Abstract Did the COVID-19 pandemic affect the success or failure of candidates for reelection in the 2020 municipal elections? We attempt to answer this question by tested the influence of five-dimension variables: individual candidate traits, municipal political factors, socioeconomic and governance issues, as well as contextual indicators of the pandemic on the performance of those running for a second term. The study comprehended 3,032 cities in which mayors participated in elections. The following factors positively influenced reelection: population size, campaign expenses, investments in health, education, and hiring doctors during the pandemic. Nevertheless, negative drivers included electoral competition and mayors’ gender. We conclude therefore that the determining factors of reelection are connected to COVID-19 responses, individual candidate traits, and municipal political factors, rather than epidemiological phenomena such as the number of cases or even deaths.

Resumen ¿El éxito o fracaso de los candidatos que quieren ser reelegidos como alcaldes en las elecciones de 2020 fue determinado por el contexto de la pandemia? Para responder a esa pregunta, analizamos la influencia de variables de cinco dimensiones: características individuales de los postulantes, factores políticos municipales, cuestiones socioeconómicas y de gobernanza, así como indicadores contextuales de la pandemia sobre el desempeño de aquellos que intentaron renovar sus mandatos. La investigación abarcó 3032 municipios en los que los alcaldes participaron de la contienda electoral. Los siguientes factores influenciaron positivamente la reelección: tamaño de la población, gastos de campaña, en salud y educación y contratación de médicos durante la pandemia. Con efectos negativos se encontraron la competencia electoral y el género del jefe del ejecutivo. Se puede concluir que los aspectos que, de hecho, determinaron la reelección, están relacionados con el combate al Covid-19, a atributos individuales del candidato y a las características políticas del municipio y no a factores epidemiológicos ligados a la pandemia, como casos confirmados e incluso fallecimientos.

Résumé Le succès ou l’échec des candidats à la réélection aux postes de maire lors des élections de 2020 a-t-il été déterminé par le contexte de la pandémie ? Pour répondre à cette question, nous avons testé l’influence des variables provenant de cinq dimensions : les caractéristiques individuelles des candidats, les facteurs politiques municipaux, les questions socio-économiques et de gouvernance, ainsi que les indicateurs contextuels de la pandémie sur les performances de ceux qui ont tenté de renouveler leur mandat. La recherche a porté sur 3032 municipalités où les maires ont participé à la course électorale. Les facteurs suivants ont eu une influence positive sur la réélection : la taille de la population, les dépenses de campagne, les dépenses de santé et d’éducation, ainsi que le recrutement de médecins pendant la pandémie. Des effets négatifs ont été observés pour la concurrence électorale et le genre du chef de l’exécutif. Nous avons conclu que les aspects qui ont réellement déterminé la réélection sont liés à la lutte contre la Covid-19, aux attributs individuels du candidat et aux caractéristiques politiques de la municipalité, et non aux facteurs épidémiologiques liés à la pandémie, tels que les cas confirmés ou même les décès.

Resumo O sucesso ou o fracasso de candidatos à reeleição nas prefeituras nas eleições de 2020 foi determinado pelo contexto da pandemia? Para responder essa questão, testamos a influência de variáveis de cinco dimensões: características individuais dos postulantes, fatores políticos municipais, questões socioeconômicas e de governança, assim como indicadores contextuais da pandemia sobre o desempenho daqueles que tentaram renovar os seus mandatos. A pesquisa circunscreveu 3032 municípios em que prefeitos participaram da corrida eleitoral. Influenciaram positivamente a reeleição os seguintes fatores: tamanho da população, gastos de campanha e gastos em saúde e em educação e contratação de médicos durante a pandemia. Como efeitos negativos, foram encontrados a competição eleitoral e o gênero do chefe do executivo. Concluiu-se que os aspectos que, de fato, determinaram a reeleição estão relacionados ao enfrentamento da Covid-19, a atributos individuais do candidato e às características políticas do município, e não a fatores epidemiológicos ligados à pandemia, como casos confirmados ou mesmo óbitos.

