Socio-economic vulnerability and deaths of despair in Brazilian counties.

Over the past few years, there has been a progressive increase in premature deaths attributable to suicide, drug overdose, and alcohol-related liver disease that impact life expectancy. Regarding the relationship with contextual effects, the evidence is developing, especially in countries with a peripheral economy, as is the case of Brazil. We carried out an analysis aimed at estimating the relationship between socioeconomic insecurity and deaths due to despair in Brazilian cities. We used 5,570 counties' data to create clusters concerning socioeconomic development and then analyzed age-adjusted mortality rates (ASMR) from each of them and compared them using the ANOVA test. Cluster analysis generated two groups of Brazilian municipalities. DoD rates are consistently higher in the group that experiences more deprivation. However, considering differences between 2010 and 2019, the increase in rates was higher in the group with less deprivation experience (48.82 % vs. 39.53 %) We verified an existing gap between the clusters before the beginning of economic stagnation in 2010 The gap between those two groups decreased from 20.58 % (p < 0.001) in 2010 to 14.03 % in 2019 (p = 0.034). The conjuncture of economic crises creates mortality differentials in certain population groups. Also, significant inequalities explain how causes of death from despair affect different subpopulations. Our first approach assessed this assumption, and we could check those differentials at an ecological level. Public policies should focus on reducing the difference in mortality from despair between higher and lower socioeconomic strata.

Relationship between body composition and bone mass in normal-weight and overweight adolescents.

Adolescence is a period characterized by large accumulation of bone mass. Body composition is an important determinant of bone mass. This study aimed to assess the relationship of bone mass with lean mass (LM) and fat mass (FM) in normal-weight and overweight adolescents with consideration of sex, sexual maturation and physical activity covariates. A total of 118 adolescents (60 girls and 58 boys) aged between 10 and 14 years participated in the study. Individuals were classified as normal weight or overweight according to body mass index. Bone mineral density (BMD), bone mineral content (BMC), LM, and FM were measured by dual-energy X-ray absorptiometry. In normal-weight adolescents, LM (ß = 0.725, p < 0.001) and FM (ß = 0.185, p = 0.019) were associated with lumbar spine BMC, whereas in overweight adolescents only LM (ß = 0.736, p < 0.001) was associated with lumbar spine BMC. Furthermore, in the normal-weight group, FM and LM were associated with total body less head BMD (LM, ß = 0.792, p < 0.001; FM, ß = 0.257, p = 0.007) and lumbar spine BMD (LM, ß = 0.553, p < 0.001; FM, ß = 0.199, p < 0.035). In the overweight group, only LM was associated with total body less head BMD (ß = 0.682, p < 0.001) and lumbar spine BMD (ß = 0.528, p < 0.001). LM was the main predictor of bone mass in normal-weight and overweight adolescents. FM was associated with bone mass in normal-weight adolescents only. LM may be considered an important and useful marker in adolescents, when investigating bone health in this population. Activities that promote LM gain to reduce the risk of bone fractures and diseases in adulthood are recommended.

Cohort study protocol of the Brazilian collaborative research network on COVID-19: strengthening WHO global data.

INTRODUCTION: With the COVID-19 pandemic, hospitals in low-income countries were faced with a triple challenge. First, a large number of patients required hospitalisation because of the infection's more severe symptoms. Second, there was a lack of systematic and broad testing policies for early identification of cases. Third, there were weaknesses in the integration of information systems, which led to the need to search for available information from the hospital information systems. Accordingly, it is also important to state that relevant aspects of COVID-19's natural history had not yet been fully clarified. The aim of this research protocol is to present the strategies of a Brazilian network of hospitals to perform systematised data collection on COVID-19 through the WHO platform. METHODS AND ANALYSIS: This is a multicentre project among Brazilian hospitals to provide data on COVID-19 through the WHO global platform, which integrates patient care information from different countries. From October 2020 to March 2021, a committee worked on defining a flowchart for this platform, specifying the variables of interest, data extraction standardisation and analysis. ETHICS AND DISSEMINATION: This protocol was approved by the Research Ethics Committee (CEP) of the Research Coordinating Center of Brazil (CEP of the Hospital Nossa Senhora da Conceicao), on 29 January 2021, under approval No. 4.515.519 and by the National Research Ethics Commission (CONEP), on 5 February 2021, under approval No. 4.526.456. The project results will be explained in WHO reports and published in international peer-reviewed journals, and summaries will be provided to the funders of the study.

Effect of losartan potassium, metformin hydrochloride, and simvastatin on in vitro bioaccessibility of Cu, Fe, Mn, and Zn in oat flour from Brazil.

BACKGROUND: The simultaneous administration of drugs with food can compromise the bioaccessibility and absorption of nutrients. The objective of this study was to evaluate the influence of the use of losartan potassium (LP), metformin hydrochloride (MH), and simvastatin (S) on the in vitro bioaccessibility of micronutrients (Cu, Fe, Mn, and Zn) in oat flour from Bahia, Brazil. METHODS: The experimental procedure consisted of the in vitro extraction of the bioaccessible fraction of Cu, Fe, Mn, and Zn in oat flour-with and without LP (50 mg), MH (500 mg), and S (20 mg)-using the unified bioaccessibility method (UBM), simulating the conditions of the gastrointestinal tract. For decomposition of the samples (oat flour and residue), a digester block with a closed system was used. To determine the total content (flour and residual fraction) and bioaccessible micronutrients, inductively coupled plasma optical emission spectrometry (ICP OES) was used. RESULTS: The bioaccessible contents (µg g-1) without the addition of drugs were: Cu 5.86 ± 0.21, Fe 32.80 ± 1.32, Mn 87.90 ± 1.90, and Zn 30.33 ± 2.05, with bioaccessibility ranging from 31.5 % for Fe to 99 % for Mn. The in vitro extraction method was validated by mass balance with recovery values from 89.78 % for Cu to 101.94 % for Mn. The range of bioaccessible contents (µg g-1) were: Cu (<4.14), Fe (32.10 ± 0.20-54.10 ± 2.03), Mn (81.40 ± 0.93-93.22 ± 0.80), and Zn (<10.80-29.11 ± 2.20). The estimation of the bioaccessibility of Cu, Mn, and Zn in oat flour were compromised in the presence of LP, MH, and S (p < 0.05). CONCLUSION: Chemical interactions can occur between drugs and micronutrients. Taken together, our results highlight that LP, MH, and S can interfere with the bioaccessibility of Cu, Fe, Mn, and Zn in oat flour in patients who use these drugs, suggesting its rational use in further investigations.

The effect of primary health care on tuberculosis in a nationwide cohort of 7·3 million Brazilian people: a quasi-experimental study.

