Contribución y desafíos de las enfermeras en tiempos de Covid-19: una revisión narrativa de la literatura / Contribuição e desafios do enfermeiro em tempos de Covid-19: uma revisão narrativa da literatura / Contribution and challenges of nurses in times of Covid-19: a narrative review of the literature

La pandemia por Covid-19 ha puesto a prueba el liderazgo y experiencia prácticade las enfermeras, y ha visibilizado el cuidado como un tema esencial para la vida humanay la salud global. Objetivo. El propósito de esta revisión de la literatura es reflexionarsobre las contribuciones y desafíos de las enfermeras en tiempos de pandemia. Método.Se realizó una revisión de la literatura, usando la base de datos Wos y SciencieDirect conla búsqueda de las palabras claves “nursing” AND “Covid-19” AND “disaster”, luego secomplementó con otros documentos seleccionados de variadas fuentes, principalmenteinformes de organizaciones internacionales que han sido relevantes en el quehacer deenfermería y de la salud pública durante el periodo de pandemia. Resultados. Se revisaron48 documentos y artículos que cumplieron con los criterios de inclusión. Conclusiones.La principal contribución de las enfermeras a la pandemia se relaciona con la capacidadde formar una gran fuerza de contención en contra del Covid-19, guiada por un cuidadocompasivo. Mientras algunos desafíos son el autocuidado y la planificación para larecuperación del sistema salud postpandemia.(AU)

The Covid-19 pandemic has put the leadership and practical experience of nursesto the test, and has made care visible as an essential issue for human life and global health.Objective. The purpose of this literature review is to reflect on the contributions andchallenges of nurses in times of pandemic. Method. A literature review was carried out,using the Wos and SciencieDirect databases, searching for the keywords “nursing” AND“Covid-19” AND “disaster”, then it was supplemented with other documents selectedfrom various sources, mainly reports of international organizations that have beenrelevant in the nursing and public health work during the pandemic period. Results. 48documents and articles that met the inclusion criteria were reviewed. Conclusions. Themain contribution of nurses to the pandemic is related to the ability to form a largecontainment force against Covid-19, guided by compassionate care. While somechallenges are self-care and planning for the recovery of the post-pandemic health system.(AU)

A pandemia Covid-19 colocou à prova a liderança e a experiência prática dosenfermeiros e tornou o cuidado visível como uma questão essencial para a vida humanae a saúde global. Objetivo. O objetivo desta revisão de literatura é refletir sobre ascontribuições e desafios dos enfermeiros em tempos de pandemia. Método. Foi realizadauma revisão da literatura, utilizando as bases de dados Wos e SciencieDirect, buscandoas palavras-chave “enfermagem” AND “Covid-19” AND “desastre”, a seguir foicomplementada com outros documentos selecionados de várias fontes, principalmente relatórios de organizações internacionais que foram relevantes no trabalho deenfermagem e saúde pública durante o período de pandemia. Resultados. Foram revisados48 documentos e artigos que atenderam aos critérios de inclusão. Conclusões. A principalcontribuição dos enfermeiros para a pandemia está relacionada à capacidade de formaruma grande força de contenção contra a Covid-19, guiada pelo cuidado compassivo.Enquanto alguns desafios são o autocuidado e o planejamento para a recuperação dosistema de saúde pós-pandemia.(AU)

Caracterização da vulnerabilidade relacionada a síndromes respiratórias graves nos municípios da Região Metropolitana do Vale do Paraíba e Litoral Norte de São Paulo / Vulnerability characterization related to severe respiratory syndromes in the Paraíba Valley and North Coast of the State of São Paulo Metropolitan Region municipalities

Desde o final de 2019 até os dias atuais, todo o planeta tem sido significativamente impactado pela pandemia COVID-19 (Corona Virus Desease-2019), causada pelo SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2), com impactos em diversos setores, como saúde, economia, educação e emprego. A gestão desse tipo de epidemia está inserida na tipologia do desastre biológico e exige ações integradas em diversas áreas do conhecimento. Assim, para combater e prevenir futuras epidemias de síndromes respiratórias agudas graves (SARS), é necessário, entre outros esforços, identificar as vulnerabilidades populacionais nos diferentes níveis de divisão política. Nesse contexto, o presente trabalho propõe um índice de vulnerabilidade que permite contextualizar os municípios da Região Metropolitana do Vale do Paraíba e Litoral Norte de São Paulo (RMVPLN), utilizando técnicas de geoprocessamento em Sistema de Informações Geográficas (SIG) que possam subsidiar tomadores de decisão na gestão e nas ações de enfrentamento aos impactos de tal desastre biológico.

