RESUMO Objetivo: Investigar os fatores contextuais associados à qualidade de vida (QV) de crianças brasileiras de zero a 12 anos, em momento de ápice de distanciamento social. Métodos: Estudo observacional, transversal, online, de julho a setembro de 2020, com questionário sobre fatores do contexto familiar associados à QV e Inventário Pediátrico sobre QV — PedsQL™. A análise dos dados foi feita por de regressão logística multinomial. Resultados: A amostra foi de 849 crianças, na maioria da Região Sul (75%), brancas (83%), com desenvolvimento típico (79%), sedentárias (68%), com uso de telas (85%) em tempo >3h/dia (44%). As mães eram as cuidadoras principais (90%). Foram significativamente associadas a escores mais elevados de QV: a condição de saúde típica (odds ratio — OR 2,38; intervalo de confiança de 95% — IC95% 1,60–3,55), o tempo de tela ≤2h/dia (OR 1,62; IC95% 1,17–2,24), o distanciamento social considerado “fácil” (OR 1,67; IC95% 1,20–2,32) e a família afirmar estimular a criança (OR 1,93; IC95% 1,08–3,45). Conclusões: Este estudo mostra que o contexto familiar pode influenciar a QV de crianças, especialmente no período de pandemia e de reorganização do ambiente domiciliar. Objetivo (QV 1 anos Métodos observacional transversal online 2020 PedsQL PedsQL™ multinomial Resultados 84 75%, 75 75% , (75%) 83%, 83 83% (83%) 79%, 79 79% (79%) 68%, 68 68% (68%) 85% 85 (85% 3hdia hdia 3h dia h 44%. 44 44% . (44%) 90%. 90 90% (90%) odds 2,38 238 2 38 95 IC95 IC 1,60–3,55, 160355 1,60–3,55 60 3 55 1,60–3,55) 2hdia 2h 1,62 162 62 1,17–2,24, 117224 1,17–2,24 17 24 1,17–2,24) fácil “fácil 1,67 167 67 1,20–2,32 120232 20 32 1,93 193 93 1,08–3,45. 108345 1,08–3,45 08 45 1,08–3,45) Conclusões domiciliar 202 8 7 (75% (83% (79% 6 (68% (85 4 (44% 9 (90% 2,3 23 IC9 16035 1,60–3,5 5 1,6 16 11722 1,17–2,2 1,20–2,3 12023 1,9 19 10834 1,08–3,4 0 (75 (83 (79 (68 (8 (44 (90 2, 1603 1,60–3, 1, 1172 1,17–2, 1,20–2, 1202 1083 1,08–3, (7 (6 ( (4 (9 160 1,60–3 117 1,17–2 1,20–2 120 108 1,08–3 1,60– 11 1,17– 1,20– 10 1,08– 1,60 1,17 1,20 1,08 1,1 1,2 1,0

ABSTRACT Objective: The aim of this study was to investigate the contextual factors associated with the quality of life (QOL) of Brazilian children aged 0–12 years during the strict period of social isolation. Methods: This observational cross-sectional study was conducted between July and September 2020 using an online questionnaire on QOL-related family factors and the Pediatric Quality of Life Inventory (PedsQL™). Results were analyzed by multinomial logistic regression analysis. Results: The sample had 849 children, mostly from the South Region of Brazil (75%), white (83%), with typical development (79%), sedentary (68%), using screen (85%) for >3 h/day (44%). Their mothers were their main caregivers (90%). The following variables were significantly associated with high scores of QOL: typical health status (OR 2.38; 95%CI 1.60–3.55; screen time ≤2 h/day (OR 1.62; 95%CI 1.17–2.24); social distancing considered as “easy” (OR 1.67; 95%CI 1.20–2.32), and stimulation of the child by the family (OR 1.93; 95%CI 1.08–3.45). Conclusions: This study indicates that the family context can influence children’s QOL, especially during the COVID-19 pandemic and home environment reorganization. Objective QOL (QOL 012 0 12 0–1 isolation Methods crosssectional cross sectional 202 QOLrelated related PedsQL™. PedsQL PedsQL™ . (PedsQL™) analysis 84 75%, 75 75% , (75%) 83%, 83 83% (83%) 79%, 79 79% (79%) 68%, 68 68% (68%) 85% 85 (85% 3 > hday h day 44%. 44 44% (44%) 90%. 90 90% (90%) OR 2.38 238 2 38 95CI CI 95 1.60–3.55 160355 1 60 55 ≤ 1.62 162 62 1.17–2.24 117224 17 24 1.17–2.24) easy “easy 1.67 167 67 1.20–2.32, 120232 1.20–2.32 20 32 1.20–2.32) 1.93 193 93 1.08–3.45. 108345 1.08–3.45 08 45 1.08–3.45) Conclusions childrens s COVID19 COVID 19 COVID-1 reorganization 01 0– (PedsQL™ 8 7 (75% (83% (79% 6 (68% (85 4 (44% 9 (90% 2.3 23 1.60–3.5 16035 5 1.6 16 1.17–2.2 11722 12023 1.20–2.3 1.9 10834 1.08–3.4 COVID1 COVID- (PedsQL (75 (83 (79 (68 (8 (44 (90 2. 1.60–3. 1603 1. 1.17–2. 1172 1202 1.20–2. 1083 1.08–3. (7 (6 ( (4 (9 1.60–3 160 1.17–2 117 120 1.20–2 108 1.08–3 1.60– 1.17– 11 1.20– 10 1.08– 1.60 1.17 1.20 1.08 1.1 1.2 1.0

