Guia para Controle de Tuberculose em Instituições de Acolhimento para População em Situação de Rua / Guide to Tuberculosis Control in Reception Institutions for Population in Street Situation

Este guia se destina a profissionais que atuam, principalmente, nas Instituições de Acolhimento destinadas à População em Situação de Rua (PSR). Entretanto, vários conceitos e informações que serão apresentados aqui podem ser usados em outros espaços de acolhimento e de oferta de cuidados a esta população, como os de grupos informais e de organizações públicas, governamentais ou não-governamentais.

Conhecimento dos estudantes de enfermagem sobre biossegurança no contexto hospitalar na pandemia: abordagem qualitativa / Nursing students' knowledge about biosafety in the hospital context during the pandemic: a qualitative approach

OBJETIVO: Descrever o conhecimento dos estudantes de enfermagem sobre as medidas de biossegurança no contexto hospitalar em tempos de pandemia. MÉTODO: Estudo descritivo, exploratório, qualitativo, com estudantes de enfermagem de uma universidade pública da baixada litorânea do Rio de Janeiro, Brasil, através de entrevista em ambiente virtual, entre julho e setembro de 2021. Utilizou-se o Interface de R pour Analyses Multidimensionnelles de Textes Et de Questionnaires para processamento do corpus textual e Análise de Conteúdo Temática para interpretação das falas. RESULTADOS: Participaram 29 estudantes que reconhecem a biossegurança, mas não possuem segurança ao abordá-la. Para eles, trata-se de normas para proteção do trabalhador e pacientes, associando-as aos EPIs e ao uso durante a pandemia. CONCLUSÃO: A biossegurança não é reconhecida na sua totalidade entre estudantes de enfermagem que estarão no mercado de trabalho futuramente. É necessário um olhar ampliado em perspectiva transversal, especialmente nas disciplinas do ciclo profissionalizante da enfermagem.

OBJECTIVE: To describe Nursing students' knowledge about the biosafety measures in the hospital context in pandemic times. METHOD: A descriptive, exploratory and qualitative study conducted through interviews in a virtual environment between July and September 2021 with Nursing students from a public university in the coastal lowland of Rio de Janeiro, Brazil. Interface de R pour Analyses Multidimensionnelles de Textes Et de Questionnaires was used to process the text corpus and Thematic Content Analysis was employed to interpret the testimonies. RESULTS: The participants were 29 students that recognize biosafety but are not confident enough to address it. For them, it is but a set of standards for the protection of workers and patients alike, associating it with PPE and with its use during the pandemic. CONCLUSION: Biosafety is not recognized in its entirety by the Nursing students who will enter the labor market in the near future. An expanded and cross-sectional perspective is required, especially in the academic disciplines of Nursing training cycle.

Uso de EPIs e seu impacto na saúde do cirurgião-dentista em tempos de Covid-19 / Use of PEES and its impact on the health of the dental surgeon in Covid-19 times

O objetivo do presente estudo foi identificar quais EPIs foram utilizados pelos cirurgiões-dentistas e a relação destes EPIs com a presença de dores osteomusculares em virtude do novo estilo de vida profissional ocasionado pelo SARS-CoV-2. Foram aplicados dois questionários com a temática por intermédio da plataforma Google Forms®. Os participantes da pesquisa (n= 110) tiveram acesso aos questionários via e-mail e através das redes sociais. A análise de dados foi realizada por meio de teste qui-quadrado com nível de confiança de 95%. Os resultados obtidos demonstraram predomínio de indivíduos do sexo masculino, com idade entre 21 a 29 anos, solteiros, entre 1 a 10 anos de formado, possuindo renda mensal de 1 a 5 salários-mínimos, especialistas, atuando em consultório particular, com atualizações para atendimento durante o período de pandemia. Observou-se relação estatisticamente significativa (p<0,05) na utilização de gorro durante os atendimentos odontológicos para os profissionais que realizaram atualizações para atendimento durante o período de pandemia da COVID-19. Em relação aos demais EPIs não houve relação estatisticamente significativa (p>0,05). No que diz respeito às dores osteomusculares, observou-se relação estatisticamente significativa (p<0,05) apenas entre a utilização de avental descartável e o relato de dores na região do pescoço, ombro e costas. Ademais, não foi possível observar relação estatisticamente significativa (p>0,05) entre EPIs e dores osteomusculares. Pôde-se concluir que uma grande parcela dos cirurgiões-dentistas adotou medidas de proteção contra o novo Coronavírus (SARS-CoV-2), utilizando os EPIs recomendados para executar atendimento durante o período pandêmico. Com relação às dores osteomusculares, os participantes relataram dor com ou sem a utilização de EPIs, porém ao utilizarem avental descartável, houve predominância de sintomatologia na região do pescoço, ombros e coluna(AU)

