Abstract Background Sleep disorders have a negative impact on health, being associated with neurocognitive problems, cardiovascular diseases and obesity, influencing children's development and learning. Objective To assess the sleep pattern of people with Down syndrome (DS) and correlate changes with functionality and behavior. Methods A cross-sectional study was conducted to evaluate the sleep pattern in adults with DS > 18 years old. Twenty-two participants were assessed using the Pittsburgh Sleep Quality Index, the Functional Independence Measure and the Strengths and Difficulties Questionnaire, and the 11 who presented indications of disorders by the screening questionnaires were referred to polysomnography. Statistical tests were performed using a significance level of 5%, including sample normality tests and correlation tests (sleep and functionality). Results Impairment in sleep architecture was found due to an increase in the rate of awakenings in 100% of the participants, a decrease in the number of slow waves, and a high prevalence of sleep disordered breathing (SDB), with higher averages in the Apnea and Hypopnea Index (AHI) in the group. There was a negative correlation between sleep quality and global functionality (p= 0.011) and the motor (p= 0.074), cognitive (p= 0.010), and personal care (p= 0.072) dimensions in the group. Global and hyperactivity behavior changes were related to worse sleep quality (p= 0.072; p= 0.015, respectively). Conclusion There is an impairment in the sleep quality of adults with DS, with an increase in the rate of awakenings, a decrease in the number of slow waves, and a high prevalence of SDB affecting this population in the functional and behavioral aspects.

Resumo Antecedentes Os distúrbios de sono têm impacto negativo na saúde, estando associados a problemas neurocognitivos, doenças cardiovasculares e obesidade, influenciando no desenvolvimento e aprendizado. Objetivo Avaliar o padrão de sono de pessoas com síndrome de Down (SD) e correlacionar as alterações com a funcionalidade e comportamento. Métodos Foi realizado um estudo transversal para avaliação do padrão de sono em adultos com SD > 18 anos. Foram avaliados 22 participantes, através do Índice de Qualidade do Sono de Pittsburgh, da Medida de Independência Funcional e do Questionaário de Capacidades e Dificuldades. Os 11 participantes que apresentaram indicativos de presença de distúrbios pelos questionários de triagem foram indicados a polissonografia. Os testes estatísticos foram realizados com nível de significância de 5%, incluindo testes de normalidade e testes de correlação (sono e funcionalidade). Resultados Foi encontrado prejuízo na arquitetura de sono pelo aumento do índice de despertares em 100% dos participantes, diminuição na quantidade de ondas lentas, e alta prevalência de distúrbio respiratório do sono (DRS), com maiores médias nos Índices de Apneia e Hipopneia (IAH). Houve correlação negativa entre a qualidade de sono e a funcionalidade global (p= 0,011), e as dimensões motora (p= 0,074), cognitiva (p= 0,010) e cuidados pessoais (p= 0,072). As alterações de comportamento global e comportamentos de hiperatividade foram relacionados à pior qualidade do sono (p= 0,072; p= 0,015, respectivamente). Conclusão Existe prejuízo na qualidade de sono de adultos com SD, com aumento de índice de despertares, diminuição na quantidade de ondas lentas, e alta prevalência de DRS, afetando essa população nos aspectos funcionais e comportamentais.

ABSTRACT The exercise of analysis of performance dance discourse is carried out grounded in Bakhtin’s concept of chronotope. On the basis of the classical ballet genre, theater is established as a constitutive chronotope that materializes its social-aesthetic values spatial-temporally. The analysis of chronotopic transgressions allows identifying the emergence of modern ballet based on two choreographies by Russian artist Vaslav Nijinski.

RESUMO Exercício de análise do discurso da dança de espetáculo através do conceito bakhtiniano de cronotopo. A partir do gênero do balé clássico, estabelece-se o teatro como cronotopo constitutivo que concretiza espaço-temporalmente seus valores sócioestéticos. A análise de transgressões cronotópicas permite identificar o surgimento do balé moderno com base em duas coreografias do artista russo Vaslav Nijinski.

