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Knowledge and perception about the welfare and mistreatment of dogs in Brazil

by Gabriela Ferreira Siano, Camila Stefanie Fonseca de Oliveira, Felipe Gaia de Sousa, Suzane Lilian Beier, Adriane Pimenta da Costa-Val

Animal welfare encompasses the overall well-being of an animal, spanning both its physical and mental health, assessable through potential measurements. It stands in contrast to mistreatment, which involves actions, direct or indirect, that endanger an animal’s well-being. This study sought to appraise the factors influencing the Brazilian population’s understanding of dog welfare and mistreatment. The survey questions were adapted from the Animal Welfare Examination Protocol, utilized by veterinarians to evaluate suspected passive abuse cases in dogs. Out of 1377 responses, 1353 were valid and analyzed. Among the 19 assessed indicators, 15 demonstrated an adequate response rate surpassing 90% of all 1353 responses. However, for three questions related to comfort, a smaller yet notable percentage of responses were only minimally adequate. Moreover, in one question within the comfort assessment, 186 participants (13.74%) provided inadequate responses. This implies that these people could potentially subject animals to a state of low Animal Welfare. Lack of knowledge emerged as a potential root of passive abuse, specifically negligence. In the assessment of nutritional indicators, water supply and quality received unanimous adequate responses. In evaluating comfort perceptions, significant associations were noted between gender, dog ownership, family income, and responses regarding resting surface. Regarding health indicators, the majority responded appropriately. Female gender and dog ownership correlated with providing the appropriate response, while not owning a dog was associated with minimally adequate responses. In the context of comfort indicators, "Hitting the Dog" also demonstrated an association with gender, with females tending towards appropriate responses. Given the lack of significant correlation between educational levels and the most suitable responses, it underscores the urgency of implementing environmental education programs in schools with a focus on animal protection.

Non-pharmacological therapies for pain management in paediatric intensive care units: a protocol for a scoping review

Introduction

In critically ill children, pain management is complex owing to cognitive development and the nature of hospitalisation in paediatric intensive therapy units. Although there are many protocols and guidelines for pain control via pharmacological interventions, non-pharmacological practices should also be explored and disseminated for their potential benefit.

Methods and analysis

A systematic literature search will be performed using the following databases: Academic Search Premier, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, Excerpta Medica Database, Virtual Health Library, Medical Literature Analysis and Retrieval System Online, ScienceDirect, Scopus, Web of Science Core Collection, Theses from Coordenacão de Aperfeicoamento de Pessoal de Nível Superior, Dart Europe, Open Access Theses and Dissertations and grey literature from Google Scholar. The research will consider quantitative and qualitative studies, mixed-method studies, systematic reviews, text articles, opinion articles, letters to editors and editorials in any language and from any database. The following will be eligible for inclusion: (1) newborns, infants, children and adolescents; and (2) non-pharmacological therapies used for pain in paediatric intensive care.

Ethics and dissemination

This study does not require ethical approval. The results of this research will be disseminated through social media channels and podcasts about pain in children.

Trial registration number

This protocol has been registered with the Open Science Framework (DOI 10.17605/OSF.IO/DZHKT).

Content analysis of the nursing diagnosis of ineffective peripheral tissue perfusion in patients with diabetic foot

Abstract

Aim

To analyse the content of the nursing diagnosis ineffective peripheral tissue perfusion in patients with diabetic foot.

Design

A methodological study with a quantitative approach was performed.

Methods

The analysis was performed between January and May 2021 by 34 nurses with clinical/theoretical/research experience with diabetes or nursing diagnoses. These nurses evaluated the relevance, clarity and precision of 12 diagnosis-specific etiological factors, 22 clinical indicators and their conceptual and operational definitions.

Findings

All 12 etiological factors analysed were considered relevant to diagnostic identification. However, five showed inconsistencies regarding the clarity or precision of the operational definitions, requiring adjustments. Regarding the 22 clinical indicators evaluated, all of them presented a Content Validity Index (CVI) that was statistically significant. However, in the indicators, the colour does not return to lowered limb after 1 min of leg elevation, and cold foot had Content Validity Index (CVI) <0.9 regarding relevance and accuracy of operational definitions.

Conclusions

Twelve etiological factors and 22 clinical indicators were validated. Thus, this study revealed new and relevant aspects characterising peripheral perfusion in patients with diabetic foot that have not yet been clinically validated.

