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      Trabalho remoto docente e saúde: repercussões das novas exigências em razão da pandemia da Covid-19 Translated title: Trabajo docente remoto y salud: repercusiones de las nuevas exigencias debido a la pandemia de Covid-19 Translated title: Remote teaching work and health: repercussions of new requirements in the context of the Covid-19 pandemic

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          Abstract

          Resumo O estudo objetivou descrever características do trabalho remoto, situação de saúde mental e qualidade de sono na pandemia da Covid-19 em docentes da Bahia. Foi conduzido websurvey, seguindo protocolo CHERRIES, com professoras/es de todos os níveis de ensino da rede particular do estado. Participaram 1.444 docentes, de 18 julho a 30 de julho de 2020. Predominaram mulheres (76,1%), 21-41 anos (61,6%), negras (71,9%), dez anos ou mais na profissão (56,9%). Na pandemia, 51,4% relataram alterações no contrato de trabalho e 76,8%, aumento da jornada laboral. O ambiente domiciliar e equipamentos tinham baixo nível de adequação ao trabalho remoto: espaço físico (19,6%), mobiliário (21,7%), nível de ruído (17,2%), computadores (44,5%) e internet banda larga (36,7%). Entre as mulheres, 42,3% referiram sobrecarga doméstica alta; entre os homens, 17,4%. As mulheres apresentaram situação de saúde preocupante, destacando-se crises de ansiedade (53,7%), mau humor (78,0%), transtornos mentais comuns (69,0%) e qualidade do sono ruim (84,6%). A pandemia remodelou as formas de exercer o ofício docente. O trabalho, transferido para a casa, se sobrepôs às atividades domésticas e familiares, produzindo consequências à saúde docente que, mesmo pouco conhecidas, são alarmantes. Os resultados fortalecem a necessidade de ações de enfrentamento para situações de calamidade pública, medidas de regulação do trabalho remoto e proteção à saúde docente.

          Translated abstract

          Resumen El estudio tuvo como objectivo describir las características del trabajo remoto, la situación de salud mental y la calidad del sueño en la pandemia de Covid-19 entre docentes de Bahia. Se condujo una encuesta websurvey, siguiendo el protocolo CHERRIES, con profesoras y profesores de todos los niveles educativos de la red privada del estado/departamento. Contestaron a la encuesta 1.444 docentes, del 18 de junio hasta el 30 de julio de 2020. Predominaron mujeres (76,1%), de 21-41 años de edad (61,6%), negras (71,9%), con diez años o más de profesión (56,9%). En la pandemia, el 51,4% informó cambios en los contratos de trabajo y el 76, 8%, un aumento en la jornada laboral. El ambiente domiciliario y los equipos tenían un bajo nivel de adecuación para el trabajo remoto: espacio físico (19,6%), mobiliario (21,7%), nivel de ruido (17,2%), ordenadores (44,5%) y internet banda ancha (36,7%). Entre las mujeres, el 42,3% refirió una alta sobrecarga de trabajo doméstico; entre los hombres, 17,4% lo informó. Las mujeres presentaron una situación de salud preocupante, mayormente crises de ansiedad (53,7%), mal humor (78,9%), trastornos mentales comunes (69,0%) y mala calidad del sueño (84,6%). La pandemia remodeló las formas de ejercer el oficio docente. El trabajo, transferido al hogar, se ha sobrepuesto a las actividades domésticas y de la família, produciendo consecuencias a la salud de los docentes que, aun poco conocidas, son alarmantes. Los resultados refuerzan la necesidad de acciones para el enfrentamiento de situaciones de calamidad pública, de medidas de regulación del trabajo remoto y de protección a la salud docente.

