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Aims and objectives. To analyse the sensitivity and specificity of clinical indicators of ineffective airway clearance in children with congenital heart disease and to identify the indicators that have high predictive power. Background. The precise establishment of nursing diagnoses has been found to be one of the factors contributing to higher quality of care and cost reduction in healthcare institutions. The use of indicators to diagnose ineffective airway clearance could improve care of children with congenital heart disease. Design. Longitudinal study. Methods. Participants consisted of 45 children, <=1 year of age, with congenital heart disease, who had not had definitive or palliative surgical correction. Six assessments were made at 2-day intervals. Each clinical indicator was defined based on previously established operational criteria. Sensitivity, specificity and positive and negative predictive values of each indicator were calculated based on a model for the longitudinal data. Results. A nursing diagnosis of ineffective airway clearance was made in 31% of patients on the first assessment, rising to 71% on the last assessment, for a 40% increase. Sensitivity was highest for Changes in Respiratory Rates/Rhythms (0·99), followed by Adventitious Breath Sounds (0·97), Sputum Production (0·85) and Restlessness (0·53). Specificity was higher for Sputum Production (0·92), followed by Restlessness (0·73), Adventitious Breath Sounds (0·70) and Changes in Respiratory Rates/Rhythms (0·17). The best positive predictive values occurred for Sputum Production (0·93) and Adventitious Breath Sounds (0·80). Conclusions. Adventitious Breath Sounds followed by Sputum Production were the indicators that had the best overall sensitivity and specificity as well as the highest positive predictive values. Relevance to clinical practice. The use of simple indicators in nursing diagnoses can improve identification of ineffective airway clearance in children with congenital heart disease, thus leading to early treatment of the problem and better care for these children. [ABSTRACT FROM AUTHOR]

BACKGROUND AND RESEARCH OBJECTIVE: Factors predictive of growth deficit and nutritional status in children with congenital heart disease remain unclear. The objective of this study was to characterize the growth and nutritional status of children with congenital heart disease based on anthropometric measurements and z scores. SUBJECTS AND METHODS: One hundred and thirty-five children 1 year or younger, who had not undergone surgical correction, were evaluated. The variables studied were sex; age; type of heart disease; length, weight; z scores (length-for-age, weight-for-age, weight-for-length); abdominal, thoracic, and cephalic circumferences; triceps and subscapular skinfold thickness; and birth weight and birth length. RESULTS AND CONCLUSIONS: The mean age of children in this study was 4.75 +/- 3.75 months and most (66.7%) were male. Mean anthropometric measurements were birth length, 48.6 +/- 2.34 cm; birth weight, 3.11 +/- 0.63 kg; cephalic circumference, 38.51 +/- 3.28 cm; thoracic circumference, 38.65 +/- 3.76 cm; abdominal circumference, 37.96 +/- 3.27 cm; triceps skinfold thickness, 3.69 +/- 1.57 mm; subscapular skinfold thickness, 3.22 +/- 1.34 mm; current length, 57.54 +/- 7.87 cm; and current weight, 4.46 +/- 1.49 kg. Variables significant for malnutrition in logistic regression models were sex, type of heart disease, birth weight, birth length, subscapular thickness, triceps thickness, and cephalic circumference. Nutritional defects were more evident in the case of the weight-for-age index. Boys had greater deterioration in the weight-for-age index, possibly indicating acute malnutrition, and girls had worse values for the height-for-age index, indicating a risk of chronic malnutrition. [ABSTRACT FROM AUTHOR]

In this article the common physiologic adaptation problems presented by patients with unstable angina were identified, having as a base Callista Roy's Adaptation Model. A descriptive study was carried out in a specialized hospital for cardiac diseases. The sample for the study comprised a total of 20 patients. For characterization and discussion, we used the definitions presented by Roy for each physiologic adaptation problem identified. Regarding common physiologic adaptation problems, the following were identified: Activity intolerance, Constipation, Impairment of a primary sense: vision and audition, Nutrition in excess to body requirements, Sleep deprivation, Potential sleep pattern disturbance, Hyponatremia, Disuse syndrome, Restricted mobility, Anorexia, Memory deficit, Potential ineffective coping with allergic reaction, Stress, Oedema, Hypokalemia, Infection, Instability of Behavior and mood, and Delayed wound healing. [ABSTRACT FROM AUTHOR]

Purpose: To determine the accuracy of nursing diagnoses at hospital admission and discharge for patients with heart failure (HF)., Methods: This comparative study examined the documentation in 155 medical records of patients with an admitting diagnosis of HF during August 2018 and July 2019. An audit tool was used to record the diagnoses made by nurses during routine care at the time of admission and discharge. Two researchers (L.S. and A.C.) examined the records and evaluated the documented nursing diagnoses using the Nursing Diagnosis Accuracy Scale version 2. Kappa was used for agreement between them. Patient social and clinical characteristics were described using percentages, absolute frequencies, means, and standard deviations., Findings: A total of 18 unique nursing diagnoses were identified across the 155 patients. Among the 754 nursing diagnoses recorded, 85% of those identified at admission (n = 644) were deemed highly accurate. At discharge, of the 527 diagnoses recorded, 66% (n = 349) were rated as highly accurate. Excess fluid volume was the most common diagnosis (85% at admission, 49% at discharge). Three risk diagnoses were frequent at both points: risk for infection, risk for falls, and risk for decreased cardiac output. Agreement between evaluators ranged from Κ = 0.234 to 1.00., Conclusions: Greater agreement in nursing diagnoses at discharge likely reflects ongoing patient monitoring. Persistent diagnoses at discharge highlight the need for continued nursing care post-discharge., Implications for Nursing Practice: This study encourages nurses to improve clinical evaluation for HF patients from admission to discharge. As key clinical indicators are identified, nurses can improve the accuracy of their diagnoses and plan more effective interventions to achieve positive health outcomes and reduce unnecessary hospitalization., (© 2025 NANDA International, Inc.)

Purpose: This purpose of this article was to use the method of conceptual history to analyze the evolution of the concept of "validity" in nursing diagnoses and to identify key transformations, theoretical influences, and implications for contemporary clinical judgment and decision-making., Methods: Five stages derivate from the approach proposed by Reinhart Koselleck, including: identify the concept and its relevance, historical contextualization, contextual use, semantic changes over time, and synthesis and interpretation., Findings: The concept of "validity" in nursing diagnoses is essential for accurate diagnostics, interdisciplinary communication, and evidence-based decision-making, though its interpretation varies due to differing philosophical perspectives and methodological challenges. Historically, "validity" in nursing evolved from empirical methods to theory-driven approaches incorporating psychometric and clinical frameworks. Validation processes have adapted, integrating scientific rigor, ethical considerations, and practical utility, while also reflecting societal, technological, and cultural shifts. Today, the focus is on balancing methodological diversity and evidence-based practice, with a need for continuous quality improvement, interdisciplinary collaboration, cultural sensitivity, and patient involvement., Conclusions: The concept of "validity" in nursing diagnoses has evolved from early empirical methods to its current focus on evidence-based practices, interdisciplinary integration, and cultural sensitivity, emphasizing the need for accurate, technologically informed diagnostics to enhance patient care and guide clinical decision-making., Implications for Nursing Practice: Nursing must integrate diverse perspectives, cultural sensitivity, and technology into its diagnoses, and professionals should be trained in both scientific and ethical aspects to improve patient outcomes., (© 2025 NANDA International, Inc.)

Purpose: 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., Findings: 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., Conclusions: 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., Implications for Nursing Practice: 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., (© 2024 NANDA International, Inc.)

