The observation of the actions performed during the insertion of the catheter made it possible to identify the risk factors associated with infection, and the research protocol may have contributed to the reduction of infection rates.

A capacidade de direcionar atenção é essencial para o funcionamento efetivo da vida diária, pois permite a pessoa manter atividade intencionada, apesar de distrações do ambiente. Este estudo de abordagem qualitativa teve como objetivo identificar as demandas de atenção vivenciadas por um paciente portador de leucemia mielóide aguda, submetido a Transplante de Medula Óssea (TMO), seguindo o referencial teórico de atenção e demandas de atenção. Os dados foram obtidos por meio de entrevista semi-estruturada e observação assistemática, com posterior análise de conteúdo temático. Os resultados apontaram que o paciente em TMO está exposto a muitas demandas de atenção, como: ausência da família, o medo da morte, incerteza do futuro, espaço físico restrito, afastamento do trabalho, excesso de manuseio da equipe de enfermagem, entre outras.

RESUMO: Objetivou-se analisar a eficiência da tecnologia Bota de Unna no processo de cicatrização de úlceras varicosas. Trata-se de pesquisa descritiva retrospectiva, realizada no ambulatório de tratamento de feridas de um hospital de ensino da região sul do Brasil, tendo como fonte de dados prontuários de pacientes portadores de úlcera venosa e que utilizaram a Bota de Unna. Incluiu-se 49 pacientes que apresentaram 80 úlceras varicosas, predominantemente em membro inferior direito com 56,2% (n=45) e região de maléolo medial com 42,5% (n=34). Em relação à cicatrização das úlceras, houve significância estatística para volume intenso do exsudato (p-valor=0,0193) e tamanho da úlcera (p-valor<0,0001), tendência para deambulação sem auxílio (p-valor=0,0986) e exsudato purulento (p-valor=0,0629) UNNA BOOT TECHNOLOGY IN THE HEALING OF VARICOSE ULCERS ABSTRACT:This study aimed to analyze the efficiency of Unna Boot technology in the varicose ulcer healing process. This was a retrospective descriptive study conducted in the wound care clinic of a teaching hospital in southern Brazil, using as the data source the medical records of patients with venous ulcers that used the Unna Boot. The study included 49 patients with 80 varicose ulcers, predominantly in the right lower limb, with 56.2% (n = 45), and the medial malleolus region, with 42.5% (n = 34). Regarding the healing of the ulcers, a large volume of exudate (p = 0.0193) and ulcer size (p <0.0001)were statistically significant, while walking without assistance (p = 0.0986) and purulent exudate (p = 0.0629) showed a tendency, as variables that affected the healing. Estudio cuyo objetivo fue analizar la eficiencia de la tecnología Bota de Unna en el proceso de cicatrización de úlceras varicosas. Fue una investigación descriptiva retrospectiva, realizada en el ambulatorio de tratamiento de heridas de un hospital de enseñanza de la región sur de Brasil, que tuvo como fuente de datos prontuarios de pacientes con úlcera venosa que utilizaron la Bota de Unna. Participaron 49 pacientes que presentaron 80 úlceras varicosas, con predominancia en el miembro inferior derecho con 56,2% (n=45) y región de maléolo medial con 42,5% (n=34). Acerca de la cicatrización de las úlceras, hubo significancia estadística para volumen intenso de exudato(p-valor=0,0193) y tamaño de la úlcera (p-valor<0,0001), tendencia para deambulación sin ayuda (p-valor=0,0986) y exudato purulento (p-valor=0,0629) como variables que interfieren en la cicatrización. Cuarenta y uno pacientes (51,3%) presentaron cicatrización de las lesiones a causa del uso de la Bota de Unna en hasta 12 semanas. La tecnología fue eficiente en la cicatrización de las úlceras varicosas, especialmente en las de pequeño tamaño.

