A systematic review of the methods used to assess race and racial disparities in uterine fibroid research

Context: Black women are reported to have a higher prevalence of uterine fibroids, and a threefold higher incidence rate and relative risk for clinical uterine fibroid development as compared to women of other races. Uterine fibroid research has reported that black women experience greater uterine fibroid morbidity and disproportionate uterine fibroid disease burden. With increased interest in understanding uterine fibroid development, and race being a critical component of uterine fibroid assessment, it is imperative that the methods used to determine the race of research participants is defined and the operational definition of the use of race as a variable is reported for methodological guidance, and to enable the research community to compare statistical data and replicate studies. ^ Objectives: To systematically review and evaluate the methods used to assess race and racial disparities in uterine fibroid research. ^ Data Sources: Databases searched for this review include: OVID Medline, NML PubMed, Ebscohost Cumulative Index to Nursing and Allied Health Plus with Full Text, and Elsevier Scopus. ^ Review Methods: Articles published in English were retrieved from data sources between January 2011 and March 2011. Broad search terms, uterine fibroids and race, were employed to retrieve a comprehensive list of citations for review screening. The initial database yield included 947 articles, after duplicate extraction 485 articles remained. In addition, 771 bibliographic citations were reviewed to identify additional articles not found through the primary database search, of which 17 new articles were included. In the first screening, 502 titles and abstracts were screened against eligibility questions to determine citations of exclusion and to retrieve full text articles for review. In the second screening, 197 full texted articles were screened against eligibility questions to determine whether or not they met full inclusion/exclusion criteria. ^ Results: 100 articles met inclusion criteria and were used in the results of this systematic review. The evidence suggested that black women have a higher prevalence of uterine fibroids when compared to white women. None of the 14 studies reporting data on prevalence reported an operational definition or conceptual framework for the use of race. There were a limited number of studies reporting on the prevalence of risk factors among racial subgroups. Of the 3 studies, 2 studies reported prevalence of risk factors lower for black women than other races, which was contrary to hypothesis. And, of the three studies reporting on prevalence of risk factors among racial subgroups, none of them reported a conceptual framework for the use of race. ^ Conclusion: In the 100 uterine fibroid studies included in this review over half, 66%, reported a specific objective to assess and recruit study participants based upon their race and/or ethnicity, but most, 51%, failed to report a method of determining the actual race of the participants, and far fewer, 4% (only four South American studies), reported a conceptual framework and/or operational definition of race as a variable. However, most, 95%, of all studies reported race-based health outcomes. The inadequate methodological guidance on the use of race in uterine fibroid studies, purporting to assess race and racial disparities, may be a primary reason that uterine fibroid research continues to report racial disparities, but fails to understand the high prevalence and increased exposures among African-American women. A standardized method of assessing race throughout uterine fibroid research would appear to be helpful in elucidating what race is actually measuring, and the risk of exposures for that measurement. ^

The role of environmental tobacco smoke in the development and exacerbation of asthma among children in developing countries: A systematic review

Environmental tobacco smoke (ETS) is an important indoor air pollutant associated with adverse effects on the respiratory health of the general population, especially people with asthma. ETS consists mainly of sidestream smoke from burning cigarettes and a smaller quantity of mainstream smoke which is exhaled by the smoker. At least one out of every three children is frequently exposed to ETS. ^ This paper reviewed the literature for studies on the role of ETS in the development and exacerbation of asthma among children in developing countries, specifically the low and middle income countries from the year 1980 to the present. The databases searched in this systematic review were: Ovid Medline; PubMed (National Library of Medicine); and Cumulative Index to Nursing and Allied Health (CINAHL) (EBSCOhost). Out of a total of 197 articles initially identified, only four studies (two from China, one from Macedonia and one from Brazil) were rated by two independent raters as being of high quality, and were selected for final abstraction, synthesis and evidence weighting. Results from these four studies suggests that, in developing countries, ETS exposure is associated with childhood asthma, and that asthma prevalence increases with an increase in the amount and duration of exposure to ETS. Similarly, exposure to ETS is associated with persistent cough, current night dry cough, and exacerbation of asthma symptoms. ^ Therefore, as is the case in developed nations, there is suggestive evidence in the literature that ETS exposure plays substantial role in the development and/or exacerbation of asthma among children in developing countries. To decrease the likelihood of new asthma development, enhance asthma control, and reduce the rate of medical service utilization in children exposed to ETS, smoking should be eliminated at home and in public places.^

