A call to action in review of the Australian Dietary Guidelines: Impacts of conflicting nutrition information: A mixed methods study.

ISSUES ADDRESSED: The overabundance of conflicting nutrition information (CNI) and accompanying confusion and backlash are a public health concern; however, the complexity of responses to CNI has yet to be explored. The following mixed methods study brings depth to the perceptions and behavioural responses to CNI among Australian millennials to better inform successful nutrition guidelines. METHODS: An explanatory sequential mixed methods design explored the cognitive and behavioural responses to CNI in Australian millennials. Cross-sectional data (n = 204) on CNI exposure, confusion, and backlash was analysed via multivariate ordinal logistic regression. The qualitative phase thematically analysed 18 semi-structured interviews on experiences with and responses to CNI. RESULTS: Exposure to CNI via social media was positively associated with confusion. Nutrition confusion was positively associated with backlash. Qualitative analysis confirmed social media as a frequent, yet sometimes trusted, source of CNI. In addition, participants revealed using various methods to alleviate backlash while also relying heavily on traditional nutrition information (TNI) to inform dietary choices. CONCLUSIONS: The methods to alleviate nutrition backlash provide new and innovative ways to tailor nutrition messages for maximum impact. Nutrition promotion initiatives and dietary guidelines should consider the complexity of responses to CNI and modernise interventions across mediums, including social media, with clear and attractive dietary recommendations. SO WHAT?: Results can inform the drafting of the new Australian Dietary Guidelines in 2023 and how they are promoted to the community on an ongoing basis.

Contraception-related knowledge, attitude, belief contexts among US women experiencing homelessness: A scoping review.

Contraception provision may help reduce undesired pregnancies, but women experiencing homelessness may have low health literacy, specific attitudes, and certain beliefs that influence contraception uptake. This scoping review identifies what is known about pregnancy prevention and contraception knowledge, attitudes, and beliefs among US women experiencing homelessness. This review examined English articles that measured the context of knowledge, attitudes, and beliefs related to contraceptive use for avoiding pregnancy among US women experiencing homelessness. Using PRISMA-ScR guidelines, articles published before May 2022 were located via PubMed, EBSCOhost, and Embase. The initial search identified 1204 articles, and 10 met the inclusion criteria. There were five quantitative, four qualitative, and one mixed-methods study, published between 2000 and 2022, with samples of 15-764 women ranging from ages 15-51. Contraception knowledge, attitudes, and beliefs related to pregnancy prevention suggested several knowledge gaps (e.g., contraception efficacy), contraception preferences and past experiences, interpersonal relationship influences, and vulnerability to clinic and shelter-specific barriers. These findings may ultimately inform contraception interventions in partnership with the community of US women who experience homelessness and the health care and social service organizations who serve them.

Zika virus knowledge, attitudes and prevention behaviors among pregnant women in the ZEN cohort study, Colombia, 2017-2018.

BACKGROUND: Zika virus (ZIKV) infection during pregnancy can cause severe birth defects in the fetus and is associated with neurodevelopmental abnormalities in childhood. Our objective was to describe ZIKV knowledge and attitudes among pregnant women in Colombia while ZIKV was circulating and whether they predicted the adoption of behaviors to prevent ZIKV mosquito-borne and sexual transmission. METHODS: We used self-reported data from Zika en Embarazadas y Niños (ZEN), a cohort study of women in early pregnancy across three regions of Colombia during 2017-2018. We used Poisson regression to estimate associations between knowledge, attitudes and previous experience with mosquito-borne infection and preventative behaviors. RESULTS: Among 1519 women, knowledge of mosquito-borne transmission was high (1480; 97.8%) and 1275 (85.5%) participants were worried about ZIKV infection during pregnancy. The most common preventive behavior was wearing long pants (1355; 89.4%). Regular mosquito repellent use was uncommon (257; 17.0%). While ZIKV knowledge and attitudes were not associated with the adoption of ZIKV prevention behaviors, previous mosquito-borne infection was associated with increased condom use (prevalence ratio 1.4, 95% CI 1.1 to 1.7). CONCLUSIONS: Participants were well informed about ZIKV transmission and its health consequences. However, whether this knowledge resulted in behavior change is less certain.

Avaliação do conhecimento e do manejo clínico bucal de endocrinologistas frente a pacientes que estejam em rastreamento ou em tratamento para diabetes mellitus / Evaluation of endocrinologists' knowledge and oral clinical management of patients being examined or treated for diabetes mellitus / Evaluación de los conocimientos de los endocrinólogos y de la gestión clínica oral de los pacientes examinados o tratados por diabetes mellitus

Introdução: Diabetes Mellitus é uma doença crônica resultante de defeitos na secreção do hormônio insulina e/ou de sua ação prejudicada no organismo. Indivíduos diabéticos podem apresentar complicações bucais significativas como, por exemplo, a doença periodontal. Objetivo: Avaliar o conhecimento dos endocrinologistas cadastrados/ativos no Conselho Regional de Medicina da Paraíba quanto ao manejo clínico bucal de pacientes em rastreamento e tratamento para diabetes. Materiais e Métodos: Estudo transversal, no qual 47 endocrinologistas participaram por meio de formulário estruturado, baseado nas diretrizes conjuntas da Sociedade Brasileira de Periodontologia e da Sociedade Brasileira de Endocrinologia e Metabologia (2022). Todas as análises foram conduzidas com auxílio do software IBM SPSS Statistics versão 20.0 e as variáveis do estudo foram analisadas por meio do teste Qui-quadrado de Pearson (p<0,05). As variáveis consideradas relevantes para o desfecho foram avaliadas usando o algoritmo CHAID (Chi-squared Automatic Interaction Detector). Resultados: A maioria dos participantes tinha até 40 anos (55,3%), era do sexo feminino (91,5%) e tinha, no máximo, 10 anos de tempo de experiência (55,3%). A partir da análise multivariada, por meio da Árvore de Decisão (CHAID), verificou-se a associação entre possuir manejo clínico bucal adequado endocrinologistas com faixa etária >40 anos e com conhecimento sobre os sinais clínicos da doença periodontal. Conclusões: Apesar do conhecimento teórico dos endocrinologistas ser relativamente satisfatório, ainda existe uma lacuna entre conhecimento teórico e prática clínica na conduta da maioria desses profissionais, que ainda se distancia do que é preconizado pelas evidências científicas e diretrizes atuais.

