Fatores de risco para near miss materno: revisão integrativa / Risk factors for maternal near miss: an integrative review / Factores de riesgo para near miss materno: revisión integrativa

Objetivo: sumarizar os principais fatores de risco relacionados ao near miss materno. Método: revisão integrativa da literatura. A busca foi efetuada em 21 de março de 2021, nas bases de dados: NationalLibrary of Medicine - Medline via PubMed; Current Index to Nursing and Allied Health Literature; Science Direct,Elservier's Scopus, Web of Science e no portal da Biblioteca Virtual de Saúde. Os estudos foram avaliados com a Hierarchy of Evidence for Intervention Studies. Resultados: 12 artigos compuseram a revisão, todos de método quantitativo e idioma inglês. As evidências destacaram como risco para near miss materno: distúrbios hipertensivos, complicações hemorrágicas e a sepse puerperal. Demais achados relacionam-se à distância da moradia e dificuldade de acesso aos serviços de saúde além da baixa escolaridade. Conclusões: os fatores de risco para near miss materno se relacionam com pré-natal inadequado, decorrente de questões geográficas e falta de acesso aos serviços, questões econômicas, educacionais e sociais.

Mapa conceitual: representação social na graduação de enfermagem / Conceptual map: social representation in nursing graduation / Mapa conceptual: representación social en graduación de enfermería

Objetivo: Compreender as representações sociais do uso de mapas conceituais em grupo tutorial de estudantes de enfermagem. Método: Pesquisa qualitativa, feita a partir da análise do Discurso do Sujeito Coletivo de 26 estudantes de uma universidade pública no Centro-Oeste do Brasil. Resultados: Emergiram duas categorias provenientes da análise do discurso: 1) Mapa Conceitual: ferramenta facilitadora de organização da aprendizagem e 2) Mapa Conceitual: ferramenta que provoca tensão e desfavorece o aprendizado. Conclusões: O mapa conceitual facilita o auto estudo e a aprendizagem, pois possibilita a sintetização do conhecimento e a organização do raciocínio. Quanto à sua utilização coletiva, observou-se falhas em relação ao tempo gasto na elaboração e na necessidade de encontrar palavras de ligação. (AU)

Objective: To understand the social representations of the use of concept maps in a tutorial group of nursing students. Methods: Qualitative research, based on the Collective Subject Discourse analysis of 26 students from a public university in the Midwest of Brazil. Results: Two categories emerged from the discourse analysis: 1) Concept Map: a facilitating tool for learning organization and 2) Concept Map: a tool that causes tension and disadvantages learning. Conclusion: The concept map facilitates self-study and learning, as it enables the synthesis of knowledge and the organization of reasoning. Regarding their collective use, there were flaws in the time spent in elaboration and in the need to find linking words. (AU)

Objetivo: Comprender las representaciones sociales del uso de mapas conceptuales en un grupo tutorial de estudiantes de enfermería. Métodos: Investigación cualitativa, basada en el análisis del discurso del sujeto colectivo de 26 estudiantes de una universidad pública en el medio oeste de Brasil. Resultados: Del análisis del discurso surgieron dos categorías: 1) Mapa conceptual: una herramienta facilitadora para la organización del aprendizaje y 2) Mapa conceptual: una herramienta que causa tensión y desventajas del aprendizaje. Conclusion: El mapa conceptual facilita el autoaprendizaje y el aprendizaje, ya que permite la síntesis del conocimiento y la organización del razonamiento. Con respecto a su uso colectivo, hubo fallas en el tiempo dedicado a la elaboración y en la necesidad de encontrar palabras de enlace. (AU)

Improving five-year survival prediction via multitask learning across HPV-related cancers.

