Postdischarge telephone follow-up among chronic disease patients discharged from a vascular surgery service: a best practice implementation project.

OBJECTIVES: To improve postdischarge telephone follow-up in the context of chronic disease management (peripheral artery disease), in a vascular surgery service. INTRODUCTION: Patients with chronic diseases, such as peripheral artery disease, present a higher risk of complications and greater constraints regarding their adherence to treatment, leading to an increasing mortality rate and decreased functional capacity. Comprehensive discharge planning plus postdischarge telephone follow-up may reduce 30-day re-hospitalization rates. METHODS: The project used the JBI audit and feedback methodological approach to implement the best available evidence into practice. Two audit criteria were used: existence of comprehensive discharge planning and timely telephone follow-up. A baseline audit was conducted, followed by analysis of barriers, which led to the implementation of several strategies, namely, a targeted training program, the development of educational resources and standardized procedures for the discharge process, and postdischarge telephone follow-up. RESULTS: Results from the baseline and first follow-up audits showed improvement for both criteria. Compliance for criterion 1 (comprehensive discharge planning, including postdischarge telephone follow-up) increased from 0% to 40.7%, and for criterion 2 (patient is followed up by telephone within 2 weeks of discharge) increased from 0% to 44.4%. These two criteria sustained improvements in the second follow-up audit: compliance increased to 45% (criterion 1) and 60% (criterion 2). CONCLUSIONS: This implementation project contributed to the optimization of the chronic disease management, including improved compliance with discharge planning and early postdischarge telephone follow-up.

Experiences with remote communication in adult intensive care units during the COVID-19 pandemic: a systematic review protocol.

OBJECTIVE: The objective of this review is to explore the lived experiences of critically ill adults, their families, or health care professionals with remote communication in intensive care units (ICUs) during the COVID-19 pandemic. INTRODUCTION: Family visiting restrictions in ICUs during the COVID-19 pandemic imposed significant challenges to communication between critically ill adults, their families, and the health care team. Evidence shows that several communication strategies were developed and implemented in ICUs during the COVID-19 pandemic to promote family engagement; however, the experiences of critically ill adults, their families, and health care professionals with these strategies are scattered across primary qualitative studies. INCLUSION CRITERIA: This review will consider qualitative studies that include critically ill adults, their families, or health care professionals, focusing on their experiences with remote communication strategies in ICUs during the COVID-19 pandemic. METHODS: This review will be conducted in accordance with JBI methodology. The search strategy will aim to locate both published and unpublished qualitative studies in English, Spanish, and Portuguese. Studies published after January 2020 will be included. Study selection, critical appraisal, and data extraction will be performed independently by 2 reviewers. Data will be presented in narrative format and synthesized using the JBI meta-aggregation process. A ConQual Summary of Findings will be presented. REVIEW REGISTRATION: PROSPERO CRD42022383603.

Novel Approach to Intradialytic Progressive Resistance Exercise Training.

Physical activity levels are typically undesirably low in chronic kidney disease patients, especially in those undergoing haemodialysis, and particularly on dialysis days. Intradialytic exercise programmes could be a solution to this issue and have been reported to be safe and relatively easily implemented in dialysis clinics. Nevertheless, such implementation has been failing in part due to barriers such as the lack of funding, qualified personnel, equipment, and patient motivation. Intradialytic aerobic exercise has been the most used type of intervention in dialysis clinics. However, resistance exercise may be superior in eliciting potential benefits on indicators of muscle strength and mass. Yet, few intradialytic exercise programmes have focused on this type of intervention, and the ones which have report inconsistent benefits, diverging on prescribed exercise intensity, absent or subjective load progression, equipment availability, or exercise supervision. Commonly, intradialytic resistance exercise interventions use free weights, ankle cuffs, or elastic bands which hinder load progression and exercise intensity monitoring. Here, we introduce a recently developed intradialytic resistance exercise device and propose an accompanying innovative resistance exercise training protocol which aims to improve the quality of resistance exercise interventions within dialysis treatment sessions.

Effectiveness of school-based sleep promotion programs for adolescents: a systematic review protocol.

OBJECTIVE: This systematic review will assess the effectiveness of school-based sleep promotion programs on sleep knowledge, hygiene, quality, behavior, and efficiency in adolescents. INTRODUCTION: Adolescents need to sleep between 8 and 10 hours per night; however, most sleep fewer hours due to peer and school pressure, stress, and excessive use of electronic devices at night. Sleep deprivation can lead to cardiovascular problems, issues with stress management, and suicidal ideation. Schools are an ideal space to implement intervention programs, providing the opportunity to reach a large number of adolescents. Considering the negative impacts of poor sleep, it is essential to assess the effectiveness of school-based sleep promotion programs on sleep knowledge, hygiene, quality, behavior, and efficiency. INCLUSION CRITERIA: Studies with adolescents (10-19 years old) exposed to school-based sleep promotion programs will be included. Studies in English, Spanish, and Portuguese will be considered, with no time limits. METHODS: Nine databases, CINAHL, Cochrane Central Register of Controlled Trials, ERIC (all via EBSCOhost), MEDLINE (PubMed), LILACS, SciELO, Psychology and Behavioral Sciences Collection, Web of Science Core Collection, and Scopus, will be searched from inception to identify relevant studies. Two independent reviewers will perform the study selection, critical appraisal using JBI tools, and data extraction. Studies will, where possible, be pooled in meta-analysis. Heterogeneity will be assessed using the standard χ 2 and I2 tests. Statistical analyses will be performed using the random effects model. If fewer than 5 studies are included, the fixed effects model will be used. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach will be used to grade the certainty of evidence and a Summary of Findings will be created. REVIEW REGISTRATION: PROSPERO CRD42023374838.

