A segurança do paciente grave é uma meta da qualidade do atendimento em Unidade de Terapia Intensiva (UTI), daí a necessidade de se investigar os fatores relacionados à ocorrência de eventos adversos nesse contexto. Trata-se este estudo de uma pesquisa quantitativa, retrospectiva, analítico-transversal que teve como objetivo analisar os fatores associados aos incidentes e/ou eventos adversos (INC/EA) no preparo e administração de medicamentos, nos cuidados com tubo endotraqueal/traqueostomia, sondas, drenos, cateteres e queda em UTI segundo as características demográficas e clínicas do paciente e recursos estruturais da Unidade. Os dados foram coletados por meio dos registros de INC/EA dos prontuários dos pacientes que tiveram notificado algum tipo de INC/EA no período de 2003 e 2006, inclusive, em cinco UTI de cinco hospitais do Município de São Paulo. No tratamento estatístico, foi utilizada a análise de regressão logística multivariada para a identificação dos fatores independentes de INC/EA e condições de saída da Unidade. Para a identificação dos fatores independentes do tempo de permanência nas UTI, utilizou-se a análise de regressão linear múltipla. As variáveis que entraram nos modelos foram aquelas que apresentaram na regressão logística univariada um valor de teste Wald<0,20; em todas as análises realizadas foi utilizado o nível de significância de 5%. Do total de 21.230 admissões nas UTI, 377 (1,78%) pacientes sofreram algum tipo de INC/EA. Foram notificadas 461 ocorrências, a maioria relacionada ao preparo e administração de medicamentos (196-42,51%), seguidas aos cateteres periféricos e arteriais (105-22,77%) e às sondas nasogástricas (73-15,83%). Quanto aos fatores associados aos INC/EA e recursos materiais/equipamentos e ambiente físico das unidades, o baixo número de ocorrências (16-2,82%) inviabilizou a análise dessas variáveis. Da mesma forma, nenhum hospital dispunha das escalas diárias de enfermagem com dados retrospectivos sobre os recursos humanos existentes no período do estudo. Verificou-se que o número de dias de permanência dos artefatos terapêuticos foi um dos principais fatores independentes associados aos INC/EA quer no preparo e administração de medicamentos (número de dias de TE/Traq.), quer nos cuidados com cateter periférico, sonda nasogástrica e cateter central (número de dias de artefatos terapêuticos), seguidos da gravidade e da não sobrevivência dos pacientes. Referente ao tempo de permanência na UTI, os fatores associados foram número de dias de sondas, drenos e cateteres, número de itens da prescrição medicamentosa, não sobrevivência e INC/EA com cateteres periféricos e medicamentos. Finalizando, constatou-se que pacientes não sobreviventes tiveram maior número de dias com TE/Traq., eram mais graves e apresentaram, aproximadamente, cinco vezes mais chance de sofrer um INC/EA com TE/Traq.. Considerando que o enfoque da segurança do paciente é de responsabilidade compartilhada de todos os profissionais, da área de saúde ou não, julga-se que os resultados dessa investigação contribuam para a melhoria da assistência ao paciente crítico, por abrir perspectivas para o estabelecimento de protocolos de prevenção dessas ocorrências / The safety of serious patients is a goal of the quality of service in Intensive Care Units (ICUs), therefore, the need to investigate the factors related to the occurrence of adverse events in this context. This study reports a quantitative, retrospective, analytic-transversal research that aimed to analyze the factors associated with the incidents and/or adverse events (INC/AE) in the preparation and administration of medication, in the care of endotracheal/tracheostomy tubes, probes, drains, catheters and fall in ICUs according to the demographic and clinical characteristics of patients and structural resources of the Units. Data was collected from the registry of INC/AE made in the charts of patients that were notified with some type of INC/AE in five ICUs of five hospitals of the City of Sao Paulo from 2003 to 2006. The statistical treatment consisted of an analysis of multivariate logistic regression to identify the independent factors of INC/AE and exit conditions of the Units. The author also ran the multiple linear regression analysis to identify the independent factors of the length of stay in the ICUs. Variables that presented a Wald test rate <0,20 in the univariate logistic regression entered in the models. All analysis adopted a 5% significance level. From 21.230 total admissions in the ICUs, 377 (1,78%) patients suffered some type of INC/AE. A total of 461 occurrences were notified. Most of these occurrences were related to the preparation and administration of medication (196-42,51%), followed by the peripheral catheters and A- lines (105-22,77%), and the nasograstic tubes (73-15,83%). The low number of occurrences (16-2,82%) of factors associated with INC/AE, material/equipment resources and physical settings of the units made the analysis of these variables unfeasible. The same