Purpose: To identify the prevalence of the nursing diagnosis of compromised end-of-life syndrome in patients in end-of-life care., Methods: This is a clinical validation based on a cross-sectional epidemiological clinical study conducted at the National Cancer Institute in Rio de Janeiro, Brazil. The defining characteristics of a syndrome diagnosis were identified, defined as a "subset of nursing diagnoses," using sensitivity and specificity measures through the application of latent class statistical methods., Findings: The statistical results revealed seven nursing diagnoses characterizing the syndrome: imbalanced nutrition: less than body requirements, nausea, anxiety, ineffective breathing pattern, disturbed sleep pattern, ineffective thermoregulation, and fatigue. Compromised end-of-life syndrome was present in 76% of the sample., Conclusion: The study demonstrated the presence of compromised end-of-life syndrome in most end-of-life patients from the sample., Implications for Nursing Practice: Recognizing the presence of the syndrome diagnosis enables nurses to have efficient and effective clinical reasoning for implementing the nursing process in palliative care. CAAE Number: 85415618.0.3001.5274., (© 2024 NANDA International, Inc.)

Purpose: To evaluate the accuracy of clinical indicators and etiological factors associated with the nursing diagnosis of excessive sedentary behavior among university students., Method: This study employed a cross-sectional diagnostic accuracy design. The sample comprised 108 students from a Brazilian public university. Fisher's exact and chi-square tests were utilized to determine associations. A latent class analysis model was applied to assess the sensitivity and specificity of clinical indicators and the prevalence of the diagnosis. The odds ratio for etiological factors was calculated using univariate logistic regression. The research ethics committee of the responsible institution approved the study., Results: The prevalence of the nursing diagnosis excessive sedentary behavior among university students was 16.3%. The sensitive clinical indicators identified were 'inadequate sleep quality' (0.9999), while the specific indicators included 'lack of physical fitness' (0.9998) and 'cardiovascular alterations' (0.9557). The etiological factor 'physical activity in frequency, intensity and duration lower than recommended' was associated with the diagnosis. Additionally, statistical associations were found between the diagnosis and the following variables: body composition, muscle capacity, flexibility, scores from the International Physical Activity Questionnaire (with emphasis on the days of the week of vigorous physical activity), minutes per week of vigorous activity, days of the week of walking, hours of sleep per night, and average sleep quality., Conclusion: There is evidence of construct validity for the nursing diagnosis excessive sedentary behavior in university students, supported by one sensitive clinical indicator and two specific indicators., Implications for Nursing Practice: Increased knowledge of the nursing diagnosis Excessive sedentary behavior in university students can enhance clinical reasoning among nurses and contribute to the elevation of evidence levels and the continuous improvement of the NANDA-I taxonomy., (© 2024 NANDA International, Inc.)

Parental involvement in youth sports is increasingly relevant in scientific research since parents have gradually developed awareness regarding youngsters' sports experiences. This study aimed to (1) examine potential differences in athletes' and parents' perceptions of parental involvement practices in youth basketball, (2) verify whether these perceptions differ by sex, and (3) analyze the relationship between the different perceptions dimensions recorded. The analysis included a large sample of 423 Portuguese participants (151 youth basketball athletes and 272 parents) who completed the Parental Behaviors in Sports (PBSP) questionnaire. The PBSP comprises a version for parents and a version for athletes, composed of five dimensions: (1) sports support, (2) competition attendance, (3) technical influence, (4) performance pressure, and (5) sports expectations. No significant statistical differences regarding PBSP dimensions were observed between boys and girls in the athletes' group. However, in the parents' group, fathers scored significantly lower than mothers in sports expectations ( p = 0.001). Differences between athletes' and parents' perceptions were evident in competition attendance ( p = 0.023), technical influence ( p ≤ 0.001), and sports expectations ( p = 0.023). When analyzing the dyads of boys-fathers and girls-mothers, significant differences were found for technical influence ( p = 0.035), performance pressure ( p = 0.020), and sports expectations ( p < 0.001) between boys and fathers. Among girls and mothers, differences were perceived exclusively for technical influence ( p = 0.005). Finally, technical influence correlated significantly with performance pressure (r = 0.351, p < 0.001) and sports expectations (r = 0.367, p < 0.001). These findings demonstrate the crucial importance for sports researchers and practitioners to consider differences in perceptions based on sex and role (athlete or parent) when designing and implementing parental educational programs.

Vibrio spp. are remarkably diverse bacteria, being worthy of investigation not only for their antibiotic resistance and virulence, but also for their biotechnological potential. Indeed, there is increasing evidence that these bacteria display industrially relevant traits, particularly as producers of antimicrobial substances, tensioactive/emulsifying compounds, and enzymes. Here, our aim was to investigate the potential of Vibrio strains isolated from two different marine sources to produce such biotechnologically applicable substances. From the eighteen analyzed strains, five were isolated from plastic particles from a heavily polluted urban estuary and 13 from calcareous sponges inhabiting submarine caves in an isolated volcanic archipelago in the Atlantic Ocean. Enzymatic screening revealed that most strains were agarolytic and cellulolytic. Overall, six strains showed antimicrobial activity against Staphylococcus aureus ATCC 29,213, with four of them active towards Escherichia coli ATCC 25,922 as well. Additionally, eight strains were positive for the production of bioemulsifiers. Genomic analyses of four strains further revealed insights regarding the enzymatic arsenal, as shown by the detection of several key gene clusters pertaining to the chitin degradation pathway, and also encoding diverse classes of antimicrobial-active metabolites. Our findings highlight the biotechnological potential of Vibrio spp., evidencing their functional diversity and the need for continued and sustained prospecting of this bacterial genus to uncover its potential high-value-added bioproducts., Competing Interests: Declarations. Competing Interests: The authors have non-financial interests to disclose. Ethical Approval: Not applicable. Animal and Human Rights Statement: Not applicable., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Migraine is a genetically determined disorder that predisposes to recurrent episodes of headache. Interleukin (IL)-18 is a pro-inflammatory cytokine that seems to play a role in migraine pathophysiology, and its genetic variants could potentially impact susceptibility to migraine., Objective: To investigate the association between IL18 rs360717 and rs187238 genetic variants with migraine diagnosis and its clinical characteristics., Methods: A case-control study was conducted with 152 people with migraine and 155 healthy controls, matched by sex, age, ethnicity, and body mass index. Clinical characteristics of migraine, as well as validated questionnaires regarding disability and impact of migraine, presence of allodynia, anxiety, depression, and hyperacusis were collected. Genotyping for IL18 rs360717 and rs187238 variants was performed using real-time polymerase chain reaction (qPCR) and TaqMan™ method., Results: The IL18 rs360717A and rs187238G alleles were associated with increased chance of being diagnosed with migraine (OR = 1.53, 95%CI 1.05-2.24, p = 0.028 and OR = 1.46, 95%CI 1.00-2.14, p = 0.049, respectively). In the dominant model, the rs360717GA + AA genotypes were also associated with a higher chance of migraine than the GG genotype (OR = 1.69, 95%CI 1.05-2.73, p = 0.030). In women, in addition to the previous associations, there was also an effect of the variants on the chance of migraine in the codominant models and dominant models. Furthermore, among women, there was an influence on the prevalence of postdrome perception with rs360717GA + AA (OR = 3.04, 95%CI 1.10-8.42, p = 0.032) and rs187238CG + GG (OR = 2.97, 95%CI 1.08-8.21, p = 0.035)., Conclusion: IL18 rs360717 and rs187238 variants were associated with migraine diagnosis and postdrome symptoms, especially in women., Significance: This study has demonstrated that IL18 rs360717 and rs187238 variants play a role in migraine, influencing the chance of being diagnosed with migraine, particularly among women. There are prospects that IL18 variants could be considered potential genetic biomarkers for migraine., (© 2024 European Pain Federation ‐ EFIC ®.)

