Identification of Inflammatory Mediators in Saliva Samples From Hospitalized Newborns: Potential Biomarkers?

Saliva measurements serve as a noninvasive tool for clinically monitoring newborns (NB) and children, a vulnerable population with promising potential for both research and clinical practice. Saliva acts as a repository for various inflammatory biomarkers involved in diverse biological functions. Particularly for children, it offers numerous advantages when compared to plasma and urine sampling. Nevertheless, there is a significant knowledge gap regarding detectable levels of cytokines in the saliva of newborns and children, as well as studies aiming to assess the relationship of this content with physiological and pathological processes.

OBJECTIVES

To characterize the levels of 11 inflammatory mediators (IFNg, IL1b, IL2, IL4, IL6, IL8, IL10, IL12, IL17, TNF, and VEGF) in saliva samples from NB on the first and second day of hospitalization in the Neonatal Intensive Care Unit (NICU).

METHOD

Exploratory study, descriptive, nested within a primary clinical, observational, and prospective study, conducted in the NICU of a public hospital in São Paulo, Brazil. Demographic data and vital signs were recorded in the clinical records of 90 NB, and five saliva samples from 5 NB were collected between the first and second day of life (D1-D2) at approximately 8-hr intervals (8-9 am, 4-5 pm, and 11-12 pm). Saliva samples were used for the measurement of 11 cytokines (IFNg, IL1b, IL2, IL4, IL6, IL8, IL10, IL12, IL17, TNF, and VEGF).

RESULTS

Five NBs participated in this exploratory study, and the vital signs showed variability from the first (D1) to the second day (D2) of hospitalization, variability similar to that of the total population of the primary study. The presence and levels of the 11 cytokines were detected in the saliva samples, as well as a statistical correlation between 10 cytokines (IFNg, IL1b, IL2, IL4, IL6, IL10, IL12, IL17, TNF, and VEGF) and vital signs.

CONCLUSIONS

The novelty of measuring inflammatory mediators in saliva samples from hospitalized NBs in the NICU is highlighted, providing support and new perspectives for the development of clinical and experimental research and an opportunity for developing and implementing new salivary biomarkers in different population segments.

Continued breastfeeding and work: scenario of maternal persistence and resilience

OBJECTIVES

to understand the challenges in mothers' daily life and strategies adopted to reconcile activities outside the home and continued breastfeeding.

METHODS

a cross-sectional, qualitative study. Theoretical-methodological assumptions were discursive practices and production of meanings in everyday life. Participants were 22 women from a specific social media group who had breastfed at least one child for >7 months. Data were collected between November 2020 and March 2021.

RESULTS

themes: Around the world of activities outside the home; Work environment: routines, opportunities and difficulties to maintain breastfeeding.

FINAL CONSIDERATIONS

women's experiences reveal a daily life with difficulties in reconciling the desire to breastfeed and the work scenario. Support network and adaptation to children's food routine were strategies adopted to minimize risks of weaning. The results show the need to consolidate policies to encourage continued breastfeeding in the labor market.

Amamentação continuada e trabalho: cenário de persistência e resiliência materna

RESUMO Objetivos: compreender os desafios do cotidiano materno e as estratégias adotadas para conciliação entre as atividades fora do lar e a amamentação continuada. Métodos: estudo transversal, qualitativo. Pressupostos teórico-metodológicos foram: práticas discursivas e produção de sentidos no cotidiano. Participaram 22 mulheres, de um grupo de mídia social específico, que amamentaram pelo menos um filho por > sete meses. Dados foram coletados entre novembro de 2020 e março de 2021. Resultados: temas: A volta ao mundo das atividades fora do lar; Ambiente no trabalho: rotinas, oportunidades e dificuldades para manter a amamentação. Considerações Finais: a vivência das mulheres revela um cotidiano com dificuldades de conciliar o desejo de amamentar e o cenário laboral. Rede de apoio e a adaptação na rotina alimentar da criança foram estratégias adotadas para minimizar os riscos de desmame. Os resultados mostram a necessidade de consolidação das políticas de incentivo ao aleitamento continuado no mercado de trabalho.

Painful procedures and pain management in newborns admitted to an intensive care unit

OBJECTIVE

To characterize painful procedures, analgesic strategies, vital signs, and pain scores in hospitalized newborns.