Knowledge and Attitudes of Young People in Nigeria about HIV/AIDS---A systematic review

Background: HIV/AIDS has remained one of Nigeria's biggest health and social issues for decades. People aged between 10 and 24 are the most affected. Research into why this population subset is affected is very pertinent. We therefore conducted a systematic review of the Knowledge and Attitudes of young people in Nigeria about HIV/AIDS to understand where the gaps between knowledge and attitudes can be bridged. ^ Methods: We conducted searches in Medline, PubMed, African Index Medicus, Cumulative Index of Nursing and Allied Health. WHO and UNAIDS documents were also searched. Other journals were hand searched. Searches were for studies between 1986 (when HIV/AIDS was first reported in Nigeria) till date. In addition, data abstraction and quality assessment were done. ^ Results: 279 titles and abstracts were found and 33 articles in full text were appraised critically and 17 articles were selected based on our criteria. This revealed a dearth of well conducted studies in the literature despite the enormity of the HIV/AIDS epidemic. Constructs for Knowledge and attitudes were itemized on two tables for each article based on the Health Belief Model. Even though many of the studies showed high level of knowledge about HIV/AIDS, it did not impact attitudes about the disease. Also fear and anxiety prevented participants from acquiring knowledge. These recurring themes arguably were not limited to any region or area, background or group. ^ Conclusion: There is a need for future research to be culturally sensitive with a focus on attitudes and correction of misconceptions about HIV/AIDS among our youth.^

Attitudes and other barriers to the utilization of clinical research findings by American physicians: A systematic review

Background: The Institute of Medicine estimates that only a maximum of 25% of clinical research findings are incorporated into practice by physicians. To improve clinical practice, efforts have been made to promote evidence-based medicine and the use of clinical guidelines. Despite these efforts, the gap between research and clinical practice remains wide.^ Objective: To systematically review the literature describing the factors which influence the use of clinical research recommendations by American physicians.^ Hypothesis: Barriers exist in the application of clinical research into clinical practice, and are multifactorial. The establishment of the Clinical and Translational Awards (CTSA; special federal grants awarded to selected institutions to support clinical and translational research) has reduced the effect of these barriers and improved the process of clinical research translation into practice among American physicians.^ Aims: Identify barriers and facilitators of the use of research findings in clinical practice by American physicians. Contrast studies published six years before and after the creation of the CTSA.^ Methods: The sources of data include published literature from Medline, PubMed and PsycINFO. Selected studies must be qualitative, a survey of American clinicians, based on evidence-based medicine practice, clinical guidelines or treatment pathways. Systematic reviews and reports were excluded, as well as studies with less than 100 respondents.^ Results: In total, 1036 abstracts were reviewed; 115 full text potential articles were identified and reviewed, and a total of 31 studies met all criteria for inclusion in the final review.^ Conclusions: The barriers against the application of clinical research findings, in the forms of clinical guidelines, evidence-based medicine guides and clinical pathways, can be divided broadly into physician barriers, practice/system barriers and patient barriers. Physician barriers are the most common barriers, especially the lack of familiarity with guidelines and the lack of time. Of the factors which improve the use of research based guidelines, physician factors such as younger age, lower duration of clinical practice, specialty training, and practice in large group Health Maintenance Organization (HMO) settings with fewer patients seen were the most commonly cited.^

