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Objective: to verify associations between sociodemographic variables and factors that facilitate and hinder the transition from face-to-face psychological care to remote mode in the first year of the COVID-19 pandemic. Method: this is an analytical, quantitative, cross-sectional study. After approval by the Research Ethics Committee, data collection was performed by applying an online form consisting of 55 questions. Data were analyzed using descriptive and inferential statistics techniques. Results: the intentional sampling consisted of a total of 385 Brazilian psychologists, mostly women (67.01%), young professionals with up to five years of graduation (44.16%) most of activities in the private clinic. It was found that training time between five and 10 years was associated with a greater perception of difficulties and that previous experience with remote care facilitated adaptation in the transition from one modality to another. Conclusion: considering that call center can be a powerful tool in the health scenario, it is suggested the inclusion of remote care issues in the research agenda and syllabus in the curricula of health training courses.
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Objectives: Patients with Systemic Lupus Erythematosus (SLE) are predisposed to serious infections due to immunocompromise, comorbidities, immunomodulatory and/or immunosuppressive therapy, as well as the lack of these medications faced by patients dependent on the Sistema Unico de Saude (SUS) during the COVID-19 pandemic. Studies revealed a low risk of worsening disease activity after vaccination against SARS-CoV-2 and safety in the continuity of immunomodulatory therapy during the vaccination stages. Thus, immunization against COVID-19 is an important pillar in reducingmorbidity and mortality related to infectious conditions and SLE. This study had the objective to understand the disease activity in SLE patients after vaccination against COVID-19. Method(s): This is an observational, longitudinal, ambidirectional study with follow-up of subgroups of patients with immune-mediated rheumatic diseases immunized with vaccines made available by the Programa Nacional de Imunizacao (Butantan Institute, Pfizer/BioNTech, BioManguinhos/Fiocruz and Janssen). Data from the SLE disease activity index 2000 (SLEDAI-2 K) and sociodemographic data were collected and stored via an online platform, with a comparison of the index before and after each dose. This study was approved by the local Research Ethics Committee, and it is associated to the SAFER Project from Brazilian Society of Rheumatology. Result(s): A total of 223 patients were included, of which 83% were female and 39% had SLE, 36.7 +/- 11.76 years old. Regarding the disease activity, at inclusion the mean PGA score(SD) was 2,61 +/- 2,77. After the 1st dose it was 1.38 +/- 2.17, after the 2nd dose it was 2,35 +/- 2,99, after the 3rd dose it was 2,19 +/- 2,58 and after the 4th dose 1.18 +/- 1.88. The mean SLEDAI-2 K score at inclusion was 7,27 +/- 9,70, after the 1st dose it was 2,75 +/- 5,29, after the 2nd dose it was 4,73 +/- 6,40, after the 3rd dose 3,33 +/- 5,51 and after the 4th dose 2.12 +/- 4.27. 6% of the patients referred worsening disease activity after the 1st dose, 14,3%after the 2nd dose, and no patient reportedworsening of disease activity after the 3rd and 4th doses. Conclusion(s): Vaccination did not contribute toworsening disease activity of the SLE patientss studied, according to the indices used to assess disease activity.