Resumo O trabalho remoto atingiu 11% da população ocupada do Brasil no contexto da pandemia da COVID-19: uma maioria de mulheres, pessoas brancas, com nível superior de escolaridade, e atuantes no setor de educação e serviços. Esse perfil é distinto do padrão predominante de trabalhadores em domicílio: mulheres negras com baixo nível de escolaridade e atuantes na indústria de transformação. Mas, ao revisar os dados da PNAD entre 1992 e 2019, encontramos algumas transformações nos setores da economia e atividades ocupacionais realizados em domicílio, bem como uma mudança no perfil do trabalhador em domicílio: crescimento na participação de homens com maior nível de escolaridade e remuneração e atuantes no setor de serviços e de comunicação. Defendemos, neste artigo, que essas mudanças no trabalho em domicílio observadas na pré-pandemia contribuem para compreender o espaço que o trabalho remoto ganhou durante e após a pandemia para se fortalecer enquanto modalidade de trabalho e se justificar enquanto alternativa de organização de espaço de trabalho. 11 COVID19 COVID 19 COVID-19 brancas transformação Mas 199 2019 comunicação Defendemos artigo prépandemia pré 1 COVID1 COVID-1 201 COVID- 20 2

Resumé Le télétravail à domicile a atteint 11% de la population occupée du pays dans le contexte de la pandémie de COVID-19. Il s'agissait en majorité de femmes, de personnes blanches, diplômées de l'enseignement supérieur, et travaillant dans les secteurs des services et de la communication. La réalité des télétravailleurs à domicile est différente de celle de la plupart des travailleurs à domicile d'avant la pandémie: femmes noires, peu scolarisées et travaillant dans l'industrie manufacturière. Cependant, en examinant les données du PNAD entre 1992 et 2019, on peut observer la croissance, dans ce type de travail, de la participation des hommes ayant une formation et une rémunération supérieures et travaillant dans les secteurs des services et de la communication. En ce sens, bien que le travail à domicile ait peu varié dans le période, certaines tendances d'évolution de ce type de travail se dégagent des données, réalisées à domicile et sur le profil du travailleur à domicile. Nous comprenons que ces changements observés dans la pré pandémie contribuent à comprendre l'espace que le télétravail à domicile a gagné dans la pandémie, à se renforcer comme modalité de travail et à se justifier comme alternative pour organiser l'espace de travail. 11 COVID19. COVID19 COVID 19. 19 COVID-19 sagissait s agissait blanches lenseignement l enseignement supérieur communication davant d avant noires lindustrie industrie manufacturière Cependant 199 2019 croissance sens période dévolution évolution lespace espace 1 COVID1 COVID-1 201 COVID- 20 2

Abstract Remote work reached 11% of Brazil's employed population in the context of the COVID-19 pandemic: the majority being women, white individuals with higher education levels, and working in the education and services sectors. This profile is distinct from the predominant pattern of home-based workers: black women with lower education levels and working in the manufacturing industry. However, upon reviewing PNAD data from 1992 to 2019, we found some transformations in home-based economic sectors and occupational activities. Additionally, there has been a shift in the profile of home-based workers: an increase in the participation of men with higher education and income levels, working in the services and communication sectors. In this article, we argue that these pre-pandemic changes in home-based work contribute to understanding the space that remote work has gained during and after the pandemic to strengthen itself as a work modality and justify itself as an alternative for organizing workspaces. 11 Brazils Brazil s COVID19 COVID 19 COVID-1 homebased home based workers industry However 199 2019 activities Additionally article prepandemic pre workspaces 1 COVID1 COVID- 201 20 2

Abstract This article studies the evolution and determinants of the quality of education in Colombia during the years 2017 (before) and 2021 (during the pandemic), with the purpose of evaluating the impact of COVID-19 on students' academic performance. For this purpose, the decomposition method proposed by Firpo et al. (2007, 2011) was used to analyze the factors that determine the differential in academic performance through the calculation of counterfactual decompositions for the entire distribution of academic performance; specifically, the 10th, 30th, 50th, 70th, and 90th quantiles were analyzed. It was found that the pandemic affected the academic performance of all students in general, but especially those in the lower part of the distribution. This confirms the hypothesis that the deterioration in socio-economic, family and personal characteristics of the students worsened existing educational inequalities.

Resumen Este artículo estudia la evolución y los determinantes de la calidad de la educación en Colombia durante los años 2017 (antes) y 2021 (durante la pandemia), con el propósito de evaluar el impacto del covid-19 sobre el rendimiento académico de los estudiantes. Para ello, se empleó el método de descomposición propuesto por Firpo et al. (2007, 2011) que permite analizar los factores que determinan el diferencial en el rendimiento académico a través del cálculo de descomposiciones contrafactuales para toda la distribución del rendimiento académico; en particular se analizaron los cuantiles 10, 30, 50, 70 y 90. Se encontró que la pandemia afectó el rendimiento académico de todos los estudiantes en general, pero en especial, a los estudiantes de la parte baja de la distribución. Con ello se comprueba la hipótesis de que el desmejoramiento en las características socioeconómicas, familiares y personales de los estudiantes empeoró las desigualdades educativas existentes.

Abstract External audit has consolidated as a control tool for organizational decision-making, especially in critical moments such as the global expansion of coviD-19 that forced this service to adopt new practices. Objective: This research identified the changes in external audit practices due to pandemic restrictions in audit firms in Medellín and their implications for the quality of external audit services from the auditors' point of view. Methodology: A qualitative approach of descriptive scope was used in which a semi-structured interview protocol was applied to a group of senior auditors, partners or leaders who coordinated external audits in their firms to organizations located in Medellin, Colombia. Key findings: It was found that remote, technology-mediated audits, data analytics, continuous risk assessment, and changing materiality stand out as the most important changes during this critical period. Conclusions: There were also changes in the auditors' workload and fees; for the future, complete changes are envisioned in how external audits are conducted even in the absence of restrictions such as pandemics.

