Alianza de la enfermería con el usuario en la defensa del SUS

Estudo reflexivo com o objetivo de apresentar, na perspectiva dos direitos humanos, elementos relevantes para o cuidado de enfermagem na defesa dos sujeitos no contexto do Sistema Único de Saúde (SUS) brasileiro. A saúde como um direito de todos e um dever do Estado materializou-se como uma conquista da população com o SUS, com os princípios de universalidade, integralidade e equidade da atenção em saúde, ampliando a concepção de saúde para além da ausência de doença e passando a ser entendida como qualidade de vida. O enfermeiro tem grande potencial para desempenhar um papel singular na defesa do direito à saúde e do direito à vida e, por meio de alianças, fortalecer o exercício da cidadania das pessoas

Ambiente virtual de aprendizaje: estructuración de guión para curso online

O presente trabalho visa descrever os passos para desenvolvimento de um curso e sua estrutura em ambiente virtual de aprendizagem Moodle. Para tanto, a pesquisa consistiu na aplicação de conteúdos de enfermagem para oferecimento de curso online em workshop internacional para grupo de estudantes de graduação e licenciatura em enfermagem do Brasil e de Portugal. Durante a pesquisa foram registradas etapas distintas, desde o planejamento do curso passando pela construção e transformação dos conteúdos, até a disponibilização aos estudantes. As atividades interativas e conteúdos foram elaborados pelos professores com participação de equipe técnica. No trabalho são apresentados procedimentos específicos e papéis a serem desempenhados por professores, especialistas, estudantes e técnicos. Os resultados do desenvolvimento e oferecimento do curso online apontaram alguns aspectos a serem aperfeiçoados no processo de trabalho, no formato dos conteúdos e na utilização das ferramentas

Empowering nurses in angola: the transformative outcome of training pioneer heroes / Empoderando enfermeiros em angola: as transformações resultantes da educação de heróis pioneiros

ABSTRACT Objective: to revisit the history of cooperation of two Portuguese Speaking countries, which resulted in the graduation of the first Nurses in Angola; to characterize the Angolan students who participated in the cooperation agreement; to identify their perspectives regarding their feelings at the end of the undergraduate program, the influences of the education received, their motivation to continue studying and their work satisfaction. Methods: Exploratory study conducted with Angolan students who graduated at a public Nursing School in Brazil. Data were collected through a questionnaire developed by the researchers, and culturally validated by two Angolan nurses experts. Results: efforts, challenges and achievements of heroes from both sides of the Atlantic are recognized and reflected in the social reality of the African country. Conclusion: Cooperation agreements are recommended as a path for the sustainability of the health policies at a global perspective. DESCRIPTORS: Nursing; Global health; International cooperation; Collaboration; Human resources.RESUMEN Objetivo: Revisitar la história de cooperación de dos países de lengua portuguesa, que ha resultado en la formación de los primeiros enfermeros de Angola; Caracterizar los alumnos angolanos que participaron del acuerdo de cooperación ; Identificar sus perspectivas y sentimientos al final del programa, las influencias de la educación recibida, motivaciones para continuar estudiando y satisfacción en el trabajo. Métodos: estudio exploratório conducido con alumnos angolanos que se graduaron en una Escuela de Enfermería pública de Brasil. Los datos fueron recoleccionados por medio de cuestionário desarrollado por los investigadores y culturalmente validado con dos especialistas enfermeros de Angola. Resultados: esfuerzos, retos y realizaciones de héroes de ambos los lados del Atlántico son reconocidos reflejados en la realidad social del país africano. Conclusión: Acuerdos de cooperación son recomendados como un camino para la sostenibilidad de las políticas de salud a partir de una perspectiva global. DESCRIPTORES: Enfermería, Salud global, Cooperación internacional, Colaboración, Recursos humanos, Enfermero.Objetivo: Revisitar a história de cooperação de dois países de língua portuguesa, que resultou na formação dos primeiros enfermeiros de Angola ; Caracterizar os alunos angolanos que participaram do acordo de cooperação ; Identificar suas perspectivas e sentimentos ao final do programa, as influências da educação recebida, motivações para continuarem estudando e satisfação no trabalho. Método: estudo exploratório conduzido com alunos angolanos que graduados em Escola de Enfermagem pública do Brasil. Os dados foram coletados por meio de questionário desenvolvido pelos pesquisadores,  culturalmente validado com dois especialistas enfermeiros de Angola. Resultados: os esforços, desafios e realizações de heróis de ambos os lados do Atlântico são reconhecidos e se refletem na realidade social do país africano. Conclusão: Acordos de cooperação são recomendados como um caminho para a sustentabilidade das políticas de saúde a partir de uma perspectiva global.

