Technological Challenges and Solutions in Emergency Remote Teaching for Nursing: An International Cross-Sectional Survey.

OBJECTIVES: With the sudden global shift to online learning modalities, this study aimed to understand the unique challenges and experiences of emergency remote teaching (ERT) in nursing education. METHODS: We conducted a comprehensive online international cross-sectional survey to capture the current state and firsthand experiences of ERT in the nursing discipline. Our analytical methods included a combination of traditional statistical analysis, advanced natural language processing techniques, latent Dirichlet allocation using Python, and a thorough qualitative assessment of feedback from open-ended questions. RESULTS: We received responses from 328 nursing educators from 18 different countries. The data revealed generally positive satisfaction levels, strong technological self-efficacy, and significant support from their institutions. Notably, the characteristics of professors, such as age (p = 0.02) and position (p = 0.03), influenced satisfaction levels. The ERT experience varied significantly by country, as evidenced by satisfaction (p = 0.05), delivery (p = 0.001), teacher-student interaction (p = 0.04), and willingness to use ERT in the future (p = 0.04). However, concerns were raised about the depth of content, the transition to online delivery, teacher-student interaction, and the technology gap. CONCLUSIONS: Our findings can help advance nursing education. Nevertheless, collaborative efforts from all stakeholders are essential to address current challenges, achieve digital equity, and develop a standardized curriculum for nursing education.

Mobile Application Model for Supporting in Wound Treatment.

OBJECTIVE: This article presents a mobile application model for the treatment tracking of in-hospital wounds. METHODS: A survey of the literature on mobile apps for wound monitoring was carried out. Health professionals were interviewed and wound forms were analyzed to synthesize the application's fields and features. We designed the application model using a prototyping tool. RESULTS: The prototype features interfaces for patient evaluation, different functionalities according to the role of the health professional, a dashboard for monitoring the open admissions, selection of wound locations using a body model, treatment prescribing, tracking the wounds using photos, and generating wound reports. CONCLUSION: The adoption of this application could optimize wounds' treatment, increase patient safety, reduce material expenditures and time for professionals with rework in the dressing procedure.

Emergency Remote Learning in Nursing Education During the COVID-19 Pandemic.

Due to the corona (COVID-19) pandemic, several countries are currently conducting non-face-to-face education. Therefore, teachers of nursing colleges have been carrying out emergency remote education. This study developed a questionnaire to understand the status of Emergency Remote Learning (ERL) in nursing education internationally, translated it into 7 languages, and distributed it to 18 countries. A total of 328 nursing educators responded, and the most often used online methods were Social networking technology such as Facebook, Google+ and Video sharing platform such as YouTube. The ERL applied to nursing education was positively evaluated as 3.59 out of 5. The results of the study show that during the two semesters nursing college professors have well adapted to this unprecedent crisis of teaching. The world after COVID-19 has become a completely different place, and nursing education should be prepared for 'untact' education.

Coronary risk assessment in primary health care: a descriptive study / Avaliação do risco coronariano na atenção primária à saúde: um estudo descritivo / Evaluación de riesgo coronario en la atención primaria de salud: estudio descriptivo

Problem: The risk of coronary disease in the Brazilian population has increased along with other chronic non-communicable diseases and accounts for more than 70% of the mortality in this population. Aim: Determine the health profile and risk of coronary disease among youth, adults, and elderly people in primary health care. Method: A descriptive study was conducted in a basic health unit in Londrina city, Brazil. We interviewed 120 individuals. Their personal, anthropometric, and biochemical data; daily habits; history of disease; and coronary risk scores were analyzed using a mobile application. Results: The results showed 66.5% of individuals were overweight, 36.5% were physically active, 39% had hypercholesterolemia, 21.5% were hypertensive, 29% were smokers, 25.5% consumed alcoholic drinks, and 11% had hyperglycemia. The coronary risks were 88% and 68% in men and women, respectively. Conclusion: The results demonstrated a substantial risk for developing coronary heart disease in this population.