Oncology is a highly siloed field of research in which sub-disciplinary specialization has limited the amount of information shared between researchers of distinct cancer types. This can be attributed to legitimate differences in the physiology and carcinogenesis of cancers affecting distinct anatomical sites. However, underlying processes that are shared across seemingly disparate cancers probably affect prognosis. The objective of the current study is to investigate whether multitask learning improves 5-year survival cancer patient survival prediction by leveraging information across anatomically distinct HPV related cancers. Data were obtained from the Surveillance, Epidemiology, and End Results (SEER) program database. The study cohort consisted of 29,768 primary cancer cases diagnosed in the United States between 2004 and 2015. Ten different cancer diagnoses were selected, all with a known association with HPV risk. In the analysis, the cancer diagnoses were categorized into three distinct topography groups of varying specificity. The most specific topography grouping consisted of 10 original cancer diagnoses differentiated by the first two digits of the ICD-O-3 topography code. The second topography grouping consisted of cancer diagnoses categorized into six distinct organ groups. Finally, the third topography grouping consisted of just two groups, head-neck cancers and ano-genital cancers. The tasks were to predict 5-year survival for patients within the different topography groups using 14 predictive features which were selected among descriptive variables available in the SEER database. The information from the predictive features was shared between tasks in three different ways, resulting in three distinct predictive models: 1) Information was not shared between patients assigned to different tasks (single task learning); 2) Information was shared between all patients, regardless of task (pooled model); 3) Only relevant information was shared between patients grouped to different tasks (multitask learning). Prediction performance was evaluated with Brier scores. All three models were evaluated against one another on each of the three distinct topography-defined tasks. The results showed that multitask classifiers achieved relative improvement for the majority of the scenarios studied compared to single task learning and pooled baseline methods. In this study, we have demonstrated that sharing information among anatomically distinct cancer types can lead to improved predictive survival models.

Functional and transcriptional characterization of complex neuronal co-cultures.

Brain-on-a-chip systems are designed to simulate brain activity using traditional in vitro cell culture on an engineered platform. It is a noninvasive tool to screen new drugs, evaluate toxicants, and elucidate disease mechanisms. However, successful recapitulation of brain function on these systems is dependent on the complexity of the cell culture. In this study, we increased cellular complexity of traditional (simple) neuronal cultures by co-culturing with astrocytes and oligodendrocyte precursor cells (complex culture). We evaluated and compared neuronal activity (e.g., network formation and maturation), cellular composition in long-term culture, and the transcriptome of the two cultures. Compared to simple cultures, neurons from complex co-cultures exhibited earlier synapse and network development and maturation, which was supported by localized synaptophysin expression, up-regulation of genes involved in mature neuronal processes, and synchronized neural network activity. Also, mature oligodendrocytes and reactive astrocytes were only detected in complex cultures upon transcriptomic analysis of age-matched cultures. Functionally, the GABA antagonist bicuculline had a greater influence on bursting activity in complex versus simple cultures. Collectively, the cellular complexity of brain-on-a-chip systems intrinsically develops cell type-specific phenotypes relevant to the brain while accelerating the maturation of neuronal networks, important features underdeveloped in traditional cultures.

Generation and evaluation of synthetic patient data.

BACKGROUND: Machine learning (ML) has made a significant impact in medicine and cancer research; however, its impact in these areas has been undeniably slower and more limited than in other application domains. A major reason for this has been the lack of availability of patient data to the broader ML research community, in large part due to patient privacy protection concerns. High-quality, realistic, synthetic datasets can be leveraged to accelerate methodological developments in medicine. By and large, medical data is high dimensional and often categorical. These characteristics pose multiple modeling challenges. METHODS: In this paper, we evaluate three classes of synthetic data generation approaches; probabilistic models, classification-based imputation models, and generative adversarial neural networks. Metrics for evaluating the quality of the generated synthetic datasets are presented and discussed. RESULTS: While the results and discussions are broadly applicable to medical data, for demonstration purposes we generate synthetic datasets for cancer based on the publicly available cancer registry data from the Surveillance Epidemiology and End Results (SEER) program. Specifically, our cohort consists of breast, respiratory, and non-solid cancer cases diagnosed between 2010 and 2015, which includes over 360,000 individual cases. CONCLUSIONS: We discuss the trade-offs of the different methods and metrics, providing guidance on considerations for the generation and usage of medical synthetic data.

Modeling the temporal network dynamics of neuronal cultures.

Neurons form complex networks that evolve over multiple time scales. In order to thoroughly characterize these networks, time dependencies must be explicitly modeled. Here, we present a statistical model that captures both the underlying structural and temporal dynamics of neuronal networks. Our model combines the class of Stochastic Block Models for community formation with Gaussian processes to model changes in the community structure as a smooth function of time. We validate our model on synthetic data and demonstrate its utility on three different studies using in vitro cultures of dissociated neurons.

