Effects of the timing of satisfactory sedation with preoperative oral midazolam on anesthesia induction and recovery in children undergoing adenotonsillectomy / 中国临床药理学与治疗学

AIM: To investigate the effect of the timing of satisfactory sedation with preoperative oral midazolam on anesthesia induction and recovery in children undergoing adenotonsillectomy. METHODS: A total of 147 children undergoing elective adenotonsillectomy, with ASA physical status orⅡ, aged 2-7 years were selected from November 2022 to June 2023 in the Second Affiliated Hospital of Wenzhou Medical University. The children were orally administered 0.5 mg/kg midazolam in preoperative waiting area and were divided into 10-20 min (rapid onset, M1 group) and 21-30 min (slow onset, M2 group) based on the satisfactory sedation time, or equal volume of sugar pear drink orally (blank control group, C group). Children in all three groups received a general anesthesia method of propofol+fentanyl combined with sevoflurane induction and sevoflurane maintenance. The primary outcome measures were the induction compliance checklist (ICC) score and the pediatric anesthesia emergence delirium (PAED) score in the post-anesthesia care unit (PACU) to assess the occurrence of emergence agitation (EA), and the secondary outcome measures included the parental separation anxiety scale (PSAS), sedation Ramsay score, surgery duration, recovery time, PACU stay time, discharge time, the incidence of perioperative respiratory adverse events (PRAE) and other adverse events in the ward. RESULTS: 147 children were included in the result analysis, with 49 cases in each group. The proportion of perfect induction (ICC=0) were significantly higher in two M groups than that in group C (95.9% vs. 91.8% vs. 61.2%, P=0.001). The maximum and average PAED score in PACU in group M1 showed a significantly higher (6.4±5.0 vs. 4.4 ± 4.1, P=0.029; 5.2 ± 4.5 vs. 3.4 ± 3.6, P=0.030), and the incidence of EA was significantly higher than those in group C (10.2% vs. 30.6%, P=0.022), and increased compared to the group M2 (OR= 0.581, 95%CI 0.231-1.463, P=0.354). There was no statistically significant difference in the maximum and average PAED scores, incidence of EA between group M2 and group C (P>0.05). The Ramsay score and PSAS score in two M groups were higher, PACU stay time and recovery time was longer than those in group C (P0.05). CONCLUSION: Preoperative oral midazolam can improve the ICC and PSAS scores of children during induction, but it also leads to prolonged recovery time and PACU retention time. The rapid onset of midazolam did not result in better induction and recovery quality, but instead increased the incidence of EA and postoperative pain score.

Methodology for the Development of Clinical Practice Guidelines for Chinese Patent Medicine （Part 7）： Introduction and Interpretation of the Guideline Reporting Checklist / 中医杂志

The systematic and comprehensive introduction and interpretation of the Reporting Checklist of Clinical Practice Guidelines for Chinese Patent Medicines V1.0 is conducive to the presentation of high-quality clinical practice guidelines for Chinese patent medicines （CPMs）， thus improving their dissemination and use. The Reporting Checklist of Clinical Practice Guidelines for Chinese Patent Medicines V1.0 specifies the requirements for clear， complete and transparent reporting of the whole process of developing CPMs guidelines， containing 4 domains， 17 topics and 43 items， and involving the basic information， recommendations and methods of guideline development. Especially， it details the items related to the rules and regulations of the use of CPMs in the recommendations， which is helpful for improving the completeness， scientificity and practicality of the reporting of CPMs guideline.

Alta hospitalar de pacientes adultos e idosos: elaboração e validação de checklist / Alta hospitalaria de pacientes adultos y mayores: elaboración y validación de checklist / Hospital discharge of adults and older adults: checklist elaboration and validity

Resumo Objetivo Descrever a elaboração e a validação do conteúdo de um checklist para o preparo da alta hospitalar de pacientes adultos e idosos. Métodos Estudo metodológico desenvolvido de maio de 2020 a setembro de 2022 (em duas etapas) para elaboração e validação do checklist. Foi usada a técnica Delphi, com avaliação por um comitê de especialistas para validação de conteúdo. Para o cálculo do grau de concordância, utilizou-se a taxa de concordância e o Índice de Validade de Conteúdo (IVC). Resultados Foi elaborado e validado um checklist com 17 itens que ajudam a organizar a alta hospitalar. O checklist foi elaborado partindo da compilação dos resultados obtidos em entrevistas realizadas com os profissionais de uma equipe multidisciplinar, os quais atuavam em unidades de internação, revisão integrativa sobre a transição do cuidado na alta hospitalar de pacientes adultos e leitura de artigos sobre o uso de checklist para a alta. Na primeira etapa de validação, foi obtida uma média para a taxa de concordância, para abrangência (94%) e pertinência (91%) do instrumento. Ao final da segunda rodada, foi obtida a média do cálculo do IVC (clareza: 0,95; pertinência: 0,96). Conclusão O checklist foi validado quanto ao seu conteúdo por consenso pelo comitê de especialistas, podendo ser utilizado por equipes assistenciais ou de gestão de altas hospitalares.

Resumen Objetivo Describir la elaboración y la validación del contenido de una checklist para la preparación del alta hospitalaria de pacientes adultos y mayores. Métodos Estudio metodológico llevado a cabo de mayo de 2020 a septiembre de 2022 (en dos etapas) para la elaboración y validación de la checklist. Se utilizó el método Delphi, con evaluación realizada por un comité de especialistas para la validación de contenido. Para calcular el nivel de concordancia, se utilizó el índice de concordancia y el Índice de Validez de Contenido (IVC). Resultados Se elaboró y validó una checklist con 17 ítems que ayudan a organizar el alta hospitalaria. La checklist fue elaborada a partir de la compilación de los resultados obtenidos en entrevistas realizadas a profesionales de un equipo multidisciplinario que trabajaban en unidades de internación, de revisiones integradoras sobre la transición del cuidado en el alta hospitalaria de pacientes adultos y de la lectura de artículos sobre el uso de checklists para el alta. En la primera etapa de validación, se obtuvo un promedio del índice de concordancia, respecto al alcance (94 %) y pertinencia (91 %) del instrumento. Al final de la segunda ronda, se obtuvo el promedio del cálculo del IVC (claridad: 0,95; pertinencia: 0,96). Conclusión La checklist fue validada en cuanto a su contenido por consenso del comité de especialistas y puede ser utilizada por equipos asistenciales o de gestión de altas hospitalarias.

Abstract Objective To describe content elaboration and validity of a checklist for preparing adults and older adults for hospital discharge. Methods This is a methodological study, developed from May 2020 to September 2022 (in two stages), for checklist elaboration and validity. The Delphi technique was used, with assessment by an expert committee for content validity. To calculate the degree of agreement, the agreement rate and the Content Validity Index (CVI) were used. Results A checklist with 17 items that help organize hospital discharge was prepared and validated. The checklist was prepared based on the compilation of results obtained from interviews with multidisciplinary team professionals, who worked in inpatient units, an integrative review on transition of care at hospital discharge of adult patients and reading of articles on the use of discharge checklist. In the first stage of validity, a mean was obtained for the instrument's agreement rate, scope (94%) and relevance (91%). At the end of the second round, the mean CVI calculation was obtained (clarity: 0.95; relevance: 0.96). Conclusion The checklist was validated as to its content by consensus by an expert committee, and can be used by care teams or hospital discharge management.

Safe practices for bed bathing in the intensive care unit: validation of a checklist / Prácticas seguras para baño en el lecho en la unidad de cuidados intensivos: validación de un checklist / Práticas seguras para banho no leito na unidade de terapia intensiva: validação de um checklist

ABSTRACT Objective: To validate a checklist for safe bathing in critically ill patients. Methods: This is a methodological and quantitative study. Researchers developed a checklist for safe bathing in critically ill patients consisting of 41 items, which were submitted to the apparent and content validation process, evaluated by eleven judges, and interobserver reliability. For reliability analysis, the instrument was applied in 54 bed bath procedures in the ICU; Kappa and CHF tests were used. Results: In the apparent and content validation, adjustments were made according to the judges' suggestions. Kappa values ranged from moderate to almost perfect (0.462 to 0.962), and, in some items, there was 100% agreement; the reliability of the instrument was excellent (ICC = 0.962). Conclusion: The instrument proved to be dependable and easy to apply. Its use will contribute to safe bed bathing and subsidize interventions aimed at increasing the quality of care.

RESUMEN Objetivo: Validar lista de verificación para el baño seguro en pacientes críticos. Métodos: Estudio metodológico y cuantitativo. Se elaboró una lista de verificación para baño seguro en paciente crítico compuesta por 41 ítems, que fue sometida al proceso de validación aparente y de contenido, evaluada por 11 jueces, y confiabilidad interobservadores. Para el análisis de confiabilidad, el instrumento fue aplicado en 54 procedimientos de baño en el lecho en UTI; utilizados las pruebas de Kappa e ICC. Resultados: En la validación aparente y de contenido, fueron realizados ayustes conforme sugestiones de los jueces. Los valores de Kappa variaron de moderado a casi perfecto (0,462 a 0,962); y, en algunos ítems, hubo 100% de concordancia; la confiabilidad del instrumento fue excelente (ICC = 0,962). Conclusión: El instrumento se demostró confiable y de fácil aplicación. Su utilización contribuirá para el baño en el lecho seguro y subsidiará intervenciones que objetiven aumentar la calidad asistencial.

RESUMO Objetivo: Validar uma lista de verificação para o banho seguro em pacientes críticos. Métodos: Estudo metodológico e quantitativo. Elaborou-se uma lista de verificação para banho seguro no paciente crítico composta por 41 itens, que foi submetida ao processo de validação aparente e de conteúdo, avaliada por 11 juízes, e confiabilidade interobservadores. Para a análise de confiabilidade, o instrumento foi aplicado em 54 procedimentos de banho no leito em UTI; utilizaram-se os testes de Kappa e ICC. Resultados: Na validação aparente e de conteúdo, foram realizados ajustes conforme sugestões dos juízes. Os valores de Kappa variaram de moderado a quase perfeito (0,462 a 0,962); e, em alguns itens, houve 100% de concordância; a confiabilidade do instrumento foi excelente (ICC = 0,962). Conclusão: O instrumento demonstrou-se confiável e de fácil aplicação. Sua utilização contribuirá para o banho no leito seguro e subsidiará intervenções que visem aumentar a qualidade assistencial.

Comprehensive inventory of páramo birds and their habitat affinities in a conservation hotspot, the Macizo del Cajas Biosphere Reserve, southern Ecuador

The páramo ecosystem is a significant centre of Andean bird diversity with high concentrations of threatened species. The Macizo del Cajas Biosphere Reserve's páramos are a district of the biogeographic páramo province of northern Andes and are therefore considered a conservation hotspot with representative bird diversity. To enhance regional conservation efforts, comprehensive inventories of bird species that occupy this páramo are required. We present an updated bird inventory for the páramos of Macizo del Cajas and included validated records from eBird and GBIF databases along with records from continuous monitoring across this páramo landscape for five years. We also provide notes on habitat affinity and important new, rare, restricted range, and threatened birds. We report 112 bird species within the reserve, including five endemics, and three globally and 12 nationally threatened species. Finally, we discuss the use of habitat affinities as indicators of biodiversity patterns in páramo to improve conservation tools for key habitats.

El ecosistema de páramo es un centro importante de diversidad de aves andinas con altas concentraciones de especies amenazadas. Los páramos de la Reserva de la Biosfera Macizo del Cajas son un distrito biogeográfico de la provincia del páramo de los Andes del norte y por tanto, son un punto crítico de conservación con una diversidad de aves representativa. Inventarios exhaustivos de la avifauna que ocupa este páramo son requeridos para asegurar esfuerzos de conservación regional. El presente estudio brinda un inventario actualizado de aves de los páramos del Macizo del Cajas. Se incluyen registros verificados desde eBird y GBIF, así como registros de cinco años continuos de monitoreo a través del paisaje de páramo. Además, se incluyen notas acerca de la afinidad de hábitat y registros importantes, nuevos, raros y de aves amenazadas. En total, se reportan 112 especies de aves dentro de la reserva, incluyen cinco endémicas, tres globalmente amenazadas y 12 a escala nacional. Finalmente, se discute el uso de la afinidad de hábitat como indicador de los patrones de biodiversidad en el páramo para mejorar herramientas de conservación para hábitats clave.

Estudio sobre la salud mental de una población de niños y niñas escolarizados desde la perspectiva epidemiológica / Study on the mental health of a population of school children from an epidemiological perspective

Resumen Se presentan resultados de una investigación empírica sobre problemas comportamentales en niños y niñas escolarizados entre 6 y 11 años. El objetivo principal es describir, desde la perspectiva epidemiológica, los problemas comportamentales de una muestra clínica (N = 395; edad: . = 7.92 y DE = 1.75) y de una muestra no clínica (N = 363; edad: . = 8.78 años y DE = 1.73). Son objetivos específicos el analizar las diferencias por sexo y variables sociodemográficas en ambos contextos: clínico y no clínico. No se efectuó un estudio comparativo entre ambas muestras. Se administró el formulario Child Behaviour Checklist (CBCL) y una encuesta sociodemográfica a los adultos responsables. El análisis cuantitativo se efectuó mediante estudios de frecuencia, distribución y asociaciones entre variables con el objetivo de describir a ambas muestras desde el punto de vista de los resultados del CBCL y de las variables sociodemográficas. Se estudiaron asociaciones entre los valores de las escalas de síndromes del CBCL y las variables sociodemográficas mediante el análisis de la varianza (ANOVA). Se obtuvieron asociaciones estadísticamente significativas entre la presencia de problemas comportamentales y las condiciones socioeconómicas de la familia: a mayor vulnerabilidad socioeconómica y educativa, mayor deterioro en la salud mental infantil. Este estudio se encontró con la dificultad de las restricciones sanitarias por la pandemia de COVID-19 para continuar el trabajo de campo. Interesa replicar el estudio y considerar el impacto de la pandemia y el presunto deterioro de las variables sociodemográficas. Se debe priorizar la continuidad de una indagación sostenida para un seguimiento de la salud mental infantil.

Abstract This article shows the results of an empirical research study on behavioral and emotional problems in schoolchildren between 6 and 11 years old. From an epidemiological perspective the goal is to describe the behavioral problems of a clinical sample (N= 395, age: . = 7.92 y SD = 1.75) and a non-clinical sample (N = 363, age: M = 8.78 años y DE = 1.73). The specific objectives are to analyze the differences by sex and possible sociodemographic variables in both clinical and non-clinical contexts. A comparative study between both samples is not carried out. We administered the Child Behavior Checklist (CBCL) and a sociodemographic survey to the responsible adults. The quantitative analysis was carried out through studies of frequency, distribution and associations among variables in order to describe both samples from the point of view of the CBCL results and of the sociodemographic variables. In order to identify the possible sociodemographic conditioning factors in the childhood and youth psychopathology, we studied the associations among the CBCL syndrome scale scores and the different sociodemographic variables through the analysis of variance (ANOVA). The results of the clinical sample show mental health deterioration in boys and girls compared to previous studies. The increase of the internalizing and externalizing syndrome scores is significant. The prejudices and gender stereotypes constitute obstacles to gain access to mental health services in childhood, especially for girls whose psychological conditions may often go unnoticed. In the non-clinical sample, the gender distribution is even and the total average of average scores is lower compared to studies performed in other populations in previous years. In both samples we observe a significant relation between the psychological and behavioral problems and the socio-economic conditions of the family. The higher the educational and socio-economic vulnerability, the higher the deterioration of the children's mental health. The simultaneous study from the epidemiological perspective in both samples is necessary to detect psychopathological problems in childhood. This study encountered some limitations: the difficulty to continue the field work due to sanitary restrictions because of the COVID-19 pandemic. We want to replicate the study in both samples considering the impact of the pandemic and the alleged deterioration of the sociodemographic variables and family conditions. Another limitation has been the socio-economic homogeneity of the clinical sample. It would be useful in the future to include clinical samples that belong to other socioeconomic sectors who receive mental health care from private medical insurances or medical insurances run by labor unions. The shortage of epidemiological studies on emotional and behavioral problems in children and the lack of research work on the right to receive mental health care in childhood, indicate the absence of this topic in the political agenda. This deficit prevents the implementation of efficient programs to prevent and early detect mental health problems in children, to extend clinical care proposals in the community and to train professionals so that the programs can have an accurate impact on the population. It is a priority to continue the sustained inquiry in both populations in order to ensure the follow-up of the mental health conditions. Also, it would be useful to extend and deepen the analysis incorporating the examination of other family problems such as violence situations, consumption of psychoactive drugs, suicides and other loss situation.

