Objective: To identify self-care actions for the maintenance of arteriovenous fistula of renal patients. Method: An integrative review study was conducted and literature were searched in Medline/PubMed, Scopus, CINAHL, LILACS, BDENF and SciELO Library databases using the descriptors chronic renal insufficiency, arteriovenous fistula, self-care, and knowledge. The inclusion criteria were that the documents be written in Portuguese, English, and Spanish, full text available, published in the last five years, and that they address the research question. Reflection articles, theses, dissertations, editorials of non-scientific journals, and research studies that did not follow the necessary methodological rigor were excluded. Data were analyzed with the IRAMUTEQ software. Results: Fifteen articles were selected and comprised the final sample. Seven classes of self-care actions emerged from the text segments analysis and grouped into three categories: 1) Self-care actions that maintain the arteriovenous fistula; 2) Self-care actions for the prevention and the monitoring of complications with arteriovenous fistula; 3) Self-care actions directed at the perioperative period of arteriovenous fistula preparation. Conclusion: The results allowed us to identify important care for the maintenance of arteriovenous fistula functionality. The self-care actions identified in this study can guide a nursing care policy for implementation with protocols that help identify problems related to self-care actions and, thus, subsidize the development of actions aimed at the renal patient. However, more studies with high levels of evidence that identify self-care actions with arteriovenous fistula and the factors involved in its implementation are needed

Ensuring sustainable consumption and production (SCP) patterns in the Asia region is a high-priority policy issue but challenged by a number of obstacles and the emergence of the coronavirus pandemic in 2020. This article argues that not only conventional policy approaches but also alternative approaches are needed in Asia to decouple socio-economic development and increases in environmental loads from people’s sense of well-being. To achieve human and planetary well-being under the situation of compressed development, four strategic courses of SCP policy are presented. These four courses are SCP policy expansion, enhanced linkage of consumption and production (CP), system transition and bottom-up approaches. Policy makers in Asia should keep these courses of action in mind and utilize opportunities, 13 of which are outlined here, to mainstream SCP. The 13 SCP opportunities, the key words of which include among others experience, genuine wealth, local design, digitalization, infrastructure, indigenous wisdom, collaboration and challenges, indicate entry points for Asian SCP policy development in the 2020s. Finally, based on these, the authors have devised an SCP case matrix and produced 43 example SCP cases for better application of the suggested SCP policy approach in the Asian region.

INTRODUCTION: The gold standard in the management of cervical incompetence is cerclage via vaginal approach. Minimally invasive techniques, such as robotic, have been also described. MATERIALS AND METHODS: A systematic search was performed in PubMed and Scopus, searching evidence on robotic assisted laparoscopic cerclage in both pregnant and non pregnant women. RESULTS: Sixty four patients were included in this study. Cervical insufficiency, failure of transvaginal cerclage and short cervix were the most frequent indications for robotic assisted cerclage. Mean operative time was 107.3 minutes. Mean estimated blood loss was 62.8 ml. Four patients converted to laparotomy. No postoperative complications were reported. Pregnancy after robotic cerclage was reported in 59 patients with mean gestational age at delivery of 36.4 weeks. The majority of pregnant women who underwent robotic assisted cerclage gave birth to live neonates. CONCLUSION: Till now evidence does not show a clear advantage of robotic over laparoscopic approach, under the evaluation of the current literature. However, further comparative studies might be essential to clarify the possible role of da Vinci(R) robot in this field, this might be quite difficult even in the near future based on the fact that only 5 cases per year are described in the current literature.