METHOD

This is a primary, observational, prospective clinical study, developed in a Brazilian public hospital. Demographic data, painful procedures, pain relief measures, vital signs, and pain scores were collected from the clinical records of 90 newborns admitted to the intensive care unit and evaluated between admission and the third day of admission. For statistical analysis, the software Statistic Package for the Social Sciences and the R Software were used.

RESULTS

Newborns underwent 2,732 painful procedures, 540 non-pharmacological and 216 pharmacological strategies. The most frequently performed procedure was the heel prick (20.96%). The most commonly recorded non-pharmacological strategy was dim lighting (28.33%) and continuous fentanyl (48.83%) was the main pharmacological measure adopted. Pain score and vital signs show variability in the period evaluated.

CONCLUSION

Despite the high number of painful procedures, pain assessment records do not reflect procedural pain and the use of analgesic strategies was insufficient.

Fatigue Failure Load of a Bonded Simplified Monolithic Feldspathic Ceramic: Influence of Hydrofluoric Acid Etching and Thermocycling

Objective:

To evaluate the effect of hydrofluoric acid (HF) etching and thermocycling (Tc) on fatigue failure load of feldspathic ceramic restorations cemented with two resin cements.

Methods:

Disc-shaped feldspathic ceramic (Vitablocs Mark II; Ø=10 mm, 1.0-mm thick) and G10 epoxy resin (Ø=10 mm, 2.5-mm thick) specimens were made and randomly allocated considering three factors: ceramic etching (ie, with vs without 10% HF plus silane application), resin cement (ie, self-adhesive [RelyX U200; U200] or conventional [Multilink Automix; MA]), and Tc (ie, with vs without 5-55°C/12,000 cycles). Adhesive cementation followed each manufacturer's instructions. The fatigue test (n=20) was based on the staircase approach (250,000 cycles; 20 Hz). Contact angle, surface topography, and fractography analysis were also executed. Specific statistical tests were employed for each outcome (α=0.05).

Results:

The interaction of HF and Tc factors decreased the fatigue resistance for both cements (U200 542.63>U200/HF-Tc 495.00; MA 544.47>MA/HF-Tc 506.84). Comparing the cements associated with HF or Tc, there was statistical superiority for MA (U200-Tc 537.37<MA-Tc 561.32; U200/HF 535.79<MA/HF 557.11), and no statistical difference was detected when only cement type or its association with HF-Tc was compared (U200 542.63=MA 544.47; U200/HF-Tc 495.00=MA/HF-Tc 506.84). The fracture always originated from defects at the ceramic-intaglio surface as radial cracks.

Conclusion:

HF etching plus silane agent increased the ceramic surface free energy and its wettability, but it did not provide better results in terms of fatigue resistance compared with silane agent application only. The association of HF etching and aging significantly reduced the fatigue resistance of the material, regardless of the resin cement used.

SIGNIFICANDO O AMAMENTAR NA PRISÃO

RESUMO Objetivo: compreender os significados da experiência de amamentar atribuídos por mulheres privadas de liberdade. Método: trata-se de uma pesquisa qualitativa, desenvolvida por meio dos princípios da análise comparativa dos dados, adotando a codificação aberta e axial, e do Interacionismo Simbólico como referencial teórico. A coleta de dados foi feita por meio de entrevistas em profundidade, com 27 nutrizes e três gestantes, em seis penitenciárias do Estado de São Paulo, que compuseram três grupos amostrais. Resultados: a análise dos dados resultou em três temas: “Buscando a remissão pela maternidade”, onde a amamentação se insere como elemento de promoção vínculo entre mãe e filho e na promoção do bem estar materno, mas está inserida em um contexto de conflitos e perdas sociais; “Vivendo o cotidiano do apego e a expectativa da separação”, que reflete a possibilidade de ruptura da relação mãe e filho, com a conclusão do período de permanência regulamentar da criança no ambiente prisional; “Reconhecendo que houve perdas”, mas que valeu a pena, que revela uma avaliação materna sobre sua decisão de manter a criança junto a si na prisão. Conclusão: a amamentação é um dos cuidados fundamentais que a mulher privada de liberdade pode oferecer ao filho, e ainda, experiência alentadora que propicia o bem estar infantil e materno e que ela vivencia em meio a um contexto de rupturas, conflitos e preocupações com suas perdas pessoais e a condição penal.

Breastfeeding self-efficacy and postpartum depression: a cohort study

OBJECTIVE

to evaluate breastfeeding self-efficacy, the presence of postpartum depression symptons and the association between breastfeeding self-efficacy and postpartum depression with cessation of exclusive breastfeeding.

