The Essentials of Multiomics.

Within the last decade, the science of molecular testing has evolved from single gene and single protein analysis to broad molecular profiling as a standard of care, quickly transitioning from research to practice. Terms such as genomics, transcriptomics, proteomics, circulating omics, and artificial intelligence are now commonplace, and this rapid evolution has left us with a significant knowledge gap within the medical community. In this paper, we attempt to bridge that gap and prepare the physician in oncology for multiomics, a group of technologies that have gone from looming on the horizon to become a clinical reality. The era of multiomics is here, and we must prepare ourselves for this exciting new age of cancer medicine.

Familiares vivenciando cuidados paliativos de crianças com câncer hospitalizadas: uma revisão integrativa / Families experiencing palliative care for hospitalized children with cancer: an integrative review / Familiares vivenciando cuidados paliativos de niños hospitalizados con cáncer: una revisión integradora

Objetivo: analisar a produção do conhecimento sobre a experiência da família acerca dos cuidados paliativos da criança com câncer hospitalizada na unidade de terapia intensiva e discutir o papel da enfermagem no atendimento à família da criança com câncer frente aos cuidados paliativos. Método: revisão integrativa realizada na PUBMED, LILACS, SCOPUS, SCIELO e CINAHL entre janeiro e março de 2020. Resultados: a amostra foi composta por 13 artigos, originando duas categorias: O impacto do cuidado paliativo da criança com câncer na dinâmica familiar e o cuidado multiprofissional, em especial dos enfermeiros, à família da criança com câncer. Conclusão: os estudos revelaram o panorama nacional e internacional dos cuidados paliativos à criança com câncer e a desestruturação da dinâmica familiar nos aspectos físicos, sociais, psicológicos, e financeiros, caracterizando o período como estressante e doloroso. Os enfermeiros estabelecem condutas terapêuticas objetivando promover qualidade de vida para crianças em cuidados paliativos e seus familiares.

Objective: to examine production of knowledge on families' experience of palliative care for children with cancer hospitalized in an intensive care center and discuss the role of nursing in assisting the family of the child in palliative cancer care. Method: this integrative review was conducted on PubMed, LILACS, Scopus, SciELO and CINAHL between January and March 2020. Results: from the sample of 13 articles, two categories originated: The impact of palliative cancer care for children on family dynamics and multiprofessional care, especially by nurses, for the family of the child with cancer. Conclusion: the studies revealed the national and international panorama of palliative care for children with cancer and the breakdown of physical, social, psychological, and financial family dynamics, characterizing the period as stressful and painful. Nurses establish therapeutic approaches aimed at promoting quality of life for children in palliative care and their families.

Objetivo: analizar la producción de conocimiento sobre la experiencia familiar en los cuidados paliativos de niños con cáncer, hospitalizados en la unidad de cuidados intensivos, y discutir el papel de la enfermería en la asistencia a la familia del niño con cáncer frente a los cuidados paliativos. Método: Revisión integradora realizada en PUBMED, LILACS, SCOPUS, SCIELO y CINAHL entre enero y marzo de 2020. Resultados: La muestra estuvo conformada por 13 artículos, originando dos categorías: El impacto de los cuidados paliativos para niños con cáncer en la dinámica familiar y los cuidados multiprofesionales, especialmente de las enfermeras, a la familia del niño con cáncer. Conclusión: Los estudios revelaron el panorama nacional e internacional de los cuidados paliativos para niños con cáncer y la ruptura de la dinámica familiar en aspectos físicos, sociales, psicológicos y económicos, caracterizándolo como un período estresante y doloroso. Las enfermeras establecen enfoques terapéuticos dirigidos a promover la calidad de vida de los niños en cuidados paliativos y sus familias.

Spotlight on International Quality: COVID-19 and Its Impact on Quality Improvement in Cancer Care.

This report from ASCO's International Quality Steering Group summarizes early learnings on how the COVID-19 pandemic and its stresses have disproportionately affected cancer care delivery and its delivery systems across the world. This article shares perspectives from eight different countries, including Austria, Brazil, Ghana, Honduras, Ireland, the Philippines, South Africa, and the United Arab Emirates, which provide insight to their unique issues, challenges, and barriers to quality improvement in cancer care during the pandemic. These perspectives shed light on some key recommendations applicable on a global scale and focus on access to care, importance of expanding and developing new treatments for both COVID-19 and cancer, access to telemedicine, collecting and using COVID-19 and cancer registry data, establishing measures and guidelines to further enhance quality of care, and expanding communication among governments, health care systems, and health care providers. The impact of the COVID-19 pandemic on cancer care and quality improvement has been and will continue to be felt across the globe, but this report aims to share these experiences and learnings and to assist ASCO's international members and our global fight against the pandemic and cancer.

