RESUMOApresentam-se reflexões acerca da prática da promoção da saúde em instituições hospitalares, abordando os aspectos que permeiam o ambiente hospitalar e dificultam a implementação de estratégias para a promoção da saúde nesses serviços. Discute-se o hospital como lugar estratégico para novas práticas, ressaltando-se ações realizadas nesse espaço, que podem contribuir para efetivação da promoção da saúde dos clientes. Acredita-se que a promoção da saúde tanto seja possível quanto necessária em ambientes hospitalares; e que as ações desenvolvidas nesse sentido podem conduzir o indivíduo e sua família na busca de uma melhor qualidade de vida. descritores: Enfermagem; Promoção da saúde; Instituições de saúde; Assistência hospitalar. ABSTRACTReflections on the practice of health promotion in hospitals are presented, addressing the aspects that permeate the hospital environment and hinder the implementation of strategies for health promotion in these services. The hospital is discussed as a strategic place for new practices, highlighting actions taken in this space, which can contribute to effective the health promotion of the clients. It is believed that health promotion is both, possible and necessary, in hospital settings, and that the actions in this direction may lead the individual and his family in search of a better quality of life. Key words: health promotion; health facilities; hospital care, nursing. RESUMEN Se presentan reflexiones sobre la práctica de la promoción de la salud en los hospitales, abordando los aspectos que permean el ambiente del hospital e impiden la aplicación de estrategias para la promoción de la salud en estos servicios Se discute el hospital como un lugar estratégico para las nuevas prácticas, destacando las acciones realizadas en este espacio, que pueden contribuir a la efectiva promoción de la salud de los clientes. Se cree que la promoción de la salud es, a la vez, posible y necesaria en el ámbito hospitalario, y que las acciones en este sentido pueden llevar al individuo y su familia en busca de una mejor calidad de vida. Palabras clave: promoción de la salud; instituciones de salud; atención hospitalaria, enfermería. Promoção da saúde em ambientes hospitalares Health promotion in hospital settingsPromoción de la salud en ambientes hospitalarios

the educational intervention is an effective and viable strategy for older adults' caregivers.

Objective: To evaluate the knowledge and attitudes of Family Health Strategy nurses regarding sexuality in old age. Method: Cross-sectional, exploratory, descriptive, quantitative study with nurses of the Family Health Strategy of the city of Sobral-CE. The instruments used were a socio-demographic and professional questionnaire and the Aging Sexual Knowledge and Attitudes Scale, Brazilian version. Data were processed in GraphPad Prism 5 ® , and the significance level was set at p<0.05. Results: The participants were 56 nurses, most of them female, young adults, who reported they were able to provide orientations about sexuality. The mean score in the knowledge dimension was 29.95 (SD=2.21), in a range of 20 to 60; the mean score in the attitude dimension was 27.14 (SD=2.19), in a range of eight to 40. Participants who declared receiving permanent health education and conducting health education on sexuality presented a significantly favorable knowledge, but no statistically significant attitude. Conclusion: Nurses have adequate knowledge about sexuality in old age, but still present conservative attitudes. Investing in processes of continuing health education can improve the knowledge and practice of nurses.

