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2.
Rev. enferm. UERJ ; 28: e50360, jan.-dez. 2020.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1097275

RESUMO

Objetivo: descrever as recomendações sobre o uso racional e seguro dos equipamentos de proteção individual (EPI) no transcorrer da cadeia assistencial de pessoas com suspeita ou confirmação de contaminação pelo novo coronavírus. Conteúdo: o novo coronavírus é responsável pela doença Covid-19, e dentre as pessoas com maior risco de desenvolver a infecção estão os trabalhadores de saúde, devido ao contato muito próximo a pacientes. Desse modo, a utilização de EPI é recomendação prioritária a estes trabalhadores. Todavia, em função do desabastecimento internacional e nacional relacionado a estes equipamentos, o uso racional é fundamental a fim de evitar que o impacto do desabastecimento seja ainda maior. Conclusão: o uso de EPI é indispensável aos trabalhadores de saúde durante a pandemia de Covid-19, contudo, é imprescindível coordenar a cadeia de fornecimento destes insumos, implementar estratégias que minimizem a necessidade de EPI e garantir o uso de maneira adequada.


Objective: to describe the recommendations on the rational, safe use of personal protective equipment (PPE) throughout the chain of care for people with suspected or confirmed contamination by the new coronavirus. Content: the new coronavirus is responsible for the disease Covid-19, and among those at high risk of infection are health workers in very close contact with patients. It is thus a priority recommendation for these workers to use PPE. However, international and national shortages of this equipment make rational use essential in order to prevent even greater impact from these shortages. Conclusion: it is essential that health workers use PPE during the Covid-19 pandemic, but it is also essential to coordinate the supply chain for these inputs, implement strategies that minimize the need for PPE and ensure proper use.


Objetivo: describir las recomendaciones sobre el uso racional y seguro del equipo de protección personal (EPP) en toda la cadena de atención para las personas con sospecha o confirmación de contaminación por el nuevo coronavirus. Contenido: el nuevo coronavirus es responsable de la enfermedad de Covid-19, y entre aquellos con alto riesgo de infección se encuentran los trabajadores de la salud en contacto muy cercano con los pacientes. Por lo tanto, es una recomendación prioritaria para estos trabajadores usar EPP. Sin embargo, la escasez internacional y nacional de este equipo hace que el uso racional sea esencial para evitar un impacto aún mayor de esta escasez. Conclusión: es esencial que los trabajadores de la salud usen EPP durante la pandemia de Covid-19, pero también es esencial coordinar la cadena de suministro para estos insumos, implementar estrategias que minimicen la necesidad de EPP y garantizar un uso adecuado.


Assuntos
Infecções por Coronavirus/prevenção & controle , Equipamento de Proteção Individual/provisão & distribução , Betacoronavirus , Máscaras/provisão & distribução , Riscos Ocupacionais , Contenção de Riscos Biológicos/normas , Equipamento de Proteção Individual/normas , Máscaras/normas
3.
Rev. bioét. derecho ; (50): 5-17, nov. 2020.
Artigo em Espanhol | IBECS | ID: ibc-191343

RESUMO

La epidemia de la COVID-19 ha puesto en primer plano tensiones entre valores que se sintetizan en un dilema ético-político clásico: "seguridad-libertad" o "la salud como bien común-la salvaguarda de las libertades individuales". Al tratarse de una emergencia sociosanitaria, las medidas para su contención implican costes y sacrificios. También restricciones de derechos y libertades básicas. Determinar quién tiene que cargar con los costes se convierte en una cuestión acuciante con implicaciones morales. En este artículo, se plantea un ejercicio de filosofía aplicada a la salud pública en ocasión de esta pandemia y, a su vez, una genealogía de la relación entre la salud y la solidaridad basada en la máxima ciceroniana salus populi suprema lex esto


The COVID-19 epidemic has brought to the fore tensions between values that are synthesized in a classic ethical-political dilemma: "security-freedom" or "health as a common good-the safeguard of individual liberties". As it is a socio-sanitary emergency, the measures for its containment involve costs and sacrifices. Also, restrictions on basic rights and freedoms. Determining who has to bear the costs and what their magnitude should be becomes a pressing question with moral implications. In this article, an exercise in philosophy applied to public health is presented on the occasion of this pandemic and, in turn, a genealogy of the relationship between health and solidarity based on the Ciceronian maxim salus populi suprema lex esto


