Getting knowledge to provide care: prevalence and factors associated with Sexually Transmitted Infections in immigrants from Goiás.

OBJECTIVE: To estimate the prevalence of Sexually Transmitted Infections (STIs) in immigrants and refugees living in the metropolitan region of Goiânia, Goiás. METHOD: This is a cross-sectional and analytical study. Data collection was carried out from July 2019 to January 2020 and 308 immigrants and refugees were included in the sample. All were underwent face-to-face interviews and were tested for HIV, Syphilis, and Hepatitis B, using rapid tests. RESULTS: The general prevalence for any of the STIs investigated was 8.8% (95%CI 6.0% - 12.3%), being 5.8% (95%CI 3.6% - 8.9%) for Hepatitis B, 2.3% for Syphilis (95%CI 1.00% - 4.4%) and 0.7% for HIV (95%CI 0.1% - 2.1%). Multiple analysis, using logistic regression, showed that the variables male gender (OR = 2.7) and length of time living in Brazil (OR = 2.6) were significantly associated with STIs (p < 0.05). CONCLUSION: The results of this study suggest that STIs are a health problem in immigrants/refugees, which appear to be enhanced with the length of migration in the country. Public policies that guarantee health care for this population shall be considered.

Genetic literacy and experiential knowledge on sickle cell disease among Canadian- and foreign-born male and female Anglophone and Francophone youth in Canada.

OBJECTIVES: Growing global human mobility raises concerns about impacts on global health, particularly on the prevalence of sickle cell disease. This research unveiled the level of genetic literacy on sickle cell disease of male and female Anglophone and Francophone youth living in Canada. The research responded to questions about whether the type of information about the disease has been more prevalent among the youth's family, friends, acquaintances and school circles, and the influence of such information on shaping the current youth level of genetic literacy on the disease. METHODS: An online survey hosted by a Canadian university (2019/2020) platform was conducted with youth (n=87, aged 16-29) recruited in their natural, social environments in seven Canadian provinces. Data analysis used descriptive statistics and manual qualitative content analysis. RESULTS: Youth, mostly Canadian-born, 71.42 % Francophones and 67.12 % Anglophones, descend from parents who had been born in countries at risk for the disease. Results indicated that experiential knowledge is due to the familiarity with the disease occurrence among family members and acquaintances. Participants did not comment about how academic-gained knowledge could influence their own decision on becoming a parent. CONCLUSIONS: Independently of their country of birth, Canadian youth seem to have unmet information needs: a complex challenge requiring creativity and simplicity to deliver information through attractive media.

A proof-of-concept study of iCope: A nurse-led psychoeducational telephone intervention for women attending a rapid diagnostic centre for breast abnormality.

The period between the initial discovery of a suspicious breast lesion and a confirmed diagnosis is a time of significant psychological distress, heightened anxiety, and uncertainty for many women. This proof of concept (PoC) study explored the clinical outcomes and acceptability of iCope, a nurse-led psycho-educational telephone intervention aimed to assist with uncertainty, anxiety and coping in women going through a Rapid Diagnostic Centre (RDC) offering quick diagnosis of breast cancer (same day to three-day post-investigation). Guided by the Uncertainty Theory, and using a one-arm pretest-posttest design, two brief 15-minute telephone sessions were delivered by a nurse prior to the women's day of testing at the RDC and three days after the receipt of their results. Six women completed measures of anxiety, uncertainty, and coping before the clinic visit, three days and three weeks after receiving their test results. Results show that the implementation of the telephone intervention was challenging, yet may offer potential for positive impact. That is, trends of decreased uncertainty and anxiety in participants over time were noted. Considering the difficulty observed in the recruitment and delivering the two interventions in the timeline planned, feasibility testing is recommended before the conduct of a large-scale study.

Awakening Undergraduate Nursing Students' Critical Awareness About Men's Health, Health Literacy and Nursing Practice.

BACKGROUND: This article reports an evaluative replication study, including a workshop inspired by Paulo Freire's critical pedagogy. Purpose: Assess how the nursing students' participation in critiquing Canadian empirical evidence on men's health literacy provokes new perceptions; explore students' intentions of incorporating the aforementioned contents into their professional practice; and test students' skills to formulate a hypothetical short action plan about men's health literacy. METHODS: A qualitative evaluation study inspired by the qualitative program evaluation approach. The setting was a university-based Canadian undergraduate nursing program located in a major metropolitan city. Seventeen undergraduate students (representing 3.65% of year 4 student population) composed the sample. The educational intervention was two workshops (6 h duration; February 2017) including a lecture about men's health literacy with video presentations, class discussions and group work using Freire's method of reflection and discussion for awareness awakening. Hypothetical health literacy promotion was the key outcome. All interactions were digitally audiorecorded, verbatim transcribed and submitted to thematic analysis having as themes: Perspectives of awareness and knowledge expansion, and New personal-professional assets. RESULTS: Students were able to relate new knowledge with their own experiences in the classroom or in the practicum. Application of new knowledge was related to students' social circles and reported familiar health matters. Cultural and community life shaped knowledge expansion and references to men's behaviors. CONCLUSIONS: Mobilization of personal knowledge awoke students' awareness about gaps in the nursing curriculum and the paucity of experiences in clinical placements relating to men's health literacy.

