Showing papers in "Ciencia & Saude Coletiva in 2020"
TL;DR: To control COVID-19 in Brazil, it is also crucial that epidemiological monitoring is strengthened at all three levels of the Brazilian National Health System (SUS), which includes evaluating and usingsupplementary indicators to monitor the progression of the pandemic and the effect of the control measures.
Abstract: The COVID-19 pandemic has challenged researchers and policy makers to identify public safety measures forpreventing the collapse of healthcare systems and reducingdeaths. This narrative review summarizes the available evidence on the impact of social distancing measures on the epidemic and discusses the implementation of these measures in Brazil. Articles on the effect of social distancing on COVID-19 were selected from the PubMed, medRXiv and bioRvix databases. Federal and state legislation was analyzed to summarize the strategies implemented in Brazil. Social distancing measures adopted by the population appear effective, particularly when implemented in conjunction with the isolation of cases and quarantining of contacts. Therefore, social distancing measures, and social protection policies to guarantee the sustainability of these measures, should be implemented. To control COVID-19 in Brazil, it is also crucial that epidemiological monitoring is strengthened at all three levels of the Brazilian National Health System (SUS). This includes evaluating and usingsupplementary indicators to monitor the progression of the pandemic and the effect of the control measures, increasing testing capacity, and making disaggregated notificationsand testing resultstransparentand broadly available.
380 citations
TL;DR: In this paper, the authors present the results of an opinion poll conducted in Brazil on the perception of social isolation during the COVID-19 pandemic, with questions about the socioeconomic profile and factors associated with isolation.
Abstract: This paper presents the results of an opinion poll conducted in Brazil on the perception of social isolation during the COVID-19 pandemic. The questionnaire was prepared on Google Forms, disseminated through social networks, with questions about the socioeconomic profile and factors associated with isolation. A non-probabilistic sample was obtained with 16,440 respondents. Data were analyzed using the Stata 13 software. Social interaction was the most affected aspect among people with higher education and income (45.8%), and financial problems caused a more significant impact (35%) among people with low income and education. Those who practice some physical activity showed lower levels of stress 13%, as well as greater normality in sleep 50.3%. People who reported living in worse habitability conditions reported willingness to remain isolated for less time, 73.9%. Among non-isolated people (10.7% of the total sample), 75.8% believe that social isolation will reduce the number of victims of COVID-19. We conclude, based on this sample, that the perception about social isolation as a pandemic mitigation action varies by income, education, age, and gender. However, most believe that it is the most appropriate control measure and are willing to wait as long as necessary to contribute to the fight against COVID-19.
235 citations
TL;DR: This work revives the analysis of the chronic problems affecting health workers, resulting from the underfinancing of the Brazilian Unified Health System (SUS), the sector's spending freeze, the deterioration of services and workforce's insecurity, and points out the acute challenges of work management and staff training.
Abstract: This work aims to systematize a set of scientific evidence presented in international papers that identify the main problems affecting health professionals directly involved in coping with the COVID-19 pandemic and point out actions and strategies for the protection and healthcare of these professionals. The risk of infection is the main issue and has led to absence from work, illness, death, and intense psychological distress, expressed in generalized anxiety and sleep disorders, fear of becoming ill and infecting colleagues and relatives. In the Brazilian reality, this work revives the analysis of the chronic problems affecting health workers, resulting from the underfinancing of the Brazilian Unified Health System (SUS), the sector's spending freeze, the deterioration of services and workforce's insecurity, and points out the acute challenges of work management and staff training, given the expanded hospital bed infrastructure and reorganization of the work process in primary care to face the pandemic, emphasizing the necessary measures for the protection and promotion of the physical and mental health of health professionals and workers.
154 citations
TL;DR: A survey of the World Health Organization adapted to the local context was applied to study people's feelings about COVID-19, and content analysis was subsequently conducted as mentioned in this paper, which revealed that the population surveyed felt uncertainty, fear and anguish, albeit a feeling of responsibility and care.
