Contaminação pelo Covid-19 em profissionais de hospital de referência no Pará / Contamination by Covid-19 in professionals of a reference hospital in Para's state / Contaminación por Covid-19 en profesionales de un hospital de referencia del estado de Pará

A pandemia do novo coronavírus colocou em alerta os sistemas de saúde, estabelecendo sentimentos de instabilidade e de medo. O trabalho é e importante pilar para o traçado de políticas públicas. Objetivo: analisar a contaminação pelo COVID-19 em profissionais de hospital de referência no Pará. Metodologia: Trata-se de estudo retrospectivo, quantitativo, observacional, com aplicação de série temporal no período de março de 2020 a março de 2022. Foram incluídos todos os servidores atuantes durante a pandemia, que apresentaram atestados médicos com diagnóstico de COVID, e/ou testagem positiva, ou atestados por suspeita de contaminação. O perfil de servidores foi analisado, explorando as variáveis sexo, idade, convivência ou não com parceiros, grau de escolaridade, cargo e setor; juntamente com a incidência de casos confirmados e incidência total (suspeitos e confirmados). Resultados: O total de afastamentos do trabalho devido ao diagnóstico de COVID-19 foi de 1.420 casos, mais 839 casos suspeitos; sendo que 173 trabalhadores apresentaram reincidência. A incidência foi maior nos meses de maio de 2020, março de 2021 e janeiro de 2022. Houve predominância do sexo feminino e da categoria de enfermagem. Setores administrativos e financeiros apresentaram maior porcentagem de contaminados durante a pandemia (73,40%), proporcionalmente ao quantitativo de servidores atuantes na lotação. Entretanto, foram servidores da assistência direta ao paciente que apresentaram maior porcentagem de reinfecção. Conclusão: Foi possível visualizar três ondas na distribuição temporal dos casos de COVID-19, com destaque para elevação nos primeiros meses de 2022. O declínio no diagnóstico de casos novos no hospital estudado após dois anos de pandemia pode representar esforços individuais e coletivos em resistir às dificuldades da conjuntura. É importante observar o comportamento da pandemia em distintas regiões do Brasil para atualização de estratégias de enfrentamento como um todo.

The new coronavirus pandemic has put health systems on alert, establishing feelings of instability and fear. Working is an important pillar for the design of public policies. Objective: to analyze the contamination by COVID-19 in professionals of a reference hospital in Para's State. Methodology: This is a retrospective, quantitative, observational study, with the application of a time series from March 2020 to March 2022. All civil servants working during the pandemic, who presented medical certificates with a diagnosis of COVID, and/or or positive test, or attestations for suspected contamination. The servants' profile was analyzed, exploring the variables sex, age, living or not with partners, education level, position and sector; along with the incidence of confirmed cases and total incidence (suspected and confirmed). Results: The total number of absences from work due to the diagnosis of COVID-19 was 1,420 cases, plus 839 suspected cases; 173 workers presented recurrence. The incidence was higher in the months of May 2020, March 2021 and January 2022. There was a predominance of females and the nursing category. Administrative and financial sectors had a higher percentage of people infected during the pandemic (73.40%), proportionally to the number of servers working in the capacity. However, it was direct patient care workers who had the highest percentage of reinfection. Conclusion: It was possible to visualize three waves in the temporal distribution of COVID-19 cases, with emphasis on an increase in the first months of 2022. The decline in the diagnosis of new cases in the hospital studied after two years of the pandemic may represent individual and collective efforts to resist to the difficulties of the situation. It is important to observe the behavior of the pandemic in different regions of Brazil to update coping strategies in a general scenery.

La nueva pandemia de coronavirus ha puesto en alerta a los sistemas de salud, estableciendo sentimientos de inestabilidad y miedo. El trabajo es un pilar importante para el diseño de políticas públicas. Objetivo: analizar la contaminación por COVID-19 en profesionales de un hospital de referencia en el Estado de Pará. Metodología: Se trata de un estudio retrospectivo, cuantitativo, observacional, con la aplicación de una serie de tiempo de marzo de 2020 a marzo de 2022. Todos los funcionarios que trabajaron durante la pandemia, que presentaron certificados médicos con diagnóstico de COVID, y/o o test positivo, o atestados por sospecha de contaminación. Se analizó el perfil de los funcionarios, explorando las variables sexo, edad, convivencia o no con la pareja, nivel de escolaridad, cargo y sector; junto con la incidencia de casos confirmados y la incidencia total (sospechosos y confirmados). Resultados: El número total de bajas laborales por diagnóstico de COVID-19 fue de 1.420 casos, más 839 casos sospechosos; 173 trabajadores presentaron recurrencia. La incidencia fue mayor en los meses de mayo de 2020, marzo de 2021 y enero de 2022. Hubo predominio del sexo femenino y de la categoría de enfermería. Los sectores administrativo y financiero presentaron mayor porcentaje de infectados durante la pandemia (73,40%), proporcionalmente al número de servidores que trabajaban en esa función. Sin embargo, fueron los trabajadores de atención directa al paciente los que presentaron el mayor porcentaje de reinfección. Conclusiones: Fue posible visualizar tres olas en la distribución temporal de los casos de COVID-19, destacándose un aumento en los primeros meses de 2022. La disminución en el diagnóstico de nuevos casos en el hospital estudiado después de dos años de pandemia puede representar esfuerzos individuales y colectivos para resistir a las dificultades de la situación. Es importante observar el comportamiento de la pandemia en diferentes regiones de Brasil para actualizar las estrategias de afrontamiento en un escenario general.