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Objectives: Immunization against SARS-CoV-2 is an effective strategy to reduce morbidity and mortality in the face of the COVID-19 pandemic. People with Immune-mediated Rheumatic Diseases (IMRD) also benefited from this campaign. However, there is a limited amount of data on the outcome of vaccination in these patients, in terms of those who were infected by the virus. This study had the objective to evaluate the rate of COVID-19 cases in patients with IMRD after vaccination against SARS-CoV-2. Method(s): Observational, longitudinal and ambidirectional study with follow-up of subgroups of patients with IMRD immunized with vaccines made available by the National Immunization Plan (inactivated adsorbed vaccine registered by the Instituto Butantan (IB), recombinant vaccines registered by Bio Manguinhos/ Fiocruz and by Janssen, and Pfizer/BioNTech). Sociodemographic data and questionnaires on flu syndrome, laboratory confirmation of infection and need for hospitalization and outcomes were collected and stored via an online platform. This study is associated to the SAFER Project from the Brazilian Society of Rheumatology and it was approved by the local Research Ethics Committee. Result(s): A total of 223 patients aged over 18 years, mean age 42.79 +/- 15.18 years, were included. All were within the inclusion/exclusion criteria, with 83% being female. The main IMRD included were systemic lupus erythematosus (39%) and rheumatoid arthritis (33.6%). After the 1st dose, 1.45% of patients had COVID-19, 50% sought health services (emergency care), without the need for hospitalization and after the 2nd dose, 1.5% had the disease, of which none sought health services, required hospitalization or had a negative outcome. After the 3rd dose,: 2.9%were infected with SARS-CoV-2 one month later, 15.6% two to three months later and 5.5% four to six months later, all with laboratory confirmation;only 4% presenting any serious complication;there were no deaths. After the 4th dose, 9.1%of patients had COVID-19, of which 40%were hospitalized, without the need for assisted ventilation;half of these patients had a serious complication, but there no deaths. Conclusion(s): In this study, we observed the effectiveness of the vaccine in preventing severe cases of COVID-19 and complications of SARS-CoV-2 infection.
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Objectives: Chronic Inflammatory Immune-mediated Diseases (CIMD) can cause pain and severe discomfort to the patient, leading to significant reductions in his/her quality of life. Vaccination against COVID-19 has proven to be an efficient method in preventing cases and serious repercussions. However, there is insufficient evidence on the safety of these vaccines in the CIMD population. Objective(s): To assess disease activity in adolescent patients with CIMD after vaccination against SARS-CoV-2. Method(s): Observational, longitudinal, ambidirectional study with follow-up of groups of adolescent patients with CIMDwho received the vaccine provided by the National Immunization Program -Pfizer/BioNTech. Sociodemographic and clinical disease activity data were collected before and after each vaccine dose. Data were stored through an online platform (REDCap). This study is associated to the SAFER Project from the Brazilian Society of Rheumatology and was approved by the local Research Ethics Committee. Result(s): Nineteen adolescents aged between 12 and 17 years were included, all of whom met the inclusion/exclusion criteria. Of the total, 31.6% have Juvenile Idiopathic Arthritis (JIA)-14.33 +/- 2.25 years of age, whose subtypes included persistent oligoarticular JIA (16.7%), Polyarticular Rheumatoid Factor (RF) negative (33.3%), Polyarticular RF positive (16.7%) and Systemic (33.3%);68.4% have Systemic Lupus Erythematosus (SLE) -14.77 +/- 1.96 years of age. Regarding JIA patients, at inclusion, the mean disease activity assessed by the physician was 3 +/- 3.83 and 3.25 +/- 3.77 as assessed by the patient. After the 1st dose, the mean activity assessed by the physician was 2.8 +/- 3.9 and after the 2nd dose it was 3 +/- 4.24. Themean activity after the first dose as assessed by the patient was 3.2 +/- 3.96, and after the 2nd dose it was 2.8 +/- 3.11. In the SLE patients, at inclusion, the mean degree of disease activity was 1.92 +/- 1.83 and of the SLEDAI-2 K was 4.67 +/- 5.14. After the 1st dose, the mean disease activity was 1.11 +/- 1.96, and after the 2nd dose, it was 2.25 +/- 2.76. After the 1st dose, the SLEDAI-2 K was 1.11 +/- 1.76, and after the 2nd dose it was 4.25 +/- 5.28. No reports of worsening of disease activity after the vaccine were found. Conclusion(s): The vaccination proved not to contribute to worsening of clinical activity of rheumatic diseases in adolescents, without significant changes in SLE assessment indices and in the personal and medical assessment of JIA patients.