Current Applications of Recycled Aggregates from Construction and Demolition: A Review.

A literature review comprising 163 publications published over a period of 26 years from 1992 to 2018 is presented in this paper. This review discusses the generation and recycling of construction and demolition waste (CDW) as well as its main uses as raw materials for the construction engineering sector. This review pays attention to the use of CDW aggregates for sand, pavements/roads, bricks, ceramics, cementitious materials, and concrete productions, as well its uses as eco-friendly materials for water decontamination. The physical-chemical and mechanical characteristics of recycled aggregates play an important role in their correctly chosen applications. The results found in this literature survey allow us to conclude that recycled aggregates from CDW can be successfully used to produce construction materials with quality comparable to those produced with natural aggregates. We concluded that the use of CDWs as raw materials for manufacturing new construction materials is technically feasible, economical, and constitutes an environmentally friendly approach for a future construction and demolition waste management strategy.

Facile fabrication of hybrid titanium(IV) isopropoxide/pozzolan nanosheets (TnS-Pz) of high photocatalytic activity: characterization and application for Cr(VI) reduction in an aqueous solution.

This paper presents the synthesis of a hybrid material through the use of natural pozzolan and titanium(IV) isopropoxide using the sol-gel method and its application in the photocatalytic hexavalent chromium reduction. The characterization data indicated a mesoporous material possessing a surface area of 271.7 m2 g-1. The morphology studies (SEM and TEM) showed nanosheet hybrid structures. The analysis of DRUV, FTIR, XRD, and Mössbauer spectroscopy provides a different electronic structure of the synthetized material when compared with the originals, proving the hybridization process between pozzolan and titanium(IV) isopropoxide. The photocatalytic reduction of Cr(VI) to Cr(III) using the hybrid material showed a better performance than conventional photocatalysts (precursor and TiO2-P25). Operational conditions such as chromium initial concentration (0.02-0.20 mM), solution pH (3-6), and type of scavenger (citric or tartaric acid) were evaluated in order to determine the best experimental conditions for the Cr(VI) photoreduction. At their optimum (catalyst load of 15 mg L-1, tartaric acid as scavenger, [scavenger]0/[Cr(VI)]0 M ratio = 3:1, pH 3, and 25 °C), the total photoreduction of 0.20 mM Cr(VI) was achieved in 180 min. The novel hybrid materials synthesized from pozzolan and titanium(IV) isopropoxide showed to be a potential catalyst for the Cr(VI) reduction in aqueous solution. Graphical abstract.

Carga horária de enfermagem aplicada ao paciente com infarto agudo do miocárdio / Nursing hour load applied to the patient with acute myocardial infarction / Carga horaria de enfermería aplicada al paciente con infarto agudo de miocardio

Objetivo: identificar a Carga Horaria de enfermagem aplicada ao Infarto agudo do Miocárdio, de acordo com a classificação de Killip. Método: pesquisa de campo com abordagem quantitativa, descritiva, exploratória, retrospectiva. Foram utilizados prontuários de pacientes que obtiveram como diagnostico inicial o Infarto Agudo do Miocárdio, e que apresentaram alterações nos marcadores bioquímicos Resultados: foram avaliados 200 prontuários. A partir dos dados obtidos conseguimos traçar uma progressão de carga horaria entre as categorias Killip, sobre as necessidades de assistência prestada. Conclusão: a carga horaria de enfermagem varia de acordo com a complexidade que o Infarto do Miocárdio pode manifestar. O paciente necessita de maior número de pessoal de enfermagem devido alta carga horaria para atender todas as intervenções necessárias

Objective: to identify the nursing time load applied to acute myocardial infarction, according to the Killip classification. field research with quantitative, descriptive, exploratory, retrospective approach. The medical records of patients Methods: who obtained an initial diagnosis of acute myocardial infarction and who presented alterations in the biochemical markers were used. Results: 200 medical records were evaluated. From the data obtained we were able to trace a progression of time load between the Killip categories, on the assistance needs provided. Conclusion: the nursing time load varies according to the complexity that the Myocardial Infarction can manifest. The patient needs a larger number of nursing personnel due to high workload to attend all necessary interventions

Objetivo: identificar la carga horaria de enfermería aplicada al infarto agudo de miocardio, de acuerdo con la clasificación de Killip. Métodos: investigación de campo con abordaje cuantitativo, descriptivo, exploratorio, retrospectivo. Se utilizaron prontuarios de pacientes que obtuvieron como diagnóstico inicial el Infarto Agudo del Miocardio, y que presentaron alteraciones en los marcadores bioquímicos. Resultados: se evaluaron 200 prontuarios. A partir de los datos obtenidos conseguimos trazar una progresión de carga horaria entre las categorías Killip, sobre las necesidades de asistencia prestada. Conclusión: la carga horaria de enfermería varía de acuerdo con la complejidad que el Infarto del Miocardio puede manifestar. El paciente necesita un mayor número de personal de enfermería debido a una alta carga horaria para atender todas las intervenciones necesarias

Atmospheric nanocompounds on Lanzarote Island: Vehicular exhaust and igneous geologic formation interactions.

