Burnout in Healthcare Professionals during Covid-19 Pandemic Times

During the COVID-19 pandemic, the increased work overload of healthcare professionals, in the near breakdown of healthcare services, may have affected their emotional state and burnout levels. To know the impact of the COVID-19 pandemic on the burnout levels of healthcare professionals in a hospital institution, identifying the relationship with sociodemographic, organisational and other characteristics. Quantitative, observational, descriptive, analytical and transversal methodology, in a convenience sampling process, consisting of 324 healthcare professionals. A questionnaire-based on validated methods was used as a data collection instrument. The data obtained were statistically analysed. Healthcare professionals presented moderate levels of burnout in emotional exhaustion and depersonalisation, and high in the professional achievement dimension;30.2% met high burnout criteria. Higher burnout levels have been associated with organisational aspects such as working directly with infected patients, not having access to the necessary personal protective equipment, and high-risk perception of COVID-19 infection. It is essential to implement organisational measures, health and psychosocial risks surveillance and psychosocial risks to stop burnout increase in healthcare professionals,, an alarming trend and transversal to various health services.

COVID-19 in liver transplant recipients

Coronavirus disease 2019 (COVID-19), an infection caused by severe acute respiratory syndrome coronavirus-type 2 (SARS-CoV-2), has emerged as a serious threat to public health. Liver transplant (LT) recipients may be at increased risk of acquisition of SARS-CoV-2 infection and higher morbidity and mortality due to constant contact with health-care services, the use of immunosuppressants and frequent comorbidities. In the first part of this review we discuss (1) the epidemiology and risk factors for SARS-CoV-2 infection in LT recipients;(2) the clinical and laboratory features of COVID-19 in this specific population, highlighting differences in presenting signs and symptoms with respect to general populations and (3) the natural history and prognostic factors in LT recipients hospitalized with COVID-19, with particular focus on the possible role of immunosuppression. Thereafter, we review the potential therapeutic options for COVID-19 treatment and prevention. Specifically, we give an overview of current practice in immunosuppressant regimen changes, showing the potential benefits of this strategy, and explore safety and efficacy issues of currently approved drugs in LT recipients. The last topic is dedicated to the potential benefits and pitfalls of vaccination.Copyright © 2021 The Authors

Pandemic sociomaterial bricolage: how vulnerable communities used social media to tackle the COVID-19 crisis

Purpose: This research was conducted to understand how vulnerable communities used social media (SM) tools to face the impacts of the COVID-19 pandemic. Affected by the lack of information and the absence of effective public policies, residents from slums in the city of Rio de Janeiro displayed new and unexpected uses to SM tools to tackle the health and socio-economic impacts of the pandemic. Design/methodology/approach: The research methodology consisted of a qualitative, exploratory study, combining a series of in-depth interviews with the analysis of various posts, containing videos and texts, extracted from SM during the first six months of the pandemic. The data were collected in the context of 10 different communities in Rio de Janeiro city. Findings: In the context of the pandemic, people combined different uses of SM not only to inform themselves and communicate with others but also to articulate and execute fundraising and food donation strategies within vulnerable communities. Accordingly, this SM use is characterized by improvisation, learning by doing and building resilience, which are all constructs related to the concept of bricolage. Users had no specific SM knowledge, and adjusted these technological tools to emergent new activities in practice, which is characteristic of sociomaterial process. In addition to emphasizing the importance of context for the emergence of the phenomenon, this work also highlights reliability, validity and authority as characteristics related to the citizen-led participation approach that was observed. Research limitations/implications: Future research can develop approaches based on pandemic sociomaterial bricolage (PSB) aspects, which could guide governments and practitioners on building innovative solutions for the use of SM by the population, especially in emergency situations. Originality/value: This study proposes a framework, termed PSB, to represent SM usage promoted by the pandemic context, which emerged from the triangulation of empirical data and an analysis based on the concepts of bricolage and sociomateriality. © 2022, Emerald Publishing Limited.

