Salud Mental en estudiantes universitarios en aislamiento social durante la pandemia COVID-19. Arequipa, Perú

Introducción: La Pandemia COVID-19, ha tenido impactos negativos en la salud física y mental de las personas, así como las medidas adoptadas por los gobiernos, para prevenir el contagio masivo de la población como el confinamiento, el aislamiento social, el trabajo y educación virtual. Dentro de los afectados por estos cambios, se encontrarían los estudiantes universitarios del área de la salud, que además de estudiar en estas condiciones de pandemia, no han podido hacer sus prácticas de los servicios de salud. Esta situación de exposición al aislamiento, podría afectar la salud mental de los jóvenes estudiantes universitarios. Objetivo: determinar los niveles de depresión, ansiedad y estrés en estudiantes universitarios y su relación con variables sociodemográficas y las características del aislamiento social durante la Pandemia COVID-19. Métodos: Se realizó un estudio descriptivo, observacional, de corte transversal y cuantitativo, con una muestra de 818 estudiantes universitarios de facultades de ciencias de la salud, mediante el cuestionario autoadministrado DASS-21. Resultados: Los principales hallazgos fueron: una mayor prevalencia en niveles altos (severos y extremadamente severos) en la ansiedad, alcanzado casi a 4 de cada 10 de los evaluados; por otro lado, en depresión y el estrés, 2 de cada 10 de los evaluados, se encontraron en los niveles mencionados. En relación con las variables sociodemográficas, las relacionadas con el COVID-19 y aislamiento social, se hallaron diferencias estadísticamente significativas con el género (mujeres > varones), el haber tenido COVID-19 (Sí > No) y vivir con familiares como antes de la pandemia (Sí > No) obtuvieron en promedio mayores puntajes en depresión, ansiedad y estrés. Conclusión: Los estudiantes que presentaron mayor depresión, ansiedad y estrés con una diferencia significativa fueron de género femenino, con antecedentes de haber tenido Covid-19, menor contacto con familiares y haber cumplido con aislamiento social total.

Introduction: The COVID-19 Pandemic has had negative impacts on the physical and mental health of people, as well as the measures adopted by governments to prevent the massive contagion of the population, such as confinement, social isolation, virtual work, and virtual education. Among those affected by these changes would be university students in the health area who, in addition to studying in these pandemic conditions, have been unable to do their health service practices. This situation of exposure to isolation could affect the mental health of young university students. Objective: To determine the levels of depression, anxiety, and stress in university students, their relationship with sociodemographic variables, and the characteristics of social isolation during the COVID-19 Pandemic. Methods: A descriptive, observational, cross-sectional, and quantitative study was carried out with a sample of 818 university students from health sciences faculties using the DASS-21 self-administered questionnaire. Results: The main findings were a higher prevalence of high levels (severe and highly severe) in anxiety, reaching almost 4 out of 10 of those evaluated; On the other hand, in depression and stress, 2 out of 10 of those evaluated were found at the mentioned levels. Concerning the sociodemographic variables, those related to COVID-19 and social isolation, statistically significant differences were found with gender (women > men), having had COVID-19 (Yes > No), and living with relatives as before. On average, the pandemic (Yes > No) obtained higher scores in depression, anxiety, and stress. Conclusion: The students who presented greater depression, anxiety, and stress with a significant difference were female, with a history of having had Covid-19, less contact with family members, and having complied with total social isolation

Percepción de los médicos residentes de Pediatría sobre el impacto de la pandemia por COVID-19 en su proceso formativo / Pediatric residents' perceptions about the impact of the COVID-19 pandemic on their training

Introducción. Las residencias médicas experimentaron modificaciones que pudieron afectar la formación académica durante la pandemia por COVID-19. Objetivos. Describir la percepción de residentes de Pediatría en relación con el impacto de la pandemia en su formación. Efectuar la adaptación transcultural y validación al idioma español del instrumento "COVID-19 Resident Education and Experience Survey". Materiales y métodos. Estudio observacional, transversal. Participaron residentes de Pediatría de distintos hospitales del país. Se utilizó la encuesta de Ostapenko y col. modificada. Se realizó el análisis descriptivo utilizando SPSS vs. 21. El proyecto fue aprobado por el Comité de Ética institucional. Resultados. Completaron la encuesta 127 residentes. La mayoría dedicaba más de 50 horas a actividades asistenciales antes y durante la pandemia. El 43,3 % (IC95% 35-52) dedicaba hasta 1 hora diaria al estudio individual previo a la pandemia, y un 63 % (IC95% 54,3-70,9) dedicaba ese tiempo durante la pandemia. El 75,6 % (IC95% 67,4-82,2) reportó que el tiempo previo dedicado a actividades académicas era al menos de 4 horas semanales, descendiendo al 41,7 % (IC95% 33,5-50,4) en la pandemia. Más del 60 % (IC95% 54,3-70,1) percibió que la pandemia perjudicó su formación para convertirse en especialista y el 93,7 % (IC95% 88,1-96,8), que su nivel de estrés se incrementó. Conclusiones. La cantidad de horas destinadas a actividades académicas fue percibida como menor durante la pandemia. La mayoría de los encuestados refirió que su nivel de estrés aumentó y que la pandemia perjudicó su formación para convertirse en especialista.

