Systematization of Nursing Care: how did the concept mature?

OBJECTIVES: to analyze the Systematization of Nursing Care conceptual maturation from the perspective of pragmatic utility. METHODS: a concept analysis study. The stages were: select the concept; elaborate analytical questions; comprehensively review the literature; and determine concept structural components. Sixty-one documents were analyzed after a search carried out until October 2019. RESULTS: four temporal periods of contextual changes have occurred since the emergence of ideas of a systematization in the 1960s. This first lasted until 1990. It was followed by those from 1990 to 2002, from 2002 to 2009 and from 2009 onwards. Partial conceptual maturity was identified, operationalization over the years, based on multiple definitions, and, currently, a concept of Systematization of Nursing Care with managerial and organizational attributes. CONCLUSIONS: the concept of Systematization of Nursing Care is partially mature, presents multiple definitions, being operationalized in uncertain connections with other concepts.

Systematization of Nursing Care: how did the concept mature? / Sistematización de la Atención de Enfermería: ¿cómo maduró el concepto? / Sistematização da Assistência de Enfermagem: como amadureceu o conceito?

ABSTRACT Objectives: to analyze the Systematization of Nursing Care conceptual maturation from the perspective of pragmatic utility. Methods: a concept analysis study. The stages were: select the concept; elaborate analytical questions; comprehensively review the literature; and determine concept structural components. Sixty-one documents were analyzed after a search carried out until October 2019. Results: four temporal periods of contextual changes have occurred since the emergence of ideas of a systematization in the 1960s. This first lasted until 1990. It was followed by those from 1990 to 2002, from 2002 to 2009 and from 2009 onwards. Partial conceptual maturity was identified, operationalization over the years, based on multiple definitions, and, currently, a concept of Systematization of Nursing Care with managerial and organizational attributes. Conclusions: the concept of Systematization of Nursing Care is partially mature, presents multiple definitions, being operationalized in uncertain connections with other concepts.

RESUMEN Objetivos: analizar la maduración conceptual de la Sistematización de los Cuidados de Enfermería en la perspectiva de la utilidad pragmática. Métodos: estudio de análisis de concepto. Los pasos fueron: seleccionar el concepto; elaborar preguntas analíticas; revisar exhaustivamente la literatura; y determinar componentes estructurales del concepto. Se analizaron 61 documentos luego de una búsqueda realizada hasta octubre de 2019. Resultados: ocurrieron cuatro períodos temporales de cambios contextuales desde el surgimiento de ideas de una sistematización en la década de 1960. Esta primera duró hasta 1990. Le siguieron las de 1990 a 2002, de 2002 a 2009 y de 2009 en adelante. Se identificó madurez conceptual parcial, operacionalización a lo largo de los años, a partir de múltiples definiciones, y, actualmente, un concepto de Sistematización de la Atención de Enfermería con atributos gerenciales y organizativo. Conclusiones: el concepto de Sistematización de la Atención de Enfermería está parcialmente maduro, tiene múltiples definiciones y se operativiza en conexiones inciertas con otros conceptos.

RESUMO Objetivos: analisar o amadurecimento conceitual de Sistematização da Assistência de Enfermagem na perspectiva da utilidade pragmática. Métodos: estudo de análise de conceito. As etapas foram: selecionar o conceito; elaborar questões analíticas; revisar a literatura de modo abrangente; e determinar componentes estruturais do conceito. Foram analisados 61 documentos após busca realizada até outubro de 2019. Resultados: quatro períodos temporais de mudanças contextuais ocorreram desde o surgimento das ideias de uma sistematização nos anos de 1960. Esse primeiro perdurou até 1990. Foi seguido pelos de 1990 a 2002, de 2002 a 2009 e a partir de 2009. Foi identificada parcial maturidade conceitual, operacionalização ao longo dos anos, com base em múltiplas definições, e, atualmente, um conceito de Sistematização da Assistência de Enfermagem com atributos gerenciais e organizativos. Conclusões: o conceito de Sistematização da Assistência de Enfermagem é parcialmente maduro, apresenta múltiplas definições, sendo operacionalizado em ligações incertas com outros conceitos.