Getting knowledge to provide care: prevalence and factors associated with Sexually Transmitted Infections in immigrants from Goiás / Conocer para cuidar: prevalencia y factores asociados a las Enfermedades de Transmisión Sexual en inmigrantes de Goiás / Conhecer para cuidar: prevalência e fatores associados às Infecções Sexualmente Transmissíveis em imigrantes de Goiás

ABSTRACT Objective: To estimate the prevalence of Sexually Transmitted Infections (STIs) in immigrants and refugees living in the metropolitan region of Goiânia, Goiás. Method: This is a cross-sectional and analytical study. Data collection was carried out from July 2019 to January 2020 and 308 immigrants and refugees were included in the sample. All were underwent face-to-face interviews and were tested for HIV, Syphilis, and Hepatitis B, using rapid tests. Results: The general prevalence for any of the STIs investigated was 8.8% (95%CI 6.0% - 12.3%), being 5.8% (95%CI 3.6% - 8.9%) for Hepatitis B, 2.3% for Syphilis (95%CI 1.00% - 4.4%) and 0.7% for HIV (95%CI 0.1% - 2.1%). Multiple analysis, using logistic regression, showed that the variables male gender (OR = 2.7) and length of time living in Brazil (OR = 2.6) were significantly associated with STIs (p < 0.05). Conclusion: The results of this study suggest that STIs are a health problem in immigrants/refugees, which appear to be enhanced with the length of migration in the country. Public policies that guarantee health care for this population shall be considered.

RESUMEN Objetivo: Estimar la prevalencia de Enfermedades de Transmisión Sexual (ETS) en inmigrantes y refugiados residentes en la región metropolitana de Goiânia, Goiás. Método: Se trata de un estudio transversal y analítico. La recolección de datos se llevó a cabo desde julio de 2019 hasta enero de 2020 y se incluyeron en la muestra 308 inmigrantes y refugiados. Todos fueron entrevistados cara a cara y sometidos a pruebas de VIH, Sífilis y Hepatitis B, mediante pruebas rápidas.. Resultados: La prevalencia general para cualquiera de las ETS investigadas fue de 8,8% (IC95% 6,0% - 12,3%), siendo 5,8% (IC95% 3,6% - 8,9%) para Hepatitis B, 2,3% para Sífilis (IC95% 1,00% - 4,4%) y 0,7% para VIH (IC95% 0,1% - 2,1%). El análisis múltiple, mediante regresión logística, mostró que las variables género masculino (OR = 2,7) y tiempo de residencia en Brasil (OR = 2,6) se asociaron significativamente con las ETS (p < 0,05). Conclusión: Los resultados de este estudio sugieren que las ETS son un problema de salud en inmigrantes/refugiados, que parecen exacerbarse con la duración de la migración en el país. Se deben considerar políticas públicas que garanticen la atención de la salud de esta población.

RESUMO Objetivo: Estimar a prevalência de Infecções Sexualmente Transmissíveis (IST) em imigrantes e refugiados residentes na região metropolitana de Goiânia, Goiás. Método: Trata-se de um estudo transversal e analítico. A coleta de dados foi realizada no período de julho de 2019 a janeiro de 2020 e integraram a amostra 308 imigrantes e refugiados. Todos foram entrevistados face-a-face e testados para HIV, Sífilis e Hepatite B, por meio de testes rápidos. Resultados: A prevalência geral para alguma das IST investigadas foi de 8,8% (IC95% 6,0% - 12,3%), sendo 5,8% (IC95% 3,6% - 8,9%) para Hepatite B, 2,3% para Sífilis (IC95% 1,00% - 4,4%) e 0,7% para HIV (IC95% 0,1% - 2,1%). A análise múltipla, por regressão logística, mostrou que as variáveis sexo masculino (OR = 2,7) e tempo de moradia no Brasil (OR = 2,6) foram associadas significativamente às IST (p < 0,05). Conclusão: Os resultados deste estudo sugerem que as IST são um problema de saúde em imigrantes/refugiados, que parecem ser exacerbadas com o tempo de migração no país. Políticas públicas que garantam a assistência à saúde dessa população devem ser consideradas.

Interações entre usuários brasileiros sobre enfrentamento e apoio social durante pandemias: um estudo de análise de mídia / Interacciones sobre el apoyo social de afrontamiento durante la pandemia por parte de usuarios brasileños: un estudio de análisis de medios / Interactions about Coping-Social Support during Pandemics by Brazilian Users: a Media Analysis Study

Objective: explore how the Brazilian online community mobilized its own coping resources during the COVID-19 pandemic to deal with mass vaccination concerns, manage and cope with personal stressors brought on by the pandemic, and seek social support. Method: the Canadian Population Health Promotion Model and the Transactional Model of Stress and Coping framed this media content analysis focusing on a socially impactful event: the authorization of COVID-19 vaccinations in Brazil. Results: the retrieval of posts (January-May 2021) found 488 contents distributed as modus operandi (n=117; 24%), coping strategies focused on emotion (n=175; 35.8%), on problem (n=40; 8.1%), on reflection (n=67; 13.7%), and offer of social support (n=89; 18.2%). Among the top-five (n=393; 80.5%) actions and coping strategies, 255 contents about coping strategies with a predominant discourse on emotion-focused coping (n=160; 63.2 %). Conclusion: interactions sustained a feeling of connection and created a context for belonging, support, and motivation.