A flexible 3-dimensional microelectrode array for in vitro brain models.

Three-dimensional (3D) in vitro models have become increasingly popular as systems to study cell-cell and cell-ECM interactions dependent on the spatial, mechanical, and chemical cues within the environment of the tissue, which is limited in traditional two-dimensional (2D) models. Although electrophysiological recordings of neuronal action potentials through 2D microelectrode arrays (MEAs) are a common and trusted method of evaluating neuronal function, network communication, and response to chemicals and biologicals, there are currently limited options for measuring electrophysiological activity from many locations simultaneously throughout a 3D network of neurons in vitro. Here, we have developed a thin-film, 3D flexible microelectrode array (3DMEA) that non-invasively interrogates a 3D culture of neurons and can accommodate 256 channels of recording or stimulation. Importantly, the 3DMEA is straightforward to fabricate and integrates with standard commercially available electrophysiology hardware. Polyimide probe arrays were microfabricated on glass substrates and mechanically actuated to collectively lift the arrays into a vertical position, relying solely on plastic deformation of their base hinge regions to maintain vertical alignment. Human induced pluripotent stem cell (hiPSC)-derived neurons and astrocytes were entrapped in a collagen-based hydrogel and seeded onto the 3DMEA, enabling growth of suspended cells in the matrix and the formation and maturation of a neural network around the 3DMEA probes. The 3DMEA supported the growth of functional neurons in 3D with action potential spike and burst activity recorded over 45 days in vitro. This platform is an important step in facilitating noninvasive electrophysiological characterization of 3D networks of electroactive cells in vitro.

Tissue-specific extracellular matrix accelerates the formation of neural networks and communities in a neuron-glia co-culture on a multi-electrode array.

The brain's extracellular matrix (ECM) is a macromolecular network composed of glycosaminoglycans, proteoglycans, glycoproteins, and fibrous proteins. In vitro studies often use purified ECM proteins for cell culture coatings, however these may not represent the molecular complexity and heterogeneity of the brain's ECM. To address this, we compared neural network activity (over 30 days in vitro) from primary neurons co-cultured with glia grown on ECM coatings from decellularized brain tissue (bECM) or MaxGel, a non-tissue-specific ECM. Cells were grown on a multi-electrode array (MEA) to enable noninvasive long-term interrogation of neuronal networks. In general, the presence of ECM accelerated the formation of networks without affecting the inherent network properties. However, specific features of network activity were dependent on the type of ECM: bECM enhanced network activity over a greater region of the MEA whereas MaxGel increased network burst rate associated with robust synaptophysin expression. These differences in network activity were not attributable to cellular composition, glial proliferation, or astrocyte phenotypes, which remained constant across experimental conditions. Collectively, the addition of ECM to neuronal cultures represents a reliable method to accelerate the development of mature neuronal networks, providing a means to enhance throughput for routine evaluation of neurotoxins and novel therapeutics.

Bayesian multitask learning regression for heterogeneous patient cohorts.

Multitask learning (MTL) leverages commonalities across related tasks with the aim of improving individual task performance. A key modeling choice in designing MTL models is the structure of the tasks' relatedness, which may not be known. Here we propose a Bayesian multitask learning model that is able to infer the task relationship structure directly from the data. We present two variations of the model in terms of a priori information of task relatedness. First, a diffuse Wishart prior is placed on a task precision matrix so that all tasks are assumed to be equally related a priori. Second, a Bayesian graphical LASSO prior is used on the task precision matrix to impose sparsity in the task relatedness. Motivated by machine learning applications in the biomedical domain, we emphasize interpretability and uncertainty quantification in our models. To encourage model interpretability, linear mappings from the shared input spaces to task-dependent output spaces are used. To encourage uncertainty quantification, conjugate priors are used so that full posterior inference is possible. Using synthetic data, we show that our model is able to recover the underlying task relationships as well as features jointly relevant for all tasks. We demonstrate the utility of our model on three distinct biomedical applications: Alzheimer's disease progression, Parkinson's disease assessment, and cervical cancer screening compliance. We show that our model outperforms Single Task (STL) models in terms of predictive performance, and performs better than existing MTL methods for the majority of the scenarios.

Insulin autoimmune syndrome in an occidental woman: a case report and literature review.

