Psychological stress factors and salivary cortisol in nursing students throughout their training.

OBJECTIVE: to analyze psychological stress factors and salivary cortisol concentration in nursing undergraduates throughout their training. METHOD: a cross-sectional, analytical, and comparative study carried out in an evening course using a sociodemographic questionnaire, an Instrument to Assess Stress in Nursing Students, and salivary cortisol analysis. The study included descriptive and comparative analyses and a multiple linear regression model. RESULTS: 187 participants answered the questionnaires, and 129 had their cortisol quantified. The domains Practical Activities Execution, Professional Communication, and Professional Training represented the stress factors with the highest mean values for 3rd, 4th, and 5th-year students compared to 1st and 2nd year. For the 5th year, it was the domains Professional Communication and Professional Training compared to the 3rd year and Environment compared to the 1st and 3rd year. A significant result was obtained between the times of cortisol collections for males (p < 0.0001), females (p < 0.0001), and for 1st (p = 0.0319) 2nd (p = 0.0245), and 5th (p < 0.0001) years. CONCLUSION: Students in years 3 through 5 had higher exposure to stressors, and there were adjustments in cortisol production rhythmicity for students in years 1, 2, and 5.

What Do Physicians Think About the Use of Telemedicine to Recruit and Assess Participants in mHealth-Related Clinical Studies as a Consequence of the COVID-19 Pandemic?

Objectives: To evaluate physician's opinion and availability to participate in mHealth-related clinical studies with patient recruitment and assessment via telemedicine and to identify characteristics associated with the willingness to participate. Methods: Cross-sectional, observational study, based on an anonymous web survey conducted in May-Jun of 2020 to 237 physicians, from Portugal and Spain that collaborated with an asthma mHealth project (INSPIRERS). Results: Response rate was 51% (n = 120). Most (74%, n = 89) physicians were available to participate in such studies, but 62% anticipated lower recruiting capacity and 40% increased difficulty in obtaining quality data. Physicians aged ≤40 years, from secondary care (vs. general practitioners) and that used apps in personal life or clinical practice were more likely to be available. Conclusions: Three-quarters of the physicians were available to participate in mHealth-related clinical studies with patient recruitment and assessment through telemedicine. Age group, medical specialty, and app use were associated with the willingness to participate.

Psychological stress factors and salivary cortisol in nursing students throughout their training / Factores de estrés psicológico y cortisol salivar en alumnos de enfermería a lo largo de la formación / Fatores de estresse psicológico e cortisol salivar em alunos de enfermagem ao longo da formação

ABSTRACT Objective: to analyze psychological stress factors and salivary cortisol concentration in nursing undergraduates throughout their training. Method: a cross-sectional, analytical, and comparative study carried out in an evening course using a sociodemographic questionnaire, an Instrument to Assess Stress in Nursing Students, and salivary cortisol analysis. The study included descriptive and comparative analyses and a multiple linear regression model. Results: 187 participants answered the questionnaires, and 129 had their cortisol quantified. The domains Practical Activities Execution, Professional Communication, and Professional Training represented the stress factors with the highest mean values for 3rd, 4th, and 5th-year students compared to 1st and 2nd year. For the 5th year, it was the domains Professional Communication and Professional Training compared to the 3rd year and Environment compared to the 1st and 3rd year. A significant result was obtained between the times of cortisol collections for males (p < 0.0001), females (p < 0.0001), and for 1st (p = 0.0319) 2nd (p = 0.0245), and 5th (p < 0.0001) years. Conclusion: Students in years 3 through 5 had higher exposure to stressors, and there were adjustments in cortisol production rhythmicity for students in years 1, 2, and 5.

RESUMEN Objetivo: analizar los factores de estrés psicológico y la concentración de cortisol salivar de estudiantes de enfermería a lo largo de su formación. Método: es un estudio transversal, analítico y comparativo realizado en un curso nocturno mediante cuestionario sociodemográfico, Instrumento para Evaluación del Estrés en Estudiantes de Enfermería y análisis del cortisol salivar. Se llevaron a cabo diversos análisis descriptivos, comparativos y modelo de regresión linear múltiple. Resultados: 187 respondieron a los cuestionarios y a 129 se les cuantificó el cortisol. Los dominios Realización de Actividades Prácticas, Comunicación Profesional y Formación Profesional representaron los factores de estrés con los valores medios más altos en los estudiantes de 3er, 4º y 5º año en comparación con los de 1er y 2º año. Para el 5º año fueron los dominios Comunicación Profesional y Formación Profesional en comparación con el 3er año y Medio Ambiente en comparación con el 1er y 3er año. Se obtuvo un resultado significativo entre los momentos de las recogidas de cortisol de los hombres (p < 0,0001), de las mujeres (p < 0,0001), y del 1er (p = 0,0319), 2º (p = 0,0245) y 5º (p < 0,0001) año. Conclusión: los alumnos de 3er a 5º año tuvieron una mayor exposición a los estresores y hubo ajustes en la ritmicidad de la producción de cortisol en los alumnos de 1er, 2º y 5º año.

