A neural tract-inspired conduit for facile, on-demand biopsy of glioblastoma.

Background: A major hurdle to effectively treating glioblastoma (GBM) patients is the lack of longitudinal information about tumor progression, evolution, and treatment response. Methods: In this study, we report the use of a neural tract-inspired conduit containing aligned polymeric nanofibers (i.e., an aligned nanofiber device) to enable on-demand access to GBM tumors in 2 rodent models. Depending on the experiment, a humanized U87MG xenograft and/or F98-GFP+ syngeneic rat tumor model was chosen to test the safety and functionality of the device in providing continuous sampling access to the tumor and its microenvironment. Results: The aligned nanofiber device was safe and provided a high quantity of quality genomic materials suitable for omics analyses and yielded a sufficient number of live cells for in vitro expansion and screening. Transcriptomic and genomic analyses demonstrated continuity between material extracted from the device and that of the primary, intracortical tumor (in the in vivo model). Conclusions: The results establish the potential of this neural tract-inspired, aligned nanofiber device as an on-demand, safe, and minimally invasive access point, thus enabling rapid, high-throughput, longitudinal assessment of tumor and its microenvironment, ultimately leading to more informed clinical treatment strategies.

Primero yo: Triage sin demoras, ni complicaciones y humanizado / Me first: Triage without delays, complications and humanized

Objetivo principal: Comprender el significado que los pacientes que consultan al servicio de urgencias le dan al proceso de triage. Metodología: Estudio cualitativo con enfoque etnográfico, la información se recolectó por medio de 14 entrevistas semiestructuradas y se llevó diario de campo, para el análisis se sacaron unidades de significado que se agruparon en categorías. Resultados principales: Los participantes acuden al servicio de urgencias después de intentar manejar sus situaciones por medio de recursos que tienen en su entorno, al no encontrar soluciones se desplazan al servicio de urgencias, donde quieren ser atendidos inmediatamente, sin embargo, encuentran barreras que los presiona a usar estrategias para lograr la solución de sus necesidades en la atención de urgencias, en todo este proceso los pacientes esperan ser “primero yo” en la atención. Conclusión principal: el significado que los pacientes le dan al triage es que ellos sean el eje de la atención y por lo tanto tienen la expectativa que sea sin demora, sin complicaciones y que sea humanizado.(AU)

Objective: To understand the meaning that patients who consult the emergency department give to the triage process. Methods: qualitative study with an ethnographic approach, the information was collected through semi-structured interviews and a field diary was kept. Results: the participants go to the emergency department after trying to manage their situations through the resources that they have in their environment, not finding solutions, they go to the emergency department, where they want to be attended immediately, however, they find barriers that pressure them to Using strategies to achieve the solution of their needs in emergency care, throughout this process patients expect to be "first me" in care. Conclusions: the meaning that the patients give to triage is that they are the axis of care and therefore, they expect it to be without delay, without complications and that it be humanized.(AU)

Volver a la presencialidad sin ser el mismo: los docentes después de la pandemia / Returning to presentiality without being the same: teachers after the pandemic

Objetivo: Comprender los significados que los docentes le dan a su práctica profesional en el regreso al trabajo presencial después del confinamiento por Covid-19. Metodología: Investigación cualitativa con enfoque etnográfico exploratorio durante febrero y agosto de 2022. La información se recolectó por entrevistas semiestructuradas y se realizó diario de campo. Resultados: Volver a la normalidad luego de pandemia es un reto pedagógico para los docentes; el regreso a las aulas les ha generado sentimientos contradictorios: por un lado, felicidad al recuperar lo que se tenía y hacían anterior a la pandemia, pero angustia y disconfort por perder lo logrado en la virtualidad. Conclusión: La presencialidad genera ventajas y desventajas para los docentes y los reta a procesos de adaptación y resistencia. Es indispensable conservar los logros de la virtualidad y, para ello, las instituciones de educación deben ofrecer las mejores condiciones laborales que favorezcan el bienestar docente y la buena formación de los futuros profesionales.(AU)

Objective: Understand the meanings that teachers give to their professional practice in the return to face-to-face work after the confinement by Covid-19. Methods: Qualitative research with an exploratory ethnographic approach during February and August 2022. The information was collected through semi-structured interviews and a field diary was carried out. Results: Returning to normality after the pandemic is a pedagogical challenge for teachers; the return to the classroom has generated contradictory feelings: on the one hand, happiness at recovering what they had and did before the pandemic, but anguish and discomfort at losing what they had achieved online. Conclusion: To be in person generates advantages and disadvantages for teachers and challenges them to processes of adaptation and resistance. It is essential to preserve the achievements of virtuality and, for this, educational institutions must offer the best working conditions that favor teacher well-being and the good training of future professionals.(AU)

Cytostatic hypothermia and its impact on glioblastoma and survival.