Resumo A auditoria externa tem se consolidado como uma ferramenta de controle para a tomada de decisões organizacionais, especialmente durante momentos críticos, como a expansão global da coviD-19, que levou esse serviço a adotar novas práticas devido às restrições da pandemia. Objetivo: Esta pesquisa identificou as mudanças nas práticas de auditoria externa devido às restrições da pandemia nas empresas de auditoria em Medellín e suas implicações para a qualidade dos serviços de auditoria externa do ponto de vista dos auditores. Metodologia: Foi utilizada uma abordagem qualitativa de escopo descritivo, na qual um protocolo de entrevista semiestruturada foi aplicado a um grupo de auditores seniores, sócios ou líderes que coordenavam auditorias externas em suas empresas para organizações localizadas em Medellín, Colômbia. Principais resultados: Constatou-se que as auditorias remotas e mediadas por tecnologia, a análise de dados, a avaliação contínua de riscos e a mudança de materialidade se destacam como as mudanças mais importantes durante esse período crítico. Conclusões: Também houve mudanças na carga de trabalho dos auditores e nos honorários, e o futuro promete ver transformações na forma como as auditorias externas são conduzidas, mesmo na ausência de restrições, como pandemias.

Resumen La auditoría externa se ha consolidado como una herramienta de control para la toma de decisiones organizacionales, máxime en momentos críticos como la expansión global de la COVID-19, que ocasionó la adopción de nuevas prácticas por las restricciones. Objetivo: Esta investigación identificó los cambios en las prácticas de auditoría externa por las restricciones de la pandemia en firmas de auditoría de Medellín y sus implicaciones en la calidad de los servicios de auditoría externa desde la visión de los auditores. Metodología: Se empleó un enfoque cualitativo de alcance descriptivo en el que se aplicó un protocolo de entrevista semiestructurada a un grupo de auditores séniores, socios o líderes que coordinaron auditorías externas en sus firmas a organizaciones situadas en Medellín, Colombia. Resultados principales: Se encontró que la realización de auditorías remotas, mediadas por tecnología, la analítica de datos, la evaluación continua de los riesgos y la materialidad cambiante resaltan como los cambios más importantes durante ese periodo crítico. Conclusiones: Hubo modificaciones en la carga laboral de los auditores y los honorarios; a futuro se vislumbran cambios completos en las auditorías externas incluso ante la ausencia de restricciones como las pandémicas.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and subsequent coronavirus disease 2019 (COVID-19) had widespread disruptive consequences on various sectors including tertiary education. Universities were shut down and forced to introduce emergency remote teaching and learning. This coincided with the period where the authors of this article started advanced professorial training through the Future Professors Programme Phase 2, Cohort 1 (FPP). Like other educators, the authors experienced COVID-19-linked challenges and opportunities and decided to report on this through a review of the literature and reflective writing. While most publications between 2020 and now focused on the challenges and opportunities caused by the pandemic within the teaching and learning environment, challenges and opportunities experienced in the research environment were less reported on. Often, the findings presented also focused on one discipline or in single institutions. This meant that the responses to address pandemic-associated disruptions would be limited in its view and weighted to teaching and learning and specific discipline(s). Set against the background of the South African higher education (HE) system, the authors review how COVID-19 augmented existing challenges as well as how it presented opportunities for improved teaching, learning and research. This is done by providing context to the challenges and opportunities of not only teaching and learning but of the research environment whilst focusing on several disciplines and institutions. While there is an overlap in the COVID-19 experience within the five Institutions (UCT, UWC, UJ, NWU and TUT) in terms of challenges and opportunities, the impact on research was as devastating as it was on teaching and learning with unique scenarios applicable to the respective disciplines/institutions. The supplemental FPP training and teachings placed the authors in a unique position compared to our peers, in our approach to dealing with the academic disruption. While the pandemic had a general negative outlook for most academics, the FPPs programme better prepared the authors to reimagine and reshape our teaching, learning and research practices to face future pandemics.

This qualitative study employed a community-based participatory action research approach to explore adolescent mothers' lived experiences and meaning-making processes in a marginalised South African community. Amidst the challenges posed by the COVID-19 pandemic, we adapted our study's methodology by leveraging my skills as an intern educational psychologist and art teacher. With my supervisor's guidance, I created a safe and empowering virtual environment for our co-researchers to share their experiences and emotions, which allowed us to navigate the pandemic's unique constraints while maintaining our research's integrity. Using innovative arts-based methods, including river of life, clay modelling, photo collage, and photovoice activities, provided a powerful means for the co-researchers to express their stories, identities, and aspirations in diverse and nuanced ways. These creative interventions served as catalysts for self-reflection, collective meaning-making, and facing the challenge of societal stigma-fostering a sense of solidarity and empowerment among the co-researchers. The transformative potential of arts-based methods was amplified by the research's participatory ethos, which prioritised the voices and experiences of the co-researchers and sought to generate insights that could inform community-driven solutions. The virtual space became a platform for authentic dialogue, relationship building, and the co-creation of knowledge, underscoring the adaptability and resilience of participatory research in the face of global challenges. This study highlights the power of arts-based data generation methods and participatory approaches in generating rich, meaningful data and fostering transformative experiences for marginalised communities. It calls for further research and interventions that prioritise the voices and needs of adolescent mothers, ultimately promoting their well-being, resilience, and social change.