Objetivo: explorar como a comunidade online brasileira mobilizou seus próprios recursos de enfrentamento durante a pandemia de COVID-19 para lidar com as preocupações com a vacinação em massa, gerenciar e lidar com os estressores pessoais provocados pela pandemia e buscar apoio social. Método: o Modelo Canadense de Promoção da Saúde da População e o Modelo Transacional de Estresse e Coping enquadraram esta análise de conteúdo midiático com foco em um evento de impacto social: a autorização da vacinação contra a COVID-19 no Brasil. Resultados: a recuperação das postagens (janeiro-maio de 2021) encontrou 488 conteúdos distribuídos como modus operandi (n=117; 24%), estratégias de enfrentamento focadas na emoção (n=175; 35,8%), no problema (n=40; 8,1%), na reflexão (n=67; 13,7%) e na oferta de apoio social (n=89; 18,2%). Entre as cinco principais (n=393; 80,5%) ações e estratégias de enfrentamento, 255 conteúdos sobre estratégias de enfrentamento predominaram com discurso de enfrentamento focado na emoção (n=160; 63,2%). Conclusão: as interações mantiveram um sentimento de conexão e criaram um contexto de pertencimento, apoio e motivação.

Objetivo: explorar cómo la comunidad brasileña en línea movilizó sus propios recursos de afrontamiento durante la pandemia de COVID-19 para hacer frente a las preocupaciones sobre la vacunación masiva, gestionar y hacer frente a los factores estresantes personales provocados por la pandemia y buscar apoyo social. Método: el Modelo Canadiense de Promoción de la Salud de la Población y el Modelo Transaccional de Estrés y Afrontamiento enmarcaron este análisis de contenido mediático centrándose en un evento de impacto social: la autorización de la vacunación contra la COVID-19 en Brasil. Resultados: la recuperación de publicaciones (enero-mayo de 2021) encontró 488 contenidos distribuidos como modus operandi (n=117; 24%), estrategias de afrontamiento centradas en la emoción (n=175; 35,8%), en el problema (n=40; 8,1%), en la reflexión (n=67; 13,7%) y en la oferta de apoyo social (n=89; 18,2%). Entre las cinco acciones y estrategias de afrontamiento más destacadas (n=393; 80,5%), 255 contenidos sobre estrategias de afrontamiento con un discurso predominante sobre el afrontamiento centrado en las emociones (n=160; 63,2 %). Conclusión: las interacciones mantuvieron un sentimiento de conexión y crearon un contexto de pertenencia, apoyo y motivación.

Análise de particularidades da participação lusófona em uma Rede de Conhecimentos em Enfermagem / Análisis de las particularidades de la participación lusófona en una Red de Conocimientos de Enfermería / Analysis of the particularities of Lusophone participation in a Nursing Knowledge Network

Resumo Objetivo Descrever o exercício conceitual de reflexão sobre as possibilidades e particularidades da participação das Escolas de Enfermagem e Faculdades de Enfermagem lusófonas na Rede de Conhecimentos em Enfermagem. Método Análise das informações obtidas em um levantamento de recursos institucionais de acordo com o marco conceitual proposto por Prug e Prusak sobre rede de conhecimentos. A ponderação de aspectos positivos e negativos - analisando o aprendizado com as informações - levou em consideração as possíveis soluções para um plano de ação. Resultados Tanto nas ações institucionais para suportar a pesquisa em Enfermagem como nos benefícios almejados com a participação na Rede existe o interesse na internacionalização da pesquisa e no trabalho colaborativo. Com a ampliação dos horizontes da ciência da Enfermagem lusófona, este trabalho visa aumentar o impacto da pesquisa e agilizar a divulgação e a utilização dos resultados, tanto na educação como na clínica. Conclusão e Implicações para a prática A participação das referidas instituições oferece inúmeras possibilidades de demonstrar originalidade, criatividade e perícia de sua prática docente e de pesquisa, favorecendo o compartilhamento de ideias e práticas. A prática de produção científica, por docentes e discentes, pode ser aprimorada pelo refinamento de modos de pensar, criar, produzir e disseminar.