Histological Techniques for the Study of the Dentogingival Junction: A Scoping Review Using the Anatomical Quality Assurance Checklist (AQUA) / Técnicas Histológicas para el Estudio de la Unión Dentogingival: Una Revisión de Alcance Utilizando el Anatomical Quality Assurance Checklist (AQUA)

SUMMARY: The dentogingival junction (DGJ) is an adaptation of the oral mucosa composed of epithelial and connective tissues intimately related with the mineralised tissues of the tooth. The histological evidence available is mainly based on studies in animals, separate evaluations of hard and soft tissues, and studies using conventional histological techniques that eliminate the enamel from preparations. The aim of this study was to carry out a review of the existing evidence on histological techniques available for study of the tooth and periodontium in conjunction in humans. A scoping review was carried out of the available literature referring to study of the tooth and the periodontium in conjunction in humans, in the Web of Science (WoS), EMBASE, Scopus and SciELO databases, using the terms "Histological Techniques"[Mesh]) and "Epithelial Attachment"[Mesh]. One hundred and fifty-nine articles were found, of which 54 were selected for full- text reading. Ten were finally included in the qualitative synthesis, and we applied the Anatomical Quality Assurance (AQUA) checklist for analysis the methodological quality of the selected articles. The results showed that the only articles with a low risk of bias in all five domains according to the AQUA criteria corresponded to Silva et al. (2011) and Agustín-Panadero et al. (2020). Finally, we conclude that the quality of the histological sections to observe tissues that simultaneously contain the tooth and the periodontium, is conditioned by the selected technique and by the care required in certain specific tasks during the histological processing of the samples.

La unión dentogingival (DGJ) es una adaptación de la mucosa oral compuesta por tejidos epitelial y conectivo íntimamente relacionados con los tejidos mineralizados del diente. La evidencia histológica disponible se basa principalmente en estudios en animales, evaluaciones separadas de tejidos duros y blandos y estudios utilizando técnicas histológicas convencionales que eliminan el esmalte de las preparaciones. El objetivo de este estudio fue realizar una revisión de la evidencia existente sobre las técnicas histológicas disponibles para el estudio del diente y el periodonto en conjunto en humanos. Se realizó un scoping review de la literatura disponible referente al estudio del diente y el periodonto en conjunto en humanos, en las bases de datos Web of Science (WoS), EMBASE, Scopus y SciELO, utilizando los términos "Histological Techniques"[Mesh]) y "Epithelial Attachment"[Mesh]. Se encontraron 159 artículos, de los cuales 54 fueron seleccionados para lectura de texto completo. Diez fueron finalmente incluidos en la síntesis cualitativa, y se aplicó la lista de verificación Anatómica Quality Assurance (AQUA) para el análisis de la calidad metodológica de los artículos seleccionados. Los resultados mostraron que los únicos artículos con bajo riesgo de sesgo en los cinco dominios según los criterios AQUA correspondían a Silva et al. (2011) y Agustín-Panadero et al. (2020). Finalmente, concluimos que la calidad de los cortes histológicos para observar los tejidos que contienen simultáneamente el diente y el periodonto, está condicionada por la técnica seleccionada y por el cuidado requerido en ciertas tareas específicas durante el procesamiento histológico de las muestras.

Utility of the Teacher Behavior Checklist beyond Psychology Majors: Replication with Brazilian Physical Education Students / Utilidad del Teacher Behavior Checklist más allá de la psicología: replicación con estudiantes brasileños de educación física

Abstract The Teacher Behavior Checklist (TBC) is a worldwide valued instrument to measure teachers' performance. Nonetheless, the studies about TBC in Brazil are still scarce, with samples mainly composed of psychology and civil engineering students. The aim of this study was to replicate the research by Keeley et al. (2010) to evaluate the psychometric properties of the Brazilian version of the TBC with a new sample. Participants were 107 undergraduates from physical education courses from a Brazilian public university. Participants used the TBC to evaluate three types of teachers: the worst they had ever had, a regular one, and the best one. The order of evaluation of teacher types did not interfere with the response patterns, but as expected, statistically significant differences were found among the three types of teachers. Additionally, the two-factor model of the TBC was confirmed through Confirmatory Factor Analysis, providing additional evidence of construct validity. However evidence to advocate in favor of a one-factor solution was also found. McDonald's Omega results provided evidence of reliability. These findings support the use of TBC in the formative evaluation of teachers in Brazil.

Resumen The Teacher Behavior Checklist (TBC) es un instrumento valorado en todo el mundo para medir el desempeño de los profesores. Sin embargo, los estudios sobre el TBC en Brasil siguen siendo escasos, con muestras compuestas principalmente por estudiantes de psicología e ingeniería civil. El objetivo de este estudio fue replicar la investigación de Keeley et al. (2010) para evaluar las propiedades psicométricas de la versión brasileña del Teacher Behavior Checklist (TBC) con una nueva muestra. Participaron 107 estudiantes de educación física de una universidad pública brasileña. Los participantes utilizaron el TBC para evaluar tres tipos de profesores: el peor que hayan tenido, uno regular y el mejor. El orden de evaluación de los tipos de docentes no interfirió con los patrones de respuesta, pero como se esperaba, encontramos diferencias estadísticamente significativas entre los tres tipos de docentes. Además, el modelo de dos factores del TBC se confirmó a través de un análisis factorial confirmatorio, proporcionando evidencia adicional de validez de la construcción. No obstante, también encontramos evidencia para abogar a favor de una solución de un factor. Los resultados del Omega de McDonald indicaron evidencia de confiabilidad. Estos hallazgos apoyan el uso de TBC en la evaluación formativa de los docentes en Brasil.

Effectiveness of checklist in objective structured practical examination as teaching tool for learning practical physiology

Background: Objective structured practical examination (OSPE) is becoming popular as an assessment tool among pre and paraclinical departments. Checklist being the important component of OSPE, which can set out skills, attitudes, strategies, and offers ways to systematically organize information that student needs to learn. Traditional demonstration (TD) with its own drawback makes us to look for newer teaching method of objective learning, which checklist of OSPE can serve. Hence, we intend to know whether the checklist of OSPE can be used as a tool for teaching practical physiology. Aims and Objectives: The aim of the study was to compare effectiveness of using checklist of OSPE and TD in teaching practical physiology and to evaluate the perception of students and faculty regarding checklist of OSPE as teaching tool. Materials and Methods: Sixty First MBBS students were sensitized to both checklist of OSPE and TD for six physiology practical sessions in two groups. Crossover was done between the groups for checklist of OSPE and TD. Marks obtained in OSPE were compared. Feedback was given to students about their performance after their OSPE assessment. Student’s and faculty’s perception on use of checklist of OSPE as teaching tool were obtained using questionnaires. Results: The mean marks scored in OSPE were compared using unpaired t-test. The total mean scores following the sensitization with checklist of OSPE were 53.36 ± 4.78 and with TD were 47.01 ± 5.52 and P value < 0.001, which was highly significant. The students and faculty felt that checklist of OSPE pattern was more objective, helped to learn clinical skills and knowledge better. Conclusions: Checklist of OSPE is a better tool to teach practical and clinical skills in physiology as it is more reliable, objective, and also helps to self-assess different aspects of knowledge.

