A good nursing handover process is a crucial part of providing quality nursing care in a modern healthcare environment. The conservation of patient data during the handover process is vital to ensure good continuity of care and safe practice. Any errors or omissions made during the handover process may have dangerous consequences. The authors observed the handover of 12 simulated patients over five consecutive handover cycles between nurses. Three handover styles were used and the amount of data loss was recorded for each style. A purely verbal handover style resulted in the loss of all data after three cycles. A note-taking style (the traditional style used in most hospital wards) resulted in only 31% of data being transferred correctly after five cycles. When a typed sheet was included with the verbal handover, data loss was minimal. Current handover methods may result in significant loss of important data that may impact on patient care. The authors recommend that prior to handover, a formal handover sheet be constructed that can be transferred as part of the handover process.

Ann R Coll Surg Engl 2007; 89: 298-300 298Medical handover is 'the transfer of professional responsibility and accountability for some or all aspects of care for a patient, or group of patients, to another person or professional group on a temporary or permanent basis'.1 The implementation of the New Deal and the European Working Time Directive has meant that junior doctors are increasingly working in shifts and that handover of clinical information is taking place more frequently. There is reduced continuity of care with patients often being looked after by more than one group of doctors on any given day.3 In many instances, doctors have no day-to-day contact with patients for whom they are responsible in the outof-hours period.2 There are many published examples of cases where poor communication between doctors has had serious consequences for patients; 3 for these reasons, it is now well recognised that accurate handover of clinical information is of great importance to patient safety. 1There are currently many different handover methods being used in clinical practice. 4 Often, a verbal handover is conducted, either by telephone or in person, where the recipient of the handover may or may not take notes to refer to over the course of his shift. Some groups arrange for a handover book or folder to be used so that teams can leave messages about patients of particular concern. In this case, there may be no verbal contact at all. Increasingly, more formal pre-prepared handover sheets are being used which contain information about all of the patients belonging to that particular team.5 This can be typed on a computer and printed out for the on-call doctor for his reference. However, this process inevitably takes more time and effort.Despite this variation in clinical practice, there is very little prospective experimental evidence in the literature investigating optimal methods of handover. The British Medical Association, in conjunction with the General Medical Council, NHS Modernisation agency, National Patient Safety Agency and the Junior Doctors Committee have recently published guidelines 4 for safe handover, but these are based largely on expert opinion. We designed a study to assess the differences in information retention for different handover styles. The styles examined included a purely verbal style, a verbal with note-taking style and a handover using a pre-prepared sheet.

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Introduction the oncological patient submitted to ostomy faces multiple losses which affect their quality of life. Objective: assess quality of life in ostomized patients due to colorectal cancer, regarding the physical, psychological, social and environmental relationships, treated at the Ostomy Program of the Health Department of Distrito Federal, Brazil. Methods: epidemiological-based, analytical, cross-sectional and descriptive study. The sample consisted of 54 patients enrolled in the Ostomy Program of the Health Department of Distrito Federal - Brazil. The WHOQOL-BREF questionnaire was used to evaluate quality of life. Data was analyzed by Microsoft ® Office Excel 2010 and SPSS 20.0. Results: the Physical, Social and Environmental aspects were correlated to the mean score, resulting in statistical significance (p<0.0001). The item “Positive feelings” in the Psychological Domain was the only one that did not achieve statistical significance. Conclusion: the results demonstrate that the care of cancer patients with ostomies should focus on the technical-scientific, political and socio-educational actions, to allow a multidisciplinary team to recognize health as a right for all, working to guarantee the health care process.

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A comunidade quilombola Kalunga, grupo étnico afro-brasileiro, ocupa a região do cerrado no nordeste do Estado de Goiás. O presente estudo trata do perfil sócio epidemiológico em ambiente rural, no qual são consideradas as condições de vida que afetam a saúde dos quilombolas, sob a perspectiva da Bioética de Intervenção. Aplicou-se um questionário do tipo semiestruturado contendo variáveis relativas à identificação dos participantes nos cenários sanitário, socioeconômico e étnico-cultural. Os resultados apontam para a persistência de fragilidades relacionadas às questões sociais e de saúde, bem como para a dificuldade de promoção dos processos inclusivos de universalidade e equidade em saúde para aquela comunidade.

SummaryLack of conservation of the Amazon tropical rainforest has imposed severe threats to its human population living in newly settled villages, resulting in outbreaks of some infectious diseases. We conducted a seroepidemiological survey of 1100 inhabitants of 15 villages of Paço do Lumiar County, Brazil. Thirty-five (3%) individuals had been exposed to Trypanosoma cruzi (Tc), 41 (4%) to Leishmania braziliensis (Lb) and 50 (4.5%) to Leishmania chagasi (Lc) infections. Also, 35 cases had antibodies that were cross-reactive against the heterologous kinetoplastid antigens. Amongst these, the Western blot assays revealed that 11 (1%) had Tc and Lb, that seven (0.6%) had Lc and Tc, and that 17 (1.6%) had Lb and Lc infections. All of these cases of exposures to mixed infections with Leishmania sp, and eight of 11 cases of Tc and Lb were confirmed by specific PCR assays and Southern hybridizations. Two cases had triple infections. We consider these asymptomatic cases showing phenotype and genotype markers consistent with mixed infections by two or more kinetoplastid flagellates a high risk factor for association with Psychodidae and Triatominae vectors blood feeding and transmitting these protozoa infections. This is the first publication showing human exposure to mixed asymptomatic kinetoplastid infections in the Amazon.

Objetivo: identificar o estilo de coping religioso-espiritual utilizado entre familiares de crianças eadolescentes em tratamento quimioterápico.Método: estudo descritivo quantitativo. Os dados foram coletados com 63 familiares cuidadoresem um hospital pediátrico no Distrito Federal, com um questionário para caracterização da amostrae a escala coping religioso/espiritual. Na análise utilizou-se os programas Statistical Package for theSocial Sciences versão 16.0 e Microsoft Excel 2013.Resultados: o valor do coping religioso/espiritual total obtido foi de 3,7. A média de coping religioso/espiritual positivo foi de 3,4 e negativo foi de 2. A razão coping religioso/espiritual negativo/copingreligioso/espiritual positivo foi de 0,6 com direcionamento do uso do coping religioso/espiritualpara as estratégias negativas.Conclusão: os familiares cuidadores utilizaram o coping religioso-espiritual empregando tantoestratégias positivas quanto negativas, com predomínio das estratégias negativas. Esses resultadosfundamentam a assistência de enfermagem associando as competências para o cuidado dadimensão física às necessidades espirituais de toda a unidade familiar.