Association between vitamin D insufficiency and depressive symptoms, and functional disability in community-dwelling Brazilian older adults: results from ELSI-Brazil study.

Low serum 25(OH)D levels (< 30 nmol/L) have been associated with increased depressive symptom scores over time, and it is believed that functionality may play a mediating role in the relationship between 25(OH)D and depressive symptoms. To comprehend the association between these factors could have significant implications for public health policy. The aim of this study was to verify the association between simultaneous vitamin D insufficiency and depressive symptoms, and functional disability in community-dwelling older adults. This was a cross-sectional study with data from the Brazilian Longitudinal Study of Aging (ELSI-Brazil), collected between 2015 and 2016. The outcomes were functional disability assessed through basic activities of daily living (ADL) and instrumental activities of daily living (IADL). The exposures were vitamin D insufficiency (< 30 nmol/L) and depressive symptoms (≥ 4 points in 8-item version of the Center for Epidemiological Studies-Depression). Crude and adjusted Poisson regression was performed to estimate associations. A total of 1781 community-dwelling older adults included in this study, 14.6% had disability in ADL and 47.9% in IADL; 59.7% had vitamin D insufficient levels, and 33.2% depressive symptoms. The concomitant presence of vitamin D insufficient and depressive symptoms increased the prevalence of ADL by 2.20 (95% CI: 1.25; 3.86) and IADL by 1.54 (95% CI: 1.24; 1.91), respectively. Therefore, preventive strategies to keep older adults physically and socially active, with a good level of vitamin D, are essential to avoid depression and functional disability.

Geopolymer Foam Reinforced with Iron Ore Flotation Tailing for Potassium Adsorption and Controlled Release in Water.

A geopolymer foam was synthesized for the evaluation of its capacity for fast retention and slow release of potassium in water. The base matrix of the geopolymer binder was obtained by mixing metakaolin, sodium silicate, and sodium hydroxide solutions. A factorial design of experiments (DOE) was applied to analyze the effect of adding hydrogen peroxide, aluminum powder, soybean oil, and iron ore flotation tailing on the water absorption and compressive strength of the geopolymer samples. The best-performing samples were characterized and evaluated for morphological aspects, chemical stability in different pH ranges, optimal adsorption time, and the ability to release potassium in the water. The inclusion of hydrogen peroxide was not a statistically significant factor at the 95% confidence level. The inclusion of aluminum powder and oil increased the water absorption, whereas the addition of tailing decreased it. The addition of soybean oil and tailing contributed positively to the compressive strength, but the addition of aluminum powder caused its reduction. The tailing addition not only increased the porous samples compressive strength but also prevented large cracks in their structure. The optimized response of 63 wt % of water absorption and 6 MPa of compressive strength was achieved by adding 0.05% of Al-powder, 1.5% of soybean oil, and 20% of tailing on the geopolymer binder. This sample exhibited 72% open porosity, a maximum adsorptive capacity of q = 5.7 mg/g, and chemical stability at pH > 4. Adsorption stabilized after 9 h of contact with water. Kinetics modeling suggested that the concentration gradient and chemical reactions probably drove potassium adsorption. The potassium release step was possibly controlled by the concentration gradient. After 60 days, the water solution released only 28% of absorbed potassium.

[The particularity of large-scale simulation: from learning by observation to professionalization]. / La particularité de la simulation à grande échelle : de l'apprentissage par l'observation vers la professionnalisation.

A full-scale exercise designed to test emergency plans, large-scale simulation in the face of nuclear, radiological, biological, chemical and explosive (NRBCe) risks also contributes to the health response and the organization of the health system. For future caregivers working in hospitals, it allows them to take into consideration the impact of an event outside the hospital on their hospital care. It enables them to pool their responses to a possible disaster, in particular by identifying the health response (Health Response Organization) and the security response (Civil Security Response Organization).

Identification of the main proteins secreted by Kluyveromyces marxianus and their possible roles in antagonistic activity against fungi.