way, no hospital made available daily nursing schedules that contained retrospective data about the existing human resources at the time of the study. The author verified that the number of days of use of therapeutic artifacts was one of the main independent factors associated with INC/AE. These related to the preparation and administration of medication (number of days of TE/Traq.), as well as to the care of peripheral catheters, nasograstic tubes and central catheters (number of days of therapeutic artifacts), followed by seriousness and non-survival of the patients. The factors associated with the length of stay in the ICU were number of days with probes, drains and catheters, number of items of the prescribed medication, non-survival and INC/AE with peripheral catheters and medication. At last, the author established that non-survival patients spent a greater number of days with TE/Traq. They were also more serious and were about five times more likely to suffer INC/AE with TE/Traq. Considering that the focus of a patient safety is shared responsibility of all professionals, from the health field or not, the author considers that the results of this investigation contribute to the improvement of the assistance to critical patients, as it opens perspectives for the establishment of protocols for the prevention of such occurrences

No Bioma Pampa, somente 4.753,42 hectares são preservados como Unidades de Conservação Estaduais oficialmente inseridas no Sistema Estadual de Unidades de Conservação. Observa-se, também, que, no Estado do Rio Grande do Sul, não existe uma unidade de conservação que represente os ecossistemas de campos com ocorrência de areais, os chamados campos de areais, locais com ocorrência de endemismo, elevado risco às espécies ali existentes e com registros arqueológicos significativos. O Código Estadual do Meio Ambiente do Estado do RS determina, em seu artigo 41, que as UC serão criadas por ato do Poder Público, sendo prioritária a criação daquelas que contiverem ecossistemas ainda não representados no SEUC, em iminente perigo de eliminação ou degradação, ou, ainda, pela ocorrência de espécies endêmicas ou ameaçadas de extinção. Tal situação ocorre nesta região do RS, uma vez que existe lacuna na conservação. Na busca por entendimento desta situação, esta dissertação aborda a indicação de áreas de relevante interesse ambiental, na região de ocorrência de campos com areais, localizadas na porção sudoeste do Rio Grande do Sul, com potencial para integrarem o Sistema Estadual de Unidades de Conservação. Tal indicação inclui o areal de Quaraí/RS, área de grande beleza, com representação para a história do RS e possuidora de sítios arqueológicos. / In the Pampa biome, only 4753.42 acres are preserved as State Protected Areas officially incorporated in the State System of Conservation Units. It is noted also that the state of Rio Grande do Sul, there is a conservation unit that represents the ecosystems of fields with the occurrence of sand, called sand fields, with the occurrence of local endemism, high-risk species found there and significant archaeological records. The State Environmental Code of the State of RS stipulates in its article 41 that the UC will be created by an act of the public, with priority to create ecosystems that contain those not yet represented in SEUC, or in imminent danger of elimination or degradation, or Furthermore, the occurrence of endemic or endangered. This situation occurs in this region RS, since there is gap conservation. In the search for understanding of this situation, this paper discusses the appointment of the relevant areas of environmental concern in the region of occurrence of fields with sandy beaches, located in the southwestern portion of Rio Grande do Sul, with the potential to integrate the State System of Conservation Units. Such indications include the sands of Quarai / RS, an area of great beauty, with representation in the history of RS and owner of archaeological sites.

This essay is a study of how English is used in a Swedish discussion forum called Flashback. The mixing of two languages when speaking or writing is called Code switching. Code switching often occurs in bilingual societies. In Sweden it is possible to say that English is a second language due to the daily encounter with the language through education, but also through different media. The daily encounter with English and the number of English loan words in Swedish might be a reason why code switching exists in Sweden. The material that was analyzed in this essay was collected from Flashback and analyzed with a method based on Sharp’s (2001) study of spoken language. The aim of this study was to see how often and in what way the users on Flashback code switched between Swedish and English. The results showed that even though English was used in the discussion, Swedish was the main language. Most of the code switches that were found in the material occurred in mixed units, in other words English was mixed with Swedish.

