Physiological Adaptations to Progressive Endurance Exercise Training in Adult and Aged Rats: Insights from the Molecular Transducers of Physical Activity Consortium (MoTrPAC).

While regular physical activity is a cornerstone of health, wellness, and vitality, the impact of endurance exercise training on molecular signaling within and across tissues remains to be delineated. The Molecular Transducers of Physical Activity Consortium (MoTrPAC) was established to characterize molecular networks underlying the adaptive response to exercise. Here, we describe the endurance exercise training studies undertaken by the Preclinical Animal Sites Studies component of MoTrPAC, in which we sought to develop and implement a standardized endurance exercise protocol in a large cohort of rats. To this end, Adult (6-mo) and Aged (18-mo) female (n = 151) and male (n = 143) Fischer 344 rats were subjected to progressive treadmill training (5 d/wk, ∼70%-75% VO2max) for 1, 2, 4, or 8 wk; sedentary rats were studied as the control group. A total of 18 solid tissues, as well as blood, plasma, and feces, were collected to establish a publicly accessible biorepository and for extensive omics-based analyses by MoTrPAC. Treadmill training was highly effective, with robust improvements in skeletal muscle citrate synthase activity in as little as 1-2 wk and improvements in maximum run speed and maximal oxygen uptake by 4-8 wk. For body mass and composition, notable age- and sex-dependent responses were observed. This work in mature, treadmill-trained rats represents the most comprehensive and publicly accessible tissue biorepository, to date, and provides an unprecedented resource for studying temporal-, sex-, and age-specific responses to endurance exercise training in a preclinical rat model.

Mid-range theory of the nursing diagnosis Overweight.

OBJECTIVE: To build a mid-range theory for the nursing diagnosis Overweight in adolescents and young adults. METHODS: A methodological study in the light of the theoretical frameworks of Roy and of Lopes, Silva and Herdman. A total of 3,925 articles were retrieved and assessed using the State of the Art Through Systematic Review software. The final sample consisted of 28 articles. RESULTS: The findings converged to 3 essential attributes, 13 antecedents, and 7 consequences. A mid-range theory was built consisting of an illustrated diagram, 11 propositions, and 12 causal relationships. FINAL CONSIDERATIONS: From the creation of the theory, it was possible to better understand the nursing diagnosis Overweight within the context of adolescents and young adults. Understanding nursing phenomena contributes to nursing science's advancement and strengthening.

Predictors of excess fluid volume in hemodialysis patients: an observational study.

OBJECTIVES: to assess risk factors for excess fluid volume in hemodialysis patients. METHODS: a retrospective case-control study was conducted. A total of 392 patients (196 cases and 196 controls) from two hemodialysis centers were included. Sociodemographic data and 23 risk factors for excess fluid volume were assessed using a data collection form. Data were analyzed using a multivariate logistic regression model. RESULTS: the insufficient knowledge (OR=2.06), excessive fluid intake (OR=2.33), inadequate fluid removal during hemodialysis (OR=2.62) and excessive sodium intake (OR=1.91) risk factors may increase the chance of occurrence of excess fluid volume in hemodialysis patients by approximately two times. Education level (OR=0.95) and age (OR=0.97) are protective factors for excessive fluid volume. CONCLUSIONS: knowing these risk factors may help nurses with accurate and rapid diagnostic inference of the risk of excessive fluid volume.

Influence of Lemongrass Essential Oil (Cymbopogon flexuosus) Supplementation on Diabetes in Rat Model.

(1) Background: Species of the genus Cymbopogon and its essential oil are known for their antioxidant and hypoglycemic effects. This study aimed to investigate the impact of the essential oil of Cymbopogon flexuosus (EOCF), and its major component, citral, on glycemic, lipid, antioxidant parameters, and oxidative stress in a type 1 diabetes (DM1) rat model. (2) Methods: Initially, EOCF was analyzed by Gas chromatography-mass spectrometry (GC-MS) and the antioxidant activity of EOCF and citral was evaluated. Next, male Wistar rats (3 months old, 200-250 g) induced with DM1 using Streptozotocin (STZ) were divided into four groups: negative control supplemented with an 80% Tween solution, two groups of animals supplemented with EOCF (32 mg/kg and 64 mg/kg) and with citral (32 mg/kg), and treated for 14 days. Measurements of blood glucose levels and body weight were taken; after euthanasia, biochemical markers, including lipid profile, uric acid, alanine aminotransferase (ALT), and aspartate aminotransferase (AST), were evaluated. (3) Results: The predominant compounds in EOCF were α-citral (53.21%) and neral (19.42%), constituting 72.63% citral. EOCF showed good antioxidant activity, significantly greater than citral. EOCF supplementation demonstrated a mitigating effect on glycemic, lipid, and hepatic abnormalities induced by DM1. (4) Conclusions: EOCF emerges as a promising therapeutic option for the management of DM1.

Deficient knowledge in patients with heart failure: A study of diagnostic accuracy and etiological relationships.

