Submitted by Renata Lopes (renatasil82@gmail.com) on 2018-09-04T11:52:25Z No. of bitstreams: 1 annelisafarahsilvapaesleme.pdf: 3714457 bytes, checksum: 04f67b418a9032046d649343f4ef5330 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2018-09-04T13:18:39Z (GMT) No. of bitstreams: 1 annelisafarahsilvapaesleme.pdf: 3714457 bytes, checksum: 04f67b418a9032046d649343f4ef5330 (MD5) / Made available in DSpace on 2018-09-04T13:18:39Z (GMT). No. of bitstreams: 1 annelisafarahsilvapaesleme.pdf: 3714457 bytes, checksum: 04f67b418a9032046d649343f4ef5330 (MD5) Previous issue date: 2014-02-14 / CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Biofilmes associados a dispositivos médicos são responsáveis por 85% das infecções de corrente sanguínea relacionadas a catéteres (ICSRC). O objetivo deste trabalho foi testar duas formulações, como revestimento para catéteres venosos centrais (CVC), as quais tiveram a eficácia antimicrobiana e antiaderente avaliadas in vitro e a eficácia e biocompatibilidade, in vivo. A atividade antimicrobiana foi determinada por método turbidimétrico e a concentração inibitória mínima (CIM) foi estabelecida. A microscopia eletrônica de varredura (MEV) avaliou a propriedade antiaderente dos CVC revestidos com a formulação 1 (CVC-R1) e formulação 2 (CVC-R2), comparados aos não revestidos (CVC-NR). Implantes subcutâneos foram inseridos na área dorsal de ratos. O primeiro ensaio compreendeu análises hematológicas e microbiológicas (hemocultura e colonização das superfícies de CVC), a fim de avaliar a eficácia dos revestimentos. A biocompatibilidade foi avaliada no segundo ensaio pela observação das reações inflamatórias após 7 e 21 dias. Ambas formulações apresentaram atividade antimicrobiana frente a todas as cepas testadas. A desagregação do biofilme, com redução significativa da aderência microbiana, foi observada em ambos CVC revestidos. In vivo, foi observada maior eficácia antibiofilme de CVC-R2, com redução da colonização por Staphylococcus aureus ATCC 25923. As reações teciduais provocadas por CVC-R1 e CVC-R2 foram mais pronunciadas inicialmente, contudo, ao longo do experimento, se tornaram estatisticamente semelhantes às do CVC-NR. Ambas as formulações foram biocompatíveis, com maior velocidade de reparo tecidual no grupo CVC-R2. O uso de CVC- R1 e, especialmente de CVC-R2, pode diminuir a incidência de ICSRC. Acredita-se que CVC-R2 apresenta potencial para ser testado clinicamente. / Device-associated biofilms are responsible for 85% of catheter-related bloodstream infections (CRBSI). The aim of this study was investigate two formulations, as central venous catheters (CVC) coating, which were submitted to in vitro evaluation of antimicrobial and anti-adherent efficacy and in vivo evaluation of efficacy and biocompatibility. The antimicrobial activity was assessed by turbidimetric method and the minimum inhibitory concentration (MIC) was determined. The scanning electron microscopy (SEM) was used to assess the anti-adherent property of CVC coated with formulation 1 (CVC-R1) and formulation 2 (CVC-R2), in comparison to uncoated CVC fragments (CVC-NR). Subcutaneous implants were inserted into the dorsal area of rats. The first assay consisted in hematological and microbiological analysis (hemoculture and CVC surfaces colonization) in order to evaluate the coatings effectiveness. The second assay evaluated the biocompatibility by the observation of inflammatory reactions after 7 and 21 days. Both formulations showed antimicrobial activity against all tested strains. The biofilm disaggregation, with reduction in microbial adherence, was noted in coated catheters. In vivo results showed greater antibiofilm efficacy of CVC-R2 since a reduction of Staphylococcus aureus ATCC 25923 colonization was observed. The tissue reactions of CVC-R1 and CVC-R2 groups were initially more pronounced, however, throughout the experiment, the histological parameters have become statistically similar those found in CVC-NR group. Both formulations were biocompatible and a higher speed of tissue repair in CVC-R2 group was noted. The use of CVC- R1, and especially of CVC-R2, may reduce the development of CRBSI, and thereby, CVC-R2 have potential to be clinically tested.

