Impact of a culturally tailored informative video on cervical cancer: a pilot study with Amazonian women in treatment for cervical cancer.

The present study is a randomised pilot study that evaluated a culturally tailored video promoting information about cervical cancer (CC), developed with Amazonian women in treatment for CC. The sample included 63 patients in treatment for CC who were randomly assigned to three groups of 21 patients. The experimental group watched an informative video about CC. The active control group watched a video on healthy habits and the passive control group received no intervention. The groups were compared in terms of change in knowledge and illness perceptions, over time. The results showed that the experimental group was the only one with a significant increase in knowledge (ß = .166; p = .03) that was not maintained over time (ß = -.195; p = .04). Threatening illness perceptions about the disease increased in all groups over time (ß = .105; p = .001). Future studies should replicate the results testing the efficacy of an audiovisual strategy in a larger sample, in health services that serve populations with similar social and cultural characteristics. This study emphasises the importance of interprofessional oncology teams providing clear information regarding CC, during all stages of the disease, and patients' treatment.Impact StatementWhat is already known on this subject? Latin American countries, such as Brazil, the low coverage of screening for CC can be related to the low education of women and their difficulty of access to health care. Hence, educational interventions may be a good strategy to reinforce the importance of screening and increase knowledge about illness prevention and treatment.What the results of this study add? An audiovisual informational intervention on CC was developed, addressing prevention, causes, control, consequences and treatment while respecting the patients' cultural and social reality through an approach that is simple and easy to understand. The group that watched the informative video was the only one that increased knowledge, revealing that it was a good CC informational strategy.What are the implications of these findings for clinical practice and/or further research? This study confirmed the importance of developing informational and educational strategies that are appropriate to patients' social and cultural reality. The video is now available to health teams in primary, secondary and tertiary care units, as a strategy for health promotion and CC prevention.

Factors related to the adoption of the Brazilian National Immunization Program Information System.

BACKGROUND: One way to optimize the adoption and use of technological innovations is to understand how those involved perceive, assess and decide to use them. This study aims to analyze the attributes that influence the adoption and use of the Brazilian National Immunization Program Information System (NIPIS) from the perspective of vaccination room workers. METHODS: This is a mixed method research, and a quantitative cross-sectional analytical study, with concomitant triangulation of data, carried out in a region of Brazil by using the Diffusion of Innovation Theory. We used a questionnaire with 183 nursing professionals who work at vaccination rooms in 12 municipalities. To test the research model, partial least squares structural equation modeling (PLS-SEM) and SmartPLS 2.3.0 have been applied to estimate the model. The qualitative research had a descriptive-exploratory character, using interviews (n = 18) analyzed through thematic analysis. RESULTS: The model proposed showed a mean correlation between the perceived attributes in the adoption and use of NIPIS. The results of the multiple regression indicated that the attributes "relative advantage" and "image" have a significant effect at 5% level (T > 1.97), positively influence the adoption and use of NIPIS; the attribute "voluntary use" negatively influences the adoption and use of the system; the attributes "experimentation", "compatibility", "profitability", and "ease of use" did not influence the adoption and use of NIPIS. Emphasis has been placed on aspects that weaken the adoption and use of NIPIS such as lack of good quality internet and resistance to use the technology by some professionals. Workers perceive the importance of NIPIS for the municipality and point out that technological innovation provides data at an individual level, inserted in real time, which makes it possible to assess vaccination coverage. Lack of an unstable internet compromises data release due to system slowness. CONCLUSIONS: The mixed method allowed an in-depth analysis of the adoption and use of NIPIS in the Western Health Macroregion of Minas Gerais State, and similarities were observed in the results. The attribute "relative advantage" is the one that most influences the adoption and use of NIPIS, which is the strongest predictor of innovation adoption rate.

MicroRNA-23b and microRNA-27b plus flutamide treatment enhances apoptosis rate and decreases CCNG1 expression in a castration-resistant prostate cancer cell line.

The acquisition of a castration-resistant prostate cancer phenotype by prostate cancer cells is the alteration that has the worst prognosis for patients. The aim of this study was to evaluate the role of the microRNAs-23b/-27b as well as the possible CCNG1 target gene in tissue samples from patients with localized prostate cancer that progressed to castration-resistant prostate cancer and in a castration-resistant prostate cancer cell line (PC-3). The microRNAs and target gene expression levels of the surgical specimens were analyzed by quantitative real-time polymerase chain reaction. The prostate cancer cell line, PC-3, was transfected with pre-miR-23b, pre-miR-27b, and their respective controls using Lipofectamine RNAiMAX and exposed or not to flutamide. After transfections, expression levels of both the microRNAs and the gene, CCNG1, were analyzed by quantitative real-time polymerase chain reaction. The apoptosis and cell cycle assays were performed on the mini MUSE cytometer. MicroRNAs-23b/-27b were underexpressed in surgical specimens of prostate cancer; however, their target gene, CCNG1, was overexpressed in 69% of the cases. After transfection with the microRNAs-23b/-27b and flutamide, we observed a reduction in gene expression compared with cells that were treated only with microRNAs or only with flutamide. In the apoptosis assay, we demonstrated cell sensitization following transfection with microRNAs-23b/-27b and potentiation when co-administered with flutamide. The number of cells in apoptosis was almost three times higher with the simultaneous treatments (miR + flutamide) compared with the control (p < 0.05). In the cell cycle assay, only flutamide treatment showed better results; a higher number of cells were found in the G0-G1 phase, and a lower percentage of cells completed the final phase of the cycle (p < 0.05). We conclude that microRNAs-23b/-27b are downexpressed in prostate cancer, and their target gene, CCNG1, is overexpressed. We postulated that microRNAs-23b/-27b sensitize the PC-3 cell line and that after the addition of flutamide in the apoptosis assay, we would observe synergism in the treatments between miR and flutamide. In the cell cycle assay, the use of flutamide was sufficient to decrease the number of cells in mitosis. Therefore, we postulate that microRNAs, along with other drugs, may become very useful therapeutic tools in the treatment of castration-resistant prostate cancer.

