Hand hygiene compliance of healthcare professionals in an emergency department

Abstract OBJECTIVE To analyze compliance with hand hygiene by healthcare professionals in an emergency department unit. METHOD This is a longitudinal quantitative study developed in 2015 with healthcare professionals from a university hospital in the state of Rio Grande do Sul. Each professional was monitored three times by direct non-participant observation at WHO’s five recommended moments in hand hygiene, taking the concepts of opportunity, indication and action into account. Descriptive and analytical statistics were used. RESULTS Fifty-nine healthcare professionals participated in the study. The compliance rate was 54.2%. Nurses and physiotherapists showed a compliance rate of 66.6% and resident physicians, 41.3%. When compliance was compared among professional categories, nurses showed greater compliance than resident physicians (OR = 2.83, CI = 95%: 1.09-7.34). CONCLUSION Hand hygiene compliance was low. Multidisciplinary approaches could be important strategies for forming partnerships to develop learning and implementation of hand hygiene practices

A participação dos agentes indígenas de saúde nos serviços de atenção à saúde: a experiência em Santa Catarina, Brasil Participation by indians health agents in health services: the experience in Santa Catarina State, Brazil

Este trabalho analisa a formação e o papel do agente indígena de saúde (AIS) nas Terras Indígenas (T.I.) Xapecó e Laklãnõ, Santa Catarina, Brasil, frente à Política Nacional de Atenção à Saúde dos Povos Indígenas. O papel do AIS na atenção básica de saúde é definido com base na mediação entre os saberes e práticas de atenção à saúde tradicionais e biomédicos, inserido no conceito de atenção diferenciada. Em ambas as T.I. foi constatada uma grande rotatividade de AIS, bem como a falta e/ou a inadequação de cursos de capacitação. Observaram-se ainda dificuldades dos AIS para entender a justificativa das atividades delegadas a eles, agravadas pela ambigüidade de seu papel frente à comunidade e por problemas na comunicação com os outros profissionais de saúde. Considerando os pressupostos da Política Nacional, esta pesquisa indicou que a articulação entre as práticas indígenas de auto-atenção e os serviços biomédicos é precária, necessitando de um aprofundamento nas discussões, com a efetiva participação de todos os atores envolvidos na atenção à saúde.<br>This study analyzes the role and training of indian health agents as defined by the National Policy for Health Care of Indians Peoples on two Indian reservations in Santa Catarina, Brazil. The health agent's role in primary care is based on mediation between traditional health practices and biomedicine, subsumed in the concept of differentiated care. On both reservations, a large turnover of indigenous health agents and lack of adequate training were observed. The indigenous health agents expressed difficulty in understanding the reasons for their activities, role ambiguity vis-à-vis the community, and communications problems with other health professionals. Considering the national policy guidelines, this study indicates that the provision of differentiated care is precarious and that a dialogue is necessary, with actual participation by all stakeholders in the health services

Desain protokol dan prototipe aplikasi permainan Scrabble berbasis jaringan

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Key points summary When the hepatic insulin signaling is compromised, there is an inadequate suppression of gluconeogenic pathways, leading the organism to high levels of glucose. Studies with animals with obesity induced by high fat diet or genetically modified showed increased MKP-3 expression and MKP-3/Foxo1 association in liver, with a consequent increase in blood glucose concentration, development of insulin resistance and DM2. As a non-pharmacological strategy recognized and indicated for prevention and treatment of diabetes is the regular practice of physical exercise. In this study we demostrated that physical training is an important tool capable of reducing insulin resistance in the liver by reducing the inflammatory process, including the inhibition of MKP-3 and, therefore, suppress gluconeogenic program in obesity rats. The understanding of these new mechanisms by which physical training regulates glucose homeostasis has critical importance to health professionals for the understanding and prevention of diabetes. Insulin plays an important role in the control of hepatic glucose production. Insulin resistant states are commonly associated with excessive hepatic glucose production, which contributes to both fasting hyperglycaemia and exaggerated postprandial hyperglycaemia. In this regard, increased activity of phosphatases may contribute to the dysregulation of gluconeogenesis. Mitogen-activated protein kinase phosphatase-3 (MKP-3) is a key protein involved in the control of gluconeogenesis. MKP-3-mediated dephosphorylation activates FoxO1 (a member of the forkhead family of transcription factors) and subsequently promotes its nuclear translocation and binding to the promoters of gluconeogenic genes such as phosphoenolpyruvate carboxykinase (PEPCK) and glucose-6-phosphatase (G6Pase). In this study, we investigated the effects of exercise training on the expression of MKP-3 and its interaction with FoxO1 in the livers of obese animals. We found that exercised obese mice had a lower expression of MKP-3 and FoxO1/MKP-3 association in the liver. Further, the exercise training decreased FoxO1 phosphorylation and protein levels of Peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC-1 alpha) and gluconeogenic enzymes (PEPCK and G6Pase). These molecular results were accompanied by physiological changes, including increased insulin sensitivity and reduced hyperglycaemia, which were not caused by reductions in total body mass. Similar results were also observed with oligonucleotide antisense (ASO) treatment. However, our results showed that only exercise training could reduce an obesity-induced increase in HNF-4 alpha protein levels while ASO treatment alone had no effect. These findings could explain, at least in part, why additive effects of exercise training treatment and ASO treatment were not observed. Finally, the suppressive effects of exercise training on MKP-3 protein levels appear to be related, at least in part, to the reduced phosphorylation of Extracellular signal-regulated kinases (ERK) in the livers of obese mice.592613251340Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)FAPESP [2010/12091-2, 2011/14727-4, 2011/13779-0]CNPq [471498/2011-4

Effect of the litter material on drinking water quality in broiler production

Considering the importance of drinking water and its effect on broiler performance, drinking water quality was studied using six different litter materials. The presence of coliform bacteria and Escherichia coli was investigated. The following litter materials were used in the trial: wood shavings, rice husks, chopped Napier grass (Pennisetum pupureum), 50% sugarcane bagasse (Saccharum L.) + 50% wood shavings, 50% sugarcane bagasse (Saccharum L.) + 50% rice husks, and plain sugarcane bagasse (Saccharum L.). A number of 1620 Ross® one-day-old chicks were reared in 54 pens measuring 4.5 m² each, equipped with a bell drinker and a tube feeder. Water samples were collected in sterile tubes on days 28 and 42 of the rearing period, and submitted to the laboratory for analyses. Microbiological data were organized by classes expressed in a logarithm scale, where the lowest contamination corresponds to class 1 and the highest contamination to class 4. Results showed that total coliform contamination was higher on day 28 than in the end of the rearing period, and that E. coli presence was detected during both analyzed periods. The litter materials that presented lower degree of water contamination, predominantly class 1, were sugarcane bagasse and 50% of sugarcane bagasse and 50% of rice husks