Summary: The state of Chiapas presents degradation processes of dif ferent kinds, as a consequence of the current established agricultural model. It is estimated that, in the near future, the surface of the state of Chiapas will present more than 55% degradation, generating changes in the physical, chemical and biological properties of the soil, af fecting the quality of life of human beings, mainly due to scarcity of food. The objective of this research was to evaluate the quality of the soils in three municipalities of the central depression of Chiapas, Mexico. The analysis were interpreted taking NOM-021-SEMARNAT-2000 as a reference and were classified according to the world reference base (WRB), version 2014. For the evaluation of soil quality, the sustainable use of land subindex (SUSS). 144 soil samples corresponding to 21 profiles were analyzed. Of the 21 profiles studied, 17 present poor soil qualities, two a sensitive quality, one acceptable quality and one with good quality. Only two soil groups presented good fertility and are classified as Vertisols and Phaeozems, which present good quality and capacity to maintain sustainable agricultural production in this region.

Resumen: El estado de Chiapas presenta procesos de degradación de diferente índole, como consecuencia del actual modelo agrícola establecido. Se estima que, en el futuro cercano, la superficie del estado de Chiapas presente más de 55% de degradación, generando modificaciones en las propiedades físicas, químicas y biológicas del suelo; afectando la calidad de vida de los seres humanos, principalmente por escasez de alimentos. El objetivo de esta investigación fue evaluar la calidad de los suelos en tres municipios de la depresión central de Chiapas, México. Los análisis se interpretaron tomando como referencia la NOM-021-SEMARNAT-2000 y se clasificaron de acuerdo con la world reference base (WRB), versión 2014, para la evaluación de calidad del suelo se utilizó el subíndice de uso sustentable del suelo (SUSS). Se analizaron 144 muestras de suelo correspondientes a 21 perfiles. De los 21 perfiles estudiados, 17 presentan calidad de suelo pobre, dos calidades sensibles, uno calidad aceptable y uno con calidad buena. Solo dos Grupos de suelo presentaron buena fertilidad y son clasificados como Vertisols y Phaeozems, los cuales presentan buena calidad y capacidad para mantener producción agrícola sostenible en esta región.

ABSTRACT The objective of this research was to determine the level of work stress of Rotating Nursing Interns in the context of the COVID-19 pandemic. We worked with the entire universe of students of the Rotating Nursing Internship, made up of 200 students who carried out pre-professional practices, a design with a descriptive, non-experimental scope was established, relating the variables work stress and places of care for respiratory symptomatic patients, with the application of a previously validated survey (The Nursing Stress Scale), adapted to the COVID-19 Pandemic. The results obtained demonstrated a severe level of stress with 87.8% being exposed to physical stressors such as the interruption of tasks and strenuous workdays. Regarding the rotation services where high levels of perception of risk of contagion by COVID-19 were identified, they were: The Internal Medicine area, the Vaccination Brigades and Primary Health Care where the greatest apprehension of contagion in the population was perceived studied. It is concluded that the students perceived a higher risk of contagion by COVID-19 in services where the spaces have a higher concentration of respiratory symptomatic people with a high risk of presenting the disease and transmitting it with the prevalence of work-type stressors.

RESUMEN El objetivo de la presente investigación fue determinar el nivel de estrés laboral de los Internos Rotativos de Enfermería en el contexto de la pasada pandemia por COVID-19. Se trabajó con todo el universo de estudiantes del Internado Rotativo de Enfermería, constituidos por 200 alumnos que realizaban las prácticas pre profesionales, se estableció un diseño con alcance descriptivo, no experimental, relacionando las variables estrés laboral y lugares de atención a pacientes sintomáticos respiratorios, con la aplicación de una encuesta previamente validada (The Nursing Stress Scale), adaptada a la Pandemia por COVID-19. Los resultados obtenidos demostraron un severo nivel de estrés con un 87.8% con exposición a estresores físicos como la interrupción de tareas y jornadas laborales extenuantes. En lo referente a los servicios de rotación donde se identificaron altos niveles de percepción de riesgo de contagio por COVID-19 fueron: El área de Medicina Interna, las Brigadas de vacunación y Atención Primaria de Salud donde se percibió mayor aprensión al contagio de la población estudiada. Se concluye que los estudiantes percibieron mayor riesgo de contagio por COVID-19 en servicios donde los espacios presentan mayor concentración de personas sintomáticas respiratorias con alto riesgo de presentar la enfermedad y transmitirla con la prevalencia de estresores de tipo laboral.