Prevalence of errors causing events allegedly attributable to vaccination/immunization: systematic review and meta-analysis.

OBJECTIVE: To identify the prevalence of errors that caused events supposedly attributable to vaccination or immunization. METHOD: Systematic literature review with meta-analysis carried out on the Medline, Cochrane Library, Cinahl, Web of Science, Lilacs, Scopus; Embase; Open Grey; Google Scholar; and Grey Lit databases; with studies that presented the prevalence of immunization errors that caused events or that provided data that allowed this indicator to be calculated. RESULTS: We evaluated 11 articles published between 2010 and 2021, indicating a prevalence of 0.044 errors per 10,000 doses administered (n=762; CI95%: 0.026 - 0.075; I2 = 99%, p < 0.01). The prevalence was higher in children under 5 (0.334 / 10,000 doses; n=14). The predominant events were fever, local pain, edema and redness. CONCLUSION: A low prevalence of errors causing events was identified. However, events supposedly attributable to vaccination or immunization can contribute to vaccine hesitancy and, consequently, have an impact on vaccination coverage.

[Analysis of the operational conditions to preserve immunobiological products in vaccination rooms in Brazil: a mixed study]. / Análise das condições operacionais para conservação de imunobiológicos nas salas de vacinação do Brasil: estudo misto.

This study aimed to analyze the operational conditions to preserve immunobiological products in Brazil. This mixed-method study with a sequential explanatory design was developed in vaccination rooms in several Brazilian regions from 2021 to 2022. Its quantitative stage developed a descriptive cross-sectional study by applying the Immunobiological Conservation Assessment Scale to nursing professionals. Data were analyzed by descriptive statistics. Its qualitative stage developed a descriptive-exploratory study in cold chain instances with the respective technical managers and nursing professionals. The interviews were evaluated by thematic content analysis. The data were combined by connection, and joint-displays and meta-inferences were elaborated. Overall, 280 rooms were analyzed. Most were for exclusive use (79.6%), had polyurethane boxes (77.8%), and kept their equipment away from sunlight/heat (73.5%). Only 27.5% had batteries/generators and 26.5% had other temperature measuring instruments. In total, 60% had refrigerated rooms and 67.6%, air-conditioned rooms. This study found weaknesses associated with geographical conditions, infrastructure, material inputs, human and financial resources, work organization and management, turnover, and training. These findings showed the plurality of the Brazilian cold chain and identified the potentialities and weaknesses related to the structures and work processes in preserving immunobiological products, which require improvement.

Este estudo objetivou analisar as condições operacionais para conservação de imunobiológicos no Brasil. Trata-se de um estudo de método misto com delineamento explanatório sequencial, desenvolvido nas salas de vacinação de distintas regiões brasileiras entre 2021 e 2022. Na etapa quantitativa, desenvolveu-se um estudo transversal descritivo, com a aplicação da Escala de Avaliação da Conservação de Imunobiológicos aos profissionais de enfermagem. Os dados foram analisados por meio de estatística descritiva. Já na etapa qualitativa, desenvolveu-se um estudo descritivo-exploratório nas instâncias da cadeia de frio, com os respectivos responsáveis técnicos e profissionais de enfermagem. Analisou-se as entrevistas por meio da Análise de Conteúdo na Modalidade Temática. Os dados foram combinados mediante conexão, com elaboração de joint-displays e metainferências. Foram analisadas 280 salas, em que grande parte: era de uso exclusivo (79,6%); utilizava caixas de poliuretano (77,8%); e mantinha seus equipamentos distantes da incidência de luz solar/fontes de calor (73,5%). Apenas 27,5% dispunham de baterias/geradores e 26,5% de outros instrumentos de medição de temperatura. Sessenta por cento detinham câmaras refrigeradas e 67,6% ambientes climatizados. Revelaram-se fragilidades associadas a condições geográficas, infraestrutura, insumos materiais, recursos humanos e financeiros, organização e gestão do trabalho, rotatividade e capacitação. Os achados possibilitaram conhecer a pluralidade da cadeia de frio brasileira e permitiram a identificação de potencialidades e fragilidades na conservação de imunobiológicos relacionadas às estruturas e aos processos de trabalho que requerem aprimoramento.