Since the end of 2019 to the present day, the entire planet has been significantly impacted by the COVID-19 (Corona Virus Desease-2019) pandemic, caused by the SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2), with impacts on several sectors, such as health, economy, education, and employment. The management of this kind of epidemic is inserted in the biological disaster typology and demands integrated actions in several areas of knowledge. Thus, to combat and prevent future epidemics of severe acute respiratory syndromes (SARS), it is necessary, among other efforts, to identify the population vulnerabilities at different political division levels. In this context, the present work proposes a vulnerability index which allows to describe the municipalities in the Paraíba Valley and North Coast of São Paulo Metropolitan Region, demanding geoprocessing techniques in Geographic Information System (GIS) that can subsidize decision makers to take actions to manage and to cope with the impacts of such biological disaster.

Interação entre Proteção e Defesa Civil e setor de Saúde em resposta à pandemia da COVID-19 em Vinhedo-SP / Interaction between Protection and Civil Defense and Health Sector in Response to the Pandemic of COVID-19 in Vinhedo-SP

A Proteção e Defesa Civil do Município de Vinhedo (SP) atua em várias atividades, principalmente ligadas à redução de riscos e desastres, como parte do Projeto "Plataforma Regional para Redução dos Riscos de Desastres da Região Metropolitana de Campinas". No início de 2020, com o surgimento de uma nova doença causada pelo vírus "Sars-Cov-2", nomeada pela Organização Mundial de Saúde como COVID-19, foi necessário alterar as atividades usuais da Proteção e Defesa Civil. Este trabalho busca avaliar a interação entre os setores de Saúde e Proteção e Defesa Civil com relação à COVID-19 e seus impactos em Vinhedo. Como método, foi feita pesquisa bibliográfica relacionada aos principais conceitos teóricos do trabalho, pesquisa documental, com dados dos setores de Saúde e Proteção e Defesa Civil nos três níveis de governo, e pesquisa de campo de base qualitativa, entre os meses de fevereiro e agosto de 2020, com utilização de um diário de bordo, observações em campo e realização de entrevistas. Após a finalização da coleta de dados, foi feita a análise quantitativa e qualitativa, considerando as ações governamentais e informações da pandemia durante o período de tempo delimitado, as orientações técnicas para gestão e governança pública, incluídas Saúde e Proteção e Defesa Civil frente a epidemias, e uma análise mais crítica dos impactos no cotidiano, relações interpessoais, e à saúde coletiva como um todo. A crise da COVID-19 mostrou diversos acontecimentos disruptivos, de diferentes naturezas, que agravaram os riscos e a desconfiança social. Nas três esferas de governo o modelo e a interação entre Saúde e Proteção e Defesa Civil se deu principalmente em logísticas operacionais. Permitido o papel previsto para a Proteção e Defesa Civil de gestora responsável pela articulação multisetorial e, nesse sentido, haver uma cooperação com a Saúde seria possível monitorar impactos econômicos e psicossociais no curto, médio e longo prazo pós COVID-19.

The Civil Protection and Defense of the Municipality of Vinhedo (SP) operates in several activities, mainly related to risk and disaster reduction, as part of the Project "Regional Platform for Disaster Risk Reduction of the Metropolitan Region of Campinas". In early 2020, with the emergence of a new disease caused by the virus "Sars-Cov-2", named by the World Health Organization as COVID-19, it was necessary to change the usual activities of Civil Protection and Defense. This study aims to evaluate the interaction between the Health and Protection and Civil Defense sectors in relation to COVID-19 and its impacts in Vinhedo. As a method, bibliographic research related to the main theoretical concepts of the work, documentary research, with data from the sectors of Health and Protection and Civil Defense in the three levels of government, and qualitative-based field research, between February and August 2020, using a logbook, field observations and interviews. After the completion of the data collection, a quantitative and qualitative analysis was carried out, taking into account the governmental actions and information of the pandemic during the defined period of time, the technical guidelines for management and public governance, including Health and Protection and Civil Defense in the face of epidemics, and a more critical analysis of impacts on daily life, interpersonal relations, and collective health as a whole. The COVID-19 crisis has shown various disruptive events of different natures, which have aggravated risks and social distrust. In the three spheres of government, the model and the interaction between Health and Civil Protection and Defense was mainly in operational logistics. Allowed the role foreseen for the Civil Protection and Defense of manager responsible for the multisectorial articulation and, in this sense, having a cooperation with Health would be possible to monitor economic and psychosocial impacts in the short, medium and long term after COVID-19

