Comparação entre as percepções de familiares e as de profissionais de saúde a respeito de um modelo de visitação flexível em uma unidade de terapia intensiva adulto: estudo transversal / Comparison between the perceptions of family members and health professionals regarding a flexible visitation model in an adult intensive care unit: a cross-sectional study

RESUMO Objetivo: Comparar as percepções de familiares de pacientes com as percepções de profissionais de saúde a respeito de um modelo de visitação flexível em unidades de terapia intensiva. Métodos: Este estudo transversal foi realizado de setembro a dezembro de 2018 com familiares de pacientes e membros de equipe de assistência ao paciente de uma unidade de terapia intensiva clínico-cirúrgica com um modelo de visitação flexível (12 horas ao dia). A avaliação da política de visitação flexível foi realizada por meio de um instrumento de visitação aberto composto de 22 perguntas divididas em três domínios (avaliação do estresse familiar, fornecimento de informações e interferência no trabalho da equipe). Resultados: Foram analisados 95 familiares acompanhantes e 95 membros da equipe de assistência. As percepções dos familiares quanto à diminuição da ansiedade e do estresse com visitas flexíveis foram superiores às percepções da equipe (91,6% versus 58,9%; p < 0,001). A família também teve uma percepção mais positiva quanto ao fornecimento de informações (86,3% versus 64,2%; p < 0,001). A equipe de assistência acreditava que a presença do parente dificultava a assistência ao paciente e causava interrupções de trabalho (46,3% versus 6,3%; p < 0,001). Conclusão: Os familiares e as equipes da unidade de terapia intensiva têm percepções diferentes sobre visitas flexíveis na unidade de terapia intensiva. Entretanto, predomina uma visão positiva entre os membros da família em relação à percepção da diminuição da ansiedade e do estresse e maiores informações e contribuições para a recuperação do paciente.

ABSTRACT Objective: To compare the perceptions of patients' relatives with the perceptions of health professionals regarding a flexible visitation model in intensive care units. Methods: Cross-sectional study. This study was carried out with patients' relatives and members of the care team of a clinical-surgical intensive care unit with a flexible visitation model (12 hours/day) from September to December 2018. The evaluation of the flexible visitation policy was carried out through an open visitation instrument composed of 22 questions divided into three domains (evaluation of family stress, provision of information, and interference in the work of the team). Results: Ninety-five accompanying relatives and 95 members of the care team were analyzed. The perceptions of relatives regarding the decrease in anxiety and stress with flexible visitation was higher than the perceptions of the team (91.6% versus 58.9%, p < 0.001), and the family also had a more positive perception regarding the provision of information (86.3% versus 64.2%, p < 0.001). The care team believed that the presence of the relative made it difficult to provide care to the patient and caused work interruptions (46.3% versus 6.3%, p < 0.001). Conclusion: Family members and staff-intensive care unit teams have different perceptions about flexible visits in the intensive care unit. However, a positive view regarding the perception of decreased anxiety and stress among the family members and greater information and contributions to patient recovery predominates.

Emergency Department Visits and Deaths from Cardiovascular Diseases at a Referral Center for Cardiology During the COVID-19 Pandemic

Abstract Background The COVID-19 pandemic has imposed measures of social distancing and, during this time, there has been an elevation in cardiovascular mortality rates and a decrease in the number of emergency visits. Objectives To assess and compare in-hospital mortality for cardiovascular diseases and emergency department visits during the COVID-19 pandemic and the same period in 2019. Methods Retrospective, single-center study that evaluated emergency visits and in-hospital deaths between March 16, 2020 and June 16, 2020, when the steepest fall in the number of emergency admissions for COVID-19 was registered. These data were compared with the emergency visits and in-hospital deaths between March 16 and June 16, 2019. We analyzed the total number of deaths, and cardiovascular deaths. The level of significance was set at p < 0.05. Results There was a 35% decrease in the number of emergency visits and an increase in the ratio of the number of deaths to the number of emergency visits in 2020. The increase in the ratio of the number of all-cause deaths to the number of emergency visits was 45.6% and the increase in the ratio of the number of cardiovascular deaths to the number of emergency visits was 62.1%. None of the patients who died in the study period in 2020 tested positive for COVID-19. Conclusion In-hospital mortality for cardiovascular diseases increased proportionally to the number of emergency visits during the COVID-19-imposed social distancing compared with the same period in 2019. (Int J Cardiovasc Sci. 2020; [online].ahead print, PP.0-0)

Visita à criança hospitalizada em terapia intensiva: vivências de irmãos reveladas por meio do brinquedo terapêutico dramático / Visita al niño hospitalizado en terapia intensiva: vivencias de hermanos revelado por el juego terapéutico dramático / Visiting a hospitalized child in intensive care: experiences of siblings revealed through the dramatic therapeutic play

Resumo Objetivo: compreender, por meio do brinquedo terapêutico dramático, o significado, para o irmão, de visitar a criança hospitalizada em terapia intensiva. Método: pesquisa qualitativa, modalidade fenomenológica, que utilizou o brinquedo terapêutico dramático para acessar às experiências dos irmãos. Foi realizada em Unidade de Terapia Intensiva Pediátrica do interior do estado de São Paulo, Brasil. Participaram das sessões de brinquedo terapêutico 11 irmãos menores de 10 anos, as quais foram analisadas à luz da Teoria do Amadurecimento. Resultados: os irmãos, tendo um lugar para brincar, dramatizaram situações, anteriormente, vividas, de seu cotidiano e da visita à criança hospitalizada. Ao viver, criativamente, revelaram que brincar é fazer a integração das experiências do "eu", favorecendo o continuar a ser diante da situação vivida. Conclusões e implicações para a prática: o Brinquedo Terapêutico Dramático compreendido à luz de um referencial teórico possibilitou que o irmão significasse a visita como uma experiência de integração do "eu", revelando emoções, desejos e preferências do cotidiano. Nesse sentido, o cuidado ao irmão da criança hospitalizada define-se pela oferta do brincar livre, para que ele demonstre o sentimento de continuar a ser em suas interações com o mundo, no qual o contexto hospitalar tornou parte da realidade.

