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1.
Front Psychol ; 15: 1310594, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38659692

RESUMO

Introduction: The COVID-19 pandemic led many countries to adopt strict measures aimed at reducing circulation of the virus and mitigating the burden on health services. Among these, the lockdown (social distancing/confinement) was probably the most controversial and most widely debated, since it affected the population's daily life abruptly, with consequences for people's emotional state and the operational logic of various economic sectors. Objective: Analyze the relationship been Brazilians' opinions on lockdown during the pandemic and individual, sociodemographic, and belief characteristics. Methods: We conducted an online survey to evaluate Brazilians' opinions on the lockdown during the COVID-19 pandemic. We prepared a questionnaire with questions on sociodemographic aspects and individuals' points of view toward the lockdown. We sent a link for the survey through social media and encouraged participants to also share the link in their respective social networks, as a snowball sample. Cluster analysis was performed to identify different opinion profiles. Cluster Analysis is a multivariate approach that aims to segment a set of data into distinct groups, using some classification criteria. Results: From April to May 2021, the link received 33,796 free participations via social networks from all over Brazil. We analyzed data from 33,363 participants. Pro-lockdown opinions predominated in most of the sociodemographic strata. Cluster analysis identified two groups: pro-lockdown, aligned with the scientific recommendations, and anti-lockdown, characterized by economic insecurity and denialism. Anti-lockdown participants downplayed the pandemic's seriousness and believed in unproven measures to fight SARS-CoV-2. However, these same participants were afraid of losing their jobs and of being unable to pay their bills. In general, participants did not believe in the feasibility of a lockdown in Brazil or in the efficacy of the prevailing government administration's measures. Conclusion: The study identified a lack of consensus among participants concerning lockdown as a practice. Issues such as disbelief in the pandemic's seriousness, denialism, and economic insecurity were important in the determination of the profiles identified in the study. Denialism is believed to have been a subjective defense against the economic problems resulting from social control measures and the lack of adequate social policies to deal with the pandemic. It was also highlighted that political polarization and the lack of central coordination during social distancing are crucial aspects. The variation in results in different locations highlights the diversity of the Brazilian scenario. By analyzing Brazilians' opinions about the lockdown, considering individual characteristics, the study seeks insights to face the pandemic and prepare for future crises, contributing to more effective public health strategies.

2.
Cien Saude Colet ; 28(10): 3069-3076, 2023 Oct.
Artigo em Português, Inglês | MEDLINE | ID: mdl-37878947

RESUMO

The mental health of health professionals who worked directly in services during the COVID-19 pandemic to care for patients affected by the disease became a fundamental issue to be considered, given the several consequences of this activity for these professionals. This article aimed to understand the challenges and demands of health professionals concerning support to address the emotional and physical exhaustion of working on the so-called frontline during the COVID-19 pandemic. The qualitative methodological approach was based on semi-structured interviews conducted online with these professionals after the first months of the pandemic. The hero's place in which they were set, even if only in media discourses, soon gave way to their weaknesses and fragile work relationships to emerge: stress, fear, and the listening and reception desire. Marcel Mauss' gift theory was brought up considering that new ways of reading and interpreting health work relationships contribute to necessary and urgent reformulations of their current context, targeting mental health and, more broadly, the comprehensive health of healthcare professionals.


Durante a pandemia de COVID-19, a saúde mental dos profissionais de saúde, que trabalharam diretamente nos serviços voltados para o cuidado dos pacientes afetados pela doença, tornou-se questão fundamental a ser considerada, dado os diversos desdobramentos que essa atuação gerou para esses profissionais. O objetivo deste artigo foi compreender desafios e demandas dos profissionais de saúde em termos de suporte para lidar com o desgaste emocional e físico com a atuação na chamada linha de frente durante a pandemia de COVID-19. A abordagem metodológica qualitativa se deu a partir de entrevistas semiestruturadas realizadas em ambiente online com esses profissionais, passados os primeiros meses de pandemia. O lugar de herói em que eles foram colocados, ainda que apenas nos discursos midiáticos, logo deu espaço para que as fragilidades destes e das relações de trabalho aparecessem: estresse, medo e o desejo de escuta e acolhimento. A teoria da dádiva de Marcel Mauss foi trazida considerando que novas formas de leitura e interpretação das relações de trabalho em saúde contribuem para reformulações necessárias e urgentes do contexto em que se encontram hoje, visando a saúde mental e, mais amplamente, a saúde integral dos profissionais da área de saúde.