Atmosphere contamination management is one of the most important features in pollution risk management. The worldwide rise in tourism increases apprehension about its probable destructive conservation influence on various aspects of global conservation. One of the principal dangers increased by tourism-based modes of travel are nanoparticles (NPs) containing potentially hazardous elements (PHEs) contamination. One example of this is island destination of Lanzarote, in Spain's Canary Islands in which we examined contamination of the local atmosphere, water and soil. Important NPs containing PHEs, (e.g. arsenic, chromium, lead, and mercury), were found in this locale. It is reasonable to assume that this pollution poses an increased environmental danger to the local biome(s). Modes of transport (i.e. by car, airplane, bus) were shown to be an important contributor to this localized contamination as demonstrated by particulate matter (PM) readings collected near the island's airport. If no measures are taken to reduce vehicle and aircraft traffic, the tendency is to increase environmental degradation will continue unabated. As this particular area of Lanzarote is also one of wine production, increased pollution has the potential for negative impacts on the region's economy.

Can Creatine Supplementation Interfere with Muscle Strength and Fatigue in Brazilian National Level Paralympic Powerlifting?

The aim of the present study was to analyze the effect of creatine (Cr) supplementation on peak torque (PT) and fatigue rate in Paralympic weightlifting athletes. Eight Paralympic powerlifting athletes participated in the study, with 25.40 ± 3.30 years and 70.30 ± 12.15 kg. The measurements of muscle strength, fatigue index (FI), peak torque (PT), force (kgf), force (N), rate of force development (RFD), and time to maximum isometric force (time) were determined by a Musclelab load cell. The study was performed in a single-blind manner, with subjects conducting the experiments first with placebo supplementation and then, following a 7-day washout period, beginning the same protocol with creatine supplementation for 7 days. This sequence was chosen because of the lengthy washout of creatine. Regarding the comparison between conditions, Cr supplementation did not show effects on the variables of muscle force, peak torque, RFD, and time to maximum isometric force (p > 0.05). However, when comparing the results of the moments with the use of Cr and placebo, a difference was observed for the FI after seven days (U3: 1.12; 95% CI: (0.03, 2.27); p = 0.02); therefore, the FI was higher for placebo. Creatine supplementation has a positive effect on the performance of Paralympic powerlifting athletes, reducing fatigue index, and keeping the force levels as well as PT.

Lecithin:cholesterol acyltransferase: symposium on 50 years of biomedical research from its discovery to latest findings.

LCAT converts free cholesterol to cholesteryl esters in the process of reverse cholesterol transport. Familial LCAT deficiency (FLD) is a genetic disease that was first described by Kaare R. Norum and Egil Gjone in 1967. This report is a summary from a 2017 symposium where Dr. Norum recounted the history of FLD and leading experts on LCAT shared their results. The Tesmer laboratory shared structural findings on LCAT and the close homolog, lysosomal phospholipase A2. Results from studies of FLD patients in Finland, Brazil, Norway, and Italy were presented, as well as the status of a patient registry. Drs. Kuivenhoven and Calabresi presented data from carriers of genetic mutations suggesting that FLD does not necessarily accelerate atherosclerosis. Dr. Ng shared that LCAT-null mice were protected from diet-induced obesity, insulin resistance, and nonalcoholic fatty liver disease. Dr. Zhou presented multiple innovations for increasing LCAT activity for therapeutic purposes, whereas Dr. Remaley showed results from treatment of an FLD patient with recombinant human LCAT (rhLCAT). Dr. Karathanasis showed that rhLCAT infusion in mice stimulates cholesterol efflux and suggested that it could also enhance cholesterol efflux from macrophages. While the role of LCAT in atherosclerosis remains elusive, the consensus is that a continued study of both the enzyme and disease will lead toward better treatments for patients with heart disease and FLD.

Optimization and dust emissions analysis of the air jigging technology applied to the recycling of construction and demolition waste.

