Effects of naps at work on the sleepiness of 12-hour night shift nursing personnel

Background and objective: The purpose of the present study was to evaluate the effects of a nap at work on the sleepiness of 12-hour, night-shift (registered and assistant) nursing personnel.Methods: Twelve nurses filled out daily logs, the Karolinska Sleepiness Scale (KS), and wore wrist actigraphs for two periods of four continuous days.Results: Mean nap duration during the night shifts was 138.3 (SD+39.8) minutes. The mean sleepiness level assessed by the KS score was lower, 3.3 (SD±1.6), when the nap was taken during the first span (00:01 - 03:00h) of the night shift, compared with 6.6 (SD±1.0) when there was no nap. The mean sleepiness level assessed by the KS score was also lower, 3.6 (SD±0.9), when the nap was taken during the second span (03:01 - 06:00h) of the night shift, compared with 7.0 (SD±1.1) when there was no nap. Thus, napping either during the first or second part of the night shift reduces sleepiness of 12-hour, night-shift nursing personnel. Moreover, the mean duration of the first sleep episode after night work was longer in those who did not nap than in those who did. Conclusions: The results of this study show that napping during the 12-hour, night-shift results in less sleepiness at work and less need for recovery sleep after work

Contraceptive methods with male participation: a perspective of brazilian couples

OBJECTIVE: To assess the perspectives of couples who requested vasectomy in a public health service on the use of male participation contraceptive methods available in Brazil: male condoms, natural family planning/calendar, coitus interruptus and vasectomy. METHODS: A qualitative study with semi-structured interviews was held with 20 couples who had requested vasectomy at the Human Reproduction Unit of the Universidade Estadual de Campinas, Brazil. Data analysis was carried out through thematic content analysis. FINDINGS: The couples did not, in general, know any effective contraceptive options for use by men and/or participating in their use, except for vasectomy. The few methods with male participation that they knew of were perceived to interfere in spontaneity and in pleasure of intercourse. Men accepted that condom use in extra-conjugal relations offered them protection from sexually transmitted diseases; that their wives might also participate in extra-marital relationships was not considered. DISCUSSION: The few contraceptive options with male participation lead to difficulty in sharing responsibilities between men and women. On the basis of perceived gender roles, women took the responsibility for contraception until the moment when the situation became untenable, and they faced the unavoidable necessity of sterilization. CONCLUSIONS: Specific actions are necessary for men to achieve integral participation in relation to reproductive sexual health. These include education and discussions on gender roles, leading to greater awareness in men of the realities of sexual and reproductive health

The right to the screen: from media education to educommunication in Brazil

Nowadays in Brazil, some social organizations, governments and mass media are discussing the need to establish an oversight committee to guarantee the quality of television programmes, as well as the need to set a system to determine what kind of pro, gram is appropriate for every television time slot. Across Brazil, a representative body of children and young people have come to the conclusion that the right to receive quality television programmes is not enough. The children of the new generations think they have the right to access new technologies and the production of their own messages, in accordance with their own creativity, interests and lifestyle projects within society.

The right to screens: from media education to educommunication in Brazil

Social organizations, local governments and the media in Brazil are confronting them, selves over the need for an oversight board to guarantee quality television programming, and establishing a system to determine which television programs are appropriate for which television time slots. Across Brazil, a representative body of children and young adults have determined that the right to receive quality programming is not currently being met. Children of the new generation see themselves as having a right to access new technologies which enable them to produce their own messages according to their own creativity, interests, and social participation. This new generation wants to go beyond education in order to watch and conquer their ""right to screens"".