Assuntos
COVID-19 , Humanos , Saúde Mental , Pandemias , Pessoal de Saúde , Atenção à Saúde
3.
Cad Saude Publica ; 39(10): e00159122, 2023.
Artigo em Português | MEDLINE | ID: mdl-37851730

RESUMO

The objective is to unveil the reasons for vaccine hesitancy among parents and/or guardians of children and adolescents toward the prevention of COVID-19. This is a descriptive study, with a qualitative approach that seeks to analyze the answers to the open question "Why will you not vaccinate or have not vaccinated or are in doubt about vaccinating the children and adolescents under your responsibility, for the prevention of COVID-19?". The research included adult individuals, Brazilians, living in the country, responsible for children and adolescents under 18 years of age. Data collection took place electronically in November and December 2021. The answers were organized and processed with the support of the software Iramuteq. The textual corpus of this research was composed of the response of 1,896 participants, consisting of 87% who were hesitant (1,650) and 13% (246) of parents who intend to vaccinate but who outlined some doubts and considerations about the vaccination of children and adolescents. These are reasons why parents and/or guardians have not vaccinated or are in doubt about vaccinating the children and adolescents under their responsibility for the prevention of COVID-19: fears about vaccination regarding the conception that the vaccine is in the experimental phase, fear of adverse reactions and long-term effects. The reasons for the lack of intention to vaccinate stem from the understanding of the participants that COVID-19 in children is not serious, the risks of vaccination are greater than the benefits, and the right of choice not to vaccinate.


Objetiva-se desvelar os motivos para hesitação vacinal de pais e/ou responsáveis de crianças e adolescentes para prevenção da COVID-19. Trata-se de um estudo descritivo, de abordagem qualitativa, que busca analisar as respostas da pergunta aberta "por que você não vai vacinar, não vacinou ou está na dúvida em vacinar as crianças e os adolescentes sob sua responsabilidade para prevenção da COVID-19?". A pesquisa incluiu indivíduos adultos, brasileiros, residentes no país, responsáveis por crianças e adolescentes menores de 18 anos. A coleta de dados aconteceu de forma eletrônica entre os meses de novembro e dezembro de 2021. As respostas foram organizadas e processadas com suporte do software Iramuteq. O corpus textual desta pesquisa foi composto pela resposta de 1.896 participantes, constituído por 87% de hesitantes (1.650) e 13% (246) de pais que têm intenção de vacinar, mas que esboçaram algumas dúvidas e considerações a respeito da vacinação de crianças e adolescentes. São motivos pelos quais pais e/ou responsáveis não vacinaram ou estão na dúvida em vacinar as crianças e os adolescentes sob sua responsabilidade para prevenção da COVID-19: receio em razão de a vacina estar em fase experimental e medo das reações adversas e dos efeitos a longo prazo. Já os motivos para ausência de intenção de vacinar decorrem dos entendimentos dos participantes de que a COVID-19 em crianças não é grave, os riscos da vacinação são maiores do que os benefícios e o direito de escolha em não vacinar.


El objetivo es revelar los motivos de la indecisión a las vacunas de padres y/o responsables de niños y adolescentes para la prevención de COVID-19. Se trata de un estudio descriptivo con enfoque cualitativo, que busca analizar las respuestas a la pregunta abierta "¿Por qué no va a vacunar o no vacunó o tiene dudas en vacunar a los niños y los adolescentes bajo su responsabilidad para la prevención del COVID-19?". La investigación incluyó individuos adultos, brasileños, residentes en el país, responsables de niños y adolescentes menores de 18 años. La recolección de datos se realizó de forma electrónica entre los meses de noviembre y diciembre de 2021. Las respuestas se organizaron y procesaron con ayuda del software Iramuteq. El corpus textual de esta investigación fue compuesto por la respuesta de 1.896 participantes, siendo constituido por el 87% de indecisos (1.650) y el 13% (246) de padres que tienen la intención de vacunar, pero que esbozaron algunas dudas y consideraciones respecto a la vacunación de niños y adolescentes. Son motivos por los cuales los padres y/o responsables no vacunaron o están en duda en vacunar a los niños y adolescentes bajo su responsabilidad para prevención del COVID-19: temores con la vacunación en cuanto a la concepción de que la vacuna está en fase experimental, miedo a las reacciones adversas y los efectos a largo plazo. Los motivos de la ausencia de intención en vacunar se deben a que los participantes entienden que el COVID-19 en niños no es grave, que los riesgos de la vacunación son mayores que los beneficios y que tienen derecho a decidir no vacunarse.


Assuntos
COVID-19 , Hesitação Vacinal , Adulto , Humanos , Adolescente , Criança , Brasil/epidemiologia , COVID-19/prevenção & controle , Coleta de Dados , Emoções , Pais , Vacinação
4.
Front Cell Infect Microbiol ; 13: 1182257, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37588055

