Supplementing flaxseed meal with sucrose, flaxseed oil, or both: Effect on milk enterolactone, ruminal microbiota profile, production performance, and nutrient utilization in dairy cows.

Flaxseed is the richest source of secoisolariciresinol diglucoside, which is converted by ruminal microorganisms primarily to the mammalian lignan enterolactone. Our objective was to investigate the effect of diets containing soybean meal or flaxseed meal (FM) supplemented with sucrose, flaxseed oil, or both on milk enterolactone concentration and yield, diversity and relative abundance of ruminal bacterial taxa, ruminal fermentation profile, production performance, milk fatty acid (FA) yield, and nutrient utilization in dairy cows. Sixteen Holstein cows [8 multiparous (4 ruminally-cannulated) and 8 primiparous] averaging (mean ± SD) 134 ± 54.1 DIM and 679 ± 78.9 kg of BW in the beginning of the study were assigned to treatment sequences in a replicated 4 × 4 Latin square design. Each experimental period lasted 25 d with 18 d for diet adaptation and 7 d for data and sample collection. Diets were formulated to contain a 60:40 forage:concentrate ratio and included (DM basis): 1) 8% soybean meal and 23% ground corn (SBM), 2) 15% FM, 10.7% ground corn, and 5% sucrose (FLX+S), 3) 15% FM, 15.4% ground corn, and 3% flaxseed oil (FLX+O), and 4) 15% FM, 10.2% ground corn, 5% sucrose, and 3% flaxseed oil (FLX+SO). Compared with SBM, the concentration and yield of milk enterolactone increased in cows fed the FM diets, but did not differ among FLX+S, FLX+O, and FLX+SO. The relative abundances of the phyla Firmicutes, Verrucomicrobiota, and Actinobacteriota and those of the bacterial genera Lachnospiraceae NK3A20 group, Eubacterium coprostanoligenes group, Anaeromusa-Anaeroarcus, WCHB1-41, and p-251-o5 decreased, whereas Prevotella and NK4A214 group increased when comparing SBM against at least 1 diet containing FM. Furthermore, the relative abundances of Firmicutes and Actinobacteriota and those of Prevotella, Lachnospiraceae NK3A20 group, Eubacterium coprostanoligenes group, Acetitomaculum, Lachnospiraceae unclassified, NK4A214 group, and Anaeromusa-Anaeroarcus changed (increased or decreased) across the FLX+S, FLX+O, and FLX+SO diets. However, all these changes in the relative abundance of the ruminal bacterial taxa were not conclusively associated with the effect of diets on milk enterolactone. Diets did not affect ruminal pH and concentrations of NH3-N and total VFA. Dry matter intake and yields of milk, milk fat, and milk true protein all decreased in cows fed FLX+O or FLX+SO. Yields of milk total odd-chain FA, branched-chain FA, total < 16C FA, and total 16C FA all decreased with feeding FLX+O and FLX+SO. The apparent total-tract digestibilities of DM and OM were lowest in the FLX+S and FLX+O diets, with CP and ADF digestibilities lowest in cows receiving FLX+S or FLX+O, respectively. Urinary excretion of total N was lowest with feeding SBM. Contrarily, diets did not affect the urinary excretion of total purine derivatives. In brief, despite the effect of diets on the relative abundance of several ruminal microbiota phyla and genera, we were unable to conclusively associate these changes with increased milk enterolactone in FM-containing diets versus SBM.

Efficacy of immune checkpoint inhibitors in alveolar soft-part sarcoma: results from a retrospective worldwide registry.

BACKGROUND: Conventional cytotoxic drugs are not effective in alveolar soft-part sarcoma (ASPS). Immune checkpoint (programmed cell death protein 1/programmed death-ligand 1) inhibitors (ICIs) are promising drugs in ASPS. A worldwide registry explored the efficacy of ICI in ASPS. MATERIALS AND METHODS: Data from adult patients diagnosed with ASPS and treated with ICI for advanced disease in expert sarcoma centers from Europe, Australia and North America were retrospectively collected, including demographics and data related to treatments and outcome. RESULTS: Seventy-six ASPS patients, with a median age at diagnosis of 25 years (range 3-61 years), were registered. All patients received ICI for metastatic disease. Immunotherapy regimens consisted of monotherapy in 38 patients (50%) and combination in 38 (50%) (23 with a tyrosine kinase inhibitor). Among the 68 assessable patients, there were 3 complete responses and 34 partial responses, translating into an overall response rate of 54.4%. After a median follow-up of 36 months [95% confidence interval (CI) 32-40 months] since the start of immunotherapy, 45 (59%) patients have progressed on ICI, with a median progression-free survival (PFS) of 16.3 months (95% CI 8-25 months). Receiving ICI in first line (P = 0.042) and achieving an objective response (P = 0.043) correlated with a better PFS. Median estimated overall survival (OS) from ICI initiation has not been reached. The 12-month and 24-month OS rates were 94% and 81%, respectively. CONCLUSIONS: This registry constitutes the largest available series of ASPS treated with ICI. Our results suggest that the ICI treatment provides long-lasting disease control and prolonged OS in patients with advanced ASPS, an ultra-rare entity with limited active therapeutic options.

