Reaction with Water Vapor Defines Surface Reconstruction and Membranolytic Activity of Quartz Milled in Different Molecular Environments.

Industrial processing of quartz (SiO2 ) and quartz-containing materials produces toxic dust. Fracturing quartz crystals opens the Si-O bond and produces highly reactive surface species which mainly react with molecules like water and oxygen. This surface-reconstruction process forms silanol (Si-OH) on the quartz surface, which can damage biological membranes under specific configurations. To comprehend the impact of the quartz surface restructuring on membranolytic activity, the formation and reactivity of quartz radicals produced in four distinct molecular environments with electron paramagnetic resonance (EPR) spectroscopy are evaluated and their membranolytic activity is measured through in vitro hemolysis test. The four molecular environments are formulated with and without molecular water vapor and oxygen (±H2 O/±O2 ). The absence of water favored the formation of surface radical species. In water-rich environments, diamagnetic species prevailed due to radical recombination. Quartz milled in -H2 O/±O2 acquired membranolytic activity when exposed to water vapor, unlike quartz milled in +H2 O/±O2 . After being stabilized by reaction with water vapor, the membranolytic activity of quartz is maintained over time. It is demonstrated that the type and the reactivity of radical sites on quartz are modulated by the outer molecular environment, ultimately determining the biological activity of milled quartz dust.

Eco-friendly PVA-LYS fibers for gold nanoparticle recovery from water and their catalytic performance.

In this work, we grafted lysine on PVA electrospun fibers, using a green preparation technique. The resulting fiber mats were proposed for gold nanoparticles (AuNPs) removal from water. The efficiency of three fibers with different lysine amounts (10, 20, and 30%) was investigated. The incorporation of amino groups in PVA fibers was firstly proved by FTIR, SEM, and elemental analysis, confirming the presence of lysine. Among the three different fibers, PVA-LYS 30% has shown the best removal efficiency, reaching 65%, at pH equal to 5. Adsorption isotherms were studied and showed that the Langmuir model is the best model fitting our experimental results, with a maximum adsorption capacity of 20.1 mg g-1. Metal-ligand interactions and electrostatic attraction between protonated amino groups of lysine on the fibers and negatively charged, citrate capped, AuNPs are the main proposed mechanisms for AuNP adsorption on the fibers. Sustainability of AuNPs adsorbed on these fibers has been checked through their reuse as catalyst for the reduction of 4-nitrophenol to 4-aminophenol. The process was completed within 60 min, and their reusability showed more than 99% efficiency after 5 reduction cycles. Our results prove that green PVA-LYS fibers can extract nanoparticles from water, as low cost-effective and eco-friendly adsorbent, and contribute to the promotion of a circular economy approach, through their reuse as catalyst in the reduction of pollutants.

Mercury and Organic Pollutants Removal from Aqueous Solutions by Heterogeneous Photocatalysis with ZnO-Based Materials.

The removal of four Contaminants of Emerging Concern, namely bisphenol A, sulfamethoxazole, diclofenac and benzotriazole; two odorous compounds, geosmin and 2-methylisoborneol, frequently detected in recirculating aquaculture systems; and Hg(II) was investigated using ZnO-based materials doped or co-doped with Ce and Cu under simulated solar radiation. Photocatalysts were synthetized via a hydrothermal route and their efficiency was assessed by changing some operational parameters in different water matrices of increasing complexity. The mixture of contaminants was successfully degraded in just 1 h, while the complete mineralization was achieved in a few hours; experiments performed in an actual aquaculture water confirmed the efficiency and broad versatility of the synthesized materials.

Surface species in direct liquid phase synthesis of dimethyl carbonate from methanol and CO2: an MCR-ALS augmented ATR-IR study.

