Cássia Regina Vancini-Campanharo

Knowledge about epilepsy among health professionals: a cross-sectional survey in São Paulo, Brazil

Objective To evaluate the epilepsy knowledge among health professionals in São Paulo, Brazil. Design This is a cross-sectional study. Participants Professionals with academic degrees in physical education (n=134), nutrition (n=116), medicine (n=100), psychology (n=53), nursing (n=122) and physiotherapy (n=99) who lived in São Paulo City, Brazil. Primary and secondary outcome measures Knowledge of health professionals about epilepsy. Methods Professionals with academic degrees in physical education (n=134), nutrition (n=116), medicine (n=100), psychology (n=53), nursing (n=122) and physiotherapy (n=99) who lived in São Paulo City, Brazil, were invited to participate in the study. The subjects (n=624) answered a questionnaire composed of 25 simple closed-ended questions from three areas: personal, educational and knowledge. Results Out of all subjects, 88.5% (n=552) had a postgraduate education, while 11.5% (n=72) had only an undergraduate degree. The authors found that physical educators, nutritionists and physiotherapists received lower scores on their epilepsy knowledge than other health professionals. Conclusions Health professionals are considered better-educated group inside the society, especially with regards to healthcare issues. Thus, it is important they also have an accurate and correct knowledge about epilepsy. The findings of the present study indicate an imperative improvement in education about epilepsy, as well as an inclusion of formal programmes for epilepsy education especially for non-medical professionals. An improvement in epilepsy education might contribute to an improvement in epilepsy care and management.

Nursing care based on risk assessment and classification: agreement between nurses and the institutional protocol

OBJECTIVE to verify the degree of agreement between the levels of priority given by baccalaureate nurses in care based on risk assessment and classification and the institutional protocol, and also among peers. METHOD descriptive study, using a questionnaire with thirty fictitious clinical cases based on the institutional protocol, which is considered the gold standard, answered by twenty baccalaureate nurses. RESULTS the agreement analysis through the Kappa Coefficient concluded that the agreement between baccalaureate nurses and the institutional protocol in relation to prioritizing the levels of severity was moderate. When the agreement among peers was evaluated, it was low, as represented by the colorimetric density in shades of light gray. CONCLUSION in Brazil, some institutions have developed their own protocol, which makes it necessary to develop tools in order to evaluate the accuracy of professionals in relation to the protocols, highlighting the need for capable people to perform this activity, thus contributing to patient safety.Objetivo: verificar el grado de concordancia entre los niveles de prioridad atribuidos en el acogimiento con evaluacion y clasificacion de riesgo cuando efectuado por los enfermeros, en comparacion con el protocolo institucional y entre los pares. Metodo: estudio descriptivo, utilizando un cuestionario con treinta casos clinicos ficticios, basado en el protocolo institucional, considerado la regla de oro, respondido por veinte enfermeros. Resultados: el analisis de concordancia a traves del Coeficiente Kappa concluyo que la concordancia entre la priorizacion de los niveles de gravedad entre los enfermeros y el protocolo institucional fue moderada. La concordancia entre los pares fue baja, representada por la densidad colorimetrica en las tonalidades de gris claro. Conclusion: en Brasil, algunas instituciones desarrollaron protocolos propios, lo que hace fundamental el desarrollo de herramientas para evaluar la precision de los profesionales respecto a los protocolos, evidenciando las necesidades de capacitacion para esta actividad, contribuyendo a la seguridad del paciente.

Factors associated with functional impairment of elderly patients in the emergency departments

ABSTRACT Objective: To assess the functional capacity of elderly patients in the emergency department as to Basic and Instrumental Activities of Daily Living. Methods: A cross-sectional study of 200 elderly patients admitted to the emergency department of a teaching hospital in São Paulo (SP), Brazil. The functional capacity of the elderly was assessed by the Katz index and Lawton & Brody scale. Statistical analyses were performed using analysis of variance, Bonferroni correction, χ2 test, or the likelihood ratio test. Results: Most seniors were independent (65%), and the degree of dependence was related to age, female gender, being single and widowed, and presence of cerebrovascular disease and dementia. The more dependent elderly for Instrumental Activities of Daily Living had increased dependence for Basic Activities. Conclusion: We emphasize the importance of assessing the functional capacity of the elderly in the emergency department as it provides data for the nursing care in order to minimize or to avoid their functional impairment.

