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

Resumen La utilización de agroquímicos en la agricultura y el aumento de intoxicaciones derivadas de su manejo han llevado a discusiones acerca de su peligrosidad para la salud humana y el ambiente. Objetivo: conocer las causas de intoxicaciones por el uso de agroquímicos y describir propuestas para enfrentar el problema desde la perspectiva de los agricultores rurales, agentes de salud y extensionistas rurales de Cerro Azul (Misiones, Argentina). Metodología: cualitativa de tipo exploratorio-descriptiva, se realizaron 14 entrevistas a los diferentes actores las cuales fueron transcriptas y analizadas con el apoyo del software Atlas ti. Resultados: se encontró que las causas de intoxicación identificadas por los actores fueron: no utilizar vestimenta protectora, no seguir medidas de bioseguridad apropiadas, no poseer los medios de protección, falta de conciencia de la peligrosidad de los agroquímicos, y falta del cumplimiento de la ley relativa al uso de agroquímicos tanto por parte de agricultores como de vendedores de insumos, como propuestas para enfrentar el problema se plantearon: tomar conciencia de la peligrosidad y usar correctamente los medios de protección, dar capacitaciones, hacer visitas a los predios productivos, hacer cumplir la ley y establecer controles de residuos sobre los productos agrícolas. Conclusiones: se identificó que el uso de agroquímicos tiene efectos en la salud humana y en el ambiente, esta afirmación debería ser suficiente para generar y promover cada vez más dispositivos, programas y modelos de producción que disminuyan o eliminen su utilización.

Abstract The use of agrochemicals in agriculture and the increase in poisoning resulting from their handling has led to discussions about their danger to human health and the environment. Objetive: the objective of this research was to know the causes of poisoning due to the use of agrochemicals and describe proposals to face the problem from the perspective of rural producers, health agents and rural extension workers of Cerro Azul (Misiones, Argentina). Methodology: the methodology used was qualitative, exploratory-descriptive, 14 interviews were carried out with the different actors, which were transcribed and analyzed with the support of the Atlas ti software. Results: as a result, it was found that the causes of poisoning identified by the actors were: not using protective clothing, not following appropriate biosafety measures, not having the means of protection, lack of awareness of the danger of agrochemicals, and lack of compliance with the law regarding the use of agrochemicals by both producers and input sellers. Proposals to address the problem were proposed: becoming aware of the danger and correctly using protective means, providing training, visiting productive properties, enforcing the law and establishing residue controls on agricultural products. Conclusion: As a discussion and conclusions, it was identified that the use of agrochemicals has effects on human health and the environment; this statement should be sufficient to generate and promote more and more devices, programs and production models that reduce or eliminate their use.

Resumo O uso de agroquímicos na agricultura e o aumento das intoxicações decorrentes do seu manuseio têm gerado discussões sobre seus perigos para a saúde humana e o meio ambiente. Objetivo: o objetivo desta pesquisa foi conhecer as causas das intoxicações pelo uso de agrotóxicos e descrever propostas para o enfrentamento do problema na perspectiva de produtores rurais, agentes de saúde e extensionistas rurais de Cerro Azul (Misiones, Argentina). Metodologia: a metodologia utilizada foi qualitativa, exploratório-descritiva, foram realizadas 14 entrevistas com os diferentes atores, as quais foram transcritas e analisadas com o apoio do software Atlas ti. Resultados: como resultado, constatou-se que as causas de intoxicação identificadas pelos atores foram: não utilizar roupas de proteção, não seguir medidas adequadas de biossegurança, não possuir meios de proteção, falta de conscientização sobre o perigo dos agroquímicos e falta de cumprimento das normas. a lei relativa ao uso de agroquímicos tanto pelos produtores quanto pelos vendedores de insumos. Foram propostas propostas para enfrentar o problema: conscientizar-se do perigo e utilizar corretamente os meios de proteção, ministrar treinamentos, visitar propriedades produtivas, fazer cumprir a lei e estabelecer controles de resíduos nos produtos agrícolas. Conclusões: como discussão e conclusões, identificou-se que o uso de agrotóxicos traz efeitos à saúde humana e ao meio ambiente; esta afirmação deveria ser suficiente para gerar e promover cada vez mais dispositivos, programas e modelos de produção que reduzam ou eliminem seu uso.

ABSTRACT Introduction: The pandemic of COVID-19 has been the very high morbidity and mortality cause worldwide that has also affected the health personnel due to the nature characteristic of its work, many times under insecure conditions and with infection risk. Objective: To characterize health workers affected by covid-19 according to clinical and sociodemographic variables. Method: An observational, descriptive and cross-sectional study of 114 health workers with COVID-19 belonging to José Martí Pérez Teaching Polyclinic was carried out in Santiago de Cuba, in 2021. To pick up the information the database of the Hygiene and Epidemiology Department was revised and surveys were elaborated. Results: There was a prevalence of the female sex (78.0 %), aged 30 to 59 (83.3 %). The personal history of hypertension was present in 46.5% of those affected. The loss of smell was the most frequent symptom (53.5 %). Pneumonia (14.9 %) and fatigue (37.7%) were the complication and sequel that prevailed. Doctors represented 50.0% in the occupational profile and the most frequent infection area was the polyclinic (36.8 %). Conclusions: The clinical and sociodemographic characteristics found in health workers with COVID-19 showed that this personnel is vulnerable, reason why biosafety measures should be strictly followed.