The aim of this study was to identify which PPE was used by Dental Surgeons and the relationship of this PPE with the presence of musculoskeletal pain due to the new professional lifestyle caused by SARS-CoV-2. Two questionnaires with the theme were applied through the Google Forms® platform. Research participants (n = 110) had access to the questionnaires via e-mail and through social networks. Data analysis was performed using a chi-square test with a 95% confidence level. The results showed a predominance of male individuals, aged between 21 and 29 years old, single, between 1 and 10 years since graduation, having a monthly income of 1 to 5 minimum wages, specialists, working in private practice, with updates for care during the pandemic period. There was a statistically significant relationship (p<0.05) in the use of a cap during dental care for professionals who updated for care during the COVID-19 pandemic period. About the other PPE there was no statistically significant relationship (p>0.05). Regarding musculoskeletal pain, there was a statistically significant relationship (p<0.05) only between the use of a disposable apron and the report of pain in the neck, shoulder, and back. Furthermore, it was not possible to observe a statistically significant relationship (p>0.05) between PPE and musculoskeletal pain. It was concluded that a large portion of dentists adopted protective measures against the new Coronavirus (SARS-CoV-2), using the recommended PPE to perform care during the pandemic period. Regarding musculoskeletal pain, participants reported pain with or without the use of PPE, however, when using a disposable apron, there was a predominance of symptoms in the neck, shoulders, and back(AU)

Pediatric dentist attire and relationship with anxiety in children and parents during Covid-19 pandemic

Aim The study aimed to evaluate children's and parent's preferences of dentist's attire during Covid-19 pandemic and their relationship with dental anxiety. Methods A total of 139 Children(71 boys, 68 girls) aged 6-12 years were shown videos of a pediatric dentist working with different attire such as Personal Protective Equipment (PPE) and pedoscrub, and they were asked to express the way they preferred their dentist to be dressed. Children's anxiety levels with different attire of paediatric dentists were assessed in different age groups and for boys and girls separately and recorded it using the Facial image scale. A questionnaire regarding dental anxiety was created online and completed by 139 parents (76 females, 63 males) of various ages and different educational backgrounds who were asked to choose between two outfits. Results were tabulated and statistically analysed using Chi-square test. Results Children aged 10-12 years preferred PPE by 50.6%, whereas 48.1% of children aged 6-9 years least preferred PPE (<0.05). About 46 (33%) were scored as anxious children and they had a preference for pedoscrub. Also, nonanxious children 43(31%) preferred PPE. All educated parents (100%) selected PPE over pedoscrub and the result were shown to be statistically significant. (<0.05). Conclusion Ultimately, the majority of the anxious children chosen pedoscrub, whereas non - anxious children have chosen PPE. Furthermore, the data reveals that both educated parents and older children preferred PPE as their attire for paediatric dentists.

Evaluation of customized peripheral sealing device acceptance for surgical/medical masks among dental professionals during early COVID-19 pandemic / Evaluación de la aceptación de dispositivos de sellado periférico personalizados para máscaras quirúrgicas/médicas entre dentistas durante la pandemia temprana de COVID-19

Abstract A 3-dimensional (3D) printed custom-frame can improve the peripheral seal of readily available surgical/medical masks. This study aimed to assess the acceptance of a 3D-printed custom-frame with the American Society for Testing and Materials (ASTM) surgical/medical masks and the use of a face shield. A total of 206 subjects from a dental school participated, who answered a multiple-choice questionnaire. Participants received an invitation through the institutional email of the school via Qualtrics platform. 3D printed custom-frames were fabricated for each participant. According to their response, participants were divided into 4 groups: mask only (M), mask and frame (MF), mask and face shield (MFS), and all 3 personal protective equipment (MFFS). Data was analyzed in absolute and relative frequency. The acceptance of a 3D-printed custom-frame in the group MFFS varied between ''poor''/''very poor'' (44.7%). It allowed ''good'' performance of routine procedures (40.3%), but ''poor'' visual quality (48.1%). Musculoskeletal tolerance and ease to perform movements were adequate. There was no interference in olfactory sensitivity (44.7%) or in the ability to breathe (34.5%). Finally, it showed "moderate pain" (48.1%) on the ear and "no pain" (38.9%) on the head. The 3D-printed custom-frame adapted to ASTM surgical/medical face masks showed reasonable tolerance. Side effects of ear pain ranging in degrees were noted. Further research is indicated to evaluate safety, comfort, compliance, side effects, and occupational hazards of long-term use of enhanced PPE recommendations.Avoiding the recurrent outbreaks of COVID-19, the use of PPE by the public is necessary. Improper PPE use is a major source of concern for human and environmental health. Preventing such activities can be done by following steps involved in PPE disposals or by getting a new way to re-use such as improving peripherical sealing. Our work highlights that a custom-frame can improve protection, without adverse effects.