Resumen Objeto: Comprender por medio del juego terapéutico dramático el significado, para el hermano, de la visita al niño hospitalizado en Terapia Intensiva Pediátrica. Método: Investigación cualitativa, modalidad fenomenológica, que utilizó el juego terapéutico dramático para comprender la experiencia del hermano. Se realizó en Unidad de Terapia Intensiva Pediátrica del interior del Estado de São Paulo, Brasil. Participaron de las sesiones de juego terapéutico 11 hermanos con menos de 10 años, quienes fueron analizados a la luz de la Teoría de la Maduración. Resultados: Los hermanos, al tener un lugar para jugar, dramatizaron situaciones anteriormente vividas, de su cotidiano y de la visita al niño hospitalizado. Al vivir de forma creativa, revelaron que jugar es permitir la integración de las experiencias del "yo", lo que favorece el concepto de seguir siendo, ante la situación vivida. Conclusiones e implicaciones para la práctica: El Juego Terapéutico Dramático comprendido a la luz de un referencial teórico hizo posible que el hermano entendiera la visita como una experiencia de integración del "yo", revelando emociones, deseos y preferencias cotidianas. En este sentido, el cuidado del hermano del niño hospitalizado se define por la oferta de juego libre, para que pueda demostrar su sentimiento de seguir siendo en sus interacciones con el mundo, en el que el contexto hospitalario se ha convertido en parte de la realidad.

Abstract Objective: to understand, by means of dramatic therapeutic play, the meaning, for the sibling, of visiting the child hospitalized in intensive care. Method: a qualitative research, phenomenological modality, which used the dramatic therapeutic play to access the siblings' experiences. It was carried out in a Pediatric Intensive Care Unit in the countryside of the State of São Paulo, Brazil. Eleven siblings under ten years of age participated in the therapeutic play sessions, which were analyzed in the light of the Theory of Maturation. Results: the siblings, having a place to play, dramatized previously lived situations, from their daily life and from the visit to the hospitalized child. By living creatively, they revealed that playing is to integrate the experiences of the "I", favoring the continuity of being in the face of the situation lived. Conclusions and implications for practice: the Dramatic Therapeutic Play understood in the light of a theoretical framework allowed the sibling to mean the visit as an experience of integration of the "I", revealing emotions, desires and preferences of daily life. In this sense, the care for the brother of the hospitalized child is defined by the offer of free play, so that he demonstrates the feeling of continuing to be in his interactions with the world, in which the hospital context has become part of reality.

Floral and reproductive biology and pollinators of Campomanesia guazumifolia (Cambess.) O. Berg., neglected species

Studies on the Myrtaceae family are mainly distributed in floristic surveys, reproductive studies of plant communities or related to family taxonomy. Based on this, the objective of the present study was to elucidate aspects of floral and reproductive biology and, of floral visitors from Campomanesia guazumifolia (Cambess.) O. Berg., a neglected species. Information was obtained on floral morphology and morphometry, anthesis, nectary, and structures attractive to pollinators, characterization of pollinators, receptiveness of stigma and maturing of the androecium components, and characterization of the reproductive system. Sete-capote tree has hermaphrodite flowers, and the floral opening occurs mainly during the daytime. Pollen grains was the main resource offered to pollinators. The flowers had mellow sweet odor, attracting mainly native bees and Apis melifera, which was characterized as effective pollinators. The species presents high reproductive efficiency and could be considered self-compatible; however, fertilization also occurs by cross-pollination.

Floral and reproductive biology and pollinators of Campomanesia guazumifolia (Cambess.) O. Berg., neglected species / Floral and reproductive biology and pollinators of Campomanesia guazumifolia (Cambess.) O. Berg., neglected species

The aim of the study was to elucidate aspects of floral and reproductive biology and floral visitors of this species. Information was obtained on floral morphology and morphometry, anthesis, nectary, and structures attractive to pollinators, characterization of pollinators, receptiveness of stigma and maturing of the androecium components, and characterization of the reproductive system. Sete-capoteiro tree has hermaphrodite flowers, and the floral opening occurs mainly during the night period, however, it also occurs in the morning. Pollen grains was the main resource offered to pollinators. The flowers had mellow sweet odor, attracting mainly native bees and Apis melifera, which was characterized as effective pollinators. The species presents high reproductive efficiency and could be considered self-compatible; however, fertilization also occurs by cross-pollination.

Studies on the Myrtaceae family are mainly distributed in floristic surveys, reproductive studies of plant communities or related to family taxonomy. Based on this, the objective of the present study was to elucidate aspects of floral and reproductive biology and, of floral visitors from Campomanesia guazumifolia (Cambess.) O. Berg., a neglected species. Information was obtained on floral morphology and morphometry, anthesis, nectary, and structures attractive to pollinators, characterization of pollinators, receptiveness of stigma and maturing of the androecium components, and characterization of the reproductive system. Sete-capote tree has hermaphrodite flowers, and the floral opening occurs mainly during the daytime. Pollen grains was the main resource offered to pollinators. The flowers had mellow sweet odor, attracting mainly native bees and Apis melifera, which was characterized as effective pollinators. The species presents high reproductive efficiency and could be considered self-compatible; however, fertilization also occurs by cross-pollination.

