Revista Contexto & Saúde is a publication of the Stricto-Sensu Graduate Program in Comprehensive Health Care at the Regional University of Northwestern Rio Grande do Sul (UNIJUÍ) and Unijuí Publisher. The Journal was created in 2001. All its articles are available in online format. The Journal aims to disseminate technical-scientific production on topics related to the Health Sciences area. The scope of the journal covers the dissemination of research results that contemplate advances in the health-disease-care process and in the knowledge and applicability of new chemical and biological processes in health. In this journal, it is understood that the publication of studies with epidemiological, care, and educational aspects in health, both experimental and applied, is a way to support and qualify health care in an interdisciplinary manner. ISSN: 2176-7114
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Knowledge of health professionals on nutritional management of obese adolescents in primary health care
This study assessed primary care personnel’s knowledge regarding nutritional management for obese adolescents receiving care in Primary Health Care under Brazilian Unified Health System in Piauí. This descriptive, cross-sectional, quantitative study used data from the Obesity Prevention and Control Program implemented in Primary Health Care under Brazilian Unified Health System in Piauí, conducted between March and October 2021. Health professionals completed two questionnaires: “Knowledge of Nutrition in Obese Adolescents” and “Diagnosis of the Organization, Management, and Nutritional Care Offered to People with Overweight and Obesity in Primary Health Care”. Statistical analyses were performed using Stata version 14. Differences between nutritionists and other health professionals were assessed using the Student’s t-test and the Mann-Whitney U test, with a 5% significance level. Out of 585 primary health care units across the 190 municipalities included in the sample, 183 health professionals participated in the study, the majority being nutritionists (71.58%), public sector employees (41.53%), and working in rural areas (51.91%). Among all participants, 59.02% showed knowledge rated as good or very good. Statistical differences were observed between respondent groups, with dietitians demonstrating higher knowledge regarding general adolescent nutrition in obesity (p=0.000) and across specific questionnaire topics: fruit and vegetable consumption (p=0.010), fat intake (p=0.000), and nutritional management for obese adolescents (p=0.000). The implementation of public policies aimed at the training and ongoing education of health professionals, emphasizing obesity prevention and control, should be encouraged.
Copyright (c) 2025 Layonne de Sousa Carvalho Rodrigues, Jéssica Batista Beserra, Osmar de Oliveira Cardoso, Marize Melo dos Santos http://creativecommons.org/licenses/by/4.0
High-risk pregnancy due to hypertension: Childbirth care and associated factors
This study aimed to analyze the factors associated with high-risk pregnancy due to hypertension, as well as childbirth care in a high-complexity public maternity hospital linked to the Stork Network Program. This was a cross-sectional observational study conducted in a state tertiary referral maternity hospital for high-risk pregnancy and childbirth, part of the Stork Network Program, located in Fortaleza, Ceará, Brazil. A total of 300 postpartum women with high-risk deliveries participated. Most participants had low socioeconomic conditions and lived in situations of social vulnerability. Statistical associations were observed between age group and parity (p < 0.001), educational level and first pregnancy (p = 0.002), maternal age and choice of maternity hospital (p = 0.03), and age and not being admitted at the first maternity hospital visited (p = 0.014). High-risk pregnant women in socially vulnerable situations had access to prenatal care, starting in the first trimester, but faced difficulties in accessing maternity services, often going through two or more facilities in search of childbirth care. The maternity hospitals did not guarantee all the rights of pregnant women, weakening the humanization of care during childbirth and the postpartum period.
Copyright (c) 2025 Revista Contexto & Saúde http://creativecommons.org/licenses/by/4.0
Collaborative interprofessional practice between primary healthcare professionals and residents
To understand Collaborative Interprofessional Practice experiences from primary healthcare professionals’ and residents’ perspective. This qualitative study involved 12 healthcare professionals and residents, including residents with at least three months of service and professionals with more than six months of service. Data collection used semi-structured interviews, lasting an average of 25 minutes. After transcribing the recordings, the statements were organized into topics. It was revealed that understanding Collaborative Interprofessional Practice must be based on interactions with professionals to serve several areas of the healthcare universe. Service experiences and strengthening of the topic permeate numerous specific situations in the studied service, but the collaborative act strengthens care. Professionals and residents understand that Collaborative Interprofessional Practice is essential for strengthening healthcare.
Cláudia Machado Coelho Souza de Vasconcelos
Perception of ethical climate among nurses in the hospital setting
Understanding nurses’ perceptions of the ethical climate based on their experiences of moral distress in the face of ethical and moral conflicts encountered in the hospital setting. This is a qualitative, exploratory-descriptive study conducted with 20 nurses working in psychiatry, emergency care, surgical clinic, and obstetric center of a university hospital in southern Brazil. Data collection took place between August and October 2021 through semi-structured interviews. Discursive textual analysis was employed. Two categories emerged: the first, “The ethical climate in the hospital setting” addressed aspects related to weaknesses and conflicts in care, interpersonal relationships, and management based on hierarchical structures; the second, “Moral sensitivity fostering an ethical climate in nursing practice”, referred to patient rights advocacy, organizational policies and practices, and professional recognition and appreciation. Moral sensitivity and effective communication are key elements for a positive ethical climate, as they promote an appropriate care environment and contribute to the defense of patient rights.
Copyright (c) 2025 Camila Milene Soares Bernardi, Ariel Siqueira Lemos, Camila Antunez Villagran, Taís Carpes Lanes, Valdecir Zavarese da Costa, Graziele de Lima Dalmolin http://creativecommons.org/licenses/by/4.0
Validity based on internal structure of the Kidney Transplant Understanding Tool – Brazil (K-TUT-BR)
This study aimed to evaluate the evidence of validity based on the internal structure of the "Kidney Transplant Understanding Tool - Brazil" (K-TUT-BR). This is a methodological study with quantitative approach in which the data collection took place through the application of a sociodemographic/clinical questionnaire and K-TUT-BR. The participants were pre-transplant renal patients or outpatient follow-up transplants. The sample consisted of 300 patients. The study was approved by the Research Ethics Committee under Opinion number 5,939,285. The data were analyzed in the software FACTOR version - 12.04.01 and JASP version 0.17.3.0. Successive exploratory factor analyses were performed for the set of items, followed by analysis of variance of the items. In this study, a 4-factor model (F1, F2, F3 and F4) was found for 11 items of the instrument under test, with good adjustment indices. The parallel analysis recommended extraction of four factors as the most representative for the data, which revealed acceptable composite reliability (greater than 0.70) for F1 and F3 factors. The overall reliability of the instrument was also acceptable (CRC=0.660). Thus, the K-TUT-BR represents an important instrument to evaluate patients' knowledge about kidney transplantation.
Niellys de Fátima da Conceição Gonçalves Costa
Copyright (c) 2025 Andriel Tavares de Aquino, Natália Ramos Costa Pessoa, Ravana Amália Ribeiro Barreto, Niellys de Fátima da Conceição Gonçalves Costa, Mônica Maria Oliveira da Silva, Camila Francielly de Santana Santos, Katarinne Lima Moraes, Cecília Maria Farias de Queiroz Frazão http://creativecommons.org/licenses/by/4.0
Analysis of the RS10750097 and RS3741298 polymorphisms of the APOA5 genes in relation to dyslipidemia
Dyslipidemia is characterized by a disorder in lipid metabolism and arises from external causes or predisposing genetic disorders. This observational, cross-sectional study aimed to analyze the correlation between the genetic polymorphisms RS10750097 and RS3741298 associated with the lipoprotein ApoA5-ZNF259 and the development of dyslipidemia. A sample of 200 Military Police officers from the state of Goiás was used, and genotyping of the polymorphisms was performed. Regarding the participating individuals, 93% were male and 7% were female. The polymorphisms observed in the groups with and without dyslipidemia showed a significant difference between the two groups for all variables analyzed (p<0.05) The present study found that the RS10750097 and RS3741298 polymorphisms did not increase the odds ratio of the dyslipidemia group actually having dyslipidemia (OR and 95% CI <1), which corroborates with previously described studies in different populations. Therefore, the RS10750097 and RS3741298 polymorphisms did not influence the development of dyslipidemia within the variables involved in this study and in this population, despite being part of the SNP spectrum of the APOA5 ZNF 259 region. Thus, the influence of each population's epigenetics on the results is observed, and the need for similar research in other target groups is highlighted.
Organic silicon in the acceleration of tissue healing in wound healing by secondary intention
Objective: To evaluate the efficacy and safety of different concentrations of organic silicon in tissue repair in wounds with healing by second intention. Methodology: A total of 27 Wistar rats were divided into five groups: Control (n=5), Hydrogel (n=5), 5% Silicon (n=5), 10% Silicon (n=6), and 15% Silicon (n=5). For this purpose, incision and dissection of the tissue were performed in the region of the dorsal midline close to the scapulae, up to the muscular fascia (2 cm² area). Following this, the wound was cleaned daily with saline and gauze in all animals, with subsequent treatment with organic silicon at concentrations of 5%, 10%, and 15%, and hydrogel, respectively. At the end of 23 days, euthanasia and blood collection for hematological and biochemical analysis were performed. Results: Treatment with 15% organic silicon was more effective in shedding the crust and in tissue repair of the lesion. The safety of silicon in the treatment of wounds was demonstrated from laboratory tests that did not indicate hematological, hepatic, and renal toxicity with the proposed treatment. Conclusion: It was found that 15% organic silicon is effective in accelerating wound healing by second intention and has not shown any toxic effect on hematological, metabolic, hepatic, and renal parameters.
Copyright (c) 2025 Alexander Rodrigues de Souza, Lucas Machado Sulzbacher, Evandro Tatim da Silva, Diovana Gelati de Batista, Guilherme Pimentel Soares Lima, Juliana Furlanetto Pinheiro, Welerson Roberto dos Reis, João Vinícius Müller Kaufmann, Gabriele Maria Callegaro Serafini, Maicon Machado Sulzbacher, Pauline Brendler Goettms Fiorin, Mirna Stela Ludwig, Thiago Gomes Heck, Matias Nunes Frizzo http://creativecommons.org/licenses/by/4.0
Challenges of nurses and caregivers in the care of children in oncological treatment
The practice of caring in pediatric oncology is challenging, since it requires, in addition to specific material and therapeutic resources, a health team and caregivers attentive to the demands inherent to this universe. Thus, the objective was to analyze the challenges of caring for children with cancer from the perspective of nurses and caregivers. It is a strategic social research, with qualitative approach, which had as participants 18 nurses and caregivers of children in oncological treatment of two public health institutions of the hinterland of Pernambuco. Data collection was carried out by semi-structured interviews, analyzed in the light of the Complexity Paradigm. Thus, from the reports of the research participants, several challenges were identified as a result of cancer treatment emerged as a challenge for nurses and caregivers in the follow-up of the affected child, what required these actors the development of mechanisms to deal with situations of uncertainty and insecurity, in order to provide care without being overwhelmed by the difficulties imposed by the context of the disease. Nurses and caregivers listed relevant aspects about barriers to cancer therapy, revealing strategies used to overcome barriers found and, thus, it was shown that the emotional of the interviewees appeared as a hindrance to treatment, beyond the recognition of the existence of gaps in the training of nurses, limiting their performance. It is concluded, therefore, that the challenges experienced in the care of children with cancer involves a context of significant changes in the routine of the family and the child, as well as difficulties in the logistics of displacement and hospitalization, and the awakening of fears and uncertainties before the treatment brings negative impacts on the experience of this disease process.
Flávia Emília Cavalcante Valença Fernandes
Copyright (c) 2025 Lana Quele Pereira da Silva, Flávia Emília Cavalcante Valença Fernandes, Mariane Cardoso Carvalho, Joebson Maurilio Alves dos Santos, Rosana Alves de Melo http://creativecommons.org/licenses/by/4.0
Analysis of the longitudinality attribute with the implementation of the advanced access model: multiple case study
The aim was to evaluate the longitudinality of care in family health units before, during, and after the implementation of the Advanced Access model. The reference for this evaluation was the usual provider continuity index (UPC). This was a descriptive study with a mixed-methods approach, conducted at the Southern Regional Coordination of the city of São Paulo-SP. The research participants were the coordinators of 5 basic health units (BHU), doctors, nurses, and 295 users of these BHU. Data were collected using the Primary Care Assessment Tool (PCATool) and production records available at the BHU. The data were organized on the REDCap® platform. Statistical analysis was performed using R® software. The results demonstrate that 3 of the 5 BHUs had a higher provider continuity index (UPC) before the implementation of the Advanced Access model, indicating that in these BHUs the implementation of the Advanced Access model compromised the longitudinality of care. In contrast, in two BHUs, there was an improvement in the provider continuity index (UPC) after the model was implemented. It was concluded that the longitudinality of care attribute was due to planning and coverage problems in the BHUs in the southern region of the city of São Paulo. These problems cannot be attributed solely to the implementation of the Advanced Access model.
Copyright (c) 2025 Celia Regina Maganha e Melo, Lislaine Aparecida Fracolli, Larayne Gallo Farias Oliveira http://creativecommons.org/licenses/by/4.0
Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios as predictive biomarkers for decreased glomerular filtration rate in patients with type 2 diabetes mellitus
Diabetes mellitus is considered one of the major public health problems of the 21st century and is one of the most important risk factors for chronic kidney disease. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are biomarkers associated with systemic inflammation, measured through complete blood count, and have been investigated as biomarkers for other inflammatory diseases, showing promising results. In this context, diabetic nephropathy is associated with chronic low-grade inflammation. Therefore, the present study aimed to evaluate the correlation between leukocyte parameters and renal function biomarkers in patients with type 2 diabetes mellitus (T2DM). A total of 33 male patients with T2DM, with a mean age of 65 years, underwent clinical and laboratory assessment to evaluate hematological and biochemical parameters. Descriptive statistical analysis was performed using the Kolmogorov-Smirnov test for normality, Pearson’s test (for parametric data), or Spearman’s test (for nonparametric data), with statistical significance set at P ≤ 0.05. NLR and PLR were inversely correlated with decreased glomerular filtration rate and positively correlated with increased urea and creatinine concentrations. The use of NLR and PLR proved to be predictive biomarkers for reduced glomerular filtration rate in patients with T2DM, representing a low-cost tool in patient care.
Copyright (c) 2025 Carla Luara Lima Padilha, Maicon Machado Sulzbacher, Pauline Brendler Goettems Fiorin, Mirna Stela Ludwig, Matias Nunes Frizzo http://creativecommons.org/licenses/by/4.0
Prenatal care and systemic arterial hypertension previa in women with pre-eclampsia
Hypertensive syndrome in pregnancy has become a serious global health problem, resulting in high hospitalization rates. The objective was to characterize women with preeclampsia treated at a public maternity hospital. This was a retrospective cross-sectional study of pregnant women hospitalized in a public maternity hospital in Piauí between 2017 and 2021, using the International Classification of Diseases (ICD)-10 O14. The sample consisted of 186 medical records. Measures of central tendency, separatrices, simple and relative frequencies, and a chi-square test with p<0.05 were used. The measure of the effect of the independent variables on the outcomes was the Prevalence Ratio (PR), measured by Poisson regression. Clinical and obstetric characterization revealed that 70.6% were multigravidae, 37.5% were nulliparous, and 17.7% had already had some type of abortion. The majority of deliveries were cesarean sections (76.2%). A total of 85.7% of pregnant women received prenatal care and 38.4% had up to 6 prenatal appointments, with 31% of pregnant women having their first appointment in the third trimester of pregnancy. Regarding the association of clinical characteristics with previous Systemic Arterial Hypertension (SAH), compared to full-term, preterm gestational age increases the chances of previous SAH by 2.78 times Regarding clinical characteristics and postpartum complications, preterm births increase the prevalence of postpartum complications by 5.0 times compared to full-term births. The prevalence of previous systemic arterial hypertension was 20.6%. Regarding prenatal care, 85.7% reported having attended prenatal care, with 38.4% reporting up to six appointments. Furthermore, 31% reported late initiation of prenatal care.
Copyright (c) 2025 Morgana Boaventura Cunha, Maurício Batista Paes Landim http://creativecommons.org/licenses/by/4.0
Urinary infection rate associated with indwelling bladder catheters in intensive care units
Objective: To identify the infection rate related to the use of indwelling urinary catheters in patients admitted to intensive care units. Method: A cross-sectional, retrospective study was conducted at a public referral hospital in the metropolitan region of Pernambuco. Data were analyzed using SPSS software, version 26, and descriptive analyses were generated with mean, minimum, maximum, and standard deviation values. The data collected included demographics, age, and sex; clinical information; indwelling urinary catheter insertion; duration; urinary tract infection diagnosis; antimicrobial use; microorganisms; and outcome, which included discharge, transfer, or death. Results: A total of 192 notification forms were evaluated, of which 71.88% used indwelling urinary catheters for more than 10 days, with a maximum duration of 106 days. During hospitalization, 120 patients were suspected of having urinary tract infections and underwent urine culture tests. A total of 61 patients (31.77%) were diagnosed with infections related to indwelling urinary catheters. The most common etiological agent found in laboratory analyses was Candida spp., followed by Pseudomonas aeruginosa. Conclusion: The results indicate a high frequency of infections related to indwelling urinary catheters in patients admitted to the ICU, making it important to implement preventive measures.
Cynthia Angelica Ramos de Oliveira Dourado
Copyright (c) 2025 Marcela Cristina dos Santos Barros, Cynthia Angelica Ramos de Oliveira Dourado, Karol Fireman de Farias, Thainá da Silva Cabral Bezerra, Igor Michel Ramos dos Santos, Yohana Sumaya Mendes Tavares http://creativecommons.org/licenses/by/4.0
Primary health care nurses and knowledge about environmental health and covid-19
Objective: to analyze the knowledge of Primary Health Care (PHC) nurses about the relationship between environment, health, and COVID-19. Methods: This is a cross-sectional analytical study conducted with PHC nurses in Brazil. Data were collected from September 14, 2021, to April 15, 2022, through a self-administered questionnaire and analyzed using prevalence ratios and a Poisson regression model. Results: 253 nurses participated in the study. It was found that most nurses are aware of the relationship between environmental health and human health. In addition, nurses with more than 20 years of experience had, on average, a 19% higher prevalence of perceiving the difficulties that the assisted population faced in understanding measures to prevent COVID-19 infection (p < 0.01). Conclusion: Most nurses are aware of the relationship between environmental issues and COVID-19. However, despite the relevance of environmental impacts on health, there is still a lack of coordination with practical nursing activities.
Copyright (c) 2025 Natalia Maria Assunção, Ana Cristina Ribeiro, Ana Paula de Vechi Corrêa, Silvia Carla da Silva André Uehara http://creativecommons.org/licenses/by/4.0
Teacher’s illness and absenteeism in Uruguaiana-RS / Brazil: why do they get ill?