Sistema de alarmas asistenciales para hospitales y residencias

En los hospitales y residencias geri��tricas de hoy en d��a es necesario que tengan un sistema asistencial paciente-enfermera. Este sistema debe ser capaz de controlar y gestionar cada una de las alarmas que se puedan generar en el menor tiempo posible y con la mayor eficacia. Para ello se ha dise��ado una soluci��n completa llamada ConnectCare. La arquitectura modular del sistema y la utilizaci��n de comunicaci��n IP permiten adaptar el sistema a cada situaci��n proporcionando soluciones espec��ficas a medida. Este sistema se compone de un software llamado Buslogic que gestiona las alarmas en un servidor y de unos dispositivos llamados Fonet Control TCP/IP que posee una doble funci��n: por una parte, sirve como dispositivo intercomunicador telef��nico y por otra parte, sirve como dispositivo de gesti��n de alarmas y control de otros dispositivos externos. Como dispositivo intercomunicador telef��nico, se integra en la red telef��nica como un terminal de extensi��n anal��gica permitiendo la intercomunicaci��n entre el paciente y el personal sanitario. Se har�� una breve descripci��n de la parte intercomunicadora pero no es el objeto de este proyecto. En cambio, en la parte de control se har�� m��s hincapi�� del dise��o y su funcionamiento ya que s�� es el objeto de este proyecto. La placa de control permite la recepci��n de se��ales provenientes de dispositivos de llamadas cableados, como son pulsadores asistenciales tipo ���pera��� o tiradores de ba��o. Tambi��n es posible recibir se��ales de alerta de dispositivos no estrictamente asistenciales como detectores de humo o detectores de presencia. Adem��s, permite controlar las luces de las habitaciones de los residentes y actuar sobre otros dispositivos externos. A continuaci��n se mostrar�� un presupuesto para tener una idea del coste que supone. El presupuesto se divide en dos partes, la primera corresponde en el dise��o de la placa de control y la segunda corresponde a la fabricaci��n en serie de la misma. Despu��s hablaremos sobre las conclusiones que hemos sacado tras la realizaci��n de este proyecto y sobre las posibles mejoras, terminando con una demostraci��n del funcionamiento del equipo en la vida real. ABSTRACT. Nowadays, in hospitals and nursing homes it is required to have a patient-nurse care system. This system must be able to control and manage each one of the alarms, in the shortest possible time and with maximum efficiency. For this, we have designed a complete solution called ConnectCare. The system architecture is modular and the communication is by IP protocol. This allows the system to adapt to each situation and providing specific solutions. This system is composed by a software, called Buslogic, which it manages the alarms in the PC server and a hardware, called Fonet Control TCP / IP, which it has a dual role: the first role, it is a telephone intercom device and second role, it is a system alarm manager and it can control some external devices. As telephone intercom device, it is integrated into the telephone network and also it is an analog extension terminal allowing intercommunication between the patient and the health personnel. A short description of this intercommunication system will be made, because it is not the subject of this project. Otherwise, the control system will be described with more emphasis on the design and operation point of view, because this is the subject of this project. The control board allows the reception of signals from wired devices, such as pushbutton handset or bathroom pullcord. It is also possible to receive warning signals of non nurse call devices such as smoke detectors or motion detectors. Moreover, it allows to control the lights of the patients��� rooms and to act on other external devices. Then, a budget will be showed. The budget is divided into two parts, the first one is related with the design of the control board and the second one corresponds to the serial production of it. Then, it is discussed the conclusions of this project and the possible improvements, ending with a demonstration of the equipment in real life.

A medical book collection for physician assistants

Selecting resources for physician assistants is challenging and can be overwhelming. Although several core lists exist for nursing, allied health, and medical libraries, judging the scope and level of these resources in relation to the information needs of the physician assistant is difficult. Medical texts can be highly specialized and very expensive, in essence, ���overkill��� for the needs of the physician assistant. This bibliography is meant to serve as a guide to appropriate medical texts for physician assistants. Titles were selected from the Brandon/Hill list, Doody's Electronic Journal, and various other reference resources. Resources were evaluated based on the subject and scope, audience, authorship, cost, and currency. The collection includes 195 titles from 33 specialty areas. Standard texts in each area are also included.

