Assessment of the quality of life and mental health of healthcare students during the COVID-19 pandemic.

OBJECTIVE: to evaluate the quality of life (QOL) and the presence of symptoms related to depression, anxiety, and stress among students in the healthcare field, in comparison to the period before the COVID-19 pandemic. METHODS: A comparative cross-sectional research was conducted at a Brazilian public university. QOL was assessed using the WHOQOL-bref scale, while symptoms of depression, anxiety, and stress were evaluated using the DASS-21 scale. Descriptive and inferential analyses were employed to compare the two time periods. RESULTS: A total of 355 students participated in this study. During the pandemic, there were significant increases in severe depression symptoms (15.1% versus 24.8%), moderate anxiety (18.3% versus 29.4%), and moderate stress (40.9% versus 53.8%) observed among the participants. Additionally, a significant reduction in QOL was noted, particularly in the domain of social relationships (65.2 versus 59.6, p-value 0.029). CONCLUSION: The study highlights a deterioration in both the quality of life and the mental health of healthcare students during the COVID-19 pandemic.

Síntomas de depresión, ansiedad y estrés en estudiantes del área de la salud e impacto en la calidad de vida / Symptoms of depression, anxiety and stress in health students and impact on quality of life / Sintomas de depressão, ansiedade e estresse em estudantes da saúde e impacto na qualidade de vida

Objetivo: evaluar la asociación entre la calidad de vida y la presencia de síntomas de depresión, ansiedad y estrés en estudiantes universitarios del área de la salud. Método: estudio transversal que incluyó a 321 estudiantes de carreras del área de la salud. La calidad de vida se midió mediante la escala de la Organización Mundial de la Salud, versión abreviada, en los dominios físico, psicológico, relaciones sociales y ambiente, y los síntomas se evaluaron por la escala de depresión, ansiedad y estrés. Se realizó un análisis multivariante por medio de regresión lineal robusta para evaluar la asociación entre la calidad de vida y los síntomas presentados. Resultados: se observó una asociación negativa entre la calidad de vida y los síntomas de depresión en todos los dominios, mientras que los síntomas de ansiedad tuvieron una asociación negativa en el dominio ambiente, y los síntomas de estrés tuvieron una asociación negativa en el dominio psicológico. La gravedad de los síntomas se asoció desfavorablemente con la calidad de vida, es decir, cuanto mayor la gravedad de los síntomas, menores las puntuaciones medias en todos los dominios. Conclusión: los síntomas de depresión, ansiedad y estrés fueron prevalentes e impactaron negativamente en la calidad de vida de los estudiantes, especialmente en presencia de síntomas depresivos. Las puntuaciones disminuidas se asociaron significativamente con la gravedad de los síntomas.

Objective: to evaluate the association between quality of life and presence of symptoms of depression, anxiety, and stress in college students in the health area. Method: cross-sectional study that included 321 students from undergraduate courses in the health area. Quality of life was measured using the World Health Organization scale, abbreviated version, in the physical, psychological, social relations and environment domains, and symptoms were assessed by the depression, anxiety and stress scale. Multivariate analysis was performed using robust linear regression to evaluate the association between quality of life and symptoms. Results: a negative association was observed between the quality of life and depression symptoms in all domains, while anxiety symptoms showed a negative association in the environment domain, and stress symptoms had a negative association in the psychological domain. Symptom severity was unfavorably associated with quality of life, that is, the greater the symptom severity, the lower the mean scores in all domains. Conclusion: symptoms of depression, anxiety, and stress were prevalent and had a negative impact on students' quality of life, especially in the presence of depressive symptoms. The decrease in scores was significantly associated with the severity of symptoms.

Objetivo: avaliar a associação entre qualidade de vida e presença de sintomas de depressão, ansiedade e estresse em estudantes universitários da área da saúde. Método: estudo transversal que incluiu 321 estudantes de cursos de graduação da área da saúde. A qualidade de vida foi mensurada por meio da escala da Organização Mundial da Saúde, versão abreviada, nos domínios físico, psicológico, relações sociais e meio ambiente, e os sintomas avaliados pela escala de depressão, ansiedade e estresse. Foi realizada análise multivariada utilizando regressão linear robusta para avaliar a associação entre qualidade de vida e sintomas apresentados. Resultados: observou- se associação negativa entre qualidade de vida e sintomas de depressão em todos os domínios, enquanto os sintomas de ansiedade apresentaram associação negativa no domínio meio ambiente, e os sintomas de estresse tiveram associação negativa no domínio psicológico. A gravidade dos sintomas associou-se de forma desfavorável com a qualidade de vida, ou seja, quanto maior a gravidade dos sintomas, menor a média dos escores em todos os domínios. Conclusão: sintomas de depressão, ansiedade e estresse mostraram-se prevalentes e com impacto negativo na qualidade de vida dos estudantes, principalmente na presença de sintomas depressivos. A diminuição dos escores foi significativamente associada à gravidade dos sintomas.

Long working hours and self-rated health in the national Brazilian working population: gender and employment status differences, 2019.

BACKGROUND: The regulation of working hours is governed by legal standards in formal employment. While the association between long working hours and various health outcomes has been extensively studied, there is limited evidence regarding Brazil. The objective of this study was to investigate the association among working hours, employment status, and self-rated health (SRH), taking into account differences between men and women in a national representative sample of the working population in Brazil. METHODS: A cross-sectional study was conducted among a representative sample of 33,713 workers in Brazil to assess self-rated health (SRH). We examined the associations between working hours and employment status, categorizing working hours as standard (40-44 h per week) or long (> 44 h per week), and employment status as formal or informal. Logistic regression models were employed, adjusting for sociodemographic, occupational characteristics, and health behaviors. Probabilities of negative SRH were calculated for men and women in different exposure profiles. Results were stratified by gender, and 95% confidence intervals (CIs) were applied to the findings. RESULTS: The prevalence of long working hours was higher among informal workers for both men and women. Adjusted odds ratio (AOR) results revealed that informal employment (AORwomen = 1.53; 95% CI: 1.13-2.07 and AORmen = 1.55; 95% CI: 1.22-1.96) and long working hours (AORwomen = 1.23; 95% CI: 1.06-1.43 and AORmen = 1.14; 95% CI: 1.00-1.30) were independently associated with negative SRH. Significant interactions between long working hours and informal employment were observed. Among individuals with the same exposure profile, women who engaged in long working hours had a higher probability of reporting negative SRH compared to men. CONCLUSIONS: The results of this study are in line with the literature, as differences between men and women in the likelihood of negative self-rated health were observed. The adverse health effects underscore the importance of implementing intersectoral actions to inform the revision of regulations concerning weekly working hours and the expansion of informal employment in low- and middle-income countries.