This study aimed to identify the primary causes of medical leave among teachers in the municipal education system of Uruguaiana, RS. It is a descriptive, documental, cross-sectional, and quantitative study which analyzed data from teachers from 1st to 9th grade, across 16 public municipal schools. Variables included sex, age, date of admission, ICD code/reason for medical consultation, school assignment, and the month/year of medical certificate submission, covering the period from July 2018 to July 2019. Statistical analyses comprise means, medians, standard deviations, absolute and relative frequencies, 95% confidence intervals (CI), and the Chi-square test, with significance set at p<0.05. An amount of 1,776 medical certificates was submitted during the study period. Among the teachers, 33.3% were aged 50.1 years or older, and 67.4% worked in peripheral schools. The most frequent reasons for medical leave were miscellaneous ICD diagnoses (29.9%), various causes (25.8%), family-related appointments (17.3%), and musculoskeletal disorders (13.9%). A statistically significant association was found between the reason for medical leave and most of the analyzed variables, except for school location (p=0.387). Nonetheless, teachers from peripheral schools showed higher rates of illness and absenteeism. Musculoskeletal disorders emerged as the leading specific cause of medical leave, with a marked increase in related certificates during the second academic semester. Overall, health issues documented in the certificates were predominantly associated with age, length of service, number of sick leave days, and the academic calendar period.
Copyright (c) 2025 Nathalie Yelena Plucinski Cardoso Ribas, Patrícia Becker Engers, Simone Lara, Phillip Vilanova Ilha, Susane Graup http://creativecommons.org/licenses/by/4.0
Sociodemographic, clinical, and therapeutic characteristics of patients with Visceral Leishmaniasis in southwestern Maranhão, Brazil
Introduction: Human Visceral Leishmaniasis (HVL) remains a significant public health issue in Brazil, with an estimated 400,000 cases and 20,000 to 40,000 deaths annually. Over the past three decades, the disease has rapidly expanded, primarily due to urbanization, resulting in a shift in its epidemiological profile toward urban centers. Despite this trend, regional data on the sociodemographic, clinical, and therapeutic characteristics of HVL cases remain limited, particularly in Maranhão. This study aimed to fill this gap by characterizing HVL cases in the southwestern region of the state. Methods: A descriptive, cross-sectional, and retrospective study was conducted using data from the Notifiable Diseases Information System (SINAN). HVL cases reported from 2009 to 2018 across sixteen municipalities within the macro-region of the 10th Health Regional Management Unit of Maranhão were analyzed. Results: A total of 623 HVL cases were recorded, with 95% classified as new cases. The incidence rate was 1.15 cases per 100,000 inhabitants over the ten-year period. Most cases involved male children from urban areas, revealing key sociodemographic patterns. Conclusions: The study confirmed the region's high endemicity and the predominance of new HVL cases. These findings highlight the need for enhanced surveillance efforts and underscore the clinical significance of early diagnosis.
Using the fundamentals of programmed instruction as a teaching method on mechanical ventilation for nurses
Objective: To assess the effectiveness of mechanical ventilation training based on programmed instruction for nurses at a Regional University Hospital in northwest Paraná. Method: A quasi-experimental, before-and-after study, with pre- and post-intervention assessment of a single group, carried out between June and September 2022. Data was collected at three phases: pre-test, immediate post-test, and delayed post-test, the last of which took place three months after the training. The SPSS software was used for analysis, with the Friedman and Durbin-Conover Post-hoc tests. Cronbach's alpha coefficient was used to analyze the instrument. Results: In the pre-test, 51 nurses participated; in the immediate post-test, participation decreased to 45 nurses, and in the delayed post-test, 30 nurses remained involved in the study. The mean age was 42+7.56 years, 45% of the participants had double jobs, and 64% had never received training on mechanical ventilation. The pre-test had an average score of 8.73+2.21; the immediate post-test had an average score of 12.4+1.87, and the delayed post-test had an average score of 10.7+2.21. Friedman's test resulted in a p-value <0.01, and Cronbach's alpha showed that in the delayed post-test, there was better reliability of the questionnaire (value of 0.88). Conclusion: It can be concluded that the training was effective, but three months after it took place, there were still errors that theoretically shouldn't have been present, highlighting the need for the training to become periodic.
Copyright (c) 2025 Context and Health Journal http://creativecommons.org/licenses/by/4.0
Parkinson's disease: innovations in communication and functional health education in social media
Parkinson's Disease (PD) results in the reduction of the individual's independence and functionality. Physiotherapy acts in the management of PD based on several strategies, such as health education. The objective of this study was to identify, analyze and develop innovative and educational content in health and analyze the metrics achieved in social networks. The research is exploratory, explanatory of content analysis and descriptive of data collection, divided into 6 phases: 1. Search for thematic materials on PD, 2. Definition of content to be produced, 3. Development of scripts, 4. Technical production, 5. Disclosure and 6. Analysis of metrics achieved. Most of the content found is of the generalist information type and the result of the achieved metrics yielded 373 views. It is necessary to advance in health education, mainly in the quality and depth of information
The impact of age on functionality and fall risk in transfemoral amputees
Lower-limb amputations result in significant impairments in functional capacity, balance, and motor coordination. Among these functional limitations, the elevated incidence of falls in this population is particularly prominent, with such outcomes being directly associated with age. Accordingly, the objective of this study was to investigate the influence of age on functional performance and fall risk in individuals with transfemoral amputation. This is an observational, analytical, cross-sectional study, comprising a sample of 18 male individuals with transfemoral amputation, aged between 30 and 80 years. The following instruments were employed for the assessments: Amputee Mobility Predictor (AMP), Functional Independence Measure (FIM) and the Timed Up and Go (TUG) test. Descriptive statistics and the Spearman correlation test were applied (p<0.05). A moderate, inverse, and significant correlation was observed between age and the Amputee Mobility Predictor (AMP), as well as the total and motor domains of the Functional Independence Measure (FIM) (p=0.01, p=0.05, and p=0.01, respectively). In addition, age demonstrated a strong and significant correlation with the Timed Up and Go (TUG) test (p<0.000), indicating a greater risk of falls. Age had a negative impact on both functionality and fall risk, as higher age was associated with longer completion time in the TUG test and poorer functional performance assessed by the AMP and FIM. These findings may contribute to the rehabilitation process by promoting greater independence and quality of life in individuals with lower-limb amputation.
Copyright (c) 2025 Thais Andréia Schepa Weber, Júlia Garcia, Leandro Viçosa Bonetti, Raquel Saccani http://creativecommons.org/licenses/by/4.0
Population control of the mosquito Aedes aegypti in Santa Catarina - Brazil: perception of municipal and state managers
The aim of the study was to analyze, from the perspective of municipal and state managers, the effectiveness of policies and practices in controlling Aedes aegypti in Santa Catarina State. A semi-structured interview was conducted with the manager of Health Surveillance - Ae. aegypti control of the Santa Catarina State and managers of municipal vector control programs in the west of the state. There were difficulties in implementing the National Dengue Control Program (PNCD), considering the limitations of the work of the Endemic Disease Control Agent (ACE). Medical certificates, job deviations, absenteeism and turnover of these workers are among the problems. Health education for the community should be carried out in an intersectoral way, allied to the work of the ACEs in controlling Ae. aegypti. This study contributes to improving the possibilities of strategies, practices and policies for controlling Ae. aegypti used in Santa Catarina and Brazil.
Factors that can influence postpartum depression: study in a reference hospital in the amazon region
Objective: Investigate from the clinical epidemiological profile, factors that may influence the possibility of Postpartum Depression (PPD) in pregnant women assisted at the Santa Casa de Misericordia do Pará Foundation. Methods: This was a prospective, descriptive, cross-sectional cohort study with a quantitative approach. Two questionnaires were applied: one for self-assessment of postpartum depression, based on the Edinburgh Postpartum Depression Scale, and another, developed by the researchers themselves, containing information on sociodemographic data and maternal obstetric history. The questionnaires were applied to postpartum women. The established cut-off point was greater than or equal to 10, with a sensitivity of 82.6% and a specificity of 65.4%. Statistical significance was analyzed by the G and Chi-Square Adherence Tests, adopting a significance level of 5%. Results: 214 questionnaires were collected. The prevalence of Ages was 20-29 years old, completed high school, unemployed, breastfeeding and nulliparous. Of the complications during pregnancy hypertensive disorders showed statistical significance. In the group studied, there was no relationship between the types of parturition with the PPD. The existence of a correlation between PPD and breastfeeding, the newborn’s weight and the mother’s mood was verified. Conclusion: No association was found between the type of parturition and the presence of postpartum depression. Of the factors that showed significance, there are breastfeeding and birth weight, which are important markers of maternal and child health care, and it is necessary to emphasize the primordiality of stimulating breastfeeding soon after birth while still in the maternity ward also relating to the mother-baby bond as a protective factor.
Knowledge and participation in public physical activity programs of brazilians with self-reported diabetes mellitus
Objective: To describe the prevalence of knowledge and participation in public physical activity programs and barriers related to non-participation in these programs by individuals with self-reported diabetes mellitus. Methods: Cross-sectional study with data from the National Health Survey, 2019. Pearson's chi-square test was used in the analysis. Results: A total of 7,088 adults with self-reported diabetes mellitus were included. The prevalence of knowledge was 28.5% (95%CI: 26.5-30.5) and, of these, 11.1% (95%CI: 8.7-14.2) reported participating in public physical activity programs. The most reported barriers were lack of interest in the activities offered (37.4%) and schedule incompatibility (23.6%). Knowledge was higher among women, individuals with higher education, those with higher household income per capita, and residents of the Southeast macro-region. Conclusion: A small portion of individuals with self-reported diabetes mellitus reported knowing about and participating in public physical activity programs. The prevalence of knowledge differed according to sex, education, income, and geographic macro-region. The barriers of lack of interest and lack of time were the most reported by individuals with self-reported diabetes mellitus. It is necessary to expand actions and programs to promote physical activity to prevent and control diabetes mellitus.
Copyright (c) 2025 Maria Fernanda Rossetti Rogerio, Bruno de Souza Moreira, Ana Elza do Nascimento, Juliana Ilídio da Silva, Vanessa Moraes Bezerra, Amanda Cristina de Souza Andrade http://creativecommons.org/licenses/by/4.0
Eating behavior during pregnancy and its relationship with the child's birth weight
This study aimed to evaluate the relationship between eating behaviors during pregnancy and infant birth weight. This was a cross-sectional study conducted with pregnant women receiving care in public and private health services in Lavras, Minas Gerais, Brazil. Eating behavior was assessed using the Three Factor Eating Questionnaire (TFEQ), the Intuitive Eating Scale-2 (IES), and the Mindful Eating Questionnaire (MEQ). Infant birth weight was reported by the mother, based on data recorded in the Child Health Booklet. The Shapiro-Wilk test was performed to check for normality, and Spearman's correlation and Mann-Whitney U tests were applied to correlate and compare different domains of eating behavior with infant birth weight. The sample consisted of 127 mother-child pairs, with maternal age ranging from 18 to 42 years and gestational age at birth between 37 and 42 weeks. No correlations or associations were found between different eating behaviors during pregnancy and infant birth weight. Intuitive and mindful eating behaviors adopted during pregnancy, when considered in isolation, may not be able to predict deviations in infant birth weight.
Evaluation of immuno-inflammatory parameters as predictive biomarkers in critical patients with covid-19
The SARS-CoV-2 virus, the etiological agent of coronavirus disease 2019 (COVID-19), infects host cells and begins its viral replication process. After the viral incubation period, the disease can lead to symptoms that range from flu-like symptoms to severe forms of disease (such as respiratory failure), posing a risk to life. The exacerbated inflammatory response in COVID-19 is associated with changes in leukocyte (global and differential counts), platelet, and C-reactive protein (CRP) levels, which when evaluated in isolation have lower power to provide an accurate clinical picture. However, blood count ratios such as lymphocyte-to-total leukocyte ratio (L/WBC) and platelet-to-lymphocyte ratio (PLR) can assertively infer the immuno-inflammatory clinical status. The objective of this study was to evaluate whether leukocyte parameters can be used as biomarkers of prognosis and outcome in critically ill COVID-19 patients. A total of 236 patients admitted to the COVID-19 ICU in a medium-sized and highly complex hospital located in the northwest of the state of Rio Grande do Sul were included in the study. The clinical and laboratory parameters evaluated were CRP, L/WBC and PLR, collected at patient admission and outcome. Data were expressed as mean and standard deviation and analyzed using the Student's T test, considering a significance level of 5%. We identified the applicability of PCR, L/WBC and PLR as predictive biomarkers in critically ill COVID-19 patients. Serum concentrations of CRP, L/WBC and PLR can predict the outcome and indicate the prognosis of COVID-19 patients with COVID-19.
Copyright (c) 2025 Matias Nunes Frizzo, Vitor Antunes de Oliveira, Gabriel Henrique Schmidt Mattos, Kassandra Cristina Gaklik, Vitória de Oliveira Viland http://creativecommons.org/licenses/by/4.0
Giardicidal effect of black tea (camellia sinensis) in the treatment of giardia duodenalis in swiss mice
This study evaluated the in vivo giardicidal potential of black tea (Camellia sinensis) in male Swiss mice experimentally infected with 104 cysts of Giardia duodenalis assemblage BIV. The animals were assigned to nine groups and treated with filtered water (GC+), metronidazole (MT, 500 mg/kg/day), black tea (CP) at 100, 150, or 200 mg/kg/day, or combinations of CP with MT. A negative control group (GC−) included uninfected animals receiving filtered water. Treatments were administered for seven days, and infection status was assessed through parasitological analysis and Polymerase Chain Reaction (PCR). CP at 200 mg/kg induced complete elimination of G. duodenalis, while doses of 100 and 150 mg/kg reduced parasite load from high to medium and low levels, respectively. MT alone did not result in cure but reduced parasite burden. The combination of MT with any CP dose achieved full parasite clearance, indicating a synergistic effect. These results demonstrate a dose-dependent giardicidal effect of black tea and suggest that its combination with metronidazole enhances treatment efficacy. The findings reinforce the therapeutic potential of phytotherapeutics as effective, low-cost adjuncts in the management of giardiasis. From a health promotion perspective, the identification of natural antiparasitic compounds supports the development of accessible and sustainable treatment strategies. This is particularly relevant in resource-limited settings, where conventional therapies may be less accessible or poorly tolerated. Further research, including clinical trials and mechanistic studies, is warranted to explore the broader applicability of these combinations in human populations.
Perception of doctors, patients and family members about the role of clinical empathy in promoting patient rights in the context of disclosure
The present article aims to analyze the existing connections between clinical empathy and patient rights, proposing foundations to build a theoretical basis for the branch of Clinical Bioethics that is based on patient rights and clinical empathy. To this end, a descriptive-exploratory research was conducted with a qualitative approach, involving 4 doctors who deal with the topic of disclosure and 5 patients and family members who experienced an adverse event in the context of health care.All participants are adults and legally capable. Disclosure is a complex and multifaceted approach, encompassing a communicational process and an apology. In the event of an adverse occurrence, disclosure must be adopted by the health organization. Thus, from its beginning to the end, it is a process permeated by emotions, given that some harm has been caused to the patient and their families, and, in certain situations, it has also affected the professional directly involved in the event. Therefore, it is important to investigate the role of empathy in the disclosure process, especially regarding the fact that the empathy of health professionals is subject to a choice process, in being empathetic or not in the disclosure process, in empathetic communication, and in the apology, which can directly affect all those involved.
Copyright (c) 2025 Mariana Menegaz, Luiza Pinheiro, Roberta Mânica, Aline Albuquerque http://creativecommons.org/licenses/by/4.0
Epidemiological profile of colorectal cancer patients at an oncology center in Rio Grande do Sul - Brazil
Objective: To describe the epidemiological profile of patients diagnosed with colorectal cancer (CRC) in the Vale do Taquari region, Rio Grande do Sul (RS), Brazil. Methods: This is a descriptive, retrospective study based on the analysis of medical records from patients diagnosed with CRC between 2017 and 2021. Descriptive statistical methods were employed. To compare proportions between clinical variables, such as staging, metastasis, and outcomes, and their associations with sex, age, and educational level, Pearson’s chi-square test and Fisher’s exact test were applied, as appropriate. Results: The sample comprised 252 medical records. The study population was predominantly male (59.1%), in their sixties (38.9%), White (94.4%), with 8 to 10 years of education (51.6%), and with a family history of cancer in 29.8% of cases. Most diagnoses were made via colonoscopy (69.9%), with adenocarcinoma (96.8%), histological grade 2 (62.3%), and clinical stage IIA (21.9%). Metastases were present in 38.1% of cases. The most frequently indicated treatment approach was adjuvant therapy (31.4%). An educational level of 8 to 10 years was proportionally more frequent among fatal cases (X² = 43.9; P = 0.029). The presence of metastasis showed a statistically significant association in the 60–69 and 70–79 age groups (X² = 14.8; P = 0.022). Conclusion: The epidemiological profile of CRC in the Vale do Taquari region, RS, Brazil was outlined, underscoring the importance of public policies for timely diagnosis and treatment, as well as the implementation of effective CRC screening programs.
Software to prevent and treat friction injury
Objective: To develop an application for the assessment, prevention, and treatment of friction injuries. Methods: Content validation of the application was carried out by 26 nurse judges using the Delphi technique. The Content Validity Index (CVI) was used for data analysis. Results: In the first evaluation, the judges rated the application content from “inadequate” to “fully adequate.” After incorporating their suggested revisions, the application was re-evaluated and rated from “adequate” to “fully adequate.” The CVI ranged from 0.87 to 1.0 in the first round and from 0.98 to 1.0 in the second. Conclusion: The Skin Tears application was developed based on a literature review and validated by expert professionals in the field, achieving consensus among the evaluators in the second assessment.
Pedro Henrique Aparecido de Oliveira da Silva
Self-perceived anxiety and worry among primary dental care professionals during the pandemic
The objective of this study was to analyze the factors associated with anxiety and worry about working during the pandemic, as self-perceived by primary care dentistry professionals. This cross-sectional study had a sample of 512 dentists, technicians, and oral health assistants working in the state of Paraná. Data was collected via an online form between August and October 2020. Associations between the outcome (feeling anxious and worried) and individual (sociodemographic, health, and training) and organizational (work process and biosafety measures adopted) explanatory variables were obtained using Poisson regression (p<0.05). The prevalence of anxiety and worry about working in that period was 79.4%. Multivariate analysis indicated that assistants and technical professionals were more anxious and worried, reporting a risk of being affected by severe COVID-19, working in settings where patients were not questioned about respiratory symptoms and minimum social distancing was not observed in waiting rooms, and those who did not follow recommended standards for doffing. The conclusion is that there was a high prevalence of professionals who were anxious and/or worried about providing dental care during the first year of the COVID-19 pandemic. Furthermore, individual and organizational factors related to the work process in dental services were associated with anxiety and worry among dental professionals.
Copyright (c) 2025 Letícia Simeoni Avais , Elis Carolina Pacheco, Renata Cristina Soares, Giovana Daniela Pecharki Vianna , Rafael Gomes Ditterich, Manoelito Ferreira Silva Junior, Marcia Helena Baldani http://creativecommons.org/licenses/by/4.0
C-Reactive Protein, platelet-to-lymphocyte ratio, and D-Dimer as prognostic biomarkers in covid-19 patients
Objective: To evaluate the biomarkers platelet-to-lymphocyte ratio (PLR), D-dimer, and C-reactive protein (CRP) as indicators of prognosis and outcome in patients with coronavirus disease 2019 (COVID-19). Methodology: A retrospective, descriptive, and analytical study was conducted using clinical and laboratory data from patients hospitalized in a hospital located in the northwestern region of the state of Rio Grande do Sul, Brazil. The clinical and laboratory parameters evaluated were C-reactive protein (CRP), D-dimer, and absolute lymphocyte and platelet counts (used to calculate the PLR), recorded at the patient admission and at the outcome. Data were expressed as mean ± standard deviation and analyzed using the Student's t-test, with a significance level of 5% (P<0.05). Results: CRP (174.82 ± 116.8 mg/dL, P = 0.001) and D-dimer (1.25 ± 1.1 µg/mL, P < 0.0001) levels were elevated, while PLR (92.83 ± 61.73/mm³, P = 0.01) was decreased at the admission in patients who progressed to death compared to those who were discharged. Conclusion: The biomarkers CRP, D-dimer, and PLR demonstrated potential for use in COVID-19 patient care protocols as prognostic and outcome parameters.