Fadiga e sono em trabalhadores de enfermagem intensivistas na pandemia COVID-19 / Fatigue and sleep in intensive care nursing workers in the COVID-19 pandemic

Resumo Objetivo Analisar a relação entre fadiga, qualidade do sono, variáveis de saúde e laborais em trabalhadores de enfermagem de terapias intensivas, na pandemia COVID-19. Métodos Estudo transversal, correlacional, realizado de julho de 2020 a fevereiro de 2021, com amostra aleatória e probabilística de enfermeiros e técnicos de enfermagem de hospitais universitários do Rio Grande do Sul, Brasil. Para a coleta de dados foi utilizado questionário sociodemográfico/ocupacional, Escala de Avaliação da Fadiga e Índice de Qualidade do Sono de Pittsburgh. Nas análises utilizaram-se teste Qui-Quadrado, teste U Mann-Whitney e coeficiente de correlação de Spearman, com nível de significância de 5%. Foi realizada análise de regressão binária logística. Resultados Participaram 114 trabalhadores, com prevalência de fadiga baixa e qualidade do sono ruim. A fadiga alta associou-se às variáveis ir trabalhar doente e perceber ruídos/vibrações como causa de desconforto. Técnicos de enfermagem associaram-se a qualidade do sono ruim e preocupação com a exposição a substâncias químicas. Fadiga e Qualidade do sono correlacionaram-se de forma moderada e direta. As análises ajustadas evidenciaram que enfermeiros e técnicos de enfermagem com fadiga alta apresentaram quatro vezes mais chances de terem qualidade do sono ruim (OR = 4,86; IC = 1,50-15,75). Conclusão A fadiga e qualidade do sono se correlacionaram de forma direta, e estão associados a fatores individuais e do trabalho. A fadiga alta aumentou as chances de ter pior avaliação da qualidade do sono. Estratégias institucionais e organizacionais devem ser revistas a fim de priorizar a proteção da saúde destes trabalhadores de enfermagem.

Resumen Objetivo Analizar la relación entre fatiga, calidad del sueño, variables de salud y laborales en trabajadores de enfermería de terapias intensivas, durante la pandemia de COVID-19. Métodos Estudio transversal, correlacional, realizado de julio de 2020 a febrero de 2021, con muestreo aleatorio y probabilístico de enfermeros y técnicos de enfermería de hospitales universitarios de Rio Grande do Sul, Brasil. Para la recopilación de datos se utilizó un cuestionario sociodemográfico/laboral, la Escala de Evaluación de Fatiga y el Índice de Calidad del Sueño de Pittsburgh. Para los análisis se utilizó la prueba χ2 de Pearson, la prueba U de Mann-Whitney y el coeficiente de correlación de Spearman, con un nivel de significación de 5 %. Se realizó el análisis de regresión binaria logística. Resultados Participaron 114 trabajadores, con prevalencia de fatiga baja y sueño de mala calidad. Se relacionó la fatiga con las variables ir a trabajar enfermo y percibir ruidos/vibraciones como causa de malestar. Se relacionó a los técnicos de enfermería con el sueño de mala calidad y la preocupación por la exposición a sustancias químicas. La fatiga y la calidad del sueño se correlacionaron de forma moderada y directa. Los análisis realizados evidenciaron que enfermeros y técnicos de enfermería con fatiga alta presentaron cuatro veces más probabilidades de tener sueño de mala calidad (OR = 4,86; IC = 1,50-15,75). Conclusión La fatiga y la calidad del sueño se correlacionan de forma directa y están relacionadas con factores individuales y del trabajo. La fatiga alta aumentó las probabilidades de tener una peor evaluación de la calidad del sueño. Las estrategias institucionales y organizacionales deben ser revisadas a fin de priorizar la protección de la salud de los trabajadores de enfermería.

Abstract Objective To analyze the relationship between fatigue, sleep quality, variables of health and work in intensive care nursing workers during the COVID-19 pandemic. Methods Cross-sectional, correlational study conducted from July 2020 to February 2021 with a random and probabilistic sample of nurses and nursing technicians from university hospitals in Rio Grande do Sul, Brazil. A sociodemographic/occupational questionnaire, the Fatigue Assessment Scale and the Pittsburgh Sleep Quality Index were used in data collection. The chi-square test, Mann-Whitney U test and the Spearman correlation coefficient were used in the analyzes, adopting a significance level of 5%. Binary logistic regression analysis was performed. Results Participation of 114 workers. There was prevalence of low fatigue and poor sleep quality. High fatigue was associated with the variables going to work sick and perceiving noise/vibrations as a cause of discomfort. Nursing technicians were associated with poor sleep quality and concern about exposure to chemical substances. Fatigue and sleep quality were moderately and directly correlated. Adjusted analyzes showed that nurses and nursing technicians with high fatigue were four times more likely to have poor sleep quality (OR = 4.86; CI = 1.50-15.75). Conclusion Fatigue and sleep quality were directly correlated and are associated with individual and work factors. High fatigue increased the chances of having worse sleep quality assessment. Institutional and organizational strategies should be reviewed in order to prioritize the health protection of these nursing workers.

Senso de coerência em pessoas privadas de liberdade: ferramenta para a promoção da saúde / Sense of coherence in people deprived of liberty: a tool for health promotion / Sentido de coherencia en personas privadas de libertad: herramientas para la promoción de salud

Objetivo: determinar o Senso de Coerência em pessoas privadas de liberdade de uma região de tríplice fronteira e correlacionar com variáveis sociodemográficas, clínicas e hábitos de vida. Método: estudo transversal realizado com 326 pessoas privadas de liberdade que autopreencheram o Questionário de Senso de Coerência, de abril a agosto de 2021. Protocolo de Pesquisa aprovado pelo Comitê de Ética em Pesquisa. Resultados: homens (90,80%), com idade média de 32,28 anos, solteiros (43,25%), baixa escolaridade (55,83%) e prevalência do Senso de Coerência moderado (65,95%) foram identificados. O Senso de Coerência teve relação estatisticamente significante com a idade (p-valor=0,011) e realização de atividades na unidade penal (p-valor=0,005). Senso de Coerência fraco foi prevalente em pessoas com transtornos mentais (p-valor=0,001) e doenças infectocontagiosas (p-valor=0,018). Considerações finais: analisar o Senso de Coerência em grupos vulneráveis, como as pessoas privadas de liberdade, permite apreender como compreendem, manejam e significam suas vidas, constituindo-se de ferramenta para a promoção da saúde.

