Cockroaches as carriers of fungi of medical importance.

The fungal pathogenic flora of the external surface of 103 cockroaches (Periplaneta americana) collected from the intensive care unit of a hospital were investigated. In this study, a high percentage of test cockroaches (93.2%) were found to carry fungi of medical importance. The main fungi isolated were species of Candida, Aspergillus and Penicillium. Information about the carriage of pathogenic fungi by cockroaches in hospital environment is scanty. The results suggest that cockroaches can play a role in dissemination of fungi, which they can carry on their external surface.

[Changes in life-style, needs and difficulties faced by caregivers of AIDS patients in home care]. / Alterações no estilo de vida, necessidades e dificuldades enfrentadas pelos cuidadores de portadores de AIDS, no âmbito do domicílio.

This study aimed at delineating the social and demographic profile of 17 home caregivers for AIDS patients, identifying the alterations occurring in their life style and detecting the main needs and doubts presented by them when assisting a person living with AIDS at home, as well as the difficulties stemming from the disease and the care given by them. We identified that the introduction of HIV/AIDS within the family generates a crisis situation and awakens many negative feelings in caretakers. An alteration in life routine takes place and there is also an overload of tasks to be carried out. The main difficulties of caretakers are related to taking care of the patient at home in addition to financial and emotional difficulties. We have shown the need for more effective orientation as to protection measure while caring for the patient. We have also pointed out the importance of orientation and educational actions to be given by health professionals, during which nurses' participation in home assistance/visits is essential.

[Sexual problems experienced by women in HIV-1 crisis]. / Dificuldade sexual vivenciada por mulheres em crise de HIV-1.

This descriptive study was based on the assumptions of qualitative investigation methods and on the Crisis Theory formulated by CAPLAN (1966). The objective of the study was to identify the sexual problems experienced by women undergoing an HIV-1 crisis. Data were collected through a semi-structured interview recorded by the method of FREITAS et al. (1992) and analyzed by the method of MEIHY (1996). Authors concluded that these women maintained themselves unbalanced using negative coping mechanisms. Thus, authors believe that it would be possible to help them using adequate nursing actions such as educational and guidance actions, but mainly by actions directed to the needs of patients undergoing an HIV-1 crisis.

[Human sexuality in nursing education]. / Sexualidade humana na formação do enfermeiro.

A questionnaire was applied to undergraduate nursing students in order to verify the ideas on the sexuality theme they had absorbed from the notions they received in their nursing undergraduate program. Results showed that most of these students have slightly, limited and unbased notions concerning human sexuality. They also use the terms sex and sexuality as if they were synonyms. Therefore, authors concluded that these students need to acquire knowledge about sexuality and some professional situations experienced are also mentioned. They also discussed the type of knowledge received and which courses approach it during the program.

[General aspects of the sexuality of patients with pulmonary tuberculosis, cared for at basic health units in Ribeirão Preto-SP]. / Aspectos gerais de sexualidade dos portadores de tuberculose pulmonar atendidos em unidades básicas de saúde de Ribeirão Preto-SP.

This descriptive study was carried out in order to identify and analysing the knowledge that the patients with pulmonary tuberculosis have about the disease and the experiences which they have passed through; to identify some aspects related to their sexuality's changing after acquiring the pulmonary tuberculosis and characterizing the living experiences toward their family, the friends'/relatives' reactions and the emerging feelings. Fifty sexually active patients were interviewed. The results showed that 15 (30.0%) patients with pulmonary tuberculosis did not have any knowledge about the disease and 32 (64.0%) did not know how to prevent it. Among the fifty patients interviewed, 29 (58.0%) have realized negative reactions. The pulmonary tuberculosis do not interferes directly only in these sexual and social people's lives, but also in their partners social lives. This fact has been contributing in order to decrease their sexual relations often.