Este estudio tuvo como objetivo analizar las condiciones operativas para la conservación de inmunobiológicos en Brasil. Estudio de método mixto con diseño explicativo secuencial, desarrollado en las salas de vacunación de las distintas regiones brasileñas, entre 2021 y 2022. En la etapa cuantitativa se desarrolló un estudio transversal descriptivo, con la aplicación de la Escala de Evaluación de la Conservación de Inmunobiológicos a los profesionales de enfermería. Los datos fueron analizados mediante estadística descriptiva. En la etapa cualitativa se desarrolló un estudio descriptivo-exploratorio en las instancias de la cadena de frío, con los respectivos responsables técnicos y profesionales de enfermería. Las entrevistas se analizaron por medio del Análisis de Contenido en la Modalidad Temática. Los datos fueron combinados mediante conexión, con elaboración de joint-displays y metainferencias. Se analizaron 280 salas. Gran parte era de uso exclusivo (79,6%); utilizaba cajas de poliuretano (77,8%) y mantenía sus equipos alejados de la incidencia de la luz solar/fuentes de calor (73,5%). Solo el 27,5% disponía de baterías/generadores y el 26,5% de otros instrumentos de medición de temperatura. El 60% tenía cámaras refrigeradas y el 67,6% ambientes climatizados. Se revelaron debilidades asociadas a las condiciones geográficas, la infraestructura, los insumos de materiales, los recursos humanos y financieros, la organización y gestión del trabajo, la rotación y la capacitación. Los hallazgos posibilitaron conocer la pluralidad de la cadena de frío brasileña y permitieron la identificación de potencialidades y debilidades de la conservación de inmunobiológicos relacionadas con las estructuras y los procesos de trabajo que requieren mejoras.

Performance indicators of Primary Care of the Previne Brasil Program. / Indicadores de desempeño de la Atención Primaria del Programa Previne Brasil.

OBJECTIVE: to analyze the scope of the performance indicators of the Previne Brasil Program of Primary Health Care. METHOD: an observational, descriptive study with a quantitative approach was carried out using secondary data, referring to the years 2020 and 2021, in the five Brazilian regions (North, Northeast, South, Southeast and Midwest), available in the Primary Health Care Information System. Descriptive statistics, relative frequencies and measures of central tendency and semiparametric modeling were used considering a 5% confidence interval. RESULTS: there was evidence of evolution in the rates of performance indicators in most Brazilian regions in 2021, compared to 2020, however, the North and Midwest regions had incipient or negative rates, compared to the Southeast region. Despite the evolution in the rates of the indicators, few States managed to reach the goals established by the Ministry of Health for the strategic actions of prenatal care and women's health; and no state achieved the goal in strategic action on chronic diseases. CONCLUSION: it is considered important to monitor the evolution of current indicators, envisioning their qualification so that they can evaluate primary health care and assistance, as well as guarantee the achievement of goals by ensuring funding for primary care actions.

Vaccination coverage in children under one year of age and associated socioeconomic factors: maps of spatial heterogeneity.

OBJECTIVE: to analyze vaccination coverage spatial distribution in children under one year old and the socioeconomic factors associated with meeting the recommended goals in Minas Gerais. METHODS: an ecological study, carried out in 853 municipalities in the state. Pentavalent, poliomyelitis, meningococcal conjugate, yellow fever, rotavirus, and 10-valent pneumococcal conjugate vaccination coverage were analyzed. Scan statistics and multiple logistic regression were performed to identify spatial clusters and factors associated with meeting coverage goals. RESULTS: spatial analysis revealed clusters with risk of low coverage for all vaccines. Number of families with per capita income of up to 1/2 wage, Minas Gerais Social Responsibility Index and percentage of the poor or extremely poor population were associated with meeting the established goals. CONCLUSIONS: the results are useful for designing interventions regarding the structuring of vaccination services and the implementation of actions to increase vaccination coverage in clusters with less propensity to vaccinate.

Incidence of immunization errors in the state of Minas Gerais, Brazil: a cross-sectional study, 2015-2019. / Incidência de erros de imunização em Minas Gerais: estudo transversal, 2015-2019.

OBJECTIVE: To evaluate the incidence of immunization errors in the public health service of the state of Minas Gerais, Brazil. METHODS: This was a cross-sectional study, based on errors reported on the National Immunization Program Information System between 2015 and 2019. A descriptive analysis and calculation of the incidence for the state's health macro-regions were performed. RESULTS: A total of 3,829 notifications were analyzed. Children younger than 1 year old were the most affected (39.1%) and the intramuscular route accounted for 29.4% of the errors. The most frequently reported error was administration of vaccines outside minimum and maximum recommended ages (37.7%). There was a higher incidence of errors in Vale do Aço (26.5/100,000) and Triângulo do Norte (22.6/100,000) macro-regions. CONCLUSION: Immunization errors showed a heterogeneous incidence among the macro-regions of the state of Minas Gerais, between 2015-2019, and the administration of vaccines outside minimum and maximum recommended ages was the most frequently reported error.

[Primary Healthcare e-SUS: determinant attributes for the adoption and use of a technological innovation]. / e-SUS Atenção Primária: atributos determinantes para adoção e uso de uma inovação tecnológica.

The study aimed to analyze the adoption and use of the Primary Healthcare e-SUS (PHC e-SUS) as a technological innovation from the perspective of workers in primary healthcare (PHC). This was a sequential exploratory mixed-methods study (QUAN → qual) in municipalities in the interior of São Paulo state, Brazil, drawing on Diffusion of Innovation Theory. The quantitative component was analytical cross-sectional, applying a validated questionnaire to 114 PHC workers. The model was tested by applying partial least squares structural equation modeling (PLS-SEM) using SmartPLS 2.3.0. The qualitative study was descriptive-exploratory, using interviews (n = 10) with thematic content analysis, aimed at understanding the attributes that did not influence the adoption and use of PHC e-SUS. The attributes "experimentation", "ease of use", "relative advantage", and "compatibility" did not display statistical significance, indicating that they were not determinant attributes for the adoption and use of PHC e-SUS. Integration of the data evidenced failures in connectivity; lack of time to feed the system in real time and training; lack of prior experimentation; abrupt presentation of the system; and lack of skill with the technology. The results can assist other municipalities in Brazil with the implementation of the PHC e-SUS in relation to the importance of the organizational infrastructure, as well as training in the technology's use and handling. The study contributes to reflections and proposals for interventions in the problems faced in daily work with the adoption and use of a technological innovation such as the PHC e-SUS.