METHOD

cohort study with 83 women. The instruments used were the Breastfeeding Self-Efficacy Scale and the Edinburgh Postnatal Depression Scale. Statistical analysis was conducted using the log-rank tests, analysis of variance and the Cox survival model.

RESULTS

breastfeeding self-efficacy (p = 0.315) and postpartum depression (p = 0.0879) did not show any statistical difference over time. The chances of cessation of exclusive breastfeeding decreased by 48% when self-efficacy changed from low to medium and by 80% when it changed from medium to high. Postpartum women who scored ≥10 on the Edinburgh Postnatal Depression Scale interrupt exclusive breastfeeding, on average, 10 days earlier than those with a score ≤9, whose median breastfeeding duration was 38 days postpartum.

CONCLUSION

breastfeeding self-efficacy was proved to be a protective factor for exclusive breastfeeding, while postpartum depression is a risk factor.

What are the factors that contribute to the development of sexual dysfunction in breastfeeding women? A systematic scoping review protocol

INTRODUCTION

Female sexual dysfunction is a public health problem. Evidence suggests that the population of nursing women is more vulnerable to the phenomenon due to breast feeding. Thus, this protocol was developed to explore the factors that contribute to the development of sexual dysfunction in breastfeeding women.

METHODS AND ANALYSIS

The systematic scoping review will be conducted in six stages, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. The databases used will be: PubMed, Excerpta Medica Database, Cumulative Index for Nursing and Allied Health Literature, PsycINFO, Science Direct, Web of Science and Google Scholar. The searches were made until 1 June 2018, and no retrospective time limit was used. For the organisation of the literature retrieved from the databases, the EndNote Basic manager will be used. The Cochrane model will be used for the data extraction. The analysis of the quantitative data will be carried out through descriptive statistics and the qualitative data will be submitted to thematic analysis. The methodological quality of the empirical studies will be evaluated using the Mixed Methods Appraisal Tool.

ETHICS AND DISSEMINATION

As it will be a review study, without human involvement, there will be no need for ethical approval. The results will be disseminated in a scientific journal, as well as in various media, such as: conferences, seminars, congresses or symposia.

Depressão pós-parto e autoeficácia materna para amamentar: prevalência e associação

Resumo Objetivo Identificar a prevalência de sintomas de depressão pós-parto e o nível de autoeficácia para amamentar, entre puérperas atendidas num Centro de Incentivo ao Aleitamento Materno, e analisar possíveis associações. Métodos Estudo transversal com 208 mulheres, até 60 dias pós-parto, submetidas à Escala de Depressão Pós-parto de Edinburgo e à Escala de Autoeficácia para Amamentar. Resultados Sintomas de depressão pós-parto estiveram presentes em 31,25% das mulheres, que apresentaram níveis de autoeficácia para amamentar médio (39,9%) e alto (36,06%). Ter média ou alta autoeficácia diminui em 27,4% ou 38,8%, respectivamente, o escore de depressão, enquanto a elevada pontuação na escala de depressão pós-parto reduz em 11,84 pontos o escore da autoeficácia na amamentação. Conclusão Prevalência elevada de sintomas de depressão pós-parto e de autoeficácia para amamentar foram evidenciados na população estudada. Os níveis de sintomas de depressão pós-parto e de autoeficácia revelaram associação de causa e efeito entre si.

Observation of environment-induced double sudden transitions in geometric quantum correlations

Correlations in quantum systems exhibit a rich phenomenology under the effect of various sources of noise. We investigate theoretically and experimentally the dynamics of quantum correlations and their classical counterparts in two nuclear magnetic resonance setups, as measured by geometric quantifiers based on trace norm. We consider two-qubit systems prepared in Bell diagonal states, and perform the experiments in real decohering environments resulting from Markovian local noise which preserves the Bell diagonal form of the states. We then report the first observation of environment-induced double sudden transitions in the geometric quantum correlations, a genuinely nonclassical effect not observable in classical correlations. The evolution of classical correlations in our physical implementation reveals in turn the finite-time relaxation to a pointer basis under nondissipative decoherence, which we characterize geometrically in full analogy with predictions based on entropic measures.