RESUMO

Introduction: Despite the existing data on the Multisystem Inflammatory Syndrome in Children (MIS-C), the factors that determine these patients evolution remain elusive. Answers may lie, at least in part, in genetics. It is currently under investigation that MIS-C patients may have an underlying innate error of immunity (IEI), whether of monogenic, digenic, or even oligogenic origin. Methods: To further investigate this hypothesis, 30 patients with MIS-C were submitted to whole exome sequencing. Results: Analyses of genes associated with MIS-C, MIS-A, severe covid-19, and Kawasaki disease identified twenty-nine patients with rare potentially damaging variants (50 variants were identified in 38 different genes), including those previously described in IFNA21 and IFIH1 genes, new variants in genes previously described in MIS-C patients (KMT2D, CFB, and PRF1), and variants in genes newly associated to MIS-C such as APOL1, TNFRSF13B, and G6PD. In addition, gene ontology enrichment pointed to the involvement of thirteen major pathways, including complement system, hematopoiesis, immune system development, and type II interferon signaling, that were not yet reported in MIS-C. Discussion: These data strongly indicate that different gene families may favor MIS- C development. Larger cohort studies with healthy controls and other omics approaches, such as proteomics and RNAseq, will be precious to better understanding the disease dynamics.


Assuntos
COVID-19 , Criança , Humanos , Brasil , COVID-19/genética , Estudos de Coortes , Apolipoproteína L1
5.
PLoS One ; 18(1): e0279393, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36595513

RESUMO

OBJECTIVE: This study aims to assess the trustworthiness of information sources, perception of clear information about the vaccine, and strategies to increase adherence to vaccination to provide managers with information that helps establish effective communication with the population about vaccination. METHOD: This is an online survey conducted between January 22 and 29, 2021, preceded by an Informed Consent, that aims to assess vaccine hesitancy, which corresponded to the first week of vaccination initiation to prevent COVID-19 in Brazil. Data were obtained from a questionnaire made available through a free platform and stored in Google Forms and later exported to the SPSS statistical package for analysis. The sample consisted of all questionnaires from participants who self-declared as age 18 or older, Brazilian, and residing in Brazil at the time of the survey. Incomplete records with more than 50% of blank items and duplicates were excluded. All categorical variables were analyzed from their absolute and relative frequencies. Multivariate logistic regression was performed to verify the relationship between dependent variables and independent variables. RESULTS: The results show that trust in information sources diverges between hesitant and non-hesitant. They also showed that some participants show an overall distrust that seems to have deeper foundations than issues related only to the source of information. The high rejection of television and the WHO as sources of information among hesitant suggests that integrated actions with research institutes, public figures vaccinating, and religious leaders can help to combat vaccine hesitation. Two actors become particularly important in this dynamic, both for good and bad, and their anti-vaxxer behavior must be observed: the doctor and the Ministry of Health. CONCLUSION: This study contributes to gathering valuable information to help understand the behavior and thinking relevant to the adherence to vaccination recommendations.


Assuntos
COVID-19 , Vacinas , Humanos , Adolescente , Fonte de Informação , Brasil/epidemiologia , Vacinas contra COVID-19 , COVID-19/epidemiologia , COVID-19/prevenção & controle , Vacinação
6.
Artigo em Inglês | MEDLINE | ID: mdl-37444052

RESUMO

BACKGROUND: The control of the COVID-19 pandemic has been a great challenge. Understanding the thoughts and beliefs underlying vaccine hesitancy can help in the formulation of public policies. The present study aimed to analyze the social representations of hesitant Brazilians about vaccination against COVID-19. METHODS: Qualitative research guided by the Theory of Social Representations, carried out through an online survey among Brazilian adults living in Brazil. The data were analyzed using the IRaMuTeQ software. RESULTS: Of the 173,178 respondents, 10,928 were hesitant and declared reasons for vaccination hesitation. The analysis generated three classes: mistrust of the vaccine and underestimation of the severity of the pandemic; (dis)information and distrust of political involvement; and fear of adverse reactions to COVID-19 vaccines. CONCLUSIONS: Social knowledge, presented by the representations apprehended in this study, demonstrates difficulty in discerning the reliability of information and a social imagination full of doubts and uncertainties. Understanding the internal dynamics of these groups, with their representations of the world, is important to propose policies and actions that echo and cause changes in the understanding of the role of immunization. It is essential to shed light on the sociological imagination so that gaps filled with false information can be dismantled and confronted with scientific knowledge accessible to the population.


Assuntos
COVID-19 , Hesitação Vacinal , Adulto , Humanos , Brasil , COVID-19/prevenção & controle , Vacinas contra COVID-19/uso terapêutico , Pandemias/prevenção & controle , Política Pública , Reprodutibilidade dos Testes , Vacinação , Hesitação Vacinal/psicologia
7.
Lancet Reg Health Am ; 7: 100170, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35005692