O estudo objetivou analisar a adoção e o uso do e-SUS Atenção Primária (e-SUS APS) como inovação tecnológica na perspectiva dos profissionais da atenção primária à saúde (APS). Trata-se de um estudo de método misto explanatório sequencial (QUAN → qual) realizado em municípios do interior de São Paulo, Brasil, utilizando a Teoria da Difusão de Inovação. O estudo quantitativo foi do tipo transversal analítico, aplicando-se um questionário validado a 114 profissionais da APS. Para testar o modelo do estudo, aplicou-se a modelagem de equações estruturais de mínimos quadrados parciais (PLS-SEM) por meio do software SmartPLS 2.3.0. O estudo qualitativo teve caráter descritivo-exploratório, por meio de entrevistas (n = 10) analisadas por análise temática de conteúdo, visando entender os atributos que não influenciaram a adoção e o uso do e-SUS APS. Os atributos "experimentação", "facilidade de uso", "vantagem relativa" e "compatibilidade" não apresentaram significância estatística, indicando não serem atributos determinantes para adoção e uso do e-SUS APS. Na integração dos dados, evidenciaram-se: falhas de conectividade; ausência de tempo para alimentação do sistema em tempo real e de capacitação; não experimentação prévia; apresentação abrupta do sistema e ausência de habilidade com a tecnologia. Os resultados podem auxiliar os demais municípios do Brasil na implantação e/ou efetivação do e-SUS APS, no que tange à importância da infraestrutura organizacional, bem como na capacitação para utilização e manuseio da tecnologia. Este estudo contribui para reflexões e propostas de intervenções aos problemas enfrentados no cotidiano do trabalho quanto à adoção e ao uso de uma inovação tecnológica, como o e-SUS APS.

El objetivo del estudio fue analizar la adopción y uso del e-SUS Atención Primaria (e-SUS APS), como innovación tecnológica, desde la perspectiva de los profesionales de la atención primaria en salud (APS). Se trata de un estudio de método mixto secuencial explicativo (CUAN → Cual) realizado en municipios del interior de São Paulo, utilizando la Teoría de la Difusión de Innovación. El estudio cuantitativo fue de tipo transversal analítico, aplicándose un cuestionario validado a 114 profesionales de la APS. Para probar el modelo del estudio se aplicó el modelado de ecuaciones estructurales de mínimos cuadrados parciales (PLS-SEM), a través del software SmartPLS 2.3.0. El estudio cualitativo tuvo carácter descriptivo-exploratorio, mediante entrevistas (n = 10), analizadas por análisis de contenido temático, con el objetivo de entender los atributos que no influenciaron en la adopción y uso de la e-SUS APS. Los atributos "probar", "facilidad de uso", "ventaja relativa" y "compatibilidad" no presentaron significación estadística, indicando no ser atributos determinantes para la adopción y uso de la e-SUS APS. En la integración de los datos se evidenciaron: fallos de conectividad; ausencia de tiempo para alimentación del sistema en tiempo real y de capacitación; no pruebas previas; presentación abrupta del sistema y ausencia de habilidad con la tecnología. Los resultados pueden ayudar a los demás municipios de Brasil en la implantación y/o efectuación de la e-SUS APS, en lo que atañe a la importancia de la infraestructura organizativa, así como la capacitación para la utilización y manejo de la tecnología. Este estudio contribuye a las reflexiones y propuestas de intervenciones, respecto a los problemas enfrentados en el día a día del trabajo, en cuanto a la adopción y uso de una innovación tecnológica, como la e-SUS APS.

Adequacy assessment of immunobiological agent conservation in the Western Health macro-region of Minas Gerais State, Brazil: a descriptive study, 2017. / Avaliação da adequação da conservação de imunobiológicos na macrorregião de saúde Oeste de Minas Gerais: estudo descritivo, 2017.

OBJECTIVE: To describe the adequacy of immunobiological agent conservation in vaccination rooms in the municipalities of the Western health macro-region of the state of Minas Gerais, Brazil. METHODS: This was a descriptive study, based on a validated scale, with a maximum score of 15 points. A descriptive analysis and an association test between the scores obtained by the municipalities and variables of the external context were performed. RESULTS: 275 out of a total of 295 existing vaccination rooms were evaluated. Immunobiological agent conservation in the West macro-region obtained an average score of 4 points (standard score, 0 to 15). There was a poor availability of immunization supplies aimed at immunobiological agent conservation, and work processes, that require improvement. Small municipalities presented better immunobiological agent conservation (p=0.011). CONCLUSION: Immunobiological agent conservation in vaccination rooms in the Western health macro-region of Minas Gerais State was considered inadequate.

Evaluation of the Psychometric Properties of the Immunobiological Agent Conservation Assessment Scale.

