ZIKV Strains Elicit Different Inflammatory and Anti-Viral Responses in Microglia Cells.

In recent years, the Zika Virus (ZIKV) has caused pandemic outbreaks associated with a high rate of congenital ZIKV syndrome (CZS). Although all strains associated with worldwide outbreaks derive from the Asian lineage, the reasons for their enhanced spread and severity are not fully understood. In this study, we conducted a comparative analysis of miRNAs (miRNA-155/146a/124) and their cellular targets (SOCS1/3, SHP1, TRAF6, IRAK1), as well as pro- and anti-inflammatory and anti-viral cytokines (IL-6, TNF-α, IFN-γ, IL-10, and IFN-ß) and peroxisome proliferator-activated receptor γ (PPAR-γ) expression in BV2 microglia cells infected with ZIKV strains derived from African and Asian lineages (ZIKVMR766 and ZIKVPE243). BV2 cells were susceptible to both ZIKV strains, and showed discrete levels of viral replication, with delayed release of viral particles without inducing significant cytopathogenic effects. However, the ZIKVMR766 strain showed higher infectivity and replicative capacity, inducing a higher expression of microglial activation markers than the ZIKVPE243 strain. Moreover, infection with the ZIKVMR766 strain promoted both a higher inflammatory response and a lower expression of anti-viral factors compared to the ZIKVPE243 strain. Remarkably, the ZIKKPE243 strain induced significantly higher levels of the anti-inflammatory nuclear receptor-PPAR-γ. These findings improve our understanding of ZIKV-mediated modulation of inflammatory and anti-viral innate immune responses and open a new avenue to explore underlining mechanisms involved in the pathogenesis of ZIKV-associated diseases.

Ensino de segurança do paciente segundo as percepções e vivências de docentes de enfermagem / La enseñanza en seguridad del paciente según las percepciones y experiencias de profesores de enfermería / The teaching of patient safety according with the perceptions and experiences of nursing professors

Objetivo: descrever as percepções e vivências de docentes da graduação de enfermagem sobre o ensino de segurança do paciente. Método: estudo transversal, descritivo, quali-quantitativo, realizado com professores de enfermagem de uma universidade federal, realizado de setembro a novembro de 2018. Os dados foram coletados através de um formulário eletrônico e processados de forma descritiva simples com auxílio do software Interface de R pour Analyses Multidimensionnelles de Textes et de Questionneires. Resultados: a amostra foi composta por 21 docentes e emergiram três classes: primeiros passos e estímulos para o ensino de segurança do paciente no curso de enfermagem (42,5%), ações realizadas em prol do ensino de segurança do paciente na graduação (26,4%) e agentes promotores de mudanças no ensino de segurança do paciente na graduação de enfermagem (31,1%). Conclusão: os docentes reconheceram a segurança do paciente como um tema transversal e importante no processo formativo, mas com pouca expressividade na instituição.

Objetivo: describir las percepciones y experiencias de profesores de graduación en enfermería sobre la enseñanza de la seguridad del paciente. Método: estudio transversal, descriptivo, cuali-cuantitativo, realizado con profesores de enfermería de una universidad federal, realizado de septiembre a noviembre de 2018. Los datos fueron recolectados a través de un formulario electrónico y procesados de forma descriptiva simple con ayuda del Interface de R pour Analyses Multidimensionnelles de Textes et de Questionneires. Resultados: la muestra estuvo compuesta por 21 profesores y surgieron tres clases: primeros pasos y estímulos para la enseñanza de la seguridad del paciente en la carrera de enfermería (42,5%), acciones realizadas a favor de la enseñanza de la seguridad del paciente en la graduación (26,4%) y agentes promotores cambios en la enseñanza de la seguridad del paciente en la graduación de enfermería (31,1%). Conclusión: los profesores reconocieron la seguridad del paciente como un tema transversal e importante en el proceso de formación, pero con poca expresión en la institución.

Objective: To describe the perceptions and experiences of nursing graduation professors regarding the teaching of patient safety. Method: Cross-sectional, descriptive, quali-quantitative study, carried out with nursing professors from a federal university from September to November 2018. Data was collected using an electronic form and processed using simple descriptive analysis aided by the software Interface de R pour Analyses Multidimensionnelles de Textes et de Questionneires. Results: The sample was formed by 21 professors, and three classes were generated: First steps and encouragement for the teaching of patient safety in the nursing course (42.5%); Actions towards patient safety teaching in graduation (26.4%); and Actors of change in the teaching of patient safety in nursing graduation (31.1%). Conclusion: The professors recognized patient safety as an important cross-sectional topic in the formation process, despite its little presence in the institution.

