Global legislation regulating the donation, procurement and distribution processes of organs and tissues from deceased donors for transplants: A scoping review.

Introduction: Organ transplantation is one of the most successful advances in modern medicine. However, a legal system is necessary for its practice to be free from ethical flaws and to respect donors, recipients, and family members. Objective: To map the global legislation regulating the donation, capture and distribution processes of organs and tissues from deceased donors for transplants. Method: A scoping review according to the Joanna Briggs Institute was conducted in the following databases: Medline, CINAHL, Virtual Health Library, SCOPUS, Web of Science, Science Direct, and EMBASE, as well as gray literature, and reported according to the PRISMA extension for scoping reviews. Results: We identified 3302 records, of which 77 were analyzed which enabled mapping the type of consent adopted and the existence of current legislation for harvesting organs and tissues after circulatory and brain death. Conclusion: Opt-out consent predominates in Europe, and there is harvesting after brain and circulatory death. Opt-out predominates in the Americas, while Opt-in and harvesting of organs and tissues after brain death predominate in Asia and Oceania. The procurement of organs and tissues from deceased donors is practically non-existent in Africa.

Costs related to obtaining organs for transplantation: A systematic review.

INTRODUCTION: The number of transplants in the world is growing, although there is a demand that exceeds supply. It is worth mentioning that the costs for obtaining organs are considered high. However, few studies have been developed on analyzing the costs of obtaining organs and tissues for transplants in order to support the decision-making of managers and health professionals. OBJECTIVE: To summarize the studies related to the cost of obtaining organs for transplants from a deceased donor. METHOD: A systematic literature review was conducted in the following databases: PubMed, Cochrane Library CINAHAL, Virtual Health Library (BVS), SCOPUS, Web of Science and EMBASE, using the following descriptors: Costs and cost analysis; Donor Selection; Tissue and Organ Procurement; Tissue and Organ Harvesting; and Tissue Donors, in studies published until April 2021. The risk of bias assessment was performed using the Joanna Briggs Institute's Checklist for Economic Assessments. It was not possible to perform a meta-analysis due to the heterogeneity of the studies. RESULTS: A total of 1731 studies were identified, of which 11 were analyzed. The cost of kidneys in US dollars (USD) ranged between USD $1672 and USD $25,058. Obtaining a liver ranged from USD $586 to USD $44,478. Heart procurement ranged from USD $633 to USD $24,264. The combined heart-lung transplant ranged from USD $860 to USD $23,203. Obtaining the pancreas ranged from USD $413 to USD $29,708. CONCLUSIONS: Cost of obtaining organs for transplants from a deceased donor is substantial and varies widely across different studies. The overall cost of failures to obtain organs is currently unknown. Understanding organ procurement expenses can help clarify areas in which organ and tissue procurement can improve in cost and efficiency.

Mapa conceitual: representação social na graduação de enfermagem / Conceptual map: social representation in nursing graduation / Mapa conceptual: representación social en graduación de enfermería

Objetivo: Compreender as representações sociais do uso de mapas conceituais em grupo tutorial de estudantes de enfermagem. Método: Pesquisa qualitativa, feita a partir da análise do Discurso do Sujeito Coletivo de 26 estudantes de uma universidade pública no Centro-Oeste do Brasil. Resultados: Emergiram duas categorias provenientes da análise do discurso: 1) Mapa Conceitual: ferramenta facilitadora de organização da aprendizagem e 2) Mapa Conceitual: ferramenta que provoca tensão e desfavorece o aprendizado. Conclusões: O mapa conceitual facilita o auto estudo e a aprendizagem, pois possibilita a sintetização do conhecimento e a organização do raciocínio. Quanto à sua utilização coletiva, observou-se falhas em relação ao tempo gasto na elaboração e na necessidade de encontrar palavras de ligação. (AU)

Objective: To understand the social representations of the use of concept maps in a tutorial group of nursing students. Methods: Qualitative research, based on the Collective Subject Discourse analysis of 26 students from a public university in the Midwest of Brazil. Results: Two categories emerged from the discourse analysis: 1) Concept Map: a facilitating tool for learning organization and 2) Concept Map: a tool that causes tension and disadvantages learning. Conclusion: The concept map facilitates self-study and learning, as it enables the synthesis of knowledge and the organization of reasoning. Regarding their collective use, there were flaws in the time spent in elaboration and in the need to find linking words. (AU)