O impacto da pandemia da Covid-19 na saúde mental de estudantes universitários / The impact of the Covid-19 pandemic on the mental health of university students / El impacto de la pandemia de Covid-19 en la salud mental de los estudiantes universitarios

A pandemia pelo SARS-CoV-2 é um dos maiores desafios sanitários em escala global. Devido estado de emergência, uma série de medidas de controle e prevenção foram adotadas, como distanciamento social e redução das reuniões públicas. Nesse cenário, buscou-se avaliar a saúde mental de estudantes de uma instituição privada de Ensino Superior diante da pandemia. Esta pesquisa trata-se de um estudo transversal descritivo desenvolvido na Faculdade do Vale do Jaguaribe, localizada em Aracati-CE. A coleta de dados ocorreu de dezembro de 2020 a fevereiro de 2021, utilizando formulário eletrônico contendo variáveis sociodemográficas, epidemiológicas e relativas aos diferentes aspectos da saúde mental do estudante frente a pandemia da COVID-19. A análise foi baseada no cálculo de frequências absolutas e relativas das variáveis além de medidas de tendência central e dispersão. Dos 333 discentes que participaram do estudo, a média de idade foi 25, com variação entre 18 e 56 anos, sendo maioria do sexo feminino (72,7%), autodenominação de cor/etnia parda (72,7%) e não estarem trabalhando (53,8%). A taxa de positividade entre os graduandos para COVID-19 foi de 9% (30). Ao serem questionados sobre como a pandemia alterou seus níveis de estresse ou saúde mental, 75,5% responderam que houve piora. Dentre os sintomas mais relatados no período da quarentena, estavam medo e ansiedade (ambos com 74,2%), seguidos por insegurança (69,7%). Baseados nos achados deste estudo, recomenda-se a incorporação de ações multiprofissionais na atenção aos estudantes dentro da academia. Sugere-se a implantação de um serviço qualificado buscando desenvolver um olhar holístico para os discentes.

The SARS-CoV-2 pandemic has presented itself as one of the greatest health challenges on a global scale. Given the state of public health emergency, a series of control and prevention measures have been adopted, such as social distancing and reduction of public meetings, as in universities. Faced with this scenario, we sought to evaluate the mental health of students from a private institution of Higher Education in the face of the COVID-19 pandemic. Thus, this research was a descriptive cross-sectional study developed at the Faculdade do Vale do Jaguaribe, located in the City of Aracati- CE. Data collection occurred from December 2020 to February 2021, using an electronic form containing sociodemographic and epidemiological variables, as well as variables related to the repercussions in different aspects of the student's mental health when facing the pandemic of COVID-19. The analysis was based on the calculation of absolute and relative frequencies of the variables, as well as measures of central tendency and dispersion. Of the 333 students who participated in the study, the mean age was 25 years, with ages ranging from 18 to 56 years, the majority being female (72.7%), self- denominated as Brown (72.7%), not working when answering the form (53.8%). The positivity rate among undergraduates for COVID-19 was 9% (30/333). When asked how the pandemic altered their stress levels or mental health, 75.5% responded that it had worsened. Among the symptoms most reported by students during the quarantine period were fear and anxiety (both 74.2%), followed by insecurity (69.7%). It is suggested the implementation of a qualified approach service seeking to develop a holistic look for the students.

La pandemia por SARS-CoV-2 es uno de los mayores desafíos sanitarios a escala global. Debido al estado de emergencia, se han adoptado una serie de medidas de control y prevención, como el distanciamiento social y la reducción de reuniones públicas. En este escenario, se buscó evaluar la salud mental de los estudiantes de una institución privada de educación superior frente a la pandemia. Esta investigación es un estudio descriptivo transversal desarrollado en la Facultad de Valle de Jaguaribe, ubicada en Aracati-CE. La recopilación de datos se llevó a cabo de diciembre de 2020 a febrero de 2021, utilizando un formulario electrónico que contiene variables sociodemográficas, epidemiológicas y relacionadas con los diferentes aspectos de la salud mental del estudiante frente a la pandemia de COVID-19. El análisis se basó en el cálculo de frecuencias absolutas y relativas de las variables, además de medidas de tendencia central y dispersión. De los 333 estudiantes que participaron en el estudio, la media de edad fue de 25 años, con variación entre 18 y 56 años, siendo la mayoría del sexo femenino (72,7%), autodenominación de la raza / etnia morena (72,7%) y no trabajando (53,8%). La tasa de positividad entre los estudiantes de pregrado para COVID-19 fue del 9% (30). Cuando se les preguntó cómo la pandemia había alterado su nivel de estrés o salud mental, el 75,5% respondió que había empeorado. Entre los síntomas más comunes durante el período de cuarentena, se encontraban el miedo y la ansiedad (ambos con un 74,2%), seguidos de la inseguridad (69,7%). Basados en los resultados de este estudio, se recomienda la incorporación de acciones multiprofesionales en la atención a los estudiantes dentro de la academia. Se sugiere la implementación de un servicio calificado que busque desarrollar una mirada holística hacia los estudiantes.

Prevalence of tuberculosis, COVID-19, chronic conditions and vulnerabilities among migrants and refugees: an electronic survey / Prevalência de tuberculose, COVID-19, condições crônicas e vulnerabilidades entre migrantes e refugiados: inquérito eletrônico / Prevalencia de tuberculosis, COVID-19, condiciones crónicas y vulnerabilidades en inmigrantes y refugiados: encuesta electrónica

Abstract Objective: to analyze the prevalence of tuberculosis, coronavirus, chronic conditions and vulnerabilities among migrants and refugees in Brazil. Method: this is a cross-sectional study of the electronic survey type conducted with international migrants during the COVID-19 pandemic. Descriptive statistics was applied for the analysis, with calculation of position and dispersion measures. Regarding the categorical variables, relative and absolute frequencies were estimated. Results: the study participants were 553 migrants and refugees, verifying 3.07%, 7.2% and 27.3% prevalence of tuberculosis, COVID-19 and chronic conditions, respectively. Among the vulnerabilities, 32% reported unemployment, 37.6% moved to Brazil as a result of the social situation in their countries and 33.6% were living as refugees or sheltered people. Conclusion: tuberculosis, chronic diseases and COVID-19 presented higher prevalence values in migrants and refugees than in the general population. As this is a population group that still has significant difficulty accessing health services and social protection systems, based on diverse evidence, the study will subsidize public policies, Nursing care and the incorporation of new routines in the service.