RESUMO

BACKGROUND: COVID-19 has exacerbated health inequalities worldwide. Yet, such a perspective has not been investigated in specific healthcare workers and their resulting inclusion as a priority group for vaccination have been an important focus of political and social discussion. This study aimed at investigating whether SARS-CoV-2-seropositivity in healthcare workers in a public hospital in Rio de Janeiro, Brazil, was influenced by social determinants of health and the social vulnerability in subgroups of workers. METHODS: A serological survey was conducted in 1,154 healthcare workers in June and July 2020. The association between the serological test results for detection of IgG antibodies to SARS-CoV-2 and socioeconomic, occupational characteristics and transportation used by the workers to commute was assessed using the Pearson´s chi-square test and Cramer's V. FINDINGS: Overall, the serum prevalence for the virus in the healthcare workers was 30% (342/1141). Non-white workers (208/561) with lower income (169/396) and schooling (150/353), as well as users of the mass transportation system (157/246) showed the highest infection rates. Importantly they mostly corresponded to hospital support workers (131/324), in particular the cleaning personnel (42/70). Accordingly, income, schooling and work modality appeared as negative predictors, as ascertained by forest plot analysis. INTERPRETATIONS: The data clearly illustrate the inequality in SARS-CoV-2 infection in the Brazilian population, comprising even healthcare workers of the Brazilian unified health system.

8.
PLoS One ; 17(1): e0261814, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35061719

RESUMO

Brazil has been severely affected by the COVID-19 pandemic. The high numbers of confirmed cases and deaths have continued unabated since the first reported case, with no flattening or downward turn in the curve. In this context, healthcare workers have been exposed uninterruptedly to stress factors throughout a year of the pandemic. The study´s aim was to identify and analyze healthcare workers´ perceptions of their feelings and concerns that have surfaced in responding to the pandemic. METHOD: This was a cross-sectional online qualitative survey study of 554 healthcare personnel working in the state of Rio de Janeiro during the COVID-19 pandemic. Recruitment occurred from July 20 to September 30, 2020, using an online survey, preceded byfree informed consent term. Data were analyzed with the Iramuteq software. RESULTS: Through a dendrogram, the words with the highest chi-square were highlighted and grouped into four classes: healthcare workers´ fear of falling ill to COVID-19 and infecting their family members; work/labor issues; feelings of powerlessness and need for public policies for government action; and fatigue and burnout in the pandemic. Each word class was also illustrated by a similarity tree. CONCLUSION: The study revealed healthcare workers´ exacerbated fear of infection and transmission of COVID-19 to their family members, besides financial losses and feelings of powerlessness and abandonment.


Assuntos
Esgotamento Profissional/epidemiologia , COVID-19/psicologia , Medo/psicologia , Pessoal de Saúde/psicologia , Adolescente , Adulto , Brasil , Esgotamento Profissional/psicologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Adulto Jovem
9.
Rev Soc Bras Med Trop ; 54: e0865-2020, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33759933

RESUMO

This report describes a case of multisystem inflammatory syndrome in a child that evolved with a pattern of toxic shock syndrome with coronary artery ectasia and neurological involvement, documented by magnetic resonance imaging, with changes in the corpus callosum and myopathy in the pelvic girdle and paravertebral musculature.


Assuntos
COVID-19 , Doenças Musculares , Criança , Humanos , Imageamento por Ressonância Magnética , Doenças Musculares/diagnóstico , SARS-CoV-2 , Síndrome , Síndrome de Resposta Inflamatória Sistêmica
10.
Vaccine ; 39(42): 6262-6268, 2021 10 08.
Artigo em Inglês | MEDLINE | ID: mdl-34535318

RESUMO

BACKGROUND: The COVID-19 pandemic has affected the entire world, and the vaccine has emerged as a source of hope for return to normal life. Still, various countries have reported high vaccine hesitancy rates. It is important to know the vaccine hesitancy profile in Brazil to help design adequate communication strategies. METHODS: A voluntary, anonymous online survey was conducted from January 22 to 29, 2021, including resident Brazilian adults to assess factors related to vaccine hesitancy. Sociodemographic and epidemiological data were analyzed. A bivariate analysis was conducted with the independent variables, with vaccine hesitancy as the outcome variable, and a multivariate logistic model was used to calculated adjusted odds ratios. RESULTS: The sample included 173,178 respondents, and vaccine hesitancy was found in 10.5%. The principal factors associated with vaccine hesitancy were the following: assigning importance to the vaccinés efficacy (AOR = 16.39), fear of adverse reactions (AOR = 11.23), and assigning importance to the vaccinés country of origin (AOR = 3.72). Other risk factors were the following: male gender (AOR = 1.62), having children (AOR = 1.29), 9 years of schooling or less (AOR = 1.31), living in the Central-West region (AOR = 1.19), age ≥ 40 years (AOR = 1.17), and monthly income < U$788.68 (AOR = 1.13). The two vaccines available in Brazil, Covishield and CoronaVac, showed similar confidence, 80.13% and 76.36%, respectively, despite the higher rejection of the latter vaccinés Chinese origin. INTERPRETATION: This online survey confirms the low vaccine hesitancy rate among Brazilians and allowed the identification of a profile that can assist the elaboration of communication strategies to increase vaccine adherence. FUNDING: National Institute of Women, Children and Adolescents Health Fernandes Figueira, FIOCRUZ, Rio de Janeiro, Brazil.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Adolescente , Adulto , Brasil , Criança , Feminino , Humanos , Masculino , Pandemias , SARS-CoV-2
11.
Clin Nutr ; 39(4): 1188-1194, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31153673

