Resumo Objetivou-se realizar uma análise espacial da taxa de mortalidade hospitalar (TMH) por síndrome respiratória aguda grave (SRAG) atribuída à COVID-19 em crianças e adolescentes no Brasil no período de 2020 a 2021. Utilizou-se o método de cluster para agrupar as unidades federativas (UFs) com base na TMH. Em 2020, clusters com altas TMHs foram formados por UFs Norte/Nordeste. Em 2021, houve redução na TMH. Os clusters com maiores taxas permaneceram na região N/NE. Diferenças regionais foram observadas nas TMHs. Os achados podem refletir as desigualdades sociais e o acesso à atenção hospitalar, principalmente na faixa etária de menores de 1 ano pela gravidade da doença neste grupo.

Abstract The objective was to perform a spatial analysis of the hospital mortality rate (HMR) due to severe acute respiratory syndrome (SARS) attributed to COVID-19 among children and adolescents in Brazil from 2020 to 2021. A cluster method was used to group federal units (FUs) based on HMR. In 2020, clusters with high HMRs were formed by north/northeast FUs. In 2021, there was a reduction in HMR. Clusters with higher rates remained in the N/NE region. Regional differences were observed in the HMR. The findings may reflect social inequalities and access to hospital care, especially in the under 1-year-old age group due to the severity of the disease in this group.

Abstract The objective was to perform a spatial analysis of the hospital mortality rate (HMR) due to severe acute respiratory syndrome (SARS) attributed to COVID-19 among children and adolescents in Brazil from 2020 to 2021. A cluster method was used to group federal units (FUs) based on HMR. In 2020, clusters with high HMRs were formed by north/northeast FUs. In 2021, there was a reduction in HMR. Clusters with higher rates remained in the N/NE region. Regional differences were observed in the HMR. The findings may reflect social inequalities and access to hospital care, especially in the under 1-year-old age group due to the severity of the disease in this group.

Resumo Objetivou-se realizar uma análise espacial da taxa de mortalidade hospitalar (TMH) por síndrome respiratória aguda grave (SRAG) atribuída à COVID-19 em crianças e adolescentes no Brasil no período de 2020 a 2021. Utilizou-se o método de cluster para agrupar as unidades federativas (UFs) com base na TMH. Em 2020, clusters com altas TMHs foram formados por UFs Norte/Nordeste. Em 2021, houve redução na TMH. Os clusters com maiores taxas permaneceram na região N/NE. Diferenças regionais foram observadas nas TMHs. Os achados podem refletir as desigualdades sociais e o acesso à atenção hospitalar, principalmente na faixa etária de menores de 1 ano pela gravidade da doença neste grupo.

Abstract The objective was to perform a spatial analysis of the hospital mortality rate (HMR) due to severe acute respiratory syndrome (SARS) attributed to COVID-19 among children and adolescents in Brazil from 2020 to 2021. A cluster method was used to group federal units (FUs) based on HMR. In 2020, clusters with high HMRs were formed by north/northeast FUs. In 2021, there was a reduction in HMR. Clusters with higher rates remained in the N/NE region. Regional differences were observed in the HMR. The findings may reflect social inequalities and access to hospital care, especially in the under 1-year-old age group due to the severity of the disease in this group.

Resumo Objetivou-se realizar uma análise espacial da taxa de mortalidade hospitalar (TMH) por síndrome respiratória aguda grave (SRAG) atribuída à COVID-19 em crianças e adolescentes no Brasil no período de 2020 a 2021. Utilizou-se o método de cluster para agrupar as unidades federativas (UFs) com base na TMH. Em 2020, clusters com altas TMHs foram formados por UFs Norte/Nordeste. Em 2021, houve redução na TMH. Os clusters com maiores taxas permaneceram na região N/NE. Diferenças regionais foram observadas nas TMHs. Os achados podem refletir as desigualdades sociais e o acesso à atenção hospitalar, principalmente na faixa etária de menores de 1 ano pela gravidade da doença neste grupo.