This work aims to evaluate the use of the air jigging technique, a density-based separation technology commonly applied in mineral processing, to upgrade the quality of mixtures (density and geometric properties) that represents the typical composition of construction and demolition waste (CDW) produced in Brazil. In this sense, tests involving the variation of the main operational parameters of jigging (bed expansion rate, pulsation frequency and jigging time) were carried out aiming to find those which provided the best recycled aggregates quality after processing. Also, fines and dust emissions generation during jigging were measured in order to estimate their potential impacts on human health and environment. The results showed that the air jigging process is adequate to improve the quality of CDW by increasing the concrete concentration in the dense product. The use of high bed expansion rates showed to be of major importance to decrease the content of ceramic aggregates in the dense product, allowing obtaining products richer in concrete. Also, the measured properties of the obtained aggregates (size distribution, shape, etc) met the usual standards required for natural aggregates. Finally, material losses and dust emissions generated were negligible in comparison to the total mass processed, although special attention must be given to safety measures due the presence of inhalable particles (<10 µm).

Demolished concretes recycling by the use of pneumatic jigs.

Large quantities of construction and demolition waste is generated annually around the world. Part of this material is processed in recycling plants. After removing metals, fines and lights, the construction and demolition waste is crushed and sized and can be used as aggregates for low resistance concrete, for road sub-base, city landfill and other low value-added applications. For their use as coarse aggregate in structural concretes, construction and demolition waste must exhibit high densities and regularity of the material. This material usually is presented in demolished concretes. About 20% of the particles from demolished concretes can be used as coarse aggregates substituting part of natural aggregates in structural concretes. This article presents studies of demolished concretes recycling by the use of a pneumatic jig. All jigging tests were carried out with three different concretes produced in three strength classes: C16/20, ordinary concrete; C50/60, high strength concrete; and C70/85, very high strength concrete. Based on density distribution of the three concretes, there are reasonable masses with densities over 2.7 g cm-3, particle density considered appropriate to the used as coarse aggregate for structural concretes. The concretes present different mass recoveries of the denser particles (different liberation). Coarse aggregates can be recovered with reasonable masses by the use of air jigs: About 65% for high strength concretes and about 75% for the low strength concrete. The jigging concentration efficiency depends on the concrete liberation, density and size distribution.

A three-dimensional nanoscale study in selected coal mine drainage.

Sediments from coal mine drainages (CMDs) contain large quantities of suspended pollutants (possibly numerous chemical substances) along with sulfates and hazardous elements (e.g., chromium, zinc, copper, lead) that irreversibly accumulate in the water. As this accumulation can continue for decades after discontinuation of coal extraction, it is necessary to employ multidisciplinary approaches to control the threat in such zones. The quantity of amorphous material in some CMDs was evaluated by X-ray powder diffraction (XRD) using the Rietveld-based SIROQUANT software package. Modern Dual Beam Focused Ion Beam (FIB), field emission scanning electron microscopy (FE-SEM), high-resolution transmission electron microscope (H-TEM), and energy-dispersive X-ray spectrometer (EDS) were used to evaluate the occurrence and transformation of nanophases (NPs). FIB is used to determine the 3D distribution of different species (internal structure) within individual NPs, whereas EDS is used to observe NP features (e.g., shape, constituent, range, assembly, and form of polymerization). The mineralogy of the sediment from the Brazilian CMDs, including the proportions of quartz, clays, Al-Fe-oxides, and amorphous NPs, appears to be related to the nature of the mineral matter in the relevant coal cleaning rejects (CCRs). The sediments of CMDs from the Brazilian coal area derived at a lower-pH range have different amorphous compositions as compared to those derived at a higher pH range. These special amorphous compositions are shown to be related to several other sediment properties such as particle surface area. The information gleaned in this study will be useful for further geochemical evaluation of CMDs in other parts of the world.

Phase III Trial of Adjuvant Capecitabine After Standard Neo-/Adjuvant Chemotherapy in Patients With Early Triple-Negative Breast Cancer (GEICAM/2003-11_CIBOMA/2004-01).

