Background and Objectives: Several factors can compromise patient safety, such as ineffective teamwork, failed organizational processes, and the physical and psychological overload of health professionals. Studies about associations between burn out and patient safety have shown different outcomes. Objective: To analyze the relationship between burnout and patient safety. Materials and Methods: A systematic review with a meta-analysis performed using PubMed and Web of Science databases during January 2018. Two searches were conducted with the following descriptors: (i) patient safety AND burnout professional safety AND organizational culture, and (ii) patient safety AND burnout professional safety AND safety management. Results: Twenty-one studies were analyzed, most of them demonstrating an association between the existence of burnout and the worsening of patient safety. High levels of burnout is more common among physicians and nurses, and it is associated with external factors such as: high workload, long journeys, and ineffective interpersonal relationships. Good patient safety practices are influenced by organized workflows that generate autonomy for health professionals. Through meta-analysis, we found a relationship between the development of burnout and patient safety actions with a probability of superiority of 66.4%. Conclusion: There is a relationship between high levels of burnout and worsening patient safety.

This paper discusses findings from a systematic review of literature pertaining to methadone maintenance in relation to the role of the nurse working in a general practice setting. Five electronic databases were searched for period of 2000-2008: Medline, CINAHL, Embase, PsycINFO and Cochrane Database of Systematic Reviews. Included studies were peer-reviewed literature articles that: (1) were dated no earlier than the year 2000; (2) represented a primary study (qualitative and quantitative), systematic review or meta-analysis; (3) focused on methadone maintenance for treatment of opiate dependence, not for pain; and (4) were published in English. In this review, three broad themes emerged as being significant to the role of the nurse in relation to methadone maintenance treatment (MMT) programming. These themes included: (1) identifying the client's personal characteristics; (2) having knowledge about methadone; and (3) supporting clients in MMT programmes. In conclusion, it is important to address the needs of health professionals working with clients on MMT, in order for them to provide the necessary care for this patient population. In particular, nurses need to gain knowledge about MMT to assist them in carrying out their nursing role competently when caring for this vulnerable population.

Introduction: Autistic Spectrum Disorder (ASD) is part of neurodevelopmental disorders, which are behavioral and cognitive. These symptoms appear according to the child's development, however, most of the time, they present themselves before the age of three, and they may evolve to greater intensities or not. Objective: To analyze the experience of families with children with Autistic Spectrum Disorder. Methods: Exploratory study with a qualitative approach carried out at the Associação de Pais e Amigos dos Excepcionais (Association of Parents and Friends of the Exceptional/APAE). 46 families and 10 professionals participated in the study. For the analysis of the results, the technique of content analysis proposed by Bardin was used. The research project for this study was approved by the Ethics Committee for Research with Human Beings under opinion No. 3172.942 on February 27, 2019. Results: It was evident that the family is an important instrument for the care of children with ASD and, for this reason, it should be seen in an integrated and not fragmented way in care, thus revealing the need to promote actions that take care of the caregiver and not just of the child itself, because as seen, every process that goes from birth to diagnosis and treatment of the child requires changes that can also bring harm to the health of the family. Conclusion: The experience of families of children with ASD goes through phases of acceptance and adaptation and depends on the interaction and assistance of professionals so that they can, despite life changes, perceive them as important in promoting the child's life from the motor and cognitive interaction with society.

Introduction: Syphilis is still a worldwide problem; with approximately 12 million people infected every year. Over the last decade, Brazil had an increment in the number of cases. The year 2016 reported 37,436 cases of syphilis in pregnant women and 20,474 cases of congenital syphilis, with 185 deaths. The Southeast region reached the highest numbers, especially in the state of Espírito Santo with high rates in pregnant women, being the third highest incidence rate in the country with 10.4 cases/1,000 live births, above the national average of 6.8 cases/1,000 live births. Objective: Describe the therapeutic treatment of children affected with congenital syphilis as well as the clinical, radiological and laboratory changes associated to this disease. Methods: Retrospective, descriptive, exploratory, quantitative study, based on 204 notification forms of congenital syphilis from January 2016 to December 2017. Results: The findings showed that 88.7% of the puerperal women performed prenatal care. Regarding newborns, 85.3% were asymptomatic. When analyzing the therapeutic regimen instituted, 22.5% used procaine Penicillin G, 22.5% crystalline Penicillin G and 20.6% benzathine Penicillin G.  Conclusion: The treatment instituted by this philanthropic maternity for newborns with congenital syphilis is in line with the guidelines proposed by the Ministry of Health. The clinical symptoms do not represent a frequent finding during the neonatal period, however, they can occur later.

Background The Rheumatic Heart disease in Timor Leste school students (RHD-TL) study identified Timor Leste as having some of the highest rates of definite rheumatic heart disease (RHD) in the world. The RHD-TL follow-up study aimed to assess the delivery and outcomes of the secondary prophylaxis program in known patients with echocardiographic screen detected definite and borderline RHD. Methods School-students in Timor Leste where reassessed over a 3-year period since the initial study in 2016. Prospective assessments included adherence to secondary prophylaxis, complications of prophylaxis, follow-up clinical assessment and serial echocardiography. Of the 48 patients, 25 Definite and 23 Borderline, 38 (79%) of all patients, and 92% of definite RHD cases have had one or more follow-up assessments including full datasets for adherence, recurrence rates and progression of disease. Follow-up is provided by the volunteer paediatric cardiology team and rheumatic heart disease team of two NGOs in collaboration with local clinics. Results The median duration of follow-up of the 38 patients was of 1.6 years. The median age was 13 years (range 8-22) and 75% were female. Adherence rates in patients with definite RHD was on average greater than 95% during the follow-up period. Of the 23 patients with mild or moderate RHD one case with documented acute rheumatic fever (ARF) recurrence progressed whilst 8 cases improved on benzathine-penicillin G (BPG) therapy. There was no progression of the 6 borderline cases who were not prescribed BPG. Out of the 9 borderline cases in whom BPG was prescribed, one, with 67% adherence, had a documented episode of ARF leading to echocardiographic progression and moderate definite RHD. Conclusion This was the first follow-up study to look at disease natural history, both in treated and untreated groups, in Timor-Leste and brought practical insights into the efficacy of the Timor Leste RHD monitoring and prophylaxis programs. Its ongoing project will enable advocacy and quality assessment for the program as it expands. Abstract 225 Figure 1.

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A aplicabilidade da consulta de enfermagem no pré-natal da atenção primária The applicability of pre-natal primary care nursing consultation