In a hospital environment the focus is on quality patient care. One of the important factors to improve the quality of patient care is the implementation of a continuous professional development programme. In a continuous professional development programme of a hospital three stakeholders namely management, clinical facilitators and the nurse practitioners are identified as partners. When the stakeholders reach a point where it is believed that the continuous professional development programme does not serve its purpose to improve the quality of patient care it is time to evaluate and refine the programme. This study evaluate the critical care and high care units in a private hospital in Gauteng’s continuous professional development programme and the conclusions and recommendations are therefore limited to this specific clinical setting. The refinements recommended cannot be utilised in other clinical setting but the evaluation and research methodology can be utilised to evaluate similar continuous professional development programmes. Evaluation of a continuous professional development has the potential to negatively influence the nurse practitioners attitude towards continuous professional development. The objective of the research approach chosen namely a 4-D Appreciative Inquiry approach was to gain the collaboration of all the stakeholders in an effort to ensure that the evaluation of the continuous professional development programme of the critical care and high care units in the private hospital in Gauteng does not negatively affect the delivery of quality patient care. The Appreciative Inquiry research approach with its positive approach lends it to be the most appropriate research methodology of the study. The study utilised a Focus Group Inquiry as data a collection mechanism. From the study In-service training emerged as the element that form an important element of an effective continuous professional development programme but that it is of the at most importance that an effective Workplace learning environment exists. The supportive role of Management for a continuous professional development programme also emerged as one of the main themes required for the implementation of a continuous professional development programme. These findings were utilised in the refinement for the continuous professional development programme for the critical care and high care units in the private hospital in Gauteng. The research recommends that a steering committee be appointed to implement a pilot continuous professional development programme that incorporate the refinement elements identified. Due to the continuous improvement nature of the Appreciative Inquiry methodology it is also recommended that the pilot continuous professional development programme been re-evaluation to ensure long-term success and improvement. / Dissertation (MCur)--University of Pretoria, 2013. / gm2014 / Nursing Science / unrestricted

Text in English / The purpose of this study was to develop strategies to overcome the challenges in the management of large intensive care units (ICUs). Qualitative, research was conducted to explore and describe the challenges and needs experienced by the ICU managers and critical care nurses in the management of large ICUs. Data was collected through interviews. The study was conducted in two phases, that is, Phases I and II which involved compilation of evidence in preparation for development of the strategies and development of the strategies respectively. Two groups of critical care nurses participated in the steps of data collection in Phase I of the study. The unit managers participated in Phase I step 1 which was individual interviews and the critical care nurses not in the management role participated in Phase I, step 2 which was focus group interviews. Data was analysed using the descriptive analysis method of Tesch (1990). The study has highlighted the challenges and needs in the management of large ICUs, through seven themes that emerged from the findings. Ten strategies were developed to overcome the challenges and address the identified needs. The strategies have been presented as a contribution to literature. / Health Studies / D. Litt. et Phil. (Health Studies)

