Nursing leadership strategies in addressing COVID-19 in light of John Kotter's framework.

OBJECTIVE: To analyze the leadership strategies of nurses in university hospitals in response to care management changes during the COVID-19 pandemic, informed by John Kotter's insights. METHODS: This multicentric study utilized qualitative and analytical methods. It was conducted through semi-structured interviews with 139 lead nurses from 10 university hospitals in Brazil. Data analysis included Bardin's content analysis and the webQDA software. RESULTS: The primary category identified was "Nursing Leadership Strategies in the Battle Against COVID-19," encompassing five subcategories. This category underscored the importance of strategic vision in nursing leadership for combating COVID-19 within hospital settings, as well as the necessity of working collaboratively with their teams and other healthcare professionals. FINAL CONSIDERATIONS: The results highlight the strategies used by lead nurses in confronting COVID-19, which can be associated with John Kotter's theoretical framework and his model of change.

Josicélia Dumêt Fernandes' professional trajectory: contributions to psychiatric and mental health nursing.

OBJECTIVES: to analyze nurse Josicélia Dumêt Fernandes' life story, with emphasis on her work in the psychiatry and mental health fields. METHODS: historical, qualitative research. Semi-structured interviews and documentary research were used as data collection techniques, collected from September to October 2021. For data analysis, we opted for the content analysis method and comparison with the Foucauldian philosophical framework. RESULTS: four categories emerged: Transforming herself and mental health practices; (Re)framing professional practice; Nursing practice and power relations; and The paths and implications in the psychiatry and mental health fields. FINAL CONSIDERATIONS: the study of the biographer demonstrates a search for transformation of herself and mental health practices, with a rupture in paradigms and reframing of her practice in psychiatry and mental health.

Effect of an exercise-based cardiac rehabilitation program on quality of life of patients with chronic Chagas cardiomyopathy: results from the PEACH randomized clinical trial.

To investigate the effect of an exercise-based cardiac rehabilitation program on the quality of life (QoL) of patients with chronic Chagas cardiomyopathy (CCC). PEACH study was a single-center, superiority randomized clinical trial of exercise training versus no exercise (control). The sample comprised Chagas disease patients with CCC, left ventricular ejection fraction < 45%, without or with HF symptoms (CCC stages B2 or C, respectively). QoL was assessed at baseline, after three months, and at the end of six months of follow-up using the SF-36 questionnaire. Patients randomized for the exercise group (n = 15) performed exercise training (aerobic, strength and stretching exercises) for 60 min, three times a week, during six months. Patients in the control group (n = 15) were not provided with a formal exercise prescription. Both groups received identical nutritional and pharmaceutical counseling during the study. Longitudinal analysis of the effects of exercise training on QoL, considering the interaction term (group × time) to estimate the rate of changes between groups in the outcomes (represented as beta coefficient), was performed using linear mixed models. Models were fitted adjusting for each respective baseline QoL value. There were significant improvements in physical functioning (ß = + 10.7; p = 0.02), role limitations due to physical problems (ß = + 25.0; p = 0.01), and social functioning (ß = + 19.2; p < 0.01) scales during the first three months in the exercise compared to the control group. No significant differences were observed between groups after six months. Exercise-based cardiac rehabilitation provided short-term improvements in the physical and mental aspects of QoL of patients with CCC.Trial registration: ClinicalTrials.gov Identifier: NCT02517632; August 7, 2015.

Chagas heart disease is associated with decreased physical activity levels: A cross-sectional analysis.

