Incident analysis occurrence related to potentially dangerous medicines distributed in teaching hospital. / Análise das ocorrências de incidentes relacionados aos medicamentos potencialmente perigosos dispensados em hospital de ensino.

OBJECTIVE: To analyze the reports of incidents related to potentially hazardous medications distributed at a teaching hospital in the interior of São Paulo. METHODS: A descriptive, retrospective study with a quantitative approach of data from the analysis of pharmacovigilance notifications that occurred between January 2009 and December 2014, from tables and graphs, showing the absolute/relative frequencies. RESULTS: From 786 reports of pharmacovigilance, 188 were related to potentially hazardous medicines, 36.7% of which were ineffective, 32.44% were technical complaints, 15.95% were adverse reactions, 7.44% were phlebitis, 5.13% were extravasation , 1.06% dispensing error, 0.53% administration error and 0.53% medication error. The professionals who most notified were nurses. The most commonly reported pharmacological groups were drugs with action on the nervous system (35.63%). CONCLUSION: The analysis showed that there were a significant number of reports and the need to adopt strategies to ensure greater patient safety.

Depression and anxiety in pregnant women with diabetes or mild hyperglycemia.

INTRODUCTION: A number of physical and psychological changes that occur during pregnancy can stimulate the development of psychological disorders such as anxiety and depression. The study evaluated psychological aspects related to maternal depression and anxiety in pregnant women with diabetes mellitus or hyperglycemia, contrasting the results with those of non-diabetic pregnant women. METHOD: In a prospective and longitudinal approach, two questionnaires were applied and validated for use in Brazil, the Beck depression inventory and the State-Trait Anxiety Inventory. The questionnaires were applied to pregnant women at the first prenatal visit or at the time of disease diagnosis (T1) and reapplied at admission for delivery (T2). Regardless of the degree of hyperglycemia, both at first and in the second stage most women had severe anxiety trait. In early pregnancy (T1), however, severe state anxiety was more frequent in women with hyperglycemia than in those from the NG group. RESULTS: Most pregnant women showed moderate state anxiety over their pregnancy, regardless of glycemic status. In early pregnancy, however, severe state anxiety was more prevalent in hyperglycemic women than in those with normal glycemic status. Most women showed moderate trait anxiety and mild depression in both early and late pregnancy, irrespective of glycemic status. CONCLUSION: The incidence of severe state anxiety in early pregnancy is more frequent in women with diabetes or hyperglycemia, but their levels of trait anxiety and depression are not affected by glycemic status.

Technological prospecting of patents related to monitoring accidents due to falls in hospitals.

OBJECTIVES: to map the production of technologies aimed at monitoring falls in a hospital environment protected by registered patents. METHODS: a technological prospecting of international patents, with a quantitative approach, with search carried out between February and March 2022 in the Derwent Innovations Index database with descriptors fall, hospital, monitoring. RESULTS: 212 patents were found, with the majority filed and published since 2010, by Tran B (9) and Cerner Innovation Inc (9), focused on health technology. Universities were responsible for 13% of deposits. There was a predominance of records from the United States (43.4%), China (21.7%) and Japan (12.3%), in addition to technological strategies classified as devices for the environment (80.7%) and for preventing falls (66.5%) as well as trend towards resources with multiple functionalities in the same technology. CONCLUSIONS: the plurality of functions in the same device reflects the search for optimizing resources and the concern with comprehensive care.

Analysis of patent records related to the prevention and signaling of falls in Brazil.

OBJECTIVE: To analyze patent records aimed at preventing and signaling falls in a Brazilian database. METHOD: Electronic documentary research carried out in the database of the Instituto Nacional da Propriedade Industrial using the word "fall" in the search resource. Patent records related to the prevention and signaling of falls at home and in care environment applied from 2000 to 2021 were included. Tabulated data were evaluated using absolute/relative frequencies. RESULTS: From the 45 patents, 91% were published starting from 2011, with an average of 1214 days between application and publication, 11% of applicants were from public universities and 9% of the inventors were nurses, physician or physical therapists. CONCLUSION: There was a delay in the publication of the patents and small participation of researchers linked to the academic area and health professionals, revealing the need to equip universities and health services in order to guarantee the development of innovations.

Teaching entrepreneurship in undergraduate Nursing course: evaluation of an educational proposal.

OBJECTIVE: To evaluate a proposal for teaching entrepreneurship in an undergraduate Nursing course that uses active methodologies and activities based on the theory of meaningful learning. METHODS: Interventional, prospective study, with a quantitative perspective, with a total of 102 participating students, carried out from July 2017 to December 2019 at a public university in the state of Sao Paulo. Statistical analysis were performed by non-parametric Chi-square or Fisher's exact tests, with differences considered statistically significant if p < 0.05. RESULTS: Improvements were observed in almost all items evaluated, revealing that meaningful learning became more effective with the use of active teaching methodologies. Most students need adaptation and effort to be put into these methods. CONCLUSIONS: The proposal offers pedagogical content adaptation, specifically for nursing students. New research should expand teaching-learning techniques for the development of future nurses, preparing them adequately for the job market.

