Marco contextual: La experiencia de transición de las residentes de enfermería se produce a través de cambios intencionales motivados por la posibilidad de cualificarse en su ejercicio profesional. Objetivo: Analizar las motivaciones de la experiencia de transición de las estudiantes de especialización en enfermería en un municipio del noreste de Brasil. Metodología: Estudio transversal y exploratorio realizado con 40 enfermeras de los estudios de especialización en enfermería, en la modalidad de residencia. Para recopilar los datos se utilizó la técnica de la entrevista semiestructurada con guion dirigido según el análisis de contenido. Resultados: El estudio hizo posible la construcción de la categoría “motivaciones de la experiencia de transición”, en la que se examinan las motivaciones de la experiencia de transición, lo que dio lugar a tres subcategorías temáticas, necesidad de profundizar en el conocimiento y experimentar la práctica; la insuficiencia de la graduación, y la experiencia previa en los escenarios de la práctica. Conclusión: La realización de los estudios de especialización es una experiencia de transición motivada por las posibilidades de las enfermeras para cualificarse en su ejercicio profesional.

Enquadramento: A experiência transicional de especialistas de enfermagem ocorre por meio de mudanças intencionais motivadas pela possibilidade de qualificar o exercício profissional. Objetivo: Analisar as motivações para a experiência transicional das egressas do curso de especialização em enfermagem de um município do Nordeste do Brasil. Metodologia: Estudo transversal e exploratório realizado com 40 enfermeiras egressas do curso de especialização em enfermagem na modalidade de residência. Para a colheita dos dados foi utilizada a técnica de entrevista semiestruturada com roteiro norteador. Os dados obtidos foram analisados à luz da análise de conteúdo. Resultados: O estudo possibilitou a construção da categoria motivações para a experiência transicional, que discute as motivações para a experiência transicional, o que resultou em três subcategorias temáticas - necessidade de aprofundar o conhecimento e vivenciar a prática; insuficiência da graduação; e experiência prévia em cenários de prática. Conclusão: A realização do curso de especialização é uma experiência transicional motivada pelas possibilidades de qualificar o exercício profissional de enfermeiras.

Background: The transitional experience of nurse residents occurs through intentional changes motivated by the possibility of enhancing their practice. Objective: To analyze the motivations for the transitional experience of former students of the nurse residency program in a municipality in Northeast Brazil. Methodology: Cross-sectional exploratory study carried out with 40 former students of the nurse residency program. The semi-structured interview technique with a guide was used for data collection. Data were analyzed through content analysis. Results: The category Motivations for the transitional experience emerged, which discusses the motivators influencing the transitional experience. Three subcategories also emerged: Need to enhance knowledge and experience clinical practice; Undergraduate training is insufficient; and Previous experience in practical settings. Conclusion: The completion of the nurse residency program is a transitional experience motivated by the possibilities of improving nurses' practice.

Resumo O óleo essencial de Melaleuca alternifolia (Maiden & Betche) (óleo da árvore do chá) foi eficaz em estudos anteriores, no tratamento da infestação por ácaros Demodex em humanos. O presente estudo teve por objetivo avaliar o tempo do efeito acaricida, in vitro, desse fitoterápico sobre Demodex canis. Para o exame parasitológico, amostras foram coletadas da pele de um cão e examinadas por microscopia óptica. Apenas amostras com ácaros íntegros e com evidente movimentação de quelíceras e tarsos foram selecionadas. Vinte e uma amostras foram direcionadas para teste com o óleo, em sete concentrações diferentes: 100%; 50%; 25%; 12,5%; 6,25%; 5,0% e 3,13%. Três amostras foram testadas com o controle positivo, amitraz, e três com o controle negativo, xampu neutro. O intervalo entre o momento em que a solução foi adicionada e o instante em que cessou o movimento do último ácaro definiu o tempo de sobrevivência na amostra. Os tempos nas diferentes concentrações e nos controles foram comparados. Quanto mais alta a concentração do óleo, mais rapidamente ocorreu seu efeito letal. Os tempos de sobrevivência nos controles foram maiores que nas diferentes concentrações do óleo de melaleuca.

