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Aims: To assess the impact of the COVID-19 pandemic on the health condition of people ≥75 years of age and on their family caregivers in Spain. Design: Multicentric, mixed method concurrent study. Methods: This work, which will be conducted within the primary care setting in 11 administrative regions of Spain, will include three coordinated studies with different methodologies. The first is a population-based cohort study that will use real-life data to analyze the rates and evolution of health needs, care provision, and services utilization before, during, and after the pandemic. The second is a prospective cohort study with 18 months of follow-up that will evaluate the impact of COVID-19 disease on mortality, frailty, functional and cognitive capacity, and quality of life of the participants. Finally, the third will be a qualitative study with a critical social approach to understand and interpret the social, political, and economic dimensions associated with the use of health services during the pandemic. We have followed the SPIRIT Checklist to address trial protocol and related documents. This research is being funded by the Instituto de Salud Carlos III since 2021 and was approved by its ethics committee (June 2022). Discussion: The study findings will reveal the long-term impact of the COVID-19 pandemic on the older adults and their caregivers. This information will serve policymakers to adapt health policies to the needs of this population in situations of maximum stress, such as that produced by the COVID-19 pandemic. Trial Registration: Identifier: NCT05249868 [ClinicalTrials.gov].
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COVID-19 , Autocuidado , Humanos , COVID-19/epidemiologia , Espanha/epidemiologia , Idoso , Estudos Prospectivos , Cuidadores/estatística & dados numéricos , Cuidadores/psicologia , Feminino , Idoso de 80 Anos ou mais , Qualidade de Vida , Masculino , Nível de Saúde , SARS-CoV-2 , Pandemias , Atenção Primária à Saúde/estatística & dados numéricosRESUMO
This paper aims to bring reflections and notes for strengthening Brazilian structuring public policies, focusing on Popular Health Education in the Unified Health System (SUS) from the perspectives built in the Observatory of Popular Health Education and the Brazilian Reality. The Observatory is a valuable space for sharing health professionals' and popular educators' interpretations and experiences about local and Brazilian realities from the perspective of Popular Health Education. During its two years of activity, the Observatory has gathered summary interpretations of Popular Health Education for the crises that traverse the country's recent history in a dialogical and participatory way. In a panoramic view, the shared statements point to challenges for valuing the human approach to health promotion, including respecting local and community knowledge and social practices. Moreover, we underscore the importance of social participation in constructing participatory social processes in public health toward citizen autonomy and expanded democratic dynamics in the Brazilian State and its social equipment.
Este trabalho se propõe a trazer reflexões e apontamentos para o fortalecimento de políticas públicas estruturantes no Brasil, com foco na Educação Popular em Saúde no Sistema Único de Saúde (SUS), a partir das perspectivas construídas no Observatório de Educação Popular em Saúde e Realidade Brasileira. O Observatório é um espaço profícuo para o compartilhamento de interpretações e experiências de profissionais de saúde e educadores populares sobre a realidade local e realidade brasileira, a partir da ótica da Educação Popular em Saúde. De forma dialógica e participativa, ao longo de seus 2 anos de atividade, o Observatório foi capaz de reunir interpretações sintéticas da Educação Popular em Saúde para as crises que atravessam a história recente do país. De maneira panorâmica, as falas compartilhadas apontam desafios para valorização da abordagem humana na promoção da saúde, com a inclusão e o respeito aos saberes e práticas sociais locais e comunitárias. Além disso, destaca-se a importância da participação social na construção de processos sociais participativos na saúde pública, visando à autonomia do cidadão e à ampliação da dinâmica democrática no Estado brasileiro e em seus equipamentos sociais.
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Educação em Saúde , Política de Saúde , Promoção da Saúde , Saúde Pública , Brasil , Humanos , Educação em Saúde/métodos , Promoção da Saúde/métodos , Saúde Pública/educação , Programas Nacionais de Saúde/organização & administração , Política Pública , Atenção à Saúde/organização & administração , Participação Social , Participação da Comunidade/métodosRESUMO
This narrative review aims to analyze the literature on Collective Health to recognize what has been discussed in Popular Health Education (PHE) from 2019 to 2022. Fifty-nine articles were selected, critically analyzed, and separated into six summary categories: popular education practices as promoters of a participatory vision of health; popular education and the valorization of local popular culture knowledge and practices; popular health education as a strategy to support social reconstruction in the face of setbacks in public policies; the importance of national articulation in popular education as a response to its devaluation; popular education as a liberating project thinking about the democratic formation and the fight against institutional and structural violence; popular education in the university health training process. We achieved significant results that elucidate the importance of PHE within the Unified Health System and the academic education of health professionals, fostering respect for ancestral knowledge and care horizontality. We also reaffirm the need for national articulation and dialogue with grassroots movements to advance Brazil's emancipatory and dignifying health agenda.
