The reinvention of the Agroecological and Solidarity Economy Fair of Cameta (PA) in the midst of the Covid-19 pandemic

The article analyzes the challenges and marketing strategies of farmers at the agroecological fair in the municipality of Cameta-PA during the Covid-19 pandemic. Data collection was based on documentary analysis of the fair's marketing records from March/2020 to March/2021 and semi-structured interviews with farmers, fair organizers and consumers. It was found that mobility difficulties, road closures and the fear of being contaminated were factors that were harmful to the progress of sales, especially in the first three months. Despite this, the virtual marketing alternative was a wise strategy. 94% of customers said they would like to stay with the virtual purchase even after the pandemic. Thus, it is concluded that virtual marketing was a strategy that favored both the farmer and the customers, emerging as an alternative to the flow of rural family production and to guarantee food security for farmers and consumers.

Consumption of bee products during the COVID-19 pandemic in Piaui

The aim was to investigate the use of bee products in Piaui state during the COVID-19 pandemic. To that end, data were collected remotely via an online form sent on WhatsApp and Instagram. Sampling was stratified considering the four mesoregions of Piaui and the sex of the participants using the Survey Monkey calculator. After stratification, the study contained 392 participants. A total of 85.46% of the interviewees reported regularly consuming bee products, primarily (24.78%) due to their nutritional potential. During the pandemic, 79.34% used bee products, honey being the most consumed (59.16%), followed by propolis honey (26.04%) and propolis alone (4.82%). With respect to COVID-19-related use, 23.47% and 3.21% of the subjects related consumption for disease prevention and treatment, respectively. In general, there was a 37.24% increase in the consumption of bee products during the pandemic, but most of the participants (52.05%) did not know the extent of the increase.

Acidente Vascular Encefalico Isquemico Associado a Plaquetopenia Apos Vacinacao Para Covid-19

Objetivo: Relatar caso de Trombocitopenia Trombotica Imune induzida por Vacina (VITT) ocorrido na cidade de Uberaba - MG. Resultado: Paciente, 22 anos, admitida no dia 14/04/22 em Pronto Atendimento (PA) da cidade de Uberaba devido quadro de cefaleia, febre e plaquetopenia. Pela suspeita de dengue, foi internada em Unidade de Terapia Intensiva, onde realizou AngioTC de cranio, sem evidencia de tromboses ou sangramentos. Dado inicio de recuperacao plaquetaria e estabilidade clinica, recebeu alta hospitalar dois dias apos. Os testes laboratoriais para dengue foram negativos. Entretanto, retornou ao PA depois de 8 dias devido a rebaixamento do nivel de consciencia, com exame de imagem evidenciando isquemia em lobo parietal esquerdo com transformacao hemorragica. Propedeutica laboratorial mostrava plaquetopenia moderada, dimero D elevado (12.670) e hipofibrinogenemia. Dada a informacao sobre historico de vacinacao com Astrazeneca 10 dias antes de abertura do quadro, foi levantada suspeita de VITT e iniciada terapia com imunoglobulina humana e corticoide em dose imunossupressora, e solicitada pesquisa de anticorpos Antifator-4-Plaquetario (anti-F4P). A anticoagulacao foi contraindicada devido a gravidade do sangramento em sistema nervoso central e previsao de possivel abordagem cirurgica. Apesar da terapia instituida, paciente evoluiu com novas complicacoes tromboticas em outros sitios (pulmonar e membro inferior) e novas areas de isquemia em sistema nervoso central associado a sangramento, culminando no obito 6 dias apos a readmissao. Posteriormente, o resultado do anti-F4P foi liberado como reativo em altos titulos (IgG: 2996, IgM + IgA + IgG: 2631 sendo o valor de referencia menor que 0,4), preenchendo assim os criterios diagnosticos para VITT. Discussao: Durante a pandemia de COVID-19, em resposta ao crescente numero de casos e mortes, e ao consequente impacto economico e social resultante, vacinas foram desenvolvidas e administradas em campanhas de vacinacao no mundo inteiro. Neste contexto, efeitos colaterais raros associados a vacina comecaram a ser observados. Dentre eles, destaca-se a VITT, a qual e uma condicao rara e grave, descrita quase exclusivamente apos a AstraZeneca-Oxford e Johnson & Johnson, sem predominio entre os sexos, e com maior risco relatado em individuos mais jovens. O principal mecanismo fisiopatologico descrito, assim como ocorre na trombocitopenia induzida por Heparina (HIT), e o desenvolvimento de anticorpos contra o fator-4-plaquetario, porem a forma como a vacina induz esta resposta imunologica ainda nao e bem compreendida. Clinicamente apresenta-se como uma coagulopatia que se desenvolve 5 a 30 dias apos a vacinacao, com trombose venosa e/ou arterial, plaquetopenia, D-dimero elevado e hipofibrinogenemia, alem da presenca de anti-F4P. O tratamento assemelha-se ao de HIT, baseando-se em modulacao da resposta autoimune e anticoagulacao (opcoes sem heparina). A paciente descrita apresentou todos os criterios definidores de VITT. Conclusao: A VITT e uma entidade de identificacao recente, com poucos casos descritos em literatura, e, portanto, com fisiopatologia, clinica e arsenal terapeutico ainda em estudo. Os estudos evidenciam alta taxa de mortalidade, principalmente em pacientes que evoluem com complicacoes hemorragicas. A divulgacao de casos clinicos visa enriquecer o conhecimento disponivel sobre esta condicao e ressaltar a importancia da suspeicao precoce e instituicao de terapia direcionada. Copyright © 2022

