Social isolation and its impact on child and adolescent development: a systematic review

OBJECTIVE: This study aims to analyze the effects of social isolation on children's and teenagers' development, with emphasis on the possible impacts over their physical and mental health. DATA SOURCE: Review of the literature following the standards of PRISMA using the SciELO, LILACS and PubMed databases. The following key-words were used: "social isolation" and "child development", "quarantine" and "adolescent development" according to the Medical Subject Headings (MESH) and their translation to the Portuguese. Studies in English, Portuguese and Spanish from inception were included. DATA SYNTHESIS: 519 studies were screened and 12 were included in the systematic review. Five of those focused the psychology and social issues, two of them the effects of pandemics on these issues;four studies reported on impacts on general health and two consequences over the hypothalamus- hypophysis - adrenal axis and the cognitive and social development. CONCLUSIONS: The review shows a strong association between social isolation and anxiety and depression in children and adolescents. Social isolation leads to higher levels of cortisol and worse cognitive development. Therefore, the mental and physical health of children and adolescents need a careful follow up by health professionals during and after the COVID-19 pandemic.

Coping in mental health during social isolation: analysis in light of Hildegard Peplau

OBJECTIVES: to analyze the coping of individuals in social isolation due to suspicion or confirmation of coronavirus infection from the perspective of Hildegard Peplau's Theory of Interpersonal Relations. METHODS: this is a qualitative, descriptive research, carried out with 34 individuals in social isolation due to suspicion or confirmation of coronavirus infection who passed through a screening tent of a university hospital in Parana. Data were collected through semi-structured interviews in June and July 2020. Empirical categories were interpreted by content analysis. RESULTS: four categories emerged: Distance;Social and emotional support;Self-awareness and resolution;Learning. These categories established the coping strategies. CONCLUSIONS: individuals undergoing social isolation are more likely to present problems related to mental health. It was highlighted that coping strategies, motivated by nurses, anchored in Hildegard Peplau's theoretical framework, promoted the necessary learning for promoting participants' mental health in the face of a pandemic context.

Covid-19: What do the codes of professional ethics say?

The new coronavirus arrived in Brazil in February 2020, with a high rate of transmissibility and lethality. In view of this situation, the Ministry of Health issued Ordinance 639/2020, legitimizing the action “Brazil counts on me – health professionals,” to train and register professionals. In order to identify which professions, listed by the Ordinance, have in their Codes of Professional Ethics guidelines for the current situation and analyze the content found, this documentary research has an exploratory, descriptive nature and qualitative and quantitative character, presenting statistical and content analysis. The data were processed using specificity and similarity analysis techniques, using the Iramuteq software. Of the professions analyzed, presented in their code of ethics content related to covid-19: nursing, pharmacy, speech therapy, physiotherapy, psychology, social services and occupational therapy. The existing guidelines have little connection with the text of the committees, indicating deontological insufficiency. © 2021, Conselho Federal de Medicina. All rights reserved.

Impact of COVID-19 on the number of transplants performed in Brazil during the pandemic. Current situation

The intense use of resources to combat COVID-19 causes concern in the entire transplant community because, in addition to physical limitations such as ICU beds, lack of homogeneous treatment protocols and uncertainties about the effects of immunosuppression on viral progression have significant impact on transplant surgeries. The aim of the present study is to comparatively assess the number of solid organ transplants performed in 2019 and 2020, as well as the impact of the COVID-19 pandemic on organ donation and transplant surgeries in Brazil. The last 10 years have shown increasing trend in the number of solid organ transplants, which have significantly decreased in 2020. Lung transplantations were mostly affected by the pandemic;these surgeries have been carried out only in Rio Grande do Sul and Sao Paulo states. Liver transplantations were the least affected ones, since the number of surgeries have only decreased by 10.8% in the first three quarters of 2020, in comparison to 2019. The number of active patients on the waiting list for heart and kidney transplantation has increased in 2020. Therefore, it is necessary developing strategies to keep the structure necessary for organ transplantation processes active and, consequently, to reduce the impacts of the pandemic on these patients.

Medical education in times of COVID - 19: an experience at Faculdade Pernambucana da saude. (Special issue.)

Objectives: to describe and discuss interventions and strategies carried out at Faculdade Pernambucana de Saude (FPS) during the COVID-19 pandemic to mitigate impairment in learning and preserve students, tutors, and staff 's health. Experience report: the teaching methodology used by FPS is problem-based learning, which greatly facilitated the non-discontinuity of theoretical activities carried out in-person in tutorial sessions involving a tutor and 10 to 12 students. This format was transferred to Webex Meetings rooms and held remotely. Practical laboratory activities were suspended and resumed when allowed in July. The teaching outpatient activities (third and fourth year) were suspended and resumed in August. Two years of internship were interrupted for 30 days (fifth year) and for 15 days (sixth year). External activities of practices in primary care were also suspended and resumed gradually. All assessments and activities that required face-to-face meetings, integrations, scientific initiation program orientations, collegiate meetings, meetings of the self-assessment committee were and are being carried out remotely. Conclusions: we believe that we were able to mitigate impairment in students' learning without compromising the conclusion of the school year that was facilitated by Problem Based Learning method.