Resumen Objetivo Describir el ejercicio conceptual de reflexión de las posibilidades y particularidades de la participación de facultades de Enfermería de lengua portuguesa en la Red de Conocimientos de Enfermería. Método Análisis de datos obtenidos de un sondeo de recursos institucionales bajo el marco conceptual de Prug y Prusak sobre la red de conocimiento. El planteamiento de aspectos positivos y negativos del aprendizaje abarcó soluciones para elaborar un plan de acción. Resultados En las acciones institucionales de apoyo a la investigación en Enfermería y los beneficios aspirados con la participación en la Red, existe un interés por la internacionalización de la investigación y el trabajo colaborativo -que tiene como objetivo aumentar el impacto de la investigación, estimular la divulgación y el aprovechamiento de los resultados en la enseñanza y la clínica, con la ampliación de los horizontes de la Enfermería de instituciones de habla portuguesa. Conclusión e Implicaciones en la práctica La Red ofrece numerosas posibilidades para las instituciones participantes respecto a la demostración de originalidad, creatividad y experiencia en la práctica docente y de investigación, fomentando el intercambio de ideas y prácticas. La práctica de la producción científica por profesores y estudiantes puede verse mejorada por la reflexión, creación, producción y difusión de conocimientos.

Abstract Objective To describe the conceptual exercise of reflecting on the possibilities and particularities of the participation of Lusophone schools of nursing in the Nursing Knowledge Network. Method An analysis was conducted using information obtained from an environmental scan of institutional resources following the conceptual framework by Prug and Prusak on the knowledge networks. The learnings reported in the analysis are based on the collected information and reflections on the positive and negative aspects of participation, while proposing possible solutions for an action plan. Results There is interest in the internationalization of research and collaborative work both as institutional actions to support nursing research and potential benefits due to participation in the Network. The collaborative work has potential to increase the impact of research, expedite dissemination and use of results both in education and in clinical practice, broadening the horizons of Lusophone nursing science. Conclusion and Implications for practice Participation of these institutions in the Network offers numerous possibilities to demonstrate the originality, creativity and expertise of their teaching and research practice, encouraging the sharing of ideas and practices. The practice of scientific production in all its scenarios by educators and students can be improved through refined ways of thinking, creating, producing, and disseminating knowledge.

Internacionalização para o incremento da produção de conhecimentos em enfermagem: estudo de reflexão / Internationalization to increase the production of knowledge in nursing: a reflection study

Objetivo: refletir sobre oportunidades para a internacionalização da Enfermagem em países lusófonos proporcionadas por uma rede internacional de conhecimentos em Enfermagem. Método: método reflexivo que conduz à percepção modificada de uma dada situação levando a novas ideias, revelando temas de análise e propostas de possíveis soluções através de um plano de ação. A reflexão concentrou-se em diálogos interdisciplinares, inovação conceitual-metodológica e fortalecimento da liderança em Enfermagem. Resultados: a reflexão focalizou: (a) o diálogo além do contexto cultural e científico lusófono para a Rede ser reconhecida como parceiro intelectual substancial; (b) a incorporação de abordagens, referenciais e desenhos de pesquisa multidisciplinares; e (c) a mobilização de conhecimento sobre causas sociais para o fortalecimento da liderança da Enfermagem global nas questões de justiça social e equidade em saúde. Considerações finais: a Enfermagem lusófona possui expertise para inovar com estratégias para reforçar a internacionalização.

Objective: reflect on opportunities for the internationalization of nursing in Lusophone countries provided by an international network of nursing knowledge. Method: a reflexive method leading to the modified perception of a given situation leading to new ideas, revealing themes of analysis and proposals for possible solutions through an action plan. This reflection focused on interdisciplinary dialogues, methodological-conceptual innovation, and strengthening of leadership in nursing. Results: the reflection focused on: 1) the dialogue beyond the Lusophone cultural and scientific context for the network to be recognized as a substantial intellectual partner; 2) the incorporation of multidisciplinary approaches, references, and research designs; and 3) the mobilization of knowledge about social causes to strengthen global nursing leadership in issues of social justice and health equity. Final considerations: Lusophone nursing has expertise to innovate with strategies to strengthen internationalization.

Objetivo: reflexionar sobre las oportunidades de internacionalización de la Enfermería en los países de lengua portuguesa proporcionadas por una red internacional de conocimiento en Enfermería. Método: método reflexivo que conduce a una percepción modificada de una situación que lleva a nuevas ideas, revelando temas de análisis y propuestas de posibles soluciones por medio de un plan de acción. La reflexión se centró en los diálogos interdisciplinarios, la innovación conceptual-metodológica y el fortalecimiento del liderazgo en enfermería. Resultados: la reflexión tuvo como foco: (a) el diálogo más allá del contexto cultural y científico de la lengua portuguesa para que la Red sea reconocida como un socio intelectual sustancial; (b) la incorporación de enfoques, referencias y diseños de investigación multidisciplinarios; y (c) la movilización de conocimiento sobre las causas sociales para fortalecer el liderazgo mundial de enfermería en temas de justicia social y equidad en salud. Consideraciones finales: La Enfermería em países de lengua portuguesa tiene el expertise para innovar con estrategias para reforzar la internacionalización.

