Microemulsions strongly promoted the activity of α-bisabolol against different Leishmania species and its skin permeation.

This study aimed to develop microemulsions (MEs) containing α-bisabolol for the topical treatment of cutaneous leishmaniasis (CL). Initially, pseudoternary phase diagrams were developed using α-bisabolol as the oil phase, Eumulgin® CO 40 as the surfactant, Polymol® HE as the co-surfactant, and distilled water as the aqueous phase. Two transparent liquid systems (TLS) containing 5% of α-bisabolol were selected and characterized (F5E25 and F5EP25). Next, skin permeation and retention assays were performed using Franz cells. The interaction of the formulation with the stratum corneum (SC) was evaluated using the FTIR technique. The cytotoxicity was evaluated in murine peritoneal macrophages. Finally, the antileishmanial activity of microemulsions was determined in promastigotes and amastigotes of L. amazonensis (strain MHOM/BR/77/LTB 0016). As a result, the selected formulations showed isotropy, nanometric size (below 25 nm), Newtonian behavior and pH ranging from 6.5 to 6.9. The MEs achieved a 2.5-fold increase in the flux and skin-permeated amount of α-bisabolol. ATR-FTIR results showed that microemulsions promoted fluidization and extraction of lipids and proteins of the stratum corneum, increasing the diffusion coefficient and partition coefficient of the drug in the skin. Additionally, F5E25 and F5EP25 showed higher activity against promastigotes (IC50 13.27 and 18.29, respectively) compared to unencapsulated α-bisabolol (IC50 53.8). Furthermore, F5E25 and F5EP25 also showed antileishmanial activity against intracellular amastigotes of L. amazonensis, with IC50 50 times lower than free α-bisabolol and high selectivity index (up to 15). Therefore, the systems obtained are favorable to topical administration, with significant antileishmanial activity against L. amazonensis promastigotes and amastigotes, being a promising system for future in vivo trials.

Hesperetin-Based Hydrogels Protect the Skin against UV Radiation-Induced Damage.

UV radiation can cause damages, such as erythema, skin photoaging, and carcinogenesis. The adoption of protective measures against sun exposure is essential to prevent these damages, and the interest in using natural substances as an alternative for photoprotection is growing. Thus, hesperetin with antioxidant, anti-inflammatory, and anticancer properties is a promising substance to be used with photochemopreventive action and to protect the skin from damage induced by UV radiation. Therefore, the present study aimed to develop a topical formulation based on AAMVPC gel containing hesperetin and evaluate its photoprotective effect on the skin of rats exposed to UVA-UVB radiation. The animals were submitted to the irradiation protocol UVA-UVB, and at the end, erythema, lipid peroxidation, and activity of the antioxidant enzyme catalase and superoxide dismutase were evaluated. Additionally, it evaluated the activity of myeloperoxidase and histological changes. The formulation presented a rheological and spreadability profile suitable for cutaneous application. In vivo results demonstrated that the topical formulation of AAMVPC gel containing hesperetin at a concentration of 10% protected the skin from damage induced by UVA-UVB radiation, with the absence of erythema, lipid lipoperoxidation, and inflammation (low myeloperoxidase activity), and increased catalase and superoxide dismutase activities. The morphology and architecture of the dermo-epidermal tissue of these animals were like those observed under normal conditions (non-irradiated animals). Thus, the results showed that hesperetin was able to protect the animals' skin against UV radiation-induced skin damage and the protection mechanisms may be related to the antioxidant and anti-inflammatory properties of this natural product.

Virtual clinical simulation in nursing education: a concept analysis.