Background: Studies evaluating physical activity (PA) levels in individuals with Chagas disease (CD) are still scarce. The present study aimed to evaluate PA levels in CD individuals and examine their association with Chagas heart disease (ChHD). Methods: We included patients with CD regularly followed in a reference center for treatment of infectious diseases. PA levels were assessed using the short version of the International Physical Activity Questionnaire (IPAQ). ChHD was determined following the Brazilian Consensus on Chagas Disease. The association between ChHD and levels of PA (total, walking, moderate, and vigorous) as a continuous variable was fitted using generalized linear models. Logistic regression models were fitted to evaluate the association between ChHD and meeting WHO's PA recommendations. Results: Among the 361 participants included in the analysis (60.7 ± 10.7 years; 56.2 % women), 58.1 % (n = 210) complied with the WHO's PA recommendations. After adjustments for potential confounders, regression analyses revealed that ChHD without heart failure was significantly associated with reduced vigorous PA (Exp ß 0.32 95 % CI 0.10 to 0.98). ChHD with heart failure had significantly lower levels of total (Exp ß 0.61 95 % CI 0.44 to 0.84) and moderate (Exp ß 0.59 95 % CI 0.39 to 0.89) PA. ChHD with heart failure had a lower odd of meeting the PA recommendation in comparison to those with no cardiac involvement (OR 0.48 95 % CI 0.24 to 0.97). Conclusions: We found low levels of PA among individuals with CD. Presence of ChHD (mainly with HF) was associated with decreased levels of PA.

Development of a multivariate predictive model for dapsone adverse drug events in people with leprosy under standard WHO multidrug therapy.

BACKGROUND: The occurrence of adverse drug events (ADEs) during dapsone (DDS) treatment in patients with leprosy can constitute a significant barrier to the successful completion of the standardized therapeutic regimen for this disease. Well-known DDS-ADEs are hemolytic anemia, methemoglobinemia, hepatotoxicity, agranulocytosis, and hypersensitivity reactions. Identifying risk factors for ADEs before starting World Health Organization recommended standard multidrug therapy (WHO/MDT) can guide therapeutic planning for the patient. The objective of this study was to develop a predictive model for DDS-ADEs in patients with leprosy receiving standard WHO/MDT. METHODOLOGY: This is a case-control study that involved the review of medical records of adult (≥18 years) patients registered at a Leprosy Reference Center in Rio de Janeiro, Brazil. The cohort included individuals that received standard WHO/MDT between January 2000 to December 2021. A prediction nomogram was developed by means of multivariable logistic regression (LR) using variables. The Hosmer-Lemeshow test was used to determine the model fit. Odds ratios (ORs) and their respective 95% confidence intervals (CIs) were estimated. The predictive ability of the LRM was assessed by the area under the receiver operating characteristic curve (AUC). RESULTS: A total of 329 medical records were assessed, comprising 120 cases and 209 controls. Based on the final LRM analysis, female sex (OR = 3.61; 95% CI: 2.03-6.59), multibacillary classification (OR = 2.5; 95% CI: 1.39-4.66), and higher education level (completed primary education) (OR = 1.97; 95% CI: 1.14-3.47) were considered factors to predict ADEs that caused standard WHO/MDT discontinuation. The prediction model developed had an AUC of 0.7208, that is 72% capable of predicting DDS-ADEs. CONCLUSION: We propose a clinical model that could become a helpful tool for physicians in predicting ADEs in DDS-treated leprosy patients.

Josicélia Dumêt Fernandes' professional trajectory: contributions to psychiatric and mental health nursing / Trayectoria profesional de Josicélia Dumêt Fernandes: aportes a la enfermería psiquiátrica y de salud mental / Trajetória profissional de Josicélia Dumêt Fernandes: contribuições para a enfermagem psiquiátrica e de saúde mental

ABSTRACT Objectives: to analyze nurse Josicélia Dumêt Fernandes' life story, with emphasis on her work in the psychiatry and mental health fields. Methods: historical, qualitative research. Semi-structured interviews and documentary research were used as data collection techniques, collected from September to October 2021. For data analysis, we opted for the content analysis method and comparison with the Foucauldian philosophical framework. Results: four categories emerged: Transforming herself and mental health practices; (Re)framing professional practice; Nursing practice and power relations; and The paths and implications in the psychiatry and mental health fields. Final Considerations: the study of the biographer demonstrates a search for transformation of herself and mental health practices, with a rupture in paradigms and reframing of her practice in psychiatry and mental health.