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Objectives: In the Chronic Inflammatory Immune-mediated Diseases (CIMD), infections mainly occur in the respiratory tract and their occurrence is related to drug-induced immunosuppression, underlying diseases and comorbidities. To reduce this morbidity and mortality, vaccination is an effective means of prevention. However, the available studies on SARS-CoV-2 vaccines have not addressed this group of patients with CIMD, and there are still many doubts regarding the indications, adverse effects, safety and efficacy of these vaccines. Objective(s): to evaluate the adverse effects of vaccines against SARS-CoV-2 in adolescent patients with CIMD. Method(s): Research associated to the SAFER Project from Brazilian Society of Rheumatology. It is an observational, longitudinal, ambidirectional study, with follow-up of groups of vaccinated adolescent patients with CIMD, vaccine by Pfizer/BioNTech. Sociodemographic data were collected, stored on an online platform, and adverse events were presented by filling in diaries issued for each patient. This study was approved by the local Research Ethics Committee. Result(s): We included 19 adolescents, aged between 12 to 17 years, who met the inclusion and exclusion criteria. The mean age was 14.63 +/- 2.01 years. Of these, 68.4% were female. In relation to CIMD, 31.6% have Juvenile Idiopathic Arthritis and 68.4% have Systemic Lupus Erythematosus. All were vaccinated with the Pfizer vaccine. In the 1st dose, the main adverse effects presented were Pain at the injection site (85.7%), Headache (42.9%), Tiredness (33.3%) and Edema and skin induration at the injection site (26, 7%). After the 2nd dose, the only adverse effect reported was Pain at the injection site (57.1%), with no other complaints. Conclusion(s): The adverse effects reported are of mild tomoderate reactogenicity;no serious adverse events were reported.
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Vaccines are an essential public health resource for disease containment and reduction of associated mortality rates. With the emergence of COVID-19, public debates on the themes of vaccines and vaccination processes became important topics on diverse media and social networking platforms. In this article, our objective was to identify and reflect on the emotions evoked in the Brazilian public with respect to the COVID-19 vaccine during 2020 and 2021 on Facebook. To achieve this, we used the Crowdtangle graphical interface to extract complete copies of posts made by public Facebook profiles during this timeframe, from which a random sample of 1,067 posts was selected for analysis. Identification of emotions was performed using the Human-Machine Interaction Network on Emotion (HUMAINE) descriptors as a baseline reference. Emotions were then grouped into categories following Core Affect Model guidelines. Data analysis and interpretation indicated a prevalence of positive emotions such as trust, interest, and hope directed toward vaccines in the Brazilian domestic scenario. Negative emotions such as worry and disapproval were also expressed, albeit in reference to contextual issues (for example, the spread of COVID-19, delays in vaccine access, and the emergence of new variants) and public figures, such as the President of Brazil. © COMUNICAR, 76 (2023-3)
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To analyze the design of educational governance for Basic Education that materialized in the first year of the Covid-19 pandemic in Amazonas, the article resumes and analyzes the decision-making of the public power on the municipal and state education systems of the capital and state between March 2020 and February 2021. Based on the Sociology of Public Action and a qualitative approach, the study that serves as the basis for this article – developed by researchers in the field of Education at the Federal University of Amazonas, based on an integrative review of the specialized literature, mapping and analysis of the actions of the education departments of Manaus and Amazonas – reconstructed the consolidated paths in the educational field in one of the epicenters of the pandemic in the country. The data reveal the complex network of public and private agents that engender the governance investigated here, the tensions between the comings and goings around the resumption of face-to-face classes, as well as alternative teaching models for the pandemic scenario and the deepening of public-private partnerships. © 2023, Ensaio. All Rights Reserved.