OBJECTIVES: To analyze the concept of virtual clinical simulation in nursing education. METHODS: The Walker and Avant concept analysis model guided the study process and the data collection followed the integrative literature review method. Databases searched were: CINAHL, PubMed, Education Resources Information Center, and Scopus. Search terms and Boolean operators were: e-simulation OR virtual clinical simulation OR computer-simulation OR computer simulation OR virtual gaming OR virtual reality AND nursing education OR nursing. The sample comprised 45 studies. RESULTS: Virtual clinical simulation in nursing education was defined as the innovative teaching and learning technological strategy that provides immersive self-regulated training of nursing practice, reproducing real-life experiences and feedback in a virtual environment that is safe, interactive, dynamic and enjoyable. CONCLUSIONS: Clarification of this concept contributes to the development of a standardized terminology to include in the nursing nomenclature system and its dissemination for the construction of nursing science.

[Understanding advanced practice nursing as a step towards its implementation in BrazilComprender la enfermería de práctica avanzada como un paso hacia su aplicación en Brasil]. / A compreensão da prática avançada de enfermagem como um passo à sua implementação no Brasil.

OBJECTIVE: To describe the elements of the practice of certified nurse-midwives and women's health nurse practitioners in the context of the United States of America in order to facilitate the implementation of advanced practice nursing in Brazil. METHOD: Exploratory case study describing elements of advanced practice nursing in one of the largest hospitals in New York City, United States of America. The practice of certified nurse-midwives and women's health nurse practitioners was observed between April and May 2019. The data were analyzed inductively and a category scheme was developed from the analysis of field notes. RESULTS: The results were organized into the following categories: activities that are commonly performed; foundations that support practice; differential function of these professionals; interaction with other health professionals; barriers to practice; facilitating elements; and results of the practice. CONCLUSIONS: The observation of advanced practice nursing in another context, such as the United States, is a relevant step in the process of its implementation in Brazil. Nursing professionals and other stakeholders need to understand this practice in order to truly support the implementation process.

OBJETIVO: Describir los elementos de la práctica de las enfermeras-parteras certificadas (certified nurse-midwives) y las enfermeras de la salud de la mujer (women's health nurse practitioners) en el contexto de los Estados Unidos de América a fin de facilitar la aplicación de la enfermería de práctica avanzada en Brasil. MÉTODO: Estudio de casos exploratorio con descripción de los elementos de la enfermería de práctica avanzada en uno de los hospitales más grandes de la ciudad de Nueva York, Estados Unidos de América. Se observó la práctica de las enfermeras-parteras certificadas y las enfermeras de la salud de la mujer entre abril y mayo de 2019. Los datos se analizaron de forma inductiva y se elaboró un esquema de categorías a partir del análisis de las notas de campo. RESULTADOS: Los resultados se organizaron en las siguientes categorías: actividades que se realizan comúnmente; fundamentos que sustentan la práctica; función diferencial de estos profesionales; interacción con otros profesionales de la salud; barreras presentes en la práctica; elementos facilitadores; y resultados de la práctica. CONCLUSIONES: La observación de la enfermería de práctica avanzada en otro contexto, como el estadounidense, es un paso relevante en el proceso de aplicación en Brasil. Es necesario que los profesionales de enfermería y otras partes interesadas comprendan esta práctica para poder apoyar verdaderamente el proceso de aplicación.

Delay in Growth in Adolescents: Clinical Validation of a Proposed Nursing Diagnosis.

PURPOSE: This study aims to analyse the accuracy of clinical indicators of the proposed diagnosis of delayed growth in school-aged adolescents. DESIGN AND METHODS: This is a diagnostic accuracy study of 385 adolescents in public schools from July to September 2017 that aimed to assess the accuracy of clinical indicators of the proposed nursing diagnosis of delayed growth; the sensitivity and specificity values were calculated using latent class analysis. RESULTS: Growth velocity less than expected was associated with sensitivity and specificity. The clinical indicator short stature for age and sex showed sensitivity. Low weight for age and sex, stature below genetic target and delayed sexual maturation were specific indicators. CONCLUSION: In a sample of adolescents in public schools in northeastern Brazil, a set of five clinical indicators best indicated delayed growth in adolescents. Two clinical indicators showed sensitivity, and four clinical indicators showed specificity. PRACTICE IMPLICATIONS: This study contributes to refining the diagnostic proposition of delayed growth in adolescents. Accurate measures for nursing diagnoses can help paediatric nurse practitioners confirm or exclude this diagnosis in adolescents with a similar profile.