Objective: To analyze the relevance of a set of clinical elements to represent the content domain of the nursing diagnosis Ineffective Protection., Design and Methods: This study employed content validation, using expert judgment to assess the appropriateness of clinical indicators, etiological factors, and conceptual and operational definitions, integrating the collective wisdom framework, the theory of predictive diversity, and the determination of rater skill level., Results: From the middle range theory, 28 clinical indicators and 17 etiological factors were identified, which were rated by 34 raters. The analysis showed that the clinical indicators restlessness and insomnia and the etiological factors ambient temperature and humidity were not considered relevant for the nursing diagnosis of Ineffective Protection, because the median content validity index was lower than 0.9., Conclusions: Content validation verified that most of the components of the nursing diagnosis of Ineffective Protection were considered relevant by judges., Practical Implications: It is believed that the data obtained can help nurses to more easily evaluate the related factors and clinical indicators of Ineffective Protection presented by adolescents with cancer, which favors the process of diagnostic inference., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Purpose: To analyze the accuracy of defining characteristics of the NANDA International nursing diagnosis, fatigue (00093), in patients with heart failure., Methods: A cross-sectional study on the diagnostic accuracy of the defining characteristics of the nursing diagnosis. The sample consisted of 96 patients with heart failure in treatment in a public hospital. The latent class analysis method was used to test the accuracy measurements and estimate the prevalence of the diagnosis. The study was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte., Results: The prevalence of the fatigue nursing diagnosis was 42.54%. Increased physical symptoms (0.9988) and tiredness (0.9988) were the sensitive defining characteristics. Disinterested in surroundings (0.9999) was the specific defining characteristics., Conclusions: A set of three defining characteristics of the nursing diagnosis of fatigue was accurate in patients with heart failure. Thus, this set can be used by nurses to confirm nursing diagnosis fatigue in patients with heart failure., Implications for Nursing Practice: This research contributes by providing accurate defining characteristics of fatigue in patients with heart failure. Thus, nurses should recognize the nursing diagnosis of fatigue in patients with heart failure through accurate defining characteristics and propose rapid and effective nursing interventions that have positive health results., (© 2023 NANDA International, Inc.)

Purpose: This study aims to perform specific causal validation of nursing diagnosis Risk for thrombosis (00291) of the NANDA International (NANDA-I) classification., Methods: This is a case-control study conducted in a university hospital from January to October 2020. A total of 516 adult patients were included-344 in the Case Group (with venous or arterial thrombosis evidenced by imaging) and 172 in the Control Group (without thrombosis). Statistical analysis was performed by univariate and multivariate logistic regression test, and odds ratios were calculated to measure the effect of exposure between groups. The study was approved by the Research Ethics Committee., Findings: The patients were predominantly female and aged 59 ± 16 years. In the univariate logistic analysis, five risk factors were significantly associated with thrombosis, two at-risk populations and 12 associated conditions. In the multivariate regression model, the following risk factors remained independently associated (p < 0.05): inadequate knowledge of modifiable factors (OR: 3.03; 95% CI: 1.25-8.56) and ineffective medication self-management (OR: 3.2; 95% CI:1.77-6.26); at-risk populations with history (OR: 2.16; 95% CI: 1.29-3.66) and family history of thrombosis (OR:2.60; 95% CI: 1.03-7.49); and the conditions associated with vascular diseases (OR:6.12; 95% CI:1.69-39.42), blood coagulation disorders (OR: 5.14; 95% CI:1.85-18.37), atherosclerosis (OR:2.07; 95% CI: 1.32-3.27), critical illness (OR: 2.28; 95% CI: 1.42-3.70), and immobility (OR: 2.09; 95% CI: 1.10-4.12)., Conclusions: The clinical validation allowed to establish strong evidence for the refinement of the diagnosis Risk for thrombosis and, consequently, to raise its level of evidence in the classification of NANDA-I., Implications for Nursing Practice: The evidence pointed out by this study favors the establishment of thrombosis diagnosis in an accurate way by nurses in clinical practice, directing preventive interventions to patients in this risk condition., (© 2023 NANDA International, Inc.)

Purpose: Insomnia is an important sleep disorder in older persons. Conceptual analysis studies on this nursing diagnosis have been developed, but the diagnostic accuracy has not been verified. This study aimed to verify the diagnostic accuracy of the nursing diagnosis of Insomnia (00095) in older adults in a community center in Brazil., Methods: A validation study for diagnostic accuracy of the defining characteristics of the nursing diagnosis Insomnia. Data were collected through telephone interviews with 90 participants. Latent class analysis was used to verify the sensitivity and specificity of the defining characteristics. Poisson regression was used to assess the prevalence of the association of factors related to the nursing diagnosis of insomnia., Findings: A 47.42% prevalence of insomnia in the sample was identified. Defining characteristics such as expresses dissatisfaction with sleep and nonrestorative sleep-wake cycle showed the best accuracy values for insomnia, with a specificity of 0.92 (0.78-1.00) and 0.89 (0.74-1.00), respectively. Related factors such as stressors and frequent naps during the day were more likely to develop insomnia in individuals., Conclusions: This study indicates diagnostic accuracy of nursing diagnosis of insomnia in community-dwelling older people from a community center. The findings highlighted the importance of the defining characteristics of nursing diagnosis insomnia and its main related factors contributing to accurate diagnostic identification., Implications for Nursing Practice: This study can contribute to providing objective clinical indicators of insomnia in the older population to guide nurses in early diagnostic confirmation for the selection of health interventions. In addition, it can be a consistent contribution to theoretical and conceptual reviews of this diagnosis., (© 2023 NANDA International, Inc.)

Aim: To analyse the content of the nursing diagnosis ineffective peripheral tissue perfusion in patients with diabetic foot., Design: A methodological study with a quantitative approach was performed., Methods: The analysis was performed between January and May 2021 by 34 nurses with clinical/theoretical/research experience with diabetes or nursing diagnoses. These nurses evaluated the relevance, clarity and precision of 12 diagnosis-specific etiological factors, 22 clinical indicators and their conceptual and operational definitions., Findings: All 12 etiological factors analysed were considered relevant to diagnostic identification. However, five showed inconsistencies regarding the clarity or precision of the operational definitions, requiring adjustments. Regarding the 22 clinical indicators evaluated, all of them presented a Content Validity Index (CVI) that was statistically significant. However, in the indicators, the colour does not return to lowered limb after 1 min of leg elevation, and cold foot had Content Validity Index (CVI) <0.9 regarding relevance and accuracy of operational definitions., Conclusions: Twelve etiological factors and 22 clinical indicators were validated. Thus, this study revealed new and relevant aspects characterising peripheral perfusion in patients with diabetic foot that have not yet been clinically validated., Implications for Nursing Practice: This study contributes to support the professional practice of nurses through the early identification of etiological factors and clinical indicators in persons with diabetic foot. As a proposal, we suggest the inclusion of new defining characteristics and related factors for the nursing diagnosis ineffective peripheral tissue perfusion in the NANDA-I taxonomy., Impact: The research highlights new and relevant aspects such as etiological factors and clinical indicators to characterise peripheral perfusion in patients with diabetic foot. Based on these findings, clinical validation is recommended to confirm the relevance of the proposed elements in the population studied for greater reliability and improved diagnostic assessment for the professional practice of nurses., Reporting Method: EQUATOR guidelines were adhered to using the GRRAS checklist for reporting reliability and agreement studies., Patient or Public Contribution: No patient or public contribution., (© 2024 John Wiley & Sons Ltd.)