Empowering nurses in angola: the transformative outcome of training pioneer heroes / Empoderando enfermeiros em angola: as transformações resultantes da educação de heróis pioneiros

Objetivo: Revisitar a história de cooperação de dois países de língua portuguesa, que resultou na formação dos primeiros enfermeiros de Angola ; Caracterizar os alunos angolanos que participaram do acordo de cooperação ; Identificar suas perspectivas e sentimentos ao final do programa, as influências da educação recebida, motivações para continuarem estudando e satisfação no trabalho. Método: estudo exploratório conduzido com alunos angolanos que graduados em Escola de Enfermagem pública do Brasil. Os dados foram coletados por meio de questionário desenvolvido pelos pesquisadores,  culturalmente validado com dois especialistas enfermeiros de Angola. Resultados: os esforços, desafios e realizações de heróis de ambos os lados do Atlântico são reconhecidos e se refletem na realidade social do país africano. Conclusão: Acordos de cooperação são recomendados como um caminho para a sustentabilidade das políticas de saúde a partir de uma perspectiva global.

CONTRIBUIÇÃO DE EDUCAÇÃO PERMANENTE SEMIPRESENCIAL NO CONHECIMENTO DE ENFERMEIROS SOBRE ESTOMIAS INTESTINAIS DE ELIMINAÇÃO

RESUMO Objetivo: avaliar a contribuição de um programa de educação permanente semipresencial no conhecimento de enfermeiros sobre estomias intestinais de eliminação. Método: estudo quase-experimental, do tipo grupo único, antes e depois, realizado com 51 enfermeiros de três hospitais de grande porte do Piauí, no período de agosto a outubro de 2014, nas seguintes etapas: identificação dos enfermeiros, exposição dos objetivos e convite para participação na pesquisa, pré-teste, programa de educação permanente semipresencial e pós-teste. Resultados: a média do número de acertos dos enfermeiros no pré-teste 25,5 (dp=4,2) foi menor do que no pós-teste 31,5 (dp=3,0) e essa diferença foi estatisticamente significante (p=0,000). Conclusão: neste estudo, o programa de educação permanente semipresencial contribuiu para melhorar o conhecimento dos enfermeiros sobre estomias intestinais de eliminação