[Nursing contributions to the development of the Brazilian Telehealth Lactation Support Program]

The National Telehealth Program was founded by the Ministry of Health, in partnership with the Ministry of Education (Ministério da Educação - MEC) and the Ministry of Science and Technology (Ministério da Ciência e Tecnologia - MCT), to support the development of family healthcare teams throughout the country. The São Paulo Telehealth Center has developed the Telehealth Lactation Support program, which provides primary healthcare professionals with information on diverse aspects of breastfeeding. This paper reports the development of the Lactation Support program and the nursing contributions. Project methodology included the formation of a multidisciplinary group of pediatricians, nurses, speech and language therapists, nutritionists, and dentists. Multimedia teaching resources were prepared for inclusion in the Cybertutor platform. Telehealth Lactation Support is an innovative and promising addition to continuing education for healthcare professionals and provides a framework for the development of other programs.

Measuring bipartite quantum correlations of an unknown state

We report the experimental measurement of bipartite quantum correlations of an unknown two-qubit state. Using a liquid state Nuclear Magnetic Resonance setup and employing geometric discord, we evaluate the quantum correlations of a state without resorting to prior knowledge of its density matrix. The method is applicable to any 2 ⊗ d system and provides, in terms of number of measurements required, an advantage over full state tomography scaling with the dimension d of the unmeasured subsystem. The negativity of quantumness is measured as well for reference. We also observe the phenomenon of sudden transition of quantum correlations when local phase and amplitude damping channels are applied to the state.

Abordagem da amamentação nos primeiros anos do ensino fundamental

Para analisar os currículos e os livros escolares adotados nos primeiros cinco anos do Ensino Fundamental na disciplina de Ciências quanto à presença ou não de termos relacionados à prática da amamentação, realizamos um estudo descritivo analisando o currículo e 16 manuais de 25 escolas públicas de três municípios do interior paulista, de setembro/2010 a fevereiro/2011. Definimos previamente alguns conceitos considerados imprescindíveis para ensinar e explicar à criança noções de amamentação. Verificamos que nenhum bloco temático do currículo aborda explicitamente a temática amamentação. Nove dos 16 conteúdos definidos estavam presentes em oito dos 16 livros. Da análise emergiu a categoria apoio e ajuda da família. Três obras utilizavam ilustrações associadas à alimentação artificial. No programa e nos manuais escolares existem diversas oportunidades de incluir este tema. Aconselha-se a integração dos conteúdos em todos os manuais de Ciências dos primeiros anos do ensino fundamental.

Prevalence of Anemia in Children Three to 12 Months Old in a Health Service in Ribeirão Preto, SP, Brazil

Iron deficiency anemia is the most common nutritional deficiency among children. This cross-sectional, descriptive and quantitative study is part of a multicenter project, which verified the prevalence of anemia in children aged three to 12 months, treated by a health service unit in Ribeirão Preto, SP, Brazil. Interviews with mothers and determining hemoglobin dosage were carried out with 121 children who participated in the study. Two international criteria were adopted as parameters of anemia according to the children's age. Descriptive statistics, measures of central tendency and associations were used for data analysis. The prevalence of anemia among 69 children aged three to 5 months was 20.2% and 48.0% among 52 children aged six to 12 months. The total prevalence of anemia was 32.2%. There was significant association between anemia and children's age, and anemia and the consumption of liquid cow's milk.

Necessidades de saúde de mulheres em processo de amamentação

Nosso objetivo foi identificar as necessidades de saúde de mulheres no processo de amamentação. Entrevistamos 238 mulheres, organizamos os dados segundo proposta do Discurso do Sujeito Coletivo. Utilizando taxonomia de Matsumoto, encontramos: Necessidade de boas condições de vida (ter boa alimentação; trabalhar/estudar; ter tempo para si; sono e repouso adequados; boa saúde mental; boas condições para amamentar seu filho); Necessidade de ter acesso a todas as tecnologias de saúde que contribuam para melhorar e prolongar a vida (lidar com intercorrências da amamentação, ter acesso aos serviços de saúde); Necessidade de ter vínculo com um profissional/equipe de saúde; Necessidade de autonomia e autocuidado na escolha do modo de "andar a vida" (ter orientação quanto à amamentação; receber apoio do profissional; sentir-se segura para amamentar).