INTRODUCTION AND OBJECTIVE: The cold chain of immunobiological agent conservation occupies a strategic position in the immunization system and, therefore, needs to be evaluated. This study psychometrically evaluated the Immunobiological Agent Conservation Assessment Scale (Escala de Avaliação da Conservação de Imunobiológicos-EACI). METHODS: Methodological study carried out in Minas Gerais, Brazil, including 275 immunization rooms, divided into three stages: (a) pilot study; (b) internal consistency and temporal reproducibility; (c) criterion validity and structural validity. RESULTS: The EACI items were analyzed for comprehension and clarity; presenting internally consistency (Cronbach's alpha: 0.72 [95% CI: 0.666-0.763]) and temporal reproducibility (ICC: 0.948 [95% CI: 0.911-0.981]), in addition to explaining 72% of the variance and discriminating the groups criteria (p = .0025). CONCLUSION: The EACI is psychometrically reliable and valid and is the first assessment instrument available for this construct.

Fucoxanthin for Topical Administration, a Phototoxic vs. Photoprotective Potential in a Tiered Strategy Assessed by In Vitro Methods.

Fucoxanthin possesses a well-described antioxidant activity that might be useful for human skin photoprotection. However, there is a lack of scientific information regarding its properties when applied onto human skin. Thus, the objective of the present study was to assess the photoprotective and phototoxicity potential of fucoxanthin based on its ultraviolet (UVB 280-320 nm; UVA 320-400 nm) and visible (VIS 400-700 nm) absorption, photostability, phototoxicity in 3T3 mouse fibroblast culture vs. full-thickness reconstructed human skin (RHS), and its ability to inhibit reactive oxygen species formation that is induced by UVA on HaCaT keratinocytes. Later, we evaluated the antioxidant properties of the sunscreen formulation plus 0.5% fucoxanthin onto RHS to confirm its bioavailability and antioxidant potential through the skin layers. The compound was isolated from the alga Desmarestia anceps. Fucoxanthin, despite presenting chemical photo-instability (dose 6 J/cm2: 35% UVA and 21% VIS absorbance reduction), showed acceptable photodegradation (dose 27.5 J/cm2: 5.8% UVB and 12.5% UVA absorbance reduction) when it was added to a sunscreen at 0.5% (w/v). In addition, it increased by 72% of the total sunscreen UV absorption spectra, presenting UV-booster properties. Fucoxanthin presented phototoxic potential in 3T3 fibroblasts (mean photo effect 0.917), but it was non-phototoxic in the RHS model due to barrier function that was provided by the stratum corneum. In addition, it showed a significant inhibition of ROS formation at 0.01% (p < 0.001), in HaCat, and in a sunscreen at 0.5% (w/v) (p < 0.001), in RHS. In conclusion, in vitro results showed fucoxanthin protective potential to the skin that might contribute to improving the photoprotective potential of sunscreens in vivo.

Acceptance and use of the Information System of the National Immunization Program.

OBJECTIVE: to analyze the acceptance and use of the Information System of the National Immunization Program in primary health care vaccination rooms. METHOD: a unique case study of a qualitative approach in the light of the Unified Theory of Acceptance and Use of Technology. Data collection included an interview with 18 professionals responsible for the implementation of the information system, observation of vaccination rooms in 12 municipalities of the West Macro-region of Minas Gerais, selected from a preliminary study. Data was systematized and analyzed through Content Analysis. RESULTS: the interviewees are satisfied with the usefulness and ease of the system usage, but do not have the same satisfaction with the organizational infrastructure due to the lack of computers and low Internet connectivity in the health units, as well as with the incipient training for the use of the information system and the lack of skills with the technology among the human resources. CONCLUSION: nursing professionals perceive advantages in the acceptance and use of the Information System of the National Immunization Program. It was clear that the vaccinated individual's history control and the decrease of records in paper are evidenced as facilitators of this acceptance. The system was considered reliable and secure.

Digital application developed to evaluate functional results following robot-assisted radical prostatectomy: App for prostate cancer.

INTRODUCTION: Mobile applications ("apps") developed for smartphones and tablets are increasingly used in healthcare, allowing remote patient support or promoting self-health care. Prostate cancer (PC) screening allows for early-stage PC diagnosis, resulting in high rates of curative procedures such as radical prostatectomy. The main complications following surgery are urinary incontinence and erectile dysfunction. However, the exact numbers related to these morbidities are often missing due to brief interviews during consultations in the medical office. Therefore, the aim of this study was to create an app to determine whether response rates to pre- and post-surgical PC questionnaires will increase. METHODS: The app was built using the IONIC framework system and provided to patients through a prospective randomized study. We included 100 patients divided into two groups: 1. first group used the app (n = 50); and 2. second group responded via validated printed questionnaires (control group) (n = 50). All patients received discharge counseling to respond to the questionnaires 1, 3, 6 and 12 months after the procedure. The app group received verbal guidance on how monitoring would occur, received an SMS containing a username and password providing access to the system and received reminder alerts to respond to the questionnaires. RESULTS: The new app is called UroHealth and is available for download in the Apple App Store or at www.urohealth.com.br. When we evaluated the response rates, we found that 42.9% of the patients answered the preoperative questionnaire in the app group, while 16% responded in the control group (p = 0.003). By the end of the follow-up, we found that 24.5% of the patients answered the questionnaire in the app group, while 4% responded in the control group (p = 0.003). CONCLUSION: This app enabled almost 6 times more patients to answer long-term follow-up questions after surgical procedures, providing high-quality information regarding morbidity related to treatment. Although our initial results indicate that this app may become a useful tool in obtaining more frequent and realistic answers, thus helping to improve surgical techniques, other ways of reaching the patient should be tested to achieve higher response rates.

Parenting cultural models of a group of mothers from Rio de Janeiro.