BACKGROUND: Universal health coverage is one of the WHO End TB Strategy priority interventions and could be achieved-particularly in low-income and middle-income countries-through the expansion of primary health care. We evaluated the effects of one of the largest primary health-care programmes in the world, the Brazilian Family Health Strategy (FHS), on tuberculosis morbidity and mortality using a nationwide cohort of 7·3 million individuals over a 10-year study period. METHODS: We analysed individuals who entered the 100 Million Brazilians Cohort during the period Jan 1, 2004, to Dec 31, 2013, and compared residents in municipalities with no FHS coverage with residents in municipalities with full FHS coverage. We used a cohort design with multivariable Poisson regressions, adjusted for all relevant demographic and socioeconomic variables and weighted with inverse probability of treatment weighting, to estimate the effect of FHS on tuberculosis incidence, mortality, cure, and case fatality. We also performed a range of stratifications and sensitivity analyses. FINDINGS: FHS exposure was associated with lower tuberculosis incidence (rate ratio [RR] 0·78, 95% CI 0·72-0·84) and mortality (0·72, 0·55-0·94), and was positively associated with tuberculosis cure rates (1·04, 1·00-1·08). FHS was also associated with a decrease in tuberculosis case-fatality rates, although this was not statistically significant (RR 0·84, 95% CI 0·55-1·30). FHS associations were stronger among the poorest individuals for all the tuberculosis indicators. INTERPRETATION: Community-based primary health care could strongly reduce tuberculosis morbidity and mortality and decrease the unequal distribution of the tuberculosis burden in the most vulnerable populations. During the current marked rise in global poverty due to the COVID-19 pandemic, investments in primary health care could help protect against the expected increases in tuberculosis incidence worldwide and contribute to the attainment of the End TB Strategy goals. FUNDING: TB Modelling and Analysis Consortium (Bill & Melinda Gates Foundation), Wellcome Trust, and Brazilian Ministry of Health. TRANSLATION: For the Portuguese translation of the abstract see Supplementary Materials section.

Association of insufficient practice of physical activity with demographic, anthropometric and biochemical factors in hypertensive patients / Fatores associados à atividade física em pacientes com hipertensão tratados e monitorados pelo Hiperdia

Resumo Introdução Considerando-se a magnitude da hipertensão arterial sistêmica e suas complicações, assim como a importância da atividade física regular na sua prevenção e/ou tratamento, é necessário identificar os fatores associados à prática de atividade física insuficiente. Objetivo Analisar os fatores associados à atividade física insuficiente em hipertensos atendidos na atenção primária à saúde. Método Estudo transversal realizado com amostra aleatória de 305 hipertensos em três unidades de saúde de São Luís (MA). Foi realizada análise bivariada, com estimativas de razões de prevalência, intervalos de confiança e análise multivariada por regressão de Poisson. Resultados A atividade física insuficiente foi observada em 38,7% da amostra. Atividade física insuficiente foi associada a menos de 8 anos de educação formal (razão de prevalência - RP = 1,58; intervalo de confiança de 95% - IC = 1,04-2,39), colesterol total ≥200 mg/dL (RP = 0,78; IC 95% = 0,58 -1,04), lipoproteína de baixa densidade colesterol-LDLc ≥100 mg/dL (RP = 0,79; IC 95% = 0,53-0,95) e lipoproteína de alta densidade colesterol-HDLc <40 mg / dL entre homens e <50 mg/dL entre mulheres (RP = 1,21; IC 95% = 0,90-1,64). A escolaridade <8 anos (RP = 1,50; IC 95% = 0,99-2,29) e LDLc ≥100 mg/dL (RP = 0,72; IC 95% = 0,54-0,96) também estiveram associados na regressão multivariada. Conclusão Observou-se alta prevalência de atividade física insuficiente e sua associação com baixa escolaridade e LDLc alterado em hipertensos.

Abstract Background Considering the magnitude of systemic hypertension (SH) and its complications, as well as the importance of regular physical activity in its prevention and/or treatment, there is a necessity to identify the factors associated with insufficient practice of physical activity. Objective To analyze factors associated with insufficient physical activity in hypertensive patients treated at Primary Health Care (PHC). Method This cross-sectional study was performed with a random sample of 305 hypertensive patients in three PHC units in São Luis, state of Maranhão, Brazil. A bivariate analysis was performed with estimates of prevalence ratios and confidence intervals, and multivariate analysis using Poisson regression. Results Insufficient physical activity was observed in 38.7% of the sample. Insufficient physical activity was associated with having <8 years of formal education (prevalence ratio-PR=1.58; 95% confidence interval-CI=1.04-2.39), total cholesterol ≥200 mg/dL (PR=0.78; 95% CI=0.58-1.04), low-density lipoprotein cholesterol-LDL ≥100 mg/dL (PR=0.79; 95% CI=0.53-0.95), and high-density lipoprotein cholesterol-HDL <40 mg/dL among men and <50 mg/dL among women (PR=1.21; 95% CI=0.90-1.64). Length of education <8 years (PR=1.50; 95% CI=0.99-2.29) and LDL ≥100 mg/dL (PR=0.72;95% CI=0.54-0.96) were also associated in the multivariate regression. Conclusion High prevalence of insufficient physical activity and its association with low education level and altered LDL serum levels were observed in hypertensive patients.

Uma década de cooperação técnica por meio dos Laboratórios de Inovação em Saúde / A decade of technical cooperation through health innovation laboratories / Una década de cooperación técnica a través de laboratorios de innovación en salud

Objetivo: Relatar os 10 anos da ferramenta de cooperação técnica desenvolvida pela Organização Pan-Americana da Saúde/Organização Mundial da Saúde (OPAS/OMS) no Brasil, por meio dos Laboratórios de Inovação em Saúde (LIS). Métodos: Estudo descritivo do tipo relato de experiência. Resultados: A iniciativa identifica, sistematiza e divulga experiências inovadoras e bem-sucedidas pelos profissionais de saúde no Sistema Único de Saúde (SUS). Aborda temas sobre redes de atenção em saúde, atenção à saúde a populações em situação de vulnerabilidade, ampliação do acesso à atenção primária à saúde e, na edição mais recente, as contribuições da Enfermagem para o fortalecimento do SUS. A cooperação técnica é realizada em parceria com o Conselho Federal de Enfermagem, Ministério da Saúde, Conselho Nacional de Secretários de Saúde, entre outros. Conclusão: Além da disseminação de conhecimento, as experiências divulgadas têm um efeito de superação e motivação, tornando-se um reconhecimento da qualidade das equipes de saúde. (AU)

Objective: To report the 10 years of the technical cooperation tool developed by the Pan American Health Organization/World Health Organization (PAHO/WHO) in Brazil, through the Health Innovation Laboratories (LIS). Methods: Descriptive study of the experience report type. Results: The initiative identifies, systematizes and disseminates innovative and successful experiences practiced in the Unified Health System (SUS) by health professionals and addresses issues on health care networks, health care for populations in vulnerable situations, expansion of access to care primary health care and, in the most recent edition, focusing on the contributions of the Nursing category to the strengthening of the SUS. Technical cooperation is carried out in partnership with the Federal Council of Nursing, the Ministry of Health, the National Council of Health Secretaries, among others. Conclusion: In addition to the dissemination of knowledge, the experiences disseminated have an overcoming and motivational effect, becoming a recognition of the quality of healthcare teams. (AU)