Feelings and experiences of women with sexually transmitted infections
Objective: to describe the feelings and experiences of women exposed to sexually transmitted infections. Method: qualitative study, conducted with seven women in a reference center for the care of women in a municipality on the western border of Rio Grande do Sul. Data were collected in December 2020, through semi-structured interviews and the Dynamics of Creativity and Sensitivity, submitted to content thematic analysis. Results: participants indicated prejudice and judgment among family members and friends. Regarding transmission, women did not use condoms during sexual intercourse because they had a fixed relationship. Stood out in the lines, the feeling of frustration for not being able to breastfeed their children. Conclusion: the need to disseminate information about sexually transmitted infections is identified, since most of the participants had incipient knowledge on the subject.
Patient-centered care: a study in clinical and surgical hospitalization units
Objective: To understand patient-centered care from the perspective of adult inpatients during hospitalization. Method: This qualitative, exploratory, and descriptive study was conducted with 31 patients admitted to the medical and surgical units. Data were collected through recorded interviews, which were transcribed, validated, and processed using Iramuteq software. Categories were constructed based on the Institute of Medicine’s guiding principles for patient-centered care, and content analysis was applied. The study complied with ethical principles for research involving human subjects and was approved by the Institutional Review Board of the Federal University of Rio Grande do Sul (CAAE No. 73679623.4.0000.5324). Results: Four categories emerged: respecting patient preferences; information, education, and integration of care; physical comfort and emotional support; and access to care. Including patients and family members in the care process is essential to ensure greater safety, understanding, and support. Conclusions: The study offered insights into patient-centered care from the perspective of patients and families, revealing both strengths and obstacles to its consolidation. It highlights the importance of patients’ role as active participants in creating a safe environment and improving clinical conditions.
Copyright (c) 2025 Natalia Antiqueira Garcia, Laurelize Pereira Rocha, Raissa Garcia Brum, Laís Farias Juliano, Caroline Passos Arruda, Julia Severo dos Santos http://creativecommons.org/licenses/by/4.0
Clinical and sleep-related characteristics as predictors for risk of dysphagia in patients with chronic obstructive pulmonary disease
Objective: To identify clinical risk predictors for dysphagia in patients with chronic obstructive pulmonary disease (COPD). Methods: This is a cross-sectional study carried out in the pulmonary rehabilitation unit of a University Hospital. The sample included 37 COPD patients, of both sexes, in ambulatory follow-up. Patients were evaluated in relation to aspects of body composition, peak expiratory flow, perception of dyspnea (Modified Medical Research Council - mMRC), impact of the disease on health status (COPD Assessment Test - CAT), excessive daytime sleepiness (Epworth Sleepiness Scale - ESS), risk of sleep apnea (Berlin Clinical Questionnaire), modified Mallampati index and symptoms indicative of dysphagia (Questionnaire for Dysphagia Screening - QDS). Data were analyzed using multivariate analysis and the level of significance was set at 5%, with a confidence interval of 95%. Results: In a sample of patients with moderate to severe COPD, 83% reported symptoms of swallowing dysfunction assessed by the QDS and 62.2% presented risk for sleep apnea. The CAT, Epworth and Berlin indices predicted 32% of risk for dysphagia. Conclusion: The impact of the disease on health status, daytime sleepiness scores and risk of sleep apnea were the best predictors for risk of dysphagia for COPD among those surveyed. In this sense, it is proposed that assessments of health status, sleepiness and QDS be included in the routine assessment of COPD patients.
Nursing care protocol for children discharged from the Neonatal Intensive Care Unit
Objective: to develop and validate a protocol for continuity of care for children discharged from the Neonatal Intensive Care Unit. Methods: Action research, conducted at a health insurance company. Ten nurses participated in the development of the protocol and 12 nurse judges participated in the content validation. Results: the protocol directs the continuity of nursing care for children discharged from the Neonatal Intensive Care Unit according to their health complexity, low, medium or high, measured by means of a Classification Table, developed in this study. For each level of complexity, this table indicates the systematization of care between professional, child and family. The protocol was validated with a Content Validation Index of 0.95 and a Kappa coefficient of 0.26. Conclusion: the protocol developed collectively and according to local needs, has innovative potential, since it systematizes nursing care according to the complexity of the child's health at hospital discharge, provides for continuity of care, and promotes evidence-based practice.
Quality of life and persistent symptoms in patients with post-covid syndrome
Introduction: "Post-COVID-19 syndrome" refers to the persistence of physical and mental symptoms after the acute phase of the disease. These symptoms affect the individual's well-being, modifying his relationship with and perception of social and cultural contexts. Objective: To investigate how COVID-19 and its sequelae affected the individual's quality of life. Method: The research was divided into two phases: retrospective and observational cross-sectional analysis. The retrospective cross-sectional analysis consisted of analyzing the medical records of patients admitted to a hospital in the city of São Paulo, while the observational phase consisted of conducting structured interviews via telephone within one year after hospital discharge. Results: Data from 103 respondents were analyzed, of which 65% had pulmonary involvement, 52% were admitted to the ward, 39% to the ICU, and 53% were intubated. The most common persistent symptoms were muscle weakness (74.8%), dyspnea (61.2%), and loss of taste (48.5%), loss of smell (45.6%), desaturation (35.9%), and oxygen dependence (11.7%). Regarding quality of life, the environmental domain had the lowest score (~15%). Conclusion: More than half of the individuals developed persistent symptoms, a condition that affected quality of life, especially in the environmental domain, making it difficult to return to work and leisure activities.
Validation of an educational technology on healthy eating among university students
Objective: To validate an educational technology on healthy eating among university students. Method: This is a quantitative study, developed at private universities in São Luís-MA from May to October 2022, with three study groups: target audience (n=24), health expert judges (n=22) and communication expert judges (n=13). Data collection from each group was carried out through digital questionnaires produced in Google Forms and was evaluated using a Likert scale. Aspects of content, writing, appearance, motivation, language, graphic illustration, cultural and content adequacy, objective and relevance were evaluated. To validate the e-book, the Content Validity Index (CVI) was used. Results: The e-book presented a total CVI of 0.97, a validation index considered adequate. The overall CVI for the target audience was 0.97; for the health expert judges, the content was validated with a CVI of 0.95; and for the communication judges, the CVI was 0.99, indicating a high level of agreement. Conclusion: The technology was considered valid by the target audience, health expert judges, and communication judges and can be used as an educational tool, leading the target audience to think more critically and ensuring effectiveness in self-care and health promotion.
Health literacy and eating-related behaviors stratified by the presence of comorbidities in public Brazilian school teachers
This study aimed to analyze the cross-sectional association between health literacy and eating-related behaviors (usage of nutrition labels and eating behaviors) in public school teachers, from a large city in southern Brazil. Health literacy was assessed using the Newest Vital Sign instrument. Poisson regression models were adjusted for sociodemographic covariates, and the analysis was stratified by the presence of obesity, hypertension, diabetes, and dyslipidemia. Among the 961 schoolteachers studied, 37.0% were classified as having adequate health literacy. Adequate health literacy was associated with more frequent verification of calories (results given in relation to prevalence ratio and confidence interval 95%: 1.34; 1.13-1.58), sodium (1.27; 1.11-1.46), unsaturated fat (2.36; 1.53-3.65) and trans fat (1.81; 1.39-2.36), more frequent use of such information to guide food consumption (1.23; 1.02-1.49), as well as lower frequent consumption of ultra-processed food (0.62; 0,41-0.93). However, adequate health literacy was also associated with a lower frequency of checking sugars or simple sugars (0.53; 0.33-0.87) on food labels, a higher prevalence of frequent consumption of sweetened carbonated beverages (1.23; 1.03-1.64), while failed to correlate with important healthy eating-related behaviors, such as consumption of fruits and vegetables. Analysis stratified by the presence of comorbidities suggest that adequate health literacy was associated with consulting only a few items on food labels and showed few associations with eating habits. These results suggest that, at least for school teachers, health literacy has a discrete association on information seeking and eating habits.
The impact of urinary incontinence on the quality of life of older adults
The objective is to understand the impact of urinary incontinence on the quality of life of older adults. This is a qualitative, descriptive-exploratory study conducted with eleven older adults affected by UI, belonging to the Family Health Strategy of a municipality located in the far west region of Santa Catarina. Data collection took place in August 2021 through individual semi-structured interviews. Data analysis was performed using thematic content analysis. From the analysis, one thematic category emerged: Discourses and experiences of older adults with urinary incontinence and its impact on their quality of life. It is evident that urinary incontinence negatively affects the quality of life of older adults, mainly in the psychological and social domains. The triggered feelings are verbalized as shame due to odor, frustration at the risk of being seen in public with wet clothes, fear, anxiety, insecurity, and sadness. When compounded, such sensations increase the likelihood of psychological disorders, which are responsible for the development of depressive conditions, low self-esteem, withdrawal from leisure activities, and, overall, contribute to social isolation. Based on the study, it is clear that there is a need to increase the visibility of the problem, highlighting the influence of qualified listening that can bring improvements not only to the physical problems arising from urinary incontinence, but also – and especially – to the biopsychosocial and spiritual dimensions of the individual.
Copyright (c) 2025 Camila Amthauer, Ana Caroline Baldissera, Marieli Cristina Pereira http://creativecommons.org/licenses/by/4.0
Supervised physical training after hospitalization for covid-19: an experimental study
Objective: To verify the effects of supervised physical training after hospitalization for COVID-19. Methods: Quasi-experimental study with 17 patients referred to the physiotherapy outpatient clinic of a public hospital in Goiânia, Goiás, Brazil after hospitalization for COVID-19. They were evaluated before and after 18 sessions of supervised physical training. A form with sociodemographic and economic data, six-minute walk test, one-minute sit-to-stand test, manovacuometry, Modified Medical Research Council, London Chest Activity of Daily, post-COVID-19 functional status scale and the Short Form Health Survey were used. For continuous variables, mean, standard deviation or median with 25th and 75th percentiles were used. For categorical variables, frequencies were used. The distribution was tested by Shapiro Wilk. For comparison, the paired t-test and Wilcoxon tests were used. The significance level was 5%. Results: There was an increase in the distance walked (392.5 ± 105.9 vs 484.7 ± 95.4 m, p<0.001), in the number of repetitions in the sit-to-stand test (16.0 vs 21.5, p<0.001), in the maximum inspiratory pressure (100 vs 110, p=0.005) and in all domains of quality of life (p<0.001). Dyspnea reduced in the Modified Medical Research Council from grades two, three, four (10 patients) to zero and one (17 patients) and in the London Chest Activity of Daily from 25.8 ± 11.2 to 15.6 ± 4.5 points (p<0.001). Conclusion: Supervised physical training improved functional capacity and quality of life, in addition to reducing dyspnea during daily activities and increasing maximum inspiratory pressure.
Trust in the dentist and intention to return: a cross-sectional study
Objectives: This study aimed to analyze patients’ confidence and intention to return to the dentist who last performed dental care, and to verify associated factors. Methods: From a cross-sectional study, the sample consisted of 378 patients aged 15 years or older who underwent dental treatment in different locations in a city in southern Brazil. A self-administered questionnaire regarding affection and cognition with the dentist, confidence, and intention to return to dental service, life satisfaction, and sociodemographic questions formed of the data collection instrument. Results: Data were analyzed using a binary logistic regression model. Patients who had affection and cognition with their dentist (PR=2.01; 95%CI 1.73-2.32) and were satisfied with their lives were more likely to trust their dentist and return for dental care (PR=1.11; 95%CI 1.05-1.23). The positive aspects of cognition and affect for the dentist as well as life satisfaction influence the confidence in, and intention to return to the professional who performed the last dental procedure. Conclusions: The subjectivities of dental care and treatment, as well as professional behavior, are approaches that must be incorporated during dental training.
In vitro anthelmintic effect of aqueous extract of Croton blanchetiana leaf on sheep endoparasites
The development of small ruminants has been hampered by infections related to gastrointestinal endoparasites. This problem arose due to the incorrect use of anthelmintics and inadequate management practices, which led to the emergence of parasite resistance. Given this, herbal medicine offers an alternative approach to parasite control. Among the various options, Croton blanchetianus stands out for its bioactive compounds and demonstrates antibacterial, antifungal, ectoparasiticidal and anthelmintic properties. Thus, the objective of this study was to evaluate the in vitro ovicidal activity of the aqueous extract derived from Croton blanchetianus leaves. For this, fecal samples were collected directly from the rectal ampulla of naturally infected animals, without administration of antiparasitics, for a period of 90 days. When the egg count per gram of feces exceeded 2,000 eggs, these eggs were collected for hatchability testing. Simultaneously, phytochemical analyzes were carried out on the leaves and toxicity tests on Artemia salina. The results revealed that the aqueous extract, at concentrations of 5 %, 2.5 %, 1.25 % and 0.625 %, presented hatching inhibition rates of 81.8 %, 70.0 %, 47.8 % and 40.4 %, respectively. Phytochemical analysis confirmed the presence of secondary metabolites in the extract. Furthermore, the toxicity test demonstrated that the C. blanchetianus extract was non-toxic to Artemia salina at all concentrations tested. Consequently, it can be concluded that the aqueous extract had inhibitory effects on egg hatching due to the presence of several secondary metabolites, thus increasing its potential as an anthelmintic treatment against gastrointestinal parasites in sheep.
Risk and/or protective factors for the neuropsychomotor development of babies from the perspective of the sustainable development goals
This research approached 4- to 18-month-old children who attended daycare centers aiming to identify their neuropsychomotor development (NPMD) and home stimulation and verify the association of neonatal, socioeconomic, and environmental variables with NPMD, from the perspective of the sustainable development goals (SDGs). Cross-sectional study in 181 children, assessing their NPMD (Alberta Infant Motor Scale – AIMS and Denver II screening test) and contexts (Affordances in the Home Environment for Motor Development Infant Scale – AHEMD-IS). The data were analyzed with chi-square independence tests. The NPMD of 45.3% of the children were at risk/delayed; 31.5% had little home stimulation. There was an association with NPMD perceived as typical by parents (p=0.005), who were 7.5 times more likely to correctly identify NPMD. There was an association with maternal educational attainment (p=0.011); mothers with lower educational attainment were up to 3.8 times more likely to have at-risk babies. Better AHMED-IS Physical Space (p=0.006), Variety of Stimulation, and Total scores (p<0.001) were protective to NPMD. The results showed that SGD 3 and 4 are threatened by the lack of home stimulation and low maternal educational attainment; hence, the parental perception must be given importance. These findings may optimize NPMD protective measures proposed by SDGs, providing services and actions to improve early childhood development.
‘Meat and eggs’ dietary pattern in overweight and obese adolescents and its relationship with cardiometabolic markers
To associate dietary patterns with cardiometabolic markers in overweight and obese adolescents. A cross-sectional study was conducted with 227 adolescents aged 10 to 19 years, who were attending six public healthcare services in a city in Southern Brazil. A semi-quantitative food frequency questionnaire was administered. Dietary patterns were identified using principal component analysis followed by orthogonal Varimax rotation. Independent associations between dietary patterns and marker values (glucose, fasting insulin, Homeostatic Model Assessment index, total cholesterol, triacylglycerols, Low-Density Lipoprotein, High-Density Lipoprotein, cholesterol not transported by HDL, C-reactive protein, and blood pressure) were tested using quantile regression. The scores of dietary patterns were categorized into tertiles and associated with the outcomes of altered cholesterol transported by HDL or triacylglycerols levels due to their significant associations. A significance level of p<0.05 was considered. Five dietary patterns were identified: ‘Meat and eggs’, ‘Coffee, dairy, and vegetables’, ‘Breads and processed meats’, ‘Sugar and fat’, and ‘Soup and cereals’. The ‘Meat and eggs’ pattern, characterized by red meat, white meat, and eggs, was the most representative and showed a negative association with cholesterol transported by HDL and a positive association with triacylglycerols. The ‘Soup and cereals’ pattern had a positive association with triacylglycerols. Adolescents belonging to the third tertile of the ‘Meat and eggs’ pattern had 2.76 times higher odds of elevated triacylglycerols. Greater adherence to the ‘Meat and eggs’ pattern was associated with lower levels of cholesterol transported by HDL and higher plasma triacylglycerols.
Rárica Isidório Sampaio Feitosa de Matos Vieira
Theater workshops as a theurapetic device in psycological care centers of Seridó Potiguar- Brazil
Objective: To identify the users of psychosocial Care Centers perception about theater workshops in their treatments. Methodology: Qualitative study. Twelve users participated to the study, belonging to theater groups offered in two towns of Seridó Potiguar. The datas were collected by semi-structured interview between the months of august and october in 2019. The analysis occurred using the IRAMUTEQ software (Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires). In this article are presented two of the three built categories derived from the findings: the dimension from the mental disorder of the theater perspective; talking and acting freely: the changes in life after the theater. Results: According to the analysis, the categories evoke the theater paper in the comprehension of mental disorder, its contributions to in the recognition and management of symptons, the skills and social interaction perception and development being a way that produces new life conceptions, ally to the fight against mental health stigma and marginalization. Conclusion: the users realize the theater as a valid therapy, exemplifying the transformations occurred in their lives after the participation in the workshops.
Susceptibility profile to antifungals of Candida spp. isolated from infants and children
Pediatric candidiasis and candidemia are important causes of morbidity and mortality worldwide. This study aimed to analyze the incidence and antifungal susceptibility profile of Candida. spp. isolated from infants and children in maternity wards and public hospitals. This is a retrospective, analytical-cross-sectional observational study carried out through the analysis of data from medical records and the antifungigram of patients diagnosed with candidiasis or candidemia admitted from January 2015 to December 2021 in the city of São Luís-MA. A total of 627 episodes of Candida infection were observed (45.3% female and 54.7% male). The highest incidence occurred within the age groups of 1-3 months (41.63%) and 1-3 years (22.65%) and the main isolated species were C. albicans, C. parapsilosis and C.tropicalis. The highest diversity of pathogenic Candida was detected in blood, mid-stream urine, and tracheal secretions (p<0.001) recovered mainly from patients hospitalized in the pediatric ward and ICU. The species C. glabrata, C. haemulonii and C. tropicalis exhibited resistance to 2-3 differents antifungals (amphotericin B, caspofungin, fluconazole and voriconazole). Our study indicates the urgency of implementing more rigorous control measures in maternity wards and pediatric hospitals and serves as a guide to conduct health professionals in selecting the most appropriate antifungal therapy.