PURPOSE: To evaluate the accuracy of defining characteristics and causal relationships of the etiological factors of the nursing diagnosis deficient knowledge in individuals with heart failure . DATA SOURCES: An analytical, cross-sectional study on the diagnostic accuracy of the defining characteristics and causal relationships of the etiological factors of the nursing diagnosis. The sample consisted of 140 patients with chronic HF and in outpatient follow-up. The latent class analysis method was used to test the accuracy of measurements and estimate the prevalence of the diagnosis. The calculation of subsequent probabilities and the odds ratio ( were also parameters employed. The study was approved by the Research Ethics Committee of the Federal University of Pernambuco. DATA SYNTHESIS: The diagnosis had an estimated prevalence of 38.57% in the sample. The inaccurate statements about the disease and/or therapy, self-care deficient performance, and inadequate behavior were the clinical indicators that best predicted the presence of the diagnosis and demonstrated the same sensitivity value (1.0000), specificity (1.0000), and 95% confidence interval (0.9999-1.0000) for all. The populations at risk was elderly (OR = 2.12, confidence interval 95% = 1.05-4.27), and illiterate individuals (OR = 2.07, confidence interval 95% = 1.03-4.16) had an approximately twofold great chance of developing havening deficient knowledge. CONCLUSION: The evaluation of the accuracy of clinical indicators, corresponding to the defining characteristics in the study, contributed to screening and diagnostic establishment capacity in clinical practice, and to the translation of theoretical and practical knowledge. IMPLICATIONS FOR NURSING PRACTICE: Accurate clinical indicators of the nursing diagnosis deficient knowledge facilitate the clinical reasoning of nurses and favor the professional's role in the development of health education strategies focused on the acquisition of knowledge about the disease by patients, family members, and caregivers.

OBJETIVO: Avaliar a acurácia das características definidoras e relações causais dos fatores etiológicos do diagnóstico de enfermagem Conhecimento deficiente em pacientes com insuficiência cardíaca. FONTE DE DADOS: Estudo analítico, transversal, sobre a acurácia diagnóstica das características definidoras e relações causais dos fatores etiológicos do diagnóstico de enfermagem. A amostra foi composta por 140 pacientes com insuficiência cardíaca crônica e em acompanhamento ambulatorial. O método de análise de classes latentes foi utilizado para testar as medidas de acurácia e estimar a prevalência do diagnóstico. O cálculo de probabilidades posteriores e a Odds Ratio também foram parâmetros empregados. O estudo teve aprovação do Comitê de Ética em Pesquisa da Universidade Federal de Pernambuco. SÍNTESE DE DADOS: O diagnóstico apresentou prevalência estimada de 38,57% na população. As Declarações imprecisas sobre a doença e/ou terapêutica, Déficit no desempenho do autocuidado e Comportamento inadequado foram os indicadores clínicos que melhor predisseram a presença do diagnóstico e demonstraram o mesmo valor de sensibilidade (1.0000), especificidade (1.0000) e intervalo de confiança 95% (0.9999­1.0000) para todos. As populações em risco Idoso (Odds Ratio = 2.12, intervalo de confiança 95% = 1.05­4.27) e Indivíduos analfabetos (Odds Ratio = 2.07, intervalo de confiança 95% = 1.03­4.16) apresentaram, aproximadamente, duas vezes a chance de desenvolver o conhecimento deficiente. CONCLUSÃO: A avaliação da acurácia dos indicadores clínicos, correspondentes as características definidoras no estudo, contribuiu para a capacidade de triagem e estabelecimento de diagnósticos na prática clínica e para a tradução de conhecimentos teóricos e práticos. IMPLICAÇÕES PARA PRÁTICA DE ENFERMAGEM: Indicadores clínicos acurados do diagnóstico de enfermagem Conhecimento deficiente facilitam o raciocínio clínico do enfermeiro e favorecem a atuação do profissional na elaboração de estratégias de educação em saúde focadas na aquisição do conhecimento sobre a doença por parte de pacientes, familiares e cuidadores.

Predictors of excess fluid volume in hemodialysis patients: an observational study / Preditores de volume excessivo de líquidos em pacientes em hemodiálise: estudo observacional / Predictores de volumen excesivo de líquidos en pacientes en hemodiálisis: estudio observacional

ABSTRACT Objectives: to assess risk factors for excess fluid volume in hemodialysis patients. Methods: a retrospective case-control study was conducted. A total of 392 patients (196 cases and 196 controls) from two hemodialysis centers were included. Sociodemographic data and 23 risk factors for excess fluid volume were assessed using a data collection form. Data were analyzed using a multivariate logistic regression model. Results: the insufficient knowledge (OR=2.06), excessive fluid intake (OR=2.33), inadequate fluid removal during hemodialysis (OR=2.62) and excessive sodium intake (OR=1.91) risk factors may increase the chance of occurrence of excess fluid volume in hemodialysis patients by approximately two times. Education level (OR=0.95) and age (OR=0.97) are protective factors for excessive fluid volume. Conclusions: knowing these risk factors may help nurses with accurate and rapid diagnostic inference of the risk of excessive fluid volume.