RESUMO

BACKGROUND & AIMS: Sepsis is still a significant cause of death in the Intensive Care Unit and its early diagnosis is vital. Changes in cell permeability have been observed early in sepsis. Lower values of bioelectrical impedance (BIA) such as reactance adjusted by height (Xc/H) and phase angle (PA) have already been studied as a prognostic biomarker for many diseases and may indicate cell injury. BIA is a low cost, practical, noninvasive method that can be measured at bedside. This study investigated the utility of PA and Xc/H raw values in the pediatric critical care unit as predictors of progression to septic shock, as a clinical monitoring tool and to support the diagnosis of septic shock. METHODS: We prospectively analyzed bioelectrical impedance in 145 children aged between one month and six years who were not in septic shock on admission to the intensive care unit Serial bioelectrical impedance analysis (BIA) measures were analyzed to determine the sensitivity and specificity of accurately identifying children who subsequently developed septic shock. Kaplan-Meier septic shock-free survival curves modeled by Xc/H and PA were done. RESULTS: The free-septic shock survival curve analysis showed that patients with the lowest median values of Xc/H and PA were associated with the highest percentage of occurrence of septic shock (p = 0.0001 for Xc/H and <0.0006 for PA) and longest length of stay in the intensive care unit (p < 0.0011 for Xc/H and p < 0.004 for PA). Values of Xc/H below 48.63 Ohm/m at admission showed statistically significant odds ratio (OR) of 3.72 for developing septic shock any time during the hospitalization period, with a 87% sensitivity, 35% specificity and an area under the curve (AUC) of 0.62. The PA at admission did not show significant results. During hospitalization, patients with Xc/H below 35.72 Ohm/m were 3.38 times more likely to develop septic shock in the next day, with a sensitivity of 66.7%, a specificity of 62.3% and AUC of 0.65. PA values below 3.27 had an OR of 9.58 for a septic shock the next day with a sensitivity of 95.8%, specificity of 29.4% and AUC of 0.62. The presence of a value of Xc/H below 33 Ohm/m showed a strong association with the occurrence of septic shock on the same day of the measurement, with an OR of 11.7, as well as a value of PA below 2.64, showed an OR of 14.2. CONCLUSIONS: The bioelectrical parameters Xc/H and phase angle have limitations in predicting septic shock as isolated biomarkers, but have a potential role as a monitoring tool in the pediatric intensive care unit. The comparative value with other biomarkers remains to be elucidated.


Assuntos
Composição Corporal/fisiologia , Impedância Elétrica , Unidades de Terapia Intensiva Pediátrica , Sepse/diagnóstico , Sepse/fisiopatologia , Criança , Pré-Escolar , Estado Terminal , Progressão da Doença , Feminino , Humanos , Lactente , Masculino , Estudos Prospectivos , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Choque Séptico/diagnóstico , Análise de Sobrevida
12.
Rev Soc Bras Med Trop ; 51(4): 560-562, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30133647

RESUMO

Accidents related to Africanized honey bees are growing globally and are associated with multiple stings owing to the aggressive behavior of this species. The massive inoculation of venom causes skin necrosis and rhabdomyolysis leading to renal failure. Anaphylactic manifestations are more common and are treated using well-defined treatment protocols. However, bee venom-induced toxic reactions may be serious and require a different approach. We report the case of a 3-year-old child, which would help clinicians to focus on the treatment approach required after an incident involving multiple bee stings.


Assuntos
Injúria Renal Aguda/etiologia , Venenos de Abelha/intoxicação , Abelhas , Infecções Oculares/etiologia , Mordeduras e Picadas de Insetos/complicações , Rabdomiólise/etiologia , Animais , Pré-Escolar , Humanos , Masculino
13.
Ciênc. Saúde Colet. (Impr.) ; Ciênc. Saúde Colet. (Impr.);28(10): 3069-3076, out. 2023. tab
Artigo em Português | LILACS-Express | LILACS | ID: biblio-1520594

RESUMO

Resumo Durante a pandemia de COVID-19, a saúde mental dos profissionais de saúde, que trabalharam diretamente nos serviços voltados para o cuidado dos pacientes afetados pela doença, tornou-se questão fundamental a ser considerada, dado os diversos desdobramentos que essa atuação gerou para esses profissionais. O objetivo deste artigo foi compreender desafios e demandas dos profissionais de saúde em termos de suporte para lidar com o desgaste emocional e físico com a atuação na chamada linha de frente durante a pandemia de COVID-19. A abordagem metodológica qualitativa se deu a partir de entrevistas semiestruturadas realizadas em ambiente online com esses profissionais, passados os primeiros meses de pandemia. O lugar de herói em que eles foram colocados, ainda que apenas nos discursos midiáticos, logo deu espaço para que as fragilidades destes e das relações de trabalho aparecessem: estresse, medo e o desejo de escuta e acolhimento. A teoria da dádiva de Marcel Mauss foi trazida considerando que novas formas de leitura e interpretação das relações de trabalho em saúde contribuem para reformulações necessárias e urgentes do contexto em que se encontram hoje, visando a saúde mental e, mais amplamente, a saúde integral dos profissionais da área de saúde.