ABSTRACT Several studies have shown that the survival and reproduction of lacewings varies depending on the type of prey they consumed, especially during the first instar. In this study, we evaluated the effect of a diet consisting of Ephestia kuehniella (EK) and/or Planococcus-citri (PC) eggs offered to first instar Chrysoperla externa on subsequent development and survival. Larvae supplied only with P. citri (PC) nymphs had extended immature development, low survival, adults with lower weight and longevity, low fecundity and egg viability, and lower net reproduction rate (R0). Larvae submitted to the treatment EK+PC responded positively to the diet, showing results similar to those obtained in the control-EK treatment. Therefore, this mealybug supports suitable development and reproduction of C. externa when it is provided to second instar larvae after they fed on E. kuehniella eggs as first instars. As far as we know, this is the first report that demonstrates the effect of natural prey and alternatives on different larval stages of lacewings. This information is valuable in developing protocols for use of C. externaas a pest control agent.

ABSTRACT Objectives: to assess the factors associated with the safety culture of patients under dialysis in the context of the COVID-19 pandemic. Methods: a cross-sectional and analytical study, carried out in Minas Gerais, with 134 professionals from three dialysis services. The Hospital Survey on Patient Safety Culture, adapted for Brazil, was used. Results: only variable type of management was associated with the highest percentage of positive response in public and private services. Patient safety was rated as good by 55.7% of respondents. In dimension assessment, the public service presented one strength and five weaknesses, the private service did not present weak areas, and the philanthropic service presented a weakness. The priority areas for improvement actions are represented by dimensions “Nonpunitive response to error” and “Staffing”. Conclusions: interventions should consider the type of service management, as it is a factor associated with safety culture.

RESUMEN Objetivos: evaluar los factores asociados a la cultura de seguridad del paciente en diálisis en el contexto de la pandemia de COVID-19. Métodos: estudio transversal y analítico, realizado en Minas Gerais, con 134 profesionales de tres servicios de diálisis. Se utilizó el instrumento Hospital Survey on Patient Safety Culture, adaptado para Brasil. Resultados: solo la variable tipo de gestión se asoció con el mayor porcentaje de respuesta positiva en los servicios públicos y privados. La seguridad del paciente fue calificada como buena por el 55,7% de los encuestados. En la evaluación de las dimensiones, el servicio público presentó una fortaleza y cinco debilidades, el servicio privado no presentó áreas frágiles y el servicio filantrópico presentó fragilidad. Las áreas prioritarias de acciones de mejora están representadas por las dimensiones “Respuesta no punitiva a los errores” y “Escalamiento de personal”. Conclusiones: las intervenciones deben considerar el tipo de gestión del servicio, ya que es un factor asociado a la cultura de seguridad.

RESUMO Objetivos: avaliar os fatores associados à cultura de segurança do paciente em diálise no contexto da pandemia de COVID-19. Métodos: estudo transversal e analítico, realizado em Minas Gerais, com 134 profissionais de três serviços de diálise. Utilizou-se o instrumento Hospital Survey on Patient Safety Culture, adaptado para o Brasil. Resultados: apenas a variável tipo de gestão esteve associada à maior porcentagem de resposta positiva nos serviços púbicos e privados. A segurança do paciente foi classificada como boa para 55,7% dos respondentes. Na avaliação das dimensões, o serviço público apresentou uma fortaleza e cinco fragilidades, o serviço privado não apresentou áreas frágeis, e o serviço filantrópico apresentou uma fragilidade. As áreas prioritárias para ações de melhoria estão representadas pelas dimensões “Resposta não punitiva para erros” e “Dimensionamento de pessoal”. Conclusões: intervenções devem considerar o tipo de gestão do serviço, por ser um fator associado à cultura de segurança.

ABSTRACT The exercise of analysis of performance dance discourse is carried out grounded in Bakhtin’s concept of chronotope. On the basis of the classical ballet genre, theater is established as a constitutive chronotope that materializes its social-aesthetic values spatial-temporally. The analysis of chronotopic transgressions allows identifying the emergence of modern ballet based on two choreographies by Russian artist Vaslav Nijinski.

