Effectiveness of nursing interventions in heart failure patients in home care using NANDA-I,NIC, and NOC

ObjectiveThe objective of the study is to evaluate the effectiveness of nursing interventions (NIC) using nursing outcomes (NOC) and based on NANDA-I nursing diagnoses in patients with heart failure in home care.MethodIn this longitudinal study, 23 patients with heart failure were followed for 6 months, in four home visits. During the visits, nursing diagnoses were established, outcomes assessed, and interventions implemented.ResultsOf the 11 NIC interventions implemented, eight proved effective, that is, showed significant improvement between the first and the fourth visit, according to scores obtained for six outcomes: knowledge: treatment regimen, knowledge: medication, compliance behavior, symptom control, activity tolerance, and energy conservation.ConclusionNIC interventions health education, self-modification assistance, behavior modification, teaching: prescribed medication, teaching: disease process, nutritional counseling, telephone consultation, and energy conservation showed effective outcomes based on NOC scores, suggesting that the NANDA-I, NIC, and NOC linkage is useful in patients with heart failure in home care.     

Molecular characterization,serotyping, and antibiotic susceptibility profile of Leptospira interrogans serovar Copenhageni isolates from Brazil

Leptospira interrogans serogroup Icterohaemorrhagiae is the major serogroup infecting humans worldwide, and rodents and dogs are the most significant transmission sources in urban environments. Knowledge of the prevalent serovars and their maintenance hosts is essential to understand the epidemiology of leptospirosis. In this study, 20 Leptospira isolates were evaluated by pulsed-field gel electrophoresis (PFGE), variable number tandem-repeat analysis (VNTR), serotyping, and determination of antimicrobial resistance profile. Isolates, originated from bovine, canine, human, and rodent sources, were characterized by microscopic agglutination test with polyclonal and monoclonal antibodies and were identified as L. interrogans serogroup Icterohaemorrhagiae serovar Copenhageni. MICs of antimicrobials often used in veterinary medicine were determined by broth microdilution test. Most of tested antibiotics were effective against isolates, including penicillin, ampicillin, and ceftiofur. Higher MIC variability was observed for fluoroquinolones and neomycin; all isolates were resistant to trimethoprim/sulfamethoxazole and sulphadimethoxine. Isolates were genotyped by PFGE and VNTR; both techniques were unable to discriminate between serovars Copenhageni and Icterohaemorrhagiae, as expected. PFGE clustered all isolates in 1 pulsotype, indicating that these serovars can be transmitted between species and that bovine, rodent, and dogs can maintain them in the environment endangering the human population.     

Impact of an In-Person Versus Web-Based Practice Standardized Patient Examination on Student Performance on a Subsequent High-Stakes Standardized Patient Examination

Background: Optimal methods of preparing students for high-stakes standardized patient (SP) examinations are unknown. Purposes: The purpose is to compare the impact of two formats of a formative SP examination (Web-based vs. in-person) on scores on a subsequent high-stakes SP examination and to compare students' satisfaction with each formative examination format. Methods: Clustered randomized trial comparing a Web-based module versus in-person formative SP examination. We compared scores on a subsequent high-stakes SP examination and satisfaction. Results: Scores on the subsequent high-stakes SP examination did not differ between the two formative formats but were higher after the formative assessment than without (p < .001). Satisfaction was higher with the in-person than Web-based formative assessment format (4.00 vs. 3.62 on a 5-point scale, p = .01). Conclusions: Two formats of a formative SP examination led to equivalent improvement in scores on a subsequent high-stakes examination. Students preferred an in-person formative examination to online but were satisfied with both.     

Mapping of mangrove forests on the southern coast of São Paulo,Brazil, using synthetic aperture radar data from ALOS/PALSAR

Widespread in the coastal zones of (sub)tropical regions, mangroves are an essential habitat for many animal species and provide subsistence resources for many human coastal communities. Among remote sensing techniques, synthetic aperture radar is a particularly advantageous method to monitor mangroves: images are not dependent on cloud cover and can provide information from forest understory. This article mapped mangrove forests in the southern coast of São Paulo State (Brazil) using frequency-based contextual classification of incoherent attributes derived from a multi-polarized Phased Array L-Band Synthetic Aperture Radar (PALSAR) image. The use of 10 incoherent attributes and only 3 Synthetic Aperture Radar (SAR) vegetation indices as input for digital classification showed the best accuracies with kappa index values of 0.739 and 0.734, respectively. HH polarization and SAR vegetation indices were the attributes that contributed most to the mangrove mapping procedure. The use of L-Band SAR data was effective for mapping mangrove areas, and therefore it is recommended as a tool for coastal management.     

Translumbar catheter redirection using a tip-deflector technique

A new technique is described for reversing the direction of the catheter tip during translumbar aortography, without the need for partial withdrawal of the catheter from the aortic lumen. The method ensures optimal delivery of contrast medium at the desired level, while avoiding the risk of retroperitoneal bleeding or dislodgement during catheter manipulation.     

Assistive technology for communication of older adults: a systematic review

Objective: Describe the use of assistive technology to enhance communication opportunities for older adults.

Methods: A systematic review was conducted in two databases, PubMed and Web of Science, by using two different searches in each. The search was limited to original articles, in English language, including people aged 60 years and older that used any type of assistive technology for communication. The articles found in the initial search were filtered by title, abstracts and the remaining articles were fully read.

Results: Eighteen studies were included in this review after the reading of full-texts. Most of the studies included apparently healthy participants with communication limitations due to aging related changes and the others included people with some pathology that prevent them from normal communication.

Conclusion: Four categories of assistive technology were identified: assistive technology for people with speech problems; robot or videoconferencing systems; Information and Communication Technologies and, other types of assistive technology for communication, such as hearing aids and scrapbooks. Assistive technology for communication of older adults is not only used by people with disabilities that prevent them from usual communication. They are mostly for older adults without a pathological communication problem.