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Among the problems caused by the pandemic of the new coronavirus (SARS-COV-2), besides the irreparable loss of loved ones and the damage to global health caused by the disease, the restrictions imposed and the economic losses incurred by them stood out. Given the sudden changes imposed on the routine of society and companies, many businesses went bankrupt, while the other survivors needed to adapt quickly, resulting in a routine based on home office, ecommerce and distance learning. The educational sector was strongly affected by these restrictions, as well as the assets linked to it, as highlighted by the cumulative annual drop of 22% of the IFIX (index of Real Estate Investment Funds), witnessed by investors during the arrival and spread of the pandemic in Brazilian territory. Thus, the work was based on the prospective analysis of scenarios through the Momentum method, producing three possible future scenarios for the recovery of the educational REITs (Pessimistic, Optimistic, and Trend), with the help of three financial planning specialists. At the end of this study, it was possible to configure the scenarios: "The recovery of education REITs" as optimistic scenario, "Challenges of education REITs" as trend scenario, and "The crisis of education REITs" as Pessimistic scenario.
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The pandemic scenario is analyzed in this article focusing on the educational field and on the transformations and challenges faced by Basic Education schools. With the objective of analyzing the pendular tensions between suspension and return of face-to-face classes in the state of Amazonas in the first months of the Covid-19 pandemic, the article retraces educational governance in the first half of 2020. From the Sociology of Public Action, we demonstrate: the main consequences of the pandemic on education;the complex web of educational governance in times of a pandemic;and the struggles for hegemony from the movements between suspension and return of classes in schools in Amazonas.
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Post COVID-19 patients have been suffering from persistent symptoms even after long periods. The physiopathology of these clinical manifestations still has a lack of knowledge. The objective was to evaluate the total expression of metabolites and spittle biological pathways in patients with 60 days post COVID-19. We included 30 post-hospital discharge patients and we compared seven non COVID-19 patients control. All COVID-19 patients were assessed by demographic characteristics, pulmonary function, exercise capacity, quality of life and body composition. The metabolomic analysis was performed in the patient's splits. From the total of post COVID-19 patients, 66% were male, 60+/-14 years. The lean body mass was 30+/-7kg and fat mass 34+/-13kg. Spirometry mean severity showed FVC of 4+/-1L, FEV1 3+/-1L. Pimax and Pemax values were 90+/-31(cmH2O) and 97+/-31(cmH2O), respectively. The quality of life evaluated by the SGRQ questionnaire showed a mean percentage of magnitude of symptoms 32+/-15, activities 41+/-25, impact 13+/-11 and total of 24+/-15. Physical capacity was measured by the distance in the 6MWT, and presented an average of 413+/-131. The metabolomic analysis showed 19 metabolites statistically significant difference between groups. We observed 3 metabolites overexpressed and 16 with lower expression in post COVID19 patients. From those metabolites, we can have attention to Sphinganine(p=0.03), Piperenol A triacetate(p=0.02) and 1-Monopalmitin(p=0.03) were lower expressed in control group. The creatin was one of the non-expressed metabolites in post hospital discharge COVID-19 patients compared to the control group. Thus, metabolomic analysis can demonstrate different metabolites in post COVID-19 patients to answer persistent symptoms.
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During the COVID-19 pandemic that paused sports worldwide, the German Bundesliga League (GBL) and English Premier League (EPL) took two different strategic approaches to agree with their players on returning to play. To become better informed and prepared for future crisis management, this study examines consumer responses to these opposing strategies. We also identify how perceived organizational legitimacy, trustworthiness, reliance, and justifiability have an impact on consumer multimedia consumption of the games. A sample of 503 participants responded to an online questionnaire regarding the contrasting decisions taken by the GBL and the EPL during the global health crisis. SEM with multi-group analysis was conducted to test the research hypotheses. When comparing the two selected sport leagues, the league that reached an agreement with their players experienced higher levels of perceived legitimacy while needing fewer perceptions of trustworthiness, reliance, and justifiability to obtain higher multimedia consumption intention from consumers. © 2022, The Author(s).