A vivência de mães de recém-nascidos prematuros no processo de lactação e amamentação

Este estudo qualitativo teve como objetivo geral compreender a vivência da amamentação de mães de recém-nascidos prematuros durante a internação de seus filhos e como objetivo específico descrever a performance de amamentação e condições de suas mamas e lactação, por ocasião da alta dos filhos. Adotaram-se o modelo Pesando Riscos e Benefícios como referencial de análise e o método do Discurso do Sujeito Coletivo para organização dos dados. Participaram do estudo 11 mulheres, mães de bebês prematuros internados na Unidade Neonatal do HU-USP. A entrevista semiestruturada possibilitou a elaboração de oito Discursos do Sujeito Coletivo listados em dois blocos com os seguintes temas: "Lactação e amamentação" e "Contexto hospitalar e doméstico", que possibilitaram de compreensão de que as mães deste estudo vivenciam um processo de avaliação contínua das condições de saúde, crescimento e desenvolvimento da criança, que contribui para sua motivação para amamentar e direciona suas ações no prosseguimento da amamentação.

[Women's needs in immediate puerperium in a public maternity in Salvador, Bahia, Brazil]

In order to identify women's needs in their immediate puerperium and to understand their perception of the nursing care they received during this period, the authors developed a descriptive study with qualitative data in a gender perspective. Twenty-five women were interviewed in a public hospital in Salvador, State of Bahia. From the content's analysis, in which a thematic approach was used, emerged two categories: the need for physical care and for a gentle welcome. The study results point out to the need for a change in nursing practices, which should incorporate values and humanitarian initiatives as well as technical procedures.

Doctoral education in nursing in Brazil

This study aimed to present the trajectory of doctoral education in nursing in Brazil from 1981 to 2004. A descriptive and analytical study was carried out, using documents available at the Brazilian Federal Agency for Support and Evaluation of Graduate Education, a body responsible for the recognition, evaluation and coordination of graduate studies in Brazil. Data analysis revealed that there are 13 doctoral courses in nursing, most of which are concentrated in the Southeast (69.2%), and that teaching and scientific production have been influenced by demographic and epidemiological transitions and by historical, social and political movements. Knowledge production is related to Nursing Care, Health Management and Practices and Theoretical Foundations of Care. Doctoral programs have prepared leaders in the fields of education, research and public policy development, in health institutions as well as in public policies, health institutions and governmental entities.

Traço e estado de ansiedade de nutrizes com indicadores de hipogalactia e nutrizes com galactia normal

Este estudo objetivou identificar e comparar o traço e estado de ansiedade, no 10º dia pós-parto e estado de ansiedade no 30º dia puerperal, das nutrizes primíparas e multíparas que apresentaram indicadores de hipogalactia e nutrizes com galactia normal; verificar possíveis relações entre o estado de ansiedade das nutrizes nesses dois momentos com a presença dos indicadores de hipogalactia. É um estudo exploratório/descritivo, cujos dados foram obtidos com 168 nutrizes e seus filhos, por meio de entrevistas realizadas em consulta de enfermagem nos 10º e 30º dias pós-parto. Os resultados obtidos mostraram que as primíparas e multíparas hipogalactas e as primíparas com galactia normal apresentaram traço de ansiedade mais elevado do que os estados de ansiedade por ocasião do 10º e 30º dia pós-parto. Houve remissão dos sinais maternos de ansiedade, com o passar do tempo, que pode ter sido decorrente da correção da técnica da amamentação e apoio às nutrizes.

[The history of the nursing interunits doctoral program and its contribution to Brazilian nursing]

Authors aimed at describing the history of the Nursing Interunits Doctoral Program offered at the São Paulo and Ribeirão Preto campi from 1981 to 2004. Data were collected based on the Program documents (resolutions, opinion, students' records, reports, etc). The Nursing Interunits Doctoral Program was approved by the University of São Paulo Graduate Council in May 25, 1981. During the past several years, until the beginning of the 1990s, the demand was centered in the students from the Schools responsible for the Program, followed by faculty from other Nursing Schools in Brazil. The Program has resulted in the formation of researchers from different Brazilian and South American Universities, leading the creation of research groups and originating new graduate programs.

[Doctoring interunits in nursing program: 21 years building science]

The Doctoring Interunits in Nursing Program was the first created in Latin America and has titled 290 nurses until the second semester of 2004. This study presents some thesis characteristics upheld in the program, focusing the thematic areas and research methods used. The summaries of 287 theses supported until the first semester of 2004, have been analyzed. The most investigated fields up to now were: Children, Woman, Adult/ Elderly Health and Education. The quantitative research method predominated until the end of the 80's, since then an intense production of qualitative method researches started to occur. Still in the first decade of the program, the themes started to talk about the aspects that connect the practice of nursing to the political and social contexts, converging to the current program's paradigmatic axis: "Theoretical, philosophical, historical bases of knowledge and of the nursing practice."