Objetivo: Informar los 10 años de la herramienta de cooperación técnica desarrollada por la Organización Panamericana de la Salud/Organización Mundial de la Salud (OPS / OMS) en Brasil, a través de los Laboratorios de Innovación en Salud (LIS). Métodos: Estudio descriptivo del tipo de relato de experiencia. Resultados: La iniciativa identifica, sistematiza y difunde experiencias innovadoras y exitosas practicadas en el Sistema Único de Salud (SUS) por profesionales de la salud y aborda temas sobre redes de atención de salud, atención a poblaciones en situación de vulnerabilidad, ampliación del acceso a la atención primaria de salud y, en la edición más reciente, enfocada en los aportes de la categoría Enfermería al fortalecimiento del SUS. La cooperación técnica se realiza en alianza con el Consejo Federal de Enfermería, el Ministerio de Salud, el Consejo Nacional de Secretarios de Salud, entre otros. Conclusión: Además de la difusión del conocimiento, las experiencias difundidas tienen un efecto superador y motivador, convirtiéndose en un reconocimiento a la calidad de los equipos de salud. (AU)

Evaluation of slurry sampling preparation of enteral nutrition formulations for multielement determination using inductively coupled plasma optical emission spectrometry.

An analytical procedure for the multielement determination in enteral nutrition formulations employing slurry sampling and inductively coupled plasma optical emission spectrometry (ICP OES) is proposed. A two-level full-factorial design was applied to assess the influence of the presence of stabilizing agents (HNO3, Triton X-100 and ethanol) on the composition of the slurry. Multiple response was established as a dependent variable. The experimental conditions for the preparation of the slurry were: 2.0 mL of sample and 8.0 mL of 10% (v/v) HNO3. The limits of detection (LOD) were 5; 9; and 10 µg L-1 for Cu, Fe, Zn, respectively. For P, and K, the LOD were 8 and 24 mg L-1, respectively. The method was applied for the analysis of three enteral nutrition formulation samples and the obtained concentrations ranges were (in mg L-1): 0.41-0.43 (Cu), 2.0-2.9 (Fe), 1.7-3.1 (Zn), 682-1409 (K), and 217-344 (P).

Evaluation of multielement/proximate composition and bioactive phenolics contents of unconventional edible plants from Brazil using multivariate analysis techniques.

Unconventional edible plants (UEP) are potential supplementary sources of minerals and bioactive compounds. However, there is still a gap in the literature on UEP composition. In this study, the multielement/proximate composition of ten UEP from Brazil was evaluated by ICP OES. Furthermore, phenolic bioactives were quantified by HPLC-UV-DAD. The UEP showed high moisture content (84.85-95.27%) and elements (in mg Kg-1): Al (122-657), Ca (145-14,229), Cu (8.3-18.81), Fe (177-586), K (12.46-34.50%), Mg (157-1,552), Mn (16.85-84.96), Na (1,107-23,775), P (2,535-6,127), Si (189-1,695), Sr (25.56-104.63) and Zn (0.3-72.31). Nine phenolic bioactive compounds (1-2,147) and three flavonoids (1-2,042 mg Kg-1) were determined. PCA and HCA grouped samples (Java ginseng, Coriander, Spearmint and Indian borage) rich in minerals. Spearmint showed high levels of transcinamic acid, kaempferol and quercetin. This study contributes to the scientific development and use of UEP.

Behavior in children and adolescents associated to screen time in Porto Velho, Brazilian Western Amazon / Comportamento de crianças e adolescentes em relação ao tempo de tela em Porto Velho, Amazônia Ocidental Brasileira

INTRODUCTION: In studies directed to children and adolescents, the sedentary behavior has been usually represented by exposure to screen, which comprise the total or separate measured time exposed to television, videogame, tablets, mobile devices, and computer. OBJECTIVE: To analyze the prevalence and factors associated with screen time in children and adolescents. METHODS: A cross-sectional school-based study was carried out with 1,471 students from Elementary School, aged between 7 to 18 years (51.3% male), enrolled at public schools (55.6%) in Porto Velho, Rondônia (RO) state, Brazil. Excess screen time was defined as watching television, using the computer, and playing video games for more than two hours per day. Poisson regression was used to obtain crude and adjusted prevalence ratios and their respective 95% CI. RESULTS: Overall prevalence of screen time exposure over two hours per day was 65.9%. After adjustments, risk of screen time exposure was higher in males, PR = 1.51 (95% CI: 1.08 - 1.92), under or equal to 14 years old, PR = 1.69 (95% CI: 1.48 - 1.92), in the 5th grade, PR = 1.41 (95% CI: 1.02 - 1.89), in the 6th grade, PR = 1.44 (95% CI: 1.06 - 1.97) and in the 7th grade, PR = 1.52 (95% CI: 1.09 - 2.13), attending two weekly PE classes or fewer, PR = 1.25 (95% CI: 1.07 - 1.53) ), consuming more than 3 daily meals, PR = 2.69 (95% CI: 2.14 - 3.37) and overweight, PR = 1.51 (95% CI: 1.13 - 2.03). CONCLUSION: The findings showed that the exposure equal to or more than two hours of daily screen time was high. The students more exposed to this outcome had the next characteristics: male sex, age less than or equal to 14 years, from the fifth, sixth, and seventh grade of elementary education, practice physical education classes less than or equal to two hours per week, consume more than three meals daily and have excess body fat (G%).

INTRODUÇÃO: Em estudos direcionados a crianças e adolescentes, o comportamento sedentário tem sido usualmente representado pela exposição aos comportamentos de tela, que compreendem as medidas (unificadas ou distintas) do tempo de televisão, videogame, tablets, aparelhos celulares e computador. OBJETIVO: Investigar a prevalência e os fatores associados ao tempo de tela em crianças e adolescentes. MÉTODO: Estudo transversal de base escolar, com 1471 escolares de 9 a 18 anos, sendo 51,3% do sexo masculino pertencentes às escolas públicas (55,6%) do ensino fundamental de Porto Velho, Rondônia. O tempo excessivo de tela foi definido como assistir televisão, usar o computador e jogar videogames por mais de duas horas diárias. Análise utilizada foi regressão de Poisson para obtenção das razões de prevalências brutas e ajustadas e seus respectivos IC95%. RESULTADOS: A prevalência geral de exposição de tempo de tela maior que duas horas diárias foi de 65,9%. Após ajustes, o risco à exposição de tempo de tela foi maior no sexo masculino RP = 1,51 (IC95%: 1,08 - 1,92), idade menor ou igual a 14 anos RP = 1,69 (IC95%: 1,48 - 1,92), graus de ensino 5ª ano RP=1,41 (IC95%: 1,02 - 1,89), 6ª ano RP=1,44 (IC95%: 1,06 - 1,97) e 7ª ano RP = 1,52 (IC95%: 1,09 - 2,13), frequentar as aulas de educação física menos ou igual a duas aulas semanais RP = 1,25 (IC95%:1,07 - 1,53), consumir refeições diárias mais de três por dia RP = 2,69 (IC95%:2,14 - 3,37) e ter excesso de gordura RP = 1,51 (IC95%: 1,13 - 2,03. CONCLUSÃO: Os resultados mostraram que a exposição igual ou superior a duas horas de tela diária era alta. Os estudantes mais expostos a este desfecho tiveram as seguintes características: sexo masculino, idade menor ou igual a 14 anos, de quinta, sexta e sétima série do ensino fundamental, praticar aulas de educação física menor ou igual a duas horas semanais, consumir mais de três refeições diárias e estar com excesso de gordura corporal (G%).