RESUMO Objetivos: avaliar os fatores de risco para o excesso de volume de líquidos em pacientes em hemodiálise. Métodos: estudo retrospectivo caso-controle. Foram incluídos 392 pacientes (196 casos e 196 controles) de dois centros de hemodiálise. Dados sociodemográficos e 23 fatores de risco para excesso de volume de líquidos foram avaliados por meio de formulário de coleta de dados. Os dados foram analisados por meio de modelo de regressão logística multivariada. Resultados: os fatores de risco conhecimento insuficiente (OR=2,06), ingestão excessiva de líquidos (OR=2,33), retirada inadequada de líquidos durante hemodiálise (OR=2,62) e ingestão excessiva de sódio (OR=1,91) podem aumentar a chance de ocorrência de excesso de líquidos volume em pacientes em hemodiálise em aproximadamente duas vezes. Escolaridade (OR=0,95) e idade (OR=0,97) são fatores de proteção para volume excessivo de líquidos. Conclusões: conhecer esses fatores de risco pode auxiliar enfermeiros na inferência diagnóstica precisa e rápida do risco de volume excessivo de líquidos.

RESUMEN Objetivos: evaluar los factores de riesgo del exceso de volumen de líquido en pacientes en hemodiálisis. Métodos: estudio retrospectivo de casos y controles. Se incluyeron 392 pacientes (196 casos y 196 controles) de dos centros de hemodiálisis. Se evaluaron datos sociodemográficos y 23 factores de riesgo de exceso de volumen de líquido mediante un formulario de recolección de datos. Los datos se analizaron mediante un modelo de regresión logística multivariado. Resultados: factores de riesgo conocimiento insuficiente (OR=2,06), ingesta excesiva de líquidos (OR=2,33), retirada inadecuada de líquidos durante la hemodiálisis (OR=2,62) e ingesta excesiva de sodio (OR=1,91) pueden aumentar aproximadamente dos veces la posibilidad de que se produzca un exceso de volumen de líquido en pacientes en hemodiálisis. La educación (OR=0,95) y la edad (OR=0,97) son factores protectores del volumen excesivo de líquido. Conclusiones: conocer estos factores de riesgo puede ayudar a las enfermeras a realizar una inferencia diagnóstica precisa y rápida del riesgo de volumen excesivo de líquidos.

Mid-range theory of the nursing diagnosis Overweight / Teoria de médio alcance do diagnóstico de enfermagem sobrepeso / Teoría de rango medio del diagnóstico de enfermería sobrepeso

ABSTRACT Objective: To build a mid-range theory for the nursing diagnosis Overweight in adolescents and young adults. Methods: A methodological study in the light of the theoretical frameworks of Roy and of Lopes, Silva and Herdman. A total of 3,925 articles were retrieved and assessed using the State of the Art Through Systematic Review software. The final sample consisted of 28 articles. Results: The findings converged to 3 essential attributes, 13 antecedents, and 7 consequences. A mid-range theory was built consisting of an illustrated diagram, 11 propositions, and 12 causal relationships. Final considerations: From the creation of the theory, it was possible to better understand the nursing diagnosis Overweight within the context of adolescents and young adults. Understanding nursing phenomena contributes to nursing science's advancement and strengthening.

RESUMO Objetivo: Construir uma teoria de médio alcance para o diagnóstico de enfermagem Sobrepeso em adolescentes e adultos jovens. Método: Estudo metodológico à luz dos referenciais teóricos de Roy e Lopes, Silva e Herdman. Um total de 3.925 artigos foram identificados e avaliados usando o programa State of the Art Through Systematic Review. A amostra final foi composta por 28 artigos. Resultados: Os achados convergiram para 3 atributos essenciais, 13 antecedentes e 7 consequentes. Foi construída uma teoria de médio alcance composta por um diagrama ilustrado, 11 proposições e 12 relações causais. Considerações finais: A partir da elaboração da teoria, foi possível compreender melhor o diagnóstico de enfermagem Sobrepeso no contexto de adolescentes e adultos jovens. A compreensão dos fenômenos da enfermagem contribui para o avanço e fortalecimento da ciência da enfermagem.

RESUMEN Objetivo: Construir una teoría de rango medio para el diagnóstico de enfermería Sobrepeso en adolescentes y adultos jóvenes. Métodos: Estudio metodológico a la luz de los marcos teóricos de Roy y de Lopes, Silva y Herdman. Un total de 3.925 artículos fueron recuperados y evaluados utilizando el software State of the Art Through Systematic Review. La muestra final fue de 28 artículos. Resultados: Los resultados convergieron en 3 atributos esenciales, 13 antecedentes y 7 consecuencias. Se construyó una teoría de rango medio compuesta por un diagrama ilustrado, 11 proposiciones y 12 relaciones causales. Consideraciones finales: A partir de la creación de la teoría, fue posible comprender mejor el diagnóstico de enfermería Sobrepeso en el contexto de adolescentes y adultos jóvenes. La comprensión de los fenómenos de enfermería contribuye para el avance y fortalecimiento de la ciencia de enfermería.

Diagnostic accuracy study of the clinical indicators of vascular trauma in patients undergoing antineoplastic chemotherapy in peripheral veins.

