[Cross-sectional study on the use of masks among occupational groups with high-risk positions for overseas import and pollution transmission].

Objective: To investigate the wearing of masks and the knowledge of masks among high-risk positions for overseas import and pollution transmission. Methods: From May 14 to 17, 2022, a convenient sampling method was used to conduct an online survey among 963 workers in high-risk positions for overseas import and pollution transmission in Beijing. The behaviors of individual use and wearing masks, the distribution and supervision of the unit, the knowledge of personal mask protection and the subjective feelings of wearing masks were analyzed. The χ(2) test and logistic regression model were used to analyze the influencing factors of the correct selection of masks. Results: The majority of the workers in high-risk positions for overseas import and pollution transmission were male (86.0%, 828/963), age concentration in 18-44 years old (68.2%, 657/963), and the majority of them had college or bachelor degrees (49.4%, 476/963). 79.4%(765/963) of the workers chose the right type of masks, female, 45-59 years old and high school education or above were the risk factors for correct selection of masks (P <0.05). Workers had good behaviors such as wearing/removing masks, but only 10.5% (101/963) could correctly rank the protective effect of different masks. 98.4% (948/963) of the workers believed that their work units had provided masks to their employees, and 99.1% (954/963) and 98.2%(946/963) of them had organized training and supervision on the use of masks, respectively. 47.4%(456/963) of the workers were uncomfortable while wearing masks. Conclusion: The overall selection and use of masks among occupational groups in high-risk positions for overseas import and pollution transmission in China need to be further standardized. It is necessary to strengthen supervision and inspection on the use of masks among occupational groups, and take improvement measures to improve the comfort of wearing masks.

Vaccine hesitancy in primary care: Building bridges by understanding barriers.

Adult vaccination is an accepted part of health care and diabetes care. In spite of evidence regarding the efficacy and utility of vaccination in preventing disease, we continue to encounter vaccine hesitancy and vaccine skepticism. As physicians, it is our duty to encourage the public to get vaccinated. In this article, we create a simple framework which helps assess the barriers to vaccine acceptance, and create bridges to overcome vaccine hesitancy and skepticism. We use an interesting mnemonic, NARCO, to remind ourselves, and our readers, of the appropriate hierarchy of interviewing related to vaccine acceptance.

Construction and use of a risk stratification instrument for vaccination of elderly against Covid-19 / Construção e utilização de instrumento de estratificação de risco para vacinação de idosos contra a Covid-19 / Construcción y uso de un instrumento de estratificación de riesgo para la vacunación del anciano contra el Covid- 19

Objetivo: Relatar a experiência da construção e utilização de um instrumento de estratificação de risco para vacinação de idosos contra a COVID-19. Métodos: Relato da experiência desenvolvida no município de Massapê ­ Ceará, durante o ano de 2021, a partir do início da campanha de vacinação de idosos contra a COVID-19. Descrição da Experiência: Por conta da escassez de imunobiológicos, na fase inicial da vacinação contra a COVID-19, a Secretaria da Saúde do município de Massapê, estado do Ceará, criou um instrumento para estratificação de riscos sanitários, epidemiológicos e sociais dos idosos, contendo seus dados sociodemográficos e as comorbidades. Após o estabelecimento das variáveis, foram estabelecidos escores para os estratos de risco, que foram classificados em baixo (um a três pontos), médio (quatro a seis pontos), alto (sete a nove pontos) e muito alto (dez pontos e mais). Considerações Finais: O estudo mostra que, apesar da pandemia de COVID-19, uma crise sanitária global sem precedentes como já dito, ações pontuais, mesmo que localizadas, podem ter efeito em cadeia e ser replicadas em outros cenários e momentos.

Objective: To report the experience of building and using a risk stratification instrument for vaccinating the elderly against COVID-19. Methods: Report of the experience developed in the municipality of Massapê - Ceará, during the year 2021, from the beginning of the vaccination campaign for the elderly against COVID-19. Experience Description: Due to the scarcity of immunobiologicals, in the initial phase of vaccination against COVID-19, the Department of Health of the municipality of Massapê, state of Ceará, created an instrument to stratify the health, epidemiological and social risks of the elderly, containing sociodemographic data and comorbidities of the elderly. After establishing the variables, scores were established for the risk strata, which were classified as low (one to three points), medium (four to six points), high (seven to nine points) and very high (ten points and more). Final Considerations: The study shows that, despite the COVID-19 pandemic, an unprecedented global health crisis as already mentioned, specific actions, even if localized, can have a chain effect and be replicated in other scenarios and times.

