La ausencia familiar en la atención de urgencia conlleva sufrimiento en pacientes y familiares / The absence of the family in emergency care contributes to suffering in patients and family members

OBJETIVO: Conocer el significado que atribuyen pacientes adultos y sus familias a la ausencia familiar durante la atención de urgencia. MÉTODO: Estudio cualitativo siguiendo la propuesta de la teoría fundamentada con recogida de datos en 2 unidades públicas de urgencias hospitalarias, localizadas en el sur de Brasil. Se llevaron a cabo 15 entrevistas con pacientes y 15 entrevistas con familiares durante los meses de octubre de 2016 a febrero de 2017. Los datos fueron analizados siguiendo el método comparativo contante. RESULTADOS: Los pacientes y familiares vivencian la ausencia familiar en la atención de urgencia como un proceso de sufrimiento causado por la separación del binomio familia-paciente; por la falta de entendimiento acerca de los motivos que justifican la exclusión familiar, y por enfrentarse a la situación con resignación. CONCLUSIÓN: La urgencia per se conlleva un sufrimiento en el paciente y sus familiares; este sufrimiento se intensifica cuando la familia es apartada y no puede acompañar al paciente durante la atención de urgencia. En vista de estos resultados, es necesario desarrollar estrategias y políticas sanitarias que contribuyan a la atención integral de pacientes y familias en unidades de urgencias hospitalarias

AIM: To understand what the absence of the family during emergency care means to adult patients and their families to. METHOD: A grounded theory study was conducted in two emergency units of two public hospitals in southern Brazil. From October 2016 to February 2017, 15 interviews with patients and 15 with family members were carried out. The data were analyzed following the comparative method. RESULTS: The patients and families experienced the absence of the family in emergency care as a process of suffering caused by the separation of patient and family; they did not understand the reasons for family exclusion, and were resigned to the situation. CONCLUSIÓN: Urgent care per se entails suffering in patients and their relatives; this suffering intensifies when the family is separated and cannot accompany the patient during emergency care. These results show the need to develop health strategies and policies that contribute to the comprehensive care of patients and families in hospital emergency units

The absence of the family in emergency care contributes to suffering in patients and family members. / La ausencia familiar en la atención de urgencia conlleva sufrimiento en pacientes y familiares.

AIM: To understand what the absence of the family during emergency care means to adult patients and their families to. METHOD: A grounded theory study was conducted in two emergency units of two public hospitals in southern Brazil. From October 2016 to February 2017, 15 interviews with patients and 15 with family members were carried out. The data were analyzed following the comparative method. RESULTS: The patients and families experienced the absence of the family in emergency care as a process of suffering caused by the separation of patient and family; they did not understand the reasons for family exclusion, and were resigned to the situation. CONCLUSION: Urgent care per se entails suffering in patients and their relatives; this suffering intensifies when the family is separated and cannot accompany the patient during emergency care. These results show the need to develop health strategies and policies that contribute to the comprehensive care of patients and families in hospital emergency units.

Violência intrafamiliar: caminhos para o enfrentamento na saúde pública / Family violence: pathways for coping in public health

A violência é um assunto relevante na área da saúde, pois suas consequências causam grande impacto na integridade do indivíduo, afetando seu bem-estar físico, moral, espiritual e mental. A violência intrafamiliar, por sua vez, representa um importante desafio aos profissionais da saúde pública, que se sentem inseguros e despreparados para manejar essa situação. Frente a isso, o presente estudo se propôs a identificar como os serviços de saúde abordam as situações de violência intrafamiliar no cotidiano da prática. Tratase de uma pesquisa do tipo bibliográfica, realizada nos últimos cinco anos. Foram consultadas duas bases de dados, Lilacs e Scielo, e utilizados os descritores "violência" e "serviços de saúde". Os 12 artigos que compuseram a amostra atenderam aos critérios de inclusão previamente estabelecidos. Constatou-se que a maioria dos autores optou pelo delineamento qualitativo e escolheu a entrevista para realizar a coleta de dados. Grande parte dos estudos foi desenvolvida na região Sudeste do País, tendo a amostra composta por profissionais de saúde, usuários e profissionais de outras áreas. Observou-se que a violência intrafamiliar é comumente relacionada à violência contra a mulher e a perspectiva diagnóstica do problema é amplamente discutida, apesar da escassez de relatos de experiência. Nota-se que os profissionais de saúde se sentem pouco habilitados para lidar com a questão e têm dificuldade para reconhecê-la como um problema de interesse epidemiológico e social, o que reflete no baixo número de notificações e impede a visualização dos efeitos desse fenômeno sobre os indivíduos, famílias e comunidades.

