Doar ou não doar: significados da negação familiar para a doação de órgãos e tecidos / To donate or not to donate: meanings of family refusal to the refusal to donate organs and tissues

Objetivo: Compreender os significados atribuídos por familiares sobre a negação para a doação de órgãos e tecidos. Métodos: Estudo descritivo, exploratório, com abordagem qualitativa. Utilizou-se um questionário semiestruturado para a coleta de dados e a análise temática de conteúdo para o tratamento dos dados obtidos. A amostragem de 10participantes foi definida pelo critério de saturação teórica. Resultados: Percebeu-se a tendência de os familiares consentirem a doação quando bem orientados sobre a morte encefálica e de a finalidade humanística do doador, mas os principais obstáculos para a negação da doação são a falta de conhecimento sobre a doação de órgãos, o medo da mutilação do corpo por não saber como é realizado o procedimento de retirada de órgãos e tecidos, a burocracia com a demora na liberação do corpo para sepultamento e a discordância entre os familiares. Conclusão: Os significados da negação familiar permeiam o medo, o sentimento de vazio, a falta de informação sobre os processos que envolvem a doação e captação de órgãos e tecidos, bem como aspectos culturais e religiosos, embora o desespero, a dor e a falta de empatia das equipes de saúde também possam corroborar a recusa. Descritores: Obtenção de Tecidos e Órgãos; Transplante; Relações Familiares

Objective: To understand the meanings attributed by family members about the refusal to donate organs and tissues.Methods: Adescriptive and exploratory study with a qualitative approach. A semi-structured questionnaire was used for data collection and thematic content analysis was employed for the treatment of the data obtained. The sample comprised by 10participants was defined by means of the theoretical saturation criterion. Results: There was a tendency for family members to consent to thedonation when well-oriented about brain death and the humanistic purpose of the donor, but the main obstacles to refuse donation are as follows: lack of knowledge about organ donation, fear of body mutilation for not knowing how the procedure for removingorgans and tissues is performed, bureaucracy with the delay in releasing the body for burial and disagreement between family members.Conclusion:The meanings of family refusal permeate fear, a feeling of emptiness and lack of information about the processes involved in organ and tissue donation, as well as cultural and religious aspects, although despair, pain and lack of empathy of the health teams can also corroborate refusal.Descriptors:Tissue and Organ Procurement; Transplant; Family relationships.

Validation methods of nursing protocols: an integrative review / Métodos de validación de los protocolos de atención de enfermería: revisión integrativa / Métodos de validação de protocolos assistenciais de enfermagem: revisão integrativa

ABSTRACT Objective: to identify scientific production about validation methods of nursing care protocols. Method: an integrative review with search at Scielo, Pubmed/MEDLINE, Virtual Health Library, Web of Science, Scopus, and EBSCOhost. The descriptors "validation studies", "validation studies as topic", "protocols", "clinical protocols", "practice guidelines as topic", "nursing" and "nursing assessment" and the uncontrolled descriptor "validation" were used. Results: thirty-two articles were selected, most of them Brazilian. Content validation by experts was the most frequent method, with no consensus on the number of participants for the process. The collection instruments were mostly created by the authors. Data analysis was performed using descriptive statistics and Content Validity Index, with a variable consensus rate in the analyzed articles. Conclusion: protocols validated by experts are robust tools for use in clinical practice, with methodological rigor in development essential for its quality.

RESUMEN Objetivo: identificar la producción científica sobre los métodos de validación de los protocolos de atención de enfermería. Método: revisión integradora, búsqueda en las bases de datos Scielo, PubMed/MEDLINE, Biblioteca Virtual en Salud, Web of Science, Scopus y EBSCOhost, utilizando los descriptores validation studies, validation studies as topic, protocols, clinical protocols, practice guidelines as topic, nursing e nursing assessment y el descriptor no controlado validation. Resultados: se seleccionaron 32 artículos, la mayoría de ellos brasileños. La validación del contenido por expertos fue el método más frecuente, sin consenso sobre el número de participantes para el proceso. Los instrumentos de colección fueron elaborados principalmente por los autores. El análisis de datos se realizó utilizando estadísticas descriptivas e índice de validez de contenido, con una tasa de acuerdo variable en los artículos analizados. Conclusión: los protocolos validados por especialistas son herramientas robustas para su uso en la práctica clínica, y el rigor metodológico en el desarrollo es esencial para su calidad.

RESUMO Objetivo: identificar a produção científica acerca dos métodos de validação de protocolos assistenciais de enfermagem. Método: revisão integrativa, com busca nas bases de dados Scielo, PubMed/MEDLINE, Biblioteca Virtual em Saúde, Web of Science, Scopus e EBSCOhost, utilizando os descritores validation studies, validation studies as topic, protocols, clinical protocols, practice guidelines as topic, nursing e nursing assessment e o descritor não controlado validation. Resultados: foram selecionados 32 artigos, sendo a maioria brasileiros. A validação de conteúdo por especialistas foi o método mais frequente, sem consenso sobre o número de participantes para o processo. Os instrumentos de coleta foram majoritariamente elaborados pelos autores. A análise dos dados foi realizada por estatística descritiva e Índice de Validade de Conteúdo, com taxa de concordância variável nos artigos analisados. Conclusão: protocolos validados por especialistas constituem ferramentas robustas para o uso na prática clínica, sendo o rigor metodológico no desenvolvimento imprescindível para a qualidade do mesmo.