Objective: To map nursing diagnoses related to cardiovascular function reported in studies involving patients in primary care., Method: A scoping review follows JBI guidelines. Literature searches were conducted from March to May 2024. Studies included focused on nursing diagnoses for adults and older adult patients with cardiovascular conditions in primary care settings. Results were systematically presented in tables and narratively., Findings: Among the 12 included studies, the most prevalent diagnosis was "noncompliance" (00079), removed from NANDA-I in 2017. Sixteen other diagnoses were identified, indicating a broader clinical profile of individuals with cardiovascular health issues in primary care. Most studies involved patients with hypertension in Brazil., Conclusions: Key nursing diagnoses for patients with cardiovascular conditions in primary care were identified. Ineffective health management emerged as a common characteristic among this population., Implications for Nursing Practice: Identifying prevalent diagnoses allows nurses to reinforce their commitment to managing cardiovascular conditions, improve care plans, and generate practice indicators for services, thus enhancing the quality of care provided., (© 2024 NANDA International, Inc.)

Purpose: To verify clinical validity evidence for the ineffective social support network nursing diagnosis., Method: A quantitative, descriptive, cross-sectional study was performed with 98 violence-victimized women treated in two reference centers for violence in the city of Recife, Pernambuco, Brazil. The women were interviewed from August 2021 to June 2022., Findings: The clinical indicators that best predicted the nursing diagnosis were as follows: Frustration with unmet support expectations, negative social interaction, perceived neglect of support demands, feeling of abandonment, low reciprocity, and encouragement of negative behaviors. Etiological factors that showed greater association were excessive demand for support, limited social network, social isolation, the fragility of institutional service networked organizations, and inadequate appreciation of available social support., Conclusions: The clinical validity evidence for the ineffective social support network nursing diagnosis has been verified. Thus, the validated clinical indicators and etiological factors can accurately diagnose and predict the emergence of this phenomenon in violence-victimized women., Implications for Nursing Practice: The results contribute to advancing scientific knowledge in nursing teaching, research, and practice and support the nursing process in violence-victimized women., (© 2024 NANDA International, Inc.)

Purpose: The coronavirus disease 2019 (COVID-19) generates long-term sequelae, but studies investigating patients with chronic pain syndrome (CPS) are limited. This study aimed to establish the etiological factors of CPS in patients with post-COVID-19 conditions., Methods: This was a case-control retrospective study. The predictor variables were sex, diabetes mellitus, obesity (predisposing factors), unfavorable socioeconomic conditions, impaired rehabilitation (disabling factors), repeated exposure to COVID-19 (precipitating factor), home isolation, stress overload, fear of dying, admission to intensive care unit, prone positioning, and use of medications (reinforcing factors). The outcome variable was the presence of CPS., Findings: This study included 120 individuals. Prolonged days of isolation (p = 0.005), fear (p < 0.001), stress overload (p < 0.001), and impaired rehabilitation (p = 0.003) were significantly associated with CPS., Conclusions: A significant relationship was found between prolonged days of isolation, fear, stress overload, impaired rehabilitation, and CPS., Implications for Nursing Practice: The study findings can assist nurses by promoting their knowledge of the causes of CPS and supporting the care planning needs of patients with post-COVID-19 conditions, in addition to promoting the use of the NANDA-International taxonomy., (© 2023 NANDA International, Inc.)

Purpose: To evaluate the accuracy of defining characteristics and causal relationships of the etiological factors of the nursing diagnosis deficient knowledge in individuals with heart failure ., Data Sources: An analytical, cross-sectional study on the diagnostic accuracy of the defining characteristics and causal relationships of the etiological factors of the nursing diagnosis. The sample consisted of 140 patients with chronic HF and in outpatient follow-up. The latent class analysis method was used to test the accuracy of measurements and estimate the prevalence of the diagnosis. The calculation of subsequent probabilities and the odds ratio ( were also parameters employed. The study was approved by the Research Ethics Committee of the Federal University of Pernambuco., Data Synthesis: The diagnosis had an estimated prevalence of 38.57% in the sample. The inaccurate statements about the disease and/or therapy, self-care deficient performance, and inadequate behavior were the clinical indicators that best predicted the presence of the diagnosis and demonstrated the same sensitivity value (1.0000), specificity (1.0000), and 95% confidence interval (0.9999-1.0000) for all. The populations at risk was elderly (OR = 2.12, confidence interval 95% = 1.05-4.27), and illiterate individuals (OR = 2.07, confidence interval 95% = 1.03-4.16) had an approximately twofold great chance of developing havening deficient knowledge., Conclusion: The evaluation of the accuracy of clinical indicators, corresponding to the defining characteristics in the study, contributed to screening and diagnostic establishment capacity in clinical practice, and to the translation of theoretical and practical knowledge., Implications for Nursing Practice: Accurate clinical indicators of the nursing diagnosis deficient knowledge facilitate the clinical reasoning of nurses and favor the professional's role in the development of health education strategies focused on the acquisition of knowledge about the disease by patients, family members, and caregivers., (© 2023 NANDA International, Inc.)

Objectives: This cross-sectional study aimed to examine the relationships of sleep timing and sleep variability with depressive symptoms, health-related quality of life (HRQoL), daytime sleepiness, and body mass index (BMI) in adolescents., Methods: Adolescents from three schools ( n  = 571, 56% female, 16.3 ± 1.0 years) had their sleep examined by actigraphy, their anthropometrics assessed, and answered a survey. Sleep timing was examined by combining groups of median-dichotomized onset and wakeup times (early onset and early wakeup; early onset and late wakeup; later onset and early wakeup; later onset and later wakeup); sleep variability was based on within-participant standard deviations of onset and wakeup; and sleep duration as the length of time between onset and wakeup. The sleep variables were separated for weekdays and weekend. Mixed linear models were fitted to compare each sleep variable with health-related outcomes., Results: Higher values of daytime sleepiness were observed in adolescents from the late-early and late-late timing group during the week. Greater sleep midpoint and wakeup variability on weekdays were related with higher daytime sleepiness. Adolescents in the late-late and early-late groups showed higher daytime sleepiness. Increased of all sleep variability variables was related with greater daytime sleepiness. Higher depressive symptoms scores were found among adolescents in the late-early subgroup and with the increase of sleep variability. Participants with greater sleep onset variability and sleep midpoint variability reported less HRQoL., Conclusions: Not only sleep duration, but sleep timing and variability also relate to health outcomes, and should be addressed by policies and interventions among adolescents.

Objective: To evaluate the accuracy of the defining characteristics of the nursing diagnosis ineffective peripheral tissue perfusion in patients with diabetic foot., Method: A diagnostic accuracy study with a cross-sectional design was carried out with patients with type 2 diabetes mellitus on outpatient diabetic foot treatment. We evaluated 134 patients with diabetic foot to determine the accuracy of the defining characteristics of ineffective peripheral tissue perfusion. A latent class model with random effects was used to establish the sensitivity and specificity of the defining characteristics assessed., Results: Ineffective peripheral tissue perfusion was present in 83.79% of the patients. The defining characteristics color does not return to lowered limb after 1-minute leg elevation and edema had high sensitivity (0.8370 and 0.7213) and specificity (0.9991 and 0.9995)., Conclusion: The defining characteristics color does not return to lowered limb after 1-minute leg elevation and edema are good clinical indicators that can be used for screening and confirming ineffective peripheral tissue perfusion in patients with diabetic foot., (© 2023 NANDA International, Inc.)