[Changes in professional practice of nurses at a teaching hospital in the inner Sao Paulo, as a result of the emergence of HIV/AIDS]. / Alterações na prática profissional de enfermeiros de um hospital de ensino do interior paulista, em consequéncia ao surgimento do HIV/AIDS.

This investigation was conducted with the purpose of identifying the changes in the professional practice of nurses at a public teaching hospital as a result of the arrival of HIV/AIDS. Through interviews with 100 nurses it was found that 76 (76%) referred changes in their professional practice. Of these, 52 (68.4%) referred to the use of garments; 17 (22.3%) to continuing education; and 7 (9.2%) to nursing care. Of a total of 76 reasons presented by the nurses, 46 (60.5%) were related to fear of becoming infected; and 30 (39.5%) related to nursing care. The study revealed that the advent of HIV/AIDS has risen various changes in practical activities of nurses, especially in those related to garments, having as the main concern the fear of becoming infected. Continuing education programs that aim not only to identify the causes that determine low adherence to standard precaution measures and undesirable behavior as well as biosafety surveillance are needed.

[Biosafety: scientific production in nursing]. / Biossegurança: a produção científica em enfermagem.

The aim of this study was to investigate thematic approach and methodological focuses used in researches about biosafety, as well as the qualification of the authors of papers published in Brazilian Nursing periodicals. The publications were classified according to the main subject, as follows: worker's health; patient's health; and environment. The results showed that in a 65 years period (1932-1997) a total of 224 studies about biosafety were published, 76 were articles and conferences; 148 scientific articles, monographs and thesis. There was a predominance of articles about worker's and patient's health. Most of the studies were descriptive researches and were published by nurses of the Southeast area of the country. The majority of the authors were teachers with a Master or Doctorate degree.

[Understanding the sexuality of HVI-1 carriers]. / Compreendendo a sexualidade de indivíduos portadores de HIV-1.

The objective of the present investigation was to identify the sexual difficulties experienced by persons in an HIV-1 crisis. This is a study of a descriptive nature based on the Theory of Crisis. The sample consisted of 5 patients with HIV-1 followed up clinically in a town in the hinterland of the state of São Paulo. Semistructured interviews were tape recorded and transcribed. Data were analyzed according to MEIHY (1996) and BARDIN (1994). We conclude that the subjects presented a negative adaptation with respect to sexual, social and emotional difficulties. The results indicate the need for effective nursing interventions with persons in an HIV-1 crisis.

[Evaluation by HIV/AIDS specialists of risk of HIV infection in university students, based on different sex practices]. / Avaliação dos riscos da infecção pelo HIV segundo diferentes práticas sexuais na perspectiva de estudantes universitários e especialistas em HIV/AIDS.

To detect the beliefs concerning the risk levels related to several sexual practices/habits and the HIV infection among undergraduate students and to compare their opinion with the AIDS experts were the objectives of this study. A 25-item questionnaire (Likert Probability Scale) about sexual practices/habits were answered by undergraduate students enrolled in the courses of nursing, medical school, pharmacy-biochemistry, psychology. Based on Factorial analysis and by using the Varimax Rotation System, 25 patients were distributed in 7 factors, and 5 patients were excluded. From the 20 patients, 5 were reunited in 2 factors and studied in this paper. Factor X reunited the patients 1 (vaginal intercourse with condom) and 2 (anal sex with condom). In factor Y the patients included were: 3 (heterosexual intercourse), 4 (vaginal intercourse without condom) and 5 (anal intercourse without condom). In 80% of the 5 patients, it was observed that the students have knowledge similar to the experts"s evidences But, continuing education is necessary to these people, as human beings and as future health care givers to the HIV infected/AIDS patients.

[Preventive measures against AIDS and other sexually transmitted diseases known by students in the health field]. / Medidas preventivas contra a AIDS e outras doenças sexualmente transmissíveis conhecidas por universitários da área de saúde.

