Efeitos do adalimumabe, clindamicina e/ou rifampicina no tratamento da hidradenite supurativa: um protocolo de revisão sistemática / Effects of adalimumab, clindamycin, and/or rifampicin in the treatment of hidradenitis suppurativa: a systematic review protocol

OBJETIVO: Avaliar a efetividade, segurança, níveis de dor e qualidade de vida associados ao uso de adalimumabe, clindamicina e/ou rifampicina no tratamento da hidradenite supurativa. MÉTODO: Serão incluídos estudos do tipo coorte prospectiva e retrospectiva, ensaios clínicos randomizados e de equivalência, bem como análises econômicas realizadas com adultos diagnosticados com hidradenite supurativa, que tenham utilizado pelo menos uma das seguintes alternativas terapêuticas: adalimumabe, clindamicina ou rifampicina. Os estudos devem abordar um ou mais desfechos, tais como contagem de abscessos e/ou nódulos, presença de nódulos inflamatórios, níveis de dor, qualidade de vida, segurança e custos. As bases de dados consultadas serão: Medical Literature Analysis and Retrieval System Online (MEDLINE, Interface OVID), Excerpta Medica DataBASE (EMBASE), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Cumulative Index to Nursing and Allied Health Literature (CINAHL, interface EBSCO), Psychological Abstracts (PsycINFO, interface EBSCO), Web of Science (WoS) e Source-Neutral Abstract and Citation Database (Scopus). Os processos de triagem, seleção e extração serão conduzidos por pesquisadores independentes e previamente treinados. O risco de viés será avaliado por meio dos instrumentos Risk of Bias 2.0 e ROBINS-I. Os resultados serão combinados em uma síntese qualitativa e quantitativa, com a realização de análises de especificidade e subgrupos.

OBJECTIVE: To evaluate the efficacy, safety, pain, and quality of life associated with the use of adalimumab, clindamycin, and/or rifampicin in the treatment of hidradenitis suppurativa. METHOD: Prospective and retrospective cohort studies randomized clinical trials and equivalence studies, and economic analyses, conducted in adults diagnosed with hidradenitis suppurativa who have used at least one of the following therapeutic alternatives: adalimumab, clindamycin, or rifampicin, will be included. Studies should address one or more outcomes such as abscess and/or nodule counts, presence of inflammatory nodules, pain levels, quality of life, safety, and cost. Databases consulted will include Medical Literature Analysis and Retrieval System Online (MEDLINE, OVID interface), Excerpta Medica DataBASE (EMBASE), Latin American and Caribbean Literature in Health Sciences (LILACS), Cumulative Index to Nursing and Allied Health Literature (CINAHL, EBSCO interface), Psychological Abstracts (PsycINFO, EBSCO interface), Web of Science (WoS), and Source-Neutral Abstract and Citation Database (Scopus). Screening, selection, and extraction processes will be conducted by independent and previously trained researchers. The risk of bias will be assessed using the Risk of Bias 2.0 and ROBINS-I tools. Results will be summarized in a qualitative and quantitative synthesis, including specificity and subgroup analyses.

Blood pressure variability in individuals with diabetes mellitus: a scoping review.

OBJECTIVES: to map methods and devices used to assess very short-, short-, medium-, and long-term pressure variability in adults with type 1 or 2 diabetes mellitus. METHODS: scoping review conducted in January and February 2021 in MEDLINE, Web of Science, CINAHL, LILACS, PubMed, and Embase databases. Studies conducted within the last ten years analyzing pressure variability in adult and older patients with diabetes mellitus type 1 or 2 were included. Studies that used discontinued devices were excluded. RESULTS: the sample was composed of 25 articles published since 2017, with the majority developed in Japan (n=11); with the predominance of the oscillometric method (n=22); the most used devices were from the Omron® brand (n=14); the most detected type was long-term variability (n=10). CONCLUSIONS: we observed the increasing application of the oscillometric method for pressure variability analysis with various brands and models of automatic devices.

Health Interventions for Preventing Climate-Sensitive Diseases: Scoping Review.

