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In this article, of an essayistic nature, we aim to present theoretical-conceptual foundations in the field of discourse and communication that allow us to reflect on epidemics as discursive realities (Maingueneau, 2020). For this, we revisit research developed by Bessa (1997;2002), Treichler (1987), Daniel and Parker (2018) and Santos Filho (2020) on the HIV/aids epidemic and tension the contemporary experience of the COVID-19 pandemic in a mediatization scenario. From our reflection, we propose, as a result, the expansion of the concept of discursive epidemic as a set of imaginaries created and shared discursively by different social spheres, in a context of mediatization and excess of statements on a certain theme, expressing certain dominant worldviews in a given society and at a given moment, but which, through proliferation and lasting reiteration without mutability, are consolidated in the collective memory in such a powerful way as to be frequently remembered.
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Surveillance of health care–associated infection (HAI) is the foundation of infection control and one of the first steps in infection prevention. Traditionally, however, surveillance is performed by infection control professionals (ICPs) who manually review patients' records, searching for defined criteria. Such an approach leaves room for subjective interpretation, resulting in low interrater reliability. Moreover, depending on the surveillance method used — for instance, a search based on antimicrobial results — it may have low sensitivity. In Brazil, leaders at Tacchini Hospital and Qualis, a startup that offers infection control advisory and antimicrobial stewardship, have developed a machine-learning–algorithm robot that has been demonstrated to be a reliable tool for identifying patients with HAIs using a semiautomated method. The performance of this infection surveillance assistant (ISA) robot shows optimal sensitivity, specificity, accuracy, and negative predictive values, and the precision (positive predictive value) is acceptable. The ISA robot identified more patients with HAIs than did the infection control manual surveillance reference. The time spent on patient review was also reduced compared with that spent on manual surveillance. The robot detected HAI in one of every two or three patients reviewed in the interface. The years of the Covid-19 pandemic have highlighted the problem of the shortage of health care professionals, including ICPs. Tacchini Hospital and Qualis aim to increase infection control efficiency, enabling these professionals to spend more time on inpatient wards, implementing care bundles, than handling office activities, such as manual surveillance. In this study, the authors describe the implementation of semiautomated surveillance in a single center, but expanding the model for different patient scenarios and multiple centers should be the future for external validation of machine-learning surveillance. Such models have the potential for generalization because they do not depend only on fixed rules for HAI classification, but they can also learn from data sets in different patient population settings. © 2022 Massachusetts Medical Society. All rights reserved.
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The Agile approach is focused on individuals and customer satisfaction, based on the dynamic and streamlined work of a team that is capable of adapting, and adapting the project to changing scenarios and demands. However, amidst the COVID-19 pandemic, Agile teams accustomed to in-person communication have encountered the challenges of working from home. The main objective of this research is to analyze the challenges generated by the pandemic context, and the consequent social distance, for the development of software projects that use Agile approaches within a large state-owned company and identify the effect it had on the course and results of the projects. The research was qualitative in nature and had two exploratory diagnostic stages. The findings indicate that there were no negative impacts of relevance on project deliveries. On the one hand, results indicated losses in socialization, in spontaneous exchanges of knowledge, and in interaction among teams, as well as a demand for greater engagement of professionals. Additionally, limitations were revealed for more complex discussions and knowledge management. The study highlights solutions that were found and/or suggested for many challenges, contributing to the literature on best practices for the Agile approach, and is focused on the unprecedented context of the COVID-19 pandemic. Our findings can contribute to other companies with a similar profile that work with Agile projects, besides contributing to building a dialogue between the academic and business environments. © 2023 Brazilian Institute for Information in Science and Technology. All rights reserved.
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Backgroung: Brazil was slow to implement an expanded testing policy for COVID-19, which may have affected the most vulnerable population's access to testing services. Objective: to evaluate the factors associated with performing the molecular test for COVID-19. Methods: cross-sectional study of secondary data from the COVID-19 panel in the state of Espírito Santo. COVID-19 suspicion notification forms were included between September 11, 2020 and March 2, 2021. Hierarchical logistic regression was used to estimate the odds ratio (OR) with 95% confidence interval (CI95%). Results: 419,771 notification forms were analyzed. The prevalence of performing the molecular teste for COVID-19 was 81.1% (CI95% 81.0-81.2). Elderly (OR= 2.70 – CI95% 2.56-2.85), health professional (OR=1.43 – CI95% 1.36-1.50), chronic cardiovascular disease (OR=1.13 – CI95% 1.09-1.17), diabetes mellitus (OR=1.07 – CI95% 1.01-1.14) and hospitalization (OR=5.95 – CI95% 4.53;7.82) were more likely to have undergone the molecular test. Male sex (OR=0.96 – CI95% 0.94-0.98), black skin color (OR=0.75 – CI95% 0.73-0.78), yellow skin color (OR=0.74 – CI95% 0.71-0.77), residing in the northern health region (OR=0.37 – CI95% 0.36-0.39) and the homeless population (OR=0.76 – CI95% 0.67-0.85) had the lowest chance of having undergone the molecular test. Conclusion: Social, economic, contextual factors and the risk of aggravation of the disease were associated with carrying out the molecular test for COVID-19 in the state of Espírito Santo. Actions are needed to guarantee the access of the most vulnerable population to molecular testing. © The authors (2023), this article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4. 0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1. 0/) applies to the data made available in this article, unless otherwise stated.
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The development of pedagogical activities through remote teaching became common during the pandemic. Based on a survey carried out by the National Confederation of Municipalities, a set of heterogeneities was identified regarding the actions adopted in the area of education in Brazil. This study finds support in the concept of state capacities and aims to deepen the understanding of the factors that contributed to the increase of municipalities' capacity to respond to the crisis. A regression was performed considering a set of variables linked to the characteristics of the local governments. It was concluded that variables related to technical-administrative and political-relational capacities related to the existence of participatory channels were fundamental in this process.
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In the last decade, we have witnessed a growth of contestation movements against touristification on the global scale. Before the COVID-19 pandemic, the intensive, disordered flux of travelers in some popular destinations was blamed for negatively affecting the everyday life of local inhabitants. One effect was the degradation of their intangible cultural heritage (ICH), including culinary legacies, and more research has focused on this issue from different disciplinary areas. However, the approaches usually adopted only consider the immediate consequences of the ongoing phenomenon that can be observed during a field enquiry. This paper explores a new path. Assuming that cultural heritage is a long-term social construction, an historian's outlook is needed to see the big picture. The case study of the Madeiran cuisine allows us to understand to what extent receiving guests has long-term effects on the ICH of host communities. Madeira is one of the oldest destinations of the world, with a hospitality industry in activity since the early 19th century. Additionally, numerous documents attest the evolution of dietary patterns of the insular society, not only at this period, but also before and after. From this point of view, it is an excellent place to monitor the socio-cultural impact of tourism. Historical sources from different periods are confronted to understand the dynamic of the culinary repertoire in the archipelago. The point of view of local stakeholders currently involved in this arena are also considered. The results obtained by this diachronic approach enable us to relativize the Manichean vision of holidaymakers as a threat to cultural heritage, demonstrating that touristification studies should take into account the longue durée. © 2022, Ponteditora. All rights reserved.
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This article aims to present an epistemological discussion based on the assumption that, in times of Covid-19, Humanities and Social Sciences are equally important to monitor the effects of the new coronavirus in society. Although research aimed at the development of medicines and vaccines attract more attention during pandemics, the extent of social phenomena also needs to be investigated based on an analysis that encompasses the vast knowledge of the field of Humanities and Social Sciences. Therefore, we criticize the misleading way the concept of Science has been used to prescribe, discussing publications on the social network Twitter, which is widely used by the current Brazilian government to create hierarchies and distinctions in the scientific field. We argue about the need to understand science in a meaningful and socially referenced way.