This study was carried out in to identify the preventive measures against Aids and other Sexually Transmitted Diseases (STD) that undergraduate health students predominantly know and to identify if there is a significant difference among the measures mentioned, considering the sex of subjects studied. A questionnaire was answered by health undergraduate students randomly selected. The results show that most of the items mentioned as preventive for Aids and other STD are important measures for their prevention. However, when data are analysed considering the frequency, that is the number of students that mentioned correct measures, we can observe that it is less than it was expected, what is very worrying. Another point observed in the results is that, there was no statistical difference, according to the sex of subjects studied. Data analysis evidence that knowledge of most undergraduate students is not enough, reinforcing the need to implement continuous specific educational actions.

[Motivational profile of nurses working in a general hospital in the state of São Paulo]. / Perfil motivacional do enfermeiro atuante em um hospital geral do interior paulista.

The present study aimed at identifying the motivational profile of nurses who work in a public general hospital as well as at finding out the motivations that lead nurse in their work and correlating attitudes and beliefs verified in the responses of the subjects to work and their motivations. Data were collected through three instruments, two of them were scales of Likert type (MOSE e ACTRA) and one questionnaire with data to characterize the sample that was formed by 184 nurses. Results enabled the author to delineate a motivational profile based on the three social motivations and conclude that the majority of nurses studied are working in order to overcome the underdevelopment.

[Knowledge about AIDS and changes in professional practice by manicurists from Ribeirão Preto]. / Conhecimentos sobre AIDS e alterações nas ações profissionais das manicures de Ribeirão Preto.

This study was carried out to evaluate the knowledge of Ribeirão Preto manicurists concerning the general features of AIDS and the changes occurred in their professional procted in consequence to this syndrome. A total of 40 manicurists form Ribeirão Preto-SP were selected, through the telephone number guide and by considering the manicurists indications. The data were collected through individual interview, based on a structured form. The results showed that some professionals have incorrect knowledge about basic notions related to HIV/AIDS (transmission/prevention). We emphasize that sterilization methods used by all of them are not efficient to inactivate HIV.

[The nursing team and occupational accidents with potentially contaminated material in the era of HIV]. / A enfermagem frente a acidentes de trabalho com material potencialmente contaminado na era do HIV.

This investigation was carried out in order to: identify the occurrence of professional accidents with perforate cutting potentially contaminated material among nurses and nursing auxiliaries that work in a general teaching hospital in the interior of the state of São Paulo. The other objectives were: to associate the occurrence of accident with the professional category and period of work; to identify the type of perforate cutting material most involved in accidents, to identify the attitudes taken by the person accidented. The data were collected on individual interview based on a structured formulary in which the following information was registered: the probable reason of accident, how long the professional has been working on such function, the material involved in the accident, the actions taken after the accident. It was evidenced that the Standard Precautions or the Universal Precautions as they used used to be nominated are not being used as they should be. Such attitude brings risks to the nursing team. We think that this team needs specific orientations through continuing education concerning the theme.

[Information and education on sexually transmitted diseases, AIDS and human sexuality--a case report after 14 years of experience]. / Informação/educação em DST/AIDS/sexualidade humana--um relato de experiência de 14 anos.

The authors present their 14-year experience about Information/education on sexually transmitted diseases/Aids and human sexuality. They describe the actions implemented, emphasizing the positive and negative points. Concerning the positive results they mention the divulgation of information about preventive measures against HIV infection/Aids, Sexually Transmitted Diseases and human sexuality to several people from scientific and non scientific community. Another positive point is the transmission of knowledge gotten in such experiences at undergraduation and graduation teaching, as well as the development of research. Concerning the negative aspects, the difficult to evaluate the information actions, specially lectures was perceived, mainly because it is a communication tool basically unilateral. The authors mention some facts that historically influenced the implementation of the official actions.

[Hospital infections in teaching hospitals: analysis of their control]. / Infecção hospitalar nos hospitais escola: uma análise sobre seu controle.

