New tick records with notes on rickettsial infection from the wildlife of the state of Espírito Santo, southeastern Brazil.

This work aimed to report ticks infesting the wildlife among 15 municipalities of the state of Espírito Santo between 2016 and 2021, within the Atlantic Forest biome of southeastern Brazil. A total of 576 tick specimens (187 males, 56 females, 149 nymphs, and 184 larvae) was collected from 41 species of wild vertebrates (two reptiles, nine mammals, and 30 birds). Ticks were identified by morphological or molecular methods into 18 species, being 12, four, one and one of the genera Amblyomma, Ixodes, Rhipicephalus and Ornithodoros, respectively. Amblyomma rotundatum was the only species collected from reptiles. Ticks collected from mammals were identified as Amblyomma brasiliense, Amblyomma calcaratum, Amblyomma dubitatum, Amblyomma longirostre, Amblyomma nodosum, Amblyomma pacae, Amblyomma sculptum, Amblyomma varium and Rhipicephalus microplus. Amblyomma sculptum was the species found on the widest variety of hosts, collected from four mammal orders and five bird orders. Passeriformes birds were infested by Amblyomma fuscum, A. longirostre (also found on non- passerine birds), A. nodosum, Amblyomma parkeri, Amblyomma romarioi, A. varium and Ixodes loricatus. An adult female of Ixodes rio was collected from a Piciformes bird. Seabirds of the order Procellariiformes were infested by Ixodes percavatus sensu lato and Ixodes uriae. The argasid Ornithodoros capensis was collected from an offshore metallic platform that was used by Suliformes seabirds. Rickettsial agents of the spotted fever group, Rickettsia amblyommatis and Rickettsia sp. strain Pampulha, were detected in the ticks A. longirostre [from the Paraguayan hairy dwarf porcupine (Coendou spinosus)] and A. dubitatum [from the capybara (Hydrochoerus hydrochaeris)], respectively. The following nine tick species are reported for the first time in Espírito Santo state: A. calcaratum, A. fuscum, A. pacae, A. parkeri, A. romarioi, I. loricatus, I. rio, I. uriae, and O. capensis. Although it is also the first report of I. uriae in Brazil, we do not consider it established in the country. Multiple new tick-host associations are reported in the present study.

Changes in the quality of life of adults with an ostomy during the first year after surgery as part of the Best Practice Spotlight Organisation® Programme.

The aim was to analyse changes in the perceived quality of life of patients with an ostomy during the first year after surgery at two or three follow-ups. This is a prospective study of a cohort of 55 patients who were ostomised between June 2021 and September 2022 and cared for under the recommendations set out in the Registered Nurses' Association of Ontario® best practice guideline Supporting Adults Who Anticipate or Live with an Ostomy as part of the Best Practice Spotlight Organisation® (BPSO®) programme. The Stoma Quality of Life tool was used. A univariate analysis was performed to identify variables associated with a non-improvement in quality of life. Variables showing p < 0.1 were included in a multivariate model. Patients with an ostomy exhibited a moderate-to-good perception of quality of life in both the personal and social dimensions, with no worsening over the first year. Being female (OR = 10.32) and being younger (OR = 0.89) were associated with a higher risk of no improvement in quality of life. The most frequent complications were urinary leakage (p = 0.027) and dermatitis (p = 0.052) at first follow-up; and parastomal hernia (p = 0.009) and prolapse (p = 0.05) at third follow-up. However, they did not lead to a worsening of quality of life, suggesting that these patients were adequately supported under the BPSO® programme.

Nurses' evidence-based practice competence and hospital practice environment after specific training under the Best Practice Spotlight Organization® Programme. A cross sectional study.

