Graduate nursing education in the United States is undergoing major transformations, as a result of factors both within nursing and in the larger society. Objective: In this paper the authors examine the trends and factors that are influencing the changes, especially in doctoral education, for both nurse scientist and advanced practice preparation.  Conclusion: The paper provides a background that serves as context, it gives an overview of the PhD and the DNP degrees, focusing on the recent changes and identifying the most compelling issues and concerns, ending with a series of recommendations.

Analytical and descriptive study of the process of change being experienced in the Spanish university system over the last decade (2005-2014). Objective: To describe the structural changes occurring in Nursing Education in Spain, reaching access to doctoral studies from the European Convergence Process and the subsequent legislative development. Methodology: Bibliographical review of royal decrees and reference literature on the subject of study and descriptive analysis of the situation. Results: Carries various changes suffered in the curricula of nursing education in the last decade, the legislation of the European Higher Education sets the guidelines for current studies of Masters and Doctorates. Conclusions: The implementation of the Master and Doctorate stages after a basic degree, which is now possible with the new legislation. A formal beginning made of scientific nursing in order to generate their own lines of research led by Doctors of nursing who can integrate in research groups under the same condition as other researcher, yet now, from the nursing discipline itself.

Objective: to analyze in detail the current situation of doctorate training in Nursing in Chile. Methodology: through a historical and contextual analysis of the background to the development of postgraduate education in Nursing, especially at doctorate level. Results: aspects that limit development were identified in national institutionalism of the sciences as well as in higher education and health institutions, especially the limited value placed on nursing as an area of knowledge in this country, the lack of clear institutional policies for postgraduate studies, as well as the postgraduate’s re-inclusion into the academic and care area, with access to national research funds difficult. Final considerations: access to grants and funds, together with recognition as an area of knowledge belonging on academic schedules, especially in health institutions, are the main challenges to consolidation. One aspect that would enable a more rapid advance is through national and international inter-institutional agreements, adding together potential, with access to funds for studies and academic and student internships, enabling joint research to go ahead.

Objective: to analyze the formation of nursing doctorates in Brazil, from theses production, disciplines and other strategies focusing on research offered by courses. Method: a descriptive and analytical study of the performance of 18 doctoral courses in nursing, running from 1982 to 2010, and defended their theses between 2010-2012. Results: 502 theses were defended in this period, most linked to the online research process of health and nursing care. There are gaps in the knowledge of theoretical and philosophical foundations of care, nursing history and ethics. There are also weaknesses in the methodological design of the theses, with a predominance of descriptive and/or exploratory studies. This was consistent with international standards set with regards to the proposition of research of disciplines and complementary strategies in forming the doctorate. Conclusion: despite the efforts and advances in research formation, it is essential to expand to more robust research designs with a greater impact on production knowledge that is incorporated into practice.

Objectives: The Millennium Development Goals are centered around combatting poverty and other social evils all over the world. Thus, this study seeks to identify the Millennium Development Goals as an object of study in theses from Postgraduate Nursing Programs in Brazil scoring 5 (national excellence) and 6 or 7 (international excellence), and evaluate the association between the score for the program and achieving the Millennium Development Goals. Method: Exploratory descriptive document research. Data were collected from the Notes on Indicators/Coordination for Higher Education Personnel Improvement for the 15 Postgraduate Nursing Courses scoring between 5 and 7 in the three-year-period of 2010/2012. Results: of the 8 Millennium Development Objectives, 6 were dealt with in the theses. There was an association (Fisher’s exact test p-value=0.0059) between the distribution of the theses and the program scores in relation to the Millennium Development Objectives (p-valor=0.0347) Conclusion: the doctoral theses were slightly related to the Millennium Development Objectives, covering the population’s economic development, health conditions and quality of life. It is recommended that Postgraduate Programs in Nursing pay closer attention to the Millennium Development Objectives.

Objective: to identify the training nursing professionals receive and its relevance to the workplace, as well as professional demand for continuous education. Methodology: this was a descriptive observational study using a questionnaire entitled “Training and Adaptation of the Nursing Professional to the Workplace” available at: http://enfermeriadocente.es for nursing professionals. Results: 53.8% of nurses do not consider the training received to be relevant to the needs of the workplace and 94.2% reported that linking academic education to the workplace impacts on the quality of care provided. Conclusions: Nursing professionals think that continuous education needs to be adjusted to their jobs and careers. Education should be viewed as a continuum, which begins with training.