L'epidèmia de la COVID-19 ha posat en primer pla tensions entre valors recollits en un dilema ètico-polític clàssic: "seguretat-llibertat" o "la salut com a bé comú-la salvaguarda de les llibertats individuals". Quan es tracta d'una emergència sociosanitària, les mesures per a la seva contenció impliquen costos I sacrificis. També restriccions de drets I llibertats bàsiques. Determinar qui ha de carregar amb els costos esdevé una qüestió urgent amb implicacions morals. En aquest article, es planteja un exercici de filosofia aplicada a la salut pública en qüestió d'aquesta pandèmia i, a la vegada, una genealogia de la relació entre la salut I la solidaritat basada en la màxima ciceroniana salus populi suprema lex esto


Assuntos
Humanos , Liberdade de Circulação , Quarentena , Controle Social Formal , Infecções por Coronavirus/prevenção & controle , Pneumonia Viral/prevenção & controle , Pandemias
4.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-47927

RESUMO

A Global Child Dental Fund (GCDFund) – organização sem fins lucrativos do Reino Unido – atualizou o Guia de Saúde Oral Materno-infantil, elaborado pela equipe de consultores da instituição e apoiado pela Sociedade Brasileira de Pediatria (SBP), com foco na gestante, no bebê e na criança. O documento traz a importância de manter de forma regular a consulta ao dentista durante a gestação e nos primeiros anos de vida, mesmo durante a pandemia de Covid-19.


Assuntos
Saúde Bucal , Infecções por Coronavirus/prevenção & controle , Gestantes , Betacoronavirus
7.
Int Marit Health ; 71(3): 184-190, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33001430

RESUMO

BACKGROUND: Work-related stress among seafarers is well known but a suspected excess of work-related stress due to the COVID-19 so far has not been published. The aim of the study was to evaluate the well- -being of the seafarers during the outbreak of COVID-19 pandemic and their evaluation of the precautions taken by the shipping companies. MATERIALS AND METHODS: Seventy-two seafarers completed the General Health Questionnaire (GHQ12) with three extra questions on how the COVID-19 precautions were taken on board. RESULTS: The mean Likert score was 13.9 for the whole sample, corresponding to "no problems" while a subgroup of 40% had mean Likert sum scores of 16.1 (level 15-23) corresponding to "starting problems." In response to the extra items, 50% of the seafarers did not feel safe doing their job in relation to the epidemic and 60% did not think everything has been done to ensure their health at work in relation to the epidemic. Thirty per cent suffered of insomnia to the extent of becoming concerned and 26% had been unhappy and depressed during the latest tours of duty. CONCLUSIONS: The hypothesis that excess work-related stress has been put on the seafarers in this specific situation was confirmed and calls for prevention. A combination of person-focused and organisation-focused prevention approaches has been advocated as the most promising for alleviation of job stress in the workplaces at sea.


Assuntos
Infecções por Coronavirus/psicologia , Medicina Naval , Estresse Ocupacional/epidemiologia , Pneumonia Viral/psicologia , Adolescente , Adulto , Betacoronavirus , Criança , Infecções por Coronavirus/prevenção & controle , Estudos Transversais , Humanos , Masculino , Mar Mediterrâneo , Pessoa de Meia-Idade , Estresse Ocupacional/psicologia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Segurança , Distúrbios do Início e da Manutenção do Sono , Estresse Psicológico/epidemiologia , Inquéritos e Questionários
8.
10.
Gastroenterol Nurs ; 43(5): 375-381, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33003024

RESUMO

Elective surgical and endoscopic procedures were suspended nationwide during the March 2020 COVID-19 pandemic to minimize exposure and healthcare resource utilization. This resulted in an unprecedented backlog of procedures in most clinical practices including pediatrics. Our group developed an internal process toward the rational development of an algorithm prioritizing elective procedures. This was based on patient disease severity defined by the presence of alert symptoms, symptom severity for dysphagia and abdominal pain, and diagnostic investigation findings. The underlying rationale is to prioritize patients in whom suspected disease course would be greatest impacted by endoscopy. We developed a nurse phone call-based process utilizing REDCap®, identifying relevant symptoms categorized by severity, and a validated functional impairment questionnaire for abdominal pain. We abstracted key laboratory and radiological findings also categorized by severity. The order of priority of procedures was established on the basis of a 4-tiered system factoring both presence and severity of symptoms or prior diagnostic testing results. We present the framework that we have adopted toward prioritizing procedures with the assumption that it offers an objective methodology and that can be efficiently and more broadly applied to other similar practice scenarios. Our tool may have wide-ranging implications both in the current COVID-19 pandemic and in other scenarios of limited resource allocation and deserves further investigation.


