Delivery of menopause care during a pandemic: an evaluation of patient satisfaction with telephone visits.

OBJECTIVE: We aimed to evaluate patient satisfaction with telephone appointments during the first wave of the COVID-19 pandemic, determine visit type preference (in-person vs telephone), and predictors of those preferences. METHODS: In this cross-sectional study, patient visits during the first wave of COVID-19 (March 20 to July 15, 2020) were characterized (in-person vs telephone) in a single provider's weekly menopause clinic in Toronto, Canada. Patients attending telephone appointments were asked to complete a modified Telemedicine Satisfaction Questionnaire with 5-point Likert-scale responses. Demographic information was collected along with the patient-reported cost to attend an in-person appointment (monetary, travel time, and time away from work). Of those who experienced both visit types, preference was evaluated and bivariate analysis was performed identifying factors associated with visit type preference and included in a multivariable binary logistic regression model. RESULTS: During the first wave of the COVID-19 pandemic, 214 women had 246 visits, attending mostly by telephone (221/246, 90%). Mean Telemedicine Satisfaction Questionnaire composite score was 4.23 ±â€Š0.72. Of those who attended a prepandemic in-person appointment (118/139, 85%), a minority (24/118, 20%) preferred in-person visits. Those favoring in-person were more likely to commute less than 30 minutes (OR 3.78, 95% CI 1.16-12.29, P = 0.027), require less than 2 hours away from work (OR 4.05, 95% CI 1.07-15.4, P = 0.04), and spend less than $10 to attend (OR 3.67, 95% CI 1.1-12.26, P = 0.035). CONCLUSIONS: Menopause clinic telephone appointments had high patient satisfaction, with most preferring this visit type, although in-person visits are preferred among a minority of women.

Implementation of Telemedicine in Indonesian Urology Practice During COVID-19 Pandemic: a National Survey.

BACKGROUND: The pandemic of COVID-19 is nowhere from over, which pushes us to adapt to it.  Social distancing rules were applied to restrict the people and prevent virus transmission. Despite these restrictions, the patient's care should not be compromised. Doctors are encouraged to technologically improve themselves to get used to the utilization of telemedicine. METHODS: We conducted an online survey of urology specialists and urology residents throughout the country. The survey was accompanied by the Indonesian Urological Association, and the survey was opened for one month and sent by email to all members of the association. RESULTS: A total of 50 urologists and 182 urology residents participated. Almost half (48%) currently do not have facilities to hold a telemedicine practice in their institution, and 14% reported inadequate facilities. The majority reveals that the barrier to conducting this method was due to insufficient facility. Other issues like insurance coverage and patient's interest in telemedicine, the risk of patient's data leak, and the urologist's lack of interest in telemedicine might also be challenging. Despite some doubts, in sum, more than half have thought that telemedicine would keep utilized although the pandemic is resolved. CONCLUSIONS: We are currently learning the novel telemedicine implementation and some challenges still need to be resolved. Starting from the regulation and legal protection fundamentally, and the health insurance coverage needs to be determined. After all, the low interest in adopting this method has become the greatest barrier.

Arrhythmogenesis and COVID-19.

The ongoing coronavirus infection-2019 (COVID-19) global pandemic has had devastating impacts on the global population since 2019. Cardiac complications are a well-documented sequala of COVID-19, with exposed patients experiencing complications such as myocardial infarction, myocarditis, and arrythmias. This article aims to review prominent literature regarding COVID-19 and its link with arrhythmias, as well as to discuss some of the possible mechanisms by which arrhythmogenesis may occur in patients with COVID-19.

National COVID-19 vaccination plan: using artificial spatial intelligence to overcome challenges in Brazil. / Plano nacional de vacinação contra a COVID-19: uso de inteligência artificial espacial para superação de desafios.

This article explores the use of spatial artificial intelligence to estimate the resources needed to implement Brazil's COVID-19 immu nization campaign. Using secondary data, we conducted a cross-sectional ecological study adop ting a time-series design. The unit of analysis was Brazil's primary care centers (PCCs). A four-step analysis was performed to estimate the popula tion in PCC catchment areas using artificial in telligence algorithms and satellite imagery. We also assessed internet access in each PCC and con ducted a space-time cluster analysis of trends in cases of SARS linked to COVID-19 at municipal level. Around 18% of Brazil's elderly population live more than 4 kilometer from a vaccination point. A total of 4,790 municipalities showed an upward trend in SARS cases. The number of PCCs located more than 5 kilometer from cell towers was largest in the North and Northeast regions. Innovative stra tegies are needed to address the challenges posed by the implementation of the country's National COVID-19 Vaccination Plan. The use of spatial artificial intelligence-based methodologies can help improve the country's COVID-19 response.