Resumo Objetivo: analisar a prevalência de tuberculose, coronavírus, condições crônicas e vulnerabilidades entre migrantes e refugiados no Brasil. Método: trata-se de estudo transversal, do tipo inquérito eletrônico, realizado com migrantes internacionais durante a pandemia de COVID-19. Para a análise, aplicou-se estatística descritiva, com cálculo de medidas de posição e de dispersão. Quanto às variáveis categóricas, estimaram-se as frequências relativas e absolutas. Resultados: participaram do estudo 553 migrantes e refugiados, verificando-se prevalência de 3,07% de tuberculose, 7,2% de COVID-19 e 27,3% de condições crônicas. Entre as vulnerabilidades, 32% referiram desemprego, 37,6% mudaram para o Brasil em decorrência da situação social do seu país e 33,6% residiam em asilo e ou abrigo. Conclusão: a tuberculose, as doenças crônicas e a COVID-19 apresentaram maior prevalência em migrantes e refugiados que na população em geral. Por tratar-se de uma população ainda com grande dificuldade de acesso aos serviços de saúde e aos sistemas de proteção social, o estudo subsidiará, com base em evidências, as políticas públicas, o atendimento do enfermeiro e a incorporação de novas rotinas no serviço.

Resumen Objetivo: analizar la prevalencia de tuberculosis, coronavirus, condiciones crónicas y vulnerabilidades en inmigrantes y refugiados en Brasil. Método: se trata de un estudio transversal, del tipo encuesta electrónica, realizado con migrantes internacionales durante la pandemia de COVID-19. Para el análisis se aplicó estadística descriptiva, con cálculo de medidas de posición y dispersión. En cuanto a las variables categóricas, se estimaron las frecuencias relativas y absolutas. Resultados: participaron del estudio 553 inmigrantes y refugiados, la prevalencia de tuberculosis era del 3,07%, de COVID-19 del 7,2% y de condiciones crónicas del 27,3%. Entre las vulnerabilidades, el 32% reportó desempleo, el 37,6% emigró a Brasil por la situación social de su país y el 33,6% vivía en un asilo o albergue. Conclusión: la tuberculosis, las enfermedades crónicas y el COVID-19 fueron más prevalentes en inmigrantes y refugiados que en la población general. Por tratarse de una población que aún tiene grandes dificultades para acceder a los servicios de salud y sistemas de protección social, el estudio contribuirá, con base en la evidencia, a las políticas públicas, la atención de enfermería y la incorporación de nuevas rutinas en el servicio.

The impact of the COVID-19 pandemic on sleep disorders among Nursing professionals / O impacto da pandemia de COVID-19 nas alterações do sono de profissionais de enfermagem / Impacto de la pandemia de COVID-19 en los trastornos del sueño de profesionales de enfermería

Abstract Objective: to analyze the factors related to sleep disorders reported by Nursing professionals during the COVID-19 pandemic. Method: this is a cross-sectional and analytical study conducted with Nursing professionals from all Brazilian regions. Sociodemographic data, working conditions and questions about sleep disorders were collected. The Poisson regression model with repeated measures was used to estimate the Relative Risk. Results: 572 answers were analyzed, which revealed that non-ideal sleep duration, poor sleep quality and dreams about the work environment were predominant during the pandemic, with 75.2%, 67.1% and 66.8% respectively; as well as complaints of difficulty sleeping, daytime sleepiness and non-restorative sleep during the pandemic were reported by 523 (91.4%), 440 (76.9%) and 419 (73.2%) of the Nursing professionals, respectively. The relative risk of having such sleep disorders during the pandemic was significant for all variables and categories studied. Conclusion: non-ideal sleep duration, poor sleep quality, dreams about the work environment, complaints regarding difficulty sleeping, daytime sleepiness and non-restorative sleep were the predominant sleep disorders among Nursing professionals during the pandemic. Such findings point to possible consequences on health, as well as on the quality of the work performed.

Resumo Objetivo: analisar os fatores relacionados às alterações no sono relatadas pelos profissionais de enfermagem durante a pandemia de COVID-19. Método: trata-se de um estudo transversal e analítico, realizado com profissionais de enfermagem de todas as regiões do Brasil. Foram coletados dados de caracterização sociodemográfica, condições de trabalho e questões sobre alterações de sono. Para estimar o Risco Relativo foi utilizado o modelo de regressão de Poisson com medidas repetidas. Resultados: foram analisadas 572 respostas, as quais revelaram que a duração não ideal do sono, a má qualidade do sono e os sonhos com o ambiente de trabalho foram predominantes durante a pandemia, com 75,2%, 67,1% e 66,8% respectivamente, assim como as queixas de dificuldade ao dormir, sonolência diurna e sono não restaurador durante a pandemia foram relatadas por 523 (91,4%), 440 (76,9%) e 419 (73,2%) dos profissionais de enfermagem, respectivamente. O risco relativo de apresentar tais alterações de sono, durante a pandemia foi significativo para todas as variáveis e as categorias estudadas. Conclusão: duração não ideal do sono, má qualidade do sono, sonhos com o ambiente de trabalho, queixas de dificuldade ao dormir, sonolência diurna e sono não restaurador foram as alterações do sono predominantes entre os profissionais de enfermagem durante a pandemia. Estes achados apontam para possíveis consequências na saúde, bem como na qualidade do trabalho realizado.

