The relative age effect in under-17, under-20, and adult elite female soccer players

To investigate the RAE in elite female soccer players, the absolute and relative birthdate distributions of players who disputed the Women's World Cup were assessed. Differences between observed and expected distributions were analyzed using chi-square and effect sizes. The birthdates of 1224 female soccer players were assessed in Under-17 (N = 336), Under-20 (N = 336) and adult (N = 552) categories. There was no significant RAE in adult category for different playing positions and players in general (including all playing positions per age category). There was significant RAE for midfielders and players in general with mainly small effect sizes for the U-17 and U-20. In both age categories, players born in Q1 were over-represented with the highest quartile ratio for midfielders. In regard of RAE and success defined by final ranking at the World Cup, we found no significant differences between the birthdate distributions of players who participated in either the group stages or finally the knockout phases. Coaches should consider this information to avoid bias in talent programs designed to promote and select female soccer players independently of their birthdates. Young female players should be encouraged to learn to play in different field positions before to reach high-level performance.

ReScape: transforming coral-reefscape images for quantitative analysis

Ever since the first image of a coral reef was captured in 1885, people worldwide have been accumulating images of coral reefscapes that document the historic conditions of reefs. However, these innumerable reefscape images suffer from perspective distortion, which reduces the apparent size of distant taxa, rendering the images unusable for quantitative analysis of reef conditions. Here we solve this century-long distortion problem by developing a novel computer-vision algorithm, ReScape, which removes the perspective distortion from reefscape images by transforming them into top-down views, making them usable for quantitative analysis of reef conditions. In doing so, we demonstrate the first-ever ecological application and extension of inverse-perspective mapping-a foundational technique used in the autonomous-driving industry. The ReScape algorithm is composed of seven functions that (1) calibrate the camera lens, (2) remove the inherent lens-induced image distortions, (3) detect the scene's horizon line, (4) remove the camera-roll angle, (5) detect the transformable reef area, (6) detect the scene's perspective geometry, and (7) apply brute-force inverse-perspective mapping. The performance of the ReScape algorithm was evaluated by transforming the perspective of 125 reefscape images. Eighty-five percent of the images had no processing errors and of those, 95% were successfully transformed into top-down views. ReScape was validated by demonstrating that same-length transects, placed increasingly further from the camera, became the same length after transformation. The mission of the ReScape algorithm is to (i) unlock historical information about coral-reef conditions from previously unquantified periods and localities, (ii) enable citizen scientists and recreational photographers to contribute reefscape images to the scientific process, and (iii) provide a new survey technique that can rigorously assess relatively large areas of coral reefs, and other marine and even terrestrial ecosystems, worldwide. To facilitate this mission, we compiled the ReScape algorithm into a free, user-friendly App that does not require any coding experience. Equipped with the ReScape App, scientists can improve the management and prediction of the future of coral reefs by uncovering historical information from reefscape-image archives and by using reefscape images as a new, rapid survey method, opening a new era of coral-reef monitoring.

Nursing outcomes for patients with multiple traumas and impaired physical mobility: An integrative review

PURPOSE

This research identifies nursing outcomes for patients with multiple traumas who present changes in physical mobility.

METHODS

This was a thorough literature review, following Whittemore and Knafl's method and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses´ guidelines (2005) and adopting the Oxford Center for Evidence-Based Classification Medicine-Levels of Evidence (2011). The literature search included databases from Virtual Health Library, Cochrane Library, Excerpta Medica Database, Medical Literature Analysis and Retrieval System Online, PubMed, SciVerse Scopus, The Cumulative Index to Nursing and Allied Health Literature, and Web of Science. It was conducted between October and December 2019 and updated in April 2022.

FINDINGS

Upon our first analysis of the 254 articles that could correlate to the present study, we concluded that 15 of them are of foremost relevance. The nursing outcomes found are correlated with skin care, position in hospital bed, pressure injury prevention, self-care assistance to bath, intimate, and oral hygiene, pain control, circulatory precaution, and impaired physical mobility assistance. All of these outcomes are directly or indirectly involved with the consequences of mobility impairment.

CONCLUSIONS

The main nursing outcomes of our research identified for patients with multiple traumas were related to mobility, the consequences of immobility, self-care, and skin maintenance. In conclusion, this review highlights the importance of measuring outcomes related to the provision of nursing care.

IMPLICATIONS FOR NURSING PRACTICE

The nursing outcomes classification provides results that can be used across the continuum of care to assess the patient's status after nursing interventions. It also allows for improved care for multiple trauma patients who have altered mobility, identifying the real needs of these patients.