Implications for Nursing Practice

This study contributes to support the professional practice of nurses through the early identification of etiological factors and clinical indicators in persons with diabetic foot. As a proposal, we suggest the inclusion of new defining characteristics and related factors for the nursing diagnosis ineffective peripheral tissue perfusion in the NANDA-I taxonomy.

Impact

The research highlights new and relevant aspects such as etiological factors and clinical indicators to characterise peripheral perfusion in patients with diabetic foot. Based on these findings, clinical validation is recommended to confirm the relevance of the proposed elements in the population studied for greater reliability and improved diagnostic assessment for the professional practice of nurses.

Reporting Method

EQUATOR guidelines were adhered to using the GRRAS checklist for reporting reliability and agreement studies.

Patient or Public Contribution

No patient or public contribution.

Consumption of ultra-processed foods and low dietary diversity are associated with sedentary and unhealthy eating behaviors: A nationwide study with Brazilian Schoolchildren

by Giovanna Angela Leonel Oliveira, Vivian Siqueira Santos Gonçalves, Eduardo Yoshio Nakano, Natacha Toral

Background

Consumption of ultra-processed foods and low dietary diversity are risk factors for chronic diseases.

Aim

To evaluate the association between food consumption and sedentary and unhealthy eating behaviors of Brazilian schoolchildren between 6 and 11 years old.

Methods

Cross-sectional study. A prevalence sample was calculated considering the number of children enrolled in elementary school. This sample was distributed proportionally to Brazil’s macro-regions and the type of school (public or private). The questionnaire was developed in Google Forms and disseminated through the snowball technique. The questionnaire was filled in by the children’s parents, with information about the child’s identification and health. Afterward, the child completed a questionnaire by her/himself. We used the previously validated Illustrated Questionnaire on Food Consumption for Brazilian Schoolchildren and the Illustrated Questionnaire on Eating and Sedentary Behaviors. Food consumption was analyzed using the NOVA score and the dietary diversity score. Poisson’s regression with robust variance was performed (p Results

The study included 2,021 dyads. Of these, 27.6% of children reported eating five or more ultra-processed foods and 39.0% four or fewer natural or staple foods the previous day. Using screens, proxy of sedentary behavior (Prevalence Ratio–PR = 1.8, Confidence Interval–CI95%1.2–2.8) and eating at irregular hours (PR = 1.6, CI95%1.2–2.2) were risk factors for high consumption of ultra-processed foods and low dietary diversity in schoolchildren. In addition, eating the three main meals on the previous day (PR = 0.6, CI95%0.4–0.8) was identified as protective factors against the consumption of ultra-processed foods and in favor of dietary diversity among schoolchildren.

Conclusion

Sedentary and unhealthy eating behaviors were associated with the consumption of ultra-processed foods and low dietary diversity in Brazilian schoolchildren.

Integrating factors associated with complex wound healing into a mobile application: Findings from a cohort study

Abstract

Complex, chronic or hard-to-heal wounds are a prevalent health problem worldwide, with significant physical, psychological and social consequences. This study aims to identify factors associated with the healing process of these wounds and develop a mobile application for wound care that incorporates these factors. A prospective multicentre cohort study was conducted in nine health units in Portugal, involving data collection through a mobile application by nurses from April to October 2022. The study followed 46 patients with 57 wounds for up to 5 weeks, conducting six evaluations. Healing time was the main outcome measure, analysed using the Mann–Whitney test and three Cox regression models to calculate risk ratios. The study sample comprised various wound types, with pressure ulcers being the most common (61.4%), followed by venous leg ulcers (17.5%) and diabetic foot ulcers (8.8%). Factors that were found to impair the wound healing process included chronic kidney disease (U = 13.50; p = 0.046), obesity (U = 18.0; p = 0.021), non-adherence to treatment (U = 1.0; p = 0.029) and interference of the wound with daily routines (U = 11.0; p = 0.028). Risk factors for delayed healing over time were identified as bone involvement (RR 3.91; p < 0.001), presence of odour (RR 3.36; p = 0.007), presence of neuropathy (RR 2.49; p = 0.002), use of anti-inflammatory drugs (RR 2.45; p = 0.011), stalled wound (RR 2.26; p = 0.022), greater width (RR 2.03; p = 0.002), greater depth (RR 1.72; p = 0.036) and a high score on the healing scale (RR 1.21; p = 0.001). Integrating the identified risk factors for delayed healing into the assessment of patients and incorporating them into a mobile application can enhance decision-making in wound care.