RESUMEN Introducción: La pandemia de COVID-19 ha sido la causa de morbilidad y mortalidad muy elevadas a escala mundial, que también ha afectado al personal de salud debido a la naturaleza propia de su trabajo, muchas veces en condiciones inseguras y con riesgo de contagio. Objetivo: Caracterizar a trabajadores de la salud afectados por la covid-19 según variables clínicas y sociodemográficas. Método: Se realizó un estudio observacional, descriptivo y transversal de 114 trabajadores de la salud con COVID-19, pertenecientes al Policlínico Docente José Martí Pérez de Santiago de Cuba, en el 2021. Para recoger la información se revisó la base de datos del Departamento de Higiene y Epidemiología y se elaboraron encuestas. Resultados: Se encontró un predominio del sexo femenino (78,0 %), en las edades de 30 a 59 años (83,3 %). Los antecedentes personales de hipertensión arterial estuvieron presentes en 46,5 % de los afectados. La pérdida del olfato resultó ser el síntoma más frecuente (53,5 %). La neumonía (14,9 %) y la fatiga (37,7 %) fueron la complicación y la secuela que prevalecieron. Los médicos representaron 50,0 % en el perfil ocupacional y el área de contagio más frecuente fue el policlínico (36,8 %). Conclusiones: Las características clínicas y sociodemográficas encontradas en los trabajadores de la salud con COVID-19 mostraron que este personal es vulnerable, por lo que se debe cumplir estrictamente con las medidas de bioseguridad.

RESUMEN Fundamento: la bioseguridad es importante dentro de los servicios hospitalarios para evitar potenciales riesgos de contaminación que atenten contra la salud del personal sanitario. Objetivo: evaluar el nivel de gestión del conocimiento en bioseguridad respecto a universalidad, barreras de protección y medidas de eliminación en el personal sanitario que labora diariamente en hospitales peruanos. Métodos: estudio cuantitativo, de corte transversal y diseño descriptivo comparativo realizado en 150 trabajadores que laboran en dos centros hospitalarios de Chimbote (Perú) que pertenecen al sector público y privado. Se utilizó un cuestionario en bioseguridad que fue sometido a un análisis psicométrico de validez y confiabilidad. El análisis de los datos requirió la estadística descriptiva e inferencial, con un nivel de confiabilidad del 95 %. Resultados: en el análisis descriptivo se obtuvo que ambos centros hospitalarios se encontraban en el nivel medio, mientras, en el análisis inferencial existió diferencia estadísticamente significativa. Conclusiones: el contexto donde labora el personal de salud determina que la gestión del conocimiento sobre bioseguridad sea diferente.

ABSTRACT Foundation: biosafety is important within hospital services to avoid potential risks of contamination that threaten the healthcare staff’s health. Objective: evaluate the knowledge management level in biosafety regarding universality, protection barriers and elimination measures in health staff who works daily in Peruvian hospitals. Methods: quantitative, prospective, cross-sectional study and comparative descriptive design carried out in 150 workers from two hospital centers in Chimbote (Peru) that belong to the public and private sectors. A biosafety questionnaire was used that was subjected to a validity and reliability psychometric analysis. Data analysis required descriptive and inferential statistics, with a reliability level of 95 %. Results: in the descriptive analysis it was found that both hospital centers were at the average level, while in the inferential analysis there was a statistically significant difference. Conclusions: the context where health staff work determines that the knowledge management about biosafety is different.

RESUMEN Introducción: En la actualidad, el riesgo biológico ha pasado de ser un escenario desconocido a formar parte de la cotidianidad. Se considera un aspecto básico y necesario la superación continua de los trabajadores expuestos a riesgos biológicos, para la prevención de enfermedades ocupacionales en el ambiente laboral. Objetivo: Fundamentar la importancia de la capacitación para la prevención de enfermedades ocupacionales por exposición a riesgos biológicos. Métodos: Se realizó una revisión sistemática de investigaciones situadas en bases de datos y revistas científicas indexadas. Se abordó como temática principal la capacitación para la prevención de enfermedades ocupacionales por exposición a riesgos biológicos. Antes de la búsqueda de información, se revisaron las palabras claves según el tesauro DeCS/MeSH y el uso de operadores booleanos "AND" y "OR".Se realizaron la selección de artículos mediante la lectura de títulos y resúmenes. Fueron elegidos 27 artículos. El 92,3 % de los últimos cinco años. Desarrollo: Se evidenció que la capacitación laboral en el área de salud y seguridad del trabajo, tiene como objetivo transmitir conocimientos a los trabajadores que le permitan el cumplimiento de normas y leyes de bioseguridad. Identificar las necesidades de aprendizaje para trazar estrategias de capacitación garantizará prácticas seguras encaminadas a la protección de los trabajadores, medio ambiente y brindar una atención médica de calidad. Conclusiones : La capacitación es un elemento clave para dotar al personal expuesto a riesgos biológicos de conocimientos imprescindibles para el cumplimiento de normas y procedimientos con el fin de prevenir accidentes y enfermedades ocupacionales en el entorno laboral.