O objetivo deste artigo é analisar o uso da inteligência artificial espacial no contexto da imunização contra COVID-19 para a seleção adequada dos recursos necessários. Trata-se de estudo ecológico de caráter transversal baseado em uma abordagem espaço-temporal utilizando dados secundários, em Unidades Básicas de Saúde do Brasil. Foram adotados quatro passos analíticos para atribuir um volume de população por unidade básica, aplicando algoritmos de inteligência artificial a imagens de satélite. Em paralelo, as condições de acesso à internet móvel e o mapeamento de tendências espaço-temporais de casos graves de COVID-19 foram utilizados para caracterizar cada município do país. Cerca de 18% da população idosa brasileira está a mais de 4 quilômetros de distância de uma sala de vacina. No total, 4.790 municípios apresentaram tendência de agudização de casos de Síndrome Respiratória Aguda Grave. As regiões Norte e Nordeste apresentaram o maior número de Unidades Básicas de Saúde com mais de 5 quilômetros de distância de antenas de celular. O Plano nacional de vacinação requer o uso de estratégias inovadoras para contornar os desafios do país. O uso de metodologias baseadas em inteligência artificial espacial pode contribuir para melhoria do planejamento das ações de resposta à COVID-19.

SwabExpress: An End-to-End Protocol for Extraction-Free COVID-19 Testing.

BACKGROUND: The urgent need for massively scaled clinical testing for SARS-CoV-2, along with global shortages of critical reagents and supplies, has necessitated development of streamlined laboratory testing protocols. Conventional nucleic acid testing for SARS-CoV-2 involves collection of a clinical specimen with a nasopharyngeal swab in transport medium, nucleic acid extraction, and quantitative reverse-transcription PCR (RT-qPCR). As testing has scaled across the world, the global supply chain has buckled, rendering testing reagents and materials scarce. To address shortages, we developed SwabExpress, an end-to-end protocol developed to employ mass produced anterior nares swabs and bypass the requirement for transport media and nucleic acid extraction. METHODS: We evaluated anterior nares swabs, transported dry and eluted in low-TE buffer as a direct-to-RT-qPCR alternative to extraction-dependent viral transport media. We validated our protocol of using heat treatment for viral inactivation and added a proteinase K digestion step to reduce amplification interference. We tested this protocol across archived and prospectively collected swab specimens to fine-tune test performance. RESULTS: After optimization, SwabExpress has a low limit of detection at 2-4 molecules/µL, 100% sensitivity, and 99.4% specificity when compared side by side with a traditional RT-qPCR protocol employing extraction. On real-world specimens, SwabExpress outperforms an automated extraction system while simultaneously reducing cost and hands-on time. CONCLUSION: SwabExpress is a simplified workflow that facilitates scaled testing for COVID-19 without sacrificing test performance. It may serve as a template for the simplification of PCR-based clinical laboratory tests, particularly in times of critical shortages during pandemics.

Integra Project: strengthening social participation in the agenda of health policies, services, and technologies. / Projeto Integra: fortalecimento da participação social na agenda das políticas, serviços e tecnologias em saúde.

The 16th National Health Conference illustrated the interest of health councils to intervene in public policies in order to guarantee the right to health technologies. The INTEGRA project (Integration of policies for Health Surveillance, Pharmaceutical Care, Science, Technology, and Innovation in Health) is a partnership among the National Health Council, the National School of Pharmacists, and the Oswaldo Cruz Foundation (Fiocruz), with support from the Pan American Health Organization (PAHO), with the goal of strengthening participation and social engagement in the theme, as well as the integration of health policies and practices within different sectors of society (social movements, health councils, and health professionals), with the various stages related to the access to medicines (research, incorporation, national production, and services) being the main theme in the context of the COVID-19 pandemic. It seeks to offer training for leadership groups in the health regions and activities with a broad national and political scope, and it hopes to establish an intersectorial and integrated network of leaders capable of acting collaboratively to defend the development of science, public policies, national sovereignty, and social control of health.