Abstract: The scope of this work is to explore the feelings and expectations that COVID-19 has generated in Argentina during the first stage of the pandemic. A survey of the World Health Organization adapted to the local context was applied. Open-ended questions were included to study people's feelings about COVID-19, and content analysis was subsequently conducted. In terms of results, it is revealed that the population surveyed feels uncertainty, fear and anguish, albeit a feeling of responsibility and care in the face of COVID-19 also emerges. Moreover, positive feelings regarding society stand out as an achievement of social interdependence. The results obtained show that the impact on mental health differs in accordance with gender, educational level, and perceived comfort in the home. The study concludes that the emotional and bonding dimensions of people are central to confronting the COVID-19 pandemic in Argentina. It is recommended that these dimensions, as well as their subjective and differential social impact among the different population groups, should be considered in the planning of policies to address the COVID-19 pandemic.
106 citations
TL;DR: In this paper, the authors investigated the factors associated with indicators of mental disorders symptoms in residents of Rio Grande do Sul during the initial period of the social distancing policy and found that having decreased income, being part of the risk group and being more exposed to information about deaths and infected, are factors that can significantly harm mental health in this pandemic period.
Abstract: Pandemics such as that of COVID-19 affect a relatively large number of people and impose new rules and social habits on the world population. Information about the pandemic is constant in the media. Moreover, social distancing has been adopted in Brazil to prevent the spread of COVID-19, which may have economic and psychosocial consequences. This study aimed to verify the factors associated with indicators of mental disorders symptoms in residents of Rio Grande do Sul during the initial period of the social distancing policy. The study was approved by CONEP. There were 799 participants, aged between 18 and 75 years (M = 36.56; SD = 12.88); 82.7% were women, who answered a sociodemographic questionnaire of social distancing and the Self-Report Questionnaire (SRQ-20). The results indicated that having decreased income in the period, being part of the risk group and being more exposed to information about deaths and infected, are factors that can significantly harm mental health in this pandemic period. Investigating social determinants that contribute to greater vulnerability to the mental illness of the population is vital in the field of collective health for the planning of public actions and policies.
92 citations
TL;DR: In this paper, the authors present an analysis of the most widespread fake news about the New Coronavirus (Sars-CoV-2) on social networks and how it can harm public health.
Abstract: This paper aims to present an analysis of the most widespread fake news about the New Coronavirus (Sars-CoV-2) on social networks and how it can harm public health. This is a quantitative empirical study, based on the notifications received by the Eu Fiscalizo Brazilian application. The conclusions show that WhatsApp is the primary channel for sharing fake news, followed by Instagram and Facebook. We can conclude that the dissemination of malicious content related to Covid-19 contributes to the discrediting of science and global health institutions, and the solution to this problem is to increase the level of adequate information for Brazilian society.
91 citations
TL;DR: Atencao Primaria a Saude (APS) as discussed by the authors is a politica de saude, which is similar to ours, but with a different model of atendimento, centralidade no cuidado individual, enfraquecimento do enfoque territorial comunitario and cobertura por cadastramento.
Abstract: Resumo O artigo analisa politicas recentes no campo da Atencao Primaria a Saude (APS) e suas possiveis implicacoes para o modelo assistencial no Sistema Unico de Saude (SUS). Inicialmente resgatam-se algumas das concepcoes que influenciaram os modelos de atencao no sistema publico brasileiro e argumenta-se que a Estrategia Saude da Familia (ESF) apresenta as bases para reorientacao das praticas assistenciais na atencao basica coerentes com os principios do SUS. A seguir, analisam-se elementos centrais de politicas federais recentes para a APS. Demonstra-se que as mudancas no modelo assistencial da APS com ameacas a multiprofissionalidade das equipes, prioridade ao pronto atendimento, centralidade no cuidado individual, enfraquecimento do enfoque territorial comunitario e cobertura por cadastramento, evidenciam redirecionamento da politica de saude, ferindo os principios da universalidade, integralidade e equidade no SUS.
78 citations
TL;DR: In this article, the authors argue that the risks to hunger and food security in Brazil have been present since 2016 and are now being exacerbated due to the emergence of the COVID-19 epidemic.
Abstract: The emergence of COVID-19 in Brazil further explained the massive discrepancy between different social realities coexisting in the country, rekindling the discussions about food and nutrition security, similarly to what has been happening in other countries facing the same pandemic situation. In this paper, we argue that the risks to hunger and food security in Brazil have been present since 2016 and are now being exacerbated due to the emergence of the COVID-19 epidemic. This situation requires knowing the extent and magnitude of the issue and articulation of measures in the three governmental spheres(federal, municipal and state) to ensure access to adequate and healthy food and reduce the disease's adverse effectson the diet, health, and nutrition among the most vulnerable people. Thus, this work aims to contribute to the debate on the measures to be adopted by governments and society to promote and ensure food and nutrition security and prevent insecurity and the expansion of hunger during and after the social and health crisis created by the pandemic.
