Background: The increase in violence against health professionals in the COVID-19 pandemic makes it necessary to identify the predictors of violence, in order to prevent these events from happening. Objective: Evaluating the prevalence and analyzing the variables involved in the occurrence of violence against health professionals during the COVID-19 pandemic in Brazil. Method: This is a cross-sectional study conducted online involving Brazilian health professionals during the COVID-19 pandemic. The data were collected through a structured questionnaire (Google Online Form) sent to health professionals on social networks and analyzed through logistic regression by using sociodemographic variables. The set of grouped variables was assigned to the final model when p <0.05. A network was built using the Mixed Graph Models (MGM) approach. A centrality measurement chart was constructed to determine which nodes have the greatest influence, strength and connectivity between the nodes around them. Results: The predictors of violence in the adjusted regression model were the following: being a nursing technician / assistant; having been working for less than 20 years; working for over 37 hours a week; having suffered violence before the pandemic; having been contaminated with COVID-19; working in direct contact with patients infected by the virus; and having family members who have suffered violence. The network created with professionals who suffered violence demonstrated that the aggressions occurred mainly in the workplace, with an indication of psycho-verbal violence. In cases in which the aggressors were close people, aggressions were non-verbal and happened both in public and private places. The assaults practiced by strangers occurred in public places. Conclusions: Violence against health professionals occurs implicitly and explicitly, with consequences that can affect both their psychosocial well-being and the assistance given to their patients and families.
Background/Objectives: Breast cancer is one of the leading causes of female mortality worldwide, but significant racial and socioeconomic disparities persist in disease outcomes. This review aimed to analyze racial and socioeconomic inequalities in mortality and survival from breast cancer, identifying the impact of social risk factors on access to diagnosis and treatment. Methods: A systematic literature review and meta-analysis was performed following PRISMA guidelines. Eighteen studies published between 2014 and 2024 were included, with 11 contributing to the meta-analysis. Random-effect models were used to assess correlations between socioeconomic status, race, and clinical outcomes, including heterogeneity and publication bias analyses. Results: The strongest associations were observed between income, race, and breast cancer survival, with survival significantly worse among Black women and low-income populations (p < 0.001). Income also showed a strong positive correlation with clinical outcomes. In contrast, the overall effect on mortality was not statistically significant (p = 0.290), likely due to high heterogeneity across studies (I2 = 100%). These findings suggest that structural disparities in access to healthcare and early detection substantially affect survival rates. Conclusions: Racial and socioeconomic disparities in breast cancer outcomes remain critical public health challenges. Targeted policies to expand early diagnosis and ensure equitable access to effective treatment are essential to reduce these disparities and improve survival in underserved populations.
Introduction: The COVID-19 pandemic stressed the importance of healthcare personnel. However, there is evidence of an increase in violence against them, which brings consequences, such as anxiety. The aim of this study was to analyze the anxiety levels of health professionals who have or not suffered violence during the COVID-19 pandemic, and verify the variables associated with the risk of starting to take medication for anxiety.Methods: We assessed the anxiety profile of health professionals in Brazil through an online questionnaire, using the Generalized Anxiety Disorder 7-item Scale (GAD-7), in relation to groups of participants who have or not suffered violence during the COVID-19 pandemic. We used Cronbach's alpha reliability coefficient to check the consistency of the responses, and the effect size using the r coefficient. Principal Component Analysis was used to verify the differences in anxiety scores between the two groups. Logistic regression analysis was also used to verify the variables associated with the risk of starting medication for anxiety and considered statistically significant when p < 0.05.Results: A total of 1,166 health professionals participated in the study, in which 34.13% had a normal anxiety profile, 40.14% mild, 15.78% moderate, and 9.95% severe. The mean score of the sum of the GAD-7 was 7.03 (SD 5.20). The group that suffered violence had a higher mean (8.40; SD 5.42) compared to the group that did not (5.70; SD 4.60). In addition, the median between both groups was significantly different (7.0 vs. 5.0; p < 0.01). Approximately 18.70% of the participants reported having started taking medication to treat anxiety during the pandemic. The factors that increased the chances of these professionals starting medication for anxiety p < 0.05 were having suffered violence during the pandemic (OR 1.97; 95% CI 1.42–2.77), being nurses (OR 1.61; 95% CI 1.04–2.47) or other types of health professionals (OR 1.58; 95% CI 1.04–2.38), and having a mild (OR 2.11; 95% CI 1.37–3.34), moderate (OR 4.05; 95% CI 2.48–6.71) or severe (OR 9.08; 95% CI 5.39–15.6) anxiety level.Conclusion: Brazilian healthcare professionals who have suffered violence during the pandemic have higher anxiety scores and higher risk to start taking anxiety medication.