Clinical validation of the nursing diagnosis of ineffective protection in haemodialysis patients.

AIMS AND OBJECTIVES: To evaluate the clinical validity of indicators of the nursing diagnosis of "ineffective protection" in haemodialysis patients. BACKGROUND: Haemodialysis patients have reduced protection. Studies on the nursing diagnosis of "ineffective protection" are scarce in the literature. The use of indicators to diagnose "ineffective protection" could improve the care of haemodialysis patients. The clinical usefulness of the indicators requires clinical validation. DESIGN: This was a diagnostic accuracy study. METHOD: This study assessed a sample of 200 patients undergoing haemodialysis in a reference clinic for nephrology during the first half of 2015. Operational definitions were created for each clinical indicator based on concept analysis and content validation by experts for these indicators. Diagnostic accuracy measurement was performed with latent class analysis with randomised effects. RESULTS: The clinical indicator of "fatigue" had high sensitivity (p = .999) and specificity (p = 1.000) for the identification of "ineffective protection." Additionally, "maladaptive response to stress" (p = .711) and "coagulation change" (p = .653) were sensitive indicators. The main indicators that showed high specificity were "fever" (p = .987), "increased number of hospitalisations" (p = .911), "weakness" (p = .937), "infected vascular access" (p = .962) and "vascular access dysfunction" (p = .722). CONCLUSION: A set of nine clinical indicators of "ineffective protection" were accurate and statistically significant for haemodialysis patients. Three clinical indicators showed sensitivity, and six indicators showed specificity. RELEVANCE TO CLINICAL PRACTICE: Accurate measures for nursing diagnoses can help nurses confirm or rule out the probability of the occurrence of "ineffective protection" in patients undergoing haemodialysis.

Microemulsion Formulations for the Transdermal Delivery of Lapachol.

This project was carried out to investigate the feasibility of using microemulsions for transdermal delivery of lapachol. From the screening of surfactants and oils, a range of microemulsions were developed using oleic acid, a mixture of Cremophor EL and Tween 20 and water. The solubility of lapachol was determined in these ingredients and in the formulated microemulsions. The microemulsions were characterised using cross-polarising light microscopy, their electrical conductivity, pH, zeta potential and rheology were analysed, and they were also investigated using small-angle X-ray scattering and differential scanning calorimetry. Ex vivo studies were performed using porcine ear skin and Franz diffusion cells to investigate the permeation and retention of lapachol. Systems containing different concentrations of Cremophor EL (8.4-41.6%), Tween 20 (5.4-41.6%) and oleic acid (12-31.9%) are able to form microemulsions. Lapachol was delivered more effectively through the skin from all of the microemulsions tested than by the control (oleic acid). These studies indicated that microemulsions incorporating lapachol were formed successfully and that these enhanced drug delivery and retention in the skin. Microemulsion systems may, therefore, provide promising vehicles for percutaneous delivery of lapachol.

Third-Generation Transdermal Delivery Systems Containing Zidovudine: Effect of the Combination of Different Chemical Enhancers and a Microemulsion System.

