Health Sciences Information Research Articles

Adverse Events in Emergency Department Boarding: A Systematic Review.

Overcrowding in emergency departments (EDs) is a worldwide challenge. As a result of the increased demand for EDs, slow internal patient flow, and unavailability of hospital beds, patients are kept in the corridors, causing a boarding effect. Studies have associated boarding in EDs with unfavorable clinical outcomes and adverse events. Thus, the purpose of this systematic review was to describe the effects of ED boarding on the occurrence of adverse events. We followed the Meta-Analysis of Observational Studies in Epidemiology checklist and registered this systematic review with PROSPERO (CRD42020117915). Literature searches were performed using the databases PubMed, Scopus, Latin American and Caribbean Center on Health Sciences Information (LILACS), Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Cochrane, as well as Google Scholar, OpenThesis, and the Brazilian Digital Library of Theses and Dissertations from September to November 2019. Cohort or case control studies that evaluated the occurrence of adverse events in patients who remained in an ED, waiting for a hospital bed, were included in the review. Seven studies met our eligibility criteria. Boarding in EDs may be related to a reduction in the quality of care, resulting in unfavorable clinical outcomes and adverse events. Boarding in EDs may be related to increases in adverse incidents and events. The evidence in this review suggests that ED boarding increases the occurrence of unfavorable outcomes and identifies important considerations for future research.

Community-based non-pharmacological interventions for improving pain, disability and quality of life in pregnant women with musculoskeletal conditions: protocol for a systematic review with meta-analyses

IntroductionTwenty five per cent of pregnant women with musculoskeletal pain have disabling symptoms that negatively influence quality of life. Studies have reported varying effects of non-pharmacological interventions including exercise, manipulation...

House modifications for preventing malaria.

BackgroundDespite being preventable, malaria remains an important public health problem. The World Health Organization (WHO) reports that overall progress in malaria control has plateaued for the first time since the turn of the century. Researchers and policymakers are therefore exploring alternative and supplementary malaria vector control tools. Research in 1900 indicated that modification of houses may be effective in reducing malaria: this is now being revisited, with new research now examining blocking house mosquito entry points or modifying house construction materials to reduce exposure of inhabitants to infectious bites.ObjectivesTo assess the effects of house modifications on malaria disease and transmission.Search methodsWe searched the Cochrane Infectious Diseases Group Specialized Register; Central Register of Controlled Trials (CENTRAL), published in the Cochrane Library; MEDLINE (PubMed); Embase (OVID); Centre for Agriculture and Bioscience International (CAB) s (Web of Science); and the Latin American and Caribbean Health Science Information database (LILACS), up to 1 November 2019. We also searched the WHO International Clinical Trials Registry Platform (www.who.int/ictrp/search/en/), ClinicalTrials.gov (www.clinicaltrials.gov), and the ISRCTN registry (www.isrctn.com/) to identify ongoing trials up to the same date.Selection criteriaRandomized controlled trials, including cluster‐randomized controlled trials (cRCTs), cross‐over studies, and stepped‐wedge designs were eligible, as were quasi‐experimental trials, including controlled before‐and‐after studies, controlled interrupted time series, and non‐randomized cross‐over studies. We only considered studies reporting epidemiological outcomes (malaria case incidence, malaria infection incidence or parasite prevalence). We also summarised qualitative studies conducted alongside included studies.Data collection and analysisTwo review authors selected eligible studies, extracted data, and assessed the risk of bias. We used risk ratios (RR) to compare the effect of the intervention with the control for dichotomous data. For continuous data, we presented the mean difference; and for count and rate data, we used rate ratios. We presented all results with 95% confidence intervals (CIs). We assessed the certainty of evidence using the GRADE approach.Main resultsSix cRCTs met our inclusion criteria, all conducted in sub‐Saharan Africa; three randomized by household, two by village, and one at the community level. All trials assessed screening of windows, doors, eaves, ceilings or any combination of these; this was either alone, or in combination with eave closure, roof modification or eave tube installation (a "lure and kill" device that reduces mosquito entry whilst maintaining some airflow). In two trials, the interventions were insecticide‐based. In five trials, the researchers implemented the interventions. The community implemented the interventions in the sixth trial.At the time of writing the review, two of the six trials had published results, both of which compared screened houses (without insecticide) to unscreened houses. One trial in Ethiopia assessed screening of windows and doors. Another trial in the Gambia assessed full screening (screening of eaves, doors and windows), as well as screening of ceilings only.Screening may reduce clinical malaria incidence caused by Plasmodium falciparum (rate ratio 0.38, 95% CI 0.18 to 0.82; 1 trial, 184 participants, 219.3 person‐years; low‐certainty evidence; Ethiopian study). For malaria parasite prevalence, the point estimate, derived from The Gambia study, was smaller (RR 0.84, 95% CI 0.60 to 1.17; 713 participants, 1 trial; low‐certainty evidence), and showed an effect on anaemia (RR 0.61, 95% CI 0.42, 0.89; 705 participants; 1 trial, moderate‐certainty evidence).Screening may reduce the entomological inoculation rate (EIR): both trials showed lower estimates in the intervention arm. In the Gambian trial, there was a mean difference in EIR between the control houses and treatment houses ranging from 0.45 to 1.50 (CIs ranged from ‐0.46 to 2.41; low‐certainty evidence), depending on the study year and treatment arm. The Ethiopian trial reported a mean difference in EIR of 4.57, favouring screening (95% CI 3.81 to 5.33; low‐certainty evidence).Pooled analysis of the trials showed that individuals living in fully screened houses were slightly less likely to sleep under a bed net (RR 0.84, 95% CI 0.65 to 1.09; 2 trials, 203 participants). In one trial, bed net usage was also lower in individuals living in houses with screened ceilings (RR 0.69, 95% CI 0.50 to 0.95; 1 trial, 135 participants).Authors' conclusionsBased on the two trials published to date, there is some evidence that screening may reduce malaria transmission and malaria infection in people living in the house. The four trials awaiting publication are likely to enrich the current evidence base, and we will add these to this review when they become available.

