Cuidados de enfermagem no banho de aspersão em instituição de longa permanência: revisão integrativa / Nursing care in the spray bath in a long-term care institution: integrative review

Identificar os cuidados de enfermagem necessários para o banho de aspersão seguro para idosos no quotidiano de uma instituição de longa permanência. Método: Revisão Integrativa da literatura, recorte entre 2001 e 2022. Os dados dos estudos incluídos resultaram em uma síntese descritiva, fundamentada na Teoria das Necessidades Humanas Básicas. Resultados: Obteve-se 13 estudos sobre cuidados no banho com e sem auxílio, envolvendo o equilíbrio psicobiológico, psicossocial e psicoespiritual, remoção de barreiras ambientais, adaptação domiciliar, maneiras de abordagem, musicoterapia e cuidados com a integridade da pele, oportunizando segurança e qualidade nas ações prestadas. Conclusões: Os cuidados precisam estar integrados às necessidades humanas básicas, respeitando as peculiaridades do processo de envelhecimento e as fragilidades dos idosos mais vulneráveis. A qualificação dos profissionais de enfermagem/cuidadores formais visa a padronização da execução do procedimento e a redução de ocorrência de desvios de procedimento.(AU)

To identify the nursing care necessary for safe spray baths for elderly people in daily life in a long-term care institution. Method: Integrative literature review, cut between 2001 and 2022. Data from the included studies resulted in a descriptive synthesis, based on the Theory of Basic Human Needs. Results: 13 studies were obtained on bath care with and without assistance, involving psychobiological, psychosocial and psychospiritual balance, removal of environmental barriers, home adaptation, approaches, music therapy and care for the integrity of the skin, providing safety and quality in the actions provided. Conclusions: Care needs to be integrated with basic human needs, respecting the peculiarities of the aging process and the weaknesses of the most vulnerable elderly people. The qualification of nursing professionals/formal caregivers aims to standardize the execution of the procedure and reduce the occurrence of procedural deviations.(AU)

Identificar los cuidados de enfermería necesarios para baños de aspersión seguros para personas mayores en la vida diaria en una institución de cuidados a largo plazo. Método: Revisión integrativa de la literatura, cortada entre 2001 y 2022. Los datos de los estudios incluidos resultaron en una síntesis descriptiva, basada en la Teoría de las Necesidades Humanas Básicas. Resultados: Se obtuvieron 13 estudios sobre cuidados del baño con y sin asistencia, involucrando equilibrio psicobiológico, psicosocial y psicoespiritual, remoción de barreras ambientales, adaptación domiciliaria, abordajes, musicoterapia y cuidado de la integridad de la piel, brindando seguridad y calidad en las acciones. proporcionó. Conclusiones: Los cuidados deben integrarse con las necesidades humanas básicas, respetando las peculiaridades del proceso de envejecimiento y las debilidades de las personas mayores más vulnerables. La calificación de los profesionales de enfermería/cuidadores formales tiene como objetivo estandarizar la ejecución del procedimiento y reducir la ocurrencia de desviaciones procesales.(AU)

A longitudinal study of the progression of Huntington's disease and oropharyngeal dysphagia: A four-case follow-up

ABSTRACT Huntington's disease (HD) is a neurodegenerative disorder, with dysphagia being a common symptom of the disease. Few studies established a relationship between neuromotor impairment and dysphagia. There is also a lack of described therapeutic approaches for dysphagia in HD. This study aimed to better understand the progression of neurological clinical aspects, instrumental swallowing and dysphagia management in four patients presented with HD in an outpatient follow-up setting. The longitudinal follow-up period was 36 to 43 months through neuroclinical assessments (Unified Huntington's Disease Rating Scale) and fiberoptic endoscopic swallowing evaluations. Case 1 - a moderate decline of independence with safe swallowing. Case 2 - a moderate motor impairment, safe swallowing and moderate dysphagia during follow-up. Case 3 - a longer disease duration and increased motor impairment associated with moderate/severe dysphagia. Case 4 - a longer disease duration, need of assistance to perform daily activities, severe dysphagia and palliative care, considering the family decision of exclusive oral feeding. This longitudinal study revealed that the progression of neuromotor damage was not directly related to dysphagia development. This case series demonstrates the importance of follow-up settings with instrumental swallowing evaluations and careful consideration of early palliative care for HD patients.

Isometric tongue endurance and incomplete laryngeal vestibule closure in Parkinson's disease.

BACKGROUND: Dysphagia is a common symptom of Parkinson's disease (PD). A delay in laryngeal vestibule closure (LVC) and a reduction in tongue pressure, may affect swallowing safety and increase the risk of pulmonary aspiration. OBJECTIVE: To verify the relationship between tongue pressure and airway protection in PD patients: (1) comparing tongue pressure measures and physiological events in the pharyngeal phase of swallowing between PD and controls and (2) analysing the association between tongue pressure and LVC in the PD group. METHODS: Twenty-three patients with idiopathic PD (64.9 years) and 24 healthy controls (64.1 years) participated in this study. All participants underwent the following procedures to verify tongue pressure measurements using the Iowa Oral Performance Instrument: maximum anterior and posterior pressure, isotonic and isometric tongue endurance and anterior and posterior tongue pressure during saliva swallowing. To verify swallowing safety, videofluoroscopic swallowing studies focusing on the pharyngeal phase were performed based on the MBSImP protocol. RESULTS: Compared to healthy controls, PD exhibited a statistically significant decline in tongue pressure tasks: posterior maximum pressure, isotonic endurance, anterior and posterior isometric endurance and tongue pressure during posterior swallowing. Patients with PD had worse pharyngeal scores, including LVC scores, than controls. PD and incomplete LVC had lower anterior isometric endurance scores when compared to those with complete LVC. CONCLUSION: PD with incomplete LVC scored lower in the anterior isometric endurance task. We observed a potential clinical use of this task for the assessment and management of dysphagia in patients with PD.