Cohort study on the factors associated with survival post-cardiac arrest

CONTEXT AND OBJECTIVE Cardiac arrest is a common occurrence, and even with efficient emergency treatment, it is associated with a poor prognosis. Identification of predictors of survival after cardiopulmonary resuscitation may provide important information for the healthcare team and family. The aim of this study was to identify factors associated with the survival of patients treated for cardiac arrest, after a one-year follow-up period. DESIGN AND SETTING Prospective cohort study conducted in the emergency department of a Brazilian university hospital. METHODS The inclusion criterion was that the patients presented cardiac arrest that was treated in the emergency department (n = 285). Data were collected using the In-hospital Utstein Style template. Cox regression was used to determine which variables were associated with the survival rate (with 95% significance level). RESULTS After one year, the survival rate was low. Among the patients treated, 39.6% experienced a return of spontaneous circulation; 18.6% survived for 24 hours and of these, 5.6% were discharged and 4.5% were alive after one year of follow-up. Patients with pulseless electrical activity were half as likely to survive as patients with ventricular fibrillation. For patients with asystole, the survival rate was 3.5 times lower than that of patients with pulseless electrical activity. CONCLUSIONS The initial cardiac rhythm was the best predictor of patient survival. Compared with ventricular fibrillation, pulseless electrical activity was associated with shorter survival times. In turn, compared with pulseless electrical activity, asystole was associated with an even lower survival rate.

Knowledge, perceptions and use of generic drugs: a cross sectional study

Objective To assess the level of knowledge, perceptions and usage profile for generic drugs among laypersons. Methods A cross-sectional study was conducted with 278 volunteers (180 women and 98 men, aged 37.1±15.8 years). A questionnaire was drawn up with questions on their use, perceptions and knowledge of generic drugs. Results Most respondents (99.6%) knew that generic drugs exist, but only 48.6% were able to define them correctly, while 78.8% of the respondents had some information about generics. This information was obtained mainly through television (49.3%). In terms of generic drug characteristics, 79.1% stated that they were confident about their efficacy, 74.8% believed that generic drugs have the same effect as branded medications, 88.8% said that generics were priced lower than branded medications, and 80.2% stated that they bought generic drugs because of price. With regard to drugs prescribed by medical practitioners, 17.6% of the participants said that their doctors never prescribed generics and only 7.5% confirmed that their doctors always prescribed generics. Conclusion For the lay public, the sample in this study has sufficient knowledge of generic drugs in terms of definition, efficacy and cost. Consequently, the volunteers interviewed are very likely to use generics. Furthermore, the results of this study indicate that programs should be implemented in order to boost generic drug prescriptions by medical practitioners.

Acolhimento com avaliação e classificação de risco: concordância entre os enfermeiros e o protocolo institucional

OBJECTIVE to verify the degree of agreement between the levels of priority given by baccalaureate nurses in care based on risk assessment and classification and the institutional protocol, and also among peers. METHOD descriptive study, using a questionnaire with thirty fictitious clinical cases based on the institutional protocol, which is considered the gold standard, answered by twenty baccalaureate nurses. RESULTS the agreement analysis through the Kappa Coefficient concluded that the agreement between baccalaureate nurses and the institutional protocol in relation to prioritizing the levels of severity was moderate. When the agreement among peers was evaluated, it was low, as represented by the colorimetric density in shades of light gray. CONCLUSION in Brazil, some institutions have developed their own protocol, which makes it necessary to develop tools in order to evaluate the accuracy of professionals in relation to the protocols, highlighting the need for capable people to perform this activity, thus contributing to patient safety.Objetivo: verificar el grado de concordancia entre los niveles de prioridad atribuidos en el acogimiento con evaluacion y clasificacion de riesgo cuando efectuado por los enfermeros, en comparacion con el protocolo institucional y entre los pares. Metodo: estudio descriptivo, utilizando un cuestionario con treinta casos clinicos ficticios, basado en el protocolo institucional, considerado la regla de oro, respondido por veinte enfermeros. Resultados: el analisis de concordancia a traves del Coeficiente Kappa concluyo que la concordancia entre la priorizacion de los niveles de gravedad entre los enfermeros y el protocolo institucional fue moderada. La concordancia entre los pares fue baja, representada por la densidad colorimetrica en las tonalidades de gris claro. Conclusion: en Brasil, algunas instituciones desarrollaron protocolos propios, lo que hace fundamental el desarrollo de herramientas para evaluar la precision de los profesionales respecto a los protocolos, evidenciando las necesidades de capacitacion para esta actividad, contribuyendo a la seguridad del paciente.