Resumen El sellado periférico de las máscaras médicas/quirúrgicas puede ser mejorado fácilmente mediante un marco personalizado impreso en 3 dimensiones (3D). Este estudio tuvo como objetivo evaluar la aceptación de un marco personalizado impreso en 3D cuando usado en combinacion con máscaras médicas/quirúrgicas de la Sociedad Estadounidense para Pruebas y Materiales (ASTM) asi como con el uso de protector facial. Participaron un total de 206 sujetos de una facultad de odontología, quienes respondieron un cuestionario de opción múltiple. Los participantes recibieron una invitación a través del correo institucional de la escuela a través de la plataforma Qualtrics. Se fabricaron marcos personalizados impresos en 3D para cada participante. Según su respuesta, los participantes se dividieron en 4 grupos: solo máscara (M), máscara y marco (MF), máscara y protector facial (MFS) y los 3 equipos de protección personal (MFFS). Los datos se analizaron en frecuencia absoluta y relativa. La aceptación de un marco personalizado impreso en 3D en el grupo MFFS varió entre ''pobre''/''muy pobre'' (44,7%). Permitió un ''buen'' desempeño de los procedimientos de rutina (40,3%), pero una ''mala'' calidad visual (48,1%). La tolerancia musculoesquelética y la facilidad para realizar movimientos fueron adecuadas. No hubo interferencia en la sensibilidad olfativa (44,7%) ni en la capacidad de respirar (34,5%). Finalmente, mostró "dolor moderado" (48,1%) en el oído y "sin dolor" (38,9%) en la cabeza. El marco personalizado impreso en 3D adaptado a las máscaras faciales quirúrgicas/ médicas de ASTM mostró una tolerancia razonable. Se observaron efectos secundarios de dolor de oído que variaron en grados. Estudios futuros deben evaluar la seguridad, la comodidad, efectos secundarios y los riesgos laborales del uso a largo plazo para este tipo de combinación. Para evitar los brotes recurrentes de COVID-19, es necesario el uso de equipamento personal de protección (EPP) por parte del público. El uso inadecuado de EPP es una fuente importante de preocupación para la salud humana y ambiental. La prevención de tales actividades se puede hacer siguiendo los pasos involucrados en la eliminación de EPP o obteniendo una nueva forma de reutilización, como mejorar el sellado periférico. Nuestro trabajo resalta que un marco personalizado puede mejorar la proteccion, sin afectos adversos.

Lineamientos generales para la adopción de medidas sanitarias en la reanudación de actividades de los sectores público y privado. (2 ed.) / General guidelines for the adoption of sanitary measures in the resumption of activities in the public and private sectors. (2 ed.)

En los presentes lineamientos se desarrollaran los siguientes componentes: los principios rectores para un retorno exitoso, factores de riesgo ante el Covid-19, disposiciones sanitarias en el ámbito laboral, medidas sanitarias generales, recomendaciones desde la salida del hogar, transporte, arribo y llegada al trabajo, medidas de higiene y desinfección, medidas de prevención de contagio, uso de equipo de protección personal, medidas de seguridad según el rol en el área laboral, mejoramiento de las condiciones de salud de los empleados, vigilancia y supervisión

The following components will be developed in these guidelines: the guiding principles for a successful return, risk factors against Covid-19, health provisions in the workplace, general health measures, recommendations from home, transportation, arrival and arrival. to work, hygiene and disinfection measures, contagion prevention measures, use of personal protective equipment, safety measures according to the role in the work area, improvement of the health conditions of employees, surveillance and supervision

Conocimiento y percepción sobre bioseguridad en estudiantes de medicina / Knowledge and perception about biosafety in medical students

Los estudiantes de medicina pueden estar expuestos a infecciones graves relacionadas con la atención de la salud si no siguen las medidas de prevención y control. Hay información limitada sobre el conocimiento y la percepción de los estudiantes de medicina con respecto a la bioseguridad y los enfoques educativos utilizados para enseñarles estas prácticas. El objetivo fue evaluar el conocimiento y la percepción de los estudiantes de medicina hacia las prácticas básicas de bioseguridad. Una encuesta descriptiva y transversal basada en entrevistas incluyó a 120 estudiantes de medicina de la Universidad Regional Autónoma de los Andes, Ecuador. Los estudiantes completaron un cuestionario sobre el conocimiento y la percepción con respecto a las prácticas de bioseguridad. El conocimiento de los estudiantes se evaluó por sus respuestas correctas a las preguntas del instrumento. El 57,5% de los estudiantes cumplen con las medidas de bioseguridad. La mayoría de los estudiantes perciben alto de riesgo de exposición a través de diferentes rutas con distintos patógenos, el argumento mayormente reportado fue el que puede ocurrir un accidente. Se observó que 81(67,5%) de los estudiantes mostraron tener conocimiento adecuado sobre bioseguridad, mientras que 39 demostraron lo contrario. El conocimiento sobre la bioseguridad fue bueno aunque se necesita más énfasis para mejorar su conocimiento en secciones como la técnica de colocación de guantes, momento de colocarse el gorro y qué es una sustancia antiséptica. Los cursos de Prevención y Control de Infecciones se pueden impartir a partir de su primer año de educación universitaria(AU)

Medical students can be exposed to serious health care-associated infections, if they are not following prevention and control measures. There is limited information on medical students' knowledge and perception of biosafety and the educational approaches used to teach these practices. The objective was to evaluate the knowledge and perception of medical students towards basic biosafety practices. A descriptive and cross-sectional, interview-based survey included 120 medical students from the Autonomous Regional University of the Andes, Ecuador. The students completed a questionnaire on knowledge and perception regarding biosafety practices. The knowledge of the students was evaluated by their correct answers to the questions of the instrument. 57.5% of students comply with biosafety measures. Most of the students perceive a high risk of exposure through different routes with different pathogens, the most reported argument was that an accident can occur. It was observed that 81 (67.5%) of the students showed adequate knowledge about biosafety, while 39 showed the opposite. Biosafety knowledge was good although more emphasis is needed to improve their knowledge in sections such as gloving technique, time to put on the cap and what is an antiseptic substance. Infection Prevention and Control courses can be taught beginning in your first year of college education(AU)

