Rural-urban disparities in fruit and vegetable consumption and cognitive performance in Brazil

Objectives: Rural residents are exposed to many risk factors for poor diet quality, such as low socioeconomic status and food insecurity. However, the differences between urban and rural residents regarding the association of fruit and vegetable consumption with cognitive performance have not been explored. The aim of this study was to investigate the association of fruit and vegetable consumption with cognitive performance in urban and rural areas in a nationally representative sample of Brazilian older adults. Methods: The sample included 9,412 adults aged 50 years or older from the Brazilian Longitudinal Study of Aging (Estudo Longitudinal da Saúde dos Idosos Brasileiros [ELSI]). The association between consumption of fruits and vegetables and cognitive performance was evaluated using linear regression. Results: In 8,158 participants (mean age 61.6 ± 9.3 years, 54% women, 44% White, and 15% from rural areas), the mean frequency of fruit and vegetable consumption was 2.0 ± 1.3 times a day. Higher intake of fruits and vegetables was associated with better memory (β = 0.031, 95%CI 0.014-0.049), verbal fluency (β = 0.030, 95%CI 0.004-0.056), and global cognition (β = 0.035, 95%CI 0.015-0.055) performance in urban, but not rural residents (p for interaction = 0.036). Conclusion: Higher frequency of fruit and vegetable intake was associated with better cognitive performance in urban, but not in rural areas in Brazil.

Rural-urban disparities in fruit and vegetable consumption and cognitive performance in Brazil.

OBJECTIVES: Rural residents are exposed to many risk factors for poor diet quality, such as low socioeconomic status and food insecurity. However, the differences between urban and rural residents regarding the association of fruit and vegetable consumption with cognitive performance have not been explored. The aim of this study was to investigate the association of fruit and vegetable consumption with cognitive performance in urban and rural areas in a nationally representative sample of Brazilian older adults. METHODS: The sample included 9,412 adults aged 50 years or older from the Brazilian Longitudinal Study of Aging (Estudo Longitudinal da Saúde dos Idosos Brasileiros [ELSI]). The association between consumption of fruits and vegetables and cognitive performance was evaluated using linear regression. RESULTS: In 8,158 participants (mean age 61.6 ± 9.3 years, 54% women, 44% White, and 15% from rural areas), the mean frequency of fruit and vegetable consumption was 2.0 ± 1.3 times a day. Higher intake of fruits and vegetables was associated with better memory (ß = 0.031, 95%CI 0.014-0.049), verbal fluency (ß = 0.030, 95%CI 0.004-0.056), and global cognition (ß = 0.035, 95%CI 0.015-0.055) performance in urban, but not rural residents (p for interaction = 0.036). CONCLUSIONS: Higher frequency of fruit and vegetable intake was associated with better cognitive performance in urban, but not in rural areas in Brazil.

Assessment of VITEK® 2, MALDI-TOF MS and full gene 16S rRNA sequencing for aerobic endospore-forming bacteria isolated from a pharmaceutical facility.

VITEK®2, MALDI-TOF MS and 16S rRNA sequencing were evaluated for the identification of aerobic endospore-forming bacteria (AEB) from a pharmaceutical facility. MALDI-TOF MS demonstrated higher accuracy compared to VITEK®2, although both databases were insufficient to identify AEB species. Sequencing was the best methodology, but unable to identify closely related species.

In situ off-line extracorporeal photopheresis conducted in a real-life situation at a Hemobiotherapy Department in France: A comparison of costs vs on-line procedure.

BACKGROUND: The off-line extracorporeal photopheresis (ECP) procedure requires photosensitization in an external cell therapy laboratory as per the French regulatory requirement. This regulation results in higher time and costs compared with the on-line alternative performed entirely at the patient's bedside. Recently, full in situ execution of the off-line procedure has been implemented in the Pitié-Salpêtrière Hospital Hemobiotherapy Department (Paris, France). This report summarizes the center's experience regarding the organizational and costs impacts of this change compared with the on-line procedure. MATERIAL AND METHODS: ECP was broken down into stages, and several procedures were monitored prospectively in real-life settings. The total costs associated with both procedures were the sum of the fixed costs and variable costs related to all stages of the procedures, nursing-time costs, property costs, and patient-related production loss costs. RESULTS: Eight off-line ECP and fourteen on-line ECP procedures were monitored during five consecutive days. Procedure duration was not different (median 137.5 vs 154.0 minutes, P = .29). Times and costs associated with nursing were higher but offset by lower fixed costs of the off-line ECP. Total direct costs per procedure associated with using the off-line ECP were significantly lower than those of the on-line procedure (459.6 ± 7.1 EUR vs 953.8 ± 6.5 EUR; P = .0002). Similar results were observed when including the costs of patient production loss. CONCLUSIONS: As a competitive time procedure, the in situ off-line method proved to be cost-efficient by effectively offering similar patient treatment per year compared with the on-line procedure.

