RESUMOObjetivo: conhecer a perspectiva dos profissionais de Enfermagem, que atuam na sala de emergência, sobre o processo de morte e morrer. Método: estudo qualitativo, descritivo e exploratório, realizado com 17 profissionais de Enfermagem que atuavam na sala de emergência de um hospital universitário. Os dados foram coletados por meio de entrevistas semiestruturadas, audiogravadas que, após transcritas, foram submetidas à Análise de Conteúdo na modalidade Temática. Resultados: emergiram as categorias - Sentimentos e percepções frente ao processo de morte e morrer e Alterações na percepção da morte em diferentes fases da vida. Ambas mostram sentimentos, experiências iniciais com a morte enquanto profissional e a falta de preparo acerca do tema durante a formação. Conclusão: os profissionais entendem que a morte faz parte do processo de viver, mas sentem tristeza, frustração e impotência, especialmente, quando o paciente permanece por mais tempo na emergência. Acredita-se que este estudo possa contribuir para que os profissionais se sintam motivados para refletir e discutir sobre cuidados mais humanos e solidários no serviço hospitalar de urgência. Descritores: Morte; Profissionais de Enfermagem; Serviços Médicos de Emergência; Serviço Hospitalar de Emergência; Percepção; Relações Profissional-Paciente.ABSTRACT Objective: to know the perspective of Nursing professionals, who work in the emergency room, about the process of death and dying. Method: a qualitative, descriptive and exploratory study, carried out with 17 Nursing professionals who worked in the emergency room of a university hospital. Data was collected through semi-structured, audio-taped interviews that, after being transcribed, were submitted to Content Analysis in the Thematic modality. Results: categories emerged - Feelings and perceptions regarding the process of death and dying and Alterations in the perception of death in different phases of life. Both show feelings, initial experiences with death as a professional, and lack of preparation on the subject during training. Conclusion: professionals understand that death is part of the process of living, but they feel sadness, frustration and impotence, especially when the patient stays for longer in the emergency room. It is believed that this study may contribute to the professionals feel motivated to reflect and discuss more humane and supportive care in the hospital emergency service. Descriptors: Death; Nurse Practitioners; Emergency Medical Services; Emergency Service Hospital; Perception; Professional-Patient Relations.RESUMEN Objetivo: conocer la perspectiva de los profesionales de Enfermería, que actúan en la sala de emergencia, sobre el proceso de muerte y morir. Método: estudio cualitativo, descriptivo y exploratorio, realizado con 17 profesionales de Enfermería que actuaban en la sala de emergencia de un hospital universitario. Los datos fueron recolectados por medio de entrevistas semiestructuradas, audiogravadas que, tras transcritas, fueron sometidas al Análisis de Contenido, en la modalidad Temática. Resultados: surgieron dos categorías - Sentimientos y percepciones frente al proceso de muerte y morir y Alteraciones en la percepción de la muerte en diferentes fases de la vida. Ambos muestran sentimientos, experiencias iniciales con la muerte como profesional y la falta de preparación acerca del tema durante la formación. Conclusión: los profesionales entienden que la muerte es parte del proceso de vivir, pero sienten tristeza, frustración e impotencia, especialmente cuando el paciente permanece por más tiempo en la emergencia. Se cree que este estudio puede contribuir a que los profesionales, se sientan motivados para reflexionar y discutir sobre cuidados más humanos y solidarios en el servicio hospitalario de urgencia. Descriptores: Muerte; Enfermeras Practicantes; Servicios Médicos de Urgencia; Servicio de Urgencia en Hospital; Percepción; Relaciones Profesional-Paciente.

Objective: To identify factors associated with cognitive, emotional, psychomotor, and relational skills of informal caregivers in home care. Methods: A cross-sectional study carried out with a sample of 216 informal caregivers residing in a municipality in the state of Paraná. Data collection took place between February and July 2019, with an instrument developed and validated to assess the skills of informal caregivers. Descriptive and inferential analyses were used. Results: The factors associated with a greater competence of informal caregivers were being female, having training in the field, and having more than five years home care experience. The lowest competence was observed in caregivers who had health problems and belonged to the lowest strata of family purchasing power. Participants had lower scores in psychomotor competence and had better results in cognitive competence. Conclusion: It was found that women with experience in care had higher levels of competence to provide quality care at home assistance services.

Objective to compare the skill of informal caregivers to care for dependent people undergoing educational planning discharge intervention with and without follow-up at home. Method this is a quasi-experimental, randomized, simple pilot study, with pre and post-test, not blind, however, with blind assessment of the outcomes, with two follow-up interventions. It was carried out between October 2019 and January 2020 in Maringá, Brazil, with 21 informal caregivers of dependent people, randomized to Intervention Group I and Intervention Group II. Group I underwent an educational intervention consisting of guidance and training during the hospitalization period, with follow-up after hospital discharge by nurses at home, and participants in Group II received only guidance at the hospital. To assess the difference in the level of skill, the COPER 14 instrument was used, applied at times 0, week 1 and week 4, submitting the results to analysis of variance. Results group I had more than twice as much (mean score=8.94) of skill as Group II (mean score=3.90), with a significant increase in practically all the variables analyzed. A significant increase in the score ranks was detected between the variables cognitive and behavioral skill (1.19 - 3.00, p=0.001), psychomotor (1.13 - 3.00, p=0.001) and relational (1.75 - 2.75, p=0.037) in Group I. Conclusion the educational intervention given to the Intervention Group I (IG-I) was effective in increasing the skill of informal caregivers of dependent people. Brazilian Registry of Clinical Trials RBR-5rzmzf.