75 citations
TL;DR: The profession faces many challenges, both in the field of education and in the job market, that must be addressed, aiming at the valorization of these professionals who, despite all the difficulties they are subjected to, are committed to the health of the Brazilian population.
Abstract: Resumo O artigo debate a importância da Enfermagem para o Sistema Unico de Saude, considerando a mesma estar presente em todas as estruturas organizacionais de saude, nas 27 unidades da Federacao e em todos os municipios do pais, essencial, portanto, para a prestacao de uma assistencia de qualidade. Apesar disso, a profissao enfrenta muitos desafios, quer no campo da formacao e do mercado de trabalho, que necessitam ser enfrentados, visando a valorizacao desses profissionais que apesar de todas as dificuldades a que estao submetidos, sao comprometidos com a saude da populacao brasileira.
72 citations
TL;DR: The approach to the COVID-19 pandemic varies by social aspects, such as gender, age, education, and place of residence, as well as the belief system of the population of the State of Ceara.
Abstract: Resumo O objetivo deste estudo foi avaliar os aspectos comportamentais e as crencas da populacao cearense frente a pandemia de COVID-19. Foi realizado um questionario “on line” sobre aspectos sociodemograficos e crencas relacionados a pandemia. Foram calculadas frequencias absoluta e relativa, a associacao entre variaveis foi realizada com Qui-quadrado e o nivel de significância foi de 5%. A amostra final contou com 2.259 participantes e foi observada associacao entre o genero feminino e se perceber com um alto risco de contaminacao (p = 0,044) e o genero masculino com a nao realizacao voluntaria da quarentena (p < 0,001). Pessoas com 80 anos ou mais realizaram quarentena parcialmente devido ao fluxo de pessoas em casa (p < 0,001). Os participantes com o ensino fundamental se perceberam com um risco menor de contaminacao que aqueles com grau de escolaridade mais elevado (p < 0,001). Neste grupo estao as pessoas que menos fizeram quarentena voluntaria (p < 0,001). Os participantes que moram no interior do estado, tiveram menos contato direto com alguem testado positivamente para o coronavirus (p = 0,031) e estao menos reclusos (p < 0,001). E possivel concluir que a abordagem frente a pandemia de COVID-19 varia de acordo com aspectos sociais, como genero, idade, escolaridade e local de residencia, assim como o sistema de crencas da populacao do estado do Ceara.
63 citations
TL;DR: In this article, the implications of social isolation due to the COVID-19 pandemic for the intensive use of the internet among children and adolescents and its possible consequences for the practice of self-inflicted violence are discussed.
Abstract: This essay aimed to discuss the implications of social isolation due to the COVID-19 pandemic for the intensive use of the internet among children and adolescents and its possible consequences for the practice of self-inflicted violence. We briefly discussed the anxiogenic potential and the reproduction of a "global fear" that are consolidated with the massive and unmediated exposure of the content consumed, which can increase the vulnerabilities to stress and suicidal ideas. We centered our debate on "recreational" practices, called "challenges" with self-harm power, carried out by teenagers on the YouTube website. This practice has been shown to increase with the social isolation measures. Our reflection on these risks builds on the theoretical perspective of digital sociability, and its implications for the internet-mediated interactions of adolescents.
TL;DR: Based on the analysis, the new policy seems to have a restrictive purpose, which should limit universality, increase distortions in financing and induce the focus of PHC actions on the SUS, contributing to the reversal of historic achievements in reducing health inequalities in Brazil.
Abstract: Resumo Em 2019, o governo brasileiro lancou uma nova politica para a Atencao Primaria a Saude (APS) no Sistema Unico de Saude (SUS). Chamada de “Previne Brasil”, a politica modificou o financiamento da APS para municipios. No lugar de habitantes e de equipes de Estrategia Saude da Familia (ESF), as transferencias intergovernamentais passaram a ser calculadas a partir do numero de pessoas cadastradas em servicos de APS e de resultados alcancados sobre um grupo selecionado de indicadores. As mudancas terao um conjunto de impactos para o SUS e para a saude da populacao que precisaram ser identificados e monitorados. Neste artigo, discute-se os possiveis efeitos da nova politica a partir de uma breve analise de contexto sobre tendencias globais de financiamento de sistemas de saude e de remuneracao por servicos de saude, bem como dos avancos, desafios e ameacas a APS e ao SUS. Com base na analise realizada, entende-se que a nova politica parece ter objetivo restritivo, que deve limitar a universalidade, aumentar as distorcoes no financiamento e induzir a focalizacao de acoes da APS no SUS, contribuindo para a reversao de conquistas historicas na reducao das desigualdades na saude no Brasil.