Validation of the Adolescent Barriers Questionnaire for use in Brazilian adolescents with cancer

Abstract Objective To translate, culturally adapt, and evaluate the psychometric properties of Adolescent Barriers Questionnaire for use in Brazilian adolescents with cancer aged 12 to 18 years, based on the original American Adolescent Barriers Questionnaire which was designed to measure the extent to which adolescents with cancer have concerns about reporting pain and using analgesics. Methods The study analyzed the psychometric properties reliability (internal consistency and test-retest) and validity (known groups and convergent) of Adolescent Barriers Questionnaire in adolescents between 12 and 18 years of age with a diagnosis of cancer who were using or who had used analgesic medication (opioid or not) in a pediatric public health institution. It was estimated 64 adolescents as sample size and the research was conclude with 48. Results Results of pre-test suggest good understanding (content validity index > 0.9). The internal consistency value Cronbach's α was 88%. The convergent validity values ranged between -0.400 and -0.450. Analysis of known groups showed that the instrument discriminated groups of patients with solid vs. hematologic tumors. The intraclass correlation coefficient obtained after retest was 0.863. Conclusion After the process of translations, validations and analysis of psychometric properties, the Brazilian Portuguese version of Adolescent Barriers Questionnaire could be considered culturally adapted, valid, and reliable for the Brazilian adolescent population with cancer aged 12 to 18 years and it can be useful in practical clinic, offering the health professionals the opportunity to understand which barriers the adolescent with cancer can encounter and offer, thus, all the support to overcome them.

Dengue Virus Serotype 2 Intrahost Diversity in Patients with Different Clinical Outcomes.

Intrahost genetic diversity is thought to facilitate arbovirus adaptation to changing environments and hosts, and it might also be linked to viral pathogenesis. Dengue virus serotype 2 (DENV-2) has circulated in Brazil since 1990 and is associated with severe disease and explosive outbreaks. Intending to shed light on the viral determinants for severe dengue pathogenesis, we sought to analyze the DENV-2 intrahost genetic diversity in 68 patient cases clinically classified as dengue fever (n = 31), dengue with warning signs (n = 19), and severe dengue (n = 18). Unlike previous DENV intrahost diversity studies whose approaches employed PCR, here we performed viral whole-genome deep sequencing from clinical samples with an amplicon-free approach, representing the real intrahost diversity scenario. Striking differences were detected in the viral population structure between the three clinical categories, which appear to be driven mainly by different infection times and selection pressures, rather than being linked with the clinical outcome itself. Diversity in the NS2B gene, however, showed to be constrained, irrespective of clinical outcome and infection time. Finally, 385 non-synonymous intrahost single-nucleotide variants located along the viral polyprotein, plus variants located in the untranslated regions, were consistently identified among the samples. Of them, 124 were exclusively or highly detected among cases with warning signs and among severe cases. However, there was no variant that by itself appeared to characterize the cases of greater severity, either due to its low intrahost frequency or the conservative effect on amino acid substitution. Although further studies are necessary to determine their real effect on viral proteins, this heightens the possibility of epistatic interactions. The present analysis represents an initial effort to correlate DENV-2 genetic diversity to its pathogenic potential and thus contribute to understanding the virus's dynamics within its human host.

Validation of the Adolescent Barriers Questionnaire for use in Brazilian adolescents with cancer.

OBJECTIVE: To translate, culturally adapt, and evaluate the psychometric properties of Adolescent Barriers Questionnaire for use in Brazilian adolescents with cancer aged 12 to 18 years, based on the original American Adolescent Barriers Questionnaire which was designed to measure the extent to which adolescents with cancer have concerns about reporting pain and using analgesics. METHODS: The study analyzed the psychometric properties reliability (internal consistency and test-retest) and validity (known groups and convergent) of Adolescent Barriers Questionnaire in adolescents between 12 and 18 years of age with a diagnosis of cancer who were using or who had used analgesic medication (opioid or not) in a pediatric public health institution. It was estimated 64 adolescents as sample size and the research was conclude with 48. RESULTS: Results of pre-test suggest good understanding (content validity index >0.9). The internal consistency value Cronbach's α was 88%. The convergent validity values ranged between -0.400 and -0.450. Analysis of known groups showed that the instrument discriminated groups of patients with solid vs. hematologic tumors. The intraclass correlation coefficient obtained after retest was 0.863. CONCLUSION: After the process of translations, validations and analysis of psychometric properties, the Brazilian Portuguese version of Adolescent Barriers Questionnaire could be considered culturally adapted, valid, and reliable for the Brazilian adolescent population with cancer aged 12 to 18 years and it can be useful in practical clinic, offering the health professionals the opportunity to understand which barriers the adolescent with cancer can encounter and offer, thus, all the support to overcome them.