Mapping the literature of cytotechnology

The major purpose of this study was to identify and assess indexing coverage of core journals in cytotechnology. It was part of a larger project sponsored by the Nursing and Allied Health Resources Section of the Medical Library Association to map the literature of allied health. Three representative journals in cytotechnology were selected and subjected to citation analysis to determine what journals, other publication types, and years were cited and how often. Bradford's Law of Scattering was applied to the resulting list of cited journals to identify core titles in the discipline, and five indexes were searched to assess coverage of these core titles. Results indicated that the cytotechnology journal literature had a small core but wide dispersion: one third of the 21,021 journal citations appeared in only 3 titles; another third appeared in an additional 26 titles; the remaining third were scattered in 1,069 different titles. Science Citation Index Expanded rated highest in indexing coverage of the core titles, followed by MEDLINE, EMBASE/Excerpta Medica, HealthSTAR, and Cumulative Index to Nursing and Allied Health Literature (CINAHL). The study's results also showed that journals were the predominantly cited format and that citing authors relied strongly on more recent literature.

Evaluation of quality of life related to nutritional status

The way in which the quality of life related to health (HRQoL) is affected by the nutritional status of the patient is a subject of constant interest and permanent debate. The purpose of the present paper is to review those studies that relate HRQoL to nutritional status and examine the tools (questionnaires) that they use to investigate this relationship. A critical review of published studies was carried out via an investigation of the following databases: MEDLINE (via PubMed); EMBASE; The Cochrane Library; Cumulative Index to Nursing and Allied Health Literature (CINAHL); Institute for Scientific Information (ISI) Web of Science; Latin American and Caribbean Health Sciences Literature (LILACS); Spanish Health Sciences Bibliographic Index (IBECS). The search was carried out from the earliest date possible until July 2007.The medical subject heading terms used were ���quality of life���, ���nutritional status��� and ���questionnaires���. The articles had to contain at least one questionnaire that evaluated quality of life. Twenty-eight documents fulfilling the inclusion criteria were accepted, although none of them used a specific questionnaire to evaluate HRQoL related to nutritional status. However, some of them used a combination of generic questionnaires with the intention of evaluating the same. Only three studies selectively addressed the relationship between nutritional status and quality of life, this evaluation being performed not by means of specific questionnaires but by statistical analysis of data obtained via validated questionnaires.

Validaci��n de la versi��n espa��ola del cuestionario Physician Readiness To Manage Intimate Partner Violence Survey (PREMIS)

Fundamentos: El Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS) es uno de los cuestionarios m��s completos en el contexto internacional para la valoraci��n de la capacidad de respuesta frente a la violencia del compa��ero ��ntimo por los profesionales de Atenci��n Primaria de Salud. El objetivo de este estudio fue determinar la fiabilidad, consistencia interna y validez de constructo de la versi��n espa��ola de este cuestionario. M��todos: Tras la traducci��n, retrotraducci��n y valoraci��n de la validez de contenido del cuestionario, se distribuyeron en una muestra de 200 profesionales de medicina y enfermer��a de 15 centros de atenci��n primaria de 4 Comunidades Aut��nomas en 2013 (Comunidad Valenciana, Castilla Le��n, Murcia y Cantabria). Se calcularon los coeficientes alfa de Cronbach, los de correlaci��n intraclase y rho de Spearman (test-retest). Resultados: la versi��n espa��ola del PREMIS incluy�� 64 ��tems. El coeficiente �� de Cronbach fue superior a 0,7 o muy cercano a ese valor en la mayor��a de los ��ndices. Se obtuvo un coeficiente de correlaci��n intraclase de 0,87 y un coeficiente de Spearman de 0,67 que muestran una fiabilidad alta. Todas las correlaciones observadas para la escala de opiniones, la ��nica tratada como estructura factorial en el cuestionario PREMIS, fueron superiores a 0,30. Conclusiones: el PREMIS en espa��ol obtuvo una buena validez interna, alta fiabilidad y capacidad predictiva de las pr��cticas auto-referidas por m��dicos(as) y enfermeros(as) frente a casos de violencia del compa��ero ��ntimo en centros de atenci��n primaria.

