Changing face-to-face psychological care to remote mode: facilitators and obstacles in the COVID-19 pandemic

Objective: to verify associations between sociodemographic variables and factors that facilitate and hinder the transition from face-to-face psychological care to remote mode in the first year of the COVID-19 pandemic. Method: this is an analytical, quantitative, cross-sectional study. After approval by the Research Ethics Committee, data collection was performed by applying an online form consisting of 55 questions. Data were analyzed using descriptive and inferential statistics techniques. Results: the intentional sampling consisted of a total of 385 Brazilian psychologists, mostly women (67.01%), young professionals with up to five years of graduation (44.16%) most of activities in the private clinic. It was found that training time between five and 10 years was associated with a greater perception of difficulties and that previous experience with remote care facilitated adaptation in the transition from one modality to another. Conclusion: considering that call center can be a powerful tool in the health scenario, it is suggested the inclusion of remote care issues in the research agenda and syllabus in the curricula of health training courses.

HEMO TERAPIA: IMPLEMENTAÇÃO DE UM PROGRAMA DE ATENÇÃO À SAÚDE MENTAL DOS COLABORADORES DE UM HEMOCENTRO

A pandemia da COVID-19 trouxe alterações e necessidades de adaptações nas atividades laborais, que passaram a ser, na sua maioria, realizadas na modalidade online. Para muitos profissionais, essas alterações, aliadas ao sofrimento de outras perdas e inseguranças em função do cenário pandêmico, foram fontes de sofrimento emocional. Descrever a implementação de um programa de atenção à saúde mental dos colaboradores de um Hemocentro no segundo ano de pandemia da COVID-19. Um questionário sobre adaptação do trabalho durante a pandemia foi respondido por 113 colaboradores: 75% relataram aumento de ansiedade;65% aumento de cansaço;61% notaram aumento de sobrecarga. Frente a essas queixas, a equipe de psicologia elaborou um plano de intervenção que constava de atividades psicoeducativas e de um grupo de apoio emocional. Inicialmente, foi realizada uma palestra com o tema sofrimento emocional no trabalho, enfocando, em especial, ansiedade, depressão e estresse. Em seguida, foi proposto um grupo de conversa sobre os impactos emocionais da pandemia, com cinco encontros de uma hora de duração, sempre nos mesmos dias e horários e com os mesmos coordenadores. Ressaltou-se o fato de que o conteúdo do grupo seria sigiloso e que aconteceria depois do horário do expediente de trabalho. Antes e após os encontros dos grupos, os participantes foram solicitados a realizar avaliações de estresse, ansiedade e de depressão com os seguintes instrumentos: Inventário de Sintomas de Stress para adultos de Lipp- (ISSL) e Hospital Anxiety and Depression Scale (HAD). Dos dezoito colaboradores que manifestaram interesse na proposta, nove aderiam e foram distribuídos em dois grupos, sendo que um grupo contou com quatro participantes e outro, com cinco integrantes. Dos nove participantes, sete responderam os instrumentos pré-grupo. Observa-se que cinco apresentavam estresse, sendo quatro na fase de resistência e um na fase de quase exaustão. Sintomas de depressão foram mais frequentes do que de ansiedade. Os tópicos abordados nos encontros tangenciaram os impactos da pandemia na vida cotidiana, com acentuada incerteza a respeito do futuro e diminuição da socialização de das atividades de bem-estar. Em relação ao trabalho, foram notadas dificuldades decorrentes do aumento da sobrecarga de trabalho e na interação com outros colaboradores, que foi prejudicada devido mudanças na organização do trabalho e do estresse causado pela pandemia. Segundo avaliação dos participantes, os encontros contribuíram para ventilação de emoções, compartilhamento de experiências, aumento do sentido do trabalho, promoção apoio entre os colaboradores e desenvolvimento de estratégias para controle das atividades de forma a evitar sobrecarga. Depois do grupo, os participantes foram solicitados a responder novamente os mesmos instrumentos. Pós-grupo, cinco respostas foram registradas. Observou-se uma queda nos sintomas de ansiedade e uma não alteração nos de depressão. O melhor resultado foi encontrado na redução de estresse: dos cinco participantes que apresentaram quadro de estresse pré-grupo, somente um participante continuava com estresse. Conclui-se que intervenções preocupadas com a saúde emocional dos colaboradores e alinhadas com suas necessidades podem contribuir para a prevenção e o cuidado de sintomas de depressão, ansiedade e estresse.