Objetivo: Comprender las representaciones sociales del uso de mapas conceptuales en un grupo tutorial de estudiantes de enfermería. Métodos: Investigación cualitativa, basada en el análisis del discurso del sujeto colectivo de 26 estudiantes de una universidad pública en el medio oeste de Brasil. Resultados: Del análisis del discurso surgieron dos categorías: 1) Mapa conceptual: una herramienta facilitadora para la organización del aprendizaje y 2) Mapa conceptual: una herramienta que causa tensión y desventajas del aprendizaje. Conclusion: El mapa conceptual facilita el autoaprendizaje y el aprendizaje, ya que permite la síntesis del conocimiento y la organización del razonamiento. Con respecto a su uso colectivo, hubo fallas en el tiempo dedicado a la elaboración y en la necesidad de encontrar palabras de enlace. (AU)

Occupational Stress and Quality of Life in Nursing / Estresse Ocupacional e Qualidade de Vida em Profissionais de Enfermagem / Estres Ocupacional y Calidad de Vida en Profesionales de Enfermería

Abstract To reduce the work related to stress and the psychosocial risk is not only an imperative question, but also moral. This epistemological study aims to verify the presence of the occupational stress and quality of life related to health in nursing professionals. We used three questionnaires: (a) Socio Demographic Questionnaire, (b) Job Strain Scale, and (c) Item Short Form Health Survey. Statistical analysis was performed between the questionnaires, analysis of variance (ANOVA) and simple and multiple linear regression. It was found that 60.8% of the participants see the high demand of work, 71.8% high control on the developed activity and 85.5% low social support. Related to eight dominant of quality of life, the most damaged are: pain (µ = 61.87) and vitality (µ = 62.25). It was concluded that although in most sample experiences an intermediary risk situation to stress, the quality of life showed a damaged.(AU)

Resumo Reduzir o estresse relacionado ao trabalho e os riscos psicossociais não é apenas uma questão imperativa, mas também moral. O objetivo deste estudo epidemiológico foi verificar a presença de estresse ocupacional e avaliar a qualidade de vida relacionada à saúde entre profissionais de enfermagem. Foram utilizados três questionários: (a) Questionário sociodemográfico, (b) Job Strain Scale e (c) Item Short Form Health Survey. Realizou-se análise estatística por associações entre os questionários, análise de variância (ANOVA) e regressão linear simples e múltipla. Verificou-se que 60,8% dos participantes vivenciam uma alta demanda no trabalho, 71,8% um alto controle sobre a atividade desempenhada e 85,5% baixo apoio social. Dos oito domínios da qualidade de vida relacionada à saúde, os mais afetados foram: dor (µ = 61,87) e vitalidade (µ = 62,25). Concluiu-se que, embora a maioria da amostra vivencie um risco intermediário de estresse, a qualidade de vida relacionada à saúde mostrou-se comprometida.(AU)

Resumen Reducir el estres ocupacional y riesgos psicosociales no es sólo una cuestión imperativa, sino también moral. El objetivo deste estudio epidemiológico es verificar la presencia de estrés laboral y la calidad de vida relacionada con la salud en profesionales de enfermería. Se utilizaron tres cuestionarios: (a) Cuestionario sociodemografico, (b) Job Strain Scale y (c) Item Short Form Health Survey. Análisis estadístico se realizó mediante asociaciones entre los cuestionarios, análisis de varianza (ANOVA) y de regresión lineal simple y múltiple. Se encontró que 60,8% de los participantes experimentan una alta demanda en el trabajo, 71,8% un alto control sobre la actividad realizada, y 85,5% bajo apoyo social. De los ocho dominios de la calidad de vida relacionada con la salud, los más afectados fueron: dolor (μ = 61,87) y la vitalidad (μ = 62,25). Se concluyó que, además que la presente muestra tenga riesgo intermedio de estrés, la calidad ser comprometida.(AU)

Occupational Stress and Quality of Life in Nursing / Estresse Ocupacional e Qualidade de Vida em Profissionais de Enfermagem / Estres Ocupacional y Calidad de Vida en Profesionales de Enfermería

To reduce the work related to stress and the psychosocial risk is not only an imperative question, but also moral. This epistemological study aims to verify the presence of the occupational stress and quality of life related to health in nursing professionals. We used three questionnaires: (a) Socio Demographic Questionnaire, (b) Job Strain Scale, and (c) Item Short Form Health Survey. Statistical analysis was performed between the questionnaires, analysis of variance (ANOVA) and simple and multiple linear regression. It was found that 60.8% of the participants see the high demand of work, 71.8% high control on the developed activity and 85.5% low social support. Related to eight dominant of quality of life, the most damaged are: pain (µ = 61.87) and vitality (µ = 62.25). It was concluded that although in most sample experiences an intermediary risk situation to stress, the quality of life showed a damaged...

