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OBJECTIVE: To determine the impact that implementing a combination of a computer-based clinical decision support system and a program of training seminars has on the use of appropriate prophylaxis for venous thromboembolism (VTE). METHODS: We conducted a cross-sectional study in two phases (prior to and after the implementation of the new VTE prophylaxis protocol) in order to evaluate the impact that the combined strategy had on the use of appropriate VTE prophylaxis. The study was conducted at Nossa Senhora da Conceição Hospital, a general hospital in the city of Porto Alegre, Brazil. We included clinical and surgical patients over 18 years of age who were hospitalized for ≥ 48 h. The pre-implementation and post-implementation phase samples comprised 262 and 261 patients, respectively. RESULTS: The baseline characteristics of the two samples were similar, including the distribution of patients by risk level. Comparing the pre-implementation and post-implementation periods, we found that the overall use of appropriate VTE prophylaxis increased from 46.2% to 57.9% (p = 0.01). Looking at specific patient populations, we observed that the use of appropriate VTE prophylaxis increased more dramatically among cancer patients (from 18.1% to 44.1%; p = 0.002) and among patients with three or more risk factors (from 25.0% to 42.9%; p = 0.008), two populations that benefit most from prophylaxis. CONCLUSIONS: It is possible to increase the use of appropriate VTE prophylaxis in economically constrained settings through the use of a computerized protocol adhered to by trained professionals. The underutilization of prophylaxis continues to be a major problem, indicative of the need for ongoing improvement in the quality of inpatient care.

OBJETIVO: Determinar o impacto da implantação de um sistema informatizado de suporte à decisão clínica combinado com seminários instrucionais na utilização de profilaxia para tromboembolia venosa (TEV) de forma adequada. MÉTODOS: Estudo transversal em duas fases (antes e depois da implantação de um novo protocolo de profilaxia para TEV) para avaliar o impacto que a estratégia combinada teve na utilização adequada da profilaxia para TEV. O estudo foi conduzido no Hospital Nossa Senhora da Conceição, um hospital geral localizado em Porto Alegre (RS). Foram incluídos pacientes clínicos e cirúrgicos com mais de 18 anos com tempo de hospitalização > 48 h. Nas fases pré e pós-implantação, foram incluídos 262 e 261 pacientes, respectivamente. RESULTADOS: As características de base das duas amostras foram semelhantes, inclusive em relação à distribuição dos pacientes por nível de risco. Comparando-se os períodos pré e pós-implantação, verificou-se que a adequação da profilaxia para TEV aumentou de 46,2% para 57,9% (p = 0,01). Ao se observar populações específicas de pacientes, o uso adequado da profilaxia para TVE aumentou dramaticamente em pacientes com câncer (de 18,1% para 44,1%; p = 0,002) e em pacientes com três ou mais fatores de risco (de 25,0% para 42,9%; p = 0,008), populações essas que mais se beneficiam da profilaxia. CONCLUSÕES: É possível aumentar o uso de profilaxia adequada para TEV em cenários economicamente desfavoráveis através do uso de protocolos informatizados e de profissionais treinados. A subutilização da profilaxia permanece como um problema importante, destacando a necessidade da melhora continuada na qualidade da assistência hospitalar.OBJECTIVE: To determine the impact that implementing a combination of a computer-based clinical decision support system and a program of training seminars has on the use of appropriate prophylaxis for venous thromboembolism (VTE). METHODS: We conducted a cross-sectional study in two phases (prior to and after the implementation of the new VTE prophylaxis protocol) in order to evaluate the impact that the combined strategy had on the use of appropriate VTE prophylaxis. The study was conducted at Nossa Senhora da Conceição Hospital, a general hospital in the city of Porto Alegre, Brazil. We included clinical and surgical patients over 18 years of age who were hospitalized for > 48 h. The pre-implementation and post-implementation phase samples comprised 262 and 261 patients, respectively. RESULTS: The baseline characteristics of the two samples were similar, including the distribution of patients by risk level. Comparing the pre-implementation and post-implementation periods, we found that the overall use of appropriate VTE prophylaxis increased from 46.2% to 57.9% (p = 0.01). Looking at specific patient populations, we observed that the use of appropriate VTE prophylaxis increased more dramatically among cancer patients (from 18.1% to 44.1%; p = 0.002) and among patients with three or more risk factors (from 25.0% to 42.9%; p = 0.008), two populations that benefit most from prophylaxis. CONCLUSIONS: It is possible to increase the use of appropriate VTE prophylaxis in economically constrained settings through the use of a computerized protocol adhered to by trained professionals. The underutilization of prophylaxis continues to be a major problem, indicative of the need for ongoing improvement in the quality of inpatient care.

Analisou-se o perfil de consumidores de carne bovina e determinou-se o consumo de carne com certificação visando obter dados sobre a importância e o valor da certificação da carne na hora da compra. Avaliou-se ainda o conhecimento do consumidor de carne bovina quanto à certificação da carne e quanto esse consumidor paga por este processo. A pesquisa foi realizada em uma rede de supermercados, mediante a aplicação de questionários dirigidos às pessoas próximas aos balcões com carne, independentemente da espécie animal. Os consumidores exigem alimentos com qualidade e certificados confiáveis que demonstrem e garantam a qualidade dos alimentos, porém, estão dispostos a pagar somente um pouco a mais pela certificação, em comparação ao valor atual de mercado, provavelmente pelo fato de sua renda mensal não permitir maior valorização desse atributo.The profile of beef meat consumers was analyzed, as well as the consumption of certificated meat, with the objective of obtaining data on the importance the of certification value at the purchasing occasion. The aim of this study was to evaluate the beef meat consumers awareness regarding the meat certification and how much they are willing to pay for this process. The data survey was carried out in only one supermarket chain from the city of Porto Alegre - RS, Brazil, which authorized the research interviewing people through questionnaires, close to refrigerator counters of any meat species. It was observed that consumers are demanding for food with quality attributes, with trustful certifications that testify these quality attributes. However, the data obtained from interviews with consumers showed that they are willing to pay only little more for certification than the current price, probably due to the fact that their average monthly income ranges from one to six minimum wages.

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Self-heating effects in AlGaN/GaN high-electron mobility transistors (HEMTs) can notably reduce electron mobility and produce reliability concerns. Electrothermal characterization and appropriate thermal management are required to address this situation. This letter presents the measurement of channel temperature ( \mathbf Tch ) of GaN HEMTs in multiple bias conditions with a good accuracy. The measurements are executed using the integrated microresistance thermometer detector ( \mu RTD) technique in AlGaN/GaN HEMTs on SiC and sapphire substrates. The integrated Ti/Pt \mu RTD sensor with linear resistance-temperature characteristic is used to obtain an Ids – Vds – Tch map for each device. Thermal resistances are compared for similar operation conditions, obtaining RTH = 34.7\, \mathrm ^\circ \mathbfC \boldsymbol \cdot \mathbfW^-\mathbf1 for the HEMT on SiC and R \rm TH = 157.2~ {\mathrm { {^{\circ }}{\mathbf{C}} \boldsymbol {\cdot } {\mathbf{W}}^{-{\mathbf{1}}} }} for the HEMT on sapphire. [ABSTRACT FROM PUBLISHER]