Conhecimentos e atitudes dos encarregados de educação e educadores de infância das crianças em idade pré-escolar acerca da prevenção do abuso sexual / Knowledge and attitudes of parents and kindergarten teachers about the prevention of sexual abuse

Enquadramento: Este relatório representa o trabalho desenvolvido ao longo da componente clínica de Mestrado da área específica de Enfermagem de Saúde Comunitária e de Saúde Pública, no qual foi, também, conduzido um projeto de investigação na área do abuso sexual de crianças/jovens. Este é um grave problema de violência, que se traduz numa experiência adversa na infância com consequências para a saúde física, mental e comportamental. É reconhecido que os pais e outros cuidadores desempenham um papel fundamental na prevenção do abuso sexual, contudo, em Portugal é escassa a investigação neste âmbito. Objetivos: Caracterizar os contextos clínicos onde decorreu o estágio; Contribuir para a redução de casos de abuso sexual de crianças e jovens; Caracterizar conhecimentos, atitudes e práticas de educação de pais/encarregados de educação, e conhecimentos e atitudes das educadoras de infância, acerca da prevenção do abuso sexual de crianças; Descrever as atividades realizadas em estágio e refletir sobre o seu contributo para o desenvolvimento das competências do enfermeiro especialista. Metodologia: O estudo de investigação conduzido foi do tipo transversal exploratório, de carácter descritivo e correlacional. Pais/encarregados de educação e educadores de infância das escolas selecionados de um concelho do centro de Portugal foram convidados a participar no estudo. Os questionários foram disponibilizados em Formulário Google ou em papel. Os dados foram analisados no SPSS, recorrendo a estatística descritiva e correlacional. Resultados: A investigação conduzida demostrou que, apesar, dos elevados níveis de conhecimento e atitudes positivas acerca da prevenção do abuso sexual dos pais/encarregados de educação e dos educadores de infância, há ainda algumas lacunas para as quais é necessário planear intervenções. Conclusão: As atividades realizadas durante a componente clínica possibilitaram mobilizar conhecimentos e habilidades que vão ao encontro das competências comuns e das competências específicas do Enfermeiro Especialista na área de Enfermagem de Saúde Comunitária e de Saúde Pública. Da componente de investigação emergiu a necessidade de realizar mais investigação, em Portugal, na área em apreço e implementar intervenções que permitam colmatar as lacunas identificadas ao nível dos conhecimentos, atitudes e práticas educativas dos pais/encarregados de educação e educadores de infância acerca da prevenção do abuso sexual.

Prevention of risky sexual behavior in primary healthcare: a best practice implementation project.

INTRODUCTION AND OBJECTIVES: Sexually transmitted infections are a public health problem affecting 45% of adolescents and young adults worldwide. The evidence suggests that primary care settings are uniquely positioned to provide an opportunity for these preventive interventions. The aim of this project is to improve nurses' interventions for preventing risky sexual behaviors in adolescents attending nursing consultations in a primary healthcare unit. METHODS: An audit and feedback were conducted by the JBI Model and Implementation Framework. Five audit criteria representing best practice recommendations for preventing risky sexual behaviors in adolescents were used. Barriers to compliance with the best practices were identified, and strategies were adopted to overcome them. A follow-up audit was conducted using the same approach as the baseline audit. RESULTS: Compliance rates improved in four criteria from baseline audit to follow-up audit. CONCLUSION: Through auditing and feedback, evidence-based interventions were implemented to prevent sexual risk behavior in adolescents in primary care settings. Further best practice implementation projects should be conducted to improve adolescent health outcomes.

Effectiveness of Caregiver-Provided Individual Cognitive Interventions in Older Adults with Dementia.

