Conhecimento dos enfermeiros sobre a técnica de inserção do cateter central de inserção periférica em recém-nascidos

The right to practice the Peripherally Inserted Central Catheter (PICC) technique, mainly in neonatal intensive care units, was achieved by nursing and consists of efforts that lead to a new challenge: the improvement of the practice of this procedure. This study determined and evaluated the theoretical and practical knowledge acquired by nurses in qualification courses concerning aspects of PICC line insertion in the case of newborns. This descriptive and quantitative study used a questionnaire with nine questions to collect data. The study population was composed of 40 nurses qualified to insert a PICC line in newborns. According to the conceptual knowledge scale established for this study, the results reveal that the nurses have inadequate knowledge concerning the studied aspects, indicating the need for nurses to constantly update and improve their knowledge about this practice so as to better the quality of care delivered to newborns.La utilización del catéter central de inserción periférica (PICC), principalmente en unidades de terapia intensiva neonatal, es una conquista de la enfermería constituida por una trayectoria de esfuerzos que condujeron a un nuevo desafío - el perfeccionamiento del ejercicio de esa práctica. Este artículo tuvo como objetivo verificar el conocimiento teórico y práctico adquirido por los enfermeros, en los cursos de calificación, sobre algunos aspectos de la técnica de inserción del PICC en recién nacidos. Se trata de un estudio descriptivo, de naturaleza cuantitativa, que utilizó como instrumento de investigación un cuestionario con nueve preguntas. La población se constituyó de 40 enfermeros calificados para inserción del PICC en neonatos. Los resultados mostraron que, según la atribución conceptual establecida para el estudio, los enfermeros presentaron un nivel de conocimiento malo sobre esos aspectos, denotando la necesidad de actualización y perfeccionamiento constante de los enfermeros sobre esa práctica para mejorar la calidad de la asistencia prestada a los recién nacidos.A utilização do cateter central de inserção periférica (PICC), principalmente em unidades de terapia intensiva neonatal, é uma conquista da enfermagem constituída por trajetória de esforços que conduziu a um novo desafio - o aperfeiçoamento do exercício dessa prática. Este artigo teve como objetivo verificar o conhecimento teórico-prático adquirido pelos enfermeiros, nos cursos de qualificação, sobre alguns aspectos da técnica de inserção do PICC em recém-nascidos. Trata-se de estudo descritivo, de natureza quantitativa, que utilizou como instrumento de pesquisa um questionário com nove questões. A população constituiu-se de 40 enfermeiros qualificados para inserção do PICC em neonatos. Os resultados mostraram que, segundo a atribuição conceitual estabelecida para o estudo, os enfermeiros apresentaram conhecimento ruim sobre esses aspectos, denotando a necessidade de atualização e aperfeiçoamento constante dos enfermeiros sobre essa prática para melhorar a qualidade da assistência prestada aos recém-nascidos.Hospital do Coração Pediatric Intensive Care UnitUniversidade Federal de São Paulo (UNIFESP) Departamento de EnfermagemUNIFESP, Depto. de EnfermagemSciEL

Conocimiento de los enfermeros sobre la técnica de inserción del catéter central de inserción periférica en recién nacidos