RESUMO Exercício de análise do discurso da dança de espetáculo através do conceito bakhtiniano de cronotopo. A partir do gênero do balé clássico, estabelece-se o teatro como cronotopo constitutivo que concretiza espaço-temporalmente seus valores sócioestéticos. A análise de transgressões cronotópicas permite identificar o surgimento do balé moderno com base em duas coreografias do artista russo Vaslav Nijinski.

ABSTRACT Objective: to evaluate the patient safety culture from the perspective of nursing staff in dialysis services in the context of the COVID-19 pandemic. Method: cross-sectional study with 56 nursing professionals from three dialysis services in Minas Gerais - Brazil, between March and June 2021. The Hospital Survey on Patient Safety Culture instrument was used. The data were analyzed by descriptive and inferential statistics; chi-square test; and Generalizable Estimating Equations (p≤0.05). Results: Patient safety was rated as good or excellent by 69.6% of participants. The dimension “Expectations and actions of the service management that favor safety” was considered a strength (85.42%). “Non-punitive response to errors” (23.99%) and “Staff sizing” (45.83%) were considered weak. There was a higher percentage of positive responses in public and philanthropic services (p<0.001). Conclusion: few dimensions indicated strengths, and the type of management influenced the percentage of positive responses.

RESUMEN Objetivo: Evaluar la cultura de seguridad del paciente desde la perspectiva del personal de enfermería de los servicios de diálisis en el contexto de la pandemia de COVID-19. Método: estudio transversal con 56 profesionales de enfermería de tres servicios de diálisis de Minas Gerais - Brasil, entre marzo y junio de 2021. Se utilizó el instrumento Hospital Survey on Patient Safety Culture. Los datos se analizaron mediante estadística descriptiva e inferencial, test de chi cuadrado y Ecuaciones de Estimación Generalizables (p≤0,05). Resultados: la seguridad de los pacientes fue calificada de buena o excelente por el 69,6% de los participantes. La dimensión “Expectativas y acciones de la dirección del servicio que favorecen la seguridad” se consideró un punto fuerte (85,42%). “Respuesta no punitiva a los errores” (23,99%) y “Dotación de personal” (45,83%) se consideraron débiles. Hubo un mayor porcentaje de respuestas positivas en los servicios públicos y filantrópicos (p<0,001). Conclusión: pocas dimensiones indicaron puntos fuertes, y el tipo de gestión influyó en el porcentaje de respuestas positivas.

RESUMO Objetivo: avaliar a cultura de segurança do paciente sob a perspectiva da equipe de enfermagem em serviços de diálise no contexto da pandemia de COVID-19. Método: estudo transversal com 56 profissionais de enfermagem de três serviços de diálise em Minas Gerais - Brasil, entre março e junho de 2021. Utilizou-se o instrumento Hospital Survey on Patient Safety Culture. Os dados foram analisados por: estatística descritiva e inferencial; teste qui-quadrado; e Equações de Estimativas Generalizáveis (p≤0,05). Resultados: a segurança do paciente foi classificada como boa ou excelente por 69,6% dos participantes. A dimensão “Expectativas e ações da direção do serviço que favoreçam a segurança” foi considerada fortaleza (85,42%). “Resposta não punitiva para erros” (23,99%) e “Dimensionamento de pessoal” (45,83%) foram consideradas frágeis. Houve maior percentual de respostas positivas nos serviços público e filantrópico (p<0,001). Conclusão: poucas dimensões indicaram fortalezas, e o tipo de gestão influenciou o percentual de respostas positivas.

Aim To compare the profile and overall survival of young adults and elderly people diagnosed with SCC. Methods A retrospective study was carried out at a High Complexity Oncology Unit, between 2010 and 2016. A descriptive analysis, a bivariate analysis using the chi-square and Fisher’s exact test and the Kaplan-Meier estimator were performed. The predictor variables were tested using the log-rank test and those with statistical significance and the literature were maintained for the Cox regression model. Results 282 cases of SCC were recorded, with only 12.4% diagnosed in young adults. The profile was similar between groups, with the majority of cases of the disease occurring in males, smokers and alcohol consumers. The lesions predominantly located on the tongue and were diagnosed in an advanced stage of the disease, resulting in 35.7% of deaths. The median survival time was 30 months in the elderly and 31 months in young people. In the multivariate analysis, age was not statistically significant, only staging and treatment were predictors of reduced overall survival. Conclusion Tumor staging, and treatment were prognostic factors for the disease.

