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Article ; Online: Reaffirming primary health care's vital role.

Fernandez, Michelle / Massuda, Adriano / Tasca, Renato

2024 Volume 403, Issue 10435, Page(s) 1448–1449

MeSH term(s)	Humans ; Primary Health Care
Language	English
Publishing date	2024-04-11
Publishing country	England
Document type	Letter
ZDB-ID	3306-6
ISSN	1474-547X ; 0023-7507 ; 0140-6736
ISSN (online)	1474-547X
ISSN	0023-7507 ; 0140-6736
DOI	10.1016/S0140-6736(24)00499-9
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Article ; Online: Hesitação vacinal infantil e COVID-19: uma análise a partir da percepção dos profissionais de saúde.

Souto, Ester Paiva / Fernandez, Michelle Vieira / Rosário, Celita Almeida / Petra, Priscila Cardia / Matta, Gustavo Correa

Cadernos de saude publica

2024 Volume 40, Issue 3, Page(s) e00061523

Abstract: This article presents the results of a study on health professionals' perceptions of childhood vaccine hesitancy related to COVID-19. Based on the theoretical construct of vaccine hesitancy, a qualitative study was conducted with 86 primary health care ( ... ...

Title translation	Childhood vaccine hesitancy and COVID-19: an analysis based on the perception of health professionals.
Abstract	This article presents the results of a study on health professionals' perceptions of childhood vaccine hesitancy related to COVID-19. Based on the theoretical construct of vaccine hesitancy, a qualitative study was conducted with 86 primary health care (PHC) workers in four municipalities in four Brazilian states and in the Federal District. A thematic analysis was performed and three categories were obtained: fear, misinformation about vaccines, and the role of health professionals. Fear as a reason for vaccine hesitancy has led to reflections on the Brazilian Federal Government's management of the pandemic, especially regarding governability and the consequences of the use of digital platforms on the population. Fear was related to the vaccine still being perceived as experimental; to the adverse reactions it may cause; to the lack of long-term studies; to the false perception of reduced risk of COVID-19 in children; and to the Federal Government's behavior, which creates uncertainty about the effects of the vaccine. Vaccine misinformation was related to fake news about the vaccine and its reactions; the phenomenon of infodemic and misinformation; and the lack of guidance and knowledge about vaccines. Finally, the article discusses the fundamental role of PHC workers in increasing vaccination coverage due to the trust among the population and proximity to the territories, factors that enable the reversal of fear and misinformation about vaccines. Throughout the study, authors' sought to show the convergences between the content of the themes outlined and the determinants of vaccine hesitancy and to consider possibilities for rebuilding high adherence to childhood vaccines.
MeSH term(s)	Child ; Humans ; COVID-19 ; Brazil ; Vaccination Hesitancy ; Vaccines ; Perception
Chemical Substances	Vaccines
Language	Portuguese
Publishing date	2024-03-11
Publishing country	Brazil
Document type	English Abstract ; Journal Article
ZDB-ID	1115730-6
ISSN	1678-4464 ; 0102-311X
ISSN (online)	1678-4464
ISSN	0102-311X
DOI	10.1590/0102-311XPT061523
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Article ; Online: Immunization against covid-19 and mortality in hospitalized patients: a retrospective cohort.

Figueiredo, Alexandre Medeiros de / Massuda, Adriano / Fernandez, Michelle / Medeiros Neto, Agostinho Hermes de / Carvalho, Marcus

Revista de saude publica

2024 Volume 58, Page(s) 7

Abstract: Objective: To evaluate the effectiveness of vaccines developed against covid-19 in reducing mortality in people hospitalized with severe acute respiratory syndrome (SARS) caused by SARS-CoV-2.: Methods: This is a retrospective cohort that evaluated ... ...

