Challenges of Implementing a Human Multi-Tissue Bank in a Public Hospital in the Interior of São Paulo: Under the Light of the Quality Management System.

BACKGROUND: Human multi-tissue banks (HMTB) are important health institutions specialized in the capture, processing, and distribution of human tissues for transplants and research, aiming for safety and quality in the supply of their products, intended for reconstructive surgeries and injury repair, in addition to contributing to the advancement of research developed in regenerative medicine. This study aims to report and share the experience of implementing an HMTB, as well as creating an institution's own quality management system. METHODS: This is a descriptive study, an experience report type, which identifies historical aspects of an HMTB's actions in the 5 years of implementing and operating the service. RESULTS: Initially, a musculoskeletal tissue bank was established in collaboration with the Department of Orthopedics at the State University of Campinas, São Paulo, Brazil, in June 2018. In 2023, through a management model and associated technologies, the banks of human musculoskeletal and ocular tissues at the institution established the HC-UNICAMP Human Multi-tissue Bank. CONCLUSIONS: The implementation of the HMTB with modern and technological infrastructure, associated with the development and operation of the quality management system, allowed us to provide excellent organization of work processes, as well as obtain the necessary health license to begin activities. It is believed that this report can be an important source of information and recommendations applicable to the implementation of other human HMTBs.

Isolation and primary culture of human abdominal aorta smooth muscle cells from brain-dead donors: an experimental model for vascular diseases.

Primary cell cultures are essential tools for elucidating the physiopathological mechanisms of the cardiovascular system. Therefore, a primary culture growth protocol of cardiovascular smooth muscle cells (VSMCs) obtained from human abdominal aortas was standardized. Ten abdominal aorta samples were obtained from patients diagnosed with brain death who were organ and tissue donors with family consent. After surgical ablation to capture the aorta, the aortic tissue was removed, immersed in a Custodiol® solution, and kept between 2 and 8 °C. In the laboratory, in a sterile environment, the tissue was fragmented and incubated in culture plates containing an enriched culture medium (DMEM/G/10% fetal bovine serum, L-glutamine, antibiotics and antifungals) and kept in an oven at 37 °C and 5% CO2. The aorta was removed after 24 h of incubation, and the culture medium was changed every six days for twenty days. Cell growth was confirmed through morphological analysis using an inverted optical microscope (Nikon®) and immunofluorescence for smooth muscle alpha-actin and nuclei. The development of the VSMCs was observed, and from the twelfth day, differentiation, long cytoplasmic projections, and adjacent cell connections occurred. On the twentieth day, the morphology of the VSMCs was confirmed by actin fiber immunofluorescence, which is a typical characteristic of VSMCs. The standardization allowed VSMC growth and the replicability of the in vitro test, providing a protocol that mimics natural physiological environments for a better understanding of the cardiovascular system. Its use is intended for investigation, tissue bioengineering, and pharmacological treatments.

Educational Actions to Raise Student Awareness About the Donation and Transplantation of Human Organs and Tissues.

BACKGROUND: In Brazil, family refusal to donate organs and tissues is the main reason for not performing transplants, making it necessary to implement different educational strategies in diverse populations on this topic. Thus, this study aimed to raise awareness among school-aged adolescents about the method of organ and tissue donation and transplantation. METHODS: This is a descriptive experience report with a quantitative and qualitative approach to educational actions in the school environment, mediated by the action research method, carried out with 936 students aged between 14 and 18 years from public schools in the interior of Sao Paulo, Brazil. These actions were developed according to the themes identified and worked on through the culture circle, using active methodologies. Two semistructured questionnaires were applied, pre- and postinterventions. For analysis, sample normality tests and Student's t test were used (P < .0001). RESULTS: The topics identified were as follows: clarifications on the legislative history of donation and transplants; diagnosis of brain and circulatory death; bioethical aspects of transplants; reflections on mourning, death, and dying; maintenance and notification of the potential donor; types of viable organs and tissues for donation; and the process from collection to transplantation, among others. Comparative analysis showed statistical differences between pre- and postinterventions. CONCLUSIONS: Educational interventions through active methodologies are presented as tools capable of making students aware of organ and tissue donation and transplantation.

Temperature Monitoring of Two Different Thermal Boxes for the Transport of Biological Samples.