TL;DR: The use of triangulation in qualitative research is presented as a strategy to achieve the proposed objectives, to ensure credibility, reliability, and greater scientific accuracy in its achievement.
Abstract: This paper aims to present the use of triangulation in qualitative research as a strategy to achieve the proposed objectives, to ensure credibility, reliability, and greater scientific accuracy in its achievement. In this sense, triangulation - since it is not restricted to the use of only one method, theory, data source or researcher in the process of analyzing an event - allows the apprehension of a given reality from several angles, enabling information confrontation, in order to minimize bias resulting from a single analytical perspective. Thus, aiming at evidencing the possibilities of using such a methodological design, we used as an example a qualitative study about experiences of caregivers for patients with head and neck neoplasms, developed through multiple triangulation, namely: methodological (intra-method), data, researcher and environmental triangulation. When demonstrating a structured study in the form of triangulation, one aims to guide researchers interested in conducting qualitative studies with greater depth and methodological rigor in qualitative research.
TL;DR: This study is aimed at estimating the prevalence of infected individuals in the state of Rio Grande do Sul, Brazil, to document how fast the infection spreads, and to estimate the proportion of infected persons who present or presented symptoms, as well as theportion of asymptomatic infections.
Abstract: COVID-19, the disease produced by the virus SARS-CoV-2, has spread quickly throughout the world, leading the World Health Organization to first classify it as an international health emergency and, subsequently, declaring it pandemic. The number of confirmed cases, as April 11, surpassed 1,700,000, but this figure does not reflect the prevalence of COVID-19 in the population as, in many countries, tests are almost exclusively performed in people with symptoms, particularly severe cases. To properly assess the magnitude of the problem and to contribute to the design of evidence-based policies for fighting COVID-19, one must accurately estimate the population prevalence of infection. Our study is aimed at estimating the prevalence of infected individuals in the state of Rio Grande do Sul, Brazil, to document how fast the infection spreads, and to estimate the proportion of infected persons who present or presented symptoms, as well as the proportion of asymptomatic infections. Four repeated serological surveys will be conducted in probability samples of nine sentinel cities every two weeks. Tests will be performed in 4,500 participants in each survey, totaling18,000 interviews. Interviews and tests will be conducted at the participants' household. A rapid test for the detection of antibodies will be used; the test was validated prior to the beginning of the fieldwork.
TL;DR: In this article, the authors show that the COVID-19 pandemic has been most severe in the poorest regions of Brazil, such as the states of the Northeast Region, and that the response was a significant increase in social distancing, especially in Ceara and Pernambuco, a decline in the reproduction rate, and a separation of the curve of observed cases versus expected cases if the nonpharmacological interventions had not been implemented in all states.
Abstract: The COVID-19 pandemic has been most severe in the poorest regions of Brazil, such as the states of the Northeast Region. The lack of national policies for pandemic control forced state and municipal authorities to implement public health measures. The aim of this study is to show the effect of these measures on the epidemic. The highest incidence of COVID-19 among the nine states in the Northeast was recorded in Sergipe, Paraiba and Ceara. Piaui, Paraiba and Ceara were the states that most tested. Factors associated with transmission included the high proportion of people in informal work. States with international airports played an important role in the entry of the virus and the initial spread, especially Ceara. All states applied social distancing measures, banned public events and closed schools. The response was a significant increase in social distancing, especially in Ceara and Pernambuco, a decline in the reproduction rate (Rt), and a separation of the curve of observed cases versus expected cases if the non-pharmacological interventions had not been implemented in all states. Poverty, inequality, and the high rates of informal work provide clues to the intensity of COVID-19 in the region. On the other hand, the measures taken early by the governments mitigated the effects of the pandemic.
TL;DR: In this article, the authors revisited the scientific evidence that reaffirms the contribution of health to the quality of life of individuals and populations, and concretized on healthy municipalities and intersectoral actions, in health and in all policies which confront social determinants, through their own foundations and practices that are closely related to innovations in public management for integrated and sustainable local development.