The reaction mechanism of dimethyl carbonate (DMC) production over ZrO2 from CO2 and CH3OH is well-known, but the level of understanding has not improved in the last decade. Most commonly, the reaction mechanism has been explored in the gas phase, whilst DMC production occurs in the liquid phase. To overcome this contradiction, we exploited in situ ATR-IR spectroscopy to study DMC formation over ZrO2 in the liquid phase. A multiple curve resolution-alternate least square (MCR-ALS) approach was applied to spectra collected during the CO2/CH3OH interaction with the catalyst surface, leading to the identification of five pure components with their respective concentration profiles. CO2 and CH3OH activation to carbonates and methoxide species was found to strongly depend on the reaction temperature. Low temperature prevents methanol dissociation leaving a catalyst covered with stable carbonates, whilst higher temperature decreases the stability of the carbonates and enhances the formation of methoxides. A reaction path involving the methoxide/carbonate interaction at the surface was observed at low temperature (≤50 °C). We propose that a different reaction path, independent of carbonate formation and involving the direct CO2/methoxide interplay, occurs at 70 °C.

Red Upconverter Nanocrystals Functionalized with Verteporfin for Photodynamic Therapy Triggered by Upconversion.

Upconversion (UC) nanoparticles characterized by red upconversion emission, particularly interesting for biological applications, have been prepared and subsequently modified by the covalent anchoring of Verteporfin (Ver), an FDA approved photosensitizer (PS) which usually exerts its photodynamic activity upon excitation with red light. ZrO2 was chosen as the platform where Yb3+ and Er3+ were inserted as the sensitizer and activator ions, respectively. Careful control of the doping ratio, along with a detailed physico-chemical characterization, was carried out. Upon functionalization with a silica shell to covalently anchor the photosensitizer, a theranostic nanoparticle was obtained whose architecture, thanks to a favorable energy level match and a uniform distribution of the PS, allowed us to trigger the photodynamic activity of Ver by upconversion, thus paving the way to the use of Photodynamic Therapy (PDT) in deep tissues, thanks to the higher penetrating power of NIR light.

Nitrogen-Doped Zinc Oxide for Photo-Driven Molecular Hydrogen Production.

Due to its thermal stability, conductivity, high exciton binding energy and high electron mobility, zinc oxide is one of the most studied semiconductors in the field of photocatalysis. However, the wide bandgap requires the use of UV photons to harness its potential. A convenient way to appease such a limitation is the doping of the lattice with foreign atoms which, in turn, introduce localized states (defects) within the bandgap. Such localized states make the material optically active in the visible range and reduce the energy required to initiate photo-driven charge separation events. In this work, we employed a green synthetic procedure to achieve a high level of doping and have demonstrated how the thermal treatment during synthesis is crucial to select specific the microscopic (molecular) nature of the defect and, ultimately, the type of chemistry (reduction versus oxidation) that the material is able to perform. We found that low-temperature treatments produce material with higher efficiency in the water photosplitting reaction. This constitutes a further step in the establishment of N-doped ZnO as a photocatalyst for artificial photosynthesis.

Natural solar activation of modified zinc oxides with rare earth elements (Ce, Yb) and Fe for the simultaneous disinfection and decontamination of urban wastewater.

This study investigates the capability of modified zinc oxides (ZnO) with Ce, Yb and Fe towards the simultaneous inactivation of pathogenic bacteria (Escherichia coli, Enterococcus faecalis and Pseudomonas aeruginosa) and Contaminants of Emerging Concern (CECs, Diclofenac, Sulfamethoxazole and Trimethoprim) under natural sunlight. Several catalyst loads (from 0 to 500 mg/L) were assessed as proof-of principle in isotonic solution followed by the evaluation of organic matter effect in simulated and actual urban wastewater (UWW), using bare TiO2-P25 as reference. The order of photocatalysts efficiency for both bacterial and CECs removal was: ZnO-Ce â‰… TiO2-P25 > ZnO-Yb > ZnO-Fe > photolysis > darkness in all water matrices. The best photocatalytic performance for water disinfection and decontamination was obtained with 500 mg/L of ZnO-Ce: 80% of ∑CECs removal after 45 min (4.4 kJ/L of accumulated solar UV-A energy (QUV)) and the total inactivation of bacteria (Detection Limit of 2 CFU/mL) after 120 min (14 kJ/L of QUV) in UWW. The microbial and CECs abatement mechanism was described based on the generation of hydroxyl radicals, which was experimentally demonstrated for ZnO-Ce. Additionally, no significant release of Zn2+ and Ce was detected after the solar exposure. These results point out for the first time the capability of ZnO-Ce for the simultaneous UWW disinfection and decontamination under natural sunlight.