EFFECTS OF PHYSICAL EXERCISE DURING HOSPITALIZATION IN CHILDREN AND ADOLESCENTS WITH CANCER: A SYSTEMATIC REVIEW.

ABSTRACTObjective: To identify the effects of exercise programs during hospitalization on children and adolescents with cancer.Data source: This is a systematic review, carried out in PubMed/ Medical Literature Analysis and Retrieval System Online (MEDLINE), Latin American and Caribbean Health Sciences Literature (LILACS), Scientific Electronic Library Online (SciELO), Latin American and Caribbean Center on Health Sciences Information (BIREME), and Physiotherapy Evidence Database (PEDro). We selected studies that included children and adolescents diagnosed with cancer (solid or hematologic) and submitted to exercise protocols during hospitalization. Studies involving patients with other pathologies or with a medical contraindication for exercise were excluded. We used the following search strategy: Neoplasm OR Leukemia OR Cancer OR Tumor OR Medical Oncology AND Hospitalization OR Inpatient Care Units OR Intrahospital AND Exercise. The methodological quality of the studies was analyzed by the PEDro scale.Data synthesis: Among the 626 articles found, only 9 fulfilled the inclusion criteria, obtaining a regular methodological quality. The samples had 172 participants, aged 4 to 18 years. Only 6 studies presented both intervention group and control group. The intervention group received strength, aerobic, and muscle stretching exercises, and games, among others. The control group received the standard treatment. The studies varied regarding time, frequency, intensity, and type of exercise. Most studies showed an increase in muscle strength (4/5), followed by an improvement in physical fitness (2/3) and functional capacity (2/4). No adverse events were reported during the interventions. The methodological quality was considered regular.Conclusions: The findings suggest that. during hospitalization of children and adolescents with cancer, exercise improves muscle strength, physical fitness, and functionality.

Psychic suffering and depression in black children and adolescents: systematic review and meta-analysis.