A vigilância em saúde, como vigilância de agravos e doenças, tem um escopo bastante amplo. Discutiremos aqui a face mais conhecida, que é a vigilância de doenças transmissíveis, e assumiremos como mote a pandemia causada pelo vírus SARS-CoV-2. No desenvolvimento do texto, a abordagem se amplia para uma reflexão sobre tecnologias, modelo e organização do sistema. A mais grave epidemia de nossa época, classificada como pandemia, por atingir simultaneamente todo o planeta, tem obrigado a reflexões que envolvem múltiplos campos do conhecimento. O sofrimento decorrente deve inibir a tentação de associá-la a qualquer imagem positiva, ainda que tenha havido oportunidade para aprender e, em algumas circunstâncias, testemunhar a capacidade humana de agir solidariamente. Poucas coisas são tão didáticas como tragédias e erros. Cabe explorá-los cuidadosamente e extrair a necessária retroalimentação para corrigir rumos da atuação em saúde. Neste texto, trataremos das condições que levaram a vigilância em saúde no Brasil a falhar fragorosamente em sua missão frente à emergência desencadeada pela doença do novo coronavírus 2019 e levantaremos pontos que merecem atenção em uma reestruturação do sistema de vigilância em saúde.

The term "health surveillance" encompasses a wide range of activities, including the monitoring and observation of illnesses and diseases. In this section, we will examine the most well-known aspect of health surveillance, namely the monitoring of communicable diseases. To illustrate our discussion, we will use the ongoing pandemic caused by the SARS-CoV-2 virus as a case study. As the text progresses, the focus shifts to an examination of technologies, models, and the structure of the system. The most severe epidemic of our era, classified as a pandemic due to its global impact, has compelled us to reflect on a multitude of disciplines. The resulting suffering should preclude any association with positive images, despite the opportunity to learn and, in some instances, observe the capacity of humans to act in solidarity. It is often observed that few things are as didactic as tragedies and mistakes. It is therefore important to explore them carefully to extract the necessary feedback to correct the course of action in health. In this text, we will discuss the conditions that led health surveillance in Brazil to fail miserably in its mission in the face of the emergency triggered by the novel coronavirus disease 2019. We will also present points that deserve attention in a restructuring of the health surveillance system.

ABSTRACT Objectives. To analyze the evolution of COVID-19 in rural populations of Loreto and Ucayali in the early stage of the pandemic. Materials and methods. A community-level longitudinal observational study was conducted and based on two rounds of telephone surveys with local authorities of more than 400 indigenous and non-indigenous rural communities in Loreto and Ucayali, in July and August 2020. We collected information on cases and deaths by COVID-19 in their communities, protective measures adopted and if state assistance was received in the early stage of the pandemic. Descriptive statistics allowed us to evaluate the evolution of the pandemic after the initial outbreak and compare the trends of the two regions, as well as between indigenous and non-indigenous populations. Results. In July 2020, COVID-19 had reached 91.5% of the communities, although deaths from COVID-19 were reported in 13.0% of the communities, with rural mortality being higher in Ucayali (0.111%) than in Loreto (0.047%) and in non-indigenous communities. By August, prevalence decreased from 44.0% to 32.0% of communities, but became more frequent in indigenous communities, and those in Ucayali. Traveling to the city to receive state bonuses and difficulties maintaining social distancing contributed to the spread. Conclusions. Our findings show the evolution of COVID-19 in rural communities and point to important areas of attention in future public policies, for the adoption of protective measures and reconsidering strategies for the distribution of assistance in the face of future pandemics.

RESUMEN Objetivos. Analizar la evolución del COVID-19 en poblaciones rurales de Loreto y Ucayali en la etapa temprana de la pandemia. Materiales y métodos. Se realizó un estudio observacional longitudinal a nivel de comunidades basado en dos rondas de encuestas telefónicas con autoridades locales de más de 400 comunidades rurales indígenas y no-indígenas en Loreto y Ucayali, en julio y agosto de 2020, para recopilar información sobre casos y muertes por COVID-19 en sus comunidades, medidas de protección adoptadas y la recepción de asistencia estatal en la etapa temprana de la pandemia. Estadísticas descriptivas permiten evaluar la evolución de la pandemia después del brote inicial y comparar las tendencias de las dos regiones, así como entre poblaciones indígenas y no-indígenas. Resultados. En julio de 2020, el COVID-19 había llegado al 91,5% de las comunidades, aunque se reportaron muertes por COVID-19 en 13,0% de las comunidades, siendo la mortalidad rural mayor en Ucayali (0,111%) que en Loreto (0,047%) y en comunidades no-indígenas. Para agosto, la prevalencia disminuyó de 44,0% a 32,0% de comunidades, pero se volvió más frecuente en las comunidades indígenas, y aquellas en Ucayali. Viajar a la ciudad para recibir bonos estatales y las dificultades para mantener el distanciamiento social contribuyeron al contagio. Conclusiones. Los hallazgos mostraron la evolución del COVID-19 en comunidades rurales y señalan áreas importantes de atención en futuras políticas públicas, para la adopción de medidas de protección y reconsiderar estrategias para la distribución de asistencia ante pandemias futuras.