ABSTRACT Hepatitis C virus (HCV) infection is a significant cause of morbidity and mortality among hematopoietic stem cell transplant (HCT) recipients. In Brazil, its occurrence in HCT recipients remains undetermined. We now report on HCV prevalence in HCT recipients and its clinical consequences. The medical records of all HCT recipients seen at Hospital das Clinicas, Sao Paulo University Medical School, from January 2010 to January 2020 were reviewed to determine HCV serostatus. A retrospective analysis of medical charts was undertaken on all seropositive cases to determine HCV genotype, presence of liver fibrosis, co-infections with other viruses, previous treatments, and clinical evolution of liver pathology after HCT. Of the 1,293 HCT recipients included in the study, seven (0.54%) were HCV antibody-positive and five (0.39%) were also viremic for HCV-RNA. Four of these individuals had moderate to severe liver fibrosis (METAVIR F2/F3) and one was cirrhotic. Two of the viremic patients developed acute liver dysfunction following transplantation. All patients had their acute episode of liver dysfunction resolved with no further complications. Four of the viremic patients were treated for HCV infection with direct acting agents (DAA). Information regarding HCV treatment was lacking for one of the viremic HCV patients due to loss of follow up. Sustained anti-virologic responses were observed in three cases after the use of DAA. The detection of HCV in hematological adults undergoing HCT and its successful treatment with DAA highlight the necessity of testing for HCV both prior to and following transplantation. (HCV (HCT Brazil undetermined consequences Clinicas School 201 202 serostatus genotype coinfections co infections viruses treatments 1293 1 293 1,29 study 0.54% 054 0 54 (0.54% antibodypositive antibody positive 0.39% 039 39 (0.39% HCVRNA. HCVRNA RNA. RNA HCV-RNA METAVIR F2/F3 F2F3 FF F2 F3 F cirrhotic transplantation complications . (DAA) up antivirologic anti virologic 20 129 29 1,2 0.54 05 5 (0.54 0.39 03 3 (0.39 F2/F F2F (DAA 2 12 1, 0.5 (0.5 0.3 (0.3 0. (0. (0 (

Resumo Introdução: Na atenção à pessoa com anemia falciforme, é imprescindível um cuidado compartilhado e coordenado pela Atenção Primária à Saúde. Os profissionais de saúde da família devem se comprometer com a assistência, sendo necessária uma articulada rede de atenção à saúde. Este estudo teve por objetivo compreender as visões de profissionais de saúde da família acerca da atenção à saúde da pessoa com anemia falciforme. Método: Pesquisa qualitativa, realizada em Diamantina, estado de Minas Gerais, Brasil, com enfermeiros e médicos da Estratégia Saúde da Família (ESF). Conduziram-se entrevistas semiestruturadas com 15 profissionais — sendo, depois, submetidas à análise temática de conteúdo. Resultados: Emergiram duas categorias temáticas: "assistência à pessoa com anemia falciforme: fragilidades no contexto da Estratégia Saúde da Família" e "referência e contrarreferência na atenção: uma rede fragmentada". Revelaram-se desafios a serem superados: o acompanhamento sistemático mostrou-se incipiente, atribuiu-se a responsabilidade pelo cuidado principalmente ao serviço do hemocentro e o sistema de referência e contrarreferência apresentou fragmentação. Conclusões: No cenário da ESF, a assistência requer avanços para que seja de melhor qualidade, com efetiva atuação da equipe e rede de atenção bem estruturada. Introdução falciforme Método qualitativa Diamantina Gerais Brasil ESF. ESF . (ESF) Conduziramse Conduziram 1 depois conteúdo Resultados temáticas fragmentada. fragmentada fragmentada" Revelaramse Revelaram superados mostrouse mostrou incipiente atribuiuse atribuiu fragmentação Conclusões qualidade estruturada (ESF

Abstract Background: While caring the patients with sickle cell anemia, shared care coordinated by Primary Health Care is essential. Family health professionals must commit to care, and an articulated healthcare network is necessary. This study aimed to understand the visions of family health professionals about health care for patients with sickle cell anemia. Method: Qualitative research was carried out in Diamantina, state of Minas Gerais, Brazil, with nurses and physicians of the Family Health Strategy (ESF). Semi-structured interviews were conducted with 15 professionals and the results were submitted to content thematic analysis. Results: Two thematic categories emerged: "assistance to the person with sickle cell anemia: fragilities in the context of the Family Health Strategy" and "reference and counterreference in care: a fragmented network." Challenges to overcome were revealed: systematic follow-up was incipient; responsibility for care was attributed mainly to the blood center service; and the reference and counter-reference system presented fragmentation. Conclusions: In the ESF scenario, care requires advances to be of better quality, with effective team performance and a well-structured care network. Background anemia essential necessary Method Diamantina Gerais Brazil ESF. . (ESF) Semistructured Semi structured 1 analysis Results emerged assistance revealed followup follow up incipient service counter fragmentation Conclusions scenario quality wellstructured well (ESF

