eHealth promoting stoma self-care for people with an elimination ostomy: focus group study

Background: The construction of an elimination stoma has a physical, psychological, and social impact on the person. The development of stoma self-care competence contributes to the adaptation to a new health condition and improvement of quality of life. eHealth refers to everything associated with information and communication technology and health care, including telemedicine, mobile health, and health informatics. The use of eHealth platforms by the person with an ostomy, as a digital application that includes websites and mobile phone apps, can bring scientific knowledge and well-informed practices to individuals, families, and communities. It also allows functionalities that enable the person to describe and identify early signs and symptoms and precursors of complications and to be guided to an adequate health response for their problems. Objective: This study aimed to define the most relevant content and features to promote ostomy self-care integrated into an eHealth platform as a digital app or website to be used by patients for self-management of stoma care. Methods: We developed a descriptive, exploratory study with a qualitative approach using the focus group methodology, which was oriented to reach a consensus of at least 80%. A convenience sample of 7 participants consisting of stomatherapy nurses was used. The focus group discussion was recorded, and field notes were taken. The focus group meeting was fully transcribed, and a qualitative analysis was performed. The research question was: Which content and features for ostomy self-care promotion should be integrated into an eHealth platform as a digital app or website? Results: An eHealth platform, which can be a smartphone app or website, for people with ostomy should provide content aimed at promoting self-care, namely in the field of knowledge and self-monitoring, as well as the possibility of interacting with a stomatherapy care nurse. Conclusions: The stomatherapy nurse has a decisive role in promoting adaptation to life with a stoma, namely through the promotion of stoma self-care. Technological evolution has emerged as a useful tool to enhance nursing interventions and promote self-care competence. The development of an eHealth platform aimed at promoting ostomy self-care should include the capabilities for telehealth and help with decision-making regarding self-monitoring and seeking differentiated care.info:eu-repo/semantics/publishedVersio

Patient-physician discordance in assessment of adherence to inhaled controller medication: a cross-sectional analysis of two cohorts

We aimed to compare patient's and physician's ratings of inhaled medication adherence and to identify predictors of patient-physician discordance.(SFRH/BPD/115169/2016) funded by Fundação para a Ciência e Tecnologia (FCT); ERDF (European Regional Development Fund) through the operations: POCI-01-0145-FEDER-029130 ('mINSPIRERS—mHealth to measure and improve adherence to medication in chronic obstructive respiratory diseases—generalisation and evaluation of gamification, peer support and advanced image processing technologies') cofunded by the COMPETE2020 (Programa Operacional Competitividade e Internacionalização), Portugal 2020 and by Portuguese Funds through FCT (Fundação para a Ciência e a Tecnologia).info:eu-repo/semantics/publishedVersio

Swine wastewater treatment using an anaerobic baffled (ARB) and a UASB reactor system

The purpose of this study was to assess the swine wastewater treatment system, consisting of the anaerobic baffled reactor (ABR), followed by the upflow anaerobic sludge blanket (UASB) reactor at full scale. The system was monitored by analyzing samples collected in the influent and effluent of ABR and UASB. The following parameters were analyzed: temperature, pH, total suspended solids (TSS), volatile suspended solids (VSS), biochemical oxygen demand (BOD), and chemical oxygen demand (COD). Averages of total removal of COD and BOD were 96.7 and 98.4%, respectively. The mean concentrations of COD, BOD, TSS, and VSS at the final effluent were 611, 124, 138, and 134 mg L-1, respectively. The mean volumetric organic loadings (VOL) at the ABR and UASB were 10.29 and 0.99 kg COD m-1d-1. Therefore, the ABR-UASB system was found to be a promising alternative for the swine wastewater treatment

Avaliação de gestantes admitidas em um hospital público segundo a classificação de Robson / Evaluation of admitted pregnant in a public hospital according to Robson classification