This study aimed to examine the influence of the combination of chemical enhancers and a microemulsion on the transdermal permeation of zidovudine (AZT). Ethanol, 1,8-cineole, and geraniol were incorporated in a microemulsion. The droplet size, zeta potential, rheology, and SAXS analysis were performed. The permeation enhancer effect was evaluated using pig ear skin. Snake skin (Boa constrictor) treated with the formulations was also used as a stratum corneum model and studied by attenuated total reflectance-infrared spectroscopy. As a result, it was observed that the incorporation of the chemical enhancers promoted a decrease of the droplet size and some rheological modifications. The 1,8-cineole associated with the microemulsion significantly increased the permeated amount of AZT. Conversely, ethanol significantly increased the quantity of the drug retained in the skin. The probable mechanism for the cineole and ethanol effects was respectively: fluidization and increasing of the diffusion coefficient, and increasing of the partition coefficient. Surprising, geraniol + microemulsion drastically decreased both the permeated and the retained amount of AZT into the skin. Thus, the adequate association of microemulsion and chemical enhancers showed to be a crucial step to enable the topical or transdermal use of drugs.

Pruritus in hemodialysis patients: association with phosphorus intake and serum calcium level. / Prurido no paciente em hemodiálise: associação com ingestão de fósforo e nível sérico de cálcio.

OBJECTIVE: To analyze the association between the occurrence of pruritus and adherence to the prescribed diet, biochemical indicators of renal function and the quality of hemodialysis in chronic renal patients. METHOD: A cross-sectional study performed at a dialysis clinic in the Northeast of Brazil, with 200 patients undergoing hemodialysis in the first half of 2015.To analyze the data, inferential statistics were used, using Chi-Square and Fisher's Exact tests; and Mann Whitney U test. RESULTS: The pruritus was present in 51% of the sample, being associated statistically with phosphorus consumption (P = 0.024) and elevation of serum calcium (P = 0.009). CONCLUSION: Pruritus in chronic renal patients undergoing hemodialysis is influenced by adequate nonadherence to the prescribed diet, in addition to the elevation of biochemical indicators of renal function.

Understanding "patient discharge in leprosy": a concept analysis. / Compreendendo a "alta em hanseníase": uma análise de conceito.

OBJECTIVE: To analyze the concept of patient discharge in leprosy. METHODS: Theoretical study guided in the methodological framework of concept analysis. A bibliographical survey was held from December 2015 to January 2016 using the following bases: SCOPUS, CINAHL, PubMed, LILACS, SCIELO and BDENF, by use of the descriptors "Leprosy" and "Patient Discharge", resulting in 13 studies. RESULTS: The following were identified as possible uses for the concept: discharge by cure, drug use discharge, bacteriological discharge and post-discharge. The attributes defined were completion of multidrug therapy, completion of multidrug therapy for paucibacillary leprosy, completion of multidrug therapy for multibacillary leprosy and cure from leprosy. The presence of an M. leprae infection, symptoms present in skin and peripheral nerves, diagnosis and treatment and leprosy reactions were identified as antecedents. Consequents were exclusion from the active leprosy record and continuity of health care. One case model and one opposing case were presented. CONCLUSIONS: The analysis broadened the concept "discharge in leprosy", providing other meanings than the clinical definition of multidrug therapy.

Analyzing the concept of fluid overload in Chronic Kidney Disease patients in dialysis therapy: an integrative review.

Objective To analyze the concept of fluid overload in Chronic Kidney Disease patients undergoing dialysis therapy and comparing it to the Nursing Diagnosis of Excess fluid volume present in the NANDA International. Method An integrative literature review carried out in the LILACS, CINAHL and SCOPUS databases. Results The sample was comprised of 22 articles. The defining attributes of the concept were: fluid retention, fluid buildup in the body, and weight gain over a short period; while the attributes composing the definition were: fluid retention in the body (intracellular/extracellular space) expressed by weight gain over short period of time. Twenty-one (21) antecedents and 22 consequents of fluid overload in patients with renal disease in dialysis therapy were identified. Conclusion The definition evidenced by the NANDA International taxonomy for the Excess fluid volume Nursing Diagnosis and the components of this diagnosis need to be complemented in order to better target the care of patients with kidney disease undergoing dialysis therapy.

Association of socioeconomic and clinical factors and tissue integrity outcome of patients with ulcers. / Associação dos fatores socioeconômicos e clínicos e o resultado integridade tissular em pacientes com úlceras.

