The Mastery of Competencies for the Care of LGBT+ People by Different Health Professionals.

This study aims to compare the mastery of competencies in assisting the LGBT+ population of Brazilian health professionals. Data collection occurred in a face-to-face and virtual manner, in the first semester of 2018. The health professionals answered a socio-demographic and functional questionnaire, in addition to the questionnaire Measurement of Training Needs for Health Care for the LGBT+ Public. The data was analyzed using Mann-Whitney and Chi-square tests. The project research was submitted to and approved by the IMED Research Ethics Committee (CAAE 69116917.6.0000.5319). The sample (n= 380) was made up mostly of psychologists (42.3%), female (81%), heterosexual (73.2%), aged between 26 and 35 years (36%), Catholic (41%), living in the south region (36.9%), and working in the profession for ten years or more (34.3%). Skills gaps on the LGBT+ theme was identified, especially in topics such as "approach to the patient's sexuality," "interference of religious beliefs in care," "care with the genitalia and breast of the trans individual," among others. Professionals trained in psychology and non-heterosexuals had a greater mastery of the theme than the others. The fragmentation of knowledge and skills hinders the full and equal access to the health system, and continued educational actions are recommended.

Neural network-based method to stratify people at risk for developing diabetic foot: A support system for health professionals.

BACKGROUND AND OBJECTIVE: Diabetes Mellitus (DM) is a chronic disease with a high worldwide prevalence. Diabetic foot is one of the DM complications and compromises health and quality of life, due to the risk of lower limb amputation. This work aimed to build a risk classification system for the evolution of diabetic foot, using Artificial Neural Networks (ANN). METHODS: This methodological study used two databases, one for system design (training and validation) containing 250 participants with DM and another for testing, containing 141 participants. Each subject answered a questionnaire with 54 questions about foot care and sociodemographic information. Participants from both databases were classified by specialists as high or low risk for diabetic foot. Supervised ANN (multi-layer Perceptron-MLP) models were exploited and a smartphone app was built. The app returns a personalized report indicating self-care for each user. The System Usability Scale (SUS) was used for the usability evaluation. RESULTS: MLP models were built and, based on the principle of parsimony, the simplest model was chosen to be implemented in the application. The model achieved accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of 85%, 76%, 91%, 89%, and 79%, respectively, for the test data. The app presented good usability (93.33 points on a scale from 0 to 100). CONCLUSIONS: The study showed that the proposed model has satisfactory performance and is simple, considering that it requires only 10 variables. This simplicity facilitates its use by health professionals and patients with diabetes.

Simultaneous Concept Analysis of Diagnoses Related to Urinary Incontinence.

PURPOSE: To elucidate six diagnostic concepts related to urinary incontinence (UI). METHODS: Eight out of nine steps of the simultaneous concept analysis (SCA) method were used to elucidate six diagnostic concepts related to UI proposed by NANDA International. FINDINGS: Individual concepts of each diagnosis were elucidated, including antecedents, outcomes, associated conditions, and risk populations, and the interrelations among these concepts were identified, comparing them to those already present in the current NANDA-I taxonomy. The overflow UI was excluded, and were included mixed and transient UI diagnoses. CONCLUSIONS: SCA enabled identifying similar characteristics and factors exclusive to the revised nursing diagnoses. IMPLICATIONS FOR NURSING PRACTICE: To support for clinical reasoning to identify properly the types of UI. OBJETIVO: Elucidar seis conceitos diagnósticos relacionados à incontinência urinária. MÉTODOS: Oito das nove etapas do método de análise simultânea de conceitos foram utilizadas para elucidar seis conceitos diagnósticos relacionados à incontinência urinária propostos pela NANDA International. RESULTADOS: Conceitos individuais de cada diagnóstico foram elucidados, incluindo antecedentes, consequentes, condições associadas e populações em risco, e as inter-relações entre esses conceitos foram identificadas, comparando-as com aquelas já presentes na atual taxonomia da NANDA-I. A incontinência urinária por transbordamento foi excluída e foram incluídos os diagnósticos de incontinência urinária mista e incontinência urinária transitória. CONCLUSÕES: A análise simultânea de conceitos permitiu identificar características e fatores semelhantes exclusivos aos diagnósticos de enfermagem revisados. IMPLICAÇÕES PARA A PRÁTICA DE ENFERMAGEM: Apoiar o raciocínio clínico para identificar adequadamente os tipos de incontinência urinária.