Enhancing women's knowledge, attitude, and practice (KAP) concerning urinary incontinence (UI) through diverse educational strategies has been a focal point for professionals in recent years. This ...study was aimed at assessing the impact of the educational application Continence App® on the KAP of postpartum women experiencing UI. We hypothesized that access to the app would lead to improved KAP among these women.INTRODUCTION AND HYPOTHESISEnhancing women's knowledge, attitude, and practice (KAP) concerning urinary incontinence (UI) through diverse educational strategies has been a focal point for professionals in recent years. This study was aimed at assessing the impact of the educational application Continence App® on the KAP of postpartum women experiencing UI. We hypothesized that access to the app would lead to improved KAP among these women.Postpartum women who had undergone vaginal birth, aged 18 years or above, literate, admitted in a maternity ward, delivered a full-term or large-for-gestational-age infant, and possessed a smartphone or compatible device for app usage were included. Changes in KAP were evaluated using a survey specifically designed for this purpose. The Mann-Whitney U test was employed to compare KAP scores between control and intervention groups, as well as between baseline and post-intervention assessments.METHODSPostpartum women who had undergone vaginal birth, aged 18 years or above, literate, admitted in a maternity ward, delivered a full-term or large-for-gestational-age infant, and possessed a smartphone or compatible device for app usage were included. Changes in KAP were evaluated using a survey specifically designed for this purpose. The Mann-Whitney U test was employed to compare KAP scores between control and intervention groups, as well as between baseline and post-intervention assessments.Among the 542 women screened for eligibility, 349 were enrolled in the study, with 138 completing post-intervention assessments. The mean (standard deviation SD) age of participants was 25.9 (5.8) years. Post-intervention scores for knowledge and practice demonstrated a decline among non-app users, whereas a significant increase was observed among those in the intervention group. Attitudinal changes remained insignificant.RESULTSAmong the 542 women screened for eligibility, 349 were enrolled in the study, with 138 completing post-intervention assessments. The mean (standard deviation SD) age of participants was 25.9 (5.8) years. Post-intervention scores for knowledge and practice demonstrated a decline among non-app users, whereas a significant increase was observed among those in the intervention group. Attitudinal changes remained insignificant.The findings highlight the effectiveness of an app-based educational intervention in enhancing the knowledge and practice related to UI among postpartum women.CONCLUSIONSThe findings highlight the effectiveness of an app-based educational intervention in enhancing the knowledge and practice related to UI among postpartum women.
To analyze evidence of content validity of the nursing diagnosis (ND) Risk for Unstable Blood Pressure in incarcerated women. METHOD: A methodological study assessing the content validity of an ND, ...was performed in Brazil, between June and September 2022, with 49 nurses as experts. The label, definition, and relevance of the 19 risk factors of the ND Risk for Unstable Blood Pressure were appraised. Based on the predictive diversity model, the content validity index (CVI) and respective 95% confidence intervals were calculated for each risk factor. A CVI ≥ 0.8 was considered adequate evidence of content validity.
The label and the definition of the diagnosis was reformulated. The relevance of 19 etiological factors showed a CVI ≥ 0.8. According to the recommendation of the panel of experts, one of the etiological factors was split in two and two label of etiological factors were changed.
A new label (Risk for Imbalanced Blood Pressure), new definition, and 20 etiological factors (11 risk factors, five associated conditions, and four at-risk populations) of the ND Risk for Unstable Blood Pressure in incarcerated women were considered valid.
NANDA-I accepted the proposal for this nursing diagnosis; hence this study contributed to updating the classification based on scientific evidence. This evidence will favor diagnostic reasoning and recognition of the diagnosis during clinical assessment, and support studies assessing the clinical validity of these elements in incarcerated women.
Describing the Continence App development as an educational technology to promote adherence to pelvic floor muscle training and prevent urinary incontinence in postpartum women.
Study of ...technological production carried out in two stages: construction and validation. The first happened in four steps: modeling, navigation project, abstract design of the interface and implementation. In the validation phase 22 experts (11 health experts and 11 from the information technology/computing/communication areas) and 22 puerperal women were invited to evaluate the content and appearance of the education application. The content validity was analyzed through the Content Validity Index and the appearance validity through 75% minimum agreement in the items evaluated. The study was conducted during 2016 and 2017. For the content validation, the judges evaluated the following aspects: concepts and definitions used in the application, possibility of comprehension by the target audience and form of presentation. In order to validate the appearance, the installation, execution of the functions, objectives, usability, interface, practicality and interaction with the user were evaluated.