Objective: to understand the meaning of the Adult Intensive Care Unit environment of care, experienced by professionals working in this unit, managers, patients, families and professional support services, as well as build a theoretical model about the Adult Intensive Care Unit environment of care. Method: Grounded Theory, both for the collection and for data analysis. Based on theoretical sampling, we carried out 39 in-depth interviews semi-structured from three different Adult Intensive Care Units. Results: built up the so-called substantive theory "Sustaining life in the complex environment of care in the Intensive Care Unit". It was bounded by eight categories: "caring and continuously monitoring the patient" and "using appropriate and differentiated technology" (causal conditions); "Providing a suitable environment" and "having relatives with concern" (context); "Mediating facilities and difficulties" (intervenienting conditions); "Organizing the environment and managing the dynamics of the unit" (strategy) and "finding it difficult to accept and deal with death" (consequences). Conclusion: confirmed the thesis that "the care environment in the Intensive Care Unit is a living environment, dynamic and complex that sustains the life of her hospitalized patients".

Objective: to identify the main gains and stressors perceived by the patient, one year subsequent to kidney transplantation. Method: a qualitative study, in which the data were obtained and analyzed through the Discourse of the Collective Subject and frequency counting, with the participation of 50 patients who had received kidney transplantation. Results: the sample presented a mean age of 44±12.8 years old, and a predominance of males (62%). The principal positive changes provided by the transplant were: return to activities; freedom/independence; well-being and health; strengthening of the I; and closening of interpersonal relationships. The most-cited stressors were: fear; medication; excess of care/control; specific characteristics of the treatment; and failure to return to the social roles. Conclusion: kidney transplantation caused various positive changes in the patient’s routine, with the return to activities of daily living being the most important gain, in the participants’ opinion. In relation to the stressors, fear related to loss of the graft, and questions relating to the immunosuppressive medication were the main challenges to be faced following transplantation.

Objective: this study’s aim was to interpret the meanings assigned to quality of life by patients with colorectal cancer undergoing chemotherapy. Method: the ethnographic method and the medical anthropology theoretical framework were used. Data were collected through semi-structured interviews and participant observations with 16 men and women aged from 43 to 75 years old undergoing chemotherapy in a university hospital. Results: the meanings and senses describe biographical ruptures, loss of normality of life, personal and social suffering, and the need to respond to chemotherapy’s side effects; chemotherapy is seen as a transitional stage for a cure. Quality of life is considered unsatisfactory because the treatment imposes personal and social limitations and QoL is linked to resuming normal life. Conclusions: the meanings show the importance of considering sociocultural aspects in the conceptualization and assessment of quality of life.

Objective: to identify the prevalence of Metabolic Syndrome among nursing personnel, and its association with occupational stress, anxiety and depression. Method: a descriptive correlational study undertaken with 226 nursing personnel from a teaching hospital. Data collection was undertaken through application of the Job Stress Scale, the Hospital Anxiety and Depression Scale and a sociodemographic questionnaire, with variables of Metabolic Syndrome. Univariate analyses and Chi-squared and Pearson tests were used for correlation between the variables, with a level of significance of 5%. Results: 86 (38.1%) workers presented Metabolic Syndrome, of whom 183 (81.1%) were female, and 43 (19.9%) male, aged between 23 and 66 years old. In relation to anxiety and depression, 154 (68.1%) presented anxiety, with 48 (31.2%) also presenting Metabolic Syndrome; 185 (81.8%) presented depression, of whom 62 (33.5%) also had Metabolic Syndrome. It was ascertained that 61 (27.0%) workers presented stress and that of these, 14 (22.9%) presented Metabolic Syndrome. Conclusion: a correlation was observed between the variables of anxiety and Metabolic Syndrome and stress and Metabolic Syndrome, there being no correlation between the variables of depression and Metabolic Syndrome.

Objectives: to analyze the spatial distribution of reported cases of pregnant women infected by the human immunodeficiency virus and to identify the urban areas with greater social vulnerability to the infection among pregnant women. Method: ecological study, developed by means of spatial analysis techniques of area data. Secondary data were used from the Brazilian National Disease Notification System for the city of Recife, Pernambuco. Birth data were obtained from the Brazilian Information System on Live Births and socioeconomic data from the 2010 Demographic Census. Results: the presence of spatial self-correlation was verified. Moran’s Index was significant for the distribution. Clusters were identified, considered as high-risk areas, located in grouped neighborhoods, with equally high infection rates among pregnant women. A neighborhood located in the Northwest of the city was distinguished, considered in an epidemiological transition phase. Conclusion: precarious living conditions, as evidenced by the indicators illiteracy, absence of prenatal care and poverty, were relevant for the risk of vertical HIV transmission, converging to the grouping of cases among disadvantaged regions.