Bakgrund: Hypotermi innebär en kärntemperatur under 36 °C och är en vanlig komplikation under perioperativa förloppet. Vid anestesi störs kroppens normala fysiologiska temperatureglering. Hypotermi kan leda till flertalet allvarliga komplikationer som kan orsaka ett lidande för patienten samt en ökad kostnad för samhället. Trots att forskning länge visat att preventiva åtgärder minskar risken för hypotermi kvarstår problemet. Syfte: Syftet är att identifiera preoperativa aktiva värmebevarande metoder och vilken effekt dessa har på att minska risken för perioperativ hypotermi hos den vuxna patienten. Metod: En systematisk litteraturstudie valdes som metod för att besvara syftet. Sökningar genomfördes i CINAHL, PubMed och Web of Science. Totalt 19 kvantitativa artiklar inkluderades och data extraherades genom en extraktionsmall. Resultat: Resultatet är sammanfattat i två huvudkategorier, preoperativa aktiva värmebevarande metoder och effekten av preoperativ aktiv värmning på patientens perioperativa temperatur. Fem olika värmebevarande metoder identifierades. Resultatet visar att preoperativa aktiva värmemetoder har en positiv effekt på att minska uppkomst av hypotermi under det perioperativa förloppet. Slutsats: Perioperativ hypotermi kan förebyggas genom ökad medvetenhet hos vårdpersonal kring problemet och genom aktiva värmebevarande metoder under det perioperativa förloppet. / Background: Hypothermia means a core temperature below 36 ° C and is a common complication during the perioperative process. In the event of anesthesia, the body's normal physiological temperature control is disturbed. Hypothermia can lead to a number of serious complications that can cause a patient suffering and an increased cost for society. Although research has long shown that preventive efforts reduce the risk of hypothermia, the problem persists. Aim: The aim is to identify preoperative active heat-saving methods and the effect they have on reducing the risk of perioperative hypothermia in the adult patient. Method: A systematic literature study was chosen as a method of answering the purpose. Searches were conducted in CINAHL, PubMed and Web of Science. A total of 19 quantitative scientific articles were included and data extracted by an extraction template. Result: The result is summarized in two main categories, preoperative active heat-saving methods and the effect of preoperative active warming at the patient's perioperative temperature. Five different heat-saving methods were identified. The result shows that preoperative active heat methods have a positive effect on reducing the appearance of hypothermia during the perioperative process. Conclusion: Perioperative hypothermia can be prevented through increased awareness of healthcare professionals around the problem and through active heat-saving methods during the perioperative process.

Orientador: Otávio Rizzi Coelho / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-26T20:39:44Z (GMT). No. of bitstreams: 1 Almeida_RaitanyCostade_D.pdf: 3902239 bytes, checksum: 8a2cfd7f0667fa050bead8f4ebaf4e95 (MD5) Previous issue date: 2015 / Resumo: Hipertensão arterial sistêmica (HAS) é uma importante causa evitável de morbidade e mortalidade cardiovascular. Vários estudos apontam para o aumento de sua prevalência no mundo e baixo controle pressórico, mas existem poucos dados referentes as comunidades ribeirinhas. Esta pesquisa compara a prevalência, consciência, tratamento e controle de HAS entre população urbana e ribeirinha em Porto Velho, região Amazônica, assim como avalia outros fatores de risco cardiovascular. Foi conduzido um estudo transversal, fundamentado em inquérito domiciliar em indivíduos de 35 a 80 anos, recrutados entre julho e dezembro de 2013. Realizado entrevista com questionário padronizado, medidas de pressão arterial (PA), peso, altura e circunferência abdominal (CA). HAS foi definido através de indivíduos que relataram ter a doença, ou prescritos para uso de medicações anti-hipertensivas ou aqueles que tinham PA sistólica ? 140 mmHg ou PA diastólica ? 