Understanding of nurses about barriers and strategies to promote health literacy in the elderly
Objective: To identify nurses' understanding of the barriers and strategies for promoting health literacy among the elderly in primary health care. Method: A qualitative research of the descriptive exploratory type was carried out with 12 nurses linked to health units in the city of Arapiraca/AL. Data exploration occurred by thematic analysis of Minayo. Results: Four thematic categories related to understanding, skills, barriers and strategies for developing literacy in the health of the elderly emerged. The main barriers were lack of training, time of attendance, limitations related to aging, internet access and schooling. The strategies included use of simple language, teach-back method and use of visual resources. Conclusion: The nurses identified strategies to help the elderly and recognized the barriers that hinder the promotion of health literacy. Future interventions should focus on developing literacy skills in elderly health.
Is there a relationship between interleukin-6 (rS1800795) polymorphism and human papillomavirus?
Objective: To assess the relationship between interleukin-6 (IL-6) polymorphism and the human papillomavirus (HPV) infection among women in a capital city in Northeastern Brazil. Methods: This cross-sectional study included sexually active women who received care through the public health system in São Luís, Maranhão State, Brazil. Information was collected on sociodemographic characteristics, sexual health, and number of pregnancies. Cytopathological analysis was performed using the Papanicolaou stain. HPV was detected using a nested polymerase chain reaction (PCR), and IL-6 −174G>C (rs1800795) polymorphism was detected by real-time PCR. For analysis of relationships with epidemiological and clinical data, patients were divided into two groups according to HPV status (HPV DNA-positive and -negative), and differences were deemed significant at p < 0.05. Results: The sample comprised 195 participants, 68 (34.88%) of whom were positive for HPV DNA. The prevalence of IL-6 −174G>C polymorphism was 28.72%, with 26.67% of patients exhibiting heterozygosity (GC) and 2.05% homozygosity (CC), indicating Hardy–Weinberg equilibrium. Conclusion: There was no association between IL6 −174G>C polymorphism and HPV status in the analyzed population. The findings of this study do not support the association between HPV DNA positivity and IL-6 −174G>C polymorphism among sexually active women in São Luís, Brazil.
Risk factors associated with acute radiodermatitis among cancer patients
Aim: Cutaneous radiotoxicity occurs due to damage caused by the generation of free-radicals and reactive oxygen species in fast-dividing cells in the basal layer and dermis. Exposure to radiation also leads to impairment of the barrier function of the epidermis. The aim is therefore to carry out a global assessment of cancer patients undergoing external RT, exploring other patient-related factors that may be associated with the occurrence of radiodermatitis after this treatment. The aim is therefore to identify the risk factors associated with acute radiodermatitis in cancer patients. Method: This is a cross-sectional study, of the survey type, carried out in accordance with the Checklist Strengthening the Reporting of Observational Studies in Epidemiology. Result: It was identified that patients on continuous medication for the treatment of other comorbidities have a 2.3-fold increase in the chance of radiodermatitis. Another relevant finding in this investigation was that being overweight increased the chance of this outcome by 4.7 times. Smoking, in turn, is a factor associated with severe skin reactions, as chronic exposure to tobacco hinders the skin's healing process and causes changes in the physiology of systems, including the skin. Conclusion: Finally, the risk factors identified should be part of the clinical assessment of patients who will undergo or are undergoing radiotherapy for cancer treatment.
Interprofessional care and its implications for patient safety in primary care
Objective: Identify possible facilitators or barriers to collaborative interprofessional care in primary health care and its relationship with safe care. Method: This is an exploratory qualitative study using a focus group technique with family health teams from a municipality in the interior of São Paulo. The inclusion criterion was to have been part of the team for at least six months. The exclusion criterion was being on vacation or absent during the data collection. A script with guiding questions about collaborative interprofessional practices and safe care was used. The transcript was processed using IRAMUTEQ software and analyzed considering the theoretical framework of collaborative interprofessional practices and safe care. Results: Six classes were formed: implementation of safe care, work objectives, decision-making, care construction, team communication, and actions that integrate safe care. How each member performs their role, their understanding of work objectives, communication, how care is provided, and how team disagreements are handled are reflected in work performance and resolution. Conclusion: Thus, factors related to safe care and team climate, such as job satisfaction, are influenced by how the team interacts daily.
Support network for young women undergoing cancer treatment
The aim of this study was to get to know the support network of young women undergoing cancer treatment. This is a qualitative, descriptive study carried out using semi-structured interviews mediated by the dynamics of creativity and sensitivity. Twenty young women undergoing cancer treatment took part. The settings were the chemotherapy and radiotherapy outpatient clinics of a university hospital in Rio Grande do Sul. Inductive Thematic Analysis was used to analyze the data, and the National Humanization Policy was used as the theoretical framework. Most of the women were experiencing cancer for the first time and were undergoing cancer treatment for curative purposes. The analysis of the interviews emerged in two thematic categories: “Nursing as a reference in care”; and “The support network in the course of cancer therapy”. The support network was characterized as an important coping tool, consisting mainly of family, faith and religiosity, friends, and the healthcare team, with emphasis on the professional nurse.
Hospitalizations and mortality due to falls in the elderly, piauí-brazil, 2014 to 2021
This study aimed to analyze the trend of hospitalizations and mortality due to falls among the elderly in Piauí between 2014 and 2021. This is an ecological, time-series study using data on hospitalizations and deaths due to falls during the period from 2014 to 2021 in Piauí. Data were collected from the Hospital Information System of the Brazilian Unified Health System (SUS). To analyze trends, the Prais-Winsten linear regression model was applied, with autocorrelation assessed using the Durbin-Watson test. A total of 16,048 hospitalizations and 516 deaths due to falls among elderly people were analyzed by sex, age group, and health region. A stationary trend in hospitalization and mortality rates was observed according to the variables used. The need to improve and expand fall prevention measures and programs for the elderly is reinforced.
Lactation care by nurse consultants: It just hit me, there's a field there
The objective of this study is to describe lactation care through consulting provided by nurses. This is an exploratory-descriptive study with a qualitative approach. Twenty lactation consultant nurses participated. Semi-structured interviews were conducted via Google Meet, recorded and transcribed. The data were analyzed in the thematic modality. Lactation consulting arises from personal experiences and the desire to undertake in this area. However, the topics of breastfeeding and entrepreneurship are superficial in nursing training for qualified practice. It is provided in online and in-person modalities, occurring mainly in the puerperium and at the clients' homes. As it is aimed at mother-baby-family and the extended network if possible, its actions include general guidance, baby care and clinical management in lactation. Consulting promotes maternal empowerment and self-confidence to breastfeed, allows for autonomous work by the nurses, but also involves overload, lack of a fixed salary and demand for successful breastfeeding outcomes. We conclude that lactation consultancy is an emerging entrepreneurial professional field in nursing. The expansion of this powerful strategy in public and private health services may contribute to increasing breastfeeding rates. The role of the nurse consultants favors best practices in lactation that positively imply the promotion, protection and support of breastfeeding and child health.
Objective: To identify health literacy among nursing undergraduates in their final year of undergraduate studies. Method: This is a cross-sectional study with descriptive analysis and a quantitative approach, using the Health Literacy Questionnaire instrument with nursing undergraduates in the 9th and 10th semesters, between 18 and 60 years old, of both sexes, at a private educational institution in the Federal District. The sample included 67 participants who agreed to participate in the study. Results: The study indicates that more than half of nursing undergraduates are female, have not taken a technical course and are up to 40 years old. The ability to find good information about health and understand it stands out among the potentialities in health literacy, while poor time management for self-care stands out among the weaknesses. Conclusion: This study presents evidence about the health literacy conditions of undergraduates who will be a source of knowledge for different populations in the future due to their understanding and mastery of health literacy. This enables research into new interventions in the academic environment aiming at both professional and educational improvement. A more comprehensive health system with more qualified professionals is essential.
Pediatric Multisystem Inflammatory Syndrome (MIS-C) temporally associated with covid-19: a cross-sectional study
Objective: To analyze the occurrence of cases of MIS-C, temporally associated with covid-19, in the State of Ceará. Method: This is a cross-sectional study of a secondary database containing 82 cases of children and adolescents notified with MIS-C associated with covid-19, in the State of Ceará, from 2020 to 2021. RStudio® was used to calculate the data. Results: The following were more severe: adolescents aged 10 to 14 years, with hospitalizations of more than 10 days, mean of 36 days between hospitalization and notification, with ICU admission, detection for SARS-CoV-2 by RT-PCR, imaging tests with infiltrate, ascites, and myocardial dysfunction; treatment with corticosteroids, outcome for death, hospital discharge without sequelae and closure according to laboratory criteria. Conclusion: The findings of this study support early diagnosis, allowing the reduction of negative outcomes and a better prognosis.
Intensive admissions for neoplasms in Brazil: Analysis of the historical series from 2001 to 2020
The aim of the study was to analyze the magnitude of intensive care unit (ICU) admission rates due to neoplasms in Brazil, according to admission diagnosis, regions, sex, and age group from 2001 to 2020. Method: This ecological time-series study analyzed ICU admission rates for neoplasms under the Unified Health System (SUS). The rates were standardized and analyzed descriptively, as well as through trend analysis. Results: Over 20 years, there was an increase in rates across all states. Brazil and the Southeast, South, and Central-West regions showed no trend, while the North and Northeast regions exhibited growth. The population over 60 years of age had the highest admission rates. Both sexes showed an increasing trend, but the ratio between them decreased. Among the neoplasms, malignant tumors of the digestive organs were the most prevalent. Conclusion: There was an observed increase in intensive cancer-related admissions in the country, with no identified trend related to the extensive historical series. Further studies are needed to describe ICU admissions in Brazil, in order to contribute to the development of strategies for reducing hospitalizations and healthcare costs.
Situational diagnosis of the pillars method-personnel-tools for implementing the nursing process with religious eldery women
The objective was to perform a situational diagnosis of the method-personnel-instruments pillars, to implement the Nursing Process in a religious home care facility for elderly women. This is the diagnostic phase of a strategic, qualitative action research study conducted with 19 nursing professionals and three managers from a religious home care facility for elderly women. The data collected in February 2022, using semi-structured interviews, were submitted to a discursive textual analysis technique. Ten diagnostic categories were listed, related to the three fundamental pillars for implementing the Nursing Process and the strategies suggested by the professionals to help with the weaknesses experienced. Regarding the Method pillar, the absence of a formal care process structure and the quality and humanization of care for the elderly were identified. In the Personnel pillar, the sizing of personnel, the fragmentation of the team, and the presence of a multidisciplinary team were recognized. In the Instrument pillar, the absence of instruments, materials, and protocols, as well as the presence and supervision of nurses in the daily care of the elderly, were diagnosed. Strategies included returning to training and meetings, staffing levels, and developing guidelines, manuals, and care protocols. Strengths and weaknesses were identified in each of the pillars, along with strategies to address the shortcomings, which will serve as inputs to assist in implementing the nursing process.
Prevalence of addictive eating behavior among university student in social distancing due to covid-19
This cross-sectional study determines the prevalence of addictive eating behavior among university students in the southern region of Brazil amid social distancing by the COVID-19 pandemic. Data were collected sociodemographic characteristics, anthropometric parameters, previous eating frequency and eating during social distancing, and duration of social distancing using an online self-report questionnaire. The modified Yale Food Addiction Scale 2.0 was also used. A total of 1525 students aged between 18 and 60 participated in the study, who were majority female, white, single, and from the state of Rio Grande do Sul. The prevalence of addictive eating behavior was 18%. Addictive eating behavior was found to be associated with being a female (PR=1.80; 95% CI 1.32–2.47), being between the ages of 18 and 33 (PR=5.12; 95% CI 1.44–18.3), being divorced (PR=2.46; 95% CI 1.41–4.27), an increased BMI 12 months after social distancing (PR=2.31; 95% CI 1.40–3.82); and decreased (PR=1.63; 95% CI 1.18–2.27) and increased (PR=2.18; 95% CI 1.31–2.79) number of meals per day. This study assessed the prevalence of addictive eating behaviors among university students in the southern region of Brazil during the COVID-19 pandemic, indicating that the COVID-19 pandemic negatively impacted Brazilian academics.
Safe alternatives for treating hypertension and diabetes in older adults of the Federal District - Brazil
Introduction: This study aims to present alternatives available in the Unified Health System for de-prescribing potentially inappropriate drugs (PIM) or potential drug interactions (PDI) in the treatment of hypertension or diabetes mellitus (DM) in the elderly in the Federal District. Methods: A cross-sectional study was carried out with an analysis of prescriptions to identify PIM and an analysis of clinical protocols and guidelines. The aim was to present alternatives from the list of standardized medicines of the Federal District Health Department and the Brazil's Popular Pharmacy Program. Results: The most frequent PIM was insulin (13.7%), followed by clonidine (1.6%) and glibenclamide (1.0%). The most frequent PDI was between angiotensin II receptor blockers, angiotensin-converting enzyme inhibitors or potassium-sparing diuretics (6.6%). Discussion: Antidiabetics with a lower risk of causing hypoglycemia, such as metformin and dapagliflozin, are available from the Federal District Health Department and the Brazil's Popular Pharmacy Program. Modified-release gliclazide is an alternative to sulfonylureas, with advantages in terms of efficacy in glycemic control, cardiovascular safety and low potential for triggering hypoglycemia; however, free access is restricted to the Federal District Health Department. The availability of thiazide diuretics, beta-blockers and calcium channel blockers in the SUS makes it possible to associate antihypertensives that act on the renin-angiotensin system more safely. Conclusion: The differences between the List of Medicines of the State of the Federal District and the Brazil's Popular Pharmacy Program showed that the Federal District Health Department offers more options for treating hypertension or DM, including safer alternatives for older adults and the possibility of more effective drug combinations.
A self-perception of ageism among elderly individuals during the covid-19 pandemic
The objective of the study was to analyze the self-perception of elderly individuals regarding ageism during the COVID-19 pandemic in the Amazonas state. A quantitative and qualitative study was conducted in Manaus, AM, with a sample population of 44 elderly individuals aged ≥ 60 years, of both sexes, who were affected by the COVID-19 pandemic from March 2020 to May 2023. The study was divided into two stages. The first stage consisted of a quantitative study, of the observational epidemiological type, cross-sectional, in which information was collected through the application of a Likert-type ageism self-perception scale. The second stage consisted of a qualitative study composed of two open-ended questions related to experiences of ageism during the COVID-19 pandemic by the research participants, who were interviewed in structured interviews, with 10 volunteers in total, representing a percentage of 20% of the participants. The results showed that 75% of the respondents experienced two or more situations of ageism. They self-reported two or more types of ageism compared to those who did not report ageism or reported only one type of ageism. In the qualitative analysis, mesostructural and macrostructural ageism, predominantly of explicit origin, were observed. We concluded that the COVID-19 pandemic increased instances of ageism experienced by elderly individuals in Manaus, particularly noting that this discrimination occurred among healthcare professionals and public transportation drivers. We acknowledge the study's sample size limitation and its focus on a specific elderly population. However, it is extremely important to establish strategies to combat ageism through strengthening and updating policies and laws, as well as educational and research interventions.
Evaluation of anxiety in preoperative patients: State-Trait Anxiety Inventory Instrument (STAI)
Objective: To assess levels of state and trait anxiety in preoperative patients admitted to the Surgical Unit of a hospital located in the extreme south of Brazil. Method: This quantitative, exploratory-descriptive study was conducted with 50 preoperative inpatients. Data were collected using the State-Trait Anxiety Inventory (STAI), translated and adapted for use in Brazil. Data were analyzed using the Statistical Package for the Social Sciences (SPSS), version 22.0.2. Descriptive statistics were applied, and a t-test was performed to compare state and trait anxiety according to sex. Results: Trait anxiety scores were higher than state anxiety scores. Most participants exhibited trait anxiety rather than state anxiety, indicating that these preoperative patients already showed an anxious profile—that is, they possessed personality traits more prone to the development of anxiety. Conclusion: These findings are relevant to clinical nursing practice, considering that when professionals identify patients with anxiety symptoms, they must plan interventions that contribute to a calmer perioperative period and support postoperative recovery.
Process of death and child’s death: Perception of nursing academics
Objective: Recognizing the perception of nursing academics regarding the process of dying and the death of the child. Methods: This is an exploratory-descriptive study of qualitative approach conducted with academics of a nursing course and using semi-structured interviews with eight participants, so that these resulted in the corpus of research that was organized based on the Thematic Content Analysis Technique and analyzed based on concepts of Logotherapy. Results: The results were organized in thematic units grouped by convergence of meanings and meanings resulting in two categories: 1) Training of the academic nursing and the unpreparedness to deal with the death of the child; 2) The death of the child as a premature event and potentialized by negative feelings. Conclusion: The results point to a lack of preparation of academics to deal with infant death due to the poor approach of the theme during graduation. They described death as a moment of sadness, suffering and denial and demonstrated difficulty in accepting that moment and claim that the death of a child is much more difficult to deal with and accept than that of an elderly person. This scenario reinforces the need for the insertion of the thematic process of dying and death of the child during graduation through strategies that enable reflections about death and assistance to the child.
Software prototyping for hospitalized patient participation in the medication system
Objective: to develop a prototype to support hospitalized patients' participation in the medication system. Method: this is a methodological study, carried out between March and December 2019, in Fortaleza, Brazil. The study stages were: analysis, design, development, evaluation, and administration. In the first three stages, in addition to the researcher, graphic designers and software programmers participated in organizing the content and navigation architecture. In the following stages, 25 experts (physicians, nurses, and pharmacists) participated in evaluating the software in a simulated environment. The data related to the evaluation were analyzed using the percentage of agreement and the content validity index. Results: the MedPAd software had its operating architecture structured in three integrated devices: web service system (for including prescription and medication dispensing data); server (for programming and data storage); and application (intended for use by the patients, with information about their medication therapy). The experts evaluated functionality, reliability, usability, communicability, applicability and efficiency with an overall agreement percentage greater than 90% and an overall content validity index of 0.94. Conclusion: the prototype presented evidence of validity regarding the tested items.
Rhanna Emanuela Fontenele Lima de Carvalho
Content validation of instruments for realistic simulation in initial trauma care
Objective: To validate the content of a prior knowledge questionnaire, simulated scenario, and checklist used in realistic simulation for initial trauma care. Method: This methodological study was conducted in two stages: instrument development and content validation by expert judges. Data analysis was performed using the percentage of agreement among assessors regarding the retention or exclusion of instrument items. A minimum acceptance criterion of 80% agreement was established. Results: For the assessment of the prior knowledge questionnaire, simulated scenario, and checklist, an overall score of 8.8 was obtained, based on assessments from 12 and 8 judges, respectively. The instruments were assessed based on the percentage of agreement among judges. In the overall assessment, the instruments achieved an agreement index of 8.2, with a standard deviation of 0.7 and an average agreement score of 9.2 among the judges. Conclusion: The instruments demonstrated satisfactory validity evidence and may be used as educational tools for teaching this topic.