Floral, reproductive and pollinators biology of Myrcianthes pungens (Berg) Legrand, neglected species

Studies related to floral biology are essential for the understanding of the ecological relations between different species, and the beginning of breeding programs. In this way, the aim of the study was to elucidate aspects of floral and reproductive biology and floral visitors of this species. Information about floral morphology and morphometry, anthesis, nectaries and pollinator attractive structures, characterization of floral visitors, receptivity of androcytic stigma and maturation, in vitro pollen storage and germination, and characterization of the reproductive system were obtained. The guabiju tree has hermaphrodite flowers, and the floral opening occurs mainly during the night, but also in the morning. Anthers are the main attractive structure to the pollinating insects, releasing fetid odor, attracting mainly flies and wasps characterized as occasional pollinators, and moths characterized as effective pollinators. For the germination of pollen, it is recommend using it without desiccation, collected in post-anthesis, and for the culture medium the use of 11% of sucrose and 7% of boric acid. Pollen presents recalcitrant behavior, so even when stored in refrigerator, freezer, liquid nitrogen and natural environment lose viability in less than 30 days. It presents high reproductive efficiency, and can be considered self-compatible; however, fertilization also occurs by cross-pollination.

Rural tourism marketing: Lavender tourism in Turkey / Marketing do turismo rural: Turismo lavanda na Turquia

ABSTRACT: This study aimed to comprehend rural tourism marketing through the visitors' eyes and discuss its sustainability. What makes rural tourism marketing more sophisticated and complex is that it is a service marketing, associated with agricultural activities, natural conditions and rural areas, and the main providers have no experience in rural tourism or service marketing. The study investigated perception of visitors in a small village, Kuyucak, in the Southwest part of Turkey, where rural tourism based on lavender production has recently developed. Results of the analysis of 175 questionnaires completed by visitors online showed that more than half of the respondents had heard and got information about the village via social media. Although, the main purpose of their visit was stated as nature/rural experience and recreation/holiday, the primary motivation of the majority was taking and sharing photos via social media tools. Appearance of lavender and previous social media sharing are very important determinants in the decision-making and expectations of visitors. Results of the factor analysis showed that two components composed of the variables regarding pre-visit perception and the physical conditions of the village together explain sixty-five per cent of the overall satisfaction. The most important component in decision making of visitors was found their perception before visiting, which means that what they expected to see was more important than what they actually saw, which was represented by visitors' satisfaction. Making visitors experience their pre-visit perception will contribute to the sustainability of rural tourism activities benefiting the area.

RESUMO: Este estudo teve como objetivo compreender o marketing do turismo rural através dos olhos dos visitantes e discutir sua sustentabilidade. O que torna o marketing do turismo rural mais sofisticado e complexo é que ele é um marketing de serviços, associado a atividades agrícolas, condições naturais e áreas rurais, e os principais provedores não têm experiência em turismo rural ou marketing de serviços. O estudo investigado a percepção de visitantes em uma pequena aldeia, Kuyucak, no sudoeste da Turquia, onde o turismo rural baseado na produção de lavanda se desenvolveu recentemente. Os resultados da análise de 175 questionários preenchidos pelos visitantes online mostraram que mais da metade dos entrevistados ouviram e receberam informações sobre o vilarejo pelas mídias sociais, e embora o objetivo principal de sua visita tenha sido declarado como natureza experiência rural e recreação feriado, a principal motivação da maioria foi tirar e compartilhar fotos através de ferramentas de mídia social. O surgimento da lavanda e o compartilhamento prévio de mídias sociais são determinantes muito importantes na tomada de decisões e expectativas dos visitantes. Os resultados da análise fatorial mostram que dois componentes compostos pelas variáveis relativas à percepção pré-visita e às condições físicas da aldeia, juntos, explicam 65% da satisfação geral. O que foi considerado interessante foi o componente sobre a percepção deles antes de visitar, o que significa que o que eles esperavam ver era mais importante do que o que eles realmente viram e encontraram o que foi representado pelo componente em evidências físicas sobre a satisfação dos visitantes. Fazer com que os visitantes experimentem sua percepção pré-visita contribuirá para a sustentabilidade das atividades de turismo rural e seus benefícios na área.

Hand Hygiene Compliance among Visitors at a Long-term Care Hospital in Korea: A Covert Observation Study

PURPOSE: This study aimed to assess hand hygiene (HH) compliance among visitors at a long-term care hospital in South Korea. METHODS: The study was conducted at a 502-bed long-term care hospital located in Gyeonggi-do Province. From July 1 to August 15, 2017, including more than 6 weekends and one holiday, a trained observer covertly assessed visitors' HH at all five units (360 beds in total) of the study hospital building until the completion of 1,000 HH opportunities (i.e., 200 opportunities per unit). The modified World Health Organization (WHO) HH observation form was used. Instead of professional categories and the “before clean/aseptic procedure” moment, the estimated age range for each visitor were recorded in four categories: children (<14 years old), adolescents (14~18), adults (19~64), and the elderly (≥65). The collected data were analyzed using SPSS 22.0. RESULTS: A total of 1,000 HH opportunities were observed from 766 visitors (an average of 1.31 per visitor) and the overall HH compliance rate was 20.3%. Overall, 53.7% of the HH cases were performed with soap and water. Among the 4 HH moments, the “after body fluid exposure risk” moment showed the highest compliance rate (83.5%); 93.9% used soap and water. The most commonly exposed potential body fluid among visitors was saliva (48.1%). CONCLUSION: For hospital visitors in long-term care hospitals, HH education programs including HH moments need to be developed and implemented. Further studies are necessary to evaluate visitors' HH compliance in various hospital settings and find the related variables influencing visitors' HH.

