Ecotoxicity of heavy metals in soil around long-term e-waste recycling sites in Tema and Ashaiman areas of Ghana.

The effect of e-waste recycling activities on the prevalence of metals (Cd, Cu, Hg, Ni, Pb, and Zn) and a metalloid (As) in soil was assessed for four e-waste sites in Ghana. Samples of top- and subsoil were collected from dismantling and burning sections, and the prevalence and the distribution of selected metals were determined using atomic absorption spectroscopy. The concentrations of the metals analyzed were above the background concentrations except for Cd, which was detected at a comparable level to the background levels. Levels of Cu and Pb increased with increasing soil depth. Cd, Zn, As, and Ni levels decreased with increasing soil depth. However, Hg levels showed no recognizable trend in its distribution relative to soil depth. The pollution indices evaluated revealed deterioration of the soil quality at the e-waste sites. Pollution indices are used to categorize soil pollution levels based on cut-off values. Geo-accumulation indices suggested that the soil was very highly polluted with Pb, highly polluted with Cu, and moderately polluted with As, Hg, Cd, and Zn. The enrichment factor values indicated that soil from the studied sites was very highly enriched with Pb (i.e., EF of 9.60 to 63.14; median being 28.51) and significantly enriched with Cu and Hg (i.e., EF of 3.09 to 21.86; median 7.72 for Cu and EF of 1.48 to 25.5; median 10.57 for Hg). The contamination factor analysis revealed very high contamination of soils with Pb. The metals Cu, Zn, As, Ni, Cd, and Hg exhibited moderate to considerable contamination. This study is part of the continuous effort to assist policymakers with scientific information needed to influence policy decisions on environmental management in Ghana.

[Bibliometric analysis of female authorship in original articles in the journal ATENCIÓN PRIMARIA]. / Análisis bibliométrico de la autoría femenina en artículos originales en la revista ATENCIÓN PRIMARIA.

OBJECTIVES: To determine the percentage of female authors in original articles published during 2periods, in the journal of Atención Primaria (Primary Care), and to examine the differences between the categories of authorship (first, last author, and co-author) between both periods. DESIGN: Cross-sectional study. SETTING: Feminine scientific production published during the periods 2007-2008 and 2017-2018. PARTICIPANTS: The study was focused on original articles. MAIN MEASUREMENTS: The following variables were collected in an ad hoc form: gender based on the name of the author, total number of women and men appearing as authors, and order of authorship. Absolute and relative authorship frequencies were calculated, and the χ2 test was used to examine the evolution of the percentages by type of authorship and gender. RESULTS: A total of 108 articles were analysed in 2007-2008, and 100 in 2017-2018. No statistically significant differences were observed between the mean numbers of women authors within and between periods. In 2007-2008 a total of 548 female authors were identified and 540 in 2017-2018, the percentage of female authors was 48.7% and 54.4%, respectively. Only an increase in the percentage of first authors was observed between periods. CONCLUSIONS: Practically one out of every 2authors of original articles published in the journal Atención Primaria was female. There was also a significant increase in the percentage of female first authors between the 2periods. Nevertheless, and despite the greater number of health workers, the number of latest female authors remain unchanged, which points to the persistence of female under-representation.

Preliminary investigation on the occurrence and health risk assessment of antibiotics in cultured tilapia retailed at a commercial outlet in Tema, Ghana.

In Ghana, Nile tilapia is one of the most commonly cultivated fish species. Bacterial infections, which mostly occur in intensive fish farming, are considered to be the most significant health issue facing these culture systems in Ghana's aquaculture industry. To prevent, and treat bacterial infections and promote fish growth, antimicrobials are often used, and in most cases at unregulated doses. However, this misuse and neglect of withdrawal durations for such antimicrobials may result in drug residues showing up in fish edible tissue, posing a risk to human consumers. To evaluate the risk to consumers, this study screened for antibiotic residues in popular tilapia fish sold at a retail outlet in Tema. Using ultra-high-performance liquid chromatography-tandem mass spectrometry (UHPLC/MS/MS), the study analysed the levels of 12 antibiotics present in 24 tilapia samples sold at a retail outlet in Tema. Erythromycin, tetracycline, oxytetracycline, and amoxicillin were detected at varying levels, with frequencies of 20.8 %, 62.5 %, 58.3 %, and 54.2 %, respectively. The highest concentration of 3.521 ± 0.32 µg/kg was found for oxytetracycline, while erythromycin had the lowest concentration (0.276 ± 0.11 µg/kg) in the samples. According to the study, the levels of antibiotics detected in the sampled tilapia were lower than the maximum residue limits (MRL) recommended by the WHO. Additionally, both the hazard quotient (HQ) and hazard index (HI) values were less than one. Therefore, consuming retail farmed tilapia purchased from the commercial outlet in Tema metropolis was deemed to pose no significant risk to human health. However, regular monitoring of antibiotics and other contaminants is necessary to minimise their potential impacts on human health.

Usefulness of Cochrane Skin Group reviews for clinical practice.

BACKGROUND AND OBJECTIVE: Systematic reviews are one of the most important sources of information for evidence-based medicine. However, there is a general impression that these reviews rarely report results that provide sufficient evidence to change clinical practice. The aim of this study was to determine the percentage of Cochrane Skin Group reviews reporting results with the potential to guide clinical decision-making. MATERIAL AND METHODS: We performed a bibliometric analysis of all the systematic reviews published by the Cochrane Skin Group up to 16 August, 2012. We retrieved 55 reviews, which were analyzed and graded independently by 2 investigators into 3 categories: 0 (insufficient evidence to support or reject the use of an intervention), 1 (insufficient evidence to support or reject the use of an intervention but sufficient evidence to support recommendations or suggestions), and 2 (sufficient evidence to support or reject the use of an intervention). RESULTS: Our analysis showed that 25.5% (14/55) of the studies did not provide sufficient evidence to support or reject the use of the interventions studied, 45.5% (25/25) provided sufficient but not strong evidence to support recommendations or suggestions, and 29.1% (16/55) provided strong evidence to support or reject the use of 1 or more of the interventions studied. CONCLUSIONS: Most of the systematic reviews published by the Cochrane Skin Group provide useful information to improve clinical practice. Clinicians should read these reviews and reconsider their current practice.