ABSTRACT Introduction: Nowadays, biological risk has gone from being an unknown scenario to being part of everyday life. The continuous improvement of workers exposed to biological risks is considered a basic and necessary aspect, for the prevention of occupational diseases in the work environment. Objective: To substantiate the importance of training for the prevention of occupational diseases due to exposure to biological risks. Methods: A systematic review of research located in databases and indexed scientific journals were carried out. Training for the prevention of occupational diseases due to exposure to biological risks was addressed as the main topic. Before searching for information, the keywords were reviewed according to the DeCS/MeSH thesaurus and the use of Boolean operators "AND" and "OR". Articles were selected by reading titles and summaries. 27 articles were chosen. 92.3% of the last five years. Development: It is evident that job training in the area of occupational health and safety aims to transmit knowledge to workers that allows them to comply with biosafety standards and laws. Identifying learning needs to draw up training strategies will guarantee safe practices aimed at protecting workers, the environment, and providing quality medical care. Conclusions: Training is a key element to provide personnel exposed to biological risks with essential knowledge for compliance with standards and procedures in order to prevent accidents and occupational diseases in the work environment.

Abstract Salmon farming in the face of antimicrobial resistance and effects on human health and environment. Abstract: The present review compiles and analyzes studies of the last five years on antibiotic use in the salmon industry, reported effects on fish and humans, and impacts on the environment. There is a growing concern regarding the current management of veterinary therapeutic plans used for the treatment and control of bacterial infections. The main problems are related to the increase of resistance to antibiotics by pathogenic and non-pathogenic bacteria communities, horizontal transfer of resistance genes between bacterial cells, and a major number of cases of failed medical treatments in human and animal populations. Therefore, the challenges for the future will be to reduce dependence on antibiotics in animal production through research into alternatives technologies, the collection of epidemiological information from productive sectors that allow detailed monitoring in the different cultivation phases, biosafety measures from an approach of One Health, and strict supervision in the formulation of medicines by professionals in the animal area.

Resumen La salmonicultura frente a la resistencia de los antimicrobianos y los efectos sobre la salud humana y medio ambiente. Resumen: La presente revisión recopila y analiza estudios de los últimos 5 años sobre uso de antimicrobianos en la industria del salmón, efectos reportados en peces y seres humanos, y los impactos sobre el medio ambiente. Existe una creciente preocupación respecto al manejo actual de los planes terapéuticos veterinarios empleados para el tratamiento y control de infecciones bacterianas. Las principales problemáticas están relacionadas con el aumento en la resistencia hacia antimicrobianos por parte comunidades bacterianas patógenas y no patógenas, la transferencia horizontal de genes de resistencia entre células bacterianas y, un mayor número de casos de tratamientos médicos fallidos en poblaciones humanas y animales. Por lo tanto, los desafíos a futuro serán reducir la dependencia hacia los antimicrobianos en producciones animales mediante la investigación de tecnologías alternativas, la recopilación de información epidemiológica de sectores productivos que permitan realizar monitoreo detallado en las diferentes fases de cultivo, medidas de bioseguridad desde un enfoque de “One Health” y, una supervisión estricta en la formulación de medicamentos por parte de los profesionales en el área animal.

ABSTRACT: Aujeszky’s Disease (AD) is a highly infectious swine disease caused by Suid herpesvirus 1 (SuHV 1). The present study evaluated the biosafety of commercial swine farms and carried out the first serological survey for Aujeszky’s Disease in Espírito Santo State, Brazil. A total of 55 farms in 27 municipalities of the state were selected, where 416 swine serum samples were collected to be submitted to serological diagnosis for AD. Finally, a survey was carried out using a questionnaire to obtain information on the biosecurity of the farms. The results by the ELISA technique indicated the absence of antibodies for AD. Regarding the biosecurity of the farms, 56.4% of the farms did not meet the requirement of internal isolation, 67.3% did not have changing rooms, 72.7% did not provide specific clothing for employees and visitors, 85.5% did not require visitors bathe to access the sheds and only 10.9% of the farms controlled the flow of visitors and vehicles accessing the property. Another noteworthy factor is that only 25.5% of the farms had an area to quarantine replacement animals and 69.1% had an access ramp located close to the animal pens. With the results, it was concluded that there is a need to improve biosecurity measures on commercial farms in the state of Espírito Santo and that there was no presence of Aujeszky’s Disease in the evaluated animals. ABSTRACT Aujeszkys Aujeszky s AD (AD SuHV 1. . 1) State Brazil 5 2 selected 41 Finally 564 56 4 56.4 isolation 673 67 3 67.3 rooms 727 72 7 72.7 855 85 85.5 109 10 9 10.9 property 255 25 25.5 691 69 69.1 pens 56. 6 67. 72. 8 85. 10. 25. 69.

