Feasibility of a pregnancy intervention mimicking viral transmission mitigation measures on the incidence of preterm birth in high-risk pregnant women enrolled in antenatal clinics in Melbourne, Australia: protocol for a pilot, randomised trial.

INTRODUCTION: Preterm birth is a leading cause of perinatal morbidity and mortality. During the COVID-19 pandemic, reduction in rates of preterm birth in women exposed to viral mitigation measures was reported by multiple studies. In addition, others and we observed a more pronounced reduction of preterm birth in women who had previously experienced a preterm birth. The aim of this pilot study is to establish the feasibility of a lifestyle intervention based on viral mitigation measures in high-risk pregnancies, with the ultimate aim to reduce the incidence of preterm birth. METHODS AND ANALYSIS: One hundred pregnant women, enrolled in antenatal clinics at two tertiary maternity centres in Melbourne, Australia, who have had a previous preterm birth between 22 and 34 weeks gestation will be recruited. This is a two-arm, parallel group, open-label randomised controlled feasibility trial: 50 women will be randomised to the intervention group, where they will be requested to comply with a set of lifestyle changes (similar to the viral mitigation measures observed during the pandemic). Another 50 women will be randomised to the control group, where they will undergo standard pregnancy care. The primary outcome of this trial is feasibility, which will be assessed by measuring patient eligibility rate, recruitment rate, compliance rate and data completion rate. Secondary outcomes include incidence of preterm birth, maternal satisfaction, maternal quality of life and other pregnancy outcomes. Standard methods in statistical analysis for randomised controlled trials on an intention to treat basis will be followed. ETHICS AND DISSEMINATION: This trial has been approved by the Monash Human Research Ethics Committee; approval reference number RES-22-0000-122A. Study findings will be reported and submitted to peer-reviewed journals for publication, and presentation at conferences. TRIAL REGISTRATION NUMBER: ACTRN12622000753752; Pre-results.

Perfil das pessoas com diabetes que utilizaram a telefarmácia na pandemia de covid-19: resultados da DIABETES / Profile of people with diabetes who used telepharmacy during the covid-19 pandemic: results from DIABETES / Perfil de personas con diabetes que usaron telefarmacia durante la pandemia de covid-19: resultados de DIABETES

O objetivo foi analisar o perfil das pessoas com diabetes que utilizaram a telefarmácia na pandemia de covid-19. Trata-se de um estudo transversal com dados oriundos da websurvey DIABETESvid que ocorreu nos meses de setembro e outubro de 2020. Verificou-se que 45 participantes recorreram à telefarmácia, sendo que 55,6% eram do sexo masculino, 42,2% tinham idade compreendida entre 18 e 34 anos e 46,7% estudaram 12 ou mais anos. Além disso, 48,9% autorreferiram diabetes mellitus tipo 1. A maioria usava insulina (55,6%) e obteve os medicamentos para o diabetes em farmácias do sistema público de saúde (60%). Ademais, as pessoas que tiveram o diagnóstico de covid-19 buscaram mais pela telefarmácia (RP=2,20; IC95% 1,23­3,94). Sabe-se que os medicamentos são essenciais para o tratamento do diabetes. Logo, no período estudado em que se preconizava o distanciamento físico, os participantes apropriaram-se da telefarmácia a fim de obter a integralidade do cuidado

The objective was to analyze the profile of people with diabetes who used telepharmacy during the covid-19 pandemic. This is a cross-sectional study with data from the DIABETESvid websurvey that took place in September and October 2020. It was found that 45 participants used telepharmacy, 55.6% of whom were male, 42.2% were between 18 and 34 years-old and 46.7% studied 12 or more years. In addition, 48.9% self-reported type 1 diabetes mellitus. Most used insulin (55.6%) and obtained their diabetes medication from pharmacies in the public health system (60%). Also, people diagnosed with covid-19 used telephar-macy more often (PR=2.20; 95%CI 1.23­3.94). It is known that drugs are essential for the treatment of diabetes. Therefore, in the period studied in which physical distancing was advocated, the participants used telepharmacy to obtain comprehensive care

El objetivo fue analizar el perfil de las personas con diabetes que utilizaron la telefarmacia durante la pandemia del covid-19. Estudio transversal con datos de la encuesta por internet DIABETESvid realizada en septiembre y octubre de 2020. Se encontró que 45 participantes recurrieron a la telefarmacia, de los cuales el 55,6% eran hombres, el 42,2% tenían entre 18 y 34 años y el 46,7% estudiaban 12 o más años. Además, el 48,9% se autorrefirió diabetes mellitus tipo 1. La mayoría utilizaba insulina (55,6%) y recibía su medicación antidiabética en farmacias del sistema público (60%). Además, las personas diagnosticadas con covid-19 buscaron telefarmacia con más frecuencia (RP = 2,20; IC 95% 1,23­3,94). Los medicamentos son esenciales para el tratamiento de la diabetes. Por lo tanto, en el período estudiado en el que se propugnaba el distanciamiento físico, los participantes se apropiaron de la telefarmacia para la atención integral

Genomic epidemiology of SARS-CoV-2 in large university hospital cohort: the UnCoVER-Brazil project.