Insulin autoimmune syndrome (IAS, Hirata's disease) is a rare hypoglycemic disorder characterized by spontaneous hypoglycemia associated with extremely high circulating insulin levels and positive anti-insulin antibody results. Thus far, most cases have been reported in Asian countries, notably Japan, with few cases reported in western countries. As a possible cause, it is associated with the use of drugs containing sulfhydryl radicals, such as captopril. This report refers to a 63-year-old female Brazilian patient with a history of postprandial hypoglycemia. After extensive investigation and exclusion of other causes, her hyperinsulinemic hypoglycemia was considered to have likely been induced by captopril. Most cases of IAS are self-limiting. However, dietary management, corticosteroids, plasmapheresis, and rituximab have already been used to treat patients with IAS. In our case, after discontinuation of captopril, an initial decrease in insulin autoantibody levels was observed followed by improvement in episodes of hypoglycemia. Although it is a rare disease, IAS should be considered in the differential diagnosis of endogenous hyperinsulinemic hypoglycemia. Patients with suspected IAS must be screened for autoimmunity-related drugs for insulin. Initial clinical suspicion of IAS can avoid unnecessary costs associated with imaging examinations and/or invasive surgical procedures.

A influência da cultura nas práticas de cuidado a pacientes com hipertensão: uma revisão integrativa / Cultural influence in the care of patients with hypertension: an integrative review

Os profissionais de saúde, cotidianamente, estabelecem ações de cuidado congruentes à cultura do indivíduo e mesmo que essas ações não estejam claramente estabelecidas, isso não o isenta de utilizá-las, inclusive com pessoas que possuem hipertensão. Objetivo: Descrever a influência da cultura nas práticas assistenciais a pacientes com hipertensão na atenção primária à saúde. Métodos: Revisão integrativa no período de 2014 a 2018 usando as seguintes bases de dados eletrônicas: LILACS; CINAHL; PUBMED; e Web of Science. Resultados: Três artigos foram selecionados e a análise da evidência científica obtida permitiu organizar os resultados em três áreas temáticas: abordagem culturalmente sensível e práticas de enfermagem; as iniquidades de saúde; e a (não) adesão à medicação. Considerações finais: Os resultados apontaram explorar as barreiras culturais no desenvolvimento de estratégias efetivas para a melhoria do cuidado do indivíduo com hipertensão e minimizar riscos de eventos cardiovasculares.

Daily, health professionals establish care actions that are consistent with the individual's culture. Even if these actions are not clearly established, this does not exempt the professional from using the cultural approach to care, especially with people who have hypertension. Objective: To describe the cultural influence in care practices in the care of patients with hypertension in primary health care. Methods: Integrative review in the period from 2014 to 2018 using the following electronic databases: LILACS; CINAHL; PUBMED; and Web of Science. Results: Three articles were selected and the analysis of the scientific evidence obtained allowed to organize the results in three thematic areas: culturally sensitive approach and nursing practices; health inequities; and (non) adherence to medication. Considerations: The results pointed out the need for exploring cultural barriers in the development of effective strategies to improve the care of individuals with hypertension and minimize cardiovascular risk events.

Insulin autoimmune syndrome in an occidental woman: a case report and literature review

SUMMARY Insulin autoimmune syndrome (IAS, Hirata's disease) is a rare hypoglycemic disorder characterized by spontaneous hypoglycemia associated with extremely high circulating insulin levels and positive anti-insulin antibody results. Thus far, most cases have been reported in Asian countries, notably Japan, with few cases reported in western countries. As a possible cause, it is associated with the use of drugs containing sulfhydryl radicals, such as captopril. This report refers to a 63-year-old female Brazilian patient with a history of postprandial hypoglycemia. After extensive investigation and exclusion of other causes, her hyperinsulinemic hypoglycemia was considered to have likely been induced by captopril. Most cases of IAS are self-limiting. However, dietary management, corticosteroids, plasmapheresis, and rituximab have already been used to treat patients with IAS. In our case, after discontinuation of captopril, an initial decrease in insulin autoantibody levels was observed followed by improvement in episodes of hypoglycemia. Although it is a rare disease, IAS should be considered in the differential diagnosis of endogenous hyperinsulinemic hypoglycemia. Patients with suspected IAS must be screened for autoimmunity-related drugs for insulin. Initial clinical suspicion of IAS can avoid unnecessary costs associated with imaging examinations and/or invasive surgical procedures.