Abstract The mental health of health professionals who worked directly in services during the COVID-19 pandemic to care for patients affected by the disease became a fundamental issue to be considered, given the several consequences of this activity for these professionals. This article aimed to understand the challenges and demands of health professionals concerning support to address the emotional and physical exhaustion of working on the so-called frontline during the COVID-19 pandemic. The qualitative methodological approach was based on semi-structured interviews conducted online with these professionals after the first months of the pandemic. The hero's place in which they were set, even if only in media discourses, soon gave way to their weaknesses and fragile work relationships to emerge: stress, fear, and the listening and reception desire. Marcel Mauss' gift theory was brought up considering that new ways of reading and interpreting health work relationships contribute to necessary and urgent reformulations of their current context, targeting mental health and, more broadly, the comprehensive health of healthcare professionals.

14.
Cad. Saúde Pública (Online) ; 39(10): e00159122, 2023. graf
Artigo em Português | LILACS-Express | LILACS | ID: biblio-1550172

RESUMO

Resumo: Objetiva-se desvelar os motivos para hesitação vacinal de pais e/ou responsáveis de crianças e adolescentes para prevenção da COVID-19. Trata-se de um estudo descritivo, de abordagem qualitativa, que busca analisar as respostas da pergunta aberta "por que você não vai vacinar, não vacinou ou está na dúvida em vacinar as crianças e os adolescentes sob sua responsabilidade para prevenção da COVID-19?". A pesquisa incluiu indivíduos adultos, brasileiros, residentes no país, responsáveis por crianças e adolescentes menores de 18 anos. A coleta de dados aconteceu de forma eletrônica entre os meses de novembro e dezembro de 2021. As respostas foram organizadas e processadas com suporte do software Iramuteq. O corpus textual desta pesquisa foi composto pela resposta de 1.896 participantes, constituído por 87% de hesitantes (1.650) e 13% (246) de pais que têm intenção de vacinar, mas que esboçaram algumas dúvidas e considerações a respeito da vacinação de crianças e adolescentes. São motivos pelos quais pais e/ou responsáveis não vacinaram ou estão na dúvida em vacinar as crianças e os adolescentes sob sua responsabilidade para prevenção da COVID-19: receio em razão de a vacina estar em fase experimental e medo das reações adversas e dos efeitos a longo prazo. Já os motivos para ausência de intenção de vacinar decorrem dos entendimentos dos participantes de que a COVID-19 em crianças não é grave, os riscos da vacinação são maiores do que os benefícios e o direito de escolha em não vacinar.


Abstract: The objective is to unveil the reasons for vaccine hesitancy among parents and/or guardians of children and adolescents toward the prevention of COVID-19. This is a descriptive study, with a qualitative approach that seeks to analyze the answers to the open question "Why will you not vaccinate or have not vaccinated or are in doubt about vaccinating the children and adolescents under your responsibility, for the prevention of COVID-19?". The research included adult individuals, Brazilians, living in the country, responsible for children and adolescents under 18 years of age. Data collection took place electronically in November and December 2021. The answers were organized and processed with the support of the software Iramuteq. The textual corpus of this research was composed of the response of 1,896 participants, consisting of 87% who were hesitant (1,650) and 13% (246) of parents who intend to vaccinate but who outlined some doubts and considerations about the vaccination of children and adolescents. These are reasons why parents and/or guardians have not vaccinated or are in doubt about vaccinating the children and adolescents under their responsibility for the prevention of COVID-19: fears about vaccination regarding the conception that the vaccine is in the experimental phase, fear of adverse reactions and long-term effects. The reasons for the lack of intention to vaccinate stem from the understanding of the participants that COVID-19 in children is not serious, the risks of vaccination are greater than the benefits, and the right of choice not to vaccinate.