Teses produzidas nos programas de Pós-Graduação em Enfermagem de 1983 a 2001

Este estudo descreve a relação das teses de doutorado em enfermagem defendidas nos Programas de Pós-Graduação em Enfermagem, no Brasil, com as linhas de pesquisas definidas pela área da Enfermagem, em três campos: profissional, assistencial e organizacional. É uma pesquisa descritiva-exploratória, com base nos relatórios dos programas de Pós-Graduação, avaliados pela Capes e no Catálogo Informações sobre Pesquisas e Pesquisadores em Enfermagem CEPEn/ABEn, referentes ao período de 1983-2001, totalizando 448 resumos. O campo assistencial alberga o maior número de produção, seguido do organizacional e do profissional. As investigações evidenciam uma tendência para estudos de abordagem qualitativa, descortinando possibilidades de aprofundamento do conhecimento da realidade ou compreensão de fenômenos sociais que tangenciam a prática da enfermagem, porém, os estudos de intervenção na prática profissional e de desenvolvimento de tecnologia ainda estão em fase de construção.

In vitro HgCl2 exposure of immune cells at different stages of maturation: effects on phenotype and function

This is the first study to investigate the hypothesis that the immunotoxic effects of inorganic mercury may be modulated by inherent differences in the responsiveness of immune cells related to the age of the donor. We exposed cells from lymph nodes, spleen, and thymus, collected from 7- and 10-day-old CD.1 pups, as well as from adult CD.1 mice, in terms of the effects of mercury in vitro on responses to Con-A stimulation with respect to proliferation, cytokine production, and cell phenotype. The effects of mercury on proliferation were age and organ dependent, while effects on cytokine production were only age dependent. Effects of mercury were observed only on splenocyte T-cell subpopulations and only in cells from 10-day-old pups and from adults. Mercury had no effect on IFN-gamma and IL-4 production by splenocytes from 7-day-old pups, but significantly decreased release of these cytokines by splenocytes from 10-day-old pups and adults. Hg did not affect IL-4 production by lymph node cells or thymocytes. In lymph node cells Hg affected IFN-gamma production only at 7 days. These data indicate that inherent properties of immune cells at different stages of development may influence the response to immunotoxicants.

Prenatal HgCl2 exposure in BALB/c mice: gender-specific effects on the ontogeny of the immune system

Because mercury is highly toxic to developing organisms, we tested the hypothesis that prenatal exposure to HgCl(2) can induce persistent immune dysfunction. Pregnant BALB/c mice were administrated every other day, for 11 days with HgCl(2) (200 microg/kg). Their offspring were studied at PND10, 14, 21, and 60. Lymph nodes (LN), spleens, and thymus were harvested and proliferation and cytokine production were studied in vitro. We report that prenatal HgCl(2) exposure exerts organ-specific effects on cell number, proliferation, and cytokine production in pre-weaning pups. At adulthood (PND60), effects of prenatal HgCl(2) exposure were still observed, but expressed differently in females and males. In adult females, an inhibitory effect was observed on cytokine production by thymocytes, LN cells, and splenocytes. In males, a stimulatory effect was observed. Overall, we conclude that in vivo exposures to low doses of HgCl(2) can induce persistent sex-specific immunotoxic effects, observable in adulthood.

Comunicação não-verbal: uma contribuição para o aconselhamento em amamentação

O "Curso de Aconselhamento em Amamentação", idealizado e implantado pela United Nation's Children's Emergency Fund -UNICEF, em parceria com a Organização Mundial da Saúde - OMS, representa uma das importantes iniciativas no sentido de valorizar a mulher enquanto agente da amamentação. Visando a compreensão e facilitação da aplicação das habilidades de comunicação não-verbal, que esse curso se propõe a desenvolver nos profissionais, este trabalho tem como objetivo organizar pressupostos teóricos que dêem suporte para o ensino das Habilidades de Ouvir e Aprender 1- "Use comunicação não-verbal útil", fundamentado a partir de conceitos da comunicação humana, extraídos de diversos autores sobre o tema. Percebemos que as habilidades discorridas no curso centram-se em técnicas somente voltadas para as atitudes dos profissionais, porém, é fundamental estarmos atentos aos sinais não-verbais da mulher, pois esses retratam suas emoções. Tais sinais podem ser indicadores das dificuldades que a mulher enfrenta, das interpretações que ela está fazendo acerca de elementos interacionais em seu contexto e que, muitas vezes, são os indicativos do curso que ela poderá imprimir ao processo de amamentação.