Experience in managing action research on hepatitis C survey in the prison community

We aimed to report the experience in managing action research on hepatitis C investi-gation in the prison community in the Triangulo Mineiro region, Minas Gerais, Brazil. The proposal was developed from March 2019 to March 2020, reaching 240 people to contain the spread of the disease through a survey, testing, and mo-nitoring of positive cases. We adopted intersecto-ral action with articulation between Universities, Medical Society, Teaching Hospital, and State Secretariat for Justice and Public Security. Strategies for the management of action research are descri-bed: study settings and stakeholders, registration and formalization of the activity, application of tests, and management of reagent inmates. We identified difficulties regarding the accommoda-tion of routines among the research team and the proper functioning of the penitentiary, which required extensive training between the parties and managerial articulations. We consider that the report collaborates with the organization of future research aimed at accessing this still invi-sible population, the prison community when it highlights the strategies adopted to conduct the research. Copyright © 2022, Associacao Brasileira de Pos - Graduacao em Saude Coletiva. All rights reserved.

Development of an air purifier with UVC radiation and HEPA filter in the context of COVID-19

The transmission of respiratory infections has an important role on human health, especially in the current context of the COVID-19 pandemic. In this work, we present the assessment of an air purifier that uses ultraviolet-C (UVC) radiation and a "High Efficiency Particulate Air” (HEPA) filter as mechanisms to decontaminate indoor environments with low air circulation. To assess the physicochemical and microbicidal characteristics of the equipment, the irradiance produced by the lamp, the flow rate at the entrance and exit of the device, possible changes in the ozone concentration and the equipment's decontamination potential for Staphylococcus aureus, Escherichia coli and Candida albicans. The total dose of UVC radiation that the air receives when passing through the equipment was 801.4 μJ cm-2, which would represent an inactivation of up to 80% of SARS-CoV-2 in the air. Furthermore, the filtration efficiency dropped with smaller particle diameter, and reduced to around 60% for particles with less than 1 μm and remained above 90% for PM2.5 and PM10 . In microbiological tests, there was a reduction of 99.4%, 99.9% and 99.5% for S aureus, E. coli and C. albicans, respectively, in 11 minutes. © 2022 Associação Brasileira de Engenharia Sanitária e Ambiental Este é um artigo de acesso aberto distribuído nos termos de licença Creative Commons.

IMPOSSIBLE SPACES AND OTHER EMBODIMENTS: Co-constructing Virtual Realities

There is an urgent need to build affectively rich virtual environments for creative collaboration between international and culturally diverse communities of researchers using arts-based methods. The COVID-19 pandemic shone a bright light on an already existing gap in platforms for individual artists, researchers, and global arts research communities wanting to exchange and build new knowledge toward social justice through effective virtual spaces beyond video conferencing. This chapter will reflect on one such experiment: an iterative, experimental virtual reality space for knowledge exchange and collaboration between global artists, designers, and transdisciplinary researchers of the Center for Arts, Design, and Social Research (CAD+SR). The space was co-designed with M Eifler and Evelyn Eastmond (Microsoft), as well as a focus group of CAD+SR Research Fellows. In July 2020, the authors led this process of creating a remote-spatial collaboration space in Mozilla Hubs for the group’s virtual research residency. This chapter shares their reflections and frames the first-person responses of the collaborating artists and researchers who co-created and engaged the space. Collaborators produced multiple forms of virtual reality exhibitions and exchanges, and the space activated a significant sense of affective connection, despite considerable differences in technology literacy, hardware, and internet or cellular data access. © 2022 selection and editorial matter, xtine burrough and Judy Walgren.

An Automated Strategy to Handle Antigenic Variability in Immunisation Protocols, Part II: In Vitro Transcribed mRNA Vector Design for Inoculation Against Infectious Agent Variants

A fully automated strategy to handle antigenic variability in immunisation protocols is here presented. The method comprises of (1) nanopore sequencing of infectious agent variants, with focus on the SARS-CoV-2 and its variants, followed by (2) in-vitro transcribed mRNA vector design for immunotherapy. This chapter introduces the mRNA vector design protocol and Chapter 16 presents the nano-pore sequencing step.