Esta revisão narrativa tem por objetivo analisar a literatura no âmbito da Saúde Coletiva no intento de reconhecer o que se tem discutido em Educação Popular em Saúde (EPS) entre 2019 e 2022. Após busca, 59 artigos foram selecionados, analisados criticamente e separados em seis categorias-síntese: as práticas de educação popular como promotoras de uma visão participativa da saúde; educação popular e a valorização dos saberes e práticas da cultura popular local; a educação popular em saúde como estratégia de apoio à reconstrução social ante aos retrocessos nas políticas públicas; a importância da articulação nacional em educação popular como resposta à sua desvalorização; a educação popular como projeto libertador pensando a formação democrática e luta contra violências institucionais e estruturais; educação popular no processo de formação universitária em saúde. Pôde-se obter importantes resultados que elucidam a importância da EPS no contexto do Sistema Único de Saúde e na formação acadêmica de profissionais da saúde, favorecendo o respeito aos saberes ancestrais e a horizontalidade do cuidado. Ainda, reafirma-se a necessidade de articulação nacional e dialogada com os movimentos populares para o avanço de uma agenda emancipadora e dignificante da saúde no Brasil.
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Educação em Saúde , Humanos , Brasil , Educação em Saúde/métodos , Política Pública , Pessoal de Saúde/educação , Programas Nacionais de Saúde/organização & administração , Atenção à Saúde/organização & administração , Saúde Pública/educação , Política de SaúdeRESUMO
Resumo Este trabalho se propõe a trazer reflexões e apontamentos para o fortalecimento de políticas públicas estruturantes no Brasil, com foco na Educação Popular em Saúde no Sistema Único de Saúde (SUS), a partir das perspectivas construídas no Observatório de Educação Popular em Saúde e Realidade Brasileira. O Observatório é um espaço profícuo para o compartilhamento de interpretações e experiências de profissionais de saúde e educadores populares sobre a realidade local e realidade brasileira, a partir da ótica da Educação Popular em Saúde. De forma dialógica e participativa, ao longo de seus 2 anos de atividade, o Observatório foi capaz de reunir interpretações sintéticas da Educação Popular em Saúde para as crises que atravessam a história recente do país. De maneira panorâmica, as falas compartilhadas apontam desafios para valorização da abordagem humana na promoção da saúde, com a inclusão e o respeito aos saberes e práticas sociais locais e comunitárias. Além disso, destaca-se a importância da participação social na construção de processos sociais participativos na saúde pública, visando à autonomia do cidadão e à ampliação da dinâmica democrática no Estado brasileiro e em seus equipamentos sociais.
Abstract This paper aims to bring reflections and notes for strengthening Brazilian structuring public policies, focusing on Popular Health Education in the Unified Health System (SUS) from the perspectives built in the Observatory of Popular Health Education and the Brazilian Reality. The Observatory is a valuable space for sharing health professionals' and popular educators' interpretations and experiences about local and Brazilian realities from the perspective of Popular Health Education. During its two years of activity, the Observatory has gathered summary interpretations of Popular Health Education for the crises that traverse the country's recent history in a dialogical and participatory way. In a panoramic view, the shared statements point to challenges for valuing the human approach to health promotion, including respecting local and community knowledge and social practices. Moreover, we underscore the importance of social participation in constructing participatory social processes in public health toward citizen autonomy and expanded democratic dynamics in the Brazilian State and its social equipment.
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Resumo Esta revisão narrativa tem por objetivo analisar a literatura no âmbito da Saúde Coletiva no intento de reconhecer o que se tem discutido em Educação Popular em Saúde (EPS) entre 2019 e 2022. Após busca, 59 artigos foram selecionados, analisados criticamente e separados em seis categorias-síntese: as práticas de educação popular como promotoras de uma visão participativa da saúde; educação popular e a valorização dos saberes e práticas da cultura popular local; a educação popular em saúde como estratégia de apoio à reconstrução social ante aos retrocessos nas políticas públicas; a importância da articulação nacional em educação popular como resposta à sua desvalorização; a educação popular como projeto libertador pensando a formação democrática e luta contra violências institucionais e estruturais; educação popular no processo de formação universitária em saúde. Pôde-se obter importantes resultados que elucidam a importância da EPS no contexto do Sistema Único de Saúde e na formação acadêmica de profissionais da saúde, favorecendo o respeito aos saberes ancestrais e a horizontalidade do cuidado. Ainda, reafirma-se a necessidade de articulação nacional e dialogada com os movimentos populares para o avanço de uma agenda emancipadora e dignificante da saúde no Brasil.
