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Abstract Although sucrose is widely administered to hospitalized infants for single painful procedures, total sucrose volume during the entire neonatal intensive care unit (NICU) stay and associated adverse events are unknown. In a longitudinal observation study, we aimed to quantify and contextualize sucrose administration during the NICU stay. Specifically, we investigated the frequency, nature, and severity of painful procedures; proportion of procedures where neonates received sucrose; total volume of sucrose administered for painful procedures; and incidence and type of adverse events. Neonates

Introduction Oral sucrose is repeatedly administered to neonates in the neonatal intensive care unit (NICU) to treat pain from commonly performed procedures; however, there is limited evidence on its long-term cumulative effect on neurodevelopment. We examined the association between total sucrose volumes administered to preterm neonates for pain mitigation in the NICU and their neurodevelopment at 18 months of corrected age (CA).Methods A prospective longitudinal single-arm observational study that enrolled hospitalised preterm neonates

IntroductionUnderstanding human-wildlife interactions is critical to overcoming the socio-environmental crises we face worldwide. Among these interactions, poaching and hunting, human-wildlife conflict, and transmission of zoonotic diseases are major causes of biodiversity loss and detrimental to human well-being. Therefore, this study aimed to analyze wildlife poaching, feral pig hunting, human-wildlife conflict, and health issues in a region of the Brazilian Cerrado, in the state of Mato Grosso do Sul. The study also focused on the lowland tapir (Tapirus terrestris), a poached species listed as vulnerable to extinction.MethodsFrom October 2016 to September 2017, we conducted face-to-face semi-structured interviews with 51 local people from nine stakeholder groups. Interview answers and additional information compiled during the study were evaluated using coding, narrative, and co-occurrence analyses.Results and discussionWe found that the main human-wildlife conflict in the region involves feral pigs, and hunting is practiced as a population control strategy. The lowland tapir is not considered a conflictual species, as it is beloved by most people. However, tapirs are still poached, although less so than in the past, mainly for cultural reasons. Culture was the main motivation behind wildlife poaching in general. We identified 28 species and five taxa currently poached in this Cerrado region, of which 11 are used for medical and aphrodisiac purposes. Historically, wildlife poaching was linked to poor livelihood conditions and lack of support from governmental institutions during the Agrarian Reform process, becoming a cultural habit over the years. Nevertheless, wildlife poaching is less frequent than in the past, and its main barriers are surveillance, poaching prohibition by landowners, and social norm. Therefore, promoting a change in the way people relate to nature, meeting socioeconomic needs, and increasing surveillance appear to be important conservation strategies. Although feral pig hunting may replace wildlife poaching, some hunters still poach wild species, especially peccaries. Hence, it is necessary to keep hunters under surveillance, raise awareness among them, and make them allies in conservation strategies. We found a worryingly low level of awareness about disease transmission risk through bushmeat manipulation and consumption, highlighting the importance of One Health approaches.

OBJECTIVES: Acrodermatitis Enteropathica (AE) is a rare disease that can be transmitted by autosomal recessive inheritance, it can be related to parenteral nutrition without zinc, or it can be secondary to malabsorptive syndromes. Clinically, it is characterized by the triad of acral and periorificial dermatitis, alopecia and diarrhea, accompanied by growth restriction. The condition can be fatal if left untreated. METHODS: We describe the case of a child with AE and Crohns Disease (CD), with AE being a known complication, secondary to malabsorption caused by CD. RESULTS: Treatment for CD was started with systemic steroids, Azathioprine and Mesalazine, and local care with the diaper area. Oral zinc replacement was also started. The child showed significant clinical and dermatological improvement within a few weeks. CONCLUSIONS: The diagnosis of AE is made with serum zinc levels lower than 70 ug/dL. Treatment involves zinc supplementation, at a dose ranging from 1 to 3 mg/kg/day. In the case described, the zinc value was 65 ug/dL. In this case, we started replacement with 2mg/kg/day, with rapid clinical improvement. Zinc deficiency AE is a well-known complication of CD, secondary to malabsorption. In the case described, the cutaneous condition came after the intestinal condition, with the deficiency in the absorption of zinc being secondary to Crohns Disease, leading to a condition with extensive lesions, but with a quick response to the treatment and with an important improvement of the condition.