Os EPI's adotados para controle local de transmissibilidade da COVID-19 no retorno das atividades presenciais de atendimento à população nos cursos de odontologia em Minas Gerais / Personal protective equipment adopted for local control of transferability by COVID-19 in the return of face-to-face activities to serve the population in dentistry courses in Minas Gerais

Desde o início da pandemia, no final de 2019, até a retomada das atividades presencias de atendimento ao público nos cursos da área de saúde em Minas Gerais, especificamente nos cursos de odontologia; foram elaboradas notas técnicas, recomendações e manuais de biossegurança. Documentos esses que serviram como referencial para a padronização de protocolos de atendimento, incluindo o uso de EPI's mais eficientes no controle da transmissibilidade da Covid-19. A pesquisa de revisão foi realizada na base de dados PubMed/MEDLINE e Scielo, World Health Organization, Ministério da Saúde, Associação Brasileira de Ensino Odontológico, Conselho Federal de Odontologia, Conselhos Regionais de Odontologia dos Estados de São Paulo e Minas Gerais e instituições de ensino superior. Priorizando os conteúdos publicados entre os meses de janeiro a setembro de 2020. Período correspondente ao início da pandemia até o retorno das atividades de atendimento nos cursos de saúde em Minas Gerais. Buscando os documentos que nortearam esse retorno e que justificaram a adoção do uso desses EPI's pelos graduandos.

Since the beginning of the pandemic, at the end of 2019, until the resumption of face-to-face activities to serve the public in health care courses in Minas Gerais, specifically in dentistry courses; technical notes, recommendations and biosafety manuals were prepared. These documents served as a reference for the standardization of care protocols, including the use of more efficient personal protection equipment to control Covid-19's transmissibility. The review search was carried out in the PubMed/MEDLINE and Scielo databases, World Health Organization, Ministry of Health of Brazil, Brazilian Association of Dental Education, Federal Council of Dentistry, Regional Councils of Dentistry of the States of São Paulo and Minas Gerais and college. Prioritizing the contents published between January and September 2020. Period corresponding to the beginning of the pandemic until the return of care activities in health courses in Minas Gerais. Seeking the documents that guided this return and that justified the adoption of the use of this personal protective equipment by college students.

Reconstrucción microquirúrgica en pandemia por Covid-19 / MICROSURGICAL RECONSTRUCTION IN THE COVID - 19 PANDEMIC

Introducción: la Pandemia por SARS CoV ­ 2 (COVID ­ 19) tuvo un impacto significativo en el desarrollo de los servicios quirúrgicos en general y obligo a establecer protocolos de actuación para las distintas patologías a fin de cuidar al máximo los recursos humanos y la capacidad instalada de los hospitales para hacer frente a esta contingencia mundial. Objetivos: presentar una casuística de 7 pacientes con reconstrucción microquirúrgica de patología de cabeza y cuello en estadios avanzados y patología de miembros inferiores durante la pandemia por COVID - 19. Materiales y Métodos: trabajo retrospectivo, se revisaron las historias clínicas físicas y digitales. Se incluyeron 5 pacientes con patología avanzada de cabeza y cuello y 2 pacientes con patología de miembros inferiores. Resultados: cinco pacientes fueron operados por patología avanzada de cabeza y cuello: 3 pacientes con carcinomas escamosos de cavidad oral estadio IVa, 1 paciente con carcinoma escamoso de piel avanzado estadio IV y 1 paciente con fractura compleja de maxilar inferior por herida de arma de fuego con fistula oro-cutánea crónica, con exposición del material de osteosíntesis, mala oclusión y pérdida de peso importante por dificultad para alimentación. Dos pacientes fueron operados por patología de miembros inferiores en tercio inferior de pierna, uno por fractura expuesta grave con defecto de tejidos blandos y el otro por una ulcera arterial. Conclusión: la cirugía reconstructiva microquirúrgica puede realizarse con buenos niveles de seguridad para el personal de salud y para los pacientes afectados por patologías avanzadas de cabeza y cuello y otras patologías que requieran colgajos libres. Es fundamental respetar estrictamente los protocolos para evitar los contagios en el medio intrahospitalario, entendiendo que debe considerarse todo paciente que ingrese al hospital como COVID (+) hasta que se demuestre lo contrario