Correlations between a Flexible Parental Visiting Environment and Parental Stress in Neonatal Intensive Care Units

PURPOSE: The purpose of this study was to examine the correlation between a flexible parental visiting environment and parental stress in neonatal intensive care units (NICUs).METHODS: The study participants included 60 parents of premature infants in NICUs. Structured questionnaires and interviews, as well as observations by researchers using a caregiving behavior checklist, were used to measure the flexibility of the parental visiting environment and parents' stress levels. Quantitative and qualitative data were collected concurrently and were initially analyzed as separate data sets. Data collection extended from March 11, 2018 to June 30. 2018 and the data were analyzed using descriptive statistics, the independent t-test, one-way analysis of variance, and Pearson correlation coefficients.RESULTS: There was a negative correlation (r=−.30, p=.021) between parental stress and the total number of visits in 7 days. We also found that the average duration of each visit and the number of caregiving behaviors performed by parents were positively correlated (r=.73, p<.001).CONCLUSION: When designing a flexible visiting environment for parents, parents should be encouraged to visit their babies. By doing so, stress can be reduced both for babies and for parents. Therefore, it is suggested that the related polices and regulations in South Korea should be changed to provide more a flexible visiting environment to promote better parent-child attachment and family adjustment.

Capital simbólico do trabalho das visitadoras sanitárias da Fundação Serviço de Saúde Pública, Alagoas/Brasil / Symbolic capital of the work of the female health visitors of the Public Health Service Foundation in the State of Alagoas, Brazil

Resumo De caráter histórico, o estudo analisa o trabalho das visitadoras sanitárias da Fundação Serviço de Saúde Pública, em Alagoas, entre 1960 e 1990 e o capital simbólico a elas conferido. Foram utilizadas fontes documentais e orais, estas produzidas em entrevistas realizadas com recurso da história oral temática, concedidas por visitadoras, médico e enfermeira. As informações foram analisadas com base nos conceitos de habitus, campo, capital simbólico e distinção, de Pierre Bourdieu, e revelaram que as visitadoras sanitárias foram relevantes na assistência à saúde das comunidades onde atuaram, detendo marcas distintivas para inculcar práticas sanitárias por meio de visitas domiciliares e discurso autorizado para reconfigurar o habitus higiênico das famílias. Essa atuação lhes conferiu poder e capital simbólicos legitimados pela comunidade.

Abstract This study of a historical nature analyzes the work of health visitors of the Public Health Service Foundation in Alagoas between 1960 and 1990 and the symbolic capital attributed to them. Documental and oral sources were used, the latter produced in interviews conducted using thematic oral history, given by the visitors, the physician and nurse. The information was analyzed based on the concepts of habitus, field, symbolic capital and distinction of Pierre Bourdieu, and revealed that health visitors were relevant in the healthcare of the communities where they worked with distinctive approaches to inculcate health practices through home visits and authority to reconfigure the hygienic habitus of families. This activity gave them symbolic power and capital legitimized by the community.

Experience of Patients and Families about Flexible Visiting / 중환자간호학회지

PURPOSE: This study aimed to understand the essence of experiences of patients and family members during flexible visiting in an intensive care unit (ICU).METHODS: This is a qualitative study using interviews with open ended questions. We used Colaizzi's method of phenomenological interpretation.RESULTS: Flexible visiting in the ICU impacted the patients and their families in various ways. The following categories were extracted from the patients' experiences with flexible visiting: 1) the opportunity to feel the presence of the family and 2) the burden of unrestricted visiting. The following categories were extracted from the families' experiences with flexible visiting: 1) psychological comfort by convenience 2) being aware of health care professionals and critical care nursing in the intensive care unit, and 3) double trouble.CONCLUSIONS: These results showed that flexible visiting in the ICU affected the patients and their families positively and negatively. Therefore, nursing staff need to design psychological and social interventions that address the needs of patients and their families.

CAPACIDAD DE CARGA ASIGNABLE AL AGROECOTURISMO EN ÁREAS PROTEGIDAS DE BOLIVIA / ALLOCABLE CAPACITY TO AGROECOTOURISM IN BOLIVIAN PROTECTED AREAS

Este documento tiene como objetivo valorar la capacidad de carga asignable al agroturismo en áreas protegidas de Bolivia en el marco de la economía ecológica. En esta nación, el agroturismo puede constituirse en una práctica novedosa para hacer que los visitantes de áreas protegidas sean partícipes de las actividades de desarrollo económico local. Además, permite determinar la cantidad de personas que pueden visitar un sitio protegido sin alterar el equilibrio de los ecosistemas que alberga. Metodológicamente se empleó un enfoque mixto (cuantitativo y cualitativo) apoyado con la medición tradicional de carga turística física, real y efectiva. En el caso de los agroecosistemas de las áreas protegidas de Bolivia se puede observar que existe capacidad de carga suficiente para su operación que actualmente que alcanza el 96 %. También, es posible mejorarla e incrementarla en función de las características ecológicas, físicas y sociales de estos sitios. Por otra parte es importante resaltar la importancia de los ingresos económicos obtenidos diarios de un área protegida individual que corresponde a 404 Bs. en promedio. Finalmente, el empleo de la economía ecológica permite establecer el valor y aprovechamiento de los recursos existentes en las áreas protegidas de interés nacional de Bolivia. De esta manera, es posible mejorar la gestión de sitios protegidas a nivel ambiental y financiero.