Development of an ergonomics management model in the workplace: Introduction of the TUGA ergonomics management and analysis model (TEMA).

BACKGROUND: Conducting practical studies in ergonomics requires attention to all aspects of ergonomics with a comprehensive approach and focus on continuous improvement cycles. OBJECTIVE: This study aimed to develop and present an ergonomics management model in the workplace. METHODS: This study was performed using a three-stage Delphi study with 30 experts and a fuzzy analytical hierarchy process. According to the literature review and experts' opinions, the general cycle of the ergonomics management system with eight steps was developed. New methods were formed in two of these eight steps: the 3rd step (developing an ergonomic evaluation method) and the 5th step (creating a cost-benefit evaluation method). RESULTS: The eight implementation steps of the TEMA were determined as follows: 1) Performing task analysis (TTA), 2) Ergonomic hazard identification, 3) Estimating the ergonomic index, 4) Determining control measures, 5) Evaluating cost-benefit parameter, 6) Implementing control measures, 7) Continuous monitoring, and 8) Evaluating the effectiveness of control measures. The Delphi study revealed that the number of deleted parameters includes one item (burnout), and the remaining parameters were 16 items. The mean CVI and CVR values were 0.92 and 0.80, respectively. Cronbach's alpha values for each of the physical, environmental, and cognitive components and the entire model were 0.91, 0.87, 0.85, and 0.89, respectively. CONCLUSION: Using the mentioned management model can be a practical step towards properly evaluating the most critical dimensions of ergonomics in the workplace and optimal planning to implement control measures to establish a dynamic management system to reduce ergonomic risk factors in the workplace.

Evaluation of surveillance system for pneumonia in children below five years, Tema Metropolis, Ghana, 2012 - 2016.

BACKGROUND: We evaluated the pneumonia surveillance system in Tema Metropolis to determine whether it is meeting its objectives and to assess its attributes. DESIGN: Descriptive primary and secondary data analysis. DATA SOURCE: We interviewed health staff on the system's operation and resources. We also extracted 2012-2016 surveillance dataset for under-five pneumonia cases and deaths from the District Health Information Management System for review. PARTICIPANTS: Health staff. INTERVENTION: The Centers for Disease Control (CDC) updated guidelines for evaluating surveillance systems was used to assess system attributes. MAIN OUTCOME MEASURE: state of the pneumonia surveillance system in Tema. RESULTS: A suspected case was defined as fast breathing in any child < 5 years old. The case definition was easy to apply, even at the community level. From 2012 to 2016, a total of 3,337 cases and 54 deaths (case fatality rate 1.6%) was recorded from 13 (23.6%) of 55 health facilities. Two epidemics were missed by the district because data were not being analysed. There were no laboratory data on antimicrobial resistance. Although reporting timeliness increased from 28.1% in 2012 to 83% in 2016, data inconsistencies existed between reporting levels. CONCLUSION: The surveillance system for under-five pneumonia in Tema Metropolis is simple, stable, flexible, timely, but of low sensitivity and acceptability, and only partly meeting its objectives. Major shortcomings are lack of laboratory data, non-use of data and low representativeness. FUNDING: The study was supported by a grant to author DB by the President's Malaria Initiative (PMI) -CDC CoAg 6NU2GGH001876.

Attendee Survey and Practical Appraisal of a Telegram®-Based Dermatology Congress During the COVID-19 Confinement. / Congreso virtual de dermatología realizado a través de Telegram® durante el confinamiento de la COVID-19: organización y evaluación.

INTRODUCTION: The COVID-19 pandemic outbreak introduced dramatic changes in all our lives, daily practice, and medical conferences. In search of a tool to spread dermatologic knowledge during confinement, an online medical meeting was held on April 25th to 26th, 2020. In this study, we aimed to assess the characteristics, opinion and satisfaction of the attendees to a free-of-charge online congress. Secondarily, we intended to explain how this meeting was prepared. MATERIAL AND METHODS: Online survey administered to the attendees to an online congress organised via the Telegram® Messenger App. Its organisation and planning, which needed no financial support and was done by volunteer organisers, moderators and speakers, is described step by step. RESULTS: The satisfaction of both speakers and attendees was very high. All participants considered that this format had a great present and future, and most of them rated it as superior to regular face-to-face meetings. Female gender and predominantly private practice favoured this opinion. DISCUSSION: The COVID-19 pandemic has forced the cancellation of most scientific gatherings. This has been seen by some authors as an excellent opportunity, encouraging medical societies and organisations to lead the change to virtual meetings. Although confinement did not allow real contact, our online meeting showed it was possible to ensure interaction and participation between attendees, moderators and speakers. Dermatologists enjoyed some dermatologic science, even despite the extraordinary circumstances disrupting their daily clinical practice. Most of them felt they were participating in something new and compelling that many felt superior to traditional meetings.

Prophylaxis against postcontrast acute kidney injury (PC-AKI): updates in the ESUR guidelines 10.0 and critical review. / Profilaxis de la lesión renal aguda poscontraste (LRA-PC). Actualización según la guía clínica ESUR 10.0 y revisión crítica.