Zinc oxide hollow spheres decorated with cerium dioxide. The role of morphology in the photoactivity of semiconducting oxides.

The photochemical activity of the recently proposed CeO2-ZnO photocatalytic material active under visible light has been improved by means of significant modifications of its morphology. A polymeric templating agent (Pluronic) has been used in the synthesis obtaining a particle morphology based on hollow spheres that is better defined in the case of high template concentration. The charge separation ability and the light-induced surface electron transfer under irradiation with visible polychromatic light in various ranges of wavelengths has been investigated by electron paramagnetic resonance. The reactivity of the photogenerated holes has been monitored by the spin trapping technique in the presence of DMPO. The hollow spheres morphology achieved through the synthesis here reported leads to systems with a higher photoactivity under visible irradiation than the same system displaying the classic platelets morphology. A parallel increase of the photocatalytic activity of this novel system in pollution remediation reactions is therefore predictable.

The "Lab4treat" Outreach Experience: Preparation of Sustainable Magnetic Nanomaterials for Remediation of Model Wastewater.

The Lab4treat experience has been developed to demonstrate the use of magnetic materials in environmental applications. It was projected in the frame of the European project Mat4Treat, and it was tested several times in front of different audiences ranging from school students to the general public in training and/or divulgation events. The experience lends itself to discuss several aspects of actuality, physics and chemistry, which can be explained by modulating the discussion depth level, in order to meet the interests of younger or more experienced people and expand their knowledge. The topic is relevant, dealing with the recycling of urban waste and water depollution. The paper is placed within the field of water treatment for contaminant removal; therefore, a rich collection of recent (and less recent) papers dealing with magnetic materials and environmental issues is described in the Introduction section. In addition, the paper contains a detailed description of the experiment and a list of the possible topics which can be developed during the activity. The experimental approach makes the comprehension of scientific phenomena effective, and, from this perspective, the paper can be considered to be an example of interactive teaching.

Nitrogen-doped semiconducting oxides. Implications on photochemical, photocatalytic and electronic properties derived from EPR spectroscopy.

Engineering defects in semiconducting metal oxides is a challenge that remains at the forefront of materials chemistry research. Nitrogen has emerged as one of the most attractive elements able to tune the photochemical and photocatalytic properties of semiconducting oxides, boosting visible-light harvesting and charge separation events, key elements in promoting solar driven chemical reactions. Doping with nitrogen is also a strategy suggested to obtain p-type conduction properties in oxides showing n-type features in their pristine state and to impart collective magnetic properties to the same systems. Here, we review the evolution in the understanding of the role of nitrogen doping in modifying the photochemical and electronic properties of the most common semiconducting oxides used in mentioned applications including: TiO2, ZnO, SnO2 and zirconium titanates. With an emphasis on polycrystalline materials, we highlight the unique role of Electron Paramagnetic Resonance (EPR) spectroscopy in the direct detection of open-shell N-based defects and in the definition of their structural and electronic properties. Synthetic strategies for the insertion of nitrogen defects in the various matrices are also discussed, along with the influence of the corresponding low-lying energy states on the general electronic properties of the doped solids.

Cuidados paliativos e limitação de suporte de vida em terapia intensiva / Palliative care and limitation of life support in intensive care / Cuidados paliativos y limitación del soporte de vida en cuidados intensivos

Resumo A limitação de suporte de vida tem sido aplicada na terapia intensiva em quadros de doença irreversível e tratamento improdutivo. Nessas situações, cuidados paliativos visam prevenir e aliviar o sofrimento e tornam-se essenciais para propiciar atenção específica e contínua para o paciente e sua família, possibilitando morte digna. Este estudo envolveu pesquisa qualitativa realizada com 37 profissionais da equipe multidisciplinar em unidade de terapia intensiva clínico-cirúrgica de hospital público em Curitiba, Paraná, Brasil. A análise temática dos dados estabeleceu quatro temas, que permitiram investigar o conhecimento da equipe sobre eles e elaborar ações de cuidados paliativos a pacientes com limitação de suporte de vida em terapia intensiva. Os profissionais reconheceram a importância dos cuidados paliativos à população em apreço naquela unidade.