Perceived quality of life and associated factors in long COVID syndrome among older Brazilians: A cross‐sectional study

Abstract

Aims and objectives

This paper aims to: (a) determine the personal, sociodemographic, clinical, behavioural, and social characteristics of older Brazilians with clinical evidence of long COVID; (b) evaluate perceived quality of life and determine its association with personal, sociodemographic, behavioural, clinical and social variables; and (c) assess significant predictors of high perceived QoL.

Background

Given the inherent vulnerabilities of the ageing process, the older people are an at-risk group for both contagion of SARS-CoV-2 and the perpetuation of residual symptoms after infection, the so-called long COVID or post-COVID syndrome.

Design

A cross-sectional survey design using the STROBE checklist.

Methods

Brazilian older people with long COVID syndrome (n = 403) completed a phone survey measuring personal, sociodemographic, behavioural, clinical, and social characteristics, and perceived Quality of Life (QoL). Data were collected from June 2021–March 2022. A multiple linear regression model was performed to identify salient variables associated with high perceived QoL.

Results

The mean age of participants was 67.7 ± 6.6 years old. The results of the multivariate regression model showed that race, home ownership, daily screen time, musculoskeletal and anxiety symptoms, and work situation were the significant predictors of QoL among COVID-19 survivors.

Conclusions

Knowledge about the persistence of physical, emotional, and social symptoms of COVID-19 can help nurses and other healthcare providers to improve the management of survivors, bringing benefits to the whole society.

Relevance to clinical practice

Given the novelty of long-COVID and its heterogeneous trajectory, interventions focusing on the repercussions and requirements unique to more vulnerable older persons should be developed and these aspects should be included in public health recommendations and policymakers' concerns.

Patient or Public Contribution

No patient or public contribution was required to design, to outcome measures or undertake this research. Patients/members of the public contributed only to the data collection.

Impact of an intervention program on drug adherence in patients with ulcerative colitis: Randomized clinical trial

by Mila Pacheco, Pedro Sá, Gláucia Santos, Ney Boa-Sorte, Kilma Domingues, Larissa Assis, Marina Silva, Ana Oliveira, Daniel Santos, Jamile Ferreira, Rosemeire Fernandes, Flora Fortes, Raquel Rocha, Genoile Santana

Aims

Evaluate the impact of an intervention program in non-adherent patients with ulcerative colitis.

Methods

Parallel controlled randomized clinical trial (1:1), approved by the ethics committee (No. 3.068.511/2018) and registered at The Brazilian Clinical Trials Registry (No. RBR-79dn4k). Non-adherent ulcerative colitis patients according to the Morisky-Green-Levine-test were included. Recruitment began in August 2019 until August 2020, with 6-month follow-up. All participants received standard usual care, and additionally the intervention group received educational (video, educational leaflet, verbal guidance) and behavioral interventions (therapeutic scheme, motivational and reminder type short message services). Researchers were blinded for allocation prior to data collection at Visits 1 and 2 (0 and 6 months). Primary outcome: 180-day adherence rate, with relative risk 95%CI. Secondary outcome: 180-day quality of life according to SF-36 domains, using Student’s t test. Variables with p Results

Forty-six and 49 participants were allocated in control and intervention groups, respectively. Two were excluded due to intervention refusal, and 4 and 6 were lost to follow-up in control and intervention groups. There was no post-intervention adherence rate difference, even after adjustment for type of non-adherence (unintentional/both/intentional) as confounder, or if considered as adherent the intervention group participants lost in follow-up. Interventions promoted better quality of life scores even after multivariate analysis for “Pain”, when adjusted for ulcerative colitis severity, sex, and marital status (β = 18.352, p = 0.004), “Vitality”, when adjusted for ulcerative colitis severity (β = 10.568, p = 0.015) and “Emotional Aspects”, when adjusted for disease severity, income, and education (β = 24.907, p = 0.041).

Conclusions

The intervention program was not able to produce a significant medication adherence rate difference between comparative groups, however, there was a significant improvement in quality of life. Study limitations may include: sample size calculated to identify differences of 30%, leading to a possible insufficient power; non blinded participants, exposing the results to the risk of performance bias; outcomes based on self-reported data.

Indices for measurement of sustainable diets: A scoping review

by Rosa Sá de Oliveira Neta, Severina Carla Vieira Cunha Lima, Lorena Lima do Nascimento, Camila Valdejane Silva de Souza, Clélia de Oliveira Lyra, Dirce Maria Lobo Marchioni, Angelo Giuseppe Roncalli da Costa Oliveira

Introduction

The current food system is associated with negative impacts on health, food insecurity and environmental harm. Sustainable diets have attracted increasing interest and novel proposals with a global scope have emerged. This scoping review aims to give an overview of the analysis of all the available evidence related to the sustainable diet indices that have been developed based on the EAT-Lancet Commission.