Sexual initiation of school adolescents in a context of sexual and gender diversity
Adolescence is marked by various biopsychosocial transformations that influence decision-making. The awakening of sexuality and early sexual initiation are factors that expose adolescents to vulnerable health situations. This study aims to understand the experiences and influencing factors related to the sexual initiation of adolescents within the context of sexual and gender diversity, through the lens of Madeleine Leininger’s theory. This qualitative study was conducted with adolescents from a public school in Recife, Pernambuco, Brazil, using semi-structured interviews carried out between June and December 2019. The results were analyzed using Bardin’s content analysis and processed with IRaMuTeQ through the similarity analysis interface. Three thematic axes emerged: Factors contributing to early sexual initiation; Conflicts related to sexual orientation, gender identity, and gender expression; and Knowledge about sexual and reproductive health. Early sexual initiation among adolescents is not limited to chronological age, as recognizing vulnerability factors may support a better understanding of sexuality in the context of sexual and gender diversity.
Mariana Boulitreau Siqueira Campos Barros
Work process of managers of Primary Health Care managers during the covid-19 pandemic
Objective: To understand the work process of Primary Health Care (PHC) managers during the COVID-19 pandemic. Method: A qualitative, descriptive-exploratory study with data collected through semi-structured interviews with 11 managers. Thematic content analysis was carried out based on the theoretical framework of the health work process and the psychodynamics of work. Results: Five thematic categories were constructed: 1. Production in action: reformulations of the service to maintain PHC as the gateway to the SUS, in which the managers pointed out the reformulation of the service to keep care in PHC; 2. New flows to serve users in the context of the pandemic in the healthcare network; 3. Democratization of management: participatory versus autocratic in planning and decision-making; 4. Precarious working conditions and the sickening of frontline workers; 5. Weaknesses imposed by the pandemic: mischaracterization of comprehensive and longitudinal care in PHC. Conclusion: The research made it possible to produce memories and learnings to understand the crossings in the work process of managers, between prescribed and actual work, and the objective and subjective aspects of this complex web of initiatives.
Impact of the covid-19 pandemic on tuberculosis diagnosis in the general population and the prison population in Manaus, Amazonas
Introduction: During the pandemic, health services were restructured to meet the demand from COVID-19 cases, which led to the neglect of other diseases, including tuberculosis (TB). Objective: Assess whether there was a change in the number of TB cases identified using the rapid molecular test for tuberculosis and whether there was an increase in resistance to antituberculosis drugs after the pandemic, both in the general population and the prison population. Methodology: Individuals who underwent molecular rapid testing for tuberculosis (MRT-TB) and sensitivity tests to anti-TB drugs were evaluated at the Northern District Municipal Laboratory, during the period from January 2018 to December 2022. Results: We included 12,208 (81.7%) individuals from the general population and 2,731 (18.3%) from the prison population (PP) of the city of Manaus. The initial year of the pandemic, 2020, had the highest percentage of positive tests (20.6%, n=205) in the general population. This trend continued in the following years, being equal to 12.5% (n=347) and 12.9% (n=392), in 2021 and 2022, respectively. However, in the PP, the years with the highest rates of positive exams were 2018 and 2019, with 13.1% (n=55) and 20.5% (n=50) respectively, with a significant reduction in the percentage of positive exams in later years. Resistance to the drug Isoniazid was the most frequent resistance found in both the general population and the prison population, but without a significant increase. Conclusion: The COVID-19 pandemic negatively influenced the control of tuberculosis, increasing the number of cases of this disease in the general population, and it is necessary to improve health policies to control and reduce cases of this disease.
Moral distress among nurses in a hospital setting during the covid-19 pandemic
Objective: To analyze moral distress among nurses working during the COVID-19 pandemic in a hospital setting. Methods: This qualitative, exploratory-descriptive study was conducted with 18 nursing professionals from a hospital located in the extreme south of Brazil. Data were collected between December 2020 and March 2021 through individual semi-structured interviews conducted via videoconference on Google Meet. All participants signed an informed consent form. Data were analyzed using discursive textual analysis. Results: Participants reported experiencing moral distress related to fear of exposure to and contamination by the virus, illness, terminal conditions, deaths due to COVID-19, the population’s disregard for protective measures, work overload, shortage or inadequacy of materials, and insufficient bed availability, among other factors. Conclusion: The findings contribute to a deeper understanding of the factors that cause moral distress among nurses working in hospital settings during the COVID-19 pandemic and may support the development of strategies to minimize its adverse effects on workers’ health.
The mental health and the work of endemic disease control agents in the covid-19 pandemic
This study aimed to investigate the occurrence of common mental disorders in Vector Control Workers (VCW) (Agentes de Combate à Endemias - ACE) in the state of Rio de Janeiro and the relationship with health and work conditions in the context of the COVID-19 pandemic. Methodology: This work used a cross-sectional study inspired by the Italian Workers' Model (MOI) and, therefore, with the participation of workers and unions in the category. Data collection was through a self-administered multidimensional questionnaire (online) that included the Self-Report Questionnaire (SRQ) for screening common mental disorders (CMD) from a sample of 139 participants. The statistical analysis used Pearson's chi-square and Fisher's exact tests. Results: We found that 43.2% of VCW had suspected CMD associated with gender (p ≤ 0.04), demand for mental health professionals (p ≤ 0.021), and different pre-pandemic complaints related to mental health (p ≤ 0.00). During the first months of the pandemic, more than 80% of VCW were working; 6.5% reported suicidal ideation and 15.8% depression. The research allowed actions to welcome and monitor workers in real-time and created a space for dialogues about mental health and work, especially during the pandemic. Conclusion: The research made it possible to identify the demands of VCW regarding mental health. Even though they are a predominantly male class, we observed important differences in the impact of the pandemic on the mental health of women and workers who had to work to combat COVID-19. Monitoring this population is essential because of their exposure to pesticides.
Priscila Jeronimo da Silva Rodrigues Vidal
Older adults’ perceptions of how health professionals communicate information
Objective: To identify the perception of older adults with limited or inadequate Functional Health Literacy regarding how primary healthcare professionals communicate information. Method: This is a qualitative, exploratory, and descriptive study. Twenty-seven older adults participated. Data were collected from seven Family Health Units in a city in the southern region of Rio Grande do Sul, Brazil. Results: The participants' average Functional Health Literacy score was 36.21 points, indicating inadequate literacy. They reported difficulties that compromised their understanding, including the excessive amount of information provided during medical appointments and the need to bring a family member to help interpret the information. Final considerations: Identifying the difficulties reported by older adults in understanding health information supports the development of strategies to improve health outcomes in this population's care.
Epidemiological profile and distribution of hansen’s disease" cases in the state of Amazonas
Objective: To describe the epidemiological profile and distribution of hansen’s disease cases in the state of Amazonas between 2018 and 2022. Method: This is a descriptive study based on secondary data with a quantitative approach, conducted in the 62 municipalities of the state of Amazonas. Data were obtained from reported cases in the Notifiable Diseases Information System (SINAN) during the period from 2018 to 2022. Results: Sociodemographic data reveal a higher number of cases among adult males and individuals of mixed race (pardo). Hansen’s disease also more frequently affects individuals with low educational attainment. Regarding clinical characteristics, 73.9% of cases were classified as multibacillary, with the dimorphic form being predominant and physical disability commonly classified as "grade zero." There was a statistically significant association between the operational classification and the number of lesions, clinical form, and therapeutic regimen. The Southern Mesoregion recorded the highest rates of new cases, with a significant shift in this pattern only in 2022. A reduction in hansen’s disease rates was observed across all mesoregions in 2020 and 2021, reflecting the impact of the COVID-19 pandemic. Conclusion: Hansen’s disease remains a prevalent disease among vulnerable populations in the state of Amazonas, with high incidence rates in all mesoregions. Active surveillance of hansen’s disease in Amazonas is essential, focusing on early detection and reduction of transmission sources. Continuous permanent education initiatives are necessary to train healthcare professionals in the proper identification and management of hansen’s disease cases.
Evaluation of the work process of primary health care teams in prenatal care
The objective was to identify the factors associated with prenatal care based on the work process of primary health care teams in Brazil. This is a cross-sectional study with secondary data from 38,865 teams interviewed who took part in the external evaluation of the third cycle of the National Program for Improving Primary Care Access and Quality (PMAQ-AB, acronym in Portuguese) in 2017. The dependent variable was prenatal care, and the independent variables were grouped into hierarchical levels. Multiple logistic regression analysis was conducted, and the variables were classified into management and care. The care factors associated with consultation included continuing education, safety in providing care, and enough professionals. An institutionalized communication flow with the specialist team is absent in the managerial dimension. The lack of defined flows for delivery/maternity and the absence of a central regulation system for referrals, among others, contributed to the pregnant woman not having a consultation. The analysis provides input for improving work processes in prenatal care and strengthening the integration of the care network.
Socioeconomic profile and symptoms associated with the use of non-traditional smoking devices in the state of São Paulo-Brazil
Introduction: The use of electronic smoking devices (ESDs) exposes the body to chemical components contained in the vapor. These include carcinogens and cytotoxic substances, potentially associated with lung and cardiovascular diseases. In regular hookah users, it is possible to observe elevated levels of carbon monoxide (CO) and carboxyhemoglobin (COHb), both for sessions that use tobacco and nicotine, and for sessions free of these components. Objective: To analyze the behavior of young people in the state of São Paulo regarding the use of hookah and ESDs. To verify the frequency of use of these devices, the knowledge of young people about the physiological effects of using these devices and the consequences for health. Method: This is a prospective observational study in which a questionnaire was applied to collect information about the use of hookah and ESDs among young people in the state of São Paulo. Conclusion: The habit of smoking these devices is frequent and is already present in the daily lives of people, especially young people, as a form of social interaction. Even though they are aware of the health risks posed by these devices and have already experienced some adverse effects during and/or after a smoking session, users continue to use them. This reinforces the need for public health policy campaigns emphasizing the consequences of exposure to smoke from electronic cigarettes and hookahs.
Comfort oral route in hospitalized older people: The multidisciplinary team perception
Objective: To analyze the perception of the multidisciplinary team regarding the use of comfort oral feeding in elderly individuals before and after training. Methods: A cross-sectional and descriptive quantitative study was conducted with professionals from the multidisciplinary team of a University Hospital. A questionnaire was administered before and after training on the use of comfort oral feeding. The sample consisted of 21 professionals from different professions. Statistical analysis was performed using Pearson's Chi-Square test (5% significance level). Results: The average age of the sample was 31.86 years, with most participants having one to five years of professional experience and being from the Nursing field. In the association between pre- and post-training responses, only the question related to the authorization of oral feeding for a patient despite aspiration risk showed statistical significance (p=0.003), indicating that the training was an effective tool, as professionals who had previously marked "do not know" in response to the first questionnaire took a clear favorable or unfavorable position. Conclusion: The perception of the multidisciplinary team regarding comfort oral feeding for hospitalized elderly individuals reveals that this topic is still not widely disseminated and lacks consensus among healthcare professionals. There are doubts regarding its applicability in hospital routines. These uncertainties can be resolved through health education strategies tailored to daily workflow realities, such as training sessions utilizing banners.
Acute ST-Elevation myocardial infarction in primary hospitals: Does Tele-ECG still make a difference?
Electrocardiogram Transfer Systems (TELE-ECG) may increase the survival of patients with ST-segment elevation myocardial infarction (STEMI). However, regional differences may generate disparities in this process and consequently in the final outcome of patients. Given the above, the objective of this study is to evaluate the influence of TELE-ECG on the transfer time of patients with STEMI in the state of Paraná, Brazil, based on secondary data from 76 patients transferred from a primary hospital to the reference hospital for interventional cardiology in the city of Arapongas, Paraná. Comparisons between the transfer time of municipalities with TELE-ECG (Group A) and without TELE-ECG (Group B) were performed using the Mann-Whitney test and chloropleth maps were plotted to demonstrate the route taken by the Advanced Life Support ambulances. A significant difference (p<0.05) was observed between the groups, with the mean transfer time being 323.82 ±59.00 minutes for group A and 284.71±96.04 minutes for group B. Therefore, respectively, 203.82 minutes and 164.71 minutes above the recommended. During the journey, patients often passed through municipalities with hemodynamic and/or chemical reperfusion centers before arriving at the referral hospital. It is concluded that the transfer time was shorter in municipalities without TELE-ECG, indicating that possibly the activation of the Mobile Emergency Care Service closest to the site of the event, speeding up the patient transfer process. Therefore, further studies on the factors associated with the delay in intervention and outcome of patients with STEMI are essential.
Understandings, pedagogical assumptions and experiences of permanent education in health in the state of Paraná-Brazil
Permanent education suggests the continuous acquisition of knowledge in the professionals' work context and based on their previous knowledge. This study aims to explore how permanent health education (PHE) has been integrated in the State of Paraná, from the point of view of professionals who work in regional health departments. This is a descriptive study with a qualitative approach, in which 23 professionals involved with EPS participated, the interviews were conducted online from July to September 2021. The interviews were submitted to thematic content analysis, emerging the themes: About the understanding of what permanent health education is; The pedagogical assumptions of permanent education in health; The experiences lived with UNA-SUS and PROADI-SUS; Obstacles faced to carry out permanent education in health. It is concluded that the experience of professionals working with EPS in the state takes plac e on two fronts, one being a distance education experience, which has a study environment on the UNA-SUS platform, in which professionals seek qualifications in several areas, and the other that focuses on the actions developed by the Escola de Saúde Pública do Paraná, together with the regional health departments and municipalities, and that there are challenges to be overcome for the affirmation of this policy in the state.
Spatial and temporal distribution of schistosomiasis mansoni in northeast Brazil from 2012 to 2021
The objective of this study is to analyze the spatial and temporal patterns of schistosomiasis in the Northeast region of Brazil between 2012 and 2021. An ecological study was conducted, analyzing variables of schistosomiasis cases reported in the Northeast region of Brazil from 2012 to 2021, as recorded in the Notifiable Diseases Information System (SINAN). A univariate analysis of the cases was expressed in absolute and relative frequencies. The Joinpoint software was used to analyze the temporal trend of mortality. A total of 10,563 cases of schistosomiasis were recorded in Northeast Brazil, with males being the most affected (n=5,779; 54.7%), followed by mixed-race individuals (n=512; 70.3%), those with education levels between 1st and 4th grade of elementary school (n=1,646; 26.7%), and individuals aged 20 to 39 years (n=3,401; 32.2%). The intestinal form was the most prevalent (n=4,625; 75.1%), with a cure outcome in most cases (n=4,775; 82.0%). The state of Bahia recorded the highest number of cases (n=4,866; 42.1%). The study highlights that schistosomiasis remains a prevalent disease in the Northeast region, emphasizing the need for continuous health and environmental policies.
Perception of coordinators of Basic Health Units in Irati-PR / Brazil on the proposal for a physical activity program for the elderly
The aim of the study was to analyze the perceptions of the coordinators of the Basic Health Units (BHU) about a proposed physical activity program for the elderly, in the context of Primary Health Care (PHC) in Irati-PR. This is a qualitative, descriptive and explanatory study. As a research technique, we used semi-structured interviews to gather information on the coordinators' perception of the program's proposal. The data was analyzed through content analysis, using the categorical analysis technique. The study involved eleven participants, nine of whom were BHU coordinators, one outpatient coordinator and one PHC coordinator. The results showed that the BHU coordinators' perceptions of the proposal for a physical activity program for the elderly were: attribution of adjectives connoting approval of the proposal; insertion of the Physical Education professional and development of the program in the BHU; prospects for improvements in the physical and mental health levels of the elderly participants; potential for promoting physical activity for the elderly population in the BHU territory; dependence on the efforts of municipal management related to financial resources for the feasibility of implementing programs of this nature; lack of professionals and employees available to work in the program. Despite the positive attitudes towards the proposal, recognition of the potential and importance of programs of this nature for the health of the municipality's elderly population, the coordinators highlight aspects that deserve attention in order to enable the implementation of actions aimed at promoting healthy aging.
Impact of tele-rehabilitation on post covid-19 syndrome: a brazilian experience
Objective: The aim of this study was to report the effectiveness of the proposed tele-rehabilitation program to promote the respiratory rehabilitation and the functional recovery of people with post-COVID-19 syndrome. Method: 99 patients with COVID-19 sequelae participated in the tele-rehabilitation program, were shared in three groups: oxygen group (OG), COPD group (COPD-G), and general group (GG). The program lasted 12 sessions and included a protocol of respiratory exercises and muscle strengthening. Medical Research Council (MRC) and CR-10 Borg Scale were used to asses the patients at the beginning and at the end of the program, the oxygen saturation (SO2) and the heart rate (HR) were measured daily. Result: The patients had an increase of 5% in COPD-G (p<0.001) and 6% in OG/GG (p<0.001) for the SO2. For the MRC scale, patients had an increase of at least one point in COPD-G (p<0.001) and two points in OG/GG (p<0.001). The BORG scale values had a decrease of at least 5 and 4 points in the scale in COPD-G (p=0.003) and OG/GG (p<0.001) wich indicates that the intervention benefited the both groups. There were no significant differences between the initial and the final assessments for HR. Conclusion: The tele-rehabilitation program helped the pulmonary rehabilitation and the functional recovery of people with post-COVID-19 syndrome, and it also improved the muscular strengthen, the effort perception to do the exercises and the oxygen saturation. This program arose as a feasible, accessible and low cost assistance alternative that could be used beyond the pandemic period.
Aspects of child violence during covid-19 in a state in the legal Amazon
This research aimed to analyze the recorded cases of child violence in a state in the Legal Amazon during the COVID-19 pandemic. To this end, a document-based time series was carried out based on notifications of child abuse in the state of Tocantins from 2020 to 2021. The variables used were the year of aggression, sex and age of the victim and aggressor, place of occurrence, and type(s) of violence perpetrated. Simple descriptive statistics (absolute and relative frequency), measures of central tendency (mean and standard deviation), and the Chi-square test were used for categorical variables (outcome variable type of violence). A significance level of 5% (p≤0.05) was adopted. A total of 2,389 (100%) records were considered valid for analysis. In 2021, there were more records of child abuse than in 2020, going from 1,099 (46.0%) notifications in 2020, the start of the pandemic scenario, to 1,290 (54.0%) in the following year. In addition, in 2021, children had a 0.70 higher risk of suffering neglect and 0.82 psychological violence compared to 2020. It is concluded that child maltreatment was associated with the period, with a higher occurrence in the second year of the pandemic, the sex of the child and the aggressor, and the type of violence. These aspects signal the urgent need for intersectoral actions aimed at a culture of peace and gender equality, especially during the pandemic period.
Georeferencing and real-time temperature monitoring during the transport of human biological materials
Objective: To evaluate and compare the average temperature between active electric packaging and passive thermal packaging with artificial ice packs during the transport of human biological materials. Methods: The temperatures (in °C) of the transported biological samples were assessed over 6 consecutive days, using two different biological material transport boxes: (1) passive thermal box cooled with artificial ice packs, and (2) active electric box with a long-lasting lithium battery, cooled by a closed-circuit system using a compressor and coil. A total of 2,247.1 km was traveled, and 10,606 biological samples were collected across 11 different clinical analysis laboratories. Temperature monitoring was carried out through sensors installed in both boxes, allowing real-time online tracking and temperature monitoring. Results: On all analyzed days, the active box proved more efficient than the passive box, maintaining the average temperature within the established requirements (2 to 8°C) throughout the journey until final delivery. Environmental temperature variation did not directly affect the internal temperature of either packaging used in this type of transport. Conclusion: Active electric packaging is more efficient when compared to passive packaging cooled with artificial ice packs, as it maintained the correct temperature throughout the entire biological material transport process.
