The article seeks to assess the Brazilian health system ability to respond to the challenges imposed by the coronavirus disease 2019 (COVID-19) pandemic by measuring the capacity of Brazilian hospitals to care for COVID-19 cases in the 450 Health Regions of the country during the year 2020. Hospital capacity refers to the availability of hospital beds, equipment, and human resources.

We used longitudinal data from the National Register of Health Facilities (CNES) regarding the availability of resources necessary to care for patients with COVID-19 in inpatient facilities (public or private) from January to December 2020. Among the assessed resources are health professionals (certified nursing assistants, nurses, physical therapists, and doctors), hospital beds (clinical, intermediate care, and intensive care units), and medical equipment (computed tomography scanners, defibrillators, electrocardiograph monitors, ventilators, and resuscitators). In addition to conducting a descriptive analysis of absolute and relative data (per 10,000 users), a synthetic indicator named Installed Capacity Index (ICI) was calculated using the multivariate principal component analysis technique to assess hospital capacity. The indicator was further stratified into value ranges to understand its evolution.

There was an increase in all selected indicators between January and December 2020. It was possible to observe differences between the Northeast and North regions and the other regions of the country; most Health Regions presented low ICI. The ICI increased between the beginning and the end of 2020, but this evolution differed among Health Regions. The average increase in the ICI was more evident in the groups that already had considerably high baseline capacity in January 2020.

It was possible to identify inequalities in the hospital capacity to care for patients affected by COVID -19 in the Health Regions of Brazil, with a concentration of low index values in the Northeast and North of the country. As the indicator increased throughout the year 2020, inequalities were also observed. The information here provided may be used by health authorities, providers, and managers in planning and adjusting for future COVID-19 care and in dimensioning the adequate supply of hospital beds, health-care professionals, and devices in Health Regions to reduce associated morbidity and mortality. We recommend that the ICI continue to be calculated in the coming months of the pandemic to monitor the capacity in the country’s Health Regions.

To develop and validate protocols for photographed food record directed to visually impaired people.

Photographic techniques were established for capturing food images using a smartphone, and written protocols were defined. Thereafter, visually impaired people made photographic records of three standardised meals (breakfast, lunch/dinner, and snack) following the previously developed protocols. These photographs were then evaluated by a panel of experts (nutritionists and photographer) to indicate whether the framing, focus and angle were suitable to identify the food type, food amount and portion size. Agreement between the experts was assessed using Fleiss’ Kappa.

Natal, the capital of Rio Grande do Norte, Brazil.

Visually impaired people (n 40); nutritionists (n 2); professional photographer (n 1).

Both protocols obtained a high proportion of satisfactory photos for all the items in the three dimensions investigated. When overall quality was assessed, the experts’ agreement was a substantial that through the images it would be possible to identify the food type and portion size, both for Frontal Photos (k = 0·70 and k = 0·62, respectively) and Aerial Photos (k = 0·68 and k = 0·70, respectively). The degree of agreement that the photos presented a satisfactory global quality was moderate for the Frontal Photo (k = 0·43) and substantial for the Aerial Photo (k = 0·64). Participants who frequently used smartphone-type cell phones obtained better quality images for all these attributes for both protocols.

The protocols for photographed food record developed for visually impaired people in this study are feasible and present themselves as an alternative strategy to qualitatively assess their dietary intake.

To investigate factors associated with anaemia in preschool children.

A home survey was conducted in 2018. Anaemia in children (capillary blood Hb level < 110 g/l) was the outcome, and socio-economic, demographic and health factors of the mother and child were the independent variables. The measure of association was the prevalence ratio, and its 95 % CI was calculated using Poisson’s regression with robust variance and hierarchical selection of independent variables.

Afro-descendants communities living in the state of Alagoas, northeast Brazil.

Children aged 6–59 months and their mothers (n 428 pairs).

The prevalence of child anaemia was 38·1 % (95 % CI 33·5, 42·7). The associated factors with child anaemia were male sex, age < 24 months, larger number of residents at home (> 4), relatively taller mothers (highest tertile) and higher z-score of BMI for age, after further adjustment for wealth index, vitamin A supplementation in the past 6 months and clinical visit in the last 30 d.

The high prevalence of anaemia observed reveals a relevant public health problem amongst children under five from the quilombola communities of Alagoas. Considering the damage caused to health and multiplicity of risk factors associated with anaemia, the adoption of intersectoral strategies that act on modifiable risk factors and increase vigilance concerning those that are not modifiable becomes urgent.

To evaluate the effectiveness of a positive deviance strategy for the improvement of hand hygiene compliance in 2 adult step-down units.

A 9-month, controlled trial comparing the effect of positive deviance on compliance with hand hygiene.

Two 20-bed step-down units at a tertiary care private hospital.

The first phase of our study was a 3-month baseline period (from April to June 2008) in which hand hygiene episodes were counted by use of electronic handwashing counters. From July to September 2008 (ie, the second phase), a positive deviance strategy was implemented in the east unit; the west unit was the control unit. During the period from October to December 2008 (ie, the third phase), positive deviance was applied in both units.

During the first phase, there was no statistically significant difference between the 2 step-down units in the number of episodes of hand hygiene per 1,000 patient-days or in the incidence density of healthcare-associated infections (HAIs) per 1,000 patient-days. During the second phase, there were 62,000 hand hygiene episodes per 1,000 patient-days in the east unit and 33,570 hand hygiene episodes per 1,000 patient-days in the west unit (P < .01). The incidence density of HAIs per 1,000 patient-days was 6.5 in the east unit and 12.7 in the west unit (P = .04). During the third phase, there was no statistically significant difference in hand hygiene episodes per 1,000 patient-days (P = .16) or in incidence density of HAIs per 1,000 patient-days.

A positive deviance strategy yielded a significant improvement in hand hygiene, which was associated with a decrease in the overall incidence of HAIs.