Estrategias educativas para la prevención de incidentes en unidades intensivas / Estratégias educativas para prevenção de incidentes em unidades intensivas / Educational strategies for the prevention of incidents in intensive care units

Objetivo: Mapear las estrategias educativas dirigidas a los profesionales de la salud para la prevención de incidentes en unidades de cuidados intensivos. Método: Revisión integradora realizada entre abril y mayo de 2021 en las bases de datos: LILACS, MEDLINE, BDENF y CINAHL. Se incluyeron estudios publicados entre 2016 y 2021 en textos completos en inglés, español y portugués. Se excluyen resúmenes, editoriales, tesis y disertaciones. Utilizados como descriptores: "personal de salud", "educación continua", "error médico", "seguridad del paciente" y "unidades de cuidados intensivos" con operador booleano "AND" y "OR". Los datos se organizaron en una tabla de la revista, qualis, autores, año de publicación, título y acciones educativas. Los contenidos fueron comparados y agrupados por similitud. Resultados: Se identificaron acciones educativas como capacitación, protocolos, clases con discusiones interactivas, apoyo profesional dirigido, uso de mensajes de texto cortos, videos y actividad lúdica. Conclusión: Hubo un predominio de actividades educativas de la manera tradicional como capacitaciones, clases y videos con poca interacción del profesional. (AU)

Objetivo: Mapear as estratégias educativas direcionadas aos profissionais de saúde para a prevenção de incidentes em unidades de terapia intensiva. Método: Revisão integrativa realizada entre abril e maio de 2021 nas bases de dados: LILACS, MEDLINE, BDENF e CINAHL. Incluídos estudos publicados entre 2016 a 2021 nos idiomas inglês, espanhol e português com textos completos. Excluídos resumos, editoriais, teses e dissertações. Utilizados como descritores: “pessoal de saúde”, “educação continuada”, “erro médico”, segurança do paciente”e “unidades de terapia intensiva” com operador booleano “AND” e “OR”. Os dados foram organizados em uma tabela a partir do periódico, qualis, autores, ano de publicação, título e acões educativas.Os conteúdos foram comparados e agrupados por similaridade. Resultados: Foram identificadas ações educativas como treinamentos, protocolos, aulas com discussões interativas, apoio profissional direcionado, uso de mensagens de texto curtas, vídeos e atividade lúdica.Conclusão: Observou-se predominância de atividades educativas da forma tradicional como treinamento, aulas e vídeos com pouca interação do profissional. (AU)

Objective: To map the educational strategies directed to health professionals for the prevention of incidents in intensive care units. Method: Integrative review carried out between April and May 2021 in the databases: LILACS, MEDLINE, BDENF and CINAHL. Included studies published between 2016 and 2021 in English, Spanish and Portuguese full texts. Excluded abstracts, editorials, theses and dissertations. Used as descriptors: "health personnel", "continuing education", "medical error", patient safety" and "intensive care units" with Boolean operator "AND" and "OR". The data were organized in a table from the journal, qualis, authors, year of publication, title and educational actions. The contents were compared and grouped by similarity. Results: Educational actions such as training, protocols, classes with interactive discussions, targeted professional support, use of short text messages, videos and playful activity were identified. Conclusion: There was a predominance of educational activities in the traditional way such as training, classes and videos with little interaction of the professional. (AU)

HRV Monitoring Using Commercial Wearable Devices as a Health Indicator for Older Persons during the Pandemic.

Remote monitoring platforms based on advanced health sensors have the potential to become important tools during the COVID-19 pandemic, supporting the reduction in risks for affected populations such as the elderly. Current commercially available wearable devices still have limitations to deal with heart rate variability (HRV), an important health indicator of human aging. This study analyzes the role of a remote monitoring system designed to support health services to older people during the complete course of the COVID-19 pandemic in Brazil, since its beginning in Brazil in March 2020 until November 2021, based on HRV. Using different levels of analysis and data, we validated HRV parameters by comparing them with reference sensors and tools in HRV measurements. We compared the results obtained for the cardiac modulation data in time domain using samples of 10 elderly people's HRV data from Fitbit Inspire HR with the results provided by Kubios for the same population using a cardiac belt, with the data divided into train and test, where 75% of the data were used for training the models, with the remaining 25% as a test set for evaluating the final performance of the models. The results show that there is very little difference between the results obtained by the remote monitoring system compared with Kubios, indicating that the data obtained from these devices might provide accurate results in evaluating HRV in comparison with gold standard devices. We conclude that the application of the methods and techniques used and reported in this study are useful for the creation and validation of HRV indicators in time series obtained by means of wearable devices based on photoplethysmography sensors; therefore, they can be incorporated into remote monitoring processes as seen during the pandemic.

Translation into Brazilian Portuguese and Cultural Adaptation of the Component Scores Definition from the Modified Barium Swallow Impairment Profile (MBSImPTM). / Tradução para o português brasileiro e adaptação cultural da Definição de Pontuações de Componentes (Component Scores Definition) pertencentes ao Modified Barium Swallow Impairment Profile ­ MBSImP(™).

