Validity and reliability of a questionnaire on knowledge of cardiovascular risk factors for use in Brazil

Using a sample of patients with coronary artery disease, this methodological study aimed to conduct a cross-cultural adaptation and validation of a questionnaire on knowledge of cardiovascular risk factors (Q-FARCS), lifestyle changes, and treatment adherence for use in Brazil. The questionnaire has three scales: general knowledge of risk factors (RFs); specific knowledge of these RFs; and lifestyle changes achieved. Cross-cultural adaptation included translation, synthesis, back-translation, expert committee review, and pretesting. Face and content validity, reliability, and construct validity were measured. Cronbach’s alpha for the total sample (n = 240) was 0.75. Assessment of psychometric properties revealed adequate face and content validity, and the construct revealed seven components. It was concluded that the Brazilian version of Q-FARCS had adequate reliability and validity for the assessment of knowledge of cardiovascular RFs.

Scientific production on the applicability of phenytoin in wound healing

Phenytoin is an anticonvulsant that has been used in wound healing. The objectives of this study were to describe how the scientific production presents the use ofphenytoinas a healing agent and to discuss its applicability in wounds. A literature review and hierarchy analysis of evidence-based practices was performed. Eighteen articles were analyzed that tested the intervention in wounds such as leprosy ulcers, leg ulcers, diabetic foot ulcers, pressure ulcers, trophic ulcers, war wounds, burns, preparation of recipient graft area, radiodermatitis and post-extraction of melanocytic nevi. Systemic use ofphenytoinin the treatment of fistulas and the hypothesis of topical use in the treatment of vitiligo were found. In conclusion, topical use ofphenytoinis scientifically evidenced. However robust research is needed that supports a protocol for the use ofphenytoinas another option of a healing agent in clinical practice.

Assessing the vulnerability of women to sexually transmitted diseases STDS/ HIV: construction and validation of markers

Objective To construct and validate markers of vulnerability of women to STDs/HIV, taking into consideration the importance of STDs/HIV. Method Methodological study carried out in three stages: 1) systematic review and identification of elements of vulnerability in the scientific production; 2) selection of elements of vulnerability, and development of markers; 3) establishment of the expert group and validation of the markers (content validity). Results Five markers were validated: no openness in the relationship to discuss aspects related to prevention of STDs/HIV; no perception of vulnerability to STDs/HIV; disregard of vulnerability to STDs/ HIV; not recognizing herself as the subject of sexual and reproductive rights; actions of health professionals that limit women’s access to prevention of STDs/HIV. Each marker contains three to eleven components. Conclusion The construction of such markers constituted an instrument, presented in another publication, which can contribute to support the identification of vulnerabilities of women in relation to STDs/HIV in the context of primary health care services. The markers constitute an important tool for the operationalization of the concept of vulnerability in primary health care and to promote inter/multidisciplinary and inter/multi-sectoral work processes.


Technologies of birth and models of midwifery care

This article is based on a study of a reform in the organisation of maternity services in the United Kingdom, which aimed towards developing a more woman-centred model of care. After decades of fragmentation and depersonalisation of care, associated with the shift of birth to a hospital setting, pressure by midwives and mothers prompted government review and a relatively radical turnaround in policy. However, the emergent model of care has been profoundly influenced by concepts and technologies of monitoring. The use of such technologies as ultrasound scans, electronic foetal monitoring and oxytocic augmentation of labour, generally supported by epidural anaesthesia for pain relief, have accompanied the development of a particular ecological model of birth – often called active management –, which is oriented towards the idea of an obstetric norm. Drawing on analysis of women’s narrative accounts of labour and birth, this article discusses the impact on women’s embodiment in birth, and the sources of information they use about the status of their own bodies, their labour and that of the child. It also illustrates how the impact on women’s experiences of birth may be mediated by a relational model of support, through the provision of caseload midwifery care.

Model endophenotype for bipolar disorder: Qualitative Analysis, etiological factors, and research areas

The aim of this study is to present an updated view of the writings on the endophenotype model for bipolar disorder using analytical methodologies. A review and analysis of networks was performed through descriptors and keywords that characterize the composition of the endophenotype model as a model of health. Information was collected from between 1992 and 2014, and the main thematic areas covered in the articles were identified. We discuss the results and question their cohesion, emphasizing the need to strengthen and identify the points of connection between etiological factors and characteristics that make up the model of endophenotypes for bipolar disorder.

