Coronavirus disease 2019 (COVID-19) is associated with high risk of malnutrition, primarily in older people; assessing nutritional risk using appropriate screening tools is critical. This systematic review identified applicable tools and assessed their measurement properties. Literature was searched in the MEDLINE, Embase, and LILACS databases. Four studies conducted in China met the eligibility criteria. Sample sizes ranged from six to 182, and participants’ ages from 65 to 87 years. Seven nutritional screening and assessment tools were used: the Nutritional Risk Screening 2002 (NRS-2002), the Mini Nutritional Assessment (MNA), the MNA-short form (MNA-sf), the Malnutrition Universal Screening Tool (MUST), the Nutritional Risk Index (NRI), the Geriatric NRI (GNRI), and modified Nutrition Risk in the Critically ill (mNUTRIC) score. Nutritional risk was identified in 27.5% to 100% of participants. The NRS-2002, MNA, MNA-sf, NRI, and MUST demonstrated high sensitivity; the MUST had better specificity. The MNA and MUST demonstrated better criterion validity. The MNA-sf demonstrated better predictive validity for poor appetite and weight loss; the NRS-2002 demonstrated better predictive validity for prolonged hospitalization. mNUTRIC score demonstrated good predictive validity for hospital mortality. Most instruments demonstrate high sensitivity for identifying nutritional risk, but none are acknowledged as the best for nutritional screening in older adults with COVID-19.

Resumo O objetivo deste estudo é identificar a prevalência de ansiedade em profissionais de saúde durante a pandemia da COVID-19. Trata-se de revisão sistemática de estudos publicados em qualquer idioma em 2020. Foi realizada busca nas bases de dados Embase, LILACS e PubMed utilizando os descritores anxiety, COVID-19, health workers, e sinônimos. A estimativa da prevalência geral de ansiedade com intervalo de confiança de 95% foi calculada utilizando o modelo de efeitos aleatórios. Dos 861 registros identificados, 36 artigos foram incluídos na revisão sistemática e 35 na metanálise. A prevalência geral de ansiedade foi de 35% (IC95%: 29-40). Foi identificado maior risco de ansiedade nas mulheres em relação aos homens (Odds Ratio: 1.64 [IC95%: 1,47-1,84]), e nos enfermeiros, na comparação com médicos (Odds Ratio: 1.19 [IC95%: 1,07-1,33]). Atuar na linha de frente no combate a COVID-19, estar infectado com coronavírus e apresentar doenças crônicas também foram fatores associados com maior risco de ansiedade. Observa-se alta prevalência de ansiedade entre profissionais de saúde, com maior risco entre mulheres e enfermeiros. Há necessidade de medidas que visem sua prevenção, bem como o fornecimento de tratamento precoce e adequado aos com ansiedade moderada e grave.

Objective: examine the contributions of teaching-service-community integration to health training and the Unified Health System, as well as the potential and challenges of this integration, from the viewpoint of professors. Method: descriptive study with a qualitative and quantitative approach. The study population was composed of 103 professors from the nursing, medical and dentistry courses of the Federal University of Rio Grande do Norte. The data was collected from October 2016 to February 2017, through an interview form. Imaruteq software and Bardin's content analysis were used for the data analysis. Results: according to the professors, teaching-service-community integration helps train students, since it provides multiprofessional and interdisciplinary experiences in real-life situations, in addition to promoting improved quality of care. However, various challenges need to be overcome, such as the hospital-centric model, which is still prevalent; fragmented curricula in disciplines; resistance of some professors to participate in integration; few interdisciplinary activities; emphasis on technical training with a predominance of traditional teaching methodologies; the infrastructure of the Unified Health System, among others. Conclusion: there is a need to institutionalize teaching-service-community integration and emphasize initiatives that dynamize and provide flexibility to multiprofessional and interdisciplinary activities. Institutions involved in the modification of health training and the transformation of health care processes also need to make a commitment.

OBJECTIVE To describe feeding practices and the risk factors for the mixed breastfeeding and early weaning in the neonatal period. METHODS Cohort study, which we collected socioeconomic, demographic, health care and feeding data from 415 mother/child binomials born in four public maternity hospitals in Natal/Brazil. They were followed-up at 48 hours, 7 and 28 days after birth. The association was established using Pearson’s Chi-square test and Poisson’s regression, after adjusting it to other variables. RESULTS The prevalence of mixed breastfeeding in the first 2 days was 47,2% and early weaning in 7 and 28 days was 8,4% and 16,2% in that order. The main reasons for mixed breastfeeding and early weaning were: colostrum deficiency (33.8%), difficulty in latching/sucking (23.5%) and “little milk” (70.0%). The use of formula/milk/porridge remained associated with maternal age ≤ 20 years (RR = 0.64; 95%CI: 0.47–0.86), age 20–29 years (RR = 0,70; 95%CI: 0,57–0,87), primiparity (RR = 1.37; 95%CI: 1.11–1.60) and cesarean delivery (RR = 1.20; 95%CI: 1.00–1.45) at 2 days; absence of paternal support (RR = 4.98; 95%CI: 2.54–9.79) and pacifier use (RR = 3.21; 95%CI: 1.63–6.32) at 7 days; and only pacifier use (RR = 2.48; 95%CI: 1.53–4.02) at 28 days. CONCLUSIONS Early weaning was associated with maternal and health care factors, thus suggesting the need to readjust good practices and educational actions to achieve the exclusive offer to the maternal breast in the neonatal period.

