bluuebunny/crossref_metadata_2025 huggingface dataset:
Usefulness of Child HCAHPS Survey Data for Improving Inpatient Pediatric Care Experiences
Authors: Quigley Denise D. , Slaughter Mary Ellen , Gidengil Courtney , Palimaru Alina , Lerner Carlos , Hays Ron D.
Published: October 2021

OBJECTIVES

Quality improvement (QI) requires data, indicators, and national benchmarks. Knowledge about the usefulness of Child Hospital Consumer Assessment of Healthcare Providers and Systems (Child HCAHPS) data are lacking. We examined quality leader and frontline staff perceptions about patient experience measurement and use of Child HCAHPS data for QI.

METHODS

We surveyed children’s hospital leaders and staff about their use of Child HCAHPS for QI, including measures from other studies. We compared scale and item means for leaders and staff and compared means to other studies.

RESULTS

Almost all leaders, but only one-third of staff, received reports with Child HCAHPS data. Leaders found the data more useful for comparisons to other hospitals than did staff. Both agreed on the validity of Child HCAHPS scores and used these data for improving pediatric care experiences. They agreed the data accurately reflect their hospital’s quality of care, provide specific information for QI, and can be used to improve pediatric care experiences. They also agreed on approaches to improve Child HCAHPS scores. Among staff, QI was reported as essential to their daily work and that Child HCAHPS data were integral to QI.

CONCLUSIONS

As uptake of the Child HCAHPS survey increases, our study of one medium-sized, urban children’s hospital revealed that leaders and staff believe Child HCAHPS provides actionable metrics for improvement. Our study fills a gap in research about the use of Child HCAHPS for pediatric QI. A multisite evaluation would provide further information about how the Child HCAHPS survey can improve care.
Parent and Physician Qualitative Perspectives on Reasons for Pediatric Hospital Readmissions
Authors: Hamline Michelle Y. , Sauers-Ford Hadley , Kair Laura R. , Vadlaputi Pranjali , Rosenthal Jennifer L.
Published: October 2021

OBJECTIVES

One in 5 parents report a problem in their child’s hospital-to-home transition, leading to adverse events, dissatisfaction, and readmissions. Although researchers in several studies have explored parent insights into discharge needs, few have explored perceptions of causes for pediatric readmissions. We sought to investigate factors contributing to pediatric readmissions, from both parent and physician perspectives.

METHODS

We conducted a qualitative study using semistructured interviews with parents, discharging and readmitting physicians, and subspecialist consultants of children readmitted within 30 days of initial discharge from the pediatric ward at an urban nonfreestanding children’s hospital. Participants were interviewed during the readmission and asked about care transition experiences during the initial admission and potential causes and preventability of readmission. Data were analyzed iteratively by using a constant-comparative approach. We identified major themes, solicited feedback, and inferred relationships between themes to develop a conceptual model for preventing readmissions.

RESULTS

We conducted 53 interviews from 20 patient readmissions, including 20 parents, 20 readmitting physicians, 11 discharging physicians, and 3 consulting subspecialists. Major themes included the following: (1) unclear roles cause lack of ownership in patient care tasks, (2) lack of collaborative communication leads to discordant understanding of care plans, and (3) incomplete hospital-to-home transitions result in ongoing reliance on the hospital.

CONCLUSIONS

Clear definition of team member roles, improved communication among care team members and between care teams and families, and enhanced care coordination to facilitate the hospital-to-home transition were perceived as potential interventions that may help prevent readmissions.
Facilitators and Barriers to Providing Vaccinations During Hospital Visits
Authors: Bryan Mersine A. , Hofstetter Annika M. , Ramos Daniela , Ramirez Magaly , Opel Douglas J.
Published: October 2021

BACKGROUND

Many children are undervaccinated at the time of hospital admission. Our objective was to explore the facilitators and barriers to vaccinating during hospitalization.

METHODS

We conducted qualitative interviews of parents, primary care pediatricians, emergency department (ED) physicians, and pediatric hospitalists. Parents of undervaccinated hospitalized children who were admitted through the ED were invited to participate. We used purposive sampling to identify physician participants. Semistructured interviews querying participants' perspectives on hospital-based vaccination were audiorecorded and transcribed. Parent demographics and physician practice characteristics were collected. Transcripts were analyzed for facilitators and barriers to vaccinating during acute hospital visits by using inductive content analysis. A conceptual framework was developed on the basis of the social ecological model.

RESULTS

Twenty-one parent interviews and 10 physician interviews were conducted. Of parent participants, 86% were female; 76% were white. Physician participants included 3 primary care pediatricians, 3 ED physicians, and 4 hospitalists. Facilitators and barriers fell under 4 major themes: (1) systems-level factors, (2) physician-level factors, (3) parent-provider interactional factors, and (4) parent- and child-level factors. Parent participants reported a willingness to receive vaccines during hospitalizations, which aligned with physician participants' experiences. Another key facilitator identified by parent and physician participants was the availability of shared immunization data. Identified by parent and physician participants included the availability of shared immunization data. Barriers included being unaware that the child was vaccine-eligible, parental beliefs against vaccination, and ED and inpatient physicians’ perceived lack of skills to effectively communicate with vaccine-hesitant parents.