This work aimed to study the role of different SARS-CoV-2 lineages in the epidemiology of multiple waves of the COVID-19 pandemic in Ribeirão Preto (São Paulo state), with comparison within Brazil and globally. Viral genomic sequencing was combined with clinical and sociodemographic information of 2,379 subjects at a large Brazilian hospital. On the whole 2,395 complete SARS-CoV-2 genomes were obtained from April 2020 to January 2022. We report variants of concern (VOC) and interest (VOI) dynamics and the role of Brazilian lineages. We identified three World Health Organization VOCs (Gamma, Delta, Omicron) and one VOI (Zeta), which caused distinct waves in this cohort. We also identified 47 distinct Pango lineages. Consistent with the high prevalence of Gamma in Brazil, Pango lineage P.1 dominated infections in this cohort for half of 2021. Each wave of infection largely consisted of a single variant group, with each new group quickly and completely rising to dominance. Despite increasing vaccination in Brazil starting in 2021, this pattern was observed throughout the study and is consistent with the hypothesis that herd immunity tends to be SARS-CoV-2 variant-specific and does not broadly protect against COVID-19.

REDbox: a comprehensive semantic framework for data collection and management in tuberculosis research.

Clinical research outcomes depend on the correct definition of the research protocol, the data collection strategy, and the data management plan. Furthermore, researchers often need to work within challenging contexts, as is the case in tuberculosis services, where human and technological resources for research may be scarce. Electronic Data Capture Systems mitigate such risks and enable a reliable environment to conduct health research and promote result dissemination and data reusability. The proposed solution is based on needs pinpointed by researchers, considering the need for an accommodating solution to conduct research in low-resource environments. The REDbox framework was developed to facilitate data collection, management, sharing, and availability in tuberculosis research and improve the user experience through user-friendly, web-based tools. REDbox combines elements of the REDCap and KoBoToolbox electronic data capture systems and semantics to deliver new valuable tools that meet the needs of tuberculosis researchers in Brazil. The framework was implemented in five cross-institutional, nationwide projects to evaluate the users' perceptions of the system's usefulness and the information and user experience. Seventeen responses (representing 40% of active users) to an anonymous survey distributed to active users indicated that REDbox was perceived to be helpful for the particular audience of researchers and health professionals. The relevance of this article lies in the innovative approach to supporting tuberculosis research by combining existing technologies and tailoring supporting features.

Does ascitic fluid filtration improve the microbiological diagnosis of spontaneous bacterial peritonitis? An experimental laboratory study / A filtração do líquido ascítico melhora o diagnóstico microbiológico da peritonite bacteriana espontânea? Um estudo experimental laboratorial

Background: Spontaneous Bacterial Peritonitis (SBP) is a serious and frequent complication among cirrhotic patients with ascites and can be diagnosed by cytological analysis of the ascitic fluid. The microbiological culture of ascitic fluid, however, is positive in less than 40% of SBP cases, which often results in inappropriate antimicrobial therapy. Empirical therapy may be suboptimal, increasing patient's risk of aggravation, or overestimated, unnecessarily boosting bacterial resistance. Objective: This experimental laboratory study aimed to standardize and verify the technical feasibility of ascitic fluid vacuum filtration, as a way to optimize the etiological diagnosis of SBP, compared to the automated method. Method: The method evaluated and standardized in this study was ascitic fluid vacuum filtration. Its principle is the concentration of bacteria on a filter membrane. Results: This study included 36 cirrhotic patients treated at a public university hospital between 11.13.2017 and 06.30.2019. Among them, 47.2% (17/36) presented cytology test results compatible with SBP. For these patients, culture sensitivity using the automated method was 35.3% (6/17), against 11.8% (2/17) with the vacuum filtration method. Conclusion: In conclusion, vacuum filtration does not improve the microbiological diagnosis of SBP in this population compared to the automated method (AU)

Contexto: A Peritonite Bacteriana Espontânea (PBE) é uma complicação grave e frequente entre pacientes cirróticos com ascite, diagnosticada por meio da análise citológica do líquido ascítico. A cultura microbiológica do líquido ascítico, por sua vez, é positiva em menos de 40% dos casos de PBE, o que resulta frequentemente na instituição de terapia antimicrobiana inapropriada. A terapia empírica pode ser subótima, aumentando o risco de agravamento do paciente, ou superestimada, impulsionando desnecessariamente a resistência bacteriana. Objetivo: Estudo experimental laboratorial, propôs padronizar e verificar a viabilidade técnica da filtração a vácuo do líquido ascítico, como forma de otimizar o diagnóstico etiológico na PBE, comparativamente ao sistema automatizado de culturas de sangue. Método: O método avaliado e padronizado neste estudo foi a da filtragem a vácuo do líquido ascítico. Esse tem como princípio a concentração da bactéria em uma membrana filtrante. Resultados: Nesse estudo, foram incluídos 36 pacientes cirróticos atendidos em um hospital público universitário, entre 13.11.2017 e 30.06.2019. Entre eles, 47,2% (17/36) apresentaram citologia compatível com PBE. Nesses, a sensibilidade da cultura pelo método semi-automatizado foi de 35,3% (6/17) e da cultura pelo método da filtragem a vácuo foi de 11,8% (2/17). Conclusão: Em conclusão, a filtragem a vácuo não melhora o diagnóstico microbiológico da PBE em relação ao método automatizado (AU)

Impact of a dental care intervention on the hospital mortality of critically ill patients admitted to intensive care units: A quasi-experimental study.