Assuntos
Agendamento de Consultas , Betacoronavirus , Controle de Doenças Transmissíveis/organização & administração , Infecções por Coronavirus/prevenção & controle , Procedimentos Cirúrgicos do Sistema Digestório , Procedimentos Cirúrgicos Eletivos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Adolescente , Algoritmos , Criança , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Endoscopia , Feminino , Humanos , Masculino , Seleção de Pacientes , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Avaliação de Sintomas , Triagem
11.
Environ Health Prev Med ; 25(1): 57, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33008319

RESUMO

BACKGROUND: At the end of 2019, the outbreak of coronavirus disease 2019 (COVID-19) severely damaged and endangered people's lives. The public health emergency management system in China has played an essential role in handling the response to the outbreak, which has been appreciated by the World Health Organization and some countries. Hence, it is necessary to conduct an overall analysis of the development of the health emergency management system in China. This can provide a reference for scholars to aid in understanding the current situation and to reveal new research topics. METHODS: We collected 2247 international articles from the Web of Science database and 959 Chinese articles from the China National Knowledge Infrastructure database. Bibliometric and mapping knowledge domain analysis methods were used in this study for temporal distribution analysis, cooperation network analysis, and co-word network analysis. RESULTS: The first international article in this field was published in 1991, while the first Chinese article was published in 2005. The research institutions producing these studies mainly existed in universities and health organizations. Developed countries and European countries published the most articles overall, while eastern China published the most articles within China. There were 52 burst words for international articles published from 1999-2018 and 18 burst words for Chinese articles published from 2003-2018. International top-ranked articles according to the number of citations appeared in 2005, 2007, 2009, 2014, 2015, and 2016, while the corresponding Chinese articles appeared in 2003, 2004, 2009, and 2011. CONCLUSIONS: There are differences in the regional and economic distribution of international and Chinese cooperation networks. International research is often related to timely issues mainly by focusing on emergency preparedness and monitoring of public health events, while China has focused on public health emergencies and their disposition. International research began on terrorism and bioterrorism, followed by disaster planning and emergency preparedness, epidemics, and infectious diseases. China considered severe acute respiratory syndrome as the starting research background and the legal system construction as the research starting point, which was followed by the mechanism, structure, system, and training abroad for public health emergency management.


Assuntos
Controle de Doenças Transmissíveis/organização & administração , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Betacoronavirus , China/epidemiologia , Surtos de Doenças/prevenção & controle , Humanos , Internacionalidade
13.
Artigo em Inglês | MEDLINE | ID: mdl-33020395

RESUMO

In the wake of the sudden spread of COVID-19, a large amount of the Italian population practiced incongruous behaviors with the protective health measures. The present study aimed at examining psychological and psychosocial variables that could predict behavioral compliance. An online survey was administered from 18-22 March 2020 to 2766 participants. Paired sample t-tests were run to compare efficacy perception with behavioral compliance. Mediation and moderated mediation models were constructed to explore the association between perceived efficacy and compliance, mediated by self-efficacy and moderated by risk perception and civic attitudes. Machine learning algorithms were trained to predict which individuals would be more likely to comply with protective measures. Results indicated significantly lower scores in behavioral compliance than efficacy perception. Risk perception and civic attitudes as moderators rendered the mediating effect of self-efficacy insignificant. Perceived efficacy on the adoption of recommended behaviors varied in accordance with risk perception and civic engagement. The 14 collected variables, entered as predictors in machine learning models, produced an ROC area in the range of 0.82-0.91 classifying individuals as high versus low compliance. Overall, these findings could be helpful in guiding age-tailored information/advertising campaigns in countries affected by COVID-19 and directing further research on behavioral compliance.


Assuntos
Controle de Doenças Transmissíveis/métodos , Infecções por Coronavirus/prevenção & controle , Aprendizado de Máquina , Pandemias/prevenção & controle , Cooperação do Paciente/estatística & dados numéricos , Pneumonia Viral/prevenção & controle , Algoritmos , Betacoronavirus , Humanos , Itália
14.
R I Med J (2013) ; 103(8): 14-17, 2020 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-33003675

RESUMO

The COVID-19 pandemic challenges safe and equitable voting in the United States' 2020 elections, and in response, several states including Rhode Island (RI) have made significant changes to election policy. In addition to increasing accessibility of mail-in voting by mailing applications to all registered voters, RI has suspended their notary/witness requirement for both the primary and general election. However, RI's "emergency" voting process still plays a crucial role in allowing voters who missed the mail-in ballot application deadline, such as those unexpectedly hospitalized in the days leading up to the election, to still cast their ballot. COVID-19 has also forced RI to modify its emergency voting procedures, most notably allowing healthcare workers to serve on bipartisan ballot delivery teams. This commentary highlights these salient updates to voting procedures and serves as a primer as to how interested health care workers may navigate this process alongside patients and lead in the arena of patient voting rights.