Purpose: The purpose of this study was to verify the validity of the content of the proposal for the nursing diagnosis of low self-efficacy in health., Methods: Content validation study using the approach proposed by Lopes, a panel of 47 experts on the phenomenon of interest analyzed the content of the diagnosis using a Likert-type scale to evaluate the relevance of 16 clinical indicators and 18 etiological factors of the nursing diagnosis under investigation. These components were previously identified and defined through a middle-range theory. Based on the predictive diversity model, the experts' verifications were weighted according to their level of expertise. The pseudomedian and 95% confidence intervals were calculated. A content validity index above 0.9 was considered valid, and the Wilcoxon test was used to validate each pseudomedian with a p-value above 0.05., Findings: Thirteen clinical indicators were considered relevant, demonstrating the importance of these elements for the clinical identification of low self-efficacy in health. Three clinical indicators were excluded because they were not representative for this diagnosis. The eighteen etiological factors analyzed were considered relevant., Conclusion: The findings of the present study may help nurses to identify low self-efficacy in health early and direct effective interventions to increase people's confidence in their abilities to promote their health., Implications for Nursing Practice: A new diagnostic framework is presented with peer-reviewed content, representing a phenomenon frequently reported by clinicians. This new diagnosis can guide nursing care and produce better health outcomes that depend on patients' confidence in their ability to take care of their own health., (© 2022 NANDA International, Inc.)

Purpose: This study aimed to clinically validate the NANDA-I nursing diagnosis of "Spiritual distress (00066)" in people under assisted reproductive technologies, and to determine the sensitivity, specificity, and predictive value of the defining characteristics., Methods: Cross-sectional study that was conducted between September 2019 and June 2020. Recruitment happened by invitation posted in fertility-related websites. Those who accepted to participate were asked to fill the consent form and the online questionnaire. Statistical analysis was based on Rasch's model. The study was approved by the Ethics Committee., Findings: The sample comprised 104 Portuguese individuals undergoing assisted reproductive techniques. The "Spiritual distress (00066)" was validated and 22 defining characteristics were confirmed as representative. No item showed differential item functioning. "Perceived suffering" was the most sensitive defining characteristic and had the highest negative predictive value. "Insufficient courage" had the highest positive predictive value, and "Anger toward power greater than self" was the most specific., Conclusions: Results validated the presence of the NANDA-I nursing diagnosis of "Spiritual distress (00066)" in a sample going through assisted reproductive technologies, improving accuracy of this nursing diagnosis in such population., Implications for Nursing Practice: This is a crucial step to raise the level of evidence of such nursing diagnosis and to increase the level of evidence on NANDA-I terminology. Furthermore, this study has contributed to raising the quality of nurse's critical judgement and clinical reasoning and allow an early spiritual and a more holistic and personalized patient-centered intervention in the reproductive field., (© 2022 NANDA International, Inc.)

Backgound: Although obesogenic behaviors have been found to be related to social isolation, evidence-based person-centered approaches are lacking. This study investigated the association between clusters of obesogenic behavior - derived from a data-driven process - and social isolation among Brazilian adolescents., Methods: Data from the National Adolescent School-based Health Survey (PeNSE) 2015 were analyzed. A total of 100,794 9 th -grade students (51.3% females; 14.3 ± 0.1 years old) enrolled in 3,040 public and private high schools participated in the study. Social isolation was assessed by two outcomes (i.e., perceived loneliness and lack of close friends). A two-step cluster analysis was conducted to identify patterns of obesogenic behaviors with the input of leisure-time physical activity (PA), sitting time as a proxy of sedentary behavior (SB), and the weekly consumption of healthy and unhealthy food. Crude and adjusted binary logistic regression models were applied to evaluate the associations between the clusters of obesogenic behaviors and social isolation variables in adolescents., Results: Three clusters were identified. Adolescents in the "Health-promoting SB and diet" (32.6%; OR = 0.69; 95% CI = 0.62-0.76) and "Health-promoting PA and diet" (44.9%; OR = 0.73; 95% CI = 0.67-0.79) clusters had lower odds of loneliness compared to those in the "Health-risk" cluster (22.5%). Those belonging to the "Health-promoting PA and diet" cluster were more likely to report having close friends (OR = 1.19; 95% CI = 1.00-1.41) than those in the "Health-risk" cluster., Conclusion: Adolescents in clusters where positive behaviors outweighed negative ones were less likely to perceive themselves as lonely and without close connections., (© 2023. The Author(s).)

Worldwide, cosmetics (especially eye shadows) are widely consumed and have a great impact on the economy. The aim of this study was to determine the multielement composition, focusing on essential and potentially toxic elements, in cosmetics (eye shadow) exposed to consumption in Brazil. Concentrations of 17 elements (Al, As, Ba, Cd, Co, Cr, Cu, Mn, Mo, Ni, Pb, Sb, Se, Sr, Ti, V and Zn) were determined in samples (produced in China and Brazil) using a sequential optical emission spectrometer with inductively coupled plasma (ICP OES) after acid digestion, assisted by a closed digester block (6 mL of HNO 3  + 2 mL of H 2 O 2  + 1 mL of Triton ×-100 + 1 mL of ultrapure water). The method was validated by linearity, precision, accuracy, limits of detection (LoD) and quantification (LoQ). The elements were quantified (in µg g -1 ): Al (852-21,900), Ba (3.47-104), Cd (1.70-6.93), Cr (< 8.53-66.6), Cu (< 0.480-14.5), Mn (92.20-1,190), Ni (< 4.23-40.7), Pb (< 2.16-5.06), Sb (1.10-10.5), Sr (0.760-46.0), Ti (32.0-440), V (< 0.85-1.7) and Zn (24.90-2,600). As, Co, Mo and Se in all the investigated samples were found to be below the LoQ values of ICP OES. In this study, regardless of sample compositions and origins (Brazilian or Chinese), high levels of Al, Cd, Cr, Cu, Mn, Ni, Pb, Sb, Ti, V and Zn were observed, exceeding the recommended maximum tolerable limits, according to Brazilian and global legislations, which may present potential risks to human health and the environment., (© 2022. The Author(s), under exclusive licence to Springer Nature B.V.)

Aim: To perform a simultaneous concept analysis of the concepts associated to nursing diagnoses ineffective airway clearance, ineffective breathing pattern, and impaired gas exchange., Background: Concepts about respiratory manifestations need to be well defined, especially in the current pandemic scenario. For that, the simultaneous concept analysis can help in the clarity and differentiation of similar concepts., Methods: A concept analysis using the Walker and Avant approach and an integrative review. Data were collected by a group of nurses through a literature review. The group identified 10 articles that met the inclusion criteria and complemented the understanding of the concepts analysed through the sequential description of respiratory physiology in technical books., Results: The final list included 28, 22, and 21 clinical indicators for ineffective breathing pattern, impaired gas exchange, and ineffective airway clearance, respectively. The former, the final proposal incorporated 13 indicators that were pointed out by the group and 15 defining characteristics of NANDA-International. For Impaired gas exchange, the indicator "decreased oxygen saturation" was included; among the defining characteristics of NANDA-International, "abnormal arterial blood gases" was excluded, and "abnormal breathing pattern" was subdivided into "alterations in respiratory depth," "bradypnea," "tachypnea," and "change in respiratory rhythm." The latter, only the "wide-eyed" was removed from the final list of clinical indicators, which subsequently consisted of nine indicators suggested by the group and 12 defining characteristics., Conclusion: This concept analysis may aid in the process of differentiation for ineffective airway clearance, ineffective breathing pattern, and impaired gas exchange, and aid in safer diagnostic inference. This concept analysis can support the understanding of respiratory nursing diagnoses, helping nurses to identify and differentiate them more safely., (© 2022 Wiley Periodicals LLC.)

