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Percepción de adolescentes sobre sexualidad y salud reproductiva: la escuela como espacio para la educación sexual

Objetivo: Analizar la percepción y el conocimiento de los adolescentes sobre Infecciones Sexualmente Transmisibles (IST's), embarazo y formas de prevención por medio de los métodos anticonceptivos. Metodología: Se trata de un estudio descriptivo con enfoque cualitativo. Para la recolección de datos utilizamos cuestionario autoaplicable en los adolescentes escolares del 6º al 9º año de la enseñanza fundamental y el análisis de los datos fue realizado por medio del análisis de contenido, en su modalidad temática. Resultados: Sobre las informaciones de las IST's y los Métodos anticonceptivos, se observa que los / las adolescentes encuestados son vulnerables, pues la investigación reveló que la mayoría de los adolescentes desconocen sobre el tema o no tienen informaciones necesarias para protegerse. Conclusión: Podemos considerar que hay una laguna en el conocimiento de los adolescentes escolares sobre los métodos anticonceptivos, los tipos de infecciones sexualmente transmisibles y los métodos preventivos, lo que implica aumentar las posibilidades de un comportamiento sexual de riesgo.

Información a los padres durante el tratamiento del cáncer infantil: un estudio descriptivo

Objetivo: Este estudio tuvo como objetivo explorar la perspectiva de los padres de niños con cáncer en la búsqueda de información en diferentes momentos del tratamiento.

Método: Estudio descriptivo, con enfoque cualitativo. Las entrevistas semiestructuradas fueran desarrolladas con 22 padres en dos hospitales públicos de Sao Paulo, Brasil. Los datos se analizaron mediante análisis de contenido inductiva.

Resultados: No se observó un estándar en la búsqueda de información en el curso de la enfermedad, pero diferentes requisitos en cuanto al tipo de información según el avance del niño o adolescente en el plan de tratamiento. Las principales fuentes de información fueron: médicos, otros profesionales de salud que no enfermeras y Internet. El médico sigue siendo la referencia como fuente de información. La enfermera tiene papel muy modesto en relación con sus posibilidades de actuación como proveedora de información. Los padres pusieron de relieve la necesidad de una información clara e individualizada.

Conclusiones: Se espera de los profesionales implicados en la atención a esta clientela la disposición a proporcionar la información y la adopción de estrategias para simplificar la información proporcionada con el fin de preparar los padres para cuidar y para el proceso de toma de decisiones durante el tratamiento.

Informações aos pais durante o tratamento do câncer infantil: um estudo descritivo

Objetivo: Este estudo teve como objetivo explorar a perspectiva de pais de crianças com câncer na busca de informações em diferentes momentos do tratamento.

Método: Estudo descritivo, qualitativo. Realizaram-se entrevistas semiestruturadas com 22 pais em dois hospitais públicos de São Paulo, Brasil. Os dados foram analisados segundo os procedimentos da análise de conteúdo indutiva.

Resultados: Não foi observado um padrão na busca por informações na trajetória da doença, mas necessidades diferentes quanto ao tipo de informação, à medida que a criança ou adolescente avança dentro do plano terapêutico. As principais fontes de informação apontadas foram: os médicos, outros profissionais de saúde que não o enfermeiro e a internet. O médico ainda é a referência como fonte de informação. O enfermeiro apresentou um papel bem modesto em relação às suas possibilidades de atuação enquanto educador e provedor de informações. Pais e mães evidenciaram a necessidade de informações claras e individualizadas. 

Conclusões: Espera-se que os profissionais envolvidos no cuidado dessa clientela estejam dispostos a fornecer informações e adotar estratégias para simplificar as informações fornecidas, a fim de preparar os pais para o processo de tomada de decisão durante o tratamento.

Descritores: Neoplasias, criança, pais, competência em informação, enfermagem.

Contribution of Chinese and French ear acupuncture for the management of chronic back pain: A randomised controlled trial

Abstract

Aims and objectives

To compare the efficacy of Chinese and French ear acupuncture in people with chronic back pain.

Background

Chronic back pain is a common public health problem worldwide. An intervention for this condition is ear acupuncture. Several approaches are used for ear acupuncture, particularly the Chinese and French guidelines.

