Short stay facilities: the future of efficient paediatric emergency services

OBJECTIVE: To assess the reactions of parents and their children to the request for a blood sample and an attempt to take blood. METHODS: 1859 children aged 1.5-4.5 years took part in a national survey of diet and nutrition. A retrospective inquiry of the parents' and children's reported reactions was carried out six to 18 months later by postal questionnaire sent only to the 1157 who had given consent for an attempt to take blood. RESULTS: 866 questionnaires were returned; 790 were from parents of children in whom an attempt to take blood had been successful. Thirteen per cent said that their child had given blood previously. About 30% discussed the request with the family doctor or nurse. Some 90% said that they were given enough information and that the phlebotomist was sympathetic. Attempting to take blood caused upset in over 50%, which, in most, lasted for less than five minutes. A substantial minority were upset for up to 30 minutes and a few much longer. Bruising or bleeding occurred in 20-27%. Degree and duration of upset were both adversely associated with a failed attempt to obtain blood. CONCLUSION: The majority of preschool children experienced no more than a little upset of short duration after an attempt to take blood, but a substantial minority exhibited a greater degree of upset. These responses should be taken into account when assessing the benefits and risks of the procedure. The best equipment and expertise should be employed for taking blood as successful attempts are less upsetting.     

The perspective of the female archetype in nursing

The present study proposes a new approach to the feminine origins of nursing, utilizing an archetypical framework, analysing the features of this profession which has changed very little along its history. The article advocates that nursing characteristics are the result of a collective unconscious, that is, a primitive model of innate ideas. The perspective adopted for a feminine archetype in this investigation are related to the historical and social basis of nursing, as well as, with its pre-defined objective which is caring. Utilizing their own professional experience throughout the years, the authors identity that the essence of the nursing profession is caring and that this act, which involves protecting, promoting and preserving the human being, is basically associated to women. Based on these reflections, the authors advocate the idea nurses have an individual conscience that is influenced by a collective unconscious which is inherited.     

Insight and alexithymia in adult outpatients with obsessive–compulsive disorder

Objective

To elucidate the relationships between insight and alexithymia in a sample of adult outpatients with obsessive–compulsive disorder (OCD).

Methods

112 adult outpatients with OCD were tested. Severity of OCD was assessed with the first 10–items of the Yale–Brown Obsessive Compulsive Scale (Y–BOCS) and score for item # 11 on the Y–BOCS was considered as a measure of insight. Alexithymia was measured with 20–item Toronto Alexithymia Scale (TAS–20). Additional measures were Maudsley Hospital Obsessive Compulsive Inventory (MOCI) and Montgomery Åsberg Depression Rating Scale (MADRS).

Results

Of the patients, 29.5% showed poor or no insight. Patients with poor or no insight were more alexithymic than patients with excellent, good and moderate insight. TAS–20 total score and subfactors positively correlated with score for item # 11 on the Y–BOCS, severity of OCD and MADRS scores. In stepwise regression model, MADRS scores, factor 3 of TAS–20 (Externally Oriented Thinking), somatic and hoarding–saving obsessions were significantly associated with lower insight.

Conclusions

Results show a relationship between poor or absent insight and high alexithymia levels in OCD patients.     

A randomized formula controlled trial of Bifidobacterium lactis and Streptococcus thermophilus for prevention of antibiotic-associated diarrhea in infants

GOALS: This clinical trial was carried out to determine whether oral treatment with a commercial probiotic formula containing Bifidobacterium lactis and Streptococcus thermophilus would reduce the frequency of antibiotic-associated diarrhea (AAD) in infants. STUDY: In this double-bind formula controlled study, 80 infants, 6 to 36 months of age, were randomly assigned to receive a commercial formula containing 10 viable cells of B. lactis and 10 viable cells of S. thermophilus at the initiation of antibiotics for a duration of 15 days. The infants were assessed daily for formula intake, stool frequency, and stool consistency for a total duration of 30 days. Seventy-seven infants received nonsupplemented formula for the entire duration. RESULTS: There was a significant difference in the incidence of AAD in the children receiving probiotic-supplemented formula (16%) than nonsupplemented formula (31%). CONCLUSIONS: The present study shows that prevention against AAD in infants was obtained by oral treatment with daily dose of B. lactis and S. thermophilus.     

Epidemiological survey of histoplasmine and paracoccidioidine skin reactivity in an agricultural area in Bolívar state, Venezuela

Paracoccidiodomycosis and histoplasmosis are endemic diseases in the south of Venezuela, representing a public health problem. Prevalence of Paracoccidiodes brasiliensis and Histoplasma capsulatum infections were estimated in Monte Ralo, a rural community area of Bolivar state using paracoccidiodine and histoplasmine skin tests. Paracoccidiodine was intradermically injected to 173 persons and readings were made at 24 and 48 h afterwards to 167 persons (97.85%). Reaction was positive in 8.5% (n = 14) at 24 h post-injection and 13.2% (n = 20) at 48 h. Farmers showed the higher percentage of positivity at 24 and 48 h. One hundred-seventy five persons were intradermically injected with histoplasmine but 167 and 157 of them attended for reading of the dermal reaction at 24 and 48 h post-injection respectively. Tests were positive in 25.7% (n = 43) at 24 h and 42.7% (n = 67) at 48 h. Further studies are needed in surrounding places to delimit the endemic area of these mycosis in the Bolivar state. However, epidemiological vigilance of PCM and H should be considered by local health authorities.