CONCLUSIONS

Parents and physicians identified several key facilitators and barriers to vaccinating during hospitalization. Efforts to provide inpatient vaccines need to address existing barriers.
Improving Communication for Admissions From Urgent Care to Inpatient Using a Structured Handoff
Authors: Nedved Amanda , Berg Kathleen , Lee Brian , Montalbano Amanda
Published: October 2021

BACKGROUND

Previous studies reveal that ineffective communication contributes to patient-safety events. Structured handoffs improve communication during shift change and transfers from outpatient clinics to emergency departments. We aimed to improve the perceived quality of admission handoffs from a baseline of 22.2% to 50% by the end of the study period through use of a standardized template between urgent care (UC) and inpatient providers.

METHODS

We used quality improvement methodology to identify key themes (clarity in illness severity, organization, completeness, and pace) that contribute to decreased quality communication. A survey to evaluate the perception of communication and key themes between the groups was administered. During the 15-month quality improvement study at a tertiary pediatric institution, we implemented a handoff tool with visual aids. Givers of information received formal training. Participants received iterative performance feedback. A control chart was used to monitor fidelity to the handoff tool. We used statistical analyses to compare changes in perceived communication between provider types before and after implementation of the handoff tool.

RESULTS

Both UC and inpatient providers had an increased rate of positive perceptions in the overall quality of communication after 12 months of using the admission handoff tool (22% vs 67.3%; P = .01). Complete fidelity to the admission handoff tool increased over time. There was no change in mean duration of handoff (4 minutes) after implementing the structured handoff.

CONCLUSIONS

A structured handoff during admission of pediatric patients from an off-site UC to inpatient setting improved the perception of the quality of admission handoff communication.
Using Quality Improvement and Technology to Improve Social Supports for Hospitalized Children
Authors: Fortin Kristine , Vasan Aditi , Wilson-Hall C. Leigh , Brooks Elizabeth , Rubin David , Scribano Philip V.
Published: October 2021

OBJECTIVES

To develop and test the feasibility of a caregiver self-administered social needs screener, a Web-based searchable community resource map, and a process map for implementation of these tools as part of social needs screening and referral on a pediatric inpatient unit.

METHODS

A multidisciplinary team used quality improvement methodology to develop an electronic social needs screener, resource map Web site, and electronic health record enhancements. A process map for implementation of these tools was refined through plan-do-study-act cycles before full implementation. Weekly measures included the number of eligible caregivers screened, prevalence of reported social needs, and use of social work resources.

RESULTS

During the 22-week study period, 147 caregivers were screened and 2 declined to participate. Thirty-four percent of caregivers endorsed ≥1 social need. The most common needs identified were depressive symptoms (23%), food insecurity (19%), and need for assistance with utilities (10%). All participants received information about the resource map, and 99% of caregivers with an identified need met with a social worker during their admission.

CONCLUSIONS

Using quality improvement methodology and technology, the team implemented a new standardized process for addressing social needs on an inpatient unit. This led to identification of social needs in more than one-third of caregivers screened and provision of resource map information to all caregivers. These findings reinforce the importance of standardized assessment of social needs in the pediatric inpatient setting. The role of technology, including resource maps and electronic health record enhancements, was highlighted.
Decreasing Unnecessary Antibiotic Usage in Patients Admitted With Bronchiolitis
Authors: Naeem Fouzia , Kuzmic Brenik , Khang Leepao , Osburn T. Shea
Published: October 2021

BACKGROUND AND OBJECTIVES

Bronchiolitis is a viral syndrome that occurs in children aged <2 years and is a common reason for admission to children’s hospitals. The American Academy of Pediatrics bronchiolitis guideline discourages routine antibiotic therapy for bronchiolitis. Despite this, there is high use of antibiotics in this patient population.

METHODS

We performed a retrospective chart review of all patients aged ≤2 years admitted to our tertiary care center with bronchiolitis during 2 subsequent respiratory seasons. Between the 2 seasons, we provided an intervention to our hospital medicine group, which included a didactic review of American Academy of Pediatrics bronchiolitis guideline followed by subsequent, ongoing reinforcement from antibiotic stewardship weekday rounds.

RESULTS

We were able to achieve a 40% decrease in overall antibiotic use between the 2 study periods (25% vs 15%, P < .001).

CONCLUSIONS

Provider education, along with focused antibiotic stewardship audits with real-time feedback, resulted in decreased use of antibiotics in patients admitted with bronchiolitis.
Parents as Advocates for Pediatric Palliative Care
Authors: Lord Blyth Taylor , Morrison Wynne , Goldstein Richard D. , Feudtner Chris
Published: October 2021

Caring for a child with a serious or life-limiting illness presents many challenges for families and health care providers. Through that experience (and, many times, as it ends), parents are compelled to find and make meaning from their ultimate loss and the many losses along the way. In this Advocacy Case Study, we describe the experiences that led a bereaved mother to seek to harness the insights from her own family’s loss to help support other families facing the challenges and complexities of a child’s serious illness. Her family initially established a family foundation to advocate for palliative care. She later partnered with her family’s general pediatrician and the American Academy of Pediatrics to educate providers and bring parent voices to health care provider discussions. This work eventually led to the development of the Courageous Parents Network, a nonprofit focused on making these parent and provider voices widely available to families and providers through a Web-based collection of videos, blogs, podcasts, and printable guides. Through these insights, the organization addresses feelings of isolation, anxiety, and grief. In addition, these voices illustrate the power and benefits of the growing acceptance of pediatric palliative care practices. Important lessons learned through these efforts include: (1) the power of stories for validation, healing, and understanding; (2) opportunity to extend the reach of pediatric palliative care through provider education and skill-building; (3) critical importance of the parent–provider advocacy collaboration; and (4) necessity of market testing and continuous improvement.
Integrative analysis of dietary water footprint and dietary quality – Towards the practical application of sustainable nutrition
Authors: Tompa O. , Kanalas O. , Kiss A. , Soós S. , Lakner Z.
Published: October 2021