Evaluación de la cultura de seguridad del paciente en la Atención Primaria de Salud / Avaliação da cultura de segurança do paciente na Atenção Primária à Saúde / Assessment of patient safety culture in Primary Health Care

Introducción: La evaluación de la cultura de seguridad del paciente en Atención Primaria de Salud permite analizar el estado de compromiso de los profesionales y organizaciones en la viabilidad continua de una atención eficazmente segura desde el momento en que el usuario ingresa al servicio. Objetivo: Analizar la cultura de seguridad del paciente en Atención Primaria de Salud. Material y Método: Investigación transversal realizada en Unidades Básicas de Salud. La recolección de datos se realizó en 2019, con 29 profesionales de la salud, a través del instrumento Encuesta sobre Cultura de Seguridad del Paciente en Atención Primaria. Los datos se analizaron de acuerdo con las recomendaciones del instrumento utilizado. Resultados: En las dimensiones de cultura se destacaron como positivas el Trabajo en equipo (65,23%) y Seguimiento de la atención al paciente (52,59%); en las respuestas negativas, Presión y tasa de trabajo (49,14%) y Formación de equipos (33,33%) y, como respuestas neutrales, la Seguridad del paciente y Problemas de calidad y (56,55%) e Intercambio de información con otras instituciones (51,72%). Conclusiones: No se identificaron dimensiones fuertes para la cultura de seguridad del paciente, por lo que se revela que la cultura de seguridad del paciente en las unidades de salud investigadas es incipiente. (AU)

Introduction: The assessment of patient safety culture in Primary Health Care enables the analysis of the commitment of professionals and organizations in the continuous provision of effectively and safe care from the moment the user enters the service. Objective: To analyze patient safety culture in Primary Health Care. Material and Method: Cross-sectional research carried out in Basic Health Units. Data collection took place in 2019, with 29 health professionals, through the instrument Survey on Patient Safety Culture for Primary Care. Data were analyzed according to the recommendations of the instrument. Results: In the dimensions of culture, Teamwork (65.23%), and Continuity of care (52.59%) stood out as positive; in the negative answers, Work pressure and pace (49.14%) and Staff training (33.33%) stood out; and, among neutral answers, Patient safety and quality issues (56.55%) and Exchange of information with other institutions (51.72%) were the highest. Conclusions: No strong dimensions were identified for the patient safety culture; therefore, it has been shown that the patient safety culture in the health units investigated is incipient. (AU)

Introdução: A avaliação da cultura de segurança do paciente na Atenção Primária à Saúde possibilita a análise dostatusde comprometimento dos profissionais e das organizações na viabilização contínua de um cuidado efetivamente seguro desde o momento da entrada do usuário no serviço. Objetivo: Analisar a cultura de segurança do paciente na Atenção Primária à Saúde. Material e Método: Pesquisa transversal, realizada em Unidades Básicas de Saúde. A coleta de dados ocorreu em 2019, com 29 profissionais da saúde, por meio do instrumento Pesquisa sobre Cultura de Segurança do Paciente para Atenção Primária. Os dados foram analisados mediante as recomendações do instrumento utilizado. Resultados: Nas dimensões de cultura destacaram-se como positivas o Trabalho em equipe (65,23%) e o Acompanhamento do cuidado ao paciente (52,59%); nas respostas negativas a Pressão e ritmo de trabalho (49,14%) e o Treinamento da equipe (33,33%) e, como respostas neutras a Segurança do paciente e problemas de qualidade (56,55%) e a Troca de informações com outras instituições (51,72%). Conclusões: Não foram identificadas dimensões fortes para a cultura de segurança do paciente, logo, revela-se que a cultura de segurança do paciente nas unidades de saúde investigadas apresenta-se incipiente. (AU)

Wise Infant Development®: creation of a software for teaching in pediatric nursing education.

OBJECTIVES: to create a software application for nursing education on child development assessment. METHODS: this is a methodological applied research developed in three stages: analysis, design, and development. Product quality characteristics from the ISO/IEC 25010 standards were adopted. The programming language used was JavaScript. The educational software was developed based on a constructivist cognitive theory. RESULTS: it was possible to create the software from the following quality metrics: functional suitability, reliability, usability, performance efficiency, compatibility, security, maintainability, and portability. The technology addresses child development in physical, cognitive, and psychosocial domains and how this assessment should be carried out in Brazil. The software has pre and posttests, 5 learning modules, certificate issuance, support for doubts, and an administrative panel. Final Considerations: it is concluded that the software adds to the existing tools for child development monitoring, facilitating students' knowledge acquisition in promoting child health.

Wise Infant Development®: creation of a software for teaching in pediatric nursing education / Wise Infant Development®: criação de um software para ensino em enfermagem pediátrica / Wise Infant Development®: creación de un software para la enseñanza de la educación en enfermería pediátrica

ABSTRACT Objectives: to create a software application for nursing education on child development assessment. Methods: this is a methodological applied research developed in three stages: analysis, design, and development. Product quality characteristics from the ISO/IEC 25010 standards were adopted. The programming language used was JavaScript. The educational software was developed based on a constructivist cognitive theory. Results: it was possible to create the software from the following quality metrics: functional suitability, reliability, usability, performance efficiency, compatibility, security, maintainability, and portability. The technology addresses child development in physical, cognitive, and psychosocial domains and how this assessment should be carried out in Brazil. The software has pre and posttests, 5 learning modules, certificate issuance, support for doubts, and an administrative panel. Final Considerations: it is concluded that the software adds to the existing tools for child development monitoring, facilitating students' knowledge acquisition in promoting child health.