Symptoms of depression, anxiety and stress in health students and impact on quality of life. / Síntomas de depresión, ansiedad y estrés en estudiantes del área de la salud e impacto en la calidad de vida.

OBJECTIVE: to evaluate the association between quality of life and presence of symptoms of depression, anxiety, and stress in college students in the health area. METHOD: cross-sectional study that included 321 students from undergraduate courses in the health area. Quality of life was measured using the World Health Organization scale, abbreviated version, in the physical, psychological, social relations and environment domains, and symptoms were assessed by the depression, anxiety and stress scale. Multivariate analysis was performed using robust linear regression to evaluate the association between quality of life and symptoms. RESULTS: a negative association was observed between the quality of life and depression symptoms in all domains, while anxiety symptoms showed a negative association in the environment domain, and stress symptoms had a negative association in the psychological domain. Symptom severity was unfavorably associated with quality of life, that is, the greater the symptom severity, the lower the mean scores in all domains. CONCLUSION: symptoms of depression, anxiety, and stress were prevalent and had a negative impact on students' quality of life, especially in the presence of depressive symptoms. The decrease in scores was significantly associated with the severity of symptoms.

Influence of the COVID-19 pandemic on labor and childbirth care practices in Brazil: a cross-sectional study.

BACKGROUND: It has been hypothesized that the coronavirus disease 2019 (COVID-19) pandemic may have changed the conduct of obstetric practices at the time of labor, delivery, and birth. In Brazil, many practices lacking scientific evidence are implemented in this care, which is charcaterized by excessive use of unnecessary interventions. This scenario may have been worsened by the pandemic. Thus, we analyzed the effects of the pandemic on care during prenatal care and delivery by comparing the results of two surveys (one was administered before the pandemic and the other during the pandemic) in public hospitals in Belo Horizonte - Minas Gerais (MG), Brazil. METHODS: This cross-sectional and comparative study analyzed preliminary data from the study "Childbirth and breastfeeding in children of mothers infected with SARS-CoV-2", which was conducted in three referral maternity hospitals in Belo Horizonte - MG during the pandemic in the first half of 2020 in Brazil. The final sample consisted of 1532 eligible women. These results were compared with data from 390 puerperae who gave birth in the three public hospitals in the study "Birth in Belo Horizonte: labor and birth survey", conducted before the pandemic to investigate the changes in practices of labor and delivery care for the mother and her newborn, with or without COVID-19 infection, before and during the pandemic. In this research, "Birth in Belo Horizonte: labor and birth survey", data collection was performed between November 2011 and March 2013 by previously trained nurses. Between study comparisons were performed using Pearson's chi-square test, with a confidence level of 95%, and using Stata statistical program. RESULTS: We found a significant increase in practices recommended by the World Health Organization during the pandemic including the following: diet offering (48.90 to 98.65%), non-pharmacological pain relief (43.84 to 67.57%), and breastfeeding in the newborn´s first hour of life (60.31 to 77.98%) (p < 0.001). We found a significant reduction of non-recommended interventions, such as routine use of episiotomy (15.73 to 2.09%), the Kristeller maneuver (16.55 to 0.94%), oxytocin infusion misused (45.55 to 28.07%), amniotomy (30.81 to 15.08%), and lithotomy position during labor (71.23 to 6.54%) (p < 0.001). CONCLUSION: Our study revealed a statistically significant increase in the proportion of use of recommended practices and a reduction in non-recommended practices during labor and delivery. However, despite advances in the establishment of World Health Organization recommended practices in labor, delivery, and birth, the predominance of interventionist and medicalized practices persists, which is worsened by events, such as the pandemic.

[Self-rated health and factors related to the work of basic education's teachers in Brazil]. / Autoavaliação de saúde e fatores relacionados ao trabalho dos professores da educação básica no Brasil.

The scope of this article is to analyze the association between teachers' self-rated health and the conditions in which they work in Basic Education schools in Brazil. It involved a cross-sectional study, carried out between 2015 and 2016, representative of Basic Education teachers in the country, the outcome variable of which was self-rated health (SRH). The explanatory variables were the work-related characteristics. To assess the factors associated with SRH, the Proportional Odds Logistic Regression Model was used. The prevalence of poor SRH was 27%. The probability of poor SRH was significantly higher for the group that reported episodes of verbal violence (OR=1.26; 95%CI 1.09-1.44), work pressure (OR=1.18; 95%CI 1, 04-1.33), and a commute to school of more than 50 minutes (OR=1.19; 95%CI 1.03-1.38). The probability of poor SRH was significantly better for those who reported having enough time to complete their tasks (OR=0.77; 95%CI 0.64-0.92), social support (OR=0.79; 95%CI 0.69-0.89) and satisfaction with their workload (OR=0.79; 95%CI 0.69-0.91). Actions on the school environment and organization and improvements in the transport of teachers to work are desirable.