Background: In a society increasingly committed to promoting an active life in the community, new resources are needed to respond to the needs of citizens with Alzheimer's disease and other forms of dementia. The potential of several individual cognitive interventions to be provided by caregivers has been explored in the literature. Objective: To synthesize the best available evidence on the effectiveness of caregiver-provided individual cognitive interventions in older adults with dementia. Methods: Systematic review of experimental studies on individual cognitive interventions for older adults with dementia. An initial search of MEDLINE and CINAHL was undertaken. Another search for published and unpublished studies was performed on major healthcare-related online databases in March 2018 and updated in August 2022. This review considered studies that included older adults with dementia, aged 60 years and over. All studies that met the inclusion criteria were assessed for methodological quality using a JBI standardized critical appraisal checklist. Data were extracted using a JBI data extraction form for experimental studies. Results: Eleven studies were included: eight randomized controlled trials and three quasi-experimental studies. Caregiver-provided individual cognitive interventions had several beneficial effects in cognitive domains, including memory, verbal fluency, attention, problem-solving, and autonomy in activities of daily living. Conclusion: These interventions were associated with moderate improvements in cognitive performance and benefits in activities of daily living. The findings highlight the potential of caregiver-provided individual cognitive interventions for older adults with dementia.

Performance, carcass, and meat traits of locally adapted Brazilian cattle breeds under feedlot conditions.

Little is known about the performance, carcass, and meat traits of locally adapted cattle in Brazil. This study aimed to compare the growth, slaughter, and carcass traits as well as meat quality of two local breeds (Curraleiro Pé-Duro and Pantaneiro) with the Nelore breed. Fifteen 30-month-old steers of each breed were weighted (Curraleiro Pé-Duro = 264.80 kg; Nelore = 346.80 kg; Pantaneiro = 316.20 kg) and raised in a feedlot condition for 112 days, with measurements to assess growth and slaughter, visual and carcass and meat traits. Data were submitted to variance and multivariate analyses. Nelore and Curraleiro Pé-Duro had similar Gluteus medius depths. Pantaneiro and Curraleiro Pé-Duro were superior for leg compactness index (P < 0.05) and had higher eye muscle area than Nelore (P < 0.05). Although there was no difference in daily weight gain and slaughter weight between breeds, Curraleiro Pé-Duro had a lower initial weight (264.80 kg) when compared to Nelore (346.80 kg; P < 0.05). Nelore and Curraleiro Pé-Duro deposited more fat than Pantaneiro (P < 0.05), while Curraleiro Pé-Duro and Pantaneiro had more muscle than Nelore (P < 0.05), which also had more bone and a higher percentage of second-quality cuts (P < 0.05). Meat from Nelore also showed lower succulence than Pantaneiro (P < 0.05) and higher shear force than the other breeds (P < 0.05). Pantaneiro's meat had the most capacity to retain water (P < 0.05), lower shear force (P < 0.05), and was more succulent (P < 0.05) when compared to the other breeds. Multivariate analysis showed that Pantaneiro, Curraleiro Pé-Duro, and Nelore breeds can be considered distinct in growth, carcass, and meat traits, with the local breeds showing superior meat traits. The local breeds Curraleiro Pé-Duro and Pantaneiro presented characteristics similar or better to those of the Nelore, proving to be animals with great productive potential and generate high meat quality under feedlot conditions.

Effectiveness of perioperative family-centered educational interventions in the anxiety, pain and behaviors of children/adolescents and their parents: Systematic Review Protocol / Eficacia de las intervenciones educativas perioperatorias familiares centradas en la ansiedad, el dolor y las conductas de las personas menores y adolescentes y de sus progenitores: protocolo de revisión sistemática

Introduction: Every year, millions of children and adolescents undergo surgery, 50%-75% of them experience fear and anxiety. Children are particularly susceptible to stress and anxiety surrounding surgery as a result of their cognitive development, previous experiences, and knowledge about healthcare; this leads to additional interventions to prevent and reduce these symptoms. Objective: To evaluate the effectiveness of family-centered educational interventions in the children's and adolescents' anxiety, pain, and behaviors and their parents' anxiety during the perioperative period. Methods: This review will follow the Joanna Briggs Institute guidelines for systematic reviews of effectiveness and will consider those studies (experimental and quasi-experimental) in which perioperative educational interventions have been applied to children and adolescents and their parents; these studies measured children and adolescents' pain, anxiety, and behaviors, as well as their parent's anxiety. An initial search of MEDLINE and CINAHL will be followed by a second search for published and unpublished studies from January 2007 on, available in English, Spanish and Portuguese. After all full texts are retrieved, the methodological quality assessment and data extraction will be independently and critically evaluated by two reviewers, and the data will then be presented in a tabular format. An explanatory synthesis will accompany the results. Whenever possible, a meta-analysis will be performed, and a Grading of Recommendations, Assessment, Development, and Evaluation Summary of Findings will be presented. Expected Results: This review will provide guidance on how family-centred educational interventions can be used as a resource to manage anxiety, pain, and behavior in children, adolescents and their relatives during the perioperative processes.