Abstract Objective To evaluate the impact of the race (Black versus non-Black) on maternal and perinatal outcomes of pregnant women with COVID-19 in Brazil. Methods This is a subanalysis of REBRACO, a Brazilian multicenter cohort study designed to evaluate the impact of COVID-19 on pregnant women. From February2020 until February 2021, 15 maternity hospitals in Brazil collected data on women with respiratory symptoms. We selected all women with a positive test for COVID-19; then, we divided them into two groups: Black and non-Black women. Finally, we compared, between groups, sociodemographic, maternal, and perinatal outcomes. We obtained the frequency of events in each group and compared them using X2 test; p-values < 0.05 were considered significant. We also estimated the odds ratio (OR) and confidence intervals (CI). Results 729 symptomatic women were included in the study; of those, 285 were positive for COVID-19, 120 (42.1%) were Black, and 165 (57.9%) were non-Black. Black women had worse education (p = 0.037). The timing of access to the health system was similar between both groups, with 26.3% being included with seven or more days of symptoms. Severe acute respiratory syndrome (OR 2.22 CI 1.17–4.21), intensive care unit admission (OR 2.00 CI 1.07–3.74), and desaturation at admission (OR 3.72 CI 1.41–9.84) were more likely to occur among Black women. Maternal death was higher among Black women (7.8% vs. 2.6%, p = 0.048). Perinatal outcomes were similar between both groups. Conclusion Brazilian Black women were more likely to die due to the consequences of COVID-19.

Resumo Objetivo Avaliar o impacto da raça (negra versus não negra) nos desfechos maternos e perinatais de gestantes com COVID-19 no Brasil. Métodos Esta é uma subanálise da REBRACO, um estudo de coorte multicêntrico brasileiro desenhado para avaliar o impacto da COVID-19 em mulheres grávidas. De fevereiro de 2020 a fevereiro de 2021, 15 maternidades do Brasil coletaram dados de mulheres com sintomas respiratórios. Selecionamos todas as mulheres com teste positivo para COVID-19; em seguida, as dividimos em dois grupos: mulheres negras e não negras. Finalmente, comparamos, entre os grupos, os resultados sociodemográficos, maternos e perinatais. Obtivemos a frequência dos eventos em cada grupo e comparamos usando o teste X2; Valores de p <0,05 foram considerados significativos. Também estimamos o odds ratio (OR) e os intervalos de confiança (IC). Resultados 729 mulheres sintomáticas foram incluídas no estudo; desses, 285 foram positivos para COVID-19, 120 (42,1%) eram negros e 165 (57,9%) não eram negros. As mulheres negras apresentaram pior escolaridade (p = 0,037). O tempo de acesso ao sistema de saúde foi semelhante entre os dois grupos, com 26,3% incluídos com sete ou mais dias de sintomas. Síndrome respiratória aguda grave (OR 2,22 CI 1,17–4,21), admissão em unidade de terapia intensiva (OR 2,00 CI 1,07–3,74) e dessaturação na admissão (OR 3,72 CI 1,41–9,84) foram mais prováveis de ocorrer entre mulheres negras. A mortalidade materna foi maior entre as negras (7,8% vs. 2,6%, p = 0,048). Os resultados perinatais foram semelhantes entre os dois grupos. Conclusão Mulheres negras brasileiras tiveram maior probabilidade de morrer devido às consequências da COVID-19.

Abstract Background Postoperative cough may occur after tracheal intubation, but it is indistinct which drug is best at diminishing these events. Additionally, airway reflexes are commonly accompanied by severe hemodynamics responses during emergence. Objectives To evaluate the role of topical airway anesthesia on immediate post-extubation cough/bucking and extubation time. Methods Randomized clinical trials from MEDLINE, EMBASE, CENTRAL, and LILACS published until December 23, 2020 were included. Our primary outcome was postoperative cough/bucking incidence which was compared between local anesthetics and controls. Extubation times were likewise considered. Predisposition appraisal and subgroup, affectability investigations were likewise performed. Results The pooled analysis found a 45% reduction in cough incidence after treatment with topical airway local anesthetic (RR = 0.55; 95% CI: 0.42 to 0.72; p< 0.001). The number needed to treat (NNT) was 4.61. The intervention showed no differences in reduction of the extubation time (mean difference = -0.07; 95% CI: -0.14 to 0.28; p= 0.49). Conclusion Topical airway anesthesia demonstrated better than placebo or no medication in reducing immediate post-extubation cough/bucking. Further studies could have this objective to combine the different ways to perform better outcomes for patients.