Objective to analyze the association between socioeconomic and clinical factors and indicators of the tissue integrity outcome in nursing among patients with venous ulcers. Methods a cross-sectional study at a university hospital in Natal, RN, Brazil, from February to June 2012, with 50 individuals. To analyze the variables, we used the Spearman correlation test and the Mann-Whitney and Kruskal-Wallis tests at a level of 5%. Results there was a correlation of low intensity between age and the indicators hydration and skin peeling, and family income and necrosis. There was also an association between gender and the indicators temperature, amount of body hair and exudation. Conclusion the associated variables provide important information for the treatment of patients with venous ulcers, and can help reduce ulcer time and the consequent discomfort, limitations and costs. This information should be considered when providing care for patients with a nursing diagnosis of impaired skin integrity and/or impaired tissue integrity.

Mouse genome-wide association and systems genetics identify Asxl2 as a regulator of bone mineral density and osteoclastogenesis.

Significant advances have been made in the discovery of genes affecting bone mineral density (BMD); however, our understanding of its genetic basis remains incomplete. In the current study, genome-wide association (GWA) and co-expression network analysis were used in the recently described Hybrid Mouse Diversity Panel (HMDP) to identify and functionally characterize novel BMD genes. In the HMDP, a GWA of total body, spinal, and femoral BMD revealed four significant associations (-log10P>5.39) affecting at least one BMD trait on chromosomes (Chrs.) 7, 11, 12, and 17. The associations implicated a total of 163 genes with each association harboring between 14 and 112 genes. This list was reduced to 26 functional candidates by identifying those genes that were regulated by local eQTL in bone or harbored potentially functional non-synonymous (NS) SNPs. This analysis revealed that the most significant BMD SNP on Chr. 12 was a NS SNP in the additional sex combs like-2 (Asxl2) gene that was predicted to be functional. The involvement of Asxl2 in the regulation of bone mass was confirmed by the observation that Asxl2 knockout mice had reduced BMD. To begin to unravel the mechanism through which Asxl2 influenced BMD, a gene co-expression network was created using cortical bone gene expression microarray data from the HMDP strains. Asxl2 was identified as a member of a co-expression module enriched for genes involved in the differentiation of myeloid cells. In bone, osteoclasts are bone-resorbing cells of myeloid origin, suggesting that Asxl2 may play a role in osteoclast differentiation. In agreement, the knockdown of Asxl2 in bone marrow macrophages impaired their ability to form osteoclasts. This study identifies a new regulator of BMD and osteoclastogenesis and highlights the power of GWA and systems genetics in the mouse for dissecting complex genetic traits.

[Prevalence of nursing diagnosis of fluid volume excess in patients undergoing hemodialysis]. / Prevalência do diagnóstico de enfermagem Volume de líquidos excessivo em pacientes submetidos à hemodiálise*

OBJECTIVE: To identify the prevalence of nursing diagnosis of fluid volume excess and their defining characteristics in hemodialysis patients and the association between them. METHOD: Cross-sectional study conducted in two steps. We interviewed 100 patients between the months of December 2012 and April 2013 in a teaching hospital and one hemodialysis clinic. The inference was performed by diagnostician nurses between July and September 2013. RESULTS: The diagnostic studied was identified in 82% of patients. The characteristics that were statistically associated: bounding pulses, pulmonary congestion, jugular vein distention, edema, change in electrolytes, weight gain, intake greater than output and abnormal breath sounds. Among these, edema and weight gain had the highest chances for the development of this diagnostic. CONCLUSION: The analyzed diagnostic is prevalent in this population and eight characteristics presented significant association.

Deficient knowledge in patients with heart failure: A study of diagnostic accuracy and etiological relationships.

