O USO DE TECNOLOGIAS COMO FERRAMENTA DO CUIDADO DA CRIANÇA HOSPITALIZADA

O processo da internação pode gerar impactos devastadores na vida de qualquer ser humano, visando uma forma de melhorar o sofrimento da internação. Com isso, torna-se de fundamental relevância a criação de estratégias como forma de atenuar o processo de hospitalização decorrente do estresse e ansiedade devido às consequências que a doença pode trazer ao paciente, como o sofrimento físico e emocional, as mudanças de rotina e outras limitações que a criança sofre no momento da hospitalização.   O uso das novas tecnologias de informação age como um potencializador nas atividades lúdicas no ambiente hospitalar possibilitando assim que a criança conheça e entenda melhor o momento pela qual ela está passando para desta forma enfrentar a situação dolorosa de forma mais suave, estimulando assim a sua autoestima e confiança. O uso de equipamentos eletrônicos como notebook, tablets, celulares dentre outros, tem se mostrado de forma atrativa para as crianças no âmbito hospitalar devido aos multimeios e inovação. Nesse sentido o uso da tecnologia pode ser uma ferramenta para o cuidado da criança hospitalizada. O presente trabalho trata-se de um estudo descritivo - exploratório, de natureza qualitativa. A pesquisa foi realizada na Unidade Pediátrica de um Hospital de grande porte na cidade de Salvador, Bahia. A pesquisa foi realizada com a participação de 15 enfermeiras da Unidade Pediátrica. Como resultado, emergiu das entrevistas realizadas a seguinte categoria analítica: o uso da tecnologia como ferramenta do cuidado. Com isso, o objetivo deste artigo é descrever o uso da tecnologia como ferramenta lúdica para o cuidado da criança hospitalizada

O USO DE TECNOLOGIAS COMO FERRAMENTA DO CUIDADO DA CRIANÇA HOSPITALIZADA

O processo da internação pode gerar impactos devastadores na vida de qualquer ser humano, visando uma forma de melhorar o sofrimento da internação. Com isso, torna-se de fundamental relevância a criação de estratégias como forma de atenuar o processo de hospitalização decorrente do estresse e ansiedade devido às consequências que a doença pode trazer ao paciente, como o sofrimento físico e emocional, as mudanças de rotina e outras limitações que a criança sofre no momento da hospitalização.   O uso das novas tecnologias de informação age como um potencializador nas atividades lúdicas no ambiente hospitalar possibilitando assim que a criança conheça e entenda melhor o momento pela qual ela está passando para desta forma enfrentar a situação dolorosa de forma mais suave, estimulando assim a sua autoestima e confiança. O uso de equipamentos eletrônicos como notebook, tablets, celulares dentre outros, tem se mostrado de forma atrativa para as crianças no âmbito hospitalar devido aos multimeios e inovação. Nesse sentido o uso da tecnologia pode ser uma ferramenta para o cuidado da criança hospitalizada. O presente trabalho trata-se de um estudo descritivo - exploratório, de natureza qualitativa. A pesquisa foi realizada na Unidade Pediátrica de um Hospital de grande porte na cidade de Salvador, Bahia. A pesquisa foi realizada com a participação de 15 enfermeiras da Unidade Pediátrica. Como resultado, emergiu das entrevistas realizadas a seguinte categoria analítica: o uso da tecnologia como ferramenta do cuidado. Com isso, o objetivo deste artigo é descrever o uso da tecnologia como ferramenta lúdica para o cuidado da criança hospitalizada

O sistema nacional de inspeção e vigilância sanitária para a agricultura familiar e empresarial no Brasil

Neste trabalho é analisado o Sistema Nacional de Inspeção e Vigilância Sanitária - SNIVS, por meio do conjunto de normas que o constitui, assim como, de sua operacionalização enquanto instrumentos de regulação das atividades de produção, distribuição e consumo de alimentos de origem agrícola e pecuária no Brasil. O objetivo desta pesquisa é compreender o funcionamento do Sistema Nacional de Inspeção e de Vigilância Sanitária–SNIVS, suas vinculações institucionais e sua atuação na agricultura familiar e empresarial no Brasil, no contexto da discussão da concentração fundiária. O método utilizado foi à análise documental. Nos resultados da pesquisa identificam-se dois períodos distintos que caracterizam a atuação dos órgãos e entidades que compõem o SNIVS: num primeiro momento, suas atuações são favoráveis a Agricultura Empresarial, num segundo momento, as ações daqueles órgãos e entidades favorecem aos interesses da Agricultura Familiar. A pesquisa mostrou também que o SNIVS está operando um cuidadoso processo de harmonização institucional e operacional de acordo com os tratados bilaterais de comércio firmados com a Organização Mundial do Comércio – OMC e com a Organização Mundial da Saúde – OMS

Asociación del índice de masa corporal con la absorciometría con rayos X de doble energía (DEXA) en diabéticos tipo 1