The right to practice the Peripherally Inserted Central Catheter (PICC) technique, mainly in neonatal intensive care units, was achieved by nursing and consists of efforts that lead to a new challenge: the improvement of the practice of this procedure. This study determined and evaluated the theoretical and practical knowledge acquired by nurses in qualification courses concerning aspects of PICC line insertion in the case of newborns. This descriptive and quantitative study used a questionnaire with nine questions to collect data. The study population was composed of 40 nurses qualified to insert a PICC line in newborns. According to the conceptual knowledge scale established for this study, the results reveal that the nurses have inadequate knowledge concerning the studied aspects, indicating the need for nurses to constantly update and improve their knowledge about this practice so as to better the quality of care delivered to newborns.La utilización del catéter central de inserción periférica (PICC), principalmente en unidades de terapia intensiva neonatal, es una conquista de la enfermería constituida por una trayectoria de esfuerzos que condujeron a un nuevo desafío - el perfeccionamiento del ejercicio de esa práctica. Este artículo tuvo como objetivo verificar el conocimiento teórico y práctico adquirido por los enfermeros, en los cursos de calificación, sobre algunos aspectos de la técnica de inserción del PICC en recién nacidos. Se trata de un estudio descriptivo, de naturaleza cuantitativa, que utilizó como instrumento de investigación un cuestionario con nueve preguntas. La población se constituyó de 40 enfermeros calificados para inserción del PICC en neonatos. Los resultados mostraron que, según la atribución conceptual establecida para el estudio, los enfermeros presentaron un nivel de conocimiento malo sobre esos aspectos, denotando la necesidad de actualización y perfeccionamiento constante de los enfermeros sobre esa práctica para mejorar la calidad de la asistencia prestada a los recién nacidos.A utilização do cateter central de inserção periférica (PICC), principalmente em unidades de terapia intensiva neonatal, é uma conquista da enfermagem constituída por trajetória de esforços que conduziu a um novo desafio - o aperfeiçoamento do exercício dessa prática. Este artigo teve como objetivo verificar o conhecimento teórico-prático adquirido pelos enfermeiros, nos cursos de qualificação, sobre alguns aspectos da técnica de inserção do PICC em recém-nascidos. Trata-se de estudo descritivo, de natureza quantitativa, que utilizou como instrumento de pesquisa um questionário com nove questões. A população constituiu-se de 40 enfermeiros qualificados para inserção do PICC em neonatos. Os resultados mostraram que, segundo a atribuição conceitual estabelecida para o estudo, os enfermeiros apresentaram conhecimento ruim sobre esses aspectos, denotando a necessidade de atualização e aperfeiçoamento constante dos enfermeiros sobre essa prática para melhorar a qualidade da assistência prestada aos recém-nascidos

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple organism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region's vulnerability to environmental change. 15%–18% of the most neglected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lost

Worldwide trends in population-based survival for children, adolescents, and young adults diagnosed with leukaemia, by subtype, during 2000–14 (CONCORD-3): analysis of individual data from 258 cancer registries in 61 countries

Background: Leukaemias comprise a heterogenous group of haematological malignancies. In CONCORD-3, we analysed data for children (aged 0–14 years) and adults (aged 15–99 years) diagnosed with a haematological malignancy during 2000–14 in 61 countries. Here, we aimed to examine worldwide trends in survival from leukaemia, by age and morphology, in young patients (aged 0–24 years). Methods: We analysed data from 258 population-based cancer registries in 61 countries participating in CONCORD-3 that submitted data on patients diagnosed with leukaemia. We grouped patients by age as children (0–14 years), adolescents (15–19 years), and young adults (20–24 years). We categorised leukaemia subtypes according to the International Classification of Childhood Cancer (ICCC-3), updated with International Classification of Diseases for Oncology, third edition (ICD-O-3) codes. We estimated 5-year net survival by age and morphology, with 95% CIs, using the non-parametric Pohar-Perme estimator. To control for background mortality, we used life tables by country or region, single year of age, single calendar year and sex, and, where possible, by race or ethnicity. All-age survival estimates were standardised to the marginal distribution of young people with leukaemia included in the analysis. Findings: 164 563 young people were included in this analysis: 121 328 (73·7%) children, 22 963 (14·0%) adolescents, and 20 272 (12·3%) young adults. In 2010–14, the most common subtypes were lymphoid leukaemia (28 205 [68·2%] patients) and acute myeloid leukaemia (7863 [19·0%] patients). Age-standardised 5-year net survival in children, adolescents, and young adults for all leukaemias combined during 2010–14 varied widely, ranging from 46% in Mexico to more than 85% in Canada, Cyprus, Belgium, Denmark, Finland, and Australia. Individuals with lymphoid leukaemia had better age-standardised survival (from 43% in Ecuador to ≥80% in parts of Europe, North America, Oceania, and Asia) than those with acute myeloid leukaemia (from 32% in Peru to ≥70% in most high-income countries in Europe, North America, and Oceania). Throughout 2000–14, survival from all leukaemias combined remained consistently higher for children than adolescents and young adults, and minimal improvement was seen for adolescents and young adults in most countries. Interpretation: This study offers the first worldwide picture of population-based survival from leukaemia in children, adolescents, and young adults. Adolescents and young adults diagnosed with leukaemia continue to have lower survival than children. Trends in survival from leukaemia for adolescents and young adults are important indicators of the quality of cancer management in this age group