The contribution of food production to the environmental burden is considerable, therefore, numerous countries have been trying to create a sustainable food supply chain to ensure food and nutrition security. The scope of this study was to analyse the association between water footprint and healthiness based on dietary records. Furthermore, it was aimed to create a classification of integrative dietary indicators of sustainable nutrition. With these methodological aims, the dietary records of 25 healthy adults were assessed. The dietary quality scores and dietary water footprint were calculated and Spearman's rank correlation was tested between them. The indicator nutrients were classified based on their advantageous or disadvantageous health impact and association with water footprint. There was a significant positive correlation between the meat consumption and water footprint, while significant negative correlations were found between the dietary quality score and water footprint and dietary quality score and meat consumption (P< 0.05). Protein, energy, sodium, and saturated fatty acids as integrated indicator nutrients could be identified for both dietary quality and water footprint. The improvement in dietary quality could simultaneously decrease the dietary water footprint. The integration of environmental impact into the analysis of diets could be the future direction in the counseling practice of nutritionists.
Information Technologies of Digital Adaptive Medicine
Authors: Bogomolov Alexey
Published: October 2021

The article provides a comprehensive description of information technologies of digital adaptive medicine. The emphasis is on the applicability to the development of specialized automated complexes, software models and systems for studying the adaptive capabilities of a person to environmental conditions. Requirements for information technologies to enhance these capabilities are formulated. The features of information technologies are reflected in relation to the implementation of applied systemic studies of life support, preservation of professional health and prolongation of human longevity.

Six basic concepts of adaptive medicine with an emphasis on the features of the mathematical support for information processing are characterized, priorities for improving information technologies used in these concepts are determined.

The information technologies used in the tasks of ensuring the professional performance of a person with an emphasis on the need to use adequate methods for diagnosing the state of a person at all stages of professional activity and the need to develop technologies for digital twins that adequately simulate the adaptation processes and reactions of the body in real conditions are considered.

The characteristics of information technologies for personalized monitoring of health risks are given, which make it possible to objectify the effects of physical factors of the conditions of activity and to implement individual and collective informing of personnel about environmental hazards.

The urgent need to standardize information processing methods in the development of information technologies for digital adaptive medicine in the interests of ensuring physiological adequacy and mathematical correctness of approaches to obtaining and processing information about a person's state is shown.

It is concluded that the priorities for improving information technologies of digital adaptive medicine are associated with the implementation of the achievements of the fourth industrial revolution, including the concept of sociocyberphysical systems.
Reabilitação funcional para pacientes acometidos por covid-19
Authors:   Secretaria Municipal de Saúde, De Souza Júlio César , Saraiva Ferreira Joel , Rocha Macedo De Souza Geize
Published: October 2021

O vírus SARS-CoV-2 foi detectado na cidade de Wuhan, na China, no final de 2019. Desde então, a alta transmissibilidade deste novo coronavirus e a elevada morbimortalidade relacionada à COVID-19, a infecção viral causada pelo SARS-CoV-2, cresceu exponencialmente em todo o planeta, culminando, primeiramente, em uma emergência de saúde pública de importância internacional e, logo em seguida, em uma grave pandemia. A transmissão do vírus ocorre tanto por vias respiratórias quanto extrarrespiratórias e durante o período de desenvolvimento da COVID-19 no organismo humano a apresentação clínica inclui sintomas relacionados a alterações no olfato, paladar e complicações gastrointestinais, além do acometimento de forma mais acentuada do sistema respiratório. Em consequência dos sintomas da COVID-19, muitos pacientes precisam ser internados e, em alguns casos, são submetidos a procedimentos invasivos para garantir a condição fisiológica básica para a manutenção da vida. Durante o período de internação os pacientes desenvolvem condição clínica com debilitação fisiológica e a aptidão física geral reduz sensivelmente. Ao receber alta hospitalar, muitos desses pacientes precisam de tratamentos voltados à recuperação da condição física debilitada pela ação da doença. A Secretaria Municipal de Saúde Pública (SESAU) de Campo Grande/MS, na Região Centro-Oeste do Brasil, se mostrou atenta a esta demanda. O Serviço de Doenças Crônicas Não Transmissíveis (DANT), juntamente com a Coordenadoria de Atenção Especializada, estruturou no Sistema Único de Saúde (SUS) um serviço de reabilitação funcional destinado às pessoas com doenças crônicas não transmissíveis, que estiveram internadas por infecção pelo SARS-CoV-2 e precisam de atenção especializada para restabelecer a capacidade de trabalho e de realização das atividades da vida diária. O atendimento é realizado na Unidade Especializada de Reabilitação e Diagnóstico (UERD), que faz parte da Rede Municipal de Saúde (REMUS). Um projeto de reabilitação funcional foi elaborado pela equipe técnica da SESAU, para ser desenvolvido por meio de uma equipe multiprofissional formada por fisioterapeuta, profissional de educação física, nutricionista e psicólogo. As intervenções são realizadas com o uso de Projetos Terapêuticos Singulares (PTS), seguindo critérios de inclusão e exclusão pré-estabelecidos, para pacientes com doenças crônicas não transmissíveis, em condição de pós-internação decorrente de COVID-19. O encaminhamento dos pacientes, vindos dos demais pontos da REMUS, é realizado por médicos dos três níveis de atenção à saúde (primária, secundário e terciário), via Sistema de Regulação (SISREG).
Factors associated with vulnerability and fragility in the elderly: a cross-sectional study
Authors: Sousa Caroline Ribeiro de , Coutinho Janaína Fonseca Victor , Freire Neto João Bastos , Barbosa Rachel Gabriel Bastos , Marques Marília Braga , Diniz Jamylle Lucas
Published: October 2021