Objective: to determine the Sense of Coherence in people deprived of liberty in a tri-border region and correlate it with sociodemographic, clinical and lifestyle variables. Method: in this cross-sectional study, 326 people deprived of liberty self-completed the Sense of Coherence Questionnaire, between April and August 2021. The research protocol was approved by the research ethics committee. Results: men (90.80%), mean age 32.28 years, single (43.25%), with little education (55.83%), and moderate prevalence of Sense of Coherence (65.95%) were identified. Sense of Coherence was statistically significantly related to age (p-value = 0.011) and performing activities in the penal unit (p-value = 0.005). Weak sense of coherence was prevalent in those with mental disorders (p-value = 0.001) and infectious diseases (p-value = 0.018). Final cosiderations: examination of Sense of Coherence in vulnerable groups, such as people deprived of liberty, affords an understanding of how they comprehend, manage and give meaning to their lives, and thus constitutes a tool for health promotion.

Objetivo: determinar el Sentido de Coherencia en personas privadas de libertad en una región de triple frontera y correlacionarlo con variables sociodemográficas, clínicas y de estilo de vida. Método: estudio transversal realizado con 326 personas privadas de libertad que llenaron el Cuestionario de Sentido de Coherencia autoaplicado, de abril a agosto de 2021. Protocolo de investigación aprobado por el Comité de Ética en Investigación. Resultados: se identificaron hombres (90,80%), con promedio de edad de 32,28 años, solteros (43,25%), escolaridad baja (55,83%) y prevalencia de Sentido de Coherencia moderado (65,95%). El Sentido de Coherencia tuvo una relación estadísticamente significativa con la edad (p-valor=0,011) y el desempeño de actividades en la unidad penal (p-valor=0,005). El Sentido de Coherencia débil prevaleció en personas con trastornos mentales (p-valor de = 0,001) y enfermedades infectocontagiosas (p-valor = 0,018). Consideraciones finales: analizar el Sentido de Coherencia en grupos vulnerables, como las personas privadas de libertad, permite captar cómo comprenden, gestionan y dan sentido a sus vidas, lo que constituye una herramienta para la promoción de la salud.

Política de saúde prisional brasileira: uma revisão integrativa / Brazilian prison health policy: an integrative review / Política brasileña de salud penitenciaria: una revisión integrativa

Objetivo: identificar as temáticas relacionadas à saúde das pessoas privadas de liberdade no Brasil, abordadas em periódicos científicos, e correlacioná-las com as diretrizes da Política Nacional de Atenção à Saúde das Pessoas Privadas de Liberdade no Sistema Prisional (PNAISP), em vigência. Metodologia: tratou-se de uma revisão integrativa de literatura, realizada nas bases de dados da Biblioteca Virtual de Saúde, National Library of Medicine e Scopus e resultando em 37 artigos selecionados. Resultados e discussão: as temáticas relacionadas à saúde das pessoas privadas de liberdade no Brasil, discutidas nos artigos, estão alicerçadas na perspectiva curativista, com ênfase nas doenças infectocontagiosas, havendo poucos estudos sobre ações promotoras de saúde. A maior parte dos estudos se ocupou da diretriz Controle e/ou redução de agravos mais frequentes, em detrimento das demais diretrizes da PNAISP. Conclusão: a superação da perspectiva curativista nos cuidados em saúde de pessoas presas pressupõe o fomento de ações promotoras de saúde, que fortaleçam a implementação das diretrizes da política de saúde prisional brasileira. Este estudo contribui com a reflexão sobre a saúde nas prisões ao reconhecer das diretrizes estruturantes da PNAISP.

Objective: to identify topics related to the health of people deprived of liberty in Brazil that are covered in scientific journals and compare them with the guidelines of the current National Health Care Policy for Liberty Deprived People in the Prison System (PNAISP, in Portuguese). Methods: this was an integrative literature search conducted in the Virtual Health Library, National Library of Medicine, and Scopus databases, resulting in 37 selected articles. Results and discussion: the topics addressed in the articles related to the health of people deprived of their liberty in Brazil were based on a curative perspective with a focus on infectious diseases, with few studies on health promotion interventions. Most studies addressed guideline control and/or reduction of the most common diseases, to the detriment of the other guidelines of the PNAISP. Conclusion: overcoming the curative perspective in prisoner health care requires the promotion of health-promoting interventions that strengthen the implementation of the Brazilian Prison Health Policy guidelines. This study contributes to the reflection on prison health by recognizing the structuring guidelines of the PNAISP.

Objetivo: identificar cuestiones relacionadas con la salud de las personas privadas de libertad en Brasil, abordadas en revistas científicas, y correlacionarlas con las directrices de la Política Nacional de Atención a la Salud de las Personas Privadas de Libertad en el Sistema Penitenciario (PNAISP), en vigor. Metodología: se trató de una revisión integrativa de la literatura, realizada en las bases de datos Biblioteca Virtual en Salud, Biblioteca Nacional de Medicina y Scopus, resultando en 37 artículos seleccionados. Resultados y discusión: los temas relacionados con la salud de las personas privadas de libertad en Brasil, discutidos en los artículos, se basan en una perspectiva curativa, con énfasis en las enfermedades infecciosas, con pocos estudios sobre acciones promotoras de salud. La mayoría de los estudios versaron sobre la directriz Control y/o reducción de las enfermedades más frecuentes, en detrimento de las demás directrices de la PNAISP. Conclusión: la superación de la perspectiva curativa en la atención a la salud de los presos presupone la promoción de acciones promotoras de salud que fortalezcan la implementación de las directrices de la política brasileña de salud penitenciaria. Este estudio contribuye a la reflexión sobre la salud en las cárceles al reconocer las directrices estructurantes del PNAISP.

Lung cancer and occupational exposure: hospital-based case-control study.