A Classificação de Robson é utilizada para avaliar taxas de cesarianas entre hospitais, composta por dez grupos, sendo cada gestante classificada em um único grupo de acordo com suas características obstétricas. Objetivo: classificar as gestantes admitidas para parto em um Hospital Maternidade Público do Oeste Paulista segundo os critérios de Robson.  Estudo exploratório, retrospectivo, de natureza quantitativa e descritiva, por meio de pesquisas em prontuários de 300 gestantes admitidas para partos no segundo semestre de 2017, no período de 25 de junho a 25 de julho de 2018.  Em uma comparação entre dois estudos apontaram que as gestantes são comumente classificadas entre 1 e 3, embora a cesárea prevalecer, pelo fato dos hospitais serem de alto risco. Os resultados demonstraram que 161 (53,67%) gestantes foram classificadas de 1 a 4. Esses indicadores permitiram identificar que a maioria da população estudada é elegível para o parto normal conforme suas características obstétricas

PERSPECTIVAS FARMACOLÓGICAS NO TRATAMENTO DO AUTISMO INFANTIL: UMA REVISÃO INTEGRATIVA

Childhood autism is a neurodevelopmental disorder characterized by difficulties in social communication, interaction and repetitive behavior patterns. This study aims to carry out an integrative review of the pharmacological interventions used in the treatment of childhood autism, focusing on current approaches. Understanding these interventions is crucial to optimizing clinical management and improving the quality of life of affected children. An integrative literature review was conducted, searching for scientific articles in indexed databases, using descriptors related to childhood autism and pharmacological interventions. Studies investigating the use of drugs in the treatment of autism were included, focusing on recent and relevant approaches. The references were analyzed and organized according to the Vancouver style. Several pharmacological interventions used in the treatment of childhood autism were identified, with methylphenidate and cannabinoids standing out. These have shown positive effects in improving symptoms related to attention and hyperactivity. In addition, studies have pointed to pathophysiological changes, such as immunoregulation, inflammation, oxidative stress and mitochondrial dysfunction, which may offer additional therapeutic targets for future approaches. The integrative review demonstrates the diversity of pharmacological interventions available for the treatment of childhood autism, highlighting the need for a personalized and interdisciplinary approach. The individualization of treatment, taking into account individual characteristics and clinical peculiarities, is fundamental. In addition, the long-term safety and efficacy of pharmacological interventions must be carefully monitored. This study contributes to the current understanding of pharmacological therapeutic options and offers insights for future research in this field.O autismo infantil é um transtorno do neurodesenvolvimento caracterizado por dificuldades na comunicação social, interação e padrões de comportamento repetitivos. O presente estudo visa realizar uma revisão integrativa das intervenções farmacológicas utilizadas no tratamento do autismo infantil, com foco nas abordagens atuais. O entendimento dessas intervenções é crucial para otimizar o manejo clínico e melhorar a qualidade de vida das crianças afetadas. Foi conduzida uma revisão integrativa da literatura, com a busca de artigos científicos nas bases de dados indexadas, utilizando descritores relacionados ao autismo infantil e intervenções farmacológicas. Foram incluídos estudos que investigaram o uso de fármacos no tratamento do autismo, com foco em abordagens recentes e relevantes. As referências foram analisadas e organizadas conforme o estilo de Vancouver. Foram identificadas diversas intervenções farmacológicas utilizadas no tratamento do autismo infantil, com destaque para o metilfenidato e os canabinóides. Estes mostraram efeitos positivos na melhoria dos sintomas relacionados à atenção e hiperatividade. Além disso, estudos apontaram para alterações fisiopatológicas, como imunorregulação, inflamação, estresse oxidativo e disfunção mitocondrial, que podem oferecer alvos terapêuticos adicionais para abordagens futuras. A revisão integrativa demonstra a diversidade de intervenções farmacológicas disponíveis para o tratamento do autismo infantil, evidenciando a necessidade de uma abordagem personalizada e interdisciplinar. A individualização do tratamento, considerando características individuais e peculiaridades clínicas, é fundamental. Além disso, a segurança e eficácia a longo prazo das intervenções farmacológicas devem ser cuidadosamente monitoradas. Este estudo contribui para o entendimento atual das opções terapêuticas farmacológicas e oferece insights para futuras pesquisas nesse campo

Depression, anxiety, stress, and social support: a cross-sectional study with caregivers of visually impaired children in Rio de Janeiro, Brazil - Views-QoL Study.