BACKGROUND: We aimed to evaluate the impact of providing dental care to critically ill patients on their risk of death and ventilator-associated pneumonia (VAP). METHODS: A quasi-experimental study was conducted in 2 intensive care units (ICU) from 2016 to 2019. The intervention consisted of implementing routine dental care, focusing on oral hygiene and periodontal treatment, at least 3 times a week, for patients admitted to the study units. In the pre-intervention period, routine oral hygiene was provided by the ICU nursing staff. The primary and secondary study outcomes were mortality, evaluated at the end of the ICU stay, and VAP incidence density, respectively. Data were analyzed using the ARIMA (autoregressive integrated moving average) time series model in R software. RESULTS: During the intervention period, 5,147 dental procedures were performed among 355 patients. The time series showed that ICU mortality was 36.11%, 32.71%, and 32.30% within the 3 years before the intervention, and 28.71% during the intervention period (P = .015). VAP incidence density did not significantly change during the study period (P = .716). CONCLUSION: A dental care intervention focused on oral hygiene and periodontal treatment regularly provided by dentists to critically ill patients may decrease their risk of dying in the ICU. Randomized clinical trials should be performed to confirm these findings. TRIAL REGISTRATION: WHO-affiliated Brazilian Clinical Trials Registry. RBR-4jmz36. Registered 7 October 2018, before first patient enrollment.

Long-Term Symptoms among COVID-19 Survivors in Prospective Cohort Study, Brazil.

We conducted a prospective cohort study in a population with diverse ethnic backgrounds from Brazil to assess clinically meaningful symptoms after surviving coronavirus disease. For most of the 175 patients in the study, clinically meaningful symptoms, including fatigue, dyspnea, cough, headache, and muscle weakness, persisted for >120 days after disease onset.

COVID-19 BR: A web portal for COVID-19 information in Brazil.

Brazil is a large developing country that requires attention to regionalized behaviors regarding the dissemination of COVID-19. To deal with this complexity, the COVID-19 Brazil observatory was developed. The Portal aims to monitor and analyze data from different sources. Therefore, with a detailed audit, we centralized this information on the evolution of the disease, allowing for territorial and temporal monitoring. The daily publication of numbers about COVID-19 allowed anyone to follow the current scenario in several Brazilian cities. With about 1,7 million accesses, the Portal offers clarity and an easy understanding of the pandemic data in the country.

Does ascitic fluid filtration improve the microbiological diagnosis of spontaneous bacterial peritonitis? An experimental laboratory study / A filtração do líquido ascítico melhora o diagnóstico microbiológico da peritonite bacteriana espontânea? Um estudo experimental laboratoria

ABSTRAC: Background: Spontaneous Bacterial Peritonitis (SBP) is a serious and frequent complication among cirrhotic patients with ascites and can be diagnosed by cytological analysis of the ascitic fluid. The microbiological culture of ascitic fluid, however, is positive in less than 40% of SBP cases, which often results in inappropriate antimicrobial therapy. Empirical therapy may be suboptimal, increasing patient's risk of aggravation, or overestimated, unnecessarily boosting bacterial resistance. Objective: This experimental laboratory study aimed to standardize and verify the technical feasibility of ascitic fluid vacuum filtration, as a way to optimize the etiological diagnosis of SBP, compared to the automated method. Method: The method evaluated and standardized in this study was ascitic fluid vacuum filtration. Its principle is the concentration of bacteria on a filter membrane. Results: This study included 36 cirrhotic patients treated at a public university hospital between 11.13.2017 and 06.30.2019. Among them, 47.2% (17/36) presented cytology test results compatible with SBP. For these patients, culture sensitivity using the automated method was 35.3% (6/17), against 11.8% (2/17) with the vacuum filtration method. Conclusion: In conclusion, vacuum filtration does not improve the microbiological diagnosis of SBP in this population compared to the automated method. (AU)

RESUMO:Contexto: A Peritonite Bacteriana Espontânea (PBE) é uma complicação grave e frequente entre pacientes cirróticos com ascite, diagnosticada por meio da análise citológica do líquido ascítico. A cultura microbiológica do líquido ascítico, por sua vez, é positiva em menos de 40% dos casos de PBE, o que resulta frequentemente na instituição de terapia antimicrobiana inapropriada. A terapia empírica pode ser subótima, aumentando o risco de agravamento do paciente, ou superestimada, impulsionando desnecessariamente a resistência bacteriana. Objetivo: Estudo experimental laboratorial, propôs padronizar e verificar a viabilidade técnica da filtração a vácuo do líquido ascítico, como forma de otimizar o diagnóstico etiológico na PBE, comparativamente ao sistema automatizado de culturas de sangue. Método: O método avaliado e padronizado neste estudo foi a da filtragem a vácuo do líquido ascítico. Esse tem como princípio a concentração da bactéria em uma membrana filtrante. Resultados: Nesse estudo, foram incluídos 36 pacientes cirróticos atendidos em um hospital público universitário, entre 13.11.2017 e 30.06.2019. Entre eles, 47,2% (17/36) apresentaram citologia compatível com PBE. Nesses, a sensibilidade da cultura pelo método semi-automatizado foi de 35,3% (6/17) e da cultura pelo método da filtragem a vácuo foi de 11,8% (2/17). Conclusão: Em conclusão, a filtragem a vácuo não melhora o diagnóstico microbiológico da PBE em relação ao método automatizado. (AU)