This document has the objective to value the allocable capacity assigned to agrotourism in Bolivian protected areas within the framework of ecological economy, Agroecotourism in this nation can become an innovating alternative to enhance the participation of protected areas visitors in local economic activities development. Furthermore, it allows quantifying the amount of people who can visit a protected site without disturbing the ecosystems equilibrium in the area. Methodologically, a mixed approach (quantitative and qualitative) was applied based on the traditional measuring of physical, real and effective tourism allocable capacity. In the case of the Bolivian agroecosystems protected areas it is possible to observe that there is enough allocable capacity for its operation, which is currently reaching 96%. In addition, it is possible to improve it and increase it according to the ecological, physical and social characteristics of these sites. On the other hand, it is possible to highlight the importance of the economical revenues obtained daily in an individual protected area that corresponds to an average of 404 Bs. Finally, the application of ecological economy allows establishing the value and use of existing resources in the protected areas of national interest in Bolivia. In this way, it is possible to improve protected sites management in financial and environmental terms.

Polinização e sistema reprodutivo de Acanthaceae Juss. no Brasil: uma revisão / Pollination and reproductive system of Acanthaceae Juss. in Brazil: a review

Estudos que envolvem aspectos da polinização e sistema reprodutivo em Angiospermas são fundamentais para a compreensão de diversos processos ecológicos e evolutivos. Desta forma, foi realizada uma revisão bibliográfica com o objetivo de compilar informações sobre a polinização e o sistema reprodutivo encontrados na família Acanthaceae Juss. no Brasil. Um total de 30 estudos, com 31 espécies, fizeram parte da presente revisão. Quanto a distribuição geográfica e domínio fitogeográfico, a região Sudeste (50%) e o bioma Mata Atlântica (56,7%) apresentaram a maior proporção de estudos. Quatro síndromes de polinização foram registradas, sendo elas: troquilofilia, melitofilia, psicofilia e quiropterofilia, sendo a troquilofilia predominante (79,31% das espécies). Consequentemente, beija-flores foi o grupo mais comum de visitantes florais, interagindo com 86,2% das espécies, sendo Phaethornis pretrei o principal beija-flor visitante. Outros grupos de visitantes também foram registrados, como abelhas (segundo principal grupo), borboletas, morcegos, mariposas, vespas, moscas e besouros. Das 17 espécies estudadas no Brasil quanto ao sistema reprodutivo, todas apresentaram flores andróginas, sendo 16 espécies (94,1%) autocompatíveis. Fatores intrínsecos como a hercogamia e a dicogamia foram comuns em espécies de Acanthaceae, constituindo mecanismos que minimizam a interferência entre as funções masculina e feminina em flores andróginas e maximizam a polinização cruzada. Aproximadamente, 41,2% das espécies exibiram autopolinização espontânea, isto é, produção de frutos sem a necessidade de agentes polinizadores. Estratégias reprodutivas como a cleistogamia e a agamospermia também foram registradas nas espécies de Acanthaceae no Brasil. Contudo, mais estudos a respeito da polinização e sistema reprodutivo com acantáceas brasileiras precisam ser desenvolvidos, para ampliar a amostragem e, então subsidiar mais as estimativas desta revisão.

Studies involving aspects of pollination and breeding system in Angiosperms are fundamental in understanding many ecological and evolutionary processes. Thus, a literature review was conducted to aim of compiling information on the pollination and reproductive system in species of Acanthaceae Juss. in Brazil. A total of 30 studies, count 31 species, were part of this review. Regarding geographical distribution of studies, the Southeast Brazil (50%) and Atlantic Forest biome (56.7%) had the higher proportion of studies. Four pollination syndromes were recorded: trochilophily, melittophily, psycophily, and chiropterophily, in which trochilophily was predominant (79.31% of species). Consequently, hummingbirds were the most common flower visitors, interacting with 86.2% of the species, and Phaethornis pretrei was the main hummingbird visitor. Other groups of visitors were also recorded, such as bees (second main group, 34.5%), butterflies, bats, moths, wasps, flies and beetles. From the 17 species studied in Brazil about the reproductive system, all have androgynous flowers and 16 species (94.1%) selfcompatibility. Intrinsic factors such as herkogamy and dichogamy were common in species of Acanthaceae, constituting mechanisms that minimize interference between male and female functions in androgynous flowers and maximize cross-pollination. Approximately 41.2% of species presented spontaneous self-pollination, i.e. production of fruits without the need of pollinators. Reproductive strategies such as cleistogamy and agamospermy were also recorded in species of Acanthaceae in Brazil. However, more studies on the pollination and reproductive system with species of Acanthaceae in Brazil need to be developed to expand the sampling and then support better the estimates of this review.

Anxiety and depression symptoms in family members of ICU patients

Objective: This study investigated symptoms of anxiety and depression in relatives of patients admitted in the Intensive Care Unit and determined whether these symptoms were associated to the seriousness of the patients' condition. Metodology: A total of 102 patients' relatives were surveyed during the study. They were given a self-report questionnaire in order to assess demographic data, anxiety and depression symptoms. The symptoms of anxiety and depression were evaluated with the Hospital Anxiety and Depression Scale (HADS). Patient's condition was evaluated with A.P.A.CH.E II Score. Results: More than 60% of patients' relatives presented severe symptoms of anxiety and depression. No relation was found between symptoms of anxiety and depression of the relatives of patients and patients' condition of health. On the contrary, these feelings used to exist regardless of the seriousness of patient's condition. Conclusions: The assessment of these patients is recommended in order serious problems of anxiety and depression to be prevented.