PURPOSE: Translate into Brazilian Portuguese and culturally adapt the component scores definition from the Modified Barium Swallow Impairment Profile - MBSImP videofluoroscopy protocol. METHODS: This study was conducted based on international guidelines for creation, translation and transcultural adaptation according to domestic publications for the validation of international speech-language pathology tests. A specialist committee was convened with two otorhinolaryngologists and three speech-language pathologists familiar with videofluoroscopy examinations. Translation into Brazilian Portuguese was carried out by two otorhinolaryngologists with subsequent back translation performed independently by two U.S.-born translators. The final Brazilian Portuguese version was written by speech-language pathologists after revision of translations and back translations resolved semantic, idiomatic, conceptual, linguistic and contextual inconsistencies. This version was tested by committee members, who assessed subjects with no disease, with head and neck cancer and with mild cognitive impairment. RESULTS: Translation of the component scores definition from MBSImP was performed independently and translators agreed on a final version. The MBSImP protocol was renamed "Martin-Harris scale for swallowing videofluoroscopy". Some terms were adapted for the final Brazilian Portuguese version. Use of the translated protocol did not reveal any deviations from the original. CONCLUSION: Translation of the MBSImP fragment into Brazilian Portuguese was consistent with the original version. Approval from specialist committee members refined the protocol adaptation, allowing precise concepts to be accurately translated.

OBJETIVO: Traduzir para o português brasileiro e adaptar culturalmente a definição dos componentes e pontuação (Component Scores Definition) pertencentes ao protocolo para videofluoroscopia Modified Barium Swallow Impairment ­ MBSImPTM. MÉTODO: Esse estudo foi desenvolvido com base nas recomendações internacionais para elaboração, tradução e adaptação transcultural em consonância com publicações nacionais para validação de testes internacionais em Fonoaudiologia. Foi formado um comitê de especialistas, composto por dois médicos otorrinolaringologistas e três fonoaudiólogas conhecedoras do exame de videofluoroscopia. A tradução para o português brasileiro foi realizada por dois otorrinolaringologistas com retrotradução de forma independente por dois nativos norte-americanos. A versão final em português brasileiro foi elaborada pelas fonoaudiólogas certificadas após a revisão das traduções e das retrotraduções com resolução de discrepâncias semânticas, idiomáticas, conceituais, linguísticas e contextuais. Essa versão foi testada pelas fonoaudiólogas membros do Comitê, que avaliaram indivíduos saudáveis, com Câncer de Cabeça e Pescoço e Comprometimento Cognitivo Leve. RESULTADOS: A tradução da definição dos componentes e pontuação do MBSImP foi realizada de forma independente e os tradutores chegaram a um consenso para a versão final. O protocolo original Modified Barium Swallow Impairment, foi traduzido para "Escala Martin-Harris para videofluoroscopia da deglutição". Na versão final em português brasileiro alguns termos foram adaptados. A aplicação do protocolo traduzido não apresentou discrepâncias em relação ao protocolo original. CONCLUSÃO: A tradução do excerto do protocolo MBSImP para o português brasileiro foi compatível com a versão original. A certificação de membros do comitê favoreceu a adaptação do material, permitindo a adaptação conceitual.

Professional qualification of Brazilian Speech-Language Pathologists and its impacts on the Blue Dye Test (BDT). / Formação profissional do fonoaudiólogo brasileiro e seu impacto na aplicação do Blue Dye Test (BDT).

PURPOSE: To characterize the professional profile of Speech Pathologists working in health services in Brazil and to verify if the time length of professional practice, specialized formation and experience in dysphagia contribute to the more adequate interpretation and application of the Blue Dye Test (BDT). METHODS: Through social medias and class entities, speech pathologists from all over Brazil were contacted by e-mail, that provided them a link from which they could access the online quiz, containing questions about the professional profile and the application of the BDT. The responses were categorized dichotomously according to the most robust scientific researches on the BDT and were compared statistically according to time length of professional practice, specialized formation and experience in dysphagia. RESULTS: 145 speech pathologists participated, 91.7% of them females. Most work in hospitals, have 11 to 15 years of profession (27.6%), and working from 1 to 5 years in the area of dysphagia (32.4%). Professionals with lato sensu training (54.3%) and with more than a decade of profession (58.1%) showed greater adequacy in interpreting the positive result of BDT. CONCLUSION: The present study reinforces the important role of specialized training in dysphagia in addition to continuing health educational practices in determining the excellence of clinical speech therapy, especially with tracheostomized patients after intubation and at risk of bronchoaspiration.

OBJETIVO: Caracterizar o perfil dos profissionais de Fonoaudiologia atuantes nos serviços de saúde do território brasileiro e verificar se o tempo de profissão, formação especializada e o tempo de experiência em disfagia contribuem para a interpretação e aplicação mais adequada do Blue Dye Test (BDT). MÉTODO: Por meio de mídias sociais e órgãos de classe, profissionais fonoaudiólogos de todo território nacional foram contactados por e-mail, com envio de um link para acessar um questionário online, contendo perguntas sobre o perfil profissional e a aplicação do BDT. As respostas foram categorizadas de forma dicotômica de acordo com as referências científicas mais robustas do BDT e foram comparadas estatisticamente de acordo com o tempo de profissão, formação especializada e o tempo de experiência. RESULTADOS: Participaram 145 fonoaudiólogos, com predomínio do sexo feminino (91,7%). A maioria atuante em hospitais, com 11 a 15 anos de profissão (27,6%) e de 1 a 5 anos na área de disfagia (32,4%). Profissionais com formação lato sensu (54,3%) e com mais de uma década de profissão (58,1%) apresentaram maior adequação na interpretação do resultado positivo do BDT. CONCLUSÃO: O presente estudo reforça o importante papel da formação especializada em disfagia e das práticas de educação continuada em saúde, na determinação da atuação fonoaudiológica clínica de excelência, principalmente com pacientes traqueostomizados pós intubação e com risco de broncoaspiração.

