ABSTRACT
Background: Patients with end-stage renal disease (ESRD) undergoing haemodialysis (HD) are associated with low quality of life (QoL) and high disease-related symptoms. The patient self-report instruments can assess the burden of physical and psychological symptoms. The Dialysis Symptom Index (DSI) is a specific instrument to evaluate the multidimensional reported symptoms by patients undergoing HD. Aims: To translate, validate and assess the psychometric properties of the Portuguese version of the DSI. Methods: A cross-cultural adaptation process from English to Portuguese and a validation study (n = 156) were conducted. Reliability, validity and responsiveness were assessed. Results: The patients' most reported symptoms were, nausea (n = 86, 55%), muscle cramps (n = 92, 59%), feeling tired or lack of energy (n = 92, 59%), bone or joint pain (n = 88, 56%) and trouble staying asleep (n = 95, 60%). Cronbach's alpha of the DSI was 0.87, and intraclass correlation coefficient was 0.868 (95%CI 0.836-0.896). The smallest detectable change was 28.32. Conclusion: The Portuguese DSI demonstrates excellent psychometric properties for assessing HD patients' reported symptoms. It highlights symptom severity and impact, providing valuable insights for healthcare practitioners. Nurses can use the DSI to tailor interventions and enhance patient-centred care.
ABSTRACT
BACKGROUND: The cannulation of the arteriovenous fistula (AVF) for hemodialysis (HD) has traditionally depended on the nurse's tactile sensation, which has been associated with suboptimal needle placement and detrimental effects on vascular access (VA) longevity. While the introduction of ultrasound (US) has proven beneficial in mapping the AVF outflow vein and assisting in cannulation planning, aneurysmal deformations remain a common occurrence resulting from various factors, including inadequate cannulation techniques. Within this context, the utilization of skin pigmentation as a clinical landmark has emerged as a potential approach to enhance cannulation planning in HD. METHODS: A prospective longitudinal study was undertaken to investigate the correlation between the occurrence of venous morphological deformations and the cannulation technique guided by skin pigmentation after a 2-month period of implementation. RESULTS: Thirty patients were enrolled in the study with 433 cannulations being described within the first 2 months of AVF use. The overall rate of cannulation-related adverse events was 21.9%. Comparative analysis demonstrated a statistically significant relationship (p < 0.001) between aneurysmal deformation and non-compliance with the proposed cannulation technique, resulting in cannulation outside the designated points. Non-compliance was primarily attributed to nurse's decision (57.1%). CONCLUSION: The integration of US mapping of the AVF outflow vein and the utilization of skin pigmentation as a guiding tool have shown promising results in enhancing cannulation planning over time. Consistent adherence to a cannulation technique other than the area technique has been found to reduce the risk of AVF morphological deformation. These findings underscore the potential benefits of incorporating skin pigmentation as a clinical landmark in cannulation practices, highlighting its ability to impact positively cannulation outcomes.
ABSTRACT
BACKGROUND: Vascular access (VA) is a central condition for hemodialysis (HD). Screening patients' views regarding their VA is a significant end point for improving the quality of care. The Short-form Vascular Access Questionnaire (SF-VAQ) is a specific questionnaire to assess patients' satisfaction levels regarding their VA. PURPOSE: This study aims to develop the Portuguese version of the SF-VAQ and assess its psychometric properties. METHODS: A forward and back translation was used. A multicentric study was conducted with 156 patients undergoing hemodialysis to psychometric testing. Reliability (internal consistency and test-retest) was assessed using Cronbach's alpha and Intraclass Correlation Coefficient. A construct validity test was conducted using factor analysis. The convergent validity was calculated using the correlation coefficient. RESULTS: An obtained Cronbach's alpha of 0.77 indicates good internal consistency. The test-retest reliability was established using the Intraclass Correlation Coefficient (ICC) of 0.771. The four sub-scales proposed by the instrument's designer were confirmed, which together accounted for 53% of the variance. The correlation with the Visual Analogue Scale was r = 0.895 (p < 0.001), confirming the convergent validity. CONCLUSION: The Portuguese version of the SF-VAQ is a valid and reliable instrument with good psychometric properties to be implemented to promote an evaluation of VA satisfaction in HD patients and improve patient care.