Abstract The essential oil of the Melaleuca alternifolia (Maiden & Betche) (tea tree oil) has been effective in previous studies, in the treatment of infestation by Demodex mites in humans. The present study aimed at evaluating the in vitro acaricidal effect of this herbal medicine on Demodex canis. For the parasitological examination, samples were collected from a dog’s skin and examined using optical microscopy. Only samples with intact mites and with evident movement of chelicerae and tarsi were selected. Twenty-one samples were tested with the oil, in seven different concentrations: 100%; 50%; 25%; 12.5%; 6.25%; 5.0% and 3.13%. Three samples were tested with the positive control amitraz, and three with the negative control neutral shampoo. The interval between the time the solution was added and the moment the movement of the last mite ceased defined the survival time in the sample. By comparing the times at different concentrations and controls, the results showed that the higher the concentration of the oil, the more quickly its lethal effect occurred, and that the survival times in the controls were longer than in the different concentrations of melaleuca oil.

Marco contextual: Los estudios de especialización en Enfermería Médico-Quirúrgica es un posgrado que confiere el título de especialista, reconocido por el Colegio de Enfermería de Portugal. Objetivo: Analizar las expectativas profesionales de los enfermeros especialistas que realizan los estudios de especialización en Enfermería Médico-Quirúrgica en Portugal. Metodología: Estudio cualitativo para el cual se recurrió a la entrevista no estructurada. La muestra fue no probabilística de conveniencia y estuvo constituida por 10 enfermeros especialistas. Las entrevistas se transcribieron y analizaron según la técnica de análisis de contenido de Laurence Bardin. Resultados: Después de finalizar los estudios, no hubo cambios en la carrera profesional. Los estudios contribuyeron al desarrollo del conocimiento, la prestación de cuidados a los usuarios y, consecuentemente, a una mayor competencia profesional. Conclusión: A pesar de la ausencia de cambio en la carrera profesional, los enfermeros consideran que los estudios les proporcionaron mayor competencia para prestar atención sanitaria en el área de especialidad.

Enquadramento: O curso de Especialização em Enfermagem Médico-Cirúrgica é uma pós-licenciatura que confere o título de especialista, reconhecido pela Ordem dos Enfermeiros Portugueses. Objetivo: Analisar as expectativas profissionais dos enfermeiros especialistas que frequentaram um Curso de Especialização em Enfermagem Médico-Cirúrgica em Portugal. Metodologia: Estudo qualitativo para o qual se recorreu à entrevista semiestruturada. Amostra não probabilística de conveniência, constituída por 10 enfermeiros especialistas. As entrevistas foram transcritas e analisadas conforme a técnica de análise de conteúdo de Laurence Bardin. Resultados: Não houve mudança na carreira profissional após a conclusão do curso; a contribuição do curso para o desenvolvimento do conhecimento, da prestação de cuidados aos utentes e, consequentemente, maior competência profissional. Conclusão: Apesar da ausência de mudança na carreira profissional, os enfermeiros consideram que a frequência do curso lhes proporcionou maior competência para a prestação de cuidados de saúde na área da especialidade.

Background: The Specialization Program in Medical-Surgical Nursing is a postgraduate program that confers the title of specialist, which is recognized by the Portuguese Order of Nurses. Objective: To analyze specialist nurses' professional expectations after completing the Specialization Program in Medical-Surgical Nursing in Portugal. Methodology: A qualitative study was conducted using semi-structured interviews. The nonprobability convenience sample consisted of 10 specialist nurses. The interviews were transcribed and analyzed according to Laurence Bardin's content analysis technique. Results: No changes were found in the professional career after the program. The program improved nurses' knowledge and practice and, consequently, their professional competence. Conclusion: Despite the lack of change in their careers, nurses considered that the program improved their competence in delivering care in their area of specialization.

Biofilm production is an important mechanism that allows microbes to escape host defences and antimicrobial therapy. Vancomycin has been used largely for the treatment of methicillin-resistant staphylococcal infections. Here, we determined the minimal inhibitory concentration (MIC) and minimal biofilm eradication concentration (MBEC) for 82 Staphylococcus species isolated from central venous catheters (CVC). Our results showed that the 41 strong and moderate-biofilm-producing isolates presented a higher MBEC/MIC ratio for vancomycin than the 24 weak-biofilm-producing isolates, illustrating the importance of biofilm production ability and the difficulty in treating biofilm-related infections. The MBEC was significantly higher in moderate-biofilm-producing isolates than in weak-biofilm-producing isolates (p < 0.001) and in strong-biofilm-producing isolates than in weak-biofilm-producing isolates (p = 0.001). The correlation between the MIC and the MBEC was poor. Based on our results, we recommend that bacterial biofilms be suspected in all cases of CVC infection.