Abstract The objective was to perform a spatial analysis of the hospital mortality rate (HMR) due to severe acute respiratory syndrome (SARS) attributed to COVID-19 among children and adolescents in Brazil from 2020 to 2021. A cluster method was used to group federal units (FUs) based on HMR. In 2020, clusters with high HMRs were formed by north/northeast FUs. In 2021, there was a reduction in HMR. Clusters with higher rates remained in the N/NE region. Regional differences were observed in the HMR. The findings may reflect social inequalities and access to hospital care, especially in the under 1-year-old age group due to the severity of the disease in this group.

Resumo Objetivou-se realizar uma análise espacial da taxa de mortalidade hospitalar (TMH) por síndrome respiratória aguda grave (SRAG) atribuída à COVID-19 em crianças e adolescentes no Brasil no período de 2020 a 2021. Utilizou-se o método de cluster para agrupar as unidades federativas (UFs) com base na TMH. Em 2020, clusters com altas TMHs foram formados por UFs Norte/Nordeste. Em 2021, houve redução na TMH. Os clusters com maiores taxas permaneceram na região N/NE. Diferenças regionais foram observadas nas TMHs. Os achados podem refletir as desigualdades sociais e o acesso à atenção hospitalar, principalmente na faixa etária de menores de 1 ano pela gravidade da doença neste grupo.

Abstract Objective The first wave of COVID-19 was challenging for healthcare workers. This study analyzed the ways of coping with stress at a university hospital. Method A Sociodemographic Characterization, Risk and Exposure Assessment, Burnout Assessment Tool (BAT-23), and COVID-19 Coping Scale were responded online by 181 professionals. Results The sample was composed mainly of women, white, married, physicians, with one job. Over 80% of the sample were at high exposure and risk for infection, with 17.1% having tested positive. The most reported stressors were risks of transmitting the disease, being hospitalized, and being separated from loved ones; 11% presented the risk of/probable burnout, with exhaustion and emotional impairment. They presented adaptive coping strategies, such as problem-solving and information-seeking, with a negative correlation between adaptive coping and burnout. Being a physician with maladaptive coping, in psychiatric care, and having religious beliefs were predictors of burnout. Conclusion Promoting adaptive coping may improve the mental health of these workers.

Resumo Objetivo A primeira onda da COVID-19 foi desafiadora para os profissionais de saúde. Este estudo analisou o enfrentamento do estresse em um hospital universitário. Método De forma online, 181 profissionais responderam: Caracterização Sociodemográfica, Avaliação do Risco e Exposição, Burnout Assessment Tool (BAT-23) e Escala de Coping da COVID-19. Resultados A amostra foi composta principalmente por mulheres, caucasianos, casados, médicos, com um emprego. Tiveram alta exposição e risco à infecção mais de 80% da amostra, com 17,1% positivos. Os estressores mais relatados foram: riscos de transmitir a doença, ser hospitalizado e separado de pessoas queridas; 11% apresentaram risco/provável de burnout, com exaustão e prejuízo emocional. Apresentaram estratégias mais adaptativas, como Resolução de Problemas e Busca de Informações, havendo uma correlação negativa entre coping adaptativo e burnout. Ser médico, com coping mal adaptativo, em atendimento psiquiátrico e ter crença religiosa foram preditores de burnout. Conclusão Promover um coping adaptativo poderá melhorar a saúde mental desses trabalhadores.

RESUMO Objetivos: analisar a percepção dos profissionais de saúde sobre aleitamento materno exclusivo em unidades de Estratégia Saúde da Família do município de Macaé. Métodos: estudo qualitativo realizado em quatro unidades de Estratégia Saúde da Família no município de Macaé, estado do Rio de Janeiro. Entrevistaram-se 30 profissionais de saúde entre março e maio de 2019. Os conteúdos textuais foram processados no software IRaMuTeQ® pela Classificação Hierárquica Descendente. Resultados: os profissionais utilizam diferentes estratégias para ações de promoção, proteção e apoio ao aleitamento materno nas consultas de pré-natal, mas determinantes sociais e culturais são questões importantes que interferem nesse processo, sendo essencial o envolvimento da família para o sucesso dessa prática. Considerações Finais: os profissionais de saúde, incluindo os enfermeiros, necessitam de treinamento e capacitação para fortalecer o apoio e a rede social da gestante e inserir a família nas diferentes estratégias utilizadas para melhorar a adesão ao aleitamento materno exclusivo.