90 mmHg, na média de duas medidas usando dispositivo digital automático. Consciência foi baseada em autorrelatos, tratamento no uso de medicamento anti-hipertensivo, e controle foi definido quando indivíduos apresentavam PA menor do que 140/90 mmHg. Foi calculado índice de massa corpórea (IMC) e CA para avaliação de obesidade e obesidade abdominal. Também foi avaliado, através de autorrelatos, a taxa de diabetes, dislipidemia, tabagismo. Entre 1410 participantes, 750 (53,19%) tinham HAS e 473 (63,06%) eram cientes do diagnóstico. Daqueles que tinham consciência do diagnóstico, a maioria 404 (85.41%) recebia tratamento farmacológico, mas a taxa de controle foi baixa. As percentagens de prevalência e tratamento foram maiores na área urbana, respectivamente, (55,48% vs. 48,87%)(p=0,02) e (61,25% vs. 52,30%)(p<0,01). A consciência de HAS foi maior na área ribeirinha (61,05% vs. - 67,36%)(p<0,01), mas as taxas de controle, tanto entre todos os hipertensos quanto naqueles que faziam tratamento farmacológico, foram similares, respectivamente, (22,11% vs. 23,43%)(p=0,69) e (33,88% vs. 34,32%) (p=0,77). Não houve diferença significativa no sobrepeso (40,93% vs. 40,28%)(p=0,73); obesidade (19,10% vs 19,63%)(p=0,68) e tabagismo (18,56% vs. 16,76%)(p=0,09). Cerca de metade dos participantes apresentavam HAS. A prevalência foi mais alta nos urbanos, mas a diferença para os ribeirinhos foi pequena. Dos indivíduos hipertensos, tanto na área urbana quanto ribeirinha, menos de um quarto tinham HAS controlada / Abstract: High blood pressure (hypertension) is a major preventable cause of cardiovascular morbidity and mortality. Several studies indicate to the increase its prevalence in the world and low control rate, but there are few data on the riverside communities. This research compares the prevalence, awareness, treatment and control of hypertension between urban and riverside population in Porto Velho, the Amazon region, as well as evaluating other cardiovascular risk factors. A cross-sectional study was conducted, based on a household survey in individuals 35-80 years recruited between July and December 2013. Directed interview with standardized questionnaire, blood pressure measurements (PA), weight, height and waist circumference (WC). Hypertension was defined by individuals who reported having the disease, or prescribed for use of antihypertensive medications or those who had systolic blood pressure ? 140 mmHg or diastolic BP ? 90 mmHg, the mean of two measurements using automatic digital device. Awareness was based on self-reports, treatment in the use of antihypertensive medication, and control was defined as a BP ? 140/90 mm Hg. We calculated body mass index (BMI) and WC for assessing obesity and abdominal obesity. We also assessed through self-report, the rate of diabetes, dyslipidemia, smoking. Among 1410 participants, 750 (53.19%) had hypertension and 473 (63.06%) were aware of their diagnosis. Of those who were aware of the diagnosis, 404 (85.41%) received pharmacological treatment, but the control rate was low. The percentages of prevalence and treatment were higher in urban areas, respectively (55.48% vs. 48.87%) (p = 0:02) and (61.25% vs. 52.30%) (p <0.01). Awareness was higher in the riverside area (61.05% vs. 67.36%) (p <0.01), but control rates, both among all hypertensive patients and in those who were pharmacological treatment were similar, respectively, (22.11% vs . 23.43%) (p = 0.69) and (33.88% vs. 34.32%) (p = 0.77). - There was no significant difference in the overweight (40.93% vs. 40.28%) (p = 0.73); obesity (19.10% vs. 19.63%) (p = 0.68) and smoking (18.56% vs. 16.76%) (p = 0.09). Hypertension prevalence was higher in the urban population than in the riverside population. Of the hypertensive individuals in both areas, < 25% had controlled blood pressure / Doutorado / Clinica Medica / Doutor em Clínica Médica

INTRODUÇÃO: Estudos epidemiológicos demonstram que as doenças cardiovasculares e suas complicações estão associadas ao estilo de vida das pessoas. Há evidências de que o processo aterosclerótico se inicia na infância, e que sua prevenção pode ser mais efetiva se iniciada precocemente, com ações de educação em saúde que visem a promover a prática regular de atividade física e a mudança de hábitos alimentares. OBJETIVOS: Observação das representações dos adolescentes sobre hábitos alimentares e práticas de atividade física no contexto da promoção da saúde cardiovascular. Verificação d a exeqüibilidade das técnicas de ensino-aprendizagem baseadas em Paulo Freire, Pichon-Rivière, Prochaska e Di Clemente na reflexão com os adolescentes sobre a prevenção primária dos fatores de risco relacionados com essas representações. Testar a hipótese de que a presença da doença cardiovascular