Factors influencing individualized nursing care in acute medical and perioperative settings: A scoping review

Individualized nursing care addresses the needs,experiences,behaviors,feelings,and perceptions of patients and families,but its implementation in clinical practice contexts remains challenging.This review aims to map the factors that interfere with the individualization of nursing care,in acute medical and perioperative settings.Scoping review was conducted according to the Joanna Briggs Institute guidelines.The MEDLINE,CINAHL,Cochrane,SciELO,Scientific Repository of Open Access,and LILACS databases were searched for publications from January 2017 up to March 2023.Of the 124 articles selected,17 met the inclusion criteria.The individualization of nursing care is complex and shaped by multiple variables in the care environment,nursing,and patient characteristics.The institutional organization,the nurses’expertise,and the patient’s attributes were identified as variables that interfere with the individualization of nursing care.Individualized nursing care is responsible for better quality of care and health outcomes.The identification of the variables that affect individualized care contributes to planning programs to improve individualization,during hospitalization and the discharge.

A geomechanics classification for the rating of railroad subgrade performance

The type of subgrade of a railroad foundation is vital to the overall performance of the track structure.With the train speed and tonnage increase,as well as environmental changes,the evaluation and influence of subgrade are even more paramount in the railroad track structure performance.A geomechanics classification for subgrade is proposed coupling the stiffness(resilient modulus)and permanent deformation behaviour evaluated by means of repeated triaxial loading tests.This classification covers from fine-to coarse-grained soils,grouped by UIC and ASTM.For this achievement,we first summarize the main models for estimating resilient modulus and permanent deformation,including the evaluation of their robustness and their sensitivity to mechanical and environmental parameters.This is followed by the procedure required to arrive at the geomechanical classification and rating,as well as a discussion of the influence of environmental factors.This work is the first attempt to obtain a new geomechanical classification that can be a useful tool in the evaluation and modelling of the foundation of railway structures.

Enhancement of the benthic communities around an isolated island in the Antarctic Ocean

Insular marine biotas are often richer in faunal diversity than those from the open sea in the same geo- graphical region. The existence of particular island effects were tested under polar conditions by compar- ing infaunal benthic assemblages on Peter I Island with those of similar latitudes in the open ocean at the Bellingshausen Sea and also from the coast of the Antarctic Peninsula. Sampling was carried out aboard the R/V Hesperides during the expedition named BENTART-2003 from 24 January to 3 March 2003. Benthic samples were collected at 18 stations ranging from 90 to 2 044 m depth, using an USNEL-type box corer （BC） dredge. Representatives of 32 higher taxa of invertebrates were found. Univariate and multivariate analyses revealed various patterns in the data. First, significant differences in polychaete abundance were detected between the stations located in the open sea and the remaining sites （island plus mainland sites）. Bivalve abundances were also distinct between island and mainland sampling sites. Sediment columns taken from the island seafloor exhibited the highest rate of bioturbation by the infauna. These findings confirm the model that islands develop distinct assemblages characterized by the enhancement of the benthic commu- nities even in cold waters. Several abiotic factors were measured simultaneously at the seafloor and along the water column to investigate faunal distribution patterns. Significant correlations were found between the benthic assemblages and a combination of two environmental variables： ＂island effect＂ （measured as a categorical variable） and the redox state of sediments. Richer and more complex benthic assemblages were found in Peter I Island＇s sea bottom, whereas the more depauperate bottoms remained in the open sea.

Influence of train speed and its mitigation measures in the short-and long-term performance of a ballastless transition zone

The ballastless track is nowadays the most popular railway system due to the required low number of maintenance opera-tions and costs,despite the high investment.The gradual change from ballasted to ballastless tracks has been occurring in Asia,but also in Europe,increasing the number of transition zones.The transition zones are a special area of the railway networks where there is an accelerated process of track degradation,which is a major concern of the railway infrastructure managers.Thus,the accurate prediction of the short-and long-term performance of ballastless tracks in transition zones is an important topic in the current paradigm of building/rehabilitating high-speed lines.This work purposes the development of an advanced 3D model to study the global performance of a ballastless track in an embankment-tunnel transition zone considering the influence of the train speed(220,360,500,and 600 km/h).Moreover,a mitigation measure is also adopted to reduce the stress and displacements levels of the track in the transition.A resilient mat placed in the tunnel and embank-ment aims to soften the transition.The behaviour of the track with the resilient mat is evaluated considering the influence of the train speed,with special attention regarding the critical speed.The used methodology is a novel and hybrid approach that allows including short-term and long-term performance,through the development of a powerful 3D model combined with the implementation of a calibrated empirical permanent deformation model.