PURPOSE: To evaluate the accuracy of defining characteristics and causal relationships of the etiological factors of the nursing diagnosis deficient knowledge in individuals with heart failure . DATA SOURCES: An analytical, cross-sectional study on the diagnostic accuracy of the defining characteristics and causal relationships of the etiological factors of the nursing diagnosis. The sample consisted of 140 patients with chronic HF and in outpatient follow-up. The latent class analysis method was used to test the accuracy of measurements and estimate the prevalence of the diagnosis. The calculation of subsequent probabilities and the odds ratio ( were also parameters employed. The study was approved by the Research Ethics Committee of the Federal University of Pernambuco. DATA SYNTHESIS: The diagnosis had an estimated prevalence of 38.57% in the sample. The inaccurate statements about the disease and/or therapy, self-care deficient performance, and inadequate behavior were the clinical indicators that best predicted the presence of the diagnosis and demonstrated the same sensitivity value (1.0000), specificity (1.0000), and 95% confidence interval (0.9999-1.0000) for all. The populations at risk was elderly (OR = 2.12, confidence interval 95% = 1.05-4.27), and illiterate individuals (OR = 2.07, confidence interval 95% = 1.03-4.16) had an approximately twofold great chance of developing havening deficient knowledge. CONCLUSION: The evaluation of the accuracy of clinical indicators, corresponding to the defining characteristics in the study, contributed to screening and diagnostic establishment capacity in clinical practice, and to the translation of theoretical and practical knowledge. IMPLICATIONS FOR NURSING PRACTICE: Accurate clinical indicators of the nursing diagnosis deficient knowledge facilitate the clinical reasoning of nurses and favor the professional's role in the development of health education strategies focused on the acquisition of knowledge about the disease by patients, family members, and caregivers.

OBJETIVO: Avaliar a acurácia das características definidoras e relações causais dos fatores etiológicos do diagnóstico de enfermagem Conhecimento deficiente em pacientes com insuficiência cardíaca. FONTE DE DADOS: Estudo analítico, transversal, sobre a acurácia diagnóstica das características definidoras e relações causais dos fatores etiológicos do diagnóstico de enfermagem. A amostra foi composta por 140 pacientes com insuficiência cardíaca crônica e em acompanhamento ambulatorial. O método de análise de classes latentes foi utilizado para testar as medidas de acurácia e estimar a prevalência do diagnóstico. O cálculo de probabilidades posteriores e a Odds Ratio também foram parâmetros empregados. O estudo teve aprovação do Comitê de Ética em Pesquisa da Universidade Federal de Pernambuco. SÍNTESE DE DADOS: O diagnóstico apresentou prevalência estimada de 38,57% na população. As Declarações imprecisas sobre a doença e/ou terapêutica, Déficit no desempenho do autocuidado e Comportamento inadequado foram os indicadores clínicos que melhor predisseram a presença do diagnóstico e demonstraram o mesmo valor de sensibilidade (1.0000), especificidade (1.0000) e intervalo de confiança 95% (0.9999­1.0000) para todos. As populações em risco Idoso (Odds Ratio = 2.12, intervalo de confiança 95% = 1.05­4.27) e Indivíduos analfabetos (Odds Ratio = 2.07, intervalo de confiança 95% = 1.03­4.16) apresentaram, aproximadamente, duas vezes a chance de desenvolver o conhecimento deficiente. CONCLUSÃO: A avaliação da acurácia dos indicadores clínicos, correspondentes as características definidoras no estudo, contribuiu para a capacidade de triagem e estabelecimento de diagnósticos na prática clínica e para a tradução de conhecimentos teóricos e práticos. IMPLICAÇÕES PARA PRÁTICA DE ENFERMAGEM: Indicadores clínicos acurados do diagnóstico de enfermagem Conhecimento deficiente facilitam o raciocínio clínico do enfermeiro e favorecem a atuação do profissional na elaboração de estratégias de educação em saúde focadas na aquisição do conhecimento sobre a doença por parte de pacientes, familiares e cuidadores.

Middle-Range theory of the nursing diagnosis of sedentary lifestyle in young adults.