Cost-effectiveness analysis of intravenous paricalcitol vs. oral calcitriol in the treatment of hyperparathyroidism secondary to chronic kidney disease.

INTRODUCTION: Hyperparathyroidism (SHPT) secondary to chronic kidney disease (CKD) is characterized by high levels of parathyroid hormone (PTH), hyperplasia of the parathyroid glands and cardiovascular disease. Selective and non-selective and selective vitamin D-receptor activators, calcimimetics, are available in the Brazilian market to reduce PTH levels. OBJECTIVES: To develop a cost-effectiveness (C/E) and budgetary impact (BI) analysis of intravenous paricalcitol vs. oral calcitriol for patients on dialysis with SHPT, from the perspective of the Brazilian Public Health Care System (SUS). METHODOLOGY: We built a decision-tree model to analyze C/E, which considered the outcome of avoided death and a time horizon of 1 year. As for the BI analysis, two scenarios were considered, one of demand and one of epidemiological approach, based on data from the Brazilian Society of Nephrology. RESULTS: The analysis showed that the C/E ratio was R$ 1,213.68 per year, and an incremental effectiveness of 0.032, referring to avoided death. The incremental C/E ratio was R$37,927.50 per death averted by paricalcitol. It was estimated that the incremental BI with the expansion of paricalcitol use will be between R$1,600,202.28 and R$4,128,565.65 in the first year, considering the main and epidemiological scenarios. At the end of 5 years after the expansion of its use, an incremental BI was estimated between R$ 48,596,855.50 and R$ 62,90,555.73. CONCLUSION: Intravenous paricalcitol has superior efficacy and similar safety to oral calcitriol, reducing the overall mortality of dialysis patients, although it implies a higher cost.

Exploring the COVID-19 Pandemic's Impact on the Health Technology Assessment Process of the National Commission for the Incorporation of Technologies Into the Brazilian Health System.

OBJECTIVES: This study aimed to evaluate the impact of the COVID-19 pandemic on Brazilian health technology assessment processes based on public reports from the National Committee for Health Technology Incorporation (CONITEC). METHODS: This descriptive study analyzed CONITEC's official reports on Brazil available on its website between 2018 and 2021 that aimed to propose recommendations for technologies to be incorporated into its public healthcare system. We used descriptive statistics covering the number of technologies and number of reports about drugs per year, objective, type of technology, demanding sector, and outcome before 2018 to 2019 and during the COVID-19 pandemic (2020-2021). Furthermore, we used logistic regression to explore any association between the final decision labeled as "incorporated" and the emergence of the COVID-19 pandemic. RESULTS: A total of 278 reports were analyzed. Approximately 85% (136 of 278), 79% (220 of 278), and 45% of the reports (125 of 278) were about drugs, for incorporation, and requested by the government, respectively. Moreover, 74 of 130 (57%) and 56 of 148 decisions (38%) were "incorporated" before and during the pandemic, respectively. No significant association was noted between incorporated decisions and the arrival of the COVID-19 pandemic for all technologies (odds ratio 1.43; 95% CI 0.84-2.46; P = .192) and for drugs (odds ratio 1.43; 95% confidence interval 0.81-2.53; P = .223) while adjusting for the type of technology and demandant. CONCLUSIONS: The COVID-19 pandemic has brought many challenges, but it does not seem to have had a significant impact on the health technology assessment approval decisions of CONITEC in Brazil.

Nursing workload associated with neonatal mortality risk: a cross-sectional study.

OBJECTIVES: to analyze the association between nursing workload and neonatal mortality risk in newborns admitted to the Neonatal Intensive Care Unit. METHODS: this is an observational, cross-sectional study conducted from January 2019 to January 2020. RESULTS: the sample consisted of 399 newborns, 55.4% male, Nursing Activities Score mean of 67.5%, and Score for Neonatal Acute Physiology Perinatal Extension mean of 17.7, revealed itself as a predictor of the risk of death, while gestational age, length of hospitalization, and the first-minute Apgar established a protective relationship. The correlation between workload and neonatal mortality was low (r= 0.23, p=0.0009). CONCLUSIONS: the workload of the nursing team is not associated with the risk of mortality in the Neonatal Intensive Care Unit, as measured by the Nursing Activities Score.

Supplementation of Vitamin D in the Postdelivery Period of Women with Previous Gestational Diabetes Mellitus: Systematic Review and Meta-Analysis of Randomized Trials.