Resumen Objetivo: analizar los factores relacionados con los trastornos del sueño que informaron los profesionales de enfermería durante la pandemia de COVID-19. Método: se trata de un estudio transversal y analítico realizado con profesionales de enfermería de todas las regiones de Brasil. Se recolectaron datos sobre caracterización sociodemográfica, condiciones de trabajo y preguntas sobre trastornos del sueño. Para estimar el Riesgo Relativo se utilizó el modelo de regresión de Poisson con medidas repetidas. Resultados: se analizaron 572 respuestas, que revelaron que durante la pandemia predominaron la duración del sueño no ideal, la mala calidad del sueño y los sueños sobre el ambiente laboral, con 75,2%, 67,1% y 66,8% respectivamente, además 523 (91,4%), 440 (76,9%) y 419 (73,2%) profesionales de enfermería manifestaron quejas de dificultad para conciliar el sueño, somnolencia diurna y sueño no reparador durante la pandemia, respectivamente. El riesgo relativo de padecer trastornos del sueño durante la pandemia fue significativo para todas las variables y categorías estudiadas. Conclusión: la duración del sueño no ideal, la mala calidad del sueño, los sueños sobre el ambiente laboral, las quejas de dificultad para conciliar el sueño, la somnolencia diurna y el sueño no reparador fueron los trastornos del sueño predominantes en los profesionales de enfermería durante la pandemia. Estos hallazgos indican posibles consecuencias para la salud, así como para la calidad del trabajo realizado.

Safety of nursing professionals and patient facing COVID-19 pandemic in critical care unit / Segurança dos profissionais de enfermagem e do paciente frente à pandemia da COVID-19 em unidades críticas / Seguridad de los profesionales de enfermería y del paciente ante la pandemia de COVID-19 en unidades críticas

Abstract Objective: to evaluate nursing professionals and patient safety culture during the professional performance in the care of suspected or infected patients with COVID-19. Method: a cross-sectional study carried out with 90 professionals from critical care units of two teaching hospitals. An instrument for sociodemographic characterization and health conditions was used, in addition to the constructs "Nursing professional and patient safety" and the Hospital Survey on Patient Safety Culture. Univariate analyzes were performed between the diagnosis of COVID-19 and the characteristics of Nursing professionals, applying Kendell's correlation between the constructs. Results: the COVID-19 diagnosis presented a significant statistical difference between nursing professionals that worked for more than six years at the critical care unit (p=0.020) and the items of the construct "Nursing professional and patient safety" regarding the doubts about how to remove the personal protective equipment (p=0.013) and safety flow (p=0,021). The dimensions 2 (p=0.003), 3 (p=0.009), 4 (p=0.013), 6 (p<0.001), and 9 (p=0.024) of the Hospital Survey on Patient Safety Culture were associated with the accomplishment of training. Conclusion: a higher professional nursing experience time was associated with non-infection by COVID-19. The perception of the safety culture of the patient was related to the accomplishment of training.

Resumo Objetivo: avaliar a segurança dos profissionais de enfermagem e a cultura de segurança do paciente durante a atuação profissional no atendimento de pacientes suspeitos ou com COVID-19. Método: estudo transversal realizado com 90 profissionais de unidades críticas de dois hospitais-escola. Foi utilizado um instrumento para caracterização sociodemográfica e condições de saúde, além dos constructos "Segurança do profissional e do paciente" e Hospital Survey on Patient Safety Culture. Foram realizadas análises univariadas entre o diagnóstico de COVID-19 e as características dos profissionais, aplicando-se a correlação de Kendell entre os constructos. Resultados: o diagnóstico de COVID-19 apresentou diferença estatisticamente significativa entre os profissionais que trabalhavam há mais de seis anos na unidade (p=0,020) e os itens do constructo "Segurança do profissional e do paciente" referentes às dúvidas sobre como retirar o equipamento de proteção individual (p=0,013) e fluxo seguro (p=0,021). As dimensões 2 (p=0,003), 3 (p=0,009), 4 (p=0,013), 6 (p<0,001) e 9 (p=0,024) do Hospital Survey on Patient Safety Culture foram associadas à realização de treinamentos. Conclusão: maior tempo de experiência profissional do profissional de enfermagem esteve associado a não infecção por COVID-19. A percepção de cultura de segurança do paciente esteve relacionada à realização de treinamentos.

Resumen Objetivo: evaluar la seguridad de los profesionales de enfermería y la cultura de seguridad del paciente durante su actuación profesional en el cuidado de pacientes sospechosos o con COVID-19. Método: estudio transversal realizado con 90 profesionales de unidades críticas de dos hospitales universitarios. Se utilizó un instrumento de caracterización sociodemográfica y de condiciones de salud, además de los constructos "Seguridad del profesional y del paciente" y Hospital Survey on Patient Safety Culture. Se realizaron análisis univariados entre el diagnóstico de COVID-19 y las características de los profesionales y se aplicó la correlación de Kendell entre los constructos. Resultados: el diagnóstico de COVID-19 mostró diferencia estadísticamente significativa entre los profesionales que actuaron por más de seis años en la unidad (p=0,020) y los ítems del constructo "Seguridad del profesional y del paciente" referentes a dudas sobre cómo retirar el Equipo de Protección Personal (p=0,013) y flujo seguro (p=0,021). Las dimensiones 2 (p=0,003), 3 (p=0,009), 4 (p=0,013), 6 (p<0,001) y 9 (p=0,024) del Hospital Survey on Patient Safety Culture se asociaron a la realización de formación. Conclusión: mayor tiempo de experiencia profesional de enfermería se asoció con la no infección por COVID-19. La percepción de la cultura de seguridad del paciente se relacionó con la realización de entrenamiento.