RESUMEN Objetivos: analizar la historia de vida de la enfermera Josicélia Dumêt Fernandes, con énfasis en su trabajo en el área de psiquiatría y salud mental. Métodos: investigación histórica, cualitativa. Se utilizaron como técnicas de recolección de datos entrevistas semiestructuradas e investigación documental, recolectados de septiembre a octubre de 2021. Para el análisis de los datos, se optó por el método de análisis de contenido y comparación con el marco filosófico foucaultiano. Resultados: surgieron cuatro categorías: Transformación del yo y de las prácticas de salud mental; El (re)significado de la práctica profesional; Práctica de enfermería y relaciones de poder; y Los caminos e implicaciones en el campo de la psiquiatría y la salud mental. Consideraciones Finales: el estudio de la biógrafa demuestra una búsqueda de transformación de ella misma y de las prácticas de salud mental, rompiendo paradigmas y resignificando su práctica en psiquiatría y salud mental.

RESUMO Objetivos: analisar a história de vida da enfermeira Josicélia Dumêt Fernandes, com ênfase em sua atuação na área da psiquiatria e saúde mental. Métodos: pesquisa histórica, do tipo qualitativa. Foram utilizadas como técnicas de coleta de dados a entrevista semiestruturada e a pesquisa documental, coletados de setembro a outubro de 2021. Para a análise dos dados, optou-se pelo método de análise de conteúdo e a confrontação com o referencial filosófico foucaultiano. Resultados: emergiram quatro categorias: A transformação de si e das práticas em saúde mental; A (re)significação da prática profissional; A prática de enfermagem e as relações de poder; e Os caminhos e implicações no campo da psiquiatria e da saúde mental. Considerações Finais: o estudo da biografada demonstra uma busca por transformação de si e das práticas de saúde mental, com ruptura de paradigmas e ressignificações da sua prática em psiquiatria e saúde mental.

Implementing nursing diagnoses and care for the spiritual dimension of people with cancer: educational actions.

OBJECTIVE: To establish the implementation of nursing diagnoses and care for the spiritual dimension of people with cancer. METHOD: Action research in a university hospital in the north-east of Brazil. Nine nurses and thirteen nursing technicians from the Onco-hematology and Bone Marrow Transplant Unit of this hospital took part. Data collection took place in four phases and involved the talking map technique, pedagogical workshops and a logbook. The groups' speeches were coded using Maxqda software, subjected to Braun and Clarke's thematic analysis and interpreted in the light of Paulo Freire's constructs. RESULTS: Phase 1 sought to apprehend the participants' prior knowledge on the subject; in phase 2, proposals emerged for spiritual care organized in the Nursing Process; in phase 3, the diagnoses and care plan for the spiritual dimension for clinical practice were contemplated; and in phase 4, through the final evaluation, it was possible to see the transformations that occurred in the nursing team's practice with the proposed implementation. CONCLUSION: The educational actions provided significant learning for the nursing team and the implementation of diagnoses and nursing care for the spiritual dimension of people with cancer.

Overview of nursing ethics teaching in Brazilian public higher education institutions.

OBJECTIVES: to outline the teaching of ethics in undergraduate Nursing programs in Brazilian public higher education institutions. METHODS: descriptive and exploratory study, carried out through the documentary analysis of pedagogical projects of undergraduate Nursing programs in Brazil. RESULTS: 153 active undergraduate Nursing programs were found, of which 106 provide the pedagogical project. In addition to deontological teaching, the teaching of ethics was identified in a transversal way associated with themes such as Social Context, Hospital and Community Care, Pharmacology, Systematization of Nursing Care, Surgical Nursing, Epidemiology, Palliative Care, Management in Nursing, Diversity, Women's, Children's, Adolescent's, Adult's and Older People's Health, and Mental Health. FINAL CONSIDERATIONS: the challenge in teaching nursing ethics is its integration with each action of caring, teaching and managing.

