Alignment and contribution of nursing doctoral programs to achieve the sustainable development goals

Background: Different social segments from several regions of the world face challenges in order to achieve the sustainable development goals (SDGs). Nursing represents the greatest number of health workforce in the globe, dealing with these challenges in different paths, among them the training of human resources. In this context, the goal of this study was to compare the relationship between the objectives and research areas underlying nursing doctoral programs in Latin America and the SDGs. Method: Documental research comparing data of all Latin American nursing doctoral programs and the SDGs, conducted between January and March 2020. Results: From the total of 56 existing programs in Latin America, this study analyzed 52 of them, representing 92.8% of the total. Most nursing doctoral programs have contributed to SDG 3, in addition to goals 1, 2, 4, 5, 6, 8, 9, 10, 12 and 16. The SDGs 11, 13, 14, 15 and 17 were not related to any of the analyzed programs. Data reveal that the training of nursing PhDs is essential to fulfilling these goals. Results also indicate a need of programs to remain committed to relationships that enhance nursing skills to cope with the current challenges in terms of global health, such as investments for the reduction of social and gender inequities. Conclusion: The doctoral training of nurses in Latin America needs to be better aligned with the sustainable development goals (SDGs), since there is a high concentration in SDG 3. We believe that nursing will bring a greater contribution to the movement to protect planetary health as the principles governing nursing practices are better aligned with international health demands and agendas.publishersversionpublishe

Both “illness and temptation of the enemy”: melancholy, the medieval patient and the writings of King Duarte of Portugal (r. 1433–38)

Recent historians have rehabilitated King Duarte of Portugal, previously maligned and neglected, as an astute ruler and philosopher. There is still a tendency, however, to view Duarte as a depressive or a hypochondriac, due to his own description of his melancholy in his advice book, the Loyal Counselor. This paper reassesses Duarte's writings, drawing on key approaches in the history of medicine, such as narrative medicine and the history of the patient. It is important to take Duarte's views on his condition seriously, placing them in the medical and theological contexts of his time and avoiding modern retrospective diagnosis. Duarte's writings can be used to explore the impact of plague, doubt and death on the life of a well-educated and conscientious late-medieval ruler

Intra- and Inter-Rater Reliability and Agreement of Ultrasound Imaging of Muscle Architecture and Patellar Tendon in Post-COVID-19 Patients Who Had Experienced Moderate or Severe COVID-19 Infection

COVID-19 is associated with musculoskeletal disorders. Ultrasound is a tool to assess muscle architecture and tendon measurements, offering an idea of the proportion of the consequences of the disease, since significant changes directly reflect the reduction in the ability to produce force and, consequently, in the functionality of the patient; however, its application in post-COVID-19 infection needs to be determined. We aimed to assess the intra- and inter-rater reliability of ultrasound measures of the architecture of the vastus lateralis (VL), rectus femoris (RF), vastus medialis (VM), gastrocnemius lateralis (GL), gastrocnemius medialis (GM), soleus (SO), and tibialis anterior (TA) muscles, as well as the patellar tendon (PT) cross-sectional area (CSA) in post-COVID-19 patients. An observational, prospective study with repeated measures was designed to evaluate 20 post-COVID-19 patients, who were measured for the pennation angle (θp), fascicular length (Lf), thickness, echogenicity of muscles, CSA and echogenicity of the PT. The intra-class correlation coefficient (ICC) and 95% limits of agreement were used. The intra-rater reliability presented high or very high correlations (ICC = 0.71–1.0) for most measures, except the θp of the TA, which was classified as moderate (ICC = 0.69). Observing the inter-rater reliability, all the evaluations of the PT, thickness and echogenicity of the muscles presented high or very high correlations. For the Lf, only the RF showed as low (ICC = 0.43), for the θp, RF (ICC = 0.68), GL (ICC = 0.70) and TA (ICC = 0.71) moderate and the SO (ICC = 0.40) low. The ultrasound reliability was acceptable for the muscle architecture, muscle and tendon echogenicity, and PT CSA, despite the low reliability for the Lf and θp of the RF and SO, respectively

Intra- and inter-rater reliability and agreement of stimulus electrodiagnostic tests in post-COVID-19 patients