Evidence of nursing patterns of knowing communicated by the brazilian press before Florence Nightingale's model.

OBJECTIVE: to identify evidence of nursing patterns of knowing disseminated by the Brazilian press before the implementation of Florence Nightingale's model in Brazil and categorize topics of journalistic articles according to Carper's and White's patterns of knowing. METHODS: categorical content analysis of materials related to Florence Nightingale, published in Brazil between 1850 and 1919, collected at Hemeroteca Digital. Four analysts identified themes of journalistic article, performing classification in patterns of knowing. RESULTS: there was a predominance of evidence of the sociopolitical pattern followed by the empirical pattern. In the analyses per decade, ethical and aesthetic patterns showed predominance between 1860 and 1870, respectively. CONCLUSION: White's classification by nursing patterns of knowing was useful in understanding precursor themes of professional/disciplinary knowledge that spread in Brazil, linked to Nightingale's character, in addition to the repercussions of her actions and her expanded sociopolitical perspective.

Association between Tooth Loss and Stroke: A Systematic Review.

This systematic review aims to evaluate the association between tooth loss and stroke. The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines were followed. The PECO strategy was used to limit the eligibility criteria. The following databases were used on searches: PubMed, Scopus, Web of Science, The Cochrane Library, LILACS and OpenGrey. We included observational studies performed in adults (Population), in which patients with tooth loss (Exposition) and patients without tooth loss (Comparison) were observed to investigate the association between tooth loss and stroke (Outcome). After searches, the results were submitted to a selection process, followed by data extraction, quality assessment and risk of bias evaluation. The certainty of the evidence was evaluated through GRADE approach. A total of 925 potential studies were retrieved by the searches and 9 were included in this review. Seven of the included articles described an association between tooth loss and stroke. Low risk of bias and a low certainty of the evidence were identified to all studies. The certainty of the evidence may be associated with the observational nature of the included studies. Even though an association between tooth loss and stroke was suggested, the low strength of the current evidence indicated the need for further investigations with a better methodological design to conclude this question.

Evidence of nursing patterns of knowing communicated by the brazilian press before Florence Nightingale's model / Indicaciones de normas de conocimiento de enfermería comunicadas por la prensa brasileña antes del modelo de Florence Nightingale / Indícios de padrões de conhecimento de enfermagem comunicados pela imprensa brasileira antes do modelo nightingaleano

ABSTRACT Objective: to identify evidence of nursing patterns of knowing disseminated by the Brazilian press before the implementation of Florence Nightingale's model in Brazil and categorize topics of journalistic articles according to Carper's and White's patterns of knowing. Methods: categorical content analysis of materials related to Florence Nightingale, published in Brazil between 1850 and 1919, collected at Hemeroteca Digital. Four analysts identified themes of journalistic article, performing classification in patterns of knowing. Results: there was a predominance of evidence of the sociopolitical pattern followed by the empirical pattern. In the analyses per decade, ethical and aesthetic patterns showed predominance between 1860 and 1870, respectively. Conclusion: White's classification by nursing patterns of knowing was useful in understanding precursor themes of professional/disciplinary knowledge that spread in Brazil, linked to Nightingale's character, in addition to the repercussions of her actions and her expanded sociopolitical perspective.