ASSESSMENT OF FEAR AND STRESS BY THE ELDERLY IN THE NEW CORONAVIRUS PANDEMIC: A CROSS-SECTIONAL STUDY

Objective: to identify the main fears and level of stress regarding the New coronavirus pandemic in the aged. Method: cross-sectional, analytical study based on a non-probability sample by convenience composed of 25 elderly users of a public square in the municipality of Belém, Pará, Brazil, conducted from January to June 2021. The sociodemographic questionnaire, New coronavirus fear scale, and perceived stress scale were applied. The parametric t-test (p<0.05) was used. Results: the average age was 67.6 years, predominantly female (72%). It was evidenced that the elderly presented a moderate level of fear (p0.001) related to the fear of COVID-19 (t=0.26). Moderate level of perceived stress (p0.001) related to irritability caused by the out-of-control situation (t=0.00) prevailed. Conclusion: perceiving fear and stress in the elderly contributes to the development of actions by professionals to promote mental health in times of pandemic. © 2022, Universidade Federal do Parana. All rights reserved.

CIPA and COVID 19: occupational prevention and safety

The current moment of the COVID-19 pandemic has caused several interferences in the world of work, ranging from the suspension of countless work activities to the precariousness of health and safety conditions, causing accidents and illnesses in workers. Since December 2019, the world has been impacted by COVID-19, with several changes in society, no different for Labor Law. The role of the Internal Accident Prevention Commission (CIPA) in preventing COVID-19 and the risks to worker health and safety is of paramount importance so that work environments are safe and healthy. The research discusses legal aspects for CIPA's role in the prevention of accidents and diseases at work, as well as the prevention of COVID-19 in the context of work environments. Making use of bibliographic and documentary research, supported by the analysis of occupational health and safety standards, using the deductive method, it addresses legal aspects of CIPA's work, as a diffuser of preventive measures in the workplace. There is legal support for the CIPA to implement its attributions and its work program in order to prevent accidents and illnesses at work and, consequently, provide beneficial results for the company, the worker and society in general. The present study concludes by indicating that further investigations on the subject should be continued, in order to further clarify these approaches.

Adapting academic contexts to the COVID-19 times

Introduction: In December 2019, China reported to the World Health Organization a cluster of pneumonia in March 2020 has classified as pandemic. Given the situation, ESEnfC, based on the rules and guidelines sent by DGS, reorganized teaching activities, face-to-face work and adapted spaces to minimize the impact of COVID-19, adopting preventive measures and control procedures at the level of risk. Objectives: Describe the implementation of preventive measures at ESEnfC. Methodology: Experience report. Results: number of cases retrieved 141 students (9.51%);13 employees (6.81%);active surveillance 244 students (16.45%);24 employees (12.57%) - 1557 tests. Conclusions: the implementation of guidelines, actions and correction of applied measures impact in the epidemiological control of COVID-19. The unexpected risk led ESEnfC to adjust its operation to the established permissions, safeguarding the interests of students in carrying out their academic year with the least possible harm. Encouraging the sharing of information and adopting a positive change in relation to the culture of safety and prevention of COVID-19 infection was the purpose of ESEnfC.