Climate variations cause public health problems, but the literature is still scarce on studies involving health interventions against climate-sensitive diseases. The objective of this review was to identify health interventions for the prevention of such diseases. We conducted a scoping review using the JBI Methodology. Six large research databases were searched (PubMed, Scopus, Web of Science, Lilacs, Embase, and Cochrane). The following inclusion criterion was used: studies addressing health interventions to prevent climate-sensitive diseases or consequences of climate on people's health. The exclusion criteria consisted of thesis, dissertations, conference proceedings, studies with unclear information/methodology, and studies not addressing climate-related health interventions. No language or date restrictions were applied. Of 733 studies identified and screened by title and abstract, 55 studies underwent full-text screening, yielding 13 studies for review. The health interventions identified were classified into three levels of management. The macro level included the use of epidemiological models, renewable energy, and policies sensitive to climate change. The meso level comprised interventions such as the creation of environmental suitability maps, urban greening, chemoprophylaxis, water security plans, and sanitation projects, among other measures. Some interventions are at the intersection, such as educational campaigns and the modification of artificial larvae sites. Finally, the micro level contained interventions such as the inspection of window screens and the use of light-colored clothing and repellents. The health interventions at the macro, meso, and micro levels and the intersection may serve as a basis for public managers to implement appropriate interventions against climate-sensitive diseases.

Cardiovascular risk and cardiovascular risk factors in adolescents.

OBJECTIVES: to identify cardiovascular risk and cardiovascular risk factors in adolescents and verify correlations between these variables and biochemical markers, and between blood pressure percentiles, Body Mass Index, and biochemical markers. METHODS: a cross-sectional study, conducted at a Brazilian school, from August to September 2019, including 205 participants who were interviewed. After the interview, anthropometric assessments, including weight, height, arm circumference, blood pressure checking, and blood collection for laboratory tests were performed. Descriptive and inferential analysis using the chi-square test was conducted. RESULTS: a total of 18.5% had blood pressure percentiles >95%, 25.4% were overweight, and 25.9% were at very high cardiovascular risk. Statistically significant associations were found between cardiovascular risk and sex, Body Mass Index and blood pressure percentiles, and between blood pressure percentiles and triglycerides. CONCLUSIONS: high prevalence of risk factors among school adolescents reinforces the need for interventions for cardiovascular risk reduction in this population.

Cardiovascular risk and cardiovascular risk factors in adolescents / Risco cardiovascular e fatores de risco cardiovascular em adolescentes / Riesgo cardiovascular y factores de riesgo cardiovascular en adolescentes

ABSTRACT Objectives: to identify cardiovascular risk and cardiovascular risk factors in adolescents and verify correlations between these variables and biochemical markers, and between blood pressure percentiles, Body Mass Index, and biochemical markers. Methods: a cross-sectional study, conducted at a Brazilian school, from August to September 2019, including 205 participants who were interviewed. After the interview, anthropometric assessments, including weight, height, arm circumference, blood pressure checking, and blood collection for laboratory tests were performed. Descriptive and inferential analysis using the chi-square test was conducted. Results: a total of 18.5% had blood pressure percentiles >95%, 25.4% were overweight, and 25.9% were at very high cardiovascular risk. Statistically significant associations were found between cardiovascular risk and sex, Body Mass Index and blood pressure percentiles, and between blood pressure percentiles and triglycerides. Conclusions: high prevalence of risk factors among school adolescents reinforces the need for interventions for cardiovascular risk reduction in this population.

RESUMO Objetivos: identificar o risco cardiovascular e os fatores de risco cardiovascular em adolescentes e verificar correlações entre essas variáveis e marcadores bioquímicos, e entre percentis de pressão arterial, Índice de Massa Corporal e marcadores bioquímicos. Métodos: estudo transversal, realizado em escola brasileira, de agosto-setembro de 2019, incluindo 205 participantes que foram entrevistados. Após a entrevista, foram realizadas avaliações antropométricas, incluindo peso, altura, circunferência do braço, aferição da pressão arterial e coleta de sangue. Foi realizada análise descritiva e inferencial por meio do Teste do Qui-Quadrado. Resultados: 18,5% apresentavam percentis de pressão arterial>95%, 25,4% com sobrepeso e 25,9% com risco cardiovascular muito alto. Foram encontradas associações estatisticamente significativas entre risco cardiovascular e sexo, Índice de Massa Corporal e percentis de pressão arterial e entre percentis de pressão arterial e triglicérides. Conclusões: a alta prevalência de fatores de risco em adolescentes escolares reforça a necessidade de intervenções para redução do risco cardiovascular nessa população.

RESUMEN Objetivos: identificar riesgo cardiovascular y factores de riesgo cardiovascular en adolescentes y verificar las correlaciones entre estas variables y marcadores bioquímicos, y entre percentiles de presión arterial, Índice de Masa Corporal y marcadores bioquímicos. Métodos: estudio transversal, realizado en una escuela brasileña, de agosto a septiembre de 2019, que incluyó a 205 participantes que fueron entrevistados. Después de la entrevista, se realizaron evaluaciones antropométricas que incluyeron peso, talla, perímetro del brazo, medición de la presión arterial y extracción de sangre para pruebas de laboratorio. El análisis descriptivo e inferencial se realizó mediante la prueba de chi-cuadrado. Resultados: el 18,5% tenía percentiles de presión arterial>95%, el 25,4% tenía sobrepeso y el 25,9% tenía un riesgo cardiovascular muy alto.Se encontraron asociaciones estadísticamente significativas entre el riesgo cardiovascular y el sexo, el Índice de Masa Corporal y los percentiles de presión arterial, y entre los percentiles de presión arterial y los triglicéridos. Conclusiones: la alta prevalencia de factores de riesgo en estudiantes adolescentes refuerza la necesidad de intervenciones para reducir el riesgo cardiovascular en esta población.

Blood pressure variability in individuals with diabetes mellitus: a scoping review / Variabilidad de la presión arterial en individuos con diabetes mellitus: revisión del área / Variabilidade da pressão arterial em indivíduos com diabetes mellitus: revisão de escopo

ABSTRACT Objectives: to map methods and devices used to assess very short-, short-, medium-, and long-term pressure variability in adults with type 1 or 2 diabetes mellitus. Methods: scoping review conducted in January and February 2021 in MEDLINE, Web of Science, CINAHL, LILACS, PubMed, and Embase databases. Studies conducted within the last ten years analyzing pressure variability in adult and older patients with diabetes mellitus type 1 or 2 were included. Studies that used discontinued devices were excluded. Results: the sample was composed of 25 articles published since 2017, with the majority developed in Japan (n=11); with the predominance of the oscillometric method (n=22); the most used devices were from the Omron® brand (n=14); the most detected type was long-term variability (n=10). Conclusions: we observed the increasing application of the oscillometric method for pressure variability analysis with various brands and models of automatic devices.

RESUMEN Objetivos: mapear métodos y dispositivos utilizados para evaluación de la variabilidad presórica de cortísimo, corto, mediano y largo plazo en adultos con diabetes mellitus tipo 1 o 2. Métodos: revisión del área realizada en enero y febrero de 2021 en las bases de datos MEDLINE, Web of Science, CINAHL, LILACS, PubMed y Embase. Incluidos estudios, realizados en los últimos diez años, que analizaron la variabilidad presórica en pacientes adultos y ancianos con diabetes mellitus tipo 1 o 2. Excluidos estudios que utilizaron dispositivos descontinuados. Resultados: la muestra fue compuesta por 25 artículos, publicados desde 2017, con mayoría desarrollada en Japón (n=11); predominancia del método oscilométrico (n=22); los dispositivos más utilizados fueron de la marca Omron® (n=14); el tipo de variabilidad más detectada fue la de largo plazo (n=10). Conclusiones: observado el creciente uso del método oscilométrico para análisis de la variabilidad presórica, presentando variedad de marcas y modelos de dispositivos automáticos.

RESUMO Objetivos: mapear métodos e dispositivos utilizados para avaliação da variabilidade pressórica de curtíssimo, curto, médio e longo prazo em adultos com diabetes mellitus tipo 1 ou 2. Métodos: revisão de escopo realizada nos meses de janeiro e fevereiro de 2021 nas bases de dados MEDLINE, Web of Science, CINAHL, LILACS, PubMed e Embase. Incluíram-se estudos, realizados nos últimos dez anos, que analisaram a variabilidade pressórica em pacientes adultos e idosos com diabetes mellitus tipo 1 ou 2. Excluíram-se estudos que utilizaram dispositivos descontinuados. Resultados: a amostra foi composta por 25 artigos, publicados a partir de 2017, com maioria desenvolvida no Japão (n=11); predominância do método oscilométrico (n=22); os dispositivos mais utilizados foram da marca Omron® (n=14); o tipo de variabilidade mais detectada foi a de longo prazo (n=10). Conclusões: observou-se o crescente uso do método oscilométrico para análise da variabilidade pressórica, apresentando variedade de marcas e modelos de dispositivos automáticos.

Effectiveness of the fall prevention intervention in older adults with arterial hypertension: randomized clinical trial.

OBJECTIVE: To evaluate the effectiveness of the nursing intervention Fall Prevention in reducing falls in older adults with arterial hypertension. METHODS: Pilot clinical trial, with 118 participants with arterial hypertension from a city in the Northeast of Brazil. Participants were allocated by simple randomization into two groups: intervention (n = 58) and control (n = 60). The intervention was carried out at the participants' homes and consisted of guidelines for modifying environmental and behavioral risk factors for falls. A protocol with nursing activities associated with the Fall Prevention intervention proposed in the Nursing Interventions Classification (NIC) taxonomy was used. The outcome was the self-reported occurrence of falls. RESULTS: There was a significant difference between the groups in the frequency of self-reported falls (p=0.38) with fewer falls occurring in the intervention group. Sixteen participants fell, of which 5.1% attributed the fall to difficulty walking, 6.8% fell in the living room, 3.4% had a sprain, and 6.8% reported to be afraid to fall again. CONCLUSION: The nursing intervention Fall Prevention was effective in reducing the occurrence of falls in older adults with arterial hypertension. These findings contribute to the advancement of clinical protocols for the prevention of falls in older adults, as the educational intervention investigated is applicable to different sociodemographic and cultural scenarios.