Introducción: Cada año, millones de personas menores y adolescentes se someten a cirugía, de las cuales entre el 50-75 % experimenta miedo y ansiedad. Las niñas y los niños son particularmente susceptibles al estrés y la ansiedad que rodea a la cirugía, como resultado de su desarrollo cognitivo, experiencias previas y conocimiento de la salud, lo que requiere intervenciones para prevenir y reducir estos síntomas. Objetivo: Esta revisión tiene como objetivo evaluar la efectividad de las intervenciones educativas familiares centradas en la ansiedad, el dolor y los comportamientos de las personas menores y adolescentes y de sus progenitores en el período perioperatorio. Métodos: Esta revisión seguirá las pautas del Instituto Joanna Briggs para revisiones sistemáticas de efectividad y considerará estudios experimentales y cuasiexperimentales en los que las intervenciones educativas perioperatorias para medir el dolor, la ansiedad y los comportamientos en niñas, niños y adolescentes y la ansiedad de sus progenitores. Se ha realizado una búsqueda inicial limitada de MEDLINE y CINAHL. Además, una segunda búsqueda de estudios publicados y no publicados de enero de 2007 disponibles en inglés, español y portugués. Una vez recuperados los textos completos, dos revisores evaluarán críticamente, de forma independiente, la calidad metodológica y la extracción de datos y se presentarán en forma de tabla. Una síntesis narrativa acompañará a los resultados y, si es posible, se realizará un metanálisis y se presentará un Grading of Recommendations, Assessment, Development and Evaluation. Resultados esperados: Esta revisión brindará orientación sobre cómo las intervenciones educativas centradas en la familia pueden usarse como un recurso para controlar la ansiedad, el dolor y el comportamiento en niñas, niños, adolescentes y sus familias en el contexto perioperatorio.

Introdução: Todos os anos, milhões de crianças e adolescentes são submetidos a cirurgias e 50-75% apresentam medo e ansiedade. Crianças/adolescentes são particularmente suscetíveis ao stress e ansiedade em torno da cirurgia devido ao seu desenvolvimento cognitivo, experiências anteriores e conhecimento que possuem sobre os cuidados de saúde, necessitando de intervenções para a prevenção/redução destes sintomas. Objetivo: Avaliar a eficácia de intervenções educacionais centradas na família na ansiedade, dor e comportamentos de crianças/adolescentes e ansiedade dos pais no período perioperatório. Métodos: Esta revisão seguirá a metodologia do Instituto Joanna Briggs para revisões sistemáticas de eficácia e considerará estudos (experimentais e quase-experimentais) em que as intervenções educacionais perioperatórias tenham sido aplicadas a crianças/ adolescentes e seus pais e avaliadas a dor, ansiedade e comportamento em crianças/adolescentes e ansiedade dos pais como resultados. Uma pesquisa inicial limitada de MEDLINE e CINAHL foi realizada. Será seguida por uma segunda busca por estudos publicados e não publicados de janeiro de 2007 disponíveis em inglês, espanhol e português. Após a recuperação dos textos completos, a avaliação da qualidade metodológica e a extração de dados serão avaliadas de forma crítica e independente por dois revisores e apresentadas em forma de tabela. Uma síntese narrativa acompanhará os resultados e, se possível, uma meta-análise será realizada e um resumo das Grading of Recommendations, Assessment, Development and Evaluation apresentado. Resultados esperados: Esta revisão fornecerá orientações sobre como as intervenções educativas centradas na família podem ser utilizadas como um recurso para gestão da ansiedade, dor e comportamento em crianças, adolescentes e suas famílias no contexto perioperatório.

Generation of Functional-RNA Arrays by In Vitro Transcription and In Situ RNA Capture for the Detection of RNA-RNA Interactions.

RNA performs a wide variety of vital cellular functions. These functions typically require interactions with other biological macromolecules, often as part of an intricate communication network. High-throughput techniques capable of analyzing RNA-based interactions are therefore essential. Functional-RNA arrays address this need, providing the capability of performing hundreds of miniature assays in parallel. Here we describe a method to generate functional-RNA arrays using in vitro transcription of a DNA template array and in situ RNA capture. We also suggest how functional-RNA arrays could be applied to investigating RNA-RNA interactions.

Oral Hygiene in Patients with Stroke: A Best Practice Implementation Project Protocol.

Oral hygiene has been shown to reduce adverse events and promote the quality of life of patients with stroke. However, a stroke can result in the impairment of physical, sensory, and cognitive abilities, and comprise self-care. Although nurses recognize its benefits, there are areas for improvement in the implementation of the best evidence-based recommendations. The aim is to promote compliance with the best evidence-based recommendations on oral hygiene in patients with stroke. This project will follow the JBI Evidence Implementation approach. The JBI Practical Application of Clinical Evidence System (JBI PACES) and the Getting Research into Practice (GRiP) audit and feedback tool will be used. The implementation process will be divided into three phases: (i) establishing a project team and undertaking the baseline audit; (ii) providing feedback to the healthcare team, identifying barriers to the implementation of best practices, and co-designing and implementing strategies using GRIP, and (iii) undertaking a follow-up audit to assess the outcomes and plan for sustainability. So, the successful adoption of the best evidence-based recommendations on oral hygiene in patients with stroke will reduce the adverse events related to poor oral care and may improve patients' quality of care. This implementation project has great transferability potential to other contexts.