Abstract Objective: This survey was designed to assess the profile of professionals working in intradialytic exercise programs (IEPs) in Brazil and reveal the motivators and barriers they face. Methods: The survey was sent to physiotherapists and exercise physiologists working in IEPs in Brazil. Phone interviews and electronic forms were used to collect the answers to the survey questionnaire. Results: Forty-one of the 261 included dialysis centers had IEPs; 44 professionals answered the questionnaire over the phone and 26 used the electronic form to do it. A total of 70 professionals (mean age 33.4±7.4 years; 84.3% physiotherapists) answered the questionnaire. Resistance training was the preferred mode of therapy. Most of the IEPs were connected to research and were paid for by private health insurance. The desire to work in a different field (30.0%) and lack of resources (31.4%) were the most prevalent motivator and barrier cited by IEP professionals working in dialysis centers, respectively. Conclusion: The majority of the few professionals that work in IEPs in Brazil are physiotherapists. Lack of resources was the most commonly reported barrier faced by survey respondents.

Resumo Objetivo: Avaliar o perfil dos profissionais que atuam em programas de exercício físico intradialítico (EFI) no Brasil e as motivações e barreiras para a atuação desses profissionais. Métodos: Foram incluídos fisioterapeutas e profissionais de educação física que atuam em programas de EFI no Brasil. Para coletar os dados, foi aplicado um questionário por ligação telefônica ou formulário eletrônico. Resultados: Dos 261 centros de diálise analisados, 41 apresentaram programas de EFI, sendo que 44 profissionais responderam ao questionário por telefone e outros 26, por meio eletrônico. Foram avaliados 70 profissionais (33,4±7,4 anos, 84,3% fisioterapeutas). A modalidade terapêutica mais aplicada foi o treinamento resistido. A maioria dos programas de EFI está associada a atividades de pesquisa e é financiada pela saúde suplementar. A possibilidade de atuação em um novo campo de trabalho (30,0%) e a falta de recursos (31,4%) foram a motivação e a barreira mais prevalentes para atuação dos profissionais nos centros de diálise, respectivamente. Conclusão: Poucos profissionais atuam em programas de EFI no Brasil, sendo a maioria fisioterapeutas. A falta de recursos foi a barreira mais prevalente para a atuação desses profissionais.

Resumo O objetivo deste trabalho foi determinar funções de pedotransferência para a predição da retenção de água nos potenciais matriciais -33 e -1500 kPa, em solos sob Cerrado, no sul do estado de Mato Grosso, Brasil. Amostras (n=156) foram coletadas para a calibração (n=124) e validação (n=32) dos modelos. Utilizou-se uma regressão múltipla passo a passo, para determinar as funções de pedotransferência. Utilizaram-se o índice de concordância de Willmott, a raiz do erro quadrático médio, o coeficiente de correlação de Pearson e o índice de confiança, para avaliar o desempenho das funções e compará-las com as descritas na literatura. As variáveis mais eficientes para estimar a retenção de água foram: microporosidade, areia total e argila a -33 kPa; e areia total, silte e argila a -1500 kPa. As funções de pedotransferência regionais explicaram mais de 94% da variância da retenção de água nos solos estudados. A confiabilidade da predição da retenção de água, -33 kPa, aumentou com o uso da propriedade estrutural microporosidade e, a -1500 kPa, com o uso de parâmetros granulométricos. Funções de pedotransferência regionais predizem melhor a retenção de água nos potenciais matriciais -33 e -1500 kPa, em solos sob Cerrado, no sul de Mato Grosso, do que as funções descritas na literatura.

