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.

Prophylactic and therapeutic alternatives for respiratory diseases: technological innovations obtained in natural products

Chronic respiratory diseases affect both the upper and lower airways. The main components of the respiratory system are the rib cage, airways, and the pulmonary interstitium. The airway originates in the trachea, a structure located in the mediastinum, which splits into two parts to form the main bronchus (right and left bronchi). The bronchi gradually divide into secondary bronchi, bronchioles, alveolar ducts, and alveoli. Acute or chronic respiratory diseases are present in all age groups, with many different forms of clinical presentation. In general, the most common diseases are asthma, chronic obstructive pulmonary disease, respiratory allergies, occupational lung diseases, pulmonary hypertension, sinusitis, pharyngitis, bronchitis, tuberculosis, cold, and influenza (flu). Among the acute illnesses, infections of the upper respiratory tract, flu, and pneumonia are particularly prominent, and since 2019, we could include in this group the COVID-19 with the beginning of the pandemic of this disease. For chronic diseases, diseases of the lower respiratory tract are the most common, such as bronchitis, emphysema, and asthma. © 2023 Elsevier B.V.

Changes in Assistance and Care in the Pregnancy-Puerperal Cycle in Times of Coronavirus

Objective: to know the specific procedures and care provided to pregnant women, puerperal women and newborns in times of a pandemic and to analyze changes in prenatal care, labor, delivery and the postpartum period during the coronavirus pandemic. Methods: this is a qualitative, descriptive and exploratory study involving 26 women. The interviews were conducted via the Google Forms platform, with closed and open questions. Results: Two categories emerged from the study: 1) Influence of social isolation on the emergence of mental disorders;2) Adaptations with loss of sexual and reproductive, social and labor rights. Conclusion: mental health and sexual and reproductive, social and labor rights were shown to be more vulnerable in women who experienced pregnancy and postpartum in the coronavirus pandemic.

Food security and fruit and vegetable consumption among preschoolers: an exploratory study during the COVID-19 pandemic

Studies that assess food insecurity and its association with the consumption of fruits, legumes, and vegetables (FLV) can help identify groups and risk factors of inadequate food consumption, in order to propose assertive nutritional interventions. The aim of this study was to describe FLV consumption by children in different food security situations. This is an exploratory cross-sectional study, conducted with parents/guardians of 44 children from zero to four years old. The short version of the Brazilian Food Insecurity Scale and a Food Frequency Questionnaire were applied to parents/guardians via a telephone interview. The children were 2.6 years old on average, 56.8% were female, 67.5% were eutrophic, and 70.5% of the families were in a situation of food insecurity. For households in a situation of food security, the median consumption of FLV was 213.4 g/day (P25=97.89;P75=425.91). As for those in a situation of food insecurity, the median FLV was 105.4 g/day (P25=33.58;P75=205.16). It was concluded that the consumption of FLV by children from families in a situation of food security is higher than that of children in a situation of food insecurity, who are strongly influenced by the offer of cheap food with low nutritional quality. Public policies are needed to favor the guarantee of access to FLV of quality and at an affordable cost for all families.

Protein Blend Suppress Inflammatory Response from Bronchial Epithelial Cells Induced by SARS-Cov-2

Even after virus elimination, coronavirus disease 2019 (COVID-2019) leaves numerous sequelae. Growing evidence demonstrates that massive release of proinflammatory cytokines, which drives COVID-19 progression, severity, and mortality, remains elevated after acute phase of COVID-2019, playing a central role in the disease' sequelae. In this way, bronchial epithelial cells are the first cells hyperactivated by coronavirus-2 (SARS-Cov-2) leading to massive cytokine release, triggering leukocytes and other cells hyperactivation, mediating COVID-19 sequelae. So, proinflammatory cytokines are initiated by the host. Thus, this in vitro study tested the hypothesis that ImmuneRecovTM, a protein blend, could inhibit the hyperactivation of human bronchial epithelial cells (BEAS-2B) induced by SARS-Cov-2. BEAS-2B (5x104/mL/well) cells were co-cultivated with 1ml of blood of a SARS-Cov-2 infected patient for 4 hours and protein blend (1ug/mL) was added in the first minute of the co-culture. After 4 hours, the cells were recovered and used for analysis of cytotoxicity by MTT and for mRNA expression of IL-1beta, IL-6, IL-10. The supernatant was used to measure cytokines. SARS-Cov-2 incubation resulted in increased levels of IL-1beta and IL-6 by BEAS-2B cells (p<0.001). Treatment with the protein blend resulted in reduced levels of pro-inflammatory IL1beta and IL-6 (p<0.001), and increased the levels of anti-inflammatory IL-10 (p<0.001). Protein blend reduced SARS Cov-2-increased the mRNA expression of IL-1beta and IL-6, and increased the expression of IL-10 and IFN-gamma. In conclusion, protein blend presents important anti-inflammatory effects in the context of SARS-Cov-2 infection.

