A invenção de um setting on-line para atendimento psicológico remoto / The invention of an online environment for remote psychological care / La invención de un entorno en línea para la atención psicológica remota

Com o advento da covid-19, foi declarado estado de emergência de saúde pública e decretadas medidas de isolamento e distanciamento social para conter a propagação da doença. O Conselho Federal de Psicologia, considerando a importância do acolhimento seguro durante a pandemia, publicou a Resolução CFP nº 4/2020, permitindo que serviços psicológicos aconteçam de maneira remota. O presente estudo visa, através do Método da Cartografia, apresentar a construção de um setting on-line para intervenções grupais e os desafios na oferta de acolhimento e atendimento remoto. Foram ofertados grupos terapêuticos, por meio da plataforma Google Meet, para estudantes da Universidade Federal Rural do Rio de Janeiro. Um diário de bordo foi produzido para acompanhar as forças que atravessavam e constituíam o território e a experiência grupal remota. Compreendemos que o território-espaço-grupal-on-line era composto pelo espaço virtual em que nos reuníamos, pelos espaços individuais de cada integrante e pelas forças que os atravessavam. Observamos que nem sempre os participantes dispunham de um lugar privado, mas estiveram presentes no encontro com câmeras e áudios abertos e/ou fechados e/ou através do chat da videochamada. A participação no grupo funcionou como alternativa no momento de distanciamento social, sendo uma possibilidade para o atendimento psicológico em situações de dificuldade de encontros presenciais; entretanto, se mostrou dificultada em diversos momentos, pela falta de equipamentos adequados e instabilidade na internet, fatores que interferiram nas reuniões e impactaram na possibilidade de falar e escutar o que era desejado.(AU)

With the advent of COVID-19, a state of public health was declared, and measures of isolation and social distance to contain the spread of the disease was decreed. The Federal Council of Psychology, considering the importance of safe reception during the pandemic, published CFP Resolution No. 4/2020, allowing psychological services to happen remotely. This study narrates, via the Cartography Method, the experience of inventing an Online Setting for group reception. Therapeutic groups were offered, via Google Meet Platform, to students at the Federal Rural University of Rio de Janeiro. A logbook was produced to accompany the forces that crossed and constituted the territory and the remote group experience. We understand that the territoryspace-group-online was composed by the virtual-space that we gathered, by the individualspaces of each member and by the forces that crossed them. We observed that the participants did not always have a private place, but they were present at the meeting with open and/or closed cameras and audio and/or through the video call chat. Participation in the group worked as an alternative at the time of social distancing, being a possibility for psychological care in situations of difficulty in face-to-face meetings, however, it proved to be difficult at various times, due to the lack of adequate equipment and instability on the internet, factors that interfered in meetings and impacted the possibility of speaking and listening to what was desired.(AU)

La llegada de la COVID-19 produjo un estado de emergencia de salud pública, en el que se decretaron medidas de confinamiento y distanciamiento físico para contener la propagación de la enfermedad. El Consejo Federal de Psicología, considerando la importancia de la acogida segura durante la pandemia, publicó la Resolución CFP nº 4/2020, por la que se permite la atención psicológica remota. Este estudio tiene por objetivo presentar, mediante el método de la Cartografía, la elaboración de un escenario en línea para la intervención grupal y los desafíos en la oferta de acogida y atención remota. Grupos terapéuticos se ofrecieron, en la plataforma Google Meet, a estudiantes de la Universidad Federal Rural de Río de Janeiro. Se elaboró un diario para acompañar a las fuerzas que atravesaron y constituyeron el territorio y la experiencia remota del grupo. Entendemos que el territorio-espacio-grupo-en línea estaba compuesto por el espacio-virtual que reunimos, por los espacios individuales de cada integrante y por las fuerzas que los atravesaban. Observamos que los participantes no siempre tenían un lugar privado y que estaban presentes en la reunión con cámaras y audio abiertos y/o cerrados y/o por el chat de la videollamada. La participación en el grupo funcionó como una alternativa en el momento del distanciamiento físico y revela ser una posibilidad de atención psicológica en situaciones de dificultad en los encuentros presenciales, sin embargo, se mostró difícil en varios momentos, ya sea por la falta de medios adecuados o por inestabilidad en Internet, factores que interferían en las reuniones e impactaban en la posibilidad de hablar y escuchar lo que se deseaba.(AU)

[Mandatory Testing in Schools can Significantly Reduce Underreporting of COVID-19 Infections Among Students with in-Class Teaching Compared to Home Schooling]. / Reihentestungen an Schulen können die Dunkelziffer von COVID-19 Infektionen unter Schülern signifikant senken.