OBJECTIVE: To analyze the relationship between occupation and lung cancer in patients at a national referral hospital for cancer care in southern Brazil. METHOD: Hospital-based case-control study conducted between February and October 2019. Occupational histories were coded according to international classifications and translated into occupations associated with lung cancer (List A and B). The odds ratios were adjusted for smoking, with a 95% confidence interval, calculated by conditional logistic regression. RESULTS: 99 cases and 227 controls were included. Among men, the occupation of painters (list A) was associated with lung cancer (OR = 14.3; 95% CI: 1.8-116.5), there were no occupations in list B associated with lung cancer. In women, no increased risks were found. CONCLUSIONS: It has been shown that exposure to occupational carcinogens among repair and construction painters increases the risk of lung cancer.

SELNET clinical practice guidelines for bone sarcoma.

Bone sarcoma are infrequent diseases, representing < 0.2% of all adult neoplasms. A multidisciplinary management within reference centers for sarcoma, with discussion of the diagnostic and therapeutic strategies within an expert multidisciplinary tumour board, is essential for these patients, given its heterogeneity and low frequency. This approach leads to an improvement in patient's outcome, as demonstrated in several studies. The Sarcoma European Latin-American Network (SELNET), aims to improve clinical outcome in sarcoma care, with a special focus in Latin-American countries. These Clinical Practice Guidelines (CPG) have been developed and agreed by a multidisciplinary expert group (including medical and radiation oncologist, surgical oncologist, orthopaedic surgeons, radiologist, pathologist, molecular biologist and representatives of patients advocacy groups) of the SELNET consortium, and are conceived to provide the standard approach to diagnosis, treatment and follow-up of bone sarcoma patients in the Latin-American context.

Occupational characterization of workers exposed to asbestos: an integrative review.

Asbestos is a mineral fiber abundant in nature and classified as a carcinogen since 1987. The present study aimed to identify, in the scientific literature, what are the occupation and activities developed by sick workers and which categories would be affected with asbestos-related diseases. Through a literature review performed in the following databases: PubMed, CINAHL (Cumulative Index to Nursing and Allied Health Literature), Web of Science, and Regional Portal of the Virtual Health Library, 23 studies published from 2015 to 2020 were selected and evaluated. The occupations that showed greater illness due to exposure to asbestos were general asbestos workers (40%), miners (22%), and textile workers (9%), followed by naval, automotive, carpentry, doll-making, construction, and upholstery workers, as well as workers involved in the rescue, recovery, cleaning, and restoration of the World Trade Center (4%). Of the disease associated with exposure to asbestos, the most described is malignant mesothelioma (43%). Evidence found corroborate pre-existing information in the literature showing that exposure to asbestos may be harmful to health. Moreover, the importance of using personal protective equipment was emphasized, in order to prevent the development of asbestos-related diseases.

O asbesto é uma fibra mineral abundante na natureza, classificado como substância cancerígena desde 1987. Objetivou-se identificar, na literatura científica, quais são as ocupações e atividades desenvolvidas por trabalhadores adoecidos e quais categorias seriam afetadas com doenças relacionadas ao asbesto. O presente estudo trata-se de uma revisão de literatura realizada mediante a busca nas bases de dados PubMed, CINAHL (Cumulative Index to Nursing and Allied Health Literature), Web of Science e Portal Regional da Biblioteca Virtual em Saúde, sendo selecionados e avaliados 23 estudos publicados entre 2015 e 2020. As ocupações que demonstraram maior adoecimento pela exposição ao asbesto foram trabalhadores gerais de indústrias de asbesto (40%), mineradores (22%) e do setor têxtil (9%), seguidos por trabalhadores da indústria naval, do setor automotivo, carpinteiros, do setor de fabricação de bonecas, da construção civil, estofadores e trabalhadores que participaram do resgate, recuperação, limpeza e restauração do local do World Trade Center (4%). Entre as patologias associadas à exposição ao asbesto, a principal descrita é o mesotelioma maligno (43%). As evidências encontradas corroboram as informações preexistentes na literatura de que a exposição ao asbesto pode ser prejudicial à saúde. Ainda, ressalta-se a importância da utilização de equipamentos de proteção individual, a fim de evitar o desenvolvimento de doenças relacionadas ao asbesto.

Recent developments in drug delivery strategies for targeting DNA damage response in glioblastoma.

Glioblastoma is the most frequent and malignant brain tumor. The median survival for this disease is approximately 15 months, and despite all the available treatment strategies employed, it remains an incurable disease. Preclinical and clinical research have shown that the resistance process related to DNA damage repair pathways, glioma stem cells, blood-brain barrier selectivity, and dose-limiting toxicity of systemic treatment leads to poor clinical outcomes. In this context, the advent of drug delivery systems associated with localized treatment seems to be a promising and versatile alternative to overcome the failure of the current treatment approaches. In order to bypass therapeutic tumor resistance mechanisms, more effective combinatorial therapies should be identified, such as the use of cytotoxic drugs combined with the inhibition of DNA damage response (DDR)-related targets. Additionally, critical reasoning about the delivery approach and administration route in brain tumors treatment innovation is essential. The outcomes of future experimental studies regarding the association of delivery systems, alternative treatment routes, and DDR targets are expected to lead to the development of refined therapeutic interventions. Novel therapeutic approaches could improve the life's quality of glioblastoma patients and increase their survival rate.

Removal of herbicide 1-chloro-2,4-dinitrobenzene (DNCB) from aqueous solutions by electrochemical oxidation using boron-doped diamond (BDD) and PbO2 electrodes.