Antineoplastic chemotherapy patients are susceptible to vascular trauma. The identification of this problem is possible through accurate clinical indicators. However, there are few diagnostic accuracy studies of vascular trauma in these patients. Thus, the objective was to analyze the accuracy of clinical indicators of vascular trauma in antineoplastic chemotherapy patients. A diagnostic accuracy study was carried out with a sample of 200 patients undergoing antineoplastic chemotherapy, in an oncology reference clinic, during 2018. A data collection form was created with sociodemographic and clinical data and indicators of vascular trauma. The sensitivity and specificity of the clinical indicators were assessed using a latent class analysis of random effects. The clinical indicators of decreased vascular elasticity (0.8384), pain (0.9573), and signs of infection at the catheter insertion site (0.9999) were specific for identifying vascular trauma in antineoplastic chemotherapy patients. The prevalence of vascular trauma in these patients was 11.17%. A set of three clinical indicators was considered accurate and statistically significant for confirming vascular trauma. This study has provided accurate clinical indicators of vascular trauma in antineoplastic chemotherapy patients. These results can contribute to establishing interventions, thereby reducing costs and maximizing health outcomes in this population.

Análise da teoria da diversidade e universalidade do cuidado cultural de Madeleine Leininger / Analysis of the Madeleine Leininger’s theory of diversity and universality of cultural care / Análisis de la teoría de la diversidad y universalidad del cuidado cultural de Madeleine Leininger

This study aimed to analyze Madeleine Leininger's Theory of Diversity and Universality of Cultural Care. It is a study of interpretive analysis based on the model of theory evaluation proposed by Johnson, carried out in the months of January and February 2022. It is confirmed that Leininger's theory has theoretical consistency and the ability to contribute to practical, scientific and nursing profession. The theory is presented as easy to understand, with accessible and clear language, and presents well-defined concepts that stimulate the formulation of propositions. It presents further variations and assumptions that contribute to the interpretation and understanding of the propositions, as well as theoretical knowledge that helps to explain and make predictions about two phenomena o interest in the disease. To analyze it is possible to show Leininger's theory to theoretical consistency and to the capacity to contribute to nursing practice. The relevance of the application of nursing hairs in various contexts of care is highlighted for the scope of care that is culturally and consistently guided by the context and the needs of two individuals.(AU)

Este estudio tuvo como objetivo analizar la Teoría de la Diversidad y Universalidad del Cuidado Cultural de Madeleine Leininger. Se trata de un estudio de análisis interpretativo basado en el modelo de evaluación de la teoría propuesto por Johnson, realizado en enero y febrero de 2022. Se constató que la teoría de Leininger tiene consistencia teórica y capacidad de contribuir a la práctica, la ciencia y la profesión de enfermería. La teoría es de fácil comprensión, con un lenguaje accesible y claro, y presenta conceptos bien definidos que estimulan la formulación de proposiciones. También presenta variables y supuestos que contribuyen a la interpretación y comprensión de proposiciones, así como conocimientos teóricos que ayudan a explicar y hacer predicciones sobre los fenómenos de interés para la enfermería. El análisis permitió evidenciar en la teoría de Leininger la consistencia teórica y la capacidad de contribuir a la práctica de enfermería. Se destaca la relevancia de la aplicación de los enfermeros en diferentes contextos de trabajo para lograr un cuidado guiado cultural y congruentemente con el contexto y las necesidades de los individuos.(AU)

Este estudo objetivou analisar a Teoria da Diversidade e Universalidade do Cuidado Cultural de Madeleine Leininger. Tratase de um estudo de análise interpretativa baseado no modelo de avaliação de teorias proposto por Johnson, realizado nos meses de janeiro e fevereiro de 2022. Constatouse que a teoria de Leininger possui consistência teórica e capacidade de contribuir para a prática, ciência e profissão de enfermagem. A teoria se apresenta de fácil compreensão, com linguagem acessível e clara, e apresenta conceitos bem delimitados que estimulam a formulação de proposições. Apresenta ainda variáveis e suposições que contribuem para a interpretação e compreensão das proposições, assim como conhecimento teórico que auxilia a explicar e fazer predições acerca dos fenômenos de interesse da enfermagem. A análise possibilitou evidenciar na teoria de Leininger a consistência teórica e a capacidade de contribuir para a prática de enfermagem. Destacase a relevância da aplicação da pelos enfermeiros em diversos contextos de atuação para o alcance de um cuidado culturalmente e congruentemente pautado no contexto e nas necessidades dos indivíduos.(AU)

Perspectivas do ser cuidadora informal de crianças com deficiência / Perspectives of being a female informal caregiver of children with disabilities

Objetivo: Conhecer a perspectiva do ser cuidadora informal de crianças com deficiência.Métodos: Estudo descritivo, exploratório, de abordagem qualitativa. As participantes foram cuidadoras informais de crianças com deficiência. A coleta de dados se deu por meio de quatro grupos focais virtuais, pela plataforma Google Meet. A análise ocorreu por meio da Análise de Conteúdo Temática. O critério para a categorização foi o semântico. As categorias emergidas foram nomeadas à luz da literatura científica pertinente.Resultados: Após a análise dos grupos focais, emergiram três categorias: categoria 1 -Os pares como rede de apoio; categoria 2 -A vivência da espiritualidade; categoria 3 -Inquietações frente a aspectos sociais e legais.Conclusão: A perspectiva do ser cuidadora informal de crianças com deficiência envolve uma ótica negativa e positiva. Negativa, no sentido de que há uma insatisfação mediante os julgamentos imputados pela sociedade em relação a elas e ao arcabouço legal que rege seus direitos. Positiva, por meio da rede de apoio que demais mães de crianças com deficiência formam e da vivência da espiritualidade no contexto do cuidar, tornando a rotina de cuidados mais suave. Descritores:Cuidadores Informais; Crianças com Deficiência; Pesquisa Qualitativa.