Introduction: the SARS CoV ­ 2 (COVID ­ 19) Pandemic had a significant impact on the development of surgical services in general and forced the establishment of action protocols for the different pathologies in order to take maximum care of human resources and capacity. installed in hospitals to deal with this global contingency. Objectives: to present a casuistry of 7 patients with microsurgical reconstruction of head and neck pathology in advanced stages and lower limb pathology during the COVID - 19 pandemic. Materials and Methods: retrospective work, physical and digital medical records were reviewed. Five patients with advanced head and neck disease and 2 patients with lower limb disease were included. Results: five patients underwent surgery for advanced head and neck disease: 3 patients with stage IVa squamous cell carcinoma of the oral cavity, 1 patient with stage IV advanced squamous cell carcinoma of the skin, and 1 patient with a complex fracture of the lower jaw due to a gunshot wound. with chronic oro-cutaneous fistula, with exposure of the osteosynthesis material, poor occlusion and significant weight loss due to difficulty feeding. Two patients underwent surgery for pathology of the lower limbs in the lower third of the leg, one for a severe open fracture with a soft tissue defect and the other for an arterial ulcer. Conclusion: microsurgical reconstructive surgery can be performed with good levels of safety for health personnel and for patients affected by advanced pathologies of the head and neck and other pathologies that require free flaps. It is essential to strictly respect the protocols to avoid contagion in the hospital environment, understanding that every patient who enters the hospital must be considered as COVID (+) until proven otherwise.

Estresse ocupacional relacionado à pandemia de covid-19: o cotidiano de uma unidade de pronto atendimento / Estrés ocupacional relacionado con la pandemia covid-19: la vida diaria de una unidad de atención de emergencia / Occupational stress related to the covid-19 pandemic: the daily life of an emergency care unit

RESUMO Objetivo: analisar o cotidiano de trabalho dos profissionais de saúde de uma Unidade de Pronto Atendimento (UPA), com ênfase nos estressores ocupacionais relacionados à pandemia de COVID-19. Método: estudo de caso qualitativo, fundamentado no referencial teórico-metodológico de Michel de Certeau acerca do cotidiano, realizado em uma UPA porte II do interior de Minas Gerais, Brasil. Foi realizada triangulação de dados, com observações, entrevistas com 31 profissionais e análise documental. Os dados foram organizados no MAXQDA2020® e submetidos à análise de conteúdo de Bardin. Resultados: o cotidiano da UPA foi alterado pela pandemia e a instituição passou por adaptações para atender os casos suspeitos ou confirmados de COVID-19, com novas estratégias de funcionamento e redefinição do mapa da assistência. Os estressores ocupacionais identificados foram falta de clareza nas informações iniciais sobre a doença, medo de se contaminarem ou a familiares, uso de equipamentos de proteção individual (EPIs), testagem, afastamento e sobrecarga de profissionais, risco de falta de medicamentos e estigmatização dos profissionais de saúde. Por outro lado, disponibilidade de EPIs, queda do número de atendimentos, orientações e treinamentos foram fatores protetores contra o estresse. Ademais, alguns profissionais adotaram táticas para amenizar os estressores decorrentes da pandemia. Conclusão: o cotidiano da UPA foi alterado e o estresse ocupacional relacionado à pandemia acomete profissionais de saúde. Medidas de proteção da saúde mental são necessárias para que possam enfrentar a grave crise sanitária, com vistas à prevenção do sofrimento, melhor qualidade de vida no trabalho e melhores condições laborais e de atendimento aos usuários.

RESUMEN Objetivo: analizar el trabajo diario de los profesionales de la salud en una Unidad de Cuidados de Emergencia (UPA), con énfasis en los estresores ocupacionales relacionados con la pandemia de COVID-19. Método: estudio de caso cualitativo, basado en el marco teórico-metodológico de Michel de Certeau sobre la vida cotidiana, realizado en una UPA tamaño II en el interior de Minas Gerais, Brasil. Se realizó triangulación de datos, con observaciones, entrevistas a 31 profesionales y análisis de documentos. Los datos se organizaron en MAXQDA2020® y sometidos al análisis de contenido de Bardin. Resultados: la vida cotidiana de la UPA fue modificada por la pandemia y la institución fue adaptada para atender casos sospechosos o confirmados de COVID-19, con nuevas estrategias operativas y redefinición del mapa de atención. Los estresores ocupacionales identificados fueron falta de claridad en la información inicial sobre la enfermedad, miedo a contaminarse o de familiares, uso de equipo de protección personal (EPI), pruebas, baja y sobrecarga de profesionales, riesgo de falta de medicación y estigmatización de los profesionales de la salud. Por otro lado, la disponibilidad de EPP, la disminución del número de consultas, la orientación y la formación fueron factores protectores frente al estrés. Además, algunos profesionales adoptaron tácticas para aliviar los factores estresantes resultantes de la pandemia. Conclusión: la vida diaria de la UPA cambió y el estrés laboral relacionado con la pandemia afecta a los profesionales de la salud. Las medidas de protección de la salud mental son necesarias para que puedan afrontar la grave crisis sanitaria, con el fin de prevenir el sufrimiento, mejorar la calidad de vida en el trabajo y mejores condiciones de trabajo y servicio para los usuarios.