Lesiones cutáneas asociadas con el uso de respiradores N95 en profesionales de la salud de Brasil durante 2020 / Skin lesions associated with the use of N95 respirators among health professionals in Brazil in 2020 / Lesões de pele associadas ao uso de respiradores N95 entre profissionais de saúde no Brasil em 2020

Objetivo: investigar la prevalencia de lesiones cutáneas y factores asociados con el uso de respiradores N95 en profesionales de la salud de Brasil. Método: estudio transversal realizado con 11.368 profesionales de la salud en el que se empleó un método de muestreo dirigido por encuestados adaptado para entornos en línea. Se ejecutaron análisis univariados y multivariados para investigar la asociación entre la variable "lesiones cutáneas por utilizar respiradores N95" y sexo, categoría profesional, lugar de trabajo, capacitación, diagnóstico de COVID-19 y disponibilidad de suficiente provisión de Equipo de Protección Personal de buena calidad. Resultados: la prevalencia de lesiones cutáneas fue del 61,8%. Las mujeres fueron 1,203 veces (IC 95%: 1,154-1,255) más propensas a desarrollar lesiones que los hombres. La probabilidad de lesiones cutáneas en psicólogos (RP=0,805; IC 95%: 0,678-0,956) y dentistas (RP=0,884; IC 95%: 0,788-0,992) fue menor en comparación con la encontrada en los profesionales de Enfermería. Los profesionales con diagnóstico positivo de COVID-19 y que trabajan en la Unidad de Cuidados Intensivos son más propensos a sufrir lesiones cutáneas (RP=1,074; IC 95%: 1,042-1,107); (RP=1,203; IC 95%: 1,168-1,241), respectivamente, Conclusión: la prevalencia de lesiones cutáneas causadas por utilizar respiradores N95 fue del 61,8% y estuvo asociada al sexo femenino, a la categoría profesional, al lugar de trabajo, a la capacitación, a diagnóstico de COVID-19 y a la disponibilidad de suficiente provisión de Equipo de Protección Personal de buena calidad.

Objective: to investigate the prevalence of skin lesions and factors associated with the use of N95 respirators among health professionals in Brazil. Method: cross-sectional study conducted with 11,368 health professionals using a respondent-driven sampling method adapted for online environments. Univariate and multivariate analyses were performed to investigate the association between the "skin lesions with the use of N95 respirators" variable and gender, professional category, workplace, training, COVID-19 diagnosis, and availability of sufficient and high-quality Personal Protective Equipment. Results: the prevalence of skin lesions was 61.8%. Women were 1.203 times (95% CI: 1.154-1.255) more likely to develop a lesion than men. The chances of skin lesions in psychologists (PR=0.805; 95% CI: 0.678-0.956) and dentists (PR=0.884; 95% CI: 0.788-0.992), were lower when compared to Nursing professionals. Professionals with a positive COVID-19 diagnosis and working in the Intensive Care Unit have an increased chance of presenting skin lesions (PR=1.074; 95% CI: 1.042-1.107); (PR=1.203; 95% CI: 1.168-1.241), respectively. Conclusion: the prevalence of skin lesions caused by the use of N95 respirators was 61.8% and was associated with female gender, professional category, workplace, training, COVID-19 diagnosis, and availability of sufficient and highquality Personal Protective Equipment.

Objetivo: investigar a prevalência de lesões de pele e fatores associados ao uso de respiradores N95 entre profissionais de saúde no Brasil. Método: estudo transversal realizado com 11.368 profissionais de saúde por meio de um método de amostragem dirigido por respondentes adaptado para ambientes online. Análises univariadas e multivariadas foram realizadas para investigar a associação entre a variável "lesão de pele com uso de respirador N95" e sexo, categoria profissional, local de trabalho, treinamento, diagnóstico de COVID-19 e disponibilidade suficiente de equipamentos de proteção individual de qualidade. Resultados: a prevalência de lesões cutâneas foi de 61,8%. As mulheres foram 1,203 vezes (IC 95%: 1.154-1.255) mais propensas a desenvolver uma lesão do que os homens. As chances de lesão de pele em psicólogos (RP=0,805; IC 95%: 0,678-0,956) e dentistas (RP=0,884; IC 95%: 0,788-0,992) foram menores quando comparados aos profissionais de Enfermagem. Profissionais com diagnóstico positivo para COVID-19 e que trabalham em Unidade de Cuidados Intensivos têm maior chance de apresentar lesões de pele (RP=1,074; IC 95%: 1,042-1,107); (RP=1,203; IC 95%: 1,168- 1,241), respectivamente. Conclusão: a prevalência de lesões de pele causadas pelo uso do respirador N95 foi de 61,8% e esteve associada ao sexo feminino, categoria profissional, local de trabalho, treinamento, diagnóstico de COVID-19 e disponibilidade suficiente de equipamentos de proteção individual de qualidade.

Impact of visiting restrictions on Edinburgh postnatal depression scale screening scores at one month postpartum during the spread of COVID-19: a single-center case-control study in Japan.

BACKGROUND: This study aimed to evaluate whether "visiting restrictions" implemented due to the coronavirus disease 2019 (COVID-19) pandemic are a risk factor for postpartum depression using the Edinburgh Postnatal Depression Scale (EPDS). METHODS: This case-control study participants who gave birth during the spread of COVID-19 (COVID-19 study group) and before the spread of COVID-19 (control group). Participants completed the EPDS at 2 weeks and 1 month after childbirth. RESULTS: A total of 400 cases (200 in each group) were included in this study. The EPDS positivity rate was significantly lower with visiting restrictions than without (8.5% vs.18.5%, p = 0.002). Multivariate analysis of positive EPDS screening at the 1st month checkup as the objective variable revealed that visiting restrictions (odds ratio (OR): 0.35, 95% confidence interval (CI): 0.18-0.68), neonatal hospitalization (OR: 2.17, 95% CI: 1.08-4.35), and prolonged delivery (OR: 2.87, 95% CI: 1.20-6.85) were factors associated with an increased risk of positive EPDS screening. CONCLUSION: Visiting restrictions on family during the hospitalization period for delivery during the spread of COVID-19 pandemic did not worsen EPDS screening scores 1 month postpartum, but stabilized the mental state of some mothers.

Regulation of biomedical waste management in Kazakhstan during the pandemic in the context of best practices.