RESUMEN Objetivo: identificar evidencia de los estándares de conocimiento de enfermería difundidos por la prensa brasileña antes de la implementación del modelo nocturno en Brasil y categorizar temas en artículos de noticias de acuerdo com los estándares de conocimiento de Carper y White. Métodos: elanálisisdelcontenido categórico de artículos alusivos a Florence Nightingale, publicados en Brasil entre 1850 y 1919, recopilados enla Hemeroteca Digital. Cuatro analistas identificaron evidencia temática de los artículos, classificando los de acuerdoconlosestándares de conocimiento. Resultados: predominaba la evidencia del patrón sociopolítico seguido del empírico. Em las análisis por década, los estándares éticos y estéticos mostraron predominio entre 1860 y 1870, respectivamente. Conclusión: la clasificación de White según los estándares de conocimiento de enfermeira fue útil para compreender los temas precursores del conocimiento professional / disciplinario, que se extendió en Brasil, vinculado al carácter de Nightingale, además de las repercusiones de sus acciones y suvisión sociopolítica más amplia.

RESUMO Objetivo: identificar indícios de padrões de conhecimento da enfermagem difundidos pela imprensa brasileira antes da implantação do modelo nightigaleano no Brasil, e categorizar temas das matérias jornalísticas em função dos padrões de conhecimento de Carper e de White. Métodos: análise de conteúdo categorial de matérias alusivas a Florence Nightingale, publicadas no Brasil entre os anos de 1850 e 1919, coletados na Hemeroteca Digital. Quatro analistas identificaram indícios temáticos das matérias, realizando a classificação em padrões de conhecimento. Resultados: verificou-se a predominância de indícios do padrão sociopolítico seguido do empírico. Nas análises por década, os padrões ético e estético demonstraram predominância entre 1860 e 1870, respectivamente. Conclusão: a classificação por padrões de conhecimento de enfermagem de White foi útil no entendimento de temas precursores do conhecimento profissional/disciplinar, que se difundiram no Brasil, ligados ao caráter de Nightingale, além das repercussões de suas ações e a sua visão sócio-política ampliada.

Criação de Acervo Documental sobre acontecimentos no Ano Internacional da Enfermeira e Obstetrizes (2020) / Creación de Acervo Documental sobre eventos en el Año Internacional de los Profesionales de Enfermería y Obstetricia (2020): relato de experiencia / Creation of a Documentary Collection on events in the International Year of the Nurse and Midwives (2020): experience report

Este artigo descreve a estratégia da equipe de um projeto de extensão em História da Enfermagem para a manutenção de atividades durante a pandemia da COVID-19 e seus resultados. Seis estudantes extensionistas foram distribuídos em dois grupos para buscar fontes de informação na internet sobre os temas: atuação da enfermagem frente a COVID-19 e bicentenário de Florence Nightingale e fazer sua catalogação. O resultado foi a criação de dois acervos digitais: Enfermagem na COVID-19 e Bicentenário de Florence Nightingale, com 136 e 56 documentos, respectivamente, entre reportagens, charges, desenhos, fotografi as, vídeos e registros de eventos nacionais e internacionais. Conclusão: Foi possível estabelecer atividades extensionista durante a pandemia, preparar fontes de informação para montar acervos históricos. Com isso, os estudantes continuaram no processo de ensino-aprendizagem na universidade, mesmo com as atividades presenciais suspensas.

This article describes the team's strategy of an extension project in the History of Nursing for the maintenance of activities during the COVID-19 pandemic and its results. Six extension students were distributed in two groups to search for information sources on the internet on the themes: nursing performance in the face of COVID-19 and Florence Nightingale's bicentenary and cataloging it. The result was the creation of two digital collections: Nursing at COVID-19 and Bicentennial of Florence Nightingale, with 136 and 56 documents, respectively, among reports, cartoons, drawings, photographs, videos and records of national and international events. Conclusion: It was possible to establish extension activities during the pandemic, to prepare sources of information to set up historical collections. With that, the students continued in the teaching-learning process at the university, even with the on-site activities suspended.