Objective: Identify etiological factors related to the determination of the nursing diagnosis post-trauma syndrome in women victims of violence DATA SOURCE: : Five databases were searched: SciVerse Scopus, PubMed, Latin American and Caribbean Health Sciences Literature, CINAHL with Full Text, and PsycINFO DATA SYNTHESIS: : A total of nine etiological factors related to post-trauma syndrome were identified: physical assault, sexual assault, psychological violence, childhood trauma, low education level, low socioeconomic status, lack of employment, age under 40 years, and depression severity. Such factors were associated with the nursing diagnosis of post-trauma syndrome, according to the synthesis CONCLUSION: : We believe that identifying the nursing diagnosis post-trauma syndrome in its current form shown in the NANDA-I taxonomy is limited as the determination of nursing interventions is based on the etiological factors identified during the diagnostic reasoning step IMPLICATIONS FOR NURSING PRACTICE: : This study brings the need to implement knowledge about nursing diagnoses related to violence against women, highlighting the lack of literature that can exemplify the practice of nurses with regard to care relevant to the public in question., (© 2022 NANDA International, Inc.)

Purpose: This review aimed to analyze the use of differential validation of nursing diagnosis., Methods: Integrative literature review with search on international databases. The diagnoses, the type of the diagnosis differential validation, the sample, the method, main results, and the limitations were extracted. Ten studies were included., Findings: Differential diagnostic validation publication dates from 1994, and Brazil was the predominant country., Conclusions: This method seems helpful in improving diagnosis accuracy, particularly those related to subjective, behavioral, or complex human responses., Implications for Nursing Practice: Using this model may facilitate understanding the specificity of nursing diagnosis, which is critical for teaching clinical reasoning and for new opportunities to research., (© 2021 NANDA International, Inc.)

Introduction: Identifying a nursing diagnosis to support women victims of violence is challenging for nurses., Objective: To identify clinical indicators related to the nursing diagnosis Post-trauma syndrome in women victims of violence., Methods: A systematic review to estimate diagnostic accuracy indices was conducted. The review was registered on the Prospective International Registry of Systematic Reviews approved with the register CDR42020222474., Results: Twelve clinical indicators were investigated: depression symptoms, anxiety symptoms, alcohol abuse, stress overload, illicit drug use, body image disorder, paranoid ideation, hostility, somatic symptoms, insomnia, binge eating, and obesity. The six articles included in the quantitative synthesis provided four clinical indicators feasible for statistical analysis: depressive symptoms, anxiety symptoms, somatic symptoms, and stress overload., Conclusion: The study addresses the need for refinements in the nursing diagnoses related to violence against women. The identification of the nursing diagnosis Post-trauma syndrome in nursing practice enables the development of standardized and effective care plans for women victimized by violence., (© 2022 Wiley Periodicals LLC.)

Purpose: A standardized language system can support the elaboration of clinical guidelines by matching information from similar patterns of response to people. To identify the factors that are related to a higher likelihood of an ineffective health management nursing diagnosis., Methods: We conduct a systematic review and meta-analysis. An electronic search was conducted in MEDLINE databases via PubMed, Web of Science, SciELO, CINAHL, SCOPUS, and Embase between October and November 2020. Descriptive data were extracted from each article. The odds ratios for each etiological factor related to ineffective health management were directly extracted from the articles or calculated from the data described in the articles. The analysis of the measurements of exposure and the magnitude of the effect was performed using the statistical software R, and a forest plot was constructed for each etiological factor., Findings: Ten studies were included, and 15 related factors were recovered from the primary studies. The factors that significantly increased the likelihood of an ineffective health management nursing diagnosis were insufficient knowledge of the therapeutic regimen, perceived barriers, powerlessness, economic disadvantage, and difficulty managing complex treatment regimens. No effect was verified with the following factors: decision conflict, family pattern of healthcare, and inadequate number of cues to action., Conclusion: Factors related to a higher likelihood of ineffective health management may be the focus of early and targeted nursing interventions, contributing to an improved quality of care., Clinical Relevance: Understanding exposure to these factors can improve diagnostic reasoning at different population levels., (© 2021 Sigma Theta Tau International.)

Sustainability indicators have become essential tools to deal with compartmentalized resources planning and management in cities. The development of water, energy, and food nexus (WEF nexus) indicators is a prominent goal of current research, but the focus is mainly on economic issues and material flows. Attention to the local scale and context, social aspects, and the inclusion of non-academic actors is mostly lacking. To address these gaps, this paper reports and reflects on the co-creation of sustainability indicators related to the WEF nexus in the city of São Paulo, Brazil. With a transdisciplinary approach, non-academic actors were included in the different stages of the process using the Urban Living Lab methodology, to improve the usability of the produced indicators' set. The case of São Paulo concerned on-going actions in the peri-urban and rural areas of the city which seek to improve environmental protection by stimulating more sustainable forms of agriculture. Thirty-four indicators were developed through a sequence of interactive activities, such as workshops, meetings, and field trips. The presented process aims to strongly enhance usability by actively involving users from the start, connecting the nexus approach to previous knowledge and familiar frameworks, paying attention to the local scale and context, and to social aspects, and by anticipating future use in various ways., (© The Author(s), under exclusive licence to Springer Japan KK, part of Springer Nature 2022.)

Purpose: To develop and validate the content of the nursing diagnosis proposal for perioperative thirst., Methods: A content analysis by 34 judges. An online Delphi panel was used in one round, evaluating criteria of relevance, clarity and precision. Wilcoxon's one-tailed test was used and the content validity index to maintain the item was set to 0.80., Findings: The content validity index in relation to the evaluated items reached levels between 0.87-1.00. The final components of the diagnosis proposal included the following items as defining characteristics: dry mouth, dry throat, dry lips, thick saliva, thick tongue, constant swallowing of saliva, desire to drink water, bad taste in the mouth, and caregiver's report. Related factors are as follows: pre- and postoperative fasting, oral breathing, dehydration, hypovolemia, insensitive loss of hydration by breathing, dry mouth, habit of drinking water, high room temperature. Associated conditions: intubation, use of muscarinic and nicotinic anticholinergics and water restriction., Conclusions: All components of the nursing diagnosis were validated in relation to relevance, clarity, and accuracy, demonstrating high levels of agreement between experts. Qualitative observations were found to be fundamental for both combining and excluding some items., Implications for Nursing Practice: Improvement of refinement and clarity levels of this nursing diagnosis proposal aiding its inclusion in the NANDA International taxonomy and thus enabling greater understanding of the phenomenon of thirst in surgical patients. This study helps to explain and facilitate the identification of defining characteristics, related factors, and associated conditions for nurses, nursing students, and researchers on this subject., (© 2021 NANDA International, Inc.)

Objective: To analyze the accuracy of clinical indicators of constipation in cancer patients undergoing chemotherapy., Methods: A diagnostic accuracy study was conducted from February to September 2018, with 240 cancer patients undergoing chemotherapy. The data collection instrument was a form with sociodemographic and clinical variables, and clinical indicators of constipation. The sensitivity and specificity of the clinical indicators of interest were calculated using a latent class analysis approach., Result: The prevalence of constipation in the sample was 86.6%. The most sensitive clinical indicators were straining with defecation (100.0%), and hypoactive bowel sounds (75.0%), while headache (99.9%), abdominal pain (75.0%), pain with defecation (75.0%), straining with defecation (99.9%) and liquid stool (78.1%) were indicators with high specificity., Conclusion: A set of six clinical indicators was significantly associated with the occurrence of constipation in cancer patients undergoing chemotherapy, especially straining with defecation. These indicators can be used by nurses to identify constipation and propose prompt and effective interventions.