Conhecimento e ades��o da pr��tica de higieniza����o das m��os dos profissionais da sa��de: revis��o de literatura

O presente estudo objetiva conhecer a produ����o cient��fica da sa��de acerca da higieniza����o das m��os realizada pelos profissionais e relacionar o conhecimento e ades��o do profissional a essa pr��tica. Trata-se de uma revis��o bibliogr��fica sistem��tica, realizado na Biblioteca Virtual de Sa��de (BVS), nas bases de dados LILACS e SCIELO, com os descritores: pessoal de sa��de, lavagem de m��os e ades��o. Selecionou-se 13 artigos no per��odo de 2002 a 2012, que foram analisados em categorias. Os crit��rios de inclus��o para a sele����o dos artigos foram: artigos publicados em portugu��s e estar dispon��vel em texto completo. Os resultados da pesquisa evidenciaram que a grande maioria dos profissionais tem embasamento te��rico e pr��tico sobre higieniza����o das m��os. Por��m, no campo de trabalho temos resultados contr��rios, n��o h�� ades��o esperada nem a t��cnica correta da lavagem das m��os. Por diversos motivos ainda n��o realizam por completo essa tarefa. Concluindo assim que as a����es de educa����o que tem fun����o de orientar e motivar esses profissionais devem ser discutidas e implementadas, a fim de sanar todas as d��vidas que ainda existem sobre a t��cnica de higieniza����o das m��os.

Perce����es dos enfermeiros sobre os erros de medica����o no pr��-hospitalar

Quase metade da totalidade de eventos adversos evit��veis �� consequ��ncia de erros de medica����o (EM), contudo, n��o sendo poss��vel evit��-los completamente, estes podem ser minorados. Esta problem��tica em contexto pr��-hospitalar (PH) tem sido pouco estudada a n��vel internacional e nunca foi abordada em Portugal. O objetivo deste estudo �� relacionar as vari��veis sociodemogr��ficas, socioprofissionais, forma����o, conhecimentos e experi��ncias com EM com a perce����o dos enfermeiros que exercem no PH relativamente �� frequ��ncia da ocorr��ncia dos tipos e causas de EM, dos obst��culos ao relato de EM, dos fatores facilitadores do relato de EM e com o grau de concord��ncia sobre divulga����o de EM. M��todos: Trata-se de um estudo anal��tico, descritivo, transversal e correlacional. A amostra �� composta por 107 enfermeiros do PH (m��todo snowball), dos quais 56.1% s��o do sexo masculino. Foi aplicado um question��rio eletr��nico constitu��do por uma componente sociodemogr��fica, escala de conhecimentos, perce����es e experi��ncia com erros de medica����o (Raimundo, 2011; Maurer, 2010; Bohomol & Ramos, 2006; Mayo & Duncan, 2004; Osborne, Blais & Hayes, 1999; Gladstone, 1995). Resultados: Dos inquiridos 60.7% apresentam fracos a razo��veis conhecimentos sobre EM; mais de 54% perceciona a sua forma����o acad��mica/cont��nua sobre EM como sendo inexistente/insuficiente e 52.3% n��o recebe forma����o sobre farmacologia h�� pelo menos 6 anos; 45.8% diz ter experienciado no PH um ou mais EM sem dano para o doente e apenas 14.9% relatou um ou mais EM sem dano para o doente. Os tipos e as causas de EM identificadas ocorrem com uma frequ��ncia elevada para mais de 39% dos inquiridos. A maioria dos inquiridos (47.7%) considera que no PH existem grandes obst��culos ao relato de EM e os fatores facilitadores do relato de EM apresentados s��o considerados por 49.5% dos enfermeiros como altamente prov��veis de facilitar o relato. 52,3% dos enfermeiros do PH discordam de uma forma global com a divulga����o de EM. O sexo feminino apresenta uma perce����o mais elevada da ocorr��ncia das causas prim��rias de EM (MF=2.68, Dp= 0.60 vs MM=2.36, Dp=0.66) e uma perce����o mais elevada dos fatores facilitadores ao relato dos EM (MF=4.40, Dp= 0.64 vs MM=4.12, Dp=0.74). Os enfermeiros que exercem exclusivamente no PH possuem uma melhor perce����o da frequ��ncia de ocorr��ncia das causas prim��rias de EM. Quanto maior o conhecimento dos enfermeiros sobre EM, maior �� a perce����o destes relativamente aos tipos de erros e maior o grau de concord��ncia com a divulga����o dos EM. Existe evid��ncia estatisticamente significativa (p<0.05) de que os enfermeiros que experienciaram a ocorr��ncia de pelo menos 1 erro com dano para o doente possuem melhor perce����o dos tipos, causas prim��rias e obst��culos ao relato dos EM, assim como apresenta um maior grau de concord��ncia com a divulga����o de EM. Conclus��o: A perce����o dos enfermeiros sobre a frequ��ncia dos tipos e das causas de EM, assim como dos obst��culos e dos fatores facilitadores do relato de EM por parte dos enfermeiros no PH n��o tem, de uma forma geral, rela����o com as caracter��sticas sociodemogr��ficas e socioprofissionais, o que demonstra a transversalidade desta problem��tica. T��o ou mais importante do que avaliar a dimens��o e caracterizar a tipologia, causas, obst��culos e fatores facilitadores ao relato dos EM ser��, com base no conhecimento obtido, definir e implementar a����es de gest��o de risco que permitam a sua redu����o ou mesmo a sua supress��o. PALAVRAS-CHAVE: Erros de Medica����o, Perce����o dos Enfermeiros, Pr��- Hospitalar.

