Successful strategies for preventing and controlling violence against people with intellectual disabilities: a scoping review.

BACKGROUND: Violence against people with intellectual disabilities is unfortunately a reality all over the world, as they are one of the populations most vulnerable to various forms of aggression. Assertive prevention and control measures are crucial to tackle and reduce this problem. The aim of this study was to map and summarize the main measures for preventing and controlling domestic violence against people with intellectual disabilities.  METHODS: This was a scoping review conducted in accordance with the JBI guidelines. The databases consulted were: National Library of Medicine (PubMed); Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science; Excerpta Medica DataBASE (EMBASE); Latin American and Caribbean Health Sciences Literature (LILACS) and SCOPUS. Studies included in this review reported on strategies to address domestic violence against people with intellectual disabilities, published in  the last ten years, in Portuguese, Spanish or English. RESULTS: A total of 11 studies were included in this review. Six studies had high methodological quality and five had moderate. Cognitive-behavioral intervention programs, educational  technologies and/or auxiliary tools, along with the full participation of people with intellectual disabilities in domestic violence prevention measures are appropriate strategies for dealing with this issue. CONCLUSION: Domestic violence against people with intellectual disabilities is relatively unexplored in the health-field scientific literature. Prevention and control measures should be developed with the active involvement of people with intellectual disabilities, generating engagement and knowledge. Preventive measures should be adapted to the personal context and conditions of individuals with special needs, such as those with persistent or chronic mental disorders.

Oral colonization by Candida spp. in liver transplant patients: Molecular identification and antifungal susceptibilityOral colonization by Candida spp. in liver transplant.

Candida species are commensal to normal oral microbiota; however, they can cause infections if immune functions are reduced. The aim of this study was to investigate oral colonization, identify species, and test the susceptibility profile to antifungals. A descriptive study included 97 liver transplant patients who attended the transplant center of a referral hospital in southern Brazil. Two oral swab collections were performed, with a 6-month gap between collections. The samples were identified by sequencing the internal transcribed spacer ITS region of the ribosomal DNA. The sensitivity test was performed with fluconazole, amphotericin B, and micafungin using a broth microdilution method recommended by Clinical and Laboratory Standards Institute document M27-A4. Eighty-two patients were investigated and 15 were excluded for presenting clinical infection. The identification of yeasts showed colonization in 66% and 61.9% in collections A and B, respectively. Candida albicans was the most prevalent species in both collections (n = 29/50 and n = 27/49, respectively). In 31 (62%) patients, the yeast species remained the same for 6 months, and in 19 (38%) the colonizing species was substituted. Thirty-two isolates from collection A were sensitive (S) to Fluconazole, 13 sensitive dose-dependent (SDD), and five resistant (R). In collection B, 32 were S, 12 SDD, and 5 R. For amphotericin B and micafungin, all isolates were sensitive. With knowledge of the species and identification of strains resistant to fluconazole, useful information can be alerts about the emergence of antifungal resistance strains. LAY SUMMARY: Study of great importance because it is the first investigation that identifies Candida in the oral cavity of liver transplant patients, allowing an understanding of epidemiology and contributing to the knowledge about strains resistant to fluconazole.

Hemovigilance: the experience of transfusion reaction reporting in a Teaching Hospital. / Hemovigilância: a experiência da notificação de reações transfusionais em Hospital Universitário.

OBJECTIVE: To describe the occurrence of immediate transfusion reactions received by the Risk Management Department of Hospital São Paulo. METHOD: Cross-sectional and retrospective study which analyzed the notification sheets of transfusion reactions that occurred between May 2002 and December 2016 and were included in the Hemovigilance National System. RESULTS: One thousand five hundred and forty-eight transfusion reaction notification sheets were analyzed, all of which concerned immediate reactions associated with packed red blood cells (72.5%). The most frequently reported reaction was febrile non-hemolytic transfusion reaction, and among severe and moderate cases, allergic reaction was the most common. The most frequently reported signs and symptoms were hyperthermia, sudoresis, chills, and skin lesions. No differences were observed regarding gender and age, and 90.7% of reactions occurred in patients with Rh+ factor. CONCLUSION: This study allowed for a better assessment and understanding of transfusion reactions, which will help to improve the quality of blood circulation and provide greater safety of patients undergoing transfusion therapy.