Methods

Searches were conducted in the PubMed, Embase, Web of Science, Scopus and Science Direct databases. This review was conducted following the PRISMA-ScR guidelines. The target population were studies addressed the use of an index or metric for assessing sustainable diets based on the EAT-Lancet Commission Summary Report were included. PCC acronym was used in the design of the study to describe eligibility criteria: P (Population)—Indexes; C (Concept)—Sustainable diets; C (Context)—Knowledge on the structure and applicability of measurement indices of sustainable diets based on EAT-Lancet recommendations available in the literature. Study eligibility criteria were restricted to papers published in English, from January 2019 through October 2022, with no population restriction.

Results

A total of 1,458 papers were retrieved, 14 of which were included in the review. Seven measures of sustainable diets were identified as follow: EAT-Lancet diet score (ELD-I), New EAT-Lancet diet score (EAT), Planetary Health Diet Index (PHDI), Sustainable Diet Index (SDI), Sustainable-HEalthy-Diet (SHED), novel Nutrient-Based EAT index (NB-EAT) and World Index for Sustainability and Health (WISH). Most studies were conducted in developed countries, where greater adherence to this type of diet was found. Estimated greenhouse gas emissions was the most reported indicator of sustainability, followed by diet quality and the benefits of sustainable diets with regards to health outcomes.

Discussion

We identified barriers that hinder progress towards sustainable diets, including the difficulty of comparing different indices and the tendency to neglect social aspects and the lack of common definitions and metrics. Despite being challenge, we highlight the importance of using indices that assess sustainable diets that harmonize various indicators, as recommended by the EAT-Lancet Commission, in order to promote positive changes towards a more sustainable future.

Use of Nile tilapia (<i>Oreocromis niloticus</i>) processing residues in the production of pâtés with the addition of oregano (<i>Origanum vulgare</i>) essential oil

by Marcos Antonio Matiucci, Iza Catarini dos Santos, Natallya Marques da Silva, Patricia Daniele Silva dos Santos, Gislaine Gonçalves Oliveira, Stefane Santos Corrêa, Elder dos Santos Araujo, Rafaela Said, Jaqueline Ferreira Silva, Ana Paula Sartório Chambó, Talita Aparecida Ferreira de Campos, Oscar Oliveira Santos, Claudete Regina Alcalde, Maria Luiza Rodrigues de Souza, Andresa Carla Feihrmann

The effect of the use of Nilo tilapia filleting residues in the production of pâtés with the addition of oregano essential oil stored for 90 days at 4 °C was evaluated. For that, 5 treatments were performed as follows: TSA—control treatment; TES with the addition of sodium erythorbate; and formulation TOE1 with 600 ppm oregano essential oil; TOE2 with 1000 ppm essential oil; and TOE3 with 1400 ppm essential oil. The pâtés showed adequate technological and physicochemical characteristics and microbiological counts within the legislation standards. No significant differences were observed in the luminosity of the pâté formulations during storage, and the addition of oil contributed to the increase in a* values and stability of b* values. Regarding the lipid and protein oxidation, TOE3 showed lower values at the end of the shelf-life. The addition of essential oil did not affect the hardness and cohesiveness of the products. The fatty acids in greater amounts in the samples were linoleic, oleic, palmitic, and stearic acids. The analysis of biogenic amines indicated that only the treatments with the highest amounts of sodium erythorbate (TES and TOE1) showed losses of spermidine. It was observed that decreasing the inclusion of sodium erythorbate and increasing the inclusion of oregano essential oil resulted in a drop in cadaverine values. A total of 46 volatile compounds were detected in the samples with the highest amount of free fatty acids and all the formulations were well accepted sensorially.