Objective: To know the perspective of being a female informal caregiver of children with disabilities.Methods: A descriptive, exploratory and qualitative study. The participants were female informal caregivers of children with disabilities. Data collection took place through four virtual focus groups, via the Google Meet platform. The analysis was carried out by means of Thematic Content Analysis. The criterion for categorization was semantic. The categories that emerged were named in the light of the relevant scientific literature.Results: Three categories emerged after analyzing the focus groups, namely: Category 1 -Peers as support network; Category 2 -The spirituality experience; and Category 3 -Concerns about social and legal aspects.Conclusion: The perspective of being a female informal caregiver of children with disabilities involves a negative and positive aspect. Negative, in the sense that there is dissatisfaction through the judgments imputed by society in relation to them and the legal framework that governs their rights. Positive, through the support network comprised by other mothers of children with disabilities and the spirituality experience in the care context, making the care routine smoother.Descriptors:Caregivers; Disabled Children; Qualitative Research.

Informal caregivers of children with cerebral palsy ways of coping with the uncertainty of illness.

OBJECTIVE: To unveil the process of collective construction of interventions for coping by informal caregivers of children with cerebral palsy using the Theory of Uncertainty in Illness. METHOD: Qualitative action-research in a hybrid format with informal caregivers of children with cerebral palsy registered with the Raros group in Petrolina, Pernambuco. The research followed the planned intervention cycle, going through four phases. The analysis was carried out using the IRAMUTEQ software and content analysis. RESULTS: Interventions were designed collectively, both virtually and in person, which resulted in improvements for informal caregivers in coping with the conditions associated with the disability, promotion of self-care, empowerment and the construction of a sense of belonging to the group. There were 12 participants, all of whom were mothers. CONCLUSION: There was a facilitation of the process of coping with uncertainty in the disease on the part of the informal caregiver of children with cerebral palsy and it was evidenced that for this a prismatic perspective is necessary, which understands that the uncertainties are not only related to the conditions associated with cerebral palsy, but involve subjective aspects of the caregivers.

Fatigue in patients with heart failure: A study of diagnostic accuracy fatigue in patients with heart failure.

PURPOSE: To analyze the accuracy of defining characteristics of the NANDA International nursing diagnosis, fatigue (00093), in patients with heart failure. METHODS: A cross-sectional study on the diagnostic accuracy of the defining characteristics of the nursing diagnosis. The sample consisted of 96 patients with heart failure in treatment in a public hospital. The latent class analysis method was used to test the accuracy measurements and estimate the prevalence of the diagnosis. The study was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte. RESULTS: The prevalence of the fatigue nursing diagnosis was 42.54%. Increased physical symptoms (0.9988) and tiredness (0.9988) were the sensitive defining characteristics. Disinterested in surroundings (0.9999) was the specific defining characteristics. CONCLUSIONS: A set of three defining characteristics of the nursing diagnosis of fatigue was accurate in patients with heart failure. Thus, this set can be used by nurses to confirm nursing diagnosis fatigue in patients with heart failure. IMPLICATIONS FOR NURSING PRACTICE: This research contributes by providing accurate defining characteristics of fatigue in patients with heart failure. Thus, nurses should recognize the nursing diagnosis of fatigue in patients with heart failure through accurate defining characteristics and propose rapid and effective nursing interventions that have positive health results.

Early diagnosis of HIV/aids infection: concept analysis.

OBJECTIVES: to analyze the concept of "early diagnosis of HIV/Aids infection" in light of Walker and Avant's conceptual analysis model. METHODS: concept analysis study based on the framework proposed by Walker and Avant, instrumented by a scoping review conducted in April 2022, following the recommendations of the Joanna Briggs Institute and checklist Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. The search was made in eight data sources, obtaining sixteen articles. RESULTS: the study found homosexual intercourses, early examination, anti-HIV antibodies, CD4 count, and sexually transmitted infection as the main attributes of the concept. As antecedents: information, risky behavior, unprotected sexual relations, prevention, and access to the service. As main consequences: antiretroviral treatment, seroconversion, transmission, and consultations. FINAL CONSIDERATIONS: the study approached the circumstantial situations of the theme, its attributes, antecedents, and consequences, qualifying the work process based on knowledge of nursing practice.

