Knowledge and Perceptions of Undergraduate Nurses towards the Use of Cocaine (Smoked) in a Brazilian Context.

The aim of the study was to evaluate the perceptions and knowledge of nursing students on the identification and intervention care among users of cocaine (smoked) patients. A cross-sectional survey design was conducted with 164 undergraduate nursing students of two nursing school from Northeast of Brazil. A questionnaire on knowledge and attitudes and therapeutic commitment towards the use of cocaine (smoked) were used. The students stated that they received contents of substance misuse in the curriculum of nursing. Only 10% of the students reported that they had adequate knowledge on addiction to dealing with cocaine (smoked) users and wish to work with these users. There are positive perceptions on motivation, task specific self-esteem and work satisfaction among students.

Serum retinol concentrations in mothers and newborns at delivery in a public maternity hospital in Recife, northeast Brazil.

Serum retinol concentrations were compared in a consecutive series of 65 mother-newborn pairs at delivery in a public maternity hospital in Recife, Brazil, from January to August 2008 and examined their association with biological, socioeconomic, environmental and obstetrical characteristics. Serum retinol concentrations of the newborns (umbilical cord) and mothers (brachial venipuncture) were analyzed by high-performance liquid chromatography. Prevalence of low (< 0.70 micromol/L) and inadequate (< 1.05 micromol/L) serum retinol concentrations were observed in 23.1% (95% CI 13.9-35.5) and 23.0% (95% CI 13.5-35.8) among newborns and mothers respectively. The serum retinol distribution was lower in male than female infants (-0.4 micromol/L, p = 0.01) and, across both sexes, concentrations in paired newborn and mother were correlated (r = 0.27, p = 0.04). Further, maternal status explains only 7% of the variance in retinol concentrations in newborn's cord plasma. Among mothers delivering in public facilities in Recife, hypovitaminosis may exist.

The effect of vitamin A supplementation with 400 000 IU vs 200 000 IU on retinol concentrations in the breast milk: A randomized clinical trial.

BACKGROUND & AIMS: The vitamin A nutritional status is marginal for most of the newborns, and the prevention of that deficiency is promoted by breastfeeding. The Ministry of Health of Brazil established the National Vitamin A Supplementation Program, giving mega-doses of this nutrient to women right after delivery, in order to provide adequate vitamin A content in the breast milk and The International Vitamin A Consultative Group has supported the recommendation, to supplement with 400 000 IU of VA immediately after delivery. This study compares retinol concentrations in breast milk (colostrum, 2 and 4 months) from mothers supplemented during immediate postpartum with 400 000 IU versus 200 000 IU of vitamin A. METHODS: A randomized, controlled, triple-blind trial, conducted in two public maternities in Recife, Northeast Brazil. Two hundred and ten mothers were recruited and allocated into two treatment groups: 400 000 IU or 200 000 IU of Vitamin A and monitored for 4 months. RESULTS: There was no significant difference between retinol concentrations in breast milk between treatment groups (400 000 IU vs 200 000 IU) in the studied period: 2 months (p = 0.790) and 4 months (p = 0.279), although a progressive reduction of concentrations throughout the study was observed in both treatment groups, 400 000 IU (p < 0.0001) and 200 000 IU (p < 0.0001). CONCLUSIONS: The absence of an additional effect of a higher dosage justifies the 200 000 IU supplementation, according to the World Health Organization. Registered under ClinicalTrials.gov Identifier No. NCT00742937.

[Factors associated with excessive gestational weight gain among patients in prenatal care at a public hospital in Recife, Pernambuco, Brazil]. / Fatores associados ao ganho ponderal excessivo em gestantes atendidas em um serviço público de pré-natal na cidade de Recife, Pernambuco, Brasil.