A 16ª Conferência Nacional de Saúde demonstrou o interesse do controle social em intervir sobre as políticas públicas a fim de garantir o direito às tecnologias de saúde. O projeto Integra - Integração das Políticas de Vigilância em Saúde, Assistência Farmacêutica, Ciência, Tecnologia e Inovação em Saúde -, nasce da parceria entre o Conselho Nacional de Saúde, a Escola Nacional dos Farmacêuticos e a Fundação Oswaldo Cruz (Fiocruz), com apoio da Organização Pan-Americana de Saúde (OPAS) com objetivo de fortalecimento da participação e engajamento social na temática e a integração das políticas e práticas de saúde em diferentes setores da sociedade (movimentos sociais, controle social e profissionais de saúde), tendo as diversas etapas relacionadas ao acesso aos medicamentos (pesquisa, incorporação, produção nacional e serviços) como mote principal, no cenário da pandemia de COVID-19. Oferta-se, neste projeto, capacitação para grupos de lideranças nas regiões de saúde e atividades de grande abrangência nacional e política. Espera-se alcançar o estabelecimento de uma rede intersetorial, integrada de lideranças capazes de atuar colaborativamente para a defesa do desenvolvimento da ciência, das políticas públicas, da soberania nacional e do controle social da saúde.

Management of the health workforce in facing COVID-19: disinformation and absences in Brazil's Public Policies.

The objective of this research was to analyse federal government interventions in crisis management and the consequences for health professionals. This is a documentary-type qualitative research. Brazilian Federal regulations referring to work and health education produced during the pandemic emergency of COVID-19, published from January 28 to June 2, 2020, were identified. Of the total of 845 documents, 62 were selected in accordance with the inclusion criteria and were then submitted to Thematic Content Analysis. The results and discussions were grouped into four categories:workforce management, workforce protection, workforce training and academic-workforce relationship. Absence of a federal coordinating actions and policies for desinformation were identified. This lacking mechanisms for coordination contributed decisively to the tragic epidemiological situation still underway, especially in terms of the exposure of health workers to the risk of contamination, revealed in the extremely high rates of professionals infected or killed by COVID-19 in Brazil and the failure to control the pandemic in the population.

Neurologic manifestations associated with COVID-19: a multicentre registry.

OBJECTIVES: To provide an overview of the spectrum, characteristics and outcomes of neurologic manifestations associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. METHODS: We conducted a single-centre retrospective study during the French coronavirus disease 2019 (COVID-19) epidemic in March-April 2020. All COVID-19 patients with de novo neurologic manifestations were eligible. RESULTS: We included 222 COVID-19 patients with neurologic manifestations from 46 centres in France. Median (interquartile range, IQR) age was 65 (53-72) years and 136 patients (61.3%) were male. COVID-19 was severe or critical in 102 patients (45.2%). The most common neurologic diseases were COVID-19-associated encephalopathy (67/222, 30.2%), acute ischaemic cerebrovascular syndrome (57/222, 25.7%), encephalitis (21/222, 9.5%) and Guillain-Barré syndrome (15/222, 6.8%). Neurologic manifestations appeared after the first COVID-19 symptoms with a median (IQR) delay of 6 (3-8) days in COVID-19-associated encephalopathy, 7 (5-10) days in encephalitis, 12 (7-18) days in acute ischaemic cerebrovascular syndrome and 18 (15-28) days in Guillain-Barré syndrome. Brain imaging was performed in 192 patients (86.5%), including 157 magnetic resonance imaging (70.7%). Among patients with acute ischaemic cerebrovascular syndrome, 13 (22.8%) of 57 had multiterritory ischaemic strokes, with large vessel thrombosis in 16 (28.1%) of 57. Brain magnetic resonance imaging of encephalitis patients showed heterogeneous acute nonvascular lesions in 14 (66.7%) of 21. Cerebrospinal fluid of 97 patients (43.7%) was analysed, with pleocytosis found in 18 patients (18.6%) and a positive SARS-CoV-2 PCR result in two patients with encephalitis. The median (IQR) follow-up was 24 (17-34) days with a high short-term mortality rate (28/222, 12.6%). CONCLUSIONS: Clinical spectrum and outcomes of neurologic manifestations associated with SARS-CoV-2 infection were broad and heterogeneous, suggesting different underlying pathogenic processes.