Clinical validation of nursing diagnosis fatigue (00093) in women in the immediate hospital postpartum period

OBJECTIVE

To perform clinical validation of nursing diagnosis fatigue (00093) in women in the immediate postpartum hospital.

METHOD

This is a methodological and clinical validation study of the diagnostic accuracy of nursing diagnosis fatigue (00093) components in women in the immediate postpartum hospital period. Data were collected with women in the immediate postpartum hospital. Sensitivity and specificity accuracy measures, positive and negative predictive values of the aforementioned nursing diagnosis were investigated.

RESULTS

The sample consisted of 153 women in the immediate postpartum period hospitalized in the rooming-in ward, with a mean age of 27 years, whose defining characteristic with statistical significance was tiredness.

CONCLUSION

The defining characteristics of tiredness and pain and related factor sleep deprivation presented high prevalence and high values of fatigue (00093) accuracy measures, being validated. Thus, it is believed that this study will contribute to clinical practice nurses in the correct identification of postpartum hospital fatigue, a frequent phenomenon in this population that causes much damage throughout the puerperium period. Additionally, it will corroborate the immediate conduct aiming at good outcome.

Accuracy of delirium risk factors in adult intensive care unit patients

OBJECTIVE

To assess the accuracy measurements for predisposing and precipitating Risk Factors for delirium in an adult Intensive Care Unit.

METHOD

Cohort, prospective study with patients over 18 who had been hospitalized for over 24 hours and were able to communicate. The patients were assessed once a day until the onset of delirium or permanence in the Intensive Care Unit. Instruments were employed to track delirium, characterize the sample, and identify the risk factors. Descriptive statistics was employed for sample characterization and accuracy tests for risk factors.

RESULTS

The included patients amounted to 102, 31 of which presented delirium. The predisposing predictive risk factors were hypoalbuminemia, American Society of Anesthesiology over three, severity, altered tissue perfusion, dehydration, and being a male, whereas precipitating predictive factors were physical restraint, infection, pharmacological agent, polypharmacy, anemia, altered renal function, dehydration, invasive devices, altered tissue perfusion and altered quality and quantity of sleep.

CONCLUSION

An accurate identification of predisposing and precipitating risk factors may contribute to planning preventive measures against delirium.

Association of Cognitive Performance with Frailty in Older Individuals with Cognitive Complaints

OBJECTIVES

Frailty is a risk factor for poor cognitive performance in older adults. However, few studies have evaluated the association of cognitive performance with frailty in a low- to middle-income country (LMIC). This study aimed to investigate an association between cognitive performance and frailty in older adults with memory complaints in Brazil. Secondarily, we aim to assess an association of cognitive performance with gait speed and grip strength.

DESIGN

Cross-sectional study.

SETTING

Outpatient service from a LMIC.

PARTICIPANTS

Older adults with memory complaints reported by the participants, their proxies, or their physicians.

MEASUREMENTS

Frailty was evaluated using the Cardiovascular Health Study criteria. A neuropsychological battery evaluated memory, attention, language, visuospatial function, executive function. Linear regression analysis with adjustment for age, sex, and education was used. We also evaluated the interaction of education with frailty, grip strength, and gait speed.

RESULTS

Prefrailty was associated with poor performance in the memory domain, as well as slower gait speed was associated with worse performance in memory, attention, language, and executive function. Frailty and grip strength were not associated with cognitive performance. Interactions of education with gait speed were significant for global performance, as well as for attention and visuospatial ability.

CONCLUSION

In elderly patients with memory complaints, prefrailty was associated with poor memory performance. Slowness was associated with poorer performance in some cognitive domains, mainly in participants with low education.

Content analysis of the nursing diagnosis “Excess fluid volume (00026)” in renal patients

ABSTRACT Objective: To analyze the content of the conceptual and operational definitions of the related factors, associated condition and defining characteristics of the nursing diagnosis “Excess fluid volume (00026)” in hemodialysis renal patients. Methods: Methodological study, of the content analysis type, with 49 specialists who reached a score equal to or greater than 5, according to Fehring’s criteria. Thirty elements were evaluated for relevance, clarity, and precision. The experts’ profile was analyzed using descriptive statistics, and the binomial test analyzed the agreement between them in relation to the terms. Results: The main validated indicators were “Oliguria”, “Anasarca”, “Paroxysmal nocturnal dyspnea”, “Dyspnea”, “Change in blood pressure”, “Edema”, “Ingestion greater than elimination” and “Increased central venous pressure”. This shows that this phenomenon is present in this population. Conclusion: 29 elements were validated for relevance, clarity, and precision. This result clarifies the terms that make up the phenomenon, providing a better understanding of the concept; and assists in the accurate diagnostic proposition.