by Chow Wai-hung. / Thesis (M.B.A.)--Chinese University of Hong Kong, 1995. / Includes bibliographical references (leaves 56-57). / ABSTRACT --- p.ii / TABLE OF CONTENTS --- p.iv / LIST OF FIGURES --- p.vi / LIST OF TABLES --- p.vii / ACKNOWLEDGMENT --- p.viii / Chapter / Chapter I. --- INTRODUCTION --- p.1 / Intensive Care Services --- p.1 / Clinician as an Information Processor --- p.2 / Executive Information System (EIS) for Intensive Care Services --- p.7 / Scope of the Study --- p.7 / The Organization of the Remaining Report --- p.8 / Chapter II. --- LITERATURE REVIEW --- p.9 / Sickness Scoring Systems --- p.9 / Executive Information Systems (EIS) --- p.15 / Information Requirements Determination for EIS --- p.17 / Future Direction of EIS in Intensive Care --- p.20 / Chapter III. --- RESEARCH METHODOLOGY --- p.22 / Survey by Mailed Questionnaire --- p.23 / Personal Interview --- p.24 / Subjects Selection --- p.26 / Analysis --- p.27 / Chapter IV. --- RESULTS AND FINDINGS --- p.28 / Part 1 - Questionnaires --- p.29 / Part 2 - Interviews --- p.31 / Chapter V. --- ANALYSIS AND DISCUSSION --- p.44 / Analysis of Results and Findings --- p.44 / Evaluation on Information Requirements Determination for an EIS --- p.50 / Chapter VI. --- CONCLUSION --- p.52 / Chapter VII. --- FUTURE DIRECTION OF DECISION SUPPORT IN CRITICAL CARE --- p.54 / REFERENCES --- p.56 / INTERVIEWS --- p.59 / APPENDIX --- p.60 / Chapter 1. --- A Sample of Hospital Information System Requirement Survey Questionnaire --- p.61 / Chapter 2. --- Samples of Visual Display --- p.67 / Chapter 3. --- A Sample of Format of a Structured Report --- p.70

by Leung Ho-Yin. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1997. / Includes bibliographical references (leaves 82-89). / Abstract --- p.ii / Table of Contents --- p.iv / LIST of Figures --- p.viii / List of Tables --- p.ix / Acknowledgments --- p.xi / Chapter / Chapter 1. --- Introduction --- p.1 / Chapter 1.1 --- Intensive Care Unit --- p.2 / Chapter 1.1.1 --- Expensive Costs of Intensive Care --- p.2 / Chapter 1.1.2 --- Tremendous Demands with Limited Resources --- p.3 / Chapter 1.1.3 --- Conflicting Roles of ICU Physicians --- p.3 / Chapter 1.1.4 --- Disorganized Patient Information --- p.4 / Chapter 1.2 --- ICU Management Problems --- p.5 / Chapter 1.3 --- Executive Information Systems (EIS) for ICU Physician --- p.6 / Chapter 1.4 --- Determine Information Requirements of the EIS --- p.7 / Chapter 1.5 --- Scope of the Study --- p.8 / Chapter 1.6 --- Organization of the Report --- p.8 / Chapter 2. --- Literature Review --- p.9 / Chapter 2.1 --- Intensive Care Unit --- p.9 / Chapter 2.1.1 --- Costs of ICU --- p.10 / Chapter 2.2 --- ICU Physicians are Executives --- p.10 / Chapter 2.3 --- Computers in ICU --- p.11 / Chapter 2.3.1 --- Record Keeping --- p.11 / Chapter 2.3.2 --- Data Management --- p.12 / Chapter 2.3.3 --- Decision Making --- p.13 / Chapter 2.4 --- Problems Facing ICU Physicians --- p.14 / Chapter 2.4.1 --- Conflicting Role --- p.14 / Chapter 2.4.2 --- Information Overload --- p.14 / Chapter 2.4.3 --- Poor Information Quality --- p.15 / Chapter 2.4.4 --- Technophobia --- p.16 / Chapter 2.5 --- Executive Information Systems --- p.16 / Chapter 2.5.1 --- Definition --- p.16 / Chapter 2.5.2 --- Characteristics of EIS --- p.17 / Chapter 2.5.3 --- EIS in Healthcare Industry --- p.20 / Chapter 2.6 --- Determining Information Requirements --- p.20 / Chapter 2.6.1 --- Strategies and Methods to Determine Information Requirements --- p.21 / Chapter 2.6.2 --- Critical Success Factors Analysis --- p.25 / Chapter 2.6.2.1 --- Definition of CSFs --- p.26 / Chapter 2.6.2.2 --- Different Executives Have Different CSFs and Different Information Needs --- p.26 / Chapter 2.6.2.3 --- Hierarchical Nature of CSFs --- p.26 / Chapter 2.6.2.4 --- Steps in the CSFs Approach --- p.28 / Chapter 2.6.2.5 --- "Critical Information, Assumptions, and Decisions" --- p.29 / Chapter 3. --- Research Methodology --- p.31 / Chapter 3.1 --- Literature Review --- p.31 / Chapter 3.2 --- Design a Methodology for Information Requirements Determination --- p.32 / Chapter 3.3 --- ICU Admission Case Study --- p.34 / Chapter 3.4 --- Analysis and Validation --- p.35 / Chapter 3.5 --- COPD Survey: The Importance of Medical History --- p.36 / Chapter 3.5.1 --- Chronic Obstructive Pulmonary Disease --- p.36 / Chapter 3.5.2 --- The Survey --- p.38 / Chapter 4. --- A Three-Stage Methodology --- p.41 / Chapter 