Segurança do paciente cirúrgico pediátrico: uma revisão integrativa / Pediatric surgical patient safety: an integrative review / Seguridad del paciente quirúrgico pediátrico: una revisión integradora

No cuidado de enfermagem ao paciente cirúrgico pediátrico o checklist de cirurgia segura deve ser empregado, contribuindo para que as etapas do preparo e promoção de cirurgia segura sejam realizadas. O objetivo deste estudo foi conhecer a produção científica nacional de enfermagem sobre cirurgia segura do paciente pediátrico. Trata-se de uma revisão integrativa. A coleta de dados ocorreu nos meses de agosto e setembro de 2022, por meio da Biblioteca Virtual em Saúde e da base de dados Scientific Electronic Library Online (SciELO). É crescente a publicação sobre o tema. Pesquisas sobre a elaboração e validação de lista de verificação predominaram na amostra selecionada. O estudo revela que a implementação do checklist em cirurgias pediátricas merece destaque nas instituições de saúde que prestam atendimento ao paciente perioperatório. Este instrumento proporciona a verificação dos pontos críticos da assistência durante o processo cirúrgico, incorporando as boas práticas na rotina da equipe multidisciplinar.

In nursing care for pediatric surgical patients, the safe surgery checklist should be used, contributing to the steps of safe surgery preparation and promotion. The objective of this study was to know the national scientific nursing production on safe surgery for pediatric patients. This is an integrative review. Data collection took place in August and September 2022, through the Virtual Health Library and the Scientific Electronic Library Online (SciELO) database. There is a growing number of publications on the subject. Research on the creation and validation of checklists predominated in the selected sample. The study reveals that the implementation of the checklist in pediatric surgeries should be highlighted in health institutions providing perioperative patient care. This instrument provides verification of the critical points of assistance during the surgical process, incorporating good practices into the routine of the multidisciplinary team.

En el cuidado de enfermería al paciente quirúrgico pediátrico, se debe utilizar la lista de verificación de cirugía segura, que contribuye a los pasos de preparación y promoción para que se realice la cirugía segura. El objetivo fue conocer la producción científica nacional de enfermería sobre cirugía segura para pacientes pediátricos. Es una revisión integradora. La recolección de datos ocurrió en agosto y septiembre de 2022, a través de la Biblioteca Virtual en Salud y la base de datos Scientific Electronic Library Online. Es creciente el número de publicaciones sobre el tema. En la muestra predominó la investigación sobre la creación y validación de listas de cotejo. La implementación de la lista de verificación en las cirugías pediátricas merece ser destacada en las instituciones de salud que brindan atención al paciente. Lo que permite revisar puntos críticos de asistencia durante el proceso quirúrgico, incorporando las buenas prácticas a la rutina del equipo multidisciplinario.

Fitness checklist model for spontaneous breathing tests in pediatrics / Modelo de checklist de, aptidão para teste de respiração espontânea em pediatria

ABSTRACT Objective: To evaluate whether a model of a daily fitness checklist for spontaneous breathing tests is able to identify predictive variables of extubation failure in pediatric patients admitted to a Brazilian intensive care unit. Methods: This was a single-center, cross-sectional study with prospective data collection. The checklist model comprised 20 items and was applied to assess the ability to perform spontaneous breathing tests. Results: The sample consisted of 126 pediatric patients (85 males (67.5%)) on invasive mechanical ventilation, for whom 1,217 daily assessments were applied at the bedside. The weighted total score of the prediction model showed the highest discriminatory power for the spontaneous breathing test, with sensitivity and specificity indices for fitness failure of 89.7% or success of 84.6%. The cutoff point suggested by the checklist was 8, with a probability of extubation failure less than 5%. Failure increased progressively with increasing score, with a maximum probability of predicting extubation failure of 85%. Conclusion: The extubation failure rate with the use of this model was within what is acceptable in the literature. The daily checklist model for the spontaneous breathing test was able to identify predictive variables of failure in the extubation process in pediatric patients.

RESUMO Objetivo: Avaliar se um modelo de checklist diário de aptidão para o teste de respiração espontânea é capaz de identificar variáveis preditivas de falha no processo de extubação em pacientes pediátricos internados em uma unidade de terapia intensiva brasileira. Métodos: Estudo unicêntricotransversal, com coleta prospectiva de dados. O modelo de checklist foi elaborado com 20 itens e aplicado para avaliação de aptidão para o teste de respiração espontânea. Resultados: A amostra foi composta de 126 pacientes pediátricos em ventilação mecânica invasiva, 85 do sexo masculino (67,5%), para os quais foram aplicadas 1.217 avaliações diárias à beira do leito. A pontuação total ponderada do modelo de predição apresentou o maior poder de discriminação para a realização do teste de respiração espontânea, com índices de sensibilidade e especificidade para a falha de aptidão de 89,7% ou sucesso de 84,6%. O ponto de corte sugerido pelo checklist foi 8, com probabilidade de falha de extubação inferior a 5%. Observou-se que a falha aumentou progressivamente com o aumento da pontuação obtida, com probabilidade máxima de predição de falha de extubação de 85%. Conclusão: A taxa de falha de extubação com a utilização desse modelo ficou dentro do que é aceitável na literatura. O modelo de checklist diário para aptidão do teste de respiração espontânea foi capaz de identificar variáveis preditivas de falha no processo de extubação em pacientes pediátricos.