PURPOSE: Operable triple-negative breast cancers (TNBCs) have a higher risk of relapse than non-TNBCs with standard therapy. The GEICAM/2003-11_CIBOMA/2004-01 trial explored extended adjuvant capecitabine after completion of standard chemotherapy in patients with early TNBC. PATIENTS AND METHODS: Eligible patients were those with operable, node-positive-or node negative with tumor 1 cm or greater-TNBC, with prior anthracycline- and/or taxane-containing chemotherapy. After central confirmation of TNBC status by immunohistochemistry, patients were randomly assigned to either capecitabine or observation. Stratification factors included institution, prior taxane-based therapy, involved axillary lymph nodes, and centrally determined phenotype (basal v nonbasal, according to cytokeratins 5/6 and/or epidermal growth factor receptor positivity by immunohistochemistry). The primary objective was to compare disease-free survival (DFS) between both arms. RESULTS: Eight hundred seventy-six patients were randomly assigned to capecitabine (n = 448) or observation (n = 428). Median age was 49 years, 55.9% were lymph node negative, 73.9% had a basal phenotype, and 67.5% received previous anthracyclines plus taxanes. Median length of follow-up was 7.3 years. DFS was not significantly prolonged with capecitabine versus observation [hazard ratio (HR), 0.82; 95% CI, 0.63 to 1.06; P = .136]. In a preplanned subgroup analysis, nonbasal patients seemed to derive benefit from the addition of capecitabine with a DFS HR of 0.53 versus 0.94 in those with basal phenotype (interaction test P = .0694) and an HR for overall survival of 0.42 versus 1.23 in basal phenotype (interaction test P = .0052). Tolerance of capecitabine was as expected, with 75.2% of patients completing the planned 8 cycles. CONCLUSION: This study failed to show a statistically significant increase in DFS by adding extended capecitabine to standard chemotherapy in patients with early TNBC. In a preplanned subset analysis, patients with nonbasal phenotype seemed to obtain benefit with capecitabine, although this will require additional validation.

Influência da ansiedade em adolescentes durante a internação cirúrgica: aprimorando assistência de enfermagem / Influence of anxiety in adolescents during surgical hospitalization: improving nursing care / Influência da ansiedade em adolInfluencia de la ansiedad en adolescentes durante la hospitalización quirúrgica: mejora de la atención de enfermeira

O estudo teve como objetivo identificar de acordo com a literatura os fatores que influenciam na ansiedade do adolescente no período de internação cirúrgica e determinar a influência da ansiedade durante esse período para direcionar a assistência de enfermagem. Para realização do estudo utilizou-se revisão sistemática da literatura. De acordo com os resultados encontrados foi possível identificar a importância da equipe de enfermagem para detectar os fatores de risco e períodos de instabilidade emocional, para garantir a melhoria da qualidade de vida, conforto e maior interação, dessa forma, minimizar a ansiedade durante a internação no período transoperatório.(AU)

The study aimed to identify according to the literature the factors that influence adolescent anxiety during the period of surgical hospitalization and determine the influence of anxiety during this period to direct nursing care. Systemic review of the literature was used to perform the study and according to the results, it was possible to identify the importance of the role of the nursing team to detect risk factors and periods of emotional instability, to ensure the improvement of quality of life, comfort and greater interaction and thus minimize anxiety and patient's fear during hospitalization in the surgery period.(AU)

El estúdio tuvo como objetivo identificar, según la literatura, los factores que influyen em la ansiedade de los adolescentes durante el período de hospitalización quirúrgica y determinar la influencia de la ansiedad durante este período para guiar la atención de enfermería. Para llevar a cabo el estúdio, se utilizo uma revisión sistemática de la literatura y de acuerdo com los resultados encontrados, fue posible identificar la importância de papel Del equipo de enfermería para detectar factores de riesgo y períodos de inestabilidad emocional, para garantizar la mejora de calidad de vida, la comodidad y mayor interacción y, por lo tanto, minimizar la ansiedade y el miedo del paciente durante la hospitalización em el período transoperatório.(AU)

"A montanha-russa da insuficiência cardíaca": a percepção de dignidade pelas equipes de enfermagem / "La montaña rusa de la insuficiencia cardíaca": la percepción de dignidad por parte de los equipos de enfermería / "The roller coaster ride of heart failure": nursing staff's perceptions of dignity

Resumo Objetivo Os principais objetivos deste estudo são: a) descobrir quais são as percepções dos profissionais de enfermagem quanto à dignidade baseado em suas experiências; e b) identificar as questões éticas enfrentadas por enfermeiros ao lidar com pacientes com insuficiência cardíaca avançada. Métodos Estudo qualitativo com abordagem indutiva por meio de entrevistas em grupo focal (GF) composto por enfermeiros que prestam assistência diária a pacientes com insuficiência cardíaca e seus familiares. O estudo incluiu 18 enfermeiros portugueses provenientes de dois hospitais e dois centros de atenção primária à saúde. Os participantes foram distribuídos em quatro grupos focais. Realizou-se as entrevistas durante período de aproximadamente quatro meses. Os dados foram analisados por meio de análise de conteúdo qualitativa. Resultados Ao enfatizar a importância da dignidade, os participantes a definiram como "ser visto como uma pessoa" e "ser respeitado pela pessoa que é". A "viagem de montanha-russa da insuficiência cardíaca" é como uma jornada que ajuda a manter a dignidade do paciente dentro das restrições impostas pela doença. A abordagem das necessidades físicas, emocionais e espirituais dos pacientes propicia dignidade enquanto negligenciá-las os ameaçam. Três temas principais expressaram a variedade dos problemas éticos enfrentados pelos profissionais de enfermagem que cuidam de pacientes com insuficiência cardíaca avançada: 1) qualidade de vida versus tempo restante; 2) intervenções curativas versus paliativas; 3) morte rápida e imprevisível versus morte lenta e esperada. Conclusão O respeito e a proteção da dignidade são partes essenciais de uma assistência de enfermagem adequada, ética e competente.

