bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of brief intervention and art therapy for alcohol users
Authors: Soares Marcos Hirata , Rolin Thales Felipe de Castro , Machado Fernanda Pâmela , Ramos Layla Karina Ferrari , Rampazzo Ana Raquel Pontello
Published: October 2019

ABSTRACT Objective: To identify the impact of brief intervention paired with art therapy in patients who use alcohol. Method: This study presents intra-group design, with 11 alcoholics in the city of Tamarana-PR, Brazil, between 2015 and 2016. A test to identify the alcohol consumption level was used at the beginning/end of the actions. Cohen’s effect size and paired t-test were used to identify the impact of the actions on the reduction of alcohol intake. Results: Six participants ceased alcohol consumption, four showed high level of consumption and one presented average consumption. The paired t-test result suggested statistically significant difference between the initial and final scores, as well as 0.76 effect size. Conclusion: The brief intervention associated with the art therapy resulted in significant impact in reducing alcohol consumption. Investing in the continuous training of primary health care professionals is crucial to consolidate the improvements achieved.
Embracement with risk classification: relationship of justice with the user
Authors: Lacerda Andrea Stella Barbosa , Sauthier Marta , Paes Graciele Oroski , Teixeira Enéas Rangel
Published: October 2019

ABSTRACT Objective: to describe the conception of justice of nurses and users regarding the Risk Classification in Emergency Unit; to analyze the conception of justice in the implementation of the Risk Classification in Emergency Unit from the user’s recognition; to discuss, from Axel Honneth’s Theory of Recognition, justice with the user in the Risk Classification in Emergency Unit. Method: qualitative research of descriptive, exploratory typology, which used action research as a method. Bardin’s Content Analysis was carried out. Results: a category was created: “Justice versus Injustice” and three subcategories: “Autonomy/Freedom versus Heteronomy/Subordination”; “Communication versus Hermeneutic Problems”; “Contributions versus Conflicts”. Final considerations: Embracement with Risk Classification presents difficulties in its interpretation and effectiveness; there are situations of disrespect that compete against the required ethics. Justice addressed by this study will be achieved by an emergency access system that meets user expectations, recognizing it as a subject of rights.
Practice challenges in patient safety
Authors: Siman Andréia Guerra , Braga Luciene Muniz , Amaro Marilane de Oliveira Fani , Brito Maria José Menezes
Published: October 2019

ABSTRACT Objective: to understand the professional practice challenges in reaching the goals and objectives of the National Patient Safety Program (Programa Nacional de Segurança do Paciente). Method: qualitative case study, based on the Comprehensive Sociology, carried out with 31 professionals from the Patient Safety Center (Núcleo de Segurança do Paciente) and the nursing team, working in a teaching hospital. Data collection took place between May and December 2015 through interviews, observation and documentary analysis. The analysis proceeded according to the prerogatives of the Content Analysis. Results: three categories emerged: the prescribed reality; material resources and their impact on care; and human resources related to the reality. Final considerations: challenges to safe professional practice are caused by inadequate physical structure, insufficient physical and human resources, but mainly invade the transition from the prescriptive reality scope.
Educational technology for fatigue management related to antineoplastic chemotherapy
Authors: Perdigão Marcela Maria de Melo , Rodrigues Andrea Bezerra , Magalhães Tayanne de Lima , Freitas Fernanda Macedo Cartaxo , Bravo Lia Guedes , Oliveira Patrícia Peres de
Published: October 2019

ABSTRACT Objective: To construct and validate an educational technology (ET) on fatigue and non-pharmacological strategies for the management of this symptom in people with cancer undergoing outpatient antineoplastic chemotherapy. Method: This is a methodological study composed of three stages: 1) elaboration of the ET using the theoretical-methodological model of Doak, Doak and Root; 2) validation of content and appearance by seven nurses via the content validity index (CVI); and 3) a pilot test with 10 patients. Results: The ET “Knowing and coping with fatigue” contemplates the definition of fatigue, its causes and the interventions of physical exercise practice, sleep hygiene, energy conservation and behavioral intervention. The overall CVI obtained with the judges was 0.95. Conclusion: The ET presented content and appearance validity for health education regarding fatigue related to antineoplastic chemotherapy in outpatient cancer patients.
Religious/spiritual coping and spiritual distress in people with cancer
Authors: Silva Gabriela Cruz Noronha , Reis Dáfili Cristina dos , Miranda Talita Prado Simão , Melo Ruan Nilton Rodrigues , Coutinho Mariana Aparecida Pereira , Paschoal Gabriela dos Santos , Chaves Érika de Cássia Lopes
Published: October 2019

ABSTRACT Objective: To investigate the relation between the presence of spiritual distress and use of RSC and sociodemographic, clinical and religious/spiritual variables in people with cancer. Method: Cross-sectional study conducted in an association for support to people with cancer. The data obtained with the tools were analyzed using the Spearman‘s correlation coefficient and the Mann-Whitney Test. Results: 129 volunteers participated in the study, of which 57% showed moderate spiritual distress, 96% used medium and high positive religious/spiritual coping. Spiritual distress showed positive correlation with negative religious/spiritual coping (P<0.001) and inverse correlation with age (p 0.002). The use of positive religious coping was statistically significant in people who have religious practices (p 0.001). Conclusão: Spiritual distress is a phenomenon that is present in the lives of people with cancer and has significant relation with the use, in a negative manner, of religion/spirituality as a way of coping with the disease.
Caring ability, burden, stress and coping of family caregivers of people in cancer treatment
Authors: Coppetti Larissa de Carli , Girardon-Perlini Nara Marilene Oliveira , Andolhe Rafaela , Silva Laís Mara Caetano da , Dapper Steffani Nikoli , Noro Elissa
Published: October 2019