Problema: O risco de doença coronariana na população brasileira aumentou junto com outras doenças crônicas não transmissíveis, representando mais de 70% da mortalidade nessa população. Objetivo: Determinar o perfil de saúde e o risco de doença coronariana entre jovens, adultos e idosos na atenção primária à saúde. Método: Estudo descritivo realizado em uma Unidade Básica de Saúde da cidade de Londrina, Brasil. Entrevistamos 120 pessoas. Os dados pessoais, antropométricos e bioquímicos; hábitos diários; história de doença, e os escores de risco coronariano foram analisados usando uma aplicação móvel. Resultados: Os resultados mostraram 66,5% de sobrepeso, 36,5% fisicamente ativos, 39% de hipercolesterolemia, 21,5% hipertensos, 29% tabagistas, 25,5% consumiam bebidas alcoólicas e 11% apresentavam hiperglicemia. Os riscos coronarianos foram 88% e 68% em homens e mulheres, respectivamente. Conclusão: Os resultados demonstraram um risco substancial para o desenvolvimento de doença coronariana nessa população.

Problema: El riesgo de cardiopatía coronaria en la población de Brasil ha aumentado junto con otras enfermedades crónicas no transmisibles, y alcanza más del 70% de la mortalidad en esta población. Objetivo: Determinar el perfil de salud y el riesgo de sufrir enfermedad coronaria entre jóvenes, adultos y ancianos en atención primaria de salud. Método: Se llevó a cabo un estudio descriptivo en una Unidad Básica de Salud en la ciudad de Londrina, Brasil. Se entrevistaron 120 personas; mediante una aplicación móvil se analizaron sus datos personales, antropométricos y bioquímicos, hábitos diarios, historial médico y puntuación de riesgo coronario. Resultados: Los resultados mostraron un 66,5% de sobrepeso, un 36,5% eran físicamente activos, el 39% tenían hipercolesterolemia, el 21,5% eran hipertensos, el 29% eran fumadores, el 25,5% consumían bebidas alcohólicas y el 11% tenían hiperglucemia. El riesgo coronario fue del 88% y 68% en hombres y mujeres, respectivamente. Conclusión: Los resultados demostraron un riesgo sustancial para el desarrollo de enfermedad coronaria en esta población.

Factores de riesgo para el desarrollo de enfermedad cardiovascular en mujeres / Fatores de risco para desenvolvimento de doença cardiovascular em mulheres / Risk factors for developing cardiovascular disease in women

Objective. To evaluate the factors that predispose to the development of cardiovascular diseases in women who were attended at a Basic Health Unit in Londrina, Paraná, Brazil. Methods. The research was characterized as observational and quantitative. The population sample consisted of 60 women aged over 18 years, being chosen at random. For data collection, mHealth Data Collector (mHDC), a mobile device, was used with a questionnaire on daily habits, health status, and disease. Measurements were made of glucose and blood cholesterol, blood pressure and anthropometric measurements. Data collection took place in February 2014 to November 2014. Results. Risk factors were overweight / obesity (63.8%) and sedentary lifestyle (65%), followed by family history of cardiovascular disease (43.3%), hypercholesterolemia (38.3%), and hypertension (13.3%). Conclusion. This population of women presented risk factors for the development of cardiovascular disease in all ages, being necessary the implementation of measures that stimulate changes in the daily habits and improve health conditions among women by the health team.

Objetivo. Evaluar los factores que predisponen el desarrollo de enfermedad cardiovascular en mujeres atendidas en una Unidad Básica de Salud en Londrina, Paraná, Brasil. Métodos. Estudio descriptivo. La población de la muestra consistió en 60 mujeres mayores de 18 años, seleccionadas aleatoriamente. Para la recolección de información, se utilizó el software móvil mHealth Data Collector (mHDC), que contiene un cuestionario sobre hábitos de vida, estado de salud y la enfermedad. Se realizaron mediciones de glucosa, colesterol, presión arterial y medidas antropométricas. Resultados. Se encontraron factores de riesgo de tener sobrepeso / obesidad y la inactividad física (68.3%), seguido de antecedentes familiares de enfermedad cardiovascular (43.3%), hipercolesterolemia (38.3%) y la hipertensión (13.3%). Conclusión. Esta población de mujeres tenía factores de riesgo de desarrollar enfermedad cardiovascular en todas las edades, lo que requiere la aplicación de medidas para estimular cambios en los hábitos diarios y mejorar las condiciones de salud.