Abstract This narrative review aims to analyze the literature on Collective Health to recognize what has been discussed in Popular Health Education (PHE) from 2019 to 2022. Fifty-nine articles were selected, critically analyzed, and separated into six summary categories: popular education practices as promoters of a participatory vision of health; popular education and the valorization of local popular culture knowledge and practices; popular health education as a strategy to support social reconstruction in the face of setbacks in public policies; the importance of national articulation in popular education as a response to its devaluation; popular education as a liberating project thinking about the democratic formation and the fight against institutional and structural violence; popular education in the university health training process. We achieved significant results that elucidate the importance of PHE within the Unified Health System and the academic education of health professionals, fostering respect for ancestral knowledge and care horizontality. We also reaffirm the need for national articulation and dialogue with grassroots movements to advance Brazil's emancipatory and dignifying health agenda.
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One of the priorities in family and community care is the epidemiological surveillance of the care needs and dysfunctionality present in populations of highly complex chronic patients (HCCPs) using standardised nursing languages. The aim of this study is to establish the prevalence of care needs and dysfunctionality among HCCPs in a specific health area by municipalities and geographical areas (metropolitan, north, and south) while verifying correlations with sociodemographic, financial, and health characteristics. This is an epidemiological, observational, descriptive, cross-sectional study carried out with a sample of 51,374 HCCPs, whose data were grouped into 31 municipalities. Data were collected on the following variables: sociodemographic, financial, health, functional status (health patterns), and care needs (nursing diagnoses). The mean age of the HCCPs was 73.41 (1.45) years, of which 56.18 (2.86)% were women. The municipalities in the northern area have a significantly higher proportion of older patients, HCCPs, lower incomes, and higher unemployment rates. The southern area had higher proportions of non-Spanish nationals and professionals in the hotel and catering industry, and the metropolitan area had a higher proportion of employed individuals and higher levels of education. Northern municipalities had a higher prevalence of illnesses and anxiolytic and anti-psychotic treatments. Dysfunctionality frequencies did not differ significantly by area. However, a higher prevalence of 13 nursing diagnoses was observed in the north. A high number of correlations were observed between population characteristics, dysfunctionality, and prevalent diagnoses. Finally, the frequencies of dysfunctionality in the population and the most common care needs were mapped by municipality. This research sought to ascertain whether there was an unequal distribution of these two aspects among HCCPs in order to gain a deeper epidemiological understanding of them from a family and community perspective using standardised nursing languages. This study was not registered.
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The prevalence of gastric disorders in high-performance horses, especially gastric ulceration, ranges from 50 to 90%. These pathological conditions have negative impacts on athletic performance and health. This study was designed to evaluate changes in gastric pH during a 24 h period and to compare gastrin concentrations at different time points in horses undergoing general inhalation anesthesia and dorsal recumbency. Twenty-two mixed-breed mares weighing 400 ± 50 kg and aged 8 ± 2 years were used. Of these, eight were fasted for 8 h and submitted to 90 min of general inhalation anesthesia in dorsal recumbency. Gastric juice samples were collected prior to anesthesia (T0), and then at 15 min intervals during anesthesia (T15-T90). After recovery from anesthesia (45 ± 1 min), samples were collected every hour for 24 h (T1 to T24) for gastric juice pH measurement. During this period, mares had free access to Bermuda grass hay and water and were fed a commercial concentrate twice (T4 and T16). In a second group (control), four non-anesthetized mares were submitted to 8 h of fasting followed by nasogastric intubation. Gastric juice samples were then collected at T0, T15, T30, T45, T60, T75, and T90. During this period, mares did not receive food or water. After 45 min, mares had free access to Bermuda grass hay and water, and gastric juice samples were collected every hour for four hours (T1 to T4). In a third group comprising ten non-fasted, non-anesthetized mares with free access to Bermuda grass hay and water, gastric juice samples were collected 30 min after concentrate intake (T0). In anesthetized mares, blood gastrin levels were measured prior to anesthesia (8 h fasting; baseline), during recovery from anesthesia, and 4 months after the anesthetic procedure, 90 min after the morning meal. Mean values of gastric juice pH remained acidic during general anesthesia. Mean pH values were within the physiological range (4.52 ± 1.69) and did not differ significantly between time points (T15-T90; p > 0.05). After recovery from anesthesia, mean gastric pH values increased and remained in the alkaline range throughout the 24 h period of evaluation. Significant differences were observed between T0 (4.88 ± 2.38), T5 (7.08 ± 0.89), T8 (7.43 ± 0.22), T9 (7.28 ± 0.36), T11 (7.26 ± 0.71), T13 (6.74 ± 0.90), and T17 (6.94 ± 1.04) (p < 0.05). The mean gastric juice pH ranged from weakly acidic to neutral or weakly alkaline in all groups, regardless of food and water intake (i.e., in the fasted, non-fasted, and fed states). Mean gastric pH measured in the control group did not differ from values measured during the 24 h post-anesthesia period or in the non-fasted group. Gastrin concentrations increased significantly during the post-anesthetic period compared to baseline (20.15 ± 7.65 pg/mL and 15.15 ± 3.82 pg/mL respectively; p < 0.05). General inhalation anesthesia and dorsal recumbency did not affect gastric juice pH, which remained acidic and within the physiological range. Gastric juice pH was weakly alkaline after recovery from anesthesia and in the fasted and fed states. Serum gastrin levels increased in response to general inhalation anesthesia in dorsal recumbency and were not influenced by fasting. Preventive pharmacological measures are not required in horses submitted to general anesthesia and dorsal recumbency.