SÍNDROME GRIPAL SUSPEITA DE COVID-19 EM HOMENS QUE FAZEM SEXO COM HOMENS E SE ENVOLVERAM EM SEXO CASUAL

Objective: To evaluate the presence of flu-like syndrome suggestive of COVID-19 in men who have sex with men (MSM) and engaged in casual sex during a period of social isolation. Method: National epidemiological survey, applied in April and May 2020, by adaptation of Respondent Drive Sampling. Results: 1,337 MSM participated in the survey, of which 514 (38.4%) had fever associated with another sign or symptom of flu-like syndrome. Social, demographic characteristics, sexual practices and activities during the period of social isolation were statistically associated with the presence of flu-like syndrome. There was a statistical difference (p < 0.001) in the average of partners between those who had signs and symptoms of flu-like syndrome (3.5) and those who did not (1.7). Conclusion: Evidence of signs and symptoms indicative of flu-like syndrome suggestive of COVID 19 in Brazilian MSM who were involved in casual sex during the period of social isolation.  Objetivo: Evaluar la presencia de síndrome gripal sospecha de COVID-19 en hombres que tienen sexo con hombres (HSH) y se envolvieron en sexo con pareja ocasional durante distanciamiento social. Método: Averiguación epidemiológica, de abarcamiento nacional, aplicado en abril y mayo de 2020, por adaptación del Respondent Drive Sampling. Resultados: 1.337 HSHs participaron de la investigación, de los cuales 514 (38,4%) tuvieron fiebre relacionada a otra señal o síntoma de síndrome gripal. Características sociales, demográficas, prácticas y actividades sexuales durante el distanciamiento social han estáticamente relacionadas a la presencia de síndrome gripal. Hubo diferencia estadística (p < 0,001) en la media de parejas entre aquellos que tuvieron señales y síntomas de síndrome gripal (3,5) y aquellos que no los tuvieron (1,7). Conclusión: Se evidencia ocurrencia de señales y síntomas indicativos de síndrome gripal sugestivo de COVID-19 en HSHs brasileños que se envolvieron en sexo ocasional durante el período del distanciamiento social.Objetivo: Avaliar a presença de síndrome gripal suspeita de COVID-19 em homens que fazem sexo com homens (HSH) e se envolveram em sexo com parceiro casual durante período de distanciamento social. Método: Inquérito epidemiológico, de abrangência nacional, aplicado em abril e maio de 2020, por adaptação do Respondent Drive Sampling. Resultados: 1.337 HSHs participaram da pesquisa, dos quais 514 (38,4%) tiveram febre associada a outro sinal ou sintoma de síndrome gripal. Características sociais, demográficas, práticas e atividades sexuais durante o período de distanciamento social foram estaticamente associadas à presença de síndrome gripal. Houve diferença estatística (p < 0,001) na média de parceiros entre aqueles que tiveram sinais e sintomas de síndrome gripal (3,5) e aqueles que não os tiveram (1,7). Conclusão: Evidencia-se ocorrência de sinais e sintomas indicativos de síndrome gripal sugestiva de COVID‑19 em HSHs brasileiros que se envolveram em sexo casual durante o período do distanciamento social

Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK.

BACKGROUND: A safe and efficacious vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), if deployed with high coverage, could contribute to the control of the COVID-19 pandemic. We evaluated the safety and efficacy of the ChAdOx1 nCoV-19 vaccine in a pooled interim analysis of four trials. METHODS: This analysis includes data from four ongoing blinded, randomised, controlled trials done across the UK, Brazil, and South Africa. Participants aged 18 years and older were randomly assigned (1:1) to ChAdOx1 nCoV-19 vaccine or control (meningococcal group A, C, W, and Y conjugate vaccine or saline). Participants in the ChAdOx1 nCoV-19 group received two doses containing 5 × 1010 viral particles (standard dose; SD/SD cohort); a subset in the UK trial received a half dose as their first dose (low dose) and a standard dose as their second dose (LD/SD cohort). The primary efficacy analysis included symptomatic COVID-19 in seronegative participants with a nucleic acid amplification test-positive swab more than 14 days after a second dose of vaccine. Participants were analysed according to treatment received, with data cutoff on Nov 4, 2020. Vaccine efficacy was calculated as 1 - relative risk derived from a robust Poisson regression model adjusted for age. Studies are registered at ISRCTN89951424 and ClinicalTrials.gov, NCT04324606, NCT04400838, and NCT04444674. FINDINGS: Between April 23 and Nov 4, 2020, 23 848 participants were enrolled and 11 636 participants (7548 in the UK, 4088 in Brazil) were included in the interim primary efficacy analysis. In participants who received two standard doses, vaccine efficacy was 62·1% (95% CI 41·0-75·7; 27 [0·6%] of 4440 in the ChAdOx1 nCoV-19 group vs71 [1·6%] of 4455 in the control group) and in participants who received a low dose followed by a standard dose, efficacy was 90·0% (67·4-97·0; three [0·2%] of 1367 vs 30 [2·2%] of 1374; pinteraction=0·010). Overall vaccine efficacy across both groups was 70·4% (95·8% CI 54·8-80·6; 30 [0·5%] of 5807 vs 101 [1·7%] of 5829). From 21 days after the first dose, there were ten cases hospitalised for COVID-19, all in the control arm; two were classified as severe COVID-19, including one death. There were 74 341 person-months of safety follow-up (median 3·4 months, IQR 1·3-4·8): 175 severe adverse events occurred in 168 participants, 84 events in the ChAdOx1 nCoV-19 group and 91 in the control group. Three events were classified as possibly related to a vaccine: one in the ChAdOx1 nCoV-19 group, one in the control group, and one in a participant who remains masked to group allocation. INTERPRETATION: ChAdOx1 nCoV-19 has an acceptable safety profile and has been found to be efficacious against symptomatic COVID-19 in this interim analysis of ongoing clinical trials. FUNDING: UK Research and Innovation, National Institutes for Health Research (NIHR), Coalition for Epidemic Preparedness Innovations, Bill & Melinda Gates Foundation, Lemann Foundation, Rede D'Or, Brava and Telles Foundation, NIHR Oxford Biomedical Research Centre, Thames Valley and South Midland's NIHR Clinical Research Network, and AstraZeneca

Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK

Background A safe and efficacious vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), if deployed with high coverage, could contribute to the control of the COVID-19 pandemic. We evaluated the safety and efficacy of the ChAdOx1 nCoV-19 vaccine in a pooled interim analysis of four trials. Methods This analysis includes data from four ongoing blinded, randomised, controlled trials done across the UK, Brazil, and South Africa. Participants aged 18 years and older were randomly assigned (1:1) to ChAdOx1 nCoV-19 vaccine or control (meningococcal group A, C, W, and Y conjugate vaccine or saline). Participants in the ChAdOx1 nCoV-19 group received two doses containing 5 × 1010 viral particles (standard dose; SD/SD cohort); a subset in the UK trial received a half dose as their first dose (low dose) and a standard dose as their second dose (LD/SD cohort). The primary efficacy analysis included symptomatic COVID-19 in seronegative participants with a nucleic acid amplification test-positive swab more than 14 days after a second dose of vaccine. Participants were analysed according to treatment received, with data cutoff on Nov 4, 2020. Vaccine efficacy was calculated as 1 - relative risk derived from a robust Poisson regression model adjusted for age. Studies are registered at ISRCTN89951424 and ClinicalTrials.gov, NCT04324606, NCT04400838, and NCT04444674. Findings Between April 23 and Nov 4, 2020, 23 848 participants were enrolled and 11 636 participants (7548 in the UK, 4088 in Brazil) were included in the interim primary efficacy analysis. In participants who received two standard doses, vaccine efficacy was 62·1% (95% CI 41·0–75·7; 27 [0·6%] of 4440 in the ChAdOx1 nCoV-19 group vs71 [1·6%] of 4455 in the control group) and in participants who received a low dose followed by a standard dose, efficacy was 90·0% (67·4–97·0; three [0·2%] of 1367 vs 30 [2·2%] of 1374; pinteraction=0·010). Overall vaccine efficacy across both groups was 70·4% (95·8% CI 54·8–80·6; 30 [0·5%] of 5807 vs 101 [1·7%] of 5829). From 21 days after the first dose, there were ten cases hospitalised for COVID-19, all in the control arm; two were classified as severe COVID-19, including one death. There were 74 341 person-months of safety follow-up (median 3·4 months, IQR 1·3–4·8): 175 severe adverse events occurred in 168 participants, 84 events in the ChAdOx1 nCoV-19 group and 91 in the control group. Three events were classified as possibly related to a vaccine: one in the ChAdOx1 nCoV-19 group, one in the control group, and one in a participant who remains masked to group allocation. Interpretation ChAdOx1 nCoV-19 has an acceptable safety profile and has been found to be efficacious against symptomatic COVID-19 in this interim analysis of ongoing clinical trials

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake