Aim:To develop and validate a predictive model for falls in hospitalized adult clinical and surgical patients, assessing intrinsic (i.e. patient-related) and extrinsic factors (i.e. care process-related). Background:To identify factors predictive of falls and enable appropriate management of fall risk it is necessary to understand patient and environmental factors, along with care delivery processes. Design:A matched case-control study. Methods:This study was conducted in the medical and surgical wards of a Brazilian teaching hospital. The sample included 536 patients, with data collected in 2013- Data analysis included descriptive statistics and conditional logistic regression.Cases of patients aged 18 years or older who fell while hospitalized were included.One patient who did not fall during hospitalization, matched by sex, ward and admission date, was selected as a control for each included case. Results: The SAK Fall Scale (Severo-Almeida-Kuchenbecker) was developed and validated. The scale includes seven variables: disorientation/confusion, frequent urination, walking limitations, lack of caregiver, postoperative status, previous falls and number of medications administered within 72 hr prior to the fall. This scale showed acceptable predictive accuracy. Conclusions: The newly developed SAK Fall Scale includes five intrinsic and two extrinsic variables and differs from other predictive scales for falls. The findings of this study are broad and the scale, which is easy to apply, can be used worldwide by nurses in health services. In advanced practice, the testing of a new model for fall risk contributes to preventive interventions and thus has an impact on patient safety. K E Y W O R D S adult, advanced practice, falls, nurses, patient safety, risk management *Member of the Study Group on Adult and Elderly Care -GEPECADI -CNPq.• The study gives data for a new prediction model that should be used to predict fall risk.• The findings should be used to support the care and safety of hospitalized clinical and surgical patients. 564 | SEVERO ET AL.

Objective: to map the available evidence on the components of the transition of care, practices, strategies, and tools used in the discharge from the Intensive Care Unit (ICU) to the Inpatient Unit (IU) and its impact on the outcomes of adult patients. Method: a scoping review using search strategies in six relevant health databases. Results: 37 articles were included, in which 30 practices, strategies or tools were identified for organizing and executing the transfer process, with positive or negative impacts, related to factors intrinsic to the Intensive Care Unit and the Inpatient Unit and cross-sectional factors regarding the staff. The analysis of hospital readmission and mortality outcomes was prevalent in the included studies, in which trends and potential protective actions for a successful care transition are found; however, they still lack more robust evidence and consensus in the literature. Conclusion: transition of care components and practices were identified, in addition to factors intrinsic to the patient, associated with worse outcomes after discharge from the Intensive Care Unit. Discharges at night or on weekends were associated with increased rates of readmission and mortality; however, the association of other practices with the patient’s outcome is still inconclusive.

The effect of a short-term nutritional supplementation with steam-flaked corn on metabolism and folliculogenesis was evaluated in 14 maiden sheep. Oestrus was synchronized with two prostaglandin F(2alpha) doses given 10 days apart. From day 11 to 15 of the oestrous cycle induced with prostaglandins, half of the ewes (group 2M) were supplemented with steam-flaked corn, double the daily maintenance ration of the control sheep (group 1M). Body weight and condition remained unaffected, but the energetic supply increased plasma concentrations of glucose (3.6 +/- 0.1 vs 4.3 +/- 0.1 mmol/l, p < 0.0001) for the first 4 days and 3-hydroxybutyrate (0.323 +/- 0.58 vs 0.582 +/- 0.04 mmol/l, p < 0.005) from day 2 to 4. The profile of insulin secretion was also affected by the treatment, increasing in group 2M to reach significant differences on days 13 and 14 (p < 0.05). From similar values at the start of the food supply, the treatment induced a higher follicular development in group 2M (1.1 +/- 1.2 vs 7.4 +/- 1.06 total follicles in day 15, p < 0.05), as evidenced by the lineal increase in the number of larger follicles (>4 mm, p < 0.005). Then, the number of follicles >4 mm in size in 2M was around 60% higher on day 16 (7.86 +/- 0.45 vs 4.86 +/- 0.63, p < 0.005). Thereafter, the mean number of corpora lutea per ewe was around 30% higher in group 2M (1.43 +/- 0.2 vs 1.10 +/- 0.1, although differences were not found to be statistically significant). These data suggest that the use of diets containing high starch sources, like the steam-flaked corn, increases folliculogenesis and ovulation rate in sheep and can be applied in short-term feeding practices.

More comprehensive epidemiological information may suggest regional-specific approaches to the management of nematode parasites in ewes should be devised in the future.