ABSTRACT Objectives: to assess factors associated with vulnerability and fragility in the elderly. Methods: crosssectional study with 384 elderly people in Fortaleza, Ceará. The Vulnerable Elders Survey and Clinical-Functional Vulnerability Index - 20 were used. Chi-square and Fisher’s exact tests were used for associations. In the analysis of the combined influence of risk factors, the stepwise logistic regression and multinomial regression methods were adopted. Results: 251 (65.4%) non-vulnerable and 133 (34.6%) vulnerable elders. From the vulnerable elders analyzed, 42 (30.9%) are at high risk for frailty. Factors associated with vulnerability: age, gender, presence of comorbidities, hypertension, diabetes, osteoporosis and use of polypharmacy. There is a 30% increase in the chance of vulnerability for each additional drug. Physical activity reduces the chance of vulnerability by 60%. Factors associated with frailty: educational level; self-perception of health; comorbidities; polypharmacy. Conclusions: it is important to pay attention to the presence of arterial hypertension, osteoporosis, polypharmacy, and encourage the practice of physical activity.
Coping in mental health during social isolation: analysis in light of Hildegard Peplau
Authors: Dal’Bosco Eduardo Bassani , Floriano Lara Simone Messias , Rangel Amanda Gabrieli Schuber Spósito , Ribas Mirian Cristina , Cavalheiro Ana Paula Garbuio , Silva Carla Luiza da , Cabral Luciane Patricia Andreani
Published: October 2021

ABSTRACT Objectives: to analyze the coping of individuals in social isolation due to suspicion or confirmation of coronavirus infection from the perspective of Hildegard Peplau’s Theory of Interpersonal Relations. Methods: this is a qualitative, descriptive research, carried out with 34 individuals in social isolation due to suspicion or confirmation of coronavirus infection who passed through a screening tent of a university hospital in Paraná. Data were collected through semi-structured interviews in June and July 2020. Empirical categories were interpreted by content analysis. Results: four categories emerged: Distance; Social and emotional support; Self-awareness and resolution; Learning. These categories established the coping strategies. Conclusions: individuals undergoing social isolation are more likely to present problems related to mental health. It was highlighted that coping strategies, motivated by nurses, anchored in Hildegard Peplau’s theoretical framework, promoted the necessary learning for promoting participants’ mental health in the face of a pandemic context.
Continuity of care for children with special healthcare needs during the COVID-19 pandemic
Authors: Medeiros José Pinheiro Batista , Neves Eliane Tatsch , Pitombeira Mardênia Gomes Vasconcelos , Figueiredo Sarah Vieira , Campos Daniella Barbosa , Gomes Ilvana Lima Verde
Published: October 2021

ABSTRACT Objective: To describe the continuity of care for children with special healthcare needs during the COVID-19 pandemic through the perception of their caregivers in the Northeast of Brazil. Methods: Qualitative descriptive-exploratory research carried out between June and September 2020, in a municipality in the Northeast of Brazil. Eleven caregivers participated through semi-structured interviews conducted at home. The data were submitted to thematic content analysis. Results: The social isolation period and the suspension of health services affected the continuity of care, configuring the category “Implications of the COVID-19 pandemic for the continuity of care”. Caregivers expressed fear of children contracting the coronavirus, characterizing the category “Fears and uncertainties of the COVID-19 pandemic in view of the vulnerability of children with special healthcare needs”. Final considerations: Caregivers’ reports revealed problems in the continuity of care for the studied cohort. Therefore, health care practices must be rethought in times of pandemic.
ICNP® terminology subset for the care of people with heart failure
Authors: Nascimento Maria Naiane Rolim , Gomes Emiliana Bezerra , Félix Nuno Damácio de Carvalho , Rebouças Cristiana Brasil de Almeida , Nóbrega Maria Miriam Lima da , Oliveira Célida Juliana de
Published: October 2021