Formação profissional do fonoaudiólogo brasileiro e seu impacto na aplicação do Blue Dye Test (BDT) / Professional qualification of Brazilian Speech-Language Pathologists and its impacts on the Blue Dye Test (BDT)

RESUMO Objetivo Caracterizar o perfil dos profissionais de Fonoaudiologia atuantes nos serviços de saúde do território brasileiro e verificar se o tempo de profissão, formação especializada e o tempo de experiência em disfagia contribuem para a interpretação e aplicação mais adequada do Blue Dye Test (BDT). Método Por meio de mídias sociais e órgãos de classe, profissionais fonoaudiólogos de todo território nacional foram contactados por e-mail, com envio de um link para acessar um questionário online, contendo perguntas sobre o perfil profissional e a aplicação do BDT. As respostas foram categorizadas de forma dicotômica de acordo com as referências científicas mais robustas do BDT e foram comparadas estatisticamente de acordo com o tempo de profissão, formação especializada e o tempo de experiência. Resultados Participaram 145 fonoaudiólogos, com predomínio do sexo feminino (91,7%). A maioria atuante em hospitais, com 11 a 15 anos de profissão (27,6%) e de 1 a 5 anos na área de disfagia (32,4%). Profissionais com formação lato sensu (54,3%) e com mais de uma década de profissão (58,1%) apresentaram maior adequação na interpretação do resultado positivo do BDT. Conclusão O presente estudo reforça o importante papel da formação especializada em disfagia e das práticas de educação continuada em saúde, na determinação da atuação fonoaudiológica clínica de excelência, principalmente com pacientes traqueostomizados pós intubação e com risco de broncoaspiração.

ABSTRACT Purpose To characterize the professional profile of Speech Pathologists working in health services in Brazil and to verify if the time length of professional practice, specialized formation and experience in dysphagia contribute to the more adequate interpretation and application of the Blue Dye Test (BDT). Methods Through social medias and class entities, speech pathologists from all over Brazil were contacted by e-mail, that provided them a link from which they could access the online quiz, containing questions about the professional profile and the application of the BDT. The responses were categorized dichotomously according to the most robust scientific researches on the BDT and were compared statistically according to time length of professional practice, specialized formation and experience in dysphagia. Results 145 speech pathologists participated, 91.7% of them females. Most work in hospitals, have 11 to 15 years of profession (27.6%), and working from 1 to 5 years in the area of dysphagia (32.4%). Professionals with lato sensu training (54.3%) and with more than a decade of profession (58.1%) showed greater adequacy in interpreting the positive result of BDT. Conclusion The present study reinforces the important role of specialized training in dysphagia in addition to continuing health educational practices in determining the excellence of clinical speech therapy, especially with tracheostomized patients after intubation and at risk of bronchoaspiration.

The meaning of hope for individuals with spinal cord injury in Brazil.

AIM: To understand the meaning of hope among individuals with spinal cord injury. DESIGN: A qualitative study employing the ethnographic method was used, with 18 individuals. METHOD: Participant observation was chosen to understand individuals with spinal cord injury and interviews were used to elicit information about the hope experience. The data were analysed using Ernst Bloch's theory of hope. FINDINGS: Participants constructed their own personality and sense of self, including their hopes for their future, based on their life before their injury. Life after experiencing spinal cord injury highlighted the limitations and potentialities of their hopes. Using a sense of hope to establish goals for the future helped participants overcome obstacles. CONCLUSION: Hope in people with spinal cord injury helped them cope with the fundamental changes to their daily lives. Hope played an important role in articulating coping strategies and setting and achieving goals. These findings may help nurses understand the limits and potentialities of hope as an instigator of goals in the daily life of individuals with spinal cord injury.

Rehabilitation nursing care and emancipatory process / Cuidado em enfermagem de reabilitação e processo emancipatório / Atención de enfermería de rehabilitación y proceso de emancipación

Background: The science of nursing is immersed in the process of care, and, historically speaking, the profession was built based on scientific criteria of what care is and how to practice it. This study explores how to practice nursing care as an emancipatory process. Objective: This article aims to share and stimulate the debate about nursing care and emancipatory process, using Honneth's theory of recognition and Bloch's principle of hope. Main topics under analysis: Reflection on the theory of recognition and principle of hope as conceptual foundations for rehabilitation nursing care. Study based on philosophical literature about rehabilitation. Nursing care is considered an intersubjective relationship in the emancipatory process, in which the self-realization of the nurse depends on the self-realization of the cared-for person. Conclusion: The construction of the subject occurs in intersubjective, historical, and recognition relationships. For responsible care, we should consider the three levels of recognition: love, rights, and solidarity. In this sense, the care will be an integral and emancipatory process.