BACKGROUND: Barriers to implementing training strategies for the improvement of evidence-based practice competence of nurses in hospital practice environments still persist. OBJECTIVE: The aim of the study was to evaluate the impact of a specific training within the framework of the Best Practice Spotlight Organization® programme, on nurses' evidence-based practice competence and the practice environment in two hospitals. DESIGN: This is a observational cross-sectional study assessing evidence-based practice competence and perceptions of Practice Environments. PARTICIPANTS: The study sample were 204 nurses working at medical and surgical inpatient units at two hospitals involved in the Best Practice Spotlight Organization® programme. METHODS: The study was conducted from February 2020 to May 2020. Three questionnaires were used to collect data: a sociodemographic/occupational questionnaire, a questionnaire exploring evidence-based practice skills, and a questionnaire exploring nurses' perceptions of their hospital practice environments. RESULTS: A total of 204 nurses participated. They were classified into two groups: those who had received specific training within the framework of the programme, called trained-champions (n = 66), and those who had not yet received training, control group (n = 138). The trained-champions exhibited better evidence-based practice competence values than the control group in all dimensions (p < 0.001), with a higher difference in means in the "Utilisation" dimension (-0.80; CI:-0.99,-0.60) and the "Knowledge" dimension (-0.63; CI:-0.88,-0.38). Trained-champions also had a more positive perception of the practice environments than the controls in all dimensions (p ≤ 0.001). The largest differences in means were in the "Participation" dimension (-0.48; CI:-0.66,-0.31) and in the "Leadership" dimension (-0.41; CI:-0.59,-0.23). CONCLUSIONS: Specific EBP training within the framework of the Best Practice Spotlight Organization® programme has succeeded in nurses (trained-champions) obtaining better EBP competence than others without this training. This could have contributed to increase nurses' abilities to integrate evidence into decision making in their clinical practice, while positively influencing them to perceive their PEs more favorably.

The influence of preoperative anxiety on postoperative pain in patients undergoing cardiac surgery.

Patients undergoing cardiac surgery represent a challenge in terms of pain management due to multiple factors relating to the patients and to the procedure itself. Our aim was to identify the influence of levels of preoperative anxiety on postoperative pain in patients undergoing cardiac surgery and explore associations between preoperative anxiety, postoperative pain, analgesic requirements, and sex. We present a prospective cohort study of 116 patients undergoing cardiac surgery between January and April 2020. Preoperative anxiety was evaluated using the State-Trait Anxiety Inventory and the amount of morphine needed to keep pain intensity below 4 on the verbal numerical rating scale was recorded for 48 h post-surgery. Given the extracorporeal circulation time, type of surgery and body surface, it was observed that every percentile increase in preoperative state anxiety led to an extra 0.068 mg of morphine being administered. For each extra year of age, the amount of morphine needed decreased by 0.26 mg, no difference was observed between men and women in terms of preoperative anxiety or postoperative analgesics requirements. It may be concluded that in cardiac surgery, postoperative analgesic requirements increased with higher levels of preoperative state anxiety and decreased for every extra year of age.

Assessing the Expression of Emotions in Breast Cancer Survivors during the Time of Recovery: Perspective from Focus Groups.

Breast cancer has major public health implications, as it is the most frequent malignant tumor and the leading cause of cancer death in women. Survivors have many needs, including strategies to cope with the associated distress. We explore whether focus groups are useful for nurses to obtain information about the emotional state of breast cancer women, and develop strategies for coping with the stress that this disease entails. A qualitative study was carried out, involving 25 focus groups with 83 women treated for breast cancer, recruited from the local Breast Cancer Association (ALMOM). Four open-ended questions were employed, and 60-min discussions were carried out. They were transcribed, analyzed, coded, and the themes identified. Four major themes emerged, including "complex emotional evolution", "emotional isolation", "lack of information" and "inability to give advice". Women admitted that this disease had been a stressful factor for them, causing emotional (anxiety, irritability, anger or guilt) and cognitive disorders (confusion, lack of concentration, forgetfulness). The use of focus groups in breast cancer survivors allows nurses to evaluate the expression of emotions in these women, and collect and share information about their feelings, thoughts and experiences, so that survivors can cope more easily with the stress related to their illness.

A Semantic Social Network Analysis Tool for Sensitivity Analysis and What-If Scenario Testing in Alcohol Consumption Studies.