Canadian-brazilian insights for transcultural nursing: an exploration of community health nursing contexts / Perspectivas canadiense-brasileñas para la enfermería transcultural: una exploración de los contextos de enfermería en salud comunitaria / Introspecções canadenses-brasileiras para a enfermagem transcultural: uma exploração dos contextos da enfermagem de saúde comunitária

ABSTRACT Objective: to analyze the distinct features, incongruencies, and harmony between the features of Canadian-Brazilian community health nursing as well their practices. Method: ethnographic research conducted in primary healthcare clinics (city of João Pessoa, Brazil). Data collection unfolded from July to September 2018 and included direct, unstructured participant observation of collective social and professional-clientele interactions, with a structured personal digital log and reports of the researcher's observations, as well as social immersion in community settings. The fieldwork log was thematically analyzed to build the meaning of the comparative nursing practice. Results: analysis of observations' reports identified challenges and opportunities to promote sustainable changes and create a supportive environment. Nurses' competencies to promote health are in consonance with conceptual, political, and ethical sounding perspectives. Among the distinctive practices observed was that in Brazil, the prescribing practice has been well-established because legally the registered nurses are allowed to prescribe within the primary healthcare programs. In Canada, registered nurses have been granted authority to do so, upon receipt of specific training and under certain scope of advanced practice. Thematic analysis revealed uniqueness of the grasped information, incongruence between community health nursing practices and harmony between contextual practices of Brazil-Canada community health nursing composed the empirical evidence. Conclusions: this research uncovered the compatibility between Canadian and Brazilian practice as well as intricate features of Brazilian community health nurses. Unquestionably, the evidence sums up to the consolidation of the well-established Brazil-Canada cooperation in the field of primary health care. This evidence addresses the political perspective of cooperation for global health.

RESUMEN Objetivo: analizar las características distintivas, incongruencias y armonía entre las características de los enfermeros de salud comunitaria canadiense-brasileños y sus prácticas. Método: estudio etnográfico realizado en centros de atención primaria (ciudad de João Pessoa, Brasil). La recolección de datos se desarrolló de julio a septiembre de 2018 e incluyó la observación participante directa y no estructurada de las interacciones sociales colectivas y profesional-clientela, con un registro digital personal estructurado e informes de las observaciones del investigador, así como la inmersión social en entornos comunitarios. El registro de trabajo de campo se analizó temáticamente para construir el significado de la práctica de enfermería comparada. Resultados: el análisis de los informes de observaciones identificó desafíos y oportunidades para promover cambios sostenibles y crear un entorno de apoyo. Las competencias de los enfermeros para promover la salud están en consonancia con las perspectivas conceptuales, políticas y éticas. Entre las prácticas distintivas observadas, la práctica de prescripción ha sido bien establecida en Brasil porque legalmente las enfermeras están autorizadas a prescribir dentro de los programas de atención primaria de salud. En Canadá, a las enfermeras se les ha otorgado autoridad para hacerlo al recibir capacitación específica y bajo cierto alcance de práctica avanzada. El análisis temático reveló singularidad de la información captada, incongruencia entre las prácticas de enfermería en salud comunitaria y armonía entre las prácticas contextuales de enfermería en salud comunitaria Brasil-Canadá que compusieron la evidencia empírica. Conclusiones: esta investigación demostró que existe compatibilidad entre las prácticas canadiense y brasileña, así como las características de la enfermería comunitaria brasileña. Incuestionablemente, la evidencia resume la consolidación de la cooperación bien establecida entre Brasil y Canadá en el campo de la salud primaria. Esta evidencia aborda la perspectiva política de la cooperación para la salud global.

RESUMO Objetivo: analisar as características distintas, as incongruências e a harmonia entre as características da Enfermagem de saúde comunitária canadense e brasileira bem como suas respectivas práticas. Método: pesquisa etnográfica realizada em unidades básicas de saúde (cidade de João Pessoa, Brasil). A coleta de dados ocorreu no período de julho a setembro de 2018 e incluiu observação participante direta, não estruturada de interações sociais coletivas e entre profissionais e clientela. Houve registro digital estruturado de relatos das observações de campo pela pesquisadora, assim como imersão social em ambientes comunitários. O diário de campo foi analisado tematicamente para construir o significado da prática comparativa de Enfermagem. Resultados: a análise dos relatos das observações identificou desafios e oportunidades para promover mudanças sustentáveis e criar um ambiente de apoio. As competências dos enfermeiros para a promoção da saúde estão em consonância com perspectivas conceituais, políticas e éticas. Entre as práticas diferenciadas observadas destaca-se que, no Brasil, a prática de prescrição tem sido bem estabelecida, pois, legalmente, os enfermeiros estão autorizados a prescrever dentro dos programas de atenção primária à saúde. No Canadá, os enfermeiros receberam autorização para fazê-lo, após um treinamento específico e sob certo escopo da prática avançada. A análise temática revelou singularidades nas informações apreendidas, incongruência entre as práticas de Enfermagem de saúde comunitária Brasil-Canadá e harmonia entre tais práticas contextuais que compuseram as evidências empíricas. Conclusões: esta pesquisa revelou a compatibilidade entre a prática canadense e brasileira, assim como características próprias dos enfermeiros brasileiros nessa prática. Inquestionavelmente, as evidências resumem-se à consolidação da bem estabelecida cooperação Brasil-Canadá no campo da atenção primária à saúde. Essas evidências abordam a perspectiva política de cooperação para a saúde global.