ABSTRACT
The selection of weed biotypes that are resistant to glyphosate has increased the demand for its use mixed with other herbicides, such as sulfentrazone. However, when chemical molecules are mixed, interactions may occur, modifying the behavior of these molecules in the environment, such as the sorption and desorption in soil. In this study, we hypothesized that the presence of glyphosate-formulated products might increase the sorption or decrease the desorption of sulfentrazone, thereby increasing the risk of the contamination of water resources. Therefore, our work aimed to evaluate the sorption, desorption, and leaching of sulfentrazone in the soil in an isolated and mixed application with different glyphosate formulations. The sorption coefficients (Kfs) for the sulfentrazone, sulfentrazone + Roundup Ready, sulfentrazone + Roundup Ultra, and sulfentrazone + Zapp Qi foram were 1.3, 2.1, 2.3, and 1.9, respectively. The desorption coefficients (Kfd) for the sulfentrazone, sulfentrazone + Roundup Ready, sulfentrazone + Roundup Ultra, and sulfentrazone + Zapp Qi foram were 65.7, 125.2, 733.3 and 239.8, respectively. The experiments demonstrated that the sorption and desorption of sulfentrazone in combination with the other formulated glyphosate products are altered, supporting the hypothesis suggested by this work, i.e., that the presence of other molecules is a factor that affects the behavior of herbicides in the soil. This phenomenon altered the vertical mobility of sulfentrazone. Situations involving mixtures of pesticides should be evaluated in order to improve our understanding of the dynamics of these molecules and thus avoid environmental contamination.
ABSTRACT
The use of herbicides belonging to a single mechanism of action for several consecutive years in the same area may lead to the selection of weed biotypes resistant to herbicides. Weeds resistant to glyphosate have been problem worldwide. As an alternative control, farmers have used glyphosate mixed with sulfentrazone. When two herbicides are mixed, the parameters that govern the behaviour of herbicides in the soil can be altered. In this study, the sorption of sulfentrazone was estimated when applied in isolation with glyphosate formulations. For this, increasing doses of sulfentrazone were applied using Red-Yellow Latosol substrate and washed sand. Each dose of sulfentrazone was applied in a mixture with 1080 g a. e. ha-1 Roundup Ready®, Roundup Ultra® and Zapp Qi®. To evaluate the presence of sulfentrazone in the soil solution, Sorghum bicolor was used as an indicator species. Symptoms of intoxication were evaluated at 7, 14 and 21 days after sowing. At 21 days after sowing, the plants were collected and dried in an oven at 70 ± 10 °C to determine the dry matter. Based on the intoxication of the indicator plants, it was verified that, regardless of the formulation, the presence of glyphosate in the mixture increased the sorption of sulfentrazone in the Red-Yellow Latosol. However, based on dry matter accumulation, sulfentrazone sorption increased because of the mixture with Roundup Ultra®, but decreased due to the presence of Roundup Ready® and Zapp Qi®. Therefore, the application of sulfentrazone in mixture with glyphosate alters the sorptive forces of sulfentrazone in a Red-Yellow Latosol.
A utilização de herbicidas pertencentes a um único mecanismo de ação por vários anos consecutivos na mesma área pode levar a seleção de biótipos de plantas daninhas resistentes a herbicidas. Plantas daninhas resistentes ao glyphosate têm sido problema no mundo inteiro. Como alternativa de controle, os agricultores têm utilizado glyphosate em mistura com sulfentrazone. Quando se misturam duas moléculas herbicidas, os parâmetros que governam o comportamento de herbicidas no solo podem ser alterados. Neste estudo foi estimada a sorção do sulfentrazone quando aplicado de forma isolada e em mistura com formulações de glyphosate. Para isso, doses crescentes de sulfentrazone foram aplicadas utilizando-se como substrato Latossolo Vermelho-Amarelo e areia lavada. Cada uma das doses de sulfentrazone foi aplicada em mistura com 1080 g ha-1 de glyphosate comercializado nas formulações Roundup Ready®, Roundup Ultra® e Zapp Qi®. Para avaliar a presença do sulfentrazone na solução do solo utilizou-se o Sorghum bicolor como espécie indicadora. Os sintomas de intoxicação foram avaliados aos 7, 14 e 21 dias após a semeadura. Aos 21 dias após a semeadura, as plantas foram coletadas e secadas em estufa a 70 ±10C para determinação da matéria seca. Com base na intoxicação das plantas indicadoras, verificou-se que, independente da formulação, a presença glyphosate na mistura, aumentou a sorção do sulfentrazone no Latossolo Vermelho-Amarelo. No entanto com base no acúmulo de matéria seca, constatou-se que a sorção do sulfentrazone aumentou em função da mistura com Roundup Ultra®, mas diminuiu devido a presença de Roundup Ready® e Zapp Qi®. Conclui-se que a aplicação de sulfentrazone em mistura com glyphosate altera as forças sortivas do sulfentrazone no Latossolo Vermelho-Amarelo.
