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1.
Comp Biochem Physiol B Biochem Mol Biol ; 274: 111006, 2024 Jul 06.
Article in English | MEDLINE | ID: mdl-38977177

ABSTRACT

Psalidodon bifasciatus is a fish species sensitive to physical and chemical changes in water. It serves as a good bioindicator of temperature variations and is utilized in environmental monitoring studies in Brazilian rivers. The objective of this study was to evaluate antioxidant defense biomarkers in the heart, brain, and muscle of P. bifasciatus exposed to a 10 °C thermal increase. P. bifasciatus were collected and divided into a control group (21 °C) and groups subjected to thermal shock (31 °C) for periods of 2, 6, 12, 24, and 48h. Two-way ANOVA indicated that a 10 °C temperature increase caused oxidative stress in P. bifasciatus. This was evidenced by altered levels of lipid peroxidation (LPO), carbonylated proteins (PCO), and glutathione peroxidase (GPx) in the heart, catalase (CAT) and LPO in the brain, and LPO in the muscle. Principal component analysis (PCA) and integrated biomarker response (IBR) analysis indicated that, compared to the heart and muscle, the brain exhibited a greater activation of the antioxidant response. Sensitivity analysis indicated that the muscle was the most sensitive organ, followed by the brain and heart. Our results indicate that the stress response is tissue-specific through the activation of distinct mechanisms. These responses may be associated with the tissue's function as well as its energy demand. As expected, P. bifasciatus showed changes in response to thermal stress, with the brain showing the greatest alteration in antioxidant defenses and the muscle being the most sensitive tissue.

2.
Environ Sci Pollut Res Int ; 31(25): 37681-37704, 2024 May.
Article in English | MEDLINE | ID: mdl-38780841

ABSTRACT

Thermal pollution creates substantial challenges that alter energy demand and produce reactive oxygen species that damage fish DNA, proteins, and lipids. Rhamdia voulezi is a species of fish native to the Iguaçu river, Paraná, Brazil, that does not have scientific records of minimum (CTmin) and maximum (CTmax) temperatures required for survival. As it is a top predator species in the food chain and lives at temperatures below 22 °C, the loss of the species can cause functional problems in controlling the ecosystem and energy flow. The study evaluated the tissue metabolism of the brain, heart, and muscle of R. voulezi (n = 72) subjected to acute thermal stress of 31 °C for 2, 6, 12, 24, and 96 h after acclimatization to 21 °C. The biochemical markers SOD, GPx, MDH, HK, and CK of the brain, PCO of the heart and CAT, glycogen, G6PDH, and ALT of muscle were significant. PCA, IBR, thermal sensitive, and condition factor suggested that R. voulezi has different physiological strategies for acclimatization to 31 °C to mobilize and sustain the metabolic needs of oxygenation and energy allocation/utilization for tissue ATP production.


Subject(s)
Biomarkers , Oxidative Stress , Rivers , Animals , Brazil , Biomarkers/metabolism , Fishes/metabolism
3.
Parasit Vectors ; 17(1): 88, 2024 Feb 26.
Article in English | MEDLINE | ID: mdl-38409019

ABSTRACT

BACKGROUND: Aedes aegypti is associated with dengue, Zika, and chikungunya transmission. These arboviruses are responsible for national outbreaks with severe public health implications. Vector control is one of the tools used to prevent mosquito proliferation, and SumiLarv® 2MR is an alternative commercial product based on pyriproxyfen for larval/pupal control. In this study, the residual effectiveness of SumiLarv® 2MR in different regions of Brazil was evaluated in simulated field conditions. METHODS: We conducted a multicenter study across four Brazilian states-Amapá, Pernambuco, Rio de Janeiro, and São Paulo-given the importance to the country's climatic variances in the north, northeast, and southeast regions and their influence on product efficiency. The populations of Ae. aegypti from each location were held in an insectary. Third-instar larvae (L3) were added every 2 weeks to water containers with SumiLarv® 2MR discs in 250-, 500- and 1000-l containers in Amapá and Rio de Janeiro, and 100-l containers in Pernambuco and São Paulo, using concentrations of 0.04, 0.08, and 0.16 mg/l. RESULTS: Adult emergence inhibition over 420 days was observed in all tests conducted at a concentration of 0.16 mg/l; inhibition for 308-420 days was observed for 0.08 mg/l, and 224-420 days for 0.04 mg/l. CONCLUSIONS: Sumilarv® 2MR residual activity demonstrated in this study suggests that this new pyriproxyfen formulation is a promising alternative for Aedes control, regardless of climatic variations and ideal concentration, since the SumiLarv® 2MR showed adult emergence inhibition of over 80% and residual activity greater than 6 months, a period longer than that recommended by the Ministry of Health of Brazil between product re-application in larval breeding sites.


Subject(s)
Aedes , Insecticides , Zika Virus Infection , Zika Virus , Animals , Insecticides/pharmacology , Mosquito Control , Aedes/physiology , Brazil/epidemiology , Larva , Mosquito Vectors , Zika Virus Infection/prevention & control
4.
Fish Physiol Biochem ; 50(2): 617-633, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38175338

ABSTRACT

Exposure to high temperatures induces changes in fish respiration, resulting in an increased production of reactive oxygen species. This, in turn, affects the enzymatic and non-enzymatic components of antioxidant defenses, which are essential for mitigating cellular stress. Rhamdia voulezi, an economically important fish species endemic to Brazil's Iguaçu River, served as the subject of our study. Our goal was to assess enzymatic antioxidant biomarkers (superoxide dismutase, catalase, glutathione peroxidase, glutathione S-transferase, glutathione reductase, glucose-6-phosphate dehydrogenase), non-protein thiol levels (reduced glutathione), and markers of oxidative damage (lipoperoxidation and carbonylation) in the liver, gills, and kidneys of R. voulezi after acute exposure to high temperatures (31°C) for 2, 6, 12, 24, and 96 h. Control groups were maintained at 21°C. Our findings revealed that the liver exhibited increased superoxide dismutase levels up to 12 h and elevated glutathione S-transferase levels at 12 and 96 h at 31°C. In the gills, superoxide dismutase levels increased up to 24 h, along with increased lipoperoxidation at 2, 6, 12, and 96 h of exposure to high temperatures. The kidneys responded to heat stress at 12 h, with an increase in superoxide dismutase and catalase activity, and lipid peroxidation was observed at 2 and 6 h at 31°C. The three tissues evaluated responded differently to heat stress, with the liver demonstrating greater physiological adjustment to high temperatures. The intricate interplay of various antioxidant defense biomarkers and oxidative damage suggests the presence of oxidative stress in R. voulezi when exposed to high temperatures.