Objetivo. Avaliar os fatores que predispõem ao desenvolvimento de doenças cardiovasculares em mulheres que eram atendidas em uma Unidade Básica de Saúde em Londrina, Paraná, Brasil. Métodos. A pesquisa foi caracterizada como observacional e quantitativa. A amostra populacional consistiu de 60 mulheres com idade superior a 18 anos, sendo escolhidas aleatoriamente. Para coleta de dados, foi utilizado o software mHealth Data Collector (mHDC), dispositivo móvel, com questionário sobre hábitos diários, estado de saúde e doença. As medições realizadas foram de glicose e colesterol no sangue, pressão arterial e medidas antropométricas. A coleta de dados ocorreu em fevereiro de 2014 a novembro de 2014. Resultados. Foram encontrados fatores de risco como sobrepeso/obesidade e sedentarismo (68.3%), seguidos por história familiar para doença cardiovascular (43.3%), hipercolesterolemia (38.3%) e hipertensão (13.3%). Conclusão. Esta população de mulheres apresentaram fatores de risco para o desenvolvimento de doença cardiovascular em todas as idades, sendo necessário a implementação de medidas que estimule mudanças nos hábitos diários e melhore as condições de saúde entre as mulheres pela equipe de saúde.

Risk factors for developing cardiovascular disease in women.

OBJECTIVES: To evaluate the factors that predispose to the development of cardiovascular diseases in women who were attended at a Basic Health Unit in Londrina, Paraná, Brazil. METHODS: The research was characterized as observational and quantitative. The population sample consisted of 60 women aged over 18 years, being chosen at random. For data collection, mHealth Data Collector (mHDC), a mobile device, was used with a questionnaire on daily habits, health status, and disease. Measurements were made of glucose and blood cholesterol, blood pressure and anthropometric measurements. Data collection took place in February 2014 to November 2014. RESULTS: Risk factors were overweight / obesity (63.8%) and sedentary lifestyle (65%), followed by family history of cardiovascular disease (43.3%), hypercholesterolemia (38.3%), and hypertension (13.3%). CONCLUSIONS: This population of women presented risk factors for the development of cardiovascular disease in all ages, being necessary the implementation of measures that stimulate changes in the daily habits and improve health conditions among women by the health team.

Advancing Nursing Informatics in the Next Decade: Recommendations from an International Survey.

In the summer of 2015, the International Medical Informatics Association Nursing Informatics Special Interest Group (IMIA NISIG) Student Working Group developed and distributed an international survey of current and future trends in nursing informatics. The survey was developed based on current literature on nursing informatics trends and translated into six languages. Respondents were from 31 different countries in Asia, Africa, North and Central America, South America, Europe, and Australia. This paper presents the results of responses to the survey question: "What should be done (at a country or organizational level) to advance nursing informatics in the next 5-10 years?" (n responders = 272). Using thematic qualitative analysis, responses were grouped into five key themes: 1) Education and training; 2) Research; 3) Practice; 4) Visibility; and 5) Collaboration and integration. We also provide actionable recommendations for advancing nursing informatics in the next decade.

Nursing Informatics Research Priorities for the Future: Recommendations from an International Survey.

We present one part of the results of an international survey exploring current and future nursing informatics (NI) research trends. The study was conducted by the International Medical Informatics Association Nursing Informatics Special Interest Group (IMIA-NISIG) Student Working Group. Based on findings from this cross-sectional study, we identified future NI research priorities. We used snowball sampling technique to reach respondents from academia and practice. Data were collected between August and September 2015. Altogether, 373 responses from 44 countries were analyzed. The identified top ten NI trends were big data science, standardized terminologies (clinical evaluation/implementation), education and competencies, clinical decision support, mobile health, usability, patient safety, data exchange and interoperability, patient engagement, and clinical quality measures. Acknowledging these research priorities can enhance successful future development of NI to better support clinicians and promote health internationally.

Current Trends in Nursing Informatics: Results of an International Survey.

Nursing informatics (NI) can help provide effective and safe healthcare. This study aimed to describe current research trends in NI. In the summer 2015, the IMIA-NI Students Working Group created and distributed an online international survey of the current NI trends. A total of 402 responses were submitted from 44 countries. We identified a top five NI research areas: standardized terminologies, mobile health, clinical decision support, patient safety and big data research. NI research funding was considered to be difficult to acquire by the respondents. Overall, current NI research on education, clinical practice, administration and theory is still scarce, with theory being the least common. Further research is needed to explain the impact of these trends and the needs from clinical practice.

