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  1. Article ; Online: Development and perceived usability evaluation of an interactive smartphone application for the teaching of hemodynamics and evaluation of arterial pulse pressure variation

    Orivaldo Alves Barbosa / Edgar Marçal / David Augusto Batista Sá Araújo / Lucas Severo Melo / Hermano Alexandre Lima Rocha

    BMC Medical Informatics and Decision Making, Vol 23, Iss 1, Pp 1-

    2023  Volume 9

    Abstract: Abstract Background The use of fluids is the most frequently used therapy for circulatory shock. Its inadequate use has adverse effects, requiring hemodynamic goals, highlighting the use of pulse pressure variation due to its high accuracy. One of the ... ...

    Abstract Abstract Background The use of fluids is the most frequently used therapy for circulatory shock. Its inadequate use has adverse effects, requiring hemodynamic goals, highlighting the use of pulse pressure variation due to its high accuracy. One of the problems related to this method is the difficulties in measuring the pulse pressure variation (PPV) in most monitors for clinical use. We assessed the qualitative aspects of perceived usability of a smartphone application (app), which, based on a photograph of the patient's arterial pulse wave, can help measure PPV and help in the diagnosis and management of shock cases. Methods To assess the software perceived usability, we used the System Usability Scale (SUS) applied to 30 physicians in 2 tertiary hospitals in Brazil. The software accuracy was measured using a sequence of 3 images with different values of pulse pressure variation, comparing the obtained values with the gold standard. The educational interface of the app was evaluated qualitativelyfrom the spontaneous testimonies of the selected test participants.The project was approved by the Research Ethics Committee of Centro Universitário Christus. Results The analysis showed an average SUS of 86.3 points on a scale of 1–100 (above 80.3 is considered the best in terms of interface). The assessment of the application's accuracy when evaluating pulse pressure variation showed that the average variation of the measurements taken by the participants was small, with a good measure of repeatability and reproducibility. The app's educational interface was qualitatively evaluated, being praised by the users. Conclusions It can be concluded that the developed mobile application showed excellent qualitative aspects of perceived usability results. More studies with this app will be required to evaluate the potential to help professionals with hemodynamic evaluation in emergency and intensive care settings.
    Keywords Critical care ; Mobile applications ; Hemodynamic monitoring ; Fluid responsiveness ; Computer applications to medicine. Medical informatics ; R858-859.7
    Subject code 600
    Language English
    Publishing date 2023-02-01T00:00:00Z
    Publisher BMC
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Determinants of late neonatal nosocomial infection

    Carmen Sulinete Suliano da Costa Lima / Hermano Alexandre Lima Rocha / David Augusto Batista Sá Araújo / Cláudia Silva

    Revista de Saúde Pública, Vol

    a case-control study in Ceará

    2022  Volume 56

    Abstract: ABSTRACT OBJECTIVES To assess the determining factors of late healthcare-associated infections (HAIs) and bacterial multiple drug resistance in neonatal intensive care. METHODS This is a case-control study, conducted between January 2013 and December ... ...

    Abstract ABSTRACT OBJECTIVES To assess the determining factors of late healthcare-associated infections (HAIs) and bacterial multiple drug resistance in neonatal intensive care. METHODS This is a case-control study, conducted between January 2013 and December 2017, in a neonatal intensive care unit in the state of Ceará, Brazil. Newborns showing late HAIs were considered cases and those without infection, the control. Variables with p-values ≤ 0.05 in our initial bivariate regressive analysis were included in a non-conditional hierarchical logistic model for multivariate analysis. P-values below 0.01 were considered significant. RESULTS Of the 1,132 participants, 427 (37.7%) showed late healthcare-associated infections. Of these, 54 (12.6%), positive blood cultures, of which 14.9% contained multidrug-resistant bacteria. Bivariate analysis showed the protective effect of the feminine phenotype (OR = 0.71; 95%CI: 0.56–0.90) and of gestational ages ≥ 34 weeks (OR = 0.48; 95%CI: 0.30–0.75). In earlier-born preterm infants, late infections were 18 times more likely in those with less than 30 week-gestations (OR = 18.61; 95%CI: 9.84–35.22) and four times higher in those weighing less than 1,500 g (OR = 4.18; 95%CI: 3.12–5.61). Mechanical ventilation increased infection odds by more than seven times (OR = 7.14; 95%CI: 5.26–9.09); as did parenteral nutrition (OR = 5.88; 95%CI: 4.54–7.69); central venous catheters (OR = 10.00; 95%CI: 6.66–16.66); the number of catheters used (OR = 3.93; 95%CI: 3.02–5.12); surgery (OR = 4.00; 95%CI: 2.27–7.14); and hospitalization time (OR = 1.06; 95%CI: 1.05–1.07). The association between preterm infants with less than 30 week-gestations (OR = 5.62; 95%CI: 1.83–17.28); mechanical ventilation (OR = 1.84; 95%CI: 1.26–2.68); central venous catheters (OR = 2.48; 95%CI: 1.40–4.37); and hospitalization time (OR = 1.06; 95%CI: 1.05–1.07) remained significant after adjustment. Among deaths, 41 (55.4%) were associated with late infections. CONCLUSION Better practices should be adopted in caring for the ...
    Keywords Infant ; Newborn ; Premature ; Cross Infection ; epidemiology ; Drug Resistance ; Multiple ; Bacterial ; Risk Factors ; Case-Control Studies ; Public aspects of medicine ; RA1-1270
    Subject code 610
    Language English
    Publishing date 2022-05-01T00:00:00Z
    Publisher Universidade de São Paulo
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: Prevalence and factors associated with adverse early childhood experiences