Abstract	Objective: To evaluate the effectiveness of vaccines developed against covid-19 in reducing mortality in people hospitalized with severe acute respiratory syndrome (SARS) caused by SARS-CoV-2. Methods: This is a retrospective cohort that evaluated risk factors and the effectiveness of the two-dose vaccination schedule in reducing the mortality of people hospitalized for covid-19 in the state of Paraíba from February to November 2021. The explanatory variables were vaccination status, presence of comorbidities, socioeconomic and demographic characteristics. Descriptive analyses and bivariate and multivariable logistic regression were performed. Results: Most hospitalizations and deaths occurred until May 2021. The percentage of patients with a complete vaccination schedule was similar across patients admitted to public and private hospitals and higher in residents of less developed municipalities. Multivariable analysis demonstrated that women (OR = 0.896; 95%CI 0.830-0.967) and people admitted to private hospitals (OR = 0.756; 95%CI 0.679-0.842) were less likely to die. Presence of any comorbidity (OR = 1.627; 95%CI 1.500-1.765) and age ≥ 80 years (OR = 7.426; 95%CI 6.309-8.741) were risk factors for death. Patients with complete vaccination schedule at the time of admission were 41.7% less likely to die (OR = 0.583; 95% CI 0.501-0.679) from covid-19 in the adjusted analysis, as compared to unvaccinated patients. Conclusions: The study reveals that immunization was effective in reducing the likelihood of death from covid-19. The results suggest that greater vaccination coverage in the first half of 2021 would prevent thousands of deaths in the country.
MeSH term(s)	Humans ; Female ; Aged, 80 and over ; Retrospective Studies ; COVID-19 ; SARS-CoV-2 ; Brazil ; Immunization ; Vaccination
Language	Portuguese
Publishing date	2024-03-11
Publishing country	Brazil
Document type	Journal Article
ZDB-ID	732179-x
ISSN	1518-8787 ; 0034-8910
ISSN (online)	1518-8787
ISSN	0034-8910
DOI	10.11606/s1518-8787.2024058005476
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Article ; Online: Inequality in the middle of a crisis: an analysis of health workers during the COVID-19 pandemic from the profession, race, and gender perspectives.

Magri, Giordano / Fernandez, Michelle / Lotta, Gabriela

Ciencia & saude coletiva

2022 Volume 27, Issue 11, Page(s) 4131–4144

Abstract: Studies show that people in vulnerable conditions and some social groups such as women and black people have suffered more intensely from the COVID-19 pandemic impacts. This expression of inequality also manifests itself among healthcare workers, with ... ...

Title translation	Desigualdade em meio à crise: uma análise dos profissionais de saúde que atuam na pandemia de COVID-19 a partir das perspectivas de profissão, raça e gênero.
Abstract	Studies show that people in vulnerable conditions and some social groups such as women and black people have suffered more intensely from the COVID-19 pandemic impacts. This expression of inequality also manifests itself among healthcare workers, with greater exposure of some specific groups. This paper analyzes the effect of COVID-19 on health care workers and the working conditions in the Brazilian public health system, analyzed from professional, gender, and race perspectives. Data were collected from an online survey of 1,829 health workers conducted in March 2021. Indeed, we identified inequalities in health workers' experiences during the health crisis generated by COVID-19, which are marked by the profession of each worker and are traversed by their gender and race traits.
MeSH term(s)	Humans ; Female ; COVID-19 ; Pandemics ; SARS-CoV-2 ; Health Personnel ; Health Workforce
Language	English
Publishing date	2022-03-10
Publishing country	Brazil
Document type	Journal Article
ZDB-ID	2078799-6
ISSN	1678-4561 ; 1678-4561
ISSN (online)	1678-4561
ISSN	1678-4561
DOI	10.1590/1413-812320222711.01992022
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Article ; Online: COVID-19, vaccine hesitancy and child vaccination: Challenges from Brazil.

Fernandez, Michelle / Matta, Gustavo / Paiva, Ester

Lancet Regional Health. Americas

2022 Volume 8, Page(s) 100246

Language	English
Publishing date	2022-04-01
Publishing country	England
Document type	Journal Article
ISSN	2667-193X
ISSN (online)	2667-193X
DOI	10.1016/j.lana.2022.100246
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Article ; Online: COVID-19 vaccination challenge: what have we learned from the Brazilian process?

