Proteção individual versus proteção coletiva: análise bioética do programa nacional de vacinação infantil em massa

A Serious Game (Immunitates) About Immunization: Development and Validation Study

Background

Vaccination is a fundamental part of all levels—local to worldwide—of public health, and it can be considered one of humanity's greatest achievements in the control and elimination of infectious diseases. Teaching immunization and vaccination can be monotonous and tiring. It is necessary to develop new approaches for teaching these themes in nursing school.

Objective

We aimed to develop and validate a serious game about immunization and vaccination for Brazilian nursing students.

Methods

We developed a quiz-type game, Immunitates, using design and educational theoretical models and Brazilian National Health Guidelines. The game’s heuristics and content were evaluated with 2 different instruments by a team of experts. A sample of nursing students evaluated the validity of the game’s heuristics only. We calculated the content validity index (CVI) for each evaluation.

Results

The study included 49 experts and 15 nursing students. All evaluations demonstrated high internal consistency (Cronbach α≥.86). The game’s heuristics (experts: CVI 0.75-1.0; students: CVI 0.67-1.0) and the game’s contents demonstrated validity (experts: CVI 0.73-1.0). Participants identified some specific areas for improvement in the next version.

Conclusions

The serious game appears to be valid. It is intended as a support tool for nursing students in the teaching–learning process and as a tool for continuing education for nurses.

Are the measures to make COVID-19 vaccine mandatory in Brazil reasonable and proportionate?

ABSTRACT This is an essay based on a court decision handed down by the Court of Justice of the State of Santa Catarina, Brasil, that released a municipal teacher from vaccination. The injunction in a writ of mandamus was overturned at the higher court through an interlocutory appeal authored by the State Prosecutor´s Office. This essay discusses the grounds listed by the judge for granting the injunction and the arguments presented by the appellant, while making an analysis from the point of view of public health and health law, in the light of the decision of the Supreme Court on reasonableness and proportionality of the mandatory vaccine.

As medidas de obrigatoriedade da vacina contra a Covid-19 no Brasil são razoáveis e proporcionais?

RESUMO Trata-se de um ensaio baseado em decisão judicial do Tribunal de Justiça do Estado de Santa Catarina, que desobrigou à vacinação uma professora municipal do estado. A liminar, em Mandado de Segurança, foi cassada por meio de um agravo de instrumento de autoria do Ministério Público. Neste ensaio, são discutidos os fundamentos do julgador para a concessão da liminar e os argumentos apresentados pelo apelante, enquanto faz-se uma análise do ponto de vista da saúde coletiva e do direito sanitário, à luz da decisão do Supremo Tribunal Federal sobre a razoabilidade e proporcionalidade da vacina obrigatória.

THE PERSPECTIVE OF PROFESSIONALS IN RELATION TO THE CARE GIVEN TO WOMEN IN SITUATIONS OF SEXUAL VIOLENCE: PERSPECTIVE OF THE UNIVERSAL DECLARATION OF BIOETHICS AND HUMAN RIGHTS

ABSTRACT Objective: to analyze the care provided to women in situations of sexual violence, from the perspective of professionals and from the perspective of the Universal Declaration of Bioethics and Human Rights. Method: a qualitative, exploratory and descriptive study, conducted in a municipality in the north-central region of the state of Rio Grande do Sul, with 30 professionals from the multiprofessional team of intersectoral care services for women in situations of sexual violence. Data collection was conducted through semi-structured interview from January to April 2016. The results were subjected to Thematic Content Analysis. Results: four thematic categories emerged, entitled: principle of respect for human vulnerability and personal integrity, in which situations of vulnerability surrounding women are found; principle of non-discrimination and non-stigmatization: services with adequate structures, confidentiality of information, acceptance, unprejudiced practices and/or judgments in care; principle of human dignity and human rights, agile actions, prudence, articulation with other services, the role of the state and public policies are mentioned; and principle of autonomy and individual responsibility: in decision making, the importance of emancipation and empowerment. Conclusion: professionals face the challenge of facing a grievance surrounded by vulnerabilities and sometimes are not supported to meet the complex demands of women in situations of sexual violence. Protective public policies and care-based on user embracement are ways to minimize trauma and can encourage women to access services.

Knowledge and attitudes about human papillomavirus and vaccination

Abstract Objective: Uncover knowledge and attitudes of girls, mothers, teachers and health professionals about human papillomavirus and vaccination. Method: A qualitative study carried out by means of focus groups in public elementary schools and health units of Sanitary District IV from Recife-PE, Brazil, between June and July 2015. The sample was six schoolchildren, ten adolescents, nine mothers, ten teachers, thirteen health professionals and seven community health agents. Speeches were analyzed with the technique of Discourse of Collective Subject (DSC), using the Qualiquantisoft, version 1.3c software. Results: Four categories emerged from the DSC: controversial understanding of HPV; transmissibility of HPV virus; adequate knowledge about the vaccine; and education in health. Final considerations: Different levels of knowledge - doubts and misconceptions - about the subject were unveiled. However, attitudes were favorable to adhesion to immunization. Realities that need to be problematized in the educational practice of nurses.

Children with type 1 Diabetes Mellitus: access to special immunobiological and child care

OBJECTIVES

Identifying the use of child care situations, the vaccination situation and the reasons for non-vaccination, and characterizing whether mothers/guardians demonstrate notions about the right to special vaccines for children with type 1 Diabetes Mellitus.

METHOD

A descriptive, cross-sectional study with analysis of quantitative data based on interviews with mothers/guardians, particularly regarding access to childcare and vaccination against influenza and pneumococcal 23-valent (PPSV).

RESULTS

47 mothers/guardians participated in the study. The participants reported using more specialized services to follow child health, and only a few used the child care of the basic health care regularly. There were incomplete vaccination schedules, delayed annual follow-ups, missing vaccination cards at the consultations, misinformation about the special character of the vaccination, as well as emphasis on the need of presenting a specific form to obtain the vaccination, resulting in discontinuation of health actions and missed opportunities for vaccination.

CONCLUSION

Fragilities in child care and immunization actions require an increase of primary health care and of the care network, based on knowledge and the right to health in order to expand the evidence-based practice, access and comprehensiveness.