Psychological Factors in Temporomandibular Disorders Patients during COVID-19 Pandemic: A Cross-Sectional Study

Objective: To assess the influence of the COVID-19 pandemic on levels of anxiety, stress, and orofacial pain in individuals with and without TMD. Material and Methods: In this cross-sectional study, the participants were divided into two groups (n=10, each) experimental group (EG) TMD patients and control group (CG), without TMD. The presence of TMD was confirmed using the RDC/TMD. The Beck Anxiety Scale (BAI), Perceived Stress Scale (PSS), and Oral Analog Scale were used for assessment. The Beck Anxiety Scale is composed of 21 multiple-choice questions describing symptoms of anxiety, while the PSS is a measure that evaluates life situations as stressful. An Oral Analogue Scale was applied to each individual to quantify orofacial pain, with 0 (zero) without pain and 10 (ten) being the worst pain ever felt. The comparison between groups was performed using the Mann-Whitney test. Logistic regression was used to verify TMD dependence in relation to BAI and PSS-10. Quantitative variables were correlated with each other by Pearson's correlation coefficient. The level of significance considered for all tests was 5%. Results: The association was statistically significant (p≤0.05) for BAI and PSS with a TMD. Conclusion: Although the COVID 19 pandemic has had a psychological impact on the general population, patients with TMD have higher levels of anxiety and stress than the control group

AVALIAÇÃO DOS FATORES PSICOLÓGICOS NOS PACIENTES COM DISFUNÇÃO TEMPOROMANDIBULAR NO PERÍODO DE QUARENTENA COMO MEDIDA DE CONTROLE DE COVID-19: Estudo de Caso

Introduction: The world health organization in March 2020, considered about coronavirus infection, a public health emergency and in April recognized it as a pandemic. COVID-19 is highly infectious, with transmission mainly through saliva droplets and contaminated surfaces. Because there is no vaccine or effective treatment, the best way to prevent infection is through social distance and the use of masks. Quarantine has been used as a public health measure to contain or minimize the spread of coronavirus in several countries, demonstrating a positive role in the prevention and control of the epidemic. However, the negative psychological impact was observed in the general population. Psychosocial factors contribute to the establishment of some diseases, such as temporomandibular disorders (TMD), which have a complex and multifactorial etiology. Among TMD risk factors, biopsychosocial factors must be considered both in the etiology and in the triggering of signs and symptoms. Thus, our objective was to assess the influence of the COVID-19 pandemic on levels of anxiety, stress and orofacial pain in desire with and without TMD. Methods: Research participants were divided into two groups: experimental group (EG) patients with TMD and control group (CG), without TMD. The Beck Anxiety Scale (BAI), Perceived Stress Scale (PSS) and Oral Analog Scale were used in this study. Results: The association between variables analyzed using Pearson's correlation was statistically significant (p-value ≤ α) for BAI and PSS with a TMD. Conclusion: Although the COVID 19 pandemic has had a psychological impact on the general population, patients with TMD have higher levels of anxiety and stress than the control group.Introdução: A organização mundial de saúde em março de 2020 considerou o surto de infecção pelo coronavirus uma emergência de saúde pública e em abril reconheceu ser uma pandemia. A COVID-19 é altamente infecciosa, com transmissão principalmente por gotículas de saliva e por superfícies contaminadas. Por não ter vacina e nem tratamento eficaz a melhor forma de prevenir a infecção é pelo distanciamento social e uso de máscaras. A quarentena tem sido usada como uma medida de saúde pública para conter ou minimizar o surto de coronavirus em vários países, demonstrando um papel positivo na prevenção e controle da epidemia. Contudo o impacto psicológico negativo foi observado na população em geral. Os fatores psicossociais contribuem para o estabelecimento de algumas doenças como a disfunções temporomandibulares que possui uma etiologia complexa e multifatorial. Dentre os fatores de risco de DTM, os biopsicossociais devem ser considerados tanto na etiologia como no desencadeamento dos sinais e sintomas. Com isso, nosso objetivo foi avaliar a influência da pandemia por COVID-19 nos níveis de ansiedade, estresse e dor orofacial em indivíduos com e sem DTM. Métodos: Os participantes da pesquisa foram divididos em dois grupos: grupo experimental (GE) pacientes com DTM e grupo controle (GC) indivíduos sem DTM. A Escala de Ansiedade de Beck (BAI), Escala de Estresse percebido (PSS) e Escala Analógica Oral foram utilizadas nesse estudo. Resultados: A associação entre variáveis analisada por meio da correlação de Pearson foi estatisticamente significativa (p-value ≤ α) para do BAI e PSS com a DTM. Conclusão: Apesar da Pandemia do COVID 19 ter gerado impacto psicológico na população em geral, os pacientes com DTM apresentaram níveis de ansiedade e estresse maiores que o grupo controle

SWOT analysis to reduce surgical center idleness and increase revenue in a hospital

ABSTRACT Objective To reduce surgical center idleness by analyzing the competitive structure of the surgical center in a hospital, and thereby generate value in operations and increase hospital revenue. Methods The study used qualitative and quantitative methods and an action research approach involving the surgical center leadership of a small private specialized hospital in southeastern Brazil. We used the Strengths, Weaknesses, Opportunities, and Threats or SWOT tool to analyze the competitive structure of the surgical center and then implemented interventions as proposed by the science of improvement method proposed by the Institute of Healthcare Improvement. Results By applying the SWOT tool, we identified a concentration of surgeries in the specialty of Otolaryngology and the need to establish a health management system to reduce the idleness of the operating rooms. Based on subsequent intervention, procedures from other specialties were inserted that increased surgical production by 2.62X, reduced idleness by 67.84%, and increased revenue by over US$ 276,609.87 in 2018 compared to the previous year 2017. Conclusion Investing in quality, surgical schedule management, and inducting new surgeons to the clinical staff resulted in decreased surgical idleness, increased production, better uniformity in scheduling, and increased revenue, while costs remained below the linear trend, allowing for increased profits

Cartografia e diplomacia: usos geopolíticos da informação toponímica (1750-1850)

O artigo explora dimensões geopolíticas da toponímia, registradas em documentos cartográficos, desde as reformas empreendidas pelo consulado pombalino em meados do século XVIII, até às primeiras décadas do século XIX, em meio ao processo de afirmação do Estado imperial pós-colonial.This paper explores the geopolitical dimensions of toponymy as registered in cartographic documents dating from the reforms pushed through by the consulate of Marquis of Pombal in the mid 18th century to the early decades of the 19th century, as the post-colonial imperial State established itself

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Limitação de esforço terapêutico na pessoa com lesão encefálica grave

As discussões a respeito das condutas de limitação de esforço terapêutico (LET) são frequentes nas unidades de terapia intensiva e na especialidade médica oncológica e são também importantes em contextos hospitalares de internação de longa permanência para vítimas de grandes traumas e agravos que necessitam de cuidados prolongados à saúde e de reinserção social. Na prática clínica, a tomada de decisão para LET é complexa e deve envolver o indivíduo, a família e a equipe multiprofissional. O objetivo deste artigo é discorrer a respeito da LET como um abrangente processo de "adequação de medidas" por agregação consensual de fatores centrado na pessoa, pautado por intensificação dos cuidados paliativos