Subject(s)
Antioxidants , Catfishes , Animals , Antioxidants/metabolism , Catalase/metabolism , Temperature , Oxidative Stress/physiology , Glutathione/metabolism , Catfishes/metabolism , Superoxide Dismutase/metabolism , Biomarkers/metabolism , Glutathione Peroxidase/metabolism , Glutathione Transferase/metabolism , Gills/metabolism , Lipid Peroxidation
5.
J Dent Educ ; 88(2): 149-156, 2024 Feb.
Article in English | MEDLINE | ID: mdl-37904575

ABSTRACT

PURPOSE: Distance learning appears to be an attractive approach to continuing education courses, but one barrier is maintaining learner engagement throughout the course. The primary aim of this research was to evaluate the operational efficacy of a private Facebook™ group (FG) in serving as a support mechanism for distance learning courses, and its impact on three fundamental dimensions: the attrition rates of participants who did not complete the course (commonly referred to as dropout rates), the rates of course completion and approval, and the overall performance of the participants. METHODS: The participants of this quasi-experimental study comprised 159 dental students and 565 dentists enrolled in an e-learning course on oral mucosal lesion diagnosis. Prior to the initiation of the course, all participants were provided with the option to join a private FG. Within this group, moderators shared motivational messages and provided reminders concerning deadlines. Moreover, participants had the opportunity to engage in interactive discussions pertaining to topics related to the course. The course itself followed a self-guided format, employing the flipped-classroom methodology, spanning a total of 50 instructional hours. In order to assess the effectiveness of the course, participants were presented with photographs illustrating 30 oral lesions and were asked to propose diagnostic hypotheses both before and after the educational intervention (pre-tests and post-tests). RESULTS: Dentists who participated in the FG exhibited a significantly lower rate of discontinuation. As for dental students, their involvement in the group was positively associated with better performance, as determined by the percentage of accurate diagnostic hypotheses (a minimum of 70% correct responses was required for their approval in the course). CONCLUSIONS: Facebook™ demonstrates promise as a supplementary pedagogical tool in distance education courses. The interactive nature of the platform has the potential to alleviate the inherent challenges of remote learning.


Subject(s)
Education, Distance , Humans , Education, Distance/methods , Curriculum , Educational Measurement/methods , Learning , Social Networking
6.
Rev Rene (Online) ; 25: e92274, 2024. tab, graf
Article in Portuguese | LILACS-Express | LILACS, BDENF - Nursing | ID: biblio-1535058

ABSTRACT

RESUMO Objetivo avaliar os efeitos do lockdown na incidência da COVID-19 na fase de emergência sanitária da pandemia. Métodos trata-se de um estudo ecológico transversal. Os dados foram coletados nas páginas da Fundação Sistema Estadual de Análise de Dados e da Prefeitura Municipal de Araraquara. Para analisar a incidência da COVID-19 foram considerados os casos notificados no referido município. Para comparar os períodos em relação aos casos diários, foi utilizado o modelo de regressão com distribuição binomial-negativa com função de ligação logarítmica. Resultados para todas as faixas etárias, com exceção de menores de 20 anos, verificou-se diferença estatística nos coeficientes de incidência. Para o sexo feminino o declínio na incidência da doença foi mais expressivo. Considerando ambos os sexos e todas as faixas etárias, observou-se uma redução de 49% na incidência de casos. Conclusão houve uma redução significativa na incidência da doença considerando a população geral do município. Contribuições para a prática: a disponibilidade e adoção de medidas tradicionais de saúde pública, como o lockdown, mostraram-se essenciais para reduzir casos e óbitos de doenças de vírus respiratórios emergentes sem tratamento e vacina.


ABSTRACT Objective to assess the effects of lockdown on the incidence of COVID-19 during the health emergency phase of the pandemic. Methods this is a cross-sectional ecological study. Data was collected from the websites of the State Data Analysis System Foundation and Araraquara City Hall. To analyze the incidence of COVID-19, cases reported in the municipality were considered. A regression model with a negative binomial distribution and a logarithmic link function was used to compare the periods in terms of daily cases. Results for all age groups except those under 20, there was a statistical difference in the incidence coefficients. For females, the decline in the incidence of the disease was more significant. Considering both sexes and all age groups, there was a 49% reduction in the incidence of cases. Conclusion there was a significant reduction in the incidence of the disease in the general population of the municipality. Contributions to practice: the availability and adoption of traditional public health measures, such as lockdown, proved essential to reducing cases and deaths from emerging respiratory virus diseases without treatment or vaccine.

7.
Physis (Rio J.) ; 34: e34009, 2024. tab, graf
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1558684

ABSTRACT

Resumo O estabelecimento definitivo do Aedes aegypti nas Américas está associado às mudanças ambientais, urbanização desorganizada, ausência de água e saneamento básico e deslocamentos populacionais, definindo, assim, a trajetória da doença. O objetivo deste estudo foi analisar a distribuição espacial dos casos suspeitos de dengue e a relação com indicadores socioeconômicos no município de São Carlos-SP. Trata-se de estudo ecológico, realizado nesse município, em que foram utilizados dados secundários do Sistema de Informação sobre Agravos de Notificação no período de 2016 a 2017 e do Instituto Brasileiro de Geografia e Estatística do Censo Demográfico de 2010. Os dados foram analisados por meio da Análise de Componentes Principais pelo software Statistica 12.0 e os mapas temáticos foram gerados pelo software Arcgis versão 10.5. Os resultados mostraram elevadas taxas de casos suspeitos de dengue em áreas de ponderação com condições sociais adequadas e taxas reduzidas em áreas de ponderação com iniquidades sociais. Concluiu-se que o perfil de casos suspeitos por dengue na população de São Carlos não está relacionado a baixos indicadores socioeconômicos, uma vez que a dinâmica e a mobilidade populacional relacionadas ao elevado fluxo de universitários podem influenciar no padrão de distribuição espacial da doença.