Depression is a common disorder in the population, but some people are more vulnerable to this condition. Groups at higher risk of developing psychic suffering include black children and adolescents living in vulnerable socioeconomic conditions. This study aimed to analyze race and life conditions as determinants of depression in children and adolescents. This was a systematic review with meta-analysis. The study sources were MEDLINE Ovid, Web of Science, Latin American and Caribbean Health Science Information database, Science Citation Index-Expanded, PubMed, EMBASE, and Scopus. The following keywords were used: Child, Adolescent, Stress, Psychological, Depression, and African Continental Ancestry Group, using the logical operators AND and OR. The general criteria were observational studies published in the last 20 years. Language was not restricted to avoid possible bias in the selection of articles. Studies with a high risk of bias were excluded. General analysis was conducted with RStudio 3.0 software using odds ratio analysis with a 95% confidence interval and 0.05 significance level. We firstly found 654 studies, of which 18 met the criteria and were included in this review. Race and life conditions were determinants of depression in children and adolescents, with a negative impact for the black population.

The acquisition of health and science information in the 21st century

The ways that humans acquire information is undergoing a fundamental change comparable to the introduction of Gutenberg’s printing press and broadcast systems. Using the literature and a growing body of empirical evidence, we describe a model of information acquisition that specifies the roles of education, salience, subject-matter literacy, and navigation skills in the decision to seek information. We refer to this model as a just-in-time information acquisition system. We focus on the acquisition of health information and science information separately and discuss the similarities and differences. We utilize a national U.S. survey to describe adult information acquisition behaviors empirically.

Contribuições técnicas e socioculturais da prevenção quaternária para a atenção primária à saúde

Introdução: No contexto do Sistema Único de Saúde, o conceito da prevenção quaternária adentra timidamente os níveis de atenção à saúde, no entanto, sofre expansão significativa no âmbito da atenção primária à saúde. Objetivo: Identificar por meio da sistematização de evidências científicas, as contribuições técnicas e socioculturais da prevenção quaternária no âmbito da atenção primária à saúde no Brasil. Métodos: Trata-se de uma revisão integrativa de estudos presentes nas bases de dados científicas da Scientific Electronic Library Online, Biblioteca Virtual em Saúde, biblioteca virtual da Comissão de Aperfeiçoamento de Pessoal do Nível Superior e MEDLINE via PubMed com a utilização dos descritores “prevenção quaternária” e “atenção primária à saúde”, em inglês e português. Resultados: O corpus de análise foi composto por 22 artigos, sendo que a produção científica sobre o tema se deu de forma mais intensa a partir do ano de 2015 e, em sua maioria, possuíam como abordagem metodológica ensaios teóricos. Dentre as contribuições técnicas destacaram-se a introdução do ensino da prevenção quaternária de modo continuado aos graduandos e profissionais; a construção de protocolos e documentos de amparo profissional; a utilização de modelos explicativos dinâmicos na socialização do quadro clínico; a conduta profissional com os usuários e as contribuições socioculturais envolvendo mudanças na percepção profissional e comunitária sobre o fenômeno saúde-doença, assim como o incentivo a práticas de desmedicalização sociocultural em relação à dor, incapacidade, desconforto, envelhecimento, nascimento e morte. Conclusão: Apesar do reconhecimento das potencialidades da prevenção quaternária, faz-se necessário fortalecer estratégias que possibilitem o desenvolvimento de políticas públicas para fomentar e gerenciar alianças estratégicas com tomadores de decisão, profissionais de saúde e cidadãos, para fomentar a redução de diagnósticos e tratamentos excessivos, contribuindo com a qualidade do cuidado.

Impact of Metabolic Surgery on Type-2 Diabetes Remission.