ABSTRACT Strongyloides stercoralis infections, human T-lymphotropic virus (HTLV) infections, and Chagas diseases occur throughout many regions of Central and South America, including Peru. This study aimed to evaluate the seroprevalence of S. stercoralis, HTLV, and Chagas disease in Iquitos (Peruvian Amazon) and the associated epidemiological conditions for S. stercoralis seroprevalence in Iquitos. A population-based cross-sectional study was conducted from May 1 to June 15, 2020, to assess the seroprevalence of S. stercoralis [lysate antigen ELISA (enzyme linked immunosorbent assay)], HTLV (recombinant antigen ELISA), and Chagas disease (crude and recombinant antigen ELISAs). Of the 396 included individuals, 257 were seropositive for S. stercoralis (a 64.9% prevalence, 95% confidence interval [CI] 60.0% to 69.4%). In the multivariable analysis, seropositivity for S. stercoralis was higher in women (odds ratio [OR] 1.60, 95% CI 1.03 to 2.66) and residents of Punchana (OR 3.47, 95% CI 1.51 to 7.93), whereas residence in Iquitos was associated with lower positivity (OR 0.52, 95% CI 0.32 to 0.85). In total, four individuals were positive for HTLV (1.0% seroprevalence, 95% CI 0.3% to 2.7%), and none were positive for Chagas disease (0.0% seroprevalence, 95% CI 0.0% to 1.2%). The seroprevalence of S. stercoralis in Iquitos is high, particularly among women and residents of Punchana. The presence of HTLV infection indicates that the virus is circulating in Iquitos. This study found no cases of Chagas disease. infections Tlymphotropic T lymphotropic (HTLV America Peru S Peruvian Amazon populationbased population based crosssectional cross sectional 15 2020 lysate enzyme assay, assay , assay)] ELISA, ELISA) crude ELISAs. ELISAs . ELISAs) 39 25 a 649 64 9 64.9 prevalence 95 [CI 600 60 0 60.0 69.4%. 694 69.4% 69 4 69.4%) analysis odds OR [OR 160 1.60 103 03 1.0 2.66 266 2 66 347 3 47 3.47 151 51 1.5 7.93, 793 7.93 7 93 7.93) 052 52 0.52 032 32 0.3 0.85. 085 0.85 85 0.85) total 1.0% 10 (1.0 2.7%, 27 2.7% 2.7%) 00 (0.0 0.0 1.2%. 12 1.2% 1.2%) high 202 assay) 6 64. 60. 69.4 16 1.6 1. 2.6 26 34 3.4 5 79 7.9 05 0.5 0. 08 0.8 8 (1. 2.7 (0. 1.2 20 69. 2. 3. 7. (1 (0 (

Resumo Introdução A pandemia de COVID-19 impactou significativamente os sistemas de saúde globalmente, destacando-se assim a importância de compreender seus efeitos na oferta de cuidados odontológicos. Objetivo Avaliar o impacto da pandemia de COVID-19 nos procedimentos realizados pelos Centros de Especialidades Odontológicas (CEOs) no Brasil de 2019 a 2022 e sua relação com a Atenção Primária à Saúde (APS). Material e método Estudo ecológico utilizando dados secundários da Produção Ambulatorial do SUS (SIA/SUS). A variável de interesse foi a produção dos CEOs, incluindo CEOs habilitados no Brasil de janeiro de 2019 a dezembro de 2022, dos tipos I, II ou III. As variáveis independentes incluíram: a) período de tempo; b) região do Brasil; c) tipo de CEO; e d) porcentagem de cobertura da atenção primária (PCP). Foram utilizadas estatísticas descritivas, gráficos de controle e análise de regressão binomial negativa. Análises de correlação de Spearman foram aplicadas entre a produção dos CEOs e a PCP. Resultado Observou-se uma queda na produção em abril de 2020 em todas as regiões do país. A produção dos CEOs diminuiu de 327.206 procedimentos em março de 2020 para 37.742 em abril do mesmo ano. A produção nacional dos CEOs permaneceu baixa até dezembro de 2020. A recuperação das quantidades de procedimentos odontológicos especializados acima da média começou no início de 2022. Nos anos de 2021 e 2022, houve uma correlação positiva significativa, mas muito fraca, entre a produção dos CEOs e a PCP (p<0,05). Conclusão O período de redução na produção dos CEOs em 2020, seguido por uma recuperação gradual, reflete o impacto da pandemia de COVID-19 na produção de cuidados odontológicos especializados. COVID19 COVID 19 COVID-1 globalmente destacandose destacando se (CEOs 201 202 APS. APS . (APS) SIA/SUS. SIASUS SIA/SUS SIA (SIA/SUS) I III incluíram tempo b c CEO d (PCP) descritivas negativa Observouse Observou país 327206 327 206 327.20 37742 37 742 37.74 ano significativa fraca p<0,05. p005 p p<0,05 0 05 (p<0,05) gradual COVID1 1 COVID- 20 (APS (SIA/SUS (PCP 32720 32 327.2 3774 3 74 37.7 p00 p<0,0 (p<0,05 2 3272 327. 377 7 37. p0 p<0, (p<0,0 p<0 (p<0, p< (p<0 (p< (p

