality of the care provided for elderly people with CKD. Descrever a qualidade de vida (QV) de idosos com Doença Renal Crônica (DRC) em tratamento conservador, correlacionando-a com aspectos sociodemográficos e de saúde. Pesquisa quantitativa, transversal e descritiva que utilizou: um instrumento pré-validado para coleta dos dados de caracterização; as escalas de QV WHOQOL-BREF e WHOQOL-OLD; e o Mini Exame do Estado Mental. Participaram 35 idosos (54,30% mulheres) com média de 68,26 anos. Referiram em média 3,70 comorbidades e 5,60 complicações relacionadas à DRC. Na QV, demonstraram-se mais prejudicados o domínio "psicológico" (54,40±16,29) e a faceta "morte e morrer" (37,32±23,79); e mais fortalecidos o domínio "relações sociais" (70,36±18,32) e a faceta "intimidade" (66,61±16,80). Verificou-se correlação positiva entre número de comorbidades e de complicações (p = 0,015), e correlação inversa entre número de complicações e a QV (p = 0,004). Se levados em consideração durante o planejamento de cuidados, tais resultados podem auxiliar na melhoria da qualidade da assistência ao idoso com DRC.

Psychometric properties of the Vulnerability to Abuse Screening Scale for screening abuse of older adults.

PubMed

Dantas, Raquel Batista; Oliveira, Graziella Lage; Silveira, Andréa Maria

2017-04-10

Adapt and evaluate the psychometric properties of the Vulnerability to Abuse Screening Scale to identify risk of domestic violence against older adults in Brazil. The instrument was adapted and validated in a sample of 151 older adults from a geriatric reference center in the municipality of Belo Horizonte, State of Minas Gerais, in 2014. We collected sociodemographic, clinical, and abuse-related information, and verified reliability by reproducibility in a sample of 55 older people, who underwent re-testing of the instrument seven days after the first application. Descriptive and comparative analyses were performed for all variables, with a significance level of 5%. The construct validity was analyzed by the principal components method with a tetrachoric correlation matrix, the reliability of the scale by the weighted Kappa (Kp) statistic, and the internal consistency by the Kuder-Richardson estimator formula 20 (KR-20). The average age of the participants was 72.1 years (DP = 6.96; 95%CI 70.94-73.17), with a maximum of 92 years, and they were predominantly female (76.2%; 95%CI 69.82-83.03). When analyzing the relationship between the scores of the Vulnerability to Abuse Screening Scale, categorized by presence (score > 3) or absence (score < 3) of vulnerability to abuse, with clinical and health conditions, we found statistically significant differences for self-perception of health (p = 0.002), depressive symptoms (p = 0.000), and presence of rheumatism (p = 0.003). There were no statistically significant differences between sexes. The Vulnerability to Abuse Screening Scale acceptably evaluated validity in the transcultural adaptation process, demonstrating dimensionality coherent with the original proposal (four factors). In the internal consistency analysis, the instrument presented good results (KR-20 = 0.69) and the reliability via reproducibility was considered excellent for the global scale (Kp = 0.92). The Vulnerability to Abuse Screening Scale proved to be a valid instrument with good psychometric capacity for screening domestic abuse against older adults in Brazil. Adaptar e avaliar as propriedades psicométricas da Escala Triagem de Vulnerabilidade ao Abuso (Vulnerability to Abuse Screening Scale - VASS) para identificar risco de violência doméstica contra idosos no Brasil. O instrumento foi adaptado e validado em uma amostra de 151 idosos de um centro de referência do idoso, do município de Belo Horizonte, MG, em 2014. Foram coletadas informações sociodemográficas, clínicas e relacionadas a abusos. A confiabilidade via reprodutibilidade foi verificada em uma amostra de 55 idosos, submetidos ao reteste do instrumento sete dias após a primeira aplicação. Foram realizadas análises descritivas e comparativas para todas as variáveis, com nível de significância de 5%. A validade de construto foi analisada pelo método de componentes principais com matriz de correlação tetracórica, a confiabilidade da escala pela estatística Kappa ponderado (Kp) e a consistência interna pelo estimador Kuder-Richardson fórmula 20 (KR-20). A idade média dos participantes foi 72,1 anos (DP = 6,96; IC95% 70,94-73,17), com máxima de 92 anos, e o sexo foi predominantemente feminino (76,2%; IC95% 69,82-83,03). Ao analisar a relação entre os escores da Escala Triagem de Vulnerabilidade ao Abuso, categorizados em presença (índice > 3) ou ausência (índice < 3) de vulnerabilidade para abuso, com condições clínicas e de saúde, encontramos diferenças estatisticamente significantes para autopercepção de saúde (p = 0,002), sintomas depressivos (p = 0,000) e presença de reumatismo (p = 0,003). Em relação ao sexo, não houve diferença estatisticamente significante. A Escala Triagem de Vulnerabilidade ao Abuso comportou-se de forma aceitável na avaliação da validade no processo de adaptação transcultural, demonstrando dimensionalidade coerente com a proposta original (quatro fatores). Na análise da consistência interna, o instrumento apresentou bons resultados (KR-20 = 0,69) e a confiabilidade via reprodutibilidade foi considerara excelente para a escala global (Kp = 0,92). A Escala Triagem de Vulnerabilidade ao Abuso mostra-se como instrumento válido e com boas capacidades psicométricas para o rastreio de abuso doméstico contra idosos no contexto brasileiro.

Nursing Diagnosis Based on Signs and Symptoms of Patients With Heart Disease.

PubMed

da Costa, Cíntia; da Costa Linch, Graciele Fernanda; Nogueira de Souza, Emiliane

2016-10-01

The aim was to identify the main signs and symptoms of cardiac patients hospitalized in a unit of intensive cardiology care in order to infer the main nursing diagnoses (NDs). We performed a cross-sectional study; the sample consisted of 77 randomly selected records. Those records included only patients hospitalized for cardiovascular causes and with electronic chart available. Signs and symptoms identified at admission were psychic (40.3%), compressive dressing on arterial puncture site (33.8%), chest pain (29.9%), tachycardia (22.1%), and hemodynamic instability (20.8%). According to the data collected, we were able to infer that acute pain, excess of fluid volume, decreased cardiac output, spontaneous ventilation impaired, anxiety and impaired skin integrity are priority for the NDs in the studied population. OBJETIVO: identificar os principais sinais e sintomas de pacientes cardíacos internados em uma unidade de cuidados intensivos de cardiologia, visando inferir os diagnósticos de enfermagem prioritários. MÉTODO: Estudo transversal; a amostra foi composta por 77 registros selecionados aleatoriamente. Incluíram-se apenas pacientes internados por causa cardiovascular e com registro eletrônico disponível. Os sinais e sintomas identificados na admissão foram psíquicos (40,3%), curativo compressivo em sítio de punção arterial (33,8%), dor torácica (29,9%), taquicardia (22,1%) e instabilidade hemodinâmica (20,8%). CONCLUSÕES E IMPLICAÇÕES PARA A PRÁTICA: De acordo com os dados levantados foram inferidos Dor Aguda, Volume de Líquidos Excessivo, Débito Cardíaco Diminuído, Ventilação Espontânea Prejudicada, Ansiedade e Integridade da Pele Prejudicada como diagnósticos de enfermagem prioritários para a população estudada. © 2016 NANDA International, Inc.

Family of older adults with mental disorder: perception of mental health professionals.

PubMed

Saidel, Maria Giovana Borges; Campos, Claudinei José Gomes

2017-01-01

to understand the perceptions of healthcare professionals of the Psychosocial Care Centers regarding the family of older adults with mental disorders. study of a Qualitative Case conducted with 12 healthcare professionals from a Psychosocial Care Center, with a convenient and exhaustive sample. Conducting semi-structured interviews to collect data, which were analyzed with the Content Analysis technique. the following categories stood out: "Family exhaustion and deterioration in the perception of the healthcare professional" and "The abandonment of older adults by family members and their distancing in the perception of the healthcare professional." culpability of older adults and penalization of the family were verified by healthcare professionals. To bring awareness about the difficulties faced in the attempt to bring the family closer to the healthcare service, it is necessary to analyze the care given to the older adult and to overcome challenges in the effective construction of the bond between family, healthcare user and mental health service. compreender as percepções dos profissionais do Centro de Atenção Psicossocial acerca da família do idoso em sofrimento psíquico. estudo de Caso Qualitativo conduzido com 12 profissionais de um Centro de Atenção Psicossocial com amostra composta por intencionalidade e fechada por exaustão. Realização de entrevistas semiestruturadas para coleta de dados, analisados por meio da técnica de Análise de Conteúdo. destacaram-se as categorias "O cansaço e o desgaste familiar na percepção do profissional" e "O abandono e o afastamento do idoso pela família na percepção do profissional". verificou-se a culpabilização do idoso e a penalização da família pelos profissionais. Visando à conscientização das dificuldades em aproximar a família, é necessária a criação de espaços reflexivos sobre o cuidado a essa população, bem como a superação dos desafios na construção efetiva do vínculo entre família, usuário e serviço de saúde mental.

Pain assessment in elderly with dementia: Brazilian validation of the PACSLAC scale.

PubMed

Thé, Karol Bezerra; Gazoni, Fernanda Martins; Cherpak, Guilherme Liausu; Lorenzet, Isabel Clasen; Santos, Luciana Alves Dos; Nardes, Edlene Maria; Santos, Fânia Cristina Dos

2016-01-01

To validate the Pain Assessment Checklist for Seniors with Limited Ability to Communicate - Portuguese in demented elderly and to analyze its measurement properties. We evaluated 50 elderly with dementia, residing in a nursing home and with limited communication ability, when exposed to potentially painful situations. The tool was applied at two different moments. First, two interviewers applied it simultaneously, and the intensity of pain was asked based on the caregiver's opinion. After 14 days, with no analgesic intervention, one of the interviewers applied it again. The sample comprised more females, aged over 80 years, with dementia due to Alzheimer, presenting musculoskeletal pain of moderate to severe intensity. The psychometric properties of the tool demonstrated appropriate internal consistency (Cronbach's alpha coefficient of 0.827). The scale had excellent reproducibility, according to the intraclass correlation coefficient, and the tool has been duly validated. The Pain Assessment Checklist for Seniors with Limited Ability to Communicate - Portuguese had adequate measuring properties for use with elderly presenting limited communication. Validar o Pain Assessment Checklist for Seniors with Limited Ability to Communicate - Portuguese em idosos dementados e analisar as propriedades de suas medições. Foram avaliados 50 idosos dementados, residentes de uma casa de repouso e com capacidade de comunicação verbal limitada, quando expostos a situações potencialmente dolorosas. A ferramenta foi utilizada em dois momentos diferentes. Primeiro, foi aplicada por dois entrevistadores simultaneamente, e a intensidade da dor foi questionada com base na opinião do cuidador. Depois de 14 dias, sem intervenção de analgésico, a ferramenta foi aplicada novamente por um dos entrevistadores. A amostra teve predominância de mulheres, acima de 80 anos de idade, com demência de Alzheimer, apresentando dores musculoesqueléticas com intensidade moderada a grave. As propriedades psicométricas do instrumento demonstraram consistência interna adequada (coeficiente alfa de Cronbach de 0,827). A escala teve excelente reprodutibilidade, de acordo com o coeficiente de correlação intraclasse, e o instrumento demonstrou validade adequada. O Pain Assessment Checklist for Seniors with Limited Ability to Communicate - Portuguese teve propriedades de medição adequadas para idosos com limitações de comunicação.

Incidence and factors related to delirium in an intensive care unit.

PubMed

Mori, Satomi; Takeda, Juliana Rumy Tsuchihashi; Carrara, Fernanda Souza Angotti; Cohrs, Cibelli Rizzo; Zanei, Suely Sueko Viski; Whitaker, Iveth Yamaguchi

2016-01-01

To identify the incidence of delirium, compare the demographic and clinical characteristics of patients with and without delirium, and verify factors related to delirium in critical care patients. Prospective cohort with a sample made up of patients hospitalized in the Intensive Care Unit (ICU) of a university hospital. Demographic, clinical variables and evaluation with the Confusion Assessment Method for Intensive Care Unit to identify delirium were processed to the univariate analysis and logistic regression to identify factors related to the occurrence of delirium. Of the total 149 patients in the sample, 69 (46.3%) presented delirium during ICU stay, whose mean age, severity of illness and length of ICU stay were statistically higher. The factors related to delirium were: age, midazolam, morphine and propofol. Results showed high incidence of ICU delirium associated with older age, use of sedatives and analgesics, emphasizing the need for relevant nursing care to prevent and identify early, patients presenting these characteristics. Identificar a incidência de delirium, comparar as características demográficas e clínicas dos pacientes com e sem delirium e verificar os fatores relacionados ao delirium em pacientes internados em Unidade de Terapia Intensiva (UTI). Coorte prospectiva, cuja amostra foi constituída de pacientes internados em UTI de um hospital universitário. Variáveis demográficas, clínicas e da avaliação com o Confusion Assessment Method for Intensive Care Unit para identificação de delirium foram processadas para análise univariada, e regressão logística para identificar fatores relacionados à ocorrência do delirium. Do total de 149 pacientes da amostra, 69 (46,3%) apresentaram delirium durante a internação na UTI, observando-se que a média da idade, o índice de gravidade e o tempo de permanência nas UTI foram estatisticamente maiores. Os fatores relacionados ao delirium foram: idade, midazolam, morfina e propofol. Os resultados mostraram elevada incidência de delirium na UTI e sua ocorrência associada às idades mais avançadas e o uso de sedativos e analgésicos, ressaltando-se a importância da atuação do enfermeiro na prevenção e identificação precoce do quadro nos pacientes com essas características.

Polypharmacy and Polymorbidity in Older Adults in Brazil: a public health challenge.

PubMed

Ramos, Luiz Roberto; Tavares, Noemia Urruth Leão; Bertoldi, Andréa Dâmaso; Farias, Mareni Rocha; Oliveira, Maria Auxiliadora; Luiza, Vera Lucia; Pizzol, Tatiane da Silva Dal; Arrais, Paulo Sérgio Dourado; Mengue, Sotero Serrate

2016-12-01

To analyze variations in the prevalence of chronic use of medicines by older adults in Brazil according to its possible association with the most prevalent chronic diseases and demographic and health factors, and to identify risk factors for polypharmacy. A study based on data from the National Survey on Access, Use and Promotion of Rational Use of Medicines (PNAUM), a cross-sectional, population-based survey with probability sampling in Brazilian urban areas. The independent variable was the number of chronic-use medicines taken by older adults, linked to eight chronic diseases investigated. The intervening variables were gender, age group, marital status, level of education, socioeconomic status, Brazilian region, body mass index, smoking, self-perceived health, hospitalization in the previous year and having health insurance, besides the investigated chronic diseases. A multivariable analysis identified risk factors for polypharmacy. Prevalence of at least one chronic-use medicines among older adults was 93.0%. Of the total number of older adults, 18.0% used at least five medications (polypharmacy). Polypharmacy was higher among the oldest individuals (20.0%), in the South region (25.0%), in those with poor self-perceived health (35.0%), in obese individuals (26.0%), in those with reported health insurance (23.0%) or hospitalization in the previous year (31.0%), and among those who reported any of the investigated diseases, particularly diabetes (36.0%) and heart diseases (43.0%). The variables remaining in the final risk model for polypharmacy were age, region, perceived health, health insurance, hospitalization in the previous year and all investigated diseases except stroke. Older adults with specific diseases have risk factors for polypharmacy modifiable by actions aimed at the rational use of medicines. With the current population aging and successful drug access policy, the trend is an increase in drug use by older adults, which should feature as a priority in the planning agenda of the Brazilian Unified Health System (SUS). Analisar as variações da prevalência do uso crônico de medicamentos por idosos no Brasil segundo sua possível associação com as doenças crônicas mais prevalentes, fatores sociodemográficos e de saúde, e identificar fatores de risco para polifarmácia. Estudo com dados da Pesquisa Nacional de Acesso, Utilização e Promoção do Uso Racional de Medicamentos, de caráter transversal e amostra probabilística populacional em municípios brasileiros urbanos. A variável independente foi o número de medicamentos de uso crônico por idosos, vinculados às oito doenças crônicas investigadas. As variáveis intervenientes foram sexo, faixa etária, situação conjugal, escolaridade, nível socioeconômico, região do País, índice de massa corporal, hábito de fumar, percepção da própria saúde, internação no último ano e posse de plano de saúde privado, além das doenças crônicas referidas. Uma análise multivariável identificou os fatores de risco para polifarmácia. A prevalência de pelo menos um medicamento de uso crônico entre idosos foi de 93,0%. Do total de idosos, 18,0% utilizavam pelo menos cinco medicamentos (polifarmácia). A polifarmácia foi maior entre os mais idosos (20,0%), na região Sul (25,0%), nos que avaliaram a própria saúde como ruim (35,0%), nos obesos (26,0%), nos que referiram ter plano de saúde (23,0%) ou internação no último ano (31,0%) e entre os que referiram qualquer uma das doenças investigadas, particularmente diabetes (36,0%) e doenças cardíacas (43,0%). No modelo final de risco para polifarmácia permaneceram idade, região, percepção de saúde, posse de plano de saúde, internação no último ano e todas as doenças investigadas exceto acidente vascular cerebral. Idosos com doenças específicas têm fatores de risco para polifarmácia modificáveis por ações que visem o uso racional de medicamentos. Com o envelhecimento populacional em curso e a política exitosa de acesso a medicamentos, a tendência é aumentar a utilização de medicamentos por idosos, que deve ser prioridade na agenda de planejamento do Sistema Único de Saúde.

Health education with older adults: action research with primary care professionals.

PubMed

Mendonça, Francielle Toniolo Nicodemos Furtado de; Santos, Álvaro da Silva; Buso, Ana Luisa Zanardo; Malaquias, Bruna Stephanie Sousa

2017-01-01

To assess the development and implementation of permanent education action. Quantitative-qualitative research based on action research in three phases (diagnosis of reality, implementation of activity and evaluation), performed with health professionals and managers of basic health units. The evaluation was on the perception of changes immediately following the activity and after 120 days. In the first phase, 110 professionals took part, 36.4% of whom indicated the existence of groups for older adults at work. In the second phase, 98 professionals participated, pointing out interferences of the group in the life of older adults, items of importance and facilitation in forming groups and developing reality-based activities. The third phase showed, in the quantitative analysis, positive impact of the training, and in the qualitative analysis, reassessment of groups, greater knowledge and confidence in managing groups and increased respect for older adults. Permanent education opens pathways for the construction of differentiated care for older adults based on respect and health promotion. Avaliar o desenvolvimento e implementação de uma ação de educação permanente. Pesquisa quantitativo-qualitativa baseada na pesquisa-ação em 3 fases (diagnóstico da realidade, implementação de atividade e avaliação), realizada com profissionais de saúde e gerentes de unidades básicas. A avaliação se deu pela percepção de mudanças imediatamente à atividade e após 120 dias. Na 1ª fase, participaram 110 profissionais, dos quais 36,4% apontaram a existência de grupos para idosos no trabalho. Na 2ª fase, participaram 98 profissionais, que apontaram interferências do grupo na vida do idoso, itens de importância e facilitação para construção de grupos e atividade baseada na realidade. A 3ª fase mostrou, na análise quantitativa, impacto positivo do treinamento; e, na qualitativa, releitura dos grupos e manejo com mais conhecimento, segurança e respeito ao idoso. A educação permanente abre caminhos para a construção da atenção diferenciada aos idosos pautada no respeito e na promoção da saúde.

Healthy aging profile in octogenarians in Brazil.

PubMed

Campos, Ana Cristina Viana; Ferreira, Efigênia Ferreira E; Vargas, Andréa Maria Duarte; Gonçalves, Lúcia Hisako Takase

2016-08-29

to identify the healthy aging profile in octogenarians in Brazil. this population-based epidemiological study was conducted using household interviews of 335 octogenarians in a Brazilian municipality. The decision-tree model was used to assess the healthy aging profile in relation to the socioeconomic characteristics evaluated at baseline. All of the tests used a p-value < 0.05. the majority of the 335 participating older adults were women (62.1%), were aged between 80 and 84 years (50.4%), were widowed (53.4%), were illiterate (59.1%), had a monthly income of less than one minimum wage (59.1%), were retired (85.7%), lived with their spouse (63.8%), did not have a caregiver (60.3%), had two or more children (82.7%), and had two or more grandchildren (78.8%). The results indicate three age groups with a healthier aging profile: older adults aged 80 to 84 years (55.6%), older adults aged 85 years and older who are married (64.9%), and older adults aged 85 and older who do not have a partner or a caregiver (54.2%). the healthy aging profile of octogenarians can be explained by age group, marital status, and the presence of a caregiver. identificar o perfil do envelhecimento saudável de idosos brasileiros octogenários. estudo epidemiológico de base populacional, conduzido por meio de entrevista domiciliar em um município brasileiro, num recorte com 335 idosos octogenários. O modelo de árvore de decisão foi utilizado para analisar o perfil de envelhecimento saudável em relação às características socioeconômicas avaliadas na linha base. Todos os testes consideraram o valor p<0,05. entre os 335 idosos que participaram deste estudo, a maioria era do sexo feminino (62,1%), idade entre 80 e 84 anos (50,4%), viúvo (53,4%), analfabeto (59,1%), com renda mensal inferior a um salário-mínimo (59,1%); eram aposentados (85,7%), morando com cônjuge (63,8%), sem cuidador (60,3%), com dois ou mais filhos (82,7%) e dois ou mais netos (78,8%). Os resultados indicam três grupos com perfil de envelhecimento mais saudável: idosos com 80-84 anos (55,6%), idosos com 85 anos e mais, casados (64,9%) e idosos com 85 anos e mais, sem companheiro e também sem cuidador (54,2%). o perfil de envelhecimento saudável de octogenários pôde ser explicado pela faixa etária, estado civil e presença de cuidador. identificar el perfil de envejecimiento saludable de octogenarios brasileños. estudio epidemiológico de base poblacional que se llevó a cabo por medio de entrevistas domiciliarias en un municipio brasileño con una muestra de 335 octogenarios. Se utilizó un modelo de árbol de decisiones para analizar el perfil de envejecimiento saludable en relación a las características socioeconómicas evaluadas al inicio del estudio. Todos las pruebas consideraron un valor de p<0,05. entre los 335 adultos mayores participantes, la mayoría eran mujeres (62,1%), edades comprendidas entre 80 y 84 años (50,4%), viudos (53,4%), analfabetos (59,1 %), con ingreso mensual inferior del salario mínimo (59,1%), jubilados (85,7%), viviendo con el cónyuge (63,8%), sin cuidador (60,3%), con dos o más hijos (82,7%), y dos o más nietos (78,8%). Los resultados indican tres grupos de edad con perfil de envejecimiento más saludable: adultos mayores de 80-84 años (55,6%), adultos mayores con 85 años o más y casados (64,9%), y adultos mayores con 85 años o más sin pareja y ni cuidador (54,2%). el perfil de envejecimiento saludable de octogenarios se puede explicar por el grupo etario, el estado civil y la presencia de un cuidador.

Effects of supportive telephone counseling in the metabolic control of elderly people with diabetes mellitus.

PubMed

Becker, Tânia Alves Canata; Teixeira, Carla Regina de Souza; Zanetti, Maria Lúcia; Pace, Ana Emília; Almeida, Fábio Araújo; Torquato, Maria Teresa da Costa Gonçalves

2017-01-01

the purpose of this study was to evaluate the efficacy of telephone-based support for the metabolic control of elderly patients with diabetes mellitus. a pragmatic study was conducted in two groups, called G1 (n=36) and G2 (n=27), at a health unit from the countryside of São Paulo state. Patients in G1 group received telephone support over four months, through 16 telephone contacts with educational material; for the G2 group the educational material was mailed. significant differences were found. The G1 group showed a reduction of the parameters of fasting glucose, as well as systolic and diastolic blood pressure. In G2 group a modest reduction was noted in some parameters, with no significant difference. telephone support was effective to deliver patient education to the diabetic elderly, leading to the reduction of fasting blood glucose. This, combined with other strategies, can contribute to reduce glycated hemoglobin (NCT 01972412). avaliar a efetividade do suporte telefônico no controle metabólico de idosos com diabetes mellitus. estudo pragmático com 63 participantes, alocados em dois grupos, denominados G1(n=36) e G2(n=27), em uma unidade de saúde do interior paulista. O suporte telefônico foi oferecido, durante quatro meses, para o G1, por meio de 16 ligações telefônicas com conteúdo educativo, e, para o G2, foram enviadas correspondências por via postal. no G1 houve significância estatística na redução dos parâmetros das variáveis glicemia de jejum, pressão arterial sistólica e diastólica. No G2, houve redução discreta de algumas variáveis, mas sem significância estatística. o suporte telefônico foi considerado uma estratégia educativa efetiva para idosos com diabetes mellitus e favoreceu a redução da glicemia de jejum e, em conjunto com outras estratégias, pode agregar valor na redução da hemoglobina glicada (NCT 01972412).

Self-perception of oral health in older adults from an urban population in Lisbon, Portugal.

PubMed

Carvalho, Catarina; Manso, Ana Cristina; Escoval, Ana; Salvado, Francisco; Nunes, Carla

2016-08-22

To analyze if the self-perception of oral health in the urban context is associated with sociodemographic factors that interfere in the life quality of oral health. Cross-sectional study with convenience sample of older individuals (65 years old or more) enrolled in the Agrupamento de Centros de Saúde de Lisboa Norte (ACES Lisboa Norte - Health Centers Groupings North Lisbon). The self-perception of oral health and associated life quality was evaluated by the Geriatric Oral Health Assessment Index and the individuals were classified according to sociodemographic characteristics. The internal consistency of the questionnaire was evaluated by Cronbach's alpha (α). Later, we used binary logistic regression models to characterize the factors associated with the self-perception of oral health, considering the sociodemographic variables and the older adults' clinical conditions of oral health and establishing the crude and adjusted (to age) odds ratios and their 90% confidence intervals. A total of 369 older adults participated in this study, with an average age of 74.2 years (SD = 6.75); 62.9% were female. On average, the index was moderated, with tendency to be high: 32.9 (SD = 3.6; 12-36 interval). The Cronbach's alpha was high: 0.805. Age, marital status, and the last dental appointment were the factors significantly associated with self-perception of oral health. The study shows that these individuals have a moderate, with tendency to high, self-perception of oral health. The self-perception of oral health assessment allowed us to identify the main associated sociodemographic factors. This instrument can help guiding planning strategies and oral health promotion directed toward a better life quality for this population group. Analisar se a autopercepção de saúde bucal em contexto urbano está associada aos factores sociodemográficos que interferem na qualidade de vida da saúde bucal. Estudo transversal com amostra de conveniência de indivíduos idosos (65 anos ou mais) inscritos no Agrupamento de Centros de Saúde de Lisboa Norte. A autopercepção da saúde bucal e qualidade de vida associada foi avaliada pelo índice de avaliação da saúde bucal em idosos (Geriatric Oral Health Assessment Index) e os indivíduos foram classificados de acordo com as características sociodemográficas. A consistência interna do questionário foi avaliada por meio do alfa (α) de Cronbach. Posteriormente, foram utilizados modelos de regressão logística binária para caracterizar os factores associados com a autopercepção de saúde bucal considerando as variáveis sociodemográficas e de condições clínicas de saúde bucal dos idosos e determinados os odds ratios bruto e ajustado (à idade) e respectivos intervalos de confiança a 90%. Participaram 369 idosos, com média de idade de 74,2 anos (DP = 6,75); 62,9% eram do sexo feminino. Em média, o índice foi moderado com tendência a elevado: 32,9 (DP = 3,6; intervalo 12-36). O alfa de Cronbach foi elevado: 0,805. A idade, o estado civil e a última consulta de Medicina Dentária foram os factores significativamente associados a autopercepção da saúde bucal. O estudo mostra que esses indivíduos apresentam uma autopercepção de saúde bucal moderada, com tendência a elevada. A avaliação da autopercepção da saúde bucal permitiu identificar os principais factores sociodemográficos associados. Este instrumento pode contribuir para orientar as estratégias de planejamento e promoção da saúde bucal direcionadas para uma melhor qualidade de vida deste grupo populacional.

Stress and optimism of elderlies who are caregivers for elderlies and live with children.

PubMed

Oliveira, Nathalia Alves de; Souza, Érica Nestor; Luchesi, Bruna Moretti; Inouye, Keika; Pavarini, Sofia Cristina Iost

2017-01-01

to evaluate the relation between stress and optimism of elderlies who are informal caregivers for elderlies and live with children. cross-sectional study on 50 elderlies who provide care to elderlies, live with children, and are registered in the primary health care. The interviews occurred in the participant's residence and we evaluated characteristics of the care-dependent elderly and of the children, sociodemographic characteristics, stress through the Perceived Stress Scale and optimism through the Pinto and Pais-Ribeiro Spirituality Scale, in the elderly caregiver. For statistical analysis we used the Spearman correlation test. the mean level of stress was 23.9 points and of optimism was 3.3 points. Correlation analysis showed that the higher the level of optimism the significantly lower the level of perceived stress of elderlies who provided care to elderlies and lived with children. inversely proportional correlation was identified between stress and optimism. avaliar a relação entre estresse e otimismo de idosos cuidadores informais de idosos e que residem com crianças. Método: estudo transversal com 50 idosos cuidadores de idosos que residem com crianças e são cadastrados na atenção básica. As entrevistas ocorreram no domicílio do participante e foram avaliadas características do idoso dependente de cuidados e das crianças, características sociodemográficas, estresse por meio da Escala de Estresse Percebido e o otimismo por meio da Escala de Espiritualidade de Pinto e Pais-Ribeiro, no idoso cuidador. Para análise estatística foi utilizado o teste correlação de Spearman. o nível médio de estresse foi de 23,9 pontos e de otimismo foi de 3,3 pontos. A análise de correlação mostrou que quanto maior o nível de otimismo significativamente menor foi o nível de estresse percebido dos idosos cuidadores de idosos que residiam com crianças. foi identificada correlação inversamente proporcional entre estresse e otimismo.

Pseudoaneurisma de aorta abdominal como complicação de pancreatite crônica: relato de caso

PubMed Central

Barbosa, Eduardo Carvalho Horta; Nóbrega, Leonardo Pires de Sá; Rodrigues, Daniel Augusto de Souza; Cunha, Josué Rafael Ferreira; Kalume, Claudio Eluan

2017-01-01

Resumo A pancreatite crônica é uma enfermidade associada a diversas complicações vasculares, como pseudocisto hemorrágico, trombose do sistema venoso portal e formações varicosas e pseudoaneurismáticas. O pseudoaneurisma de aorta abdominal secundário à pancreatite crônica é uma complicação rara, de difícil suspeição clínica, que requer tratamento complexo. A fisiopatologia dessa condição envolve a corrosão enzimática tecidual após a liberação e ativação de enzimas exócrinas proteolíticas das células acinares do pâncreas. O presente estudo relata o caso de um paciente de 52 anos, etilista crônico, internado com dor abdominal difusa, cuja propedêutica revelou se tratar de um pseudoaneurisma em aorta infrarrenal. Optou-se pelo tratamento cirúrgico convencional, levando-se em consideração a idade, as condições clínicas do paciente e a disponibilidade de endopróteses compatíveis com o diâmetro da aorta. PMID:29930654

Content validity of the Geriatric Health Assessment Instrument.

PubMed

Pedreira, Rhaine Borges Santos; Rocha, Saulo Vasconcelos; Santos, Clarice Alves Dos; Vasconcelos, Lélia Renata Carneiro; Reis, Martha Cerqueira

2016-01-01

Assess the content validity of the Elderly Health Assessment Tool with low education. The data collection instrument/questionnaire was prepared and submitted to an expert panel comprising four healthcare professionals experienced in research on epidemiology of aging. The experts were allowed to suggest item inclusion/exclusion and were asked to rate the ability of individual items in questionnaire blocks to encompass target dimensions as "not valid", "somewhat valid" or "valid", using an interval scale. Percent agreement and the Content Validity Index were used as measurements of inter-rater agreement; the minimum acceptable inter-rater agreement was set at 80%. The mean instrument percent agreement rate was 86%, ranging from 63 to 99%, and from 50 to 100% between and within blocks respectively. The Mean Content Validity Index score was 93.47%, ranging from 50 to 100% between individual items. The instrument showed acceptable psychometric properties for application in geriatric populations with low levels of education. It enabled identifying diseases and assisted in choice of strategies related to health of the elderly. Avaliar a validade de conteúdo do Instrumento de Avaliação da Saúde do Idoso com baixa escolaridade. Após a elaboração do instrumento de coleta de dados, o questionário foi submetido à avaliação de um comitê de especialistas, formado por quatro profissionais da área da saúde com experiência em pesquisas da epidemiologia do envelhecimento. Os especialistas puderam sugerir questões a serem incluídas/excluídas do instrumento, e avaliar cada bloco do questionário, observando se as dimensões a serem avaliadas foram abrangidas pelos itens do instrumento, em escala intervalar, como "não válida", "pouco válida" e "válida". Como medidas para avaliar o grau de concordância do instrumento, foram utilizados o porcentual de concordância e o Índice de Validade de Conteúdo. Considerou-se uma taxa aceitável de concordância o valor de 80%. O instrumento apresentou taxa média de concordância de 86%, variando, dentre os blocos, de 63 a 99% e, dentre os itens, de 50 a 100%. O Índice de Validade de Conteúdo apresentou escore médio de 93,47% e, dentre os itens do questionário, de 50 a 100%. O instrumento apresentou qualidades psicométricas aceitáveis para ser utilizado entre a população de idosos com baixa escolaridade, permitindo a identificação dos agravos e auxiliando na escolha de estratégias, no que diz respeito à saúde do idoso.

Nurses' knowledge to identify early acute kidney injury.