Justificativa e Objetivos: Apesar das novidades relacionadas ao diagnóstico precoce e ao rastreamento microbiano dos casos de sepse, faz-se necessário compreender os aspectos clínico-epidemiológicos dos serviços de saúde visando definir as especificidades dos pacientes acometidos em Unidades de Terapia Intensiva (UTI). Nesse contexto, objetiva-se descrever as características epidemiológicas de pacientes com sepse em UTI. Métodos: Trata-se de uma pesquisa exploratória-descritiva, retrospectiva, documental, com abordagem quantitativa, realizada entre maio e julho de 2018, em hospital de ensino da Zona Norte do Estado do Ceará. Utilizou-se como fonte de dados os prontuários de pacientes que apresentaram sepse nas UTI do referido hospital, alcançando-se uma amostra de 62 prontuários para análise. Os dados coletados foram armazenados nos programas Microsoft Excel e Origin Lab 8 para posterior construção de gráficos e tabelas para análise das informações. Resultados: Os casos tiveram predominância em indivíduos do sexo masculino, residentes em municípios interioranos circunvizinhos e adultos jovens com idade entre 19 e 39 anos. O traumatismo cranioencefálico e o politraumatismo foram os diagnósticos iniciais que prevaleceram. As bactérias grampositivas tiveram maior prevalência, superando os bacilos gram-negativos e os fungos. Os antimicrobianos mais utilizados foram Cefepime e Vancomicina. As evoluções das infecções estiveram associadas a fatores como: estado de saúde dos pacientes; utilização de dispositivos invasivos e longo período de internação. Conclusão: As informações obtidas nesta pesquisa indicam que os dados epidemiológicos desempenham papel crucial no que diz respeito à aplicação de novos recursos, tecnologias e tratamentos. Tais conhecimentos permitirão desenvolver estratégias e condutas direcionadas à qualidade na assistência intensiva.

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Background: The first 1000 days after conception are a critical period to encourage lifestyle changes to reduce the risk of childhood obesity and early programming of chronic diseases. A healthy lifestyle during pregnancy is also crucial to avoid high post-partum weight retention. Currently, lifestyle changes are not consistently discussed during routine health services in Germany. The objective of this study is to evaluate a novel computer-assisted lifestyle intervention embedded in prenatal visits and infant check-ups. The intervention seeks to reduce lifestylerelated risk factors for overweight and obesity among expecting mothers and their infants. Methods:The study is designed as a hybrid effectiveness-implementation trial to simultaneously collect data on the effectiveness and implementation of the lifestyle intervention. The trial will take place in eight regions of the German state Baden-Wuerttemberg. Region were matched using propensity score matching. Expecting mothers (n = 1860) will be recruited before 12 weeks of gestation through gynecological practices and followed for 18 months. During 11 routine prenatal visits and infant check-ups gynecologists, midwives and pediatricians provide lifestyle counseling using Motivational Interviewing techniques. The primary outcome measure is the proportion of expecting mothers with gestational weight gain within the recommended range. To understand the process of implementation (focus group) interviews will be conducted with providers and participants of the lifestyle intervention. Additionally, an analysis of administrative data and documents will be carried out. An economic analysis will provide insights into cost and consequences compared to routine health services.

Objective: This study aimed to carry out the cross-cultural adaptation of the Caregiver Reaction Assessment (CRA) for use in Brazil with informal caregivers of dependent elderly. Method: A methodological study, of five steps: initial translation, synthesis of translations, retro-translation, evaluation by a judge committee and a pre-test, with 30 informal caregivers of older persons in Fortaleza, Brazil. Content validity was assessed by five experts in gerontology and geriatrics. The cross-cultural adaptation was rigorously conducted, allowing for inferring credibility. Results: The Brazilian version of the CRA had a simple and fast application (ten minutes), easily understood by the target audience. It is semantically, idiomatically, experimentally and conceptually equivalent to the original version, with valid content to assess the burden of informal caregivers for the elderly (Content Validity Index = 0.883). Conclusion: It is necessary that other psychometric properties of validity and reliability are tested before using in care practice and research.

The HMO Research Network (HMORN) is a consortium of 16 dedicated research centers based in non-profit health care systems. Its purpose is to foster collaborative research and knowledge sharing to improve health and health care for people nationally and globally. Investigators in these centers conduct public domain research that is supported by a variety of sources including federal agencies, such as the National Institutes of Health (NIH), the Agency for Healthcare Research and Quality (AHRQ), the Centers for Disease Control and Prevention (CDC), and the Food and Drug Administration (FDA), foundations, and industry. Research findings are widely disseminated through peer-reviewed publications, websites, and other channels. The 16 health care systems in the HMORN, which was founded in 1991 by four of the current member organizations, have a combined total of approximately 15.3 million current members. The clinical, epidemiologic, and health services research conducted uses a variety of data sources, including computerized data available through the health care systems and primary data collected from patients and clinicians.