nos familiares têm influência nas representações observadas. MÉTODOS: Alunos da sétima série de uma escola pública de São Paulo foram levantados por meio de questionário epidemiológico para avaliar os riscos associados ao estilo de vida. Dois grupos diferentes de alunos, selecionados de acordo com a presença de doença cardiovascular nos pais, receberam a intervenção educativa em dinâmicas aplicadas no decorrer de 10 reuniões de grupo. RESULTADOS: A matriz de Prochaska e Di Clemente permitiu avaliar que a representação dos temas de alimentação e atividade física foi modificada nos dois grupos, que passaram do estágio de pré-contemplação para contemplação; no entanto, dez reuniões não foram suficientes para os grupos se manterem no estágio de preparação para mudança, oscilando com o estágio de contemplação. A análise feita pela matriz de Pichon- Rivière demonstra que o aprendizado do grupo sem história familiar aparece de forma clara como conhecimento construído sobre os temas propostos, enquanto o grupo com história familiar possui conhecimento pré-existente, e adquire novos conceitos de maneira mais lenta. Justificando as diferentes formas de abordagem aplicadas às atividades dos grupos no presente trabalho. CONCLUSÃO: A intervenção por meio de grupos educativos baseados em Paulo Freire, Pichon-Rivière e Prochaska e Di Clemente se mostrou útil para observar as representações dos adolescentes sobre hábitos alimentares e práticas de atividade física no contexto da promoção da saúde cardiovascular. Durante as atividades dos grupos educativos foi possível avaliar a informação pré-existente, como também, estabelecer com eles um diálogo construtivo para a prevenção primária dos fatores de risco relacionados com essas representações. / INTRODUCTION: Epidemiologic studies demonstrated that the cardiovascular disease and its complications are associated with people\'s life style. There are evidences that the atherosclerotic process begins in infancy and that its prevention can be more effective if it is precociously started by taking educative actions concerning health, which aim at promoting regular physical activity practice and the change of eating habits. OBJECTIVE: Observe the adolescents\' representations on eating habits and physical activities practices to promote cardiovascular health. Verify the techniques applied in the teaching - learning process, based on Paulo Freire, Pichon- Rivière, Prochaska and Di Clemente and together with the adolescents reflect on the primary prevention of the risks related to these representations. Test the hypothesis that the presence of the cardiovascular disease in the family influences in the representations observed. METHODS: Students of the 7th. grade of a public elementary school of São Paulo were surveyed by means of an epidemiologic questionnaire to evaluate the risks associated with their life style. Two different groups of students, chosen according to the presence of cardiovascular disease in their parents were followed during ten sections, when educative dynamics were applied. RESULTS: Prochaska and Di Clemente\'s matrix enabled the evaluation of the representations related to eating and physical activity. The representations were modified in both groups, which changed from pre- contemplation stage to contemplation stage. However, the ten group meetings were not enough for the groups to keep in the stage of preparation for the change, oscillating to the stage of contemplation. The analyses made by Pichon-Rivière?s matrix demonstrates that the learning process in the group which belongs to a family with no risk of cardiovascular disease presents a clear constructed knowledge on the proposed themes, whereas the group belonging to families under such risks has a pre- existing knowledge and acquires new concepts more slowly, justifying the different approaches applied to the activities of the groups in this study. CONCLUSION: The intervention by means of educative groups based on Paulo Freire, Pichon-Rivière, Prochaska and Di Clemente was useful to observe the representations of the adolescents on eating habits and physical activities practices to promote cardiovascular health. During the activities of the educative groups it was possible to evaluate the adolescents pre-existing information as well as establish a constructive dialogue for a primary prevention of the risk factors related to these representations.