Abstract Introduction. The COVID-19 infection drastically affected health care worldwide, creating challenges for primary care. In order to mitigate and manage infection, telemedicine has become an emerging and effective modality in several medical specialties, including head and neck surgery. Methods. Retrospective cross-sectional analysis of patients seen in virtual consultation over 18 months. Absolute and relative frequencies were estimated, univariate analysis was done with chi-square, and bivariate analysis with binary logistic regression. Variables such as primary diagnosis, the resolution power of the consultation, the need for an in-person appointment, the platform, and its difficulties were included. Results. 2485 patients from 11 departments were included. Thyroid pathology was the most frequent (62.9%), followed by aerodigestive tract pathology (10.8%). The consultation was efficient in 99% of cases, with a resolution capacity of 96.4%. 1.4% had difficulties on the platform and 8.3% of patients required an in-person. When there was difficulty in reviewing exams or an inadequate functional inspection, it was 30 times more likely to not be able to efficiently be resolved. Conclusion. Telemedicine provides an efficient alternative for care in head and neck surgery, especially in thyroid pathology controls, avoiding unnecessary travel. In the aerodigestive tract, where the physical examination is essential, its usefulness is limited to the possibility of performing a subsequent endoscopic examination that allows adequate staging and facilitates in-person assessment.

Resumen Introducción. La infección por COVID-19 afectó drásticamente la atención en salud a nivel mundial, generando retos para la atención primaria. En orden de mitigar y manejar el contagio, la telemedicina se convirtió en una modalidad emergente y efectiva en varias especialidades médicas, incluida la cirugía de cabeza y cuello. Métodos. Estudio de corte transversal con análisis retrospectivo de pacientes atendidos en la consulta virtual durante 18 meses. Se estimaron frecuencias absolutas y relativas, y bivariado con regresión logística binaria. Se incluyeron las variables de diagnóstico primario, poder resolutivo de la consulta, necesidad de cita presencial, plataforma y dificultades de la misma. Resultados. Se incluyeron 2485 pacientes provenientes de 11 departamentos. La patología tiroidea fue la más frecuente (62,9 %), seguida de la aerodigestiva (10,9 %). La consulta fue eficiente en el 99 % de los casos, con una capacidad resolutiva del 96,4 %. El 1,4 % tuvo dificultades en la plataforma y el 8,3 % de los pacientes requirió cita presencial. Cuando hubo dificultad para la revisión de exámenes o una inadecuada inspección funcional, fue 30 veces más probable no poder resolver eficientemente la consulta. Conclusión. La telemedicina provee una alternativa eficiente de atención en cirugía de cabeza y cuello, especialmente en los controles de patología tiroidea, evitando desplazamientos innecesarios. En el tracto aerodigestivo, donde el examen físico es primordial, su utilidad está limitada a la posibilidad de realizar un examen endoscópico posterior que permita una adecuada estadificación y facilite la valoración presencial.

A gravidez na adolescência é um problema significativo de saúde pública no Brasil, contribuindo para altas taxas de morbimortalidade entre mulheres jovens. Durante a gestação, muitas adolescentes abandonam a escola e o trabalho, o que resulta em menor qualificação e maior vulnerabilidade ao mercado de trabalho informal. Além disso, as adolescentes grávidas enfrentam riscos elevados de complicações gestacionais e desafios emocionais, como ansiedade e depressão. A pandemia exacerbou essas vulnerabilidades, especialmente em relação ao abuso doméstico, devido ao isolamento social. Este estudo justifica-se pela necessidade de compreender o perfil demográfico e as características das parturientes adolescentes no Ceará entre 2020 e 2022, oferecendo subsídios para políticas públicas que visem melhorar a qualidade de vida dessas jovens e de seus filhos. Todos os dados foram analisados utilizando R. Durante o período analisado, foram registrados 331.924 nascimentos vivos no Ceará, dos quais 21.667 (6,53%) eram de mães com idade igual ou inferior a 17 anos. A idade média das mães adolescentes foi de 15,93 ± 1,11 anos, enquanto a média para as mães adultas foi de 28,00 ± 6,21 anos, evidenciando uma diferença estatisticamente significativa (Teste-t de Student, P < 0,05). A análise também revelou uma diferença significativa entre a idade dos pais de crianças nascidas de mães adolescentes (22,25 ± 5,72 anos) em comparação à idade dos pais de crianças nascidas de mães adultas (32,45 ± 7,81 anos) (Figura 3, Teste-T, P < 0,05). No que se refere à etnia, adolescentes indígenas representaram 9,95% dos casos de gravidez, seguidas pelas adolescentes pardas (7,26%) e pretas (5,9%). A menor proporção foi observada entre adolescentes brancas (4,43%). Não houve diferença estatisticamente significativa entre os grupos indígenas, pardas, pretas e a população amarela. Quanto ao estado civil, 71% das adolescentes se declararam solteiras. A análise educacional demonstrou uma tendência significativa de gravidez entre adolescentes com Ensino Fundamental II incompleto, completo, ou Ensino Médio incompleto, indicando que essas jovens ainda estavam em fase de conclusão desses ciclos escolares. Não foi observada uma relação significativa entre a redução da idade materna e a diminuição do escore APGAR em recém-nascidos (APGAR = 0,014 × “IDADE DA MÃE” + 8,5; P < 0,05, R² = 0,0004). Além disso, não houve diferença significativa na proporção de anomalias congênitas entre os nascimentos de mães adolescentes e adultas.