          Translated abstract

          Abstract The study aimed to describe characteristics of remote work, mental health status and sleep quality in the COVID-19 pandemic among teachers in Bahia, Brazil. A websurvey was conducted, following the CHERRIES protocol, with teachers from all levels of education in the state’s private network. A total of 1,444 professors participated, from June 18 to July 30, 2020. There was a predominance of women (76.1%), 21-41 years (61.6%), black (71.9%), ten years or more in the profession (56.9%). In the pandemic, 51.4% reported changes in the employment contract and 76.8%, an increase in working hours. The home environment and equipment had a low level of suitability for remote work: physical space (19.6%), furniture (21.7%), noise level (17.2%), computers (44.5%) and internet broadband (36.7%). Among women, 42.3% reported high housework burden; among men, 17.4%. The women presented a worrying health situation, highlighting anxiety crises (53.7%), bad mood (78.0%), common mental disorders (69.0%) and poor sleep quality (84.6%). The pandemic remodeled the ways of exercising the teaching profession. The work, transferred to the home, was superimposed on domestic and family activities, producing consequences for the health of teachers that, although little known, are alarming. The results strengthen the need for actions to deal with situations of public calamity, measures to regulate remote work and protect teachers’ health.

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          Improving the Quality of Web Surveys: The Checklist for Reporting Results of Internet E-Surveys (CHERRIES)

          Analogous to checklists of recommendations such as the CONSORT statement (for randomized trials), or the QUORUM statement (for systematic reviews), which are designed to ensure the quality of reports in the medical literature, a checklist of recommendations for authors is being presented by the Journal of Medical Internet Research (JMIR) in an effort to ensure complete descriptions of Web-based surveys. Papers on Web-based surveys reported according to the CHERRIES statement will give readers a better understanding of the sample (self-)selection and its possible differences from a “representative” sample. It is hoped that author adherence to the checklist will increase the usefulness of such reports.
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            “Pandemic fear” and COVID-19: mental health burden and strategies

