Social marketing in front of the COVID-19 Pandemic

Notorious is that, over just over 100 years, marketing has undergone changes, especially in the conceptual area, causing confusion in the correct use of expressions and use of these expressions. Knowing how to differentiate societal marketing from social marketing it is important for them to be used in order to achieve the objectives that are conceptually proposed to them. Societal marketing focuses on accepting a product, while social marketing is focused on a cause that can produce a change in social behavior. Given the problem of the pandemic that has plagued the world since December 2019, the importance of social marketing in the attempt to cause changes in the behavior of citizens. This theoretical essay aims to show the importance of social marketing in the face of the PANDEMIC of COVID-19. It also aims to clearly conceptualize societal marketing and social marketing, as well as to show the social problem caused by the new corocavirus.

Global COVID-19 vaccine inequality: An overview of critical factors and possible solutions

The effectiveness of the vaccines, as well as global distribution and intervention strategies in order to deal with vaccine hesitancy, remain a challenge in both developing and developed countries. Even though several COVID-19 vaccines are used globally in population-wide vaccination campaigns, it has been difficult to achieve population-wide immunity. This paper examines select factors within and between nations that have hampered the ability to achieve this level of immunity, including inequalities in production and distribution among low-, middle-and high-income countries and suggests some possible solutions or policies to address global vaccine hesitancy and the unequal distribution of COVID-19 vaccines. The allocation of COVID-19 vaccines should be based on ethical principles to ensure fair and timely administration. Better health education and communication, as well as planning and equitable vaccine allocation strategies, should be carried out by public health policymakers and stakeholders. A globally coordinated strategy that tackles vaccine inequity may reduce hospitalization and death rates, promote vaccine-induced population-wide immunity, and curb the spread of SARS-CoV-2 before the onset of new SARS-CoV-2 strains that might render ongoing mass vaccination campaigns ineffective. © 2022 by the authors.

FAVORABLE BALANCE of BENEFIT and HARM of LONG-TERM, LOW-DOSE PREDNISOLONE ADDED to STANDARD TREATMENT in RHEUMATOID ARTHRITIS PATIENTS AGED 65+: The PRAGMATIC, MULTICENTER, PLACEBO-CONTROLLED GLORIA TRIAL

Background: Low-dose glucocorticoid (GC) therapy is widely used in RA but the true balance of beneft and harm is still unknown. Objectives: We studied the effects of prednisolone (5 mg/day, 2 years) in RA patients aged 65+, requiring adjustment of antirheumatic therapy (DAS28≥2.60). Methods: Pragmatic double-blind placebo-controlled randomized trial;all co-treatments and changes therein were allowed during the trial except longterm open label GC;Ca/D supplementation was advised in all patients. Minimal exclusion criteria were tailored to seniors. Harm outcome: the number of patients with ≥1 serious adverse event (SAE), or ≥1 'other adverse event of special interest' (other AESI). Other AESI comprised any AE (except worsening of RA) causing study discontinuation, and GC-specifc events (Table 1). Beneft outcomes: improvement in disease activity (DAS28) and joint damage progression (Sharp/van der Heijde). Longitudinal mixed models analyzed the data. Given prior knowledge we report one-sided 95% confdence limit (95%CL) and statistical tests, performed only for the main outcomes. Results: We randomized 451 RA patients in 7 EU countries, 449 received the intervention;of these 63% prednisolone vs 61% placebo patients completed 2 years of follow up. Discontinuations were similar in both groups: for AE (14%) and active disease (4%);the remainder mostly for 'trial fatigue' and covid-related access issues (20%). Mean time on study drug was 19 (SD 8) months. 70% of patients were female, mean age was 72 (max 88) years, RA duration 11 years;67% were RF+, 56% ACPA+, 96% had joint damage on radiographs: mean score 20, median 8. Mean DAS28 was 4.5. Most patients (79%) were on current DMARD treatment, including 14% on biologics;47% had previously used GC, 14% changed DMARD therapy at baseline. Patients had mean 2.1 active comorbidities, and used median 7 drugs. Beneft: Disease activity rapidly declined to stabilize after 1 year (Figure 1), and was lower on prednisolone (adjusted mean difference in DAS28 over 2 years: 0.37, 95%CL 0.23, p<0.0001). The contrast in early (3-month) response was larger in 331 patients adherent to protocol on stable treatment: mean difference in DAS28 0.62 (95%CL 0.44), more responders on prednisolone (Figure 1). Sig-nifcant time-treatment interaction in secondary analyses suggested a decrease in contrast after the frst year, most likely caused by signifcantly more changes in DMARD treatment on placebo. Joint damage progression over 2 years was signifcantly lower on prednisolone: mean 0.6 (SD 1.9) v 1.8 (6.4) score points on placebo, difference 1.2 (95%CL 0.2, p=0.02). Harm: 60% prednisolone vs 49% placebo patients experienced the harm outcome: adjusted RR 1.24, 95%CL 1.04, p=0.02;number needed to harm 9.5 (Table 1). During the study 1 vs 2 patients died, and 3 vs 0 died within 5 months of discontinuation. Per 100 patient-years, AE totaled 278 in prednisolone vs 206 in placebo patients, and the difference was most marked for infections (Table 1);these were mostly mild or moderately severe. Other GC-specifc AESI were rare without relevant differences. Conclusion: Add-on low dose prednisolone has benefcial long-term effects on disease activity and damage progression in senior RA patients on standard treatment. The tradeoff is a 24% increase in patients with mostly mild to moderate AE, suggesting a favorable balance of beneft and harm.