ABSTRACT Objectives: to analyze the perception of health professionals about exclusive breastfeeding in Family Health Strategy units in the city of Macaé. Methods: qualitative study carried out in four units of the Family Health Strategy in the city of Macaé, Rio de Janeiro. Thirty health professionals were interviewed from March to May 2019. Textual contents were processed in the IRaMuTeQ® software by the Descending Hierarchical Classification. Results: professionals use different strategies for actions to promote, protect and support breastfeeding in prenatal consultations, but social and cultural determinants are important issues that interfere in this process, the involvement of the family being essential for the success of this practice. Final Considerations: health professionals, including nurses, need training and qualification to strengthen the support and social network of pregnant women and insert the family in the different strategies used to improve adherence to exclusive breastfeeding.

RESUMEN Objetivos: analizar la percepción de los profesionales de la salud sobre la lactancia materna exclusiva en las unidades de la Estrategia Salud de la Familia de la ciudad de Macaé. Métodos: estudio cualitativo realizado en cuatro unidades de la Estrategia Salud de la Familia en la ciudad de Macaé, Rio de Janeiro. Treinta profesionales de la salud fueron entrevistados de marzo a mayo de 2019. Los contenidos textuales fueron procesados en el software IRaMuTeQ® por la Clasificación Jerárquica Descendente. Resultados: los profesionales utilizan diferentes estrategias de acciones para promover, proteger y apoyar la lactancia materna en las consultas prenatales, pero los determinantes sociales y culturales son cuestiones importantes que interfieren en este proceso, siendo el involucramiento de la familia fundamental para el éxito de esta práctica. Consideraciones Finales: los profesionales de la salud, incluidos los enfermeros, necesitan capacitación y capacitación para fortalecer el apoyo y la red social de la gestante e insertar a la familia en las diferentes estrategias utilizadas para mejorar la adherencia a la lactancia materna exclusiva.

ABSTRACT. Evaluation of combined ability can eliminate lines that are inefficient and enable the subsequent program steps to be more successful. The objective of this study was to predict the general (gi) and specific (sij) combination ability of popcorn S1 progenies for early selection. A total of 288 topcrosses were performed under a randomized complete block design with two replicates at two sites (Campinas and Capão Bonito, São Paulo State, Brazil). Diallel analyses were performed using mixed models and the maximum likelihood restricted/best unbiased linear prediction method. Evaluated traits included grain yield (GY; kg ha-1), weight of 100 grains (g), and popping expansion (PE; mL g-1). Ear components were also evaluated, including ear length, ear diameter (cm), and the number of grain rows (unit). The S1 progeny 32 presented the highest gi for GY in Campinas, whereas progeny 46 presented the highest gi for GY in Capão Bonito. The S1 progeny, 114 was an important parent for the popcorn breeding program, because it presented high gi for the traits of agronomic interest at both sites. Combination 86×IAC12 exhibited a high sij, and the 86 parent presented the second-highest gi for PE in Campinas, and it should be used for high PE genotypes.