BACKGROUND: According to the Resolutions of the Collegiate Board of Directors RDC No. 20/2014, 214/2018, and 707/2022, validation of the temperature of thermal boxes for the transport of biological samples must be based on standardized procedures and tested by the Tissue Banks, guaranteeing safety and quality. Therefore, they can be simulated. Our objective was to monitor and compare the temperature of 2 different coolers while transporting biological samples. METHODS: The following items were packed in each of the 2 different thermal boxes (Box 1: Easy Path; Box 2: Safe Box Polyurethane Vegetal): 6 blood samples (30 mL), one bone tissue sample (200 g), 8 hard ice (Gelox, to keep the temperature <8ºC), and internal and external traceability "Time Stamp" sensors installed for measuring and storing temperature data in real-time. The monitored boxes were placed in the trunk of a bus that traveled an approximate distance of 630 km and were then placed in the trunk of a car, under direct sunlight, until they reached a temperature of 8ºC. RESULTS: In Box 1, the internal temperature was maintained in the range of -7ºC to 8ºC for approximately 26 hours. In Box 2, the internal temperature was maintained in the range of -10ºC to 8ºC for approximately 98 hours and 40 minutes. CONCLUSIONS: We concluded that both coolers, under similar storage conditions, are suitable for transporting biological samples, with Box 2 maintaining the desired temperature for longer.

Models of Quality Management Systems Applied in Specialized Services for the Donation and Transplantation of Human Organs and Tissues.

BACKGROUND: Quality management tools and models are used to improve processes and products, including those related to organ and tissue donation and transplantation protocols. This study aims to map, discuss, and disseminate models/tools of quality management systems applied in health services, specializing in the donation and/or transplantation of human organs and tissues. METHODS: This is an integrative literature review over the last 10 years, operationalized through searches carried out on the PubMed portal and the databases: SciVerse Scopus (SCOPUS), Scielo, Latin American and Caribbean Literature on Health Sciences (LILACS), Nursing Database (BDENF), and the Virtual Health Library (BVS). The organization of search results in the databases and the election of articles compatible with the guiding question and the inclusion and exclusion criteria for this study took place through the online and free application platform Rayyan. RESULTS: Six hundred seventy-eight records were found, of which, after careful analysis, 18 articles were considered relevant to the theme. We identified 17 quality management models and/or tools that emphasize using scientifically proven and/or validated techniques to reduce or eliminate the possibility of risks in the processes that permeate the stages of donation and transplantation of organs and tissues. CONCLUSION: This review brought the possible tools used and published, which can be perceived, reproduced, and improved, through the role of the multidisciplinary team in specialized centers for the donation and transplantation of human organs and tissues, aiming to offer a process of continuous improvement management to deliver better products and services.

The Significance of the Nucleic Acid Test (NAT) to Prevent Viral Contamination in Musculoskeletal Tissue Transplantation.

Objective The present study aims to highlight the significance of the nucleic acid test (NAT) for musculoskeletal tissue donation and to compare the sensitivity of this test on the different available platforms. Method The present study is a retrospective survey in a human tissue bank database and an integrative literature review encompassing the last 10 years. The PubMed portal and the SCOPUS, CINAHL, and Web of Science databases were queried for articles. Results We found no specific studies on the use and sensitivity of NAT in braindead tissue donors. The information presented in the present study consists of specific contents intended for the Brazilian Blood Transfusion Network (Hemorrede Transfusional Nacional, in Portuguese) and internal retrospective data from a tissue bank located at a city in the state of São Paulo, Brazil. Conclusions The NAT is effective in blood samples from living patients. However, since biochemical reactions in braindead patients can be different, specific research, platforms, or both are crucial to tissue banks.

Diálogo sobre doação de órgãos e tecidos: gamification na educação permanente em saúde / A dialog on organ and tissue donation: gamification in permanent education in health / Diálogo sobre donación de órganos y tejidos: la gamificación en educación permanente para la salud

RESUMO Objetivo: sistematizar a experiência da parceria ensino-serviço na elaboração e aplicação de um jogo virtual sobre doação de órgãos e tecidos enquanto proposta de educação permanente em saúde. Método: sistematização de experiência, conduzida por análise documental, envolvendo o processo de elaboração e aplicação de uma prática educativa de gamification por estudantes, professores e profissionais da enfermagem, que desenvolveram a estratégia e aplicaram em um hospital universitário no Sul do Brasil em setembro de 2020. Resultados: ante o contexto sanitário imposto pela covid-19, o jogo virtual composto por 20 questões em torno do processo de doação de órgãos e tecidos para transplantes, enquanto estratégia de educação permanente em saúde, inspirou engajamento e motivação dos profissionais, que mostraram escasso conhecimento acerca da temática e avaliaram a estratégia como positiva. Conclusão: evidenciou-se um caminho potencial a ser replicado em diferentes contextos e temáticas, estimulando e encorajando o processo de cuidado e de educação.