Yvonne Lara: enfermeira brasileira / Yvonne Lara: Brazilian nurse / Yvonne Lara: enfermera brasileña

Objetivo: apresentar a trajetória de Yvonne da Silva Lara na enfermagem brasileira. Método: método histórico com base documental na perspectiva da microanálise com ênfase em biografia. Os dados coletados dos documentos pessoais e institucionais foram triangulados com a literatura de aderência e organizados nos eixos: dados pessoais, processo de formação na enfermagem e trajetória profissional. Resultados: a análise desses dados esclareceu a divergência no ano de nascimento da biografada e a revelou como enfermeira de formação com especialização, diversidade de conhecimentos e significativa vivência prática. Conclusão: o legado deixado foi ter articulado seus saberes e ideais em prol do ethos do cuidado ao ser humano(AU)

Objective: to present the trajectory of Yvonne da Silva Lara in Brazilian nursing. Method: historical method based on documents from the perspective of microanalysis with an emphasis on biography. Data collected from personal and institutional documents were triangulated with the adherence literature and organized into axes: personal data, nursing education process and professional trajectory. Results: the analysis of these data clarified the divergence in the biographed woman's year of birth and revealed her as a trained nurse with specialization, with a diversity of knowledge and significant practical experience. Conclusion: the legacy she left was having articulated her knowledge and ideals in favor of the ethos of caring for human beings(AU)

Objetivo: presentar la trayectoria de Yvonne da Silva Lara en la enfermería brasileña. Método: método histórico basado en documentos desde la perspectiva del microanálisis con énfasis en la biografía. Los datos recolectados de los documentos personales e institucionales fueron triangulados con la literatura de adherencia y organizados en los ejes: datos personales, proceso de formación de enfermería y trayectoria profesional. Resultados: El análisis de estos datos aclaró la divergencia en el año de nacimiento de la biografiada y la reveló como siendo una enfermera de formación con especialización, con diversidad de saberes y significativa experiencia práctica. Conclusión: El legado que dejó fue haber articulado sus saberes e ideales a favor del ethos del cuidado del ser humano(AU)

Lâmpada: Signo inventado para a enfermagem / Lamp: sign invented for nursing / Lámpara: signo inventado para la enfermería

Objetivo: refletir sobre os indícios da tradição inventada do signo da enfermagem, conhecido internacionalmente, como a lâmpada. Conteúdo: ao adotarmos o percurso do ensaio teórico para o signo inventado para a enfermagem, discutimos sobre a estética da lâmpada, sua morfologia funcional e léxico (lanterna, lucerna e lâmpada), para o efeito de sua representatividade, considerando os marcos históricos a ela relacionados. Considerações finais: entender a implicação do signo como pertencimento para os estudantes e profissionais da enfermagem é assumir sua analogia direta, por semelhança e convencional(AU)

Objective: to reflect on the signs of the invented tradition of the nursing sign, known internationally as the lamp. Content: adopting the path of the theoretical essay for the sign invented for nursing, we discuss the aesthetics of the lamp, its functional morphology and lexicon (lantern, lucerne and lamp), for the purpose of its representativeness, considering the historical milestones related to it. Final considerations: understanding the implication of the sign as belonging for nursing students and professionals is to assume its direct analogy, by similarity and conventionality(AU)

Objetivo: reflexionar sobre los indicios de la tradición inventada del signo de enfermería, conocido internacionalmente como la lámpara. Contenido: adoptando el recorrido del ensayo teórico para el signo inventado para la enfermería, discutimos sobre la estética de la lámpara, su morfología funcional y el léxico (linterna, luz y lámpara) para efecto de su representatividad, considerando los marcos históricos relacionados a ella. Consideraciones finales: comprender la implicación del signo como pertenencia para los estudiantes y profesionales de enfermería es asumir su analogía directa, por semejanza y convencionalidad(AU)

Predictors of Trypanosoma cruzi PCR positivity in patients with chronic Chagas disease.

BACKGROUND: A positive Trypanosoma cruzi polymerase chain reaction (PCR) is associated with a worse prognosis in patients with chronic Chagas disease (CD). OBJECTIVES: To study the association of clinical, electrocardiographic, and echocardiographic characteristics and biomarker blood levels with positive T. cruzi PCR in chronic CD. METHODS: This is a single-centre observational cross-sectional study. Positive T. cruzi PCR association with clinical, electrocardiographic, and echocardiographic characteristics, and biomarker blood levels were studied by logistic regression analysis. p values < 0.05 were considered significant. FINDINGS: Among 333 patients with chronic CD (56.4% men; 62 ± 10 years), T. cruzi PCR was positive in 41.1%. Stepwise multivariate logistic regression showed an independent association between positive T. cruzi PCR and diabetes mellitus {odds ratio (OR) 0.53 [95% confidence interval (CI) 0.30-0.93]; p = 0.03}, right bundle branch block [OR 1.78 (95% CI 1.09-2.89); p = 0.02], and history of trypanocidal treatment [OR 0.13 (95% CI 0.04-0.38); p = 0.0002]. Among patients with a history of trypanocidal treatment (n = 39), only four (10%) patients had a positive T. cruzi PCR. MAIN CONCLUSIONS: Among several studied parameters, only diabetes mellitus, right bundle branch block, and history of trypanocidal treatment showed an independent association with positive T. cruzi PCR. History of trypanocidal treatment was a strong protective factor against a positive T. cruzi PCR.