El embarazo en la adolescencia es un problema significativo de salud pública en Brasil, que contribuye a altas tasas de morbimortalidad entre las mujeres jóvenes. Durante el embarazo, muchas adolescentes abandonan la escuela y el trabajo, lo que resulta en menor calificación y mayor vulnerabilidad en el mercado laboral informal. Además, las adolescentes embarazadas enfrentan mayores riesgos de complicaciones gestacionales y desafíos emocionales, como ansiedad y depresión. La pandemia exacerbó estas vulnerabilidades, especialmente en relación con el abuso doméstico, debido al aislamiento social. Este estudio se justifica por la necesidad de comprender el perfil demográfico y las características de las madres adolescentes en Ceará entre 2020 y 2022, ofreciendo apoyo para políticas públicas que busquen mejorar la calidad de vida de estas jóvenes y sus hijos. Todos los datos fueron analizados utilizando R. Durante el período analizado, se registraron 331.924 nacimientos vivos en Ceará, de los cuales 21.667 (6,53%) eran de madres de 17 años o menos. La edad promedio de las madres adolescentes fue de 15,93 ± 1,11 años, mientras que la media para las madres adultas fue de 28,00 ± 6,21 años, evidenciando una diferencia estadísticamente significativa (Prueba t de Student, P < 0,05). El análisis también reveló una diferencia significativa entre la edad de los padres de niños nacidos de madres adolescentes (22,25 ± 5,72 años) en comparación con la edad de los padres de niños nacidos de madres adultas (32,45 ± 7,81 años) (Prueba de Wilcoxon, P < 0,05). En cuanto a la etnia, las adolescentes indígenas representaron el 9,95% de los casos de embarazo, seguidas por las adolescentes mestizas (7,26%) y negras (5,9%). La menor proporción se observó entre las adolescentes blancas (4,43%). No hubo diferencia estadísticamente significativa entre los grupos indígenas, mestizas, negras y la población amarilla. En cuanto al estado civil, el 71% de las adolescentes se declararon solteras. El análisis educativo demostró una tendencia significativa de embarazo entre adolescentes con secundaria incompleta o completa, o educación media incompleta, lo que indica que estas jóvenes aún estaban en proceso de completar estos niveles educativos. No se observó una relación significativa entre la disminución de la edad materna y la reducción de la puntuación APGAR en los recién nacidos (APGAR = 0,014 × "EDAD DE LA MADRE" + 8,5; P < 0,05, R² = 0,0004). Además, no hubo diferencia significativa en la proporción de anomalías congénitas entre los nacimientos de madres adolescentes y adultas.

Adolescent pregnancy is a significant public health issue in Brazil, contributing to high morbidity and mortality rates among young women. During pregnancy, many adolescents drop out of school and work, leading to lower qualifications and increased vulnerability to the informal labor market. Moreover, pregnant adolescents face higher risks of gestational complications and emotional challenges, such as anxiety and depression. The pandemic exacerbated these vulnerabilities, particularly concerning domestic abuse, due to social isolation. This study is justified by the need to understand the demographic profile and characteristics of adolescent mothers in Ceará between 2020 and 2022, providing support for public policies aimed at improving the quality of life for these young women and their children. All data were analyzed using R. During the analyzed period, 331,924 live births were recorded in Ceará, of which 21,667 (6.53%) were from mothers aged 17 years or younger. The average age of adolescent mothers was 15.93 ± 1.11 years, while the average for adult mothers was 28.00 ± 6.21 years, showing a statistically significant difference (Student's t-test, P < 0.05). The analysis also revealed a significant difference between the age of fathers of children born to adolescent mothers (22.25 ± 5.72 years) compared to the age of fathers of children born to adult mothers (32.45 ± 7.81 years) (Wicoxon test, P < 0.05). Regarding ethnicity, indigenous adolescents accounted for 9.95% of pregnancy cases, followed by brown (7.26%) and black (5.9%) adolescents. The lowest proportion was observed among white adolescents (4.43%). There was no statistically significant difference among indigenous, mixed-race, black, and yellow populations. Concerning marital status, 71% of adolescents declared themselves single. Educational analysis showed a significant trend of pregnancy among adolescents with incomplete or complete middle school or incomplete high school education, indicating that these young women were still in the process of completing these educational levels. There was no significant relationship between decreasing maternal age and a reduction in newborns' APGAR scores (APGAR = 0.014 × "MOTHER'S AGE" + 8.5; P < 0.05, R² = 0.0004). Additionally, there was no significant difference in the proportion of congenital anomalies between births of adolescent and adult mothers.

Resumo Introdução: A pandemia provocada pelo coronovírus (COVID-19) condicionou a prática clínica de múltiplas formas, incluindo a restrição a exames endoscópicos não urgentes. Por este motivo, decidimos avaliar o im-pacto do primeiro ano de pandemia no diagnóstico e tratamento do cancro colorretal (CCR) em Portugal. Métodos: Este é um subestudo do estudo Francês retrospetivo multicêntrico ETICC (Etude de l’Impact de la pandémie COVID-19 sur le diagnostic et la prise en charge du Cancer Colorectal). Foram comparadas as características dos doentes, manifestações clínicas, estadiamento do CCR ao diagnóstico, intervalos entre primeiro contacto médico neste contexto, diagnóstico histológico e tratamentos, entre o primeiro ano de pandemia e o ano precedente. Resultados: Foram incluídos 766 doentes, 496 no grupo controlo e 270 no grupo COVID. Em França e em Portugal não se verificou um agravamento no estadiamento do CCR à data do diagnóstico no primeiro ano de pandemia, com 21% dos casos metastáticos à data de diagnóstico no grupo controlo e 22% no primeiro ano da pandemia (p = 0.770). Contudo, apenas em Portugal se constatou uma redução significativa do número de CCR em doentes assintomáticos (25% para 8.4%; p < 0.001) ou após uma pesquisa de sangue oculto positiva (20.8% para 11.3%; p = 0.002) durante a pandemia. Apesar do aumento na taxa de complicações ao diagnóstico não ser significativa, em Portugal a taxa de diagnósticos em contexto de oclusão intestinal aumentou significativamente (12.1% para 18.1%; p = 0.033). Em Portugal, o tempo entre início dos sintomas e a primeira consulta médica aumentou significativamente, de uma mediana de 50 para 64 dias durante o COVID (p < 0.001). Por outro lado, o tempo entre diagnóstico histológico e resseção tumoral reduziu significativamente de 65 para 39 dias (p < 0.001). O tempo entre diagnóstico histológico e tratamento neoadjuvante (mediana de 64 para 67 dias; p = 0.590) ou quimioterapia paliativa (mediana de 50 para 51 dias; p = 1.000) não foi estatisticamente significativo, tendo decrescido significativamente o tempo entre resseção e adjuvância (mediana de 54 para 43 dias, p = 0.001). Discussão: Este estudo evidenciou um impacto significativo no diagnóstico de CCR durante o primeiro ano de pandemia, mais pronunciado que em França. Este achado dever-se-á não só à limitação do acesso aos exames endoscópicos, mas também à dificuldade da população portuguesa em aceder aos Cuidados de Saúde Primários. Por outro lado, tanto em França como em Portugal, no primeiro ano de pandemia não se verificou um agravamento no estadiamento ou atraso no tratamento médico e cirúrgico do CCR.

