Brazilian medical education and the incorporation of technologies before and during the COVID-19 pandemic

During the COVID-19 pandemic, the use of information and communication technologies (ICT) was intensified. This study aimed to investigate the incorporation of ICT in the teaching-learning process by teachers, undergraduate and graduate Medicine students from Brazilian public and private institutions, before and during the COVID-19 pandemic. Cross-sectional survey was used to perform this research, with data collection carried out from May to September 2020. Data were analyzed using descriptive statistics and thematic analysis. There were 242 participants: 153 undergraduate students, 19 graduate students, and 70 faculty members. The participants considered that the support provided by their educational institutions in 2020 for the use of ICT was ‘good’ (44.2%, 107/242) or ‘excellent’ (22.3%, 54/242). The technologies most often used in 2020 were virtual learning environments (79.8%, 193/242) and videoconferences (77.7%, 188/242). The majority of respondents prefer the ‘classroom-based’ modality (50.4%, 122/242), followed by those who prefer the occasional use of ICT (22.3%, 54/242). The participants registered 171 perceptions related to the use of ICT as a pedagogical resource and its importance during the pandemic. The respondents recognized the complementary use of ICT in their academic activities and considered that the institutional support was adequate. No financial difficulties were reported, but participants mentioned lack of training and limited use of ICT in practical activities. To overcome such gaps, the use of ICT should take into account preferences and specificities of medical education, for which institutions have to prepare themselves pedagogically. © 2022, Centro Nacional de Informacion de Ciencias Medicas. All rights reserved.

Health conditions of people on the streets during the COVID-19 pandemic in light of Nightingale’s Environmental Theory

Objective: The objective was to analyze the health conditions of people living on the streets, in the COVID-19 scenario, based on the contributions of the Environ-mental Theory. Methods: This is a theoretical-reflexive analysis. Results: Two cate-gories were developed: The dichotomy between living on the street and the Night-ingalian assumptions and;The reality of people living on the street in times of pan-demic by COVID-19. The first category addressed the difference between what is experienced by people on the street and what the Nightingalian assumptions say about health conditions. The second category showed the insertion of these people in the context of prevention measures. Final considerations: It is of fundamental importance to discuss the access to prevention and health promotion strategies by these people and to promote specific actions for the reality in which they live.

Impact of the COVID-19 pandemic on tuberculosis management in Spain.

BACKGROUND: The impact of COVID-19 on the diagnosis and management of tuberculosis (TB) patients is unknown. METHODS: Participating centres completed a structured web-based survey regarding changes to TB patient management during the COVID-19 pandemic. The study also included data from participating centres on patients aged ≥18 diagnosed with TB in 2 periods: March 15 to June 30, 2020 and March 15 to June 30, 2019. Clinical variables and information about patient household contacts were retrospectively collected. RESULTS: A total of 7 (70%) TB units reported changes in their usual TB team operations. Across both periods of study, 169 patients were diagnosed with active TB (90 in 2019, 79 in 2020). Patients diagnosed in 2020 showed more frequent bilateral lesions in chest X-ray than patients diagnosed in 2019 (P = 0.004). There was a higher percentage of latent TB infection and active TB among children in households of patients diagnosed in 2020, compared with 2019 (P = 0.001). CONCLUSIONS: The COVID-19 pandemic has caused substantial changes in TB care. TB patients diagnosed during the COVID-19 pandemic showed more extended pulmonary forms. The increase in latent TB infection and active TB in children of patient households could reflect increased household transmission due to anti-COVID-19 measures.

Decongest the Clinic—a Compulsory Experiment with Virtual Heart Failure Care In the Bronx

Introduction: At the epicenter of the COVID-19 pandemic, there was an urgent need to limit the exposure of patients (pts) to SARS-CoV-2. This required shuttering high risk areas which included outpatient offices;however, the ongoing acuity of heart failure (HF) pts concurrently mandated close follow up. To overcome this predicament, at our institution pts were asked to stay at home and engage in virtual HF visits (VHFVs) via telephone or video, in lieu of in-office visits (IOVs). The purpose of this abstract is to summarize and assess the feasibility of our initial 30 day experience with VHFVs. Methods: The Montefiore- Einstein Heart Failure service cares for over 4,000 pts who predominantly reside within the Bronx borough, and represent a vulnerable, urban, low socioeconomic population. Our team includes 12 providers consisting of both NPs and MDs. On 3/17/20 all non-urgent IOVs were stopped and as a work around a virtual platform was created within our electronic medical record system (EPIC) to facilitate VHFVs. As of April 1st, all IOVs were converted to VHFVs. We retrospectively reviewed the HF clinical volume for the month of April 2020 and as a reference compared it to the same time period in 2019. In addition, we followed high risk pts (defined as those requiring multiple visits during the month for acute decompensated HF [ADHF] or renal failure) for clinical outcomes including hospital admission. Results: Over the 30 day period from April 1-30th 2020, 510 HF pts had a total of 605 VHFVs and 17 IOVs. Seventy-five pts required ≥2 visits during this time period of which 26 pts (5%) were categorized as high risk as defined above. Providers reported that 7 (27%) of these pts would have been electively hospitalized under normal circumstances. In the 30 days following initial VHFV, 3 (12%) were urgently hospitalized, 2 of whom would have been electively admitted by provider as above, and none died. Interestingly, clinical volume and outcomes of high risk individuals was comparable in April 2019 (Table 1). Three of 12 (25%) patients with ADHF or renal failure were urgently hospitalized in the 30 day follow up period. At the time of this presentation we intend to report 90 day outcomes on all pts. Conclusion: In this preliminary analysis of an experiment that was brought on by the COVID-19 epidemic, VHFVs were not associated with substantially worse clinical outcomes over the short term. Table 1: Comparison of Visit Volumes - April 2019 vs 2020

The use of masks among brazilian nursing workers during the covid-19 pandemic

Objective: to assess the use of masks among Brazilian nursing workers during the COVID-19 pandemic. Method: cross-sectional study addressing nursing workers between March and May 2020. Data were collected online using a form addressing demographic variables and the Brazilian Portuguese version of the Face Mask Use Scale (FMUS-PB). Data were analyzed using descriptive and inferential statistics, central tendency and dispersion measures, Student’s t-test, and analysis of variance. Results: a total of 3,294 workers participated;most were nurses (85.9%), women (90.2%), lived in the southeast (36.9%), and had had contact with the COVID-19 (77.8%). The participants reported using masks in public places and at work (63.1% and 78.8%, respectively). However, only 25.8% wore masks at home. Individuals aged between 35 and 45 (p=0.002) living in the south (p<0.001) reported more frequent use of masks. Nursing technicians (p<0.001), aged ≥ 45 (p<0.001), living in the south (p<0.001), scored higher in the use of masks for self-protection and to protect others (p=0.002). Prior contact with COVID-19 resulted in the more frequent use of masks for self-protection and to protect others (p<0.001). Conclusion: the use of masks by nursing workers in public places and health settings was more frequent than at home. Additionally, masks were more frequently use for self-protection than to protect others. These results show a need to promote cultural changes toward masks for personal protection and within the family and social contexts. © 2021, Universidade Federal de Santa Catarina. All rights reserved.