A Strategy Utilizing Protein-Protein Interaction Hubs for the Treatment of Cancer Diseases.

We describe a strategy for the development of a rational approach of neoplastic disease therapy based on the demonstration that scale-free networks are susceptible to specific attacks directed against its connective hubs. This strategy involves the (i) selection of up-regulated hubs of connectivity in the tumors interactome, (ii) drug repurposing of these hubs, (iii) RNA silencing of non-druggable hubs, (iv) in vitro hub validation, (v) tumor-on-a-chip, (vi) in vivo validation, and (vii) clinical trial. Hubs are protein targets that are assessed as targets for rational therapy of cancer in the context of personalized oncology. We confirmed the existence of a negative correlation between malignant cell aggressivity and the target number needed for specific drugs or RNA interference (RNAi) to maximize the benefit to the patient's overall survival. Interestingly, we found that some additional proteins not generally targeted by drug treatments might justify the addition of inhibitors designed against them in order to improve therapeutic outcomes. However, many proteins are not druggable, or the available pharmacopeia for these targets is limited, which justifies a therapy based on encapsulated RNAi.

Corrigendum: Home-based exercise program in the indeterminate form of Chagas disease (PEDI-CHAGAS study): a study protocol for a randomized clinical trial.

[This corrects the article DOI: 10.3389/fmed.2022.1087188.].

Biomarkers and Echocardiographic Predictors of Cardiovascular Outcome in Patients With Chronic Chagas Disease.

Background Chagas disease (CD) presents an ominous prognosis. The predictive value of biomarkers and new echocardiogram parameters in adjusted models have not been well studied. Methods and Results There were 361 patients with chronic CD (57.6% men, 61±11 years of age, clinical forms: indeterminate 27.1%, cardiac 56.6%, digestive 3.6%, cardiodigestive 12.7%) included in this single-center, observational, prospective longitudinal study. Echocardiographic evaluation included strain analyses of left atrial, left ventricular (LV), and right ventricular and 3-dimensional analyses of left atrial and LV volumes. Biomarkers included cardiac troponin I, brain natriuretic peptide, transforming growth factor ß1, tumor necrosis factor, matrix metalloproteinases, and Trypanosoma cruzi polymerase chain reaction. The studied end point was a composite of CD-related mortality, heart transplant, hospital admission due to worsening heart failure, or new cardiac device insertion. Event-free survival was analyzed by multivariable regression analyses adjusted for competing risks. P values <0.05 were considered significant. The composite event occurred in 79 patients after 4.9±2.0 years follow-up. LV end-diastolic volume (hazard ratio [HR], 1.01 [95% CI, 1.00-1.02]; P=0.02), peak negative global atrial strain (HR, 1.08 [95% CI, 1.00-1.17]; P=0.04), LV global circumferential strain (HR, 1.12 [95% CI, 1.04-1.21]; P=0.003), LV torsion (HR, 0.55 [95% CI, 0.35-0.81]; P=0.003), brain natriuretic peptide (HR, 2.03 [95% CI, 1.23-3.34]; P=0.005), and positive T cruzi polymerase chain reaction (HR, 1.80 [95% CI, 1.12-2.91]; P=0.01) were end point predictors independent from age, sex, 2-dimensional echocardiographic indexes, hypertension, previous cardiac device, and CD cardiac form. Conclusions Two-dimensional strain- and 3-dimensional-derived parameters, brain natriuretic peptide, and positive T cruzi polymerase chain reaction can be useful for prediction of CD cardiovascular events.