Guidelines for Urological Surgeries in the COVID-19 Pandemic: Is it Time for Revision?

In this correspondence the authors try to show that guidelines and recommendations including what was published by EAU rapid reaction group must be further updated and tailored according to different epidemiologic data in different countries. The authors assign the countries worldwide in three categories. First category comprises countries that experience the secondary surges smoother than the first one. The second category include countries with stronger or -merging and rising-secondary surges and the third category encompasses countries with successful initial response and secondary stronger but still more controllable surges. Authors proclaim that after passing the first baffling impact we find out that postponement strategies preached in many of these scout treatises are no more suitable at least for the countries delineated in the second category and can culminate in performance of procedures in worse. The authors proffer Iranian Urology Association COVID-19 Taskforce Pamphlet(IUA-CTP) as a paragonic document mentioning it's the time we must recognise the wide variability of the situation in different regions and any advisory position must consider this huge variance in epidemiologic profile.

[The colonization of epidemiological knowledge: a decolonial reading of the contemporaneity of the COVID-19 pandemic]. / A colonização do saber epidemiológico: uma leitura decolonial da contemporaneidade da pandemia de COVID-19.

This paper makes a critical assessment of epidemiology with the COVID-19 pandemic as a social event. It examines the philosophical reflection in which Agamben defines as contemporary those able to stand back to see the dark side of their own era. In the light of decolonial criticism, the concept of "epidemiological transition," with its theory of transcendence of "social determinants of health" and binarism of epidemiological variables as supports of the biomedical and quantitative structuring of the epidemiology of risk factors is queried. The scientific ambition to dominate nature and the engendering of a linear and evolutionary historical time, beginning in western modernity, contextualizes the epistemicides of popular wisdom and the coloniality of epidemiological knowledge. The theoretical constitution of decolonial thought is historically analyzed, highlighting its greater critical potential to reveal the structural colonization of epidemiological knowledge. The post-pandemic future is considered and Prigogine's idea of bifurcation - as elaborated by Sousa Santos - and Paulo Freire's untested feasibility are related with the concept of time as the creation and expectation of social transformation.

O ensaio epistemológico relaciona criticamente a epidemiologia com a pandemia de COVID-19 enquanto evento social. Explora-se a reflexão filosófica em que Agamben define contemporâneo como quem é capaz de se afastar e enxergar o lado escuro do seu tempo. À luz da crítica decolonial, questionam-se a ideia de "transição epidemiológica", com sua transcendência na teoria dos "determinantes sociais de saúde", e a disposição binarista das varáveis epidemiológicas, como suportes da estruturação quantitativa e biomédica da epidemiologia dos fatores de risco. A pretensão científica de domínio da natureza e o engendramento de um tempo histórico linear e evolutivo, que inicia com a modernidade ocidental, contextualizam os epistemicídios dos saberes populares e a colonização do saber epidemiológico. Historiciza-se a constituição do pensamento crítico decolonial e pontua-se seu potencial para a revelação do caráter estrutural da colonização do saber epidemiológico. Considera-se o futuro pós-pandemia e relacionam-se as ideias de bifurcação, originada de Ilya Prigogine e elaborada por Boaventura de Sousa Santos, e inédito viável, de Paulo Freire com a concepção do tempo como criação e a expectativa de transformação social.

Improving Patient Outcomes in the Dual Crises of Climate Change and COVID-19: Proceedings of the Third Annual Clinical Climate Change Meeting, January 8, 2021.