Abstract: This article updates the previous text of the main author published in 2000, revisiting the scientific evidence that reaffirms the contribution of health to the quality of life of individuals and populations. More than the access to health services of any quality, it is necessary to face determinants of health in its entirety, which requires healthy public policies, an effective intersectoral articulation of public power and mobilization of the population. The authors revisit the emergence and development of health promotion, focusing on the analysis of the most promising health strategies for the increase in quality of life, especially in societies with high social and health inequalities, as in the case of Brazil, reinforced by the recent pandemic of COVID-19. Such strategies were concretized on healthy municipalities and intersectoral actions, in health and in all policies which confront social determinants, through their own foundations and practices that are closely related to innovations in public management for integrated and sustainable local development, in view of the 2030 Agenda and its Sustainable Development Objectives (SDG).
TL;DR: The results showed 39,146 excess deaths for the period studied and is higher among men, and the need to improve the detection and registration of cases is highlighted to enable the efficient monitoring of the pandemic.
Abstract: Given the growing number of deaths due to the COVID-19 pandemic in Brazil, this study presents an initial and exploratory descriptive analysis of the excess mortality observed from March to May 2020 in capitals and other municipalities. The data source was the death registers from the Civil Registry Offices. The data were disaggregated by gender and capitals and other municipalities of the 26 federative units and the Federal District. The standardized mortality ratio for 2020 was calculated with the 2019 mortality coefficients as standards. The results showed 39,146 excess deaths for the period studied and is higher among men. This increase was more significant among the capitals of the North, Northeast, and Southeast regions. In the other municipalities in these regions, the increase was observed in May, indicating a possible inland-bound COVID-19 transmission. The need to improve the detection and registration of cases is highlighted to enable the efficient monitoring of the pandemic.
TL;DR: In this paper, the authors assess the changes in the habits of the Brazilian participants engaged in physical activities in relation to their practices, due the measures of social distancing during the COVID-19 epidemic in 2020.
Abstract: Physical inactivity and sedentary behavior are associated with poor physical and mental health. The article aims to assess the changes in the habits of the Brazilian participants engaged in physical activities in relation to their practices, due the measures of social distancing during the COVID-19 epidemic in 2020. The secondary objective was to describe their levels of anxiety and depression. The questionnaire used in this online survey included demographic information, questions about self-perceptions of the impact of the COVID-19 in the life routines and the 14-item Hospital Anxiety Depression Scale. A total of 1,613 adults completed the questionnaire between May 11 and 15, 2020. Of those, 79.4% reported that the measures to contain the epidemic had any impact on their physical activities, and many had to interrupt or decrease the frequency of their practices. Participants who felt a higher impact of quarantine on their physical activities tend to have higher prevalence of anxiety and depression symptoms. Individuals who practiced physical activities reported that social distance had a high influence on their practices. Furthermore, changes in these habits are associated with high levels of poor mental health.
TL;DR: The reduction of inequalities in health should be a priority for all countries, and a way forward is to promote the construction and strengthening of universal social protection systems.
Abstract: Resumen Despues de mas de una decada de avances en diversos ambitos del desarrollo social, desde 2015 en America Latina se registran aumentos en la pobreza, deterioros en indicadores del mercado laboral y un estancamiento en la reduccion de la desigualdad del ingreso. Estas tendencias son preocupantes ya que pueden perjudicar los indicadores de salud y exacerbar las profundas desigualdades en salud. Esta situacion demanda respuestas integradas de politicas, capaces de crear sinergias entre diferentes sectores. Existe un creciente reconocimiento sobre el rol de la proteccion social en la erradicacion de la pobreza y la reduccion de la desigualdad. Los diversos mecanismos de proteccion social aminoran los costos de acudir a servicios de salud de manera directa e indirecta. Mediante la expansion de la cobertura y el acceso universal, las acciones de promocion y prevencion en salud y nutricion, y de manera fundamental, la lucha contra la pobreza, la desigualdad y la exclusion, la proteccion social juega un papel ineludible para la garantia del derecho a la salud y la superacion de desigualdades en esta area. La reduccion de las desigualdades en salud debe ser una prioridad para todos los paises y un camino para avanzar en esa direccion es promover la construccion y el fortalecimiento de sistemas de proteccion social universales.
TL;DR: The aim of this essay is to review pertinent literature and present examples and recommendations from several decades of experience in the use of medical records in primary health care, in ways that can help primary care doctors to organize their work processes to improve patient care.