Lytic enzymes secreted by Kluyveromyces marxianus can lyse Saccharomyces cerevisiae cells. Their ability to hydrolyze yeast cell walls can be used in biotechnological applications, such as the production of glucans and protoplasts, as well as a biological control agent against plant pathogenic fungi. Herein, 27 proteins secreted by K. marxianus were identified by mass spectrometry analyses. Importantly, 14 out of the 27 proteins were classified as hydrolases. Indeed, the enzyme extract secreted by K. marxianus caused damage to S. cerevisiae cells and reduced yeast cell viability. Moreover, K marxianus inhibited spore germination and mycelial growth of the phytopathogenic fungus Botrytis cinerea in simultaneous cocultivation assays. We suggest that this inhibition may be partially related to the yeast's ability to secrete lytic enzymes. Consistent with the in vitro antagonistic tests, K. marxianus was able to protect strawberry fruits inoculated with B. cinerea. Therefore, these findings suggest that K. marxianus possesses potential as a biocontrol agent against strawberry gray mold during the postharvest stage and may also have potential against other phytopathogenic fungi by means of its lytic enzymatic arsenal.

A new and accessible instrumentation to determine urea in UHT milk using digital image analysis.

This research demonstrates the development, optimization and application of a new low-cost detection system, based on digital image analysis, for the detection of urea in ultra-high-temperature (UHT) milk samples. The apparatus built in the laboratory, allows the capture of images through a simple system built by polyvinyl chloride (PVC) tubes, a digital microscope and a peristaltic mini-pump, after the colorimetric reaction between urea and diacetylmonoxime (butane-2,3-dionammonoxime). The red, green and blue (RGB) and hue, saturation and value (HSV) color systems were studied, with the saturation channel of the HSV color system selected as the analytical signal. Subsequently, the experimental chemical conditions were evaluated through multivariate experimental designs and the optimal conditions were defined. The proposed method was validated, and the detection and quantification limits presented by the method were 0.35 mg L-1 and 0.52 mg L-1, respectively; precision, ranged between 1.6  and 2.8 %. The results were compared with those obtained using the mid-infrared technique and no statistically significant differences were observed at a 95 % confidence level. The proposed method was applied to eight UHT milk samples that presented urea content ranging from 187 to 386 mg L-1. The mean values obtained are in agreement with values presented in other studies for the determination of urea in milk. The results indicated that the system described and validated here is promising and can be applied to assess the authenticity and quality of milk.

Homogeneity and stability assessment of a candidate to pumpkin seed flour reference material by means of computer vision based chemometrics assisted approach.

This study proposes a preliminary assessment of the homogeneity and stability through digital image acquisition of a candidate for mechanically processed pumpkin seed meal reference material, exploring the concepts of homogeneity curve and the analysis of texture characteristics by Continuous-Level Moving Block through Robust Principal Component Analysis. This innovative methodology allowed us to examine the percentage of homogeneity in a set of samples, revealing an average of 41% with only one outlier in relation to the entire sample, indicating low homogeneity. In the stability study carried out after storing samples for 12 months at different temperatures, 83% of the samples were considered regular and 17% were outlier, which means that most of them were considered stable. Therefore, this methodology is useful for screening samples for homogeneity, by textural analysis, and detected non-homogeneity can be corrected in advance for quantification by standard protocols.

Characterization of the chemical composition (mineral, lead and centesimal) in pine nut (Araucaria angustifolia (Bertol.) Kuntze) using exploratory data analysis.

In this study, mineral composition, centesimal composition and lead were evaluated in pine nut seeds (raw and cooked) from five Brazilian states. Mineral composition was determined by ICP OES and lead by GF AAS. The results for minerals were evaluated by Boxplot, PCA and HCA, using the R software. Average minerals in raw and cooked samples (mg 100 g-1) were: 15.2 and 10.8 (Ca), 0.168 and 0.113 (Cu), 0.506 and 0.330 (Fe), 536 and 420 (K), 51.3 and 40.6 (Mg), 0.373 and 0.208 (Mn), 132 and 102 (P) and 0.746 and 0.520 (Zn). The average centesimal composition (raw and cooked) was: 53.5 and 47.2% (moisture), 1.76 and 1.26% (ash), 3.90 and 3.53% (protein), 40.8 and 48.0% (carbohydrate) and 179 and 206 kcal/100 g (total caloric value) and Pb was not detected. The chemometric analysis showed a distinction of raw and cooked samples due to significant nutrient losses after thermal processing.

Overall survival analyses of female malignancies in Southern Brazil during 2008-2017: A closer look at breast, cervical and ovarian cancer.