ABSTRACT Objective: To analyze the association between the caring ability and the burden, stress and coping of family caregivers of people in cancer treatment. Method: A cross-sectional study with 132 family caregivers. The following instruments were applied: a characterization instrument, the Caring Ability Inventory, the Zarit Burden Interview, the Perceived Stress Scale, and the Brief COPE. The Spearman Correlation was used with significance ≤5%. Results: There were significant and positive correlations between total caring ability and: burden - interpersonal relationship (p=0.03); stress (p=0.02) and maladaptive coping (p=0.00); and inversely proportional correlations with problem-focused coping (p=0.03). The courage had inversely proportional correlation with: self-efficacy (p=0.03), interpersonal relationship (p=0.00), stress (p=0.04) and maladaptive coping (p=0.00). The knowledge had significant and positive correlation with problem-focused coping (p=0.00), adaptive coping (p=0.01), and inverse correlation with stress (p=0.02). Conclusion: The level of caring ability correlates with levels of stress and burden, and with the type of coping strategy used by family caregivers.
Nursing care systematization: perceptions and knowledge of the Brazilian nursing
Authors: Oliveira Marcos Renato de , Almeida Paulo César de , Moreira Thereza Maria Magalhães , Torres Raimundo Augusto Martins
Published: October 2019

ABSTRACT Objective: to present the perception and knowledge of Brazilian nursing nurses and academics regarding Nursing Care Systematization. Method: a descriptive study, carried out in the first half of 2018. Results: of the 596 respondents, 86% perceived Nursing Care Systematization as very important, but only 60.9% used it in their care practice. Its use was statistically associated with a higher level of training. Non-utilization was associated with the perception that it is irrelevant and with little knowledge on the Nursing Process, even in the face of recognition of its obligation. Among professionals who wish to learn more about the subject, understanding the application of the process, especially the planning step, is perceived as a necessity. Conclusion: the relevance perception of systematization and levels of knowledge of the professional/academic are directly related to the use or not of Nursing Care Systematization principles.
“Waiting for a miracle”: Spirituality/Religiosity in coping with sickle cell disease
Authors: Gomes Maiara Vitor , Xavier Aline da Silva Gomes , Carvalho Evanilda Souza de Santana , Cordeiro Rosa Cândida , Ferreira Sílvia Lúcia , Morbeck Amarry Dantas
Published: October 2019

ABSTRACT Objective: To understand spirituality/religiosity as experienced by people with sickle cell disease, and its influence on coping with the disease. Method: A qualitative, descriptive, and exploratory study conducted in the State of Bahia. Twenty-nine respondents participated in semi-structured interviews. Content analysis was used to analyze the empirical material. Results: Individuals with sickle cell disease experience spirituality/religiosity motivated by their hope for a miracle, and fear of death; among their rites are: reading religious materials, individual and group prayer, and attendance at worship services. The effects on their health include: comfort by means of coping by comparing two evils, anxiety relief, social support, and lifestyle changes; however, spirituality/religiosity may be impaired. Final considerations: This study demonstrates the need to qualify health professionals to address spiritual issues of these individuals during illness, with the aims of diagnosing suffering and anguish, and providing care, comfort and strengthening of the spiritual bonds of these individuals.
Impacts of health of users with HIV/AIDS in a specialized service
Authors: Jucá Maria Augusta Cunha Lima , Silva Luciano Bairros da , Silva Ivisson Alexandre Pereira da , Queiroga Danlyne Eduarda Ulisses de , Carvalho Ana Márcia Agra Lemos de , Ferreira Sonia Maria Soares
Published: October 2019

ABSTRACT Objective: to understand the perception of users of a Specialized Care Service (SAE- Serviço de Assistência Especializada) in HIV/AIDS about their oral health. Method: qualitative research that used the techniques of participant observation and focal group. For the analysis of the material produced, categories of analysis, construction of dialogical map and identification of linguistic repertoires were used. Results: impacts arising from oral health problems such as: inability to eat properly, feeling ashamed due to tooth loss, inability to perform physical exercises and, as the main barrier to access to dental treatment, fear of exposure to practices of discrimination and prejudice. Final considerations: we need the implementation of policies of Permanent Education to all professionals involved in the care for this population, to ensure users’ rights, ensure qualified care, and create security and trust relationships with individuals living with HIV/AIDS, in access to services.
Occupational stress and engagement in primary health care workers
Authors: Cordioli Dezolina Franciele Cardin , Cordioli Junior João Roberto , Gazetta Claudia Eli , Silva Albertina Gomes da , Lourenção Luciano Garcia
Published: October 2019