Introduction. Medical residency programs suffered changes that may have affected academic training during the COVID-19 pandemic. Objectives. To describe the perceptions of pediatric residents about the pandemic's impact on their education. To transculturally adapt and validate the COVID-19 Resident Education and Experience Survey into Spanish. Materials and methods. Observational, cross-sectional study. Participants were pediatric residents from hospitals across the country. The survey by Ostapenko et al. was used. A descriptive analysis was done using the SPSS software, version 21. The project was approved by the Institutional Ethics Committee. Results. The survey was completed by 127 residents. Most did more than 50 hours of health care activities before and during the pandemic. Also, 43.3% (95% CI: 35­52) spent at least 1 hour a day studying individually before the pandemic, while 63% (95% CI: 54.3­70.9) did so during the pandemic. In relation to the time spent doing academic work, 75.6% (95% CI: 67.4­82.2) reported that, before the pandemic, they spent at least 4 hours a week doing academic activities, dropping to 41.7% (95% CI: 33.5­50.4) during the pandemic. More than 60% (95% CI: 54.3­70.1) perceived that the pandemic impaired their training to become a specialist and 93.7% (95% CI: 88.1­96.8), that their stress levels increased. Conclusions. The perception was that participants spent less hours doing academic activities during the pandemic. Most surveyed participants mentioned that their stress levels increased and that the pandemic impaired their training to become a specialist.

Human Rabies during the COVID-19 Pandemic: Insights into Rabies Worldwide and Brazil

ABSTRACT Human Rabies (HR) is a fatal zoonotic disease caused by lyssaviruses, with the rabies virus (RABV) identified as the causative agent. While the incidence of HR transmitted by dogs has decreased in Latin America, there has been a corresponding rise in transmission via wild animals. Given the lack of effective treatments and specific therapies, the management of HR relies on the availability of post-exposure prophylaxis and animal control measures. This review examines the dynamics and spread of HR during the global pandemic.

Access to emergency surgical treatment for congenital heart diseases in the state of São Paulo

Abstract Objective To analyze access to surgical care for congenital heart diseases in public specialized centers in the state of São Paulo before and during the COVID-19 pandemic and availability of surgical care in specialized hospitals, to identify bottlenecks in the care path for neonatal cardiac surgery. Methods This study included 1,437 children, under one year old, with congenital heart disease and formal referral to heart surgery between February 1, 2019, and February 28, 2021. Quantitative data analysis was performed using t-tests or the Mann-Whitney test. Results Approximately 30 % of children with urgent congenital heart disease could not access recommended care, mainly those needing complex surgeries (categories RACHS 4 to 6). The main diagnoses of neonates accessing care were patency of the ductus arteriosus (10.5 %) and coarctation of the aorta (10.1 %). Referral time for children in RACHS 1 to 3 was 4 days (median), while for those in categories 4 to 6, it was 7 days (p< 0.001). Longer referral time (20 days) was associated with court orders. During the pandemic, referral time decreased to 3 days, compared to 5 days (median) in the pre-pandemic period (p< 0.001). Conclusion The emergency surgical treatment supply for congenital heart diseases is insufficient compared to the current demand. Future research should evaluate if access to care in publicly funded hospitals could be improved by better access to prenatal care for pregnant women, increased diagnostic and therapeutic capacity in pediatric cardiology, and financial incentives for complex cardiac surgeries.

Assessment of patients'knowledge, attitude and practice of cross-infection control in the dental clinic during COVID-19 pandemic

Background:The emergence of coronavirus disease 2019 (COVID-19), a highly contagious disease that causes viral respiratory illness, has changed the lifestyle of humans worldwide. Dental practitioners and patients are at high risk of infection during their routine practice due to their exposure to saliva, blood, and droplet production.Aim:To gain insight into the patient's viewpoint regarding the practice, altitude, and knowledge of COVID-19 and its transmission and cross-infection in dental clinics.Methods:This was cross­sectional analytic survey in dentistry during the COVID-19 pandemic. Aself-administered close-ended questionnaire consisting of 32 variables was distributed among the study participants. The data were analysed using the Statistical Package for the Social Sciences (SPSS) version 25. The level of significance was p ≤ 0.05. Results:The age of the participants varied from 20 - 58 years, with a mean age of 34.6 ±5. The majority (89.3%) felt COVID-19 was a highly contagious disease, while 50.0% of the respondents believed that the most common route of COVID-19 transmission in dentistry is through aerosols. The majority, 78.6%, recorded good knowledge of infection control following the COVID-19 outbreak. The number of married patients who had good knowledge of cross-infection control was 118, which was statistically significant.Conclusion:From the study, it is evident that the patients possess a good range of knowledge in both preventive and cross-infection protocols to follow during the COVID-19 pandemic. However, the same cannot be said about the practice

The function of competitive intelligence in South African insurance post-COVID-19 outbreak

Background: Competitive intelligence (CI) involves monitoring competitors and providing organizations with actionable and meaningful intelligence. Some studies have focused on the role of CI in other industries post-COVID-19 pandemic. Objectives: This article aims to examine the impact of COVID-19 on the South African insurance sector and how the integration of CI and related technologies can sustain the South African insurance sector post-COVID-19 epidemic. Method: Qualitative research with an exploratory-driven approach was used to examine the impact of the COVID-19 pandemic on the South African insurance sector. Qualitative secondary data analyses were conducted to measure insurance claims and death benefits paid during the COVID-19 pandemic. Results: The research findings showed that the COVID-19 pandemic significantly impacted the South African insurance industry, leading to a reassessment of pricing, products, and risk management. COVID-19 caused disparities in death benefits and claims between provinces; not everyone was insured. Despite challenges, South African insurers remained well-capitalised and attentive to policyholders. Integrating CI and analytical technologies could enhance the flexibility of prevention, risk management, and product design. Conclusion: COVID-19 requires digital transformation and CI for South African insurers' competitiveness. Integrating artificial intelligence (AI), big data (BD), and CI enhances value, efficiency, and risk assessments. Contribution: This study highlights the importance of integrating CI strategies and related technologies into South African insurance firms' operations to aid in their recovery from the COVID-19 crisis. It addresses a research gap and adds to academic knowledge in this area.

