Influence of overcommitment on the quality of life and on climacteric symptoms in nursing professionals.

OBJECTIVE: To describe the general characteristics of nursing professionals and assess the influence of overcommitment on perceived climacteric symptoms and on the quality of life of nursing professionals. METHOD: A cross-sectional, analytical study of 152 nursing auxiliaries and assistants aged 40 years or older was conducted at 3 hospitals in the interior of São Paulo state. Sociodemographic data were collected and the Blatt-Kupperman Menopausal Index, Women´s Health Questionnaire, Medical Outcome Study 36-item Short Form Health Survey and Effort-Reward Imbalance were applied in 2017. A descriptive analysis was performed and network analysis was carried out. RESULTS: Participants had a mean age of 50.23 years (SD ±7.1). Group 1 comprising 61 (40.1%) women with overcommitment had poorer quality of life as well as more severe climacteric symptoms. CONCLUSIONS: Presence of overcommitment seems to influence the negative perception of climacteric symptomatology and quality of life.

Influence of overcommitment on the quality of life and on climacteric symptoms in nursing professionals / Influencia del compromiso excesivo sobre la calidad de la vida y en los síntomas del climaterio de profesionales de enfermería / Influência do comprometimento excessivo na qualidade de vida e nos sintomas do climatério de profissionais da enfermagem

ABSTRACT Objective: To describe the general characteristics of nursing professionals and assess the influence of overcommitment on perceived climacteric symptoms and on the quality of life of nursing professionals. Method: A cross-sectional, analytical study of 152 nursing auxiliaries and assistants aged 40 years or older was conducted at 3 hospitals in the interior of São Paulo state. Sociodemographic data were collected and the Blatt-Kupperman Menopausal Index, Women´s Health Questionnaire, Medical Outcome Study 36-item Short Form Health Survey and Effort-Reward Imbalance were applied in 2017. A descriptive analysis was performed and network analysis was carried out. Results: Participants had a mean age of 50.23 years (SD ±7.1). Group 1 comprising 61 (40.1%) women with overcommitment had poorer quality of life as well as more severe climacteric symptoms. Conclusions: Presence of overcommitment seems to influence the negative perception of climacteric symptomatology and quality of life.

RESUMEN Objetivo: Describir las características generales de los profesionales de enfermería y evaluar cómo el compromiso excesivo puede influir en la percepción de los síntomas del climaterio y la calidad de vida de estas mujeres. Métodos: Este es un estudio analítico de corte transversal que evaluó a 152 auxiliares de enfermería y técnicas en el grupo de edad de 40 años en 3 hospitales em el interior del estado de São Paulo. En 2017, se recopilaron los datos sociodemográficos y se aplicaron el Índice de Menopausia de Blatt-Kupperman, Women´s Health Questionnaire, El Cuestionario de Salud SF-36 y El Cuestionario Effort-reward Imbalance. Análisis descriptivo y análisis de red se realizó. Resultados: La edad promedio de los participantes fue de 50,23 años (DP = ± 7,1). Grupo 1 compuesto por 61 (40.1%) mujeres con compromiso excesivo fue la peor calidad de vida y la mayor intensidad de síntomas climáticos. Conclusiones: La presencia de compromiso excesivo parece influir en una percepción negativa de la sintomatología climática y una peor calidad de vida.

RESUMO Objetivo: Descrever as características gerais das profissionais de enfermagem e avaliar como o comprometimento excessivo pode influenciar na percepção dos sintomas do climatério e na qualidade de vida dessas mulheres. Método: trata-se de estudo transversal analítico, que avaliou 152 auxiliares e técnicas da enfermagem, na faixa etária de 40 anos ou mais, em 3 hospitais do interior do estado de São Paulo. Em 2017, foram coletados dados sociodemográficos e aplicados os instrumentos Índice Menopausal de Blatt-Kupperman, Questionário Saúde da Mulher, Medical Outcome Study 36-item short form Health Survey e Effort Reward Imbalance. Foi realizada análise descritiva e análise de rede. Resultados: A idade média das participantes foi de 50,23 anos (DP = ±7,1). O grupo 1, composto por 61(40,1%) mulheres com comprometimento excessivo apresentou pior qualidade de vida e maior intensidade de sintomas climatéricos. Conclusões: Presença de comprometimento excessivo parece influenciar em uma percepção negativa da sintomatologia do climatério e em uma pior qualidade de vida.

