Strategies designed to improve treatment adherence should address peculiarities associated with younger ages and male gender. Physicians should be made aware that prescription of less complex treatment regimens may result in better treatment adherence, and, therefore, better seizure control. The challenge in adjusting AED treatment in this population is to minimize treatment complexity, thus increasing chances for treatment adherence.

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Objective To describe nursing workload in Intensive Care Units (ICU) in different countries according to the scores obtained with Nursing Activities Score (NAS) and to verify the agreement among countries on the NAS guideline interpretation. Method This cross-sectional study considered 1-day measure of NAS (November 2012) obtained from 758 patients in 19 ICUs of seven countries (Norway, the Netherlands, Spain, Poland, Egypt, Greece and Brazil). The Delphi technique was used in expertise meetings and consensus. Results The NAS score was 72.8% in average, ranging from 44.5% (Spain) to 101.8% (Norway). The mean NAS score from Poland, Greece and Egypt was 83.0%, 64.6% and 57.1%, respectively. The NAS score was similar in Brazil (54.0%) and in the Netherlands (51.0%). There were doubts in the understanding of five out 23 items of the NAS (21.7%) which were discussed until researchers’ consensus. Conclusion NAS score were different in the seven countries. Future studies must verify if the fine standardization of the guideline can have a impact on differences in the NAS results.

Objective: to identify associations between the Burnout domains and the characteristics of the work environment. Method: cross-sectional study with 745 nurses from 40 public health institutions in São Paulo. Nursing Work Index-Revised (NWI-R) and Maslach Burnout Inventory were used. Similar institutions according to NWI-R were grouped by clustering and the Anova and Bonferroni tests were used in the comparative analyzes. Results: there was signifi cant and moderate correlation between emotional exhaustion and autonomy, control over the environment and organizational support; between reduced personal accomplishment, autonomy and organizational support; and between depersonalization and autonomy. The group that presented the worst conditions in the work environment differed on emotional exhaustion from the group with most favorable traits. Conclusion: emotional exhaustion was the trait of Burnout that was more consistently related to the group of institutions with more unfavorable working conditions regarding autonomy, organizational support and control over the environment. Descriptors: Burnout, Professional; Nursing; Health Facility Environment; Hospitals, Public; Cross-Sectional Studies. RESUMO Objetivo: identifi car associações entre os domínios do Burnout e as características do ambiente de trabalho. Método: estudo transversal com 745 enfermeiros de 40 instituições públicas de saúde de São Paulo. Nursing Work Index-Revised (NWI-R) e Maslach Burnout Inventory foram utilizados. Instituições semelhantes, segundo NWI-R, foram agrupadas pelo método de Cluster e os testes Anova e Bonferroni foram aplicados nas análises comparativas. Resultados: houve correlação signifi cativa e moderada entre exaustão emocional e autonomia, controle sobre o ambiente e suporte organizacional; baixa realização pessoal e autonomia, e suporte organizacional; despersonalização e autonomia. O grupo que apresentou as piores condições de ambiente de trabalho diferiu do que teve os mais favoráveis atributos quanto à exaustão emocional. Conclusão: a exaustão emocional foi o traço do Burnout que se relacionou de forma mais constante com o grupo de instituições com condições mais desfavoráveis de trabalho quanto à autonomia, suporte organizacional e controle sobre o ambiente. Descritores: Esgotamento Profi ssional; Enfermagem; Ambiente de Instituições de Saúde; Hospitais Públicos; Estudos Transversais. RESUMENObjetivo: identifi car asociaciones entre los dominios de Burnout y las características del ambiente de trabajo. Método: estudio transversal entre 745 enfermeros de 40 instituciones públicas de salud de São Paulo. Se utilizaron, la Escala Adaptada del Entorno de Práctica Enfermera (Nursing Work Index-Revised, NWI-R) y el cuestionario Maslach Burnout Inventory. Se agruparon instituciones semejantes por el método de Cluster, según la NWI-R y se aplicaron las pruebas Anova y Bonferroni en los análisis comparativos. Resultados: hubo correlación signifi cativa y moderada entre agotamiento emocional y autonomía, control sobre el ambien...

Diffuse axonal injury (DAI), a type of traumatic injury, is known for its severe consequences. However, there are few studies describing the outcomes of DAI and the risk factors associated with it. This study aimed to describe the outcome for patients with a primary diagnosis of DAI 6 months after trauma and to identify sociodemographic and clinical factors associated with mortality and dependence at this time point. Seventy-eight patients with DAI were recruited from July 2013 to February 2014 in a prospective cohort study. Patient outcome was analyzed using the Extended Glasgow Outcome Scale (GOS-E) within 6 months of the traumatic injury. The mean Injury Severity Score was 35.0 (SD = 11.9), and the mean New Injury Severity Score (NISS) was 46.2 (SD = 15.9). Mild DAI was observed in 44.9% of the patients and severe DAI in 35.9%. Six months after trauma, 30.8% of the patients had died, and 45.1% had shown full recovery according to the GOS-E. In the logistic regression model, the severity variables – DAI with hypoxia, as measured by peripheral oxygen saturation, and hypotension with NISS value – had a statistically significant association with patient mortality; on the other hand, severity of DAI and length of hospital stay were the only significant predictors for dependence. Therefore, severity of DAI emerged as a risk factor for both mortality and dependence.

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