Introduction: Diabetes Mellitus is a chronic disease resulting from defects in insulin hormone secretion and/or its impaired action in the body. Diabetic individuals may present significant oral complications such as periodontal disease. Objective: To evaluate the knowledge of endocrinologists registered/active in the Regional Council of Medicine of Paraíba regarding the clinical oral management of patients in screening and treatment for diabetes. Materials and Methods: Cross-sectional study, in which 47 endocrinologists participated by means of a structured form, based on the joint guidelines of the Brazilian Society of Periodontology and the Brazilian Society of Endocrinology and Metabology (2022). All analyses were conducted using IBM SPSS Statistics version 20.0 software and the study variables were analyzed using Pearson's chi-square test (p<0.05). Variables considered relevant to the outcome were evaluated using the CHAID (Chi-squared Automatic Interaction Detector) algorithm. Results: Most participants were up to 40 years old (55.3%), female (91.5%), and had a maximum of 10 years of experience time (55.3%). From multivariate analysis, using the Decision Tree (CHAID), an association was found between having adequate clinical oral management endocrinologists aged >40 years and having knowledge about the clinical signs of periodontal disease. Conclusions: Although the theoretical knowledge of endocrinologists is relatively satisfactory, there is still a gap between theoretical knowledge and clinical practice in the conduct of most of these professionals, which is still far from what is recommended by scientific evidence and current guidelines.

Introducción: La Diabetes Mellitus es una enfermedad crónica que resulta de defectos en la secreción de la hormona insulina y/o de su acción alterada en el organismo. Los individuos diabéticos pueden presentar importantes complicaciones orales como la enfermedad periodontal. Objetivo: Evaluar el conocimiento de los endocrinólogos registrados/activos en el Consejo Regional de Medicina de Paraíba sobre el manejo clínico oral de pacientes en screening y tratamiento de diabetes. Materiales y Métodos: Estudio transversal, en el cual participaron 47 endocrinólogos por medio de formulario estructurado, basado en las directrices conjuntas de la Sociedad Brasileña de Periodoncia y de la Sociedad Brasileña de Endocrinología y Metabología (2022). Todos los análisis se realizaron con el software IBM SPSS Statistics versión 20.0 y las variables del estudio se analizaron mediante la prueba de chi cuadrado de Pearson (p<0,05). Las variables consideradas relevantes para el resultado se evaluaron mediante el algoritmo CHAID (Chi-squared Automatic Interaction Detector). Resultados: La mayoría de los participantes tenían hasta 40 años (55,3%), eran mujeres (91,5%) y tenían un máximo de 10 años de tiempo de experiencia (55,3%). A partir da análise multivariada, por meio da Árvore de Decisão (CHAID), verificou-se a associação entre possuir manejo clínico bucal adequado endocrinólogos com faixa etária >40 anos e com conhecimento sobre os sinais clínicos da doença periodontal. Conclusões: Embora os conhecimentos teóricos dos endocrinólogos sejam relativamente satisfactórios, ainda existe uma brecha entre os conhecimentos teóricos e a prática clínica na conduta da maioria destes profissionais, ainda distante do que é recomendado pela evidência científica e pelas orientações vigentes.

Prevalence and associated factors of experimentation with and current use of water pipes and electronic cigarettes among medical students: a multicentric study in Brazil / Prevalência de experimentação e uso atual de narguilé e cigarros eletrônicos e os fatores associados entre estudantes de medicina: estudo multicêntrico no Brasil

ABSTRACT Objective: To evaluate the prevalence of and factors associated with experimentation with and current use of water pipes and e-cigarettes among medical students. Methods: This was a cross-sectional multicentric study involving a convenience sample of students from medical schools in most Brazilian geographic regions. Information about experimentation with and current use of conventional cigarettes, water pipes, and e-cigarettes; beliefs and attitudes toward tobacco products; religiosity; and demographics were collected by means of an online structured questionnaire. We used descriptive statistics and logistic regression to analyze the association of those factors. Results: Our sample comprised 700 individuals from four Brazilian regions. Prevalence of experimentation with and current use of cigarettes, water pipes, and e-cigarettes were, respectively, 39.1% and 7.9%; 42.6% and 11.4%; and 13.1% and 2.3%. Water pipe experimentation was higher among those who had a sibling (adjusted OR = 2.64; 95% CI, 1.24-5.61) or friends (adjusted OR = 2.33; 95% CI, 1.63-3.31) who smoke. The same occurred regarding e-cigarette experimentation: siblings (adjusted OR = 2.76; 95% CI, 1.17-6.50) and friends (adjusted OR = 2.47; 95% CI, 1:45-4.22). Curiosity and scent/taste were the major reasons for water pipe use and e-cigarette experimentation. Although 93% of the responders learned about health damages of smoking during medical school classes, 51.4% reported having experimented with at least one of these tobacco products. Most responders who reported feeling the presence of God/the Holy Spirit in their lives were never experimenters of water pipes (59.2%) or e-cigarettes (55.3%). Conclusions: There is a high prevalence of experimentation with tobacco products among medical students whose siblings or friends smoke, despite their knowledge about smoking harms.