Abstract Background . COVID-19 patients may present sequelae, such as neuromuscular electrophysiological disorders (NED), that can be assessed using the stimulus electrodiagnostic test (SET). However, little is known about the reliability and agreement of the SET in post-COVID-19 patients. Objective . We aimed to verify the intra–inter-rater reliability and agreement of SET measurements in the rectus femoris, vastus medialis, vastus lateralis, tibialis anterior, and gastrocnemius lateralis (GL) in post-COVID-19 participants. Methods . We designed an observational prospective study to evaluate 20 (10 males and 10 females) post-COVID-19 patients, age: 44.95 ± 11.07 years, weight: 87.99 ± 19.08 kg, height: 1.69 ± 0.09 m. Two independent raters took two evaluations using the SET on selected muscles. The intra-class correlation coefficient (ICC) and 95% limits of the agreement defined the quality and magnitude of the measures. Results . For intra-rater reliability, all measurements presented correlations classified as high or very high (ICC: 0.71–1.0). For inter-rater reliability, the rheobase, chronaxie, accommodation, and accommodation index presented high or very high correlations, except for the accommodation index of the GL (ICC = 0.65), which was moderate. Conclusion . The reliability of the SET obtained by independent raters was very high, except for the GL accommodation, which presented moderate ICC. Therefore, the SET is a reliable tool for evaluating NED in post-COVID-19 patients

Hip and Knee Joint Angles Determine Fatigue Onset during Quadriceps Neuromuscular Electrical Stimulation

International audienceNeuromuscular electrical stimulation (NMES) has been used to increase muscle strength and physical function. However, NMES induces rapid fatigue, limiting its application. To date, the effect of quadriceps femoris (QF) muscle length by knee and hip joint manipulation on NMES-induced contraction fatigability is not clear. We aimed to quantify the effects of different muscle lengths on NMES-induced contraction fatigability, fatigue index, and electromyographic (EMG) activity for QF muscle. QF maximum evoked contraction (QMEC) was applied in a 26 min protocol (10 s on; 120 s off; 12 contractions) in 20 healthy participants ( 24.0 ± 4.6 years old), over 4 sessions on different days to test different conditions. The tested conditions were as follows: supine with knee flexion of 60° (SUP60), seated with knee flexion of 60° (SIT60), supine with knee flexion of 20° (SUP20), and seated with knee flexion of 20° (SIT20). Contraction fatigability (torque decline assessed by maximal voluntary contraction [MVC] and during NMES), fatigue index (percentage reduction in MVC), and EMG activity (root mean square [RMS] and median frequency) of the superficial QF’ constituents were assessed. After NMES, all positions except SUP20 had an absolute reduction in MVC ( p < .001 ). Fatigue index was greater in SIT20 than in SIT60 ( p < .001 ) and SUP20 ( p = .01 ). There was significant torque reduction across the 12 QMEC in SUP60 and SIT60, up to 10.5% ( p < .001 – .005 ) and 9.49% ( p < .001 – .033 ), respectively. There was no torque reduction during NMES in SUP20 and SIT20. Fatigue was accompanied by an increase in RMS ( p = .032 ) and a decrease in median frequency for SUP60 ( p < .001 ). Median frequency increased only in the SUP20 condition ( p = .021 ). We concluded that QF NMES-induced contraction fatigability is greater when the knee is flexed at 60° compared to 20°. In addition, a supine position promotes earlier fatigue for a 60° knee flexion, but it delays fatigue onset for a 20° knee flexion compared to the seated position. These results provide a rationale for lower limb positioning during NMES, which depends on training objectives, e.g., strengthening or task-specific functionality training

Belief in Conspiracy Theories about COVID-19 Vaccines among Brazilians: A National Cross-Sectional Study