Nurse Informaticians Report Low Satisfaction and Multi-level Concerns with Electronic Health Records: Results from an International Survey.

This study presents a qualitative content analysis of nurses' satisfaction and issues with current electronic health record (EHR) systems, as reflected in one of the largest international surveys of nursing informatics. Study participants from 45 countries (n=469) ranked their satisfaction with the current state of nursing functionality in EHRs as relatively low. Two-thirds of the participants (n=283) provided disconcerting comments when explaining their low satisfaction rankings. More than one half of the comments identified issues at the system level (e.g., poor system usability; non-integrated systems and poor interoperability; lack of standards; and limited functionality/missing components), followed by user-task issues (e.g., failure of systems to meet nursing clinical needs; non nursing-specific systems) and environment issues (e.g., low prevalence of EHRs; lack of user training). The study results call for the attention of international stakeholders (educators, managers, policy makers) to improve the current issues with EHRs from a nursing perspective.

n-Octyl gallate as inhibitor of pyruvate carboxylation and lactate gluconeogenesis.

The alkyl gallates are found in several natural and industrial products. In the latter products, these compounds are added mainly for preventing oxidation. In the present work, the potencies of methyl gallate, n-propyl gallate, n-pentyl gallate, and n-octyl gallate as inhibitors of pyruvate carboxylation and lactate gluconeogenesis were evaluated. Experiments were done with isolated mitochondria and the isolated perfused rat liver. The potency of the gallic acid esters as inhibitors of pyruvate carboxylation in isolated mitochondria obeyed the following decreasing sequence: n-octyl gallate > n-pentyl gallate > n-propyl gallate > methyl gallate. A similar sequence of decreasing potency for lactate gluconeogenesis inhibition in the perfused liver was found in terms of the portal venous concentration. Both actions correlate with the lipophilicity of the compounds. The effects are harmful at high concentrations. At appropriate concentrations, however, octyl gallate should act therapeutically because its inhibitory action on gluconeogenesis will contribute further to its proposed antihyperglycemic effects.

Significance of clay art therapy for psychiatric patients admitted in a day hospital.

OBJECTIVE: To understand the significance of clay art therapy for psychiatric patients admitted in a day hospital. METHODOLOGY: Qualitative, descriptive and exploratory research, undertaken with 16 patients in a day hospital in Londrina, in the state of Parana, Brazil, who participated in seven clay therapy sessions. Data collection took place from January to July 2012 through interviews guided by a semi structured questionnaire and the data were submitted to content analysis. RESULTS: Three themes emerged: Becoming familiar with clay art therapy; Feeling clay therapy; and Realizing the effect of clay therapy. CONCLUSION: The use of clay as a therapeutic method by psychiatric patients promoted creativity, self-consciousness, and benefited those who sought anxiety relief.

mHealth data collector: an application to collect and report indicators for assessment of cardiometabolic risk.

Traditional population surveys use paper forms that are filled manually by an interviewer. This process can take a long time; in comparison, computerizing the process reduces time, promotes safety and accuracy of data, improves patient care, and offers better control over the compiled information. From this perspective, it can be argued that mobile health supports mechanisms for the diagnosis, control, and prevention of metabolic diseases. In recent years, mobile devices have been applied in several health areas, such as remote monitoring, data logging, clinical decision-making, and with applications that can help maintain or initiate practices beneficial to individual health and wellbeing. However, there is a lack of applications for conducting population surveys. Thus, this work presents an application called mHealth Data Collector (mHDC) as a model for applications used in population surveys that contain such data as Body Mass Index (BMI), health-related issues, and health habit indicators. The design of this system occurred through interviews with health professionals who utilized a prototyping method to extract requirements. To develop this mobile app, the Android platform was adopted and the SQLite database was used to store patients' health data. The JExcelAPI and AchartEngine were also employed to generate spreadsheets and charts. The mHDC was tested using a case study in a Brazilian city. The results indicated that the health team took half the time to interview patients. In addition, the system has reduced the use of paper; centered and organized data; and allowed quick data recovery and standardization to improve the readability of data input. The mHDC proved efficient at collecting, analyzing, and safely exporting the results, thus reducing time collecting and analyzing the population survey.

