Immersive virtual reality (IVR) provides great potential to experimentally investigate effects of peers on student learning in class and to strategically deploy virtual peer learners to improve ...learning. The present study examined how three social-related classroom configurations (i.e., students' position in the classroom, visualization style of virtual avatars, and virtual classmates' performance-related behavior) affect students' visual attention toward information presented in the IVR classroom using a large-scale eye-tracking data set of N = 274 sixth graders. ANOVA results showed that the IVR configurations were systematically associated with differences in learners' visual attention on classmates or the instructional content and their overall gaze distribution in the IVR classroom (Cohen's d ranging from 0.28 to 2.04 for different IVR configurations and gaze features). Gaze-based attention on classmates was negatively related to students' interest in the IVR lesson (d = 0.28); specifically, the more boys were among the observed peers, the lower students' situational self-concept (d = 0.24). In turn, gaze-based attention on the instructional content was positively related to students' performance after the IVR lesson (d = 0.26). Implications for the future use of IVR classrooms in educational research and practice are discussed.
•Peer effects in an immersive virtual reality (IVR) classroom with 24 simulated virtual classmates as social counterparts•Different social-related IVR classroom configurations regarding students' position, avatar visualization, and peer behavior•Large-scale eye-tracking data set to describe sixth graders' visual attention during instruction in the IVR classroom•Social-related IVR configuration features affect students' visual attention distribution during instruction•Gaze-based attention networks show relationships to students' interest and learning in the IVR classroom
Despite the benefits of concomitant radiotherapy and cisplatin for locally advanced cervical cancer, recurrence rates remain high. New treatment strategies such as consolidation chemotherapy and ...different concomitant chemotherapy combinations have been tested in recent years. Identification of the best candidates for each treatment strategy could optimize results.
A retrospective review of data from 127 patients with locally advanced cervical cancer (International Federation of Gynecology and Obstetrics Stages IIB–IVA), treated at a single institution from 2005 to 2014. Risk factors for loco-regional and systemic recurrence, and prognostic factors for overall survival (OS) were analysed using Cox regression. Survival of patients treated with consolidation chemotherapy was compared with survival of patients not treated with consolidation chemotherapy in the role cohort and in a propensity-score-matched cohort.
With a median follow-up time of 48.7 months, loco-regional-recurrence-free survival (LRFS), distant-metastasis-free survival (DMFS) and OS at 5 years were 76.6%, 54.0% and 63.0%, respectively. On multivariate analysis, tumour size ≥6 cm was associated with shorter LRFS hazard ratio (HR) 5.18; 95% confidence interval (CI) 1.45–18.45; p = 0.011, and adenocarcinoma (HR 2.48; 95% CI 1.10–5.57; p = 0.028) and positive lymph nodes (HR 2.21; 95% CI 1.303–4.72; p = 0.041) were associated with shorter DMFS. Tumour size ≥6 cm was associated with shorter OS (HR 2.64; 95% CI 1.09–6.35; p = 0.031). Twenty-two patients were treated with consolidation chemotherapy; on univariate analysis, these patients had longer OS compared with patients who were not treated with consolidation chemotherapy (p = 0.043). In a propensity-score-matched cohort, patients treated with consolidation chemotherapy had longer DMFS and OS compared with patients who were not treated with consolidation chemotherapy, although the difference was not significant.
Different risk factors are associated with loco-regional and distant metastases in patients with locally advanced cervical cancer, and could potentially lead to particular therapeutic strategies. Although the number of patients treated with consolidation chemotherapy in the study cohort was small, they seemed to live longer and to have better control of distant relapse then patients who were not treated with consolidation chemotherapy.
Telemedicine has emerged as a tool for overcoming the challenges of healthcare systems and is likely to become increasingly viable, since information and communication technologies have become more ...sophisticated and user-friendly.
We aimed to identify all Cochrane systematic reviews (CSRs) on telemedicine within healthcare and to summarize the current evidence regarding its use.
Review of CSRs, developed at the Discipline of Emergency and Evidence-Based Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo.
We searched for studies that compared use of telemedicine with conventional treatment or management of diseases within healthcare. Diagnostic telemedicine studies or studies using automatic text, voice-text or even self-managed care were excluded. The main characteristics and the certainty of evidence were synthetized and critically discussed by all authors.
We included 10 CSRs that investigated a broad range of diseases. There is still insufficient evidence to determine what types of telemedicine interventions are effective, for which patients and in which settings, and whether such interventions can be used as a replacement for the standard treatment. Harm relating to telemedicine technologies needs to be better investigated and addressed.
Telemedicine might be an excellent way to facilitate access to treatment, monitoring and dissemination of important clinical knowledge. However, given the recognition of systematic reviews as the best evidence resource available for decision-making, further randomized controlled trials with stricter methods are necessary to reduce the uncertainties in evidence-based use of telemedicine.
OBJECTIVETo analyze current scientific knowledge about communication of bad news by nurses. METHODSThis is an integrative literature review carried out by searching articles published in national and ...international journals indexed at SciELO, MEDLINE® (PubMed®), Scopus, Bireme and CINAHL, from 2010 to 2020, by crossing the controlled descriptors "communication", "revelation of the truth", and "nursing", and the uncontrolled descriptor "bad news". RESULTSTen articles with qualitative and cross-sectional design, as well as case reports were included. The analysis indicated the evidence available in the literature showed the nurses' lack of ability to communicate bad news, although they are professionals who have close contact with patients and families and who establish a strong bond with them, and often face challenging situations for communicating bad news. CONCLUSIONThere is an evident need to invest in training of nurses on skills to communicate bad news and establish a nurse-patient bond when dialoguing with the family. There are few studies in the literature addressing this issue; therefore, it is recommended to perform research that can contribute to improvements in the clinical practice and developing protocols to promote such care.