RESUMO Objetivo: analisar os fatores de estresse psicológico e a concentração de cortisol salivar de graduandos de Enfermagem ao longo da formação. Método: estudo transversal, analítico e comparativo realizado em curso noturno por meio de questionário sociodemográfico, Instrumento para Avaliação de Estresse em Estudantes de Enfermagem e análise do cortisol salivar. Foram feitas análises descritivas, comparativas e modelo de regressão linear múltipla. Resultados: um total de 187 responderam aos questionários, e 129 tiveram o cortisol quantificado. Os domínios Realização das Atividades Práticas, Comunicação Profissional e Formação Profissional representaram os fatores de estresse com os maiores valores médios para alunos do 3º, 4º e 5º anos em comparação ao 1º e 2º anos. Para o 5º ano, foram os domínios Comunicação Profissional e Formação Profissional em relação ao 3º ano e Ambiente em comparação ao 1º e 3º anos. Obteve-se resultado significativo entre os horários das coletas de cortisol para homens (p < 0,0001), mulheres (p < 0,0001) e para o 1º (p = 0,0319) 2º (p = 0,0245) e 5º (p < 0,0001) anos. Conclusão alunos do 3º ao 5º ano tiveram maior exposição aos fatores de estresse, e houve ajustes na ritmicidade de produção do cortisol para alunos do 1º, 2º e 5º anos.

Determinants of the Use of Health and Fitness Mobile Apps by Patients With Asthma: Secondary Analysis of Observational Studies.

BACKGROUND: Health and fitness apps have potential benefits to improve self-management and disease control among patients with asthma. However, inconsistent use rates have been reported across studies, regions, and health systems. A better understanding of the characteristics of users and nonusers is critical to design solutions that are effectively integrated in patients' daily lives, and to ensure that these equitably reach out to different groups of patients, thus improving rather than entrenching health inequities. OBJECTIVE: This study aimed to evaluate the use of general health and fitness apps by patients with asthma and to identify determinants of usage. METHODS: A secondary analysis of the INSPIRERS observational studies was conducted using data from face-to-face visits. Patients with a diagnosis of asthma were included between November 2017 and August 2020. Individual-level data were collected, including age, gender, marital status, educational level, health status, presence of anxiety and depression, postcode, socioeconomic level, digital literacy, use of health services, and use of health and fitness apps. Multivariate logistic regression was used to model the probability of being a health and fitness app user. Statistical analysis was performed in R. RESULTS: A total of 526 patients attended a face-to-face visit in the 49 recruiting centers and 514 had complete data. Most participants were ≤40 years old (66.4%), had at least 10 years of education (57.4%), and were in the 3 higher quintiles of the socioeconomic deprivation index (70.1%). The majority reported an overall good health status (visual analogue scale [VAS] score>70 in 93.1%) and the prevalence of anxiety and depression was 34.3% and 11.9%, respectively. The proportion of participants who reported using health and fitness mobile apps was 41.1% (n=211). Multivariate models revealed that single individuals and those with more than 10 years of education are more likely to use health and fitness mobile apps (adjusted odds ratio [aOR] 2.22, 95%CI 1.05-4.75 and aOR 1.95, 95%CI 1.12-3.45, respectively). Higher digital literacy scores were also associated with higher odds of being a user of health and fitness apps, with participants in the second, third, and fourth quartiles reporting aORs of 6.74 (95%CI 2.90-17.40), 10.30 (95%CI 4.28-27.56), and 11.52 (95%CI 4.78-30.87), respectively. Participants with depression symptoms had lower odds of using health and fitness apps (aOR 0.32, 95%CI 0.12-0.83). CONCLUSIONS: A better understanding of the barriers and enhancers of app use among patients with lower education, lower digital literacy, or depressive symptoms is key to design tailored interventions to ensure a sustained and equitable use of these technologies. Future studies should also assess users' general health-seeking behavior and their interest and concerns specifically about digital tools. These factors may impact both initial engagement and sustained use.

Feasibility and Acceptability of an Asthma App to Monitor Medication Adherence: Mixed Methods Study.