O objetivo deste artigo é analisar a associação entre a autoavaliação de saúde dos professores e as condições que eles encontram para trabalhar nas escolas da Educação Básica no Brasil. Estudo transversal, realizado entre 2015 e 2016, representativo dos professores da Educação Básica do País, cuja variável desfecho foi a autoavaliação de saúde (AAS). As variáveis explicativas foram as características relacionadas ao trabalho. Para avaliar os fatores associados à AAS foi utilizado o Modelo de Regressão Logística de Chances Proporcionais. A prevalência de AAS ruim foi de 27%. A probabilidade de pior AAS foi significativamente maior para o grupo que informou episódios de violência verbal (OR=1,26; IC95% 1,09-1,44), pressão laboral (OR=1,18; IC95% 1,04-1,33), e deslocamento para escola superior a 50 minutos (OR=1,19; IC95% 1,03-1,38). A probabilidade de pior AAS foi significativamente menor para aqueles que relataram dispor de tempo suficiente para cumprir suas tarefas (OR=0,77; IC95% 0,64-0,92), apoio social (OR=0,79; IC95% 0,69-0,89) e satisfação com o próprio trabalho (OR=0,79; IC95% 0,69-0,91). Ações sobre o ambiente e a organização escolar e melhorias no transporte dos professores para o trabalho são desejáveis.

Autoavaliação de saúde e fatores relacionados ao trabalho dos professores da educação básica no Brasil / Self-rated health and factors related to the work of basic education's teachers in Brazil

Resumo O objetivo deste artigo é analisar a associação entre a autoavaliação de saúde dos professores e as condições que eles encontram para trabalhar nas escolas da Educação Básica no Brasil. Estudo transversal, realizado entre 2015 e 2016, representativo dos professores da Educação Básica do País, cuja variável desfecho foi a autoavaliação de saúde (AAS). As variáveis explicativas foram as características relacionadas ao trabalho. Para avaliar os fatores associados à AAS foi utilizado o Modelo de Regressão Logística de Chances Proporcionais. A prevalência de AAS ruim foi de 27%. A probabilidade de pior AAS foi significativamente maior para o grupo que informou episódios de violência verbal (OR=1,26; IC95% 1,09-1,44), pressão laboral (OR=1,18; IC95% 1,04-1,33), e deslocamento para escola superior a 50 minutos (OR=1,19; IC95% 1,03-1,38). A probabilidade de pior AAS foi significativamente menor para aqueles que relataram dispor de tempo suficiente para cumprir suas tarefas (OR=0,77; IC95% 0,64-0,92), apoio social (OR=0,79; IC95% 0,69-0,89) e satisfação com o próprio trabalho (OR=0,79; IC95% 0,69-0,91). Ações sobre o ambiente e a organização escolar e melhorias no transporte dos professores para o trabalho são desejáveis.

Abstract The scope of this article is to analyze the association between teachers' self-rated health and the conditions in which they work in Basic Education schools in Brazil. It involved a cross-sectional study, carried out between 2015 and 2016, representative of Basic Education teachers in the country, the outcome variable of which was self-rated health (SRH). The explanatory variables were the work-related characteristics. To assess the factors associated with SRH, the Proportional Odds Logistic Regression Model was used. The prevalence of poor SRH was 27%. The probability of poor SRH was significantly higher for the group that reported episodes of verbal violence (OR=1.26; 95%CI 1.09-1.44), work pressure (OR=1.18; 95%CI 1, 04-1.33), and a commute to school of more than 50 minutes (OR=1.19; 95%CI 1.03-1.38). The probability of poor SRH was significantly better for those who reported having enough time to complete their tasks (OR=0.77; 95%CI 0.64-0.92), social support (OR=0.79; 95%CI 0.69-0.89) and satisfaction with their workload (OR=0.79; 95%CI 0.69-0.91). Actions on the school environment and organization and improvements in the transport of teachers to work are desirable.

Factors Associated With the Limitation at Work Because of the Voice: Study With Teachers of Basic Education In Brazil.

INTRODUCTION: The voice disorder can cause limitations at work, as it affects the communication and the performance of the teaching function. OBJECTIVE: To analyze the limitation at work because of the voice and to examine possible associations with sociodemographic characteristics, life and health habits and work conditions among Basic Education teachers in Brazil. METHODS: Cross-sectional epidemiological study, with a representative sample, carried out between October 2015 and March 2016, with 6,324 teachers working in Basic Education in Brazil. Data collection was carried out through the application of a questionnaire via telephone with questions regarding health and working conditions. The "limitation at work because of the voice" was considered a dependent variable, whose response options were a scale with four Likert items that varied from frequently to never. The independent variables were grouped in blocks for ordinal logistic regression analysis with hierarchical entry. The magnitude of the association was assessed by the Odds Ratio (OR) with the respective confidence intervals (95% CI). RESULTS: One third of Brazilian teachers (32.7%) reported some frequency of limitation at work (sometimes; rarely, frequently) because of the voice at some moment in the month before the survey and, of these, 5% declared high frequency. The factors that increased the chance of a greater frequency of limitation at work because of the voice were: being female (OR = 1.32; 95% CI = 1.15-1.51); teaching for elementary school (OR = 1.35; 95% CI = 1.02-1.78); use anxiolytic or antidepressant medications (OR = 1.46; 95% CI = 1.20-1.78); losing sleep due to concerns (OR = 1.69; CI = 95% = 1.46-1.95); high noise at school (OR = 2.09; 95% CI = 1.78-2.46); agitated environment by students' indiscipline (OR = 1.37; 95% CI =1.15-1.63); high demands at work (OR = 1.18; 95% CI = 1.02-1.36); not having social support (OR = 1.19; 95% CI = 1.04-1.38); having suffered verbal violence by the students (OR = 1.43; 95% CI = 1.23-1.67). On the other hand, the practice of regular physical activity (OR = 0.86; 95% CI = 0.75-1.00) and the fact of having enough time to complete work tasks (OR = 0.71; 95% CI = 0,62-0.82) decreased the chance of a higher frequency of limitation at work due to vocal problems. The perception that the work limits the teaching performance because of the voice was more frequent among teachers in the North (OR=1.41; 95% CI = 1.17-1.71) and Northeast (OR=1.46; 95% CI = 1.22-1.76) compared to the Southeast region. CONCLUSION: Factors associated with an increase in the chance of higher frequency of reporting work limitations due to the voice: being female, lack of physical activity, losing sleep due to concern, using anxiolytic or antidepressant medication, school location in the North and Northeast, teaching for the elementary school stage, high noise at school and psychosocial aspects of work organization. The Brazilian educational sector needs public policies that take into account regional inequalities and the health and work conditions of teachers.