Hepatitis B and C in Immigrants and Refugees in Central Brazil: Prevalence, Associated Factors, and Immunization.

Introduction: Eliminating hepatitis B and C in immigrant and refugee populations is a significant challenge worldwide. Given the lack of information in Brazil, this study aimed to estimate the prevalence of infections caused by hepatitis B and C viruses and factors associated with hepatitis B in immigrants and refugees residing in central Brazil. Methods: An observational, cross-sectional, and analytical study was conducted from July 2019 to January 2020 with 365 immigrants and refugees. Hepatitis B was detected by a rapid immunochromatographic test, enzyme immunoassay, and chemiluminescence, and hepatitis C by rapid immunochromatographic test. Multiple analysis was used to assess factors associated with hepatitis B infection. Results: Of the participants, 57.8% were from Haiti and 35.6% were from Venezuela. Most had been in Brazil for less than 2 years (71.2%). The prevalence of HBV infection and exposure was 6.6% (95% CI: 4.5-9.6%) and 27.9% (95% CI: 23.6-2.8%), respectively, and 34% had isolated anti-HBs positivity. Reporting a sexually transmitted infection was statistically associated with HBV infection (OR: 7.8; 95% CI: 2.3-26.4). No participant with positive anti-HCV serology was found. Conclusions: The study showed that participants were outside the reach of prevention and control actions for hepatitis B. Therefore, public health strategies must be designed to reach, inform, and vaccinate this group.

Finding the Silver Lining: Aging Well Amongst Older Brazilian Women in the Post-Migration Context.

STUDY BACKGROUND: The aging population in Canada has been increasing steadily over the past 40 years, however, there is limited information about the meaning of aging well amongst older Brazilian women in Canada. METHODS: A Heideggerian interpretive phenomenology study was conducted to understand the meaning of aging well amongst older Brazilian women in the post-migration context living in the Greater Toronto Area (GTA) in Ontario, Canada. RESULTS: Eight older Brazilian women residing in the GTA were recruited through purposive and snowball sampling and participated in individual face-to-face interviews. Through data analysis and the incorporation of Heidegger's four existentials of human existence, the themes that emerged were (a) Embracing being part of a mosaic, (b) Aging with grace, (c) Chasing your dreams and (d) Being a bridge and not a fence. The overarching theme was: Finding the silver lining: Aging well. CONCLUSION: This study informs nursing practice, research and policy development to advance the health of older immigrant adults in Canada.

Evaluation of Usability and Satisfaction of Two Online Tools to Guide Return to Work for Cancer Survivors on the Cancer and Work Website.

Prompt services and work-focused support systems are needed to aid cancer survivors returning to work or finding work. Purpose This knowledge translation and implementation project focused on the knowledge users' experience and need for refinement of three work-focused tools to support return to work and maintain work following cancer through their participation in a hands-on workshop. The tools assessed for their utility are a Job Analysis Tool (JAT), a Return to Work (RTW) tool, and a bilingual Canadian website on Cancer and Work. Methods Four workshops took place in three Canadian cities. Participants included cancer survivors, healthcare professionals, and employer representatives. Following an overview of the website and tools, workshop participants (N = 28) completed qualitative and quantitative satisfaction and usability questionnaires using the System Usability Scale and open-ended questions. Qualitative data was analyzed using content analyses from the think-aloud data and from the four open-ended questions collected during the users' use of the tools and website. Results Overall, most study participants reported high satisfaction with the JAT and RTW tools, the Cancer and work website and the workshop. Good usability scores were reported for the RTW planner (73.65 ± 12.61) and the website (74.83 ± 12.36), and only acceptable usability scores for the JAT (68.53 ± 11.90). Conclusion Overall, the study documented the value of the tools and the website to support the RTW process as assessed by several key knowledge user groups. The JAT is considered a helpful procedure to identify job demands in order to guide job accommodations. Given participants' responses that the tool is useful, the next steps are to implement the recommendations for improvement and knowledge dissemination to increase its uptake and the use of job analysis overall.

Brazil's Community Health Workers Practicing Narrative Medicine: Patients' Perspectives.