ICU Nursing Team Mental Health in The Face of the COVID-19 Pandemic: An Integrative Review / Saúde mental da equipe de enfermagem intensivista ante a pandemia da covid-19: revisão integrativa / Salud mental de los profesionales de enfermería intensivistas ante la pandemia de la COVID-19: revisión integradora

Introduction: During the COVID-19 pandemic, health professionals were at an increased risk of developing psychological conditions, especially in Intensive Care Units. A gap is verified in the knowledge about ICU Nursing teams' mental health in the care provided to patients affected by COVID-19. Objective: To review the literature to identify the mental health conditions of ICU Nursing professionals during the COVID-19 pandemic. Materials and method: This is an integrative literature review with data collection from January to April 2022 in the Embase, Cumulative Index to Nursing and Allied Health Literature, PubMed, Scopus Content Overview and Web of Science databases. The following descriptors were listed: "Intensive Care Units," "COVID-19," "Mental Health," and "Nurse." The materials included were studies produced since 2020, available in full in the Spanish, English and Portuguese languages, and which answered the research question. Search and selection of the articles were the duty of two duly trained researchers, who worked independently through peer discussion. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations were followed. Results: From a sample of 16 articles, it was observed that the critical care of COVID-19 patients affected Nursing professionals' mental health with an emphasis on depression, anxiety, stress and fear. This was associated with a lack of evidence-based training, scarcity of human and physical resources, work overload and insufficient work experience. Conclusions: ICU Nursing professionals are mentally shaken; therefore, it is imperative to implement policies, strategies and methods to improve the psychological conditions of these professionals, to ensure the quality of services.

Introdução: durante a pandemia da covid-19, os profissionais de saúde apresentaram risco aumentado para o desenvolvimento de afecções psíquicas, especialmente na unidade de terapia intensiva. Verifica-se lacuna de conhecimento sobre a saúde mental da equipe de enfermagem intensivista no atendimento aos pacientes acometidos pela covid-19. Objetivo: identificar, na literatura científica, as condições da saúde mental do profissional de enfermagem intensivista durante a pandemia da covid-19. Materiais e método: esta é uma revisão integrativa da literatura; a coleta de dados ocorreu de janeiro a abril de 2022 nas fontes de dados Embase, Cumulative Index to Nursing and Allied Health Literature, PubMed, Scopus Content Overview e Web of Science. Elencaram-se os seguintes descritores: "Intensive Care Units", "Covid 19", "Mental Health", "Nurse". Incluíram-se estudos produzidos desde 2020, disponíveis na íntegra, em espanhol, inglês e português, e que respondessem à questão de pesquisa. A busca e seleção dos artigos foram executadas por dois pesquisadores treinados, de modo independente, mediante discussão por pares. As recomendações do Preferred Reporting Items for Systematic Reviews and Meta-Analyses foram seguidas. Resultados: a partir de uma amostra de 16 artigos, observou-se que o cuidado crítico de pacientes com covid-19 afetou a saúde mental dos profissionais de enfermagem com destaque para depressão, ansiedade, estresse e medo. Isso se associou à falta de tratamento baseado em evidências, à carência de recursos humanos e físicos, à sobrecarga de trabalho e às experiências de trabalho insuficientes. Conclusões: os profissionais de enfermagem intensivistas estão mentalmente abalados; portanto, é imperativa a implantação de políticas, estratégias e métodos para melhorar as condições psicológicas desses profissionais, para, assim, garantir a qualidade nos serviços.

Introducción: durante la pandemia de la covid-19, los profesionales de la salud han presentado riesgo aumentado para el desarrollo de afecciones psíquicas, especialmente en la unidad de terapia intensiva. Se encuentra vacío de conocimiento acerca de la salud mental de los profesionales de enfermería intensivistas en la atención a los pacientes acometidos por la covid-19. Objetivo: identificar, en la literatura científica, las condiciones de la salud mental del profesional de enfermería intensivista durante la pandemia de la covid-19. Materiales y método: se trata de una revisión integradora de la literatura; la recolección de datos ocurrió de enero a abril de 2022 en las fuentes de dados Embase, Cumulative Index to Nursing and Allied Health Literature, PubMed, Scopus Content Overview y Web of Science. Se han relacionado los siguientes descriptores: "Intensive Care Units", "Covid 19", "Mental Health", "Nurse". Se han incluido estudios producidos desde el 2020, disponibles de forma integral, en español, inglés y portugués, y que atendieran a la pregunta de investigación. La búsqueda y selección de los artículos se ejecutaron por dos investigadores capacitados, de modo independiente, mediante discusión por pares. Se siguieron las recomendaciones del Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Resultados: desde una amuestra de 16 artículos, se ha observado que la atención crítica a pacientes con covid-19 ha afectado la salud mental de los profesionales de enfermería con énfasis para depresión, ansiedad, estrés y miedo. Lo anterior se asocia a la falta de tratamiento basado en evidencia, la carencia de recursos humanos y físico, la sobrecarga de trabajo y las experiencias de trabajo insuficientes. Conclusiones: los profesionales de enfermería intensivistas están mentalmente debilitados; por lo tanto, urge la implantación de políticas, estrategias y métodos para mejorar las condiciones psicológicas de estos profesionales para, así, asegurar la calidad en los servicios.

Lyotropic liquid crystal mesophases as transdermal delivery systems for lipophilic drugs: A comparative study.

