Strategies in coping with the COVID-19 pandemic by nursing professionals: doing and learning

Objective: To describe strategies in coping with the COVID-19 pandemic adopted by nursing professionals. Method: Qualitative research conducted in a public teaching hospital in Salvador  –  Bahia, Brazil, between September and October 2020. A total of 17 nursing professionals who work in a reference unit for symptomatic respiratory patients were interviewed. Data were collected through semi-structured interviews and analyzed in the IRAMUTEQ software. The project was approved by a Research Ethics Committee. Results: nursing professionals developed strategies to cope with the pandemic to care for patients with COVID-19, their own family members, the team and themselves. For patients, the strategies adopted include greater concern for comfort, safety and improvements in the communication process. The distancing of family members has given rise to the need for the use of technological resources to favor approximation. A greater concern was identified with the protection of team members and with themselves, as they emphasized the correct use of personal protective equipment as a way to feel more protected and safe, including emotionally. Conclusion: The strategies developed by the professionals emerged from the practice to the extent that they were experiencing care to patients with COVID-19. These strategies aimed to adopt measures for self-protection, protection of their family members and team colleagues; and humanized patient care

ESTRESSE OCUPACIONAL RELACIONADO À ASSISTÊNCIA DE ENFERMAGEM EM TERAPIA INTENSIVA

Objetivo: estimar a prevalência de estresse ocupacional entre profissionais de enfermagem que atuam em Unidade de Terapia Intensiva e identificar sua associação com variáveis sociodemográficas, profissionais e relacionadas à assistência de enfermagem. Método: estudo transversal, realizado em um hospital de ensino de Salvador, Bahia, Brasil, com 54 profissionais. Os dados foram coletados entre fevereiro e março de 2020 por meio da Escala Bianchi de Stress e analisados pelo Programa Stata. Resultados: a prevalência de estresse ocupacional em nível médio ou alto foi de 57,4%. Maiores níveis de estresse foram associados significativamente ao menor tempo de formação (p-valor=0,05), ser enfermeiro (p-valor=0,00), enfrentar a morte do paciente (p-valor=0,01), atender aos familiares dos pacientes críticos (p-valor=0,00) e atender às necessidades dos familiares (p-valor=0,00). Conclusão: a elevada prevalência de estresse ocupacional, bem como os fatores associados identificados, foram informações essenciais para implementação de estratégias preventivas. Descritores: Estresse Ocupacional. Cuidados de Enfermagem. Unidade de Terapia Intensiva. Equipe de Enfermagem. Enfermagem

Elaboração de um fluxograma de transporte de pacientes para um centro especializado em COVID-19

The aim was to describe the construction and implementation of a flowchart of inter-hospital transport of patients to a center specialized in the care of COVID 19. Descriptive study, type experience report carried out by nurses in a teaching hospital specializing in cardiopneumology in São Paulo, from March to April 2020. Based on national and international recommendations for patient care and safety, a flowchart for transporting these patients to a center specializing in the care of COVID was created and implemented19. The implementation of the transfer flowchart optimized the flow of care, standardized related activities, and contributed to the safety of patients and professionals.Objetivou-se descrever a construção e a implementação de um fluxograma de transporte inter-hospitalar de pacientes para um centro especializado no atendimento ao COVID 19. Estudo descritivo, tipo relato de experiência realizado por enfermeiros em um hospital de ensino especializado em cardiopneumologia de São Paulo, no período de março a abril de 2020. Com bases nas recomendações nacionais e internacionais para a assistência e segurança do paciente, foi elaborado e implementado um fluxograma para transporte destes pacientes para um centro especializado no atendimento ao COVID19. A implementação do fluxograma de transferência otimizou o fluxo de assistência, padronizou as atividades relacionadas e contribuiu para a segurança de pacientes e profissionais

LETRAMENTO EM SAÚDE POR MÍDIA SOCIAL DURANTE A PANDEMIA

Este relato de experiência, tem por objetivo descrever a elaboração e veiculação de ações de extensão para prevenção de COVID-19 em mídia social, elaboradas de acordo com os pressupostos do letramento em saúde. A extensão universitária por meio de mídia social permitiu desenvolver letramento científico com acesso e compreensão de informações relevantes para a prática baseada em evidências entre estudantes de medicina. O debate online permitiu construir processo de avaliação formativa no qual os estudantes e docentes vivenciaram a interação e aplicação de conceitos teóricos em ambiente virtual de ensino em tempo real. Por outro lado, os materiais educativos construídos e palestras online possibilitaram oportunidade de prática de letramento em saúde para os estudantes de medicina, bem como a construção de repositório de materiais educativos em mídia social para consulta e divulgação na comunidade. O uso de tecnologia de informação e comunicação para o ensino em saúde é uma alternativa de baixo custo e com ampla capacidade de divulgação na comunidade, sendo uma ferramenta potencial para atividades de extensão em situações de pandemia ou contextos que envolvam impossibilidade de acesso presencial ao público-alvo. Os principais desafios no uso dessas tecnologias são a necessidade de capacitação de professores e estudantes para uso de softwares e adequação de materiais acadêmicos a linguagem adequada ao nível de compreensão do público-alvo

Inhibition of PbGP43 expression may suggest that gp43 is a virulence factor in Paracoccidioides brasiliensis

ABSTARCT: Glycoprotein gp43 is an immunodominant diagnostic antigen for paracoccidioidomycosis caused by Paracoccidioides brasiliensis. It is abundantly secreted in isolates such as Pb339. It is structurally related to beta-1,3-exoglucanases, however inactive. Its function in fungal biology is unknown, but it elicits humoral, innate and protective cellular immune responses; it binds to extracellular matrix-associated proteins. In this study we applied an antisense RNA (aRNA) technology and Agrobacterium tumefaciens-mediated transformation to generate mitotically stable PbGP43 mutants (PbGP43 aRNA) derived from wild type Pb339 to study its role in P. brasiliensis biology and during infection. Control PbEV was transformed with empty vector. Growth curve, cell vitality and morphology of PbGP43 aRNA mutants were indistinguishable from those of controls. PbGP43 expression was reduced 80-85% in mutants 1 and 2, as determined by real time PCR, correlating with a massive decrease in gp43 expression. This was shown by immunoblotting of culture supernatants revealed with anti-gp43 mouse monoclonal and rabbit polyclonal antibodies, and also by affinity-ligand assays of extracellular molecules with laminin and fibronectin. In vitro, there was significantly increased TNF-α production and reduced yeast recovery when PbGP43 aRNA1 was exposed to IFN-γ-stimulated macrophages, suggesting reduced binding/uptake and/or increased killing. In vivo, fungal burden in lungs of BALB/c mice infected with silenced mutant was negligible and associated with decreased lung ΙΛ-10 and IL-6. Therefore, our results correlated low gp43 expression with lower pathogenicity in mice, but that will be definitely proven when PbGP43 knockouts become available.

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality