Objective: To analyze the current scientific literature to document, in an integrative review, the main findings that correlate Kawasaki disease (KD) to COVID-19. Data sources: The search was carried out in June 2020 in the following databases: Biblioteca Virtual em Saúde (BVS), periódico da CAPES and U.S National Library of Medicine (PubMed). The combination of descriptors used was [(COVID-19 OR SARS-CoV-2) AND (Kawasaki disease)], and the inclusion criteria stipulated were studies published from January 2019 to June 2020, without restriction of language or location, and available online in full. News, editorials, comments, and letters, as well as duplicates and articles that did not answer the guiding question were excluded. Data synthesis: A total of 97 articles were identified, of which seven comprised this review. The association of KD to the new coronavirus appears to trigger a severe clinical condition of vasculitis. Different from the usual, in this inflammatory syndrome, patients are older, and prevalence is higher in children from African or Caribbean ancestry; clinical and laboratory manifestations are also atypical, with a predominance of abdominal complaints and exaggerated elevation of inflammatory markers. In addition, there was a greater report of rare complications and greater resistance to the recommended treatment for KD. Conclusions: Pediatric COVID-19 and its potential association to severe KD, still unfamiliar to health professionals, reinforces the importance of testing patients with vasculitis for the new coronavirus and the need to wage high surveillance and preparation of the health system during the current pandemic.
O presente trabalho teve como objetivo analisar as principais causas de internações hospitalares emidosos de 60 anos ou mais, por regiões do Brasil, em um período de 10 anos. Trata-se de um estudo ecológico,descritivo, utilizando dados secundários provenientes do Sistema de Informações Hospitalares do SUS - SIH/SUS. Para a determinação das causas de internação foram utilizados os capítulos do CID-10. Observou-se que nas cincoregiões brasileiras as principais taxas de internações em idosos ocorreram devido às doenças do aparelho circulatórioe do aparelho respiratório. Além disso, nas regiões Norte e Nordeste ainda há uma significativa taxa de internaçãopor algumas doenças infecciosas e parasitárias.
Objective: To analyze literature data about unnecessary exposure of pediatric emergency patients to ionizing agents from imaging examinations, nowadays and during times of COVID-19. Data sources: Between April and July 2020, articles were selected using the databases: Virtual Health Library, PubMed and Scientific Electronic Library Online. The following descriptors were used: [(pediatrics) AND (emergencies) AND (diagnostic imaging) AND (medical overuse)] and [(Coronavirus infections) OR (COVID-19) AND (pediatrics) AND (emergencies) AND (diagnostic imaging)]. Inclusion criteria were articles available in full, in Portuguese or English, published from 2016 to 2020 or from 2019 to 2020, and articles that covered the theme. Articles without adherence to the theme and duplicate texts in the databases were excluded. Data synthesis: 61 publications were identified, of which 17 were comprised in this review. Some imaging tests used in pediatric emergency departments increase the possibility of developing future malignancies in patients, since they emit ionizing radiation. There are clinical decision instruments that allow reducing unnecessary exam requests, avoiding over-medicalization, and hospital expenses. Moreover, with the COVID-19 pandemic, there was a growing concern about the overuse of imaging exams in the pediatric population, which highlights the problems pointed out by this review. Conclusions: It is necessary to improve hospital staff training, use clinical decision instruments and develop guidelines to reduce the number of exams required, allowing hospital cost savings; and reducing children’s exposure to ionizing agents.
Objetivo: Conhecer a percepção dos egressos de enfermagem sobre a formação acadêmica para o trabalho na área de oncologia. Método: Pesquisa exploratória, abordagem qualitativa, desenvolvida em uma Instituição de Alta Complexidade em oncologia na região Oeste do Paraná. A coleta de dados ocorreu de abril a maio de 2019, por meio de entrevistas semiestruturadas, com 35 enfermeiros atuantes na assistência de pacientes oncológicos. Foi realizada análise de conteúdo temática dos dados. Resultados: Foram elaboradas três categorias: Desafios na Oncologia, Formação para trabalhar em Oncologia e Especialização em Oncologia. Os enfermeiros apontaram dificuldades para a realização desse cuidado e a falta de contato com a temática no decorrer da graduação, buscando a especialização para suporte ao conhecimento. Os entrevistados propõem como o tema deve ser abordado na matriz curricular. Conclusão: É necessária a ampliação da discussão sobre oncologia durante a graduação do enfermeiro. Incluir o resumo.