Indicadores de saúde bucal e inserção no mercado de trabalho: estudo descritivo com dados da Pesquisa Nacional de Saúde, Brasil, 2019 / Oral health indicators and job market insertion: a descriptive study with data from the National Health Survey, Brazil, 2019

Resumo Objetivo: descrever três indicadores de saúde bucal - as proporções de perda dentária, de consulta ao dentista e de frequência de escovação dentária - segundo o tipo de inserção na força de trabalho, no ano de 2019. Métodos: estudo descritivo realizado com dados da Pesquisa Nacional de Saúde de 2019. Foram incluídos indivíduos empregados ou desempregados, com 18 anos ou mais. Foram calculados os indicadores de saúde bucal, assim como seus respectivos intervalos de confiança de 95% (IC95%). Resultados: a amostra foi composta por 54.343 trabalhadores, sendo 29.889 (53,9%) do sexo masculino. A proporção de perda de 13 ou mais dentes foi maior no setor informal [10,5% (IC95%: 9,8;11,2)]. A proporção de pessoas que não consultaram um dentista nos últimos 12 meses foi maior no setor informal [51,9% (IC95%: 50,8;53,0)] e entre os desempregados [52,4% (IC95%: 49,6;55,2)]. Menor frequência de escovação dentária foi observada no grupo com vínculo informal de emprego [5,2% (IC95%: 4,7;5,6)] e entre indivíduos do sexo masculino [7,5% (IC95%: 6,8;8,2)]. Conclusão: piores indicadores foram encontrados entre os trabalhadores do setor informal ou desempregados e foram observadas desigualdades entre os sexos.

Abstract Objective: to describe three oral health indicators-the proportions of tooth loss, dental visits, and toothbrushing frequency-according to job market insertion in 2019. Methods: a descriptive study with data from the 2019 Brazilian National Health Survey (PNS). We included individuals aged from 18 years or older, irrespective of employment status. We calculated the oral health indicators, as well as their respective 95% confidence intervals (95%CI). Results: the sample was composed by 54,343 workers, 29,889 (53.9%) being male. The proportion of 13 or more teeth loss was higher in the informal employment sector [10.5% (95%CI: 9.8;11.2)]. The proportion of people that did not consult a dentist in the previous 12 months was higher in the informal sector [51.9% (95%CI: 50.8;53.0)] and among unemployed [52.4% (95%CI: 49.6;55.2)]. Lower toothbrushing frequency was observed in the informal workers' group [5.2% (95%CI: 4.7;5.6)] and among male workers [7.5% (95%CI: 6.8;8.2)]. Conclusion: worse oral health indicators were found among informal and unemployed workers, in addition to gender inequalities.

Assessment of the quality of life and mental health of healthcare students during the COVID-19 pandemic / Evaluación de la calidad de vida y la salud mental de estudiantes de salud durante la pandemia de COVID-19 / Avaliação da qualidade de vida e saúde mental de estudantes da saúde durante a pandemia de COVID-19

ABSTRACT Objective: to evaluate the quality of life (QOL) and the presence of symptoms related to depression, anxiety, and stress among students in the healthcare field, in comparison to the period before the COVID-19 pandemic. Methods: A comparative cross-sectional research was conducted at a Brazilian public university. QOL was assessed using the WHOQOL-bref scale, while symptoms of depression, anxiety, and stress were evaluated using the DASS-21 scale. Descriptive and inferential analyses were employed to compare the two time periods. Results: A total of 355 students participated in this study. During the pandemic, there were significant increases in severe depression symptoms (15.1% versus 24.8%), moderate anxiety (18.3% versus 29.4%), and moderate stress (40.9% versus 53.8%) observed among the participants. Additionally, a significant reduction in QOL was noted, particularly in the domain of social relationships (65.2 versus 59.6, p-value 0.029). Conclusion: The study highlights a deterioration in both the quality of life and the mental health of healthcare students during the COVID-19 pandemic.

RESUMEN Objetivo: Evaluar la calidad de vida (CV) y la presencia de síntomas de depresión, ansiedad y estrés en estudiantes del área de la salud, en comparación con el período previo a la pandemia de COVID-19. Métodos: Investigación transversal comparativa realizada en una universidad pública brasileña. La CV se evaluó utilizando la escala WHOQOL-bref, mientras que los síntomas de depresión, ansiedad y estrés se evaluaron utilizando la escala DASS-21. Se emplearon análisis descriptivos e inferenciales para comparar los dos períodos. Resultados: Un total de 355 estudiantes participaron en este estudio. Durante la pandemia, se observaron aumentos significativos en los síntomas de depresión grave (15,1% versus 24,8%), ansiedad moderada (18,3% versus 29,4%) y estrés moderado (40,9% versus 53,8%) entre los participantes. Además, hubo una reducción significativa en la CV, especialmente en el ámbito de las relaciones sociales (65,2 versus 59,6, valor de p 0,029). Conclusión: Se evidenció un deterioro en tanto la calidad de vida como la salud mental de los estudiantes de salud durante la pandemia de COVID-19.

