ABSTRACT
The study aimed to investigate ethnic/racial disparities in COVID-19 mortality in Brazilian federative units and their respective capitals in 2020. Population data and number of COVID-19 deaths were extracted by skin color (white, black, brown and indigenous) from all Brazilian states and their respective capitals. The mortality rate of COVID-19 by ethnicity in Brazilian states was higher between people from brown skin color, followed by indigenous and black. Only in one state, in the Federal District and in the federal capital, age-standardized mortality rates were higher among white's people. There is a high percentage of deaths from COVID-19 higher than expected among non-white individuals, especially in south-central states and capitals of the country. Mortality from COVID-19 affect ethnic-racial groups unevenly in Brazil and the number of excess deaths among non-whites was over 9000. Urgent government measures are needed to reduce the racial disparity in health indicators in Brazil.
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Introduction: Hand dermatitis causes significant physical, psychosocial, and economic burden. The internet is a major source of health education for patients. Here, we evaluate the readability, quality, and comprehensiveness of online health resources on hand dermatitis. Methods: On July 27th 2021, a Google search was conducted with terms “hand dermatitis” and “hand eczema” and the first 40 items were evaluated. Articles that were advertisements, blogs, intended for professionals, scientific papers, or irrelevant were excluded. Contents of articles were evaluated using several validated grading tools/criteria for readability and quality and Pearson’s correlation assessed the relationship between readability and quality. Results: Twenty-three articles met inclusion criteria. Average readability was at the 11th-grade level (range 7.7-15.6). University-level reading comprehension (≥13th grade) was required for 5/23 websites. The highest quality website based on the Discern instrument was Medical News Today (55.5);nearly half of the websites (48%, 11/23) rated as poor or very poor. The average JAMA benchmark score was only 1.4/4. Nineteen websites contained images (83%) and only 4 websites (21%) included images representing hand dermatitis in skin of color (SOC). Quality and readability of the articles were significantly correlated (P =.02). Conclusion: Our results demonstrate that generally, articles were too difficult to read, have low quality, and lack representation of SOC images. With increases in hand dermatitis in the setting of frequent hand-hygiene practices during the COVID-19 pandemic, it is important for online health information to improve in readability, quality, and inclusion of SOC images to optimize online patient education.
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Objectives: To compare the number of deaths that occurred in the state of Amazonas and in Brazil, from March 16th to August 20th 2020, using the variables skin color, sex, place of death, age group and association with COVID-19, and secondly, to verify whether between 2019 and 2020, in the period from March 16th to August 20th, there was a significant change in the number of deaths from diseases not associated with COVID-19. Methods: We searched the databases of the Brazilian public agency "Transparency Portal" for the data on deaths that occurred in the state of Amazonas and Brazil in the period from March 16th to August 20th, 2019 and 2020. The absolute frequencies and percentages of the variables studied were used for statistical analysis. Results: COVID-19 was responsible for an 11.01% increase in deaths in Brazil;however, this rate quadrupled in the state of Amazonas. In relation to age group, there was a similar percentage between Amazonas and the national average. The stratified analysis showed significant differences between genders and races, with higher death rates in men and people of brown/black skin. The number of deaths at home increased significantly, especially those from causes not associated with COVID-19. Conclusions: The national drop in deaths from diseases not associated with COVID between March and August 2020 in Brazil is misleading and may be due to the result of misreported causes of death.
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Introduction: Social isolation, as a result of the coronavirus pandemic, favored the exposure of elderly people to stressors that may have compromised the quality of sleep. Objective: To verify the quality of sleep of elderly people in the face of the COVID-19 pandemic. Methods: A study was carried out with 305 elderly from 61 cities, recruited through social networks, from February- June/2021. The online questionnaire included general data (city, age, gender, skin, color, education level). Questions were asked about the practice of Physical Activity (PA), the quality of sleep during the pandemic (Mini Sleep Questionnaire/MSQ altered sleep score ≥ 25;EPWORTH-sleepiness score ≥ 10 points) and whether was diagnosed with COVID-19. Results: Out of 305 individuals who participated, 71% were between 60 to 69 years, and 72% were women. In addition, 59.5% practiced some type of physical activity, 9.5% contracted the SARS-CoV2 virus, 65% reported that their sleep pattern was not altered by the pandemic, 28.8% had impaired sleep quality, 72% were not taking sleep medication. The sleepiness was within the normal range. The relation of sleep quality of elderly practitioners of PA did not show statistically significant difference in relation to those who did not practice it during the pandemic. Sleep quality and the diagnosis of COVID-19 did not present relevant statistical data either. Although the individuals did not show any change in sleep quality during the pandemic, the data signaled a poor quality of sleep in the elderly surveyed, with a score showing an overall mean (MSQ) of 31.7 indicating severe difficulty in sleeping. In this study, women had a higher sleep quality score (32.6) than men (29.5), signaling the worsening of sleep in females. Elderly people in age group 70 years more demonstrated a better sleep pattern than age group 60 to 69 years. There was a statistically significant difference in the quality of sleep of the elderly who snored (33.1) compared to those who did not snore (28.0) and those who took a nap during the day (32.7) and those who did not take a nap (30,4). Tiredness was also shown to be a sign of worsening sleep quality when related to those who were not tired during the day. Conclusion: The results suggest that there were no significant changes in the sleep pattern of the elderly during the period evaluated in the pandemic. The changes found were similar in the literature for this population.