Developmental contexts have been studied in terms of systems of beliefs and practices, treated as part of general cultural models. This paper aims to describe aspects of parenting cultural models of a group of 200 primiparous Brazilian mothers from Rio de Janeiro, who had children less than 44 months old. Mothers answered the Socialization Goals Interview (SGI), and an adapted version of an inventory of beliefs about practices of care, developed by M. Suizzo. Answers to the SGI were coded in five categories and their subcategories: Self-maximization (SM), Self-control (SC), Lovingness (L), Proper demeanor (PD) and Decency (D), and scores in each of them were calculated. A factor analysis indicated three dimensions of mothers' beliefs about practices: Awaking and exposing the child to diverse stimuli (Stimulation), ensuring the Proper presentation of the child and Responding to and bonding to the child. Data was further analyzed in terms of subcategories of SM and D and of the relation to the factors mothers' educational level and sex of their child. Results showed that mothers from Rio de Janeiro share a cultural model of autonomy for their children, but that they also believe in the importance of their relationship to others.

Temporal trends in vaccination coverage in the first year of life in Brazil / Tendência temporal das coberturas vacinais no primeiro ano de vida no Brasil

ABSTRACT Objective: The aim of this study was to analyze the temporal trends in vaccination coverage (VC) during the first year of life of children in Brazil. Methods: Data on VC for the first year of life from 2011 to 2020 for Bacille Calmette-Guerin (BCG), hepatitis B, polio, pentavalent, and triple viral vaccines at the national, regional, and state levels were obtained from the Information System of the National Immunization Program. Trends were analyzed using Prais-Winsten generalized linear regression models and average annual percent change (APC) estimates. Results: Decreasing trends were observed for the BCG (APC −3.58%; p<0.05), pentavalent (APC −4.10%; p<0.05), polio (APC −2.76%; p<0.05), and triple viral (APC −2.56%; p<0.05) vaccines in the country. Hepatitis B vaccine was the only vaccine that displayed stationary behavior (APC −4.22%; p>0.05). During the study period, no increasing trends were observed in any territory or vaccine. Conclusions: This study shows a recent significant reduction and decreasing trends in VC during the first year of life of children in Brazil, indicating the need for interventions to curb this ongoing phenomenon and to recover acceptable VC rates in the country.

RESUMO Objetivo: Analisar a tendência temporal da cobertura vacinal (CV) em crianças com idade menor ou igual a um ano no Brasil. Métodos: Foram empregados dados da CV no primeiro ano de vida de 2011 a 2020 referentes às vacinas BCG, hepatite B, poliomielite, pentavalente e tríplice viral, obtidos do Sistema de Informação do Programa Nacional de Imunizações (SI-PNI). Os dados estão agregados em nível nacional, regional e estadual. Para a análise de tendência foi utilizado o modelo de regressão linear generalizado de Prais-Winsten e foi calculada a variação percentual média anual (APC). Resultados: As tendências de CV para as vacinas BCG (APC −3,58%; p<0,05), pentavalente (APC −4,10%; p<0,05), poliomielite (APC −2,76%; p<0,05) e tríplice viral (APC −2,56%; p<0,05) foram decrescentes no país. Apenas para a CV da vacina contra hepatite B foi identificado comportamento estacionário (APC −4,22%; p>0,05). Nenhum território ou vacina apresentou tendência crescente para cobertura vacinal no período estudado no Brasil. Conclusões: Este estudo alerta sobre a redução expressiva das CV no primeiro ano de vida nos últimos anos no Brasil e sua tendência decrescente, sendo imperativa a adoção de intervenções com o fim de frear o fenômeno em curso e de resgatar níveis aceitáveis de CV no país.

Violência entre Parceiros Íntimos adolescentes: Atuação da Rede de proteção durante a pandemia da COVID-19 / Intimate partner violence in adolescence: Action of the protection network during the COVID-19 pandemic

A Violência por Parceiro Íntimo (VPI) envolve comportamentos violentos entre parceiros formais e eventuais. Apesar de Curitiba ter uma Rede de Proteção à Criança e ao Adolescente, não há ações específicas para abordar a VPI nessa população. É crucial que os profissionais de saúde identifiquem e implementem medidas interdisciplinares para prevenir e combater esse problema. Por isso, esse estudo teve como objetivo descrever e analisar a percepção de trabalhadores da Rede de Proteção à criança e ao adolescente em situação de risco para violência de Curitiba diante do fenômeno violência entre parceiros íntimos adolescentes. Estudo de abordagem qualitativa sob o referencial teórico da Teoria da Intervenção Práxica da Enfermagem em Saúde Coletiva. Os dados foram coletados em 2022 via entrevistas semiestruturadas, submetidos à análise de conteúdo com apoio do software WebQDA. As categorias analíticas foram gênero e geração. Participaram cinco trabalhadores da Rede de Proteção e emergiram duas categorias: a VPI como um fenômeno comum na adolescência e no território, e a atuação em rede diante da VPI adolescente e as limitações durante a pandemia de COVID-19. As concepções negativas sobre a VPI na adolescência, baseadas em estereótipos de gênero e geração, frequentemente subjugam as meninas. A abordagem fragmentada nos serviços de saúde pesquisados não reconhece a VPI como uma questão de saúde, e a assistência aos adolescentes, já deficiente, piorou durante a pandemia. Apesar disso, a Rede de Proteção é vista como uma esperança para enfrentar a VPI adolescente, sendo uma ferramenta promissora, porém ainda precisa ser mais integrada aos serviços de saúde.