The characteristics of depressive symptoms in medical students during medical education and training: a cross-sectional study

Background: Medical education and training can contribute to the development of depressive symptoms that might lead to possible academic and professional consequences. We aimed to investigate the characteristics of depressive symptoms among 481 medical students (79.8% of the total who matriculated). Methods: The Beck Depression Inventory (BDI) and cluster analyses were used in order to better describe the characteristics of depressive symptoms. Medical education and training in Brazil is divided into basic (1(st) and 2(nd) years), intermediate (3(rd) and 4(th) years), and internship (5(th) and 6(th) years) periods. The study organized each item from the BDI into the following three clusters: affective, cognitive, and somatic. Statistical analyses were performed using analysis of variance (ANOVA) with post-hoc Tukey corrected for multiple comparisons. Results: There were 184 (38.2%) students with depressive symptoms (BDI > 9). The internship period resulted in the highest BDI scores in comparison to both the basic (p < .001) and intermediate (p < .001) periods. Affective, cognitive, and somatic clusters were significantly higher in the internship period. An exploratory analysis of possible risk factors showed that females (p = .020) not having a parent who practiced medicine (p = .016), and the internship period (p = .001) were factors for the development of depressive symptoms. Conclusion: There is a high prevalence towards depressive symptoms among medical students, particularly females, in the internship level, mainly involving the somatic and affective clusters, and not having a parent who practiced medicine. The active assessment of these students in evaluating their depressive symptoms is important in order to prevent the development of co-morbidities and suicide risk.

Short Cognitive Performance Test: Diagnostic Accuracy and Education Bias in Older Brazilian Adults

The ""Short Cognitive Performance Test"" (Syndrom Kurztest, SKT) is a cognitive screening battery designed to detect memory and attention deficits. The aim of this study was to evaluate the diagnostic accuracy of the SKT as a screening tool for mild cognitive impairment (MCI) and dementia. A total of 46 patients with Alzheimer`s disease (AD), 82 with MCI, and 56 healthy controls were included in the study. Patients and controls were allocated into two groups according to educational level (< 8 years or > 8 years). ROC analyses suggested that the SKT adequately discriminates AD from non-demented subjects (MCI and controls), irrespective of the education group. The test had good sensitivity to discriminate MCI from unimpaired controls in the sub-sample of individuals with more than 8 years of schooling. Our findings suggest that the SKT is a good screening test for cognitive impairment and dementia. However, test results must be interpreted with caution when administered to less-educated individuals.

MEMORY TRAINING FOR OLDER ADULTS WITH LOW EDUCATION: MENTAL IMAGES VERSUS CATEGORIZATION

This study aimed to describe the benefits of memory training for older adults with low education. Twenty-nine healthy older adults with zero to two years of formal education participated. Sixteen participants received training based on categorization (categorization group = CATG) and 13 received training based on mental images (imagery group = IMG). One group served as control for the other because they trained with different strategies. Training was offered in eight sessions of 90 minutes. The participants were evaluated pre- and posttraining. IMG improved performance in episodic memory tests and had reduced depressive symptoms. CATG increased the use of categorization but did not increase performance in episodic memory tests. Results suggest that the strategy based on the creation of mental images was more effective for older adults with low formal education.

The importance of scientific literacy in fostering education for sustainability: Theoretical considerations and preliminary findings from a Brazilian experience

Scientific literacy can be considered as a new demand of post-industrial society. It seems necessary in order to foster education for sustainability throughout students` academic careers. Universities striving to teach sustainability are being challenged to integrate a holistic perspective into a traditional undergraduate curriculum, which aims at specialization. This new integrative, inter- and transdisciplinary epistemological approach is necessary to cultivate autonomous citizenship, i.e., that each citizen be prepared to understand and participate in discussions about the complex contemporary issues posed by post-industrial society. This paper presents an epistemological framework to show the role of scientific literacy in fostering education for sustainability. We present a set of 26 collaborative concept maps (CCmaps) in order to illustrate an instance of theory becoming practice. During a required course for first-year undergraduate students (ACH 0011, Natural Sciences), climate change was presented and discussed in broad perspective by using CCmaps. We present students` CCmaps to show how they use concepts from quantitative and literacy disciplines to deal with the challenges posed by the need of achieving a sustainable development. (C) 2009 Elsevier Ltd. All rights reserved.