Abstract The bibliometric can be used to evaluate the production of institutionalized scientific knowledge, focusing on the production of theses and dissertations. The literature reports that these studies can highlight trends in the cognitive and social institutionalization of research, to strengthen and give visibility to science. This study presents the results of a literature review that mapped bibliometric studies that had as object documents of the theses and dissertations type, searching for the investigated bibliometric indicators. The methodology is characterized as basic and descriptive research, with a quant-qualitative approach, using the integrative literature review as a technical procedure. A sample of 29 studies was analyzed, based on the following categories: authorship, year of publication, areas of knowledge, objective and conclusion, method, data visualization, and collaboration networks. The results show the multidisciplinary character of bibliometric studies and their recurrent use to map scientific production in Brazilian PPGs. As future studies are suggested: mapping of the productivity of PPGs, collaboration networks and software for data collection and analysis.

Resumo O estudo bibliométrico pode ser utilizado para avaliar a produção do conhecimento científico institucionalizado, tendo como foco a produção referente a teses e dissertações. A literatura relata que esses estudos podem evidenciar as tendências de institucionalização cognitiva e social da pesquisa, visando fortalecer e dar visibilidade à ciência. Este estudo apresenta os resultados de uma revisão de literatura que mapeou estudos bibliométricos que tiveram como objeto documentos do tipo teses e dissertações, buscando pelos indicadores bibliométricos que foram investigados. A metodologia se caracteriza como pesquisa básica e descritiva, com abordagem quanti-qualitativa, utilizando como procedimento técnico a revisão integrativa da literatura. Foi analisada uma amostra de 29 estudos, a partir das seguintes categorias: autoria, ano de publicação, áreas do conhecimento trabalhadas, objetivo e conclusão, método, visualização de dados e redes de colaboração. Os resultados demonstram o caráter multidisciplinar dos estudos bibliométricos e o seu uso recorrente para mapear a produção científica nos PPGs brasileiros. Como estudos futuros sugerem-se: mapeamento da produtividade dos PPGs, das redes de colaboração e de softwares de coleta e análise de dados.

Did the covid-19 pandemic affect the success or failure of candidates for reelection in the 2020 municipal elections? To answer this question, we tested the influence of five-dimensional variables: individual characteristics of applicants, political factors municipalities, socioeconomic and governance issues, as well as contextual indicators of the pandemic on the performance of those who tried to renew their mandates. The research circumscribed 3032 municipalities in which mayors participated in the electoral race. The following factors positively influenced reelection: population size, campaigns and spending on health and education. With negative effects, the electoral competition and the gender of the chief executive. It was concluded that the aspects that fact, determined reelection are related to individual attributes of the candidate and the socioeconomic and political characteristics of the municipality, and not to factors directly linked to the pandemic, such as confirmed cases or even deaths.

O sucesso ou o fracasso de candidatos à reeleição nas prefeituras nas eleições de 2020 foi determinado pelo contexto da pandemia? Para responder essa questão, testamos a influência de variáveis de cinco dimensões: características individuais dos postulantes, fatores políticos municipais, questões socioeconômicas e de governança, assim como indicadores contextuais da pandemia sobre o desempenho daqueles que tentaram renovar os seus mandatos. A pesquisa circunscreveu 3032 municípios em que prefeitos participaram da corrida eleitoral. Influenciaram positivamente a reeleição os seguintes fatores: tamanho da população, gastos de campanha e gastos em saúde e em educação. Com efeitos negativos, foram encontrados a competição eleitoral e o gênero do chefe do executivo. Concluiu-se que os aspectos que, de fato, determinaram a reeleição estão relacionados a atributos individuais do candidato e a características socioeconômicas e políticas do município, e não a fatores ligados diretamente à pandemia, como casos confirmados ou mesmo óbitos. 