RESUMO Objetivo: Avaliar a qualidade de vida (QV) e a presença de sintomas de depressão, ansiedade e estresse em estudantes da área da saúde, em comparação ao período anterior à pandemia de COVID-19. Métodos: Pesquisa transversal comparativa em uma universidade pública brasileira. A QV foi avaliada por meio da escala WHOQOL-bref, enquanto os sintomas de depressão, ansiedade e estresse foram avaliados usando a escala DASS-21. Foram empregadas análises descritivas e inferenciais para comparar os dois períodos. Resultados: Um total de 355 estudantes participaram deste estudo. Durante a pandemia, foram observados aumentos significantes nos sintomas de depressão grave (15,1% versus 24,8%), ansiedade moderada (18,3% versus 29,4%) e estresse moderado (40,9% versus 53,8%) entre os participantes. Além disso, houve uma redução significativa na QV, especialmente no domínio das relações sociais (65,2 versus 59,6, p-valor 0,029). Conclusão: Evidenciou-se piora da QV e da saúde mental dos estudantes da saúde durante a pandemia de COVID-19.

Fatores preditivos para a cicatrização de úlceras da perna em pessoas com doença falciforme: coorte retrospectivo / Factors predictive of leg ulcer healing in people with sickle cell disease: a retrospective cohort / Factores predictivos de la cicatrización de úlceras de la pierna en personas con anemia falciforme: cohorte retrospectivo

Objetivo: identificar a taxa de cicatrização e os fatores preditivos para cura das úlceras da perna em pessoas com doença falciforme. Método: coorte retrospectivo, realizado de junho a agosto de 2020, em um serviço especializado de tratamento de pessoas com feridas, contemplando um período de nove anos, com amostra de 52 úlceras que atenderam os critérios de elegibilidade. Protocolo de pesquisa aprovado pelo comitê de ética. Resultados: a taxa de cicatrização foi 76,9%. Os fatores que contribuíram para cura em um menor tempo foram a não recidiva (HR= 3,03; IC 95%: 1,07-8,60) e extensão abaixo da mediana 7,25 cm2 (HR= 2,25; IC 95%: 1,19-4,27). Fatores para a não cicatrização foram: coberturas de alginato de cálcio (HR=0,29; IC 95%: 0,13-0,62), carvão com prata (HR=0,06; IC 95%: 0,02-0,21) e outras (HR=0,35; IC 95%: 0,15-0,80). Conclusão: a taxa de cicatrização da úlcera foi elevada. Recidiva, área da úlcera e determinadas coberturas podem influenciar no processo de cura.

Objective: to identify the healing rate and predictive factors for healing of leg ulcers in people with sickle cell disease. Method: retrospective cohort, carried out from June to August 2020, in a specialized service for the treatment of people with wounds, covering a period of nine years, with a sample of 52 ulcers that met the eligibility criteria. Research protocol approved by the ethics committee. Results: healing rate was 76.9%. The factors that contributed to cure in a shorter time were non-recurrence (HR= 3.03; 95% CI: 1.07-8.60) and extension below the median 7.25 cm2 (HR= 2.25; CI 95%: 1.19-4.27). Factors for non-healing were: calcium alginate dressings (HR=0.29; 95% CI: 0.13-0.62), charcoal with silver (HR=0.06; 95% CI: 0.02- 0.21) and others (HR=0.35; 95% CI: 0.15-0.80). Conclusion: the ulcer healing rate was high. Recurrence, ulcer area and certain dressings can influence the healing process.

Objetivo: identificar la tasa de curación y los factores predictivos para la curación de las úlceras en las piernas en pacientes con enfermedad de células falciformes. Método: cohorte retrospectiva, realizada de junio a agosto de 2020, en un servicio especializado para el tratamiento de personas con heridas, cubriendo un período de nueve años, con una muestra de 52 úlceras que cumplieron con los criterios de elegibilidad. Protocolo de investigación aprobado por el comité de ética. Resultados: La tasa de cicatrización fue del 76,9%. Los factores que contribuyeron a la curación en menor tiempo fueron la no recurrencia (HR= 3,03; IC 95%: 1,07-8,60) y extensión por debajo de la mediana de 7,25 cm2 (HR= 2,25; IC 95%: 1,19-4,27). Los factores de no cicatrización fueron: apósitos de alginato de calcio (HR=0,29; IC 95%: 0,13-0,62), carbón con plata (HR=0,06; IC 95%: 0,02-0,21) y otros (HR=0,35; IC 95%: 0,15-0,80). Conclusión: la tasa de curación de la úlcera fue alta. La recurrencia, el área de la úlcera y ciertos revestimientos pueden influir en el proceso de curación.

[Individual and contextual factors associated with smoking among young Brazilian adults]. / Fatores individuais e contextuais associados ao tabagismo em adultos jovens brasileiros.

Young people receive special attention regarding smoking as it is a period of life in which the use of this and other substances generally starts and is consolidated. There are no studies on risk factors associated with young adults with a representative sample from Brazil that take into consideration individual and contextual aspects. The objective was to identify factors associated with smoking among young Brazilian adults aged 18 to 24 years, considering the combined influence of individual and contextual factors assessed through the Municipal Human Development Index (MHDI). It involved a cross-sectional, population-based study that used data from the 2019 National Health Survey. Using the Poisson multilevel model with robust variance for estimating the Prevalence Ratio, individual variables were analyzed, and the MHDI as a contextual variable in each Federative Unit. In addition to individual factors, the MHDI was also associated with smoking among young people, with an increase in the prevalence of tobacco consumption among young people as the state's MHDI increases (p<0.001), indicating that living in a state with better conditions according to the MHDI, socioeconomic status is associated with a higher probability of young people smoking when compared to those residing in other states.

