Humoral immune response to measles and varicella vaccination in former very low birth weight preterm infants

Introduction

Immune response to vaccination in infants born prematurely may be lower than in infants born at full-term. Some clinical factors might be associated with humoral immune response.

Applying cultural safety beyond Indigenous contexts: Insights from health research with Amish and Low German Mennonites

People who identify as members of religious communities, such as the Amish and Low German Mennonites, face challenges obtaining quality health care and engagement in research due in part to stereotypes that are conveyed through media and popular discourses. There is also a growing concern that even when these groups are engaged in research, the guiding frameworks of the research fail to consider the sociocultural or historical relations of power, further skewing power imbalances inherent in the research relationship. This paper aims at discussing the uses of cultural safety in the context of health research and knowledge translation with groups of people that are associated with a specific religion. Research with the Amish and Low German Mennonites is provided as examples to illustrate the use of cultural safety in this context. From these examples, we discuss how the use of cultural safety, grounded in critical theoretical perspectives, offers new insight into health research with populations that are traditionally labeled as minority, vulnerable, or marginalized, especially when a dominant characteristic is a unique religious perspective.     

Validation of the self-confidence scale of nursing care in urinary retention

Objective:

to validate an instrument to measure self-confidence of nursing care in urinary retention.

Methods:

methodological research study, carried out after ethical approval. A Likert-like scale of 32 items related to nursing care in urinary retention was applied to students of the graduate nursing course. For instrument validation, analysis of the sample adequacy and main components, Varimax orthogonal rotation and internal consistency analyses were developed.

Results:

in a sample of 305 students, there was high correlation of all items with the total scale and Cronbach''s alpha of 0.949. The scale items were divided into five factors with internal consistency: Factor 1 (0.890), Factor 2 (0.874), Factor 3 (0.868), Factor 4 (0.814) and Factor 5 (0.773), respectively.

Conclusion:

the scale meets the validity requirements, demonstrating potential for use in evaluation and research.     

Home-based nursing interventions improve knowledge of disease and management in patients with heart failure

OBJECTIVE:

to assess patient knowledge of heart failure by home-based measurement of two NOC Nursing Outcomes over a six-month period and correlate mean outcome indicator scores with mean scores of a heart failure Knowledge Questionnaire.

METHODS:

in this before-and-after study, patients with heart failure received four home visits over a six-month period after hospital discharge. At each home visit, nursing interventions were implemented, NOC outcomes were assessed, and the Knowledge Questionnaire was administered.

RESULTS:

overall, 23 patients received home visits. Mean indicator scores for the outcome Knowledge: Medication were 2.27±0.14 at home visit 1 and 3.55±0.16 at home visit 4 (P<0.001); and, for the outcome Knowledge: Treatment Regimen, 2.33±0.13 at home visit 1 and 3.59±0.14 at home visit 4 (P<0.001). The correlation between the Knowledge Questionnaire and the Nursing Outcomes Classification scores was strong at home visit 1 (r=0.7, P<0.01), but weak and non significant at visit 4.

CONCLUSION:

the results show improved patient knowledge of heart failure and a strong correlation between Nursing Outcomes Classification indicator scores and Knowledge Questionnaire scores. The NOC Nursing Outcomes proved effective as knowledge assessment measures when compared with the validated instrument.     

Validation to Portuguese of the Scale of Student Satisfaction and Self-Confidence in Learning

Objective:

translate and validate to Portuguese the Scale of Student Satisfaction and Self-Confidence in Learning.

Material and Methods:

methodological translation and validation study of a research tool. After following all steps of the translation process, for the validation process, the event III Workshop Brazil - Portugal: Care Delivery to Critical Patients was created, promoted by one Brazilian and another Portuguese teaching institution.

Results:

103 nurses participated. As to the validity and reliability of the scale, the correlation pattern between the variables, the sampling adequacy test (Kaiser-Meyer-Olkin) and the sphericity test (Bartlett) showed good results. In the exploratory factorial analysis (Varimax), item 9 behaved better in factor 1 (Satisfaction) than in factor 2 (Self-confidence in learning). The internal consistency (Cronbach''s alpha) showed coefficients of 0.86 in factor 1 with six items and 0.77 for factor 2 with 07 items.