Social determinants of health and heart failure hospitalizations in Brazil. / Determinantes sociais em saúde e internações por insuficiência cardíaca no Brasil.

OBJECTIVE: To analyze the relationship between social determinants of health and heart failure hospitalizations in Brazil. METHOD: A retrospective ecological study, whose units of analysis were the cities of the Brazilian states. The outcome variable was heart failure hospitalization rate. The independent variables were Family Health Strategy coverager, federal transfer to Primary Care, expenditure on Primary Care, overlapping of the female population and age group above 60 years old. Regressive techniques were adopted for panel data, with estimation of weighted least squares by fixed effect. RESULTS: Twenty-six cities were analyzed. Hospitalization rates showed a non-uniform distribution between the areas, with lower median in the North and higher in the South. The regression model identified a relationship between hospitalization rates and Family Health Strategy coverage, federal transfer to Primary Care, and overlapping of the female population. CONCLUSION: Heart failure occurrence, a condition sensitive to Primary Care in Brazil, is influenced by social determinants of health represented by demographic, budgetary, and health service coverage factors.

Nursing Diagnosis Risk for Unstable Blood Glucose Level in Patients with Diabetes Mellitus.

AIM: To validate the nursing diagnosis risk for unstable blood glucose level in adult/elderly patients with type 1 and type 2 diabetes. METHOD: Study Methodological was used in this article. The validation process was carried out using the model proposed by Hoskins (1989). RESULTS: The risk factors ineffective medication management and high carbohydrate and lipid food intake achieved a concordance index greater than 85%. CONCLUSION: This study contributed to the identification of new risk factors, at risk populations, and important associated conditions. IMPLICATIONS FOR NURSING PRACTICE: It is believed that the findings reported in this paper can be used to improve clinical protocols for the prevention of unstable blood glucose, in addition to contributions to the advancement of nursing science.

Hierarchical analysis of factors associated with hospital readmissions for coronary heart disease: A case-control study.

AIMS AND OBJECTIVES: To analyse, hierarchically, factors associated with hospital readmissions for acute coronary syndrome. BACKGROUND: Hospital readmissions have risen, especially in patients with multiple comorbidities, which are most often chronic. The leading causes of hospital readmission include acute coronary syndrome, which is costly and often preventable. Determining clinical and nonclinical variables that increase the chances of readmission is important to assess and evaluate patients hospitalised for coronary heart diseases. DESIGN: A case-control study whose dependent variable was hospital readmission for acute coronary syndrome. METHODS: The study included 277 inpatients, of whom 132 were in their first hospitalisation and 145 had already been hospitalised for acute coronary syndrome. The independent variables for this hierarchical model were sociodemographic conditions, life habits, access to health services and physical health measures. Data were obtained by interviews, anthropometric measurements and patient records. Logistic regression analysis was performed using the stepwise technique, with Microsoft Excel and R version 3.2.3. The research was reported via strengthening the reporting of observational studies in epidemiology (STROBE). RESULTS: In the final hierarchical logistic model, the following risk factors were associated with readmission for acute coronary syndrome: inadequate drug therapy adherence, stress, history of smoking for 30 years or more, and the lack of use of primary healthcare services. CONCLUSIONS: Clinical and nonclinical variables are related to hospital readmission for acute coronary syndrome and can increase the chance of readmission by up to six times. RELEVANCE TO CLINICAL PRACTICE: The predictive model can be used to avoid readmission for acute coronary syndrome, and it represents an advance in the prediction of the occurrence of the outcome. This implies the need for a reorientation of the network for postdischarge care in the first hospitalisation for acute coronary syndrome.

Development of middle-range theories in nursing.

OBJECTIVE: To identify in the literature how Middle-Range Theories (MRT) are being developed in Nursing. METHOD: Integrative review on the databases Lilacs (Latin American and Caribbean Literature in Health Sciences), Scopus, Cinahl (Cumulative Index to Nursing and Allied Health Literature), Web of Science and PubMed portal, using the keywords middle range theory and nursing, as well its Portuguese correspondents (Lilacs), and the Boolean operator AND. The sample included 25 articles. RESULTS: All articles presented concepts related to MRT. Most developed a synthesis picture. Some theories have formulated specific propositions, hypotheses, and names. Only 16 articles cited the methodological framework, while 22 used theories or models for theoretical foundation and 11 carried out literature reviews. FINAL CONSIDERATIONS: The development of MRT included the presentation of fundamental concepts, synthesis, propositions, hypotheses and specific name. The MRT is recognized as a way of developing knowledge to guide the nursing practice.