COMPETENCY-BASED TRAINING IN NURSING: LIMITS AND POSSIBILITIES

Objective To analyze the possibilities and limits of competency-based training in nursing. Method An integrative review of the literature on the subject was carried out, and an analysis was made of the results of a survey evaluating a nursing course based on areas of competency. A dialog was then established between the review and the results of the research. Results On the question of which theoretical type of competency the articles from the literature relate to, there is a predominance of the constructivist perspective, followed by the functionalist approach and the dialog-based approach. In the dialog between the literature and the research, limits and possibilities were observed in the development of a training by areas of competency. Conclusion The dialog-based approach to competency is the proposition that most approximates to the profile defined by the National Curriculum Guidelines for training in nursing, and this was also identified in the evaluation survey that was studied. However, it is found that there are aspects on better work is needed, such as: partnership between school and the workplace, the role of the teacher, the role of the student, and the process of evaluation.

Hypertension prevalence among indigenous populations in Brazil: a systematic review with meta-analysis

Abstract OBJECTIVE Evaluating the evidence of hypertension prevalence among indigenous populations in Brazil through a systematic review and meta-analysis. METHODS A search was performed by two reviewers, with no restriction of date or language in the databases of PubMed, LILACS, SciELO, Virtual Health Library and Capes Journal Portal. Also, a meta-regression model was designed in which the last collection year of each study was used as a moderating variable. RESULTS 23 articles were included in the review. No hypertension was found in indigenous populations in 10 studies, and its prevalence was increasing and varied, reaching levels of up to 29.7%. Combined hypertension prevalence in Indigenous from the period of 1970 to 2014 was 6.2% (95% CI, 3.1% - 10.3%). In the regression, the value of the odds ratio was 1.12 (95% CI, 1.07 - 1.18; p <0.0001), indicating a 12% increase every year in the probability of an indigenous person presenting hypertension. CONCLUSION There has been a constant increase in prevalence despite the absence of hypertension in about half of the studies, probably due to changes in cultural, economic and lifestyle habits, resulting from indigenous interaction with non-indigenous society.

Clinical reasoning in undergraduate nursing education: a scoping review

Abstract OBJECTIVE This study aimed at analyzing the current state of knowledge on clinical reasoning in undergraduate nursing education. METHODS A systematic scoping review through a search strategy applied to the MEDLINE database, and an analysis of the material recovered by extracting data done by two independent reviewers. The extracted data were analyzed and synthesized in a narrative manner. RESULTS From the 1380 citations retrieved in the search, 23 were kept for review and their contents were summarized into five categories: 1) the experience of developing critical thinking/clinical reasoning/decision-making process; 2) teaching strategies related to the development of critical thinking/clinical reasoning/decision-making process; 3) measurement of variables related to the critical thinking/clinical reasoning/decision-making process; 4) relationship of variables involved in the critical thinking/clinical reasoning/decision-making process; and 5) theoretical development models of critical thinking/clinical reasoning/decision-making process for students. CONCLUSION The biggest challenge for developing knowledge on teaching clinical reasoning seems to be finding consistency between theoretical perspectives on the development of clinical reasoning and methodologies, methods, and procedures in research initiatives in this field.

Morphostructural characterization of soil conventionally tilled with mechanized and animal traction with and without cover crop

The structural stability and restructuring ability of a soil are related to the methods of crop management and soil preparation. A recommended strategy to reduce the effects of soil preparation is to use crop rotation and cover crops that help conserve and restore the soil structure. The aim of this study was to evaluate and quantify the homogeneous morphological units in soil under conventional mechanized tillage and animal traction, as well as to assess the effect on the soil structure of intercropping with jack bean (Canavalia ensiformis L.). Profiles were analyzed in April of 2006, in five counties in the Southern-Central region of Paraná State (Brazil), on family farms producing maize (Zea mays L.), sometimes intercropped with jack bean. The current structures in the crop profile were analyzed using Geographic Information Systems (GIS) and subsequently principal component analysis (PCA) to generate statistics. Morphostructural soil analysis showed a predominance of compact units in areas of high-intensity cultivation under mechanized traction. The cover crop did not improve the structure of the soil with low porosity and compact units that hamper the root system growth. In areas exposed to animal traction, a predominance of cracked units was observed, where roots grew around the clods and along the gaps between them.

Tomographic diagnosis and relevant aspects of otosclerosis

A literature review and pictorial essay were developed to discuss the importance of knowing the main findings and locations of otosclerosis at multidetector computed tomography (MDCT). The authors performed a retrospective review of cases of otosclerosis diagnosed in their institution by means of high resolution multidetector computed tomography. Otosclerosis corresponds to otic capsule dysplasia characterized by metabolic derangement of its endochondral layer. Such condition constitutes a relevant cause of sensorineural hearing loss, affecting about 7% to 10% of the general population. The diagnosis is usually clinical, but imaging methods play a significant role in the anatomical detailing, differential diagnosis, surgical planning and evaluation of postoperative complications. Among such methods, the relevance of MDCT is highlighted. Radiologists should be familiar with the MDCT findings of otosclerosis, as well as with the temporal bone anatomy to assist in the appropriate clinical management of this disease.

