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by Ariene Silva do Carmo, Paulo César Pereira de Castro Júnior, Thais Cristina Marquezine Caldeira, Daniela Silva Canella, Rafael Moreira Claro, Luiza Delazari Borges, Larissa Loures Mendes
The present study analyzed the prices of food sold in canteens of Brazilian private schools and described price-based marketing strategies, according to the NOVA food classification system. This is a mixed methods study combining a cross-sectional component and time series analysis, with data from 2,241 canteens in private elementary and secondary schools in the 26 capitals of Brazil and the Federal District, collected between June 2022 and June 2024. Price data collected for unprocessed, minimally processed, or processed foods and culinary preparations based on these foods (UMPCP), and ultra-processed foods and culinary preparations based on these foods (UpCP) sold in school canteens and from the National System of Consumer Price Indices (SNIPC), were used to create a data set containing deflated monthly prices for food and beverages sold between August 2022 and July 2024. Calculations were made for adjusted prices (R$/100 g or ml) and absolute prices (R$ per portion), and frequency of use of strategies such as combos and promotions. UMPCP showed lower adjusted price, but higher absolute price than UpCP, especially for solid foods. About 27% of the study canteens implemented pricing strategies for both food groups. Most of these strategies did not exclusively favor healthy foods, indicating that promotions and combos were used without distinction. The affordability of healthy foods is disadvantaged in school canteens when considering the price per portion, which may negatively influence students’ food choices. The findings show that current prices for food sold in most canteens discourage the purchase of healthy items, but favor the purchase of unhealthy ones. These results reinforce the importance of interventions for promoting healthy foods and making them more affordable.Diabetes is a serious health condition that challenges a person’s daily life, emotional well-being and perceived quality of life. It increases one’s risk of developing other health-related complications and encountering an early death. People with diabetes require comprehensive and meticulous management through a collaborative clinical multidisciplinary team. Optimal management reduces the risk of diabetes-related health issues. Significantly, people’s knowledge of diabetes and its management depends, to a large extent, on the adequacy and effectiveness of the diabetes-related care and education they receive. Diabetes specialist nurses (DSNs) are essential in diabetes care and education. The management of diabetes is rapidly changing, with advances in technologies to monitor glycaemic control, growth in new therapies and devices, and new ways of interacting with people with diabetes instead of traditional face-to-face consultations. DSNs are at the forefront in delivering diabetes care and have had to adapt their practice and learn new skills to embrace these changes. Meanwhile, the competency framework has evolved to keep abreast of these changes and ensure that nurses provide high-quality care for people with diabetes. A scoping review of the global core competencies of DSNs and identifying a worldwide framework of core competencies holds significant importance for their professional growth and role standardisation worldwide.
The scoping review will be conducted in accordance with Arksey and O’Malley’s framework and the Joanna Briggs Institute methodology. Moreover, this protocol will be reported in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols checklist. The following online databases will be searched from the earliest available record to 4 October 2024, including CINAHL (EBSCO), Embase, PubMed, Scopus and Web of Science. Grey literature will be retrieved through OAIster, Google Scholar and OpenGrey, supplemented by targeted manual searches of official websites of national diabetes associations of different countries. Study selection and data extraction of the full text will be done independently by two reviewers based on the inclusion criteria and a predetermined data extraction form. In the event of any discrepancies, they will be resolved through discussion with the third reviewer. The extracted data will be summarised and exhibited in tabular or graphical form.
This study does not require ethical approval, as all data will be collected from published and grey literature. The findings will be presented at relevant conferences and submitted to peer-reviewed journals for publication.
Chagas disease (CD) is one of the most neglected diseases in the world. In Latin America, CD is endemic in 21 countries, with an estimated 70 million people at risk of infection. Current treatments are limited to two nitroheterocyclic compounds: nifurtimox and benznidazole (BZN). Each has significant limitations, including long duration and safety concerns. However, data from recently completed studies suggest that reduced-duration regimens may be equally effective while enhancing safety.