The COVID-19 pandemic actualized questions about the proper management of biomedical waste while creating several regulatory challenges and requiring countries to look for an appropriate response. These issues have become particularly relevant for Kazakhstan, where waste management issues traditionally face inefficient legal regulation and are particularly acute. This study aims to answer the question of what regulatory problems Kazakhstan currently face in the area of proper biomedical waste management, and how existing foreign experience can help solve them. The present study highlights several pertinent challenges within the context of medical waste management. These include issues concerning the licencing activities associated with waste management, the absence of well-defined regional plans for the management of medical waste and the lack of effective strategies to address the proper handling and disposal of this specific category of waste. At the same time, there are reasons to say that the country requires additional technical and expert support in the field of medical waste management.

Mammography screening beliefs and barriers through the lens of Black women during the COVID-19 pandemic.

BACKGROUND: Mammography is an effective screening tool that leads to decreased breast cancer mortality, yet minority women continue to experience barriers. The coronavirus disease 2019 (COVID-19) pandemic has been proven to have negatively affected minority communities, yet its effect on mammography screening habits in Black women is uncertain. The purpose of this study was to evaluate breast cancer mammography screening habits and barriers for Black women in two northeast communities amid the COVID-19 pandemic. METHODS: The study participants were Black women aged 40 years or older who were recruited from community outreach initiatives. Study coordinators conducted telephone surveys to determine mammography screening behaviors, perceptions, and psychosocial factors. RESULTS: Two hundred seventy-seven surveys were completed. Two hundred fifty-six patients who reported ever having a mammogram became the study population of interest. One hundred seventy-four of these patients (68%) reported having a mammogram within the past year (nondelayed), and 82 (32%) had a mammogram more than a year ago (delayed). Only thirty-one of the delayed participants (37.8%) had private insurance. There was a significant difference in the mean score for mammography screening perceived barriers for nondelayed participants (mean = 9.9, standard deviation [SD] = 3.6) versus delayed participants (mean = 11.2, SD = 4.3, p = .03). There was also a significant difference in the mean score when they were asked, "How likely is it that 'other health problems would keep you from having a mammogram'?" (p = .002). CONCLUSIONS: Barriers to mammography screening for Black women during the COVID-19 era include insurance, competing health issues, and perceptions of screening. Community outreach efforts should concentrate on building trust and collaborating with organizations to improve screening despite the COVID-19 pandemic.

A New Experience in the Turkish Health System in Response to COVID-19.

OBJECTIVE: A substantial amount of work addressing strategies on how to respond to the coronavirus disease (COVID-19) crisis already exists. However, there is simply not enough evidence to support a systematic and all-encompassing approach. This study aims to systematically review and present the roadmap of Turkiye's response to COVID-19. METHODS: This study is based on a thematic content analysis of official policy documents to present the roadmap in Turkiye's fight against COVID-19. The analysis included 46 press releases accessed from the Ministry of Health's website. The coding structure was created by the researchers based on the literature. Documents were analyzed by dividing them into 3 periods: the panic period, the controlled normalization period, and the normalization period. Each document was sub-coded under the main themes of "concerns" and "strategies" and interpreted by comparing them with each other. RESULTS: The study results show that different categories and coding structures were formed between periods. Some categories that emerged under the theme of concerns were "vaccine concerns" and "social concerns." Similarly, some categories that appeared under the theme of strategies were "vaccine strategies," "monitoring and surveillance strategies," and "intervention strategies." CONCLUSION: The results provide policy-makers with an appropriate conceptual framework to deal with the pandemic crisis that may be encountered in the future.

Navigating the Storm: An Exquisite Leadership Insight into Healthcare Management amidst the COVID-19 Pandemic.

This article presents a reflective analysis of the role of public leadership within the context of crises, advocating for increased involvement of public health experts in crisis management. The study delves into the intricate dynamics that executives and board members exhibit when faced with crises. A primary focus of this research is the essential aspects that illuminate the engagement of public officials in the ongoing crisis, notably rapid decision-making and innovative thinking. The article underscores the paramount importance of leaders emphasizing values and mission while employing clear, meaningful, and empathetic communication. A comprehensive comprehension of public leadership emerges as a pivotal factor in crisis management, particularly when devising policy remedies for public health emergencies. The criticality of nurturing a new generation of healthcare CEOs and elevating the visibility of public health roles is underscored as an imperative for adeptly addressing the array of crises confronting us. This article broadens our insights into the multifaceted responsibilities of human resource management in both crisis response and recovery. Consequently, this endeavor facilitates the identification of evolving leadership roles essential for efficacious crisis management, fostering preparedness for prospective public health challenges.

Impact of the educational program "Igiene Insieme"in 1,991 Italian primary schools: student behavior and incidence of SARS-CoV-2.

OBJECTIVE: To evaluate the impact of the health educational program "Igiene Insieme 2021/2022" on Italian primary school children's knowledge, attitudes and practice of hygiene and sanitation and to compare incidence of SARS-CoV-2 in schools participating the project with regional data of Lombardy and Apulia. METHODS: Participating schools were provided with a hygiene kit containing educational material for teachers and sanitizing products for students. We conducted a pre-post evaluation administering a questionnaire before and after the intervention. In addition, we compared SARS-CoV-2 incidence of the participating primary schools (225 in Lombardy and 120 in Apulia) to regional-level data. We tested the differences between groups by using the Chi-squared test. RESULTS: Of 1,991 schools, 472 responded to both questionnaires for a total of 16,988 students. 17.3% of the students learned the importance of handwashing in preventing infections, 22.6% when to wash hands, 18.5% the existence of alternative solutions in absence of soap and water, 23.2% how to correctly wash hands. A lower incidence of SARS-CoV-2 infections was recorded in primary schools participating in the project as compared to the average regional incidence in Lombardy (9.6% vs.14.8%) and Apulia (10.7% vs.12.0%) for the same age group. CONCLUSIONS: We report an overall positive effect of health education interventions in primary schools. Although the limitations in the study design, our findings are important to inform planning, implementation and monitoring of health promotion campaigns in young generations so as to contribute to limit the risk of infection spread at the community level.

Delays in cancer diagnosis: challenges and opportunities in Europe.

