Concepções de bacharelandos de enfermagem sobre a promoção e educação em saúde / The conceptions of nurse students about the health promotion and education

O enfermeiro possui um papel fundamental para implementar as políticas públicas de saúde que garantirão os princípios do Sistema Único de Saúde à comunidade na qual está inserido, especialmente com ações de promoção e educação em saúde. Este estudo tem por objetivo analisar as concepções dos bacharelandos de enfermagem sobre essas ações. Trata-se de uma pesquisa qualitativa que segue todos os princípios éticos com aprovação do CEP da EERP/USP. A investigação ocorreu com treze bacharelandos de enfermagem de uma instituição privada de ensino superior no interior paulista. Os dados foram construídos com dois grupos focais: um formado por concluintes do curso do período Integral e outro com concluintes do curso do período noturno. Por meio do referencial da análise temática, os resultados foram divididos em: 1. Definindo conceitos: nesta temática, os bacharelandos de enfermagem relacionam a promoção e a educação em saúde como sendo complementares; creem que a saúde deve ser vista de forma mais ampla e que deve, ainda, articular os vários setores sociais com vistas à coletividade. No entanto, quando as conceituam separadamente, tendem a fazer referência a ações preventivas e pontuais; 2. O propósito é ensinar à população: neste tópico, o enfermeiro ganha destaque nas atividades voltadas à educação em saúde em busca de parcerias multidisciplinares/profissional e intersetoriais para atuarem juntos nas Determinantes Sociais de Saúde, por meio de estratégias voltadas ao interesse e à necessidade da população, considerando a participação social e desenvolvendo a reflexão para a manutenção da saúde, muito embora, algumas atividades permaneçam no modelo de educação bancária; 3. Saindo da Unidade: todos os espaços intra e extra-muros são considerados como possíveis locais para se desenvolver as atividades de educação em saúde. A escola, porém, ganha relevância pelo fato de os escolares estarem se apropriando do conhecimento sobre saúde em seu significado mais amplo, bem como e pela necessidade deles vivenciarem temas abordados de forma transversal por equipes multiprofissionais; 4. Revisitando a formação: neste último tema, os graduandos percebem a promoção da saúde em algumas disciplinas, com destaque para as vivenciadas na atenção básica e na maternidade; nos demais campos de prática, mencionam a orientação em saúde e o cuidado de forma curativista e medicamentosa. Pode-se concluir que os participantes deste estudo percebem a necessidade de um olhar ampliado para a questão da saúde voltado às Determinantes Sociais de Saúde, mas não compreendem a complexidade desse processo pautado em referenciais de educação alinhados a uma pedagogia libertadora. É de importância estratégica para o SUS a formação de bacharéis de enfermagem a partir do conceito ampliado de saúde e da promoção da saúde. Novos estudos são necessários para análise das matrizes curriculares dos cursos de bacharelado em enfermagem, em busca de aprofundamento das questões evidenciadas neste estudo

The nurse has a fundamental role in the implementation of public health politics in order to guarantee the principles of the health service system for the community in which it is inserted, especially with actions involving health education promotion. This study's aim is to analyze the conceptions of baccalaureate nursing students about the promotion of health education. This qualitative investigation followed all the ethical proceedings and was approved by the University of São Paulo's Committee of research ethics. The study included 13 baccalaureate student nurses in a private institution of higher education in the interior of the State of São Paulo. The data was constructed through two focal groups, one carried out with undergraduates of the day course and the other of the night course. Through the referential of thematic analysis the results were divided into 1. defined concepts: in this thematic, the senior nursing students associate the promotion and health education as completing each other and that health should be seen in a more ample way, joining together the various social sectors aiming at collectivity, however, when they are conceived separately they tend to refer to prompt preventative actions; 2. the proposal is to teach the population: in this subject the nurse gains distinction in the activities directed towards health education in search of multidisciplinary professionals and intersectorial partnerships to act together in the Health and Social Determinants, through strategies directed towards the populations interests and needs considering the social participation and developing contemplation for maintaining health, even though some activities remain focused on traditional and not dialogued education; 3. leaving the unit: all of the spaces inside and outside the walls are considered as possible places to develop activities in health education, becoming relevant to schools, as scholars are taking the knowledge about health in its more ample significance and also because of the necessity of these youths to experience the themes dealt with in a transversal way by the multiprofessional teams; 4. Revisiting academic preparation: In this last item, the undergraduates perceive the promotion of health in some of their subjects, with emphasis on the experience acquired in basic health attention services and in the maternity unit: in the other areas for practical training the focus is on health counseling in curative care and medication. Conclusion: The participants in this investigation see the necessity for an extended focus on health especially in regard to the social determinants, but they do not comprehend the complexities of this process drawn out by the educational references aligned in a liberating pedagogy. The graduation of Bachelors in Nursing is an important strategy for the Brazilian Health Service starting with a concept expansion of health and promotion of health. New studies are necessary in order to analyze the curriculums of Bachelor in Nursing courses, in pursuit of deepening understanding of the questions evidenced in this study