ABSTRACT Objective: To evaluate levels of occupational stress and work engagement among primary health care workers. Method: A descriptive, correlational and transversal study was carried out in a small municipality in the countryside of São Paulo, with a non-probabilistic sample of convenience, with 85 workers. Three self-applied instruments were used: one developed by researchers, containing sociodemographic variables; Work Stress Scale (WSS) and Utrech Work Engagement Scale (UWES). Results: Prevalence of women (72.6%), 40 years old or more (45.9%), 4 years and 4 months of mean working time in primary care. Thirty-one workers (36.5%) presented significant stress (scores ≥2.5). Work engagement showed a mean of 4.1 (±1.2) to 4.4 (±1.4), classified as high in all dimensions. Occupational stress and work engagement correlated negatively. Conclusion: Workers presented high levels of work engagement; more than one-third had significant occupational stress. Workers with high levels of occupational stress tend to have lower work engagement.
Social determinants of health and vulnerabilities to sexually transmitted infections in adolescents
Authors: Costa Maria Isabelly Fernandes da , Viana Tamires Rebeca Forte , Pinheiro Patrícia Neyva da Costa , Cardoso Maria Vera Lúcia Moreira Leitão , Barbosa Lorena Pinheiro , Luna Izaildo Tavares
Published: October 2019

ABSTRACT Objective: To verify the association between social determinants of health and the vulnerability of adolescents to Sexually Transmitted Infections (STIs). Method: Cross-sectional study, performed with 287 students aged 11 to 17 years, in the outskirts of Fortaleza, Ceará, Brazil, from August do September 2016. Two instruments were used, one destined to social determinants of health and another to investigating the vulnerability to STIs. The magnitude of associations was expressed through odds ratio and interval of confidence, considering a 5% significance level. This research was approved by the Research Ethics Committee of the Federal University of Ceará. Results: 212 (73.9%) adolescents were considered more vulnerable, with a score ≥ 4. The intermediate social determinant “housing (home ownership)” obtained significant association with with the vulnerability to STIs (p of 0.022; CI 1.1 to 3.3; OR 1.9). Conclusion: The intermediate social determinant “type of housing” influences the vulnerability to STAs.
Mental health in primary health care: health-disease according to health professionals
Authors: Barros Sônia , Nóbrega Maria do Perpétuo Socorro de Sousa , Santos Jussara Carvalho dos , Fonseca Laís Mariana da , Floriano Lara Simone Messias
Published: October 2019

ABSTRACT Objective: to analyze perceptions of the Family Health Strategy (FHS) professional team about mental health-disorder and to identify health actions developed by the team for people with mental disorders. Method: a qualitative study of a Marxist theoretical framework and a dialectical method. 99 FHS middle and higher level professionals from São Paulo participated. Semi-structured interviews were conducted. Data were submitted to ALCESTE software and Thematic Content Analysis. Results: there were three empirical categories: Training in Mental Health; Perception of the FHS professional about mental health-disorder; and Health actions developed by the FHS team with people with mental disorders. Actions that converge and diverge from the psychosocial care model were identified. Final considerations: there is an effort from professionals to work according to the psychosocial care model, but it is necessary to invest in the Permanent Education in Health of these professionals to overcome barriers and foster successful territorial actions.
Self-confidence in the care of critically ill patients: before and after a simulated intervention
Authors: Almeida Rodrigo Guimarães dos Santos , Mazzo Alessandra , Martins José Carlos Amado , Jorge Beatriz Maria , Souza Júnior Valtuir Duarte de , Mendes Isabel Amélia Costa
Published: October 2019

ABSTRACT Objective: To evaluate the self-confidence of nurses in the care of critically ill patients, before and after a simulated intervention. Method: A quasi-experimental study was carried out with 103 nurses who participated in a workshop on the care of critically ill patients in the first semester of 2016. A clinical simulation pedagogical instrument was used throughout the event, and self-confidence was assessed by the Portuguese version of the Self-confidence Scale (SCSvp). Results: Most participants reported not being prepared to provide first care to critically ill patients, which was carried out during care practice. The participants presented a significant increase in self-confidence after the simulated intervention (p<0.001) in the cardiac, neurological, and respiratory dimensions. Conclusion: Simulation has proved to be an effective strategy for the development of individuals’ self-confidence, which contributes to the improvement of skills required for professional practice.
Multidisciplinary team actions of a Brazilian Psychosocial Care Center for Alcohol and Drugs
Authors: Lopes Liana Longo Teixeira , Silva Mara Regina Santos da , Santos Alessandro Marques dos , Oliveira Jacqueline Flores de
Published: October 2019

ABSTRACT Objective: to investigate the criteria used by health professionals to identify the phase of consumption of alcohol and drug users, and actions directed to their care. Method: a qualitative study developed with 14 professionals from a Brazilian Psychosocial Care Center for Alcohol and Drugs (Centro de Atenção Psicossocial Álcool e Drogas) based in the south of the country. Data were collected in June 2017 through semi-structured interviews and then submitted to thematic analysis. Results: the criteria used by the professionals were: periodicity of use; amount and type of drug used; repercussions of misuse; and place that the drug occupies in the person’s life. The actions developed were orientation and referral to support groups, therapeutic workshops and individual care. Final considerations: the chronic nature of alcohol/drug use/dependence requires specific care in each phase, and objective criteria to identify and intervene in early phases, aiming at the prevention of chemical dependence.
Being an institutionalized elderly person: meaning of experiences based on Heidegger’s phenomenology
Authors: Reis Camila Calhau Andrade , Menezes Tânia Maria de Oliva , Freitas Adriana Valéria da Silva , Pedreira Larissa Chaves , Freitas Raniele Araújo de , Pires Isabella Batista
Published: October 2019