Bibliometric indicators of the nursing journals according to the index databases. / Indicadores bibliométricos das Revistas de Enfermagem sob a ótica das bases indexadoras.

Objective To analyze the bibliometric indicators of the national and international journals in the area of nursing from the perspective of index databases. Method A historical cohort referring to the period of 2014 to 2016. National nursing journals indexed in the SciELO database and classified in the Qualis as A1, A2 and B1, and international nursing journals with impact factor above 1.0 and below 1.8, indexed in the Web of Science and Scopus Bases, were selected. Nursing specialty periodicals were excluded. The bibliometric indicators were collected from the index databases and imported into Ms Excel for analysis and data tabulation. Results The bibliometric indicators of the different index databases are divergent and cannot be compared. Lower title coverage and shorter calculation periods amplify the distortions between the indicators of national and international journals. Conclusion The internationalization criteria imposed on national journals do not contribute to obtaining or increasing the impact factor. A broader coverage of indexed titles and a longer calculation period for citations represent a significant difference in results. The h-index and CiteScore appear to be better impact indicators for national nursing research.

[Effectiveness of enteral nutritional therapy in the healing process of pressure ulcers: a systematic review]. / Efetividade da terapia nutricional enteral no processo de cicatrização das úlceras por pressão: revisão sistemática.

OBJECTIVE: To evaluate the effectiveness of enteral nutritional therapy (ENT) in the healing process of pressure ulcers (PU) in adults and the elderly. METHOD: A systematic review whose studies were identified through the databases of Cochrane, MEDLINE/PubMed, SciELO, LILACS, EMBASE, CINAHL, Web of Science, and manual searches. It included randomized clinical trials (RCTs) without delimiting the period or language of publication, which addressed adults and elderly patients with pressure ulcers in a comparative treatment of enteral nutritional therapy and placebo or between enteral nutritional therapy with different compositions and dosages. RESULTS: We included ten studies that considered different interventions. It resulted in more pressure ulcers healed in the groups that received the intervention. The included studies were heterogeneous with regard to patients, the type of intervention, the sample and the follow-up period, all of which made meta-analysis impossible. CONCLUSION: Although the enteral nutritional therapy demonstrates a promotion of pressure ulcer healing, sufficient evidence to confirm the hypothesis was not found.

[Triage at the Emergency Department: association between triage levels and patient outcome]. / Triagem no serviço de emergência: associação entre as suas categorias e os desfechos do paciente.

OBJECTIVE: Identify association between sociodemographic, clinical and triage categories with protocol outcomes developed at Hospital São Paulo (HSP). METHODS: Retrospective cohort study conducted with patients older than 18 years submitted to the triage protocol in August 2012. Logistic regression was used to associate the risk categories to outcomes (p-value ≤0,05). RESULTS: Men with older age and those treated in clinical specialties had higher rates of hospitalization and death. Patients in the high-priority group had hospitalization and mortality rates five and 10.6 times, respectively (p < 0.0001). CONCLUSION: The high-priority group experienced higher hospitalization and mortality rates. The protocol was able to detect patients with more urgent conditions and to identify risk factors for hospitalization and death.

[Prevalence of Staphylococcus aureus colonization in renal transplant patients]. / Prevalência de colonização por Staphylococcus aureus em pacientes transplantados renais.

OBJECTIVE: to evaluate the prevalence of Staphylococcus aureus nasal colonization in renal transplant patients and to identify the related risk factors. METHOD: Swabs were used to collect nasal samples from 160 patients who had undergone a transplant within the previous year at the Kidney and Hypertension Hospital. The 'National Committee for Clinical Laboratory Standards' norms were followed for the collection, isolation, identification and sensitivity measurements. RESULTS: There was a 9.4% (15) prevalence of Staphylococcus aureus nasal colonization, of which one (6.7%) was resistant to oxacillin. It was possible to identify as an associated risk factor a wait of more than one year for accessing dialysis prior to the transplant (p=0.029). CONCLUSION: Given the high morbidity and mortality rates that this microorganism causes in the target population, other studies should be carried out, and pre- and post-transplant screening should occur in order to develop strategies that improve the prevention and control of the spread of Staphylococcus aureus.