Methods

An open, randomised and controlled clinical trial, followed the recommendations of the CONSORT Checklist. One hundred and eleven people were selected and randomised into three groups: Chinese ear acupuncture, French ear acupuncture and Control. Evaluations were performed before the first intervention session (initial), 1 week after the fifth session (final) and after a fifteen‐day follow‐up period (follow‐up), using the Brief Pain Inventory, Rolland Morris Disability Questionnaire, and a thermal imaging camera. For data analysis, the Generalized Estimating Equation Model was applied, with significance level set at 5%.

Results

Pain severity was significantly decreased by Chinese ear acupuncture throughout intervention period. Both types of ear acupuncture affected pain interference with daily activities. However, in the comparison between initial and final evaluations, only Chinese ear acupuncture produced statistically significant results. A reduction in physical disability was observed in both ear acupuncture‐treated groups during the intervention period and, although Chinese ear acupuncture failed to induce significant changes in tissular temperature at individual time points, a significant increase in cutaneous temperature was detected after the follow‐up period in the dorsal region of individuals treated with Chinese ear acupuncture. Importantly, at this time point, the mean difference between Chinese and French ear acupuncture revealed a more benefic effect of Chinese procedure on this parameter.

Conclusions

The individualised treatment based on the Chinese precepts showed, in an overall evaluation, better results for management of chronic back pain in the present study.

Relevance to clinical practice

Ear acupuncture can be implemented in the nurse's clinical practice to assist the treatment of people with chronic back pain.

Familia conviviendo con una persona con estomía intestinal: un análisis documental

Objetivo: Describir la tendencia de la producción de la enfermería brasileña en las tesis y disertaciones sobre familias que conviven con personas con estomías intestinales.

Método: Investigación documental realizada en mayo de 2017 en el Catálogo de Tesis y Disertaciones de la Coordinación de Perfeccionamiento de Personal de Nivel Superior. La búsqueda de los documentos en línea fue realizada por el término "familia" y posteriormente por los respectivos sinónimos: "estomía OR ostomía OR estoma OR ostoma". El corpus consta de nueve documentos.

Resultados: De los documentos analizados, cinco eran disertaciones y cuatro eran tesis. El cuidado de enfermería en la perspectiva de las familias y de las personas con estomía intestinal, la influencia de la cultura en el sistema de convivencia familiar, la red social de apoyo de la familia, el contexto del familiar cuidador, la relación de la persona con estomía intestinal y la calidad de la vida de las personas con estómago intestinal y sus familiares fue el objetivo de una investigación cada una. Las tecnologías educativas como soporte para la educaciónde familias de personas con colostomía fueron contempladas en dos estudios.

Conclusión: Las lagunas encontradas en el conocimiento producido involucran el desarrollo de estudios que aborden el conocimiento científico y práctico de enfermería en el cuidado a la persona con estomía intestinal ya sus familiares.

Caracterización de la conciliación de medicamentos en urgencias

Objetivo: Explorar los aspectos principales de la conciliación de medicamentos en los servicios de urgencias. Metodología: Revisión panorámica de la literatura que sintetice los conocimientos existentes sobre la conciliación de medicamentos en los servicios de urgencias. Para ello se realizó una búsqueda sistemática de artículos originales publicados en revistas específicas de la ciencia enfermera y ciencias de la salud durante los últimos 10 años, e indexadas en bases de datos y otros recursos en español e inglés, como son: Cuiden Plus, Pubmed, IBECS, SCIELO y Google académico. En cada base de datos, se introdujeron una serie de palabras claves relacionadas con el tema y basadas en las nomenclaturas MeSH y DeCS.  Resultados: Se encontraron 5 artículos que identifican áreas claves en la conciliación de medicamentos en urgencias. En este sentido, las personas mayores de 65 años, polimedicadas y pluripatológicas son las más susceptibles de padecer un error en la medicación, sucediendo entre un 79,3 y un 95,8%. La omisión de la medicación es la discrepancia no justificada más frecuente (23,8 - 71,7%). A pesar del tipo de error y la frecuencia que se produce en un perfil de paciente vulnerable de antemano, en raras ocasiones les produce daño. Las barreras principales para una correcta conciliación se observan en la incorrecta anamnesis y registro en la historia clínica, así como la ausencia de un listado único de medicamentos. Los estudios realizados en urgencias se han centrado en el farmacéutico como profesional para detectar dichos errores. Conclusión: La caracterización de los errores en la conciliación de medicamentos facilita diseñar estrategias específicas que prevengan dichos errores o detectarlos precozmente con el fin de reducir los efectos adversos y la descompensación de patologías con consecuencias para la salud de la población y para el sistema sanitario.