Diabetes Mellitus is characterized by numerous metabolic disorders, which have in common the serum elevation of glucose, caused for a pancreatic malfunction in insulin secretion and / or its action. It is a non-communicable disease, considered major public health problems and generalized growth worldwide, being a chronic disease, which can generate a high treatment cost. Metabolic surgery is a safe treatment, regulated by the Federal Council of Medicine and useful in treating people with BMI over 30 years of age, who are unable to control pathologies associated with obesity, primarily type 2 diabetes. The general objective of this study is to understand through a literature review the main impacts of metabolic surgery about the remission of DM 2. This present study it is an exploratory and descriptive study carried out through a literature review. Data were collected through research in virtual health databases, at the Virtual Health Library - VHL, Latin American and Caribbean Health Sciences Information System, LILACS, National Library of Medicine - MEDLINE, Scielo, USP database, PUBMED theses and books. Metabolic surgery proof be a good and effective treatment for having and maintaining good weight loss, as well as a significant clinical and metabolic improvement that extends beyond weight loss. Metabolic surgery is a satisfactory way of achieving long-term weight reduction in obese individuals, increasing survival for these patients. Obese patients with DM2 have a long-term remission of DM2 after bariatric / metabolic surgery. Therefore, it concludes that such procedure is effective in the treatment of the disease and other diseases associated with obesity.

Paediatric formulations of artemisinin-based combination therapies for treating uncomplicated malaria in children.

BackgroundIn endemic malarial areas, young children have high levels of malaria morbidity and mortality. The World Health Organization recommends oral artemisinin‐based combination therapy (ACT) for treating uncomplicated malaria. Paediatric formulations of ACT have been developed to make it easier to treat children.ObjectivesTo evaluate evidence from trials on the efficacy, safety, tolerability, and acceptability of paediatric ACT formulations compared to tablet ACT formulations for uncomplicated P falciparum malaria in children up to 14 years old.Search methodsWe searched the Cochrane Infectious Diseases Group Specialized Register; Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE; Embase; the Latin American and Caribbean Health Science Information database (LILACS); ISI Web of Science; Google Scholar; Scopus; and the metaRegister of Controlled Trials (mRCT) to 11 December 2019.Selection criteriaWe included randomised controlled clinical trials (RCTs) of paediatric versus non‐paediatric formulated ACT in children aged 14 years or younger with acute uncomplicated malaria.Data collection and analysisTwo authors independently assessed eligibility and risk of bias, and carried out data extraction. We analyzed the primary outcomes of efficacy, safety and tolerability of paediatric versus non‐paediatric ACT using risk ratios (RR) and 95% confidence intervals (CI). Secondary outcomes were: treatment failure on the last day of observation (day 42), fever clearance time, parasite clearance time, pharmacokinetics, and acceptability.Main resultsThree trials met the inclusion criteria. Two compared a paediatric dispersible tablet formulation against crushed tablets of artemether‐lumefantrine (AL) and dihydroartemisinin‐piperaquine (DHA‐PQ), and one trial assessed artemether‐lumefantrine formulated as powder for suspension compared with crushed tablets. The trials were carried out between 2006 and 2015 in sub‐Saharan Africa (Benin, Mali, Mozambique, Tanzania, Kenya, Democratic Republic of the Congo, Burkina Faso, and The Gambia).In all three trials, the paediatric and control ACT achieved polymerase chain reaction (PCR)‐adjusted treatment failure rates of < 10% on day 28 in the per‐protocol (PP) population.For the comparison of dispersible versus crushed tablets, the two trials did not detect a difference for treatment failure by day 28 (PCR‐adjusted PP population: RR 1.35, 95% CI 0.49 to 3.72; 1061 participants, 2 studies, low‐certainty evidence). Similarly, for the comparison of suspension versus crushed tablet ACT, we did not detect any difference in treatment failure at day 28 (PCR‐adjusted PP population: RR 1.64, 95% CI 0.55 to 4.87; 245 participants, 1 study).We did not detect any difference in serious adverse events for the comparison of dispersible versus crushed tablets (RR 1.05, 95% CI 0.38 to 2.88; 1197 participants, 2 studies, low‐certainty evidence), or for the comparison of suspension versus crushed tablet ACT (RR 0.74, 95% CI 0.17 to 3.26; 267 participants, 1 study).In the dispersible ACT arms, drug‐related adverse events occurred in 9% of children in the AL study and 34% of children in the DHA‐PQ study. In the control arms, drug‐related adverse events occurred in 12% of children in the AL study and in 42% of children in the DHA‐PQ study. Drug‐related adverse events were lower in the dispersible ACT arms (RR 0.78, 95% CI 0.62 to 0.99; 1197 participants, 2 studies, moderate‐certainty evidence).There was no detected difference in the rate of drug‐related adverse events for suspension ACT versus crushed tablet ACT (RR 0.66, 95% CI 0.33 to 1.32; 267 participants, 1 study).Drug‐related vomiting appeared to be less common in the dispersible ACT arms (RR 0.75, 95% CI 0.56 to 1.01; 1197 participants, 2 studies, low‐certainty evidence) and in the suspension ACT arm (RR 0.66, 95% CI 0.33 to 1.32; 267 participants, 1 study), but both analyses were underpowered.No study assessed acceptability.Authors' conclusionsTrials did not demonstrate a difference in efficacy between paediatric dispersible or suspension ACT when compared with the respective crushed tablet ACT for treating uncomplicated P falciparum malaria in children. However, the evidence is of low to moderate certainty due to limited power. There appeared to be fewer drug‐related adverse events with dispersible ACT compared to crushed tablet ACT. None of the included studies assessed acceptability of paediatric ACT formulation.