BACKGROUND: Poor medication adherence is a major challenge in asthma, and objective assessment of inhaler adherence is needed. The InspirerMundi app aims to monitor adherence while providing a positive experience through gamification and social support. OBJECTIVE: This study aimed to evaluate the feasibility and acceptability of the InspirerMundi app to monitor medication adherence in adolescents and adults with persistent asthma (treated with daily inhaled medication). METHODS: A 1-month mixed method multicenter observational study was conducted in 26 secondary care centers from Portugal and Spain. During an initial face-to-face visit, physicians reported patients' asthma therapeutic plan in a structured questionnaire. During the visits, patients were invited to use the app daily to register their asthma medication intakes. A scheduled intake was considered taken when patients registered the intake (inhaler, blister, or other drug formulation) by using the image-based medication detection tool. At 1 month, patients were interviewed by phone, and app satisfaction was assessed on a 1 (low) to 5 (high) scale. Patients were also asked to point out the most and least preferred app features and make suggestions for future app improvements. RESULTS: A total of 107 patients (median 27 [P25-P75 14-40] years) were invited, 92.5% (99/107) installed the app, and 73.8% (79/107) completed the 1-month interview. Patients interacted with the app a median of 9 (P25-P75 1-24) days. At least one medication was registered in the app by 78% (77/99) of patients. A total of 53% (52/99) of participants registered all prescribed inhalers, and 34% (34/99) registered the complete asthma therapeutic plan. Median medication adherence was 75% (P25-P75 25%-90%) for inhalers and 82% (P25-P75 50%-94%) for other drug formulations. Patients were globally satisfied with the app, with 75% (59/79) scoring ≥4,; adherence monitoring, symptom monitoring, and gamification features being the most highly scored components; and the medication detection tool among the lowest scored. A total of 53% (42/79) of the patients stated that the app had motivated them to improve adherence to inhaled medication and 77% (61/79) would recommend the app to other patients. Patient feedback was reflected in 4 major themes: medication-related features (67/79, 85%), gamification and social network (33/79, 42%), symptom monitoring and physician communication (21/79, 27%), and other aspects (16/79, 20%). CONCLUSIONS: The InspirerMundi app was feasible and acceptable to monitor medication adherence in patients with asthma. Based on patient feedback and to increase the registering of medications, the therapeutic plan registration and medication detection tool were redesigned. Our results highlight the importance of patient participation to produce a patient-centered and engaging mHealth asthma app.

Profiling Persistent Asthma Phenotypes in Adolescents: A Longitudinal Diagnostic Evaluation from the INSPIRERS Studies.

We aimed to identify persistent asthma phenotypes among adolescents and to evaluate longitudinally asthma-related outcomes across phenotypes. Adolescents (13-17 years) from the prospective, observational, and multicenter INSPIRERS studies, conducted in Portugal and Spain, were included (n = 162). Latent class analysis was applied to demographic, environmental, and clinical variables, collected at a baseline medical visit. Longitudinal differences in clinical variables were assessed at a 4-month follow-up telephone contact (n = 128). Three classes/phenotypes of persistent asthma were identified. Adolescents in class 1 (n = 87) were highly symptomatic at baseline and presented the highest number of unscheduled healthcare visits per month and exacerbations per month, both at baseline and follow-up. Class 2 (n = 32) was characterized by female predominance, more frequent obesity, and uncontrolled upper/lower airways symptoms at baseline. At follow-up, there was a significant increase in the proportion of controlled lower airway symptoms (p < 0.001). Class 3 (n = 43) included mostly males with controlled lower airways symptoms; at follow-up, while keeping symptom control, there was a significant increase in exacerbations/month (p = 0.015). We have identified distinct phenotypes of persistent asthma in adolescents with different patterns in longitudinal asthma-related outcomes, supporting the importance of profiling asthma phenotypes in predicting disease outcomes that might inform targeted interventions and reduce future risk.

Monitoring Adherence to Asthma Inhalers Using the InspirerMundi App: Analysis of Real-World, Medium-Term Feasibility Studies.