Lotta, Gabriela / Fernandez, Michelle / Kuhlmann, Ellen / Wenham, Clare

The Lancet. Global health

2022 Volume 10, Issue 5, Page(s) e613–e614

MeSH term(s)	Brazil/epidemiology ; COVID-19/epidemiology ; COVID-19/prevention & control ; COVID-19 Vaccines ; Humans ; SARS-CoV-2 ; Vaccination
Chemical Substances	COVID-19 Vaccines
Language	English
Publishing date	2022-03-10
Publishing country	England
Document type	Journal Article
ZDB-ID	2723488-5
ISSN	2214-109X ; 2214-109X
ISSN (online)	2214-109X
ISSN	2214-109X
DOI	10.1016/S2214-109X(22)00049-3
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Article ; Online: The impact of the COVID-19 pandemic in the frontline health workforce: Perceptions of vulnerability of Brazil's community health workers.

Lotta, Gabriela / Nunes, João / Fernandez, Michelle / Garcia Correa, Marcela

Health policy OPEN

2022 Volume 3, Page(s) 100065

Abstract: The COVID-19 pandemic has resulted in calls for an increased integration of community health workers (CHWs) into the health system response. Historically, CHWs can play an important role in ensuring the sustainability of health policy implementation - by ...

Abstract	The COVID-19 pandemic has resulted in calls for an increased integration of community health workers (CHWs) into the health system response. Historically, CHWs can play an important role in ensuring the sustainability of health policy implementation - by addressing social determinants of health and maintaining care for ongoing health problems. Their frontline work, with close contact to populations, places CHWs in a position of increased vulnerability to becoming infected and to being the target of abuse and violence. These vulnerabilities compound underlying problems faced by CHWs, who often come from poor backgrounds, are insufficiently paid and receive inadequate training. Speaking to a scarcity of studies on how CHWs are impacted by the pandemic, this paper conducts a systematic study of CHWs in Brazil. Based on quantitative and qualitative data collected during June and July 2020, it considers perceptions and experiences of CHWs, comparing them with other health professionals. We study the extent to which the pandemic added to existing vulnerabilities and created new problems and imbalances in the work of CHWs. We conclude that COVID-19 led to a deterioration of the working conditions of CHWs, of their relations with other health professionals, and of their ability to carry out their essential work in the public health system.
Language	English
Publishing date	2022-01-05
Publishing country	Netherlands
Document type	Journal Article
ISSN	2590-2296
ISSN (online)	2590-2296
DOI	10.1016/j.hpopen.2021.100065
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Article ; Online: The vulnerabilities of the Brazilian health workforce during health emergencies: Analysing personal feelings, access to resources and work dynamics during the COVID-19 pandemic.

Lotta, Gabriela / Fernandez, Michelle / Corrêa, Marcela

The International journal of health planning and management

2021 Volume 36, Issue S1, Page(s) 42–57

Abstract: Public health emergencies are a test of resilience for health systems, which depend on health workforces that are well managed and cared for. The COVID-19 pandemic exposed the weakness of many health systems in preparing their health workforces. The ... ...

Abstract	Public health emergencies are a test of resilience for health systems, which depend on health workforces that are well managed and cared for. The COVID-19 pandemic exposed the weakness of many health systems in preparing their health workforces. The crisis also exacerbated the unequal conditions between different professions, an issue that is still understudied in the workforce literature. This paper analyzes the consequences of the COVID-19 pandemic for different health professionals, considering the ways in which Brazil's the health system does or does not protect them. We also analyse the role of pre-existing inequalities between different professions and social groups within the workforce in shaping their different experiences of the pandemic. We present data comparing the perceptions of different health professionals facing the pandemic in Brazil: physicians, nurses, and community health workers. Data were collected in an online survey in Brazil with 1630 health care workers between June 15th and July 1st. Findings suggest that none of the professions felt well prepared to work under emergencies. However, differences relating to professional background were exacerbated during the pandemic, creating unequal conditions for different health workers. These inequalities may pose new challenges for the post-pandemic scenario.
MeSH term(s)	Brazil ; COVID-19/transmission ; Delivery of Health Care ; Health Knowledge, Attitudes, Practice ; Health Personnel/psychology ; Health Resources/supply & distribution ; Humans ; Infectious Disease Transmission, Patient-to-Professional/prevention & control ; Pandemics ; Public Health ; SARS-CoV-2 ; Surveys and Questionnaires ; Workplace
Language	English
Publishing date	2021-01-27
Publishing country	England
Document type	Journal Article
ZDB-ID	632786-2
ISSN	1099-1751 ; 0749-6753
ISSN (online)	1099-1751
ISSN	0749-6753
DOI	10.1002/hpm.3117
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Article ; Online: Gender, race, and health workers in the COVID-19 pandemic.