Social Network Analysis (SNA) is a set of techniques developed in the field of social and behavioral sciences research, in order to characterize and study the social relationships that are established among a set of individuals. When building a social network for performing an SNA analysis, an initial process of data gathering is achieved in order to extract the characteristics of the individuals and their relationships. This is usually done by completing a questionnaire containing different types of questions that will be later used to obtain the SNA measures needed to perform the study. There are, then, a great number of different possible network-generating questions and also many possibilities for mapping the responses to the corresponding characteristics and relationships. Many variations may be introduced into these questions (the way they are posed, the weights given to each of the responses, etc.) that may have an effect on the resulting networks. All these different variations are difficult to achieve manually, because the process is time-consuming and error-prone. The tool described in this paper uses semantic knowledge representation techniques in order to facilitate this kind of sensitivity studies. The base of the tool is a conceptual structure, called "ontology" that is able to represent the different concepts and their definitions. The tool is compared to other similar ones, and the advantages of the approach are highlighted, giving some particular examples from an ongoing SNA study about alcohol consumption habits in adolescents.

The Influence of Adolescents' Social Networks on Alcohol Consumption: A Descriptive Study of Spanish Adolescents Using Social Network Analysis.

In adolescence, friends are important due to their influence on the acquisition of habits such as alcohol consumption. However, there is a lack of studies that describe the structural context of adolescents, which would be useful to implement prevention strategies. Therefore, our research question was how adolescent friendship networks influence alcohol consumption. Our goal was to determine the structural profile of adolescent at-risk alcohol users and their relational context in the classroom. We designed a descriptive cross-sectional study based on social network analysis to analyze structural patterns. We recruited 195 students. Social-network and alcohol-consumption variables were analyzed using the UCINET and STATA programs. Some 86.67% of participants had consumed alcohol at some time in their lives and the prevalence of at-risk alcohol use was higher in females (50.48% vs. 49.52%; OR: 1.84; CI 95%: 0.99⁻3.43%; p = 0.036). The lower the intensity of friendship, the more contacts adolescent at-risk alcohol users had within the network, and the easier it was for them to access their peers. Consequently, we conclude that the structure of a class is a key factor that merits further research.

A Web-Based Tool for Automatic Data Collection, Curation, and Visualization of Complex Healthcare Survey Studies including Social Network Analysis.

There is a great concern nowadays regarding alcohol consumption and drug abuse, especially in young people. Analyzing the social environment where these adolescents are immersed, as well as a series of measures determining the alcohol abuse risk or personal situation and perception using a number of questionnaires like AUDIT, FAS, KIDSCREEN, and others, it is possible to gain insight into the current situation of a given individual regarding his/her consumption behavior. But this analysis, in order to be achieved, requires the use of tools that can ease the process of questionnaire creation, data gathering, curation and representation, and later analysis and visualization to the user. This research presents the design and construction of a web-based platform able to facilitate each of the mentioned processes by integrating the different phases into an intuitive system with a graphical user interface that hides the complexity underlying each of the questionnaires and techniques used and presenting the results in a flexible and visual way, avoiding any manual handling of data during the process. Advantages of this approach are shown and compared to the previous situation where some of the tasks were accomplished by time consuming and error prone manipulations of data.

A Qualitative Study of Secondary School Teachers' Perception of Social Network Analysis Metrics in the Context of Alcohol Consumption among Adolescents.

Adolescence is a transitional period during which a number of changes occur. Social relationships established during this period influence adolescent behaviour and affect academic performance or alcohol consumption habits, among other issues. Teachers are very important actors in observing and guiding the evolution of their students, and should therefore have the appropriate knowledge and tools to gain insight into the complex social relationships that exist in their classes. The use of social network analysis (SNA) techniques may be helpful in order to study and monitor the evolution of these social networks. This study tries to understand how teachers perceive SNA metrics from an intuitive point of view. Using this information, useful tools could be created that allow teachers to use SNA techniques to improve their understanding of student relationships. A number of interviews with different teachers were held in secondary schools in Spain, allowing SNA concepts to be related to the everyday terms used by the teachers to characterize their students. Results from the study have an impact on questionnaire design for gathering data from students in order to perform an SNA analysis and on the design of software applications that can help teachers to understand the results of this analysis.