Práticas interprofissionais em saúde e enfermagem na unidade de pronto atendimento: revisão integrativa

Objetivo: Identificar as práticas interprofissionais em saúde e enfermagem que podem ser desenvolvidas na unidade de pronto atendimento, evidenciadas na literatura. Método: Foi realizada uma pesquisa de revisão integrativa, limitada em artigos de 2015 a 2020, na biblioteca eletrônica do Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde (BIREME), na base de dados Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), na Scientific Electronic Library Online (SciELO) e Medical Literature Analysis and Retrieval Sistem on-line (MEDLINE), utilizando os descritores "relações interprofissionais" "comportamento cooperativo" "equipe de assistência ao paciente" "enfermagem" e "emergências". Sendo feito a pesquisa isolada e o cruzamento entre eles. A análise de dados e discussão foram baseadas na revisão de literatura. Resultados: A busca resultou em 143 artigos, sendo selecionados 10 artigos que atenderam os critérios de inclusão. Conclusão: O trabalho interprofissional em saúde e enfermagem permite satisfação do usuário, do profissional e uma assistência de qualidade.

Health Information Science: Perspectives on a Discipline in Development

This panel convenes six emerging scholars in the area of health information science, to trace some of the multiple pathways taken by this pluralistic discipline in research, practice and policy areas. How is HIS developing as an academic discipline? In describing the conceptual and methodological concerns of their work, presenters will raise some of the live questions shaping a health information science lens, including: - What practice and policy sectors contain pressing HIS questions right now?- What methodologies are most saliently informing research production in HIS?- What theoretical approaches have been tried in current and ongoing HIS research?- How is knowledge translation effected in HIS? Ce panel réunit six chercheurs émergents dans le domaine de la science de l'information sur la santé (SIS), afin de retracer certaines des multiples voies empruntées par cette discipline pluraliste dans les domaines de la recherche, de la pratique et des politiques. Comment la SIS évolue-t-il en tant que discipline universitaire? En décrivant le concept et la méthodologie préoccupations de leur travail, les présentateurs soulèveront certaines des questions en direct qui façonnent le prisme des sciences de l'information sur la santé, notamment:- Quels secteurs pratiques et politiques comportent actuellement des questions urgentes relevant de la SIS?- Quelles méthodologies sont les plus importantes dans la recherche dans la SIS?- Quelles approches théoriques ont été utilisées dans les recherches actuelles et en cours sur la SIS?- Comment les connaissances sont-elles appliquées dans la SIS?

