Técnica de incidente crítico e seu uso na Enfermagem: revisão integrativa da literatura

Revisão integrativa da literatura realizada nas bases de dados LILACS, MEDLINE e SciELO no período de 2000 a 2010, com os objetivos de sintetizar o conhecimento produzido nas pesquisas em enfermagem que utilizaram a técnica de incidente crítico e identificar o uso e a aplicabilidade dessa técnica como referencial metodológico. Os achados perfizeram um total de dezessete artigos científicos e demonstraram que o Brasil se destacou com 76,5% de publicações. A análise e categorização, segundo os três elementos da técnica, ocorreram em 76,0% dos artigos. A categoria "análise de iatrogenias" provocadas pelos profissionais de saúde se destacou quanto à utilização da técnica de incidente crítico. A revisão integrativa possibilitou a construção de uma síntese do conhecimento científico sobre essa técnica, além de demonstrar sua ampla contribuição para a melhoria da assistência de enfermagem e de saúde

Clinical Ethics Support for Healthcare Personnel : An Integrative Literature Review

This study describes which clinical ethics approaches are available to support healthcare personnel in clinical practice in terms of their construction, functions and goals. Healthcare personnel frequently face ethically difficult situations in the course of their work and these issues cover a wide range of areas from prenatal care to end-of-life care. Although various forms of clinical ethics support have been developed, to our knowledge there is a lack of review studies describing which ethics support approaches are available, how they are constructed and their goals in supporting healthcare personnel in clinical practice. This study engages in an integrative literature review. We searched for peer-reviewed academic articles written in English between 2000 and 2016 using specific Mesh terms and manual keywords in CINAHL, MEDLINE and Psych INFO databases. In total, 54 articles worldwide described clinical ethics support approaches that include clinical ethics consultation, clinical ethics committees, moral case deliberation, ethics rounds, ethics discussion groups, and ethics reflection groups. Clinical ethics consultation and clinical ethics committees have various roles and functions in different countries. They can provide healthcare personnel with advice and recommendations regarding the best course of action. Moral case deliberation, ethics rounds, ethics discussion groups and ethics reflection groups support the idea that group reflection increases insight into ethical issues. Clinical ethics support in the form of a ‘‘bottom-up’’ perspective might give healthcare personnel opportunities to think and reflect more than a ‘‘top-down’’ perspective. A ‘‘bottom-up’’ approach leaves the healthcare personnel with the moral responsibility for their choice of action in clinical practice, while a ‘‘top-down’’ approach risks removing such moral responsibility

High-molecular-weight organic matter in the particles of comet 67P/Churyumov–Gerasimenko

International audienceThe presence of solid carbonaceous matter in cometary dust was established by the detection of elements such as carbon, hydrogen, oxygen and nitrogen in particles from comet 1P/Halley1, 2. Such matter is generally thought to have originated in the interstellar medium3, but it might have formed in the solar nebula—the cloud of gas and dust that was left over after the Sun formed4. This solid carbonaceous material cannot be observed from Earth, so it has eluded unambiguous characterization5. Many gaseous organic molecules, however, have been observed6, 7, 8, 9; they come mostly from the sublimation of ices at the surface or in the subsurface of cometary nuclei8. These ices could have been formed from material inherited from the interstellar medium that suffered little processing in the solar nebula10. Here we report the in situ detection of solid organic matter in the dust particles emitted by comet 67P/Churyumov–Gerasimenko; the carbon in this organic material is bound in very large macromolecular compounds, analogous to the insoluble organic matter found in the carbonaceous chondrite meteorites11, 12. The organic matter in meteorites might have formed in the interstellar medium and/or the solar nebula, but was almost certainly modified in the meteorites’ parent bodies11. We conclude that the observed cometary carbonaceous solid matter could have the same origin as the meteoritic insoluble organic matter, but suffered less modification before and/or after being incorporated into the comet