The electrochemical removal of the 1-chloro-2,4-dinitrobenzene (DNCB) herbicide, a potentially carcinogenic agent from aqueous solutions, was performed at PbO2 and BDD electrodes by bulk electrolysis under galvanostatic control (300 and 400 A m-2) and under two pH conditions (3 and 9). Results clearly indicated that a 62 % of mineralization was achieved with BDD anode at pH 3, while only a 46 % of electrochemical oxidation (EO) was achieved at PbO2 electrode. The mineralization current efficiency (MCE) depended on the electrode material, current density, and pH conditions; but, for both PbO2 and BDD, high MCE was achieved at pH 3 and 300 A m-2, obtaining 2.54 % and 1.99 % for BDD and PbO2, respectively. The EO pathway depended on the electrocatalytic properties of each one of the anodes to produce hydroxyl radicals which attacked the DNCB molecule as well as the deactivating effects of the chlorine and nitro groups attached to the aromatic ring on the DNCB structure. Finally, HPLC analyses also showed that phenolic intermediates as well as carboxylic acids were formed, at a different extent, during the electrolysis process on both electrodes.

Qualidade de vida no trabalho dos profissionais de enfermagem: reflexão sobre os impactos da COVID-19 / Calidad de vida en el trabajo de los profesionales de enfermería: reflexión sobre los impactos de COVID-19 / Quality of life at work of nursing professionals: reflection on the impacts of COVID-19

Objetivo: Refletir sobre os principais impactos causados na qualidade de vida no trabalho dos profissionais de enfermagem durante a pandemia do novo coronavírus. Método: Tratase de uma reflexão teórica, baseada na teoria de qualidade de vida no trabalho. A discussão foi embasada em artigos nacionais e internacionais com enfoque na temática. Resultados: Oito critérios influenciam na qualidade de vida no trabalho, dentre os relacionados aos profissionais de Enfermagem, quatro foram positivos no enfrentamento da pandemia: oportunidades de crescimento e segurança contínuas, constitucionalismo e cidadania, relevância social da vida no trabalho e desenvolvimento de capacidades humanas. Entretanto, quatro tiveram reflexos negativos, sendo comuns os apontamentos de longas jornadas de trabalho, com o afastamento dos profissionais, seja por adoecimento ou por serem de grupo de riscos, aumento da sobrecarga de trabalho, o que causa a eles um maior sofrimento físico e mental. Em relação aos aspectos de compensação justa e adequada, os profissionais continuam recebendo baixos salários, quanto à segurança e saúde, foram relatados casos de ausência de equipamento de proteção individual e reuso inadequado desses equipamentos. Considerações finais: Espera-se demonstrar, analisar e refletir sobre os fatores que influenciam e afetam na qualidade de vida no trabalho dos profissionais de enfermagem em decorrência ao enfrentamento da COVID-19(AU)

Objective: To reflect on the main impacts on the quality of life at work of Nursing Professionals during the pandemic novel coronavirus. Method: This is a theoretical reflection, based on the theory of quality of life at work. The discussion was based on national and international articles focusing on the theme. Results: Eight criteria influence the quality of life at work, among those related to nursing professionals, four were positive in coping with the pandemic: opportunities for continuous growth and security, constitutionalism and citizenship, social relevance of life at work and development of human capabilities. However, four had negative reflexes, being common the notes of long working hours, with the removel of professionals, either due to illness or because They are from a risk group, increased work overload, which causes them greater physical and mental suffering. Regarding the aspects of fair and adequate compensation, professionals continue to receive low wages, regarding safety and health, cases of absence of personal protective equipment and inadequate reuse of this equipment have been reported. Final considerations: It is expected to demonstrate and analyze, reflect on the factors that influence and affect the quality of life at work of nursing professionals due to coping with COVID 19(AU)

Objetivo: Reflexionar sobre los principales impactos causados en la calidad de vida en el trabajo de los profesionales de enfermería durante la pandemia del nuevo coronavirus. Método: Esta es una reflexión teórica, basada en la teoría de la calidad de vida en el trabajo. La discusión se basó en artículos nacionales e internacionales centrados en el tema. Resultados: Ocho criterios influyen en la calidad de vida en el trabajo, entre los relacionados con los profesionales de enfermería, cuatro fueron positivos para enfrentar la pandemia: oportunidades de crecimiento y seguridad continuos, constitucionalismo y ciudadanía, relevancia social de la vida en el trabajo y desarrollo de capacidades humanas. Sin embargo, cuatro tenían reflejos negativos, las notas de largas horas de trabajo son comunes, con la retirada de profesionales, ya sea por enfermedad y por ser un grupo de riesgos, aumenta la sobrecarga de trabajo que les causa un mayor sufrimiento físico y mental. Con respecto a los aspectos de compensación justa y adecuada, los profesionales continúan recibiendo bajos salarios, en términos de seguridad y salud, se han reportado casos de ausencia de equipo de protección personal y la reutilización inadecuada de algunos de estos equipos. Consideraciones finales: Se espera que demuestre y analice reflexione sobr los factores que influyen y afectan la calidad de vida en el trabajo de los profesionales de enfermería debido a cómo hacer frente a COVID 19.(AU)

Lung cancer related to occupational exposure: an integrative review.

OBJECTIVE: To identify in the literature the carcinogenic agents found in the work environment, the occupations and the risk for lung cancer. METHOD: A descriptive and analytical study of the Integrative Literature Review type was carried out in national and international databases from the last ten years in the period from 2009 to 2018, concerning 32 studies referring to association between carcinogenic substances to which the worker is exposed and lung cancer. RESULTS: Nine (28.1%) publications originated in China and only one in Brazil. The most exposed workers were from the secondary sector, 50% being from industry and 6.2% from construction, mostly male. Asbestos and silica stood out among the carcinogenic substances most associated with lung cancer risk, accounting for 37.5% and 28.1%, respectively. CONCLUSIONS: The association between occupational exposure and the risk for lung cancer was characterized in this research by the substantial scientific evidence from the described studies that confirm this association.