Comunicação e saúde: reflexões sobre o Sistema Único de Saúde em Palmas ­ TO e a saúde digital durante a pandemia de covid-19 / Communication and health: reflections on the Unified Health System in Palmas ­ TO and digital health during the covid-19 pandemic / Comunicación y salud: reflexiones sobre el Sistema Único de Salud en Palmas ­ TO y la salud digital durante la pandemia de covid-19

O objetivo deste artigo é refletir sobre o papel da saúde digital no acesso à saúde pública no contexto do Sistema Único de Saúde durante a pandemia de covid-19 em Palmas ­ TO. Para tanto, adotou-se como referencial teórico os pressupostos do campo Comunicação & Saúde e, como forma de análise, o método denominado Discurso do Sujeito Coletivo, que busca compreender os modos de pensar de um grupo social sobre dado tema. Neste caso, trata-se de moradores do condomínio Residencial Parque da Praia, situado em Palmas. Também se procurou entender em que medida essas pessoas estão inseridas no mundo tecnológico ou são excluídas dele, e qual a percepção delas sobre saúde digital, Sistema Único de Saúde, direito à saúde e à comunicação. O grupo se considera relativamente informado sobre esses temas e a maioria faz uso, no cotidiano, das Tecnologias da Informação e Comunicação e da internet. Entretanto, observou-se que a saúde digital é uma realidade ainda distante para essa comunidade

The purpose of this article is to reflect on the role of digital health in the access to public health in the context of the Unified Health System during the covid-19 pandemic in Palmas ­ TO. In order to do this, the assumptions of the Communication & Health field were adopted as a theoretical framework and the method called Collective Subject Discourse was used as a form of analysis. This method seeks to understand the ways of thinking of a social group on a given topic. In the case examined here, the group is constituted by residents of the Residencial Parque da Praia condominium, situated in Palmas. We also sought to understand to what extent these people are included in or excluded from the technological world and their perception of digital health, the Unified Health System, the right to health and communication. The group considers itself relatively informed about these topics and the majority of those residents use Information and Communication Technologies as well as the internet in their daily live. However, it was observed that digital health is still a distant reality for this community

El objetivo de este artículo es reflexionar sobre el papel de la salud digital en el acceso a la salud pública en el contexto del Sistema Único de Salud durante la pandemia de covid-19 en Palmas ­ TO. Para hacer eso, se adoptó como marco teórico los presupuestos del campo de Comunicación y Salud y, como forma de análisis, el método denominado Discurso del Sujeto Colectivo, que busca comprender las formas de pensar de un grupo social acerca de un tema determinado. En el caso abordado en este artículo, el grupo es constituido por residentes del condominio Residencial Parque da Praia, situado en Palmas. También buscamos comprender en qué medida estas personas están incluidas en el mundo tecnológico o son excluidas de él, y su percepción sobre la salud digital, el SUS, el derecho a la salud y a la comunicación. El grupo se considera relativamente informado sobre esos temas y su mayoría utiliza las Tecnologías de la Información y las Comunicaciones y la internet en su vida diaria. Sin embargo, se observó que la salud digital es aún una realidad lejana para esta comunidad

Ergonomia en actividades académicas desde casa

Introducción: A consecuencia de la emergencia sanitaria por el virus SARS-CoV2, las actividades académicas migraron de forma repentina a un entorno de trabajo remoto; esto provocó que los hogares de todo el mundo se convirtieran en el asentamiento urgente de las estaciones de trabajo académico. La ergonomia como disciplina científica cobra relevancia al ser un aliado subsanador para mitigar los riesgos asociados con la aparición de lesiones musculoesqueléticas. De acuerdo con la memoria estadística del Instituto Mexicano de Seguridad Social, IMSS1, en el primer año de pandemia de COVID-19 se registraron 30 860 atenciones por lesiones en la región de manos y muñecas, 9696 en la zona de cabeza y cuello, 6251 dorsopatías y 1673 atenciones por astenopia a jóvenes de entre 18 a 29 años que desarrollaban actividades escolares. Objetivo: En este sentido, se aborda la presente investigación para conocer la composición de los espacios de trabajo académico en casa y analizar si existen factores o elementos que incidan en el riesgo de lesiones musculoesqueléticas en los estudiantes del nivel superior. Metodología: A través de un modelo de ecuaciones estructurales que cuenta con el constructo latente de las posibles lesiones (PL) en manos, espalda, piernas, cabeza, vista, oído, agotamiento físico y la respiración, las variables observables se atribuyen a los espacios utilizados para las actividades académicas en casa, muebles y equipos, Condiciones y Medio Ambiente (CyMAT). Resultados y discusión: Se encontró que un mal diseño de la estación de trabajo académico en casa, aunado a la utilización inadecuada de los muebles y equipos, aumenta la posibilidad de presentar síntomas asociados con las LMEs y, por tanto, daños en la salud del estudiante. Conclusión: La mediación de las estaciones de trabajo a través de la implementación de elementos ergonómicos mejora de forma sustancial la calidad de trabajo académico en casa, y hace evidente la importancia de la ergonomía como disciplina científica.