Exploring the activities and outcomes of digital teaching and learning of practical skills in higher education for the social and health care professions: a scoping review.

Higher education for health care professionals faces numerous challenges. It is important to develop and apply methods supporting education, especially the practical skills. This scoping review aimed to explore the activities and learning outcomes of digital technology in practical skills teaching and learning in higher education for the social and health professions. Scoping review recommendations and the PRISMA-ScR checklist were applied. Randomized controlled trials published between 2016 and 2021 involving students in higher education who were taking courses in the social sciences and health care and reported interventions with digital technology activities and practices in practical teaching and learning were included. The CINAHL Plus, PubMed, Scopus, ERIC, and Sociological Abstracts/Social Services Abstracts databases were searched. Teaching methods were blended, e-learning or other online-based, and digital simulation-based activities. Teaching and learning environments, methods, resources, and activity characteristics varied, making a summary difficult. Interventions were developed in a face-to-face format prior to digitalization. The outcomes were measured at the knowledge level, not at the performance level. One-third of the studies showed a significant improvement in practical skills in the intervention group in comparison to the control conditions. The use of digital technology in the learning and teaching process have potential to develop of students' skills, knowledge, motivation, and attitudes. The pedagogy of technology use is decisive. The development of new digital methods for teaching and learning practical skills requires the engagement of students and teachers, in addition the researchers.

Diagnóstico tardio do Vírus da Imunodeficiência Humana e da Síndrome da Imunodeficiência Adquirida em Idosos: protocolo scoping review / Late diagnosis of Human Immunodeficiency Virus and Acquired Immunodeficiency Syndrome in the Elderly: scoping review protocol

As pessoas idosas, diagnosticadas tardiamente, tem maior risco de desenvolver AIDS. Com a contagem de CD4 inferior a 200 células/ml3, elas apresentam em média mais chances de morrer no primeiro ano após o diagnóstico. O objetivo desta revisão de escopo é mapear evidências relativas aos fatores associados e de risco do diagnóstico tardio de HIV/AIDS em pessoas idosas, mas especificamente, esta revisão quer dar resposta às seguintes questões: Quais são os fatores associados do diagnóstico tardio de HIV/AIDS em pessoas idosas? Quais são os fatores de riscos do diagnóstico tardio de HIV/AIDS em pessoas idosas? Que contexto o diagnóstico tardio de HIV/AIDS em pessoas idosas foi realizado? Esta revisão será orientada pela metodologia do Joanna Briggs Institute, que assentará na estratégia de definição dos participantes, conceito e contexto. Os resultados serão apresentados pelo resumo lógico e descritivo, apresentados, como um mapa de dados extraídos dos artigos e alinhado com o objetivo e as perguntas da revisão de escopo. Espera-se que esta revisão de escopo contribua para a análise compreensiva das práticas de cuidados à saúde das pessoas idosas.

Elderly people, diagnosed late, have a higher risk of developing AIDS. With a CD4 count of less than 200 cells / ml3, they are on average more likely to die in the first year after diagnosis. The purpose of this scope review is to map evidence regarding the associated risk factors of late diagnosis of HIV / AIDS in older people, but specifically, this review aims to address the following questions: What are the associated factors of late diagnosis of HIV / AIDS in elderly people? What are the risk factors for late diagnosis of HIV / AIDS in elderly people? In what context was the late diagnosis of HIV / AIDS in elderly people given? This review will be guided by the methodology of the Joanna Briggs Institute, which will be based on participant definition strategy, concept and context. Results will be presented by the logical and descriptive summary, presented as a map of data extracted from the articles and aligned with the objective and scope review questions. This scope review is expected to contribute to a comprehensive analysis of the health care practices of elderly people.

Las personas mayores, diagnosticadas tardíamente, tienen un mayor riesgo de desarrollar SIDA. Con un recuento de CD4 de menos de 200 células/ml3, tienen en promedio más probabilidades de morir en el primer año después del diagnóstico. El objetivo de esta revisión de alcance es mapear las evidencias relacionadas con los factores asociados y de riesgo del diagnóstico tardío del VIH/SIDA en personas mayores, pero específicamente esta revisión tiene como objetivo responder a las siguientes preguntas: ¿Cuáles son los factores asociados con el diagnóstico tardío del VIH/SIDA en las personas mayores? ¿Cuáles son los factores de riesgo para el diagnóstico tardío del VIH/SIDA en las personas mayores? ¿Cuál es el contexto del diagnóstico tardío del VIH/SIDA en las personas mayores? Esta revisión se guiará por la metodología del Joanna Briggs Institute, que se basará en la estrategia de definición, concepto y contexto de los participantes. Los resultados se presentarán mediante un resumen lógico y descriptivo, presentado como un mapa de los datos extraídos de los artículos y alineados con el objetivo y las preguntas de la revisión del alcance. Se espera que esta revisión del alcance contribuya al análisis exhaustivo de las prácticas de atención de la salud de los ancianos.