            In the wake of the September 11 attack in the United States and the Kiss Nightclub fire in Brazil, psychological assistance task forces for victims and their families were quickly organized. However, during pandemics it is common for health professionals, scientists and managers to focus predominantly on the pathogen and the biological risk in an effort to understand the pathophysiological mechanisms involved and propose measures for preventing, containing and treating the disease. In such situations, the psychological and psychiatric implications secondary to the phenomenon, both on an individual and a collective level, tend to be underestimated and neglected, generating gaps in coping strategies and increasing the burden of associated diseases.1,2 Although infectious diseases have emerged at various times in history, in recent years, globalization has facilitated the spread of pathological agents, resulting in worldwide pandemics. This has added greater complexity to the containment of infections, which has had an important political, economic and psychosocial impact, leading to urgent public health challenges.2-6 HIV, Ebola, Zika and H1N1, among other diseases, are recent examples.1 The coronavirus (COVID-19), identified in China at the end of 2019, has a high contagion potential, and its incidence has increased exponentially. Its widespread transmission was recognized by the World Health Organization (WHO) as a pandemic. Dubious or even false information about factors related to virus transmission, the incubation period, its geographic reach, the number of infected, and the actual mortality rate has led to insecurity and fear in the population. The situation has been exacerbated due to the insufficient control measures and a lack of effective therapeutic mechanisms.5,7,8 These uncertainties have had consequences in a number of sectors, with direct implications for the population’s daily life and mental health. This scenario raises a number of questions: is there a fear/stress pandemic concomitant with the COVID-19 pandemic? How can we evaluate this phenomenon? To understand the psychological and psychiatric repercussions of a pandemic, the emotions involved in it, such as fear and anger, must be considered and observed. Fear is an adaptive animal defense mechanism that is fundamental for survival and involves several biological processes of preparation for a response to potentially threatening events. However, when it is chronic or disproportionate, it becomes harmful and can be a key component in the development of various psychiatric disorders.9,10 In a pandemic, fear increases anxiety and stress levels in healthy individuals and intensifies the symptoms of those with pre-existing psychiatric disorders.11 During epidemics, the number of people whose mental health is affected tends to be greater than the number of people affected by the infection.12 Past tragedies have shown that the mental health implications can last longer and have greater prevalence than the epidemic itself and that the psychosocial and economic impacts can be incalculable if we consider their resonance in different contexts.11,12 Since the economic costs associated with mental disorders is high, improving mental health treatment strategies can lead to gains in both physical health and the economic sector. In addition to a concrete fear of death, the COVID-19 pandemic has implications for other spheres: family organization, closings of schools, companies and public places, changes in work routines, isolation, leading to feelings of helplessness and abandonment. Moreover, it can heighten insecurity due to the economic and social repercussions of this large-scale tragedy. During the Ebola outbreak, for example, fear-related behaviors had an epidemiological impact both individually and collectively during all phases of the event, increasing the suffering and psychiatric symptom rates of the population, which contributed to increases in indirect mortality from causes other than Ebola.13 Currently, ease of access to communication technologies and the transmission of sensational, inaccurate or false information can increase harmful social reactions, such as anger and aggressive behavior.14 Diagnostic, tracking, monitoring and containment measures for COVID-19 have been established in several countries.6 However, there are still no accurate epidemiological data on disease-related psychiatric implications or their impact on public health. A Chinese study provided some insights in this regard. Approximately half of the interviewees classified the psychological impact of the epidemic as moderate to severe, and about a third reported moderate to severe anxiety.15 Similar data have been reported in Japan, where the economic impact has also been dramatic.11 Another study reported that patients infected with COVID-19 (or suspected of being infected) may experience intense emotional and behavioral reactions, such as fear, boredom, loneliness, anxiety, insomnia or anger,11 as has been reported about similar situations in the past.16 Such conditions can evolve into disorders, whether depressive, anxiety (including panic attacks and post-traumatic stress), psychotic or paranoid, and can even lead to suicide.17,18 These conditions can be especially prevalent in quarantined patients, whose psychological distress tends to be higher.16 In some cases, uncertainty about infection and death or about infecting family and friends can potentiate dysphoric mental states.11,18 Even among patients with common flu symptoms, stress and fear due to the similarity of the conditions can generate mental distress and worsen psychiatric symptoms.15,19 Despite the fact that the rate of confirmed vs. suspected cases of COVID-19 is relatively low and that the majority of cases are considered asymptomatic or mild, as well as that the disease has a relatively low mortality rate,20,21 the psychiatric implications can be significantly high, overloading emergency services and the health system as a whole. In conjunction with actions to help infected and quarantined patients, strategies targeting the general population and specific groups must be developed, including health professionals who are directly exposed to the pathogen and have high stress rates.22 Although some protocols for clinicians have been established, most health professionals who work in isolation units and hospitals are neither trained to provide mental health assistance during pandemics1,17 nor receive specialized care. Previous studies have reported high rates of anxiety and stress symptoms, as well as mental disorders, such as post-traumatic stress, in this population (especially among nurses and doctors), which reinforces the need for care.22,23 Other specific groups are especially vulnerable in pandemics: older adults, the immunocompromised, patients with previous clinical and psychiatric conditions, family members of infected patients and residents of high-incidence areas. In these groups, social rejection, discrimination, and even xenophobia are frequent.17 Providing psychological first aid is an essential care component for populations that have been victims of emergencies and disasters, but there are no universal protocols or guidelines for the most effective psychosocial support practices.24 Although some reports on local mental health care strategies have been published, more comprehensive emergency guidelines for such scenarios are unknown,1,17,19 since previous evidence refers only to specific situations.24 In Brazil, a large developing country with pronounced social disparity, low education levels and humanitarian-cooperative culture, there are no parameters for estimating the impact of this phenomenon on the population’s mental health or behavior. Will it be possible to implement effective preventive and emergency actions aimed at the psychiatric implications of this biological pandemic in broad spheres of society? Specifically for this new COVID-19 scenario, Xiang et al., suggest that three main factors should be considered when developing mental health strategies: 1) multidisciplinary mental health teams (including psychiatrists, psychiatric nurses, clinical psychologists and other mental health professionals); 2) clear communication involving regular, accurate updates on the COVID-19 outbreak; and 3) establishing safe psychological counseling services (for example, via electronic devices or apps).17 Finally, it is extremely necessary to implement public mental health policies in conjunction with epidemic and pandemic response strategies before, during and after the event.13 Mental health professionals, such as psychologists, psychiatrists and social workers, must be on the front line and play a leading role in emergency planning and management teams.1 Assistance protocols, such as those used in disaster situations, should cover areas relevant to the individual and collective mental health of the population. Recently, the WHO25 and the U.S. Center for Disease Control and Prevention26 published a series of psychosocial and mental health recommendations, several of which are included in Box 1. This is in line with longitudinal data from the WHO demonstrating that psychological factors are directly related to the main causes of morbidity and mortality in the world.25 Thus, increased investment in research and strategic actions for mental health in parallel with infectious outbreaks is urgently needed worldwide.1 Disclosure The authors report no conflicts of interest.
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              Medidas de distanciamento social no controle da pandemia de COVID-19: potenciais impactos e desafios no Brasil