The tremendous global toll of the COVID-19 pandemic does not fall equally on all populations. Indeed, this crisis has exerted more severe impacts on the most vulnerable communities, spotlighting the continued consequences of longstanding structural, social, and healthcare inequities. This disparity in COVID-19 parallels the unequal health consequences of climate change, whereby underlying inequities perpetuate adverse health outcomes disproportionately among vulnerable populations. As these two crises continue to unfold, there is an urgent need for healthcare practitioners to identify and implement solutions to mitigate adverse health outcomes, especially in the face of global crises. To support this need, the 2021 Clinical Climate Change Conference held a virtual meeting to discuss the implications of the convergence of the climate crisis and COVID-19, particularly for vulnerable patient populations and the clinicians who care for them. Presenters and panelists provided evidence-based solutions to help health professionals improve and adapt their practice to these evolving scenarios. Together, participants explored the community health system and national solutions to reduce the impacts of COVID-19 and the climate crisis, to promote community advocacy, and foster new partnerships between community and healthcare leaders to combat systemic racism and achieve a more just and equitable society.

COVID-19 pandemic: dissatisfaction with work among teachers in the state of Minas Gerais, Brazil. / Pandemia da COVID-19: insatisfação com o trabalho entre professores(as) do estado de Minas Gerais, Brasil.

This article aimed to verify the prevalence and factors associated with dissatisfaction with teaching work among teachers from the state public basic education network in the state of Minas Gerais during the COVID-19 pandemic. This is a websurvey, carried out with these teachers between August and September 2020 via digital form. The dependent variable was job satisfaction during the pandemic, with satisfied people being the reference category. Multinomial Logistic Regression was used. 15,641 teachers from 795 municipalities participated in the study. Regarding work satisfaction, 21.6% were satisfied, 44.7% were indifferent and 33.7% were unsatisfied. The chances of being unsatisfied were higher among those without a spouse (OR=1.23), longer teaching time (OR=1.19), difficulty with remote activities (OR=37.60), without possession of a computer (OR=1.40), smokers (OR=1.27), using alcoholic beverages (OR=1.54), sedentary (OR=1.22) and absent leisure activities (OR=1.49). The changes caused in the educational system in the face of the pandemic impacted the teacher's routine, contributing to the dissatisfaction with the work of this professional.

O objetivo deste artigo foi verificar a prevalência e fatores associados à insatisfação com o trabalho docente entre professores(as) da rede pública estadual de educação básica do estado de Minas Gerais durante a pandemia da COVID-19. Inquérito epidemiológico do tipo websurveys, realizado com esses(as) professores(as) entre agosto e setembro de 2020 via formulário digital. A variável dependente foi a satisfação com o trabalho durante a pandemia, sendo os(as) satisfeitos(as) a categoria de referência. Foi utilizada a Regressão Logística Multinomial. Participaram do estudo 15.641 professores(as) de 795 municípios. Em relação a satisfação com o trabalho, 21,6% estavam satisfeitos(as), 44,7% indiferentes e 33,7% insatisfeitos(as). As chances de estarem insatisfeitos(as) foram maiores entre aqueles(as) sem cônjuge (OR=1,23), maior tempo de docência (OR=1,19), dificuldade com atividades remotas (OR=37,60), sem posse de computador (OR=1,40), tabagistas (OR=1,27), em uso de bebida alcoólica (OR=1,54), sedentários(as) (OR=1,22) e atividade de lazer ausente (OR=1,49). As mudanças causadas no sistema educacional diante da pandemia impactaram a rotina do(a) professor(a), contribuindo para a insatisfação com o trabalho deste(a) profissional.

[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.

Primary care-based health surveillance actions in response to the COVID-19 pandemic: contributions to the debate. / Ações de vigilância à saúde integradas à Atenção Primária à Saúde diante da pandemia da COVID-19: contribuições para o debate.

We conducted an integrated literature review aimed at reflecting on the challenges related to primary care-based health surveillance actions in response to the COVID-19 pandemic in selected countries. The study included countries with different PHC models that adopted surveillance as an approach to control the transmission of COVID-19. We performed a search in October 2020 for relevant literature and norms and guidelines related to the organization of primary health care (PHC) in response to the pandemic on official government websites and the databases Web of Science and Science Direct. The integrated health surveillance actions demonstrated that efforts were more focused on risks, with some countries adopting innovative and effective measures to respond to COVID-19, considering emerging needs within PHC. However, in addition to ethical controversies and operational difficulties, access to technology was a challenge in actions developed by some countries due to social inequalities.