Abstract Introduction: The outbreak of coronavirus disease 2019 (COVID-19) had affected clinical practice in several ways, including the restriction of nonessential endoscopic procedures. Therefore, our aim was to evaluate how colorectal cancer (CRC) diagnosis and management was affected during the first year of pandemics in Portugal. Methods: This is a Portuguese substudy of the French retrospective multicentric study ETICC (Etude de l’Impact de la pandémie COVID-19 sur le diagnostic et la prise en charge du Cancer Colorectal). We compared patients’ characteristics, clinical manifestations, CRC staging at diagnosis, delay to first medical appointment, histological diagnosis, surgical and medical treatments between the year previous to the pandemics (control) and the first year of pandemics. Results: We included 766 patients: 496 in the control group and 270 in the COVID group. There was no significant difference in CRC staging at diagnosis between both groups, with 21% being diagnosed as metastatic in the control group and 22% in the first year of pandemics (p = 0.770). Contrary to what happened in France, there was a significant decrease in CRC diagnosis in asymptomatic patients (25-8.4%; p < 0.001) and after a positive fecal immunochemical test (20.8-11.3%; p = 0.002) during the pandemics. Although the increase in the overall complication rate at diagnosis was nonsignificant, in Portugal, there was a significant increase in diagnosis of abdominal occlusion (12.1-18.1%; p = 0.033). In Portugal, time between the beginning of symptoms and the first medical appointment significantly increased from a median of 50 days to 64 days during COVID (p < 0.001). On the contrary, time between histological diagnosis and tumor resection had significantly decreased from a median of 65 to 39 days (p < 0.001). Time between histological diagnosis and neo-adjuvant treatment was not statistically different (median of 64-67 days; p = 0.590), as was time between histological diagnosis and palliative chemotherapy (median of 50-51 days; p = 1.000). Time from CRC resection and adjuvant treatment has significantly decreased from a median of 54 to 43 days (p = 0.001). Discussion: We found a significant impact in CRC diagnosis in the first year of pandemics, more pronounced than what was found in France. These are likely related not only with the closing of endoscopy units but also with the difficulties patients had in finding an appointment with their general practitioners. On the other hand, both in France and Portugal, the first year of pandemics did not worsen CRC staging at diagnosis and did not significantly affect medical and surgical treatments once the diagnosis was made.

Abstract The significance of social networks in medical education, particularly in the field of movement disorders, is immeasurable. The current trend revolves around the emergence of new-onset pandemics, such as the COVID-19 virus or the rising use of consumer opioids. This phenomenon is evident across social networks, where non-professional videos depicting individuals experiencing abnormal movement disorders, such as upright postures and gait issues, are widely shared. These videos often feature people living on the streets in various locations throughout the United States and other major cities worldwide. The phenomenology of movement disorders involves closely observing patients in the examination room to identify the clinical phenotype and distinguish between hyperkinetic and hypokinetic disorders. This initial step is crucial in the assessment of any movement disorder. Given the limited availability of literature discussing the clinical features of opioid users, our research strategy involved exploring articles in the PubMed database that met the PRISMA criteria for 2020. Specifically, we sought articles addressing the clinical phenomenology and pathophysiology related to movement disorders from 1980 to the present. Our objective was to investigate cases, propose potential theories regarding implicated mechanisms, and explore the role of opioids in the movement circuits within the basal ganglia.

Resumen La importancia de las redes sociales para el aprendizaje en medicina, especialmente en el campo de los trastornos del movimiento, es incalculable. La tendencia actual es el desarrollo de pandemias de inicio reciente (por ejemplo, el virus COVID-19 o el aumento de opioides entre consumidores) que se observa a través de las redes sociales, donde se suben videos sobre personas que viven en las calles de Estados Unidos y otras ciudades importantes en el mundo, y que muestran trastornos anormales del movimiento, como posturas erguidas y trastornos de la marcha. La fenomenología en trastornos del movimiento se centra en observar al paciente en la sala de examen para determinar el fenotipo clínico (trastornos hiperquinéticos o hipocinéticos) como primer paso en la evaluación de cualquier trastorno del movimiento. Por lo tanto, debido a la escasez de documentos escritos en la literatura médica sobre las características clínicas de los usuarios de opioides, decidimos investigar en la base de datos PubMed artículos seleccionados bajo los criterios PRISMA 2020 sobre la fenomenología clínica y la fisiopatología relacionada con los trastornos del movimiento desde 1980 hasta la actualidad, abordando los casos y la teoría posible sobre el mecanismo implicado y el papel de los opioides en los circuitos del movimiento en los ganglios basales. Nuestro objetivo fue investigar casos, proponer teorías potenciales sobre los mecanismos involucrados y explorar el papel de los opioides en los circuitos de movimiento dentro de los ganglios basales.