[Correlation between depressive symptoms and quality of life in users of psychoactive substances]. / Correlação entre sintomas depressives e qualidade de vida de usuários de substâncias psicoativas.

OBJECTIVES: To evaluate the correlation between the presence of depressive symptoms and quality of life in users of psychoactive substances from Psychosocial Attention Centers in Mato Grosso. METHOD: A cross-sectional analytical study, conducted in Psychosocial Attention Centers, with 109 users. The instruments used were: Medical Outcomes Study 36, Beck Depression Inventory, socio-demographic variables and the use of psychoactive substances. A Tukey analysis and a Spearman correlation were conducted with a significance level of α<0,05. RESULTS: The most affected domains of quality of life were emotional, social and mental health aspects, besides the strong correlation between depressive symptoms and quality of life. CONCLUSION: The use of psychoactive substances and the presence of symptoms significantly interfere in the life of users, which can compromise the motivation to the treatment, negatively affecting the quality of life in this population.

[Nephrotoxicity of polymyxin B: experimental study in cells and implications for nursing practice]. / Nefrotoxicidade da polimixina B: estudo experimental em células e implicações para a prática de enfermagem.

The aim of the study was to characterize the cell damage mechanisms involved in the pathophysiology of cytotoxicity of polymyxin B in proximal tubular cells (LLC - PK1) and discuss about the nurses interventions to identify at risk patients and consider prevention or treatment of nephrotoxicity acute kidney injury. This is a quantitative experimental in vitro study, in which the cells were exposed to 375µM polymyxin B sulfate concentration. Cell viability was determined by exclusion of fluorescent dyes and morphological method with visualization of apoptotic bodies for fluorescence microscopy. Cells exposed to polymyxin B showed reduced viability, increased number of apoptotic cells and a higher concentration of the enzyme lactate dehydrogenase. The administration of polymyxin B in vitro showed the need for actions to minimize adverse effects such as nephrotoxicity.

Epidemiological differences, clinical aspects, and short-term prognosis of patients with healthcare-associated and community-acquired infective endocarditis.

Background: The prevalence of healthcare-associated infective endocarditis in Brazil is poorly known. Aim: To analyze the epidemiological, clinical and microbiological characteristics, and the prognosis of healthcare-associated infective endocarditis (HAIE) compared with community-acquired infective endocarditis (CIE) and identify the associated factors with hospital mortality. Method: A historical cohort study was carried out, with a data collection period from January 2009 to December 2019 at the Federal University of São Paulo. Data were collected from medical records of patients with infective endocarditis (IE) hospitalized during the study period. Patients were classified into three groups: CIE, non-nosocomial HAIE (NN-HAIE) and nosocomial HAIE (NHAIE). Results: A total of 204 patients with IE were included; of these, 127 (62.3%) were cases of HAIE, of which 83 (40.7%) were NN-HAIE and 44 (21.6%) were NHAIE. Staphylococcus spp. Were the main causative agents, especially in HAIE groups (P<0.001). Streptococcus spp. were more prevalent in the CIE group (P<0.001). In-hospital mortality was 44.6%, with no differences between groups. Independent risk factors for in-hospital mortality were age ≥ 60 years (odds ratio (OR): 6.742), septic shock (OR 5.264), stroke (OR 3.576), heart failure (OR 7.296), and Intensive Care Unit admission (OR 7.768). Conclusion: HAIE accounted for most cases in this cohort, with a higher prevalence of non-nosocomial infections. Staphylococcus spp. were the main causative agents. Hospital mortality was high, 44.6%, with no difference between groups.

Nursing rights in comics: educational technological innovation report.

OBJECTIVES: to report an educational technology construction on nursing professionals' rights. METHODS: an experience report on educational technology construction during the crediting of university extension hours in an undergraduate nursing course at a Brazilian public university, between March and June 2023. The Deming cycle was used as a procedural method. RESULTS: four meetings were held between students and extension workers. Eight comic books were produced based on the Code of Ethics for Nurses, addressing professional autonomy, fair remuneration, risk-free work, denial of exposure in the media and others. The Deming cycle proved to be an important strategy for constructing products. CONCLUSIONS: nursing professionals' rights must be discussed and improved. Educational technologies, such as comic books, provide playful and reflective learning.

Oral candidiasis in liver transplant patients: species identification and antifungal susceptibility profile.