Introduction: As a result of the health emergency of the SARS-CoV2 virus, academic activities suddenly migrated to a remote work environment, causing homes around the world to become the urgent settlement of academic workstations. Ergonomics as a scientific discipline becomes relevant as it is a healing ally to mitigate the risks associated with the appearance of musculoskeletal injuries. According to the statistical report of the Mexican Institute of Social Security, IMSS1, in the first year of the COVID 19 pandemic, 30,860 care for injuries in the hands and wrists region, 9,696 in the head and neck area, 6,251 dorsopathies and 1,673 care for asthenopia were registered to young people between 18 and 29 years old who develop school activities. Objective: In this sense, this research is addressed to know the composition of academic workspaces at home and analyze if some factors or elements affect the risk of musculoskeletal injuries in students of the higher level. Methodology: Through a structural equations model that has the latent construct of possible injuries (PL) in the hands, back, legs, head, eyesight, hearing, physical exhaustion, and breathing; the observable variables are attributed to the spaces used for academic activities at home, furniture and equipment, conditions and environment (CyMAT) Results and discussion: It is explored that a bad design of the academic workstation at home coupled with the inappropriate use of furniture and equipment increases the possibility of presenting symptoms associated with SCI and therefore, damage to the student's health. Conclusion: The mediation of workstations through the implementation of ergonomic elements substantially improves the quality of academic work at home, making evident the importance of ergonomics as a scientific discipline

Food purchasing and preparation patterns by gender during the COVID-19 lockdown in Chilean workers / Patrones de compra y preparación de alimentos según género durante la cuarentena por COVID-19 en trabajadores chilenos

Abstract The COVID-19 pandemic has increased the demands that workers face regarding household food-related tasks, such as grocery shopping and cooking. The literature shows that there are differences in these demands by gender, but also based on other sociodemographic characteristics, such as schooling level. The aim of this study was to compare food purchasing and preparation patterns by gender in Chilean workers, before the COVID-19 lockdown and during the first six weeks of lockdown. The study was cross-sectional, and data was collected for the first wave of a multi-country study in April 2020. The sample was composed of 317 participants who were employed during lockdown (67.8% women, mean age of 38.14). Participants answered sociodemographic questions and reported their food purchasing and preparing practices before and during lockdown. Analysis of comparison of proportions was used. On average, during lockdown, men increased their involvement in grocery shopping while women cooked more. Overall, female workers have turned to food-related tasks more often during the pandemic than male workers. This study shows the extent to which workers have changed their degree of involvement in food-related tasks, accounting for conditions such as gender roles, schooling level and working from home. These findings can inform interventions and policies that reinforce advantageous changes brought on by lockdown measures (e.g., home-cooking) to contribute to workers' and their families' food-related well-being during and in the aftermath of the pandemic.

Resumen La pandemia por COVID-19 ha aumentado las demandas que enfrentan los trabajadores con respecto a su alimentación, como comprar alimentos y cocinar. Estudios muestran diferencias de género en estas demandas, pero también según características sociodemográficas como el nivel de escolaridad. Este estudio comparó patrones de compra y preparación de alimentos por género en trabajadores chilenos, antes y durante el confinamiento por COVID-19. Este estudio es de corte transversal y utilizó datos de la primera ola de un estudio multinacional realizado en abril de 2020. La muestra fue 317 participantes que tenían trabajo durante el confinamiento (67.8 % mujeres, edad promedio de 38.14). Los participantes respondieron preguntas sociodemográficas y reportaron sus prácticas de compra y preparación de alimentos antes y durante el confinamiento. Se utilizó el análisis de comparación de proporciones. Durante el confinamiento, los hombres realizaron más compras de alimentos y las mujeres cocinaron más. Las mujeres se dedicaron a tareas relacionadas con la alimentación con más frecuencia durante la pandemia que los hombres. Este estudio muestra que personas trabajadoras han cambiado su nivel de involucramiento en tareas de alimentación durante la pandemia, tomando en cuenta condiciones como los roles de género, escolaridad y teletrabajo. Estos hallazgos pueden guiar intervenciones y políticas que refuercen ventajas derivadas de las medidas de confinamiento (e.g., cocinar en casa), para contribuir al bienestar alimentario de personas trabajadoras y sus familias durante y después de la pandemia.

Público e privado: masculinidades e práticas de cuidados na pandemia / Public and private: masculinities and care practices in the pandemic / Público y privado: masculinidades y prácticas de cuidado en la pandemia

Frente ao cenário pandêmico de COVID-19 vivenciado por todo o mundo, fomos forçados a produzir rearranjos relacionais para lidar com as dificuldades impostas por esse momento e uma das grandes mudanças que tivemos foi a necessidade de distanciamento social para não propagação do vírus. Neste sentido, trazemos para análise as mudanças da dimensão do público para o privado de homens brasileiros, tendo como objetivo compreender como tal mudança reverberou em suas práticas de cuidado para si e para o outro. Tivemos como referencial metodológico as práticas discursivas para a análise de entrevistas realizadas com homens que participam de um grupo terapêutico virtual. Concluímos que no contexto pandêmico, estes homens tiveram que lidar com dimensões do cuidado doméstico, de filhos, do outro e de si de forma inédita, que por vezes acarretaram situações angustiantes e desafiadoras que exigiram ressignificação e novas relações com as práticas de cuidado. (AU)

Front to COVID-19 pandemic scenario experienced around the world, we were forced to produce relationshiprearrangements to deal with the difficulties imposed by this moment and one of the great changes we had was the need for social distance to avoidthe vírus spreading. Therefore, we bring to analysis the changes from the public to the private dimension of Brazilian men, aiming to understand how this change reverberated in their care practices for themselves and for the others.We had as a methodological reference the discursive practices tointerviewsanalysiscarried out with men who participate in a virtual therapeutic group. We conclude that inthe pandemic context, these men had to deal with domestic carecontextual, of children, of theother and of themselves in an unprecedented way, which sometimes led to distressing and challenging situations that required a re-signification of their forms ofcare and a change in the theme perception. (AU)

Ante el escenario de pandemia del COVID-19 vivido en todo el mundo, nos vimos obligados a producir reacomodos relacionales para hacer frentea las dificultades que impone este momento y uno de los grandes cambios que tuvimosfue la necesidad del distanciamiento social para evitar la propagación del virus. En ese sentido, traemos para el análisis los cambios de la dimensiónpública a la privadade los hombres brasileños, con el objetivo de comprender cómo ese cambio repercutióen sus prácticas de cuidado para sí y para el otro. Tuvimos como referente metodológico las prácticas discursivas para el análisis deentrevistas realizadas a hombres que participan en un grupo terapéutico virtual. Concluimos que en el contexto de la pandemia, estos hombres debieron lidiar con dimensiones del cuidado doméstico, de los niños, del otro y de sí mismos de una forma inédita,lo que en ocasiones condujo a situaciones angustiosas y desafiantes que exigieron una resignificación de sus formas. del cuidado y un cambio en la percepción del tema. (AU)