Abstract The definitive establishment of Aedes aegypti in the Americas is associated with environmental changes, disorganized urbanization, lack of water and basic sanitation and population displacement, thus defining the trajectory of the disease. The aim of this study was to analyze the spatial distribution of the dengue suspected cases and understand its correlation with the socioeconomic indicators in the city of São Carlos (SP). This is an ecological study, carried out at the São Carlos (SP). Secondary data from the Information System on Notifiable Diseases in the period from 2016 to 2017 and from the Brazilian Institute of Geography and Statistics of the 2010 Demographic Census were used. The data were analyzed using Principal Component Analysis (ACP) by the software Statistica 12.0 and the thematic maps were generated by the software Arcgis version 10.5. The results showed high rates of suspected dengue cases in areas with adequate social conditions and reduced rates in areas with worst social condition. It was concluded that the outline of suspected dengue cases in the population of São Carlos (SP) is not related to low socioeconomic indicators, once the population dynamics and mobility related to the high flow of university students can influence the pattern of spatial distribution of the disease.

8.
Rev. enferm. UERJ ; 31: e71004, jan. -dez. 2023.
Article in English, Portuguese | LILACS, BDENF - Nursing | ID: biblio-1525080

ABSTRACT

Objetivo: comparar o conhecimento de enfermeiros e técnicos de enfermagem atutentes em Unidades de Pronto Atendimento quanto ao reconhecimento de manifestações clínicas e grupos de risco para o desenvolvimento da forma grave da COVID-19. Método: estudo descritivo, realizado com 53 profissionais de três unidades de pronto atendimento, com coleta de dados realizada por meio de questionário autorrespondido. Dados analisados por meio de estatística descritiva e inferencial (testes t-student e qui-quadrado). Protocolo de pesquisa aprovado pelo Comitê de Ética em Pesquisa da instituição. Resultados: destaca-se uma associação entre a citação de manifestações clínicas como náuseas e vômitos, grupos de risco e a função, enfermeiros ou técnicos de enfermagem (p<0,05) e o nível de formação, ou seja, os enfermeiros relataram com maior frequência a presença desses sintomas que os técnicos de enfermagem. Conclusão: os profissionais de enfermagem apresentam conhecimento quanto a sintomatologia e grupos de risco, ainda que haja diferença entre o nível profissional(AU)


Objective: to compare the knowledge of nurses and nursing technicians working in Emergency Care Units regarding the recognition of clinical manifestations and risk groups for the development of the severe form of COVID-19. Method: descriptive study, carried out with 53 professionals from three emergency care units, with data collection carried out through a self-answered questionnaire. Data analyzed using descriptive and inferential statistics (t-student and chi-square tests). Research protocol approved by the institution's Research Ethics Committee. Results: an association stands out between the mention of clinical manifestations such as nausea and vomiting, risk groups and the role, nurses or nursing technicians (p<0.05) and the level of training, that is, nurses reported with the presence of these symptoms was more frequent than nursing technicians. Conclusion: nursing professionals have knowledge regarding symptoms and risk groups, even if there is a difference between the professional level(AU)


Objetivo: comparar los conocimientos de enfermeros y técnicos de enfermería que trabajan en Unidades de Atención de Emergencia sobre el reconocimiento de manifestaciones clínicas y grupos de riesgo para el desarrollo de la forma grave de COVID-19. Método: estudio descriptivo, realizado con 53 profesionales de tres unidades de atención de emergencia, con recolección de datos realizada a través de un cuestionario auto respondido. Datos analizados mediante estadística descriptiva e inferencial (pruebas t de Student y chi-cuadrado). Protocolo de investigación aprobado por el Comité de Ética en Investigación de la institución. Resultados: se destaca asociación entre la mención de manifestaciones clínicas como náuseas y vómitos, grupos de riesgo y el rol, enfermeros o técnicos de enfermería (p<0,05) y el nivel de formación, es decir, los enfermeros reportaron la presencia de estos síntomas. fue más frecuente que los técnicos de enfermería. Conclusión: los profesionales de enfermería tienen conocimientos sobre síntomas y grupos de riesgo, aunque exista diferencia entre el nivel profesional(AU)


Subject(s)
Humans , Male , Female , Clinical Competence , Nurse's Role , COVID-19/diagnosis , COVID-19/epidemiology , Nursing, Team , Brazil/epidemiology , Cross-Sectional Studies , Emergency Medical Services , Licensed Practical Nurses , Nurses
9.
Rev. enferm. UERJ ; 31: e75585, jan. -dez. 2023.
Article in English, Portuguese | LILACS, BDENF - Nursing | ID: biblio-1526913

ABSTRACT

Objetivo: analisar a organização e assistência dos serviços da Atenção Primária à Saúde no enfrentamento da COVID-19. Método: estudo transversal realizado com 49 profissionais da saúde de unidades básicas de saúde e estratégia de saúde da família no município de São Carlos. Os dados foram coletados por meio de questionário auto respondido no período de maio de 2021 a fevereiro de 2022. As associações foram analisadas por teste qui-quadrado e estimadas as razões de prevalência. O protocolo de pesquisa foi aprovado pelo Comite de Ética em Pesquisa. Resultados: a identificação de sinais e sintomas do paciente, orientações sobre as medidas de prevenção e verificação da disponibilidade de leitos em hospitais de referência, foram variáveis que se apresentaram diferentes entre os serviços de saúde. Conclusão: a APS exerce papel central no enfrentamento da pandemia, com necessidade de os gestores identificarem as fragilidades e direcionarem ações de educação permanente diante de novos cenários(AU)


Objective: to analyze the organization and assistance of Primary Health Care services facing COVID-19. Method: cross-sectional study carried out with 49 health professionals from basic health units and family health strategy in the city of São Carlos. Data were collected through a self-answered questionnaire from May 2021 to February 2022. Associations were analyzed using the chi-square test and prevalence ratios were estimated. The research protocol was approved by the Research Ethics Committee. Results: identification of the patient's signs and symptoms, guidance on prevention measures and checking the availability of beds in reference hospitals were variables that differed between health services. Conclusion: Primary Health Care services play a central role facing COVID-19 pandemic, with managers needing to identify weaknesses and direct ongoing education actions in the face of new scenarios(AU)


