Situações de conflito vivenciadas no contexto hospitalar: a visão dos técnicos e auxiliares de enfermagem

Realizamos um estudo no Hospital das Clínicas-UFMG, objetivando analisar como o enfermeiro lida com os conflitos no ambiente organizacional. Desenvolvemos a pesquisa em duas fases de coleta de dados. Aplicamos um questionário e, em seguida, realizamos uma entrevista semiestruturada. Organizamos os dados de acordo com os conteúdos temáticos. Segundo os profissionais pesquisados, o termo conflito traz uma denotação negativa. Alguns sujeitos apontaram os seguintes tipos de conflito: intrapessoal, interpessoal e intergrupal. Determinado número de pesquisados relatou que o enfermeiro está preparado para lidar com situações conflituosas utilizando o diálogo e a negociação. No entanto, outros responderam que o enfermeiro não está preparado, devido à inexperiência profissional e a falta de interação com a equipe. Consideramos que esses resultados trazem uma reflexão para o enfermeiro acerca da sua conduta gerencial.Realizamos un estudio en el Hospital de Clínicas UFMG (Minas Gerais, Brasil), objetivando analizar el modo en el que el enfermero se enfrenta con los conflictos en el ambiente organizacional. Desarrollamos la investigación en dos fases de recolección de datos. Aplicamos un cuestionario y a continuación realizamos una entrevista semiestructurada. Organizamos los datos de acuerdo a los contenidos temáticos. Según los profesionales entrevistados, el término conflicto acarrea una connotación negativa. Algunos sujetos apuntaron los siguientes tipos de conflicto: intrapersonal, interpersonal e intergrupal. Determinado número de entrevistados relató que el enfermero está preparado para enfrentarse a situaciones de conflicto utilizando el diálogo y la negociación. Entretanto, otros respondieron que el enfermero no está preparado, en razón de la inexperiencia profesional y la falta de interacción con el equipo. Consideramos que esos resultados apuntan a que el enfermero reflexione acerca de su conducta gerencial.This study was developed at the Federal University of Minas Gerais Hospital with the purpose to analyze how nurses deal with the conflicts that occur in the work environment. The research was developed in two data collection stages. Authors applied a questionnaire, followed by a semi-structured interview. Data was organized according to their thematic content. According to the interviewed workers, the term conflict has a negative denotation. Some subjects pointed out the following types of conflict: intrapersonal, interpersonal and intergroup. Some of them also reported that nurses are prepared to face conflict situations using dialogue and negotiation. However, others answered that nurses are not prepared, due to professional inexperience and the lack of interaction with the team. Authors considered that these results must encourage nurses towards reflecting about their management practice

Off-target effects of bacillus Calmette–Guérin vaccination on immune responses to SARS-CoV-2: implications for protection against severe COVID-19

Background and objectives: Because of its beneficial off-target effects against non-mycobacterial infectious diseases, bacillus Calmette–Guérin (BCG) vaccination might be an accessible early intervention to boost protection against novel pathogens. Multiple epidemiological studies and randomised controlled trials (RCTs) are investigating the protective effect of BCG against coronavirus disease 2019 (COVID-19). Using samples from participants in a placebo-controlled RCT aiming to determine whether BCG vaccination reduces the incidence and severity of COVID-19, we investigated the immunomodulatory effects of BCG on in vitro immune responses to SARS-CoV-2. Methods: This study used peripheral blood taken from participants in the multicentre RCT and BCG vaccination to reduce the impact of COVID-19 on healthcare workers (BRACE trial). The whole blood taken from BRACE trial participants was stimulated with γ-irradiated SARS-CoV-2-infected or mock-infected Vero cell supernatant. Cytokine responses were measured by multiplex cytokine analysis, and single-cell immunophenotyping was made by flow cytometry. Results: BCG vaccination, but not placebo vaccination, reduced SARS-CoV-2-induced secretion of cytokines known to be associated with severe COVID-19, including IL-6, TNF-α and IL-10. In addition, BCG vaccination promoted an effector memory phenotype in both CD4+ and CD8+ T cells, and an activation of eosinophils in response to SARS-CoV-2. Conclusions: The immunomodulatory signature of BCG’s off-target effects on SARS-CoV-2 is consistent with a protective immune response against severe COVID-19