Análise de situações de trabalho na fiscalização sanitária de medicamentos da agência reguladora federal / Analysis of work scenarios in the sanitary enforcement of medicines from the federal regulatory agency

Resumo Este estudo analisa as situações de trabalho vividas pelos profissionais na fiscalização sanitária de medicamentos da Agência Nacional de Vigilância Sanitária, durante a pandemia de COVID-19. Estudo de caso único, de natureza qualitativa, com abordagem ergológica. Os dados foram produzidos entre 2020 e 2021, por meio de 18 entrevistas e observação participante em três reuniões de trabalho online. As práticas discursivas foram sistematizadas em mapas ergodialógicos, resultando em três categorias: os trabalhos vividos na fiscalização dos medicamentos; as variabilidades do contexto organizacional e as renormalizações frente à pandemia. As fragilidades dos sistemas de informação, o marco regulatório desatualizado, o modelo de atuação, a fragmentação do trabalho, dentre outros, ocasionaram entraves à realização da atividade pelo profissional. A conformação de novo modo de fazer fiscalização envolve a combinação de intervenções direcionadas à prevenção, detecção e resposta ao consumo de medicamentos nocivos à saúde. A transformação necessária ultrapassa a função restrita de controle e punição e se consolida como um novo modelo de atuação proativo e dinâmico, baseado na gestão do risco sanitário e na implantação das Boas Práticas de Fiscalização.

Abstract This study analyzes the work situations experienced by professionals in the sanitary fiscalization of medicines at the Brazilian Health Regulatory Agency, during the COVID-19 pandemic. This is a single-case study, qualitative in nature, with an ergological approach. The data were collected from 2020 to 2021. During this period, 18 interviews and 3 online work meetings were conducted. The discursive practices were systematized in ergodialogical maps, resulting in three categories: the works experienced in the sanitary enforcement of medicines; the variabilities of the organizational context and the renormalizations facing the pandemic. The fragilities of the information systems, the outdated regulatory framework, the performance model, the fragmentation of the work, among others, have caused barriers to the professional's activity. The conformation of a new way of performing the sanitary fiscalization of medicines involves the combination of interventions aimed at prevention, detection, and response to the consumption of medicines that are harmful to health. The necessary transformation goes beyond the restricted function of control and punishment and consolidates itself as a new proactive and dynamic action model, based on health risk management and the implementation of Good Fiscalization Practices.

Transformações no mundo do trabalho em saúde: os(as) trabalhadores(as) e desafios futuros / Transformations in the world of healthcare work: workers and future challenges

Resumo O artigo versa sobre o mundo do trabalho da saúde, especialmente no SUS no contexto da pandemia no Brasil. O artigo utilizou dados das pesquisas "Condições de trabalho dos profissionais de saúde no contexto da COVID-19 no Brasil" e "Os trabalhadores invisíveis da saúde: condições de trabalho e saúde mental no contexto da COVID-19 no Brasil". A análise dos dados comprova que a pandemia evidenciou problemas estruturais existentes no âmbito do Sistema Único de Saúde, envolvendo a gestão da FTS o que pode ser interpretado como mais um dos reflexos das desigualdades socioeconômicas já existentes no país. Destacam-se: a reduzida oferta de educação permanente, a regulação do cuidado híbrido, precarização, desproteção no ambiente de trabalho, frágil biossegurança levando a trágicas taxas de adoecimento e mortes de trabalhadores da saúde. Conclui mostrando a importância de formulação de políticas públicas no âmbito da gestão da educação e do trabalho no SUS que assegurem a discussão sobre cuidado híbrido como nova forma de atuar sem perder qualidade, a necessidade de se rever questões referentes a: educação permanente, proteção, valorização e redução das desigualdades apontadas entre os contingentes profissionais analisados nesse artigo.

Abstract This article addresses the world of healthcare work, especially in the Brazilian Unified Healthcare System (SUS) in the context of the COVID-19 pandemic in Brazil. This study used data from the following surveys: "Working conditions of health professionals in the context of COVID-19 in Brazil" and "The Invisible health workers: working conditions and mental health in the context of COVID-19 in Brazil". Data analysis proves that the pandemic highlighted existing structural problems within SUS, involving the issue of healthcare workforce (HWF) management, which can be interpreted as another reflection of the socioeconomic inequalities that already exist in the country. This article highlights: the reduced provision of permanent education, the regulation of hybrid care, precariousness, a lack of protection in the work environment, as well as fragile biosecurity leading to tragic rates of illness and death of health workers. Our study concludes by showing the importance of formulating public policies in the scope of education and work management in SUS that ensure the discussion on hybrid care as a new way of acting without losing quality, together with the need to review issues related to permanent education, protection, valuation, and reduction of inequalities pointed out among the professional contingents analyzed in this article.