Development of middle-range theories in nursing / Desarrollo de las teorías de medio alcance en enfermería / Desenvolvimento das teorias de médio alcance na enfermagem

ABSTRACT Objective: To identify in the literature how Middle-Range Theories (MRT) are being developed in Nursing. Method: Integrative review on the databases Lilacs (Latin American and Caribbean Literature in Health Sciences), Scopus, Cinahl (Cumulative Index to Nursing and Allied Health Literature), Web of Science and PubMed portal, using the keywords middle range theory and nursing, as well its Portuguese correspondents (Lilacs), and the Boolean operator AND. The sample included 25 articles. Results: All articles presented concepts related to MRT. Most developed a synthesis picture. Some theories have formulated specific propositions, hypotheses, and names. Only 16 articles cited the methodological framework, while 22 used theories or models for theoretical foundation and 11 carried out literature reviews. Final considerations: The development of MRT included the presentation of fundamental concepts, synthesis, propositions, hypotheses and specific name. The MRT is recognized as a way of developing knowledge to guide the nursing practice.

RESUMEN Objetivo: Identificar en la literatura cómo las Teorías de Medio Alcance (TMA) se están desarrollando en enfermería. Método: Revisión integrativa en las bases de datos: LILACS (Literatura Latinoamericana y del Caribe en Ciencias de la Salud), Scopus, Cinahl (Cumulative Index to Nursing and Allied Health Literature), Web of Science y PubMed, utilizando la palabra clave middle range theory, el descriptor nursing y sus equivalentes en portugués (LILACS) y el operador booleano AND. La muestra constó de 25 artículos. Resultados: Todos los artículos presentaron conceptos relacionados con las TMA. La mayoría desarrolló un cuadro resumen. Algunas teorías presentaron proposiciones, plantearon hipótesis y nombres específicos. Solamente 16 artículos citaban el referencial metodológico, mientras que 22 utilizaban teorías o modelos en la fundamentación teórica y 11 hicieron revisión de la literatura. Consideraciones finales: El desarrollo de las TMA incluyó la presentación de conceptos fundamentales, de cuadro resumen, de proposiciones, hipótesis y nombre específico. Se reconocen las TMA como forma de desarrollar conocimiento para orientar la práctica en enfermería.

RESUMO Objetivo: Identificar na literatura como as Teorias de Médio Alcance (TMA) têm sido desenvolvidas na enfermagem. Método: Revisão integrativa nas bases Lilacs (Literatura Latino-Americana e do Caribe em Ciências da Saúde), Scopus, Cinahl (Cumulative Index to Nursing and Allied Health Literature), Web of Science e portal PubMed, utilizando a palavra-chave middle range theory, o descritor nursing, seus correspondentes em português (Lilacs) e o operador booleano AND. A amostra incluiu 25 artigos. Resultados: Todos os artigos apresentaram conceitos relacionados às TMA. A maioria desenvolveu quadro síntese. Algumas teorias formularam proposições, hipóteses e nomes específicos. Apenas 16 artigos citavam o referencial metodológico, enquanto 22 usavam teorias ou modelos para fundamentação teórica e 11 utilizavam revisão na literatura. Considerações finais: O desenvolvimento das TMA incluiu apresentação de conceitos fundamentais, quadro síntese, proposições, hipóteses e nome específico. Reconhece-se as TMA como forma de desenvolver conhecimento para orientar a prática de enfermagem.

Promoção do controle de peso corporal infantil: validação de álbum seriado / Promotion of children's body weight control: serial album validation

RESUMO Objetivo validar semanticamente o álbum seriado De Olho no Peso, para promoção do controle de peso corporal infantil. Métodos estudo metodológico, de análise semântica da tecnologia educativa, por 42 crianças de sete a 10 anos, por meio da aplicação individual de questionário. Considerou-se o Índice de Concordância Semântica mínimo de 0,80. Resultados todos os itens do questionário (organização, conteúdo, atratividade e persuasão) foram validados. As crianças consideraram de fácil entendimento as ilustrações do álbum seriado exceto a, dois. As respostas sobre haver gostado de cada ilustração variaram de 47,6 a 100,0%. A média de índice de concordância das ilustrações foi 0,86. Após análise das respostas, realizaram-se alterações no álbum seriado. Conclusão o álbum seriado De Olho no Peso apresentou índice de concordância semântica igual a 0,89, demonstrando ser tecnologia validada para mediar ações educativas sobre prevenção e controle do peso corporal infantil.