This study assessed excessive weight gain in the second and third trimesters of pregnancy and the influence of biological, socio-demographic, behavioral, and reproductive factors and co-morbidity. The cross-sectional sample included 240 pregnant women at low risk of obstetric complications, followed from May 2000 to July 2001. There were 347 patient records in the original database, but 107 were excluded because of age (42 patients were younger than 18 years) or lack of data on weight (65 women). Excessive weight gain was common in all categories of baseline nutritional status, but was more frequent in the second trimester among women who were already overweight or obese upon entering pregnancy. In the third trimester, variables associated with excessive weekly weight gain were schooling and marital status.

Validade e Confiabilidade do Maastricht Clinical Teaching Questionnaire para Língua Portuguesa / Validity and Reliability of the Portuguese-Language Version of the Maastricht Clinical Teaching Questionnaire

RESUMO Introdução Num cenário de aprendizagem clínica, preceptores devem se comportar como mediadores entre os saberes que o estudante já tem e os que necessita adquirir, integrando a teoria e a prática no contexto da assistência ao paciente. Para isso, é necessário capacitar preceptores e desenvolver instrumentos capazes de aferir o desempenho de tais docentes. Em 2008, foi desenvolvido na Holanda o Maastricht Clinical Teaching Questionnaire (MCTQ), destinado à avaliação de preceptores pelos estudantes com o objetivo de proporcionar feedback a esses sobre suas habilidades de ensino em relação à supervisão realizada durante o estágio. A validação de um instrumento para outro idioma é de grande valia, uma vez que permite avaliar e investigar determinado fenômeno em diferentes países. Objetivo Realizar a validação do MCTQ para a língua portuguesa. Metodologia Trata-se de um estudo de validação de instrumento de pesquisa realizado em quatro hospitais do Nordeste brasileiro com a aplicação da versão adaptada para a língua portuguesa do MCTQ em uma amostra não probabilística composta por 246 estudantes de Medicina do quinto e sexto anos de quatro diferentes instituições de ensino do Estado de Pernambuco. Para avaliar a validade do construto, foi utilizado o índice Kappa. A confiabilidade foi medida por meio do Coeficiente Alfa de Cronbach padronizado. O nível de reprodutibilidade do MCTQ foi calculado pelo teste t de Student para medidas repetidas, comparando valores do teste e do reteste. A pesquisa foi aprovada no Comitê de Ética e Pesquisa da Faculdade Pernambucana de Saúde. Resultados O índice Kappa variou entre 0,527 e 0,710, e o Coeficiente Alfa de Cronbach de 0,77 a 0,954, comprovando bom grau de concordância e de consistência interna do instrumento, respectivamente. Em relação à reprodutibilidade, todos os valores de coeficiente de correlação encontrados foram significativos e de boa magnitude (≥ 0,72). Conclusão A versão em português do MCTQ mostrou-se confiável e válida para uso na língua portuguesa e pode ser útil como instrumento a promover melhorias pedagógicas nos cursos de graduação e pós-graduação, especialmente aqueles relacionados às ciências da saúde.

ABSTRACT Introduction In clinical learning scenarios, preceptors should mediate between the knowledge students already possess and the knowledge they need to acquire, integrating theory and practice into the patient care context. In order to make this possible, we must train preceptors and develop instruments for evaluating their performance as educators. In 2008, the Maastricht Clinical Teaching Questionnaire (MCTQ) was developed in the Netherlands with the purpose of enabling students to evaluate their preceptors, in order to provide preceptors with feedback regarding their teaching skills and the supervision provided by them during the internship period. Validating an instrument that has been translated is important and valuable, because it enables certain phenomena to be evaluated and investigated in different countries. Objective To validate the Portuguese-language version of the MCTQ. Methodology This is an instrument validation study, with research carried out in four different hospitals in the Northeast Region of Brazil. It applied the Portuguese-language version of the MCTQ to a non-probability sample composed of 246 fifth- and sixth-year students of Medicine from four different institutions in the state of Pernambuco. Kappa values were used to evaluate the validity of the construct, and reliability was measured using standardized Cronbach's alpha coefficient. The reproducibility level of the MCTQ was calculated using the Student's t-test for repeated measures, comparing test and re-test values. This study was approved by the Human Research Ethics Committee of the Faculdade Pernambucana de Saúde. Results The kappa index was between 0.527 and 0.71, and Cronbach's alpha coefficient was between 0.77 and 0.954, demonstrating that the instrument has good levels of agreement and internal consistency, respectively. With respect to reproducibility, all coefficient correlation values found were significant and showed good magnitude (≥0.72). Conclusion The Portuguese-language version of the MCTQ proved to be reliable and valid for use in Portuguese-language settings, and can be useful as an instrument for promoting pedagogical improvements in undergraduate and graduate courses, especially in health sciences.