Rotações de Iniciação à Investigação: Programa de iniciação à investigação para estudantes de licenciatura / Research Initiation Rotations: Research initiation Program for undergraduate students / Rotaciones de iniciación a la investigación: Programa de iniciación a la investigación para estudiantes de grado

Resumo Enquadramento: As Rotações de Iniciação à Investigação (RII) enquadram-se no Eixo Estratégico de Desenvolvimento para a Formação de Investigadores da Unidade de Investigação em Ciências da Saúde: Enfermagem, no contexto das oportunidades da Janela do Jovem Investigador. Os estudantes do Curso de Licenciatura em Enfermagem (CLE) voluntariamente disponibilizam-se para desenvolver atividades de ligação do ensino à investigação integrando equipas de investigação. Objetivo: Analisar os resultados das cinco edições do Programa RII, envolvendo os estudantes do CLE (2014/2015-2018/2019). Principais tópicos em análise: Trinta e dois projetos de investigação acolheram 202 RII, das quais 133 foram concluídas com êxito. Para além das competências adquiridas em contexto de integração nas equipas dos projetos de investigação, os estudantes frequentaram nove atividades de formação promovidas para eles. Conclusão: As RII concluídas com sucesso são registadas no suplemento ao diploma. Apesar da limitada disponibilidade de tempo dos estudantes devido à exigência do plano curricular, estes têm avaliado esta experiência como muito positiva. A integração deste programa no plano curricular é um passo a promover no futuro.

Abstract Background: Research Initiation Rotations (RIRs) fall under the Development Strategic Axis for Researchers' Training of the Health Sciences Research Unit: Nursing as part of the Young Researcher Window opportunities. Undergraduate nursing students volunteer to integrate research teams that develop activities linking teaching and research. Objective: To analyze the results of the five editions of the RIR Program involving undergraduate nursing students (2014/2015 to 2018/2019). Main topics under analysis: Thirty-two research projects involved 202 RIRs, 133 of which were successfully completed. In addition to the skills acquired as part of the research project teams, students attended nine training activities that were specifically designed for them. Conclusion: Successfully completed RIRs are included in the diploma supplement. Despite the limited time available due to curriculum demands, students have rated this experience as very positive. The integration of this program into the curriculum is a step to be taken in the future.

Resumen Marco contextual: Las Rotaciones de Iniciación a la Investigación (RII) forman parte del Eje Estratégico de Desarrollo para la Formación de Investigadores de la Unidad de Investigación en Ciencias de la Salud: Enfermería, en el contexto de las oportunidades de la Ventana del Joven Investigador. Los estudiantes del Grado en Enfermería (CLE, en portugués) se ponen voluntariamente a disposición para desarrollar actividades que vinculen la docencia con la investigación, al formar parte de equipos de investigación. Objetivo: Analizar los resultados de las cinco ediciones del programa RII, con la participación de estudiantes del CLE (2014/2015-2018/2019). Principales temas en análisis: Treinta y dos proyectos de investigación acogieron 202 RII, de las cuales 133 se completaron satisfactoriamente. Además de las competencias adquiridas en el marco de la integración en los equipos de los proyectos de investigación, los estudiantes asistieron a nueve actividades de formación promovidas para ellos. Conclusión: Las RII concluidas satisfactoriamente se registran en el suplemento al título. A pesar de la escasa disponibilidad de tiempo de los estudiantes debido a las exigencias del plan curricular, han valorado esta experiencia como muy positiva. La integración de este programa en el plan curricular es un paso que se debe promover en el futuro.

Rotações de Iniciação à Investigação: Programa de iniciação à investigação para estudantes de licenciatura / Research Initiation Rotations: Research initiation Program for undergraduate students / Rotaciones de iniciación a la investigación: Programa de iniciación a la investigación para estudiantes de grado

Resumo Enquadramento: As Rotações de Iniciação à Investigação (RII) enquadram-se no Eixo Estratégico de Desenvolvimento para a Formação de Investigadores da Unidade de Investigação em Ciências da Saúde: Enfermagem, no contexto das oportunidades da Janela do Jovem Investigador. Os estudantes do Curso de Licenciatura em Enfermagem (CLE) voluntariamente disponibilizam-se para desenvolver atividades de ligação do ensino à investigação integrando equipas de investigação. Objetivo: Analisar os resultados das cinco edições do Programa RII, envolvendo os estudantes do CLE (2014/2015-2018/2019). Principais tópicos em análise: Trinta e dois projetos de investigação acolheram 202 RII, das quais 133 foram concluídas com êxito. Para além das competências adquiridas em contexto de integração nas equipas dos projetos de investigação, os estudantes frequentaram nove atividades de formação promovidas para eles. Conclusão: As RII concluídas com sucesso são registadas no suplemento ao diploma. Apesar da limitada disponibilidade de tempo dos estudantes devido à exigência do plano curricular, estes têm avaliado esta experiência como muito positiva. A integração deste programa no plano curricular é um passo a promover no futuro.