Most of health experts were physiotherapists (n = 07) and professionals with a PhD (n = 07). Regarding the CVI, 100% of the evaluated items obtained values of 0.86 or greater. Most of information technology/computing/communication experts were male (81.8%) and of the information technology area (63.6%). Except for “restart sessions”, “ways of presenting suggestions”, “user interaction” and “motivates questioning”, all the other aspects received between 81.8% and 100% positive responses. All items evaluated by the target audience obtained a minimum of 94.3% positive responses from the participants. In this step, points for adjustment were identified in relation to the application content and interface, which were promptly corrected.
The application has been validated for use in clinical practice as an educational technology to promote adherence to pelvic floor muscle training and prevention of urinary incontinence in postpartum women.
To assess clinical-causal validity evidence of the nursing diagnosis, risk for unstable blood glucose level (00179), in individuals with type 2 diabetes mellitus.
A case-control study was conducted ...in 5 primary healthcare units, involving 107 subjects with type 2 diabetes mellitus, 60 in the case group and 47 in the control group. Causality was determined by the association between sociodemographic and clinical factors, risk factors related to the nursing diagnosis, and the occurrence of unstable blood glucose level. An association was considered when the risk factor had a p-value of <0.05 and odds ratio >1.
Risk factors, such as stress, inadequate physical activity, and low adherence to therapeutic regimen, were prevalent in the sample. Time since diagnosis between 1-5 and 6-10 years, multiracial ethnicity, and the risk factor of low adherence to therapeutic regimen increased the likelihood of the outcome. Completion of high school education was identified as a protective factor.
The clinical validation of the nursing diagnosis, risk for unstable blood glucose level, has been successfully established, revealing a clear association between sociodemographic and clinical factors and the risk factors inherent to the nursing diagnosis.
The results contribute to advancing scientific knowledge related to nursing education, research, and practice and provide support for the evolution of nursing care processes for individuals with type 2 diabetes mellitus.
Background
Familial hypercholesterolemia (FH) is a genetic disorder caused by low‐density lipoprotein receptor (LDLr) dysfunction, resulting in elevated plasma cholesterol levels. Previous reports ...have shown an interplay between LDLr and amyloid‐β (Aβ) metabolism, a peptide linked to Alzheimer's disease. Indeed, LDLr‐/‐ mice are more vulnerable to the deleterious memory impact induced by Aβ. Here, we investigated whether the gene expression of proteins involved in Aβ metabolism and Aβ content is altered in adult or middle‐aged LDLr‐/‐ mice brains. Also, we investigated neuroinflammation as well as neuronal and synaptic damage.
Method
Young adult (3‐month‐old) and middle‐aged (14‐month‐old) male C57BL/6 wild‐type (WT) and LDLr‐/‐ mice were first submitted to the Morris water maze test. After spatial memory assessment, the Aβ1‐42 levels and gene expression of proteins involved in Aβ synthesis were evaluated in the prefrontal cortex (PFC) and hippocampus of 3 and 14‐months‐old WT and LDLr‐/‐ mice. We also assessed the apoptosis signaling, levels of synaptic proteins, and Iba‐1 immunoreactivity (a marker for microglia) in the experimental groups' brain structures.
Result
LDLr‐/‐ mice presented spatial memory impairment, which was more severe in middle‐aged animals, which was not associated with altered expression of proteins involved in Aβ processing and Aβ1‐42 levels in either hippocampus or PFC. We further found that the expression of the apoptotic protein Bax was increased in both the PFC and hippocampus of 3‐ and 14‐month‐old LDLr‐/‐ mice. LDLr‐/‐ mice presented increased immunoreactivity for activated caspase‐3 in the neurons of the PFC and hippocampus. We also observed a reduction in immunocontent of PSD 95 in the hippocampus of 3‐month‐old LDLr‐/‐ mice. Moreover, synaptophysin immunocontent was decreased in the middle‐age LDLr‐/‐ mice hippocampi. In addition, we observed that LDLr‐/‐ mice displayed increased immunoreactivity for Iba‐1 in the PFC already at 3 months of age and in the hippocampus at middle‐age. Finally, we found that LDLr ‐/‐ at middle‐age exhibited microglial morphological changes related to their activated state in the PFC.
Conclusion
Cognitive impairments in LDLr‐/‐ mice were associated with exacerbation of neuronal apoptosis, synaptic dysfunction, and microglial activation in brain regions related to memory formation, but not with significant changes in Aβ processing or levels.
Background:
Bleeding-related re-exploration is a life-threatening complication after cardiac surgery. Nurses must be aware of important risk factors for this complication so that their assessment, ...monitoring and evaluation activities can be prioritized, focused and anticipated.
Aims:
To identify the predictive factors for bleeding-related re-exploration after cardiac surgery and to describe the sources of postoperative bleeding.