Background: Poor medication adherence is a major challenge in asthma and objective assessment of inhaler adherence is needed. InspirerMundi app aims to monitor inhaler adherence while turning it into a positive experience through gamification and social support. Objective: We assessed the medium-term feasibility of the InspirerMundi app to monitor inhaler adherence in real-world patients with persistent asthma (treated with daily inhaled medication). In addition, we attempted to identify the characteristics of the patients related to higher app use. Methods: Two real-world multicenter observational studies, with one initial face-to-face visit and a 4-month telephone interview, were conducted in 29 secondary care centers from Portugal. During an initial face-to-face visit, patients were invited to use the app daily to register their asthma medication intakes. A scheduled intake was considered taken when patients took a photo of the medication (inhaler, blister, or others) using the image-based medication detection tool. Medication adherence was calculated as the number of doses taken as a percentage of the number scheduled. Interacting with the app ≥30 days was used as the cut-off for higher app use. Results: A total of 114 patients {median 20 [percentile 25 to percentile 75 (P25-P75) 16-36] years, 62% adults} were invited, 107 (94%) installed the app and 83 (73%) completed the 4-month interview. Patients interacted with the app for a median of 18 [3-45] days, translated on a median use rate of 15 [3-38]%. Median inhaler adherence assessed through the app was 34 [4-73]% when considering all scheduled inhalations for the study period. Inhaler adherence assessed was not significantly correlated with self-reported estimates. Median adherence for oral and other medication was 41 [6-83]% and 43 [3-73]%, respectively. Patients with higher app use were slightly older (p = 0.012), more frequently taking medication for other health conditions (p = 0.040), and more frequently prescribed long-acting muscarinic antagonists (LAMA, p = 0.024). After 4 months, Control of Allergic Rhinitis and Asthma Test (CARAT) scores improved (p < 0.001), but no differences between patients interacting with the app for 30 days or less were seen. Conclusions: The InspirerMundi app was feasible to monitor inhaler adherence in patients with persistent asthma. The persistent use of this mHealth technology varies widely. A better understanding of characteristics related to higher app use is still needed before effectiveness studies are undertaken.

Integration of mandarin (Citrus reticulata) cytogenetic map with its genome sequence.

Citrus is an extremely important genus in terms of world fruit production. Despite its economic importance and the small genome sizes of its species (2n = 18, 1C = 430 ± 68 Mbp), entire genomic assemblies have only recently become available for some of its representatives. Together with the previous CMA/DAPI banding and fluorescence in situ hybridization (FISH) in the group, these data are important for understanding the complex relationships between its species and for assisting breeding programs. To anchor genomic data with the cytogenetic map of mandarin (Citrus reticulata), the parental species of several economically important hybrids such as sweet orange and clementine, 18 BAC (bacterial artificial chromosome) clones were used. Eleven clementine BACs were positioned by BAC-FISH, doubling the number of chromosome markers so far available for BAC-FISH in citrus. Additionally, six previously mapped BACs were end-sequenced, allowing, together with one BAC previously sequenced, their assignment to scaffolds and the subsequent integration of chromosomes and the genome assembly. This study therefore established correlations between mandarin scaffolds and chromosomes, allowing further structural genomic and comparative study with the sweet orange genome, as well as insights into the chromosomal evolution of the group.

Stress factors of nursing students in their final year.

OBJECTIVE: To identify the stress factors of the university environment and the repercussions on the quality of sleep and life of students in their last year of undergraduate nursing. METHOD: A cross-sectional, comparative, quantitative study conducted with students in their last year of undergraduate nursing in a private institution in the south of Minas Gerais. The Instrument for the Assessment of Stress in Nursing Students (ASNS), the Pittsburgh Sleep Quality Index (PSQI), the WHOQOL-Bref quality of life questionnaire and the sociodemographic characterization questionnaire were applied for data collection; association, comparison and correlation coefficient tests and descriptive statistics were performed for data analysis. RESULTS: The sample consisted of 55 participants. There was a strong correlation between Time Management of stress with sleep and the physical, psychological and environmental domains of quality of life, in addition to the significant association for insomnia and some sociodemographic variables. CONCLUSION: Stress factors were associated with poor quality sleep and changes in quality of life. Time Management was the factor with the greatest potential for stress. The ninth semester had greater exposure to stressors, worse quality of sleep and life.

Profile of nursing students: quality of life, sleep and eating habits.

OBJECTIVE: to profile and analyze sleep quality, quality of life and eating habits of nursing students. METHODS: a cross-sectional, comparative and correlational study with the following variables: sociodemographic characteristics, Pittsburgh sleep quality index, quality of life and eating habits. One hundred ninety-five students participated in the study. RESULTS: participants were on average 24 years old. Results showed that females were prevalent (87.1%); 71.0% of the students had poor sleep quality; 98.9% used electronic devices before bedtime. Self-perception of quality of life was indifferent (38.3%), and self-perception of general health, 36.9% expressed satisfaction. Among the participants, 45.13% consumed one portion of fruit and 40.66% two to three portions of vegetables daily. CONCLUSION: the study allowed the profile of these students, sedentary, overweight and poor sleep quality young students who studied and worked.