Enquadramento: A ciência da enfermagem está imersa no processo de cuidar, e, historicamente, a profissão foi construída com base em critérios científicos sobre o que é e como cuidar. Este estudo pretende questionar como se pratica o cuidado de enfermagem enquanto processo emancipatório. Objectives: Este artigo tem como objetivo compartilhar e estimular o debate sobre cuidados de enfermagem e processo empancipatório, usando a teoria do reconhecimento de Honneth e o princípio da esperança de Bloch. Principais tópicos em análise: Reflexão sobre a teoria do reconhecimento e dialética da esperança como fundamentos conceituais para o cuidado de enfermagem na reabilitação. Baseado na literatura filosófica contextualizada na reabilitação. Para isso, o cuidado de enfermagem é considerado uma relação intersubjetiva num processo emancipatório, no qual a autorrealização do enfermeiro depende da autorrealização da pessoa cuidada. Conclusão: A construção do sujeito ocorre em relações intersubjetivas, históricas e de reconhecimento. Para o cuidado responsável, devemos considerar os três níveis de reconhecimento: amor, direitos e solidariedade. Assim, o cuidado será um processo emancipatório e integral.

Marco contextual: La ciencia de la enfermería está inmersa en el proceso de atención, e históricamente la profesión se construyó con base en criterios científicos de lo que es y cómo atender. Lo que se cuestiona en este estudio es cómo ejercer la atención de enfermería como proceso de emancipación. Objetivo: Este artículo pretende compartir y estimular el debate sobre la atención de enfermería y el proceso de emancipación, utilizando, para ello, la teoría del reconocimiento de Honneth y la dialéctica de la esperanza de Bloch. Principales temas en análisis: Reflexión sobre la teoría del reconocimiento y la dialéctica de la esperanza como fundamentos conceptuales de la atención de enfermería en la rehabilitación. Estudio basado en la literatura filosófica en la rehabilitación. La atención de enfermería se considera una relación intersubjetiva en un proceso emancipador, en el que la autorrealización del enfermero depende de la autorrealización de la persona atendida. Conclusión: La construcción del sujeto tiene lugar en relaciones intersubjetivas, históricas y de reconocimiento. Para una atención responsable, debemos considerar los tres niveles de reconocimiento: amor, derechos y solidaridad. Así, la atención será un proceso integral y emancipador.

Galangin Prevents Increased Susceptibility to Pentylenetetrazol-Stimulated Seizures by Prostaglandin E2.

Epilepsy is one of the most common chronic neurological diseases. It is characterized by recurrent epileptic seizures, where one-third of patients are refractory to existing treatments. Evidence revealed the association between neuroinflammation and increased susceptibility to seizures since there is a pronounced increase in the expression of key inflammatory mediators, such as prostaglandin E2 (PGE2), during seizures. The purpose of this study was to investigate whether PGE2 increases susceptibility to pentylenetetrazol-induced (PTZ) seizures. Subsequently, we evaluated if the flavonoid isolated from the plant Piper aleyreanum (galangin) presented any anticonvulsive effects. Our results demonstrated that the group treated with PGE2 increased susceptibility to PTZ and caused myoclonic and generalized seizures, which increased seizure duration and electroencephalographic wave amplitudes. Furthermore, treatment with PGE2 and PTZ increased IBA-1 (microglial marker), GFAP (astrocytic marker), 4-HNE (lipid peroxidation marker), VCAM-1 (vascular cell adhesion molecule 1), and p-PKAIIα (phosphorylated cAMP-dependent protein kinase) immunocontent. Indeed, galangin prevented behavioral and electroencephalographic seizures, reactive species production, decreased microglial and astrocytic immunocontent, as well as decreased VCAM-1 immunocontent and p-PKA/PKA ratio induced by PGE2/PTZ. Therefore, this study suggests galangin may have an antagonizing role on PGE2-induced effects, reducing cerebral inflammation and protecting from excitatory effects evidenced by administrating PGE2 and PTZ. However, further studies are needed to investigate the clinical implications of the findings and their underlying mechanisms.

Introdução da flipped classroom no ensino de enfermagem / Introduction of the Flipped Classroom in nursing teaching

Objetivo: relatar a experiência do uso da flipped classroom em um seminário deenfermagem sobre a temática do pensamento crítico-criativo na formação de enfermeiros pósgraduandos. Método: construção e desenvolvimento de um seminário que teve duração de quatrohoras, e contou com a participação de dez professores e alunos da pós-graduação em enfermagem.Foram utilizados três metodologias de flipped classroom: Just in time teaching, Peer Instruction eo Problem Based Learning. Resultados: foi possível contribuir para maior participação eapropriação de conhecimento acerca do tema como uso da flipped classroom, proporcionando aexperimentação e sensibilização de métodos em professores e alunos. Considerações finais:através desta experiência buscou-se incentivar a reflexão, uma vez que esses métodos de ensinocolocam o aluno como o sujeito ativo na aprendizagem, fazendo com que busquem em suasvivências ou estudos respostas para questões feitas por ele mesmo ou por outros.

Aim to report the experience of using the flipped classroom in a nursingseminar on critical-creative thinking in graduate nursing students’ training. Method:creation and development of a seminar, which lasted four hours and included theparticipation of ten teachers and graduate nursing students. Three flipped classroommethodologies were used: Just in time teaching, Peer Instruction and Problem BasedLearning. Results: it was possible to contribute for a greater participation and knowledge appropriation on the topic as flipped classroom use in nursing, providing experimentationand sensitization of methods in teachers and students. Final considerations: through thisexperience, we sought to encourage reflection, since these teaching methods put the studentsas the active subjects in learning, leading them to search for answers once asked bythemselves, in their own experiences and studies.