Objetivo: Relatar la experiencia de construcción y uso de un instrumento de estratificación de riesgo para la vacunación de ancianos contra la COVID-19. Métodos: Informe de la experiencia desarrollada en el municipio de Massapê - Ceará, durante el año 2021, desde el inicio de la campaña de vacunación de ancianos contra la COVID-19. Descripción de la Experiencia: Debido a la escasez de inmunobiológicos, en la fase inicial de la vacunación contra la COVID-19, la Secretaría de Salud del municipio de Massapê, estado de Ceará, creó un instrumento para estratificar los riesgos sanitarios, epidemiológicos y sociales de los ancianos, que contiene datos sociodemográficos y comorbilidades de los ancianos. Luego de establecer las variables, se establecieron puntajes para los estratos de riesgo, los cuales se clasificaron en bajo (uno a tres puntos), medio (cuatro a seis puntos), alto (siete a nueve puntos) y muy alto (diez puntos y más). Consideraciones finales: El estudio muestra que, a pesar de la pandemia de COVID-19, una crisis sanitaria mundial sin precedentes como ya se mencionó, las acciones específicas, aunque sean localizadas, pueden tener un efecto en cadena y replicarse en otros escenarios y tiempos.

Subacute thyroiditis and thyrotoxicosis after SARS-CoV-2 vaccine: report of 2 cases / Tiroiditis subaguda y tirotoxicosis posterior a vacuna contra SARS-CoV-2: reporte de 2 casos

La enfermedad por coronavirus SARS-CoV-2 que surgió en el año 2019 (COVID-19), ha obligado al rápido desarrollo de vacunas para prevenir su propagación e intentar controlar la pandemia. Dentro de las vacunas desarrolladas, las primeras en ser aprobadas con una tecnología nueva en el campo de la vacunación, fueron las vacunas basadas en ARNm (ácido ribonucleico mensajero), que lograron tasas de efectividad cercanas al 95 % para la prevención de la enfermedad COVID-19 grave. Los eventos adversos comunes son reacciones locales leves, pero ha habido varios informes de pacientes que desarrollaron tiroiditis subaguda y disfunción tiroidea después de recibir la vacuna contra SARS-CoV-2. Este artículo presenta dos casos de tiroiditis subaguda poco después de recibir la vacuna contra COVID-19

The SARS-CoV-2 coronavirus disease which emerged in 2019 (COVID-19), has forced the rapid development of vaccines to prevent the spread of infection and attempt to control the pandemic. Among the vaccines developed, one of the first to be approved with a new technology in the field of vaccination, was the mRNA (messenger ribonucleic acid) vaccine, with rates of effectiveness close to 95% for the prevention of severe COVID-19 disease. Common adverse events are mild local reactions, but there have been some reports of patients developing sub-acute thyroiditis and thyroid dysfunction after receiving the SARS-CoV-2 vaccine. This article presents two case reports of subacute thyroiditis shortly after receiving the COVID-19 vaccine

Professional nursing practice environment from students' perspective in COVID-19 / Ambiente de prática profissional em enfermagem na perspectiva de estudantes na COVID-19 / Ambiente de práctica profesional de enfermería por la perspectiva de estudiantes en el COVID-19

Resumo Objetivo Avaliar o ambiente da prática profissional em enfermagem na perspectiva de estudantes no contexto da pandemia da COVID-19. Métodos Estudo transversal, realizado com amostra por conveniência de 43 estudantes da última série do bacharelado em Enfermagem de uma universidade federal, localizada no município de São Paulo, SP, Brasil. Variáveis de caracterização: gênero, etnia, idade, local de estágio e um questionamento se já trabalharam e/ou realizam estágio extracurricular na área. Aplicou-se o Instrumento Practice Environment Scale - versão brasileira validada, composto de 24 itens e 5 subescalas. Os dados foram analisados com estatística descritiva e inferencial por meio dos testes: Kruskal Wallis, ANOVA, Tukey, t-student e Mann Whitney. Foi realizada a análise de regressão logística. Considerou-se como nível de significância de p<0,005. Resultados A Subescala 3 "adequação da equipe e de recursos" foi a única que apresentou média desfavorável (53,49%). A variável "ter trabalhado e/ou realizado estágio extracurricular" mostrou-se estatisticamente significante na Subescala 2 "habilidade, liderança e suporte dos coordenadores/supervisores de enfermagem aos enfermeiros/equipe de enfermagem" (p=0,003). Na média geral, os estudantes avaliaram o ambiente como favorável (p<0,001). Conclusão Apesar do contexto, a maioria dos estudantes avaliaram o ambiente como favorável. A variável "ter trabalhado e/ou realizado estágio extracurricular" foi estatisticamente significativa. A capacitação das lideranças, o fortalecimento de programas de educação continuada e o envolvimento dos enfermeiros nas atividades, resoluções de problemas e comissões internas da instituição, são considerados preâmbulos para ofertar uma assistência qualificada dentro de um ambiente de prática profissional próximo do favorável.