ABSTRACT Objective: to develop an ICNP® terminology subset for the care of people with heart failure. Methods: this is a methodological study, which used the theoretical framework of the Mid-Range Nursing Theory for Cardiovascular Rehabilitation, with the steps: Construction of nursing diagnoses/outcomes and interventions statements and Cross-mapping of statements constructed. Results: forty-two diagnosis/outcome statements and 179 nursing intervention statements were constructed, organized based on five theory concepts, with a higher prevalence of statements related to “Rehabilitative care”, “Psychosocial support for patients and families” and “Supervised cardiovascular rehabilitation program”. Final considerations: it was possible to build nursing diagnosis/outcome and intervention statements for developing a terminology subset for the care of people with heart failure, based on the chosen theory.
Cross-cultural adaptation of the Social Appearance Anxiety Scale to the Portuguese language
Authors: Donofre Giovanna Soler , Campos Juliana Alvares Duarte Bonini , Marôco João , Silva Wanderson Roberto da
Published: October 2021

ABSTRACT Objectives To perform the cross-cultural adaptation of the Social Appearance Anxiety Scale (SAAS) to the Portuguese language and estimate its internal consistency in a sample of Brazilian young adults. Methods The cross-cultural adaptation process followed international references based on five stages (translation, synthesis, back-translation, expert assessment, and pretest) to assess idiomatic, semantic, conceptual, and cultural equivalence. The internal consistency was estimated by the ordinal alpha coefficient (α). Results The new Portuguese version is presented in this study with minor changes from the original that did not violate the meaning of the items. This version was tested in 30 adults (women = 56.7%, M age = 26.0 [SD = 6.2] years) who understood the content. The participants completed the scale in an average time of 4.6 (SD = .6) minutes. The internal consistency of the scale was good (α = .95) when applied in a sample of 80 adults (women = 51.2%, M age = 28.0 [SD = 5.7] years). Conclusions The new Portuguese version of the SAAS was equivalent to the original in the idiomatic, semantic, and conceptual area. As the Brazilian participants understood the Portuguese version, cultural equivalence was found. The instrument’s internal consistency was adequate to the sample. The findings of this study may help researchers and clinicians interested in using the SAAS in Brazilian context for tracking characteristic symptoms of social anxiety due to physical appearance. However, before using SAAS in any protocol, it is important to evaluate its psychometric properties, especially the construct validity.
Relationship between levels of mindfulness and substance use pattern
Authors: Baptista Júlia de Souza , Leite Tatiana Henriques , Ferreira Vanessa Karam de Lima , Magalhães Luciana de Souza Pereira de , Cruz Marcelo Santos , Mathias Ana Carolina Robbe
Published: October 2021

ABSTRACT Objective Evaluate the association between levels of mindfulness and sociodemographic characteristics and pattern of drug use of individuals seeking treatment in a University Service Specialized in Substance Use Disorders. Methods This is a cross-sectional study with 164 individuals over 18 years of age seeking treatment for the use of psychoactive substances in the June 2018-December 2019 period, using a questionnaire for sociodemographic data, the Mindful Attention Awareness Scale (MAAS) self-reporting instrument, and the Alcohol, Smoking, and Substance Involvement Screening Test. Results An association was found between low levels of mindfulness mainly with the individual risk of being a medium/high-risk user of sedative-hypnotic drugs (p = 0.020). A borderline association was also found between MAAS and the risk of the individual being a medium/high risk of alcohol (p = 0.053) and with a more severe pattern of substance use (p = 0.065). Conclusion Individuals seeking treatment for substance use presented impairments in the attentional aspect of mindfulness and levels of mindfulness seem to protect against behaviors related to substance use, especially against the use of high/moderate risk of sedative-hypnotics.
A perspectiva dos homens sobre os partos domiciliares planejados
Authors: Brigagão Jacqueline Isaac Machado , Gonçalves Roselane
Published: October 2021

Resumo Este artigo apresenta os resultados de uma pesquisa que teve por objetivo estudar a perspectiva dos homens/pais sobre o parto domiciliar e os modos como eles participaram do nascimento de seus/suas filhos/as. Realizamos entrevistas semiestruturadas com cinco homens que participaram dos partos domiciliares e do nascimento de seus filhos. A análise discursiva possibilitou identificar que os homens prepararam-se para o parto, vivenciaram muitas expectativas e aprendizagens nesse processo, enfrentaram diversos preconceitos contra o parto domiciliar e participaram ativamente do parto e do pós-parto. Concluímos que, na perspectiva dos homens/pais, o parto domiciliar é uma experiência enriquecedora que amplia as possibilidades de participação dos homens nesse evento e o exercício da paternidade durante o planejamento e o parto.
A vez dos leitores: o retornar do desastre
Authors: Papini Pedro Augusto , Fonseca Tania Mara Galli
Published: October 2021

Resumo Neste artigo levantamos as problemáticas sobre uma função ética da criação e da imaginação diante dos restos do desastre. Objetivamos percorrer articulações teóricas que enredam as reflexões sobre os conceitos de testemunho e de lugar de fala, colocando-os em perspectiva no que concerne a remontar ou recontar o tempo sofrido. Para isso, localizamos vincos aporéticos nesses conceitos, os quais insistem na exploração do lugar da leitura e do leitor diante de um tempo paradoxal que se coloca também como produção e invenção do tempo presente. Exploramos o caminho das articulações entre tempo, imaginação, imagem, catástrofe e responsabilidade, tendo como resultado a ampliação de um ponto de vista ético pelo ato de criação, que coloca a leitura como produtora de memória.
Humor y copla. Hacia una educación sentimental*
Authors: ROSAL NADALES María
Published: October 2021

