Change in perceptions of family nurses about the assumptions of family intervention after the MDAIF formative process

The Dynamic Model of Family Assessment and Intervention (MDAIF) aims to constitute itself as a reference that promotes clinical decision processes based on systemic proposition. This study aimed to evaluate the changes in nurses’ perceptions about the assumptions of family intervention after the training process centered on this referential. This is an exploratory and quantitative study with a sample of 553 family nurses who participated in the “MDAIF” training, organized by the Northern Regional Health Administration, until 2017. A 10 item Likert scale was used with responses between 1 “totally incompetent and 7” “fully competent”, based on MDAIF and applied in the pre and post training periods. T-test was performed for paired samples using SPSS version 23.0. There were very significant statistical changes regarding the perception of competence in all items evaluated, and participants after training perceived with higher competence on the assumptions of family intervention. The results confirm the importance of formative processes based on family health nursing theoretical references. May contribute to the development of family-centered practices as a client, as well as to investigate the health returns resulted from them.info:eu-repo/semantics/publishedVersio

Auto-perceção da competência dos enfermeiros na avaliação e intervenção familiar nas etapas do processo de enfermagem.

info:eu-repo/semantics/publishedVersio

a hospital-based cohort study

Publisher Copyright: © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.OBJECTIVES: Healthcare workers (HCWs) were the first to be prioritised for COVID-19 vaccination. This study aims to estimate the COVID-19 vaccine effectiveness (VE) against SARS-CoV-2 symptomatic infection among HCWs in Portuguese hospitals. DESIGN: Prospective cohort study. SETTING AND PARTICIPANTS: We analysed data from HCWs (all professional categories) from three central hospitals: one in the Lisbon and Tagus Valley region and two in the central region of mainland Portugal, between December 2020 and March 2022. VE against symptomatic SARS-CoV-2 infection was estimated as one minus the confounder adjusted HRs by Cox models considering age group, sex, self-reported chronic disease and occupational exposure to patients diagnosed with COVID-19 as adjustment variables. RESULTS: During the 15 months of follow-up, the 3034 HCWs contributed a total of 3054 person-years at risk, and 581 SARS-CoV-2 events occurred. Most participants were already vaccinated with a booster dose (n=2653, 87%), some are vaccinated with only the primary scheme (n=369, 12.6%) and a few remained unvaccinated (n=12, 0.4%) at the end of the study period. VE against symptomatic infection was 63.6% (95% CI 22.6% to 82.9%) for HCWs vaccinated with two doses and 55.9% (95% CI -1.3% to 80.8%) for HCWs vaccinated with one booster dose. Point estimate VE was higher for individuals with two doses taken between 14 days and 98 days (VE=71.9%; 95% CI 32.3% to 88.3%). CONCLUSION: This cohort study found a high COVID-19 VE against symptomatic SARS-CoV-2 infection in Portuguese HCWs after vaccination with one booster dose, even after Omicron variant occurrence. The small sample size, the high vaccine coverage, the very low number of unvaccinated individuals and the few events observed during the study period contributed to the low precision of the estimates.publishersversionpublishe

COVID-19 vaccine effectiveness: implementation of a cohort study of health care workers from hospitals in Portugal

COVID-19 vaccine effectiveness among healthcare workers in Portugal (Project Research Group): Adriana Silva (Instituto Nacional de Saúde Doutor Ricardo Jorge), Alexandra Lima o que (Centro Hospitalar de Lisboa Ocidental), Ana Catarina Dias (Centro Hospitalar Tondela-Viseu), Ana Paula Rodrigues (Instituto Nacional de Saúde Doutor Ricardo Jorge), André Peralta Santos (Direção-Geral da Saúde), Artur Paiva (Centro Hospitalar Universitário de Coimbra), Ausenda Machado (Instituto Nacional de Saúde Doutor Ricardo Jorge), Baltazar Nunes (Instituto Nacional de Saúde Doutor Ricardo Jorge), Carlos Matias Dias (Instituto Nacional de Saúde Doutor Ricardo Jorge), Carlos Penha Gonçalves (Instituto Gulbenkian de Ciência), Elvira Perea (Centro Hospitalar de Lisboa Ocidental), Inês Costa (Instituto Nacional de Saúde Doutor Ricardo Jorge), Irina Kislaya (Instituto Nacional de Saúde Doutor Ricardo Jorge), Isabel Antunes (Centro Hospitalar Universitário de Coimbra), João Gonçalves (Faculdade de Farmácia da Universidade de Lisboa), João Paulo Gomes (Instituto Nacional de Saúde Doutor Ricardo Jorge), Jocelyne Demengeot (Instituto Gulbenkian de Ciência), Lígia Antunes Gonçalves (Instituto Gulbenkian de Ciência), Lucília Araújo (Centro Hospitalar Universitário de Coimbra), Nuno Verdasca (Instituto Nacional de Saúde Doutor Ricardo Jorge), Palmira Amaral (Centro Hospitalar Tondela-Viseu), Patrícia Conde (Instituto Nacional de Saúde Doutor Ricardo Jorge), Pedro Pinto Leite (Direção-Geral da Saúde), Raquel Guiomar (Instituto Nacional de Saúde Doutor Ricardo Jorge), Sandra Martins (Direção-Geral da Saúde), Vânia Gaio (Instituto Nacional de Saúde Doutor Ricardo Jorge), Vânia Pacheco (Centro Hospitalar Universitário de Coimbra).Num contexto de pandemia, os profissionais de saúde dos hospitais são considerados um grupo de elevado risco para a infeção por SARS-CoV-2 sendo um grupo prioritário para a vacinação. Apesar dos bons resultados da eficácia das vacinas nos ensaios clínicos, são muitos os fatores que podem influenciar a sua eficácia no mundo real (efetividade). Com base num desenho de estudo de coorte prospetivo, desenvolveu-se um projeto cujo objetivo foi avaliar a efetividade da vacina contra a COVID-19 em profissionais de saúde no ambiente hospitalar. Foram recrutados 2367 profissionais de saúde e o seguimento do estudo ocorreu até abril de 2022. A maioria reportou ser enfermeiro (39.8%), do sexo feminino (80,7%) e do grupo etário 40-49 anos (29,5%). Verificou-se ainda que 95,3% dos participantes tinham vacinação completa. Adicionalmente, 3,1% dos profissionais reportou ter tido infeção por SARS-CoV-2 antes da vacinação e 2,8% reportou infeção após vacinação completa. Numa altura em que praticamente toda a população se encontra vacinada contra a COVID-19 é essencial a existência de estudos para o apoio à decisão política na gestão da pandemia e das medidas de saúde pública que possam ser necessárias de implementar.In a pandemic context, healthcare workers from hospitals are considered a high risk group for SARS-CoV-2 infection and are a priority group for vaccination. Despite the good results of vaccine efficacy in clinical trials, there are many factors that can influence the vaccine's efficacy in the real world (effectiveness). Based on a prospective cohort study design, a project was developed to evaluate the effectiveness of the vaccine against COVID-19 in healthcare workers in the hospital environment. 2367 health professionals were recruited and followed until April 2022. The majority reported being a nurse (39.8%), female (80.7%) and aged 40-49 years (29.5 %). It was also found that 95.3% of the participants had complete vaccination. Additionally, 3.1% of the professionals reported SARS-CoV-2 infection before complete vaccination and 2.8% reported infection after complete vaccination. At a time when practically the entire population is vaccinated against COVID-19, it is important to have studies that support the pandemic management policy and the public health measures that could be necessary to implement.info:eu-repo/semantics/publishedVersio