Resumen Objetivo Los principales objetivos de este estudio son: a) descubrir cuáles son las percepciones de los profesionales de enfermería respecto a la dignidad con base en sus experiencias, y b) identificar las cuestiones éticas enfrentadas por enfermeros al lidiar con pacientes con insuficiencia cardíaca avanzada. Métodos Estudio cualitativo con enfoque inductivo por medio de entrevistas en grupo focal (GF) compuesto por enfermeros que prestan asistencia diaria a pacientes con insuficiencia cardíaca y sus familiares. El estudio incluyó 18 enfermeros portugueses provenientes de dos hospitales y dos centros de atención primaria de salud. Los participantes fueron distribuidos en cuatro grupos focales. Las entrevistas se realizaron durante un período de cuatro meses aproximadamente. Los datos fueron analizados por medio del análisis de contenido cualitativo. Resultados Al enfatizar la importancia de la dignidad, los participantes la definieron como "ser visto como una persona" y "ser respetado por la persona que es". El "viaje de la montaña rusa de la insuficiencia cardíaca" es como una jornada que ayuda a mantener la dignidad del paciente dentro de las restricciones impuestas por la enfermedad. El enfoque de las necesidades físicas, emocionales y espirituales de los pacientes proporciona dignidad, mientras que desatenderlas los amenaza. Tres temas principales demostraron la variedad de los problemas éticos enfrentados por los profesionales de enfermería que cuidan pacientes con insuficiencia cardíaca avanzada: 1) calidad de vida vs. tiempo restante; 2) intervenciones curativas vs. paliativas; 3) muerte rápida e imprevisible vs. muerte lenta y esperada. Conclusión El respeto y la protección de la dignidad son partes esenciales de una atención de enfermería adecuada, ética y competente.

Abstract Objective The main aims of this study are to a) uncover the nurse´s perceptions of dignity based on their experiences; and b) identify ethical issues experienced by nurses when confronted with individuals with advanced heart failure. Methods This study has a qualitative design with an inductive approach using focus group (FG) interviews with registered nurses who meet patients with HF and their family caregivers on a daily basis. A total of 18 Portuguese registered nurses, from two hospitals and two primary health care centers, were distributed across 4 FG. Interviews occurred over a period of about 4 months. Data were analyzed using qualitative content analysis; Results The participants emphasized the importance of dignity as 'being seen as a person' and 'respected for the person one is'. The ´roller coaster ride of heart failure` is like a pilgrimage that serves to maintain the patient's dignity within the strictures of the sick person's role. Addressing the physical, emotional and spiritual needs of patients promotes their dignity, while neglecting their needs threatens their dignity. Three main themes captured the range of ethical problems when nurses care for people with advanced heart failure: 1) Quality of life versus length of time left; 2) Curative versus palliative interventions; 3) Unpredictable and quick death versus expected and prolonged death. Conclusion Respecting and protecting dignity is an essential piece of good, ethical, and competent nursing care.

O enfermeiro e a questão da adesão do paciente ao tratamento da hipertensão arterial sistêmica / Nurses and patient adherence to treatment for systemic arterial hypertension / El enfermero y la cuestión de la adhesión del paciente al tratamiento de la hipertensión arterial sistémica

Objetivo: identificar os recursos utilizados pelo enfermeiro da estratégia saúde da família (ESF) para estimular a adesão do paciente ao tratamento da Hipertensão Arterial Sistêmica. Método: abordagem qualitativa. O projeto foi aprovado por Comitê de Ética em Pesquisa. A coleta de dados ocorreu no período de abril a agosto de 2017, por meio de entrevista semiestruturada com 10 enfermeiros atuantes em unidades de ESF localizadas no Estado do Rio de Janeiro. Os depoimentos dos sujeitos foram submetidos à análise de conteúdo de Bardin. Resultados: os enfermeiros realizam consultas de enfermagem garantindo a adesão dos participantes em atividades educativas de grupo, como palestras e orientações de enfermagem. Conclusão: o sistema utilizado na adesão ao tratamento é similar entre as unidades de ESF mantendo um padrão preconizado pela literatura.