Resumen La educación sentimental durante la dictadura franquista tuvo en la copla una poderosa aliada, gracias al éxito popular y a su enorme difusión. Abordamos en este trabajo el estudio de la copla desde la perspectiva de su carácter de manual normativo de las costumbres de la época y de las imágenes de mujer que transmite. Los modelos patriarcales se difunden a través de la copla, habitualmente por medio de textos dramáticos. Sin embargo, aunque en menor medida, también se publicaron obras que basan en el humor la construcción de imágenes de mujeres que recurren a los estereotipos para ridiculizar modelos y situaciones. Centramos el análisis en un corpus de obras de Rafael de León.
Viver com HIV/Aids em contextos descentrados: articulações e modos de pensar (em torno de) subjetividades políticas*
Authors: Oliveira Thiago de Lima , Damasceno Éverson de Brito , Melo Lucas Pereira de
Published: October 2021

Resumo Este artigo aborda o modo como categorias de diferenciação como sexualidade, geração, classe social e lugar são corporificados em trajetórias de vida de pessoas vivendo com HIV/aids em cidades interioranas do Nordeste brasileiro. Nesse sentido, buscamos explorar a articulação entre noções de pessoa, práticas de cuidado e de conhecimento à luz da constituição de subjetividades políticas. A proposta é ampliar o olhar sobre processos de sofrimento social, sexualidade e saúde e suas complexas relações que conferem sentido e lugar ao vírus, ao cuidado, ao adoecer e suas economias de conhecimento.
Aplicación del enfoque decolonial y de equidad de género en instituciones de educación básica y media alternativa en Colombia*
Authors: MUÑOZ GAÑAN Gicela , LÓPEZ BRAVO Dayan , RINCÓN PRÉSIGA Ángela
Published: October 2021

Resumen La investigación se hizo con el fin de identificar en algunas experiencias pedagógicas la implementación de los enfoques de equidad de género y decolonial, en algunas instituciones de educación básica y media alternativas en tres ciudades de Colombia. La metodología fue cualitativa y se hizo con el diseño de categorías de análisis y la construcción de información con fuentes primarias, como entrevistas abiertas, observación registrada en fotografías y diarios de campo. Uno de los hallazgos relevantes es la relación que hacen algunos docentes entre la equidad de género y el ejercicio de la sexualidad o la diversidad sexual de sus estudiantes.
“Juntas imparables”: femvertising como estrategia publicitaria en Nike*
Authors: MENÉNDEZ-MENÉNDEZ María Isabel
Published: October 2021

Resumen En una época caracterizada por la visibilidad del feminismo muchas firmas están utilizando la femvertising, publicidad formalmente comprometida con la igualdad pero puesta bajo sospecha por su intrínseco carácter comercial. Se analiza el fenómeno mediante un estudio de caso de la empresa Nike para diagnosticar si la marca trabaja adecuadamente por la equidad de género y la autonomía de mujeres y niñas. Las conclusiones demuestran que es posible realizar una comunicación comercial que mejore la relación de las mujeres con el deporte y que favorezca su empoderamiento.
Factors associated with unfavorable outcome of tuberculosis treatment in people deprived of liberty: a systematic review
Authors: Saita Nanci Michele , Andrade Rubia Laine de Paula , Bossonario Pedro Augusto , Bonfim Rafaele Oliveira , Hino Paula , Monroe Aline Aparecida
Published: October 2021

ABSTRACT Objective: to analyze factors associated with unfavorable outcome of tuberculosis treatment in people deprived of liberty. Method: systematic review, carried out in March 2021 in seven databases, with no delimitation of period of publication. The selection process of publications and data extraction was carried out by two independent reviewers. Results: a total of 1,448 publications was identified and nine were included in the study. Unfavorable outcome was higher among those who were men; had low level of education; were living in a rural area before detention; had longer prison time; received occasional visits; had been transferred between prisons; with no sputum smear microscopy or with a positive result at the diagnosis; with no follow-up sputum smear microscopy, previous history of tuberculosis; having both clinical forms of the disease, HIV/AIDS; alcoholics; smokers; low body weight; and self-administered treatment. Treatment default was associated with young people and death with older people. Conclusion: prison health managers and professionals are expected to establish mechanisms of surveillance and health actions innovation aimed at the population deprived of liberty, making efforts to reduce the unfavorable outcomes of tuberculosis treatment.
Peripherally inserted central catheter in newborns: association of number of punctures, vein, and tip positioning
Authors: Carneiro Thaís Aquino , Nobre Keline Soraya Santana , Fontenele Fernanda Cavalcante , Façanha Ana Paula Melo , Ferreira Roberta Pinheiro
Published: October 2021

ABSTRACT Objective: to assess the use of peripherally inserted central catheters regarding the neonate’s profile, indications for use, and catheterized vein; the relation between the number of puncture attempts and vein; and assessment of the catheter tip position. Method: documentary, descriptive, retrospective, quantitative study, developed in a tertiary maternity hospital in Ceará. A total of 3,005 PICC insertion formularies was included and 1,583 were excluded due to incomplete data, with a convenience sampling of 1,422 insertions being obtained. Results: There were 1,200 (84.4%) newborns with gestational age below 37 weeks; 781 (54.9%) males; Apgar score above 7 in the first (628–44.2%) and fifth minutes (1,085–76.3%); and weight between 1,000 and 1,499 grams on the day of insertion (417–29.3%). Antibiotic therapy had 1,155–53.8% indications for insertion; the basilic was the most used vein (485–34.1%); basilic and cephalic veins had lower median puncture attempts and 1,124–79% insertions were centrally positioned. Conclusion: The results of this research highlight the continuous need to improve technical-scientific knowledge to qualify actions in neonatology.
Hand hygiene by the nursing team in home care: a cross-sectional study
Authors: Cordeiro Jéssica Fernanda Corrêa , Menegueti Mayra Gonçalves , Laus Ana Maria , Tipple Anaclara Ferreira Veiga , Santana Rodrigo Carvalho , Canini Silvia Rita Marin da Silva
Published: October 2021