Sea turtles migrate thousands of miles annually between foraging and breeding areas, carrying dozens of epibiont species with them on their journeys. Most sea turtle epibiont studies have focused on large-sized organisms, those visible to the naked eye. Here, we report previously undocumented levels of epibiont abundance and biodiversity for loggerhead sea turtles (Caretta caretta), by focusing on the microscopic meiofauna. During the peak of the 2018 loggerhead nesting season at St. George Island, Florida, USA, we sampled all epibionts from 24 carapaces. From the subsamples, we identified 38,874 meiofauna individuals belonging to 20 higher taxa. This means 810,753 individuals were recovered in our survey, with an average of 33,781 individuals per carapace. Of 6992 identified nematodes, 111 different genera were observed. To our knowledge, such levels of sea turtle epibiont abundance and diversity have never been recorded. Loggerhead carapaces are without doubt hotspots of meiofaunal and nematode diversity, especially compared to other non-sedimentary substrates. The posterior carapace sections harbored higher diversity and evenness compared to the anterior and middle sections, suggesting increased colonization and potentially facilitation favoring posterior carapace epibiosis, or increased disturbance on the anterior and middle carapace sections. Our findings also shed new light on the meiofauna paradox: “How do small, benthic meiofauna organisms become cosmopolitan over large geographic ranges?” Considering high loggerhead epibiont colonization, the large distances loggerheads migrate for reproduction and feeding, and the evolutionary age and sheer numbers of sea turtles worldwide, potentially large-scale exchange and dispersal for meiofauna through phoresis is implied. We distinguished different groups of loggerhead carapaces based on divergent epibiont communities, suggesting distinct epibiont colonization processes. These epibiont observations hold potential for investigating loggerhead movements and, hence, their conservation.

RESUMO: Este estudo objetivou buscar evidências científicas que abordassem os principais erros de medicação e suas causas observados pela enfermagem nas instituições hospitalares de internação integral, bem como, descrever as estratégias utilizadas para promover a segurança medicamentosa nestas instituições. Foram selecionados 79 artigos de três bases de dados, entre os anos de 2004 a 2015. Os tipos de erros mais citados foram dose imprópria 35 (13,3%), omissão de dose 30 (11,5%), e horário errado 29 (11,1%). As causas mais citadas foram as relacionadas ao fator humano 43 (35,2%), sistema 37 (30,3%) e comunicação 22 (18%). As estratégias que se destacaram foram implantação de protocolos de segurança de preparo e administração de medicamentos, prescrição eletrônica, inclusão do profissional farmacêutico na equipe e treinamento/orientação da equipe. Acredita-se que esta revisão possa contribuir para melhoria do processo de administração de medicamentos e para criação de estratégias de prevenção que fomentem a segurança do paciente.

In the world, Evidence-Based Nursing (EBN) has carried out an intense statement of position, including determining health policies. But, in Brazil, still, it is a subject that requires greater discussion. International policy recommends the training of leaders for the development and dissemination of knowledge with the aim of improving Nursing practice. At the last International Nursing Research Congress, held in Melbourne, Australia, in July of this year, the Society of Nursing, Sigma Theta Tau International, organizer of the event, promoted extensive debate and presentations of successful experiences and research on Evidence-Based Nursing as basis for professional Nursing practice. EBN is characterized as the integration of the best available evidence, Nursing competence and values and preferences of the individuals, families and communities served. This presupposes that the nurse is able to exercise his judgment, planning and provide care that take into account cultural and personal values and preferences. Demographic changes, life expectancy, increased prevalence of chronic diseases, prevention with a focus on well-being and health policies, are factors that affect overall health. Since 2015, the World Health Organization has set goals for the sustainable development of population health, with the attributes established being accessibility, acceptability and adaptability. Accessibility refers mainly to the recommendations of the WCAG (1) (World Content Accessibility Guide) and, in the case of the Government of Brazil, the e-MAG (Accessibility Model in Electronic Government). E-MAG is aligned with international recommendations, but sets standards for accessible behavior for government sites. Acceptability, in Evidence-Based Nursing, is an essential attribute of an information system and is characterized by the adherence of health professionals to the guidelines, contributing to adaptability to different circumstances. It is considered that health systems should be resilient because they face significant limitations that are clearly stated, such as insufficient numbers of skilled health professionals, available medicines below the needs, fragile information systems, inadequate infrastructure and scarce public funding. Resilience is characterized as the ability of a system to adjust its activities to maintain its basic functionality, even when environmental challenges, failures and changes occur (2). The resilience of the health system refers to the ability to absorb disruption, respond and recover with the timely delivery of the necessary services. That is, the capacity of actors, health institutions, and the population to prepare themselves to respond effectively to crises while maintaining core functions (2). EBN responds quickly to the resilience attribute, as it establishes a current and future voice and vision of Nursing in the search to promote global health, while at the same time strengthening professional roles. It is understood that the greatest challenge for the training of nurses in Evidence-Based N...