ABSTRACT Objective: to analyze the daily work of health professionals in an Emergency Care Unit (ECU), with an emphasis on occupational stressors related to the COVID-19 pandemic. Method: qualitative case study, based on Michel de Certeau's theoretical-methodological framework about everyday life, carried out in a ECU size II in the countryside of Minas Gerais, Brazil. Data triangulation was performed, with observations, interviews with 31 professionals and document analysis. Data were organized in MAXQDA2020® and submitted to Bardin's content analysis. Results: the daily life in the ECU was changed by the pandemic and the institution underwent adaptations to attend to suspected or confirmed cases of COVID-19, with new operating strategies and redefinition of the assistance map. The occupational stressors identified were lack of clarity in the initial information about the disease, fear of contaminating themselves or family members, use of personal protective equipment (PPE), testing, removal and overload of professionals, risk of lack of medication and stigmatization of professionals of health. On the other hand, availability of PPE, drop in the number of visits, guidance and training were protective factors against stress. In addition, some professionals have adopted tactics to alleviate the stressors arising from the pandemic. Conclusion: the routine of the ECU has changed and the occupational stress related to the pandemic affects health professionals. Mental health protection measures are necessary so that they can face the serious health crisis, with a view to preventing suffering, better quality of life at work and better working conditions and service to users.

Lineamientos técnicos para el uso apropiado de equipos de protección personal por la pandemia de COVID-19. 4ª. ed. / Technical guidelines for the appropriate use of personal protective equipment during the COVID-19 pandemic. 4th. ed

Los presentes lineamientos técnicos establecen las disposiciones relacionadas con el uso apropiado del equipo de protección personal que debe ser utilizado por el personal del Sistema Nacional Integrado de Salud, para protegerse y proteger al paciente y familia, el presente documento se constituye en una actualización e incluye consideraciones prácticas basadas en datos científicos concernientes al uso de equipos de protección personal destinados a reducir la propagación del SARS-CoV-2

These technical guidelines establish the provisions related to the appropriate use of personal protection equipment that must be used by the personnel of the National Integrated Health System, to protect themselves and the patient and family, this document is an update and includes practical considerations based on scientific data concerning the use of personal protective equipment intended to reduce the spread of SARS-CoV-2

Adaptación de la imagen corporal en personal de salud durante la COVID-19 / Body image adaptation in health personnel during COVID-19

Introducción: todo lo que tiene contacto con el cuerpo también se integra como parte de la imagen corporal del individuo; el equipo de protección personal (EPP) podría integrarse a la imagen corporal. Objetivo: describir las características del dibujo de la figura humana como herramienta proyectiva de la imagen corporal en el personal de salud. Material y métodos: se realizó un estudio descriptivo longitudinal retrospectivo, que consistió en la recopilación y análisis de los test de dibujo de la figura humana realizado al personal de salud en la contingencia por COVID-19. Se realizó un análisis descriptivo de las variables cualitativas y un análisis inferencial con prueba de McNemar para comparar proporciones entre grupos. Resultados: se incluyeron 147 dibujos en contexto previo y sus respectivos dibujos en contexto durante la contingencia. Al comparar ambos grupos, en el contexto pandémico se observó un incremento en las distorsiones u omisiones (p = 0.013), principalmente localizadas en manos y brazos (p < 0.001). También, se observaron trazos sugerentes de aislamiento (p = 0.039), dibujos con poca definición de los ojos (p = 0.69), inclusión del EPP (p < 0.001) y omisión de nariz (p = 0.011) y boca (p < 0.001). Conclusiones: el incremento en las distorsiones u omisiones puede estar relacionado con la reconstrucción de la parte social. Seis meses posteriores al inicio de la contingencia, el 40% del personal de salud ya había incorporado el EPP a su dibujo proyectivo de imagen corporal.

Background: Everything that has contact with the body is also integrated as part of the individual's body image; Personal Protective Equipment (PPE) could be integrated into body image. Objective: To describe the characteristics of the drawing of the human figure as a projective tool of body image in health personnel. Material and methods: A retrospective longitudinal descriptive study was carried out, which consisted of the compilation and analysis of the drawing tests of the human figure performed on health personnel in the contingency of COVID-19. A descriptive analysis of the qualitative variables and an inferential analysis with McNemar's test were carried out to compare proportions between groups. Results: 147 drawings in the previous context and their respective drawings in context during the contingency were included. When comparing both groups, in the pandemic context an increase in distortions or omissions was observed (p = 0.013), mainly located in the hands and arms (p < 0.001). Also, traces suggestive of isolation (p = 0.039), drawings with poor definition of the eyes (p = 0.69), inclusion of PPE (p < 0.001), and omission of the nose (p = 0.011) and mouth (p < 0.001) were observed). Conclusions: The increase in distortions or omissions maybe related to reconstructing the social part. Six months after the start of the contingency, 40% of the health personnel had already incorporated the PPE into their projective drawing of body image.