IF IT IS ESSENTIAL, WHY IS IT PRECARIOUS? MOBILIZATIONS, RESISTANCE AND ORGANIZATION OF DELIVERY WORKERS VIA DIGITAL APPS DURING THE COVID-19 PANDEMIC

This theoretical work has the pressing objective of analyzing the consequences of the new configurations of work, based mainly on the uberization of labor relations. In summary, uberization is characterized by the expansion of precarious forms of work, made possible by the development and massification of digital technologies. To this end, through bibliographic review and analysis of secondary studies, it is intended to examine the precariousness of work of delivery workers via digital apps, aggravated during the period of the Covid-19 pandemic. In response to these conditions, these workers are beginning to organize themselves to demand better working conditions, symbolized by the stoppages of July 1 and 25, 2020. In this way, the collective organization is understood as a way to oppose adverse working conditions. It is also understood, the role of the academy in expanding studies of the various areas of knowledge about the living and working conditions of these workers to enable the development of specific public policies.

TEACHING WORK IN FRONT OF DISCENT COGNITIVE AND SOCIOAFFECTIVE DEVELOPMENT

This essay brings reflections on teaching work based on the main theoretical approaches to teacher professionalism, highlighting its cognitive and socioaffective dimensions. The cognitive dimension refers to the acquisition of content knowledge based on curriculum programs and the socio-affective dimension refers to the identification of socio-affective aspects that interfere in student relationships and learning. Based on this differentiation, we analyse the daily work developed by teachers in the classroom, emphasizing the interdisciplinary character of each function as complementary aspects of teaching practices, the complexities of teaching and new challenges posed by the Covid-19 pandemic.

Silently withdrawn or retracted preprints related to Covid-19 are a scholarly threat and a potential public health risk: theoretical arguments and suggested recommendations