RESUMO Objetivo: Avaliar a prevalência de experimentação e uso atual de narguilé e cigarros eletrônicos e os fatores associados entre estudantes de medicina. Métodos: Estudo transversal multicêntrico com uma amostra de conveniência de estudantes de faculdades de medicina da maioria das regiões geográficas brasileiras. Informações sobre experimentação e uso atual de cigarros convencionais, narguilé e cigarros eletrônicos; crenças e atitudes em relação aos produtos do tabaco; religiosidade; e dados demográficos foram coletados por meio de um questionário on-line estruturado. Utilizou-se estatística descritiva e regressão logística para analisar a associação desses fatores. Resultados: Nossa amostra foi composta por 700 indivíduos de quatro regiões brasileiras. As prevalências de experimentação e uso atual de cigarros, narguilé e cigarros eletrônicos foram, respectivamente, de 39,1% e 7,9%; 42,6% e 11,4%; e 13,1% e 2,3%. A experimentação de narguilé foi maior entre aqueles que tinham irmãos (OR ajustada = 2,64; IC95%: 1,24-5,61) ou amigos (OR ajustada = 2,33; IC95%: 1,63-3,31) fumantes. O mesmo ocorreu em relação à experimentação de cigarros eletrônicos: irmãos (OR ajustada = 2,76; IC95%: 1,17-6,50) e amigos (OR ajustada = 2,47; IC95%: 1,45-4,22). Curiosidade e aroma/sabor foram os principais motivos para o uso de narguilé e a experimentação de cigarros eletrônicos. Embora 93% dos respondentes tenham aprendido sobre os danos do tabagismo à saúde nas aulas da faculdade de medicina, 51,4% relataram já ter experimentado pelo menos um desses produtos do tabaco. A maioria dos respondentes que relataram sentir a presença de Deus/Espírito Santo em suas vidas nunca experimentou narguilé (59,2%) ou cigarros eletrônicos (55,3%). Conclusões: Há uma alta prevalência de experimentação de produtos do tabaco entre estudantes de medicina cujos irmãos ou amigos fumam, apesar de terem conhecimento sobre os malefícios do tabagismo.

Conhecimentos e práticas da enfermagem sobre os resíduos de saúde nas unidades pediátricas: revisão integrativa / Nursing knowledge and practices in relation to medical waste in pediatric units: integrative review / Conocimientos y prácticas de enfermería con relación a los residuos sanitarios en unidades pediátricas: revisión integradora

Objetivo: identificar publicações que abordam a educação em saúde relacionada à prevenção da Síndrome da Morte Súbita em Lactentes. Método: revisão integrativa realizada no PubMed, Portal Periódicos da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, Cochrane Reviews, Scientific Electronic Library Online e a Biblioteca Virtual em Saúde. Incluíram-se aquelas nas línguas inglesa, espanhola e portuguesa, sem recorte temporal, disponíveis gratuitamente, independentemente do delineamento. Excluíram-se duplicidades, literatura cinzenta, editoriais e cuja população eram prematuros. Resultados: identificou-se duas categorias de análise: temas para educação em saúde e barreiras e facilitadores de aderência às recomendações de prevenção. O profissional de saúde deve estimular as boas práticas de saúde, identificando barreiras e facilitadores para a adesão às recomendações. Conclusão: o profissional deve trazer a ideia de que todo bebê tem risco potencial para a síndrome da morte súbita e utilizar as estratégias disponíveis para tirá-lo da situação de vulnerabilidade.

Objectives: : identifying the current scientific production in relation to Nursing knowledge and practices on medical waste in pediatric units. Method: integrative review in the Scielo, Cinahl, Web of Science, Pubmed, Scopus and Embase databases, between the years 2016 to 2021, totalizing 13 articles. Results: the findings pointed to three main categories: knowledge and practices in relation to Medical Waste, permanent education like a tool for the disposal of Medical Waste; and sustainability in the context of Medical Waste and its relationship with social responsibility. Conclusion: it is necessary to provide the opportunity for periodic training, as well as the use of self-explanatory instruments that can help all health professionals, especially the Nursing professionals, at the time of practice. It was checked the presence of gaps was verified with studies showing Medical Waste and Pediatric Nursing.

Objetivos:identificar la producción científica actual en relación a los conocimientos y prácticas de enfermería sobre los Residuos Sanitarios en las unidades de pediatría. Método: revisión integrativa en las bases de datos Scielo, Cinahl, Web of Science, Pubmed, Scopus y Embase, con un marco temporal de 2016 a 2021, totalizando 13 artículos. Resultados:los hallazgos apuntaron a tres categorías principales: conocimientos y prácticas en relación a los Residuos Sanitarios, educación permanente con una herramienta para la disposición de los Residuos Sanitarios y sostenibilidad en el contexto de los Residuos Sanitarios y su relación con la responsabilidad social. Conclusión: es necesario brindar oportunidades de capacitación periódica, así como el uso de instrumentos autoexplicativos que puedan ayudar todos los profesionales de la salud, especialmente a los profesionales de Enfermería, en el momento de la práctica. Se verifico la presencia de lagunas en los estudios que destacan los Residuos Sanitarios y la Enfermería Pediátrica.

Nivel de conocimiento, actitudes y prácticas sobre enfermedad periodontal en pacientes diabéticos / Level of knowledge, attitudes and practices on periodontal disease in diabetic patients

RESUMEN Fundamento: La diabetes mellitus y la enfermedad periodontal tienen una relación bidireccional, siendo la prevención la herramienta indispensable para lograr el mejoramiento del nivel de salud bucal. Objetivo: Identificar el nivel de conocimientos, actitudes y prácticas de la enfermedad periodontal en pacientes diabéticos. Metodología: Se realizó un estudio observacional descriptivo de corte transversal de septiembre de 2019 a abril de 2020 en la población diabética de 19 a 40 años del Consultorio Médico de Familia n.o 11 del área de salud de Zaza del Medio perteneciente al municipio Taguasco, provincia Sancti Spíritus. Se estudiaron las variables edad, sexo, nivel de conocimiento, actitudes y prácticas sobre salud bucal. Resultados: En el 67.9 % de los pacientes se observó bajo nivel de conocimientos sobre la enfermedad periodontal, actitud desfavorable el 78.6 % y prácticas deficientes el 57.1 %. Conclusiones: La mayoría de los pacientes diabéticos presentó bajo nivel de conocimientos, actitud desfavorable y prácticas deficientes para lograr la salud periodontal.