ABSTRACT Objective: to identify whether nursing professionals carry out hand hygiene, how they do it, and what resources are available for this practice during home visits. Method: cross-sectional study conducted in a public Home Care service. The World Health Organization instrument was used to observe the hand hygiene technique, the time of performance, and the product used. Results: a total of 940 hand hygiene opportunities taking place in 231 home visits were observed. Overall adherence was 14.4%, with the practice of hand hygiene being higher after contact with the patient (53.7%). Before aseptic procedures, after risk/exposure to body fluids, after contact with the patient’s environment, and before contact with the patient, adherence was 0.4%. Regarding the quality of the technique, in none of the 135 practices the recommended steps were followed. As for the structure available in the households, 35 (15.2%) had accessible sinks and none had liquid soap and alcohol-based formulation. Conclusion: adherence to hand hygiene by nursing professionals in home care was low, the technique was not performed, and households did not have resources for the practice.
NURSING INTERVENTIONS TO PROMOTE CHILD DEVELOPMENT THROUGH BRONFENBRENNER'S BIOECOLOGICAL THEORY
Authors: Sousa Rute Costa Régis de , Monteiro Estela Maria Leite Meirelles , Albuquerque Grayce Alencar , Paula Weslla Karla Albuquerque de , Coriolano-Marinus Maria Wanderleya de Lavor
Published: October 2021

ABSTRACT Objective: to analyze the benefits and limitations of nursing interventions for the promotion of child development, according to the Bioecological Theory of Human Development, by Bronfenbrenner. Method: an integrative review, from the databases PubMed, Lilacs, CINAHL, Web of Science and Scopus, using the descriptors: "child development" AND "nurses" OR "nursing". No time limit was set for publications. The search was perfomed in September 2019 and update in March 2020. Results: 24 studies were selected for the final sample. The predominant type of study design was the clinical trial (60%). The home visit was the most used strategy (60%). Seven main themes emerged from the outcomes of the interventions: the child, maternal health, parenting skills, relationship between nurse and mother/father, use of social benefits, professional practice, and family violence. The process component was present in all studies, portraying the relevance of proximal interactions in the home environment. Only two interventions had no impact on any outcome. Conclusion: nursing interventions showed benefits in all outcomes, especially in outcomes related to children and parental practices, and improved situations of interaction between caregivers and children, reducing punitive practices and violence against children. It is essential to consider the bioecological perspective, so that nursing interventions, in promoting child development, are more effective.
Prevenção Quaternária: da medicalização social à atenção integral na Atenção Primária à Saúde
Authors: Schopf Karina , Vendruscolo Carine , Silva Clarissa Bohrer da , Geremia Daniela Savi , Souza Aline Lemes de , Angonese Lucas Lasta
Published: October 2021

Resumo Objetivo conhecer as percepções e perspectivas dos profissionais da saúde para o desenvolvimento da Prevenção Quaternária na Atenção Primária à Saúde. Método Pesquisa Apreciativa, que aplicou as fases do “ciclo 4-D”, na língua inglesa: discovery, dream, design e destiny. Este artigo analisa os resultados referentes à fase discovery (descoberta), de cujos dois encontros correspondentes participaram nove profissionais da Atenção Primária. Realizou-se análise de conteúdo, seguindo as etapas de pré-análise, exploração do material e tratamento dos dados. Resultados a Prevenção Quaternária representa uma potencialidade na inovação da atenção, com possibilidade de reduzir a medicalização social, que ocorre mediante a sobremedicalização, sobrediagnósticos e sobretratamentos. Como perspectivas, é apresentada a necessidade de conscientização da sociedade e dos profissionais sobre esses excessos e de (re) posicionamento da indústria, do mercado e da mídia sobre o significado de “estar saudável”. Conclusão e implicações para prática é necessário atentar para a ética na prestação de cuidados quanto ao rastreio, diagnóstico e tratamento de doenças. A Prevenção Quaternária tem potencial para reverter um modelo hegemônico em relação ao cuidado de indivíduos e famílias ao fomentar a integralidade. A Enfermagem, como prestadora do cuidado, junto com a equipe multiprofissional, deve incorporar ações de Prevenção Quaternária em suas práticas.
A method to estimate the damage of Diabrotica speciosa larvae on potato tubers
Authors: Barboza Marcos Roberto , Outeiro Vitor Hugo , Tokarski Alessandra , Rech Caroline , Kawakami Jackson , Nardi Cristiane
Published: October 2021