Computed tomography angiography in patients with active gastrointestinal bleeding

Abstract Gastrointestinal bleeding represents a common medical emergency, with considerable morbidity and mortality rates, and a prompt diagnosis is essential for a better prognosis. In such a context, endoscopy is the main diagnostic tool; however, in cases where the gastrointestinal hemorrhage is massive, the exact bleeding site might go undetected. In addition, a trained professional is not always present to perform the procedure. In an emergency setting, optical colonoscopy presents limitations connected with the absence of bowel preparation, so most of the small bowel cannot be assessed. Scintigraphy cannot accurately demonstrate the anatomic location of the bleeding and is not available at emergency settings. The use of capsule endoscopy is inappropriate in the acute setting, particularly in the emergency department at night, and is a highly expensive method. Digital angiography, despite its high sensitivity, is invasive, presents catheterization-related risks, in addition to its low availability at emergency settings. On the other hand, computed tomography angiography is fast, widely available and minimally invasive, emerging as a promising method in the diagnostic algorithm of these patients, being capable of determining the location and cause of bleeding with high accuracy. Based on a critical literature review and on their own experience, the authors propose a computed tomography angiography protocol to assess the patient with gastrointestinal bleeding.

Eletrodos de pasta de carbono modificados com ácidos húmicos: estudo e determinação de metais em meio aquoso

Since 1992, the carbon paste electrodes modified with humic acids have been used for studying the behavior of metals in aqueous solutions. Many parameters influence the performance of the electrodes, such as the humic acid ratio, the nature of the humic acid, the accumulation time, the pH, the scan rate, and the preparation of the electrodes itself. There are various methos of preparing the electrodes. The goal of this paper is to review some of them. The advantages of using electrodes modified with humic acids as electrochemical sensors for evaluating metals in aqueous solution are stressed.

Fases estacionárias monolíticas para separações cromatográficas

Monolithic stationary phases represent a new generation of chromatographic separation media. These phases consist of a continuous separation bed prepared by in situ polymerization or consolidation inside the column tubing. In recent years, their simple preparation procedure, unique properties and excellent performance have attracted quite remarkable attention in liquid chromatography and capillary electrochromatography. This review summarizes the preparation, characterization and applications of monolithic stationary phases. The analytical potential of these columns is demonstrated with separations involving various families of compounds in different separation modes.

Bionanocompósitos preparados por incorporação de nanocristais de celulose em polímeros biodegradáveis por meio de evaporação de solvente, automontagem ou eletrofiação

This review reports the preparation and characterization of bionanocomposites based on biodegradable polymers reinforced with cellulose nanocrystals (CNC) described in the literature. The outstanding potential of cellulose nanocrystals as reinforcement fillers of biodegradable polymers is presented with an emphasis on the solution casting process, which is an appropriate method to investigate the physico-chemical effects of the incorporation of CNC into the polymeric matrices. Besides solution casting, other small scale methods such as electrospinning and layer-by-layer are also covered.

Conservative Treatment of Stress Urinary Incontinence: A Systematic Review with Meta-analysis of Randomized Controlled Trials

We performed a systematic review and meta-analysis of randomized controlled trials that studied the conservative management of stress urinary incontinence (SUI). There were 1058 results after the initial searches, from which 37 studies were eligible according to previously determined inclusion criteria. For the primary outcomes, pelvic floor muscle training (PFMT) was more efficacious than no treatment in improving incontinence-specific quality of life (QoL) scales (SMD = [1]1.24SDs; CI 95% = [1]1.77 to [1]0.71SDs). However, its effect on pad tests was imprecise. Combining biofeedback with PFMT had an uncertain effect on QoL (MD = [1]4.4 points; CI 95% = [1]16.69 to 7.89 points), but better results on the pad test, although with elevated heterogeneity (MD = 0.9g; 95%CI = 0.71 to 1,10g); group PFMT was not less efficacious than individual treatment, and home PFMT was not consistently worse than supervised PFMT. Both intravaginal and superficial electrical stimulation (IES and SES) were better than no treatment for QoL and pad test. Vaginal cones had mixed results. The association of IES with PFMT may improve the efficacy of the latter for QoL and pad test, but the results of individual studies were not consistent. Thus, there is evidence of the use of PFMT on the treatment of SUI, with and without biofeedback.