PubMed

Nascimento, Roseli Aparecida Matheus do; Assunção, Murillo Santucci Cesar; Silva, João Manoel; Amendola, Cristina Prata; Carvalho, Taysa Martindo de; Lima, Emerson Quintino; Lobo, Suzana Margareth Ajeje

2016-01-01

To evaluate the knowledgeof nurses on early identification of acute kidney injury (AKI) in intensive care, emergency and hospitalization units. A prospective multi-center study was conducted with 216 nurses, using a questionnaire with 10 questions related to AKI prevention, diagnosis, and treatment. 57.2% of nurses were unable to identify AKI clinical manifestations, 54.6% did not have knowledge of AKI incidence in patients admitted to the ICU, 87.0% of the nurses did not know how to answer as regards the AKI mortality rate in patients admitted to the ICU, 67.1% answered incorrectly that slight increases in serum creatinine do not have an impact on mortality, 66.8% answered incorrectly to the question on AKI prevention measures, 60.4% answered correctly that loop diuretics for preventing AKI is not recommended, 77.6% answered correctly that AKI does not characterize the need for hemodialysis, and 92.5% said they had no knowledge of the Acute Kidney Injury Networkclassification. Nurses do not have enough knowledge to identify early AKI, demonstrating the importance of qualification programs in this field of knowledge. Avaliar o conhecimento do enfermeiro na identificação precoce da Injúria Renal Aguda (IRA) em Unidade de Terapia Intensiva, Unidade de Internação e Emergência. Estudo multicêntrico, prospectivo.Participaram do estudo 216 enfermeiros,por meio de questionário com 10 questões relacionadas à prevenção, ao diagnóstico e ao tratamento da IRA. 57,2% não souberam identificar as manifestações clínicas da IRA, 54,6% não têm conhecimento da incidência de IRA em pacientes internados na UTI, 87,0% dos enfermeiros não souberam responder ao índice de mortalidade de IRA em pacientes internados na UTI, 67,1% responderam incorretamente que aumentos discretos da creatinina sérica não têm impacto na mortalidade, 66,8% responderam incorretamente à questão sobre as medidas de prevenção da IRA, 60,4% acertaram quando responderam que não é recomendada a utilização de diuréticos de alça na prevenção da IRA, 77,6% acertaram ao responder que IRA não caracteriza necessidade de hemodiálise e 92,5% disseram não conhecer a classificação AKIN. Enfermeiros não têm conhecimento suficiente para a identificação precoce da IRA, mostrando a importância de programas de capacitação nesta área do conhecimento.

Severity and workload related to adverse events in the ICU.

PubMed

Serafim, Clarita Terra Rodrigues; Dell'Acqua, Magda Cristina Queiroz; Castro, Meire Cristina Novelli E; Spiri, Wilza Carla; Nunes, Hélio Rubens de Carvalho

2017-01-01

To analyze whether an increase in patient severity and nursing workload are correlated to a greater incidence of adverse events (AEs) in critical patients. A prospective single cohort study was performed on a sample of 138 patients hospitalized in an intensive care unit (ICU). A total of 166 AEs, occurred, affecting 50.7% of the patients. Increased patient severity presented a direct relationship to the probability of AEs occurring. However, nursing workload did not present a statistically significant relationship with the occurrence of AEs. The results cast light on the importance of using evaluation tools by the nursing personnel in order to optimize their daily activities and focus on patient safety. Analisar se o aumento da gravidade do paciente e a carga de trabalho de enfermagem está relacionado à maior incidência de Eventos Adversos (EAs) em pacientes críticos. Estudo de coorte única, prospectivo, com amostra de 138 pacientes internados em uma Unidade de Terapia Intensiva (UTI). Ao todo, foram evidenciados 166 EAs, que acometeram 50,7% dos pacientes. O aumento da gravidade do paciente apresentou relação direta com a chance de ocorrência de EAs. Entretanto, a carga de trabalho de enfermagem não apresentou relação estatisticamente significativa, na ocorrência de EAs. Os resultados permitem refletir acerca da importância da equipe de enfermagem, em utilizar instrumentos de avaliação, com o objetivo de melhorar e planejar suas ações diárias, com foco na segurança do paciente.

Effects that passive cycling exercise have on muscle strength, duration of mechanical ventilation, and length of hospital stay in critically ill patients: a randomized clinical trial.

PubMed

Machado, Aline Dos Santos; Pires-Neto, Ruy Camargo; Carvalho, Maurício Tatsch Ximenes; Soares, Janice Cristina; Cardoso, Dannuey Machado; Albuquerque, Isabella Martins de

2017-01-01

To evaluate the effects that passive cycling exercise, in combination with conventional physical therapy, have on peripheral muscle strength, duration of mechanical ventilation, and length of hospital stay in critically ill patients admitted to the ICU of a tertiary care university hospital. This was a randomized clinical trial involving 38 patients (≥ 18 years of age) on mechanical ventilation who were randomly divided into two groups: control (n = 16), receiving conventional physical therapy; and intervention (n = 22), receiving conventional physical therapy and engaging in passive cycling exercise five days per week. The mean age of the patients was 46.42 ± 16.25 years, and 23 were male. The outcomes studied were peripheral muscle strength, as measured by the Medical Research Council scale, duration of mechanical ventilation, and length of hospital stay. There was a significant increase in peripheral muscle strength (baseline vs. final) in both groups (control: 40.81 ± 7.68 vs. 45.00 ± 6.89; and intervention: 38.73 ± 11.11 vs. 47.18 ± 8.75; p < 0.001 for both). However, the range of increase in strength was higher in the intervention group than in the control group (8.45 ± 5.20 vs. 4.18 ± 2.63; p = 0.005). There were no significant differences between the groups in terms of duration of mechanical ventilation or length of hospital stay. The results suggest that the performance of continuous passive mobilization on a cyclical basis helps to recover peripheral muscle strength in ICU patients. (ClinicalTrials.gov Identifier: NCT01769846 [http://www.clinicaltrials.gov/]). Avaliar os efeitos da realização de exercícios passivos com um cicloergômetro, associada à fisioterapia convencional, na força muscular periférica, no tempo de ventilação mecânica e no tempo de internação hospitalar em pacientes críticos internados em UTI de um hospital universitário terciário. Ensaio clínico randomizado envolvendo 38 pacientes (idade > 18 anos) em ventilação mecânica e divididos aleatoriamente em grupo controle (n = 16), que realizou fisioterapia convencional, e grupo intervenção (n = 22) submetidos a fisioterapia convencional e exercícios passivos em cicloergômetro cinco vezes por semana. A média de idade dos pacientes foi de 46,42 ± 16,25 anos, e 23 eram homens. Os desfechos analisados foram força muscular periférica, mensurada pela escala Medical Research Council, tempo de ventilação mecânica e tempo de internação hospitalar. Houve um aumento significativo da força muscular periférica (basal vs. final) tanto no grupo controle (40,81 ± 7,68 vs. 45,00 ± 6,89; p < 0,001) quanto no grupo intervenção (38,73 ± 11,11 vs. 47,18 ± 8,75; p < 0,001). Entretanto, a variação do aumento da força foi maior no grupo intervenção que no controle (8,45 ± 5,20 vs. 4,18 ± 2,63; p = 0,005). Não foram observadas diferenças significativas entre os grupos quanto ao tempo de ventilação mecânica e tempo de internação hospitalar. Os resultados sugerem que a realização de mobilização passiva contínua de forma cíclica auxilia na recuperação da força muscular periférica de pacientes internados em UTI. (ClinicalTrials.gov Identifier: NCT01769846 [http://www.clinicaltrials.gov/]).

Needs of family caregivers in home care for older adults.

PubMed

Bierhals, Carla Cristiane Becker Kottwitz; Santos, Naiana Oliveira Dos; Fengler, Fernanda Laís; Raubustt, Kamila Dellamora; Forbes, Dorothy Anne; Paskulin, Lisiane Manganelli Girardi

2017-04-06

to reveal the felt and normative needs of primary family caregivers when providing instrumental support to older adults enrolled in a Home Care Program in a Primary Health Service in the South of Brazil. using Bradshaw's taxonomy of needs to explore the caregiver's felt needs (stated needs) and normative needs (defined by professionals), a mixed exploratory study was conducted in three steps: Descriptive quantitative phase with 39 older adults and their caregiver, using a data sheet based on patient records; Qualitative exploratory phase that included 21 caregiver interviews, analyzed by content analysis; Systematic observation, using an observation guide with 16 caregivers, analyzed by descriptive statistics. the felt needs were related to information about instrumental support activities and subjective aspects of care. Caregivers presented more normative needs related to medications care. understanding caregivers' needs allows nurses to plan interventions based on their particularities. identificar as necessidades sentidas e normativas dos cuidadores familiares principais no apoio instrumental a idosos registrados em um Programa de Atenção Domiciliar em uma Unidade Básica de Saúde no Sul do Brasil. usando a Taxonomia de Necessidades de Bradshaw para explorar as necessidades sentidas (necessidades declaradas) e normativas (definidas por profissionais), desenvolveu-se um estudo exploratório misto em três etapas: Etapa descritiva quantitativa, envolvendo 39 idosos e seus cuidadores, com a ajuda de um folha de dados baseada no prontuário do paciente; Etapa exploratória qualitativa, baseada em entrevistas com 21 cuidadores, analisadas mediante a análise de conteúdo; Observação sistemática, aplicando um roteiro de observação a 16 cuidadores, com análise estatística descritiva. as necessidades sentidas estavam relacionadas a informações sobre atividades de apoio instrumental e aspectos subjetivos do cuidado. Os cuidadores apresentaram maior número de necessidades normativas associadas ao cuidado com as medicações. compreender as necessidades dos cuidadores permite aos enfermeiros planejar intervenções baseadas em suas particularidades. descubrir las necesidades sentidas y normativas de los cuidadores primarios familiares en la prestación de apoyo instrumental a ancianos registrados en un Programa de Atención Domiciliaria en una Unidad Básica de Salud en el sur de Brasil. usando la Taxonomía de Necesidades de Bradshaw para explorar las necesidades sentidas (necesidades declaradas) y normativas (definidas por profesionales), fue desarrollado un estudio exploratorio mixto en tres etapas: Etapa descriptiva cuantitativa, involucrando 39 ancianos y sus cuidadores, mediante una hoja de datos basada en el archivo del paciente; Etapa exploratoria cualitativa, basada en entrevistas con 21 cuidadores, analizadas mediante el análisis de contenido; Observación sistemática, aplicando un manual de observación a 16 cuidadores, con análisis estadístico descriptivo. las necesidades sentidas estaban relacionadas a informaciones sobre actividades de apoyo instrumental y aspectos subjetivos de la atención. Los cuidadores presentaron mayor número de necesidades normativas asociadas al cuidado con medicaciones. comprender las necesidades de los cuidadores permite a los enfermeros planificar intervenciones basadas en sus particularidades.

Zarit Burden Interview Psychometric Indicators Applied in Older People Caregivers of Other Elderly.

PubMed

Bianchi, Mariana; Flesch, Leticia Decimo; Alves, Erika Valeska da Costa; Batistoni, Samila Sathler Taveres; Neri, Anita Liberalesso

2016-11-28

to derive psychometric indicators of construct validity and internal consistence of the Zarit Burden Interview scale for caregivers, describing associations of the scale with metrics related to care demands, coping strategies and depression in aged caregivers. crosscutting descriptive and correlational study. The convenience sample was composed by a hundred and twenty one senior caregivers (Avg=70.5 ± 7.2 years, 73% women). They answered a questionnaire to check the physical and cognitive demands of care, the Zarit Burden Interview (ZBI), the California Inventory of Coping Strategies and the Geriatric Depression Scale (GDS-15). ZBI showed good internal consistency and also for the three factors emerging from factor analysis, explaining 44% of variability. ZBI is positively related with objective care demands (p < 0.001), depression (p = 0.006) and use of dysfunctional coping strategies (p = 0.0007). ZBI is of interest to be applied to aged caregivers and the association of higher degrees of burden, dysfunctional coping and depression show a vulnerability scenario that may affect to older people taking care of other elderly. derivar indicadores psicométricos de validade de construto e consistência interna da escala de sobrecarga de cuidadores de Zarit Burden Interview e descrever associações desta com medidas referentes às demandas de cuidado, estratégias de enfrentamento e depressão em cuidadores idosos. estudo descritivo, transversal e correlacional. Cento e vinte e um cuidadores idosos (M= 70,5 ± 7,2 anos, 73% feminino) compuseram uma amostra de conveniência e responderam a um protocolo de pesquisa para levantamento de demandas de cuidado de natureza física e cognitiva, à Zarit Burden Interview (ZBI), ao Inventário de Estratégias de Enfrentamento da Califórnia e à Escala de Depressão Geriátrica (GDS-15). a ZBI revelou bons índices de consistência interna e para os três fatores resultantes da análise fatorial, os quais explicaram 44% da variabilidade. A ZBI correlacionou-se positivamente com demandas de cuidado objetivas (p < 0,001), depressão (p = 0,006) e uso de estratégias de enfrentamento disfuncionais (p = 0,0007). a ZBI revela-se interessante para a aplicação a cuidadores idosos e as associações entre altos graus de sobrecarga, enfrentamento disfuncional e depressão apontam um cenário peculiar de vulnerabilidade a que este idoso que cuida de outro idoso pode estar exposto. obtener indicadores psicométricos de validez de constructo y consistencia interna de la escala de sobrecarga de cuidadores Zarit Burden Interview y describir asociaciones de ésta con medidas referentes a demandas de cuidado, estrategias de enfrentamiento y depresión, en cuidadores ancianos. estudio descriptivo, transversal y correlacional. Ciento veinte y un cuidadores ancianos (P = 70,5 ± 7,2 años, 73% femenino) compusieron una muestra de conveniencia, los que respondieron a protocolos de investigación, para levantamiento de demandas de cuidado de naturaleza física y cognitiva, a través de: la Zarit Burden Interview (ZBI), el Inventario de Estrategias de Enfrentamiento de California y la Escala de Depresión Geriátrica (GDS-15). la ZBI reveló buenos índices de consistencia interna para los tres factores resultantes del análisis factorial que explicaron 44% de la variabilidad. La ZBI se correlacionó positivamente con demandas de cuidado específicas (p < 0,001): depresión (p = 0,006) y uso de estrategias de enfrentamiento disfuncionales (p = 0,0007). la ZBI se revela interesante para explicar los cuidadores ancianos y las asociaciones entre altos grados de sobrecarga, enfrentamiento disfuncional y depresión; los resultados apuntan un escenario peculiar de vulnerabilidad a la que éste anciano, que cuida de otro anciano, puede estar expuesto.

Neuropsychiatric symptoms of the elderly with Alzheimer's disease and the family caregivers' distress.

PubMed

Storti, Luana Baldin; Quintino, Débora Teles; Silva, Natália Michelato; Kusumota, Luciana; Marques, Sueli

2016-08-15

to analyze the relationship between the distress of the family caregiver and the presence of neuropsychiatric symptoms in elderly patients with Alzheimer's disease or mixed dementia. a descriptive, cross-sectional study conducted in the Geriatric and Dementias Clinic of a general tertiary hospital, with 96 elderly people with Alzheimer's disease or mixed dementia and their family caregivers. Questionnaires to characterize the elderly and caregivers, and the Neuropsychiatric Inventory were used. Descriptive statistics and Pearson correlation test were performed. 68.7% of the elderly were women, average age 80.8 years, 56.2% had Alzheimer's disease and 43.7%, mixed dementia. Among caregivers, 90.6% were women, average age 56, 70.8% took care of parents and 64.6% lived with the elderly. There was a strong (r = 0.82) and significant (p <0.01) correlation between the total score on the Neuropsychiatric Inventory and the total score on the Neuropsychiatric Inventory-Distress and strong (r = 0.80) and significant (p <0 01) correlation between the total score on the Neuropsychiatric Inventory Distress and the number of neuropsychiatric symptoms, i.e., the higher the number, frequency and severity of these symptoms in the elderly, the more intense is the caregiver distress. the presence of neuropsychiatric symptoms in the elderly was related to increased distress in caregivers. analisar a relação entre o desgaste do cuidador familiar e a presença de sintomas neuropsiquiátricos em idosos com doença de Alzheimer ou demência mista. estudo descritivo, transversal, realizado no Ambulatório de Geriatria e Demências de um Hospital Geral Terciário, com 96 idosos com doença de Alzheimer ou demência mista e seus cuidadores familiares. Foram utilizados o questionário para caracterização dos idosos e cuidadores e o Inventário Neuropsiquiátrico. Foram realizadas estatísticas descritivas e o teste de correlação de Pearson. 68,7% dos idosos eram mulheres, média de idade 80,8 anos, 56,2% possuíam doença de Alzheimer e 43,7%, demência mista. Dos cuidadores, 90,6% eram mulheres, média de idade 56 anos, 70,8% cuidavam do pai/mãe e 64,6% moravam com o idoso. Houve correlação forte (r=0,82) e significativa (p<0,01) entre o escore total do Inventário Neuropsiquiátrico e o escore total do Inventário Neuropsiquiátrico Desgaste e correlação forte (r=0,80) e significativa (p<0,01) entre o escore total do Inventário Neuropsiquiátrico Desgaste e o número de sintomas neuropsiquiátricos, ou seja, quanto maiores o número, a frequência e a gravidade destes sintomas nos idosos maior é o desgaste do cuidador. a presença dos sintomas neuropsiquiátricos nos idosos apresentou relação com maior desgaste nos cuidadores. analizar la relación entre el desgaste del cuidador familiar y la presencia de síntomas neuropsiquiátricos en pacientes ancianos con enfermedad de Alzheimer o demencia mixta. estudio descriptivo, transversal, realizado en la clínica de Geriatría y Demencias de un hospital general terciario, con 96 ancianos con enfermedad de Alzheimer o demencia mixta y sus cuidadores familiares. Se utilizaron cuestionarios para caracterizar los ancianos y cuidadores y el Inventario Neuropsiquiátrico. Se realizaron estadísticas descriptivas y prueba de correlación de Pearson. el 68,7% de los ancianos eran mujeres, con una edad promedio de 80,8 años, el 56,2% tenían enfermedad de Alzheimer y el 43,7%, demencia mixta. Entre los cuidadores, el 90,6% eran mujeres, con una media de 56 años, el 70,8% se hacía cargo del padre / madre y el 64,6% vivía con los ancianos. Hubo una fuerte (r = 0,82) y significativa (p <0,01) correlación entre la puntuación total en el Inventario Neuropsiquiátrico y la puntuación total en el Inventario Neuropsiquiátrico-Desgaste y fuerte correlación (r = 0,80) y significativa (p <0 01) entre la puntuación total en el Inventario Neuropsiquiátrico-Desgaste y el número de síntomas neuropsiquiátricos, es decir, cuanto mayor sea el número, la frecuencia y la severidad de estos síntomas en los ancianos, mayor es el desgaste del cuidador. la presencia de síntomas neuropsiquiátricos en los ancianos estaban relacionados con un mayor desgaste en los cuidadores.

Informal and paid care for Brazilian older adults (National Health Survey, 2013).

PubMed

Lima-Costa, Maria Fernanda; Peixoto, Sérgio Viana; Malta, Deborah Carvalho; Szwarcwald, Célia Landmann; Mambrini, Juliana Vaz de Melo

2017-06-01

To describe the prevalence and sociodemographic factors associated with informal and paid care for Brazilian older adults with functional limitations. Of the 23,815 participants of the National Health Survey aged 60 or older, 5,978 reported needing help to perform activities of daily living and were included in this analysis. The dependent variable was the source of care, categorized as exclusively informal (unpaid), exclusively formal (paid), mixed or none. The socio-demographic variables were age (60-64, 65-74, ≥ 75 years old), gender and number of residents in the household (1, 2, ≥ 3). The multivariate analysis was based on binomial and multinomial logistic regressions. Informal care predominated (81.8%), followed by paid (5.8%) or mixed (6.8%) and no care (5.7%). The receipt of care from any source increased gradually with the number of residents in a same household, regardless of age and gender (OR = 4.85 and 9.74 for 2 and ≥ 3, respectively). Age was positively associated with receiving any care while the male gender showed a negative association. The number of residents in the household showed the strongest association with informal care (OR = 10.94 for ≥ 3 residents), compared with paid (OR = 5.48) and mixed (OR = 4.16) care. Informal care is the main source of help for community-dwelling older adults with functional limitations. In a context of rapid population aging and decline in family size, the results reinforce the need for policies to support long-term care for older Brazilians. Descrever a prevalência e fatores sociodemográficos associados à ajuda informal e remunerada a idosos com limitações funcionais. Dos 23.815 participantes com 60 anos ou mais da Pesquisa Nacional de Saúde, 5.978 declararam necessitar de ajuda para realizar atividades da vida diária e foram incluídos nesta análise. A variável dependente foi a fonte de ajuda, categorizada como exclusivamente informal (não remunerada), exclusivamente remunerada, mista ou nenhuma. Os fatores sociodemográficos foram idade (60-64, 65-74, ≥ 75 anos), sexo e número de moradores no domicílio (1, 2, ≥ 3). A análise multivariada foi baseada nas regressões logísticas binomial e multinomial. A ajuda informal predominou (81,8%), seguida pela remunerada (5,8%) ou mista (6,8%) e nenhuma (5,7%). A propensão ao recebimento da ajuda por qualquer fonte aumentou gradativamente com o número de moradores no domicílio, independentemente da idade e do sexo (OR = 4,85 e 9,74 para 2 e ≥ 3 moradores, respectivamente). A idade apresentou associação positiva e o sexo masculino apresentou associação negativa com o recebimento de qualquer ajuda. O número de moradores no domicílio apresentou associação mais forte com a ajuda informal (OR = 10,94 para ≥ 3 moradores), em comparação à ajuda remunerada (OR = 5,48) e mista (OR = 4,16). O cuidado informal é a principal fonte de ajuda domiciliar aos idosos com limitações funcionais. Em um contexto de rápido envelhecimento populacional e diminuição do tamanho das famílias, os resultados reforçam a necessidade de políticas para garantir o cuidado domiciliar aos idosos com limitações funcionais.

Socioeconomic determinants of access to health services among older adults: a systematic review.

PubMed

Almeida, Ana Paula Santana Coelho; Nunes, Bruno Pereira; Duro, Suele Manjourany Silva; Facchini, Luiz Augusto

2017-05-15

The objective of this study was to analyze the association between the socioeconomic characteristics and the access to or use of health services among older adults. This is a systematic review of the literature. The search has been carried out in the databases PubMed, LILACS and Web of Science, without restriction of dates and languages; however we have included only articles published in Portuguese, English, and Spanish. The inclusion criteria were: observational design, socioeconomic factors as variables of interest in the analysis of the access to or use of health services among older adults, representative sample of the target population, adjustment for confounding factors, and no selection bias. We have found 5,096 articles after deleting duplicates and 36 of them have been selected for review after the process of reading and evaluating the inclusion criteria. Higher income and education have been associated with the use and access to medical appointments in developing countries and some developed countries. The same association has been observed in dental appointments in all countries. Most studies have shown no association between socioeconomic characteristics and the use of inpatient and emergency services. We have identified greater use of home visits in lower-income individuals, with the exception of the United States. We have observed an unequal access to or use of health services in most countries, varying according to the type of service used. The expansion of the health care coverage is necessary to reduce this unequal access generated by social inequities. Analisar a associação entre características socioeconômicas e acesso ou utilização de serviços de saúde entre idosos. Revisão sistemática da literatura. A busca foi realizada nas bases de dados PubMed, Lilacs e Web of Science, sem restrição de datas e idiomas, entretanto foram incluídos somente os artigos publicados em português, inglês e espanhol. Foram critérios de inclusão: ter delineamento observacional; possuir os fatores socioeconômicos como variáveis de interesse na análise do acesso ou utilização de serviços de saúde entre idosos; ter amostra representativa da população alvo; fazer ajuste para fatores de confusão; e não apresentar viés de seleção. Foram encontrados 5.096 artigos após a exclusão de duplicidades e 36 foram selecionados para a revisão após o processo de leitura e avaliação dos critérios de inclusão. Maior renda e escolaridade estiveram associadas à utilização e acesso a consultas médicas nos países em desenvolvimento e em alguns países desenvolvidos. A mesma associação foi observada nas consultas odontológicas em todos os países. A maioria dos estudos não apresentou associação entre características socioeconômicas e uso de serviços de internação e emergência. Foi identificado maior uso de visita domiciliar em indivíduos de menor renda, com exceção dos Estados Unidos. Observou-se desigualdade no acesso ou na utilização de serviços de saúde na maior parte dos países, variando em relação ao tipo de serviço utilizado. A ampliação da cobertura de serviços de saúde faz-se necessária para a redução da desigualdade no acesso gerada por iniquidades sociais.

Living arrangements of the elderly and the sociodemographic and health determinants: a longitudinal study.

PubMed

Bolina, Alisson Fernandes; Tavares, Darlene Mara Dos Santos

2016-08-08

to describe the sociodemographic characteristics and the number of morbidities in the elderly, according to the dynamics of living arrangements and evaluate the sociodemographic and health determinants of the living arrangements. this is a household longitudinal survey (2005-2012), carried out with 623 elderly people. Descriptive statistical analysis and multinomial logistic regression were performed (p<0.05). there was predominance of elderly living alone, accompanied and with change in the living arrangements, females, age range between 60├ 70 years, 1├ 4 years of study and with income between 1├┤ 3 minimum wages. During the development of this research, it was identified an increase in the incidence of elderly with 1├┤3 minimum wages. The number of morbidities increased in the three groups throughout the study, with the highest rates observed among the elderly with change in the dynamics of living arrangements. It was found that elderly men showed less chance of living alone (p=0.007) and having change in the living arrangements compared to women (p = 0.005). Incomes less than a minimum wage decreased the chances of change in the living arrangements compared to incomes above three salaries (p=0.034). the determining factors of the living arrangements were sex and income, and the variables functional capacity and number of morbidities were not associated with the outcome analyzed. descrever as características sociodemográficas e o número de morbidades de idosos, segundo a dinâmica do arranjo domiciliar; e verificar os determinantes sociodemográficos e de saúde do arranjo domiciliar. trata-se de uma pesquisa domiciliar e longitudinal (2005-2012), conduzida com 623 idosos. Foi realizada análise estatística descritiva e regressão logística multinomial (p<0,05). predominaram, idosos que moram sozinhos, acompanhados e com mudança do arranjo domiciliar, do sexo feminino, faixa etária 60├ 70 anos, 1├ 4 anos de estudo e com renda entre 1├┤ 3 salários mínimos. Durante o desenvolvimento dessa pesquisa, identificou-se uma elevação da distribuição de idosos com 1├┤3 salários mínimos. O número de morbidades aumentou nos três grupos ao longo do estudo, com maiores taxas entre os idosos que mudaram a dinâmica do arranjo domiciliar. Verificou-se que idosos do sexo masculino apresentaram menores chances de morar sozinhos (p=0,007) e mudar o arranjo domiciliar comparados às mulheres (p = 0,005). Ganhar menos de um salário mínimo diminuiu as chances de mudança do arranjo domiciliar em relação aos que ganham mais de três salários (p=0,034). os fatores determinantes do arranjo domiciliar foram o sexo e a renda, sendo que as variáveis capacidade funcional e número de morbidades não estiveram associadas ao desfecho analisado. describir las características sociodemográficas y el número de enfermedades concomitantes de ancianos, según la dinámica de la acomodación domiciliaria; y verificar los determinantes sociodemográficos y de salud del espacio domiciliario. se trata de una investigación domiciliaria y longitudinal (2005-2012), realiza con 623 ancianos. Fue realizado análisis estadístico descriptivo y regresión logística multinomial (p<0,05). predominaron, ancianos que viven solos, acompañados y con cambio de acomodación domiciliaria, del sexo femenino, intervalo etario 60├ 70 años, 1├ 4 años de estudio y con ingreso mensual entre 1├┤3 sueldos mínimos. Durante el desarrollo de la investigación, se identificó una aumento en la distribución de ancianos de 1├┤3 sueldos mínimos. El número de enfermedades concomitantes aumentó en los tres grupos a lo largo del estudio, con mayores tasas entre los ancianos que cambiaron la dinámica de la acomodación domiciliaria. Se verificó que ancianos del sexo masculino presentaron menores probabilidades de vivir solos (p=0,007) y de cambiar la acomodación domiciliaria, comparados a las mujeres (p = 0,005). Ganar menos de un salario mínimo disminuye las probabilidades de cambiar la acomodación domiciliaria en relación a los que ganan más de tres sueldos (p=0,034). los factores determinantes de la acomodación domiciliaria fueron el sexo y la ingreso mensual, siendo que las variables capacidad funcional y número de enfermedades concomitantes, no estuvieron asociadas al resultado analizado.

Drug-drug interactions and adverse drug reactions in polypharmacy among older adults: an integrative review.

PubMed

Rodrigues, Maria Cristina Soares; Oliveira, Cesar de

2016-09-01

to identify and summarize studies examining both drug-drug interactions (DDI) and adverse drug reactions (ADR) in older adults polymedicated. an integrative review of studies published from January 2008 to December 2013, according to inclusion and exclusion criteria, in MEDLINE and EMBASE electronic databases were performed. forty-seven full-text studies including 14,624,492 older adults (≥ 60 years) were analyzed: 24 (51.1%) concerning ADR, 14 (29.8%) DDI, and 9 studies (19.1%) investigating both DDI and ADR. We found a variety of methodological designs. The reviewed studies reinforced that polypharmacy is a multifactorial process, and predictors and inappropriate prescribing are associated with negative health outcomes, as increasing the frequency and types of ADRs and DDIs involving different drug classes, moreover, some studies show the most successful interventions to optimize prescribing. DDI and ADR among older adults continue to be a significant issue in the worldwide. The findings from the studies included in this integrative review, added to the previous reviews, can contribute to the improvement of advanced practices in geriatric nursing, to promote the safety of older patients in polypharmacy. However, more research is needed to elucidate gaps. identificar e sintetizar estudos que examinam as interações medicamentosas (IM) e reações adversas a medicamentos (RAM) em idosos polimedicados. revisão integrativa de estudos publicados de janeiro de 2008 a dezembro de 2013, de acordo com critérios de inclusão e exclusão, nas bases de dados eletrônicas MEDLINE e EMBASE. foram analisados 47 estudos de texto completo, incluindo 14,624,492 idosos (≥ 60 anos): 24 (51,1%) sobre RAM, 14 (29,8%) sobre IM e 9 estudos (19,1%) que investigaram tanto IM como RAM. Encontramos uma variedade de desenhos metodológicos. Os estudos revisados reforçaram que a polifarmácia é um processo multifatorial, e os preditores e a prescrição inadequada estão associados a resultados negativos de saúde, como aumento da frequência e tipos de RAM e IM envolvendo diferentes classes de drogas, além disso, alguns estudos mostram as intervenções mais bem-sucedidas para otimizar a prescrição. IM e RAM entre idosos continuam a ser um problema significativo no mundo todo. Os resultados dos estudos incluídos nesta revisão integrativa, adicionado às revisões anteriores, podem contribuir para a melhoria das práticas avançadas de enfermagem geriátrica, para promover a segurança dos pacientes idosos em polifarmácia. No entanto, são necessárias mais pesquisas para elucidar lacunas. identificar y resumir los estudios que analizan tanto las interacciones medicamentosas (IM) como las reacciones adversas a medicamentos (RAM) en los adultos mayores polimedicados. revisión integradora de estudios publicados entre enero de 2008 a diciembre de 2013, siguiendo criterios de inclusión y exclusión, en las bases de datos electrónicas MEDLINE y EMBASE. cuarenta y siete estudios de texto completo incluidos fueron analizados incluyendo 14,624,492 adultos mayores (≥ 60 años), de ellos 24 (51,1%) en relación con RAM, 14 (29,9%) con IM y 9 estudios (19,1%) que investigaron tanto IM como RAM. Encontramos una gran variedad de diseños metodológicos. Los estudios revisados reforzaron el concepto que la polifarmacia es un proceso multifactorial, y los predictores y la prescripción inadecuada se asocian con resultados negativos para la salud tales como el aumento de la frecuencia y tipos de RAM y IM implicando diferentes clases de fármacos, además que algunos estudios muestran cuales son las intervenciones más exitosas para optimizar la prescripción. IM y RAM siguen siendo un problema importante en el mundo entero entre los adultos mayores. Los resultados de los estudios incluidos en esta revisión integradora, sumado a las revisiones previas, pueden contribuir a la mejora de las prácticas avanzadas de enfermería geriátrica, para promover la seguridad de los pacientes de mayor edad en la polifarmacia. Sin embargo, se necesita más investigación para esclarecer los vacíos de conocimiento.

Test-retest reliability of Brazilian version of Memorial Symptom Assessment Scale for assessing symptoms in cancer patients.