RESUMO Objetivos: criar um aplicativo de software para ensino de enfermagem na avaliação do desenvolvimento infantil. Métodos: pesquisa metodológica aplicada, desenvolvida em três etapas: análise, desenho e desenvolvimento. As características de qualidade do produto das normas ISO/IEC 25010 foram adotadas. A linguagem de programação usada foi JavaScript. O software educacional foi desenvolvido com base em uma teoria cognitiva construtivista. Resultados: foi possível criar o software a partir das seguintes métricas de qualidade: adequação funcional, confiabilidade, usabilidade, eficiência de desempenho, compatibilidade, segurança, manutenibilidade e portabilidade. A tecnologia aborda o desenvolvimento infantil nos domínios físico, cognitivo e psicossocial e como essa avaliação deve ser realizada no Brasil. O software possui pré e pós-testes, 5 módulos de aprendizagem, emissão de certificados, suporte para dúvidas e painel administrativo. Considerações Finais: o software agrega às ferramentas existentes para o acompanhamento do desenvolvimento infantil, facilitando a aquisição de conhecimentos dos alunos na promoção da saúde infantil.

RESUMEN Objetivos: crear una aplicación informática para la enseñanza de la enfermería en la evaluación del desarrollo infantil. Métodos: investigación metodológica aplicada, desarrollada en tres etapas: análisis, diseño y desarrollo. Se han adoptado las características de calidad del producto de las normas ISO/IEC 25010. El lenguaje de programación utilizado fue JavaScript. El software educativo se desarrolló en base a una teoría cognitiva constructivista. Resultados: fue posible crear el software a partir de las siguientes métricas de calidad: idoneidad funcional, confiabilidad, usabilidad, eficiencia de desempeño, compatibilidad, seguridad, mantenibilidad y portabilidad. La tecnología aborda el desarrollo infantil en los dominios físico, cognitivo y psicosocial y cómo esta evaluación debe llevarse a cabo en Brasil. El software cuenta con pruebas previas y posteriores, 5 módulos de aprendizaje, emisión de certificados, soporte para dudas y panel administrativo. Consideraciones Finales: el software se suma a las herramientas existentes para monitorear el desarrollo infantil, facilitando la adquisición de conocimientos por parte de los estudiantes en la promoción de la salud infantil.

Content analysis of clinical indicators for Impaired gas exchange.

OBJECTIVE: To analyze the relevance of clinical indicators and the clarity and precision of conceptual and operational definitions of the diagnosis Impaired gas exchange. METHODS: Content analysis, by 39 nurse judges, divided into the phases of conceptual definition of the phenomenon of interest, construction of the structure of the phenomenon of interest and analysis of the judges on the built structure. RESULTS: From the 22 indicators, 21 were considered relevant Impaired gas exchange. The indicators that obtained absolute relevance were Cyanosis, Hypercapnia, Hypoxemia and Tachycardia. The indicator Headache upon waking did not show any statistically significant relevance for the diagnosis. All conceptual and operational definitions were clear and precise. CONCLUSION: The indicators listed for Impaired gas exchange were relevant to the phenomenon, except Headache upon waking because it does not correspond to a safe manifestation to identify the diagnosis, according to the analysis of the judges. Each conceptual and operational definition was adequate for its indicator.

Feasibility of a mHealth survey application for incarcerated and postrelease people living with HIV in a low-resource setting.

Mobile health (mHealth) holds considerable promise as a way to give people greater control of their health information, privacy, and sharing in the context of HIV research and clinical services. The purpose of this study was to determine the feasibility of an mHealth research application from the perspective of three stakeholder groups involved in an HIV clinical trial in Jakarta, Indonesia: (a) incarcerated people living with HIV (PLWH), (b) research assistants (RAs), and (c) research investigators. Incarcerated PLWH (n = 150) recruited from two large all-male prisons completed questionnaires, including questions about mHealth acceptability, on an mHealth survey application using a proprietary data collection software development platform. RAs who administered questionnaires (n = 8) rated the usability of the software application using the system usability scale (SUS) and open-ended questions. Research investigators (n = 2) completed in-depth interviews, that were coded and analyzed using the technology acceptance model (TAM) as a conceptual framework. Over 90% of incarcerated PLWH felt the mHealth application offered adequate comfort, privacy, and accuracy in recording their responses. RAs' SUS scores ranged from 60% to 90% (M = 76.25) and they found the mHealth survey application challenging to learn, but highly satisfying. Compared with paper-based data collection, researchers felt that electronic data collection led to improved accuracy and efficiency of data collection and the ability to monitor data collection remotely and in real time. The researchers perceived the learnability of the application as acceptable but required self-instruction.

A Content Analysis of Clinical Indicators of the Nursing Diagnosis Ineffective Breathing Pattern.