The Effect of a Maternal Double Megadose of Vitamin A Supplement on Serum Levels of Retinol in Children Aged under Six Months.

Objective. To measure concentrations of serum retinol in children after the use of maternal vitamin A double megadose supplements. Design. Randomized controlled clinical trial. Setting. The study was conducted at two maternity hospitals in the city of Recife, in the northeast region of Brazil between August 2007 and June 2009. Subjects and Methods. 276 children/mothers were recruited after birth and the women received a 200,000 IU capsule of vitamin A. After ten days they were randomly assigned to two treatment groups. One group received a second 200.000 IU capsule, while the other received a placebo. The concentrations of retinol in the serum of the children from each group were measured at 2, 4, and 6 months. Results. 173 children completed the study. There was no difference between the two treatment groups (P = 0.514). The mean base retinol level was lower than that at four and six months (P < 0.001). Conclusions. The maternal double megadose supplement had no additional effect on the serum retinol levels of the children, although concentrations of retinol in the children rose in the first six months of life. This trial is registered with NCT00742937.

Surgical infection in a videolaparoscopic cholecystectomy when using peracetic acid for the sterilization of instruments.

OBJECTIVE: To determine the frequency of surgical site infection in patients undergoing laparoscopic cholecystectomy with instruments sterilized by peracetic acid. METHODS: We conducted a retrospective, cohort, descriptive, cross-sectional study. Peracetic acid has been used for sterilization following the protocol recommended by the manufacturer. We observed the criteria and indicators of process and structure for preventing surgical site infection pre and intraoperatively. For epidemiological surveillance, outpatient visits were scheduled for the 15th and between the 30th and 45th days after discharge. RESULTS: Among the 247 patients, there were two cases of surgical site infection (0.8%). One patient was readmitted to systemic antibiotic therapy and percutaneous puncture; in the other the infection was superficial and followed at the clinic. CONCLUSION: Ethical issues prevent the conduction of a prospective study because of peracetic acid have been banned for the sterilization of instruments that penetrate organs and cavities. Nevertheless, these results encourage prospective case-control studies comparing its use (historical control) with ethylene oxide sterilization.

Opinião dos enfermeiros sobre educação permanente em um hospital público / Opinion of nurses on permanent education in a public hospital / Opinion de infermeros sobre la educación permanente en un hospital público

Objetivo: analisar a opinião dos enfermeiros sobre um programa de educação permanente, identificando motivos que interferem na adesão. Método: estudo descritivo transversal com 152 enfermeiros em um hospital público de Pernambuco. Aplicou-se um questionário com 25 perguntas, pós autorização pelo Comitê de Ética e Pesquisa da Faculdade Pernambucana de Saúde nº 02-2012. Resultados: os entrevistados concordaram que a educação permanente aprimora a formação profissional. A maioria dos participantes aprecia a metodologia e aprova as três modalidades do programa: em sala de simulação prática; in loco; e reunião clínica. Conclusão: constatou-se ser fundamental considerar a opinião dos enfermeiros que relatam sobrecarga de trabalho após participar das atividades de capacitação e que preferem ser consultados previamente quanto aos temas oferecidos. Reconhecer e valorizar as sugestões dos profissionais mostra-se relevante para adotar medidas voltadas a aumentar a efetiva adesão ao programa.(AU)