4.1 --- Stage 1 - Understanding ICU Operations --- p.42 / Chapter 4.2 --- Stage 2 - Determine CSFs within the ICU --- p.43 / Chapter 4.2.1 --- CSFs Analysis Steps in the Study --- p.44 / Chapter 4.2.2 --- Step 1: Determine CSFs of ICUs --- p.44 / Chapter 4.2.3 --- Step 2: Determine CSFs of the ICU Physicians --- p.45 / Chapter 4.2.4 --- Step 3: Determine CSFs of the ICU Admission --- p.45 / Chapter 4.3 --- Stage 3 譯 Determine Information Requirements --- p.45 / Chapter 4.4 --- Importance of Medical History: A COPD Survey --- p.46 / Chapter 4.4.1 --- COPD Questionnaire --- p.46 / Chapter 5. --- Findings --- p.48 / Chapter 5.1 --- Findings in Stage 1 --- p.48 / Chapter 5.1.1 --- Decision Making in ICU --- p.49 / Chapter 5.2 --- Findings in Stage 2 - CSFs --- p.54 / Chapter 5.2.1 --- CSFs of the ICU --- p.54 / Chapter 5.2.2 --- CSFs of the ICU Physicians --- p.56 / Chapter 5.2.3 --- CSFs of the ICU Admission --- p.56 / Chapter 5.3 --- Findings in Stage 3 --- p.58 / Chapter 5.3.1 --- Types of Information Requirement --- p.58 / Chapter 5.3.2 --- Detailed Contents of the Information Requirements --- p.59 / Chapter 6. --- Analysis --- p.65 / Chapter 6.1 --- A Three-Stage Methodology for Information Requirements Determination --- p.65 / Chapter 6.1.1 --- Comparison of the Three-Stage Methodology with CSFs Analysis --- p.66 / Chapter 6.1.2 --- A Case Study Using the Three-Stage Methodology --- p.67 / Chapter 6.2 --- Roles of Information Types in Admission Decision --- p.68 / Chapter 6.2.1 --- Admitting Patients from Different Sources --- p.69 / Chapter 6.2.2 --- Admitting Patients with Different Diseases --- p.70 / Chapter 6.3 --- The Importance of Medical History --- p.71 / Chapter 7 --- Conclusions --- p.78 / Bibliography --- p.82 / Interviews --- p.90 / Appendices --- p.91

Esta pesquisa desenvolveu uma anÃlise das unidades de conservaÃÃo do MunicÃpio de Paraipaba, localizado na Costa Oeste do CearÃ, observando-se as caracterÃsticas socioambientais, a categoria de criaÃÃo e a forma de gestÃo das referidas unidades, com o objetivo de avaliÃ-las juridicamente com relaÃÃo aos critÃrios regulamentados pelo Sistema Nacional de Unidades de ConservaÃÃo (SNUC). A partir dessa avaliaÃÃo propuseram-se novas definiÃÃes de perÃmetro e categoria para que as unidades de conservaÃÃo cumpram sua finalidade de conservaÃÃo e preservaÃÃo ambiental. Foi considerado o momento histÃrico em que foram instituÃdas as diretrizes nacionais para a proteÃÃo ambiental atravÃs da criaÃÃo e da gestÃo de Ãreas protegidas, diretrizes essas que tÃm o reconhecimento do Plano EstratÃgico Nacional de Ãreas Protegidas (PNAP). Embora prescinda sua efetividade, em parte, da regulamentaÃÃo especÃfica pelos estados-membros dos critÃrios e regras capazes de concretizar a proteÃÃo ambiental por meio da implantaÃÃo e gestÃo sustentÃvel de referidas Ãreas, o que ainda nÃo se verifica no Estado do CearÃ. Esta pesquisa, portanto, espera contribuir com o elenco dos critÃrios instituidores da proteÃÃo ambiental sistemÃtica no litoral oeste do CearÃ, atualmente realizada de modo fragmentado e com alguns critÃrios de interesse divergente à preservaÃÃo ambiental, como o financiamento de atividades potencialmente poluidoras, sem o devido cuidado e respaldo legal e comunitÃrio. Um dos critÃrios mais importantes que se aportou neste trabalho, foi o da anÃlise integrada das unidades de conservaÃÃo do estuÃrio do rio Curu e das dunas da Lagoinha, quando se pÃde identificar a atual inadequaÃÃo da categoria dessas unidades, considerados os elementos constituintes do seu ambiente natural e socioeconÃmico, o que impede o alcance do seu objetivo de proteÃÃo ambiental. / This research developed an analysis on the conservation units in the city of Paraipaba, located on the East coast of CearÃ, highlighting the socioenvironmental characteristics, the implementation as well as the managerial procedures of such units. The aim of the analysis is to evaluate those units juridically, concerning the criteria stated by the National System of Conservation Units (SNUC). Following the referred evaluation, new definitions of perimeter and category were proposed in order to accomplish the conservation and environmental preservation. It was considered the historical moment when the national guidelines were established to protect the environment through the creation