Profile of nursing students: quality of life, sleep and eating habits / Perfil de los estudiantes de enfermería: calidad de vida, sueño y hábitos alimentícios / Perfil dos estudantes que cursam enfermagem: qualidade de vida, sono e hábitos alimentares

ABSTRACT Objective: to profile and analyze sleep quality, quality of life and eating habits of nursing students. Methods: a cross-sectional, comparative and correlational study with the following variables: sociodemographic characteristics, Pittsburgh sleep quality index, quality of life and eating habits. One hundred ninety-five students participated in the study. Results: participants were on average 24 years old. Results showed that females were prevalent (87.1%); 71.0% of the students had poor sleep quality; 98.9% used electronic devices before bedtime. Self-perception of quality of life was indifferent (38.3%), and self-perception of general health, 36.9% expressed satisfaction. Among the participants, 45.13% consumed one portion of fruit and 40.66% two to three portions of vegetables daily. Conclusion: the study allowed the profile of these students, sedentary, overweight and poor sleep quality young students who studied and worked.

RESUMEN Objetivo: identificar lo perfil y analizar la calidad del sueño, la calidad de vida y los hábitos alimenticios de los estudiantes de enfermería. Métodos: estudio transversal, comparativo y correlacional con las siguientes variables: características sociodemográficas, índice de calidad del sueño de Pittsburgh, calidad de vida y hábitos alimenticios. 195 estudiantes participaron en el estudio. Resultados: los participantes tenían en promedio 24 años de edad. Los resultados mostraron que las mujeres eran prevalentes (87.1%); El 71.0% de los estudiantes tenían mala calidad del sueño; El 98.9% usó dispositivos electrónicos antes de acostarse. La autopercepción de la calidad de vida fue indiferente (38.3%), y la autopercepción de la salud general, 36.9% expresó satisfacción. Entre los participantes, el 45.13% consumió una porción de fruta y el 40.66% dos o tres porciones de vegetales diariamente. Conclusión: el estudio permitió el perfil de estos estudiantes, estudiantes sedentarios, con sobrepeso y con poca calidad del sueño que estudiaron y trabajaron.

RESUMO Objetivo: traçar o perfil e analisar a qualidade do sono, qualidade de vida e hábitos alimentares dos estudantes de enfermagem. Métodos: estudo transversal, comparativo e correlacional com as seguintes variáveis: características sociodemográficas, índice de qualidade de sono de Pittsburgh, qualidade de vida e hábitos alimentar. 195 estudantes participaram do estudo. Resultados: os participantes tinham em média 24 anos. Os resultados demonstraram que o sexo feminino foi prevalente (87,1%); 71,0% dos estudantes apresentaram qualidade de sono ruim; 98,9% faziam uso de aparelhos eletrônicos antes de dormir. A autopercepção da qualidade de vida foi indiferente (38,3%) e quanto à autopercepção de saúde geral, 36,9% expressaram-se satisfeitos. Dentre os participantes, 45,13% consumiam uma porção de fruta e 40,66% duas a três porções de verduras e legumes, diariamente. Conclusão: o estudo permitiu traçar o perfil desses estudantes, jovens que estudavam e trabalhavam, sedentários, acima do peso e com qualidade de sono ruim.

Stress factors of nursing students in their final year / Los factores de estrés en estudiantes del último año de enfermeira / Fatores de estresse em estudantes do último ano da graduação em enfermagem

Abstract Objective: To identify the stress factors of the university environment and the repercussions on the quality of sleep and life of students in their last year of undergraduate nursing. Method: A cross-sectional, comparative, quantitative study conducted with students in their last year of undergraduate nursing in a private institution in the south of Minas Gerais. The Instrument for the Assessment of Stress in Nursing Students (ASNS), the Pittsburgh Sleep Quality Index (PSQI), the WHOQOL-Bref quality of life questionnaire and the sociodemographic characterization questionnaire were applied for data collection; association, comparison and correlation coefficient tests and descriptive statistics were performed for data analysis. Results: The sample consisted of 55 participants. There was a strong correlation between Time Management of stress with sleep and the physical, psychological and environmental domains of quality of life, in addition to the significant association for insomnia and some sociodemographic variables. Conclusion: Stress factors were associated with poor quality sleep and changes in quality of life. Time Management was the factor with the greatest potential for stress. The ninth semester had greater exposure to stressors, worse quality of sleep and life.

Resumen Objetivo: Identificar los factores de estrés del ambiente universitario y las repercusiones en la calidad del sueño y de vida de los estudiantes del ultimo año de la graduación de Enfermeria. Método: Estudio transversal, comparativo, cuantitativo, realizado con estudiantes del ultimo año de la graduación de Enfermeria de una institución particular al sur de Minas Gerais. Se aplicaron para a recolección de datos la Escala para Evaluación del Estrés en Estudiantes de Enfermeria, el Indice de la Calidad del Sueño de Pittsburgh, el Cuestionario de la calidad de vida WHOQOL-bref y el Cuestionario de la caracterización sociodemografica. Para el análisis de los datos fueron realizados testes de asociación, comparación y de coeficiente de correlación y estadística descriptiva. Resultados: Muestra de 55 participantes. Hube correlación fuerte entre la Gestión del Tiempo del estrés con el sueño y los domínios físico, psicologico y del ambiente de la calidad de vida, mas allá de la asociación significante para el insomnio y algunas variables sociodemograficas. Conclusión: Factores de estrés se asociaran al sueño de mala calidad y la alteración de la calidad de vida. La Gestión del Tiempo fue el factor de mayor potencialidad para el estrés. El nono semestre tuve mayor exposición a factores de estrés, peor calidad del sueño e de vida.

Resumo Objetivo: Identificar os fatores de estresse do ambiente universitário e as repercussões na qualidade de sono e de vida de estudantes do último ano da graduação em Enfermagem. Método: Estudo transversal, comparativo, quantitativo, realizado com estudantes do último ano da graduação em Enfermagem de uma instituição particular no sul de Minas Gerais. Aplicaram-se, para a coleta de dados, a Escala para Avaliação de Estresse em Estudantes de Enfermagem, o Índice de Qualidade do Sono de Pittsburgh, o questionário de qualidade de vida WHOQOL-bref e o questionário de caracterização sociodemográfica. Para a análise dos dados, foram realizados testes de associação, comparação e de coeficiente de correlação e estatística descritiva. Resultados: A amostra foi de 55 participantes. Houve correlação forte entre o Gerenciamento do Tempo do estresse com o sono e os domínios físico, psicológico e de ambiente da qualidade de vida, além da associação significante para insônia e algumas variáveis sociodemográficas. Conclusão: Fatores de estresse associaram-se ao sono de má qualidade e a alterações da qualidade de vida. O Gerenciamento de Tempo foi o fator de maior potencialidade para o estresse. O nono semestre teve maior exposição aos fatores de estresse, pior qualidade de sono e de vida.

Sono e variáveis de saúde de profissionais de enfermagem nos diferentes turnos de trabalho / Sleep and health variables of nursing professionals in the different working shifts / El sueño y las variables de salud de profesionales de enfermería en diferentes turnos laborales

INTRODUÇÃO: a relação entre sincronizadores e a organização temporal interna pode ser perturbada por mudanças causadas pelo trabalho em turnos, manifestando-se como distúrbios cardiovasculares, metabólicos e do sono. OBJETIVO: analisar o padrão de sono, características antropométricas, glicemia e pressão arterial de 88 profissionais de Enfermagem, trabalhadores de turnos diurnos e noturnos fixos. MÉTODOS: estudo descritivo e transversal realizado em serviços públicos de pronto atendimento de um município do estado de Minas Gerais, no qual se utilizaram questionário sociodemográfico e o diário do sono. As medidas realizadas foram glicemia, pressão arterial, índice de massa corporal e circunferência da cintura. RESULTADOS: a duração e a qualidade de sono noturno dos trabalhadores do turno da noite apresentaram-se com média estatisticamente inferior em relação aos funcionários do turno diurno. No entanto, entre as outras variáveis estudadas e turnos não houve diferença estatística significante. CONCLUSÃO: observaram-se sobrepeso e obesidade em 59,09% dos profissionais e alterações da circunferência de cintura em 70,46% deles. O conhecimento dessa realidade pode contribuir para estudos adicionais, com possíveis programas de acompanhamento periódico da saúde do trabalhador.(AU)

The relationship between synchronizers and the internal temporal organization can be disturbed by changes caused by shift work, manifesting as cardiovascular, metabolic, and sleep disorders. Objective: to analyze the sleep pattern, anthropometric characteristics, blood glucose and blood pressure of 88 Nursing professionals, day and night shift workers. Method: a descriptive and cross-sectional study conducted in public emergency services of a city in the state of Minas Gerais, in which a sociodemographic questionnaire and a sleep diary were used. The measurements taken were blood glucose, blood pressure, body mass index and waist circumference. Results: the duration and the quality of the night sleep of the night-shift workers were statistically lower than those of their day-shift peers. However, there was no statistically significant difference between the other studied variables and the shifts. Overweight and obesity were observed in 59.09% of the professionals and waist circumference changes in 70.46% of them. Conclusion: knowledge of this reality may contribute to further studies, with possible programs for periodic monitoring of the workers' health.(AU)

Introducción: la relación entre los sincronizadores y la organización temporal interna puede verse alterada por los cambios causados por el trabajo en turnos, que se manifiestan como trastornos cardiovasculares, metabólicos y del sueño. Objetivo: analizar el patrón de sueño, las características antropométricas, la glucosa en sangre y la presión arterial de 88 profesionales de enfermería, trabajadores de turno diurno y nocturno. Métodos: estudio descriptivo de corte transversal realizado en los servicios públicos de emergencia de una ciudad del estado de Minas Gerais, que utilizó un cuestionario sociodemográfico y un diario del sueño. Las medidas tomadas fueron glucosa en sangre, presión arterial, índice de masa corporal y circunferencia de cintura. Resultados: la duración y la calidad del sueño nocturno de los trabajadores del turno nocturno fueron estadísticamente más bajas que las de los trabajadores del turno diurno. Sin embargo, entre las otras variables estudiadas y turnos no hubo diferencias estadísticamente significativas. Conclusión: se observó sobrepeso y obesidad en el 59,09% de los profesionales y alteración en la circunferencia de cintura en el 70,46% de ellos. El tener conciencia de esta realidad puede contribuir a futuros estudios, con posibles programas para el monitoreo periódico de la salud de los trabajadores.(AU)

Melanin: Quantification and protection against oxidative stress in chromoblastomycosis agents.

Chromoblastomycosis (CBM) is a chronic cutaneous and subcutaneous infection caused by melanized fungal species. We quantified the extractable melanin of 77 strains of CBM agents distributed within five genera. Moreover, resistance to oxidative stress was evaluated in strains exposed or not to the melanin inhibitor tricyclazole. The median percentage of melanin mass extracted from dry fungal mass varied from 0.69 (Rhinocladiella similis) to 3.81 (Phialophora americana). Inhibition of melanin synthesis decreased survival rates to hydrogen peroxide. Together, these data highlight the importance of melanin in CBM agents.

In Vitro Differentiation of Gata2 and Ly6a Reporter Embryonic Stem Cells Corresponds to In Vivo Waves of Hematopoietic Cell Generation.

In vivo hematopoietic generation occurs in waves of primitive and definitive cell emergence. Differentiation cultures of pluripotent embryonic stem cells (ESCs) offer an accessible source of hematopoietic cells for blood-related research and therapeutic strategies. However, despite many approaches, it remains a goal to robustly generate hematopoietic progenitor and stem cells (HP/SCs) in vitro from ESCs. This is partly due to the inability to efficiently promote, enrich, and/or molecularly direct hematopoietic emergence. Here, we use Gata2Venus (G2V) and Ly6a(SCA1)GFP (LG) reporter ESCs, derived from well-characterized mouse models of HP/SC emergence, to show that during in vitro differentiation they report emergent waves of primitive hematopoietic progenitor cells (HPCs), definitive HPCs, and B-lymphoid cell potential. These results, facilitated by enrichment of single and double reporter cells with HPC properties, demonstrate that in vitro ESC differentiation approximates the waves of hematopoietic cell generation found in vivo, thus raising possibilities for enrichment of rare ESC-derived HP/SCs.

South Brazilian wines: culturable yeasts associated to bottled wines produced in Rio Grande do Sul and Santa Catarina.

A comprehensive understanding of the presence and role of yeasts in bottled wines helps to know and control the organoleptic quality of the final product. The South Region of Brazil is an important wine producer, and the state of "Rio Grande do Sul" (RS) accounts for 90% of Brazilian wines. The state of "Santa Catarina" (SC) started the production in 1975, and is currently the fifth Brazilian producer. As there is little information about yeasts present in Brazilian wines, our main objective was to assess the composition of culturable yeasts associated to bottled wines produced in RS and SC, South of Brazil. We sampled 20 RS and 29 SC bottled wines produced between 2003 and 2011, and we isolated culturable yeasts in non-selective agar plates. We identified all isolates by sequencing of the D1/D2 domain of LSU rDNA or ITS1-5.8 S-ITS2 region, and comparison with type strain sequences deposited in GenBank database. Six yeast species were shared in the final product in both regions. We obtained two spoilage yeast profiles: RS with Zygosaccharomyces bailii and Pichia membranifaciens (Dekkera bruxellensis was found only in specific table wines); and SC with Dekkera bruxellensis and Pichia manshurica. Knowledge concerning the different spoilage profiles is important for winemaking practices in both regions.

Sete Cidades and Furnas lake eutrophication (São Miguel, Azores): analysis of long-term monitoring data and remediation measures.