Leitura de textos literários como subversão à linguagem do poder / Literary text reading like subversion of the language of power

Este ensaio propõe apontamentos sobre as especificidades da leitura de textos literários como experiência potencialmente formadora de novos sentidos para o leitor e subversiva à linguagem do poder, com seus discursos normatizados e normatizadores do cotidiano. Foi realizada uma revisão narrativa de literatura sobre a temática, e dividiu-se este texto em quatro eixos centrais: o primeiro, em que se apresenta algumas concepções sobre literatura, texto literário e leitura literária; o segundo, em que se discorre sobre a leitura individual e de escuta, partindo do pressuposto de que tal modalidade possibilita ao leitor uma experiência criativa e crítica a partir da produção de sentidos derivada do encontro com o texto. Este ponto encontra-se intimamente relacionado ao terceiro, a leitura literária como experiência; e por fim, apresentam-se interpretações sobre a leitura literária como experiência de subversão à palavra de ordem e à linguagem do poder. Tal diálogo nos levou a concluir que a leitura literária pode representar uma resistência às naturalizações do instituído cotidiano, uma vez que ela se revela como um âmbito de produção de singularidades, instigando no leitor a interrogação sobre o mundo concreto ao seu redor e seus discursos hegemônicos.(AU)

This essay proposes notes on the specificities of reading literary texts as an experience, potentially forming new meanings for the reader, and subversive to the language of power, with its normative and normative discourses of daily life. To this end we conducted a narrative literature review on the subject, and divided this text into four central axes: in the first, we present some conceptions about literature, literary text and literary reading; in the second, we discuss about individual and listening reading, assuming that such modality allows the reader a creative and critical experience from the production of meanings derived from the encounter with the text. This point is closely related to the third, literary reading as an experience; and finally, we present interpretations about literary reading as an experience of subversion of the watchword and the language of power. This dialogue led us to conclude that literary reading may represent a resistance to the naturalizations of the daily institute, because it reveals itself as a scope for the production of singularities, prompting the reader to question the concrete world around him and his hegemonic discourses.(AU)

Este ensayo propone notas sobre las especificidades de la lectura de textos literarios como una experiencia que potencialmente forma nuevos significados para el lector y que es subversiva al lenguaje del poder, un lenguage con discursos normalizados y normalizadores de la vida cotidiana. Se realizó una revisión de la literatura narrativa sobre el tema, y ​​este texto se dividió en cuatro ejes centrales: el primero, en el que se presentan algunas concepciones sobre la literatura, el texto literario y la lectura literaria; el segundo, en que se discute la lectura y la escucha individual, a partir de la suposición de que esta modalidad permite al lector una experiencia creativa y crítica a partir de la producción de significados derivados de su encuentro con el texto. Este punto está muy relacionado con el tercero, la lectura literaria como experiencia; y finalmente, las interpretaciones de la lectura literaria se presentan como una experiencia de subversión a la orden y al lenguaje del poder. Este diálogo nos llevó a concluir que la lectura literaria puede representar una resistencia a las naturalizaciones en el cotidiano, pues se revela como un ámbito de producción de singularidades, e instiga al lector a cuestionar el mundo concreto que le rodea y sus discursos hegemónicos.(AU)

Onde os brasileiros obtiveram os medicamentos para o diabetes na pandemia de COVID-19? Resultados da DIABETESvid / Where did Brazilians get their diabetes drugs during the COVID-19 pandemic? DIABETESvid results

O acesso aos medicamentos para o diabetes é fundamental para o controle da doença. Contudo, o distanciamento social na pandemia de COVID-19 pode ter limitado a provisão de medicamentos e insumos. Assim, o objetivo deste estudo foi analisar as fontes de obtenção dos medicamentos para o diabetes na pandemia de COVID-19 no Brasil. Os dados são oriundos da pesquisa DIABETESvid e nesta análise considerou-se a amostra de conveniência de 1608 participantes que responderam ao questionário divulgado em mídias sociais de sociedades científicas relacionadas ao diabetes. Trata-se de um estudo transversal, conduzido na forma de websurvey, no período de 1 de setembro a 19 de outubro de 2020. O desfecho analisado foi as fontes de obtenção dos medicamentos para o diabetes categorizadas em farmácias do Sistema Único de Saúde, farmácias do programa "Aqui Tem Farmácia Popular", bem como, farmácias e drogarias privadas e outras fontes. A maioria dos participantes autorreferiu diagnóstico de diabetes mellitus tipo 1 (49,8%), usava insulina (61,9%) e possuía plano privado de saúde (68,7%). As farmácias e drogarias privadas e outras fontes foram os principais locais de provisão dos medicamentos para o diabetes (47,5%). Os participantes que residiam na região Centro-Oeste do país apresentaram menor frequência de provisão em farmácias do programa "Aqui tem Farmácia Popular" (0,57; IC95% 0,36-0,92). Verificou-se, na amostra estudada, maior frequência de provisão dos medicamentos para o diabetes em farmácias e drogarias privadas e outras fontes com redução na frequência em farmácias públicas na pandemia de COVID-19 no Brasil.