Aim of the study The aim of this was to study investigate the effectiveness of mandatory Covid-19 tests for in-classroom teaching in reopened schools as a containment measure in the pandemic. In Bavaria, mandatory testing at schools was implemented directly after the Easter vacations in 2021. For the first week after the vacations, this resulted in a natural experiment that allowed us to quantify the impact of the new testing strategy on reported Covid-19 cases.Methods We compared changes in the reported 7-day incidence of new infections between districts with in-classroom teaching at school and districts with closed schools. During the calendar week 15, districts with reported incidences below 100 were allowed to reopen schools and have in-classroom teaching if mandatory COVID-19 testing was performed at school with rapid antigen tests. We do not have data on the rapid test results; however, positive test results in the rapid antigen test were verified by a PCR test, and cases of positive PCR test results were reported at the district level by age groups. In the calendar weeks 13 and 14, all schools in Bavaria were closed due to Easter vacations. Taking into account a latency period of about 3-4 days and a reporting period of 1-2 days, this means that any additional increase in reported incidences for districts with in-class teaching and mandatory testing in the week after the vacation cannot be attributed to transmissions at schools, but reflects the reduction of underreporting due to the newly implemented testing strategy.Results Reported incidence increased by a factor of 6.6 for 5-11 year old and by 1.7 for 12-20 year old pupils in districts with in-classroom teaching and mandatory testing at schools. This increase was accompanied by a reduction in underreporting and was significant compared to districts with school closure. Given the situation of a natural experiment, this increase in the reported incidence among school children can be attributed to the testing strategy. For the same time period, no differences in reported incidences were found for the other age groups.Conclusion In-class teaching with mandatory testing in reopened schools changes the role of schools in the pandemic. Our analyses show that reopening schools with a mandatory testing approach is beneficial from an epidemiologic perspective as it can strongly reduce the dark figure of COVID-19 cases among children.

Schools under mandatory testing can mitigate the spread of SARS-CoV-2.

We use event study models based on staggered summer vacations in Germany to estimate the effect of school reopenings after the summer of 2021 on the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Estimations are based on daily counts of confirmed coronavirus infections across all 401 German counties. A central antipandemic measure in German schools included mandatory rapid testing multiple times per week. Our results are consistent with mandatory testing contributing to the containment of the viral spread. We find a short-term increase in infection rates right after summer breaks, indicating the uncovering of otherwise undetected (asymptomatic) cases through the testing. After a period of about 2 wk after school reopenings, the growth of case numbers is smaller in states that reopened schools compared with the control group of states still in summer break. The results show a similar pattern for older age groups as well, arguably as a result of detected clusters through the school testing. This means that under certain conditions, open schools can play a role in containing the spread of the virus. Our results suggest that closing schools as a means to reduce infections may have unintended consequences by giving up surveillance and should be considered only as a last resort.

Clinical Characteristics of Patients with Ckd Crash Landing and Initiating Dialysis Is it Time for Mandatory Screening Programme for Detection of CKD?