Este artículo describe la estrategia del equipo de un proyecto de extensión en Historia de la Enfermería para la manutención de actividades durante la pandemia de COVID-19 y sus resultados. Seis estudiantes extensionistas fueron repartidos en dos grupos para buscar fuentes de informaciones en la internet sobre los temas: actuación de la enfermería frente a COVID-19 y bicentenario de Florence Nightingale, y hacer su catalogación. El resultado fue la creación de dos acervos digitales: Enfermería en COVID-19 y Bicentenario de Florence Nightingale, con 136 y 56 documentos, respectivamente, entre reportajes, caricaturas, dibujos, fotografías, videos y registros de eventos nacionales e internacionales. Conclusión: Fue posible establecer actividades extensionistas durante la pandemia, preparar fuentes de información para montar acervos históricos, aunque las actividades presenciales estuviesen suspendidas.

A Influenza Espanhola / The Spanish Influenza

A publicação do jornal O Paiz, na edição nº 12.424 de uma quarta-feira, 16 de outubro de 1918, trazia a epidemia de gripe espanhola como assunto aos seus leitores cariocas. Mesmo com o assunto da Guerra que atingia o Continente Europeu em voga, O Paiz fez destaque ao tema, ocupando cerca de 70% de uma página de jornal, que no todo continha apenas 8 páginas. A Influenza Espanhola ou "Gripe" assolou a capital do Brasil, a época o Rio de Janeiro, no início do século XX, e rapidamente tornou-se um caso de Saúde Pública a ser solucionado.

Convulsoterapias na prática psiquiátrica brasileira / Convulsive therapy in Brazilian psychiatric practice / Convulsoterapia en la práctica psiquiátrica brasileña

Contexto: Nas décadas de 1920-40, a psiquiatria tradicional no Brasil apostava na prática de convulsoterapias como tratamento inovador para reduzir sintomas das doenças mentais. Objetivo: Analisar as técnicas de aplicação de convulsoterapias em dois periódicos médicos. Metodologia: Estudo documental, qualitativo, cujas fontes históricas foram os Arquivos Brasileiros de Neurologia e Psiquiatria (ABNP) e os Anais do Instituto de Psiquiatria (IPUB) de 1928 a 1947. Para análise crítica foi feita a triangulação dos dados e organização temática. Resultados: Foram encontradas 27 publicações em ambos os periódicos. As publicações encontradas foram agrupadas de acordo com as técnicas utilizadas [choque cardiazólico (14); malarioterapia (5); choque insulínico (4); choque cardiazólico associado ao choque insulínico (2); eletroconvulsoterapia (1); choque cardiazólico associado a eletroconvulsoterapia (1)]. Conclusão: Os periódicos pesquisados contribuíam para a difusão do desenvolvimento científico sobre as terapias biológicas, publicando estudos que norteavam a sua aplicação, visando estabelecer um sentido entre as doenças mentais, os seus sintomas e os efeitos de cada uma das técnicas convulsivas de tratamento, sem mencionar explicitamente a participação da enfermagem.

Context: From 1920 to 40, traditional psychiatry in Brazil focuses on convulsive practices as an innovative treatment to reduce symptoms of mental illness. Objective: To analyze the techniques of application of convulsive therapies disclosed in two major medical journals. Methodology: Documental study, with a qualitative approach. The historical sources were the Brazilian Archives of Neurology and Psychiatry (ABNP) and the Annals of the Institute of Psychiatry (IPUB) from 1928 to 1947. Critical analysis was based on data triangulation and thematic organization. Results: Twenty-seven publications were found in both journals. The publications were gathered in groups according to the techniques used [cardiazolic shock (14); malariotherapy (5); insulin shock (4); cardiazolic shock associated with insulin shock (2); electroconvulsive therapy (1); cardiazolic shock associated with electroconvulsive therapy (1)]. Conclusion: The journals had contributed to the dissemination of scientific development on the biological therapies, with the publishing of studies to guide their implementation. They aimed to establish correlations between mental illnesses, their symptoms, and the effects of each convulsive treatment technique, without any explicit reference to the participation of nursing professionals.