Abstract The objective of this work was to determine pedotransfer functions to predict water retention at the -33 and -1500 kPa matric potentials of soils under Cerrado, in the south of the state of Mato Grosso, Brazil. Samples (n=156) were collected for model calibration (n=124) and validation (n=32). A stepwise multiple regression was used to determine pedotransfer functions. Willmott’s index of agreement, root-mean-square error, Pearson’s correlation coefficient, and the confidence index were used to evaluate the performance of the functions and to compare them with those described in the literature. The most efficient variables to estimate water retention were: microporosity, total sand, and clay at -33 kPa; and total sand, silt and clay at -1500 kPa. The regional pedotransfer functions explained more than 94% of water retention variance in the studied soils. The reliability of the functions to predict water retention increased, at -33 kPa, with the use of the structural property microporosity and, at -1500 kPa, with the use of granulometric parameters. The studied regional pedotransfer functions predict water retention at the -33 and -1500 kPa matric potentials of soils under Cerrado, in southern Mato Grosso, better than the functions described in the literature.

ABSTRACT This study aimed to determine the consumption of Planococcus citri (Risso, 1813) (Hemiptera: Pseudococcidae) nymphs and the predator:prey ratio required for high predatory efficacy and survival of Chrysoperla externa (Hagen, 1861) (Neuroptera: Chrysopidae) larvae under different densities of prey, reared in rose bushes. Consumption by first-, second-, and third-instar larvae of C. externa was assessed. The predatory efficiency and survival of the predator were calculated for larvae in the second instar under densities of 20, 40, 80, 120, and 160 nymphs of P. citri and predator:prey ratios of 1:5, 1:10, and 1:20. The assessments were performed after 24 and 48 hours of exposure between species. There was increasing consumption throughout the larval development of C. externa. The predator:prey ratios 1:5 and 1:10 were the most efficient for P. citri population reduction, but the 1:5 ratio led to lower survival of larvae than the 1:10 and 1:20 ratios. There was a positive correlation between C. externa larval density and cannibalism (ρ = 0.45) and a negative correlation between predator density and P. citri population density (ρ = -0.81). Third-instar larvae consume more P. citri nymphs than second-instar larvae. Second-instar larvae of this lacewing released at a 1:20 ratio caused total mortality of mealybug nymphs within 48 hours, regardless the density of P. citri, with high larvae survival of C. externa.

ABSTRACT The predator Chrysoperla externa (Hagen, 1861) (Neuroptera: Chrysopidae) is a polyphagous species that has, among its wide range of acceptable prey, the aphid Macrosiphum rosae (Linnaeus, 1758) (Hemiptera: Aphididae), an important pest of rose plants. We assessed the consumption of nymphs and adults of M. rosae by C. externa larvae, the predatory efficiency, and larval survival under different predator:prey ratios, densities of aphids, and ages of aphids. The bioassays were performed at 25 ± 1°C and 70 ± 10% RH under a 12-hour photoperiod, with aphids taken from roses of the cultivar Avalanche. Consumption was assessed by making young aphids (2nd and 3rd instars) and more developed aphids (4th instar and adult) available throughout the larval stage of the predator. The predatory efficiency and survival were studied for second-instar larvae offered M. rosae nymphs at densities of 20, 40, 80, 120, and 160 using predator:prey ratios of 1:5, 1:10, and 1:20. The assessments were performed 24, 48, and 72 hours after putting the species together. All of the C. externa instars consumed younger than older aphids. Larvae in the third instar consumed 80% of the young aphids and 77% of the older aphids. The higher the predator:prey ratio and larval density, the higher the predatory efficiency and the lower the larval survival. The ratios 1:5 and 1:10 led to the elimination of younger and older aphid populations 72 hours into the interaction between species.