Simulacro de Actuación de las Unidades Operativas NRBQ / Training exercise of CBN Operating Units

Antecedentes: Ante la creciente amenaza terrorista, la mayoría de los países han creado Unidades Operativas especializadas en la lucha contra armas de destrucción masiva (ADM). Uno de los puntos críticos en un incidente bioterrorista es la detección e identificación precoz de estos agentes, para lo cual es imprescindible realizar una adecuada toma de muestras, conservación, transporte y custodia de las mismas hasta el laboratorio de referencia. Objetivo: Valorar el entrenamiento de las Unidades de toma de muestras NBQ mediante la realización de simulacros. Lugar de realización: Área de Defensa Biológica del Instituto Nacional de Técnica Aeroespacial «Esteban Terradas» (INTA). Diseño: Se presenta la preparación y desarrollo de un ejercicio de entrenamiento de los Equipos de Reconocimiento (RECO) y de Muestreo e Identificación de Agentes Biológicos, Químicos y Radiológicos (SIBCRA en inglés) del Regimiento de la Defensa NBQ Valencia I (RGTO DNBQ Valencia I). Resultados: Se obtienen muestras NBQ y se evalúa la eficacia de la operativa de la toma de muestras, transmisión de los datos y coordinación general del ejercicio (AU)

Antecedents: Due to the merging terrorist threat, most of the countries have created specialized operating units to fight weapons of mass destruction. One of the critical points in a bioterrorist incident is the early detection and identification of these agents. In this sense, it is essential to perform appropriate procedures for sampling, storage, transportation and custody of them until the reference laboratory. Objective: to train the different NBC Units by means of simulacrums. Place of performance: Biological Defense Area of the National Institute of Aerospace Technique "Esteban Terradas" (INTA). Design: This paper shows the preparation and development of a training exercise of Reconnaissance teams (RECO) and Sampling and Identification of Biological, Chemical and Radiological Agents teams (SIBCRA) from NBC Defense Regiment Valencia I. Results: NBQ samples are obtained and the efficiency of the operations, sampling, data transmission and general coordination of the exercise is evaluated (AU)

Estudio exploratorio sobre nivel de preparación del personal sanitario en Defensa NBQ / Exploratory study on preparedness level of health personnel in NBC Defense

Introducción. El personal sanitario debe estar preparado para poder intervenir con eficacia en un incidente NBQ. El objetivo principal de este estudio exploratorio era conocer el nivel de preparación del personal sanitario que trabajaba en el ámbito militar ante incidentes NBQ en general, y químico en particular. Material y métodos: Se realizó un estudio descriptivo transversal mediante un cuestionario autoadministrado en una muestra de 348 oficiales del Cuerpo Militar de Sanidad (50,6% médicos y 49,4% enfermeros) de los que el 71,8% eran mujeres. Resultados: El 68,4% habían recibido formación especifica de Defensa NBQ durante su periodo de formación militar técnica, y el 23% la habían recibido fuera del ámbito militar. El 95,4% consideraban necesario recibir formación en defensa NBQ y el 89,3% no se consideran preparados para intervenir en un incidente NBQ. Dentro de los empleos de la muestra estudiada son los tenientes y capitanes los que muestran más interés en recibir formación. Discusión: A la vista de los resultados obtenidos parece que las actividades formativas no son suficientes para alcanzar la capacidad de intervención en incidentes NBQ. Conclusiones: Los empleos de teniente y capitán son los que refieren una mejor preparación para intervenir con eficacia frente a un incidente NBQ. Se deduce una necesidad en la preparación del personal sanitario por lo que se debe de establecer un sistema de capacitación sanitaria de defensa NBQ (AU)