RESUMO: A Doença de Aujeszky (DA) é uma enfermidade de suínos altamente infecciosa, causada pelo herpesvírus suíno 1 (SuHV 1). O presente estudo objetivou avaliar a biosseguridade das granjas comerciais capixabas de suínos e realizar o primeiro inquérito sorológico para Doença de Aujeszky no Estado do Espírito Santo, Brasil. Foram selecionadas 55 granjas em 27 municípios do Estado, onde se coletou 416 amostras de soro de suínos para serem submetidos ao diagnóstico sorológico para DA. Por fim, foi realizado inquérito, mediante questionário para obter informações sobre a biosseguridade das granjas. Os resultados pela técnica de ELISA indicaram ausência de anticorpos para DA. Em relação à biosseguridade das granjas, 56,4% das granjas não atenderam o requisito de cerca de isolamento interno, 67,3% não possuíam vestiários, 72,7% não disponibilizavam roupas específicas para funcionários e visitantes, 85,5% não exigiam a prática de banho dos visitantes para acesso aos galpões e somente 10,9% das granjas faziam o controle do fluxo de visitantes e veículos que acessam a propriedade. Outro fator destacado é que apenas 25,5% das granjas apresentavam área para realizar quarentena dos animais de reposição e 69,1% possuíam o embarcador localizado próximo às baias dos animais. Com os resultados, concluiu-se que há necessidade de melhoria das medidas de biosseguridade nas granjas comerciais no Estado do Espírito Santo e que não houve presença da Doença de Aujeszky nos animais avaliados. RESUMO DA (DA infecciosa SuHV 1. . 1) Brasil 5 2 41 fim 564 56 4 56,4 interno 673 67 3 67,3 vestiários 727 72 7 72,7 855 85 85,5 109 10 9 10,9 propriedade 255 25 25,5 691 69 69,1 concluiuse concluiu avaliados 56, 6 67, 72, 8 85, 10, 25, 69,

ABSTRACT Objective: To evaluate the prevalence of sharps accidents among dental students in southwest Goiás state, Brazil, and further survey their knowledge of biosafety and post-injury management. Material and Methods: A cross-sectional analytical observational study was carried out in 2018 following the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. The study population included dental students in the 4th and 10th course semester. A pre-formulated self-administered questionnaire containing 14 objective questions was used for data collection. Mean and standard deviation values were calculated. Results: A total of 308 responses were obtained. Overall, 15.9% of the respondents reported having previously experienced accidents with sharps. Most dental students who claimed to know the biological risks to which they are exposed were in the 5th and 8th course semesters, and 67.2% of them reported knowing how to proceed in the event of a sharp accident. Conclusion: A low prevalence of sharps accidents has been reported, and dental students are considered to have a good knowledge of biosafety. Objective state Brazil postinjury post injury management Methods crosssectional cross sectional 201 STROBE (STROBE guidelines th semester preformulated pre formulated selfadministered self administered 1 collection calculated Results 30 obtained Overall 159 15 9 15.9 semesters 672 67 2 67.2 accident Conclusion 20 3 15. 6 67.

Abstract As a positional and geometrical isomer of linoleic acid, trans 10, cis 12 conjugated linoleic acid (t10c12-CLA) reduces white fat by reducing food intake, modulating lipid metabolism, and stimulating energy expenditure. However, the t10c12-CLA products are mostly mixtures, making it difficult to obtain accurate results. Studies are needed to investigate the effects of pure t10c12-CLA on animals and humans. In this study, we used the biallelic transgenic (tg) mice, which could produce t10c12-CLA itself, to investigate the effects of pure t10c12-CLA on female reproductive ability. The results showed that the body and relative ovary weights had no significant difference between tg and wild-type (wt) littermates at ages 3 or 10 weeks. While the fecundity test found that tg mice had a significantly longer first litter time (32.0 ± 4.70 days vs. 21.3 ± 2.31 days, P<0.05), and a significantly lower number of litters (4.75 ± 2.75 vs. 6.67 ± 0.57, P<0.05) when compared with wt mice during continuous mating within seven months. Hormone profiles showed that serum estradiol levels did not change in tg mice; however, significantly (P<0.05) decreased progesterone and increased prostaglandin E2 levels were observed in tg mice compared with those of wt mice. Hematoxylin-eosin staining showed no pathological characteristics in tg ovaries, except for the increased atresia follicles (P<0.05). Moreover, the tg mice had a significantly more extended diestrus period than the wt mice (48.4 ± 6.38% vs. 39.6 ± 3.81%, P<0.05). In summary, t10c12-CLA could affect serum progesterone and prostaglandin E2 levels, lead to a disordered estrus cycle, and impact the reproductive performance of female mice. This study provided theoretical and biosafety recommendations for applying t10c12-CLA in female mammals. 1 t10c12CLA tcCLA t10c12 CLA t c (t10c12-CLA intake metabolism expenditure However mixtures humans (tg itself ability wildtype wild type (wt weeks 32.0 320 32 0 (32. 470 4 70 4.7 vs 213 21 21. 231 2 31 2.3 P<0.05, P005 P P<0.05 , 05 4.75 475 75 (4.7 275 2.7 667 6 67 6.6 057 57 0.57 months however (P<0.05 E Hematoxylineosin Hematoxylin eosin ovaries P<0.05. . Moreover 48.4 484 48 (48. 638 38 6.38 396 39 39. 381 81 3.81% summary cycle mammals tc t10c1 32. (32 47 7 4. 23 2. P00 P<0.0 (4. 27 66 6. 5 0.5 (P<0.0 48. (48 63 6.3 8 3.81 t10c (3 P0 P<0. (4 0. (P<0. 3.8 ( P<0 (P<0 3. P< (P< (P