    Maria Iara Socorro Martins / Hermano Alexandre Lima Rocha / Álvaro Jorge Madeiro Leite / Sabrina Gabriele Maia Oliveira Rocha / David Augusto Batista Sá Araújo / Márcia Maria Tavares Machado / Jocileide Sales Campos / Edgar Gomes Marques Sampaio / Anamaria Cavalcante e Silva / Luciano Lima Correia

    Revista Brasileira de Epidemiologia, Vol

    a population-based study in Ceará, Brazil

    2022  Volume 25

    Abstract: ABSTRACT Objective: To estimate the prevalence of adverse childhood experiences and identify associated factors. Methods: A population-based cross-sectional study comprised data from a sample of 3,200 households with 3,566 children under 6 years of age, ... ...

    Abstract ABSTRACT Objective: To estimate the prevalence of adverse childhood experiences and identify associated factors. Methods: A population-based cross-sectional study comprised data from a sample of 3,200 households with 3,566 children under 6 years of age, representative of the state of Ceará, Brazil. A multistage sampling approach was used, with stratification among the state capital, Fortaleza, and the 28 countryside municipalities, in which 160 census tracts were randomly selected, each one with a cluster of 20 households. The outcome variable was structured based on adverse childhood experiences as suggested by the Center for Disease Control and Prevention, according to the number of situations to which the child was exposed: 0–2, 3–5, and 6–9. Ordinal logistic regression multivariate model was applied to assess associations. Results: Among the 3,566 children studied, 89.7% (95%CI 88.7–90.7) were exposed to at least one adverse experience, of which the most prevalent were neglect, and emotional/physical abuse. The main factors associated were maternal advanced age and smoking, paternal absence, low education level of the head of the family, food insecurity and lack of a social support network. Conclusion: The study found a high occurrence of adverse early childhood experiences, particularly among preschool children born to mothers of older age, solo, who smoke and in a situation of social and economic vulnerability, including food insecurity, who should be target of control and prevention measures.
    Keywords Adverse childhood experiences ; Socioeconomic factors ; Prevalence ; Brazil ; Public aspects of medicine ; RA1-1270
    Subject code 360
    Language English
    Publishing date 2022-11-01T00:00:00Z
    Publisher Associação Brasileira de Pós-Graduação em Saúde Coletiva
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: Primary Health Care during the COVID-19 pandemic in Fortaleza, Brazil

    Luciano Lima Correia / Márcia Maria Tavares Machado / David Augusto Batista Sá Araújo / Yuri Valentim Carneiro Gomes / Maria Suelly Nogueira Pinheiro / Hermano Alexandre Lima Rocha / Denise Lima Nogueira / Geziel dos Santos de Sousa / Simone Farias-Antuñez / Márcia Caldas Castro

    Revista Brasileira de Epidemiologia, Vol

    associated factors and pattern of use by mothers and children up to 18 months of age

    2022  Volume 25

    Abstract: ABSTRACT Objective: To analyze the delay or failure to seek primary health care by the mother-child dyads during the COVID-19 pandemic, a practice that has a high potential to increase maternal and child morbidity and mortality. Methods: Data from three ... ...

    Abstract ABSTRACT Objective: To analyze the delay or failure to seek primary health care by the mother-child dyads during the COVID-19 pandemic, a practice that has a high potential to increase maternal and child morbidity and mortality. Methods: Data from three survey rounds of the Iracema-COVID cohort study, collected 6, 12, and 18 months after birth, showed the patterns of postpartum attendance to primary health care consultation of the mother-child dyad. Crude and adjusted multinomial logistic regressions with robust variance were used to assess factors associated with nonattendance. Results: Among the 314 cohort mothers, 25% did not attend any primary health care consultation during the 18-months postpartum, while 30% of the mothers did all three. Regarding the child, 75% had regular primary health care consultations in all three survey rounds, while 4% did not attend any in their first 18 months of life. By the end of the first COVID-19 wave, the proportion of mother and child who attended the consultations had fallen by 23 and 18%, respectively. The main factors associated with nonattendance were mothers aged below 25 years, and mothers with more than one child. Conclusion: An important delay or nonattendance to primary health care consultation by the mother-child dyad was observed during the COVID-19 pandemic. Such practice, with a high potential to increase maternal and child morbidity and mortality, was particularly frequent among younger mothers and those with more than one child.
    Keywords Primary health care ; Maternal and child health ; Cohort study ; Epidemiologic factors ; COVID-19 ; Public aspects of medicine ; RA1-1270
    Subject code 360
    Language English
    Publishing date 2022-11-01T00:00:00Z
    Publisher Associação Brasileira de Pós-Graduação em Saúde Coletiva
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: Cohort profile

    Marcia C Castro / Márcia Maria Tavares Machado / Simone Farías-Antúnez / David Augusto Batista Sá Araújo / Ana Luiza Penna / Francisco Ariclene Oliveira / Camila Machado de Aquino / Antônio Silva Lima Neto / Geziel dos Santos de Sousa

    BMJ Open, Vol 12, Iss

    maternal and child health and parenting practices during the COVID-19 pandemic in Ceará, Brazil: birth cohort study (Iracema-COVID)

    2022  Volume 6

    Keywords Medicine ; R
    Language English
    Publishing date 2022-06-01T00:00:00Z
    Publisher BMJ Publishing Group
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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