PubMed

Menezes, Josiane Roberta de; Luvisaro, Bianca Maria Oliveira; Rodrigues, Claudia Fernandes; Muzi, Camila Drumond; Guimarães, Raphael Mendonça

2017-01-01

To assess the test-retest reliability of the Memorial Symptom Assessment Scale translated and culturally adapted into Brazilian Portuguese. The scale was applied in an interview format for 190 patients with various cancers type hospitalized in clinical and surgical sectors of the Instituto Nacional de Câncer José de Alencar Gomes da Silva and reapplied in 58 patients. Data from the test-retest were double typed into a Microsoft Excel spreadsheet and analyzed by the weighted Kappa. The reliability of the scale was satisfactory in test-retest. The weighted Kappa values obtained for each scale item had to be adequate, the largest item was 0.96 and the lowest was 0.69. The Kappa subscale was also evaluated and values were 0.84 for high frequency physic symptoms, 0.81 for low frequency physical symptoms, 0.81 for psychological symptoms, and 0.78 for Global Distress Index. High level of reliability estimated suggests that the process of measurement of Memorial Symptom Assessment Scale aspects was adequate. Avaliar a confiabilidade teste-reteste da versão traduzida e adaptada culturalmente para o português do Brasil do Memorial Symptom Assessment Scale. A escala foi aplicada em forma de entrevista em 190 pacientes com diversos tipos de câncer internados nos setores clínicos e cirúrgicos do Instituto Nacional de Câncer José de Alencar Gomes da Silva e reaplicada em 58 pacientes. Os dados dos testes-retestes foram inseridos num banco de dados por dupla digitação independente em Excel e analisados pelo Kappa ponderado. A confiabilidade da escala mostrou-se satisfatória nos testes-retestes. Os valores do Kappa ponderado obtidos para cada item da escala apresentaram-se adequados, sendo o maior item de 0,96 e o menor de 0,69. Também se avaliou o Kappa das subescalas, sendo de 0,84 para sintomas físicos de alta frequência, de 0,81 para sintomas físicos de baixa frequência, de 0,81 também para sintomas psicológicos, e de 0,78 para Índice Geral de Sofrimento. Altos níveis de confiabilidade estimados permitem concluir que o processo de aferição dos itens do Memorial Symptom Assessment Scale foi adequado.

Sociodemographic and health factors associated with mortality in community-dwelling elderly.

PubMed

Borim, Flávia Silva Arbex; Francisco, Priscila Maria Stolses Bergamo; Neri, Anita Liberalesso

2017-05-04

The objective of this study is to identify factors associated with mortality, with emphasis on gender and age differences. This is a cross-sectional study, which uses data from the FIBRA-2008-2009 network in Campinas, State of São Paulo, Brazil, with information on non-institutionalized residents of the urban area and the Mortality Information System. The dependent variable has been death, in 2013. The associations have been tested by odds ratio (OR) and their 95% confidence intervals, and the analyses have been conducted using the program Stata 12.0. Average age has been 72.3 years, 69.3% have been women, and 8.9% have died. We have found greater OR for mortality in individuals aged ≥ 75 years, classified as pre-frail or frail, and in those who have reported heart disease. In this study, the analysis of specific subgroups has allowed us to better understand the relationship between the factors associated with death in the elderly. With the exception of age, strategies based on primary and secondary care, focused on priority groups, can have a positive impact on the reduction of mortality among the elderly. Identificar fatores associados à mortalidade, com ênfase nas diferenças de gênero e idade. Trata-se de estudo transversal, utilizando dados provenientes da rede FIBRA-2008-2009 em Campinas, SP, com informações de pessoas não institucionalizadas residentes na área urbana e pelo Sistema de Informações de Mortalidade. A variável dependente foi a ocorrência de óbito, verificada em 2013. As associações foram testadas pelas razões de chances (OR) e respectivos intervalos de confiança de 95%, e as análises conduzidas no programa Stata 12.0. A média de idade foi 72,3 anos, 69,3% eram mulheres e 8,9% foram a óbito. Encontrou-se maior OR para mortalidade nos indivíduos com idade ≥ 75 anos, nos classificados como pré-frágil ou frágil e naqueles que referiram doença do coração. Neste estudo, a análise para os subgrupos específicos permitiu melhor compreender a relação entre fatores que se associam ao óbito no idoso. Com exceção da idade, estratégias baseadas no cuidado específico de atenção primária e secundária, direcionadas a grupos prioritários, podem ter um impacto positivo na redução da mortalidade entre os idosos.

Indicators of health and safety among institutionalized older adults.

PubMed

Cavalcante, Maria Lígia Silva Nunes; Borges, Cíntia Lira; Moura, Acácia Maria Figueiredo Torres de Melo; Carvalho, Rhanna Emanuela Fontenele Lima de

2016-01-01

To identify the incidence of mortality, diarrheal diseases, scabies and falls; and the prevalence of pressure ulcers - all of which are related to the safety ofinstitutionalized older adults. This was a documentary retrospective study developed in a long-term residential careinstitution for older adults in the Northeast region of Brazil. The data were gathered from records of health assessment indicators filed between January 2008 and December 2015. Analysis included absolute case frequency; the sum of monthly prevalence and incidence rates; mean values of cases; and mean annual incidence and prevalence rates. The incidence of mortality over these nine years ranged from 9% to 13%; of acute diarrheic disease from 13% to 45%; and scabies from 21% to 63%. The prevalence of pressure ulcers ranged from 8% to 23%. Between 2012 and 2015, the incidence rate of falls without injury varied from 38% to 83%, and with injury from12% to 20%. Analysis of the health indicators revealeda high incidence of scabies and falls and a high prevalence of pressure ulcers. The identification of less than optimal rates for performance indicators canhelp improve the quality of nursing care. Identificar a incidência de mortalidade, doenças diarreicas, escabiose e quedas, e a prevalência de lesões por pressão para a segurança do idoso institucionalizado. Estudo documental, retrospectivo desenvolvido em uma Instituição de Longa Permanência para Idosos, localizada no nordeste do Brasil. Os dados foram coletados por meio dos registros dos indicadores de avaliação de saúde, arquivados de janeiro de 2008 a dezembro de 2015. A análise incluiu a frequência absoluta dos casos; o somatório das taxas de prevalência e incidência mensais; a média de casos e das taxas de incidência e prevalência anuais. Observa-se que a incidência de óbitos nos nove anos considerados variou de 9 a 13%; de doenças diarreicas agudas, de 13 a 45%; e de escabiose, de 21 a 63%. A prevalência de lesão por pressão oscilou de 8 a 23%. Entre os anos de 2012 a 2015, a taxa de incidência de quedas sem lesão variou em torno de 38 a 83%, e com lesão, de 12 a 20%. A análise da amplitude dos indicadores de saúde permitiu identificar a alta incidência de escabiose e de quedas e a elevada prevalência de lesões por pressão. A identificação do comprometimento dos indicadores contribui para otimização da qualidade da assistência de enfermagem.

Therapeutic nursing care: transition in sexuality of the elderly caregiving spouse.

PubMed

Lima, Claudia Feio da Maia; Caldas, Célia Pereira; Santos, Iraci Dos; Trotte, Liana Amorim Correa; Silva, Bárbara Martins Corrêa da

2017-01-01

To understand the transitions experienced, and the conditions and expected response patterns to changes in sexuality of the spouse-caregiver of the elderly, during progression of the dementia process. A qualitative research study, conducted at the neurogeriatric clinic between May of 2014 and May of 2015. An intensive, individual interview was administered to 12 elderly caregivers. Thematic content analysis was applied, using the theoretical model of Transition Theory. Seven categories emerged, involving relationship and conjugal sexuality; disease repercussions; care and professional approach; attitudes, beliefs and social imagery of sexuality and care; family relationship and redefining of sexuality. Family development and marital life, the aspects of formation and development of sexuality, the specifics that involved living and caring for the other were understood, with successive events and changes influenced by old age, dementia, beliefs and social imagery. compreender as transições vivenciadas, suas condições e os padrões de resposta esperados a mudanças na sexualidade do cônjuge-cuidador do idoso em processo demencial. pesquisa de abordagem qualitativa, realizada no ambulatório de neurogeriatria, entre maio de 2014 e maio de 2015. Aplicou-se a entrevista individual e intensiva a 12 cônjuges-cuidadores de idosos. Fez-se a análise de conteúdo temática, com aplicação do modelo teórico da Teoria das Transições. emergiram sete categorias, que envolveram relação e sexualidade conjugal; repercussões da doença; o cuidado e a abordagem profissional; atitudes, crenças e imaginário social de sexualidade e cuidado; relação familiar e ressignificação de sexualidade. compreendeu-se a construção de vida familiar e conjugal; os aspectos de formação e desenvolvimento da sexualidade; as especificidades que envolvem viver e cuidar do outro, com sucessivos acontecimentos e mudanças influenciados pela velhice, por processo demencial, crenças e imaginário social.

Phlebitis associated with peripheral intravenous catheters in adults admitted to hospital in the Western Brazilian Amazon.

PubMed

Enes, Sandra Maria Sampaio; Opitz, Simone Perufo; Faro, André Ricardo Maia da Costa de; Pedreira, Mavilde de Luz Gonçalves

2016-04-01

To identify the presence of phlebitis and the factors that influence the development of this complication in adult patients admitted to hospital in the western Brazilian Amazon. Exploratory study with a sample of 122 peripheral intravenous catheters inserted in 122 patients in a medical unit. Variables related to the patient and intravenous therapy were analyzed. For the analysis, we used chi-square tests of Pearson and Fisher exact test, with 5% significance level. Complication was the main reason for catheter removal (67.2%), phlebitis was the most frequent complication (31.1%). The mean duration of intravenous therapy use was 8.81 days in continuous and intermittent infusion (61.5%), in 20G catheter (39.3%), inserted in the dorsal hand vein arc (36.9 %), with mean time of usage of 68.4 hours. The type of infusion (p=0.044) and the presence of chronic disease (p=0.005) and infection (p=0.007) affected the development of phlebitis. There was a high frequency of phlebitis in the sample, being influenced by concomitant use of continuous and intermittent infusion of drugs and solutions, and more frequent in patients with chronic diseases and infection. Identificar a presença de flebite e os fatores que influenciam o desenvolvimento desta complicação em pacientes adultos internados em hospital da Amazônia Ocidental Brasileira. Estudo exploratório, com amostra de 122 cateteres intravenosos periféricos instalados em 122 pacientes de uma unidade de clínica médica. Foram analisadas variáveis relacionadas ao paciente e à terapia intravenosa. Para a análise utilizaram-se os testes de Qui-quadrado de Pearson e Exato de Fisher, com nível de significância de 5%. A complicação foi o principal motivo da retirada do cateter (67,2%), e a flebite a complicação mais frequente (31,1%). O tempo médio de uso de terapia intravenosa foi de 8,81 dias, em infusão contínua e intermitente (61,5%), em cateter calibre 20G (39,3%), inseridos nas veias do arco dorsal da mão (36,9%), com média de tempo de permanência de 68,4 horas. O tipo de infusão (p=0,044) e a presença de doença crônica (p=0,005) e de infecção (p=0,007) influenciaram o desenvolvimento de flebite. Houve alta frequência de flebite na amostra estudada, sendo influenciada pelo emprego concomitante de infusão contínua e intermitente de fármacos e soluções, e mais frequente em pacientes com doenças crônicas e infecção.

Comparação entre cirurgia aberta e endovascular no tratamento do aneurisma da artéria poplítea: uma revisão

PubMed Central

Gonçalves, Ana Fernanda Fagundes; Pelek, Carlos Augusto; Nogueira, Lorena Slusarz; de Carvalho, Renan Francisco; Stumpf, Matheo Augusto Morandi; Gomes, Ricardo Zanetti; Kluthcovsky, Ana Claudia Garabeli Cavalli

2018-01-01

Resumo Os aneurismas de artéria poplítea correspondem a 70% dos aneurismas periféricos e o tratamento é cirúrgico, com controvérsias sobre os resultados da via endovascular. Este estudo objetivou realizar uma revisão da literatura sobre a comparação entre cirurgia aberta e endovascular no tratamento dos aneurismas da artéria poplítea. A pesquisa foi realizada utilizando os termos apropriados nos portais de periódicos LILACS e MEDLINE, com a seleção de 15 artigos. Um total de 5.166 procedimentos cirúrgicos foram comparados, sendo 3.930 cirurgias abertas e 1.236 cirurgias endovasculares. A cirurgia aberta com bypass venoso continua sendo o padrão-ouro. A cirurgia endovascular apresenta menor tempo de internação e é uma opção viável em pacientes eletivos, com baixa expectativa de vida, alto risco cirúrgico, comorbidades e mais idosos, desde que tenham anatomia favorável para o procedimento. Contudo, são necessários estudos de longo prazo para estabelecer os reais benefícios e indicações das duas técnicas, como o ensaio clínico randomizado controlado.

Anxiety, depression, resilience and self-esteem in individuals with cardiovascular diseases.

PubMed

Carvalho, Isabela Gonzales; Bertolli, Eduarda Dos Santos; Paiva, Luciana; Rossi, Lidia Aparecida; Dantas, Rosana Aparecida Spadoti; Pompeo, Daniele Alcalá

2016-11-28

to analyze the relationship between anxiety and depression symptoms, resilience and self-esteem with sociodemographic and clinical characteristics; correlate resilience and self-esteem with age and duration of the disease; check associations between anxiety and depression with measures of resilience and self-esteem among individuals with cardiovascular diseases. correlational study conducted in a large university hospital in the interior of the state of São Paulo, Brazil. The population was composed of adult inpatients with cardiovascular diseases. A non-probabilistic consecutive sample was composed of 120 patients. Variables of interest were assessed using the Hospital Anxiety and Depression Scale, Resilience Scale, and Rosenberg Self-Esteem Scale. anxiety and depression symptoms were present in 32.5% and 17.5% of the patients, respectively, and were associated with the female sex (p = 0.002; p = 0.022). Manifestations of depression were associated with the presence of comorbidities (p = 0.020). More resilient patients did not present depression symptoms (p < 0.001) and anxious women were more resilient (p = 0.042). The highest scores regarding self-esteem were present in patients with anxiety and depression. Men presented higher resilience and lower self-esteem compared to women. patients with anxiety and depression were less resilient but presented higher self-esteem. analisar as relações entre os sintomas ansiosos e depressivos, resiliência e autoestima com as características sociodemográficas e clínicas; correlacionar resiliência e autoestima com a idade e o tempo da doença; analisar associações entre ansiedade e depressão com as medidas de resiliência e autoestima em indivíduos com doenças cardiovasculares. estudo correlacional, realizado em Hospital de Ensino de grande porte do interior do Estado de São Paulo. A população era constituída por pacientes adultos internados com doenças cardiovasculares. Uma amostra consecutiva e não probabilística foi constituída por 120 pacientes. As variáveis de interesse foram avaliadas pela Escala Hospitalar de Ansiedade e Depressão, Escala de Resiliência e Escala de Autoestima de Rosenberg. os sintomas de ansiedade e depressão estavam presentes em 32,5% e 17,5% dos pacientes, respectivamente e foram associados ao sexo feminino (p = 0,002; p = 0,022). As manifestações de depressão foram associadas à presença de comorbidades (p = 0,020). Pacientes mais resilientes não apresentaram sintomas depressivos (p < 0,001) e, as mulheres ansiosas, foram menos resilientes (p = 0,042). Os maiores escores de autoestima estiveram presentes em pacientes com ansiedade e depressão. Os homens apresentaram maior resiliência e menor autoestima quando comparados às mulheres. pacientes com ansiedade e depressão foram menos resilientes e apresentaram maior autoestima. analizar las relaciones entre los síntomas ansiedad y depresión, resiliencia y autoestima, con las características sociodemográficas y clínicas; correlacionar la resiliencia y autoestima con la edad y el tiempo de la enfermedad; analizar asociaciones entre ansiedad y depresión con las medidas de resiliencia y autoestima en individuos con enfermedades cardiovasculares. estudio de correlación, realizado en un Hospital de Enseñanza de gran porte del interior del estado de Sao Paulo. La población estuvo constituida por pacientes adultos internados con enfermedades cardiovasculares. Una muestra consecutiva y no probabilística fue constituida por 120 pacientes. Las variables de interés fueron evaluadas por la Escala Hospitalaria de Ansiedad y Depresión, la Escala de Resiliencia y la Escala de Autoestima de Rosenberg. los síntomas de ansiedad y depresión estaban presentes en 32,5% y 17,5% de los pacientes, respectivamente y fueron asociados al sexo femenino (p = 0,002; p = 0,022). Las manifestaciones de depresión fueron asociadas a la presencia de comorbilidades (p = 0,020). Pacientes más resilientes no presentaron síntomas depresivos (p < 0,001) y, las mujeres ansiosas, fueron menos resilientes (p = 0,042). Los mayores puntajes de autoestima estuvieron presentes en pacientes con ansiedad y depresión. Los hombres presentaron mayor resiliencia y menor autoestima cuando comparados a las mujeres. los pacientes con ansiedad y depresión fueron menos resilientes y presentaron mayor autoestima.

Incidence of colorectal cancer in young patients.

PubMed

Campos, Fábio Guilherme C M DE; Figueiredo, Marleny Novaes; Monteiro, Mariane; Nahas, Sérgio Carlos; Cecconello, Ivan

2017-01-01

Sporadic colorectal cancer (CRC) is traditionally diagnosed after de sixth decade of life, although a small percentage of cases are diagnosed in patients under 40 years of age, and incidence is increasing. There exists a great volume of controversy regarding clinical outcome of young patients diagnosed with colorectal cancer (CRC) when compared to elder counterparts. Our aims were to evaluate the rate of CRC in young patients, to review the pertaining literature and to discuss outcomes and clinical prognosis. A retrospective review involving patients with CRC was undertaken, focusing on age at diagnosis. The information extracted from this literature review showed a trend towards a decreased incidence in older people with an opposite effect among adolescents and young adults. Moreover, biological aggressiveness in young adults diagnosed with CRC has not been fully recognized, although it is usually diagnosed later and in association with adverse histological features. Besides that, these features don't affect outcome. These apparent increase in CRC incidence among young patients during the last decades raises the need for a greater suspicious when evaluating common symptoms in this group. Thus, educational programs should widespread information for both population and physicians to improve prevention and early diagnosis results. RESUMO O câncer colorretal (CCR) esporádico é tradicionalmente diagnosticado após a sexta década de vida, embora uma pequena porcentagem de casos seja diagnosticada em doentes abaixo dos 40 anos de idade, e a incidência está aumentando. Existe uma grande controvérsia a respeito da evolução clínica de doentes jovens portadores de CCR em comparação aos mais idosos. Os objetivos deste estudo foram avaliar a prevalência de CCR em doentes jovens, rever a literatura pertinente e discutir suas características mais importantes nesta faixa etária. Para tanto realizou-se revisão da literatura envolvendo doentes com CCR com foco na idade ao diagnóstico. A informação extraída da revisão de literatura demonstrou uma tendência de redução da incidência em pessoas mais idosas com efeito oposto em adolescentes e adultos jovens. Sua agressividade biológica ainda não foi claramente reconhecida, embora seja usualmente diagnosticado mais tardiamente e em associação com características histológicas adversas. Apesar disso, estas características não afetam a evolução. Este aparente aumento na incidência de CCR entre pacientes jovens durante as últimas décadas levanta a necessidade de uma maior suspeita diagnóstica na avaliação de sintomas comuns neste grupo. Assim, programas educacionais devem disseminar informação tanto para população como para médicos a fim de melhorar a prevenção e o diagnóstico precoce.

Social representations of older adults regarding quality of life.

PubMed

Ferreira, Marielle Cristina Gonçalves; Tura, Luiz Fernando Rangel; Silva, Rafael Celestino da; Ferreira, Márcia de Assunção

2017-01-01

to identify the social representations of older adults regarding quality of life, and to analyze the care practices adopted to promote it. qualitative, exploratory, descriptive research, applying the Theory of Social Representations. Thirty older people from a Health Academy of Rio de Janeiro participated in the study. The software Alceste was used, and lexical analysis of data was performed. social representations of quality of life are based on the social determinants of health; they evidence knowledge and practices of care by valuing physical activities. The practices promoting quality of life comprise healthy eating habits, daily physical exercise, social participation, interaction and socialization, accomplishment of leisure activities and daily tasks with independence and autonomy, and support and family contact. the elderly have a global understanding of the concept of quality of life, coordinate knowledge built in daily life and knowledge coming from the technical-professional field, which evidences the multidimensionality of the concept. identificar as representações sociais de idosos sobre qualidade de vida e analisar as práticas de cuidado por eles adotadas para promovê-la. pesquisa qualitativa, exploratória, descritiva, com aplicação da Teoria das Representações Sociais. Participaram 30 idosos de uma Academia Carioca de Saúde. Utilizou-se o software Alceste e realizou-se análise lexical dos dados. As representações sociais de qualidade de vida sustentam-se nos determinantes sociais de saúde, evidenciam saberes e práticas de cuidado, com valorização de atividades físicas. As práticas promotoras de qualidade de vida congregam hábitos alimentares saudáveis, exercícios físicos diários, participação social, convívio e interação, realização de atividades de lazer e tarefas cotidianas com independência e autonomia, apoio e contato familiar. Os idosos têm uma compreensão global do conceito de qualidade de vida, articulam saberes construídos no cotidiano e advindos do campo técnico-profissional, o que evidencia a multidimensionalidade do conceito.

Applicability of the Spoken Knowledge in Low Literacy Patients with Diabetes in Brazilian elderly.

PubMed

Souza, Jonas Gordilho; Apolinario, Daniel; Farfel, José Marcelo; Jaluul, Omar; Magaldi, Regina Miksian; Busse, Alexandre Leopold; Campora, Flávia; Jacob-Filho, Wilson

2016-01-01

To translate, adapt and evaluate the properties of a Brazilian Portuguese version of the Spoken Knowledge in Low Literacy Patients with Diabetes, which is a questionnaire that evaluate diabetes knowledge. A cross-sectional study with type 2 diabetes patients aged ≥60 years, seen at a public healthcare organization in the city of Sao Paulo (SP). After the development of the Portuguese version, we evaluated the psychometrics properties and the association with sociodemographic and clinical variables. The regression models were adjusted for sociodemographic data, functional health literacy, duration of disease, use of insulin, and glycemic control. We evaluated 129 type 2 diabetic patients, with mean age of 75.9 (±6.2) years, mean scholling of 5.2 (±4.4) years, mean glycosylated hemoglobin of 7.2% (±1.4), and mean score on Spoken Knowledge in Low Literacy Patients with Diabetes of 42.1% (±25.8). In the regression model, the variables independently associated to Spoken Knowledge in Low Literacy Patients with Diabetes were schooling (B=0.193; p=0.003), use of insulin (B=1.326; p=0.004), duration of diabetes (B=0.053; p=0.022) and health literacy (B=0.108; p=0.021). The determination coefficient was 0.273. The Cronbach a was 0.75, demonstrating appropriate internal consistency. This translated version of the Spoken Knowledge in Low Literacy Patients with Diabetes showed to be adequate to evaluate diabetes knowledge in elderly patients with low schooling levels. It presented normal distribution, adequate internal consistency, with no ceiling or floor effect. The tool is easy to be used, can be quickly applied and does not depend on reading skills. Traduzir, adaptar e avaliar as propriedades de uma versão, em português do Brasil, do Spoken Knowledge in Low Literacy Patients with Diabetes, um questionário que avalia conhecimento em diabetes. Estudo transversal, em diabéticos tipo 2, com idade ≥60 anos de uma instituição pública de saúde, em São Paulo (SP). Após o desenvolvimento da versão na língua portuguesa, foram avaliadas suas propriedades psicométricas e associação com variáveis sociodemográficas e clínicas. Os modelos de regressão foram ajustados para dados sociodemográficos, alfabetismo funcional em saúde, tempo de doença, uso de insulina e controle glicêmico. Foram avaliados 129 diabéticos, com média de idade de 75,9 (±6,2) anos, escolaridade média de 5,2 (±4,4) anos, hemoglobina glicada média de 7,2% (±1,4) e valor médio do Spoken Knowledge in Low Literacy Patients with Diabetes de 42,1% (±25,8). No modelo de regressão, as variáveis associadas de forma independente ao Spoken Knowledge in Low Literacy Patients with Diabetes foram escolaridade (B=0,193; p=0,003), uso de insulina (B=1,326; p=0,004), tempo de doença (B=0,053; p=0,022) e alfabetismo em saúde (B=0,108; p=0,021). O coeficiente de determinação foi de 0,273. O a de Cronbach apresentou valor de 0,75, revelando consistência interna adequada. Esta versão traduzida do Spoken Knowledge in Low LiteraFcy Patients with Diabetes mostrou-se adequada para avaliar conhecimentos em diabetes em idosos de baixa escolaridade, apresentando distribuição normal, consistência interna adequada, sem a presença de efeito teto ou chão. O instrumento teve boa aplicabilidade, já que pôde ser administrado de maneira rápida e não depende da capacidade de leitura.

Age-related changes in bone architecture.

PubMed

Giordano, Vincenzo; Franco, José Sérgio; Koch, Hilton Augusto; Labronici, Pedro José; Pires, Robinson Esteves S; Amaral, Ney Pecegueiro DO

2016-01-01

: to evaluate the histologic and morphometric characteristics of bone biopsies of the anterior iliac crest of patients of different age groups. : we studied 30 bone samples from the iliac crest, using brightfield optical microscopy. We divided the samples by donors' age groups in three groups: Group 1 (n = 10), subjects aged between 25 and 39 years; Group 2 (n = 10), subjects aged between 40 and 64 years; Group 3 (n = 10), individuals aged 65 years and over. We randomly divided the samples into two sets with 15 specimens. In the first study segment (n = 15), we used histological to assess the osteogenic property of the graft, through the analysis of cell reserve in the periosteum, the number of osteocytes in the lacunae and the number of Haversian and Volkmann's canals. In the second study segment (n = 15), we investigated the morphology of osteoconductive property of the graft, through quantification of the trabecular meshwork (Vv) and trabecular area (Sv). : histologically, we observed degeneration of bone occurring with age, characterized by thinning of the periosteum, with gradual replacement of the steogenic layer by fibrous tissue, small amount of Haversian and Volkmann's canals, osteocyte lacunae voids and fine spongy bone trabeculae, allowing ample medullary space, usually occupied by fat cells and adipocytes. Morphologically, with respect to the quantification of the trabecular meshwork (Vv), we found statistically significant differences between Groups 1 and 3 and between Groups 2 and 3, with reduction of the trabecular meshwork of about 45% in the elderly over 65 years old ; there was no statistically significant difference between Groups 1 and 2. There was also no statistical difference between the Groups regarding Sv. : the results of this experiment suggest that, in the elderly (over 65 years old), the osteogenic property of autologous bone graft decreases and the osteoconductive property is compromised. avaliar as características histológicas e morfométricas de biópsias ósseas da região anterior da crista ilíaca de pacientes de diferentes faixas etárias. foram estudadas 30 amostras de osso da crista ilíaca, utilizando-se microscopia óptica de campo claro. As amostras foram divididas pela faixa etária dos doadores em três grupos: Grupo 1 (n = 10), indivíduos com idade entre 25 e 39 anos; Grupo 2 (n = 10), indivíduos com idade entre 40 e 64 anos; Grupo 3 (n = 10), indivíduos com idade igual ou superior a 65 anos. As amostras foram separadas aleatoriamente em dois conjuntos com 15 peças. No primeiro segmento do estudo (n = 15), foi avaliada histologicamente a propriedade osteogênica do enxerto, através da análise da reserva celular no periósteo, do número de osteócitos nas lacunas e da quantidade de canais de Havers e de Volkmann. No segundo segmento do estudo (n = 15), investigou-se morfologicamente a propriedade osteocondutora do enxerto, através da quantificação da rede trabecular (Vv) e da área trabecular (Sv). histologicamente, observou-se que ocorre degeneração do tecido ósseo com a idade, caracterizada pelo adelgaçamento do periósteo, com substituição gradual da camada osteogênica por tecido fibroso, pequena quantidade de canais de Havers e de Volkmann, osteoplastos vazios e trabéculas finas de osso esponjoso, permitindo amplo espaço medular, em geral ocupado por células lipídicas e adipócitos. Morfologicamente, com relação à quantificação da rede trabecular (Vv), foi observada diferença estatisticamente significante entre os Grupos 1 e 3 e entre os Grupos 2 e 3, com redução da rede trabecular de cerca de 45% no idoso acima de 65 anos de idade; não foi observada diferença estatisticamente significante entre os Grupos 1 e 2. Não foi observada diferença estatística entre os grupos quanto à Sv. os achados do presente experimento sugerem que nos indivíduos idosos (acima de 65 anos de idade), a propriedade osteogênica do enxerto ósseo autólogo diminui e a propriedade osteocondutora está comprometida.

Nursing workload and occurrence of adverse events in intensive care: a systematic review.

PubMed

Oliveira, Andrea Carvalho de; Garcia, Paulo Carlos; Nogueira, Lilia de Souza

2016-01-01

To identifyevidences of the influence of nursing workload on the occurrence of adverse events (AE) in adult patients admitted to the intensive care unit (ICU). A systematic literature review was conducted in the databases MEDLINE, CINAHL, LILACS, SciELO, BDENF, and Cochrane from studies in English, Portuguese, or Spanish, published by 2015. The analyzed AE were infection, pressure ulcer (PU), patient falls, and medication errors. Of 594 potential studies, eight comprised the final sample of the review. TheNursing Activities Score (NAS; 37.5%) and the Therapeutic Intervention Scoring System(TISS; 37.5%) were the instruments most frequently used for assessing nursing workload. Six studies (75.0%) identified the influence of work overload in events of infection, PU, and medicationerrors. An investigation found that the NAS was a protective factor for PU. The nursing workload required by patients in the ICU influenced the occurrence of AE, and nurses must monitor this variable daily to ensure proper sizing of staff and safety of care. Identificar evidências sobre a influência da carga de trabalho de enfermagem na ocorrência de eventos adversos (EA) em pacientes adultos internados em Unidade de Terapia Intensiva (UTI). Revisão sistemática da literatura realizada nas bases de dados MEDLINE, CINAHL, LILACS, SciELO, BDENF e Cochrane deestudosem inglês, português ou espanhol, publicados até 2015. Os EA analisados foram infecção, úlcera por pressão (UPP), quedas e erros associados a medicamentos. Das 594 pesquisas potenciais identificadas, oito compuseram a amostra final da revisão. O NursingActivities Score -NAS (37,5%) e o TherapeuticInterventionScoring System -TISS (37,5%) foram os instrumentos mais utilizados para avaliação da carga de trabalho de enfermagem. Seis pesquisas (75,0%) identificaram influência da sobrecarga de trabalho na ocorrência de infecção, UPP e uso de medicamentos. Uma investigação identificou que o NAS foi fator de proteção para UPP. A carga de trabalho de enfermagem requerida por pacientes na UTI influenciou a ocorrência de EA, e os enfermeiros devem monitorar diariamente esta variável para garantir o correto dimensionamento da equipe e a segurança da assistência prestada.

Religiosity and spirituality as resilience strategies among long-living older adults in their daily lives.

PubMed

Reis, Luana Araújo Dos; Menezes, Tânia Maria de Oliva

2017-01-01

to investigate religiosity and spirituality as a resilience strategy for the long-living older adults in their daily lives. Qualitative research of phenomenological approach based on Martin Heidegger thoughts. Interviews were conducted with 14 older adults registered at a family health unit in the city of Jequié, BA, Brazil. The data were analyzed in the light of Being and Time. The results revealed that God occupies a central position in their lives, and the reading of the bible, praying the rosary and prayers are resilience strategies used for coping with unfavorable situations, recovery and/or maintenance of health, personal and family protection, and, above all, the experience of a satisfactory aging. Religiosity and spirituality were presented as an important resilience strategy in the existence of older adults, showing that through them it is possible to achieve well-being and cope with health and social problems. Desvelar a religiosidade e espiritualidade nas estratégias de resiliência do idoso longevo no cotidiano. Pesquisa qualitativa de abordagem fenomenológica fundamentada no pensamento de Martin Heidegger. Foram realizadas entrevistas com 14 pessoas idosas longevas cadastradas em uma unidade de saúde da família no município de Jequié, BA, Brasil. Os dados foram analisados à luz de Ser e Tempo. Desvelaram que Deus ocupa uma posição central em suas vidas, e a leitura da bíblia, a reza do terço e a oração são estratégias de resiliência utilizadas para o enfretamento de situações desfavoráveis, a recuperação e/ou manutenção da saúde, a proteção pessoal e familiar e, sobretudo, a vivência de uma velhice satisfatória. A religiosidade e espiritualidade foram desveladas como importante estratégia de resiliência no existir da pessoa idosa longeva, sinalizando que, por meio dela, é possível alcançar o bem-estar e enfrentar problemas de saúde e sociais.

Zero Calcium Score as a Filter for Further Testing in Patients Admitted to the Coronary Care Unit with Chest Pain.

PubMed

Correia, Luis Cláudio Lemos; Esteves, Fábio P; Carvalhal, Manuela; Souza, Thiago Menezes Barbosa de; Sá, Nicole de; Correia, Vitor Calixto de Almeida; Alexandre, Felipe Kalil Beirão; Lopes, Fernanda; Ferreira, Felipe; Noya-Rabelo, Márcia

2017-06-12

The accuracy of zero coronary calcium score as a filter in patients with chest pain has been demonstrated at the emergency room and outpatient clinics, populations with low prevalence of coronary artery disease (CAD). To test the gatekeeping role of zero calcium score in patients with chest pain admitted to the coronary care unit (CCU), where the pretest probability of CAD is higher than that of other populations. Patients underwent computed tomography for calcium scoring, and obstructive CAD was defined by a minimum 70% stenosis on invasive angiography. In 146 patients studied, the prevalence of CAD was 41%. A zero calcium score was present in 35% of the patients. The sensitivity and specificity of zero calcium score yielded a negative likelihood ratio of 0.16. After logistic regression adjustment for pretest probability, zero calcium score was independently associated with lower odds of CAD (OR = 0.12, 95%CI = 0.04-0.36), increasing the area under the ROC curve of the clinical model from 0.76 to 0.82 (p = 0.006). Zero calcium score provided a net reclassification improvement of 0.20 (p = 0.0018) over the clinical model when using a pretest probability threshold of 10% for discharging without further testing. In patients with pretest probability < 50%, zero calcium score had a negative predictive value of 95% (95%CI = 83%-99%), with a number needed to test of 2.1 for obtaining one additional discharge. Zero calcium score substantially reduces the pretest probability of obstructive CAD in patients admitted to the CCU with acute chest pain. (Arq Bras Cardiol. 2017; [online].ahead print, PP.0-0). A acurácia do escore de cálcio coronário zero como um filtro nos pacientes com dor torácica aguda tem sido demonstrada na sala de emergência e nos ambulatórios, populações com baixa prevalência de doença arterial coronariana (DAC). Testar o papel do escore de cálcio zero como filtro nos pacientes com dor torácica admitidos numa unidade coronariana intensiva (UCI), na qual a probabilidade pré-teste de DAC é maior do que em outras populações. Pacientes foram submetidos a tomografia computadorizada para quantificar o escore de cálcio, DAC obstrutiva foi definida por uma estenose mínima de 70% na cineangiocoronariografia invasiva. Um escore clínico para estimar a probabilidade pré-teste de DAC obstrutiva foi criado em amostra de 370 pacientes, usado para definir subgrupos na definição de valores preditivos negativos do escore zero. Em 146 pacientes estudados, a prevalência de DAC foi 41% e o escore de cálcio zero foi demonstrado em 35% deles. A sensibilidade e a especificidade para escore de cálcio zero resultaram numa razão de verossimilhança negativa de 0,16. Após ajuste com um escore clínico com a regressão logística para a probabilidade pré-teste, o escore de cálcio zero foi preditor independente associado a baixa probabilidade de DAC (OR = 0,12, IC95% = 0,04-0,36), aumentando a área abaixo da curva ROC do modelo clínico de 0,76 para 0,82 (p = 0,006). Considerando a probabilidade de DAC < 10% como ponto de corte para alta precoce, o escore de cálcio aumentou a proporção de pacientes para alta precoce de 8,2% para 25% (NRI = 0,20; p = 0,0018). O escore de cálcio zero apresentou valor preditivo negativo de 90%. Em pacientes com probabilidade pré-teste < 50%, o valor preditivo negativo foi 95% (IC95% = 83%-99%). O escore de cálcio zero reduz substancialmente a probabilidade pré-teste de DAC obstrutiva em pacientes internados em UCI com dor torácica aguda. (Arq Bras Cardiol. 2017; [online].ahead print, PP.0-0).