ABSTRACT Objective: Analyze the meaning of being an elderly person living in a long-term institution. Method: Qualitative study based on Martin Heidegger’s thought. Twelve phenomenological interviews were conducted with people aged over 60 years living in a long-term institution for the elderly in the city of Itabuna, Bahia, Brazil. Results: The units of meaning identified were: experience of progressive loss of autonomy and independence, perception of living in an institution as an inevitable circumstance; and being-with becoming being-alone/being-lonely. After the identification of ontic aspects and hermeneutical understanding, the unit of meaning was constructed: meaning of being an elderly person living in a long-term institution. Final considerations: The ontological needs referring to being an elderly person remain forgotten. As we are ontic and ontological, limited care to the ontic instance indicates deficiencies in institutionalization. Improvements are required to ensure the right to age with quality of life to this population.
Clinical supervision and preceptorship/tutorship: contributions to the Supervised Curricular Internship in Nursing Education
Authors: Esteves Larissa Sapucaia Ferreira , Cunha Isabel Cristina Kowal Olm , Bohomol Elena , Santos Margarida Reis
Published: October 2019

ABSTRACT Objective: To reflect on the contributions of the clinical supervision and preceptorship/tutorship as means to approach and engage nurses of healthcare services in activities related to the Supervised Curricular Internship, discussing conceptual, theoretical, and practical approaches for higher education in nursing. Method: This is a reflection based on the discursive formulation concerning clinical supervision and preceptorship/tutorship. Results: Clinical supervision has been widely used by international healthcare institutions to qualify the work processes of nurses, supporting their self-development. Currently, is has been supporting the work of nurses who are preceptors/tutors and monitors students on clinical internships. Final considerations: The clinical supervision of nursing students features a robust and effective strategy for the development of interns and for the completion of the teaching-service integration.
Hand hygiene: knowledge and skill of caregivers in the hematopoietic stem cell transplantation
Authors: Fernandes Daiane Rubinato , Braga Fernanda Titareli Merizio Martins , Silveira Renata Cristina de Campos Pereira , Garbin Livia Maria
Published: October 2019

ABSTRACT Objective: to identify the knowledge and ability of caregivers on hand hygiene in hematopoietic stem cell transplantation. Method: a prospective cross-sectional study. A questionnaire was used to identify the knowledge and it was observed the hygiene technique performance. Data were collected in two units (autologous and allogeneic transplant). Results: the 37 participants recognized the importance of hand hygiene and 95.5% related to removal of dirt or infection prevention. 91.9% stated that it was important to clean their hands with soap and water when entering and leaving the room, and 64.9% understood that it was necessary to apply alcoholic solution after washing. On average, the caregivers scored 6.16 steps, when demonstrating the washing technique and 3.91 steps in the friction with alcoholic solution. Conclusion: although they recognize the importance of the procedure, there are deficits related to the moment and the correct way of doing it, evidencing the need for strategies aimed at improving this process.
Time series of hospitalizations of adolescents due to mental and behavioral disorders
Authors: Bertelli Ellen Vanuza Martins , Oliveira Rosana Rosseto de , Santos Marcia Lorena Alves dos , Souza Eniuce Menezes , Fernandes Carlos Alexandre Molena , Higarashi Ieda Harumi
Published: October 2019

ABSTRACT Objective: to analyze the trend of hospitalizations of adolescents due to mental and behavioral disorders in Paraná, from 1998 to 2015. Method: ecological study of time series. Data were analyzed by means of segmented linear regression modeling for time series, estimated for each of the four health macro-regions. Results: the East macro-region showed a greater trend to increase hospitalizations from January 1998 to November 2003 (β1=0.006, p<0.001). In other macro-regions, there were similar trends with a sudden increase in February 2010, but with a further gradual decrease until December 2015. In the quadrennium 2012-2015, 38.06% of the hospitalizations lasted 29 or more days, and in the Northwest macro-region, hospitalizations lasted for up to seven days. The main cause of hospitalization was the use of alcohol and other drugs. Conclusion: there is a need to strengthen health actions to prevent drug use and improvements in the care network.
Inclusion of mental health in primary health care: care strategy in the territory
Authors: Souza Ândrea Cardoso de , Amarante Paulo Duarte , Abrahão Ana Lúcia
Published: October 2019

ABSTRACT Objective: To analyze the strategies, challenges and possibilities of the articulation between mental health and primary health care from the perspective of health managers. Method: Exploratory, qualitative research carried out with 28 managers of mental health and primary care. The data were collected through semi-structured interviews between July and November 2013 and submitted to thematic content analysis. Results: The inclusion of mental health actions in primary care made it possible, in the view of managers, to increase users’ access to the care they need. This care strategy allows the extension of care practices in the territory, with matrix support as the main tool for the implementation of this care strategy. Final considerations: The articulation between primary care and mental health is a powerful device for psychosocial care, but it demands a new conformation of the Psychosocial Care Centers (Caps) and primary care services.
Consumption of alcohol and drugs and school absenteeism among high school students of public schools
Authors: Soares Francisco Rafael Ribeiro , Farias Bárbara Rebecca Fernandes de , Monteiro Ana Ruth Macêdo
Published: October 2019

ABSTRACT Objective: To evaluate the relation between the consumption of alcohol and other drugs and school absenteeism in high school students of public schools in the 30 days prior to data collection. Method: Cross-sectional study of quantitative character conducted from May to September 2017, with 282 high school students of public schools of Mossoró-RN. We used a closed questionnaire with questions about drug consumption as our instrument of analysis. We performed hierarchical binary logistic regression by using the SPSS 20.0. Results: In bivariate analysis, the relation between absenteeism and drug consumption patterns proved to be significant to those who engage in heavy episodic drinking of alcohol and in the use of tobacco, inhalants and marijuana. The adjusted regression model only included the variables tobacco and heavy episodic drinking of alcohol. Conclusion: The hierarchical binary logistic regression analysis corroborated with absenteeism outcomes, explaining it in 12.3% of cases.
Caregiver burden and stress in psychiatric hospital admission
Authors: Pedroso Tássia Ghissoni , Araújo Angélica da Silva , Santos Maria Tereza Signorini , Galera Sueli Aparecida Frari , Cardoso Lucilene
Published: October 2019