Abstract This is a qualitative study that explores the perspectives and experiences of a group of Mexican women who experienced institutionalized childbirth care in the first and second waves of the COVID-19 pandemic. Through a semi-structured script, nine women who experienced childbirth care were interviewed between March and October 2020 in public and private hospitals in the city of San Luis Potosí, Mexico. Under the Grounded Theory analysis proposal, it was identified that the health strategies implemented during the pandemic brought with them a setback in the guarantee of humanized childbirth. Women described themselves as distrustful of the protocols that personnel followed to attend to their births in public sector hospitals and very confident in those implemented in the private sector. The intervention of cesarean sections without a clear justification emerged as a constant, as did early dyad separation. Healthcare personnel’s and institutions’ willingness and conviction to guarantee, protect and defend the right of women to experience childbirth free of violence remain fragile. Resistance persists to rethink childbirth care from a non-biomedicalizing paradigm. COVID19 COVID 19 COVID-1 semistructured semi structured script 202 Potosí Mexico proposal constant separation personnels s institutions fragile nonbiomedicalizing non biomedicalizing paradigm COVID1 1 COVID- 20 2

Resumen Estudio de tipo cualitativo que explora las perspectivas y experiencias de un grupo de mujeres mexicanas que vivieron la atención institucionalizada del parto en la primera y segunda ola de la pandemia por COVID-19. A través de un guión semiestructurado se entrevistó a nueve mujeres que vivieron la experiencia de la atención del parto entre marzo y octubre de 2020, en hospitales públicos y privados de la ciudad de San Luis Potosí, en México. Bajo la propuesta de análisis de la teoría fundamentada, se identificó que las estrategias sanitarias implementadas en el marco de la pandemia, trajeron consigo un retroceso en la garantía del parto humanizado, las mujeres se narraron desconfiadas en los protocolos que siguió el personal para la atención de sus partos en los hospitales del sector público y muy confiadas en los que se implementaron en el sector privado. La realización de cesáreas sin una justificación clara emergió como una constante, igual que la separación temprana de los binomios. Continúa frágil la disposición y el convencimiento del personal sanitario y las instituciones para garantizar, proteger y defender el derecho de las mujeres a vivir el parto libre de violencia. Persisten resistencias para repensar la atención del parto desde un paradigma no biomédicalizante. COVID19. COVID19 COVID 19. 19 COVID-19 2020 Potosí México fundamentada humanizado privado constante binomios garantizar violencia biomédicalizante COVID1 1 COVID-1 202 COVID- 20 2

RESUMO A pandemia de covid-19 trouxe inúmeras mudanças aos territórios sustentáveis e saudáveis, implicando a necessidade de reorganização de estruturas sociais e de saúde. Objetivou-se compreender a dinâmica das feiras livres de vendas de alimentos no período pós-pandêmico de covid-19 em cidades do Maciço de Baturité, no Ceará, e avaliar as estratégias sanitárias e/ou de biossegurança utilizadas no enfrentamento da covid-19 por feirantes e consumidores. Realizou-se um estudo qualitativo entre outubro de 2021 e janeiro de 2023, em cinco cidades do Ceará. Em uma primeira etapa, foi realizada a observação das condições sanitárias e de biossegurança nas feiras livres, mediante um instrumento estruturado em quatro categorias. Em seguida, consumidores e feirantes foram entrevistados para o aprofundamento de discussões sobre os reflexos da pandemia sobre as feiras. Avaliaram-se as feiras de cinco cidades e entrevistaram-se 44 pessoas. Quatro cidades mostraram-se com condições sanitárias precárias e comprometimento da biossegurança e comercialização de alimentos. Feirantes e consumidores tiveram uma baixa percepção de risco sobre a covid-19 e levantaram a necessidade da perpetuação das feiras livres para a qualidade de vida e economia da região. As feiras livres são territórios sociais e econômicos sustentáveis, que ainda carecem de atenção por gestores e profissionais de saúde. covid19 covid 19 covid-1 saudáveis saúde Objetivouse Objetivou se póspandêmico pós pandêmico Baturité Ceará eou ou Realizouse Realizou 202 2023 etapa categorias seguida Avaliaramse Avaliaram entrevistaramse entrevistaram 4 pessoas mostraramse mostraram região covid1 1 covid- 20 2

ABSTRACT The COVID-19 pandemic has brought countless changes to sustainable and healthy territories, implying the need to reorganize social and health structures. The aim was to understand the dynamics of open-air food sales markets in the post-COVID-19 pandemic period in cities in the Maciço de Baturité, in Ceará, Brazil, and to evaluate the health and/or biosafety strategies used by marketers and consumers to deal with covid-19. A qualitative study was carried out between October 2021 and January 2023, in five cities in the state of Ceará. In the first stage, the sanitary and biosafety conditions at the street markets were observed using an instrument structured into four categories. Then, consumers and stallholders were interviewed to deepen discussions about the impact of the pandemic on the markets. We evaluated fairs in five cities and interviewed 44 people. Four cities were found to have precarious sanitary conditions and compromised biosafety in the sale of food. Marketers and consumers had a low-risk perception regarding COVID-19 and raised the need to perpetuate open-air markets for the region’s quality of life and economy. Free markets are sustainable social and economic territories, which still require attention from managers and health professionals. COVID19 COVID 19 COVID-1 territories structures openair open air postCOVID19 postCOVID post post-COVID-1 Baturité Ceará Brazil andor or covid19. covid19 covid 19. covid-19 202 2023 stage categories Then 4 people lowrisk low risk regions region s economy professionals COVID1 1 COVID- postCOVID1 post-COVID- covid1 covid-1 20 post-COVID covid- 2