Construction and validation of a Brazilian educational comic book for pediatric perioperative care

PURPOSE

Educational material can facilitate familiarization with the hospital and surgical contexts for children and guardians and minimize potential difficulties experienced during hospitalization. This study aimed to construct and validate a comic book for guiding children in perioperative care.

DESIGN AND METHODS

A descriptive study was conducted at a pediatric ward in a university hospital in Brazil. A content validity index with a concordance of 0.8 was used for validation.

RESULTS

The content was validated with the participation of 19 content judges (nurses, anesthesiologists, and surgeons); face validity was achieved with the participation of 22 parents and their respective children aged 7-12 years old. The contents of the comic book included perioperative care (hospitalization, fasting, surgical team, operating room, and anesthesia). Universal content validity indices of 0.89 and 0.99 were obtained for content and face validity, respectively. Free Portuguese educational material titled "Getting to know the Surgery Center" was created in the form of a 19-page comic book in print and digital formats. The comic book was face and content validated and considered relevant for children in perioperative care. The suggestions of the healthcare professional and families who participated contributed toward the final version of this educational comic book.

PRACTICE IMPLICATIONS

This study aimed to further the development of educational materials that help alleviate stress, fear, and anxiety among children awaiting surgery, as well as their parents/guardians. As such, it offers a positive and appropriate contribution to perioperative nursing. The study further contributes to a discussion on pediatric nursing, which goes beyond clinical care and procedure. In the context of pediatric surgery and the children themselves, the results indicate that the family must be included in the surgical process and that the language employed must be appropriate to the target audience. Our comic book can be used by nurses to develop similar resources for diverse needs.

Risk indicators of caries lesion activity in children

AIM

Determine the risk indicators of caries lesion activity in a child sample from Porto Alegre, Brazil.

MATERIALS AND METHODS

Study design: cross-sectional study included 97 individuals aged between 3 and 12-years who sought treatment at the Paediatric Clinic at the Dental Teaching Hospital at the Federal University of Rio Grande do Sul, between 2017 and 2018. Questionnaires recorded sociodemographic data, frequency of sugar intake, and toothbrushing frequency. Clinical examination included the visible plaque index, gingival blood index, and caries lesion activity.

RESULTS

s The mean of surfaces with active caries lesions was 9.81 (IC 95% = 8.47-11.15). Children who presented a frequency of sugar intake of twice/day (PR = 1.62, IC 95% = 1.30-2.03), three times/day (PR = 1.68, IC 95% = 1.37-2.08), and four or more times/day (PR = 1.59, IC 95% = 1.26-2.01), were likely to have active lesions. Ages between 8 and 12-years were associated with a lower probability of active carious lesions (PR = 0.77, IC 95% = 0.66-088).

STATISTICS

Poisson regression analysis was used to estimate the child's relative risk of developing new active caries lesions.

CONCLUSIONS

The monitoring of sugar intake should be considered a strong instrument for the strategies of control of dental caries in children.

Evaluation of CD83 antigen in the normal mammary epithelium and fibroadenoma human

Abstract #2038

Background: The immune response initiation requests the capture and the presentation of the antigens to the specific lymphocytes. The cells that has this capacity are denominated antigen-presenting cells, and the dendritic cell (DC) is the one that has larger specialization degree for these functions. The DC maturation it is considered essential for the beginning of the immune response. The CD83 antigen is a co-stimulator, member of the immunoglobulin superfamily with 45Kd, and your expression is an important marker of the maturation of DC.
 Objectives: To analyze the CD83 antigen expression in the human's breast fibroadenoma and in the adjacent breast tissue and to identify the clinical features that can influence this expression.
 Material and Methods: It is a retrospective study where 29 histopathologic materials of breast fibroadenomas and the adjacent breast tissue, of 28 women in reproductive age, were analyzed. The immunohistochemistry method was used for analysis of the CD83 antigen expression and, subsequently, the cells were counted by light microscopy. A thousand epithelium cells of each case were analyzed (five hundred of the fibroadenoma and five hundred of the adjacent breast tissue) for statistical calculation of the expression or not of the antigen reaction in the cells. We used parametric test (t-Student) for statistical analysis of the results.
 Results: The CD83 antigen expression positive in the fibroadenoma's cells (365.52 ± 133.13) in relation to the adjacent breast tissue's cells (189.59 ± 140.75) was statistically greater (p <0.001). Several clinical features were analyzed, however, only parity showed influence in the expression of the CD83 antigen in the adjacent mammary tissues, and the positive expression was more evident in nulliparous women (p=0.042).
 
 Conclusion: The CD83 antigen expression was statistically greater in the breast fibroadenoma's cells, when compared with the one of the adjacent breast tissue. No clinical variable influenced CD83 expression in the breast's fibroadenoma, however, it was significantly greater in the adjacent normal breast tissue of nulliparous women.

Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 2038.

Validity of diode laser to monitor carious lesions in pits and fissures

OBJECTIVE

To analyse the DIAGNOdent's performance to longitudinally monitor the arrestment of non-cavitated carious lesions in occlusal surfaces.

METHODS

The sample consisted of 15 children (12-13 years old) with 40 active non-cavitated lesions. The protocol for the examinations was: prophylaxis, drying teeth for 30s; clinical examination, examination with DIAGNOdent. Lesions were classified as active or arrested according to this criteria--active lesion: opaque and whitened enamel, and arrested lesion: enamel with shiny, white or dark spot. The cut offs used for DIAGNOdent measurements were: between 0 and 14--sound tissue (stage 1), between 15 and 20--enamel lesion (stage 2) and above 20--dentine lesion (stage 3). The patients were treated with professional plaque removal, topical application of 1.23% of fluoride in gel and oral hygiene instructions. Thirty days after the first session, the lesions were examined (clinical and DIAGNOdent examinations). The lesions that were not arrested after this period were resubmitted to the previous treatment measurements at 14-day intervals until total clinical arrestment.

RESULTS

The Kappa index was 0.75 for the clinical examination and 0.71 for the DIAGNOdent examination. After 60 days, all the 40 initial lesions were arrested. The mean, +/-standard deviation, median and range of values with DIAGNOdent of active lesions were respectively 22.34, +/-21.41, 15.00 and 0-81.00; after clinical arrestment these values were 20.25, +/-18.01, 15.00 and 0-71.00. No significant difference was observed between the two periods.

CONCLUSION

DIAGNOdent was not capable to monitor changes occurring during the clinical arrestment of lesions.