Objetivo: analizar la organización y asistencia de los servicios de Atención Primaria de Salud en el combate al COVID-19. Método: estudio transversal realizado con 49 profesionales de la salud de unidades básicas de salud y estrategia de salud de la familia de la ciudad de São Carlos. Los datos se recolectaron a través de un cuestionario de auto respuesta desde mayo de 2021 hasta febrero de 2022. Se analizaron las asociaciones mediante la prueba de chi-cuadrado y se estimaron las razones de prevalencia. El protocolo de investigación lo aprobó el Comité de Ética en Investigación. Resultados: la identificación de los signos y síntomas del paciente, las orientaciones sobre medidas de prevención y la verificación de la disponibilidad de camas en los hospitales de referencia fueron variables que difirieron entre los servicios de salud. Conclusión: La APS juega un papel central en el enfrentamiento a la pandemia, siendo necesario que los gestores identifiquen debilidades y orienten acciones educativas continuas ante nuevos escenarios(AU)


Subject(s)
Humans , Male , Female , Primary Health Care/organization & administration , Health Personnel/organization & administration , COVID-19/prevention & control , Coping Skills , Brazil , Cross-Sectional Studies , Pandemics , COVID-19/epidemiology
10.
CuidArte, Enferm ; 17(2): 211-217, jul.-dez. 2023. tab
Article in Portuguese | BDENF - Nursing | ID: biblio-1553558

ABSTRACT

Introdução: HIV/AIDs é um problema de saúde pública com mudanças epidemiológicas mundiais. Objetivo: Analisar a tendência dos coeficientes de incidência de Aids e possíveis pontos de mudanças em adultos de 20 a 59 anos no Brasil, por região, no período de 2010 a 2017. Método: Estudo ecológico de série temporal e local, com dados referentes aos anos de 2010 a 2017, coletados no Departamento de Informática do Sistema Único de Saúde, sobre as doenças referidas, e os dados populacionais no site do Instituto Brasileiro de Geografia e Estatística. Os casos foram divididos por regiões do Brasil, além de sexo e faixa etária. Para analisar as mudanças nas incidências anuais por sexo e faixa etária foi utilizado um modelo de regressão do Joinpoint. Resultados: A Aids apresentou tendência crescente entre indivíduos do sexo masculino de 20 a 29 anos nas regiões Centro-Oeste, Nordeste e Norte e se manteve, em sua maioria, estacionária nas demais faixas-etárias em ambos os sexos. Conclusão: Nota-se a necessidade de fortalecer a equipe de Atenção Primária à Saúde e seu papel na prevenção da Aids bem como a ampliação dos serviços especializados nas demais regiões, além do Sudeste e do Sul. Ações de prevenção direcionadas ao público masculino devem ser estimuladas, e também discutidas em ambiente escolar, de forma contínua, com os jovens


Introduction: HIV/AIDs is a public health problem with worldwide epidemiological changes. Objective: To analyze the trend in AIDS incidence coefficients and possible points of change in adults aged 20 to 59 in Brazil, by region, from 2010 to 2017. Method: Ecological study of time and local series, with data referring to the years 2010 to 2017, collected in the Information Technology Department of the Unified Health System, on the diseases referred to, and population data on the website of the Brazilian Institute of Geography and Statistics. The cases were divided by regions of Brazil, in addition to sex and age group. To analyze changes in annual incidences by sex and age group, a Joinpoint regression model was used. Results: AIDS showed an increasing trend among male individuals aged 20 to 29 years in the Central-West, Northeast and North regions and remained, for the most part, stationary in the other age groups in both sexes. Conclusion: There is a need to strengthen the Primary Health Care team and its role in preventing AIDS, as well as expanding specialized services in other regions, in addition to the Southeast and South. Prevention actions aimed at the male public must be stimulated, and also discussed in a school environment, on an ongoing basis, with young people


Introducción: El VIH/SIDA es un problema de salud pública con cambios epidemiológicos a nivel mundial. Objetivo: Analizar la tendencia de los coeficientes de incidencia del SIDA y posibles puntos de cambio en adultos de 20 a 59 años en Brasil, por región, de 2010 a 2017. Método: Estudio ecológico de series temporales y locales, con datos referentes a los años de 2010 a 2017, recolectados en el Departamento de Tecnología de la Información del Sistema Único de Salud, sobre las enfermedades referidas, y datos poblacionales en el sitio web del Instituto Brasileño de Geografía y Estadística. Los casos fueron divididos por regiones de Brasil, además de sexo y grupo de edad. Para analizar la evolución de la incidencia anual por sexo y grupo de edad se utilizó un modelo de regresión de Joinpoint. Resultados: El SIDA mostró tendencia creciente entre los varones de 20 a 29 años de las regiones Centro-Oeste, Nordeste y Norte y permaneció, en su mayor parte, estacionario en los demás grupos etarios de ambos sexos. Conclusión: Es necesario fortalecer el equipo de Atención Primaria de Salud y su papel en la prevención del SIDA, así como ampliar los servicios especializados en otras regiones, además del Sudeste y Sur, estimular acciones de prevención dirigidas al público masculino y También se discute en el ambiente escolar, de manera permanente, con los jóvenes


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Young Adult , HIV Infections/epidemiology , Acquired Immunodeficiency Syndrome/epidemiology , Brazil/epidemiology , Incidence , Spatio-Temporal Analysis
11.
CuidArte, Enferm ; 17(1): 38-45, jan.-jun. 2023.
Article in Portuguese | BDENF - Nursing | ID: biblio-1512013

ABSTRACT

Introdução: Recém-nascidos de qualquer idade gestacional são capazes de reconhecer, processar e responder a estímulos dolorosos. Garantir a segurança e alívio do tratamento da dor é uma responsabilidade ética do profissional da saúde, pois é reconhecido que a maior parte da dor testada em bebês pode ser precavida ou aliviada. Objetivo: Compreender a percepção dos profissionais de enfermagem no manejo da dor no recém-nascido. Método: Trata-se de um estudo descritivo com abordagem qualitativa, realizado na Unidade de Terapia Intensiva Neonatal de um hospital escola do interior do estado de São Paulo, Brasil. A amostragem empregada foi intencional, com a participação de 11 profissionais, enfermeiros e técnicos em enfermagem. A coleta de dados se deu através de entrevista audiogravada em mídia digital portátil, guiada por uma pergunta norteadora. A análise de dados foi realizada com base na Análise de Conteúdo Temática de Bardin. Resultados: Emergiram três categorias temáticas: Métodos no manejo da dor do recém-nascido, Práticas de humanização e Percepção da avaliação da dor do recém-nascido, demonstrando que a equipe de enfermagem apresenta conhecimento e técnicas abrangentes em relação à percepção no manejo da dor do recém-nascido. Conclusão: Compreender a percepção dos profissionais de enfermagem no manejo da dor no recém nascido é importante, entretanto faz-se necessário a implantação de atividades que amplifiquem o conhecimento da equipe de enfermagem para adequado tratamento e controle da dor no RN