Purpose: The purpose of this study was to analyze the prognostic capacity of the clinical indicators of a delayed surgical recovery nursing diagnosis throughout the hospital stay of patients having cardiac surgery., Design: A prospective cohort design was adopted. A sample of inpatients undergoing elective cardiac surgery was followed during the immediate preoperative period and hospitalization. This research was conducted in the southeast region of Brazil at a national reference institution that treats highly complex diseases and performs cardiac surgeries. Data were collected from July 2017 to July 2018., Methods: At the end of 1 year of data collection, 181 patients were followed in this study. The Kaplan-Meier method was used to calculate the survival time related to delayed surgical recovery. In addition, an extended Cox model of time-dependent covariates was adjusted to identify the clinical signs that influenced the change in the nursing diagnosis status., Results: A delayed surgical recovery nursing diagnosis was present in 23.2% of the sample studied. With an expected length of stay of 8 to 10 days, most new cases of delayed surgical recovery were observed on the 10th postoperative day, and the survival rate after this day was decreased until the 29th postoperative day, when the nursing diagnosis no longer appeared. Interrupted healing of the surgical area, loss of appetite, and atrial flutter were indicators related to an increased risk for delayed surgical recovery., Conclusions: Timely recognition of selected clinical indicators demonstrates a promising prognostic capacity for delayed surgical recovery., Clinical Relevance: Accurate identification of prognostic factors allows nurses to identify early signs of postoperative complications. Consequently, the professional can develop an individualized plan of care, aiming at the satisfactory clinical recovery of the patient., (© 2021 Sigma Theta Tau International.)

Aim: To characterize the usage profile and the factors associated with the prolonged use of proton pump inhibitor drugs in a community pharmacy., Methodology: This is a cross-sectional, prospective and observational study involving interviews with 410 patients who acquired PPI for their own use from community pharmacies. To characterize the factors associated with the prolonged use of PPI, a multivariate logistic regression model was used., Results: Pantoprazole (42.7%) and omeprazole (31%) were the most acquired PPIs, prescribed mainly by gastroenterologists (49.5%). They are used in the morning, especially for gastrointestinal symptoms, however, they had been consumed for more than 5 years in 30% of cases. The factors associated with prolonged use are old age (OR 1.03 CI95% 1.01-1.05), body mass index (OR 1.07 CI95% 1.01-1.12), use of non-steroidal anti-inflammatories (OR 3.18 CI95% 1.20-8.43) and selective serotonin reuptake inhibitors (OR 3.5 95% CI 1.39-8.88)., Conclusion: PPIs are adequate in terms of indication and form of use, however, prolonged use associated with old age, being overweight and use of anti-inflammatories and antidepressants is frequent., Competing Interests: The authors have declared that no competing interests exist.

Purpose: To construct a middle-range theory, based on the Roy adaptation model, for nurses can diagnose an ineffective infant feeding pattern., Data Source: Scientific findings were used through a literature review and the concepts of the Roy model., Data Synthesis: The theory indicated new elements for the diagnosis: 12 etiological factors and 13 clinical indicators. Most of those are not contained in the NANDA taxonomy., Conclusion: The middle-range theory for these diagnoses highlights the need for a review of the components present in the taxonomy., Implications for Nursing Practice: This approach guides research on nursing diagnoses to revise the content of the theory and to expand its concepts and elements for the diagnosis of an ineffective infant feeding pattern., (© 2020 NANDA International, Inc.)

Purpose: To construct a situation-specific theory (SST) to represent nutritional deficits for assessing children with cancer., Data Sources: Literature review., Data Synthesis: The SST included the definition of key concepts, a pictorial scheme, propositions, causal relationships, and evidence for nursing practice., Conclusions: It was possible to characterize the elements as antecedent and consequent clinical factors to allow for an understanding of the existing relationships between them and their temporality. These elements differed considerably from those included in NANDA International., Implications for Nursing Practice: This study provides additional information so that nurses in clinical practice can infer the presence of nutritional deficits in children with cancer early, given the risk already inherent in the diagnosis of cancer and treatment., (© 2020 NANDA International, Inc.)

Objective: To identify the measures of accuracy for defining characteristics of the nursing diagnosis: Ineffective thermoregulation in newborns., Method: Diagnostic accuracy study with cross-sectional design performed in medium and high-risk maternity units, located in Fortaleza city/Brazil. A total of 216 newborns were evaluated to identify the defining characteristics of the diagnosis under study. The measures of accuracy for defining characteristics were obtained from a latent class model with random effects for the calculation of sensitivity and specificity values., Results: The characteristics of increased respiratory rate and warm skin to the touch had higher sensitivity values (99.9%) and lower specificity (79 and 75%) and the characteristics of body temperature fluctuations above and below the normal parameters and hypertension had the highest specificity (80.4 and 100%, respectively)., Conclusion: The characteristic fluctuation of the body temperature above and below the normal parameters may be better to confirm the diagnosis, having presented a higher specificity value., (Copyright © 2020 Elsevier España, S.L.U. All rights reserved.)

Purpose: The study's objective was the clinical validation of the nursing diagnosis Risk for delayed surgical recovery (00246)., Method: Case control study was conducted in a university hospital; the charts of 239 patient, 71 cases and 168 controls. Odds ratio was calculated for the association between each risk factor and the outcome of delayed surgical recovery., Results: Risk factors with higher odds of association were malnutrition, pain, and postoperative emotional response. The associated conditions were perioperative surgical site infection, psychological disorder in the postoperative period, and surgical site contamination., Conclusion: Risk factors have different impact on the postoperative recovery., Implications for Nursing Practice: Knowing the magnitude of the risk factors allows a decision making best interventions for a fast surgical recovery., (© 2020 NANDA International, Inc.)

Aims and Objectives: To analyse, hierarchically, factors associated with hospital readmissions for acute coronary syndrome., Background: Hospital readmissions have risen, especially in patients with multiple comorbidities, which are most often chronic. The leading causes of hospital readmission include acute coronary syndrome, which is costly and often preventable. Determining clinical and nonclinical variables that increase the chances of readmission is important to assess and evaluate patients hospitalised for coronary heart diseases., Design: A case-control study whose dependent variable was hospital readmission for acute coronary syndrome., Methods: The study included 277 inpatients, of whom 132 were in their first hospitalisation and 145 had already been hospitalised for acute coronary syndrome. The independent variables for this hierarchical model were sociodemographic conditions, life habits, access to health services and physical health measures. Data were obtained by interviews, anthropometric measurements and patient records. Logistic regression analysis was performed using the stepwise technique, with Microsoft Excel and R version 3.2.3. The research was reported via strengthening the reporting of observational studies in epidemiology (STROBE)., Results: In the final hierarchical logistic model, the following risk factors were associated with readmission for acute coronary syndrome: inadequate drug therapy adherence, stress, history of smoking for 30 years or more, and the lack of use of primary healthcare services., Conclusions: Clinical and nonclinical variables are related to hospital readmission for acute coronary syndrome and can increase the chance of readmission by up to six times., Relevance to Clinical Practice: The predictive model can be used to avoid readmission for acute coronary syndrome, and it represents an advance in the prediction of the occurrence of the outcome. This implies the need for a reorientation of the network for postdischarge care in the first hospitalisation for acute coronary syndrome., (© 2020 John Wiley & Sons Ltd.)