The present study was undertaken to study clinical, biochemical and echocardiographic characteristics of patients with Chronic Kidney Disease crash- landing and initiating hemodialysis at first presentation in our centre. MATERIAL: Ours was a cross-sectional study of one hundred and seventy patients with chronic kidney disease starting hemodialysis. Detailed history and examination were done. Apart from routine biochemical tests and CKD-MBD profile, all patient underwent ultrasonography, urine examination and echocardiography. Efforts were made to delineate etiology in each patient. OBSERVATION: Out of 170 patients 64% were males, 36% were females. Mean age at presentation in our study was 41.27 (±16.47) yrs. Chronic glomerulonephritis was the most common etiology accounting for 54% of cases followed by Diabetes (20%). Mean eGFR at presentation was <5 ml/min/1.73 m². Hypocalcemia was present in 87.1%, hyperphosphatemia in 84.2% and elevated PTH levels in 98% with mean PTH levels being 588.07±309.58 ng/ml. LVH on echocardiogram was present in 58.4 % of patient with diastolic dysfunction being reported in 31 % of patients. DCM was present in 28% of patients and 21% of patients had frank left ventricular failure at presentation. CONCLUSION: Chronic Kidney Disease patients referred late have clinical and lab characteristics which are worse as compared to routine CKD patients .This calls for a mandatory CKD screening programme for increasing awareness and early identification of CKD patients.

Experiencia y resultados del tratamiento al proceso formativo en la Covid-19. Facultad Ciencias Médicas de Bayamo / Experience and results of the treatment of the formation process in Covid- 19. Faculty of Medical Sciences of Bayamo

Introducción: la pandemia de la COVID-19 implicó cambios en el quehacer universitario que orientaron a enfatizar en el tratamiento al proceso formativo, acorde con las necesidades sociales y del sector salud. Objetivo: exponer las experiencias y resultados obtenidos en el tratamiento al proceso formativo en la COVID-19 en la Facultad Ciencias Médicas de Bayamo. Métodos: se realizó un estudio transversal del periodo marzo 2020-febrero 2022. Se emplearon métodos teóricos con un enfoque general sistémico, el analítico-sintético, inductivo-deductivo y la modelación, además de estadística descriptiva e inferencial que incluyó prueba de diferencias de proporciones para muestras independientes con un 5 por ciento de significación. Resultados: la reorganización del proceso formativo distinguió etapas de reordenamiento, sistematización y valoración formativa contextual. El 99 por ciento de la matrícula prevista de estudiantes se integró al enfrentamiento y control de la COVID-19 en el trabajo integral comunitario. Se desarrollaron acciones en centros de aislamiento, sitios de vacunación, puestos de mando de oxígeno y laboratorios especializados. Se obtuvo una amplia participación estudiantil en eventos científicos virtuales y foros debates, entre otras actividades. Los resultados de promoción superaron al curso precedente y la calidad resultó significativa. Conclusiones: la reorganización sistémica del proceso formativo aseguró el desarrollo de un proceso integral con amplia inserción de estudiantes en actividades curriculares, extracurriculares y sociopolíticas, se evidenció elevado compromiso y sentido de pertenencia, manifestado en la sistematicidad y diversidad de acciones desarrolladas y en resultados académicos superiores(AU)

Introduction: the COVID-19 pandemic implied changes in university activities that led to emphasizing treatment of the formation process, in accordance with social and health sector needs. Objective: to expose the experiences and results obtained in the treatment of the formation process in COVID-19 at the Faculty of Medical Sciences of Bayamo. Methods: a cross-sectional study was carried out from March 2020 to February 2022. Theoretical methods were used with a general systemic approach, analytical-synthetic,inductive-deductive and modeling, in addition to descriptive and inferential statistics that included a test of differences in proportions for independent samples with 5 percent significance. Results: the reorganization of the formation process distinguished stages of reordering, systematization and contextual training assessment. 99 percent of the expected enrollment of the students was integrated into the confrontation and control of COVID-19 in comprehensive community work. Actions were carried out in isolation centers, vaccination sites, oxygen command posts and specialized laboratories. Wide participation of the students was obtained in virtual scientific events and discussion forums, among other activities. The promotion results exceeded the previous course and the quality was significant. Conclusions: the systemic reorganization of the formation process ensured the development of a comprehensive process with a wide insertion of students in curricular, extracurricular and sociopolitical activities, high commitment and sense of belonging was evidenced, manifested in the systematicity and diversity of actions developed and in academic results superiors(EU)

Modeling COVID-19 spread in small colleges.