The production of school numbers (1871-1931): contributions to a critical approach to statistical sources in History of Education

This article intends to contribute to the reflection on the Educational Statistics as being source for the researches on History of Education. The main concern was to reveal the way Educational Statistics related to the period from 1871 to 1931 were produced, in central government. Official reports - from the General Statistics Directory - and Statistics yearbooks released by that department were analyzed and, on this analysis, recommendations and definitions to perform the works were sought. By rending problematic to the documental issues on Educational Statistics and their usual interpretations, the intention was to reduce the ignorance about the origin of the school numbers, which are occasionally used in current researches without the convenient critical exam.

Enrollment in Physical Education Is Associated With Health-Related Behavior Among High School Students

METHODS: A total of 4210 students attending public high schools in Pernambuco (northeast of Brazil) were selected using random 2-stage cluster sampling. Data were collected by using the Global School-based Student Health Survey. The independent variable was the frequency of participation in PE classes, whereas physical activity, television viewing, smoking, and alcohol, fruit, vegetables and soda consumption were dependent variables. Logistic regressions were carried out to perform crude and adjusted analysis of the association between enrollment in PE classes and health-related behaviors. RESULTS: Sixty-five percent of students do not take part in PE classes, with a significantly higher proportion among females (67.8%). It was observed that enrollment in PE classes was positively associated with physical activity, TV viewing, and fruit consumption, but was negatively associated with soda drinking. The likelihood of reporting being active and eating fruit on a daily basis was 27% and 45% higher, respectively, among those who participate in at least 2 classes per week in comparison with those who do not. Students who participate in PE classes had 28-30% higher likelihood of reporting lower TV viewing during week days. CONCLUSIONS: Findings suggest that higher levels of enrollment in PE classes could play a role in the promotion of health-related behaviors among high school students.

Fatigue in Brazilian cancer patients, caregivers, and nursing students: a psychometric validation study of the Piper Fatigue Scale-Revised

The objective of this study was to validate the Piper Fatigue Scale-Revised (PFS-R) for use in Brazilian culture. Translation of the PFS-R into Portuguese and validity and reliability tests were performed. Convenience samples in Brazil we as follows: 584 cancer patients (mean age 57 +/- 13 years; 51.3% female); 184 caregivers (mean age 50 +/- 12.7 years; 65.8% female); and 189 undergraduate nursing students (mean age 21.6 +/- 2.8 years; 96.2% female); Instruments used were as follows: Brazilian PFS, Beck Depression Inventory (BDI), and Karnofsky Performance Scale (KPS). The 22 items of the Brazilian PFS loaded well (factor loading > 0.35) on three dimensions identified by factor analysis (behavioral, affective, and sensorial-psychological). These dimensions explained 65% of the variance. Internal consistency reliability was very good (Cronbach`s alpha ranged from 0.841 to 0.943 for the total scale and its dimensions). Cancer patients and their caregivers completed the Brazilian PFS twice for test-retest reliability and results showed good stability (Pearson`s r a parts per thousand yenaEuro parts per thousand 0,60, p < 0,001). Correlations among the Brazilian PFS and other scales were significant, in hypothesized directions, and mostly moderate contributing to divergent (Brazilian PFS x KPS) and convergent validity (Brazilian PFS x BDI). Mild, moderate, and severe fatigue in patients were reported by 73 (12.5%), 167 (28.6%), and 83 (14.2%), respectively. Surprisingly, students had the highest mean total fatigue scores; no significant differences were observed between patients and caregivers showing poor discriminant validity. While the Brazilian PFS is a reliable and valid instrument to measure fatigue in Brazilian cancer patients, further work is needed to evaluate the discriminant validity of the scale in Brazil.