ABSTRACT Background: Diabetes mellitus and periodontal disease have a bidirectional relationship, being prevention the essential tool to achieve an improvement in the level of oral health. Objective: To identify the level of knowledge, attitudes and practices of periodontal disease in diabetic patients. Methodology: A cross-sectional descriptive observational study was conducted from September 2019 to April 2020 in the diabetic population aged 19 to 40 years at the doctor´s office 11 in Zaza del Medio health area of Taguasco municipality in Sancti Spíritus province. The variables age, sex, level of knowledge, attitudes and practices on oral health were studied. Results: 67.9 % of the patients had a low level of knowledge about periodontal disease, 78.6 % had an unfavorable attitude and 57.1 % had deficient practices. Conclusions: The majority of diabetic patients presented low level of knowledge, non-favorable attitude and poor practices to accomplish periodontal health.

Development and semantic validation of an instrument for the assessment of knowledge and attitudes towards cardiopulmonary resuscitation in adolescents.

OBJECTIVES: Develop and semantically validate an instrument to assess the knowledge and attitudes of adolescents towards cardiopulmonary resuscitation (CPR). METHODS: Validation study of an instrument to evaluate the knowledge and attitudes of adolescents towards CPR, developed in three phases: (i) development of the evaluation instruments by the authors; (ii) content validation performed by 14 expert judges in the area using the content validity index for analysis; and (iii) semantic validation carried out with the participation of 30 adolescents between 11 and 13 years old. RESULTS: In the content validation, the questions on CPR knowledge obtained a content validity index (CVI) between 0.92 and 1.00, with a general index of 0.98; and the questions about attitudes obtained an IVC between 0.85 and 1.00, with a general index also of 0.98. Regarding semantic validation, three questions were modified in the knowledge assessment instruments and five in the attitude assessment instrument. CONCLUSIONS: Semantic and content validation of the instruments studied showed that they are suitable for assessing the knowledge and attitudes of adolescents related to CPR, so their use is recommended in the evaluation of training actions in this population group.

Development and semantic validation of an instrument for the assessment of knowledge and attitudes towards cardiopulmonary resuscitation in adolescents / Desarrollo y validación semántica de un instrumento para la evaluación en adolescentes de los conocimientos y actitudes hacia la Resucitación cardiopulmonar / Desenvolvimento e validação semântica de um instrumento para a avaliação em adolescentes dos conhecimentos e atitudes para a Ressuscitação cardiopulmonar

Objective. Develop and semantically validate an instrument to assess the knowledge and attitudes of adolescents towards cardiopulmonary resuscitation (CPR)..Methods. Validation study of an instrument to evaluate the knowledge and attitudes of adolescents towards CPR, developed in three phases: (i) development of the evaluation instruments by the authors; (ii) content validation performed by 14 expert judges in the area using the content validity index for analysis; and (iii) semantic validation carried out with the participation of 30 adolescents between 11 and 13 years old. Results. In the content validation, the questions on CPR knowledge obtained a content validity index (CVI) between 0.92 and 1.00, with a general index of 0.98; and the questions about attitudes obtained an IVC between 0.85 and 1.00, with a general index also of 0.98. Regarding semantic validation, three questions were modified in the knowledge assessment instruments and five in the attitude assessment instrument. Conclusion. Semantic and content validation of the instruments studied showed that they are suitable for assessing the knowledge and attitudes of adolescents related to CPR, so their use is recommended in the evaluation of training actions in this population group.

Objetivo. Desarrollar y validar semánticamente un instrumento para evaluar los conocimientos y las actitudes de adolescentes hacia la resucitación cardiopulmonar (RCP). Métodos. Estudio de validación de un instrumento para evaluar los conocimientos y las actitudes de adolescentes hacia la RCP que se desarrolló en tres fases: (i) desarrollo de los instrumentos de evaluación por parte de los autores; (ii) validación de contenido realizada por 14 jueces expertos en el área utilizando el índice de validez de contenido para el análisis; y (iii) validación semántica realizada con la participación de 30 adolescentes, entre los 11 y 13 años. Resultados. En la validación de contenido, las preguntas sobre conocimientos de RCP obtuvieron un índice de validez de contenido (IVC) entre 0.92 y 1.00, con índice general de 0.98; y las preguntas sobre actitudes obtuvieron un IVC entre 0.85 a 1.00, con un índice general también de 0.98. En cuanto a la validación semántica, se modificaron tres preguntas en los instrumentos de evaluación de conocimientos y cinco en el instrumento de evaluación de actitudes. Conclusión. La validación semántica y de contenido de los instrumentos estudiados mostraron que son adecuados para la valoración de conocimientos y actitudes de los adolescentes relacionados con la RCP, por lo que se recomienda su uso en la evaluación de acciones formativas en este grupo poblacional.

Objetivo. Desenvolver e validar semanticamente um instrumento para avaliar os conhecimentos e as atitudes de adolescentes para a ressuscitação cardiopulmonar (RCP). Métodos. Estudo de validação de um instrumento para avaliar os conhecimentos e as atitudes de adolescentes para a RCP que se desenvolveu em três fases: (i) desenvolvimento dos instrumentos de avaliação por parte dos autores; (ii) validação de conteúdo realizada por 14 juízes especialistas na área utilizando o índice de validez de conteúdo para a análise; e (iii) validação semântica realizada com a participação de 30 adolescentes de entre 11 e 13 anos. Resultados. Na validação de conteúdo, as perguntas sobre conhecimentos de RCP obtiveram um índice de validez de conteúdo (IVC) entre 0.92 e 1.00, com índice geral de 0.98; e as perguntas sobre atitudes obtiveram um IVC entre 0.85 a 1.00, com um índice geral também de 0.98. Enquanto à validação semântica, se modificaram três perguntas nos instrumentos de avaliação de conhecimentos e cinco no instrumento de avaliação de atitudes. Conclusão. A validação semântica e de conteúdo dos instrumentos estudados mostraram que são adequados para a valoração de conhecimentos e atitudes dos adolescentes relacionados com a RCP, por isso se recomenda seu uso na avaliação de ações formativas neste grupo populacional.