Strategies for coping with family members of patients with mental disorders.

PubMed

Pompeo, Daniele Alcalá; Carvalho, Arélica de; Olive, Aline Morgado; Souza, Maria da Graça Girade; Galera, Sueli Aparecida Frari

2016-09-09

to identify the coping strategies of family members of patients with mental disorders and relate them to family member sociodemographic variables and to the patient's clinical variables. this was a descriptive study conducted at a psychiatric hospital in the interior of the state of São Paulo, with 40 family members of hospitalized patients over the age of 18, and who followed the patient before and during hospitalization. We used tools to characterize the subjects and the Folkman and Lazarus Inventory of Coping Strategies. the coping strategies most often used by family members were social support and problem solving. Mothers and fathers used more functional strategies (self-control p=0.037, positive reappraisal p=0.037, and social support p=0,021). We found no significant differences between the strategies and other variables examined. despite the suffering resulting from the illness of a dear one, family members make more use of functional strategies, allowing them to cope with adversities in a more well-adjusted way. identificar as estratégias de enfrentamento de familiares de pacientes com transtornos mentais e relacioná-las com as variáveis sociodemográficas do familiar e clínicas do paciente. estudo descritivo, desenvolvido em hospital psiquiátrico do interior do estado de São Paulo, com 40 familiares de pacientes internados, maiores de 18 anos e que acompanhavam o paciente antes e durante a internação. Foram utilizados instrumentos para caracterização dos sujeitos e o Inventário de Estratégias de Enfrentamento de Folkman e Lazarus. as estratégias de enfrentamento mais utilizadas pelos familiares foram suporte social e resolução de problemas. Pais e mães utilizaram mais estratégias funcionais (autocontrole p=0,037; reavaliação positiva p=0,037; suporte social p=0,021). Não foram evidenciadas diferenças significativas entre as estratégias e as demais variáveis estudadas. apesar do sofrimento causado pelo impacto do adoecimento do seu ente querido, os familiares utilizam mais estratégias funcionais, permitindo-lhes enfrentar as adversidades de forma mais ajustada. identificar las estrategias de enfrentamiento de familiares de pacientes con trastornos mentales y relacionarlas con las variables sociodemográficas del familiar y clínicas del paciente. estudio descriptivo, desarrollado en un hospital psiquiátrico del interior del estado de Sao Paulo, con 40 familiares de pacientes internados, mayores de 18 años y que acompañaban el paciente antes y durante la internación. Fueron utilizados instrumentos para caracterización de los sujetos y el Inventario de Estrategias de Enfrentamiento de Folkman y Lazarus. las estrategias de enfrentamiento más utilizadas por los familiares fueron el soporte social y la resolución de problemas. Los padres y madres utilizaron más estrategias funcionales (autocontrol p=0,037; reevaluación positiva p=0,037; soporte social p=0,021). No fueron evidenciadas diferencias significativas entre las estrategias y las demás variables estudiadas. a pesar del sufrimiento causado por el impacto de la enfermedad de su ser querido, los familiares utilizan más estrategias funcionales, permitiéndoles enfrentar las adversidades de forma más ajustada.

ENDOSCOPIC SLEEVE GASTROPLASTY FOR OBESITY TREATMENT: TWO YEARS OF EXPERIENCE.

PubMed

Lopez-Nava, Gontrand; Galvão, M P; Bautista-Castaño, I; Fernandez-Corbelle, J P; Trell, M; Lopez, N

2017-01-01

Bariatric endoscopic techniques are minimally invasive and induce gastric volume reduction to treat obesity. Aim : To evaluate endoscopic sleeve gastroplasty (Apollo method) using a suturing method directed at the greater curvature, as well as the perioperative care, two year safety and weight loss. Prospective single-center study over 154 patients (108 females) using the endoscopic sleeve gastroplasty procedure under general anesthesia with overnight inpatient observation. Of the154 initial patients, 143 were available for 1-month of follow-up, 133 for 6-month, 64 for 12-month and 28 completed the 24 month assessment. Follow-up was carried out by a multidisciplinary team (nutritionist and psychologist). Outcomes evaluated were: change in BMI; change in body weight (TBWL); % of loss of initial body weight (%TBWL); % of excess body weight loss (%EWL) (segregated in > or <25% and adverse effects. Voluntary oral contrasted radiological examinations were scheduled to assess the gastroplasty at different times post-procedure. Mean age was 44.9 (23-69) years. At 24 months after the procedure baseline mean BMI change from 38.3 to 30.8 kg/m2. TBWL, %TBWL and %EWL were of 21.3 kg, 19.5% and 60.4% respectively. 85.7% of patients achieve the goal of >25% %EWL. There were no mayor adverse events intraprocedure or during the 24 months of follow-up . Endoscopic sleeve gastroplasty with regular monitoring by a multidisciplinary team can be considered an effective, safe and well tolerated procedure for obesity treatment, at least for two years of follow-up. As técnicas de endoscopia bariátrica são minimamente invasivas e induzem à redução do volume gástrico para tratar a obesidade. Avaliar a gastroplastia sleeve endoscópica (método Apollo) usando um método de sutura direcionado para a grande curvatura, bem como os cuidados perioperatórios, segurança em dois anos e perda de peso. Estudo prospectivo em um único centro com 154 pacientes (108 mulheres) usando o procedimento endoscópico de gastroplastia sleeve sob anestesia geral com observação do paciente internado durante a noite. Dos 154 pacientes iniciais, 143 estiveram disponíveis para acompanhamento de um mês, 133 durante seis meses, 64 durante 12 meses e 28 completaram a avaliação de 24 meses. O acompanhamento foi realizado por equipe multidisciplinar (nutricionista e psicólogo). Foram avaliados nos resultados as mudanças no IMC, no peso corporal (TWBL), no % de perda do peso corporal inicial (% TBWL) no % de excesso de perda de peso corporal (%EWL) segregado em > ou < 25% e efeitos adversos. Estudos radiológicos contratados orais voluntários foram programados para avaliar a gastroplastia em diferentes tempos após o procedimento. A idade média foi de 44,9 anos (23-69). Aos 24 meses após o procedimento a linha de base média do IMC mudou de 38,3 para 30,8 kg/m2. O TBWL, %TBWL e %EWL foram de 21,3 kg, 19,5% e 60,4%, respectivamente, e 85,7% dos pacientes alcançaram o objetivo de >25% EWL. Não houve eventos adversos graves peroperatórios ou durante os 24 meses de acompanhamento. A gastroplastia sleeve endoscópica com monitoramento regular por equipe multidisciplinar pode ser considerado procedimento eficaz, seguro e bem tolerado para o tratamento de pacientes com obesidade, pelo menos nos dois anos de acompanhamento.

Use of health services by Brazilian older adults with and without functional limitation.

PubMed

Silva, Alexandre Moreira de Melo; Mambrini, Juliana Vaz de Melo; Peixoto, Sérgio Viana; Malta, Deborah Carvalho; Lima-Costa, Maria Fernanda

2017-06-01

To analyze the use of health services and the quality of medical care received by Brazilian older adults with and without functional limitation. The main analyses were based on a national sample representing 23,815 participants of the National Survey on Health (PNS) aged 60 years or older. Functional limitation was defined by the difficulty to perform at least one out of ten basic or instrumental activities of daily living. Potential confounding variables included predisposing and enabling factors of the use of health services. The prevalence of functional limitation was 30.1% (95%CI 29.2-31.4). The number of doctor visits and hospitalizations in the past 12 months showed statistically significant associations with functional limitation, both for users of the public system (OR = 2.48 [95%CI 2.13-2.88] for three or more doctor visits and OR = 2.58 [95%CI 2.15-3.09] for one or more hospitalizations) and of the private system (OR = 2.56 [95%CI 1.50-4.36] and OR = 2.22 [95%CI 1.64-3.00], respectively). The propensity to use basic health units was higher among users of the private system with functional limitations (OR = 2.01 [95%CI 1.12-3.59]). Only two out of seven indicators of the quality of medical care received were associated with functional limitation, in the perception of users of public and private systems. The public system users with functional limitations did worse evaluation of the freedom for choosing the doctor and waiting time for an appointment, when compared with users of the same system without these limitations (OR = 0.81 [95%CI 0.67-0.99] and OR = 0.76 [95%CI 0.62-0.93], respectively). Older adults with functional limitations use more health services in comparison with those without such limitations. The magnitude of the association between functional limitation and number of doctor visits and hospitalizations was similar in the public and private health systems. Analisar o uso de serviços de saúde e a qualidade da atenção médica recebida por idosos brasileiros com e sem limitação funcional. As análises principais foram baseadas em amostra nacional representativa de 23.815 participantes da Pesquisa Nacional de Saúde com 60 anos ou mais. A limitação funcional foi definida pela dificuldade para realizar pelo menos uma entre dez atividades básicas ou instrumentais da vida diária. Potenciais variáveis de confusão incluíram fatores predisponentes e facilitadores do uso de serviços de saúde. A prevalência da limitação funcional foi de 30,1% (IC95% 29,2-31,4). O número de consultas médicas e a ocorrência de hospitalizações nos últimos 12 meses apresentaram associações estatisticamente significantes com a limitação funcional, tanto entre usuários do sistema público (OR = 2,48 [IC95% 2,13-2,88] para três ou mais consultas e OR = 2,58 [IC95% 2,15-3,09] para uma ou mais hospitalizações) quanto do sistema privado (OR = 2,56 [IC95% 1,50-4,36] e OR = 2,22 [IC95% 1,64-3,00], respectivamente). A propensão ao uso da unidade básica de saúde foi maior entre usuários do sistema privado com limitações funcionais (OR = 2,01 [IC95% 1,12-3,59]). Entre sete indicadores da qualidade da atenção médica recebida, na percepção dos usuários dos sistemas público e privado, somente dois apresentaram associação com a limitação funcional. Os usuários do sistema público com limitações funcionais fizeram pior avaliação da liberdade para escolha do médico e do tempo de espera para a consulta, em comparação aos usuários do mesmo sistema sem essas limitações (OR = 0,81 [IC95% 0,67-0,99] e OR = 0,76 [IC95% 0,62-0,93], respectivamente). Idosos com limitações funcionais utilizam mais serviços de saúde em comparação aos seus pares sem essas limitações. A magnitude da associação entre a limitação funcional e o número de consultas médicas e de hospitalizações foi semelhante nos sistemas público e privado de saúde.

Frailty and cardiovascular risk in community-dwelling elderly: a population-based study.

PubMed

Ricci, Natalia Aquaroni; Pessoa, Germane Silva; Ferriolli, Eduardo; Dias, Rosangela Correa; Perracini, Monica Rodrigues

2014-01-01

Evidence suggests a possible bidirectional connection between cardiovascular disease (CVD) and the frailty syndrome in older people. To verify the relationship between CVD risk factors and the frailty syndrome in community-dwelling elderly. This population-based study used data from the Fragilidade em Idosos Brasileiros (FIBRA) Network Study, a cross-sectional study designed to investigate frailty profiles among Brazilian older adults. Frailty status was defined as the presence of three or more out of five of the following criteria: unintentional weight loss, weakness, self-reported fatigue, slow walking speed, and low physical activity level. The ascertained CVD risk factors were self-reported and/or directly measured hypertension, diabetes mellitus, obesity, waist circumference measurement, and smoking. Of the 761 participants, 9.7% were characterized as frail, 48.0% as pre-frail, and 42.3% as non-frail. The most prevalent CVD risk factor was hypertension (84.4%) and the lowest one was smoking (10.4%). It was observed that among those participants with four or five risk factors there was a higher proportion of frail and pre-frail compared with non-frail (Fisher's exact test: P=0.005; P=0.021). Self-reported diabetes mellitus was more prevalent among frail and pre-frail participants when compared with non-frail participants (Fisher's exact test: P≤0.001; P≤0.001). There was little agreement between self-reported hypertension and hypertension identified by blood pressure measurement. Hypertension was highly prevalent among the total sample. In addition, frail and pre-frail older people corresponded to a substantial proportion of those with more CVD risk factors, especially diabetes mellitus, highlighting the need for preventive strategies in order to avoid the co-occurrence of CVD and frailty.

Frailty and cardiovascular risk in community-dwelling elderly: a population-based study

PubMed Central

Ricci, Natalia Aquaroni; Pessoa, Germane Silva; Ferriolli, Eduardo; Dias, Rosangela Correa; Perracini, Monica Rodrigues

2014-01-01

Background Evidence suggests a possible bidirectional connection between cardiovascular disease (CVD) and the frailty syndrome in older people. Purpose To verify the relationship between CVD risk factors and the frailty syndrome in community-dwelling elderly. Methods This population-based study used data from the Fragilidade em Idosos Brasileiros (FIBRA) Network Study, a cross-sectional study designed to investigate frailty profiles among Brazilian older adults. Frailty status was defined as the presence of three or more out of five of the following criteria: unintentional weight loss, weakness, self-reported fatigue, slow walking speed, and low physical activity level. The ascertained CVD risk factors were self-reported and/or directly measured hypertension, diabetes mellitus, obesity, waist circumference measurement, and smoking. Results Of the 761 participants, 9.7% were characterized as frail, 48.0% as pre-frail, and 42.3% as non-frail. The most prevalent CVD risk factor was hypertension (84.4%) and the lowest one was smoking (10.4%). It was observed that among those participants with four or five risk factors there was a higher proportion of frail and pre-frail compared with non-frail (Fisher’s exact test: P=0.005; P=0.021). Self-reported diabetes mellitus was more prevalent among frail and pre-frail participants when compared with non-frail participants (Fisher’s exact test: P≤0.001; P≤0.001). There was little agreement between self-reported hypertension and hypertension identified by blood pressure measurement. Conclusion Hypertension was highly prevalent among the total sample. In addition, frail and pre-frail older people corresponded to a substantial proportion of those with more CVD risk factors, especially diabetes mellitus, highlighting the need for preventive strategies in order to avoid the co-occurrence of CVD and frailty. PMID:25336932

Results after implementation of a protocol on the incidence of urinary tract infection in an intensive care unit.

PubMed

Miranda, Anna Letícia; Oliveira, Ana Lúcia Lyrio de; Nacer, Daiana Terra; Aguiar, Cynthia Adalgisa Mesojedovas

2016-09-09

to compare the results of urinary tract infection incidence, by means of the rate of indwelling urethral catheter use, and to identify microorganisms in urine cultures and surveillance cultures before and after the implementation of a clinical protocol for intensive care unit patients . urinary tract infection is defined as a positive urine culture > 105 CFU/mL, notified by the hospital infection control service, six months before and after the implementation of the protocol. The sample consisted of 47 patients, 28 reported before and 19 after implementation. The protocol established in the institution is based on the Ministry of Health manual to prevent healthcare-related infections; the goal is patient safety and improving the quality of health services. a negative linear correlation was observed between the later months of implementation and the reduction of reported cases of urinary tract infection, using the Spearman rank order coefficient (p = 0.045), and a reduction in the number of urine culture microorganisms (p = 0.026) using the Fisher exact test. educational interventions with implementation protocols in health institutions favor the standardization of maintenance of the invasive devices, which may reduce colonization and subsequent infections. comparar os resultados da incidência de infecção do trato urinário, por meio da taxa de utilização do cateter vesical de demora e identificar os micro-organismos na urocultura e cultura de vigilância antes e após a implementação de um protocolo assistencial em pacientes internados em unidade de terapia intensiva. definiu-se infecção do trato urinário pacientes com urocultura positiva >105 UFC/mL, notificados pelo Serviço de Controle de Infecção Hospitalar, seis meses antes e após a implementação do protocolo. A amostra foi constituída por 47 pacientes, sendo 28 notificados antes e 19 após. O protocolo, criado na instituição, é baseado no manual do Ministério da Saúde na prevenção de infecções relacionadas à assistência a saúde, como meta a segurança do paciente e o aperfeiçoamento na qualidade dos serviços de saúde. foi possível observar uma correlação linear negativa entre os meses posteriores da implementação e a redução dos casos notificados de infecção do trato urinário, pelo teste de Spearman (p=0,045) e redução do número de micro-organismos na urocultura (p=0,026) pelo teste de Fisher. intervenções educativas com implementação de protocolos nas instituições de saúde favorece a padronização da manutenção com dispositivos invasivos podendo reduzir a colonização e posterior casos de infecção. comparar los resultados de la incidencia de infección del tracto urinario, por medio de la tasa de utilización del catéter vesical de demora e identificar los microorganismos en el urocultivo y cultura de vigilancia antes y después de la implementación de un protocolo asistencial, en pacientes internados en unidad de terapia intensiva. se definió la infección del tracto urinario de pacientes con urocultivo positivo >105 UFC/mL, notificados por el Servicio de Control de Infección Hospitalario, seis meses antes y después de la implementación del protocolo. La muestra estuvo constituida por 47 pacientes, siendo 28 notificados antes y 19 después. El protocolo, creado en la institución, está basado en el manual del Ministerio de la Salud para la prevención de infecciones relacionadas a la asistencia la salud, siendo la meta la seguridad del paciente y el perfeccionamiento de la calidad de los servicios de la salud. fue posible observar una correlación linear negativa entre los meses posteriores a la implementación y la reducción de los casos notificados de infección del tracto urinario, por el test de Spearman (p=0,045) y reducción del número de microorganismos en el urocultivo (p=0,026) por el test de Fisher. las intervenciones educativas con implementación de protocolos en las instituciones de la salud favorecen la estandarización de la manutención de dispositivos invasivos, lo que podría reducir la colonización y posterior aparecimiento de casos de infección.

Assessment of risk of falls in elderly living at home.

PubMed

Smith, Adriana de Azevedo; Silva, Antonia Oliveira; Rodrigues, Rosalina Aparecida Partezani; Moreira, Maria Adelaide Silva Paredes; Nogueira, Jordana de Almeida; Tura, Luiz Fernando Rangel

2017-04-06

to assess the risk of falls in elderly, by comparing the sociodemographic and cognitive factors, history of falls and self-reported comorbidities. cross-sectional and quantitative study with 240 elderly. Data were collected based on the social profile, through the instrument of risk of falls and assessment of falls, by univariate analysis, bivariate and multiple logistic regression. The Statistical Package for the Social Sciences (SPSS) version 19 was used for statistical analysis. there was a significant association of the risk of falls, as measured by the Fall Risk Score, with sex (<0.001), age (0.054), cognitive status (<0.001) and history of falls (<0.001). All variables were statistically significant and contributed to the occurrence of falls. In logistic regression, the variables that showed association with risk of falls were: fall, with whom they live, hypertension and visual impairment. female gender, older elderly (over 80 years old), with low cognitive status and occurrence of previous falls in the last six months are factors that increase the prevalence of falls. In logistic regression, the variables that were associated with risk of falls were: fall, with whom they live, visual impairment and rheumatologic diseases. avaliar o risco de quedas em idosos, comparando com os fatores sóciodemográficos, cognitivos, presença de quedas e co-morbidades autorreferidas. Estudo transversal e quantitativo com 240 idosos. Os dados foram coletados a partir do perfil social, instrumento do risco de quedas e avaliação de quedas, utilizando análise univariada, bivariada e regressão logística múltipla. Para a análise estatística, utilizou-se o Statistical Package for the Social Sciences (SPSS) versão 19. há associação entre o risco de quedas, mensurado pelo Fall Risk Score, com o sexo (<0,001), a faixa etária (0,054), o desempenho cognitivo (<0,001) e a presença de quedas (<0,001). Todas as variáveis apresentaram significância estatística e contribuíram para a ocorrência das quedas. Na regressão logística, as variáveis que apresentaram associação com o risco de quedas foram: queda, com quem mora, hipertensão arterial e déficit visual. sexo feminino, idoso mais velho (acima de 80 anos), com baixo desempenho cognitivo e apresentar quedas anteriores nos últimos seis meses, aumentam a prevalência de quedas. Na regressão logística, as variáveis que apresentaram associação com o risco de quedas foram: queda, com quem mora, visão prejudicada e doenças reumatológicas. evaluar el riesgo de caídas del adulto mayor, mediante la comparación de los factores cognitivos y sociodemográficos, antecedentes de caídas y comorbilidades auto-reportadas. estudio transversal y cuantitativo con 240 adultos mayores. Los datos fueron recolectados utilizando instrumento del riesgo de caídas y evaluación de caídas, mediante el análisis univariado, bivariado y regresión logística múltiple. Para el anpalisis estadístico, fue utilizado software Statistical Package for the Social Sciences (SPSS) versión 19, se utilizó en el análisis estadístico. hay una asociación significativa del riesgo de caídas, medido por el Fall Risk Score, con el sexo (<0.001), la edad (0.054), el desempeño cognitivo (<0.001) y los antecedentes de caídas (<0.001). Todas las variables fueron estadísticamente significativas y contribuyeron a la ocurrencia de caídas. En la regresión logística, las variables que mostraron asociación con el riesgo de caídas fueron: caída, con quien viven, hipertensión y discapacidad visual. sexo femenino, adulto mayor de edad más avanzada (más de 80 años de edad), bajo desempeño cognitivo, y antecedentes de caídas en los últimos seis meses son factores que aumentan la prevalencia de caídas. En la regresión logística, las variables que mostraron asociación con el riesgo de caídas fueron: caída, con quien vive, discapacidad visual y enfermedades reumáticas.

Financial impact of nursing professionals staff required in an Intensive Care Unit.

PubMed

Araújo, Thamiris Ricci de; Menegueti, Mayra Gonçalves; Auxiliadora-Martins, Maria; Castilho, Valéria; Chaves, Lucieli Dias Pedreschi; Laus, Ana Maria

2016-11-21

to calculate the cost of the average time of nursing care spent and required by patients in the Intensive Care Unit (ICU) and the financial expense for the right dimension of staff of nursing professionals. a descriptive, quantitative research, using the case study method, developed in adult ICU patients. We used the workload index - Nursing Activities Score; the average care time spent and required and the amount of professionals required were calculated using equations and from these data, and from the salary composition of professionals and contractual monthly time values, calculated the cost of direct labor of nursing. the monthly cost of the average quantity of available professionals was US$ 35,763.12, corresponding to 29.6 professionals, and the required staff for 24 hours of care is 42.2 nurses, with a monthly cost of US$ 50,995.44. the numerical gap of nursing professionals was 30% and the monthly financial expense for adaptation of the structure is US$ 15,232.32, which corresponds to an increase of 42.59% in the amounts currently paid by the institution. calcular o custo do tempo médio de assistência de enfermagem despendido e requerido pelos pacientes internados em Unidade de Terapia Intensiva (UTI) e o dispêndio financeiro para adequação do quadro de profissionais de enfermagem. pesquisa descritiva, quantitativa, na modalidade de estudo de caso, desenvolvida na UTI de pacientes adultos. Utilizou-se o índice de carga de trabalho - Nursing Activities Score; o tempo médio de assistência despendido, requerido e o quantitativo de profissionais requerido foram calculados por meio de equações e, a partir desses dados, e de valores da composição salarial dos profissionais e tempo mensal contratual, calculou-se o custo da mão de obra direta de enfermagem. o custo mensal do quantitativo médio de profissionais disponível foi de US$ 35.763,12, correspondendo a 29,6 profissionais, e o requerido para 24 horas de cuidado é de 42,2 profissionais de enfermagem, com custo mensal de US$ 50.995,44. a defasagem numérica de profissionais da enfermagem foi de 30% e o dispêndio financeiro mensal para adequação do quadro é de US$ 15.232,32, o que corresponde a um acréscimo de 42,59% nos valores atualmente desembolsados pela instituição. calcular el costo del tiempo promedio de asistencia de enfermería invertido y requerido por los pacientes internados en la unidad de cuidados intensivos (UCI) y el gasto para la adecuación de la dotación de profesionales de enfermería. investigación descriptiva y cuantitativa en la modalidad de estudio de caso desarrollada en la UCI de pacientes adultos. Se utilizó el índice de carga de trabajo Nursing Activities Score; el tiempo promedio de asistencia invertido y requerido y la cantidad de profesionales necesaria se calculó con ecuaciones y, a partir de estos datos y de los valores de la composición de salario de los profesionales y el tiempo de contrato mensual, se calculó el costo de la mano de obra directa de enfermería. el costo mensual de la cantidad promedio de profesionales disponible fue de US$ 35,763.12, que corresponde a 29.6 profesionales, mientras que el requerido para 24 horas de atención es de 42.2 profesionales de enfermería, con un costo mensual de US$ 50,995.44. el desfase numérico de profesionales de enfermería fue de 30% y el gasto mensual para la adecuación de la dotación es de US$ 15,232.32, que corresponde a un incremento de 42.59% en los valores que actualmente desembolsa la institución.

Spontaneous breathing test in the prediction of extubation failure in the pediatric population.

PubMed

Nascimento, Milena Siciliano; Rebello, Celso Moura; Vale, Luciana Assis Pires Andrade; Santos, Érica; Prado, Cristiane do

2017-01-01

To assess whether the spontaneous breathing test can predict the extubation failure in pediatric population. A prospective and observational study that evaluated data of inpatients at the Pediatric Intensive Care Unit between May 2011 and August 2013, receiving mechanical ventilation for at least 24 hours followed by extubation. The patients were classified in two groups: Test Group, with patients extubated after spontaneous breathing test, and Control Group, with patients extubated without spontaneous breathing test. A total of 95 children were enrolled in the study, 71 in the Test Group and 24 in the Control Group. A direct comparison was made between the two groups regarding sex, age, mechanical ventilation time, indication to start mechanical ventilation and respiratory parameters before extubation in the Control Group, and before the spontaneous breathing test in the Test Group. There was no difference between the parameters evaluated. According to the analysis of probability of extubation failure between the two groups, the likelihood of extubation failure in the Control Group was 1,412 higher than in the Test Group, nevertheless, this range did not reach significance (p=0.706). This model was considered well-adjusted according to the Hosmer-Lemeshow test (p=0.758). The spontaneous breathing test was not able to predict the extubation failure in pediatric population. Avaliar se o teste de respiração espontânea pode ser utilizado para predizer falha da extubação na população pediátrica. Estudo prospectivo, observacional, no qual foram avaliados todos os pacientes internados no Centro de Terapia Intensiva Pediátrica, no período de maio de 2011 a agosto de 2013, que utilizaram ventilação mecânica por mais de 24 horas e que foram extubados. Os pacientes foram classificados em dois grupos: Grupo Teste, que incluiu os pacientes extubados depois do teste de respiração espontânea; e Grupo Controle, pacientes foram sem teste de respiração espontânea. Dos 95 pacientes incluídos no estudo, 71 crianças eram do Grupo Teste e 24 eram do Grupo Controle. Os grupos foram comparados em relação a: sexo, idade, tempo de ventilação mecânica, indicação para início da ventilação mecânica e parâmetros ventilatórios pré-extubação, no Grupo Controle, e pré-realização do teste, no Grupo Teste. Não foram observadas diferenças entre os parâmetros analisados. Em relação à análise da probabilidade de falha da extubação entre os dois grupos de estudo, a chance de falha do Grupo Controle foi 1.412 maior do que a das crianças do Grupo Teste, porém este acréscimo não foi significativo (p=0,706). O modelo foi considerado bem ajustado de acordo com o teste de Hosmer-Lemeshow (p=0,758). O teste de respiração espontânea para a população pediátrica não foi capaz de prever a falha da extubação.

Elderly with knee osteoarthritis should perform nutritional assessment: integrative literature review.

PubMed

Souza, Isabelle Ferreira da Silva; Oliveira Neta, Rosa Sá de; Gazzola, Juliana Maria; Souza, Marcelo Cardoso de

2017-01-01

To review scientific literature to assess nutritional status of elderly patients with osteoarthritis in the last 16 years. This is an integrative literature review that included articles published in national and international journals indexed in PubMed, SciELO and BIREME. We selected 14 articles, and English language was predominant. The year of publication of articles ranged from 2006 to 2016, and most of papers were cross-sectional studies. To gather papers and for posterior evaluate, we used a validated data collection instrument and the included studies were critical analyzed by reading, gathering and analysis of articles. Studies suggested that there is a positive correlation between obesity and knee osteoarthritis. Obesity is one of the most important modifiable factors in worsening of osteoarthritis symptoms. RESUMO O objetivo da pesquisa foi revisar a produção científica referente à avaliação do estado nutricional de idosos com osteoartrite nos últimos 16 anos. Assim, o estudo foi uma revisão integrativa da literatura, realizada com a busca de artigos publicados em periódicos nacionais e internacionais indexados no PubMed, na SciELO e na BIREME. Foram selecionados 14 artigos, e o idioma inglês foi preponderante. O período de publicação dos artigos variou de 2006 a 2016, com predominância de estudos do tipo transversais. Para reunir os artigos e para posterior avaliação, foi utilizado um instrumento de coleta de dados validado, e as análises críticas dos estudos incluídos foram realizadas por meio da leitura, do agrupamento e da análise dos artigos. As pesquisas sugeriram que existe correlação positiva entre obesidade e osteoartrite de joelhos. Além disto, a obesidade é um dos fatores mais significativos e modificáveis no agravamento dos sintomas da osteoartrite.

Temporal analysis of reported cases of tuberculosis and of tuberculosis-HIV co-infection in Brazil between 2002 and 2012.

PubMed

Gaspar, Renato Simões; Nunes, Natália; Nunes, Marina; Rodrigues, Vandilson Pinheiro

2016-01-01

To investigate the reported cases of tuberculosis and of tuberculosis-HIV co-infection in Brazil between 2002 and 2012. This was an observational study based on secondary time series data collected from the Brazilian Case Registry Database for the 2002-2012 period. The incidence of tuberculosis was stratified by gender, age group, geographical region, and outcome, as was that of tuberculosis-HIV co-infection. Nationally, the incidence of tuberculosis declined by 18%, whereas that of tuberculosis-HIV co-infection increased by 3.8%. There was an overall decrease in the incidence of tuberculosis, despite a significant increase in that of tuberculosis-HIV co-infection in women. The incidence of tuberculosis decreased only in the 0- to 9-year age bracket, remaining stable or increasing in the other age groups. The incidence of tuberculosis-HIV co-infection increased by 209% in the ≥ 60-year age bracket. The incidence of tuberculosis decreased in all geographical regions except the south, whereas that of tuberculosis-HIV co-infection increased by over 150% in the north and northeast. Regarding the outcomes, patients with tuberculosis-HIV co-infection, in comparison with patients infected with tuberculosis only, had a 48% lower chance of cure, a 50% greater risk of treatment nonadherence, and a 94% greater risk of death from tuberculosis. Our study shows that tuberculosis continues to be a relevant public health issue in Brazil, because the goals for the control and cure of the disease have yet to be achieved. In addition, the sharp increase in the incidence of tuberculosis-HIV co-infection in women, in the elderly, and in the northern/northeastern region reveals that the population of HIV-infected individuals is rapidly becoming more female, older, and more impoverished. Investigar os casos notificados de tuberculose e de sua coinfecção com o HIV na população brasileira no período entre 2002 e 2012. Realizou-se um estudo observacional de série temporal, no qual foram analisados dados secundários coletados do Sistema de Informação de Agravos de Notificação, no período entre 2002 e 2012. As incidências de tuberculose e tuberculose-HIV foram estratificadas por sexo, faixa etária, macrorregião e situação de encerramento. A incidência de tuberculose decaiu 18%, enquanto a de coinfecção tuberculose-HIV aumentou 3,8% no país. Houve uma redução geral da incidência de tuberculose apesar do aumento expressivo de tuberculose-HIV em mulheres. A taxa de incidência de tuberculose diminuiu apenas na faixa etária de 0-9 anos, permanecendo estável ou com variação positiva nas outras faixas etárias. A incidência da coinfecção tuberculose-HIV cresceu 209% na faixa etária ≥ 60 anos. A incidência de tuberculose diminuiu em todas as macrorregiões, exceto no Sul, enquanto a de tuberculose-HIV aumentou mais de 150% no Norte e Nordeste. Quanto à situação de encerramento, revelou-se que pacientes com tuberculose-HIV têm 48% menos chance de cura, 50% mais chance de abandonar o tratamento e 94% mais chance de óbito por tuberculose em relação àqueles sem a coinfecção. O presente estudo evidencia a tuberculose como um importante problema de saúde pública no Brasil, uma vez que as metas estabelecidas de cura e controle da doença ainda não foram alcançadas. Ademais, o aumento vertiginoso na incidência de tuberculose-HIV em mulheres, idosos e nas regiões Norte e Nordeste evidencia a feminização, a transição etária e a pauperização pelo HIV.