NuestroBen is a phase III, randomised, multicentre clinical trial designed to assess whether shorter (2- and 4-week) regimens of BZN are non-inferior to the standard 8-week treatment. A total of 540 adult participants with no evidence of organ damage (the indeterminate form) or with mild cardiac progression (mild electrocardiographic alterations and without systolic dysfunction or symptoms), all in the chronic phase of CD, will be recruited at six study sites in Argentina and two study sites in Bolivia. Participants will be randomised to receive one of the two shortened regimens of BZN (300 mg per day for 2 or 4 weeks) or standard treatment (300 mg per day for 8 weeks). The primary endpoint is sustained elimination of parasitaemia from the end of treatment through 12 months of follow-up. Secondary endpoints will assess sustained clearance of parasitaemia at 1, 4, 6 and 8 months of follow-up from the end of treatment, drug tolerability and adherence to treatment. NuestroBen will also evaluate whether two shortened regimens of BZN improve drug tolerability and treatment adherence compared with the current standard treatment while maintaining efficacy in participants with the indeterminate form of CD or with mild cardiac involvement.
In Argentina, this study was approved by Fundación de Estudios Farmacológicos y Medicamentos ‘Luis M. Zieher’ for its conduct at the Instituto de Cardiología de Corrientes ‘Juana Francisca Cabral’ (reference: NuestroBen-2020/2021) and the Instituto Nacional de Parasitología ‘Dr. Mario Fatala Chaben’ (reference: NuestroBen-2020/2021) by Comité Institucional de Ética de Investigación en Salud for the Centro de Chagas y Patología Regional de Santiago del Estero (reference: NuestroBen-2020-088/2021), by Comité de Ética en Investigación for the Hospital de Infecciosas F.J. Muñiz (reference: NuestroBen-2020–4037) and the Hospital General de Agudos D.F. Santojanni (reference: NuestroBen-2020–4039) and by Comité de Bioética for the Fundación Huésped (reference: NuestroBen-2020/2021). In Bolivia, it was approved by Comité de Ética en Investigación en Salud from the Universidad Autónoma Juan Misael Saracho (reference: NuestroBen-2020/2025). All participants are asked to provide written informed consent to participate. Recruitment processes started in July 2023, and as of 15 June 2025, 140 participants have been recruited. Findings will be shared with Argentinian and Bolivian public health officials and with the Chagas and tropical medicine communities via international conferences. Findings will also be published in medical journals.
To synthesise current evidence on physiotherapists’ use of electronic health records (EHRs), with a focus on the determinants of adoption, implementation processes and associated implementation outcomes.
A systematic review employing a narrative synthesis approach.
PubMed, Cochrane, Scopus and Web of Science, covering all records from the inception of each database to 10 May 2024.
Studies conducted in physiotherapy clinical settings and using the International Classification of Functioning, Disability and Health (ICF).
Two authors independently screened articles and assessed methodological quality. Risk of bias was assessed using the Critical Appraisal Skills Programme tool for qualitative and for cohort studies, the Mixed Methods Appraisal Tool for mixed-methods studies and the JBI Critical Appraisal Checklist for analytical cross-sectional studies.
From 3820 records screened, 9 observational studies met inclusion criteria. Key factors influencing EHR adoption included organisational readiness, perceived usefulness, managerial support and training availability. Implementation patterns clustered into three domains: recorded content, ICF framework integration and record quality. Reported outcomes focused on care quality metrics and evidence of clinical effectiveness.
Persistent challenges in physiotherapy EHR use were identified, notably in data quality, completeness and alignment with the ICF framework. Improving EHR practices is crucial to improve clinical assessment and support digital health integration. However, limited evidence and methodological heterogeneity remain key limitations.
CRD42023420267.
Objetivo: identificar, nas produções científicas, os fatores relacionados à construção da identidade
profissional do enfermeiro. Métodos: Trata-se de revisão integrativa realizada nas bases de dados
SCIELO, BDENF e LILACS disponíveis na Biblioteca virtual em saúde no intervalo temporal de
2015 a 2019 a partir dos descritores “Papel do profissional de enfermagem” AND “Cuidados de
enfermagem” OR “Competência profissional”. Resultados: A identificação profissional do
enfermeiro está relacionada à sua atuação no serviço de saúde com estratégias de atendimento
domiciliar, empreendedorismo, gerenciamento do cuidado e da equipe, educação em saúde,
consultas de enfermagem, procedimentos técnicos, articulação da rede de atenção, organização do
serviço e qualificação da equipe mas que sofrem algumas limitações individuais, organizacionais,
institucionais e sociais. Conclusão: A identificação dos fatores que caracterizam o enfermeiro e
fomentam sua identidade profissional exerce grande influência no empoderamento da categoria e
melhor autonomia nos diversos campos de atuação.