Marco contextual: En las décadas de 1920-40, la psiquiatría tradicional en Brasil apostaba por la práctica de la convulsoterapia como tratamiento innovador para reducir los síntomas de las enfermedades mentales. Objetivo: Analizar las técnicas de aplicación de la convulsoterapia en dos fuentes médicas. Metodología: Estudio documental, cualitativo, cuyas fuentes históricas fueron los Archivos Brasileños de Neurología y Psiquiatría (ABNP) y los Anales del Instituto de Psiquiatría (IPUB) de 1928 a 1947. Para el análisis crítico se realizó la triangulación de los datos y la organización temática. Resultados: Se encontraron 27 publicaciones en ambas fuentes. Las publicaciones encontradas se agruparon de acuerdo con las técnicas utilizadas: choque cardiazólico (14); malarioterapia (5); choque insulínico (4) [choque cardiazólico asociado al choque insulínico (2); electroconvulsoterapia (1); choque cardiazólico asociado a la electroconvulsoterapia (1)]. Conclusión: Las fuentes utilizadas contribuyeron a difundir el desarrollo científico sobre las terapias biológicas, así como a publicar estudios que orientaban su aplicación con el objetivo de establecer un sentido entre las enfermedades mentales, sus síntomas y los efectos de cada una de las técnicas convulsivas de tratamiento, sin mencionar explícitamente la participación de la enfermería.

Host susceptibility to Brucella abortus infection is more pronounced in IFN-γ knockout than IL-12/ß2-microglobulin double-deficient mice.

Brucella abortus is a facultative intracellular bacterial pathogen that causes abortion in domestic animals and undulant fever in humans. IFN-γ, IL-12, and CD8+ T lymphocytes are important components of host immune responses against B. abortus. Herein, IFN-γ and IL-12/ß2-microglobulin (ß2-m) knockout mice were used to determine whether CD8+ T cells and IL-12-dependent IFN-γ deficiency would be more critical to control B. abortus infection compared to the lack of endogenous IFN-γ. At 1 week after infection, IFN-γ KO and IL-12/ß2-m KO mice showed increased numbers of bacterial load in spleens; however, at 3 weeks postinfection (p.i.), only IFN-γ KO succumbed to Brucella. All IFN-γ KO had died at 16 days p.i. whereas death within the IL-12/ß2-m KO group was delayed and occurred at 32 days until 47 days postinfection. Susceptibility of IL-12/ß2-m KO animals to Brucella was associated to undetectable levels of IFN-γ in mouse splenocytes and inability of these cells to lyse Brucella-infected macrophages. However, the lack of endogenous IFN-γ was found to be more important to control brucellosis than CD8+ T cells and IL-12-dependent IFN-γ deficiencies.

Interleukin-1 receptor-associated kinase 4 is essential for initial host control of Brucella abortus infection.

Brucella abortus is a facultative intracellular bacterial pathogen that causes abortion in domestic animals and undulant fever in humans. Recent studies have revealed that Toll-like receptor (TLR)-initiated immune response to Brucella spp. depends on myeloid differentiation factor 88 (MyD88) signaling. Therefore, we decided to study the role of the interleukin-1 receptor-associated kinase 4 (IRAK-4) in host innate immune response against B. abortus. After Brucella infection, it was shown that the number of CFU in IRAK-4(-/-) mice was high compared to that in IRAK-4(+/-) animals only at 1 week postinfection. At 3 and 6 weeks postinfection, IRAK-4(-/-) mice were able to control the infection similarly to heterozygous animals. Furthermore, the type 1 cytokine profile was evaluated. IRAK-4(-/-) mice showed lower production of systemic interleukin-12 (IL-12) and gamma interferon (IFN-γ). Additionally, a reduced percentage of CD4(+) and CD8(+) T cells expressing IFN-γ was observed compared to IRAK-4(+/-). Further, the production of IL-12 and tumor necrosis factor alpha (TNF-α) by macrophages and dendritic cells from IRAK-4(-/-) mice was abolished at 24 h after stimulation with B. abortus. To investigate the role of IRAK-4 in mitogen-activated protein kinase (MAPK) and NF-κB signaling pathways, macrophages were stimulated with B. abortus, and the signaling components were analyzed by protein phosphorylation. Extracellular signal-regulated kinase 1 (ERK1) and ERK2 and p38 as well as p65 NF-κB phosphorylation was profoundly impaired in IRAK-4(-/-) and MyD88(-/-) macrophages activated by Brucella. In summary, the results shown in this study demonstrated that IRAK-4 is critical to trigger the initial immune response against B. abortus but not at later phases of infection.