ABSTRACT Objective: to evaluate the relation between sociodemographics factors, stress and burden of care of family caregivers of patients at a psychiatric hospital admission. Method: quantitative study, with a cross-sectional correlation design. A total of 112 family caregivers participated, older than 18, in a Brazilian psychiatric hospital. A sociodemographic questionnaire was used to collect data, the Zarit Burden Interview and LIPP Adult Stress Symptom Inventory. Results: burden of care in family caregivers at a psychiatric hospital admission was significantly associated with stress (p=0.000). The psychological symptoms of stress predicted severe burden. Most caregivers presented a moderate or severe burden, with 52.7% in the resistance phase of stress; 66.1% presented psychological symptoms. Conclusion: results show the alarming situation of caregivers of patients from a psychiatric hospital, evidencing their own vulnerability to illness. Indeed, the during admission in a psychiatric hospital, not only patients need care, but also their caregivers.
Functional independence of elderly patients who fell: a follow-up study
Authors: Sá Guilherme Guarino de Moura , Santos Ana Maria Ribeiro dos
Published: October 2019

ABSTRACT Objective: to evaluate, in emergency hospital service and at home, the functional independence of elderly people who fell. Method: longitudinal study with 151 elderly. Functional Independence Measure (FIM) was used. Statistical tests were performed with univariate and bivariate analysis. Results: mean of total FIM value in the hospital was 70.4; and at home 84.3 (p <0.001). Independence was lower in the motor domain, in “self-care”, “mobility” and “locomotion” dimensions, in the two evaluations (p <0.001). Dependence reduced from 97.3% elderly in the hospital to 82.8% at home (p <0.001). There was a negative correlation between total FIM and age, number of medications, number of diseases and hospitalization time in both evaluations. Femoral and hip fractures were associated with lower total FIM values (p <0.001). Conclusion: the elderly had less independence in the hospital compared to at home, with greater impairment in the motor domain and “self-care”, “mobility” and “locomotion” dimensions, in the two moments evaluated.
Characteristics of caregivers submitted to music therapy after the death of loved ones
Authors: Silva Vladimir Araujo da , Silva Rita de Cássia Frederico , Turrini Ruth Natalia Teresa , Marcon Sonia Silva , Silva Maria Júlia Paes da
Published: October 2019

ABSTRACT Objective: To describe the characteristics of bereaved caregivers submitted to post-loss music therapy. Method: This is a cross-sectional database from a randomized clinical trial that performed music therapy for caregivers who lost their loved ones to cancer. The following variables were used for this analysis: sociodemographic, religious beliefs, previous sound-musical experiences, and experiences related to care, loss and repair processes. Descriptive statistical analyzes were performed. Results: Of the 69 participants, 85.5% had a strong bond/secure attachment with their loved ones; 68.1% followed a long death and dying process (> 6 months), which was related to a chronic disease; 88.4% did not participate in conspiracy of silence, suggesting a satisfactory communication; 60.9% reported receiving spiritual/religious support, suggesting healthy and continent support; and all participated in funeral rites. Conclusion: The process of elaborating the bereavement of caregivers indicated the presence of protective factors.
Educational hypermedia in nursing assistance at birth: building and validation of content and appearance
Authors: Oliveira Lara Leite de , Mendes Igor Cordeiro , Balsells Marianne Maia Dutra , Bernardo Elizian Braga Rodrigues , Castro Régia Christina Moura Barbosa , Aquino Priscila de Sousa , Damasceno Ana Kelve de Castro
Published: October 2019

ABSTRACT Objective: to build an educational hypermedia about nursing care at usual risk birth and to perform validation of content and appearance. Method: methodological research carried out following the following stages: content and planning of modules; media production and organization of tutorial units; organization of student space, tutor and communication between them; availability of hypermedia; assessment by experts in nursing and informatics; and implementation of proposed suggestions. Results: educational hypermedia showed to be a validated material, since it presented an optimum index of global content of 0.97 and statistical significance in the binomial test for the content and appearance. Conclusion: it is believed that the use of this material with undergraduate students in nursing will contribute to the quality of obstetric care, considering that it is an illustrated technology capable of favoring teaching-learning about normal humanized childbirth.
Um estudo longitudinal sobre a influência do internato em saúde mental na redução de atitudes negativas de estudantes de Medicina em relação a portadores de transtornos mentais
Authors: Rocha Neto Helio Gomes da , Serra Rosana Denobile , Stefanovics Elina , Rosenheck Robert , Cavalcanti Maria Tavares
Published: October 2019

