Analyzing households' food insecurity during the COVID-19 pandemic and the role of public policies to mitigate it: evidence from Ceará, Brazil.

OBJECTIVE: To evaluate the association of conditional cash transfer policies to mitigate the food insecurity (FI) among families living in poverty during the COVID-19 pandemic in Ceará, Brazil. METHODS: An analytical cross-sectional study was carried out through telephone contact during the period of May-July 2021, during the second wave of the COVID-19 pandemic in Ceará. Families in a situation of high social and economic vulnerability participated in this study (monthly per capita income of less than US$16.50). FI was assessed using the EBIA, a Brazilian validated questionnaire. The participation of families in government programs and public policies was also investigated. Logistic regression models were used to assess the association of the several factors assessed with food insecurity. RESULTS: The prevalence of any food insecurity in this sample was 89.1% (95% Confidence interval (95% CI: 86.2 - 92.1) and of severe food insecurity, 30.3% (95% CI: 26.0 - 34.6). The Mais Infância card program, adopted as a cash transfer supplement in the state of Ceará, was significantly associated with food insecurity (OR 4.2 (95% CI: 1.7 - 10.2), with a p-value of 0.002. In addition, families affected by job losses due to the COVID-19 pandemic presented higher odds of FI. CONCLUSIONS: In this study, 89% of evaluated families presented food insecurity. Conditional cash transfer programs were associated with FI. We highlight the need for policies and interventions to reduce the impact of the COVID-19 pandemic on food insecurity. Such policies can adopt appropriate criteria for defining the participants, as well as connect the participants to an appropriate set of broader social protection measures.

Active methodologies association with online learning fatigue among medical students.

BACKGROUND: Due to the current scenario of the COVID-19 pandemic and the social distancing issues, distance learning was implemented in many medical schools. Educational institutions faced the challenge of continuing to promote teaching and learning while keeping teachers and students in their homes, aiming to reduce the spread of the virus. This change compromised the students' mental health, due to the degree of exhaustion or fatigue attributed to the involvement in videoconferences, called "zoom fatigue". Despite the importance of zoom fatigue for medical education, it can be observed that there have not been studies on the role of the online teaching and learning process through active methodologies in the genesis of this fatigue. We aimed to assess the association of the teaching method used and the prevalence of zoom fatigue. METHODS: A cross-sectional, quantitative, analytical study was carried out in Medical Schools of Ceará, Brazil. Problem-Based Learning (PBL) teaching methodology is the only methodology used in the first semester and PBL together with traditional teaching, i.e., hybrid teaching, is used in the other ones. The Zoom Exhaustion & Fatigue Scale (ZEF) was used, with the questions currently validated for Brazilian Portuguese. Chi-square tests were used to verify the statistical association between the measured variables and the teaching methodology. RESULTS: The prevalence of zoom fatigue reached 56% in students using the hybrid model, versus 41% in those using the PBL methodology, with a statistically significant difference (p value = 0.027). The mean prevalence of overall zoom fatigue was 48%. Students using the hybrid methodology differed from PBL students by having a significantly higher frequency of feelings of wanting to be alone after a videoconference (16.9 vs. 7.1%, respectively) and needing time to be alone after a video conference (10.2 vs. 3.6%, respectively). CONCLUSIONS: Considering that zoom fatigue may stay with us for years beyond the COVID-19 pandemic, it is important to know and provide instructions on how to reduce video conferencing fatigue. The present study suggests that the active participation of students and the number of activities are important factors to be considered.

Hypertension and arterial stiffness in heart transplantation patients.

OBJECTIVES: Post-transplantation hypertension is prevalent and is associated with increased cardiovascular morbidity and subsequent graft dysfunction. The present study aimed to identify the factors associated with arterial stiffness as measured by the ambulatory arterial stiffness index. METHODS: The current study used a prospective, observational, analytical design to evaluate a group of adult heart transplantation patients. Arterial stiffness was obtained by monitoring ambulatory blood pressure and using the ambulatory arterial stiffness index as the surrogate outcome. Multivariate logistic regression analyses were performed to control confounding. RESULTS: In a group of 85 adult heart transplantation patients, hypertension was independently associated with arterial stiffness (OR 4.98, CI 95% 1.06-23.4) as well as systolic and diastolic blood pressure averages and nighttime descent. CONCLUSIONS: Measurement of ambulatory arterial stiffness index is a new, non-invasive method that is easy to perform, may contribute to better defining arterial stiffness prognosis and is associated with hypertension.

Hypertension and arterial stiffness in heart transplantation patients

OBJECTIVES: Post-transplantation hypertension is prevalent and is associated with increased cardiovascular morbidity and subsequent graft dysfunction. The present study aimed to identify the factors associated with arterial stiffness as measured by the ambulatory arterial stiffness index. METHODS: The current study used a prospective, observational, analytical design to evaluate a group of adult heart transplantation patients. Arterial stiffness was obtained by monitoring ambulatory blood pressure and using the ambulatory arterial stiffness index as the surrogate outcome. Multivariate logistic regression analyses were performed to control confounding. RESULTS: In a group of 85 adult heart transplantation patients, hypertension was independently associated with arterial stiffness (OR 4.98, CI 95% 1.06-23.4) as well as systolic and diastolic blood pressure averages and nighttime descent. CONCLUSIONS: Measurement of ambulatory arterial stiffness index is a new, non-invasive method that is easy to perform, may contribute to better defining arterial stiffness prognosis and is associated with hypertension.