Resumen Objetivo Evaluar el ambiente de la práctica profesional de enfermería por la perspectiva de estudiantes en el contexto de la pandemia del COVID-19. Métodos Estudio transversal, realizado con muestra por conveniencia de 43 estudiantes del último año del grado de Enfermería de una universidad federal, ubicada en el municipio de São Paulo, São Paulo, Brasil. Variables de caracterización: género, etnia, edad, lugar de la pasantía y un interrogante sobre si ya trabajaron o realizan una pasantía extracurricular en el área. Se aplicó el Instrumento Practice Environment Scale - versión brasileña validada, compuesto por 24 ítems y 5 subescalas. Los datos fueron analizados con estadística descriptiva e inferencial por medio de las pruebas: Kruskal Wallis, ANOVA, Tukey, t-student y Mann Whitney. Se realizó el análisis de regresión logística. Se consideró un nivel de significación de p<0,005. Resultados La Subescala 3 "adecuación del equipo y de recursos" fue la única que presentó un promedio desfavorable (53,49 %). La variable "haber trabajado o realizado una pasantía extracurricular" se mostró estadísticamente significante en la Subescala 2 "habilidad, liderazgo y suporte de los coordinadores/supervisores de enfermería a los enfermeros/equipo de enfermería" (p=0,003). En el promedio general, los estudiantes evaluaron al ambiente como favorable (p<0,001). Conclusión Pese al contexto, la mayoría de los estudiantes evaluaron al ambiente como favorable. La variable "haber trabajado o realizado una pasantía extracurricular" fue estadísticamente significante. La capacitación de los liderazgos, el fortalecimiento de programas de educación continua y la participación de los enfermeros en las actividades, resoluciones de problemas y comisiones internas de la institución, son considerados preámbulos para brindar una asistencia calificada dentro de un ambiente de práctica profesional próxima a lo favorable.

Abstract Objective To assess the professional nursing practice environment from the perspective of students in the context of the COVID-19 pandemic. Methods Cross-sectional study conducted with a convenience sample of 43 students attending the last grade of the Nursing Undergraduate course at a federal university located in the city of São Paulo, SP, Brazil. Characterization variables: sex, ethnicity, age, place of internship and a question on whether they have worked and/or did an extracurricular internship in the area. The Practice Environment Scale - Brazilian validated version, consisting of 24 items and five subscales, was applied. Data were analyzed using descriptive and inferential statistics with the following tests: Kruskal Wallis, ANOVA, Tukey, t-student and Mann Whitney. Logistic regression analysis was performed. A significance level of p<0.005 was considered. Results Subscale 3 "Staffing and resource adequacy" was the only one with an unfavorable mean (53.49%). The variable "having worked and/or done an extracurricular internship" was statistically significant in Subscale 2 "Nurse manager ability, leadership and support of nurses" (p=0.003). On overall mean, students rated the environment as favorable (p<0.001). Conclusion Despite the context, most students rated the environment as favorable. The variable "having worked and/or done an extracurricular internship" was statistically significant. The training of leaders, the strengthening of continuing education programs and involvement of nurses in activities, problem solving and internal committees of the institution are considered preambles to offer qualified care within a close to favorable environment of professional practice.

Quality of life of nursing residents in the midst of the COVID-19 pandemic: a descriptive study / Qualidade de vida de residentes de enfermagem em meio à pandemia COVID-19: estudo descritivo

OBJETIVO: Avaliar a qualidade de vida do residente de enfermagem em meio à pandemia da COVID-19. MÉTODO: Estudo transversal, descritivo, de abordagem quantitativa com 57 residentes de enfermagem no município do Rio de Janeiro, por meio de questionário contendo dados socioeconômicos e o World Health Organization Quality of Life, versão abreviada (WHOQOL-bref). RESULTADOS: Participantes consideram possuir uma Qualidade de Vida satisfatória (58,11), dado ratificado através da interpretação dos Domínios que apresentou um Score Geral de 53,46, onde o Domínio Físico foi o mais satisfatório (58,33) e o Meio Ambiente (48,63) o menos satisfatório. CONCLUSÃO: Os residentes apresentaram uma Qualidade de Vida Satisfatória, contudo percebeu-se que alterações nos padrões de sono/repouso podem estar ligados diretamente à diminuição da qualidade de vida dos residentes durante a pandemia.

OBJECTIVE: To evaluate the quality of life of nursing residents in the covid-19 pandemic. METHOD: Cross-sectional, descriptive, quantitative study with 57 nursing residents in the city of Rio de Janeiro, through a questionnaire containing socioeconomic data and the World Health Organization Quality of Life, abbreviated version (WHOQOL-BREF). RESULTS: Participants consider having a satisfactory Quality of Life (58.11), data ratified through the interpretation of the Domains that presented a General Score of 53.46, where the Physical Domain was the most satisfactory (58.33) and the Environment (48.63) the least satisfactory. CONCLUSION: Residents had a Satisfactory Quality of Life, however it was noticed that changes in sleep/ rest patterns may be directly linked to the decrease in Quality of Life of residents during the pandemic.