An Inhalable Powder Formulation Based on Micro- and Nanoparticles Containing 5-Fluorouracil for the Treatment of Metastatic Melanoma

Melanoma is the most aggressive and lethal type of skin cancer, with a poor prognosis because of the potential for metastatic spread. The aim was to develop innovative powder formulations for the treatment of metastatic melanoma based on micro- and nanocarriers containing 5-fluorouracil (5FU) for pulmonary administration, aiming at local and systemic action. Therefore, two innovative inhalable powder formulations were produced by spray-drying using chondroitin sulfate as a structuring polymer: (a) 5FU nanoparticles obtained by piezoelectric atomization (5FU-NS) and (b) 5FU microparticles of the mucoadhesive agent Methocel™ F4M for sustained release produced by conventional spray drying (5FU-MS). The physicochemical and aerodynamic were evaluated in vitro for both systems, proving to be attractive for pulmonary delivery. The theoretical aerodynamic diameters obtained were 0.322 ± 0.07 µm (5FU-NS) and 1.138 ± 0.54 µm (5FU-MS). The fraction of respirable particles (FR%) were 76.84 ± 0.07% (5FU-NS) and 55.01 ± 2.91% (5FU-MS). The in vitro mucoadhesive properties exhibited significant adhesion efficiency in the presence of Methocel™ F4M. 5FU-MS and 5FU-NS were tested for their cytotoxic action on melanoma cancer cells (A2058 and A375) and both showed a cytotoxic effect similar to 5FU pure at concentrations of 4.3 and 1.7-fold lower, respectively

Severe scorpion envenomation in Brazil: clinical, laboratory and anatomopathological aspects Escorpionismo grave no Brasil: aspectos clínicos, laboratoriais e anatomopatológicos

Scorpion stings in Brazil are important not only because of their incidence but also for their potential ability to induce severe, and often fatal, clinical situations, especially among children. In this report we present the clinical and laboratory data of 4 patients victims of scorpion stings by T. serrulatus, who developed heart failure and pulmonary edema, with 3 of them dying within 24 hours of the sting. Anatomopathologic study of these patients revealed diffuse areas of myocardiocytolysis in addition to pulmonary edema. The surviving child presented enzymatic, electrocardiographic and echocardiographic changes compatible with severe cardiac involvement, which were reversed within 5 days. These findings reinforce the need for continuous monitoring of patients with severe scorpion envenoming during the hours immediately following the sting.<br>Os acidentes escorpiônicos no Brasil, assumem grande importancia não só pela sua incidência como pela sua potencialidade em induzir quadros clínicos graves, muitas vezes fatais, principalmente em crianças. Apresentamos neste relato os dados clínicos e laboratoriais de 4 pacientes vítimas de escorpionismo, causado pelo T. serrulatus, que evoluíram com falência cardíaca e edema pulmonar, sendo que 3 foram a óbito dentro das primeiras 24 horas após acidente. O estudo anátomopatológico desses pacientes revelou áreas de miocardiocitólise, além do edema pulmonar. Na criança que sobreviveu foram detectadas alterações enzimáticas, eletro e ecocardiográficas compatíveis com grave comprometimento cardíaco, reversíveis dentro de 5 dias. Tais achados reafirmam a necessidade de monitorização contínua no paciente com escorpionismo grave, nas horas subsequentes ao envenenamento