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  • ItemResenha
    Nursing protocols to reduce urinary tract infection caused by indwelling catheters: an integrative review
    (2023-01-01) Miranda, Maria Estela de Queiroz [UNESP]; Rosa, Marcelo Ricardo [UNESP]; Castro, Meire Cristina Novelli E. [UNESP]; Fontes, Cassiana Mendes Bertoncello [UNESP]; Bocchi, Silvia Cristina Mangini [UNESP]; Universidade Estadual Paulista (UNESP)
    Objectives: to analyze the production of knowledge in research articles about the effectiveness of nursing protocols for reducing indwelling urinary catheter dwell time and catheter-associated urinary tract infection rate in hospitalized adult and older patients. Methods: an integrative review of three full articles, available in the MEDLINE Complete-EBSCO, Scopus and Web of Science databases, from 01/01/2015 to 04/26/2021. Results: the three protocols reduced infection rates, and from the review/synthesis of their knowledge, a level IV body of evidence emerged to compose the nursing care process aimed at reducing indwelling urinary catheter dwell time and catheter-associated urinary tract infection. Final Considerations: this process gathers scientific evidence to support the elaboration of nursing protocols and, consequently, the conduction of clinical trials on its effectiveness in reducing urinary tract infection by indwelling urinary catheter.
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    Instruments to measure interaction of mothers and newborns: A systematic review
    (2023-05-01) Nascimento, Tayomara Ferreira [UNESP]; Bocchi, Silvia Cristina Mangini [UNESP]; Trenado, Rosa M.; Cerezo, M. Angeles; Jensen, Rodrigo [UNESP]; Universidade Estadual Paulista (UNESP)
    Interactions between newborns and their parents/primary caregivers are characterized by asymmetric and dependent relationships. This systematic review mapped, identified, and described the psychometric parameters, categories, and items of instruments used to assess mother–newborn interaction. Seven electronic databases were accessed in this study. Furthermore, this research included neonatal interaction studies describing instruments’ items, domains, and psychometric properties while excluding studies that focused on maternal interactions and lacked items for assessing newborns. Additionally, studies validated with older infants that did not have a newborn in the sample were used for test validation, which is a criterion used to decrease the risk of bias. Fourteen observational instruments from 1047 identified citations were included that addressed interactions using varying techniques, constructs, and settings. Particularly, we focused on observational settings that assessed interactions with communication-based constructs in the context of proximity or distance as influenced by physical, behavioral, or procedural barriers. These tools are also used to predict risk behaviors in a psychological context, mitigate feeding difficulties, and conduct neurobehavioral assessments of mother–newborn interactions. The elicited imitation was also an observational setting. This study found that the most described properties in the included citations were inter-rater reliability followed by criterion validity. However, only two instruments reported content, construct, and criterion validity, as well as a description of an internal consistency assessment and inter-rater reliability. Finally, the synthesis of the instruments reported in this study can guide clinicians and researchers in selecting the most appropriate one for their own application.
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    Teaching entrepreneurship in undergraduate Nursing course: evaluation of an educational proposal
    (2023-01-01) Colichi, Rosana Maria Barreto [UNESP]; Spiri, Wilza Carla [UNESP]; Juliani, Carmen Maria Casquel Monti [UNESP]; Lima, Silvana Andrea Molina [UNESP]; Universidade Estadual Paulista (UNESP)
    Objective: To evaluate a proposal for teaching entrepreneurship in an undergraduate Nursing course that uses active methodologies and activities based on the theory of meaningful learning. Methods: Interventional, prospective study, with a quantitative perspective, with a total of 102 participating students, carried out from July 2017 to December 2019 at a public university in the state of Sao Paulo. Statistical analysis were performed by non-parametric Chi-square or Fisher’s exact tests, with differences considered statistically significant if p < 0.05. Results: Improvements were observed in almost all items evaluated, revealing that meaningful learning became more effective with the use of active teaching methodologies. Most students need adaptation and effort to be put into these methods. Conclusions: The proposal offers pedagogical content adaptation, specifically for nursing students. New research should expand teaching-learning techniques for the development of future nurses, preparing them adequately for the job market.
  • ItemArtigo
    Lycopene, Mesoporous Silica Nanoparticles and Their Association: A Possible Alternative against Vulvovaginal Candidiasis?