Objetivos: describir la experiencia de la utilización del flipped classroom en unseminario de enfermería, sobre el pensamiento crítico creativo, en la formación de enfermeros enel postgrado. Método: construcción y desarrollo de un seminario de cuatro horas, en el cualparticiparon diez profesores y alumnos del postgrado en enfermería. Se utilizó tres metodologíasdel flipped classroom: Just in time teaching, Peer Instruction y el Problem Based Learning.Resultados: por medio del flipped classroom hubo mayor participación y acercamiento alconocimiento del tema del seminario, lo que posibilitó la experimentación y sensibilización de losmétodos en profesores y alumnos. Consideraciones finales: por medio de esta experiencia sebuscó ampliar la reflexión, ya que estos métodos de enseñanza ponen el estudiante como sujetoactivo en el proceso de aprendizaje, lo que implica la búsqueda de respuestas, en sus vivencias oestudios, para cuestiones propias o de otras personas.

Revolta da Vacina: leitura iconográfica da capa da Revista da Semana (1904) / La Revuelta de la Vacuna: la lectura iconográfica de la portada de la Revista da Semana (1904) / Vaccine Revolt: iconographic reading of the cover of Revista da Semana (1904)

Objetivo: Analisar os elementos simbólicos na capa da Revista da Semana de 1904 sobre a Revolta da Vacina como meio de leitura imagética de um movimento social e sanitário. Método: Trata-se de uma pesquisa documental que utilizou como abordagem as primeiras fases de análise das noções de Erwin Panofsky, pré-iconográfica e iconográfica. Resultados: A Revolta da Vacina retratada na capa da Revista da Semana de outubro de 1904 mostra a imposição do governo de medidas sanitárias e da participação popular na luta contra essas propostas abusivas e verticais com o discurso de prevenção de risco. Conclusão: Com esse estudo, foi possível fazer um aprofundamento acerca de dois personagens que são representantes opostos dentro de uma sociedade marcada por determinantes, disparidades sociais e com políticas que não favoreciam a realidade econômica e sanitária vivenciada; e também retratava a relação de poder vigente na época em que foram implementadas medidas que culminaram no movimento da Revolta da Vacina

Objetivo: Analizar los elementos simbólicos en la portada de la Revista da Semana 1904 en la Revuelta de la Vacuna como medio de lectura de imágenes de un movimiento social y de la salud. Método: Se trata de una investigación documental que utiliza para acercarse a las primeras etapas del análisis de los conceptos de Erwin Panofsky, pre-iconográfico e iconográfico. Resultados: La Revuelta de la Vacuna representada en la portada de la revista Semana de Octubre 1904 muestra la imposición por parte del gobierno de las medidas sanitarias y la participación popular en la lucha contra estas propuestas abusivas y verticales con la imposición de la prevención de riesgos. Conclusión: En este estudio, se realizó un análisis en profundidad alrededor de dos personajes que son representantes opuestos dentro de una sociedad marcada por las desigualdades, y las políticas sociales decisivas que no contemplan la realidad económica y la de la salud como experiencia; y también estableciendo la relación de las tendencias del momento se llevaron a cabo las medidas que dieron como resultado el denominado: "movimiento de la Revuelta de la Vacuna o Rebelión de la Vacuna"

Objective: Analyze the symbolic elements on the cover of the 1904 of Revista da Semana on Vaccine Revolt as a means of imaging a social and sanitary movement. Method: This is a documental research that has utilized as a subject the preliminary phases of Erwin Panofsky's notions, pre iconographic and iconographic. Results: The vaccine's uprising portrayed on the cover of the magazine of the week of 1904 shows the imposition of sanitary measures by the government and the popular participation in the struggle against these abusive and vertical proposals with the risk prevention's speech. Conclusion: With this study it was possible to do a deepening about two characters who are opposite representatives in a society marked by determinants, social disparateness and politics that didn't assist the health and economical reality. And it also portrayed the power relationship in force at the time steps that culminated in the movement of Vaccine Revolt were implemented

Protocol for a scoping review on nursing care and the autonomy of disabled persons.

INTRODUCTION: Considering the limitations that disabled persons experience, our understanding of caring for these people has evolved over time worldwide. Because nursing care is dependent on the choices made by patients, nurses can play an emancipatory role by empowering patients with disabilities to become the primary agent in their rehabilitation. Objective was to conduct a range analysis protocol proposing the mapping of conceptual elements for a nursing care model based on the autonomy of disabled persons. METHODS AND ANALYSIS: A protocol was developed in corporating insights from recent innovations and applying the scope review method of Arksey and O'Malley as a reference using their scoping review methodology as a guide. For the construction of research guiding question, the patient, intervention, comparison and outcomes strategy was adapted. Considerable research in online databases (14) from 2000 to 2018 will be integrated by bibliographical research. Proceed a consult in the Annals of the Brazilian Congress of Nursing, Brazilian Nursing Association and Portuguese Rehabilitation Nursing Association, as well as professional Portuguese and Brazilian nursing legislation. The entire reference list of the covered studies searched manually to detect considerable additional studies. In addition to these searches, stakeholders, including nurse experts in the rehabilitation field and disabled persons, will be requested and included. ETHICS AND DISSEMINATION: This study does not require ethical approval because it is a review and collection of data on publicly available materials. The results of this research will be published in a relevant journal on the subject of rehabilitation and presented at international scientific events in the area of rehabilitation nursing. Thus, the elaboration of this protocol further maps the gaps and strengthens the concepts capable of presenting strong evidence which assists and supports safer, smarter and more objective care for those living with permanent daily care obligations.