Introduction: Health workers should be prepared to intervene effectively in a CBRN incident. The aim of this work is to know the preparedness level of health workers who work in NBC incidents in general, and chemical in particular, in military environment. Material and methods: A cross-sectional descriptive study was carried out using a self-administered questionnaire in a sample of 348 officers of the Military Health Corps (50.6% of physicians and 49.4% of nurses), of which 71.8% were women. Results: 68.4% had received specific training of CBRN defense during their military technical training, and 23% had received training in NBC Defense outside. 95.4% they considered necessary to receive training in NBC defense. 89.3% are not considered ready to intervene in a CBRN incident. Within the military ranks of the sample studied are lieutenants and captains who show more interest in receiving training. Discussion: In view of the results obtained, it seems that the training activities are not enough to reach the capacity of intervention in incidents NBC. Conclusion: The positions of lieutenant and captain are those that refer to a better preparation to intervene effectively against an NBC incident. It follows that there is a need for the preparation of health workers, which is why a NBC defense health training system should be established (AU)

Estudio exploratorio de percepción del riesgo NBQ en personal sanitario / Exploratory study on NBC risk perception of health personnel

Introducción. A partir del atentado de Tokio en 1995 y de la crisis de los sobres en 2001, se observa un cambio en la percepción del riesgo NBQ entre los profesionales sanitarios. Un objetivo secundario del estudio era estudiar el nivel de percepción del riesgo NBQ entre los médicos y enfermeros militares. Material y Métodos. Se realizó un estudio exploratorio descriptivo transversal basado en un cuestionario autoadministrado dirigido a la población de médicos y enfermeros militares (348 oficiales del Cuerpo Militar de Sanidad -50,6% médicos y 49,4% enfermeros). Resultados. El 74,7% de los participantes consideraban como probable que se produjera un incidente NBQ en los próximos cinco años. El 78,7% consideraba que se vería implicado. El 42,7% consideraban que el entorno seria militar, mientras que el 24,5% consideraban que lo seria en entorno civil. En torno al 30% de los pertenecientes al Órgano Central y la Armada consideraban como más probable el escenario biológico. Discusión: Se observa una elevada percepción del riesgo NBQ entre el personal sanitario militar, fundamentalmente entre los menores de 30 años, siendo más marcada esta percepción en los hombres que en las mujeres. En relación al empleo militar, el personal con empleos de teniente y coronel son los que referían una mayor percepción del riesgo. Mientras que los tenientes coroneles, fundamentalmente médicos y destinados en el Órgano Central,consideraban que no se verían implicados profesionalmente en un incidente NBQ. Conclusiones: Existe una elevada percepción del riesgo NBQ entre el personal sanitario militar, fundamentalmente entre los tenientes y menores de 30 años. Hecho que se ve corroborado con la idea de la implicación profesional en incidentes NBQ en un futuro (AU)

Introduction. Since the Tokyo terrorist attack in 1995 and the Amerithrax in 2001, there has been a change in the perception of NBC risk among health professionals. A secondary objective of was to evaluate NBC risk perception among military health personnel. Material and Methods. It was made a descriptive cross-sectional study based on a self-administered questionnaire addressed to the population of medical and military nurses (348 348 officials of Health Branch -50,6% physicians and the 49,4% nurses. Results. The 74,7% considered as a possible that occurred a NBC incident in the next five years. The 78,7% considered that would be involved. The 42,7% considered that the incident will be military, while the 24,5% considered that it will be in civil area. Around 30% of personnel enlisted at the DoD (Central Organ) and the Navy considered that the biological scenario was the most probable. Discussion: A high perception of NBC risk is observed among the military health personnel, mainly among those under 30 years, a tendency stressed more in men than in women. Regarding the military employment, lieutenant and colonel are those reporting a greater perception whereas the physicians’ lieutenant colonel thought they would not be involved professionally in a NBC incident. Conclusions: There is a high perception of CBRN risk among the military medical personnel, mainly among lieutenants and those under 30 years old. This fact is corroborated by the idea of professional involvement in CBRN incidents in the future (AU)