RESUMO OBJETIVOS Descrever a tendência da atividade física (AF) em quatro domínios realizada por gestantes residentes nas capitais brasileiras e no Distrito Federal (DF) e verificar a associação entre fatores sociodemográficos e a prática de atividade física de lazer entre 2007 e 2017. MÉTODOS Estudo de tendência temporal realizado com dados do Sistema de Vigilância de Fatores de Risco para doenças crônicas por inquérito telefônico (Vigitel). Foram estudadas 3.730 gestantes no período, considerando as variáveis sociodemográficas (idade, macrorregião, trabalho, estado civil, escolaridade, cor) e de atividade física nos quatro domínios (lazer, trabalho, deslocamento, doméstico – sim/não). Para as gestantes que realizavam atividade física de lazer, foi questionada a duração, expressa na variável AF ≥ 150 minutos/semana (sim/não). A tendência temporal foi avaliada por regressão linear ponderada pela variância (variação anual média foi expressa em pontos percentuais – p.p.) e a associação de fatores sociodemográficos com a atividade física de lazer por regressão de Poisson, com estimativa da razão de prevalência (RP). RESULTADOS A prevalência de gestantes com 12 anos ou mais de estudo aumentou no período analisado (+1,37 p.p./ano), assim como a prevalência de gestantes com mais de 35 anos (+1,11 p.p./ano) e aquelas que trabalham (+0,75 p.p./ano). A prevalência de atividade física de lazer pelas gestantes aumentou de 29,3%, em 2007, para 37,6%, em 2017 (+1,37 p.p./ano), e de AF ≥ 150min/semana de 2,3% para 20,6% (+2,33 p.p./ano), respectivamente, e houve redução de atividades físicas domésticas de 63,9% para 38,9% (-1,65 p.p./ano). A prevalência da prática de atividade física de lazer foi superior entre as gestantes com mais de 12 anos de estudo (RP = 2,22; IC95% 1,73–2,84), quando comparadas àquelas com menos de 8 anos, e menor entre gestantes pretas/pardas/indígenas, comparadas às brancas/amarelas (RP = 0,87; IC95% 0,78–0,97). A prevalência da AF ≥ 150min/semana aumentou conforme os anos de escolaridade e idade. CONCLUSÕES A prevalência da prática de atividade física de lazer e sua realização por ≥ 150minutos/semana aumentou no período analisado, e ambas se associaram diretamente à maior escolaridade.

ABSTRACT OBJECTIVES To describe the trend of physical activity (PhA) in four domains performed by pregnant women living in Brazilian capitals and the Federal District (FD) and to verify the association between sociodemographic factors and the practice of leisure-time physical activity between 2007 and 2017. METHODS Time trend study carried out with data from the Surveillance System of Risk Factors for chronic diseases by telephone survey (Vigitel). A total of 3,730 pregnant women were interviewed in the period, considering sociodemographic variables (age, macro-region, work, marital status, schooling, skin color) and physical activity in the four domains (leisure-time, work, commuting, domestic – yes/no). For pregnant women who performed leisure-time physical activity, its duration was inquired, expressed in the variable PhA ≥ 150 minutes/week (yes/no). The time trend was evaluated by variance-weighted linear regression (average annual variation was expressed in percentage points – pp) and the association of sociodemographic factors with leisure-time physical activity by Poisson regression, with prevalence ratio (PR) estimation. RESULTS The prevalence of pregnant women with 12 years of schooling or more increased in the analyzed period (+1.37 pp/year), as well as the prevalence of pregnant women with more than 35 years of age (+1.11 pp/year) and those who work (+0.75 pp/year). The prevalence of leisure-time physical activity by pregnant women increased from 29.3% in 2007 to 37.6% in 2017 (+1.37 pp/year), and of PhA ≥ 150min/week from 2.3% to 20.6% (+2.33 pp/year), respectively, and there was a reduction in domestic physical activities from 63.9% to 38.9% (-1.65 pp/year). The prevalence of leisure-time physical activity was higher among pregnant women with more than 12 years of schooling (PR = 2.22; 95%CI: 1.73–2.84) as compared to those with less than 8 years of age, and lower among black/brown/indigenous pregnant women, compared to white/yellow ones (PR = 0.87; 95%CI: 0.78–0.97). The prevalence of PhA ≥ 150min/week increased according to years of schooling and age. CONCLUSIONS The prevalence of leisure-time physical activity and its performance for ≥ 150 minutes/week increased in the analyzed period, and both were directly associated with greater schooling.