RESUMO Objetivo Avaliar o efeito do internato em saúde mental nas atitudes dos alunos de medicina quanto ao portador de transtorno mental (PTM). Métodos Atitudes foram avaliadas por questionário antes e depois do internato, por meio dos fatores: “aceitação social de PTM” (F1), “não acreditar em causas sobrenaturais para doença mental” (F2), “papéis sociais comuns para PTM” (F3), “acreditar em causas psicossociais para doença mental” (F4), “intimidade” (F5). Diferenças foram avaliadas por meio de testes t, fatores confundidores por ANOVA e correlações entre expectativa de melhora e fatores por Pearson. Resultados 74 de 85 alunos responderam ao questionário. Houve redução significativa em quatro fatores avaliados (F1, p < 0,001, F2, p = 0,002, F3, p = 0,04, F5, p < 0,001). Uma associação entre ter um amigo PTM e F3 foi identificada antes do curso (p = 0,04), porém não após (p = 0,13). Houve correlação positiva entre crenças de melhora e atitudes negativas com o F2 antes do curso (p = 0,01), mas não após. F5 esteve relacionado com a expectativa de melhora (p < 0,001) após o curso, indicando melhores atitudes quando melhor expectativa. Observou-se a melhora da expectativa quanto a resposta ao tratamento da esquizofrenia (p = 0,02), transtorno bipolar (p = 0,03) e transtorno de ansiedade (p = 0,03). Conclusões O internato esteve associado à redução de atitudes negativas com relação aos PTMs. O contato direto com o paciente parece ter influência direta nessa redução. Acreditamos que, mais importante do que possíveis efeitos de esclarecimento sobre causas do adoecimento, a desconstrução do mito sobre o louco violento é essencial para a melhora das atitudes. Estudos com populações de outras regiões do Brasil e voltadas para avaliação do medo de violência são necessários para a confirmação dessa hipótese e do efeito do internato sobre os alunos.
Eficácia da reabilitação cognitiva na melhoria e manutenção das atividades de vida diária em pacientes com doença de Alzheimer: uma revisão sistemática da literatura
Authors: Sá Camila de Carvalho , Silva Daiane Fuga da , Bigongiari Aline , Machado-Lima Adriana
Published: October 2019

RESUMO Objetivo Avaliar a eficácia da reabilitação cognitiva em pacientes com a doença de Alzheimer em estágio leve a moderado por meio de uma revisão sistemática. Métodos O levantamento de artigos se deu pelas bases de dados MEDLINE (acessado via PubMed), EMBASE e LILACS, seguindo a Colaboração Cochrane e a recomendação PRISMA, por meio dos critérios de elegibilidade: ensaios clínicos randomizados e que apresentaram o uso da reabilitação cognitiva como intervenção não farmacológica em pacientes com a doença de Alzheimer em estágio leve a moderado, devendo haver pelo menos um grupo de intervenção e um grupo de comparação. Resultados Foram selecionados seis ensaios clínicos randomizados para a realização desta revisão. Em todos os estudos analisados, foi observada melhora no desempenho dos pacientes nos instrumentos de avaliação, principalmente no que diz respeito à realização de atividades da vida diária. Conclusão A reabilitação cognitiva é capaz de prolongar a independência do paciente na realização de atividades da vida diária e de gerar alterações funcionais e estruturais. Como consequência da constatação de poucos trabalhos que atingiram os critérios de elegibilidade, também se constatou a necessidade de se realizarem mais estudos controlados e com maior controle de aplicação, considerando o alto risco de viés nos estudos utilizados.
Relato de caso de síndrome de Hikikomori em Portugal: uma síndrome primária ou expressão de outra perturbação mental?
Authors: Mota Ana Margarida , Lázaro Mariana , Gaspar Elsa , Rosa David , Farias Ana Cristina
Published: October 2019

RESUMO O fenómeno hikikomori, forma de isolamento social grave e prolongado, constitui um desafio diagnóstico. A nível conceptual, alguns autores diferenciam o hikikomori em primário e secundário. Este último conceito é utilizado quando está presente comorbilidade que, pelo menos parcialmente, explique a síndrome, enquanto na ausência de diagnóstico psiquiátrico denomina- se “hikikomori primário”. Os autores apresentam um caso clínico português com as mesmas características sociodemográficas e clínicas descritas no Japão. Esse caso ilustra que o hikikomori pode potencialmente ser explicado por uma perturbação psiquiátrica subjacente, nem sempre clara à apresentação, e a importância da avaliação cuidadosa e continuada no tempo, por forma a conseguir o esclarecimento diagnóstico e intervenção terapêutica adequada.
Characterization and selection of "Maracujá-do-mato" (Passiflora cincinnata mast) morphoagronomic descriptors
Authors: Dutra Jéssica Alves , Oliveira Antonio Carlos de , Porto Antonio Carlos Mota , Mathias Jéssika Layanne Moreira
Published: October 2019

Abstract The present study consists of the in situ characterization and selection of minimal morphoagronomic descriptors in Passiflora cincinnata genotypes. Forty-one quantitative morphoagronomic descriptors were used, divided in “Plant and Leaf”, “Floral” and “Fruit”. Principal component analysis were used to eliminate descriptors that were less important in the study of multivariate dissimilarity among genotypes. The formation of groups was carried out using Ward’s hierarchical grouping method. The importance of the characters was estimated through the participation of the components by Singh’s method (1981) in order to verify the similarity between lower participation variables in the components. For the set of descriptors “Plant and Leaf” the characteristics that presented the greatest relative contributions were: maximum leaf width 76.1% and leaf blade length 17.2%. For the set of descriptors “Floral” the characteristics that presented the greatest relative contributions were: pedicel length 42.1%, corona tip diameter 32.6% and petal length 11.8%. For the set of descriptors “Fruit” the characteristic that presented the greatest relative contribution was: number of seeds per fruit 89.2%. From the results obtained, we can infer that from the 41 descriptors, only 15 were relevant for the evaluation of the genetic diversity among the individuals of the population. These descriptors were: titratable acidity, bract length, leaf blade length, petal length, sepal length, pedicel length, corona filament ring length, corona tip diameter, fruit longitudinal diameter, sepal width, maximum leaf width, number of fruits, number of seeds per fruit, bark weight and fruit mass.
ASSOCIATION OF RS2435357 AND RS1800858 POLYMORPHISMS IN RET PROTO-ONCOGENE WITH HIRSCHSPRUNG DISEASE: SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: AMOOEE Abdolhamid , LOOKZADEH Mohamad Hosein , MIRJALILI Seyed Reza , MIRESMAEILI Seyed Mohsen , AGHILI Kazem , ZARE-SHEHNEH Masoud , NEAMATZADEH Hossein
Published: October 2019