Introduction: Newborns of any gestational age are able to recognize, process and respond to painful stimuli. Ensuring the safety and relief of pain treatment is an ethical responsibility of the health professional, as it is recognized that most pain tested in infants can be cautious or relieved. Objective: To understand the perception of nursing professionals in the management of pain in the newborn. Method: This is a descriptive study with a qualitative approach, conducted in the Neonatal Intensive Care Unit of a teaching hospital in the state of São Paulo, Brazil. The sample used was intentional, with the participation of 11 professionals, nurses and nursing technicians. Data collection took place through an audio interview recorded on portable digital media, guided by a guiding question. Data analysis was performed based on Bardin's Thematic Content Analysis. Results: Three thematic categories emerged: Methods in the management of newborn pain, Humanization practices and Perception of newborn pain assessment nursing team presents comprehensive knowledge and techniques in relation to the perception in the management of pain of the newborn. Conclusion: Understanding the perception of nursing professionals in the management of pain in newborns is important, however, it is necessary to implement activities that expand the knowledge of the nursing team for adequate treatment and control of pain in newborns


Introducción: Los recién nacidos de cualquier edad gestacional son capaces de reconocer, procesar y responder a estímulos dolorosos. Garantizar la seguridad y el alivio del manejo del dolor es una responsabilidad ética del profesional de la salud, ya que se reconoce que la mayoría de los dolores probados en los bebés se pueden prevenir o aliviar. Objetivo: Comprender la percepción de los profesionales de enfermería sobre el manejo del dolor en el recién nacido. Método: Se trata de un estudio descriptivo con abordaje cualitativo, realizado en la Unidad de Cuidados Intensivos Neonatales de un hospital escuela del interior del estado de São Paulo, Brasil. El muestreo utilizado fue intencional, con la participación de 11 profesionales, enfermeros y técnicos de enfermería. La recolección de datos se realizó a través de entrevistas grabadas en audio en medios digitales portátiles, guiadas por una pregunta orientadora. El análisis de datos se realizó con base en el Análisis de Contenido Temático de Bardin. Resultados: Surgieron tres categorías temáticas: Métodos para el manejo del dolor en el recién nacido, Prácticas de humanización y Evaluación de la percepción del dolor en el recién nacido, demostrando que el equipo de enfermería posee conocimientos y técnicas integrales en relación a la percepción en el manejo del dolor del recién nacido. Conclusión: Comprender la percepción de los profesionales de enfermería en el manejo del dolor en el recién nacido es importante, sin embargo, es necesario implementar actividades que amplíen el conocimiento del equipo de enfermería para el adecuado tratamiento y control del dolor en el recién nacido


Subject(s)
Humans , Infant, Newborn , Perception , Pain Management/nursing , Infant, Newborn, Diseases/nursing , Nursing Care , Intensive Care Units, Neonatal , Qualitative Research , Humanization of Assistance
12.
Parasit Vectors ; 16(1): 162, 2023 May 12.
Article in English | MEDLINE | ID: mdl-37173754

ABSTRACT

BACKGROUND: Most cases of malaria in Brazil are concentrated in the Amazon region. One of the vector control alternatives recommended by the WHO is the long-lasting insecticidal net (LLIN). This tool is used in the nine federal states of the Brazilian Legal Amazon, where LLINs are essential for reducing vector density and disease transmission as they prevent contact between the mosquito and the individual. The objective of this study was to evaluate the residuality and use of LLIN insecticides in different health regions in a city located in the Brazilian Amazon. METHODS: A total of 17,027 LLINs were installed in the third, fifth and ninth health regions of the municipality of Porto Velho, Rondonia State, Brazil. The LLINs were of two types: Olyset (permethrin), for around the bed, and Interceptor (alphacypermethrin), for around hammocks. The residuality of 172 LLINs was evaluated using cone bioassays to verify the mortality rate of the mosquito Nyssorhynchus darlingi, over a period of 2 years. Structured questionnaires on the acceptance and use of LLINs were distributed to the participating population (n = 391), covering a total sample of 1147 mosquito nets. The mortality rate was evaluated both in terms of days after LLIN installation and the type of insecticide used. Statistical analyses were based on analysis of variance (ANOVA) and Chi-square and were performed using the SPSS statistical program. RESULTS: For the Ny. darlingi mosquito, Interceptor-type LLINs showed residual efficacy, with mortality rates ≥ 80% during the 2-year study period, as determined by the WHO. In contrast, Olyset-type LLINs were associated with a reduction in mortality rates, with 76% and 45% mortality rates in the last two assessments, which occurred during the last 6 months of the study period. Based on the structured questionnaires, the acceptance rate, i.e. percentage of individuals accepting the permanence of the 1147 LLINs sampled, in the three health regions of Porto Velho was 93.8% (of 1076 LLINs). CONCLUSION: The alphacypermethrin-impregnated LLIN was more effective than the LLIN impregnated with permethrin. The results indicate that the correct use of mosquito nets-and consequently the protection of the population-needs to be supported by health promotion actions. These initiatives are considered to be essential for the success of this vector control strategy. New studies that consider the monitoring of the placement of mosquito nets are necessary to provide effective support in the correct use of this methodology.


Subject(s)
Insecticide-Treated Bednets , Insecticides , Malaria , Animals , Humans , Insecticides/pharmacology , Permethrin , Brazil/epidemiology , Mosquito Control/methods , Mosquito Vectors , Malaria/epidemiology , Malaria/prevention & control
13.
REME rev. min. enferm ; 27: 1531, jan.-2023. Tab., Fig.
Article in English, Portuguese | LILACS, BDENF - Nursing | ID: biblio-1523824