Validação clínica do diagnóstico de enfermagem fadiga (00093) em mulheres no pós-parto hospitalar imediato

RESUMO Objetivo: Realizar a validação clínica do diagnóstico de enfermagem fadiga (00093) em mulheres no pós-parto hospitalar imediato. Método: Trata-se de estudo metodológico, do tipo validação clínica, de acurácia diagnóstica dos componentes do diagnóstico de enfermagem fadiga (00093) em mulheres no pós-parto hospitalar imediato. A coleta de dados foi realizada junto a mulheres no pós-parto imediato hospitalar. Foram investigadas as medidas de acurácias de sensibilidade e especificidade, valores preditivos positivos e negativos do referido diagnóstico de enfermagem. Resultados: A amostra foi composta por 153 mulheres no pós-parto imediato internadas na enfermaria de alojamento conjunto, com idade média de 27 anos, cuja característica definidora com significância estatística foi cansaço. Conclusão: As características definidoras cansaço e dor e o fator relacionado privação de sono apresentaram alta prevalência e altos valores de medidas de acurácia para fadiga (00093), sendo validadas. Assim, acredita-se que este estudo contribuirá para os enfermeiros da prática clínica na identificação correta da fadiga pós-parto hospitalar, um fenômeno frequente nesta população que causa muitos prejuízos em todo período do puerpério. Além disso, corroborará na condução imediata visando bom desfecho.

Conceptual and operational definition of the components of the nursing diagnosis hypothermia (00006) in the perioperative period

OBJECTIVE

to construct the conceptual and operational definitions of the defining and conceptual characteristics of the related factors of the nursing diagnosis (ND) hypothermia (00006) of NANDA-I, 2015-2017, in adult patients in the perioperative period.

METHOD

an integrative literature review in the Medical Literature Analysis and Retrieval System Online, Cochrane Library, The Cumulative Index to Nursing and Allied Health Literature and in Latin & American Literature in Health Sciences databases.

RESULTS

2,041 articles were found, 95 selected for reading in full and 24 used to construct such definitions. Gay literature was also explored to ensure robustness to the elucidation of topics not found in articles.

CONCLUSION

such definitions will assist nurses in surgical practice in information collection, in accurate determination of the referred ND, in teaching and in future research related to this theme, as well as in the next validation stages of such ND to the referred population.

USE OF THE TERMINOLOGICAL SUBSET "COMMUNITY NURSING" FOR HYPERTENSIVE AND/OR DIABETIC USERS

ABSTRACT Objective: to determine the accuracy measures of clinical indicators of nursing diagnoses contained in the Terminological Subset "Community Nursing" for hypertensive and/or diabetic users. Method: methodological diagnostic accuracy study. The study population consisted of 363 hypertensive and/or diabetic users under follow-up care in three Health Centers in the city of Campinas, from August 2017 to February 2018. Data were collected through anamnesis. Data analysis consisted of the characterization of the population through descriptive statistics, and the analysis of clinical indicators and their respective Nursing Diagnoses was performed through accuracy measures. Results: 25 Nursing diagnoses were listed, related to 37 clinical indicators, which could be used in the hypertensive and/or diabetic population. It is emphasized that three were not contained in the Terminological Subset "Community Nursing", and it is recommended that they be introduced in the International Council of Nurses. Conclusion: through the evaluation of accuracy measures, the Terminological Subset "Community Nursing" can and should be used in Brazil in the hypertensive and/or diabetic population.