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Context: Social distancing measures to reduce the impacts of the COVID-19 pandemic bring challenges for several organizations and their Information Systems (IS). Problem: Social distancing were suddenly implemented, with no adequate planning. Furthermore, there is not a clear understanding of the impacts of social distancing measures on the software development teams' work. Solution: This study aims to identify the presence and impacts of social distancing on collaboration between people, as well as on activities and technologies used in software development, from the perspective of professionals who work in software development teams. IS Theory: The research was developed under the aegis of the Team Resilience Theory. Method: A field study was conducted based on structured interviews and qualitative analysis. Results: In general, it was observed no impact on the software processes activities, although their performance was affected. It was also observed that the impact on the collaboration dynamics in software development was perceived in different ways, by several team members. This study identified the most common tools used by organizations, as well as the benefits and challenges of collaboration in software development after social distancing measures. Contribution: The impacts of social distancing on collaboration in software development were identified, reinforcing the Team Resilience Theory and similar study conducted in the beginning of the COVID-19 pandemic. This study contributes to the Grand Research Challenge "Systemic and Socially Aware Perspective for Information Systems". © 2022 ACM.
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Objective: To compare absenteeism in Hospital Nursing before and during the COVID-19 pandemic. Method: A cross-sectional study. It involved compilation of the records of absence from Nursing work at a university hospital in southern Brazil in March, April and May 2019 (n=622) and during the same period in 2020 (n=475). The data were analyzed by means of descriptive and analytical statistics. Results: Both periods presented the same absence frequencies in women (98.4%;98.3%), aged between 40 and 49 years old (47.9%;44.8%) and working in wards for adults (30.7%;29.2%). Absenteeism-Disease was the most prevalent cause (48.4%;48%). The absolute number of absence cases was higher in the prepandemic period;however, the time in days and hours lost, as well as the absenteeism rate (13.9;18.6%), was significantly higher (p-value<0.001) in the current pandemic period. Conclusion: The COVID-19 pandemic exerted an impact on the increase in Hospital Nursing absenteeism. © 2022, Universidade Federal de Santa Catarina. All rights reserved.
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COVID-19 rapidly spread across the world in an unprecedented outbreak with a massive number of infected and fatalities. The pandemic was heavily discussed and searched on the internet, which generated big amounts of data related to it. This led to the possibility of attempting to forecast coronavirus indicators using the internet data. For this study, Google Trends statistics for 124 selected search terms related to pandemic were used in an attempt to find which keywords had the best Spearman correlations with a lag, as well as a forecasting model. It was found that keywords related to coronavirus testing among some others, such as "I have contracted covid", had high correlations (0.7) with few weeks of lag (4 weeks). Besides that, the ARIMAX model using those keywords had promising results in predicting the increase or decrease of epidemiological indicators, although it was not able to predict their exact values. Thus, we found that Google Trends data may be useful for predicting outbreaks of coronavirus a few weeks before they happen, and may be used as an auxiliary tool in monitoring and forecasting the disease in Brazil.
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The phenomenon called infodemia refers to the increase in the volume of information on a specific topic, which multiplies rapidly in a short period of time, and has stood out in the context of the health crisis triggered by the COVID-19 pandemic. Too much information can trigger feelings of fear, anxiety, stress, and other conditions of mental distress. The study aims to describe the profile of exposure to information about COVID-19 and its repercussions on the mental health of elderly Brazilians. This is a cross-sectional study carried out with 1924 elderly Brazilians. Data were collected through a web-based survey sent to the elderly via social networks and email, from July to October 2020. The results of the descriptive analysis of the data show that most of the elderly were aged between 60 and 69 years (69.02%), female (71.26%), married (53.79%) and white (75.57%). About 21.67% (n = 417) concluded their graduation, 19.75% (380) concluded their specialization and 16.63% (320) concluded their master's or doctoral degrees. Television 862 (44.80%) and social networks 651 (33.84%) were reported as frequent sources of exposure to news or information about COVID-19. Participants indicated that television (46.47%;n = 872), social networks (30.81%;n = 575) and radio (14.48%;251) affected them psychologically and/or physically. Receiving fake news about COVID-19 on television (n = 482;19.8%) and on social media (n = 415;21.5%) mainly resulted in stress and fear. The disseminated information contributes to awareness, but also affects physically and/or psychologically many elderly people, mainly generating fear and stress. © 2022, Centro Nacional de Informacion de Ciencias Medicas. All rights reserved.