Lotta, Gabriela / Fernandez, Michelle / Pimenta, Denise / Wenham, Clare

Lancet (London, England)

2021 Volume 397, Issue 10281, Page(s) 1264

MeSH term(s)	COVID-19 ; Health Personnel ; Health Workforce ; Humans ; Pandemics ; SARS-CoV-2
Language	English
Publishing date	2021-03-24
Publishing country	England
Document type	Letter ; Comment
ZDB-ID	3306-6
ISSN	1474-547X ; 0023-7507 ; 0140-6736
ISSN (online)	1474-547X
ISSN	0023-7507 ; 0140-6736
DOI	10.1016/S0140-6736(21)00530-4
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Article ; Online: Appropriateness of adult plain abdominal radiograph requesting in a regional Emergency Department.

Fernandez, Michelle / Craig, Simon

Journal of medical imaging and radiation oncology

2019 Volume 63, Issue 2, Page(s) 175–182

Abstract: Introduction: Although commonly ordered, abdominal x-rays are thought to be overused and unhelpful in many emergency department patients. Our objectives were to evaluate the appropriateness of plain abdominal X-ray (AXR) requests in adult patients ... ...

Abstract	Introduction: Although commonly ordered, abdominal x-rays are thought to be overused and unhelpful in many emergency department patients. Our objectives were to evaluate the appropriateness of plain abdominal X-ray (AXR) requests in adult patients presenting to a Victorian regional emergency department (ED). Methods: A retrospective chart review was performed of all adult patients with a plain AXR requested by ED medical staff members in a regional healthcare centre in Victoria, Australia in 2016. Patient demographics, ED disposition and any further imaging results were extracted from the medical record. Indications for X-ray and clinician seniority were determined from the radiology request slips signed by the treating emergency doctor. Appropriateness of imaging was determined by comparing the indication for abdominal radiograph to local evidence-based guidelines. Results: One hundred and nine episodes of plain AXR requests met the inclusion criteria. Of these, 40 were considered inappropriate according to clinical guidelines. Overall, 36% (39/109) had normal or non-specific findings and 42% (46/109) demonstrated faecal loading, while 22% (24/109) identified pathology. Thirty-three patients had further imaging, mostly with computed tomography (CT). Junior staff members were responsible for most of the AXR requests. Conclusion: In our regional hospital ED, over one third of AXRs requested for adult patients were inappropriate according to clinical guidelines. AXRs have a low diagnostic yield and frequently do not reduce the need for further imaging. The use of a clinical practice guideline and education of junior medical staff may increase the appropriate use of plain AXRs in the regional ED setting.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Emergency Service, Hospital ; Female ; Guideline Adherence ; Humans ; Male ; Middle Aged ; Radiography, Abdominal/statistics & numerical data ; Retrospective Studies ; Unnecessary Procedures/statistics & numerical data ; Victoria
Language	English
Publishing date	2019-01-10
Publishing country	Australia
Document type	Journal Article
ZDB-ID	2389687-5
ISSN	1754-9485 ; 1440-1673 ; 1754-9477 ; 0004-8461
ISSN (online)	1754-9485 ; 1440-1673
ISSN	1754-9477 ; 0004-8461
DOI	10.1111/1754-9485.12847
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