OBJECTIVE: To evaluate the effects of vitamin D supplementation in the postpartum period of women with previous gestational diabetes mellitus (GDM). METHODS: Randomized clinical trials of pregnant women with GDM of any chronological, gestational age and parity, with no history of previous disease who received vitamin D supplementation in the prenatal and/or postpartum period and were evaluated in the postpartum period were included. The PubMed, EMBASE, Cochrane, and LILACS databases were consulted until July 2019. Serum vitamin D concentration (25-hydroxyvitamin D in nmol/L), fasting blood glucose, glycated hemoglobin, serum calcium concentration, homeostatic model assessment of insulin resistance (HOMA-IR), quantitative insulin sensitivity check index (QUICKI), parathyroid hormone (PTH) and body mass index (BMI) were evaluated. Similar results in at least two trials were plotted using the RevMan 5; Cochrane Collaboration, Oxford, Reino Unido. The quality of the evidence was generated according to the classification, development, and evaluation of the classification of the recommendations. RESULTS: Four studies were included in the present review (200 women). The findings indicate that there is no difference in the postpartum period in women diagnosed with previous GDM who received vitamin D supplementation in the prenatal and/or in the postpartum period, showing only that there was a significant increase in the concentration of vitamin D (relative risk [RR]: 1.85; 95% confidence interval [CI]: 1.02-2.68). CONCLUSION: This increase in the concentration of vitamin D should be interpreted with caution, since the assessment of the quality of the evidence was very low. For the other analyzed outcomes, there was no significance between the intervention and control groups, and the outcomes, when analyzed in their strength of evidence, were considered very low and low in their evaluation.

OBJETIVO: Avaliar os efeitos da suplementação de vitamina D no pós-parto de mulheres com diabetes mellitus gestacional (DGM) anterior. MéTODOS: Foram incluídos ensaios clínicos randomizados com gestantes com GDM de qualquer idade cronológica, gestacional e paridade, sem história de doença prévia, que receberam suplementação de vitamina D no pré-natal e/ou no pós-parto e foram avaliadas no pós-parto. As bases de dados consultadas foram PubMed, EMBASE, Cochrane e LILACS, até julho de 2019. Foram avaliados concentração sérica da vitamina D (25-hidroxivitamina D em nmol/L), glicemia de jejum, hemoglobina glicada, concentração sérica de cálcio, modelo de avaliação da homeostase de resistência à insulina (HOMA-IR, na sigla em inglês), índice qualitativo de verificação da sensibilidade à insulina (QUICKI, na sigla em inglês), hormônio da paratireoide (PTH) e índice de massa corpórea (IMC). Resultados semelhantes em pelo menos dois ensaios foram plotados no software RevMan 5; Cochrane Collaboration, Oxford, Reino Unido. A qualidade das evidências foi gerada de acordo com a classificação, o desenvolvimento e a avaliação da classificação das recomendações. RESULTADOS: Quatro estudos foram incluídos na presente revisão (200 mulheres). Os achados indicam que não há diferença no período pós-parto em mulheres com diagnóstico prévio de DMG que receberam suplementação de vitamina D no período pré-natal e/ou pós-parto, mostrando apenas que houve um aumento significativo na concentração de vitamina D (risco relativo [RR]: 1,85; IC [intervalo de confiança] 95%: 1,02­2,68). CONCLUSãO: Este aumento na concentração de vitamina D deve ser interpretado com cautela, uma vez que a avaliação da qualidade das evidências foi muito baixa. Para os demais desfechos analisados, não houve significância entre os grupos intervenção e controle, e os desfechos, quando analisados em sua força da evidência, foram considerados muito baixa e baixa em sua avaliação. PROSPERO: CRD42018110729.

Profile and entrepreneurial intention of nursing students: a comparison between Brazil and Chile.

OBJECTIVE: to identify and compare factors associated with profile, intentions, motivations, and barriers to entrepreneurial behavior of nursing students from Brazil and Chile. METHODS: this cross-sectional study was carried out between March and September 2018 including 889 nursing students. A form was used to assess the socio-demographic profile, professional claims, entrepreneurial intentions and motivations. Statistical analysis used Chi-Square and Fisher's Exact tests, with a 5% significance level, and a simple logistic regression model. RESULTS: there are significant differences between countries in the profile of students and in the motivations studied, but not in professional pretensions and entrepreneurial intentions. Lack of education on the subject reveals itself as an important barrier to entrepreneurship. CONCLUSION: given the lack of teaching entrepreneurship in undergraduate nursing courses and the characteristics inherent to students, education must be appropriate to different cultures to prepare future professionals for other areas of practice.

Accuracy and Effectiveness of Mammography versus Mammography and Tomosynthesis for Population-Based Breast Cancer Screening: A Systematic Review and Meta-Analysis.