Fatty Acid Biosynthesis from Chlorella in Autotrophic and Mixotrophic Cultivation

Abstract Microalgae are photosynthetic microorganisms whose composition and biomass production can be influenced by manipulating the cultivation conditions employed. However, few studies have evaluated the effects of various cultivation conditions in autotrophic and mixotrophic conditions. The present work aimed to evaluate the effects of cultivation conditions on the cell growth and biosynthesis of fatty acids (FAs) by microalgae of the genus Chlorella in autotrophic and mixotrophic cultivation. Evaluation of the effects of the conditions was performed using an experimental design methodology. The highest values of maximum biomass concentration (Xmax) and maximum biomass productivity (Pmax) were obtained in autotrophic cultures. Palmitic acid was the FA obtained at the highest concentration in both cultivation modes. The concentrations of polyunsaturated FAs (PUFAs) ranged from 12.2 to 41.2% in autotrophic cultures and from 11 to 34.3% in the mixotrophic cultures. The variables photoperiod and sodium bicarbonate concentration showed the greatest influence on the Xmax, Pmax, and PUFA concentration in autotrophic and mixotrophic cultivations, respectively. This study verified that the selection of conditions and mode of cultivation contribute to the production of microalgal biomass and FA biosynthesis.

Carbon Dioxide Biofixation and Production of Spirulina sp. LEB 18 Biomass with Different Concentrations of NaNO3 and NaCl

ABSTRACT Microalgae are efficient at using solar energy to turn CO2 and nutrients into biomass containing lipids, proteins, carbohydrates and other compounds that may be used to produce bioproducts for human and animal consumption and pharmaceutical use. The aim of this study was to assess the effect of the NaNO3 and NaCl concentration on the growth kinetics, the biomass composition and the ability to biofix CO2 using the microalga Spirulina sp. LEB 18. The assays were carried out according to a 22 central composite design (CCD) with different concentrations of NaNO3 (1.25, 1.88 and 2.50 g L-1) and NaCl (1.00, 15.0 and 30.0 g L-1). The assays were carried out in 2 L vertical tubular photobioreactors at 30°C, 12 h light/dark and an injection of 12.0% v/v of CO2 at 0.3 vvm. The best growing results (Xmax = 1.60 g L-1, Pmax = 0.109 g L-1 d-1, μmax = 0.208 d-1) and CO2 biofixation rate (197.4 mg L-1 d-1) were observed in the assay with 1.25 g L-1 NaNO3 and 1.00 g L-1 NaCl. Increasing the NaCl concentration produced biomass with a higher carbohydrate content, while increasing the NaNO3 concentration reduced the protein concentration. According to the results, in addition to using Spirulina as a source of protein, it can also be used as a source of carbohydrates and to biologically remove CO2 from the atmosphere.

Prevalência e fatores associados à anemia em gestantes de alto risco de Maceió, Alagoas / Prevalence and factors associated with anemia in high-risk pregnant women in Maceió, Alagoas

Introdução: Alguns agravos ou doenças na gravidez apresentam relação com o aumento da incidência de anemia. Além disso, a anemia pode agravar os sintomas de certas doenças durante esse período. Portanto, a atenção a esse grupo de gestantes quanto a esse aspecto deveria ser redobrada. Objetivo: O objetivo do estudo foi avaliar a prevalência e os fatores associados à anemia em gestantes de alto risco. Método: Estudo transversal envolvendo amostra (n=129) obtida, considerando a prevalência de anemia em gestantes (50%), intervalo de confiança (IC) de 90%, erro de 8%, sendo elegíveis gestantes de alto risco internadas no hospital universitário do município no ano de 2013, por meio de coleta de dados socioeconômicos, de pré-natal, clínicos, antropométricos e medida de hemoglobina. A anemia foi identificada por um nível de hemoglobina < 11 g/dL e sua associação com os fatores de risco foi testada por meio de análise de regressão múltipla de Poisson, com os resultados expressos pela Razão de Prevalência e IC95%. Resultado: A prevalência de anemia foi de 49,6%, com associação dessa variável com: estado nutricional de baixo peso (RP=1,77; IC=1,21; 2,60; p=0,003) e ganho ponderal gestacional insuficiente (RP=0,55; IC=0,38; 0,81; p=0,002). Conclusões: A anemia em gestantes de alto risco de Maceió é um problema de magnitude elevada; no entanto, não ultrapassou os valores esperados para gestantes saudáveis. Somado a isso, essa condição se associou a um estado nutricional comprometido, o que pode elevar ainda mais as taxas de morbimortalidade materna e fetal nesse grupo.(AU)

Introduction: Some injuries or illnesses during pregnancy have relationship with the increased incidence of anemia. Further, anemia can aggravate the symptoms of some diseases during this period. Therefore, attention to this group of pregnant women in this regard should be redoubled. Objective: The objective of the study was to evaluate the prevalence and associated factors with anemia in high-risk pregnant women. Methods: Cross-sectional study conducted on a sample (n=129) obtained on the basis of the estimated prevalence of anemia during pregnancy (50%), a 90% confidence interval (CI), an error of 8%, being eligible high-risk pregnant women admitted to university hospital in the city in 2013, of which were collected socioeconomic, prenatal care and clinical data, anthropometric measure and hemoglobin held. Anemia was identified by a hemo- globin level <11 g / dL and its association with risk factors was tested using multivariate Poisson regression analysis, with the results expressed by the prevalence ratio (PR) and 95% CI. Results: The prevalence of anemia was 49.6%, with association of this variable with: nutritional status of low birth weight (PR=1.77, CI=1.21, 2.60; p=0.003) and insufficient gestational weight gain (PR=0.55, CI=0.38, 0.81; p=0.002). Conclusions: Anemia in high-risk pregnant women from the Maceió is a high magnitude problem; however, did not exceed the expected values for healthy pregnant women. Added to this, this condition was associated with a compromised nutritional status, which can further increase the maternal and fetal morbidity and mortality rates in this group.(AU)