Objective: to analyze the opinions of nurses on a permanent education program, identifying reasons that influence adherence. Method: cross-sectional study with 152 nurses in a public hospital in Pernambuco. We applied a questionnaire with 25 questions, after authorization by the Ethics and Research Committee of the Pernambuco Faculty of Health under No. 02-2012. Results: respondents agreed that lifelong learning improves formation professional. The majority of participants appreciate the methodology and approves three types of program: in practice simulation room; on the spot; and clinical meeting. Conclusion: it was found to be essential to consider the opinion of nurses reporting workload after participating in training activities and who prefer to be consulted in advance about the subjects offered. Recognize and value the professional advice shows up relevant for to adopt measures aimed at increasing the effective entry into the program.(AU)

Objetivo: analizar la opinión de los enfermeros sobre un programa de educación permanente, identificando motivos que interfieren en la adhesión. Método: estudio descriptivo transversal con 152 enfermeros en un hospital público de Pernambuco. Aplico se un cuestionario con 25 preguntas, después autorización del Comité de Ética y Pesquisa de la Facultad Pernambucana de Salud nº 02-2012. Resultados: los entrevistados concordaron que la educación permanente primara la formación profesional. La mayoría de los participantes aprecia la metodología e aprobó las tres modalidades del programa: en sala de simulación práctica; in loco; y reunión clínica. Conclusión: constató-se ser fundamental considerar la opinión de los enfermeros que relaten sobrecarga de trabajo después participar en las actividades de capacitación y que prefieren ser consultados previamente sobre los temas ofrecidos. Retoñecer y valorizar las sugestiones de los provisionáis muestra-se relevante para adoptar medidas volteadas a aumentar la adhesión efectiva al programa.(AU)

Elaboração e validação do protocolo assistencial de enfermagem para sala de pré-parto, parto e pós-parto / Creation and validation of a nursing assistance protocol for the prenatal, delivery and recovery room

Objetivou-se desenvolver e validar um protocolo assistencial para os cuidados de enfermagem em sala de pré-parto, parto e pós-parto (PPP) do Instituto de Medicina Integral Prof. Fernando Figueira ­ IMIP por meio de uma pesquisa metodológica desenvolvida em três etapas: revisão integrativa da literatura, construção do protocolo assistencial e validação do material com 26 especialistas. O protocolo foi elaborado baseando-se em 25 referências e validado com Índice de Validade do Conteúdo Geral (IVC) de 0,96; IVC dos objetivos variando entre 0,96 e 1,00; IVC do conteúdo entre 0,92 e 1,00 e IVCda relevância de 0,96. O protocolo foi estruturado com qualidade para guiar enfermeiros, residentes e acadêmicos de enfermagem na assistência à parturiente e indica-se, portanto, a sua utilização

Our objective was to develop and validate an assistance protocol for nursing care in a prenatal, delivery and recovery room (PDR) from the Institute of Integral Medicine Prof. Fernando Figueira ­ IMIP. We used a methodologic study developed in three steps: an integrative review of the literature, construction of the assistance protocol and validation of the material using 26 specialists. The protocol was created based on 25 references and validated with the Index for General Content Validation (IVC) of 0.96; the objectives IVC varied from 0.96 to 1.00; content IVC ranged from 0.92 to 1.00 and, relevance IVC was 0.96. The protocol was structured with quality to guide nurses, resident students and nursing academics in assisting the parturient, therefore, we indicate its use

Infecção cirúrgica em colecistectomia videolaparoscópica usando ácido peracético como esterilizante dos instrumentais / Surgical infection in a videolaparoscopic colecistectomy when using peracetic acid for the sterilization of instruments