OBJECTIVE: To construct a middle-range theory for the nursing diagnosis of Sedentary Lifestyle in young adults. METHODS: A methodological study for the validation of a nursing diagnosis based on a Middle-Range Theory, carried out in six stages: definition of the approach; definition of theoretical-conceptual models; definition of main concepts; development of a pictorial scheme; construction of propositions; establishment of causal relationships and evidence for practice. The theory construction was operationalized through an integrative review and supported by Roy's adaptation model. RESULTS: Three essential attributes were identified; 10 antecedents; 7 clinical consequences; a pictogram, 9 propositions, and 11 causal relationships and evidence for practice. CONCLUSION: The middle-range theory for the nursing diagnosis of Sedentary Lifestyle in young adults was constructed, expanding the understanding of this phenomenon, to be applied in clinical practice by nurses.

Disrupted mother-fetus dyad risk in high-risk pregnancies: a Middle-Range Theory.

OBJECTIVES: to develop and evaluate a Middle-Range Theory for the nursing diagnosis "Disrupted Mother-Fetus Dyad Risk" in high-risk pregnancies. METHODS: this methodological study was conducted in two stages: theory development and evaluation. Dorothea Orem's General Nursing Model was used as the theoretical-conceptual foundation. Evaluation was conducted using the Delphi method with seven judges, and consensus was achieved when the Content Validity Index of the evaluated items was ≥ 0.80. RESULTS: the theory identified 20 elements of the nursing diagnosis "Disrupted Mother-Fetus Dyad Risk" (10 risk factors, 4 at-risk populations, and 6 associated conditions), 14 propositions, and 1 pictogram. After two rounds of evaluation, the theory was considered consistent, with consensus reached for all items, each achieving a Content Validity Index ≥ 0.80. CONCLUSIONS: the Middle-Range Theory included biopsychosocial factors explaining the nursing phenomenon "Disrupted Mother-Fetus Dyad Risk," which aids in nurses' diagnostic reasoning.

Mid-range theory of the nursing diagnosis Overweight.

OBJECTIVE: To build a mid-range theory for the nursing diagnosis Overweight in adolescents and young adults. METHODS: A methodological study in the light of the theoretical frameworks of Roy and of Lopes, Silva and Herdman. A total of 3,925 articles were retrieved and assessed using the State of the Art Through Systematic Review software. The final sample consisted of 28 articles. RESULTS: The findings converged to 3 essential attributes, 13 antecedents, and 7 consequences. A mid-range theory was built consisting of an illustrated diagram, 11 propositions, and 12 causal relationships. FINAL CONSIDERATIONS: From the creation of the theory, it was possible to better understand the nursing diagnosis Overweight within the context of adolescents and young adults. Understanding nursing phenomena contributes to nursing science's advancement and strengthening.

Cultural adaptation and evaluation of the measurement properties of the Facilitator Competency Rubric for clinical simulation facilitators.

OBJECTIVE: translate and adapt the Facilitator Competency Rubric to the Portuguese language and the Brazilian culture, and analyze the measurement properties. METHOD: methodological study that completed the steps of translation, synthesis of translations, back translation, review by a Committee of Experts composed of 7 professionals, testing of the pre-final version with 33 simulation facilitators, and submission to the author of the original instrument. For content validation, the Content Validity Index and the modified Kappa Coefficient were calculated. For reliability, Cronbach's α and the Intraclass Correlation Coefficient were evaluated by 52 and 15 simulation facilitators, respectively. RESULTS: two rounds of content evaluation were carried out, resulting in changes to 19 items in the first evaluation and 3 items in the second. The overall scale achieved a Cronbach's α of 0.98 and an Intraclass Correlation Coefficient of 0.95 to 0.97. CONCLUSION: the Facilitator Competency Rubric was translated and culturally adapted to the Brazilian reality and presented content validity, reliability and stability, with safe results for use in teaching and research.