    (2022-12-01) Carvalho, Gabriela Corrêa [UNESP]; Marena, Gabriel Davi [UNESP]; Leonardi, Gabriela Ricci; Sábio, Rafael Miguel [UNESP]; Corrêa, Ione [UNESP]; Chorilli, Marlus [UNESP]; Bauab, Tais Maria [UNESP]; Universidade Estadual Paulista (UNESP); University of Ribeirão Preto (UNAERP)
    Commonly found colonizing the human microbiota, Candida albicans is a microorganism known for its ability to cause infections, mainly in the vulvovaginal region known as vulvovaginal candidiasis (VVC). This pathology is, in fact, one of the main C. albicans clinical manifestations, changing from a colonizer to a pathogen. The increase in VVC cases and limited antifungal therapy make C. albicans an increasingly frequent risk in women’s lives, especially in immunocompromised patients, pregnant women and the elderly. Therefore, it is necessary to develop new therapeutic options, especially those involving natural products associated with nanotechnology, such as lycopene and mesoporous silica nanoparticles. From this perspective, this study sought to assess whether lycopene, mesoporous silica nanoparticles and their combination would be an attractive product for the treatment of this serious disease through microbiological in vitro tests and acute toxicity tests in an alternative in vivo model of Galleria mellonella. Although they did not show desirable antifungal activity for VVC therapy, the present study strongly encourages the use of mesoporous silica nanoparticles impregnated with lycopene for the treatment of other human pathologies, since the products evaluated here did not show toxicity in the in vivo test performed, being therefore, a topic to be further explored.
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    Nursing workload associated with neonatal mortality risk: a cross-sectional study
    (2022-01-01) da Silveira, Raquel Rondina Pupo [UNESP]; Serafim, Clarita Terra Rodrigues [UNESP]; E Castro, Meire Cristina Novelli [UNESP]; Rodrigues, Gabrielle Maria [UNESP]; Corrente, José Eduardo [UNESP]; Lima, Silvana Andrea Molina [UNESP]; Universidade Estadual Paulista (UNESP)
    Objectives: to analyze the association between nursing workload and neonatal mortality risk in newborns admitted to the Neonatal Intensive Care Unit. Methods: this is an observational, cross-sectional study conducted from January 2019 to January 2020. Results: the sample consisted of 399 newborns, 55.4% male, Nursing Activities Score mean of 67.5%, and Score for Neonatal Acute Physiology Perinatal Extension mean of 17.7, revealed itself as a predictor of the risk of death, while gestational age, length of hospitalization, and the first-minute Apgar established a protective relationship. The correlation between workload and neonatal mortality was low (r= 0.23, p=0.0009). Conclusions: the workload of the nursing team is not associated with the risk of mortality in the Neonatal Intensive Care Unit, as measured by the Nursing Activities Score.
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    Factors associated with COVID-19 severity among Brazilian pregnant adolescents: a population-based study
    (2022-01-01) Duarte, Brenda Katheryne [UNESP]; Parenti, Ana Beatriz Henrique [UNESP]; Jamas, Milena Temer [UNESP]; Nunes, Hélio Rubens De Carvalho [UNESP]; Parada, Cristina Maria Garcia De Lima [UNESP]; Universidade Estadual Paulista (UNESP)
    Objective: to identify the factors associated with need for intensive care unit admission of Brazilian pregnant adolescents with COVID-19. Method: population-based non-concurrent cohort study using secondary databases. Brazilian pregnant adolescents who had laboratory confirmation of SARS-CoV-2 by RT-PCR, between March 14, 2020 and April 11, 2021 were included in the study. Statistical analysis using the Poisson multiple regression model, estimating the relative risk and respective 95% confidence intervals, with values of p <0.05 considered significant. Results: in total, 282 pregnant women were included in the study, with median age of 17 years, most with brown skin, in the third trimester of pregnancy, and living in urban or peri-urban areas. The intensive care unit admission rate was 14.5%, associated with living in the Southeast region of Brazil (RR=5.03, 95%CI=1.78-14.24, p=0.002), oxygen saturation below 95% (RR=2.62, 95%CI=1.17-5.87, p=0.019), and having some comorbidity (RR=2.05, 95%CI=1.01-4.16, p=0.047). Conclusion: the intensive care unit admission rate was high among Brazilian pregnant adolescents and was associated with living in the Southeast region of Brazil, having some comorbidity and/or presenting low oxygen saturation.
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    Fatores associados à gravidade da COVID-19 em gestantes adolescentes brasileiras: estudo de base populacional
    (2022-01-01) Duarte, Brenda Katheryne [UNESP]; Parenti, Ana Beatriz Henrique [UNESP]; Jamas, Milena Temer [UNESP]; Nunes, Hélio Rubens De Carvalho [UNESP]; Parada, Cristina Maria Garcia De Lima [UNESP]; Universidade Estadual Paulista (UNESP)
    OBJECTIVE: to identify the factors associated with need for intensive care unit admission of Brazilian pregnant adolescents with COVID-19. METHOD: population-based non-concurrent cohort study using secondary databases. Brazilian pregnant adolescents who had laboratory confirmation of SARS-CoV-2 by RT-PCR, between March 14, 2020 and April 11, 2021 were included in the study. Statistical analysis using the Poisson multiple regression model, estimating the relative risk and respective 95% confidence intervals, with values of p <0.05 considered significant. RESULTS: in total, 282 pregnant women were included in the study, with median age of 17 years, most with brown skin, in the third trimester of pregnancy, and living in urban or peri-urban areas. The intensive care unit admission rate was 14.5%, associated with living in the Southeast region of Brazil (RR=5.03, 95%CI=1.78-14.24, p=0.002), oxygen saturation below 95% (RR=2.62, 95%CI=1.17-5.87, p=0.019), and having some comorbidity (RR=2.05, 95%CI=1.01-4.16, p=0.047). CONCLUSION: the intensive care unit admission rate was high among Brazilian pregnant adolescents and was associated with living in the Southeast region of Brazil, having some comorbidity and/or presenting low oxygen saturation. (1) The ICU admission rate of pregnant adolescents was high: 14.5%. (2) Low oxygen saturation was a predictor of COVID-19 severity. (3) Living in the Southeast region in Brazil increased the risk of ICU admission by five times. (4) Having some comorbidity increased the risk of ICU admission by two times.