Violence is an important issue in health care because it takes toward deep impacts on the personal integrity, affecting physical, moral, spiritual and mental well-being. Family Violence, in turn, represents an important challenge for public healthcare professionals who are insecure and unprepared to manage this situation. Faced to it, this study was performed to identify how health services deal with these issues on its routine. It is a data literature survey performed in the past five years. Two databases, Lilacs and Scielo were surveyed and the keywords "violence" and "health services" were researched. The sampled 12 articles matched the inclusion criteria previously established. We found that most authors used a qualitative design and choose interview procedures as data collection. Most of the studies were developed in the Southeast of the country and the sample data was composed by healthcare professionals, patients and professionals from other areas. We observed that domestic violence is commonly related to violence against women and the diagnostic perspective of this problem is widely discussed, despite the lack of experience reports. During the study we noticed that healthcare professionals feel themselves poorly qualified to deal with this problem and does not recognize it as a trouble for social and epidemiological interest. It reflects the low number of violence cases notifications and blocks the view of the effects of this phenomenon on individuals, families and communities.

Diethylzinc-mediated one-step stereoselective synthesis of alpha-fluoroacrylates from aldehydes and ketones. Two different pathways depending on the carbonyl partner.

A efficient methodology allowing the one-pot stereoselective synthesis of alpha-fluoroacrylates, based on the addition of ethyl dibromofluoroacetate to a carbonyl derivative using diethylzinc as organometallic mediator, is described. Two different pathways have been identified depending on the involved carbonyl partner. In the case of aldehydes, an E2-type mechanism has been identified, whereas ketones go through an E1cb-type mechanism.

[The experience of institutionalized children]. / Conhecendo a experiência de crianças institucionalizadas.

The aim of this study was to know the experience of the institutionalized child and was guided by the theoretical referential of the "Symbolic Interactionism" and by the methodological referential of the "Grounded Theory". The data had been collected in two stages: the first one understood group activities and second stage consisted of personal interviews. The results had shown that the institutionalization occurred for abandonment and reject of the parents or for legal decision as a measure of child protection, having as context the poverty of its family. The child's experience is conflicting in relation to being institutionalized, because while he/she perceives the necessity of material gain, they miss their family, their home, their friends, and simply life outside.

Diastereoselective protonation of lactam enolates derived from (R)-phenylglycinol. A novel asymmetric route to 4-phenyl-1,2,3, 4-tetrahydroisoquinolines.

Highly diastereoselective protonation of chiral lactam enolates of 4-substituted-1,4-dihydroisoquinolin-3-ones is reported. Protonation and alkylation processes of these lactam enolates derived from phenylglycinol occur with opposite diastereofacial selectivity. This diastereoselective protonation has been applied to the asymmetric synthesis of (4S)-N-methyl-4-phenyl-1,2,3,4-tetrahydroisoquinoline 9 obtained in up to 97% ee.

[Seeking to guarantee the rights of children and adolescents: our experience]. / Buscando garantir os direitos da criança e do adolescente: relato de experiência.

This report discusses the nursing activities developed by a group of professionals within the family context. Children and their families maintain relationships determined historically by the social context within which they live. According to the National Survey by Address Sampling, 53.5% of Brazilian children and adolescents live in families whose monthly income per capita is under one half of a minimum salary. The consequences of the country's recessive economy have a serious effect upon the entire population, potentially interfering in the family's health and, thus, in that of children and adolescents. When working with families we must consider what the family believes to be its function, since, despite the fact that the Children's and Adolescent's Statute gives the legal definition of family obligations, it is the family's beliefs that actually direct or define the role it plays in caring for and protecting each of its members. The "Support Couples" project, directed by this group, takes into consideration a family's particular characteristics so that it can offer support to the family to help it meet those legal requirements related to child and adolescent care. The objective of this work is to divulge the Project itself, and to place professional nurses in activities that are directly related to the promotion and maintenance of children's and adolescent's rights as citizens inserted into a family and social context.

[The importance of symbolic interactionism in nursing practice]. / A importância do interacionismo simbólico na prática de enfermagem.

The nurse should combine, in their daily practice, technical abilities with a profound comprehension of the main object oh their work, the human being. Symbolic Interactionism is an approach which enables the nursery professional to understand patients by the meaning they value their living experiences. The use of qualitative methods in nursery research is essential because it studies the humans beings and their relationship with the environment, allowing the understanding of the living experiences. These kind of approaches should be even more applied in nursery practice as they open new ways for professional knowledge and enrich practical skills.

[Nursing in a pediatric unit. Proposal for systematization]. / Assistência de enfermagem em unidade pediátrica: uma proposta de início de sistematização.

The present work reports an initial process of nursing assistance systematization developed in a Pediatric Unit of a medium size hospital in São Carlos-SP, considering the actual human resources and the type of approach adopted by the institution on the assistance given to the hospitalized child. A Routine Manual was elaborated based on the literature and with the staff participation, and after that, a training was realized with these employees, starting from routines previously sketched, using groupal dynamics that looked forward to rescue the knowledge that they already had about the themes. The work considered the employees opinion about their participation in the systematization process.

[Ethnographic research: the beginning of understanding]. / Pesquisa etnográfica: iniciando sua compreensão.

This study aimed at presenting a number of theoretical considerations related to ethnographic investigation viewing the disclosing of that type of nursing research. This study shows the definitions provided by various authors in addition to the methodology aspects regarding this type of approach.