Abstract Introduction The COVID-19 pandemic has significantly impacted healthcare systems globally, emphasizing the importance of understanding its effects on the provision of dental care. Objective To assess the impact of the COVID-19 pandemic on the procedures conducted by the Specialized Dental Centers (CEOs) in Brazil from 2019 to 2022 and its relationship with Primary Health Care (PHC). Material and method An ecological study using secondary data from the Outpatient Production of the SUS (SIA/SUS). The variable of interest was the production of CEOs, including accredited CEOs in Brazil from January 2019 to December 2022, of types I, II, or III. The independent variables included: a) time period; b) region of Brazil; c) CEO type; and d) the percentage of coverage of primary care (PCP). Descriptive statistics, control charts, and negative binomial regression analysis were used. Spearman correlation analyses were applied between CEOs production and PCP. Result A decline in production was observed in April 2020 across all regions of the country. CEOs production decreased from 327,206 procedures in March 2020 to 37,742 in April of the same year. National CEOs production remained low until December 2020. The recovery of specialized dental procedure quantities above the average began in early 2022. In the years 2021 and 2022, there was a significant but very weak positive correlation between CEOs production and PCP (p<0.05). Conclusion The period of reduced CEOs production in 2020, followed by a gradual recovery, reflects the impact of the COVID-19 pandemic on specialized dental care production. COVID19 COVID 19 COVID-1 globally (CEOs 201 202 PHC. PHC . (PHC) SIA/SUS. SIASUS SIA/SUS SIA (SIA/SUS) I II III included b c type d (PCP) statistics charts used country 327206 327 206 327,20 37742 37 742 37,74 year p<0.05. p005 p p<0.05 0 05 (p<0.05) COVID1 1 COVID- 20 (PHC (SIA/SUS (PCP 32720 32 327,2 3774 3 74 37,7 p00 p<0.0 (p<0.05 2 3272 327, 377 7 37, p0 p<0. (p<0.0 p<0 (p<0. p< (p<0 (p< (p

Abstract This study focuses on the laboratory-scale petrophysical characterization of sandstones from the Rio Bonito Formation (Lower Permian), Paraná Basin, carried out from drill core samples from well PN-14-SC.02 obtained by CPRM-Brazilian Geological Service in the 1980s on the eastern edge of the Basin. This study includes integrating experimental data from routine petrophysics, sedimentary petrography, and nuclear magnetic resonance (NMR) obtained from 6 samples arranged in the normal direction of the stratification, present between 40 and 200 m deep. It was possible to conclude that the values of the permeability and porosity properties obtained from the NMR technique correlated in a very satisfactory way, with correlation coefficient R2 = 0.957 and Root Mean Squared Error (RMSE) = 0.208 about the porosity reference results offered by routine petrophysics, with lower values being less than a porosity unit (+/- 1 p.u.), in the range between 8 and 14%. The same was observed for the estimated permeability, R2 = 0.885 and RMSE = 0.152, by the Timur Coates method, with values in the range between 0.096 and 2.42 mD, which were well supported by the spectra information, as well as by petrographic analyses. laboratoryscale laboratory scale Lower Permian, Permian , Permian) Basin PN14SC.02 PN14SC02 PNSC PN 14 SC.02 SC 02 PN-14-SC.0 CPRMBrazilian CPRM Brazilian s petrophysics petrography (NMR stratification 4 20 deep way R 0957 0 957 0.95 (RMSE 0208 208 0.20 +/ (+/ p.u., pu p.u. p u p.u.) 14% 0885 885 0.88 0152 152 0.152 method 0096 096 0.09 242 2 42 2.4 mD information analyses PN14SC PN14SC.0 PN14SC0 SC02 SC.0 PN-14-SC. 095 95 0.9 020 0.2 + (+ p.u 088 88 0.8 015 15 0.15 009 09 0.0 24 2. PN14SC. SC0 SC. PN-14-SC 9 0. ( 08 01 0.1 00