Kinetics of the transformation of n-propyl gallate and structural analogs in the perfused rat liver.

n-Propyl gallate and its analogs are used in foods and other products to prevent oxidation. In the liver the compound exerts several harmful effects, especially gluconeogenesis inhibition. The mode of transport and distribution of n-propyl gallate and its kinetics of biotransformation have not yet been investigated. To fill this gap the transformation, transport and distribution of n-propyl gallate and two analogs were investigated in the rat liver. Isolated perfused rat liver was used. n-Propyl gallate, methyl gallate, n-octyl gallate and transformation products were quantified by high pressure-liquid chromatography coupled to fluorescence detection. The interactions of n-propyl gallate and analogs with the liver presented three main characteristics: (1) the hydrolytic release of gallic acid from n-propyl gallate and methyl gallate was very fast compared with the subsequent transformations of the gallic acid moiety; (2) transport of the esters was very fast and flow-limited in contrast to the slow and barrier-limited transport of gallic acid; (3) the apparent distribution volume of n-propyl gallate, but probably also of methyl gallate and n-octyl gallate, greatly exceeded the water space in the liver, contrary to the gallic acid space which is smaller than the water space. It can be concluded that at low portal concentrations (<50µM) the gallic acid esters are 100% extracted during a single passage through the liver, releasing mainly gallic acid into the systemic circulation. For the latter a considerable time is required until complete biotransformation. The exposure of the liver to the esters, however, is quite prolonged due to extensive intracellular binding.

Hepatic effects of flunixin-meglumin in LPS-induced sepsis.

The aim of this study was to evaluate the actions of the non-steroidal anti-inflammatory drug flunixin-meglumin (FM) on the changes caused by lipopolysaccharide (LPS)-induced sepsis in the rat liver. Eight groups of five adult male Wistar rats were analysed: (1) saline injected (controls), (2) FM treated with 1.1 mg/kg, (3) FM treated with 2.2 mg/kg, (4) LPS-injected (10 mg/kg), (5) LPS-injected with 1.1 mg/kg FM pretreatment, (6) LPS-injected with 2.2 mg/kg FM pretreatment, (7) LPS-injected with 1.1 mg/kg FM post-treatment and (8) LPS-injected with 2.2 mg/kg FM post-treatment. All drugs were intraperitoneally injected. The following parameters were evaluated: plasma levels of hepatic enzymes and urea, hepatic histological characteristics, antioxidant enzymes and several metabolic fluxes. The latter comprised gluconeogenesis, ureagenesis and oxygen consumption. Liver damage in LPS-induced sepsis was characterized by histological changes, increased plasma levels of alanine aminotransferase and aspartate aminotransferase (P < 0.001) and diminished gluconeogenesis (P < 0.001) and ureagenesis (P < 0.01). LPS also induced oxidative stress as evidenced by increased catalase (P < 0.05) and superoxide dismutase activities and enhanced lipid peroxidation (P < 0.001). Pretreatment of the animals with FM minimized the histological changes and normalized, in part, all enzymatic activities. Pretreatment of the animals with FM also normalized gluconeogenesis and partly restored ureagenesis (P < 0.05). These and other results show that LPS-induced sepsis may lead to severe liver damage, affecting both structure and function. Treatment with FM can be used to avoid this damage. The antioxidant properties of FM can be, partly at least, responsible for this protective action.

The action of n-propyl gallate on gluconeogenesis and oxygen uptake in the rat liver.

In the present study the metabolic actions of n-propyl gallate on hepatic gluconeogenesis, oxygen uptake and related parameters were investigated. Experiments were done in the isolated perfused rat liver. n-Propyl gallate inhibited gluconeogenesis and stimulated oxygen uptake at concentrations up to 200 microM. The inhibitory effects on lactate gluconeogenesis (ED(50) 86.4 microM) and alanine gluconeogenesis were considerably more pronounced than those on glycerol and fructose gluconeogenesis. n-Propyl gallate also stimulated oxygen uptake in both the mitochondrial (63%) and microsomal (37%) electron transport chains. The first one is due mainly to the oxidation of n-propanol, as a metabolite of the first step of n-propyl gallate transformation. The second one results from a direct stimulation of the microsomal electron transport chain. n-Propyl gallate inhibited pyruvate carboxylation (ED(50) 142.2 microM) in consequence of an inhibition of pyruvate transport into the mitochondria an effect not found for gallic acid. This is probably the main cause for glucose output inhibition. Secondary causes are (1) deviation of intermediates for the production of NADPH to be used in microsomal electron transport; (2) deviation of glucose 6-phosphate for glucuronidation reactions; (3) gluconeogenesis inhibition by n-propanol, produced intracellularly from n-propyl gallate. Inhibition of mitochondrial energy metabolism is not significant in the range up to 200 microM, as indicated by the very small effect on the cellular ATP levels (5% decreased). n-Propyl gallate can be considered a kind of metabolic effector, whose actions on the liver metabolism are relatively mild although they can become harmful for the organ and the whole organism at high doses and concentrations.