Experiencias del personal de salud sobre la implementación de prácticas de protección contra COVID-19 en la Argentina / Experiences of protection against COVID-19

El objetivo de este estudio fue indagar sobre experiencias y percepciones del personal de salud (PDS) de la Argentina en la implementación de protocolos para su protección durante la pandemia por COVID-19. Se realizó una encuesta al PDS a nivel nacional, relevando datos sociodemográficos, de protocolos, recursos y aspectos psicosociales. Se analizaron 2010 encuestas. El 76,4% fueron mujeres, 43 años de edad media, 35% médicos/as y 72,7% del subsistema público. El 37,2% aumentó su carga horaria y el 22,5% presentaba algún factor de riesgo, de quienes 20,4% tuvo licencia o reasignación de tareas. Se establecieron protocolos sobre uso de equipos de protección personal (EPP) en 91% de las instituciones y otras temáticas en menor medida. La claridad de los mismos fue bien valorada y hubo entrenamiento en el 60,8% de los casos. La conformidad con la disponibilidad y calidad del EPP fue variable, con mejor valoración en el subsector privado. El 60,4% tuvo necesidad de obtener EPP por medios propios. El 48,4% de los encuestados siguió los protocolos de uso de EPP, variando según grupos de riesgo. El indicador global de valoración institucional fue 6,45/10 (IC 95% 6,38-6,53). El 87,2% del PDS dijo haber sentido angustia y esto se relacionó con peor comunicación con superiores y peor valoración institucional. De este estudio surgen dificultades en la implementación de los nuevos cuidados, y la necesidad de intensificar esfuerzos en recursos y organización institucional para mejorar las condiciones de trabajo.

During the COVID-19 pandemic, health personnel (HP) faced changes in their working conditions due to exposure to the virus and increased demand for attention. This study inquires on the experiences and perceptions of HP in Argentina about the implementation of protocols for their protection. A survey including information on sociodemographic characteristics, protocols, resources and psychological aspects was performed for HP all over the country. Two thousand and ten surveys were analyzed: 76.4% female, mean age 43 years old, 35% physician, 72.7% public institutions. Hours of work increased for 37.2%, 22.5% had at least one risk factor, of which 20.4% had leave or re-assigned tasks. Protocols about use of personal protective equipment (PPE) were established by 91% of institutions and less frequently about other topics. Clarity of protocols was well evaluated, and in 60.8% of cases trainament was performed. Approval about access and quality of PPE was variable, with better performance on private institutions. 60.4% of the HP had to obtain PPE by their own means. 48.4% of the participants followed protocols on PPE, being this variable according to groups of risk. The global index for institutional valuation was 6.45/10 (CI 95%, 6.38-6.53). HCP expressed fear or anxiety in 87.2% of the cases, and this was related to worse communication with superiors and worse institutional valuation. This study raises difficulties on the implementation of new protocols and the need to reinforce efforts on resources and institutional organization, to improve working conditions for HP

Validation of a brochure to guide health professionals in the dressing and undressing of personal protective equipment during the SARS-CoV-2 pandemic

Objective: To develop and validate a brochure to guide health professionals in properly dressing and undressing the personal protective equipment (PPE) used in the SARS-CoV-2 pandemic. Methods: To develop the brochure, an integrative literature review was conducted after searching the following databases: SciELO, LILACS, and MEDLINE. The brochure was evaluated by 38 health professionals (nurses, physical therapists, and doctors) employing the Delphi technique. The results were analyzed using the Content Validity Index. Results: In the first evaluation cycle, the items in the brochure were considered by the panel of experts as ranging from "unsuitable" to "totally adequate". After the appropriate corrections suggested by the experts, the brochure once again was sent to the second evaluation cycle, in which all items were rated as "adequate" or "totally adequate." The result is a Content Validity Index of 1.0. Conclusion: The present study allowed the development of a brochure and its validation by consensus among the evaluation group. The developed and validated brochure presents the reliability of the technique of dressing and undressing the PPE used by health professionals during the pandemic of COVID-19. This information contributes to the management of assistance with quality and safety for the frontline workers and patients. (AU)

Prevalence of COVID-19 in medical school and residency in Porto Alegre, RS

SUMMARY OBJECTIVE: A multicentric, cross-sectional study was carried out to determine the prevalence and risk factors for Coronavirus disease 2019 in medical students and residents from four universities and affiliated hospitals in Brazil. METHODS: A survey about contamination risk and symptoms was sent to all participants through email and WhatsApp. Prevalence was measured by the self-report of positive polymerase chain reaction or serological test. Univariate and multivariate analyses were performed, and odds ratio and 95% confidence interval were calculated. RESULTS: Prevalence of infection by Sars-CoV-2 was 14.9% (151/1011). The disease was more prevalent in residents and interns than in undergraduate students. Contact with an infected relative outside the hospital or with colleagues without using personal protective equipment was associated with higher contamination. Contact with patients without wearing goggles and higher weekly frequency of contact were the two factors independently associated with the infection by Coronavirus disease 2019 in the multivariate analysis. CONCLUSIONS: Medical students, interns, and residents have a higher prevalence of Coronavirus disease 2019 than the general population, in which the last two groups are significantly at higher risk. Contacting patients at a higher weekly frequency increases the risk for infection. The use of goggles should be reinforced when contacting patients.

