Richardson Augusto Rosendo da Silva

Background: Childhood and adolescent cancer has substantial social relevance due to premature mortality, years of potential life lost, and its consequences for children, adolescents, families, and society. Cancer treatment can result in a high symptom burden, particularly nausea and vomiting, for which antiemetic prophylaxis is the main preventive and therapeutic strategy. However, these symptoms remain frequent and clinically relevant, highlighting the need for complementary approaches to broaden symptom management options. In this context, aromatherapy has been investigated as a non-pharmacological adjunctive intervention. Objective: This systematic review aims to synthesize the available evidence on the use of aromatherapy for managing nausea and vomiting in patients aged 0-21 years with cancer. Methods: Eligibility criteria were defined according to the PICOS framework: Population - patients aged 0-21 years with cancer; Intervention - aromatherapy; Comparator - conventional treatment, placebo, no intervention, or other complementary therapies; Outcomes - frequency, duration, and intensity of nausea and vomiting; Study design - randomized controlled trials. Searches were conducted in PubMed/MEDLINE, Scopus, Web of Science, Embase, LILACS, and ProQuest Dissertations & Theses Global on September 10, 2026.

Objective: To clinically validate the nursing diagnosis “Risk for shock” in patients with acute myocardial infarction (AMI) admitted to an Intensive Care Unit (ICU). Method: A retrospective case-control study conducted at a high-complexity university hospital in Brazil. The sample consisted of 116 medical records of adult patients with AMI, equally distributed between the case group (with cardiogenic shock; n = 58) and the control group (without cardiogenic shock; n = 58). Diagnostic accuracy measures (sensitivity, specificity, predictive values, and likelihood ratios) were calculated, and multivariate binary logistic regression using the Stepwise Forward method was applied to identify independent predictors and control for confounders. Results: In the accuracy analysis, the indicator “Unstable blood pressure” showed the best clinical balance, with a sensitivity of 85.0% (95% CI: 76.2–93.8) and a specificity of 83.6% (95% CI: 74.4–92.8). “Hyperthermia” and “Inadequate fluid volume” showed the highest individual specificities (90.1% and 80.3%, respectively). After adjusting the logistic regression model (Nagelkerke R ² = 0.614; Hosmer-Lemeshow p = 0.782), only four factors remained significant as independent predictors of the outcome: unstable blood pressure (aOR = 7.80; 95% CI: 3.10–19.60; p < 0.001), hypoxia (aOR = 3.70; 95% CI: 1.50–9.20; p = 0.006), hypoxemia (aOR = 2.90; 95% CI: 1.40–6.10; p = 0.004), and inadequate fluid volume (aOR = 2.10; 95% CI: 1.00–4.50; p = 0.048). Thermal and hemorrhagic indicators lost significance after adjustment. Conclusion: The study clinically validated the diagnosis and confirmed a robust predictive model composed of four indicators. Prioritizing the monitoring of these risk factors enables critical care nurses to anticipate hemodynamic collapse, support targeted care protocols, and optimize multiprofessional decision-making at the bedside.

Objective: To analyze the association between income inequality and age-standardized mortality from diabetes mellitus and hypertensive diseases among adults aged 30–69 across Brazilian Federative Units (2012–2024). Methods: Ecological longitudinal study using balanced panel data from the 27 Federative Units. Data were retrieved from the Mortality Information System and IBGE/IPEA databases. Mortality rates were standardized using the direct method (WHO population). Trends were evaluated via Joinpoint regression, and associations were analyzed using mixed linear models with random intercepts and first-order autoregressive covariance structure. Results: Inequality decreased in 25 Federative Units, accompanied by rising income and declining poverty, whereas national aggregated analysis showed a linear increase in inequality (APC = 0.514%; p < 0.001). Overall mortality trends were stationary for diabetes (AAPC = −1.507%; p = 0.102) and hypertension (AAPC = −0.881%; p = 0.524), despite significant declines from 2021 to 2024. In adjusted mixed models, higher per capita household income was independently associated with lower diabetes mortality (β = −0.012; p = 0.031), while hypertension displayed an upward adjusted linear trend (β = 0.289; p = 0.001). Neither the Gini Index nor poverty rates maintained significant independent associations with mortality. Conclusions: After structural adjustment, only absolute per capita household income maintained an independent protective association with diabetes mortality, highlighting the relevance of material living conditions beyond inequality measures alone.