ABSTRACT

Objetivo: analisar a relação entre a raça/cor da pele e a morbimortalidade por COVID-19 no estado de São Paulo-SP. Métodos: Estudo ecológico, retrospectivo e analítico, cujos dados foram coletados no Sistema Estadual de Análise de Dados (SEADE) do Governo do Estado de São Paulo e correspondem ao período de fevereiro de 2020 a setembro de 2021. Na análise de dados, utilizou-se o modelo de regressão com distribuição binomial-negativa múltipla, para comparar a incidência e a mortalidade específica entre as raças/cores de pele. Resultados: ao se compararem as curvas de incidência de COVID-19, houve diferença estatística significativa entre as comparações de todos os grupos de raça/cor da pele. Na comparação entre tendências branca vs parda, o resultado foi p = 0,007; na comparação entre tendências branca vs preta, p = <0,001; na comparação entre tendências parda vs preta, p = 0,003. Porém, quando foram comparadas as tendências de incidência por sexo e faixa etária e as tendências de óbito, não houve diferença estatística. Conclusão: a raça/cor da pele influenciou nas curvas de incidência geral por COVID-19 no estado de São Paulo, porém a não associação com a mortalidade pode estar relacionada com a falta de informação sobre raça/cor/etnia nas fichas de notificação, afetando consequentemente sua disponibilidade nos sistemas de informação, o que reforça a importância da divulgação de dados epidemiológicos oficiais de qualidade.(AU)


Objective: to analyze the relationship between ethnicity/skin color and morbi-mortality from COVID-19 in the state of São Paulo-SP. Methods: ecological, retrospective, and analytical study, whose data were collected from the State Data Analysis System (SE-ADE) of the Government of the State of São Paulo, covering from February 2020 to September 2021. Data analysis used a regression model with multiple binomial negative distribution, to compare the incidence and mortality specific between ethnicities/skin colors. Results: a comparison between the incidence curves of COVID-19 showed a signi-ficant statistical difference between all groups of ethnicity/skin color. In the comparison of trends between white and brown, the result was p = 0.007; in the comparison of trends between white and black, it was p = 0.001; in the comparison of trends between brown and black, p = 0.003. However, when we compare the trends of incidence per sex and age group with death trends, there was no statistical difference. Conclusion: ethnicity/skin color has influenced general incidence curves by COVID-19 in São Paulo. The fact that it was not associated with mortality can be related with the lack of information about ethnicity/color in notification forms, thus affecting the availability of such data in information systems, which reiterates the importance of publicizing quality official epidemiological data.(AU)


Objetivo: analizar la relación entre la raza/color de piel y la morbimortalidad por Covid-19 en el estado de São Paulo-SP.Métodos: estudio ecológico, retrospectivo y analítico, cuyos datos fueron recolectados en el Sistema Estatal de Análisis de Datos (SEADE) del Gobierno del Estado de São Paulo y corresponden al período de febrero de 2020 a septiembre de 2021. Para el análisis de datos se utilizó el modelo de regresión con distribución binomial-negativa múltiple para comparar la incidencia y la mortalidad específica entre las razas/colores de piel.Resultados: al comparar las curvas de incidencia de Covid-19, hubo una diferencia estadística significativa entre las comparaciones de todos los grupos de raza/color de piel, siendo que en la comparación entre tendencias blanca vs parda p= 0,007; comparación entre tendencias blanca vs negra p= <0,001; comparación entre tendencias parda vs negra p= 0,003. Sin embargo, cuando se compararon las tendencias de incidencia por sexo y grupo etario y las tendencias de muerte, no hubo diferencia estadística. Conclusión: la raza/color de piel influyó en las curvas de incidencia general por Covid-19 en el estado de São Paulo, sin embargo, la no-asociación con la mortalidad puede estar relacionada con la falta de información sobre raza/color/etnia en las fichas de notificación, y consecuentemente su disponibilidad en los sistemas de información, reforzando la importancia de la divulgación de datos epidemiológicos oficiales de calidad.(AU)


Subject(s)
Humans , Male , Female , Infant, Newborn , Aged , Socioeconomic Factors , Indicators of Morbidity and Mortality , Health Information Systems , Data Analysis , COVID-19/mortality , COVID-19/epidemiology , Incidence , Racial Groups
14.
Eur J Dent Educ ; 27(3): 633-639, 2023 Aug.
Article in English | MEDLINE | ID: mdl-35997548

ABSTRACT

INTRODUCTION: Dentists usually refer to difficulties in performing the diagnosis of oral mucosal lesions. This may be attributed to limited access to theoretical lectures and practical training on this subject along the graduation course. The primary aim of this cross-sectional study was to verify if there is an association between the perception of time dedicated to lectures/training and oral diagnosis abilities in oral medicine. The secondary aim was to evaluate the association between self--confidence to perform oral mucosal lesions diagnosis and performance in a diagnostic abilities test. MATERIALS AND METHODS: The sample comprised 36 final-year dental students of a South-Brazilian dental school. The participants answered a questionnaire on their perception of time dedicated to lectures on oral medicine along the course (sufficient or insufficient) and their self-confidence to diagnose oral mucosal lesions or oral cancer (yes or not). The students were also submitted to a diagnostic abilities test based on 30 clinical photos of oral lesions, which should be classified as benign, potentially malignant or malignant. Moreover, the participants had to inform their clinical impression for each case. Finally, the participants informed their decision making for the case (refer the patient to a specialist or not). RESULTS: Students with higher self-confidence showed a higher percentage of correct answers on classification of the nature of lesions (81.1% vs. 68.5%, p = .03, teste t de Student) and on their clinical impression (66.3% vs. 41.7%, p < .01, Student's t-test). The perception of time dedicated to theoretical lectures on oral medicine as sufficient did not influence the students' diagnostic abilities (p > .05, Student's t-test) CONCLUSION: It may be concluded that self-confidence to diagnose oral lesions is associated with dental students' diagnostic abilities.


Subject(s)
Education, Dental , Students, Dental , Humans , Cross-Sectional Studies , Self Concept , Brazil
15.
Rev. enferm. UERJ ; 30: e68717, jan. -dez. 2022.
Article in English, Portuguese | LILACS-Express | LILACS | ID: biblio-1417151

ABSTRACT

Objetivo: analisar o perfil dos acidentes ocorridos com materiais perfurocortantes entre a equipe de enfermagem notificados em dois hospitais. Métodos: estudo documental e descritivo realizado em um hospital de ensino e um filantrópico do interior paulista. Os dados foram coletados em fichas de notificação de acidentes com material biológico envolvendo profissionais da enfermagem entre 2016 e 2020, e analisados por meio de estatística descritiva. Protocolo de pesquisa aprovada pelo comitê de Ética em Pesquisa da instituição envolvida. Resultados: foram identificados 208 acidentes: 187 (89,9%) no hospital filantrópico e 21 (10,1%) no hospital de ensino. No hospital filantrópico e no hospital universitário foram notificados, respectivamente, 119 (63,64%) e 35 (18,71%) acidentes entre os técnicos de enfermagem; sendo 51 (27,27%) e 8 (38,1%) durante descarte de perfurocortante. Agulhas causaram 166 (79,8%) acidentes. Conclusão: os acidentes nos dois hospitais ocorreram majoritariamente por agulhas, no momento de descarte de perfurocortante, acometendo principalmente os técnicos em enfermagem.