Resumen: El objetivo es revelar los motivos de la indecisión a las vacunas de padres y/o responsables de niños y adolescentes para la prevención de COVID-19. Se trata de un estudio descriptivo con enfoque cualitativo, que busca analizar las respuestas a la pregunta abierta "¿Por qué no va a vacunar o no vacunó o tiene dudas en vacunar a los niños y los adolescentes bajo su responsabilidad para la prevención del COVID-19?". La investigación incluyó individuos adultos, brasileños, residentes en el país, responsables de niños y adolescentes menores de 18 años. La recolección de datos se realizó de forma electrónica entre los meses de noviembre y diciembre de 2021. Las respuestas se organizaron y procesaron con ayuda del software Iramuteq. El corpus textual de esta investigación fue compuesto por la respuesta de 1.896 participantes, siendo constituido por el 87% de indecisos (1.650) y el 13% (246) de padres que tienen la intención de vacunar, pero que esbozaron algunas dudas y consideraciones respecto a la vacunación de niños y adolescentes. Son motivos por los cuales los padres y/o responsables no vacunaron o están en duda en vacunar a los niños y adolescentes bajo su responsabilidad para prevención del COVID-19: temores con la vacunación en cuanto a la concepción de que la vacuna está en fase experimental, miedo a las reacciones adversas y los efectos a largo plazo. Los motivos de la ausencia de intención en vacunar se deben a que los participantes entienden que el COVID-19 en niños no es grave, que los riesgos de la vacunación son mayores que los beneficios y que tienen derecho a decidir no vacunarse.

15.
Sao Paulo Med J ; 124(5): 298-303, 2006 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-17262164

RESUMO

Medical progress has reduced the mortality from infectious diseases in most countries, but allergic diseases have become more prevalent worldwide over the same period, especially in industrialized countries. This has prompted speculation that modern lifestyles have altered the relationship between heredity and environment so as to promote development of an atopic phenotype when exposure to infection decreases. A healthy uterine microenvironment is known to favor Th2 lymphocyte development. However, some evidence suggests that persistence of the Th2 pattern of immunity directs the developing organism's immune response towards a long-lasting atopic phenotype. Even though the outcome also depends on other factors (such as infection, functional state of the intestinal microflora, and exposure to environmental allergens at times critical to development), it seems that the immune system during the perinatal period is responsive to interventions that are no longer effective in adulthood. We have reviewed the literature accessible through Medline to identify recent advances in the prevention of allergic disease through interventions in the fetal-maternal relationship. Diet seems to have a significant impact on the immunological profile of the pregnant uterus, as well as on the postnatal development of allergic disease in the offspring, as suggested by the effects of probiotic bacteria and by manipulations of the dietary content of polyunsaturated fatty acids and antioxidants. This highlights the need for further studies, in order to define the best intervention methods, the most appropriate time interval and the individuals who will most likely benefit from them.


Assuntos
Dieta , Hipersensibilidade/prevenção & controle , Troca Materno-Fetal/imunologia , Efeitos Tardios da Exposição Pré-Natal/prevenção & controle , Células Th2/imunologia , Útero/imunologia , Antioxidantes/uso terapêutico , Asma/prevenção & controle , Citocinas , Dermatite Atópica/prevenção & controle , Gorduras Insaturadas na Dieta/uso terapêutico , Feminino , Humanos , Hipersensibilidade/imunologia , Imunoglobulina E/imunologia , Lactente , Recém-Nascido , Gravidez , Efeitos Tardios da Exposição Pré-Natal/imunologia , Probióticos/uso terapêutico , Cordão Umbilical
16.
Rev. Soc. Bras. Med. Trop ; Rev. Soc. Bras. Med. Trop;54: e0865-2020, 2021. graf
Artigo em Inglês | LILACS | ID: biblio-1155585

RESUMO

Abstract This report describes a case of multisystem inflammatory syndrome in a child that evolved with a pattern of toxic shock syndrome with coronary artery ectasia and neurological involvement, documented by magnetic resonance imaging, with changes in the corpus callosum and myopathy in the pelvic girdle and paravertebral musculature.


Assuntos
Humanos , Criança , Infecções por Coronavirus , Doenças Musculares/diagnóstico , Síndrome , Imageamento por Ressonância Magnética , Síndrome de Resposta Inflamatória Sistêmica , Betacoronavirus
17.
Artigo em Inglês | Arca: Repositório institucional da Fiocruz | ID: arc-40562