Background: The aim of this study was to report the overall survival and baseline factors associated with OS for breast, cervical and ovarian cancer in Florianópolis, Southern Brazil, a region with quality-of-life indicators comparable to high-income countries. Methods: Cohort study was performed from probabilistic record linkage of the Mortality Information System and the Population-based cancer registry of Florianópolis. It was included breasts, cervical and ovarian cancer diagnosis during the period of 2008-2012 with a follow up of 60 months. Cox regression and Kaplan-Meier method were used for associations with overall survival and risk factors. Findings: 1857 cases of the three malignancies were included in the analysis. We identified 202 deaths in breast cancer subjects, 53 for cervical cancer and 51 for ovarian cancer. Metastatic disease at diagnosis was present in 31%, 9.6%, and 55% of the cases, respectively. Overall survival was statistically correlated with age, educational level and stage for breast cancer; age and stage for cervical cancer; age and stage for ovarian cancer. Interpretation: Metastatic disease and age are the main prognostic factors for the malignancies studied, as they were associated with both overall survival and risk of death. Better screening and preventive tests for early diagnosis are needed. Funding: Support of Research and Innovation in the State of Santa Catarina, Research Program for the Unified Health System (FAPESC/MS-DECIT/CNPQ/SES-SC-PPSUS); the Brazilian National Research Council (CNPq); and the Coordination for the Improvement of Higher Education Personnel (CAPES).

Higher levels of TNF and IL-4 cytokines and low miR-182 expression in visceral leishmaniasis-HIV co-infected patients.

AIMS: The aim of the present study was to assess serum cytokine and miRNA expression in visceral leishmaniasis-HIV (VL-HIV) co-infection and HIV mono-infection. METHODS AND RESULTS: We analysed 113 serum samples from HIV patients in areas endemic for leishmaniasis. The diagnosis of VL was confirmed in 65 of these 113 samples. The VL-HIV and HIV groups presented significant differences regarding haemoglobin level (P < .0001), lymphocyte count (P = .0444), white blood cell count (P = .0108), weight loss (P = .0310), HIV load (P < .0001) and CD4+ T-lymphocytes count (P = .0003). Levels of IL-6 and IL-10, IFN-γ and IL-6, IFN-γ and IL-10, TNF and IL-2 were positively correlated in VL-HIV co-infection, indicating higher serum levels of TNF and IL-4 (P < .0001). In addition, miR-182 expression was found to be significantly higher in HIV (P = .009), miR-210 exhibited no statistically significant difference between groups, and nonexpression of miR-122 was found in both groups. CONCLUSION: Together, TNF, IL-4 and miR-182 may represent circulatory biomarkers of VL-HIV co-infection.

SLC11A1 (rs3731865) polymorphism and susceptibility to visceral leishmaniasis in HIV-coinfected patients from Northeastern Brazil.

Following the emergence of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), the number of visceral leishmaniasis-HIV (VL-HIV) coinfections has increased worldwide, mainly in Brazil. The development of clinical forms of VL can be influenced by nutritional status, age, and host genetic factors, which are important variables determining susceptibility to disease. There are no studies with a candidate gene approach assayed directly in the VL-HIV-coinfected population. Herein, we determined and analyzed the associations of SLC11A1, LECT2, CCL1, CCL16, and IL4 genetic polymorphisms with susceptibility to VL-HIV coinfection in Northeastern Brazil. We analyzed 309 DNA samples extracted from the peripheral blood of HIV patients, and clinical and hematological data were collected from medical records. The diagnosis of VL was confirmed in 110 out of 309 patients; genotyping was carried out by TaqMan assays afterwards. Our results confirmed the association between the SLC11A1 polymorphism (rs3731865) and VL-HIV coinfection (p = 0.0206, OR 1.8126, 95% CI 1.1050-2.9727). In addition, the SLC11A1 genotype GG (p = 0.0050, OR 3.0395, 95% CI 1.4065-6.5789) and CD4+ T lymphocyte count (p = 0.0030, OR 0.9980, 95% CI 0.9970-0.9990) were associated with VL-HIV coinfection in a multivariate model. The polymorphism of the SLC11A1 gene (rs3731865) was associated with VL-HIV coinfection, suggesting a possible genetic mechanism involved in the susceptibility to VL in HIV patients. This finding can suggest new therapeutic targets and genetic markers for the VL-HIV-coinfected population.