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About seven months after the start of the COVID-19 pandemic, the first vaccine against the disease was approved for emergency use. Since then, twenty-three more vaccines have been approved, while more than three hundred are in development. Despite being one of the fastest vaccines ever created, several questions about it remain open. Computational models can be useful to answer some of these questions. This paper aims to evaluate whether a computer model previously used to reproduce the effects of the yellow fever vaccine in the body is also capable of reproducing the effects of a distinct vaccine: ChAdOx1 nCoV-19. Preliminary results show that the model is a promising tool to achieve this goal since it was able to reproduce the antibody curves observed in individuals vaccinated with ChAdOx1 nCoV-19. © 2021 IEEE.
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Introdução: a Mucormicose é uma infecção fúngica extremamente rara e grave, causada por fungos da ordem Mucorales, a qual pode ser classificada em 6 categorias: cutânea, rinocerebral, pulmonar, gastrointestinal, disseminada e formas raras incomuns. A manifestação clínica imediata varia de acordo com a topografia e o seu diagnóstico frequentemente é atrasado devido a inespecificidade dos sintomas, sendo os exames padrão-ouro para o diagnóstico a biópsia e a avaliação histopatológica dos tecidos infectados. Em relação ao tratamento, este pode ser feito cirurgicamente pelo desbridamento da lesão, ou por meio de antifúngicos, na qual a Anfotericina B com formulação lipídica é o medicamento de primeira escolha. Descrição do caso: Paciente pediátrico do sexo masculino, 10 meses de vida, sem diagnóstico de doenças prévias e com RT-PCR negativo para COVID-19, apresentando lesão aparentemente infiltrativa em face há 4 meses. Foi transferido de hospital oncológico infantil para o Hospital Universitário João de Barros Barreto, referência no tratamento de doenças infecciosas, após a biópsia descartar neoplasia maligna e sugerir infecção fúngica. Neste hospital, o paciente foi admitido acompanhado da mãe, em bom estado geral, sem queixas clínicas, apresentando os resultados diagnósticos do histopatológico e da tomografia computadorizada dos seios da face, os quais demonstraram lesão expansiva, heterogênea e infiltrativa no tecido subcutâneo, compreendendo a área ocular, interocular frontal e nasomalar direita, com inflamação crônica apontando granuloma, necrose e estruturas fúngicas sugestivas de mucormicose. Em sua admissão, realizou exames laboratoriais, os quais apresentaram discreta anemia, microcitose, anisocitose e leucocitose, além de função renal e hepática preservadas e ionograma sem alterações significativas. Iniciou antibioticoterapia no primeiro hospital e deu prosseguimento com Anfotericina B Complexo Lipídico após transferência para o tratamento da mucormicose. Ao finalizar o processo terapêutico, obteve alta hospitalar, na qual a mãe foi instruída a realizar hidratação da pele do bebê, e orientada acerca do tratamento para a anemia e da necessidade de acompanhamento com imunologista. Comentários: Ante o exposto, é imperioso que o diagnóstico seja feito precocemente, para que o manejo da infecção seja o menos traumático e com a menor quantidade de sequelas possíveis para o paciente.