Reduzir o estresse relacionado ao trabalho e os riscos psicossociais não é apenas uma questão imperativa, mas também moral. O objetivo deste estudo epidemiológico foi verificar a presença de estresse ocupacional e avaliar a qualidade de vida relacionada à saúde entre profissionais de enfermagem. Foram utilizados três questionários: (a) Questionário sociodemográfico, (b) Job Strain Scale e (c) Item Short Form Health Survey. Realizou-se análise estatística por associações entre os questionários, análise de variância (ANOVA) e regressão linear simples e múltipla. Verificou-se que 60,8% dos participantes vivenciam uma alta demanda no trabalho, 71,8% um alto controle sobre a atividade desempenhada e 85,5% baixo apoio social. Dos oito domínios da qualidade de vida relacionada à saúde, os mais afetados foram: dor (µ = 61,87) e vitalidade (µ = 62,25). Concluiu-se que, embora a maioria da amostra vivencie um risco intermediário de estresse, a qualidade de vida relacionada à saúde mostrou-se comprometida...

Reducir el estres ocupacional y riesgos psicosociales no es sólo una cuestión imperativa, sino también moral. El objetivo deste estudio epidemiológico es verificar la presencia de estrés laboral y la calidad de vida relacionada con la salud en profesionales de enfermería. Se utilizaron tres cuestionarios: (a) Cuestionario sociodemografico, (b) Job Strain Scale y (c) Item Short Form Health Survey. Análisis estadístico se realizó mediante asociaciones entre los cuestionarios, análisis de varianza (ANOVA) y de regresión lineal simple y múltiple. Se encontró que 60,8% de los participantes experimentan una alta demanda en el trabajo, 71,8% un alto control sobre la actividad realizada, y 85,5% bajo apoyo social. De los ocho dominios de la calidad de vida relacionada con la salud, los más afectados fueron: dolor (μ = 61,87) y la vitalidad (μ = 62,25). Se concluyó que, además que la presente muestra tenga riesgo intermedio de estrés, la calidad ser comprometida...

[Tumor characteristics and five-year survival in breast cancer patients at the National Cancer Institute, Rio de Janeiro, Brazil]. / Características tumorais e sobrevida de cinco anos em pacientes com câncer de mama admitidas no Instituto Nacional de Câncer, Rio de Janeiro, Brasil.

Numerous factors have been studied to establish more secure prognostic criteria in breast cancer patients. This study estimates five-year survival rates and principal prognostic factors related to tumor characteristics in women with invasive breast cancer and submitted to surgery at the National Cancer Institute, Rio de Janeiro, Brazil, from May 1995 to July 1996. Study variables were: lymph node status, tumor size, aggressiveness grade, and presence of estrogen and progesterone receptors. Survival functions were calculated according to the Kaplan-Meyer method. The Cox proportional hazards model was used to evaluate prognostic factors. Five-year survival was 75% for all women and 64% for those with node involvement. Multivariate analyses identified node involvement as the strongest predictor of outcome; a positive estrogen receptor test was associated with a better prognosis. These findings highlight the need for studies to assess new variables to be added to known factors in order to better orient therapy for breast cancer.

Características tumorais e sobrevida de cinco anos em pacientes com câncer de mama admitidas no Instituto Nacional de Câncer, Rio de Janeiro, Brasil / Tumor characteristics and five-year survival in breast cancer patients at the National Cancer Institute, Rio de Janeiro, Brazil

Vários fatores vêm sendo estudados com respeito ao estabelecimento de critérios mais seguros que influenciam o prognóstico de pacientes com câncer de mama. Este estudo teve como objetivo avaliar as taxas de sobrevida de cinco anos e os principais fatores prognósticos relativos ao tumor em mulheres com carcinoma invasivo de mama submetidas à cirurgia no Instituto Nacional de Câncer, Rio de Janeiro, Brasil, entre maio de 1995 e julho de 1996. As variáveis estudadas foram: presença de linfonodo comprometido, tamanho do tumor, grau de agressividade e presença de receptores hormonais para estrogênio e progesterona. As funções de sobrevida foram calculadas por meio do método de Kaplan-Meier. Foi utilizado o modelo de riscos proporcionais de Cox para avaliação dos fatores prognósticos. A taxa de sobrevida em cinco anos foi de 75,0 por cento para todas as pacientes e, de 64,0 por cento para as com metástase para linfonodo. A análise multivariada identificou o comprometimento de linfonodo como o mais forte preditor do desfecho; ter receptor positivo para estrogênio se associou a um melhor prognóstico. Esses resultados mostram a necessidade de condução de estudos que investiguem novos fatores que, combinados aos já conhecidos, possam melhor orientar a conduta terapêutica.