Spirituality, Religiosity, Quality of Life and Mental Health Among Pantaneiros: A Study Involving a Vulnerable Population in Pantanal Wetlands, Brazil.

This study aims to investigate the relationship between spirituality, religiosity (S/R), mental health and quality of life in a vulnerable population in the Pantanal wetlands of Brazil. A total of 129 individuals were interviewed. We examined mental health (Hospital Anxiety and Depression Scale), quality of life (SF-12), spirituality (self-spirituality rating scale), religiosity (DUREL) and R/S opinions. Individuals had high levels of spirituality, non-organizational and intrinsic religiosity, but low levels of religious attendance. Most participants said they would like to have their faith addressed by a health professional and that this approach would strengthen their trust on the doctors. Higher levels of spirituality were associated with less anxiety (ß = - 0.236, p < 0.01) and depressive symptoms (ß = - 0.398, p < 0.001); higher levels of non-organizational religiosity were associated with less anxiety (ß = - 0.250, p < 0.01) and depressive symptoms (ß = - 0.351, p < 0.001); and higher levels of intrinsic religiosity were associated with less depressive symptoms (ß = - 0.315, p < 0.001). Quality of life was not associated with any religious/spiritual measures.

Evaluation of in vitro neuronal platforms as surrogates for in vivo whole brain systems.

Quantitatively benchmarking similarities and differences between the in vivo central nervous system and in vitro neuronal cultures can qualify discrepancies in functional responses and establish the utility of in vitro platforms. In this work, extracellular electrophysiology responses of cortical neurons in awake, freely-moving animals were compared to in vitro cultures of dissociated cortical neurons. After exposure to two well-characterized drugs, atropine and ketamine, a number of key points were observed: (1) significant differences in spontaneous firing activity for in vivo and in vitro systems, (2) similar response trends in single-unit spiking activity after exposure to atropine, and (3) greater sensitivity to the effects of ketamine in vitro. While in vitro cultures of dissociated cortical neurons may be appropriate for many types of pharmacological studies, we demonstrate that for some drugs, such as ketamine, this system may not fully capture the responses observed in vivo. Understanding the functionality associated with neuronal cultures will enhance the relevance of electrophysiology data sets and more accurately frame their conclusions. Comparing in vivo and in vitro rodent systems will provide the critical framework necessary for developing and interpreting in vitro systems using human cells that strive to more closely recapitulate human in vivo function and response.

Flexible, cluster-based analysis of the electronic medical record of sepsis with composite mixture models.

The widespread adoption of electronic medical records (EMRs) in healthcare has provided vast new amounts of data for statistical machine learning researchers in their efforts to model and predict patient health status, potentially enabling novel advances in treatment. In the case of sepsis, a debilitating, dysregulated host response to infection, extracting subtle, uncataloged clinical phenotypes from the EMR with statistical machine learning methods has the potential to impact patient diagnosis and treatment early in the course of their hospitalization. However, there are significant barriers that must be overcome to extract these insights from EMR data. First, EMR datasets consist of both static and dynamic observations of discrete and continuous-valued variables, many of which may be missing, precluding the application of standard multivariate analysis techniques. Second, clinical populations observed via EMRs and relevant to the study and management of conditions like sepsis are often heterogeneous; properly accounting for this heterogeneity is critical. Here, we describe an unsupervised, probabilistic framework called a composite mixture model that can simultaneously accommodate the wide variety of observations frequently observed in EMR datasets, characterize heterogeneous clinical populations, and handle missing observations. We demonstrate the efficacy of our approach on a large-scale sepsis cohort, developing novel techniques built on our model-based clusters to track patient mortality risk over time and identify physiological trends and distinct subgroups of the dataset associated with elevated risk of mortality during hospitalization.

Maternal exposure to an environmentally relevant dose of triclocarban results in perinatal exposure and potential alterations in offspring development in the mouse model.