Death risk and the importance of clinical features in elderly people with COVID-19 using the random forest algorithm. (Special issue.)

Objectives: train a Random Forest (RF) classifier to estimate death risk in elderly people (over 60 years old) diagnosed with COVID-19 in Pernambuco. A "feature" of this classifier, called feature importance, was used to identify the attributes (main risk factors) related to the outcome (cure or death) through gaining information.

Brazilian's frequency of anxiety, depression and stress symptoms in the COVID- 19 pandemic. (Special issue.)

Objectives: to analyze the frequency of anxiety, stress and depression in Brazilians during the COVID-19 pandemic period.

COVID-19 and kidney: a narrative review. (Special issue.)

COVID-19 is a pandemic associated with systemic clinical manifestations. In this study, we aimed to present a narrative review on kidney involvement in COVID-19. Kidney involvement could be derived from direct cytopathic effects, immunological mechanisms, indirect effects on renal tissue through other mediators, and dysfunction or injury of other organs. The evolution of COVID-19 may be complicated with acute kidney injury (AKI) in a significant percentage of patients, and renal dysfunction seems to be associated with worse prognosis. Patients with chronic kidney disease (CKD) seem to be more susceptible to the severe forms of COVID-19. Patients with renal replacement therapy (RRT) are also a vulnerable population as consequence of their advanced age, underlying comorbidities, impaired immune response, and clustering in hemodialysis centers, with requirements for frequent contact with healthcare services. Kidney transplant patients may be at high-risk due to longterm immunosuppression and comorbidities, hence, managing immunosuppression is imperative. Lastly, renal replacement therapy may be required during COVID-19, and different modalities are discussed based on clinical findings and laboratorial aspects. Therefore, COVID-19 seems to affect kidney by different mechanisms, which contributes for AKI development and increases the severity of the disease. Also, patients with CKD and kidney transplant recipients are at higher risk for COVID-19 and mortality.

The COVID-19 pandemic and nurses' attitudes toward death

OBJECTIVE: to analyze nurses' attitudes toward death in a hospital context after the critical period of the COVID-19 pandemic in Portugal. METHOD: this quantitative, descriptive, exploratory study was conducted in a university hospital and addressed 995 nurses. Revised Death Attitude Profile (DAP-R) was used to collect data, which were analyzed using analytical and inferential statistics. RESULTS: the nurses most frequently agreed with the statements concerning the Neutral/Neutrality Acceptance and Fear. Age, marital status, profession, and unit of work influenced the nurses' attitudes toward death. During the critical pandemic period, the nurses providing care to patients with COVID-19 presented the following means: Fear (28.89/+/-8.521) and Avoidance Acceptance (18.35/+/-7.116), which were higher than the mean obtained in the Escape Acceptance dimension, with significant differences (p=0.004). CONCLUSION: the nurses held Fear and Avoidance attitudes, revealing the need to qualify and support Nursing workers to cope with the death of those they provide care and manage pandemics and catastrophes.

Coping strategies, concerns, and habits of Brazilian men in the COVID-19 context

OBJECTIVE: To describe coping strategies, concerns and habits of Brazilian men during the COVID-19 pandemic. METHOD: Cross-sectional, descriptive and nationwide study, carried out in 2020 with a total of 1015 men living in Brazil. A descriptive statistic was used. RESULTS: Young (41.2%), black (61.4%), highly educated (66.8%), high income (33.2%), living with family/friends (49.7%) and formal workers (65.6%) predominated. As coping strategies predominated: exclusive use of the private health system (36.4%), support from family/friends (78.2%) and leisure (97.7%) and domestic activities (64.9 %). Social distancing (59.7%), economic (58.0%) and work situations (44.4%) were the main reasons for concern. Among the prevention/control attitudes, hand washing (94.3%) and social distancing (91.0%) prevailed. Media consumption (84.6%) and health risk (65.4%) were the main increased habits. CONCLUSION: Brazilian men adopted coping strategies recommended by health authorities, with concerns and habits of potential risk to physical and mental health.

Women and COVID-19: reflections for a sexual and reproductive rights-based obstetric care

OBJECTIVE: This essay aims to reflect on the repercussions of the pandemic in obstetric care in the light of sexual and reproductive rights, focusing on delivery and birth care. RESULTS: The reflection shows that the pandemic has accentuated the violation of these rights, which is evidenced by racial inequalities in maternal mortality, as well as restrictions and interventions in childbirth care without scientific evidence, detour of resources, interruption of services, reduced human resources, shortage of medicines and supplies, and imbalances in the provision of health services. CONCLUSION: It is concluded obstetric care faces even greater barriers in access to health care, just as the pandemic of COVID-19 highlighted inequities, disproportionately impacting vulnerable populations whose human rights are less protected.