ABSTRACT Objective to semantically validate the serial album De Olho no Peso (Keeping an eye on weight), to promote children's body weight control. Methods methodological study, of semantic analysis of educational technology, by 42 children aged seven to 10 years, through the individual application of a questionnaire. The minimum semantic concordance index of 0.80 was considered. Results all items of the questionnaire (organization, content, attractiveness and persuasion) were validated. The children found the illustrations on the flipchart easy to understand except for two. Responses about having liked each illustration ranged from 47.6 to 100.0%. The average concordance index of the illustrations was 0.86. After analyzing the responses, changes were made to the flipchart. Conclusion the serial album De Olho no Peso presented a semantic concordance index equal to 0.89, demonstrating to be a validated technology to mediate educational actions on prevention and control of infant body weight.

Determinantes sociais em saúde e internações por insuficiência cardíaca no Brasil / Determinantes sociales de la salud y hospitalizaciones por insuficiencia cardíaca en Brasil / Social determinants of health and heart failure hospitalizations in Brazil

RESUMO Objetivo Analisar a relação entre determinantes sociais em saúde e internações por insuficiência cardíaca no Brasil. Método Estudo ecológico retrospectivo, cujas unidades de análise foram os municípios dos estados brasileiros. A variável desfecho foi a taxa de internação hospitalar por insuficiência cardíaca, e as variáveis independentes foram a cobertura da Estratégia Saúde da Família, repasse federal ao bloco da Atenção Básica, despesa executada com Atenção Básica, sobreposição da população feminina e componente etário acima de 60 anos. Adotaram-se técnicas regressivas por dados em painel, com estimação dos mínimos quadrados ponderados por efeito fixo. Resultados Foram analisados 26 municípios. Taxas de internação pelo diagnóstico apresentaram distribuição não uniforme entre as regiões, com mediana mais baixa na região Norte e mais alta na Sul. O modelo de regressão identificou relação entre taxa de internação pelo diagnóstico e cobertura da Estratégia Saúde da Família, repasses federais à Atenção Básica e sobreposição da população feminina. Conclusão Ocorrência de insuficiência cardíaca, uma condição sensível à Atenção Primária no Brasil, é influenciada por determinantes sociais em saúde representados por fatores demográficos, orçamentários e de cobertura de serviços de saúde.

RESUMEN Objetivo Analizar la relación entre los determinantes sociales de la salud y las hospitalizaciones por insuficiencia cardíaca en Brasil. Método Estudio ecológico retrospectivo, cuyas unidades de análisis fueron los municipios de los estados brasileños. La variable de resultado fue la tasa de hospitalización por insuficiencia cardíaca, y las variables independientes fueron la cobertura de la Estrategia de Salud Familiar, la transferencia federal al bloque de Atención Primaria, el gasto en Atención Primaria, la superposición de la población femenina y un componente de edad superior a 60 años. años. Se adoptaron técnicas regresivas para datos de panel, con estimación de mínimos cuadrados ponderados por efecto fijo. Resultados Se analizaron 26 municipios. Las tasas de hospitalización debido al diagnóstico mostraron una distribución no uniforme entre las regiones, con una mediana más baja en el norte y más alta en el sur. El modelo de regresión identificó una relación entre la tasa de hospitalización para el diagnóstico y la cobertura de la Estrategia de Salud Familiar, las transferencias federales a Atención Primaria y la superposición de la población femenina. Conclusión La aparición de insuficiencia cardíaca, una afección sensible a la atención primaria en Brasil, está influenciada por determinantes sociales en la salud representados por factores demográficos, presupuestarios y de cobertura de los servicios de salud.

ABSTRACT Objective To analyze the relationship between social determinants of health and heart failure hospitalizations in Brazil. Method A retrospective ecological study, whose units of analysis were the cities of the Brazilian states. The outcome variable was heart failure hospitalization rate. The independent variables were Family Health Strategy coverager, federal transfer to Primary Care, expenditure on Primary Care, overlapping of the female population and age group above 60 years old. Regressive techniques were adopted for panel data, with estimation of weighted least squares by fixed effect. Results Twenty-six cities were analyzed. Hospitalization rates showed a non-uniform distribution between the areas, with lower median in the North and higher in the South. The regression model identified a relationship between hospitalization rates and Family Health Strategy coverage, federal transfer to Primary Care, and overlapping of the female population. Conclusion Heart failure occurrence, a condition sensitive to Primary Care in Brazil, is influenced by social determinants of health represented by demographic, budgetary, and health service coverage factors.

Nurses' competencies in health promotion for homebound older people.