We proposed to compare the accuracy and effectiveness of digital breast tomosynthesis (DBT), plus digital or synthetic mammography, with digital mammography alone in women attending population-based breast cancer screenings. We performed a systematic review and included controlled studies comparing DBT with digital mammography for breast cancer screening. Search strategies were applied to the MEDLINE, Embase, LILACS, and CENTRAL databases. With moderate quality of evidence, in 1,000 screens, DBT plus digital mammography increased the overall and invasive breast cancer rates by 3 and 2 (RR 1.36, 95% CI 1.18 to 1.58 and RR 1.51, 95% CI 1.27 to 1.79, respectively). DBT plus synthetic mammography increased both overall and invasive breast cancer rates by 2 (RR 1.38, 95% CI 1.24 to 1.54 and RR 1.37, 95% CI 1.22 to 1.55, respectively). DBT did not improve recall, false positive and false negative rates. However due to heterogeneity the quality of evidence was low. For women attending population-based breast cancer screenings, DBT increases rates of overall and invasive breast cancer. There is no evidence with high or moderate quality showing that DBT compared with digital mammography decreases recall rates, as well as false positive and false negative rates.

Effectiveness of the pelvic floor muscle training on muscular dysfunction and pregnancy specific urinary incontinence in pregnant women with gestational diabetes mellitus: A systematic review protocol.

BACKGROUND: There is ample evidence that gestational diabetes mellitus has a direct influence on urinary incontinence and pelvic floor muscles. There are no standardized pelvic floor muscle exercise programs in the literature for the physiotherapy and differ in the type of exercise, intensity, type and duration of application, and the frequency and duration of treatment sessions. The aim of this systematic review will be to investigate that Pelvic Floor Muscle Training can prevent and/or decrease the pregnancy specific urinary incontinence in women with gestational diabetes mellitus or gestational hyperglycemia. METHODS: We will perform a systematic review according to the Cochrane methodology of Randomized Controlled Trials. An overall search strategy will be developed and adapted for Embase, MEDLINE, LILACS, and CENTRAL databases, with the date of consultation until June 2020. The MeSH terms used will be "Pregnancy", "Hyperglycemia", "Diabetes Mellitus, Type 2", "Diabetes Mellitus, Type 1", "Pregnancy in Diabetics", "Diabetes, Gestational", "Urinary Incontinence", "Pelvic Floor Muscle Strength". Primary outcomes: improvement or cure of pregnancy specific urinary incontinence (which can be assessed by questionnaires, and tools such as tampon test, voiding diary, urodynamic study). Secondary outcomes: improvement of pelvic floor muscle strength (pelvic floor functional assessment, perineometer, electromyography, functional ultrasonography), improved quality of life (questionnaires), presence or absence of postpartum Urinary Incontinence and adverse effects. Quality assessment by Cochrane instrument. Metanalysis if plausible, will be performed by the software Review Manager 5.3. DISCUSSION: The present study will be the first to analyze the effectiveness of pelvic floor exercises in pregnant women with Gestational Diabetes Mellitus or Hyperglycemia, who suffer from pregnancy specific urinary incontinence. Randomized Controlled Trials design will be chosen because they present the highest level of evidence. It is expected to obtain robust and conclusive evidence to support clinical practice, in addition to promoting studies on the theme and contributing to new studies. TRIAL REGISTRATION: Systematic review registration: PROSPERO CRD42017065281.

Technological prospecting of patents related to monitoring accidents due to falls in hospitals / Prospección tecnológica de patentes relacionadas con el seguimiento de accidentes por caídas en hospitales / Prospecção tecnológica de patentes relacionadas ao monitoramento de acidentes por quedas em hospitais

ABSTRACT Objectives: to map the production of technologies aimed at monitoring falls in a hospital environment protected by registered patents. Methods: a technological prospecting of international patents, with a quantitative approach, with search carried out between February and March 2022 in the Derwent Innovations Index database with descriptors fall, hospital, monitoring. Results: 212 patents were found, with the majority filed and published since 2010, by Tran B (9) and Cerner Innovation Inc (9), focused on health technology. Universities were responsible for 13% of deposits. There was a predominance of records from the United States (43.4%), China (21.7%) and Japan (12.3%), in addition to technological strategies classified as devices for the environment (80.7%) and for preventing falls (66.5%) as well as trend towards resources with multiple functionalities in the same technology. Conclusions: the plurality of functions in the same device reflects the search for optimizing resources and the concern with comprehensive care.