Purpose - Thousands of preprints related to Covid-19 have effused into the academic literature. Even though these are not peer-reviewed documents and have not been vetted by medical or other experts, several have been cited, while others have been widely promoted by the media. While many preprints eventually find their way into the published literature, usually through integrated publishing streams, there is a small body of preprints that have been opaquely withdrawn/retracted, without suitable reasons, leaving only a vestigial or skeletal record online. Others have, quite literally, vanished. This paper aims to examine some of those cases. Design/methodology/approach - For peer-reviewed literature, a retracted academic paper is usually watermarked with "RETRACTED" across each page of the document, as recommended by ethical bodies such as the Committee on Publication Ethics, which represents thousands of journals and publishers. Curiously, even though pro-preprint groups claim that preprints are an integral part of the publication process and a scholarly instrument, there are no strict, detailed or established ethical guidelines for preprints on most preprint servers. This paper identifies select withdrawn/retracted preprints and emphasizes that the opaque removal of preprints from the scholarly record may constitute unscholarly, possibly even predatory or unethical, behavior. Findings - Strict ethical guidelines are urgently needed for preprints, and preprint authors, in the case of misconduct, should face the same procedure and consequences as standard peer-reviewed academic literature. Originality/value - Journals and publishers that have silently retracted or withdrawn preprints should reinstate them, as for regular retracted literature, except for highly exceptional cases.

Teacher identity in the context of assessments in a pandemic period

This essay presents a critical analysis of teachers' professional identity within the context of assessments in the period marked by the COVID-19 pandemic. Considerations were made regarding the evaluation of students during the specific dynamics of a process marked by sensitive changes in the universe of Brazilian education in 2020 and 2021. The reinvention of teaching practice was highly needed, which sparks off a debate surrounding the teacher's role in the changes of assessment practices. In this sense, the fine line between teaching and learning is questioned, changing the aforementioned "formula" for the conduction of activities and the reception of answers, in view of an unbridled search for attendance, and not for systemic learning. The considerations point to a necessary dialogue about the relationship between the teaching profession and assessment.

SARS-CoV-2 outbreak in autoimmune diseases: The euro-covimid study

Background: Coronavirus disease 2019 (COVID-19), has raised several questions in patients with immune-mediated inflammatory diseases (IMID). Whether the seroprevalence and factors associated with symptomatic COVID-19 are similar in IMID patients and in the general population is still unknown. Objectives: To assess the serological and clinical prevalence of COVID-19 in European IMID patients, along with the factors associated with its risk and the impacts the pandemic had on the IMID management. Methods: Prospective multicentre cross-sectional study among patients with five IMID (i.e. systemic lupus erythematous, Sjögren's syndrome, rheumatoid arthritis, axial spondylarthritis or giant cell arteritis) from six tertiary-referral centers from France, Germany, Italy, Portugal, Spain and United Kingdom. Demographics, comorbidities, IMID, treatments, flares and COVID-19 details were collected. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) serological tests were systematically performed. Results: Between June 7 and December 8, 2020, 3028 patients were included (median age 58 years, 73.9% females). SARS-CoV-2 antibodies were detected in 166 (5.5%) patients. Symptomatic COVID-19 was seen in 122 patients (prevalence: 4.0%, 95% CI 3.4-4.8%);23 (24.2%) of them were hospitalized and four (3.2%) died. In multivariate logistic regression analysis, symptomatic COVID-19 was more likely to be observed in patients with higher levels of C-reactive protein (OR: 1.18;95% CI 1.05-1.33;p = 0.006), and increased with the number of IMID flares (OR: 1.27;95% CI 1.02-1.58;p = 0.03). Conversely, it was less likely to occur in patients treated with biological therapy (OR: 0.51;95% CI 0.32-0.82;p = 0.006). During the pandemic, at least one self-reported disease flare was seen in 654 (21.6%) patients. Also, 519 (20.6%) patients experienced changes in their treatment, with 125 of these (24.1%) being due to COVID-19. Conclusion: The SARS-CoV-2 prevalence in IMID patients over the study period seems to be similar to that of the general population1. The IMID inflammatory status seems to be independently associated with the development of COVID-19.