Segurança do paciente na usabilidade de bombas de infusão na terapia intensiva: revisão integrativa

Objetivou-se analisar o impacto na segurança do paciente diante da usabilidade de bombas de infusão pela equipe de enfermagem na terapia intensiva. Trata-se de uma revisão integrative da literatura nas bases: Medical Literature Analysis and Retrieval System Online, Latin American and Caribbean Center in Health Sciences Information, Web of Science Core Collection e Base de Dados em Enfermagem. Os descritores usados na estratégia de pesquisa foram: "Patient Safety", "Equipment and Supplies Utilization", "Critical Care" e "Nursing Care". Foram selecionados 21 estudos. A partir da análise de conteúdo, emergiram três categorias: Usabilidade de bombas de infusão na Terapia Intensiva, Ocorrência de eventos adversos na utilização das bombas de infusão e O impacto da usabilidade de alarmes na segurança do paciente. Conclui-se que a destreza na usabilidade de alarmes demonstrou-se benéfica por corroborar com maior atenção da equipe e evitar a ocorrência da fadiga e dessensibilização destes alarmes.

Fatores de risco para a disseminação de microrganismos em creches: revisão integrativa da literatura

O objetivo deste estudo foi identificar na literatura fatores de risco para a disseminação de microrganismos em creches. Método: A seleção da amostra se deu por meio do acesso í s bases de dados: Literatura Latino-Americana e do Caribe de Informação em Ciências da Saúde (LILACS), Current Nursing and Allied Health Literature (CINAHL), Cochrane, Embase, Medical Literature Analysis and Retrieval System Online (MedLine/PubMed), Web of Science (WOS). Resultados: A amostra final foi de 67 artigos que indicam o risco de disseminação de microrganismos e doenças infecciosas entre crianças em creches depende das caracterí­sticas das crianças e do ambiente. No entanto, somente o fato de crianças serem assistidas em creches aumenta a probabilidade de adquirir e desenvolver infecções, sobretudo as de repetição. Conclusões: A identificação dos fatores de risco visa garantir a assistência de crianças em creches de forma que não sejam submetidas a um ambiente ou situações insalubres que afetem seu estado de saúde ou favorecer a ocorrência de doenças infecciosas.

New Health Science Descriptors to classify and retrieve information on equity

RESUMENEl vocabulario Descriptores en Ciencias de la Salud (DeCS) establece un lenguaje único y común que permite la organización y facilita la búsqueda y recuperación de la literatura técnica y científica en salud disponible en las fuentes de información de la Biblioteca Virtual en Salud. El DeCS, creado por el Centro Latinoamericano y del Caribe de Información en Ciencias de la Salud (BIREME), un centro especializado de la Organización Panamericana de la Salud/Organización Mundial de la Salud (OPS/OMS), es la traducción y la extensión del vocabulario Medical Subject Headings (MeSH), mantenido por la National Library of Medicine de los Estados Unidos. BIREME, en coordinación con expertos de América Latina y el Caribe, ha incluido en el DeCS los temas de equidad, género, etnicidad y derechos humanos —temas transversales en el marco programático de la cooperación técnica de la OPS/OMS— para garantizar una mejor recuperación y uso de la información y evidencia científica relacionadas a estos temas. El objetivo de este artículo es describir el método de revisión terminológica del DeCS e informar los resultados obtenidos y los impactos de la ampliación terminológica en el área de equidad, que comprendió la inclusión de 35 nuevos descriptores.

House modifications for preventing malaria.