Objetivo: El presente estudio se propuso investigar los síntomas de ansiedad y depresión en familiares de pacientes que fueron admitidos en la Unidad de Cuidados Intensivos y se determinó si estos síntomas se asociaron con la gravedad de la condición del paciente. Metodología: Durante este estudio se encuestó un total de 102 familiares de pacientes, a quienes se les solicitó diligenciar un cuestionario auto-administrado para estimar aspectos sociodemográficos y síntomas de ansiedad y depresión. Los síntomas de ansiedad y depresión fueron evaluados con la Hospital Anxiety and Depression Scale (HADS). La condición del paciente fue evaluada con el A.P.A.CH.E II Score. Resultados: Más del 60% de los familiares encuestados presentaron síntomas severos de ansiedad y depresión. No se encontró relación entre los síntomas de ansiedad y depresión de los familiares de los pacientes y el estado de salud de éstos. Por el contrario, aquellas sensaciones solían darse con independencia de la gravedad de la condición del paciente. Conclusiones: Se recomienda la evaluación de estos pacientes para evitar problemas serios de ansiedad y depresión.

Objetivo: O presente estudo pesquisou os sintomas de ansiedade e depressão em familiares de pacientes que foram admitidos na Unidade de Terapia Intensiva e se determinou se esses sintomas se associaram com a gravidade da condição do paciente. Metodologia: Durante este estudo se inquiriu um total de 102 familiares de pacientes, a quem se solicitou diligenciar um questionário auto-administrado, para estimar aspectos sociodemográficos e sintomas de ansiedade e depressão. Os dados sobre sintomas de ansiedade e depressão foram processados usando a Hospital Anxiety and Depression Scale (HADS). A condição do paciente foi avaliada com o A.P.A.CH.E II Score. Resultados: Mais de 60% dos familiares questionados apresentaram sintomas severos de ansiedade e depressão. Não se encontrou relação entre os sintomas de ansiedade e depressão dos familiares dos pacientes e o estado de saúde deles. Pelo contrário, essas sensações com frequência se apresentavam com independência da gravidade da condição do paciente. Conclusões: Recomenda-se a avaliação destes pacientes para evitar problemas sérios de ansiedade e depressão.

Biologia reprodutiva e ausência de frutificação de Aloe saponaria (Aiton) Haw. (Xanthorrhoeaceae) fora do local de origem / Reproductive biology and absence of fruiting of Aloe saponaria (Aiton) Haw. (Xanthorrhoeaceae) outside its place of origin

RESUMO O gênero Aloe, originário principalmente da África, tem atualmente uma ampla distribuição no mundo. No entanto, são poucas as regiões que têm realizado estudos quanto ao sistema reprodutivo. O objetivo do presente trabalho foi analisar as características e o comportamento reprodutivo de Aloe saponaria em Florianópolis, Santa Catarina. Foram conduzidos estudos sobre sua morfologia e biologia floral, visitantes florais e sistema reprodutivo. Esta espécie apresentou uma inflorescência por planta, com um comprimento de 105 ± 0,1 cm e 267 ± 92,7 flores. A razão pólen/óvulo sugere que a espécie é xenogâmica. O volume e concentração de sólidos solúveis totais do néctar potencial foi 16,6 ± 6,3 μL e 22 ± 2,4 °Brix respectivamente. O néctar instantâneo não apresentou diferenças significativas nos períodos avaliados (9:00h e 15:00h) e o estigma permaneceu receptivo até o segundo dia após a antese. Foram coletados 110 insetos visitantes florais, dos quais 61,8% foram indivíduos de Trigona spinipes. Entretanto, nos testes de polinização não foi observada frutificação efetiva, indicando que a propagação vegetativa é o principal tipo de reprodução usado nessa população. Isto pode estar relacionado a um mecanismo de autoincompatibilidade esporofítica, a anormalidades cromossômicas durante a formação do pólen, as condições climáticas, e a escassa variabilidade genética no local de estudo.

ABSTRACT The Aloe genus, originating mainly from Africa, currently has a wide distribution in the world. However, in few regions studies about the reproductive system have been carried on. The aim e of this study was to analyze the characteristics and reproductive performance of the Aloesaponaria in Florianópolis, Santa Catarina. The morphology, floral biology, flower visitors and the reproductive system were determined. The plants presented an inflorescence per plant, with 105 ± 0,1 cm in length and 267 ± 92.7 flowers. The pollen/ovule ratio suggested that the species is xenogamic. The volume and concentration of total soluble solids in the potential nectar were 16.6 ± 6.3 μL and 22 ± 2.4°Brix, respectively. The instant nectar showed no significant differences between the evaluated periods (9:00h and 15:00h) and the stigma remained receptive until the second day the after anthesis. 110 insects were collected, from which 61.8% were from theTrigona spinipesspecies. However, in the pollination tests the fruit set was not observation, indicating that vegetative propagation is the main type of reproduction used by this population. This may be related to a mechanism of sporophytic self-incompatibility, to chromosomal abnormalities during the formation of pollen, to weather conditions, and to the low genetic variability at the study site.