ABSTRACT Objective: to systematize the teaching-service partnership experience in the creation and application of a virtual game on organ and tissue donation as a proposal for permanent education in health. Method: systematization of an experience, conducted through documentary analysis, involving the process to create and apply an educational gamification practice by Nursing students, professors and professionals who developed the strategy and applied it at a university hospital in southern Brazil in September 2020. Results: given the health context imposed by COVID-19, the virtual game consisting of 20 questions about the organ and tissue donation process for transplants, as a strategy for ongoing health education, inspired engagement and motivation among the professionals, who showed limited knowledge about the theme and evaluated the strategy as positive. Conclusion: a potential path to be replicated in different contexts and scenarios was made evident, stimulating and encouraging the care and education processes.

RESUMEN Objetivo: sistematizar la experiencia de la asociación entre enseñanza y servicio en la creación y aplicación de un juego virtual sobre donación de órganos y tejidos en términos de una propuesta de educación permanente para la salud. Método: sistematización de la experiencia, dirigida por análisis documental y abarcando el proceso de elaboración y aplicación de una práctica educativa de gamificación por parte de estudiantes, profesores y profesionales de Enfermería, que desarrollaron la estrategia y la aplicaron en un hospital universitario del sur de Brasil en septiembre de 2020. Resultados: frente al contexto sanitario impuesto por la COVID-19, en términos de estrategia de educación permanente para la salud, el juego virtual compuesto por 20 preguntas sobre el proceso de donación de órganos y tejidos para trasplantes inspiró compromiso y motivación en los profesionales, quienes demostraron escasos conocimientos acerca de la temática y evaluaron la estrategia como positiva. Conclusión: se evidenció un potencial camino a ser replicado en diferentes contextos y temáticas, estimulando y alentando el proceso de la atención y educación en salud.

The Significance of the Nucleic Acid Test (NAT) to Prevent Viral Contamination in Musculoskeletal Tissue Transplantation / A importância da realização do teste de ácidos nucleicos (NAT) para a prevenção de contaminação viral nos transplantes de tecidos musculoesqueléticos

Abstract Objective The present study aims to highlight the significance of the nucleic acid test (NAT) for musculoskeletal tissue donation and to compare the sensitivity of this test on the different available platforms. Method The present study is a retrospective survey in a human tissue bank database and an integrative literature review encompassing the last 10 years. The PubMed portal and the SCOPUS, CINAHL, and Web of Science databases were queried for articles. Results We found no specific studies on the use and sensitivity of NAT in braindead tissue donors. The information presented in the present study consists of specific contents intended for the Brazilian Blood Transfusion Network (Hemorrede Transfusional Nacional, in Portuguese) and internal retrospective data from a tissue bank located at a city in the state of São Paulo, Brazil. Conclusions The NAT is effective in blood samples from living patients. However, since biochemical reactions in braindead patients can be different, specific research, platforms, or both are crucial to tissue banks.

Resumo Objetivo Evidenciar a importância da realização do teste de ácido nucleico (NAT, na sigla em inglês) para doação de tecidos musculoesqueléticos, assim como comparar a sensibilidade deste exame nas diferentes plataformas existentes no mercado. Método Trata-se de um levantamento retrospectivo no banco de dados de um determinado Banco de Tecidos Humanos e de uma revisão integrativa da literatura, operacionalizada nos últimos 10 anos. As buscas de artigos ocorreram no portal PubMed e nas bases de dados SCOPUS, CINAHL e Web of Science. Resultados Não foram encontrados estudos específicos sobre a utilização e a sensibilidade do exame NAT em pacientes doadores de tecidos com morte encefálica (ME), sendo as informações apresentadas no presente estudo conteúdos específicos destinados à Hemorrede Transfusional Nacional e aos dados retrospectivos internos de um Banco de Tecidos do interior do estado de São Paulo, Brasil. Conclusões O exame NAT se apresenta efetivo em amostras de sangue de pacientes vivos. Porém, reações bioquímicas em pacientes com condições de ME podem se apresentar de formas diferenciadas, tornando-se indispensáveis a realização de pesquisas específicas e/ou a indicação de plataformas aos Bancos de Tecidos.

Assessment of physicians' knowledge about brain death and organ donation and associated factors.