Background: Vaccine hesitancy is a complex challenge that demands a comprehensive approach, one that not only acknowledges legitimate concerns within communities but also actively confronts misinformation. In this context, this study aimed to investigate the prevalence of belief in conspiracy theories about COVID-19 vaccines among Brazilians, seeking to understand the factors associated with this behavior. Method: Utilizing a national online survey conducted between May and August 2020, with a sample of 4247 participants, we conducted multivariate analysis to identify the independent determinants of this adherence, calculating adjusted prevalence ratios (APRs) and their 95% confidence intervals. Results: It was revealed that 27.7% of participants believed in at least one conspiracy theory. Factors associated with a higher level of adherence included agreement with at least one piece of COVID-19 misinformation on social media (APR: 3.65; 95% CI: 3.07–4.34), lack of difficulty accessing leisure activities during the pandemic (APR: 3.11; 95% CI: 1.85–5.24), age 50 years or older (APR: 1.70; 95% CI: 1.49–1.94), absence of difficulty accessing protective measures (APR: 1.47; 95% CI: 1.26–1.72), use of face masks (APR: 1.62; 95% CI: 1.33–1.97), non-use of at least one traditional media source for information (APR: 1.47; 95% CI: 1.26–1.72), female gender (APR: 1.41; 95% CI: 1.25–1.60), and age between 30 and 49 years (APR: 1.35; 95% CI: 1.19–1.52). Conclusions: Our findings highlight that it is crucial to recognize that vaccine hesitancy is not merely an isolated phenomenon but often rooted in a complex interplay of social, cultural, psychological, and political factors. There is a need for multifaceted strategies to combat vaccine hesitancy, effectively address conspiracy theories, and consider the various factors associated with their prevalence

ESCOLEX: a grade-level lexical database from European Portuguese elementary to middle school textbooks

In this article, we introduce ESCOLEX, the first European Portuguese children’s lexical database with gradelevel- adjusted word frequency statistics. Computed froma 3.2- million-word corpus, ESCOLEX provides 48,381 word forms extracted from 171 elementary and middle school textbooks for 6- to 11-year-old children attending the first six grades in the Portuguese educational system. Like other children’s grade-level databases (e.g., Carroll, Davies, & Richman, 1971; Corral, Ferrero, & Goikoetxea, Behavior Research Methods, 41, 1009–1017, 2009; Lété, Sprenger-Charolles, & Colé, Behavior ResearchMethods, Instruments,&Computers, 36, 156–166, 2004; Zeno, Ivens, Millard, Duvvuri, 1995), ESCOLEX provides four frequency indices for each grade: overall word frequency (F), index of dispersion across the selected textbooks (D), estimated frequency per million words (U), and standard frequency index (SFI). It also provides a new measure, contextual diversity (CD). In addition, the number of letters in the word and its part(s) of speech, number of syllables, syllable structure, and adult frequencies taken from PPAL (a European Portuguese corpus-based lexical database; Soares, Comesaña, Iriarte, Almeida, Simões, Costa, …, Machado, 2010; Soares, Iriarte, Almeida, Simões, Costa, França,…, Comesaña, in press) are provided. ESCOLEX will be a useful tool both for researchers interested in language processing and development and for professionals in need of verbal materials adjusted to children’s developmental stages. ESCOLEX can be downloaded along with this article or from http://p-pal.di.uminho.pt/about/databases.Fundação para a Ciência e a Tecnologia (FCT

Adherence to inhaled corticosteroids and long-acting β2-agonists in asthma: A MASK-air study

International audienceIntroduction: Adherence to controller medication is a major problem in asthma management, being difficult to assess and tackle. mHealth apps can be used to assess adherence. We aimed to assess the adherence to inhaled corticosteroids+long-acting β2-agonists (ICS+LABA) in users of the MASK-air® app, comparing the adherence to ICS+formoterol (ICS+F) with that to ICS+other LABA. Materials and methods: We analysed complete weeks of MASK-air® data (2015-2022; 27 countries) from patients with self-reported asthma and ICS+LABA use. We compared patients reporting ICS+F versus ICS+other LABA on adherence levels, symptoms and symptom-medication scores. We built regression models to assess whether adherence to ICS+LABA was associated with asthma control or short-acting beta-agonist (SABA) use. Sensitivity analyses were performed considering the weeks with no more than one missing day. Results: In 2598 ICS+LABA users, 621 (23.9%) reported 4824 complete weeks and 866 (33.3%) reported weeks with at most one missing day. Higher adherence (use of medication ≥80% of weekly days) was observed for ICS+other LABA (75.1%) when compared to ICS+F (59.3%), despite both groups displaying similar asthma control and work productivity. The ICS+other LABA group was associated with more days of SABA use than the ICS+F group (median=71.4% versus 57.1% days). Each additional weekly day of ICS+F use was associated with a 4.1% less risk in weekly SABA use (95%CI=-6.5;-1.6%;p=0.001). For ICS+other LABA, the percentage was 8.2 (95%CI=-11.6;-5.0%;p<0.001). Conclusions: In asthma patients adherent to the MASK-air app, adherence to ICS+LABA was high. ICS+F users reported lower adherence but also a lower SABA use and a similar level of control