BACKGROUND AND AIM: Early cancer diagnosis is a public health priority, but large proportions of patients are diagnosed with advanced disease or as an emergency, even in countries with universal healthcare coverage. The study aimed at examining factors contributing to diagnostic delays and inequalities in cancer care, discussing challenges and opportunities for improving the diagnosis of cancer. METHODS: We performed a critical review of the literature examining factors contributing to delays and inequalities in cancer diagnosis, published between 2019-2023, in Europe with a specific focus on Italy. RESULTS: Disparities in screening, cancer diagnosis and treatment have been reported in many European countries, with poorer outcomes for some population sub-groups. For example, some Northern regions in Italy have six-times higher screening participation versus Southern regions. In 2019 36% of the Italian population aged 50-74 reported colorectal cancer screening, higher than the EU average (33%), but lower than in countries like Denmark (>60%). In Italy, the EU country with the largest percentage of people aged 65+, incident cancers are expected to rise by 19.6% over two decades. Older age is also associated with multimorbidity, with physical and mental health morbidities possibly affecting cancer diagnostic pathways. For example, colon cancer patients with pre-existing mental health conditions were 28% less likely to have a prompt colonoscopy when presenting with red-flag symptoms, according to recent UK research. Covid-19 has exacerbated pre-existing inequalities, with reductions in scheduled surgery and oncological treatments, especially affecting women, older and less educated individuals. CONCLUSIONS: For ensuring appropriate care, it is crucial to better understand how different factors, including physical and mental health morbidities, impact cancer diagnosis. The "NextGenerationEU" program and the "National Recovery and Resilience Plan" (PNNR in Italy) following the Covid-19 pandemic offer opportunities for reducing inequalities, improving cancer care and chronic disease management for ageing populations.

The Changing Landscape of Global Child Health Education in the United States and the Effects of the COVID-19 Pandemic and Civil Unrest.

The events of recent years have affected the landscape of global child health education (GCHE) in the United States. War, racism, forced displacement, and the coronavirus disease 2019 (COVID-19) pandemic had global repercussions that reached US GCHE. The aim of this article is to examine the effect of these events on the landscape of GCHE in the US. Key areas of GCHE have been reframed, reshaped, and accelerated by these events. Travel restrictions accelerated virtual learning opportunities. Core curriculum needed to be reconsidered to address antiracism, equity, and decolonization. Expansion of GCHE activities, including local-global electives, was needed to meet increased resident demand and help address local community needs. Inequities in international partnerships were further highlighted, requiring new approaches. Global research education and practices were also affected with a rapid expansion in virtual opportunities and further development of education in equitable research practices. [Pediatr Ann. 2023;52(9):e324-e329.].

A new time-varying coefficient regression approach for analyzing infectious disease data.

Since the beginning of the global pandemic of Coronavirus (SARS-COV-2), there has been many studies devoted to predicting the COVID-19 related deaths/hospitalizations. The aim of our work is to (1) explore the lagged dependence between the time series of case counts and the time series of death counts; and (2) utilize such a relationship for prediction. The proposed approach can also be applied to other infectious diseases or wherever dynamics in lagged dependence are of primary interest. Different from the previous studies, we focus on time-varying coefficient models to account for the evolution of the coronavirus. Using two different types of time-varying coefficient models, local polynomial regression models and piecewise linear regression models, we analyze the province-level data in Canada as well as country-level data using cumulative counts. We use out-of-sample prediction to evaluate the model performance. Based on our data analyses, both time-varying coefficient modeling strategies work well. Local polynomial regression models generally work better than piecewise linear regression models, especially when the pattern of the relationship between the two time series of counts gets more complicated (e.g., more segments are needed to portray the pattern). Our proposed methods can be easily and quickly implemented via existing R packages.

Unleashing the link between the relaxation of the COVID-19 control policy and residents' mental health in China: the mediating role of family tourism consumption.

Objective: COVID-19 has negatively influenced industrial development, family consumption, and residents' mental health. Unfortunately, it has not yet been studied whether this adverse situation can be alleviated after the relaxation of the COVID-19 control policy (RCC). Therefore, this study aimed to analyze the effect of the RCC on the resident's mental health and the mediating effect of family tourism consumption. Methods: By using the PSM and mediating effetc model to research the panel data of two periods (April 2021 and April 2023) for Shaanxi province, China. Results: The RCC negatively inhibited the mental health severity of residents, and the mental health severity decreased by 0.602. In particular, the RCC showed the most substantial negative effect on residents' stress, followed by anxiety and depression. Meanwhile, it is found that the impact of the RCC on the mental health of residents is highly heterogeneous. The RCC indicates a linear significant effect on the mental health of residents under 60 years of age, while the results were found insignificant for residents above 60 years of age. Meanwhile, the RCC's improvement effect on urban residents' mental health is greater than that of rural residents. In addition, mechanism analysis showed that tourism consumption plays a mediating role in the influence of the RCC on the mental health of residents, and the mediating effect accounted for 24.58% of the total effect. Conclusion: Based on the findings, the study proposes that government and policymakers should strengthen mental health intervention, improve access to mental health counseling, stimulate economic development, expand the employment of residents, and track the mutation of the novel coronavirus.

COVID-19 and cognitive performance: a Mendelian randomization study.