We develop an agent-based model on a network meant to capture features unique to COVID-19 spread through a small residential college. We find that a safe reopening requires strong policy from administrators combined with cautious behavior from students. Strong policy includes weekly screening tests with quick turnaround and halving the campus population. Cautious behavior from students means wearing facemasks, socializing less, and showing up for COVID-19 testing. We also find that comprehensive testing and facemasks are the most effective single interventions, building closures can lead to infection spikes in other areas depending on student behavior, and faster return of test results significantly reduces total infections.

Avaliação psicológica em concursos públicos e porte de arma: histórico e desafios / Psychological assessment in civil service entrance examination and firearms license: history and challenges / Evaluación psicológica en competencias y la portación de armas: historia y desafíos

Resumo Trata-se de um estudo teórico que aborda a avaliação psicológica no contexto de avaliações compulsórias, tanto em concurso público quanto para posse ou porte de arma de fogo. São apresentados os maiores desafios da área, a partir do histórico e da exposição de alguns dos problemas enfrentados na prática, diante das diferentes normativas que regulam este contexto. Na avaliação psicológica em concursos, ressalta-se como um dos maiores desafios a forte influência do poder judiciário nos últimos 60 anos, que inclui a definição ou restrição de procedimentos na atuação do profissional. Quanto à avaliação para porte de arma de fogo, discutem-se as diversas mudanças que ocorreram nos últimos anos e suas implicações. O texto incentiva os profissionais que atuam na área a refletir sobre as consequências sociais que o resultado dessa avaliação pode trazer. No Brasil, as pesquisas realizadas no contexto de avaliação psicológica compulsória ainda são escassas, o que mostra a necessidade de estudos que contribuam para melhoria nesse campo de atuação. É necessário compreender, inclusive, os impactos que a publicação de normativas e a qualidade da atuação dos profissionais podem provocar, bem como seus efeitos sobre a sociedade como um todo.

Abstract This theoretical study addresses psychological assessment in the context of compulsory exams for civil service entrance examination and firearms licenses. By presenting the history and some issues related to regulations, this article presents the greatest challenges in the area of compulsory exams. When it comes to procurement exams, a major challenge accounts for the strong influence of the judiciary over the past 60 years, defining or restricting procedures in professional performance. As for firearms license exams, the article expatiates on several changes that have occurred in recent years, as well as their implications. The text encourages professionals working in the field to reflect upon the social consequences of this assessment results. Studies on compulsory psychological assessment are still scarce in the Brazilian literature, indicating the need for research to improve this field of action. Moreover, one should also consider the impacts of regulations and quality professionals on these assessments and on society as a whole.

Resumen Este estudio teórico aborda la evaluación psicológica en el contexto de las evaluaciones obligatorias tanto en concurso público como por posesión o portación de armas de fuego. Se presentan los mayores desafíos del área a partir de la historia y de algunos de los problemas que se enfrentan en la práctica, dadas las diferentes normativas que regulan este contexto. En el contexto de la evaluación psicológica en los concursos públicos, uno de los mayores desafíos es la fuerte influencia del Poder Judicial en los últimos 60 años, que incluye la definición o restricción de procedimientos en el desempeño del profesional. En cuanto a la evaluación para portación de arma de fuego, se discuten los distintos cambios que se han producido en los últimos años y sus implicaciones. El texto anima a los profesionales que trabajan en el área a reflexionar sobre las consecuencias sociales que puede traer el resultado de esta evaluación. En Brasil, la investigación realizada en el contexto de la evaluación psicológica obligatoria es aún escasa, lo que muestra la necesidad de estudios que contribuyan a la mejora en este campo de acción. Incluso es necesario comprender los impactos que puede causar la publicación de normativas y la calidad del desempeño de los profesionales, así como sus efectos en la sociedad en su conjunto.