Viver com deficiência física e o papel da rede de apoio / Vivir con discapacidad física y el papel de la red de apoyo / Living with physical disability and the role of the support network

OBJETIVO: compreender o impacto da deficiência física na pessoa e a contribuição da rede de apoio. MÉTODOS: Trata-se de um estudo exploratório descritivo de abordagem qualitativa. Foram entrevistadas 10 pessoas com deficiência física de um município localizado no Sul do Brasil. Os dados foram coletados no período de março de 2013 a fevereiro de 2015, por meio de entrevistas semiestruturada em profundidade e realizada análise de conteúdo. RESULTADOS: os dados foram organizados em três categorias temáticas: perda da autonomia/independência; mudanças no cotidiano e no viver; e rede como apoio para superar/enfrentar as dificuldades. CONCLUSÃO: a deficiência física apresenta transformações na vida das pessoas, sendo a rede de apoio a elas, peça fundamental para o enfrentamento das dificuldades.

OBJECTIVE: To understand the impact of physical disability on the person and the contribution of the support network. METHODS: This is an exploratory descriptive study with a qualitative approach. Ten people with physical disabilities from a municipality located in the South of Brazil were interviewed. Data were collected from March 2013 to February 2015, through semi-structured in-depth interviews and content analysis. RESULTS: data were organized into three thematic categories: loss of autonomy/independence; changes in daily life and living, and network as support to overcome/face difficulties. CONLCUSION: the physical disability presents changes in the lives of people, being the network of support to them, fundamental piece to face the difficulties.

OBJETIVO: Para entender el impacto de la discapacidad física de la persona y la contribución de la red de apoyo. MÉTODOS: Se trata de un estudio cualitativo descriptivo y exploratorio. Hemos entrevistado a 10 personas con discapacidad física en un municipio situado en el sur de Brasil. Los datos fueron recolectados a partir de marzo 2013 a febrero 2015, por meio de entrevistas semiestructuradas y análisis de contenido. RESULTADOS: Los datos se organizan en tres categorías temáticas: la pérdida de la autonomía/independencia; cambios en la vida cotidiana y en el vivir; y la red como apoyo para superar/vencer las dificultades. CONCLUSIÓN: la discapacidad física presenta cambios en la vida de las personas, la red de apoyo de las personas con discapacidad como una clave para hacer frente a las dificultades.

Condutas dos enfermeiros da atenção primária no cuidado a pessoas com pé diabético / Conduct of primary care nurses in the care of people with diabetic foot

Objetivo: conhecer as ações do enfermeiro da atenção primária no cuidado das pessoas com Diabetes Mellitus (DM) referente ao pé diabético. Método: estudo qualitativo, exploratório e descritivo, com 22 enfermeiros entrevistados da Estratégia de Saúde da Família. Os dados foram produzidos por meio de entrevistas semiestruturadas. Para a análise dos dados, foi utilizada a técnica de Análise de Conteúdo, na modalidade Análise Categorial. Resultados: evidenciaram que o conhecimento dos enfermeiros sobre os cuidados com a pessoa com DM é parcial, superficial e fragmentado, não possibilitando ações adequadas ao cuidado, especialmente, na detecção dos riscos para o desenvolvimento do pé diabético e para realizar a avaliação do exame dos pés. Conclusão: foi compreendido que a conduta dos enfermeiros da atenção primária, neste modelo atual realizado no sistema de saúde local, é ineficaz porque os enfermeiros não realizam, de forma sistematizada, os cuidados básicos para a prevenção de complicações.

Protocol for a scoping review of skin self-care of people with spinal cord injury.

INTRODUCTION: In recent years, increasing methodological references have been used in scientific research; these are points of support in the search for evidence, formulation and elaboration of instruments, scales, guideline and protocols. However, significant variability currently exists in scoping review conduct and reporting, thus limiting the potential of the methodology to advance research and practice about skin self-care of people with spinal cord injury (SCI). Our objective was to perform a scoping review protocol within the health rehabilitation context of people with SCI, focusing on skin self-care. METHODS AND ANALYSIS: The protocol was developed by using the scoping review methodological framework proposed by Arksey and O'Malley and further refined by the Joanna Briggs Institute, incorporating insights from more recent innovations in scoping review methodology. Sensitive searches of 13 electronic databases from 2007 to 2017 will be supplemented by grey literature searches. Two reviewers using a tool developed for this scoping review will screen eligible studies. ETHICS AND DISSEMINATION: The scoping review will undertake a secondary analysis of previously collected data and does not require ethical approval; however, the ethical precepts of copyright will be respected. The results will facilitate a better understanding of the practical health rehabilitation context of people with SCI, the impacts of these rehabilitations and how to build an evidence base for this work in the future.

Cirurgias de amputação realizadas em hospitais públicos de referência / Amputation surgeries performed in public hospitals of reference / Cirugías de amputación realizadas en hospitales públicos de referencia

Objetivo: caracterizar as cirurgias de amputação em membros, exceto extremidades, realizadas em hospitais públicos de referência, entre 2008 e 2010. Método: estudo quantitativo com amostra determinada pelos relatórios de cirurgias de amputação realizadas; a análise estatística foi realizada pelo SEstatNET. O projeto de pesquisa teve a aprovação pelo Comitê de Ética em Pesquisa, parecer n° 95.521. Resultados: destaca-se que os homens são a maioria e os mesmos são mais jovens que as mulheres. As causas externas foram um dos motivos relacionados à amputação e atinge os adultos jovens e conforme a idade aumenta maior é a relação com as doenças crônico-degenerativas. Conclusão: deve haver ações que promovam à saúde que diminuam o índice desses agravos, no entanto a efetivação das políticas públicas envolvidas na diminuição dos índices dos fatores de risco de amputação se faz necessária.(AU)