The European Society of Urogenital Radiology (ESUR) updated its guidelines for prophylaxis against postcontrast acute kidney injury (PC-AKI) in 2018 (ESUR 10.0). These guidelines drastically reduce the indications for prophylaxis against PC-AKI after iodine-based contrast administration, lowering the cutoff for administering prophylaxis to glomerular filtration rates <30ml/min/1.73m2 and eliminating most of the prior risk factors. Moreover, in cases where prophylaxis is considered necessary, the periods of hydration are shorter than in the previous version. These guidelines have been approved by most radiological societies, although they have also been criticized for excessive relaxation regarding risk factors, especially by the nephrological community. In this article, we critically review the changes to the guidelines.

Epidemiological, clinical and virological characteristics of patients with monkeypox. A retrospective study / Características epidemiológicas, clínicas y virológicas de pacientes con viruela símica. Estudio retrospectivo

Abstract Introduction : The outbreak of monkeypox occurred in 2022 and led to a fast spread of the disease worldwide. The goal of this study is to describe the epidemiologi cal, clinical, virological and evolving characteristics of the disorder. Methods : We conducted a retrospective, observational and analytical study between July and October, 2022, in a Dermatology Unit. Results : 124 subjects were included. Mean age was 31.5 years, 123 (99.2%) were men and 75 (60.5%) were HIV positive. The main transmission route was sexual and the incubation period was 7 days. The onset of the rash were the genitalia and perianal region in 74.2% of cases, and median time elapsed until the last scab fell off was 16 days. All patients developed a vesicular rash and 86.3% of them had systemic symptoms. Disease was moderate in 68.5% of patients and complications occurred most often when systemic symptoms and/or disseminated skin disease were present. Proctitis was the most frequent complication (59.4%) and its greater incidence was seen in the population with HIV. No significant difference was observed in real-time PCR cycle threshold values with regards to type of sample or duration of disease. Survival rate was 99.2% and other concomitant sexually transmitted infections were de tected in 33.8% of patients. Discussion : It is important to suspect the disease in subjects with high-risk sexual practices and a consistent clinical presentation. Swab samples of lesions as well as of scabs have proven useful for the diagnosis.

Resumen Introducción : El brote de viruela símica 2022 se ex tendió rápidamente por todo el mundo. El objetivo del presente trabajo es describir las características epide miológicas, clínicas, evolutivas y virológicas. Métodos : Estudio retrospectivo, observacional y analí tico entre julio-octubre del 2022 en pacientes atendidos en una Unidad de Dermatología. Resultados : Se incluyeron 124 individuos. La mediana de edad fue de 31.5 años, siendo 123 (99.2%) hombres y 70 (60.5%) HIV positivos. La vía principal de contagio fue la transmisión sexual y el período de incubación de 7 días. Las lesiones se iniciaron en la región genital y perianal en el 74.2% de los casos y el tiempo hasta la caída de la última costra presentó una mediana de 16 días. Todos desarrollaron exantema vesiculoso, el 86.3% de los individuos presentó síntomas sistémicos. La en fermedad fue moderada en el 68.5% de los pacientes y las complicaciones se observaron con mayor frecuencia en aquellos con síntomas sistémicos y/o enfermedad 61 diseminada. Proctitis fue la complicación más destacada (59.4%) y su mayor incidencia se observó en la población con HIV. No hubo diferencias significativas en los valores de Ct de la qPCR al evaluar tipo de muestra procesada o tiempo de evolución de la enfermedad. La sobrevida fue del 99.2% y en el 33.8% de los pacientes se detectaron otras infecciones concomitantes de transmisión sexual. Discusión : Se debe sospechar la enfermedad en in dividuos con cuadro compatible y prácticas sexuales de riesgo. Las muestras de hisopado de lesiones y de costra resultaron útiles para el diagnóstico.

Insights sobre educação nutricional: uma metassíntese interpretativa qualitativa a partir da perspectiva latino-americana / Insights into nutrition education: a qualitative interpretive meta synthesis from the Latin American perspective

Os estudos sobre educação em saúde têm focado mais no que se ensina do que em quem aprende. Este artigo relata os resultados de uma metassíntese interpretativa qualitativa (QIMS) sobre experiências de pacientes que emergem durante a participação em intervenções educativas sobre alimentação e nutrição na América Latina. Foi realizada uma busca por estudos baseados no paradigma construtivista, hermenêutico ou interpretativo publicados entre 2006 e 2020 abrangendo nove bases de dados, identificando 1.676 registros. Foram contempladas três etapas: I) identificação da amostra por meio de fichas de caracterização e avaliação da qualidade, resultando em nove estudos; II) extração de temas abordados nos resultados da pesquisa para compreensão das experiências de participação, e III) tradução de dados e compreensão sinérgica por meio de integração de experiências, incluindo uma nova categorização de temas. O QIMS gerou sete temas: "conflito social", "insegurança", "sacrifício", "cuidado", "valorização da abordagem", "mudança na compreensão" e "aprendizado". Dado o nível de detalhamento da realidade social em que ocorre a participação, os temas destacam três dimensões cruciais na educação alimentar e nutricional na perspectiva dos pacientes: "história de vida", "configuração alimentar" e "apreciação educativa". A complexidade das experiências dos pacientes exige uma abordagem que reconheça melhor a configuração dentro das dimensões encontradas. Isto exige explorar como as experiências individuais dos pacientes se relacionam com o contexto mais amplo da nutrição e da educação alimentar na região latino-americana.