An Automated Strategy to Handle Antigenic Variability in Immunisation Protocols, Part I: Nanopore Sequencing of Infectious Agent Variants

Infectious agents often challenge therapeutics, from antibiotics resistance to antigenic variability affecting inoculation measures. Over the last decades, genome sequencing arose as an important ally to address such challenges. In bacterial infection, whole-genome-sequencing (WGS) supports tracking pathogenic alterations affecting the human microbiome. In viral infection, the analysis of the relevant sequence of nucleotides helps with determining historical variants of a virus and elucidates details about infection clusters and their distribution. Additionally, genome sequencing is now an important step in inoculation protocols, isolating target genes to design more robust immunisation assays. Ultimately, genetic engineering has empowered repurposing at scale, allowing long-lasting repeating clinical trials to be automated within a much shorter time-frame, by adjusting existing protocols. This is particularly important during sanitary emergencies as the ones caused by the 2014 West African Ebola outbreak, the Zika virus rapid spread in both South and North America in 2015, followed by Asia in 2016, and the pandemic caused by the SARS-CoV-2, which has infected more than 187 million people and caused more than 4 million deaths, worldwide, as per July 2021 statistics. In this scenery, this chapter presents a novel fully automated strategy to handle antigenic variability in immunisation protocols. The methodology comprises of two major steps (1) nanopore sequencing of infectious agent variants - the focus is on the SARS-CoV-2 and its variants;followed by (2) mRNA vector design for immunotherapy. This chapter presents the nanopore sequencing step and Chapter 17 introduces a protocol for mRNA vector design.

Novel Nanotechnology-Driven Prototypes for AI-Enriched Implanted Prosthetics Following Organ Failure

Meeting medical challenges posed by global burdens is proven to be of primary interest. One example is the COVID-19 epidemic that humankind is currently experiencing, since around December 2019. Innovation is key to respond rapidly and effectively to sanitary and health emergencies, when human lives are severely threatened. In this scenery, medical devices that can be rapidly launched in the market and manufactured at scale are crucial for saving lives. One example is a lifesaving respiratory device launched in about 10 days (Mercedes F1 team's new device based on continuous positive airway pressure devices) and rapidly approved by international agencies responsible for assuring drug and medical devices safety, in response to the COVID-19 burden. Remarkably, it is the first time in history that mankind observes disease spread reaching such high proportions, globally, in such short time scale. However, while this epidemic had, in March 2020, reached the critical figures of about 38,000 deaths and c. 738,000 infected, organ donation and transplantation patients are suffering for years, accounting for an increasing number of affected, annually. These patients are invisible for the general public. Therefore, this chapter approaches the organ donation and transplantation burden, proposing effective solutions to leverage the suffering, improving life quality of patients enduring several underlying issues, from hemodialysis complications and critical organ failure to lacking compatible donors. This, on the basis of technology repurposing, to speed up approval processes followed by international agencies responsible for assuring drug and medical devices safety, while adding innovative methods to existing technology and reducing invasiveness.

Nanotechnology-Driven Delivery Systems in Inoculation Therapies

Nanotechnology and genomics are the newest allies of inoculation design. In recent years, nucleic acids have been targeted as sources of therapeutics to stimulate immune responses, to both fight disease and create memory to trigger further responses to threat. A myriad of promising findings in cancer research and virology has been reported in the current literature. Nanosystems are demonstrating their capabilities as efficient carriers, improving the efficacy of drug delivery, including nucleic acids as therapeutics, at focal sites, in living systems. This chapter approaches major elements involved in the successful use of nanotechnology as delivery platforms to optimise the efficacy of nucleic acids-driven therapeutics, particularly mRNA vectors as coding engines for targeted viral proteins. Latest findings in nanotechnological design are highlighted, key discoveries associated with the success of nanodelivery platforms are presented, and key characteristics of nanodelivery systems in nucleic acids-based vaccine technology are discussed, to illustrate their distinct advantages and disadvantages.