Risco cardiovascular em profissionais de sa��de

Enquadramento: As doen��as cardiovasculares s��o a principal causa de morte, cuja etiologia surge da conjuga����o de fatores de risco, causando uma patogenia complexa. Objetivos: identificar quais os fatores de risco, em presen��a, nos profissionais de sa��de do Centro Hospitalar Tondela-Viseu; analisar a rela����o das vari��veis sociodemogr��ficas (sexo e idade) com o risco cardiovascular. M��todos: Estudo quantitativo e n��o experimental, transversal, descritivo e correlacional. Recorreu-se ao Question��rio de N��vel de Risco Cardiovascular (QNRC) (Cunha & Mac��rio, 2012). A amostragem �� n��o probabil��stica por conveni��ncia, constitu��da por 1000 profissionais de sa��de do Centro Hospitalar Tondela-Viseu. Resultados: Amostra maioritariamente feminina (71.3%), na faixa et��ria dos 36-45 anos (35.8%), a exercerem em servi��os m��dicos (40.1%), destacando-se os enfermeiros (42.7%). Quanto �� presen��a de fatores de risco cardiovascular, 5.2% s��o hipertensos; 3.5% s��o obesos; 1.6% sofrem de doen��a card��aca; 1.6% sofrem de diabetes mellitus; verificou-se a presen��a de hist��ria familiar de hipertens��o arterial (40.6%), obesidade (7.8%), doen��a card��aca (15.9%), diabetes mellitus (23.4%); 69.9% apresentavam press��o arterial normal; 37.3% relataram h��bitos tab��gicos; 80.7% n��o apresentavam situa����o sem riso em rela����o aos triglicer��deos, mas em 19.3% esse estava presente; 61.9% n��o revelaram risco no par��metro colesterol total, contudo, 38.1% patenteavam; 88.8% n��o apresentam risco quanto ao colesterol HDL, por��m, 11.2% enquadravam-se no grupo de risco face ao colesterol HDL; 64.0% n��o apresentam valores de colesterol LDL considerados de risco, todavia, 36.0% revelaram valores de colesterol LDL considerados de risco. Conclus��o: Os resultados apontam para a realiza����o de sess��es de esclarecimento na promo����o da sa��de e preven����o das doen��as cardiovasculares para profissionais de sa��de. Palavras-chave: Fatores de Risco Cardiovascular; Profissionais de Sa��de.