Despite being preventable, malaria remains an important public health problem. The World Health Organization (WHO) reports that overall progress in malaria control has plateaued for the first time since the turn of the century. Researchers and policymakers are therefore exploring alternative and supplementary malaria vector control tools. Research in 1900 indicated that modification of houses may be effective in reducing malaria: this is now being revisited, with new research now examining blocking house mosquito entry points or modifying house construction materials to reduce exposure of inhabitants to infectious bites. To assess the effects of house modifications on malaria disease and transmission. We searched the Cochrane Infectious Diseases Group Specialized Register; Central Register of Controlled Trials (CENTRAL), published in the Cochrane Library; MEDLINE (PubMed); Embase (OVID); Centre for Agriculture and Bioscience International (CAB) Abstracts (Web of Science); and the Latin American and Caribbean Health Science Information database (LILACS), up to 1 November 2019. We also searched the WHO International Clinical Trials Registry Platform (www.who.int/ictrp/search/en/), ClinicalTrials.gov (www.clinicaltrials.gov), and the ISRCTN registry (www.isrctn.com/) to identify ongoing trials up to the same date. Randomized controlled trials, including cluster-randomized controlled trials (cRCTs), cross-over studies, and stepped-wedge designs were eligible, as were quasi-experimental trials, including controlled before-and-after studies, controlled interrupted time series, and non-randomized cross-over studies. We only considered studies reporting epidemiological outcomes (malaria case incidence, malaria infection incidence or parasite prevalence). We also summarised qualitative studies conducted alongside included studies. Two review authors selected eligible studies, extracted data, and assessed the risk of bias. We used risk ratios (RR) to compare the effect of the intervention with the control for dichotomous data. For continuous data, we presented the mean difference; and for count and rate data, we used rate ratios. We presented all results with 95% confidence intervals (CIs). We assessed the certainty of evidence using the GRADE approach. Six cRCTs met our inclusion criteria, all conducted in sub-Saharan Africa; three randomized by household, two by village, and one at the community level. All trials assessed screening of windows, doors, eaves, ceilings or any combination of these; this was either alone, or in combination with eave closure, roof modification or eave tube installation (a "lure and kill" device that reduces mosquito entry whilst maintaining some airflow). In two trials, the interventions were insecticide-based. In five trials, the researchers implemented the interventions. The community implemented the interventions in the sixth trial. At the time of writing the review, two of the six trials had published results, both of which compared screened houses (without insecticide) to unscreened houses. One trial in Ethiopia assessed screening of windows and doors. Another trial in the Gambia assessed full screening (screening of eaves, doors and windows), as well as screening of ceilings only. Screening may reduce clinical malaria incidence caused by Plasmodium falciparum (rate ratio 0.38, 95% CI 0.18 to 0.82; 1 trial, 184 participants, 219.3 person-years; low-certainty evidence; Ethiopian study). For malaria parasite prevalence, the point estimate, derived from The Gambia study, was smaller (RR 0.84, 95% CI 0.60 to 1.17; 713 participants, 1 trial; moderate-certainty evidence), and showed an effect on anaemia (RR 0.61, 95% CI 0.42, 0.89; 705 participants; 1 trial, moderate-certainty evidence). Screening may reduce the entomological inoculation rate (EIR): both trials showed lower estimates in the intervention arm. In the Gambian trial, there was a mean difference in EIR between the control houses and treatment houses ranging from 0.45 to 1.50 (CIs ranged from -0.46 to 2.41; low-certainty evidence), depending on the study year and treatment arm. The Ethiopian trial reported a mean difference in EIR of 4.57, favouring screening (95% CI 3.81 to 5.33; low-certainty evidence). Pooled analysis of the trials showed that individuals living in fully screened houses were slightly less likely to sleep under a bed net (RR 0.84, 95% CI 0.65 to 1.09; 2 trials, 203 participants). In one trial, bed net usage was also lower in individuals living in houses with screened ceilings (RR 0.69, 95% CI 0.50 to 0.95; 1 trial, 135 participants). Based on the two trials published to date, there is some evidence that screening may reduce malaria transmission and malaria infection in people living in the house. The four trials awaiting publication are likely to enrich the current evidence base, and we will add these to this review when they become available.