Access to diabetes medications is critical to disease control. However, social distancing in the COVID-19 pandemic may have limited the provision of medicines and supplies. Thus, the objective of this study was to analyze the sources of obtaining diabetes drugs in the COVID-19 pandemic in Brazil. The data came from the DIABETESvid survey, and this analysis considered a convenience sample of 1608 participants who responded to the questionnaire published on social media of scientific societies related to diabetes. This is a cross-sectional study, conducted in the form of a web survey, from September 1 to October 19, 2020. The outcome analyzed was the sources for obtaining diabetes drugs categorized in pharmacies of the "Sistema Único de Saúde", pharmacies of the "Aqui tem Farmácia Popular" program, as well as private pharmacies and drugstores and other sources. Most participants self-reported a diagnosis of type 1 diabetes mellitus (49.8%), used insulin (61.9%), and had a private health plan (68.7%). Private pharmacies and drugstores and other sources were the main places where medicines for diabetes were supplied (47.5%). Participants residing in the Midwest region of the country had a lower frequency of supply in pharmacies in the "Aqui tem Farmácia Popular" program (0.57; 95%CI 0.36-0.92). In the studied sample, there was a higher frequency of supply of diabetes drugs in private pharmacies and drugstores and other sources with a reduction in frequency in public pharmacies during the COVID-19 pandemic in Brazil.

Sobre a autonomia na definição da temporalidade livre dos médicos / About the autonomy of the definition of free time of doctors

Objetivou-se compreender a autonomia de médicos recém-especialistas na definição de suas temporalidades livres e as possíveis repercussões nos diferentes âmbitos de suas vidas. Por meio de uma pesquisa exploratória, de cunho qualitativo, sete médicos especialistas responderam a um roteiro de entrevista semiestruturada e um pressuposto de tempos de atividades, compreendidos através da análise de conteúdo de Bardin. Observou-se que os médicos compreendem o tempo livre em oposição ao trabalho e afirmam não o possuir. Destacam ainda que a existência de tempo livre é decorrência da especialidade escolhida, menor carga de trabalho, conclusão da residência e decisão pessoal. Conclui-se que a falta de tempo é uma característica marcante que merece ser melhor refletida no que se refere às consequências dessa realidade sobre o profissional, sua saúde e suas relações sociais.

This study aimed to understand the autonomy of newly doctors experts in defining their free time frames and its possible repercussions in different aspects of your life. From an exploratory research, seven doctors experts answered a semistructured interview guide and an assumption activity times, understood by a qualitative bias by Bardin content analysis. It was observed that doctors understand free time in opposition to the work. They say they don't have free time and want to own it to invest more in them. Also underscore that the existence of free time is due to the type of specialty choice, lower workload, completion of the residence and personal decision. We conclude that lack of time is a remarkable feature that deserves to be better reflected as regards the consequences of this reality on the professional, their health and their social relations.

Diabetes self-care practices and resilience in the Brazilian COVID-19 pandemic: results of a web survey: DIABETESvid.

BACKGROUND: The world guidance on the measures of social distancing for prevention of COVID-19 has changed the daily habits of great part of the population, and this could influence the care and resilience with diabetes during situations of adversity. This study aimed at assessing the characteristics of diabetic individuals and self-care practices and resilience with diabetes in the context of the COVID-19 pandemic in Brazil. METHODS: This is a cross-sectional web survey study carried out among adults with diabetes, in which a structured 43-item questionnaire was conducted on the REDCap plataform, including the Diabetes Self-Care Activities Questionnaire and Connor-Davidson Resilience Scale, to measure socio-demographic and clinical characteristics. The web survey was disseminated through the main social media and data were collected from September 1st to October 19th, 2020. Data analysis was performed according to type of diabetes mellitus (DM) and at a significance level of 5% (p < 0.05). RESULTS: Of the 1633 participants, 67.5% were women, 43.2% aged between 35 and 59 years old, 68.0% lived in the south-eastern region of Brazil, 57.1% had a high education level, 49% reported to have DM1 and 140 participants reported to have had COVID-19. Diabetes care mostly involved the use of medications (93%), whereas the least used ones were physical activity (24.6%) and examination of the shoes (35.7%). About 40% of the participants reported to be followed up by telemedicine, 61.5% monitored the glycaemic levels, 61.2% followed a healthy diet and 43.4% left home only to go to the supermarket and drugstore. The mean resilience was 25.4 (SD = 7.7). CONCLUSIONS: In Brazil, individuals with diabetes followed social distancing and maintained their medication treatment for DM. However, practice of physical activity and foot examination was little followed by the participants, who also had a low level of resilience. These findings showed the importance of patient follow-up in the healthcare services, meaning that telemedicine should be improved and support provided for adaptation in view of the therapeutic setbacks.