RESUMO OBJETIVOS Descrever a tendência da atividade física (AF) em quatro domínios realizada por gestantes residentes nas capitais brasileiras e no Distrito Federal (DF) e verificar a associação entre fatores sociodemográficos e a prática de atividade física de lazer entre 2007 e 2017. MÉTODOS Estudo de tendência temporal realizado com dados do Sistema de Vigilância de Fatores de Risco para doenças crônicas por inquérito telefônico (Vigitel). Foram estudadas 3.730 gestantes no período, considerando as variáveis sociodemográficas (idade, macrorregião, trabalho, estado civil, escolaridade, cor) e de atividade física nos quatro domínios (lazer, trabalho, deslocamento, doméstico – sim/não). Para as gestantes que realizavam atividade física de lazer, foi questionada a duração, expressa na variável AF ≥ 150 minutos/semana (sim/não). A tendência temporal foi avaliada por regressão linear ponderada pela variância (variação anual média foi expressa em pontos percentuais – p.p.) e a associação de fatores sociodemográficos com a atividade física de lazer por regressão de Poisson, com estimativa da razão de prevalência (RP). RESULTADOS A prevalência de gestantes com 12 anos ou mais de estudo aumentou no período analisado (+1,37 p.p./ano), assim como a prevalência de gestantes com mais de 35 anos (+1,11 p.p./ano) e aquelas que trabalham (+0,75 p.p./ano). A prevalência de atividade física de lazer pelas gestantes aumentou de 29,3%, em 2007, para 37,6%, em 2017 (+1,37 p.p./ano), e de AF ≥ 150min/semana de 2,3% para 20,6% (+2,33 p.p./ano), respectivamente, e houve redução de atividades físicas domésticas de 63,9% para 38,9% (-1,65 p.p./ano). A prevalência da prática de atividade física de lazer foi superior entre as gestantes com mais de 12 anos de estudo (RP = 2,22; IC95% 1,73–2,84), quando comparadas àquelas com menos de 8 anos, e menor entre gestantes pretas/pardas/indígenas, comparadas às brancas/amarelas (RP = 0,87; IC95% 0,78–0,97). A prevalência da AF ≥ 150min/semana aumentou conforme os anos de escolaridade e idade. CONCLUSÕES A prevalência da prática de atividade física de lazer e sua realização por ≥ 150minutos/semana aumentou no período analisado, e ambas se associaram diretamente à maior escolaridade.

ABSTRACT OBJECTIVES To describe the trend of physical activity (PhA) in four domains performed by pregnant women living in Brazilian capitals and the Federal District (FD) and to verify the association between sociodemographic factors and the practice of leisure-time physical activity between 2007 and 2017. METHODS Time trend study carried out with data from the Surveillance System of Risk Factors for chronic diseases by telephone survey (Vigitel). A total of 3,730 pregnant women were interviewed in the period, considering sociodemographic variables (age, macro-region, work, marital status, schooling, skin color) and physical activity in the four domains (leisure-time, work, commuting, domestic – yes/no). For pregnant women who performed leisure-time physical activity, its duration was inquired, expressed in the variable PhA ≥ 150 minutes/week (yes/no). The time trend was evaluated by variance-weighted linear regression (average annual variation was expressed in percentage points – pp) and the association of sociodemographic factors with leisure-time physical activity by Poisson regression, with prevalence ratio (PR) estimation. RESULTS The prevalence of pregnant women with 12 years of schooling or more increased in the analyzed period (+1.37 pp/year), as well as the prevalence of pregnant women with more than 35 years of age (+1.11 pp/year) and those who work (+0.75 pp/year). The prevalence of leisure-time physical activity by pregnant women increased from 29.3% in 2007 to 37.6% in 2017 (+1.37 pp/year), and of PhA ≥ 150min/week from 2.3% to 20.6% (+2.33 pp/year), respectively, and there was a reduction in domestic physical activities from 63.9% to 38.9% (-1.65 pp/year). The prevalence of leisure-time physical activity was higher among pregnant women with more than 12 years of schooling (PR = 2.22; 95%CI: 1.73–2.84) as compared to those with less than 8 years of age, and lower among black/brown/indigenous pregnant women, compared to white/yellow ones (PR = 0.87; 95%CI: 0.78–0.97). The prevalence of PhA ≥ 150min/week increased according to years of schooling and age. CONCLUSIONS The prevalence of leisure-time physical activity and its performance for ≥ 150 minutes/week increased in the analyzed period, and both were directly associated with greater schooling.

