Aprender a cuidar de estoma e as contribuições de um vídeo educativo / Learning to take care of stoma and the contributions of an educational video

Objetivo: conhecer a percepção de pacientes colostomizados por causas não oncológicas e seus familiares acerca da forma como aprenderam a cuidar do estoma e da possibilidade de utilização de um vídeo educativo como estratégia de educação em saúde. Métodos: pesquisa qualitativa, realizada por meio de grupo focal com oito pessoas, sendo quatro pacientes e quatro familiares. Os dados foram submetidos à análise de conteúdo temática. Resultados: organizou-se três categorias: Aprendendo a cuidar do estoma; o apoio familiar como potencializador do cuidado e da adaptação; as possibilidades e limitações no uso do vídeo educativo. Considerações finais: o processo de aprender a cuidar do estoma foi marcado pela escassez de orientações de enfermagem e concretizado no aprender fazendo, sendo a colaboração da família importante para o cuidado. O vídeo educativo mostra-se como tecnologia útil para educação em saúde, ao apresentar orientações básicas para o cuidado da colostomia, podendo complementar as orientações de enfermagem.

Objective: to know the perception of colostomized patients due to non-oncological cause and their relatives in front of the use of an educational video as a health education strategy. Methods:qualitative research, performed through a focus group with eight people, four patients and fourrelatives. The data were submitted to the thematic content analysis. Results: three categories were organized: Learning how to take care of and manage the stoma; Acceptance and adaptation: family support as a potentiator of this process; Educational video: possibilities and limitations. Final considerations: the process of learning to take care of the stoma was marked by the scarcity of nursing guidelines and made feasible in learning-doing, with family collaboration being important to care. The educational video is a useful technology in the health education process, presenting basicguidelines for colostomy care, and can to complement nursing orientations.

Effects of transcranial direct current stimulation on working memory and negative symptoms in schizophrenia: a phase II randomized sham-controlled trial.

BACKGROUND: The lack of efficacy of pharmacological treatments for cognitive and negative symptoms in schizophrenia highlights the need for new interventions. We investigated the effects of tDCS on working memory and negative symptoms in patients with schizophrenia. METHOD: Double-blinded, randomized, sham-controlled clinical trial, investigating the effects of 10 sessions of tDCS in schizophrenia subjects. Stimulation used 2 mA, for 20 min, with electrodes of 25 cm2 wrapped in cotton material soaked in saline solution. Anode was positioned over the left DLPFC and the cathode in the contralateral area. Twenty-four participants were assessed at baseline, after intervention and in a three-months follow-up. The primary outcome was the working memory score from MATRICS and the secondary outcome the negative score from PANSS. Data were analyzed using generalized estimating equations. RESULTS: We did not find group ∗ time interaction for the working memory (p = 0.720) score or any other cognitive variable (p > 0.05). We found a significant group ∗ time interaction for PANSS negative (p < 0.001, d = 0.23, CI.95 = -0.59-1.02), general (p = 0.011) and total scores (p < 0.001). Exploratory analysis of PANSS 5 factors suggests tDCS effect on PANSS negative (p = 0.012), cognitive (p = 0.016) and depression factors (p = 0.029). CONCLUSION: The results from this trial highlight the therapeutic effects of tDCS for treatment of persistent symptoms in schizophrenia, with reduction of negative symptoms. We were not able to confirm the superiority of active tDCS over sham to improve working memory performance. Larger sample size studies are needed to confirm these findings.

Hemoencephalography self-regulation training and its impact on cognition: A study with schizophrenia and healthy participants.

BACKGROUND: Cognitive impairments in schizophrenia are strongly correlated to functional outcome and recovery rates, with no pharmacological agent approved for its treatment. Neurofeedback has emerged as a non-pharmacological approach to enhance neuroplasticity, which consists in inducing voluntary control of brain responses through operant conditioning. METHOD: The effects of hemoencephalography neurofeedback (HEG-NFBK) in 4 brain sites (F7, Fp1, Fp2 and F8) was studied in 8 patients with schizophrenia (SCH, mean age 36.5±9.98) and 12 health controls (mean age 32.17±5.6). We analyzed groups' performance (10 sessions) and cognitive differences in 3 time points (baseline, after training and follow-up) with generalized estimated equations. For SCH we also evaluate the impact on psychopathology. RESULTS: We found a group∗time interaction for HEG-NFBK performance in the left hemisphere sites (F7 an Fp1) and a near-to-significant in the right frontotemporal region (F8), with no group differences and a significant time effect. Most of cognitive domains improved after intervention, including information processing speed, attention processing, working memory, executive functioning, verbal and visual learning. No group∗time interaction was found. Results suggest that both groups benefit from HEG-NFBK training regardless of cognitive differences at baseline. No significant time effects were found for Calgary and PANSS total scale and subscales (positive, negative neither general). CONCLUSION: To our knowledge, this is the first controlled trial showing effects of NFBK on cognitive performance improvement in schizophrenia. Further research investigating the effects of HEG-NFBK training in schizophrenia should be performed.