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    Leadership and empowering behavior: understandings of nurse managers in Primary Health Care
    (2023-01-01) dos Santos, Lucas Cardoso [UNESP]; Silva, Fernanda Marques [UNESP]; da Silva Domingos, Thiago; Andrade, Juliane; Spiri, Wilza Carla [UNESP]; Universidade Estadual Paulista (UNESP); Universidade Federal de São Paulo (UNIFESP); Universidade de Brasília (UnB)
    Objective: To understand the empowering behavior of nurses in their management practice in the Primary Health Care context. Methods: Exploratory qualitative study of nurse managers working in Basic Health Centers in a city in the state of São Paulo, Brazil. Semi-structured interviews were conducted for data collection and the content of interviews was fully transcribed. Data collection was ended after reaching theoretical data saturation in the seventh participant. The content analysis framework guided the organization of the qualitative corpus into themes and sub-themes. Results: As leaders, nurse managers use empowering behavior to interpret their perceptions and attitudes in order to positively influence teamwork and mediate conflicts. Staff sizing and difficulties in holding team meetings and sharing decision-making processes generate challenges that create tension in the implementation of empowering behavior. Conclusion: Aspects related to the management work of nurse leaders in Basic Health Centers are understood as empowering behavior and the challenges for its implementation are related to the organization and planning of the work process in Primary Health Care.
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    Orofacial anti-hypernociceptive effect of citral in acute and persistent inflammatory models in rats
    (2023-08-01) Santos, Bruna M.; Santos, Wanderson S.; Solon, Isabelly G.; Garcia, Felipe S.; Emilio-Silva, Maycon T. [UNESP]; Jesus, Aline A.; Hiruma-Lima, Clélia A. [UNESP]; Nascimento, Glauce C.; Cárnio, Evelin C.; Branco, Luiz G.S.; Universidade de São Paulo (USP); Universidade Estadual Paulista (UNESP)
    Orofacial pain has significant psychological and physiological effects. Citral (3,7-dimethyl-2,6-octadienal) is the main component of Cymbopogon citratus (DC) Stapf, an herb with analgesic properties. Although citral has been considered a potent analgesic, its putative effects on orofacial pain are still unknown. Objective: The objective of this study is to test the hypothesis that citral modulates orofacial pain using two experimental models: formalin-induced hyperalgesia in the vibrissae area and during persistent temporomandibular hypernociception using Complete Freund's Adjuvant - CFA test. Methods: For the formalin test, citral (100 and 300 mg/kg, oral gavage) or its vehicle (Tween 80, 1 %) were given 1 h before the formalin injection subcutaneously (sc) into the vibrissae area. For the CFA model, we analyzed the prophylactic (100 mg/kg of citral by oral gavage, 1 h before CFA injection) and the chronic therapeutic (citral treatment 1-hour post-CFA injection and daily post-CFA injection) effect of citral or its vehicle in animals treated with CFA for 8 days. Results: Citral caused a decrease in formalin-induced local inflammation and the time spent performing nociceptive behavior in a dose-dependent fashion. Similarly, prophylactic and therapeutic citral treatment decreased the CFA-induced persistent mechanical hypernociception in the temporomandibular area. Conclusion: Our data strengthen the notion that citral plays a powerful antinociceptive role by decreasing orofacial hypernociception in formalin and CFA models.