Abstract The Limitation of Life Support has been applied in intensive care in cases of irreversible disease and futile treatment. In these situations, palliative care aims at preventing and alleviating suffering. It becomes essential to provide specific and ongoing care to patients and their families, enabling death with dignity. This study involved qualitative research carried out with 37 health professionals working within the multidisciplinary team in a Clinical Surgical Intensive Care Unit of a public hospital located in Curitiba, Paraná, Brazil. Through the thematic analysis of the data, four themes were formed, which made it possible to investigate the knowledge of the team regarding the subject and develop palliative care actions for patients with limitation of life support in intensive care. The professionals recognized the importance of Palliative Care for these patients in the Intensive Care Unit.

Resumen La limitación del soporte de vida se ha aplicado en terapia intensiva en cuadros de enfermedad irreversible y ante tratamientos improductivos. En estas situaciones, los cuidados paliativos surgen con el objetivo de prevenir y aliviar el sufrimiento y se tornan esenciales para propiciar una atención específica y continua para el paciente y su familia, posibilitando una muerte digna. Este estudio implicó una investigación cualitativa realizada con 37 profesionales del equipo multidisciplinario de una unidad de cuidados intensivos clínico-quirúrgica de un hospital público situado en Curitiba, Paraná, Brasil. El análisis temático de los datos estableció cuatro temas, que permitieron investigar el conocimiento del equipo sobre estos y elaborar acciones de cuidados paliativos para pacientes con limitación del soporte de vida en cuidados intensivos. Los profesionales reconocieron la importancia de los cuidados paliativos para la población en cuestión en dicha unidad.

Electron magnetic resonance in heterogeneous photocatalysis research.

The contribution of electron magnetic resonance techniques, and in particular of CW-EPR, to the experimental research on photocatalytic phenomena is illustrated in this paper with selected examples. In the first part of the paper the role of EPR in unravelling the nature and the features of extrinsic point defects in semiconducting oxides is epitomized using the important example of the photoactive nitrogen center in various semiconducting oxides. In the second part we describe how EPR can monitor the processes that follow the initial photoinduced charge separation in photocatalysis, namely the stabilisation, migration and surface reactivity of electrons and holes. Finally, we will discuss how the role of EPR in photocatalysis is not limited to monitor phenomena occurring in the solid or at its surface but it can be extended to the investigation of the liquid phase by employing the spin trapping techniques to monitor the nature and the concentration of the reactive free radicals formed along the photocatalytic process.

An Easy Synthesis for Preparing Bio-Based Hybrid Adsorbent Useful for Fast Adsorption of Polar Pollutants.

For the first time, γ-Al2O3 and Bio-Based Substances (BBS) hybrids (A-BBS) were prepared through a simple electrostatic interaction occurring between alumina, used as a support, and BBS (Bio-Based Substance from composted biowastes) carrying positive and negative charges, respectively. We evaluated the optimal amount of BBS to be immobilized on the support and the stability of the resulting A-BBS in order to use this novel hybrid material as an adsorbent for the removal of polar pollutants. Characterization was carried out by X-Ray Diffraction (XRD) for evaluating the crystal structure of the support, Fourier transform infrared spectroscopy (FT-IR) to evidence the presence of BBS on the hybrid material, thermogravimetric analysis (TGA) to measure the thermal stability of the hybrid materials and quantify the BBS amount immobilized on the support, N2 adsorption at 77 K for the evaluation of the surface area and porosity of the systems, Zeta potential measurements to evaluate the effect of BBS immobilization on the surface charge of the particles and choose the substrates possibly interacting with them. Firstly, we tested the adsorption capability of three samples differently coated with BBS toward cationic species considering various adsorbate/adsorbent ratio. Crystal Violet (CV) was chosen as model pollutant to compare the performance of the hybrid materials with those of other materials described in the literature. The adsorption data were modeled by Langmuir and Freundlich adsorption isotherms. Then, we studied the adsorption capability of the developed material towards molecules with different structures; for this purpose, two contaminants of emerging concerns (carbamazepine and atenolol) were tested. The results indicate that A-BBS could be applied in wastewater treatment for the removal of a significant amount of polar species. In addition, a comparison with literature data concerning CV adsorption was carried out in order to evaluate the environmental impact of synthetic routes used to prepare different adsorbents.