Objective: characterizing the amputation surgeries in limbs, except ends, carried out in public hospitals of reference, between 2008 and 2010. Method: this is a quantitative study with a sample determined by amputation surgery reports conducted; the statistical analysis was performed by SEstatNET. The research project was approved by the Research Ethics Committee, Opinion n° 95.521. Results: it is emphasized that men are the majority and the same are younger than the women. External causes were one of the reasons related to amputation and affect young adults and, as age increases, the greater is the relation to chronic degenerative diseases. Conclusion: there must be actions that promote health that reduce the rate of these diseases; however the effectiveness of public policies involved in decreasing the rates of risk factors amputation is needed.(AU)

Objetivo: caracterizar las cirugías de amputación de los miembros, excepto extremidades, llevadas a cabo en los hospitales públicos de referencia, entre 2008 y 2010. Método: es un estudio cuantitativo con una muestra determinada por los informes de cirugías de amputación realizadas; el análisis estadístico se realizó mediante SEstatNET. El proyecto de investigación fue aprobado por el Comité de Ética en Investigación, Dictamen n° 95.521. Resultados: se destaca que los hombres son la mayoría y son más jóvenes que las mujeres. Las causas externas fueron una de las razones relacionadas con la amputación y afecta a los adultos jóvenes y a medida que la edad aumenta la mayor relación con enfermedades crónico degenerativas. Conclusión: debe haber acciones que promueven la salud que reducen la tasa de estas enfermedades, sin embargo, se necesita la eficacia de las políticas públicas que intervienen en la disminución de las tasas de los factores de riesgo de amputación.(AU)

The leishmanicidal activity of a cyclopentenedione derivative isolated from the roots of a native Amazonian pepper (Piper carniconnectivum)

The Piper species chemistry has been widely investigated and the phytochemical analyses have led to the isolation of a number of active compounds like alkaloids, terpenes and flavones among others. The aim of this study was to evaluate the leishmanicidal activity of 2-[1-hydroxy-3-phenyl-(Z,2E)-2-propenylidene]-4-methyl-4-cyclopentene-1,3-dione (DCPC), a cyclopentenedione derivative isolated from the roots of Piper carniconnectivum C. DC., Piperaceae. Leishmanicidal activity against Leishmania amazonensis promastigotes was assessed, and the risk to host cell was assessed by measuring the cytotoxicity to peritoneal macrophages from BALB/c mice in vitro. L. amazonensis promastigotes and host macrophages were cultured in the presence of 100, 50, 25, 12.5 and 6 µg/mL of the cyclopentenedione derivative for up to 96 h. At the end of this period, the inhibitory concentrations (IC50) were compared with those from untreated cultures. The IC50 for promastigotes was 4.4 µg/mL after 96 h of treatment with the derivative. The 50% cytotoxic concentration (CC50) against murine peritoneal macrophages was 129 µg/mL. These results indicate that DCPC is a promising molecule for the development of leishmanicidal drugs.

Evaluation of the antinociceptive, anti-inflammatory and gastric antiulcer activities of the essential oil from Piper aleyreanum C.DC in rodents.

ETHNOPHARMACOLOGICAL RELEVANCE: Piper aleyreanum is a small tree that is widely distributed in tropical and subtropical regions, mostly in North and South America, and is used as an immunomodulator, analgesic and antidepressant in folk medicine. AIM OF THE STUDY: This study was designed to investigate the antinociceptive, anti-inflammatory and gastric antiulcer activities of the essential oils from the aerial parts of Piper aleyreanum (EOPa) in rodents. MATERIALS AND METHODS: The antinociceptive and anti-inflammatory effects of orally administered EOPa were evaluated in mice subjected to the formalin and pleurisy models, respectively. We also pretreated the rats with EOPa before acute ethanol-induced gastric lesions and measured gastric lesion extension and mucus and glutathione (GSH) levels in the gastric mucosa. Finally, we performed a phytochemical analysis of EOPa. RESULTS: The chemical composition of EOPa was analyzed by gas chromatography and mass spectrometry (GC/MS), which identified 35 compounds, representing 81.7% of total oil compounds. Caryophyllene oxide (11.5%), ß-pinene (9%), spathulenol (6.7%), camphene (5.2%), ß-elemene (4.7%), myrtenal (4.2%), verbenone (3.3%) and pinocarvone (3.1%) were the major oil constituents. The oral administration of EOPa (10-1000 mg/kg) significantly inhibited the neurogenic and inflammatory phases of formalin-induced licking, with ID50 values of 281.2 and 70.5 mg/kg, respectively. The antinociception caused by EOPa (100 mg/kg, p.o.) was not reversed by naloxone (1 or 5 mg/kg, i.p.) in the formalin test. EOPa (100-300 mg/kg, p.o.) did not affect animal motor coordination in an open-field model. In carrageenan-induced pleurisy, EOPa (1-100 mg/kg, p.o.) significantly decreased the total cell count, neutrophils and mononuclear cells with mean ID50 values of 53.6, 21.7 and 43.5 mg/kg, respectively. In addition, EOPa (1-30 mg/kg, p.o.) protected the rats against ethanol-induced gastric lesions with an ID50 value of 1.7 mg/kg and increased the mucus and GSH levels of the gastric mucosa to levels similar to those of the non-lesioned group. CONCLUSIONS: These data show for the first time that EOPa has significant antinociceptive and anti-inflammatory actions, which do not appear to be related to the opioid system. EOPa also has interesting gastroprotective effects related to the maintenance of protective factors, such as mucus production and GSH. These results support the widespread use of Piper aleyreanum in popular medicine and demonstrate that this plant has therapeutic potential for the development of phytomedicines with antinociceptive, anti-inflammatory and gastroprotective properties.