Report of multiple abuse against older adults in three Brazilian cities.

This study analyses the multiple abuse against older adults reported to the elder abuse police units of three Brazilian cities from 2009 to 2013. This is a longitudinal and retrospective study carried out through the analysis of police reports (PRs) in the elder abuse police units of three Brazilian cities: Ribeirão Preto (SP), Teresina (PI), and João Pessoa (PB). Descriptive statistical analysis consisted of absolute and percentage frequencies. The chi-square test, Fisher's Exact test, and Relative Risk (RR) were used to analyze the data, with a 95% Confidence Interval (CI) and a significance of 5%. A total of 2,313 reports of older adult abuse were analyzed, of which 245 (10.6%) were related to reports of multiple abuse, 49.4% in Ribeirão Preto, São Paulo, 22.9% in João Pessoa, Paraíba, and 27.8% in Teresina, Piauí. Most of the victims of recurrent older adult abuse are female and younger elderly. Psychological abuse was the most recurrent, followed by financial abuse, occurring in the victim's own home. In João Pessoa, older women and elderly living with their abusers were at a higher risk of report of multiple abuse acts. In Ribeirão Preto, living with the aggressor was a risk factor for multiple violent acts. In the total population of the study, living without companion and not living with the aggressor were identified as protective factors against recurrent violence. The need to implement social and legal actions to improve safety for the more vulnerable groups is emphasized.

Simultaneous optimization of multiple responses and its application in Analytical Chemistry - A review.

This manuscript covers the application of the main techniques for simultaneous optimization of multiple responses generated by the application of multivariate designs (two-factor factorial, Central Composite, Doehlert, etc.) or by chromatographic runs in the development of analytical methods. Special attention will be given to the graphical method, desirability function, multiple response function and chromatographic response functions, since they are more frequently used in the analytical area. The advantages, disadvantages, limitations, and potentialities of these methods will also be addressed, as well as some of their applications, commenting on real examples from the literature. Some less usual methods in multiple response optimization in Analytical Chemistry will also be commented.

Screening of Mangifera indica L. functional content using PCA and neural networks (ANN).

A method using reversed-phase high-performance liquid chromatography with diode array detection (HPLC-DAD) was applied after extraction with acidified methanol, to determine 12 bioactive phenolic compounds in the peel and pulp of the mango fruit (Mangifera indica L.) cultivated in the Bahia, state of Brazil. The proposed methodology was previously fully validated and proven successful in the analysis of methanolic extracts of lyophilized samples. The limits of quantification ranged between 0.78 and 3.14 mg L-1 and the individual recovery values obtained for the spiked samples ranged from 80% to 120%. The results were evaluated using PCA and ANN. The results indicate that the fruits are rich in polyphenols, mainly: ellagic acid, gallic acid, rutin and catechin, which contribute to their greater use as functional foods, natural antioxidants and in the pharmaceutical industry, as well as other applications.

Indicadores de calidad en la terapia intravenosa / Analysis of quality indicators in intravenous therapy

RESUMEN Introducción: Los eventos adversos son comunes durante el uso de la terapia intravenosa, pueden causar daño al paciente y contribuir a agravar el estado de salud y la estancia hospitalaria prolongada. Además, al proporcionar acceso directo a la corriente sanguínea, los eventos adversos relacionados con la terapia intravenosa pueden tener repercusiones más graves y perjudiciales. Objetivo: Analizar indicadores de calidad relacionados con la atención de salud en la terapia intravenosa en un hospital público y de enseñanza. Métodos: Estudio descriptivo-exploratorio, transversal realizado en un hospital público, de enseñanza. Para recopilar datos se utilizó una forma adaptada compuesta por 03 indicadores: identificación de acceso venoso periférico, la identificación de goteo intravenoso para botellas de infusión y la identificación de suero y control de la velocidad de infusión de las soluciones. La muestra, intencional, consistió en 94 participantes. Resultados: Se realizaron 1 355 observaciones. De éstas, 439 fueron el acceso venoso periférico, 463 de los catéteres para la infusión intravenosa de 453 botellas de suero y medicamentos. La validez de un acceso venoso periférico, basado solo en accesos identificados correctamente, fue el único cuyo resultado de calidad de la atención (QA) era deseable (100 por ciento) y segura (83,3 por ciento); todos los demás mostraron QA mal (< 70 por ciento). Conclusión: Los resultados encontrados en este estudio están por debajo del deseado para que una asistencia de calidad en terapia intravenosa sea garantizada. La calidad de la atención en la terapia intravenosa es mucho menor que la recomendada(AU)