Triclocarban (TCC) is among the top 10 most commonly detected wastewater contaminants in both concentration and frequency. Its presence in water, as well as its propensity to bioaccumulate, has raised numerous questions about potential endocrine and developmental effects. Here, we investigated whether exposure to an environmentally relevant concentration of TCC could result in transfer from mother to offspring in CD-1 mice during gestation and lactation using accelerator mass spectrometry (AMS). 14C-TCC (100 nM) was administered to dams through drinking water up to gestation day 18, or from birth to post-natal day 10. AMS was used to quantify 14C-concentrations in offspring and dams after exposure. We demonstrated that TCC does effectively transfer from mother to offspring, both trans-placentally and via lactation. TCC-related compounds were detected in the tissues of offspring with significantly higher concentrations in the brain, heart and fat. In addition to transfer from mother to offspring, exposed offspring were heavier in weight than unexposed controls demonstrating an 11% and 8.5% increase in body weight for females and males, respectively. Quantitative real-time polymerase chain reaction (qPCR) was used to examine changes in gene expression in liver and adipose tissue in exposed offspring. qPCR suggested alterations in genes involved in lipid metabolism in exposed female offspring, which was consistent with the observed increased fat pad weights and hepatic triglycerides. This study represents the first report to quantify the transfer of an environmentally relevant concentration of TCC from mother to offspring in the mouse model and evaluate bio-distribution after exposure using AMS. Our findings suggest that early-life exposure to TCC may interfere with lipid metabolism and could have implications for human health.

Prevalência do tabagismo e terapêutica da dependência de nicotina: uma revisão integrativa / Smoking prevalence and of nicotine dependence’s therapeutics: anintegrative review / Prevalencia de tabaquismo y tratamiento de la dependencia a la nicotina: una revisión integradora

Objective: To identify available evidence in the literature on the epidemiological aspects, the approach to the smoker, and therapeutic of nicotine addiction in the population. Method: This is an integrative review carried out in the Health Virtual Library using the following combinations of keywords: “prevalence and smoking,” “dependence and nicotine”, “depression and smoking,” and “smoking cessation.” Results: The results from the sixteen selected articles pointed out: incomplete primary education, low income, early teenage smoking, and higher prevalence and recurrence among women than men. Conclusion: Smoking is more prevalent in women,and women have a higher incidence of relapse after treatment than men. The most widely used therapy was the useof drugs in conjunction with a psychosocial approach and/or cognitive behavioral method. It is necessary to train health professionals to understand the smoking habit as a public health problem to refer individuals to treatment.

Objetivo: Identificar evidências disponíveis na literatura sobre os aspectos epidemiológicos, abordagem do tabagista e terapêutica da dependência da nicotina na população. Método: Trata-se de revisão integrativa realizada na Biblioteca Virtual de Saúde, com as seguintes associações de palavras chave:“prevalência e tabagismo”, “dependência e nicotina”, “depressão e tabagismo” e “abandono do hábito de fumar”. Resultados: Os resultados dos dezesseis artigos selecionados apontaram: ensino fundamental incompleto, baixa renda, início do tabagismo na adolescência, maior prevalência e recidiva entre mulheres. Conclusão: O tabagismo é mais prevalente em mulheres e estas apresentam maior recidiva após o tratamento. A terapêutica mais utilizada foi o uso conjunto de fármacos com a abordagem psicossocial e/ou método cognitivo comportamental. É necessário capacitar os profissionais de saúde para compreender o tabagismo como problema de saúde pública e encaminhar o usuário para tratamento.

Objetivo: Identificar evidencias disponibles en la literatura sobre los aspectos epidemiológicos, abordaje del tabaquista y terapéutica de la dependencia de la nicotina en la población. Método: Se trata de una revisión integradora realizada en la Biblioteca Virtual de Salud, con las siguientes asociaciones de palabras-clave: “prevalencia y tabaquismo”, “dependencia y nicotina”, “depresión y tabaquismo”, y “abandono del hábito de fumar”. Resultados: Los resultados de los dieciséis artículos seleccionados señalaron: enseñanza primaria incompleta, baja renta, inicio del tabaquismo en la adolescencia, mayor prevalencia y recurrencia entre mujeres. Conclusión: El tabaquismo es más frecuente entre mujeres y éstas presentan mayor recurrencia después del tratamiento. La terapéutica más utilizada fue el uso conjunto de fármacos con el abordaje psicosocial y/o método cognitivo comportamental. Es necesario capacitar los profesionales de salud para comprender el tabaquismo como problema de salud pública y encaminar el usuario para tratamiento.