Patients with glioblastoma (GBM) have limited options and require novel approaches to treatment. Here, we studied and deployed nonfreezing "cytostatic" hypothermia to stunt GBM growth. This growth-halting method contrasts with ablative, cryogenic hypothermia that kills both neoplastic and infiltrated healthy tissue. We investigated degrees of hypothermia in vitro and identified a cytostatic window of 20° to 25°C. For some lines, 18 hours/day of cytostatic hypothermia was sufficient to halt division in vitro. Next, we fabricated an experimental tool to test local cytostatic hypothermia in two rodent GBM models. Hypothermia more than doubled median survival, and all rats that successfully received cytostatic hypothermia survived their study period. Unlike targeted therapeutics that are successful in preclinical models but fail in clinical trials, cytostatic hypothermia leverages fundamental physics that influences biology broadly. It is a previously unexplored approach that could provide an additional option to patients with GBM by halting tumor growth.

Triage hospitalario para las enfermeras: Entre la incertidumbre, la sobrecarga y los desacuerdos / Hospital triage for nurses: Between uncertainty, overload, and disagreements

Resumen Estudio cualitativo, las participantes fueron enfermeras que realizaban triage hospitalario en la ciudad de Medellín Colombia. Objetivo Describir las dificultades que las enfermeras tienen al realizar el triage y cómo las afrontan. Metodología Estudio etnográfico en el que se realizaron siete entrevistas con las cuales se logró la saturación de las categorías y llevó diario de campo; la ética fue parte integral del proceso. Resultados Las dificultades en el triage son la incertidumbre, la sobrecarga y los desacuerdos con las escalas, los médicos, los pacientes y los familiares y están mediadas por la interacción con el paciente, la familia y la institución; las enfermeras para afrontar las dificultades se "resetean", liberan cargas, toman las decisiones que consideran adecuadas, hablan con sus colegas y oran. Conclusiones Las enfermeras reciben presiones que las hace sentirse vulnerables ante la sobrecarga, los problemas de interacción y la incertidumbre llevándola a que tenga que realizar diferentes sistemas de afrontamiento.

Summary Qualitative study, the participants were nurses who performed hospital triage in the city of Medellín Colombia. Objective To describe the difficulties facing by nurses when performing triage and how they deal with them. Methodology An Ethnographic design was conducted, data saturation was achieved after seven interviews, field notes were taken; ethics was part of the research process. Results The difficulties in triage are uncertainty, overload and disagreements with scales, doctors, patients and relatives and are mediated by interaction with the patient, family and institution; nurses to cope with difficulties need to "reset" themselves, release burdens, make the decisions they deem appropriate, talk to their colleagues and pray. Conclusions Nurses receive pressures that make them feel vulnerable to overload, interaction problems and uncertainty leading them to have to perform different coping systems.

Ser especial: requisito del paciente para sentirse tranquilo, protegido y cuidado por la enfermera / Be kind: patient requirement to feel calm, protected and cared by nurse

Los pacientes valoran la cercanía de la enfermera, pero no siempre la encuentran. Este trabajo se realizó con pacientes que estuvieron hospitalizados en la ciudad de Medellín. Objetivo: comprender el significado que el paciente le da a la interacción con el personal de enfermería en el proceso de hospitalización. Método: estudio cualitativo con enfoque etnográfico. La investigación se realizó con doce personas que estuvieron hospitalizadas. La información se recolectó por entrevistas y se llevó diario de campo. El estudio se fundamentó en el respeto, la confidencialidad y no implicó riesgos. Resultados: El paciente necesita estar tranquilo, protegido y cuidado, para lograrlo debe ser pasivo y obediente e interactuar con una enfermera que lo considere especial. La enfermera debe ser educada, y espera que la auxiliar le alegre el día. Conclusiones: El paciente se siente especial si la enfermera lo protege y lo trata como ser humano, da más valor a las acciones de cuidado menos tangibles. (AU)

Patients value the closeness of the nurse, but do not always find this type of nursing staff. This work was carried out with hospitalized patients in the city of Medellín. Objective: to understand the meaning that the patient gives to the interaction with the nursing staff in the hospitalization process. Methodology: qualitative study with an ethnographic focus. The interviews and the field diary were carried out to collect the information, this was done with 10 people who were hospitalized. The study was based on respect, confidentiality and did not involve risks. Results: for the patient to be calm, protected and cared for, he must be passive, obedient and interact with a nurse who considers him special. Additionally, the nurse must be educated and expect the nursing assistant to make her day more joyous. Conclusions: the patient feels special if the nurse protects him and treats him as a human being, giving more value to less tangible care actions. (AU)