Ecosystems, strategy, and resilience: Four empirical cases in the COVID-19 crisis

The pandemic pushed companies to rethink competitive strategies and the innovation ecosystem structure. Then, we studied four small organizations from different industries through interviews, observations, and documentation. We offer five key findings: First, the crisis affected the cases in distinct ways, benefiting those in the healthcare sector. Second, innovation ecosystems provided opportunities for digitalization to keep businesses running. Third, resilience and initiative from the ecosystem leaders were crucial in responding to the crisis. Fourth, shifts in competition and cooperation favored survival. Lastly, the competitive strategy and ecosystem goals set before the pandemic have not changed, but how to achieve them. © 2023 Elsevier B.V.

Clinical outcome and associated factors in patients with COVID-19 admitted to an Intensive Care Unit

Methods: This is a case series, carried out from March to July 2020, with data recorded in the nutritional monitoring records of patients hospitalized with COVID-19. The variables analyzed were: demographic (age and sex);clinical (comor-bidities, underlying disease and outcome), anthropometric, biochemical and nutritional support. Results: The sample consisted of 102 patients, 65.7% had the severe acute respiratory syndrome, the main underlying disease observed was heart disease (23.5%) and 69.3% of patients were discharged from the ICU. Regarding nutritional variables, approximately 50% of patients received enteral feeding and 73.3% started early. Concerning biochemical markers, patients who died had higher C-reactive protein (CRP)/albumin ratios (p=0.024) and CRP concentrations (p=0.012) when compared to those who progressed to dis-charge from the ICU. In addition, it is observed that the eld-erly (adjusted HR = 3.62;95%CI 1.19 - 10.97) and early ini-tiation of enteral nutritional therapy (adjusted HR = 10.62;95%CI 2.41 - 46 .87) were factors related to ICU discharge. Conclusion: Monitoring the inflammatory process using different markers seems to be a good parameter for the clinical evolution of these patients. In addition, the benefits of early enteral nutrition therapy may be associated with better clinical outcomes and reduced complications during hospitalization.

The Effects of Modified Personal Protective Equipment (PPE) Protocols on Healthcare Personnel Providing Patient Care During the COVID-19 Pandemic: A Qualitative Assessment

Background. Healthcare personnel (HCP) faced personal protective equipment (PPE)-related challenges during the COVID-19 pandemic including supply shortages, additional PPE items, different designs, and modified protocols (PR)/guidelines. We used a human factors engineering- and ethnography-informed approach to qualitatively assess the effects of these challenges on HCP and their PPE use during the pandemic. Methods. We observed PPE use (e.g., donning/doffing) by HCP caring for patients with COVID-19, those under investigation (PUI), and those with other conditions in 1 acute, 1 intermediate, and 1 intensive care unit at a large Midwestern academic hospital. We conducted mini-interviews with a subset of HCP to clarify observed behavior and identify PPE-related concerns. We captured observation, interview, and additional data (e.g., unit layouts, signage) in structured and unstructured notes. We transcribed and imported notes into MAXQDA and applied a deductive-inductive analytical approach. Results. From April-July 2021, we observed 188 patient care episodes and conducted 47 mini-interviews. Observations included COVID-19 (n=102), PUI (n=4), and non-COVID-19 (n=82) rooms on varying isolation precautions. PRs related to masks and eye protection changed during the study period and particularly affected donning practices. Other barriers included time-intensive PRs, unclear PR communication, unfamiliar designs, lack of surfaces on which to set supplies while donning/ doffing, and inconvenient PPE storage/cleaning locations. We observed recommendation/ PR deviations related to PPE use (e.g., exposed wrists, unapproved/no eye protection), cleaning, and signage/storage (e.g., designated 'clean' surfaces). HCP reported PPE extended use/reuse, provision of design options, and their own adaptations (e.g., 'batching' tasks, modifying PPE) facilitated donning/doffing. New PPE requirements highlighted tensions between HCP comfort and safety;despite this, some wanted to include modified PRs in their routine infection prevention practices permanently. Conclusion. PPE use barriers and facilitators related to modified COVID-19 PRs have implications for the ongoing pandemic and future respiratory pathogen outbreaks.

Main changes perceived by parents related to parental educational practices in the context of covid-19

This research aimed to identify the perception of parents about changes in their parenting practices and their impact on their children, aged 6 to 12 years, during the Covid-19 pandemic. This is a descriptive and qualitative study developed from the application of a Likert-type questionnaire with 26 items, which were answered by 35 participants who met the inclusion criteria. The results indicate that the most prevalent parenting practices during the pandemic context were positive monitoring and moral behavior, to the detriment of those considered negative, such as negligence, relaxed discipline, inconsistent punishment and negative monitoring. Data analysis also highlighted the predominance of the authoritative parenting style to resolve conflicting situations. It was possible to identify that, even in a challenging scenario, most parents sought dialogue and affection as a means to resolve the conflicts that arose with their children during social isolation and so many other adversities brought about by the pandemic.