Indications for accurate and appropriate use of personal protective equipment for healthcare professionals. A systematic review

ABSTRACT BACKGROUND: The speed of the spread of coronavirus disease 2019 (COVID-19) has put enormous pressure on hospitals and other healthcare facilities. This, together with blockages in several countries, has hindered the availability and accessibility of the necessary personal protective equipment (PPE). OBJECTIVE: To identify, systematically evaluate and summarize the available scientific evidence on the efficacy, safety, safe use and reuse of PPE for healthcare professionals, for preventing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. DESIGN AND SETTING: Systematic review of studies analyzing products for disinfecting and enabling reuse of PPE for coronavirus within the evidence-based health program of a federal university in São Paulo (SP), Brazil. METHODS: A systematic search of the relevant literature was conducted in the PubMed, EMBASE, Cochrane Library, CINAHL, SCOPUS, Web of Science and LILACS databases, for articles published up to November 30, 2020. RESULTS: Ten studies were selected. These analyzed the use of N95, surgical and cotton masks, face shields, flexible enclosures with plastic covers or polycarbonate intubation boxes and plastic curtains; and also PPE disinfection using several substances. CONCLUSION: Combined use of a face shield with a N95 mask proved to be superior to other associations for protecting healthcare workers. Some products are useful for disinfecting PPE, such as 70% ethanol, 0.1% sodium hypochlorite and a mixture of quaternary ammonium and H2O2, and hydrogen peroxide. Ultraviolet light and dry heat at 70 °C can be used to decontaminate N95 masks. REGISTRATION NUMBER: DOI: 10.17605/OSF.IO/4V5FD at the OPENSCIENCE Framework.

Evaluation of Aids and Hepatitis-B knowledge and job satisfaction among hairdressers and barbers in Turkey

Blood-borne viruses, includingthe human immunodeficiency virus and hepatitis B virus, have certain common epidemiological characteristics and these viruses infect millions of people worldwide. This study aimed to determine the job satisfaction and the level of knowledge and practices regarding infectious diseases of employees working as hairdressers and barbers.This descriptive and cross-sectional study comprised 1200 hairdressers and barbers. The study sample comprised 628 people who consented to participate in the study. The mean age of the participants who participated in the study was 28, 13 ± 6. 9 years. The mean job satisfaction score of the participants was 3.85 ± 0.58. The job satisfaction score was found to be higher among those with sufficient knowledge of hepatitis B (p < 0.005). Employees should be provided performance trainings to achieve job satisfaction. It is recommended that employees be encouraged to wear gloves and gowns to protect their health and prevent contamination.

Socio-environmental and parasitological aspects of waste pickers in Minas Gerais, Brazil

The increase in the generation of Solid Urban Waste causes social, environmental problems and damages to the population's health. Professionals who work in the collection of recyclable waste are exposed to risks of contamination either by toxic elements or pathogenic organisms. The objective of the work was to estimate the types and prevalence of intestinal parasites inwaste pickers. A field research was carried out from December 2017 to April 2018 with the voluntary participation of 26 waste pickers belonging to three associations in the municipality of Conselheiro Lafaiete, Minas Gerais, Brazil (CAAE: nº 79937817.7.0000.8122). In addition to the application a socio-environmental questionnaire, each volunteer provided a stool sample for laboratory testing the parasitological examination. Of the 26 survey participants, four (15.4%) had a positive result and were infected by the parasites Giardia lamblia, Entamoebacoliand Iodamoeba butschlii. Among the main factors that can contribute to the infection these waste pickersare the ingestion of untreated water for consumption in addition to reduced access to Personal Protective Equipment(PPE) during waste management. One way to control the presence of parasites would be through health and environmental education actions, periodic parasitological examinations and permanent use of PPE.

Implicações da Covid-19 na condição de trabalho de profissionais de enfermagem: estudo descritivo / Implications of Covid-19 on the working conditions of nursing professionals: a descriptive study

OBJETIVO: analisar as condições de trabalho dos profissionais de enfermagem no contexto de pandemia da Covid-19 em um hospital do interior de Mato Grosso. MÉTODO: estudo descritivo, transversal, de abordagem quantitativa com coleta de dados realizada por meio de um questionário onde a escala de Likert foi atribuída. Os dados foram obtidos no período entre novembro de 2020 a janeiro de 2021 e tabulados por meio do Microsoft Excel®. RESULTADOS: amostra composta por 50 profissionais de enfermagem. A maioria dos participantes 48 (96,00%) realizaram atendimento direto aos casos de COVID-19 e asseguram ter recebido equipamentos de paramentação individual para assistência. Em relação a capacitações, 41 (82,0%) afirmaram ter obtido no ambiente de trabalho e 42 (84,00%) profissionais perceberam alterações no labor decorrente da situação pandêmica. CONCLUSÃO: os participantes reconhecem que houve alterações na rotina laboral decorrente da pandemia da Covid-19, potencializando os desgastes físicos e mentais associados ao trabalho.

OBJECTIVE: to analyze the working conditions of nursing professionals in the context of the Covid-19 pandemic in a hospital in the interior of Mato Grosso State. METHOD: descriptive, cross-sectional, quantitative study with data collection performed through a questionnaire using the Likert scale. Data were obtained between November 2020 and January 2021 and tabulated on Microsoft Excel®. RESULTS: sample composed of 50 nursing professionals. The majority of the participants 48 (96.00%) performed direct care to Covid-19 patients and ensured they had received individual PPE equipment. Regarding training, 41 (82.0%) stated that they had obtained training in the work environment and 42 (84.00%) professionals noticed changes in work due to the pandemic situation. CONCLUSION: the participants recognized that there were changes in the work routine resulting from the Covid-19 pandemic, potentiating the physical and mental strain associated with work.