O trabalho foi realizado em granja com histórico de ocorrência de Circovirose Suína e Doenças Associadas - PCVAD maior que 5%. Foram utilizados 560 leitões na fase de creche (25 - 66 dias de idade) e 468 no início de crescimento (66 - 94 dias de idade), em experimento delineado em blocos ao acaso, com dois tratamentos e 9 repetições por tratamento na creche e 18 repetições no crescimento. Os tratamentos: Plasma - os leitões foram alimentados com rações contendo plasma (AP 920®) conforme segue: 6,0% na ração pré-inicial I (15 dias); 3,0% na ração pré-inicial II (13 dias); 1,5% de na ração inicial (14 dias); e 1,0% na ração de crescimento I (14 dias), seguindo-se por mais 14 dias com a mesma ração sem plasma. Controle: os leitões foram alimentados com as mesmas rações, porém sem plasma. As rações utilizadas foram formuladas para satisfazer as necessidades nutricionais dos leitões. As variáveis avaliadas: ganho de peso, consumo de ração, conversão alimentar, ocorrência da PCVAD, taxa de mortalidade pela PCVAD e anticorpos anti-PCV2. Houve diferença significativa (P<0,05) no peso dos leitões e no ganho de peso diário em todas as medidas realizadas na fase de creche. A diferença de peso no final da creche foi de 1,92 kg/leitão a mais para o Plasma. Não houve diferença estatística (P>0,05) no coeficiente de variação do peso dos leitões em todas as medidas realizadas. O consumo médio de ração com plasma foi superior (P<0,05) em todas as fases de creche. A conversão alimentar foi melhor (P=0,087) no Plasma. As idades calculadas dos leitões, para o peso ideal para venda (22 e 24 kg), indicaram que os leitões do Plasma atingiriam tais pesos 2,3 e 2,2 dias antes que os controles, respectivamente. Na fase inicial de crescimento, houve diferença significativa (P<0,05) no consumo de ração e no peso final (94 dias de idade) com uma diferença final de 2,28 kg/suíno a mais no grupo Plasma. Isso tem conseqüências importantes no manejo das granjas, permitindo um período maior de vazio sanitário. Aos 39, 52 e 66 dias de idade, houve menor freqüência (P<0,05) de leitões com sinais da PCVAD no Plasma. Verificou-se que a infecção pelo PCV2 estava disseminada nos leitões de ambos os tratamentos. Houve efeito de bloco e idade no título de anticorpos para o PCV2. No período total, o aumento nesse título foi parcial (P=0,0856) para o Plasma. Porém, aos 52 dias de idade, os leitões alimentados com plasma apresentaram aumento nesse título (P<0,05). Isso sugere que os leitões que receberam plasma apresentavam melhor capacidade de resposta imunológica ao PCV2. Os leitões tratados com plasma apresentaram: melhor ganho de peso na creche, que foi ampliado no início do crescimento, reduzindo em 2,3 dias a idade para atingir 22,0 kg; melhor capacidade de resposta imunológica ao PCV2 aos 52 dias de idade e menor manifestação de PCVAD. O aumento no ganho de peso nos leitões foi atribuído ao aumento no consumo de ração e à menor ocorrência de leitões com sinais de PCVAD. / The work was conducted in a farm with historical data, recording pigs with clinical Porcine Circovirus and Associated Diseases - PCVAD higher than 5%. In the nursery 560 pigs (25-66 days of age) and early in growing phase 468 piglets (66-94 days of age) were used in random blocks design with two treatments and 9 replicates in the nursery and 18 replicates in growing phase per treatment. Treatments: Plasma - pigs were fed plasma (AP 920®) containing diets as follows: 6% in the pre-starter I (15 days); 3% in the pre-starter II (13 days); 1.5% in the starter phase (14 days); and 1% in the growing phase (14 days), followed by 14 days with the same feed without plasma. Control: pigs were fed with the same feeds from the Plasma treatment but without plasma. Both feeds were formulated to meet the nutritional requirements of the pigs in different stages. Evaluated variables: weight gain, feed intake, feed conversion, clinical presence of PCVAD, mortality rate related with PCVAD and antibodies against PCV2. There was a significant difference (P<0.05) in the pigs weight and in the weight gain the nursery. The weight difference at the end of the nursery phase was 1.92 kg/pig grater to the plasma group. There was no statistical difference (P>0.05) in the coefficient of variation of weight in all measurements performed. The average feed intake was higher (P<0.05) on Plasma in all nursery phases. A better feed conversion was observed on Plasma (P=0.087). The calculated age of pigs to reach the ideal sale weight (22-24 kg) indicated that Plasma achieved those weights 2.3-2.2 days prior than the Control respectively. In the growing phase there was a significant difference (P<0.05) in the feed intake and final weight (94 days of age) with a final weight 2.28 kg/pig heavier for Plasma. This has important consequences in the management of a farm, allowing a longer downtime period between groups. At 39, 52 and 66 days of age, there was less frequency (P<0.05) of pigs with sings of PCVAD in the plasma fed group. It was observed that the infection by PCV2 was widely spread in both treatments pigs. There was block and age effect in the PCV2 antibody titers. There was a partial treatment effect (P=0.0856) over the PCV2 antibodies when the data was evaluated at different sampling ages. However, at 52 days of age, there was an increase in the PCV2 antibody titers (P<0.05) of pigs that received plasma. This observation suggests that plasma fed pigs had a better immune response to PCV2. The plasma fed pigs showed better weight gain in the nursery. That effect was amplified in the beginning of the growing phase, leading to a reduction in 2.3 days the age to reach 22.0 kg of body weight, better immune response to PCV2 at 52 days of age and less presence of sings of PCVAD. The increase in the weight gain was due to an increase in feed intake and lower incidence of pigs with sings of PCVAD.