RESUMEN Objetivos: mapear la producción de tecnologías destinadas al monitoreo de caídas en un ambiente hospitalario protegido por patentes registradas. Métodos: prospección tecnológica de patentes internacionales, con enfoque cuantitativo, con búsqueda realizada entre febrero y marzo de 2022 en la base de datos Derwent Innovations Index con los descriptores caída, hospital, monitoreo. Resultados: se encontraron 212 patentes, la mayoría presentadas y publicadas desde 2010, por Tran B (9) y Cerner Innovation Inc (9), enfocadas en tecnología de la salud. Las universidades fueron responsables del 13% de los depósitos. Hubo predominio de registros de Estados Unidos (43,4%), China (21,7%) y Japón (12,3%), además de estrategias tecnológicas catalogadas como dispositivos ambientales (80,7%) y para prevenir caídas (66,5%), así como la tendencia hacia recursos con múltiples funcionalidades en una misma tecnología. Conclusiones: la pluralidad de funciones en un mismo dispositivo refleja la búsqueda de optimización de recursos y la preocupación por la atención integral.

RESUMO Objetivos: mapear a produção de tecnologias voltadas para monitoramento de quedas em ambiente hospitalar protegidas por patentes registradas. Métodos: prospecção tecnológica de patentes internacionais, com abordagem quantitativa, com busca realizada entre fevereiro e março de 2022 na base Derwent Innovations Index com os descritores fall, hospital, monitoring. Resultados: foram encontradas 212 patentes, com maioria depositada e publicada a partir de 2010, por Tran B (9) e Cerner Innovation Inc (9), focadas em tecnologia em saúde. As universidades foram responsáveis por 13% dos depósitos. Houve predomínio de registros dos Estados Unidos (43,4%), da China (21,7%) e Japão (12,3%), além de estratégias tecnológicas classificadas como dispositivos para ambiente (80,7%) e para prevenção de quedas (66,5%), bem como a tendência de recursos com múltiplas funcionalidades em uma mesma tecnologia. Conclusões: a pluralidade de funções em um mesmo dispositivo reflete a busca pela otimização dos recursos e a preocupação com a integralidade do cuidado.

Entrepreneurship and Nursing: integrative review.

OBJECTIVE: To identify the knowledge produced on business entrepreneurship in Nursing. METHOD: Integrative literature review in the following databases: Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE, SCOPUS, Web of Science, PubMed, Medline, Latin American and Caribbean Literature in Health Sciences (LILACS), Nursing Database (BDENF), Index Psychology and National Information Center of Medical Sciences of Cuba (CUMED). We included available studies in their totality in the period from 2007 to 2017. RESULTS: 22 articles were included. The categories that emerged from the study are the following: Concepts of entrepreneurship in nursing, Profile of the entrepreneur nurse, Business Diversity, Business Management, Barriers to business entrepreneurship in nursing, Support to entrepreneurial nurses and Entrepreneurship in Nursing Undergraduate. CONCLUSION: There is a need to prepare nurses with adequate skills to increase the capacity to integrate into the labor market and to improve their own well-being and that of society.

Quality of life in patients who undergo conventional or robotic-assisted total laparoscopic hysterectomy: Protocol for a systematic review of randomized controlled trials.

BACKGROUND: Hysterectomy for benign gynecologic diseases, especially dysfunctional uterine bleeding, is one of the most common gynecologic interventions. The uterus can be removed using abdominal, vaginal, laparoscopic, or robotic-assisted laparoscopic hysterectomy. In a robotic-assisted procedure, the surgeon directs the robot while seated at a console in the operating room. This differs from laparoscopic hysterectomy because a "robot" performs the operation, while the surgeon watches a monitor. This systematic review will compare quality of life (QOL) in patients who undergo total robotic-assisted laparoscopic hysterectomy for benign indications and those who undergo conventional laparoscopic surgery. METHODS: We will perform a systematic review according to the Cochrane Methodology for randomized controlled trials. The review will include studies reporting use of QOL metrics to assess patients who undergo total hysterectomy for benign indications using robotic-assisted technique or conventional laparoscopic surgery. QOL will be the primary outcome and will be measured using validated instruments. An overall search strategy will be developed and adapted for Embase, MEDLINE, LILACS, and CENTRAL databases. Two reviewers will independently select the eligible studies, assess the risk of bias, and extract the data from included studies. Similar outcomes measured in at least 2 trials will be plotted in the meta-analysis using Review Manager 5.3. The quality of evidence will be determined using the GRADE approach. RESULTS: This systematic review is designed to provide high quality evidence on QOL in patients undergoing total hysterectomy for benign indications using either robotic-assisted or conventional laparoscopic surgery. CONCLUSION: It is expected that high-quality evidence on QOL can be used to guide decision-making by institutions and clinicians to improve health care; the evidence can also be used in future studies. PROSPERO REGISTRATION NUMBER: PROSPERO CRD 42019129913.

Prenatal care satisfaction: perception of caregivers with diabetes mellitus.