Abstract Genetically modified (GM) crops have been on the market for almost 27 years and since the beginning have been protected by intellectual property (IP) rights that restrict their use and commercialization by third parties. In addition, their development is typically associated with elevated costs, making their production by public research institutions extremely difficult, especially in developing countries. Nevertheless, many patents for the first generation of GM crops have already expired, and others will do so soon, opening the path to generic GM crops. Using technologies in the public domain makes it possible to deliver GM seeds adapted to the local environment at affordable prices. This paper describes the development of the first Latin American off-patent GM corn and discusses the relevant IP and regulatory issues that allowed its commercial release in Colombia. The approach exposed here can be utilized for other crops or characteristics of agronomic interest. (GM 2 (IP parties addition costs difficult countries Nevertheless expired soon prices offpatent off patent Colombia interest

Abstract Objectives: to analyze the factors associated with workplace insecurity during the COVID-19 pandemic among oral healthcare providers of the Unified Health System of the state of Ceará. Methods: cross-sectional study with secondary data made available by the Health Care Coordination, which were collected in May 2020. Logistic regression models were constructed. Results: in total, 801 professionals participated in this research, of whom 72.8% were dentists, 73.9% reported receiving only some of the recommended Personal Protective Equipment (PPE), and 58.2% reported feeling unsafe to carry out work activities. In the adjusted analysis, the following factors were associated with workplace insecurity: permanent employment (OR=1.85; 95%CI: 1.15; 2.99) and not receiving all the recommended PPE (OR=1.84; 95%CI: 1.16; 2.91); whereas the chance of feeling insecure was higher among dental assistants and technicians (OR=2.13; 95%CI 1.34; 3.40) than among dental surgeons. Conclusion: professionals reported workplace insecurity during the first wave of the pandemic. This study shows the need for improving working conditions with equal distribution of PPE throughout the state, ensuring safer working conditions. Objectives COVID19 COVID 19 COVID-1 Ceará Methods crosssectional cross sectional Coordination 2020 constructed Results total 80 research 728 72 8 72.8 dentists 739 73 9 73.9 PPE, , (PPE) 582 58 2 58.2 activities analysis OR=1.85 OR185 OR 1 85 (OR=1.85 95CI CI 95 1.15 115 15 2.99 299 99 OR=1.84 OR184 84 (OR=1.84 1.16 116 16 2.91 291 91 2.91) OR=2.13 OR213 13 (OR=2.13 1.34 134 34 3.40 340 3 40 surgeons Conclusion COVID1 COVID- 202 7 72. 73. (PPE 5 58. OR=1.8 OR18 (OR=1.8 1.1 11 2.9 29 OR=2.1 OR21 (OR=2.1 1.3 3.4 4 20 OR=1. OR1 (OR=1. 1. 2. OR=2. OR2 (OR=2. 3. OR=1 (OR=1 OR=2 (OR=2 OR= (OR= (OR