Nursing Interventions in the Perioperative Pathway of the Patient with Breast Cancer: A Scoping Review.

The decrease in average hospitalisation time and the increase in outpatient surgery in some types of breast cancer represent gains for the reduction of the negative impact of hospitalisation in women with breast cancer but are also a challenge for the organisation of nursing care to prepare women for surgery, reduce anxiety about the interventions, and ensure continuity of care in the postoperative period. The aim of this study is to identify nursing interventions present in the care provided to patients with breast cancer during the perioperative period. A scoping review was the method chosen to answer the research question: What are the specialised nursing interventions in the perioperative pathway of the patient with breast cancer? Inclusion and exclusion criteria were defined for the articles that were identified in the CINAHL and MEDLINE databases; later, additional sources were identified from the list of bibliographic references for each selected study. The final bibliographical sample consisted of seven articles, which allowed the identification of three key moments of nursing interventions in the perioperative period of patients with breast cancer: the preoperative consultation, the reception of the patient in the operating room, and the postoperative consultation. Factors such as psychological, emotional, and spiritual support, communication and patient-centred care, health education and surgical safety, and the definition of a perioperative pathway for these patients contribute significantly to patients' satisfaction and the improvement of their quality of life. The results of this study make it possible to establish recommendations for practise and for research, increasing the range of nurses' actions.

Scientific production of mental health nursing using phenomenology's theoretical framework.

OBJECTIVE: To map and characterize the studies produced by stricto sensu postgraduate programs on mental health nursing care using the theoretical framework of phenomenology. METHOD: Bibliographic, retrospective, and descriptive research, carried out in October 2022 using the Catalog of Theses and Dissertations of the Coordination for the Improvement of Higher Education Personnel as a data source. The search strategy associated the term "phenomenology" with the Boolean operator "AND" and the descriptor "Mental Health". RESULTS: 22 studies were identified, 15 were MS dissertations and (68%) and 7 (32%) were PhD theses. The main phenomenological framework was the work of Schütz. FINAL CONSIDERATIONS: The scientific production of nursing in mental health, in the light of phenomenology, is highly variable. Although still incipient, the interest in' phenomenology's framework illuminates new perspectives for paradigms of care that value users' singularities and potentialities.

The use of pracaxi oil collector in the selective flotation of xenotime from silicates.

Rare earth elements have played a key role in technological advancement, attracting great visibility in the global commodity market. Xenotime, a heavy rare earth resource (YPO4), can be found associated with granitic rocks, as in the Pitinga deposit, located in the Brazilian Amazon region, where the main gangue minerals are quartz, microcline and albite. This research investigates the application of a new collector produced from pracaxi oil, an Amazon oil abundant in Brazil, in the selective flotation between xenotime and its main gangue minerals. The study conducted the synthesis and characterization of the collector, the chemical, mineralogical and surface characterization of minerals, as well as the evaluation of collector adsorption and flotability via microflotation tests, zeta potential measurements, surface tension determination and XRD, WDXRF, ICP-MS, FTIR and XPS analyses. The pracaxi collector was found to be mainly composed of oleic acid (56.2%), linoleic acid (14.1%) and behenic acid (10.6%), in addition to exhibiting a critical micelle concentration (CMC) of approximately 150 mg/L. Microflotation tests indicated that the best condition for selective recovery of xenotime occur at alkaline condition (pH 9.0), presenting selectivity of approximately 90% with collector concentration of 10.0 mg/L. The zeta potential data confirmed a selective adsorption of pracaxi collector onto xenotime, with an increase in the surface charge from -30 mV to -68 mV, whereas no significant changes were detected in the silicates. The FTIR spectra showed the appearance of a band at 1545 cm-1 on the surface of the xenotime after collector adsorption, which indicates, along with the zeta potential data, the chemical nature of the adsorption. The presence of small amounts of iron in the lattice structure of silicate gangues can act as an activator, and therefore, may be responsible for the small flotability of these minerals. The performance of the pracaxi oil collector presented in this study indicates the great potential of this Amazonian oil for application in the selective flotation of xenotime ores found in the region.