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Introduction: Surgical intervention is the treatment of choice in patients with urachal carcinoma. Due to complications and to reduce hospital stay from open surgery, minimally invasive approaches are desirable. Nowadays, robotic-assisted surgery has become increasingly popular, and robot-assisted cystectomy can be performed in patients with urachal carcinoma with low complication rates. Methods: We performed a systematic review to search for studies that evaluated patients who underwent robotic-assisted surgery for urachal carcinoma. The outcomes of interest were the type of cystectomy performed, whether there was umbilicus resection, total operative time, console time, intraoperative complications, estimated blood loss, postoperative complications, time of hospitalisation, positive surgical margins and the presence of documented tumour recurrence. Results: In this study, we evaluated three cohorts comprising a total of 21 patients. The median follow-up period ranged from 8 to 40 months. Medium age was between 51 and 54 years, with a majority (63.1%) being male. One patient (5.2%) underwent a radical cystectomy, and 19 patients (94.7%) underwent to partial cystectomy. Umbilical resections were performed in all cases, and pelvic lymphadenectomy in 14 cases (73.6%). Recurrence occurred in three patients at a median of 17 months postoperation, two cases in the trocar insertion site. Additionally, there was one death, which was attributed to postoperative cardiovascular complications. Conclusion: Robotic-assisted partial cystectomy has a low incidence of adverse outcomes in patients with urachal carcinoma. Controlled studies, ideally randomised, are warranted to establish the comparative efficacy and safety of the robotic-assisted cystectomy approach relative to open surgery.
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The MONITOOL project (2017-2023) was carried out to describe the relationships between total dissolved and labile metal concentrations measured in spot water samples and in concurrently deployed Diffusive Gradients in Thin-films (DGTs) passive samplers, respectively. The ultimate aim was to adapt existing marine metal Environmental Quality Standards (EQS marine water) for DGTs, enabling their use in the context of the European Directives (the Water Framework Directive (WFD) and the Marine Strategy Framework Directive (MSFD)). Time-integrated metal concentrations provided by DGTs, representing several days, are an advantage compared to conventional spot sampling, especially in highly dynamic systems, such as transitional waters. Hence, the MONITOOL project aimed to provide a robust database of dissolved and labile metal concentrations in transitional and coastal waters, based upon co-deployments of DGTs and collection of spot water samples at several sampling sites (England, France, Ireland, Italy, Northern Ireland, Portugal, Scotland and Spain), followed subsequently by DGT and water metal analysis. Samplings were carried out in 2018 and 2022, following agreed protocols developed in the framework of the project. The MONITOOL dataset includes metal concentrations from DGTs, measured with Inductively Coupled Plasma Mass Spectrometry (ICP-MS: Cd, Co, Cu, Fe, Mn, Ni, Pb, Zn) and in concurrently collected spot water samples by ICP-MS (Al, Cd, Co, Cu, Mn, Ni, Pb, Zn) and Anodic/Cathodic Stripping Voltammetry (ASV/CSV: Cd, Pb, Ni). Moreover, data on seawater physical-chemical parameters (salinity, temperature, dissolved oxygen, pH, turbidity, total suspended solids, dissolved organic carbon, and total organic carbon) is provided. This database presents the results obtained using, concurrently, different forms of sampling and analytical techniques, enabling the comparison of the results obtained by these strategies and allowing the adaptation of EQS in marine water (EQS marine water) to DGTs (EQS DGT), in the context of the WFD. Moreover, due to the large number of sampling sites, it could also be used for other types of research, such as those dealing with metal speciation or the determination of baseline levels.
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Continuing Bonds among grieving men from Costa Rica and Spain were compared, with the primary hypothesis that there would be significant differences between the two groups. A descriptive, comparative, and cross-sectional research study was conducted. Non-probability and convenience sampling was employed, involving 227 grieving men who completed an online questionnaire comprising sociodemographic data, mediators of mourning, and the Continuing Bonds Scale. The results did not reveal significant differences in Continuing Bonds expressions. However, upon controlling for the interaction between degree of kinship with the deceased person, notable differences emerged in Continuing Bonds and internalized and externalized Continuing Bonds (p < 0.05). The influence of sociocultural factors in each country on Continuing Bonds expressions is considered. The findings could support the development of strategies centered on grieving men, Continuing Bonds, and their specific needs.