La pesquisa activa y la Atención Primaria de Salud en el enfrentamiento a la Covid-19 / Active research and Primary Health Care in the confrontation with COVID-19

Estimado Editor: La pandemia del coronavirus está planteando cambios sociales, políticos y económicos que están transformando usos y costumbres para luchar contra la enfermedad. Desde que fue identificada su circulación en Cuba el Programa del Médico y Enfermera de la Familia hace aportes en el combate a la misma. Desde ese momento, el personal que labora en el primer nivel de atención desarrolla estudios preliminares sobre la pesquisa activa y Montano Luna, Tamarit Díaz, Rodríguez Hernández, Zelada Pérez y Rodríguez Zelada han publicado su experiencia por lo que nos gustaría exponer algunas reflexiones a partir de esos resultados y conclusiones, ya que los mismos fueron obtenidos a partir de la experiencia cubana....

[Systematic identification of smokers and tobacco smoking management in the general hospital]. / Repérage systématique et prise en charge du tabagisme à l'hôpital général.

INTRODUCTION: The prevalence of daily smoking in France was 24 % in 2019 and tobacco control remains a major public health issue. A hospital stay provides an opportunity for smoking cessation intervention. Identification and management of smokers during a hospital stay may be variously integrated into electronic health records (EHR). STATE OF THE ART: Smoking status identification, which have included pre-filled forms, check-box, reminders, icons, is heterogeneous. Specific modules in EHR have been implemented for smoking cessation management such as counselling sessions, tobacco cessation prescriptions, smoking cessation guidelines and long-term follow-up. EHR-based intervention to identify and manage smokers with a long-term follow-up for at least one month after hospital discharge has shown an increase in smoking abstinence at 6-12 months. OUTLOOK: Due to the lower quality of free data about smoking status, systematic identification with check-box, reminders or icons in EHR may be more appropriate. Integration of functionalities such as help for prescription, reminders and follow-up of patients would make tobacco cessation management easier for health professionals. CONCLUSION: EHR interventions to identify smokers and manage smoking cessation during hospital stays are an opportunity to increase smoking cessation.

Mandatory preoperative COVID-19 testing for cancer patients-Is it justified?

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 has caused substantial disruptions in routine clinical care. Emerging data show that surgery in coronavirus disease (COVID)-positive cases can be associated with worsening of clinical outcomes and increased postoperative mortality. Hence, preoperative COVID-19 testing for all patients before elective surgery was implemented in our institution. MATERIALS AND METHODS: Two hundred and sixty-two asymptomatic cancer patients were preoperatively tested for COVID-19 using reverse-transcription polymerase chain reaction technique with nasopharyngeal and oropharyngeal swabbing. All negative patients were operated within 72 hours, and positive patients were quarantined for a minimum 14 days before re-swabbing. RESULTS: In our cohort, 21 of 262 (8.0%) asymptomatic preoperative patients, who were otherwise fit for surgery, tested positive. After adequate quarantine and a negative follow-up test report, 12 of 21 (57%) had an operation. No major postoperative morbidity due to COVID-19 was noted during the immediate postoperative period before discharge from the hospital. CONCLUSION: Routine preoperative COVID-19 testing was successful in identifying asymptomatic viral carriers. There was no incidence of symptomatic COVID-19 disease in the postoperative period, and there was no incidence of morbidity attributable to COVID-19. These data suggested a beneficial role for mandatory preoperative COVID-19 testing.

Union of the European Phoniatricians' position statement on the exit strategy of phoniatric and laryngological services: staying safe and getting back to normal after the peak of coronavirus disease 2019 (issued on 25th May 2020).

BACKGROUND: The following position statement from the Union of the European Phoniatricians, updated on 25th May 2020 (superseding the previous statement issued on 21st April 2020), contains a series of recommendations for phoniatricians and ENT surgeons who provide and/or run voice, swallowing, speech and language, or paediatric audiology services. OBJECTIVES: This material specifically aims to inform clinical practices in countries where clinics and operating theatres are reopening for elective work. It endeavours to present a current European view in relation to common procedures, many of which fall under the aegis of aerosol generating procedures. CONCLUSION: As evidence continues to build, some of the recommended practices will undoubtedly evolve, but it is hoped that the updated position statement will offer clinicians precepts on safe clinical practice.