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Antarctica is the southernmost continent of our planet, and it has been verified as the coldest region on earth. The Brazilian Antarctic Program (PROANTAR) has as its main objective the promotion of high-quality scientific research in the Antarctic region, seeking to understand the events that occur there. PROANTAR, coordinated by the Navy Commander, has some sectors that are based in Brazil and others that are located in the Antarctic continent. The military that volunteers to occupy any vacancy that is allocated to that continent needs, besides passing through several pre-established criteria, to pass the selection process. The purpose of this article is to help the Naval Administration in the selection of volunteer officers to occupy a vacancy in the Antarctic continent. To obtain the alternatives, the officers that best fit the established vacancy, and the criteria to be evaluated, Value-Focused Thinking (VFT) was applied. Next, with all the necessary data, the CRITIC-GRA-3N method was used as a Multicriteria Decision Support (MDS) technique, the CRITIC-GRA-3N method, the CRITIC Importance Through Intercriteria Correlation (CRITIC) method to obtain the criteria weights and the Grey Relational Analysis (GRA) method, with three normalizations, to order the alternatives. At the end of the application of the methods, the article can generate five ordinations of the volunteer officers to occupy the vacancy offered in PROANTAR. © 2022 The Authors. Published by Elsevier B.V.
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Investments should be decisions made by companies at a strategic level, aiming to maximize the return on invested capital. However, the evaluation required to obtain the best results demand, in addition to information about available assets, the ability of decision-makers to relate and weigh all the criteria that must be maximized or minimized to achieve the expected goal. This article plays an important role in supporting the decision making of a micro company, located in the state of Rio de Janeiro, which needs to invest the available amount in investment. In order to obtain the investment alternatives, as well as the evaluation criteria, the Value-Focused Thinking (VFT) was applied. After obtaining all necessary data, the CRITIC-GRA-3N method was used as a Multicriteria Decision Support technique, with the CRiteria Importance Through Intercriteria Correlation (CRITIC) method to generate the criteria weights and the Grey Relational Analysis (GRA) method, with three normalizations, to order the alternatives. With this, five ordinations were established, being the first three ordinations performed with the help of two normalizations and the last two ordinations being the arithmetic and geometric averages of the first three ordinations normalized with the third normalization. In the end it brought positive results to the microenterprise. © 2022 The Authors. Published by Elsevier B.V.
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In line with the losses brought about by the recent pandemic of the new coronavirus, the oil market, as well as other segments, has been facing economic difficulties to recover. Seeking to bring a practical and efficient strategy to the corporate environment, in this area, this study demonstrates a new multi-criteria method based on multi-objectives, capable of calculating the importance of each criterion, to encourage more assertive and objective decision-making to evaluate different situations in the oil industry, such as the application of resources, investments and other strategies. As a case study, a group of AHTS (Anchor Handling Tug Supply) vessels was used to supply offshore platforms and application of the CRITIC-MOORA-3N method, which allows a logical analysis of the relevant criteria and presents an objective solution, as result for the scenario that applies. © 2022 The Authors. Published by Elsevier B.V.
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Among the problems caused by the pandemic of the new coronavirus (SARS-COV-2), besides the irreparable loss of loved ones and the damage to global health caused by the disease, the restrictions imposed and the economic losses incurred by them stood out. Given the sudden changes imposed on the routine of society and companies, many businesses went bankrupt, while the other survivors needed to adapt quickly, resulting in a routine based on home office, e-commerce and distance learning. The educational sector was strongly affected by these restrictions, as well as the assets linked to it, as highlighted by the cumulative annual drop of 22% of the IFIX (index of Real Estate Investment Funds), witnessed by investors during the arrival and spread of the pandemic in Brazilian territory. Thus, the work was based on the prospective analysis of scenarios through the Momentum method, producing three possible future scenarios for the recovery of the educational REITs (Pessimistic, Optimistic, and Trend), with the help of three financial planning specialists. At the end of this study, it was possible to configure the scenarios: "The recovery of education REITs” as optimistic scenario, "Challenges of education REITs” as trend scenario, and "The crisis of education REITs” as Pessimistic scenario. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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Background The sustainability of Healthcare Services will depend on the proper implementation of the digital transformation of Primary Health Care (PHC) Services. COVID-19 Pandemic have shown precisely this, where there was pressure from health Professionals and managers for the integration of teleconsultations within the health work processes. This study aims at developing scenarios for the digitalization of PHC in the Portuguese Health System. Methods This study follows the methodology of scenario development, similar to the future of community pharmacy services scenario study. A conceptual model of PHC services was developed, based on the literature and a set of interviews. The target group was the primary healthcare professionals: family doctors, nurses, and operational assistants. The time horizon was 2032 and, by selecting actors from different regions of Portugal, it was possible to achieve broad representativeness. Results Three focus groups were conducted. The first enabled to identify the two driving forces that may influence the digitalization of PHCs in the next 10 years: 1) service innovation and 2) Governance and Regulations. These two driving forces enabled to design three plausible scenarios: a) Innovate or Fade-away;b) Isolated PHC and c) Digital PHC. These scenarios were developed, and their impacts were reflected upon. It was found that the role of human Resources is critical. Conclusions The process of reflection and discussion for the identification of the different driving forces made the different actors discuss the different points of view and find a meeting point to reach a conclusion. Furthermore, this study allowed the different stakeholders to understand the measures and actions to be taken for PHC digitization to be implemented in the most effective way, allowing the sustainability of the National Health Service in Portugal, which until this point were only ideas discussed at the institutional and individual level.
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This study analyzes the context of pregnancy, prenatal care and birth of children with Congenital Zika Syndrome (CZS). A single case exploratory study was conducted with a mother of a child diagnosed with CZS in Pernambuco, Brazil. Data were collected by an in-depth interview and content was categorized into four themes: discovery of pregnancy;conditions of prenatal and childbirth care;conditions of diagnosis and childcare;and feelings involved in the pregnancy discovery and syndrome diagnosis. This case study highlights failures in reproductive planning and in prenatal and childbirth care;unpreparedness of health professionals;and significant changes in the family's routine, which imply difficult choices under a deficient public health care. CZS epidemic uncovered problems that go beyond mosquito vector control. The current scenario highlights the vulnerabilities of these families, intensified by the emergence and consequences of COVID-19, which has further exposed the weaknesses of women's comprehensive health care and the need to maintain an articulated and resolute network in health care and surveillance. Copyright © 2022, Universidade de Sao Paulo. Museu de Zoologia. All rights reserved.
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AFRICAN DEVELOPMENT : Critical climate change and health action needs to be considered globally post the COVID-19 pandemic. The WHO Climate Change and Health Special Report outlines 10 priority recommendations to be considered by nations and adopted at COP26. The special report provides South Africa with the opportunity to consider how the priority recommendations can be implemented locally
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The coronavirus Covid-19 pandemic has caused an unprecedented global crisis. From the economic scenario until the Indigenous people’s lifestyle, including the typically capitalist society, has been significantly reshaped. As invisible characters in History, the Indigenous people of Paraná have been socially isolated and may be under non-measurable inequalities, misleading statistics, and limited support by the health institutions. This study aimed to analyze the vulnerabilities and resilience responses of the Indigenous people of Paraná to the Covid-19 pandemic and discuss the underreporting and inconsistency of data on confirmed cases and deaths by Covid-19 based on state and national health institutions. This research consists of descriptive and qualiquantitative analysis conducted online that lasted ten months in which: (i) data from two governmental health institutions responsible for monitoring Covid-19 among the Indigenous people of Paraná and two Indigenous were collected and compared;and (ii) perceptions from the Indigenous people of Paraná through interviews and responses to the considered problem at indigenous organizations. As non-conclusive results, it is mentioned: (a) the confirmed cases and deaths by Covid-19 among Indigenous people of Paraná were discrepant according to the considered health institutions;(b) the Indigenous people of Paraná have probably got limited access to health services, including the lack of Covid-19 testing that may be influencing on the underreporting data, and (c) the transparency of methods of data collection and publishing has been inadequate among the studied health institutions. © 2022 Universidade Federal do Parana. All rights reserved.