BACKGROUND: Narrative medicine (NM) encourages health care providers to draw on their personal experiences to establish therapeutic alliances with patients of prevention and care services. NM medicine practiced by nurses and physicians has been well documented, yet there is little understanding of how community health workers (CHWs) apply NM concepts in their day-to-day practices from patient perspectives. OBJECTIVE: To document how CHWs apply specific NM concepts in Brazil's Family Health Strategy (FHS), the key component of Brazil's Unified Health System. DESIGN: We used a semi-structured interview, grounded in Charon's (2001) framework, including four types of NM relationships: provider-patient, provider-colleague, provider-society, and provider-self. A hybrid approach of thematic analysis was used to analyze data from 27 patients. KEY RESULTS: Sample: 18 females; 13 White, 12 "Pardo" (mixed races), 12 Black. We found: (1) provider-patient relationship-CHWs offered health education through compassion, empathy, trustworthiness, patience, attentiveness, jargon-free communication, and altruism; (2) provider-colleague relationship-CHWs lacked credibility as perceived by physicians, impacting their effectiveness negatively; (3) provider-society relationship-CHWs mobilized patients civically and politically to advocate for and address emerging health care and prevention needs; (4) provider-self relationship-patients identified possible low self-esteem among CHWs and a need to engage in self-care practices to abate exhaustion from intense labor and lack of resources. CONCLUSION: This study adds to patient perspectives on how CHWs apply NM concepts to build and sustain four types of relationships. Findings suggest the need to improve provider-colleague relationships by ongoing training to foster cooperation among FHS team members. More generous organizational supports (wellness initiatives and supervision) may facilitate the provider-self relationship. Public education on CHWs' roles is needed to enhance the professional and societal credibility of their roles and responsibilities. Future research should investigate how CHWs' personality traits may influence their ability to apply NM.

Blindness, deafness, silence and invisibility that shields racism in nursing education-practice in multicultural hubs of immigration.

BACKGROUND: This paper relies on data from the multilevel, sectoral discussions held among professional nursing and sociology individuals. PURPOSE: To present the outcomes of a reflective process on racism in nursing education and practice in the cities of Toronto and Paris. METHOD: The method used was a reflection on research conducted by eight individuals dealing with racism at distinct stages of their professional career. The reflections are organized as a systematic description of facts, noted feelings, appraisal of issues, analysis of learned lessons, and lead to recommendations for nursing education and practice. RESULTS: The promotion of social justice and social inclusion has become a matter of nursing practice, yet a lack of critical discussion about racism with racialized students may result in feelings of being silenced. Increased awareness of racial negligence within a clinical setting can instigate change and allow nursing professionals to advocate for more culturally-sensitive care for a multicultural clientele. Insight from nurses with different professional status and from different racial backgrounds will garner an understanding of how the experiences of racism are in some ways individualized. CONCLUSION: A collective reflection is required to understand the factors that underpin racism in nursing and can be used to elicit dialogue on a national and international scale in order to address racism in global nursing.

Reflexão metodológica sobre o trabalho de campo de pesquisa internacional multicêntrica Brasil-Canadá / Reflexión metodológica sur el trabajo de campo de la investigación internacional multi sitio Brasil-Canadá / Methodological reflection about the fieldwork of an international multisite research Brazil-Canada

Resumo Objetivo Apresentar o resultado de uma reflexão metodologicamente estruturada sobre o caminho trilhado em todas as fases de uma pesquisa internacional no Brasil sobre a implementação do Programa de Humanização do Pré-natal e do Nascimento e seus atores sociais. Método Método reflexivo de pesquisa que conduz à percepção modificada de uma dada situação levando a novas ideias, com o potencial de revelar temas de análise e engendrar propostas de possíveis soluções com desenho de um plano de ação. O objeto das reflexões concentrou-se nas participações dos copesquisadores de um estudo etnográfico internacional, multidisciplinar e multicêntrico implantado em Junho/2019-Março/2020. Resultados As reflexões indicam sensibilidade sobre o tema e silêncio imposto em relação à violência obstétrica. Sob múltiplas manifestações da violência institucionalizada, constatou-se ações como resistência ao assunto na rede hospitalar, negligência e questionamentos distorcidos nos espaços políticos de autorização para a anuência institucional. A demora por comitê de ética colocando em risco o calendário de conclusão da condução da pesquisa, exigido por agência estrangeira de fomento. Conclusão e implicação para a prática A reflexão estruturada possibilitou um processo ímpar de aprendizagem para os copesquisadores navegando em distintas culturas universitárias e sociais de pesquisa.

Resumen Objetivo Presentar resultados de una reflexión estructurada metodológicamente sobre el camino metodológico seguido en todas las fases de una investigación internacional en Brasil sobre la implementación del Programa de Humanización del Cuidado Prenatal y el Nacimiento y sus actores sociales. Método Método de investigación reflexiva que conduce a una percepción modificada de una situación dada, dando lugar a nuevas ideas, con el potencial de revelar temas de análisis y generar propuestas de posibles soluciones con el diseño de un plan de acción. El objeto de las reflexiones se centró en la participación de los co-investigadores en una investigación etnográfica internacional, multidisciplinar y multi sitio implementada en Junio / 2019-Marzo / 2020. Resultados Las reflexiones indican sensibilidad sobre el tema y silencio impuesto en relación a la violencia obstétrica. Bajo múltiples manifestaciones de violencia institucionalizada, hubo acciones como resistencia al tema en el ámbito hospitalario, negligencia y cuestionamientos distorsionados en los espacios políticos de autorización para el consentimiento institucional y demora por parte del comité de ética, poniendo en riesgo el calendario para completar la realización de la investigación requerida para una agencia de desarrollo extranjera. Conclusión e implicación para la práctica La reflexión estructurada permitió un proceso de aprendizaje único para los co-investigadores que navegaron en diferentes culturas universitarias y de investigación social.