•Senior dance is effective for elders and adults with neurological problems.•Senior dance improve motors parameters as balance and decrease fear of falling.•Senior dance improves quality of life and ...decrease anxiety-state.
Senior dance has been used in different health contexts, but information on its effectiveness has not been yet compiled. The present review shows the results of a search carried out in the Cochrane, PubMed, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Virtual Health Library (VHL) databases, including material published between 1974 and 2019, using the keyword “senior dance” in Portuguese, Spanish, and English. Twenty-one articles were retrieved, and seven met the selection criteria. Different intervention protocols were found, with the most common being therapy using two weekly sessions, with sessions lasting up to 60 min. The studies had small samples but indicated improvements in the cognitive or psychological component, especially in depression and anxiety; higher willingness to participate in other social activities; and improvements in self-care and family and social roles. The evidence also suggests gains in the biological dimensions, with improved body structure and function.
As coastal communities around the globe contend with the impacts of climate change including coastal hazards such as sea level rise and more frequent coastal storms, educating stakeholders and the ...general public has become essential in order to adapt to and mitigate these risks. Communicating SLR and other coastal risks is not a simple task. First, SLR is a phenomenon that is abstract as it is physically distant from many people; second, the rise of the sea is a slow and temporally distant process which makes this issue psychologically distant from our everyday life. Virtual reality (VR) simulations may offer a way to overcome some of these challenges, enabling users to learn key principles related to climate change and coastal risks in an immersive, interactive, and safe learning environment. This article first presents the literature on environmental issues communication and engagement; second, it introduces VR technology evolution and expands the discussion on VR application for environmental literacy. We then provide an account of how three coastal communities have used VR experiences developed by multidisciplinary teams—including residents—to support communication and community outreach focused on SLR and discuss their implications.
to evaluate the effect of an educational program on blood pressure recording for nursing professionals in relation to theoretical knowledge and the quality of these records.
quasi-experimental study ...conducted in a hospital service located in the city of São Paulo. The theoretical knowledge of 101 professionals was measured using a validated questionnaire before and after the educational intervention; the quality of blood pressure records was evaluated using a validated form which was applied to 354 records in the pre-intervention period and 288 in the post-intervention period. The educational program was based on active teaching-learning methodologies and consisted of two strategies: expository/dialogue class and a board game. The Wilcoxon, Mann-Whitney, Fisher and Chi-Square tests were used for comparisons, adopting a level of significance of α=0.05.
the median of the professionals' scores increased from 19 to 22 points in the post-intervention period (p<0.001). There was an improvement in the quality of the blood pressure recordings regarding the variables: cuff size (p<0.001), arm used in the procedure (p<0.001) and patient position (p<0.001).
the educational program showed positive results in the promotion of knowledge among nursing professionals and in the improvement of the quality of blood pressure recording.
Introduction: Byrsonima garcibarrigae is an endemic tree of Amazonas state, Brazil, with pharmacological and chemical knowledge poorly understood. Aim: To investigate the antidiabetic potential of ...the B. garcibarrigae stem bark. Methods: The stem bark was sequentially extracted by maceration with hexane (EHBG), ethyl acetate (EABG), and methanol (EMBG). The antioxidant capacity, α-glucosidase inhibitory potentials and anti-glycation capacities were evaluated. A bio-guided fractionation gave compounds that were characterized by MS and NMR. Results: 8 compounds were identified by HPLC-MS. EMBG showed the highest α-glucosidase inhibitory activity (1.09±0.32 μg/mL), antioxidant activity (9.2±0.23 μg/mL) and phenolic compounds content (61.43±0.50%), thus was fractionated producing hexane (FHX), chloroform (FCL) and hydromethanolic (FHM) fractions. After additional anti-α-glucosidase assays, FHM (1.02±0.49 μg/mL) was fractionated giving quercitrin and epicatechin. The anti-glycation assay showed that EMBG, FHM and quercitrin presented higher activities in comparison to the positive control, aminoguanidine. Conclusions: B. garcibarrigae displayed antidiabetic potential since inhibited α-glucosidase, as well as presented expressive antioxidant and anti-glycation activities were recorded.
To conduct a cross-cultural adaptation of the Preterm Parenting & Self-Efficacy Checklist to the Brazilian Portuguese.
A methodological study was carried out with 51 parents of premature infants. ...Data analysis was based on psychometric and inferential statistical analyses.
The instrument content validation by experts obtained excellent agreement (97%) and the semantic analysis by the target population showed good understanding of the terms and ease of use. In test-retest, most participants were female (64.7%); and parents with higher education (47.1%). The instrument showed stability over time, with good internal consistency (α = 0.84). Four factors were generated in the subscales parenting self-efficacy, importance of tasks and self-perceived parental competence (67.0% to 74.2% of the variance).
The properties of the Preterm Parenting & Self-Efficacy Checklist - Brazilian Version were maintained, which is a reliable indicator to evaluate the hospital discharge of premature infants.
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