OBJECTIVE: to identify competencies related to health promotion targeting homebound older people, as they appear in the literature. METHOD: systematic review using the LILACS, Scopus, CINAHL, PubMed and Cochrane Library databases. The search was performed in November 2017. Selected articles were analyzed according to nine competency domains: enable change; advocate for health; mediate through partnership; communication; leadership; assessment; planning; implementation, and evaluation and research. RESULTS: nine clinical trials were included. All health promotion competency domains were identified in the reviewed research interventions, performed with homebound older people. CONCLUSION: studies showed that the employed treatments were beneficial for the homebound older population. Interventions based on health promotion competencies were positively identified, and are linked to an effective and high-quality health care practice.

Nurses' competencies in health promotion for homebound older people / Competencias del enfermero en torno a la promoción de la salud de ancianos en domicilio / Competências do enfermeiro para promoção da saúde de idosos no domicílio

ABSTRACT Objective: to identify competencies related to health promotion targeting homebound older people, as they appear in the literature. Method: systematic review using the LILACS, Scopus, CINAHL, PubMed and Cochrane Library databases. The search was performed in November 2017. Selected articles were analyzed according to nine competency domains: enable change; advocate for health; mediate through partnership; communication; leadership; assessment; planning; implementation, and evaluation and research. Results: nine clinical trials were included. All health promotion competency domains were identified in the reviewed research interventions, performed with homebound older people. Conclusion: studies showed that the employed treatments were beneficial for the homebound older population. Interventions based on health promotion competencies were positively identified, and are linked to an effective and high-quality health care practice.

RESUMEN Objetivo: identificar en la literatura las competencias del enfermero relacionadas a la promoción de la salud de ancianos en domicilio. Método: revisión sistemática realizada en las bases de datos LILACS, Scopus, CINAHL, portal PubMed y biblioteca Cochrane, en noviembre de 2017. Se hizo el análisis de los artículos seleccionados a partir de nueve dominios de competencias: permitir el cambio; preservar la salud; intermediar mediante asociación; comunicarse; liderar; evaluar; planificar; aplicar; y evaluar e investigar. Resultados: se incluyeron nueve ensayos clínicos. Se identificaron todos los dominios de las competencias en torno a la promoción de la salud en las intervenciones realizadas en las encuestas con los ancianos residentes en domicilio. Conclusión: los estudios demostraron que los tratamientos utilizados fueron beneficiosos para la población de ancianos en domicilio, y que las intervenciones con base en las competencias para promover la salud pueden ser identificadas, además de establecer una práctica asistencial eficaz y de calidad.

RESUMO Objetivo: identificar na literatura as competências do enfermeiro relacionadas à promoção da saúde de idosos no domicílio. Método: revisão sistemática realizada nas bases de dados LILACS, Scopus, CINAHL, no portal PubMed e na biblioteca Cochrane, em novembro de 2017. Os artigos selecionados foram analisados de acordo com os nove domínios de competências: permitir a mudança; advogado para a saúde; mediar através de parceria; comunicação; liderança; avaliação; planejamento; implementação; e avaliação e pesquisa. Resultados: foram incluídos nove ensaios clínicos. Todos os domínios de competências de promoção da saúde foram identificados nas intervenções realizadas nas pesquisas nos idosos residentes no domicílio. Conclusão: os estudos mostraram que os tratamentos utilizados foram benéficos para a população de idosos no domicílio e as intervenções baseadas em competências para a promoção da saúde podem ser identificadas e produzem uma prática assistencial eficaz e de qualidade.

Association between follow-up in health services and antihypertensive medication adherence.

OBJECTIVE: To analyze the association between the characteristics of follow-up in health services and adherence to antihypertensive medication in patients with cardiovascular disease. METHOD: Analytical study carried out with 270 patients suffering from hypertension and hospitalized due to cardiovascular complications. Data collection occurred between November 2015 and April 2016, involving sociodemographic variables, presence of self-reported diabetes, accessibility and use of health services, blood pressure levels and medication adherence (analyzed through the Morisky-Green Test). RESULTS: The rate of adherence to antihypertensive therapy was 63.0%. Enrollment in the Hiperdia program had no statistical significance to medication adherence. People who attended at least between 4 and 6 nursing consultations throughout the data collection period (p = 0.02) had better adherence. CONCLUSION: The study's findings provide support for the reorientation of health services and their public policies towards improving adherence to antihypertensive therapeutics.

Influence of socio-demographic characteristics in the self-care of people with heart failure.