Studies about health education have focused more on what is taught than on who is learning. This article reports the findings of a qualitative interpretive meta-synthesis (QIMS) on patients' experiences which emerge during participation in educational interventions on food and nutrition in Latin America. A search for studies based on constructivist, hermeneutic or interpretive paradigm published between 2006 and 2020 encompassing nine databases was conducted, identifying 1,676 records. Three stages were contemplated: I) identification of the sample through characterization and quality assessment forms, resulting in nine studies; II) extraction of themes addressed in the research results to understand the participation experiences, and III) translation of data and synergistic comprehension through an integration of experiences, including a new categorization of themes. The QIMS generated seven themes: "social conflict", "insecurity", "sacrifice", "care", "valuing the approach", "change in understanding" and "learning". Given the level of detail regarding the social reality in which participation occurs, the themes highlight three dimensions that are crucial in food and nutrition education from the patients' perspective: "life history", "food configuration" and "educational appreciation". The complexity of patient experiences demands an approach that better acknowledges the configuration within the encountered dimensions. This necessitates exploring how individual patient experiences relate to the broader context of nutrition and food education in the Latin American region.

Efficacy of a Hospital Discharge Transition Plan in the care competence of patients with chronic conditions and their family caregivers: a clinical trial / Eficacia del Plan Transicional de Alta Hospitalaria en la competencia para el cuidado del paciente con condición crónica y su cuidador familiar: ensayo clínico / Eficácia do Plano Transicional de Alta Hospitalar na competência para o cuidado de pacientes com condições crônicas e seu cuidador familiar: ensaio clínico

Objective: to assess the efficacy of a Hospital Discharge Transition Plan in the care competence and in adherence to the therapy of dyads comprised by patients with non-communicable chronic diseases and their caregivers. Method: a controlled and randomized clinical trial; the sample was comprised by 80 dyads of patients with chronic conditions and their caregivers, randomly allocated as follows: 40 to the control group and another 40 to the intervention group. The instruments to characterize the patient-caregiver dyad, the patients' and caregivers' care competence and the patients' adherence to the treatment scale were applied. The " CUIDEMOS educational intervention" was applied to the intervention group; in turn, the control group was provided usual care with the aid of a booklet, with phone follow-up via at month 1. Results: 52.5% of the patients and 81.3% of the caregivers were women. The patients' and caregivers' mean ages were 69.5±12.6 and 47.5±13.1 years old, respectively. The Hospital Discharge Transition Plan increased the scores in the "knowledge", "uniqueness", "instrumental", "enjoying", "anticipation" and "social relations" dimensions, as well as the global care competence of the patients and family caregivers; in addition to the following factors: medications, diet, stimulants control, weight control, stress management, and global adherence to the therapy by the patient. There were no statistically significant differences between the control and intervention groups. Conclusion: the Hospital Discharge Transition Plan increased the patients' and family caregivers' care competence after the intervention, as well as the patients' adherence to the treatment. However, there were no differences between the control and intervention groups, possibly due to the similarity of the activities.

Objetivo: evaluar la eficacia del Plan Transicional de Alta Hospitalaria en la competencia para el cuidado y adherencia terapéutica de la díada paciente-cuidador con enfermedad crónica no transmisible. Método: ensayo clínico aleatorizado controlado; la muestra estuvo conformada por 80 diadas paciente-cuidador con condición crónica asignadas aleatoriamente, 40 diadas al grupo control y 40 al grupo intervención. Se aplicaron los instrumentos de caracterización de la díada paciente-cuidador, competencia para el cuidado del paciente y cuidador y la escala de adherencia al tratamiento del paciente. Se realizó la "Intervención Educativa Cuidemos" al grupo intervención y al grupo control se le brindaron los cuidados habituales con ayuda de un folleto; con seguimiento telefónico al mes. Resultados: el 52,5% de los pacientes son mujeres al igual que el 81,3% de los cuidadores. El promedio de edad en pacientes y cuidadores es de 69,5±12,6 y 47,5±13,1 años. El Plan Transicional de Alta Hospitalaria aumentó los puntajes de las dimensiones, conocimiento, unicidad, instrumental, disfrutar, anticipación y relación y la competencia global del cuidado del paciente y cuidador familiar. También, los factores medicamentos, dieta, control de estimulantes, control del peso, manejo del estrés y la adherencia terapéutica global del paciente. No hubo diferencias estadísticamente significativas entre el grupo control e intervención. Conclusión: el Plan Transicional de Alta Hospitalaria aumenta la competencia para el cuidado del paciente y cuidador familiar post intervención, y también la adherencia del paciente. Sin embargo, no hubo diferencias entre el grupo intervención y control, posiblemente debido a la semejanza de las actividades.

Objetivo: avaliar a efetividade do Plano Transicional de Alta Hospitalar na competência para o cuidado e adesão terapêutica da díade paciente-cuidador com doença crônica não transmissível. Método: ensaio clínico randomizado controlado; a amostra foi composta por 80 díades paciente-cuidador com condição crônica distribuídas aleatoriamente, sendo 40 díades para o grupo controle e 40 para o grupo intervenção. Foram aplicados os instrumentos de caracterização da díade paciente-cuidador, competência do cuidar de pacientes e cuidadores e escala de adesão ao tratamento do paciente. No grupo intervenção foi realizada a " Intervención Educativa Cuidemos " e no grupo controle foram prestados os cuidados habituais, com auxílio de folheto; com acompanhamento telefônico após um mês. Resultados: 52,5% dos pacientes são mulheres, assim como 81,3% dos cuidadores. A idade média dos pacientes e cuidadores é de 69,5±12,6 e 47,5±13,1 anos. O Plano Transicional de Alta Hospitalar aumentou os escores das dimensões conhecimento, singularidade, instrumentalidade, desfrutar, antecipação e relação e competência global do cuidado ao paciente e cuidador familiar. Também os fatores medicamentos, dieta, controle de estimulantes, controle de peso, gerenciamento de estresse e adesão terapêutica geral do paciente. Não houve diferenças estatisticamente significativas entre os grupos controle e intervenção. Conclusão: o Plano Transicional de Alta Hospitalar aumenta a competência para o cuidado do paciente e do cuidador familiar pós-intervenção, e também a adesão do paciente. Porém, não houve diferenças entre os grupos intervenção e controle, possivelmente pela semelhança das atividades.