Trata-se de uma revisão de síntese integrativa com objetivo de refletir sobre os desafios atinentes às ações de vigilância em saúde no enfrentamento da COVID-19, no âmbito da Atenção Primária à Saúde (APS), em sistemas de saúde de países selecionados. Foram incluídos, no estudo, países com modelos de APS distintos, mas que adotaram a vigilância nos territórios como premissa para o controle da transmissão da COVID-19. Houve a revisão bibliográfica da literatura científica e a análise documental de normas e diretrizes relacionadas à organização da APS para enfrentamento da pandemia. A produção dos dados ocorreu no período entre abril e julho de 2020 e envolveu a busca de documentos sobre o enfrentamento da COVID-19, no que se refere à APS, nos sites oficiais governamentais de cada país e nas bases de dados científicas Web of Science e Science Direct. Ações integradas de vigilância em saúde demonstraram atuação mais direcionada sobre riscos, sendo possível respostas inovadoras e mais efetivas para enfrentamento da COVID-19, considerando necessidades emergentes no âmbito da APS. Contudo, experiências desenvolvidas por alguns países apresentaram controvérsias éticas e operacionais além dos desafios de acesso às tecnologias decorrente das desigualdades sociais.

The infodemic transcends the pandemic. / A infodemia transcende a pandemia.

This paper highlights the advance of science in interpreting pandemics, in contrast to the failure of governments that politicized the approach to the global public health emergency resulting from the COVID-19 pandemic. This study reflects on cognitive dissonance caused by the infodemic. It addresses the need to apply infodemiology to mitigate the deleterious effects of fake news intentionally fabricated to confuse, mislead, manipulate, and deny the reality without losing sight of the fact that the roots of the problem are historical, circumstantial, profound, and challenging. This work reveals the impacts of this situation for health professionals and exposes the fine line between freedom of expression and the fundamental right to life, leading to the conclusion that wrong choices in public health can cause preventable deaths.

O artigo evidencia o avanço da ciência na interpretação de pandemias, em contraste com o fracasso de governos que politizaram a abordagem da emergência de saúde pública global decorrente da COVID-19. Trata-se de um estudo que apresenta uma reflexão sobre o processo de dissonância cognitiva causada pela infodemia e aborda a necessidade de aplicar a infodemiologia para mitigar os efeitos deletérios de notícias falsas que são fabricadas intencionalmente, com o objetivo de confundir, enganar, manipular e negar a realidade, sem, contudo, perder de vista que as raízes do problema são históricas, conjunturais, profundas e de difícil solução. O trabalho revela os impactos dessa situação para profissionais de saúde e expõe a linha tênue que existe entre a liberdade de expressão e o direito essencial à vida, levando à conclusão de que escolhas erradas, no que tange à saúde pública, podem causar mortes evitáveis.

[Predisposition to severe forms of COVID-19 and adherence to preventive measures: the role of social support]. / Predisposição a formas graves de COVID-19 e adesão às medidas de prevenção: o papel do apoio social.

This study sought to assess the adherence to preventive measures among the elderly more prone to severe forms of COVID-19, and the association and interaction with social support. It is a cross-sectional study conducted with a sample of 3,477 participants of the telephone survey of the Brazilian Longitudinal Study of Aging (ELSI-COVID-19 initiative), who reported going out of the home in the past week. The adherence was based on the frequency of leaving the house, the need to venture outside the home, use of masks, and sanitization of hands. Statistical analysis was based on the Poisson model with robust variance. Predisposing factors for severe forms of COVID-19 included age ≥65 years, hypertension, diabetes, and obesity. Social support included living arrangements and social distancing during the pandemic. Approximately 46% of the participants showed higher adherence, which was positively associated with the number of predisposing factors for severe forms of COVID-19. Social support was not associated with adherence, nor was this association modified after adjustments. The conclusion drawn is that higher adherence is concentrated among the elderly with greater predisposition to severe forms of COVID-19, irrespective of social support, albeit preventive measures should be adopted by all.