Precocity and assertiveness when diagnosing brain death are essential for identifying potential donors. To assess the knowledge of physicians about brain death and organ donation, cross-sectional web-based survey was carried out with physicians from different specialties. The knowledge about brain death and organ donation was assessed by a questionnaire with 12 multiple-choice or multiple-answer questions (possible range from 0 to 12). The nonparametric Mann-Whitney and Kruskal-Wallis tests were performed to verify the association between the physicians' knowledge and others variables. The project was approved by the Research Ethics Committee of the Hospital das Clínicas, Faculty of Medicine of Ribeirão Preto, University of São Paulo, under number 4.022.657, and all patients agreed to participate and provided free prior-informed consent. Three hundred sixty physicians were included in this study, most of them have postgraduate (55%) and 59.2% were intensive care physicians. The median of responses was 5 (obtained range from 0 to 10). The participants were classified in 2 groups: with satisfactory knowledge (scores above 5) or without satisfactory knowledge (scores equal/below 5). There was better performance among participants who: completed graduation between 6 and 10 years (P < .012); were intensive care physicians (P < .002); had participated in training courses (P < .001); and those who had worked in intensive care unit (ICU) from 6 to 10 years (P < .023); had performed over 10 brain death protocols (P < .001), and felt safe to talk to family members about brain death (P < .001). The results showed that the participants had low knowledge about diagnosis of brain death and organ donation protocols despite the majority working in ICUs. Be an intensive care physician, had large time experience in ICU, and had performed brain death protocols were associated with unsatisfactory knowledge concerning the subject.

"Programa universitário por um dia": ação de responsabilidade social e inclusão / "Programa universitario por un día": acción de responsabilidad social e inclusión / "University for a day program": action of social responsibility and inclusion

RESUMO Introdução: ações de aproximação de alunos de ensino médio público para universidades públicas são essenciais para facilitar a transição acadêmica e incentivar o ingresso e a permanência estudantil. Tais ações ainda apresentam aos alunos visitantes as possibilidades inerentes ao ambiente acadêmico qualificado e propiciam oportunidades e novo pensar sobre seu futuro pessoal e profissional. Objetivo: relatar as atividades do Programa Universitário por um Dia (EERP-USP), que se caracterizam como ações de responsabilidade social e de inclusão universitária. Método: estudo descritivo, tipo relato de experiência, de ações de extensão universitária para os alunos do ensino médio público, obtido a partir da análise de um banco de dados preexistente. Resultados: no período de março a novembro de 2019, o Programa Universitário por um Dia recebeu 426 alunos do ensino médio de escolas públicas de Ribeirão Preto-SP e região, sendo a maioria do sexo feminino (64%) e com idade média de 17 anos. Do total de participantes do projeto, seis obtiveram aprovação no processo seletivo da Fundação Universitária para o Vestibular (FUVEST) para ingresso na Universidade de São Paulo. Conclusão: os resultados revelam o caráter social de inclusão com impacto positivo como ação de extensão universitária.

RESUMEN Introducción: las acciones para acercar a los estudiantes de secundaria pública a las universidades públicas son fundamentales para facilitar la transición académica y fomentar la matrícula y permanencia de los estudiantes. Tales acciones aún presentan a los estudiantes visitantes las posibilidades inherentes al entorno académico calificado y brindan oportunidades y nuevas formas de pensar sobre su futuro personal y profesional. Objetivo: dar a conocer las actividades del Programa Universitario por un Día (EERP-USP), las cuales se caracterizan como acciones de responsabilidad social e inclusión universitaria. Método: estudio descriptivo, tipo de relato de experiencia, de acciones de extensión universitaria para estudiantes de secundaria pública, obtenido a partir del análisis de una base de datos preexistente. Resultados: en el período de marzo a noviembre de 2019, el Programa Universitario por un Día recibió a 426 estudiantes de secundaria de escuelas públicas de Ribeirão Preto-SP y región, la mayoría mujeres (64%) y con una edad promedio de 17 años. Del total de participantes en el proyecto, seis obtuvieron la aprobación en el proceso de selección de la Fundación Universitaria del Vestibular (FUVEST) para el ingreso a la Universidad de São Paulo. Conclusión: los resultados revelan el carácter social de la inclusión con impacto positivo como acción de extensión universitaria.

ABSTRACT Introduction: actions to bring public high school students closer to public universities are essential to facilitate the academic transition and encourage student enrollment and permanence. Such actions still present visiting students with the possibilities inherent in the qualified academic environment and provide opportunities and new thinking about their personal and professional future. Objective: to report the activities of the University for a Day Program (EERP-USP), which are characterized as actions of social responsibility and university inclusion. Method: descriptive study, type of experience report, of university extension actions for public high school students, obtained from the analysis of a pre-existing database. Results: in the period from March to November 2019, the University for a Day Program received 426 high school students from public schools in Ribeirão Preto-SP and region, the majority being female (64%) and with an average age of 17 years old. Of the total number of project participants, six obtained approvals in the selection process of the Fundação Universitária para o Vestibular (FUVEST) for admission to the University of São Paulo. Conclusion: the results reveal the social character of inclusion with a positive impact as a university extension action.