The Open Algorithm Based on Numbers (ABN) Method: An Effective Instructional Approach to Domain-Specific Precursors of Arithmetic Development.

This article presents the results of a comparative study regarding the impact and contribution of two instructional approaches to formal and informal mathematical reasoning with two groups of Spanish students, aged four and five. Data indicated that for both age groups, children under the ABN method [Open Algorithm Based on Numbers (ABN)] (n = 147) achieved better results than the group under the CBC approach (Closed Algorithms Based on Ciphers) (n = 82), which is the widespread approach in Spanish schools to teach formal and informal mathematical reasoning. Furthermore, the comparative analyses showed that the effect is higher in the group of students who received more instruction on skills considered domain-specific predictors of later arithmetic performance. Statistically significant differences were found in 9 of the 10 dimensions evaluated by TEMA-3 (p < 0.01), as well as on estimation tasks in the number-line for the 5-year-old-group. However, the 4-year-old group only presented significant results in calculation and concepts tasks about informal mathematical reasoning. We discuss that these differences arise by differential exposure to specific number-sense tasks, since the groups proved to be equivalent in terms of receptive vocabulary, processing speed, and working memory. The educational consequences of these results were also analyzed.

Settling fluxes and ecotoxicological risk assessment of fine sedimentary metals in Tema Harbour (Ghana).

Sediment traps were deployed in the Tema Harbour to estimate the settling fluxes of silt-clay particles and associated metals (Fe, Mn, Pb, Cr, Cu, Zn, Ni, Hg, Sn and As) and characterise their potential ecotoxicological risks. The mean daily settling fluxes of the silt-clay particles and associated metals ranged from 42.7 to 85.0gm-2d-1 and 1.3×10-2 to 49.4mgm-2d-1, respectively, and were characterised by large fluctuations at each station. The silt-clay and metal fluxes strongly correlated, indicating the important role of the silt-clay particles in metal transport and distribution in the harbour. Geochemical indices indicated anthropogenic influences on the harbour as the Pb, Cr, Zn, Hg, Sn and As content in the settling silt-clay particles exceeded their average crustal concentrations. Sediment quality guidelines indicated these metals pose appreciable ecotoxicological risks, particularly As. Increasing temporal trends in As necessitates increased pollution control efforts at the harbour.

Modelo teórico-metodológico de elaboração e validação de tecnologia educacional para a área da enfermagem / Modelo teórico-metodológico con el objetivo de crear y validar tecnología educativa para el área de enfermería / Theoretical-methodological model to develop and validate educational technology for the nursing area

Objetivo: apresentar um modelo teórico-metodológico para nortear a elaboração e validação de tecnologia educacional do tipo cartilhas educativas para a área da Enfermagem. Método: trata-se de um estudo teórico-reflexivo, baseado na Taxonomia de Bloom. Resultados: o estudo apresentou um modelo teórico-metodológico que descreve a elaboração do roteiro e conteúdo do material educativo seguindo as recomendações da Taxonomia de Bloom, na dimensão do processo cognitivo. Ainda, apresentou os passos para elaboração e validação de cartilhas educativas: diagnóstico situacional, revisão de literatura e documental, seleção e sumarização de conteúdo, elaboração do roteiro, criação e diagramação de imagens, validação com especialistas e com o público-alvo. Considerações finais: a proposição do modelo teórico-metodológico solidifica o conhecimento da literatura e auxilia enfermeiros e pesquisadores na elaboração de cartilhas educativas com maior rigor científico e passíveis de efetividade.

Objetivo: presentar un modelo teórico-metodológico para orientar la creación y validación de tecnología educativa del tipo folletos didácticos para el área de Enfermería. Método: estudio teórico-reflexivo basado en la Taxonomía de Bloom. Resultados: el estudio presentó un modelo teórico-metodológico que describe la elaboración del guión y contenido del material educativo siguiendo las recomendaciones de la Taxonomía de Bloom, en la dimensión del Proceso cognitivo. También presentó los pasos para crear y validar folletos educativos: Diagnóstico situacional, Revisión de documental y de la literatura, Selección e sumario del contenido, Elaboración del guión, Creación y diagramación de imágenes, y Validación con especialistas y con la población objetivo. Consideraciones finales: la propuesta del modelo teórico-metodológico consolida el conocimiento existente en la literatura y auxilia enfermeros e investigadores en la creación de folletos educativos con mayor rigor científico y buenas perspectivas de efectividad.

Objective: to present a theoretical-methodological framework guiding the development and validation of educational technology, specifically didactic booklets for the Nursing area. Method: this is a theoretical-reflexive study grounded on Bloom's Taxonomy. Results: the study presented a theoretical-methodological model outlining the educational material script and content development in accordance with Bloom's Taxonomy recommendations, in the Cognitive Process dimension. Additionally, it outlined the steps for creating and validating educational booklets: situational analysis, literature and documentary review, content selection and summarization, script development, creation and layout of the illustrations, validation with experts, and validation with the target audience. Final considerations: the theoretical-methodological model proposal consolidates the knowledge existing in the literature and assists nurses and researchers in creating educational booklets with greater scientific rigor, increasing their effectiveness potential.

Assessment of DDT, HCH and PAH contamination and associated ecotoxicological risks in surface sediments of coastal Tema Harbour (Ghana).