Cuidar al paciente con COVID-19: entre la incertidumbre y el deseo de salir adelante / Caring for the patient with COVID-19: between uncertainty and the desire to get ahead

Introducción: la realidad a la cual la humanidad ha tenido que enfrentarse producto de la pandemia por COVID-19 ha implicado para el personal de la salud, y el de enfermería de manera específica, un gran reto para brindar cuidado a los pacientes, mientras se cuida a sí mismo de un contagio. Objetivo: comprender el significado que tiene para los integrantes de los equipos de enfermería el cuidado de los pacientes infectados por el COVID-19. Método: trabajo cualitativo en el que participaron profesionales y auxiliares de enfermería del Departamento de Antioquia, Colombia; la recolección de datos se realizó mediante entrevistas virtuales y el análisis fue inductivo. Resultados: el equipo de enfermería cuida a los pacientes infectados por el COVID-19 con gran incertidumbre y sin apoyo. Esto los lleva a experimentar sentimientos de miedo, rabia y desconcierto. Su forma de afrontar esta situación es tener una actitud positiva con esperanza, aislarse de los medios de comunicación o pensar en dejar su trabajo. Por ello, sugieren la necesidad de capacitación a ellos y a la comunidad. Por otro lado, piden mejores condiciones laborales y ser escuchados. Conclusiones: el personal de enfermería lleva a cabo el cuidado de los pacientes en medio de incertidumbre y afectación en su salud mental.

Introduction: The reality that humanity has had to face due to the COVID-19 pandemic has implied a great challenge for health personnel, specifically for nurses, to provide care to patients while protecting themselves from getting infected. Objective: Understand what it means for nursing team members to care for patients infected with COVID-19. Methods: Qualitative work in which nurses and nursing assistants from the department of Antioquia, Colombia, participated; data were collected through online interviews, and the analysis was inductive. Results: Nursing teams care for patients with COVID-19 feeling great uncertainty and without support. This leads them to experience feelings of fear, anger, and bewilderment. Their way of dealing with this situation is to have a positive attitude with hope, isolate themselves from media, or think about quitting their jobs. Therefore, they suggest the need for training, both for themselves and the community. They also ask for better working conditions and to be heard. Conclusions: The nurses care for the patients amid uncertainty and mental health conditions.

Introdução: a realidade que a humanidade tem enfrentado em decorrência da pandemia por COVID-19 tem implicado para os profissionais de saúde, e especificamente para os enfermeiros, um grande desafio no cuidado aos pacientes, en quanto cuidam-se a se mesmos do contágio. Objetivo: compreender o significado que tem para os membros da equipe de enfermagem o cuidado aos pacientes infectados pelo COVID-19. Método: trabalho qualitativo, no qual participaram profissionais e auxiliares de enfermagem do Departamento de Antioquia, Colômbia. A coleta de dados foi realizada por meio de entrevistas virtuais e a análise foi indutiva. Resultados: a equipe de enfermagem cuida de pacientes infectados pelo COVID-19 com grande incerteza e sem suporte. Isso os leva a experimentar sentimentos de medo, raiva e perplexidade. A sua forma de lidar com esta situação é ter uma atitude positiva com esperança, isolar-se dos meios de comunicação ou pensar em deixar o emprego. Portanto, sugerem a necessidade de capacitação para eles e para a comunidade. De outro lado, reclamam melhores condições de trabalho e ser escutados. Conclusões: a equipe de enfermagem oferece cuidado aos pacientes em meio de incertezas e afetações em sua saúde mental.

Enriching neural stem cell and anti-inflammatory glial phenotypes with electrical stimulation after traumatic brain injury in male rats.

Traumatic brain injury (TBI) by an external physical impact results in compromised brain function via undesired neuronal death. Following the injury, resident and peripheral immune cells, astrocytes, and neural stem cells (NSCs) cooperatively contribute to the recovery of the neuronal function after TBI. However, excessive pro-inflammatory responses of immune cells, and the disappearance of endogenous NSCs at the injury site during the acute phase of TBI, can exacerbate TBI progression leading to incomplete healing. Therefore, positive outcomes may depend on early interventions to control the injury-associated cellular milieu in the early phase of injury. Here, we explore electrical stimulation (ES) of the injury site in a rodent model (male Sprague-Dawley rats) to investigate its overall effect on the constituent brain cell phenotype and composition during the acute phase of TBI. Our data showed that a brief ES for 1 hr on day 2 of TBI promoted anti-inflammatory phenotypes of microglia as assessed by CD206 expression and increased the population of NSCs and Nestin+ astrocytes at 7 days post-TBI. Also, ES effectively increased the number of viable neurons when compared to the unstimulated control group. Given the salience of microglia and neural stem cells for healing after TBI, our results strongly support the potential benefit of the therapeutic use of ES during the acute phase of TBI to regulate neuroinflammation and to enhance neuroregeneration.