Syncytia Induction by Clinical Isolates of Human Respiratory Syncytial Virus A.

OBJECTIVE: Syncytia formation is the hallmark of the cytopathic effect caused by human respiratory syncytial virus (HRSV), which is the most important viral respiratory pathogen in children. This article reports methodological improvements in primary HRSV isolation and the importance of syncytia formation and mRNA levels of F protein for the progeny yield, using clinical isolates of HRSV. METHODS: The A and B strains of HRSV were isolated in HEp-2 cell cultures from fresh and frozen nasopharyngeal aspirates. The formation of syncytia was evaluated using 2 different assays. Levels of F protein mRNA were quantified by real-time PCR while HRSV progeny titration was done by plaque assay. RESULTS: HRSV was primarily isolated from 238 of 312 (90.7%) samples, and 13 of these (12 HRSV-A and 1 HRSV-B) were continuously passaged in vitro. The quantity and size of syncytia formed by 6 pure HRSV-A clinical isolates were different, as were the levels of F protein mRNA. CONCLUSION: There is a direct correlation of quantities of syncytia and inoculum size, but not with mRNA levels of HRSV-A F protein. Importantly, levels of F protein mRNA were directly related to progeny production.

Detection of human bocavirus mRNA in respiratory secretions correlates with high viral load and concurrent diarrhea.

Human bocavirus (HBoV) is a parvovirus recently identified in association with acute respiratory infections (ARI). Despite its worldwide occurrence, little is known on the pathogenesis of HBoV infections. In addition, few systematic studies of HBoV in ARI have been conducted in Latin America. Therefore, in order to test whether active viral replication of human bocavirus is associated with respiratory diseases and to understand the clinical impact of this virus in patients with these diseases, we performed a 3-year retrospective hospital-based study of HBoV in outpatients and inpatients with symptoms of Acute Respiratory Infections (ARI) in Brazil. Nasopharyngeal aspirates (NPAs) from 1015 patients with respiratory symptoms were tested for HBoV DNA by PCR. All samples positive for HBoV were tested by PCR for all other respiratory viruses, had HBoV viral loads determined by quantitative real time PCR and, when possible, were tested by RT-PCR for HBoV VP1 mRNA, as evidence of active viral replication. HBoV was detected in 4.8% of patients, with annual rates of 10.0%, 3.0% and 3.0% in 2005, 2006 and 2007, respectively. The range of respiratory symptoms was similar between HBoV-positive and HBoV-negative ARI patients. However, a higher rate of diarrhea was observed in HBoV-positive patients. High HBoV viral loads (>108 copies/mL) and diarrhea were significantly more frequent in patients with exclusive infection by HBoV and in patients with detection of HBoV VP1 mRNA than in patients with viral co-infection, detected in 72.9% of patients with HBoV. In summary, our data demonstrated that active HBoV replication was detected in a small percentage of patients with ARI and was correlated with concurrent diarrhea and lack of other viral co-infections.