O materialismo histórico e dialético na assistência de enfermagem: revisão integrativa / Historical and dialectical materialism in nursing care: integrative review / El materialismo dialéctico e histórico en el cuidado de enfermería: examen integrador

INTRODUÇÃO: Ressalta-se a necessidade do envolvimento científico nas mudanças que ocorrem no universo da enfermagem, na intenção de oferecer condutas baseadas nas melhores evidências científicas, visto que a enfermagem é uma das profissões da área da saúde presente em todo o mundo e dela são esperadas respostas para os mais diversos problemas de saúde, inclusive os pertencentes à equipe multiprofissional. OBJETIVO: analisar a produção científica nacional e internacional acerca das contribuições da Teoria do Materialismo Histórico e Dialético no campo da Enfermagem. MATERIAL E MÉTODO: revisão integrativa que tem como questão norteadora << O que se tem publicado em âmbito nacional e internacional a respeito do materialismo histórico e dialético no campo da enfermagem? >> A busca ocorreu nas bases de dados MEDLINE, LILACS, IBECS, BDENF e biblioteca virtual SciELO. Utilizaram-se os descritores: "materialismo histórico e dialético" AND "enfermagem". Incluíram-se artigos nos idiomas português, espanhol e inglês, publicados no período 2004 a 2014. Excluíram-se teses e/ou dissertações. RESULTDOS: dos 134 artigos encontrados, oito atenderam foram incluídos. Predomínio de pesquisas qualitativas e idioma na língua portuguesa. CONCLUSÃO: a análise da produção nacional e internacional apontou a escassez de artigos referente quanto ao uso do materialismo histórico e dialético na enfermagem. Os estudos mostraram como a teoria pode contribuir com o processo de trabalho em enfermagem

INTRODUCTION: Emphasis is placed on the need for scientific involvement in the changes that occur in the nursing universe, with the intention of offering conduits based on the best scientific evidence, since nursing is one of the health professions present in the world and answers are expected for the most diverse health problems, including those belonging to the multiprofessional team. OBJECTIVE: to analyze the national and international scientific production about the contributions of the Historical and Dialectical Materialism Theory in the field of Nursing. Method: integrative review which guiding question is << What has been published in national and international level regarding the historical and dialectical materialism in the field of nursing? >> Searching occurred in the MEDLINE, LILACS, IBECS, BDENF databases and in SciELO virtual library. These descriptors were used: "historical and dialectical materialism" AND "nursing". Articles in Portuguese, Spanish and English languages were included, published in the period from 2004 to 2014. Theses and/or dissertations were excluded. Results: of 134 found, 8 articles were included. Predominance of qualitative research and Portuguese language. Conclusion: the national and international production analysis pointed out the shortage of articles referring to the use of historical and dialectical materialism in nursing. Studies have shown how theory can contribute to the work process in nursing.

INTRODUCCIÓN: Se resalta la necesidad de la implicación científica en los cambios que ocurren en el universo de la enfermería, en la intención de ofrecer conductas basadas en las mejores evidencias científicas, ya que la enfermería es una de las profesiones del área de la salud presente en todo el mundo y de ella se esperan respuestas para los más diversos problemas de salud, incluso los pertenecientes al equipo multiprofesional. OBJETIVO: analizar la producción científica nacional e internacional sobre las contribuciones de la teoría dialéctico y materialismo histórico en el campo de la enfermería. MATERIAL E MÉTODO: revisión integrativa que tiene como pregunta guía << lo que se publica en el ámbito nacional e internacional en relación con el materialismo histórico y dialéctico en el campo de la enfermería? >> búsqueda ocurrieron en las bases de datos MEDLINE, LILACS, IBECS, BDENF y biblioteca virtual SciELO. Se utilizaron los descriptores: "materialismo dialéctico e histórico" y "enfermería". Artículos incluidos en los idiomas portugués, españolas e inglés, publicado en el período 2004-2014. Eliminar-en caso tesis o disertaciones. RESULTADOS: de los 134 artículos encontrados, ocho asistieron fueron incluido. Predominio de la investigación cualitativa y el lenguaje en el idioma portugués. CONCLUSIÓN: el análisis de la producción nacional e internacional señaló la escasez de artículos sobre cómo el uso del materialismo dialéctico e histórico en enfermería. Los estudios han demostrado cómo la teoría puede contribuir al proceso de trabajo en enfermería.