Abstract Background: Research Initiation Rotations (RIRs) fall under the Development Strategic Axis for Researchers' Training of the Health Sciences Research Unit: Nursing as part of the Young Researcher Window opportunities. Undergraduate nursing students volunteer to integrate research teams that develop activities linking teaching and research. Objective: To analyze the results of the five editions of the RIR Program involving undergraduate nursing students (2014/2015 to 2018/2019). Main topics under analysis: Thirty-two research projects involved 202 RIRs, 133 of which were successfully completed. In addition to the skills acquired as part of the research project teams, students attended nine training activities that were specifically designed for them. Conclusion: Successfully completed RIRs are included in the diploma supplement. Despite the limited time available due to curriculum demands, students have rated this experience as very positive. The integration of this program into the curriculum is a step to be taken in the future.

Resumen Marco contextual: Las Rotaciones de Iniciación a la Investigación (RII) forman parte del Eje Estratégico de Desarrollo para la Formación de Investigadores de la Unidad de Investigación en Ciencias de la Salud: Enfermería, en el contexto de las oportunidades de la Ventana del Joven Investigador. Los estudiantes del Grado en Enfermería (CLE, en portugués) se ponen voluntariamente a disposición para desarrollar actividades que vinculen la docencia con la investigación, al formar parte de equipos de investigación. Objetivo: Analizar los resultados de las cinco ediciones del programa RII, con la participación de estudiantes del CLE (2014/2015-2018/2019). Principales temas en análisis: Treinta y dos proyectos de investigación acogieron 202 RII, de las cuales 133 se completaron satisfactoriamente. Además de las competencias adquiridas en el marco de la integración en los equipos de los proyectos de investigación, los estudiantes asistieron a nueve actividades de formación promovidas para ellos. Conclusión: Las RII concluidas satisfactoriamente se registran en el suplemento al título. A pesar de la escasa disponibilidad de tiempo de los estudiantes debido a las exigencias del plan curricular, han valorado esta experiencia como muy positiva. La integración de este programa en el plan curricular es un paso que se debe promover en el futuro.

Como medir e explorar a heterogeneidade de uma meta-análise: Estratégias metodológicas fundamentais / How to measure and explore heterogeneity in a meta-analysis: Key methodological strategies / Cómo medir y explorar la heterogeneidad en un metaanálisis: Estrategias metodológicas clave

Resumo Enquadramento: As revisões sistemáticas ao incluírem diversos estudos, ainda que abordem uma questão semelhante, irão reunir inevitavelmente algum grau de diversidade. Os estudos têm diferentes desenhos, assim como participantes, intervenções/exposições ou mesmo outcomes/ resultados esperados. Essa diversidade é denominada de heterogeneidade e pela sua pertinência consideramos essencial apresentar algumas estratégias metodológicas para a medir e explorar. Objetivo: Demonstrar como se mede e explora a heterogeneidade de uma meta-análise. Principais tópicos em análise: É apresentado o conceito de heterogeneidade em meta-análise, bem como as suas tipologias, modelos de medida e condições para a sua aplicação. Adicionalmente apontamos diversas opções metodológicas que permitem explorar a heterogeneidade, recorrendo a exemplos práticos para as operacionalizar. Conclusão: A exploração da heterogeneidade de uma meta-análise assume-se como um passo imprescindível na realização de uma revisão sistemática que melhora a consistência dos seus resultados e, consequentemente, a força das suas recomendações.

Abstract Background: Systematic reviews including several studies will have some diversity, even if they address a similar topic. Studies have different designs, participants, interventions/exposures, and expected outcomes. This diversity is called heterogeneity. For its relevance, we will put forward some methodological strategies to measure and explore it. Objective: To demonstrate how to measure and explore heterogeneity in a meta-analysis. Main topics under analysis: We present the concept of heterogeneity in meta-analysis, as well as its types, measurement models, and conditions for its application. We also put forward several methodological options for exploring heterogeneity, using practical examples to operationalize them. Conclusion: Exploring heterogeneity in a meta-analysis is an essential step in the development of a systematic review to increase the consistency of its results and, consequently, the strength of its recommendations.

Resumen Marco contextual: Las revisiones sistemáticas, al incluir varios estudios, aunque aborden una cuestión similar, reunirán inevitablemente cierto grado de diversidad. Los estudios tienen diferentes diseños, así como participantes, intervenciones/exposiciones o incluso resultados esperados. Esta diversidad se denomina heterogeneidad y, debido a su relevancia, consideramos imprescindible presentar algunas estrategias metodológicas para medirla y explorarla. Objetivo: Demostrar cómo medir y explorar la heterogeneidad en un metaanálisis. Principales temas en análisis: Se presenta el concepto de heterogeneidad en el metaanálisis, así como sus tipologías, modelos de medición y condiciones para su aplicación. Además, señalamos varias opciones metodológicas que permiten explorar la heterogeneidad, utilizando ejemplos prácticos para operacionalizarlas. Conclusión: Explorar la heterogeneidad de un metaanálisis es un paso esencial en la realización de una revisión sistemática que mejora la consistencia de sus resultados y, en consecuencia, la fuerza de sus recomendaciones.