Purpose: To elucidate six diagnostic concepts related to urinary incontinence (UI)., Methods: Eight out of nine steps of the simultaneous concept analysis (SCA) method were used to elucidate six diagnostic concepts related to UI proposed by NANDA International., Findings: Individual concepts of each diagnosis were elucidated, including antecedents, outcomes, associated conditions, and risk populations, and the interrelations among these concepts were identified, comparing them to those already present in the current NANDA-I taxonomy. The overflow UI was excluded, and were included mixed and transient UI diagnoses., Conclusions: SCA enabled identifying similar characteristics and factors exclusive to the revised nursing diagnoses., Implications for Nursing Practice: To support for clinical reasoning to identify properly the types of UI., Objetivo: Elucidar seis conceitos diagnósticos relacionados à incontinência urinária. MÉTODOS: Oito das nove etapas do método de análise simultânea de conceitos foram utilizadas para elucidar seis conceitos diagnósticos relacionados à incontinência urinária propostos pela NANDA International., Resultados: Conceitos individuais de cada diagnóstico foram elucidados, incluindo antecedentes, consequentes, condições associadas e populações em risco, e as inter-relações entre esses conceitos foram identificadas, comparando-as com aquelas já presentes na atual taxonomia da NANDA-I. A incontinência urinária por transbordamento foi excluída e foram incluídos os diagnósticos de incontinência urinária mista e incontinência urinária transitória. CONCLUSÕES: A análise simultânea de conceitos permitiu identificar características e fatores semelhantes exclusivos aos diagnósticos de enfermagem revisados. IMPLICAÇÕES PARA A PRÁTICA DE ENFERMAGEM: Apoiar o raciocínio clínico para identificar adequadamente os tipos de incontinência urinária., (© 2019 NANDA International, Inc.)

Objective: To clinically validate risk factors for the nursing diagnosis risk for suicide in older adults., Methods: Case-control study (105 older adults). The strength of the association between variables was assessed using odds ratio (OR). Risk factors were grouped into hierarchical blocks according to the Integrated Motivational-Volitional Model of Suicidal Behaviour., Results: Anxiety; guilt; divorce; hostility; inability to express feelings; loss of important relationship; financial problems; apathy; low self-esteem; hopelessness; dependence and functional incapacity; unhappiness; failure; frustration; marked change in attitude and behavior; sadness; self-neglect; stockpiling medication; depression; ideation and suicidal plans; and mental disorders were associated with risk for suicide., Conclusions: It is expected that this study will contribute to clinical nursing practice by the identification of this diagnosis in a safer and more precise manner. Descriptors: clinical judgment, nursing diagnosis, psychiatric nursing, suicide, older adult., Competing Interests: Declaration of competing interest Authors must declare did not have financial support or relationships that may pose conflict of interest. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Although the French Polynesian reefs are among the most well studied reefs of the world, sponges are still poorly known, with only 199 species or OTUs of sponges having been described from French Polynesia, 167 at an OTU level and 32 at a species level. From those 199 species, just five are calcareous sponges. As it is possible that this number is underestimated, the aim of the present work was to study the diversity of calcareous sponges from French Polynesia. Hence, different French Polynesian archipelagos were surveyed by SCUBA from 3 to 60 m of depth. Identifications were performed using morphological and molecular (ITS and C-LSU) tools. We found a total of nine species of Calcarea, comprising five different genera. Five species are new to science: Clathrina fakaravae sp. nov., Clathrina huahineae sp. nov., Ernstia variabilis sp. nov., Leucascus digitiformis sp. nov., and Leucandra tahuatae sp. nov. With the present work, the number of identified sponges from French Polynesia at a species level increased from 32 to 41. The only calcareous sponge previously known from French Polynesia that was recollected by our group was Leucetta chagosensis. Our results suggest that the Eastern Indo-Pacific Realm shows more affinity with the Central and the Western Indo-Pacific Realms. Four species supported these affinities: Ascandra cf. crewsi, previously known only from Papua New Guinea, Leucascus simplex from South Australia, and Leucetta chagosensis and L. microraphis, both widespread species in the Indo-Pacific. These two Leucetta species, however, most likely represent species complexes. Once again the molecular markers ITS and C-LSU helped in the identification of calcareous sponges, showing how important is an integrative taxonomy. Although our work has increased in 250% (6 spp to 15 spp) the diversity of calcareous sponges in French Polynesia, it is most possible that this number is still underestimated.

The thermoelectric conversion technique has been explored in a broad range of heat-flow sensors. In this context, the Spin Seebeck Effect emerges as an attractive candidate for biosensor applications, not only for the sensibility improvement but also for the power-saving electronic devices development. Here, we investigate the Longitudinal Spin Seebeck Effect in films with a Co 2 FeAl/W bilayer structure grown onto GaAs (100) substrate, systems having induced uniaxial magnetic anisotropy combined with cubic magnetic anisotropy. From numerical calculations, we address the magnetic behavior and thermoelectric response of the films. By comparing experiment and theory, we explore the possibility of modulating a thermoelectric effect by magnetic anisotropy. We show that the thermoelectric voltage curves may be modulated by the association of magnetic anisotropy induction and experimental parameters employed in the LSSE experiment.

Cutaneous leishmaniasis (CL) is a neglected parasitic disease conventionally treated by multiple injections with systemically toxic drugs. Aiming at a more acceptable therapy, we developed lipid-core nanocapsules (LNCs) entrapping the potent antileishmanial chalcone (CH8) for topical application. Rhodamine-labeled LNC (Rho-LNC-CH8) was produced for imaging studies. LNC-CH8 and Rho-LNC-CH8 had narrow size distributions (polydispersity index <0.10), with similar mean sizes (~180 nm) by dynamic light scattering. In vitro, Rho-LNC-CH8 was rapidly internalized by extracellular Leishmania amazonensis parasites macrophages in less than 15 min. LNC-CH8 activated macrophage oxidative mechanisms more efficiently than CH8, and was more selectively toxic against the intracellular parasites. In vivo, topically applied Rho-LNC-CH8 efficiently permeated mouse skin. In L. amazonensis-infected mice, LNC-CH8 reduced the parasite load by 86% after three weeks of daily topical treatment, while free CH8 was ineffective. In conclusion, LNC-CH8 has strong potential as a novel topical formulation for CL treatment., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Background: Excess body fat has been growing alarmingly among adolescents, especially in low income and middle income countries where access to health services is scarce. Currently, the main method for assessing overweight in adolescents is the body mass index, but its use is criticized for its low sensitivity and high specificity, which may lead to a late diagnosis of comorbidities associated with excess body fat, such as cardiovascular diseases. Thus, the aim of this study was to develop a computational model using linear regression to predict obesity in adolescents and compare it with commonly used anthropometric methods. To improve the performance of our model, we estimated the percentage of fat and then classified the nutritional status of these adolescents., Methods: The model was developed using easily measurable socio-demographic and clinical variables from a database of 772 adolescents of both genders, aged 10-19 years. The predictive performance was evaluated by the following metrics: accuracy, sensitivity, specificity, and area under ROC curve. The performance of the method was compared to the anthropometric parameters: body mass index and waist-to-height ratio., Results: Our model showed a high correlation (R = 0.80) with the body fat percentage value obtained through bioimpedance. In addition, regarding discrimination, our model obtained better results compared to BMI and WHtR: AUROC = 0.80, 0.64, and 0.55, respectively. It also presented a high sensitivity of 92% and low false negative rate (6%), while BMI and WHtR showed low sensitivity (27% and 9.9%) and a high false negative rate (65% and 53%), respectively., Conclusions: The computational model of this study obtained a better performance in the evaluation of excess body fat in adolescents, compared to the usual anthropometric indicators presenting itself as a low cost alternative for screening obesity in adolescents living in Brazilian regions where financial resources are scarce.

Purpose: To establish prognostic indicators of survival for impaired gas exchange (IGE) (00030)., Methods: Secondary analysis of data from an open prospective cohort developed with a group of 136 children with acute respiratory infection (ARI)., Findings: On Day 1, IGE (00030) was present in 42.6% of the sample. New cases arose until the last day of evaluation. With regards to defining characteristics, only hypoxemia and abnormal skin color were associated with a higher risk of developing diagnosis., Conclusions: Children with ARI who exhibit hypoxemia and abnormal skin color had a worse prognosis for IGE (00030)., Implications for Nurse Practice: Nurses can use the research findings as a predictive marker of the evolution of the patient's health status., (© 2018 NANDA International, Inc.)