Acupuncture for healthcare workers during the COVID-19 pandemic: The experience of a University Hospital in southern Brazil

Introduction: Complaints related to mental health and psychiatric illnesses have emerged since the beginning of SARSCoV- 2 pandemic, especially among health-care workers (HCWs). Acupuncture could be a useful tool in this context. Objective: To describe the experience of using acupuncture in an integrative initiative at the University Hospital of the Federal University of Santa Catarina (HU-UFSC) to provide care to HCWs with medical disorders that have emerged or aggravated during the pandemic. Methods: HU-UFSC has implemented a contingency plan to cope with the new demands that emerged as a result of the SARS-CoV-2 pandemic. Within this contingency plan, a support team to HU-UFSC's HCWs was established. The initiative offered a comprehensive integrative approach that included acupuncture, psychiatry, psychology and homeopathy. HCWs sought support as they presented evolving symptoms or worsening of chronic conditions. Results: From April 2020 to July 2020, the acupuncture team completed a total of 340 appointments. Most patients were treated with acupuncture once a week for approximately 4 weeks. A survey of chief complaints showed that 83% of patients had mental health complaints. Among those, 56% had concurrent pain disorders;10% sought care for pain conditions exclusively and 7% reported other complaints. Mental health-related complaints were mostly associated with worsening of preexisting conditions, mainly anxiety, followed by irritability and sleep disorders. We observed a large number of patients with acute chronic pain associated with mental health complaints (56%). The three acupuncture medical professionals and two acupuncture residents involved in this project observed a significant improvement in symptoms among HCWs treated with acupuncture. In addition, the integrative approach facilitated the process of coping with suffering triggered by the pandemic. Conclusion:The present experience of using acupuncture for workers in a Brazilian university hospital setting suggests that acupuncture may help individuals suffering from mental health issues triggered by the pandemic.

Evolution of mortality over time: results from the COVID-19 Swiss hospital surveillance system (CH-SUR)

Introduction: The assessment of COVID-19 associated mortality is crucial to evaluate the impact of the pandemic and to assess the effectiveness of measures. Objectives: We aimed to investigate trends in COVID-19 related mortality over time in Switzerland, using data from the COVID-19 Hospitalbased Surveillance (CH-SUR) database. Methods: Considering four different time periods of COVID-19 epidemic, we calculated crude and adjusted mortality rates and performed competing risks survival analyses for all patients and for patients admitted to intensive care (ICU). Results: Overall, 16,967 COVID-19 related hospitalizations and 2,307 deaths of adult patients were recorded. Crude hospital mortality rates were 15.6% in the 1st and 14.4% in the 2nd wave;for ICU patients it was 24% and 31.3%, respectively. The overall adjusted risk of death was lower for hospitalised patients during the 2nd compared to the 1st wave (HR 0.75, 95% CI 0.73 - 0.77). In contrast, patients admitted to ICU as well as patients with invasive ventilation presented a higher risk of death during the 2nd wave (HR 1.62, 95% CI 1.54-1.70 and HR 2.10, 95% CI 1.99-2.20, respectively). Conclusion: Our findings may be explained by various changes in the COVID-19 patient management in Swiss hospitals, e.g. with the use of effective drugs against complications or with different guidelines for ICU admission and invasive ventilation use.

The meanings attributed to teaching work by teachers in the context of the covid-19 pandemic

This article aims to discuss the meanings attributed to teaching work by teachers in the context of the covid-19 pandemic. The current pandemic has increased human challenges in the search for ways to overcome the virus, in a race of science for medicines and vaccines. This situation brought consequences to millions of people from all over the world and the challenge of reframing human relationships. Education as part of the social totality is not alien to these historical determinations, its professionals continue to carry out their work in even more intensified conditions, precarious, with little financial and symbolic recognition. For the development of the research, we carried out an exploratory study, we applied a questionnaire with closed and open questions for teachers and professors of the State Secretariat of Education of the Federal District (SEEDF), who work in different levels and functions, totaling 94 answers. We will present the analysis and synthesis based on three axes: 1) the meaning of teaching work as a service offer;2) the meanings of teacher training in the pandemic;3) the meanings of resistance and withdrawal from teaching in the pandemic context. In this dialectical and contradictory movement, we show that the demands of the pandemic have significantly influenced and constituted meanings for the teaching work, which need to be analyzed based on an atypical and historical social concreteness. © 2021 UNIVERSIDADE FEEVALE . All Rights Reserved.