Rubella immunization in human immunodeficiency virus type 1-infected children

Background: HIV infection can have important although sometimes unexpected consequences, such as contributing to enlargement of the pool of rubella-susceptible children.Methods: At the Federal University of São Paulo, Brazil, we assessed response to rubella immunization at 15 months of age in 15 human immunodeficiency virus type 1 (HIV)-infected children, 20 seroreverted children (SR) and 18 healthy control children born to HIV-seronegative mothers (CON). Blood samples were collected before and 3 months after vaccination. All HIV-infected children had started highly active antiretroviral therapy during their first 6 months of life. Serum samples were tested with a rubella IgG enzyme-linked immunosorbent assay kit.Results: HIV children in immunologic categories 2/3 had lower rubella antibody titers (geometric mean, 33 IU/mL) than those from CON (125 IU/mL) and SR group (236 IU/mL) (Tukey, P = 0.01). Antibody values after vaccination were positively associated with CD4 T cell numbers and negatively associated with HIV viral load assessed immediately before vaccination. the percentage of children with protective antibodies after vaccination (above 10.0 IU/mL) was also significantly different among groups (Fisher's exact test, P = 0.013): CON, 94%; SR, 100%; HIV category 1, 100%; HIV category 2/3, 62%.Conclusions: HIV-infected children with a preserved immune system at measles-mumps-rubella immunization can have a good response to rubella vaccine. in contrast, those in more advanced categories for HIV infection respond poorly.Universidade Federal de São Paulo, Dept Pediat, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Pediat, São Paulo, BrazilWeb of Scienc

(Re)pensando a gerência em enfermagem a partir de conceitos utilizados no campo da Saúde Coletiva (Re)thinking nursing management based on Collective Health concepts

Estudos mostram que para gerenciar a assistência de enfermagem, o enfermeiro utiliza métodos e estratégias de gestão oriundos da teoria clássica da administração. Este estilo de gerência não tem permitido aos trabalhadores de enfermagem criarem espaços coletivos de gestão, onde possam atuar como sujeitos sociais. Partindo do princípio de que a gerência em enfermagem necessita, na atualidade, ser vista e exercitada sob um novo olhar, procurou-se neste ensaio teórico elaborar uma reflexão acerca desta prática, utilizando os conceitos de sujeito social e de coletivo, que são fundamentais no campo da Saúde Coletiva. Assim, aproximar deste campo, além de contribuir para ampliar os conhecimentos e os questionamentos acerca da temática, contribuiu também para compreender a equipe de enfermagem como um coletivo de sujeitos sociais em ação, visto que os trabalhadores são seres humanos dotados de interesses próprios, de necessidades e de desejos, que produzem relações sociais, na medida em que interagem constantemente com outros sujeitos e podem adquirir capacidade para intervir na sua realidade. Este coletivo organizado possui como objetivo principal a prestação de uma assistência integral à população, realizando ações de forma ética, digna, segura e humanizada.<br>Studies show that in order to manage nursing care, nurses use management methods and strategies based on the classic administration theory. This management does not enable nursing workers to create collective spaces, where they can act as social subjects. Based on the principle that nursing management needs, at the moment, to be seen and exercised under a new view, the author aims at elaborating a reflection on this practice, using the concepts of collective and social subject that are fundamental to Collective Health. Thus, the possibility of approaching this field contributed to expand the author's knowledge and concerns regarding the theme as well as to better understand the nursing theme as a collective of social subjects in action. Therefore, it is important to emphasize that the workers are human beings with their own interests, needs and wishes, producing social relations as they constantly interact with other subjects and are able to build capacities to intervene in this reality. This organized group has the main objective to provide an integral care to the population, performing actions in an ethic, secure and humanized direction