Incidence of and Risk Factors for SARS-CoV-2 Infection Among Vaccinated Healthcare Workers During Emergence of SARS-CoV-2 Gamma Variant in the Amazon Region, Brazil, 2021.

Background: The emergence of new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants poses a significant threat to public health and healthcare workers (HCWs). The SARS-CoV-2 Gamma variant emerged in Manaus, Brazil, in December 2020, leading to a large wave of infections and deaths.

Methods: We conducted a prospective cohort study among HCWs at 2 hospitals in Manaus from 31 March to 31 May 2021.

Antibody Response in Healthcare Workers During the Severe Acute Respiratory Syndrome Coronavirus 2 Gamma Variant Outbreak in Manaus, Brazil.

Background: This study aimed to evaluate severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-specific binding and neutralizing antibody responses in healthcare workers (HCWs) who received coronavirus disease 2019 (COVID-19) vaccines, with or without postvaccination infections.

Methods: We conducted a prospective, observational cohort study of HCW in 2 hospitals in Manaus, Brazil. From 31 March through 31 May 2021, HCWs had nasal swabs collected and questionnaires administered weekly for 4 visits.

The intersection of the social determinants of health and antimicrobial resistance in human populations: a systematic review.

Introduction: The social determinants of health (SDoH) impact the emergence and spread of antimicrobial resistance (AMR). We conducted a systematic review of literature mapping evidence on the intersection of SDoH, drug-resistant infections, antibiotic use, and public-facing interventions.

Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, Ovid MEDLINE, Ovid EMBASE, the Cochrane Library, PsycINFO and Scopus were searched for published evidence in English between 2000 and 2022.

Understanding context to plan antimicrobial stewardship: A mixed-method study in a Brazilian urban primary care.

Background: The Centres for Antimicrobial Optimization Network Brazil aims to implement an antimicrobial stewardship program in Brazilian municipality. This study explores barriers and enablers to its implementation, through understanding the context and beliefs regarding antimicrobial use in this environment.

Methods: The study occurred in 12 primary health care units, where a mixed-method study was conducted.

Cultivating excellence: Development and validation of a bilingual competency self-assessment tool for infection prevention and control practitioners.

Background: The study aimed at developing and validating a bilingual competency self-assessment tool for infection prevention and control practitioners based on the core competencies proposed by the World Health Organization.

Methods: The study was conducted from December 2021 to June 2023. The bilingual tool (Brazilian Portuguese and English versions) was developed according to 4 stages: (1) conceptual framework establishment and item generation; (2) content validity; (3) response process validity; and (4) internal structure validity.

Research priorities for antimicrobial stewardship nurses in a middle-income country: a nominal group technique study.

Background: Antimicrobial stewardship programs (ASPs) have become important strategies for addressing antimicrobial resistance (AMR). Despite the increasing number of international publications identifying the important roles played by nurses as part of ASPs in low- and middle-income countries, this topic is yet poorly researched. This study aimed to identify priority research gaps in the Brazilian context concerning nurses' performance in ASPs from the perspective of nursing professionals and explore the main themes among the ideas generated by these nurses.

Research priorities to strengthen environmental cleaning in healthcare facilities: the CLEAN Group Consensus.

Environmental cleaning is essential to patient and health worker safety, yet it is a substantially neglected area in terms of knowledge, practice, and capacity-building, especially in resource-limited settings. Public health advocacy, research and investment are urgently needed to develop and implement cost-effective interventions to improve environmental cleanliness and, thus, overall healthcare quality and safety. We outline here the CLEAN Group Consensus exercise yielding twelve urgent research questions, grouped into four thematic areas: standards, system strengthening, behaviour change, and innovation.

Colonisation by multidrug-resistant organisms in health workers in primary care: narrow spectrum oral antimicrobials are a risk factor.

Background: Limited information exists on carriage of multidrug-resistant organisms (MDRO) by health workers (HWs) in primary care settings. This study aims to determine the prevalence of MDRO carriage among HWs in primary care and to identify associated risk factors.

Methods: A cross-sectional study was conducted across all 12 primary care units in São Caetano do Sul-SP, Brazil, from October to December 2023.

Competency assessment tools for infection preventionists: A scoping review.

Background: Infection prevention competencies are critical for successful job performance, career progression and robust performance of infection prevention and control programs.

Aim/objective: Identify competency assessment tools available to infection preventionists and describe their characteristics, validation processes and reliability.

Methods: A scoping review was conducted on five databases and grey literature from 1999 to 2022.

Workload assessment: cross-cultural adaptation, content validity and instrument reliability.

Objectives: to adapt, validate the content and assess the reliability of the instrument National Aeronautics and Space Administration - Task Load Index, translated into Brazilian Portuguese.