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ABSTRACT: Brito, P, Costa, J, Figueiredo, P, and Brito, J. Simulated soccer game protocols: A systematic review on validated protocols that represent the demands of the game. J Strength Cond Res 38(1): 192-205, 2024-Several laboratory and field testing protocols have been developed attempting to simulate the activity pattern and physiological demands of soccer. In the present systematic review, we aimed to analyze and discuss the appropriateness, strengths, and limitations of soccer-specific simulated tests. A systematic review of the literature was conducted based on the PRISMA guidelines. Studies conducted in soccer, simulated soccer match tests, and validated simulation protocols performed on-the-field or on a treadmill were considered. No sex restriction was applied, and age >18 years (i.e., adults) was considered. At least 1 outcome measure (e.g., neuromuscular performance, external load, internal load, or psychometric state) of post-simulated-match test or protocol had to be reported. Within the 14 studies included, the average methodological quality of the included articles was 0.61 ± 0.09 (mean ± SD) of 1. Overall, 9 validated protocols were identified. In the protocols, only amateur, university, or semiprofessional soccer players were analyzed. Only one study evaluated female soccer players. None of the studies evaluated the effect on performance over the 2-3 days after the protocol. Accelerations and decelerations, and changes in direction typically present in a game have not been clearly described in any protocol. Future research should address this issue and validate soccer-specific protocols in women.
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Desempenho Atlético , Corrida , Futebol , Adolescente , Adulto , Feminino , Humanos , Aceleração , Desempenho Atlético/fisiologia , Corrida/fisiologia , Futebol/fisiologiaRESUMO
O texto trata da abordagem teórico-prática da Educação Popular em Saúde (EPS), apresentando reflexões sobre construções possíveis com base nos princípios dessa filosofia. Esse processo de discussão teórica transita pelos processos educativos em saúde; pela capacidade mobilizadora da participação social e promoção de encontros humanos transformadores nos serviços de saúde; e pelas possibilidades para o presente e o futuro do Sistema Único de Saúde (SUS). Tem-se, pois, a importância da participação social nos serviços de saúde, destacando a abordagem comunitária como estratégia para potencializar o trabalho na Atenção Primária à Saúde e dinamizar a promoção e a vigilância em saúde. Desse modo, com os caminhos viabilizados e orientados pela EPS, pode-se contribuir para a construção de práticas mais democráticas e emancipadoras no SUS.
El texto trata del abordaje teórico-práctico de la Educación Popular en Salud (EPS), presentando reflexiones sobre construcciones posibles con base en los principios de esa filosofía. Este proceso de discusión teórica transita por los procesos educativos en salud, por la capacidad movilizadora de la participación social y promoción de encuentros humanos transformadores en los servicios de salud y por las posibilidades para el presente y el futuro del Sistema Brasileño de Salud (SUS). Se ve, por lo tanto, la importancia de la participación social en los servicios de salud, destacando el abordaje comunitario como estrategia para potenciar el trabajo en la Atención Primaria de la Salud y dinamizar la promoción y vigilancia en salud. De ese modo, con los caminos viabilizados y orientados por la EPS es posible contribuir para la construcción de prácticas más democráticas y emancipadoras en el SUS.
The text deals with the theoretical-practical approach of Popular Education in Health (PEH), presenting reflections on possible constructions based on the principles of this philosophy. This process of theoretical discussion covers educational processes in health, the mobilizing capacity of social participation and the promotion of transformative human encounters in health services and the possibilities for the present and future of the Brazilian National Health System (SUS). This highlights the importance of social participation in health services, highlighting the community approach as a strategy to enhance work in Primary Health Care and boost health promotion and surveillance. In this way, the paths made possible and guided by the EPS can contribute to the construction of more democratic and emancipatory practices in the SUS.
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BACKGROUND Lymphocytic myocarditis (LM) is a rare inflammatory disease of the heart. The clinical presentation of LM varies from mild flu-like symptoms to fulminant myocarditis with cardiogenic shock. Fulminant myocarditis has a poor prognosis and the usual treatment is inotropes with or without ventricular assist devices such as intra-aortic balloon pump (IABP) and venoarterial extracorporeal membrane oxygenation (V-A ECMO). We report the case of fulminant LM with severe cardiogenic shock that was successfully treated with concomitant use of IABP and V-A ECMO. CASE REPORT A 32-year-old woman with no medical history presented to the Emergency Department (ED) with chest pain with irradiation to the left upper limb, worse when supine. The electrocardiogram (ECG) on admission showed sinus rhythm with nonspecific ST-T repolarization abnormalities, and laboratory results showed elevated ultrasensitive troponin and C-reactive protein. Transthoracic echocardiography (TTE) showed left ventricular ejection fraction (LVEF) of 25% and diffuse hypokinesis. On the next day, she developed cardiogenic shock requiring vasoactive drugs, IABP, and V-A ECMO. Pulse therapy with methylprednisolone was started. Endomyocardial biopsy (EMB) revealed acute LM, and intravenous human immunoglobulin was administered. The patient evolved with progressive clinical improvement, being discharged 56 days after admission, with an improvement in the LVEF to 55%. CONCLUSIONS Fulminant LM is a rare and potentially fatal condition that requires immediate intervention. The combination of IABP and V-A ECMO among patients with LM-cardiogenic shock may provide survival benefits.