Management of locally advanced rectal cancer during the COVID-19 outbreak: First results of a shift towards short course neoadjuvant radiotherapy

Background: Alike other tumor types, it was recommended that the management of locally advanced rectal cancer (LARC) during the COVID outbreak would shift towards hypofractionated RT schemes. Short-course neoadjuvant radiotherapy (SCRT) is comparable to long-course chemoradiation (CRT) in terms of toxicity and survival;nevertheless, CRT is still largely used, especially in advanced tumors. We aim to report the clinical-pathological characteristics and first treatment results of patients treated in a 3-month period during COVID-19 outbreak and to compare them to those treated in the previous year. Methods: We retrospectively reviewed consecutive cases of patients with LARC treated with neoadjuvant RT during Apr-Jun 2020 and Apr-Jun 2019 (control group). Chi square and independent T tests were used for comparison. Results: During Apr-Jun 2020, 35 patients (median age 62 [31-86] years, median Charlson score 4 [2-8]) were treated with neoadjuvant RT. Primary tumor was staged as cT2 (6%), cT3 (57% T3a-b, 17% T3c-d) and cT4 (17% T4a, 3% T4b);83% were cN+;11% patients were M1 at diagnosis and had primary CT. All patients were treated with SCRT (25Gy/5Gyfr);20% patients had perioperative CT and 46% had adjuvant CT. In the control group (n=34), 9 patients had SCRT and 25 had CRT (50.4Gy, 1.8Gyfr, plus capecitabine);6% had primary CT for M1 disease and 6% had perioperative CT. Both groups (2019 vs 2020) were comparable in terms of clinical-pathological variables (age, comorbidities, TNM stage, mesorectal fascia involvement, R0 margin). Pathological complete response (9% vs 11%, p=0.720), modified Ryan tumor regression score ≥2 (74% vs 80%, p=0.456) and rate of postoperative complications ≥III-b (20% vs 9%, p=0.357) also did not differ. Median time from diagnosis to start of RT was 58±43 days vs 61±31 days, p=0.448. Median time to delayed surgery was 66±18 days vs 67±18 days, p=0.948. The start of RT was postponed in 1 patient due to COVID+. Conclusions: Patient characteristics and time to neoadjuvant RT did not appear to differ during COVID-19 outbreak. A shift towards a safer treatment for LARC during this period did not seem to impact pathological response neither postoperative complications. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.

Integration teaching and service in the context of the pandemic of COVID-19: experience report of the praxis of residents of health in epidemiological surveillance

Introduction: Initially identified in the city of Wuhan, China in 2019, Coronavirus Disease 2019 (COVID-19), demonstrated itself with a high dissemination power. Due to the potential for contagion, the World Health Organization recommended isolation measures to countries, avoiding agglomerations, reducing the incidence of cases. Vitoria de Santo Antao, a municipality located near the Metropolitan Region of Recife, required in this context an essential role of epidemiological surveillance to develop contingency strategies and actions in this pandemic health scenario. Objective: To report the experience of health residents working in the epidemiological surveillance sector during the COVID-19 pandemic. Method: Experience report carried out by health residents of the Multiprofessional Residency Program for the Interiorization of Health Care to strengthen epidemiological surveillance in the face of the pandemic in the municipality of Vitoria de Santo Antao. Results: Two forms were created via Google Forms in order to register and monitor cases of influenza syndrome, SRAG and COVID-19 in the municipality. The creation of daily epidemiological bulletins for the dissemination of data was adopted by the health surveillance sector, presenting the most pertinent information obtained from the monitoring of cases of SRAG, COVID-19 and Flu Syndrome of the local population, always comparing with the state and federal scenarios. Conclusions: The pandemic scenario brought about a readjustment of residents' activities, imposing on them the challenge of adapting to a new epidemiological context, envisioning a look at the needs of the territories and their learning process, strengthening the surveillance actions during the scenario of pandemic.