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    Immunogenetics of HLA-B: SNP, allele, and haplotype diversity in populations from different continents and ancestry backgrounds
    (2023-06-01) Silva, Nayane dos Santos Brito [UNESP]; Souza, Andreia da Silva [UNESP]; Andrade, Heloisa de Souza; Pereira, Raphaela Neto [UNESP]; Castro, Camila Ferreira Bannwart [UNESP]; Vince, Nicolas; Limou, Sophie; Naslavsky, Michel Satya; Zatz, Mayana; Duarte, Yeda Aparecida de Oliveira; Mendes-Junior, Celso Teixeira; Castelli, Erick da Cruz [UNESP]; Universidade Estadual Paulista (UNESP); Nantes Université; Universidade de São Paulo (USP); Centro Universitário Sudoeste Paulista; Hospital Israelita Albert Einstein
    HLA-B is among the most variable gene in the human genome. This gene encodes a key molecule for antigen presentation to CD8+ T lymphocytes and NK cell modulation. Despite the myriad of studies evaluating its coding region (with an emphasis on exons 2 and 3), few studies evaluated introns and regulatory sequences in real population samples. Thus, HLA-B variability is probably underestimated. We applied a bioinformatics pipeline tailored for HLA genes on 5347 samples from 80 different populations, which includes more than 1000 admixed Brazilians, to evaluate the HLA-B variability (SNPs, indels, MNPs, alleles, and haplotypes) in exons, introns, and regulatory regions. We observed 610 variable sites throughout HLA-B; the most frequent variants are shared worldwide. However, the haplotype distribution is geographically structured. We detected 920 full-length haplotypes (exons, introns, and untranslated regions) encoding 239 different protein sequences. HLA-B gene diversity is higher in admixed populations and Europeans while lower in African ancestry individuals. Each HLA-B allele group is associated with specific promoter sequences. This HLA-B variation resource may improve HLA imputation accuracy and disease-association studies and provide evolutionary insights regarding HLA-B genetic diversity in human populations.
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    Evidence for Epistatic Interaction between HLA-G and LILRB1 in the Pathogenesis of Nonsegmental Vitiligo
    (2023-02-01) Oliveira-Caramez, Maria Luiza de; Veiga-Castelli, Luciana; Souza, Andreia S. [UNESP]; Cardili, Renata Nahas; Courtin, David; Flória-Santos, Milena; Donadi, Eduardo; Giuliatti, Silvana; Sabbagh, Audrey; Castelli, Erick C. [UNESP]; Mendes-Junior, Celso Teixeira; Universidade de São Paulo (USP); Universidade Estadual Paulista (UNESP); Université de Paris
    Vitiligo is the most frequent cause of depigmentation worldwide. Genetic association studies have discovered about 50 loci associated with disease, many with immunological functions. Among them is HLA-G, which modulates immunity by interacting with specific inhibitory receptors, mainly LILRB1 and LILRB2. Here we investigated the LILRB1 and LILRB2 association with vitiligo risk and evaluated the possible role of interactions between HLA-G and its receptors in this pathogenesis. We tested the association of the polymorphisms of HLA-G, LILRB1, and LILRB2 with vitiligo using logistic regression along with adjustment by ancestry. Further, methods based on the multifactor dimensionality reduction (MDR) approach (MDR v.3.0.2, GMDR v.0.9, and MB-MDR) were used to detect potential epistatic interactions between polymorphisms from the three genes. An interaction involving rs9380142 and rs2114511 polymorphisms was identified by all methods used. The polymorphism rs9380142 is an HLA-G 3′UTR variant (+3187) with a well-established role in mRNA stability. The polymorphism rs2114511 is located in the exonic region of LILRB1. Although no association involving this SNP has been reported, ChIP-Seq experiments have identified this position as an EBF1 binding site. These results highlight the role of an epistatic interaction between HLA-G and LILRB1 in vitiligo pathogenesis.
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    Nitrate-rich beet juice intake on cardiovascular performance in response to exercise in postmenopausal women with arterial hypertension: study protocol for a randomized controlled trial
    (2023-12-01) Benjamim, Cicero Jonas R.; Sousa, Yaritza Brito Alves; Porto, Andrey Alves [UNESP]; de Moraes Pontes, Yasmim Mota; Tavares, Simone Sakagute; da Silva Rodrigues, Guilherme; da Silva, Leonardo Santos Lopes; da Silva Goncalves, Leonardo; Guimaraes, Carolina Scoqui; Rebelo, Macário Arosti; da Silva Sobrinho, Andressa Crystine; Tanus-Santos, Jose E.; Valenti, Vitor Engracia [UNESP]; Gualano, Bruno; Bueno Júnior, Carlos Roberto; Universidade de São Paulo (USP); Universidade Estadual Paulista (UNESP); Universidade Estadual de Campinas (UNICAMP)
    Background: There is no evidence of the use of beetroot juice with a previously recommended dose of nitrate (NO3) (> 300 mg) on the cardiovascular performance during and recovery following exercise in postmenopausal women with systemic arterial hypertension (SAH). Methods: We will investigate the effects of beetroot juice rich in NO3 acutely (800 mg) and during a week with daily doses (400 mg) on blood pressure, heart rate (HR), cardiac autonomic control, endothelial function, inflammatory, hormonal, and stress biomarkers oxidative stress and enzymes involved in nitric oxide synthesis and mitochondrial regulation, under resting conditions, as well as mediated by submaximal aerobic exercise sessions. Through a randomized, crossover, triple-blind, placebo-controlled clinical trial, 25 physically inactive women with SAH will undergo an acute and 1-week trial, each with two intervention protocols: (1) placebo and (2) beetroot, in which will ingest beet juice with or without NO3 in its composition with a 7-day washout interval. On collection days, exercise will be performed on a treadmill for 40 min at a speed corresponding to 65–70% of VO2peak. The collection of variables (cardiovascular, autonomic, and blood samples for molecular analyses) of the study will take place at rest (135 min after ingestion of the intervention), during exercise (40 min), and in the effort recovery stage (during 60 min) based on previously validated protocols. The collections were arranged so that the measurement of one variable does not interfere with the other and that they have adequate intervals between them. Discussion: The results of this research may help in the real understanding of the nutritional compounds capable of generating safety to the cardiovascular system during physical exercise, especially for women who are aging and who have cardiovascular limitations (e.g., arterial hypertension) to perform physical exercise. Therefore, our results will be able to help specific nutritional recommendations to optimize cardiovascular health. Trial registration: NCT05384340. Registered on May 20, 2022.