Key points Pregnancy places a metabolic overload on the maternal thyroid, especially in the first trimester, mainly because of the demand imposed by the conceptus. The fetal thyroid becomes functionally mature only around pregnancy week 20. Until then, the fetus depends on the transfer of maternal thyroid hormones (THs). Thyroid hormones are essential for the adequate fetal neurofunctional and cognitive development. Hypothyroidism brings higher risks of obstetric and fetal complications, namely, first-trimester miscarriage, preeclampsia and gestational hypertension, placental abruption, prematurity, low birth weight, and higher perinatal morbidity and mortality. Primary hypothyroidism (involvement of the gland with difficulty in producing and/or releasing TH) is the most common form of disease presentation, with the main etiology of Hashimoto's thyroiditis of autoimmune origin. In about 85%-90% of cases of Hashimoto's thyroiditis, antithyroid antibodies are present; the antithyroperoxidase (ATPO) is the most frequent. Positivity for ATPO is determined when circulating values exceed the upper limit of the laboratory reference. It implies greater risks of adverse maternal-fetal outcomes. Such a correlation occurs even in ranges of maternal euthyroidism. The critical point for the diagnosis of hypothyroidism during pregnancy is an elevation of thyroid-stimulating hormone (TSH). The measurement of free thyroxine (FT4) differentiates between subclinical and overt hypothyroidism. In subclinical hypothyroidism, FT4 is within the normal range, whereas in overt hypothyroidism, FT4 values are below the lower limit of the laboratory reference. Treatment of hypothyroidism is performed with levothyroxine (LT4) replacement with the aim of achieving adequate TSH levels for pregnancy. Some women have a previous diagnosis of hypothyroidism, and may or may not be compensated at the beginning of pregnancy. Even in compensated cases, the increase in LT4 dose is necessary as soon as possible. In the postpartum period, adjustment of the LT4 dose depends on the condition of previous disease, on the positivity for ATPO, and also on the value of LT4 in use at the end of pregnancy. Recommendations In places with full technical and financial conditions, TSH testing should be performed for all pregnant women (universal screening) as early as possible, ideally at the beginning of the first trimester or even in preconception planning. In places with less access to laboratory tests, screening is reserved for cases with greater risk factors for decompensation, namely: previous thyroidectomy or radioiodine therapy, type 1 diabetes mellitus or other autoimmune diseases, presence of goiter, previous history of hypo or hyperthyroidism or previous ATPO positivity. The TSH dosage should be repeated throughout pregnancy only in these cases. The diagnosis of hypothyroidism is made from the TSH value > 4.0 mIU/L. Pregnant women with previous hypothyroidism, overt hypothyroidism diagnosed during pregnancy or those with the above-mentioned higher risk factors for decompensation should be referred for risk antenatal care, preferably in conjunction with the endocrinologist. Overt hypothyroidism in pregnancy is identified when TSH > 10 mIU/L, and treatment with LT4 is readily recommended at an initial dose of 2 mcg/kg/day. TSH values > 4.0 mUI/L and ≤ 10.0 mUI/L require FT4 measurement with two diagnostic possibilities: overt hypothyroidism when FT4 levels are below the lower limit of the laboratory reference, or subclinical hypothyroidism when FT4 levels are normal. The treatment for subclinical hypothyroidism is LT4 at an initial dose of 1 mcg/kg/day, and the dose should be doubled upon diagnosis of overt hypothyroidism. In cases of TSH > 2.5 and ≤ 4.0 mIU/L, if there are complete conditions, ATPO should be measured. If positive (above the upper limit of normal), treatment with LT4 at a dose of 50 mcg/day is indicated. If conditions are not complete, the repetition of the TSH dosage should be done only for cases at higher risk. In these cases, treatment with LT4 will be established when TSH > 4.0 mIU/L at a dose of 1 mcg/kg/day; if needed, the dose can be adjusted after FT4 evaluation. Women with previous hypothyroidism should have their LT4 dose adjusted to achieve TSH < 2.5 mIU/L at preconception. As soon as they become pregnant, they need a 30% increase in LT4 as early as possible. In practice, they should double the usual dose on two days a week. Levothyroxine should be given 30-60 minutes before breakfast or three hours or more after the last meal. Concomitant intake with ferrous sulfate, calcium carbonate, aluminum hydroxide and sucralfate should be avoided. The target of LT4 therapy during pregnancy is to achieve a TSH value < 2.5 mIU/L. Once the therapy is started, monthly control must be performed until the mentioned goal is reached. In the postpartum period, women with previous disease should resume the preconception dose. Cases diagnosed during pregnancy in use of LT4 ≤ 50 mcg/day may have the medication suspended. The others should reduce the current dose by 25% to 50% and repeat the TSH measurement in six weeks. Cases of ATPO positivity are at higher risk of developing postpartum thyroiditis and de-escalation of LT4 should be performed as explained.

RESUMO Este artigo discute as múltiplas formas de estudo da liderança, com um interesse particular nos recentes estudos empíricos e teóricos da produção científica brasileira. O artigo revisa o que denominamos as três principais lentes de estudo da liderança (i.e., liderança individual, followership, liderança coletiva), e a tipologia utilizada no artigo resume a visão essencial de cada lente, bem como a sua evolução histórica. Essa discussão sobre as três lentes é utilizada para analisar a literatura científica sobre liderança em periódicos científicos brasileiros no período entre 2016 e 2021. A revisão sistemática de literatura de 32 artigos aponta para uma ênfase na primeira lente, isto é, o foco em líderes individuais, em posições formais de autoridade e para a ideia de que liderança é mais uma atividade hierárquica e vertical do que um fenômeno coletivo. O artigo conclui sinalizando as oportunidades para estudos empíricos em abordagens mais contemporâneas sobre liderança coletiva em organizações brasileiras.