Avaliação de profissionalismo como competência na formação do enfermeiro: uma revisão integrativa Evaluation of professionalism as a competence in in nursing education: an integrative review Evaluación de competencias de profesionalismo como en la formación en enfermería: una revisión integrativa
The evaluation of the General Competencies in undergraduate courses in the healthcare area remains challenging. Objectives To develop an instrument for supporting teaching staff in evaluating the General Competencies of undergraduate students in the healthcare area; to test the reliability of the instrument with teachers and students of the same working field; validate the instrument of General Competencies, directed to teachers and students from the health area. Methods the present was a Methodological study, approved by REC N. 826.770. The validation of the construct, criterion and content based on the National Curricular Guidelines (NCG), and the search for a theoretical framework were performed, as well as statistical tests such as alpha Cronbach, t Test, p-value, Factorial Analysis, Pearson’s Correlation Coefficient and Akaike Information Criterion, which also ensured the reliability. The study was performed in a Higher Education Institution in Curitiba/PR, in the courses of Nursing, Biomedical Sciences, Pharmacy, Psychology and Medicine. The study population consisted of 50 evaluations of students and 50 of teachers, covering all the periods and courses during the second half of 2014. Results it was possible to create one model with three versions of instruments that evaluated the general competencies for the healthcare area courses. One of these was directed towards the general competencies of 10 courses in the healthcare area, subdivided in Health Care, Decision-making, Communication, Leadership, Administration and Management and Continuing Education, with one instrument directed at the student and another ‘mirror’ at the professor. The second and third versions had three dimensions: Health Care, Management in Healthcare and Education in Health, directed towards the general competencies of the new structure of the NCG of the medical course. The three versions also had an instrument for teachers and a mirror one for students. Conclusion To validate the instrument on General Competencies, directed to teachers and undergraduate students of health area courses, the theoretical search, the NCG and the experts’ evaluation were used for Content Validity; the t Test, Chi-square Test and Pearson’s correlation coefficient were used for Criterion Validation; statistical tests of exploratory and confirmatory factorial analysis and the AIC were used for Construct Validity; and Cronbach’s alpha and the AIC were used for Content validity, using the same steps described for the first goal, to ensure the reliability of the instruments. After this process three versions of the instrument were developed, the first two to be used with teachers and with teachers and students together; and the third version is adequate to be used with students or teachers; and also, for teachers and students together. However, it can be used by all health courses studied.
A segurança no transporte do paciente crítico em ambiente intra-hospitalar: uma revisão integrativa Transport safety of the critical patient in intrahospital environment: an integrative review Seguridad en el transporte del paciente crítico en el ámbito hospitalario: una revisión integrativa
Quality of life is a comprehensive concept that includes ideals of health, psychological well-being, social relations and environmental conditions. The Quality of Life of Medical Students (CVEM) has become a notorious issue in the last decade, even in the scientific community. Increasing rates of anxiety, depression, stress, and drug use related to the college lifestyle have been reported. The objective of this work was to highlight the effectiveness of the interventions used to improve CVEM. The systematic review method was adopted to conduct the study. All stages of the review followed the PRISMA guideline. The search words "Medical Student" and "Quality of Life" were used in the databases: PubMed, ERIC, EMBASE and Scopus. Articles from the last ten years that had evaluated an intervention to improve CVEM scores were included. Ten studies of high quality according to MERSQI were included, which met the eligibility criteria, with half of the studies assessed from CVEM using the WHOQOL-BREF instrument. The interventions or assessments found were relaxation exercises, resilience and educational environment, received social support, physical activity, unified protocol for the treatment of emotional disorders, mindfulness and curricular change. We highlight the effectiveness of three studies that proposed as interventions, relaxation exercises, resilience in an educational environment, social support and implementation of a unified protocol for the treatment of emotional disorders. All of them with the purpose of showing ways in which medical schools can improve the CVEM. La calidad de vida es un concepto integral que incluye ideales de salud, bienestar psicológico, relaciones sociales y condiciones ambientales. La Calidad de Vida de los Estudiantes de Medicina (CVEM) se ha convertido en un tema notorio en la última década, incluso en la comunidad científica. Se han señalado crecientes índices de ansiedad, depresión, estrés y consumo de drogas relacionados con el estilo de vida universitario. El objetivo de este trabajo fue resaltar la efectividad de las intervenciones utilizadas para mejorar el CVEM. Se adoptó el método de revisión sistemática para realizar el estudio. Todas las etapas de la revisión siguieron la guía PRISMA. Se utilizaron las palabras de búsqueda "Medical Student" y "Quality of Life" en las bases de datos: PubMed, ERIC, EMBASE y Scopus. Se incluyeron artículos de los últimos diez años que habían evaluado una intervención para mejorar las puntuaciones del CVEM. Se incluyeron diez estudios alta calidad según MERSQI, que cumplió con los criterios de elegibilidad La mitad de los estudios evaluados CVEM utilizando el instrumento WHOQOL-BREF Las intervenciones o valoraciones encontradas fueron: ejercicios de relajación, resiliencia y ambiente educativo, apoyo social recibido, actividad física, protocolo unificado para el tratamiento de trastornos emocionales, mindfulness y cambio curricular, destacando la efectividad de tres estudios que trajeron como intervenciones: ejercicios de relajación, resiliencia en un ambiente educativo, apoyo social e implementación de un protocolo unificado para el tratamiento de los trastornos emocionales. mostrar formas en las que las escuelas de medicina pueden mejorar CVEM.
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