This study assessed DDTs, HCHs and PAHs contamination in sediments from the Tema Harbour (Ghana) and the associated ecotoxicological risks. The results showed widespread DDTs, HCHs and PAHs contamination in the harbour sediments with mean concentrations ranging from 6.0-12.8, 2.8-12.7 and 2750-5130µg·kg-1d·w, respectively. The silt-clay and total organic carbon contents of the sediments poorly correlated with the pollutant concentrations. DDTs and HCHs contamination relate to past use of DDT and lindane, which under the anoxic harbour conditions resulted in disproportionately higher concentrations of p,p'-DDD and γ-HCH in the sediments. No conclusion could be drawn on the sources of PAHs as either petrogenic or pyrogenic. The pollutant concentrations in the harbour sediments, particularly γ-HCH, may pose high ecotoxicological risks. In comparison to a previous study, this study indicates there has been a considerable reduction in PAH contamination in the Tema Harbour since the last major oil spill in 2007.

Settling fluxes and sediment accumulation rates by the combined use of sediment traps and sediment cores in Tema Harbour (Ghana).

Settling fluxes and sediment accumulation rates in coastal Tema Harbour (Ghana) were investigated by the combined analyses of results in sediment traps and sediment cores. Sediment traps were deployed at 5 stations within the Tema Harbour at two sampling depths and were retrieved every two weeks till the end of 12weeks to estimate the Settling Fluxes (SFs). Four sediment cores from the harbour were analysed for their radioactivity (7Be, 234Th, 210Pb, 212Pb, 226Ra, 40K and 137Cs) profiles to quantify Sediment Accumulation Rates (SARs). The sediment cores exhibited variable bulk density profiles, indicating highly dynamic and non-steady sedimentation conditions. 7Be-derived gross-estimates of very recent SARs using the constant flux-constant sedimentation (CF-CS) model were in the range of 2.5-9.0g·cm-2·y-1. These values were much lower than the estimated average SFs (15.2-53.8g·cm-2·y-1), indicating sediment resuspension plays an important role. On a decadal time scale, conventional 210Pb sediment dating models did not allow any estimation of SARs in the Tema Harbour. Thus, the 210Pb-based TERESA model was applied to depict a reliable scenario for sedimentation with time-averaged SARs in the range of 1.4-3.0g·cm-2·y-1 and fluxes of matter contributed by the marine inflow and local sources. Sediment accretion rates of 1.7-3cm·y-1 were also inferred, which may pose a moderate problem of sustainability for the Tema Harbour. This study reveals how the geochemical behaviour of different radionuclides with Gamma spectrometry in the marine environment can be used to obtain reliable information on the complex dynamics of Suspended Particulate Matter (SPM), even in a very disturbed and anthropic environment as a coastal harbour area where (1) conventional 210Pb-based dating methods fail and (2) the use of sediment traps and 234Th and 7Be profiles in sediment cores show serious constraints.

Presencia de las distintas áreas quirúrgicas en el Congreso Nacional de Cirugía. Análisis de los últimos 12 años

Introducción: Los trabajos científicos permiten divulgar, compartir y contrastar resultados a terceros. Una de las formas de ver la actividad investigativa de cada especialidad es a través de las presentaciones que realizan en reuniones científicas. Objetivo: Describir el número de presentaciones de las distintas especialidades o áreas quirúrgicas en Chile en el principal congreso realizado a nivel nacional y evaluar si el comportamiento fue distinto durante los años de pandemia por coronavirus. Material y Método: Estudio bibliométrico del Congreso Chileno de Cirugía entre los años 2010 y 2021 evaluando el número total de presentaciones por área quirúrgica, año de presentación y período categorizado en 2010 a 2019 y 2020 a 2021. Se realiza estadística descriptiva y análisis de asociación de medias de publicaciones por área y período. Resultados: Se identificaron 4.462 presentaciones, incluyendo resúmenes orales, póster, videos y jornada de residentes. La media total fue 371,8 trabajos anuales. Coloproctología y Cirugía Gastroesofágica aportaron un total de 616 (13,8%) y 598 (13,4%) respectivamente. La media de presentaciones anuales previo a la pandemia por coronavirus fue de 414, en contraste a los 160 trabajos anuales durante ella, existiendo una disminución significativa de medias de presentaciones por área de 27,6 (± 18,8) a 10,7 (± 8,69) (p < 0,001), sin diferencias sus porcentajes de participación respecto del total (p = 0,776). Conclusión: Coloproctología y Cirugía Gastroesofágica son las áreas quirúrgicas más representadas. Si bien en el período contemporáneo a la pandemia por coronavirus significó una disminución en las presentaciones, no se observó una modificación en el porcentaje de participación de algún área en particular.

Introduction: Scientific studies allow the disclosure, sharing and comparison of results with third parties. One of the ways to see the investigative activity of each medical specialty is through the presentations they make at scientific meetings. Aim: To describe the number of presentations of the different surgical specialties or areas in Chile in the main congress held at a national level and to assess whether the behavior was different during the years of the coronavirus pandemic. Material and Method: Bibliometric study of the Chilean Congress of Surgery between 2010 and 2021, evaluating the total number of presentations by surgical area, year of presentation and two categorized periods (2010 to 2019 and 2020 to 2021). Descriptive statistics and association analysis of publication means by area and period are performed. Results: 4,462 presentations were identified, including oral summaries, posters, videos, and residents' sessions, with a mean of 371.8 per year. Coloproctology and Gastroesophageal Surgery contributed a total of 616 (13.8%) and 598 (13.4%) respectively. The mean number of annual presentations prior to the coronavirus pandemic was 414, in contrast to the 160 annual works during it, with a significant decrease in the mean number of presentations per area from 27.6 (± 18.8) to 10.7 (± 8.69) (p < 0.001), without differences in their percentages of participation with respect to the total (p = 0.776). Conclusion: Coloproctology and Gastroesophageal Surgery are the most represented surgical areas. Although the contemporary period of the coronavirus pandemic meant a decrease in presentations, no change was observed in the percentage of participation in any particular area.