Pros and cons of plastic during the COVID-19 pandemic

Since the beginning of the first cases of the new coronavirus, opinions and laws on the use of plastic materials have been questioned around the world. Their importance in the manufacture of hospital devices and personal protective equipment (PPE) is unquestionable, as they contribute largely to the reduction of the virus spread, helping health systems from all edges of the world and, most importantly, saving lives. However, the same material that is a protector, becomes a polluter when inadequately disposed of in the environment, generating or worsening socio-environmental problems, such as pollution of water bodies by plastic. A critical overview of the role of plastic during the COVID-19 pandemic is provided in this paper. A future panorama is attempted to be outlined. The real possibility of the virus spread from the use of plastic is discussed, as well as the recycling of plastic during the pandemic, correlating its use with problems that it may cause. © 2020 by the author. Licensee MDPI, Basel, Switzerland.

Facteurs associés à l’infection par le SARS-CoV2 et parcours de soins des populations précaires

Introduction Les personnes sans domicile, en logement social, sont particulièrement à risque d’infection à COVID-19 du fait d’habitats souvent collectifs, de leur dépendance au système d’aide notamment alimentaire et parfois de difficultés à appliquer les gestes barrières (manque de masques, de douches individuelles…). L’objectif principal de cette étude vise à identifier les facteurs associés à l’infection au SARS-CoV2 au sein des populations vivant en « logement social ». L’objectif secondaire est de décrire leurs parcours de soins en contexte épidémique. Matériels et méthodes Étude prospective multicentrique cas/témoin réalisée entre mars 2020 et mai 2020. Les critères d’inclusion sont d’être hébergé dans une structure de logement social, d’avoir une infection à COVID-19 confirmée (test PCR rhinopharyngée positif) et ou suspectée (symptomatologie évocatrice sans test PCR réalisé) et être pris en charge par une IDE de ces structures d’accueil (pool santé). Les cas témoins sont les usagers présentant un besoin en santé autre que COVID-19. Une analyse univariée puis multivariée est réalisée afin d’identifier les facteurs associés à l’infection à COVID-19. Des courbes de Kaplan–Meier avec test de log-rank sont réalisées pour analyser les délais de prise en charge. Résultats Sur la période d’étude, 29 cas confirmés ou suspects sont retrouvés. L’âge moyen est de 19,7 ans (sex-ratio H/F à 0,2) vs 22,6 ans pour les 35 témoins (p<0,05). La majeure partie des participants est originaire d’Afrique de l’Ouest et du Moyen Orient (53,1 % et 18,8 % respectivement). Les facteurs associés à l’infection COVID-19 en analyse multivariée sont : le fait de vivre en collocation (OR=23,5 [3,18–496,79]), ne pas avoir respecter la distanciation sociale (OR=8,53 [1,50–71,36]) et d’avoir une hygiène corporelle insuffisante (OR=1,99×108 [3,1×10−76 - ∞]). Trois participants ont décompensés une pathologie chronique. Un stress psychosocial a été retrouvé chez un tiers des participants et on note plus d’angoisse ressentie chez les cas par rapport aux témoins (p<0,05). Le délai de prise en charge médicale est de 5,7jours chez les cas vs 20jours chez les témoins (p<0,05). Plus d’un tiers (35,0 %) des cas n’étaient pas compliants à l’isolement et seuls 2 cas ont bénéficiés d’une adaptation du type d’hébergement. Un nombre important (n=9/23) étaient dans le déni d’être porteur d’une infection à COVID-19. Conclusion Cette étude rappelle l’importance de prendre en compte les populations vulnérables en étant particulièrement attentif aux mesures d’hébergement qui doivent être individualisées. Par ailleurs, l’impact psychosocial de l’épidémie apparaît comme fréquent. Enfin, la prise en charge de l’épidémie doit être pensée avec chaque communauté face aux nombreux dénis de l’infection et du fait du manque de compliance face à une nécessaire distanciation sociale.