COVID-19 pandemic and impact on dental education: perception of Brazilian dental students

Aim: The aim of the present study is to assess the perception of undergraduate students on the impact of the COVID-19 pandemic on Brazilian dental education. Methods: This crosssectional study was conducted using an online questionnaire hosted in Google Forms platform and publicized on Instagram® and Facebook®. The questionnaire was available between July 8-27, 2020. Absolute and relative frequencies were obtained for variables of interest using Pearson's chi-squared and considering 95% confidence intervals. Prevalence of learning resource variables according to self-reported skin color, educational institution, and Brazilian region were presented using equiplots. Results: A total of 1,050 undergraduate dental students answered the questionnaire. Most students reported being in full-distance learning mode. Among the undergraduate students, 65.4% reported perceiving a very high impact in dental education, and 16.6% of students reported not being able to follow distance learning. In addition, 14% reported not having a personal laptop or desktop to study with, with this condition being more prevalent among non-white than white individuals. Conclusion: We conclude that Brazilian dental students perceived a high impact of COVID-19 on dental education, as well as one-sixth of the students reported not having adequate resources to continue with distance learning. It is important that different policies are developed at the institutional and governmental levels to reduce the impact of the pandemic on dental education

Temporomandibular disorders and associated comorbidities among brazilian dental students during COVID-19

Aim: This study aimed to assess the prevalence of temporomandibular disorders (TMD) and psychosocial comorbidities in undergraduate dental students in a southern Brazilian university, during the COVID-19 pandemic. Also, it aimed to verify the association between psychosocial factors and TMD. Methods: Fonseca Anamnestic Index, Depression Anxiety Stress Scale (DASS-21), a socioeconomic questionnaire, and questions about academic performance and social distancing were applied. Poisson regression analysis was used to assess the association of predictive variables with TMD. Results: The prevalence of TMD was found to be 82.4%, and more than half of the students had some degree of stress, anxiety, and depression. Students who had symptoms of stress (RR 1.11; 95% CI 1.04-1.19), anxiety (RR 1.19; 95% CI 1.12-1.27) and reported academic performance worsening (RR 1.12; 95% CI 1.07-1.19) had higher TMD scores. Conclusion: The findings suggest that TMD was highly prevalent among dental students at a federal university in southern Brazil during the pandemic, being associated with high levels of stress, anxiety, poor academic performance, and greater social distancing

Reactive lymphadenopathy due to Pfizer-BioNTech COVID-19 vaccine: a case report / Linfadenopatía reactiva por vacuna Pfizer-BioNTech para COVID-19: reporte de un caso

Uno de los efectos secundarios encontrados en pacientes con antecedente de vacunación por COVID-19, especialmente con la vacuna Pfizer-BioNTech, es la aparición de múltiples adenopatías hiperplásicas, principalmente en los ganglios linfáticos axilares, supraclaviculares e infraclaviculares ipsilaterales al sitio de vacunación. Presentamos el caso de una paciente femenina de 33 años, con aparición de masa dolorosa supraclavicular izquierda, quien una semana antes había sido vacunada con la primera dosis de la vacuna Pfizer-BioNTech en región deltoidea izquierda. Los hallazgos citológicos fueron sugestivos de una enfermedad linfoproliferativa, y el estudio histopatológico reveló linfadenopatía reactiva con proliferación de inmunoblastos B activados, secundaria a la vacunación contra COVID-19. Aportamos a la literatura con la caracterización de los hallazgos histopatológicos de la linfadenopatía posvacunación contra COVID-19. Es importante que los médicos tratantes y radiólogos estén familiarizados con este diagnóstico diferencial, para brindar recomendaciones adecuadas basadas en un seguimiento a corto plazo, en lugar de realizar biopsias, intervenciones y conductas inmediatas innecesarias en el manejo de los pacientes

One of the side effects found in patients with a history of vaccination for COVID-19, especially with the Pfizer-BioNTech vaccine, is the appearance of multiple hyperplastic adenopathies, mainly axillary, supraclavicular and infraclavicular lymph nodes ipsilateral to the vaccination site. We present the case of a 33-year-old female patient, with the appearance of a painful left supraclavicular mass, who was vaccinated a week earlier with the first dose of the Pfizer-BioNTech vaccine in the left deltoid region. The cytological findings were suggestive of a lymphoproliferative disease, and the histopathological study revealed reactive lymphadenopathy with proliferation of activated B immunoblasts, secondary to vaccination against COVID-19. We contribute to the literature with the characterization of the histopathological findings of COVID-19 post-vaccination lymphadenopathy. It is important for treating physicians and radiologists to be familiar with this differential diagnosis, in order to provide appropriate recommendations based on short-term follow-up, instead of performing unnecessary immediate biopsies or interventions in patient management.