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Background: The novel coronavirus emerged in 2019 in Wuhan has caused a global pandemic of coronavirus disease (COVID-19). Immune-mediated diseases (IMID), as inflammatory arthritis or inflammatory bowel disease (IBD), have some special implications due to their pathogenesis and treatments. Some treatments employed in IMID are now being used in the treatment of severe COVID-19. There still exists controversy about IMID behavior and its complications. 1, 2 Objectives: To assess COVID-19 severity in IMID patients and its prognosis predictors. Methods: An observational retrospective multicenter study was performed in two Spanish Hospitals (Clinical University Hospital in Santiago De Compostela and Gregorio Marañón Hospital). Patients were selected if they were diagnosed of an IMID (rheumatoid arthritis, psoriatic arthritis, espondyloarthritis, ulcerative colitis and Crohn's disease) and had COVID-19 infection between February and April 2020. Demographic, clinical, analytical and treatment data were collected. Logistic regression was used to evaluate potential predictors. Stata 15.1 was used to perform statistical analysis. Results: 91 patients were recruited. 55 suffered from a rheumatic disease and 36 suffer IBD. Baseline characteristics are shown in Table 1. Univariable analysis reached age, comorbidity, female gender, flu vaccine, arthropathy, basal classical synthetic anti-rheumatic drugs (csDMARD), pneumonia and basal C-reactive protein (CRP) as potential predictors of non-severe (absence of death, respiratory insufficiency, intensive care unit admission or sepsis) COVID-19 disease (p < 0.2). After multivariable analysis, only female gender (OR 4.60 [CI95% 1.00, 21.2] p=0.050), lower age (OR 0.94 [CI95% 0.88, 1.00] p=0.042) and lower basal levels of CRP (OR 0.87 [CI95% 0.77, 0.97] p=0.010) were predictors for non-severe disease (p < 0.005). Mean time of healing (symptoms solved in outpatient and hospital discharge in admitted) from COVID-19 was 13.8 days (SD 16.3). Univariable analysis showed arthropathy, COVID-19 symptomatic and basal glucocorticoids (GC) dose as potential predictors of higher time-to-healing from COVID-19 disease (p < 0.2). After multivariable analysis, only lower GC basal dose predicts higher time-tohealing (OR -1.83 [CI95% -2.81, -0.84] p=0.001). 11 patients deceased because of COVID-19. Univariable analysis reached age, basal csDMARD, pneumonia and basal CRP as potential predictors of COVID-19 mortality (p < 0.2). After multivariable analysis, only higher age was a predictor for mortality (OR 1.14 [CI95% 1.04,1.25] p=0.006). Conclusion: IMID patients showed similar predictors of mortality than general population involving COVID-19. Immune-modulating agents did not seem to overshadow the prognosis of COVID-19 infection. Female gender, lower age and lower basal CRP could select a cohort of “good” prognosis patients with mild COVID-19 disease as well higher age points out the worst prognosis. Even that, each case should be individiualized.
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Background: Chloroquine (CQ) and hydroxychloroquine (HCQ) have been employed in a huge range of indications, from autoimmune diseases (such as rheumatoid arthritis [RA], cutaneous lupus or systemic erythematosus lupus [SLE]) to infectious ones (as malaria or helminthiasis).1 A newer purpose came upon the new coronavirus disease 2019 (COVID-19), where they seem to be effective modulating immune response. Controversial results have been published from clinical and observational data concerning its effectiveness.2 Ocular toxicity have been described as a serious adverse event of these antimalarial drugs and screening protocols have been displayed for its prevention.3 Objectives: To evaluate CQ/HCQ ocular toxicity and to identify potential predictors of appearance. Also to asses screening protocols compliance. Methods: Demographic, diagnostic and treatment data were collected from patients under CQ or HCQ treatment in the Clinical University Hospital in Santiago De Compostela (Spain) during the first wave of the COVID-19 pandemic (January to April 2020). Univariable logistic regression was performed to identify potential predictors of maculopathy. Variables with p<0.20 were selected for multivariable testing. Stata 15.1 was used to perform statistical analysis. Results: 503 patients taking CQ/HCQ were identified. 495 were women. Most frequent diagnosis were SLE (48.28%), cutaneous lupus (22.85%) and rheumatoid arthritis (RA, 12.54%). Mean age at diagnosis was 44.99 years (SD 17,88). 93.33% of patients were under treatment with HCQ. Mean age at beginning of CQ/HCQ treatment was 48.10 years (SD 17.79) and mean time between diagnosis and CQ/ HCQ onset was 2.03 years (SD 5.50). Mean maximum HCQ dosage per patient was 3.83 mg/kg (SD 1,59;252.57 mg per day, SD 89.98) and CQ was 3.24 mg/kg (SD 1,91;219.49 mg per day, SD 103.90). Mean time under CQ/HCQ treatment was 6.39 years (SD 5.63). 