We aimed to identify the reports of symptoms of depression, anxiety, and stress among caregivers of children without visual impairment, with low vision, and with blindness and their relationship with the degree of social, emotional, material, and affective support. This cross-sectional and multicenter study was conducted in the municipality of Rio de Janeiro, Brazil, from 2019 to 2020. A questionnaire was applied to obtain caregivers' sociodemographic and economic data. The Medical Outcomes Study Social Support Scale (MOS-SSS) and The Depression, Anxiety, and Stress Scale (DASS-21) were used. Tests were used for multiple comparisons of these scales. The prevalence ratio of symptoms of depression, anxiety, and stress was estimated. Of all caregivers (N = 355), more than 90% were women-mothers. Caregivers of children with visual impairment show the highest proportion of no schooling, incomplete elementary education, or lower average monthly income. Most caregivers of children with blindness reported symptoms of depression, anxiety, and stress (66.7%, 73.3%, and 80%, respectively) as did those of children with low vision. The evaluation of the relationship between MOS-SSS and DASS-21 results shows greater support and lower scores of reports of depression, anxiety, and stress for caregivers of children without disabilities or with less visual impairment. For caregivers of blind children, the highest prevalence of such reports was independent of the received support. Results indicate the need for a care policy with mechanisms to protect the mental health of caregivers of visually impaired children

Prevenção de alto índice de massa corporal e transtornos alimentares: meta-análise

Transtornos alimentares (TA) e o alto Índice de Massa Corporal (IMC) são dois problemas de saúde pública com impactos significativos na saúde e nos custos. Estudos anteriores foram realizados para estabelecimento de intervenções eficazes na prevenção desses problemas. Este artigo tem por objetivo estabelecer as intervenções na prevenção de transtornos alimentares e do alto índice de massa corporal através de ensaios controlados randomizados ou quase randomizados. As bases de dados eletrônicas foram pesquisadas em outubro de 2022, cujos critérios de inclusão foram artigos que constituíram ensaios randomizados ou quase randomizados que avaliaram alguma intervenção preventiva e relataram transtornos alimentares relacionados aos resultados de IMC. A síntese narrativa quanto a meta-análise foram utilizadas para sintetizar os resultados. O viés de publicação também foi investigado. Dos estudos incluídos nesta análise (figura 01) o principal objetivo deles foi a prevenção de transtornos alimentares (n=23), prevenção de IMC alto (n=21) e prevenção de TA e IMC alto (n=10). Os resultados da meta-análise indicaram que as intervenções preventivas tiveram um efeito significativo em vários resultados como preocupações com a forma e peso, insatisfação corporal, afeto negativo, sintomas de transtorno alimentar e internalização, com tamanhos de efeito variando de -0,16 (IC 95% - 0,27, - 0,06) a – 0,61 (IC 95% - 0,29, - 0,04). Apesar de vários estudos que demonstraram impactos positivos no IMC, não houve efeito significativo nas medidas relacionadas ao IMC na meta-análise. O risco de viés de publicação foi baixo para a maioria dos resultados de efeito agrupado. As intervenções preventivas foram eficazes para IMC alto ou TAs. Contudo, as evidências são limitadas para mostrar que as atuais intervenções preventivas foram eficazes na redução de ambos os resultados. Mais pesquisas são necessárias para explorar os fatores de risco que são compartilhados por esses distúrbios relacionados ao peso, bem como intervenções de prevenção eficazes