Aos jovens é atribuída especial atenção no que tange ao tabagismo por se tratar de um período da vida em que o uso dessa e outras substâncias geralmente inicia e se consolida. Não há estudos sobre fatores de risco associados aos adultos jovens, com amostra representativa do Brasil e que consideram aspectos individuais e contextuais. O objetivo foi identificar fatores associados ao tabagismo em adultos jovens brasileiros de 18 a 24 anos, considerando a influência conjunta de fatores individuais e contextual avaliado por meio do Índice de Desenvolvimento Humano Municipal (IDHM). Estudo transversal, de base populacional, que utilizou dados da Pesquisa Nacional de Saúde de 2019. Por meio do modelo multinível de Poisson com variâncias robustas para estimação da Razão de Prevalência, foram analisadas variáveis individuais, e como variável contextual, o IDHM em cada Unidade Federativa. Além de fatores individuais, o IDHM também se mostrou associado ao tabagismo dos jovens, com aumento da prevalência de consumo de tabaco entre os jovens à medida que se aumenta o IDHM do estado (p<0,001), indicando que residir em UF com melhores condições socioeconômicas segundo o IDHM está associado a maior probabilidade de o jovem fumar se comparados com aqueles que residem nos demais estados.

Fatores individuais e contextuais associados ao tabagismo em adultos jovens brasileiros / Individual and contextual factors associated with smoking among young Brazilian adults

Resumo Aos jovens é atribuída especial atenção no que tange ao tabagismo por se tratar de um período da vida em que o uso dessa e outras substâncias geralmente inicia e se consolida. Não há estudos sobre fatores de risco associados aos adultos jovens, com amostra representativa do Brasil e que consideram aspectos individuais e contextuais. O objetivo foi identificar fatores associados ao tabagismo em adultos jovens brasileiros de 18 a 24 anos, considerando a influência conjunta de fatores individuais e contextual avaliado por meio do Índice de Desenvolvimento Humano Municipal (IDHM). Estudo transversal, de base populacional, que utilizou dados da Pesquisa Nacional de Saúde de 2019. Por meio do modelo multinível de Poisson com variâncias robustas para estimação da Razão de Prevalência, foram analisadas variáveis individuais, e como variável contextual, o IDHM em cada Unidade Federativa. Além de fatores individuais, o IDHM também se mostrou associado ao tabagismo dos jovens, com aumento da prevalência de consumo de tabaco entre os jovens à medida que se aumenta o IDHM do estado (p<0,001), indicando que residir em UF com melhores condições socioeconômicas segundo o IDHM está associado a maior probabilidade de o jovem fumar se comparados com aqueles que residem nos demais estados.

Abstract Young people receive special attention regarding smoking as it is a period of life in which the use of this and other substances generally starts and is consolidated. There are no studies on risk factors associated with young adults with a representative sample from Brazil that take into consideration individual and contextual aspects. The objective was to identify factors associated with smoking among young Brazilian adults aged 18 to 24 years, considering the combined influence of individual and contextual factors assessed through the Municipal Human Development Index (MHDI). It involved a cross-sectional, population-based study that used data from the 2019 National Health Survey. Using the Poisson multilevel model with robust variance for estimating the Prevalence Ratio, individual variables were analyzed, and the MHDI as a contextual variable in each Federative Unit. In addition to individual factors, the MHDI was also associated with smoking among young people, with an increase in the prevalence of tobacco consumption among young people as the state's MHDI increases (p<0.001), indicating that living in a state with better conditions according to the MHDI, socioeconomic status is associated with a higher probability of young people smoking when compared to those residing in other states.

Impact of the COVID-19 Pandemic on Human Papillomavirus Vaccination in Brazil.

Objective: To analyze the number of applied HPV vaccine doses before (from April 2019 to March 2020) and after (from April 2020 to September 2020) social distancing measures in response to the COVID-19 pandemic in states and regions of Brazil. Methods: Ecological time-series study, using data from the Brazilian National Immunization Program (PNI). Using the Mann-Whitney test, we evaluated the difference between the median number of applied doses during the periods April 2019 to March 2020 and from April 2020 to September 2020. Spatial analysis identified clusters with a high or low percentage reduction in the median applied doses. Prais-Winsten regression models identified temporal trends in the applieddoses from both periods. Results: There was a significant reduction in the median HPV vaccine doses applied, formation of spatial clusters and, after a sharp drop in the number of applieddoses during the months following social distancing. There was a tendency to increase the applied vaccines doses. Conclusion: The COVID-19 pandemic resulted in reduction of the number of HPV vaccine doses applied as a possible effect of restrictive measures caused by the pandemic.

Criteria to evaluate the quality of alginate wound dressings.

OBJECTIVES: to validate an instrument with criteria to evaluate the quality of calcium alginate wound dressings to treat skin injuries. METHODS: methodological study, developed in two stages: the elaboration of criteria to evaluate the quality of the alginate wound dressing based on literature; validation of these criteria by a group of evaluators in two moments. Data was analyzed using descriptive statistics, central tendency measures and the Content Validity Index. RESULTS: seven articles were selected, leading to the elaboration of 7 criteria and 11 expected results. The Content Validity Index was 0.98 in stage 1 and 0.93 in stage 2. After adjustments, 8 criteria were validated, and 13 results were expected. FINAL CONSIDERATIONS: the study allowed the validation of criteria to evaluate the quality of calcium alginate wound dressings, helping the nurses to choose with more autonomy and assertiveness.

Materiais e medicamentos com validade expirada, gerenciamento e desafios / Materials and medicines with expired validity, management and challenges

Objetivo: conhecer o gerenciamento de resíduos de serviços de saúde oriundos de materiais hospitalares e medicamentos descartados devido à data de validade expirada, em um hospital universitário. Método: trata-se de um estudo quantitativo, descritivo, transversal, a ser realizado em um hospital universitário. Coletar-se-ão os dados por meio de consulta ao banco de dados e formulários restritos do cenário de estudo. Investigar-se-ão as seguintes variáveis: descrição do resíduo; período de destinação final; custo do produto e da destinação final; quantidade e local de geração. Organizar-se-ão os dados em planilhas de Excel, analisando-os pelo software Statistical Package for the Social Sciences, versão 19. Realizar-se-á o estudo após a aprovação dos Comitês de Ética responsáveis. Resultados esperados: pretendem-se obter informações que subsidiem a intervenção por meio de planejamento, monitoramento e avaliação logística de todos os processos da gestão de resíduos de serviços de saúde.(AU)