PURPOSE: To verify the relevance of the clinical indicators, the clarity and precision of the conceptual, and operational definitions for Ineffective breathing pattern (IBP). METHODS: A content analysis by 39 judges. FINDINGS: The results showed 28 clinical indicators for IBP. However, only seven were not considered relevant for the diagnosis. These are not listed in NANDA International taxonomy. All conceptual and operational definitions were adequate, according to the analysis of the judges. CONCLUSION: The list of 28 clinical indicators of IBP was submitted for analysis by judges, which then resulted in the validation of 21 of these elements. IMPLICATIONS FOR NURSING PRACTICE: This study clarifies that gaps in the structure of diagnoses, helping nurses' diagnostic reasoning process in clinical practice.

Content analysis of clinical indicators for Impaired gas exchange / Análisis de contenido de indicadores clínicos para Deterioro del intercambio gaseoso / Análise de conteúdo dos indicadores clínicos para Troca de gases prejudicada

ABSTRACT Objective To analyze the relevance of clinical indicators and the clarity and precision of conceptual and operational definitions of the diagnosis Impaired gas exchange. Methods Content analysis, by 39 nurse judges, divided into the phases of conceptual definition of the phenomenon of interest, construction of the structure of the phenomenon of interest and analysis of the judges on the built structure. Results From the 22 indicators, 21 were considered relevant Impaired gas exchange. The indicators that obtained absolute relevance were Cyanosis, Hypercapnia, Hypoxemia and Tachycardia. The indicator Headache upon waking did not show any statistically significant relevance for the diagnosis. All conceptual and operational definitions were clear and precise. Conclusion The indicators listed for Impaired gas exchange were relevant to the phenomenon, except Headache upon waking because it does not correspond to a safe manifestation to identify the diagnosis, according to the analysis of the judges. Each conceptual and operational definition was adequate for its indicator.

RESUMEN Objetivo Analizar la relevancia de los indicadores clínicos y la claridad y precisión de las definiciones conceptuales y operativas del diagnóstico Deterioro del intercambio gaseoso. Métodos Análisis de contenido, realizado por 39 jueces enfermeros, dividido en las fases de definición conceptual del fenómeno de interés, construcción de la estructura del fenómeno de interés y análisis de los jueces sobre la estructura construida. Resultados De los 22 indicadores, 21 fueron considerados relevantes Deterioro del intercambio gaseoso. Los indicadores que obtuvieron relevancia absoluta fueron Cianosis, Hipercapnia, Hipoxemia y Taquicardia. El indicador Cefalea al despertar no mostró relevancia estadísticamente significativa para el diagnóstico. Todas las definiciones conceptuales y operativas fueron claras y precisas. Conclusión Los indicadores enumerados para Deterioro del intercambio gaseoso fueron relevantes para el fenómeno, excepto Cefalea al despertar porque no corresponde a una manifestación segura para identificar el diagnóstico, según el análisis de los jueces. Cada definición conceptual y operativa fue adecuada para su indicador.

RESUMO Objetivo Analisar a relevância dos indicadores clínicos e a clareza e precisão das definições conceituais e operacionais do diagnóstico Troca de gases prejudicada. Métodos Análise de conteúdo, por 39 juízes enfermeiros, dividida nas fases de definição conceitual do fenômeno de interesse, construção da estrutura do fenômeno de interesse e análise dos juízes sobre a estrutura construída. Resultados Dos 22 indicadores, 21 foram considerados relevantes Troca de gases prejudicada. Os indicadores que obtiveram relevância absoluta foram Cianose, Hipercapnia, Hipoxemia e Taquicardia. O indicador Cefaleia ao acordar não apresentou relevância estatisticamente significante para o diagnóstico. Todas as definições conceituais e operacionais foram claras e precisas. Conclusão Os indicadores elencados para Troca de gases prejudicada foram relevantes ao fenômeno, exceto Cefaleia ao acordar pois não corresponde a uma manifestação segura para identificar o diagnóstico, conforme a análise dos juízes. Cada definição conceitual e operacional foi adequada para seu referido indicador.

Clima de segurança do paciente na atenção primária à saúde: análise de causa-raiz / Clima de seguridad del paciente en la atención primaria de salud: análisis de la causa raíz / Patient safety atmosphere in primary health care: root cause analysis

RESUMO Objetivo: avaliar o clima de segurança na atenção primária à saúde e analisar as possíveis causas dos problemas identificados. Método: pesquisa-ação realizada em 2017, em um município do Nordeste do Brasil, dividida em três momentos: aproximação do campo, aplicação do Safety Attitudes Questionary e discussão com trabalhadores de saúde sobre causas de incidentes na atenção primária por meio de um diagrama de Ishikawa. Participaram 55 profissionais de sete equipes de saúde da família, presentes nas unidades básicas de saúde no momento da coleta de dados. Os dados quantitativos foram organizados no banco de dados do Statistical Package for the Social Science (SPSS). Resultados: na avaliação do clima de segurança, a satisfação no trabalho foi a que obteve o maior escore. O menor escore foi relacionado às condições de trabalho. Todos esses aspectos interferem diretamente na segurança do paciente. As causas identificadas pelos trabalhadores por meio do diagrama foram: ausência de recursos, falta de adesão ao tratamento dos pacientes e estresse dos profissionais. Conclusão: nota-se a necessidade de ações construídas coletivamente com gestores, usuários e trabalhadores da saúde para melhoria do clima de segurança. Tais ações podem proporcionar melhorias na qualidade do cuidado prestado.

