Breastfeeding knowledge and practice of health professionals in public health care services

Objetivou-se avaliar conhecimentos e práticas sobre aleitamento materno de profissionais que atendem lactentes em unidades de atenção básica, ou maternidades públicas, de município do interior paulista, Brasil. É estudo epidemiológico, sendo a população composta por 89 enfermeiros e médicos. Suas respostas a um questionário estruturado foram analisadas no total e segundo o local de trabalho, aplicando-se o teste de diferença de proporções (qui-quadrado), considerando-se pSe tuvo por objetivo evaluar los conocimientos y las prácticas sobre amamantamiento materno que tienen los profesionales que atienden lactantes en unidades de atención básica, o maternidades públicas, de un municipio del interior del estado de Sao Paulo, en Brasil. Es estudio epidemiológico, siendo la población compuesta por 89 enfermeros y médicos. Sus respuestas a un cuestionario estructurado fueron analizadas en su totalidad y según el local de trabajo, aplicándose la prueba de diferencia de proporciones (chi-cuadrado), considerándose pThis study evaluated breastfeeding knowledge and practice of professionals who care for infants at health care services in a city in the interior of São Paulo, Brazil. This epidemiological study was carried out with a population of 89 nurses and physicians. Their answers to a structured questionnaire were analyzed in total and by place of work through the test for difference between proportions (Chi-square) with the level of significance at

Safety issues of raw milk: evaluation of bacteriological and physicochemical characteristics of human milk from a bank in a teaching hospital, focusing on Staphylococcus species

Many infants are nurtured with milk supplied by human banks, whose bacteriological and physical-chemical profiles are a major issue. We investigated the bacteriological and physical-chemical characteristics, as well as genotypic and phenotypic and profiles of Staphylococcus species isolated from 240 samples of breast milk from a bank in a teaching hospital. Dornic acidity of milk revealed that 95.4% (229/240) had acceptable limits (< 8.0 oD). Caloric intake showed a wide variation in cream content (4%), fat (4%) and energy values (559.81 Kcal/L). Staphylococcus (105/186 or 56.5%) and Enterobacter (25/186 or 13.4%) were the most prevalent genera, although other microorganisms were identified, including Klebsiella pneumoniae and Pseudomonas aeruginosa. Amoxicillin/clavulanic acid (125/157 or 79.6%), vancomycin (115/157 or 73.2%), and cephalexin (112/157 or 71.3%) were the most effective antimicrobials. High resistance rates of isolates were found to penicillin G (141/157 or 89.8%), ampicillin (135/157 or 86%), and oxacillin (118/157 or 75.2%). Multidrug resistance to ≥ 3 antimicrobials occurred in 66.2% (123/186) of the isolates. Residues of microbial multiplication inhibitory substances were found in 85% (204/240) of samples. Among the coagulase-positive-CPS and negative-CoNS staphylococci, the mecA gene was detected in 53.3% (8/15) and 75% (30/40), respectively. Genes sea, seb and sec were detected in 20% (3/15) of CPS, while tsst-1 was detected in 13.34% (2/15). In addition, 13.3% (2/15) of S. aureus were toxin-producers. Genes sea, seb and sec were detected in 90% (36/40), 5% (2/40) and 15% (6/40) CoNS, respectively. Enterotoxin production was identified in 5% (2/40) of CoNS. The identification of multidrug-resistant bacteria, staphylococci species toxin-producers harboring methicillin-resistance genes, and residues of microbial multiplication inhibitory substances reinforce the need for a continuous vigilance of milk quality offered to infant consumption by human banks

Conhecimentos e práticas sobre aleitamento materno de profissionais que atendem lactentes nos serviços públicos de saúde de Botucatu-SP