Análise das percepções e atitudes dos profissionais de enfermagem perante o paciente com dor / Analysis of perception and attitudes of nurse professionals in face the patient presenting pain

Considerando a importância do estudo da dor e seu controle pelos profissionais de enfermagem objetivou-se analiasar o real preparo desses profissionais quanto à percepção e atitudes aos pacientes com quadro doloroso. Utilizamos um questionário que foi aplicado a 141 técnicos e auxiliares de enfermagem de três hospitais de médio porte. Os resultados mostraram que os profissionais possuem boa precepção da dor através do comportamento do paciente e as atitudes principais foram avisar o médico e avaliar a dor verbalmente, entretanto, a maioria relatou não ter recebido capacitação e nem possuir instrumentos para avaliação da dor, demonstrando a necessidade de treinamentos e uso de instrumentos unidimensionais ou multidimensionais para avalição adequada desta, objetivando a implementação de estratégias para o alívio da dor.

O enfermeiro e as terapias complementares para o alívio da dor / The nurse and the complementary therapies for pain relief

O controle da dor por meio da avaliação e implementação de estratégias de alívio pelo enfermeiro tem sido um desafio, visto que o sintoma se caracteriza como o principal fator de procura ao atendimento médico pelos pacientes. Buscando opções de tratamentos que possam ser implementados pelos enfermeiros em ambientes clínicos e hospitalares, revisamos neste artigo as terapias complementares utilizadas para o alívio do quadro doloroso, sendo as principais terapias as técnicas de relaxamento, a estimulação cutânea, a aromaterapia, a imaginação guiada, a terapia vibracional e a música, sendo estas terapias implementadas junto a outras condutas de enfermagem, como as de promover o conforto ao paciente, evitar negar a dor, valorizar e partilhar a dor, evitar a manipulação do paciente, explicar o motivo da dor, oferecer apoio psicológico e orientar quanto às medidas tomadas para o alívio da dor. Essas medidas complementares baseiam-se principalmente em promover relaxamento, distração e, conseqüentemente, permitir ao paciente sentir-se mais confortável, proporcionando o alívio da dor. Apesar da utilização das terapias complementares serem incipientes para a enfermagem, observa-se um campo amplo para atuação, pois o enfermeiro está em constante contato com o paciente e tem um importante papel na implementação dessas terapias, a fim de que o alívio da dor ocorra e conseqüentemente, haja melhoria da qualidade de vida do paciente.

Pain control by means of evaluation and implementation of relief strategies by the nurse has been a challenge since the symptom characterizes itself as the main reason why patients look for medical attendance. By searching treatment options which may be implemented by the nurses within both clinical and hospital environments, we revised, in this article, the complementary therapies currently used for the relief of the painful picture, having as the main therapies the relaxation techniques, the cutaneous stimulation, the aromatically therapy, the guided imagination, the vibration therapy and music, whereas these therapies are implemented together with other nursing procedures such as, promoting comfort, preventing the pain deny, valorazing and sharing pain, preventing the manipulation of the patient, explaining the reason of pain, offering psychological support, and orientating the patient in relation to the procedures taken to relief the pain. These complementary measures are mainly based on promoting relaxation, distraction, and consequently allowing the patient to feel more comfortable, thus providing the pain relief. Despite the use of complementary therapies is incipient in nursing, a broad of performance is observed, therefore the nurse is in an ongoing contact with the patient, and has an important role in the implementation such therapies so that the pain relief occurs, and, consequently, the improvement of the patient?s quality of life.