Application of convolutional neural networks for classification of adult mosquitoes in the field

by Daniel Motta, Alex Álisson Bandeira Santos, Ingrid Winkler, Bruna Aparecida Souza Machado, Daniel André Dias Imperial Pereira, Alexandre Morais Cavalcanti, Eduardo Oyama Lins Fonseca, Frank Kirchner, Roberto Badaró

Dengue, chikungunya and Zika are arboviruses transmitted by mosquitos of the genus Aedes and have caused several outbreaks in world over the past ten years. Morphological identification of mosquitos is currently restricted due to the small number of adequately trained professionals. We implemented a computational model based on a convolutional neural network (CNN) to extract features from mosquito images to identify adult mosquitoes from the species Aedes aegypti, Aedes albopictus and Culex quinquefasciatus. To train the CNN to perform automatic morphological classification of mosquitoes, we used a dataset that included 4,056 mosquito images. Three neural networks, including LeNet, AlexNet and GoogleNet, were used. During the validation phase, the accuracy of the mosquito classification was 57.5% using LeNet, 74.7% using AlexNet and 83.9% using GoogleNet. During the testing phase, the best result (76.2%) was obtained using GoogleNet; results of 52.4% and 51.2% were obtained using LeNet and AlexNet, respectively. Significantly, accuracies of 100% and 90% were achieved for the classification of Aedes and Culex, respectively. A classification accuracy of 82% was achieved for Aedes females. Our results provide information that is fundamental for the automatic morphological classification of adult mosquito species in field. The use of CNN's is an important method for autonomous identification and is a valuable and accessible resource for health workers and taxonomists for the identification of some insects that can transmit infectious agents to humans.

Role of diffusional kurtosis imaging in grading of brain gliomas: a protocol for systematic review and meta-analysis

Por: Abdalla · G. · Sanverdi · E. · Machado · P. M. · Kwong · J. S. W. · Panovska-Griffiths · J. · Rojas-Garcia · A. · Yoneoka · D. · Yousry · T. · Bisdas · S.
Introduction

Central nervous system (CNS) gliomas are the most common primary intra-axial brain tumours and pose variable treatment response according to their grade, therefore, precise staging is mandatory. Histopathological analysis of surgical tumour samples is still deemed as the state-of-the-art staging technique for gliomas due to the moderate specificity of the available non-invasive imaging modalities. A recently evolved analysis of the tissue water diffusion properties, known as diffusional kurtosis imaging (DKI), is a dimensionless metric, which quantifies water molecules’ degree of non-Gaussian diffusion, hence reflects tissue microenvironment’s complexity by means of non-invasive diffusion-weighted MRI acquisitions. The objective of this systematic review and meta-analysis is to explore the performance of DKI in the presurgical grading of gliomas, both regarding the differentiation between high-grade and low-grade gliomas as well as the discrimination between gliomas and other intra-axial brain tumours.

Methods and analysis

We will search PubMed, Medline via Ovid, Embase and Scopus in July 2018 for research studies published between January 1990 and June 2018 with no language restrictions, which have reported on the performance of DKI in diagnosing CNS gliomas. Robust inclusion/exclusion criteria will be applied for selection of eligible articles. Two authors will separately perform quality assessment according to the quality assessment of diagnostic accuracy studies-2 tool. Data will be extracted in a predesigned spreadsheet. A meta-analysis will be held using a random-effects model if substantial statistical heterogeneity is expected. The heterogeneity of studies will be evaluated, and sensitivity analyses will be conducted according to individual study quality.

Ethics and dissemination

This work will be based on published studies; hence, it does not require institutional review board approval or ethics clearance. The results will be published in peer-reviewed journals.

PROSPERO registration number

CRD42018099192.

Lack of serological and molecular evidence of arbovirus infections in bats from Brazil

by Cíntia Bittar, Rafael R. G. Machado, Manuela T. Comelis, Larissa M. Bueno, Eliana Morielle-Versute, Matheus R. Beguelini, Renato P. de Souza, Maurício L. Nogueira, Paula Rahal