Situations of mistreatment in the academic environment are prevalent worldwide, but research in this area is scarce in middle-low-income countries. This study aimed to estimate the prevalence of mistreatment inflicted against Brazilian medical students. In addition, characterize these situations and analyze their consequences. Cross-sectional study conducted with 831 medical students from public and private institutions. Absolute and relative frequencies of the analyzed variables and possible associations were determined through univariate and multivariate logistic regression. Chi-square test of association with second-order Rao-Scott adjustment was also used. The response rate was 56%. Public institution pointed to a higher prevalence of mistreatment when compared to private (59% versus 43%). Female students were the most affected. Verbal and psychological aggression was more prevalent. The aggressor usually was a faculty member. Mistreatment incidence increased over the years of training, with higher rates in the internship. About 94% of the students felt affected in anyway, with 77% feeling diminished and depressed. More than 50% reported impaired academic performance. Almost 30% sought help from experts. The reporting rate was extremely low. Adequate identification of the situations by the victims, safe reporting mechanisms and, an educational system capable of maintaining an appropriate learning environment are essential to break this destructive cycle.
Out-of-hospital cardiac arrests (OHCAs) have high mortality rates, worsened by limited access to automated external defibrillators (AEDs). This study analyzed OHCA response times, identified areas with prolonged ambulance travel times, and proposed optimal AED locations in a medium-sized city in southern Brazil. Data from 278 non-traumatic OHCA cases (2019–2022) in patients over 18 years old, with ambulance response times under 20 min, were included. Spatial survival analysis assessed the probability of exceeding the recommended 5-min (300 s) ambulance response time. The maximal covering location problem identified 100 strategic AED sites within a 150-s reach for bystanders. AED and ambulance travel times were compared using the Wilcoxon test (p < 0.01). Defibrillation occurred in 89 cases (31.01%), and bystander CPR was performed in 149 cases (51.92%). Despite these efforts, 77% of patients died. The median ambulance response time was 11.63 min, exceeding 5 min in most cases, particularly at peak times like 11 a.m. AED placement in selected locations could cover 76% of OHCA occurrences, with a mean AED travel time of 320 s compared to 709 s for ambulances. Strategic AED placement could enhance early defibrillation and improve survival outcomes.
Objective: To analyze the management of bullying by the managers of elementary schools. Methods: Descriptive, exploratory research carried out through semi-structured interviews with 17 school counselors from a city in the South of Brazil, randomly selected from different geographical sectors. The interviews were recorded with participants’ consent and, after transcription and checking, were discarded. The interviews covered the following subjects: sociodemographic characterization of subjects, school functioning, comprehension, recognition and management of bullying cases by counselors. Data analysis was performed using the Bayesian network associated with content analysis. Results: The majority of subjects were females, between 30 and 50 years old. Fifteen subjects were graduated in pedagogy, and all had postgraduate degrees. Most of them worked as counselor for less than three years. Only two subjects, between 30 and 50 years old, understood the term bullying. Case recognition was lower in this age group. Having a degree influenced positively the recognition of bullying. The higher the number of students in the school, the lower the recognition of cases by managers. All subjects managed cases by addressing children, families, staff, and involving professionals and support groups. Conclusions: The understanding and recognition of bullying was given by a few interviewees. All managers reported similar management actions in the cases. Given the scarcity of studies on bullying management in schools, more studies in this area could improve the approach of cases and contribute to their reduction.