Políticas de visitação em unidades de terapia intensiva no Brasil: um levantamento multicêntrico / Intensive care unit visitation policies in Brazil: a multicenter survey

Objetivo: Este estudo teve como objetivo determinar a política de visitação predominante nas unidades de terapia intensiva e quais comodidades proporcionadas aos visitantes. Métodos: Foram enviados 800 convites a endereços de e-mail de médicos e enfermeiros intensivistas listados nos grupos de pesquisa da Rede da Associação de Medicina Intensiva Brasileira e da Rede Brasileira de Pesquisa em Terapia Intensiva. A mensagem por e-mail continha um link para um questionário de 33 itens a respeito do perfil de suas respectivas unidades de terapia intensiva. Resultados: Foram incluídos no estudo os questionários de 162 unidades de terapia intensiva localizadas em todas as regiões do país, mas foram predominantes as das Regiões Sudeste (58%) e Sul (16%). Apenas 2,6% das unidades de terapia intensiva relataram ter políticas liberais de visitação, enquanto 45,1% das unidades de terapia intensiva possibilitavam dois períodos diários de visitação e 69,1% permitiam de 31 a 60 minutos de visita por período. Em situações especiais, como casos de fim de vida, 98,7% delas permitiam visitas em horários flexíveis. Cerca de metade das unidades de terapia intensiva (50,8%) não oferecia qualquer comodidade aos visitantes. Apenas 46,9% das unidades de terapia intensiva tinham uma sala de reunião com familiares, e 37% não dispunham de uma sala de espera. ...

Objective: This study aimed to determine which visitation policy was the most predominant in Brazilian intensive care units and what amenities were provided to visitors. Methods: Eight hundred invitations were sent to the e-mail addresses of intensivist physicians and nurses who were listed in the research groups of the Brazilian Association of Intensive Care Network and the Brazilian Research in Intensive Care Network. The e-mail contained a link to a 33-item questionnaire about the profile of their intensive care unit. Results: One hundred sixty-two questionnaires from intensive care units located in all regions of the country, but predominantly in the Southeast and South (58% and 16%), were included in the study. Only 2.6% of the intensive care units reported having liberal visitation policies, while 45.1% of the intensive care units allowed 2 visitation periods and 69.1% allowed 31-60 minutes of visitation per period. In special situations, such as end-of-life cases, 98.7% of them allowed flexible visitation. About half of them (50.8%) did not offer any bedside amenities for visitors. Only 46.9% of the intensive care units had a family meeting room, and 37% did not have a waiting room. Conclusion: Restrictive visitation policies are predominant in Brazilian intensive care units, with most of them allowing just two periods of visitation per day. There is also a lack of amenities for visitors. .

Bees (Hymenoptera: Apoidea) and flowers in natural forest patches of southern Pantanal

This is the first systematic survey of bees in the Pantanal wetland, Brazil. We recorded bee species and their floral resources within grassland and natural forest edge habitats in the Pantanal. Surveys were conducted during two to four-days per month, for a total of 12 months. Overall, we recorded 56 bee species visiting a total of 63 flowering plants. Asteraceae and Fabaceae presented the highest number of visited species, however Hyptis suaveolens (Lamiaceae) was the plant most visited by different bee species (18). The most generalist native bee was Trigona fuscipennis visiting a total of 17 flowering plant species. Apis mellifera, an exotic bee, visited 27 species. We also report the overlap (37.5%) in the use of floral resources between the exotic bee Apis mellifera and native bee species. Our updated bee checklist here presented includes 10 new records for the State of Mato Grosso do Sul. These data will support management strategies targeting the conservation of plant-pollinator interactions in the Pantanal ecosystem.

Esta é a primeira amostragem sistemática de abelhas realizada no Pantanal, Brasil. Nós coletamos espécies de abelhas bem como as plantas que utilizaram como recurso floral em áreas de pastagens naturais e bordas de áreas florestadas. As coletas foram conduzidas durante dois a quatro dias a cada mês, durante 12 meses. Foram registradas 56 espécies de abelhas visitando um total de 63 espécies de plantas. As famílias Asteraceae e Fabaceae apresentaram o maior numero de espécies visitadas, entretanto Hyptis suaveolens (Lamiaceae) foi a espécie visitada pelo maior número de espécies diferentes de abelhas (18). A abelha nativa mais generalista encontrada foi Trigona fuscipennis, que visitou 17 espécies de plantas. Apis mellifera, uma espécie exótica, visitou 27 espécies. Reportamos também a sobreposição (37,5%) no uso de recursos florais entre A. mellifera e espécies de abelhas nativas. A listagem de abelhas aqui apresentada inclui 10 espécies ainda não mencionadas para o estado de Mato Grosso do Sul. Esses dados apoiarão estratégias de manejo focadas na conservação das interações entre plantas e polinizadores no ecossistema Pantanal.

O impacto da visita de enfermagem sobre as necessidades dos familiares de pacientes de UTI / The impact of the visit of nursing on the necessities of the host families of ICU / El impacto de la visita de cuidar en las necesidades de la familia unas de la unidad de cuidados intensivos

Estudo de abordagem quantitativa que teve como objetivo implantar a Visita de Enfermagem na UTI adulta e verificar e atender as principais necessidades de informação e acolhimento verbalizadas pelas famílias. Após autorização do CEP do HU-USP foi questionado aos familiares se gostariam de receber alguma informação por parte da Enfermagem. Todos os familiares quiseram receber informações do enfermeiro nas três visitas realizadas com cada família. Os temas de maior dúvida entre os familiares foram o Estado Clínico do paciente e a Alta da UTI. Verificamos que o número médio de dúvidas diminuiu da primeira para a terceira visita. A Visita de Enfermagem atendeu as principais necessidades dos familiares de informação e acolhimento, respondendo suas questões sobre o cuidado de Enfermagem prestado para o paciente. Também foi observado que as dúvidas e ansiedades dos familiares diminuíram no decorrer dos dias, enfatizando a necessidade desse contato de Enfermeiros e Familiares.

Study of a quantitative approach that aimed to implement the Visiting Nurse ICU adult and check and meet the main needs for information and verbalized by host families. After approval of the CEP of the HU-USP was asked if the family would like to receive some information on the part of nursing. All family members wanted to receive information from nurses in three visits with each family. The themes of doubt among the most familiar were the patient's clinical state and discharged from the ICU. We found that the average number of questions decreased from the first to third visit. The Visiting Nurse attended the main needs of the host family information and answering your questions about the nursing care provided to patients. It was also observed that the doubts and anxieties of family members decreased during the day, emphasizing the need that contact of Nurses and Families.