Engineered glycomaterial implants orchestrate large-scale functional repair of brain tissue chronically after severe traumatic brain injury.

Severe traumatic brain injury (sTBI) survivors experience permanent functional disabilities due to significant volume loss and the brain's poor capacity to regenerate. Chondroitin sulfate glycosaminoglycans (CS-GAGs) are key regulators of growth factor signaling and neural stem cell homeostasis in the brain. However, the efficacy of engineered CS (eCS) matrices in mediating structural and functional recovery chronically after sTBI has not been investigated. We report that neurotrophic factor functionalized acellular eCS matrices implanted into the rat M1 region acutely after sTBI significantly enhanced cellular repair and gross motor function recovery when compared to controls 20 weeks after sTBI. Animals subjected to M2 region injuries followed by eCS matrix implantations demonstrated the significant recovery of "reach-to-grasp" function. This was attributed to enhanced volumetric vascularization, activity-regulated cytoskeleton (Arc) protein expression, and perilesional sensorimotor connectivity. These findings indicate that eCS matrices implanted acutely after sTBI can support complex cellular, vascular, and neuronal circuit repair chronically after sTBI.

La familia es la voz del paciente en la interacción con la enfermera / A família como a voz do paciente na interação enfermeira-paciente / Family as the Patient's Voice in Nurse-Patient Interaction

Introducción: La familia experimenta un reto importante cuando uno de sus miembros está hospitalizado, pues los obliga a modificar sus dinámicas en términos de funciones y roles. Esta investigación cualitativa se realizó con familiares que acompañaron a uno de sus integrantes durante una experiencia de hospitalización; se consideró familia a quienes compartieran una historia en común con el paciente. Objetivo: Comprender el significado que le da la familia al papel que desempeña con el paciente en la interacción con las enfermeras durante el tiempo de hospitalización. Materiales y Métodos: Se utilizó el enfoque etnográfico. Se aplicaron 10 entrevistas a personas adultas. Se obtuvo información hasta lograr la saturación. Se tuvo en cuenta los criterios de rigor y los principios éticos. Resultados: La familia considera que tienen el derecho de ser la voz del paciente para interactuar con la enfermera, y la asume como una de sus funciones en su rol cuidador, para lograrlo es indispensable que ésta acuda al llamado, atienda, acompañe y brinde al paciente unos cuidados mínimos requeridos, relacionados primordialmente con la esfera física, de tal forma que en esa interacción demuestre su calidad humana, reconozca las necesidades del paciente y base su comunicación en la verdad y la cercanía. La familia espera una enfermera que los reconozca y los eduque, así mismo que les diga la verdad y se muestre cercana. Conclusiones: La familia se constituye en la voz del paciente como derecho connatural filial y en ese sentido, asume el cuidado del paciente con apoyo de las enfermeras, quienes tienen el deber de generar confianza y buen trato.

Introduction: Families experience a major challenge when a next of kin is admitted to hospital as family dynamics are forced to change in terms of duties and roles. Qualitative research has been conducted with family members who supported one of their next of kin during their hospitalization. Family members were defined as those who had shared a common history with patients. Objective: To understand the meaning given by families to the patient's voice role in the interaction with nurses during hospitalization. Materials and Methods: An ethnographic approach was used. Complete information was collected from 10 interviews with adults. Strict criteria and ethical principles were also applied. Results: Families consider that their right is to be the patient's voice to interact with nurses, assuming it as one of their caregiving functions. To this end, nurses must respond to the call, assist, accompany and provide patients with minimal care required, primarily related to physical care, so they can demonstrate their human qualities, recognize patients' needs and communicate on the basis of truth and closeness when interacting with patients. Families expect that nurses would recognize and instruct them, as well as tell the truth and be close to them. Conclusions: Families are the patient's voice as a matter of connatural right, assuming patients' care supported by nurses, who are in charge of building trust and providing good care.