Abstract Background: respiratory insufficiency is a syndrome with a great impact on hospital admissions, morbidity and mortality. The applicability of High-flow nasal oxygen has been the subject of interest in critically ill patients. Objective: to know the effectiveness of High-flow nasal oxygen as a treatment for respiratory insufficiency in adult patients admitted to the intensive care units. Methods: systematic reviews of effectiveness using the PICO strategy and recommendations from the Joanna Briggs Institute. The survey was carried out in august 2021 using the PubMed and EBSCOhost access platforms. Results: 583 results were identified. Six randomized clinical trials were analyzed. The selection was made after elimination of duplicates; title reading, abstract reading and full text reading according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses diagram. Conclusion: high-flow nasal oxygen proved to be comfortable, tolerable and effective in the treatment of hypoxemic and hypercapnic respiratory insufficiency. It was effective when compared with conventional oxygen therapy in the post-extubation of hypoxemic patients and in reducing partial pressure of carbon dioxide when compared with Non-Invasive Ventilation in hypercapnic patients.

Resumen Marco contextual: la insuficiencia respiratoria es un síndrome que tiene un gran impacto en los ingresos hospitalarios, la morbilidad y mortalidad. La aplicabilidad del oxígeno nasal de alto flujo ha sido objeto de interés en pacientes críticos. Objetivo: conocer la efectividad del oxígeno nasal de alto flujo en el tratamiento de la insuficiencia respiratoria en adultos en unidades de cuidados intensivos. Métodos: revision sistemática de efectividad utilizando la estrategia PICO y recomendaciones del Instituto Joanna Briggs. La búsqueda se llevó a cabo en agosto de 2021 utilizando las plataformas de acceso PubMed y EBSCOhost. Resultados: se identificaron 583 resultados. Se analizaron seis ensayos clínicos aleatorios. La selección se realizó después de la eliminación de duplicados; lectura de títulos, de resúmenes y de texto completo siguiendo el diagrama Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Conclusión: el Oxígeno nasal de alto flujo demostró ser cómodo, tolerable y eficaz en el tratamiento de la insuficiencia respiratoria hipoxémica e hipercápnica. Fue eficaz en comparación con la oxigenoterapia convencional en la postextubación de pacientes hipoxémicos y en la reducción de la presión parcial de dióxido de carbono en comparación con la Ventilación No Invasiva en pacientes hipercápnicos.

Resumo Enquadramento: a insuficiência respiratória é uma síndrome com grande impacto nos internamentos, na morbilidade e mortalidade. A aplicabilidade do oxigénio nasal de alto fluxo tem sido alvo de interesse no doente crítico. Objetivo: conhecer a efetividade do oxigénio nasal de alto fluxo no tratamento da insuficiência respiratória no adulto em unidades de cuidados intensivos. Métodos: revisão sistemática de efetividade que utiliza a estratégia PICO e recomendações do Joanna Briggs Institute. A pesquisa foi realizada em agosto de 2021 com recurso às plataformas de acesso PubMed e EBSCOhost. Resultados: identificaram-se 583 resultados. Foram analisados seis ensaios clínicos randomizados. A seleção foi feita após eliminação de duplicados; leitura do título, resumos e textos integrais de acordo com o diagrama Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Conclusão: o oxigénio nasal de alto fluxo revelou-se confortável, tolerável e eficaz no tratamento da insuficiência respiratória hipoxémica e hipercápnica. Foi eficaz quando comparado com oxigenoterapia convencional na pós-extubação de doentes hipoxémicos e na redução da pressão parcial de dióxido de carbono quando comparado com a Ventilação Não Invasiva nos doentes hipercápnicos.

Abstract Background: Delirium is a common condition in institutionalized adults, characterized by disturbance of consciousness, decreased attention span and disorganized thinking, with an evolution in a short period of time. Delirium has a more detailed symptomatic presentation than acute confusion, being the first one a medical diagnosis and the second a nursing diagnosis. Acute confusion is often subject to misinterpretation by nurses. Aim: To identify autonomous nursing interventions capable of preventing acute confusion. Methods: Integrative Review, starting from the question: “Which autonomous nursing interventions can prevent acute confusion?” Research carried out in october 2020 using the following databases: CINAHL®Complete; MEDLINE Complete; Nursing & Allied Health collection: Comprehensive; Cochrane Central Register of Controlled Trials; Cochrane Database of Systematic Reviews and SciELO, with the inclusion criteria: articles with full text, between 2015 and 2020, in portuguese, spanish and english. Results: 71 results were identified and ten articles were included. The selection was made by reading the title, eliminating duplicates, reading abstracts and full texts, using Preferred Reporting Items for Systematic Reviews and Meta-Analyses, according to the inclusion criteria. The articles included are: two systematic reviews; four meta-analyses; two experimental studies; a quasi-experimental study and a literature review. Conclusions: Autonomous nursing interventions fit into the ten domains of multicomponent interventions, being perceived a heterogeneity of interventions. Multicomponent interventions are those that show better results, when compared to isolated interventions.