Representações de puérperas sobre o sistema alojamento conjunto: do abandono ao acolhimento

O objetivo desse estudo foi compreender a representação social das puérperas acerca do Alojamento Conjunto (AC). Participaram 23 puérperas internadas no AC do HU-USP. A análise dos dados, obtidos por entrevistas individuais e grupos focais, baseou-se nas Representação Sociais. Uma das representações sobre sua internação mostra sentimento de medo, submissão às rotinas institucionais e equipe de saúde, um misto de acomodação e resistência a maneira impessoal como são tratadas. A Hospitalização: do abandono ao acolhimento, indica como a disponibilidade de interagir dos profissionais atua como elemento de re-significação das representações de abandono e indiferença sobre o atendimento à mulher.

Molluscicidal activity against Biomphalaria glabrata of Brazilian Cerrado medicinal plants

Alcoholic extracts of six Brazilian Cerrado medicinal plants were evaluated for their molluscicidal activity against Biomphalaria glabrata, intermediate host of schistosomiasis. Stryphnodendron polyphyllum bark extract, rich in condensed tannins, was the most promising as molluscicide.

[The Pro-ABEn project: contributions and reflexions for a marketing strategy for the association]

In the present study, an internal analysis of the Brazilian Association of Nursing (ABEn) was carried out in order to identify the representations of the members of the national and regional management departments of ABEn, regarding this association. The objective was to gather subsidies for the planning and implementation of a project aiming at institutional empowerment. The scenarios for data collection were the regional and national management departments, as well as all the members available from the each regional section and two members from the national office. Data collection was done through a form, which was answered by 15 sections during the period between 1997 and 2002. The analysis of the empirical data material was done in two ways. The first analysis was based on the Discourse of the Collective Subject--DCS, and the second through Institutional Analysis. The representations of the subjects interviewed could be identified, enabling the planning of marketing strategies for ABEn.

[Nursing and breastfeeding: combining secular practices]

Support for breastfeeding, one of the factors contributing to mother-child wellbeing, has increased through innumerable government and non-government initiatives. Despite this, women still have difficulty finding specialised help to solve problems related to breastfeeding and lactation after discharge from hospital. We describe the Domiciliary Attendance to Mother and son, whose aim it is to give assistance and advice to mothers in their homes. This assistance consists of teaching simplified breastfeeding management techniques, based on the Symbolic Interactionism Model. All the women assisted under this program have been able to continue breastfeeding or to re-lactate successfully.

[Gastric probe used in pre-term newborns: study of changes in flexibility of constituent polymer]

The pre-term newborn care at neonatal units, which makes continued use of orogastric probes have drawn our attention to an apparent alteration in probes flexibility upon removal thereof for routine replacement at approximately 72 hours. Due to the lack of elements explaining such facts and information as to whether or not such findings are additional risks to the health condition of such children, the main objective of this study was as follows: to compare the flexibility of vinyl-made gastric probes use for pre-term newborn at 24 48 and 72 hours.

[Revealing the different aspects of breastfeeding through qualitative research]

The purpose of this study is to understand the issues related to breastfeeding, which have generated the current scene, as well as, new scientific trends in this area. It also indicates current concepts, which emerged from qualitative studies done by nurses having as reference different theoretical models. These studies show that breastfeeding depends on the meanings women attribute to this experience built through their personal history and interactions within the family and community context. In general, their studies elucidate the experience of breastfeeding and provide tools for nursing professionals to develop in their practice with the mother, infant and family during the breastfeeding period.

[Constructing the meaning of breast feeding through nursing care]

From the referential of Symbolic Interactionism and Dada Based Theory we have searched to achieve the objectives of comprehending the meaning, attributed by the nursing student to breastfeeding and to nursing interventions in this process. The study was accomplished with graduation students from Sao Paulo University (USP) Nursing School. The study results show that the student experience his relation to breastfeeding and to his learning process in assisting the nutrice and her child expressed by two themes: BUILDING UP A VIEW OVER BREASTFEEDING and BUILDING UP ASSISTANCE TO BREASTFEEDING. These themes portrait students' conceptual and technical evolutive process about breastfeeding assistance and their perception of being a nurse, attributing meanings to their performance in the process that is experienced by woman and her child.

[Production of scientific papers by nurses from public and private hospitals in the district of Sao Paulo]

This study shows the nurse's scientific publication from seven public and six private hospitals in São Paulo city, from january/1989 to june/1995. From a total of 486 papers identified, 242 were published as abstracts, 124 in annals, 92 in nationals and international journals, 21 as book chapters and 7 as books in nursing. The facilities and difficulties in publishing nursing scientific production were also discussed.