Introdução: As famílias experimentam um grande desafio quando um parente próximo é hospitalizado, pois as dinâmicas familiares são forçadas a mudar em termos de deveres e papéis. Esta pesquisa qualitativa foi realizada com membros da família que acompanharam um de seus parentes durante a hospitalização. Os membros da família foram definidos como aqueles que tinham compartilhado uma história comum com os pacientes. Objetivo: Entender o significado dado pelas famílias ao papel da voz do paciente na interação com enfermeiros durante a hospitalização. Materiais e métodos: Uma abordagem etnográfica foi utilizada. Informações completas foram coletadas a partir de 10 entrevistas com adultos. Critérios rígidos e princípios éticos também foram aplicados. Resultados: As famílias consideram que tem o direito de ser a voz do paciente para interagir com enfermeiros, assumindo-a como uma de suas funções de cuidado. Para isso, os enfermeiros devem responder ao chamado, prestar assistência, acompanhar e prover aos pacientes os cuidados mínimos necessários, principalmente relacionados ao cuidado físico, para que possam demonstrar suas qualidades humanas, reconhecer as necessidades dos pacientes e se comunicar com base na verdade e na proximidade ao interagir com os pacientes. As famílias esperam que os enfermeiros os reconheçam e os instruam, assim como que digam a verdade e estejam próximos deles. Conclusões: As famílias são a voz do paciente como uma questão de direito conatural, assumindo os cuidados dos pacientes apoiados por enfermeiros, que são responsáveis por construir confiança e prestar bons cuidados.

Lesion Volume Estimation from TBI-MRI.

Traumatic brain injury (TBI) is a major problem affecting millions of people around the world every year. Usually, TBI results from any direct or indirect physical impact, sudden jerks, or blunt impacts to the head, leading to damage to the brain. Current research in TBI is focused on analyzing the biological and behavioral states of patients prone to such injuries. This paper presents a technique applied on MRI images in estimation of lesion volumes in brain tissues of traumatic brain-injured laboratory rats that were subjected to controlled cortical impacts. The lesion region in the brain tissue is estimated using segmentation of the brain, diffusion, and the damage regions. After the segmentation, the area of the damaged portion is estimated across each slice of MRI and the combined volume of damage is estimated through 3D reconstruction.

Cuidado del paciente moribundo: una confrontación entre mostrar sentimientos y desempeño profesional / Dying Patient Care: The Conflict between Showing Feelings and Professional Performance / Cuidado do paciente terminal: um confronto entre demonstrar sentimentos e desempenhar-se como profissional

RESUMEN Objetivo: comprender el significado que las enfermeras le dan al cuidado del paciente ad portas de la muerte. Método: se realizaron entrevistas a 23 enfermeras que han cuidado a pacientes ad portas de la muerte y se realizó observación participante en un hospital de tercer nivel de Medellín, Colombia. Los datos se analizaron por proceso inductivo para obtener categorías y subcategorías. Resultados: el cuidado del paciente que está ad portas de la muerte significa una confrontación interna, pues ellas tienen la concepción que mostrar sentimientos por la muerte no es profesional, pero al no hacerlo sienten que ejercen una práctica profesional poco humanizada. Discusión: cuando un paciente va a morir, las enfermeras evalúan qué tan profesional es mostrar sentimientos y qué tan deshumanizado es no hacerlo. Conclusión: cuidar a un paciente ad portas de morir significa ejercer una profesión humanística que deben aceptar.

ABSTRACT Objective: The objective of the study was to understand the meaning nurses afford to the care of patients who are on the verge of death. Method: Interviews were carried out with 23 nurses who have cared for dying patients, and participant observation was done at a third level hospital in the city of Medellín (Colombia). The data were analyzed through an inductive process to establish categories and subcategories. Results: Caring for a patient who is on the brink of death implies an internal conflict, since nurses believe that showing their feelings in the face of death is unprofessional. However, when they fail to do so, they sense their professional practice is less humane. Discussion: When a patient is about to die, nurses evaluate how professional it is to show their feelings and how inhumane it is not to do so. Conclusion: Caring for a dying patient calls for exercising the humanistic aspects of the profession that must be accepted.

RESUMO Objetivo: compreender o significado que as enfermeiras dão ao cuidado do paciente na fase terminal. Método: foram realizadas entrevistas com 23 enfermeiras que cuidaram de pacientes em fase terminal e foi realizada observação participante num hospital de nível terciário em Medellín (Colômbia). Os dados foram analisados por processo indutivo para obter categorias e subcategorias. Resultados: o cuidado do paciente em fase terminal significa um confronto interno, pois elas acreditam que mostrar sentimentos pela morte não é profissional, mas ao não fazer isso sentem que exercem uma prática profissional pouco humanizada. Discussão: quando um paciente está prestes a morrer, as enfermeiras avaliam que tão profissional é mostrar sentimentos e que tão desumanizado é não fazer isso. Conclusões: cuidar de um paciente em fase terminal significa exercer uma profissão humanizada que os enfermeiros devem aceitar.