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.

Reflections in Facing Covid-19 in a Number of Pulmonary Respirators Repair

This is a qualitative, exploratory and descriptive research, linked to the project of the Nucleus for the repair of pulmonary ventilators (NRVP). Objective: to report the experiences and reflections of a team of nursing teachers who work in the repair of pulmonary respirators. The reflections contributed to coping with COVID-19, its daily implications. Fostering the creation of a specific training course for the maintenance of hospital equipment is a necessity in force at this time of the pandemic and in the post-pandemic. The strategy developed for the repair and maintenance of pulmonary respirators, in coping with COVID-19 should be configured as a legacy of this period and as a social contribution of those involved in the process. In this way, we can say that the attitude of creating the repair nucleus was constituted as a social action, of volunteering and engagement of the participants that integrate the responses of the teaching and research institutions to the crisis of COVID-19 in Brazil. .

Augmented Reality and Its Use as a Helping Tool in Education

This work suggests the use of Augmented Reality in education to provide an additional tool to help students’ understanding of studied content through visual stimulation, while capturing their attention and motivating them to complete tasks proposed. This assistance can be especially important for online laboratories—whether remote, virtual or hybrid—since activities in these environments are often performed with no tutors present—as they can usually be done at any time and place. Due to the COVID-19 pandemic, it was not possible to apply studied theories inside classrooms;therefore, a form was structured on Google Forms and shared with 30 educators from different areas and levels of education, seeking to hear their perceptions about the use of technology in their classes. Then there was an analysis and selection of seven AR applications for both Android and iOS operating systems, which were compared to check which one seems to have greater efficiency when being handled by educators. It was concluded that the Augmania™ software would be the best option for these professionals to create AR projects and activities to be performed in their classrooms, since it presents a simple and intuitive interface, while also offering different possibilities to augment information. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

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.

Crisis Management in Tourism Destinations: Experiences from the Municipality of Maputo in Mozambique within the Context of Covid-19

The tourism sector has experienced several crisis situations due to various factors such as wars, terrorism, extreme weather events, economic recessions and pandemics. Those events adversely affect this sector. Furthermore, with the Covid-19 pandemic a number of negative impacts were observed in this sector, mainly with the limitation of the mobility of persons by the restrictions imposed in pandemic containment. Indeed, the municipality of Maputo in Mozambique is struggling with the effects of this crisis and requires a more pragmatic stance from governmental entities in managing the relevant sector's crisis. Faced with this scenario, this study assesses the crisis management in the tourism sector in the municipality of Maputo within the context of the Covid-19 pandemic. In methodological terms, besides the bibliographical consultation of works addressing management crisis in the tourism sector and the impacts of Covid-19 in Mozambique and Maputo, a documental analysis was carried out and interviews were held with managers of institutions - public and private - for data and information gathering on the impacts of Covid-19, including the counter measures outlined to face the crisis in this economic field. The data show that despite is the existence of a national entity responsible for managing crisis in the tourism sector as the Tourism Forum, and there exists the Culture and Tourism Council in Maputo, the study has concluded that since the pandemic outbreak, these management bodies have taken a few actions minimizing the negative impacts of the pandemic. On the basis of this finding, other approaches to tackling the current crisis and future ones are recommended.

Temporal analysis of meningitis and its sociodemographic risk factors in Brazil over the last decade

Background and aims: This paper aims to evaluate the risk factors for hospitalizations for meningitis in Brazil and whether COVID-19 has an influence on this process. Methods: The patients' data is from the Notifiable Diseases Information System of Brazil's Ministry of Health. The lethality and odds ratio analyses were performed in the OpenEpi software using the Taylor Series with an IC95%. The temporal analysis is from January 2010 to November 2021, collected from the Hospitals' Information System of the Unified Health System. The statistical modelling used Gretl software and the US Census Bureau's X-13-ARIMASEATS tool (1.1). The adjustment statistics were calculated using MS Excel. We also checked the influence of COVID- 19 on the subject. Results: Aetiology, age, ethnicity, region and municipal income were considered statistically significant risk factors for unfavourable outcomes in meningitis. The sex category did not show a significant difference in meningitis lethality (Table 1). Regarding the temporal analysis, the best ARIMA models were (0,1,1,) x (0,0,0) for the North region and (0,1,1) x (0,1,1) for the others regions. All models proved to be more efficient than the naive prediction (MASE <1;Theil's U<1) and obtained R2 above 85% (Table 2). The trend of hospitalizations has been negative since 2020. Least squares regression showed that the COVID-19 was statistically significant in reducing hospitalization values in all Brazilian regions. Conclusion: It is possible that the measures against Sars- CoV-2 have contributed to reducing the hospitalizations by meningitis. (Figure Presented).