The purpose of this study is to identify methodologies of vigilance and hospital infection control, to analyse nurse's actuation in the context of hospital infection control and to associate nurse's actuation on the control of hospital infection and the execution of nursing process. It is an analytic-descriptive study developed at 81 Commissions of Hospital Infection Control (CCIH) at School Hospitals from 21 Brazilian states through a questionnaire. The variables studied were: characteristics and functioning of CCIH; criteria to diagnose hospital infection; methods of data collection; types of epidemiological vigilance, prevention and control measures and nurse's participation. The analysis of data was qualitative and quantitative. The results showed that in the collection of data prevailed general vigilance (66.6%) and the association of passive and active methods (48.4%); 67 CCIH mentioned measures of prevention and control, related to urinary tract (54 CCIH) and to respiratory tract (21 CCIH). The antimicrobian control distinguishing the lack of resonance between the CCIH and the units personnel brings to the conclusion that the problems of hospital infection control are, in their essence, of philosophical, educational or administrative character. Authors evidenced the importance of the implementation of methodologies to facilitate the control of hospital infection, indicating that the adoption of nursing process, as an instrument, can result in benefits to CCIH and to patients.

[Communicable diseases and isolation: a nursing student's perceptions]. / Doenças transmissíveis e isolamento: a percepção de aluno de enfermagem.

The Communicable Diseases have been associated to stigma and segregation for a long time. This investigation was carried out in order to detect the undergraduation students' perception concerning communicable diseases and isolation, as well as their expectation in working at isolation units. A questionnaire was elaborated and then validated by 3 referees. We attested that some of these students have stereotyped and negative conotations concerning the bearer of such diseases and isolation. Just a few of them mentioned that they would choose this specific unit as the workplace. It is important for us, professors, to know their previous knowledgement about the concepts of communicable diseases and isolation, so that we can reinforce the positive features and work with the negative ones during the courses. It can contribute to prepare these students to give an effective nursing care without fears and stigmas.

High-frequency jet ventilation in endolaryngeal surgery.

STUDY OBJECTIVE: To describe the clinical experience with high-frequency jet ventilation (HFJV) of the lungs during endolaryngeal surgery and its effect on acid-base balance and capillary PO2 (PcO2), PCO2, central hemodynamics, and tracheobronchial mucous membrane. DESIGN: Evaluation of different modalities of HFJV. SETTING: Operating rooms and otolaryngology intensive care unit in a medical institute. PATIENTS: 218 patients undergoing elective endolaryngeal surgery. INTERVENTIONS: Patients receive HFJV through catheters with an inner diameter of 1.4 to 1.8 mm. Catheters were introduced orotracheally, nasotracheally, percutaneously, or through a fenestrated tracheostomy tube. Minute volume was based on body weight times 0.2, corrected for acid-base balance. MEASUREMENTS AND MAIN RESULTS: Intraoperative cardiac output, airway pressure, changes in tracheobronchial mucosa, and acid-base balance were monitored. HFJV changed central hemodynamics slightly and preserved gas exchange: PcCO2 remained within normal limits, while PcO2 increased. Use of thin catheters enhanced largyneal exposure and surgical manipulation. Percutaneous catheterization permitted resumption of HFJV in the event of laryngeal edema and inadequate spontaneous respiration after surgery. CONCLUSION: HFJV leads to optimal conditions for endolaryngeal surgery, reverses constant outflow of the respiratory gas mixture, prevents aspiration of tissue products and blood, and removes smoke from the operative site when using laser surgery.

[The trash collection service: occupational risks versus damages to health]. / O serviço dos coletores de lixo: riscos ocupacionais versus agravos à saúde.

The authors studied the kind of work a sample of 36 garbage collectors have been doing in a city of the State of São Paulo. A high frequency of occupational accidents and sick-due to health problem and some occupational risks was observed among them, and also that these worker haven't worn the individual protection equipment received, that probably contributes to such number of stop working.