Subjective Tools for Burn Scar Assessment: An Integrative Review.

OBJECTIVE: To review the clinical and scientific literature on the subjective ways of assessing burn scars and describe their main characteristics. DATA SOURCES: The Latin American, Caribbean Health Sciences Literature, Nursing Database, PubMed, CINAHL, and Scopus and Web of Science databases were used to search for studies published between 2014 and 2018 using descriptors in Portuguese, Spanish, and English. STUDY SELECTION: After establishing the research question and the location and definition of the studies, as well as accounting for differences among databases and application of filters based on inclusion and exclusion criteria, 886 references remained. DATA EXTRACTION: Investigators reviewed the titles and abstracts of the sample and selected 188 relevant studies for full review. DATA SYNTHESIS: Twenty-six subjective forms of assessment were found; most research concerned the Patient and Observer Scar Assessment Scale and the Vancouver Scar Scale. CONCLUSIONS: The Patient and Observer Scar Assessment Scale and the Vancouver Scar Scale are the most common scales for assessing burn scars and have similar evaluation points such as vascularization, pliability, pigmentation, and height, which are the main parameters that contribute to the general assessment and severity of a scar. There is a need to improve instructions for application of the scales to facilitate better understanding and improve agreement among evaluators.

Desenvolvimento do raciocínio clínico de enfermeiros de um serviço hospitalar de emergência / Development of the clinical reasoning of nurses of an emergency hospital service

Objetivo: compreender o desenvolvimento do raciocínio clínico de enfermeiros de um serviço hospitalar de emergência. Métodos: pesquisa qualitativa, com referencial metodológico da Teoria Fundamentada nos Dados. Coleta de dados ocorreu por meio de entrevistas, com amostragem teórica de 21 participantes e análise mediante codificação substantiva e teórica. Resultados: identificou-se a categoria central Sabendo o que fazer, e quatro categorias conceituais: 1) Descobrindo as atribuições do enfermeiro no serviço de emergência; 2) Aprimorando o raciocínio clínico por meio da experiência profissional; 3) Prestando assistência com qualidade e segurança para o paciente; e 4) Conquistando reconhecimento profissional da equipe de saúde. Conclusão: o desenvolvimento do raciocínio clínico do enfermeiro é um processo gradativo e experiencial cumulativo de "saber o que fazer" em emergência. Baseia-se no trabalho colaborativo com a equipe de saúde e na aquisição de conhecimentos técnico-científicos para realização de assistência qualificada a pacientes. (AU)

Adherence to the objectives of the Safe Surgery Saves Lives Initiative: perspective of nurses / Adesão aos objetivos do Programa Cirurgias Seguras Salvam Vidas: perspectiva de enfermeiros / Adherencia a los objetivos del Programa Cirugías Seguras Salvan Vidas: perspectiva de enfermeros

ABSTRACT Objective: to measure the adherence to the objectives of the Safe Surgery Saves Lives Initiative in surgical centers from the perspective of nurses. Method: cross-sectional study, developed through an online survey via the Google Forms® platform. The study participants were 220 nurses from surgical centers in different regions of Brazil. The data were collected through a socio-professional characterization form and a questionnaire in which the participants indicated their level of agreement in relation to the fulfillment of the objectives of the Safe Surgery Saves Lives Initiative. Data analysis was performed using descriptive statistics. Results: objective 1, The team will operate on the correct patient at the correct site, presented the highest levels of total agreement (n = 144; 65.5%) and partial agreement (n = 52; 23.6%). Objective 10, Hospitals and the public health systems will establish routine surveillance of surgical capacity, volume and results, obtained the lowest percentages of total (n = 69, 31.4%) and partial agreement (n = 81, 36.8%). Conclusion: adherence to the objectives of the Initiative is adequate, but there are weaknesses, especially in relation to the prevention of never events.

RESUMO Objetivo: mensurar a adesão aos objetivos do Programa Cirurgias Seguras Salvam Vidas em centros cirúrgicos a partir da perspectiva de enfermeiros. Método: estudo transversal, desenvolvido por meio de um survey on-line via plataforma Google Forms ®. Os participantes da pesquisa foram 220 enfermeiros de centros cirúrgicos de diferentes regiões do Brasil. Os dados foram coletados por meio de uma ficha de caracterização socioprofissional e questionário em que os participantes indicavam seu nível de concordância em relação ao cumprimento dos objetivos do Programa Cirurgias Seguras Salvam Vidas. A análise dos dados foi realizada por meio de estatística descritiva. Resultados: o objetivo 1, operar o paciente certo e local cirúrgico certo, apresentou os maiores níveis de concordância total (n=144; 65,5%) e parcial (n=52; 23,6%). O objetivo 10, o hospital e os sistemas de saúde pública estabelecem vigilância de rotina sobre capacidade, volume e resultados cirúrgicos, obteve os menores percentuais de concordância total (n=69; 31,4%) e parcial (n=81; 36,8%). Conclusão: a adesão aos objetivos do Programa é adequada, mas há fragilidades especialmente em relação à prevenção de never events.

RESUMEN Objetivo: medir la adherencia a los objetivos del Programa Cirugías Seguras Salvan Vidas en centros quirúrgicos desde la perspectiva de enfermeros. Método: estudio transversal, desarrollado por medio de survey on-line vía plataforma Google Forms ®. Los participantes de la investigación fueron 220 enfermeros de centros quirúrgicos de diferentes regiones de Brasil. Los datos fueron recolectados por medio de una ficha de caracterización socioprofesional y cuestionario en que los participantes indicaban su nivel de concordancia en relación al cumplimiento de los objetivos del Programa Cirugías Seguras Salvan Vidas. El análisis de los datos fue realizado por medio de estadística descriptiva. Resultados: el objetivo 1, operar el paciente correcto y local quirúrgico cierto, presentó los mayores niveles de concordancia total (n=144, 65,5%) y parcial (n=52; 23,6%). El objetivo 10, el hospital y los sistemas de salud pública establecen vigilancia de rutina sobre capacidad, volumen y resultados quirúrgicos, obtuvo los menores porcentuales de concordancia total (n=69; 31,4%) y parcial (n=81; 36, 8%). Conclusión: la adherencia a los objetivos del Programa es adecuada, pero hay fragilidades especialmente en relación a la prevención de never events.

Avaliação da qualidade de vida relacionada à saúde no primeiro ano após a queimadura / Assessment of health-related quality of life in the first year after burn / Evaluación de calidad de vida relaciona con la salud en el primer año después de la quemadura

Objetivo: Comparar a percepção de qualidade de vida de vítimas de queimaduras entre o 4º e 6º mês e entre o 9º e 12º mês após a alta hospitalar, de acordo com o sexo, superfície corporal queimada e visibilidade das cicatrizes. Métodos: Estudo longitudinal. Participaram adultos internados em uma unidade de queimados. Foram aplicados formulário de dados sociodemográficos e oMedical Outcomes Study 36-Item Short-Form Survey. Resultados: Houve melhora na percepção da qualidade de vida, destacando-se os domíniosAspecto físico e emocionais. Os homens apresentaram melhores resultados no domínio Dor; e aqueles que classificaram suas cicatrizes como não visíveis nos domínios Estado geral de saúde, Vitalidade, Aspecto social e Emocional entre o 9º e 12º mês. Conclusão: Pacientes relataram pior qualidade de vida em fase precoce e melhora em fase tardia, principalmente no domínio Aspecto físico e emocional entre os homens. As cicatrizes visíveis representaram avaliação negativa na fase tardia.

Objective: To compare the perception of quality of life for burn victims between the 4th and 6th and between the 9th and 12thmonths after hospital discharge, according to gender, body surface burned and visibility of scars. Methods: A longitudinal study.The study participants were adults admitted to a burn unit. A socio-demographic data form and the Medical Outcomes Study36-Item Short-Form Survey were applied. Results: There was an improvement in the perception of quality of life, highlighting thedomains: Role physical and Role emotional. Men showed better results in the domain Bodily pain; and also those who classifiedtheir scars as not visible in the domains: General Health, Vitality, Social Functioning and Role emotional, between the 9th and12th month. Conclusion: Patients reported worse quality of life at an early phase and improvement in a late phase, mainly inthe domains of Role physical and Role emotional, among men. The visible scars represented negative rating in the late phase

Objetivo: Comparar la percepción de calidad de vida de victimas de quemaduras entre el 4º e 6º y entre el 9º y 12º mes despuésdel alta, y sus diferencias según sexo, superficie corporal quemada y visibilidad de la cicatriz. Métodos: Estudio longitudinal.Participaron adultos internados en una Unidad de Quemados. Aplicado formulario de datos sociodemográficos y el MedicalOutcomes Study 36-Item Short-Form-Survey. Resultados: Huvo mejora de la percepción de calidad de vida, destacándoseAspectos físicos y Emocionales. Los hombres presentaron mejores resultados en el dominio Dolor; y los que classificaron suscicatrizes como no visibles en los domínios Estado general de salud, Vitalidad, Aspecto social y Emocional entre el 9º e 12ºmes. Conclusión: Pacientes relataron peor calidad de vida en la fase precoz y mejor en la fase tardía, principalmente en losdomínios Aspecto físico e emocional, entre los hombres. Las cicatrizes visibles representan evaluación negativa en la fase tardía.

Assessment of the health status in Brazilian burn victims five to seven months after hospital discharge.

PURPOSE: To evaluate health status, impact of event, anxiety, and depression in burn victims at five-to-seven months after hospital discharge, and to explore the association between those variables with age, body surface area burn (BSA), sex, and marital status. METHODS: Cross-sectional study involving 73 adults who were interviewed for general health status (BSHS-R), impact of event (IES), and anxiety and depression (HADS). RESULTS: Participants were mostly men (68.5%), with mean age 38.4 years (SD = 14.5), and mean hospital length of stay (LOS) 24.5 days (SD = 25.3). Mean scores were: 128.1 (SD = 18.9) for BSHS-R, 62.1(SD = 35.8) for IES, 5.5 (SD = 4.1) for anxiety, and 3.9 (SD = 3.9) for depression. Health status was highly and inversely correlated with impact of event, depression, anxiety, LOS, number of surgeries, and BSA. Men and women differed in the BSHS-R affect and body image domains, and depression. Individuals with larger BSA reported worse scores for BSHS-R (work domain). CONCLUSION: Burn victims reported good health status on average, which was negatively correlated with reported depression, anxiety, impact of event, LOS, number of operations, and BSA. These findings suggest that general health might be improved by interventions that target modifiable behavioral factors, such as support groups and cognitive behavioral therapies.

Evaluación de la producción científica de postgrado en enfermería según los indicadores de salud / Evaluation of scientific production in nursing graduate program according to health indicators

Este estudio comparó la producción de disertaciones y tesis de postgrado de la Escuela de Enfermería de Ri-beirão Preto de la Universidad de São Paulo (EERP-USP) con los indicadores nacionales de salud: mortalidad general y morbilidad hospitalaria, por grupos de causas. Fueron recolectadas informaciones acerca de las tesis y disertaciones de 2007-2009 y de los indicadores de 2007. Las producciones se clasificaron de acuerdo a los capítulos de la Clasificación Estadística Internacional de Enfermedades y Problemas Relacionados con la Salud (CIE 10). Se encontraron 334 publicaciones y tesis. Cinco capítulos de la CIE 10 fueron similares cuando se compararon los principales temas de las disertaciones y tesis con las causas de mortalidad; en relación a la morbilidad, ocho capítulos coincidieron. Los temas de las producciones de la EERP y los datos de mortalidad general y morbilidad hospitalaria se relacionaron. De este modo, las producciones están alineadas a las necesidades de la población, la práctica profesional y las políticas de salud.

This study compared the production of theses and dissertations from Graduate Programs at the University of São Paulo at Ribeirão Preto College of Nursing (EERP-USP) with national health indicators: general mortality and hospital morbidity, according to the groups of causes. Information about theses and dissertations between 2007 and 2009 and health indicators from 2007 were collected. Theses and dissertations were classifed according to chapters of the International Statistical Classification of Diseases and Related Health Problems (ICD 10). In total, 334 dissertations and theses were found. Five chapters of the ICD 10 were similar when compared to the main themes of these productions and the causes of mortality. Regarding morbidity, eight chapters coincided. There was a relationship between the subjects of dissertations and theses produced by EERP and the data of general mortality and hospital morbidity. Thus, the production are related to the needs of the population, the professional practice and to the health policies.