Aprendizaje generado a partir de la pandemia COVID-19 en enfermeros

Introducción: La enfermería brasileña parece haber alcanzado importantes niveles de aprendizaje durante la pandemia, no solo por la necesidad de controlar la circulación del nuevo coronavirus y cuidar a los enfermos. Objetivo: Conocer los aprendizajes generados a partir de la pandemia de COVID-19 entre las enfermeras. Métodos: estudio exploratorio y cualitativo, realizado en agosto y septiembre de 2021, con enfermeros de tercer nivel de salud que estuvieron en primera línea durante la pandemia, en el Estado de Mato Grosso, Brasil. Se realizaron entrevistas individuales, a partir de preguntas orientadoras. Para el análisis de los datos se utilizó el discurso del sujeto colectivo. Resultados: Como aprendizajes generados, los participantes señalaron aspectos profesionales (teórico/práctico), así como aspectos personales (reflejo del valor del ser humano, familia y realización profesional). Conclusión: Los aprendizajes proporcionados por la pandemia, si bien contribuye a la percepción de que ante la inseguridad y la incertidumbre es posible aprender y desarrollarse, enfatiza la condición de fortaleza del enfermero, que inicialmente durante la pandemia se vio debilitado, pero que se potenció la sensibilidad a nuevos descubrimientos, confrontaciones y fortalecimiento de sus recursos individuales y colectivos.

Cuidado de la familia al niño en una Unidad de Terapia Intensiva Pediátrica

Este estudio tiene el objetivo de conocer el cuidado dispensado por el familiar al niño internado en la Unidad de Terapia Intensiva Pediátrica (UTIP). Se trata de una investigación descriptiva y exploratoria con abordaje cualitativo, desarrollada en una UTIP de un hospital del sur de Rio Grande do Sul / Brasil. Participaron 15 familiares cuidadores de niños. La recolección ocurrió entre diciembre / 2017 a enero / 2018, por medio de una entrevista semiestructurada que ocurrió después de la aprobación del Comité de Ética en Investigación de la Facultad de Medicina de la Universidad Federal de Pelotas (UFPel), bajo el parecer nº 2.416.925. Los datos fueron interpretados según el análisis de contenido temático. Se elaboró ​​dos categorías: el cuidado prestado por los familiares dentro de una UTIP; Relación establecida por el equipo de salud de la UTIP con el familiar cuidador y el niño. La familia ofrece al niño un cuidado basado en el amor, cariño y calidez, expuestos al realizar acciones como cambiar los pañales, auxiliar en el baño y en curativos. De la misma forma el cuidado recibido por los familiares por parte del equipo de salud se mostró importante para facilitar el proceso de adaptación a la situación vivida y la continuidad del cuidado del familiar al niño.

Pulmonary expansion manoeuvres compared to usual care on ventilatory mechanics, oxygenation, length of mechanical ventilation and hospital stay, extubation, atelectasis, and mortality of patients in mechanical ventilation: A randomized clinical trial

by Karina da Silva, Cristino Carneiro Oliveira, Leandro Ferracini Cabral, Carla Malaguti, Anderson José

Pulmonary expansion manoeuvres are therapeutic techniques used to prevent and reverse atelectasis; however, no randomized controlled trials have provided evidence supporting the use of this intervention among individuals on mechanical ventilation. Objective: To evaluate the effects of chest compression-decompression and chest block manoeuvres compared to usual care among patients on mechanical ventilation. Methods: The current study was a randomized clinical trial of adult subjects on mechanical ventilation for 12 to 48 hours. The control group received usual care (passive or active mobilization, manoeuvres for airway clearance and tracheal aspiration). The intervention group received usual care plus two lung expansion manoeuvres, i.e., chest decompression and chest block, while remaining on mechanical ventilation. Assessments were performed before and after usual care, immediately after the intervention and 30 minutes after the intervention. The primary outcome was static compliance. The secondary outcomes were the incidence of atelectasis, dynamic compliance, airway resistance, driving pressure, oxygenation, duration of mechanical ventilation, extubation success, length of hospital and ICU stay, and mortality. Results: Fifty-one participants (67±15 years old, 53% men, 26 in the control group and 25 in the intervention group) were evaluated. No differences in static compliance were observed between groups (intervention minus control) before and after expansion manoeuvres [3.64 ml/cmH2O (95% CI: -0.36–7.65, p = 0.074)]. Peripheral oxygen saturation differed between groups before and after expansion manoeuvres, with more favourable outcome observed in the control group [-1.04% (95% CI: -1.94 –-0.14), p = 0.027]. No differences were found in other outcomes. Conclusion: Chest compression-decompression and chest block manoeuvres did not improve ventilatory mechanics, the incidence of atelectasis, oxygenation, the duration of mechanical ventilation, the length of stay in the ICU and hospital, or mortality in individuals on mechanical ventilation. The findings of this study can be valuable for guiding evidence-based clinical practice and developing a therapeutic approach that provides real benefits for this population.