Bias against Vitamin C in Mainstream Medicine: Examples from Trials of Vitamin C for Infections.

Evidence has shown unambiguously that, in certain contexts, vitamin C is effective against the common cold. However, in mainstream medicine, the views on vitamin C and infections have been determined by eminence-based medicine rather than evidence-based medicine. The rejection of the demonstrated benefits of vitamin C is largely explained by three papers published in 1975-two published in JAMA and one in the American Journal of Medicine-all of which have been standard citations in textbooks of medicine and nutrition and in nutritional recommendations. Two of the papers were authored by Thomas Chalmers, an influential expert in clinical trials, and the third was authored by Paul Meier, a famous medical statistician. In this paper, we summarize several flaws in the three papers. In addition, we describe problems with two recent randomized trial reports published in JAMA which were presented in a way that misled readers. We also discuss shortcomings in three recent JAMA editorials on vitamin C. While most of our examples are from JAMA, it is not the only journal with apparent bias against vitamin C, but it illustrates the general views in mainstream medicine. We also consider potential explanations for the widespread bias against vitamin C.

Instrumentos sobre conhecimentos/atitudes em segurança do paciente entre graduandos: protocolo de revisão de escopo / Instruments on patient safety knowledge/attitudes among undergraduate students: a scoping review protocol / Instrumentos sobre conocimientos/actitudes que poseen los estudiantes universitarios sobre seguridad del paciente: protocolo de revisión de alcance

OBJETIVO: Mapear os instrumentos validados disponíveis na literatura para avaliação de conhecimentos e atitudes de estudantes de graduação na área da saúde sobre segurança do paciente. MÉTODO: Revisão de escopo conduzida a partir da metodologia Joanna Briggs Institute, com utilização da extensão do checklist PRISMA-ScR, nas seguintes fontes de informação: Biblioteca Virtual em Saúde, MEDLINE via Pubmed, COCHRANE, CINAHL, Scopus, Embase, Web of Science e Google Scholar. Serão considerados elegíveis estudos que respondam à pergunta de pesquisa, publicados em inglês, português e espanhol e que apresentem a descrição do instrumento utilizado. A seleção ocorrerá de maneira independente por dois revisores, a partir do software Rayyan. Divergências serão apreciadas por um terceiro revisor. Síntese e extração dos dados serão executadas considerando os itens de um formulário elaborado pelos autores. Os resultados serão apresentados por meio de quadro resumo, fluxograma e discussão narrativa. Registro da revisão no Open Science Framework: https://osf.io/wak7f.

OBJECTIVE: To map the validated instruments available in the literature to assess the knowledge and attitudes of undergraduate students in the health area about patient safety. METHOD: A scoping review conducted based on the Joanna Briggs Institute methodology, using the PRISMA-ScR checklist extension, in the following information sources: Virtual Health Library, MEDLINE via Pubmed, COCHRANE, CINAHL, Scopus, Embase, Web of Science and Google Scholar. Studies that answer the research question, published in English, Portuguese and Spanish and that present a description of the instrument used will be considered eligible. Selection will take place independently by two reviewers, based on the Rayyan software. Disagreements will be appreciated by a third reviewer. Data synthesis and extraction will be performed considering the items of a form prepared by the authors. The results will be presented through a summary chart, flowchart and narrative discussion. Review record in the Open Science Framework: https://osf.io/wak7f.

OBJETIVO: Mapear los instrumentos validados disponibles en la literatura para evaluar el conocimiento y las actitudes que poseen los estudiantes universitarios del área de la salud sobre la seguridad del paciente. MÉTODO: Revisión de alcance realizada según la metodología del Joanna Briggs Institute, utilizando la extensión de la checklist PRISMA-ScR, en las siguientes fuentes de información: Biblioteca Virtual en Salud, MEDLINE a través de Pubmed, COCHRANE, CINAHL, Scopus, Embase, Web of Science y Google Scholar. Se considerarán elegibles los estudios que respondan a la pregunta de investigación, publicados en inglés, portugués y español y que presenten una descripción del instrumento utilizado. La selección se llevará a cabo de forma independiente por dos revisores mediante el software Rayyan. Un tercer revisor evaluará los desacuerdos. La síntesis y extracción de los datos se realizará considerando los ítems de un formulario elaborado por los autores. Los resultados se presentarán a través de cuadro resumen, diagrama de flujo y discusión narrativa. La revisión fue registrada en Open Science Framework: https://osf.io/wak7f.

Factors Associated with Low Screening Participation and Late Presentation of Cancer amongst Women in the Pacific Island Countries and Territories: A Systematic Review.

BACKGROUND AND OBJECTIVE: In most Pacific Island Countries and Territories (PICTs), cancer patients commonly present at very late stages and by the time the disease is diagnosed, it is often too late for treatment. This review examines the evidence on factors associated with low cancer screening participation and late presentation of cancer among women of the PICTs. MATERIALS AND METHODS: Medline, PubMed, ProQuest and The Cumulative Index to Nursing and Allied Health Literature were searched to identify relevant studies for this review. Terms of medical subject headings was performed in combination with other key words such as "screening", "delay", "determinants", "awareness". RESULTS: Eleven studies met the inclusion criteria of this review. Six factors were identified from these studies: resources and facilities, trust in the health care system, culture and tradition, modesty, awareness and socioeconomic status. CONCLUSION: Due to several barriers and factors, women in the PICTs are hindered from accessing cancer screening practices and often present late with cancer symptoms leading to advanced stage diagnosis. The findings of this study provide a foundation for future studies that could focus more in-depth to explain how these factors contribute to the presentation of cancer in late stages.