Psychosocial risks and the health of health workers: reflections on Brazilian labor reform / Los riesgos psicosociales y la salud de los trabajadores de la salud: reflexiones sobre la reforma laboral brasileña / Riscos psicossociais e a saúde dos trabalhadores de saúde: reflexões sobre a Reforma Trabalhista Brasileira

ABSTRACT Objective: to reflect on the psychosocial risks and their impacts on the health of health workers in light of the Brazilian economic context and Labor Reform. Method: reflective study on the Brazilian Labor Reform and its impacts on health of health workers. Results: although the changes observed in the labor sphere have contributed to improvements in health and safety policies for, these changes have also contributed to the emergence of new risks arising from work activities, including psychosocial risks, which affect all occupational categories. Final considerations: we understand that the Brazilian Labor Reform carried out in 2017 leads to the weakening of labor relations, increases workers' exposure to risks in the workplace, increases the risk of illness, and opposes the global movement of international organizations aimed at the prevention of aggravation in workers' health and also at preserving their health.

RESUMEN Objetivo: reflexionar sobre los riesgos psicosociales y sus impactos en la salud de los trabajadores de la salud a la luz del contexto económico y la Reforma Laboral Brasileña. Método: estudio reflexivo sobre los impactos de la Reforma Laboral Brasileña en la salud del trabajador de la salud. Resultados: los cambios en el mundo del trabajo contribuyeron a la aparición de nuevos riesgos derivados de las actividades laborales, destacando los riesgos psicosociales asociados con el trabajo, incluyendo los trabajadores de la salud. Consideraciones finales: se puede ver que la Reforma Laboral Brasileña que tuvo lugar en 2017 induce el debilitamiento de las relaciones laborales, aumenta la exposición de los trabajadores a los riesgos en el lugar de trabajo, aumenta el riesgo de enfermedad en el trabajo, en oposición al movimiento mundial para la prevención de lesiones y la protección de la salud de los trabajadores.

RESUMO Objetivo: refletir sobre os riscos psicossociais e seus impactos na saúde dos trabalhadores de saúde frente ao contexto econômico e à Reforma Trabalhista Brasileira. Método: estudo reflexivo acerca da Reforma Trabalhista Brasileira e seus impactos na saúde dos trabalhadores de saúde. Resultados: embora tenham colaborado para avanços nas políticas de saúde e segurança dos trabalhadores, as mudanças ocorridas no mundo do trabalho - muitas delas decorrentes do modelo econômico globalizado - contribuíram para o surgimento de novos riscos decorrentes das atividades laborais, entre eles os riscos psicossociais, que atingem todas as categorias profissionais. Considerações finais: compreendemos que a Reforma Trabalhista Brasileira conduzida em 2017 induz à fragilização das relações de trabalho, potencializa a exposição dos trabalhadores aos riscos existentes no ambiente laboral, aumenta o risco de adoecimento, contrapondo-se ao movimento global de organizações internacionais voltadas à prevenção de agravos na saúde dos trabalhadores e também à proteção de sua saúde.

Lung cancer related to occupational exposure: an integrative review / Cáncer de pulmón relacionado con la exposición ocupacional: revisión integrativa / Câncer de pulmão relacionado à exposição ocupacional: revisão integrativa

ABSTRACT Objective: To identify in the literature the carcinogenic agents found in the work environment, the occupations and the risk for lung cancer. Method: A descriptive and analytical study of the Integrative Literature Review type was carried out in national and international databases from the last ten years in the period from 2009 to 2018, concerning 32 studies referring to association between carcinogenic substances to which the worker is exposed and lung cancer. Results: Nine (28.1%) publications originated in China and only one in Brazil. The most exposed workers were from the secondary sector, 50% being from industry and 6.2% from construction, mostly male. Asbestos and silica stood out among the carcinogenic substances most associated with lung cancer risk, accounting for 37.5% and 28.1%, respectively. Conclusions: The association between occupational exposure and the risk for lung cancer was characterized in this research by the substantial scientific evidence from the described studies that confirm this association.

RESUMEN Objetivo: Identificar en la literatura los agentes cancerígenos presentes en el entorno laboral, las ocupaciones y el riesgo de cáncer de pulmón. Método: Estudio descriptivo y analítico de una revisión integradora realizada en una base de datos nacional e internacional de los últimos diez años, entre 2009 y 2018, que comprende 32 estudios referidos a la vinculación entre el cáncer de pulmón y las sustancias cancerígenas de exposición ocupacional. Resultados: Nueve (28,1%) publicaciones tuvieron su origen en China y solo una en Brasil. Los trabajadores más expuestos pertenecían al sector secundario, el 50% a la industria y un 6,2% a la construcción, siendo en su mayoría hombres. El asbesto y la sílice se destacaron entre las sustancias cancerígenas más asociadas con el riesgo de cáncer de pulmón, con índices de 37,5% y el 28,1%, respectivamente. Conclusiones: La vinculación entre la exposición ocupacional y el riesgo de cáncer de pulmón se caracterizó en esta investigación por la evidencia científica sustancial de los estudios descriptos que confirman esta asociación.

RESUMO Objetivo: Identificar na literatura os agentes carcinogênicos presentes no ambiente ocupacional, as ocupações e o risco do câncer de pulmão. Método: Estudo descritivo e analítico de revisão integrativa realizada em base de dados nacionais e internacionais dos últimos dez anos, entre 2009 e 2018, compreendendo 32 estudos referentes à associação entre câncer de pulmão e substâncias carcinogênicas de exposição ocupacional. Resultados: Nove (28,1%) publicações originadas na China e apenas uma brasileira. Os trabalhadores mais expostos foram do setor secundário, sendo 50% da indústria e 6,2% da construção civil, em sua maioria do sexo masculino. O amianto e a sílica sobressaíram-se entre as substâncias carcinogênicas mais associadas ao risco de câncer de pulmão correspondendo a 37,5% e 28,1%, respectivamente. Conclusões: A associação entre a exposição ocupacional e o risco de câncer de pulmão ficou caracterizada nesta pesquisa pelas substanciais evidências científicas dos estudos descritos que confirmam essa associação.

