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Figueiredo Dos Santos RV, Bado FMR, da Cunha IP, de Castro Meneghim M. Impact of COVID-19 pandemic on pediatric dental procedures in primary healthcare settings in Piracicaba, Brazil: an ecological study. BMC PRIMARY CARE 2024; 25:71. [PMID: 38413864 PMCID: PMC10898019 DOI: 10.1186/s12875-024-02315-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 02/16/2024] [Indexed: 02/29/2024]
Abstract
BACKGROUND The COVID-19 pandemic brought significant changes to dental care, which may have affected pediatric dental care offered in primary healthcare settings. Therefore, the aim of this study was to analyze the quantity of dental procedures performed in primary healthcare for children aged 6 to 12 years, before and during the COVID-19 pandemic. METHODS This is an ecological study using data from the health information system of Piracicaba, São Paulo, Brazil. The variables considered were: coverage of first programmed dental consultation, restoration of permanent and deciduous teeth, topical fluoride application (individual per session), emergency care, and deciduous tooth extraction. Two periods were considered: period I (March 1, 2019 to February 29, 2020) and period II (April 1, 2020 to March 31, 2021), before and during the pandemic, respectively. Comparisons between periods were made using the paired nonparametric Wilcoxon test with a significance level of 5%. RESULTS There was an increase in emergency care from 15.4 to 32.4% (p = 0.0095) and a decrease in the number of restorations of deciduous teeth from 32.8 to 20.2% (p = 0.0217). The first programmed consultation showed a decrease of 9.60% (p = 0.0930) in period II. CONCLUSIONS The COVID-19 pandemic has hindered access to primary dental care for children, impacting the quantity of emergency care, reducing restorations of deciduous teeth, and first programmed dental consultations. These findings highlight the need for strategies to ensure that pediatric dental care is not neglected during pandemics.
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Coutinho BMC, Anunciação LFC, Landeira-Fernandez J, Krahe TE. Tracking demands for seeking psychological help before and during the COVID-19 pandemic: a quanti-qualitative study. PSICOLOGIA-REFLEXAO E CRITICA 2023; 36:22. [PMID: 37640891 PMCID: PMC10462552 DOI: 10.1186/s41155-023-00264-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 07/31/2023] [Indexed: 08/31/2023] Open
Abstract
The COVID-19 pandemic has placed unprecedented burdens on individuals and communities around the world. The isolation, fear, and uncertainty caused by the virus has led to increased rates of anxiety, depression, and other mental health issues. The pandemic has also had a disproportionate impact on individuals and communities with low income and socioeconomic status.ObjectiveTo shed light on the consequences of the pandemic on individuals from minorities and low-income areas, we investigate the main reasons that led patients who were referred to a social clinic of a private university in Rio de Janeiro to seek psychological treatment before (2019) and during the pandemic (2020 and 2021).MethodsWe conducted a quanti-qualitative study with a lexical analysis that evaluated 549 complaint forms of patients seeking treatment in these two distinct periods. Our analyses included descending hierarchical analysis (DHA) and correspondence factor analysis (CFA).ResultsFamily dynamics and communication factors play a dominant role in the reason for seeking therapy and psychological treatment. Additionally, our study suggested an increase in anxiety and panic attacks among other mental health issues associated with grief and losses during the pandemic years.ConclusionBased on these analyses, we can begin to identify a few changes in the main demand and redirection of complaints of patients during the period of COVID-19.
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Affiliation(s)
- Bruna M C Coutinho
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro, Rua Marquês de São Vicente 225 Gávea, Rio de Janeiro, RJ CEP: 22451-900, Brazil
| | - Luis F C Anunciação
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro, Rua Marquês de São Vicente 225 Gávea, Rio de Janeiro, RJ CEP: 22451-900, Brazil
| | - Jesus Landeira-Fernandez
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro, Rua Marquês de São Vicente 225 Gávea, Rio de Janeiro, RJ CEP: 22451-900, Brazil
| | - Thomas E Krahe
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro, Rua Marquês de São Vicente 225 Gávea, Rio de Janeiro, RJ CEP: 22451-900, Brazil.