Objetivou-se verificar a adesão às medidas de prevenção em idosos com maior predisposição a formas graves de COVID-19 e sua associação e interação com o apoio social. Trata-se de um estudo transversal realizado em amostra de 3.477 participantes do inquérito telefônico do Estudo Longitudinal da Saúde dos Idosos Brasileiros (iniciativa ELSI-COVID-19), que informaram ter saído de casa na semana anterior à realização do inquérito. A adesão foi aferida pela frequência com que saiu de casa, necessidade de sair de casa, uso de máscara e higienização das mãos. As análises basearam-se no modelo Poisson com variância robusta. Idade ≥ 65 anos, hipertensão, diabetes e obesidade foram considerados fatores predisponentes para formas graves de COVID-19. O apoio social incluiu o arranjo domiciliar e a conexão social na pandemia. Aproximadamente 46% apresentaram melhor adesão, que foi associada positivamente ao número de fatores predisponentes para formas graves. O apoio social não foi associado à adesão e não modificou essa associação, após ajustamentos. Conclui-se que a adesão às medidas de prevenção, que deveria ser estendida a todos, está concentrada nos idosos com maior predisposição a formas graves de COVID-19, independentemente do apoio social.

[Trust, attitudes, information: a study on the perception of the COVID-19 pandemic in 12 Brazilian cities]. / Confiança, atitudes, informação: um estudo sobre a percepção da pandemia de COVID-19 em 12 cidades brasileiras.

In this study, the perception of Brazilians regarding COVID-19 in 12 cities in the country was analyzed. Issues about the severity and dangers of the disease, sources of information and reliability, checking information, attitudes, precautions, and priorities for coping and trusting relationships in science were addressed. This study was carried out in the context of broader research on how Brazilians perceive the Oswaldo Cruz Foundation (Fiocruz). The survey was applied between May 18 and June 10, 2020, with 1,643 residents over 16 years of age in Brazilian cities where Fiocruz has a technical unit or office. The results reveal that the majority of the interviewees appreciate the seriousness of the pandemic, the importance of being properly informed, considers the measures indicated by health authorities important and trusts scientists and scientific institutions as sources of information. With the sense of urgency and experience of uncertainties about the present and the future, the need for strengthening of trust in institutions is present.

Neste estudo, analisamos a percepção de brasileiros e brasileiras sobre a COVID-19 em 12 cidades do país. Foram abordadas questões sobre a gravidade e os perigos da doença, fontes de informações e confiabilidade, checagem de informações, atitudes, precauções e prioridades para o enfrentamento e relações de confiança na ciência. Este estudo foi realizado no contexto de uma pesquisa mais ampla sobre como brasileiros e brasileiras veem a Fundação Oswaldo Cruz (Fiocruz). A survey foi aplicada no período de 18 de maio e 10 de junho de 2020 com 1.643 moradores com mais de 16 anos nas cidades brasileiras em que a Fiocruz possui unidade ou escritório técnico. Os resultados revelam que boa parte dos entrevistados reconhece a gravidade da pandemia, a importância de se informar corretamente, considera as medidas indicadas por autoridades de saúde válidas e confia em cientistas e instituições científicas como fontes de informação. Com o senso de urgência e a potencialização e vivência das incertezas acerca do presente e do futuro, o fortalecimento da confiança nas instituições se faz presente.

Sexuality and prevention among men who have sex with men in the contexts of the AIDS and COVID-19 pandemics. / Sexualidade e prevenção entre homens que fazem sexo com homens nos contextos das pandemias de AIDS e da Covid-19.

This essay reflects on sexual practices and prevention in the contexts of the AIDS and COVID-19 pandemics. It analyses data collected between July and October 2020 through participant observation, as part of an ethnographic research project on HIV vulnerability and prevention among men who have sex with men in the Metropolitan Region of Recife, state of Pernambuco (PE), Brazil. The results point to the relevance of physical appearance and the affective bond between partners in engendering emotions that mediate coping with the risk of infection during both pandemics. It indicates the need to incorporate those communicational dimensions into informational materials to make them more effective.

Este ensaio reflete sobre práticas sexuais e prevenção nos contextos das pandemias de AIDS e da COVID-19. Analisa dados coletados entre julho e outubro de 2020, por meio de observação participante, no âmbito de uma pesquisa etnográfica sobre vulnerabilidade e prevenção ao HIV entre homens que fazem sexo com homens da Região Metropolitana do Recife. Os resultados apontam para a relevância da aparência corporal e da vinculação afetiva entre os parceiros no engendramento de emoções que medeiam a lida com risco de infecção em ambas as pandemias. Sinaliza para a necessidade de incorporar essas dimensões comunicacionais em materiais informativos, de modo a torná-los mais eficazes.