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Oxigenação por Membrana Extracorpórea , Coração Auxiliar , Miocardite , Adulto , Feminino , Humanos , Oxigenação por Membrana Extracorpórea/métodos , Miocardite/complicações , Miocardite/terapia , Choque Cardiogênico/etiologia , Choque Cardiogênico/terapia , Volume Sistólico , Função Ventricular EsquerdaRESUMO
Odonata species live through their immature development in aquatic habitats, where the eggs are adapted to survive the initial stages. The survival of the eggs is linked to the layers that make up the eggshell. These layers are common to all odonate species, but show variations among them, depending on the oviposition method. For example, endophytic eggs (laid in plant tissues) and exophytic eggs (laid on the water surface) have different morphologies, which may reveal egg adaptations to environmental conditions and stresses. The differences in the egg morphologies could be shown in the length of the egg layers, their histochemical composition, and in the ultrastructure. The histochemical composition can reveal several features that could lead us to a better understanding of its function, for example, how glycoproteins and total proteins could regulate the humidity and water retention in the eggs according to the environments in which the eggs are placed.
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Odonatos , Feminino , Animais , Odonatos/fisiologia , Oviposição/fisiologia , Ecossistema , Umidade , ÁguaRESUMO
The decision-making in clinical nursing, regarding diagnoses, interventions and outcomes, can be assessed using standardized language systems such as NANDA International, the Nursing Interventions Classification and the Nursing Outcome Classification; these taxonomies are the most commonly used by nurses in informatized clinical records. The purpose of this review is to synthesize the evidence on the effectiveness of the nursing process with standardized terminology using the NANDA International, the Nursing Interventions Classification and the Nursing Outcome Classification in care practice to assess the association between the presence of the related/risk factors and the clinical decision-making about nursing diagnosis, assessing the effectiveness of nursing interventions and health outcomes, and increasing people's satisfaction. A systematic review was carried out in Medline and PreMedline (OvidSP), Embase (Embase-Elsevier), The Cochrane Library (Wiley), CINAHL (EbscoHOST), SCI-EXPANDED, SSCI and Scielo (WOS), LILACS (Health Virtual Library) and SCOPUS (SCOPUS-Elsevier) and included randomized clinical trials as well as quasi-experimental, cohort and case-control studies. Selection and critical appraisal were conducted by two independent reviewers. The certainty of the evidence was assessed with the Grading of Recommendations Assessment, Development and Evaluation Methodology. A total of 17 studies were included with variability in the level and certainty of evidence. According to the outcomes, 6 studies assessed diagnostic decision-making and 11 assessed improvements in individual health outcomes. No studies assessed improvements in intervention effectiveness or population satisfaction. There is a need to increase studies with rigorous methodologies that address clinical decision-making about nursing diagnoses using NANDA International and individuals' health outcomes using the Nursing Interventions Classification and the Nursing Outcome Classification as well as implementing studies that assess the use of these terminologies for improvements in the effectiveness of nurses' interventions and population satisfaction with the nursing process.
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Introducción: El duelo es una respuesta compleja ante la pérdida de un ser querido que exhibe diferentes rutas para su ajuste, la continuidad de vínculos forma parte de su naturaleza. Objetivo: Analizar la experiencia de duelo por un ser querido en hombres y mujeres relacionada a percepción de cercanía con la persona fallecida, continuidad de vínculos y diagnósticos de Enfermería. Materiales y Métodos: Análisis secundario. Muestra a conveniencia de 251 dolientes, adultos, residentes de Canarias, hispanohablantes. Recolección con encuesta en línea compuesta por características sociodemográficas y de salud, y relacionadas con la pérdida, Escala de inclusión del otro en el yo, Escala de Continuidad de Vínculos y diagnósticos de Enfermería. Se utilizó análisis descriptivo, U de Mann-Whitney, coeficiente de Spearman. Nivel de significancia p<0,05. Resultados: Edad media de 45,09 años ±10,38. Un 22,70% (57) fue hombre, 77,30% (194) mujer. Se identificaron diferencias significativas entre hombres y mujeres en percepción de cercanía con el fallecido (p<0,05), y relaciones significativas entre percepción de cercanía con el fallecido, continuidad de vínculos y diagnósticos de Enfermería (p=0,001). Discusión: Al confrontar los resultados con otros estudios se presentan algunas consistencias y diferencias en el comportamiento de las variables demostrando el dinamismo del fenómeno. Conclusiones: Para este grupo de participantes, la experiencia de duelo no estaría ligada a construcciones sociales de género si no que contesta a una respuesta de afrontamiento según sus necesidades. La comprensión del proceso de duelo permite a la Enfermería de Salud Mental implementar acciones fundamentadas en el Proceso de Enfermería.