Aging and health: Self-efficacy for Self-direction in Health Scale.

PubMed

Oliveira, Albertina L; Silva, José T; Lima, Margarida P

2016-07-04

To validate the Escala de Autoeficácia para a Autodireção na Saúde (EAAS - Self-efficacy for Self-direction in Health Scale). Non-experimental quantitative study of EAAS validation, by confirmatory factorial analyses, evaluating a sample of 508 older adults from the north and the center of Portugal with mean age of 71.67 (from 51 to 96 years), to whom the Self-efficacy for Self-direction in Health Scale, the Rosenberg Self-esteem Scale, the Positive and Negative Affect Schedule, the Satisfaction with Life Scale, and the Instrumental Activities of Daily Living Scale were applied. The EAAS was developed from the theoretical constructs of self-efficacy and from self-directed learning within the PALADIN European project framework, aiming to develop an instrument able to assess the extent to which older adults take good care of their health. The internal consistency was 0.87 (Cronbach's alpha) and confirmatory factorial analyses enabled to find a model near the one theoretically proposed, indicating a structure consisting of four dimensions: physical exercise, healthy diet, engaging in health-related learning, and visits to health professionals. From the psychometric point of view, the model in four factors showed quite satisfactory fit indicators. The Self-efficacy for Self-direction in Health Scale, with 16 items, is adequate to evaluate to what extent older adults have confidence in their ability to take care of their own health, with high degree of autonomy. Validar a Escala de Autoeficácia para a Autodireção no domínio da Saúde (EAAS). Estudo quantitativo não experimental de validação da EAAS, por meio de análises fatoriais confirmatórias, avaliando amostra de 508 seniores e idosos provenientes das regiões Norte e Centro de Portugal com média etária de 71.67 (51 a 96 anos), a quem foram aplicadas a Escala de Autoeficácia para a Autodireção na Saúde, a Escala de Autoestima de Rosenberg, a Escala de Afeto Positivo e Afeto Negativo, a Escala de Satisfação Com a Vida e a escala de Atividades Instrumentais da Vida Diária. A EAAS foi desenvolvida a partir dos construtos teóricos da autoeficácia e da aprendizagem autodirigida no âmbito do projeto europeu PALADIN, visando constituir um instrumento apto a avaliar até que ponto os seniores cuidam bem da sua saúde. A consistência interna encontrada foi de 0.87 (alfa de Cronbach) e as análises fatoriais confirmatórias permitiram encontrar um modelo próximo ao proposto teoricamente, indicando uma estrutura constituída por quatro dimensões: exercício físico, alimentação saudável, envolvimento em aprendizagens relativas à saúde e visitas a profissionais de saúde. Do ponto de vista psicométrico, o modelo em quatro fatores mostrou indicadores de ajustamento bastante satisfatórios. A Escala de Autoeficácia para a Autodireção na Saúde, com 16 itens, é adequada para avaliar em que medida os seniores têm confiança na sua capacidade para tomar conta da própria saúde, com elevado grau de autonomia.

Changes in frailty conditions and phenotype components in elderly after hospitalization.

PubMed

Marchiori, Gianna Fiori; Tavares, Darlene Mara Dos Santos

2017-07-10

describing the changes in frailty conditions over the period of a year after hospital discharge, verifying predictive variables for changes in frailty conditions and frailty phenotype components according to worsening, improving and stable groups. a longitudinal survey carried out with 129 elderly. A structured form for socioeconomic and health data, scales (Geriatric Depression Scale - short form, Katz scale, Lawton and Brody scale) and frailty phenotype according to Fried were used. Descriptive analysis and multinomial logistic regression model (p<0.05) were performed. we found that 56.7% of older adults changed their condition from non-frail to pre-frail, with no changes from non-frail to frail. Deaths were found between frail and pre-frail elderly. In the worsening group, the increase in the number of morbidities was a predictor for exhaustion and/or fatigue, while in the improving group, increased dependence on instrumental activities of daily living was a predictor for weight loss, and reduced scores indicative of depression due to low level of physical activity. a greater percentage of changes from non-frail condition to pre-frail older adults were observed, and health variables were only predictive for frailty phenotype components. descrever as mudanças nas condições de fragilidade ao longo de um ano após a alta hospitalar, e verificar as variáveis preditoras da mudança das condições de fragilidade e dos componentes do fenótipo de fragilidade, segundo grupos de piora, melhora e estabilidade. inquérito longitudinal, realizado com 129 idosos. Utilizou-se formulário estruturado para dados socioeconômicos e saúde, escalas (Depressão Geriátrica Abreviada, Katz, Lawton e Brody) e fenótipo de fragilidade, segundo Fried. Procederam-se às análises descritiva e modelo de regressão logística multinomial (p<0,05). constatou-se que 56,7% dos idosos mudaram sua condição de não frágeis para pré-frágeis, não ocorrendo mudança dos não frágeis para frágeis. Observou-se o óbito entre idosos frágeis e pré-frágeis. No grupo de piora, o aumento do número de morbidades foi preditor para exaustão e/ou fadiga, enquanto que, no grupo de melhora, o aumento na dependência das atividades instrumentais de vida diária foi preditor para a perda de peso, e a diminuição dos escores do indicativo de depressão para o baixo nível de atividade física. houve maior percentual de mudança na condição de idosos não frágeis para pré-frágeis e as variáveis de saúde foram preditoras apenas para os componentes do fenótipo de fragilidade. describir los cambios en las condiciones de fragilidad a lo largo de un año después del alta hospitalaria, y verificar las variables predictoras del cambio de las condiciones de fragilidad y de los componentes del fenotipo de fragilidad, según grupos de empeoramiento, mejoría y estabilidad. encuesta longitudinal, realizada con 129 ancianos. Se utilizó formulario estructurado para recoger datos socioeconómicos y salud; se utilizaron las escalas Depresión Geriátrica Abreviada (GDS-15), Actividades Básicas de Vida Diaria de Katz, Actividades Instrumentales de Vida Diaria de Lawton y Brody, y Fenotipo de Fragilidad, según Fried. Se procedió al análisis descriptivo y modelo de regresión logística multinomial (p<0,05). se constató que 56,7% de los ancianos cambiaron su condición de no-frágiles para prefrágiles, no habiendo ocurriendo cambio de los no-frágiles para frágiles. Se observó muerte entre ancianos frágiles y prefrágiles. En el grupo de empeoramiento, el aumento del número de morbilidades fue predictor para agotamiento y/o fatiga, en cuanto en el grupo de mejoría, el aumento en la dependencia de las actividades instrumentales de vida diaria fue predictor para la pérdida de peso y la disminución de los puntajes del indicativo de depresión para el bajo nivel de actividad física. hubo mayor porcentaje de cambio en la condición de ancianos no-frágiles para prefrágiles y las variables de salud fueron predictoras apenas para los componentes del fenotipo de fragilidad.

Climate Prediction Center - Stratosphere: Stratosphere-Troposphere

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Wave 2 Wave 3 - NH EQ SH NH EQ SH NH EQ SH NH EQ SH NH SH NH SH NH SH NH SH Annual N E S N E S N E S N E S N S N S N S N S JFM N E S N E S N E S N E S N S N S N S N S AMJ N E S N E S N E S N E S N S N S N S N S JAS N E S N E S N E S N E S N S N S N S N S OND N E S N E S N E S N E S N S N S N S N S Past

CFSv2 Seasonal Climate Forecasts

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Nino3.4 Nino4 E1 (data) E2 (data) E3 (data) E1 (data) E2 (data) E3 (data) E1 (data) E2 (data) E3 (data) E1 (data) E2 (data) E3 (data) E1 (data) E2 (data) E3 (data) E1 (data) E2 (data) E3 (data) E1 (data) E2 (data) E3 (data) E1 (data) E2 (data) E3 (data) E1 (data) E2 (data) E3 (data) Sea surface height and

Conacyt

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Organismos de Inspección Organismos de Certificación de personas Calidad Acreditación ¿Que es la : Estructuración de la Evaluación de la Conformidad 1.2: Fortalecimiento y articulación de las instituciones Componente 2: Fortalecimiento del Sistema Nacional de Innovación 6: Incorporación de la Innovación en la

Berkeley Lab - Materials Sciences Division

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2018 [PDF] October 2017 [PDF] July 2017 [PDF] April 2017 [PDF] January 2017 [PDF] October 2016 [PDF ] July 2016 [PDF] April 2016 [PDF] January 2016 [PDF] October 2015 [PDF] March 2015 [PDF] December 2014 [PDF] April 2014 [PDF] February 2014 [PDF] September 2013 [PDF] March 2013 [PDF] October, 2012 [PDF

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ACHP | Case Digest - Protecting Historic Properties: Section 106 in Action

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Digest index. Previous issues: Summer 2012 (PDF) Spring 2012 (PDF) Winter 2012 (PDF) Fall 2011 (PDF ) Summer 2011 (PDF) Spring 2011 (PDF) Winter 2011 (PDF) Fall 2010 (PDF) Summer 2010 (PDF) Winter 2010 (PDF ) Fall 2009 (PDF) Summer 2009 (PDF) Spring 2009 (PDF) Winter 2009 (PDF) Fall 2008 (PDF) Summer 2008 (PDF

NOAA Weather Radio

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recepción confiable en algunas localidades debido a bloqueos de las señales y/o distancia excesiva de la mensajes NOTA: Servicio de NWR para un condado depende de recepción confiable la señal, la cual cobertura de NWR, o cobertura parcial, serán indicados. Algunos condados o partes de condados

Periodic Table of Elements: Los Alamos National Laboratory

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, Communication Specialist talks about the Periodic Table of Elements 7/17/17 Back to Elements List Fermium is process, but the identification of Pu-244 raised the possibility that still more neutrons could have been discovery of the new elements, and the new data on neutron capture, was kept secret on the orders of the U.S

Staff - Trystan M. Herriott | Alaska Division of Geological & Geophysical

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sandstone interval in outcrop of the Tonnie Siltstone Member, Chinitna Formation, lower Cook Inlet, south Paveloff Siltstone Member of the Chinitna Formation: Exploring the potential role of facies variations in member of the Upper Jurassic Naknek Formation, northern Chinitna Bay, Alaska, in Wartes, M.A., ed

NOAA Weather Radio

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. -------------------------------------------------------------------------------- La DESCRIPCIÓN DE COLUMNAS EN TABLAS DE ESTADOS Al hacer un clic en un estado o territorio de la la radio. (Todas áreas de ahora en adelante serán llamados condados.) Entonces la radio les mensaje de la emisión, los oyentes oirán un corto estallido estático digital que señala el fin del

United States Nuclear Data Program (USNDP)

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Report FY 2016 Annual Report FY 2015 Annual Report FY 2014 Annual Report FY 2013 Annual Report FY 2012 Annual Report FY 2011 Annual Report FY 2010 Annual Report FY 2009 Annual Report FY 2008 Annual Report FY 2007 Annual Report FY 2006 Annual Report FY 2005 Annual Report FY 2004 Final Report FY 2003 Final

Potential intravenous drug incompatibilities in a pediatric unit.

PubMed

Leal, Karla Dalliane Batista; Leopoldino, Ramon Weyler Duarte; Martins, Rand Randall; Veríssimo, Lourena Mafra

2016-01-01

To investigate potential intravenous drug incompatibilities and related risk factors in a pediatric unit. A cross-sectional analytical study conducted in the pediatric unit of a university hospital in Brazil. Data on prescriptions given to children aged 0-15 years from June to October 2014 were collected. Prescriptions that did not include intravenous drugs and prescriptions with incomplete dosage regimen or written in poor handwriting were excluded. Associations between variables and the risk of potential incompatibility were investigated using the Student's t test and ANOVA; the level of significance was set at 5% (p<0.05). Relative risks were calculated for each drug involved in potential incompatibility with 95% confidence interval. A total of 222 children participated in the study; 132 (59.5%) children were male and 118 (53.2%) were aged between 0 and 2 years. The mean length of stay was 7.7±2.3 days. Dipyrone, penicillin G and ceftriaxona were the most commonly prescribed drugs. At least one potential incompatibility was detected in about 85% of children (1.2 incompatibility/patient ratio). Most incompatibilities detected fell into the non-tested (93.4%), precipitation (5.5%), turbidity (0.7%) or chemical decomposition (0.4%) categories. The number of drugs and prescription of diazepam, phenytoin, phenobarbital or metronidazole were risk factors for potential incompatibility. Most pediatric prescriptions involved potential incompatibilities, with higher prevalence of non-tested incompatibilities. The number of drugs and prescription of diazepam, phenobarbital, phenytoin or metronidazole were risk factors for potential incompatibilities. Avaliar o potencial de incompatibilidade dos medicamentos intravenosos, identificando possíveis fatores de risco em uma unidade pediátrica. Trata-se de um estudo observacional analítico do tipo transversal realizado na unidade de pediatria de um hospital de ensino no Brasil. Os dados foram coletados de junho a outubro de 2014 a partir da análise das prescrições de crianças (0 a 15 anos) hospitalizadas. Foram excluídas prescrições sem medicamento intravenoso e com posologia incompletas ou grafia inadequada. A associação entre as variáveis e o risco de potenciais incompatibilidades foi determinada pelo teste t de Student e ANOVA, considerando significativo para p<0,05. Calculou-se o risco relativo com intervalo de confiança de 95% de cada medicamento envolvido. Duzentos e vinte e duas crianças participaram do estudo, 132 (59,5%) eram do gênero masculino, 118 (53,2%) tinham idade entre 0 a 2 anos e estiveram internados em média 7,7±2,3 dias. Os medicamentos mais prescritos foram dipirona, penicilina G e ceftriaxona. Quase 85% das crianças apresentaram ao menos uma potencial incompatibilidade, razão de 1,2 incompatibilidades/paciente. Os tipos de incompatibilidades mais comuns foram: não testada (93,4%), precipitação (5,5%), turbidez (0,7%) e decomposição química (0,4%). Os fatores associados a potenciais incompatibilidades foram: número de medicamentos e a prescrição dos medicamentos diazepam, fenitoína, fenobarbital e metronidazol. A maioria das prescrições pediátricas apresentou potenciais incompatibilidades e a incompatibilidade não testada foi o tipo mais comum. O número de medicamentos e a prescrição dos medicamentos diazepam, fenobarbital, fenitoína e metronidazol foram fatores de risco para potenciais incompatibilidades.

Staff - Nina T. Harun | Alaska Division of Geological & Geophysical Surveys

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mapping of the Upper Jurassic Naknek Formation in a footwall syncline associated with the Bruin Bay fault Ivishak Formation in the northeastern Brooks Range, Alaska: University of Alaska Fairbanks, M.S. thesis Triassic Ivishak Formation in the Sadlerochit Mountains, northeastern Alaska: Alaska Division of Geological

NOAA Weather Radio

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televisión afuera o dentro de la casa. Todos éstos pueden mejorar recepción a cualquier radio de FM , incluso NWR. Cualquier pregunta específica sobre la recepción (o falta de ella) en su sitio debe Search For Go NWS All NOAA NWR Recepción El área de la recepción nominal para un receptor de Radio

Fermilab Today - Related Content

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Fermilab Today Related Content Subscribe | Contact Fermilab Today | Archive | Classifieds Search Experiment Profiles Current Archive Current Fermilab Today Archive of 2015 Archive of 2014 Archive of 2013 Archive of 2012 Archive of 2011 Archive of 2010 Archive of 2009 Archive of 2008 Archive of 2007 Archive of

Neutron Scattering Reference

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Conversion Factors Periodic Table of the Elements Chart of the Nuclides Map of the Nuclides Computer Index of (Atominstitut der Österreichischen Universitäten) Neutron Activation Table of Elements Neutron Scattering at neutronsources.org. The information contained here in the Neutron Scattering Web has been

Homepage

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Defense.gov Special Report: National Disability Employment Awareness Month

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service at the U.S. Army Corps of Engineers, DeLisa L. Kviz currently works as chief ... Profile photo of of service with the Department of the Navy, including over 11 years ... Profile photo of Ivan E is a technical information specialist in the Analysis and ... Profile photo of Chad A. Molenhour

Owen Barwell - Chief Financial Officer | NREL

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Owen Barwell - Chief Financial Officer Owen Barwell - Chief Financial Officer A photo of Owen , analysis, and management. He previously served as the Acting Chief Financial Officer and Deputy Chief Financial Officer of the U.S. Department of Energy (DOE), where he was directly responsible for DOE's

Smoot Cosmology Group

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. ___________________________________________________________________________________ What do the different colors on the map of the CMB represent? Although the temperature of the CMB is The most conclusive and carefully examined evidence for The Big Bang is the existence of an isotropic radiation bath that permeates the entirety of the universe known as the cosmic microwave

Automotive Research Center

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| photos Web page Web page 2016 PDF | photos Web page Web page 2015 PDF | photos | video Web page Web page 2014 PDF | photos | videos Web page Web page 2013 PDF | photos Web page Web page 2012 PDF | photos Web page Web page 2011 PDF | photos PDF Web page 2010 PDF PDF PDF 2009 PDF PDF PDF 2008 PDF PDF PDF 2007

NOAA Weather Radio - EAS Description

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Programación Español Listado de estación Explicacion de SAME Coverage Station Listing County Listing ±ol Condado de cobertura Listado de estación Lista de Emisora y Cobertura Acerca de NWR ESTACIONES NACIONAL Información General Información Para el consumidor receptor NWR Recepción Explicacion de NWR

NOAA Weather Radio - Outage Reporting

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Programación Español Listado de estación Explicacion de SAME Coverage Station Listing County Listing ±ol Condado de cobertura Listado de estación Lista de Emisora y Cobertura Acerca de NWR ESTACIONES NACIONAL Información General Información Para el consumidor receptor NWR Recepción Explicacion de NWR

NOAA Weather Radio

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Programación Español Listado de estación Explicacion de SAME Coverage Station Listing County Listing Condado de cobertura Listado de estación Lista de Emisora y Cobertura Acerca de NWR ESTACIONES NACIONAL Información General Información Para el consumidor receptor NWR Recepción Explicacion de NWR SAME

NOAA Weather Radio - Reception Problems

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Programación Español Listado de estación Explicacion de SAME Coverage Station Listing County Listing ±ol Condado de cobertura Listado de estación Lista de Emisora y Cobertura Acerca de NWR ESTACIONES NACIONAL Información General Información Para el consumidor receptor NWR Recepción Explicacion de NWR

NOAA Weather Radio

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Programación Español Listado de estación Explicacion de SAME Coverage Station Listing County Listing interés abajo de dentro de la lista entera del archivo nacional Transmisores de NWR en los Estados ±ol Condado de cobertura Listado de estación Lista de Emisora y Cobertura Acerca de NWR ESTACIONES

AF family shares experience with child's autism > U.S. Air Force >

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Reading List 2017 CSAF Reading List 2016 CSAF Reading List 2015 CSAF Reading List 2014 CSAF Reading List 2013 CSAF Reading List 2012 CSAF Reading List 2011 CSAF Reading List 2010 CSAF Reading List 2009 CSAF Reading List 2008 CSAF Reading List 2007 CSAF Reading List 2006 CSAF Reading List 50 Years of the CMSAF

Mobile phones and elderly people: a noisy communication.

PubMed

Stamato, Cláudia; Moraes, Anamaria de

2012-01-01

Knowing the users is capital for building user-friendly digital interfaces. One way to think about the users is considering their familiarity with this technology. This article presents the results of twelve interviews with elderly people residing in the so-called South Zone of Rio de Janeiro (Brazil) who have used mobile phones over at least one year. It is part of the Doctor's Thesis "Mobile phones for elderly people - usability for social integration" ("Celulares para idosos - usabilidade a serviço da integração social"), which is targeted at ascertaining if the current mobile phones are user-friendly for elderly people. Through the technique of Guided Interviews, we found usage time, criteria for choice of phones, reasons for changes, preferences, and manners of use. Preliminarily, we have noticed differences in the behavior of the participating users and performed a qualitative analysis according to groups of age and gender.

X-Ray Data Booklet

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X-RAY DATA BOOKLET Center for X-ray Optics and Advanced Light Source Lawrence Berkeley National Laboratory Introduction X-Ray Properties of Elements Electron Binding Energies X-Ray Energy Emission Energies Table of X-Ray Properties Synchrotron Radiation Characteristics of Synchrotron Radiation History of X

Air and Pesticides

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Pesticides and Human Health Pesticide Incidents What Happens to Pesticides Released into the Environment Pesticides and Human Health Pesticide Incidents What Happens to Pesticides Released into the Environment ; Environment Human Health Animal Health Safe Use Practices Food Safety Environment Air Water Soil Wildlife

Smoot Cosmology Group

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all forces show that they are the same basic force, and have frozen out to different forces in the . What do the different colors on the map of the CMB represent? Although the temperature of the CMB is Implications of the COBE DMR Map of the Early Universe What COBE DMR saw: The COBE DMR (Cosmic

What about using pesticides if I am pregnant or have a baby?

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? Related Topics: Pesticides and Human Health Pesticides and Pregnancy Pesticides and Children Understanding @ace.orst.edu. Last updated January 27, 2016 Related Topics: Pesticides and Human Health Pesticides and ; Environment Human Health Animal Health Safe Use Practices Food Safety Environment Air Water Soil Wildlife

Mineral Resources | Alaska Division of Geological & Geophysical Surveys

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and geophysical framework of Alaska as it pertains to the mineral resources of the state. Summary maps and reports illustrate the geology of the state's prospective mineral terranes and provide data on the location, type, and potential of the state's mineral resources. These data aid in the state's management of

Centro Nacional de Información de Pesticidas - Portada

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a.m. a 12:00 p.m. PT, de lunes a viernes A B C D E F G H I J K L M N O P Q R S T U V W X Y Z Índice acuerdo de cooperación entre la Universidad Estatal de Oregón y la Agencia de Protección Ambiental de los Estados Unidos (acuerdo de cooperación # X8-83560101). La información contenida en esta

NOAA Weather Radio - County Coverage by State

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Programación Español Listado de estación Explicacion de SAME Coverage Station Listing County Listing ±ol Condado de cobertura Listado de estación Lista de Emisora y Cobertura Acerca de NWR ESTACIONES NACIONAL Información General Información Para el consumidor receptor NWR Recepción Explicacion de NWR

NOAA Weather Radio - Deaf and Hard of Hearing

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Programación Español Listado de estación Explicacion de SAME Coverage Station Listing County Listing ±ol Condado de cobertura Listado de estación Lista de Emisora y Cobertura Acerca de NWR ESTACIONES NACIONAL Información General Información Para el consumidor receptor NWR Recepción Explicacion de NWR

NOAA Weather Radio

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Emergencia (EAS) de la Comisión Federal de Comunicaciones, Radio NOAA es una red para todo tipo de peligros . De este modo, es la fuente más comprensiva de información del tiempo y emergencias que està químicos o derramamientos de petróleo). Conocida como "La Voz del Servicio Nacional de Meteorología

NOAA Weather Radio - Viewing Outages

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Programación Español Listado de estación Explicacion de SAME Coverage Station Listing County Listing Listado de estación Lista de Emisora y Cobertura Acerca de NWR ESTACIONES NACIONAL Información General Información Para el consumidor receptor NWR Recepción Explicacion de NWR SAME Programación en Español

Publications - GMC 395 | Alaska Division of Geological & Geophysical

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investigations of the diatom stratigraphy of Borehole TA8, Portage Alaska: Alaska Division of Geological & Visiting Alaska State Employees DGGS State of Alaska search Alaska Division of Geological & Geophysical DGGS GMC 395 Publication Details Title: Preliminary investigations of the diatom stratigraphy of

CXRO - Mi-Young Im, Staff Scientist

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X-Ray Database Zone Plate Education Nanomagnetism X-Ray Microscopy LDJIM EUV Lithography EUV Mask Publications Contact The Center for X-Ray Optics is a multi-disciplined research group within Lawrence Berkeley -Ray Optics X-Ray Database Nanomagnetism X-Ray Microscopy EUV Lithography EUV Mask Imaging

Solar Integration Data Sets | Grid Modernization | NREL

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modeled solar data to study the operational impacts of solar on the electric power grid. Solar Power Data need to estimate power production from hypothetical solar power plants. Solar Integration National Dataset (SIND) Toolkit The next generation of modeled solar data with higher temporal and spatial

CNEA - Centro Atómico Bariloche

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³mica (CNEA), a través de la Sección de... EL RA-6, RENOVADO EN EL AÑO DE SU 35º ANIVERSARIO EL RA-6 DIRIGIDAS A DOCENTES REALIZAN EN EL CAB CAPACITACIONES DIRIGIDAS A... La Comisión Nacional de Energía Atà ... RECONOCIMIENTO PARA LA SECCIÓN DE DIVULGACIÓN CIENTÍFICA Y TECNOLÓGICA DEL CAB RECONOCIMIENTO PARA LA SECCIÃ

NOAA Weather Radio

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para un condado depende de recepción de la seña fiable, que típicamente se extiende en un radio de 40 millas del transmisor, asumiendo terreno plano. Condados sin la cobertura de NWR o cobertura obstáculos de la seña y/o la distancia excesiva del transmisor. Usted puede referirse directamente a

Defense.gov - Special Report - Travels With Gates

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. If you wish to see the latest content, please visit the current version of the site. For persons with look at production of the newest all-terrain vehicles slated for Afghanistan, and praised the modern You have reached a collection of archived material. The content available is no longer being

Publications - PIR 2008-1 | Alaska Division of Geological & Geophysical

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investigations in the Brooks Range Foothills and North Slope, Alaska: Alaska Division of Geological & interpretations of the Nanushuk Formation exposed along the Colville River near the confluences with the Awuna and Surveys Skip to content State of Alaska myAlaska My Government Resident Business in Alaska

Periodic Table of Elements: Los Alamos National Laboratory

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, Communication Specialist talks about the Periodic Table of Elements 7/17/17 Back to Elements List Seaborgium is Phone Periodic Table of Elements: LANL Chemistry Division » Periodic Table of Elements Chemistry the Elements Chemical Properties Elements List Periodic Table Download News LANL Biofuels Work

NIST Digital Archives

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Nederlands Français Search Search Advanced Search Find results with: error div Add another field Search by date Search by date: from after before on from: mm/dd/yyyy to to: mm/dd/yyyy Search Clear All Searching physical science laboratories. Instant Search Search PHOTOS Search Photos Search NIST PUBLICATIONS Search

Department of Navy Chief Information Officer

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(6) Freedom of Information Act (29) IT Investment Management (47) Records Management (37 Management and Knowledge Management programs. DON CIO Information About the DON CIO Website Accessibility this website is to facilitate effective information flow about information management/information

Alternative Fuels Data Center: Recursos en español

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colaboración entre el gobierno y la industria patrocinada por el Programa de Tecnologías de Vehículos del enchufables Recursos en la web Use estas recursos para obtener información sobre: Economía de combustible y huella de carbono de su vehículo Cómo aumentar la economía de combustible Importancia de la economía

NOAA Weather Radio

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¡tico de programación de la Radio del Tiempo de NOAA la capacidad de transmitir en español. Cualquier Programación Español Listado de estación Explicacion de SAME Coverage Station Listing County Listing Search For Go NWS All NOAA Las Políticas de Programación en Español Se le añadió al sistema automÃ

Operating the Western Interconnection with 80%-90% Renewables - Text

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different penetration levels. This chart here shows the left column is the actual penetration of the renewables in all of the different scenarios. The higher base load and the higher VG before curtailment are to a lot of results. This next slide shows the generation by the different types of both renewable

Philip A. Parilla | NREL

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atomic layer deposition for applications. He also manages the majority of X-ray characterization equipment at NREL, specifically X-ray diffraction and X-ray fluorescence instrumentation. Additionally, he for EERE's Hydrogen Storage program. He is also an expert in X-ray diffraction and X-ray fluorescence

Energy Analysis Publications | Energy Analysis | NREL

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Systems Impact Analysis We perform impact analysis to evaluate and understand the impact of markets publications. Featured Publications Complex Systems Analysis Complex systems analysis integrates all aspects of , policies, and financing on technology uptake and the impact of new technologies on markets and policy

News

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Professors Senior Mentor Biographies Fact Sheets Commander's Call Topics CCT Archive CSAF Reading List 2017 CSAF Reading List 2016 CSAF Reading List 2015 CSAF Reading List 2014 CSAF Reading List 2013 CSAF Reading List 2012 CSAF Reading List 2011 CSAF Reading List 2010 CSAF Reading List 2009 CSAF Reading List

NREL's Advanced Atomic Layer Deposition Enables Lithium-Ion Battery

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Battery Technology News Release: NREL's Advanced Atomic Layer Deposition Enables Lithium-Ion Battery increasingly demanding needs of any battery application. These lithium-ion batteries feature a hybrid solid further customized lithium-ion battery materials for high performance devices by utilizing our patented

Chunmei Ban | NREL

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degradation in silicon nanowires for lithium ion battery," ACS Nano, 2015, 9(5), pp 5559-5566, DOI molecular layer deposited coating on silicon nanoparticles for lithium ion battery anodes," ACS Nano lithium-ion batteries, lithium-air batteries, organic radical batteries, and magnesium-ion batteries. The

Transportation Research News | Transportation News | Transportation

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Engineering has yielded new insights for lithium-ion (Li-ion) battery electrodes at the microstructural level -Phase Stochastics in Lithium-Ion Battery Electrodes" detailing the research and resulting revolutionizes the way lithium-ion (Li-ion) batteries are evaluated so designs can be improved before batteries

DoD ESI

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Information Management, Microsoft Platform Management, Identity & Access Management, Endpoint Systems /2016-24054/category-management). OMB released this IT Success Story for "Information Sharing Management of Common Information Technology: Mobile Devices and Services 7/1/2016 Category Management Policy

Electron Microscopy Lab

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NOAA Weather Radio - Station Search

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Programación Español Listado de estación Explicacion de SAME Coverage Station Listing County Listing estación Lista de Emisora y Cobertura Acerca de NWR ESTACIONES NACIONAL Información General Información Para el consumidor receptor NWR Recepción Explicacion de NWR SAME Programación en Español NOAA

NOAA Weather Radio

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automatizado apoyará la difusión en español. Idioma español de voz sintetizada será proporcionado para algunas oficinas donde el personal permite y los dictados de la población, la radiodifusión española Programación Español Listado de estación Explicacion de SAME Coverage Station Listing County Listing

NOAA Weather Radio - Cobertura de Condado a Condado

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para un condado depende de recepción de la seña fiable, que típicamente se extiende en un radio de 40 millas del transmisor, asumiendo terreno plano. Condados sin la cobertura de NWR o cobertura obstáculos de la seña y/o la distancia excesiva del transmisor. Usted puede referirse directamente a

DIY Solar Market Analysis Webinar Series: PVWatts® | State, Local, and

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, and updates the energy prediction algorithms to be in line with the actual performance of modern the latest update." In this webinar, one of the tool's developers explains how the new version of ® Wednesday, July 9, 2014 As part of a Do-It-Yourself Solar Market Analysis summer series, NREL's Solar

Publications | Argonne National Laboratory

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Carlo, F. De Carlo, Francesco De Graef, Marc de Jalon, Garcia De La Rosa, K. de Leon, P.A. Ignacio- de . Degenkolb, E. DeJongh, M. DeLisi, M. Delmont, T. O. DeLuca, C. Demas, N. Demchenko, Y. Demeshko, I. Demiguel , N. Kyrpides, Nikos La Joie, C. Labarta, J. LaBissoniere, D. Lacinski, L. Lacour, S. Laguna, I. Lai

Solar Requests for Proposals | State, Local, and Tribal Governments | NREL

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who have a lot of experience in this area may handle the process on their own while others may decide greatest number of respondents and give the agency the greatest number of options. Solar RFP Elements As to the selection criteria. Sources Solar Powering Your Community: Key Elements of Solar Requests for

What's New | Galaxy of Images

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] View Images Details ID: SIL32-035-02 Enlarge Image View Images Details ID: SIL32-038-02 Enlarge Image View Images Details ID: SIL-2004_CT_6_1 Enlarge Image View Images Details ID: SIL32-010-01 Enlarge Image View Images Details ID: SIL32-013-05 Enlarge Image View Images Details ID: SIL32-014-02 Enlarge

SMS Two Column Template: Smithsonian Marine Station (SMS) at Fort Pierce

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appreciation of this invaluable natural resource. My image My image My image My image My image Discover: - over difference in IRL water quality Check Out: - the IRL Photo Gallery - the IRL Species Image Collection Downloads: - Species Database - IRL Species Bibliography My image My image My image My image My image EOL

Chief Information Officer > DoDSection508 > Std_Stmt

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Skip to main content (Press Enter). Toggle navigation Chief Information Officer Search Search Chief Information Officer: Search Search Chief Information Officer: Search Chief Information Officer U.S. Department of Defense Chief Information Officer Home About DoD CIO Bios Organization DCIO C4&IIC DCIO IE

Chief Information Officer - U.S. Department of Defense

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Skip to main content (Press Enter). Toggle navigation Chief Information Officer Search Search Chief Information Officer: Search Search Chief Information Officer: Search Chief Information Officer U.S. Department of Defense Chief Information Officer Home About DoD CIO Bios Organization DCIO C4&IIC DCIO IE

Compcon '95 Paper

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has the ability to view various parts of a frog from many different angles, and with the different here - the Virtual Dissection Kit - has been accessed by 50,000 different sites, in over 50 different form document that is a translation of the user interface into a different language (the Virtual Frog