O aleitamento materno exclusivo até os seis meses e complementado por outros alimentos até os dois anos de idade ou mais se configura como prática fundamental para a qualidade de saúde e de vida do lactente, com vantagens também para a mãe e os demais sujeitos envolvidos com este fenômeno. Para o sucesso desta prática destaca-se, entre outras condições, a competência técnico-científica dos profissionais de saúde que atuam na atenção à saúde materno-infantil. Considerando essas premissas, objetivou-se investigar os conhecimentos e práticas sobre o aleitamento materno de médicos e enfermeiros que atendem lactentes nos serviços públicos de saúde de um município do interior paulista. Trata-se de um estudo epidemiológico, analítico, inserido no campo da educação em saúde, realizado em município de médio porte, situado na região centro sul do Estado de São Paulo. A população do estudo foi composta pelos médicos e enfermeiros que atendiam lactentes nos serviços públicos de saúde do referido município, incluindo Centros de Saúde e Policlínicas, Unidades de Saúde da Família e Unidades Hospitalares de Nível Secundário e Terciário, totalizando 101 profissionais. A coleta de dados foi realizada no segundo semestre de 2007, a partir de um questionário estruturado com questões abertas e fechadas sobre características profissionais, conhecimentos específicos e práticas relacionadas ao processo de amamentação. Quanto à análise dos acertos sobre conhecimentos e práticas em aleitamento materno, foram tomadas como parâmetro as recomendações do Ministério da Saúde brasileiro. Inicialmente, a análise dos dados considerou as freqüências das respostas de todos os profissionais, a cada aspecto abordado das variáveis de conhecimentos e práticas em aleitamento materno, bem como foram consideradas as porcentagens médias de...Exclusive breastfeeding for six months complemented by other types of food until the age of two years or longer is a fundamental practice for the quality of life of breastfed infants. It also brings advantages to the suckling mother and other subjects involved in this phenomenon. In order to achieve success in such practice, the technical and scientific competence, among other conditions, of health care professionals working in maternal-child health care is pointed out. By taking these premises into account, this study aimed at investigating the breastfeeding knowledge and practices of physicians and nurses assisting breastfed infants at the health care services of a city in inner São Paulo state. It is an analytical epidemiological study in the field of health education conducted in a medium-sized city located in the mid-southern region of São Paulo state. The studied population consisted of physicians and nurses assisting breastfed infants at the public health care services in the abovementioned city, which included Health Care Units, Polyclinics, Family Health Units and Secondary and Tertiary Referral Hospitals, thus totaling 101 professionals. Data were collected in the second semester of 2007 by using a structured questionnaire with open and closed questions on professional characteristics, specific knowledge and practices related to the breastfeeding process. As regards the analysis of correct answers concerning breastfeeding knowledge and practices, the recommendations by the Brazilian Department of Health were taken as parameters. Initially, data analysis considered the frequencies of answers by all professionals to each approached aspect of the breastfeeding Summary Patrícia Kelly Silvestre knowledge and practices variables as well as the mean percentages of correct answers for each one of such aspects. It is pointed out that all the professionals were questioned with regard... (Complete abstract click electronic access below)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Breastfeeding knowledge and practice of health professionals in public health care services Conocimientos y prácticas de profesionales de la salud sobre amamantamiento materno en servicios públicos de salud Conhecimentos e práticas de profissionais de saúde sobre aleitamento materno em serviços públicos de saúde