[Choice of type of delivery: factors reported by puerperal woman]. / Escolha do tipo de parto: fatores relatados por puérperas.

OBJECTIVE: To know the factors listed by puerperal woman that influenced the choice in type of delivery. METHODS: Qualitative research, developed with 25 puerperal women in a University Hospital of Mato Grosso do Sul, between September and November 2014. A semi-structured interview was used for data collection and the Collective Subject Discourse was used to organize and tabulate the data collected. RESULTS: The Collective Subject Discourses resulted in the following categories: Desire for the type of delivery; Respect for the chosen type of delivery and Factors that influenced the choice. Most of the women interviewed (76%) expressed a preference for normal birth due to rapid recovery, less pain and suffering. CONCLUSIONS: The influence of family members, previous experience with childbirth, professional-customer interaction and internet information influenced the type of delivery chosen, which reinforces the importance of health education since the pre-natal stage, highlighting the need to equip women to perform a conscious choice.

Escolha do tipo de parto: fatores relatados por puérperas / La elección del tipo de parto: factores relatados por puérperas / Choice of type of delivery: factors reported by puerperal woman

RESUMO Objetivo Conhecer os fatores relatados por puérperas que concorreram na escolha do tipo de parto. Métodos Pesquisa qualitativa, desenvolvida com 25 puérperas em um Hospital Universitário de Mato Grosso do Sul, entre setembro e novembro de 2014. Utilizou-se a entrevista semiestruturada para a coleta de dados e o Discurso do Sujeito Coletivo para organizar e tabular os depoimentos. Resultados Os Discursos dos Sujeitos Coletivos resultaram nas categorias: Desejo pelo tipo de parto realizado; Respeito pelo tipo de parto escolhido e Fatores que influenciaram a escolha. A maioria das mulheres entrevistadas (76%) manifestou preferência pelo parto normal devido à recuperação rápida, menor dor e sofrimento. Conclusões Concorreram na escolha do tipo de parto: influência da família, experiências prévias com parto, interação profissional – cliente e informações via internet, o que reforça a importância da educação em saúde desde o pré-natal, destacando a necessidade de instrumentalizar a mulher para realizar uma escolha consciente.

RESUMEN Objetivos Conocer los factores relatados por puérperas que concurrieron en la elección del tipo de parto. Métodos Investigación cualitativa, desarrollada con 25 parturientas que se encontraban en un Hospital Universitario de Mato Grosso do Sul, entre septiembre y noviembre de 2014. Se utilizó la encuesta semiestructurada para la recolección de datos y el Discurso del Sujeto Colectivo (DSC) para organizar y tabular las informaciones. Resultados Los DSCs resultaron en las categorías: Deseo por el tipo de parto realizado; Respeto por el tipo de parto elegido y Factores que influyeron en la elección. La mayoría de las mujeres encuestadas (76%) prefirieron el parto vaginal debido a la recuperación rápida, menos dolor y sufrimiento. Conclusiones Concurrieron en la elección por la vía de nacimiento fueron: influencia de la familia, experiencia previa con parto, interacción profesional — cliente e información vía internet, lo que refuerza la importancia de la educación en salud desde el prenatal, destacando la necesidad de instrumentalizar a la mujer para realizar una decisión consciente.

ABSTRACT Objective To know the factors listed by puerperal woman that influenced the choice in type of delivery. Methods Qualitative research, developed with 25 puerperal women in a University Hospital of Mato Grosso do Sul, between September and November 2014. A semi-structured interview was used for data collection and the Collective Subject Discourse was used to organize and tabulate the data collected. Results The Collective Subject Discourses resulted in the following categories: Desire for the type of delivery; Respect for the chosen type of delivery and Factors that influenced the choice. Most of the women interviewed (76%) expressed a preference for normal birth due to rapid recovery, less pain and suffering. Conclusions The influence of family members, previous experience with childbirth, professional-customer interaction and internet information influenced the type of delivery chosen, which reinforces the importance of health education since the pre-natal stage, highlighting the need to equip women to perform a conscious choice.