Criteria to evaluate the quality of alginate wound dressings / Criterios para evaluación de la calidad de coberturas de alginato en tratamiento de heridas / Critérios para avaliação da qualidade de coberturas de alginato no tratamento de feridas

ABSTRACT Objectives: to validate an instrument with criteria to evaluate the quality of calcium alginate wound dressings to treat skin injuries. Methods: methodological study, developed in two stages: the elaboration of criteria to evaluate the quality of the alginate wound dressing based on literature; validation of these criteria by a group of evaluators in two moments. Data was analyzed using descriptive statistics, central tendency measures and the Content Validity Index. Results: seven articles were selected, leading to the elaboration of 7 criteria and 11 expected results. The Content Validity Index was 0.98 in stage 1 and 0.93 in stage 2. After adjustments, 8 criteria were validated, and 13 results were expected. Final Considerations: the study allowed the validation of criteria to evaluate the quality of calcium alginate wound dressings, helping the nurses to choose with more autonomy and assertiveness.

RESUMEN Objetivos: validar un instrumento con criterios para evaluación de la calidad de coberturas de alginato de calcio para tratamiento de herida cutánea. Métodos: estudio metodológico, desarrollado en dos etapas: elaboración de criterios para evaluación de la calidad de la cobertura de alginato basándose en la literatura; validación de esos criterios por grupo de jueces en dos momentos. Los datos fueron analizados por estadística descriptiva, medidas de tendencia central e Índice de Validez de Contenido. Resultados: seleccionaron 7 artículos que respaldaron la elaboración de 7 criterios y 11 resultados esperados. El Índice de Validez de Contenido fue 0,98 en la etapa 1 y 0,93 en la etapa 2. Después de ajustes, fueron validados 8 criterios y 13 resultados esperados. Consideraciones Finales: el estudio permitió validar criterios para evaluación de la calidad de las coberturas de alginato de calcio, encaminando la elección de los enfermeros con mayor autonomía y asertividad.

RESUMO Objetivos: validar um instrumento com critérios para avaliação da qualidade de coberturas de alginato de cálcio para tratamento de ferida cutânea. Métodos: estudo metodológico, desenvolvido em duas etapas: elaboração de critérios para avaliação da qualidade da cobertura de alginato baseando-se na literatura; validação desses critérios por grupo de juízes em dois momentos. Osdados foram analisados por estatística descritiva, medidas de tendência central e Índice de Validação de Conteúdo. Resultados: selecionaram-se 7 artigos que respaldaram a elaboração de 7 critérios e 11 resultados esperados. O Índice de Validação de Conteúdo foi 0,98 na etapa 1 e 0,93 na etapa 2. Após ajustes, foram validados 8 critérios e 13 resultados esperados. Considerações Finais: o estudo permitiu validar critérios para avaliação da qualidade das coberturas de alginato de cálcio, direcionando a escolha dos enfermeiros com maior autonomia e assertividade.

Factors associated to alcohol use by adolescents / Factores asociados al consumo de alcohol por parte de adolescentes / Fatores associados ao uso de álcool por adolescentes

ABSTRACT Objective to analyze the association between alcohol use by adolescents and environmental, family and social relations factors. Method and epidemiological study, of the cross-sectional cohort type, with a sample consisting of 303 students from the Brazilian 9thgrade of elementary level of public and private schools in Divinópolis, Minas Gerais, Brazil. Data was collected through the replication of the "General Information" and "Use of Alcohol" modules from the National Survey of School Health - 2015. The answer variable was alcohol consumption in life, associating it with explanatory variables related to: living with parents, maternal schooling, administrative dependency of the school, alcohol use by friends, and future perspectives. Univariate and multivariate analyses were used using Pearson's chi-square tests and Poisson's model for robust variances. Results an association was found in the multivariate analysis between consumption of beverages and intending to study only until high school or technical school (p=0.007), continuing to study and work (p=0.003), not living with parents (p=0.010), and having friends who make use alcohol (p=0.009). Conclusion social relationships were the most relevant factor for alcohol consumption by adolescents, mainly influenced by friends who use it and by the interpersonal relationships established by them.

RESUMEN Objetivo analizar la asociación entre el consumo de alcohol por parte de adolescentes y los factores ambientales, familiares y de relaciones sociales. Método estudio epidemiológico de coorte transversal, con una muestra constituida por 303 estudiantes del 9º año do enseñanza fundamental de escuelas públicas y privadas de Divinópolis, Minas Gerais, Brasil. Los datos se recolectaron por medio de la replicación de los módulos de "Información general" y "Consumo de Alcohol" de la Investigación Nacional de Salud Escolar - 2015. La variable de respuesta fue el consumo de alcohol en la vida, asociándola a las variables explicativas relacionadas con lo siguiente: vivir con los padres, escolaridad materna, dependencia administrativa de la escuela, consumo de alcohol en amigos y perspectivas a futuro. Se empleó análisis univariado y multivariado por medio de las pruebas de chi-cuadrado de Pearson y el modelo de Poisson para las varianzas robustas. Resultados se obtuvo una asociación en el análisis multivariado entre consumir bebidas alcohólicas y tener pensado estudiar solamente hasta el nivel medio o técnico (p= 0,007), seguir estudiando y trabajar (p=0,003), no vivir con los padres (p=0,010) y tener amigos que consumen alcohol (p=0,009). Conclusión las relaciones sociales fueron el factor más relevante para el consumo de alcohol por parte de los adolescentes, influenciado principalmente por los amigos que lo consumen y por las relaciones interpersonales por ellos establecidas.