Latest Trends in Nucleic Acids' Engineering Techniques Applied to Precision Medicine

Nucleic acids are paving the way for advanced therapeutics. Unveiling the genome enabled a better understanding of unique genotype-phenotype profiling. Methods for engineering and analysis of nucleic acids, from polymerase chain reaction to Cre-Lox recombination, are contributing greatly to biomarkers' discovery, mapping of cellular signaling cascades, and smart design of therapeutics in precision medicine. Investigating the different subtypes of DNA and RNA via sequencing and profiling is empowering the scientific community with valuable information, to be used in advanced therapeutics, tracking epigenetics linked to disease. Recent results from the application of nucleic acids in novel therapeutics and precision medicine are very encouraging, demonstrating great potential to treat cancer, viral infections via inoculation (e.g., SAR-COV-2 mRNA vaccines), along with metabolic and genetic disorders. Limitations posed by challenges in delivery mode are being addressed to enable efficient guided-gene-programmed precision therapies. With the focus on genetic engineering and novel therapeutics, more precisely, in precision medicine, this chapter discusses the advance enabled by knowledge derived from these innovative branches of biotechnology.

Total Quality Management: Practices to Leverage Its Principles in Distance Higher Education

The growth of distance learning in higher education has been gaining market share. The COVID-19 pandemic has reinforced this trend. Enrollments are increasing sharply while fierce competition is a threat to distance learning institutions. To conquer and retain distance learning students, it is necessary to offer quality services and products, seeking innovation and continuous improvement to meet their needs. However, studies that analyze the application of the principles and practices of TQM (Total Quality Management) in distance higher education are still scarce. From this perspective, this study seeks to identify practices that increase the presence of TQM principles in distance higher education institutions. The qualitative research was carried out with managers from 64 teaching centers of one of the largest distance learning institutions in Brazil. The pillars of TQM considered in this study are leadership, staff, students, technological resources and continuous improvement. This study contributed to the literature by identifying practices to expand the presence of TQM principles in distance higher education adopted by the studied institution and its teaching centers. Management contributions are also presented. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

The impact of the COVID-19 pandemic on the mental health, performance and productivity of Brazilian female scientists

Economic and political agencies have reported a worldwide increase in gender inequalities during the CO-VID-19 pandemic, exposing the frailty of the advances in gender equality in the context of a global crisis. Here, we provide an overview on how the COVID-19 pandemic ampli-fied gender-related vulnerabilities in Brazil, establishing a parallel with the pre-pandemic scenario and evaluating many aspects of the problem, including motherhood and racial issues. At the same time, we also discuss how the abrupt disruption in the labor routine during the COVID-19 pandemic overloaded Brazilian women with household and childcare activities and, more specifically, how women’s ca-reers and scientific-academic production were affected. Briefly, the workload and stress imposed on female researchers force them to choose between their professional accom-plishments and their families, thus exacerbating gender disparities within the Brazilian academia. Studies and gov-ernmental reports reveal that such a burden was even more prominent for mothers with young children and for black scientists. Finally, we describe examples of affirmative ac-tions aimed at counterbalancing gender inequalities within the Brazilian academia, which became crucial to mitigate the effects of the social upheaval during the pandemic. © 2022, Il Pensiero Scientifico Editore s.r.l. All rights reserved.

Psychological work demand, pleasure and suffering of Brazilian health workers from urgency and emergency services in the Covid-19 pandemic

Introduction: COVID-19 pandemic intensified objective and subjective factors influencing health and working conditions of health professionals. This study had the aim to investigate psychological work demand, pleasure and suffering of workers working in urgency and emergency services in the face of the COVID-19 pandemic. Material and Methods: descriptive, quantitative study, from April to June 2020, with 80 health workers working in urgency and emergency units, using Job Stress Scale (JSS) and Scale of Suffering and Pleasure at Work (EIPST). Descriptive statistical analysis, with investigation of association between variables (Chi-square test). Study approved by the Brazilian National Research Commission. Results: Workers in the care of cases of COVID-19 were from an average age of 37.3 years, most from Brazil Southeast (78.75%), nurses (60%), working in public service (78.75 %) and in weekly shifts longer than 60 hours (40%). There was 21,6% of occurrence of high level of psychological word demand, 48.75% of critical/severe level of pleasure, and 37.5% of critical/severe level of suffering. No statistically significant associations were found between the phenomena and independent variables (p>0,05). Conclusion: there is high psychological demand and low control at work, in addition to impairment of pleasure and the occurrence of suffering related to work activities among health care workers. Subjective conditions are essential for health promotion actions for these individuals. The non-association between the level of pleasure and suffering presupposes that the stressors are probably similar between the groups studied.