Pensar, gostar e considerar importante a prática de atividade física aumentam as chances de ser ativo no lazer? / Do thinking, enjoying, and considering important the practice of physical activity increase the chances of being active at leisure?

RESUMO: Embora reconhecida como comportamento de extrema importância na saúde da população, a prática de atividade física regular ainda é um grande desafio. Objetivo: verificar o nível de atividade física no lazer e possíveis fatores correlatados em uma comunidade acadêmica do nordeste brasileiro. Metodologia: trata-se de um estudo transversal, constituído por discentes, docentes e técnicos administrativos, utilizou-se como instrumento "Mapa de Atividade Física e Saúde-MAFIS", realizou-se estatística descritiva, teste de Qui quadrado, com posterior montagem do modelo de regressão logística. Resultados: 52,1% atingiram as recomendações de atividade física (AF), os homens apresentam 65,3% (OR: 1,65; IC95%: 1,29-2,11) mais chance de serem ativos, quem gosta de AF tem duas (OR: 2,02; IC95%: 0,82-4,96) a 4,8 (OR: 4,84; IC95%: 1,99-11,8) vezes mais chance de praticar AF, achar importante fazer AF (OR: 2,23; IC95%: 0,48-10,4) e menos dias sentado aumenta de 48,3% (OR: 1,48; IC95%: 1,032- 2,130) a 53,3% (OR: 1,53; IC95%: 1,09-2,13) a chance de fazer AF e quem pensa em fazer AF (OR: 0,362; IC: 0,203-0,645) tem menos chance de ser ativo. Conclusão: Gostar, considerar importante e menos dias sentados aumentam as chances de fazer atividade física, já pensar sempre em fazer, diminui a chance de ser ativo no lazer. (AU)

ABSTRACT: Although recognized as extremely important behavior in the health of the population, the practice of a regular physical activity is still a major challenge. Aim: verifying the level of leisure-time physical activity and possible correlated factors in an academic community in northeastern Brazil. Materials and methods: this is a cross-sectional study, consisting of stu-dents, professors, and administrative technicians. The instrument "Map of Physical Activity and Health-MAFIS" was used, as well as descriptive statistics, Chi-square test, with the subsequent assembly of the logistic regression model. Results: 52.1% reached the recommendations for physical activity (PA), men were 65.3% (OR: 1.65; 95% CI: 1.29 - 2.11) more likely to be active, those who like PA were two (OR: 2.02; 95% CI: 0.82- 4.96) to 4.8 (OR: 4.84; 95% CI: 1.99-11.8) times more likely to practice PA, finding it important to do AF (OR: 2.23; 95% CI: 0.48-10.4) and spending fewer days sitting increased by 48.3% (OR: 1.48; 95% CI: 1,032 - 2,130) to 53.3% (OR: 1 , 53; 95% CI: 1.09 - 2.13) the chance of doing PA and those who think about doing PA (OR: 0.362; CI: 0.203 - 0.645) are less likely to be active. Conclusion:Enjoying, considering important, and spending fewer days sitting increase the chances of doing physical activity, on the other hand, just thinking about doing it decreases the chances of being active at leisure. (AU)

SARS-CoV-2 em superfícies: persistência e medidas preventivas: uma revisão sistemática / SARS-CoV-2 in Surfaces: persistence and prevention measures: a systematic review / SARS-CoV-2 en Superficies: persistencia y medidas preventivas: una revisión sistemática

Objetivo: verificar a persistência do SARS-CoV-2 nas diferentes superfícies e medidas preventivas contra a transmissão do vírus. Método: revisão sistemática norteada pelo método PRISMA. Foram utilizadas as bases de buscas PubMed e LILACS de janeiro a junho de 2020, com os descritores: "2019-nCOV" OR "SARS-CoV-2" OR "COVID-19" AND "transmission" OR "transmission route" AND "viability" AND "surface" OR "inanimate surface" AND "prevention". As informações extraídas foram autor/ano, país, tipo de publicação, nome da revista, idioma, país da publicação e base de dados. Resultados: foram identificadas 178 publicações, com exclusão de 164 artigos, nove por idioma, 12 por outras doenças e/ou patógenos e 143 pelo título e/ou resumo. Foram incluídos 14 artigos qualitativos, oito artigos de revisões narrativas, uma comunicação breve, dois artigos originais e um editorial. Treze artigos foram publicados em inglês e um em português. Conclusão: coronavírus humanos (HCoV 229E) podem se manter em diferentes superfícies durante duas horas até nove dias. Baixas temperaturas e reduzida umidade relativa do ar favorecem a sobrevivência do SARS-CoV-2, sendo mais estável em plásticos e aço inoxidável do que em cobre e papelão. A recomendação é higienização de superfícies e mãos com água, sabão ou higienizadores à base de álcool.(AU)

Objective: to verify the persistence of SARS-CoV-2 on different types of surfaces and the preventive measures against the transmission of the virus. Method: a systematic review was carried out, using the PRISMA method. The PubMed and LILACS databases from January to June 2020 were used, with the following descriptors: "2019-nCOV" OR "SARS-CoV-2" OR "COVID-19" AND "transmission" OR "transmission route" AND "viability" AND "surface" OR "inanimate surface" AND "prevention". Information extracted was author/year, country, type of publication, journal name, language, country of publication and database. Results: 178 publications were identified. 164 articles were excluded, nine by language, 12 by other diseases and/or pathogens and 143 by title and/or abstract. 14 qualitative articles were included, eight articles of narrative reviews, one short communication, two original articles and one editorial. Thirteen articles were published in English and one in Portuguese. Conclusion: human coronaviruses (HCoV 229E) can persist on different surfaces for two hours up to nine days. Low temperatures and low relative humidity of the air favor the survival of SARS-CoV-2, which is more stable on plastics and on stainless steel than on copper and cardboard. The recommendation is frequent surface and hand hygiene with water, soap or alcohol-based rubs.(AU)

Objetivo: verificar la persistencia del SARS-CoV-2 en diferentes superficies y las medidas preventivas contra la transmisión del virus. Método: se realizó una revisión sistemática, utilizando el método PRISMA. Se utilizaron las bases de datos de búsqueda de PubMed y LILACS de enero a junio de 2020, con los descriptores: "2019-nCOV" O "SARS-CoV-2" O "COVID-19" Y "transmisión" O "ruta de transmisión" Y "viabilidad" Y "superficie" O "superficie inanimada" Y "prevención". Las informaciones extraídas fueron autor / año, país, tipo de publicación, nombre de la revista, idioma, país de publicación y base de datos. Resultados: se identificaron 178 publicaciones. Se excluyeron 164 artículos, nueve por idioma, 12 por otras enfermedades y/o patógenos y 143 por título y/o resumen, incluidos 14 artículos cualitativos, ocho artículos de revisiones narrativas, una comunicación breve, dos artículos originales y uno editorial. Se publicaron trece artículos en inglés y uno en portugués. Conclusión: los coronavirus humanos (HCoV 229E) pueden matenerse en diferentes superficies durante dos horas hasta nueve días. Las bajas temperaturas y la reducida humedad relativa del aire favorecen la supervivencia del SARS-CoV-2, siendo más estable en plásticos y acero inoxidable que en cobre y carton. La recomendación es limpiar superficies y manos con agua, jabón o limpiadores a base de alcohol.(AU)

Epidemiologia da COVID-19 em Uberlândia (MG): análise preliminar do impacto do grau de abertura comercial / Epidemiology of COVID-19 in Uberlândia (MG): preliminary analysis of the impact of commercial activities's openness / Epidemiología del COVID-19 en Uberlândia (MG): análisis preliminar del impacto del grado de apertura comercial

Objetivo: analisar os dados epidemiológicos da COVID-19 em Uberlândia e confrontá-los com as determinações municipais de abertura e fechamento comercial em diferentes momentos da pandemia. Método: trata-se de estudo epidemiológico, observacional e descritivo, utilizando dados secundários, referente aos casos notificados da COVID-19 em Uberlândia. Resultados: foram realizados 59.994 testes, sendo 14.389 positivos (23,98%) e 45.605 negativos (76,02%). Registraram-se 265 óbitos e taxa de letalidade de 1,89%. Casos confirmados apresentaram tendência de crescimento após abertura comercial, tendência de estabilização após fechamento comercial, e tendência de queda após a última reabertura comercial, acompanhada de acúmulo de testes suspeitos e queda da testagem populacional. Entre os internados diários, houve predomínio de homens (59%), maiores de 60 anos (55%) e alocados em leitos de enfermaria (55%). Conclusão: percebeu-se expressiva influência do grau de abertura comercial nos indicadores da doença, com incremento da frequência de testes positivos e óbitos, e manutenção das internações.(AU)

Objective: to analyze COVID-19's epidemiological data in Uberlândia and compare them with the municipal determinations of opening and closing of commercial's acitivities at different times of the pandemic. Method: this is an epidemiological, observational and descriptive study, using secondary data, referring to notified cases of COVID-19 in Uberlândia. Results: 59,994 tests were performed, of which 14,389 were positive (23.98%) and 45,605 negative (76.02%). There were 265 deaths and a fatality rate of 1.89%. Confirmed cases showed a growth tendency after commercial opening, a stabilization tendecy after commercial closing, and a downward tendecy after the last commercial reopening, accompanied by an accumulation of suspicious tests and a drop in population testing. Among daily inpatients, there was a predominance of men (59%), older than 60 years old (55%) and allocated to infirmary beds (55%). Conclusion: there was a significant influence of the degree of commercial opening in the indicators of the disease, with an increase in the frequency of positive tests and deaths, and maintenance of hospitalizations.(AU)

Objetivo: analizar los datos epidemiológicos de COVID-19 en Uberlândia y confrontarlos con las determinaciones municipales de apertura y cierre comercial en diferentes momentos de la pandemia. Método: se trata de un estudio epidemiológico, observacional y descriptivo, utilizando datos secundarios, referidos a los casos notificados de COVID-19 en Uberlândia. Resultados: se realizaron 59.994 pruebas, de las cuales 14.389 fueron positivas (23,98%) y 45,605 negativas (76,02%). Hubo 265 muertes y una tasa de mortalidad del 1,89%. Los casos confirmados mostraron una tendencia de crecimiento después de la apertura comercial, una tendencia de estabilización después del cierre comercial y una tendencia a la baja después de la última reapertura comercial, acompañada de una acumulación de pruebas sospechosas y una caída en las pruebas de población. Entre los internados diarios, hubo predominio de hombres (59%), mayores de 60 años (55%) y asignados a camas de enfermería (55%). Conclusión: hubo una influencia significativa del grado de apertura comercial en los indicadores de la enfermedad, con un aumento en la frecuencia de pruebas positivas y muertes, y mantenimiento de hospitalizaciones.(AU)

Epidemiology of COVID-19 in Uberlândia (MG): preliminary analysis of the impact of commercial activities's openness at different moments of the pandemic / Epidemiologia da COVID-19 em Uberlândia (MG): análise preliminar do impacto do grau de abertura comercial em diferentes momentos da pandemia

Introduction: The economic impact of the COVID-19's pandemic and the interruption of several commercial activities is substantial. In Brazil, there is discussions about the need to establish periods of greater flexibility in measures of social isolation, to cover the economic's impact in the country. In this context, effective Epidemiological Surveillance is essential. Objective: To analyze the epidemiological data of COVID-19 in Uberlândia and compare them to the municipal's determinations of commercial opening and closing at different times of the pandemic. Methods: This is a descriptive observational epidemiological study, using secondary data, of public uses and access, of the cases notified by COVID-19 to the Municipal Health Department of Uberlândia, obtained through the Municipal Information Bulletin. Results: 59.994 tests were performed, being 14.389 positive (23.98%) and 45.605 negative (76.02%). There were 265 deaths and a fatality rate of 1.89%. The confirmed cases tended to grow after commercial openings and to stabilize after commercial closing, with a tendency to fall after the last commercial reopening, accompanied by accumulation of suspicious tests and drop in population testing. Among daily inpatients, there was a prevalence of men (59%), older than 60 years (55%) and those allocated to nursing beds (55%). Conclusion: From the analysis of the epidemiological data and the preliminary understanding of the impact of the measures adopted by the city, a significant influence of the commercial activity's openness on the indicators of the disease was noticed. It was noticed that the frequency of positive tests and deaths increased, with maintenance of inpatients, which demonstrates the impact of this disease and the need to improve health surveillance actions in the control of the pandemic.

Introdução: O impacto econômico causado pela pandemia da COVID-19 e a paralisação de diversas atividades comerciais é grande. No Brasil, debate-se a necessidade de adoção de períodos de maior flexibilização nas medidas de isolamento social, visando garantir movimentação econômica no país. Para que isso seja possível, torna-se indispensável a atuação efetiva da Vigilância Epidemiológica. Objetivo: Analisar os dados epidemiológicos da COVID-19 em Uberlândia e confrontá-los com as determinações municipais de abertura e fechamento comerciais em diferentes momentos da pandemia. Metodologia: Trata-se um estudo epidemiológico observacional descritivo, utilizando dados secundários, de uso e acesso públicos, dos casos notificados da COVID-19 à Secretaria Municipal de Saúde de Uberlândia, obtidos por meio do Boletim Informativo Municipal. Resultados: Foram realizados 59.994 testes, sendo 14.389 positivos (23,98%) e 45.605 negativos (76,02%). Registraram-se 265 óbitos e taxa de letalidade de 1,89%. Casos confirmados apresentaram tendência de crescimento após aberturas comerciais e tendência de estabilização após fechamento comercial, com tendência de queda após a última reabertura comercial, acompanhada de acúmulo de testes suspeitos e queda da testagem populacional. Entre os internados diários, houve predomínio de homens (59%), maiores de 60 anos (55%) e alocados em leitos de enfermaria (55%). Conclusão: A partir da análise dos dados epidemiológicos e do entendimento preliminar do impacto das medidas adotadas pela prefeitura, foi percebida expressiva influência do grau de abertura comercial nos indicadores da doença, resultando no incremento da frequência de testes positivos e óbitos, com manutenção das internações, o que demostra o impacto dessa doença e a necessidade de aprimoramento das ações de vigilância em saúde no controle da pandemia.

Atividade física na prevenção de doenças crônicas não transmissíveis em homens / Physical activity in the prevention of chronic noncommunicable diseases in men

RESUMO: Introdução: A promoção da atividade física (AF) é uma das prioridades das políticas públicas de atenção básica à saúde, especialmente para o público masculino. Objetivo: Avaliar a associação da prática de atividade física com o estilo de vida e presença doenças crônicas não transmissíveis (DCNTs) em usuários do sexo masculino de Unidade Básica de Saúde (UBS). Métodos: Participaram do estudo 119 homens na faixa etária de 20 a 59 anos. A associação entre a prática de atividade física com variáveis sociodemográficas, etilismo, tabagismo, uso de medicamento, presença de doenças crônicas não transmissíveis e conhecimento da política de saúde do homem foi realizada por Regressão Logística com um α=5%. Resultados: A prevalência de atividade física foi de 58,8%, entretanto 36,7% dos participantes faziam uso de medicações diariamente e 70,6% não conhecem a Política Nacional de Atenção Integral à Saúde do Homem. Além disso, fazer atividade física demonstrou como um fator de proteção contra as doenças crônicas não transmissíveis (OR = 2,97; IC 95% 1,03 ­ 8,55; p = 0,043). Conclusão: A prática de atividade física em homens, independentemente da idade, tabagismo e etilismo foi associada à prevenção de doenças crônicas não transmissíveis.(AU)

ABSTRACT: Introduction: The promotion of physical activity (PA) is one of the priorities of public policies for primary health care, especially for the male audience. Objective: To evaluate the association between physical activity and life-style and presence of chronic noncommunicable diseases (NCDs) in male users of the Basic Health Unit (BHU). Methods: 119 men, aged between 20 and 59 years, participated in the study. The association between the practice of physical activity with sociodemographic variables, alcoholism, smoking, use of medication, presence of chronic noncommunicable diseases and knowledge of men's health policy was carried out by Logistic Regression with an α= 5%. Results: The prevalence of physical activity was 58.8%, however 36.7% of the participants used medica-tions daily and 70.6% did not know the National Policy for Comprehensive Attention to Men's Health. In addition, physical activity proved to be a protective factor against chronic non-communicable diseases (OR= 2,97; IC 95% 1,03 ­ 8,55; p = 0,043). Conclusion: The practice of physical activity in men, regardless of age, smoking and alcohol consumption was associated with the prevention of chronic noncommunicable diseases. (AU)

Influence of Family History of Diabetes on Cardiac Autonomic Dysfunction of Adolescents

Abstract Background To evaluate cardiac autonomic modulation of adolescents with a family history of diabetic parents. Objective This study aims to evaluate the influence of a family history of diabetes on cardiac autonomic modulation. Methods This is an analytical and cross-sectional study on adolescents between 11 and 18 years of age, of both genders, who were divided into group with a family history of diabetes and a control group without a family history of diabetes. The study protocol consisted of the analysis of heart rate variability, blood pressure, anthropometric measurements, and body composition. Also, by using questionnaires, level of physical activity, sexual maturation, and sleep quality were evaluated. Normality of data distribution was tested using the Kolmogorov-Smirnov test. Then, statistical significance was evaluated using the Student's t-test, and the Cohen's teste was used for calculation of the effect size. The level of significance adopted in the statistical analysis was 5%. Results When the group of individuals with a family history of diabetes was compared with the control group, statistically significant differences were observed in the variables the standard deviation of the NN time series interval (SDNN) (43.9 ± 2.2 vs. 53.5 ± 2.6 ms), the square root of the quadratic differences (RMSSD) (41.9 ± 3.3 vs. 52.4 ± 3.2 ms), standard deviation of beat-to-beat instantaneous variability (SD1) (29.7 ± 2.3 vs. 37.1 ± 2.3 ms), long-term standard deviation of continuous RR intervals (SD2) (. 54.1 ± 2.6 vs. 66.66 ± 3.5 ms), and in low frequency (LF) (496.0 ± 49.5 vs. 728 ± 71.6 ms2) and high frequency (HF) (1050.0 ± 120.4 vs. 737.4 ± 98.5 ms2) in the frequency domain. Conclusions Global autonomic modulation is decreased in adolescents with a family history of diabetes. We also observed a decrease in vagal activity in this group. So, sympathetic autonomic modulation is predominant in this population. (Int J Cardiovasc Sci. 2020; [online].ahead print, PP.0-0)

[Recommendations to strengthen primary health care in BrazilRecomendaciones para el fortalecimiento de la atención primaria de salud en Brasil]. / Recomendações para o fortalecimento da atenção primária à saúde no Brasil.

OBJECTIVE: To formulate strategic recommendations to strengthen primary health care (PHC) in Brazil's Unified Health System (SUS) based on expert consultation. METHOD: The present qualitative study, developed from March to August, 2018, included administration of an open questionnaire followed by consensus building among 20 participants representing the five Brazilian regions, selected using the criterion of recognized professional expertise in the field of PHC. Participants answered an online questionnaire created by the authors. The findings were systematized as recommendations, which were submitted for priority ranking by the expert group using a one-round Delphi technique. The final recommendations were discussed in a face-to-face workshop. RESULTS: Of 20 experts, 18 answered the open questionnaire, generating 84 themes for analysis, which were systematized into 44 proposals. Evaluation of these proposals resulted in 20 recommendations, emphasizing expansion of the Family Health Strategy (FHS); enhanced access to PHC; training of professionals for multidisciplinary work in the PHC setting; allocation of technologies to ensure PHC resolvability; improvement of regulation/coordination of services to strengthen a foundational role of PHC in the SUS; human resources, provision of professionals, and support/stimulus for teams; production and dissemination of knowledge; transparency in PHC initiatives; and mediating role of PHC in the healthcare system. CONCLUSIONS: The findings support the FHS as the best model to ensure a strong PHC in the SUS, combined with policies that prioritize essential PHC attributes, especially through innovation in care, management, and communication technologies.

OBJETIVO: Formular recomendaciones estratégicas para fortalecer la atención primaria de salud (APS) en el Sistema Único de Salud (SUS) en Brasil a partir de una consulta a expertos. MÉTODO: Este estudio cualitativo, realizado entre marzo y agosto del 2018, consistió en emplear un cuestionario abierto y lograr consenso entre 20 participantes representativos de las cinco macrorregiones brasileñas, seleccionados por su reconocida experiencia profesional en la APS. Los participantes respondieron 20 preguntas abiertas en un cuestionario en línea elaborado por los investigadores. Los hallazgos se sistematizaron en forma de recomendaciones, sometidas por el grupo de expertos a una evaluación de prioridades con la metodología Delfos en una sola ronda. Las recomendaciones finales se debatieron en un taller presencial. RESULTADOS: Dieciocho de los 20 especialistas respondieron al cuestionario abierto, que produjo 84 temas sistematizados en 44 propuestas. Después de la evaluación, se formularon 20 recomendaciones, en las cuales se acentuaron la expansión de la estrategia de salud de la familia; la ampliación del acceso a la APS; la formación de profesionales para el trabajo multidisciplinario en la APS; la asignación de tecnologías para garantizar la resolutividad en la APS; el perfeccionamiento de la regulación y la coordinación de servicios para fortalecer la APS como elemento estructurante del SUS; la estructura y el financiamiento; los recursos humanos, la dotación de profesionales, el apoyo y el estímulo a los equipos; la producción y divulgación del conocimiento; la transparencia en las actividades de APS; y la función mediadora de la APS en el sistema de atención de salud. CONCLUSIONES: Los hallazgos refuerzan la estrategia de salud de la familia como el mejor modelo para garantizar una APS fuerte en el SUS, vinculada a políticas que prioricen los atributos esenciales de la APS, sobre todo por medio de innovación en materia de tecnologías asistenciales, de gestión y de comunicación.

Recomendações para o fortalecimento da atenção primária à saúde no Brasil

[RESUMO]. (APS) no Sistema Único de Saúde (SUS) no Brasil a partir da consulta a especialistas. Método. Este estudo qualitativo, desenvolvido de março a agosto de 2018, foi composto pela aplicação de questionário aberto e construção de consenso entre 20 participantes representativos das cinco macrorregiões brasileiras, selecionados a partir do critério de reconhecida experiência profissional na APS. Os participantes responderam 20 perguntas abertas em questionário on-line elaborado pelos pesquisadores. Os achados foram sistematizados na forma de recomendações, submetidas a avaliação de prioridade pelo grupo de especialistas utilizando a metodologia Delphi em rodada única. As recomendações finais foram discutidas em oficina presencial. Resultados. Dos 20 especialistas, 18 responderam ao questionário aberto, gerando 84 temas, sistematizados em 44 propostas. Após avaliação, foram elaboradas 20 recomendações, que enfatizaram a expansão da Estratégia Saúde da Família; a ampliação do acesso à APS; a formação de profissionais para atuação multidisciplinar na APS; a alocação de tecnologias para garantir resolutividade na APS; o aprimoramento da regulação/coordenação de serviços para fortalecer a APS como elemento estruturante do SUS; estrutura e financiamento; recursos humanos, provimento de profissionais, apoio e estímulo às equipes; produção e divulgação de conhecimento; transparência nas ações da APS; e o papel mediador da APS no sistema de saúde. Conclusões. Os achados reforçam a ESF como melhor modelo para garantir uma APS forte no SUS, aliada a políticas que priorizem os atributos essenciais da APS, sobretudo pela inovação em tecnologias assistenciais, de gestão e de comunicação.

[ABSTRACT]. Objective. To formulate strategic recommendations to strengthen primary health care (PHC) in Brazil’s Unified Health System (SUS) based on expert consultation. Method. The present qualitative study, developed from March to August, 2018, included administration of an open questionnaire followed by consensus building among 20 participants representing the five Brazilian regions, selected using the criterion of recognized professional expertise in the field of PHC. Participants answered an online questionnaire created by the authors. The findings were systematized as recommendations, which were submitted for priority ranking by the expert group using a one-round Delphi technique. The final recommendations were discussed in a face-to-face workshop. Results. Of 20 experts, 18 answered the open questionnaire, generating 84 themes for analysis, which were systematized into 44 proposals. Evaluation of these proposals resulted in 20 recommendations, emphasizing expansion of the Family Health Strategy (FHS); enhanced access to PHC; training of professionals for multidisciplinary work in the PHC setting; allocation of technologies to ensure PHC resolvability; improvement of regulation/coordination of services to strengthen a foundational role of PHC in the SUS; human resources, provision of professionals, and support/stimulus for teams; production and dissemination of knowledge; transparency in PHC initiatives; and mediating role of PHC in the healthcare system. Conclusions. The findings support the FHS as the best model to ensure a strong PHC in the SUS, combined with policies that prioritize essential PHC attributes, especially through innovation in care, management, and communication technologies.

[RESUMEN]. Objetivo. Formular recomendaciones estratégicas para fortalecer la atención primaria de salud (APS) en el Sistema Único de Salud (SUS) en Brasil a partir de una consulta a expertos. Método. Este estudio cualitativo, realizado entre marzo y agosto del 2018, consistió en emplear un cuestionario abierto y lograr consenso entre 20 participantes representativos de las cinco macrorregiones brasileñas, seleccionados por su reconocida experiencia profesional en la APS. Los participantes respondieron 20 preguntas abiertas en un cuestionario en línea elaborado por los investigadores. Los hallazgos se sistematizaron en forma de recomendaciones, sometidas por el grupo de expertos a una evaluación de prioridades con la metodología Delfos en una sola ronda. Las recomendaciones finales se debatieron en un taller presencial. Resultados. Dieciocho de los 20 especialistas respondieron al cuestionario abierto, que produjo 84 temas sistematizados en 44 propuestas. Después de la evaluación, se formularon 20 recomendaciones, en las cuales se acentuaron la expansión de la estrategia de salud de la familia; la ampliación del acceso a la APS; la formación de profesionales para el trabajo multidisciplinario en la APS; la asignación de tecnologías para garantizar la resolutividad en la APS; el perfeccionamiento de la regulación y la coordinación de servicios para fortalecer la APS como elemento estructurante del SUS; la estructura y el financiamiento; los recursos humanos, la dotación de profesionales, el apoyo y el estímulo a los equipos; la producción y divulgación del conocimiento; la transparencia en las actividades de APS; y la función mediadora de la APS en el sistema de atención de salud. Conclusiones. Los hallazgos refuerzan la estrategia de salud de la familia como el mejor modelo para garantizar una APS fuerte en el SUS, vinculada a políticas que prioricen los atributos esenciales de la APS, sobre todo por medio de innovación en materia de tecnologías asistenciales, de gestión y de comunicación.