Academic effects of the prestige oil spill disaster

The effect of a large scale oil spill disaster on the academic achievement and classroom behavior of children and adolescents who lived on the Galician coast (Spain) is studied from an ecological perspective. 430 participants divided into three age groups of 5, 10, and 15 years of age, were studied. The participants came from three areas differently affected by the disaster. Dependent variables were academic achievement and classroom behavior of the participants after the Prestige disaster. Degree of exposure and other protective or risk factors were investigated as well. Repeated measures ANOVA to assess the main effects of the oil spill and hierarchical regression analyses to assess the contribution of the protective/vulnerability factors were performed. The results indicate that the effects of the disaster were relatively scarce. Some protective factors accounted for a certain degree of variance of different schoolroom behaviors. These results point to the intervention of protective factors in the adaptation to the disaster (AU)

Se estudia desde una perspectiva ecológica el efecto que el desastre provocado por un gigantesco vertido de petróleo ha tenido sobre el rendimiento académico y la conducta en el aula de niños y adolescentes que vivían en la costa de Galicia (España). Se estudiaron 430 participantes divididos en tres grupos de, 5, 10 y 15 años. Los participantes provenían de tres áreas que fueron afectadas en grado diferente por el desastre. Las variables dependientes estudiadas fueron el rendimiento académico y el comportamiento en el aula de los participantes después del desastre del Prestige. El grado de exposición y otros factores de riesgo o protectores fueron también investigados. Se realizaron análisis de varianza (ANOVA) de medidas repetidas para evaluar los efectos más importantes del vertido de petróleo y análisis de regresión jerárquica para evaluar la contribución de los factores protectores o de vulnerabilidad. Los resultados indican que los efectos del desastre fueron relativamente escasos. Algunos factores protectores explicaron un cierto grado de varianza de diferentes comportamientos en el aula. Estos resultados señalan la intervención de factores protectores en la adaptación al desastre (AU)

The next challenge in healthcare preparedness: catastrophic health events

Preparedness report which proposes key elements of national strategy for health care preparedness and response. Publication from January, 2010. Available in pdf format.

Bioterrorismo / Bioterrorism

Durante años se ha considerado el bioterrorismo como un arma letal que ha sido utilizada para atacar y causar terror en la población mundial. Es despuésde algunas décadas cuando sentimos esta amenaza nuevamente. Dentro del gran armamento que se ha utilizado para este tipo de amenaza, sehace mención a las principales formas de ataque biológico que han producido enfermedades con consecuencias devastadoras para la humanidad,dejando a su paso secuelas físicas y psicológicas, que en nuestro tiempo vuelven a centrar su atención por la gran cantidad de agentes que se encuentranal alcance.Siendo así el agente biológico ideal debería ser altamente letal, producido fácilmente y en grandes cantidades, estable, de transmisión en forma deaerosol o de persona a persona, resistente a antibióticos standard y que no sea prevenible con vacunación. Esto limita la lista de posibles agentes biológicosa ciertas bacterias: Bacillus antraccis, Brucella spp, clostridium botulinum, yersinia pestis y francisella tularensis, y a ciertos virus que mencionaremosen este documento

During years has been consider bioterrorism as a lethal weapon which has been used to attack and cause terror in world population . Is just after somedecades when we feeling this treat again.Within of big amount of weapons used for this treat, mention to the main forms of biological attack is done that have produced illnesses with devastatingconsequences for the humanity, leaving their step psychological and physical consequences, that in our time they center again their attentionby the great quantity of agents that are found al reach.Being thus the ideal biological agent should be highly deadly, produced easily and in large quantities, stable, of broadcast in the shape of person toperson, resistant to antibiotic standard and that be not prevenible with vaccination. This limits the list of possible biological agents to certain bacteria:Bacillus antraccis, Brucella spp, clostridium botulinum, yersinia pestistis and Francisella tularensis, and to certain virus that we will mention in thisdocument

Evaluación de efectos biológicos asociados al vertido del "Prestige" en poblaciones de peces de interés comercial / No disponible

No disponible

Prestige" y salud pública, tres años después. Las sociedades científicas de salud pública ante los desastres medioambientales / No disponible

No disponible

Respuesta de la salud pública a las armas biológicas y químicas: Guía de la OMS / Health aspects of chemical and biological weapons: report of a WHO Group of Consultants

Traducción realizada por la Organización Panamericana de la Salud, 2003

Terrorismo biológico: ¿estamos preparados? / Biological terrorism, are we ready?

No disponible