Chondroitin Sulfate Glycosaminoglycan Matrices Promote Neural Stem Cell Maintenance and Neuroprotection Post-Traumatic Brain Injury.

There are currently no effective treatments for moderate-to-severe traumatic brain injuries (TBIs). The paracrine functions of undifferentiated neural stem cells (NSCs) are believed to play a significant role in stimulating the repair and regeneration of injured brain tissue. We therefore hypothesized that fibroblast growth factor (FGF2) enriching chondroitin sulfate glycosaminoglycan (CS-GAG) matrices can maintain the undifferentiated state of neural stem cells (NSCs) and facilitate brain tissue repair subacutely post-TBI. Rats subjected to a controlled cortical impactor (CCI) induced TBI were intraparenchymally injected with CS-GAG matrices alone or with CS-GAG matrices containing PKH26GL labeled allogeneic NSCs. Nissl staining of brain tissue 4 weeks post-TBI demonstrated the significantly enhanced (p < 0.05) tissue protection in CS-GAG treated animals when compared to TBI only control, and NSC only treated animals. CS-GAG-NSC treated animals demonstrated significantly enhanced (p < 0.05) FGF2 retention, and maintenance of PKH26GL labeled NSCs as indicated by enhanced Sox1+ and Ki67+ cell presence over other differentiated cell types. Lastly, all treatment groups and sham controls exhibited a significantly (p < 0.05) attenuated GFAP+ reactive astrocyte presence in the lesion site when compared to TBI only controls.

El interés de las enfermeras por el alma de los pacientes en proceso de morir: asuntos culturales y espirituales / The interest of nurses for the soul of patients going through a dying process: cultural and spiritual matters / O interesse das enfermeiras para a alma dos pacientes em processo de morrer. questóes culturáis e espirituais

Las concepciones que tienen las enfermeras sobre la muerte moldean su significado, lo que genera una polisemia en torno a esta noción. Objetivo: Explorar los significados que construyen las enfermeras sobre los asuntos culturales y espirituales relacionados con la muerte de los pacientes. Método: Estudio cualitativo con enfoque etnográfico. Se realizaron 23 entrevistas a enfermeras y aproximadamente 100 horas de observación en un hospital en Medellín (Colombia) entre diciembre del 2012 y noviembre de 2013. Resultados: El interés por el alma se manifestó como una intención de respetar las concepciones del paciente, familiares y sensibilidad hacia los rituales. El proceso de la muerte se enmarca en un choque cultural. Conclusión: las concepciones culturales y religiosas se manifiestan en la práctica de los cuidados al final de la vida. Los rituales buscan dar tranquilidad al paciente y a sus familiares en el tránsito hacia la muerte de la persona y que "descanse en paz". Por esto, los asuntos culturales y religiosos se relacionan con un interés por el alma.

The conceptions that nurses have on death shape their meaning, which generates po-lysemy around this notion. Method: A qualitative study with ethnographic approach whose objective was to explore the meanings that nurses have on cultural and spiri-tual issues related to the death of patients. 23 interviews with nurses and about 100 hours of observation were performed in a hospital in Medellin (Colombia) between December 2012 and November 2013. Results: The interest in the soul manifested itself as an intention to respect the views of the patient, family and sensitivity to the rituals. The process of dying is part of a culture shock. Conclusión: cultural and reli-gious conceptions are manifested in the practice of care at the end of life. The rituals seek to reassure the patient and family in the transition to the death of the person and also to help the patient "rest in peace". Therefore, cultural and religious issues relate to an interest in the soul.

El quehacer cotidiano de la enfermera significa soportar la carga / O trabalho cotidiano da enfermeira significa suportar a carga / The daily work of nurse means bear the burden

Introducción: Las enfermeras le dan significados a su quehacer cotidiano y la comprensión de estos favorece el diseño de propuestas orientadas a promover la calidad, humanización y gestión de los servicios. El objetivo fue comprender el significado que las enfermeras le dan a su quehacer cotidiano. Materiales y Métodos: Se utilizó la investigación cualitativa con enfoque etnográfico, se realizaron entrevistas grupales y se llevó diario de campo. Resultados: Las enfermeras deben apropiarse del servicio, lo que significa realizar cuidado integral y cargar el servicio. Esta carga del servicio es entendida como soportar la carga de la culpa, los problemas, las interacciones, los indicadores y protocolos sin suficiente tiempo. Discusión: El cuidado genera motivación la cual es una emoción capaz de provocar, mantener y dirigir la conducta hacia un objetivo, la carga laboral ha obligado a las enfermeras a dedicar menos tiempo al cuidado lo cual las lleva a sentimientos de culpa, agotamiento y estrés. Conclusiones: El quehacer de enfermería significa una carga cuando sienten que deben encargarse de tareas que no son de su competencia profesional o que son impuestas limitando su autonomía. Tener que soportarla lleva a las enfermeras a la desmotivación.