Automated instruments offer many advantages for clinical laboratories. Nevertheless, they can have problems identifying and determining susceptibilities of some pathogens. Vitek® 2 (bioMérieux) is an automated system that was recently introduced to Brazil. We evaluated the performance of this equipment for Brazilian isolates that had been characterized using reference identification and antimicrobial susceptibility testing methods. Ninety-nine strains of Gram-positive cocci from a local reference center collection were analyzed, consisting of 50 coagulasenegative Staphylococcus (CoNS) and 49 Enterococcus and related species. Vitek® 2 correctly identified 79.8% (79/99) of the isolates. Oxacillin resistance was detected in 76% (19/25) of resistant S. epidermidis strains and in 88% (22/25) of other resistant CoNS species strains. Vancomycin resistance was detected in 100% (20/20) of resistant Enterococcus and related species strains. Vitek® 2 performed very well for the identification of S. epidermidis and non-epidermidis staphylococci, and for the detection of vancomycin resistance in Enterococcus and related species. However, the system needs improvement in order to provide reliable results for the characterization of some CoNS species, identification of Enterococcus and related species and for detecting oxacillin resistance in CoNS.

The NCCLS (2004) presented a new methodology to detect, by disk-diffusion agar, oxacillin-resistance using a cefoxitin disk. We identified coagulase-negative staphylococci (SCoN) to the species level and compared the use of cefoxitin disks (30 µg) with oxacillin disks (1 µg), agar dilution (minimum inhibitory concentration of oxacillin) and mecA gene detection in isolates of coagulase-negative bacteria other than Staphylococcus epidermidis (SCoNne). A total of 238 SCoNne was evaluated; oxacillin-resistance (the mecA gene) was detected in 71% of the isolates. All methods gave 100% sensitivity, based on presence of the mecA gene. The specificity of the cefoxitin disk was 100%, while the oxacillin disk gave a specificity of 91% and agar dilution oxacillin gave a specificity of 88%. We conclude that the cefoxitin disk is an efficient test, and it is an easy method for use in clinical laboratories to detect oxacillin-resistance in staphylococci.

Coagulase-negative Staphylococcus spp. was considered nonpathogenic until the emergence of multiresistance and the demonstration of their participation as infectious agents. In Brazil, oxacillin resistance may be present in over 80% of isolates, and the Clinical and Laboratory Standards Institute standardized a disk-diffusion method to predict this resistance in Staphylococcus. The aim of this study was to evaluate the variability among commercial disks of oxacillin (1 µg) and cefoxitin (30 µg) widely used in clinical laboratories of microbiology, compared with mecA gene and minimum inhibitory concentration (MIC) of oxacillin. The use of oxacillin and cefoxitin disks simultaneously allowed the detection of important differences, particularly, in less frequent species such as S. cohnii, S. haemolyticus, S. saprophyticus, and S. sciuri. Disks of cefoxitin of the brand 2 displayed good correlation with the mecA gene (98.7%) and oxacillin MIC (97.8%), while major discrepancies were observed using disks of brand 1. One of the critical points in the diffusion disk test is the quality of the disks: the use of better quality disks associated with molecular methods lead to better results to define the best antibiotic therapy.

According to the National Committee for Clinical Laboratory Standards (NCCLS, 2004), a method to evaluate the inducible clindamycin resistance in accordance with an approach of the disks of erythromycin and clindamycin - the D test - has been reported. We analyzed the performance of this method in 200 coagulase negative staphylococci (CoNS) strains obtained from blood cultures of hospitalized patients at a general hospital in Southern Brazil. Twenty-seven clinical isolates with suitable profile (erythromycin-resistant and clindamycin-susceptible) were evaluated for the D test realization. Thus, only 5 CoNS were D test positive. The D test method showed to be simple and an important technique in the detection of inducible clindamycin resistance.