Prospecção das condições de trabalho do Samu-192 fluvial em cenários de crise a partir da resiliência no enfrentamento à Covid-19 no Alto Solimões / Investigation of the working conditions of the river-based SAMU-192 in crisis scenarios based on resilience in the face of COVID-19 in Alto Solimões

RESUMO Esta pesquisa teve como objetivo prospectar as condições de trabalho das equipes de socorro do Serviço de Atendimento Móvel de Urgência (Samu-192) fluvial das áreas ribeirinhas e costeiras da região do Alto-Solimões, a partir da análise sistêmica das atividades no serviço de embarcações popularmente chamadas de 'ambulanchas' durante os picos da Covid-19 no estado do Amazonas, quando o sistema de saúde funcionou sob o estresse provocado pela pandemia. Os dados foram obtidos a partir de um desenho transversal exploratório, baseado em dados qualitativos coletados por meio de entrevistas e observação do funcionamento normal do sistema antes da pandemia. A partir daí modelos de dois cenários foram elaborados mostrando o funcionamento do serviço de ambulanchas ao lidar com a pandemia de Covid-19 e o impacto nas condições de trabalho das equipes de socorro interprofissionais de socorro. Entrevistas remotas com trabalhadores das ambulanchas após a pandemia indicaram que a prospecção das condições de trabalho a partir das instâncias dos modelos corresponderam ao funcionamento real do sistema durante a pandemia de Covid-19.

ABSTRACT This research aimed to prospect the working conditions of the rescue teams of the Mobile Emergency Care Service (SAMU-192) at the fluvial areas of the Alto Solimoes region, trough the systemic analysis of the activities of the water ambulances service popularly called 'ambulanchas' during the peaks of COVID-19 in the state of Amazonas, when the health system functioned under stress caused by the pandemic. Data were obtained from an exploratory cross-sectional design, based on qualitative data collected through interviews and observation of the normal functioning of the system before the pandemic. From there, models of two scenarios were developed showing the functioning of the water ambulances service when coping with the COVID-19 pandemic and the impact on the working conditions of the interprofessional rescue teams. Remote interviews with workers after the pandemic indicated that the prospection of working conditions from the instances of the models corresponded to the real functioning of the system during the COVID-19 pandemic.

Percepção de estudantes de Odontologia de uma Universidade do Estado da Paraíba sobre os impactos da pandemia de COVID-19 / Perception of dental students at an university in the state of Paraíba about the impacts of COVID-19 pandemic

Introdução: Durante a pandemia de SARS - COVID 19 os cursos de graduação em Odontologia aderiram ao método remoto de ensino, com o objetivo de diminuir o número de contaminações e mortes. Objetivo: Esse estudo objetivou avaliar a percepção dos impactos socioeconômicos, educacionais e psicológicos da pandemia, bem como a percepção da importância de aspectos de gestão para o enfrentamento da pandemia. Material e método: Esta é uma pesquisa qualitativa e quantitativa, efetuada em uma universidade pública do Nordeste brasileiro, baseada em questionário semiestruturado e com a amostra de 144 estudantes distribuídos nos 10 períodos do curso de Odontologia. Resultados: A maioria dos participantes se encontrava em alguma situação de isolamento ou autoisolamento durante a pandemia. Foi constatado que a experiência do ensino remoto não foi favorável para os discentes. Os estudantes consideram que a instituição participou parcialmente na elaboração de protocolos de biossegurança e instruções para retomada das atividades. Os estudantes relataram presença de: ansiedade, estresse, dificuldade de concentração, insegurança e exaustão emocional. Os alunos consideraram os conhecimentos de gestão e liderança como fundamentais para o enfrentamento dos desafios da pandemia. Conclusão: A presente pesquisa demonstrou que, em decorrência da pandemia por COVID-19, a maioria dos participantes teve prejuízo financeiro, bem como, um relevante prejuízo na formação acadêmica. Em relação aos quadros psicoemocionais, houve uma frequência variável relatada de diversas patologias destaque para ansiedade, estresse, insônia e baixa concentração. Por fim, a importância das competências de gestão para o enfrentamento da pandemia foi percebida pela maioria dos estudantes de Odontologia como indispensável

Introduction: During SARS - COVID 19 pandemic, undergraduate courses in Dentistry adhered to remote method of classes, with the aim of reducing the number of contaminations and deaths. Objective: This study aimed to assess the perception of socioeconomic, educational and psychological impacts of pandemic, as well as perception of the importance of management aspects for coping with the pandemic. Material and method: This is a qualitative and quantitative research, carried out at a public university of Brazilian Northeast, based on a semi-structured questionnaire and with a sample of 144 students distributed in the 10 periods of the Dentistry course. Results: Most participants were in some situation of isolation or self-isolation during the pandemic. It was found that the experience of remote teaching was not favorable for students. Students consider that university partially participated in the development of biosafety protocols and instructions for resuming activities. Students reported the presence of: anxiety, stress, difficulty concentrating, insecurity and emotional exhaustion. Students considered management and leadership knowledge as fundamental to face challenges of the pandemic period. Conclusion: The present research demonstrated that, as a result of the COVID-19 pandemic: most participants had financial losses, as well as a relevant loss in their academic training. Regarding psycho-emotional conditions, there was a variable frequency related to several pathologies, with emphasis on anxiety, stress, insomnia and low concentration. Finally, the importance of management skills for dealing with the pandemic was perceived by most of dental students as essential

Changes and predictors of adolescent emotion regulation, self-esteem, and locus of control during the COVID-19 pandemic: 2004 Pelotas Birth Cohort

Objectives: There is growing interest in examining the impacts of the coronavirus disease 2019 (COVID-19) pandemic on adolescent socioemotional development. This study aimed to examine changes in adolescent emotion regulation (ER), self-esteem (SE), and locus of control (LoC) from before to during the pandemic in a Brazilian birth cohort, and to investigate the variables associated with changes in those socioemotional competences. Methods: 1,949 adolescents from the 2004 Pelotas Birth Cohort were assessed before (T1, November 2019 to March 2020) and during (T2, August to December 2021) the COVID-19 pandemic (mean ages [SD] = 15.69 [0.19] and 17.41 [0.26], respectively). Adolescents' socioemotional competences were assessed, including ER, SE, and LoC. Sociodemographic, pre-pandemic, and pandemic-related correlates were examined as predictors of change. Multivariate latent change score models were used in the analyses. Results: There were significant mean increases in adolescents' ER and SE (mean ER = 1.918, p < 0.001; mean SE = 1.561, p = 0.001) and a significant mean decrease (towards internalization) in LoC levels (MLoC = -0.497, p < 0.01) during the pandemic. Factors that predicted a lower competency increase included family conflicts, harsh parenting, and maternal depressive symptoms during the pandemic. Conclusion: Despite the stress imposed by the COVID-19 pandemic, the adolescents of this cohort showed positive development in their socioemotional competences. Family-related factors emerged as important predictors of adolescent socioemotional adjustment during the study period.