RESUMO

Antecedentes e objetivos: A sepse ainda é uma causa significativa de morte na Unidade de Terapia Intensiva e seu diagnóstico precoce é vital. Alterações na permeabilidade celular foram observadas no início da sepse. Valores mais baixos de impedância bioelétrica (BIA), como reatância ajustada pela altura (Xc / H) e ângulo de fase (PA), já foram estudados como um biomarcador prognóstico para muitas doenças e podem indicar lesão celular. A BIA é um método prático, não invasivo e de baixo custo que pode ser medido ao lado da cama. Este estudo investigou a utilidade dos valores brutos de PA e Xc / H na unidade de terapia intensiva pediátrica como preditores de progressão para choque séptico, como ferramenta de monitoramento clínico e como suporte ao diagnóstico de choque séptico. Métodos: Analisamos prospectivamente a impedância bioelétrica em 145 crianças com idade entre um mês e seis anos que não estavam em choque séptico na admissão na unidade de terapia intensiva. choque séptico desenvolvido. Foram realizadas curvas de sobrevivência sem choque séptico de Kaplan-Meier, modeladas por Xc / H e PA.Resultados: A análise da curva de sobrevida do choque séptico livre mostrou que os pacientes com os menores valores medianos de Xc / H e AF estavam associados à maior porcentagem de ocorrência de choque séptico (p = 0,0001 para Xc / H e <0,0006 para PA) e maior comprimento de permanência na unidade de terapia intensiva (p <0,0011 para Xc / H ep <0,004 para AF). Valores de Xc / H abaixo de 48,63 Ohm / m na admissão mostraram odds ratio (OR) estatisticamente significante de 3,72 para o desenvolvimento de choque séptico a qualquer momento durante o período de hospitalização, com sensibilidade de 87%, especificidade de 35% e área sob a curva (AUC ) de 0,62. O PA na admissão não apresentou resultados significativos. Durante a internação, pacientes com Xc / H abaixo de 35,72 Ohm / m tiveram 3,38 vezes mais chances de desenvolver choque séptico no dia seguinte, com sensibilidade de 66,7%, especificidade de 62,3% e AUC de 0,65. Os valores de AF abaixo de 3,27 apresentaram OR de 9,58 para choque séptico no dia seguinte, com sensibilidade de 95,8%, especificidade de 29,4% e AUC de 0,62. A presença de um valor de Xc / H abaixo de 33 Ohm / m mostrou forte associação com a ocorrência de choque séptico no mesmo dia da medição, com OR de 11,7 e valor de AF abaixo de 2,64. OU de 14.2.Conclusões: Os parâmetros bioelétricos Xc / H e ângulo de fase têm limitações na previsão do choque séptico como biomarcadores isolados, mas têm um papel potencial como ferramenta de monitoramento na unidade de terapia intensiva pediátrica. O valor comparativo com outros biomarcadores ainda precisa ser elucidado.

18.
Rev. Soc. Bras. Med. Trop ; Rev. Soc. Bras. Med. Trop;51(4): 560-562, July-Aug. 2018. graf
Artigo em Inglês | LILACS | ID: biblio-957438

RESUMO

Abstract Accidents related to Africanized honey bees are growing globally and are associated with multiple stings owing to the aggressive behavior of this species. The massive inoculation of venom causes skin necrosis and rhabdomyolysis leading to renal failure. Anaphylactic manifestations are more common and are treated using well-defined treatment protocols. However, bee venom-induced toxic reactions may be serious and require a different approach. We report the case of a 3-year-old child, which would help clinicians to focus on the treatment approach required after an incident involving multiple bee stings.


Assuntos
Humanos , Animais , Masculino , Rabdomiólise/etiologia , Venenos de Abelha/intoxicação , Abelhas , Infecções Oculares/etiologia , Injúria Renal Aguda/etiologia , Mordeduras e Picadas de Insetos/complicações
19.
Clin Nutr ; 32(5): 824-9, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23416114

RESUMO

BACKGROUND & AIMS: Currently, there are no clinical or laboratory parameters that can be used efficiently to predict the prognosis of critically ill patients, but in some situations, raw bioelectrical impedance parameters have been shown to be useful. The purpose of this study was to investigate the behavior of reactance and resistance in the severity of the critically ill pediatric patient. METHODS: We prospectively analyzed bioelectrical impedance in a sample of 332 critically ill pediatric patients submitted to mechanical ventilation. The values taken on admission and discharge were correlated with major outcomes to the critically ill patient. RESULTS: We found an association of low values of Xc/H (<27.7 Ohm/m) and of R/H (<563.6 Ohm/m) on admission with multiple organs dysfunction greater or equal to 4. Both R/H and Xc/H increased significantly between admission and discharge among survivors, while among nonsurvivors there was a trend of decrease between admission and the last measurement before death. CONCLUSIONS: Bioelectrical impedance is a useful tool for monitoring of critically ill pediatric patients. A possible role of R/H and Xc/H, especially the latter, as a predictive biomarker of evolution for septic shock and organ dysfunction still remains to be elucidated.


Assuntos
Lesão Pulmonar Aguda/diagnóstico , Composição Corporal , Insuficiência de Múltiplos Órgãos/diagnóstico , Síndrome do Desconforto Respiratório/diagnóstico , Choque Séptico/diagnóstico , Lesão Pulmonar Aguda/fisiopatologia , Lesão Pulmonar Aguda/terapia , Adolescente , Biomarcadores , Criança , Pré-Escolar , Estado Terminal , Estudos Transversais , Impedância Elétrica , Feminino , Humanos , Lactente , Unidades de Terapia Intensiva Pediátrica , Masculino , Insuficiência de Múltiplos Órgãos/fisiopatologia , Insuficiência de Múltiplos Órgãos/terapia , Sistemas Automatizados de Assistência Junto ao Leito , Prognóstico , Estudos Prospectivos , Respiração Artificial , Síndrome do Desconforto Respiratório/fisiopatologia , Síndrome do Desconforto Respiratório/terapia , Índice de Gravidade de Doença , Choque Séptico/fisiopatologia , Choque Séptico/terapia
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