RESUMO Os doseamentos séricos de anticorpos específicos para o Aspergillus fumigatus (A. fumigatus) são úteis para a orientação diagnóstica de aspergilose broncopulmonar alérgica (ABPA). Objetivo: Avaliar a sensibilização aos componentes purificados do A. fumigatus por quantificação de anticorpos específicos IgE e IgG no soro de doentes com ABPA ou com asma e sensibilização a fungos, usando como comparadores doentes com asma alérgica não sensibilizados a fungos, doentes com fibrose quística (FQ) sem critérios de ABPA e doentes com aspergiloma pulmonar. Métodos: Avaliação transversal de 57 doentes com os diagnósticos de ABPA (n=13), FQ (n=9), asma sensibilizada a fungos (ASF, n=10), asma alérgica sem sensibilização a fungos (AA, n=18) e aspergiloma (n=7). A determinação das concentrações séricas de IgE e IgG específica (sIgE e sIgG) para A. fumigatus (m3) e cinco dos seus componentes antigénicos recombinantes (rAsp f) rAsp f 1, rAsp f 2, rAsp f 3, rAsp f 4 e rAsp f 6 foi realizada por ImmunoCAP. Resultados: A ABPA diferiu significativamente da ASF, pela sensibilização (sIgE>0,10 kUA/L) ao antigénio intracelular rAsp f 6 (64% versus 0% Qui2=6,2, p=0,013) e pelo aumento significativo da sIgE para o antigénio extracelular rAsp f 1 (45,3; 0,2-33,7kUA/L versus 0,3; 0,1-0,3kUA/L, p=0,041). Os níveis de sIgG para A. fumigatus foram significativamente diferentes entre os grupos (p=0,002). No entanto, os níveis de sIgG para os rAsp f testados não diferiram entre ABPA, ASF, FQ e aspergiloma. Conclusão: A avaliação da resposta IgE ao A. fumigatus para alguns dos seus antigénios excretados (rAsp f 1) e intracelulares (rAsp f 6) parece útil na distinção serológica da ABPA em relação à ASF, permitindo melhorar a classificação dos doentes. Os níveis séricos de IgG para os rAsp f não distinguem os diferentes grupos de doentes sensibilizados, não melhorando a descriminação diagnóstica obtidautilizando o extrato total do A. fumigatus.

ABSTRACT The serum assays of specific antibodies to Aspergillus fumigatus (A. fumigatus) are useful for the diagnosis of allergic bronchopulmonary aspergillosis (ABPA). Objective: To evaluate the sensitization to purified components of A. fumigatus, quantifying specific IgE and IgG antibodies to its recombinant allergens in the serum of patients with ABPA or with asthma and sensitization to molds, using as comparators patients with allergic asthma not sensitized to molds, patients with cystic fibrosis (CF) without ABPA criteria and patients with pulmonary aspergilloma. Methods: Cross-sectional evaluation of 57 patients diagnosed with ABPA (n = 13), CF (n = 9), asthma with fungal sensitization (AFS, n = 10), allergic asthma without fungal sensitization (AA, n = 18) or aspergilloma (n = 7). The quantification of serum specific IgE and IgG specific (sIgE and sIgG) to A. fumigatus (m3) and five of its recombinant antigenic components (rAsp f), rAsp f 1, rAsp f 2, rAsp f 3, rAsp f 4 and rAsp f 6 was performed by ImmunoCAP. Results: ABPA significantly differed from ASF in terms of sensitization (sIgE> 0.10 kUA/L) to its intra-cellular antigens (rAsp f 6 64% versus 0% Qui2 = 6.2, p=0.013) and higher levels of sIgE to its extra-cellular antigen rAsp f 1 (45.3; 0.2-33.7kUA/L versus 0.3; 0.1-0.3kUA/L, p=0.041). The levels of sIgG for A. fumigatus were significantly different between groups (p=0.002). However, the sIgG levels for the rAsp f tested did not differ between ABPA, ASF, FC and aspergilloma. Conclusion: The evaluation of the IgE response to A. fumigatus for some of its excreted (rAsp f 1) and intracellular (rAsp f 6) antigens seems to be useful in the serologic distinction of ABPA and asthmatic patients sensitized to molds. Serum IgG levels for rAsp f do not distinguish between different groups of sensitized patients, and do not improve diagnostic discrimination regarding the total extract of A. fumigatus.