Methods: a methodological study, divided into five steps: translation; synthesis; back-translation; assessment of the Portuguese version by an expert committee; pre-test and content validity of the final version by health professionals working in inpatient units. The Content Validity Index (CVI) (minimum 0.

The governance of antimicrobial resistance in Brazil: Challenges for developing and implementing a one health agenda.

This article explores stakeholders' perceptions of the challenges for developing a One Health agenda to tackle antimicrobial resistance (AMR) in Brazil, including the development and implementation of the Brazilian National Action Plan (BR-NAP). The data originate from 27 interviews conducted with human, environmental, and animal health stakeholders, including academics, managers, and policymakers involved in developing the BR-NAP. Through thematic analysis, we identified three interconnected themes: governance, the health system, and technical and scientific challenges.

Coping with in-locus factors and systemic contradictions affecting antibiotic prescription and dispensing practices in primary care-A qualitative One Health study in Brazil.

Antimicrobial resistance (AMR) is an increasing threat to global health. The risks and sanitary consequences of AMR are disproportionately experienced by those living in Low- and Middle-Income Countries (LMICs). While addressing antibiotic use has largely been documented in hospital settings, the understanding of social drivers affecting antibiotic prescribing and dispensing practices in the context of human and animal health in primary care (PC) in LMICs remains extremely limited.

Perceived Workload Using Separate (Filtering Facepiece Respirator and Face Shield) and Powered Air-Purifying Respirator and Integrated Lightweight Protective Air-Purifying Respirator: Protocol for an International Multisite Human Factors Randomized Crossover Feasibility Study.

Background: The design of personal protective equipment (PPE) may affect well-being and clinical work. PPE as an integrated item may improve usability and increase adherence by healthcare professionals. Human factors design and safety may reduce occupational-acquired diseases.

Experiences of antibiotic use among Brazilian healthcare users: An exploratory study.

Introduction: This article analyzes experiences of antibiotic use and bacterial infections among Primary Health Care users of the Brazilian Unified Health System (SUS) and the possible implications for antimicrobial resistance (AMR). The aim is to map aspects that shape users' lay knowledge regarding antibiotics use and AMR.

Methods: This is an exploratory study, which consists primarily of individual in-depth interviews with 19 respondents.

Lessons learned from a failed implementation: Effective communication with patients in transmission-based precautions.

Background: Patient engagement with transmission-based precautions can be an important strategy to prevent adverse events related to isolation. Most patient education is still highly prescriptive and is thus unlikely to help. Effective communication requires behavior change, leading to a meaningful dialog between the parties involved.

Personal protective equipment implementation in healthcare: A scoping review.

Background: Adherence to infection prevention and control (IPC) measures, including the proper use of protective personal equipment (PPE), in health care is complex and is influenced by many factors. Isolated interventions do not have the potential to achieve optimal PPE adherence and appropriate provision, leading to incomplete PPE implementation.

Objective: To map PPE implementation in health care with a focus on its barriers and facilitators.

A mixed methods study on effectiveness and appropriateness of face shield use as COVID-19 PPE in middle income countries.

Background: Face shields were widely used in 2020-2021 as facial personal protective equipment (PPE). Laboratory evidence about how protective face shields might be and whether real world user priorities and usage habits conflicted with best practice for maximum possible protection was lacking - especially in limited resource settings.

Methods: Relative protective potential of 13 face shield designs were tested in a controlled laboratory setting.

Step-by-step approach to reopening a Brazilian higher education institution during the COVID-19 pandemic.

Objectives: to describe the experience of reopening a Brazilian higher education institution during the COVID-19 pandemic.

Methods: experience report of a step-by-set approach to reopening a nursing higher education institution in São Paulo, Brazil, from May 2020 to May 2021.

Results: the plan was created and operated by a group including students, professors, and technical-administrative workers.

The Consolidated Framework for Implementation Research: a reflection on researchers' experiences of its benefits and challenges and the lessons learnt from using it.

Background: In healthcare implementation research, there is little discussion of researchers' experiences of using frameworks, including the Consolidated Framework for Implementation Research (CFIR).

Aim: To identify and discuss the benefits and challenges encountered and the lessons learnt from researchers' experiences of using the CFIR in different contexts and phases of research.

Discussion: This article synthesises the reflections of nursing and public health researchers on their experiences of using the CFIR across four separate healthcare-associated infection prevention and control implementation studies.

The Consolidated Framework for Implementation Research: a reflection on researchers' experiences of its benefits and challenges and the lessons learnt from using it.

Background: In healthcare implementation research, there is little discussion of researchers' experiences of using frameworks, including the Consolidated Framework for Implementation Research (CFIR).

Aim: To identify and discuss the benefits and challenges encountered and the lessons learnt from researchers' experiences of using the CFIR in different contexts and phases of research.

Discussion: This article synthesises the reflections of nursing and public health researchers on their experiences of using the CFIR across four separate healthcare-associated infection prevention and control implementation studies.