ABSTRACT Introduction: Adverse events are common during use of intravenous therapy can cause damage to the patient, and contribute to worsening health status and prolonged hospital stay. In addition, by providing direct access to the bloodstream, adverse events related to intravenous therapy may be more serious and harmful repercussions. Objective: To analyze the quality indicators related to health care in intravenous therapy in an extension public research teaching hospital. Methods: Descriptive and exploratory, cross-sectional study in a public hospital, teaching. For data collection, it was used an adapted form composed of 03 following indicators: identification of peripheral venous access, equipment used for intravenous infusion, serum bottles, and speed control of infusion solutions. The intentional sample was consisted of 94 participants. Results: 1355 observations were done.In these observations, 439 were of peripheral venous access, 463 of equipment used for intravenous infusion, 453 of serum bottles and medicine. Based only on properly identified access, the validity of peripheral venous access was the only one whose result of quality of care (QA) was desirable (100 percent) and safe (83,3 percent), all the others showed QA poorly (< 70 percent). Conclusions: The results found in this study are below desired for quality care in intravenous therapy is ensured. The quality of care in intravenous therapy is very lower than recommended(AU)

Simultaneous determination and speciation analysis of arsenic and chromium in iron supplements used for iron-deficiency anemia treatment by HPLC-ICP-MS.

This work proposes the use of high performance liquid chromatography coupled to inductively coupled plasma mass spectrometry (HPLC-ICP-MS) for simultaneous speciation of arsenic and chromium in iron supplements used for the treatment of anemia. The sample preparation procedure recommended for the total determination of arsenic and chromium was established using acid digestion in a microwave assisted oven. For speciation analysis, however, the microwave-assisted extraction procedure involved the use of water as extraction solvent at 90°C for 30min. The chromatographic separation was performed using a mobile phase containing 1.0mM tetrabutylammonium hydroxide (TBAH), 0.7mM ethylenediaminetetraacetic acid (EDTA) and 5% methanol at pH 7.2. Helium was used in the collision cell for elimination of the interferences. Under optimized conditions, the separation and detection of the As(III), As(V), Cr(III) and Cr(VI) species can be performed in 5min, permitting their quantification with the external calibration technique with standards prepared in the mobile phase. The limits of quantification obtained were 0.008, 0.010, 0.5 and 0.14µgg-1, for As(III), As(V), Cr(III) and Cr(VI), respectively. The accuracy of the method was evaluated and confirmed by addition/recovery tests. The recoveries obtained varied from 81% to 110%. The proposed method was applied to the speciation analysis of arsenic and chromium in commercially available iron supplements acquired in several cities in Brazil and Spain. The content of the species ranged from 0.01 to 1.3µgg-1 for arsenic, and from 0.4 to 61.2µgg-1 for chromium.

Determination and Evaluation of Metallothionein and Metals in Mugil cephalus (Mullet) from Pontal Bay, Brazil.

To assess environmental contamination, studies have been increasingly carried out using biomarkers to diagnose the effects of toxic metal exposure, such as metallothionein (MT). In this context, the aims of the present study were to determine Cd, Cu, Ni and Pb concentrations, by ICP-MS, in liver samples from Mugil cephalus from the municipality of Ilhéus, located in North-Southeastern Brazil, in the state of Bahia, which has been increasingly suffering from anthropogenic pressure, and to quantify total MT in liver and gills. Among essential metals, copper (199.2 µg g-1) presented concentrations approximately 7 times higher than allowed by the World Health Organization (30 µg g-1). Liver samples showed higher concentrations than gills. Metallothionein concentrations indicate differential contamination along the study area. The first sampling showed higher induction of MT synthesis overall. Differences between liver and gill MT concentration trends were relatively minor, which may indicate the adequacy of analyzing gills in an environmental monitoring context.