RESUMO Objetivo Analisar a relevância dos indicadores clínicos e a clareza e precisão das definições conceituais e operacionais do diagnóstico Troca de gases prejudicada. Métodos Análise de conteúdo, por 39 juízes enfermeiros, dividida nas fases de definição conceitual do fenômeno de interesse, construção da estrutura do fenômeno de interesse e análise dos juízes sobre a estrutura construída. Resultados Dos 22 indicadores, 21 foram considerados relevantes Troca de gases prejudicada. Os indicadores que obtiveram relevância absoluta foram Cianose, Hipercapnia, Hipoxemia e Taquicardia. O indicador Cefaleia ao acordar não apresentou relevância estatisticamente significante para o diagnóstico. Todas as definições conceituais e operacionais foram claras e precisas. Conclusão Os indicadores elencados para Troca de gases prejudicada foram relevantes ao fenômeno, exceto Cefaleia ao acordar pois não corresponde a uma manifestação segura para identificar o diagnóstico, conforme a análise dos juízes. Cada definição conceitual e operacional foi adequada para seu referido indicador.

ABSTRACT Objective To analyze the relevance of clinical indicators and the clarity and precision of conceptual and operational definitions of the diagnosis Impaired gas exchange. Methods Content analysis, by 39 nurse judges, divided into the phases of conceptual definition of the phenomenon of interest, construction of the structure of the phenomenon of interest and analysis of the judges on the built structure. Results From the 22 indicators, 21 were considered relevant Impaired gas exchange. The indicators that obtained absolute relevance were Cyanosis, Hypercapnia, Hypoxemia and Tachycardia. The indicator Headache upon waking did not show any statistically significant relevance for the diagnosis. All conceptual and operational definitions were clear and precise. Conclusion The indicators listed for Impaired gas exchange were relevant to the phenomenon, except Headache upon waking because it does not correspond to a safe manifestation to identify the diagnosis, according to the analysis of the judges. Each conceptual and operational definition was adequate for its indicator.

RESUMEN Objetivo Analizar la relevancia de los indicadores clínicos y la claridad y precisión de las definiciones conceptuales y operativas del diagnóstico Deterioro del intercambio gaseoso. Métodos Análisis de contenido, realizado por 39 jueces enfermeros, dividido en las fases de definición conceptual del fenómeno de interés, construcción de la estructura del fenómeno de interés y análisis de los jueces sobre la estructura construida. Resultados De los 22 indicadores, 21 fueron considerados relevantes Deterioro del intercambio gaseoso. Los indicadores que obtuvieron relevancia absoluta fueron Cianosis, Hipercapnia, Hipoxemia y Taquicardia. El indicador Cefalea al despertar no mostró relevancia estadísticamente significativa para el diagnóstico. Todas las definiciones conceptuales y operativas fueron claras y precisas. Conclusión Los indicadores enumerados para Deterioro del intercambio gaseoso fueron relevantes para el fenómeno, excepto Cefalea al despertar porque no corresponde a una manifestación segura para identificar el diagnóstico, según el análisis de los jueces. Cada definición conceptual y operativa fue adecuada para su indicador.

ABSTRACT The study aimed to verify the effect of diet and environmental temperature on traits of milk fat globules (MFG) of goats. The experiment was conducted in climatic chambers, where we housed 12 Alpine goats with a mean age of 4.02±1.78 years, live weight of 41.8±4.59 kg, and average milk production of 2.16±0.59 kg. The animals were subjected to two different controlled temperatures, T1 = 26 ℃ (thermoneutral) and T2 = 34 ℃ (stress), and diets with different energy levels (low, medium, and high). A milk sample of each animal was collected at 6.00 h, coinciding with milking. The effect of temperature and diet was verified on MFG. The highest MFG was observed at 26 ℃ and medium energy diet. The MFG reached lower values with the diet of medium energy and high temperature (34 ℃). On average, 35% of MFG is smaller than 2 μm, 50% is medium in size (2-5 μm), and 15% is large (>5 μm), with a maximum size of 9.57 μm. The higher prevalence of medium-sized MFG is indicative of excellent milk digestibility. The increase in dietary energy levels promoted both the fat and diameter of fat globules. The higher fat and the larger globules would positively affect the cheese-making aptitude and make it suitable for production of hard cheeses. The increase in dietary energy levels for goats promotes an increase in the diameter of fat globules and milk fat (%), essential traits to the cheese industry.