Welcome - TampaBay.WaterAtlas.org

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An edition of: WaterAtlas.orgPresented By: USF Water Institute Choose a Water Atlas Charlotte Harbor NEP Water Atlas Hillsborough County Water Atlas Lake County Water Atlas Manatee County Water Atlas Orange County Water Atlas Pinellas County Water Atlas Polk County Water Atlas Sarasota County Water Atlas

Publications - GMC 430 | Alaska Division of Geological & Geophysical

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: Formation hardness of Hemlock Formation cores after immersion in water and oil based fracturing fluids; and mechanics: Formation hardness of Hemlock Formation cores after immersion in water and oil based fracturing Surveys Skip to content State of Alaska myAlaska My Government Resident Business in Alaska

NOAA Photo Library

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- nssl0057 Early stage of tornado formation. Photo #1 of a series of classic photographs of this tornado Available Publication of the U.S. Department of Commerce, National Oceanic & Atmospheric Adminstration NOAA Photo Library Banner Takes you to the Top Page Takes you to the About this Site page. Takes

Publications - GMC 303 | Alaska Division of Geological & Geophysical

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DGGS GMC 303 Publication Details Title: The facies of the Ivishak Formation from conventional core , The facies of the Ivishak Formation from conventional core descriptions, electric logs, and Surveys Skip to content State of Alaska myAlaska My Government Resident Business in Alaska

NCEP Operational HWRF Forecasting System

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2010 Basin: North Atlantic Eastern North Pacific Central North Pacific Western North Pacific North ALBERTO01L North Atlantic: (1) active ALBERTO01L Eastern North Pacific: (0) active Central North Pacific: (0 ) active Western North Pacific: (0) active North Indian Ocean: (0) active Southern Hemisphere: (0) active Â

Wind Turbine Control Systems | Wind | NREL

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Turbine Control Systems Wind Turbine Control Systems Advanced wind turbine controls can reduce the loads on wind turbine components while capturing more wind energy and converting it into electricity turbines. A photo of a wind turbine against blue sky with white blades on their sides in the foreground

Wind Energy Modeling and Simulation | Wind | NREL

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Wind Energy Modeling and Simulation Wind Turbine Modeling and Simulation Wind turbines are unique wind turbines. It enables the analysis of a range of wind turbine configurations, including: Two- or (SOWFA) employs computational fluid dynamics to allow users to investigate wind turbine and wind power

Systems Engineering Workshop 2017 | Wind | NREL

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Energy for Wind Systems Today Cost and Value of Wind Power-Implications of Wind Turbine Design, János Aaron Smith, PPI Session II: Uncertainty Impacts on Wind Turbine Design and Performance Mitigation of Wind Turbine Design Load Uncertainties, Anand Natarajan, DTU Wind Energy Uncertainty in the Wind

Science Programs

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Research Library Science Briefs Science News Science Highlights Lab Organizations Science Programs Applied Innovation Research Capabilities Deploying Innovation Technology Opportunities Innovation in New Mexico Los Laboratory Delivering science and technology to protect our nation and promote world stability Science &

Food Safety

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veggies? Federal Pesticide Regulation Pesticides and Human Health Regulating Organic Food Production fruit and veggies? Federal Pesticide Regulation Pesticides and Human Health Regulating Organic Food ; Environment Human Health Animal Health Safe Use Practices Food Safety Environment Air Water Soil Wildlife

--No Title--

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-- OAS Intranet -- Sunday 27 May 2018 Approved Program-Budget 2018 Proposed Program-Budget 2018 Approved Program-Budget 2017 Proposed Program-Budget 2017 Approved Program-Budget 2016 Proposed Program -Budget 2016 Approved Program-Budget 2015 Proposed Program-Budget 2015 Approved Program-Budget 2014

National Centers for Environmental Prediction

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DIFFERENT BETWEEN THE 12-KM NAM PARENT DOMAIN AND THE NAM CONUS NEST? (04 Nov 2011, updated 13 April 2017 . Back to Table of Contents WHY IS THE QPF DIFFERENT BETWEEN THE 12-KM NAM PARENT DOMAIN AND THE NAM different QPF fields between the 12km NAM parent and the NAM nests. 13 April 2017 update: In the 12 August

NOAA Weather Radio - Using NWR SAME

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Programación Español Listado de estación Explicacion de SAME Coverage Station Listing County Listing Transmitter Outages FAQ NWR - Special Needs ESPAÑOL Español Condado de cobertura Listado de estación Lista de Emisora y Cobertura Acerca de NWR ESTACIONES NACIONAL Información General Información Para el

NOAA Weather Radio - EAS Event Codes

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Programación Español Listado de estación Explicacion de SAME Coverage Station Listing County Listing Transmitter Outages FAQ NWR - Special Needs ESPAÑOL Español Condado de cobertura Listado de estación Lista de Emisora y Cobertura Acerca de NWR ESTACIONES NACIONAL Información General Información Para el

NOAA Weather Radio - Station Listing

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Programación Español Listado de estación Explicacion de SAME Coverage Station Listing County Listing Outages FAQ NWR - Special Needs ESPAÑOL Español Condado de cobertura Listado de estación Lista de Emisora y Cobertura Acerca de NWR ESTACIONES NACIONAL Información General Información Para el consumidor

NOAA Weather Radio - NWR Voices

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Programación Español Listado de estación Explicacion de SAME Coverage Station Listing County Listing Transmitter Outages FAQ NWR - Special Needs ESPAÑOL Español Condado de cobertura Listado de estación Lista de Emisora y Cobertura Acerca de NWR ESTACIONES NACIONAL Información General Información Para el

NOAA Weather Radio - General Information

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Programación Español Listado de estación Explicacion de SAME Coverage Station Listing County Listing - Special Needs ESPAÑOL Español Condado de cobertura Listado de estación Lista de Emisora y Cobertura Acerca de NWR ESTACIONES NACIONAL Información General Información Para el consumidor receptor NWR

The Sky This Week, 2016 April 26 - May 3 - Naval Oceanography Portal

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the week coursing through the summer Milky Way, skirting the southern reaches of the ecliptic in the morning sky. Last Quarter occurs on the 29th at 11:29 pm Eastern Daylight Time. As Luna wanes through her begins on the 29th and lasts through May 8th. This month's target constellation is Leo, the Lion, which

The Evolving Search for the Nature of Dark Energy | Berkeley Lab

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percent of its contents is ordinary matter, 24 percent is dark matter, and all the rest is dark energy ordinary matter, 24 percent is dark matter, and all the rest is dark energy - unless there's a flaw in our Universe, and it's pushing all the rest - ordinary matter and dark matter - farther apart at an ever

Chief Information Officer > About DoD CIO > Organization > DCIO CS

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Skip to main content (Press Enter). Toggle navigation Chief Information Officer Search Search Chief Information Officer: Search Search Chief Information Officer: Search Chief Information Officer U.S. Department of Defense Chief Information Officer Home About DoD CIO Bios Organization DCIO C4&IIC DCIO IE

Defense.gov - Special Report - Progress Report: Department of Defense

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the need to re-shape and re-balance the direction of the Department and an increasingly challenging capabilities, requirements, risks and needs for the purpose of shifting the Department toward a different , the Landing Platform Dock ship and Mobile Landing Platform ship; and Completing production of the C-17

Publications - PIR 2015-5 | Alaska Division of Geological & Geophysical

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superposition of strike-slip and reverse-slip faults in the Bruin Bay fault system, Ursus Head, lower Cook Inlet , Preliminary investigation of fracture populations in Mesozoic strata of the Cook Inlet forearc basin: Iniskin observations: Continued facies analysis of the Lower Jurassic Talkeetna Formation, north Chinitna Bay, Alaska

Publications - GMC 329 | Alaska Division of Geological & Geophysical

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Bee Creek 1976 holes of Chignik C2 Quadrangle (B-1, 265'; B-2, 500'; B-3, 500'; B-4, 300' and B-5, 300 the Bee Creek 1976 holes of Chignik C2 Quadrangle (B-1, 265'; B-2, 500'; B-3, 500'; B-4, 300' and B-5

NOAA Weather Radio

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Search For Go NWS All NOAA NWR Recepción El área de la recepción nominal para un receptor de Radio cosas afectan la recepción de señas de la radio. Por ejemplo, las extensiones grandes de agua de sal de NWR. Siga leyendo si está dentro del área pero tiene dificultad con recepción. Su seña de la

Research | Photovoltaic Research | NREL

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-V cells Hybrid tandems Polycrystalline Thin-Film PV CdTe solar cells CIGS solar cells Perovskites and Organic PV Perovskite solar cells Organic PV solar cells Advanced Materials, Devices, and Science Interfacial and Surface Science Reliability and Engineering Real-Time PV and Solar Resource

Chioke Harris | NREL

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transfer and materials science to the development of high-performance building components. He is member of the Building Energy Science Group, his research focuses on the application of fundamental heat particularly interested in the development of novel opaque insulation and window frame materials using nano

Water Power Research | Water Power | NREL

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Water Power Research Water Power Research NREL conducts water power research; develops design tools Columbia River, Washington. Hydropower Research Hydropower technologies convert the energy of water moving ; and evaluates, validates, and supports the demonstration of innovative water power technologies. Photo

Mengjin Yang | NREL

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on the formation of higher efficiency formamidinium lead triiodide-based solar cells," Chem -0003-2019-4298 Dr. Mengjin Yang received his Ph.D. in Materials Science from the University of Pittsburgh, where he investigated nanomaterials for solar energy conversion under the supervision of Prof

Geothermal Energy | Climate Neutral Research Campuses | NREL

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Geothermal Energy Geothermal Energy Research campuses can take advantage of geothermal resources sections that describe how examining geothermal energy may fit into your climate action plans. Campus Options Considerations Sample Project Related Links Campus Geothermal Energy Options Campuses can use

Battery Control Algorithms | Transportation Research | NREL

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publications. Accounting for Lithium-Ion Battery Degradation in Electric Vehicle Charging Optimization Advanced Reformulation of Lithium-Ion Battery Models for Enabling Electric Transportation Fail-Safe Design for Large Capacity Lithium-Ion Battery Systems Contact Ying Shi Email | 303-275-4240

NREL: News - Winner of Solar Decathlon to be Announced

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Winner of Solar Decathlon to be Announced Friday, October 4, 2002 Washington, D.C.- The winner of National Gallery of Art Note: All houses competing in the Solar Decathlon will be open to the public from 9 the U.S. Department of Energy's first Solar Decathlon will be announced noon, Saturday, October 6 in

Site Description | CTIO

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Preserving the Dark Skies La Oficina de Protección de la Calidad del Cielo del Norte de Chile - OPCC Light view Cerro Pachón CTIO/AURA La Serena Facilities The "El Totoral" Reserve, Cerro Tololo and . back to top Sky Brightness over Cerro Pachón and Cerro Tololo Light pollution from nearby cities (La

AF Week in Photos > U.S. Air Force > Article Display

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Professors Senior Mentor Biographies Fact Sheets Commander's Call Topics CCT Archive CSAF Reading List 2017 CSAF Reading List 2016 CSAF Reading List 2015 CSAF Reading List 2014 CSAF Reading List 2013 CSAF Reading List 2012 CSAF Reading List 2011 CSAF Reading List 2010 CSAF Reading List 2009 CSAF Reading List

National Wind Technology Center | NREL

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. Wind Energy Research Wind turbine blade Wind energy research at the NWTC allows for validation and verification of large and small components and wind turbine systems. Photo by Dennis Schroeder / NREL 40935 Wind energy research at the NWTC has pioneered wind turbine components, systems, and modeling methods

Astronomical Information Center - Naval Oceanography Portal

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section Advanced Search... Sections Home Time Earth Orientation Astronomy Meteorology Oceanography Ice You the Moon Illuminated Time Universal Time and Greenwich Mean Time What is Terrestrial Time? Computing Greenwich Apparent Sidereal Time What are the U.S. Time Zones? World Time Zone Map When Does Daylight Time

Alternative Fuels Data Center: Data Downloads

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Data Downloads to someone by E-mail Share Alternative Fuels Data Center: Data Downloads on Facebook Tweet about Alternative Fuels Data Center: Data Downloads on Twitter Bookmark Alternative Fuels Data Center: Data Downloads on Google Bookmark Alternative Fuels Data Center: Data Downloads on Delicious Rank

Home Page, Alaska Department of Fish and Game

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Orders Media/Press Releases Hot Topics & Issues Board of Fisheries and Game: Actions & Activities Habitat Special Areas Fish Habitat Boards Board of Game Board of Fisheries The Joint Board Commissioner Maps & Area Information File Hunt Report Trapping Boards Board of Fisheries Board of Game

CAEBAT Model Featured on American Chemical Society Journal Tenth

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University's School of Mechanical Engineering has yielded new insights for lithium-ion (Li-ion) battery corresponding article, "Secondary-Phase Stochastics in Lithium-Ion Battery Electrodes" detailing the microstructural modifications can greatly improve overall Li-ion battery performance. The value of this work is

Energy Storage News | Transportation | Transportation Research | NREL

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NREL/Purdue team's corresponding article, "Secondary-Phase Stochastics in Lithium-Ion Battery by NREL and NASA, the Battery ISC Device revolutionizes the way lithium-ion (Li-ion) batteries are collaboration with Purdue University's School of Mechanical Engineering has yielded new insights for lithium-ion

News and Feature Stories | NREL

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insights for lithium-ion (Li-ion) battery electrodes at the microstructural level, that can lead to Lithium-Ion Battery Electrodes" detailing the research and resulting discoveries, is showcased inside 19th annual Middle School Electric Car Competition, where students raced solar and lithium-ion powered

Publications - GMC 73 | Alaska Division of Geological & Geophysical Surveys

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following seven NPRA wells: Fish Creek test well #1; Oumalik test well #1; Peard test well #1; Tunalik #1 ; Umiat test well #11; Wolf Creek test well #3; and Walapka test well #1 Authors: Unknown Publication Date wells: Fish Creek test well #1; Oumalik test well #1; Peard test well #1; Tunalik #1; Umiat test well

Self-Reported High-Cholesterol Prevalence in the Brazilian Population: Analysis of the 2013 National Health Survey.

PubMed

Lotufo, Paulo A; Santos, Raul D; Sposito, Andrei C; Bertolami, Marcelo; Rocha-Faria, Jose; Izar, M Cristina; Szwarcwald, Celia; Prado, Rogério R; Stoppa, Sheila R; Malta, Deborah C; Bensenor, Isabela M

2017-05-01

Data on the prevalence of dyslipidemia in Brazil are scarce, with surveys available only for some towns. To evaluate the prevalence of the self-reported medical diagnosis of high cholesterol in the Brazilian adult population by use of the 2013 National Health Survey data. Descriptive study assessing the 2013 National Health Survey data, a household-based epidemiological survey with a nationally representative sample and self-reported information. The sample consisted of 60,202 individuals who reported a medical diagnosis of dyslipidemia. The point prevalence and 95% confidence interval (95%CI) for the medical diagnosis of high cholesterol/triglyceride by gender, age, race/ethnicity, geographic region and educational level were calculated. Adjusted odds ratio was calculated. Of the 60,202 participants, 14.3% (95%CI=13.7-14.8) never had their cholesterol or triglyceride levels tested, but a higher frequency of women, white individuals, elderly and those with higher educational level had their cholesterol levels tested within the last year. The prevalence of the medical diagnosis of high cholesterol was 12.5% (9.7% in men and 15.1% in women), and women had 60% higher probability of a diagnosis of high cholesterol than men. The frequency of the medical diagnosis of high cholesterol increased up to the age of 59 years, being higher in white individuals or those of Asian heritage, in those with higher educational level and in residents of the Southern and Southeastern regions. The importance of dyslipidemia awareness in the present Brazilian epidemiological context must be emphasized to guide actions to control and prevent coronary heart disease, the leading cause of death in Brazil and worldwide. A prevalência de hipercolesterolemia no Brasil não é conhecida para todo o país, havendo somente inquéritos em algumas cidades. Avaliar a prevalência de diagnóstico médico de colesterol alto autorreferido na população adulta brasileira, utilizando-se dos dados da Pesquisa Nacional de Saúde (PNS) de 2013. Estudo descritivo que avaliou os dados da PNS de 2013, um inquérito epidemiológico de base domiciliar, representativo para o Brasil, com informações autorreferidas. A amostra compreendeu 60.202 indivíduos entrevistados com autorrelato de diagnóstico médico de colesterol. Calculou-se a prevalência de ponto e o intervalo de confiança de 95% (IC95%) para diagnóstico médico de colesterol/triglicerídeos alto(s) por sexo, idade, cor da pele, região geográfica, escolaridade. Foram calculadas as razões de chance ajustadas. Dos 60.202 participantes adultos, 14,3% (IC95%=13,7-14,8) nunca tiveram colesterol ou triglicerídeos dosados, sendo que um maior número de mulheres, idosos, indivíduos com instrução superior completa e de raça branca relatou aferição há menos de um ano. A prevalência de diagnóstico médico de colesterol alto foi de 12,5%, maior nas mulheres (15,1%) do que nos homens (9,7%). A frequência de diagnóstico médico de colesterol alto foi maior naqueles com idade até 59 anos, em brancos ou aqueles de origem asiática, em pessoas com maior escolaridade e entre os moradores das macrorregiões Sul e Sudeste do país. A importância do conhecimento da dislipidemia no atual contexto epidemiológico brasileiro deve ser ressaltada para orientar as ações de prevenção das doenças coronarianas, que representam a primeira causa de óbito no Brasil e no mundo.

Nolan Wilson | NREL

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Nolan Wilson Nolan Wilson Postdoctoral Researcher-Chemical Engineering Nolan.Wilson@nrel.gov | 303 Ph.D., Chemical and Biomolecular Engineering, Clemson University, 2014 M.S., Chemical and Biomolecular Engineering, Clemson University, 2012 B.S., Chemical Engineering, Auburn University, 2007 Professional

GISD

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information on the ecology of the species, its impacts and management, a comprehensive bibliography and a list ) General Impact information Management information Distribution The Distribution page presents the global page collates management information from the profile narrative page plus location-specific management

Staff - Trent D. Hubbard | Alaska Division of Geological & Geophysical

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, R.P., Darrow, M.M., and Hubbard, T.D., 2015, Influence of catchment properties on stability of frozen : Evaluating geologic hazards and the distribution and character of geologic materials on Alaska's North Slope Professor, Department of Biology and Earth Sciences, University of Central Missouri, Warrensburg, MO 2003

Standard Terms and Conditions | NREL

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and Technical Services Subcontracts, Cost-Type (1) Cost Sharing (2) Cost Reimbursement (3) Cost Plus Than Foreign) (1) Cost Sharing (2) Cost Reimbursement (2) Cost Plus Fixed Fee. Appendix B-10 (12/15/16 /15/16) Standard Terms and Conditions for Travel Requirements (1) Cost Sharing (2) Cost Reimbursement

Publications - PIR 2015-5-8 | Alaska Division of Geological & Geophysical

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lower sandstone member of the Upper Jurassic Naknek Formation, northern Chinitna Bay, Alaska, in Wartes member of the Upper Jurassic Naknek Formation, northern Chinitna Bay, Alaska Authors: Wartes, M.A Surveys Skip to content State of Alaska myAlaska My Government Resident Business in Alaska

Publications - PIR 2015-5-4 | Alaska Division of Geological & Geophysical

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facies analysis of the Lower Jurassic Talkeetna Formation, north Chinitna Bay, Alaska, in Wartes, M.A of the Lower Jurassic Talkeetna Formation, north Chinitna Bay, Alaska Authors: Bull, K.F. Publication Surveys Skip to content State of Alaska myAlaska My Government Resident Business in Alaska

Presentations - Herriott, T.M. and others, 2011 | Alaska Division of

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Details Title: Detailed geologic mapping and overview of structural and stratigraphic studies in the east Resident Business in Alaska Visiting Alaska State Employees DGGS State of Alaska search Alaska Division of in the east-central North Slope foothills, Alaska (poster): 3P Arctic, The Polar Petroleum Potential

Idaho Water Resources Research Institute

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Students Parents Alumni Faculty & Staff students walk on University of Idaho campus Visit U of I Learn Visit Students on Campus Title IX Helping to ensure U of I is a safe and engaging place for students to Diversity Athletics Events News Directory A - Z Prospective Students Current Students Parents Alumni Faculty

First International Workshop on Grid Simulator Testing of Wind Turbine

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of Wind Turbine Drivetrains First International Workshop on Grid Simulator Testing of Wind Turbine Wind Turbine Drivetrains June 13-14, 2013, at the National Wind Technology Center near Boulder apparatuses involved in grid compliance testing of utility-scale wind turbine generators. This includes both

Community Solar | State, Local, and Tribal Governments | NREL

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distributed generation owners for the power that their systems contribute to the grid. Community solar generation from an offsite solar system. Some form of VNM must exist for community solar to work properly so Electric Power Association. Community Solar: NREL's Working Group on Community Solar Gardens meeting

NREL Projects Awarded More Than $3 Million to Advance Novel Solar

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in Grid Operations," evaluating a research solution to better integrate solar power generation funding program, which advances state-of-the-art techniques for predicting solar power generation to Office to advance predictive modeling of solar power as part of its Solar Forecasting 2 funding program

Scanning Defect Mapping | Photovoltaic Research | NREL

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SDMS moves the treated wafer across a stationary laser beam and maps the defects for each location on the wafer. The amount of light reflected from an area is proportional to the dislocation density for that area and provides a direct statistical count of the number of dislocations. PV Research Other

Climate Prediction Center - Seasonal Outlook

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ACCOUNT FOR THE LATEST DYNAMICAL AND STATISTICAL GUIDANCE. LONG TERM TRENDS ACCOUNT FOR THE FAMILIAR U Time. Please consult the schedule of 30 & 90-day outlooks for exact release dates. Text Discussions COLLEGE PARK MD 830 AM EDT THU MAY 17 2018 SUMMARY OF THE OUTLOOK FOR NON-TECHNICAL USERS ENSO NEUTRAL

Project Development Model | Integrated Energy Solutions | NREL

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. The five elements of project fundamentals are: Baseline: Analyze the current situation for the site . The two-phase iterative model includes elements in project fundamentals and project development based State and Local Energy Data (SLED) tool, developed by NREL for the U.S. Department of Energy, to get

Rare Earth Elements | Alaska Division of Geological & Geophysical Surveys

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- Mineral Resources main content Rare Earth Elements Rare earth elements and the supply and demand of these deposits containing rare earth elements to meet the perceived future demand. High prices for rare earth earth element occurrences in the DGGS publications catalog. Department of Natural Resources, Division of

John B. Goodenough, Cathode Materials, and Rechargeable Lithium-ion

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cathode materials for the lithium-ion rechargeable battery that is ubiquitous in today’s portable conductors has enabled realization of the rechargeable lithium-ion battery used in cellular telephones and Goodenough, the rechargeable lithium ion battery, and related research is available in electronic documents

La Aventura de las Partículas

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ciertas formas fundamentales. Explore las siguientes rutas que le explicarán la materia del universo! La grande del logo de la Ruta SM) La ruta de las evidencias experimentales : aprenda como los físicos diseà explicación de los "por qué" de las interacciones físicas hay todavía muchos misterios por

NOAA Weather Radio - Información General

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logo La Radio de Canada NWR receiver logo recepción COVERAGE County Coverage Listings State Coverage Programación Español Listado de estación Explicacion de SAME Coverage Station Listing County Listing Search For Go NWS All NOAA Información General NWR receiver logo Información de Fondo (incluyendo

Fermilab Today

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Search GO Special Result of the Week Toward a high-intensity muon source Impact of a single pulse of 12 x moment of impact (T=0); b) 9ms after impact; c) 15ms after impact. To solve the mysteries of nature 1012 protons at 14 GeV on a 1cm-wide jet of mercury flowing at 15m/s in a 10T solenoid field: a) at the

Xiaowen Chen | NREL

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Xiaowen Chen Photo of Xiaowen Chen Xiaowen Chen Researcher IV-Chemical Engineering Xiaowen.Chen Education Ph.D., Chemical Engineering, University of Maine, 2009 M.S., Chemical Engineering, University of Maine, 2005 B.S., Chemical Engineering in Polymer Science and Technology, Nanjing University of Science

Sandia National Laboratories: Research: R&D 100 Awards

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high radiation environments such as space. Watch the video. control system for active damping of inter first commercially available, high-voltage, high-frequency, high-current, high-temperature, single-chip Materials Science Nanodevices & Microsystems Radiation Effects & High Energy Density Science

NOAA Photo Library -

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logo and clouds NSSL is one of the National Oceanic and Atmospheric Administration's internationally of tornado Tornadoes picture of vintage doppler radar Instruments picture of clouds Sky Scenes -known Environmental Research Laboratories, leading the way in investigations of all aspects of severe

Batavia Boy Scouts | News

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Financial Officer Finance Section Office of the Chief Operating Officer Facilities Engineering Services Accelerator Division Accelerator Physics Center Office of the Chief Safety Officer Environment, Safety, Health and Quality Section Office of the Chief Project Officer Office of Project Support Services Office of

Tuberculosis Reports - UDOH-EPI

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Tuberculosis Tuberculosis Reports Tuberculosis Reports Tuberculosis Utah Reports Tuberculosis in Utah - Five (IBIS-PH) Tuberculosis 2015 Monthy Reports January February March April May June Tuberculosis National Reports National TB Data and Statistics Tuberculosis Global Reports TB Incidence Map by country TB

Eric O'Shaughnessy | NREL

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of residential solar PV markets. Eric leads the lab's solar data partnerships program. Eric's current green power market research. Research Interests Economic analysis, econometrics, distributed solar PV . Ardani, R. Margolis. 2018. Solar plus: Optimization of distributed solar PV through battery storage and

Photovoltaics | Climate Neutral Research Campuses | NREL

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Photovoltaics Photovoltaics Solar photovoltaics (PV) is a mature, commercially available technology arrays. Campus Solar Energy Options A PV system requires periodic maintenance, but upkeep averages two to undertaking a solar energy assessment or PV installation. Solar Energy Resources Solar energy production

University of Maryland MRSEC - Education: Resources

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. University of Maryland Materials Research Science and Engineering Center Home About Us Leadership Moments in MSE The Materials Science and Engineering Career Resources Center Materials Research Society Central Super Science Fair Projects: Ideas, Topics, & Experiments All Science Fair Projects Science

Pesticide Information for Veterinarians

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; Environment Human Health Animal Health Safe Use Practices Food Safety Environment Air Water Soil Wildlife Ingredients Low-Risk Pesticides Organic Pesticide Ingredients Pesticide Incidents Human Exposure Pet Exposure Home Page Pesticide Health and Safety Information Pesticides and Animal Health Pesticide Information

Pesticide Regulations

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costs and benefits of pesticides to society. They try to identify the potential risks on human health ; Environment Human Health Animal Health Safe Use Practices Food Safety Environment Air Water Soil Wildlife Ingredients Low-Risk Pesticides Organic Pesticide Ingredients Pesticide Incidents Human Exposure Pet Exposure

A to Z Index of Topics

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; Environment Human Health Animal Health Safe Use Practices Food Safety Environment Air Water Soil Wildlife Ingredients Low-Risk Pesticides Organic Pesticide Ingredients Pesticide Incidents Human Exposure Pet Exposure Health and Pesticides Animal Health Care Provider Information Animal Incident Reporting Annual Reports

Council on Tall Buildings and Urban Habitat

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Publications CTBUH Journal Awards Books Technical Guides Research Reports Other Books IJHRB Research Journal TBUH Chinese Journal Virtual Research Journal Conference Publications Posters Awards Global Awards Council on Tall Buildings and Urban Habitat About CTBUH Organization & People Membership

Home | Departamento de Salud de Puerto Rico

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Publicaciones Registros Suicidio Tuberculosis Centro de Aprendizaje Virtual sobre temas de Preparación en Salud Tuberculosis Centro de Aprendizaje Virtual sobre temas de Preparación en Salud Pública Informe de Casos de Departamento de Salud Search... Search It looks like your browser does not have JavaScript enabled

The Evolving Market Structure of the U.S. Residential Solar PV Installation

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Solar PV Installation Industry, 2000-2016 The Evolving Market Structure of the U.S. Residential Solar PV residential solar photovoltaic (PV) system and that the residential PV installation industry has become more concentrated over time. From 2000 to 2016, the U.S. residential solar photovoltaic (PV) installation industry

DefenseLink.mil - Pentagon Memorial Dedication

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Dept. photo by Army Staff Sgt. Michael J. Carden An entry stone at the Pentagon Memorial lists the their lives during the Sept. 11 terrorist attack on the Pentagon. Photo by Staff Sgt. Michael J. Carden Staff Sgt. Michael J. Carden A member of The United States Air Force Band practices before the start of

O, Canada: NREL Partnership Produces New Take on Alternative Fueling

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Fueling Station Locator. The tool, which is part of a significant investment by the Canadian government to to develop a modern, bilingual web tool that makes it easier for drivers of alternative fuel vehicles Locator Tool March 5, 2018 Word of the National Renewable Energy Laboratory's (NREL) deep transportation

Publications - PIR 2015-5-9 | Alaska Division of Geological & Geophysical

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content DGGS PIR 2015-5-9 Publication Details Title: Evidence of a submarine canyon in the Snug Harbor ., Decker, P.L., and Wartes, M.A., 2015, Evidence of a submarine canyon in the Snug Harbor Siltstone and Pomeroy Arkose Members, Naknek Formation, south-central Alaska: Implications for the distribution of

Visualization and Analytics Software Tools for Peregrine System |

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R is a language and environment for statistical computing and graphics. Go to the R web site for System Visualization and Analytics Software Tools for Peregrine System Learn about the available visualization for OpenGL-based applications. For more information, please go to the FastX page. ParaView An open

Inventory of File gfs.t06z.smartguam00.tm00.grib2

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boundary layer WDIR analysis Wind Direction (from which blowing) [degtrue] 013 planetary boundary layer WIND analysis Wind Speed [m/s] 014 planetary boundary layer RH analysis Relative Humidity [%] 015 planetary boundary layer DIST analysis Geometric Height [m] 016 surface 4LFTX analysis Best (4 layer) Lifted

Fall and its association with the frailty syndrome in the elderly: systematic review with meta-analysis.

PubMed

Fhon, Jack Roberto Silva; Rodrigues, Rosalina Aparecida Partezani; Neira, Wilmer Fuentes; Huayta, Violeta Magdalena Rojas; Robazzi, Maria Lucia do Carmo Cruz

2016-01-01

To analyze the prevalence of falls and frailty syndrome and the association between these two syndromes in the elderly population. Systematic review, without restriction of dates, in English, Portuguese and Spanish languages, in the databases PubMed, CINAHL, LILACS and in the SciElo virtual library. The association between both variables was extracted from the studies (Odds Ratio and 95% Confidence Intervals). The review included 19 studies published between 2001 and 2015. The prevalence of falls in the frail elderly population was between 6.7% and 44%; in the pre-frail, between 10.0% and 52.0%, and in the non-frail, between 7.6% and 90.4%. The association between both variables presented a value of OR 1.80 (95% CI 1.51-2.13). There is evidence that falls are associated to the frailty in the elderly. Other factors may influence this association, such as age, sex, data collection instrument of the studies, place where they live and the process of senescence. Analisar a prevalência de quedas e da síndrome da fragilidade e a associação entre essas duas síndromes na população idosa. Revisão sistemática, sem restrição de datas, nos idiomas inglês, português e espanhol, nas bases de dados PubMed, CINAHL, LILACS e na biblioteca virtual SciElo. A associação entre ambas as variáveis foi extraída dos próprios artigos (Odds Ratio e os Intervalos de Confiança de 95%). Foram incluídos na revisão 19 artigos publicados entre 2001 e 2015. A prevalência de queda no idoso frágil esteve entre 6,7% e 44%; nos pré-frágeis, entre 10,0% e 52,0%, e nos não frágeis, entre 7,6% e 90,4%. A associação entre ambas as variáveis apresentou o valor de OR 1,80 (IC 95% 1,51-2,13). Há evidências de que a queda está associada à fragilidade do idoso. Outros fatores podem influenciar essa associação, como idade, sexo, instrumento de coleta de dados dos estudos, local onde vive e o próprio processo de senescência.