The present work aimed to evaluate different Liquid Crystal Mesophases (LCM) as transdermal drug delivery systems (TDDS) for nifedipine (NFD), a lipophilic drug model. The formulations composed of water, Citrus sinensis essential oil (CSEO), PPG-5-CETETH-20, and Olive oil ester PEG-7 were obtained and characterized by polarized light microscopy (PLM), rheology, small-angle x-ray scattering (SAXS), Fourier transform infrared coupled with an attenuated total reflection accessory (FTIR-ATR) and in vitro assays: bioadhesion, drug release, skin permeation, and retention tests. As a result, changes in component proportions led to several transparent viscous systems with an anisotropic profile. PLM and SAXS proved the presence of lamellar (S1), hexagonal (S3), and lamellar + hexagonal (S2) LCM, and rheology showed a high viscoelasticity profile. LCMs were able to adhere to the skin, and S2 achieved higher adhesion strength. NFD (5 mg/mL) has not modified the organization of LCMs. Results also showed that S3 promoted higher permeation and retention and higher disorganization of stratum corneum lipids, which is the main permeation-enhancing mechanism. Thus, the formulations obtained can carry and improve drug delivery through the skin and are promising TDDS for lipophilic drug administration, such as NFD.

Accuracy of the nursing diagnosis of ineffective airway clearance in intensive care unit patients.

OBJECTIVES: to analyze the accuracy of the clinical indicators of ineffective airway clearance in adult intensive care unit patients. METHODS: diagnostic accuracy study, performed in the intensive care unit of a university hospital in northeastern Brazil. The sample consisted of 104 patients hospitalized between June and October 2019. RESULTS: the prevalence of ineffective airway clearance was 36.54%. The indicators with high specificity included absence of cough (0.8326), orthopnea (0.6817), adventitious breath sounds (0.8175), and diminished breath sounds (0.8326). The clinical indicators with high sensitivity and specificity were alteration in respiratory rate (0.9999) and alteration in respiratory pattern (0.9999). CONCLUSIONS: six clinical indicators provided an accurate identification of ineffective airway clearance. The clinical indicators alteration in respiratory rate and alteration in respiratory pattern were the most accurate for critical adult patients. The findings of this study contribute to accurate diagnostic inferences and to prevention of respiratory complications in these patients.

Allopurinol and ellagic acid decrease epileptiform activity and the severity of convulsive behavior in a model of status epilepticus.

BACKGROUND: During status epilepticus, severe seizures can occur, generating recurrent cycles of excitotoxicity and oxidative stress that cause neuronal damage and cell death. The administration of agents with antioxidant properties represents a therapeutic alternative aimed at reducing the severity of status epilepticus and mitigating the neurobiological consequences that precede them. OBJECTIVE: The objective of this work was to evaluate the antiseizure effect of the antioxidants allopurinol (ALL) and ellagic acid during status epilepticus induced by pilocarpine (PILO). METHODS: Male Wistar rats (200-250 g) were injected with ALL (50 mg/kg) or ellagic acid (50 mg/kg), 30 min before PILO administration (pretreatment) or 60 min after the beginning of status epilepticus, to evaluate the antiseizure effect of these drugs on epileptiform activity and convulsive behavior. RESULTS: ALL or ellagic acid administration before or after PILO significantly decreased the epileptiform activity and the severity of convulsive behavior. Better efficacy was observed when the drugs were administered as a pretreatment, increasing the latency time of the appearance of status epilepticus from 27.2 ± 2.6 to 45.8 ± 3.31 min, and significantly reducing the amplitude of epileptiform discharges by 53.5% with ALL and 68.9% with ellagic acid. CONCLUSION: The antioxidants ALL and ellagic acid showed an antiseizure effect, representing an alternative to reduce epileptiform activity and severity of convulsive behavior during status epilepticus, an effect that may be used as adjuvants to mitigate or reduce oxidative damage processes.

Analysis of the content of the nursing diagnosis deficient knowledge in individuals with heart failure.

OBJECTIVE: To analyze the content of the nursing diagnosis deficient knowledge in individuals with heart failure. METHODS: Methodological study to validate the content of a nursing diagnosis based on the predictive model of diversity, carried out through the organization of the phenomenon of interest and analysis by judges using the collective wisdom model. The NANDA-I Knowledge Deficient diagnosis was evaluated by 48 judges and considered valid when it presented a median content validity index ≥ 0.8 in the confidence intervals. RESULTS: Note that 66.6% of the judges indicated that the new definition proposed was more adequate than the definition adopted by NANDA-I. After the experts' analysis, the following defining characteristics were considered valid: inaccurate statements about the disease and/or therapy, inadequate performance in the management of intercurrences, increase in hospital readmissions, worsened quality of life, deficit in self-care performance, and follow-up of inadequate instruction; related factors are as follows: inadequate guidance offered by health professionals, nonparticipation of the patient in the planning of their health care, weakened relationship between professional and individual; populations at risk-elderly and low level of education of the individual and/or caregiver and the associated condition, mild cognitive impairment. Anxiety, depression, and impaired social interaction were elements considered not relevant to the content domain. CONCLUSION: The validation of the content of the aforementioned diagnosis in patients with heart failure, through the analysis of judges with different degrees of expertise, made it possible to improve the definition and expansion of new diagnostic indicators. IMPLICATIONS FOR NURSING PRACTICE: Updated diagnostic elements for the nursing diagnosis deficient knowledge in individuals with heart failure will facilitate accurate clinical judgment and the establishment of a therapeutic plan aimed at etiological factors modifiable by nurses.

Thermosensitive system formed by poloxamers containing carvacrol: An effective carrier system against Leishmania amazonensis.