The psychosocial and cultural predictors of cigarette smoking were examined among a sample of 175 African-American adults. Participants completed a self-report inventory containing the Beck Depression Inventory, the Perceived Stress Scale, the Speilberger State-Trait Anxiety, the African-American Acculturation Scale, and questions regarding their smoking, demographics, and risk-taking tendencies.

No description available.

L’impact positif des formations continues numériques dans l’amélioration de la pratique infirmière en prévention et contrôle des infections (PCI) a été documenté dans la littérature. L’analyse des besoins de formation (ABF) est recommandée comme une étape importante dans le processus de conception des formations. Malgré l’intérêt de la formation continue en PCI, il y a peu d’écrits scientifiques sur le développement de modules de formation continue numérique en PCI qui soit fondé sur une ABF des infirmières québécoises. Cette étude visait à identifier les besoins de formation ressentis en regard des compétences en PCI d’infirmières exerçant dans un centre hospitalier montréalais. Un devis descriptif quantitatif a été mené à l’aide d’une enquête de besoins de formation par questionnaire auto administré. L’ensemble des infirmières d’un établissement de santé universitaire (N=2500) a été invité à participer; 390 ont répondu au questionnaire de l’étude. Les résultats de cette étude suggèrent qu’une formation numérique hybride axée sur la gestion des risques de transmission des infections, la santé et la sécurité au travail ainsi que la gestion des déchets biologiques devrait être développée au sein de l’établissement. Les résultats de notre étude ont aussi révélé des associations significatives entre certaines caractéristiques sociodémographiques et professionnelles et le besoin de formation ressenti pour une ou plusieurs compétences en PCI. Ces résultats contribuent à l’avancement des connaissances en sciences infirmières en documentant les besoins de formation numérique en PCI d’infirmières québécoises. Cette étude contribue également à l’amélioration de la qualité de la formation continue, en adaptant celle-ci aux besoins des apprenants. / The positive impact of online continuing training in infection prevention and control (IPC) nursing practice has been documented in the literature. Training Needs Analysis (TNA) is recommended as an important step in the training design process. There is little scientific literature on TNA based online continuing training module in IPC for Quebec nurses. This study aimed to identify the training needs felt with regard to the IPC skills of nurses practicing in a Montreal hospital center. 390 nurses responded to the self-administered questionnaire survey. The results of this study suggest that a hybrid online training focused on the management of infection transmission risks, occupational health and safety as well as the management of biological waste should be developed within the establishment. The results of our study also revealed significant associations between certain socio-demographic and professional characteristics and the perceived need for training for some PCI skills. These results contribute to the advancement of knowledge in nursing sciences by documenting the online training needs in IPC of Quebec nurses. This study also contributes to improving the quality of continuing education, by adapting it to the needs of learners.