Condições de trabalho e o impacto na saúde dos profissionais de enfermagem frente a Covid-19 / Working conditions and the impact on the health of the nursing professionals in the context of Covid-19 / Condiciones de trabajo y el efecto sobre la salud de los profesionales de enfermería en el contexto del Covid-19

OBJETIVO: refletir sobre as condições de trabalho dos profissionais de enfermagem no enfrentamento ao novo coronavírus e apontar o impacto na vida desses profissionais em meio à pandemia. DESENVOLVIMENTO: as fragilidades encontradas no cotidiano laboral dos profissionais de enfermagem são descritas pela literatura nacional e internacional, nas quais estão incluídas as más condições de trabalho, sobrecarga física e mental, baixa remuneração e ausência de Equipamentos de Proteção Individual adequados para o enfrentamento desse agravo. CONSIDERAÇÕES FINAIS: esta reflexão pode contribuir para repensar a saúde e segurança dos profissionais de enfermagem visando uma assistência com qualidade e segurança aos pacientes frente a esta doença.

OBJECTIVE: To reflect on the working conditions of the nursing professionals when facing the new coronavirus and to point out the impact on the lives of these professionals in the midst of the pandemic. DEVELOPMENT: The weaknesses found in the daily work of the nursing professionals are described by the national and international literature, which include poor working conditions, physical, and mental overload, low pay, and lack of adequate Personal Protective Equipment to cope with this condition. FINAL CONSIDERATIONS: This reflection can contribute to rethink the health and safety of the nursing professionals with a view to providing quality and safe care to the patients in the context of this disease.

OBJETIVO: reflexionar sobre las condiciones de trabajo de los profesionales de enfermería en la lucha contra el nuevo coronavirus y señalar el efecto sobre la vida de estos profesionales en medio de la pandemia. DESARROLLO: tanto en la literatura nacional como en la internacional se describen los déficits presentes en la rutina laboral de los profesionales de enfermería, entre los cuales se incluyen las deficientes condiciones de trabajo, la sobrecarga física y mental, la escasa remuneración y la ausencia de Equipos de Protección Personal adecuados para hacer frente a este problema sanitario. CONSIDERACIONES FINALES: esta reflexión puede ayudar a repensar la salud y la seguridad de los profesionales de enfermería con el propósito de ofrecer asistencia de calidad y seguridad a los pacientes frente a esta enfermedad.

Matriz de recomendações estratégicas para a vacinação dos trabalhadores de saúde / Matrix of strategic recommendations for immunization of health workers

Introdução: Os trabalhadores de saúde estão sob risco de exposição a doenças contagiosas, muitas delas imunopreveníveis. A imunoprevenção ocorre por meio da vacinação, sendo um direito dos trabalhadores e um dever das instituições empregadoras, conforme legislação trabalhista brasileira. Objetivo: O objetivo deste estudo foi construir uma matriz de recomendações estratégicas diante da situação vacinal de trabalhadores de saúde, dados os riscos a que tais profissionais estão expostos. Método: Trata-se de pesquisa qualitativa, realizada em uma Unidade Básica de Saúde (UBS), entre novembro e dezembro de 2016. Foram realizadas três oficinas, com participação média de 22 trabalhadores por oficina. Utilizou-se a Metodologia da Problematização com aplicação das etapas do Arco de Maguerez. As oficinas foram registradas em um diário de campo. Resultados: Essa metodologia possibilitou a compreensão dos participantes sobre o processo de adoecer e o cuidado com a saúde. As oficinas subsidiaram a construção da Matriz de Recomendações, que apresenta estratégias para orientar e monitorar a vacinação dos trabalhadores de saúde, como: informações sobre as vacinas indicadas aos trabalhadores de saúde; atualização do esquema vacinal; e a vigilância da saúde do trabalhador. Conclusão: Considera-se que esta pesquisa subsidia o cuidado em saúde do trabalhador diante da situação vacinal dos participantes e de outros trabalhadores de saúde. Tais recomendações estratégicas visam à melhoria da cobertura vacinal dos trabalhadores de saúde, contribuindo para minimizar o risco de adoecimento por doenças imunopreveníveis, que podem causar absenteísmo para o tratamento, ou até mesmo o afastamento do trabalho por tempo indeterminado.

Background: Health workers are at high risk of exposure to contagious diseases, many of which might be prevented through vaccination. According to the Brazilian labor legislation, vaccination is a right of workers and an obligation for employers. Objective: To develop a matrix of strategic recommendations relative to the vaccination status of health workers as a function of the risks to which this occupational group is exposed. Methods: Qualitative study performed at a Health Basic Unit in November and December 2016. We held three workshops with an average of 22 participants and following a problematization method based on the Maguerez arc approach. The data collected in the workshops were recorded on a field notebook. Results: The selected method helped the participants gain insights the process of illness and healthcare. The workshops resulted in a matrix of recommendations of strategies to orient and monitor immunizations for health workers, including: information on vaccinations recommended for health workers, vaccination status updates and occupational health surveillance. Conclusion: The present study provides grounds for occupational healthcare as concerns the vaccination status of the participants and other health workers. The resulting strategic recommendations aim at improving the vaccination status of health workers and thus reduce the risk of diseases preventable through immunizations, which might be a reason for sickness absenteeism, and even of indefinite sick leave.

Pneumatic dilation versus laparoscopic Heller's myotomy in the treatment of achalasia: systematic review and meta-analysis based on randomized controlled trials.