Assuntos
Betacoronavirus , Controle de Doenças Transmissíveis , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Política , Serviços Postais , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Humanos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Rhode Island
15.
R I Med J (2013) ; 103(8): 59-61, 2020 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-33003682

RESUMO

BACKGROUND AND STUDY OBJECTIVE: The COVID-19 pandemic has forced assisted living facilities (ALF) to implement strict social isolation for residents. Social isolation in the geriatric population is known to negatively impact health. Here, we describe how ALFs in Rhode Island utilized device donations received from Connect for COVID-19, a nationwide nonprofit organization which has mobilized medical students to gather devices for donations to care centers. METHODS: Rhode Island ALFs were contacted to determine if they were interested in receiving smart device donations. After donations were made, an impact survey was electronically administered. Primary Results: A total of 11 facilities completed the survey with a response rate of 24% (11/46). The facilities were located throughout all five counties in Rhode Island, with the majority located in Providence County. All but one of the facilities that responded to the survey (n=10, 90.9%) have used the devices to allow residents to video-call their family members. Seven responses (63.6%) indicated that devices were used for more than one purpose. Primary Conclusions: Smart devices were well received by Rhode Island ALFs and used for purposes beyond video conference calls. ALFs should consider advertising the need for devices to encourage community donations. Future studies should investigate the direct impact that digital connectivity has had on Rhode Island ALF residents.


Assuntos
Moradias Assistidas , Betacoronavirus , Comunicação , Infecções por Coronavirus/epidemiologia , Relações Familiares/psicologia , Pneumonia Viral/epidemiologia , Smartphone , Computadores de Mão , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Humanos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Rhode Island
16.
Neurodiagn J ; 60(3): 195-207, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33006508

RESUMO

Since 1995, ASET has periodically published updates to recommendations for best practices in infection prevention for Neurodiagnostic technologists. The latest installment was accepted in December 2019 for publication in Volume 60, Issue 1, before we had much knowledge or understanding about the SARS-CoV-2, the virus that causes COVID-19. This Technical Tips article is presented as an addendum to the 2020 update and includes important information about infection prevention measures specific to procedure protocols when working with patients positive or under investigation for a highly infectious disease, and when working with patients in general during the current pandemic. All Neurodiagnostic technologists who have direct patient care are responsible for ensuring the use of best practices to prevent the spread of infection.


Assuntos
Infecções por Coronavirus/prevenção & controle , Eletroencefalografia/métodos , Controle de Infecções/métodos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Pandemias/prevenção & controle , Equipamento de Proteção Individual , Pneumonia Viral/prevenção & controle , Pessoal Técnico de Saúde , Betacoronavirus , Técnicas de Diagnóstico Neurológico/instrumentação , Desinfecção/métodos , Eletroencefalografia/instrumentação , Contaminação de Equipamentos , Humanos , Polissonografia/instrumentação , Polissonografia/métodos
17.
BMC Surg ; 20(1): 222, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33008379

RESUMO

BACKGROUND: The coronavirus disease 2019 (COVID-19) has been declared a global pandemic by the World Health Organization. Patients with cancer are more likely to incur poor clinical outcomes. Due to the prevailing pandemic, we propose some surgical strategies for gastric cancer patients. METHODS: The 'COVID-19' period was defined as occurring between 2020 and 01-20 and 2020-03-20. The enrolled patients were divided into two groups, pre-COVID-19 group (PCG) and COVID-19 group (CG). A total of 109 patients with gastric cancer were enrolled in this study. RESULTS: The waiting time before admission increased by 4 days in the CG (PCG: 4.5 [IQR: 2, 7.8] vs. CG: 8.0 [IQR: 2,20]; p = 0.006). More patients had performed chest CT scans besides abdominal CT before admission during the COVID-19 period (PCG: 22 [32%] vs. CG: 30 [73%], p = 0.001). After admission during the COVID period, the waiting time before surgery was longer (PCG: 3[IQR: 2,5] vs. CG: 7[IQR: 5,9]; p < 0.001), more laparoscopic surgeries were performed (PCG: 51[75%] vs. CG: 38[92%], p = 0.021), and hospital stay period after surgery was longer (7[IQR: 6,8] vs.9[IQR:7,11]; p < 0.001). In addition, the total cost of hospitalization increased during this period, (PCG: 9.22[IQR:7.82,10.97] vs. CG: 10.42[IQR:8.99,12.57]; p = 0.006). CONCLUSION: This study provides an opportunity for our surgical colleagues to reflect on their own services and any contingency plans they may have to tackle the COVID-19 crisis.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Procedimentos Cirúrgicos do Sistema Digestório/estatística & dados numéricos , Laparoscopia/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Neoplasias Gástricas/cirurgia , Adulto , Idoso , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Feminino , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Seleção de Pacientes , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Padrões de Prática Médica , Utilização de Procedimentos e Técnicas , Estudos Retrospectivos
18.
Rev Bras Epidemiol ; 23: e200091, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-33027433