Bakgrund: Övervikt och fetma är ett hälsoproblem som har ökat i samhället och globalt. Forskningen visar att barnen drabbas av livsstilssjukdomar i vuxen ålder. Distriktssköterskorna har en unik arbetsplats på barnavårdscentral och möter barn med viktproblem. Genom hälsosamtal med föräldrarna får föräldrarna de råd och upplysningar som det behövs för att bekämpa eller förebygga övervikt och fetma hos barn. Genom distriktsköterskornas hälsosamtal stöds föräldrar och barn med råd och information för att förebygga övervikt och framtida livsstilssjukdomar. Syfte: Syftet med denna litteraturöversikt var att belysa distriktssköterskors upplevelse av hälsosamtal med föräldrar till barn med övervikt och fetma. Metod: En litteraturöversikt genomfördes baserad på 15 originalartiklar. Artiklarna söktes fram i databaserna PubMed och CINAHL. Data analyserades med stöd av uppdaterad integrativ granskningsmetod enligt Whittemore och Knafl (2005). Analysen resulterade i tre kategorier och tolv underkategorier. Resultat: Resultatet visade att distriktssköterskor upplevde olika svårigheter som hindrade de att utföra ett effektivt arbete med övervikt och fetmaproblem hos spädbarn och barn under fem år. Det behövs aktuella riktlinjer och även utbildning till både föräldrar och distriktssjuksköterskor för att spädbarn och barn under fem år får en fetmafri barndom. Diskussion: Låg kunskapsnivå om övervikt och fetma hos föräldrarna kan ökas med hjälp av olika bland annat digitala verktyg. Distriktssjuksköterskorna kan i sina ordinarie arbetstider få regelbundna utbildningar och det är viktigt att organisationer uppdaterar riktlinjer. Slutsats: Samhället förändras och teknologi växer och i och med det, förändras mat- och aktivitetskultur hos samhället. Nya organisationsbestämmelser och riktlinjer behövs. Nya verktyg och uppdaterad kunskap hos distriktssjuksköterskor behövs för att säkerställa samhällets hälsa nu och i framtiden. / Background: Obesity are a health problem that has increased in society and globally. Research shows that children suffer from lifestyle diseases in adulthood. The district nurses have a unique workplace at the child care center and meet children with weight problems. Through health conversations with the parents, the parents receive the advice and information needed to fight or prevent overweight and obesity in children. Through the district nurses' health talks, parents and children are supported with advice and information to prevent obesity and future lifestyle diseases. Aim: The aim of this literature review was to shed light on district nurses' experience of health conversations with parents of overweight and obese children. Method: A literature review was conducted based on 15 original articles. The articles were searched in the databases PubMed and CINAHL. Data were analyzed using an updated integrative review method according to Whittemore and Knafl (2005). The analysis resulted in three categories and twelve subcategories. Results: The results showed that district nurses experienced various difficulties that prevented them from performing effective work with obesity and obesity problems in infants and children under five years of age. Current guidelines and also training for both parents and district nurses are needed for infants and children under the age of five to have an obesityfree childhood. Discussion: Low level of knowledge about overweight and obesity in parents can be increased with the help of various digital tools, among others. The district nurses can receive regular training during their regular working hours and it is important that the organization updates guidelines. Conclusion: Society is changing and technology is growing and with it, food and activity culture in society is changing. New organizational rules and guidelines are needed. New tools and updated knowledge of district nurses are needed to ensure the health of society now and in the future. / <p>Datum för godkännande: 2021-12-06</p>

Methicillin-resistant staphylococcus aureus (MRSA) has become resistant to antibiotics. The purpose of this quantitative, retrospective cohort study was to examine the relationship between length of hospitalization and invasive MRSA infection rates among different racial and ethnic groups in the 8 service planning areas (SPAs) of Los Angeles County. Cane, O'Connor, and Michie's theoretical domain framework was used. Secondary data from the Healthcare-Associated (HA) Infections Program of the California Department of Public Health were analyzed. For the first research question, a Pearson correlation analysis was conducted to assess the relationships between length of hospitalization and invasive HA-MRSA infection rates and counts. Length of hospital stay was not correlatedwith HA-MRSA infection rates; however, it was strongly and positively correlated with HA-MRSA infection counts. For the second research question, a one-way ANOVA was conducted on the infection count rate data, with SPA as the between-subjects factor. The results were statistically significant, indicating that HA-MRSA infection counts varied among the 8 SPAs. The findings might help medical professionals better understand the risk factors associated with MRSA infections. In doing so, findings may relieve some of the burden on the U.S. health care system and improve the overall quality of life of the patients involved.