Criteria for the admission of older patients in the intensive care unit: chronological age cannot be the unique factor. (Special Section: SBGG positions before the COVID-19 pandemic.)

This brief article discusses the ICU admission and discharge criteria, and among the priorities listed for admission, are: (1) Patients in need of life support interventions, with high probability of recovery and no limitation of therapeutic support;and (2) Patients who need intensive monitoring, due to the high risk of need for immediate intervention, and without any limitation of therapeutic support.

Influenza vaccination coverage in elderly and high-risk adults: characterization of associated factors

OBJECTIVE: To evaluate the prevalence and factors associated with non-vaccination against influenza in the risk group. METHODS: A cross-sectional, population-based study, carried out in the city of Rio Grande (RS). The outcome was defined as belonging to risk groups and not having been vaccinated in the last 12 months. Demographic, socioeconomic, behavioral variables, and access for health services were analyzed. RESULTS: In this study, 680 individuals participated. The prevalence was 46.0% (95%CI: 41.8-50.3), ranging from 27.9% (elderly) to 81.8% (pregnant women). Young adults, single, intermediate socioeconomic bracket, smoker, with depressive symptoms, who did not perform physical activity and did not consult a physician in the last year, had a higher prevalence of non-vaccination. CONCLUSION: Half of the sample was not vaccinated in the period. Due to the similarity of influenza-like illness and the coronavirus 2019 disease (COVID-19), increasing vaccination would minimize mortality and use of hospital beds due to influenza, optimizing the response of hospital capacity.

Booklet on the use of personal protective equipment during the COVID-19 pandemic: preventing facial skin injuries

Introduction: In the year 2020, Brazilian and global public health systems were overwhelemend by COVID-19, a pandemic highly transmissible by droplets and contact, mainly in enclosed areas and hospital environments. Objective: Create a booklet to instruct health professionals on the use of personal protective equipment (PPE) and preventive measures for facial skin injuries during the SARS-CoV-2 pandemic. Methods: The study was conducted from June to September 2020, adopting the following steps: situational diagnosis;literature review of the main health science databases;content selection and survey;drafting texts;creating illustrations;and diagramming the manual. Results: After the literature review, 26 articles were selected for the booklet. The material was prepared by the authors of this article and reviewed by a professional in the biomedical field, with expertise in standardizing procedures and tissue injury innovations. The final version contains four chapters and three algorithms, one with step-by-step instructions on donning PPE, one on removal and one containing preventive measures for PPE-related injuries. Conclusion: After an interactive review of the literature, a booklet was created that provides theoretical and practical foundations for health professionals on PPE donning and removal techniques, with a view to preventing facial injuries and COVID-19 infection. © 2021. All Rights Reserved.

Analysis of physical therapy education in Brazil during the COVID-19 pandemic

Introduction: The COVID-19 pandemic brought the need for social distancing as a strategy to control the disease, prompting most countries to te., mporarily suspend educational activities at all levels. Objective: To analyze the status of physical therapy education in Brazilian public and private institutions during the COVID-19 pandemic. Methods: A cross-sectional study with professors from physical therapy courses in Brazil. The study was conducted using an electronic form distributed via a social media application, containing questions on the characteristics of the professor, educational institution and work process. Associations were analyzed by the chi-squared test at 5% significance. Results: A total of 313 professors from 22 Brazilian states participated, with 62.94% from private institutions and 73.80% reporting that activities were conducted via emergency remote teaching (ERT). Among the professors who shifted to ERT, 63.20% did so with no prior planning and 28.13% had received no training for this this teaching format. An association was observed between the type of institution (public or private) and professors' age (p < 0.001), sex (p < 0.001), teaching experience (p < 0.001) and adopting ERT (p < 0.001). Conclusion: In Brazil, the COVID-19 pandemic prompted most institutions to switch to ERT, more prevalent at private facilities, with no prior planning for the transition from in-person to remote teaching. © 2021. All Rights Reserved.

Development of tissue and cellulose masks for emergency response to the sars-cov-2 pandemic

Objective: to develop a model of fabric mask, with the application of a cellulose filter element, for use as a safe physical barrier for aerosols, as an emergency response strategy for the SARS-CoV-2 pandemic. Method: laboratory research carried out by means of prototypes, empirical tests and analyses, and discussions with experts. Results: the research demonstrated that aerosols are retained by the physical cellulose barrier introduced into the structure of the masks, which motivated the second phase of the study into the effectiveness of these materials at a unit of the Brazilian Analytical Health Laboratories Network. Conclusion: the making of fabric masks is an important and urgent worldwide phenomenon in tackling the COVID-19 pandemic. In view of the supply crisis and the parameters highlighted in this study, it is believed that the use of this equipment can be extended to non-critical sectors of health units, as well as to the general population. © 2020, Centro de Estudos da Faculdade de Enfermagem da UERJ. All rights reserved.