ABSTRACT Introduction: Many published studies have estimated the association of rs2435357 and rs1800858 polymorphisms in the proto-oncogene rearranged during transfection (RET) gene with Hirschsprung disease (HSCR) risk. However, the results remain inconsistent and controversial. Aim: To perform a meta-analysis get a more accurate estimation of the association of rs2435357 and rs1800858 polymorphisms in the RET proto-oncogene with HSCR risk. Methods: The eligible literatures were searched by PubMed, Google Scholar, EMBASE, and Chinese National Knowledge Infrastructure (CNKI) up to June 30, 2018. Summary odds ratios (ORs) and 95% confidence intervals (CIs) were used to evaluate the susceptibility to HSCR. Results: A total of 20 studies, including ten (1,136 cases 2,420 controls) for rs2435357 and ten (917 cases 1,159 controls) for rs1800858 were included. The overall results indicated that the rs2435357 (allele model: OR=0.230, 95% CI 0.178-0.298, p=0.001; homozygote model: OR=0.079, 95% CI 0.048-0.130, p=0.001; heterozygote model: OR=0.149, 95% CI 0.048-0.130, p=0.001; dominant model: OR=0.132, 95% CI 0.098-0.179, p=0.001; and recessive model: OR=0.239, 95% CI 0.161-0.353, p=0.001) and rs1800858 (allele model: OR=5.594, 95% CI 3.653-8.877, p=0.001; homozygote model: OR=8.453, 95% CI 3.783-18.890, p=0.001; dominant model: OR=3.469, 95% CI 1.881-6.396, p=0.001; and recessive model: OR=6.120, 95% CI 3.608-10.381, p=0.001) polymorphisms were associated with the increased risk of HSCR in overall. Conclusions: The results suggest that the rs2435357 and rs1800858 polymorphisms in the RET proto-oncogene might be associated with HSCR risk.
ASSOCIATION OF MMP-7 -181A>G POLYMORPHISM WITH COLORECTAL CANCER AND GASTRIC CANCER SUSCEPTIBILITY: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: ZARE Mohammad , JAFARI-NEDOOSHAN Jamal , AGHILI Kazem , AHRAR Hossein , JARAHZADEH Mohammad Hossein , SEIFI-SHALAMZARI Neda , ZARE-SHEHNEH Masoud , NEAMATZADEH Hossein
Published: October 2019

ABSTRACT Introduction: The matrix metalloproteinase-7 (MMP-7) gene -181A>G polymorphism has been reported to be associated with colorectal cancer (CRC) and gastric cancer (GC) susceptibility, yet the results of these previous results have been inconsistent or controversial. Aim: To elaborate a meta-analysis to assess the association of -181A>G polymorphism of MMP-7 with CRC and GC risk. Methods: Published literature evaluating the association from PubMed, Web of Science, Google Scholar and other databases were retrieved up to April 25, 2018. Pooled odds ratio (OR) and 95% confidence interval (CI) were calculated using random- or fixed-effects model. Results: A total of 19 case-control studies, which included eleven studies on CRC (2,169 CRC cases and 2,346 controls) and eight studies on GC (1,545 GC cases and 2,366 controls) were identified. There was a significant association between MMP-7 -181A>G polymorphism and GC risk under the homozygote model (GG vs. AA: OR=1.672, 95% CI 1.161-2.409, p=0.006) and the recessive model (GG vs. GA+AA: OR=1.672, 95% CI 1.319-2.554, p=0.001), but not with CRC. By subgroup analysis based on ethnicity, an increased risk of CRC and GC was found only among Asians. Conclusions: This meta-analysis suggests that MMP-7 -181A>G polymorphisms is associated with GC risk, but not with CRC. However, our results clearly showed that the MMP-7 -181A>G polymorphism significantly increased the risk of CRC only in Asians.
CRITICAL ANALYSIS OF SURGICAL TREATMENT TECHNIQUES OF MORBID OBESITY
Authors: ZILBERSTEIN Bruno , SANTO Marco Aurélio , CARVALHO Marnay Helbo
Published: October 2019