Evaluación del formato remoto en tiempos de pandemia

En el contexto de la pandemia de COVID 19 durante el año 2020 y hasta la fecha se diseñó un formato de evaluación para nuestros alumnos de pre y posgrado bajo el alero de los exámenes clínicos objetivos estructurados (ECOE) en un formato remoto. Se revisó la literatura al respecto y se diseñó un instrumento que diera cuenta en forma oportuna y estandarizada del desempeño de nuestros alumnos y residentes. Estas experiencias están siendo evaluadas en estudios con metodología mixta. Sin embargo, decidimos compartir esta experiencia, por su impacto en el desarrollo docente de las ciencias de la salud.

In the context of the COVID-19 pandemic during 2020 and to date, an evaluation format has been designed for our undergraduate and graduate students under the design of the objective structured clinical examinations (OSCE) in a remote format. The literature was reviewed, and an instrument was designed to account for the performance of our students and residents in a timely and standardized manner. These experiences are being evaluated in studies with mixed methodology. However, we wanted to convey this experience due to its impact on the educational development of health sciences.

La pandemia de COVID-19 y el cumplimiento de las guías alimentarias en una comunidad universitaria de Chile / COVID-19 pandemic and adherence to food- based dietary guidelines in a Chilean university community

Introducción. La pandemia de SARS-CoV-2/COVID-19 y las restricciones sanitarias afectaron la disponibilidad, acceso y consumo de alimentos, impactando la alimentación y el estado nutricional. Objetivo. Determinar el efecto de la pandemia SARS-CoV-2/COVID-19 sobre el cumplimiento de las Guías Alimentarias Basadas en Alimentos de Chile, en una comunidad universitaria, antes y durante la pandemia. Materiales y métodos. Estudio de cohorte retrospectiva con 427 participantes. Se aplicó una encuesta online con preguntas basadas en los mensajes de las GABA. La encuesta se validó por juicio de expertos y análisis psicométrico, evaluando la concordancia con el estadístico de Kappa (K=89,95) y la confiabilidad con el coeficiente Alfa de Cronbach (=0,97). Se fijó como período antes de la pandemia al tiempo anterior a marzo del año 2020, y durante la pandemia, entre marzo del 2020 y octubre del 2021. Para medir los cambios antes y durante la pandemia se aplicó el test de simetría considerando un p <0,05 con un intervalo de confianza del 95%, mediante el software estadístico STATA versión 16. Resultados. Se observaron cambios estadísticamente significativos antes y durante la pandemia en los mensajes relacionados con el estado nutricional (p=0,000), consumo semanal de: productos de pastelería (p=0,0040), cecinas y embutidos (p=0,0034), frituras (p=0,0070), legumbres (p=0,0000), aguas (p=0,0000) y lectura e información nutricional de los productos (p=0,0000). Conclusiones. La pandemia de SARS-CoV-2/COVID-19 generó cambios en la alimentación y estado nutricional respecto a los mensajes de las guías. Se precisan políticas alimentarias y estrategias educativas en alimentación y en nutrición para emergencias sanitarias(AU)

Introduction. The SARS-CoV-2/COVID-19 pandemic, as well as health restrictions, impacted food availability, access and consumption, affecting dietary habits and nutritional status. Objective. To determine the effect of the SARS-CoV-2/ COVID-19 pandemic on the adherence to Chilean Food-Based Dietary Guidelines, within a university community, both before and during the pandemic. Materials and methods. A retrospective cohort study involving 427 participants was conducted. An online survey was administered, with questions based on the FBDGs' messages. The survey was validated through expert judgment and psychometric analysis, and agreement was assessed using the Kappa statistic (K = 89.95) while reliability was determined using the Cronbach's Alpha coefficient ( = 0.97). The period before the pandemic was defined as the time prior to March 2020, and the pandemic period was set between March 2020 and October 2021. Changes before and during the pandemic were measured using the symmetry test, considering a p value of <0.05 and a 95% confidence level, using the STATA 16 statistical software. Results. Statistically significant changes were observed before and during the pandemic in messages related to nutritional status (p = 0.000), weekly consumption of bakery products (p = 0.0040), cold meats (p = 0.0034), fried foods (p = 0.0070), legumes (p = 0.0000), water (p = 0.0000), and messages related to reading and nutrition information of products (p = 0.0000). Conclusions. The pandemic led to dietary changes in relation to FBDGs messages. Food policies and food and nutrition education strategies are required to address health emergency contexts(AU)

Self-efficacy and well-being of youth during the COVID-19 pandemic in Indonesia / Autoeficacia y bienestar de los jóvenes durante la pandemia de COVID-19 en Indonesia

Abstract Introduction The impact of the COVID-19 pandemic on the well-being of young people has attracted the concerned of many parties. Self-efficacy, an individual's belief to cope with various situations, is believed to have a relationship with individual's psychological well-being. Objective To explore the relationship between self-efficacy and well-being of young people in Indonesia during the COVID-19 pandemic. Method A cross-sectional design with a convenience sample of high schools and universities students in Indonesia. The number of participants were 365 young people aged 15-23 years (M = 18.57; SD = 1.95). They were asked to complete the Self-efficacy Scale and the Flourishing Scale in the form of an online survey. Results There is a positive correlation between self-efficacy and well-being (r = .547, p < .01) with the contribution percentage of 33.5%. The two-way ANOVA resulted there was an effect of education level on wellbeing (F = 12.956, p < .05), while there was no gender effect on wellbeing (F = .006, p > .05). Discussion and conclusion The findings of this study highlighting the importance of developing self-efficacy in young people in order to promote well-being despite facing a challenging situation.

