Fluctuation and diversity of Hydromedusae (Hydrozoa, Cnidaria) in a highly productive region of the Gulf of Mexico inferred from high frequency plankton sampling.

Hydrozoa medusae undergo blooms and seasonal fluctuations; however the drivers of such fluctuations are unknown. To understand how medusa populations fluctuate in response to seasonal factors such as temperature, salinity, dissolved oxygen, and chlorophyll a, and to enhance our taxonomic knowledge of Hydrozoa in Galveston Bay (TX), we performed frequent plankton sampling from September 2015 to September 2016. We collected 1,321 medusae in 190 sampling days. Using molecular barcoding and morphological analyses we identified 25 species, of which 21 are a first record for Galveston Bay and eight for the Gulf of Mexico. Daily medusa abundance is non-linearly related to temperature, with peak abundance estimated with multivariate regression analysis at approximately 21C. The role that temperature plays in driving medusa abundance has implications for future climate change scenarios, given that temperature in the Gulf of Mexico is expected to rise 4 °C by the end of the century. We also show that the biodiversity of the Galveston Bay and the Gulf of Mexico is underestimated and that molecular barcoding is an important and efficient tool to identify large number of medusae. We conclude that dense plankton sampling is necessary to capture both diversity and abundance of planktonic medusae.

Ética en enfermería: incertidumbre en la efectividad de un tratamiento en un lactante con síndrome de intestino corto / Ethics in nursing: uncertainty in the effectiveness of treatment in an infant with short bowel syndrome

Enfermería como profesión y disciplina debe utilizar el patrón de conocimiento ético para solucionar los problemas a los que se ve enfrentada(o) la (el) enfermera(o) durante el desempeño de sus funciones. En el presente artículo se plantea como objetivo realizar un análisis ético clínico, utilizando para esto el procedimiento de toma de decisiones de Galveston, el cual considera: las indicaciones médicas, las preferencias del paciente, la calidad de vida y los factores no clínicos o contextuales. El análisis corresponde al caso de un lactante de siete meses hospitalizado desde su nacimiento. El menor actualmente se encuentra con diagnósticos principales de síndrome de intestino corto y daño hepático crónico secundario al uso de nutrición parenteral. En este contexto, el equipo de salud se cuestiona sobre continuar con un tratamiento (hormona del crecimiento) que no está alcanzando el restablecimiento de la salud del menor. A partir de la situación del lactante se plantea la siguiente pregunta: ¿es éticamente correcto continuar con un tratamiento que no beneficia al paciente ni mejora su calidad de vida? Se concluye que esta metodología de análisis es una excelente herramienta que puede ser utilizada por la (el) enfermera(o) y los demás miembros del equipo de salud, ya que considera y analiza desde diversas aristas el caso clínico, permitiendo tomar una decisión bien informada, con una visión amplia del problema y su contexto.

Nursing as profession and discipline, must use the pattern of ethical knowledge to solve problems that confront the nurse in the performance of their duties. This paper has like objective to make a clinical ethical analysis, using for this the decision-making procedure of Galveston, which considers: medical indications, patient preferences, quality of life and contextual features. The analysis is about a 7-month infant case hospitalized since birth. The child is now with principal diagnoses of short bowel syndrome and chronic liver damage secondary to parenteral nutrition. In this context, the health team questioned about continuing a treatment (growth hormone) that is not achieving restoring the health of the child. Given the current status of the infant, the health team raises the following question: Is it ethically corrects to continue with a treatment that not benefits the patient and not improves their quality of life? It is concluded that this method of analysis is an excellent tool that can be used by nurses and other health team members because it considers and analyzes from different edges the clinical case, allowing taking an informed decision, with a broad vision´s problem and its context.

Galveston Orientation and Amnesia Test: validação, aplicabilidade e relação com a Escala de Coma de Glasgow / Galveston Orientation and Amnesia Test: validation, aplicability and the relationship with the Glasgow Coma Scale

A amnésia pós-traumática é um distúrbio freqüente em vítimas com trauma crânio encefálico (TCE) sendo sua duração considerada um forte indicador de gravidade do TCE contuso e um seguro preditor de capacidade funcional. A duração e o término da amnésia pós-traumática têm sido, nos últimos anos, avaliados pelo "Gaveston Orientation and Amnesia Test". Esse instrumento, traduzido e validado no atual estudo, foi renomeado, em língua portuguesa, como Teste de Amnésia e Orientação de Galveston (TAOG). Sua aplicação em 73 vítimas de TCE contuso, juntamente com a avaliação do nível de consciência pela Escala de Coma de Glasgow (ECGI), permitiu verificar as propriedades de medida do TAOG, analisar sua aplicabilidade e identificar as relações entre os resultados obtidos nos dois instrumentos. A confiabilidade verificada pelo Alfa de Cronbach resultou em 0,76, valor suficiente para atestar consistência interna satisfatória do instrumento. Houve evidências de validade convergente e discriminante do TAOG. Com relação à aplicabilidade desse instrumento, o mesmo pôde ser aplicado nos pacientes com ECGI '> ou =' 12, porém o término da amnésia pós-traumática foi verificado nos pacientes com ECGI '> ou =' 14. Quanto às relações entre os resultados obtidos no TAOG e na ECGI, correlação significativa ('r IND. s'=0,65) foi verificada entre essas medidas, no entanto, em 47,2% dos casos o fim da amnésia foi indicada antes ou após pontuação 15 na ECGI. As diferentes formas de relação entre término de amnésia e alteração da consciência observadas oferecem indícios de questões adicionais sobre os déficits cognitivos que ocorrerem após TCE.

Post-traumatic amnesia (PTA) is a very frequent disturbance in victims with traumatic brain injury (TBI), that its length has been regarded a strong index of severity of closed TBI and a safe predictor of outcome. The length and the end of PTA have been evaluated in the last years by the Galveston Orientation and Amnesia Test (GOAT). This scale was translated, validated in the present study, renamed in portuguese as "Teste de Amnésia e Orientação de Galveston" (TAOG). It was applied to 73 patients whith closed TBI, as well as measuring their level of conscienceness, tested by the Glasgow Coma Scale (GCS), which allowed to check the GOAT´s efficiency as a test, its aplicability and to identify the relationship between both tests. The confiabiality was checked by the Cronbach's Alfa, that resulted in 0,75, enough value to garantee sactisfatory internal consistency of the Test. TAOG showed either convergent and discriminant validity. In relation with its aplicability, GOAT could be used in patients with GCS '> or =' 12, but the end of PTA was observed in patients with GCS '> ou =' 14. The relations between the scores presented in GOAT and GCS, a significant correlation ('r IND. s' = 0,65) was verified between these tests, however, in 47,2% the end of the amnesia was showed before or after GCS = 15. The different relationship between the end of amnesia and observed conscience's alteration, offers signs of aditional questions about cognitive deficits that happens after TBI.