The drugs used in the treatment of leishmaniasis show problems concerning side effects and toxicity. As a result, the search for new actives is necessary, and natural products like carvacrol - 5-isopropyl-2-methylphenol, become a relevant alternative. To enable the use of carvacrol as an antileishmanial agent, thermosensitive hydrogels were developed from poloxamer triblock copolymers 407 (P407) and 188 (P188). Carvacrol-free and carvacrol-containing hydrogels were obtained from P407 alone and from the mixture of P407 and P188. The hydrogels were subjected to Differential scanning calorimetry, Small-angle X-ray scattering, Scanning electron microscopy, and Rheology analysis. The activity of hydrogels and carvacrol isolated against promastigotes and intracellular amastigotes of Leishmania amazonensis and their cytotoxicity in mammalian cells was determined. The sol-gel transition temperature for the binary hydrogel containing carvacrol (HG407/188CA) was 37.04 ± 1.35 °C. HG407/188CA presented lamellar structure at temperatures of 25 °C and 37 °C. HG407/188CA and carvacrol presented IC50 against Leishmania amazonensis promastigotes of 18.68 ± 1.43 µg/mL and 23.83 ± 3.32 µg/mL, respectively, and IC50 against Leishmania amazonensis amastigotes of 35.08 ± 0.75 µg/mL and 29.32 ± 0.21 µg/mL, respectively. HG407/188CA reduced the toxicity of carvacrol in all mammalian cells evaluated, raising the CC50 in murine peritoneal macrophages from 40.23 ± 0.21 µg/mL to 332.6 ± 4.89 µg/mL, obtaining a Selectivity Index (SI) of 9.5 against 1.37 of the isolated carvacrol. HG407/188CA provided higher selectivity of carvacrol for the parasite. Thus, the binary hydrogel obtained may enable the use of carvacrol as a potential antileishmanial agent.

Selamento de lesões cariosas em molares decíduos / Sealing of carious lesions in deciduous molars

Objetivo:Investigar a eficácia do selamento de lesão de cárie dentinária em comparação com a remoção parcial de cárie seguida de restauração em molares decíduos. Material e Método: O estudo clínico randomizado foi planejado ser realizado em 60 crianças com idade entre 3 e 8 anos. As crianças foram randomizadas por sorteio, com alocação para os 3 grupos, sendo 20 em cada grupo: Grupo 1 (G1) constituído por crianças que receberam o selamento de cárie com resina fluida; Grupo 2 (G2) com crianças que receberam o selamento de cárie com cimento de ionômero de vidro de alta viscosidade e Grupo controle (G3) com crianças onde a remoção parcial da cárie foi seguida por restauração com cimento de ionômero de vidro resinoso. Foram feitos acompanhamentos clínicos e radiográficos antes e após a intervenção, bem como a cada 4 meses durante 1 ano, investigando-se se houve fratura no selamento ou na restauração (infiltração marginal), paralização, regressão ou evolução do processo carioso nos 3 grupos. Resultados: A amostra foi reduzida para 49 crianças pois durante a fase de controle clínico radiográfico, 11 não foram localizadas por mudança de endereço.O grupo G1 apresentou 50% dos casos com regressão e 50% dos casos em paralização. O grupo G2 apresentou 62,5% dos casos com regressão e 37,5% dos casos com paralização e o grupo G3 com 60% dos casos com regressão e 40% com paralização. Não houve associação estatisticamente significativa entre o tipo de grupo e a progressão da lesão, não havendo diferença entre os grupos (valor de p = 0,74). Conclusão: Não houve diferença entre os grupos quanto à progressão de lesão de cárie quando tratados somente com o selamento com resina fluida ou com cimento de ionômero de vidro de alta viscosidade ou com restauração convencional com cimento de ionômero de vidro resinoso após a remoção do tecido cariado.

Aim: To investigate the effectiveness of sealing a dentin caries lesion compared to the removal of partial caries followed by restoration in deciduous molars. Methods: The randomized clinical trial was planned to be performed on 60 children, aged 3 to 8 years. Children were randomized by lot, with allocation into 3 groups, 20 per group: Group 1 (G1) consisted of children who received a sealing of caries using fluid resin; Group 2(G2) included children who received the sealing of caries performed with high viscosity glass ionomer cement, and Group 3(G3) conducted with children where the removal of partial caries was followed by restoration with resinous glass ionomer cement. Clinical and radiographic follow-ups were performed before and after the intervention, as well as every four months for one year, investigating whether there was a fracture in the sealing or restoration (marginal infiltration), paralysis, regression, or evolution of the carious process in the three groups. Results: The sample was reduced to 49 children given that, during the radiographic clinical control phase, 11 were not located due to a change of address. The G1 group presented 50% cases with regression and 50% cases with paralysis. The G2 group presented 62.5% of the cases with regression and 37.5% of the cases with paralysis, while the G3 group showed 60% of the cases with regression and 40% with paralysis. There was no statistically significant association between the type of group and the progression of the lesion, with no difference found between the groups (p value=0.74). Conclusion: There was no difference between the groups regarding the progression of carious lesions when treated only with fluid resin sealing or with high viscosity glass ionomer cement or with conventional restoration with resinous glass ionomer cement after the removal of decayed tissue.