Objective: to analyse the accidents with sharps profile among the nursing staff reported at two hospitals. Methods: this descriptive, documentary study was conducted at a teaching hospital and a philanthropic hospital in the interior of São Paulo State. Data were collected from accident notification forms involving biological material and nursing personnel between 2016 and 2020, and analyzed using descriptive statistics. The research protocol was approved by the research ethics committee. Results: 208 accidents were identified: 187 (89.9%) at the philanthropic hospital and 21 (10.1%) at the university hospital; respectively, 119 (63.64%) and 35 (18.71%) among nursing technicians, and 51 (27.27%) and 8 (38.1%), during sharps disposal. Needles caused 166 (79.8%) accidents. Conclusion: at both hospitals, most accidents involved needles, at the time of sharps disposal, and mainly affected nursing technicians.


Objetivo: analizar el perfil de los accidentes con objetos cortopunzantes entre el personal de enfermería notificados en dos hospitales. Métodos: estudio documental y descriptivo realizado en un hospital universitario y un hospital filantrópico del interior de São Paulo. Los datos se recolectaron en fichas de notificación de accidentes con material biológico involucrando profesionales de enfermería entre 2016 y 2020 y se analizaron mediante estadística descriptiva. Investigación aprobada por el comité de ética en investigación de la institución involucrada. Resultados: se identificaron 208 accidentes: 187 (89,9%) en el hospital filantrópico y 21 (10,1%) en el hospital universitario. En el hospital filantrópico y en el hospital universitario fueron relatados 119 (63,64%) y 35 (18,71%) accidentes, respectivamente, entre técnicos de enfermería; siendo 51 (27,27%) y 8 (38,1%) durante la eliminación de objetos cortopunzantes. Las agujas provocaron 166 (79,8%) accidentes. Conclusión: los accidentes en ambos hospitales ocurrieron en su mayoría por agujas, en el momento de la eliminación de objetos cortopunzantes, afectando principalmente a los técnicos de enfermería.

16.
Rev. enferm. UERJ ; 30: e69332, jan. -dez. 2022.
Article in English, Portuguese | LILACS-Express | LILACS | ID: biblio-1417320

ABSTRACT

Objetivo: analisar a mortalidade pela doença causada pelo coronavírus do tipo 2 (COVID-19) em pessoas com cardiopatia no estado de São Paulo. Métodos: estudo observacional, retrospectivo e analítico. Os dados foram coletados no período de 4 de fevereiro de 2020 a 25 de julho de 2021. O modelo comparando pessoas com e sem cardiopatia foi ajustado por sexo, faixa etária, obesidade e diabetes, possíveis variáveis de confusão. As comparações foram analisadas por meio do modelo de regressão log-binomial e cálculo de risco relativo. Resultados: pessoas do estado de São Paulo com cardiopatia infectadas pela COVID-19 entre 21 e 50 anos apresentaram risco maior de óbito quando comparadas as pessoas sem cardiopatia. Ainda, mulheres cardiopatas acima de 51 anos apresentaram risco menor de óbito comparadas aos homens cardiopatas na mesma faixa etária. Conclusão: pessoas com cardiopatia infectadas pelo COVID-19, principalmente homens, possuem um risco aumentado de morte no estado de São Paulo.


Objective: to examine mortality from the disease caused by type-2 Coronavirus (COVID-19) in people with heart disease in São Paulo State. Methods: in this, retrospective, analytical, observational study, data were collected from February 4, 2020, to July 25, 2021. The model comparing people with and without heart disease was adjusted for the possible confounding variables sex, age group, obesity, and diabetes. Comparisons were analyzed using log-binomial regression models and relative risk calculation. Results: risk of death was higher among people between 21 and 50 years old infected by COVID-19 and with heart disease than among people without heart disease. Also, risk of death was lower among women with heart disease over 51 years old than among men with heart disease in the same age group. Conclusion: people, especially men, with heart disease and infected by COVID-19 are at increased risk of death.


Objetivo: analizar la mortalidad por la enfermedad causada por el coronavírus del tipo 2 (COVID-19) en personas cardiópatas en el estado de São Paulo. Métodos: estudio observacional, retrospectivo y analítico. Los datos se recopilaron del 4 de febrero de 2020 al 25 de julio de 2021. El modelo que compara personas con y sin cardiopatía se ajustó por sexo, grupo de edad, obesidad y diabetes, posibles variables de confusión. Las comparaciones se analizaron mediante el modelo de regresión log-binomial y el cálculo del riesgo relativo. Resultados: las personas del estado de São Paulo, con cardiopatías, infectadas por COVID-19 entre 21 y 50 años tenían mayor riesgo de muerte en comparación con las personas sin cardiopatías. Además, las mujeres con cardiopatías mayores de 51 años tenían un menor riesgo de muerte en comparación con los hombres con cardiopatías del mismo grupo de edad. Conclusión: las personas con cardiopatías infectadas por COVID-19, especialmente los hombres, tienen mayor riesgo de muerte, en el estado de São Paulo.

17.
Rev Saude Publica ; 56: 94, 2022.
Article in English, Portuguese | MEDLINE | ID: mdl-36383807

ABSTRACT

OBJECTIVE: Mapping available scientific evidence on the organization of primary health care services and professionals during the Covid-19 pandemic. METHODS: This is a scoping review that followed the Joanna Briggs Institute method. Articles published in Portuguese, Spanish, and English from January 2020 to January 2021 in the CINAHL, Lilacs, Medline, PubMed, and Web of Science databases were included. RESULTS: We selected 24 articles that presented the reorganization of primary health care services and professionals to care suspected or confirmed Covid-19 cases. Coordination measures to tackle this disease in primary health care help to control its infection, especially by the active search for respiratory symptoms, the detection of new cases, and the monitoring of confirmed cases. CONCLUSION: This study presents an overview of how primary health care services and professionals organized themselves to tackle the Covid-19 pandemic, addressing adjustments in infrastructure and care flows, such as establishing specific Covid-19 care units, separating infected and non-infected patients, using telemedicine as an alternative modality of care, and monitoring cases by applications and phone.