Introduction: Grief is a complex response to the loss of a loved one with different ways of adjustment, and Continuing Bonds are part of its nature. Objective: To analyze men's and women's experiences of grief in terms of perception of closeness to the deceased, Continuing Bonds, and Nursing diagnoses. Materials and Methods: Secondary analysis. A convenience sample of 251 Spanish-speaking adult mourners, residents of the Canary Islands, was used. Data was collected via an online survey consisting of socio-demographic, health, and loss-related characteristics, the Inclusion of Other in the Self scale, the Continuing Bonds Scale, and Nursing diagnoses. Descriptive analysis, Mann-Whitney U test, and Spearman's coefficient were used. Level of significance p<0.05. Results: The mean age was 45.09 years ±10.38 years; 22.70% (57) were male, and 77.30% (194) were female. Significant differences were found between men and women in the perception of closeness to the deceased (p<0.05), and significant relationships were found between the perception of closeness to the deceased, Continuing Bonds, and Nursing diagnoses (p=0.001). Discussion: A comparison of the results with other studies shows some consistencies and differences in the behavior of the variables, demonstrating the dynamism of the phenomenon. Conclusions: For this group of participants, the experience of grief would not be linked to social constructions of gender but instead respond to a coping response according to their needs. Understanding the grieving process allows Mental Health Nursing to implement interventions based on the Nursing Process.
Introdução: O luto é uma resposta complexa à perda de um ente querido que apresenta diferentes caminhos de ajustamento, a continuidade dos laços faz parte da sua natureza. Objetivo: Analisar a vivência do luto por um ente querido em homens e mulheres relacionada à percepção de proximidade com a pessoa falecida, continuidade de vínculos e diagnósticos de Enfermagem. Materiais e Métodos: Análise secundária. Amostra para conveniência de 251 enlutados, adultos, residentes nas Ilhas Canárias, falantes de espanhol. Coleção com inquérito online composto por características sociodemográficas e de saúde, e relacionadas à perda, Escala de inclusão do outro no eu, Escala de Continuidade de Vínculos e diagnósticos de Enfermagem. Foram utilizadas análise descritiva, U de Mann-Whitney, coeficiente de Spearman. Nível de significância p<0,05. Resultados: Idade média de 45,09 anos ±10,38. 22,70% (57) eram homens, 77,30% (194) eram mulheres. Foram identificadas diferenças significativas entre homens e mulheres na percepção de proximidade com o falecido (p<0,05), e relações significativas entre percepção de proximidade com o falecido, continuidade de vínculos e diagnósticos de Enfermagem (p=0,001). Discussão: Ao comparar os resultados com outros estudos, apresentam-se algumas consistências e diferenças no comportamento das variáveis, demonstrando o dinamismo do fenômeno. Conclusões: Para este grupo de participantes, a vivência do luto não estaria ligada a construções sociais de género, mas responde a uma resposta de enfrentamento de acordo com as suas necessidades. A compreensão do processo de luto permite à Enfermagem em Saúde Mental implementar ações pautadas no Processo de Enfermagem.
Assuntos
Fechamento Perceptivo , Luto , Pesar , Saúde Mental , EnfermagemRESUMO
Diabetic retinopathy (DR) is one of the complications of diabetes mellitus (DM), with macular oedema being one of the leading causes of avoidable blindness among individuals with DM worldwide. Fundus screening is the only method for early detection and treatment. High-quality training programmes for professionals performing primary care screening are essential to produce high-quality images that facilitate accurate lesion identification. This is a two-phase observational, descriptive, and cross-sectional study. The first phase analysed DR knowledge in a sample of nurses. The second phase explored agreement on DR screening between referral ophthalmologists in image assessment (gold standard) and a small group of nurses involved in the previous phase. In phase 1, the agreement rate for screening results was 90%. In phase 2, the overall raw agreement on the screening of fundus photography results between nurses and ophthalmologists was 75% (Cohen's kappa = 0.477; p < 0.001). Agreement on screening with ophthalmologists was moderate, suggesting that implementing a specific training programme for nurse-led imaging screening would help develop this competence among nurses, ensuring a good level of agreement and patient safety and adding value for users, and also for the sustainability of the healthcare system. This study was not registered.