Abstract: Electronic medical records have been touted as a solution to many of the shortcomings of health care systems. The aim of this essay is to review pertinent literature and present examples and recommendations from several decades of experience in the use of medical records in primary health care, in ways that can help primary care doctors to organize their work processes to improve patient care. Considerable problems have been noted to result from a lack of interoperability and standardization of interfaces among these systems, impairing the effective collaboration and information exchange in the care of complex patients. It is extremely important that regional and national health policies be established to assure standardization and interoperability of systems. Lack of interoperability contributes to the fragmentation of the information environment. The electronic medical record (EMR) is a disruptive technology that can revolutionize the way we care for patients. The EMR has been shown to improve quality and reliability in the delivery of healthcare services when appropriately implemented. Careful attention to the impact of the EMR on clinical workflows, in order to take full advantage of the potential of the EMR to improve patient care, is the key lesson from our experience in the deployment and use of these systems.
TL;DR: This is an overview on the expected influence of the COVID-19 on mental health from a research group that has not long ago been involved in the Zika epidemic and aims to discuss the effects of the pandemic on a Low and Middle-Income country (LMIC), Brazil.
Abstract: Mental disorders (MD) are commonly comorbid with cardiovascular, metabolic, and some infectious diseases. Since the current SARS-CoV-2 epidemic is affecting the most multimorbid individuals, we might expect that the epidemic will be particularly problematic for people with MD. Understanding the burden of an outbreak on mental health is fundamental to effective action towards containing the spread of the disease, as psychopathology might reduce endurance during the lockdown. This can potentially reduce adhesion to ongoing treatment resulting in avoidable recurrence of a disorder. Additionally, there is the stress caused by the eminent risk of infection or economic uncertainty, especially in low-middle income settings. This is an overview on the expected influence of the COVID-19 on mental health from a research group that has not long ago been involved in the Zika epidemic. It aims to discuss the effects of the pandemic on a Low and Middle-Income country (LMIC), Brazil.
Journal Article•
TL;DR: In this article, aplico una encuesta de la Organización Mundial de la Salud adaptada al contexto local, in which preguntas abiertas for indagar sentimientos de las personas frente al COVID-19, and se realizo un analisisis de contenido.
Abstract: Resumen El objetivo de este trabajo es explorar los sentimientos y expectativas que genera el COVID-19 en Argentina durante la primera etapa de la pandemia. Se aplico una encuesta de la Organizacion Mundial de la Salud adaptada al contexto local. Se incluyeron preguntas abiertas para indagar sentimientos de las personas frente al COVID-19, y se realizo un analisis de contenido. Como resultados se advierte que la poblacion encuestada siente incertidumbre, miedo y angustia, pero tambien emerge un sentimiento de responsabilidad y cuidado frente al COVID-19. Asi mismo se destacan sentimientos positivos para la sociedad como una valoracion de la interdependencia social. Los resultados arribados senalan que el impacto en la salud mental es desigual segun el genero, el nivel educativo alcanzado y el confort percibido en el hogar. El estudio permite concluir que las dimensiones emocionales y vinculares de las personas resultan aspectos centrales ante la pandemia del COVID-19 en Argentina. Es recomendable que estas dimensiones, asi como y su impacto subjetivo y social diferencial entre los diversos grupos poblacionales, sean consideradas en la planificacion de politicas para afrontar el COVID-19.
TL;DR: In this paper, the authors present the need for new models of responsible and transparent data and technology governance in efforts to control SARS-COV2, as well as in future public health emergencies.
Abstract: Data has become increasingly important and valuable for both scientists and health authorities searching for answers to the COVID-19 crisis. Due to difficulties in diagnosing this infection in populations around the world, initiatives supported by digital technologies are being developed by governments and private companies to enable the tracking of the public's symptoms, contacts and movements. Considering the current scenario, initiatives designed to support infection surveillance and monitoring are essential and necessary. Nonetheless, ethical, legal and technical questions abound regarding the amount and types of personal data being collected, processed, shared and used in the name of public health, as well as the concomitant or posterior use of this data. These challenges demonstrate the need for new models of responsible and transparent data and technology governance in efforts to control SARS-COV2, as well as in future public health emergencies.
TL;DR: The article discusses the professional formation of nurses, implications of the increase in the number of Higher Education Institutions and their distribution in Brazil, and the territorial distribution of the registered nurse in Brazil in 2013.