Nasogastric tube care and flushing in a Portuguese general medicine ward: a best practice implementation project.

OBJECTIVES: To implement evidence-based practice related to care and flushing of nasogastric tubes inserted for feeding, in a general medicine ward. INTRODUCTION: Nasogastric tube feeding is a widely used nutritional support form. Although performed by qualified professionals, it is not a harm-free intervention. Progression to the trachea during initial insertion, aspiration of gastric contents, improper position for patient feeding, and/or a blocked tube are examples of problems that can occur. METHODS: The project used JBI's methodological approach of the Clinical Evidence System and Getting Research into Practice audit and feedback tool. A baseline audit focused on nursing procedures related to the maintenance of nasogastric tube feeding, based on 14 criteria informed by the JBI evidence summaries, was performed for a month. Education sessions and other engagement strategies and resources were used to increase nasogastric tube maintenance. This best-practice implementation was conducted in Portugal, between January 2020 and April 2021, in a 33-bed general medicine ward with a staff of 30 registered nurses. RESULTS: Different samples, for each audited procedure, were obtained from a universe of 25 nurses and 14 episodes of patients with nasogastric tube in baseline and 10 in follow-up audit. At baseline, compliance with the criteria ranged from 0 to 88%. Ten of the 14 criteria were below 50%. The follow-up audit showed significant improvement in all compliance criteria (ranging from 44.4 to 100%). Criteria 1 and 2, which were aimed at preventing adverse consequences related to wrong placement or displacement of the nasogastric tube, showed a high postimplementation compliance level (89.3 and 90%). CONCLUSION: With an integrated plan incorporating interventions, strategies, and resources, tailored for this context, we improved nurses' knowledge of nasogastric tube maintenance and achieved significantly increased compliance with nasogastric tube care best-practice. We suggest maintaining current strategies, and reinforcing clinical supervision and regular assessment.

Administration of chemotherapy in patients admitted to a haematology service: a best practice implementation project.

OBJECTIVES: To promote evidence-based practices related to the prevention of adverse events associated with medication administration (only chemotherapy) in a hospital service. INTRODUCTION: The medication management process in a hospital setting is highly complex, going through multiple stages from drug selection, procurement and storage, to prescription, validation, dispensing, preparation, administration and monitoring. METHODS: An evidence implementation project based on an audit and feedback approach was conducted from December 2019 to April 2021 using the JBI Practical Application of Clinical Evidence System and Getting Research into Practice. RESULTS: The results of the baseline audit showed that the 10 audit criteria were mostly met; however, two of the criteria (criterion 6: the expiry date of medication is checked before use and criterion 7: the nurse who prepares the medication administers the medication to the patient) had low compliance (respectively, 0 and 67.9%). After identifying the barriers and implementing strategies to deal with the identified barriers, we verified a significant improvement in compliance with best practices (criterion 6 improved to 64.3% and criterion 7 to 78.6%). CONCLUSION: This implementation project was a success, achieving a great improvement of the implementation of evidence-based guidelines concerning the prevention of adverse events associated with medication administration in a hospital in central Portugal. More such projects should be planned to sustain the implementation of evidence-based methods to improve health outcomes, patient safety, costs and health systems.

Identification of small RNAs associated with RNA chaperone Hfq reveals a new stress response regulator in Actinobacillus pleuropneumoniae.

The RNA chaperone Hfq promotes the association of small RNAs (sRNAs) with cognate mRNAs, controlling the expression of bacterial phenotype. Actinobacillus pleuropneumoniae hfq mutants strains are attenuated for virulence in pigs, impaired in the ability to form biofilms, and more susceptible to stress, but knowledge of the extent of sRNA involvement is limited. Here, using A. pleuropneumoniae strain MIDG2331 (serovar 8), 14 sRNAs were identified by co-immunoprecipitation with Hfq and the expression of eight, identified as trans-acting sRNAs, were confirmed by Northern blotting. We focused on one of these sRNAs, named Rna01, containing a putative promoter for RpoE (stress regulon) recognition. Knockout mutants of rna01 and a double knockout mutant of rna01 and hfq, both had decreased biofilm formation and hemolytic activity, attenuation for virulence in Galleria mellonella, altered stress susceptibility, and an altered outer membrane protein profile. Rna01 affected extracellular vesicle production, size and toxicity in G. mellonella. qRT-PCR analysis of rna01 and putative cognate mRNA targets indicated that Rna01 is associated with the extracytoplasmic stress response. This work increases our understanding of the multilayered and complex nature of the influence of Hfq-dependent sRNAs on the physiology and virulence of A. pleuropneumoniae.