Alcohol consumption and maxillofacial fractures in times of Covid-19: a cross-sectional study in a cuban university hospital / Consumo de alcohol y fracturas maxilofaciales en tiempos de Covid-19: un estudio transversal en un hospital universitario cubano

Introduction: The consumption of alcoholic beverages reduces the body's ability to deal with dangerous situations and exposes people to trauma. Objective: To determine the association between the consumption of alcoholic beverages and the characteristics of maxillofacial fractures treated at a Cuban university hospital in the context of COVID-19. Material and Methods: An observational, analytical, and cross-sectional study was carried out in the Maxillofacial Surgery unit at the "Carlos Manuel de Céspedes" General University Hospital during the year 2020. Prevalence ratios, 95% confidence intervals and p-values were obtained using generalized linear models. Results: In 58.23% of the cases, fractures were related to the consumption of alcoholic beverages. The fundamental etiology was interpersonal violence (47.75%), regardless of the consumption of alcoholic beverages. There was a prevalence of patients with nasal fractures (n=98; 55.06%), among which, 35.71% had consumed alcoholic beverages at the time of the trauma. Being male (p=0.005), the lack of university studies (p=0.007), the need for surgical treatment (p<0.001), the fractures of the zygomaticomaxillary complex (p=0.023), and the traumas that occurred during the weekends (p<0.001) or during the month of June (p=0.029) were factors associated with a higher frequency of fractures related to the consumption of alcoholic beverages. There was a lower frequency of fractures associated with alcohol consumption during the months of January (p=0.006) and March (p=0.001). Conclusion: Six out of ten cases were under the influence of alcoholic beverages. There was a greater number of young and male patients, mainly due to interpersonal violence.

Introducción: La ingestión de bebidas alcohólicas disminuye la capacidad del organismo para enfrentar situaciones de peligro y lo predispone a sufrir traumatismos diversos. Objetivo: Determinar la asociación entre el consumo de bebidas alcohólicas y las características de las fracturas maxilofaciales atendidas en un hospital universitario cubano en el contexto de la COVID-19. Material y Métodos: Estudio observacional, analítico y transversal realizado en el servicio de Cirugía Maxilofacial del Hospital General Universitario "Carlos Manuel de Céspedes" durante el 2020. Se obtuvieron razones de prevalencia, intervalos de confianza a 95% y valores p mediante modelos lineales generalizados. Resultados: En el 58.23% de los casos las fracturas se relacionaron con la ingestión de bebidas alcohólicas. La etiología fundamental fue la violencia interpersonal (47.75%), independientemente del consumo o no de bebidas alcohólicas. Predominaron los pacientes con fracturas nasales (n=98; 55.06%), en los que el 35.71% había consumido bebidas alcohólicas en el momento del trauma. El sexo masculino (p=0.005), la carencia de estudios universitarios (p=0.007), la necesidad de tratamiento quirúrgico (p<0.001), las fracturas del complejo cigomático-maxilar (p=0.023), los traumas sucedidos durante los fines de semanas (p<0.001) o durante el mes de junio (p=0.029) fueron factores asociados a una mayor frecuencia de fracturas relacionadas con el consumo de bebidas alcohólicas. Hubo menor frecuencia de fracturas asociadas a este consumo durante los meses de enero (p=0.006) y marzo (p= 0.001). Conclusión: Seis de cada diez casos estuvieron bajo los efectos de la ingestión de bebidas alcohólicas. Existió una mayor afectación de pacientes jóvenes, masculinos, a causa principalmente de la violencia interpersonal.

NANDA-I® nursing diagnoses in adult critical patients with COVID-19 / Diagnósticos de enfermagem da NANDA-I® em pacientes críticos adultos portadores de COVID-19 / Diagnósticos en enfermería de NANDA-I® en pacientes críticos adultos con COVID-19

Resumo Objetivo Identificar possíveis diagnósticos de enfermagem conforme a classificação da NANDA-International presentes em pacientes críticos adultos portadores de COVID-19 a partir de pistas diagnósticas descritas pela literatura científica. Métodos Estudo descritivo, desenvolvido em três etapas: revisão de literatura e agrupamento das pistas diagnósticas identificadas de acordo com as Necessidades Humanas Básicas; levantamento dos diagnósticos de enfermagem da NANDA-International a partir da correspondência entre as pistas diagnósticas descritas pela literatura com o título e indicadores diagnósticos; validação da correspondência diagnóstica por enfermeiros peritos. Foi utilizado o índice de concordância ≥ 0,80. Resultados A partir da leitura de 20 estudos, elegeram-se 51 pistas diagnósticas que foram agrupadas em 11 Necessidades Humanas Básicas Psicobiológicas. Após três rodadas de análise pelos peritos, identificou-se correspondência das 51 pistas diagnósticas com 26 títulos diagnósticos de enfermagem da NANDA-International. Os domínios dessa classificação com maior número de diagnósticos foram: atividade/repouso (n=9); segurança/proteção (n=7) e nutrição (n=4). Ressalta-se que 45,1% das pistas diagnósticas apresentaram correspondência com mais de um título diagnóstico. Além disso, a maioria dos diagnósticos de enfermagem (60,0%) refere-se a problemas reais e 40,0% a problemas potenciais. Conclusão Os resultados obtidos permitiram a identificação de pistas diagnósticas presentes em pacientes críticos adultos portadores de COVID-19 e verificar sua equivalência com 26 títulos diagnósticos da NANDA-International.