Obesity during pregnancy and lactation increases the inflammatory response and reduces the efficacy of nimesulide in the offspring of wistar rats
The type of diet consumed during pregnancy and early life increases the possibility of developing metabolic syndrome, which can result in altered efficacy of some drugs. The aim of this study was to evaluate the inflammatory response in the offspring of Wistar rats fed a Western diet (WFD) and the anti-inflammatory effect of nimesulide. Twenty Wistar rats and their male offspring were used. The dams were divided on the 1st day of gestation into two groups: 1) DPgl: received standard diet (SD) and 2) DOgl: received DO, both from gestation to the end of lactation. On the 21st day of lactation, the male offspring were divided into six groups (n=5 animals/group) and assigned to different experimental protocols, in order to assess on the 60th day of life the influence of the type of diet on the inflammatory response (through carrageenan-induced paw oedema) and the anti-inflammatory action of nimesulide (5 mg/kg, i.p), by quantifying the levels of IL-6, TNF-α and myeloperoxidase (MPO) in the plantar tissue of the rats. The volume of edema was greater in the offspring of DOgl dams, regardless of whether they received PD or DO post-weaning; in those that received DO, the activity of nimesulide was reduced and the levels of IL-6, TNF-α and MPO were elevated. In the offspring of DPgl dams, which received PD post-weaning, the anti-inflammatory activity of nimesulide, verified in the paw volume, was maintained at all three evaluation times. Thus, the inflammatory response was more significant in the DOgl offspring that received DO, and these animals showed a reduction in the anti-inflammatory effect of nimesulide.
Management of hypertension and diabetes mellitus in the elderly in primary care: Contribution to polypharmacy, inappropriate drugs use and drugs interactions
This is a cross-sectional study analyzing the medical prescriptions of elderly people being treated for hypertension or diabetes mellitus at a Primary Health Care Unit in the Federal District, with the aim of identifying polypharmacy, potentially inappropriate medications (PIM), potential drug interactions (PDI) and the frequency of medications in continuous use according to clinical indication. Among the 1,245 prescriptions analyzed, 73.7% had polypharmacy, 95.6% contained at least one antihypertensive and 63.1% had an antidiabetic. In 301 (24.2%), a PIM or PDI was identified. The most frequent PIM was insulin, present in 13.7% (n=301; 56.5%). The most frequent PDI was between angiotensin II receptor blockers and potassium-sparing diuretics, present in 4.5% (n=301; 18.6%) of prescriptions. Polypharmacy was prevalent, especially among female patients. The most frequent PIM has an increased risk of causing hypoglycemia in the elderly, while the most identified PDI increases the risk of hyperkalemia and kidney damage. It is necessary to publicize and promote adherence to the clinical protocols and lines of care for controlling chronic diseases and to the lists of PIMs and PDIs for the elderly.
Functional health literacy in individuals with spinal cord injury treated at a rehabilitation center
This study aims to analyze the functional health literacy of individuals with spinal cord injury treated at a rehabilitation center. We conducted this analytical cross‑sectional study at a rehabilitation and readjustment center, including 85 individuals diagnosed with spinal cord injury. We collected data on sociodemographic, clinical, and functional profiles. The Short Test of Functional Health Literacy in Adults (S-TOFHLA) was used to assess functional health literacy. Most participants were male, aged between 18 and 39 years, with paraplegia caused by traumatic etiology. Analysis of functional health literacy showed that 70.6% of individuals with spinal cord injury had adequate literacy levels. Better functional health literacy outcomes were associated with younger age, higher income, longer duration of rehabilitation, higher educational levels, and having a partner. In conclusion, the services provided and the organizational structure of reference centers rehabilitating individuals with spinal cord injury may contribute to improved functional health literacy. Identifying related variables and analyzing the functional dimension of health literacy by multidisciplinary teams during rehabilitation are essential tools for enhancing the health outcomes of individuals with spinal cord injury.
Depressive symptomatology among pregnant women attended in primary health care in southern Santa Catarina / Brazil: Prevalence and associated factors
Objective: This study aimed to evaluate the presence of depressive symptoms in pregnant women who underwent prenatal care at the Family Health Strategy Units (ESF) in the municipality of Tubarão/SC, from August to December 2022. Method: This is an observational epidemiological study with a cross-sectional design, carried out with pregnant, primiparous or multiparous women with gestational age above 27 weeks who agreed to participate in the study and underwent prenatal care in the city of Tubarão/SC. The researchers elaborated a protocol for data collection and the depressive symptomatology was evaluated using the Edinburgh Postpartum Depression Scale (EPDS), a validated and self-administered instrument. For the association between the variables of interest, Pearson's Chi -Square or Fisher's Exact test was used and the pre-established confidence interval was 5%, p ≤ 0.05. Results: There was a prevalence of depressive symptoms in 25% of the evaluated pregnant women. There was an association between the EPDS instrument and: ethnicity, education, family income and planned pregnancy. Non-Caucasian pregnant women had a higher occurrence of depressive symptoms, as well as those with less education, low income and those who had not planned the pregnancy. Conclusions: In view of the prevalence of depressive symptoms found among the interviewees, the importance of the priority role of the Family Health Strategy (ESF) teams in minimizing the vulnerability of women in the peripartum period is evident.
Evaluation of the antimicrobial and antioxidant activity of the leaves of Fridericia Platyphylla species
Bacterial resistance is one of the greatest threats to global health, causing difficulties in controlling infections and increasing costs in health system. The study of plant species antimicrobial activity is of foremost importance. Brazil has a wide plant species variety, offering a vast area for research new molecules to produce drugs. Among these species is Fridericia platyphylla, popularly known as “cervejinha do campo". This research aims to evaluate the antimicrobial and antioxidant activity of the crude extract and dichlorine fraction of Fridericia platyphylla species leaves. The chemical characterization of the raw plant extract was performed using HPLC-PDA, FIA-ESI-IT-MS, and LCMS techniques. The DPPH and ABTS methods were used to evaluate the antioxidant properties. The antimicrobial activity was assessed by determination of the minimum inhibitory concentration (MIC) through microdilution assay. An in vivo model using Tenebrio molitor was employed to evaluate the toxicity. Ten compounds were identified in the crude extract. The crude leaf extract showed the highest antioxidant activity at 250 μg/mL. The antimicrobial assays showed that F. platyphylla crude extract inhibited Staphylococcus aureus ATCC 6538 with a MIC of 64 μg/mL. The dichlorine fraction inhibited the same bacteria at a MIC of 16 μg/mL. Enterococcus faecalis ATCC 51299 and Pseudomonas aeruginosa ATCC 27856 were inhibited with MIC of 1024 μg/mL and 512 μg/mL. The results emphasize the crude extract and dichlorine fraction of F. platyphylla leaves potential as an alternative to prevent and combat infections and as a source of raw material in producing drugs and natural products.
Aruanã Joaquim Matheus Costa Rodrigues Pinheiro
Management of anxiety and depression disorders by university students during the covid-19 pandemic: A cross-sectional study
Objectives: to evaluate the use of psychotropic drugs and/or psychotherapy for anxiety and/or depression management among Brazilian university students during the COVID-19 pandemic. Methods: a cross-sectional, quantitative study conducted by an online questionnaire containing sections related to sociodemographic data, academic information, mental health-related information, and evaluation of the severity of anxiety and depression symptoms. Participants included university students aged 18 and older with a previous anxiety and/or depression disorders diagnosis. Descriptive and inferential analyses were performed. The study received approval from the Ethics Committee for Human Research. Results: 409 students with an anxiety and/or depression disorders diagnosis participated in the study. Most students reported using psychotropic drugs (62.3%; n = 255). There was no significant association between medication use and sociodemographic variables. Psychotherapy use was reported by 36.7% (n = 150) of students. A significant association was observed between psychotherapy use and ethnicity/color (p < 0.01) and engagement in paid activities (p = 0.02). Conclusion: The medication use prevalence is higher compared to psychotherapy use. Ethnicity/race and performance in paid activities may be associated with psychotherapy use among Brazilian university students.
Continued breastfeeding: Prevalence and causes for weaning in children under two years of age
The objectives of this study were to estimate the prevalence of continued breastfeeding in the second year of life of children who were exclusively breastfed in the first six months and to describe the reasons for interrupting breastfeeding before the age of two years of these children. This is a cross-sectional analysis of a longitudinal study conducted at the Fernandes Figueira Institute (IFF) of the Oswaldo Cruz Foundation (FIOCRUZ), located in Rio de Janeiro, Brazil. The research sample consisted of 122 children born at the IFF or who were transferred to the unit up to seven days old. Data was collected in the second year of life of these children through 17 open and closed questions asked by telephone contact with their respective mothers and the data were then descriptively analyzed in the R software program. Approximately 40% of the mothers were not breastfeeding in the second year of life and some of the reasons cited were the child’s refusal to breastfeed, fatigue, return to work and insufficient breast milk. Considering the demands presented, it is understood that weaning before two years of age is not caused by just one, but many factors during the first 24 months. Therefore, it is important that health professionals are made aware and trained, especially with regard to encouraging breastfeeding after the exclusive period, as this is influenced by multiple factors and requires comprehensive monitoring of the mother-baby binomial.
Janaina Kelly da Silva de Souza de Araújo
Medicinal plants in the face of infectious diseases: Perception of their use by university students in the health field
Plants have been used for years as a way to restore and strengthen health. Although the use of medicinal plants is common, health professionals have limited knowledge on this topic, which may compromise the reception of patients who opt for this therapy. This study adopted a cross-sectional observational design with the aim of analyzing the perception of health academics regarding the use of medicinal plants in the face of infectious diseases. An epidemiological questionnaire was completed and sent to the institutional email of the academics via a Google form, containing variables related to medicinal plants and infectious diseases by university students in the health field (pharmacy, nursing, aesthetics and cosmetics, nutrition, dentistry, medicine, veterinary medicine, physiotherapy and psychology) from a Private University located in the northwest region of the state of Paraná, Brazil. Once completed, the results were described and submitted to statistical analysis using the Chi-Square Test (ҳ²) with Fisher's Exact Test. The results showed that the majority of participating students were between 18 and 25 years old (77.35%), mainly female (71.07%), regardless of the area evaluated. The students demonstrated that they knew and used medicinal plants, such as chamomile, lemon balm, mint, ginger, guaco, garlic, and saffron. However, this knowledge is not linked to that acquired during graduation, being equal to popular knowledge. Therefore, it is suggested that this theme be included in the pedagogical curriculum of courses in, at least, elective subjects, in line with the guidelines of the National Policy on Integrative and Complementary Practices and the National Policy on Medicinal Plants and Phytotherapeutics, which, despite being in force since 2006, still face difficulties in curricular insertion due to bureaucratic obstacles.
Digital minigame as a food and nutritional education tool for adolescents
The objective of this study was to develop a digital minigame to promote adequate, healthy and sustainable eating among adolescents. The educational game was planned and developed in mobile (Android) and desktop (website) versions by an expert team, based on the Brazilian Dietary Guidelines. The Unity platform was used for its creation and the following tools, C#, spriter, gimp and photoshop, for animation, movement, scoring and art. After developing of the game, it will be validated by an expert panel and later will be used in a pilot study with adolescents. It is concluded that “FeiraNutre” minigame is an educational tool capable of transforming the teaching-learning process into an engaging, interactive and fun experience. The playful strategy use can help the player relate the game content to his eating habits, so that they can then present healthier and more sustainable food choices. This possibility has contributed to games being continually introduced in technical schools and with the advantage of being used in face-to-face, remote, hybrid and distance learning.
Translation and cross-cultural adaptation of dietary recommendations for refugees in Brazil
In recent years, Brazil has emerged as a primary destination for migratory flows driven by political, socioeconomic, and religious factors, receiving refugees from various countries. Ensuring access to food and maintaining adequate nutritional status are central to protection measures. Existing data on the recognition process in the country do not encompass dimensions of health and food. In 2015, Portugal published a Welcoming Manual that addresses rights related to health, food, and nutritional security, serving as a reference for nutritional interventions for refugees in that country. This study translated and adapted the recommendations from this Manual, establishing a dialogue with the Dietary Guidelines for the Brazilian Population from the Ministry of Health. Understanding and recognizing dietary specificities is essential to initiating adequate reception. The translated and adapted dietary recommendations intend to be a guide for nutritional reception and can be regarded as a starting point for health professionals, emphasizing the need for broader discussions and studies to support public policies for reception.
Self-medication and public health: Analysis of risk factors, knowledge and health behaviors in adults and the elderly
This study aimed to analyze the health literacy of adults and the elderly regarding self-medication and evaluate the practice and its clinical complications. This is a descriptive, cross-sectional, quantitative study carried out in primary health care in Brazil. A structured instrument comprising 41 questions was used to collect the data. Descriptive statistics and bivariate data analysis were carried out using the Bioestart 5.0 and Epi info 7.2.5.0 software (p<0.05). Of the 241 users interviewed, 89% said they take medication independently. When asked about the practice and clinical complications of self-medication, 86% were unaware. In the last 15 days, 83% had taken medication without a prescription from a health professional. The dependent variable (knows what self-medication means and its consequences for health) had a statistically significant association with schooling (p<0.001), family income (p<0.007), profession (p<0.001), place of residence (p<0.013), and household stock (p<0.011). It was concluded that more than half of the interviewees practiced self-medication and that individuals with a higher level of education, living in urban areas, and holding public office were more likely to self-medicate.
Video chordel "Ô pé arretado" educational technology for diabetic foot prevention
Objectives: To describe the process of creating a video channel with evidence of validity as an educational technology to promote self-care and prevention of diabetic foot as a complication of living with diabetes mellitus. Method: Methodological study, developed through data collection in the literature and with the target audience; construction of the video script with chordel literature and video chordel; validation of the material through validation by judges (specialists in the fields of health and chordel) and udability test with the target audience (people living with diabetes in primary health care). Data were analysed descriptively. Results: The content and appearance of the video chordel was validated, with a content validity coefficient of 1.0; with 100% agreement between items; considered adequate for the evaluation of educational material and with the best possible usability in terms of applicability to the target audience. Conclusion: The Video Chordel was validated in all domains evaluated and can be used by people with diabetes to promote self-care and prevention of diabetic foot.
Caregivers' perspective on bonding with institutionalized children and adolescents
Objective: This study aims at exploring caregivers' perspectives on the bond established in the care of institutionalized children and adolescents. Methods: A qualitative study was conducted with ten caregivers from a child and adolescent care institution in southern Brazil. The participants were selected based on two inclusion criteria: direct involvement in child and adolescent care and minimum tenure of three months at the institution. Data collection took place between October and November 2020 through semi-structured interviews. The data underwent directed content analysis guided by Watson's Human Care Theory, which served as grounds for developing the initial coding framework. Results: Two categories were obtained: The bond as a form of transpersonal care, which allowed understanding the transpersonal relationships proposed by Jean Watson as a form of care established through the bond between the caregiver and the person cared for; and Care work in bond formation and disruption, which provided insights into how attachment influences the establishment and dissolution of caregiver-child relationships. Conclusion: It is essential to foster bonds and attachment in transpersonal relationships, particularly in the care of children and adolescents, where the caregiver's role is indispensable. Within institutional care settings, providing emotional support and recognition is crucial for enabling caregivers to establish attachment-based relationships, which are fundamental to children's and adolescents' development, especially in the deinstitutionalization context.
Perception and coping with the covid-19 pandemic in two traditional communities in the brazilian amazon
The research aimed to understand the epidemiological information of the first year of the COVID-19 pandemic in traditional communities in the Amazon. Furthermore, it analyzed the perception of the events and reported the leading practices adopted to mitigate the pandemic. The fieldwork was conducted in two communities: one riverside and one quilombola, both in the municipality of Abaetetuba, in the state of Pará. Representatives and local players from the communities participated in the data collection, after which the information was analyzed qualitatively and quantitatively. The novel coronavirus pandemic has damaged traditional communities, such as unemployment, increased social inequalities, declining public health, more expensive food, and psychological problems. Some actions have been taken by local organizations and NGOs to mitigate the impacts. However, it still has not been enough to guarantee people’s safety from the virus. Although there were no deaths, the number of people infected was undoubtedly higher than expected; in addition, as these are regions far from urban areas, health and social services have become more precarious and almost non-existent.
Quality of life and risk behaviors for eating disorders in university students
Eating disorders can lead to numerous health impairments, including poor quality of life. This study aimed to explore the association between quality of life and risk behaviors for eating disorders. A cross-sectional study was conducted with a sample of 353 health sciences university students from southern Brazil. Quality of life was assessed using the WHOQOL-BREF, while risk behaviors for eating disorders were evaluated through the EAT-26. Data analysis included descriptive statistics, non-parametric tests, and Poisson regression. The mean age of the sample was 25.9 ± 8.2 years, with a median (Med) total quality of life score of 66.3 points (interquartile range [IQR]: 58.6–74.0), and a prevalence of poor quality of life of 28.3% (95% Confidence Interval [CI]: 23.6–33.0). A lower quality of life score was observed among students with risk behaviors (Med: 63.0; IQR: 52.9–70.2) compared to those without risk behaviors (Med: 67.3; IQR: 60.6–75.0; p=0.002). After adjustment, university students with risk behaviors for eating disorders had a 79% higher probability of experiencing poor quality of life (Prevalence Ratio [PR] = 1.79; 95% CI: 1.28–2.50; p=0.001) compared to those without risk behaviors. Thus, the findings of this study indicate a poorer quality of life among university students with risk behaviors for eating disorders.
Air quality and confirmed cases of covid-19 in the metropolitan region of Porto Alegre/RS: Ecological study
This study aimed to investigate the relationship between air quality in the municipalities of Canoas and Esteio/RS and reported cases of COVID-19 from March 1, 2020 to February 28, 2021. The analysis was realized by searching and relating air quality data for NO 2 , SO 2 , MP 10 and MP 2.5 obtained from the database of the Fundação Estadual de Proteção Ambiental Henrique Luis Roessler- RS (FEPAM) and data from patients reported with COVID-19 provided by the Federal Government. A prevalence of patients infected by COVID-19 in females (54%) between 30 and 39 years old (23%) was observed in both municipalities. The most listed symptoms were dyspnea (83%) and sore throat (74%) and the most common comorbidities presented by infected patients were asthma (5.37%) in Canoas and Chronic Heart Disease (6.17%) in Esteio. The pollutant values analyzed showed fluctuations and even exceeded the established limits, and a positive statistic (<0.001) was observed between the SO2 levels and the number of confirmed cases of COVID-19 in the evaluated municipalities. With the results showing the positive relationship between air quality and COVID-19 cases, it’s expected to be able to contribute to the development of public policies that improve air quality and reduce the damage they cause to human health, as well as educational and preventive measures to increase awareness among the general population about the importance of air quality.