Estudio de un enfoque cuantitativo que tuvo como objetivo implementar la Visiting Nurse adulto UCI y comprobar y conocer las principales necesidades de información y verbalizado por las familias de acogida. Después de la aprobación de la PAC de la HU-USP se le preguntó si la familia desea recibir alguna información por parte de la enfermería. Todos los miembros de la familia quería recibir información de las enfermeras en tres visitas a cada familia. Los temas de la duda entre los más conocidos fueron el estado clínico del paciente y el alta de la UCI. Se encontró que el número medio de preguntas disminuyó desde la primera a la tercera visita. El Visiting Nurse asistieron las principales necesidades de la información de la familia de acogida y responder a sus preguntas sobre la asistencia de enfermería a los pacientes. También se observó que las dudas y las angustias de los miembros de la familia disminuyó durante el día, haciendo hincapié en la necesidad de que el contacto de Enfermeras y Familias.

EFECTOS DE LA VARIACIÓN ALTITUDINAL SOBRE LA POLINIZACIÓN EN CULTIVOS DE GULUPA (Passiflora edulis F. edulis) / Effects of Altitudinal Variation on Pollination in Purple Passion Fruit Crops (Passiflora edulis F. edulis)

El propósito de este trabajo es reconocer y diferenciar las especies visitantes y los verdaderos polinizadores de dos cultivos de gulupa (Passiflora edulis f. edulis Sims.) ubicados a diferente altitud (2225 msnm y 1657 msnm) en el municipio de Buenavista - Boyacá cordillera Oriental de Colombia. En los dos cultivos se encontraron diferencias en composición, en número de visitantes y en polinizadores. En el cultivo ubicado a 2225 msnm, se registraron siete especies, mientras que en el cultivo ubicado a 1657 msnm, se encontraron 18 especies de visitantes. Se realizaron observaciones del recurso colectado por los visitantes y la estructura floral con la que el visitante entra en contacto. Además, se realizaron cuatro tratamientos experimentales de biología floral: polinización pasiva, polinización natural, polinización manual y eficiencia de polinizadores mediante "visitas únicas", concluyendo que las especies polinizadoras son: en C1 Apis mellifera, y en C2 Xylocopa frontalis, Xylocopa lachnea y Epicharis sp.

The purpose of this paper is to study in two crops of purple passionfruit Passiflora edulis f. edulis harvested at different altitudes (2225 m.a.s.l. and 1657 m.a.s.l.) in the municipality of Buenavista - Boyacá, located in the eastern Mountain range of Colombia, in order to familiarize with visitors and pollinators. This study reveals that in both crops there were differences found in composition, the number of visitors and pollinators. In the crop at 2225 m.a.s.l., 7 species were registered, while 18 species were recorded at the 1657 m.a.s.l. crop. In order to achieve this, collected material by the visitors and the floral structures with which they approach, were observed; at the same time four experiments took place: passive pollination, natural pollination, manual pollination and pollinator's efficiency. These experiments established that pollinator species are: in C1 Apis mellifera, and in C2 and Xylocopa frontalis, Xylocopa lachnea and Epicharis sp.

Crab spiders (Araneae: Thomisidae) in flowering plants in a Brazilian "Cerrado" ecosystem / Aranhas Thomisidae em plantas floridas de um ecossistema de Cerrado

Although crab spiders are common in flowering plants, their relations with plant species and its floral traits have been poorly known in the Neotropics. Observations regarding plant habits, floral visitors and also floral characteristics such as anthesis, odour, shape, colour and floral resources were recorded in flowering plant species of an area of "Cerrado" on a 2 km long trail. Misumenops argenteus and Misumenops pallens accounted for 62.86 percent of the spiders captured on 22 flowering plant species. The plants Senna rugosa (Fabaceae), Styrax ferrugineus (Styracaceae) and Banisteriopsis campestris (Malpighiaceae), hosted, each one, about 10 to 17 percent of the total spiders collected and these plants had diurnal anthesis, bee-attractive flower colours such as yellow (S. rugosa), white (S. ferrugineus), and pink (B. campestris), poricidal anthers as well as being visited by bees which evidenced bee-pollination syndrome. This study is the first survey regarding crab spiders and their associations with plant species of the "Cerrado".

Ainda que aranhas Thomisidae sejam comumente encontradas em flores, as associações desses aracnídeos a espécies de plantas e às suas características florais foram pouco registradas na região neotropical. Observações do hábito das plantas, visitantes florais, e também das características florais, tais como antese, odor, forma, cor e recursos da flor, foram assinaladas para espécies floridas de uma área de cerrado presentes em uma trilha de 2 km de extensão. Misumenops argenteus e Misumenops pallens representaram 62,86 por cento das aranhas habitantes de 22 espécies de plantas floridas. As plantas Senna rugosa (Fabaceae), Styrax ferrugineus (Styracaceae) e Banisteriopsis campestris (Malpighiaceae) abrigaram, individualmente, cerca de 10 a 17 por cento do total das aranhas e, nestas plantas, a antese diurna; flores de coloração atrativa a abelhas, como amarela (S. rugosa), branca (S. ferrugineus) e rosa (B. campestris) e as anteras poricidas, bem como a visita das flores por abelhas reforçou a evidência de síndrome de polinização para melitofilia. Este é o primeiro levantamento de espécies de aranhas Thomisidae associadas a plantas do cerrado brasileiro.