OBJECTIVE: To determine the influence of socio-demographic characteristics in the self-care of people with heart failure (HF). METHOD: Cross-sectional, analytical study, held in three private hospitals in Fortaleza, Ceará, Brasil, with 57 hospitalized patients. The data were collected through a demographic characterization form and a self-care assessment scale and were analyzed with inferential statistics, using mean comparison tests. RESULTS: Self-care was best assessed in people with higher education level, higher household income and in a relationship. CONCLUSION: The socio-demographic characteristics influenced seven self-care practices: dietary control; monitoring of body weight; effort in labor activities; knowledge about HF; up-to-date vaccination record; leisure activities; and family and social support network with strong bonds. The higher prevalence of answers indicating satisfactory self-care practices among the patients occurred in the areas of health promotion and tolerance to stress.

Association between follow-up in health services and antihypertensive medication adherence / Asociación entre seguimiento en servicios de salud y adhesión terapéutica antihipertensiva / Associação entre acompanhamento em serviços de saúde e adesão terapêutica anti-hipertensiva

ABSTRACT Objective: To analyze the association between the characteristics of follow-up in health services and adherence to antihypertensive medication in patients with cardiovascular disease. Method: Analytical study carried out with 270 patients suffering from hypertension and hospitalized due to cardiovascular complications. Data collection occurred between November 2015 and April 2016, involving sociodemographic variables, presence of self-reported diabetes, accessibility and use of health services, blood pressure levels and medication adherence (analyzed through the Morisky-Green Test). Results: The rate of adherence to antihypertensive therapy was 63.0%. Enrollment in the Hiperdia program had no statistical significance to medication adherence. People who attended at least between 4 and 6 nursing consultations throughout the data collection period (p = 0.02) had better adherence. Conclusion: The study's findings provide support for the reorientation of health services and their public policies towards improving adherence to antihypertensive therapeutics.

RESUMEN Objetivo: Analizar la asociación entre las características del seguimiento en servicios de salud y la adhesión al tratamiento antihipertensivo en pacientes con enfermedad cardiovascular. Método: Estudio analítico, realizado con 270 pacientes con hipertensión internados por la ocurrencia de complicación cardiovascular. La recolección de datos ocurrió entre noviembre de 2015 y abril de 2016. Se analizaron variables sociodemográficas, presencia de diabetes autorreferida, condiciones de acceso y utilización de servicios de salud, niveles de presión arterial y adhesión terapéutica a través de la prueba de Morisky-Green. Resultados: La tasa de adhesión terapéutica antihipertensiva identificada fue del 63,0%. El registro en el programa Hiperdia no presentó significancia estadística con la adhesión. Esta medida fue mejor en aquellos que asistieron entre 4 y 6 consultas de enfermería en el año (p=0,02). Conclusión: Los hallazgos proporcionan subsidios para la reorientación de los servicios de salud y sus políticas públicas para la ampliación de la adhesión terapéutica antihipertensiva.

RESUMO Objetivo: Analisar a associação entre as características do acompanhamento em serviços de saúde e a adesão ao tratamento anti-hipertensivo em pacientes com doença cardiovascular. Método: Estudo analítico, realizado com 270 pacientes com hipertensão internados pela ocorrência de complicação cardiovascular. A coleta de dados ocorreu entre novembro de 2015 e abril de 2016. Analisaram-se variáveis sociodemográficas, presença de diabetes autorreferida, condições de acesso e utilização de serviços de saúde, níveis de pressão arterial e adesão terapêutica por meio do Teste de Morisky-Green (TMG). Resultados: A taxa de adesão terapêutica anti-hipertensiva identificada foi de 63,0%. O cadastro no programa Hiperdia não apresentou significância estatística com a adesão. Esta medida foi melhor naqueles que compareceram entre 4 e 6 consultas de enfermagem no ano (p=0,02). Conclusão: Os achados fornecem subsídios para a reorientação dos serviços de saúde e suas políticas públicas para a ampliação da adesão terapêutica anti-hipertensiva.

Cardiovascular adverse events associated with oral antineoplastic therapy.

OBJECTIVE: To identify in the literature the cardiovascular adverse events resulting from oral antineoplastic therapy. METHOD: Integrative review of the literature through the SCOPUS, Scientific Electronic Library Online (SciELO), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medical Literature Analysis and Retrieval System Online (MEDLINE) databases. The antineoplastic, cardiotoxicity, cardiovascular system and adverse reaction descriptors were used in Portuguese, English and Spanish. We selected 23 articles published between 1985 and 2015. RESULTS: Twenty studies were related to cardiac events and eleven to peripheral vascular events. The most frequent adverse cardiac events were reduced left ventricular ejection fraction, myocardial infarction, changes in the electrocardiogram, heart failure and angina, whereas peripheral vascular events were hypertension and thromboembolism. CONCLUSION: Oral antineoplastic therapy is associated with different adverse events, including cardiac and peripheral vascular events.