Resumo Objetivos: analisar os fatores associados à insegurança na realização das atividades laborais durante a pandemia de COVID-19 entre profissionais de saúde bucal do Sistema Único de Saúde do Ceará. Métodos: estudo transversal com dados secundários disponibilizados pela Coordenadoria de Atenção à Saúde do Ceará, coletados em maio de 2020. Foram construídos modelos de regressão logística. Resultados: participaram 801 profissionais, dos quais 72,8% eram cirurgiões-dentistas, 73,9% relataram não ter recebido todos os equipamentos de proteção individual (EPI) recomendados e 58,2% relataram não se sentirem seguros para realizar atividades laborais. Na análise ajustada, foram associados à insegurança laboral: maior tempo de formação (RC=1,90; IC95%: 1,12; 3,20), vínculo empregatício efetivo (RC=1,85; IC95%: 1,15; 2,99) e não recebimento de todos os EPI recomendados (RC=1,84; IC95%: 1,16; 2,91); enquanto a chance de insegurança foi menor entre os profissionais que atuavam no nível secundário de atenção à saúde (RC=0,52; IC95%: 0,28; 0,96). Conclusão: os profissionais relataram situação de insegurança laboral durante a primeira onda da pandemia. O estudo revelou a necessidade de melhorias nas condições de trabalho com distribuição de EPI de forma equitativa em todo o estado, garantindo um exercício laboral mais seguro. Objetivos COVID19 COVID 19 COVID-1 Ceará Métodos 2020 logística Resultados 80 728 72 8 72,8 cirurgiõesdentistas, cirurgiõesdentistas cirurgiões dentistas, dentistas cirurgiões-dentistas 739 73 9 73,9 (EPI 582 58 2 58,2 ajustada RC=1,90 RC190 RC 1 90 (RC=1,90 IC95% IC95 IC 1,12 112 12 3,20, 320 3,20 , 3 20 3,20) RC=1,85 RC185 85 (RC=1,85 1,15 115 15 2,99 299 99 RC=1,84 RC184 84 (RC=1,84 1,16 116 16 2,91 291 91 2,91) RC=0,52 RC052 0 52 (RC=0,52 0,28 028 28 0,96. 096 0,96 . 96 0,96) Conclusão estado seguro COVID1 COVID- 202 7 72, 73, 5 58, RC=1,9 RC19 (RC=1,9 IC9 1,1 11 32 3,2 RC=1,8 RC18 (RC=1,8 2,9 29 RC=0,5 RC05 (RC=0,5 0,2 02 09 0,9 RC=1, RC1 (RC=1, 1, 3, 2, RC=0, RC0 (RC=0, 0, RC=1 (RC=1 RC=0 (RC=0 RC= (RC= (RC

Este estudo qualitativo multicêntrico objetivou compreender como as dificuldades no processo de trabalho foram percebidas e sentidas por trabalhadores de saúde bucal (cirurgiões-dentistas, técnicos e auxiliares) em termos éticos e de saúde mental no enfrentamento da pandemia de Covid-19. Realizou-se a análise textual discursiva das respostas de 2560 trabalhadores a três questões abertas de um websurvey, entre agosto e outubro de 2020, na região sul do Brasil. As principais dificuldades do processo de trabalho foram: compreensão sobre suspensão dos atendimentos eletivos e priorização de urgências; acesso aos serviços; e implementação de protocolos de biossegurança. As dificuldades tornaram-se base para alguns problemas éticos: incertezas na priorização de casos, riscos aumentados e condutas profissionais heterogêneas. O sofrimento dos trabalhadores foi explícito: angústia por cobranças da população, medo pela situação da pandemia, situação de exaustão no trabalho e descaso da gestão.

El objetivo de este estudio cualitativo multicéntrico fue comprender cómo las dificultades en el proceso de trabajo fueron percibidas y sentidas por trabajadores de salud bucal (cirujanos-dentistas, técnicos y auxiliares) en términos éticos y de salud mental en el enfrentamiento de la pandemia de Covid-19. Se realizó el análisis textual discursivo de las respuestas de 2560 trabajadores a tres preguntas abiertas de un websurvey, entre agosto-octubre de 2020, en la región Sur de Brasil. Las principales dificultades del proceso de trabajo fueron: comprensión sobre la suspensión de las atenciones efectivas y priorización de urgencias, acceso a los servicios e implementación de protocolos de bioseguridad. Las dificultades pasaron a ser la base para algunos problemas éticos: incertidumbres en la priorización de casos, riesgos aumentados y conductas profesionales heterogéneas. El sufrimiento de los trabajadores fue explícito: angustia por exigencias de la población, miedo por la situación de la pandemia, situación de agotamiento en el trabajo y falta de atención de la gestión.

This multicentric qualitative study aimed to understand how difficulties in the work process were perceived and felt by oral health workers (including dentists, technicians, and assistants) in ethical and mental health terms during the Covid-19 pandemic. A discursive textual analysis was conducted analyzing responses from 2560 workers to three open-ended questions in a websurvey from August to October 2020 in the Brazilian Southern region. The main difficulties in the work process included understanding the interruption of elective appointments and prioritizing emergencies, accessing services, and implementing biosafety protocols. These difficulties became the basis for several ethical problems, including uncertainties in case prioritization, increased risks, and heterogeneous professional conduct. The suffering of the workers was explicit, including anguish due to public demands, fear of the pandemic situation, work exhaustion, and managerial neglect.