Perfil do idoso com insuficiência cardíaca internado em um hospital de urgência / Profile of elderly people with heart failure in an emergency hospital / Perfil del anciano con insuficiencia cardíaca internado en un hospital de urgencia

Objetivou-se analisar o perfil sociodemográfico e clínico do idoso com insuficiência cardíaca em um hospital de urgência. Estudo descritivo, quantitativo com amostra por conveniência composta de 83 idosos internados em um hospital de referência em urgência no período de setembro a novembro de 2015. Os resultados mostraram um perfil epidemiológico representado em sua maioria por homens, na faixa etária de 60 a 79 anos, casados, analfabetos, com renda mensal de um a dois salários mínimos. Quanto à etiologia, o tipo hipertensivo apresentou-se como a principal causa, com frequência maior na faixa etária de 60 a 79 anos. Do total de idosos, 54 (65,1%) usam de três a cinco medicamentos diariamente. Entre as doenças crônicas associadas, a hipertensão arterial encontrou-se presente em80 (96,4%) pacientes, seguindo-se da diabetes, diagnosticada em 35 (42,2%) idosos. Constatou-se vulnerabilidade da população em estudo aos fatores de risco cardiovascular, com predomínio da hipertensão arterial e diabetes (AU).

The aim of this study was to analyze the sociodemographic and clinical profile of elderly people with heart failure in an emergency hospital. This is a descriptive, quantitative study with a convenience sample of 83 elderly people hospitalized in an emergency reference hospital from September to November, 2015. The results showed an epidemiological profile represented mostly by men aged 60 to 79 years, who were married, illiterate, with monthly income of one to two minimum wages. Regarding etiology, the hypertensive type was found as the main cause, with greater frequency in the age group of 60 to 79 years. Of the total, 54 elderly people (65.1%) used three to five medications daily. Among the associated chronic diseases, arterial hypertension was present in 80 (96.4%) patients, followed by diabetes, diagnosed in 35 (42.2%) of the elderly. The study population was vulnerable to cardiovascular risk factors, with a redominance of arterial hypertension and diabetes (AU).

Se objetivó analizar perfil sociodemográfico y clínico del anciano con insuficiencia cardíaca en hospital de urgencia. Estudio descriptivo, cuantitativo, con muestra por conveniencia constituida por 83 ancianos internados en hospital de urgencia de referencia, de setiembre a noviembre de 2015. Los resultados mostraron un perfil epidemiológicamente representado en mayoría por hombres, faja etaria de 60 a 79 años, casados, analfabetos, con ingresos mensuales de uno a dos salarios mínimos. Respecto a la etiología, el tipo hipertensivo se presentó como principal causa, con frecuencia mayor en la faja etaria de 60 a 79 años. Del total de ancianos, 54 (65,1%) utilizan de tres a cinco medicamentos diarios. Entre las enfermedades crónicas asociadas, la hipertensión arterial, se encontró presente en 80 pacientes (96,4%), seguida de diabetes, diagnosticada en 35 ancianos (42,2%). Se constató vulnerabilidad de la población en estudio a los factores de riesgo cardiovascular, con predominio de hipertensión arterial y diabeteS (AU).

Construction and validation of a virtual learning object on intestinal elimination stoma / Construcción y validación de un objeto virtual de aprendizaje sobre estomas intestinales de eliminación / Construção e validação de um objeto virtual de aprendizagem sobre estomas intestinais de eliminação

Objective.To construct and validate a virtual learning object (VLO) on intestinal elimination stoma. Methods. Applied, descriptive and quantitative study. In 2014, eight stoma therapists and eight experts in computer science took part of the research. The VLO included four steps: i) planning, ii) construction of VLO and changes of content; iii) development of dynamic, and iv) conclusion and analysis. The VLO was inserted into the Moodle virtual learning environment. The ergonomic and pedagogical validation of the VLO was performed. Results. The experts appreciated the VLO satisfactorily, and scored it between good and full agreement. Conclusion. The VLO on intestinal elimination stoma is a tool that can be implemented at undergraduate programs in nursing and continuing education programs for nurses in clinical practice, contributing significantly to improve the theoretical skills necessary for the care of ostomized people safely, with quality and enabling self-care.