Methodological guidelines and publications of benefit-risk assessment for health technology assessment: a scoping review protocol

Por: De Oliveira Ascef · B. · Gabriel · F. C. · Suzumura · E. A. · Maia · F. H. d. A. · Bortoluzzi · A. F. R. · Farias · N. S. · Jahn · B. · Siebert · U. · De Soarez · P. C.
Background

Benefit–risk assessment (BRA) is used in multiple phases along the health technology’s life-cycle to evaluate the balance between the benefits and risks, as it is fundamental to all stakeholders. BRA and its methodological approaches have been applied primarily in the context of regulatory agencies. However, BRA’s application and extent in the context of health technology assessment (HTA) bodies remain less clear. Our goal is to perform a scoping review to identify and map methodological guidelines and publications on methods of BRA. This will be done considering the different phases of the life-cycle of health technologies to underline both the depth and extent of research concerning BRA, especially in the context of HTA.

Methods and analysis

This scoping review protocol was developed following the framework proposed by Arksey and O’Malley, and the updated guidelines by the Joanna Briggs Institute. We will include methodological publications that provide recommendations or guidelines on methods for BRA. We will conduct electronic searches on Medline (PubMed) and EMBASE (Ovid) databases; manual searches on the main websites of HTA bodies and drug regulatory organisations; and contact experts in the field. Systematic extraction forms will be used to screen and assess the identified publications by independent assessors. We will provide a qualitative synthesis using descriptive statistics and visual tools. Results will be summarised in systematic evidence tables and comparative evidence scoping charts.

Ethics and dissemination

This review will use data publicly available and does not require ethics approval. The results of this scoping review will contribute to scientific knowledge and act as a basis for methodologists, guideline developers and researchers for the development of BRA to inform regulatory decisions, reimbursement and coverage decision making. The results will be disseminated through peer-reviewed articles, conferences, policy briefs and workshops.

Trial registration number

Open Science Framework (https://doi.org/10.17605/OSF.IO/69T3V).

Application of ventilator-associated events (VAE) in ventilator-associated pneumonia (VAP) notified in Brazil (IMPACTO MR-PAV): a protocol for a cohort study

Por: Nascimento · G. M. · Gomes Rodrigues · D. L. · Mangas Catarino · D. G. · Piastrelli · F. T. · Cheno · M. Y. · Braz · K. C. C. · Oliveira Alves · L. B. · Avezum · A. · Veiga · V. C. · Zavascki · A. P. · Tomazini · B. · Besen · B. · Pereira · A. J. · Marques de Pinho · A. P. N. · De
Introduction

Certain criteria for ventilator-associated events (VAE) definition might influence the type of an event, its detection rate and consequently the resource expenditure in intensive care unit. The Impact of Infections by Antimicrobial-Resistant Microorganisms - Ventilator-Associated Pneumonia (IMPACTO MR-PAV) aims to evaluate the incidence and diagnostic accuracy of ventilator-associated pneumonia (VAP) using the current criteria for VAP surveillance in Brazil versus the VAE criteria defined by the US National Healthcare Safety Network-Center for Diseases Control and Prevention (CDC) criteria.

Methods and analysis

The study will be conducted in around 15 centres across Brazil from October 2022 to December 2023. Trained healthcare professionals will collect data and compare the incidence of VAP using both the current criteria for VAP surveillance in Brazil and the VAE criteria defined by the CDC. The accuracy of the two criteria for identifying VAP will also be analysed. It will also characterise other events associated with mechanical ventilation (ventilator-associated condition, infection-related ventilator-associated complication) and adjudicate VAP reported to the Brazilian Health Regulatory Agency (ANVISA) using current epidemiological diagnostic criteria.

Ethics and dissemination

This study was approved by the Institutional Review Board under the number 52354721.0.1001.0070. The study’s primary outcome measure will be the incidence of VAP using the two different surveillance criteria, and the secondary outcome measures will be the accuracy of the two criteria for identifying VAP and the adjudication of VAP reported to ANVISA. The results will contribute to the improvement of VAP surveillance in Brazil and may have implications for other countries that use similar criteria.

Trial registration number

NCT05589727; Clinicaltrials.gov.