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The COVID-19 pandemic has given rise to the need to use personal protective equipment such as masks, among healthcare professionals and the general public. Numerous facial dermatoses linked to the use of masks have been described, from which the term maskneormaskacne has emerged. Although prolonged mask usage has been necessary, and a vast majority of people develop various skin conditions, there is a lack of research on the effects of masks on skin. In this article, we review alterations in biochemical properties of skin associated with mask use in individuals with skin of color and the factors predisposing them to developing acne. Because masks are crucial in preventing the spread of COVID-19, we also elucidate some fundamental strategies such as gentle skin care measures, decreasing the duration of mask wear, and following appropriate protocols for mask re-use, which may prevent mask acne and its long-term effects.
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Objective: To determine the degree of knowledge in the usage of pulse oximeter as a home assessment tool among the community in Malaysia. Methods: A cross-sectional survey was conducted in November 2021. The questionnaire assessed the knowledge in using pulse oximeters, user experience and opinions in using pulse oximeter as a home assessment tool during the pandemic. Results: A total of 504 respondents were included in the study, and the mean score in knowledge related to application of pulse oximetry was 73.00%, while the mean score in knowledge related to factors affecting pulse oximetry readings was only 38.51%. A total of 90.5% of the respondents recognised normal pulse rate and 88.5% knew the blood oxygen saturation levels of a healthy adult, while 69.4% recognised the definition of silent hypoxia. In addition, the majority of the respondents agreed that factors such as poor blood circulation (71.2%), excessive movements (69.8%), and hand position (60.7%) affected oximetry readings. However, 61.7%, 81.7%, 77.2% and 76.8% of the respondents could not identify nail polish, skin colour, skin thickness and tattoos as factors that may affect oximetry readings respectively. Conclusions: The respondents showed a satisfactory level of knowledge related to application of pulse oximetry, but a poor level of knowledge related to factors affecting pulse oximetry readings among the community in Malaysia. Continuous efforts in educating the community on the correct use of pulse oximeters are crucial for appropriate home assessment and avoiding unnecessary stress.
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This qualitative research study highlights medical mistrust as a significant barrier to quality health care for Black women. Unraveling mistrust is essential for reducing health disparities and improving well-being for women and their families. Three research sites were included: Florida, Ohio, and the U.S. Virgin Islands. Three 90-minute focus groups were convened with 10 women in each of them. The discussions were recorded. Five themes will be discussed through the voices of women from each of the sites. Mistrust of healthcare professionals was associated with fears about being rejected, embarrassed, and misunderstood during the clinical encounter. Others reported that providers who were reluctant to make physical contact with them during the clinical visits provoked feelings that the color of their skin might seem "dirty." Finally, this research will help to inform discussions about COVID-19 vaccine hesitancy, which remains a critical health concern among Black women and healthcare providers.
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Background and Aims: Stroke is one of the leading causes of death and disability in adults, accounting for a high number of hospitalizations worldwide. This study aims to evaluate the epidemiology of hospitalizations for stroke in Brazil during 2019 and 2020. Methods: Cross-sectional, descriptive and retrospective study, which evaluated the epidemiology of hospital admissions for stroke in the Brazilian National Health System in the years 2019 and 2020. Hospital admissions were evaluated by sex, race and age group using the national database (DATASUS - Department of Informatics of the Unified Health System). The official classification of race/skin color in Brazil is composed of five categories: White, Brown [Pardo], Black, Yellow and Indigenous. Results: During this time period, there was a total of 316,859 hospitalizations for stroke in the Brazilian National Health System, with 163,120 (51.5%) hospital admissions in 2019 and 153,739 (48.5%) in 2020. Also, 166,178 (52.4%) patients were male and 150,681 (47.6%) were female. Regarding race (n=250,446);106,998 (42.7%) patients considered themselves white, 116,601 (46.6%) brown, 17,085 (6.8%) black and 9,762 (3.9%) others. Regarding age groups;64,939 (20.5%) were >80 years old, 163,114 (51.5%) were 60-79, 74,605 (23.5%) were 40-59 and 14,201 (4.5%) were<40. Conclusions: The majority of patients hospitalized for stroke were 60-79 years old and white or brown. The similar number of hospital admissions in 2019 and 2020 may suggest that hospitalizations for stroke were not significantly impacted by hospital's oversaturation by the COVID-19 pandemic.