OBJECTIVE: to understand the satisfaction of pregnant women with diabetes who took insulin during pregnancy and prenatal care performed through outpatient and inpatient follow-up. METHOD: a qualitative approach with analysis of 30 pregnant women who underwent prenatal care and participated in a clinical trial study carried out by the research group of the Perinatal Diabetes Research Center of the Hospital das Clínicas, of the Faculdade de Medicina de Botucatu. The data were collected through interviews and analyzed from content analysis. RESULTS: from the category Satisfaction, the following subcategories emerged: facilities and difficulties faced in prenatal care performed through outpatient or inpatient follow-up, demonstrating that the pregnant women were satisfied with the prenatal care offered regardless of the type of follow-up. CONCLUSION: there was satisfaction in both care, but in outpatient care some structural, technical and administrative difficulties were identified, requiring reassessment, in order to guarantee service agility.

Efficacy of vitamin D supplementation in gestational diabetes mellitus: Systematic review and meta-analysis of randomized trials.

BACKGROUND: Trials have examined on the benefits of vitamin D supplementation in pregnant women. OBJECTIVE: This review aimed to evaluate whether oral vitamin D supplements, when given to pregnant women with gestational diabetes mellitus (GDM), would improve maternal and neonatal outcomes, compared with no treatment or placebo. METHOD: We performed a systematic review following Cochrane methodology, and randomized trials were included where pregnant women with GDM received vitamin D supplementation versus placebo/no treatment or vitamin D and calcium versus placebo/no treatment. Primary outcomes were preeclampsia, preterm birth, cesarean delivery, gestational hypertension, and adverse events related to vitamin D supplementation. The search strategies were applied to the following databases: MEDLINE, Embase, LILACS, and CENTRAL. Similar outcomes in at least two trials were plotted using Review Manager 5.3 software. The quality of evidence was generated according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). RESULTS: The total of 1224 references were identified, eleven trials were potentially eligible, and six were included in this review (totaling 456 women). The meta-analysis of frequency of cesarean deliveries did not show significant differences between groups, none of the trials evaluated the remaining primary outcomes. For secondary outcomes, our results suggest that vitamin D supplementation in pregnant women with GDM may reduce newborn complications such as hyperbilirubinemia, polyhydramnios (RR: 0.40, 95% CI: 0.23 to 0.68; RR: 0.17, 95% CI: 0.03 to 0.89; respectively), and the need for maternal or infant hospitalization (RR: 0.13; 95% CI: 0.02 to 0.98; RR: 0.40, 95% CI: 0.23 to 0.69). However, the evidence was of low or very low quality. CONCLUSION: We did not find moderate or high quality evidence indicating that vitamin D supplementation, when compared with placebo, improves glucose metabolism, adverse maternal and neonatal outcomes related to GDM in pregnant women.

Analysis of patent records related to the prevention and signaling of falls in Brazil / Análisis de registros de patentes relacionados con la prevención y señalización de caídas en Brasil / Análise dos registros de patentes relacionadas à prevenção e sinalização de quedas no Brasil

ABSTRACT Objective: To analyze patent records aimed at preventing and signaling falls in a Brazilian database. Method: Electronic documentary research carried out in the database of the Instituto Nacional da Propriedade Industrial using the word "fall" in the search resource. Patent records related to the prevention and signaling of falls at home and in care environment applied from 2000 to 2021 were included. Tabulated data were evaluated using absolute/relative frequencies. Results: From the 45 patents, 91% were published starting from 2011, with an average of 1214 days between application and publication, 11% of applicants were from public universities and 9% of the inventors were nurses, physician or physical therapists. Conclusion: There was a delay in the publication of the patents and small participation of researchers linked to the academic area and health professionals, revealing the need to equip universities and health services in order to guarantee the development of innovations.

RESUMEN Objetivo: Analizar los registros de patentes destinados a la prevención y señalización de caídas en una base de datos brasileña. Método: Búsqueda documental electrónica realizada en la base de datos del Instituto Nacional de Propiedade Industrial utilizando la palabra "caída" en el buscador. Se incluyeron registros de patentes relacionadas con la prevención y señalización de caídas en el hogar y en el ambiente asistencial presentadas desde 2000 hasta 2021. Los datos tabulados se evaluaron mediante frecuencias absolutas/relativas. Resultados: De las 45 patentes, el 91% fueron publicadas a partir de 2011, con un promedio de 1214 días entre presentación y publicación, el 11% de los solicitantes estaban vinculados a universidades públicas y el 9% de los inventores eran enfermeros, médicos o fisioterapeutas. Conclusión: Hubo retraso en la publicación de patentes y poca participación de investigadores vinculados al área académica y profesionales de la salud, revelando la necesidad de equipar universidades y servicios de salud para garantizar el desarrollo de innovaciones.