Nefropatia diabética: uma revisão integrativa da literatura

Objetivo: Compreender as atribuições causais da evolução e na fisiopatologia da Nefropatia diabética em pacientes com fatores de suscetibilidade. Métodologia: Trata-se de uma revisão integrativa da literatura. Foram realizadas buscas bases de dados eletrônicas Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde (BIREME), Biblioteca Virtual Scientific Eletronic Library Online (SciELO), US National Library of Medicine National Institutes of Health (PubMed). Os parâmetros de aptidão foram artigos científicos indexados no período de 2010 a 2020, registrados nos idiomas inglês, português ou espanhol. Resultados: Na elaboração da revisão integrativa foi observado na grande maioria dos artigos, a prevalência do tipo e força da evidência III, demostrando evidências intermediárias na relação da Nefropatia diabética e seus fatores de risco. A abordagem enfatizava a Nefropatia diabética avaliando a prevalência de seus fatores de risco e ressaltando a importância da detecção precoce destes aspectos associados, vislumbrando a qualidade de vida para a sociedade. Conclusão: Os dados obtidos por meio da revisão integrativa expõem que a Nefropatia Diabética está em constante prevalência e incidência, relacionada a diversos fatores de riscos das doenças crônicas aos hábitos alimentares, salientando a importância da detecção precoce destes aspectos relacionados com o intuito de evitar e protelar as complicações renais pelo Diabetes Mellitus e consequentemente diminuir as chances de morbidade e mortalidade em casos de progressão para a ND.

Maternal trauma due to motor vehicle crashes and pregnancy outcomes: a systematic review and meta-analysis

ObjectivesTo systematically review and quantify the effect of motor vehicle crashes (MVCs) in pregnancy on maternal and offspring outcomes.DesignSystematic review and meta-analysis of observational data searched from inception until 1...

A Enfermagem na utilização da fitoterapia na lactação: uma revisão integrativa de literatura

Objetivo: identificar na literatura científica como se dá o uso da fitoterapia no período da amamentação. Método: trata-se de uma revisão integrativa da literatura, com a realização do levantamento entre novembro de 2018 e dezembro de 2019 nas seguintes bases de dados: U.S. National Library of Medicine, Centro Latino Americano e do Caribe de Informação em Ciências da Saúde, Scopus e U.S. NationalInstitutesof Health; utilizando os seguintes descritores: "Fitoterapia" e "Aleitamento Materno" e "Ervas Medicinais”, no qual foram selecionados 14 artigos em português, inglês e espanhol, no período dos últimos cinco anos. Resultados: observaram a utilização da fitoterapia para a produção do leite materno, mas ainda são necessários mais estudos para mostrar maior segurança ao binômio mãe-bebê, pois um recorrente efeito adverso ocorre com distúrbios gastrointestinais, além da intoxicação decorrente da utilização. A planta feno-grego constitui-sena mais utilizada enquanto galactagogo. Conclusão: a fitoterapia como recurso galactagogo utilizado por mulheres lactantes tem diversas influências, e nem sempre é utilizada de forma segura. A Enfermagem depara-se com a necessidade de mais estudos que avancem no sentido de assegurar a utilização da fitoterapia e a capacitação para seu uso.

The Brody School of Medicine at East Carolina University.

The Brody School of Medicine at East Carolina University.

Creches e disseminação de micro-organismos no cuidar e educar

Objetivo: Elencar os micro-organismos mais recorrentes como causas de infecções em crianças frequentadoras de creches. Método: A revisão integrativa foi o método adotado para o presente estudo, que é definida como um instrumento para obtenção, identificação, análise e síntese da literatura. A seleção da amostra se deu por meio do acesso às bases de dados: Literatura Latino-Americana e do Caribe de Informação em Ciências da Saúde (LILACS), Current Nursing and Allied Health Literature (CINAHL), Cochrane, Embase, Medical Literature Analysis and Retrieval System Online (MedLine/PubMed), Web of Science (WOS). Foram incluídos estudos nacionais e internacionais, extraídos das bases de dados elencadas, totalizando 21 artigos, após exclusão de três itens repetidos. Após a análise das referências da primeira amostra constituída, foram incorporados 46 artigos, totalizando 67 estudos. Resultados: Os micro-organismos mais recorrentes foram Staphylococcus, Haemophilus influenzae, Escherichia coli e rotavírus. Estes foram encontrados nas mãos das crianças/educadores/cuidadores/manipuladores de alimentos, brinquedos e na nasofaringe/orofaringe. Conclusão: Evidenciou-se a disseminação de micro-organismos de pessoa a pessoa. Entre as doenças que crianças em creches podem ser acometidas, destacaram-se as infecções bacterianas e virais dos tratos respiratório e gastrointestinais, como também as parasitárias.