Introdução: As enfermeiras dão significados ao seu quefazer cotidiano e a compreensão destes favorece o desenho de propostas orientadas a promover a qualidade, humanização e gestão dos serviços. O objetivo foi compreender o significado que as enfermeiras lhe dão ao seu quefazer cotidiano. Materiais e Métodos: Se utilizou a investigação qualitativa com enfoque etnográfico, se realizaram entrevistas grupais e se fez diário de campo. Resultados: As enfermeiras devem apropriar-se do serviço, o que significa realizar cuidado integral e carregar o serviço. Esta carga do serviço é entendida como suportar a carga da culpa, os problemas, as interações, os indicadores e protocolos sem suficiente tempo. Discussão: O cuidado gera motivação a qual é uma emoção capaz de provocar, manter e dirigir a conduta a um objetivo, a carga laboral há obrigado às enfermeiras a dedicar menos tempo ao cuidado o qual as leva a sentimentos de culpa, esgotamento e estresse. Conclusões: A tarefa de enfermagem significa a carga quando eles sentem que eles devem cuidar de tarefas que não são de sua competência profissional, ou que são impostas, limitando a sua autonomia. Ter que suportar a carga leva às enfermeiras à desmotivação.

Introduction: Nurses give the meaning to their daily work and its comprehension permits the design of proposals oriented to promote quality, humanization and service management. The objective was to understand the meaning that nurses give to their daily work. Materials and Methods: Qualitative study with ethnographic approach; groups interviews were conducted and a field day book was done. Results: Nurses must take ownership of the nurse department, which means to achieve an integral care and hold up the department. The weight of the department is to understand as the ability to hold up guilt, problems, interactions, indicators and protocols without enough time. Discussion: Health care creates motivation, which is a feeling capable to provoke, maintain and manage the behavior to a common objective; the work weight has forced the nurses to spend less time to the health care, which lead them to feel guilty, exhaustion and stress. Conclusions: The task of nursing means a burden when they feel that they must take care of tasks are not of her professional competence or that are imposed by limiting their autonomy. Holding up work weight, lead nurses to the demotivation.

Acompañar en la muerte es un pilar del cuidado, una dolorosa obligación y un dilema / Accompanying in death is a pillar of care, a painful duty and a dilemma

Objetivo: Comprender el significado que las enfermeras le dan al acompañamiento al paciente con enfermedad en fase terminal. Método: Investigación cualitativa. Se utilizaron herramientas de la etnografía particularista, como las entrevistas y la observación en una institución hospitalaria de alto nivel de complejidad; se obtuvo la saturación con 23 entrevistas a enfermeras que laboran en diferentes hospitales de Medellín, Colombia. Resultados: El acompañamiento de las enfermeras a los pacientes con enfermedad en fase terminal significa un pilar del cuidado, una dolorosa obligación y un dilema. Conclusión: El acompañamiento como función implica acortar distancias, como dilema implica pensar en la necesidad del paciente, en las normas de la institución y en su propio instinto.

This research had the objective of understanding the meaning that nurses give to the act of accompanying terminally-ill patients. Method: Qualitative study with ethnographic tools, such as interviews and observation in a hospital of high complexity, theoretical saturation was obtained from 23 interviews to nurses working in different hospitals in Medellin, Colombia. Results: The company provided by nurses to terminally-ill patients means a pillar of care, a painful duty and a dilemma. Conclusion: Providing company, as a function, implies being near; as a dilemma it implies thinking about the patient's needs, the institution's norms and trusting their own instinct.

Nursing care of patients during the dying process: a painful professional and human function.

OBJECTIVE: This work sought to describe the care functions of nurses with patients during the dying process. METHODOLOGY: This was a qualitative study with ethnographic approach stemming from the analysis of the culture of nurses; it was conducted in the city of Medellín, Colombia. Theoretical saturation was obtained with 23 interviews. RESULTS: Nurses feel the duty to care for patients throughout the vital cycle through functions defined as: serving, helping, accompanying, offering support, advocating, educating, and representing, which they identify as indispensable. They also perceive as their own the social responsibility for some issues related to death and due to this they get involved at the personal level, appropriate care and are affected as persons. CONCLUSION: Patient care during dying processes transcends the limits of the nurse' professional functions to become a human obligation.