RESUMEN Objetivo: evaluar el clima de seguridad en la atención primaria de salud y analizar las posibles causas de los problemas identificados. Método: investigación acción realizada en 2017, en un municipio del Nordeste de Brasil, dividida en tres momentos: acercamiento al campo, aplicación del Safety Attitudes Questionary y discusión con los trabajadores de salud sobre las causas de los incidentes en la atención primaria a través de un diagrama de Ishikawa. Participaron 55 profesionales de siete equipos de salud de la familia, presentes en las unidades básicas de salud en el momento de la recolección de datos. Los datos cuantitativos se organizaron en la base de datos Statistical Package for the Social Science (SPSS). Resultados: en la evaluación del clima de seguridad, la satisfacción laboral fue la que obtuvo la mayor puntuación. La puntuación más baja se relacionó con las condiciones laborales. Todos estos aspectos interfieren directamente con la seguridad del paciente. Las causas identificadas por los trabajadores a través del diagrama fueron: falta de recursos, falta de adherencia al tratamiento de los pacientes y estrés de los profesionales. Conclusión: existe la necesidad de acciones construidas colectivamente con gerentes, usuarios y trabajadores de la salud para mejorar el clima de seguridad. Dichas acciones pueden proporcionar mejoras en la calidad de la atención brindada.

ABSTRACT Objective: to assess the safety atmosphere in primary health care and to analyze the possible causes of the identified problems. Method: action research carried out in 2017, in a municipality in the Northeast of Brazil, divided into three moments: approaching the field, application of the Safety Attitudes Questionary and discussion with health workers about causes of incidents in primary care through a diagram of Ishikawa. Fifty-five professionals from seven family health teams, present in the basic health units at the time of data collection, participated. Quantitative data were organized in the Statistical Package for Social Science (SPSS) database. Results: in the assessment of the safety atmosphere, job satisfaction was the one that obtained the highest score. The lowest score was related to working conditions. All of these aspects directly interfere with patient safety. The causes identified by the workers through the diagram were: lack of resources, lack of adherence to the treatment of patients and stress of professionals. Conclusion: there is a need for actions collectively built with managers, users, and health workers to improve the safety atmosphere. Such actions can provide improvements in the quality of care provided.

Application of a Bundle in the Prevention of Peri-Intraventricular Hemorrhage in Preterm Newborns.

The purpose of this study was to evaluate the impact of implementing a care bundle for preventing peri-intraventricular hemorrhage (PIVH) in preterm newborns. A longitudinal, quantitative, quasi-experimental study was conducted with preterm newborns from a neonatal unit. The study was divided into 2 stages: the first consisted of a retrospective cohort of newborns (control group) not exposed to the bundle, and the second consisted of 5 practical steps of implementing a care bundle for preventing PIVH in eligible newborns. The results show that a significant reduction in PIVH occurred, from 34.8% before the intervention to 26.3% after application of the bundle. Also, after implementation of the bundle, there was a reduction in the severe forms of PIVH in the newborns who presented with hemorrhage compared with the control group. The study shows how the use of a low-cost and easy operationalization tool can contribute to the health of preterm newborns. It was found that the bundle is directly related to the decrease in the incidence of PIVH. The results may contribute to the improvement in care quality, thus promoting safe care for premature newborns.

Evaluation of user embracement software with pediatric risk classification.

OBJECTIVE: to evaluate functional performance and technical quality of user embracement software with pediatric risk classification. METHOD: descriptive exploratory study developed based on the quality requirements set forth in ISO/IEC 25010. The evaluated characteristics were: functional adequacy, reliability, usability, performance efficiency, compatibility, safety, maintainability and portability. Eight specialists from the area of informatics and 13 from nursing participated in the evaluation. The characteristics were considered adequate when they reached more than 70% of indication as very and/or completely appropriate in the evaluations of each group of specialists. RESULTS: The results obtained from the evaluation of informatics and nursing specialists were: functional adequacy (100.0%, 96.2%), reliability (82.6%, 88.5%), usability (84.9%; 98.7%), performance efficiency (93.4%; 96.2%), compatibility (85.0%, 98.1%), safety (91.7%, 100.0%), and, yet, maintainability (95.0%) and portability (87.5%) evaluated by the first ones. CONCLUSION: the software was considered adequate regarding technical quality and functional performance.

Effectiveness of Passion Fruit Peel Flour (Passiflora edulis L.) versus Turmeric Flour (Curcuma longa L.) on Glycemic Control: Systematic Review and Meta-Analysis.