Resumen Objetivo Identificar posibles diagnósticos en enfermería según la clasificación de NANDA-International presentes en pacientes críticos adultos con COVID-19 a partir de pistas diagnósticas que se describen en la literatura científica. Métodos Estudio descriptivo, desarrollado en tres etapas: revisión de literatura y agrupación de las pistas diagnósticas identificadas de acuerdo con las Necesidades Humanas Básicas; recopilación de los diagnósticos de enfermería de NANDA-International a partir de la correspondencia entre las pistas diagnósticas que se describen en la literatura con el título e indicadores diagnósticos; validación de la correspondencia diagnóstica por enfermeros expertos. Se utilizó el índice de coincidencia ≥ 0,80. Resultados A partir de la lectura de 20 estudios, se eligieron 51 pistas diagnósticas que se agruparon en 11 Necesidades Humanas Básicas Psicobiológicas. Después de tres rondas de análisis de los expertos se identificó la correspondencia de las 51 pistas diagnósticas con 26 títulos diagnósticos de enfermería de NANDA-International. Los dominios de esa clasificación con un mayor número de diagnósticos fueron: actividad/reposo (n=9); seguridad/protección (n=7) y nutrición (n=4). Se destaca que 45,1 % de las pistas diagnósticas presentaron correspondencia con más de un título diagnóstico. Además, la mayoría de los diagnósticos de enfermería (60,0 %) se refiere a problemas reales y el 40,0 % a problemas potenciales. Conclusión Los resultados alcanzados permitieron la identificación de pistas diagnósticas presentes en pacientes críticos adultos con COVID-19 y verificar su equivalencia con 26 títulos diagnósticos de NANDA-International.

Abstract Objective To identify possible nursing diagnoses according to the NANDA-International classification present in critically ill adult patients with COVID-19 based on diagnostic clues described in the scientific literature. Method This is a descriptive study, developed in three stages: literature review and grouping of diagnostic clues identified according to Basic Human Needs; survey of NANDA-International nursing diagnoses based on the correspondence between diagnostic clues described in the literature with title and diagnostic indicators; validation of diagnostic correspondence by expert nurses. An agreement index ≥ 0.80 was used. Results From the reading of 20 studies, 51 diagnostic clues were selected and grouped into 11 Psychobiological Basic Human Needs. After three rounds of analysis by the experts, a correspondence of 51 diagnostic clues with 26 NANDA-International nursing diagnosis titles was identified. The domains of this classification with the highest number of diagnoses were: activity/rest (n=9); safety/protection (n=7) and nutrition (n=4). It is noteworthy that 45.1% of the diagnostic clues corresponded to more than one diagnostic title. Moreover, most nursing diagnoses (60.0%) refer to real problems and 40.0% to potential problems. Conclusion The results obtained allowed the identification of diagnostic clues present in critically ill adult patients with COVID-19 and to verify their equivalence with 26 diagnostic titles from NANDA-International.

Learning Strategies Assessment Scale for High School (EAVAP-EM) / Escala de Avaliação das Estratégias de Aprendizagem para o Ensino Médio (EAVAP-EM) / Escala de evaluación de estrategias de aprendizaje para el bachillerato (EAVAP-EM)

This study aimed to estimate validity evidence based on the internal structure and accuracy of the adapted version of the Learning Strategies Assessment Scale for High School (EAVAP-EM), using Confirmatory Factor Analysis (CFA). Participants were 701 first- to third-year high school students (M = 16.1; SD = 1.0), from public and private institutions in the states of Paraná and São Paulo. The CFA indicated the presence of the three factors of the EAVAP-EM, with adequate internal consistency. The instrument also showed good fit indices. There were positive and significant correlations between the factors, with magnitude ranging from medium to large. Moreover, students reported making more use of metacognitive strategies. The results evinced significant advances regarding measures with good psychometric parameters to assess learning strategies, considering their relevance to the psychoeducational context (AU).

Objetivou-se no presente estudo estimar indicadores de validade com base na estrutura interna e precisão da versão adaptada da Escala de Avaliação das Estratégias de Aprendizagem para o Ensino Médio (EAVAP-EM), por meio de uma análise fatorial confirmatória (AFC). Participaram 701 alunos do primeiro ao terceiro ano do Ensino Médio (M = 16,1; DP = 1,0), provenientes de instituições públicas e particulares dos estados do Paraná e de São Paulo. A AFC indicou a presença dos três fatores da EAVAP-EM, com consistência interna considerada adequada, sendo que o instrumento apresentou bons índices de ajuste. Houve correlações positivas e significativas entre os fatores, com magnitude variando de média a grande. Ainda, os estudantes reportaram fazer mais uso de estratégias metacognitivas. Os resultados evidenciam importantes avanços no que concerne a medidas com bons indicadores psicométricos para avaliação das estratégias de aprendizagem, considerando sua relevância ao contexto psicoeducacional (AU).