Vigilância em saúde do trabalhador: o suicídio relacionado ao trabalho / Worker's health surveillance: work-related suicide / Vigilancia de la salud del trabajador: suicidio relacionado con el trabajo

OBJETIVO: investigar as possíveis relações que permeiam as temáticas da ideação suicida e do suicídio associadas aos aspectos internos e externos do trabalho. MÉTODO: ao adotar uma abordagem qualitativa e perspectiva descritiva, foi realizada uma revisão integrativa da literatura do período de 2009-2019 operacionalizada por buscas nas bases de dados PubMed, SCOPUS, Web of Science, LILACS, BDENF e BVS. RESULTADOS: partiu-se da questão norteadora "Quais são as relações existentes entre o trabalhador, vítima de suicídio, e o ambiente de trabalho em que ele está inserido?" e de descritores, encontrando-se 481 registros, dos quais dez estudos foram selecionados. Separados por dois eixos de análise (aspectos internos e externos), os estudos descreveram dez relações predominantes entre o suicídio e o trabalho, sendo elas: depressão (19,3%); assédio moral/bullying (16,1%); ausência de lazer (12,9%); estresse (9,6%); sobrecarga profissional (9,6%); acidentes no trabalho (9,6%); Síndrome de Burnout (6,4%); isolamento social (6,4%); conflitos entre a família e o trabalho (6,4%) e falta de autonomia no trabalho (3,2%). CONCLUSÃO: os resultados demonstram a relação existente entre o trabalho e o suicídio. Como a Enfermagem é uma potencial promotora no cuidado humanizado, destaca-se a necessidade de vigilância e promoção da saúde para os trabalhadores nesses ambientes.

OBJECTIVE: to investigate the possible links between the themes of suicide ideation and suicide associated with the internal and external aspects of the work. METHOD: by adopting a qualitative approach and descriptive perspective, an integrative review of the literature of the 2009-2019 period was carried out by searching the PubMed, SCOPUS, Web of Science, LILACS, BDENF and VHL databases. RESULTS: The guiding question "What are the relations between the worker, victim of suicide, and the work environment in which he is inserted?" and descriptors, with 481 records, of which ten studies, were selected. Separated by two axes of analysis (internal and external aspects), the studies described ten predominant relationships between suicide and work, being: depression (19.3%); moral harassment/bullying (16.1%); absence of leisure (12.9%); stress (9.6%); professional overload (9.6%); accidents at work (9.6%); Burnout syndrome (6.4%); social isolation (6.4%); conflicts between family and work (6.4%) and lack of autonomy at work (3.2%). CONCLUSION: the results show the relationship between work and suicide. As nursing is a potential promoter of humanized care, the need for vigilance and health promotion for workers in these environments is highlighted.

OBJETIVO: investigar las posibles relaciones que impregnan los temas de ideación suicida y suicidio, asociados con aspectos internos y externos del trabajo. MÉTODO: adoptando un enfoque cualitativo y una perspectiva descriptiva, se realizó una revisión integradora de la literatura para el período 2009-2019 mediante la búsqueda en las bases de datos PubMed, SCOPUS, Web of Science, LILACS, BDENF y BVS. RESULTADOS: Basado en la pregunta guía: "¿Cuáles son las relaciones que existen entre el trabajador, una víctima de suicidio y el ambiente de trabajo en el que está insertado?" y descriptores, se encontraron 481 registros, de los cuales se seleccionaron 10 estudios. Separados por dos ejes de análisis (aspectos internos y externos), los estudios describieron 10 relaciones predominantes entre el suicidio y el trabajo, a saber: depresión (19.3%), bullying / bullying (16.1%), ausencia de ocio (12.9%), estrés (9.6%), sobrecarga profesional (9.6%), accidentes laborales (9.6%), síndrome de Burnout (6.4%), aislamiento social (6, 4%), conflictos entre familia y trabajo (6,4%) y falta de autonomía en el trabajo (3,2%). CONCLUSIÓN: los resultados demuestran una relación entre el trabajo y el suicidio. Como la enfermería es un potencial promotor de la atención humanizada, se destaca la necesidad de vigilancia y promoción de la salud de los trabajadores en estos entornos.