Notas sobre o mal-estar na cibercultura em tempos de hiperaceleração digital / Notas sobre o mal-estar na cibercultura em tempos de hiperaceleração digital / Notes sur malaise dans la cyberculture aux temps del'hyperaceleration numérique

Toda transformação tecnológica nos convida a refletir sobre nossas formas de compreensão dos fenômenos sociais e seus impactos nos sujeitos. Hoje, temos à nossa disposição inúmeras máquinas que respondem a necessidades humanas e, mesmo assim, com as aparentes facilidades proporcionadas pela cibercultura, parece que continuamos em estado de alerta, esperando pela próxima informação e notícia, esperando sempre pela próxima urgência que surgirá em nossa tela. Nossa experiência existencial do mal-estar frente ao processo cibercultural ganha novos contornos. A hiperconexão imersiva no digital parece produzir um sentimento de instantaneidade que nos impede a reflexão e a experiência de ócio. Questões sobre a compreensão acerca dos efeitos subjetivos que tal forma de vida acarreta à humanidade começam a despertar o interesse de vários campos do conhecimento. Portanto, tomando a noção psicanalítica de mal-estar, este estudo, de natureza teórico-bibliográfica, objetiva proporcionar compreensões sobre o fenômeno da hiperaceleração digital, promovendo um diálogo entre a psicanálise e os estudos sobre a contemporaneidade e o ócio. Nesse contexto, a psicanálise, ao se colocar como um espaço de experiência que produz efeitos de significação, permitiria ao sujeito ocupar uma posição para além do lugar que lhe cabe em uma sociedade hiperacelerada, parecendo, dessa maneira, fornecer algumas pistas para se pensar sobre a experiência de ócio na cibercultura e sua respectiva importância.

All technological transformation invites us to reflect on our ways of understanding social phenomena and their impacts on the subjects. Today we have at our disposal countless machines that respond to human needs and yet with the apparent facilities provided by cyberculture, it seems that we remain on the alert, waiting for the next information and news, always waiting for the next urgency that will arise in our screen. Our existential experience of malaise in the cyberculture process is gaining new contours. The immersive hyperconnection in the digital seems to produce a feeling of instantaneity that prevents us from reflection and the experience of leisure. Questions about the understanding of the subjective effects that this way of life entail for humanity begin to arouse the interest of various fields of knowledge. Therefore, taking the psychoanalytic notion of malaise, this theoretical-bibliographic study aims to provide insights into the phenomenon of digital hyperacceleration, by promoting a dialogue between psychoanalysis and studies on contemporaneity and leisure. In this context, psychoanalysis, by placing itself as a space of experience that produces effects of signification, would allow the subject to occupy a position beyond his or her place in a hyperaccelerated society, seeming, in this way, to provide some clues to think on the leisure experience in cyberculture and its respective importance.

Tous les changements technologiques nous invitent à réfléchir sur nos formes de compréhension des phénomènes sociaux et ses effets sur les sujets. Aujourd'hui nous avons à notre disposition de nombreuses machines qui répondent aux nécessités humaines, mais, même avec les apparentes facilités produites par la cyberculture, il semble que nous sommes toujours en état d'attente de la prochaine information, en attente de la prochaine nouvelle urgente qui apparaîtra sur nos écrans. Notre expérience existentielle du malaise face au processus de la cyberculture acquiert des nouveaux contours. La hyperconexion au numérique semble produire un sentiment d'instantanéité que nos empêche la réflexion et l'expérience du temps libre du loisir. Des questions à propos de la compréhension des effets subjectifs liés à cette forme de vivre, commencent à réveiller l'intérêt de plusieurs champs de connaissances. Donc, à partir de l'idée psychanalytique de malaise, cet étude, de caractère théorique, a pour but discuter le phénomene de la hyperaceleration numérique, en dialogue avec les études sur la contemporaineté et les études sur le loisir. Dans ce sens, la psychanalyse, comme une pratique qui produit effets de signification, pourrait, peut-être améner le sujet à une position au-delà de sa place dans une societé hyperacelerée et de ce fait, pourrait fournir certaines indications pour penser à l'expérience du loisir dans la cyberculture et à son importance respective.

Brazil: the emerging epicenter of COVID-19 pandemic.

INTRODUCTION: Five months after the first confirmed case of COVID-19 in Brazil, the country has the second highest number of cases in the world. Without any scientifically proven drug or vaccine available combined with COVID-19's high transmissivity, slowing down the spread of the infection is a challenge. In an attempt to save the economy, the Brazilian government is slowly beginning to allow non-essential services to reopen for in-person customers. METHODS: In this study, we analyze, based on data analysis and statistics, how other countries evolve and under which conditions they decided to resume normal activity. In addition, due to the heterogeneity of Brazil, we explore Brazilian data of COVID-19 from the State Health Secretaries to evaluate the situation of the pandemic within the states. RESULTS: Results show that while other countries have flattened their curves and present low numbers of active cases, Brazil continues to see an increase in COVID-19 patients. Furthermore, a number of important states are easing restrictions despite a high percentage of confirmed cases. CONCLUSIONS: All analyses show that Brazil is not ready for reopening, and the premature easing of restrictions may increase the number of COVID-19-related deaths and cause the collapse of the public health system.