Teoria do autocuidado de orem nas teses de enfermagem brasileira: Estudo bibliométrico / La teoría del autocuidado de orem en las tesis de enfermería brasileñas: Un estudio bibliométrico / Orem's theory of self-care in brazilian nursing theses: A bibliometric study

Objetivos: Caracterizar a produção científica relacionada à Teoria do Autocuidado de OREM nas teses de enfermagem brasileiras disponíveis no banco de testes do portal CAPES. Método: Revisão bibliométrica de caráter descritivo, desenvolvida a partir da análise de teses disponíveis na CAPES. Pesquisa descritiva com Análise de Conteúdo, desenvolvida pela categorização dos conteúdos das teses conforme a utilização da teoria do autocuidado. Resultados: Foram incluídas 10 teses que apresentaram diferentes formas de aplicabilidade da teoria de Orem: validação de protocolo e escala, adaptação, desenvolvimento da consulta de enfermagem e elaboração de instrumento norteador da consulta de enfermagem. As estruturas semânticas relacionadas às categorizações principais de utilização da teoria do autocuidado envolveram: ação, instrumento, condições básicas e suplementares do ser humano e lócus do cuidado. Conclusão: A Teoria de Orem foi utilizada em contextos diversificados, fomentando caminhos para reflexões sobre a construção e aplicação do conhecimento próprio da enfermagem(AU)

Objectives: To characterize the scientific production related to the OREM Self-Care Theory in Brazilian nursing theses available in the CAPES portal theses bank. Method: Bibliographic review of a descriptive nature, developed from the analysis of theses available at CAPES. Descriptive research with Content Analysis, developed from the categorization of the contents of theses according to the use of the theory of self-care. Results: The sample consisted of 10 theses that resembled different forms of applicability of Orem's theory: protocol and scale validation, adaptation, development of a nursing consultation and elaboration of a nursing consultation instrument. The semantic structures related to the main categorizations of use of the selfcare theory are: action, instrument, basic and supplementary human beings and locus of care. Conclusion: Orem's Theory was used in different contexts, encouraging ways to build and apply nursing knowledge. (AU)

Objetivos: Caracterizar la producción científica relacionada con la Teoría del Autocuidado OREM en las tesis de enfermería brasileñas disponibles en el banco de tesis del portal CAPES. Método: Revisión bibliográfica de carácter descriptivo, desarrollada a partir del análisis de tesis disponibles en la CAPES. Investigación descriptiva con Análisis de Contenido, desarrollada a partir de la categorización de los contenidos de tesis según el uso de la teoría del autocuidado. Resultados: La muestra estuvo compuesta por 10 tesis que semejaron diferentes formas de aplicabilidad de la teoría de Orem: validación de protocolo y escala, adaptación, desarrollo de una consulta de enfermería y elaboración de un instrumento de consulta de enfermería. Las estructuras semánticas relacionadas con las principales categorizaciones de uso de la teoría del autocuidado son: acción, instrumento, seres humanos básicos y complementarios y locus del cuidado. Conclusión: la Teoría de Orem fue utilizada en diferentes contextos, fomentando formas de construir y aplicar el conocimiento de enfermería.(AU)

Metodologias ativas de aprendizagem na capacitação de enfermeiros para a prevenção de lesão por pressão / Metodologías de aprendizaje activo en la formación de enfermeras para la prevención de lesiones por presión / Active learning methodologies in training nurses for pressure injury prevention

Objetivos: Caracterizar a produção científica relacionada à Teoria do Autocuidado de OREM nas teses de enfermagem brasileiras disponíveis no banco de testes do portal CAPES. Método: Revisão bibliométrica de caráter descritivo, desenvolvida a partir da análise de teses disponíveis na CAPES. Pesquisa descritiva com Análise de Conteúdo, desenvolvida pela categorização dos conteúdos das teses conforme a utilização da teoria do autocuidado. Resultados: Foram incluídas 10 teses que apresentaram diferentes formas de aplicabilidade da teoria de Orem: validação de protocolo e escala, adaptação, desenvolvimento da consulta de enfermagem e elaboração de instrumento norteador da consulta de enfermagem. As estruturas semânticas relacionadas às categorizações principais de utilização da teoria do autocuidado envolveram: ação, instrumento, condições básicas e suplementares do ser humano e lócus do cuidado. Conclusão: A Teoria de Orem foi utilizada em contextos diversificados, fomentando caminhos para reflexões sobre a construção e aplicação do conhecimento próprio da enfermagem.(AU)

Objectives: To characterize the scientific production related to the OREM Self-Care Theory in Brazilian nursing theses available in the CAPES portal theses bank. Method: Bibliographic review of a descriptive nature, developed from the analysis of theses available at CAPES. Descriptive research with Content Analysis, developed from the categorization of the contents of theses according to the use of the theory of self-care. Results: The sample consisted of 10 theses that resembled different forms of applicability of Orem's theory: protocol and scale validation, adaptation, development of a nursing consultation and elaboration of a nursing consultation instrument. The semantic structures related to the main categorizations of use of the selfcare theory are: action, instrument, basic and supplementary human beings and locus of care. Conclusion: Orem's Theory was used in different contexts, encouraging ways to build and apply nursing knowledge(AU)