Personal beliefs and misconceptions, not evidence guide general practitioners in the managing of travelers' diarrhea: Results from a pilot study (North-Western Italy, 2019).

BACKGROUND: The present study aims to characterize knowledge, attitudes and practices in a sample of general practitioners (GPs) on management of travelers' diarrhea (TD). METHODS: A total of 158 GPs (44.3% males; mean age 40.2±12.4 years) completed a web questionnaire on antibiotic prophylaxis (AP) and/or an antibiotic treatment (AT) in TD cases. Participants were inquired on knowledge status (KS), risk perception and effectively applied recommendations for AP/AT through a specifically designed questionnaire. Multivariate odds ratios (OR) for predictors of AP/AT were calculated through regression analysis. RESULTS: All in all, while 15 (9.5%) participants recommended AP for TD, 61 of them (39.4%) recommended AT. KS was largely unsatisfying as participants extensively ignored the most recent AP/AT recommendations. Acknowledgment of TD as a severe disorder was predictive for recommendation of AP (OR 37.843, 95%CI 4.752-301.4). As for AT, it was relatively elevated in GPs≥10 years (OR 2.653, 95%CI 1.169-6.019), but more rarely reported in participants with higher KS (OR 0.056, 95%CI 0.021-0.153). CONCLUSIONS: Adherence of GPs to official recommendations for TD management was unsatisfying, particularly in older participants. Continuous Education of GPs should be improved by sharing up-to-date official recommendations on AT/AP for TD.

Safety culture in the perception of public-hospital health professionals / Cultura de segurança na percepção dos profissionais de saúde de hospitais públicos

ABSTRACT OBJECTIVE Evaluating safety culture in the perception of professionals working in public hospitals of the Unified Health System (SUS) of Distrito Federal, Brazil, three years after the implementation of the National Patient Safety Program (PNSP). METHODS Analytical cross-sectional study conducted in eleven public hospitals using the Safety Attitudes Questionnaire (SAQ) in electronic format. Stratified sampling was estimated according to the proportion of the total number of professionals in each hospital, as well as the representativeness of each professional group. The results of the total score and domains equal to or greater than 75 were considered positive. Descriptive and inferential analyses of professional groups and hospitals were carried out. RESULTS 909 professionals participated. The total score by professional group was negative (62.5 to 69.5) and the domains differed statistically in all cases. The eleven hospitals had a negative total score (61.5 to 68.6). The domains to attain positive performance were job satisfaction, stress recognition and teamwork climate. The lowest results were in working conditions and management perception domains, for which none of the hospitals had an average above 75. Differences were also found for domain means across hospitals, except in management perception. DISCUSSION Three years after the implementation of PNSP, the safety culture in eleven hospitals evaluated was weak, although the domains of job satisfaction, stress recognition and teamwork climate had positive results. The results can contribute to decision-making by managers, as safety culture is an essential element in the implementation of patient safety policy.

RESUMO OBJETIVO Avaliar a cultura de segurança na percepção dos profissionais que trabalham nos hospitais públicos do Sistema Único de Saúde (SUS) do Distrito Federal, Brasil, três anos após a implantação do Programa Nacional de Segurança do Paciente (PNSP). MÉTODOS estudo transversal analítico realizado em onze hospitais públicos por meio do Safety Attitudes Questionnaire em formato eletrônico. A amostragem estratificada foi calculada, obedecendo à proporção do total de profissionais em cada hospital, assim como a representatividade de cada grupo profissional. Os resultados do escore total e dos domínios iguais ou maiores que 75 foram considerados positivos. Realizadas análises descritivas e inferenciais dos grupos profissionais e dos hospitais. RESULTADOS Participaram 909 profissionais. O escore total por grupo profissional foi negativo (62,5 a 69,5) e por domínio diferiram estatisticamente entre si em todos. Os onze hospitais tiveram escore total negativo (61,5 a 68,6). Os domínios com desempenho positivo foram satisfação no trabalho, percepção do estresse e clima de trabalho em equipe. Os resultados mais baixos foram condições de trabalho e percepção da gerência, e nenhum dos hospitais obteve média superior à 75 nesses domínios. Também foram encontradas diferenças nas médias dos domínios entre os hospitais, exceto em percepção da gerência. DISCUSSÃO Após três anos de implantação no PNSP, a cultura de segurança nos onze hospitais avaliados se mostrou fragilizada, embora os domínios satisfação no trabalho, percepção do estresse e clima de trabalho em equipe tiveram resultados positivos. Os resultados podem contribuir para a tomada de decisão dos gestores, pois a cultura de segurança é um elemento essencial na implementação da política de segurança do paciente.

A Qualitative Study of Smoking-Related Causal Attributions and Risk Perceptions in Cervical Cancer Survivors.

OBJECTIVE: The prevalence of smoking among cervical cancer survivors typically exceeds what is found among women in the general population and other cancer survivors. Yet, there is a dearth of literature on risk and protective factors related to smoking among cervical cancer survivors, especially when it comes to identification of variables that are amendable to intervention. To help fill this gap in the literature, this qualitative study examines the nature of smoking-related causal attributions and risk perceptions in cervical cancer survivors who smoked at cancer diagnosis. METHODS: Participants are 21 female cervical cancer survivors (M=45.7, SD=8.4 years old), all diagnosed in the past five years. Nearly three-quarters of participants reported smoking in the past month. RESULTS: Smoking was not uniformly recognized as a cause of cervical cancer (whether in general or participants' own cancer); the link between smoking and lung, head-neck, and other cancers was more readily accepted. Despite generally weak endorsements of causal attributions, many participants reported smoking significantly increases risk for poor clinical (e.g., recurrence) and quality of life (e.g., pain) outcomes after cervical cancer diagnosis. CONCLUSIONS: Findings suggest cervical cancer survivors may not fully understand or appreciate the role of smoking in cervical cancer risk whereas their beliefs about the role of smoking in cervical cancer prognosis are more well-formed. This study highlights the potential role of causal attributions and risk perceptions in understanding and addressing the smoking-related experience of cervical cancer survivors.