Control of Membrane Fouling in Organics Filtration Using Ce-Doped Zirconia and Visible Light.

Membrane fouling has been a major issue in the development of more efficient water treatment processes. Specifically in surface waters filtration, organic matter, such as humic-like substances, can cause irreversible fouling. Therefore, this study evaluates the activity of a photocatalytic layer composed of Ce-doped zirconia nanoparticles in improving the fouling resistance during filtration of an aqueous solution of humic acid (HA). These nanoparticles were prepared by hydrothermal and sol-gel processes and then characterized. Before the filtration experiments, the photodegradation of HA catalyzed by Ce-doped zirconia nanoparticles in dispersion was studied. It was observed that the sol-gel prepared Ce-ZrO2 exhibited higher HA removal in practically neutral pH, achieving 93% efficiency in 180 min of adsorption in the dark followed by 180 min under visible-light irradiation using light-emitting diodes (LEDs). Changes in spectral properties and in total organic carbon confirmed HA degradation and contributed to the proposal of a mechanism for HA photodegradation. Finally, in HA filtration tests, Ce-ZrO2 photocatalytic membranes were able to recover the flux in a fouled membrane using visible-light by degrading HA. The present findings point to the further development of anti-fouling membranes, in which solar light can be used to degrade fouling compounds and possibly contaminants of emerging concern, which will have important environmental implications.

Rede de atenção às urgências e emergências: perfil, demanda e itinerário de atendimento de idosos / Red de atención a urgencias y emergencias: perfil, demanda e itinerario de atendimiento de ancianos* / Urgent and emergency care network: profile, demand and flow of elderly to health care points

RESUMO Objetivo: caracterizar o perfil, a demanda e o itinerário de idosos cadastrados em uma Unidade Municipal de Saúde, atendidos na Rede de Atenção às Urgências e Emergências de Curitiba. Método: pesquisa avaliativa, documental, transversal, de abordagem quantitativa, realizada entre agosto de 2015 e junho de 2016, cuja fontes de dados foram Relatórios de Atendimento na Rede e prontuários eletrônicos de usuários com 60 anos ou mais. A análise foi realizada por estatística descritiva. Resultados: identificaram-se 102 idosos que realizaram 160 consultas na Unidade de Pronto Atendimento, 59 (57,8%) eram do sexo feminino, 50 (49%) tinham entre 60 e 69 anos, em 55 (53,9%) a demanda foi considerada "pouco urgente", e 10 foram internados. Conclusão: observou-se a demanda de usuários devido a agravos comuns de saúde, sendo necessária a reorganização operacional e gerencial da rede, objetivando adequação do atendimento em todos os seus níveis de complexidade.

RESUMEN Objetivo: caracterizar el perfil, la demanda y el itinerario de ancianos registrados en una Unidad Municipal de Salud, atendidos en la Red de Atención a Urgencias y Emergencias de Curitiba. Método: pesquisa evaluativa, documental, transversal, de abordaje cuantitativo, realizada entre agosto de 2015 y junio de 2016, cuyas fuentes de datos fueron Informes de Atendimiento en la Red y prontuarios electrónicos de usuarios con 60 años o más. El análisis fue realizado por estadística descriptiva. Resultados: se identificaron 102 ancianos que realizaron 160 consultas en la Unidad de Urgencias, 59 (57,8%) eran del sexo femenino, 50 (49%) tenían entre 60 y 69 años, en 55 (53,9%) se consideró la demanda "poco urgente", y 10 fueron internados. Conclusión: se observó la demanda de usuarios a causa de agravios comunes de salud, siendo necesaria la reorganización operacional y administrativa de la red, con el objetivo de adecuar el atendimiento en todos sus niveles de complejidad.