Anfibios y reptiles del departamento de Ica con comentarios sobre su distribución

En este trabajo se presenta el listado actualizado de anfibios y reptiles de Ica. Las especies son comentadas, acompañadas de mapas de distribución y claves de identificación para reptiles y anfibios. Se recopiló información de registros en colecciones científicas, artículos científicos, informes de agencias gubernamentales de vida silvestre y bases de datos taxonómicas especializadas. Adicionalmente, entre los años 2019 y 2020 se realizaron evaluaciones de campo en zonas con vacíos de información. Se encontraron un total de 22 especies (anfibios 3 y reptiles 19). Los nuevos registros de reptiles para Ica incluyen la lagartija Liolaemus evaristoi y la serpiente Incaspis tachymenoides en la provincia de Chincha a 4200 y 3200 m de altitud respectivamente, la lagartija Stenocercus ornatissimus y la serpiente ciega Epictia tesselata en la provincia de Pisco a 3500 y 2800 m respectivamente. Los nuevos registros de anfibios incluyen a Pleurodema marmoratum en la provincia de Chincha (3900 m) y Telmatobius rimac en las provincias de Chincha y Palpa a 3900 y 2350 m respectivamente. La mayor riqueza y endemismos locales se encontraron en el desierto costero, mientras que, las ampliaciones de distribución y endemismos regionales se registraron en la vertiente occidental de los Andes. También, se observa que las familias Leptotyphlopidae y Viperidae, y los géneros Dicrodon, Stenocercus y Oxyrophus terminan su distribución en la vertiente occidental y la zona costera de los departamentos de Ica y Arequipa sin representantes en el extremo sur del Perú y Chile.

This paper presents the updated list of amphibians and reptiles of Ica. Species are commented, accompanied by distribution maps and identification keys for reptiles and amphibians. Information was collected from scientific collections, scientific articles, governmental wildlife agency reports, and specialized taxonomic database. Additionally, between 2019 and 2020, field surveys were carried out in areas with information gaps. A total of 22 species were found (amphibians 3 and reptiles 19). The new records of reptiles include the Liolaemus evaristoi lizard and the Incaspis tachymenoides snake from Chincha province at 4200 and 3200 m altitude respectively, the Stenocercus ornatissimus lizard and the blind snake Epictia tesselata from Pisco province at 3500 and 2800 m respectively. New amphibian records include Pleurodema marmoratum in Chincha province (3900 m) and Telmatobius rimac in Chincha and Palpa provinces at 3900 and 2350 m respectively. The greatest richness and local endemism were found in the coastal desert, while the expansion of distribution and regional endemism were recorded on the western slope of the Andes. Also, it is observed that the families Leptotyphlopidae and Viperidae, and the genera Dicrodon, Stenocercus and Oxyrophus are finishing their distribution in the western slope and the coastal zone of the departments of Ica and Arequipa without representatives in the extreme south of Peru and Chile.

Key elements and checklist of shared decision-making conversation on life-sustaining treatment in emergency: a multispecialty study from China / 世界急诊医学杂志（英文）

@#BACKGROUND: Shared decision-making (SDM) has broad application in emergencies. Most published studies have focused on SDM for a certain disease or expert opinions on future research gaps without revealing the full picture or detailed guidance for clinical practice. This study is to investigate the optimal application of SDM to guide life-sustaining treatment (LST) in emergencies. METHODS: This study was a prospective two-round Delphi consensus-seeking survey among multiple stakeholders at the China Consortium of Elite Teaching Hospitals for Residency Education. Participants were identified based on their expertise in medicine, law, administration, medical education, or patient advocacy. All individual items and questions in the questionnaire were scored using a 5-point Likert scale, with responses ranging from “very unimportant” (a score of 1) to “extremely important” (a score of 5). The percentages of the responses that had scores of 4-5 on the 5-point Likert scale were calculated. A Kendall’s W coefficient was calculated to evaluate the consensus of experts. RESULTS: A two-level framework consisting of 4 domains and 22 items as well as a ready-to-use checklist for the informed consent process for LST was established. An acceptable Kendall’s W coefficient was achieved. CONCLUSION: A consensus-based framework supporting SDM during LST in an emergency department can inform the implementation of guidelines for clinical interventions, research studies, medical education, and policy initiatives.

Dermoscopic features and management strategy of a 10-year history acral lentiginous melanoma in a 55-year-old Filipino

Introduction@#Acral lentiginous melanoma (ALM) is the most common type of cutaneous melanoma in Asians that is not associated with ultraviolet radiation (UV) exposure. Dermoscopy enables clinicians to distinguish between benign and malignant acral melanocytic lesions, with some dermoscopic characteristics playing a role in staging and have prognostic implications, which allows for appropriate surgical intervention. The difficulty of making an early diagnosis of ALM is highlighted by this case. ALM’s destructive nature, alongside the patient’s lack of awareness and vigilance, and healthcare access inequality, influences its prognosis. @*Case Report@#This is a case of a long-standing acral lentiginous melanoma with no palpable lymphadenopathies in which it was not immediately detected through biopsy. Upon detection, wide excision with 2 cm margins and disarticulation of the 5th digit of the right foot reconstructed with a fasciocutaneous advancement flap with split thickness skin graft, grafted from the right anterior thigh was done.