OBJETIVO: Determinar a frequência de infecção de sítio cirúrgico em pacientes submetidos à colecistectomia videolaparoscópica usando o ácido peracético como esterilizante. MÉTODOS: Foi realizado estudo retrospectivo descritivo do tipo coorte transversal. O ácido peracético foi usado para esterilização seguindo protocolo preconizado pelo fabricante. Foram observados os critérios e indicadores de processo e estrutura para prevenção de infecção de sítio cirúrgico no pré e intraoperatório. Para a vigilância epidemiológica, consultas ambulatoriais eram agendadas para o 15º e entre o 30º e 45º dias após a alta. RESULTADOS: Entre 247 pacientes foram diagnosticados dois casos de infecção de sítio cirúrgico (0,8%). Um paciente reinternou para antibioticoterapia sistêmica e punção percutânea; no outro, a infecção foi superficial e acompanhada ambulatorialmente. CONCLUSÃO: Eticamente não é permitida a realização de um estudo prospectivo pelo fato do ácido peracético ter sido proibido para a esterilização de instrumentais que penetrem em órgãos e cavidades; contudo, estes resultados encorajam estudo prospectivo caso-controle, comparando o uso dele (controle histórico) com a esterilização por óxido de etileno.

OBJECTIVE: To determine the frequency of surgical site infection in patients undergoing laparoscopic cholecystectomy with instruments sterilized by peracetic acid. METHODS: We conducted a retrospective, cohort, descriptive, cross-sectional study. Peracetic acid has been used for sterilization following the protocol recommended by the manufacturer. We observed the criteria and indicators of process and structure for preventing surgical site infection pre and intraoperatively. For epidemiological surveillance, outpatient visits were scheduled for the 15th and between the 30th and 45th days after discharge. RESULTS: Among the 247 patients, there were two cases of surgical site infection (0.8%). One patient was readmitted to systemic antibiotic therapy and percutaneous puncture; in the other the infection was superficial and followed at the clinic. CONCLUSION: Ethical issues prevent the conduction of a prospective study because of peracetic acid have been banned for the sterilization of instruments that penetrate organs and cavities. Nevertheless, these results encourage prospective case-control studies comparing its use (historical control) with ethylene oxide sterilization.

Fatores associados ao ganho ponderal excessivo em gestantes atendidas em um serviço público de pré-natal na cidade de Recife, Pernambuco, Brasil / Factors associated with excessive gestational weight gain among patients in prenatal care at a public hospital in Recife, Pernambuco, Brazil

Este estudo teve como objetivo avaliar a evolução do ganho ponderal excessivo durante o segundo e o terceiro trimestre da gestação e a influência de fatores biológicos, sócio-demográficos, comportamentais, reprodutivos e morbidades associadas a este ganho. Foi realizado um estudo descritivo com dados de 240 gestantes de baixo risco obstétrico coletadas para um ensaio clínico sobre tratamento de anemia no período de maio de 2000 a julho de 2001. O banco de dados original continha 347 registros, porém foram excluídas 107, sendo 42 por idade menor que 18 anos e 65 por falta de registro dos pesos das gestantes nos prontuários até o final do pré-natal. Foi observado elevado percentual de ganho de peso semanal excessivo em todas as categorias de peso inicial, embora, no segundo trimestre, o ganho de peso tenha sido significativamente maior naquelas que já iniciaram a gestação com sobrepeso/obesidade. No terceiro trimestre, as variáveis que apresentaram associação significante com o ganho de peso semanal excessivo foram a escolaridade materna e a situação marital.

This study assessed excessive weight gain in the second and third trimesters of pregnancy and the influence of biological, socio-demographic, behavioral, and reproductive factors and co-morbidity. The cross-sectional sample included 240 pregnant women at low risk of obstetric complications, followed from May 2000 to July 2001. There were 347 patient records in the original database, but 107 were excluded because of age (42 patients were younger than 18 years) or lack of data on weight (65 women). Excessive weight gain was common in all categories of baseline nutritional status, but was more frequent in the second trimester among women who were already overweight or obese upon entering pregnancy. In the third trimester, variables associated with excessive weekly weight gain were schooling and marital status.