ABSTRACT Objective: characterize the profile, demand and flow of care to elderly registered in a Municipal Health Unit assisted at an Emergency Care Network (RUE) of Curitiba. Method: cross-sectional study of quantitative approach for assessment and documentation purposes conducted between August 2015 and June 2016, based on reports of care provided to users at the referred Network and electronic medical records of users aged 60 and over. Descriptive statistics was used in the analysis. Results: it was found that 102 elderly people made 160 visits at the Emergency Care Unit (UPA), as follows: 59 (57.8%) were women, 50 (49%) were aged 60-69 years old, the demands of 55 (53.9%) were considered to be "not very urgent" and 10 individuals were hospitalized. Conclusion: analysis of the demands of users with ordinary health problems indicated the need for operational and managerial reorganization of the network, for adequacy of care at all its levels of complexity.

Photoactivity properties of ZnO doped with cerium ions: an EPR study.

In the present study, we investigated the effect of cerium doping in zinc oxide matrix, used as photoactive material. Cerium ions into the matrix of ZnO can act like a 'trap' for the electrons, lowering the e -/h + recombination rate and so increasing the photocatalytic efficiency of the ZnO. We synthesised doped samples using a simple precipitation route. The amount of dopant used was, 1 and 10% molar. The samples have been studied via x-ray diffraction measurements for the structural characterisation; UV-visible diffuse reflectance was used for the optical analysis; Branauer-Emmett-Teller (BET) model for the measurement of the surface area. Finally, the samples have been analysed via electron paramagnetic resonance (EPR) spectroscopy for the electronic characterisation and for testing their photoactivity. The spin trapping technique was also use to measure the amount of stable radical adducts formed via reaction of OH• radicals with molecules of the DMPO (5,5-dimethyl-1-pyrroline-N-oxide) spin probe.

[Factors influencing Intensive Care Units nurses in end-of-life decisions]. / Fatores que influenciam os enfermeiros de Unidades de Terapia Intensiva nas decisões de final de vida.

OBJECTIVE: To identify the factors that influence the Intensive Care Unit nurse in the decision-making process in end-of-life situations. METHOD: Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-structured interviews with 10 nurses. RESULTS: The inductive thematic analysis enabled us to identify four themes:The cultural context of the Intensive Care Unit: decision-making in situations of end-of-life; Beliefs and subjectivity of care in end-of-life situations; Professional experience and context characteristics of end-of-life care situations; and Humanization practices in end-of-life situations: the patient and family centered care. CONCLUSION: Professional maturity, the ability to transmit information and the ability to negotiate are directly related to the inclusion of nurses in the decision-making process.

Factors influencing Intensive Care Units nurses in end-of-life decisions / Factores que influencian a los enfermeros de unidades de cuidados intensivos en las decisiones de final de vida / Fatores que influenciam os enfermeiros de Unidades de Terapia Intensiva nas decisões de final de vida

OBJECTIVETo identify the factors that influence the Intensive Care Unit nurse in the decision-making process in end-of-life situations.METHODEthnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-structured interviews with 10 nurses.RESULTSThe inductive thematic analysis enabled us to identify four themes:The cultural context of the Intensive Care Unit: decision-making in situations of end-of-life; Beliefs and subjectivity of care in end-of-life situations; Professional experience and context characteristics of end-of-life care situations; and Humanization practices in end-of-life situations: the patient and family centered care.CONCLUSIONProfessional maturity, the ability to transmit information and the ability to negotiate are directly related to the inclusion of nurses in the decision-making process.