Objetivo: compreender a vivência de mães de filhos com síndrome de Down. Método: pesquisa descritiva e exploratória, qualitativa, desenvolvida com mães de crianças diagnosticadas com Síndrome de Down acompanhadas pela Associação de Pais e Amigos dos Excepcionais. A coleta de dados se deu por meio de entrevistas por meio da técnica de história de vida oral. A análise de conteúdo subsidiou a análise dos dados. Resultados: participaram do estudo, seis mães de crianças com Síndrome de Down. Da análise emergiram três categorias: Vivenciando o diagnóstico de Síndrome de Down; as transformações no cotidiano e suas implicações; e, A assistência de saúde dispensadas as mães com crianças diagnosticadas com Síndrome de Down. Conclusão: pode-se compreender as vivências de mães de crianças diagnosticadas com Síndrome de Down. Identificou-se emoções e sentimentos experimentados no momento do diagnóstico, os quais perpassaram durante todo o desenvolvimento do filho e incidiram sobre o processo de maternagem.

Objetivo: analisar a tendência das taxas de internação hospitalar por doenças cardiovasculares em adultos no Brasil.Método: estudo ecológico, de séries temporais, das taxas de internação por doenças cardiovasculares em adultos por sexo, faixa etária e região de residência no Brasil no período de 2005 a 2016. Foram utilizados os dados do Sistema de Informações Hospitalares do Sistema Único de Saúde. Para as análises de tendência, utilizaram-se modelos de regressão polinomial.Resultados: detectou-se tendência de declínio nas taxas de internação por doença cardiovascular em todo o país, sendo que a região Centro-Oeste obteve a redução mais expressiva (-21,29 ao ano). A região Sul deteve as maiores taxas de internação, inclusive por doenças isquêmicas do coração e cerebrovasculares.Conclusão: o Brasil apresentou tendência decrescente nas taxas de internação, entretanto, ainda são elevadas. Os resultados podem repercutir nas ações de vigilância em saúde, especialmente em regiões cujas taxas de internação apresentam-se elevadas.

Objective: to analyze the effect of vertical gastrectomy on lipid profile and cardiometabolic risk in young women, preoperatively and 6 months after the operation. Methods: retrospective study, encompassing medical record reviews of women’s charts, preoperatively and in six months after the operation. Data collection was performed in the second half of 2015, using a review protocol with questions on the clinical-laboratory profile, anthropometric and laboratory classification of dyslipidemias. Descriptive and inferential analysis were used to treat the variables, using measures of variance, association and linear regression. Results: we analyzed medical records of 114 women undergoing vertical gastrectomy, with a mean age of 33.82±10.92, and with complete high school education. There was a significant reduction of anthropometric data, as well as serum lipid values, six months after the surgical procedure. The coefficients of determination and the results of linear regression, showed that the reduction in serum triglyceride values and increase in high-density lipoprotein have a direct impact on the reduction of the cardiometabolic risk. Regarding the laboratory classification of dyslipidemias, it was observed that the majority presented a significant reduction at the six-month follow-up. Mixed hyperlipidemia showed no significant reduction. The categorized cardiometabolic risk showed a significant reduction in women at risk before vertical gastrectomy. Conclusion: at the six-month follow-up, vertical gastrectomy was effective in reducing the serum lipid profile and the cardiometabolic risk of young women when compared to the preoperative data. There was also a different improvement in the laboratory classification of dyslipidemias at the six-month follow-up after the surgical procedure.

Objectives: to understand the meanings attributed to the changes experienced after bariatric surgery by people with obesity. Methods: this is a study with a qualitative approach, with a theoretical framework in Symbolic Interactionism; and methodological, in the Grounded Theory. There were 12 participants who underwent bariatric surgery in two health services (bariatric surgery clinic; general hospital). Data collection took place between July and October 2020, through an intensive interview. Testimonies were recorded using an electronic device and transcribed in full. Data were coded in the MAXQDA 2020 software and analyzed considering the adopted theoretical framework. Results: two categories emerged: Rebuilding a social life; and Rediscovering self-esteem. From the articulation of these categories, the phenomenon “Re-signifying life after bariatric surgery” was constructed. Final Considerations: bariatric surgery contributed to significant changes in the daily lives of participants, and Symbolic Interactionism allowed the understanding of how participants interpreted their meanings.

Objectives: to indentify the time trend of rates of organs and tissues effective donors, of reports and types of transplanted organs per million people of the Brazilian population. Methods: ecological study, of time series, about reports of organ donations and on transplants. The data were provided by the Registro Brasileiro de Transplantes and analyzed using polynomial regression. Results an increasing trend was found for potential donors and effective donors, with an average increase of 2.33 and 0.92 per year, respectively. The South Region had the highest rate of potential donors (83.8) and effective donors (34.1) and the North Region, the lowest rate (20.2 and 3.9). The family refusal was the main obstacle to accomplish the donation. Conclusions the results show an increasing trend of potential donors and effective donors throughout Brazil, with emphasis on the southern region of the country. Among the main reasons for non-donation, it is worth emphasizing family refusal and medical contraindication prescription.