El objetivo del presente estudio fue estimar evidencias de validez a partir de la estructura interna y la precisión de la versión adaptada de la Escala de Evaluación de Estrategias de Aprendizaje para la Escuela Preparatoria (EAVAP-EM), mediante un Análisis Factorial Confirmatorio (AFC). Participaron 701 estudiantes de primero a tercer año de secundaria (M = 16.1; DS = 1.0), de instituciones públicas y privadas de las provincias de Paraná y São Paulo. El AFC indicó la presencia de los tres factores del EAVAP-EM, con consistencia interna considerada adecuada. El instrumento mostró índices de ajuste adecuados. Hubo correlaciones positivas y significativas entre los factores, cuya magnitud varió de moderada a alta. Además, los estudiantes informaron que hacen un mayor uso de las estrategias metacognitivas. Los resultados evidencian avances importantes en cuanto a medidas con buenos indicadores psicométricos para evaluar estrategias de aprendizaje, considerando su relevancia para el contexto psicoeducativo (AU).

[Evidence of the validity of a Brazilian version of the Fear of COVID-19 Scale]. / Evidências de validade de uma versão brasileira da Fear of COVID-19 Scale.

This study sought to analyze the evidence of the validity of a Brazilian version of the Fear of COVID-19 Scale (FCV-19S), based on indicators relating to: (1) the internal structure; (2) the internal consistency; (3) the relation with external variables; and (4) the content. The instrument was culturally adapted, focusing on semantic and specifically Brazilian linguistic aspects. The Brazilian version of the FCV-19S was then applied, in a virtual environment, to 211 participants (72.98% female) with an average age of 37.07 years (SD=13.03), together with the Self-Perception Questionnaire on Mental Health in Pandemics and the Sociodemographic and Functional Questionnaire. The confirmatory factor analysis revealed one-dimensionality. The internal consistency indices obtained (Cronbach's alpha =0.921; McDonald's omega =0.926) can be considered high. The correlation between fear and obsessive thinking of the disease, generalized anxiety, generalized stress, phobic-avoidant behavior and bereavement due to the pandemic was found to be statistically significant. Evidence of the validity related to content, derived from a qualitative approach, were satisfactory. The conclusion drawn is that the Brazilian version of the FCV-19S proved to be adequate regarding the evidence of the expected validity.

O presente estudo teve como objetivo analisar evidências de validade de uma versão brasileira da Fear of COVID-19 Scale (FCV-19S), com base em indicadores concernentes: (1) à estrutura interna; (2) à consistência interna; (3) à relação com variáveis externas; e (4) ao conteúdo. Procedeu-se a adaptação cultural do instrumento, com foco em aspectos semânticos e linguísticos próprios do Brasil. A seguir, esta versão brasileira da FCV-19S foi aplicada, em um ambiente virtual, em 211 participantes (72,98% do sexo feminino), com idade média de 37,07 anos (DP=13,03), juntamente com o Questionário de Autopercepção de Saúde Mental em Pandemia e o Questionário Sociodemográfico e Funcional. A análise fatorial confirmatória atestou unidimensionalidade. Os índices de consistência interna obtidos (alfa de Cronbach =0,921; ômega de McDonald =0,926) podem ser considerados elevados. Constatou-se correlação estatisticamente significativa entre medo e pensamento obsessivo, ansiedade generalizada, estresse generalizado, comportamento fóbico-evitativo e vivência de luto pela pandemia. As evidências de validade relativas ao conteúdo, oriundas de uma abordagem qualitativa, foram satisfatórias. Conclui-se que esta versão brasileira da FCV-19S mostrou-se adequada quanto às evidências de validade contempladas.

Tonic Pupil Following COVID-19.

ABSTRACT: A 37-year-old patient presented to our emergency department with sudden onset decreased vision with a history of being treated for COVID 19 3 weeks earlier. On examination, she was found to have a tonic right pupil, which was confirmed with a dilute pilocarpine test. As tonic pupils are known to be caused by neurotropic viruses and our current understanding of the SARS-CoV-2 is that it does affect the nervous system, we feel that the tonic pupil in our patient may be secondary to COVID 19.

Regulatory CD4+ and CD8+ T cells are negatively correlated with CD4+ /CD8+ T cell ratios in patients acutely infected with SARS-CoV-2.

Regulatory T cell can protect against severe forms of coronaviral infections attributable to host inflammatory responses. But its role in the pathogenesis of COVID-19 is still unclear. In this study, frequencies of total and multiple subsets of lymphocytes in peripheral blood of COVID-19 patients and discharged individuals were analyzed using a multicolor flow cytometry assay. Plasma concentration of IL-10 was measured using a microsphere-based immunoassay kit. Comparing to healthy controls, the frequencies of total lymphocytes and T cells decreased significantly in both acutely infected COVID-19 patients and discharged individuals. The frequencies of total lymphocytes correlated negatively with the frequencies of CD3- CD56+ NK cells. The frequencies of regulatory CD8+ CD25+ T cells correlated with CD4+ /CD8+ T cell ratios positively, while the frequencies of regulatory CD4+ CD25+ CD127- T cells correlated negatively with CD4+ /CD8+ T cell ratios. Ratios of CD4+ /CD8+ T cells increased significantly in patients beyond age of 45 years. And accordingly, the frequencies of regulatory CD8+ CD25+ T cells were also found significantly increased in these patients. Collectively, the results suggest that regulatory CD4+ and CD8+ T cells may play distinct roles in the pathogenesis of COVID-19. Moreover, the data indicate that NK cells might contribute to the COVID-19 associated lymphopenia.