Abstract: Resumo O artigo discorre sobre a formacao profissional do enfermeiro, implicacoes da expansao das Instituicoes de Ensino Superior e a distribuicao dessas no Brasil. Considera os resultados da Pesquisa Perfil da Enfermagem no Brasil, realizada com 35.916 profissionais de Enfermagem, em 2013. A analise que caracteriza a trajetoria da graduacao em enfermagem neste artigo, estrutura-se em tres dimensoes: a expansao da formacao do enfermeiro na graduacao e pos-graduacao; o boom de escolas de enfermagem e a relacao publico x privado; e, a distribuicao territorial do profissional enfermeiro no Brasil. O crescimento de Instituicoes de Ensino em Enfermagem implica em uma formacao exponencial, com predominio de escolas privadas na graduacao e na pos-graduacao; os cursos buscam alinhar-se as mudancas na saude e sociedade, mas urge equalizar as assimetrias territoriais entre as instituicoes formadoras na graduacao e pos-graduacao, a superconcentracao e vazios assistenciais decorrentes da insuficiencia de enfermeiros por habitantes, bem como qualificar o enfermeiro para o exercicio profissional ante as transformacoes globais.
TL;DR: A narrative review on the pandemic effects in prisons and how government and civil society have organized themselves in order to reduce the disease consequences at those places and how the Brazilian Penal System has reacted to the new disease.
Abstract: Prisional health is, in its essence, public health. The COVID-19 pandemic poses a great threat to the world and has shown that preventing the disease escalation in prisons integrates the novel corona virus clash in society in general. Up to this moment, the most effective known measure to curb the disease spread is social isolation. Nevertheless, in penal institutions, often overcrowded, social isolation becomes difficult to carry out and, when it happens, it takes the enclosed population to overisolation, with consequences to their mental health. Besides, prisoners suffer with clogged up environment, lack of materials for personal hygiene, poor basic sanitary conditions and difficulties in accessing health services. This paper deals with a narrative review on the pandemic effects in prisons and how government and civil society have organized themselves in order to reduce the disease consequences at those places. The text has been divided into three sections: the first with literature review on the current health theme; the second discusses how different countries have been dealing with the prison situation in the pandemic context, and, the last part focuses on how the Brazilian Penal System has reacted to the new disease.
TL;DR: The analysis and interpretation of COVID-19 containment measures, such as social distancing, should consider the profile of local vulnerability of each territory for the correct dimensioning of pandemic mitigation strategies from the perspective of developing social actions enabling greater adherence of the most impoverished populations.
Abstract: In the current scenario of the COVID-19 pandemic, Brazilian states and municipalities have adopted social distancing measures as a strategy to reduce the number of cases and control the disease. These measures affect populations and territories differently. This study aims to analyze the trend of social distancing in this pandemic and its relationship with the context of living conditions in Salvador, Bahia, Brazil. An ecological study with spatial distribution was conducted. The municipality's Social Distancing Index and the Living Conditions Index were calculated. Global and Local Moran Indices were employed to assess the degree of spatial dependence and autocorrelation. Fluctuations were observed in the social distancing levels during the analyzed period, with higher distancing percentages in neighborhoods with more favorable living conditions. The analysis and interpretation of COVID-19 containment measures, such as social distancing, should consider the profile of local vulnerability of each territory for the correct dimensioning of pandemic mitigation strategies from the perspective of developing social actions enabling greater adherence of the most impoverished populations.
TL;DR: The reflection carried out from the analyzed literature revealed that the markers of gender, class, and race emerge as a vulnerable condition to the exposure of COVID-19 in the most diverse world scenarios, revealing the historical need to implement strategies to improve the lives of this population, not only during the pandemic but also after their passing.
Abstract: This study aims to reflect the impact of COVID 19, considering gender, race, and class markers. This is an exploratory study, with an emphasis on the analysis of selected publications, based on a systematized search on official websites, and on the PubCovid-19 platform that includes papers published on COVID-19, which are indexed in PubMed and EMBASE. This work was based on these documents and built with reflections from the authors from the perspectives of social markers related to gender, race, and class, which contribute to the prognosis of the disease. The reflection carried out from the analyzed literature revealed that the markers of gender, class, and race emerge as a vulnerable condition to the exposure of COVID-19 in the most diverse world scenarios. This context reveals the historical need to implement strategies to improve the lives of this population, not only during the pandemic but also after their passing. Therefore, it is necessary to adopt socioeconomic policies with a more significant impact on the lives of these people and with greater coverage, expanding access to better health, education, housing, and income.