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RESUMEN Objetivo: Describir el Sobrepeso y obesidad autopercibidos en estudiantes universitarios. Caso: Medicina-Escuela Superior Politécnica de Chimborazo, Ecuador. Metodología: Se empleó el paradigma positivista desde la perspectiva cuantitativa, con un diseño no experimental, el tipo de investigación es de campo y el nivel descriptivo, con aplicación de un cuestionario a un grupo de estudiantes universitarios de Medicina, Escuela Superior Politécnica de Chimborazo, Riobamba, Ecuador; se estructuró un cuestionario con la herramienta Kobotoolbox, misma que contó con un total de 27 preguntas que contenían temas socio demográficos y temas específicos para analizar la presencia de obesidad y sobrepeso. Resultados: Mientras más tiempo de clases más tiempo de pantalla y esto da menos actividad física. Conclusión: Se demuestra que ser sedentario aumenta en 2,8 veces la probabilidad de sufrir sobrepeso, aunque no es determinante, se convierte en un factor de riesgo a ser considerado.
ABSTRACT Objective: To describe self-perceived overweight and obesity in university students. Case Medical School, Ecuador. Methodology: The positivist paradigm was used from the quantitative perspective, with a non-experimental design, the type of research is field and descriptive level application of a questionnaire to a group of university students, a questionnaire was structured with the Kobotoolbox tool, which had a total of 27 questions containing socio demographic issues and specific topics to analyze the presence of obesity and overweight. Results: The more class time, the more screen time, the less physical activity. Conclusion: It is shown that being sedentary increases in 2.8 times the probability of being overweight, although it is not significantly significant, it becomes a risk factor to be considered.
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RESUMEN Objetivo: El objetivo general de la investigación fue describir la evaluación de riesgo suicida en estudiantes universitarios. Metodología: Se realizó una investigación de tipo cuantitativo, no experimental de corte transversal. Dentro de las metas planteadas en este estudio no se contempla la manipulación de las variables a estudiar. El estudio tuvo un alcance descriptivo observacional, teniendo como meta el registro, análisis e interpretación de la naturaleza actual de la población estudiada. Mediante la plataforma Google Forms se envió la encuesta a 77 estudiantes de Medicina, de la Escuela Superior Politécnica de Chimborazo, Ecuador. (ESPOCH). Resultados: Se obtuvo que el 66.66% presenta riesgo suicida bajo, 14.66% riesgo medio y 18.66% corresponde a riesgo alto según la escala de SAD PERSONS. En conclusión: La investigación muestras que la población de estudiantes de Medicina, presenta algún nivel de riesgo suicida. La problemática descrita debe ser profundizada para esclarecer las consecuencias.
ABSTRACT Objective: The general objective of the research was to describe the evaluation of suicidal risk in university students. Methodology: A quantitative, non-experimental, cross-sectional research was carried out; within the goals set out in this study, the manipulation of the variables to be studied was not contemplated. The study had a descriptive observational scope, with the goal of recording, analyzing and interpreting the current nature of the population studied. The survey was sent through the Google Forms platform. The survey was sent to 77 medical students of the Escuela Superior Politécnica de Chimborazo, Ecuador (ESPOCH). Results: It was found that 66.66% presented low suicidal risk, 14.66% medium risk and 18.66% corresponded to high risk according to the SAD PERSONS scale. In conclusion: The research shows that the population of medical students presents some level of suicidal risk. The problem described should be deepened to clarify the consequences.
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Grieving is a natural, self-limiting process of adaptation to a new reality following a significant loss, either real or perceived, with a wide range of manifestations that have an impact on the health of the grieving individual. This study aims to analyse the relationships between interpersonal styles, coping strategies, and psychosocial care needs in a sample of mourners in a rural municipality. Initial hypothesis: there are associations between types of grief and psychosocial needs, as well as between types of grief and interpersonal styles or coping strategies. An observational, descriptive, analytical, cross-sectional study was carried out with a sample of 123 people. Female participants represented 64.2% of all participants. The mean age was 42.7 (±13.2) years, and 86.2% of participants reported continuing to suffer from the loss, with a 10.5% prevalence of maladaptive grieving. Regarding the associations identified between coping strategies and the interpersonal characteristics of the mourners, we found that those with the best coping scores described themselves as self-confident, boastful, jovial, forceful, gentle-hearted, self-assured, outgoing, and/or neighbourly. By contrast, mourners who obtained poorer coping scores self-identified as shy, unsparkling, timid, unsociable, unbold, and/or bashful. This provides a clinical profile linked to maladaptive grieving in which emotional, self-perception, and social problems are prevalent.