              Resumo A pandemia de COVID-19 tem desafiado pesquisadores e gestores a encontrar medidas de saúde pública que evitem o colapso dos sistemas de saúde e reduzam os óbitos. Esta revisão narrativa buscou sistematizar as evidências sobre o impacto das medidas de distanciamento social na epidemia de COVID-19 e discutir sua implementação no Brasil. Foram triados artigos sobre o efeito do distanciamento social na COVID-19 no PubMed, medRXiv e bioRvix, e analisados atos do poder público nos níveis federal e estadual para sumarizar as estratégias implementadas no Brasil. Os achados sugerem que o distanciamento social adotado por população é efetivo, especialmente quando combinado ao isolamento de casos e à quarentena dos contatos. Recomenda-se a implementação de medidas de distanciamento social e de políticas de proteção social para garantir a sustentabilidade dessas medidas. Para o controle da COVID-19 no Brasil, é imprescindível que essas medidas estejam aliadas ao fortalecimento do sistema de vigilância nos três níveis do SUS, que inclui a avaliação e uso de indicadores adicionais para monitorar a evolução da pandemia e o efeito das medidas de controle, a ampliação da capacidade de testagem, e divulgação ampla e transparente das notificações e de testagem desagregadas.
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                Author and article information

                Journal
                tes
                Trabalho, Educação e Saúde
                Trab. educ. saúde
                Fundação Oswaldo Cruz, Escola Politécnica de Saúde Joaquim Venâncio (Rio de Janeiro, RJ, Brazil )
                1678-1007
                1981-7746
                January 2021
                : 19
                : e00325157
                Affiliations
                [2] Feira de Santana Bahia orgnameUniversidade Estadual de Feira de Santana orgdiv1Departamento de Saúde Brazil amcfreitas@ 123456uefs.br
                [3] Feira de Santana Bahia orgnameUniversidade Estadual de Feira de Santana orgdiv1Departamento de Ciências Sociais e Filosofia Brazil cardoso_mariana@ 123456yahoo.com.br
                [6] Santo Antônio de Jesus Bahia orgnameUniversidade Federal do Recôncavo da Bahia orgdiv1Centro de Ciências da Saúde Brazil caiofdmuniz@ 123456gmail.com
                [4] Salvador Bahia orgnameUniversidade Federal da Bahia orgdiv1Programa de Pós-Graduação em Saúde, Ambiente e Trabalho Brazil jessica_enfa@ 123456yahoo.com.br
                [5] Salvador Bahia orgnameUniversidade Federal da Bahia orgdiv1Programa de Pós-Graduação em Saúde, Ambiente e Trabalho Brazil reis.livia@ 123456ufba.br
                [7] Feira de Santana Bahia orgnameUniversidade Estadual de Feira de Santana orgdiv1Programa de Pós-Graduação em Saúde Coletiva Brazil araujo.tania@ 123456uefs.br
                [1] Santo Antônio de Jesus Bahia orgnameUniversidade Federal do Recôncavo da Bahia orgdiv1Centro de Ciências da Saúde Brazil paloma@ 123456ufrb.edu.br
                Article
                S1981-77462021000100508 S1981-7746(21)01900000508
                10.1590/1981-7746-sol00325
                04d9e3cb-767c-4155-865b-dbbd464c1929

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 15 April 2021
                : 06 July 2021
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                docentes,worker’s health,work conditions,teachers,infecciones por coronavirus,salud del trabajador,condiciones de trabajo,infecções por coronavírus,saúde do trabalhador,condições de trabalho,coronavirus infections

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