TL;DR: The findings show that environmental degradation and inadequate infrastructure pose a serious risk to human health, insofar as the disposal of waste in dumps and landfills can cause exposure to hazardous chemicals.
Abstract: Resumo Quais as repercussoes da urbanizacao mal planejada na saude da populacao? Entender a saude urbana, os riscos acarretados pelas cidades, as repercussoes na saude e as relacoes sociais auxiliam no planejamento no qual a prevencao deve ser investida. Assim, com o objetivo de verificar a relacao entre urbanizacao e saude urbana, em especial as infeccoes ocasionadas pelo vetor “Aedes aegypti”, foi realizado um estudo qualitativo e uma investigacao descritiva e analitica atraves de busca documental e bibliografica. Os resultados apontam que os impactos ambientais decorrentes da falta de infraestrutura resultante da urbanizacao podem oferecer riscos a saude humana, visto que a disposicao de residuos em lixoes e aterros podem ocasionar exposicao a substâncias quimicas perigosas a saude. Alem disso, o saneamento ineficaz pode acarretar em doencas veiculadas pela agua e propiciar a reproducao de vetores de outras enfermidades, como e o caso do “Aedes aegypti”, responsavel pela transmissao das arboviroses (dengue, chikungunya e Zika). Dessa forma, estudar saude ambiental e urbana proporciona embasamento para a promocao de qualidade de vida das pessoas que residem nessas areas e permite propor medidas que evitem doencas relacionadas a urbanizacao.
TL;DR: This paper aims to offer theoretical elements and evidence from previous studies for a greater understanding of the situation of vulnerability of older adults to situations of violence, of the possible motivations for the increased number of cases of VAOA during the COVID-19 pandemic, and possible strategies to address the problem.
Abstract: Most Brazilian state and municipal governments have used social distancing as the primary strategy for reducing the transmission speed of the new Coronavirus (SARS-CoV-2), which causes COVID-19. However, this social isolation has had several adverse repercussions, including increased intrafamily violence against children, adolescents, and women. Recently, violence against older adults (VAOA) during the pandemic has also been on the agenda of concerns, although discussing possible strategies for coping with VAOA during COVID-19 is still unimpressive worldwide. Aiming to broaden the debate on the theme in Brazil, this paper aims to offer theoretical elements and evidence from previous studies for a greater understanding of the situation of vulnerability of older adults to situations of violence, of the possible motivations for the increased number of cases of VAOA during the COVID-19 pandemic, and possible strategies to address the problem.
TL;DR: MetS was prevalent in the Brazilian population, especially among women, individuals with low schooling, and older adults, and the need to consider laboratory data for a more accurate analysis of this condition can be challenging at the national level.
Abstract: Resumo Estimou-se a prevalencia de Sindrome Metabolica (SM) e seus componentes na populacao brasileira de acordo com fatores sociodemograficos. Estudo transversal, de base populacional, com dados laboratoriais da Pesquisa Nacional de Saude. Estimou-se prevalencia da SM e seus componentes com intervalos de 95% de confianca e Razao de Prevalencia (RP) nao ajustada e ajustada utilizando regressao de Poisson. A prevalencia de SM foi de 38,4%. A circunferencia da cintura (CC) alta (65,5%) e colesterol HDL baixo (49,4%) foram os componentes mais prevalentes, inclusive nos jovens. A ocorrencia de SM foi maior entre mulheres (41,8%), individuos com baixa escolaridade (47,5%) e idosos (66,1%). Na analise ajustada, sexo feminino (RP = 1,16; IC95% 1,08-1,24), idade avancada (RP = 3,69; IC95% 3,26-4,17) e baixa escolaridade (RP = 1,32; IC95% 1,17-1,49) associaram-se a ocorrencia de SM. A SM foi muito prevalente na populacao brasileira, principalmente entre mulheres, individuos com baixa escolaridade e idosos. A CC alta e o colesterol HDL baixo foram os componentes mais frequentes, com o agravante de prevalencias altas em adultos jovens. Esses achados revelam a necessidade de considerar dados laboratoriais para uma analise mais precisa dessa condicao, o que em âmbito nacional pode ser um desafio.