Abstract This article discusses the multiple forms of studying and approaching leadership with a particular interest in recent theoretical and empirical studies from Brazilian scholarship on the topic. The article reviews what we denote as the three main lenses of leadership: individual leader(ship), followership, and collective leadership. The article's typology epitomises the essential view of each lens and its historical treatment. We use this discussion about the three lenses to analyse the scientific literature on leadership in Brazilian scientific journals from 2016 to 2021. The systematic literature review of 32 articles reveals emphasis on the first lens, the focus on individual leaders, normally those in positions of authority, and the idea that leadership is a vertical and hierarchical activity rather than a collectivistic phenomenon. The article concludes by highlighting opportunities for empirical inquiry into more contemporary collective leadership research in Brazilian organisations.

RESUMEN Este artículo discute las múltiples formas de estudio del liderazgo, con un interés particular en los estudios empíricos y teóricos recientes de la producción científica brasileña. El artículo revisa lo que llamamos los tres lentes principales para el estudio del liderazgo (es decir, liderazgo individual, followership, liderazgo colectivo), y la tipología utilizada en el artículo resume la visión esencial de cada lente, así como su evolución histórica. Utilizamos esta discusión sobre las tres lentes para analizar la literatura científica sobre liderazgo en revistas científicas brasileñas en el período comprendido entre 2016 y 2021. La revisión sistemática de la literatura de 32 artículos apunta a un énfasis en la primera lente, es decir, el enfoque en los líderes individuales, en las posiciones formales de autoridad y en la idea de que el liderazgo es más una actividad jerárquica y vertical que un fenómeno colectivo. El artículo concluye señalando las oportunidades de estudios empíricos en enfoques más contemporáneos sobre el liderazgo colectivo en organizaciones Brasileñas.

Abstract Objective So far, at least 18 different severe acute respiratory syndrome coronavirus-2 vaccines have been approved. Until October 2022, 12.8 billion doses had been administered all over the world. Vaccination of high-risk groups and healthcare professionals was initially prioritized. This cross-sectional survey aimed to investigate the occurrence of vaccine side effects, as well as the incidence of COVID-19 among vaccinated healthcare professionals. Methods A survey was structured and shared with healthcare professionals using a digital platform to collect data between May and June 2021. Results This study included 6,115 participants. The most prevalent age group was 30-39 years (31.3%), 67.3% were female and 73.2% accounted for physicians, and nearly half worked in frontline care for COVID-19. Approximately, two-thirds of them were vaccinated with CoronaVac, and about 60% reported at least one side effect following the vaccination. Nevertheless, minor reactions were more frequent, such as pain at site of injection, fatigue, and headache. Our data could be used to inform people on the likelihood of side effects of COVID-19 vaccines, particularly CoronaVac, since this is the largest study about vaccine reactions using this vaccine, to our best knowledge. Conclusion The incidence of side effects in Brazilian healthcare professionals was 60%, and the most common side effects included local swelling/pain, fatigue/tiredness, fever, headache, and limb pain.

SUMMARY OBJECTIVE: This study aimed to assess older people’s knowledge of the purpose of drugs prescribed at medical appointments in primary care units and the possible factors related to their level of knowledge about their medications. METHODS: This was a cross-sectional study conducted in 22 basic health units in Brazil. Patients aged ≥60 years were included in this study (n=674). Knowledge of prescribed medications was assessed by comparing the responses to the questionnaire and the medication and prescription information. Multivariate analyses were conducted using the Poisson regression with robust variance. RESULTS: The mean age of the sample was 70.1 (standard deviation: ±7.1) years. Among 674 patients, 272 (40.4%) did not know the indication of at least 1 of their prescribed drugs; among them, 78 (11.6%) did not know the indication of any of their prescribed drugs. In the final multivariate analysis, polypharmacy, illiteracy, and cognitive impairment were found to be associated with misunderstanding the purpose of at least one prescribed drug. Moreover, illiteracy and cognitive impairment were associated with a greater misunderstanding of the purpose of all prescribed drugs. CONCLUSIONS: In the studied sample, patients demonstrated a high rate of misunderstanding of the purpose of prescribed drugs. Therefore, it is necessary for health services and professionals to implement strategies that increase the quality of the guidance and instructions given to older people in order to promote adherence to treatment.