Viruses are important agents of emerging zoonoses and are a substantial public health issue. Among emerging viruses, an important group are arboviruses, which are characterized by being maintained in nature in cycles involving hematophagous arthropod vectors and a wide range of vertebrate hosts. Recently, bats have received increasing attention as an important source for the emergence of zoonoses and as possible viral reservoirs. Among the arboviruses, there are many representatives of the genera Flavivirus and Alphavirus, which are responsible for important epidemics such as Dengue virus, Zika virus and Chikungunya virus. Due to the importance of analyzing potential viral reservoirs for zoonosis control and expanding our knowledge of bat viruses, this study aimed to investigate the presence of viruses of the Alphavirus and Flavivirus genera in bats. We analyzed serum, liver, lungs and intestine from 103 bats sampled in northeast and southern Brazil via Nested-PCR and the hemagglutination inhibition test. All samples tested in this study were negative for arboviruses, suggesting that no active or past infection was present in the captured bats. These data indicate that the bats examined herein probably do not constitute a reservoir for these viruses in the studied areas. Further studies are needed to clarify the role of bats as reservoirs and sources of infection of these viral zoonoses.

Perceived barriers to the implementation of clinical pharmacy services in a metropolis in Northeast Brazil

by Genival Araujo dos Santos Júnior, Sheila Feitosa Ramos, André Mascarenhas Pereira, Aline Santana Dosea, Elton Matos Araújo, Thelma Onozato, Déborah Mônica Machado Pimentel, Divaldo Pereira de Lyra Jr.

Background

CLinical pharmacy services (CPS) are professional services provided by pharmacists, who use their skills and knowledge to take an active role in patient health. These services have expanded in health systems around the world. However, it is important to have a comprehensive understanding of factors that may hinder the implementation of CPS in health systems.

Objective

To identify pharmacists’ and managers’ perceptions of barriers regarding the implementation of CPS in some public health units in a metropolis in Northeast Brazil.

Methods

This is a qualitative study based on focus groups and semi-structured, face-to-face, in-depth interviews. Participants were health-system pharmacists and managers, selected based on their direct participation in the implementation process. Focus groups were carried out with the pharmacists, and interviews were carried out with managers. The audio and videos were transcribed verbatim in full, and were independently analyzed using content analysis. This study was approved by the Brazilian Committee of Ethics in Research and all participants signed informed consent forms.

Findings

There were two focus groups and five interviews. The discussions generated 240 minutes of recordings. The health-system pharmacists and managers expressed barriers were allocated into five categories to facilitate a comprehensive understanding of the implementation of CPS; these barriers were related to: the local healthcare networks, the healthcare team, the pharmacists, the implementation process, and the patients.

Conclusions

This study revealed the perceptions of barriers associated with the participants involved in the implementation of CPS in some public health units in a metropolis in Northeast Brazil. The barriers reflect the challenges to be overcome in the CPS implementation process in the health systems.

Protocol for a scoping review on nursing care and the autonomy of disabled persons

Por: Schoeller · S. D. · Lima · D. K. S. · Martins · M. M. · Ramos · F. R. S. · Zuchetto · M. A. · Bampi · L. N. d. S. · Roos · C. M. · Tholl · A. D. · Tonnera · L. C. J. · Machado · W. C. A. · Vargas · C. P.
Introduction

Considering the limitations that disabled persons experience, our understanding of caring for these people has evolved over time worldwide. Because nursing care is dependent on the choices made by patients, nurses can play an emancipatory role by empowering patients with disabilities to become the primary agent in their rehabilitation. Objective was to conduct a range analysis protocol proposing the mapping of conceptual elements for a nursing care model based on the autonomy of disabled persons.

Methods and analysis

A protocol was developed in corporating insights from recent innovations and applying the scope review method of Arksey and O’Malley as a reference using their scoping review methodology as a guide. For the construction of research guiding question, the patient, intervention, comparison and outcomes strategy was adapted. Considerable research in online databases (14) from 2000 to 2018 will be integrated by bibliographical research. Proceed a consult in the Annals of the Brazilian Congress of Nursing, Brazilian Nursing Association and Portuguese Rehabilitation Nursing Association, as well as professional Portuguese and Brazilian nursing legislation. The entire reference list of the covered studies searched manually to detect considerable additional studies. In addition to these searches, stakeholders, including nurse experts in the rehabilitation field and disabled persons, will be requested and included.

Ethics and dissemination

This study does not require ethical approval because it is a review and collection of data on publicly available materials. The results of this research will be published in a relevant journal on the subject of rehabilitation and presented at international scientific events in the area of rehabilitation nursing. Thus, the elaboration of this protocol further maps the gaps and strengthens the concepts capable of presenting strong evidence which assists and supports safer, smarter and more objective care for those living with permanent daily care obligations.

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