This study evaluated breastfeeding knowledge and practice of professionals who care for infants at health care services in a city in the interior of São Paulo, Brazil. This epidemiological study was carried out with a population of 89 nurses and physicians. Their answers to a structured questionnaire were analyzed in total and by place of work through the test for difference between proportions (Chi-square) with the level of significance at p<0.05. Data analysis was performed according to the Ministry of Health recommendations. The significant differences found for knowledge and practice, according to place of work, were restricted to certain aspects. Results of average scores were slightly better for professionals from the basic care units. Regular and poor performance were found in different studied aspects regardless of place of work, which suggest that potential educational interventions in this subject should include professionals at all levels of health care.<br>Se tuvo por objetivo evaluar los conocimientos y las prácticas sobre amamantamiento materno que tienen los profesionales que atienden lactantes en unidades de atención básica, o maternidades públicas, de un municipio del interior del estado de Sao Paulo, en Brasil. Es estudio epidemiológico, siendo la población compuesta por 89 enfermeros y médicos. Sus respuestas a un cuestionario estructurado fueron analizadas en su totalidad y según el local de trabajo, aplicándose la prueba de diferencia de proporciones (chi-cuadrado), considerándose p<0,05 como nivel crítico. Como parámetros de aciertos fueron consideradas las recomendaciones del Ministerio de la Salud. Las diferencias significativas para conocimientos y prácticas, según el local de trabajo, fueron restrictas a algunos aspectos, con resultados discretamente mejores de los puntajes promedios de aciertos de los profesionales de las unidades de atención básica. Independientemente del local de trabajo, se verificó desempeño regular y malo en diferentes aspectos estudiados, indicando que posibles intervenciones para la capacitación en esa temática deberán incluir profesionales de todos los niveles de atención a la salud.<br>Objetivou-se avaliar conhecimentos e práticas sobre aleitamento materno de profissionais que atendem lactentes em unidades de atenção básica, ou maternidades públicas, de município do interior paulista, Brasil. É estudo epidemiológico, sendo a população composta por 89 enfermeiros e médicos. Suas respostas a um questionário estruturado foram analisadas no total e segundo o local de trabalho, aplicando-se o teste de diferença de proporções (qui-quadrado), considerando-se p<0,05 como nível crítico. Como parâmetros de acertos foram consideradas as recomendações do Ministério da Saúde. As diferenças significativas para conhecimentos e práticas, segundo o local de trabalho, foram restritas a alguns aspectos, com resultados discretamente melhores dos escores médios de acertos dos profissionais das unidades de atenção básica. Independente do local de trabalho, verificou-se desempenho regular e ruim em diferentes aspectos estudados, indicando que possíveis intervenções para a capacitação nessa temática deverão incluir profissionais de todos os níveis de atenção à saúde

Efficacy and safety of HD-tDCS and respiratory rehabilitation for critically ill patients with COVID-19 The HD-RECOVERY randomized clinical trial.

Acute Respiratory Distress Syndrome (ADRS) due to coronavirus disease 2019 (COVID-19) has been associated with muscle fatigue, corticospinal pathways dysfunction, and mortality. High-Definition transcranial Direct Current Stimulation (HD-tDCS) may be used to attenuate clinical impairment in these patients. The HD-RECOVERY randomized clinical trial was conducted to evaluate the efficacy and safety of HD-tDCS with respiratory rehabilitation in patients with moderate to severe ARDS due to COVID-19. Fifty-six critically ill patients were randomized 1:1 to active (n = 28) or sham (n = 28) HD-tDCS (twice a day, 30-min, 3-mA) plus respiratory rehabilitation for up to 10 days or until intensive care unit discharge. The primary outcome was ventilator-free days during the first 28 days, defined as the number of days free from mechanical ventilation. Furthermore, secondary outcomes such as delirium, organ failure, hospital length of stay and adverse effects were investigated. Active HD-tDCS induced more ventilator-free days compared to sham HD-tDCS. Patients in the active group vs in the sham group experienced lower organ dysfunction, delirium, and length of stay rates over time. In addition, positive clinical response was higher in the active vs sham group. There was no significant difference in the prespecified secondary outcomes at 5 days. Adverse events were similar between groups. Among patients with COVID-19 and moderate to severe ARDS, use of active HD-tDCS compared with sham HD-tDCS plus respiratory rehabilitation resulted in a statistically significant increase in the number of ventilator-free days over 28 days. HD-tDCS combined with concurrent rehabilitation therapy is a safe, feasible, potentially add-on intervention, and further trials should examine HD-tDCS efficacy in a larger sample of patients with COVID-19 and severe hypoxemia