Intimate Partner Violence (IPV) involves violent behavior between formal and occasional partners. Although Curitiba has a Child and Adolescent Protection Network, there are no specific actions to address IPV in this population. It is crucial that healthcare professionals identify and implement interdisciplinary measures to prevent and combat this problem. Therefore, this study aimed to describe and analyze the perception of workers from the Network for the Protection of Children and Adolescents at Risk for Violence in Curitiba regarding the phenomenon of violence between adolescent intimate partners. This is a qualitative study based on the theoretical framework of the Theory of Praxis Intervention in Public Health Nursing. Data were collected in 2022 via semi-structured interviews, subjected to content analysis with the support of WebQDA software. The analytical categories were gender and generation. Five workers from the Protection Network participated and two categories emerged: IPV as a common phenomenon in adolescence and in the territory, and network action in the face of adolescent IPV and limitations during the Covid-19 pandemic. Negative conceptions about adolescent IPV, based on gender and generational stereotypes, often subjugate girls. The fragmented approach in the health services surveyed does not recognize IPV as a health issue, and assistance to adolescents, already deficient, worsened during the pandemic. Despite this, the Protection Network is seen as a hope to combat adolescent IPV, being a promising tool, but it still needs to be more integrated into health services.

Prevalence of errors causing events allegedly attributable to vaccination/immunization: systematic review and meta-analysis / Prevalencia de errores causantes de acontecimientos supuestamente atribuibles a la vacunación/inmunización: revisión sistemática y metanálisis / Prevalência de erros que causaram eventos supostamente atribuíveis à vacinação/imunização: revisão sistemática e metanálise

ABSTRACT Objective: To identify the prevalence of errors that caused events supposedly attributable to vaccination or immunization. Method: Systematic literature review with meta-analysis carried out on the Medline, Cochrane Library, Cinahl, Web of Science, Lilacs, Scopus; Embase; Open Grey; Google Scholar; and Grey Lit databases; with studies that presented the prevalence of immunization errors that caused events or that provided data that allowed this indicator to be calculated. Results: We evaluated 11 articles published between 2010 and 2021, indicating a prevalence of 0.044 errors per 10,000 doses administered (n=762; CI95%: 0.026 - 0.075; I2 = 99%, p < 0.01). The prevalence was higher in children under 5 (0.334 / 10,000 doses; n=14). The predominant events were fever, local pain, edema and redness. Conclusion: A low prevalence of errors causing events was identified. However, events supposedly attributable to vaccination or immunization can contribute to vaccine hesitancy and, consequently, have an impact on vaccination coverage.

RESUMEN Objetivo: Identificar la prevalencia de errores que causaron eventos supuestamente atribuibles a la vacunación o inmunización. Método: Revisión sistemática de la literatura con metaanálisis realizada en las bases de datos Medline, Cochrane Library, Cinahl, Web of Science, Lilacs, Scopus; Embase; Open Grey; Google Scholar; y Grey Lit; con estudios que presentaran la prevalencia de errores de inmunización que causaron eventos o que aportaran datos que permitieran calcular este indicador. Resultados: Se evaluaron 11 artículos publicados entre 2010 y 2021, indicando una prevalencia de 0,044 errores por cada 10.000 dosis administradas (n=762; IC95%: 0,026 - 0,075; I2 = 99%, p < 0,01). La prevalencia fue mayor en niños menores de 5 años (0,334 / 10.000 dosis; n=14). Los eventos predominantes fueron fiebre, dolor local, edema y enrojecimiento. Conclusión: Se identificó una baja prevalencia de eventos causantes de errores. Sin embargo, los eventos supuestamente atribuibles a la vacunación o inmunización pueden contribuir a la indecisión sobre la vacunación y, en consecuencia, repercutir en la cobertura vacunal.

RESUMO Objetivo: Identificar a prevalência de erros que causaram eventos supostamente atribuíveis à vacinação ou imunização. Método: Revisão sistemática da literatura com metanálise realizada nas bases Medline, Cochrane Library, Cinahl, Web of Science, Lilacs, Scopus; Embase; Open Grey; Google Scholar; e Grey Lit; com estudos que apresentassem prevalência de erros de imunização que causaram eventos ou que disponibilizassem dados que permitissem o cálculo deste indicador. Resultados: Avaliou-se 11 artigos publicados entre 2010 e 2021, apontando prevalência de 0,044 erros por 10.000 doses administradas (n=762; IC95%: 0,026 - 0,075; I2= 99%, p < 0,01). A prevalência foi maior em crianças menores de 5 anos (0,334 / 10.000 doses; n=14). Quanto aos eventos, predominou-se: febre, dor local, edema, rubor. Conclusão: Identificou-se uma prevalência baixa de erros que causaram eventos. Entretanto, os eventos supostamente atribuíveis à vacinação ou imunização podem contribuir para a hesitação vacinal e, consequentemente, impactar nas coberturas vacinais.