Chondroitin Sulfate Glycosaminoglycan Hydrogels Create Endogenous Niches for Neural Stem Cells.

Neural stem cells (NSCs) possess great potential for neural tissue repair after traumatic injuries to the central nervous system (CNS). However, poor survival and self-renewal of NSCs after injury severely limits its therapeutic potential. Sulfated chondroitin sulfate glycosaminoglycans (CS-GAGs) linked to CS proteoglycans (CSPGs) in the brain extracellular matrix (ECM) have the ability to bind and potentiate trophic factor efficacy, and promote NSC self-renewal in vivo. In this study, we investigated the potential of CS-GAG hydrogels composed of monosulfated CS-4 (CS-A), CS-6 (CS-C), and disulfated CS-4,6 (CS-E) CS-GAGs as NSC carriers, and their ability to create endogenous niches by enriching specific trophic factors to support NSC self-renewal. We demonstrate that CS-GAG hydrogel scaffolds showed minimal swelling and degradation over a period of 15 days in vitro, absorbing only 6.5 ± 0.019% of their initial weight, and showing no significant loss of mass during this period. Trophic factors FGF-2, BDNF, and IL10 bound with high affinity to CS-GAGs, and were significantly (p < 0.05) enriched in CS-GAG hydrogels when compared to unsulfated hyaluronic acid (HA) hydrogels. Dissociated rat subventricular zone (SVZ) NSCs when encapsulated in CS-GAG hydrogels demonstrated ∼88.5 ± 6.1% cell viability in vitro. Finally, rat neurospheres in CS-GAG hydrogels conditioned with the mitogen FGF-2 demonstrated significantly (p < 0.05) higher self-renewal when compared to neurospheres cultured in unconditioned hydrogels. Taken together, these findings demonstrate the ability of CS-GAG based hydrogels to regulate NSC self-renewal, and facilitate growth factor enrichment locally.

Nursing care of patients during the dying process: a painful professional and human function / El cuidado de enfermería al paciente en proceso de fallecer: una dolorosa función profesional y humana / O cuidado de enfermagem ao paciente em processo de falecer: uma dolorosa função profissional e humana

Objective. This work sought to describe the care functions of nurses with patients during the dying process. Methodology. This was a qualitative study with ethnographic approach stemming from the analysis of the culture of nurses; it was conducted in the city of Medellín, Colombia. Theoretical saturation was obtained with 23 interviews. Results. Nurses feel the duty to care for patients throughout the vital cycle through functions defined as: serving, helping, accompanying, offering support, advocating, educating, and representing, which they identify as indispensable. They also perceive as their own the social responsibility for some issues related to death and due to this they get involved at the personal level, appropriate care and are affected as persons. Conclusion. Patient care during dying processes transcends the limits of the nurse’s professional functions to become a human obligation.

Objetivo. Describir las funciones de cuidado de las enfermeras con el paciente en proceso de fallecer. Metodología. Estudio cualitativo con enfoque etnográfico partiendo del análisis de la cultura de las enfermeras, realizado en la ciudad de Medellín, Colombia. Se obtuvo saturación teórica con 23 entrevistas y 100 horas de observación. Resultados. Las enfermeras sienten el deber de cuidar del paciente a lo largo del ciclo vital mediante funciones que definen como: servir, ayudar, acompañar, brindar soporte, abogar, educar y realizar el rol de vicario, las cuales identifican como indispensables. También, sienten como propia la responsabilidad social por algunos asuntos relacionados con la muerte y por esto se involucran personalmente del cuidado cuyo resultado es su afectación como personas. Conclusión. El cuidado del paciente en proceso de morir trasciende los límites de las funciones profesionales de la enfermera para convertirse en una obligación humana.

Objetivo. Descrever as funções de cuidado das enfermeiras com o paciente em processo de falecer. Metodologia. Estudo qualitativo com enfoque etnográfico partindo da análise da cultura das enfermeiras, foi realizado na cidade de Medellín, Colômbia. Obteve-se saturação teórica com 23 entrevistas e 100 horas de observação. Resultados. As enfermeiras sentem o dever de cuidar do paciente ao longo do ciclo vital mediante funções que definem como: servir, ajudar, acompanhar, brindar suporte, advogar, educar e consolar, que identificam como indispensáveis. Também sentem como própria a responsabilidade social por alguns assuntos relacionados com a morte e por isto se envolvem a nível pessoal, se responsabilizam do cuidado e resultam afetadas como pessoas. Conclusão. O cuidado do paciente em processo de morrer transcende os limites das funções profissionais da enfermeira para converter-se numa obrigação humana.