Medication use by the elderly: analysis of prescribing, dispensing, and use in a medium-sized city in the state of São Paulo / Uso de medicamentos por idosos: análise da prescrição, dispensação e utilização num município de porte médio do estado de São Paulo

Abstract Objective: To describe the prescribing, dispensing, use, adhesion, and storage of medicines to and by the elderly. Method: A descriptive cross-sectional study was performed in Estratégia Saúde da Família (Family Health Strategy) health centers (ESF), in Marília in the state of São Paulo, Brazil, based on the records of and interviews with 114 individuals seven to ten days after a medical consultation. A descriptive analysis was carried out. Results: The mean number of prescribed drugs was 4.98 per elderly patient. Of the total number of prescribed drugs, 81.5% were supplied by public services, with the nutrient (50%); antilipemic (62.1%); analgesic (30.7%); dermo-protector (66.6%); herbal (40%) and parasite and antifungal (37.5%) classes dispensed the least. A total of 83.8% of the prescribed drugs were used, while the drugs dispensed at the lowest rates were not used by the elderly, except for analgesics. A total of 40.3% of the respondents exhibited low adherence. Most stored their medicines in a suitable place. Conclusion: The prescribing, dispensing, use and storage of medications to and by the elderly can be considered effective, but adherence remains low, requiring new strategies and interventions. AU

Resumo Objetivo: descrever a prática de prescrição, dispensação, utilização, adesão e armazenamento dos medicamentos por idosos. Método: estudo descritivo e transversal em unidades de Estratégia Saúde da Família (ESF), do município de Marília, São Paulo, Brasil, a partir da verificação dos prontuários e entrevistas com 114 idosos, após sete a dez dias da consulta médica. A análise foi realizada de forma descritiva. Resultados: a média de medicamentos prescritos foi de 4,98 por idoso. Do total dos medicamentos prescritos, 81,5% foram dispensados pelos serviços públicos, sendo, em menor proporção, as classes dos nutrientes (50%); os antilipêmicos (62,1%); os analgésicos (30,7%); os dermoprotetores (66,6%); os fitoterápicos (40%) e os antiparasitários e antifúngicos (37,5%). Dos medicamentos prescritos, 83,8% estavam sendo utilizados; sendo que os medicamentos dispensados em menor proporção também não foram utilizados pelos idosos, exceto os analgésicos. Dos entrevistados, 40,3% apresentaram comportamento de baixa adesão. A maioria armazenava os medicamentos em local apropriado. Conclusão: a prescrição, a dispensação, a utilização e o armazenamento dos medicamentos pelos idosos podem ser considerados efetivos, embora a adesão ainda seja baixa, demandando novas ações e intervenções. AU

WITHDRAWN: Conjugate vaccines for preventing meningococcal C meningitis and septicaemia.

BACKGROUND: Meningococcal polysaccharide (MPLS) vaccines protect against Serogroup C disease, but do not produce an immune response in infants less than two years of age. This limitation can be overcome by linking C polysaccharide to carrier proteins ('conjugating'), to create meningococcal serogroup C conjugate (MCC) vaccines. In the absence of trial data, the immune response to vaccination has been considered to be a reasonable surrogate for vaccine protection. OBJECTIVES: To assess the immunogenicity, safety and efficacy of MCC vaccines for preventing meningitis and septicaemia. SEARCH STRATEGY: We searched the Cochrane Central Register Controlled Trials (CENTRAL) (The Cochrane Library 2005, issue 3); MEDLINE (1966 to September, Week 1 2005); and EMBASE (1990 to June 2005) and references of studies. SELECTION CRITERIA: Randomised controlled trials (RCTs) and controlled clinical trials (CCTs) in humans comparing MCC vaccines against a control vaccine or none. In the absence of any trials on vaccine efficacy, population-based observational studies about effectiveness were included. DATA COLLECTION AND ANALYSIS: Two authors independently screened the results of the literature searches, selected eligible studies, extracted the data and evaluated the quality of them. MAIN RESULTS: The studies showed that MCC vaccine was highly immunogenic in infants after two and three doses, in toddlers after one and two doses and in older age groups after one dose. In general higher titres were generated after MCC than after MPLS vaccines. Immunological hypo-responsiveness seen after repeated doses of MPLS vaccine may be overcome with MCC. Observational studies have documented a significant decline in meningococcal C disease in countries where MCC vaccines have been widely used. The timing of the vaccinations schedules, the specific conjugate used, and the vaccines given concomitantly or combined, may be important. AUTHORS' CONCLUSIONS: The MCC vaccine appears to be safe, immunogenic and able to induce immunological memory in all age groups. Observational studies strongly suggest that MCC is clinically effective.