MANEJO DA DOR EM RECÉM-NASCIDOS INTERNADOS EM UNIDADE DE TERAPIA INTENSIVA NEONATAL - UMA REVISÃO INTEGRATIVA

The objective was to identify the methods used to manage neonatal pain in the neonatal intensive care unit (NICU). This is an integrative review with a qualitative approach. As an instrument to elaborate the guiding question, the PICo strategy was used, implemented with the objective of directing the search for scientific evidence. This research had as a guiding question: What methods are used to manage pain in newborns admitted to the Neonatal Intensive Care Unit? The collection was carried out in the MEDLINE, LILACS and BDENF databases. We preferred to search for complete works, in Portuguese and English, published between 2016 to 2021 and that addressed the objective of the work. Papers that did not address the subject of interest were excluded, as well as publications with the presence of duplicity. Among the most used pain management methods in neonatal intensive care units, the following stand out: maternal heartbeat, the smell and taste of breast milk, non-nutritive sucking, use of music, skin-to-skin contact, shantala, balneotherapy, bath immersion and administration of sucrose. It was concluded that pain assessment has become a common practice in neonatal units in order to optimize pain relief.El objetivo fue identificar los métodos utilizados para el manejo del dolor neonatal en la unidad de cuidados intensivos neonatales (UCIN). Se trata de una revisión integradora con un enfoque cualitativo. Como instrumento para la elaboración de la pregunta orientadora se utilizó la estrategia PICo, implementada con el objetivo de orientar la búsqueda de evidencia científica. Esta investigación tuvo como pregunta orientadora: ¿Cuáles son los métodos utilizados para el manejo del dolor en los recién nacidos ingresados ​​en la Unidad de Cuidados Intensivos Neonatales? La recolección se realizó en las bases de datos MEDLINE, LILACS y BDENF. Preferimos buscar trabajos completos, en portugués e inglés, publicados entre 2016 a 2021 y que abordaran el objetivo del trabajo. Se excluyeron los trabajos que no abordaran el tema de interés, así como las publicaciones con presencia de duplicidad. Entre los métodos de manejo del dolor más utilizados en las unidades de cuidados intensivos neonatales destacan: latido materno, olor y sabor de la leche materna, succión no nutritiva, uso de música, contacto piel a piel, shantala, balneoterapia, baño. inmersión y administración de sacarosa. Se concluyó que la evaluación del dolor se ha convertido en una práctica común en las unidades neonatales con el fin de optimizar el alivio del dolor.O objetivo foi identificar os métodos utilizados para o manejo da dor neonatal na unidade de terapia intensiva neonatal (UTIN). Trata-se de uma revisão integrativa de abordagem qualitativa. Utilizou-se como instrumento para elaborar a pergunta norteadora, a estratégia PICo, implementada com o objetivo de direcionar na busca de evidencias cientificas. Essa pesquisa teve como questão norteadora: Quais os métodos utilizados para o manejo da dor em recém-nascidos internados em Unidade de Terapia Intensiva Neonatal? A coleta foi realizada nos bancos da MEDLINE, LILACS e BDENF. Preferiu-se pela busca de trabalhos completos, nos idiomas português e inglês, publicados entre 2016 a 2021 e que abordavam o objetivo do trabalho. Excluiu-se trabalhos que não abordavam o assunto de interesse, assim como publicações com presença de duplicidade. dentre os métodos para manejo da dor mais utilizados nas unidades de terapia intensiva neonatal, destacam-se: batimentos cardíacos maternos, o cheiro e sabor do leite materno, sucção não nutritiva, uso da música, contato pele a pele, shantala, balneoterapia, banho de imersão e a administração da sacarose. Concluiu-se que a avaliação da dor se tornou uma prática habitual em unidades neonatais a fim de otimizar o alívio da dor

Longer-term effectiveness of a heterologous coronavirus disease 2019 (COVID-19) vaccine booster in healthcare workers in Brazil

Abstract Objective: To compare the long-term vaccine effectiveness between those receiving viral vector [Oxford-AstraZeneca (ChAdOx1)] or inactivated viral (CoronaVac) primary series (2 doses) and those who received an mRNA booster (Pfizer/BioNTech) (the third dose) among healthcare workers (HCWs). Methods: We conducted a retrospective cohort study among HCWs (aged ≥18 years) in Brazil from January 2021 to July 2022. To assess the variation in the effectiveness of booster dose over time, we estimated the effectiveness rate by taking the log risk ratio as a function of time. Results: Of 14,532 HCWs, coronavirus disease 2019 (COVID-19) was confirmed in 56.3% of HCWs receiving 2 doses of CoronaVac vaccine versus 23.2% of HCWs receiving 2 doses of CoronaVac vaccine with mRNA booster (P < .001), and 37.1% of HCWs receiving 2 doses of ChAdOx1 vaccine versus 22.7% among HCWs receiving 2 doses of ChAdOx1 vaccine with mRNA booster (P < .001). The highest vaccine effectiveness with mRNA booster was observed 30 days after vaccination: 91% for the CoronaVac vaccine group and 97% for the ChAdOx1 vaccine group. Vacine effectiveness declined to 55% and 67%, respectively, at 180 days. Of 430 samples screened for mutations, 49.5% were SARS-CoV-2 delta variants and 34.2% were SARS-CoV-2 omicron variants. Conclusions: Heterologous COVID-19 vaccines were effective for up to 180 days in preventing COVID-19 in the SARS-CoV-2 delta and omicron variant eras, which suggests the need for a second booster