Sea turtles are exposed to numerous threats during migrations to their foraging grounds and at those locations. Therefore, information on sea turtle foraging and spatial ecology can guide conservation initiatives, yet it is difficult to directly observe migrating or foraging turtles. To gain insights into the foraging and spatial ecology of turtles, studies have increasingly analyzed epibionts of nesting turtles, as epibionts must overlap spatially and ecologically with their hosts to colonize successfully. Epibiont analysis may be integrated with stable isotope information to identify taxa that can serve as indicators of sea turtle foraging and spatial ecology, but few studies have pursued this. To determine if epibionts can serve as indicators of foraging and spatial ecology of loggerhead turtles nesting in the northern Gulf of Mexico we combined turtle stable isotope and taxonomic epibiont analysis. We sampled 22 individual turtles and identified over 120,000 epibiont individuals, belonging to 34 macrofauna taxa (&gt;1 mm) and 22 meiofauna taxa (63 μm–1 mm), including 111 nematode genera. We quantified epidermis δ13C and δ15N, and used these to assign loggerhead turtles to broad foraging regions. The abundance and presence of macrofauna and nematodes did not differ between inferred foraging regions, but the presence of select meiofauna taxa differentiated between three inferred foraging regions. Further, dissimilarities in macrofauna, meiofauna, and nematode assemblages corresponded to dissimilarities in individual stable isotope values within inferred foraging regions. This suggests that certain epibiont taxa may be indicative of foraging regions used by loggerhead turtles in the Gulf of Mexico, and of individual turtle foraging and habitat use specialization within foraging regions. Continued sampling of epibionts at nesting beaches and foraging grounds in the Gulf of Mexico and globally, coupled with satellite telemetry and/or dietary studies, can expand upon our findings to develop epibionts as efficient indicators of sea turtle foraging and spatial ecology.

RESUMO Objetivo analisar as características individuais, clínicas e os fatores associados à mortalidade de pacientes com COVID-19, em hospital público do estado do Paraná, Brasil. Métodos estudo seccional, retrospectivo, documental (n= 86), com pacientes adultos internados, de março a junho de 2020. Resultados a mortalidade foi de 12,8%, o grupo de maior risco foi de idosos com comorbidades, especialmente, cardiovasculares. A chance de óbito foi 58 vezes maior em idosos, comparada aos adultos, e oito vezes maior naqueles com comorbidades, comparadas aos hígidos. A maioria dos pacientes apresentou sintomatologia respiratória, febre e mialgia. Tratamento à base de antibióticos, anticoagulantes e antivirais, associado ao suporte ventilatório. As principais complicações foram hipóxia, insuficiência renal aguda e infecção secundária. Conclusão e implicações para a prática idosos com comorbidades cardiovasculares que necessitaram de cuidados intensivos apresentaram maior chance de óbito. Os resultados de um dos centros de referência na pandemia possibilitam discutir medidas epidemiológicas adotadas, com ênfase em conceitos restritivos nos primeiros meses.