RESUMO Objetivo analisar a associação entre uso de álcool por adolescentes e os fatores ambientais, familiares e de relações sociais. Método estudo epidemiológico, de coorte transversal, com amostra constituída por 303 estudantes do 9º ano do ensino fundamental de escolas públicas e particulares de Divinópolis, Minas Gerais, Brasil. Os dados foram coletados por meio da replicação dos módulos "Informações Gerais" e "Uso de Álcool" da Pesquisa Nacional de Saúde do Escolar - 2015. A variável resposta foi consumo de álcool na vida, associando-a a variáveis explicativas relacionadas com: morar com os pais, escolaridade materna, dependência administrativa da escola, uso de álcool por amigos e perspectivas futuras. Utilizou-se de análise univariada e multivariada por meio dos testes de qui-quadrado de Pearson e modelo de Poisson para as variâncias robustas. Resultados obteve-se associação na análise multivariada entre fazer uso de bebidas e pretender estudar apenas até o ensino médio ou técnico (p=0,007), continuar a estudar e trabalhar (p= 0,003), não morar com os pais (p=0,010) e ter amigos que fazem uso de álcool (p= 0,009). Conclusão as relações sociais foram o fator mais relevante para o uso de álcool por adolescentes, influenciado principalmente pelos amigos que fazem o uso e as relações interpessoais estabelecidas por eles.

Reproducibility of the alcoholic beverages and illicit drug modules of the 2015 National Survey of School Health. / Reprodutibilidade dos módulos bebidas alcoólicas e drogas ilícitas da Pesquisa Nacional de Saúde do Escolar 2015.

OBJECTIVE: To evaluate the reproducibility of the modules of use of alcoholic beverages and illicit drugs of the 2015 National Survey of School Health. METHOD: Cross-sectional epidemiological study aimed at evaluating the reproducibility of collection instruments, conducted in the city of Divinópolis, Minas Gerais. The sample consisted of students attending the 9th grade of public and private primary schools in 2017. The reproducibility of the modules of use of alcohol and illicit drugs was applied to the sample and the retest occurred within 15 to 20 days with the same students. In the analysis of the test-retest agreement, the Kappa coefficient was used to analyze the nominal categorical variables; Kappa with linear weighting, in the analysis of ordinal categorical variables; and Intraclass Correlation Coefficient in the analysis of numerical variables. RESULTS: Participation of 303 students. The agreement of responses was between satisfactory and moderate and there was no indicator with reasonable or poor agreement. Frequencies were close between the test-retest. CONCLUSION: The analyzed modules were satisfactory and considered replicable and reliable sources to support Public Policies and programs aimed at adolescents.

Compliance to safety barriers in the medication administration process in pediatrics / Adherencia a las barreras de seguridad en el proceso de administración de medicamentos en pediatría / Adesão às barreiras de segurança no processo de administração de medicamentos na pediatria

ABSTRACT Objective: to investigate the compliance to safety barriers adopted in the preparation and administration of intravenous drugs in Pediatric and Pediatric Intensive Care Units. Method: exploratory, observational descriptive study, conducted with the nursing team of a pediatric intensive care unit and a pediatric clinic of a large public hospital in Belo Horizonte, from August to November 2017. Results: the sample consisted of 334 opportunities to observe the preparation and administration of medications in pediatric patients. Most of the actions were performed by female professionals, nursing technicians and civil servants. The professionals did not perform all the necessary safety barriers in any of the procedures. The hygiene of the preparation site, disinfection of the ampoule, connection, conference of the drug/dose/route administered with the prescription and double checking of the drugs were those that had the lowest compliance. Conclusion: the study highlights the fragility regarding compliance to safety barriers in the preparation and administration of medicines, resulting in a risk to the safety of hospitalized children. Continued education based on good practice is believed to be an important strategy for security.

RESUMEN Objetivo: investigar la adherencia a las barreras de seguridad adoptadas en la preparación y administración de fármacos intravenosos en unidades de cuidados intensivos pediátricos y pediátricos. Método: estudio exploratorio, observacional, descriptivo realizado con el equipo de enfermería de una Unidad de Cuidados Intensivos Pediátricos y una clínica pediátrica en un gran hospital público de Belo Horizonte, en el período de agosto del nuevo 2017. Resultados: la muestra consistió en 334 oportunidades para observar la preparación y administración de medicamentos en pacientes pediátricos. La mayoría de las acciones fueron realizadas por mujeres profesionales, técnicas de enfermería y candidatas. En ninguno de los procedimientos el profesional realizó todas las barreras de seguridad necesarias. Las acciones de higiene del sitio de preparación, desinfección de la ampolla, conexión, control del medicamento / dosis / vía administrada con la prescripción y doble control de los medicamentos fueron los que tuvieron menor adherencia. Conclusión: el estudio apunta a la fragilidad en la adherencia a las barreras de seguridad en la preparación y administración de medicamentos, lo que se traduce en un riesgo para la seguridad de los niños hospitalizados. Se cree que la educación continua basada en buenas prácticas es una estrategia importante para la seguridad.

RESUMO Objetivo: investigar a adesão das barreiras de segurança adotadas no preparo e na administração de medicamentos endovenosos em unidades de Pediatria e Terapia Intensiva Pediátrica. Método: estudo descritivo exploratório, observacional, realizado com a equipe de enfermagem de uma Unidade de Terapia Intensiva Pediátrica e uma clínica pediátrica de um hospital público de grande porte de Belo Horizonte, no período de agosto a novembro de 2017. Resultados: a amostra foi constituída por 334 oportunidades de observação do preparo e administração de medicamentos em pacientes pediátricos. A maior parte das ações foi realizada por profissionais do sexo feminino, técnicos de enfermagem e concursados. Em nenhum dos procedimentos o profissional executou todas as barreiras de segurança necessárias. As ações de higienização do local do preparo, desinfecção da ampola, conexão, conferência do medicamento/dose/via administrada com a prescrição e checagem dupla dos medicamentos foram as que tiveram menor adesão. Conclusão: o estudo aponta para a fragilidade quanto à adesão das barreiras de segurança no preparo e na administração de medicamentos, resultando em risco para a segurança das crianças hospitalizadas. Acredita-se que a educação continuada pautada nas boas práticas seja uma estratégia importante para a segurança.