Introducción: Existen varias técnicas para evaluar la composición corporal, entre ellas destaca el DEXA, pero presenta alto costo. Por otro lado, el índice de masa corporal (IMC) se presenta como método más utilizado. Sin embargo, el mismo presenta limitaciones. Objetivo: Verificar la aplicabilidad de una nueva ecuación del IMC y asociarse con la absorciometría con rayos X de doble energía DEXA en adolescentes con DM1. Métodos: Esta investigación de característica intencional fue compuesta por 30 adolescentes (15 niños y 15 niñas), con edades entre 10 y 15 años. Se evaluó la estatura y la masa corporal para la obtención de los IMC2.5 y el IMC2. El porcentaje de grasa (%G) se obtuvo a través del DEXA. La hemoglobina glucosa (HbA1c) se verificó mediante la prueba inmunoturbidimétrica TurbiClin. Para el análisis de los datos se realizó la estadística descriptiva (media, desviación estándar y porcentaje de frecuencia). La correlación entre las variables (IMC, DEXA y HbA1c) fue evaluada por el coeficiente de correlación de Pearson. Se adoptó un nivel de significancia de p < 0,05. Resultados: La nueva ecuación del IMC2.5 presentó asociación con IMC2.5 Escore Z (r= 0,68; p= 0,001), IMC2 (r= 0,99; p= 0,001), IMC2 Escore Z (r = 0,67; p = 0,001) y DEXA (r = 0,58; p = 0,05). Mientras que el IMC2.5 Escore Z demostró asociación positiva con el IMC2 (r = 0,70; p = 0,001) e IMC2 Escore Z (r = 1,0; p = 0,001). Conclusión: Podemos destacar que para los adolescentes con DM1 tanto hace la ecuación utilizada para estimar el estado nutricional, pues la imprecisión de ambos IMC continúa siendo la misma para determinar %G. Lo mismo ocurre cuando se convierte en IMC2.5

Validation of an analytical method by high-performance liquid chromatography and microbiological assay, biological safety and in silico toxicity for danofloxacin

Danofloxacin is a veterinary fluoroquinolone used to treat respiratory and gastrointestinal diseases of birds, pigs and cattle. The literature reviewed shows some analytical methods to quantify this fluoroquinolone, but microbiological and biological safety studies are limited. The analytical methods were validated by the Official Codes. The LC-DAD method was developed and validated using an RP-18 column, mobile phase containing a mixture of 0.3% triethylamine (pH 3.0) and acetonitrile (85:15, v/v). The microbiological assay was performed by agar diffusion method (3 x 3) and Staphylococcus epidermidis as a microorganism test. Forced degradation studies were performed in both methods. The minimum inhibitory concentration (MIC) was performed by test microdilution and toxicity studies were evaluated using in silico study, cell proliferation, cell viability test, micronuclei and comet assay. LC and a microbiological assay proved linear, accurate, precise, and robust to quantify danofloxacin, but only the LC method showed selectivity to quantify the drug in the presence of its degradation products. These results demonstrate that the LC method is suitable for stability studies of danofloxacin, but a microbiological assay cannot be used to quantify the drug due to the biological activity of the photoproducts. Ex-vivo cytotoxicity and theoretical and experimental genotoxicity were also observed

ANÁLISE DO DESENVOLVIMENTO PSICOMOTOR EM INDIVÍDUOS COM DEFICIÊNCIA AUDITIVA

O objetivo deste estudo foi analisar o desenvolvimento psicomotor de indivíduos com deficiência auditiva. A amostra foi composta por 12 indivíduos (média de idade de 9,16±2,69 anos): 6 apresentavam deficiência auditiva (DA) e 6 eram normoauditivos (NA) pareados por sexo e idade. Foi realizado exame audiológico que confirmou a ausência de déficit auditivo (NA) e classificou os indivíduos com DA. Na avaliação do desenvolvimento psicomotor utilizou-se a Bateria Psicomotora. Os dados foram apresentados de forma descritiva com média e desvio-padrão. As médias das pontuações em todos os fatores avaliados em ambos os grupos apresentaram valores acima ou igual a 3, sendo classificados como perfil eupráxico. Os indivíduos apresentaram semelhança na pontuação final e obtiveram média de 23,83 na DA e 24,83 pontos na NA. Neste estudo ambos os grupos demonstraram desenvolvimento psicomotor adequado para a idade e não houve diferença com à presença de DA

Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants

Summary Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. Interpretation The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure &lt;= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants.

BACKGROUND: Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. METHODS: We used data from 1990 to 2019 on people aged 30-79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age. FINDINGS: The number of people aged 30-79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306-359) million women and 317 (292-344) million men in 1990 to 626 (584-668) million women and 652 (604-698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55-62) of women and 49% (46-52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43-51) of women and 38% (35-41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20-27) for women and 18% (16-21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran. INTERPRETATION: Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings. FUNDING: WHO