Atitude dos estudantes de enfermagem ao cuidar a pessoa com dor

Introdu����o: Cuidar da pessoa com dor �� imprescind��vel �� excel��ncia dos cuidados de enfermagem. Refletindo sobre a natureza desses cuidados pelos estudantes, �� poss��vel promover atitudes de abertura ao sofrimento, para que como futuros profissionais respondam �� necessidade de al��vio. O comportamento humano �� intencional, reflete prefer��ncias e para o prever podemos simplesmente examinar atitudes. Objectivo: Estimar a validade e confiabilidade da escala e analisar a atitude dos estudantes de enfermagem ao cuidar da pessoa com dor. Material e M��todo: Estudo anal��tico, correlacional e transversal, realizado com 255 estudantes da ESSV. Os dados recolhidos atrav��s de question��rio autoaplicado que integra a escala: Atitude dos Estudantes de Enfermagem ao Cuidar a Pessoa com Dor. Resultados: Ap��s o estudo psicom��trico, a escala apresenta 17 itens e 2 fatores, fator 1 ���Aptid��o Terap��utico-Curativa��� e fator 2 ���Aptid��o Centrada na Pessoa���. Os estudantes apresentam uma m��dia de idade de 21.91 anos, 77.3% do sexo feminino, maioritariamente solteiros e 40.8% frequentam o 4�� ano. Todos avaliam a dor nos ensinos cl��nicos, 86.4% com a EN e 94.9% conjuga interven����es farmacol��gicas e n��o farmacol��gicas, mais de 55% emprega a diminui����o do ru��do e luminosidade, aplica����o do frio e massagem, havendo 87.5% que usa posicionamentos. Os do sexo masculino que aplicam exerc��cios de relaxamento e os do sexo feminino com idade ���21 anos, do 3�� ano, apresentam uma atitude mais adequada. Conclus��o: A forma����o no tema dor ao longo do curso �� preponderante no desenvolvimento de compet��ncias, mas tamb��m na aquisi����o de conhecimento e promo����o de atitudes. Palavras chave: Estudantes de Enfermagem, Atitude; Dor; Cuidar.

Promover a parentalidade : recomenda����es perante as birras e momentos de alimenta����o da crian��a

Enquadramento: A parentalidade �� um tema de sa��de com muita relev��ncia na sociedade atual, intervindo o seu exerc��cio na promo����o da sa��de e bem-estar da crian��a. A parentalidade envolve acontecimentos stressantes, nomeadamente em situa����es de problemas de sa��de e necessidades b��sicas e de resposta ao comportamento da crian��a, como �� o caso do choro/birra e no momento de alimenta����o, procurando a maioria dos cuidadores responder ao problema de forma independente enquanto outros solicitam apoio dos profissionais de sa��de. Objetivo: Identificar recomenda����es concretas, baseadas na evid��ncia cient��fica, de boas pr��ticas e recomenda����es a transmitir aos pais para lidarem com o choro /birras e no momento da alimenta����o da crian��a. M��todos: Realizou-se uma revis��o sistem��tica da literatura de estudos realizados nos idiomas portugu��s, ingl��s e espanhol, publicados entre 2009 e 2014, em bases de dados internacionais CINAHL�� Plus with Full-Text, Nursing & Allied Health Collection, Cochrane Central Register of Controlled Trials; Cochrane Database of Systematic Reviews (CDSR) e Database of Abstracts of Reviews of Effects (DARE), MedicLatina , MEDLINE, com recurso a diversos descritores e operadores booleanos e recorrendo a dois revisores que avaliaram a qualidade dos estudos metodol��gicos. Resultados: Ap��s avalia����o cr��tica, foram exclu��dos 50 estudos e inclu��dos 7, sendo um de grau de evid��ncia A, dois de evid��ncia B e 4 de evid��ncia D. Os outcomes evidenciaram que para gest��o da parentalidade o aconselhamento deve feito pelo profissional de refer��ncia, que se necess��rio dever�� acompanhar os pais atrav��s de contacto telef��nico e visita domicili��ria sobretudo se m��es inexperientes. Os profissionais devem ampliar os seus conhecimentos sobre as d��vidas e preocupa����es que os pais t��m sobre a educa����o dos seus filhos consultando os espa��os de discuss��o online. A etnia e nacionalidade das m��es tem forte impacto sobre os m��todos usados para acalmar o beb��, pelo que os cuidados devem ser culturalmente congruentes. Na abordagem do choro/ birras torna-se necess��rio conhecer o normal desenvolvimento da crian��a e em que contextos surgem para minimiz��-las, sendo importante que os pais d��em �� crian��a aten����o positiva, instituindo rotinas. Para melhorar o momento da alimenta����o os pais devem reconhecer que at�� aos dois anos decorre a janela de oportunidade de aprendizagem de rotinas e de novos sabores, salientando-se a import��ncia do ambiente de aten����o e reciprocidade durante as refei����es. Conclus��o: Os enfermeiros devem procurar orientar a sua pr��tica com base nas evid��ncias cient��ficas e tendo como base o estudo efectuado, salienta-se a promo����o da parentalidade positiva como central para a abordagem dos comportamentos de choro/birra e no momento da alimenta����o da crian��a. Palavras ��� chaves: educa����o parental, enfermeiro, aleitamento materno, alimenta����o, birra, choro, rela����o pais-filhos.