and the management of protected areas, these guidelines have been acknowledged by the National Plan of Protected Areas (PNAP). Even though its effectiveness is not sustained, partially, due to the specific regulation of criteria and rules by the state members able to make real the protection of environment through the implantation of sustainable management of the areas, which is not frequently observed in the state of CearÃ. This research hopes to contribute to the granted criteria of systematical environmental protection of the eastern coastline of Cearà which is currently carried out poorly and using some criteria that oppose to the environmental preservation, such as the financing of potentially polluting activities without the proper care and support of the community or the law. One of the most important criteria reached in this work is the integrated analysis of the conservation units of the Curu river estuary along with the dunes of Lagoinha. It could be identified then the inadequacy of the categories of those units, if considered the elements that constitute their natural environment and socioeconomics which prevent from reaching the main goal of environmental protection.

Introdução: A ressuscitação fluídica agressiva, com volume superior ao preconizado por Baxter, com objetivo de evitar a hipoperfusão de órgãos e restabelecer a volemia rapidamente, se tornou uma tendência nos últimos anos. Esta prática vem sendo discutida mais recentemente após a caracterização do fenômeno fluid creep e pode ser causa de aumento da morbidade e mortalidade em crianças queimadas. A hiperhidratação impacta negativamente a evolução desses pacientes e já se estabeleceram associações do fenômeno fluid creep com diversas complicações, como, por exemplo, a síndrome compartimental abdominal. Pacientes queimados estão sob alto risco para infecção e sepse devido à perda da integridade da pele e à exposição prolongada ao ambiente nosocomial. A principal causa de óbito, se o paciente sobreviver à fase inicial do choque do queimado é a disfunção de múltiplos órgãos e sistemas secundária a sepse. Objetivos: Avaliar a associação entre o fluid creep e episódios infecciosos em crianças queimadas submetidas a duas estratégias diferentes de reanimação hídrica envolvendo albumina. Realizar análises de curvas de probabilidade livre de infecção, além de comparar o tempo de internação e número de procedimentos cirúrgicos realizados nestes grupos de pacientes. Metodologia: Estudo de coorte histórica envolvendo 46 crianças queimadas admitidas no Centro de Tratamento de Queimados do Hospital Universitário de Londrina entre junho de 2012 e janeiro de 2014 e que incluiu casos oriundos de um ensaio clínico randomizado controlado realizado no mesmo período. Foram incluídas crianças entre 1 e 12 anos, com queimaduras entre 15% e 45% de Superfície Corporal Queimada (SCQ) e profundidade de 2º e 3º graus, admitidas até a 12ª hora após o acidente. Todos os pacientes receberam reanimação fluídica com Ringer Lactato (RL), nas primeiras 24 horas, segundo a Fórmula de Parkland modificada (3ml/kg/%SCQ) ajustada de acordo com o débito urinário (DU). Os pacientes do grupo A = Exposto (n=23) receberam albumina 5% entre 8 e 12 horas do momento do acidente, e os do Grupo B= Não Exposto (n=23) receberam albumina 5% partir da 24a hora do acidente. Os grupos foram comparados quanto ao surgimento do fenômeno fluid creep, tempo de internação, número de procedimentos cirúrgicos realizados e infecção até a alta hospitalar. Resultados: Os pacientes do grupo A tiveram menos dias de internação comparadamente ao grupo B (p=0,007). O surgimento do fenômeno fluid creep foi maior em crianças no grupo B (p < 0,001). O tempo de internação maior de 14 dias assim como a presença de fluid creep foi associado com a presença de infecção, respectivamente p=0,002 e p=0,020. O tempo de internação bem como a presença de fluid creep apresentaram diferenças nas curvas de probabilidade livre de infecção (p < 0,05). Todas as crianças do grupo B receberam debridamento comparado com 73,9% daquelas incluídas no grupo A (p=0,022), assim como os enxertos foram mais frequentes no grupo B (p=0,032). Conclusões: Crianças queimadas que receberam albumina entre 8 e 12 horas após o acidente apresentaram significativamente menos fluid creep, menor tempo de internação e menor