RESUMO Objetivo: Analisar os registros de patentes voltados para prevenção e sinalização de queda em base de dados brasileira. Método: Pesquisa documental eletrônica realizada na base de dados do Instituto Nacional da Propriedade Industrial utilizando-se a palavra "queda" no recurso de busca. Foram incluídos registros de patentes relacionados à prevenção e sinalização de quedas em domicílio e ambiente de cuidado, depositados no período de 2000 a 2021. Os dados tabulados foram avaliados por meio de frequências absolutas/relativas. Resultados: Das 45 patentes, 91% foram publicadas a partir de 2011, com média de 1214 dias entre depósito e publicação, 11% dos depositantes eram vinculados a universidades públicas e 9% dos inventores eram enfermeiros, médico ou fisioterapeuta. Conclusão: Observou-se morosidade na publicação das patentes e pequena participação de pesquisadores vinculados à área acadêmica e profissionais da saúde, revelando necessidade de instrumentalizar universidades e serviços de saúde a fim de garantir o desenvolvimento de inovações.

Estratégias tecnológicas voltadas para prevenção de quedas em ambiente hospitalar: revisão integrativa / Technological strategies aimed at fall prevention in hospital environments: an integrative review

Resumo Objetivo Identificar o conhecimento produzido sobre estratégias tecnológicas voltadas para prevenção de quedas de adultos no ambiente hospitalar. Métodos Revisão integrativa da literatura realizada nas bases de dados Medical Literature Analysis and Retrieval System Online/National Library of Medicine (MEDLINE/ PubMed), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Scopus e Web of Science publicados no período de 2017 a 2022. Resultados Foram incluídos 19 artigos, a maioria publicado em revistas de Enfermagem (42%). Os temas que emergiram da análise foram: tipos de estratégias tecnológicas, custos, privacidade do paciente e relevância dos profissionais de enfermagem no desenvolvimento, avaliação e utilização dos dispositivos. Conclusão A pesquisa revelou uma gama de recursos tecnológicos voltados para prevenção de quedas disponíveis no mercado que podem ser incorporados nas práticas assistenciais. Cabe aos hospitais definirem qual estratégia aplica-se de forma mais adequada à sua realidade.

Resumen Objetivo Identificar el conocimiento producido sobre estrategias tecnológicas para la prevención de caídas de adultos en el ambiente hospitalario. Métodos Revisión integradora de la literatura realizada en las bases de datos Medical Literature Analysis and Retrieval System Online/National Library of Medicine (MEDLINE/ PubMed), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Literatura Latinoamericana y del Caribe en Ciencias de la Salud (LILACS), Scopus y Web of Science publicados durante el período de 2017 a 2022. Resultados Se incluyeron 19 artículos, la mayor parte publicados en revistas de Enfermería (42 %). Los temas que surgieron del análisis fueron: tipos de estrategias tecnológicas, costos, privacidad del paciente y relevancia de los profesionales de enfermería en el desarrollo, evaluación y utilización de los dispositivos. Conclusión La investigación reveló una variedad de recursos tecnológicos para la prevención de caídas disponibles en el mercado que pueden ser incorporados en las prácticas asistenciales. Cabe a los hospitales definir qué estrategia se aplica de forma más adecuada a su realidad.

Abstract Objective To identify the knowledge produced about technological strategies aimed at fall prevention of adults in hospital environments. Methods This is an integrative literature review conducted in the Medical Literature Analysis and Retrieval System Online/National Library of Medicine (MEDLINE/PubMed), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Latin American and Caribbean Literature in Health Sciences (LILACS), Scopus and Web of Science databases published from 2017 to 2022. Results A total of 19 articles were included, most of them published in nursing journals (42%). The themes that emerged from the analysis were: types of technological strategies, costs, patient privacy and nursing professionals' relevance in device development, assessment and use. Conclusion The research revealed a range of technological resources aimed at fall prevention available in the market that can be incorporated into care practices. Hospitals must define which strategy applies most appropriately to their reality.

Burnout, COVID-19, apoio social e insegurança alimentar em trabalhadores da saúde / Burnout, COVID-19, apoyo social e inseguridad alimentaria en trabajadores de la salud / Burnout, COVID-19, social support and food insecurity in health workers