ABSTRACT Introduction: Obesity is a disease of high prevalence in Brazil and in the world, and bariatric surgery, with its different techniques, is an alternative treatment. Objective: To compare techniques: adjustable gastric band (AGB), sleeve gastrectomy), Roux-en-Y gastric bypass (RYGB) and biliopancreatic diversion (BPD) analyzing leaks, bleeding, death, weight loss, resolution of type 2 diabetes, systemic arterial hypertension, dyslipidemia and obstructive sleep apnea. Methods: Were selected studies in the PubMed database from 2003 to 2014 using the descriptors: obesity surgery; bariatric surgery; biliopancreatic diversion; sleeve gastrectomy; Roux-en-Y gastric bypass and adjustable gastric banding. Two hundred and forty-four articles were found with the search strategy of which there were selected 116 studies through the inclusion criteria. Results: Excess weight loss (EWL) after five years in AGB was 48.35%; 52.7% in SG; 71.04% in RYGB and 77.90% in BPD. The postoperative mortality was 0.05% in the AGB; 0.16% on SG; 0.60% in RYGB and 2.52% in BPD. The occurrence of leak was 0.68% for GBA; 1.93% for SG; 2.18% for RYGB and 5.23% for BPD. The incidence of bleeding was 0.44% in AGB; 1.29% in SG; 0.81% in RYGB and 2.09% in BPD. The rate of DM2 resolved was 46.80% in AGB, 79.38% in SG, 79.86% in RYGB and 90.78% in BPD. The rate of dyslipidemia, apnea and hypertension resolved showed no statistical differences between the techniques. Conclusion: The AGB has the lowest morbidity and mortality and it is the worst in EWL and resolution of type 2 diabetes. The SG has low morbidity and mortality, good resolution of comorbidities and EWL lower than in RYGB and BPD. The RYGB has higher morbidity and mortality than AGB, good resolution of comorbidities and EWL similar to BPD. The BPD is the worst in mortality and bleeding and better in EWL and resolution of comorbidities.
EFFECT OF COPAIBA OIL IN INTESTINAL MUCOSA OF RATS SUBMITTED TO HYPOVOLEMIC SHOCK
Authors: TEIXEIRA Renan Kleber Costa , COSTA Felipe Lobato da Silva , CALVO Faustino Chaves , SANTOS Deivid Ramos dos , YASOJIMA Edson Yuzur , BRITO Marcus Vinicius Henriques
Published: October 2019

ABSTRACT Background: Hypovolemic shock is a common disease in polytrauma patients and may develop ischemia in various organs, increasing morbidity and mortality. The bowel is usually most affected by this condition. Aim: To evaluate the effects of copaiba oil on the intestinal mucosa’s injury of rats submitted to hypovolemic shock. Method: Fifteen rats were divided into three groups: sham - simulated surgery; ischemia - animals submitted to hypovolemic shock; and copaiba - animals submitted to hypovolemic shock previously treated with copaiba oil. Mean blood pressure, arterial blood gas after shock induction, degree of intestinal lesion and villus length were evaluated. Results: The sham presented the lowest values of lactate and PaCO2 and the highest values of mean arterial pressure, pH and bicarbonate in relation to the other groups. The degree of mesenteric lesion was zero in the sham group; 3.00±1.00 in the ischemia group; and 3.00±0.71 in the copaiba group. The villus length was 173.60±8.42 in the sham, 142.77±8.33 in the ischemia and 143.01±9.57 in the copaiba group. There was a significant difference between the sham and the other groups (p<0.05); however, there not significant difference between groups Ischemia and copaiba. Conclusion: Administration of copaiba oil did not reduce the intestinal mucosa lesion of rats after hypovolemic shock.
ROUTINE USE OF V-LOCK® SUTURE FOR BARIATRIC ANASTOMOSIS IS SAFE: COMPARATIVE RESULTS FROM CONSECUTIVE CASE SERIES
Authors: BURES Claudia , SEIKA Philippa , DENECKE Christian , PRATSCHKE Johann , ZORRON Ricardo
Published: October 2019

ABSTRACT Background: In high-income countries, morbid obesity is a growing health problem that has already reached epidemic proportions. When performing a laparoscopic gastric bypass several operative methods exist. Aim: To describe the institutional experience using a knotless unidirectional barbed suture (V-Loc 180/Covidien, Mansfield, MA) to create a hand-sewn gastrojejunostomy (GJ) and jejunojejunostomy (JJ) during bariatric surgery. Methods: Evaluation of a case series of 87 morbidly obese patients who underwent laparoscopic gastric bypass with a hand-sewn gastrojejunostomy (GJA) and jejunojejunostomy (JJA) between 01/2015 and 06/2017. The patients were divided into two groups: in group I, GJA und JJA sutures were performed using the knotless unidirectional barbed suture; in group II, GJA and JJA were sutured with resorbable multifilament thread (Vicryl® 3/0 Ethicon, Livingstone, UK). The recorded data on gender, age, BMI, ASA score, operative time, postoperative morbidity, length of hospital stay, and reoperation, were analyzed and compared. Results: All procedures were completed laparoscopically with no mortality. The mean operative time was 123.23 (±30.631) in group I and 127.57 (±42.772) in group II (p<0.05). The postoperative complications did not differ significantly between the two groups. Early complications were observed for two patients (0.9%) in the barbed suture group and for one patient (0.42%) in the multifilament suture group (p<0.05). In group I two patients (0.9%) required reoperation: on the basis of jejunojejunal stenosis in one patient, and local abscess near the gastrojejunostomy, without a leakage, in the other. In group II one patient (0.42%) required reoperation due to stenosis of the GJA. The duration of hospital admission was similar for both groups: 3.36 (±0.743) days in group I vs. 3.38 (±1.058) days in group II (p<0.05). Conclusion: The novel anastomotic technique is a safe and effective method and can be applied to gastrojejunal anastomosis and jejunojejunal anastomosis in laparoscopic gastric bypass.