Machine learning prediction of COVID-19 mortality in cancer patients

Background: COVID-19 is a challenge for clinical decision-making in cancer patients and the allocation of healthcare resources. An accurate prognosis prediction to effectively triage patients is needed, especially in the community oncology practice. Methods:Nationwide cohort from Oncoclínicas Brazil was used to validate previously developed multivariable logistic regression (mLR) model (Ferrari et al, JCO GO 2021) and to construct a machine learning Random Forest (RF) algorithm as predictor of 30-day mortality after SARS-CoV-2 detection by RT-PCR in cancer patients diagnosed in an outpatient setting. To find the most important baseline clinical determinants of early COVID19-related death via Gini index, a RF with 100,000 trees was trained in 75% of the dataset, and the performance was assessed in the remaining 25%. We then compared the accuracy of different models in terms of sensitivity, specificity and area under the receiver operating characteristics curves (AUC). Results:From March to December 2020, 533 patients with COVID-19 were prospectively registered in the database. Median age was 60 years (19-93) and 67% were female. Most frequent cancers were breast in 34%, hematological in 16%, and gastrointestinal in 15%. Comorbidities were common (52%), as was current/former smoking history (17%). Most patients were on active systemic therapy or radiotherapy (84%) in the advanced or metastatic disease setting (55%). The overall mortality rate was 15% (CI95% 12%-18%). We validated the original mLR model trained in the first 198 patients: management in a noncurative setting (odds ratio [OR] 3.7), age ≥ 60 years (OR 2.3), and current/former smoking (OR 1.9) were significant predictors of death in the expanded cohort. Presence of comorbidities (OR 1.9) also defined poor outcome in the updated mLR model, which yielded low sensitivity (74%), specificity (68%) and AUC (0.78). With RF modeling, the most significant predictors of 30-day death after COVID-19 (in decreasing order) were older age, treatment of advanced or metastatic disease, tumor type (respiratory tract, brain and unknown primary cancers had higher mortality), COVID-related symptom burden at baseline evaluation and treatment regimen (immunotherapy combinations had higher mortality). The RF model demonstrated high sensitivity (89%), specificity (88%) and AUC (0.96). Conclusions:The results highlight the possibility that machine learning algorithms are able to predict early mortality after COVID-19 in cancer patients with high accuracy. The proposed prediction model may be helpful in the prompt identification of high-risk patients based on clinical features alone, without having to wait for the results of additional tests such as laboratory or radiologic studies. It can also help prioritize medical resources and redefine vaccination strategies. A web-based mortality risk calculator will be created for clinical decision support.

The role of lockdowns and health policies for COVID-19 in Italy

In response to the coronavirus disease 2019 (COVID-19) pandemic, Italy initially flattened the curve after a stringent lockdown spanning from February 23 to early May but not without casualties, with 240,760 cases and 34,788 deaths on June 30, 2020. However, increasingly lax policies saw rising cases starting in August. Italy currently sits with 423,578 cases and 36,616 deaths (October 20, 2020). This retrospective observational study aimed to assess stringency policies related to nation-wide containment and closure, as well as health system instruments, to determine their potency. The first nationally implemented policy was on January 31, followed by a battery of strong restrictions imposed on February 22-23. The Stringency Index peaked at 93.5 on April 12. However, policies were relaxed following a flattening of the curve on May 4 when the Stringency Index went from 93.5 to 63.0. Italy's policies were essential to contain the spread of the virus initially, but the lax policies since the end of spring, especially related to school reopening, no stay-at-home and domestic travel restrictions, and reduced contact tracing, have now resurrected the COVID-19 pandemic.