20 patients developed maculopathy. Mean time between CQ/HCQ onset and maculopathy appearance was 2.67 years (SD 3.10). Only 25 patients did not complete ophthalmologic exams for maculopathy screening. After univariable analysis, higher age at diagnosis and age at beginning of CQ/ HCQ treatment were identified as potential predictors of maculopathy (p<0.20). After multivariable analysis, both higher age at diagnosis and higher age at CQ/ HCQ onset were identified as predictors for suffering maculopathy under treatment with CQ/HCQ (OR 1.06 [CI95% 1.03-1.10] p=0.000 and OR 1.09 [CI95% 1.02-1.16] p=0.008, respectively). Conclusion: Ocular toxicity remains as one of the most harmful and disabling adverse events in patients under CQ/HCQ treatment. Higher age at diagnosis and higher age at beginning of treatment appear to be risk factors for maculopathy appearance. Screening protocols are well-assumed by patients and seemed to be helpful for preventing and early identifying events. CQ/HCQ usage in COVID-19 patients should be individualized, specially in older patients, and protocols involving ocular toxicity should be implemented in the follow-up of this population.
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The first case of Corona Virus Disease (COVID-19) was registered in Wuhan, China, in November 2019. In March, the World Health Organization (WHO) declared COVID-19 as a global pandemic. The effects of this pandemic have been devastating worldwide, especially in Brazil, which occupies the third position in the absolute number of cases of COVID-19 and the second position in the absolute number of deaths by the virus. A big question that the population yearns to be answered is: When can life return to normal? To address this question, this work proposes an extension of a SIRD-based mathematical model that includes vaccination effects. The model takes into account different rates of daily vaccination and different values of vaccine effectiveness. The results show that although the discussion is very much around the effectiveness of the vaccine, the daily vaccination rate is the most important variable for mitigating the pandemic. Vaccination rates of 1M per day can potentially stop the progression of COVID-19 epidemics in Brazil in less than one year. © 2021, Springer Nature Switzerland AG.
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To describe the impacts on the mental health of health professionals in the face of the pandemic by COVID-19. An integrative literature review study, searching for articles in the LILACS, SciELO, MEDLINE, SciVerse Scopus databases published in 2020. 169 articles were found, of which 18 met the eligibility criteria. The most prevalent impacts on mental health for health professionals due to the COVID-19 pandemic were anxiety, depression, followed by feelings of fear, stress and insomnia. Nurses are the most affected health professionals followed by doctors. Health professionals experience a unique moment due to the COVID-19 pandemic, in which their mental health has been a concern. Studies are suggested to increase the visibility of collaborative problems for illness in mental health of professionals, their importance and the high rate of causing damage to mental integrity, which may be in effect in the short to long term.
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With the arrival of COVID-19, the scientific community was mobilized, not only in researches in the biomedical field but also in searching for ways to support professionals working on the front lines of fighting the virus. In the context of information systems (IS), several systems were developed to contribute to this collective effort. In this study, we provide an overview of the profusion of systems designed to support the fight against COVID-19. To achieve this goal, a systematic mapping of the state of art was carried out in patent documents in 2020. The study compared the national technological production to the international scenario and listed the main challenges regarding technological production during COVID-19. © 2021 ACM.
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The aim of this paper is to demonstrate the impact of the COVID-19 pandemic on families through their relation with social protection, focusing especially on health policy. The importance of Sistema Unico de Saude - SUS for working-class families in the face of the pandemic is indubitable, even as the federal government continually neglects and dismantles Brazil's social protection system. The pandemic comes to further unveil the country's profound social inequality, which turns families socially vulnerable to COVID-19. It would be salubrious for health services to be preserved and enlarged so that they could cater for the social needs of the families, both before the COVID-19 pandemic as well as other health-related issues. Resuming the State's central role as the leader in the fight of the pandemic, together with a strengthening and extension of Brazil's social protection through social security, is imperative.