Resumen Introducción: El delirium es frecuente en adultos institucionalizados, caracterizado por alteración de la conciencia, disminución de la capacidad de atención, pensamiento desorganizado y con evolución en corto espacio de tiempo. El delirium tiene una presentación de síntomas más detallada que la confusión aguda, siendo el primero un diagnóstico médico y el segundo un diagnóstico de enfermería. La confusión aguda es, muchas veces, sujeta a malas interpretaciones por parte de los enfermeros. Objetivo: Identificar intervenciones autónomas de enfermería capaces de prevenir la confusión aguda. Métodos: Revisión integrativa, a partir de la pregunta: “¿Qué intervenciones autónomas de enfermería pueden prevenir la confusión aguda?”. Investigación realizada en octubre de 2020 utilizando las siguientes bases de datos: CINAHL®Complete; MEDLINE Complete; Nursing & Allied Health collection: Comprehensive; Cochrane Central Register of Controlled Trials; Cochrane Database of Systematic Reviews y SciELO, con los criterios de inclusión: artículos con texto completo, entre 2015 y 2020, en portugués, español e inglés. Resultados: Se identificaron 71 resultados, se incluyeron diez artículos. La selección se realizó mediante lectura de título, eliminación de duplicados, lectura de resúmenes y textos completos utilizando el Preferred Reporting Items for Systematic Reviews and Meta-Análisis, de acuerdo con los criterios de inclusión determinados. Los artículos incluidos son: dos revisiones sistemáticas; cuatro metanálisis; dos estudios experimentales; un estudio cuasi-experimental y una revisión de la literatura. Conclusiones: Las intervenciones autónomas de enfermería encajan en los diez dominios de intervenciones multicomponientes, dándose cuenta de una heterogeneidad de intervenciones. Las intervenciones multicomponientes son las que muestran mejores resultados, en comparación con las intervenciones aisladas.

Resumo Introdução: O delirium é frequente em adultos institucionalizados, caracterizado por perturbação da consciência, diminuição da capacidade de atenção, pensamento desorganizado e com evolução num curto espaço de tempo. O delirium tem uma apresentação sintomática mais detalhada do que a confusão aguda, sendo o primeiro um diagnóstico médico e o segundo um diagnóstico de enfermagem. A confusão aguda é muitas vezes sujeita a interpretações erróneas por parte dos enfermeiros. Objetivo: Identificar as intervenções autónomas de enfermagem passíveis de prevenir a confusão aguda. Métodos: Revisão Integrativa, partindo da questão: “Quais as intervenções autónomas de enfermagem passiveis de prevenir a confusão aguda?”. Pesquisa realizada em outubro de 2020 com recurso às bases de dados: CINAHL®Complete; MEDLINE Complete; Nursing & Allied Health collection: Comprehensive; Cochrane Central Register of Controlled Trials; Cochrane Database of Systematic Reviews e SciELO, com os critérios de inclusão: artigos com texto integral, entre 2015 e 2020, em português, espanhol e inglês. Resultados: Identificaram-se 71 resultados, dez artigos foram incluídos. A seleção foi feita por leitura do título, eliminação de duplicados, leitura de resumos e textos integrais com recurso ao Preferred Reporting Items for Systematic Reviews and Meta-Analyses, de acordo com os critérios de inclusão determinados. Os artigos incluídos são: duas revisões sistemáticas; quatro meta-análises; dois estudos experimentais; um estudo quasi-experimental e uma revisão da literatura. Conclusões: As intervenções autónomas de enfermagem enquadram-se nos dez domínios das intervenções multicomponentes, percebendo-se uma heterogeneidade de intervenções. As intervenções multicomponentes são as que melhores resultados evidenciam, quando comparadas com as intervenções isoladas.