Estimating worldwide costs of premature mortalities caused by COVID-19

Purpose: The purpose of this paper is to provide an estimate of the costs of premature mortality caused by the COVID-19 pandemic. Design/methodology/approach: Using COVID-19 pandemic-derived mortality data for November 9, 2020 (globally 1,303,215 deaths) and applying a country-based value of statistical life (VSL), the worldwide cost of premature mortality was assessed. The cost was assessed based on income groups until November 9, 2020 and projected into the future until March 1, 2021 using three scenarios from the Institute for Health Metrics and Evaluation (IHME). Findings: The global cost of premature mortality is currently estimated at Int$5.9 trillion. For the high-income group, the current estimated cost is Int$ $4.4 trillion or $3,700 per person. Using IHME projections until March 1, 2021, global premature mortality costs will increase to Int$13.7 trillion and reach Int$22.1 trillion if policies are relaxed, while the cost with 95% universal masks is Int$10.9 trillion. The richest nations will bear the largest burden of these costs, reaching $15,500 per person by March 1, 2021 if policies are relaxed. Originality/value: The cost of human lives lost due to the pandemic is unprecedented. Preparedness in the future is the best policy to avoid many premature deaths and severe recessions in order to combat pandemics. © 2020, Jaime A. Teixeira da Silva and Panagiotis Tsigaris.

Osteoporosis management during the COVID-19 pandemic – Position paper

COVID-19 pandemic significantly increased the already large number of victims of osteoporosis in Portugal. Osteoporosis outpatient clinics were either closed or had limited presential appointments. Many hospitals reduced orthopaedic services to make space for patients with COVID-19. In additions the volunteer or forced sedentarism, as imposed by the pandemic, increased the risk of falls and fractures drastically. It urges to intensify the current efforts to improve the management of bone health, and to prioritize fragility fracture care and prevention. This paper addres ses the challenges in osteoporosis management during the COVID-19 pandemic and provides a guidance on osteoporosis management. This position paper is a joint initiative of several health professionals and patients dedicated to osteoporosis. © 2021, Acta Reumatologica Portuguesa. All Rigths Reserved.

The first 80 days of the covid-19 pandemic in the city of belo horizonte: From containment to reopening

The paper examines the implications of Co-vid-19 pandemic for the city of Belo Hori-zonte (BH), during the first 80 days of the disease. We use a descriptive-analytical approach to estimate the growth of Covid-19 cases over time, the excess of deaths, the virus’ rate of transmissibility, and the con-sequent burden on the municipal the health system, measured by the rate of occupancy of public hospital beds. Also, we identify the main containment policies adopted by local authorities, and the implications of reopening measures and the following reduction of social distancing. Our findings reveal that a well-managed Unified Health System (SUS) is paramount to effectively tackle the pandemic and its consequences for the popula-tion. The reopening process has imposed new challenges that will require close monitoring by the authorities and by the society. © 2020, Universidade Federal de Minas Gerais. All rights reserved.

Recommendations for childcare in the face of the new coronavirus

Objective: To identify in the national and international literature the recommendations for the care of children against the new coronavirus. Methods: An integrative review carried out in April 2020, in the Web of Science, CINAHL, BDENF, IBECS, LILACS, and MEDLINE databases. Recommendation articles published in 2020 were included. Clinical studies on other topics or populations were excluded. Results: The sample consisted of 10 articles, grouped into three categories of recommendations, which deal with the following: the care for children with cancer;the search for the reduction of biopsychosocial harms in confinement;and the possibilities for diagnosis and treatment. Conclusion: The highlighted recommendations are not exhausted, but represent a guide for family members/caregivers and health professionals in the face of the severe situation. For nursing, knowing the current recommendations on child care in the face of COVID-19 makes it possible to carry out actions to promote quality and safe childcare. © 2020, Universidade Federal do Parana. All rights reserved.

RISKS OF ALCOHOL ABUSE, ALCOHOLISM AND STRESS-RELATED DRINKING DURING THE COVID-19 PANDEMIC

Alcohol consumption in the COVID-19 era is a health emergency. Loneliness and social distancing cause alcohol abuse. Alcohol consumption through a continuum during the isolation period has created new cases of alcohol use disorders. To all this, we must add the increased risk of infection and deteriorating symptoms. In fact, it is known that ethanol reduces the activity of adaptive and acquired immunity and promotes the expression of ACE2 receptors. Healthcare institutions are required to inform citizens properly about alcohol-related problems in this emergency period.