Descritores: Papel do profissional de enfermagem; Cuidados de enfermagem; Competência
profissional.
Introducción: La pandemia ha debilitado el vínculo entre las personas con hipertensión arterial y/o diabetes mellitus y el sistema de salud. Objetivo: reflexionar sobre los desafíos del manejo de la hipertensión arterial y la diabetes mellitus en la atención primaria de salud en tiempos de pandemia por COVID-19. Metodología: Se trata de un estudio teórico-reflexivo, cuya fundamentación se dio mediante la realización de una revisión narrativa de la literatura. La trayectoria teórico-metodológica se estructuró a través de la fenomenología interpretativa. Resultados: La coexistencia de problemas estructurales, operativos y de gestión se encuentran entre las principales razones para la no superación de los desafíos revelados para mantener prácticas de atención efectivas a pacientes con enfermedades crónicas, frente a la pandemia de COVID-19. De los desafíos estructurales enumerados, se destacan la insuficiencia tecnológica, la debilidad de los dispositivos efectivos y los profesionales poco calificados. En el contexto operativo, se destacó el aumento de la demanda de asistencia. Y, en cuanto al manejo, el cribado y seguimiento de estas enfermedades siguen siendo retos a superar. Consideraciones finales: las reflexiones planteadas pueden ser útiles para el establecimiento de procesos de gestión más eficaces, en el contexto de la atención primaria de salud, para la atención dirigida a personas con enfermedades crónicas.
To assess the proportions and associated factors of different post-discharge referrals among adolescents treated in the emergency department after a suicide attempt.
Observational, cross-sectional retrospective study.
We conducted a study using the medical records of 140 adolescents treated for a suicide attempt between January 2015 and May 2023 in a Brazilian emergency department, focusing on post-discharge referrals, defined as discharge without referral, unaddressed referral and referral addressed to the network. Associations between the outcomes and other variables were analysed using a Poisson regression model.
Discharges without referrals prevailed, followed by addressed and unaddressed referrals. Regression models showed associations between post-discharge and age, prior continuous use of psychotropic medications, location of care, continued suicidal ideation at discharge and evaluation by a multi-professional team.
A high number of adolescents were discharged from emergency departments without co-ordination with the mental health network, and the involvement of the multi-professional team was positively associated with addressed referrals.
This study informs healthcare professionals by raising awareness of their practices in discharging adolescents after suicide attempts in emergency departments, with the possibility of improving care quality and reducing the likelihood of readmission.
STrengthening the Reporting of OBservational studies in Epidemiology (STROBE).
No patient or public contribution.
Objetivo: identificar las necesidades humanas básicas de las embarazadas de alto riesgo hospitalizadas con base en la Teoría de Wanda Horta. Método: investigación asistencial realizada con dieciséis gestantes de alto riesgo hospitalizadas en una maternidad de referencia en Ceará entre septiembre y noviembre de 2019. Se recolectó información a través de diario de campo y ficha de caracterización de las gestantes y registros de necesidades humanas básicas. Los resultados se analizaron mediante estadística descriptiva simple y un enfoque integral a la luz del marco de Wanda Horta. Resultados: las gestantes presentaron necesidades psicobiológicas, psicosociales y psicoespirituales, siendo prevalentes: ausencia de actividades de ocio, inseguridad emocional, escaso conocimiento, sueño y descanso perjudicados, y actividades físicas restringidas por indicación de descanso. Consideraciones finales: se cree que el razonamiento crítico y el juicio clínico de los enfermeros se centraron en la individualidad de las gestantes, identificando necesidades en los tres niveles propuestos por la teoría, apuntando caminos para cualificar el cuidado de enfermería a las gestantes de alto riesgo.
Rev Enferm;39(5): 8-13, 2016 May. . [Artículo]
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