[Evidence based practice of nurses working in university hospitals in the French speaking part of Switzerland: a descriptive and correlational study] / La pratique fondée sur des preuves chez les infirmières de centres hospitaliers universitaires en Suisse romande : étude descriptive et corrélationnelle.

Introduction : evidence-based practice (EBP) is too scarcely applied in nursing and is a key contemporary challenge for the discipline. Method and objective : This descriptive and correlational study invited 221 nurses working in three different clinical settings of university hospitals in Switzerland. The objective of this study was to describe their level of knowledge, beliefs and implementation of EBP. Results : of the 221 nurses in this study, only 67 were familiar EBP (30%). These demonstrate favorable beliefs and attitudes towards EBP, but indicate a lack of skills and knowledge to implement it. Compared to both internal medicine and geriatric nurses clinical nurse specialists (ISC) were significantly more familiar with EBP and its implementation. Results also indicate that positive nurses' beliefs and attitudes toward EBP are predictive of better implementation in clinical practice. Discussion and Conclusion : as demonstrated in other studies, our results show that knowledge about EBP is not that widespread and its implementation remains a challenge even in university hospitals. Future work could include testing EBP implementation strategies to overcome the barriers identified.

A brief motivational intervention based on positive experience and temporary smoking abstinence: Feasibility in a psychiatric hospital

Background and Objectives: Feasible interventions promoting tobacco cessation need to be implemented in psychiatric hospitals, where high proportions of patients are heavy smokers. This pilot study examined the feasibility of a new brief motivational intervention associating positive experiences with temporary smoking cessation. Methods: One-day interventions were proposed to 19 smokers hospitalized for severe mental disorders. The multicomponent intervention comprised a 25-hour tobacco cessation period, information about smoking, attending thermal baths and music therapy sessions, intensive group support and feedback sessions. Expired carbon monoxide was monitored and nicotine replacement was available. Patients were evaluated before, during and after the intervention. Results: Most participants were heavy smokers (68.4%) and precontemplative about smoking cessation (52.6%). Rates of successful smoking abstinence were 78.9% after 10hours and 47.4% at 25 hours; 15.8% stopped for 3 days or more. Median CO level decreased from 24 to 9 ppm. Patients reported high levels of general well-being and satisfaction during the abstinence day. Psychiatric condition did not deteriorate and frequency of withdrawal symptoms was low. 84% of patients used nicotine replacement. Significantly reduced cigarette consumption persisted for at least one week after the intervention (AU)

Determinantes urbanos para el ejercicio del control social en salud en el Distrito Capital, 1986-1996 / Urban determinants for the exercise of social control in health in the Capital District, 1986-1996

El desarrollo de este estudio parte de la idea de que los determinantes urbanos de la ciudad de Santa Fe de Bogotá son características que además de darle una connotación propia al citadino, pueden estar caracterizando el ejercicio del control social en la prestación de los servicios de salud y desarrollo de la seguridad social en salud en el Distrito Capital. Se hace una aproximación exploratoria al tema a partir de las características de los líderes comunitarios, teniendo como referentes algunos determinantes que la teoría ha definido como propios de lo urbano, en aspectos económicos, culturales, poblacionales, institucionales y en la oferta de servicios públicos. El estudio tiene como marco de referencia las reformas de los sistemas de salud de los últimos diez años; en él se hace una reflexión del significado que tiene la Constitución de 1991 sobre la participación social y su relación con la posible construcción de un nuevo concepto de ciudadanía. Así, los determinantes urbanos se identifican tomando como base inicial los definidos en el marco de referencia a partir de los elementos generales que en teoría se han descrito como características de la ciudad, y posteriormente se buscan y se confrontan algunos de éstos en el contexto local, otros en el contexto nacional, y otros en el institucional y cultural de los líderes comunitarios. El control social se abordó en el contexto de la participación, y tanto el uno como la otra desde el Estado, por ser el generador de estos procesos. Las reformas de los sistemas y los aspectos normativos de la participación comunitaria se hicieron a partir de la revisión de los tres sistemas de salud que han existido en Colombia, plasmados en el decreto 056 de 1975, la ley 10 de 1990 y la ley 100 de 1993. Se presenta una caracterización por etapas y en los tres sistemas de salud sobre la participación comunitaria promovida por el Estado en los contextos nacional y local en la última década. Hace un recorrido de la forma como ha evolucionado el uso de los términos participación comunitaria y control social en salud y propone una definición de los mismos. Genera algunas recomendaciones para diferenciar el papel de cada organización comunitaria según el régimen o plan de beneficios en el SGSSS. Diseña alternativas para involucrar a la población de estratos altos en el control social. Identifica aspectos concretos sobre las relaciones de los sectores comunitarios con las instituciones de salud y con sus funcionarios, y que están afectando positiva y negativamente su quehacer como líderes en el SGSSS. Finalmente, se hace una propuesta metodológica en la cual se retoman las conclusiones del trabajo así como las principales debilidades manifestadas por los líderes.