Atitudes de enfermeiros na administração de quimioterápicos em oncologia pediátrica / Nurses' attitudes in the administration of chemotherapy in pediatric oncology / Actitudes de enfermeros en la administración de quimioterápicos en oncología pediátrica

Objetivo: analisar as atitudes de enfermeiros acerca da administração de antineoplásicos em oncologia pediátrica. Método: estudo descritivo, com análise estatística dos dados. Participaram 20 enfermeiros de um hospital de ensino, localizado na capital paulista, que administravam quimioterapia (QT) a crianças e adolescentes. Em 2016, mediante questionário autoaplicável, foram coletados dados de caracterização dos participantes e sobre suas atividades profissionais na administração de QT, que incluíam principais receios e preocupações, além dos potenciais eventos adversos associados à quimioterapia. Resultados: poucos participantes eram especialistas na área de oncologia ou pediatria; a maioria dos profissionais buscou conhecimento e capacitação por iniciativa própria; os enfermeiros classificaram a atividade como complexa e específica para quem possui interesse na área. Conclusão: todos os enfermeiros consideraram a QT o principal tratamento para o câncer infanto-juvenil. O risco de extravasamento e a falta de dispositivos adequados para administração das drogas foram os fatores que mais preocuparam os participantes.

Objective: to examine nurses' attitudes to the administration of antineoplastics in pediatric oncology. Method: this descriptive study used statistical data analysis. The participants were twenty nurses, who administered chemotherapy to children and adolescents at a teaching hospital in São Paulo City. In 2016, data were collected using a self-report questionnaire on the participants' characteristics and their experience with chemotherapy administration, which included the main chemotherapyrelated fears, concerns and potential adverse events. Results: few participants were specialists in the field of oncology or pediatrics; most sought knowledge and capacity-building on their own initiative; and the nurses classified the activity as complex and specific to those with an interest in the field. Conclusion: all the nurses considered chemotherapy the main treatment for childhood cancer. The factors that most concerned the participants were the risk of extravasation and the lack of appropriate devices for drug administration.

Objetivo: analizar las actitudes de enfermeros acerca de la administración de antineoplásicos en oncología pediátrica. Método: estudio descriptivo, con análisis estadística de los datos. Participaron 20 enfermeros de un hospital de enseñanza, ubicado en la capital de São Paulo, que administraban quimioterapia (QT) a niños y adolescentes. En 2016, a través de cuestionario autoaplicable, se recopilaron datos sobre la caracterización de los participantes y sobre sus actividades profesionales en la administración de quimioterapia que incluían los principales temores, preocupaciones y potenciales eventos adversos asociados a la quimioterapia. Resultados: pocos participantes eran especialistas en el área de oncología o pediatría; la mayoría de los profesionales buscó conocimiento y capacitación por iniciativa propia; los enfermeros clasificaron la actividad como compleja y específica para quien tiene interés en el área. Conclusión: todos los enfermeros consideraron la quimioterapia como el tratamiento principal para el cáncer infantil. El riesgo de extravasación y la falta de dispositivos adecuados para la administración de las drogas fueron los factores que más preocuparon a los participantes.

Knowledge, attitudes and practices on tuberculosis transmission and prevention among auxiliary healthcare professionals in three Brazilian high-burden cities: a cross-sectional survey.

BACKGROUND: Tuberculosis elimination requires treatment of latently infected high-risk persons, such as contacts of index cases. Identification and referral of tuberculosis contacts for investigation are major barriers in the contact cascade-of-care. These tasks rely heavily on auxiliary primary healthcare workers in many low- and middle-income countries. We aimed to understand their knowledge, attitudes and practices (KAP) regarding contact investigation in Brazil. METHODS: We conducted a cross-sectional KAP survey on tuberculosis transmission and prevention among 135 auxiliary healthcare workers in three tuberculosis high-burden Brazilian cities. Trained interviewers applied a translated version of a previously applied questionnaire. Open answers were classified in pre-defined objective categories and analysed quantitatively. Answers were further classified as satisfactory or not according to criteria set by a panel of three specialists. RESULTS: Although 66% had received tuberculosis training in the past 10 years, only 19% were trained for tuberculosis prevention. 64% could not clearly distinguish latent tuberculosis infection (LTBI) from active tuberculosis; 63% did not know how to diagnose LTBI and 52% did not know how to prevent progression to active tuberculosis. Most believed that it is important to investigate adult (99%) and child (96%) contacts for LTBI. However, not all invite contacts - children (81%) or adults (71%) - to the clinic, despite only 24% perceiving difficulties for investigation. CONCLUSIONS: Gaps in KAP among auxiliary health workers have been reported in other areas, such as obstetrics and other infectious diseases. To the best of our knowledge, this is the first KAP survey on tuberculosis transmission and prevention among auxiliary health care workers, and relevant gaps were also found. Knowledge gaps were notably related to LTBI management, including how to recognize it and prevent progression to active tuberculosis through treatment, despite most recognizing the importance of investigating contacts. Auxiliary healthcare workers in three Brazilian high-burden cities have important knowledge gaps despite their perception of the importance of tuberculosis prevention among contacts. They need to incorporate contact referral as one of their tasks to enable progress toward the target of tuberculosis elimination.

Effectiveness Evaluation of It's Your Game: Keep It Real, a Middle School HIV/Sexually Transmitted Infection/Pregnancy Prevention Program.