ABSTRACT The marketable value of potato tubers is affected by damage caused by Diabrotica speciosa, whose larvae create holes on the tubers’ skin and internal feeding tunnels. The estimation of potato tuber damage is usually performed by assessing the external damage to the detriment of feeding tunnels caused by larvae. Thus, we propose a method to estimate the damage caused by D. speciosa larvae, considering the external and internal aspects of the tubers separately. For that, potato plants cv. Agata were grown under different infestations of larvae, measuring the area occupied by the holes and the volume of internal feeding tunnels, relating these data to the total area and volume of the tuber. The methodology used allowed us to characterize an increase in damage in tubers with the highest infestation of larvae. The correlation between internal and external damage caused by D. speciosa larvae was not significant, indicating that external damage alone is not an adequate parameter for the diagnosis of overall tuber quality. However, the method proposed here provides information regarding the volume of pulp consumed by the larvae, the extent of the galleries formed, and the relative volume of damage concerning the total tuber. Moreover, the method proposed here contemplates a more precise analysis of the external area damaged by herbivory relative to the total area of the tuber, which is not commonly considered in studies of underground plant structures.
An approach for experiment evaluations for multiple harvests crops based on non-linear regression
Authors: Lúcio Alessandro Dal’Col , Diel Maria Inês , Sari Bruno G
Published: October 2021

ABSTRACT Biologically based growth models can be an alternative in identifying the productive response of multiple harvest vegetables. By interpreting the estimates of the parameters of the models, it is possible to estimate the total production, the rate of fruit production, and the moment when the crop reaches its maximum production potential. Besides, by estimating confidence intervals, these responses can be compared between genotypes or between different treatments. Therefore, the purpose of this manuscript is to present a literature review, and a detailed step-by-step, to interpreting the evolution of the production cycle of vegetables with multiple harvests crops based on non-linear regression. All the requirements that must be met in this type of analysis were presented in detail based on non-linear regression, providing the necessary steps for this type of analysis in details. Demonstration is given using data from strawberry cultivation along with the associated R scripts and interpretation of analysis output in material supplemental. This approach can allow for more relevant inferences than standard means analyses through better examination and modeling of the underlying biological processes.
Occurrence of Pseudomonas fluorescens and P. putida associated to tomato pith necrosis in Brazil
Authors: Mota Lara Caroline BM , Tebaldi Nilvanira D , Luz José Magno Q
Published: October 2021

ABSTRACT In 2016, several reports emerged of fresh-market staked tomato plants with severe symptoms of pith necrosis and premature death in commercial cultivation areas in the states of Paraná and Minas Gerais, Brazil, which are similar to those caused by Pseudomonas corrugata. Four bacterial strains were isolated from infected tissue samples and characterized as Gram-negative, aerobic, and fluorescent on King’s B Medium. LOPAT tests were performed and the isolate UFU H120 was classified into group Vb (+ + − + −) and the isolates UFU H3, UFU H6, and UFU H21 into group Va (− + − + −). The pathogenicity of the isolates was confirmed by artificial inoculation on tomato plants of Santa Cruz type, cv. Kada Gigante, and Koch’s postulates were accomplished successfully. The isolates sequences of their 16S rRNA gene region were compared with those deposited in GenBank, the isolate UFU H120 aligning with Pseudomonas fluorescens (99,45% similarity) and the isolates UFU H3, UFU H6, and UFU H21 with Pseudomonas putida (99.2, 99.53 and 99.64% similarity, respectively). Notably, P. fluorescens and P. putida are most known as saprophytic bacteria normally present in the soil, although both of these species have already been reported to infect tomato plants in Italy. However, so far, there have not been any reports of such bacteria being phytopathogenic on tomato or any crop in Brazil. Thus, to our knowledge, this is the first report of pith necrosis of such occurrence in Brazil.
Differential growth and yield responses of local potato cultivars from basic seed tubers
Authors: Córdoba-Figueroa Mónica Eliana , Criollo-Escobar Hernando , Insuasty-Córdoba Sandra , Mateus-Rodríguez Julián Fernando
Published: October 2021

ABSTRACT Potato quality of seed tubers is a determinant factor that allows obtaining high yields, and its use must be a priority for a country or a producing region. Lack of information about how local cultivars perform differentially according to the environment has been identified in order to support potential seeds production programs. The research was carried out in 2018 at the Obonuco Research Center of Corporación Colombiana de Investigación Agropecuaria (AGROSAVIA), with the aim of analyzing the growth and yield of basic tuber seeds of five potato (Solanum tuberosum spp. andigena) cultivars. 1,080 seed tubers from each cultivar (treatments) were planted in a completely randomized block design and three replications. Mean comparison Tukey-Kramer (p≤0.05) test was performed for the yield analysis. From emergency to final harvest, destructive sampling was carried out every fifteen days in order to calculate dry matter and leaf area and establish growth models based on the accumulated degree-days (DD). The yield and proportion of seed tubers per plant were determined according to local resolution for seed certification in Colombia. Growth variables fitted better with the Hoerl, Gaussian, and third-degree polynomial models. The leaf area index of the potato cultivars reached the maximum value at 876 DD, with values ranging from 2.91 to 6.11 DD. The highest yield per plant was obtained by the Ica Única cultivar (2.73 kg plant-1). However, this cultivar showed the lowest percentage of seed tubers, with 50.59% compared to the others, which ranged between 80.82 and 87.40%. Differential potato growth responses through models based on the DD would explain the differences in final yield and seeds tuber production.