Meaning of hospitalization due to covid-19: A methodological approach in grounded theory
This study aimed to understand the meanings attributed to hospitalization by individuals who experienced moderate and severe forms of COVID-19. It is a qualitative study conducted with 19 individuals who had moderate and severe cases of COVID-19 in a municipality in the northwest region of the state of Paraná, from April to November 2021. The study was based on the theoretical framework of Symbolic Interactionism and employed the Constructivist Grounded Theory as its methodological approach. Data collection was carried out through individual interviews mediated by technology. The analysis followed open and focused coding, as proposed by the analytical method. The results indicate that both positive and negative meanings were constructed during hospitalization due to COVID-19. The influence of healthcare professionals was essential in fostering positive feelings toward the hospital environment, the disease, and the hospitalization units, as well as reinforcing the individual's role as an active agent in their recovery. Negative feelings such as fear and despair were also observed, both regarding the severity of the disease and the care received, due to healthcare professionals' lack of experience in handling COVID-19. Given the high number of hospitalizations, fear of hospital discharge was also significant, as patients were concerned about potential deterioration in their condition that might require readmission. The participants' experiences during the pandemic can serve as a foundation for understanding and formulating healthcare policies in public health emergencies.
Nutritional status of children enrolled in municipal early childhood education schools in 2004 and 2018
This study aims to describe the nutritional status of children enrolled in Municipal Early Childhood Education Schools in the city of Pelotas, RS, in 2004 and 2018. Twenty-four schools were included in 2004, and another 29 were added in 2018. Anthropometric assessment, for both years, was carried out in the schools, following the technical guidelines of the Food and Nutrition Surveillance System. Nutritional status was classified according to body mass index for age according to the growth curves proposed by the World Health Organization. Prevalence was calculated using a significance level of 5%, and the mean BMI of the two studies was compared using the T-test. Statistical analysis was performed using Stata version 15.0. In 2004, about 70% of children were normal; in 2018, this prevalence declined to 54.6%. There was a significant increase in the prevalence of overweight from 2004 (20.9%) to 2018 (26.8%), and higher among girls in both years. The results highlight the nutrition transition in children, highlighting the importance of public policies and actions to promote healthy eating and prevent childhood obesity.
South America and the World Health Organization’s goals for the elimination of cervical cancer
The World Health Organization (WHO) has established strategic targets to eliminate cervical cancer by 2030. This study evaluates the progress of South American countries toward meeting these targets. Population estimates for South American countries were obtained from the WHO website, the HPV and Cancer Information Center of the Catalan Institute of Oncology (ICO), and the International Agency for Research on Cancer (IARC). In terms of vaccination coverage, Guyana, Colombia, and Suriname reported the lowest first-dose coverage rates, while Guyana, Colombia, Paraguay, and Suriname had the lowest second-dose coverage. Screening coverage exceeded 70% in Argentina, Uruguay, Paraguay, Colombia, Chile, and Peru over the past 5 yr. In terms of treatment, the highest incidence-to-mortality ratios were observed in Suriname (0.62), Uruguay (0.58), Venezuela (0.57), and Argentina (0.56). The findings highlight significant challenges, particularly in Suriname and Venezuela, emphasizing the urgent need for effective public policies and international support to help these countries meet the 2030 targets through strategic and financial interventions.
Trends and clinical profile of leprosy cases in children and adolescents under 15 years old in inland Bahia, Brazil
Leprosy remains a significant public health challenge in Brazil, and its transmission among children and adolescents under 15 years old is predominantly associated with household contacts. Monitoring the leprosy cases within this specific age group serves as a crucial indicator for disease surveillance and control efforts. Thus, the aim of this study was to describe the trend and clinical profile of leprosy in children and adolescents under 15 years old in inland Bahia, Brazil. This retrospective cross-sectional follow-up study was performed in a specialized reference center in the Paulo Afonso municipality, Bahia. The data were obtained from the records of leprosy patients under 15 years, treated and followed up by the service between 2008 and 2022. The mean new case detection rate of leprosy in children and adolescents at 13.6 (95% CI: 7.9–19.4) cases per 100,000. The highest frequency was in the 10- to 14-year-old age group, comprising 62.1% of cases. Contact screening identified 31.0% of cases, and 12.3% had some disability at diagnosis. Paucibacillary cases (77.6%) were more prevalent than multibacillary, with tuberculoid clinical form (56.9%). The cure rate was 96.4%. The study highlights the need to intensify epidemiological surveillance efforts, including actively searching for cases, particularly among individuals aged 10 to 14 years, who represent the highest proportion of leprosy cases. Targeted interventions and education campaigns tailored to this age group are imperative to enhance awareness, early detection, and access to care, ultimately mitigating the burden of leprosy and preventing long-term sequelae among children and adolescents.
Insertion and management of peripherally inserted central catheter in high-risk newborns
The objective of this study was to analyze data on the insertion and management of peripherally inserted central catheters (PICC) in high-risk newborns admitted to a Neonatal Intensive Care Unit (NICU). This is a retrospective documentary study that included 333 PICC insertions in 204 high-risk newborns admitted to a reference NICU in the Ditrito Federal, Brazil, during the year 2022. Data were collected using a standardized form implemented by the institution's Hospital Infection Control Committee and supplemented by consultation of the patient’s electronic medical records. The research was submitted to the Research Ethics Committee and approved in 2022. The sample showed a slight predominance of females, with the majority of patients being premature and having an appropriate birth weight for gestational age. The average number of punctures was 2.44 (± 1.68). The mean dwell time was 10.65 (± 7.13) days. Older patients underwent more puncture attempts, as well as those with a higher weight at insertion. Central catheters had a longer dwell time and fewer complications. The most prevalent complications were infection, obstruction, and infiltration, with some of them leading to unscheduled removal of the device. The findings are consistent with current literature and highlight the importance of proper training for the nursing team in the insertion and management of the device.
Accuracy of the Bedside pews scale in determining clinical deterioration upon admission of pediatric patients
Objective: To evaluate the accuracy of Bedside PEWS in determining clinical deterioration in pediatric patients upon admission. Method: Cross-sectional and retrospective study. A sample of 591 medical records of children admitted to a pediatric emergency department between January and December 2018. Data were analyzed using descriptive and inferential statistics. For each Bedside PEWS cutoff point, sensitivity and specificity were estimated, using transfer to intensive care as the outcome. A Receiver Operating Characteristic (ROC) curve was constructed based on these values. Results: Upon emergency admission, for PEWS >4, the ROC curve accuracy was 76.9%, with a sensitivity of 59.1% and specificity of 78.0% (p<0.001). Upon transfer from the emergency department, for PEWS >5, the ROC curve accuracy was 87.4%, with a sensitivity of 72.6% and specificity of 94.3% (p<0.001). Conclusions: Bedside PEWS is a valid tool for assessing clinical deterioration in children, with PEWS ≥5 being the most reliable indicator.
Factors related to the quality of life of older adults caregivers of the older adults: cross-sectional study
Objective: To assess the factors associated with the quality of life of 282 senior caregivers who care for older family members. Method: A quantitative, cross-sectional study conducted through data collection in 2014, using a protocol consisting of the following instruments: sociodemographic questionnaire, Katz Index, Lawton and Brody Scale, CASP-19, Zarit Burden Inventory, Geriatric Depression Scale, Frailty Assessment (based on a five-component phenotype), Spirituality Scale, and Coping Strategies Inventory. Results: The majority of participants were married women who had been caring for their spouses for an average of 9.6 years. It was observed that older caregivers with lower burden levels were 246% more likely to report better quality of life, and for those without depressive symptoms, this likelihood increased to 527%. Non-frail individuals had a 154% higher chance of perceiving better quality of life, as did those with higher levels of spirituality and stronger coping strategies, who showed 65% and 9% greater likelihood, respectively. Conclusion: The findings highlight that a better quality of life is associated with key factors such as lower frailty and caregiver burden, especially in the absence of depressive symptoms. This underscores the importance of evaluating, identifying, preventing, and implementing when necessary through targeted interventions addressing these factors.
Microorganisms present in southern brazilian handcrafted kombucha
Kombucha is a fermented beverage produced by a symbiotic culture of microbiologically active bacteria and yeast (SCOBY) with properties that are reportedly beneficial to health. A descriptive study was conducted with kombuchas produced on a small scale in Porto Alegre/RS. Samples were collected to isolate microorganisms present in the kombucha, as well as in the ingredients used (SCOBY and green tea). The beverages were analyzed in their original and flavored versions, with and without homogenization, in triplicate, totaling 12 samples. It was found that kombucha exhibited a high yeast count, with a significant difference in the beverage depending on homogenization, both in the homogenized original version (7.39±6.46 log CFU/mL vs. non-homogenized 6.46±5.39 log CFU/mL, p<0.0065) and in the homogenized flavored version (7.54±6.81 log CFU/mL vs. non-homogenized 7.20±6.04 log CFU/mL, p<0.049). The SCOBY presented a total yeast count of 6.78±6.68 log CFU/mL, and no microbial growth was observed in the green tea. In conclusion, the analyzed kombucha exhibited a high yeast content in both the original and flavored versions, with a higher concentration of these microorganisms in the homogenized form, suggesting the importance of mild homogenization of the beverage before consumption.
Swallowing and nutritional characteristics of patients with post-covid-19 syndrome: ambispective study
The objective of this study was to describe the swallowing profile through clinical and instrumental assessments and the nutritional profile of patients with post-COVID-19 syndrome, stratified by sex. This was an ambispective study. Primary data collection was conducted at the Post-COVID-19 Rehabilitation Outpatient Clinic of a university hospital, selecting 50 adult individuals who had been hospitalized for severe COVID-19. All participants underwent swallowing assessments (Eating Assessment Tool-10 – EAT-10; Volume-Viscosity Swallowing Test – V-VST; and Fiberoptic Endoscopic Evaluation of Swallowing – FEES) and nutritional evaluations (Mini Nutritional Assessment – MNA and Body Mass Index – BMI). The study included 26 women (51.04 ± 13.59 years) and 24 men (55.92 ± 10.18 years) assessed four months after acute COVID-19 infection, with a history of prolonged intensive care unit (ICU) hospitalization for more than 20 days. Swallowing alterations in females and males were identified through EAT-10 (53.85% vs. 8.33%; p=0.001), V-VST (76.92% vs. 79.17%; p=0.848), and FEES (92.31% vs. 83.33%; p=0.651), respectively. Both women (35.41 ± 5.68 kg/m²) and men (31.65 ± 4.64 kg/m²) were classified as obese. Nutritional risk, as assessed by the MNA, was observed in both sexes (53.85% of women and 58.33% of men), with 23.08% of women classified as malnourished. No correlations were observed between swallowing variables and BMI classification or MNA scores. Our results suggest that individuals with post-COVID-19 syndrome are at risk for dysphagia and obesity, regardless of sex. Furthermore, malnutrition was more prevalent among women. These findings highlight the importance of timely management of swallowing and nutritional disorders to assess and optimize rehabilitation, preventing associated sequelae.
Being pregnant, giving birth, and being a mother in the covid-19 pandemic: women's voices
This study aims at understanding the experience of pregnancy, delivery and motherhood during the Covid-19 pandemic in Ceara, Brazil. Qualitative exploratory research was carried out in Fortaleza, Ceara, from January to March 2022, with a sample of 30 women who were participants in a larger cohort study. The semistructured interviews was analyzed through the Thematic Oral History technique and Bardin's thematic content analysis method. The participants had an average age of 29.7 years. Most had one to two children, a monthly income equal to or less than one minimum wage, stable relationship and had not been affected by SARS-CoV-2. The analysis favored the emergence of three categories: challenges, feelings and experiences lived by participants about being pregnant, giving birth and being a mother in the Covid-19 pandemic. The findings suggest that the social isolation resulting from the Covid-19 pandemic, its socioeconomic impacts and the organization of health services resulted in negative experiences these experiences favoring the emergence of fear, anxiety, insecurity and stress. Thus, this article makes it possible to subsidize healthcare services to observe more humanized models for women in contexts of health crisis.
Association of probable sleep bruxism in children with stress and quality of life: Preliminary cross-sectional study
Aim: This study aimed to investigate the association of probable sleep bruxism with stress and quality of life in children. Methods: A cross-sectional study was conducted with 117 children, aged 8–11 years, from public schools in São Luís, Maranhão, Brazil, from March to December 2019. A questionnaire with demographic and socioeconomic questions, aspects related to sleep bruxism, and deleterious oral habits was answered by parents. The children underwent clinical examination and then answered the Childhood Stress Scale and the Autoquestionnaire Qualité de Vie Enfant Imagé (AUQUEI). Data were subjected to descriptive, bivariate, and multivariate analyses (hierarchical Poisson regression models) at 5% significance level. Results: A brown race prevailed in the sample (70.1%). Probable sleep bruxism and stress were observed in 11.1% and 38.5% of the children, respectively. The “family” and “function” domains of AUQUEI were the most impaired (10,892.20 and 10,211.87, respectively), while probable sleep bruxism was not significantly associated with stress (p=0.293). Conclusions: Based on these findings, it can be concluded that probable sleep bruxism was not associated with stress or a negative impact on children’s quality of life.
Daniella Vidigal Fernandes da Silva Guimarães
Jacqueline Vitória do Nascimento Azevedo
App to guide nurses on the assessment and treatment of complex surgical wounds
Wound treatments have advanced considerably with the expansion of therapeutic possibilities, treatment techniques and technological innovations for the care of skin lesions. This study aims at developing a mobile app to guide nurses in the assessment and treatment of complex surgical wounds. This is a methodological and descriptive study with a qualitative approach developed in a High-Complexity Oncology Center from the state of Pará. It was developed in two stages: initially, by identifying the target audience's main needs through semi-structured interviews that were analyzed following Bardin's method and using the IRAMUTEQ software. The second stage consisted in the technological production itself, according to Contextualized Instructional Design (analysis, design and development). The interviews with the participants supported and justified creating the “Pense Feridas” (“Think Wounds”) app. Aiming at good usability, the following topics were included on the main screen: concepts and classifications, complications, wound assessment, updates and references. These categories present secondary screens with pertinent and updated information on each topic. In addition, the software features a “Surgical wounds” icon where the professionals can add patient and wound information to indicate the best care standard, including coverage and dressing changes. This study made it possible to produce an app that is sensitive to the reality of nurses who deal with the assessment and treatment of patients with complex surgical wounds every day. Its implementation may favor systematic care recording and care continuity.
Clusters of risk factors for chronic non-communicable diseases in community health workers
This study aimed to estimate the prevalence ofclustersof behavioral risk factors for Chronic Diseases Do NotCommunicable Diseases (NCDs), as well as associated factors in Community Health Agents (CHAs). This is a census, cross-sectional, analytical study, derived from a research project entitled Working and health conditions of CHAs in northern Minas Gerais: a longitudinal study, carried out in the city of Montes Claros, MG. The dependent variable wassimultaneous presence, orclusters of three or more behavioral risk factors for NCDs. The definition of associated variables was performed after Poisson multiple regression analysis with robust variance. A total of 675 CHWs participated in the study. Of these, 57.6% (n=389) presented at least three simultaneous risk factors for NCDs, the most prevalent being low fruit consumption, physical inactivity and excessive consumption of soft drinks. The variables that were associated with the cluster of behavioral factors were age greater than or equal to 37 years (PR=0.87; 95%CI=0.81-0.94; p=0.001), perception of poor health status (PR=1.08; 95%CI=1.00-1.16; p=0.037) and presence of hypertension (PR=1.17; 95%CI=1.06-1.30; p=0.001). It is concluded that the prevalence of three or more risk factors for NCDs in CHAs was high, and that sociodemographic and clinical factors are associated with the outcome investigated. Considering the results recorded, health services should provide differentiated care policies for CHAs, seeking to prevent behavioral factors that can increase morbidity and mortality due to NCDs.
Challenges in the public procurement of PPE in federal hospitals in Rio de Janeiro / Brazil during COVID-19
This study mapped hurdles and strategies in public procurement of Personal Protective Equipment (PPE), through a descriptive approach involving self-completion of an electronic survey instrument by personnel with purchasing experience from federal public hospitals. The instrument covered the supply process: general characteristics, common problems, and strategies necessary to overcome difficulties in the procurement process of seven selected PPEs (avental, máscara cirúrgica, máscara respiradora PFF2 ou N95, touca, protetor facial, óculos de proteção e sapatilha). We observed recurring procurement processes undertaken without tendering, in accordance to urgently-passed legislation by the Brazilian government, that waivered this obligation. High prices of PPEs and market shortages were the most usual problems, cited by over 80% of the respondents, especially for disposable surgical aprons and masks, and for filtering facepiece respirators (FFR) such as FFP2, and N95. Surge in demand associated with a disruption in global supply contributed to abusive prices. Negotiations with bidders, exchange of information between buyers and the search for alternative suppliers were the most important measures taken to tackle procurement problems. Difficulties in PPE procurement are a consequence of supply chain inadequacies as well as deficiencies in productive capacity in Brazil and worldwide. The mitigating actions employed in the face of procurement problems show the resilience of procurement systems.
Parental stress contexts in a neonatal intensive care unit
This study aimed to (re)discover the stressful situations experienced by parents in the context of a Neonatal Intensive Care Unit. This is a mixed method study conducted in two Neonatal Intensive Care Units. Thirteen fathers and/or mothers of newborns participated in the interview, and quantitative data were collected using the Parental Stress Scale: Neonatal Intensive Care Unit. Bardin was used for thematic analysis. The data resulted in four thematic categories and a “talking table” that integrates the data from the quantitative and qualitative approaches. Stress is present in both methodological facets of analysis, with emphasis on the parental role domain, with the highest mean score. The findings reinforce the need to promote unique care for newborns, taking the family into consideration. In addition to efficient communication, promoting and strengthening parental co-responsibility for care, and respecting family principles are essential for the recovery and rehabilitation of newborns.
Impact of covid-19 pandemic in hospitalizations of women with endometriosis: Ecological study
Objective: to analyze the impacts of the covid-19 pandemic on hospitalizations of women with endometriosis in Brazil. Method: this is an ecological epidemiological study, retrospective, based on documentary and quantitative approach, which followed the recommendations of STROBE. Data on hospital admissions for endometriosis were collected through the hospital information system based on DATASUS, between 2018 and 2021. Results: in 2018 and 2019 there were 12,406 and 11,989 hospitalizations of women with endometriosis. In the years 2020 and 2021 there were 7,202 and 7,759 hospitalizations, showing a decrease of about 40% compared to previous years. The prevailing age group was between 40 and 49 years (42%) and as for race/color, in 2018 and 2019 it was the white race and in 2020 and 2021 the brown race. As for the region of residence, more occurred in the southeastern region (43%), as well as the states of São Paulo (18%) and Minas Gerais (16%). Regarding the character of the service, most was elective. Conclusion: it was evidenced that the pandemic impacted on hospital admissions of women with endometriosis, who presented a white color/race profile, aged between 40 and 49 years, living in the southeastern region of the country, mainly in the states of São Paulo and Minas Gerais.
Mobile application for metabolic syndrome screening in climacteric women: Applied methodological study
The objective of this work was to present the development of an application to track metabolic syndrome in climacteric women. As for the methodology, it was an applied research developed from a study that evaluated the ability of anthropometric measures to discriminate metabolic syndrome in climacteric women. A database was created with extraction of logistic regression models and the application for smartphones was developed. Flutter, software development kit, created by Google, was used. As a result, the application called ClimatMed was developed, which is available for free in the Play Store and can be installed on smartphones with Android system. It is composed of home screen, screens for the definition of the climacteric period and adjusted variables. Measures for the calculation of the indices can be entered and the application provides the probability of development of metabolic syndrome. It is concluded that the inclusion of a computer technology in the assistance to climacteric women predisposed to develop metabolic syndrome brings positive repercussions, because it allows savings in a simple and accessible way. In addition, the identification of this population predisposed to develop metabolic syndrome helps in preventing chronic cardiovascular diseases.