John Lewis | NREL

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Lewis John Lewis John Lewis Researcher IV-Chemical Engineering John.Lewis@nrel.gov | 303-275-3021 Education Ph.D. Chemical Engineering, California Institute of Technology, Pasadena, CA, 1996 M.S. Chemical Engineering, California Institute of Technology, Pasadena, CA, 1993 B.S. Chemical Engineering, Texas A&M

Buy or sell used musical instruments | News

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Financial Officer Finance Section Office of the Chief Operating Officer Facilities Engineering Services Accelerator Division Accelerator Physics Center Office of the Chief Safety Officer Environment, Safety, Health and Quality Section Office of the Chief Project Officer Office of Project Support Services Office of

David Toback re-elected CDF co-spokesperson | News

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Financial Officer Finance Section Office of the Chief Operating Officer Facilities Engineering Services Accelerator Division Accelerator Physics Center Office of the Chief Safety Officer Environment, Safety, Health and Quality Section Office of the Chief Project Officer Office of Project Support Services Office of

MMAB Mission Statement

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services. Marine Modeling and Analysis Branch Logo Click here to go to the EMC/MMAB homepage MMAB Mission Statement The Marine Modeling and Analysis Branch is part of the Environmental Modeling Center, which is Environmental Prediction Environmental Modeling Center Marine Modeling and Analysis Branch 5830 University

Materials and Devices | Photovoltaic Research | NREL

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Polycrystalline Thin-Film PV Cadmium telluride (CdTe) solar cells Copper indium gallium diselenide (CIGS) solar cells Perovskite and Organic PV Perovskite solar cells Perovskite Patent Portfolio Organic PV (OPV ) solar cells Advanced Materials, Devices, and Concepts We explore new PV materials using high-throughput

Silicon Materials and Devices R&D | Photovoltaic Research | NREL

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" and "Si-based Tandem Solar Cells"), Next Generation Photovoltaics (NextGen PV III), and devices, especially for photovoltaic (PV) cell applications. PV Research Other Materials & Devices pages: High-Efficiency Crystalline PV Polycrystalline Thin-Film PV Perovskite and Organic PV Advanced PV

Water Resource Sustainability Conference 2015

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| Honolulu, Hawaii Presented By Water Resources Research Center (WRRC), Hawaii and American Samoa Water and Environmental Research Institute (WERI), Guam Puerto Rico Water Resources and Environmental Research Institute (PRWRERI), Puerto Rico The Virgin Islands Water Resources Research Institute (VI-WRRI), U. S. Virgin

NOAA Photo Library

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reached the mature stage of formation. Image ID: nssl0065, NOAA's National Severe Storms Laboratory (NSSL Available Publication of the U.S. Department of Commerce, National Oceanic & Atmospheric Adminstration NOAA Photo Library Banner Takes you to the Top Page Takes you to the About this Site page. Takes

NOAA Photo Library

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in its early stage of formation. Image ID: nssl0061, NOAA's National Severe Storms Laboratory (NSSL Available Publication of the U.S. Department of Commerce, National Oceanic & Atmospheric Adminstration NOAA Photo Library Banner Takes you to the Top Page Takes you to the About this Site page. Takes

NOAA Photo Library

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in its early stage of formation. Image ID: nssl0062, NOAA's National Severe Storms Laboratory (NSSL Available Publication of the U.S. Department of Commerce, National Oceanic & Atmospheric Adminstration NOAA Photo Library Banner Takes you to the Top Page Takes you to the About this Site page. Takes

NOAA Photo Library

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in its early stage of formation. Image ID: nssl0064, NOAA's National Severe Storms Laboratory (NSSL Available Publication of the U.S. Department of Commerce, National Oceanic & Atmospheric Adminstration NOAA Photo Library Banner Takes you to the Top Page Takes you to the About this Site page. Takes

Wind Maps | Geospatial Data Science | NREL

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Wind Maps Wind Maps Wind Prospector This GIS application supports resource assessment and data exploration for wind development. This collection of wind maps and assessments details the wind resource in Geospatial Data Science Team. National Wind Resource Assessment The national wind resource assessment was

Impacts | Wind | NREL

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in hard hats standing on top of a large wind turbine overlooking several other wind turbines in the Framework Transforms FAST Wind Turbine Modeling Tool NREL Assesses National Design Standards for Offshore Wind Resource NREL Identifies Investments for Wind Turbine Drivetrain Technologies Awards R&D 100

@NWTC Newsletter: Fall 2013 | Wind | NREL

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Assessment of the U.S. Wind Industry in 2012 NREL Identifies Investments for Wind Turbine Drivetrain , medium-speed, medium-voltage wind turbine drivetrain design. Tapping into unparalleled expertise, the The drivetrain of a wind turbine converts the power of the wind into electrical energy. Now

Geothermal Maps | Geospatial Data Science | NREL

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presented in these maps was aggregated from the Geothermal Energy Association 2014 Annual U.S. and Global Geothermal Maps Geothermal Maps Our geothermal map collection covers U.S. geothermal power plants , geothermal resource potential, and geothermal power generation. If you have difficulty accessing these maps

NREL: Renewable Resource Data Center - Geothermal Resource Information

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Energy's Office of Energy Efficiency and Renewable Energy Geothermal Technologies Program. Its collection , and thermal springs. View NREL's Geothermal resource maps as well as maps for other renewable energy Geothermal Resource Information Geothermal Prospector Start exploring U.S. geothermal resources

XHTML Vocabulary

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content of resource. contentinfo contains meta information about the content on the page or the page as a Applications Vocabulary alert A message with important, and usually time-sensitive, information. Also see : true, false, or mixed. columnheader A cell containing header information for a column. combobox A

Federal Pesticide Regulation

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pesticides, the EPA works to protect human health and the environment. The EPA works cooperatively with state ; Environment Human Health Animal Health Safe Use Practices Food Safety Environment Air Water Soil Wildlife Ingredients Low-Risk Pesticides Organic Pesticide Ingredients Pesticide Incidents Human Exposure Pet Exposure

Before You Control Your Pest

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; Environment Human Health Animal Health Safe Use Practices Food Safety Environment Air Water Soil Wildlife Ingredients Low-Risk Pesticides Organic Pesticide Ingredients Pesticide Incidents Human Exposure Pet Exposure activities. Public Health Departments Control pests that impact human health and that are a community concern

Alternative Fuels Data Center

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fueled for the fleet to be subject to the regulatory requirements. Under Standard Compliance, the AFVs that may be used toward compliance or banked once the fleet achieves compliance for investments in composition. For more information, visit the EPAct State and Alternative Fuel Provider Fleets website

R&D Nuggets

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Origin of the Chemical Elements and Their Discoveries [added 1/2007] National Laboratories and Other to the content of DOE R&D Accomplishments. Celebrating Einstein - series of articles about Albert Einstein and his work [added 3/2005] Compact Portable Electric Power Sources [added 1/2007] History of the

Fermilab | Science | Historic Results

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quark since the discovery of the bottom quark at Fermilab through fixed-target experiments in 1977. Both cosmic rays. Researchers previously had assumed that cosmic rays approach the Earth uniformly from random impact the Earth generally come from the direction of active galactic nuclei. Many large galaxies

ACHP | Defense Department Compliance with NHPA

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NHPA: Section 202(a)(6) Evaluation Report Defense Department Compliance with the National Historic )(6) Evaluation Report is a preliminary step in helping the Department of Defense marshall its Search skip specific nav links Home arrow Publications arrow Intro: Defense Department Compliance with

SIMES

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image nivo slider image nivo slider image nivo slider image nivo slider image nivo slider image Quick Energy@Stanford&SLAC LINAC Coherent Light Source (LCLS) Stanford Synchrotron Radiation Lightsource 29 30 31 1 2 3 Events (List View) No events See all events ©2012- Stanford University. All rights

Navy.mil The Official Website of the United States Navy: Home Page

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of the Navy Chief Of Naval Operations Master Chief Petty Officer Of The Navy Chief Of Naval Personnel Pentagon Hall of Heroes On May 25, Medal of Honor recipient retired Master Chief Petty Officer (SEAL Of Naval Operations Master Chief Petty Officer Of The Navy Chief Of Naval Personnel Biographies SES

ACHP | News | President Bush Issues Executive Order on Preserve America

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requirements of subsections 3(a)-(c) of this order. To assist agencies, the Council, in consultation with the Preservation Officer in accordance with section 110(c) of the NHPA. The senior official shall ensure that the public benefit from, and access to, Federally owned historic properties. (c) The Council is directed to

Publications - GMC 9 | Alaska Division of Geological & Geophysical Surveys

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; Texaco West Kavik #1; Canning River B-1; ARCO Kavik #1; Forest Kemik #1; BP Kemik #2; Canning River A-1 ; Toolik Federal #1 Authors: Curiale, J.A. Publication Date: 1982 Publisher: Alaska Division of Geological eight North Slope wells: Mobil West Staines #2; Texaco West Kavik #1; Canning River B-1; ARCO Kavik #1

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Energy-Water Nexus and Energy Systems Integration | Energy Systems

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on a new area of research geared at finding ways to balance our water use for power systems. Photo of a body of water NREL's research explores the relationship between how much water is evaporated to spectrum. Learn more about NREL's energy-water nexus research. Team with us on water-energy nexus research

NREL to Lead Novel Field Demonstration of Wind Turbine Control at the Wind

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Power Plant Level | News | NREL to Lead Novel Field Demonstration of Wind Turbine Control at the Wind Power Plant Level NREL to Lead Novel Field Demonstration of Wind Turbine Control at the Wind to test wind turbine technology controls at the overall wind power plant level. This is a significant

Alternative Fuels Data Center: Maps and Data

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2014 2015 2016 Acura 1 2 1 Audi 6 6 7 7 Bentley Motors 3 3 4 4 3 BMW 1 3 1 3 6 6 5 Buick 1 1 1 3 4 5 1 3 2 Cadillac 2 2 4 4 6 4 2 1 Chevrolet 1 2 3 1 4 4 6 5 7 7 8 7 8 9 11 10 11 14 20 26 24 30 27 Chrysler 2 2 3 2 4 1 1 1 3 3 4 2 3 3 3 3 5 5 Coda Automotive 1 1 0 Dodge 2 2 3 7 5 1 4 4 6 6 6 2 4 5 5 5 6

Recycling

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Alamos National Laboratory Delivering science and technology to protect our nation and promote world stability Science & Innovation Collaboration Careers Community Environment Science & Innovation Facilities Science Pillars Research Library Science Briefs Science News Science Highlights Lab Organizations

Home Energy Saver

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. Environmental Protection Agency logo PIER logo Touchstome Energy Cooperatives logo California Air Resouces Board logo Infosys logo Berkeley Lab logo Created for the US Department of Energy by the Energy Technologies Energy logo

The policy of the Laboratory is to provide a safe and healthy workplace for

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group within the Collider Accelerator (C-A) Department. The Advanced Accelerator Group, a group within ://www.tvdg.bnl.gov/index.html that also has links to the C-A and other BNL information. We hope your stay at policies are outlined in the Employees' Handbook, the BNL ES&H Standards the C-A Operations Procedure

NOAA Weather Radio

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Programación Español Listado de estación Explicacion de SAME Coverage Station Listing County Listing Search For Go NWS All NOAA Lista de Emisora y Cobertura Seleccione aquí para radiofrecuencias (La lista Transmitter Outages FAQ NWR - Special Needs ESPAÑOL Español Condado de cobertura Listado de estación Lista

Concentrating Solar Power Projects - Morón | Concentrating Solar Power |

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, 2018 Project Overview Project Name: Morón Country: Spain Location: Morón de la Frontera (Seville ? Background Technology: Parabolic trough Status: Operational Country: Spain City: Morón de la Frontera Region NREL Morón This page provides information on Morón, a concentrating solar power (CSP) project

Index of /data/nccf/com/gens/prod

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-2018 17:38 - cmce.20180527/ 27-May-2018 05:39 - fens.20180526/ 26-May-2018 17:50 - fens.20180527/ 27 -May-2018 06:20 - gefs.20180520/ 20-May-2018 22:41 - gefs.20180521/ 21-May-2018 22:43 - gefs.20180522 / 22-May-2018 22:43 - gefs.20180523/ 23-May-2018 22:42 - gefs.20180524/ 24-May-2018 22:43 - gefs

Index of /data/nccf/com/gfs/prod

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-2018 08:00 - enkf.20180527/ 27-May-2018 06:37 - gdas.20180518/ 21-May-2018 01:00 - gdas.20180519/ 22 -May-2018 01:00 - gdas.20180520/ 23-May-2018 02:00 - gdas.20180521/ 24-May-2018 01:00 - gdas.20180522 / 25-May-2018 02:00 - gdas.20180523/ 26-May-2018 02:00 - gdas.20180524/ 27-May-2018 02:00 - gdas

From Nigel Lockyer: Five things you should know | News

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Financial Officer Finance Section Office of the Chief Operating Officer Facilities Engineering Services Accelerator Division Accelerator Physics Center Office of the Chief Safety Officer Environment, Safety, Health and Quality Section Office of the Chief Project Officer Office of Project Support Services Office of

MicroBooNE project team recognized by Department of Energy | News

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Financial Officer Finance Section Office of the Chief Operating Officer Facilities Engineering Services Accelerator Division Accelerator Physics Center Office of the Chief Safety Officer Environment, Safety, Health and Quality Section Office of the Chief Project Officer Office of Project Support Services Office of

DGIC Interconnection Insights | Distributed Generation Interconnection

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Power Association (SEPA), produced a webinar Utility Participation in the Roof Top Solar PV Market with ). These leaders are pioneering utility-owned rooftop solar programs to broaden the reach of solar PV utility hired solar PV developers who, representing CPS Energy, will install, own, and maintain solar

Solar Plus: A Holistic Approach to Distributed Solar PV | Solar Research |

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NREL Plus: A Holistic Approach to Distributed Solar PV Solar Plus: A Holistic Approach to Distributed Solar PV A new NREL report analyzes "solar plus," an emerging approach to distributed solar photovoltaic (PV) deployment that uses energy storage and controllable devices to optimize

2015 PV Solar Resource Workshop | Photovoltaic Research | NREL

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PV Solar Resource Workshop 2015 PV Solar Resource Workshop Friday, February 27, 2015 Chairs understand the solar resource available to PV plants and opportunities for the community to improve over the as Adobe Acrobat PDFs. Solar Resource Needs for Prediction and Monitoring of PV Performance

The New Jersey Water Resources Research Institute at Rutgers NJAES

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Rutgers New Jersey Agricultural Experiment Station [The New Jersey Water Resources Research wetland Program Areas The New Jersey Water Resources Research Institute (NJWRRI) is a federally-funded water in the state. Its mission is to: sponsor research on all aspects of water quality, water quantity

Energy Systems Integration Facility Insight Center | Energy Systems

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simulation data. Photo of researchers studying data on a 3-D power system profile depicting the interaction of renewable energy resources on the grid. Capabilities The Insight Center offers the following Integration Facility Insight Center Located adjacent to the Energy System Integration Facility's High

NREL Leads Wind Farm Modeling Research - Continuum Magazine | NREL

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ten 2-MW Bonus wind turbines. Photo provided by HC Sorensen, Middelgrunden Wind Turbine Cooperative ) has created complex computer modeling tools to improve wind turbine design and overall wind farm activity surrounding a multi-megawatt wind turbine. In addition to its work with Doppler LIDAR, the

@NWTC Newsletter: Summer 2014 | Wind | NREL

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, Developmental Role in Major Wind Journal Boosting Wind Plant Power Output by 4%-5% through Coordinated Turbine . Part 2: Wind Farm Wake Models New Framework Transforms FAST Wind Turbine Modeling Tool (Fact Sheet ) Sensitivity Analysis of Wind Plant Performance to Key Turbine Design Parameters: A Systems Engineering

Geothermal Energy Basics | NREL

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Geothermal Energy Basics Geothermal Energy Basics Many technologies have been developed to take advantage of geothermal energy-the heat from the earth. This heat can be drawn from several sources: hot hot spring. The Earth's heat-called geothermal energy-escapes as steam at a hot springs in Nevada

Nuclear and Particle Physics, Astrophysics and Cosmology : T-2 : LANL

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linked in Search T-2, Nuclear and Particle Physics, Astrophysics and Cosmology T-2 Home T Division Focus Areas Nuclear Information Service Nuclear Physics Particle Physics Astrophysics Cosmology CONTACTS Group energy security, heavy ion physics, nuclear astrophysics, physics beyond the standard model, neutrino

99aa/99ac data sets

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-redshifted), Observed Flux, Statistical Error (Based on the optimal extraction algorithm of the IRAF packages were acquired using different instrumental settings for the blue and red parts of the spectrum to avoid extracted for systematics checks of the wavelength calibration. Wavelength and flux calibration were applied

PEER Annual Meeting | Events

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window. 2018 PEER Annual Meeting, Jan 18-19, 2018 in Berkeley, CA 2016 PEER Annual Meeting, Jan 28-29 home about peer news events research products laboratories publications nisee b.i.p. members education FAQs links Events Calendar of PEER and Other Events PEER Events Archive PEER Annual Meeting 2009

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Nicholas Brunhart-Lupo | NREL

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. Education Ph.D., Computer Science, Colorado School of Mines M.S., Computer Science, University of Queensland B.S., Computer Science, Colorado School of Mines Brunhart-Lupo Nicholas Brunhart-Lupo Computational Science Nicholas.Brunhart-Lupo@nrel.gov

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Smithsonian Marine Station at Fort Pierce Website Search Box Search Field: SMS Website Search Search Submit: Submit Advanced Search IRLSI Home Search the Inventory The IRL Stewardship IRL Photo Institution Privacy SMS Home Contact Us Search NMNH Home DCSIMG

Index of /data/nccf/com/nam/prod

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-2018 21:04 - nam.20180521/ 21-May-2018 21:03 - nam.20180522/ 22-May-2018 21:02 - nam.20180523/ 23-May -2018 21:04 - nam.20180524/ 24-May-2018 21:02 - nam.20180525/ 25-May-2018 21:04 - nam.20180526/ 26-May -2018 21:03 - nam.20180527/ 27-May-2018 11:51 - nam_mos.20180526/ 26-May-2018 14:55 - nam_mos.20180527

WPC Maximum Heat Index Forecasts

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Forecasts for Western US CLICK ON MAPS FOR MAXIMUM HEAT INDEX AND PROBABILITY FORECASTS FROM SUN MAY 27 2018 02 CLICK to view SAT JUN 02 forecast SUN JUN 03 CLICK to view SUN JUN 03 forecast SUN JUN 03 CLICK to view SUN JUN 03 forecast SUN JUN 03 CLICK to view SUN JUN 03 forecast SUN JUN 03 CLICK to view SUN JUN

River Flow Advisory Commission: Snow Survey

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Survey River Watch Home → Snow Survey RFAC Information About Us Reports Maine Cooperative Snow Survey About the Snow Survey Snow Survey Map Compare Snow Survey Data Snow Survey Graphs River Watch MEMA Home USGS (Maine) Home Maine Cooperative Snow Survey This information is provided by a partnership with

Bobi A. Garrett - Deputy Laboratory Director and Chief Operating Officer

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| NREL Bobi A. Garrett - Deputy Laboratory Director and Chief Operating Officer Bobi A. Garrett - Deputy Laboratory Director and Chief Operating Officer A photo of Bobi A. Garrett, Deputy Laboratory Director and Chief Operating Officer In her role as deputy laboratory director/chief operating officer (COO

Sistema de Vigilancia de Influenza de Puerto Rico |

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Rico VIH Publicaciones sobre la Salud Otras Publicaciones Registros Suicidio Tuberculosis Centro de Suicidio Tuberculosis Recent Ávisos Públicos Reglamentación Informe de Casos del Síndrome de Guillain Departamento de Salud de Puerto Rico Departamento de Salud Search... Search It looks like your

ACHP | News

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§ 800.10(c) provides further direction for the ACHP to consider requesting the preparation of a Reports Background. Section 213 of the National Historic Preservation Act (NHPA) [16 U.S.C. § 470u ] directs the Secretary of the Interior (Secretary), if requested by the Chairman of the Advisory Council on

Supercell and tornado roles

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where C is the storm motion vector, and k is the unit vector in the vertical (Davies-Jones et al. 1990 mutually interacting perspectives, each addressing different aspects of the supercell storms most directly marked by low clouds, extending to the left. Photograph © 2005 C. Doswell 4. Developing a conceptual

Exploring Renewable Energy Integration in California - Text Version |

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look at different penetrations of solar and understand how the duck chart shape change and how much analyses and different scenario analyses to understand the key drivers behind these challenges. Today, we each of our different scenarios. We have three different renewable portfolios that we looked at. On the

Presentations - Herriott, T.M. and others, 2015 | Alaska Division of

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Details Title: Sequence stratigraphic framework of the Upper Jurassic Naknek Formation, Cook Inlet forearc Resident Business in Alaska Visiting Alaska State Employees DGGS State of Alaska search Alaska Division of ., Wartes, M.A., and Decker, P.L., 2015, Sequence stratigraphic framework of the Upper Jurassic Naknek

Defenselink Special: Remembering September 11, 2001 - Six Years Later ...

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Sept. 11 Memorial observance, honoring the 184 people who perished when American Airline 77 crashed observance today honoring the 184 people who perished when American Airlines Flight 77 crashed into the , Irwin gets emotional quickly when talking about the day that 184 people died here. One-hundred twenty

Wind Data | Geospatial Data Science | NREL

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Class 3 or greater are suitable for most utility-scale wind turbine applications, whereas class 2 areas ) with adequate wind resource for wind turbine applications may exist in some Class 1 areas. The degree Wind Data Wind Data These datasets detail the wind resource available in the United States. 50-m

Publications | Wind | NREL

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-specific analysis can be used to assess the risk induced by loss of a wind turbine blade. The study used for different wind turbine configurations. The authors used assumptions specific to the National Wind ., failure rate for wind turbine rotors) are based on a 13-year-old report on wind turbines installed in

NREL: Renewable Resource Data Center - Wind Resource Information

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and Actual Wind Turbine Sites (September 1982) and a Wind Energy Resource Atlas of the United States Wind Resource Information Photo of five wind turbines at the Nine Canyon Wind Project. The Nine Canyon Wind Project in Benton County, Washington, includes 37 wind turbines and 48 MW of capacity

NREL Research Determines Integration of Plug-in Electric Vehicles Should

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transportation and energy systems engineer at NREL and author of the new Nature Energy paper, "Impact of Muratori, author of the new Nature Energy paper "Impact of Uncoordinated Plug-in Electric Vehicle Integration of Plug-in Electric Vehicles Should Play a Big Role in Future Electric System Planning News

Publications - SR 65 | Alaska Division of Geological & Geophysical Surveys

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; Geophysical Surveys Comments: Your help is crucial in the compilation of future Alaska Minerals Reports. The quality and completeness of the information in these annual reports is dependent on input from all members of the mineral industry. Please take time to fill out the current mining and mineral activity

Publications - SR 52 | Alaska Division of Geological & Geophysical Surveys

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; Geophysical Surveys Comments: Your help is crucial in the compilation of future Alaska Minerals Reports. The quality and completeness of the information in these annual reports is dependent on input from all members of the mineral industry. Please take time to fill out the current mining and mineral activity

SuperCDMS - Home

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radiation and therefore it cannot be seen, which has earned it the title Dark Matter. Dark matter rest (approximately three quarters) of all the matter and energy in the universe is referred to as dark energy. Dark matter is most commonly hypothesized to be made up of exotic particles such as WIMPS (Weakly

Press Release | News | Page 2

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: Attend a Dark Matter Day event October 23, 2017 The world will soon be celebrating the hunt for the universe's most elusive matter in a series of Dark Matter Day events planned in over a dozen countries reveals most accurate measurement of dark matter structure in the universe August 3, 2017 Dark Energy

Press Release | News | Page 3

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, technology, engineering and math fields. New world-leading limit on dark matter search from PICO experiment February 27, 2017 The PICO-60 dark matter bubble chamber experiment has produced a new dark matter limit . Construction of world's most sensitive dark matter detector moves forward September 26, 2016 LUX-ZEPLIN (LZ), a

New Jersey | Midmarket Solar Policies in the United States | Solar Research

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| NRELA> Jersey New Jersey An arrow graphic shows that New Jersey's renewable portfolio standard property by a renewable system is exempt from property tax. Utility Incentive Programs The Board of Public incentive programs. Renewable Portfolio Standard New Jersey Board of Public Utilities: RPS Background New

Joint Center for Energy Storage Research

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singly charged lithium ions in the lithium-ion battery by new doubly or triple charged ions. Learn More Cells that Run on Air Scientists at UIC and Argonne Produce New Design of a True Lithium-air Battery phones from cumbersome bricks to sleek, powerful devices was possible because of the lithium-ion

SLAC Phone Directory: Search Form

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Facilities LCLS Hard X-Ray LCLS IT & Networking LCLS IT Photon Systems LCLS Instrumentation Dev LCLS Delivery Dept LCLS Science Research & DevDiv LCLS Soft X-Ray LCLS Technical Support LCLS User Beam Line Ops Sup SSRL MSD Hard X-rays SSRL MSD Soft X-rays SSRL MSDBeam Line Elec SSRL MSDBeam Line

Inventory of File nam.t00z.smartconus00.tm00.grib2

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(Eta model reduction) [Pa] 014 planetary boundary layer WDIR analysis Wind Direction (from which blowing) [degtrue] 015 planetary boundary layer WIND analysis Wind Speed [m/s] 016 planetary boundary layer RH analysis Relative Humidity [%] 017 planetary boundary layer DIST analysis Geometric Height [m

Richard T. (Rick) Elander | NREL

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T. (Rick) Elander Photo of Rick Elander Richard Elander Researcher VI-Chemical Engineering Chemicals and AIChE Annual Meeting, multiple years Education M.S., Chemical Engineering (Biochemical Engineering), Colorado State University B.S., Chemical Engineering, University of Pennsylvania Professional

Photovoltaic Lifetime Project | Photovoltaic Research | NREL

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PV & Solar Resource Testing Accelerated Testing & Analysis Systems Engineering Project Sandia National Laboratories' PV Performance Modeling Collaborative website. Jinko Solar. PV systems mounted on the ground. Jinko Solar PV Lifetime installation at NREL. need-alt Light-induced degradation

Solar Photovoltaic Technology Basics | NREL

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For more information about solar photovoltaic energy, visit the following resources: Solar PV Photovoltaic Technology Basics Solar Photovoltaic Technology Basics Solar cells, also called photovoltaic (PV) cells by scientists, convert sunlight directly into electricity. PV gets its name from the

Alaska Department of Natural Resources

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Information Information Resource Management Information Resource Management (IRM) maintains the department's DNR's site DNR State of Alaska Toggle main menu visibility Home Contact Us Information Resource Management Recorder's Office/UCC Recorder's Office Recorder's Office Search Uniform Commercial Code (UCC) UCC

Publications | Geothermal Technologies | NREL

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Publications Publications NREL publishes a variety of publications related to geothermal energy geothermal energy research. Featured Publications Mexico's Geothermal Market Assessment Report NREL Technical investment in the country's geothermal energy sector. Since 2013, Mexico has enacted comprehensive reforms to

Pesticide Ingredients

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; Environment Human Health Animal Health Safe Use Practices Food Safety Environment Air Water Soil Wildlife Ingredients Low-Risk Pesticides Organic Pesticide Ingredients Pesticide Incidents Human Exposure Pet Exposure Fact Sheets Types of Pesticides Pest Control Information Pesticide Health and Safety Information

International Pesticide Regulations

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; Environment Human Health Animal Health Safe Use Practices Food Safety Environment Air Water Soil Wildlife Ingredients Low-Risk Pesticides Organic Pesticide Ingredients Pesticide Incidents Human Exposure Pet Exposure - World Health Organization (WHO) International Agencies: International Websites on Pesticides - OECD

Ella Zhou | NREL

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. 2015. Methods for Analyzing the Economic Value of Concentrating Solar Power with Thermal Energy in the United States, Potential Lessons for ChinaPDF. Golden, CO: National Renewable Energy . Renewable Electricity: Insights for the Coming DecadePDF. Golden, CO: National Renewable Energy Laboratory

Ramin Faramarzi | NREL

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Ramin Faramarzi Photo of Ramin Faramarzi Ramin Faramarzi Researcher V-Mechanical Engineering Engineering, California State University B.S. Mechanical Engineering, North Carolina State University articles and is a registered mechanical engineer in the state of California. Education M.S. Mechanical

Environmental Stewardship

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. Protecting the present through resource management The Laboratory actively manages and protects resources on shared land. Through biological monitoring, the Laboratory strives to minimize operational impacts to plants and animals. Through collaboration with its stakeholders and local tribal governments, the

Home Energy Saver Pro

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welcome your suggestions and feedback. Environmental Protection Agency logo PIER logo Touchstome Energy Cooperatives logo California Air Resouces Board logo Infosys logo Berkeley Lab logo Created for the US the HES API for your projects Department of Energy logo

Christopher Kinchin | NREL

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Kinchin Photo of Christopher Kinchin Christopher Kinchin Researcher III-Chemical Engineering . Education B.S., Chemical Engineering, Texas Tech University M.S., Chemical Engineering, University of North

Golden Rays - July 2017 | Solar Research | Solar Research | NREL

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Operator, First Solar, and NREL tested a 300-MW PV plant to demonstrate that, with proper controls, PV can technique to measure charge-carrier transport in PV materials. Solar Plus: A Holistic Approach to Distribution Solar PV By optimizing how PV interacts with other electricity loads at the household- and grid

EMC: Mesoscale Branch FAQ

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THE QPF DIFFERENT BETWEEN THE 12-KM NAM PARENT DOMAIN AND THE 4-KM NAM CONUS NEST? (04 Nov 2011) WHAT 28 MAR 2000? Eta Post Processor WHY IS THE SLP DIFFERENT BETWEEN AWIPS AND AFOS? (updated 6 Nov 98 IN THE BUFR OUTPUT DIFFERENT FROM WHAT IS OBSERVED? Eta Data Assimilation System (EDAS) COMMENTS ON

Western Wind Data Set | Grid Modernization | NREL

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replicates the stochastic nature of wind power plant output. NREL modeled hysteresis around wind turbine cut where wind speeds are often near wind turbine cut-out (~25 m/s), SCORE output does not replicate the Vestas V90). The hysteresis-corrected SCORE is an attempt to put the wind turbine hysteresis at cut-out

Wind Energy | Climate Neutral Research Campuses | NREL

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turbine or wind farm is one of the few technologies that supplies renewable energy at the scale required . Before determining whether a site is suitable for a wind turbine, read the Wind Energy Siting Handbook Community College has installed a wind turbine on site and now offers an Associate Degree in wind energy and

Glossary | Efficient Windows Collaborative

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double-hung windows as a means of counterbalancing the weight of the sash during opening and closing. Bay a fixed sash or a double-hung window. Also referred to as bead stop. Blackbody. The ideal, perfect member of the lower sash which meet at the middle of a double-hung window. Clerestory. A window in the

Publications - PDF 97-29I | Alaska Division of Geological & Geophysical

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igneous rocks of the Tanana B-1 Quadrangle and vicinity Authors: Newberry, R.J., and Haug, S.A , and Sr isotopic data for igneous rocks of the Tanana B-1 Quadrangle and vicinity: Alaska Division of ; Isotopes; Plutonic; STATEMAP Project; Trace Elements; Volcanic Top of Page Department of Natural Resources

NOAA Photo Library

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NOAA Photo Library Banner Takes you to the Top Page Takes you to the About this Site page. Takes you to the Contacts page. Takes you to the HELP page. Takes you to the Credits page. Takes you to the Collections page. Takes you to the search page. Takes you to the Links page. NOAA Photo Library Image

NOAA Photo Library - Search

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NOAA Photo Library Banner Takes you to the Top Page Takes you to the About this Site page. Takes you to the Contacts page. Takes you to the HELP page. Takes you to the Credits page. Takes you to the Collections page. Takes you to the search page. Takes you to the Links page. search banner butterfly fish

Inventory of File gfs.t06z.smartguam15.tm00.grib2

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hour fcst Visibility [m] 014 planetary boundary layer WDIR 15 hour fcst Wind Direction (from which blowing) [degtrue] 015 planetary boundary layer WIND 15 hour fcst Wind Speed [m/s] 016 planetary boundary layer RH 15 hour fcst Relative Humidity [%] 017 planetary boundary layer DIST 15 hour fcst Geometric

Inventory of File nam.t00z.smartpr00.tm00.grib2

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layer WDIR analysis Wind Direction (from which blowing) [degtrue] 016 planetary boundary layer WIND analysis Wind Speed [m/s] 017 planetary boundary layer RH analysis Relative Humidity [%] 018 planetary boundary layer DIST analysis Geometric Height [m] 019 surface 4LFTX analysis Best (4 layer) Lifted Index [K

Inventory of File nam.t00z.smartak00.tm00.grib2

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layer WDIR analysis Wind Direction (from which blowing) [degtrue] 016 planetary boundary layer WIND analysis Wind Speed [m/s] 017 planetary boundary layer RH analysis Relative Humidity [%] 018 planetary boundary layer DIST analysis Geometric Height [m] 019 surface 4LFTX analysis Best (4 layer) Lifted Index [K

Inventory of File nam.t00z.smarthi00.tm00.grib2

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layer WDIR analysis Wind Direction (from which blowing) [degtrue] 016 planetary boundary layer WIND analysis Wind Speed [m/s] 017 planetary boundary layer RH analysis Relative Humidity [%] 018 planetary boundary layer DIST analysis Geometric Height [m] 019 surface 4LFTX analysis Best (4 layer) Lifted Index [K

Assistant Secretary of Defense for Legislative Affairs

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Links Mission Congressional Links Secretary of Defense James Mattis
James Mattis" title=" Secretary of Defense James Mattis" /> The

Energy Education | NREL

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Energy Education Energy Education Learn how NREL's Workforce Development and Education Programs lectures at NREL's Education Center. Energy Education for Students 4th-12th Grades Energy Education

Publications - AR 2010 | Alaska Division of Geological & Geophysical

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Visiting Alaska State Employees DGGS State of Alaska search Alaska Division of Geological & Geophysical DGGS AR 2010 Publication Details Title: Alaska Division of Geological & Geophysical Surveys Annual Report Authors: DGGS Staff Publication Date: Jan 2011 Publisher: Alaska Division of Geological &

Center for Adaptive Optics | News

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* Methane Clouds Observed Near Titan's Equator May Explain Presence of Riverbeds on the Surface * 'Dark Center for Adaptive Optics A University of California Science and Technology Center home AO of Cosmic Time * Celebration of Science and Technology Centers Class of 2000 AO Headlines 2009

Alaska State Legislature

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The Alaska State Legislature search menu Home Senate Current Members Past Members By Session search Home Get Started About the Legislative Branch Legislative Branch The Legislative Branch is responsible for enacting the laws of the State of Alaska and appropriating the money necessary to operate the

NOAA Office of Exploration and Research > Home

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2014 Funding Opportunities Contact Us Program Review Review Panel Final Report Review Team Documents Review Review Panel Final Report Review Team Documents Presentations Supporting Documents Guiding the NOAA Science Advisory Board, a thirteen-member Review Panel conducted the first-ever formal

Building Awards | NREL

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Mountain campus is designed to meet the Gold or Platinum standards of the U.S. Green Building Council's Research Facility. South Site Entrance Building South Site Entrance Building 2013 U.S. Green Buildings Building Awards Building Awards NREL's high-performance buildings are sustainability models for the