Desempenho produtivo e características de carcaça de cordeiros Rabo Largo puro e cruzados com Santa Inês / Performance and carcass traits of Rabo Largo lambs and crossbreeding with Santa Inês

Objetivou-se avaliar o efeito do cruzamento entre ovinos nativos no desempenho e características da carcaça. Foram utilizados vinte cordeiros, machos, inteiros, com idade inicial de quatro meses, e peso médio inicial 19,0±5,11, distribuídos em dois grupos genéticos: Rabo Largo (RL) e Santa Inês x Rabo Largo (F1SI x RL), em um delineamento inteiramente ao acaso. Os animais foram terminados em regime de confinamento durante 70 dias. Os cordeiros F1SI x RL apresentaram maiores pesos ao desmame, ao abate, do corpo vazio, das carcaças quente e fria, e maior rendimento biológico. Verificaram maiores valores para os parâmetros de morfometria da carcaça para animais F1SI x RL comparados aos animais Rabo Largo (P<0,05). Os pesos da hemi-carcaça e dos cortes comerciais foram superiores para cordeiros F1SI x RL. Nas medidas obtidas no músculo Longissimus dorsi, os cordeiros Rabo Largo apresentaram valores superiores para espessura de gordura subcutânea. A utilização da raça Santa Inês como base paterna acarreta em melhorias nas características de carcaça de cordeiros Rabo Largo podendo ser indicado em sistemas de produção de carne ovina.(AU)

The aim of study was to evaluate the effect of crossbreeding among native sheep on performance and traits carcass. Twenty intact lambs, male, at four months of age, with an initial weight of 19.0±5.11kg, were distributed in two groups genetics: Rabo Largo (RL) e Santa Inês x Rabo Largo (F1SI x RL), in a completely randomized design. The animals were finished in feedlot by 70 days. The lambs F1SI x RL showed higher weight at weaning, to slaughter, of the empty body, and hot and cold carcass, and increased biological yield. Higher values for carcass morphometry in F1SI x RL animals were found in comparison to Rabo Largo animals (P<0.05). The weight of half-carcass and the commercial cuts were higher for lambs. On the measurements obtained in muscle Longissimus dorsi, Rabo Largo lambs showed higher values for subcutaneous fat thickness. The use of the breed Santa Inês like base paternal may bring in improvements in lambs's carcass characteristics Rabo Largo and may be recommended in sheep meat production systems.(AU)

Identification of trends in scientific publications related to genetic polymorphisms in gestational diabetes mellitus.

Gestational diabetes is a genetic multifactorial systemic disease that has been extensively studied. Consequently, there is a large volume of scientific literature pertaining to genes associated with gestational diabetes. The aim of this study was to characterize the main trends in scientific publications focusing on the associations between genetic polymorphisms and gestational diabetes mellitus (GDM). The related articles were extracted from Scopus using the key words "genetic polymorphism" and "gestational diabetes mellitus"; the collected data focused on various fields (medical, biochemical, etc.) and included papers published within December 2013. One hundred and eighty-three relevant articles published between 1987 and 2013 were identified; we observed a significantly increasing trend in the number of publications pertaining to GDM. A majority of the articles focused on the medical (59.9%), biochemical, and genetics and molecular biological (29.6%) aspects of the disease. The genes coding for transcription factor 7-like 2 and glucokinase (TCF7L2, 29% and GCK, 28%) were predominantly studied and reported. This study helped quantify the growth in research pertaining to GDM; researchers from the USA have published a majority of the publications related to GDM. Several candidate genes have been linked to diabetes; however, the specific gene locus responsible for GDM has not yet been identified. The results of this study could help determine the orientation of future research on genetic factors associated with GDM.

l-Arginine supplementation protects against hepatic ischemia-reperfusion lesions in rabbits.

We evaluated the effects of a substrate in the biosynthesis of nitric oxide (NO)-l-arginine (LARG)-on hepatic lesions caused by ischemia/reperfusion (I/R) injury in rabbit livers. Rabbits were pretreated with LARG (150 mg/kg IV) or saline solution 0.9% (SS) before the hepatic I/R procedure. The effects of LARG on hepatic injury were evaluated before and after I/R. The warm hepatic I/R procedure produced profound acute liver injury, as indicated by elevated values of serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), and lactic dehydrogenase (LDH), as well as a high apoptotic cell count. All changes were attenuated by treatment with LARG before the hepatic I/R procedure. These results suggested that LARG produced protective effects on hepatic I/R lesions. This protective effect of LARG was probably associated with blocking generation of superoxide anions during the hepatic I/R procedure.

Baby-friendly hospital initiative improves breastfeeding initiation rates in a US hospital setting.

OBJECTIVE: Breastfeeding initiation rates were compared at Boston Medical Center before (1995), during (1998), and after (1999) Baby-Friendly policies were in place. Boston Medical Center, an inner-city teaching hospital that provides care primarily to poor, minority, and immigrant families, achieved Baby-Friendly status in 1999. METHODS: Two hundred complete medical records, randomly selected by a computer, were reviewed from each of 3 years: 1995, 1998, and 1999. Infants were excluded for medical records missing feeding data, human immunodeficiency virus-positive parent, neonatal intensive care unit admission, maternal substance abuse, adoption, incarceration, or hepatitis C-positive mother. All infant feedings during the hospital postpartum stay were tallied, and each infant was categorized into 1 of 4 groups: exclusive breast milk, mostly breast milk, mostly formula, and exclusive formula. RESULTS: Maternal and infant demographics for all 3 years were comparable. The breastfeeding initiation rate increased from 58% (1995) to 77.5% (1998) to 86.5% (1999). Infants exclusively breastfed increased from 5.5% (1995) to 28.5% (1998) to 33.5% (1999). Initiation rates increased among US-born black mothers in this population from 34% (1995) to 64% (1998) to 74% (1999). CONCLUSIONS: Full implementation of the Ten Steps to Successful Breastfeeding leading to Baby-Friendly designation is an effective strategy to increase breastfeeding initiation rates in the US hospital setting.