Achalasia is a primary esophageal motor disorder with a variety of causes. It is most common in Central and South America, where Chagas disease is endemic. In addition to the infectious etiology, achalasia can be idiopathic, autoimmune, or drug induced. It is an incurable, progressive condition that destroys the intramural nerve plexus, causing aperistalsis of the esophageal body and impaired relaxation of the lower esophageal sphincter. The literature on the treatment of achalasia comparing pneumatic dilation (PD) and laparoscopic Heller's myotomy (LHM) shows conflicting results. Therefore, a systemic review and meta-analysis are needed. A systematic review and meta-analysis of randomized controlled trials of PD and LHM, based on the preferred reporting items for systematic reviews and meta-analyses recommendations, was presented. The primary outcome was symptom remission based on the Eckardt score. Secondary outcomes were lower esophageal sphincter pressure (LESP), gastroesophageal reflux (GER), and perforation. A total of four studies were included in this analysis. The total number of patients was 404. Posttreatment symptom remission rates did not differ significantly between LHM and PD at 2 years (RD = 0.03, 95% CI [-0.05, 0.12], P = 0.62), or 5 years (RD = 0.13, 95% CI [-0.12, 0.39], P = 0.32). The posttreatment perforation rate was lower for LHM (RD = 0.04, 95% CI [-0.08, -0.01], P = 0.03). There was no significant difference in terms of LESP or GER. For the treatment of esophageal achalasia, LHM and PD were found to be similar in terms of their long-term efficacy, as well as in terms of the posttreatment GER rates. However, the perforation rate appears to be lower when LHM is employed.

Dermatoses ocupacionais registradas em sistema de notificação na região Sul do Brasil (2007 a 2016) / Occupational dermatoses registered in a notification system in the southern region of Brazil (2007 to 2016)

Introdução: As dermatoses ocupacionais são doenças de notificação compulsória no Brasil. Objetivo: Caracterizar a notificação das dermatoses ocupacionais no Sul do Brasil e descrever o perfil desses trabalhadores. Método: Descritivo, retrospectivo de 396 casos de dermatoses ocupacionais entre 2007-e 2016 no Sistema de Informação de Agravos de Notificação. Resultados: Em relação ao sexo, houve 3,6 casos a cada 10 mil trabalhadores/ano do sexo masculino e 2,2 casos a cada 10 mil trabalhadores/ano do sexo feminino. A faixa etária com maior incidência foi entre 50 e 64 anos, com 1,8 caso a cada 10 mil trabalhadores/ano. Destacaram-se os trabalhadores de manutenção e reparação, com 3,6 casos a cada 10 mil trabalhadores/ano. Em relação à raça/cor, houve predomínio de trabalhadores brancos (77%); já a escolaridade mais acometida foi entre trabalhadores com Ensino Fundamental incompleto (37,9%). O teste de contato foi realizado em apenas 11,4% dos casos. Conclusão: Torna-se necessário reforçar medidas para o uso de equipamentos de proteção individual, bem como aprimoramento das notificações e sensibilização dos profissionais de saúde para o registro correto nos sistemas oficiais

Background: Occupational dermatoses must be mandatorily reported in Brazil. Objective: To characterize the reporting of occupational dermatoses in the Brazilian South region, and describe the profile of the involved workers. Method: Retrospective and descriptive study of 396 cases of occupational dermatoses reported from 2007 through 2016 via the Information System for Notifiable Diseases. Results: 3.6 and 2.2 cases / 10,000 workers / year were of men and women, respectively. The highest incidence of occupational dermatoses corresponded to age range 50 to 64 years old, 1.8 cases / 10,000 workers / year, and to maintenance and repair workers, 3.6 cases / 10,000 workers / year. Most cases involved whites (77%) and workers not having completed elementary school (37.6%). Patch testing was only performed for 11.4% of cases. Conclusion: Reinforcing measures to promote the use of personal protective equipment is necessary, as well as to improve reporting and sensitize professionals to perform accurate reports in official systems.

Production, milk and plasma fatty acid profile, and nutrient utilization in Jersey cows fed flaxseed oil and corn grain with different particle size.

We aimed to compare the effects of ground (GC) or cracked corn (CC), with or without flaxseed oil (FSO), on milk yield, milk and plasma fatty acid (FA) profile, and nutrient digestibility in Jersey cows fed diets formulated to contain similar starch concentrations. Twelve multiparous organic-certified Jersey cows averaging (mean ± standard deviation) 455 ± 41.9 kg of body weight and 152 ± 34 d in milk and 4 primiparous organic-certified Jersey cows averaging (mean ± standard deviation) 356 ± 2.41 kg of body weight and 174 ± 30 d in milk in the beginning of the experiment were used. Cows were randomly assigned to treatment sequences in a replicated 4 × 4 Latin square design with a 2 × 2 factorial arrangement of treatments. Each period lasted 24 d with 18 d for diet adaptation and 6 d for data and sample collection. Treatments were fed as total mixed rations consisting of (dry matter basis): (1) 0% FSO + 27.1% GC, (2) 0% FSO + 28.3% CC, (3) 3% FSO + 27.1% GC, and (4) 3% FSO + 28.3% CC. All cows were offered 55% of the total diet dry matter as mixed grass-legume baleage and treatments averaged 20% starch. Significant FSO × corn grain particle size interactions were observed for some variables including milk concentration of lactose and proportions of cis-9,cis-12,cis-15 18:3 in milk and plasma. The proportion of cis-9,cis-12,cis-15 18:3 in milk and plasma decreased slightly when comparing GC versus CC in 0% FSO cows, but a larger reduction was observed in 3% FSO cows. Dry matter intake did not differ and averaged 16.1 kg/d across diets. Feeding 3% FSO increased yields of milk and milk fat and lactose and feed and milk N efficiencies, but decreased fat, true protein, and MUN concentrations and apparent total-tract digestibility of fiber. The Σ branched-chain, Σ<16C, Σ16C, and Σn-6 FA decreased, whereas Σ18C, Σcis-18:1, and Σtrans-18:1 FA increased in 3% versus 0% FSO cows. No effect of corn particle size was observed for production and milk components. However, the apparent total-tract digestibility of starch was greater in GC than CC cows. Compared with CC, GC increased Σ branched-chain, Σ<16C, Σ16C, Σn-6 FA, and decreased Σ18C and Σ cis-18:1 FA in milk fat. Overall, results of this study are more directly applicable to dairy cows fed low starch, mixed grass-legume baleage-based diets.