Eutrophication of lakes in the Azores archipelago (Portugal) has been described since the 80s, and due to water quality deterioration several remediation methodologies were applied. Long-term monitoring data on water quality from Sete Cidades and Furnas lakes (São Miguel island) were analyzed in order to address that the success of the ongoing policy reverses their eutrophic status. Sete Cidades lake (4.46 km2), made by two branches (so-called Green and Blue lakes), has a water volume equal to 58×10(6) m3 and a depth in the range between 24 and 28.5m. Furnas lake (1.87 km2) has a volume equal to 14×10(6) m3 and a maximum depth of 15m. In Sete Cidades lake mean water temperature and pH range respectively between 13.4°C to 17.7°C and 7.04 to 8.06. Instead, mean temperature in Lake Furnas ranges between 16.6°C and 17.2°C, with a pH between 7.36 and 7.84. Mean water conductivity shows that both lakes correspond to very diluted waters, with values between 98.1 and 136.5 µS/cm. Water chemistry is influenced by the monomictic character of the lakes, as anoxic environment in the hypolimnion due to O2 consumption during the summer, when stratification prevents mixing along the water column, explains sharp increase in TP, TN, N-ammoniacal, Mn and Fe. Major-ion content is rather constant along time, with some seasonal fluctuations, despite a decrease in SO4 observed in Sete Cidades lake which is suggested to be a result of runoff diversion, a result also shown by the decrease of the molal ratio TN/TP in both studied lakes. Nevertheless, the application of the trophic state index (TSITP) does not suggest an improvement in what concerns trophic status, which is explained by the internal P-loading, a source that have to be managed by environmental authorities in the near future in order to revert eutrophication.

Evaluation of Zygosaccharomyces bailii BCV 08 as a co-starter in wine fermentation for the improvement of ethyl esters production.

Zygosaccharomyces bailii BCV 08, a yeast isolated from red wine barrels in Brazil, was evaluated as co-starter in fermentations with Saccharomyces cerevisiae. Z. bailii BCV 08 was preliminarily shown to produce high levels of esters, and the production was optimized in bench and bioreactor scales using grape must. White wine vinifications were conducted with mixed cultures containing different proportions of Z. bailii BCV 08 and an enological strain of S. cerevisiae. In all trials that contained Z. bailii BCV 08, the production of ethyl esters was enhanced in comparison to the vinification control. Our results clearly show the potential of Z. bailii BCV 08 as a mixed starter with S. cerevisiae in order to increase the aromatic complexity of wine.

Medication adherence to specific drug classes in chronic heart failure.

BACKGROUND: Adherence to medication is crucial to improve clinical outcomes in patients with heart failure (HF). However, at least 1 out of 4 patients is nonadherent to his or her medication. Several studies have quantified medication adherence in HF patients, monitoring only 1 drug with the Medication Event Monitoring System (MEMS). Some authors have argued that monitoring 1 drug reflects the whole adherence behavior, although there is some evidence of important differences in adherence to distinct drug classes. Furthermore, medication characteristics could be a relevant predictor of adherence, and different drugs could pose different barriers to patients. OBJECTIVES: To (a) quantify medication adherence to angiotensin-converting enzyme inhibitors (ACEI), beta blockers, and loop diuretics and (b) compare the agreement in adherence among drug classes in chronic HF. METHODS: Medication adherence to 3 different drugs was monitored using MEMS in 63 patients (81% male, mean age 63.5 years). Medication adherence was measured as the percentage of prescribed doses effectively taken. Patients were considered to be adherent when at least 88% of prescribed doses were taken. Adherence agreement between drug classes was analyzed with Bland-Altman plots and Kappa coefficients.  RESULTS: The mean adherence was 97.3% for ACEI, 97.2% for beta blockers, and 96.0% for loop diuretics. Individual patients did not adhere equally to all drug classes, with differences within the same patient ranging from -35% to 33%. The proportion of patients classified as adherent was 77.8% to ACEI, 69.8% to beta blockers, and 69.8% to loop diuretics. The agreement between each of 2 drugs regarding adherence was substantial (beta blocker vs. ACEI: K = 0.72; beta blocker vs. diuretic: K = 0.62; ACEI vs. diuretic: K = 0.72). If patients were classified as adherent and nonadherent based only on 1 drug, 20% of patients would be misclassified regarding the other drugs.  CONCLUSIONS: Patients can adhere differently to medication used in HF treatment, with lowest adherence to loop diuretic and beta blockers and highest adherence to ACEI. Studies measuring medication adherence should always specify the drug class being analyzed and should not mix different drug classes to generalize about adherence behavior.