Abstract Background: Teletriage comprises the preliminary remote assessment of clinical signs and symptoms and its consequent referral to the most appropriate healthcare services (emergent, urgent or non-urgent ones). LUZ24 covers videoconsultation and teletriage, the latter one being exclusively carried out by a team of nurses also composed by specialists in Mental Health and Psychiatric Nursing. Aim: To measure the results of the teletriage activity performed by LUZ24 nurses in a Mental Health and Psychiatry field. Methods: Document analysis that emerged from the following question: What are the results of the teletriage activity performed by nurses from LUZ24 in the context of psychiatric and mental health? The Strengthening Reporting of Observational Studies in Epidemiology (STROBE) guidelines were followed. Study developed from the analysis of the Oracle BI Publisher electronic clinical records database regarding teletriages carried out between January 2020 and December 2021. The analysis and consequent treatment of the data used the Microsoft Excel tool on its version 2021, with descriptive statistical measures being applied for the characterization of the sample and for the clinical data. The research was approved by the Research Commission and the Competent Ethics Commission of Hospital da Luz. Results: Out of a total of 63,396 general teletriage assessments, 1,005 (1.59%) were analyzed in the scope of mental health and psychiatry. The sample is predominantly female (64.78%), with an average age of 50.41 years. The teletriage was conducted using decision-making algorithms called protocols. Ten protocols were used, with the three most prevalent being Anxiety or Situational Crisis (47.16%), Insomnia (26.77%), and Mental Illness (14.33%). Referral to consultation was the most prevalent (63.98%). Conclusions: The teletriage conducted by expert nurses - trained in remote clinical evaluation and using protocols - enabled the evaluation of symptomatology in the scope of mental health and psychiatric, as well as the referral of clients.

Resumen Introducción: El teletriaje comprende la evaluación preliminar remota de signos y síntomas y la derivación del cliente al contexto de salud más adecuado (emergente, urgente o no-urgente). LUZ24 abarca la videoconsulta y el teletriaje, siendo esta última realizada exclusivamente por enfermeros, algunos de los cuales también especialistas en Salud Mental y Psiquiátrica. Objetivo: Mapear los resultados de la actividad de teletriaje realizada por enfermeros de LUZ24 en el campo de la Salud Mental y Psiquiátrica. Métodos: Análisis documental que surge de la cuestíon: ¿Cuáles son los resultados de la actividad en teletriaje realizada por enfermeros de LUZ24 en el campo de la salud mental y psiquiátrica? Se ha utilizado el guía de Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) para el efecto. Estudio desarrollado a partir del análisis de la base de datos de registros clínicos electrónicas Oracle BI Publisher con respecto de los teletriajes realizados en el período entre enero de 2020 y diciembre de 2021. El análisis y tratamiento de los datos se realizaron con la herramienta de Microsoft Excel en su versión 2021, utilizando medidas de estadística descriptiva para la caracterización de la muestra y datos clínicos. La investigación fue aprobada por la Comisión de Investigación y la Comisión de Ética Competente del Hospital da Luz. Resultados: De un total de 63396 teletriajes, se analizaron 1.005 (1,59%) en el ámbito de la salud mental y psiquiátrica. La muestra es predominantemente compuesta por elementos femeninos (64,78%) con una edad media de 50,41 años. El teletriaje presupone el manejo de algoritmos de toma de decisiones, también conocidos como protocolos. Se han utilizado diez protocolos, siendo los tres más prevalentes: ansiedad o crisis situacional (47,16%), Insomnio (26,77%) y enfermedad mental (14,33%). La derivación para consulta fue la más prevalente (63,98%). Conclusiones: El teletriaje realizado por enfermeros expertos - capacitados en la evaluación clínica a distancia y utilizando protocolos - aseguró la evaluación de la sintomatología en el contexto de la salud mental y psiquiatría y la derivación de clientes para consultas especializadas.

Resumo Introdução: Teletriagem compreende a avaliação remota preliminar de sinais e sintomas e a orientação do cliente para o cuidado de saúde adequado (emergente, urgente ou não urgente). A LUZ24 abrange a vídeoconsulta e a teletriagem, sendo esta última efetuada exclusivamente por enfermeiros, integrando enfermeiros especialistas em Enfermagem de Saúde Mental e Psiquiátrica. Objetivo: Mapear os resultados da atividade em teletriagem realizada por enfermeiros da LUZ24, no âmbito da saúde mental e psiquiátrica. Método: Análise documental que partiu da questão: Quais são os resultados da atividade em teletriagem, realizada por enfermeiros da LUZ24, no âmbito da saúde mental e psiquiátrica. Seguiram-se as diretrizes Strengthening the Reporting of Observational Studies in Epidemiology (STROBE). Estudo desenvolvido a partir da análise da base de dados de registos clínicos eletrónicos Oracle BI Publisher relativamente às teletriagens efetuadas no período entre janeiro de 2020 e dezembro de 2021. A análise e tratamento dos dados foi efetuada com recurso à ferramenta do Microsoft Excel versão 2021, tendo sido utilizadas medidas de estatística descritiva para a caracterização da amostra e para os dados clínicos. A investigação foi aprovada pela Comissão de Investigação e Comissão de Ética Competente do Hospital da Luz. Resultados: Do total de 63396 teletriagens do âmbito geral, foram analisadas 1005 (1,59%) no âmbito da saúde mental. A amostra é predominantemente feminina (64,78%), com idade média de 50,41 anos. A teletriagem foi realizada com recurso a algoritmos de tomada de decisão, designados de protocolos. Foram utilizados 10 protocolos, sendo os três mais prevalentes: Ansiedade ou crise situacional (47,16%), Insónia (26,77%) e Doença mental (14,33%). A orientação para a consulta foi o encaminhamento mais prevalente (63.98%). Conclusões: A teletriagem realizada por enfermeiros peritos - treinados na avaliação clínica remota e com recurso a protocolos - possibilitou a avaliação de sintomatologia no âmbito da saúde mental e psiquiátrica e o encaminhamento dos clientes.