Objective Identifying the prevalence of anxiety, depression, and stress among teachers during the COVID-19 pandemic. Methods Systematic review of original studies published in any language. Protocol published in PROSPERO under number CRD42021240543. The search was carried out in the Web of Science, PsycINFO, Pubmed, Embase, LILACS, and SciELO databases, using the descriptors: anxiety, depression, stress, teacher, faculty, COVID-19, and their synonyms. Narrative synthesis was carried out in line with the synthesis without meta-analysis (SWiM) in systematic reviews. Results Of the 1,372 records identified, six studies, all cross-sectional, were included in the review. The studies were carried out in China, Brazil, the United States of America, India, and Spain. Five studies included more women than men. The participants were aged from 24 to 60 years. Three studies included only school teachers, two included schools and universities teachers, and one only university teachers. Of the five studies, all dealt with remote activities and only one included teachers who returned to face-to-face classes one to two weeks ago. The prevalence of anxiety ranged from 10% to 49.4%, and depression from 15.9% to 28.9%, being considerably higher in studies with teachers who worked in schools. The prevalence of stress ranged from 12.6% to 50.6%. Conclusions The prevalence of anxiety, depression, and stress was high among teachers during the pandemic, with great variation between studies. Anxiety and stress were more prevalent in the Spanish study. The results show the need for measures for the care of teachers’ mental health, especially when returning to face-to-face classes. What is already known about this subject? ➢ With remote classes during the COVID-19 pandemic, there were changes in the professional practice of teachers. ➢ Sudden changes in professional practice can result in increased levels of anxiety, depression, and stress. ➢ Returning to face-to-face classes can also result in increased levels of anxiety, depression, and stress. What are the new findings? ➢ The prevalence of anxiety ranged from 10% to 49.4%, with higher rates recorded in female teachers, with comorbidities and working in schools. ➢ The prevalence of depression ranged from 15.9% to 28.9%, with higher rates identified in school teachers. ➢ The prevalence of stress varied from 12.6% to 50.6%, with higher rates observed among female teachers and those with chronic diseases. ➢ The only study that performed data collection during the return to face-to-face classes registered a higher prevalence of anxiety and stress than the other studies, in which the research was carried out during remote classes. How might this impact policy or clinical practice in the foreseeable future? ➢ Better training of teachers to handle the remote education model can contribute to preventing work overload and mental problems. Further, pedagogical and psychological support, especially for those who work in schools, can also prove effective. ➢ The return to face-to-face classes can increase stress and anxiety. Ensuring bio-safety protocols for safe return to face-to-face activities, can contribute to mitigating anxiety and stress about the risk of contracting the disease. ➢ There is insufficient evidence to determine a cause and effect relationship of the COVID-19 pandemic with anxiety, depression, and stress among teachers. Prospective cohort studies with control of confounding factors are necessary to infer that the pandemic has increased mental health problems in these professionals.

Introdução: Durante a trajetória histórica que envolve a política de saúde infantil no Brasil, houve pontos positivos e negativos no processo de cuidar, implementado por meio das políticas públicas. Nesse sentido, em vários anos e décadas, foram propostas diretrizes novas que vão ao encontro de uma assistência qualificada à saúde da criança. Objetivo: Analisar a trajetória histórica das políticas de saúde infantil no Brasil verificando as tendências do coeficiente de mortalidade infantil. Método: Revisão integrativa consolidada a partir de pesquisa realizada em documentos de domínio público, disponíveis em formato digital na rede de internet. Foram coletados dados sobre a saúde infantil do período de 1930 a 2016. Resultados: Entre 1930 e 2015 observa-se uma redução na taxa de mortalidade infantil e melhoria na economia do país, além da implantação de várias políticas com ações voltadas diretamente com o objetivo desta redução. Porém, em 2016, um ano após a implantação da última política infantil, observou-se um aumento com 10,2% na taxa de mortalidade infantil referente ao ano anterior. Conclusões: Dessa forma, este estudo mostra que nos últimos 80 anos a taxa de mortalidade infantil vem reduzindo concomitantemente com o aumento de implantações de políticas. Todavia, foi possível ver que ainda se faz necessário melhorias e uma atenção mais direcionada a esta parte da população.