Rastreamento Geográfico da COVID-19 Segundo Fatores Socioeconômicos e Demográficos no Município de Uberlândia, Minas Gerais / Geographic Tracking of COVID-19 According to the Socioeconomic and Demographic Factors in the City of Uberlândia, Minas Gerais

Objetivo: analisar a distribuição espacial da COVID-19 segundo fatores socioeconômicos e demográficos no município de Uberlândia, Minas Gerais. Método: trata-se de um estudo do ecológico, transversal, utilizando dados secundários, de uso e acesso públicos, oriundos do Ministério da Saúde do Brasil, por meio das informações disponíveis no open DataSUS com casos confirmados da COVID-19 e que possuíam, em suas respectivas fichas cadastrais, os bairros de residência. Resultados: a média de idade dos casos confirmados pela COVID-19 foi de 38,83 (±14,29) anos, as faixas etárias mais atingidas foram entre 20 a 29 anos (23,2%), 30 a 39 anos (27,7%), 40 a 49 anos (22,5%), 50 a 59 anos (13,7%) e 70 a 79 anos (5,7%). Todos os setores apresentaram casos da COVID-19, sendo o oeste o mais atingido. Entre os 20 bairros com o maior número de infecção, 11 possuem renda per capita média abaixo de um salário-mínimo, oito bairros com renda per capita média de até dois salários-mínimos e apenas um bairro com renda per capita média acima de dois salários mínimos. Conclusões: o número de casos da COVID-19 foi elevado, espalhando-se rapidamente para todos os setores, afetando, principalmente, bairros de baixa renda per capita. Nos bairros com renda per capita média da população abaixo de um salário-mínimo, concentram-se os piores cenários da COVID-19. A crise global de saúde pública ocasionada pela COVID-19 revelou as desigualdades e as injustiças que ameaçam o bem-estar, a segurança e a vida das pessoas.

Objective: To analyze the spatial distribution of COVID-19 according to socioeconomic and demographic factors in the city of Uberlândia, Minas Gerais. Method: This is an ecological, cross-sectional study, using secondary data, of public use and access, from the Ministry of Health of Brazil, based on the information available in the open DataSUS with confirmed cases of COVID-19 and that had, in their respective records, the neighborhoods of residence. Results: The average age of the cases confirmed by COVID-19 was 38.83 (± 14.29) years old, the most affected age groups were between 20 to 29 years old (23.2%), 30 to 39 years old (27 , 7%), 40 to 49 years old (22.5%), 50 to 59 years old (13.7%) and 70 to 79 years old (5.7%). All sectors presented cases of COVID-19, being the west the most affected. Among the 20 neighborhoods with the highest number of infections, 11 have an average per capita income below one minimum wage, eight neighborhoods with an average per capita income of up to two minimum wages and only one neighborhood with an average per capita income above two minimum wages. Conclusions: The number of COVID-19 cases was high, spreading rapidly to all sectors, affecting mainly neighborhoods with low per capita income. In neighborhoods with average per capita income below one minimum wage, the worst scenarios of COVID-19 are concentrated. The global public health crisis caused by COVID-19 revealed the inequalities and injustices that threaten people's well-being, security and lives.

Diagnósticos de enfermagem para pacientes em cuidados paliativos: revisão integrativa da literatura / Nursing diagnoses in patients under palliative care: an integrative review / Diagnóstico de enfermería para pacientes de atención al paciente: revisión integrativa de la literatura

Objective: The objectives of this study were to identify the nursing diagnoses in patients under palliative care according to the literature and highlight those most used. Methods: This integrative review with a descriptive nature was carried out by analyzing articles published over the last ten years. Literature search was conducted in the following online databases: Caribbean Literature on Health Sciences (LILACS), PubMed, Web of Science, Scopus, and Cumulative Index to Nursing and Allied Health Literature (CINAHL). Results: The sample consisted of 14 articles. Most of them were published in 2016. Also, the NANDA-I was the most used classification system for the formulation of the nursing diagnoses. Among the most prevalent diagnoses, 'Pain', 'Death Anxiety', and 'Impaired Physical Mobility' were highlighted. Conclusion: Although research on the topic is incipient, it is hoped that this study can make it easier for nurses to make decisions based on evidence to ensure that patients under palliative care receive dignified, humanized, systematized, and quality care

Objetivo: Identificar as evidências científicas disponíveis acerca dos diagnósticos de enfermagem para pacientes em cuidados paliativos e elencar aqueles mais utilizados nessa prática. Método: Trata-se de um estudo descritivo de revisão integrativa, na qual foram analisados artigos publicados nos últimos dez anos, nas bases de dados: Lilacs; Pubmed; Web of Science; Scopus; CINAHL. Resultados: a amostra foi composta por 14 estudos, averiguando-se um maior quantitativo de produções no ano de 2016, sendo a NANDA-I o sistema de classificação mais empregado para a formulação do diagnóstico de enfermagem. Dentre os diagnósticos mais prevalentes, destacaram-se: 'Dor', 'Ansiedade relacionada à morte' e 'Mobilidade física prejudicada'. Conclusão: embora seja incipiente a produção de estudos acerca da temática, espera-se que esta pesquisa possa contribuir para a tomada de decisão pelo enfermeiro, baseada em evidências, que possa assegurar ao paciente sob cuidados paliativos uma assistência digna, humanizada, sistematizada e de qualidade

Objetivo: Identificar la evidencia científica disponible sobre diagnósticos de enfermería para pacientes en cuidados paliativos y enumerar los más utilizados en esta práctica. Método: este es un estudio descriptivo de una revisión integradora, en el cual los artículos publicados en los últimos diez años fueron analizados en las bases de datos: Lilacs; Pubmed Web de la Ciencia; Scopus Cinahl. Resultados: la muestra consistió en 14 estudios, verificando una mayor cantidad de producciones en el año 2016, siendo NANDA-I el sistema de clasificación más utilizado para la formulación del diagnóstico de enfermería. Entre los diagnósticos más frecuentes, se destacaron los siguientes: "Dolor", "Ansiedad relacionada con la muerte" y "Movilidad física deteriorada". Conclusión: aunque la producción de estudios sobre el tema es incipiente, se espera que este estudio pueda contribuir a la toma de decisiones por parte de las enfermeras, con base en la evidencia, que puede garantizar al paciente bajo cuidados paliativos con dignidad, humanización, sistematización y calidad