Sexuality and quality of life of breast cancer patients post mastectomy

Aim: To evaluate the sexual functioning of breast cancer patients post mastectomy and its association with their quality of life, the personal characteristics of women and their partners, breast reconstruction, cancer staging and adjuvant therapies. Methods: A cross-sectional study was carried out in a University hospital located in the SouthEast of Brazil. A total of 100 women were included in the study. The parameters evaluated were sexual functioning, which was assessed based on the Sexual Quotient Female Version (SQ-F), quality of life (QoL), evaluated by the Medical Outcomes Study 36-item Short Form (SF-36), cancer staging, breast reconstruction, adjuvant therapies and the personal characteristics of patients (age, years of study and years of marriage) and their partners (age, years of study). Results: The majority (40.48%) of women had an unfavorable to regular SQ-F score. A significant positive correlation (p < 0.05) was found between the SQ-F score and years of education (p = 0.03), and the following SF-36 domains: functional capacity (p = 0.03), vitality (p = 0.06), emotional limitations (p = 0.00) and mental health (p = 0.03). A significant negative correlation was found between SQ-F score and the age of the partners (p = 0.03). SQ-F mean value was significantly higher (p = 0.04) among women who underwent breast reconstruction. Conclusions: Women with low educational level, who have older partners, and who did not have a breast reconstruction should receive special attention with respect to their sexuality, and the effects of mastectomy on the sexuality of patients should be assessed. Oncology nurses are best qualified to recognize issues related to sexuality and quality of life, and can offer specific and meaningful support for breast cancer patients. (C) 2010 Elsevier Ltd. All rights reserved.

The experience of repeated fatherhood during adolescence

Objective: to examine how adolescent fathers experience recurring parenthood. Design: qualitative study with a social phenomenological focus. Participants: five fathers between 16 and 19 years of age, each with two children. Findings: the participants perceived themselves as mature, responsible, worried about the care and education of their children, and desiring a secure future life. These factors made them seek employment, their own home, marital stability, construction of a family and return to school. They experienced the ambivalence of desiring one reality and living another, given that, as adolescent parents, they regretted the loss of their freedom. Key conclusions: recurring parenthood in adolescence is a complex phenomenon, with many possible perceptions. The diverse experiences depend on the social context that is defined by the wishes, plans, possibilities and meanings of each distinct social class. Implications for practice: care delivery to these adolescents should consider not only theoretical and chronobiological aspects, but also the experiences of these young people and the psychosocial and cultural factors involved in their fatherhood. (c) 2008 Elsevier Ltd. All rights reserved.

The ethical component of professional competence in nursing: An analysis

The purpose of this article is to initiate a philosophical discussion about the ethical component of professional competence in nursing from the perspective of Brazilian nurses. Specifically, this article discusses professional competence in nursing practice in the Brazilian health context, based on two different conceptual frameworks. The first framework is derived from the idealistic and traditional approach while the second views professional competence through the lens of historical and dialectical materialism theory. The philosophical analyses show that the idealistic view of professional competence differs greatly from practice. Combining nursing professional competence with philosophical perspectives becomes a challenge when ideals are opposed by the reality and implications of everyday nursing practice.

Brazilian registered nurses` perceptions and attitudes towards adverse events in nursing care: a phenomenological study

Aim To describe the perceptions and attitudes of registered nurses (RNs) towards adverse events (AEs) in nursing care. Background The professionals` subjective perspectives should be taken into account for the prevention of AEs in care settings. Method Schutz`s social phenomenology was developed. Interviews were conducted with nine Intensive Care Unit RNs. Results The following five descriptive categories emerged: (1) the occurrence of AEs is inherent to the human condition but provokes a feeling of insecurity, (2) the occurrence of AEs indicates the existence of failures in health care systematization, (3) the professionals` attitudes towards AEs should be permeated by ethical principles; (4) the priority regarding AEs should be the mitigation of harm to patients, and (5) decisions regarding the communication of AEs were determined by the severity of the error. Conclusions The various subjective perspectives related to the occurrence of AEs requires a health care systematization with a focus on prevention. Ethical behaviour is essential for the patients` safety. Implications for nursing management Activities aimed at the prevention of AEs should be integrated jointly with both the professionals and the health care institution. A culture of safety, not punishment, and improvement in the quality of care provided to patients should be priorities.