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Colonia SRR, Cardeal LM, de Oliveira RA, Trinca LA. Assessing COVID-19 pandemic excess deaths in Brazil: Years 2020 and 2021. PLoS One 2023; 18:e0272752. [PMID: 37228083 PMCID: PMC10212149 DOI: 10.1371/journal.pone.0272752] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 05/10/2023] [Indexed: 05/27/2023] Open
Abstract
We estimated the impact of the COVID-19 pandemic on mortality in Brazil for 2020 and 2021 years. We used mortality data (2015-2021) from the Brazilian Health Ministry for forecasting baseline deaths under non-pandemic conditions and to estimate all-cause excess deaths at the country level and stratified by sex, age, ethnicity and region of residence, from March 2020 to December 2021. We also considered the estimation of excess deaths due to specific causes. The estimated all-cause excess deaths were 187 842 (95% PI: 164 122; 211 562, P-Score = 16.1%) for weeks 10-53, 2020, and 441 048 (95% PI: 411 740; 470 356, P-Score = 31.9%) for weeks 1-52, 2021. P-Score values ranged from 1.4% (RS, South) to 38.1% (AM, North) in 2020 and from 21.2% (AL and BA, Northeast) to 66.1% (RO, North) in 2021. Differences among men (18.4%) and women (13.4%) appeared in 2020 only, and the P-Score values were about 30% for both sexes in 2021. Except for youngsters (< 20 years old), all adult age groups were badly hit, especially those from 40 to 79 years old. In 2020, the Indigenous, Black and East Asian descendants had the highest P-Score (26.2 to 28.6%). In 2021, Black (34.7%) and East Asian descendants (42.5%) suffered the greatest impact. The pandemic impact had enormous regional heterogeneity and substantial differences according to socio-demographic factors, mainly during the first wave, showing that some population strata benefited from the social distancing measures when they could adhere to them. In the second wave, the burden was very high for all but extremely high for some, highlighting that our society must tackle the health inequalities experienced by groups of different socio-demographic statuses.
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Affiliation(s)
| | | | | | - Luzia Aparecida Trinca
- Department of Biodiversity and Biostatistics, Institute of Biosciences, Unesp, Botucatu, São Paulo, Brazil
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Man OM, Fuller TL, Rosser JI, Nielsen-Saines K. Re-emergence of arbovirus diseases in the State of Rio de Janeiro, Brazil: The role of simultaneous viral circulation between 2014 and 2019. One Health 2022; 15:100427. [PMID: 36277093 PMCID: PMC9582545 DOI: 10.1016/j.onehlt.2022.100427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 08/06/2022] [Accepted: 08/07/2022] [Indexed: 01/07/2023] Open
Abstract
The burden of arbovirus diseases in Brazil has increased within the past decade due to the emergence of chikungunya and Zika and endemic circulation of all four dengue serotypes. Changes in temperature and rainfall patterns may alter conditions to favor vector-host transmission and allow for cyclic re-emergence of disease. We sought to determine the impact of climate conditions on arbovirus co-circulation in Rio de Janeiro, Brazil. We assessed the spatial and temporal distributions of chikungunya, dengue, and Zika cases from Brazil's national notifiable disease information system (SINAN) and created autoregressive integrated moving average models (ARIMA) to predict arbovirus incidence accounting for the lagged effect of temperature and rainfall. Each year, we estimate that the combined arboviruses were associated with an average of 8429 to 10,047 lost Disability-Adjusted Life Years (DALYs). After controlling for temperature and precipitation, our model predicted a three cycle pattern where large arbovirus outbreaks appear to be primed by a smaller scale surge and followed by a lull of cases. These dynamic arbovirus patterns in Rio de Janeiro support a mechanism of susceptibility enhancement until the theoretical threshold of population immunity allows for temporary cross protection among certain arboviruses. This suspected synergy presents a major public health challenge due to overlapping locations and seasonality of arbovirus diseases, which may perpetuate disease burden and overwhelm the health system.
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Affiliation(s)
- Olivia M. Man
- David Geffen School of Medicine, UCLA, 10833 Le Conte Ave, Los Angeles, CA 90095, USA,Corresponding author at: 10833 Le Conte Ave, Los Angeles, CA 90095, USA.
| | - Trevon L. Fuller
- Institute of the Environment and Sustainability, UCLA, 619 Charles E Young Drive East, La Kretz Hall, Suite 300, Box 951496, Los Angeles, CA 90095, USA
| | - Joelle I. Rosser
- Stanford University School of Medicine, Stanford, 291 Campus Drive, Stanford, CA 94305, USA
| | - Karin Nielsen-Saines
- David Geffen School of Medicine, UCLA, 10833 Le Conte Ave, Los Angeles, CA 90095, USA
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Baughman D, Baughman K, Jabbarpour Y, Waheed A. Comparable quality performance between telemedicine and office‐based care for abnormal BMI screening and management. Obes Sci Pract 2022; 9:87-94. [PMID: 37034569 PMCID: PMC10073821 DOI: 10.1002/osp4.625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 05/27/2022] [Accepted: 05/31/2022] [Indexed: 11/09/2022] Open
Abstract
Background Despite widespread adoption during COVID-19, there is limited evidence supporting the quality of telemedicine care in managing patients with abnormal BMI. Objective To evaluate the comparability of telemedicine and in-person (office) quality performance for abnormal body mass index (BMI kg/m2) screening and management in primary care. Methods This retrospective cohort study measured Healthcare Effectiveness Data and Information Set (HEDIS) quality performance for abnormal BMI screening (patients with BMIs <18.5 or >25 kg/m2 and a qualifying documented follow up plan) across an 8-hospital integrated health system seen via primary care from 4/1/20 - 9/30/21. Encounters were divided into three exposure groups: office (excluding telemedicine), telemedicine (excluding office), and blended telemedicine (office + telemedicine). Demographic stratification compared group composition. Chi squared tests determined statistical differences in quality performance (p = <0.05). Results Demographics of sub-groups for the 287,387 patients (office: 222,333; telemedicine: 1,556; blended-telemedicine: 63,489) revealed a modest female predominance, majority ages 26-70, mostly White non-Hispanics of low health risk, and the majority BMI representation was overweight, followed closely by class 1 obesity. In both HEDIS specified and HEDIS modified performance, blended-telemedicine performed better than office (12.56%, 95% CI 12.29%-13.01%; 11.16%, 95% CI: 10.85%-11.48%; p < 0.0001); office performed better than telemedicine (4.29%, 95% CI 2.84%-5.54%; 4.79%, 95% CI 3.99%-5.35%; p < 0.0001). Conclusion Quality performance was highest for blended-telemedicine, followed by office-only, then telemedicine-only. Given the known cost savings, adding telemedicine as a care venue might promote value within health systems without negatively impacting HEDIS performance.