Spread of Gamma (P.1) Sub-Lineages Carrying Spike Mutations Close to the Furin Cleavage Site and Deletions in the N-Terminal Domain Drives Ongoing Transmission of SARS-CoV-2 in Amazonas, Brazil

The Amazonas was one of the most heavily affected Brazilian states by the COVID-19 epidemic. Despite a large number of infected people, particularly during the second wave associated with the spread of the Variant of Concern (VOC) Gamma (lineage P.1), SARS-CoV-2 continues to circulate in the Amazonas. To understand how SARS-CoV-2 persisted in a human population with a high immunity barrier, we generated 1,188 SARS-CoV-2 whole-genome sequences from individuals diagnosed in the Amazonas state from 1st January to 6th July 2021, of which 38 were vaccine breakthrough infections. Our study reveals a sharp increase in the relative prevalence of Gamma plus (P.1+) variants, designated Pango Lineages P.1.3 to P.1.6, harboring two types of additional Spike changes: deletions in the N-terminal (NTD) domain (particularly Delta 144 or Delta 41-144) associated with resistance to anti-NTD neutralizing antibodies or mutations at the S1/S2 junction (N679K or P681H) that probably enhance the binding affinity to the furin cleavage site, as suggested by our molecular dynamics simulations. As lineages P.1.4 (S:N679K) and P.1.6 (S:P681H) expanded (Re > 1) from March to July 2021, the lineage P.1 declined (Re < 1) and the median Ct value of SARS-CoV-2 positive cases in Amazonas significantly decreases. Still, we did not find an increased incidence of P.1 variants among breakthrough cases of fully vaccinated patients (71%) in comparison to unvaccinated individuals (93%). This evidence supports that the ongoing endemic transmission of SARS-CoV-2 in the Amazonas is driven by the spread of new local Gamma/P.1 sublineages that are more transmissible, although not more efficient to evade vaccine-elicited immunity than the parental VOC. Finally, as SARS-CoV-2 continues to spread in human populations with a declining density of susceptible hosts, the risk of selecting more infectious variants or antibody evasion mutations is expected to increase. IMPORTANCE The continuous evolution of SARS-CoV-2 is an expected phenomenon that will continue to happen due to the high number of cases worldwide. The present study analyzed how a Variant of Concern (VOC) could still circulate in a population hardly affected by two COVID-19 waves and with vaccination in progress. Our results showed that the answer behind that was a new generation of Gamma-like viruses, which emerged locally carrying mutations that made it more transmissible and more capable of spreading, partially evading prior immunity triggered by natural infections or vaccines. With thousands of new cases daily, the current pandemics scenario suggests that SARS-CoV-2 will continue to evolve and efforts to reduce the number of infected subjects, including global equitable access to COVID-19 vaccines, are mandatory. Thus, until the end of pandemics, the SARS-CoV-2 genomic surveillance will be an essential tool to better understand the drivers of the viral evolutionary process.

Low cost devices to reduce aerosol effect during upper gastrointestinal endoscopy in COVID-19

Endoscopic procedures, as they are associated with exposure of the upper airway, have a higher risk of transmission of the SARS-CoV-2 virus;so, it is necessary to consider interventions to mitigate or eliminate exposure to it. In this article, we allow ourselves to present a low-cost mitigation strategy, since with the progress of the pandemic it could be in a state of austerity of economic resources, making these devices totally valid. © 2020 Asociaciones Colombianas de Gastroenterología, Endoscopia digestiva, Coloproctología y Hepatología.

Chronic diseases and religiosity/spirituality during the early stages of the COVID-19 pandemic

Religiosity and spirituality have been studied as resources for coping with crisis and social disruption. This study investigates religiosity/spirituality as a potential protective resource against the emotional impact of the COVID-19 pandemic in individuals diagnosed with malignant and non-malignant chronic diseases. This is a cross-sectional, descriptive-exploratory study, with a quanti-qualitative approach. The convenience sample was composed of 78 individuals, divided into two groups. An online form was used. The data from the close-ended questions were tabulated using descriptive statistics. The content of the open-ended questions was examined qualitatively by thematic analysis. The two groups showed signs of emotional distress at similar levels and expressed increased faith and belief that future gains should come from the current distress. Individuals with life-threatening diseases expressed intensified spirituality. Faith was highlighted by participants as a resource to face the challenges of this dramatic period and should be valued by health care teams. © 2022, Pontificia Universidade Catolica de Campinas. All rights reserved.