Evaluation of the report quality of Chinese and English randomized controlled trials of acupuncture based on CONSORT statement and STRICTA checklist / 中国针灸

OBJECTIVE@#To evaluate the report quality of Chinese and English randomized controlled trials (RCTs) of acupuncture based on the CONSORT statement and STRICTA checklist.@*METHODS@#The Chinese and English RCTs of acupuncture published from January 1, 2015 to December 31, 2019 were searched in 7 databases including PubMed. The report quality of the included RCTs was evaluated with the CONSORT 2010 statement and STRICTA checklist.@*RESULTS@#A total of 506 Chinese RCTs and 76 English RCTs were included. According to the CONSORT statement, in Chinese RCTs, the items with report rate less than 50% accounted for 78.38% of all items, and the report rate of 25 items, such as background and reason, study design, outcome index, and sample size, was less than 10%. In English RCTs, the items with report rate less than 50% accounted for 35.14% of all items, and 5 items had a report rate of less than 10%. The difference of the report rate of 15 items, such as background, reason and study design, was more than 50% between Chinese and English RCTs. The report rate of all items of STRICTA checklist was relatively high in both Chinese and English RCTs. In Chinese RCTs, the items with report rate less than 50% accounted for 29.41% of all items, which included acupuncture rationale and depth of insertion. In English RCTs, only two items had a report rate less than 50%, which were acupuncture rationale, setting and context of treatment. The report rate of five items, including needle retention time, frequency and duration of treatment sessions, details of other interventions administered to the acupuncture group, setting and context of treatment, and precise description of the control or comparator in Chinese RCTs, were higher than in English RCTs.@*CONCLUSION@#The report quality of Chinese acupuncture RCT needs to be improved urgently, and corresponding measures should be taken to further standardize the writing and reporting of acupuncture clinical research.

Effect of auricular point therapy on the psychological state and plasma β-endorphin level of patients with burning mouth syndrome / 口腔疾病防治

Objective@# To observe the clinical effects of auricular point therapy on burning mouth syndrome (BMS) and its effect on the psychological state of patients and plasma β-endorphin. @*Methods @# A total of 105 patients diagnosed with BMS were randomly divided into an auricular acupoint application group (50 cases) and a drug treatment group (55 cases). The treatment course lasted one month. The patients in the auricular acupoint application group selected 3 points on their tongue, heart and Shenmen through traditional Chinese medical dialectics used for patients with BMS. Wangbuliu seeds were applied, two ears were pressed alternately and one ear was applied each time. The patient was instructed to press the treatment site three times a day, 1-2 min each time, until the auricle skin became reddish and hot. The patients in the drug treatment group took vitamin E 100 mg+oryzanol 10 mg+vitamin B2 10 mg orally three times a day. Before and after treatment, the pain intensity and mental and psychological state of the patients were evaluated. The patient's plasma was detected before and after β-endorphin treatment. @* Results@#The pain sensation intensity of the two groups decreased after treatment (P<0.001). After treatment, the scores of somatization (t = 2.118, P = 0.037), fear (t = 2.084, P = 0.039) and diet and sleep (t = 2.047, P = 0.043) in the auricular acupoint application group were significantly improved compared with the level before treatment. The level of β-endorphin in plasma was increased, and the difference was statistically significant (t = 2.247, P = 0.027) in the auricular acupoint application group after treatment. @*Conclusion@#Auricular point therapy is an effective method for patients with BMS, improving psychological state and promoting the synthesis of plasma β-endorphin may be one of its mechanisms.

Identification guide of dung beetle species (Coleoptera: Scarabaeidae: Scarabaeinae) of the Brazilian Pantanal / Guia de identificação de espécies de besouros rola-bostas (Coleoptera: Scarabaeidae: Scarabaeinae) do Pantanal Brasileiro

Abstract The Pantanal is the largest seasonal freshwater wetland on Earth, characterized by the seasonal flooding and complex mosaic vegetation, which determines its biodiversity. Among this biodiversity, dung beetles (Coleoptera: Scarabaeidae: Scarabaeinae) are a group of insects that perform important ecological functions, such as: nutrient cycling, seed dispersion and parasite control. In order to mitigate the lack of information on dung beetle fauna of the Brazilian Pantanal, we conducted a bibliographic search of virtually all literature published until november-2020 on dung beetles sampled in the Pantanal. In addition, we had accessed to the records the largest collection of the dung beetle species from Brazilian Pantanal. We recorded 68 dung beetle species of 30 genera. The genera Canthon Holffmanseg 1847 is the most diverse with 13 species recorded. Although our knowledge about the dung beetle fauna in this ecosystem is still incipient, our results demonstrated a high richness of dung beetles in the Brazilian Pantanal. In addition, our study provides first list of dung beetle species and an illustrated dichotomy key to identify genera and some species occurring in the Brazilian Pantanal. Thus, the use of this guide for identification of dung beetle species and a list of species can be important tools to help researchers and provide incentive for new inventories on dung beetle fauna in the Brazilian Pantanal.

Resumo O Pantanal é a maior área úmida sazonal de água doce Neotropical da Terra, caracterizada pelas inundações sazonais e pela complexa vegetação em mosaico, que determina sua biodiversidade. Dentre essa biodiversidade, os besouros rola-bosta (Coleoptera: Scarabaeidae: Scarabaeinae) são um grupo de insetos que desempenham importantes funções ecológicas, tais como: ciclagem de nutrientes, dispersão de sementes e controle de parasitas. A fim de mitigar a falta de informações sobre a fauna de besouros rola-bosta do Pantanal brasileiro, realizamos uma pesquisa bibliográfica de praticamente toda a literatura publicada até novembro de 2020 sobre besouros rola-bosta amostrados no Pantanal. Além disso, acessamos os registros da maior coleção da espécie de rola-bosta do Pantanal brasileiro. Registramos 68 espécies de besouros rola-bosta de 30 gêneros. O gênero Canthon Holffmanseg 1847 é o mais diverso com 13 espécies registradas. Embora nosso conhecimento sobre a fauna de rola-bostas neste ecossistema ainda seja incipiente, nossos resultados demonstraram uma alta riqueza de besouros rola-bosta no Pantanal brasileiro. Além disso, nosso estudo fornece a primeira lista de espécies de besouros rola-bosta e uma chave de dicotomia ilustrada para identificar gêneros e algumas espécies encontrados no Pantanal brasileiro. Assim, a utilização deste guia para identificação das espécies de besouros rola-bostas e uma lista de espécies podem ser ferramentas importantes para auxiliar pesquisadores e incentivar novos inventários sobre a fauna de besouros rola-bostas no Pantanal brasileiro.