OBJETIVOIdentificar los factores que influencian al enfermero de Unidad de Cuidados Intensivos en el proceso de toma de decisión en las situaciones de final de vida.MÉTODOEstudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica. Se recogieron los datos mediante entrevista semiestructurada con 10 enfermeros.RESULTADOSEl análisis temático inductivo posibilitó identificar cuatro temas:El marco cultural de la Unidad de Cuidados Intensivos: la toma de decisión en las situaciones de final de vida,Creencias y subjetividades en el cuidado en las situaciones de final de vida, Experiencias profesionales y características del contexto de cuidado en las situaciones de final de vida y Prácticas de humanización en las situaciones de final de vida: el cuidado centrado en el paciente y la familia.CONCLUSIÓNLa madurez profesional, la habilidad para transmitir las informaciones y la capacidad para la negociación están directamente relacionadas con la inserción del enfermero en el proceso de toma de decisión.

OBJETIVOIdentificar os fatores que influenciam o enfermeiro de Unidade de Terapia Intensiva no processo de tomada de decisão nas situações de final de vida.MÉTODOEstudo de caso etnográfico que teve como referencial teórico a antropologia médica. Os dados foram coletados por meio de entrevista semiestruturada com 10 enfermeiros.RESULTADOSA análise temática indutiva possibilitou identificar quatro temas: O contexto cultural da Unidade de Terapia Intensiva: a tomada de decisão nas situações de final de vida, Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vida e Práticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.CONCLUSÃOA maturidade profissional, a habilidade para transmitir as informações e a capacidade para a negociação, estão diretamente relacionadas com a inserção do enfermeiro no processo de tomada de decisão.

Diretrizes para cuidados paliativos prestados a pacientes submetidos a transplante de células tronco hematopoéticas / Palliative care guidelines for patients undergoing hematopoietic stem cell transplantation / Directrices para cuidados paliativos prestados a pacientes sometidos a trasplante de células madre hematopoyéticas

Estudo de abordagem qualitativa como o objetivo de propor diretrizes de cuidados paliativos aos pacientes submetidos a transplante de células tronco hematopoéticas. O cenário foi um hospital de ensino em Curitiba, estado do Paraná. O estudo foi desenvolvido em 2014 em duas fases: a primeira, exploratória, com entrevistas semiestruturadas com 12 enfermeiros. Da análise de conteúdo emergiram três temas: 1) Percepção sobre a experiência do cuidado paliativo no trabalho; 2) Sentido atribuído ao cuidado paliativo; 3) Interação profissional-família em cuidado paliativo. Na segunda fase foram realizados encontros com os enfermeiros, para propor e aprovar diretrizes aos cuidados paliativos. A definição de diretrizes pode facilitar e beneficiar a prática do cuidado, junto ao paciente, família e equipe multiprofissional, no final de vida e no enfrentamento da morte (AU).

ualitative study aimed to propose palliative care guidelines for patients undergoing hematopoietic stem cell transplantation. The setting was a teaching hospital in Curitiba, state of Paraná. The study was conducted in 2014 in two stages: the first, exploratory stage, with semi-structured interviews with 12 nurses. Three topics emerged from content analysis: 1) Perception of palliative care in the workplace; 2) Sense assigned to palliative care; 3) Professional-family interaction in palliative care. In the second stage palliative care guidelines were proposed and approved in meetings with nurses. The definition of palliative care guidelines may facilitate and improve the palliative care delivered by multidisciplinary teams, with a positive impact on the quality of life of patients with a terminal disease and their families (AU).

Estudio de abordaje cualitativo cuya finalidad fue proponer directrices de cuidados paliativos a los pacientes sometidos a trasplante de células madre hematopoyéticas. El escenario fue un hospital de enseñanza en Curitiba, estado de Paraná. El estudio fue desarrollado en 2014 en dos fases: la primera, exploratoria, con entrevistas semiestructuradas con 12 enfermeros. Del análisis de contenido resultaron tres temas: 1) Percepción sobre la experiencia del cuidado paliativo en el trabajo; 2) Sentido del cuidado paliativo; 3) Interacción profesional-familia en cuidado paliativo. En la segunda fase, fueron realizados encuentros con los enfermeros para proponer y aprobar directrices a los cuidados paliativos. La definición de directrices puede facilitar y beneficiar la práctica del cuidado, con paciente, familia y equipo multiprofesional, en el fin de vida y en el afrontamiento de la muerte (AU).