Methods:
This is a prospective cohort study at a tertiary cardiac school-hospital in São Paulo/SP, Brazil. Adult patients (n=323) submitted to surgical correction of acquired cardiac diseases were included. Potential risk factors for bleeding-related re-exploration within the 24 hours following admission to the intensive care unit were investigated in the patients’ charts. A univariate analysis and a multiple analysis through logistic regression were conducted to identify the outcome predictors. The area under the receiver-operating characteristic curve was calculated as a measure of accuracy considering the cut-off points with the highest sensitivity and specificity.
Results:
The univariate factors significantly associated with bleeding-related re-exploration were a lower preoperative platelet count, a lower number of bypasses in coronary artery bypass surgery and postoperatively, a lower body temperature, infusion of lower intravenous volume, a higher positive end-expiratory pressure during mechanical ventilation and transfusion of blood products. The independent predictors of bleeding-related re-exploration included postoperative red blood cell transfusion, and transfusion of fresh frozen plasma, platelet or cryoprecipitate units. These predictors had a sensitivity of 87.5%, a specificity of 99.28% and an accuracy of 97.93%.
Conclusions:
Blood product transfusion postoperatively is an independent predictor of bleeding-related re-exploration. Surgical errors prevailed as sources of bleeding.
Urethane is a chemical carcinogen which causes lung tumorigenesis in mice with similarities to human adenocarcinoma (AC). The sphingosine 1-phosphate agonist FTY720 administered to mice in doses ...above 5 mg/kg/day has been able to prevent hepatocellular carcinoma and bladder cancer. We used BALB/c mice in urethane-induced lung cancer model to investigate the effects of a lower dose of FTY720 (1 mg/kg/day). The benefits of FTY720 were associated with the time point of the compound administration. FTY720 30 Group presented lower incidence and smaller area of lung nodules, decreased PCNA and increased Caspase-3 expressions. The findings in FTY720 0 Group (nodule multiplicity and area, PCNA expression) were similar to Urethane Group suggesting that the administration of the compound at early time point did not affect lung tumor development. FTY720 90 Group presented the biggest nodule area which was associated with increased PCNA and decreased Caspase-3 expressions. FTY720 (30 days and 90 days) administration decreased CD4 + splenocytes and blood lymphocytes which caused opposite effects in lung tumor development - impairment and improvement respectively.
In conclusion, FTY720 in low dose did not provide lung tumor inhibition in mice but its administration 30 days after the chemical carcinogen (Urethane) injection was associated with impaired tumor development
This study investigated the effects of pre- and peripubertal exposure (PND 15-45) to triphenyltin hydroxide (TPT: 0, 1.875, 3.75, 7.5 and 15 mg/kg bw/d
) on mouse sexual maturation and fertility. ...Half of the mice were euthanized on PND 46 and the remaining mice were submitted to fertility tests on PND 65-75. TPT caused a transient decrease of weight gain at 3.75 mg/kg bw/d, and deaths and body weight deficits at higher doses. Delays of testes descent (TD), vaginal opening (VO) and first estrus (FE) occurred at doses ≥3.75 (TD) and ≥7.5 mg/kg bw/d (VO, FE), respectively. Body weight on the days of TD, VO and FE did not differ among groups. TPT at doses ≥3.75 mg/kg decreased sperm and spermatid counts at the end of treatment (PND 46) but no alteration was noted later on PND 75. Testicular histopathology (PND 46) showed a dose-dependent reduction of seminiferous tubules diameter, a greater degree of vacuolation in Sertoli cells and germ cell degeneration and necrosis in TPT-treated mice. TPT did not affect the outcome of fertility tests. Study-derived NOAEL was 1.875 mg TPT/kg bw/d for males and 3.75 mg TPT/kg bw/d for females. The detrimental effects of TPT on spermatogenesis were reversed after treatment discontinuation.
To identify predictors of red blood cell transfusion (RBCT) after cardiac surgery.
A prospective cohort study performed with 323 adults after cardiac surgery, from April to December of 2013. A data ...collection instrument was constructed by the researchers containing factors associated with excessive bleeding after cardiac surgery, as found in the literature, for investigation in the immediate postoperative period. The relationship between risk factors and the outcome was assessed by univariate analysis and logistic regression.
The factors associated with RBCT in the immediate postoperative period included lower height and weight, decreased platelet count, lower hemoglobin level, higher prevalence of platelet count <150x10(3)/mm (3), lower volume of protamine, longer duration of anesthesia, higher prevalence of intraoperative RBCT, lower body temperature, higher heart rate and higher positive end-expiratory pressure. The independent predictor was weight <66.5Kg.
Factors associated with RBCT in the immediate postoperative period of cardiac surgery were found. The independent predictor was weight.
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