Subject(s)
COVID-19 , Telemedicine , Humans , COVID-19/epidemiology , Pandemics , Brazil , Primary Health Care
18.
PLoS One ; 17(8): e0272852, 2022.
Article in English | MEDLINE | ID: mdl-35947587

ABSTRACT

The preservative effect of the addition of different essential oils (copaiba and oregano) on meat quality parameters and sensorial acceptability was analyzed for fresh ground beef patties over 21 days of display. Five treatments were assessed: control (CON) without antioxidants; addition of the synthetic additive butylated hydroxytoluene (BHT); addition 0.05% of copaiba essential oil (CEO); 0.05% of oregano essential oil (OEO); or blend of 0.025% copaiba and 0.025% oregano essential oils (BEO). The lowest cooking losses and greatest tenderness (P <0.05) were reached with the blend (BEO). The inclusion of oregano essential oil presented a more intense chroma (P <0.05), with the best color retained during display. Oregano essential oil (OEO) and the blend (BEO) showed the highest antioxidant activity, reducing the lipid oxidation of beef patties during display (P < 0.05). Consumers preferred the odor of beef patties with essential oils (OEO and BEO) to the CON; however, the flavor from OEO had the lowest acceptability and the worst scores for overall acceptability (P < 0.05). Patties with the blend addition (BEO) were the best scored on overall acceptability assessments. In conclusion, the oregano and copaiba essential oils blend had a good preservative effect on fresh beef patties during display and increased sensory acceptability of the product, thus being a possible alternative for replacing synthetic compounds in processed foods.


Subject(s)
Oils, Volatile , Origanum , Animals , Antioxidants/pharmacology , Cattle , Cooking , Meat/analysis , Oils, Volatile/pharmacology
19.
Braz Oral Res ; 36: e101, 2022.
Article in English | MEDLINE | ID: mdl-35830144

ABSTRACT

Oral cancer represents a public health issue because of its high mortality rate, resulting mainly from diagnostic delays. Insufficient training in oral diagnosis is usually perceived by dentists. Distance learning could be used as an auxiliary tool to bridge that gap. This study evaluated the impact of a distance learning course on oral mucosal lesion diagnosis offered to public healthcare dentists. Participants of an online course answered a pretest/posttest comprising clinical images of 30 clinical cases. Participants were questioned about the diagnosis and informed their decision on the cases (referring the cases to a specialist or managing them themselves), as a parameter of perceived self-efficacy. A total of 442 dentists enrolled in the course. Their pass rate was 97%. Classification of the nature of the lesions, diagnostic hypotheses, sensitivity, and specificity improved by 13.4%, 10.0%, 13.4%, and 6.6%, respectively (p<0.01, Wilcoxon test). Regarding management, there was a 16.6% reduction in the intention to refer cases, while confidence in the diagnosis of benign lesions increased by 40%. A distance learning course may be useful in continuing education actions for primary care dentists, improving their diagnostic abilities and encouraging them in the management of oral lesions. Moreover, this strategy could contribute to disseminating knowledge to remote regions, particularly among primary health care professionals.


Subject(s)
Education, Distance , Oral Ulcer , Attitude of Health Personnel , Dentists , Humans , Practice Patterns, Dentists' , Primary Health Care , Self Efficacy , Surveys and Questionnaires
20.
Rev. Enferm. Atual In Derme ; 96(39): 1-19, Jul-Set. 2022.
Article in Portuguese | BDENF - Nursing | ID: biblio-1417266

ABSTRACT

Objetivo: identificar a relação entre saúde ambiental e Covid-19 no contexto da enfermagem da atenção primária à saúde. Métodos: trata-se de uma Scoping Review, a busca foi realizada nas bases de dados US National Library of Medicine National Institutes of Health, Medical Literature Analysis and RetrievalSystem Online, Institute for Scientific Information e Literatura Latino-Americana e do Caribe em Ciências da Saúde, sendo a amostra final composta por 32 estudos. Resultados: Foram selecionados 32 artigos, analisados em duas unidades temáticas: relação entre a Covid-19 e as mudanças climáticas e o conhecimento da enfermagem sobre saúde ambiental. Considerações finais: identificou-se que a disseminação da Covid-19 está relacionada às questões ambientais, evidenciando a importância da atuação da enfermagem da Atenção Primária à Saúde para controle da pandemia, desenvolvendo ações de mitigação, organização e promoção da saúde. Verificou-se a necessidade da inserção da saúde ambiental na formação e educação permanente da equipe de enfermagem.


Objective: to identify the relationship between environmental health and Covid-19 in the context of primary health care nursing. Methods: this is a Scoping Review, the search was carried out in the US National Library of Medicine National Institutes of Health, Medical Literature Analysis and Retrieval System Online, Institute for Scientific Information and Latin American and Caribbean Literature in Science databases. of Health, and the final sample consisted of 32 studies. Results: 32 articles were selected, analyzed in two thematic units: relationship between Covid-19 and climate change and nursing knowledge about environmental health. Final considerations: it was identified that the spread of Covid-19 is related to environmental issues, highlighting the importance of the role of Primary Health Care nursing to control the pandemic, developing actions to mitigate, organize and promote health. There was a need to include environmental health in the training and continuing education of the nursing team.


Objetivo: identificar la relación entre la salud ambiental y el Covid-19 en el contexto de la enfermería de atención primaria de salud. Métodos: se trata de una Scoping Review, la búsqueda se realizó en la Biblioteca Nacional de Medicina de EE. UU., National Institutes of Health, Medical Literature Analysis and Retrieval System Online, Institute for Scientific Information y Latin American and Caribbean Literature in Science Databases of Health, y la muestra final estuvo compuesta por 32 estudios. Resultados: se seleccionaron 32 artículos, analizados en dosunidades temáticas: relación entre el Covid-19 y el cambio climático y conocimientos de enfermería sobre salud ambiental. Consideraciones finales: se identificó que la propagación de la Covid-19 está relacionada con cuestiones ambientales, destacando la importancia del papel de la enfermería en la Atención Primaria de Salud para el control de la pandemia, desarrollando acciones para mitigar, organizar y promover la salud. Existía la necesidad de incluir la salud ambiental en la formación y educación continua del equipo de enfermería.


Subject(s)
Humans , Male , Female , Primary Health Care , Environmental Health , Nursing , Environment , COVID-19
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