Impact of type, intensity, frequency, duration and volume of physical activity on dementia and mild cognitive impairment in older adults: protocol for a systematic review and meta-analysis

Por: Junger · A. L. · de Sousa Romeiro · A. M. · Noll · M. · de Oliveira · C. · Silveira · E. A.
Introduction

Worldwide, the prevalence of degenerative diseases such as dementia and mild cognitive impairment (MCI) is increasing with population ageing and increasing life expectancy. Both conditions share modifiable risk factors. Physical inactivity is one of these modifiable risk factors, and research points to the protective effect of physical activity on the incidence of dementia and MCI. However, this association tends to change according to type, intensity, frequency, duration and volume of physical activity. Furthermore, it remains unclear which of these characteristics offers the greatest protective effect. Therefore, this study aims to evaluate the impacts of different types, intensities, frequencies, duration and volume of physical activity on dementia and cognitive decline in older adults.

Methods and analysis

The search will be carried out from October 2023, using the following databases: PubMed, Embase, Scopus, CINAHL and Web of Science. Cohort studies with a follow-up time of 1 year or longer that have investigated the incidence of dementia and/or MCI in older adults exposed to physical activity will be included. There will be no limitations on the date of publication of the studies. Studies published in English, Spanish or Portuguese will be analysed. Two researchers will independently screen the articles and extract the data. Any discrepancies will be resolved by a third reviewer. Association measures will be quantified, including OR, HR, relative risk and incidence ratio, with a 95% CI. If the data allow, a meta-analysis will be performed. To assess the methodological quality of the selected studies, the Grading of Recommendations, Assessment, Development and Evaluations instrument, and the Downs and Black instrument to assess the risk of bias, will be used.

Ethics and dissemination

Ethical approval is not required. The results will be submitted for publication in a peer-reviewed journal.

PROSPERO registration number

CRD42023400411.

Perceptions of individuals regarding barriers to participation in a pulmonary rehabilitation program after hospitalization due to COVID-19: A qualitative study

by Rafaella Rabelo Polato, Cristino Carneiro Oliveira, Yuri Augusto de Sousa Miranda, Leandro Ferracini Cabral, Carla Malaguti, Anderson José

Introduction

Several individuals with post-COVID-19 syndrome referred for pulmonary rehabilitation did not participate. This study aimed to explore individuals’ barriers to participating in posthospitalization COVID-19 rehabilitation.

Materials and methods

This was a qualitative, multicenter study performed using semistructured interviews. This study included 20 individuals hospitalized for COVID-19 who refused to participate in a pulmonary rehabilitation program at a university hospital.

Results

Individuals reported difficulties accessing the rehabilitation center, mainly due to distance, transport costs and conditions, and lack of companions. Health problems (e.g., surgeries, pain, and mobility difficulties) and lack of time due to work, commuting, and household work were also reported. Another reported theme was not perceiving the need for rehabilitation due to feeling well. Minor themes included the need for more information about rehabilitation and a lack of interest, motivation, and medical encouragement.

Conclusion

Individuals hospitalized for COVID-19 faced several barriers to participating in a pulmonary rehabilitation program. These barriers included difficulties in accessing the rehabilitation center, health problems, lack of time, and the perception that rehabilitation was unnecessary. There is a need for actions to overcome these barriers to make the program available to a larger number of individuals.

Laser and radiofrequency for treating genitourinary syndrome of menopause in breast cancer survivors: a systematic review and meta-analysis protocol

Por: Serquiz · N. · Sarmento · A. C. A. · Almeida · N. R. · Nobre · M. L. · Medeiros · K. S. · Oliveira · R. d. · Costa · A. P. F. · Goncalves · A. K.
Introduction

Breast cancer survivors (BCSs) experience more severe symptoms of genitourinary syndrome of menopause (GSM) than healthy postmenopausal women. As hormonal therapy with oestrogen should be avoided in BCSs, finding an effective and safe therapy to address vaginal symptoms and sexual dysfunction is urgently needed. Physical methods may be promising alternatives for the specificities of this group of women. This review aims to evaluate the efficacy and safety of physical methods (laser and radiofrequency) for treating GSM in BCSs.

Methods and analysis

The PubMed, Embase, Web of Science, SciELO, LILACS, Scopus, Cochrane Central Register of Controlled Trials and ClinicalTrials.gov databases will be searched. A search strategy was developed to retrieve clinical trials that evaluate the efficacy and safety of any physical method (laser or radiofrequency) used for GSM in BCSs. No date or language restrictions will be imposed. Two authors will independently select studies by title, abstract and full text to meet the inclusion criteria. Data will be extracted, and the risk of bias will be evaluated using the Cochrane risk-of-bias tool (RoB 2). Review Manager 5.4.1 will be used for data synthesis. The Grading of Recommendations, Assessment, Development and Evaluation will be used to assess the strength of the evidence.