Use of health services and adherence to social distancing by adults with Noncommunicable Diseases during the COVID-19 pandemic, Brazil, 2020. / Uso dos serviços de saúde e adesão ao distanciamento social por adultos com doenças crônicas na pandemia de COVID-19, Brasil, 2020.

The present study investigates the association between the self-reported diagnosis of noncommunicable disease (NCD) and the adherence to social distancing and the use of health services during the COVID-19 pandemic. This was a cross-sectional study with Brazilian adults who participated in the ConVid- Behavior Survey, conducted online between April 24 and May 24, 2020(n = 45.161). This studyconsidered the following NCDs: diabetes, hypertension, respiratory disease, heart disease, and cancer, and evaluated the use of health services and the adherence to social distancing, as well as estimated the prevalences and adjusted prevalence ratio (aPR); 33,9% (95% CI: 32,5-35,3) referred to one or more NCD. Individuals with NCDsshowed a greater adherence to intense social distancing (aPR: 1,07;95% CI: 1,03-1,11), sought out health services more often (aPR:1,24; 95% CI:1,11-1,38), and found greater difficultyin scheduling doctor's appointments (aPR:1.52; 95% CI 1,35-1,71), receiving healthcare treatment (APR:1,50;95% CI:1,22-1,84) and medication (APR:2,17;95% CI:1,77-2,67), and performing examinations (APR:1,78;95% CI:1,50-2,10) and scheduled interventions (APR:1,65;95% CI:1,16-2,34). The presence of NCDs was associated with social distancing, seeking out health care, and difficulty in using health services.

Este estudo investiga a associação entre diagnóstico autorreferido de Doença Crônica Não Transmissível (DCNT) e adesão ao distanciamento social e utilização dos serviços de saúde durante a pandemia de COVID-19. Estudo transversal com adultos brasileiros que participaram da ConVid Pesquisa de Comportamentos, realizada de 24 de abril a 24 de maio de 2020, via web (n = 45.161). Considerou as DCNT: diabetes, hipertensão, doença respiratória, doença do coração e câncer. Avaliou a utilização de serviços de saúde e a adesão ao distanciamento social. Estimou as prevalências e razões de prevalências ajustadas (RPa). 33,9% (IC95%: 32,5-35,3) referiu uma ou mais DCNT. Indivíduos com DCNT tiveram maior adesão ao distanciamento social intenso (RPa:1,07; IC95%:1,03-1,11), procuraram mais o serviço de saúde (RPa:1,24; IC95%:1,11-1,38) e tiveram mais dificuldades para marcar consulta (RPa:1,52; IC95%:1,35-1,71), conseguir atendimento de saúde (RPa:1,50; IC95%:1,22-1,84) e medicamentos (RPa:2,17; IC95%:1,77-2,67), realizar exames (RPa:1,78; IC95%:1,50-2,10) e intervenções programadas (RPa:1,65; IC95%:1,16-2,34). A presença de DCNT associou-se à maior adesão ao distanciamento social, procura por atendimento de saúde e dificuldade na utilização dos serviços de saúde.

Clinical analysis of 132 cases COVID-19 from Wuhan.

Numerous cases of pneumonia from a novel coronavirus (SARS-CoV-2) emerged in Wuhan, China during December 2019.We determined the correlations of patient parameters with disease severity in patients with COVID-19.A total of 132 patients from Wuhan Fourth Hospital who had COVID-19 from February 1 to February 29 in 2020 were retrospectively analyzed.Ninety patients had mild disease, 32 had severe disease, and 10 had critical disease. The severe/critical group was older (P < .05), had a higher proportion of males (P < .05), and had a greater mortality rate (0% vs 61.9%, P < .05). The main symptoms were fever (n = 112, 84.8%) and cough (n = 96, 72.7%). Patients were treated with antiviral agents (n = 94, 71.2%), antibiotics (n = 92, 69.7%), glucocorticoids (n = 46, 34.8%), intravenous immunoglobulin (n = 38, 27.3%), and/or traditional Chinese medicine (n = 40, 30.3%). Patients in the severe/critical group received mechanical ventilation (n = 22, 16.7%) or high-flow nasal can-nula oxygen therapy (n = 6, 4.5%). Chest computed tomography (CT) indicated bilateral pneumonia in all patients. Relative to the mild group, the severe/critical group had higher levels of leukocytes, C-reactive protein (CRP), procalcitonin (PCT), D-dimer, B-type natriuretic peptide (BNP), liver enzymes, and myocardial enzymes (P < .05), and decreased levels of lymphocytes and blood oxygen partial pressure (P < .05).The main clinical symptoms of patients from Wuhan who had COVID-19 were fever and cough. Patients with severe/critical disease were more likely to be male and elderly. Disease severity correlated with increased leukocytes, CRP, PCT, BNP, D-dimer, liver enzymes, and myocardial enzymes, and with decreased lymphocytes and blood oxygen partial pressure.