ABSTRACT We described a MRSA bloodstream infection outbreak that was rapidly identified and controlled in a Neonatal Intensive Care Unit after implementation of a bundle of measures, including PCR-screening and HCW decolonization. We found 35% of healthcare workers(HCW) colonized with S. aureus by PCR, one of them that presented skin lesion positive for MSSA (same clone and spa type than two patients). Our findings raise the hypothesis that the outbreak could be related to HCW colonization.

Abstract The aim of this study was to investigate the intraoral distribution of untreated caries and tooth loss and estimate the impact of different socioeconomic factors on the occurrence of these outcomes. A cross-sectional study was conducted with 652 18-year-old male adolescents from the city of Sapucaia do Sul, Brazil, who conscripted for military service. The participants answered a questionnaire addressing sociodemographic variables. Two trained and calibrated examiners performed the clinical examinations for the diagnosis of dental caries using the criteria of the World Health Organization. Tooth group and adolescent were the units of analysis for the primary outcomes of the study. Poisson regression analysis with robust variance was performed, with the calculation of crude and adjusted prevalence ratios (PR) and 95% confidence intervals (CI). The prevalence of caries experience and untreated caries was 70.2% and 39.3%, respectively, and 9.4% of the adolescents had missing teeth. Sixty-seven percent of the untreated caries and 98.8% of missing teeth were in first molars. The probability of dental caries and tooth loss was significantly higher among adolescents with less schooling (PR = 2.56; 95%CI: 1.97–3.32 and PR = 3.28; 95%CI: 1.61–6.65, respectively) and those whose mothers had less schooling (PR = 1.31; 95%CI: 1.03–1.67 and PR = 2.30; 95%CI: 1.18–4.50, respectively). In conclusion, the occurrence of untreated dental caries and tooth loss was concentrated in the first molars of adolescents. Moreover, the prevalence of both conditions was higher among adolescents with low schooling and whose mothers had low schooling, reflecting the strong intraoral and socioeconomic polarization of these outcomes.

BACKGROUND Dogs are the main peridomiciliary reservoir of Leishmania infantum thus the correct diagnosis of infection is essential for the control of the transmission and treatment as well. However, the diagnosis is based on serological assays that are not fully effective. OBJECTIVE We aimed to establish an effective serological assay for the diagnosis of L. infantum infected dogs using Leishmania-derived recombinant antigens. METHODS Leishmania derived rK39-, rK28-, rKR95-based enzyme-linked immunosorbent assay (ELISA) was standardized using symptomatic and asymptomatic L. infantum-infected dogs. Then 2,530 samples from inquiry in endemic areas for VL were evaluated and the results compared with recommended assays by the Brazilian Ministry of Health (MH algorithm). Further samples from a cohort of 30 dogs were searched. FINDINGS For rK39-, rK28- and rKR95-ELISA the sensitivity was around 97% and specificity 100%. The positivity of these three ELISA in the inquiry samples was 27-28%, around 10% higher than the assays currently in use. When cohort samples were searched, we observed likely false-negative results (> 65%) with supposedly negative samples that turned positive six months later with the assays in use (MH algorithm). MAIN CONCLUSIONS For the diagnosis of L. infantum-infected dogs, rK39-based ELISA showed better diagnostic performance than other assays in use in Brazil and worldwide.