Abstract Aim To present the results of a structured reflection on the methodological phases of an international research in Brazil regarding the implementation of the Program of Humanization of Prenatal and Childbirth, as well as, reflection on the project's social actors. Method A reflective research method that modifies the perception of a given situation, leading to new ideas, revealing themes of analysis, and engendering proposals for possible solutions with the creation of an action plan. The object of the reflection was the participation of co-investigators in an international, multidisciplinary, and multisite ethnographic study, implemented in June/2019-March/2020. Results The reflections indicate emotional sensitivity to the theme and silence about obstetric violence. There are multiple manifestations of institutionalized violence including resistance to confronting obstetric violence in hospital settings, negligence and distorted questioning in the political spaces of organizational authorization. The delay caused by a research ethics committee put the timetable for completion of research development at risk by requiring funding from a foreign agency. Conclusion and implication for practice Structured reflection allowed a unique learning process for co-investigators navigating different university and social research cultures.

Internacionalização Brasil-Canadá: coordenando uma atualização profissional para enfermeiros sobre letramento em saúde comunitário / Internacionalización Brasil-Canadá: coordinando una actualización profesional para enfermeras sobre alfabetización comunitaria en salud / International collaboration Brazil-Canada: coordinating a professional development course for nurses on health literacy

Resumo Objetivo Relatar a experiência da capacitação profissional no contexto da cooperação internacional Brasil-Canadá por meio da implantação de curso de atualização de enfermeiros sobre letramento em saúde comunitário. Método Relato de experiência do curso organizado por dez docentes, nove brasileiras e uma brasileira-canadense, com atividades de planejamento, no período de setembro a dezembro de 2019, majoritariamente com uso de ferramentas digitais e as de implantação, de 06 a 31 de janeiro de 2020, nas cidades de Brasília, Goiânia e Recife. Resultados O curso, enquanto projeto de internacionalização institucional, apoiou-se no ensino, educação em serviço, pesquisa e gestão, para colaborar com a parceria internacional liderada por uma universidade canadense e três programas brasileiros de pós-graduação em Enfermagem, sendo esta transferência de conhecimentos na área da saúde na modalidade de atividade educativa, uma possibilidade para conectar instituições de diferentes países. Conclusão e implicações para a prática Esta cooperação internacional de educação em Enfermagem possibilitou a troca de conhecimentos inovadores para superar desafios e colaborar cientificamente. O êxito dessa experiência sinalizou recomendações que possam corroborar o bojo de parceria multi-institucional. O detalhamento desta experiência constitui ferramenta para sua reprodução e adaptação a qualquer contexto acadêmico latino-americano, impulsionando assim, o processo de internacionalização.

Resumen Objetivo: Relatar la experiencia de la capacitación profesional en el contexto de la cooperación internacional Canadá - Brasil mediante la utilización de un curso de actualización de las enfermeras sobre alfabetización comunitaria en salud. Método Informe de experiencia del curso organizado por diez profesores, nueve brasileñas y una brasileña-canadiense, con actividades de planificación, durante el periodo comprendido entre septiembre a diciembre de 2019, en su mayoría utilizando herramientas digitales y las de implementación, del 6 al 31 de enero de 2020, en las ciudades de Brasília, Goiânia y Recife. Resultados El curso, como un proyecto de internacionalización institucional, fue apoyado en la enseñanza, la educación en el servicio, la investigación y la gestión, para colaborar con la asociación internacional liderada por una universidad canadiense y tres programas brasileños de postgrado en Enfermería, siendo esta transferencia de conocimiento en el campo de la salud en forma de actividad educativa, una posibilidad de conectar instituciones de diferentes países. Conclusión e implicaciones para la práctica Esta cooperación internacional en la educación de enfermería ha permitido el intercambio de conocimientos innovadores para superar desafíos y colaborar científicamente. El éxito de esta experiencia ha señalado recomendaciones que pueden corroborar la asociación multi-institucional en su seno. El detalle de la experiencia constituye una herramienta para su replicación y adaptación a cualquier contexto académico latinoamericano, impulsando así el proceso de internacionalización.

Abstract Objective Report the experience of professional development in the context of the international cooperation between Canada and Brazil by means of the implementation of an update course for nurses on community health literacy. Method Experiences were reported regarding the course, which was organized by ten professors (nine Brazilians and one Brazilian-Canadian) with planning activities from September to December 2019. mostly with the use of digital tools and discussed the course's implementation and implantation from January 6 to 31, 2020 in the cities of Brasília, Goiânia, and Recife. Results The course, as an institutional internationalization project, was supported by teaching, in-service education, research, and management in order to collaborate internationally. The project was led by one Canadian university in collaboration with graduate nursing programs from three Brazilian federal universities, facilitating the transfer of health knowledge through educational activities and connecting institutions from different countries. Conclusion and implications for practice This international collaboration in nursing education made it possible to exchange innovative knowledge to overcome challenges and promote scientific collaboration. The success of this experience led to recommendations that can corroborate multi-institutional partnerships. Detailing this experience constitutes a tool for its replication and adaptation to any Latin-American academic context, thus enhancing the internationalization process.