Quality of life of chronic renal patients on hemodialysis in Marília, SP, Brazil.

INTRODUCTION: Hemodialysis is responsible for significant alterations in the quality of life of chronic renal patients. OBJECTIVE: To compare the quality of life of patients on hemodialysis without depression (A) and those with some level of depression (B). METHODS: This was a transversal and descriptive study in which the Beck Depression Inventory (BDI) and the WHOQOL-bref scale were used. RESULTS: The studied sample consisted of 130 patients, 65.15% in A, and 33.84% in B. The highest levels of depression were related to longer periods of treatment. Quality of life indexes were better for A, and, as certain domain increased, also were the others. More differences were observed in the Psychological (A: 69.40 and B: 49.22) and Physical (A: 62.81 and B: 42.19) Domains; and the Social Relations Domain had a better average between the populations, as well as a better correlation with the other domains. CONCLUSION: Although there was a low prevalence of depression among hemodialysis patients, some investments should be made in the social, psychological and physical support aiming to improve their quality of life.

Antibiotics for treating chronic osteomyelitis in adults.

BACKGROUND: Chronic osteomyelitis is generally treated with antibiotics and surgical debridement but can persist intermittently for years with frequent therapeutic failure. Despite advances in both antibiotics and surgical treatment, the long-term recurrence rate remains at approximately 20% to 30%. OBJECTIVES: To determine the effects of different systemic antibiotic treatment regimens for treating chronic osteomyelitis in adults. SEARCH STRATEGY: We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (October 2008), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2008, Issue 3), MEDLINE (January 1966 to October 2008), EMBASE (January 1980 to October 2008), LILACS (October 2008) and reference lists of relevant articles. SELECTION CRITERIA: Randomised or quasi-randomised controlled trials addressing the effects of different antibiotic treatments given after surgical debridement for chronic osteomyelitis in adults. DATA COLLECTION AND ANALYSIS: Two authors independently screened papers for inclusion, extracted data and appraised the quality of included trials. Where appropriate, we pooled data using the fixed-effect model. MAIN RESULTS: We included eight small trials (257 participants in total, with data available from 228). Study quality was often inadequate: in particular, concealment of allocation was not confirmed and there was an absence of blinding of outcome assessment. The antibiotic regimens, duration of treatment and follow-up varied between trials. Five trials compared oral versus parenteral antibiotics. There was no statistically significant difference between the two groups in the remission rate 12 or more months after treatment (risk ratio 0.94, 95% confidence interval 0.78 to 1.13; 3 trials). Antibiotic treatment for osteomyelitis was associated with moderate or severe adverse events in 4.8% of patients allocated oral antibiotics and 15.5% patients allocated parenteral antibiotics (risk ratio: 0.40, 95% confidence interval 0.13 to 1.22; 4 trials). Single trials with very few participants found no statistical significant differences for remission or adverse events for the following three comparisons: parenteral plus oral versus parenteral only administration; two oral antibiotic regimens; and two parenteral antibiotic regimens. No trials compared different durations of antibiotic treatment for chronic osteomyelitis, or adjusted the remission rate for bacteria species or severity of disease. AUTHORS' CONCLUSIONS: Limited evidence suggests that the method of antibiotic administration (oral versus parenteral) does not affect the rate of disease remission if the bacteria are sensitive to the antibiotic used. However, this and the lack of statistically significant differences in adverse effects need confirmation. No or insufficient evidence exists for other aspects of antibiotic therapy for chronic osteomyelitis.