Acidentes com perfurocortantes em profissionais da assist��ncia do SAMU, Macei��

Introdu����o ��� Os acidentes de trabalho envolvendo material biol��gico entre profissionais de sa��de s��o frequentes e constituem um problema de sa��de p��blica, pois representam uma preocupa����o constante das institui����es e dos profissionais de sa��de. Os profissionais do pr�� hospitalar tornam-se mais expostos pela tens��o emocional vivida, pela natureza e circunst��ncias do seu exerc��cio profissional. Objetivos ��� Identificar a ocorr��ncia de acidentes ocupacionais com materiais perfurocortantes nos profissionais de sa��de do SAMU Macei��; identificar os acidentes mais frequentes, os per��odos em que ocorrem e avaliar as condutas tomadas ap��s o acidente. M��todos ��� Estudo descritivo com orienta����o anal��tico-descritiva desenvolvido numa amostra de 40 profissionais de sa��de, Enfermeiro socorrista, T��cnico Enfermagem e M��dicos Socorristas. A recolha de informa����o foi suportada num question��rio elaborado para o efeito. Resultados ��� A nossa amostra apresentou uma m��dia de idades de 39,2 anos, o sexo feminino foi maiorit��rio com 70,0% e 50,0% trabalha entre 6 a 10 anos na unidade. A maioria dos acidentes perfuro cortantes foram provocados por agulhas (75,0%) e dos quais n��o resultou incapacidade em 75%. A maioria dos acidentes ocorreram no ver��o e no turno da noite. Grande n��mero de profissionais (70%) n��o cumpriu com as normas de procedimentos ap��s o acidente e 80,0% dos profissionais n��o realizaram a quimioprofilaxia, n��o cumprindo com o protocolo do Minist��rios da Sa��de do Brasil. O paciente-fonte foi identificado em 87,5% dos casos mas verificamos uma subnotifica����o dos acidentes pois 45,0% dos profissionais n��o o fizeram. Nenhum profissional frequentou forma����o espec��fica sobre acidentes de trabalho Conclus��es ��� Verificamos uma alta incid��ncia de acidentes perfurocortantes entre os profisionais do SAMU. Existe uma subnotifica����o do acidente e um d��ficite nas condutas apropriadas ap��s o acidente. A popula����o estudada necessita de uma maior sensibiliza����o/forma����o quanto ��s medidas preventivas de seguran��a no ambiente de trabalho e motiva����o para o controle e preven����o dos acidentes ocupacionais no exerc��cio de sua profiss��o. Palavras-chave: Acidente de trabalho. Materiais biol��gicos. Materiais perfurocortantes.