Análise das condições operacionais para conservação de imunobiológicos nas salas de vacinação do Brasil: estudo misto / Analysis of the operational conditions to preserve immunobiological products in vaccination rooms in Brazil: a mixed study / Análisis de las condiciones operativas para la conservación de inmunobiológicos en las salas de vacunación de Brasil: un estudio mixto

Resumo: Este estudo objetivou analisar as condições operacionais para conservação de imunobiológicos no Brasil. Trata-se de um estudo de método misto com delineamento explanatório sequencial, desenvolvido nas salas de vacinação de distintas regiões brasileiras entre 2021 e 2022. Na etapa quantitativa, desenvolveu-se um estudo transversal descritivo, com a aplicação da Escala de Avaliação da Conservação de Imunobiológicos aos profissionais de enfermagem. Os dados foram analisados por meio de estatística descritiva. Já na etapa qualitativa, desenvolveu-se um estudo descritivo-exploratório nas instâncias da cadeia de frio, com os respectivos responsáveis técnicos e profissionais de enfermagem. Analisou-se as entrevistas por meio da Análise de Conteúdo na Modalidade Temática. Os dados foram combinados mediante conexão, com elaboração de joint-displays e metainferências. Foram analisadas 280 salas, em que grande parte: era de uso exclusivo (79,6%); utilizava caixas de poliuretano (77,8%); e mantinha seus equipamentos distantes da incidência de luz solar/fontes de calor (73,5%). Apenas 27,5% dispunham de baterias/geradores e 26,5% de outros instrumentos de medição de temperatura. Sessenta por cento detinham câmaras refrigeradas e 67,6% ambientes climatizados. Revelaram-se fragilidades associadas a condições geográficas, infraestrutura, insumos materiais, recursos humanos e financeiros, organização e gestão do trabalho, rotatividade e capacitação. Os achados possibilitaram conhecer a pluralidade da cadeia de frio brasileira e permitiram a identificação de potencialidades e fragilidades na conservação de imunobiológicos relacionadas às estruturas e aos processos de trabalho que requerem aprimoramento.

Abstract: This study aimed to analyze the operational conditions to preserve immunobiological products in Brazil. This mixed-method study with a sequential explanatory design was developed in vaccination rooms in several Brazilian regions from 2021 to 2022. Its quantitative stage developed a descriptive cross-sectional study by applying the Immunobiological Conservation Assessment Scale to nursing professionals. Data were analyzed by descriptive statistics. Its qualitative stage developed a descriptive-exploratory study in cold chain instances with the respective technical managers and nursing professionals. The interviews were evaluated by thematic content analysis. The data were combined by connection, and joint-displays and meta-inferences were elaborated. Overall, 280 rooms were analyzed. Most were for exclusive use (79.6%), had polyurethane boxes (77.8%), and kept their equipment away from sunlight/heat (73.5%). Only 27.5% had batteries/generators and 26.5% had other temperature measuring instruments. In total, 60% had refrigerated rooms and 67.6%, air-conditioned rooms. This study found weaknesses associated with geographical conditions, infrastructure, material inputs, human and financial resources, work organization and management, turnover, and training. These findings showed the plurality of the Brazilian cold chain and identified the potentialities and weaknesses related to the structures and work processes in preserving immunobiological products, which require improvement.

Resumen: Este estudio tuvo como objetivo analizar las condiciones operativas para la conservación de inmunobiológicos en Brasil. Estudio de método mixto con diseño explicativo secuencial, desarrollado en las salas de vacunación de las distintas regiones brasileñas, entre 2021 y 2022. En la etapa cuantitativa se desarrolló un estudio transversal descriptivo, con la aplicación de la Escala de Evaluación de la Conservación de Inmunobiológicos a los profesionales de enfermería. Los datos fueron analizados mediante estadística descriptiva. En la etapa cualitativa se desarrolló un estudio descriptivo-exploratorio en las instancias de la cadena de frío, con los respectivos responsables técnicos y profesionales de enfermería. Las entrevistas se analizaron por medio del Análisis de Contenido en la Modalidad Temática. Los datos fueron combinados mediante conexión, con elaboración de joint-displays y metainferencias. Se analizaron 280 salas. Gran parte era de uso exclusivo (79,6%); utilizaba cajas de poliuretano (77,8%) y mantenía sus equipos alejados de la incidencia de la luz solar/fuentes de calor (73,5%). Solo el 27,5% disponía de baterías/generadores y el 26,5% de otros instrumentos de medición de temperatura. El 60% tenía cámaras refrigeradas y el 67,6% ambientes climatizados. Se revelaron debilidades asociadas a las condiciones geográficas, la infraestructura, los insumos de materiales, los recursos humanos y financieros, la organización y gestión del trabajo, la rotación y la capacitación. Los hallazgos posibilitaron conocer la pluralidad de la cadena de frío brasileña y permitieron la identificación de potencialidades y debilidades de la conservación de inmunobiológicos relacionadas con las estructuras y los procesos de trabajo que requieren mejoras.

Postural control in subclinical neck pain: a comparative study on the effect of pain and measurement procedures.

BACKGROUND AND AIMS: This study investigated whether young university students with neck pain (NP) have postural control deficits when compared to sex and age-matched asymptomatic subjects. METHODS: Centre of pressure (COP) sway area, velocity, anterior-posterior and mediolateral distances were measured in participants with (n=27) and without (n=27) neck pain for different combinations of static standing (narrow stance, tandem stance and single leg stance) and measurement time (90, 60, 30 and 15 s) with eyes closed using a force plate. Additionally, static and dynamic clinical tests of postural control were used. RESULTS: No significant between group differences were found for the COP measurements (p>0.05). However, individuals with subclinical NP were more likely to fail the 90 s tandem test (p<0.05) in the force plate and univariate comparisons revealed significant between group differences in the tandem and single leg stance clinical test measurements. CONCLUSIONS: Taken together, the inconsistent results might suggest an emerging postural control deficit in university students with low disability and low intensity chronic idiopathic NP.