24-hour urinary sodium excretion and associated factors in non-dialysis chronic kidney disease
This study aims to determine urinary sodium excretion in 24-hour urine and correlate it with associated factors in patients with non-dialysis chronic kidney disease. Methodology: Cross-sectional study with 116 individuals. Demographic, nutritional, clinical and laboratory data were evaluated. Urinary sodium excretion was analyzed in 24-hour urine and glomerular filtration rate was estimated using the CKD-EPI equation. Categorical variables were presented as frequencies and percentages, numerical mean ± SD or median. Normality was tested using the Shapiro Wilk test. The median was used to determine urinary sodium excretion in the stages of Chronic Kidney Disease. Pearson's correlation was used to verify the association of the variables with 24-hour urinary sodium excretion. Results: Mean age 51.1 ± 14.0 years, 75.9% female, hypertensive and diabetic 54.3% and 19.8% respectively, 60.9% were in stage one of Chronic Kidney Disease. The median 24-hour urinary sodium excretion by disease stage was higher in stages II 118.6 mmol/L/24h (78.4-155.5) and I 117 mmol/L/24h (96.6-141.0). They correlated positively with 24-hour urinary sodium excretion, body mass index (r = 0.19; p-value 0.004), urinary creatinine (r = 0.48; p-value <0.001), and negatively with age (r = -0.26; p-value 0.006) and total cholesterol (r = -0.20; p-value 0.036). There was a predominance of women, hypertensive patients, stage I chronic kidney disease, elementary school, and income below the minimum wage. Conclusion: Age and total cholesterol were negatively correlated with urinary sodium, while body mass index and urinary creatinine were positively correlated.
Construct of the global patient safety challenge “medication without harm” in pediatrics
This study objective was to define the construct of health professionals working in the pediatric ward, regarding the Global Patient Safety Challenge (DGSP) “Medication without Harm”. This is a cross-sectional and observational study, which included 48 health professionals who work in pediatrics at a university hospital located in the state of São Paulo, Brazil. A questionnaire was applied, which included the characteristics of professionals and the four DGSP domains: Professionals, Medications, Patients and public, Systems, and practices. Factor analysis was performed, with rotation using the Varimax method, and Cronbach's alpha was calculated. The results revealed the median age of health professionals was 39 years old, with 89.6% being female at birth. Two dimensions were identified: (1) checking, registration, and information; and (2) reports from patients and family members, with Cronbach's alpha of 0.8598. It was concluded that health professionals consider it important to inform patients and family members, check solutions labels, understand reports from children and family members, and check the medication dispensed by the pharmacy. The construct did not include the domains of professionals and medications, which may represent weaknesses in the medication process in the pediatric ward studied. These weaknesses refer to training, communication failures, knowledge about previously occurring adverse events, discrepancies between prescriptions, labels, packaging, and keeping medications that are not being used by the patient at the bedside. The clarity of medical prescriptions was also not included in the construct, and its improvement is another important opportunity for improvement.
Mirelli Stephania de Oliveira Ramos Terra
Cubbin & Jackson scale in the risk assessment of pressure injury in neurocritical patients
Objective: To evaluate the risk of pressure injuries in neurocritical patients admitted to the intensive care unit, using the Cubbin & Jackson scale. Method: Observational study carried out in the Advanced Support Unit in Neurosurgery of a large hospital, in Recife, Pernambuco, Brazil, from August to December 2022. An instrument with sociodemographic, clinical and social data was used to collect data. application of the Cubbin & Jackson Scale every 24 hours from admission until discharge and/or the appearance of a pressure injury. For data analysis, descriptive and inferential statistics were used. Results: The Cubbin & Jackson scale proved to be a valid instrument when used in neurocritical patients, as it identified both high- and low-risk patients who developed pressure injuries. It was observed that being female, having a neurological disease, having difficulty repositioning in bed and using sedatives had a higher risk of developing pressure injuries. Conclusion: The Cubbin & Jackson scale showed that low-risk patients were subjected to pressure at a higher rate.
Use of technologies in healthcare: Advances and challenges
The advent of digital health has introduced a new paradigm in healthcare, characterized by the integration of advanced technologies into medical practice, research, and administration. Following recent reports from the Organization for Economic Co-operation and Development (OECD), four critical themes have emerged in the discourse on digital health: (1) the relationship between Artificial Intelligence (AI) and the health workforce (Almyranti et al., 2024); (2) the real value and cost of digitalization; (3) the implementation and use of electronic health records (Slawomirski et al., 2023); and (4) the collective ethical responsibility in the use of AI in healthcare (Anderson & Sutherland, 2024).
Tools for early detection of clinical deterioration and prevention of cardiorespiratory arrest: An integrative review
This study aims to identify tools for the early detection of clinical deterioration and their usability in preventing cardiopulmonary arrest. It is an integrative literature review conducted in the Medical Literature Analysis and Retrieval System Online (MEDLINE), Latin American and Caribbean Literature in Health Sciences (LILACS), and Nursing Database (BDENF). A total of 242 articles were identified, of which 12 were selected for descriptive synthesis. Most publications occurred between 2015 and 2022, with a peak in 2021 (33.3%). The most represented countries were the United States, the United Kingdom, and Taiwan, with the National Early Warning Score (NEWS) being the most frequently used tool (33.3%). All studies demonstrated that early warning tools, such as NEWS and MEWS, were effective in preventing adverse events, including cardiorespiratory arrest and death. Thus, it is concluded that the use of clinical deterioration detection tools is applicable in various hospital settings and can support the identification of cardiorespiratory arrest and other adverse events, contributing to improved patient safety and the quality of healthcare.
Maternal food diversity and seasonality as conditions for children's nutritional status: an integrative review
Nutritional status is a determining factor in achieving good health. The aim of the study was to evaluate whether maternal dietary patterns can influence nutritional disorders in children under two years of age. An integrative review was carried out, with data collected from the following databases: EMBASE, PubMed, LILACS and SciELO. A total of 273 studies were identified, 11 of which answered the guiding question, and only four met all the inclusion criteria. The findings showed that maternal nutrition decreased the risk of nutritional disorders in children. Maternal dietary diversity was a protective factor for stunting in children and a predictor of children's food variety, consequently influencing their food consumption. Maternal abstinence from food is among the common factors related to child malnutrition. It can be concluded that maternal nutrition is a protective factor for the development of nutritional disorders in children between zero and 24 months of age, since mothers are usually responsible for feeding the family, especially in traditional societies.
Impact of acute covid-19 on cardiac function in the long term: a systematic review
The present study aimed to evaluate the relationship between elevated biomarkers due to COVID-19 infection and possible permanent damage to the heart muscle. This is a systematic review including studies with eligible randomized clinical trials and case-control studies. Papers’ eligibility criteria were adults diagnosed and treated for COVID-19 and assessment of cardiac biomarkers during the acute phase of COVID-19 infection, with symptoms or not, without previous structural or functional changes related to the cardiovascular system and who, after a minimum of after 30 days, cardiac structural assessment was obtained through imaging tests, either echocardiogram or cardiac magnetic resonance. The findings were not robust when analyzing the association between the elevation of secondary cardiac biomarkers to COVID-19 and the presence of late cardiac sequelae. Based on the cost-effectiveness ratio for adopting such strategy, it becomes unjustifiable to perform it routinely in the Brazilian Unified Health System. It is more appropriate and less costly to adopt health promotion strategies, individualized attention, multidisciplinary therapeutic approach, frequent clinical surveillance and specialized assessment when affected by COVID- 19, reducing damage caused to the cardiocirculatory system, minimizing spending on public health exams and better effectiveness in collective health with care practices.
Sex hormone levels in rural workers exposed to pesticides: A systematic review with meta-analysis
The present study aims to analyze the excitatory and/or inhibitory effects of pesticide exposure on the production of male sex hormones in rural populations. The protocol for this systematic review was previously registered in PROSPERO (CRD42022354863) and follows the guidelines recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The research question addressed was: Does pesticides exposure cause excitatory and/or inhibitory effects on the production of sex hormones? The literature search was conducted from July 1 to July 17, 2023, in the following databases: Public Medline (PubMed), Latin American and Caribbean Literature in Health Sciences (LILACS), Science Direct, and Scientific Electronic Library (Scielo). The results indicate that pesticides exposure was associated with a significant decrease in testosterone levels (mean difference: -1.60, 95% CI: -2.47 to -0.72) and prolactin levels (mean difference: -1.28, 95 %: CI -2.19 to -0.37). In constrast, there was significant increase in Sex Hormone Binding Globulin (SHBG) levels (mean difference: 4.24, 95% CI: 1.54 to 6.93). No significant changes were observed in the levels of Follicle Stimulating Hormone (FSH) (mean difference: 0.98, 95% CI: 0.74 to 1.21) and Luteinizing Hormone (LH, mean difference: 0.44; 95% CI: 0.25 to 0.64) between the groups studied. In conclusion, evidence suggests that pesticide exposure may alter the production of various sex hormones. Specifically, individuals exposed to pesticides tend to exhibit lower levels of testosterone and prolactin, while SHBG levels are increased compared to those without exposure.
Perinatal care and monitoring strategies for women with mental health disorders: an integrative review
Objective: To analyze the evidence available in the literature on strategies and challenges in prenatal care for pregnant women with mental disorders. Methodology: Integrative review of the literature published between 2013 and 2023 using the BVS, MEDLINE®, Scopus, and Web of Science databases. Results and discussion: Twenty-one articles were selected. The critical analysis of their contents revealed three categories for discussion: the perceptions and accounts of women with mental disorders about prenatal care; health workers’ experiences of and knowledge about mental health during pregnancy; and strategies and interventions for mental health during prenatal care. Conclusion: The results demonstrated the importance of more discussions about the prenatal care needs of women with mental disorders. These women should be included and listened to in discussions about the delivery of such care. The approach should involve having adequately trained, inclusive multidisciplinary teams to deliver effective, comprehensive care and support.
Safety in nursing care with sedative, analgesic, and vasoactive drugs: Scope review
The objective of this study was to map the existing evidence on the safety of nursing care in the preparation and administration of sedative, analgesic, and vasoactive drugs in critically ill patients. This scoping review involved searching the following databases: EMBASE, SCOPUS, PubMED/MEDLINE, Cochrane Library, CINAHL, and Web of Science. The search was supplemented with gray literature. Thirty-two studies were selected for review, with the majority (12) from the USA and one from Brazil. Of these, 16 were published in the last five years, and 18 focused on vasoactive care, while 11 dealt with analgesics and sedatives. The literature was reviewed to identify care for invasive/painful procedures and the role of nurses in this practice for sedatives and analgesics. Regarding vasoactive drugs, the following key points emerged: administration via peripheral routes, care with infusion pumps, communication, physicochemical incompatibilities, benefits of ready-to-use or premanipulated drugs, and implementation of care protocols. The publications describe the complexity and various precautions taken by the care team to ensure the safety of these medications.
Rheumatoid arthritis, self-care, and pharmacological treatment: a scoping review
Objective: To summarize the evidence on pharmacological treatment and its relationship with self-care in individuals with rheumatoid arthritis. Method: This scoping review was conducted in the first half of 2023. Articles published since 1985 were included, covering indexed journals, gray literature, and reference lists, with no language restrictions. Study selection was performed using Rayyan software, and data were extracted using a standardized questionnaire in Excel. The protocol was registered on the Open Science Framework (doi.org/10.17605/OSF.IO/H3SZK). Results: A total of 31 studies published between 1999 and 2022 were retrieved, mostly cross-sectional and published in English. The most frequently reported factors related to pharmacological treatment and changes in self-care included medication side effects, number of medications, indefinite treatment duration, self-medication, knowledge of treatment, positive treatment effects, as well as fear and negative beliefs. Conclusion: The relationship between self-care and pharmacological treatment in individuals with rheumatoid arthritis involves multiple variables. An individualized approach may facilitate the understanding of specific factors for each person and support the management of improved self-care.
The effects of international human rights treaties on the population's health: a systematic review
Objective: The study aims to describe the scientific literature regarding the association between the ratification of international pacts and the improvement of the health situation. Methods: This is a systematic review of the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes model in the bibliographic bases of the Virtual Health Library, the Scientific Electronic Library Online, the National Library of Medicine and National Institute of Health, and CAPES Periodicals Portal. Results: Studies from 9 international treaties were found in the literature. Among them, four were considered ineffective because they were not associated with positive changes in the health status of individuals. The other 4 achieved relevant practical consequences with statistically significant changes to anemia in pregnant women, the woman's life expectancy, family planning, prenatal care, infant and maternal mortality, and the prevalence of smoking. Conclusion: This review showed that there are few scientific works in this area and that, in general, the practical effects of international health commitments are less than expected.
Mobile applications for nurses in the care of elderly people after a stroke: Scope review
Objective: to map the available scientific evidence on mobile applications to assist nurses in caring for elderly people after a stroke. Method: This is a scoping review, conducted in accordance with JBI recommendations, where searches were conducted from December 2023 to April 2024 in the listed information sources. The eligibility criteria adopted were: studies on mobile applications to assist nurses as intervention technology, guidance, rehabilitation, or other forms of care for elderly people after stroke. The selection and screening of studies were based on the use of the EndNote web reference manager and Rayyan software. Regarding the analysis of evidence, a data extraction tool developed for the review was used, which was organized in a Microsoft Excel spreadsheet. Results: a total of 346 studies were identified, and only five were selected for the final sample of the review. The results were grouped into five categories: nursing care in the functional rehabilitation of elderly people after stroke; control and self-monitoring of hypertension in elderly people after stroke; benefits of the mobile application for self-management of nursing care for elderly people in the post-stroke phase; and a mobile application for evaluating the effectiveness of care provided by nurses. Conclusion: The findings clarified that the content included in mobile applications to support nursing care was mainly associated with the rehabilitation of elderly people's functionality.
Copyright (c) 2025 Ana Maria Souza da Costa, Deyvylan Araujo Reis, Thiago Santos da Silva , Anathuza Veiga Trindade, Camila Rosália Antunes Baccin, Vanessa de Oliveira Gomes http://creativecommons.org/licenses/by/4.0
Antioxidant potential of Amazonian plants: An integrative review
Objective: review the scientific literature that addresses the antioxidant capacity of Amazon plants. Methods: This is an integrative review in English language papers carried out on PubMed/MEDLINE, in the period from 2002 to 2022. Results: The search resulted in 21 eligible papers in which 24 plants with antioxidant capacity were identified, distributed in 15 families. It was found that the studies do not have a standardized methodology, which makes it difficult to compare between plants. Despite this, it was possible to define the Myrtaceae and Lauraceae families as those that have plant species with the highest antioxidant potential, with Psidium guajava (32000 µmol TE/g) and Aniba canelilla (1.8ppm) being their representatives with the highest potential, respectively. Conclusion: A diversity of Amazonian plants with antioxidant potential was observed in different botanical families. The analysis of studies points to phenolic compounds, such as flavonoids, tannins, chromones, FAE and quercetin, as principal determinants for these species to have this antioxidant capacity. Future developments in this line of research include more studies with the plants with the highest antioxidant capacity with a focus on the analysis of the chemical constituents that make up the samples of the Amazonian plants.
Suicide and suicide attempts among mothers of children with disabilities: an integrative review
Objective: to gather scientific evidence on suicide attempts and suicides among mothers of children with disabilities. Methods: this is an integrative review conducted in five databases, using the research question: “What is the scientific evidence on suicide attempts and suicides among mothers of children with disabilities?” The descriptors “Mothers”, “Suicide”, “Attempted Suicide”, “Suicide Attempt”, “Children with Disabilities” and “Disabled Children” were used. Four studies from different countries were included, published between 2018 and 2024, were included. The critical analysis and qualitative synthesis of the selected studies were carried out descriptively and organized into two categories. Results: mothers of disabled children face high levels of stress and depression, aggravated by marginalization and lack of support. The transition into adolescence of their children intensifies this emotional burden. It is essential to offer psychological support and practical resources to improve their quality of life. Psychological and financial support and support networks are essential to reduce stress. Final considerations: ensuring access to health services and flexible working conditions, as well as including families in policy formulation, can improve the life quality of these families and promote a more inclusive society.
Efficacy, effectiveness, and safety of dienogest for the treatment of endometriosis: a systematic review
Endometriosis is a chronic and benign inflammatory disease that affects women of reproductive age and impairs their quality of life. Objective: To investigate the efficacy, effectiveness, and safety of using dienogest in the treatment of endometriosis compared to placebo and medications offered within the Brazilian Unified Health System (SUS). Method: A systematic review was conducted through searches in four scientific databases, following the recommendations of the Cochrane Handbook and reporting according to The PRISMA 2020 statement checklist (PROSPERO: CRD42023388774). Results: Nine studies were included, totaling 1,625 participants. For overall and pelvic pain, the results may favor dienogest over placebo and goserelin. There was no difference between dienogest and triptorelin for overall pain, and dienogest appears to be superior to triptorelin for pelvic pain. Dienogest was non-inferior to leuprorelin. Between dienogest and the other comparators, there was no difference in lower back pain, dyspareunia, pregnancy rate, treatment discontinuation, and total adverse events. Conclusion: Dienogest may be safe when compared to placebo and the drugs available in the SUS. Regarding efficacy and effectiveness, the results suggest the superiority of dienogest compared to placebo and goserelin; non-inferiority compared to leuprorelin, and no difference between dienogest and triptorelin and ethinylestradiol+levonorgestrel; however, the confidence in the evidence is uncertain.
Contextual analysis of the role of the healthcare-associated infections controller
This study aims to critically analyze the contextual aspects of the role of the Healthcare-Associated Infections (HAIs) Controller. It is a contextual analysis of the role of the HAI Controller, based on the perspective of Hinds, Chaves, and Cypress, and operationalized through a scoping review. The search resulted in a final sample of 58 studies. The following contextual levels were identified: metacontext (standards, resolutions, laws, and global, international, and national public policies related to the theme); general context (responsibilities of HAI Control); specific context (strengths and challenges of HAI Control); and immediate context (the role of the HAI Controller and their specific actions). Identifying the interactive levels of context enabled a comprehensive reflection on how the role of HAI controllers is directed toward reducing preventable infections through prevention and control measures, addressing various aspects of both the environment and safe practices, ultimately improving the quality of patient care.
Maria Isabel da Conceição Dias Fernandes
Functional health literacy among chronic cardiac patients: scoping review
Objective: To map functional health literacy strategies developed with chronic cardiac patients under outpatient follow-up. Method: This is a scoping review study, based on the Joanna Briggs Institute Reviewer’s Manual, with searches conducted in the following databases and portals: LILACS, Embase, Cochrane, MEDLINE/PubMed, Web of Science, ScienceDirect, Scopus, SciELO, and gray literature (BDTD). The initial sample comprised 2,199 studies, of which 327 were removed as duplicates. At the end of the selection process, 287 articles were analyzed in full, and only 16 answered the research question. Results: Findings indicate that health literacy contributed to the adoption of more positive behaviors, such as improved self-care. However, the study also revealed that patients under follow-up still presented difficulties in understanding their health condition—especially older adults. Conclusion: The results point to a promising scenario; however, current efforts remain insufficient to affirm definitive changes in knowledge and behaviors.
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