Objective: To validate the NANDA-I nursing diagnosis “Risk for Shock” through content analysis and expert evaluation. Methods: This is a methodological study with a quantitative approach, conducted in two phases: (1) theoretical-causal validation of the nursing diagnosis Risk for Shock in individuals with acute myocardial infarction (AMI), and (2) content validation performed by subject-matter experts was conducted between March and September 2024, involving two rounds of expert assessment based on predefined criteria of expertise. The Delphi technique and the Content Validity Index (CVI) were employed, with a cutoff point of ≥0.80. The definitions, defining characteristics, risk factors, and at-risk populations related to the diagnosis were analyzed. Results: A total of 62 experts participated in the first round and 51 in the second, predominantly female, with high academic qualifications and substantial experience in intensive care, cardiology, and the nursing process. In the first round, most indicators reached a CVI ≥ 0.80, except for some risk factors that were subsequently revised. In the second round, all diagnostic elements achieved consensus and satisfactory CVI, consolidating the validated diagnostic proposal. Conclusion: The nursing diagnosis “Risk for Shock” was validated in terms of content, presenting refined definitions and indicators for clinical practice, thereby contributing to diagnostic accuracy and patient safety.

BackgroundTuberculosis remains a major public health problem, strongly associated with social inequalities and further exacerbated by the COVID-19 pandemic.ObjectiveThis study aimed to analyze the temporal trends in tuberculosis incidence and mortality in Brazil from 2007 to 2024 (incidence) and from 2007 to 2023 (mortality), considering sociodemographic variables.MethodsThis ecological time-series study employed a quantitative approach using secondary data obtained from the Notifiable Diseases Information System and the Mortality Information System. Rates were calculated per 100,000 inhabitants and stratified by sex, age group, race/skin color, and geographic regions. Trend analysis was performed using Prais-Winsten regression, with estimation of annual percentage change (APC) and 95% confidence intervals (95% CI).ResultsA total of 1,646,366 tuberculosis cases and 81,469 deaths were recorded during the study period. An increasing trend in incidence was observed (APC: 1.43%; 95% CI: 0.52–2.35), with an inflection point identified in 2021, followed by a significant rise in rates in the post-pandemic period (APC: 7.50%; 95% CI: 1.83–14.37). For mortality, an inflection point was identified in 2020, with a significant increase after the onset of the pandemic (APC: 10.53%; 95% CI: 7.28–16.51). Moreover, a more pronounced increase in incidence was observed among men (APC: 1.82%), adults (APC: 1.39%), older adults (APC: 2.90%), and Black (APC: 2.12%) and Brown individuals (APC: 3.50%). Among the geographic regions, the North region showed the highest increase (APC: 3.74%). Overall mortality remained stable; however, increases were observed among older adults (APC: 1.74%), Brown (APC: 2.40%) and Indigenous individuals (APC: 2.10%), as well as in the North, South, and Central-West regions.ConclusionTuberculosis incidence in Brazil shows an increasing trend, marked by important sociodemographic and regional inequalities, while overall mortality remains stable despite increases in specific population groups. These findings highlight the urgent need for public health policies targeted at the most vulnerable populations and regions experiencing the greatest growth in disease burden.

Advances in antiretroviral therapy have transformed infection with HIV into a manageable chronic disease, increasing the survival of people living with HIV, who are also undergoing a demographic aging process marked by the emergence of non-communicable chronic diseases. This study aims to map and analyze how the scientific literature addresses the organization and integration of care in the HIV-NCD syndemic, identifying implications for nursing and for health systems. This is a Rapid Scoping Review, using the databases PubMed, Scopus, CINAHL, and LILACS. Data synthesis was conducted using Microsoft Excel. The research was structured using the PCC framework: Population—people living with HIV (≥18 years); Concept—organization and integration of care in the HIV-NCD syndemic, including care models, care coordination, service integration, and the role of nursing; and Context—health services and systems. Twenty-three studies were included, most of which used qualitative methodology, were conducted in sub-Saharan Africa, and had predominantly female samples. This study demonstrated that the organization of care in the HIV-NCD syndemic remains predominantly characterized by fragmented models, which are insufficient to address the complexity of multimorbidity. Integrated care models emerge as a promising strategy; however, their effects remain limited in settings marked by health inequalities.