RESUMEN Introducción: Los estomatólogos también tuvieron como principal misión luchar contra la COVID-19. Aunque en muchos países los servicios estomatológicos se detuvieron por la propagación de la enfermedad, existió atención de emergencia, preparada y basada en los protocolos de bioseguridad. Objetivo: Identificar las urgencias atendidas en la Clínica Universitaria de Especialidades Estomatológicas “Manuel Cedeño” de Bayamo en el primer cuatrimestre de 2021, durante la pandemia de COVID-19. Métodos: Se realizó un estudio observacional, descriptivo y de corte transversal entre los meses de enero y abril de 2021. El universo de estudio se constituyó por 2103 pacientes, incluidos todos en la investigación. Se estudiaron las variables grupos de edad, sexo, reparto según área de salud y urgencias estomatológicas. Resultados: Predominaron el grupo de 40-59 años con 36,52 % y el sexo femenino con 57,68 %. El 14,31 % y el 11,03 % de los pacientes atendidos en consulta de urgencias pertenecían a los repartos Ciro Redondo y Rosa La Bayamesa, respectivamente. Conclusiones: Las principales urgencias estomatológicas atendidas durante la pandemia fueron la caries dental, los abscesos alveolar agudo y crónico, y la hiperestesia dentinal.

ABSTRACT Introduction: Stomatologists also had as their main mission to fight against COVID-19. Although in many countries stomatological services were stopped due to the spread of the disease, there was emergency care, prepared and based on biosafety protocols. Objective: To identify the emergencies treated at the Teaching Clinic for Stomatology Specialties "Manuel Cedeño" of Bayamo in the first four-month period of 2021 during the COVID-19 pandemic. Methods: An observational, descriptive and cross-sectional study was carried out between January and April 2021. The universe consisted of 2103 patients, all of whom were included in the study. The variables considered were age group, sex, distribution according to health area and stomatological emergencies. Results: The 40-59 years age group predominated with 36.52 % and the female sex with 57.68 %. 14.31 % and 11.03 % of the patients seen in emergency consultation belonged to the Ciro Redondo and Rosa La Bayamesa districts, respectively. Conclusions: The main stomatological emergencies attended during the pandemic were dental caries, acute and chronic alveolar abscess, and dentinal hyperesthesia.

RESUMO Introdução: A pandemia de Covid-19 evidenciou lacunas no preparo de profissionais de saúde. Objetivo: Este estudo teve como objetivo conhecer as sugestões de profissionais que atuaram na assistência à saúde sobre como melhor prepará-los para lidar com esse contexto. Método: Trata-se de um estudo qualitativo exploratório, em que se realizaram entrevistas semiestruturadas em profundidade com diversas categorias de profissionais de um hospital-escola de alta complexidade do Sul do Brasil. No estudo, adotou-se a sociologia compreensiva como referencial. Resultado: As sugestões para as instituições que prestam atenção à saúde abrangeram maior atenção a seu corpo clínico, com oferta regular de programas de treinamento técnico e preparo psicológico. No caso das instituições de ensino na saúde, houve as seguintes sugestões: maior ênfase do currículo nos aspectos psicológicos e no cuidado integral destinado à saúde do ser humano, com humanização; comunicação; trabalho colaborativo em equipe; liderança e gestão de pessoas; maior carga horária de teoria e prática com simulação e práticas em cenários reais em emergência e cuidado intensivo; aspectos relacionados a conteúdos de medicina de crise, biossegurança e bioética quando os recursos são escassos; e cuidado com pacientes críticos. A literatura aponta que investimentos em programas de educação permanente minimizam os erros evitáveis, melhoram o desempenho da equipe e promovem a valorização profissional. No contexto da pandemia de Covid-19, evidenciou-se a necessidade de aprendizagem do autocuidado, comunicação com pacientes e familiares e estratégias para controle e manejo das emoções. No que diz respeito às habilidades técnicas e científicas a serem enfatizadas frente a crises em massa, destacam-se tópicos relativos à biossegurança e cuidados com pacientes críticos. Considerações finais: As sugestões fornecidas podem contribuir para melhor preparo de profissionais de saúde para atuar em contextos de pandemia. Introdução Covid19 Covid 19 Covid-1 Objetivo preparálos prepará los Método Tratase Trata exploratório hospitalescola hospital escola Brasil adotouse adotou referencial Resultado clínico psicológico humano humanização pessoas intensivo crise escassos críticos evitáveis profissional Covid19, 19, evidenciouse autocuidado emoções massa destacamse destacam finais Covid1 1 Covid-