Wind | NREL

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Facilities Support Innovation and Collaboration Take a Tour of a Wind Turbine Featured Publications 2017 Recommended Practices Lidar-Enhanced Wind Turbine Control: Past, Present, and Future Development of a 5 MW wind turbine science and lowering the cost of wind-generated electricity alongside our partners. We

NREL: Renewable Resource Data Center - Geothermal Resource Related Links

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from the following sources: U.S. Department of Energy Geothermal Technologies Office. National Geothermal Resource Related Links Comprehensive geothermal resource information is also available Geothermal Data System A portal to geothermal data. Southern Methodist University Geothermal Laboratory The

Energized Learning

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Energized Learning Students Lessons Bullet Getting Started Bullet Bringing It Home Bullet Unit activities with keys to subject matter standards. As students work through one or more of the standards-based Why Use the Energized Learning Site? How will teachers and Students Use the Energized Learning Site

K-12 Education

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reached out to elementary and high school students to expose them to earthquakes in a hands-on products laboratories publications nisee b.i.p. members education FAQs links education Education Program Internships K-12 Education Contact the PEER Education Program PEER's Educational Affiliates Student Design

Alternative Fuels Data Center

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three consecutive minutes, except under the following conditions: 1) to operate power takeoff equipment including, but not limited to, cement mixers, refrigeration systems, and delivery vehicles; 2) to operate private passenger vehicles; or 3) to operate heating equipment for five minutes when the ambient

Navy Directory

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Training Command EDIT Region Legal Service Office Japan Facebook EDIT Region Legal Service Office Mid Navy.mil Home Page Navy.mil Home Page Subscribe to Navy News Service Search Navy.mil Navy.mil Training and Readiness Center Facebook EDIT Afloat Training Group Mayport Facebook EDIT Afloat Training

Safe Use Practices for Pesticides

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; Environment Human Health Animal Health Safe Use Practices Food Safety Environment Air Water Soil Wildlife Ingredients Low-Risk Pesticides Organic Pesticide Ingredients Pesticide Incidents Human Exposure Pet Exposure Home Page Pesticide Health and Safety Information Safe Use Practices for Pesticides Related Topics

Minimizing Exposure at Work

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; Environment Human Health Animal Health Safe Use Practices Food Safety Environment Air Water Soil Wildlife Ingredients Low-Risk Pesticides Organic Pesticide Ingredients Pesticide Incidents Human Exposure Pet Exposure (chronic) exposure to certain pesticides may increase your risk of chronic health effects. Therefore, it is

Energy Analysis Research | Energy Analysis | NREL

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innovation through integration. Illustration of NREL energy analysis research, including impact systems analysis integrates all aspects of our capability set to develop future energy system scenarios evaluate and understand the impact of markets, policies, and financing on technology uptake and the impact

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Smithsonian Marine Station at Fort Pierce Website Search Box Search Field: SMS Website Search Search Submit: Submit Advanced Search IRLSI Home Search the Inventory The IRL Stewardship IRL Photo Gallery Links and Events About Us SMS Home Roseate Spoonbill Search by Word or Phrase Go to Species

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Smithsonian Marine Station at Fort Pierce Website Search Box Search Field: SMS Website Search Search Submit: Submit Advanced Search IRLSI Home Search the Inventory The IRL Stewardship IRL Photo [ TOP ] © Copyright Smithsonian Institution Privacy SMS Home Contact Us Search NMNH Home DCSIMG

Climate Prediction Center - Monitoring and Data - Regional Climate Maps:

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; Precipitation & Temperature > Regional Climate Maps: USA Menu Weekly 1-Month 3-Month 12-Month Weekly Total Precipitation Average Temperature Extreme Maximum Temperature Extreme Minimum Temperature Departure of Average Temperature from Normal Extreme Apparent Temperature Minimum Wind Chill Temperature

CFS Forecast Verification

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history of Nino3.4 SST anomalies of individual forecasts Forecast anomalies Target season Nino SST Global SST Global Prec Global T2m US Prec US T2m US SM z200 NDJ 2004/2005 Nino SST Global SST Global Prec Global T2m US Prec US T2m US SM z200 DJF 2005 Nino SST Global SST Global Prec Global T2m US Prec US T2m

Inventory of File sref.t03z.pgrb197.prob_ds_3hrly.grib

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ground WIND 3 hour fcst Wind Speed [prob] prob >12.89 005 10 m above ground WIND 3 hour fcst Wind Speed [prob] prob >17.5 006 10 m above ground WIND 3 hour fcst Wind Speed [prob] prob >25.78 007 2 ;0.015 010 10 m above ground WIND 6 hour fcst Wind Speed [prob] prob >12.89 011 10 m above ground WIND

U.S. High Seas Marine Text Forecasts by Area

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Flooding Tsunamis 406 EPIRB's U.S. High Seas Marine Text Forecasts by Area OPC N.Atlantic High Seas Forecast NHC N.Atlantic High Seas Forecast OPC N.Pacific High Seas Forecast HFO N.Pacific High Seas Forecast NHC N.Pacific High Seas Forecast HFO S.Pacific High Seas Forecast U.S. High Seas Marine Text

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NOAA Photo Library - NOAA In Space Collection/Satellite

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Systems/Geostationary Satellites NOAA Photo Library Banner Takes you to the Top Page Takes you to the About this Site page. Takes you to the Contacts page. Takes you to the HELP page. Takes you to the Credits page. Takes you to the Collections page. Takes you to the search page. Takes you to the

NOAA Photo Library - National Severe Storms Laboratory Collection -

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Tornadoes NOAA Photo Library Banner Takes you to the Top Page Takes you to the About this Site page. Takes you to the Contacts page. Takes you to the HELP page. Takes you to the Credits page. Takes you to the Collections page. Takes you to the search page. Takes you to the Links page. Tornadoes

NOAA Photo Library - National Estuarine Research Reserve System

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NOAA Photo Library Banner Takes you to the Top Page Takes you to the About this Site page. Takes you to the Contacts page. Takes you to the HELP page. Takes you to the Credits page. Takes you to the Collections page. Takes you to the search page. Takes you to the Links page. National Estuarine Research

Inventory of File gfs.t06z.smartguam24.tm00.grib2

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boundary layer WDIR 24 hour fcst Wind Direction (from which blowing) [degtrue] 016 planetary boundary layer WIND 24 hour fcst Wind Speed [m/s] 017 planetary boundary layer RH 24 hour fcst Relative Humidity [%] 018 planetary boundary layer DIST 24 hour fcst Geometric Height [m] 019 surface 4LFTX 24 hour fcst

Publications - NL 2002-1 | Alaska Division of Geological & Geophysical

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Visiting Alaska State Employees DGGS State of Alaska search Alaska Division of Geological & Geophysical 2002 Publisher: Alaska Division of Geological & Geophysical Surveys Ordering Info: Download below Reference DGGS Staff, and Werdon, M.B., 2002, Alaska GeoSurvey News - Geologic Investigations in the Salcha

2017 Cybersecurity Workshop: Readouts from Working Groups - Video Text

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applicability of artificial intelligence to search for cybersecurity gaps in our existing SKATA networks. Second primarily renewable that all back each other up; that are all highly intelligent, artificial intelligence we have in cyber security, digital technologies, artificial intelligence. We think that that would

Preservation50 - Making Archaeology Public

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. Our library of videos will grow throughout 2016, so please check back for new additions. You may share Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Virginia Wisconsin Wyoming Delaware Maryland New Hampshire New Jersey Massachusetts Connecticut West

National Centers for Environmental Prediction

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Modeling Mesoscale Modeling Marine Modeling and Analysis Teams Climate Data Assimilation Ensembles and Post Ice group works on sea ice analysis from satellite, sea ice modeling, and ice-atmosphere-ocean / VISION | About EMC Analysis Drift Model KISS Model Numerical Forecast Systems The Polar and Great Lakes

Sandia National Laboratories: Working with Sandia: Contract Audit

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Government Auditing Standards. Electronic Cost Claims Electronic Cost Claim (ECC) An Electronic Cost Claim is ) ECC-Cost Reimbursable Template and Instructions (MS Excel) ECC-University Template (MS Excel) ECC -Indirect Rates (Indirect Rate Cost Claim) (MS Excel) Electronic Cost Proposals Electronic Cost Proposal

Midscale Commercial Solar Market | Solar Research | NREL

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analysis to expand the midscale solar market. The midscale market for solar photovoltaics (PV), loosely than other PV market segments in recent years. Featured Analysis Midmarket Solar Policies in the United Midscale Commercial Solar Market Midscale Commercial Solar Market NREL experts are providing

Lawriter - OAC

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authorized by section 3709.05 of the Revised Code. (C) "Circulation system" means an arrangement of transferred and does not mean the person who formerly operated or maintained the public swimming pool. (J ://catalog.asme.org/. ASME documents are also generally available at the state library of Ohio. (c) American national

Educational

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. Northern Command: For Students The 1700s "To provide for calling forth the militia to execute the laws of the union, suppress insurrections, and repel invasions." - Article 1, Section 8, Clause 15 , Constitution of the United States Because the common defense of the New World was so crucial, our forefathers

Publications - SR 37 | Alaska Division of Geological & Geophysical Surveys

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Skip to content State of Alaska myAlaska My Government Resident Business in Alaska Visiting Alaska Section; Resource Assessment; Tyonek Formation; Type Section Top of Page Department of Natural Resources State Employees DGGS State of Alaska search Alaska Division of Geological & Geophysical Surveys Home

Presentations - Twelker, Evan and others, 2014 | Alaska Division of

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Resident Business in Alaska Visiting Alaska State Employees DGGS State of Alaska search Alaska Division of Details Title: Preliminary results from 2014 geologic mapping in the Talkeetna Mountains, Alaska Lande, Lauren, 2014, Preliminary results from 2014 geologic mapping in the Talkeetna Mountains, Alaska

Distributed Wind Research | Wind | NREL

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evaluation, and improve wind turbine and wind power plant performance. A photo of a snowy road leading to a single wind turbine surrounded by snow-covered pine trees against blue sky. Capabilities NREL's power plant and small wind turbine development. Algorithms and programs exist for simulating, designing

NREL: Renewable Resource Data Center - Webmaster

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Version RReDC Home Biomass Resource Information Geothermal Resource Information Solar Resource Information laboratory of the U.S. Department of Energy, Office of Energy Efficiency and Renewable Energy, operated by the Alliance for Sustainable Energy, LLC. NREL U.S. Department of Energy Office of Energy Efficiency

NREL: News - New Energy Systems Enhance National Security

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resources, bioenergy and bio-based products, zero energy buildings, wind energy, geothermal energy, solar Energy Systems Enhance National Security Washington D.C., March 14, 2002 Experts from the U.S . Department of Energy's National Renewable Energy Laboratory (NREL) have identified key renewable energy

SSRL HEADLINES April 2018

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and x-ray spectroscopy pioneer, Farrel W. Lytle, and include precious metals such as gold, silver structure of matter called x-ray absorption spectroscopy. The foils were donated by entrepreneur, scientist activities on x-ray fluorescence imaging in ancient materials like fossils and the Archimedes Palimpsest

Fermilab History and Archives Project | Norman F. Ramsey

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Fermilab History and Archives Project Fermilab History and Archives Project Fermilab History and Archives Project Home About the Archives History and Archives Online Request Contact Us History & ; Archives Project Fermilab History and Archives Project Norman F. Ramsey Back to History and Archives

CAP: Mobile App

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Interpreting Services Training Non-DoD Employees Partner Agencies A - L Partner Agencies M - Z Training Service Service Members Site Map + CAP Customers DoD Employees DoD Agencies Support Services Training Non-DoD Employees Partner Agencies A - L Partner Agencies M - Z Training Service Members Military Treatment

Finding New Ways to Foster Clean Energy Partnerships - Continuum Magazine

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market impact of the research conducted at DOE's national laboratories by doubling the intensity of . Many of these achievements stem from internal process improvements that have enhanced NREL's ability to " that factors in elements of each innovation's patentability, commercial impact, and licensing

Renewable Energy Technical Potential | Geospatial Data Science | NREL

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Technical Potential Renewable Energy Technical Potential The renewable energy technical potential level from Resource to Technical to Economic to Market. The benefit of assessing technical potential is potential-resource, technical, economic, and market-as shown in the graphic with key assumptions. Technical

Thermochemical Process Integration, Scale-Up, and Piloting | Bioenergy |

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; represented by spheres of hydrogen and carbon monoxide, then to "Gas Cleanup, Solids Removal, Reforming ; represented by a gasoline dispenser nozzle. A green arrow of "Fast Pyrolysis" and blue arrows for Distillation," and finally to "Fuels," represented by a gasoline dispenser nozzle Variety of

ACHP | Unified Federal Review

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UFR Process was established on July 29, 2014, by the execution of the Memorandum of Understanding Process is being led by a Steering Group consisting of the Council on Environmental Quality, the Review was established on July 29, 2014, through an interagency Memorandum of Understanding by eleven

Publications - GMC 410 | Alaska Division of Geological & Geophysical

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) Keywords Geochemistry; Rare Earth Elements Top of Page Department of Natural Resources, Division of Surveys Skip to content State of Alaska myAlaska My Government Resident Business in Alaska Visiting Alaska State Employees DGGS State of Alaska search Alaska Division of Geological & Geophysical

Publications - GMC 409 | Alaska Division of Geological & Geophysical

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) Keywords Geochemistry; Rare Earth Elements Top of Page Department of Natural Resources, Division of Surveys Skip to content State of Alaska myAlaska My Government Resident Business in Alaska Visiting Alaska State Employees DGGS State of Alaska search Alaska Division of Geological & Geophysical

Energy Systems Integration News | Energy Systems Integration Facility |

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hierarchical control architecture that enables a hybrid control approach, where centralized control systems will be complemented by distributed control algorithms for solar inverters and autonomous control of ), involves developing a novel control scheme that provides system-wide monitoring and control using a small

Legislative Affairs Media Contact - Public Affairs - NOAA's National

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Media Contacts -NWS Media Contacts -NOAA Media Contacts -Legislative Affairs Media Tools -Archived News Media Contact Matthew R. Borgia Congressional Affairs Specialist - All National Weather Service issues (202)482-1939 Back Top Home | Mission | Strategic Plan | NWS Media Contacts | NOAA Media Contacts US

Fermilab Center for Particle Astrophysics | FCPA

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Us About Us Contact Science Dark Matter Dark Energy Cosmic Microwave Background Radiation (CMBR) New detection and detailed study of the properties of cosmic dark matter particles in the laboratory » Hunting for Light Dark Matter in a Bubble Chamber September 18, 2013 | Hugh Lippincott The

FNAL Student Resources

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understandings lead to new fundamental questions and a new world of discovery. What is dark matter? What happened NOvA Detector Dark Energy Camera Whispers of Dark Matter Elusive Neutrino Particle physics research World Particle Diversity Dark Matter Neutrino Secrets The Birth of the Universe The Universe's History

Alternative Fuels Data Center

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to achieve the Replacement Fuel Goal. For more information on the Private and Local Government Fleet Private and Local Government Fleets Under the Energy Policy Act (EPAct) of 1992, the U.S . Department of Energy (DOE) was directed to determine whether private and local government fleets should be

Software Tools for Battery Design | Transportation Research | NREL

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battery designers, developers, and manufacturers create affordable, high-performance lithium-ion (Li-ion Software Tools for Battery Design Software Tools for Battery Design Under the Computer-Aided ) batteries for next-generation electric-drive vehicles (EDVs). An image of a simulation of a battery pack

Ahmad Pesaran Honored with DOE Assistant Secretary's 2017 EERE Outstanding

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lithium-ion battery performance for electric vehicles. No stranger to inspiring colleagues, providing Michelbacher (INL, VTO Battery and Electrification), Steven Boyd (DOE, VTO Battery and Electrification), Brian Cunningham (DOE, VTO Battery and Electrification), Samuel Gillard (DOE, VTO Battery and Electrification

NREL Scientists and Engineers Recognized for Top Innovations | NREL | News

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commercially available, large-format isothermal battery calorimeter for lithium-ion battery safety testing to test the performance and safety of large-format lithium-ion batteries used extensively in electric develop NREL intellectual property representing an isothermal battery calorimeter. The technical

NOAA Office of Exploration and Research > Education > Materials

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2014 Funding Opportunities Contact Us Program Review Review Panel Final Report Review Team Documents Review Review Panel Final Report Review Team Documents Presentations Supporting Documents Guiding

Staff Directory | NREL

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staff. Search by first or last name; this search is not case-sensitive. SEARCH: Search Select a search type Select your criteria Enter your search term Contact us for questions or comments

NOAA Photo Library - NOAA In Space Collection/Space Vehicles Album/Tiros

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NOAA Photo Library Banner Takes you to the Top Page Takes you to the About this Site page. Takes you to the Contacts page. Takes you to the HELP page. Takes you to the Credits page. Takes you to the Collections page. Takes you to the search page. Takes you to the Links page. Tiros Banner NOAA In Space

NOAA Photo Library - NOAA In Space Collection/Satellite Systems/Polar and

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Inclined Orbit Satellites NOAA Photo Library Banner Takes you to the Top Page Takes you to the About this Site page. Takes you to the Contacts page. Takes you to the HELP page. Takes you to the Credits page. Takes you to the Collections page. Takes you to the search page. Takes you to the Links page

NOAA Office of Exploration and Research > Science > Overview

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2014 Funding Opportunities Contact Us Program Review Review Panel Final Report Review Team Documents Opportunities Contact Us Program Review Review Panel Final Report Review Team Documents Presentations Supporting

Employee Spotlight: Clarence Chang | Argonne National Laboratory

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batteries --Electricity transmission --Smart Grid Environment -Biology --Computational biology --Environmental biology ---Metagenomics ---Terrestrial ecology --Molecular biology ---Clinical proteomics and biomarker discovery ---Interventional biology ---Proteomics --Structural biology -Environmental science &

Summer teachers' teaching tool

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and nervous system of the frog. Skeleton System Organs Digestive System Nervous System Berkeley Lab students study anatomy of a frog in Biology class room. The pictures showed the skeleton, organs, digestive

Solar Access: Issues and Policy Options | State, Local, and Tribal

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: approximately 2,580 megawatts (MW) of new residential solar photovoltaic (PV) capacity was brought online in home with rooftop solar Figure 1. Example of a residential solar PV system. NREL 00565 The existing Governments | NREL Solar Access: Issues and Policy Options Solar Access: Issues and Policy

Smoot Astrophysics Research Program

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the same basic force and have frozen out to different forces in the cooler present Universe. We see Implications of the COBE DMR Map of the Early Universe What COBE DMR saw: The COBE DMR (Cosmic Background Explorer Differential Microwave Radiometer) mapped the microwave (wavelengths of 9, 5,6, and 3.3

Big World of Small Neutrinos

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electron neutrino, muon neutrino, or tau neutrino. The three different neutrinos are complemented by anti of the neutrinos we detect will look different (have a different flavor) compared to the time they Big World of Small Neutrinos Neutrinos will find you! Fig 1: Hubble image of the deep field

Introductory Talk: Whole Frog Project

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geometric primitives (points, lines, polygons, etc.) that accurately represent the shape of the surface constant value (color). This operation effectively defines the boundary between areas of different color about 10 seconds on a 56K baud modem. The controls can be set to send compressed images of 3 different

Full Hybrid: Cruising

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1 At speeds above mid-range, both the engine and electric motor are used to propel the vehicle. The gasoline engine provides power to the drive-train directly and to the electric motor via the generator. Go , generator, power split device, and electric motor visible. The car is moving. There are blue arrows flowing

Solution for Data Security Challenges Faced by Smart Grid Evolution - Video

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the same utility - different business units that are dealing with generation, transmission, and smart grid, the consumers now also have access to information about zero utilization and the different alive to sense what's going on. And then there's certainly variety with the various different elements

what is a tornado?

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all the same. It appears that tornadoes arise in many different ways, and perhaps different process can be associated with the tornado at different times in its life cycle. Moreover, not all tornadoes , mesocyclone) be? Where do you propose to put the dividing lines between tornado-tornado cyclone-mesocyclone? c

The GFS Atmospheric Model description

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model has only one type of cloud cover represented by C. In the tropics the cloudiness is primarily due mainly through grid-scale condensation. The fractional cloud cover C is available at all model levels , 1996: Parameterizations for the absorption of solar radiation by water vapor and ozone. J. Atmos. Sci

Teachers Participate in Scientific Work to Prepare for School Year

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improve the quality of science, mathematics and technology education in Colorado schools, the U.S critical agents of change in working to improve science, mathematics and technology education in our Science and Technology Education Irene Hays. "This is NREL's way of helping the quality of teaching

Publications - PIR 2008-1C | Alaska Division of Geological & Geophysical

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investigations in the Brooks Range Foothills and North Slope, Alaska: Alaska Division of Geological & Surveys Skip to content State of Alaska myAlaska My Government Resident Business in Alaska content DGGS PIR 2008-1C Publication Details Title: Evaluation of stratigraphic continuity between the

Publications - PIR 2003-1 | Alaska Division of Geological & Geophysical

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, Alluvial facies and paleosols in the Cretaceous Nanushuk formation, Kanayut River, North Slope, Alaska Surveys Skip to content State of Alaska myAlaska My Government Resident Business in Alaska content DGGS PIR 2003-1 Publication Details Title: Alluvial facies and paleosols in the Cretaceous

Publications - RI 2015-7 | Alaska Division of Geological & Geophysical

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Surveys Skip to content State of Alaska myAlaska My Government Resident Business in Alaska content DGGS RI 2015-7 Publication Details Title: Surficial geology of the Tyonek area, south-central of the Tyonek area, south-central Tyonek Quadrangle, Alaska: Alaska Division of Geological &

Publications - PIR 2015-5-5 | Alaska Division of Geological & Geophysical

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., 2015, Stratigraphic reconnaissance of the Middle Jurassic Red Glacier Formation, Tuxedni Group, at Red Surveys Skip to content State of Alaska myAlaska My Government Resident Business in Alaska content DGGS PIR 2015-5-5 Publication Details Title: Stratigraphic reconnaissance of the Middle Jurassic

Publications - PIR 2008-1A | Alaska Division of Geological & Geophysical

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of recent geologic field investigations in the Brooks Range Foothills and North Slope, Alaska: Alaska Surveys Skip to content State of Alaska myAlaska My Government Resident Business in Alaska ; Tectonics; Thermal History; Thrust; Toolik River; Torok Formation; Turbidites; Turonian; Valanginian Top of

Electric and Plug-In Hybrid Electric Fleet Vehicle Testing | Transportation

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Research | NREL Electric and Plug-In Hybrid Electric Fleet Vehicle Evaluations Electric and Plug-In Hybrid Electric Fleet Vehicle Evaluations How Electric and Plug-In Hybrid Electric Vehicles Work EVs use batteries to store the electric energy that powers the motor. EV batteries are charged by

Eastern Wind Data Set | Grid Modernization | NREL

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cell was computed by combining these data sets with a composite turbine power curve. Wind power plants wind speed at the site. Adjustments were made for model biases, wake losses, wind gusts, turbine and conversion was also updated to better reflect future wind turbine technology. The 12-hour discontinuity was

Systems Engineering Models and Tools | Wind | NREL

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(tm)) that provides wind turbine and plant engineering and cost models for holistic system analysis turbine/component models and wind plant analysis models that the systems engineering team produces. If you integrated modeling of wind turbines and plants. It provides guidance for overall wind turbine and plant

NREL Taps Young to Oversee Geothermal Energy Program | News | NREL

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Taps Young to Oversee Geothermal Energy Program News Release: NREL Taps Young to Oversee Geothermal (NREL) promoted Katherine Young to laboratory program manager for geothermal energy. Young has been with NREL since 2008, working as a senior geothermal analyst and engineer in the Strategic Energy Analysis

ERDDAP - RESTful Web Services

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, graphs, or information about datasets). A RESTful web service (external link) - a URL that computer to get the same information in a more computer-program-friendly format like JSON (external link .jsonlKVP, where column names are on every row): Each column has a column name and one type of information

NREL and Hawaiian Electric Navigate Uncharted Waters of Energy

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potential grid impact of adding customer-side storage to rooftop solar systems-a scenario that could soon Systems Integration Facility's (ESIF's) power hardware-in-the-loop capability. NREL's ESIF was one of the justify activation of a specific grid support function called "volt-var control" for all new

DRIVE: Drive-Cycle Rapid Investigation, Visualization, and Evaluation

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specialized statistical clustering methods. The duration of these representative drive cycles, which aim to , DRIVE can benefit a variety of users. For example: Fleet managers can use the tool to make educated investment decisions by determining, in advance, the payback period for a given technology. Vehicle

Publications - PDF 98-36A | Alaska Division of Geological & Geophysical

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Oxides; Rocks; STATEMAP Project; Trace Elements Top of Page Department of Natural Resources, Division of Surveys Skip to content State of Alaska myAlaska My Government Resident Business in Alaska Visiting Alaska State Employees DGGS State of Alaska search Alaska Division of Geological & Geophysical

Publications - GMC 370 | Alaska Division of Geological & Geophysical

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(249.0 K) Keywords Rare Earth Elements Top of Page Department of Natural Resources, Division of Surveys Skip to content State of Alaska myAlaska My Government Resident Business in Alaska Visiting Alaska State Employees DGGS State of Alaska search Alaska Division of Geological & Geophysical

Message from the Director | Galaxy of Images

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Search! Enter a search term and hit the search button to quickly find an image Go The above "Quick Search" box will find ANY words you type in. Use "*" to truncate a word (dog* will get more precise search, try the "Advanced Search" option below. More search options, including

Air Force Special Operations Command > Home > POTFF

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Air Force Special Operations Command Air Force Special Operations Command Join the Air Force Home Sheets AFSOC Senior Leaders AFSOC Heritage Units 1st Special Operations Wing 24th Special Operations Wing 27th Special Operations Wing 352nd Special Operations Wing 353rd Special Operations Group 492nd Special

Publications - GMC 350 | Alaska Division of Geological & Geophysical

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in the NPRA, Alaska as follows: Ikpikpuk #1 core, cuttings, and sidewall core; South Meade #1 cuttings; Brontosaurus #1 cuttings and core; Walakpa #1 core; and Walakpa #2 cuttings and core Authors follows: Ikpikpuk #1 core, cuttings, and sidewall core; South Meade #1 cuttings; Brontosaurus #1 cuttings

John Turner | NREL

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; International Journal of Energy Research 32 (5), 379-407. Ahn, K.S., Shet, S., Deutsch, T., Jiang, C.S., Yan, Y and Sustainable Energy, an AIP journal. Research Interests Dr. Turner has been recognized as a methods, definitions, and reporting protocols." Journal of Materials Research 25 (01), 3-16. Yin, W.J

NOAA's National Weather Service/Environmental Protection Agency - United

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Integration Image | Loop View | Daily View | Point Guidance | | Experimental Air Quality Guidance | Product Map To View Additional Guidance Graphic of Air Quality Forecast Guidance for the CONUS Mouse over or Image Alaska 1-Hr Average Ozone Concentration Image Hawaii 1-Hr Average Ozone Concentration Image 8-Hr

Climate Prediction Center - Outreach: 41st Annual Climate Diagnostics &

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the University of Maine Climate Change Institute and School of Earth and Climate Sciences and is co (drought, heat waves, severe weather, tropical cyclones) in the framework of climate variability and change and including the use of paleoclimate data. Arctic climate variability and change, and linkages to

Inclusion & Diversity

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Engineering Institute Information Science & Technology Institute Center for Space and Earth Science Management System Environmental Outreach Feature Stories Individual Permit for Storm Water Public Reading Management (First-line and Mid-level) (Engineering Management, Research Management, Technical Management

Research | NREL

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manufacturing, buildings efficiency, concentrating solar power, geothermal energy, transportation, water power Integration Facility Geothermal Energy Grid Modernization Hydrogen & Fuel Cells Integrated Energy Research Research Researching energy systems and technologies-and the science behind them-for a

Homepage P. Fischer, LBNL, Berkeley CA | UC Santa Cruz CA

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mesoscale magnetic x-ray microscopy and spectroscopy (ultra-)fast spin dynamics soft x-ray tomography of condensed matter x-ray optics publications presentations invited talks conference contributions curriculum

Facilities | Argonne National Laboratory

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Skip to main content Argonne National Laboratory Toggle Navigation Toggle Search Research Facilities Advanced Powertrain Research Facility Center for Transportation Research Distributed Energy Research Center Engine Research Facility Heat Transfer Laboratory Materials Engineering Research Facility

Defense Advisory Committee on Women in the Services (DACOWITS)

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Reports & Meetings News Articles 2018 Weekly Articles 2017 Weekly Articles 2016 Weekly Articles 2015 Weekly Articles 2014 Weekly Articles Latest Updates: The Next Quarterly Business Meeting is June 19-20

Data and Tools | Energy Analysis | NREL

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and Tools Energy Analysis Data and Tools NREL develops energy analysis data and tools to assess collections. Data Products Technology and Performance Analysis Tools Energy Systems Analysis Tools Economic and Financial Analysis Tools

Inmetro - Instituto Nacional de Metrologia, Qualidade e Tecnologia

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Consumidor Laboratórios Legislação Comunicação Social Programa de Monitoramento BPL Produtos analisados de selos Indique! Sugestão para o Programa de Análise de Produtos Licitações Material de Portal do Governo Brasileiro mdic Carta de Serviços Inmetro nos Estados Acre Alagoas AmapÃ

National Centers for Environmental Prediction

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) soilm1 0-10cm soil moisture soilm2 10-40cm soil moisture soilm3 40-100cm soil moisture soilm4 100-200cm soil moisture soilt1 0-10cm soil temperature soilt2 10-40cm soil temperature soilt3 40-100cm soil temperature soilt4 100-200cm soil temperature thick700.ptype 850-700mb thickness precipitation type thick850

Ryan Davis | NREL

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design TEA LCA Biochemical conversion process pathways Algal biomass production and conversion pathways Production," Green Chemistry (2015) Process Design and Economics for the Conversion of Lignocellulosic Production," Applied Energy (2011) Process Design and Economics for Biochemical Conversion of

Treasury > Home

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Home Unclaimed Property Investments Cash Management Debt Management Admin Sign-In State of Alaska > provides cash management, investment and portfolio management, debt management and accounting services for investments, establishes and implements policies, and provides administrative and information technology

Employment Opportunities

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Conservation Education Timber Management Wildland Fire & Aviation Burn Permits Firewise Alaska Brochure (PDF) Fire Management Plans Fire Assignments Annual Fire Statistics Fire Terms Glossary Incident Business Management Grants Become an Alaska Firewise Community Community Wildland Fire Protection Plans

Forest Stewardship Committee

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Conservation Education Timber Management Wildland Fire & Aviation Burn Permits Firewise Alaska Brochure (PDF) Fire Management Plans Fire Assignments Annual Fire Statistics Fire Terms Glossary Incident Business Management Grants Become an Alaska Firewise Community Community Wildland Fire Protection Plans

Ag Data Commons Monthly Metrics | National Agricultural Library

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and Nutrition Service(84)","value":"Food and Nutrition Service(84)"," and Nutrition Service(84)","value":"Food and Nutrition Service(84)"," and Nutrition Service(84)","value":"Food and Nutrition Service(84)","

Taeho Yoon | NREL

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postdoctoral fellow. He developed his expertise in electrochemistry and lithium-ion batteries (failure for lithium-ion batteries. His current research focuses on developing: 1) a fundamental understanding electrochemical performance of lithium-ion batteries. Research Interests Fundamental understanding of

MATLAB Software Versions and Licenses for the Peregrine System |

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: Feature usage info: Users of MATLAB: (Total of 6 licenses issued; Total of ... licenses in use) Users of Compiler: (Total of 1 license issued; Total of ... licenses in use) Users of Distrib_Computing_Toolbox : (Total of 4 licenses issued; Total of ... licenses in use) Users of MATLAB_Distrib_Comp_Engine: (Total of

2014 NREL Photovoltaic Reliability Workshops | Photovoltaic Research | NREL

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Curves and Visual Inspection of PV Modules Deployed at TEP Solar Test Yard-Peter McNutt, NREL Data Determining PV System's Degradation Rate and the Impact of Data Filters-Wilson Zexu Zhang, REC Solar Pte. Ltd " Test in Qualifying Solar PV Inverters-Dutch Uselton, Lennox IND System Reliability for Utility PV

Energy Systems Integration Newsletter - January 2017 | Energy Systems

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) project with PV manufacturer First Solar and NREL, First Solar designed an advanced plant-level controller relatively long history of interconnecting solar photovoltaic (PV) systems to its electric grid, with state Photo of a solar array. Tests Show Large Solar Plants Can Balance a Low-Carbon Grid In recent years

Top Five Large-Scale Solar Myths | State, Local, and Tribal Governments |

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of large-scale photovoltaic (PV) facilities or solar farms tend to include a myriad of misperceptions technologies do use mirrors which can cause glare, most solar farms use PV modules to generate electricity. PV panels in order to convert solar energy into electricity. PV modules are generally less reflective than

NOVA - Official Website | Invisible Universe Revealed

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): They look like artworks in the heavens. Each one of them is different, like snowflakes. And these are coming to a focus at different points. And that is the classic problem called "spherical aberration chips of paint. They had thrown off the laser-guided measuring tool used to shape the mirror. JIM

Virtual Frog Dissection: Interactive 3D Graphics Via the Web

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Kit''. A student using this kit has the ability to view various parts of a frog from many different angles, and with the different anatomical structures visible or invisible. For example, the student can up to 60 kilobytes for high quality. Clicking on the image yields different results depending on how

ACHP | Section 106 Disaster Response Planning FAQ

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§ 800.1(c)). What happens once the "emergency" response phase to the disaster is over? The ACHP be shared and in what format. 36 CFR § 800.11(c) provides further information on how the Secretary Introduction In response to recent catastrophic events across the country, such as flooding, snow, ice