Ócio, lazer e tempo livre das velhices em quarentena: perspectivas psicossociais de um estudo brasileiro / Leisures and free time of the old ages in quarantine: psychosocial perspectives of a brazilian study

O presente estudo buscou identificar significados atribuídos pelos idosos brasileiros ao tempo vivido na quarentena decorrente da pandemia de COVID-19. A partir de um levantamento nacional, de abordagem multimétodos, 276 idosos responderam a um questionário online, analisado a partir de estatística descritiva no SPSS e análise textual no IRaMuTeQ. Os resultados organizaram-se em três classes de evocações sobre a percepção do tempo na quarentena: Reações negativas na quarentena; Precauções e cuidados durante a quarentena; e Reações positivas na quarentena. Tais categorias nos levam a observar apreensões pouco associadas ao tempo livre, ao lazer e ao ócio, e permeadas por sensações desde angústias à apreensão de um olhar solidário para o próximo.

The present study aimed to identify meanings attributed by elderly Brazilians to the time lived in the quarantine resulting from the COVID-19 pandemic. From a national survey, with a multi-method approach, 276 elderly people answered an online questionnaire, analyzed using descriptive statistics in SPSS and textual analysis in IRaMuTeQ. The results were organized in three classes of evocations about the perception of time in the quarantine: Negative reactions in the quarantine; Precautions and care during quarantine; and Positive reactions in the quarantine. Such categories lead us to observe apprehensions little associated with free time and leisures, but permeated by sensations ranging from anguish to the apprehension of a sympathetic look at others.

PRENACEL partner - use of short message service (SMS) to encourage male involvement in prenatal care: a cluster randomized trial.

BACKGROUND: The partner has an important role when he participates of the prenatal care as showed in the positive results relate to the mother and the child health. For this reason it is an important strategy to bring future fathers closer to health services and to improve their link with paternity. AIM: To evaluate whether the implementation of SMS technology, through the PRENACEL program for the partner as a health education program, is a useful supplement to the standard prenatal monitoring. METHODS: A parallel cluster randomized trial was carried out, with the clusters representing primary care health units. The 20 health units with the largest number of pregnant women in 2013 were selected for the study. There was a balance of the health units according to the size of the affiliated population and the vulnerability situation and these were allocated in intervention and control health units by the randomization. The partners of the pregnant women who started prenatal care prior to the 20th week of gestation were the study population of the intervention group. The participants received periodic short text messages via mobile phone with information about the pregnancy and birth. In the control group units the partners, together with the women, received the standard prenatal care. RESULTS: One hundred eighty-six partners were interviewed, 62 from the PRENACEL group, 73 from the intervention group that did not opt ​​for PRENACEL and 51 from the control group. A profile with a mean age of 30 years was found and the majority of respondents (51.3%) declared themselves as brown race/color. The interviewees presented a mean of 9.3 years of study. The majority of the men (95.2%) cohabited with their partner and 63.7% were classified as socioeconomic class C. The adherence to the PRENACEL program was 53.4%. In relation to the individual results, there was a greater participation of the PRENACEL partners in the prenatal consultations, as well as a greater presence of them accompanying the woman at the moment of the childbirth when compared to the other groups. CONCLUSION: The study showed that a health education strategy using communication technology seems to be a useful prenatal care supplement; the intervention had a good acceptability and has a promising role in men's involvement in prenatal, labour and postpartum care of their partners. TRIAL REGISTRATION: Clinical trial registry: RBR-54zf73, U1111-1163-7761.

Brazil: the emerging epicenter of COVID-19 pandemic

Abstract INTRODUCTION Five months after the first confirmed case of COVID-19 in Brazil, the country has the second highest number of cases in the world. Without any scientifically proven drug or vaccine available combined with COVID-19's high transmissivity, slowing down the spread of the infection is a challenge. In an attempt to save the economy, the Brazilian government is slowly beginning to allow non-essential services to reopen for in-person customers. METHODS: In this study, we analyze, based on data analysis and statistics, how other countries evolve and under which conditions they decided to resume normal activity. In addition, due to the heterogeneity of Brazil, we explore Brazilian data of COVID-19 from the State Health Secretaries to evaluate the situation of the pandemic within the states. RESULTS: Results show that while other countries have flattened their curves and present low numbers of active cases, Brazil continues to see an increase in COVID-19 patients. Furthermore, a number of important states are easing restrictions despite a high percentage of confirmed cases. CONCLUSIONS: All analyses show that Brazil is not ready for reopening, and the premature easing of restrictions may increase the number of COVID-19-related deaths and cause the collapse of the public health system.