Mapeamento das estratégias educativas para estudantes do ensino básico quanto ao processo de doação e transplante de órgãos e tecidos humanos: revisão integrativa / Mapping of educational strategies for elementary school students regarding the process of donation and transplantation of human organs and tissue: an integrative review

Objetivou-se mapear as estratégias educativas utilizadas para estudantes do ensino básico, quanto ao processo de doação e transplante de órgãos e tecidos humanos. Realizou-se uma metassíntese, por meio de uma revisão integrativa da literatura de estudos publicados entre 1990 a 2018, veiculados no portal da Public Medical e nas bases de dados: Scopus, Cumulative Index to Nursing & Allied Health Literature, Embase Subject Headings, Web of Science, Literatura Latino-Americana e do Caribe em Ciências da Saúde, Base de Dados em Enfermagem e Biblioteca Virtual em Saúde do Adolescente. Resultando em 1.331 registros, que após levantamento efetivo, resultaram em 14 artigos selecionados, os quais foram submetidos à leitura criteriosa quanto à metodologia utilizada, ferramentas educativas aplicadas, resultados obtidos e conclusões. Processaram-se sínteses, construídas da análise temática dos resultados, o que permitiu identificar 11 intervenções educativas, representadas, por: dinâmica em grupo (25,0%); palestras com profissionais da área (16,6%); vídeo educativo (13,8%); palestras com candidatos, receptores e familiares que doaram os órgãos para transplante (11,1%); Website interativo (8,3%); Folder explicativo, peça de teatro e intervenção educativa realizada pelos professores em sala de aula, cada um apresenta 5,5% das ferramentas educativas; literatura sobre a temática (fábula), criação de desenhos e premiações como incentivo, representam 2,7%, individualmente. Os estudos demonstram a importância da aplicação de diferentes estratégias educativas e discussões realizadas em sala de aula, quanto ao processo de doação e transplante de órgãos e tecidos humanos, sendo imprescindível a participação dos escolares no processo de construção do conhecimento acerca do tema.

This study aimed at mapping the educational strategies used for students of elementary education regarding the process of donation and transplantation of human organs and tissue. Qualitative meta-synthesis was carried out through an integrative literature review of studies published between 1990 and 2018 published on the Public Medical portal and on the following databases: Scopus; Cumulative Index to Nursing & Allied Health Literature; Embase Subject Headings; Web of Science; Latin American and Caribbean Literature on Health Sciences; Nursing Database and Virtual Library on Adolescent Health. This search resulted in 1,331 records, which after effective survey, resulted in 14 selected articles. Those selected articles were then subjected to thorough reading as to the methodology used, educational tools applied, results obtained and conclusions. Syntheses were processed, constructed from thematic analysis of the results, which allowed the identification of 11 educational interventions, represented by group dynamics (25.0%); lectures with professionals in the area (16.6%); educational video (13.8%); lectures with candidates, recipients and family members who donated the organs for transplant (11.1%); interactive website (8.3%); explanatory folder, play and educational intervention carried out by teachers in the classroom, each one representing 5.5% of the educational tools; literature on the theme (fable), creation of drawings and awards as an incentive, represent 2.7%, individually. The studies demonstrate the importance of the active participation of the students in the teaching-learning process, as well as the propagation, for their families, of the discussions held in the classroom.

Implementation and certification of ISO 9001:2015 seal in human tissue bank HCFMRP-USP.

The Quality Management System has been a management technology applied to guarantee the quality of processes and products of a given organization. Thus, ISO 9001:2015 certification assists organizations that want to develop, implement, maintain, and improve a quality management system to enable process improvements and assessments to meet the needs of its customers. This experience report addresses the implementation and certification of the ISO 9001:2015 quality management seal at the Human Tissue Bank of the Ribeirão Preto Clinical Hospital (HCRP) at the University of São Paulo (USP) at Ribeirão Preto Medical School (FMRP)-Brazil. In 2018, the Human Tissue Bank, in partnership with HCRP, received consultancies from PRIMEMODE. The consulting consisted of visits that elucidated the processes to the employees of the Tissue Bank, enabling them to clarify the applicability of all items of the standard. In March 2019, the Tissue Bank received the audit visit and was certified with the ISO 9001:2015 Seal by the Carlos Alberto Vanzolini Foundation. The Tissue Bank aims to provide human tissues for transplantation and research from organ donors. It has a complex physical structure within the required health and legal standards. Also, now it has a quality management seal. The certification guarantees the process organization and the high quality standard of the supplied tissues.