Objective: to identify the resources used by Family Health Strategy (FHS) nurses to encourage patient adherence to treatment for Systemic Arterial Hypertension. Method: qualitative approach. The project was approved by the research ethics committee. Data were collected between April and August 2017, through semi-structured interviews of 10 nurses working in FHS units in Rio de Janeiro state. The transcriptions underwent Bardin content analysis. Results: the nurses held nursing appointments thus fostering participants' adherence in group educational activities, such as talks and nursing guidance sessions. Conclusion: the treatment adherence system used is similar among FHS units, maintaining a pattern recommended by the literature.

Objetivo: identificar los recursos utilizados por el enfermero de la estrategia de salud familiar (ESF) para estimular la adhesión del paciente al tratamiento de la hipertensión. Método: enfoque cualitativo. El proyecto fue aprobado por el Comité de Ética en Investigación. La recolección de datos ocurrió en el período entre abril y agosto de 2017, por medio de entrevista semiestructurada junto a 10 enfermeros que trabajan en unidades de ESF ubicadas en el estado de Río de Janeiro. Las declaraciones fueron sometidas al análisis de contenido de Bardin. Resultados: los enfermeros realizan consultas de enfermería garantizando la adhesión de los participantes en actividades educativas de grupo, como charlas y orientaciones de enfermería. Conclusión: el sistema utilizado en la adhesión al tratamiento es similar entre las unidades de ESF manteniendo un patrón preconizado por la literatura.

Alterações dos valores gasométricos decorrentes do tempo de exposição da amostra / Changes in gasometric values around the sample exposure time / Enmiendas de los valores gasométricos desde el tiempo de exposición de la muestra

Objetivos: identificar a influência do tempo, no sangue coletado, para os parâmetros gasométricos. Método: pesquisa descritiva, exploratória de abordagem quantitativa. Foram colhidas quatro amostras de sangue arterial de sessenta pacientes internados. As sessenta amostras de sangue arterial foram divididas e identificadas seguindo a sequência: pH, pCO2 e HCO3 respectivamente. Cada amostra (contida em uma seringa) foi processada na máquina para leitura quatro vezes em momentos diferentes. Resultados: foi feita uma comparação de cada um dos principais dados gasométricos, colocando os resultados de cada tempo pré-determinado, revelando as alterações ocorridas no tempo entre a coleta e a realização do exame de gases. O pH apresentou alterações tendendo para uma acidose, o pCO2 houve um ganho na sua concentração, o HCO3 houve queda na média de sua concentração Conclusão: a amostra para gasometria arterial se apresenta instável e de rápida mudança nos valores dos gases no decorrer do tempo.(AU)

Objectives: identify the influence of time, in the blood collected, for the gasometrical parameters. Method: descriptive, exploratory, quantitative approach research Four arterial blood samples were collected from sixty inpatients. Sixty arterial blood samples were divided and identified following the sequence: pH, pCO2 and HCO3 respectively. Each sample (contained in a syringe) was processed in the machine to read four times at different times. Results: a comparison of each of the main gasometrical data was made, placing the results of each predetermined time, revealing the changes occurred in the time between the collection and the gas examination. The pH presented alterations tending to an acidosis, the pCO2 had a gain in its concentration, the HCO3 had a decrease in the mean of its concentration Conclusion: the sample for arterial blood gases shows an unstable and rapidly changing gas values over time.(AU)

Objetivos: identificar la influencia del tiempo, en la sangre recogida, para los parámetros gasométricos. Método: investigaccíon, descriptiva, exploratória de enfoque cuantitativo. Se tomaron cuatro muestras de sangre arterial de sesenta pacientes internados. Las sesenta muestras de sangre arterial fueron divididas e identificadas siguiendo la secuencia: pH, pCO2 y HCO3 respectivamente. Cada muestra (contenida en una jeringa) fue procesada en la máquina para lectura cuatro veces en momentos diferentes. Resultados: se hizo una comparación de cada uno de los principales datos gasométricos, colocando los resultados de cada tiempo predeterminado, revelando los cambios ocurridos en el tiempo entre la recolección y la realización del examen de gases. El pH presentó alteraciones tendientes a una acidosis, el pCO2 hubo una ganancia en su concentración, el HCO3 hubo caída en la media de su concentración. Conclusión: la muestra para gasometría arterial se presenta inestable y de rápido cambio en los valores de los gases en el transcurso del tiempo.(AU)

Puérperas de sífilis congênita de uma maternidade de Cabo Frio-RJ: levantamento do perfil epidemiológico / Congenital syphilis pureperes of a Cabo Frio-RJ maternity: survey of the epidemiological profile / Pureperes de sífilis congénita de una maternidad de Cabo Frio-RJ: levantamento del perfil epidemiológico