Pressure injuries remain highly prevalent in hospital and home settings, particularly among elderly patients, intensive care unit patients, and individuals with impaired mobility, generating significant healthcare and economic impacts. Although low-level laser therapy has been explored as an adjunctive therapy to accelerate healing, few validated protocols exist to guide its systematic application in clinical nursing practice. This methodological study aimed to develop and validate a nursing care protocol for low-level laser therapy in stage 1 pressure injuries, conducted in three stages: integrative literature review, protocol development, and content validation using the Delphi technique with specialist nurses selected via the Lattes Platform. Judges evaluated the protocol using a five-point Likert scale, and validity was assessed by the Content Validity Index (CVI) and Cronbach’s alpha, both with minimum acceptable values of 0.80. The integrative review identified four studies supporting low-level laser therapy efficacy, informing the protocol’s technical parameters. Thirty-one specialists participated in the first Delphi round and 25 in the second, achieving a Global CVI of 0.915 and Cronbach’s alpha of 0.91, with all items reaching consensus. The validated protocol demonstrated satisfactory content validity and internal consistency, supporting its clinical applicability and potential to standardize nursing practice and reinforce patient safety. Although the protocol demonstrated satisfactory methodological validity, further clinical studies are needed to assess feasibility, implementation, and effectiveness in routine nursing care.

Objectives: This study aimed to analyze evidence of content validity of the related factors (RFs) of the nursing diagnosis (ND) “ineffective health self-management” in people living with the human immunodeficiency virus (HIV). Methods: It is a methodological study carried out between April/2022 and May/2023 in three stages: scoping review aimed at the RFs of the ND “ineffective health self-management” for people living with HIV (PLHIV); elaboration of conceptual definitions (CDs) and operational definitions (ODs) of the RFs and proposition of new RFs for the ND studied; and content validation of the constructed definitions of the RFs. A sample of 31 expert nurses was selected for content validation. A binomial test was used, with a significance level of 5%, p < 0.05, and a percentage of 85% in the attribution of definitions considered adequate. The content validity index (CVI) was calculated, and when ≥ 0.80, they were considered relevant. Results: Three new RFs were proposed as components of the diagnosis, adding to the 30 already included in the NANDA-I version (2021–2023). Expert nurses analyzed these components, and all 33 RFs were considered adequate (>85%). All 33 CDs and 33 ODs were validated with CVI ≥ 0.80. Conclusions: In addition to constructing and validating definitions for the 30 existing RFs, this study identified and validated three new proposed RFs of the diagnosis “ineffective health self-management”: (1) unrealistic perception of vulnerability to other diseases and health problems; (2) chemical dependency and escape from reality; and (3) lack of structuring of health services and inefficiency of public policies for PLHIV. Implications for nursing: The content analysis of the diagnosis “ineffective health self-management” contributes to nursing as a science and provides specific knowledge for building the care plan, in addition to bringing professionals closer to the specific terminologies of the profession.

Objective: To analyze the concept of risk for shock in patients with acute myocardial infarction in the intensive care unit. Method: A methodological study conducted through a concept analysis operationalized via a scoping review. The following databases were searched: Web of Science, Science Direct, LILACS, PubMed, CINAHL, Scopus, and Google Scholar. The search strategy combined controlled descriptors (MeSH/DeCS) and uncontrolled vocabulary (synonyms and variations). The sample consisted of 30 studies. The analysis evaluated the attributes and antecedents of the concept “Risk for shock in patients with acute myocardial infarction in the intensive care unit.” Results: Based on the analysis of attributes and antecedents, it was possible to construct the following definition of the concept of interest: the vulnerability of patients admitted to an intensive care unit with acute myocardial infarction to develop severe hemodynamic instability, characterized by early signs of tissue hypoperfusion and circulatory compromise. Conclusion: The conceptual analysis of the term “risk for shock” regarding patients with acute myocardial infarction in the intensive care unit broadens the understanding of nursing phenomena in this population and, consequently, supports nursing actions in clinical practice.

RESUMO Objetivos: descrever uma proposta de método para validação clínica de subconjuntos terminológicos da Classificação Internacional para a Prática de Enfermagem (CIPE®), aplicável a cenários hospitalares. Métodos: trata-se de um estudo descritivo que propõe estratégias metodológicas para validação clínica de subconjuntos, incorporando aplicação prática em cenários reais de cuidado, avaliação por juízes clínicos e testes estatísticos de concordância. Resultados: o método é composto por cinco etapas: (1) Aplicação do Processo de Enfermagem, com foco na coleta sistematizada de dados clínicos; (2) Construção de estudos de caso clínico; (3) Validação clínica dos enunciados da CIPE®, realizada por juízes clínicos enfermeiros; (4) Avaliação da concordância entre juízes, utilizando-se estatística robusta; e (5) Síntese dos achados e refinamento do subconjunto terminológico. Conclusões: o método pode ser replicado em diferentes contextos clínicos, fortalecendo a cientificidade e a visibilidade da prática de enfermagem.