A comunicação de más notícias em saúde: aproximações com a abordagem centrada na pessoa / The communication of bad news in health: approximations with the person-centered approach / La comunicación de malas noticias en salud: aproximaciones con el enfoque centrado en la persona

A forma de comunicar más notícias impacta diretamente na adesão ao tratamento por parte do paciente. Frente às dificuldades em comunicar más notícias, foram elaborados protocolos que auxiliassem os profissionais de saúde nesses momentos de maior vulnerabilidade. Este estudo teórico teve por objetivo aproximar as atitudes/condições facilitadoras descritas originalmente por Carl Rogers no contexto psicoterápico a três protocolos de comunicação de más notícias frequentemente relatados na literatura da área: SPIKES, CLASS e P-A-CI-E-N-T-E. Diversas etapas desses protocolos emergem como ações que se aproximam ora da congruência/autenticidade, ora da consideração positiva incondicional ou da empatia, tornando lícito afirmar que a comunicação de más notícias também possibilita o estabelecimento de uma relação de ajuda. Conclui-se que esta associação entre os protocolos e as três atitudes elaboradas por Rogers pode contribuir para a formação acadêmica dos profissionais de saúde e também no estabelecimento de um melhor vínculo entre médico, paciente e familiares.

The way of communicating bad news directly impacts in the treatment adherence of the patient. In light of the difficulties of communicating bad news, protocols were developed to assist the health care professionals in these moments of major vulnerability. This theoretical study aimed to approach the core conditions/attitudes described originally by Carl Rogers in the psychotherapic context to three bad news communication protocols reported from the field specific literature: SPIKES, CLASS and P-A-C-I-E-N-T-E. Diverse steps of these protocols emerge as actions that approximate one moment to congruency/authenticity and another moment to unconditional positive consideration or empathy. It makes licit to affirm that the communication of bad news also approaches to the establishment of a help relation. It can be concluded that this approach between the protocols and the three attitudes developed by Rogers can contribute to the academic training of the health care professionals and also to the better connection between doctor, patient and family.

La forma de comunicar malas noticias impacta directamente en la adhesión al tratamiento por parte del paciente. Frente a las dificultades en comunicar malas noticias, se elaboraron protocolos que auxiliar a los profesionales de salud en esos momentos de mayor vulnerabilidad. Este estudio teórico tuvo por objetivo aproximar las actitudes / condiciones facilitadoras descritas originalmente por Carl Rogers en el contexto psicoterápico con tres protocolos de comunicación de malas noticias a menudo relatados en la literatura del área: SPIKES, CLASS y P-A-C-I-E-N-T-E. Diversas etapas de esos protocolos emergen como acciones que se aproximan a la congruencia / autenticidad, ya la consideración positiva incondicional o de la empatía, haciendo lícito afirmar que la comunicación de malas noticias también posibilita el establecimiento de una relación de ayuda. Se concluye que esta asociación entre los protocolos y las tres actitudes elaboradas por Rogers puede contribuir a la formación académica de los profesionales de la salud y también en el establecimiento de un mejor vínculo entre médico, paciente y familiares.

Perspectives toward brain death diagnosis and management of the potential organ donor.

BACKGROUND: Organ donation and transplantation represent one of the most important scientific advances over the last decades. Due to the complexity of these procedures and related ethical-legal aspects, however, there are a lot of doubts and uncertainty about the brain death diagnosis and the maintenance of potential organ donor. AIM: To identify and discuss the different meanings and experiences of registered nurses and physicians from an adult intensive care unit in relation to the diagnosis of brain death and the maintenance of potential organ donors for transplantation purposes. STUDY DESIGN: Participants were registered nurses and physicians from an adult intensive care unit at a University Hospital from Brazil. Data were collected through semi-structured interviews and analyzed using content analysis. ETHICAL CONSIDERATIONS: This study was approved by the University of São Paulo at Ribeirão Preto College of Nursing Research Ethics Committee. RESULTS: Two main categories emerged from the analysis: (1) brain death diagnosis and its implications and (2) maintenance of the potential organ donor and its repercussion in the donation-transplantation process. Six subcategories were also identified: (1.1) understanding the brain death diagnosis as a tool to aid decision-making; (1.2) diagnosis as guarantee of rights; (1.3) difficulties encountered to establish the diagnosis; (1.4) clinical criteria adopted in Brazil and related ethical-legal aspects; (2.1) specificities of care to the brain dead person and outcomes; and (2.2) nurse's duties toward the brain dead person. CONCLUSION: Although the brain death diagnosis is scientifically and legally defined in Brazil and the maintenance of the potential organ donor for transplantation purposes has been addressed during the last years, there are still some doubts about the subject, as its understanding varies according to the personal beliefs, culture, and educational background of individuals, including those who work in this scenario.