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Affiliation(s)
- Derek Baughman
- Policy Studies in Family Medicine and Primary Care Robert Graham Center Washington DC USA
- WellSpan Good Samaritan Hospital Family Medicine Residency Program Lebanon Lebanon Pennsylvania USA
| | - Kathryn Baughman
- WellSpan Good Samaritan Hospital Family Medicine Residency Program Lebanon Lebanon Pennsylvania USA
| | - Yalda Jabbarpour
- Policy Studies in Family Medicine and Primary Care Robert Graham Center Washington DC USA
| | - Abdul Waheed
- WellSpan Good Samaritan Hospital Family Medicine Residency Program Lebanon Lebanon Pennsylvania USA
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Miranda AE, Rosadas C, Assone T, Pereira GFM, Vallinoto ACR, Ishak R. Strengths, Weaknesses, Opportunities and Threats (SWOT) Analysis of the Implementation of Public Health Policies on HTLV-1 in Brazil. Front Med (Lausanne) 2022; 9:859115. [PMID: 35462992 PMCID: PMC9021745 DOI: 10.3389/fmed.2022.859115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 03/09/2022] [Indexed: 11/30/2022] Open
Abstract
Human T lymphotropic virus 1 (HTLV-1) is a public health issue for most countries and imposes important consequences on patients' health and socioeconomic status. Brazil is one of the global leaders of the public health response to these viruses. The country has challenges to overcome to implement meaningful policies aiming to eliminate HTLV-1/2. An analysis of strengths, weaknesses, opportunities, and threats (SWOT) for the implementation of public health policies on HTLV-1/2 was performed. The strengths identified were the Brazilian Unified Health System (SUS); Brazilian expertise in public health programs successfully implemented; currently available policies targeting HTLV; and strong collaboration with researchers and patient's representative. Lack of awareness about HTLV, insufficient epidemiological data, lack of reference centers for patient care, insufficient availability of confirmatory tests, lack of universal antenatal screening, and absence of cost-effectiveness studies were identified as weaknesses. Some interesting opportunities included the increased interest from international organizations on HTLV, possibility of integrating HTLV into other programs, external funding for research, available online platforms, opportunity to acquire data from HTLV-1/2 surveillance to gather epidemiological information, and HTLV policies that were implemented independently by states and municipalities. In addition to the COVID-19 pandemic, existing demands from different diseases, the country's demography and its marked sociocultural diversity and the volatility of the technical team working with HTLV-1/2 at the Brazilian Ministry of Health are threats to the implementation of public policies on HTLV-1/2. This SWOT analysis will facilitate strategic planning to allow continuous progress of the Brazilian response to HTLV-1/2 infection.
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Affiliation(s)
- Angelica Espinosa Miranda
- Departamento de Condições Crônicas e Infecções Sexualmente Transmissíveis, Secretaria de Vigilância em Saúde, Ministério da Saúde, Brasília, Brazil
- Departamento de Medicina Social, Universidade Federal do Espírito Santo, Vitória, Brazil
- *Correspondence: Angelica Espinosa Miranda
| | - Carolina Rosadas
- Section of Virology, Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Tatiane Assone
- Departamento de Condições Crônicas e Infecções Sexualmente Transmissíveis, Secretaria de Vigilância em Saúde, Ministério da Saúde, Brasília, Brazil
- Laboratório de Investigação Médica em Neurologia, Faculdade de Medicina, Instituto de Medicina Tropical de São Paulo, Universidade São Paulo, São Paulo, Brazil
| | - Gerson Fernando Mendes Pereira
- Departamento de Condições Crônicas e Infecções Sexualmente Transmissíveis, Secretaria de Vigilância em Saúde, Ministério da Saúde, Brasília, Brazil
| | | | - Ricardo Ishak
- Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
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