Objetivo: identificar o perfil epidemiológico de puérperas de sífilis congênita internadas em uma maternidade do município de Cabo Frio-RJ. O cenário foi uma maternidade do município de Cabo Frio. Os sujeitos foram 24 puérperas de recém-nascidos com sífilis congênita. A maior parte das entrevistadas tem entre 18 e 24 anos (66,7%), apresentam o ensino médio completo (54,2%), são solteiras (75%), declaram-se negras (54,2%) e possuem renda familiar de um salário mínimo (45,8%). A maioria não tem parceiro fixo (66,7%) e não utiliza preservativo (50%) durante as relações sexuais. O maior número declarou ter realizado o pré-natal (75%), tendo o diagnóstico de sífilis entre 3 a 6 meses de gestação (54,2%). Majoritariamente o parceiro não recebeu tratamento (62,5%) e não houve orientação de enfermagem no pré-natal (62,5%). A redução da sífilis na gestação e consequentemente da sífilis congênita, está relacionada a um atendimento prioritário e adequado na rede básica de saúde.(AU)

Objective: identify the epidemiological profile of postpartum women with congenital syphilis admitted to a maternity hospital in Cabo Frio-RJ. The scenario was a maternity hospital in Cabo Frio. The subjects were 24 puerperal women with congenital syphilis. Most of the interviewees are between 18 and 24 years old (66.7%), have completed high school (54.2%), are single (75%), declare themselves black (54.2%) and have income minimum wage (45.8%). Most have no steady partner (66.7%) and do not use condoms (50%) during sexual intercourse. The largest number reported having had prenatal care (75%), with the diagnosis of syphilis between 3 and 6 months of gestation (54.2%). Mostly the partner did not receive treatment (62.5%) and there was no prenatal nursing guidance (62.5%). The reduction of syphilis in pregnancy and consequently congenital syphilis is related to priority and adequate care in the basic health network.(AU)

Objetivo: identificar el perfil epidemiológico de mujeres posparto con sífilis congénita ingresadas en un hospital de maternidad en Cabo Frio-RJ. El escenario era un hospital de maternidad en Cabo Frio. Los sujetos fueron 24 mujeres puerperales con sífilis congénita. La mayoría de los entrevistados tienen entre 18 y 24 años (66.7%), han completado la escuela secundaria (54.2%), son solteros (75%), se declaran negros (54.2%) y tienen ingresos salario mínimo (45.8%). La mayoría no tiene pareja estable (66.7%) y no usa condones (50%) durante las relaciones sexuales. El mayor número informó haber recibido atención prenatal (75%), con el diagnóstico de sífilis entre los 3 y 6 meses de gestación (54,2%). En su mayoría, la pareja no recibió tratamiento (62.5%) y no hubo orientación de enfermería prenatal (62.5%). La reducción de la sífilis en el embarazo y, en consecuencia, la sífilis congénita está relacionada con la atención prioritaria y adecuada en la red básica de salud.(AU)

Análise técnica de água de fontes rurais / Technical analysis of water from rural sources

RESUMO O objetivo desta pesquisa foi avaliar a água bruta de fontes quanto à cor, ao pH, ao nível de amônia e à presença de coliformes totais e fecais, a qual é usada para fins de abastecimento domiciliar e na agroindústria alimentar regional do Planalto Catarinense - Santa Catarina, acordando com a Portaria no 2.914/2011 do Ministério da Saúde. As discussões permitiram concluir que a cor da água se apresentou abaixo do padrão máximo permitido; constatou-se baixa concentração de amônia; o pH apresentou variável entre 5,5 e 7,5 e algumas amostras apresentaram contaminação por coliformes fecais. Desta forma, o presente trabalho demonstrou a necessidade de notificação e orientação aos proprietários rurais para a desinfecção da água para evitar a presença de quaisquer agentes patogênicos.

ABSTRACT The objective of this research was to evaluate the raw water sources as for the color, pH, ammonia level and presence of total and faecal coliforms. This water is used for household supply and at regional food agroindustry in Planalto Catarinense - Santa Catarina, Brazil, which was evaluated according to the standards of Brazilian National Council Legislation (Resolution no 2,914/2011 from the Ministry of Health). It is concluded that there was no change in water color, presenting a below the maximum allowable standard. There is a low concentration of ammonia in the water, the pH presented a variable between 5.5 to 7.5 and some samples showed contamination by faecal coliforms. In this way, this research demonstrated that the notification and orientation to landowners was required for disinfection of the water in order to eliminate any pathogenic agents.