Objetivo.Construir y validar un Objeto Virtual de Aprendizaje (OVA) sobre estomas intestinales. Métodos. Investigación aplicada, descriptiva y cuantitativa. En 2014 participaron ocho estomaterapeutas y ocho especialistas en informática. El OVA contempló cuatro etapas: i) planeación, ii) construcción del OVA y cambios de los contenidos, iii) desarrollo de la dinámica, y iv) conclusión y análisis. El OVA se añadió al ambiente virtual de aprendizaje Moodle. Se realizó la validación ergonómica y pedagógica del OVA. Resultados. Los especialistas apreciaron satisfactoriamente el OVA; de hecho, el acuerdo de expertos se puntuó entre la buena concordancia a la concordancia plena. Conclusión. El OVA sobre estomas intestinales es una herramienta que puede ser implementada en el Curso de Graduación de Enfermería y en los programas de educación permanente para enfermeros en la práctica clínica, contribuyendo significativamente a mejorar la competencia teórica necesaria para el cuidado de personas estomizadas de forma segura, con calidad y posibilitando el autocuidado.

Construir e validar um objeto virtual de aprendizagem (OVA) sobre estomas intestinais de eliminação. Métodos. Pesquisa aplicada, descritiva e quantitativa. Em 2014 participaram oito Estomaterapeutas e oito especialistas em Informática. O OVA contemplou quatro etapas: i) planejamento, ii) construção do OVA e mudanças dos conteúdos; iii) desenvolvimento da dinâmica, e iv) conclusão e análise. O OVA foi inserido no ambiente virtual de aprendizagem Moodle. Realizou-se a validação ergonômica e pedagógica do OVA. Resultados. Os especialistas apreciaram satisfatoriamente o OVA, o acordo de especialistas pontuou-se entre a boa concordância a concordância plena. Conclusão. O OVA sobre estomas intestinais de eliminação é uma ferramenta que pode ser implementada no Curso de Graduação em Enfermagem e nos programas de educação permanente para enfermeiros na prática clínica, contribuindo significativamente a melhorar a competência teórica necessária para o cuidado de pessoas estomizadas de forma segura, com qualidade e possibilitando o autocuidado.

Construction and validation of a virtual learning object on intestinal elimination stoma.

OBJECTIVE: To construct and validate a virtual learning object (VLO) on intestinal elimination stoma. METHODS: Applied, descriptive and quantitative study. In 2014, eight stoma therapists and eight experts in computer science took part of the research. The VLO included four steps: i) planning, ii) construction of VLO and changes of content; iii) development of dynamic, and iv) conclusion and analysis. The VLO was inserted into the Moodle virtual learning environment. The ergonomic and pedagogical validation of the VLO was performed. RESULTS: The experts appreciated the VLO satisfactorily, and scored it between good and full agreement. CONCLUSION: The VLO on intestinal elimination stoma is a tool that can be implemented at undergraduate programs in nursing and continuing education programs for nurses in clinical practice, contributing significantly to improve the theoretical skills necessary for the care of ostomized people safely, with quality and enabling self-care.

Rapid Tests and the Diagnosis of Visceral Leishmaniasis and Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome Coinfection.

After the emergence of the human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), the number of visceral leishmaniasis (VL)-HIV/AIDS coinfections has increased worldwide. Herein, we assessed the usefulness of an rK39-based immunochromatographic test (rK39 ICT) (DiaMed-IT LEISH(®); DiaMed AG, Cressier-sur-Morat, Switzerland) and a latex agglutination test (KAtex; Kalon Biological, Guildford, United Kingdom) for urinary antigen detection to diagnose VL in 15 HIV/AIDS patients from northeastern Brazil. VL diagnosis was based on clinical findings, cytology, serology, parasite DNA, and/or urinary antigen detection. VL was confirmed in seven out of 15 HIV/AIDS patients. Only three patients were positive in bone marrow cytology, three patients were conventional polymerase chain reaction (PCR) positive, while six were real-time PCR positive. All patients were direct agglutination test (DAT) (Royal Tropical Institute, Amsterdam, The Netherlands) positive; of these, four were positive by rK39 ICT and five by KAtex. Large-scale studies are needed to validate the use of the KAtex in the national public health laboratory network in Brazil, aiming at improving the diagnosis of VL in HIV/AIDS patients in this country.