Objetivos: Caracterizar la producción científica relacionada con la Teoría del Autocuidado OREM en las tesis de enfermería brasileñas disponibles en el banco de tesis del portal CAPES. Método: Revisión bibliográfica de carácter descriptivo, desarrollada a partir del análisis de tesis disponibles en la CAPES. Investigación descriptiva con Análisis de Contenido, desarrollada a partir de la categorización de los contenidos de tesis según el uso de la teoría del autocuidado. Resultados: La muestra estuvo compuesta por 10 tesis que semejaron diferentes formas de aplicabilidad de la teoría de Orem: validación de protocolo y escala, adaptación, desarrollo de una consulta de enfermería y elaboración de un instrumento de consulta de enfermería. Las estructuras semánticas relacionadas con las principales categorizaciones de uso de la teoría del autocuidado son: acción, instrumento, seres humanos básicos y complementarios y locus del cuidado. Conclusión: la Teoría de Orem fue utilizada en diferentes contextos, fomentando formas de construir y aplicar el conocimiento de enfermería(AU)

Use of bedside ultrasound in the evaluation of acute dyspnea: a comprehensive review of evidence on diagnostic usefulness / Uso de ecografía a pie de cama en la evaluación de la disnea aguda: una revisión exhaustiva de la evidencia sobre su utilidad diagnóstica / Uso de ultrassom à beira do leito na avaliação da dispneia aguda: uma revisão abran-gente das evidencias sobre sua utilidade diagnostica

Introduction: Acute dyspnea is one of the most frequently observed symptoms in emergency departments, which can be caused mainly by pulmonary or cardiac system involvement. Bedside ultrasound is postulated as an inno-vative tool for basic use by the physician, which can complement the physical examination and quickly explore the integrity of thoracic structures. Objectives: To synthesize recent evidence on the use of bedside ultrasound in the evaluation of acute dyspnea. Materials and methods: A bibliographic search was carried out using search terms such as "Bedside Ultrasound" and "Acute Dyspnea," as well as synonyms, which were combined with Boolean operators, in the databases PubMed, ScienceDirect, Embase, EBSCO, and MEDLINE. Results: During the literature review, 10 observational studies, 2 clinical trials and 2 systematic reviews met the inclusion criteria and were ana-lyzed. The use of bedside ultrasound changes the main diagnosis associated with acute dyspnea in more than 60% of cases, the most frequent being acute decompensated heart failure and pneumonia. Protocols such as SEARCH 8Es for the evaluation of dyspnea in the emergency department, has a performance with sensitivity, specificity, positive and negative predictive value parameters above 95%. Conclusions: The current evidence on the use of bedside ultrasound in the management of patients with acute dyspnea in the emergency department is limited, Although the level of evidence is not the best, it suggests that this tool may promote the diagnostic perfomance of acute dyspnea of pulmonary or cardiac causes, improve the time to diagnosis, and enhance physician diagno-stic confidence.

Introducción: La disnea aguda es uno de los síntomas más observados en los servicios de urgencias, que puede estar causada por la afectación del sistema pulmonar o cardiaco. La ecografía a pie de cama se postula como una herramienta innovadora, al complementar la exploración física con la eva-luación rápida de las estructuras intratorácicas. Objetivo: Sintetizar la evidencia reciente sobre el uso de la ecografía a pie de cama en la evaluación de la disnea aguda. Materiales y métodos: Búsqueda bibliográfica utilizando términos de búsqueda como Bedside Ultra-sound y Acute Dyspnea, así como sinónimos, que se combinaron con operadores booleanos, en cinco bases de datos. Resultados: Se evidenció que el uso de la ecografía a pie de cama cambia el diagnóstico principal asociado con la disnea aguda en más del 60 % de los casos, entre los cuales los más frecuentes fueron la insuficiencia cardiaca aguda descompensada y la neumonía. Protocolos como el SEARCH 8Es para la evaluación de la disnea en el servicio de urgencias tiene un rendimiento con parámetros de sensibi-lidad, especificidad, valor predictivo positivo y negativo superiores al 95 %. Conclusión: La evidencia actual sobre el uso de la ecografía a pie de cama en el tratamiento de los pacientes con disnea aguda en el servicio de urgencias es limitada. No obstante, sugiere que esta herramienta puede favorecer el rendimiento diagnóstico de la disnea aguda de causa pulmonar o cardiaca, mejorar el tiempo de diagnóstico y aumentar la confianza del médico en el diagnóstico

Introdução: A dispneia aguda é um dos sintomas mais observados no departamento de emergência, que pode ser causado pela afetação do sistema pulmonar o cardíaco. O ultrassom à beira do leito é proposto como uma ferramenta inovadora, complementando o exame físico com uma rápida ava-liação das estruturas intratorácicas. Objetivo: sintetizar evidências recentes sobre o uso do ultrassom à beira do leito na avaliação da dispneia aguda. Materiais e métodos: Pesquisa de literatura usando termos de busca tais como Bedside Ultrasound e Acute Dyspnea, bem como sinônimos, que foram combinados com operadores booleanos, em cinco bancos de dados. Resultados: O uso do ultrassom á beira do leito mostrou a mudança do principal diagnóstico associa-do com a dispneia aguda em mais de 60% dos casos, sendo o mais frequente a insuficiência cardíaca descompensada aguda e a pneumonia. Protocolos como o SEARCH 8Es para a avaliação da dispneia no serviço de emergência tem um desempenho com parâmetros de sensibilidade, especificidade, valor preditivo positivo e negativo superiores ao 95%. Conclusão: As evidencias atuais sobre o uso do ultrassom á beira do leito no gerenciamento de pa-cientes com dispneia aguda no serviço de emergências são limitadas. No entanto, sugere que esta ferramenta pode favorecer o rendimento diagnóstico da dispneia aguda de causa pulmonar ou car-díaca, melhorar o tempo de diagnóstico e aumentar a confiança do médico no diagnóstico.