OBJECTIVE: This study aimed to verify oral candidiasis, identify the causative species, and investigate the antifungal susceptibility of yeasts isolated from liver transplant patients. METHODS: A descriptive analysis of 97 patients who underwent liver transplantation was conducted at a hospital. Two clinical examinations (Collections A and B) of the oral cavity were performed. Oral material was collected from all patients, inoculated in Sabouraud Dextrose Agar, and incubated at 35℃ for 48 hours. Samples were identified by molecular sequencing of the internal trascribed space region of rDNA. RESULTS: An antifungal susceptibility test with fluconazole, amphotericin B, and micafungin was performed using the Clinical and Laboratory Standards Institute yeast broth microdilution method. Among the patients, 15 presented with oral candidiasis: eight in Collection A and seven in Collection B. The primary type of candidiasis was atrophic, followed by pseudomembranous candidiasis. The most prevalent species was Candida albicans (nine), followed by Candida glabrata (three), Candida tropicalis (two), and Candida dubliniensis (one). Regarding susceptibility to fluconazole, of the 15 samples, 11 were susceptible, three were susceptible in a dose-dependent manner, and one was resistant. CONCLUSION: The most commonly identified type of candidiasis was atrophic, with C. albicans and C. glabrata being the most prevalent causative species. One fluconazole-resistant isolate each of C. tropicalis and C. albicans were identified.

Quality of life associated with nursing professionals' individual resources and work.

OBJECTIVES: to assess the physical and mental components of nursing professionals' quality of life and associate them with individual, health and work characteristics. METHODS: cross-sectional research, with nursing professionals from a university hospital in São Paulo. Own questionnaire and validated instruments were applied. RESULTS: the overall quality of life was compromised. The physical component was lower in relation to low family income and among those who perceived greater control/pressure at work, and better for those who practiced physical activity and had support of leader and organization. The mental component was lower in professionals who reported dissatisfaction with work, worse self-rated physical health and were older. Scores for both components reduced due to work-related illnesses, worse work ability and increased daytime sleepiness. CONCLUSIONS: quality of life was statistically associated with controllable institutional factors and individual resources that, except age, can be promoted.

Advanced Practice Nursing: "Training" Pillar in Supporting the Proposal in Brazil.

OBJECTIVES: to present the pillars that support what has been called Advanced Practice Nursing and discuss the necessary training for its implementation. METHODS: elements contained in assessment documents for graduate programs proposals, reports of presentations by international professors in countries and selected scientific publications were gathered to compose the argument. RESULTS: practice/competency (adds broad and in-depth knowledge about health processes and scientific evidence, clinical reasoning and clinical skills for therapeutic indications); 3) professional regulation (corresponding legislation and monitoring); and 4) funding (broad training and professional practice policy). FINAL CONSIDERATIONS: the agenda for implementing Advanced Practice Nursing in Brazil involves joining efforts to identify stakeholders for a work to legitimize their importance in the country's health and education overview.

Sepsis and COVID-19: outcomes in young adults in intensive care.

OBJECTIVE: to verify sepsis incidence among young adults admitted to intensive care due to COVID-19 and to analyze its association with demographic, clinical and outcome variables. METHODS: a quantitative, longitudinal, retrospective and analytical study, consisting of 58 adults aged 20 to 40 years in intensive care for SARS-CoV-2. It was carried out in a university hospital, from March 2020 to December 2021, with data collected from electronic medical records. RESULTS: sepsis incidence was 65%. Sepsis was associated with acute kidney injury, use of vasoactive drugs and mechanical ventilation, being admitted to the emergency room, severity according to the Simplified Acute Physiology Score III and bacterial pulmonary co-infection, the latter being the most frequent etiology for sepsis. CONCLUSIONS: there was a high sepsis incidence, with 42% of deaths, which points to the importance of investing in preventive measures, especially in relation to bacterial pulmonary coinfections.

Sociodemographic factors associated with suicidal behavior at a federal public university in the Western Brazilian Amazon.