The development of this study is based on the idea that the urban determinants of the city of Santa Fe de Bogotá are characteristics that, in addition to giving a connotation of the city-dweller, may be characterizing the exercise of social control in the provision of health services and the development of social security in health in the Capital District. An exploratory approach to the subject is made on the basis of the characteristics of community leaders, taking as a reference some determinants that theory has defined as typical of the urban, in economic, cultural, population, institutional aspects and in the supply of public services. The study has as a frame of reference the health system reforms of the last ten years; it reflects on the meaning of the 1991 Constitution on social participation and its relationship with the possible construction of a new concept of citizenship. Thus, the urban determinants are identified taking as an initial basis those defined in the frame of reference from the general elements that have been described in theory as characteristics of the city, and then some of these are sought and confronted in the local context, others in the national context, and others in the institutional and cultural context of community leaders. Social control was approached in the context of participation, and both the one and the other from the State, for being the generator of these processes. The reforms of the systems and the normative aspects of community participation were made from the review of the three health systems that have existed in Colombia, embodied in Decree 056 of 1975, Law 10 of 1990 and Law 100 of 1993. It presents a characterization by stages and in the three health systems of the community participation promoted by the State in the national and local contexts in the last decade. It reviews how the use of the terms community participation and social control in health has evolved and proposes a definition of these terms. It generates some recommendations to differentiate the role of each community organization according to the regime or benefit plan in the SGSSS. Designs alternatives to involve the population of high strata in the social control. It identifies specific aspects of the relationship between the community sectors and the health institutions and their officials that are positively and negatively affecting their work as leaders in the SGSSS. Finally, a methodological proposal is made in which the conclusions of the work as well as the main weaknesses expressed by the leaders are taken up.

Relaçäo entre dimensäo vertical esquelética, contorno mandibular e aumento do comprimento mandibular em indivíduos masculinos / Relationship among skeleton vertical dimension, mandibular-profile, and mandibular lenght increase in males

Um estudo cefalométrico foi conduzido para determinar a relaçäo entre a dimensäo vertical esquelética facial, contorno da borda mandibular direita, contorno da sínfise e crescimento em comprimento da mandíbula em meninos antes do crescimento puberal e depois do crescimento puberal. Os 28 casos utilizados neste estudo foram selecionados dos arquivos do Bolton Longitudinal Growth Study at Case Western University, Cleveland, Ohio. O critério para selecionar a amostra foi: praticabilidade das radiografias cefalométricas laterais nos períodos de desenvolvimento (antes e depois da puberdade); presença de tipos faciais com mordida aberta e sobremordida profunda esqueléticas pela Análise dos Arcos de Sassouni, mesmo nível sócio-econômico. As seguintes variáveis foram medidas ou calculadas: altura da parte superior anterior da face, altura da parte inferior anterior da face; ângulo entre a linha mandibular 1 e linha mandibular 2; altura da sínfise; largura da sínfise; comprimento total da mandíbula; proporçäo da altura da parte superior anterior da face para a altura da parte inferior anterior da face, proporçäo entre altura e largura da sínfise. Coeficientes de correlaçäo de Pearson e análise de regressäo múltipla foram utilizados para analisar os dados. A dimensäo vertical foi a única variável que mostrou correlaçäo significante com o comprimento total da mandíbula. Esta mesma proporçäo também foi a única que diferenciou entre os grupos de mordida aberta e sobre mordida profunda. As variáveis previsíveis (proporçäo vertical e proporçäo da sínfise) somente justificam 21 por cento da variabilidade do comprimento total da mandíbula)