Abstract. Introduction:. Treatment of pain in preterm, sick, and healthy newborns and infants and toddlers (up to 2 years of age) is consistently reported to be inadequate, and effective strategies are poorly implemented. Objectives:. To present existing evidence of effective pain treatment strategies during needle-related procedures and to highlight initiatives focused on translating evidence into practice. Methods:. This Clinical Update focuses on the 2022 International Association for the Study of Pain Global Year for Translating Pain Knowledge to Practice in the specific population of newborns, infants, and toddlers. Best evidence is reviewed, and existing knowledge translation strategies and programs available to implement evidence into practice are presented. Results:. Effective strategies for newborn and young infants during frequently occurring needle procedures include small volumes of sweet solutions, breastfeeding, or skin-to-skin care when feasible and culturally acceptable. In addition, strategies such as nonnutritive sucking, positioning, swaddling, gentle touch, facilitated tucking, and secure holding can be used. For toddlers, the evidence is less robust, and discerning between pain and distress is challenging. However, strategies recommended for needle-related procedures include upright secure comfort holding by parents/caregivers, age-appropriate distraction, and topical anesthetics. Translation of effective pain management needs to involve the family, who need to be supported and empowered to comfort their child during painful procedures. Organizational, nationwide, and global initiatives aimed at improving implementation of effective pain treatments exist. Conclusion:. There is evidence of effective pain management strategies for newborns, infants, and toddlers, and a great deal of effort is being made to translate knowledge into action.

Resumo Objetivo Descrever o processo de implementação de uma intervenção multifacetada de tradução e intercâmbio do conhecimento para melhorar as práticas de manejo da dor, e avaliar a adoção desta intervenção pelos profissionais de saúde durante procedimentos dolorosos em neonatos. Métodos Estudo quase-experimental tipo antes e depois, realizado em uma unidade neonatal. A intervenção Evidence-Based Practice for Improving Quality , norteada pela estrutura conceitual The Promoting Action on Research Implementation in Health Services , foi implementada em duas etapas (preparação e implementação), e a sua adoção foi mensurada por indicadores clínicos relacionados ao manejo da dor, apresentados por meio de estatística descritiva. Resultados Após discussão sobre práticas existentes na unidade que necessitavam de mudança; síntese das evidências científicas atuais; e dados do contexto local; os membros do Conselho de Pesquisa e Prática da unidade elaboraram e implementaram metas coerentes e factíveis para mudança da prática no manejo da dor; selecionaram estratégias de tradução e intercâmbio do conhecimento; determinaram o público-alvo e os indicadores e implementaram as intervenções. Houve uma redução em 32,8% no número de procedimentos dolorosos realizados, e aumento entre 26,6 e 50,7% na utilização das escalas de avaliação da dor e de 25,1% na administração da glicose oral. Conclusão A intervenção multifacetada Evidence-Based Practice for Improving Quality é complexa, e possui processos que demandam conhecimento e habilidades, comprometimento dos diversos atores envolvidos, disponibilidade de tempo e investimento financeiro. Os indicadores analisados mostraram que a intervenção resultou em mudanças positivas na prática clínica no manejo da dor do neonato.

Objectives: To characterize a group of university students in social isolation regarding their eating behaviors and to investigate whether dieters have a tendency to engage in binge-eating. Study Design: Cross-sectional study carried out during Brazil’s first months of social isolation. Methods: University students filled out the Eating Attitudes Test—EAT, the Binge-eating Scale—BES, and the Hay questionnaire. In addition, the current research also evaluated food cravings (FC) and intuitive eating. Student’s t-test was used to compare the effect sizes (Cohen’s d) between groups. Results: More than 90% of participants were isolated from academic activities, and 68% reported significant dietary change. Those who dieted (n = 57) were less confident in signs of hunger and satiety (d = −0.9, p < 0.001) and had higher binge-eating and FC levels than those who did not diet. Conclusions: Data reinforces the high prevalence of risk for eating disorders in university students, the impact of dieting on FC, and intuitive eating during social isolation.