Interação medicamentosa no serviço de emergência

ABSTRACT Objective: To identify the occurrence of potential drug interactions in prescriptions for adult patients admitted to the Emergency Department of Hospital São Paulo. Methods: A cross-sectional and descriptive study. Its sample consisted of 200 medical prescriptions. The analysis of drug interactions was performed using the Drugs.com database, where they are classified according to severity of interaction as severe, moderate, mild and without interaction. Results: The number of drugs in prescriptions ranged from 2 to 19, and the average per prescription was 4.97 drugs. A total of 526 potential drug interactions were identified in 159 prescriptions (79.5%); in that, 109 were severe, 354 moderate, 63 mild interactions, and 41 showed no interaction. Conclusion: This study demonstrated potential drug interactions in 79.5% of prescriptions examined in the Emergency Department. Drug interactions can occur at any time when using medications and, during this working process, the nursing staff is involved in several steps. Therefore, training the nursing staff for the rational use of drugs can increase safety of care delivered to patients.OBJECTIVE: To identify the occurrence of potential drug interactions in prescriptions for adult patients admitted to the Emergency Department of Hospital Sao Paulo. METHODS: A cross-sectional and descriptive study. Its sample consisted of 200 medical prescriptions. The analysis of drug interactions was performed using the Drugs.com database, where they are classified according to severity of interaction as severe, moderate, mild and without interaction. RESULTS: The number of drugs in prescriptions ranged from 2 to 19, and the average per prescription was 4.97 drugs. A total of 526 potential drug interactions were identified in 159 prescriptions (79.5%); in that, 109 were severe, 354 moderate, 63 mild interactions, and 41 showed no interaction. CONCLUSION: This study demonstrated potential drug interactions in 79.5% of prescriptions examined in the Emergency Department. Drug interactions can occur at any time when using medications and, during this working process, the nursing staff is involved in several steps. Therefore, training the nursing staff for the rational use of drugs can increase safety of care delivered to patients.

Zika Virus Infection, Summer Olympic and Paralympic Games in Rio 2016, and Sports Performance

1 Centro de Educação Física e Desportos (CEFD), Universidade Federal do Espírito Santo (UFES), Espírito Santo (ES), Brasil. 2 Departamento de Fisiologia, Universidade Federal de Säo Paulo (UNIFESP), São Paulo (SP), Brasil. 3 Escola Paulista de Enfermagem, Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brasil. 4 Setor de Fisiologia Humana e do Exercício, Faculdade de Educação Física e Dança, Universidade Federal de Goiás (UFG), Goiânia, Goiás (GO), Brasil. . Authors submitted their contribution to the article to the editorial board. Accepted for printing in the Journal of Human Kinetics vol. 53/2015 in September 2016. Zika Virus Infection, Summer Olympic and Paralympic Games in Rio 2016, and Sports Performance

Characterization of cardiac arrest in the emergency department of a Brazilian University Reference Hospital: A prospective study

Background & objectives: Sudden cardiac arrest (CA) represents one of the greatest challenges for medicine due to the vast number of cases and its social and economic impact. Despite advances in cardiopulmonary resuscitation (CPR) techniques, mortality rates have not significantly decreased over decades. This study was undertaken to characterize patients that have suffered CA and to identify factors related to mortality. Methods: This prospective study was conducted at Emergency Department of São Paulo Hospital, Brazil. Two hundred and eighty five patients were followed for one year after treatment for CA. The mean age was 66.3±17.2 yr, and they were predominantly male (55.8%) and Caucasian (71.9%). Mortality rate and factors associated with mortality were the primary and secondary outcome measures. Data were collected using an in-hospital Utstein-style report. A logistic regression analysis was used to determine which variables were related to mortality. Results: Regarding the characteristics of CPR, 76.5 per cent occurred in hospital, respiratory failure was the most common presumed immediate cause of CA (30.8%) and pulseless electrical activity was the most frequent initial rhythm (58.7%). All attempts at CPR utilized chest compressions and ventilation and the most utilized interventions were epinephrine (97.2%) and intubation (68.5%). Of all patients treated, 95.4 per cent died. Patients with pulseless electrical activity had a higher risk of death than those patients with ventricular fibrillation. Interpretation & conclusions: The findings of the study highlighted that the mortality rate among CA patients was high. The variable that best explained mortality was the initial CA rhythm.

Assessment of nurse’s knowledge about Glasgow coma scale at a university hospital

ABSTRACT Objective To assess knowledge of nurses of emergency services and intensive care units about Glasgow Coma Scale. Methods This cross-sectional analytical study included 127 nurses of critical units of an university hospital. We used structured interview with 12 questions to evaluate their knowledge about the scale. Association of Knowledge with professionals’ sociodemographic variables were verified by the Fisher-test, χ2 and likelihood ratio. Results Most of participants were women mean aged 31.1 years, they had graduated more than 5 years previously, and had 1 to 3 years of work experience. In the assessment of best score possible for Glasgow scale (question 3) nurses who had graduate more than 5 years ago presented a lower percentage success rate (p=0.0476). However, in the question 7, which evaluated what interval of the scale indicated moderate severity of brain trauma injury, those with more years of experience had higher percentage of correct answers (p=0.0251). In addition, nurses from emergency service had more correct answers than nurses from intensive care unit (p=0.0143) in the same question. Nurses graduated for more than 5 years ago had a lower percentage of correct answers in question 7 (p=0.0161). Nurses with more work experience had a better score (p=0.0119) to identify how assessment of motor response should be started. Conclusion Number of year since graduation, experience, and work at critical care units interfered in nurses’ knowledge about the scale, which indicates the need of training.