OBJECTIVE: to determine risk factors for suicidal behavior among students and employees of a federal public university in the Brazilian Western Amazon. METHODS: an analytical cross-sectional study of survey and association between variables with a sample of 475 participants. Statistical analyzes were performed using the Mann-Whitney test, Pearson's chi-square test, likelihood ratio test or Fisher's exact test and a logistic regression model. A significance level of 5% was used (p-value< 0.05). RESULTS: a higher proportion of suicidal behavior was found in younger participants, females, who had no religion or had one, but were non-practicing, who did not have children and/or had a monthly family income of less than two minimum wages. Lower proportions of suicidal behavior were identified in heterosexuals and/or married or in a stable relationship. CONCLUSION: the study suggests a relationship between sociodemographic factors and suicidal behavior in the studied academic community.

Work absences among hospital cleaning staff during the SARS-CoV-2 (COVID-19) pandemic.

Introduction: Absenteeism justified by sick leaves are valuable indicators of workers' health conditions. Objectives: To analyze hospital cleaning staff sick leaves during the COVID-19 pandemic. Methods: This retrospective cohort study included employees who presented a medical sick leave certificate justifying at least 1 missed day of work during the first wave of the COVID-19 pandemic. Data were collected from March 24 to December 31, 2020 at a teaching hospital. Results: A total of 199 workers who presented 689 medical certificates were included in the sample. The sample was 88.4% women. The mean ages for suspected COVID-19 cases and all other cases were 39.7 years and 40.9 years, respectively. Suspected COVID-19 cases involved longer leaves (mean 5.82 [SD, 3.35] days missed) and more medical sick leave certificates (mean 4.25 [SD, 3.13] certificates per worker) than other causes. Among suspected cases, 32.1% worked in critical areas of the hospital. Of the 83 RT-PCR tests performed, 24.1% were positive, with 80% of these employees working in semi-critical or administrative areas; 15% of workers who tested positive developed the severe form of the disease. Conclusions: Among workers who underwent RT-PCR testing, the rate of positive results was low. Most positive cases occurred in younger women who worked in non-critical units (ie, units involving no direct patient contact or without aerosol-generating procedures). The mean number of missed days was higher among suspected COVID-19 cases (7.85 days [SD, 4.05]). The use of individual protective equipment was common among these employees, and they were continuously trained.

Prognosis of patients with heart disease with acute kidney injury undergoing dialysis treatment.

OBJECTIVES: to verify the relationship of cardiovascular diseases with acute kidney injury and assess the prognosis of patients in renal replacement therapy. METHODS: a cohort study, carried out in a public hospital specialized in cardiology. Treatment, comorbidities, duration of treatment, laboratory tests, discharge and deaths were analyzed. RESULTS: of the 101 patients, 75 (74.3%) received non-dialysis treatment. The most frequent cardiological diagnoses were hypertension, cardiomyopathies and coronary syndrome. Hospitalization in patients undergoing dialysis was 18 days, hemoglobin <10.5g/dl and anuria in the first days of hospitalization contributed to the type of treatment. Each increase in hemoglobin units from the first day of hospitalization decreases the chance of dialysis by 19.2%. There was no difference in mortality. CONCLUSIONS: the main cardiological diseases were not predictive of dialysis indication, and clinical treatment was the most frequent. Anuria and anemia were predictors for dialysis treatment.

Contrast-induced acute kidney injury in patients submitted to coronary angioplasty: prospective cohort.

OBJECTIVE: To analyze the incidence, risk factors, and associations of clinical outcomes for contrast-induced acute kidney injury (CI-AKI) in patients with acute coronary syndrome (ACS) after coronary angioplasty. METHOD: Prospective cohort of 182 patients followed for three months after undergoing angioplasty, from July 2020 to June 2021. The analyzed variables were sociodemographic, clinical, and those related to the procedure. RESULTS: The incidence of CI-AKI was 35.7% (n = 65) and was associated with old age, diabetes mellitus, and chronic kidney disease (p = 0.004, p < 0.001, and p = 0.009, respectively). Out of the 17 patients who died within 90 days, 76.5% had CI-AKI (n = 13), the odds ratio between death and CI-AKI was approximately 7.2 times (95% confidence interval (CI), [2.41;26.36]; p = 0.001). The decrease of one unit in the patient's baseline hemoglobin showed a 6.5% increase for CI-AKI (95% CI, [-0.089; -0.040]; p < 0.0001). CONCLUSION: CI-AKI is prevalent in patients with ACS after angioplasty and is related to diabetes mellitus and chronic kidney disease, showing high mortality rates.