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    Time of clerkship rotations' interruption during COVID-19 and differences on Progress Test's scores
    (2022-01-01) Filho, Pedro Tadao Hamamoto [UNESP]; Moriguti, Júlio César; Ribeiro, Zilda Maria Tosta; Diehl, Leandro; Lopes, Ricardo Dantas; Adler, Ubiratan Cardinalli; De Abreu Lima, Alba Regina; De Oliveira, Rodrigo Cardoso; De Andrade, Maria Cristina; Bicudo, Angélica Maria; Universidade Estadual Paulista (UNESP); Universidade de São Paulo (USP); Marília Medical School; Universidade Estadual de Londrina (UEL); Center of Health Sciences; Universidade Federal de São Carlos (UFSCar); Medical School - São José Do Rio Preto (SP); Universidade Federal de São Paulo (UNIFESP); Universidade Estadual de Campinas (UNICAMP)
    OBJECTIVES: The transition from face-to-face to remote teaching is yet to be fully understood. In clinical training, traditional teaching must prevail because it is essential for the acquisition of skills and professionalism. However, the responses of each school to the pandemic and the decision on when to resume clerkship rotations were mixed. In this study, we aimed to analyze whether the time to resume clerkship rotations was associated with the performance of the students by using a multi-institutional Progress Test. METHODS: This is a cross-sectional study conducted at nine different Brazilian medical schools that administer the same annual Progress Test for all students. We included information from 1,470 clerkship medical students and analyzed the time of clinical training interruption as the independent variable and the student's scores as the dependent variable. RESULTS: The comparisons of the students' scores between the schools showed that there are differences; however, they cannot be attributed to the time the clerkship rotations were paused. The correlation between the schools' average scores and the time to resume clerkship rotations was not significant for the fifth year (r= -0.298, p=0.436) and for the sixth year (r= -0.440, p=0.240). By using a cubic regression model, the time to resume clerkship rotations could explain 3.4% of the 5-year students' scores (p<0.001) and 0.9% of the 6-year students, without statistical difference (p=0.085). CONCLUSIONS: The differences between the students' scores cannot be attributed to the time when the schools paused the clerkship rotations.
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    Comparative study between apocynin and protocatechuic acid regarding antioxidant capacity and vascular effects
    (2022-11-15) Graton, Murilo E. [UNESP]; Ferreira, Bruno H. S. H. [UNESP]; Troiano, Jéssica A. [UNESP]; Potje, Simone R.; Vale, Gabriel T.; Nakamune, Ana Cláudia M. S. [UNESP]; Tirapelli, Carlos R.; Miller, Francis J.; Ximenes, Valdecir F. [UNESP]; Antoniali, Cristina [UNESP]; Universidade Estadual Paulista (UNESP); Faculdades de Dracena (UNIFADRA); Universidade Estadual de Maringá (UEM); Universidade de São Paulo (USP); Vanderbilt University
    Reactive oxygen species (ROS) derived from NOX enzymes activity play an important role in the development of cardiovascular diseases. Compounds able to decrease oxidative stress damage are potential candidates as drugs and/or supplements for hypertension treatment. Here, we aimed to compare in vitro ROS scavenging potency, effective NOX inhibition and effects on vascular reactivity of apocynin to another phenolic compound, protocatechuic acid, in vascular cells from spontaneously hypertensive rat (SHR), where redox signaling is altered and contributes to the development and/or maintenance of hypertension. We evaluated the in vitro antioxidant capacity and free radical scavenging capacity of both phenolic compounds. Moreover, we investigated the effect of both compounds on lipid peroxidation, lucigenin chemiluminescence, nitric oxide (NO•) levels and ROS concentration in vascular cells of SHR or human umbilical vein endothelial cell (HUVEC). Apocynin and protocatechuic acid presented antioxidant capacity and ability as free radical scavengers, decreased thiobarbituric acid reactive substances (TBARS) in aortic cells from SHR, and increased NO• concentration in isolated HUVEC. Both compounds were able to reduce lucigenin chemiluminescence and increased the potency of acetylcholine in aorta of SHR. However, in SHR aortas, only apocynin diminished the contraction induced by phenylephrine. In conclusion, these results strongly reinforce the potential application of substances such as apocynin and protocatechuic acid that combine abilities as scavenging and/or prevention of ROS generation, establishment of NO bioactivity and modulation of vascular reactivity. Due to its phytochemical origin and low toxicity, its potential therapeutic use in vascular diseases should be considered.
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    Protective measures feasibility for infants of low-income SARS-CoV-2 positive breastfeeding mothers: A prospective multicentre cohort study
    (2022-11-01) Gonçalves-Ferri, Walusa Assad; Coca, Kelly Pereira; Martins-Celini, Fábia Pereira; Chang, Yan-Shing; Ferreira, Raquel Santos; de Siqueira Caldas, Jamil Pedro; Ferreira, Rodrigo Duarte; Marques, Patrícia Franco; Sonini, Thaise Cristina Branchee; Moraes, Viviane Christina Cortez; de Carvalho Pelicia, Simone Manso [UNESP]; Nunes, Leandro Meireles; Contrucci, Bruno Antunes; Suzuki, Edson Koji; Magalhães, Maurício; de Jesus Hartmann Nader, Paulo; de Lima Mota Ferreira, Daniela Marques; Javorsky, Juliane Barleta; de Fátima Afonso Dias, Laura; Cavasin, Bruna Pinto Dias; de Mesquita, Ana Ruth Antunes; de Oliveira Pinto, Rebecca Meirelles; Fonseca, Luciana Mara Monti; da Silva Gherardi-Donato, Edilaine Cristina; Aragon, Davi Casale; Roosch, Anelise; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP); King's College London; Universidade Estadual de Campinas (UNICAMP); Faculdade de Medicina da Universidade do Estado do Amazonas; Universidade Federal do Maranhão; Hospital Maternidade Carmela Dutra; Maternidade Perinatal Laranjeiras; Universidade Estadual Paulista (UNESP); Universidade Federal do Rio Grande do Sul; Faculdade de Medicina de São José do Rio Preto; Hospital das Clínicas da Faculdade de Medicina de Marília; Faculdade de Ciências Médicas da Santa Casa de São Paulo; Universidade Luterana do Brasil; Universidade Federal de Uberlândia (UFU); Universidade Federal do Paraná (UFPR); Campos dos Goytacazes
    Aim: The aim was to evaluate the feasibility of protective measures for infants of low-income SARS-CoV-2 positive breastfeeding mothers. Background: Breastfeeding mothers with SARS-CoV-2 positive should avoid exposing the infant through protective measures (PM), but it could be challenging in a low-income population. Methods: A prospective, multicentre study was conducted between July and October 2020 (BRACOVID). The participants were recruited at birth and interviewed through a structured questionnaire at 7 and 14 days in the home environment. The feasibility of PM during breastfeeding at home was defined by guidelines recommendations (mask using, handwashing, and distancing from newborn when not breastfeeding). Three groups according to the feasibility of guidelines: complete guidelines feasibility (CG): all PM; partial guidelines feasibility (PG): at least one PM feasible; no guidelines (NG): infeasibility to all of PM. Flu-like neonatal symptoms and breastfeeding practices were analyzed. We evaluated the association between PM feasibility and socioeconomic factors. Results: One hundred seventeen infected mothers from 17 Brazilian hospitals were enrolled. Forty-seven (40%) mothers followed all recommendations, 14 (11.9%) could not practice at least one recommendation, and 50 (42.7%) did not execute any of them. The breastfeeding rate was 98%. Factors associated with infeasibility were monthly family income <92.7 dollars/person, high housing density (>1 inhabitant/room), teenage mothers, responsive feeding, and poor schooling. Regarding infants' flu-like symptoms, 5% presented symptoms at 14 days (NG group). Conclusion: The guidelines were not applied to infants of SARs-CoV-positive mothers in 54.6% of the dyads since the recommendations were unviable in their environments. During pandemics, we should look for feasible and effective guidelines to protect neonates from low-income populations. Implications for Nursing Management: Poor socioeconomic conditions lead to the unfeasibility of protective measures for infants of low-income SARS-CoV-2 positive breastfeeding mothers during the isolation period in the pandemics. The orientations and the support provided to dyad should consider the socioeconomic factors to guide feasible measures in the home environment and promote adequate protections; only an individual approach will allow a safe environment for low-income infants. The Research Ethics Committee approved the project of the Medicine School in Ribeirão Preto, University of São Paulo, Brazil (CAAE: 31357320.9.1001.5440-4.066.741/2020) and Brazilian hospitals and maternal services.
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    Exploring the COVID-19 Pandemic's Impact on the Health Technology Assessment Process of the National Commission for the Incorporation of Technologies Into the Brazilian Health System
    (2023-09-01) Cardoso, Marilia Mastrocolla de Almeida [UNESP]; Thabane, Lehana [UNESP]; Andrade, Luis Gustavo Modelli de [UNESP]; Curado, Daniel da Silva Pereira; Komoda, Denis Satoshi; Machado-Rugolo, Juliana; Lima, Silvana Andrea Molina [UNESP]; Weber, Silke Anna Theresa [UNESP]; Brazil; Universidade Estadual Paulista (UNESP); McMaster University; St Joseph's Healthcare Hamilton; University of Johannesburg; Universidade Estadual de Campinas (UNICAMP)
    Objectives: This study aimed to evaluate the impact of the COVID-19 pandemic on Brazilian health technology assessment processes based on public reports from the National Committee for Health Technology Incorporation (CONITEC). Methods: This descriptive study analyzed CONITEC's official reports on Brazil available on its website between 2018 and 2021 that aimed to propose recommendations for technologies to be incorporated into its public healthcare system. We used descriptive statistics covering the number of technologies and number of reports about drugs per year, objective, type of technology, demanding sector, and outcome before 2018 to 2019 and during the COVID-19 pandemic (2020-2021). Furthermore, we used logistic regression to explore any association between the final decision labeled as “incorporated” and the emergence of the COVID-19 pandemic. Results: A total of 278 reports were analyzed. Approximately 85% (136 of 278), 79% (220 of 278), and 45% of the reports (125 of 278) were about drugs, for incorporation, and requested by the government, respectively. Moreover, 74 of 130 (57%) and 56 of 148 decisions (38%) were “incorporated” before and during the pandemic, respectively. No significant association was noted between incorporated decisions and the arrival of the COVID-19 pandemic for all technologies (odds ratio 1.43; 95% CI 0.84-2.46; P = .192) and for drugs (odds ratio 1.43; 95% confidence interval 0.81-2.53; P = .223) while adjusting for the type of technology and demandant. Conclusions: The COVID-19 pandemic has brought many challenges, but it does not seem to have had a significant impact on the health technology assessment approval decisions of CONITEC in Brazil.
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    Factors of a social nature associated with prematurity risk in a city in São Paulo
    (2023-01-01) da Cruz, Aline Adryane Morishigue Bássiga [UNESP]; dos Santos, Lucas Cardoso [UNESP]; de Oliveira Minharro, Michelle Cristine; Romanholi, Renata Maria Zanardo [UNESP]; Prearo, Alice Yamashita [UNESP]; Alencar, Rúbia Aguiar [UNESP]; Universidade Estadual Paulista (UNESP); Universidade Nove de Julho
    Objective: To identify the associations of factors of a social nature with prematurity. Methos: This is a cross-sectional study with a correlational method, carried out from a database of a medium-sized municipality in the countryside of São Paulo, containing information on all newborns from January 2018 to July 2020, aimed at the identification of social and biological risks after birth. Results: The analysis included 4,480 newborns, of which 78.9% were classified as usual-risk babies and 21.1% as at-risk babies. Among the risk factors of a social nature for newborns analyzed in the present study, there was a higher prevalence of newborns whose head of household had no income, had mothers under 16 years of age, a dead sibling aged less than 5 years and mothers who did not undergo prenatal care, with the last two having association with prematurity. Conclusion: Factors of a social nature were associated with prematurity. This study made it possible to improve the newborn surveillance database, facilitating the elaboration and planning of health care.
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    Technological strategies aimed at fall prevention in hospital environments: an integrative review
    (2023-01-01) Alves, Renata Camargo [UNESP]; Colichi, Rosana Maria Barreto [UNESP]; Lima, Silvana Andrea Molina [UNESP]; Universidade Estadual Paulista (UNESP)
    Objective: To identify the knowledge produced about technological strategies aimed at fall prevention of adults in hospital environments. Methods: This is an integrative literature review conducted in the Medical Literature Analysis and Retrieval System Online/National Library of Medicine (MEDLINE/PubMed), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Latin American and Caribbean Literature in Health Sciences (LILACS), Scopus and Web of Science databases published from 2017 to 2022. Results: A total of 19 articles were included, most of them published in nursing journals (42%). The themes that emerged from the analysis were: types of technological strategies, costs, patient privacy and nursing professionals' relevance in device development, assessment and use. Conclusion: The research revealed a range of technological resources aimed at fall prevention available in the market that can be incorporated into care practices. Hospitals must define which strategy applies most appropriately to their reality.
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    Spiritual/religious coping strategies and religiosity of patients living with cancer in palliative care
    (2023-04-02) Meneguin, Silmara [UNESP]; Pollo, Camila Fernandes [UNESP]; deSousa Matos, Ticiane Dionízio [UNESP]; Vitória, Amanda [UNESP]; Segalla, Zorzi [UNESP]; Jaqueline, Fary [UNESP]; Generoso, Fortaleza [UNESP]; de Oliveira, Cesar; Universidade Estadual Paulista (UNESP); University College London
    Background: The palliative care provided to cancer patients should also contemplate the psychological and spiritual dimensions of care. Aims: This study aimed to compare religiosity and spiritual/religious coping (SRC) of cancer patients in palliative care with a group of healthy volunteers and determine whether sociodemographic characteristics affected this association. Methods: This was a case-control study conducted with 86 patients living with cancer from an outpatient palliative care clinic of the São Paulo State University (UNESP) medical school, Botucatu, Brazil and 86 healthy volunteers.The brief Spiritual/Religious Coping Scale (SRCOPE) and the Duke University Religion (DUREL) Index were used as a brief measure of ‘religiosity’. Results: All 172 participants reported to be religious and, overall, made very little use of SRC strategies. DUREL scores were negatively associated with religious practice (P<0.01) and positive SRC (P<0.01). Age was associated with non-organisational religious activities and intrinsic religiosity (P<0.01); and income was associated with intrinsic religiosity (P<0.04). Positive SRC was negatively associated with the palliative group (P=0.03) and DUREL index (P<0.01). Negative SRC was positively associated with the palliative group (P=0.04) and negatively associated with education level (P=0.03) and practice of religion (P<0.01). Conclusion: All participants reported to be religious; however, their use of SRC strategies was very low. Positive religious coping was the most prevalent score. Negative religious coping was more common in the palliative care group compared to healthy volunteers. There is an association between religious coping and religiosity in palliative cancer care patients.
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    Intakes of Unprocessed and Minimally Processed and Ultraprocessed Food Are Associated with Diet Quality in Female and Male Health Professionals in the United States: A Prospective Analysis
    (2023-01-01) Rossato, Sinara Laurini; Khandpur, Neha; Lo, Chun-Han; Jezus Castro, Stela Maris; Drouin-Chartier, Jean Philippe; Sampson, Laura; Yuan, Changzheng; Murta-Nascimento, Cristiane [UNESP]; Carvalhaes, Maria Antonieta [UNESP]; Monteiro, Carlos Augusto; Sun, Qi; Fung, Teresa T.; Willett, Walter C.; Universidade Federal de Uberlândia (UFU); Harvard T.H. Chan School of Public Health; Universidade de São Paulo (USP); Massachusetts General Hospital and Harvard Medical School; Universidade Federal do Rio Grande do Sul; Québec; Ferdinand Vandry Pavillon; Brigham and Women's Hospital and Harvard Medical School; Zhejiang University School of Medicine; Universidade Estadual Paulista (UNESP); Simmons College
    Background: High unprocessed and minimally processed food (UMP) intake has been associated with high-quality diets, whereas the opposite has been shown for ultraprocessed food (UPF). Nevertheless, the association between UMP and UPF consumption and diet quality over the long-term warrants further examination. Objective: This study aimed to assess whether UMP and UPF intake are associated with three diet-quality metrics in female and male health professionals from two US cohorts over 3 decades of follow-up. Design: This was a cohort study, including data from the Nurses’ Health Study (NHS), from 1986 to 2010 (N = 51,956) and the Health Professionals Follow-up Study (HPFS) from 1986 to 2006 (n = 31,307). Participants and setting: Participants were invited in 1976 (NHS) and 1986 (HPFS) to respond to mailed questionnaires every 2 to 4 years and diet was assessed with a semi-quantitative food frequency questionnaire every 4 years. Main exposure measures: UMP and UPF intake were calculated using the NOVA classification. Statistical analyses: Generalized estimating equations for marginal means and repeated cross-sectional associations between diet-quality metrics and quintiles of UMP and UPF. Diets were assessed every 4 years from 1986 to 2010. Results: With increasing quintiles of UMP intakes, the Alternate Healthy Eating Index-2010 increased 7.1% (3.80 points, 95% CI 3.66 to 3.93) in the NHS and 10.1% (5.75 points, 95% CI 5.52 to 5.98) in the HPFS; the Mediterranean diet index increased 11.7% (0.50 points, 95% CI 0.47 to 0.52) in the NHS and 14.0% (0.64 points, 95% CI 0.60 to 0.68) in the HPFS; and the Dietary Approaches To Stop Hypertension diet score increased 7.5% (1.81 points, 95% CI 1.76 to 1.87) in the NHS and 10.6% (2.66 points, 95% CI 2.57 to 2.76) in the HPFS. In the fifth quintile of UPF intake compared with the first, the Alternate Healthy Eating Index-2010 was –9.3% (–4.60 points, 95% CI –4.73 to –4.47) lower in the NHS and –13.7% (–6.89 points, 95% CI –7.12 to –6.66) lower in the HPFS; the Mediterranean diet index was –14.7% (–0.55 points, 95% CI –0.57 to –0.53) lower in the NHS, and –19.0% (–0.74 points, 95% CI –0.78 to –0.70) lower in the HPFS; and the Dietary Approaches To Stop Hypertension diet score was –8.1% (–1.81 points, 95% CI –1.86 to –1.76) lower in the NHS and –12.8% (–2.84 points, 95% CI –2.93 to –2.74) lower in the HPFS. Conclusions: Consumption of UMP was associated with better dietary quality, whereas consumption of UPF was associated with poorer dietary quality.