Abstract In the community, malnutrition is manifested by the loss of muscle mass, being associated with a decrease in muscle strength, an increased risk of frailty, functional impairment and impaired healing of chronic wounds, as well as a higher incidence of infections. It is estimated that malnutrition affects one in three elderly people at home and one in three patients in elderly care institutions. Malnutrition is reversible as long as the patient has access to timely nutritional screening that identifies their nutritional risk and as long as an individualized nutritional intervention is instituted. Disease associated malnutrition continues to be perceived as a secondary problem in primary health care, so the implementation of nutritional risk screening, as a routine parameter, is the first step in improving access to nutritional care in the community. In this article, the Malnutrition Universal Screening Tool is proposed for routine nutritional screening in primary care.

Resumo Na comunidade, a malnutrição manifesta-se pela perda de massa muscular, estando associada à diminuição da força muscular, ao aumento do risco de fragilidade, ao comprometimento funcional e da cicatrização de feridas crónicas, assim como a maior incidência de infeções. Estima-se que a malnutrição afete um em cada três idosos no seu domicílio e um em cada três utentes em instituições de cuidados de idosos. A malnutrição é reversível desde que o utente tenha acesso a um atempado rastreio nutricional que identifique o seu risco nutricional e instituída uma intervenção nutricional individualizada. A malnutrição associada à doença continua a ser percecionada como um problema secundário nos cuidados de saúde primários, pelo que a implementação do rastreio do risco nutricional, como um parâmetro de rotina, é o primeiro passo na melhoria do acesso aos cuidados nutricionais na comunidade. Neste artigo, é proposta a ferramenta Malnutrition Universal Screening Tool para rastreio nutricional de rotina nos cuidados de saúde primários.

Abstract Medical rescuers are the frontline for COVID-19 and their psychological experience and health are major concerns to our society and healthcare system. This study aims to understand how medical rescuers psychologically experienced this pandemic and explore the contributing variables to COVID-19 anxiety. Portuguese medical rescuers (n = 203) answered questions about their COVID-19 experience, the COVID-19 Anxiety Scale, Patient-Health Questionnaire, Perceived Stress Scale, Obsessive-Compulsive Inventory, and Well-Being Questionnaire. Rescuers presented low COVID-19 anxiety and low-moderate levels of fear. Most already faced or were facing changes in their job-related tasks, did not change household and did not feel stigma/discrimination. COVID-19 workplace security measures were considered moderately adequate and low anxiety, depression and obsessive-compulsive symptoms, low to moderate stress and moderate well-being were found. Only COVID-19 fear and security measures, anxiety, depression and obsessive-compulsive symptoms explained COVID-19 anxiety. Overall, findings showed these rescuers were psychologically well adjusted during the pandemic’s initial stages.

ABSTRACT This review focuses on the effects and mechanisms of action of amphetamine-type stimulants (ATS) and their adverse effects on the cardiovascular, nervous, and immune systems. ATS include amphetamine (AMPH), methamphetamine (METH, "crystalmeth," or "ice"), methylenedioxymethamphetamine (MDMA, "ecstasy," or "Molly"), MDMA derivatives (e.g., methylenedioxyamphetamine [MDA] and methylenedioxy-N-ethylamphetamine [MDEA]), khat, and synthetic cathinones. The first section of this paper presents an overview of the historical aspects of ATS use, their initial clinical use, and regulations. The second part reviews the acute and chronic impact and the most salient clinical effects of ATS on the central nervous and cardiovascular systems, skin, and mouth. The chemical structure, pharmacokinetics, and classic and non-canonical pharmacological actions are covered in the third section, briefly explaining the mechanisms involved. In addition, the interactions of ATS with the central and peripheral immune systems are reviewed. The last section presents data about the syndemic of ATS and opioid use in the North American region, focusing on the increasing adulteration of METH with fentanyl.