Barreiras no preenchimento da lista de verificação para partos seguros: revisão integrativa / Barreras para completar la lista de verificación de la seguridad del parto: revisión integradora / Barriers in completing the checklist for safe deliveries: integrative review

Resumo Objetivo Identificar na literatura científica as barreiras que dificultam a aplicação da Lista de Verificação para Partos Seguros da Organização Mundial da Saúde. Métodos Revisão integrativa, realizada entre os meses de novembro de 2020 e maio de 2022, por meio das seguintes fontes de dados: Scopus, Medline®/PubMed®, Web of Science e Cinahl. O estudo foi realizado conforme as recomendações do protocolo Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Resultados A amostra foi composta por 14 estudos, publicados principalmente no ano de 2021, predominando a América do Sul como continente de publicação. O idioma inglês foi o mais prevalente, assim como os estudos metodológicos e a abordagem quantitativa. O nível de evidência IV prevaleceu na amostra. Observa-se que os fatores culturais foram fortemente descritos nos estudos identificados, seguidos dos fatores estruturais e fatores relacionados ao processo de trabalho. Conclusão As principais barreiras que dificultam a aplicação da Lista de Verificação para Partos Seguros foram os fatores culturais (relações interpessoais, hierarquização das classes profissionais e má comunicação); estruturais (desenho e fonte utilizada no checklist) e relacionados ao processo de trabalho (como a lista de verificação foi implantada no serviço de saúde, postura do gerente quanto à apresentação dela e necessidade de intervenção educativa/formação para os profissionais de saúde).

Resumen Objetivo Identificar en la literatura científica las barreras que dificultan la aplicación de la Lista de verificación de la seguridad del parto de la Organización Mundial de la Salud. Métodos Revisión integradora, realizada entre los meses de noviembre de 2020 y mayo de 2022, a través de las siguientes fuentes de datos: Scopus, Medline®/PubMed®, Web of Science y Cinahl. El estudio fue realizado según las recomendaciones del protocolo Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Resultados La muestra estuvo compuesta por 14 estudios, publicados principalmente en el año 2021, en los que predominó América del Sur como continente de publicación. El inglés fue el idioma predominante, así como los estudios metodológicos y el enfoque cuantitativo. El nivel de evidencia IV fue predominante en la muestra. Se observa que los factores culturales se describen con frecuencia en los estudios identificados, seguidos de los factores estructurales y los factores relacionados con el proceso de trabajo. Conclusión Las principales barreras que dificultan la aplicación de la Lista de verificación de la seguridad del parto fueron los factores culturales (relaciones interpersonales, jerarquización de las clases profesionales y mala comunicación); los factores estructurales (diseño y tipografía utilizada en la lista) y los factores relacionados con el proceso de trabajo (cómo se implementó la lista de verificación en el servicio de salud, postura del gerente con relación a la presentación de la lista y necesidad de intervención educativa/formación para los profesionales de la salud).

Abstract Objective To identify, in the scientific literature, the barriers that make it difficult to apply the Safe Childbirth Checklist of the World Health Organization. Methods An integrative review was conducted from November 2020 to May 2022, using the following data sources: Scopus, MEDLINE®/PubMed®, Web of Science, and CINAHL. This study was conducted according to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol. Results The sample consisted of 14 studies published mainly in 2021, when South America predominated as a publishing continent. The English language, methodological studies, and quantitative approaches prevailed. Level IV evidence prevailed in the sample. In the identified studies, there was a strong description of cultural factors, followed by structural factors and factors related to the work process. Conclusion Cultural (interpersonal relationships, hierarchy of professional classes, and poor communication) and structural (design and fonts used in the checklist) factors, and those related to the work process (such as the checklist implemented in the health service, the manager's attitude regarding presenting it, and need for educational/training intervention for health professionals) are the main barriers that make it difficult to apply the Safe Childbirth Checklist.

Adaptation And Use of the Papworth Haemostasis Checklist - Clinical Outcomes Analysis at Hospital Estadual Mário Covas

ABSTRACT Introduction: Postoperative bleeding is one of the main causes of complications in cardiovascular surgery, which highlights the importance of ensuring adequate intraoperative hemostasis, providing a better patient outcome. This study aimed to improve the prevention of postoperative bleeding in the Cardiovascular Surgery Department of the Hospital Estadual Mário Covas (Santo André, Brazil) using an adapted version of the Papworth Haemostasis Checklist to assess the impact of this standardization on bleeding rate, postoperative complications, reoperation, and mortality. Methods: This is a non-randomized controlled clinical trial, whose non-probabilistic sample consisted of patients undergoing cardiac surgery in the abovementioned service within a two-year interval. The Papworth Haemostasis Checklist was adapted to the Brazilian laboratory parameters and the questions were translated into Portuguese. This checklist was used before the surgeon started the chest wall closure. Patients were followed up until 30 days after surgery. A P-value < 0.05 was considered statistically relevant. Results: This study included 200 patients. After the checklist, a reduction in 24-hour drain output, postoperative complications, and reoperation was observed, although statistical significance was not reached. Finally, there was a significant reduction in the number of deaths (8 vs. 2; P=0.05). Conclusion: The use of the adapted checklist in our hospital proved to be an effective intervention to improve the prevention of postoperative bleeding, with a direct impact in the number of deaths in the study period. The reduction in deaths was possible thanks to the reduction in the bleeding rate, postoperative complications, and reoperations for bleeding.