OBJECTIVE: to describe the validation process of an educational booklet for healthy eating in pregnancy using local and regional food. METHODS: methodological study, developed in three steps: construction of the educational booklet, validation of the educational material by judges, and by pregnant women. The validation process was conducted by 22 judges and 20 pregnant women, by convenience selection. We considered a p-value<0.85 to validate the booklet compliance and relevance, according to the six items of the instrument. As for content validation, the item-level Content Validity Index (I-CVI) was considered when a minimum score of at least 0.80 was obtained. RESULTS: five items were considered relevant by the judges. The mean I-CVI was 0.91. The pregnant women evaluated positively the booklet. The suggestions were accepted and included in the final version of the material. CONCLUSION: the booklet was validated in terms of content and relevance, and should be used by nurses for advice on healthy eating during pregnancy.

Studies on validation of nursing diagnoses have been strongly influenced by the methodological framework developed in the 1980s. The suitability of these models to validate elements that make a nursing diagnosis has undergone several criticisms. This article aims to discuss these limitations and describe alternative approaches to overcome the criticism of traditional models. A critical analysis based on recent published literature on new approaches in research diagnoses was taken as basis for the discussions presented. Alternative methods are described for the concept analysis applied the procedures for validation of nursing diagnoses; methods for diagnostic content analysis by proficient judges, and methods for clinical validation of indicators and etiological factors. Conclude that there are few studies with these new approaches and the complexity of the analysis is an aspect that hinders its implementation.

Knowledge of the accuracy characteristics of clinical indicators allows the identification and discrimination of the most suitable nursing diagnoses.

O presente trabalho objetivou avaliar a incidência da sífilis congênita no Ceará de 2000 a 2009; descrever o perfil epidemiológico das gestantes cujos recém-nascidos tiveram sífilis congênita e verificar a realização do pré-natal e do tratamento dos seus parceiros. Trata-se de estudo documental, realizado em julho de 2010 a partir do banco de dados disponível no Núcleo de Informação e Análise em Saúde, que contém as informações das fichas do Sistema Nacional de Agravos de Notificação. Foram notificados 2.930 casos de sífilis congênita, demonstrando uma série histórica ascendente ano a ano. A maioria das gestantes realizou pré-natal (2.077; 70,9%), possuía de 20 a 34 (1.836; 62,7%) anos, nenhuma ou pouca escolaridade (1.623; 55,4%), O tratamento inadequado das gestantes e a falta de tratamento dos parceiros mostraram-se como realidade no SUS-CE. A incidência de sífilis congênita é um indicador da qualidade da assistência pré-natal. Logo, seu aumento nos últimos dez anos ressalta a necessidade de ações voltadas para seu controle.

ObjectiveTo describe the clinical and laboratory features of children and adolescents with acute lymphoblastic leukemia treated at three referral centers in Ceará and evaluate prognostic factors for survival, including age, gender, presenting white blood cell count, immunophenotype, DNA index and early response to treatment.MethodsSeventy-six under 19-year-old patients with newly diagnosed acute lymphoblastic leukemia treated with the Grupo Brasileiro de Tratamento de Leucemia da Infância – acute lymphoblastic leukemia-93 and -99 protocols between September 2007 and December 2009 were analyzed. The diagnosis was based on cytological, immunophenotypic and cytogenetic criteria. Associations between variables, prognostic factors and response to treatment were analyzed using the chi-square test and Fisher's exact test. Overall and event-free survival were estimated by Kaplan–Meier analysis and compared using the log-rank test. A Cox proportional hazards model was used to identify independent prognostic factors.ResultsThe average age at diagnosis was 6.3 ± 0.5 years and males were predominant (65%). The most frequently observed clinical features were hepatomegaly, splenomegaly and lymphadenopathy. Central nervous system involvement and mediastinal enlargement occurred in 6.6% and 11.8%, respectively. B-acute lymphoblastic leukemia was more common (89.5%) than T-acute lymphoblastic leukemia. A DNA index >1.16 was found in 19% of patients and was associated with favorable prognosis. On Day 8 of induction therapy, 95% of the patients had lymphoblast counts <1000/μL and white blood cell counts <5.0 × 109/L. The remission induction rate was 95%, the induction mortality rate was 2.6% and overall survival was 72%.ConclusionThe prognostic factors identified are compatible with the literature. The 5-year overall and event-free survival rates were lower than those reported for developed countries. As shown by the multivariate analysis, age and baseline white blood cell count were independent prognostic factors.