Resumen Introducción El impacto de la pandemia de COVID-19 en el bienestar de los jóvenes ha atraído la preocupación de muchas partes. Se cree que la autoeficacia, la creencia de un individuo para hacer frente a diversas situaciones, tiene una relación con el bienestar psicológico del individuo. Objetivo Este estudio tiene como objetivo explorar la relación entre la autoeficacia y el bienestar de los jóvenes en Indonesia durante la pandemia de COVID-19. Método Un diseño transversal con una muestra de conveniencia de estudiantes de escuelas secundarias y universidades en Indonesia. El número de participantes fueron 365 jóvenes de 15 a 23 años (M = 18.57; SD = 1.95). Se les pidió que completaran la Escala de Autoeficacia y la Escala de Florecimiento en forma de encuesta en línea. Resultados Existe una correlación positiva entre la autoeficacia y el bienestar (r = .547, p < .01) con el porcentaje de cotización del 33.5%. El ANOVA de dos vías resultó que hubo un efecto del nivel educativo sobre el bienestar (F = 12.956, p < .05), mientras que no hubo efecto del género sobre el bienestar (F = .006, p > .05). Discusión y conclusión Los hallazgos de este estudio destacan la importancia de desarrollar la autoeficacia en los jóvenes para promover el bienestar a pesar de enfrentar una situación desafiante.

The COVID-19 pandemic's risk factors for depression among postgraduate healthcare students / Los factores de riesgo de la pandemia de COVID-19 para la depresión entre los estudiantes de posgrado en salud

Abstract Introduction The pandemic has generated challenges which impact the mental health of the population, including postgraduate healthcare students. Objective To evaluate the factors associated with depression in postgraduate healthcare students during the COVID-19 pandemic. Method This is a cross-sectional study with postgraduate healthcare students, with a sample of 117 participants. The data were collected through an online form, between September and November 2021, using semi-structured questionnaires with sociodemographic information and information regarding participants' mental health, as defined by the DSM-5 Scale, where the depression domain was considered a variable for this study. The variables were tested using the Poisson multiple regression model with robust variance in the bivariate analysis between the dependent and independent variables (95% CI). Results In the bivariate analysis, there was an association between depression and not having a partner, also a low monthly income, studying for a master's or professional doctorate and having an employment relationship parallel to the postgraduate course. Regarding the mental health of the participants, the following factors were associated with depression: anger, mania, anxiety, somatic symptoms, suicidal ideation, mental disorder, memory, repetitive thinking, dissociation, personality functioning, and substance use (p < .05). In the multiple analysis, it was found that mania, anxiety, and dissociation remained statistically associated with depression (p < .05). Discussion and conclusion Factors associated with depression in this population raise the importance of mental health promotion interventions for postgraduate healthcare students, who seek help both through mental health services and through their universities.

Resumen Introducción La pandemia ha generado desafíos que impactan en la salud mental de la población, incluidos los estudiantes de posgrado en salud. Objetivo Evaluar los factores asociados a la depresión en estudiantes de posgrado en salud durante la pandemia de COVID-19. Método Se trata de un estudio transversal con estudiantes de posgrado en salud, con una muestra de 117 participantes. Los datos fueron recolectados a través de un formulario en línea, entre septiembre y noviembre de 2021, utilizando cuestionarios semiestructurados con información sociodemográfica e información sobre la salud mental de los participantes, según lo definido por la Escala DSM-5, donde el dominio depresión fue considerado una variable para este estudiar. Las variables se probaron mediante el modelo de regresión múltiple de Poisson con varianza robusta en el análisis bivariado entre las variables dependientes e independientes (IC 95%). Resultados En el análisis bivariado, hubo asociación entre la depresión y no tener pareja, también una baja renta mensual, estudiar maestría o doctorado profesional y tener una relación laboral paralela al posgrado. En cuanto a la salud mental de los participantes, los siguientes factores se asociaron a la depresión: ira, manía, ansiedad, síntomas somáticos, ideación suicida, trastorno mental, memoria, pensamiento repetitivo, disociación, funcionamiento de la personalidad y uso de sustancias (p < .05). En el análisis múltiple se constató que la manía, la ansiedad y la disociación permanecieron estadísticamente asociadas a la depresión (p < .05). Discusión y conclusión Los factores asociados a la depresión en esta población elevan la importancia de las intervenciones de promoción de la salud mental para los estudiantes de posgrado en salud, quienes buscan ayuda tanto a través de los servicios de salud mental como a través de sus universidades.

Transition to online teaching during COVID-19 pandemic: Perspective of higher education teachers from India

Objectives: This cross-sectional, anonymous and questionnaire-based study was undertaken to analyse online teaching experiences during COVID-19 lockdown in higher education from teachers’ perspectives. This was thought to help in improving long-distance education. Materials and Methods: An online survey was conducted to collect both quantitative and qualitative data from higher education teachers. Results: Benefits identified by online teachers indicate that distance education can cater to a large group and helps the students to access educational resources. Major challenges faced were internet connectivity (78.80%), increased workloads (68.80%) and lack of personal communication with students (84%). They believed that the online mode of teaching is the only alternative for students in such an extraordinary situation. It can be valuable for additional discussions but cannot replace traditional offline teaching. Conclusion: Suggestions pointed toward providing internet facilities and electronic databases to students and the necessity of faculty development programmes.