Conclusion:

in Portuguese this tool was called: Escala de Satisfação de Estudantes e Autoconfiança na Aprendizagem. The results found good psychometric properties and a good potential use. The sampling size and specificity are limitations of this study, but future studies will contribute to consolidate the validity of the scale and strengthen its potential use.     

Prevention of nonsteroidal inflammatory drug-induced urticaria and/or angioedema

BackgroundUrticaria and/or angioedema (U/AE) are the most frequent and less severe forms of nonallergic hypersensitivity reactions to nonsteroidal anti-inflammatory drugs (NSAIDs). Management of NSAID-induced U/AE includes (1) the avoidance of the culprit drug and of cyclooxygenase (COX) 1 inhibitors, (2) the use of weak COX-2 inhibitors, and/or (3) desensitization to aspirin. Because these possibilities may have drawbacks, we tested the possibility of preventing NSAID-induced U/AE by the administration of antihistamines and/or a combination of antihistamines and leukotriene antagonists.ObjectiveTo test the preventive effect of antihistamines and/or leukotriene antagonists on the development of U/AE in patients with a history of NSAID hypersensitivity confirmed by a positive challenge result.MethodsA single, placebo-controlled, oral challenge using the culprit NSAID was applied to 65 patients with a history of NSAID-induced U/AE. In the case of recurrence of the symptoms, another oral challenge was performed under premedication with antihistamines alone or combined antihistamines and leukotriene antagonists.ResultsA total of 59 of 65 patients (90%) tolerated a normal dose of NSAID, confirming previous data on the poor reproducibility of nonallergic hypersensitivity reactions to NSAIDs on challenge. Of the 6 patients who experienced recurrence of the U/AE on NSAID challenge, antihistamines and combined antihistamines and leukotriene antagonists prevented the hypersensitivity reactions in 2 and 3 of them, respectively. Only 1 patient still developed a moderate NSAID-induced urticaria despite the double premedication.ConclusionTreatment with NSAIDs at normal doses is possible and well tolerated in patients who have experienced NSAID-induced U/AE, which could be prevented by the concomitant use of antihistamines and leukotriene antagonists.     

Global mean diffusivity: A radiomarker discriminating good outcome long term after traumatic brain injury

BackgroundTraumatic brain injury (TBI) is a chronic pathology responsible for cognitive disorders impacting outcome. Global clinical outcome several years after TBI may be associated with anatomical sequelae. Anatomical lesions are not well described because characterizing diffuse axonal injury and brain atrophy require using specific MRI sequences with quantitative measures. The best radiologic parameter to describe the lesions long term after TBI is not known.ObjectiveWe aimed to first, assess the global volumetric and diffusion parameters related to long-term outcome after TBI and second, define the most discriminating parameter.MethodsIn this observational study, we included 96 patients with severe TBI and 22 healthy volunteers. The mean delay after TBI was 63.2 months [range 31–119]. The Glasgow Outcome Scale Extended (GOS-E) was used to assess the global long-term clinical outcome. All patients underwent multimodal MRI with measures of brain volume, ventricle volume, global fractional anisotropy (FA) and global mean diffusivity (MD).ResultsAll 96 participants had significant impairment in global FA, global MD, brain volume and ventricle volume as compared with the 22 controls (P < 0.01). Only global MD significantly differed between the “good recovery” group (GOS-E score 7-8) and the other two groups: GOS-E scores 3-4 and 5-6. Brain volume significantly differed between the GOS-E 7-8 and 3-4 groups. Global MD was the most discriminating radiological parameter for the “good recovery” group versus other patients, long term after TBI. FA appeared less relevant at this time. Global atrophy was higher in patients than controls but lacked reliability to discriminate groups of patients.ConclusionGlobal mean diffusivity seems a more promising radiomarker than global FA for discriminating good outcome long term after TBI. Further work is needed to understand the evolution of these long-term radiological parameters after TBI.