ABSTRACT Introduction: The COVID-19 pandemic provided evidence of gaps in the preparation of health professionals. The objective of this study was to know the suggestions of professionals who worked in healthcare about how to better prepare them to deal with this context. Method: This was an exploratory qualitative study with in-depth semi-structured interviews of diverse groups of professionals from a high-complexity teaching hospital in the South Region of Brazil. Comprehensive Sociology was used as a framework. Results: The suggestions for institutions that provide healthcare included greater attention to their clinical staff, with regularly offered technical training and psychological preparation programs. Suggestions for health education institutions included greater curricular emphasis on psychological aspects and comprehensive care in human health, with humanization; communication; collaborative teamwork, leadership, and management; greater theoretical and practical course load, with simulation and practice in real emergency and intensive care scenarios, in addition to contents covering crisis medicine, biosafety, bioethics when resources are scarce, and care for critically-ill patients. Discussion: The literature indicates that investments in permanent education programs minimize avoidable errors, improve team performance and promote professional development. In the context of the Covid-19 pandemic, the need to learn self-care, communication with patients and family members and strategies for controlling and managing emotions was highlighted. With regard to technical and scientific skills to be emphasized in the presence of mass crises, topics related to biosafety and care for critically-ill patients are highlighted. Final considerations: The suggestions provided can contribute to better preparation of health professionals to work in pandemic contexts. Introduction COVID19 COVID 19 COVID-1 Method indepth depth semistructured semi structured highcomplexity high complexity Brazil framework Results staff humanization teamwork leadership management load scenarios medicine scarce criticallyill critically ill Discussion errors development Covid19 Covid Covid-1 selfcare, selfcare self care, self-care highlighted crises considerations contexts COVID1 1 COVID- Covid1 Covid-

This multicentric qualitative study aimed to understand how difficulties in the work process were perceived and felt by oral health workers (including dentists, technicians, and assistants) in ethical and mental health terms during the Covid-19 pandemic. A discursive textual analysis was conducted analyzing responses from 2560 workers to three open-ended questions in a websurvey from August to October 2020 in the Brazilian Southern region. The main difficulties in the work process included understanding the interruption of elective appointments and prioritizing emergencies, accessing services, and implementing biosafety protocols. These difficulties became the basis for several ethical problems, including uncertainties in case prioritization, increased risks, and heterogeneous professional conduct. The suffering of the workers was explicit, including anguish due to public demands, fear of the pandemic situation, work exhaustion, and managerial neglect. dentists technicians assistants Covid19 Covid 19 Covid-1 256 openended open ended 202 region emergencies services protocols problems prioritization risks conduct explicit demands situation exhaustion neglect Covid1 1 Covid- 25 20 2

El objetivo de este estudio cualitativo multicéntrico fue comprender cómo las dificultades en el proceso de trabajo fueron percibidas y sentidas por trabajadores de salud bucal (cirujanos-dentistas, técnicos y auxiliares) en términos éticos y de salud mental en el enfrentamiento de la pandemia de Covid-19. Se realizó el análisis textual discursivo de las respuestas de 2560 trabajadores a tres preguntas abiertas de un websurvey, entre agosto-octubre de 2020, en la región Sur de Brasil. Las principales dificultades del proceso de trabajo fueron: comprensión sobre la suspensión de las atenciones efectivas y priorización de urgencias, acceso a los servicios e implementación de protocolos de bioseguridad. Las dificultades pasaron a ser la base para algunos problemas éticos: incertidumbres en la priorización de casos, riesgos aumentados y conductas profesionales heterogéneas. El sufrimiento de los trabajadores fue explícito: angustia por exigencias de la población, miedo por la situación de la pandemia, situación de agotamiento en el trabajo y falta de atención de la gestión. cirujanosdentistas, cirujanosdentistas cirujanos dentistas, dentistas (cirujanos-dentistas auxiliares Covid19. Covid19 Covid 19. 19 Covid-19 256 websurvey agostooctubre agosto octubre 2020 Brasil urgencias bioseguridad casos heterogéneas explícito población gestión Covid1 1 Covid-1 25 202 Covid- 2 20

Este estudo qualitativo multicêntrico objetivou compreender como as dificuldades no processo de trabalho foram percebidas e sentidas por trabalhadores de saúde bucal (cirurgiões-dentistas, técnicos e auxiliares) em termos éticos e de saúde mental no enfrentamento da pandemia de Covid-19. Realizou-se a análise textual discursiva das respostas de 2560 trabalhadores a três questões abertas de um websurvey, entre agosto e outubro de 2020, na região sul do Brasil. As principais dificuldades do processo de trabalho foram: compreensão sobre suspensão dos atendimentos eletivos e priorização de urgências; acesso aos serviços; e implementação de protocolos de biossegurança. As dificuldades tornaram-se base para alguns problemas éticos: incertezas na priorização de casos, riscos aumentados e condutas profissionais heterogêneas. O sofrimento dos trabalhadores foi explícito: angústia por cobranças da população, medo pela situação da pandemia, situação de exaustão no trabalho e descaso da gestão. cirurgiõesdentistas, cirurgiõesdentistas cirurgiões dentistas, dentistas (cirurgiões-dentistas auxiliares Covid19. Covid19 Covid 19. 19 Covid-19 Realizouse Realizou se 256 websurvey 2020 Brasil urgências serviços biossegurança tornaramse tornaram casos heterogêneas explícito população gestão Covid1 1 Covid-1 25 202 Covid- 2 20