BACKGROUND: It is undeniable that diabetes may cause several health complications for the population. Many of these complications are associated with poor glycemic control. Due to this, strategies to handle this problem are of great clinical importance and may contribute to reducing the various complications from diabetes. OBJECTIVE: The aim of this study was to compare the effectiveness of the passion fruit peel flour versus turmeric flour on glycemic control. METHODS: This is a systematic review and meta-analysis following the PRISMA protocol. The following inclusion criteria were applied: (1) Case-control studies, cohort studies, and clinical trials, due to the improved statistical analysis and, in restrict cases, cross-sectional studies; (2) Articles published in any language. The databases used for the search were PubMed, Scopus, Web of Science, Cochrane, and LILACS. A bias analysis and a meta-analyses were undertaken using R Studio (version 3.3.1) using effect- size models. RESULTS: A total of 565 studies were identified from which 11 met the inclusion and exclusion criteria. Through isolated analysis, the effectiveness of turmeric flour on glycemic control was in the order of 0.73 CI (Confidence Interval) (from 0.68 to 0.79) and the effectiveness of passion fruit peel flour was 0.32 CI (0.23 to 0.45). The joint analysis resulted in 0.59 CI (0.52 to 0.68). The assessment of blood glucose was by glycated hemoglobin levels. All values were significant at a p < 0.05 level. CONCLUSION: Both interventions showed significant effects on glycemic control.

Síndrome de Burnout e percepções acerca do clima de segurança entre profissionais intensivistas / Burnout syndrome and perceptions about safety climate among intensive care professionals

RESUMO Objetivo analisar a relação entre a Síndrome de Burnout e as percepções acerca do clima de segurança entre profissionais intensivistas. Métodos estudo transversal, com 51 profissionais de saúde de hospital público do nordeste brasileiro. Aplicaram-se os instrumentos: Inventário de Burnout de Maslach, Questionário de Atitudes de Segurança e Questionário sociodemográfico. Adotaram-se estatísticas descritiva, analítica (teste de Spearman) e inferencial. Resultados na avaliação do Burnout, constatou-se nível alto de exaustão emocional (64,7%) e níveis baixos de despersonalização (74,5%) e realização profissional (56,8%). O clima de segurança foi considerado satisfatório, sendo o domínio Comportamentos seguros o que obteve maior média. Evidenciou-se correlação moderada entre as subescalas Percepção do estresse e Despersonalização. Conclusão constatou-se correlação entre clima de segurança e Burnout, nas dimensões Percepção do estresse e Despersonalização, sendo que esta segunda pode ser considerada consequência de fatores estressantes que distanciam o profissional do paciente.

ABSTRACT Objective to analyze the relationship between Burnout Syndrome and perceptions about safety climate among intensive care professionals. Methods a cross-sectional study with 51 health professionals from a public hospital in northeastern Brazil. The following instruments were applied: the Maslach Burnout Inventory, the Safety Attitudes Questionnaire, and a Sociodemographic questionnaire. Descriptive, analytical (Spearman's test) and inferential statistics were adopted. Results there was a high level of emotional exhaustion (64.7%) and low levels of depersonalization (74.5%) and personal accomplishment (56.8%) in the Burnout assessment. The safety climate was considered satisfactory, with the Safe Behaviors domain having the highest average. There was a moderate correlation between the Stress recognition and Depersonalization subscales. Conclusion there was a correlation between safety climate and Burnout in the Stress recognition and Depersonalization dimensions, with the latter being considered a consequence of stressful factors which distance professionals from patients.

Consulta de enfermagem a pessoas com tuberculose: proposta de instrumento / Nursing consultation in people with tuberculosis: proposal of an instrument

Objective: To build a script for nursing history aimed at standardizing the nursing consultation to people with tuberculosis and subsidize an adequate record and the completeness of the nursing process. Method: this is qualitative research based on the action research methodology, carried out in the Tuberculosis Control Program, located in Pinheiro, Maranhão, Brazil, from November 2018 to May 2019. The target audience of the research was composed of people registered in the Program, under treatment and who abandoned it, and service nurses. Results: the proposed instrument has 67 items that contemplate the basic human needs of people with tuberculosis and the place to register physical examination, investigating individual and family tuberculosis. Conclusion: the suggested instrument qualifies, guides, and brings science to the nursing history record. When used, after its validation, it can support the documentation of the other stages of the nursing consultation for people with tuberculosis.

Objetivo: construir um roteiro para histórico de enfermagem, de forma a padronizar a consulta de enfermagem às pessoas com tuberculose e subsidiar adequado registro e a completude do processo de enfermagem. Método: pesquisa qualitativa, fundamentada na metodologia da pesquisa-ação, realizada no Programa de Controle da Tuberculose, situado em Pinheiro, Maranhão, Brasil, de novembro de 2018 a maio de 2019. O público-alvo da pesquisa foi composto por pessoas cadastradas no Programa, em tratamento e em abandono, e enfermeiros do serviço. Resultados: o instrumento proposto conta com 67 itens que contemplam as necessidades humanas básicas das pessoas com tuberculose e o local para registro do exame físico, além da investigação da tuberculose individual e familiar. Conclusão: o instrumento sugerido qualifica, orienta e traz cientificidade para o registro do histórico de enfermagem. Ao ser utilizado, após validação, poderá sustentar a documentação das demais etapas da consulta de enfermagem às pessoas com tuberculose.