PURPOSE: This study assessed the effectiveness of the HIV/sexually transmitted infection/pregnancy prevention program, It's Your Game: Keep It Real (IYG). METHODS: IYG was implemented by classroom teachers in 24 urban middle schools from 2012 to 2015. Using a quasi-experimental design, each year we surveyed ninth-grade students in 10 high schools that were selected based on feeder patterns from project middle schools. We compared two groups of students (n = 4,562): (1) students whose middle school grade cohorts did not receive IYG ("No-IYG"), and (2) students whose middle school grade cohorts received IYG ("IYG"). Multilevel analyses examined differences between the two groups in the initiation of any type of sexual activity (oral, vaginal, or anal sex), presexual behaviors, and psychosocial mediators. RESULTS: Students in the IYG group were less likely to report initiation of sexual activity by ninth grade compared to students in the No-IYG group (odds ratio .77; 95% confidence interval .66-.90). The IYG group was significantly less likely to have engaged in presexual behaviors, including having been on a date, had a boyfriend/girlfriend, and touched or been touched on private body parts. The IYG group had better outcomes on 11 of 19 psychosocial variables, including knowledge; beliefs about abstinence, sex, friends' beliefs, norms, and behaviors; reasons for not having sex; personal limits; exposure to risky situations; self-efficacy; and quality of dating relationships. CONCLUSIONS: The results suggest that IYG, when implemented on a large scale by trained classroom teachers in urban public schools, had positive impacts on students' behaviors, beliefs, and knowledge.

Photoprotection in adolescents: what they know and how they behave

Abstract: Background: The greatest sun exposure occurs until adolescence and this is the only factor involved in photocarcinogenesis subject to modification with photoprotection. Objective: The objective of this study was to evaluate the habits and knowledge of adolescents regarding photoprotection. Method: Cross-sectional study that included 512 students from primary and high school. Data were collected by questionnaires with questions about habits and knowledge on sun protection. For data analysis, Pearson's Chi-square test and Yates test were applied, with 5% level of significance. Results: We evaluated 512 students, with a mean age of 14 years old. The teenagers agreed that ultraviolet rays cause skin cancer and aging (96% and 70%, respectively). Knowledge about the occurrence of burns even on cloudy days was recorded in 68% of cases, as well as the need for photoprotection for sports in 72%. The source of information about sun protection were by parents in 55%. In 70% was observed previous occurrence of sunburn, the daily use of sunscreens was found in 15% and 67% used only at the beach. of sunscreens with SPF higher than 30 was reported by 70% of students and 57% reported going to the beach between 10h and 16h. In 68% of cases it was registered insufficient sun protection, attributed, in 57% of the time to forgetfulness. Study limitations: The sample refers to two schools of Curitiba (PR), Brazil. Conclusion: Teenagers know the risks of sun exposure, but they do not adopt the practices for adequate protection.

Circulação do poder-saber na constituição das práticas profissionais de médicos e enfermeiros / Circulación del poder-saber en la constitución de las prácticas profesionales de médicos y enfermeros / Circulation of power-knowledge in the constitution of professional practices of physicians and nurses

Objetivo analisar a circulação do poder nas práticas profissionais de médicos e enfermeiros de um Centro de Terapia Intensiva. Método pesquisa qualitativa, com dados coletados por meio de entrevista semiestruturada, com médicos e enfermeiros de Centro de Terapia Intensiva situado em Minas Gerais, Brasil, e submetidos à análise de discurso. Resultado em geral, a equipe médica não se mostrou muito atenta às normas institucionais, sendo os enfermeiros mais envolvidos nos processos normalizadores e disciplinares. A visibilidade do médico está relacionada à legitimação do domínio do saber científico expresso em seu discurso, o que lhe confere posição de detenção do poder, à medida que o enfermeiro tem um discurso que mostra certa resistência em assumir visibilidade e protagonismo na equipe. Conclusão o Centro de Terapia Intensiva é um cenário onde há interseção de diversos saberes especializados, que se expressam nos discursos de médicos e enfermeiros, favorecendo a circulação do poder nas práticas desses profissionais.

Objetivo analizar la circulación del poder en prácticas profesionales de médicos y enfermeros de Centro de Terapia Intensiva. Método investigación cualitativa, con datos recogidos por medio de entrevista semiestructurada, con médicos y enfermeros de Centro de Terapia Intensiva, en Minas Gerais, Brasil, y sometidos al análisis de discurso. Resultado en general, el equipo médico no se mostró muy atenta a las normas institucionales, siendo los enfermeros más involucrados en procesos normalizadores y disciplinarios. La visibilidad del médico está relacionada a la legitimación del dominio del saber científico expresado en discurso, lo que le confiere posición de detención del poder, a medida que el enfermero tiene discurso que muestra cierta resistencia en asumir visibilidad y protagonismo en el equipo. Conclusión el Centro de Terapia Intensiva es escenario donde hay intersección de diversos saberes especializados, que se expresan en discursos de médicos y enfermeros, favoreciendo la circulación del poder en las prácticas de esos profesionales.

Objective analyze the circulation of power in the professional practices of physicians and nurses of an Intensive Care Center. Method This is a qualitative research that uses data collected through semi-structured interview with physicians and nurses of an Intensive Care Center located in Minas Gerais, Brazil, and submitted to discourse analysis. Result in general, the medical team was not very attentive to institutional norms; therefore, nurses were the most involved in normalizing and disciplinary processes. The visibility of physicians is related to the legitimacy of the domain of scientific knowledge expressed in their discourse, which gives them a position of power, as the nurses have a discourse that shows some resistance in assuming visibility and protagonism in the team. Conclusion Intensive Care Center is a scenario where there is an intersection of several specialized knowledge, expressed in the discourses of doctors and nurses, favoring the circulation of power in the practices of these professionals.