[Reflections on the practice of breast feeding]

The author makes analyses of breast feeding, doing a reflexion about the mainly indicators who has determined the actual situation, looking for identify ways for win the ideal cenary to future of breast feeding.

[Breast feeding: assuming risks or guaranteeing benefits]

The development of several action of promotion of the breastfeeding seems do not reach many of the variables that determinate the breastfeeding course. With the proposal of understanding what makes the woman decide about breastfeeding or wearing, this study was developed trying to get the conscious meaning of the breastfeeding experience for the woman, how the importance of the breastfeeding is shown by the woman's action and develop a theoretical sample that represents the experience of breastfeeding for the woman. Based on the theoretical presupposition of the Symbolic Interactionism and taking the Grounded Theory as the methodology, we described the breastfeeding based on the woman's point of view. The research shows that the woman experiences the breastfeeding from a process that evaluates and gives value to it, and that is understood by the themes: Evaluating the capability of breastfeeding, Evaluating the woman's feeling and Taking Decisions which the central phenomenon, representative of the process, is called WEIGHING THE RISKS AND BENEFITS. This study shows that the elements that give the policies for the breastfeeding result from the relation between the action of breastfeeding and several significant symbols shown in the interactive situations experienced by the woman.

[The integration of teaching programs in the disciplines of obstetrical nursing and the administration of nursing services in maternity]

Este relato descreve as dificuldades e os pontos positivos sentidos pelas alunas, enfermeiras e docentes que participaram no 29 semestre de 1989, da integração das disciplinas " Enfermagem Obstétrica" e "Administração de Serviços de Enfermagem em Maternidade " na Escola de Enfermagem da Universidade de São Paulo — EEUSP.

[A descriptive study of the defining characteristics of nursing diagnosis: sexual dysfunction]

The defining characteristics of the nursing diagnosis "Sexual Dysfunction" were gathered from NAAM assessment records. From this population 96 records with the defining characteristics of Sexual Dysfunction were selected. The 9 defining characteristics proposed by The North American Nursing Diagnosis Association were used as a framework for the data collection tool. The 3 most frequently defining characteristics were absence of sexual desire (71.9%), vaginal discharge (64.5%), and pain (44.8%). The authors concluded that 6 defining characteristics have not appeared; absence of sexual desire and vaginal discharge can be considered as minor characteristics. The authors recommend the implementation of other studies to clarify the subjective defining characteristics.

[A systematized procedure for the technical nursing care of puerperae with breast engorgement]

This research approaches a systematized Procedure of Nursing Care to puerperas with mammary engorgement. The author verified the kind of engorgement most frequent, mammary sector most affected and some interference factors in the evolution of mammary engorgement.

[The emotional reactions of the woman in the puerperium]

A autora procurou obter, através de declarações de enfermeiras, informação sobre se estas conseguem identificar manifestações de comportamento de puérperas que evidenciam reações emocionais e se as mesmas se julgam preparadas para atender adequadamente as puérperas, considerando tanto os aspectos físicos quanto os emocionais.

Response of factor VIII/von Willebrand factor to intranasal DDAVP in healthy subjects and mild haemophiliacs (with observations in patients with combined deficiency of factors V and VIII)

The effect of a single standard dose of intranasal DDAVP (260 micrograms) was investigated in healthy subjects and in patients with mild deficiencies of VIII:C. Changes in FVIII/VWF activities were measured from baseline after 30, 60, 120 and 360 min of administration of the drug. Intranasal DDAVP was followed by a two-fold increase of VIII:C in both groups studied. VIIIR:AG and VIIIR:RCo increased to a lesser extent. Even though FVIII/VWF activities reached their maximum after 60-120 min, a significant increase over baseline was still observed after 360 min. The rise of VIII:C was unrelated to the body weight of the patients and was proportional to the baseline levels of this factor. In two sisters with combined deficiencies of FV/FVIII, the responses in all activities of FVIII/VWF were similar to those seen in mild hemophiliacs. Factor V did not undergo any variation. No alteration in serum osmolarity and no consistent variation in blood pressure or pulse rate were noted. It is concluded that the i.n. administration of a single high dose of DDAVP might be adopted to provide an emergency aid in bleeding patients with mild to moderate haemophilia A and to yield higher VIII:C levels in blood donors.