RESUMO

OBJECTIVE: To analyze the association between the transmission potential of SARS-CoV-2 and the decisions made by the municipal government of Florianópolis (Brazil) regarding social distancing. METHODS: We analyzed new cases of COVID-19 identified in Florianópolis residents between February 1 and July 14, 2020, using a nowcasting approach. Decrees related to COVID-19 published in the Official Gazette of the Municipality between February 1 and July 14, 2020 were also analyzed. Based on the actions proposed in the decrees, whether they loosened social distancing measures, or increased or maintained existing restrictions, was analyzed, thus creating a Social Distancing Index. Time-dependent reproduction numbers (Rt) for a period of 14 days prior to each decree were calculated. A matrix was constructed associating the classification of each decree and the Rt values, analyzing the consonance or dissonance between the potential dissemination of SARS-CoV-2 and the actions of the decrees. RESULTS: A total of 5,374 cases of COVID-19 and 26 decrees were analyzed. Nine decrees increased social distancing measures, nine maintained them, and eight loosened them. Of the 26 actions, 9 were consonant and 17 dissonant with the tendency indicated by the Rt. Dissonance was observed in all of the decrees that maintained the distance measures or loosened them. The fastest expansion in the number of new cases and the greatest amount of dissonant decrees was found in the last two months analyzed. CONCLUSION: There was an important divergence between municipal measures of social distancing with epidemiological indicators at the time of each political decision.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Tomada de Decisões , Governo Local , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Brasil/epidemiologia , Humanos , Estudos Retrospectivos , Distância Social
20.
BMC Nephrol ; 21(1): 419, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-33004002

RESUMO

BACKGROUND: Infection with the severe acute respiratory coronavirus 2 (SARS-CoV-2) has led to a worldwide pandemic with coronavirus disease 2019 (COVID-19), the disease caused by SARS-CoV-2, overwhelming healthcare systems globally. Preliminary reports suggest a high incidence of infection and mortality with SARS-CoV-2 in patients receiving kidney replacement therapy (KRT). The aims of this study are to report characteristics, rates and outcomes of all patients affected by infection with SARS-CoV-2 undergoing KRT in Scotland. METHODS: Study design was an observational cohort study. Data were linked between the Scottish Renal Registry, Health Protection Scotland and the Scottish Intensive Care Society Audit Group national data sets using a unique patient identifier (Community Health Index (CHI)) for each individual by the Public Health and Intelligence unit of Public Health, Scotland. Descriptive statistics and survival analyses were performed. RESULTS: During the period 1st March 2020 to 31st May 2020, 110 patients receiving KRT tested positive for SARS-CoV-2 amounting to 2% of the prevalent KRT population. Of those affected, 86 were receiving haemodialysis or peritoneal dialysis and 24 had a renal transplant. Patients who tested positive were older and more likely to reside in more deprived postcodes. Mortality was high at 26.7% in the dialysis patients and 29.2% in the transplant patients. CONCLUSION: The rate of detected SARS-CoV-2 in people receiving KRT in Scotland was relatively low but with a high mortality for those demonstrating infection. Although impossible to confirm, it appears that the measures taken within dialysis units coupled with the national shielding policy, have been effective in protecting this population from infection.


Assuntos
Betacoronavirus/isolamento & purificação , Controle de Doenças Transmissíveis/organização & administração , Infecções por Coronavirus , Falência Renal Crônica , Transplante de Rim/estatística & dados numéricos , Pandemias , Pneumonia Viral , Terapia de Substituição Renal , Comorbidade , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Feminino , Humanos , Falência Renal Crônica/epidemiologia , Falência Renal Crônica/cirurgia , Falência Renal Crônica/terapia , Masculino , Pessoa de Meia-Idade , Mortalidade , Avaliação de Processos e Resultados em Cuidados de Saúde , Pandemias/prevenção & controle , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Saúde Pública/métodos , Sistema de Registros/estatística & dados numéricos , Terapia de Substituição Renal/métodos , Terapia de Substituição Renal/estatística & dados numéricos , Escócia/epidemiologia
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