Estratégias educativas utilizadas na educação básica para conscientização dos alunos sobre a temática doação/transplante de órgãos e tecidos humanos: revisão integrativa da literatura / Educational strategies used in basic education to raise students' awareness about the donation / transplantation of human organs and tissues: integrative literature review

A negativa das famílias entrevistadas para autorizar a doação de órgãos e/ou tecidos de seus familiares recém-falecidos chega a 43% no Brasil, segundo o Registro Brasileiro de Transplantes de 2017. Dado preocupante diante dos 32.958 pacientes que aguardam em fila, por um órgão ou tecido. Diante desta realidade, levanta-se a necessidade da conscientização da população, por meio de estratégias educativas que possam favorecer o diálogo sobre a temática, resultando na aceitação no e aumento do número de doações. A literatura sugere que se deve considerar a possibilidade de incluir esse conteúdo no decorrer da formação escolar da criança e do adolescente, uma vez que esses são propagadores naturais na sociedade. O presente estudo teve por objetivo mapear as estratégias educativas utilizadas para a conscientização de escolares da educação básica de crianças e adolescentes, do ensino fundamental e médio, sobre a temática da Doação/Transplante de Órgãos e Tecidos Humanos. Trata-se de uma revisão integrativa da literatura sobre o tema central, operacionalizada por meio de buscas de artigos com resultados de estudos primários publicados entre 1990 e 2017 no portal PubMed e nas bases de dados SCOPUS, CINAHL, EMBASE, Web of Science, LILACS, BDENF e ADOLEC. As buscas foram guiadas pela pergunta: "Quais são as estratégias educativas utilizadas para conscientização de escolares do ensino básico sobre a temática doação e transplante de órgãos e tecidos?". Foram seguidas as seis etapas preconizadas para a elaboração da revisão integrativa. Foram encontrados 1.331 registros, dos quais foram considerados pertinentes à temática, 14 artigos. Submetidos à leitura criteriosa, os estudos selecionados descreveram 11 intervenções educativas distintas, a saber: dinâmica de grupo, vídeo educativo, palestra com profissionais da área, palestra com candidatos, receptores e familiares que doaram os órgãos para transplante, website interativo, folder explicativo, peça de teatro, intervenção educativa realizada pelos professores em sala de aula, literatura sobre a temática (fábulas), criação de desenhos e premiações como incentivo. Desse conjunto heterogêneo de intervenções observou-se uma repetição seriada (aleatória) de 36 vezes, dentro de salas de aulas da Educação Básica de sete países diferentes. Os resultados sugerem os benefícios de se investir na educação do grupo investigado, criando e executando ferramentas compatíveis e compreensíveis por meio do diálogo, no intuito de sensibilizar, familiarizar e conscientizar os escolares do ensino básico acerca da temática, de modo a favorecer a ampliação das conversações na sociedade e a eventual tomada de decisão futura em aceitar, ou não, a doação de órgãos e/ou tecidos para transplante

The refusal of the families interviewed to authorize the donation of organs and / or tissues from their newly deceased relatives reaches 43% in Brazil, according to the Brazilian Transplantation Registry of 2017. A worrisome data, facing 32,958 patients who are waiting in line for one organ or tissue. Faced with this reality, there is a need to raise awareness of the population, through educational strategies that may favor dialogue on the subject, resulting in the acceptance and increase in the number of donations. The literature suggests that consideration should be given to include this content in the course of the school education of the child and the adolescent, since they are natural propagators in society. The objective of this study was to map the educational strategies used to raise awareness among elementary and middle school students of basic education: children and adolescents, on the subject of human organ and tissue transplantation. It is an integrative review of the literature on the central theme, operationalized through search of articles with results of research published between 1990 and 2017, in the PubMed portal and in the databases SCOPUS, CINAHL, EMBASE, Web of Science, LILACS, BDENF and ADOLEC. The searches were guided by the question: "What are the educational strategies used to raise awareness among elementary school students about the issue of organ and tissue donation and transplantation?" The six stages recommended for the elaboration of the integrative review were followed. A total of 1,331 records were found, of which 14 articles were considered pertinent to the topic. The selected studies described 11 different educational interventions, namely: group dynamics, educational video, lecture with professionals from the area, lecture with candidates, recipients and family members who donated organs for transplantation, interactive website, explanatory folder, play, educational intervention by teachers in the classroom, literature on the subject (fables), creation of drawings and awards as an incentive. From this heterogeneous set of interventions we observed a serial repetition (random) of 36 times, inside Basic Education classrooms of seven different countries. The results suggest the benefits of investing in the education of the group investigated, creating and executing compatible and understandable tools through the dialogue, in order to sensitize, familiarize and raise awareness among elementary school students about the subject, with the objective of promoting the expansion of conversations in society and to facilitate the eventual decision-making in the future to accept or not to donate organs and / or tissues for transplantation