O objetivo deste artigo é compreender como o storytelling, ou a contação de histórias, é relevante para a autenticidade. Para tanto, foi desenvolvida revisão de literatura sobre autenticidade em experiências turísticas e sobre storytelling, o que deu base para as discussões teóricas deste estudo. Para que se pudesse alcançar o objetivo proposto, optou-se por uma abordagem interpretativista e qualitativa com trabalho de campo aplicado ao contexto do turismo cacaueiro e chocolateiro na Ilha do Combu, Pará. A coleta de dados se deu por meio de observação e de entrevistas semiestruturadas, e os dados - depois de organizados e transcritos - foram analisados por meio de análise de conteúdo. A partir do acesso aos dados, observou-se que o storytelling proporcionou conexão entre os objetos, o local, as pessoas (incluindo comunidade e prestadores de serviço) e a experiência turística. Nesse sentido, o estudo foi capaz de demonstrar a relação existente entre os elementos da abordagem relacional da autenticidade (Rickly-Boyd, 2012) com o storytelling. Ainda, o estudo permite perceber que as histórias conectam os envolvidos na experiência e seus repertórios, legitimam processos de produção, ilustram aspectos físicos e dão significados a ações.

Abstract Background The clinical Pandemic Practice Champion (PPC) role was created in a large tertiary pediatric hospital as a knowledge translation (KT) strategy for implementing COVID-19 evidence-based knowledge. We aimed to describe the core components of the PPC role, the process of implementing the role, and the factors that hindered or facilitated role implementation. Methods An exploratory case study was undertaken. Semi-structured interviews were conducted virtually with stakeholders including PPC, managers, and front-line health care professionals (HCP). A directed approach to qualitative content analysis consistent with the Consolidated Framework for Implementation Research (CFIR) guided the analytic process. Inductive analyses and three stages of thematic synthesis were also conducted. Results Four PPC, 3 managers, and 6 HCP were interviewed. The core components of the PPC role consisted of (a) acting as knowledge experts and educators, (b) problem-solving for complex patient care issues, (c) conducting crisis management, and (d) acting as a resource to management, HCP, and families. Facilitators for successful implementation included access to external information, a supportive organizational context and culture, dedicated time and resources, and leadership support. Lack of clarity of role definition, insufficient time, pandemic uncertainty and fatigue, inability to change infrastructure, and access to external information hindered implementation. Conclusion The PPC role was successfully implemented within a crisis context. Key barriers (role clarity, time, resources) and facilitators (organizational and leadership support) need to be considered when implementing the PPC role in practice. Future studies are needed to determine the intervention effectiveness of the champion role in changing HCP behavior and health outcomes and further examine implementation processes and mechanisms.

GoalTo determine the analgesic effectiveness of repeated sucrose administration for skin-breaking (SB) procedures over the Neonatal Intensive Care Unit (NICU) hospitalization of preterm infants.MethodsLongitudinal observational study, conducted in four level III Canadian NICUs. Eligible infants were

As afecções odontológicas que causam dor aos equinos refletem inadequada trituração do alimento, prejudicando a digestão e predispondo o animal a um emagrecimento progressivo. O presente estudo teve por objetivo avaliar a influência do tratamento odontológico preventivo sobre a deposição de gordura subcutânea e peso de éguas criadas em sistema extensivo. Foram utilizadas 16 éguas, sem raça definida, com idade entre 5 e 15 anos, apresentando escore de condição corporal entre 3 e 4 (escala de 1 a 9), sem histórico de tratamento odontológico prévio. Estes animais foram distribuídos igualmente em dois grupos, sendo o grupo tratado (GT) e o grupo controle (GC). No GT, foi realizada inspeção da cavidade oral e tratamento odontológico. No GC, foi realizada apenas inspeção da cavidade oral. Todos os animais foram pesados com fita torácica e a mensuração da camada de gordura subcutânea foi realizada através do exame ultrassonográfico na base da cauda a cada 30 dias durante cinco meses. Para a avaliação das variáveis, foi utilizado um delineamento inteiramente casualizado, e as médias entre os grupos foram comparadas pelo teste F a 5% de probabilidade para análise de variância (ANOVA). Não foi observada diferença no ganho de peso nem variação na espessura de gordura subcutânea na base da cauda entre os grupos tratado e controle no período de 5 meses. Conclui-se que embora os animais do GT não ganhassem peso comparado ao GC, o tratamento odontológico é considerado um método benéfico na prevenção de muitas afecções do sistema digestivo que poderiam culminar em cólica, também proporciona um melhor aproveitamento dos componentes contidos na dieta, e ainda favorecer o bem-estar animal.

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