número de procedimentos cirúrgicos (debridamentos e enxertos) comparativamente ao grupo que recebeu albumina após 24 horas. A presença do fluid creep e o tempo de internação superior a 14 dias apresentaram diferenças nas curvas de probabilidade livre de infecção, demonstrando pior prognóstico infeccioso / Introduction: Aggressive fluid resuscitation, defined as the administration of a superior volume to the parameters recommended by Baxter, intend to rapidly set the euvolemia and avoid organ hypoperfusion in burn individuals. The practice became a trend during the last years and has been extensively discussed after the establishment of the fluid creep phenomenon and has been considered as a possible mortality and morbidity factor in burn children. A strong association of fluid creep development has already been established with many conditions, as abdominal compartment syndrome. Burn patients are at high risk of infection and subsequent progression to sepsis due to the loss of skin integrity and long-term exposure to hospital environment. If those patients survive to the burn shock, their main cause of death is the multiple organ failure secondary to sepsis, what highlights the importance of comprehensive knowledge of infectious complications in burn children. Objectives: Assess the association between fluid creep and infection episodes in burn children that were exposed to two different fluid resuscitation strategies with the use of albumin. Analyze the patients infection-free probability curves, length of stay and number of surgery procedures needed. Methods: We developed a historic cohort of 46 burn children admitted at the Burn Treatment Center, State University of Londrina. The same patients were simultaneously enrolled in a parallel clinical trial. In this study, were included patients from 1 to 12 years old, with 15% to 45% of the body surface area (BSA) compromised, second or third-degree burns, admitted up to 12 hours after the accident. Both groups were compared according to the exposure. All the patients received fluid resuscitation with Ringer Lactate (RL) in the first 24 hours, respecting the modified Parkland formula (3 ml/kg/% TBSA) adjusted according to the urine output (UO). Patients from group A were exposed to 5% albumin between 8 and 12 hours from the accident moment and the patients from group B received 5% albumin after 24 hours from the accident. The outcomes observed were development of fluid creep phenomenon, length of stay, number of surgery procedures needed and infection until the hospital discharge. Results: Compared to the group B, the group A had a shorter median length of stay (p=0,007). Fluid creep development had higher rates on group B compared to group A (p < 0,001). The length of stay for more than 14 days, as the fluid creep arising, was associated with infection (respectively, p=0,002 and p=0,02). Both the length of stay and the fluid creep presence showed difference at the infection-free probability curves (p < 0,05). All the patients from group B were submitted to debridement compared to 73,9 from group A (p=0,022). The need of skin graft procedure was also more frequent in patients from group A (p=0,032). Conclusion: Burn children that received albumin between 8 and 12 hours from the accident moment presented significant less fluid creep, shorter length of stay, and smaller number of surgery procedures (as debridement and skin graft) compared to the group that received albumin after 24 hours from the accident. Fluid creep development and length of stay superior to 14 days presented differences at the infection-free probability curves, providing a negative infectious prognosis

Prototyping new systems on hardware is a time-consuming task with limited scope for architectural exploration. The aim of this work was to perform fast prototyping of general-purpose graphics processing units (GPGPUs) on field programmable gate arrays (FPGAs) using a novel tool chain. This hardware flow combined with the higher level simulation flow using the same source code allowed us to create a whole tool chain to study and build future architectures using new technologies. It also gave us enough flexibility at different granularities to make architectural decisions. We will also discuss some example systems that were built using this tool chain along with some results.