Ethics and dissemination

This study reviews the published data; thus, obtaining ethical approval is unnecessary. The findings of this systematic review will be published in a peer-reviewed journal.

PROSPERO registration number

CRD42023387680.

Changes in the diagnosis of depression among nursing professionals during the COVID‐19 pandemic: A longitudinal study

Abstract

Aims

To identify changes in mental health status among nursing professionals in a Brazilian municipality during the COVID-19 pandemic.

Design

An observational and longitudinal study.

Methods

Using the Patient Health Questionnaire-9, the presence of depressive symptoms was evaluated among 690 nursing professionals in the city of Pelotas, Brazil, at two moments: June/July 2020 and June/July 2021.

Results

13.0% incidence of depressive symptoms was identified; as well as 12.2% remission; 24.1% persistence and 50.7% absence. Among the factors associated with the worst prognoses we can mention female gender, greater workload, feeling of overload, illness of family members or friends due to COVID-19 and use of psychotropic drugs

Conclusions

There was significant mobility in the diagnosis of depression among the professionals studied during the period analysed, with incidence of new cases of significant depression and greater than the number of remissions. In addition to sociodemographic aspects, traumatic experiences and exposure to continuous overload were associated with persistence and incidence of new cases.

Implications for the profession and/or patient care

With the advent of the COVID-19 pandemic, several studies have shown an increase in depressive symptoms among nursing professionals; however, understanding the long-term effects of this scenario is still a challenge.

Impact

What problem did the study address? This study investigates changes in the mental health status of nursing professionals working at different care levels, taking the prevalence of screening for depression as a proxy, during a period of a year during the COVID-19 pandemic.

What were the main findings? Between both data collection moments, 2020 e 2021, there was a significant percentage of professionals with persistent depression, in addition to a significant proportion of incident cases that slightly exceeded the number of remissions and the factors associated with the worst prognoses were sociodemographic aspects such as gender and emotional stressors like illness of family members or close friends due to COVID-19, in addition to those related to the organisation and support provided by the services, such as workload and feeling of overload.

Where and on whom will the research have an impact? This study will impact the nursing professionals and in role of the health services in order to establishing actions that contribute to minimising the deleterious effects of the pandemic on the mental health of their Nursing teams.

Reporting method

The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines were adopted in this study.

Patient or public contribution

No Patient or Public Contribution.

Percepción del proceso de trabajo de los técnicos de enfermería titulados

Objetive: analizar las percepciones, motivaciones y dificultades de los técnicos de enfermería titulados en enfermería. Metodología: Me-todología: Se trata de una investigación cualitativa, exploratoria descriptiva, la recolección de datos se realizó en un Hospital Municipal del Noroeste de Paraná, durante el primer semestre de 2020, mediante la aplicación de un guión semiestructurado con preguntas orien-tadoras y un cuestionario sociodemográfico. Resultados: El conocimiento adquirido en la graduación de enfermería fue uno de los facto-res facilitadores que contribuyó a una mejor ejecución de la atención brindada, y la mayor dificultad está relacionada con la aceptación de los colegas y supervisores, en relación a las opiniones y sugerencias sobre los procedimientos u organización de la Servicio. Las razones que llevaron a los técnicos de enfermería a cursar una carrera en el área en la que trabajan se deben a la necesidad de cono-cimientos y la búsqueda de un mejor futuro financiero. Conclusión: cuando el profesional tiene un título, se desarrolla con mayor destreza y eficacia en la asistencia proporcionada.

Prematuridad: riesgos biológicos, establecidos y ambientales

Objetivo: Determinar el perfil de los bebés prematuros de cero a 30 meses de edad, que viven en un municipio de Minas Gerais, Brasil. Meto-dología: Investigación cuantitativa, descriptiva y transversal. Los datos fueron recolectados usando la herramienta de evaluación familiar. En el análisis, se utilizó la aplicación de lo Microsoft Excel 2010, evaluando su prevalencia y en porcentaje numérico. Resultados: En los factores de riesgo, 71.4% de los recién nacidos presentaron algún tipo de riesgo ambiental, con predominio de factores socioeconómicos; El 100% tenía algún tipo de riesgo biológico, con la hipertensión materna predominando sobre el riesgo prenatal (62,5%). Conclusión: la atención prenatal por parte de un equipo multiprofesional y la capacitación de profesionales de la salud para el monitoreo adecuado de las mujeres embarazadas y los recién nacidos prematuros es esencial para el correcto desarrollo neuropsicomotor de estos niños, dada la necesidad de una intervención temprana.

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