Clinical behavior of patients with asthma during the COVID-19 pandemic

Background: Asthma is a chronic respiratory disease, and respiratory viruses are well-known triggers for asthma exacerbations. The novel coronavirus named SARS-CoV-2, which causes COVID-19, can present with pulmonary symptoms. Several studies suggest that IL-13, an allergic asthma mediator, should prevent asthma exacerbations by SARS-CoV-2. The objective of this study was to evaluate the clinical behavior of patients with asthma during the COVID-19 pandemic. Asthma is a chronic respiratory disease, and respiratory viruses are well-known triggers for asthma exacerbations.The novel coronavirus named SARS-CoV-2, which causes COVID-19, can present with pulmonary symptoms.Several studies suggest that IL-13, an allergic asthma mediator, should prevent asthma exacerbations by SARS-CoV-2. The objective of this study was to evaluate the clinical behavior of patients with asthma during the COVID-19 pandemic. Method: This was a retrospective study of electronic medical records of adult asthmatic patients, being followed up in a tertiary service and who received telephone calls for rescheduling the face-to-face consultations, during the COVID-19 pandemic period.Demographic data, asthma symptoms, frequency of atopy, presence of comorbidities and symptoms related to coronavirus infection were analyzed. Patients were classified according to their history of asthma attacks. Results: Two hundred and seven patients were included, and of them, 165 patients (79.7%) were female, with a mean age of 53.3 years and asthma duration of 35 years. Atopy was confirmed in 156 patients (81.7%). The main comorbidities were obesity (32.9%), high blood pressure (47.3%), diabetes mellitus (17.4%) and emotional stress (68.1%). Of the total, 87 patients (42%) had acute symptoms, of which 20 (9.7%) sought emergency care and 15 of 20 patients (75%) were investigated for Covid-19, all of which were negative. Of the total, only 7 patients (3.4%) exacerbated and required systemic corticosteroids. During this study, the more frequent complaints among asthmatic patients with acute respiratory symptoms were dyspnea, cough, asthenia and headache when compared to those without a crisis (p < 0.05). Conclusion: This study found that asthmatic patients had a low prevalence of asthma exacerbation during the coronavirus pandemic period. Patients with acute symptoms may have been underdiagnosed for COVID-19, due to the low demand for emergency care. Previous atopy may act as a protective factor for COVID-19 in asthmatic patients.

Socio-Economic and Governance Conditions Corresponding to Change in Animal Agriculture: South Dakota Case Study

Understanding sustainable livestock production requires consideration of both qualitative and quantitative factors in a temporal and/or spatial frame. This study adapted Qualitative Comparative Analysis (QCA) to relate conditions of social, economic, and governance factors to changes in livestock inventory across several counties and over time. This paper presents an approach that (1) identified factors with the potential to relate to a change in livestock inventory and (2) analyzed commonalities within these factors related to changes spatially and temporally. This paper illustrates the approach and results when applied to five counties in eastern South Dakota. The specific response variables were periods of increasing, no change, or decreasing beef cattle, dairy cattle, and swine inventories in the specific counties for five-year census periods between 1992 and 2017. In the spatial analysis of counties, stable beef inventories and decreasing dairy inventories related to counties with increasing gross domestic products. The presence of specific social communities related to increases in county swine inventories. In the temporal analysis of census periods, local governance and economic factors, particularly market price influences, were more prevalent. Swine inventory showed a stronger link to cash crop markets than to livestock markets, whereas cattle market price increases associated with stable inventories for all animal types. Local governance tools had mixed effects for the different animal types across space and time. The factors and analysis results are context-specific. However, the process considers the various socio-economic processes in livestock production and community development applicable to agricultural sustainability questions in the Midwest and beyond.