Evaluation of user embracement software with pediatric risk classification / Evaluación del software para el acogimiento con clasificación de riesgo en pediatria / Avaliação de software para acolhimento com classificação de risco em pediatria

ABSTRACT Objective: to evaluate functional performance and technical quality of user embracement software with pediatric risk classification. Method: descriptive exploratory study developed based on the quality requirements set forth in ISO/IEC 25010. The evaluated characteristics were: functional adequacy, reliability, usability, performance efficiency, compatibility, safety, maintainability and portability. Eight specialists from the area of informatics and 13 from nursing participated in the evaluation. The characteristics were considered adequate when they reached more than 70% of indication as very and/or completely appropriate in the evaluations of each group of specialists. Results: The results obtained from the evaluation of informatics and nursing specialists were: functional adequacy (100.0%, 96.2%), reliability (82.6%, 88.5%), usability (84.9%; 98.7%), performance efficiency (93.4%; 96.2%), compatibility (85.0%, 98.1%), safety (91.7%, 100.0%), and, yet, maintainability (95.0%) and portability (87.5%) evaluated by the first ones. Conclusion: the software was considered adequate regarding technical quality and functional performance.

RESUMEN Objetivo: evaluar el desempeño funcional y la calidad técnica del software para el acogimiento con clasificación de riesgo en pediatría. Método: estudio exploratorio descriptivo, fundamentado en los requisitos de calidad dispuestos en la norma ISO/IEC 25.010. Las siguientes características fueron evaluadas: adecuación funcional, confiabilidad, facilidad de uso, eficiencia del desempeño, compatibilidad, seguridad, manutención y portabilidad. En la evaluación participaron 8 expertos en el área de informática y 13 en enfermería. Se consideradon adecuadas las características cuando habían alcanzado más del 70,0% de indicación como "muy y/o completamente apropiadas" en las evaluaciones de cada grupo de expertos. Resultados: Los resultados obtenidos a partir de la evaluación de los expertos en informática y en enfermería fueron respectivamente: adecuación funcional (100,0%; 96,2%); confiabilidad (82,6%; 88,5%); facilidad de uso (84,9%; 98,7%); eficiencia del desempeño (93,4%; 96,2%); compatibilidad (85,0%; 98,1%); seguridad (91,7%; 100,0%); y también manutención (95,0%) y portabilidad (87,5%) evaluados por los primeros. Conclusión: se observó que el software es adecuado en relación con la calidad técnica y el rendimiento funcional.

RESUMO Objetivo: avaliar desempenho funcional e qualidade técnica de software para acolhimento com classificação de risco em pediatria. Método: estudo exploratório descritivo desenvolvido com base nos quesitos de qualidade dispostos na norma ISO/IEC 25010. As características avaliadas foram: adequação funcional, confiabilidade, usabilidade, eficiência de desempenho, compatibilidade, segurança, manutenibilidade e portabilidade. Participaram da avaliação oito especialistas da área de informática e 13 de enfermagem. As características foram consideradas adequadas quando atingiram mais de 70,0% de indicação como muito e/ou completamente apropriadas nas avaliações de cada grupo de especialistas. Resultados: Os resultados obtidos a partir da avaliação dos especialistas de informática e de enfermagem foram respectivamente: adequação funcional (100,0%; 96,2%), confiabilidade (82,6%; 88,5%), usabilidade (84,9%; 98,7%), eficiência de desempenho (93,4%; 96,2%), compatibilidade (85,0%; 98,1%), segurança (91,7%; 100,0%), e, ainda, manutenibilidade (95,0%) e portabilidade (87,5%) avaliados pelos primeiros. Conclusão: o software foi considerado adequado em relação à qualidade técnica e ao desempenho funcional.

Ineffective Airway Clearance in Surgical Patients: Evaluation of Nursing Interventions and Outcomes.

PURPOSE: To evaluate the benefits of NIC interventions in postoperative patients with ineffective airway clearance (00031). METHODS: Quasi-experimental study with interrupted time-series design. A total of 101 patients were evaluated during 4 days based on the nursing outcome Respiratory Status: Airway Patency (0410). FINDINGS: Interventions such as cough enhancement (3250), ventilation assistance (3390), and airway management (3140) contributed to significative improvements of the patients' airway patency. Site of surgery and patients' intrinsic characteristics were proven to have influence in the NOC ratings. CONCLUSIONS: Interventions implemented during the research contributed to improvement of clinical indicators of airway patency. IMPLICATIONS FOR NURSING PRACTICE: Postoperative respiratory complications can be minimized by the use of standardized nursing languages.

Impaired Gas Exchange: Prognostic Clinical Indicators of Short-Term Survival in Children with Acute Respiratory Infection.

PURPOSE: To establish prognostic indicators of survival for impaired gas exchange (IGE) (00030). METHODS: Secondary analysis of data from an open prospective cohort developed with a group of 136 children with acute respiratory infection (ARI). FINDINGS: On Day 1, IGE (00030) was present in 42.6% of the sample. New cases arose until the last day of evaluation. With regards to defining characteristics, only hypoxemia and abnormal skin color were associated with a higher risk of developing diagnosis. CONCLUSIONS: Children with ARI who exhibit hypoxemia and abnormal skin color had a worse prognosis for IGE (00030). IMPLICATIONS FOR NURSE PRACTICE: Nurses can use the research findings as a predictive marker of the evolution of the patient's health status.

Falhas na administração de imunobiológicos: análise de causa raiz / Immunobiological administration failures: root cause analysis

Objetivo: buscou-se avaliar a administração de imunobiológicos em salas de vacina de Unidades Básicas de Saúde da Família de um município do Nordeste brasileiro. Método: trata-se de um estudo quantitativo, investigativo, tipo pesquisa-ação. Coletaram-se os dados por meio da observação sistemática em uma Unidade Básica de Saúde da Família. Utilizaram-se roteiros a partir das recomendações do Manual de Normas e Procedimentos para Vacinação da Política Nacional de Imunização. Apresentaram-se os resultados por meio de tabelas. Resultados: constata-se que, em 57,1% das observações, o profissional não verificou a aparência da solução no frasco dos imunobiológicos e, em 14,3% dos casos, não foi verificado o prazo de validade. Salienta-se que em nenhum dos procedimentos foi realizada a higienização das mãos. Conclusão: percebe-se, com base nas recomendações propostas pela Política Nacional de Imunização, que as práticas envolvidas na administração de imunobiológicos se encontram distantes do que é preconizado. Observaram-se falhas envolvendo as técnicas adequadas de preparo, de armazenamento e de conservação dos imunobiológicos.(AU)

Objective: to evaluate the immunobiological administration in vaccination rooms of the Basic Units of Family Health of a city in the Northeast of Brazil. Method: this is a quantitative, investigative, research-action type. The data were collected through systematic observation in a Basic Family Health Unit. The guidelines used were based on the recommendations of the Manual of Norms and Procedures for Vaccination of the National Immunization Policy. Results were presented by tables. Results: in 57.1% of the observations, the professional did not verify the appearance of the solution in the immunobiological vial and in 14.3% of the cases the expiration date was not verified. In none of the procedures, hand hygiene was performed. Conclusion: Based on the recommendations proposed by the National Immunization Policy, the practices involved in immunobiological administration are far from what is recommended. Failures involving appropriate techniques of immunobiological preparation, storage and preservation have been observed.(AU)

Objetivo: evaluar la administración de inmunobiológicos en salas de vacuna de Unidades Básicas de Salud de la Familia de un municipio del Nordeste brasileño. Método: se trata de un estudio cuantitativo, investigativo, tipo investigaciónacción. Se recogieron los datos por medio de la observación sistemática en una Unidad Básica de Salud de la Familia. Se utilizaron guías a partir de las recomendaciones del Manual de Normas y Procedimientos para Vacunación de la Política Nacional de Inmunización. Se presentaron los resultados por medio de tablas. Resultados: se constata que, en 57,1% de las observaciones, el profesional no verificó la apariencia de la solución en el frasco de los inmunobiológicos y en 14,3% de los casos, no fue verificado el plazo de validez. Se salienta que en ninguno de los procedimientos fue realizada la higiene de las mãano. Conclusión: con base en las recomendaciones propuestas por la Política Nacional de Inmunización, que las prácticas envueltas en la administración de inmunobiológicos se encuentran distantes de lo que es recomendado. Se observaron fallas envolviendo las técnicas adecuadas de preparación, de almazenamiento y de conservación de los inmunobiológicos.(AU)

Nursing students' diagnostic accuracy using a computer-based clinical scenario simulation.

BACKGROUND: Being able to make accurate clinical decisions about actual or potential health problems is crucial to provide a safe and effective care. However, nursing students generally have difficulties identifying nursing diagnoses accurately. OBJECTIVE: To compare the diagnostic accuracy within and across the NANDA-I diagnoses domains of junior, senior, and graduate-entry students. DESIGN: Descriptive study PARTICIPANTS AND SETTING: The sample comprised one hundred thirty nursing students from a Midwestern American university. METHODS: The participants were divided in three groups (juniors, seniors and graduate-entry) and invited to engage in a series of diagnostic exercises presented in a software. Students were presented with 13 scenarios and asked to identify the applicable defining characteristics, related factors, and nursing diagnoses from the NANDA-I taxonomy. The number of correct answers per scenario was used to compute diagnostic accuracy. Age, gender, previous exposure to the NANDA-I taxonomy, and student level were covariates in the analysis. RESULTS: The average percent correct answers across all groups was 64.4% and no statistical differences between the groups were found. The scenarios belonging to the Health Promotion, Self-Perception, and Growth/Development Domains were those in which students had a higher number of incorrect answers. Students also had more difficulty recognizing the correct nursing diagnoses compared with related factors and defining characteristics. CONCLUSIONS: This study found no associations between demographic variables, exposure to the NANDA-I taxonomy, or academic program level and diagnostic accuracy. Some areas in which students had a poor performance indicate need for improvement in diagnostic reasoning skills.