DISTURBED SLEEP PATTERN (000198): CONTENT ANALYSIS IN PATIENTS WITH ACUTE CORONARY SYNDROME

ABSTRACT Objective: to analyze the content of the defining characteristics of the Disturbed Sleep Pattern Nursing Diagnosis (00198) in patients with Acute Coronary Syndrome. Method: content analysis performed by specialists who achieved a score equal to or greater than five, according to established criteria: clinical experience, teaching and/or research; participation in research groups; doctorate degree; master's degree; specialization and/or residency in cardiology and/or sleep and/or nursing classifications. Eight defining characteristics were evaluated for their relationship to population, relevance, clarity and accuracy. Descriptive statistics were performed to characterize the sample, binomial statistical test to establish if there is agreement between the experts and chi-square and Fisher's exact to establish associations between the evaluated items and the experts' variables. Results: 54 experts participated in the study. The defining characteristics validated by the experts were the following: dissatisfaction with sleep, feeling unrested, sleep deprivation, alteration in sleep pattern, unintentional awakening, difficulty initiating sleep and daytime sleepiness. There was a statistically significant association between evaluated items and the variables time of training, time of operation and punctuation. Conclusion: seven of the eight defining characteristics were considered valid after the application of binomial test. This study will contribute to the refinement of the Disturbed Sleep Pattern Nursing Diagnosis (000198) and may enable the improvement of the quality of care of patients hospitalized with Acute Coronary Syndrome regarding changes in sleep pattern. The content analysis stage will support the next stage of the validation process of the present diagnosis, the clinical validation.

ELABORAÇÃO E VALIDAÇÃO DE INSTRUMENTO DE ASSISTÊNCIA DE ENFERMAGEM PARA PACIENTES EM UNIDADES DE TERAPIA INTENSIVA

Objetivo: elaborar e validar instrumento para assistência de enfermagem, baseado em literatura específica para pacientes internados em Unidade de Terapia Intensiva, de um hospital universitário do estado de São Paulo. Método: estudo metodológico, com coleta de dados de agosto a dezembro de 2015, em três fases: caracterização da população e levantamento dos diagnósticos de enfermagem, elaboração, e validação do instrumento para o registro do Processo de Enfermagem. Para a validação de conteúdo, utilizou-se a técnica Delphi, com um grupo de especialistas na área, composto por 11 jurados. Resultados: durante a coleta de dados, 152 pacientes estiveram internados, 61,18% do sexo masculino, com idade média de 54,9 anos. O conteúdo do instrumento foi validado com índice de validação > 0,81. Conclusão: a construção de instrumentos para o processo de Enfermagem é útil para facilitar a implementação da assistência, evidenciar a assistência, incrementar a comunicação e segurança dos cuidados em saúde.

Frequência de hipotermia não intencional no perioperatório de cirurgias eletivas

Objetivo: Analisar a frequência de hipotermia não intencional em pacientes submetidos a cirurgias eletivas no período perioperatório, pontuando sua relação com o tipo de anestesia. Método: Estudo transversal, descritivo e de abordagem quantitativa, com amostra de 53 pacientes com faixa etária entre 18 e 90 anos, desenvolvido num centro cirúrgico de hospital privado da região Centro-oeste do estado de São Paulo. Resultados: O sexo feminino apareceu como variável preponderante (79,3%) e 96,3% dos pacientes avaliados apresentaram hipotermia, com variação entre leve e moderada. O número de pacientes hipotérmicos submetidos à raquianestesia foi maior quando comparado àqueles submetidos à geral, tanto na sala de operação (93,5%) quanto na sala de recuperação pós-anestésica (96,8%). Conclusão: A hipotermia é um evento comum que acomete uma grande parcela de pacientes submetidos a procedimentos anestésico-cirúrgicos, assim, torna-se imprescindível que o enfermeiro identifique precocemente sua ocorrência, a fim de oferecer uma assistência qualificada e segura a esses pacientes. 

[Hydrocycarbamide induced fever: four cases and literature review]

PURPOSE

Hydroxyurea (HU) or hydroxycarbamide is an antimetabolite chemotherapy frequently used in the treatment of chronic myeloproliferative disorders. This treatment is usually well tolerated but a few cases of fever induced by the molecule have been reported in the literature. The aim of the study was to describe the clinical and biological characteristics of HU induced fever.

METHODS

We performed a cross sectional study of patients treated with HU and followed-up in an internal medicine department between 2006 and 2012. We added our cases of HU induced fever with those reported in the literature (Pubmed and Cochrane databases) since 1981.

RESULTS

We identified 38 cases of HU induced fever, including our 4 cases. The mean age was 65±10.9 years and the sex-ratio 1/2. The fever appeared after a median duration of treatment of 21 days and was usually high (40°C) but clinically well tolerated. A biological inflammatory syndrome (CRP: 131±92 mg/L) was constant and one third of the patients also presented with hepatitis or lung disease. A probabilistic antibiotic treatment was introduced for 34% of the patients. For the half of the patients, HU-reintroduction test was performed, and was positive for all the patients but one. As soon as HU was withdrawn, the fever disappeared in a median of 24 hours.

CONCLUSION

HU induced fever is unusual. Clinical presentation is very stereotyped. When this adverse effect is suspected, an infectious disease must first be ruled out. If infection is excluded, HU has to be stopped.