Notas sobre la experiencia de ocio estético / Notas sobre a experiência de ócio estético / Notes about aesthetic leisure experience / Notes sur l'expérience de loisirs esthétiques

El presente texto de carácter teórico-exploratorio tiene como objetivo esclarecer aportaciones que el concepto objeto de estudio, la experiencia de ocio estético, puede propiciar en términos de desarrollo personal y social. Atendiendo a dicho objetivo, se lleva a cabo una revisión bibliográfica a partir de escritos sobre la experiencia de ocio estético en bases de datos y colecciones de libros, tales como el Scielo o la colección Documentos de Estudios de Ocio. El descriptor que guía las búsquedas es "ocio estético", en los idiomas portugués, español e inglés: ocio estético; ócio estético y aesthetic leisure. Se destacan en este trabajo, dos apartados, denominados "Entre Experiencia de Ocio y Experiencia Estética" y "Características Específicas de la Experiencia de Ocio Estético". En la primera parte, se presentan algunos hitos sobre la experiencia estética y sus relaciones con la experiencia de ocio; posteriormente, se presentan aquellas características que son íntimamente peculiares de la experiencia de ocio estético. Todo ello, permite concluir que la percepción de la belleza es el elemento central de la experiencia de ocio estético, pues se da a partir de una mirada en la que dialogan la persona y su cultura; un diálogo que permite a la persona un encuentro consigo misma, nuevas miradas sobre su contexto y reconstrucciones identitarias, además de contribuir a posibles procesos de micro-resistencia ante discursos dominantes en su cultura.

O presente texto, de caráter teórico-exploratório, tem por objetivo esclarecer aportes que o conceito objeto de estudo, a experiencia de ócio estético, pode propiciar em termos de desenvolvimento pessoal e social. Orientados para este fim, realizamos uma revisão bibliográfica a partir de escritos sobre a experiência de ócio estético em bases de dados e coligações de livros, tais como a Scielo e a coleção Documentos de Estudios de Ocio. O descritor que guiou essas buscas foi "ócio estético", nos idiomas português, espanhol e inglês: ócio estético, ocio estético e aesthetic leisure. Usando esse fio condutor, dividimos nosso caminho em dois momentos, respectivamente intitulados: "Entre Experiência de Ócio e Experiência Estética" e " Características Marcantes da Experiência de Ócio Estético". Na primeira parte, apresentamos alguns marcos da experiência estética e suas relações com a experiência de ócio; em seguida, apresentamos características que são intimamente peculiares à experiência de ócio estético. Isto nos levou a concluir que a percepção da beleza é um elemento central da experiência de ócio estético, pois se dá a partir de um olhar em que dialogam o sujeito e elementos de sua cultura; um diálogo que permite à pessoa um encontro consigo mesma, novos olhares sobre seu contexto e reconstruções identitárias, além de contribuir para processos de microrresistências a discursos dominantes em uma cultura.

The present theoretical-exploratory text aims to clarify contributions that the concept object of study, the aesthetic leisure experience, can provide in terms of personal and social development. Orientated from this end, we carry out a bibliographical review from writings on the aesthetic leisure experience in databases and book collections, such as Scielo and the collection of Documentos de Estudios de Ocio. The descriptor that guided these searches was "ocio estético", in the Portuguese, Spanish and English languages: ocio estético, ócio estético and aesthetic leisure. Using this thread, we divided our path into two moments, respectively titled: "Between Experience of Leisure and Aesthetic Experience" and "Marking Features of the Aesthetic Leisure Experience." In the first part we present some milestones on the esthetic experience and its relations with the leisure experience; and then we present characteristics that are intimately peculiar to the aesthetic leisure experience. This led us to conclude that the perception of beauty is a central element of the aesthetic leisure experience, since it is based on a view in which the subject and elements of his culture dialogue; a dialogue that allows the person an encounter with himself, new views about his context and reconstructions of identity, and contribute to micro-resistance processes in the face of dominant discourses in a culture.

Le présent texte théorique-exploratoire vise à clarifier les contributions que le concept d'objet d'étude, l'expérience du loisir esthétique, peut apporter en termes de développement personnel et social. Dans cette optique, nous effectuons une revue bibliographique des écrits sur l'expérience de loisirs esthétiques dans des bases de données et des collections de livres, telles que Scielo et la collection de Documentos de Estudios de Ocio. Le descripteur qui a guidé ces recherches était «ocio estético¼, en portugais, espagnol et anglais: le ocio estético, le ócio estético et le aesthetic leisure. En utilisant ce fil, nous avons divisé notre chemin en deux moments, intitulés respectivement: «Entre expérience et expérience esthétique¼ et «Caractéristiques de marquage de l'expérience de loisir esthétique¼. Dans la première partie, nous présentons quelques jalons sur l'expérience esthétique et ses relations avec l'expérience de loisirs; et ensuite nous présentons des caractéristiques qui sont intimement propres à l'expérience de loisir esthétique. Cela nous a amenés à conclure que la perception de la beauté est un élément central de l'expérience de loisir esthétique, car elle est basée sur la vue dans laquelle le sujet et les éléments de sa culture dialoguent; un dialogue qui permet à la personne de se rencontrer, de nouvelles conceptions de son contexte et des reconstructions d'identité, et contribue aux processus de micro-résistance face aux discours dominants dans une culture