Background: A substantial proportion of individuals with COVID-19 experienced cognitive impairment after resolution of SARS-CoV-2 infection. We aimed to evaluate whether genetic liability to SARS-CoV-2 infection per se, or more severe COVID-19, is causally linked to cognitive deficit. Methods: We firstly performed univariable Mendelian randomization (MR) analysis to examine whether genetic liability to SARS-CoV-2 infection, hospitalized and severe COVID-19 is causally associated with cognitive performance. To dissect the causal pathway, multivariable MR (MVMR) analysis was conducted by adjusting for five inflammatory markers [C-reactive protein, interleukin (IL)-1ß, IL-6, IL-8, and tumour necrosis factor α, as proxies of systemic inflammation]. Results: In univariable MR analysis, host genetic liability to SARS-CoV-2 infection was associated with lower cognitive performance [inverse variance weighted (IVW) analysis, estimate: -0.023; 95% Confidence Interval (CI): -0.038 to -0.009]. Such causal association was attenuated in MVMR analysis when we adjusted for the five correlated inflammatory markers in one analysis (IVW analysis, estimate: -0.022; 95% CI: -0.049 to 0.004). There was insufficient evidence of association for genetic liability to hospitalized and severe COVID-19 with cognitive performance. Conclusion: The causal effect of host genetic liability to SARS-CoV-2 infection on reduced cognitive performance may be mediated by systemic inflammation. Future studies examining whether anti-inflammatory agents could alleviate cognitive impairment in SARS-CoV-2-infected individuals are warranted.

Dengue in Timor-Leste during the COVID-19 phenomenon.

Dengue is a significant public health problem in mostly tropical countries, including Timor-Leste. Dengue continues to draw attention from the health sector during the COVID-19 phenomenon. Therefore, the goal of this study is to evaluate the dengue incidence rate in comparison with the COVID-19 cumulative number and associated dengue risk factors, including the fatality rate of dengue infection in each municipality during the COVID-19 phenomenon in Timor-Leste, by applying the data processing program in Geographic Information Systems (GIS). A descriptive study using GIS was performed to provide a spatial-temporal mapping of dengue cases. Secondary data, which were sourced from the Department of Health Statistics Information under the Ministry of Health Timor-Leste, were collected for the period during the COVID-19 outbreak in 2020-2021. These data were grounded at the municipal (province) level. Quantum GIS and Microsoft Excel were used to analyze the data. During the COVID-19 outbreak (2020-2021), dengue spread nationwide. It was found that there was an increase in municipalities with high dengue cases and cumulative COVID-19 numbers. The high number of dengue cases associated with the COVID-19 cumulative number found in municipalities with an urban characteristic and in terms of severity, dengue fever (DF) is most commonly reported with a total of 1,556 cases and is followed by dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). Most cases were reported in the months of the monsoon season, such as December, January, and March. Dengue GIS mapping helps understand the disease's presence and dynamic nature over time.

Racial and ethnic disparities in telehealth use before and after California's stay-at-home order.

Introduction: Telehealth can potentially improve the quality of healthcare through increased access to primary care. While telehealth use increased during the COVID-19 pandemic, racial/ethnic disparities in the use of telemedicine persisted during this period. Little is known about the relationship between health coverage and patient race/ethnicity after the onset of the COVID-19 pandemic. Objective: This study examines how differences in patient race/ethnicity and health coverage are associated with the number of in-person vs. telehealth visits among patients with chronic conditions before and after California's stay-at-home order (SAHO) was issued on 19 March 2020. Methods: We used weekly patient visit data (in-person (N = 63, 491) and telehealth visits (N = 55, 472)) from seven primary care sites of an integrated, multi-specialty medical group in Los Angeles County that served a diverse patient population between January 2020 and December 2020 to examine differences in telehealth visits reported for Latino and non-Latino Asian, Black, and white patients with chronic conditions (type 2 diabetes, pre-diabetes, and hypertension). After adjusting for age and sex, we estimate differences by race/ethnicity and the type of insurance using an interrupted time series with a multivariate logistic regression model to study telehealth use by race/ethnicity and type of health coverage before and after the SAHO. A limitation of our research is the analysis of aggregated patient data, which limited the number of individual-level confounders in the regression analyses. Results: Our descriptive analysis shows that telehealth visits increased immediately after the SAHO for all race/ethnicity groups. Our adjusted analysis shows that the likelihood of having a telehealth visit was lower among uninsured patients and those with Medicaid or Medicare coverage compared to patients with private insurance. Latino and Asian patients had a lower probability of telehealth use compared with white patients. Discussion: To address access to chronic care management through telehealth, we suggest targeting efforts on uninsured adults and those with Medicare or Medicaid coverage, who may benefit from increased telehealth use to manage their chronic care.

Enhancing the Predictive Power of Google Trends Data Through Network Analysis: Infodemiology Study of COVID-19.

BACKGROUND: The COVID-19 outbreak has revealed a high demand for timely surveillance of pandemic developments. Google Trends (GT), which provides freely available search volume data, has been proven to be a reliable forecast and nowcast measure for public health issues. Previous studies have tended to use relative search volumes from GT directly to analyze associations and predict the progression of pandemic. However, GT's normalization of the search volumes data and data retrieval restrictions affect the data resolution in reflecting the actual search behaviors, thus limiting the potential for using GT data to predict disease outbreaks. OBJECTIVE: This study aimed to introduce a merged algorithm that helps recover the resolution and accuracy of the search volume data extracted from GT over long observation periods. In addition, this study also aimed to demonstrate the extended application of merged search volumes (MSVs) in combination of network analysis, via tracking the COVID-19 pandemic risk. METHODS: We collected relative search volumes from GT and transformed them into MSVs using our proposed merged algorithm. The MSVs of the selected coronavirus-related keywords were compiled using the rolling window method. The correlations between the MSVs were calculated to form a dynamic network. The network statistics, including network density and the global clustering coefficients between the MSVs, were also calculated. RESULTS: Our research findings suggested that although GT restricts the search data retrieval into weekly data points over a long period, our proposed approach could recover the daily search volume over the same investigation period to facilitate subsequent research analyses. In addition, the dynamic time warping diagrams show that the dynamic networks were capable of predicting the COVID-19 pandemic trends, in terms of the number of COVID-19 confirmed cases and severity risk scores. CONCLUSIONS: The innovative method for handling GT search data and the application of MSVs and network analysis to broaden the potential for GT data are useful for predicting the pandemic risk. Further investigation of the GT dynamic network can focus on noncommunicable diseases, health-related behaviors, and misinformation on the internet.