Resumo Objetivo Avaliar a prevalência de risco para a Síndrome de Burnout entre profissionais da saúde de áreas de atendimento a pacientes com COVID-19, bem como verificar possíveis associações da síndrome com o apoio social percebido e com a insegurança alimentar desses trabalhadores. Métodos Estudo transversal analítico, com trabalhadores de unidades de terapia intensiva (UTI) e de enfermarias de atendimento a pacientes com COVID-19, em um hospital universitário. A coleta de dados foi realizada no período de setembro a outubro de 2021, utilizando os instrumentos: Inventário de Burnout de Maslach (MBI-HSS), Escala Multidimensional de Suporte Social Percebido e Escala de Vivência da Insegurança Alimentar (FIES). A análise estatística utilizou modelos de regressão de Poisson e regressão múltipla de Poisson, sendo consideradas diferenças e associações estatisticamente significativas se p<0,05. Resultados 75 trabalhadores de três enfermarias (48%) e de uma UTI (52%) participaram da pesquisa, sendo que os profissionais são, em sua maioria, do sexo feminino (89,3%), formados(as) como técnicos de enfermagem (66,7%). Em relação ao risco de Síndrome de Burnout , 26,7% dos trabalhadores apresentaram escores para pelo menos uma dimensão da escala, principalmente à referente a alta exaustão emocional (20%); verificou-se a associação positiva entre o risco de desenvolver Síndrome de Burnout e a insegurança alimentar (RP = 1,11; IC95% = (1,04; 1,18); p = 0,002). O número de filhos associou-se significativamente de forma negativa à incidência de Síndrome de Burnout (RP = 0,90; IC95% = (0,83; 0,97); p = 0,008). Conclusão Foram observadas associações positivas de maior risco de SB em profissionais com insegurança alimentar e, também, que o número de filhos atua como fator protetivo ao risco de Síndrome de Burnout , o que pode estar relacionado diretamente ao apoio social percebido.

Resumen Objetivo Evaluar la prevalencia de riesgo de síndrome de burnout en profesionales de la salud de áreas de asistencia a pacientes con COVID-19, así como verificar posibles relaciones del síndrome con el apoyo social percibido y la inseguridad alimentaria de estos trabajadores. Métodos Estudio transversal analítico, con trabajadores de unidades de cuidados intensivos (UCI) y de enfermerías de asistencia a pacientes con COVID-19 en un hospital universitario. La recopilación de datos fue realizada en el período de septiembre a octubre de 2021, utilizando los instrumentos: Cuestionario Maslach de Burnout (MBI-HSS), Escala Multidimensional de Apoyo Social Percibido y Escala de Experiencias de Inseguridad Alimentaria (FIES). En el análisis estadístico se utilizaron modelos de regresión de Poisson y regresión múltiple de Poisson, donde se consideraron diferencias y asociaciones estadísticamente significativas si p<0,05. Resultados Participaron del estudio 75 trabajadores de tres enfermerías (48 %) y de una UCI (52 %), donde los profesionales, en su mayoría, eran de sexo femenino (89,3 %), graduados(as) como técnicos de enfermería (66,7 %). Con relación al riesgo de síndrome de burnout , el 26,7 % de los trabajadores presentó puntuación en por lo menos una dimensión de la escala, principalmente en la referente al alto agotamiento emocional (20 %). Se verificó una asociación positiva entre el riesgo de padecer síndrome de burnout y la inseguridad alimentaria (RP = 1,11; IC95 % = (1,04; 1,18); p = 0,002). El número de hijos se asoció significativamente de forma negativa a la incidencia de síndrome de burnout (RP = 0,90; IC95 % = (0,83; 0,97); p = 0,008). Conclusión Se observaron asociaciones positivas de mayor riesgo de síndrome de burnout en profesionales con inseguridad alimentaria, además de que el número de hijos actúa como factor protector del riesgo de síndrome de burnout , lo que puede estar directamente relacionado con el apoyo social percibido.

Abstract Objective To evaluate the prevalence of risk for Burnout Syndrome among health professionals in areas of care for patients with COVID-19, as well as to verify possible associations of the syndrome with the perceived social support and food insecurity of these workers. Methods Analytical cross-sectional study, with workers from intensive care units (ICU) and wards caring for patients with COVID-19, in a university hospital. Data collection was carried out from September to October 2021, using the instruments: Maslach Burnout Inventory (MBI-HSS), Multidimensional Perceived Social Support Scale and Food Insecurity Experience Scale (FIES). Statistical analysis used Poisson regression models and multiple Poisson regression, considering statistically significant differences and associations if p<0.05. Results A total of 75 workers from three wards (48%) and from one ICU (52%) participated in the survey, and the professionals are mostly female (89.3%), trained as health care technicians (66.7%). Regarding the risk of Burnout Syndrome, 26.7% of the workers had scores for at least one dimension of the scale, mainly referring to high emotional exhaustion (20%). There was a positive association between the risk of developing Burnout Syndrome and food insecurity (PR = 1.11; 95%CI = (1.04; 1.18); p = 0.002). The number of children was significantly negatively associated with the incidence of Burnout Syndrome (PR = 0.90; 95%CI = (0.83; 0.97); p = 0.008). Conclusion Positive associations were observed with a higher risk of BS in professionals with food insecurity and also that the number of children acts as a protective factor against the risk of Burnout Syndrome, which may be directly related to perceived social support.